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Physical Sciences and Mathematics

2010

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Dna Methylation And Its Association With Prenatal Exposures And Pregnancy Outcomes, Jennifer Straughen Dec 2010

Dna Methylation And Its Association With Prenatal Exposures And Pregnancy Outcomes, Jennifer Straughen

USF Tampa Graduate Theses and Dissertations

Altered DNA methylation may lead to suboptimal fetal programming, increasing the risk of adverse pregnancy outcomes such as small for gestational age (SGA); however, few studies have examined the associations between DNA methylation, prenatal exposures, and fetal outcomes. Cross-sectional data from a larger, ongoing study were used to assess the impact of prenatal smoking on gene specific methylation of umbilical cord blood derived DNA and to investigate the association between gene-specific methylation and risk of SGA. The association between gene-specific DNA methylation and birthweight was also assessed. Maternal and infant covariates were abstracted from medical records, cigarette smoke exposure was …


Evaluation Of Common Inherited Variants In Mitochondrial-Related And Microrna-Related Genes As Novel Risk Factors For Ovarian Cancer, Jennifer Permuth Wey Dec 2010

Evaluation Of Common Inherited Variants In Mitochondrial-Related And Microrna-Related Genes As Novel Risk Factors For Ovarian Cancer, Jennifer Permuth Wey

USF Tampa Graduate Theses and Dissertations

Epithelial ovarian cancer (EOC) is a leading cause of morbidity and mortality among women in the United States, and the etiology is incompletely understood. Common, low penetrant genetic variants such as single nucleotide polymorphisms (SNPs) likely contribute to a significant proportion of EOC. We examined whether SNPs in two understudied yet biologically important types of genes, mitochondrial-related and miRNA-related genes, may contribute to EOC susceptibility using data from a large, homogeneous study population of 1,815 EOC cases and 1,900 controls (frequency-matched on age-group and race/ethnicity) genotyped through stage 1 of an ongoing genome-wide association study. Inter-individual variation in genes involved …


Aspects Of The Life History Of The Snowy Grouper, Epinephelus Niveatus, In The Gulf Of Mexico, Kelley Kowal Dec 2010

Aspects Of The Life History Of The Snowy Grouper, Epinephelus Niveatus, In The Gulf Of Mexico, Kelley Kowal

USF Tampa Graduate Theses and Dissertations

Knowledge of many life history parameters are essential to properly assess and manage fish species. Although the snowy grouper, Epinephelus niveatus, is a commercially valuable fish, which is harvested throughout the Gulf of Mexico, little is known about its age, growth, and reproduction from this region. In this study, snowy grouper from the northern and eastern regions of the Gulf of Mexico were examined primarily using commercially-derived samples that were collected between 1984 and 2004. A total of 1,200 snowy grouper with fork lengths between 242 and 1,190 mm were collected. Sectioned saggital otoliths were used to determine the age …


Identifying Landscape Quality Objectives For Gozo, Stephanie Farrugia Dec 2010

Identifying Landscape Quality Objectives For Gozo, Stephanie Farrugia

Masters Theses, 2010-2019

The study of landscape quality has not been researched to a significant degree in Malta to date. This qualitative study explores different viewpoints in relation to perceptions of landscape quality, at present and in the future, on the island of Gozo, based on provisions of the European Landscape Convention. The latter, to which Malta is a signatory state, calls for the identification of landscape quality objectives, which should reflect public aspirations. Primary data collection methods, comprising community focus groups and key informant semi-structured interviews were used, together with an extensive document analysis, to understand a range of perceptions of present …


Assessing Vulnerability To Coastal Hazards Case Study: Gozo, Jonathan Portelli Dec 2010

Assessing Vulnerability To Coastal Hazards Case Study: Gozo, Jonathan Portelli

Masters Theses, 2010-2019

All coastal areas around the globe are vulnerable to a series of potential hazards at different degrees depending on location, altitude above sea level, geomorphological features and socio-economic factors, including demography, human settlement and infrastructural development. Since the 1990s a major effort in developing appropriate methodologies and guidelines to assess coastal vulnerability has been made. Of significant importance, the coast of Gozo embraces both natural and anthropogenic features that occupy a relatively small area. Consequently, coastal vulnerability by multiple coastal hazards is a fact due to the topography of the island, overpopulation in some coastal locations, and intensive coastal development …


