Function Of Years Research Articles

Évolution des tentatives de suicide en population clinique tunisienne de 2005 à 2015 : de nouvelles modalités de passage à l’acte chez les jeunes ?

IntroductionSuicide and suicide attempts represent a worldwide health priority. The aim of our study was to describe the epidemiological and clinical characteristics of young suicide attempters among a clinical population and to assess their potential evolution over a period of11 years. MethodsWe conducted a descriptive retrospective study among a clinical population of suicide attempters referred to the child psychiatric department of the Razi hospital, the inpatient reference department in the north and center of Tunisia, between January 2005 and December 2015. Based on the WHO definition we considered as suicide attempts, “any deliberate act, without any fatal outcome, aimed at performing a gesture of violence on one's own person or to ingest a toxic substance or drugs at a dose higher than the dose recognized as therapeutic”. We conducted collection of data from patient records based on a pre-established record with the following parameters: clinical study of patients including: socio-demographic data, clinical characteristics based on DSM 4 criteria and environmental factors including family history of psychiatric disorder, abuse, school difficulties and failure. ResultsThe sample was composed of 159 patients having a mean age of 12.8 years with extremes from 5.8 to 17 years. It was composed of 74.2% girls and 25.8% boys. Medical intoxication was the most common mean (68.6%) followed by physical means (20.1%) and toxic products ingestion (12.6%). The suicide attempts were mainly non-premeditated (83.1%). Our patients reported a previous suicide attempt in 25.8% of cases. Chronic somatic disorders were found among 24.5% of our sample. Psychiatric disorders among children, parents, abuse, and school failure were found in respectively 48.4%, 50.6%, 37.1% and 13.4% of suicidal patients. Psychiatric disorders were dominated by depressive disorders and oppositional defiant disorders associated with conduct disorder. The chronological study highlighted significant modifications starting from 2013/2014, reflecting a recent trend: a significant decrease in suicidal age was found since the year 2015: children under 10 years of age, who constituted 8.4 % (n=10) of suicides during the period from (n=119), accounted for 20 % (n=32) of the patients enumerated in the year 2015 (P=0.045). We also found that the percentage of suicidal attempts committed in winter was higher from 2013 than in previous years (P=0.019). We also noted a significant increase in 2014 in the proportion of patients with a personal history of suicidal attempt when compared to previous years (P=0.045). The use of physical means became more frequent from 2013 (P=0.019). This is confirmed by comparing the suicide attempts prior to and from 2014 (P=0.007) or by comparing the suiced attempts committed in 2015 to the ones committed during the previous ten years (P=0.007). Finally, there was a statistically significant distribution of serious organic effects (coma) as a function of years: such complications were more frequent in the course of suicidal attempts committed after 2013 (P=0.009). ConclusionsSince 2013/2014 we found a recent trend characterized by more children among suicidals, more patients reporting a previous suicide attempt, more frequent use of physical means and a greater proportion of suicide attempts realized in winter. This raises the challenge for more research on the topic as well as new therapeutic interventions.

Time-to-death patterns in markers of age and dependency

We aim to determine the extent to which variables commonly used to describe health, well-being, and disability in old age vary primarily as a function of years lived (chronological age), years left (thanatological age), or as a function of both. We analyze data from the U.S. Health and Retirement Study to estimate chronological age and time-to-death patterns in 78 such variables.We describe results for the birth cohort 1915–1919 in the final 12 years of life. Our results show that most of the markers used to study well-being in old age vary along both the age and the timeto- death dimensions, but that some markers are exclusively a function of either time to death or chronological age, while other markers display different patterns in men and women.

Knowledge of clinical trials regarding hormone therapy and likelihood of prescribing hormone therapy.

