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Sample records for multiple cohort design

  1. Evaluation of biases present in the cohort multiple randomised controlled trial design : a simulation study

    Candlish, Jane; Pate, Alexander; Sperrin, Matthew; Staa, Tjeerd P van

    2017-01-01

    BACKGROUND: The cohort multiple randomised controlled trial (cmRCT) design provides an opportunity to incorporate the benefits of randomisation within clinical practice; thus reducing costs, integrating electronic healthcare records, and improving external validity. This study aims to address a key

  2. Evaluation of biases present in the cohort multiple randomised controlled trial design: a simulation study

    Jane Candlish

    2017-01-01

    Full Text Available Abstract Background The cohort multiple randomised controlled trial (cmRCT design provides an opportunity to incorporate the benefits of randomisation within clinical practice; thus reducing costs, integrating electronic healthcare records, and improving external validity. This study aims to address a key concern of the cmRCT design: refusal to treatment is only present in the intervention arm, and this may lead to bias and reduce statistical power. Methods We used simulation studies to assess the effect of this refusal, both random and related to event risk, on bias of the effect estimator and statistical power. A series of simulations were undertaken that represent a cmRCT trial with time-to-event endpoint. Intention-to-treat (ITT, per protocol (PP, and instrumental variable (IV analysis methods, two stage predictor substitution and two stage residual inclusion, were compared for various refusal scenarios. Results We found the IV methods provide a less biased estimator for the causal effect when refusal is present in the intervention arm, with the two stage residual inclusion method performing best with regards to minimum bias and sufficient power. We demonstrate that sample sizes should be adapted based on expected and actual refusal rates in order to be sufficiently powered for IV analysis. Conclusion We recommend running both an IV and ITT analyses in an individually randomised cmRCT as it is expected that the effect size of interest, or the effect we would observe in clinical practice, would lie somewhere between that estimated with ITT and IV analyses. The optimum (in terms of bias and power instrumental variable method was the two stage residual inclusion method. We recommend using adaptive power calculations, updating them as refusal rates are collected in the trial recruitment phase in order to be sufficiently powered for IV analysis.

  3. Benefits and challenges of using the cohort multiple randomised controlled trial design for testing an intervention for depression.

    Viksveen, Petter; Relton, Clare; Nicholl, Jon

    2017-07-06

    Trials which test the effectiveness of interventions compared with the status quo frequently encounter challenges. The cohort multiple randomised controlled trial (cmRCT) design is an innovative approach to the design and conduct of pragmatic trials which seeks to address some of these challenges. In this article, we report our experiences with the first completed randomised controlled trial (RCT) using the cmRCT design. This trial-the Depression in South Yorkshire (DEPSY) trial-involved comparison of treatment as usual (TAU) with TAU plus the offer of an intervention for people with self-reported long-term moderate to severe depression. In the trial, we used an existing large population-based cohort: the Yorkshire Health Study. We discuss our experiences with recruitment, attrition, crossover, data analysis, generalisability of results, and cost. The main challenges in using the cmRCT design were the high crossover to the control group and the lower questionnaire response rate among patients who refused the offer of treatment. However, the design did help facilitate efficient and complete recruitment of the trial population as well as analysable data that were generalisable to the population of interest. Attrition rates were also smaller than those reported in other depression trials. This first completed full trial using the cmRCT design testing an intervention for self-reported depression was associated with a number of important benefits. Further research is required to compare the acceptability and cost effectiveness of standard pragmatic RCT design with the cmRCT design. ISRCTN registry: ISRCTN02484593 . Registered on 7 Jan 2013.

  4. Comparing conVEntional RadioTherapy with stereotactIC body radiotherapy in patients with spinAL metastases: study protocol for an randomized controlled trial following the cohort multiple randomized controlled trial design

    Velden, Joanne M. van der; Verkooijen, Helena M.; Seravalli, Enrica; Hes, Jochem; Gerlich, A. Sophie; Kasperts, Nicolien; Eppinga, Wietse S. C.; Verlaan, Jorrit-Jan; Vulpen, Marco van

    2016-01-01

    Standard radiotherapy is the treatment of first choice in patients with symptomatic spinal metastases, but is only moderately effective. Stereotactic body radiation therapy is increasingly used to treat spinal metastases, without randomized evidence of superiority over standard radiotherapy. The VERTICAL study aims to quantify the effect of stereotactic radiation therapy in patients with metastatic spinal disease. This study follows the ‘cohort multiple Randomized Controlled Trial’ design. The VERTICAL study is conducted within the PRESENT cohort. In PRESENT, all patients with bone metastases referred for radiation therapy are enrolled. For each patient, clinical and patient-reported outcomes are captured at baseline and at regular intervals during follow-up. In addition, patients give informed consent to be offered experimental interventions. Within PRESENT, 110 patients are identified as a sub cohort of eligible patients (i.e. patients with unirradiated painful, mechanically stable spinal metastases who are able to undergo stereotactic radiation therapy). After a protocol amendment, also patients with non-spinal bony metastases are eligible. From the sub cohort, a random selection of patients is offered stereotactic radiation therapy (n = 55), which patients may accept or refuse. Only patients accepting stereotactic radiation therapy sign informed consent for the VERTICAL trial. Non-selected patients (n = 55) receive standard radiotherapy, and are not aware of them serving as controls. Primary endpoint is pain response after three months. Data will be analyzed by intention to treat, complemented by instrumental variable analysis in case of substantial refusal of the stereotactic radiation therapy in the intervention arm. This study is designed to quantify the treatment response after (stereotactic) radiation therapy in patients with symptomatic spinal metastases. This is the first randomized study in palliative care following the cohort multiple Randomized

  5. Symptomen en persoonlijkheidsproblemen voor, tijdens en na langdurige psychoanalytische behandelingen: een multiple-cohort studie

    Berghout, C.C.; Zevalkink, D.J.; Jong, J.T.V.M. de

    2010-01-01

    Using a multiple cohort design, we compared symptoms and personality functioning (SCL-90, BDI-II, STAI, IIP-64, MMPI-2) of patients (N = 231) in different phases of long-term psychoanalytic treatment (before, during, end, follow-up). Our results confirmed findings from earlier meta-analyses that

  6. The multiple sclerosis visual pathway cohort: understanding neurodegeneration in MS.

    Martínez-Lapiscina, Elena H; Fraga-Pumar, Elena; Gabilondo, Iñigo; Martínez-Heras, Eloy; Torres-Torres, Ruben; Ortiz-Pérez, Santiago; Llufriu, Sara; Tercero, Ana; Andorra, Magi; Roca, Marc Figueras; Lampert, Erika; Zubizarreta, Irati; Saiz, Albert; Sanchez-Dalmau, Bernardo; Villoslada, Pablo

    2014-12-15

    Multiple Sclerosis (MS) is an immune-mediated disease of the Central Nervous System with two major underlying etiopathogenic processes: inflammation and neurodegeneration. The latter determines the prognosis of this disease. MS is the main cause of non-traumatic disability in middle-aged populations. The MS-VisualPath Cohort was set up to study the neurodegenerative component of MS using advanced imaging techniques by focusing on analysis of the visual pathway in a middle-aged MS population in Barcelona, Spain. We started the recruitment of patients in the early phase of MS in 2010 and it remains permanently open. All patients undergo a complete neurological and ophthalmological examination including measurements of physical and disability (Expanded Disability Status Scale; Multiple Sclerosis Functional Composite and neuropsychological tests), disease activity (relapses) and visual function testing (visual acuity, color vision and visual field). The MS-VisualPath protocol also assesses the presence of anxiety and depressive symptoms (Hospital Anxiety and Depression Scale), general quality of life (SF-36) and visual quality of life (25-Item National Eye Institute Visual Function Questionnaire with the 10-Item Neuro-Ophthalmic Supplement). In addition, the imaging protocol includes both retinal (Optical Coherence Tomography and Wide-Field Fundus Imaging) and brain imaging (Magnetic Resonance Imaging). Finally, multifocal Visual Evoked Potentials are used to perform neurophysiological assessment of the visual pathway. The analysis of the visual pathway with advance imaging and electrophysilogical tools in parallel with clinical information will provide significant and new knowledge regarding neurodegeneration in MS and provide new clinical and imaging biomarkers to help monitor disease progression in these patients.

  7. Symptoms and personality problems before, during and after long-term psychoanalytic treatment: A multiple-cohort study

    Berghout, C.C.; Zevalkink, D.J.; de Jong, J.T.V.M.

    2010-01-01

    Using a multiple cohort design, we compared symptoms and personality functioning (SCL-90, BDI-II, STAI, IIP-64, MMPI-2) of patients (N= 231) in different phases of long-term psychoanalytic treatment (before, during, end, follow-up). Our results confirmed findings from earlier meta-analyses that

  8. Secondary Analysis under Cohort Sampling Designs Using Conditional Likelihood

    Olli Saarela

    2012-01-01

    Full Text Available Under cohort sampling designs, additional covariate data are collected on cases of a specific type and a randomly selected subset of noncases, primarily for the purpose of studying associations with a time-to-event response of interest. With such data available, an interest may arise to reuse them for studying associations between the additional covariate data and a secondary non-time-to-event response variable, usually collected for the whole study cohort at the outset of the study. Following earlier literature, we refer to such a situation as secondary analysis. We outline a general conditional likelihood approach for secondary analysis under cohort sampling designs and discuss the specific situations of case-cohort and nested case-control designs. We also review alternative methods based on full likelihood and inverse probability weighting. We compare the alternative methods for secondary analysis in two simulated settings and apply them in a real-data example.

  9. Case-Cohort Studies: Design and Applicability to Hand Surgery.

    Vojvodic, Miliana; Shafarenko, Mark; McCabe, Steven J

    2018-04-24

    Observational studies are common research strategies in hand surgery. The case-cohort design offers an efficient and resource-friendly method for risk assessment and outcomes analysis. Case-cohorts remain underrepresented in upper extremity research despite several practical and economic advantages over case-control studies. This report outlines the purpose, utility, and structure of the case-cohort design and offers a sample research question to demonstrate its value to risk estimation for adverse surgical outcomes. The application of well-designed case-cohort studies is advocated in an effort to improve the quality and quantity of observational research evidence in hand and upper extremity surgery. Copyright © 2018 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  10. SUMMIT (Serially Unified Multicenter Multiple Sclerosis Investigation): creating a repository of deeply phenotyped contemporary multiple sclerosis cohorts.

    Bove, Riley; Chitnis, Tanuja; Cree, Bruce Ac; Tintoré, Mar; Naegelin, Yvonne; Uitdehaag, Bernard Mj; Kappos, Ludwig; Khoury, Samia J; Montalban, Xavier; Hauser, Stephen L; Weiner, Howard L

    2017-08-01

    There is a pressing need for robust longitudinal cohort studies in the modern treatment era of multiple sclerosis. Build a multiple sclerosis (MS) cohort repository to capture the variability of disability accumulation, as well as provide the depth of characterization (clinical, radiologic, genetic, biospecimens) required to adequately model and ultimately predict a patient's course. Serially Unified Multicenter Multiple Sclerosis Investigation (SUMMIT) is an international multi-center, prospectively enrolled cohort with over a decade of comprehensive follow-up on more than 1000 patients from two large North American academic MS Centers (Brigham and Women's Hospital (Comprehensive Longitudinal Investigation of Multiple Sclerosis at the Brigham and Women's Hospital (CLIMB; BWH)) and University of California, San Francisco (Expression/genomics, Proteomics, Imaging, and Clinical (EPIC))). It is bringing online more than 2500 patients from additional international MS Centers (Basel (Universitätsspital Basel (UHB)), VU University Medical Center MS Center Amsterdam (MSCA), Multiple Sclerosis Center of Catalonia-Vall d'Hebron Hospital (Barcelona clinically isolated syndrome (CIS) cohort), and American University of Beirut Medical Center (AUBMC-Multiple Sclerosis Interdisciplinary Research (AMIR)). We provide evidence for harmonization of two of the initial cohorts in terms of the characterization of demographics, disease, and treatment-related variables; demonstrate several proof-of-principle analyses examining genetic and radiologic predictors of disease progression; and discuss the steps involved in expanding SUMMIT into a repository accessible to the broader scientific community.

  11. Free Material Design with Multiple Load Cases

    Pedersen, Pauli; Pedersen, Niels Leergaard

    2012-01-01

    Multiple load cases and the consideration of strength is a reality that most structural designs are exposed to. Improved possibility to produce specific materials, say by fiber lay-up, put focus on research on free material optimization. A formulation for such design problems together with a prac......Multiple load cases and the consideration of strength is a reality that most structural designs are exposed to. Improved possibility to produce specific materials, say by fiber lay-up, put focus on research on free material optimization. A formulation for such design problems together...... with a practical recursive design procedure is presented and illustrated with examples. The presented finite element analysis involve many elements as well as many load cases. Separating the local amount of material from a description with unit trace for the local anisotropy, gives the free materials formulation...... a more physical interpretation of the material constraint....

  12. Preliminary A ampersand PCT multiple detector design

    Roberson, G.P.; Martz, H.E.; Camp, D.C.; Decman, D.J.; Johansson, E.M.

    1997-01-01

    The next generation, multi-detector active and passive computed tomography (A ampersand PCT) scanner will be optimized for speed and accuracy. At the Lawrence Livermore National Lab (LLNL) we have demonstrated the trade-offs between different A ampersand PCT design parameters that affect the speed and quality of the assay results. These fundamental parameters govern the optimum system design. Although the multi-detector scanner design has priority put on speed to increase waste drum throughput, higher speed should not compromise assay accuracy. One way to increase the speed of the A ampersand PCT technology is to use multiple detectors. This yields a linear speedup by a factor approximately equal to the number of detectors used without a compromise in system accuracy. There are many different design scenarios that can be developed using multiple detectors. Here we describe four different scenarios and discuss the trade-offs between them. Also, some considerations are given in this design description for the implementation of a multiple detector technology in a field- deployable mobile trailer system

  13. Autoimmune disease prevalence in a multiple sclerosis cohort in Argentina.

    Farez, Mauricio F; Balbuena Aguirre, María E; Varela, Francisco; Köhler, Alejandro A; Correale, Jorge

    2014-01-01

    Background. Comorbid autoimmune diseases in MS patients have been studied extensively with controversial results. Moreover, no such data exists for Latin-American MS patients. Methods. We conducted a case-control study aimed to establish the prevalence of autoimmune disorders in a cohort of Argentinean MS patients. Results. There were no significant differences in autoimmune disease prevalence in MS patients with respect to controls. The presence of one or more autoimmune disorders did not increase risk of MS (OR 0.85, 95% CI 0.6-1.3). Discussion. Our results indicate absence of increased comorbid autoimmune disease prevalence in MS patients, as well as of increased risk of MS in patients suffering from other autoimmune disorders.

  14. Design of Xen Hybrid Multiple Police Model

    Sun, Lei; Lin, Renhao; Zhu, Xianwei

    2017-10-01

    Virtualization Technology has attracted more and more attention. As a popular open-source virtualization tools, XEN is used more and more frequently. Xsm, XEN security model, has also been widespread concern. The safety status classification has not been established in the XSM, and it uses the virtual machine as a managed object to make Dom0 a unique administrative domain that does not meet the minimum privilege. According to these questions, we design a Hybrid multiple police model named SV_HMPMD that organically integrates multiple single security policy models include DTE,RBAC,BLP. It can fullfill the requirement of confidentiality and integrity for security model and use different particle size to different domain. In order to improve BLP’s practicability, the model introduce multi-level security labels. In order to divide the privilege in detail, we combine DTE with RBAC. In order to oversize privilege, we limit the privilege of domain0.

  15. Validation of the fatigue scale for motor and cognitive functions in a danish multiple sclerosis cohort

    Oervik, M. S.; Sejbaek, T.; Penner, I. K.

    2017-01-01

    Background Our objective was to validate the Danish translation of the Fatigue Scale for Motor and Cognitive Functions (FSMC) in multiple sclerosis (MS) patients. Materials and methods A Danish MS cohort (n = 84) was matched and compared to the original German validation cohort (n = 309) and a he......Background Our objective was to validate the Danish translation of the Fatigue Scale for Motor and Cognitive Functions (FSMC) in multiple sclerosis (MS) patients. Materials and methods A Danish MS cohort (n = 84) was matched and compared to the original German validation cohort (n = 309...... positive correlations between the two fatigue scales implied high convergent validity (total scores: r = 0.851, p gender). Correcting for depression did not result in any significant adjustments of the correlations...

  16. Design of Endoscopic Capsule With Multiple Cameras.

    Gu, Yingke; Xie, Xiang; Li, Guolin; Sun, Tianjia; Wang, Dan; Yin, Zheng; Zhang, Pengfei; Wang, Zhihua

    2015-08-01

    In order to reduce the miss rate of the wireless capsule endoscopy, in this paper, we propose a new system of the endoscopic capsule with multiple cameras. A master-slave architecture, including an efficient bus architecture and a four level clock management architecture, is applied for the Multiple Cameras Endoscopic Capsule (MCEC). For covering more area of the gastrointestinal tract wall with low power, multiple cameras with a smart image capture strategy, including movement sensitive control and camera selection, are used in the MCEC. To reduce the data transfer bandwidth and power consumption to prolong the MCEC's working life, a low complexity image compressor with PSNR 40.7 dB and compression rate 86% is implemented. A chipset is designed and implemented for the MCEC and a six cameras endoscopic capsule prototype is implemented by using the chipset. With the smart image capture strategy, the coverage rate of the MCEC prototype can achieve 98% and its power consumption is only about 7.1 mW.

  17. Allergological and Toxicological Aspects in a Multiple Chemical Sensitivity Cohort

    Pigatto, Paolo D.; Minoia, Claudio; Ronchi, Anna; Brambilla, Lucia; Ferrucci, Silvia M.; Spadari, Francesco; Passoni, Manuela; Somalvico, Francesco; Bombeccari, Gian Paolo

    2013-01-01

    Background. Multiple chemical sensitivity (MCS) is a chronic condition characterized by an exaggerated response to toxicants. We ascertained the prevalence of allergy to metals and toxicological aspects in MCS patients. Methods. We conducted a retrospective review of medical records of 41 patients with MCS. We performed patch testing (n = 21) for dental series and did lymphocyte transformation test (n = 18) for metals. We measured mercury in samples of blood (n = 19), urine (n = 19), saliva (n = 20), and scalp hair (n = 17) to investigate the association between mercury levels and cases of MCS. Results. The prevalence of metal immune hypersensitivity in a subset of 26 patients was 92.3 percent. Elevations of mercury occurred in 81.2 percent (26 of 32). The mean (±SD) in blood concentrations of mercury was 7.6 ± 13.6 μg/L; mean in urine was 1.9 ± 2.5 μg/L; mean in scalp hair was 2.2 ± 2.5 μg/g; mean in saliva was 38.1 ± 52.1 μg/L. Subgroup analyses showed that elevation of mercury levels in biological matrices were associated with mercury amalgams in patients with MCS (22 patients), compared with controls (8 patients) (odds ratio 11 : 95 percent confidence interval 1.5 to 81.6; P = 0.023). Conclusions. Our data show an increased prevalence of metal allergy and elevation of mercury levels in bioindicators among patients with MCS. PMID:24367721

  18. Design, methods and demographics from phase I of Alberta's Tomorrow Project cohort: a prospective cohort profile.

    Robson, Paula J; Solbak, Nathan M; Haig, Tiffany R; Whelan, Heather K; Vena, Jennifer E; Akawung, Alianu K; Rosner, William K; Brenner, Darren R; Cook, Linda S; Csizmadi, Ilona; Kopciuk, Karen A; McGregor, S Elizabeth; Friedenreich, Christine M

    2016-01-01

    Prospective cohorts have the potential to support multifactorial, health-related research, particularly if they are drawn from the general population, incorporate active and passive follow-up and permission is obtained to allow access by researchers to data repositories. This paper describes Phase I of the Alberta's Tomorrow Project cohort, a broad-based research platform designed to support investigations into factors that influence cancer and chronic disease risk. Adults aged 35-69 years living in Alberta, Canada, with no previous cancer diagnosis other than nonmelanoma skin cancer were recruited to the project by telephone-based random digit dialling. Participants were enrolled if they returned a Health and Lifestyle Questionnaire. Past year diet and physical activity questionnaires were mailed 3 months after enrolment. Consent was sought for active follow-up and linkage with administrative databases. Depending on enrolment date, participants were invited to complete up to 2 follow-up questionnaires (2004 and 2008). Between 2001 and 2009, 31 072 (39% men) participants (mean age 50.2 [± 9.2] yr) were enrolled and 99% consented to linkage with administrative databases. Participants reported a wide range of educational attainment and household income. Compared with provincial surveillance data from the Canadian Community Health Survey, Alberta's Tomorrow Project participants had higher body mass index, lower prevalence of smoking and similar distribution of chronic health conditions. Follow-up questionnaires were completed by 83% and 72% of participants in 2004 and 2008, respectively. Robust quality control measures resulted in low frequencies of missing data. Alberta's Tomorrow Project provides a robust platform, based on a prospective cohort design, to support research into risk factors for cancer and chronic disease.

  19. Designing Reliable Cohorts of Cardiac Patients across MIMIC and eICU

    Chronaki, Catherine; Shahin, Abdullah; Mark, Roger

    2016-01-01

    The design of the patient cohort is an essential and fundamental part of any clinical patient study. Knowledge of the Electronic Health Records, underlying Database Management System, and the relevant clinical workflows are central to an effective cohort design. However, with technical, semantic, and organizational interoperability limitations, the database queries associated with a patient cohort may need to be reconfigured in every participating site. i2b2 and SHRINE advance the notion of patient cohorts as first class objects to be shared, aggregated, and recruited for research purposes across clinical sites. This paper reports on initial efforts to assess the integration of Medical Information Mart for Intensive Care (MIMIC) and Philips eICU, two large-scale anonymized intensive care unit (ICU) databases, using standard terminologies, i.e. LOINC, ICD9-CM and SNOMED-CT. Focus of this work is lab and microbiology observations and key demographics for patients with a primary cardiovascular ICD9-CM diagnosis. Results and discussion reflecting on reference core terminology standards, offer insights on efforts to combine detailed intensive care data from multiple ICUs worldwide. PMID:27774488

  20. Study Design and Cohort Description of DEFIB-WOMEN

    Pedersen, Susanne S.; Nielsen, Jens Cosedis; Riahi, Sam

    2016-01-01

    BACKGROUND: Little systematic evidence is available on potential gender differences in patients with an implantable cardioverter defibrillator (ICD) from a real-world cohort. We designed the DEFIB-WOMEN (The Utilization of Implantable Cardioverter DEFIBrillator Therapy in the Treatment of Heart......-converting enzyme inhibitors, and psychotropic agents. Although women generally had a healthier clinical profile, they reported significantly more symptoms of anxiety and depression and ICD concerns (fear of shock) as compared to men. These differences were not only statistically significant but also clinically...