Racial Disparities Study In Diabetes-Related Complication Using National Health Survey Data, Fengxia Yan Dec 2010

Racial Disparities Study In Diabetes-Related Complication Using National Health Survey Data, Fengxia Yan

Mathematics Theses

The main aim of this study is to compare the prevalence of diabetes-related complications in white to the prevalence in other racial and ethnic groups in United States using 2009 Behavioral Risk Factor Surveillance System (BRFSS). By constructing the logistic regression model, odds ratios (OR) were calculated to compare the prevalence of diabetes complications in white and other groups. Compared to white, the prevalence of hypertension and stroke in African Americans were higher, while the prevalence of heart attack and coronary heart disease were lower. The Asian Americans or Pacific Islanders, African Americans and Hispanics were more likely to develop …


Biomarkers Of Mild Cognitive Impairment And Alzheimer's Disease, Mark A. Lovell, Bert C. Lynn Dec 2010

Biomarkers Of Mild Cognitive Impairment And Alzheimer's Disease, Mark A. Lovell, Bert C. Lynn

Chemistry Faculty Patents

A method for quantifying a neurodegenerative disorder in a patient that includes obtaining a fluid sample from the subject; measuring a protein biomarker complex in said fluid sample and correlating the measurement with mild cognitive impairment or Alzheimer's disease status. The biomarkers include those that comprise at least one of a transthyretin protein and/or a prostaglandin-H2 D-isomerase protein, and at least one second, different protein selected from a transthyretin, prostaglandin-H2 D-isomerase, beta-2-microglobulin, cystatin C, superoxide dismutase [Cu—Zn], plasma retinol-binding protein, phosphatidylethanolamine-binding protein, carbonic anhydrase 2, prostaglandin-H2 D-isomerase, and/or serotransferrin protein.


A Framework For Group Modeling In Agent-Based Pedestrian Crowd Simulations, Fasheng Qiu Dec 2010

A Framework For Group Modeling In Agent-Based Pedestrian Crowd Simulations, Fasheng Qiu

Computer Science Dissertations

Pedestrian crowd simulation explores crowd behaviors in virtual environments. It is extensively studied in many areas, such as safety and civil engineering, transportation, social science, entertainment industry and so on. As a common phenomenon in pedestrian crowds, grouping can play important roles in crowd behaviors. To achieve more realistic simulations, it is important to support group modeling in crowd behaviors. Nevertheless, group modeling is still an open and challenging problem. The influence of groups on the dynamics of crowd movement has not been incorporated into most existing crowd models because of the complexity nature of social groups. This research develops …


Shovelnose Sturgeon Age And Growth Characteristics And Fish Community Characteristics Of The Lower Platte River And Missouri River Near Nebraska, Tara L. Anderson Dec 2010

Shovelnose Sturgeon Age And Growth Characteristics And Fish Community Characteristics Of The Lower Platte River And Missouri River Near Nebraska, Tara L. Anderson

School of Natural Resources: Dissertations, Theses, and Student Research

There have been documented widespread losses of freshwater biodiversity over the past several decades. Many of these losses may be due to anthropogenic causes such as habitat alterations, pollution, and overharvest. Shovelnose sturgeon may also be influenced by anthropogenic causes and have experienced declines in population abundance near Nebraska. My objectives were to first to describe the age, growth and mortality of shovelnose sturgeon found in the lower Platte River (LPR). Second, I quantitatively evaluated similarities and differences between the Missouri River (MR) and the LPR fish community composition (presence-absence of species) and structure (abundance of species). We used trammel …


Minerva 2010, The Honors College Dec 2010

Minerva 2010, The Honors College

Minerva

This issue of Minerva celebrates the 75th anniversary of Honors at the University of Maine! It includes an article on the college's 75th anniversary celebration; a look into the inaugural Center for Undergraduate Research (CUGR) symposium; and discussions on 2010 Honors Read, Persepolis, as well as 2011 Honors Read, The Omnivore's Dilemma. Other highlights include an article on Honors graduate and historian, Kristen Gwinn, and her book Emily Greene Balch: The Long Road to Internationalism.