The aim of the study was to examine whether physicians who are better informed about large, published hormone therapy (HT) trials (eg, the Women's Health Initiative) are more likely to prescribe HT for menopausal symptoms. US obstetricians/gynecologists and primary care physicians completed a 15- to 20-minute Internet-based survey. Knowledge was assessed via nine true-false statements about HT trials (range: 0-9). Prescribing practices were assessed via six case studies with a seven-point response scale of "extremely unlikely" to "extremely likely" in relation to treatment options (range: 6-42). The primary analysis examined the correlation between HT trial knowledge and likelihood of prescribing HT. Secondary analyses gauged knowledge and prescribing practices based on practice type, sex, and years in practice. Among 501 physicians who completed the survey (representing 10.7% of those invited; median age: 51.0 y; female: 26.9%; obstetricians/gynecologists: 49.9%; median 19.0 y in practice), HT knowledge (mean [SD] 3.8 [2.3]), and prescribing (mean [SD] 24.5 [5.6]) exhibited a statistically significant, moderate positive correlation (0.30; 95% CI, 0.21-0.37; P < 0.0001). Obstetricians/gynecologists were significantly (P < 0.0001) more knowledgeable and more likely to prescribe HT than primary care physicians. Male physicians were more likely (P < 0.05) to prescribe HT but not more knowledgeable about it than female physicians. Knowledge (but not likelihood of prescribing) significantly increased as a function of years in practice. Physicians who are more knowledgeable about large, published HT trials are more likely to prescribe HT for menopausal symptoms.

Perfil dos consumidores de material de leitura no Brasil

Resumo Foi ajustado um modelo linear generalizado à probabilidade de aquisição de material de leitura com dados da Pesquisa de Orçamento Familiar 2008-2009 do Instituto Brasileiro de Geografia e Estatística - IBGE. As variáveis explicativas foram idade, sexo, anos de estudo, ser estudante, renda familiar, escolaridade da pessoa de referência e área geográfica. A variável dependente foi o evento da aquisição de diversos tipos de material de leitura. O principal achado foi a existência de descontinuidade nas probabilidades de aquisição de material de leitura como função dos anos de estudo: indivíduos com pelo menos um ano de curso superior se diferenciam dos demais. Outro fator importante é o acesso via existência de canais de comercialização. O efeito da existência de estudante na família parece ser restrito a livros didáticos. O estudo confirma resultados observados por outros autores: diferenciais entre os sexos, mesmo controlando por nível socioeconômico, educação e idade.

244 Measures of Resident Burnout, Empathy, and Emotional Intelligence as a Function of Years in Post-Graduate Training

244 Measures of Resident Burnout, Empathy, and Emotional Intelligence as a Function of Years in Post-Graduate Training

Time trend of cadmium intake in Korea.

The aim of this study was to elucidate past and current levels of cadmium (Cd) intake among the general populations in Korea. For this purpose, publications reporting dietary intake of cadmium (Cd-D), cadmium concentration in blood (Cd-B) and that in urine (Cd-U) in Korea were retrieved through literature survey for a period from 1975 to 2015. In practice, 9, 21 and 14 articles were available on Cd-D, Cd-B and Cd-Ucr (Cd-U as corrected for creatinine concentration), respectively. Linear regression analyses of the reported values as a function of years (i.e., the year when each survey was conducted) showed steady decreases in all of the three exposure markers of Cd-D, Cd-B and Cd-U(cr). Factors possibly contributing for the reduction were discussed including the government-set guideline of 0.2 mg/kg for rice and changes in food habits among general populations. There have been steady decreases in Cd-D, Cd-B and Cd-U(cr). The current estimates for Cd-D, Cd-B and Cd-Ucr were 6.0-7.4 μg/day, 0.73-0.83 μg/L and 0.60-0.95 μg/g cr, respectively.

Increase in Cesarean Operative Time Following Institution of the 80-Hour Workweek.

In 2003, the Accreditation Council for Graduate Medical Education limited resident duty hours to 80 hours per week. More than a decade later, the effect of the limits on resident clinical competence is not fully understood. We sought to assess the effect of duty hour restrictions on resident performance of an uncomplicated cesarean delivery. We reviewed unlabored primary cesarean deliveries at Duke University Hospital after 34 weeks gestation, between 2003 and 2011. Descriptive statistics and linear regression were used to compare total operative time with incision to delivery time as a function of years since institution of the 80-hour workweek. Resident training level, subject body mass index, estimated blood loss, and skin closure method were controlled for in the regression model. We identified 444 deliveries that met study criteria. The mean (SD) total operative time in 2003-2004 was 43.3 (14.3) minutes and 59.6 (10.7) minutes in 2010-2011 (P < .001). Multivariable regression demonstrated an increase in total operative time of 1.9 min/y (P < .001) but no change in incision to delivery time (P = .05). The magnitude of increased operative time was seen among junior residents (2.0 min/y, P < .001) compared to that of senior residents (1.2 min/y, P = .06). Since introduction of the 2003 duty hour limits, there has been an increase of nearly 20 minutes in the time required for a routine cesarean delivery. It is unclear if the findings are due to a change in residency duty hours or to another aspect of residency training.