  1. Multiple-membrane multiple-electrolyte redox flow battery design

    Yan, Yushan; Gu, Shuang; Gong, Ke

    2017-05-02

    A redox flow battery is provided. The redox flow battery involves multiple-membrane (at least one cation exchange membrane and at least one anion exchange membrane), multiple-electrolyte (one electrolyte in contact with the negative electrode, one electrolyte in contact with the positive electrode, and at least one electrolyte disposed between the two membranes) as the basic characteristic, such as a double-membrane, triple electrolyte (DMTE) configuration or a triple-membrane, quadruple electrolyte (TMQE) configuration. The cation exchange membrane is used to separate the negative or positive electrolyte and the middle electrolyte, and the anion exchange membrane is used to separate the middle electrolyte and the positive or negative electrolyte.

  2. Conceptual design of multiple parallel switching controller

    Ugolini, D.; Yoshikawa, S.; Ozawa, K.

    1996-01-01

    This paper discusses the conceptual design and the development of a preliminary model of a multiple parallel switching (MPS) controller. The introduction of several advanced controllers has widened and improved the control capability of nonlinear dynamical systems. However, it is not possible to uniquely define a controller that always outperforms the others, and, in many situations, the controller providing the best control action depends on the operating conditions and on the intrinsic properties and behavior of the controlled dynamical system. The desire to combine the control action of several controllers with the purpose to continuously attain the best control action has motivated the development of the MPS controller. The MPS controller consists of a number of single controllers acting in parallel and of an artificial intelligence (AI) based selecting mechanism. The AI selecting mechanism analyzes the output of each controller and implements the one providing the best control performance. An inherent property of the MPS controller is the possibility to discard unreliable controllers while still being able to perform the control action. To demonstrate the feasibility and the capability of the MPS controller the simulation of the on-line operation control of a fast breeder reactor (FBR) evaporator is presented. (author)

  3. Missed epidemics and missing links: international birth cohort trends in multiple sclerosis.

    Ajdacic-Gross, V; Tschopp, A; Schmid, M; Bopp, M; Gutzwiller, F

    2013-03-01

    Many hypotheses on the etiopathogenesis of multiple sclerosis (MS) focus on risk factors occurring early in life. This study examined the variability of birth cohort trends in international MS data by means of age-period-cohort (APC) analysis. The data from 25 countries were taken from the WHO mortality database. Data were encoded according to the International Classification of Diseases and covered slightly varying periods between 1951 and 2009. The APC analyses were based on logit models applied to cohort tables with 5-year age- and period intervals. In most countries, the birth cohort estimates peaked in those born in the first half of the 20th century. In countries from Central and Western Europe, the peak concerned those born before and around 1920. A second group of countries (Denmark, Sweden, Italy, Ireland, Scotland) shared a later peak amongst cohorts born in the 1920s and 1930s. Group 3 included Commonwealth countries, the USA and Norway, with a double or extended peak starting in the 1910s or 1920s, and ending by the 1950s. The fourth group, consisting of Mediterranean countries and Finland, was characterized by a steady increase in the birth cohort estimates until the 1950s. The fifth group with countries from Eastern Europe and Japan showed no particular pattern. Birth cohort trends have influenced the change in MS risk across the 20th century in many Western countries. This silent epidemic points to a most important but unknown latent risk factor in MS. © 2012 The Author(s) European Journal of Neurology © 2012 EFNS.

  4. Commentary: considerations for using the 'Trials within Cohorts' design in a clinical trial of an investigational medicinal product.

    Bibby, Anna C; Torgerson, David J; Leach, Samantha; Lewis-White, Helen; Maskell, Nick A

    2018-01-08

    The 'trials within cohorts' (TwiC) design is a pragmatic approach to randomised trials in which trial participants are randomly selected from an existing cohort. The design has multiple potential benefits, including the option of conducting multiple trials within the same cohort. To date, the TwiC design methodology been used in numerous clinical settings but has never been applied to a clinical trial of an investigational medicinal product (CTIMP). We have recently secured the necessary approvals to undertake the first CTIMP using the TwiC design. In this paper, we describe some of the considerations and modifications required to ensure such a trial is compliant with Good Clinical Practice and international clinical trials regulations. We advocate using a two-stage consent process and using the consent stages to explicitly differentiate between trial participants and cohort participants who are providing control data. This distinction ensured compliance but had consequences with respect to costings, recruitment and the trial assessment schedule. We have demonstrated that it is possible to secure ethical and regulatory approval for a CTIMP TwiC. By including certain considerations at the trial design stage, we believe this pragmatic and efficient methodology could be utilised in other CTIMPs in future.

  5. Cancer risk among patients with multiple sclerosis: A cohort study in Isfahan, Iran.

    Etemadifar, Masoud; Jahanbani-Ardakani, Hamidreza; Ghaffari, Sara; Fereidan-Esfahani, Maboobeh; Changaei, Hossein; Aghadoost, Nazila; Jahanbani Ardakani, Ameneh; Moradkhani, Negin

    2017-01-01

    Multiple sclerosis (MS), a central nervous system (CNS) autoimmune disorder, affects 2.3 million people around the world. Cancer kills around 7.5 million people annually. Both diseases have similar risks and intertwining molecular causes. Most studies focusing on MS and cancer have found an insignificant difference or reduction in the amount of cancer found in the MS community. We performed a cohort study using data from Isfahan Multiple Sclerosis Society (IMSS) and Isfahan cancer society and followed-up for 8 years on average (2006-2014). All of the 1718 MS patients were diagnosed according to McDonald's criteria, then standardized incidence ratio and the numbers of expected cancer case were calculated. While patients had an insignificant change in cancer prevalence, men had fewer cancer cases and women showed an increased prevalence of cancer. Certain types of cancer proved statistically significant. Breast cancer, nervous system cancers, and lymphoma were elevated in the cohort. Our results support the hypothesis that MS significantly affects certain cancers in a protective or associative manner. All cancer rates, except breast cancer, cancers located in the nervous system, and lymphomas were reduced in cohort, suggesting that unregulated immune function may provide protective effects to MS patients against cancer.

  6. Latent Variable Regression 4-Level Hierarchical Model Using Multisite Multiple-Cohorts Longitudinal Data. CRESST Report 801

    Choi, Kilchan

    2011-01-01

    This report explores a new latent variable regression 4-level hierarchical model for monitoring school performance over time using multisite multiple-cohorts longitudinal data. This kind of data set has a 4-level hierarchical structure: time-series observation nested within students who are nested within different cohorts of students. These…

  7. A Switching Anti-windup Design Using Multiple Lyapunov Functions

    Lu, L.; Lin, Z.; Chen, J.

    2009-01-01

    This paper proposes a switching anti-windup design, which aims to enlarge the domain of attraction of the closed-loop system. Multiple anti-windup gains along with an index function that orchestrates the switching among these anti-windup gains are designed based on the min function of multiple

  8. Design of a Ku band miniature multiple beam klystron

    Bandyopadhyay, Ayan Kumar, E-mail: ayan.bandyopadhyay@gmail.com; Pal, Debasish; Kant, Deepender [Microwave Tubes Division, CSIR-CEERI, Pilani, Rajasthan-333031 (India); Saini, Anil; Saha, Sukalyan; Joshi, Lalit Mohan

    2016-03-09

    The design of a miniature multiple beam klystron (MBK) working in the Ku-band frequency range is presented in this article. Starting from the main design parameters, design of the electron gun, the input and output couplers and radio frequency section (RF-section) are presented. The design methodology using state of the art commercial electromagnetic design tools, analytical formulae as well as noncommercial design tools are briefly presented in this article.

  9. Anti-JC virus antibody prevalence in a multinational multiple sclerosis cohort

    Olsson, Tomas; Achiron, Anat; Alfredsson, Lars

    2013-01-01

    JC virus (JCV) is an opportunistic virus known to cause progressive multifocal leukoencephalopathy. Anti-JC virus (Anti-JCV) antibody prevalence in a large, geographically diverse, multi-national multiple sclerosis (MS) cohort was compared in a cross-sectional study. Overall, anti-JCV antibody...... prevalence was 57.6%. Anti-JCV antibody prevalence in MS patients ranged from approximately 47% to 68% across these countries: Norway, 47.4%; Denmark, 52.6%; Israel, 56.6%; France, 57.6%; Italy, 58.3%; Sweden, 59.0%; Germany, 59.1%; Austria, 66.7% and Turkey, 67.7%. Prevalence increased with age (from 49...

  10. Design, Construction and Performance Evaluation of Multiple ...

    The complex casting machine has been designed to perform the following techniques: gravity casting, stir casting, squeeze casting, vacuum casting, compocasting and thixoforming. All these casting techniques have been integrated into this complex casting machine as different units which work with the help of automation.

  11. Production System Design for Multiple Brands

    Karlsson, Christer; Christensen, Irene

    Production systems enabling both cost efficiency and flexibility in terms of high product variation are explored. The study follows an explorative longitudinal field study approach. The database consists of three large global corporations, each consisting of several companies producing household ......-outs, worker skills, integration of distribution channels, after sales service and degree of servitization. Three production system design principles called VXY emerge....

  12. Design Methodology for Multiple Microcomputer Architectures.

    1982-07-01

    multimicro design knowledge is true both in industry and in university environments. In the industrial environment, it reduces productivity and increases...Real-Time Processor Problems," Proc. of ELECTRO-81 Tercer Seminario de Ingenieria Electronica, Nov. 9-13, 1981. 14 1981 "D Flip/Flop Substracts

  13. Stressful life-events in childhood and risk of multiple sclerosis: a Danish nationwide cohort study.

    Nielsen, Nete Munk; Pedersen, Bo V; Stenager, Egon; Koch-Henriksen, Nils; Frisch, Morten

    2014-10-01

    Current knowledge concerning the association between exposure to stressful life-events (SFLEs) in childhood and later risk of multiple sclerosis (MS) is sparse. We studied the associations between SFLEs in childhood and subsequent risk of MS in a nationwide cohort of 2.9 million Danes born from 1968 to 2011. A SFLE in childhood was defined as exposure before age 18 years to parental divorce, parental death, or death of a sibling, using information from the Danish Civil Registration System. MS cases in the cohort were identified in the Danish Multiple Sclerosis Registry. Associations of SFLE with MS risk were evaluated by incidence rate ratios (RR) of MS obtained in log-linear Poisson regression models. Persons exposed to any SFLE in childhood were at 11% elevated risk of MS (RR = 1.11; 95% confidence interval: 1.03-1.20), compared to non-exposed persons. Stratification by subtype of SFLE showed that parental death and death of a sibling were not associated with MS risk. However, persons exposed to parental divorce were at 13% increased risk of developing MS compared to non-exposed (RR = 1.13; 1.04-1.23). Associations of SFLEs in childhood with risk of MS are weak. However, parental divorce is somehow associated with modestly increased risk of MS. © The Author(s), 2014.

  14. design, construction and performance evaluation of multiple casting

    eobe

    time taken for solidification, plays an important role in the casting. There should not ... Keywords: Design, Construction, Multiple casting machine, Compo Casting operation. 1. Introduction .... metal and pathway channel pipe with heater is used.

  15. Multiple sclerosis risk sharing scheme: two year results of clinical cohort study with historical comparator.

    Boggild, Mike; Palace, Jackie; Barton, Pelham; Ben-Shlomo, Yoav; Bregenzer, Thomas; Dobson, Charles; Gray, Richard

    2009-12-02

    To generate evidence on the longer term cost effectiveness of disease modifying treatments in patients with relapsing-remitting multiple sclerosis. Prospective cohort study with historical comparator. Specialist multiple sclerosis clinics in 70 centres in the United Kingdom. Patients with relapsing-remitting multiple sclerosis who started treatment from May 2002 to April 2005 under the UK risk sharing scheme. Treatment with interferon beta or glatiramer acetate in accordance with guidelines of the UK Association of British Neurologists. Observed utility weighted progression in disability at two years' follow-up assessed on the expanded disability status scale (EDSS) compared with that expected by applying the progression rates in a comparator dataset, modified for patients receiving treatment by multiplying by the hazard ratio derived separately for each disease modifying treatment from the randomised trials. In the primary per protocol analysis, progression in disability was worse than that predicted and worse than that in the untreated comparator dataset ("deviation score" of 113%; excess in mean disability status scale 0.28). In sensitivity analyses, however, the deviation score varied from -72% (using raw baseline disability status scale scores, rather than applying a "no improvement" algorithm) to 156% (imputing missing data for year two from progression rates for year one). It is too early to reach any conclusion about the cost effectiveness of disease modifying treatments from this first interim analysis. Important methodological issues, including the need for additional comparator datasets, the potential bias from missing data, and the impact of the "no improvement" rule, will need to be addressed and long term follow-up of all patients is essential to secure meaningful results. Future analyses of the cohort are likely to be more informative, not least because they will be less sensitive to short term fluctuations in disability.

  16. The Copenhagen Oral Health Senior Cohort: design, population and dental health

    Heegaard, Karen M; Holm-Pedersen, Poul; Jensen, Allan Bardow

    2011-01-01

    Gerodontology 2010; doi: 10.1111/j.1741-2358.2010.00383.x The Copenhagen Oral Health Senior Cohort: design, population and dental health Background: In order to study the way old age influence oral health, the Copenhagen Oral Health Senior Cohort (COHS) has been established. Objectives: To describe...

  17. Use of multiple data sources to estimate hepatitis C seroprevalence among prisoners: A retrospective cohort study.

    Kathryn J Snow

    Full Text Available Hepatitis C is a major cause of preventable morbidity and mortality. Prisoners are a key population for hepatitis C control programs, and with the advent of highly effective therapies, prisons are increasingly important sites for hepatitis C diagnosis and treatment. Accurate estimates of hepatitis C prevalence among prisoners are needed in order to plan and resource service provision, however many prevalence estimates are based on surveys compromised by limited and potentially biased participation. We aimed to compare estimates derived from three different data sources, and to assess whether the use of self-report as a supplementary data source may help researchers assess the risk of selection bias. We used three data sources to estimate the prevalence of hepatitis C antibodies in a large cohort of Australian prisoners-prison medical records, self-reported status during a face-to-face interview prior to release from prison, and data from a statewide notifiable conditions surveillance system. Of 1,315 participants, 33.8% had at least one indicator of hepatitis C seropositivity, however less than one third of these (9.5% of the entire cohort were identified by all three data sources. Among participants of known status, self-report had a sensitivity of 80.1% and a positive predictive value of 97.8%. Any one data source used in isolation would have under-estimated the prevalence of hepatitis C in this cohort. Using multiple data sources in studies of hepatitis C seroprevalence among prisoners may improve case detection and help researchers assess the risk of selection bias due to non-participation in serological testing.

  18. Design of Multiple Bolted Connections for Laminated Veneer Lumber

    Borjen Yeh; Douglas Rammer; Jeff Linville

    2014-01-01

    The design of multiple bolted connections in accordance with Appendix E of the National Design Specification for Wood Construction (NDS) has incorporated provisions for evaluating localized member failure modes of row and group tear-out when the connections are closely spaced. Originally based on structural glued laminated timber (glulam) members made with all L1...

  19. Research Data Explorer: Lessons Learned in Design and Development of Context-based Cohort Definition and Selection.

    Wilcox, Adam; Vawdrey, David; Weng, Chunhua; Velez, Mark; Bakken, Suzanne

    2015-01-01

    Research Data eXplorer (RedX) was designed to support self-service research data queries and cohort identification from clinical research databases. The primary innovation of RedX was the electronic health record view of patient data, to provide better contextual understanding for non-technical users in building complex data queries. The design of RedX around this need identified multiple functions that would use individual patient views to better understand population-based data, and vice-versa. During development, the more necessary and valuable components of RedX were refined, leading to a functional self-service query and cohort identification tool. However, with the improved capabilities and extensibility of other applications for data querying and navigation, our long-term implementation and dissemination plans have moved towards consolidation and alignment of RedX functions as enhancements in these other initiatives.

  20. Rationale, design, and methods for Canadian alliance for healthy hearts and minds cohort study (CAHHM) - a Pan Canadian cohort study.

    Anand, Sonia S; Tu, Jack V; Awadalla, Philip; Black, Sandra; Boileau, Catherine; Busseuil, David; Desai, Dipika; Després, Jean-Pierre; de Souza, Russell J; Dummer, Trevor; Jacquemont, Sébastien; Knoppers, Bartha; Larose, Eric; Lear, Scott A; Marcotte, Francois; Moody, Alan R; Parker, Louise; Poirier, Paul; Robson, Paula J; Smith, Eric E; Spinelli, John J; Tardif, Jean-Claude; Teo, Koon K; Tusevljak, Natasa; Friedrich, Matthias G

    2016-07-27

    The Canadian Alliance for Healthy Hearts and Minds (CAHHM) is a pan-Canadian, prospective, multi-ethnic cohort study being conducted in Canada. The overarching objective of the CAHHM is to understand the association of socio-environmental and contextual factors (such as societal structure, activity, nutrition, social and tobacco environments, and access to health services) with cardiovascular risk factors, subclinical vascular disease, and cardiovascular and other chronic disease outcomes. Participants between 35 and 69 years of age are being recruited from existing cohorts and a new First Nations Cohort to undergo a detailed assessment of health behaviours (including diet and physical activity), cognitive function, assessment of their local home and workplace environments, and their health services access and utilization. Physical measures including weight, height, waist/hip circumference, body fat percentage, and blood pressure are collected. In addition, eligible participants undergo magnetic resonance imaging (MRI) of the brain, heart, carotid artery and abdomen to detect early subclinical vascular disease and ectopic fat deposition. CAHHM is a prospective cohort study designed to investigate the impact of community level factors, individual health behaviours, and access to health services, on cognitive function, subclinical vascular disease, fat distribution, and the development of chronic diseases among adults living in Canada.

  1. A comparison of Cox and logistic regression for use in genome-wide association studies of cohort and case-cohort design.

    Staley, James R; Jones, Edmund; Kaptoge, Stephen; Butterworth, Adam S; Sweeting, Michael J; Wood, Angela M; Howson, Joanna M M

    2017-06-01

    Logistic regression is often used instead of Cox regression to analyse genome-wide association studies (GWAS) of single-nucleotide polymorphisms (SNPs) and disease outcomes with cohort and case-cohort designs, as it is less computationally expensive. Although Cox and logistic regression models have been compared previously in cohort studies, this work does not completely cover the GWAS setting nor extend to the case-cohort study design. Here, we evaluated Cox and logistic regression applied to cohort and case-cohort genetic association studies using simulated data and genetic data from the EPIC-CVD study. In the cohort setting, there was a modest improvement in power to detect SNP-disease associations using Cox regression compared with logistic regression, which increased as the disease incidence increased. In contrast, logistic regression had more power than (Prentice weighted) Cox regression in the case-cohort setting. Logistic regression yielded inflated effect estimates (assuming the hazard ratio is the underlying measure of association) for both study designs, especially for SNPs with greater effect on disease. Given logistic regression is substantially more computationally efficient than Cox regression in both settings, we propose a two-step approach to GWAS in cohort and case-cohort studies. First to analyse all SNPs with logistic regression to identify associated variants below a pre-defined P-value threshold, and second to fit Cox regression (appropriately weighted in case-cohort studies) to those identified SNPs to ensure accurate estimation of association with disease.

  2. New architectural design of delivery room reduces morbidity in preterm neonates: a prospective cohort study.

    Terrin, Gianluca; Conte, Francesca; Scipione, Antonella; Aleandri, Vincenzo; Di Chiara, Maria; Bacchio, Erica; Messina, Francesco; De Curtis, Mario

    2016-03-23

    A multidisciplinary committee composed of a panel of experts, including a member of the American Academy of Pediatrics and American Institute of Architects, has suggested that the delivery room (DR) and the neonatal intensive care units (NICU) room should be directly interconnected. We aimed to investigate the impact of the architectural design of the DR and the NICU on neonatal outcome. Two cohorts of preterm neonates born at architectural renovation of the DR realized in accordance with specific standards (Cohort 2: "new concept of DR"). In Cohort 1, neonates were initially cared for a conventional resuscitation area, situated in the DR, and then transferred to the NICU, located on a separate floor of the same hospital. In Cohort 2 neonates were assisted at birth directly in the NICU room, which was directly connected to the DR via a pass-through door. The primary outcome of the study was morbidity, defined by the proportion of neonates with at least one complication of prematurity (i.e., late-onset sepsis, patent ductus arteriosus, intraventricular hemorrhage, periventricular leukomalacia, bronchopulmonary dysplasia, retinopathy of prematurity and necrotizing enterocolitis). Secondary outcomes were mortality and duration of hospitalization. Statistical analysis was performed using standard methods by SPSS software. We enrolled 106 neonates (56 in Cohort 1 and 50 in Cohort 2). The main clinical and demographic characteristics of the 2 cohorts were similar. Moderate hypothermia (body temperature ≤ 35.9 °C) was more frequent in Cohort 1 (57%) compared with Cohort 2 (24%, p = 0.001). Morbidity was increased in Cohort 1 (73%) compared with Cohort 2 (44%, p = 0.002). No statistically significant differences in mortality and median duration of hospitalization were observed between the 2 cohorts of the study. If realized according to the proposed architectural standards, renovation of DR and NICU may represent an opportunity to reduce morbidity in preterm neonates.

  3. Analysis of Clinical Cohort Data Using Nested Case-control and Case-cohort Sampling Designs. A Powerful and Economical Tool.

