The effect of acculturation on diabetes prevalence in Hispanics: A systematic review

Context. The high prevalence of diabetes among Hispanics in the U.S. has stimulated increased interest in the role culture plays in Hispanics' risk of diabetes. It is critical to identify gaps in the existing research and to determine the relationship between acculturation and diabetes prevalence in the Hispanic population. ^ Objective. To review the current literature to evaluate the effects of acculturation on diabetes prevalence among Hispanic Americans. ^ Methods. A literature search of diabetes-related studies was conducted. Studies were selected for review if they reported at least one acculturation measure, used Hispanics adults (ages 18 and older) and included information regarding the diabetes prevalence of Hispanics and/or Latinos. Only those that examined acculturation by diabetes prevalence for Hispanics were included in the review. ^ Results. Sixteen studies were reviewed that met the search criteria and these studies used distinct measures of acculturation that captured four primary dimensions: time (duration of exposure to U.S. culture), language, culture and residence. Data represented studies conducted in a variety of settings, such as healthcare facilities in a state or region of the U.S. and nationally representative surveys. The data indicate positive, negative and no significant relationship with diabetes. Depending on the measure of acculturation used and gender the association between acculturation and diabetes varied. ^ Conclusions. There is no clear association between acculturation and diabetes prevalence; it can not be determined based on the available literature. Many of the studies examining this relationship found non-significant results and the directionality of the relationship varied greatly depending on the type of measure used, the number of measures used, and the study population. Ideal studies of acculturation should concentrate on investigating the links between time measures of acculturation, location of residence and changing beliefs, values and norms. A comprehensive acculturation scale is needed to better understand the complex relationship between diabetes prevalence amongst Hispanics and acculturation. ^

The effect of obesity on mammography utilization in African American women

Breast cancer continues to reign as a common cause of death for women in the United States, claiming the lives of more than an estimated 40,000 women in 2009 alone (Ries et al., 2009). A mammogram, an x-ray of the breast, can aid in early detection of breast cancer and thus more successful treatment. Screening patterns indicate African American women are less likely to utilize mammography technology when compared to their Caucasian counterparts. Additionally, the obesity epidemic in the United States remains a major public health problem. Obesity trends indicate that African American women are likely to be more obese when compared to Caucasian women. Pischon, Nöthlings, & Boeing (2008) concluded there was sufficient evidence linking breast cancer and obesity. Many researchers have identified obesity as a risk factor for breast cancer. As African American women are disproportionately burdened by both breast cancer mortality and obesity, more extensive research is needed to gain more knowledge about their association. The purpose of this study was to identify the role obesity plays in lessening an African American woman’s usage of mammography technology. Data from the 2005 National Health Interview Study were analyzed using SPSS to evaluate the relationship between body mass index (BMI) and mammography utilization in the two aforementioned populations.^ After excluding respondents from the sample who did not meet the set criteria, there were 17,666 women remaining. Of the 17,666 women, 6,156 (34.8%) had a healthy weight, 6,024 (34.1%) were overweight, and 4,285 (24.3%) were obese. About 70% of the sample population reported having had a mammogram in the last two years. Another 27.6% of women reported not receiving a mammogram within this same two year time frame. Within ethnic categories, the majority of the sample was Caucasian (64.2%) while only 15.1% of the sample was African American. The relationship between mammography usage and body mass index was not statistically significant within any body mass index categories. When analyzing the relationship between mammography usage and BMI, adjusting for ethnicity, there was also no significant difference between obese African American and obese Caucasian women. The study did find significant relationships between mammography usage and body mass index when adjusting for cancer risk OR = .79 (95% CI .72 - .85), and marital status OR = 1.18 (95% CI 1.05 - 1.34). Due to insignificant findings, there was no evidence to support the hypothesis regarding differences in mammography usage based on weight or ethnicity. Mammography screening differences based on ethnicity are widely cited. Unfortunately it is still unclear exactly where these differences lie. Obesity has been widely documented in the literature as a risk factor for many chronic diseases, including certain forms of cancer. Understanding the relationship between screening behaviors and weight can assist in the development of health promotion programs aimed at high risk groups. In order to change screening behavior and reduce mortality from breast cancer, more research is needed to identify similarities within low screening populations.^

