Units Of Categories Research Articles

Does the Quality of Postpartum Hemorrhage Local Protocols Improve the Identification and Management of Blood Loss after Vaginal Deliveries? A Multicenter Cohort Study.

Substandard care, which can result from a delayed recognition of the severity of blood loss, can increase maternal morbidity. Our objectives were to assess the incidence of postpartum hemorrhage (PPH) and of second-line procedures in maternity units according to the quality of their PPH protocol. We used a mixed design, a prospective cohort (3442 women with PPH after vaginal delivery; February–July 2011), and an audit of the written protocols (177 French maternity units; September 2010–June 2011). A quality score was calculated for the protocol of each unit. Maternity units were classified into three categories according to this score: category 1 (total score: 0–8), category 2 (9–12.5), and category 3 (>12.5). The PPH incidence (>500 mL) was 3.2%, 3.3% and 4.6% among maternity units in categories 1, 2 and 3, respectively (p < 0.0001). The incidence of severe maternal morbidity (surgery and/or artery embolization and/or blood transfusion) was higher among maternity units in category 1 (54.8%; 95% CI: 51.9, 57.7) than in either category 2 (50.1%; 95% CI: 47.8, 52.5) or 3 (38.0%; 95% CI: 33.8, 42.4]) (p < 0.0001). The risks of severe maternal morbidity were lower for category 3 than category 1 and 2 (respectively, adjusted RR 0.68, 95% CI 0.60–0.86 and 0.77, 95% CI 0.68–0.87). Finally, maternity units with higher scores identified PPH better and used fewer curative second-line procedures.

Association between artificially sweetened beverages consumption and changes in body mass index among children

BACKGROUND &amp; OBJECTIVE: Poor food quality and choices are a major concern in the modern life style and increased consumption of sweetened and artificially sweetened beverages have been implicated as contributing factors for obesity. The objective of this study is to determine the association between the consumption of artificially sweetened beverages and changes in body mass index among children.&#x0D; METHODOLOGY: Data on the consumption of artificially sweetened beverages consumption and BMI for 13,287 children was analyzed for exposure and outcome from Millennium Cohort Study (MCS). The association between frequency of ASB consumption and BMI was quantified using demographics and linear regression analysis. The linear regression analysis was done adjusting demographic, socioeconomic variables and confounding factors of frequency of physical activity. Regression analysis was conducted using survey weights to account for the complex sampling design.&#x0D; RESULTS: Adjusted linear regression for demographical and socioeconomic variables showed that more frequent consumption of ASB was associated with a significant increase in BMI. As the frequency of ASB increased, BMI significantly increased by 0.69-1.06 units in categories (p&lt;0.01). Regression analysis adjusted for frequency of physical activity also showed an increase of BMI by 0.36 units (p&lt;0.01) with the highest frequency of ASB consumption.&#x0D; CONCLUSION: Higher consumption of artificially sweetened beverages causes an increase in BMI among UK children.

Abstract P228: Abdominal Lean Muscle Mass is Associated with the Density, but Not the Volume, of Coronary Arterial Calcium and Abdominal Aortic Calcium

Introduction: Higher volume of coronary arterial calcium (CAC) and abdominal aortic calcium (AAC) are predictive of incident CVD, while higher density of CAC and AAC are associated with lower risk. The purpose of the present study was to determine the associations of abdominal lean muscle mass (ALMM) with CAC volume, CAC density, AAC volume, and AAC density. Hypothesis: We hypothesized that abdominal muscle mass would be negatively associated with CAC and AAC volume but positively associated with CAC and AAC density. Methods: The current study analyzed data from the Multi-Ethnic Study of Atherosclerosis (MESA) in those participants who underwent abdominal computed tomography (CT) to assess for AAC, which was also analyzed for volumes of fat (visceral and subcutaneous) and ALMM (psoas, rectus abdominis, obliques, and paraspinus). CAC and AAC were scored separately, for density and for volume. Results: Analyses were restricted to participants who had non-zero CAC or AAC volumes. The sample sizes for the CAC analyses and AAC analyses were 963 and 1283 subjects, respectively. For the CAC analyses, 39.4% (379 of 963) were female and the mean age was 66.4 years. Mean ± SD CAC volume was 218.52 ± 344.19 (range 2.34- 3244.77 mm 3 ) ; Mean ± SD CAC density was 2.70 ± .72 (range 0.83- 4.0 Hu category units). Mean ± SD AAC volume was 1402.33 ± 1888 (range 4.68- 15822.2 mm 3 ); mean ± SD AAC density was 3.02 ± .63 (range 0.83- 4.0 Hu category units). In multivariable linear regression models that controlled for age, race, gender, CVD risk factors, visceral fat, and liver and kidney markers, both CAC and AAC density were found to be significantly associated with abdominal lean muscle mass. For every 100 cm 2 increase of ALMM, CAC density decreased by .35 Hu category units (p &lt; .05). For every 100 cm 2 increase of ALMM, AAC density decreased by .26 Hu category units (p &lt; .05). Conversely, CAC and AAC volume were not significantly associated with abdominal lean muscle mass in final models. Conclusion: Higher levels of ALMM were associated with lower CAC and AAC density, but not volume. Contrary to expectation, we found an inverse association of ALMM with CAC and AAC density, independent of relevant CVD risk factors.

