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  • 1
    Online Resource
    Online Resource
    Prediction of disability-free survival in healthy older people
    Springer Science and Business Media LLC ; 2022
    In:  GeroScience Vol. 44, No. 3 ( 2022-06), p. 1641-1655
    Details
    In: GeroScience, Springer Science and Business Media LLC, Vol. 44, No. 3 ( 2022-06), p. 1641-1655
    Abstract: Prolonging survival in good health is a fundamental societal goal. However, the leading determinants of disability-free survival in healthy older people have not been well established. Data from ASPREE, a bi-national placebo-controlled trial of aspirin with 4.7 years median follow-up, was analysed. At enrolment, participants were healthy and without prior cardiovascular events, dementia or persistent physical disability. Disability-free survival outcome was defined as absence of dementia, persistent disability or death. Selection of potential predictors from amongst 25 biomedical, psychosocial and lifestyle variables including recognized geriatric risk factors, utilizing a machine-learning approach. Separate models were developed for men and women. The selected predictors were evaluated in a multivariable Cox proportional hazards model and validated internally by bootstrapping. We included 19,114 Australian and US participants aged ≥65 years (median 74 years, IQR 71.6–77.7). Common predictors of a worse prognosis in both sexes included higher age, lower Modified Mini-Mental State Examination score, lower gait speed, lower grip strength and abnormal (low or elevated) body mass index. Additional risk factors for men included current smoking, and abnormal eGFR. In women, diabetes and depression were additional predictors. The biased-corrected areas under the receiver operating characteristic curves for the final prognostic models at 5 years were 0.72 for men and 0.75 for women. Final models showed good calibration between the observed and predicted risks. We developed a prediction model in which age, cognitive function and gait speed were the strongest predictors of disability-free survival in healthy older people. Trial registration Clinicaltrials.gov (NCT01038583)
    Type of Medium: Online Resource
    ISSN: 2509-2715 , 2509-2723
    URL: Article
    DOI: 10.1007/s11357-022-00547-x
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
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  • 2
    Online Resource
    Online Resource
    First year post-stroke healthcare costs and fall-status among those discharged to the community
    SAGE Publications ; 2018
    In:  European Stroke Journal Vol. 3, No. 3 ( 2018-09), p. 254-262
    Details
    In: European Stroke Journal, SAGE Publications, Vol. 3, No. 3 ( 2018-09), p. 254-262
    Abstract: Falls are common post-stroke events but their relationship with healthcare costs is unclear. The aim of this study was to examine the relationship between healthcare costs in the first year after stroke and falls among survivors discharged to the community. Patients and methods Survivors of acute stroke with planned home discharges from five large hospitals in Ireland were recruited. Falls and healthcare utilisation data were recorded using inpatient records, monthly calendars and post-discharge interviews. Cost of stroke was estimated for each participant from hospital admission for one year. The association of fall-status with overall cost was tested with multivariable linear regression analysis adjusting for pre-stroke function, stroke severity, age and living situation. Results A total of 109 stroke survivors with complete follow-up data (mean age = 68.5 years (SD = 13.5 years)) were included. Fifty-three participants (49%) fell following stroke, of whom 28 (26%) had recurrent falls. Estimated mean total healthcare cost was €20,244 (SD=€23,456). The experience of one fall and recurrent falls was independently associated with higher costs of care (p = 0.02 and p  〈  0.01, respectively). Discussion The observed relationship between falls and cost is likely to be underestimated as aids and adaptions, productivity losses, and nursing home care were not included. Conclusion This study points at differences across fall-status in several healthcare costs categories, namely the index admission, secondary/tertiary care (including inpatient re-admissions) and allied healthcare. Future research could compare the cost-effectiveness of inpatient versus community-based fall-prevention after stroke. Further studies are also required to inform post-stroke bone-health management and fracture-risk reduction.
    Type of Medium: Online Resource
    ISSN: 2396-9873 , 2396-9881
    URL: Article
    DOI: 10.1177/2396987318764954
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2018
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  • 3
    Online Resource
    Online Resource
    Supermarket Tampering: Cocaine Detected in Syringes and in Fruit
    ASTM International ; 2001
    In:  Journal of Forensic Sciences Vol. 46, No. 1 ( 2001-01-01), p. 144-146
    Details
    In: Journal of Forensic Sciences, ASTM International, Vol. 46, No. 1 ( 2001-01-01), p. 144-146
    Abstract: Product tampering, as detailed by the Federal Anti-Tampering Act of 1983 (1), is a felony punishable by both fine and imprisonment. The rationale for product tampering ranges from pranks and attention seeking acts to extortion, terrorism, and homicide. One such case submitted for analysis involved four medical syringes found in a supermarket and suspected of being used to tamper with various products. One of the syringes was found piercing a pear while the other three syringes were found with needles exposed in other parts of the supermarket. Microscopic analysis was used to collect residue from the syringe barrels and the pear. A multidiscipline approach involving SLM, PLM, including microchemical analysis, FTIR, and GC/MS analyses, performed on the residual liquid found in the syringe barrels and in the suspect pear, confirmed the presence of cocaine. This multidisciplinary approach is often necessary when there is a possible health risk to the public and rapid response is important. With this approach, it was quickly determined which drugs or poisons were used in this tampering.