The effect of yoga on cardiovascular health as measured by heart rate variability in a sample of breast cancer patients

The study is a three-armed randomized controlled trial comparing values for heart rate variability (HRV), a measure of cardiovascular health, throughout a yoga intervention of breast cancer patients undergoing radiotherapy. Patients attended either a yoga (n=45), stretch, (n=46), or control (n=42) condition 3 times per week for 6 weeks of radiation. Electrocardiograms (ECGs) were conducted on each participant to provide the values necessary for HRV analysis. Analyses focused on examining scores for those participants with HRV baseline values considered to be below the cutoff point for healthy HRV levels, defined by the authors as below the cutpoint of 68 ms. From the entire sample of 133 with available baselines, 26 yogis, 26 stretchers, and 23 controls were determined to be “pathologic” in terms of HRV, and selected for follow-up analysis at 3 weeks and then again at 6 weeks. Though no statistically significant differences were found between either group means at each timepoint or group change score means, the yoga group had consistently higher mean score and mean change scores. These findings are suggestive and indicate the need to refine the use of ECGs and HRV analysis programs to more accurately and comprehensively assess the effects of yoga on cardiovascular health in cancer patients.^

Retrospective cohort study to determine the effect of metformin on survival of diabetic patients with pancreatic adenocarcinoma

Background: Pancreatic cancer is the fourth most common cause of cancer death in the United States. Despite advances in cancer treatment, prognosis of pancreatic cancer remains extremely poor with survival rates of 24% and 5% in 1 and 5 years, respectively. Many patients with pancreatic cancer have a history of diabetes and are treated with various antidiabetic regimens including metformin. In multiple retrospective studies, metformin has been associated with decreased risk of cancer and cancer-related mortality. Metformin has also been reported to inhibit the growth of cancer cells, both in vitro and in vivo.^ Methods: We conducted a retrospective cohort study to examine the survival benefit of metformin in diabetic patients with pancreatic cancer at MD Anderson Cancer Center (MDACC). A dataset of 397 patients who carried the diagnosis of "Diabetes Mellitus" and "Pancreatic Cancer" at MD Anderson were screened for this study. ^ Results: Mean age of patients at diagnosis of cancer was 64.0 ± 8.7 years (range 37-84). The majority of the patients were male (65.6%) and of Caucasian race (78.5%). The most common antidiabetic regimen used were insulin and metformin (in 39.1% and 38.7%, respectively). Patients' cancer were staged as resectable in 34.1%, locally advanced unresectable in 29.1%, and disseminated disease in 36.7% of cases. Overall 1-year and 3-year survival rates for all stages combined were 51.8% and 7.6%, respectively. Earlier stage, metformin use, low CA19-9 level, better ECOG performance status, surgical intervention, negative surgical margins, and smaller tumor size were associated with longer survival. Metformin use was associated with a 33% decrease in risk of death (HR: 0.67; 95% CI: 0.51-0.88). Multivariate Cox proportional hazard regression showed hazard ratio of 1.77 (95% CI 1.49-2.10) for cancer stage, 0.65 (95% CI 0.49-0.86) for metformin use, and 1.68 (95% CI 1.26-2.23) for CA 19-9 level above population median. ^ Conclusion: Our study suggests that metformin may improve the outcome in diabetic patients with pancreatic cancer independently of other known prognostic factors. Pancreatic cancer carries extremely poor prognosis; metformin may provide a suitable adjunct therapeutic option for pancreatic cancer in patients with and without diabetes mellitus.^