Addressing The Problem Of Non-Response And Response Bias, Fabian C. Okafor Dec 2010

Addressing The Problem Of Non-Response And Response Bias, Fabian C. Okafor

CBN Journal of Applied Statistics (JAS)

Survey planners and analysts in Nigeria have devoted much more attention to sampling errors at the expense of nonsampling errors (non-response and response errors). Sampling error is the degree to which the sample estimate differs from the average value of the characteristic due to chance. The present discussion will be centered on non-sampling error, which may present serious deficiencies in the statistics and render the survey useless. According to Platek and Gray (1986), “Non-response has been generally recognized as important measure of the quality of data since it affects the estimates by introducing a possible bias in the estimates and …


The Human Population Growth And Its Ecological Consequences On Kenya And Tanzania, Lauren Noll Dec 2010

The Human Population Growth And Its Ecological Consequences On Kenya And Tanzania, Lauren Noll

Student Theses 2001-2013

The world population is growing at an alarming rate. The rapid growth in population numbers and density along with the steady increase in the rates are causing issues in many countries. Although every country is experiencing many consequences of the growth, the countries of Kenya and Tanzania in East Africa seem to be suffering immensely. Not only does the increasing human population in these third world countries create an overarching competition for natural resources such as food, water, and land, the growth also has detrimental effects on the surrounding environment, wildlife populations, ecotourism, and traditional African cultures.


A Multivariate Latent Variable Model For Mixed – Data From Continuous And Ordinal Responses With Possibility Of Missing Responses, Ehsan B. Samani, M. Ganjali Dec 2010

A Multivariate Latent Variable Model For Mixed – Data From Continuous And Ordinal Responses With Possibility Of Missing Responses, Ehsan B. Samani, M. Ganjali

Applications and Applied Mathematics: An International Journal (AAM)

A joint model for multivariate mixed ordinal and continuous outcomes with potentially non-random missing values in both types of responses is proposed. A full likelihood-based approach is used to obtain maximum likelihood estimates of the model parameters. Some modified Pearson residuals are also introduced where the correlation between responses are taken into account. The joint modelling of responses with the possibility of missing values requires caution since the interpretation of the fitted model highly depends on the missing mechanism assumptions that are unexaminable in a fundamental sense. A common way to investigate the influence of perturbations of model components on …


Aflatoxin B1 Albumin Adducts In Plasma And Aflatoxin M1 In Urine Are Associated With Plasma Concentrations Of Vitamins A And E, Francis A. Obuseh, Pauline E. Jolly, Yi Jiang, Faisal M. B. Shuaib, John Waterbor, William O. Ellis, Chandrika J. Piyathilake, Renee A. Desmond, Evans Afriyie-Gyawu, Timothy D. Phillips Dec 2010

Aflatoxin B1 Albumin Adducts In Plasma And Aflatoxin M1 In Urine Are Associated With Plasma Concentrations Of Vitamins A And E, Francis A. Obuseh, Pauline E. Jolly, Yi Jiang, Faisal M. B. Shuaib, John Waterbor, William O. Ellis, Chandrika J. Piyathilake, Renee A. Desmond, Evans Afriyie-Gyawu, Timothy D. Phillips

Evans Afriyie-Gyawu

Background: Although aflatoxin exposure has been shown to be associated with micronutrient deficiency in animals, there are few investigations on the effects of aflatoxin exposure on micronutrient metabolism in humans.
Objective: To examine the relationship between aflatoxin B1 (AFB1) albumin adducts (AF-ALB) in plasma and the aflatoxin M1 (AFM1) metabolite in urine and plasma concentrations of retinol (vitamin A) and α-tocopherol (vitamin E) in Ghanaians.
Methods: A cross-sectional study of 147 adult participants was conducted. Blood and urine samples were tested for aflatoxin and vitamins A and E levels.
Results: Multivariable analysis showed that participants with high AF-ALB (≥ 0.80 …


Voices, Echoes, And Narratives: Multidimensional Experiences Of Three Teachers Immersed In Ethnomathematical Encounters In Morocco, Mekyah Q. Mcqueen, Stanley F. H. Shaheed, Curtis V. Goings, Iman C. Chahine Dec 2010

Voices, Echoes, And Narratives: Multidimensional Experiences Of Three Teachers Immersed In Ethnomathematical Encounters In Morocco, Mekyah Q. Mcqueen, Stanley F. H. Shaheed, Curtis V. Goings, Iman C. Chahine

Middle-Secondary Education and Instructional Technology Faculty Publications

No abstract provided.