    Ohneberg, K; Wolkewitz, M; Beyersmann, J; Palomar-Martinez, M; Olaechea-Astigarraga, P; Alvarez-Lerma, F; Schumacher, M

    2015-01-01

    Sampling from a large cohort in order to derive a subsample that would be sufficient for statistical analysis is a frequently used method for handling large data sets in epidemiological studies with limited resources for exposure measurement. For clinical studies however, when interest is in the influence of a potential risk factor, cohort studies are often the first choice with all individuals entering the analysis. Our aim is to close the gap between epidemiological and clinical studies with respect to design and power considerations. Schoenfeld's formula for the number of events required for a Cox' proportional hazards model is fundamental. Our objective is to compare the power of analyzing the full cohort and the power of a nested case-control and a case-cohort design. We compare formulas for power for sampling designs and cohort studies. In our data example we simultaneously apply a nested case-control design with a varying number of controls matched to each case, a case cohort design with varying subcohort size, a random subsample and a full cohort analysis. For each design we calculate the standard error for estimated regression coefficients and the mean number of distinct persons, for whom covariate information is required. The formula for the power of a nested case-control design and the power of a case-cohort design is directly connected to the power of a cohort study using the well known Schoenfeld formula. The loss in precision of parameter estimates is relatively small compared to the saving in resources. Nested case-control and case-cohort studies, but not random subsamples yield an attractive alternative for analyzing clinical studies in the situation of a low event rate. Power calculations can be conducted straightforwardly to quantify the loss of power compared to the savings in the num-ber of patients using a sampling design instead of analyzing the full cohort.

  4. Multiple-valued logic design based on the multiple-peak BiCMOS-NDR circuits

    Kwang-Jow Gan

    2016-06-01

    Full Text Available Three different multiple-valued logic (MVL designs using the multiple-peak negative-differential-resistance (NDR circuits are investigated. The basic NDR element, which is made of several Si-based metal-oxide-semiconductor field-effect-transistor (MOS and SiGe-based heterojunction-bipolar-transistor (HBT devices, can be implemented by using a standard BiCMOS process. These MVL circuits are designed based on the triggering-pulse control, saw-tooth input signal, and peak-control methods, respectively. However, there are some transient states existing between the multiple stable levels for the first two methods. These states might affect the circuit function in practical application. As a result, our proposed peak-control method for the MVL design can be used to overcome these transient states.

  5. Japan Diabetic Nephropathy Cohort Study: study design, methods, and implementation.

    Furuichi, Kengo; Shimizu, Miho; Toyama, Tadashi; Koya, Daisuke; Koshino, Yoshitaka; Abe, Hideharu; Mori, Kiyoshi; Satoh, Hiroaki; Imanishi, Masahito; Iwano, Masayuki; Yamauchi, Hiroyuki; Kusano, Eiji; Fujimoto, Shouichi; Suzuki, Yoshiki; Okuda, Seiya; Kitagawa, Kiyoki; Iwata, Yasunori; Kaneko, Shuichi; Nishi, Shinichi; Yokoyama, Hitoshi; Ueda, Yoshihiko; Haneda, Masakazu; Makino, Hirofumi; Wada, Takashi

    2013-12-01

    Diabetic nephropathy, leading to end-stage renal disease, has a considerable impact on public health and the social economy. However, there are few national registries of diabetic nephropathy in Japan. The aims of this prospective cohort study are to obtain clinical data and urine samples for revising the clinical staging of diabetic nephropathy, and developing new diagnostic markers for early diabetic nephropathy. The Japanese Society of Nephrology established a nationwide, web-based, and prospective registry system. On the system, there are two basic registries; the Japan Renal Biopsy Registry (JRBR), and the Japan Kidney Disease Registry (JKDR). In addition to the two basic registries, we established a new prospective registry to the system; the Japan Diabetic Nephropathy Cohort Study (JDNCS), which collected physical and laboratory data. We analyzed the data of 321 participants (106 female, 215 male; average age 65 years) in the JDNCS. Systolic and diastolic blood pressure was 130.1 and 72.3 mmHg, respectively. Median estimated glomerular filtration rate (eGFR) was 33.3 ml/min/1.73 m(2). Proteinuria was 1.8 g/gCr, and serum levels of albumin were 3.6 g/dl. The majority of the JDNCS patients presented with preserved eGFR and low albuminuria or low eGFR and advanced proteinuria. In the JRBR and JKDR registries, 484 and 125 participants, respectively, were enrolled as having diabetes mellitus. In comparison with the JRBR and JKDR registries, the JDNCS was characterized by diabetic patients presenting with low proteinuria with moderately preserved eGFR. There are few national registries of diabetic nephropathy to evaluate prognosis in Japan. Future analysis of the JDNCS will provide clinical insights into the epidemiology and renal and cardiovascular outcomes of type 2 diabetic patients in Japan.

  6. The Challenges of Designing Digital Services for Multiple Mobile Platforms

    Ghazawneh, Ahmad

    2016-01-01

    on a multiple case study of three mobile application development firms from Sweden, Denmark and Norway, we synthesize the digital service design taxonomy to understand the challenges faced by third-party developers. Our study identifies a set of challenges in four different levels: user level, platform level...... to tap into and join the digital ecosystem. However, while there is an emerging literature on designing digital services, little empirical evidence exists about challenges faced by third-party developers while designing digital services, and in particular for multiple mobile platforms. Drawing......The value of digital services is increasingly recognized by owners of digital platforms. These services have central role in building and sustaining the business of the digital platform. In order to sustain the design of digital services, owners of digital platforms encourage third-party developers...

  7. Designing multiple ligands - medicinal chemistry strategies and challenges.

    Morphy, Richard; Rankovic, Zoran

    2009-01-01

    It has been widely recognised over the recent years that parallel modulation of multiple biological targets can be beneficial for treatment of diseases with complex etiologies such as cancer asthma, and psychiatric disease. In this article, current strategies for the generation of ligands with a specific multi-target profile (designed multiple ligands or DMLs) are described and a number of illustrative example are given. Designing multiple ligands is frequently a challenging endeavour for medicinal chemists, with the need to appropriately balance affinity for 2 or more targets whilst obtaining physicochemical and pharmacokinetic properties that are consistent with the administration of an oral drug. Given that the properties of DMLs are influenced to a large extent by the proteomic superfamily to which the targets belong and the lead generation strategy that is pursued, an early assessment of the feasibility of any given DML project is essential.

  8. Design and development of multiple sample counting setup

    Rath, D.P.; Murali, S.; Babu, D.A.R.

    2010-01-01

    Full text: The analysis of active samples on regular basis for ambient air activity and floor contamination from radio chemical lab accounts for major chunk of the operational activity in Health Physicist's responsibility. The requirement for daily air sample analysis on immediate counting and delayed counting from various labs in addition to samples of smear swipe check of lab led to the urge for development of system that could cater multiple sample analysis in a time programmed manner on a single sample loading. A multiple alpha/beta counting system for counting was designed and fabricated. It has arrangements for loading 10 samples in slots in order, get counted in a time programmed manner with results displayed and records maintained in PC. The paper describes the design and development of multiple sample counting setup presently in use at the facility has resulted in reduction of man-hour consumption in counting and recording of the results

  9. Automated platform for designing multiple robot work cells

    Osman, N. S.; Rahman, M. A. A.; Rahman, A. A. Abdul; Kamsani, S. H.; Bali Mohamad, B. M.; Mohamad, E.; Zaini, Z. A.; Rahman, M. F. Ab; Mohamad Hatta, M. N. H.

    2017-06-01

    Designing the multiple robot work cells is very knowledge-intensive, intricate, and time-consuming process. This paper elaborates the development process of a computer-aided design program for generating the multiple robot work cells which offer a user-friendly interface. The primary purpose of this work is to provide a fast and easy platform for less cost and human involvement with minimum trial and errors adjustments. The automated platform is constructed based on the variant-shaped configuration concept with its mathematical model. A robot work cell layout, system components, and construction procedure of the automated platform are discussed in this paper where integration of these items will be able to automatically provide the optimum robot work cell design according to the information set by the user. This system is implemented on top of CATIA V5 software and utilises its Part Design, Assembly Design, and Macro tool. The current outcomes of this work provide a basis for future investigation in developing a flexible configuration system for the multiple robot work cells.

  10. Adherence to Disease Modifying Drugs among Patients with Multiple Sclerosis in Germany: A Retrospective Cohort Study.

    Kerstin Hansen

    Full Text Available Long-term therapies such as disease modifying therapy for Multiple Sclerosis (MS demand high levels of medication adherence in order to reach acceptable outcomes. The objective of this study was to describe adherence to four disease modifying drugs (DMDs among statutorily insured patients within two years following treatment initiation. These drugs were interferon beta-1a i.m. (Avonex, interferon beta-1a s.c. (Rebif, interferon beta-1b s.c. (Betaferon and glatiramer acetate s.c. (Copaxone.This retrospective cohort study used pharmacy claims data from the data warehouse of the German Institute for Drug Use Evaluation (DAPI from 2001 through 2009. New or renewed DMD prescriptions in the years 2002 to 2006 were identified and adherence was estimated during 730 days of follow-up by analyzing the medication possession ratio (MPR as proxy for compliance and persistence defined as number of days from initiation of DMD therapy until discontinuation or interruption.A total of 52,516 medication profiles or therapy cycles (11,891 Avonex, 14,060 Betaferon, 12,353 Copaxone and 14,212 Rebif from 50,057 patients were included into the analysis. Among the 4 cohorts, no clinically relevant differences were found in available covariates. The Medication Possession Ratio (MPR measured overall compliance, which was 39.9% with a threshold MPR≥0.8. There were small differences in the proportion of therapy cycles during which a patient was compliant for the following medications: Avonex (42.8%, Betaferon (40.6%, Rebif (39.2%, and Copaxone (37%. Overall persistence was 32.3% at the end of the 24 months observation period, i.e. during only one third of all included therapy cycles patients did not discontinue or interrupt DMD therapy. There were also small differences in the proportion of therapy cycles during which a patient was persistent as follows: Avonex (34.2%, Betaferon (33.4%, Rebif (31.7% and Copaxone (29.8%.Two years after initiating MS-modifying therapy, only

  11. Adaptive Waveform Design for Cognitive Radar in Multiple Targets Situations

    Xiaowen Zhang

    2018-02-01

    Full Text Available In this paper, the problem of cognitive radar (CR waveform optimization design for target detection and estimation in multiple extended targets situations is investigated. This problem is analyzed in signal-dependent interference, as well as additive channel noise for extended targets with unknown target impulse response (TIR. To address this problem, an improved algorithm is employed for target detection by maximizing the detection probability of the received echo on the promise of ensuring the TIR estimation precision. In this algorithm, an additional weight vector is introduced to achieve a trade-off among different targets. Both the estimate of TIR and transmit waveform can be updated at each step based on the previous step. Under the same constraint on waveform energy and bandwidth, the information theoretical approach is also considered. In addition, the relationship between the waveforms that are designed based on the two criteria is discussed. Unlike most existing works that only consider single target with temporally correlated characteristics, waveform design for multiple extended targets is considered in this method. Simulation results demonstrate that compared with linear frequency modulated (LFM signal, waveforms designed based on maximum detection probability and maximum mutual information (MI criteria can make radar echoes contain more multiple-target information and improve radar performance as a result.

  12. Multivariant design and multiple criteria analysis of building refurbishments

    Kaklauskas, A.; Zavadskas, E. K.; Raslanas, S. [Faculty of Civil Engineering, Vilnius Gediminas Technical University, Vilnius (Lithuania)

    2005-07-01

    In order to design and realize an efficient building refurbishment, it is necessary to carry out an exhaustive investigation of all solutions that form it. The efficiency level of the considered building's refurbishment depends on a great many of factors, including: cost of refurbishment, annual fuel economy after refurbishment, tentative pay-back time, harmfulness to health of the materials used, aesthetics, maintenance properties, functionality, comfort, sound insulation and longevity, etc. Solutions of an alternative character allow for a more rational and realistic assessment of economic, ecological, legislative, climatic, social and political conditions, traditions and for better the satisfaction of customer requirements. They also enable one to cut down on refurbishment costs. In carrying out the multivariant design and multiple criteria analysis of a building refurbishment much data was processed and evaluated. Feasible alternatives could be as many as 100,000. How to perform a multivariant design and multiple criteria analysis of alternate alternatives based on the enormous amount of information became the problem. Method of multivariant design and multiple criteria of a building refurbishment's analysis were developed by the authors to solve the above problems. In order to demonstrate the developed method, a practical example is presented in this paper. (author)

  13. Harnessing Multiple Internal Reflections to Design Highly Absorptive Acoustic Metasurfaces

    Shen, Chen; Cummer, Steven A.

    2018-05-01

    The rapid development of metasurfaces has enabled numerous intriguing applications with acoustically thin sheets. Here we report the theory and experimental realization of a nonresonant sound-absorbing strategy using metasurfaces by harnessing multiple internal reflections. We theoretically and numerically show that the higher-order diffraction of thin gradient-index metasurfaces is tied to multiple internal reflections inside the unit cells. Highly absorbing acoustic metasurfaces can be realized by enforcing multiple internal reflections together with a small amount of loss. A reflective gradient-index acoustic metasurface is designed based on the theory, and we further experimentally verify the performance using a three-dimensional printed prototype. Measurements show over 99% energy absorption at the peak frequency and a 95% energy absorption bandwidth of around 600 Hz. The proposed mechanism provides an alternative route for sound absorption without the necessity of high absorption of the individual unit cells.

  14. Characteristics in childhood and adolescence associated with future multiple sclerosis risk in men: cohort study.

    Gunnarsson, M; Udumyan, R; Bahmanyar, S; Nilsagård, Y; Montgomery, S

    2015-07-01

    Associations with multiple sclerosis (MS) of living conditions in childhood and characteristics in adolescence including physical fitness, cognitive function and psychological stress resilience were investigated. A cohort of male Swedish residents born 1952-1956 who were included in the Swedish Military Conscription Register was used to create a nested case-control study comprising 628 MS cases and 6187 controls matched on birth year, county of residence and vital status at time of diagnosis. Conscription examination records were linked with other national register data. Conditional logistic regression was used to evaluate associations with MS subsequent to the conscription examination. Men with MS were less likely to be from more crowded households in childhood (>two persons per room) with an adjusted odds ratio of 0.67 (95% confidence interval 0.51-0.86, P = 0.023). They had lower physical working capacity in adolescence with adjusted odds ratio of 0.94 (95% confidence interval 0.89-0.99, P = 0.026). Cognitive function and stress resilience scores displayed no significant differences between cases and controls. Parental occupation in childhood and body mass index in adolescence were not associated with future MS risk. The inverse association of MS risk with higher levels of household crowding may reflect environmental factors such as the pattern of exposure to microorganisms. Lower physical fitness in men at MS risk may indicate a protective effect of exercise or could be due to prodromal disease activity, although there was no association with cognitive function. Poor psychological stress resilience (and thus risk of chronic stress arousal) was not associated with MS. © 2015 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.

  15. Some remarks on the design of HIF current multiplication rings

    Reich, K.H.

    1983-12-01

    The conceptual design of heavy ion fusion drivers has now reached a state, where the overall approach has become fairly clear. One design features an RF linac plus current and beam multiplication rings. The present remarks concern the assignment of multiturn injection, beam storage and bunching to an optimized number of rings and transport lines, as well as some criteria for their designs. The main parameter constraints are discussed, showing how they can be met, although there is little flexibility at the present stage of understanding and technology. A shortened version of this report is scheduled for presentation at the ''INS International Symposium on Heavy Ion Accelerators and Their Application to Inertial Fusion'' Tokyo, January 23-27 1984. (author)

  16. Multiple spacecraft configuration designs for coordinated flight missions

    Fumenti, Federico; Theil, Stephan

    2018-06-01

    Coordinated flight allows the replacement of a single monolithic spacecraft with multiple smaller ones, based on the principle of distributed systems. According to the mission objectives and to ensure a safe relative motion, constraints on the relative distances need to be satisfied. Initially, differential perturbations are limited by proper orbit design. Then, the induced differential drifts can be properly handled through corrective maneuvers. In this work, several designs are surveyed, defining the initial configuration of a group of spacecraft while counteracting the differential perturbations. For each of the investigated designs, focus is placed upon the number of deployable spacecraft and on the possibility to ensure safe relative motion through station keeping of the initial configuration, with particular attention to the required Δ V budget and the constraints violations.

  17. Sardasht-Iran cohort study of chemical warfare victims: design and methods.

    Ghazanfari, Tooba; Faghihzadeh, Soghrat; Aragizadeh, Hassan; Soroush, Mohammad-Reza; Yaraee, Roya; Mohammad Hassan, Zuhair; Foroutan, Abbas; Vaez-Mahdavi, Mohammad-Reza; Javadi, Mohammad-Ali; Moaiedmohseni, Sakine; Azizi, Fereidoun; Panahi, Yunes; Mostafaie, Ali; Ghasemi, Hassan; Shams, Jalaleddin; Pourfarzam, Shahryar; Jalali-Nadoushan, Mohammad-Reza; Fallahi, Faramarz; Ebtekar, Massoumeh; Davoudi, Seyyed-Masoud; Ghazanfari, Zeinab; Ardestani, Sussan K; Shariat-Panahi, Shamsa; Moin, Athar; Rezaei, Abbas; Kariminia, Amina; Ajdary, Soheila; Mahmoudi, Mahmoud; Roshan, Rasoul; Ghaderi, Sulayman; Babai, Mahmoud; Naghizadeh, Mohammad-Mehdi; Ghanei, Mohammad-Mostafa

    2009-01-01

    Insights into long-term clinical consequences of sulfur mustard have emerged from some investigations but less is known about the basic and molecular mechanisms of these complications. Sardasht-Iran Cohort Study is a comprehensive historical cohort study on Sardasht chemical victims' population which was designed to find out the long-term complications of sulfur mustard exposure and the basic mechanisms underlying clinical manifestations. This paper describes the design and methodology of Sardasht-Iran Cohort Study. In Sardasht-Iran Cohort Study, 500 individuals including 372 subjects from Sardasht, as the exposed group, and 128 subjects from Rabat, as the unexposed age-matched control group were evaluated. The exposed group was divided into two groups based on the severity of clinical complications at the time of exposure. Different samples including blood, sputum, saliva, tear, urine, and semen were collected for immunologic, hematologic, biochemical, and other laboratory analysis. Data were gathered from medical records, clinical examinations, laboratory tests, and questionnaires for psychological and lifestyle situations. The important distinctions setting this study apart from the previous ones are discussed. The Sardasht-Iran Cohort Study provides important information on various aspects of long-term consequences of sulfur mustard exposure. This database will provide a better position to suggest guidelines for the diagnosis, treatment, and prevention of delayed complications in the patients exposed to sulfur mustard.

  18. Efficiency aspects of design and analysis of prospective cohort studies on diet, nutrition and cancer

    Kaaks, R.J.

    1994-01-01

    This thesis presents and analyzes methodological approaches to improve the design and analysis of prospective cohort studies on the relations between diet, nutritional status and cancer. The first chapters discuss methods to optimize the measurement of the individuals' habitual dietary

  19. 77 FR 40059 - Designation of a Class of Employees for Addition to the Special Exposure Cohort

    2012-07-06

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Designation of a Class of Employees for Addition to the Special Exposure Cohort AGENCY: National Institute for Occupational Safety and Health (NIOSH), Centers for... days aggregating at least 250 work days, occurring either solely under this employment or in...

  20. 77 FR 9251 - Designation of a Class of Employees for Addition to the Special Exposure Cohort

    2012-02-16

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Designation of a Class of Employees for Addition to the Special Exposure Cohort AGENCY: National Institute for Occupational Safety and Health (NIOSH), Centers for..., for a number of work days aggregating at least 250 work days, occurring either solely under this...

  1. The emergence of designed multiple ligands for neurodegenerative disorders.

    Geldenhuys, Werner J; Youdim, Moussa B H; Carroll, Richard T; Van der Schyf, Cornelis J

    2011-09-01

    The incidence of neurodegenerative diseases has seen a constant increase in the global population, and is likely to be the result of extended life expectancy brought about by better health care. Despite this increase in the incidence of neurodegenerative diseases, there has been a dearth in the introduction of new disease-modifying therapies that are approved to prevent or delay the onset of these diseases, or reverse the degenerative processes in brain. Mounting evidence in the peer-reviewed literature shows that the etiopathology of these diseases is extremely complex and heterogeneous, resulting in significant comorbidity and therefore unlikely to be mitigated by any drug acting on a single pathway or target. A recent trend in drug design and discovery is the rational design or serendipitous discovery of novel drug entities with the ability to address multiple drug targets that form part of the complex pathophysiology of a particular disease state. In this review we discuss the rationale for developing such multifunctional drugs (also called designed multiple ligands or DMLs), and why these drug candidates seem to offer better outcomes in many cases compared to single-targeted drugs in pre-clinical studies for neurodegenerative diseases such as Alzheimer's and Parkinson's disease. Examples are drawn from the literature of drug candidates that have already reached the market, some unsuccessful attempts, and others that are still in the drug development pipeline. Copyright © 2011. Published by Elsevier Ltd.

  2. A Common Probe Design for Multiple Planetary Destinations

    Hwang, H. H.; Allen, G. A., Jr.; Alunni, A. I.; Amato, M. J.; Atkinson, D. H.; Bienstock, B. J.; Cruz, J. R.; Dillman, R. A.; Cianciolo, A. D.; Elliott, J. O.; hide

    2018-01-01

    Atmospheric probes have been successfully flown to planets and moons in the solar system to conduct in situ measurements. They include the Pioneer Venus multi-probes, the Galileo Jupiter probe, and Huygens probe. Probe mission concepts to five destinations, including Venus, Jupiter, Saturn, Uranus, and Neptune, have all utilized similar-shaped aeroshells and concept of operations, namely a 45-degree sphere cone shape with high density heatshield material and parachute system for extracting the descent vehicle from the aeroshell. Each concept designed its probe to meet specific mission requirements and to optimize mass, volume, and cost. At the 2017 International Planetary Probe Workshop (IPPW), NASA Headquarters postulated that a common aeroshell design could be used successfully for multiple destinations and missions. This "common probe"� design could even be assembled with multiple copies, properly stored, and made available for future NASA missions, potentially realizing savings in cost and schedule and reducing the risk of losing technologies and skills difficult to sustain over decades. Thus the NASA Planetary Science Division funded a study to investigate whether a common probe design could meet most, if not all, mission needs to the five planetary destinations with extreme entry environments. The Common Probe study involved four NASA Centers and addressed these issues, including constraints and inefficiencies that occur in specifying a common design. Study methodology: First, a notional payload of instruments for each destination was defined based on priority measurements from the Planetary Science Decadal Survey. Steep and shallow entry flight path angles (EFPA) were defined for each planet based on qualification and operational g-load limits for current, state-of-the-art instruments. Interplanetary trajectories were then identified for a bounding range of EFPA. Next, 3-degrees-of-freedom simulations for entry trajectories were run using the entry state

  3. Minimum weight design of composite laminates for multiple loads

    Krikanov, A.A.; Soni, S.R.

