Chronic conditions in adults with cerebral palsy

Adults with cerebral palsy (CP) represent a growing population whose health status and healthcare needs are poorly understood.1 Mortality records reveal that death due to ischemic heart disease and cancer is higher among adults with CP;2 however, there have been no national surveillance efforts to track disease risk in this population. We examined estimates of chronic conditions in a population-representative sample of adults with CP

Willingness to Pay for Genetic Testing for Alzheimer's Disease: A Measure of Personal Utility

Background: The increased availability of genetic tests for common, complex diseases, such as Alzheimer's disease (AD), raises questions about what people are willing to pay for these services. Methods: We studied willingness-to-pay for genetic testing in a study of AD risk assessment that included APOE genotype disclosure among 276 first-degree relatives of persons with AD. Results: Seventy-one percent reported that they would ask for such testing from their doctor if it were covered by health insurance, and 60% would ask for it even if it required self-pay. Forty-one percent were willing to pay more than $100 for testing, and more than half would have been willing to pay for the test out of pocket. Participants who learned that they were APOE -4 positive and those who had higher education were less likely to want testing if covered by insurance, possibly to avoid discrimination. Conclusion: This is the first report to examine willingness to pay for susceptibility genetic testing in a sample of participants who had actually undergone such testing. These findings reveal that some participants find valuable personal utility in genetic risk information even when such information does not have proven clinical utility.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/90504/1/gtmb-2E2011-2E0028.pd

State of the California current 2013-14: El niño looming

In 2013, the California current was dominated by strong coastal upwelling and high productivity. Indices of total cumulative upwelling for particular coastal locations reached some of the highest values on record. Chlorophyll a levels were high throughout spring and summer. Catches of upwelling-related fish species were also high. After a moderate drop in upwelling during fall 2013, the California current system underwent a major change in phase. Three major basin-scale indicators, the PDO, the NPGO, and the ENSO-MEI, all changed phase at some point during the winter of 2013/14. The PDO changed to positive values, indicative of warmer waters in the North Pacific; the NPGO to negative values, indicative of lower productivity along the coast; and the MEI to positive values, indicative of an oncoming El Niño. Whereas the majority of the California Current system appears to have transitioned to an El Niño state by August 2014, based on decreases in upwelling and chlorophyll a concentration, and increases in SST, there still remained pockets of moderate upwelling, cold water, and high chlorophyll a biomass at various central coast locations, unlike patterns seen during the more major El Niños (e.g., the 97-98 event). Catches of rockfish, market squid, euphausiids, and juvenile sanddab remained high along the central coast, whereas catches of sardine and anchovy were low throughout the CCS. 2014 appears to be heading towards a moderate El Niño state, with some remaining patchy regions of upwellingdriven productivity along the coast. Superimposed on this pattern, three major regions have experienced possibly non-El Niño-related warming since winter: the Bering Sea, the Gulf of Alaska, and offshore of southern California. It is unclear how this warming may interact with the predicted El Niño, but the result will likely be reduced growth or reproduction for many key fisheries species

Overweight and obesity status from the prenatal period to adolescence and its association with non- alcoholic fatty liver disease in young adults: cohort study

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/156435/16/bjo16199-sup-0005-ICMJES2.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/156435/15/bjo16199-sup-0012-ICMJES12.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/156435/14/bjo16199_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/156435/13/bjo16199-sup-0010-ICMJES10.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/156435/12/bjo16199-sup-0002-TableS1.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/156435/11/bjo16199.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/156435/10/bjo16199-sup-0007-ICMJES4.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/156435/9/bjo16199-sup-0008-ICMJES5.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/156435/8/bjo16199-sup-0006-ICMJES3.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/156435/7/bjo16199-sup-0003-AppendixS1.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/156435/6/bjo16199-sup-0011-ICMJES11.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/156435/5/bjo16199-sup-0013-ICMJES13.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/156435/4/bjo16199-sup-0014-ICMJES14.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/156435/3/bjo16199-sup-0001-FigS1.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/156435/2/bjo16199-sup-0009-ICMJES6.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/156435/1/bjo16199-sup-0004-ICMJES1.pd

State of the California current 2012-13: No such thing as an “average” year

This report reviews the state of the California Current System (CCS) between winter 2012 and spring 2013, and includes observations from Washington State to Baja California. During 2012, large-scale climate modes indicated the CCS remained in a cool, productive phase present since 2007. The upwelling season was delayed north of 42°N, but regions to the south, especially 33° to 36°N, experienced average to above average upwelling that persisted throughout the summer. Contrary to the indication of high production suggested by the climate indices, chlorophyll observed from surveys and remote sensing was below average along much of the coast. As well, some members of the forage assemblages along the coast experienced low abundances in 2012 surveys. Specifically, the concentrations of all lifestages observed directly or from egg densities of Pacific sardine, Sardinops sagax, and northern anchovy, Engraulis mordax, were less than previous years’ survey estimates. However, 2013 surveys and observations indicate an increase in abundance of northern anchovy. During winter 2011/2012, the increased presence of northern copepod species off northern California was consistent with stronger southward transport. Krill and small-fraction zooplankton abundances, where examined, were generally above average. North of 42°N, salps returned to typical abundances in 2012 after greater observed concentrations in 2010 and 2011. In contrast, salp abundance off central and southern California increased after a period of southward transport during winter 2011/2012. Reproductive success of piscivorous Brandt’s cormorant, Phalacrocorax penicillatus, was reduced while planktivorous Cassin’s auklet, Ptychoramphus aleuticus was elevated. Differences between the productivity of these two seabirds may be related to the available forage assemblage observed in the surveys. California sea lion pups from San Miguel Island were undernourished resulting in a pup mortality event perhaps in response to changes in forage availability. Limited biological data were available for spring 2013, but strong winter upwelling coastwide indicated an early spring transition, with the strong upwelling persisting into early summer