    Type of Medium: Online Resource
    ISSN: 0022-1198
    URL: Article
    DOI: 10.1520/JFS14926J
    RVK:
    XA 53670
    Language: English
    Publisher: ASTM International
    Publication Date: 2001
    detail.hit.zdb_id: 2026357-0
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  • 4
    Online Resource
    Online Resource
    Access to and quality of elective care: a prospective cohort study using hernia surgery as a tracer condition in 83 countries
    Elsevier BV ; 2024
    In:  The Lancet Global Health Vol. 12, No. 7 ( 2024-07), p. e1094-e1103
    Details
    In: The Lancet Global Health, Elsevier BV, Vol. 12, No. 7 ( 2024-07), p. e1094-e1103
    Type of Medium: Online Resource
    ISSN: 2214-109X
    URL: Article
    DOI: 10.1016/S2214-109X(24)00142-6
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2024
    detail.hit.zdb_id: 2723488-5
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  • 5
    Online Resource
    Online Resource
    Maintenance treatment with balsalazide provides more effective control of nocturnal symptoms of ulcerative colitis (UC) than delayed-release mesalazine
    Elsevier BV ; 1998
    In:  Gastroenterology Vol. 114 ( 1998-04), p. A987-
    Details
    In: Gastroenterology, Elsevier BV, Vol. 114 ( 1998-04), p. A987-
    Type of Medium: Online Resource
    ISSN: 0016-5085
    URL: Article
    DOI: 10.1016/S0016-5085(98)84020-1
    RVK:
    XA 44500
    Language: English
    Publisher: Elsevier BV
    Publication Date: 1998
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  • 6
    Online Resource
    Online Resource
    Distribution of Bacteria and Archaea in meromictic tropical Lake Kivu (Africa)
    Inter-Research Science Center ; 2015
    In:  Aquatic Microbial Ecology Vol. 74, No. 3 ( 2015-03-24), p. 215-233
    Details
    In: Aquatic Microbial Ecology, Inter-Research Science Center, Vol. 74, No. 3 ( 2015-03-24), p. 215-233
    Type of Medium: Online Resource
    ISSN: 0948-3055 , 1616-1564
    URL: Article
    DOI: 10.3354/ame01737
    Language: English
    Publisher: Inter-Research Science Center
    Publication Date: 2015
    detail.hit.zdb_id: 1236600-6
    detail.hit.zdb_id: 2022271-3
    SSG: 12
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  • 7
    Online Resource
    Online Resource
    Falls-Related EvEnts in the first year after StrokE in Ireland: Results of the multi-centre prospective FREESE cohort study
    SAGE Publications ; 2018
    In:  European Stroke Journal Vol. 3, No. 3 ( 2018-09), p. 246-253
    Details
    In: European Stroke Journal, SAGE Publications, Vol. 3, No. 3 ( 2018-09), p. 246-253
    Abstract: Falls are common post-stroke adverse events. This study aimed to describe the first-year falls incidence, circumstances and consequences among persons discharged home after stroke in Ireland, and to examine the association between potential risk factors and recurrent falls. Patients and methods Patients with acute stroke and planned home-discharge were recruited consecutively from five hospitals. Variables recorded pre-discharge included: age, stroke severity, co-morbidities, fall history, prescribed medications, hemi-neglect, cognition and functional independence (Barthel index). Falls were recorded with monthly diaries, and 6 and 12-month interviews. The association of pre-discharge factors with recurrent falls ( 〉 1 fall) was examined using univariable logistic regression. Results A total of 128 participants (mean age = 68.6, SD = 13.3) were recruited; 110 completed the 12-month follow-up. The first-year falls incidence was 44.5% (95% CI = 35.1–53.6) with 25.6% falling repeatedly (95% CI = 18.5–34.4). Fallers experienced 1–18 falls (median = 2) and five reported fractures; 47% of fallers experienced at least one fall outdoors. Only 10% of recurrent fallers had bone health medication prescribed at discharge. Lower Barthel index scores ( 〈 75/100, RR = 4.38, 1.64–11.72) and psychotropic medication prescription (RR = 2.10, 1.13–3.91) were associated with recurrent falls. Discussion This study presents prospectively collected information about falls circumstances. It was not powered for multivariable analysis of risk factors. Conclusion One-quarter of stroke survivors discharged to the community fall repeatedly and mostly indoors in the first year. Specific attention may be required for individuals with poor functional independence or those on psychotropic medication. Future falls-management research in this population should explore falls in younger individuals, outdoor as well as indoor falls and post-stroke bone health status.
    Type of Medium: Online Resource
    ISSN: 2396-9873 , 2396-9881
    URL: Article
    DOI: 10.1177/2396987318764961
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2018
    detail.hit.zdb_id: 2851287-X
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  • 8
    Online Resource
    Online Resource
    HER2 amplification predicts breast cancer recurrence but not overall survival.