    1995-01-01

    A new design method of constructing optimum weight composite laminates for multiple loads is proposed in this paper. A netting analysis approach is used to develop an optimization procedure. Three ply orientations permit development of optimum laminate design without using stress-strain relations. It is proved that stresses in minimum weight laminate reach allowable values in each ply with given load. The optimum ply thickness is defined at maximum value among tensile and compressive loads. Two examples are given to obtain optimum ply orientations, thicknesses and materials. For comparison purposes, calculations of stresses are done in orthotropic material using classical lamination theory. Based upon these calculations, matrix degrades at 30 to 50% of ultimate load. There is no fiber failure and therefore laminates withstand all applied loads in both examples

  4. The multiplicity of the digital textbook as design object

    Riis Ebbesen, Toke

    2015-01-01

    Building on a preliminary case study of the Danish educational publisher Systime A/S and its flagship product, the web-based ‘iBog’/‘iBook’, this article explores how digital textbooks can be understood as design. The shaping of digital books is seen as being intertwined in a wider circuit...... reorganization of the publishing company, web-based user interfaces, and ultimately the branding, which market these new digital objects, are building power- ful discourses around the product. Thus it is suggested that the design process of the iBog case can be understood in a model of database-based publishing...... with multiple levels. In the final analysis, the iBog is much more than a product and a technology. It is a brand that goes beyond what can be studied by looking at the digital textbook as a singular artefact....

  5. Revitalising the Metropolit 1953 Danish male birth cohort: background, aims and design

    Osler, Merete; Andersen, Anne-Marie Nybo; Lund, Rikke

    2004-01-01

    mobility. At age 12 years, 9537 of these cohort members completed a questionnaire in school, which included cognitive measures and information on social aspirations and leisure time activities. In 1966 educational performance tests were administered for these boys and, in 1968, mothers of 2890 cohort......Recent research indicates that factors operating during childhood are related to adult health. Thus, longitudinal studies with information on subsequent phases may be key to understanding later health outcomes. The main objective of this paper is to describe the history and design of a Danish birth...... cohort, and its revitalisation. In 1965, information from birth certificates for 11 591 of a total of 12 270 males born in 1953 in the Metropolitan area of Copenhagen, Denmark were traced. These boys were the study population of a sociological investigation conducted with the aim of describing social...

  6. 75 FR 51816 - Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort

    2010-08-23

    ... Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort AGENCY...). ACTION: Notice. SUMMARY: HHS gives notice concerning the final effect of the HHS decision to designate a... Special Exposure Cohort (SEC) under the Energy Employees Occupational Illness Compensation Program Act of...

  7. Microseismic Monitoring Design Optimization Based on Multiple Criteria Decision Analysis

    Kovaleva, Y.; Tamimi, N.; Ostadhassan, M.

    2017-12-01

    Borehole microseismic monitoring of hydraulic fracture treatments of unconventional reservoirs is a widely used method in the oil and gas industry. Sometimes, the quality of the acquired microseismic data is poor. One of the reasons for poor data quality is poor survey design. We attempt to provide a comprehensive and thorough workflow, using multiple criteria decision analysis (MCDA), to optimize planning micriseismic monitoring. So far, microseismic monitoring has been used extensively as a powerful tool for determining fracture parameters that affect the influx of formation fluids into the wellbore. The factors that affect the quality of microseismic data and their final results include average distance between microseismic events and receivers, complexity of the recorded wavefield, signal-to-noise ratio, data aperture, etc. These criteria often conflict with each other. In a typical microseismic monitoring, those factors should be considered to choose the best monitoring well(s), optimum number of required geophones, and their depth. We use MDCA to address these design challenges and develop a method that offers an optimized design out of all possible combinations to produce the best data acquisition results. We believe that this will be the first research to include the above-mentioned factors in a 3D model. Such a tool would assist companies and practicing engineers in choosing the best design parameters for future microseismic projects.

  8. Head injury is not a risk factor for multiple sclerosis: a prospective cohort study

    Pfleger, C C H; Koch-Henriksen, N; Stenager, E

    2009-01-01

    or to be refuted conclusively. OBJECTIVE: To determine whether head trauma is associated with an increased risk of developing MS. METHOD: A cohort of 150,868 subjects, 95,111 men, and 55,757 women registered in the National Danish Patient Registry with hospital admission for cerebral concussion, contusion...

  9. Conservatism implications of shock test tailoring for multiple design environments

    Baca, Thomas J.; Bell, R. Glenn; Robbins, Susan A.

    1987-01-01

    A method for analyzing shock conservation in test specifications that have been tailored to qualify a structure for multiple design environments is discussed. Shock test conservation is qualified for shock response spectra, shock intensity spectra and ranked peak acceleration data in terms of an Index of Conservation (IOC) and an Overtest Factor (OTF). The multi-environment conservation analysis addresses the issue of both absolute and average conservation. The method is demonstrated in a case where four laboratory tests have been specified to qualify a component which must survive seven different field environments. Final judgment of the tailored test specification is shown to require an understanding of the predominant failure modes of the test item.

  10. Treatment effectiveness of alemtuzumab compared with natalizumab, fingolimod, and interferon beta in relapsing-remitting multiple sclerosis: a cohort study.

    Kalincik, Tomas; Brown, J William L; Robertson, Neil; Willis, Mark; Scolding, Neil; Rice, Claire M; Wilkins, Alastair; Pearson, Owen; Ziemssen, Tjalf; Hutchinson, Michael; McGuigan, Christopher; Jokubaitis, Vilija; Spelman, Tim; Horakova, Dana; Havrdova, Eva; Trojano, Maria; Izquierdo, Guillermo; Lugaresi, Alessandra; Prat, Alexandre; Girard, Marc; Duquette, Pierre; Grammond, Pierre; Alroughani, Raed; Pucci, Eugenio; Sola, Patrizia; Hupperts, Raymond; Lechner-Scott, Jeannette; Terzi, Murat; Van Pesch, Vincent; Rozsa, Csilla; Grand'Maison, François; Boz, Cavit; Granella, Franco; Slee, Mark; Spitaleri, Daniele; Olascoaga, Javier; Bergamaschi, Roberto; Verheul, Freek; Vucic, Steve; McCombe, Pamela; Hodgkinson, Suzanne; Sanchez-Menoyo, Jose Luis; Ampapa, Radek; Simo, Magdolna; Csepany, Tunde; Ramo, Cristina; Cristiano, Edgardo; Barnett, Michael; Butzkueven, Helmut; Coles, Alasdair

    2017-04-01

    Alemtuzumab, an anti-CD52 antibody, is proven to be more efficacious than interferon beta-1a in the treatment of relapsing-remitting multiple sclerosis, but its efficacy relative to more potent immunotherapies is unknown. We compared the effectiveness of alemtuzumab with natalizumab, fingolimod, and interferon beta in patients with relapsing-remitting multiple sclerosis treated for up to 5 years. In this international cohort study, we used data from propensity-matched patients with relapsing-remitting multiple sclerosis from the MSBase and six other cohorts. Longitudinal clinical data were obtained from 71 MSBase centres in 21 countries and from six non-MSBase centres in the UK and Germany between Nov 1, 2015, and June 30, 2016. Key inclusion criteria were a diagnosis of definite relapsing-remitting multiple sclerosis, exposure to one of the study therapies (alemtuzumab, interferon beta, fingolimod, or natalizumab), age 65 years or younger, Expanded Disability Status Scale (EDSS) score 6·5 or lower, and no more than 10 years since the first multiple sclerosis symptom. The primary endpoint was annualised relapse rate. The secondary endpoints were cumulative hazards of relapses, disability accumulation, and disability improvement events. We compared relapse rates with negative binomial models, and estimated cumulative hazards with conditional proportional hazards models. Patients were treated between Aug 1, 1994, and June 30, 2016. The cohorts consisted of 189 patients given alemtuzumab, 2155 patients given interferon beta, 828 patients given fingolimod, and 1160 patients given natalizumab. Alemtuzumab was associated with a lower annualised relapse rate than interferon beta (0·19 [95% CI 0·14-0·23] vs 0·53 [0·46-0·61], pmultiple sclerosis. Alemtuzumab seems superior to fingolimod and interferon beta in mitigating relapse activity. Natalizumab seems superior to alemtuzumab in enabling recovery from disability. Both natalizumab and alemtuzumab seem highly

  11. Analysis of vestibular schwannoma size in multiple dimensions: a comparative cohort study of different measurement techniques.

    Varughese, J K; Wentzel-Larsen, T; Vassbotn, F; Moen, G; Lund-Johansen, M

    2010-04-01

    In this volumetric study of the vestibular schwannoma, we evaluated the accuracy and reliability of several approximation methods that are in use, and determined the minimum volume difference that needs to be measured for it to be attributable to an actual difference rather than a retest error. We also found empirical proportionality coefficients for the different methods. DESIGN/SETTING AND PARTICIPANTS: Methodological study with investigation of three different VS measurement methods compared to a reference method that was based on serial slice volume estimates. These volume estimates were based on: (i) one single diameter, (ii) three orthogonal diameters or (iii) the maximal slice area. Altogether 252 T1-weighted MRI images with gadolinium contrast, from 139 VS patients, were examined. The retest errors, in terms of relative percentages, were determined by undertaking repeated measurements on 63 scans for each method. Intraclass correlation coefficients were used to assess the agreement between each of the approximation methods and the reference method. The tendency for approximation methods to systematically overestimate/underestimate different-sized tumours was also assessed, with the help of Bland-Altman plots. The most commonly used approximation method, the maximum diameter, was the least reliable measurement method and has inherent weaknesses that need to be considered. This includes greater retest errors than area-based measurements (25% and 15%, respectively), and that it was the only approximation method that could not easily be converted into volumetric units. Area-based measurements can furthermore be more reliable for smaller volume differences than diameter-based measurements. All our findings suggest that the maximum diameter should not be used as an approximation method. We propose the use of measurement modalities that take into account growth in multiple dimensions instead.

  12. Capturing the fragile X premutation phenotypes: a collaborative effort across multiple cohorts.

    Hunter, Jessica Ezzell; Sherman, Stephanie; Grigsby, Jim; Kogan, Cary; Cornish, Kim

    2012-03-01

    To capture the neuropsychological profile among male carriers of the FMR1 premutation allele (55-200 CGG repeats) who do not meet diagnostic criteria for the late-onset fragile X-associated tremor/ataxia syndrome, FXTAS. We have initiated a multicenter collaboration that includes 3 independent cohorts, totaling 100 carriers of the premutation and 216 noncarriers. The initial focus of this collaboration has been on executive function. Four executive function scores are shared among the 3 cohorts (Controlled Oral Word Association Test, Stroop Color-Word Test, and Wechsler backward digit span and letter-number sequencing) whereas additional executive function scores are available for specific cohorts (Behavior Dyscontrol Scale, Hayling Sentence Completion Test Part B, and Wisconsin Card Sorting Test). Raw scores were analyzed by using statistical models that adjust for cohort-specific effects as well as age and education. Carriers scored significantly lower compared to noncarriers on the Stroop Color-Word Test (p = .01), Hayling Sentence Completion Test Part B (p < .01), and Behavioral Dyscontrol Scale (p = .03), with the Hayling displaying a significant age-related decline (p = .01), as assessed by an age and repeat length-group interaction. Follow-up analysis of the collective data did not identify any specific age groups or repeat length ranges (i.e., low premutation = 55-70 repeats, midpremutation = 71-100 repeats, high premutation = 101-199 repeats) that were associated with an increased risk of executive function deficits. Preliminary analyses do not indicate global executive function impairment among male carriers without FXTAS compared to noncarriers. However, impairment in inhibitory capacity may be present among a subset of carriers, though the risk factors for this group do not appear to be related to age or repeat length.

  13. Cohort profile for the Nurture Observational Study examining associations of multiple caregivers on infant growth in the Southeastern USA.

    Benjamin Neelon, Sara E; Østbye, Truls; Bennett, Gary G; Kravitz, Richard M; Clancy, Shayna M; Stroo, Marissa; Iversen, Edwin; Hoyo, Cathrine

    2017-02-08

    Childcare has been associated with obesity in children in cross-sectional and longitudinal studies, although some observed no association. Few studies have focused on care during infancy, a period when children may be especially vulnerable. The Nurture Study is an observational birth cohort designed to assess longitudinal associations of childcare and the presence of multiple caregivers on infant adiposity and weight trajectories throughout the first year of life. We examine as potential mediators feeding, physical activity, sleep and stress. We completed recruitment in 2015. Of the 860 women who enrolled during pregnancy, 799 delivered a single live infant who met our inclusion criteria. Of those, 666 mothers (77.4%) agreed to participate in the study for themselves and their infants. Among the 666 women in the study, 472 (71%) identified as black, 127 (19%) as white, 7 (1%) as Asian or Asian American, 6 (1%) as Native American and 49 (7%) as other race or more than one race; 43 (7%) identified as Hispanic/Latina. Just under half (48%) had a high school diploma or less, 61% had household incomes <$20 000/year and 59% were married or living with a partner. The mean (SD) infant gestational age was 41.28 weeks (2.29) and birth weight for gestational age z-score was -0.31 (0.93). Just under half (49%) of infants were females, 69% received some human milk and 40% were exclusively breast fed at hospital discharge. Data collection began in 2013, is currently underway, and is scheduled to conclude in late 2016. Results will help assess the magnitude of associations between childcare in infancy and subsequent obesity. Findings will also inform intervention and policy efforts to improve childcare environments and help prevent obesity in settings where many infants spend time. Clinicaltrials.gov, NCT01788644. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  14. Multiple pregnancies achieved with IVF/ICSI and risk of specific congenital malformations: a meta-analysis of cohort studies.

    Zheng, Zan; Chen, Letao; Yang, Tubao; Yu, Hong; Wang, Hua; Qin, Jiabi

    2018-04-01

    Studies comparing risk of specific congenital malformations (CM) between multiple pregnancies resulting from IVF/intracytoplasmic sperm injection (ICSI) and those conceived naturally report conflicting results; furthermore, there is a lack of a complete overview. This meta-analysis aimed to address which types of CM are increased in IVF/ICSI multiple pregnancies compared with those conceived naturally. All studies testing the association between IVF/ICSI multiple pregnancies and specific CM identified in various databases were considered. The literature search yielded 856 records, of which 21 cohort studies were included for analysis. Overall, multiple pregnancies achieved with IVF/ICSI experienced a significantly higher risk of chromosomal defects (relative risk [RR] = 1.36; 95% confidence interval [CI]: 1.04-1.77), urogenital (RR = 1.18; 95% CI: 1.03-1.36) and circulatory (RR = 1.22; 95% CI: 1.01-1.47) system malformations. However, the remaining specific CM, such as cleft lip and/or palate, eye, ear, face and neck, respiratory, musculoskeletal, nervous and digestive system malformations, were similar in the two groups. No substantial heterogeneity was observed for most outcomes except for digestive (P = 0.094; I 2 = 38.3%) and circulatory (P = 0.070; I 2 = 35.2%) system malformations. These findings provide additional information on risks of IVF/ICSI for use when counselling patients. Copyright © 2018 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  15. Neonatal outcomes among multiple births ≤ 32 weeks gestational age: Does mode of conception have an impact? A Cohort Study

    Yoon Woojin

    2011-06-01

    Full Text Available Abstract Background Studies comparing perinatal outcomes in multiples conceived following the use of artificial reproductive technologies (ART vs. spontaneous conception (SC have reported conflicting results in terms of mortality and morbidity. Therefore, the objective of our study was to compare composite outcome of mortality and severe neonatal morbidities amongst preterm multiple births ≤ 32 weeks gestation infant born following ART vs. SC. Methods We conducted a single center cohort study at Mount Sinai Hospital, Toronto, Ontario, Canada. Data on all preterm multiple births (≤ 32 weeks GA discharged between July 2005 and June 2008 were retrospectively collected from a prospective database at our centre. Details regarding mode of conception were collected retrospectively from maternal health records. Preterm multiple births were categorized into those born following ART vs. SC. Composite outcome was defined as combination of death or any of the three neonatal morbidities (grade 3/4 intraventricular hemorrhage or periventricular leukomalacia; retinopathy of prematurity > stage 2 or chronic lung disease. Univariate and multivariate regression analysis were preformed after adjustment of confounders (maternal age, parity, triplets, gestational age, sex, and small for gestational age. Results One hundred and thirty seven neonates were born following use of ART and 233 following SC. The unadjusted composite outcome rate was significantly higher in preterm multiples born following ART vs. SC [43.1% vs. 26.6%, p = 0.001; OR 1.98 (95% CI 1.13, 3.45]; however, when adjusted for confounders the difference between groups was not statistically significant [OR 1.39, 95% CI 0.67, 2.89]. Conclusion In our population of preterm multiple births, the mode of conception had no detectable effect on the adjusted composite neonatal outcome of mortality and/or three neonatal morbidities.

  16. The Scandinavian baltic pancreatic club (SBPC) database: design, rationale and characterisation of the study cohort.

    Olesen, Søren S; Poulsen, Jakob L; Drewes, Asbjørn M; Frøkjær, Jens B; Laukkarinen, Johanna; Parhiala, Mikael; Rix, Iben; Novovic, Srdan; Lindkvist, Björn; Bexander, Louise; Dimcevski, Georg; Engjom, Trond; Erchinger, Friedemann; Haldorsen, Ingfrid S; Pukitis, Aldis; Ozola-Zālīte, Imanta; Haas, Stephan; Vujasinovic, Miroslav; Löhr, J Matthias; Gulbinas, Antanas; Jensen, Nanna M; Jørgensen, Maiken T; Nøjgaard, Camilla

    2017-08-01

    Chronic pancreatitis (CP) is a multifaceted disease associated with several risk factors and a complex clinical presentation. We established the Scandinavian Baltic Pancreatic Club (SBPC) Database to characterise and study the natural history of CP in a Northern European cohort. Here, we describe the design of the database and characteristics of the study cohort. Nine centres from six different countries in the Scandinavian-Baltic region joined the database. Patients with definitive or probable CP (M-ANNHEIM diagnostic criteria) were included. Standardised case report forms were used to collect several assessment variables including disease aetiology, duration of CP, preceding acute pancreatitis, as well as symptoms, complications, and treatments. The clinical stage of CP was characterised according to M-ANNNHEIM. Yearly follow-up is planned for all patients. The study cohort comprised of 910 patients (608 men: 302 women; median age 58 (IQR: 48-67) years with definite 848 (93%) or probable CP 62 (7%). Nicotine (70%) and alcohol (59%) were the most frequent aetiologies and seen in combination in 44% of patients. A history of recurrent acute pancreatitis was seen in 49% prior to the development of CP. Pain (69%) and exocrine pancreatic insufficiency (68%) were the most common complications followed by diabetes (43%). Most patients (30%) were classified as clinical stage II (symptomatic CP with exocrine or endocrine insufficiency). Less than 10% of the patients had undergone pancreatic surgery. The SBPC database provides a mean for future prospective, observational studies of CP in the Northern European continent.

  17. SAS Macros for Calculation of Population Attributable Fraction in a Cohort Study Design

    Maarit A. Laaksonen

    2011-08-01

    Full Text Available The population attributable fraction (PAF is a useful measure for quantifying the impact of exposure to certain risk factors on a particular outcome at the population level. Recently, new model-based methods for the estimation of PAF and its confidence interval for different types of outcomes in a cohort study design have been proposed. In this paper, we introduce SAS macros implementing these methods and illustrate their application with a data example on the impact of different risk factors on type 2 diabetes incidence.

  18. Contribution to coherent atom optics - Design of multiple wave devices

    Impens, F.

    2008-03-01

    The theoretical work presented in this manuscript addresses two complementary issues in coherent atom optics. The first part addresses the perspectives offered by coherent atomic sources through the design of two experiment involving the levitation of a cold atomic sample in a periodic series of light pulses, and for which coherent atomic clouds are particularly well-suited. These systems appear as multiple wave atom interferometers. A striking feature of these experiments is that a unique system performs both the sample trapping and interrogation. To obtain a transverse confinement, a novel atomic lens is proposed, relying on the interaction between an atomic wave with a spherical light wave. The sensitivity of the sample trapping towards the gravitational acceleration and towards the pulse frequencies is exploited to perform the desired measurement. These devices constitute atomic wave resonators in momentum space, which is a novel concept in atom optics. A second part develops new theoretical tools - most of which inspired from optics - well-suited to describe the propagation of coherent atomic sources. A phase-space approach of the propagation, relying on the evolution of moments, is developed and applied to study the low-energy dynamics of Bose-Einstein condensates. The ABCD method of propagation for atomic waves is extended beyond the linear regime to account perturbatively for mean-field atomic interactions in the atom-optical aberration-less approximation. A treatment of the atom laser extraction enabling one to describe aberrations in the atomic beam, developed in collaboration with the Atom Optics group at the Institute of Optics, is exposed. Last, a quality factor suitable for the characterization of diluted matter waves in a general propagation regime has been proposed. (author)

  19. The Pregnancy Exposome: Multiple Environmental Exposures in the INMA-Sabadell Birth Cohort.

    Robinson, Oliver; Basagaña, Xavier; Agier, Lydiane; de Castro, Montserrat; Hernandez-Ferrer, Carles; Gonzalez, Juan R; Grimalt, Joan O; Nieuwenhuijsen, Mark; Sunyer, Jordi; Slama, Rémy; Vrijheid, Martine

    2015-09-01

    The "exposome" is defined as "the totality of human environmental exposures from conception onward, complementing the genome" and its holistic approach may advance understanding of disease etiology. We aimed to describe the correlation structure of the exposome during pregnancy to better understand the relationships between and within families of exposure and to develop analytical tools appropriate to exposome data. Estimates on 81 environmental exposures of current health concern were obtained for 728 women enrolled in The INMA (INfancia y Medio Ambiente) birth cohort, in Sabadell, Spain, using biomonitoring, geospatial modeling, remote sensors, and questionnaires. Pair-wise Pearson's and polychoric correlations were calculated and principal components were derived. The median absolute correlation across all exposures was 0.06 (5th-95th centiles, 0.01-0.54). There were strong levels of correlation within families of exposure (median = 0.45, 5th-95th centiles, 0.07-0.85). Nine exposures (11%) had a correlation higher than 0.5 with at least one exposure outside their exposure family. Effectively all the variance in the data set (99.5%) was explained by 40 principal components. Future exposome studies should interpret exposure effects in light of their correlations to other exposures. The weak to moderate correlation observed between exposure families will permit adjustment for confounding in future exposome studies.