Mental Health and Exposure to the United States: Key Correlates from the Hispanic Community Health Study of Latinos.

We examined the association between exposure to the U.S. and symptoms of poor mental health among adult Hispanic/Latinos (N = 15,004) overall and by Hispanic/Latino background. Using data from the Hispanic Community Health Study of Latinos (HCHS/SOL), we estimated logistic regressions to model the risk of moderate to severe symptoms of psychological distress, depression, and anxiety as a function of years in the U.S. and six key psychosocial risk and protective factors. In unadjusted models, increased time in the U.S. was associated with higher risk of poor mental health. After adjustment for just three key factors--perceived discrimination, perceived U.S. social standing, and the size of close social networks--differences in the odds of poor mental health by years in the U.S became insignificant for Hispanics/Latinos overall. However, analyses by Hispanic/Latino background revealed different patterns of association with exposure to the U.S. that could not be fully explained.

Factors affecting fall down rates of dead aspen (Populus tremuloides) biomass following severe drought in west-central Canada.

Increases in mortality of trembling aspen (Populus tremuloides Michx.) have been recorded across large areas of western North America following recent periods of exceptionally severe drought. The resultant increase in standing, dead tree biomass represents a significant potential source of carbon emissions to the atmosphere, but the timing of emissions is partially driven by dead-wood dynamics which include the fall down and breakage of dead aspen stems. The rate at which dead trees fall to the ground also strongly influences the period over which forest dieback episodes can be detected by aerial surveys or satellite remote sensing observations. Over a 12-year period (2000-2012), we monitored the annual status of 1010 aspen trees that died during and following a severe regional drought within 25 study areas across west-central Canada. Observations of stem fall down and breakage (snapping) were used to estimate woody biomass transfer from standing to downed dead wood as a function of years since tree death. For the region as a whole, we estimated that >80% of standing dead aspen biomass had fallen after 10 years. Overall, the rate of fall down was minimal during the year following stem death, but thereafter fall rates followed a negative exponential equation with k = 0.20 per year. However, there was high between-site variation in the rate of fall down (k = 0.08-0.37 per year). The analysis showed that fall down rates were positively correlated with stand age, site windiness, and the incidence of decay fungi (Phellinus tremulae (Bond.) Bond. and Boris.) and wood-boring insects. These factors are thus likely to influence the rate of carbon emissions from dead trees following periods of climate-related forest die-off episodes.

Global quality of life modifies terminal change in physical functioning among older adult women.

the factors that moderate decline in physical functioning as death approaches are understudied. This study aimed to assess death-related decline in global quality of life (QoL) and physical functioning and to test whether baseline QoL moderates terminal decline in physical functioning. four thousand six hundred and fifty-one decedents from the Women's Health Initiative Study (WHI) rated QoL and physical functioning each year throughout 5 years of follow-up. both QoL and physical functioning showed a steeper decline as a function of years to death than as a function of chronological age. Moreover, decedents with higher QoL at baseline showed a less steep decline in physical functioning as death approached than those with lower QoL at baseline. although QoL strongly decreases across the terminal years, its beneficial influence on physical functioning is evident till the very end of life.

Rankings in professional men’s tennis: a rich but underutilized source of information

Success in professional tennis is measured, at least in part, by rankings. However, there is little quantitative evidence to inform stakeholders regarding what represents the typical ranking progress of top-ranked players. The objective of this study was therefore to compare the ranking trajectories of male players whom achieved peak professional rankings in the Top 250, 175, 100, 50, 20 and 10. The 11,396 birthdates and weekly professional rankings of all players between 27 August 1973 and 31 October 2011 were collated. The peak ranks for each athlete according to their both chronological age and number of years on tour were identified and athletes were categorised into one of six career–peak ranking bands. One-way analysis of variance tests confirmed distinctive ranking trajectories, which were most pronounced among Top 10 players. The rankings of these players were statistically distinguishable following players’ second year on tour or by 17 years of age. The ranking signature of all Top 100 players emerged as significantly different to players that failed to enter the Top 100 by their fourth year on the tour. Indeed, the representation of ranking as a function of years on tour should be considered for use by tennis policy-makers in the future.