Heavy Flavour Production at Tevatron and Parton Shower Effects

We present hadron-level predictions from the Monte Carlo generator Cascade and numerical calculations of charm and beauty production at the Fermilab Tevatron within the framework of the $k_T$-factorization QCD approach. Our consideration is based on the CCFM-evolved unintegrated gluon densities in a proton. The performed analysis covers the total and differential cross sections of open charm and beauty quarks, $B$ and $D$ mesons (or rather muons from their semileptonic decays) and the total and differential cross sections of $b \bar b$ di-jet hadroproduction. We study the theoretical uncertainties of our calculations and investigate the effects coming from parton showers in initial and final states. Our predictions are compared with the recent experimental data taken by the D0 and CDF collaborations. Special attention is put on the specific angular correlations between the final-state particles. We demonstrate that the final state parton shower plays a crucial role in the description of such observables. The decorrelated part of angular separations can be fully described, if the process $gg^*\rightarrow gg$ is included.Comment: Fig 8,9 10 replaced, small corrections in text A discussion of the delta phi results is adde

Noncommunicable disease and multimorbidity in young adults with cerebral palsy

Purpose: Individuals with cerebral palsy (CP) are at increased risk for frailty and chronic disease due to factors experienced throughout the lifespan, such as excessive sedentary behaviors and malnutrition. However, little is known about noncommunicable diseases (NCDs) and multimorbidity profiles in young adults with CP. The study objective was to compare NCD and multimorbidity profiles between young adults with and without CP. Methods: A clinic-based sample of adults (18–30 years) with (n=452) and without (n=448) CP was examined at the University of Michigan Medical Center. The prevalence and predictors of 13 NCDs were evaluated, including existing diagnoses or historical record of musculoskeletal, cardiometabolic, and pulmonary morbidities. The level of motor impairment was determined by the Gross Motor Function Classification System (GMFCS) and stratified by less vs more severe motor impairment (GMFCS I–III vs IV–V). Logistic regression was used to determine the odds of NCD morbidity and multimorbidity in adults with CP compared to adults without CP, and for GMFCS IV–V compared to GMFCS I–III in those with CP, after adjusting for age, sex, body mass index, and smoking. Results: Adults with CP had a higher prevalence of osteopenia, osteoporosis, hypertension, myocardial infarction, hyperlipidemia, asthma, and multimorbidity compared to adults without CP, and higher odds of musculoskeletal (odds ratio [OR]: 6.97) and cardiometabolic morbidity (OR: 1.98), and multimorbidity (OR: 2.67). Adults with CP with GMFCS levels IV–V had a higher prevalence of osteopenia/osteoporosis, osteoarthritis, hypertension, other cardiovascular conditions, pulmonary embolism, and multimorbidity, and higher odds of musculoskeletal (OR: 3.41), cardiometabolic (OR: 2.05), pulmonary morbidity (OR: 1.42), and multimorbidity (OR: 3.45) compared to GMFCS I–III. Conclusion: Young adults with CP have a higher prevalence of chronic NCDs and multimorbidity compared to young adults without CP, which is pronounced in those with more severe motor impairment. These findings reiterate the importance of early screening for prevention of NCDs in CPNational Institutes of Health (NIH) and the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR

Amplified mid-latitude planetary waves favour particular regional weather extremes

Copyright © 2014 Nature Publishing GroupThere has been an ostensibly large number of extreme weather events in the Northern Hemisphere mid-latitudes during the past decade [1]. An open question that is critically important for scientists and policy makers is whether any such increase in weather extremes is natural or anthropogenic in origin [2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13]. One mechanism proposed to explain the increased frequency of extreme weather events is the amplification of mid-latitude atmospheric planetary waves [14, 15, 16, 17]. Disproportionately large warming in the northern polar regions compared with mid-latitudes—and associated weakening of the north–south temperature gradient—may favour larger amplitude planetary waves [14, 15, 16, 17], although observational evidence for this remains inconclusive [18, 19, 20, 21]. A better understanding of the role of planetary waves in causing mid-latitude weather extremes is essential for assessing the potential environmental and socio-economic impacts of future planetary wave changes. Here we show that months of extreme weather over mid-latitudes are commonly accompanied by significantly amplified quasi-stationary mid-tropospheric planetary waves. Conversely, months of near-average weather over mid-latitudes are often accompanied by significantly attenuated waves. Depending on geographical region, certain types of extreme weather (for example, hot, cold, wet, dry) are more strongly related to wave amplitude changes than others. The findings suggest that amplification of quasi-stationary waves preferentially increases the probabilities of heat waves in western North America and central Asia, cold outbreaks in eastern North America, droughts in central North America, Europe and central Asia, and wet spells in western Asia.Natural Environment Research Council (NERC