MEASURING THE EFFECT OF ILLNESS ON THE EXPECTED REMAINING SERVICE TIME FOR THE ACTIVE DUTY ARMY: A LIFE TABLE APPROACH

A life table methodology was developed which estimates the expected remaining Army service time and the expected remaining Army sick time by years of service for the United States Army population. A measure of illness impact was defined as the ratio of expected remaining Army sick time to the expected remaining Army service time. The variances of the resulting estimators were developed on the basis of current data. The theory of partial and complete competing risks was considered for each type of decrement (death, administrative separation, and medical separation) and for the causes of sick time.^ The methodology was applied to world-wide U.S. Army data for calendar year 1978. A total of 669,493 enlisted personnel and 97,704 officers were reported on active duty as of 30 September 1978. During calendar year 1978, the Army Medical Department reported 114,647 inpatient discharges and 1,767,146 sick days. Although the methodology is completely general with respect to the definition of sick time, only sick time associated with an inpatient episode was considered in this study.^ Since the temporal measure was years of Army service, an age-adjusting process was applied to the life tables for comparative purposes. Analyses were conducted by rank (enlisted and officer), race and sex, and were based on the ratio of expected remaining Army sick time to expected remaining Army service time. Seventeen major diagnostic groups, classified by the Eighth Revision, International Classification of Diseases, Adapted for Use In The United States, were ranked according to their cumulative (across years of service) contribution to expected remaining sick time.^ The study results indicated that enlisted personnel tend to have more expected hospital-associated sick time relative to their expected Army service time than officers. Non-white officers generally have more expected sick time relative to their expected Army service time than white officers. This racial differential was not supported within the enlisted population. Females tend to have more expected sick time relative to their expected Army service time than males. This tendency remained after diagnostic groups 580-629 (Genitourinary System) and 630-678 (Pregnancy and Childbirth) were removed. Problems associated with the circulatory system, digestive system and musculoskeletal system were among the three leading causes of cumulative sick time across years of service. ^

Effect of smoking on the association between periodontitis and incidence of coronary heart disease: The Atherosclerosis Risk in Communities Study

Multiple studies have shown an association between periodontitis and coronary heart disease due to the chronic inflammatory nature of periodontitis. Also, studies have indicated similar risk factors and patho-physiologic mechanisms for periodontitis and CHD. Among these factors, smoking has been the most discussed common risk factor and some studies suggested the periodontitis - CHD association to be largely a result of confounding due to smoking or inadequate adjustment for it. We conducted a secondary data analysis of the Dental ARIC Study, an ancillary study to the ARIC Study, to evaluate the effect of smoking on the periodontitis - CHD association using three periodontitis classifications namely, BGI, AAP-CDC, and Dental-ARIC classification (Beck et al 2001). We also compared these results with edentulous ARIC participants. Using Cox proportional hazard models, we found that the individuals with the most severe form of periodontitis in each of the three classifications (BGI: HR = 1.56, 95%CI: 1.15 – 2.13; AAP-CDC: HR = 1.42, 95%CI: 1.13 – 1.79; and Dental-ARIC: HR = 1.49, 95%CI: 1.22 – 1.83) were at a significantly higher risk of incident CHD in the unadjusted models; whereas only BGI-P3 showed statistically significant increased risk in the smoking adjusted models (HR = 1.43, 95%CI: 1.04 – 1.96). However none of the categories in any of the classifications showed significant association when a list of traditional CHD risk factors was introduced into the models. On the other hand, edentulous participants showed significant results when compared to the dentate ARIC participants in the crude (HR = 1.56, 95%CI: 1.34 – 1.82); smoking adjusted (HR = 1.39, 95%CI: 1.18 – 1.64) age, race and sex adjusted (HR = 1.52, 95%CI: 1.30 – 1.77); and ARIC traditional risk factors (except smoking) adjusted (HR = 1.27, 95%CI: 1.02 – 1.57) models. Also, the risk remained significantly higher even when smoking was introduced in the age, sex and race adjusted model (HR = 1.38, 95%CI: 1.17 – 1.63). Smoking did not reduce the hazard ratio by more than 8% when it was included in any of the Cox models. ^ This is the first study to include the three most recent case definitions of periodontitis simultaneously while looking at its association with incident coronary heart disease. We found smoking to be partially confounding the periodontitis and coronary heart disease association and edentulism to be significantly associated with incident CHD even after adjusting for smoking and the ARIC traditional risk factors. The difference in the three periodontitis classifications was not found to be statistical significant when they were tested for equality of the area under their ROC curves but this should not be confused with their clinical significance.^