Modeling a controversy in the press: The case of abnormal bee deaths

The dynamics of opinion about the controversy of abnormal death of bees is studied among French speaking journalists using a corpus of 1467 articles published in newspapers during the period 1998–2010. From a systematic textual analysis, each article is tagged to either one of three stances to explain the phenomenon, a uni-factor cause, namely the use of pesticides, a multi-factor cause, or the absence of an understanding. On this basis, evolutions of the respective proportions of each category are obtained over the 13 consecutive years, exhibiting a series of broken lines. Assuming journalists are either flexible or inflexible about their respective views, their associated proportions are extracted from the data applying Galam Unifying Frame (GUF) of opinion dynamics. The variation of inflexibles along each view is thus obtained as a function of years for the 13 years of the corpus. From those distributions the possible pressure applied on journalists from lobbying or other externalities can be inferred. In addition, the results highlight the critical advantage gained by the first whistle-blowers and underline opinion inertia in the debate.

Data on the safety of repeated MRI in healthy children.

PurposeTo address the question of the safety of MRI for research in normal, healthy children. We examined MRI, neurocognitive and biometric data collected in a group of healthy, normally developing children who have participated in a 10 year longitudinal fMRI study.Materials and methodsThirty-one healthy children ranging in age from 5 to 7 years were enrolled between 2000 and 2002 and were tested yearly as part of a longitudinal study of normal language development. Twenty-eight of these children have completed multiple neuroimaging, neurocognitive and biometric exams. These children ranged in age from 5 to 18 years during the course of the study and were exposed to up to 10 annual MRI scans. Linear regression of the IQ (WISC-III) (Wechsler, 1991), executive function (BRIEF) (Gioia et al., 2002), and language (OWLS) (Carrow-Woolfolk, 1995) measures was performed against the number of years of exposure to MRI in the study. Body mass index (BMI) (Ogden et al., 2006) was also examined as a function of years and compared with normative values.ResultsThe WISC-III Full Scale (FSIQ) in our longitudinal cohort was higher than the average at baseline. There was no significant change over time in mean FSIQ p = 0.80, OWLS p = 0.16, or BRIEF p = 0.67. Similarly, over 10 years there were no significant changes in the Coding subtest of WISC III and height and body mass index did not deviate from norms (50th percentile).ConclusionsExamination of neurocognitive and biometric data from a decade-long, longitudinal fMRI study of normal language development in this small, longitudinal sample of healthy children in the age range of 5 to 18 years, who received up to 10 MRI scans, provides scientific evidence to support the belief that MRI poses minimal risk for use in research with healthy children.

Privacy in Digital Age: Dead or Alive?! Regarding the New EU Data Protection Regulations

Purpose – To review and critically discuss the current state of privacy in the context of constant technological changes and to emphasize the pace of technological advancements and developments reached over the time when the last EU data protection laws came into effect. These facts inevitably affect the perception of privacy and raise the question of whether privacy is dead or takes the last breath in the digital age? This paper is an attempt to address this question. Design/Methodology/Approach – Based on the comparison and systematic analysis of scientific literature, the authors discuss problematic issues related to privacy and data protection in the technology era – where these issues are too complicated to be clearly regulated by laws and rules since “laws move as a function of years and technology moves as a function of months” (Ron Rivest). Therefore, this analytical approach towards the issue may help to facilitate reaching the best-fit decision in this area. Findings – The authors emphasize the change of perception of privacy, which originated and grew on the idea of “an integral part of our humanity”, the “heart of our liberty” and “the beginning of all freedoms” (Solove, 2008), leading to the recently raised idea that privacy is severely hanging with threat. The authors are of the opinion that legislation and regulation may be one of the best and effective techniques for protecting privacy in the twenty-first century, but it is not currently adequate (Wacks, 2012). One of the solutions lies in technology design. Research limitations/implications – The aspects of privacy and data protection in the European Union have been widely discussed recently because of their broad applicability. Therefore, it is hardly possible to review and cover all the important aspects of the issue. This article focuses on the roles of technology and legislation in securing privacy. The authors examine and provide their own views based on the critical analysis of the outstanding scientific material. Practical implications – The authors highlight the ongoing change of perception of privacy. If regulation is left behind the development of technology, privacy will hardly stay alive. On the other hand, if legislation is applied on an ex-ante basis, technological development will depend on the legislators. The balance of both may be the golden means and it basically depends on the coordinated behavior of all the stakeholders. Value – The article emphasizes that the rising role of sharp development of technology by itself does not violate privacy. It is the people using this technology and the policies they carry out that create violations (Garfinkel, 2000). In fact, threats, in the first instance, are the consequences of human behavior. In other words, technology can be a significant factor of violating or demolishing privacy, however, it may also be the major method of protecting it. The balance of both may be the key means. Research type – general review.