  20. Clinical Features in a Danish Population-Based Cohort of Probable Multiple System Atrophy Patients

    Starhof, Charlotte; Korbo, Lise; Lassen, Christina Funch

    2016-01-01

    Background: Multiple system atrophy (MSA) is a rare, sporadic and progressive neurodegenerative disorder. We aimed to describe the clinical features of Danish probable MSA patients, evaluate their initial response to dopaminergic therapy and examine mortality. Methods: From the Danish National...... the criteria for probable MSA. We recorded clinical features, examined differences by MSA subtype and used Kaplan-Meier survival analysis to examine mortality. Results: The mean age at onset of patients with probable MSA was 60.2 years (range 36-75 years) and mean time to wheelchair dependency was 4.7 years...

  1. Reassessment of HIV-1 acute phase infectivity: accounting for heterogeneity and study design with simulated cohorts.

    Steve E Bellan

    2015-03-01

    = 1.7 mo (95% CrI: 0.55-6.8. The wide credibility intervals reflect an inability to distinguish a long, mildly infectious acute phase from a short, highly infectious acute phase, given the 10-mo Rakai observation intervals. The total additional risk, measured as excess hazard-months attributable to the acute phase (EHMacute can be estimated more precisely: EHMacute = (RHacute - 1 × dacute, and should be interpreted with respect to the 120 hazard-months generated by a constant untreated chronic phase infectivity over 10 y of infection. From the Rakai data, we estimated that EHMacute = 8.4 (95% CrI: -0.27 to 64. This estimate is considerably lower than previously published estimates, and consistent with our independent estimate from viral load trajectories, 5.6 (95% confidence interval: 3.3-9.1. We found that previous overestimates likely stemmed from failure to account for risk heterogeneity and bias resulting from the retrospective cohort study design. Our results reflect the interaction between the retrospective cohort exclusion criteria and high (47% rates of censorship amongst incident serodiscordant couples in the Rakai study due to loss to follow-up, couple dissolution, or study termination. We estimated excess physiological infectivity during the acute phase from couples data, but not the proportion of transmission attributable to the acute phase, which would require data on the broader population's sexual network structure.Previous EHMacute estimates relying on the Rakai retrospective cohort data range from 31 to 141. Our results indicate that these are substantial overestimates of HIV-1 acute phase infectivity, biased by unmodeled heterogeneity in transmission rates between couples and by inconsistent censoring. Elevated acute phase infectivity is therefore less likely to undermine TasP interventions than previously thought. Heterogeneity in infectiousness and susceptibility may still play an important role in intervention success and deserves attention in

  2. Reassessment of HIV-1 Acute Phase Infectivity: Accounting for Heterogeneity and Study Design with Simulated Cohorts

    Bellan, Steve E.; Dushoff, Jonathan; Galvani, Alison P.; Meyers, Lauren Ancel

    2015-01-01

    .79–57) and d acute = 1.7 mo (95% CrI: 0.55–6.8). The wide credibility intervals reflect an inability to distinguish a long, mildly infectious acute phase from a short, highly infectious acute phase, given the 10-mo Rakai observation intervals. The total additional risk, measured as excess hazard-months attributable to the acute phase (EHMacute) can be estimated more precisely: EHMacute = (RHacute - 1) × d acute, and should be interpreted with respect to the 120 hazard-months generated by a constant untreated chronic phase infectivity over 10 y of infection. From the Rakai data, we estimated that EHMacute = 8.4 (95% CrI: -0.27 to 64). This estimate is considerably lower than previously published estimates, and consistent with our independent estimate from viral load trajectories, 5.6 (95% confidence interval: 3.3–9.1). We found that previous overestimates likely stemmed from failure to account for risk heterogeneity and bias resulting from the retrospective cohort study design. Our results reflect the interaction between the retrospective cohort exclusion criteria and high (47%) rates of censorship amongst incident serodiscordant couples in the Rakai study due to loss to follow-up, couple dissolution, or study termination. We estimated excess physiological infectivity during the acute phase from couples data, but not the proportion of transmission attributable to the acute phase, which would require data on the broader population's sexual network structure. Conclusions Previous EHMacute estimates relying on the Rakai retrospective cohort data range from 31 to 141. Our results indicate that these are substantial overestimates of HIV-1 acute phase infectivity, biased by unmodeled heterogeneity in transmission rates between couples and by inconsistent censoring. Elevated acute phase infectivity is therefore less likely to undermine TasP interventions than previously thought. Heterogeneity in infectiousness and susceptibility may still play an important role in

  3. Targeting a heterologous protein to multiple plant organelles via rationally designed 5? mRNA tags

    Voges, M.J.; Silver, P.A.; Way, J.C.; Mattozzi, M.D.

    2013-01-01

    Background Plant bioengineers require simple genetic devices for predictable localization of heterologous proteins to multiple subcellular compartments. Results We designed novel hybrid signal sequences for multiple-compartment localization and characterize their function when fused to GFP in

  4. Rationale, design, and methods for Canadian alliance for healthy hearts and minds cohort study (CAHHM – a Pan Canadian cohort study

    Sonia S. Anand

    2016-07-01

    Full Text Available Abstract Background The Canadian Alliance for Healthy Hearts and Minds (CAHHM is a pan-Canadian, prospective, multi-ethnic cohort study being conducted in Canada. The overarching objective of the CAHHM is to understand the association of socio-environmental and contextual factors (such as societal structure, activity, nutrition, social and tobacco environments, and access to health services with cardiovascular risk factors, subclinical vascular disease, and cardiovascular and other chronic disease outcomes. Methods/Design Participants between 35 and 69 years of age are being recruited from existing cohorts and a new First Nations Cohort to undergo a detailed assessment of health behaviours (including diet and physical activity, cognitive function, assessment of their local home and workplace environments, and their health services access and utilization. Physical measures including weight, height, waist/hip circumference, body fat percentage, and blood pressure are collected. In addition, eligible participants undergo magnetic resonance imaging (MRI of the brain, heart, carotid artery and abdomen to detect early subclinical vascular disease and ectopic fat deposition. Discussion CAHHM is a prospective cohort study designed to investigate the impact of community level factors, individual health behaviours, and access to health services, on cognitive function, subclinical vascular disease, fat distribution, and the development of chronic diseases among adults living in Canada.

  5. The socioeconomic profile of a Barrett's oesophagus cohort assessed by the 2010 Index of Multiple Deprivation.

    Bhattacharjee, Santanu; Caygill, Christine P J; Charlett, Andre; Fox, Anthony J; Gatenby, Piers A C; Watson, Anthony; Royston, Christine; Bardhan, Karna D

    2016-02-01

    Several reports have described the relationship between socioeconomic status and oesophageal adenocarcinoma but only one with its precursor condition, Barrett's oesophagus. We therefore investigated such an association. The majority (88%) of patients diagnosed with Barrett's at Rotherham District General Hospital between 28 April 1978 and 31 August 2012 consented to inclusion in the UK Barrett's Oesophagus Registry. Those residing within Rotherham form the basis of this study. We assessed socioeconomic status using the Index of Multiple Deprivation 2010 scores which can be assigned to every English postcode. The scores for the whole of England were divided into five equal groups; those of the 6257 postcodes within Rotherham (including those of Barrett's patients) were compared against the national quintile relevant to their score. We examined the ratio of observed against expected numbers of Barrett's in each quintile before and since 2001, the median year of diagnosis. The study group comprised 1076 patients with Barrett's oesophagus. Before 2001 their distribution across the deprivation quintiles was similar to that expected. Since then it has changed significantly, with 37% more Barrett's patients than expected among the two least deprived quintiles, but 11% fewer than expected in the larger population comprising the two most deprived quintiles (P=0.0001). There was no significant difference in the distribution of sex (P=0.27), nor the mean age at diagnosis between the two time periods (P=0.92). Since 2001, there has been a major change in the distribution of Barrett's in relation to socioeconomic status, measured by the Index of Multiple Deprivation.

  6. Multiple sclerosis susceptibility-associated SNPs do not influence disease severity measures in a cohort of Australian MS patients.

    Cathy J Jensen

    Full Text Available Recent association studies in multiple sclerosis (MS have identified and replicated several single nucleotide polymorphism (SNP susceptibility loci including CLEC16A, IL2RA, IL7R, RPL5, CD58, CD40 and chromosome 12q13-14 in addition to the well established allele HLA-DR15. There is potential that these genetic susceptibility factors could also modulate MS disease severity, as demonstrated previously for the MS risk allele HLA-DR15. We investigated this hypothesis in a cohort of 1006 well characterised MS patients from South-Eastern Australia. We tested the MS-associated SNPs for association with five measures of disease severity incorporating disability, age of onset, cognition and brain atrophy. We observed trends towards association between the RPL5 risk SNP and time between first demyelinating event and relapse, and between the CD40 risk SNP and symbol digit test score. No associations were significant after correction for multiple testing. We found no evidence for the hypothesis that these new MS disease risk-associated SNPs influence disease severity.

  7. A Signal Detection Approach in a Multiple Cohort Study: Different Admission Tools Uniquely Select Different Successful Students

    Linda van Ooijen-van der Linden

    2018-05-01

    Full Text Available Using multiple admission tools in university admission procedures is common practice. This is particularly useful if different admission tools uniquely select different subgroups of students who will be successful in university programs. A signal-detection approach was used to investigate the accuracy of Secondary School grade point average (SSGPA, an admission test score (ACS, and a non-cognitive score (NCS in uniquely selecting successful students. This was done for three consecutive first year cohorts of a broad psychology program. Each applicant's score on SSGPA, ACS, or NCS alone—and on seven combinations of these scores, all considered separate “admission tools”—was compared at two different (medium and high cut-off scores (criterion levels. Each of the tools selected successful students who were not selected by any of the other tools. Both sensitivity and specificity were enhanced by implementing multiple tools. The signal-detection approach distinctively provided useful information for decisions on admission instruments and cut-off scores.

  8. How Managers Can Benefit from Multiple Perspectives on Design Management

    Gasparin, Marta; Christiansen, John K.

    Operations management should be more concerned with the relationship to design and how the interplay between design processes and operations can be managed. The design of products and services has huge implications on operations in different ways: Design can increase the value of products......; influence and lead to innovation of manufacturing processes; implications for the supply chain processes and has implications on the life cycle of products and sustainability issues. To fully exploit the opportunities, we claim that it's useful for managers to be aware of the different ways that design...... processes might be perceived and managed. Illustrated with examples....

  9. Person mobility in the design and analysis of cluster-randomized cohort prevention trials.

    Vuchinich, Sam; Flay, Brian R; Aber, Lawrence; Bickman, Leonard

    2012-06-01

    Person mobility is an inescapable fact of life for most cluster-randomized (e.g., schools, hospitals, clinic, cities, state) cohort prevention trials. Mobility rates are an important substantive consideration in estimating the effects of an intervention. In cluster-randomized trials, mobility rates are often correlated with ethnicity, poverty and other variables associated with disparity. This raises the possibility that estimated intervention effects may generalize to only the least mobile segments of a population and, thus, create a threat to external validity. Such mobility can also create threats to the internal validity of conclusions from randomized trials. Researchers must decide how to deal with persons who leave study clusters during a trial (dropouts), persons and clusters that do not comply with an assigned intervention, and persons who enter clusters during a trial (late entrants), in addition to the persons who remain for the duration of a trial (stayers). Statistical techniques alone cannot solve the key issues of internal and external validity raised by the phenomenon of person mobility. This commentary presents a systematic, Campbellian-type analysis of person mobility in cluster-randomized cohort prevention trials. It describes four approaches for dealing with dropouts, late entrants and stayers with respect to data collection, analysis and generalizability. The questions at issue are: 1) From whom should data be collected at each wave of data collection? 2) Which cases should be included in the analyses of an intervention effect? and 3) To what populations can trial results be generalized? The conclusions lead to recommendations for the design and analysis of future cluster-randomized cohort prevention trials.

  10. Study design of DIACORE (DIAbetes COhoRtE – a cohort study of patients with diabetes mellitus type 2

    Dörhöfer Lena

    2013-02-01

    Full Text Available Abstract Background Diabetes mellitus type 2 (DM2 is highly associated with increased risk for chronic kidney disease (CKD, end stage renal disease (ESRD and cardiovascular morbidity. Epidemiological and genetic studies generate hypotheses for innovative strategies in DM2 management by unravelling novel mechanisms of diabetes complications, which is essential for future intervention trials. We have thus initiated the DIAbetes COhoRtE study (DIACORE. Methods DIACORE is a prospective cohort study aiming to recruit 6000 patients of self-reported Caucasian ethnicity with prevalent DM2 for at least 10 years of follow-up. Study visits are performed in University-based recruiting clinics in Germany using standard operating procedures. All prevalent DM2 patients in outpatient clinics surrounding the recruiting centers are invited to participate. At baseline and at each 2-year follow-up examination, patients are subjected to a core phenotyping protocol. This includes a standardized online questionnaire and physical examination to determine incident micro- and macrovascular DM2 complications, malignancy and hospitalization, with a primary focus on renal events. Confirmatory outcome information is requested from patient records. Blood samples are obtained for a centrally analyzed standard laboratory panel and for biobanking of aliquots of serum, plasma, urine, mRNA and DNA for future scientific use. A subset of the cohort is subjected to extended phenotyping, e.g. sleep apnea screening, skin autofluorescence measurement, non-mydriatic retinal photography and non-invasive determination of arterial stiffness. Discussion DIACORE will enable the prospective evaluation of factors involved in DM2 complication pathogenesis using high-throughput technologies in biosamples and genetic epidemiological studies.

  11. Practical Design of Delta-Sigma Multiple Description Audio Coding

    Leegaard, Jack Højholt; Østergaard, Jan; Jensen, Søren Holdt

    2014-01-01

    It was recently shown that delta-sigma quantization (DSQ) can be used for optimal multiple description (MD) coding of Gaussian sources. The DSQ scheme combined oversampling, prediction, and noise-shaping in order to trade off side distortion for central distortion in MD coding. It was shown that ...

  12. 76 FR 72928 - Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort

    2011-11-28

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort AGENCY: National Institute for Occupational Safety and Health... concerning the final effect of the HHS decision to designate a class of employees from Vitro Manufacturing in...

  13. 77 FR 15759 - Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort

    2012-03-16

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort AGENCY: National Institute for Occupational Safety and Health...). ACTION: Notice. SUMMARY: HHS gives notice concerning the final effect of the HHS decision to designate a...

  14. 78 FR 21955 - Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort

    2013-04-12

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort AGENCY: National Institute for Occupational Safety and Health...). ACTION: Notice. SUMMARY: HHS gives notice concerning the final effect of the HHS decision to designate a...

  15. 76 FR 7852 - Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort

    2011-02-11

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort AGENCY: National Institute for Occupational Safety and Health... concerning the final effect of the HHS decision to designate a class of employees from Texas City Chemicals...

  16. 76 FR 59701 - Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort

    2011-09-27

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort AGENCY: National Institute for Occupational Safety and Health... concerning the final effect of the HHS decision to designate a class of employees from the Sandia National...

  17. 78 FR 70949 - Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort

    2013-11-27

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort AGENCY: National Institute for Occupational Safety and Health...). ACTION: Notice. SUMMARY: HHS gives notice concerning the final effect of the HHS decision to designate a...

  18. 77 FR 60438 - Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort

    2012-10-03

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort AGENCY: National Institute for Occupational Safety and Health...). ACTION: Notice. SUMMARY: HHS gives notice concerning the final effect of the HHS decision to designate a...

  19. 75 FR 67364 - Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort

    2010-11-02

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort AGENCY: National Institute for Occupational Safety and Health... concerning the final effect of the HHS decision to designate a class of employees from the Blockson Chemical...

  20. 75 FR 27784 - Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort

    2010-05-18

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort AGENCY: National Institute for Occupational Safety and Health... concerning the final effect of the decision to designate a class of employees from Lawrence Livermore...

  1. 75 FR 27785 - Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort

    2010-05-18

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort AGENCY: National Institute for Occupational Safety and Health... concerning the final effect of the decision to designate a class of employees from Area IV of the Santa...

  2. 75 FR 37812 - Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort

    2010-06-30

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort AGENCY: National Institute for Occupational Safety and Health... and Human Services (HHS) gives notice concerning the final effect of the HHS decision to designate a...

  3. 77 FR 60437 - Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort

    2012-10-03

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort AGENCY: National Institute for Occupational Safety and Health...). ACTION: Notice. SUMMARY: HHS gives notice concerning the final effect of the HHS decision to designate a...

  4. 77 FR 69845 - Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort

    2012-11-21

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort AGENCY: National Institute for Occupational Safety and Health...). ACTION: Notice. SUMMARY: HHS gives notice concerning the final effect of the HHS decision to designate a...

  5. 78 FR 21954 - Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort

    2013-04-12

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort AGENCY: National Institute for Occupational Safety and Health...). ACTION: Notice. SUMMARY: HHS gives notice concerning the final effect of the HHS decision to designate a...

  6. The Multiple Roles of the Task Design Mediator in Telecollaboration

    Fuchs, Carolin; Snyder, Bill; Tung, Bruce; Jung Han, Yu

    2017-01-01

    This case study explores how a Chinese-American novice teacher acted as mediator in a telecollaboration with student teacher (ST) peers in the USA who designed tasks for his English as a foreign language (EFL) learners in China. The novice teacher was instrumental in mediating the student teachers' task design process by providing feedback…

  7. A Cohort Study on Long-Term Adverse Effects of Parental Drinking: Background and Study Design

    Ingunn Olea Lund

    2015-01-01

    Full Text Available Although many studies have addressed adverse outcomes in children of parents with alcohol abuse/dependence, less is known about the possible long-term effects of more normative patterns of parental alcohol consumption, including drinking at lower risk levels and heavy episodic or binge drinking. The extent of harm from parental drinking may therefore be underestimated. With this research proposal, we describe a project that aims to assess possible long-term adverse effects of parental drinking by combining survey and nationwide registry data. Advantages of a longitudinal general population cohort design include that it allows for detailed information on parental drinking through survey data and identification of possible negative long-term health and social outcomes from exposure to parental drinking 1–19 years after exposure through continuously updated nationwide registers. The rich information available from combining survey and registry data allows us to take into account important confounders, mediators, and moderators.

  8. A Design Study to Develop Young Children's Understanding of Multiplication and Division

    Bicknell, Brenda; Young-Loveridge, Jenny; Nguyen, Nhung

    2016-01-01

    This design study investigated the use of multiplication and division problems to help 5-year-old children develop an early understanding of multiplication and division. One teacher and her class of 15 5-year-old children were involved in a collaborative partnership with the researchers. The design study was conducted over two 4-week periods in…

  9. Supporting Affect Regulation in Children With Multiple Disabilities During Psychotherapy: A Multiple Case Design Study of Therapeutic Attachment. [Miscellaneous Article

    Schuengel, C; Sterkenburg, P S; Jeczynski, P; Janssen, C G C; Jongbloed, G

    2009-01-01

    : In a controlled multiple case design study, the development of a therapeutic relationship and its role in affect regulation were studied in 6 children with visual disabilities, severe intellectual disabilities, severe challenging behavior, and prolonged social deprivation. In the 1st phase,

  10. Neuropsychological, balance, and mobility risk factors for falls in people with multiple sclerosis: a prospective cohort study.

    Hoang, Phu D; Cameron, Michelle H; Gandevia, Simon C; Lord, Stephen R

    2014-03-01

    To determine whether impaired performance in a range of vision, proprioception, neuropsychological, balance, and mobility tests and pain and fatigue are associated with falls in people with multiple sclerosis (PwMS). Prospective cohort study with 6-month follow-up. A multiple sclerosis (MS) physiotherapy clinic. Community-dwelling people (N=210; age range, 21-74y) with MS (Disease Steps 0-5). Not applicable. Incidence of falls during 6 months' follow-up. In the 6-month follow-up period, 83 participants (39.7%) experienced no falls, 57 (27.3%) fell once or twice, and 69 (33.0%) fell 3 or more times. Frequent falling (≥3) was associated with increased postural sway (eyes open and closed), poor leaning balance (as assessed with the coordinated stability task), slow choice stepping reaction time, reduced walking speed, reduced executive functioning (as assessed with the difference between Trail Making Test Part B and Trail Making Test Part A), reduced fine motor control (performance on the 9-Hole Peg Test [9-HPT]), and reported leg pain. Increased sway with the eyes closed, poor coordinated stability, and reduced performance in the 9-HPT were identified as variables that significantly and independently discriminated between frequent fallers and nonfrequent fallers (model χ(2)3=30.1, Pbalance, coordination, and cognitive determinants of falls in PwMS. These should assist the development of effective strategies for prevention of falls in this high-risk group. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  11. RNAblueprint: flexible multiple target nucleic acid sequence design.

    Hammer, Stefan; Tschiatschek, Birgit; Flamm, Christoph; Hofacker, Ivo L; Findeiß, Sven

    2017-09-15

    Realizing the value of synthetic biology in biotechnology and medicine requires the design of molecules with specialized functions. Due to its close structure to function relationship, and the availability of good structure prediction methods and energy models, RNA is perfectly suited to be synthetically engineered with predefined properties. However, currently available RNA design tools cannot be easily adapted to accommodate new design specifications. Furthermore, complicated sampling and optimization methods are often developed to suit a specific RNA design goal, adding to their inflexibility. We developed a C ++  library implementing a graph coloring approach to stochastically sample sequences compatible with structural and sequence constraints from the typically very large solution space. The approach allows to specify and explore the solution space in a well defined way. Our library also guarantees uniform sampling, which makes optimization runs performant by not only avoiding re-evaluation of already found solutions, but also by raising the probability of finding better solutions for long optimization runs. We show that our software can be combined with any other software package to allow diverse RNA design applications. Scripting interfaces allow the easy adaption of existing code to accommodate new scenarios, making the whole design process very flexible. We implemented example design approaches written in Python to demonstrate these advantages. RNAblueprint , Python implementations and benchmark datasets are available at github: https://github.com/ViennaRNA . s.hammer@univie.ac.at, ivo@tbi.univie.ac.at or sven@tbi.univie.ac.at. Supplementary data are available at Bioinformatics online. © The Author(s) 2017. Published by Oxford University Press.