Effect of misorientation on the compression of highly anisotropic single-crystal micropillars

The effect of crystal misorientation, geometrical tilt, and contact misalignment on the compression of highly anisotropic single crystal micropillars was assessed by means of crystal plasticity finite element simulations. The investigation was focused in single crystals with the NaCl structure, like MgO or LiF, which present a marked plastic anisotropy as a result of the large difference in the critical resolved shear stress between the “soft” {110}〈110〉 and the “hard” {100}〈110〉 active slip systems. It was found that contact misalignment led to a large reduction in the initial stiffness of the micropillar in crystals oriented in the soft and hard direction. The crystallographic tilt did not modify, however, the initial crystal stiffness. From the viewpoint of the plastic response, none of the effects analyzed led to significant differences in the flow stress when the single crystals were oriented along the “soft” [100] direction. Large differences were found, however, if the single crystal was oriented in the “hard” [111] direction as a result of the activation of the soft slip system. Numerical simulations were in very good agreement with experimental literature data.

Effect of positioning on the accuracy of decision making of association football top-class referees and assistant referees during competitive matches

The aim of this study was to examine the effect of positioning on the correctness of decision making of top-class referees and assistant referees during international games. Match analyses were carried out during the Fe´de´ration Internationale de Football Association (FIFA) Confederations Cup 2009 and 380 foul play incidents and 165 offside situations were examined. The error percentage for the referees when indicating the incidents averaged 14%. The lowest error percentage occurred in the central area of the field, where the collaboration of the assistant referee is limited, and was achieved when indicating the incidents from a distance of 11–15 m, whereas this percentage peaked (23%) in the last 15-min match period. The error rate for the assistant referees was 13%. Distance of the assistant referee to the offside line did not have an impact on the quality of the offside decision. The risk of making incorrect decisions was reduced when the assistant referees viewed the offside situations from an angle between 46 and 608. Incorrect offside decisions occurred twice as often in the second as in the first half of the games. Perceptual-cognitive training sessions specific to the requirements of the game should be implemented in the weekly schedule of football officials to reduce the overall error rate.

Effect of concentration on the performance of quantum dot intermediate-band solar cells

Implementation of a high-efficiency quantum dot intermediate-band solar cell (QD-IBSC) must accompany a sufficient photocurrent generation via IB states. The demonstration of a QD-IBSC is presently undergoing two stages. The first is to develop a technology to fabricate high-density QD stacks or a superlattice of low defect density placed within the active region of a p-i-n SC, and the second is to realize half-filled IB states to maximize the photocurrent generation by two-step absorption of sub-bandgap photons. For this, we have investigated the effect of light concentration on the characteristics of QDSCs comprised of multi-layer stacks of self-organized InAs/GaNAs QDs grown with and without impurity doping in molecular beam epitaxy.

The effect of Windbreaks on Railway Overheads subject to Cross-Winds at O Eixo Viaduct