Individual Patient Data Of Conditional Survival Analysis In a Large Cohort Of 816 Multiple Myeloma (MM) Patients Constitutes a Different Way To Identify Patients With Extended Life Expectancy

BackgroundPrior analyses have advocated that mortality from major cancer has declined reflecting continuing progress in cancer prevention, early detection and treatment. Survival estimates are typically presented as the probability of surviving a given length of time after the diagnosis. In contrast, conditional survival describes the probabilities of surviving y additional years given patients survived x years. Conditional survival provides additional information about how the risk of death may change over time, taking into account, how long someone has already survived. In multiple myeloma, many prognostic parameters have been proposed to predict survival, but results on conditional survival are lacking. MethodsWe evaluated 816 consecutive multiple myeloma patients treated at our department between 1997-2011 with almost complete long-term follow-up. Patients' data were assessed via electronic medical record (EMR) retrieval within an innovative research data warehouse. Our platform, the University of Freiburg Translational Research Integrated Database Environment (U-RIDE), acquires and stores all patient data contained in the EMR at our hospital and provides immediate advanced text searching capacity. In an initial step, we assessed age, gender, disease stage (Durie&Salmon [D&S]), time of death and last follow-up. Moreover, we determined 5-year conditional survival as the probability of surviving at least 5 more years as a function of years a patient had already survived since initial diagnosis (i.e. 5-year conditional survival for those, who survived 0, 1, 2, 3, 4 and 5 years after initial diagnosis). Five year conditional survival was stratified according to gender, stage, age and other risk variables. ResultsThe OS probabilities at 5-/10-years were 50% and 25%, respectively. The 5-year-conditional survival remained constant over the years (50%, even at 5 years). As expected, D&S stage I vs. II+III showed different 5-year conditional survival estimates of 75% vs. 42%, respectively for those who survived 1 year after diagnosis. Similarly, age subgroups <60, 60-70 and >70 years showed notably different 5-year conditional survival estimates, but also remained constant over the course of time with ∼63%, 51% and 27%, respectively. Via multivariable Cox model including gender, admission period (<2001, 2001-2007, >2007), age and disease stage by D&S, the latter two were of statistical significance (p<0.001).To distinctively identify long-term survivors via conditional survival, we performed a comprehensive analysis of various prognostic factors, including disease-related factors, such as single components of the D&S (e.g. hemoglobin, calcium, creatinine and osteolyses) and International Staging System, laboratory variables (e.g. LDH, type of paraprotein) and host-related risks. The latter includes comorbid conditions, such as performance status and organ function. Via multivariable analysis, we identified an impaired Karnofsky Performance Status <80%, ≥2 osteolyses, hemoglobin <10g/dl, ß2-microglobulin ≥5.5mg/l and LDH ≥200U/l as significant additional risk factors (Table 1). Extensive cytogenetic analyses are currently included in our risk assessment (according to Moreau P. ASH 2012:#598 and Avet-Loiseau H. JCO 2012).Table 1Multivariable Cox proportional hazard model incorporating the covariables selected by boostingVariablesHR95%- CIp-valueKPS (%)80-100<8012.4-1.01-5.680.05Osteolyses<2≥212.17-1.52-3.10<0.001Hemoglobin≤10>1010.58-0.4-0.840.004ß2-MG<5.5≥5.511.73-1.08-2.770.02LDH<200≥20011.39-1.01-1.920.05eGFR≥9060-89<6011.221.28-0.79-1.870.76-2.140.88Albumin<3.5≥3.510.87-0.61-1.230.42Lung diseaseno-mildmoderate-severe11.31-0.87-1.980.20Freiburg Comorbidity Index01-0.691-31.210.47-3.08ISSI-II1-0.77III1.070.68-1.68 ConclusionsConditional survival analyses constitute an attractive tool to predict outcome, supplements existing measures and may guide cancer survivors in planning their future. Our ongoing risk assessment via inclusion of additional variables and cytogenetics aims to define long- vs. short-term survivors in a multiple myeloma specific risk model and should help to provide clinically relevant prognostic information (e.g accurate estimate of cause-specific survival), and to implement preventive and interventional strategies. Disclosures:No relevant conflicts of interest to declare.