How Is It That One Particular Statement Appeared Rather Than Another?: Opening A Different Space For Different Statements About Urban Mathematics Education, David W. Stinson Dec 2010

How Is It That One Particular Statement Appeared Rather Than Another?: Opening A Different Space For Different Statements About Urban Mathematics Education, David W. Stinson

Middle-Secondary Education and Instructional Technology Faculty Publications

In this editorial, the author applies Michel Foucault's concept of "discursive formations" to examine fictions, fantasies, and power relationships in mathematics education research.


Effects Of Acculturation On Hiv/Aids Sexual Risk Behaviors Among Asian And Pacific Islander (Api) Women, Margaret Cabotage Salud Dec 2010

Effects Of Acculturation On Hiv/Aids Sexual Risk Behaviors Among Asian And Pacific Islander (Api) Women, Margaret Cabotage Salud

Loma Linda University Electronic Theses, Dissertations & Projects

Background. In the US women are the fastest growing group for sexually transmitted infections (STIs), including HIV and AIDS. In addition, the estimated AIDS cases among female adults and adolescents, aged 13-19, increased from 7% in 1985 to approximately 26% in 2002. Most infections occur by heterosexual transmission with 53% occurring through contact with a high-risk sexual partner. While overall HIV/AIDS rates in the Asian Pacific Islander (API) community remain low, they are rising and HIV testing rates, one of the major prevention strategies for HIV, are lower than that of other populations. Furthermore, very little is known about APIs …


Coronary Heart Disease Mortality And Long-Term Exposure To Ambient Particulate Air Pollutants In Elderly Nonsmoking California Residents, Lie Hong Chen Dec 2010

Coronary Heart Disease Mortality And Long-Term Exposure To Ambient Particulate Air Pollutants In Elderly Nonsmoking California Residents, Lie Hong Chen

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study is to assess the effect of long-term concentrations of ambient PM on risks of all causes, cardiopulmonary, coronary heart disease (CHD), total cancer, and any mention of nonmalignant respiratory disease (NMRD) mortality.

The health effects of long-term ambient air pollution have been studied with up to 30 years of follow-up in the AHSMOG cohort, a cohort of 6,338 nonsmoking white California adults. Monthly concentrations of ambient air pollutants [particulate matter(PMio), Ozone (O3), sulfur dioxide (SO2), nitrogen dioxide (NO2) or particulate matter

In the AHSMOG cohort, each increment of 10 |ig/m3 in PMio in two-pollutant models …


Conservation From The Bottom-Up: Human, Financial, And Natural Capital As Determinants Of Resilient Livelihoods In Kigoma Rural, Tanzania, Yared J. Fubusa Dec 2010

Conservation From The Bottom-Up: Human, Financial, And Natural Capital As Determinants Of Resilient Livelihoods In Kigoma Rural, Tanzania, Yared J. Fubusa

All Graduate Theses and Dissertations, Spring 1920 to Summer 2023

Rhetoric of "community-based conservation" has gained prominence among development specialists and environmentalists, yet such projects are often implemented from the top-down in Africa. This dissertation contends that only a bottom-up approach can foster resilient livelihoods and environmental stewardship.

This study focused on determinants of household resilience within a poverty-stricken agricultural community near Gombe Stream National Park (GSNP) in western Tanzania. The research purpose was to explore: 1) relationships between villagers and GSNP management; 2) how groups and individuals view priority livelihood problems and solutions; 3) various attributes of households; and 4) perceived trends for household resilience and how these are …


Analysis Of A Database Insider Threat Model, Andrea Samuel Dec 2010

Analysis Of A Database Insider Threat Model, Andrea Samuel

Computer Science and Computer Engineering Undergraduate Honors Theses

According to Silicon.com's CIO Insight - Beware the Insider Security Threat, insiders are bigger threats to corporate security than external threats such as denial of service attacks or malware. Statistics show that 70% of fraud is perpetrated by staff and that the main data security threat comes from poorly trained or disgruntled employees who are authorized to have access to data and file stores [4]. This research project focuses specifically on the problem of insider threat in relational database systems. The project involves simulating research conducted in Qussai Yaseen and Brajendra Panda's research paper, Predicting and Preventing Insider Threat in …