  12. Role of BMI and age in predicting pathologic vertebral fractures in newly diagnosed multiple myeloma patients: A retrospective cohort study.

    Chen, Yi-Lun; Liu, Yao-Chung; Wu, Chia-Hung; Yeh, Chiu-Mei; Chiu, Hsun-I; Lee, Gin-Yi; Lee, Yu-Ting; Hsu, Pei; Lin, Ting-Wei; Gau, Jyh-Pyng; Hsiao, Liang-Tsai; Chiou, Tzeon-Jye; Liu, Jin-Hwang; Liu, Chia-Jen

    2018-04-01

    Vertebral fractures affect approximately 30% of myeloma patients and lead to a poor impact on survival and life quality. In general, age and body mass index (BMI) are reported to have an important role in vertebral fractures. However, the triangle relationship among age, BMI, and vertebral fractures is still unclear in newly diagnosed multiple myeloma (NDMM) patients. This study recruited consecutive 394 patients with NDMM at Taipei Veterans General Hospital between January 1, 2005 and December 31, 2015. Risk factors for vertebral fractures in NDMM patients were collected and analyzed. The survival curves were demonstrated using Kaplan-Meier estimate. In total, 301 (76.4%) NDMM patients were enrolled in the cohort. In the median follow-up period of 18.0 months, the median survival duration in those with vertebral fractures ≥ 2 was shorter than those with vertebral fracture BMI BMI ≥ 24.0 kg/m 2 (adjusted RR, 2.79; 95% CI, 1.44-5.43). In multivariable logistic regression, BMI BMI ≥ 24.0 kg/m 2 (adjusted OR, 6.05; 95% CI, 2.43-15.08). Among age stratifications, patients with both old age and low BMI were at a greater risk suffering from increased vertebral fractures, especially in patients > 75 years and BMI BMI. Elder patients with low BMI should consider to routinely receive spinal radiographic examinations and regular follow-up. Copyright © 2017 John Wiley & Sons, Ltd.

  13. Exploring multiple trajectories of causality: collaboration between Anthropology and Epidemiology in the 1982 birth cohort, Pelotas, Southern Brazil

    Béhague, Dominique P; Gonçalves, Helen

    2009-01-01

    OBJECTIVE: Although the relationship between epidemiology and anthropology has a long history, it has generally been comprised of the integration of quantitative and qualitative methods. Only recently have the two fields begun to converge along theoretical lines, leading to a growing mutual interest in explaining rather than simply describing phenomena. This paper aimed to illustrate how ethnographic analyses can be used to assist with the in-depth and theoretically-imbued interpretation of epidemiological results. METHODS: The anthropological analysis presented in this paper used ethnographic data collected as part of the ongoing 1982 birth cohort study, between 1997 and 2007 in Pelotas, Southern Brazil. Analyses were framed according to the results presented in two of the epidemiological articles published in this series on the determinants of mental morbidity and age of sexual initiation. RESULTS AND CONCLUSIONS: The ethnographic results show that statistical associations consist of multiple pathways of influence and causality that generally correspond to the unique experiences of specific subgroups. In exploring these pathways, the paper highlights the importance of an additional set of mediating factors that account for epidemiological results; these include the awareness and experience of inequities, the role of violence in everyday life, traumatic life events, increasing social isolation and emotional introversion as a response to life's difficulties, and differing approaches towards socio-psychological maturation. Theoretical and methodological collaboration between anthropology and epidemiology is important for public health, as it has positively modified both fields. PMID:19142353

  14. [Exploring multiple trajectories of causality: collaboration between Anthropology and Epidemiology in the 1982 birth cohort, Pelotas, Southern Brazil].

    Béhague, Dominique P; Gonçalves, Helen

    2008-12-01

    Although the relationship between epidemiology and anthropology has a long history, it has generally been comprised of the integration of quantitative and qualitative methods. Only recently have the two fields begun to converge along theoretical lines, leading to a growing mutual interest in explaining rather than simply describing phenomena. This paper aimed to illustrate how ethnographic analyses can be used to assist with the in-depth and theoretically-imbued interpretation of epidemiological results. The anthropological analysis presented in this paper used ethnographic data collected as part of the ongoing 1982 birth cohort study, between 1997 and 2007 in Pelotas, Southern Brazil. Analyses were framed according to the results presented in two of the epidemiological articles published in this series on the determinants of mental morbidity and age of sexual initiation. The ethnographic results show that statistical associations consist of multiple pathways of influence and causality that generally correspond to the unique experiences of specific subgroups. In exploring these pathways, the paper highlights the importance of an additional set of mediating factors that account for epidemiological results; these include the awareness and experience of inequities, the role of violence in everyday life, traumatic life events, increasing social isolation and emotional introversion as a response to life's difficulties, and differing approaches towards socio-psychological maturation. Theoretical and methodological collaboration between anthropology and epidemiology is important for public health, as it has positively modified both fields.

  15. Seismic isolation systems designed with distinct multiple frequencies

    Wu, Ting-shu; Seidensticker, R.W.

    1991-01-01

    Two systems for seismic base isolation are presented. The main feature of these system is that, instead of only one isolation frequency as in conventional isolation systems, they are designed to have two distinct isolation frequencies. When the responses during an earthquake exceed the design value(s), the system will automatically and passively shift to the secondly isolation frequency. Responses of these two systems to different ground motions including a harmonic motion with frequency same as the primary isolation frequency, show that no excessive amplification will occur. Adoption of these new systems certainly will greatly enhance the safety and reliability of an isolated superstructure against future strong earthquakes. 3 refs

  16. The HIV-Brazil cohort study: design, methods and participant characteristics.

    Alexandre Grangeiro

    Full Text Available BACKGROUND: The HIV-Brazil Cohort Study was established to analyze the effectiveness of combination antiretroviral therapy (cART and the impact of this treatment on morbidity, quality of life (QOL and mortality. The study design, patients' profiles and characteristics of cART initiation between 2003 and 2010 were described. METHODOLOGY/PRINCIPAL FINDINGS: Since 2003, the HIV-Brazil Cohort has been following HIV-infected adults receiving cART at 26 public health care facilities, using routine clinical care data and self-reported QOL questionnaires. When not otherwise available, data are obtained from national information systems. The main outcomes of interest are diseases related or unrelated to HIV; suppression of viral replication; adverse events; virological, clinical and immunological failures; changes in the cART; and mortality. For the 5,061 patients who started cART between 2003 and 2010, the median follow-up time was 4.1 years (IQR 2.2-5.9 years with an 83.4% retention rate. Patient profiles were characterized by a predominance of men (male/female ratio 1.7∶1, with a mean age of 36.9 years (SD 9.9 years; 55.2% had been infected with HIV via heterosexual contact. The majority of patients (53.4% initiated cART with a CD4+ T-cell count ≤200 cells/mm3. The medications most often used in the various treatment regimens were efavirenz (59.7% and lopinavir/ritonavir (18.2%. The proportion of individuals achieving viral suppression within the first 12 months of cART use was 77.4% (95% CI 76.1-78.6. Nearly half (45.4% of the patients presented HIV-related clinical manifestations after starting cART, and the AIDS mortality rate was 13.9 per 1,000 person-years. CONCLUSIONS/SIGNIFICANCE: Results from cART use in the daily practice of health services remain relatively unknown in low- and middle-income countries, and studies with the characteristics of the HIV-Brazil Cohort contribute to minimizing these shortcomings, given its scope and patient

  17. Absorption in multiple scattering systems of coated spheres: design applications

    Stout, Brian; Andraud, Christine; Stout, Sophie; Lafait, Jacques

    2003-01-01

    We illustrate the utility of some recently derived transfer matrix methods for electromagnetic scattering calculations in systems composed of coated spherical scatterers. Any of the spherical coatings, cores, or host media may be composed of absorbing materials. Our formulae permit the calculation of local absorption in either orientation fixed or orientation averaged situations. We introduce methods for estimating the macroscopic transport properties of such media, and show how our scattering calculations can permit 'design' optimization of macroscopic properties

  18. Sequential circuit design for radiation hardened multiple voltage integrated circuits

    Clark, Lawrence T [Phoenix, AZ; McIver, III, John K.

    2009-11-24

    The present invention includes a radiation hardened sequential circuit, such as a bistable circuit, flip-flop or other suitable design that presents substantial immunity to ionizing radiation while simultaneously maintaining a low operating voltage. In one embodiment, the circuit includes a plurality of logic elements that operate on relatively low voltage, and a master and slave latches each having storage elements that operate on a relatively high voltage.

  19. The feasibility of collecting information from people with Multiple Sclerosis for the UK MS Register via a web portal: characterising a cohort of people with MS

    Ford David V

    2012-07-01

    Full Text Available Abstract Background A UK Register of people with Multiple Sclerosis has been developed to address the need for an increased knowledge-base about MS. The Register is being populated via: a web-based portal; NHS neurology clinical systems; and administrative data sources. The data are de-identified and linked at the individual level. At the outset, it was not known whether people with MS would wish to participate in the UK MS Register by personally contributing their data to the Register via a web-based system. Therefore, the research aim of this work was to build an internet-mounted recruitment and consenting technology for people with Multiple Sclerosis, and to assess its feasibility as a questionnaire delivery platform to contribute data to the UK MS Register, by determining whether the information provided could be used to describe a cohort of people with MS. Methods The web portal was developed using VB.net and JQuery with a Microsoft SQL 2008 database. UK adults with MS can self-register and enter data about themselves by completing validated questionnaires. Descriptive statistics were used to characterise the respondents. Results The web portal was launched in May 2011, and in first three months 7,279 individuals registered on the portal. The ratio of men to women was 1:2.4 (n = 5,899, the mean self-reported age at first symptoms was 33.8 (SD 10.5 years, and at diagnosis 39.6 (SD 10.3 years (n = 4,401. The reported types of MS were: 15% primary progressive, 63% relapsing-remitting, 8% secondary progressive, and 14% unknown (n = 5,400. These characteristics are similar to those of the prevalent MS population. Employment rates, sickness/disability rates, ethnicity and educational qualifications were compared with the general UK population. Information about the respondents’ experience of early symptoms and the process of diagnosis, plus living arrangements are also reported. Conclusions These initial findings from the MS

  20. Safe design and operation of tank reactors for multiple-reaction networks: uniqueness and multiplicity

    Westerterp, K.R.; Westerink, E.J.

    1990-01-01

    A method is developed to design a tank reactor in which a network of reactions is carried out. The network is a combination of parallel and consecutive reactions. The method ensures unique operation. Dimensionless groups are used which are either representative of properties of the reaction system

  1. Layout design of user interface components with multiple objectives

    Peer S.K.

    2004-01-01

    Full Text Available A multi-goal layout problem may be formulated as a Quadratic Assignment model, considering multiple goals (or factors, both qualitative and quantitative in the objective function. The facilities layout problem, in general, varies from the location and layout of facilities in manufacturing plant to the location and layout of textual and graphical user interface components in the human–computer interface. In this paper, we propose two alternate mathematical approaches to the single-objective layout model. The first one presents a multi-goal user interface component layout problem, considering the distance-weighted sum of congruent objectives of closeness relationships and the interactions. The second one considers the distance-weighted sum of congruent objectives of normalized weighted closeness relationships and normalized weighted interactions. The results of first approach are compared with that of an existing single objective model for example task under consideration. Then, the results of first approach and second approach of the proposed model are compared for the example task under consideration.

  2. 78 FR 3897 - Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort

    2013-01-17

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort AGENCY: National Institute for Occupational Safety and Health... number of work days aggregating at least 250 work days, occurring either solely under this employment or...

  3. 78 FR 3898 - Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort

    2013-01-17

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort AGENCY: National Institute for Occupational Safety and Health... number of work days aggregating at least 250 work days, occurring either solely under this employment or...

  4. Serial network simplifies the design of multiple microcomputer systems

    Folkes, D.

    1981-01-01

    Recently there has been a lot of interest in developing network communication schemes for carrying digital data between locally distributed computing stations. Many of these schemes have focused on distributed networking techniques for data processing applications. These applications suggest the use of a serial, multipoint bus, where a number of remote intelligent units act as slaves to a central or host computer. Each slave would be serially addressable from the host and would perform required operations upon being addressed by the host. Based on an MK3873 single-chip microcomputer, the SCU 20 is designed to be such a remote slave device. The capabilities of the SCU 20 and its use in systems applications are examined.

  5. Multiple lifestyle behaviours and mortality, findings from a large population-based Norwegian cohort study - The HUNT Study

    Steinar Krokstad

    2017-01-01

    Full Text Available Abstract Background Lifestyle risk behaviours are responsible for a large proportion of disease burden and premature mortality worldwide. Risk behaviours tend to cluster in populations. We developed a new lifestyle risk index by including emerging risk factors (sleep, sitting time, and social participation and examine unique risk combinations and their associations with all-cause and cardio-metabolic mortality. Methods Data are from a large population-based cohort study in a Norway, the Nord-Trøndelag Health Study (HUNT, with an average follow-up time of 14.1 years. Baseline data from 1995–97 were linked to the Norwegian Causes of Death Registry. The analytic sample comprised 36 911 adults aged 20–69 years. Cox regression models were first fitted for seven risk factors (poor diet, excessive alcohol consumption, current smoking, physical inactivity, excessive sitting, too much/too little sleep, and poor social participation separately and then adjusted for socio-demographic covariates. Based on these results, a lifestyle risk index was developed. Finally, we explored common combinations of the risk factors in relation to all-cause and cardio-metabolic mortality outcomes. Results All single risk factors, except for diet, were significantly associated with both mortality outcomes, and were therefore selected to form a lifestyle risk index. Risk of mortality increased as the index score increased. The hazard ratio for all-cause mortality increased from 1.37 (1.15-1.62 to 6.15 (3.56-10.63 as the number of index risk factors increased from one to six respectively. Among the most common risk factor combinations the association with mortality was particularly strong when smoking and/or social participation were included. Conclusions This study adds to previous research on multiple risk behaviours by incorporating emerging risk factors. Findings regarding social participation and prolonged sitting suggest new components of healthy lifestyles and

  6. Long-term persistence with injectable therapy in relapsing-remitting multiple sclerosis: an 18-year observational cohort study.

    Simon Zhornitsky

    Full Text Available Disease modifying therapies (DMTs reduce the frequency of relapses and accumulation of disability in multiple sclerosis (MS. Long-term persistence with treatment is important to optimize treatment benefit. This long-term, cohort study was conducted at the Calgary MS Clinic. All consenting adults with relapsing-remitting MS who started either glatiramer acetate (GA or interferon-β 1a/1b (IFN-β between January 1st, 1996 and July 1st, 2011 were included. Follow-up continued to February 1st, 2014. Time-to-discontinuation of the initial and subsequently-prescribed DMTs (switches was analysed using Kaplan-Meier survival analyses. Group differences were compared using log-rank tests and multivariable Cox regression models. Analysis included 1471 participants; 906 were initially prescribed GA and 565 were initially prescribed IFN-β. Follow-up information was available for 87%; 29 (2% were lost to follow-up and 160 (11% moved from Southern Alberta while still using DMT. Median time-to-discontinuation of all injectable DMTs was 11.1 years. Participants with greater disability at treatment initiation, those who started treatment before age 30, and those who started between 2006 and 2011 were more likely to discontinue use of all injectable DMTs. Median time-to-discontinuation of the initial DMT was 8.6 years. Those initially prescribed GA remained on treatment longer. Of 610 participants who discontinued injectable DMT, 331 (54% started an oral DMT, or a second-line DMT, or resumed injectable DMT after 90 days. Persistence with injectable DMTs was high in this long-term population-based study. Most participants who discontinued injectable DMT did not remain untreated. Further research is required to understand treatment outcomes and outcomes after stopping DMT.

  7. Does decision documentation help junior designers rationalize their decisions? A comparative multiple-case study

    Heesch, U. van; Avgeriou, P.; Tang, A.

    Software architecture design is challenging, especially for junior software designers. Lacking practice and experience, junior designers need process support in order to make rational architecture decisions. In this paper, we present the results of a comparative multiple-case study conducted to find

  8. Optimal design of structures with multiple design variables per group and multiple loading conditions on the personal computer

    Nguyen, D. T.; Rogers, J. L., Jr.

    1986-01-01

    A finite element based programming system for minimum weight design of a truss-type structure subjected to displacement, stress, and lower and upper bounds on design variables is presented. The programming system consists of a number of independent processors, each performing a specific task. These processors, however, are interfaced through a well-organized data base, thus making the tasks of modifying, updating, or expanding the programming system much easier in a friendly environment provided by many inexpensive personal computers. The proposed software can be viewed as an important step in achieving a 'dummy' finite element for optimization. The programming system has been implemented on both large and small computers (such as VAX, CYBER, IBM-PC, and APPLE) although the focus is on the latter. Examples are presented to demonstrate the capabilities of the code. The present programming system can be used stand-alone or as part of the multilevel decomposition procedure to obtain optimum design for very large scale structural systems. Furthermore, other related research areas such as developing optimization algorithms (or in the larger level: a structural synthesis program) for future trends in using parallel computers may also benefit from this study.

  9. Prognosis of acute low back pain: design of a prospective inception cohort study

    York John

    2006-06-01

    Full Text Available Abstract Background Clinical guidelines generally portray acute low back pain as a benign and self-limiting condition. However, evidence about the clinical course of acute low back pain is contradictory and the risk of subsequently developing chronic low back pain remains uncertain. There are few high quality prognosis studies and none that have measured pain, disability and return to work over a 12 month period. This study aims to provide the first estimates of the one year prognosis of acute low back pain (pain of less than 2 weeks duration in patients consulting primary care practitioners. A secondary aim is to identify factors that are associated with the prognosis of low back pain. Methods/Design The study is a prospective inception cohort study. Consecutive patients consulting general medical practitioners, physiotherapists and chiropractors in the Sydney metropolitan region will complete a baseline questionnaire regarding their back pain. Subsequently these patients will be followed up by telephone 6 weeks, 3 months and 12 months after the initial consultation. Patients will be considered to have recovered from the episode of back pain if they have no pain and no limitation of activity, and have returned to pre-injury work status. Life tables will be generated to determine the one year prognosis of acute low back pain. Prognostic factors will be assessed using Cox regression. Discussion This study will provide the first estimates of the one year prognosis of acute low back pain in a representative sample of primary care patients.

  10. Improving Graduate Students' Graphing Skills of Multiple Baseline Designs with Microsoft[R] Excel 2007

    Lo, Ya-yu; Starling, A. Leyf Peirce

    2009-01-01

    This study examined the effects of a graphing task analysis using the Microsoft[R] Office Excel 2007 program on the single-subject multiple baseline graphing skills of three university graduate students. Using a multiple probe across participants design, the study demonstrated a functional relationship between the number of correct graphing…

  11. Turning challenges into design principles: Telemonitoring systems for patients with multiple chronic conditions.

    Sultan, Mehwish; Kuluski, Kerry; McIsaac, Warren J; Cafazzo, Joseph A; Seto, Emily

    2018-01-01

    People with multiple chronic conditions often struggle with managing their health. The purpose of this research was to identify specific challenges of patients with multiple chronic conditions and to use the findings to form design principles for a telemonitoring system tailored for these patients. Semi-structured interviews with 15 patients with multiple chronic conditions and 10 clinicians were conducted to gain an understanding of their needs and preferences for a smartphone-based telemonitoring system. The interviews were analyzed using a conventional content analysis technique, resulting in six themes. Design principles developed from the themes included that the system must be modular to accommodate various combinations of conditions, reinforce a routine, consolidate record keeping, as well as provide actionable feedback to the patients. Designing an application for multiple chronic conditions is complex due to variability in patient conditions, and therefore, design principles developed in this study can help with future innovations aimed to help manage this population.

  12. Trends in the incidence of dementia: design and methods in the Alzheimer Cohorts Consortium.

    Chibnik, Lori B; Wolters, Frank J; Bäckman, Kristoffer; Beiser, Alexa; Berr, Claudine; Bis, Joshua C; Boerwinkle, Eric; Bos, Daniel; Brayne, Carol; Dartigues, Jean-Francois; Darweesh, Sirwan K L; Debette, Stephanie; Davis-Plourde, Kendra L; Dufouil, Carole; Fornage, Myriam; Grasset, Leslie; Gudnason, Vilmundur; Hadjichrysanthou, Christoforos; Helmer, Catherine; Ikram, M Arfan; Ikram, M Kamran; Kern, Silke; Kuller, Lewis H; Launer, Lenore; Lopez, Oscar L; Matthews, Fiona; Meirelles, Osorio; Mosley, Thomas; Ower, Alison; Psaty, Bruce M; Satizabal, Claudia L; Seshadri, Sudha; Skoog, Ingmar; Stephan, Blossom C M; Tzourio, Christophe; Waziry, Reem; Wong, Mei Mei; Zettergren, Anna; Hofman, Albert

    2017-10-01

    Several studies have reported a decline in incidence of dementia which may have large implications for the projected burden of disease, and provide important guidance to preventive efforts. However, reports are conflicting or inconclusive with regard to the impact of gender and education with underlying causes of a presumed declining trend remaining largely unidentified. The Alzheimer Cohorts Consortium aggregates data from nine international population-based cohorts to determine changes in the incidence of dementia since 1990. We will employ Poisson regression models to calculate incidence rates in each cohort and Cox proportional hazard regression to compare 5-year cumulative hazards across study-specific epochs. Finally, we will meta-analyse changes per decade across cohorts, and repeat all analysis stratified by sex, education and APOE genotype. In all cohorts combined, there are data on almost 69,000 people at risk of dementia with the range of follow-up years between 2 and 27. The average age at baseline is similar across cohorts ranging between 72 and 77. Uniting a wide range of disease-specific and methodological expertise in research teams, the first analyses within the Alzheimer Cohorts Consortium are underway to tackle outstanding challenges in the assessment of time-trends in dementia occurrence.

  13. Prospect-EPIC Utrecht: study design and characteristics of the cohort population. European Prospective Investigation into Cancer and Nutrition.