Health Practitioners' Implicit and Explicit Attitudes Toward Drug Addicts Predict Absenteeism and Extra Work

We analyzed the correspondence between implicit and explicit attitudes of health care practitioners working with drug addicts as a function of years of professional experience, and its relation with important organizational outcomes. Consistent with the hypothesis that implicit–explicit attitude inconsistency is unpleasant and people struggle to resolve it, practitioners' implicit–explicit consistency increased with years of experience. Moreover, for practitioners self-reporting positive attitudes, negative implicit attitudes led to increased absenteeism and decreased voluntary extra work. For practitioners self-reporting negative attitudes, positive automatic associations had similar effects. Strengths, limitations, and possible extensions of this research are discussed.

Conditional Survival Analysis in a Large Cohort of Multiple Myeloma Patients Provides Detailed Information about Long-Term Survival and Constitutes a Different Way to Identify Patients with Extended Life Expectancy

Abstract 4982 Introduction:Prior analyses have advocated that mortality from major cancer has declined reflecting continuing progress in cancer prevention, early detection and treatment. Survival estimates are typically presented as the probability of surviving a given length of time after the diagnosis. In contrast, conditional survival describes the probabilities of surviving y additional years given patients survived x years. Conditional survival provides additional information about how the risk of death may change over time, taking into account, how long someone has already survived. In multiple myeloma many prognostic parameters have been proposed to predict survival, but results on conditional survival are still lacking. Methods:We evaluated 816 consecutive multiple myeloma patients treated at our department between 1997–2011. Patients’ data were assessed via electronic medical record (EMR) retrieval within an innovative research data warehouse. Our platform, the University of Freiburg Translational Research Integrated Database Environment (U-RIDE), acquires and stores all patient data contained in the EMR at our hospital and provides immediate advanced text searching capacity. In an initial step, we assessed age, gender, disease stage (Durie&Salmon [D&S]), time of death and last follow-up. Moreover, we determined 5-year conditional survival as the probability of surviving at least 5 more years as a function of years a patient had already survived since initial diagnosis (i. e. 5-year conditional survival for those, who survived 0, 1, 2, 3, 4 and 5 years after initial diagnosis). Five year conditional survival was stratified according to gender, stage, age and other risk variables. Results:The OS probabilities at 5- and 10- years were 50% and 25%, respectively. The 5-year conditional survival probabilities remained almost constant over the years a patient had already survived after initial diagnosis (∼53%). According to baseline variables, conditional survival estimates showed no gender differences. As expected, D&S stage I vs. stage II+III showed substantially different 5-year conditional survival estimates over the years for those who survived 1 year after initial diagnosis (75% vs. 42%, respectively). Similarly, age subgroups <60, 60–70 and >70 years showed notably different 5-year conditional survival estimates, but also remained constant over the course of time with ∼63%, 51% and 27%, respectively. The multivariable Cox model, including gender, year of admission (before 2001, 2001–2007 and after 2007), D&S (stage II-III) and age (>70 years) showed increased hazard ratio (HR) for both latter groups of 2. 2 (95% CI 1. 8–2. 7; <0. 0001) and 3. 5 (95% CI: 2. 7–4. 4, <0. 0001), respectively. Ongoing analyses aim to distinctively identify long-term survivors via conditional survival. In order to obtain a comprehensive analysis of relevant prognostic factors, we have focused on variables with high degree of completeness. These include disease-related factors, such as single components of the D&S (e. g. hemoglobin, calcium, creatinine and osteolyses) and International Staging System, laboratory variables (e. g. LDH, type of paraprotein) and host-related risk factors. The latter include comorbid conditions such as performance status and organ function. Of note, over the study period, admission of patients <60 years decreased from 60% to 34%, but increased for those ≥70 years from 10% to 35%, respectively, illustrating that not only young and fit, but also elderly patients are increasingly treated within large referral and university centers and that patient cohorts and risks do not remain constant over time. Conclusions:In this study, involving a large cohort of multiple myeloma patients, analyses stratified by age and stage revealed substantially different conditional survival estimates. Conditional survival seems an attractive tool to predict outcome over time, supplements existing measures and may guide cancer survivors in planning their future. The combination of the main prognostic factors of the ongoing analysis in a multiple myeloma specific risk model, may define long-term survivors via conditional survival more distinctively and will be presented at the meeting. Disclosures:No relevant conflicts of interest to declare.