Review Of Grouse Of The Plains And Mountains - The South Dakota Story, By Lester D. Flake, John W. Connelly, Thomas R. Kirschenmann, And Andrew J. Lindbloom., Brent E. Jamison Dec 2010

Review Of Grouse Of The Plains And Mountains - The South Dakota Story, By Lester D. Flake, John W. Connelly, Thomas R. Kirschenmann, And Andrew J. Lindbloom., Brent E. Jamison

The Prairie Naturalist

Grouse are a fascinating group of birds that offer elaborate breeding displays for birders in the spring, provide sporting opportunities for hunters in the fall, and serve as indicators of grassland health. Though the authors claim that the book targets those who enjoy the outdoors, bird watching, and upland game bird hunting, there is ample reason for ecologists, ornithologists, and grouse researchers to reference this book as well. The book contains general information of interest to a broad audience, but often moves beyond the introductory information to greater detail. Many details are supported by peer-reviewed literature. This book strikes a …


Educators' Attitudes Toward Outdoor Classrooms And The Cognitive Benefits In Children, Carlie Speedlin Dec 2010

Educators' Attitudes Toward Outdoor Classrooms And The Cognitive Benefits In Children, Carlie Speedlin

Department of Environmental Studies: Undergraduate Student Theses

A case study was organized at a K-5 elementary school in Lincoln, Nebraksa. This school is Saratoga Elementary School and is a United States Title I Distinguished School1 under No Child Left Behind. It has a population of 266 students, with 47% being minority, 1% gifted, and 28% special education (LPS School Profile Brochure). 80% of the student population is eligible for free/reduced meals, implying that it’s a school with a lower socioeconomic status. At this school a garden space was constructed and an after school garden club was implemented for this case study. The club had been running since …


Who Wins And Who Loses? A Community Approach To Understanding The Well-Being Of Boomtown Residents, Douglas Alan Malloy Dec 2010

Who Wins And Who Loses? A Community Approach To Understanding The Well-Being Of Boomtown Residents, Douglas Alan Malloy

All Graduate Theses and Dissertations, Spring 1920 to Summer 2023

The purpose of this thesis is to accurately identify residents of a boomtown who are either experiencing a higher level of well-being, or lower level of well-being. By definition, we consider the former to be winning, and the latter to be losing. Multivariate ordinary least squares regression analyses help to distinguish between winners and losers by generating statistical coefficients which will show both strength and direction of the relationship between individuals and various indicators of social well-being.

The data used in this thesis are from a community impact study issued in the spring of 2009, to residents of …


The Update, December 2010, University Of Northern Iowa. College Of Humanities, Arts And Sciences. Dec 2010

The Update, December 2010, University Of Northern Iowa. College Of Humanities, Arts And Sciences.

Update

Inside this issue:

-- American Chemical Society, a student affiliate group
-- Department News
-- Iowa Writing Project
-- UNI School of Music to Host 50th Anniversary Celebration: Varsity Men's Glee Club Christmas Variety Shows
-- Communication Studies: Student Showcased on the Jay Leno Show
-- Dmitri Vorobiev: An All Beethoven Recital Series
-- Student Spotlight: Philosophy: Joel Anderson
-- Student Spotlight: World Religions: Elizabeth Wiedenheft
-- Student Spotlight: Industrial Technology: Hannah Loan
-- UNI Students attend and participate in sixth Annual Multicultural Conference
-- Student Spotlights Continued
-- School of Music Events
-- UNI Forensics
-- Communication Studies Students …


Evaluation Of Spotlight Surveys For Monitoring Mink Populations In Coastal South Carolina, Michael Waller Dec 2010

Evaluation Of Spotlight Surveys For Monitoring Mink Populations In Coastal South Carolina, Michael Waller

All Theses

Annual commercial fur harvest data suggests a decline in South Carolina's mink (Mustela vison) populations over the past century (Butfiloski and Baker 2005). In 1990, DNR began conducting assessments of South Carolina's coastal marshes, revealing mink populations to be scarce to absent in the northern coastal regions (Baker 1999). Since 1999, restoration efforts have re-established mink populations in the Cape Romain National Wildlife Refuge and additional areas in the northern coastal marshes of South Carolina. Because mink are a species of high conservation priority throughout the coastal zone of South Carolina, it is important to develop and implement a reliable …