Designing and evaluating risk-based surveillance systems: Potential unwarranted effects of applying adjusted risk estimates

Risk-based surveillance systems reveal occurrence of disease or infection in a sample of population units, which are selected on the basis of risk factors for the condition under study. The purpose of such systems for supporting practical animal disease policy formulations and management decisions are: A: to detect an emerging disease or infection, if it becomes introduced into a population; or B: to substantiate freedom from a condition in a population; or C: to detect cases and estimate the prevalence of an endemic condition in a population. In risk-based surveillance these aims should be met with prudent use of resources while maintaining acceptable system performance.High-risk category units are selected for testing by identification of the presence of specific high-risk factor(s), while disregarding other factors that might also influence the risk. On this basis we argue that the most applicable risk estimate for use in designing and evaluating a risk-based surveillance system would be a crude (unadjusted) relative risk, odds ratio or apparent prevalence. Risk estimates found in the published literature, however, are often the results of multivariable analyses implicitly adjusting the estimates for confounding from other risk factors.We describe some potential unintentional effects when using adjusted risk estimates in evaluating the efficacy and sensitivity of risk-based surveillance systems (SSe).In two examples, we quantify and compare the efficacy and SSe using adjusted and crude risk estimates. The examples use Danish surveillance data from previously published studies to evaluate systems aimed at risk-based detection of new cases of an endemic infection, i.e. Salmonella in dairy cattle herds (Example 1), and for substantiating the absence of a specific infection, i.e. Trichinella in the national slaughter pig population (Example 2), respectively.

Alternate ranging methods for cancer mortality maps.

Mapping techniques can highlight the spatial or temporal variations in rates of cancer mortality. In mapping geographic patterns of cancer mortality, spatial units are grouped into categories defined by specified rate ranges, and then the units in each category are assigned a particular color in the map. We examined the consequences of using different ranging methods when comparing maps over several time intervals. Maps of mortality rates for cancers of the breast, lung (including the lung, trachea, bronchus, and pleura), and cervix uteri in the United States by county or state economic area are created for different time intervals between 1950 and 1994. Two ranging methods are employed: 1) Ranges are defined for individual time interval by the deciles of rates in that interval (ranging within intervals), and 2) constant ranges for all time intervals are defined by the deciles of rates for the entire 45-year period from 1950 through 1994 (ranging across intervals). The time intervals from 1950 through 1969 and from 1970 through 1994 were chosen to accommodate the availability of detailed county-level population estimates specifically for blacks starting in 1970. The ranging method has little impact on maps for breast cancer mortality, which changed little over time. For lung cancer, which increased over time, and cervix uteri cancer, which decreased over time, ranging within time intervals shows the geographic variability but does not convey the temporal trends. Trends are evident when ranging across time intervals is employed; however, geographic variability is partially obscured by the predominance of spatial units in the highest rate categories in the recent time intervals for lung cancer and in the early time intervals for cervix uteri cancer. Ranging within time intervals displays geographic patterns and changes in geographic patterns, regardless of time trends in rates. Ranging across time intervals shows temporal changes in rates but with some loss of information about geographic variability.

Empirical Bayes rules for selecting the most and least probable multivariate hypergeometric event

In this paper, we consider a multivariate hypergeometric population with k-category π = π( N, M, s 1,…, s k ), where s i , i = 1,…, k, is the number of units in category π i , with Σ i−1 k s i = M, the total number of units in population π, and N is the number of units selected from population π. Let s [1] = min 1⩽ i⩽ k s i , s [ k] = max 1⩽ i⩽ k s i . A category associated with s i = s [ k] (or s i = s [1]) is considered as the most (or the least) probable event. We are interested in selecting the most and the least probable event. It is assumed that the unknown parameters s i , i = 1,…, k, follow a multinomial prior distribution with unknown hyperparameters. Under this statistical framework, two empirical Bayes selection rules are studied according to the two different selection problems. It is shown that for each empirical Bayes selection rule, the corresponding Bayes risk tends to the minimum Bayes risk with a rate of convergence of order O(exp(− cn)) for some positive constant c, where the value of c varies depending on the rule and n is the number of accumulated past observations at hand.

Geometric units in tetragonal crystal structures

Tetragonal space groups are classified from the geometric-unit view point by considering crystal structures as a result of combinations and permutations of some basic polyhedral units. There are nine patterns among two categories represented by four units packed on the (1{\bar 1}0) and (100) planes. Category (I) consists of five types with four units packed on the (1{\bar 1}0) plane. The centers of these units are 0,0,0; 0,0,½; ½,½,0 and ½,½,½. In that order, the patterns can be represented by ABCD, AA'BB', ABA'B', ABB'A' and AA 'A"A". Each letter here represents an independent unit: primes are used to indicate one of the following orientation relationships: identity, fourfold rotation, mirror plane parallel to (110), and mirror plane parallel to (100). These units have the shape of tetragonal prisms and they stack in the same way as the crystallographic unit cells. Category (II) has four types packed on the (100) plane and the centers of these units are at 0,0,0; 0,½,¼; 0,0,½ and 0,½,¾. In that order, the patterns can be represented by ACBD, ABA 'B', AA 'BB' and AA'A"A". The ideal polyhedra for category (II) are truncated tetragonal prisms or flattened truncated octahedra depending on the axial ratio c/a. For simplicity, these polyhedra are transformed into tetragonal prisms so that all geometric units have the same shape. Units in category (II) stack in an interlocking fashion, like the work of a bricklayer. The overlap displacements for the interlocking are in the (001) direction. The symmetries of the geometric units in some space groups depend on the choice of origin, but a shift to equivalent origins changes neither the packing patterns nor the symmetries of the geometric units.

Gender and the Category Unit Augmented

Gender and the Category Unit Augmented