    American Association for Cancer Research (AACR) ; 2009
    In:  Cancer Research Vol. 69, No. 2_Supplement ( 2009-01-15), p. 6070-
    Details
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 69, No. 2_Supplement ( 2009-01-15), p. 6070-
    Abstract: Abstract #6070 INTRODUCTION: Human epidermal growth factor receptor-2 (HER2) amplification has been associated with an aggressive breast cancer phenotype. The aims of this study were: 1) to determine if a relationship between HER2 amplification and local recurrence or overall survival (OS) existed; and 2) to compare prognostic effects of HER2 amplification with race, age, TNM stage, Scarff-Bloom-Richardson (SBR) grade, and hormone receptor status. & #x2028; METHODS: Data were collected prospectively in our institutional review board approved breast center patient registry for patients with infiltrating ductal or infiltrating ductal-lobular mixed breast cancer; all other histologic types, including pure infiltrating lobular, were excluded from this analysis. Variables analyzed included race, age at diagnosis, tumor size, overall TNM stage, SBR grade, HER2 status, and hormone receptor status. Outcomes were defined as disease-free survival (local and distant) and OS. The prognostic effect of HER2 amplification on disease-free survival (DFS) and OS was assessed after adjusting for race, age, TNM stage, SBR grade, and hormone receptor status; Cox proportional hazards analysis was used in the multivariable analysis. A stepwise selection procedure was used in the multivariable analysis with p & lt;0.10 required to allow a variable into the model and p & lt;0.05 required to retain it in the final model. & #x2028; RESULTS: Data were available for 1750 patients (mean age at diagnosis 60 years) diagnosed between January 2001 and July 2007; mean tumor size 1.8 cm, of which 384 (22%) were hormone receptor negative and 296 (17%) were HER2 amplified. Risk factors for DFS included HER2 amplification (Table 1), black race, increasing TNM stage, and negative hormone receptors. Risk factors for OS included black race, increasing TNM stage, and negative hormone receptors. HER2 amplification was associated with decreased disease-free survival (Fig 1a) but not OS (Fig 1b). & #x2028; & #x2028; & #x2028; & #x2028; CONCLUSIONS: Although HER2 amplification predicted disease-free survival, it did not predict OS in the multivariable analysis. A possible explanation for this finding is the increasing use of Trastuzumab for HER2 amplified tumors after relapse. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 6070.
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
    URL: Article
    DOI: 10.1158/0008-5472.SABCS-6070
    RVK:
    XA 36000
    RVK:
    XA 10000
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2009
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    detail.hit.zdb_id: 1432-1
    detail.hit.zdb_id: 410466-3
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  • 9
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    Online Resource
    HER2 amplification does not alter outcome in small (≤1 cm) tumors.
    American Association for Cancer Research (AACR) ; 2009
    In:  Cancer Research Vol. 69, No. 2_Supplement ( 2009-01-15), p. 6058-
    Details
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 69, No. 2_Supplement ( 2009-01-15), p. 6058-
    Abstract: Abstract #6058 INTRODUCTION: Amplification of human epidermal growth factor receptor-2 (HER2) has been associated with an aggressive clinical phenotype, however the management of patients with small tumors ( & lt;1 cm) that amplify HER2 is controversial. The goals of this study were: 1) to describe characteristics of HER2 amplified tumors based on tumor size, and 2) compare outcomes among 4 groups based on tumor size (small tumors & lt;1 cm or large tumors & gt;1 cm) and HER2 amplification (+ or -.) & #x2028; METHODS: Data were collected prospectively in our institutional review board approved breast center patient registry for patients with infiltrating ductal or infiltrating ductal-lobular mixed breast cancer. There were 770 patients with N0 tumors who were diagnosed between January 2001 and April 2005 (prior to treatment of HER2 amplified tumors with Trastuzumab). Categorical variables were compared using the Chi-squared test; outcomes were estimated using the Kaplan-Meier method and the log-rank test. & #x2028; RESULTS: At 4 years, estimated disease free interval was 97% in small HER2- tumors, 92% in large HER2- tumors, 91% in small HER2+ tumors, and 86% in large HER2+ tumors. & #x2028; & #x2028; At 4 years, breast cancer specific survival was 97% in small HER2- tumors, 92% in large HER2- tumors, 91% in small HER2+ tumors, and 86% in large HER2+ tumors. & #x2028; CONCLUSIONS: In our series, larger as opposed to smaller HER2+ tumors tended to be of higher histologic grade (SBR), and showed a trend toward more frequent lymphovascular invasion (LVI) and negative hormone receptor status. In small tumors, HER2 amplification did not predict recurrence-free survival or breast cancer disease specific survival at 4 years. The survival curves do show trends towards worsening outcomes for small tumors with HER2 amplification; these trends may show significance with additional follow-up. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 6058.
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
    URL: Article
    DOI: 10.1158/0008-5472.SABCS-6058
    RVK:
    XA 36000
    RVK:
    XA 10000
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2009
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    detail.hit.zdb_id: 1432-1
    detail.hit.zdb_id: 410466-3
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