A measurement investigation, at ADIF's test site at the O Eixo viaduct which is on the Spanish Santiago-Ourense high speed railway line, has been carried out during the last year. The main goal of the investigation is to study the effect of the cross-wind on railway overheads (catenaries) and the influence of the presence of windbreaks on the wind-induced motion of the railway overhead. A description of the O Eixo viaduct test site is presented in this paper, including the installed windbreaks, the sensor and power supply systems. Three catenary spans has been instrumented at the center point of the catenary span contact wire with one ultrasonic anemometer and two unidirectional accelerometers. Additionally, another ultrasonic anemometer placed in the central catenary span has been installed to provide reference wind data. Wind roses of wind speed and standard deviation of the accelerometers are presented. As expected, the four wind roses look very similar and the two dominant directions close to the perpendicular to the bridge longitudinal axes, north and south have been identified. The wind roses of the standard deviation of the acceleration shows that the acceleration of the catenary contact wire is related to the directions of the two dominant winds. The vertical standard deviation of the acceleration is higher than the horizontal one for the spans with windbreaks. It has also been observed that the presence of the windbreaks modifies the wind flow leading to a wind-induced motion of the catenary contact wire which shows a higher variability than the corresponding unprotected case. On the one hand, the baseline southerly wind configuration (south wind, windbreaks in the windward side and catenary in the leeward side) influence both the mean speed at the catenary and the turbulence intensity. On the other hand, the northerly wind configuration, windbreaks in the leeward side and catenary in the windward side, provide a reference to the response of the catenary for an unprotected railway overhead, and, as it is expected, the windbreak influence is much more reduced compared to the southerly wind configuration. Both the height of the windbreak and the eaves contribute to the increase in the turbulence intensity at the catenary contact wire height. It can be seen that the height of the windbreak plays a crucial role in the increase of turbulence intensity, much more intense than the presence of the windbreak eave.

A 2D computational parametric analysis of the sheltering effect of fences on a railway vehicle standing on a bridge and experiencing crosswinds

In a crosswind scenario, the risk of high-speed trains overturning increases when they run on viaducts since the aerodynamic loads are higher than on the ground. In order to increase safety, vehicles are sheltered by fences that are installed on the viaduct to reduce the loads experienced by the train. Windbreaks can be designed to have different heights, and with or without eaves on the top. In this paper, a parametric study with a total of 12 fence designs was carried out using a two-dimensional model of a train standing on a viaduct. To asses the relative effectiveness of sheltering devices, tests were done in a wind tunnel with a scaled model at a Reynolds number of 1 × 105, and the train’s aerodynamic coefficients were measured. Experimental results were compared with those predicted by Unsteady Reynolds-averaged Navier-Stokes (URANS) simulations of flow, showing that a computational model is able to satisfactorily predict the trend of the aerodynamic coefficients. In a second set of tests, the Reynolds number was increased to 12 × 106 (at a free flow air velocity of 30 m/s) in order to simulate strong wind conditions. The aerodynamic coefficients showed a similar trend for both Reynolds numbers; however, their numerical value changed enough to indicate that simulations at the lower Reynolds number do not provide all required information. Furthermore, the variation of coefficients in the simulations allowed an explanation of how fences modified the flow around the vehicle to be proposed. This made it clear why increasing fence height reduced all the coefficients but adding an eave had an effect mainly on the lift force coefficient. Finally, by analysing the time signals it was possible to clarify the influence of the Reynolds number on the peak-to-peak amplitude, the time period and the Strouhal number.

Analysis of a rate-adaptive reconciliation protocol and the effect of leakage on the secret key rate

Quantum key distribution performs the trick of growing a secret key in two distant places connected by a quantum channel. The main reason is so that the legitimate users can bound the information gathered by the eavesdropper. In practical systems, whether because of finite resources or external conditions, the quantum channel is subject to fluctuations. A rate-adaptive information reconciliation protocol, which adapts to the changes in the communication channel, is then required to minimize the leakage of information in the classical postprocessing. We consider here the leakage of a rate-adaptive information reconciliation protocol. The length of the exchanged messages is larger than that of an optimal protocol; however, we prove that the min-entropy reduction is limited. The simulation results, both in the asymptotic and in the finite-length regime, show that this protocol allows to increase the amount of a distillable secret key.

Effect of Uncertainty on the Reaction Response in Fencing

Biomecanica del rendimiento en esgrima

Biomass Gasification in a Fluidized Bed Reactor: Effect of Temperature, Stoichiometric Ratio and Biomass Type

This paper investigates the gasification of two biomass types (pine wood and olive stones) in a laboratory scale bubbling fluidized bed reactor, in order to evaluate comparatively their potential in the production of syngas.