    Boker, L K; van Noord, P A; van der Schouw, Y T; Koot, N V; Bueno de Mesquita, H B; Riboli, E; Grobbee, D E; Peeters, P H

    2001-01-01

    The European Prospective Investigation into Cancer and Nutrition (EPIC), which has been established in order to investigate the relations between nutrition and cancer, was initiated in 1990 and involves 10 European countries with heterogeneous dietary patterns and differing cancer incidence rates. This manuscript presents the design, recruitment and baseline characteristics of the Prospect-EPIC cohort co-ordinated in Utrecht, The Netherlands. The cohort is based on volunteers recruited among women participating in a regional breast cancer screening program. It comprises of 17,357 subjects aged 50-69 years at enrolment from Utrecht and vicinity, who have consented to participate in the study and its follow-up. Each participant filled out a general questionnaire and a food frequency questionnaire. Participants were also physically examined and have donated a blood sample. Participation rate was 34.5%. Blood samples were donated by most participants (97.5%) and detailed informed consents were obtained from 87.4% of participants. Mean age at enrolment was 57 years. Anthropometric, lifestyle and morbidity characteristics of the cohort population did not differ largely from those of similar study populations in The Netherlands. Based on the Prospect-EPIC population, we intend to conduct prospective total cohort, nested case-control or case-cohort studies, in order to investigate relations between consumption of certain food groups or nutrients and chronic diseases, including hormone dependant cancers such as breast, colon, endometrial and ovary cancers.

  14. Signatures of inflammation and impending multiple organ dysfunction in the hyperacute phase of trauma: A prospective cohort study.

    Cabrera, Claudia P; Manson, Joanna; Shepherd, Joanna M; Torrance, Hew D; Watson, David; Longhi, M Paula; Hoti, Mimoza; Patel, Minal B; O'Dwyer, Michael; Nourshargh, Sussan; Pennington, Daniel J; Barnes, Michael R; Brohi, Karim

    2017-07-01

    Severe trauma induces a widespread response of the immune system. This "genomic storm" can lead to poor outcomes, including Multiple Organ Dysfunction Syndrome (MODS). MODS carries a high mortality and morbidity rate and adversely affects long-term health outcomes. Contemporary management of MODS is entirely supportive, and no specific therapeutics have been shown to be effective in reducing incidence or severity. The pathogenesis of MODS remains unclear, and several models are proposed, such as excessive inflammation, a second-hit insult, or an imbalance between pro- and anti-inflammatory pathways. We postulated that the hyperacute window after trauma may hold the key to understanding how the genomic storm is initiated and may lead to a new understanding of the pathogenesis of MODS. We performed whole blood transcriptome and flow cytometry analyses on a total of 70 critically injured patients (Injury Severity Score [ISS] ≥ 25) at The Royal London Hospital in the hyperacute time period within 2 hours of injury. We compared transcriptome findings in 36 critically injured patients with those of 6 patients with minor injuries (ISS ≤ 4). We then performed flow cytometry analyses in 34 critically injured patients and compared findings with those of 9 healthy volunteers. Immediately after injury, only 1,239 gene transcripts (4%) were differentially expressed in critically injured patients. By 24 hours after injury, 6,294 transcripts (21%) were differentially expressed compared to the hyperacute window. Only 202 (16%) genes differentially expressed in the hyperacute window were still expressed in the same direction at 24 hours postinjury. Pathway analysis showed principally up-regulation of pattern recognition and innate inflammatory pathways, with down-regulation of adaptive responses. Immune deconvolution, flow cytometry, and modular analysis suggested a central role for neutrophils and Natural Killer (NK) cells, with underexpression of T- and B cell responses. In

  15. Signatures of inflammation and impending multiple organ dysfunction in the hyperacute phase of trauma: A prospective cohort study.

    Claudia P Cabrera

    2017-07-01

    Full Text Available Severe trauma induces a widespread response of the immune system. This "genomic storm" can lead to poor outcomes, including Multiple Organ Dysfunction Syndrome (MODS. MODS carries a high mortality and morbidity rate and adversely affects long-term health outcomes. Contemporary management of MODS is entirely supportive, and no specific therapeutics have been shown to be effective in reducing incidence or severity. The pathogenesis of MODS remains unclear, and several models are proposed, such as excessive inflammation, a second-hit insult, or an imbalance between pro- and anti-inflammatory pathways. We postulated that the hyperacute window after trauma may hold the key to understanding how the genomic storm is initiated and may lead to a new understanding of the pathogenesis of MODS.We performed whole blood transcriptome and flow cytometry analyses on a total of 70 critically injured patients (Injury Severity Score [ISS] ≥ 25 at The Royal London Hospital in the hyperacute time period within 2 hours of injury. We compared transcriptome findings in 36 critically injured patients with those of 6 patients with minor injuries (ISS ≤ 4. We then performed flow cytometry analyses in 34 critically injured patients and compared findings with those of 9 healthy volunteers. Immediately after injury, only 1,239 gene transcripts (4% were differentially expressed in critically injured patients. By 24 hours after injury, 6,294 transcripts (21% were differentially expressed compared to the hyperacute window. Only 202 (16% genes differentially expressed in the hyperacute window were still expressed in the same direction at 24 hours postinjury. Pathway analysis showed principally up-regulation of pattern recognition and innate inflammatory pathways, with down-regulation of adaptive responses. Immune deconvolution, flow cytometry, and modular analysis suggested a central role for neutrophils and Natural Killer (NK cells, with underexpression of T- and B cell

  16. The Carriage Of Multiresistant Bacteria After Travel (COMBAT) prospective cohort study: methodology and design.

    Arcilla, Maris S; van Hattem, Jarne M; Bootsma, Martin C J; van Genderen, Perry J; Goorhuis, Abraham; Schultsz, Constance; Stobberingh, Ellen E; Verbrugh, Henri A; de Jong, Menno D; Melles, Damian C; Penders, John

    2014-04-28

    Antimicrobial resistance (AMR) is one of the major threats to public health around the world. Besides the intense use and misuse of antimicrobial agents as the major force behind the increase in antimicrobial resistance, the exponential increase of international travel may also substantially contribute to the emergence and spread of AMR. However, knowledge on the extent to which international travel contributes to this is still limited. The Carriage Of Multiresistant Bacteria After Travel (COMBAT) study aims to 1. determine the acquisition rate of multiresistant Enterobacteriaceae during foreign travel 2. ascertain the duration of carriage of these micro-organisms 3. determine the transmission rate within households 4. identify risk factors for acquisition, persistence of carriage and transmission of multiresistant Enterobacteriaceae. The COMBAT-study is a large-scale multicenter longitudinal cohort study among travellers (n = 2001) and their non-travelling household members (n = 215). Faecal samples are collected before and immediately after travel and 1 month after return from all participants. Follow-up faecal samples are collected 3, 6 and 12 months after return from travellers (and their non-travelling household members) who acquired multiresistant Enterobacteriaceae. Questionnaires are collected from all participants at each time-point. Faecal samples are screened phenotypically for the presence of extended-spectrum beta-lactamase (ESBL) or carbapenemase-producing Enterobacteriaceae. Positive post-travel isolates from travellers with negative pre-travel samples are genotypically analysed for ESBL and carbapenemase genes with microarray and gene sequencing. The design and scale of the COMBAT-study will enable us to provide much needed detailed insights into the risks and dynamics of introduction and spread of ESBL- and carbapenemase-producing Enterobacteriaceae by healthy travellers and the potential need and measures to monitor or manage these risks

  17. The Urban Environment and Childhood Asthma (URECA birth cohort study: design, methods, and study population

    Sandel Megan T

    2009-05-01

    Full Text Available Abstract Background The incidence and morbidity of wheezing illnesses and childhood asthma is especially high in poor urban areas. This paper describes the study design, methods, and population of the Urban Environment and Childhood Asthma (URECA study, which was established to investigate the immunologic causes of asthma among inner-city children. Methods and Results URECA is an observational prospective study that enrolled pregnant women in central urban areas of Baltimore, Boston, New York City, and St. Louis and is following their offspring from birth through age 7 years. The birth cohort consists of 560 inner-city children who have at least one parent with an allergic disease or asthma, and all families live in areas in which at least 20% of the population has incomes below the poverty line. In addition, 49 inner-city children with no parental history of allergies or asthma were enrolled. The primary hypothesis is that specific urban exposures in early life promote a unique pattern of immune development (impaired antiviral and increased Th2 responses that increases the risk of recurrent wheezing and allergic sensitization in early childhood, and of asthma by age 7 years. To track immune development, cytokine responses of blood mononuclear cells stimulated ex vivo are measured at birth and then annually. Environmental assessments include allergen and endotoxin levels in house dust, pre- and postnatal maternal stress, and indoor air nicotine and nitrogen dioxide. Nasal mucous samples are collected from the children during respiratory illnesses and analyzed for respiratory viruses. The complex interactions between environmental exposures and immune development will be assessed with respect to recurrent wheeze at age 3 years and asthma at age 7 years. Conclusion The overall goal of the URECA study is to develop a better understanding of how specific urban exposures affect immune development to promote wheezing illnesses and asthma.

  18. Living with diabetes: rationale, study design and baseline characteristics for an Australian prospective cohort study

    Donald Maria

    2012-01-01

    Full Text Available Abstract Background Diabetes mellitus is a major global public health threat. In Australia, as elsewhere, it is responsible for a sizeable portion of the overall burden of disease, and significant costs. The psychological and social impact of diabetes on individuals with the disease can be severe, and if not adequately addressed, can lead to the worsening of the overall disease picture. The Living With Diabetes Study aims to contribute to a holistic understanding of the psychological and social aspects of diabetes mellitus. Methods/Design The Living With Diabetes Study is a 5-year prospective cohort study, based in Queensland, Australia. The first wave of data, which was collected via a mailed self-report survey, was gathered in 2008, with annual collections thereafter. Measurements include: demographic, lifestyle, health and disease characteristics; quality of life (EQ-5D, ADDQoL; emotional well-being (CES-D, LOT-R, ESSI; disease self-management (PAM; and health-care utilisation and patient-assessed quality of care (PACIC. 29% of the 14,439 adults who were invited to participate in the study agreed to do so, yielding a sample size of 3,951 people. Discussion The data collected by the Living With Diabetes Study provides a good representation of Australians with diabetes to follow over time in order to better understand the natural course of the illness. The study has potential to further illuminate, and give a comprehensive picture of the psychosocial implications of living with diabetes. Data collection is ongoing.

  19. Design optimization of offshore wind farms with multiple types of wind turbines

    Feng, Ju; Shen, Wen Zhong

    2017-01-01

    Most studies on offshore wind farm design assume a uniform wind farm, which consists of an identical type of wind turbines. In order to further reduce the cost of energy, we investigate the design of non-uniform offshore wind farms, i.e., wind farms with multiple types of wind turbines and hub-he...

  20. Assessment of Worldwide Acute Kidney injury Epidemiology in Neonates (AWAKEN: Design of a Retrospective Cohort Study

    Jennifer Garcia Jetton

    2016-07-01

    Full Text Available INTRODUCTION: Acute kidney injury (AKI affects ~30% of hospitalized neonates. Critical to advancing our understanding of neonatal AKI is collaborative research among neonatologists and nephrologists. The Neonatal Kidney Collaborative (NKC is an international, multidisciplinary group dedicated to investigating neonatal AKI. The AWAKEN study (Assessment of Worldwide Acute Kidney injury Epidemiology in Neonates was designed to describe the epidemiology of neonatal AKI, validate the definition of neonatal AKI, identify primary risk factors for neonatal AKI, and investigate the contribution of fluid management to AKI events and short term outcomes. METHODS and ANALYSIS: The NKC was established with at least one pediatric nephrologist and neonatologist from 24 institutions from 4 countries (USA, Canada, Australia, India. A Steering Committee and four subcommittees were created. The database subcommittee oversaw the development of the web-based database (MediData Rave™ that captured all NICU admissions from 1/1/14-3/31/14. Inclusion and exclusion criteria were applied to eliminate babies with a low likelihood of AKI. Data collection includes: 1 baseline demographic information; 2 daily physiologic parameters and care received during the first week of life; 3 weekly snapshots; 4 discharge information including growth parameters, final diagnoses, discharge medications and need for renal replacement therapy; and 5 all serum creatinine values. ETHICS and DISSEMINATION: AWAKEN was proposed as human subjects research. The study design allowed for a waiver of informed consent/parental permission. NKC investigators will disseminate data through peer-reviewed publications and educational conferences. DISCUSSION: The purpose of this publication is to describe the formation of the NKC, the establishment of the AWAKEN cohort and database, future directions and a few lessons learned. The AWAKEN database includes ~325 unique variables and >4 million discrete data

  1. Functional health status in subjects after a motor vehicle accident, with emphasis on whiplash associated disorders: design of a descriptive, prospective inception cohort study

    Helders Paul JM

    2008-12-01

    Full Text Available Abstract Background The clinical consequences of whiplash injuries resulting from a motor vehicle accident (MVA are poorly understood. Thereby, there is general lack of research on the development of disability in patients with acute and chronic Whiplash Associated Disorders. Methods/Design The objective is to describe the design of an inception cohort study with a 1-year follow-up to determine risk factors for the development of symptoms after a low-impact motor vehicle accident, the prognosis of chronic disability, and costs. Victims of a low-impact motor vehicle accident will be eligible for participation. Participants with a Neck Disability Index (NDI score of 7 or more will be classified as experiencing post-traumatic neck pain and will enter the experimental group. Participants without complaints (a NDI score less than 7 will enter the reference group. The cohort will be followed up by means of postal questionnaires and physical examinations at baseline, 3 months, 6 months, and 12 months. Recovery from whiplash-associated disorders will be measured in terms of perceived functional health, and employment status (return to work. Life tables will be generated to determine the 1-year prognosis of whiplash-associated disorders, and risk factors and prognostic factors will be assessed using multiple logistic regression analysis. Discussion Little is known about the development of symptoms and chronic disability after a whiplash injury. In the clinical setting, it is important to identify those people who are at risk of developing chronic symptoms. This inception prospective cohort study will provide insight in the influence of risk factors, of the development of functional health problems, and costs in people with whiplash-associated disorders.

  2. Functional health status in subjects after a motor vehicle accident, with emphasis on whiplash associated disorders: design of a descriptive, prospective inception cohort study

    Schmitt, Maarten A; van Meeteren, Nico LU; de Wijer, Anton; Helders, Paul JM; Graaf, Yolanda van der

    2008-01-01

    Background The clinical consequences of whiplash injuries resulting from a motor vehicle accident (MVA) are poorly understood. Thereby, there is general lack of research on the development of disability in patients with acute and chronic Whiplash Associated Disorders. Methods/Design The objective is to describe the design of an inception cohort study with a 1-year follow-up to determine risk factors for the development of symptoms after a low-impact motor vehicle accident, the prognosis of chronic disability, and costs. Victims of a low-impact motor vehicle accident will be eligible for participation. Participants with a Neck Disability Index (NDI) score of 7 or more will be classified as experiencing post-traumatic neck pain and will enter the experimental group. Participants without complaints (a NDI score less than 7) will enter the reference group. The cohort will be followed up by means of postal questionnaires and physical examinations at baseline, 3 months, 6 months, and 12 months. Recovery from whiplash-associated disorders will be measured in terms of perceived functional health, and employment status (return to work). Life tables will be generated to determine the 1-year prognosis of whiplash-associated disorders, and risk factors and prognostic factors will be assessed using multiple logistic regression analysis. Discussion Little is known about the development of symptoms and chronic disability after a whiplash injury. In the clinical setting, it is important to identify those people who are at risk of developing chronic symptoms. This inception prospective cohort study will provide insight in the influence of risk factors, of the development of functional health problems, and costs in people with whiplash-associated disorders. PMID:19099574

  3. Multiple mini-interview as a predictor of performance in the objective structured clinical examination among Physician Associates in the United Kingdom: a cohort study

    Kumar, Narendra; Bhardwaj, Shailaja; Rahman, Eqram

    2018-01-01

    Introduction Patient satisfaction and health care outcomes are directly linked to useful communication skills. Therefore, excellent interpersonal skills are imperative for health care professionals. Multiple mini-interview (MMI) is designed as a selection tool to assess the communication skills of applicants in medical schools during the admission process. However, objective structured clinical examination (OSCE) assesses students’ communication and clinical skills at the end of their academic terms. Recently, Anglia Ruskin University, Chelmsford, UK, adopted MMI in the selection process for the first cohort of MSc Physician Associate trainees for the academic year 2015–2016. This study aimed to determine the likelihood of MMI as a predictor of future performance of communication skills in the OSCE. Materials and methods The anonymous data of the average scores of communication skills attained in MMI and OSCE at the end of year 1 were collected for 30 students from the Physician Associate program team. Subsequently, Pearson’s correlation was computed to determine the relationship between the average scores of communication skills attained in MMI, and OSCE during trimester 2 and trimester 3 by the Physician Associate trainees. Results The study showed positive correlation between the scores of communication skills attained in MMI and OSCE during trimester 2 (r=0.956, n=30, p<0.001) and trimester 3 (r=0.966, n=30, p<0.001). Conclusion The study provides empirical evidence for the validity of MMI as a predictor of future performance of Physician Associate trainees’ communication skills during subsequent OSCEs. PMID:29695944

  4. Bilevel formulation of a policy design problem considering multiple objectives and incomplete preferences

    Hawthorne, Bryant; Panchal, Jitesh H.

    2014-07-01

    A bilevel optimization formulation of policy design problems considering multiple objectives and incomplete preferences of the stakeholders is presented. The formulation is presented for Feed-in-Tariff (FIT) policy design for decentralized energy infrastructure. The upper-level problem is the policy designer's problem and the lower-level problem is a Nash equilibrium problem resulting from market interactions. The policy designer has two objectives: maximizing the quantity of energy generated and minimizing policy cost. The stakeholders decide on quantities while maximizing net present value and minimizing capital investment. The Nash equilibrium problem in the presence of incomplete preferences is formulated as a stochastic linear complementarity problem and solved using expected value formulation, expected residual minimization formulation, and the Monte Carlo technique. The primary contributions in this article are the mathematical formulation of the FIT policy, the extension of computational policy design problems to multiple objectives, and the consideration of incomplete preferences of stakeholders for policy design problems.

  5. Does decision documentation help junior designers rationalize their decisions? A comparative multiple-case study

    Heesch, U. van; Avgeriou, P.; Tang, A.

    2013-01-01

    Software architecture design is challenging, especially for junior software designers. Lacking practice and experience, junior designers need process support in order to make rational architecture decisions. In this paper, we present the results of a comparative multiple-case study conducted to find out if decision viewpoints from van Heesch et al. (2012, in press) can provide such a support. The case study was conducted with four teams of software engineering students working in industrial s...

  6. Cohort profile

    Tollånes, Mette C; Strandberg-Larsen, Katrine; Forthun, Ingeborg

    2016-01-01

    PURPOSE: The purpose of MOthers and BAbies in Norway and Denmark cerebral palsy (MOBAND-CP) was to study CP aetiology in a prospective design. PARTICIPANTS: MOBAND-CP is a cohort of more than 210 000 children, created as a collaboration between the world's two largest pregnancy cohorts-the Norweg......PURPOSE: The purpose of MOthers and BAbies in Norway and Denmark cerebral palsy (MOBAND-CP) was to study CP aetiology in a prospective design. PARTICIPANTS: MOBAND-CP is a cohort of more than 210 000 children, created as a collaboration between the world's two largest pregnancy cohorts......-the Norwegian Mother and Child Cohort study (MoBa) and the Danish National Birth Cohort. MOBAND-CP includes maternal interview/questionnaire data collected during pregnancy and follow-up, plus linked information from national health registries. FINDINGS TO DATE: Initial harmonisation of data from the 2 cohorts...... has created 140 variables for children and their mothers. In the MOBAND-CP cohort, 438 children with CP have been identified through record linkage with validated national registries, providing by far the largest such sample with prospectively collected detailed pregnancy data. Several studies...

  7. On strength design using free material subjected to multiple load cases

    Pedersen, Pauli; Pedersen, Niels Leergaard

    2013-01-01

    Multiple load cases and the consideration of strength is a reality that most structural designs are exposed to. Improved possibility to produce specific materials, say by fiber lay-up, put focus on research on free material optimization. A formulation for such design problems together with a prac......Multiple load cases and the consideration of strength is a reality that most structural designs are exposed to. Improved possibility to produce specific materials, say by fiber lay-up, put focus on research on free material optimization. A formulation for such design problems together...... with a practical recursive design procedure is presented and illustrated with examples. The presented finite element analysis involve many elements as well as many load cases. Separating the local amount of material from a description with unit trace for the local anisotropy, gives the free materials formulation...

  8. BSDB: A New Consistent Designation Scheme for Identifying Objects in Binary and Multiple Stars

    Kovaleva D. A.

    2015-06-01

    Full Text Available The new consistent scheme for designation of objects in binary and multiple systems, BSDB, is described. It was developed in the frame of the Binary star DataBase, BDB (http://www.inasan.ru, due to necessity of a unified and consistent system for designation of objects in the database, and the name of the designation scheme was derived from that of the database. The BSDB scheme covers all types of observational data. Three classes of objects introduced within the BSDB nomenclature provide correct links between objects and data, what is especially important for complex multiple stellar systems. The final stage of establishing the BSDB scheme is compilation of the Identification List of Binaries, ILB, where all known objects in binary and multiple stars are presented with their BSDB identifiers along with identifiers according to major catalogues and lists.

  9. Design of an Air Pollution Monitoring Campaign in Beijing for Application to Cohort Health Studies.

    Vedal, Sverre; Han, Bin; Xu, Jia; Szpiro, Adam; Bai, Zhipeng

    2017-12-15

    No cohort studies in China on the health effects of long-term air pollution exposure have employed exposure estimates at the fine spatial scales desirable for cohort studies with individual-level health outcome data. Here we assess an array of modern air pollution exposure estimation approaches for assigning within-city exposure estimates in Beijing for individual pollutants and pollutant sources to individual members of a cohort. Issues considered in selecting specific monitoring data or new monitoring campaigns include: needed spatial resolution, exposure measurement error and its impact on health effect estimates, spatial alignment and compatibility with the cohort, and feasibility and expense. Sources of existing data largely include administrative monitoring data, predictions from air dispersion or chemical transport models and remote sensing (specifically satellite) data. New air monitoring campaigns include additional fixed site monitoring, snapshot monitoring, passive badge or micro-sensor saturation monitoring and mobile monitoring, as well as combinations of these. Each of these has relative advantages and disadvantages. It is concluded that a campaign in Beijing that at least includes a mobile monitoring component, when coupled with currently available spatio-temporal modeling methods, should be strongly considered. Such a campaign is economical and capable of providing the desired fine-scale spatial resolution for pollutants and sources.