Navigating the Auditory Scene: An Expert Role for the Hippocampus

Over a typical career piano tuners spend tens of thousands of hours exploring a specialized acoustic environment. Tuning requires accurate perception and adjustment of beats in two-note chords that serve as a navigational device to move between points in previously learned acoustic scenes. It is a two-stage process that depends on the following: first, selective listening to beats within frequency windows, and, second, the subsequent use of those beats to navigate through a complex soundscape. The neuroanatomical substrates underlying brain specialization for such fundamental organization of sound scenes are unknown. Here, we demonstrate that professional piano tuners are significantly better than controls matched for age and musical ability on a psychophysical task simulating active listening to beats within frequency windows that is based on amplitude modulation rate discrimination. Tuners show a categorical increase in gray matter volume in the right frontal operculum and right superior temporal lobe. Tuners also show a striking enhancement of gray matter volume in the anterior hippocampus, parahippocampal gyrus, and superior temporal gyrus, and an increase in white matter volume in the posterior hippocampus as a function of years of tuning experience. The relationship with gray matter volume is sensitive to years of tuning experience and starting age but not actual age or level of musicality. Our findings support a role for a core set of regions in the hippocampus and superior temporal cortex in skilled exploration of complex sound scenes in which precise sound "templates" are encoded and consolidated into memory over time in an experience-dependent manner.

The Subjective Effects of Cocaine: Relationship to Years of Cocaine Use and Current Age

Background: Little is known about whether the duration of cocaine use or an individual’s age may influence the acute effects of cocaine, patterns of use, and specific treatment needs. Objectives: This post hoc analysis determined whether the duration of cocaine use or current age influenced the acute subjective response to cocaine. Data from four smoked cocaine self-administration laboratory studies were combined and analyzed to determine whether the subjective effects of a 25-mg smoked cocaine dose varied as a function of years of cocaine use or current age. Methods: Thirty-six nontreatment-seeking healthy cocaine users (ages 32–49) were admitted to studies lasting from 12 to 105 days. Participants rated the subjective effects of each cocaine dose from 0 to 100 by completing a computerized self-report visual analogue scale (VAS). The main outcome measures were the change in VAS ratings between a baseline placebo dose and the first 25-mg dose of smoked cocaine. Results: No significant relationship was found between the subjective effects of cocaine and years of cocaine use (mean 20.9, range 5–30) or current age (mean 41.1, range 32–49). Conclusion: Among long-term cocaine users between the ages of 32 and 49, the acute subjective effects of cocaine did not vary as a function of years of cocaine use or current age. Scientific Significance: These data fail to support the incentive sensitization theory for addiction by Robinson and Berridge, as cocaine “liking” and “wanting” remained the same regardless of age or years of cocaine use.

Dependence of time derivative of horizontal geomagnetic field on sunspot number and aa index

This work investigated an interrelationship between the monthly means of time derivatives of horizontal geomagnetic field, dH/dt, sunspot number, Rz, and aa index for the period of substorms (from −90 to −1800 nT) during the years 1990–2009. A total of 232 substorms were identified during the period of study. The time derivative of horizontal geomagnetic field, dH/dt, used as a proxy for geomagnetically induced current (GIC) exhibited high positive correlation with sunspot number (0.86) and aa index (0.8998). The obtained geomagnetic activity is in 92.665% explicable by the combined effect of sunspot number and aa index. The distribution of substorms as a function of years gives a strong support for the existence of geomagnetic activity increases, which implies that as the sunspot number increases the base level of geomagnetic activity increases too.