Farmers' Markets In Kentucky: A Geospatial, Statistical, And Cultural Analysis, Elizabeth Ann Schmitz Dec 2010

Farmers' Markets In Kentucky: A Geospatial, Statistical, And Cultural Analysis, Elizabeth Ann Schmitz

Masters Theses & Specialist Projects

To assess what factors are driving the exponential growth of farmers’ markets in Kentucky, geospatial and statistical analysis of a database of 121 farmers’ markets was conducted. A statewide survey of market leaders and a case study of a single farmers’ market both identified reasons for growing support of farmers’ markets in Kentucky.

Market distribution, vendor levels, and gross sales were mapped against a backdrop of county urban classification, median household income, and education levels. Kruskal-Wallace analysis was used to identify if Kentucky’s rural, micropolitan, and metropolitan markets differ significantly in terms of their age, number of vendors, and market …


Robust Interval Estimation Of A Treatment Effect In Observational Studies Using Propensity Score Matching, Scott F. Kosten Dec 2010

Robust Interval Estimation Of A Treatment Effect In Observational Studies Using Propensity Score Matching, Scott F. Kosten

Dissertations

Estimating the treatment effect between a treatment group and a control group in an observational study is a challenging problem in statistics. Without random assignment of subjects, there are likely to be differences between the treatment group and control group on a set of baseline covariates. If one of these baseline covariates is correlated to the response variable, then the difference in sample means between the groups is likely to be a biased estimate of the true treatment effect.

Propensity score matching has become an increasingly popular strategy for reducing bias in estimates of the treatment effect. This reduction in …


Influence Of Sex On Long-Term Outcomes After Percutaneous Coronary Intervention With The Paclitaxel-Eluting Coronary Stent: Results Of The "Taxus Woman" Analysis, Ghada W. Mikhail Md, Robert T. Gerber Md, Phd, David A. Cox Md, Stephen G. Ellis Md, John M. Lasala Md, Phd, John A. Ormiston Mbchb, Gregg W. Stone Md, Mark A. Turco Md, Anita A. Joshi Phd, Donald S. Baim Md, Antonio Colombo Md Dec 2010

Influence Of Sex On Long-Term Outcomes After Percutaneous Coronary Intervention With The Paclitaxel-Eluting Coronary Stent: Results Of The "Taxus Woman" Analysis, Ghada W. Mikhail Md, Robert T. Gerber Md, Phd, David A. Cox Md, Stephen G. Ellis Md, John M. Lasala Md, Phd, John A. Ormiston Mbchb, Gregg W. Stone Md, Mark A. Turco Md, Anita A. Joshi Phd, Donald S. Baim Md, Antonio Colombo Md

Department of Medicine

No abstract provided.


A Study On Eco-Friendly Merchandise In A Resort Retail Environment, Lindsey C. Patrick Dec 2010

A Study On Eco-Friendly Merchandise In A Resort Retail Environment, Lindsey C. Patrick

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study is to determine consumer purchasing habits of ecofriendly apparel in a retail resort environment. In order to find the rationale behind purchasing decisions, this study measured sales and survey responses based on the choice of two tee shirt options, eco-friendly tee shirts and regular cotton tee shirts. The survey was given to all customers purchasing these tee shirts in order to determine specific demographic information as well as their personal opinions on eco-friendliness, and willingness to pay a premium for eco-friendly products. Due to a lack of previous research in this field, this study is …


The Determinants Of Colorectal Cancer Survival Disparities In Nevada, Lucas N. Wassira Dec 2010

The Determinants Of Colorectal Cancer Survival Disparities In Nevada, Lucas N. Wassira

UNLV Theses, Dissertations, Professional Papers, and Capstones

Different population groups across Nevada and throughout the United States suffer disproportionately from colorectal cancer and its after-effects. Overcoming cancer health disparities is important for lessening the burden of cancer. There has been an overall decline in the incidence of and mortality from colorectal cancer (CRC). This is likely due, in part, to the increasing use of screening procedures such as Fecal Occult Blood Test (FOBT) and/or endoscopy, which can reduce the risk of CRC mortality by fifty percent. Nevertheless, screening procedures are routinely used by only fifty percent of Americans aged fifty years and older. Despite overall mortality decreasing …