  10. Design of an Air Pollution Monitoring Campaign in Beijing for Application to Cohort Health Studies

    Sverre Vedal

    2017-12-01

    Full Text Available No cohort studies in China on the health effects of long-term air pollution exposure have employed exposure estimates at the fine spatial scales desirable for cohort studies with individual-level health outcome data. Here we assess an array of modern air pollution exposure estimation approaches for assigning within-city exposure estimates in Beijing for individual pollutants and pollutant sources to individual members of a cohort. Issues considered in selecting specific monitoring data or new monitoring campaigns include: needed spatial resolution, exposure measurement error and its impact on health effect estimates, spatial alignment and compatibility with the cohort, and feasibility and expense. Sources of existing data largely include administrative monitoring data, predictions from air dispersion or chemical transport models and remote sensing (specifically satellite data. New air monitoring campaigns include additional fixed site monitoring, snapshot monitoring, passive badge or micro-sensor saturation monitoring and mobile monitoring, as well as combinations of these. Each of these has relative advantages and disadvantages. It is concluded that a campaign in Beijing that at least includes a mobile monitoring component, when coupled with currently available spatio-temporal modeling methods, should be strongly considered. Such a campaign is economical and capable of providing the desired fine-scale spatial resolution for pollutants and sources.

  11. 76 FR 26299 - Designation of a Class of Employees for Addition to the Special Exposure Cohort

    2011-05-06

    ... Special Exposure Cohort AGENCY: National Institute for Occupational Safety and Health (NIOSH), Department... at least 250 work days, occurring either solely under this employment, or in combination with work... Safety and Health (NIOSH), 4676 Columbia Parkway, MS C-46, Cincinnati, OH 45226, Telephone 877-222-7570...

  12. 76 FR 51035 - Designation of a Class of Employees for Addition to the Special Exposure Cohort

    2011-08-17

    ... Special Exposure Cohort AGENCY: National Institute for Occupational Safety and Health (NIOSH), Department... Mexico, from January 1, 1949 through December 31, 1962, for a number of work days aggregating at least..., Division of Compensation Analysis and Support, National Institute for Occupational Safety and Health (NIOSH...

  13. 77 FR 58381 - Designation of a Class of Employees for Addition to the Special Exposure Cohort

    2012-09-20

    ... Special Exposure Cohort AGENCY: National Institute for Occupational Safety and Health (NIOSH), Centers for... December 31, 1967, for a number of work days aggregating at least 250 work days, occurring either solely..., National Institute for Occupational Safety and Health. [FR Doc. 2012-23207 Filed 9-19-12; 8:45 am] BILLING...

  14. 77 FR 32640 - Designation of a Class of Employees for Addition to the Special Exposure Cohort

    2012-06-01

    ... Special Exposure Cohort AGENCY: National Institute for Occupational Safety and Health (NIOSH), Centers for... number of work days aggregating at least 250 work days, occurring either solely under this employment or... Occupational Safety and Health. [FR Doc. 2012-13381 Filed 5-31-12; 8:45 am] BILLING CODE 4163-19-P ...

  15. 77 FR 9250 - Designation of a Class of Employees for Addition to the Special Exposure Cohort

    2012-02-16

    ... Special Exposure Cohort AGENCY: National Institute for Occupational Safety and Health (NIOSH), Centers for... January 1, 1953, through September 30, 1972, for a number of work days aggregating at least 250 work days... . John Howard, Director, National Institute for Occupational Safety and Health. [FR Doc. 2012-3645 Filed...

  16. 78 FR 18350 - Designation of a Class of Employees for Addition to the Special Exposure Cohort

    2013-03-26

    ... Supply Company in Fort Wayne, Indiana, as an addition to the Special Exposure Cohort (SEC) under the... Employees who worked for Joslyn Manufacturing and Supply Company at the covered facility in Fort Wayne, Indiana, from March 1, 1943, through December 31, 1947, for a number of work days aggregating at least 250...

  17. Validating predictors of disease progression in a large cohort of primary-progressive multiple sclerosis based on a systematic literature review.

    Jan-Patrick Stellmann

    Full Text Available New agents with neuroprotective or neuroregenerative potential might be explored in primary-progressive Multiple Sclerosis (PPMS--the MS disease course with leading neurodegenerative pathology. Identification of patients with a high short-term risk for progression may minimize study duration and sample size. Cohort studies reported several variables as predictors of EDSS disability progression but findings were partially contradictory.To analyse the impact of published predictors on EDSS disease progression in a large cohort of PPMS patients.A systematic literature research was performed to identify predictors for disease progression in PPMS. Individual case data from the Sylvia Lawry Centre (SLC and the Hamburg MS patient database (HAPIMS was pooled for a retrospective validation of these predictors on the annualized EDSS change.The systematic literature analysis revealed heterogeneous data from 3 prospective and 5 retrospective natural history cohort studies. Age at onset, gender, type of first symptoms and early EDSS changes were available for validation. Our pooled cohort of 597 PPMS patients (54% female had a mean follow-up of 4.4 years and mean change of EDSS of 0.35 per year based on 2503 EDSS assessments. There was no significant association between the investigated variables and the EDSS-change.None of the analysed variables were predictive for the disease progression measured by the annualized EDSS change. Whether PPMS is still unpredictable or our results may be due to limitations of cohort assessments or selection of predictors cannot be answered. Large systematic prospective studies with new endpoints are needed.

  18. National cohort study of absolute risk and age-specific incidence of multiple adverse outcomes between adolescence and early middle age.

    Mok, Pearl L H; Antonsen, Sussie; Pedersen, Carsten Bøcker; Appleby, Louis; Shaw, Jenny; Webb, Roger T

    2015-09-19

    Psychiatric illness, substance misuse, suicidality, criminality and premature death represent major public health challenges that afflict a sizeable proportion of young people. However, studies of multiple adverse outcomes in the same cohort at risk are rare. In a national Danish cohort we estimated sex- and age-specific incidence rates and absolute risks of these outcomes between adolescence and early middle age. Using interlinked registers, persons born in Denmark 1966-1996 were followed from their 15(th) until 40(th) birthday or December 2011 (N = 2,070,904). We estimated sex- and age-specific incidence rates of nine adverse outcomes, in three main categories: Premature mortality (all-causes, suicide, accident); Psychiatric morbidity (any mental illness diagnosis, suicide attempt, alcohol or drug misuse disorder); Criminality (violent offending, receiving custodial sentence, driving under influence of alcohol or drugs). Cumulative incidences were also calculated using competing risk survival analyses. For cohort members alive on their 15(th) birthday, the absolute risks of dying by age 40 were 1.99 % for males [95 % confidence interval (CI) 1.95-2.03 %] and 0.85 % for females (95 % CI 0.83-0.88 %). The risks of substance misuse and criminality were also much higher for males, especially younger males, than for females. Specifically, the risk of a first conviction for a violent offence was highest amongst males aged below 20. Females, however, were more likely than males to have a hospital-treated psychiatric disorder. By age 40, 13.25 % of females (95 % CI 13.16-13.33 %) and 9.98 % of males (95 % CI 9.91-10.06 %) had been treated. Women aged below 25 were also more likely than men to first attempt suicide, but this pattern was reversed beyond this age. The greatest gender differentials in incidence rates were in criminality outcomes. This is the first comprehensive assessment of the incidence rates and absolute risks of these multiple adverse outcomes

  19. Evaluation of statistical designs in phase I expansion cohorts: the Dana-Farber/Harvard Cancer Center experience.

    Dahlberg, Suzanne E; Shapiro, Geoffrey I; Clark, Jeffrey W; Johnson, Bruce E

    2014-07-01

    Phase I trials have traditionally been designed to assess toxicity and establish phase II doses with dose-finding studies and expansion cohorts but are frequently exceeding the traditional sample size to further assess endpoints in specific patient subsets. The scientific objectives of phase I expansion cohorts and their evolving role in the current era of targeted therapies have yet to be systematically examined. Adult therapeutic phase I trials opened within Dana-Farber/Harvard Cancer Center (DF/HCC) from 1988 to 2012 were identified for sample size details. Statistical designs and study objectives of those submitted in 2011 were reviewed for expansion cohort details. Five hundred twenty-two adult therapeutic phase I trials were identified during the 25 years. The average sample size of a phase I study has increased from 33.8 patients to 73.1 patients over that time. The proportion of trials with planned enrollment of 50 or fewer patients dropped from 93.0% during the time period 1988 to 1992 to 46.0% between 2008 and 2012; at the same time, the proportion of trials enrolling 51 to 100 patients and more than 100 patients increased from 5.3% and 1.8%, respectively, to 40.5% and 13.5% (χ(2) test, two-sided P < .001). Sixteen of the 60 trials (26.7%) in 2011 enrolled patients to three or more sub-cohorts in the expansion phase. Sixty percent of studies provided no statistical justification of the sample size, although 91.7% of trials stated response as an objective. Our data suggest that phase I studies have dramatically changed in size and scientific scope within the last decade. Additional studies addressing the implications of this trend on research processes, ethical concerns, and resource burden are needed. © The Author 2014. Published by Oxford University Press. All rights reserved.

  20. Canadian Alliance for Healthy Hearts and Minds: First Nations Cohort Study Rationale and Design.

    Anand, Sonia S; Abonyi, Sylvia; Arbour, Laura; Brook, Jeff; Bruce, Sharon; Castleden, Heather; Desai, Dipika; de Souza, Russell J; Harris, Stewart; Irvine, James; Lai, Christopher; Lewis, Diana; Oster, Richard T; Poirier, Paul; Toth, Ellen L; Bannon, Karen; Chrisjohn, Vicky; Davis, Albertha D; L'Hommecourt, Jean; Littlechild, Randy; McMullin, Kathleen; McIntosh, Sarah; Morrison, Julie; Picard, Manon; Landing First Nation, Pictou; M Thomas, Melissa; Tusevljak, Natasa; Friedrich, Matthias G; Tu, Jack V

    2018-01-01

    This is the first national indigenous cohort study in which a common, in-depth protocol with a common set of objectives has been adopted by several indigenous communities across Canada. The overarching objective of the Canadian Alliance for Healthy Hearts and Minds (CAHHM) cohort is to investigate how the community-level environment is associated with individual health behaviors and the presence and progression of chronic disease risk factors and chronic diseases such as cardiovascular disease (CVD) and cancer. CAHHM aims to recruit approximately 2,000 First Nations indigenous individuals from up to nine communities across Canada and have participants complete questionnaires, blood collection, physical measurements, cognitive assessments, and magnetic resonance imaging (MRI). Through individual- and community-level data collection, we will develop an understanding of the specific role of the socioenvironmental, biological, and contextual factors have on the development of chronic disease risk factors and chronic diseases. Information collected in the indigenous cohort will be used to assist communities to develop local management strategies for chronic disease, and can be used collectively to understand the contextual, environmental, socioeconomic, and biological determinants of differences in health status in harmony with First Nations beliefs and reality.

  1. The Shozu Herpes Zoster (SHEZ) Study: Rationale, Design, and Description of a Prospective Cohort Study

    Takao, Yukiko; Miyazaki, Yoshiyuki; Onishi, Fumitake; Kumihashi, Hideaki; Gomi, Yasuyuki; Ishikawa, Toyokazu; Okuno, Yoshinobu; Mori, Yasuko; Asada, Hideo; Yamanishi, Koichi; Iso, Hiroyasu

    2012-01-01

    Background The incidence and risk factors for herpes zoster have been studied in cross-sectional and cohort studies, although most such studies have been conducted in Western countries. Evidence from Asian populations is limited, and no cohort study has been conducted in Asia. We are conducting a 3-year prospective cohort study in Shozu County in Kagawa Prefecture, Japan to determine the incidence and predictive and immunologic factors for herpes zoster among Japanese. Methods The participants are followed for 3 years, and a telephone survey is conducted every 4 weeks. The participants were assigned to 1 of 3 studies. Participants in study A gave information on past history of herpes zoster and completed health questionnaires. Study B participants additionally underwent varicella-zoster virus (VZV) skin testing, and study C participants additionally underwent blood testing. If the participants develop herpes zoster, we evaluate clinical symptoms, measure cell-mediated immunity and humoral immunity using venous blood sampling, photograph skin areas with rash, conduct virus identification testing by polymerase chain reaction (PCR) and virus isolation from crust sampling, and evaluate postherpetic pain. Results We recruited 12 522 participants aged 50 years or older in Shozu County from December 2009 through November 2010. The participation rate was 65.7% of the target population. Conclusions The present study is likely to provide valuable data on the incidence and predictive and immunologic factors for herpes zoster in a defined community-based population of Japanese. PMID:22343323

  2. PC-based Multiple Information System Interface (PC/MISI) design plan

    Dominick, Wayne D. (Editor); Hall, Philip P.

    1985-01-01

    The general design plan for the implementation of a common user interface to multiple remote information systems within a microcomputer-based environment is presented. The intent is to provide a framework for the development of detailed specifications which will be used as guidelines for the actual development of the system.

  3. PC-based Multiple Information System Interface (PC/MISI) detailed design and implementation plan

    Dominick, Wayne D. (Editor); Hall, Philip P.

    1985-01-01

    The design plan for the personal computer multiple information system interface (PC/MISI) project is discussed. The document is intended to be used as a blueprint for the implementation of the system. Each component is described in the detail necessary to allow programmers to implement the system. A description of the system data flow and system file structures is given.

  4. The guinea pig maximization test--with a multiple dose design

    Andersen, Klaus Ejner; Vølund, A; Frankild, S

    1995-01-01

    The guinea pig maximization test (GPMT) is usually performed with one moderately irritant induction dose of the allergen and gives a qualitative assessment-hazard identification-of the allergenicity of the chemical. We refined the GPMT by applying a multiple dose design and used 30 guinea pigs in...

  5. Design of a smart textile mat to study pressure distribution on multiple foam material configurations

    Donselaar, van R.; Chen, W.

    2011-01-01

    In this paper, we present a design of a smart textile pressure mat to study the pressure distribution with multiple foam material configurations for neonatal monitoring at Neonatal Intensive Care Units (NICU). A smart textile mat with 64 pressure sensors has been developed including software at the

  6. The guinea pig maximization test--with a multiple dose design

    Andersen, Klaus Ejner; Vølund, A; Frankild, S

    1995-01-01

    The guinea pig maximization test (GPMT) is usually performed with one moderately irritant induction dose of the allergen and gives a qualitative assessment-hazard identification-of the allergenicity of the chemical. We refined the GPMT by applying a multiple dose design and used 30 guinea pigs...

  7. Residue-based Coordinated Selection and Parameter Design of Multiple Power System Stabilizers (PSSs)

    Su, Chi; Hu, Weihao; Fang, Jiakun

    2013-01-01

    data from time domain simulations. Then a coordinated approach for multiple PSS selection and parameter design based on residue method is proposed and realized in MATLAB m-files. Particle swarm optimization (PSO) is adopted in the coordination process. The IEEE 39-bus New England system model...

  8. The computer-aided design of a servo system as a multiple-criteria decision problem

    Udink ten Cate, A.J.

    1986-01-01

    This paper treats the selection of controller gains of a servo system as a multiple-criteria decision problem. In contrast to the usual optimization-based approaches to computer-aided design, inequality constraints are included in the problem as unconstrained objectives. This considerably simplifies

  9. Optimal design of compact and connected nature reserves for multiple species.

    Wang, Yicheng; Önal, Hayri

    2016-04-01

    When designing a conservation reserve system for multiple species, spatial attributes of the reserves must be taken into account at species level. The existing optimal reserve design literature considers either one spatial attribute or when multiple attributes are considered the analysis is restricted only to one species. We built a linear integer programing model that incorporates compactness and connectivity of the landscape reserved for multiple species. The model identifies multiple reserves that each serve a subset of target species with a specified coverage probability threshold to ensure the species' long-term survival in the reserve, and each target species is covered (protected) with another probability threshold at the reserve system level. We modeled compactness by minimizing the total distance between selected sites and central sites, and we modeled connectivity of a selected site to its designated central site by selecting at least one of its adjacent sites that has a nearer distance to the central site. We considered structural distance and functional distances that incorporated site quality between sites. We tested the model using randomly generated data on 2 species, one ground species that required structural connectivity and the other an avian species that required functional connectivity. We applied the model to 10 bird species listed as endangered by the state of Illinois (U.S.A.). Spatial coherence and selection cost of the reserves differed substantially depending on the weights assigned to these 2 criteria. The model can be used to design a reserve system for multiple species, especially species whose habitats are far apart in which case multiple disjunct but compact and connected reserves are advantageous. The model can be modified to increase or decrease the distance between reserves to reduce or promote population connectivity. © 2015 Society for Conservation Biology.

  10. Association between metformin use and progression of monoclonal gammopathy of undetermined significance to multiple myeloma in US veterans with diabetes mellitus: a population-based retrospective cohort study.

    Chang, Su-Hsin; Luo, Suhong; O'Brian, Katiuscia K; Thomas, Theodore S; Colditz, Graham A; Carlsson, Nils P; Carson, Kenneth R

    2015-01-01

    Multiple myeloma is one of the most common haematological malignancies in the USA and is consistently preceded by monoclonal gammopathy of undetermined significance (MGUS). We aimed to assess the association between metformin use and progression of MGUS to multiple myeloma. We did a retrospective cohort study of patients registered in the US Veterans Health Administration database and diagnosed with MGUS between Oct 1, 1999, and Dec 31, 2009. We included patients (aged >18 years) with at least one International Classification of Diseases (9th revision) code for diabetes mellitus and one treatment for their diabetes before MGUS diagnosis. We reviewed patient-level clinical data to verify diagnoses and extract any available data for size of baseline M-protein and type of MGUS. We defined metformin users as patients with diabetes who were given metformin consistently for 4 years after their diabetes diagnosis and before multiple myeloma development, death, or censorship. Our primary outcome was time from MGUS diagnosis to multiple myeloma diagnosis. We used Kaplan-Meier curves and Cox models to analyse the association between metformin use and MGUS progression. We obtained data for 3287 patients, of whom 2003 (61%) were included in the final analytical cohort. Median follow-up was 69 months (IQR 49–96). 463 (23%) participants were metformin users and 1540 (77%) participants were non-users. 13 (3%) metformin users progressed to multiple myeloma compared with 74 (5%) non-users. After adjustment, metformin use was associated with a reduced risk of progression to multiple myeloma (hazard ratio 0·47, 95% CI 0·25–0·87). For patients with diabetes diagnosed with MGUS, metformin use for 4 years or longer was associated with a reduced risk of progression of MGUS to multiple myeloma. Prospective studies are needed to establish whether this association is causal and whether these results can be extrapolated to non-diabetic individuals. Barnes-Jewish Hospital Foundation

  11. Recruiting Black Americans in a Large Cohort Study: The Adventist Health Study-2 (AHS-2) Design, Methods and Participant Characteristics

    Herring, R. Patti; Butler, Terry; Hall, Sonja; Montgomery, Susanne B.; Fraser, Gary E.

    2011-01-01

    Objective The goal of the prospective Adventist Health Study-2 (AHS-2) was to examine the relationship between diet and risk of breast, prostate and colon cancers in Black and White participants. This paper describes the study design, recruitment methods, response rates, and characteristics of Blacks in the AHS-2, thus providing insights about effective strategies to recruit Blacks to participate in research studies. Design We designed a church-based recruitment model and trained local recruiters who used various strategies to recruit participants in their churches. Participants completed a 50-page self-administered dietary and lifestyle questionnaire. Participants Participants are Black Seventh-day Adventists, aged 30–109 years, and members of 1,209 Black churches throughout the United States and Canada. Results Approximately 48,328 Blacks from an estimated target group of over 90,000 signed up for the study and 25,087 completed the questionnaire, comprising about 26% of the larger 97,000 AHS-2-member cohort. Participants were diverse in age, geographic location, education, and income. Seventy percent were female with a median age of 59 years. Conclusion In spite of many recruitment challenges and barriers, we successfully recruited a large cohort whose data should provide some answers as to why Blacks have poorer health outcomes than several other ethnic groups, and help explain existing health disparities. PMID:21305834

  12. Rationale, design, and preliminary results of the Quebec Warfarin Cohort Study.

    Perreault, Sylvie; Shahabi, Payman; Côté, Robert; Dumas, Stéphanie; Rouleau-Mailloux, Étienne; Feroz Zada, Yassamin; Provost, Sylvie; Mongrain, Ian; Dorais, Marc; Huynh, Thao; Kouz, Simon; Diaz, Ariel; Blostein, Mark; de Denus, Simon; Turgeon, Jacques; Ginsberg, Jeffrey; Lelorier, Jacques; Lalonde, Lyne; Busque, Lambert; Kassis, Jeannine; Talajic, Mario; Tardif, Jean-Claude; Dubé, Marie-Pierre

    2018-05-01

    Over- and undercoagulation with warfarin are associated with hemorrhagic and thromboembolic events, respectively. Genetic and clinical factors affect warfarin response, and the causes of this variability remain unclear. We present descriptive statistics and test for predictors of poor anticoagulation control. The Quebec Warfarin Cohort (QWC) comprises 1059 new warfarin users, with prospective follow-up using telephone questionnaires every 3 months for 1 year, and using healthcare administrative databases (RAMQ and Med-Echo) for 5 years prior to cohort entry and up to 10 years following active patient participation. Genetic material was collected, and genotyping of CYP2C9 and VKORC1 genes was conducted. Measured outcomes included the percentage of time patients spent within therapeutic range, anticoagulation control, warfarin dose, bleeding, and thromboembolic events. We report baseline characteristics and outcomes after 1 year of follow-up. Poor anticoagulation control was defined as time in therapeutic range <60% in the 3- to 12-month interval. Participants had a mean age of 71 years, and 62% were men. The most common indication for warfarin was atrial fibrillation (87%). Mean time in therapeutic range was 56% (±25%) in the 3 months following warfarin initiation, and 70% (±21%) in the 3- to 12-month interval. During follow-up, the rate of stroke or systemic embolism was 1.8 events per 100 person-years; for major bleeding events, 3.3 events per 100 person-years. Independent predictors of poor anticoagulation control were chronic kidney disease, heart failure, dyslipidemia, and age. The QWC represents a good research cohort to investigate clinical and genetic factors in a warfarin-anticoagulated population. © 2018 Wiley Periodicals, Inc.

  13. Design of clinical trials involving multiple hypothesis tests with a common control.

    Schou, I Manjula; Marschner, Ian C

    2017-07-01

    Randomized clinical trials comparing several treatments to a common control are often reported in the medical literature. For example, multiple experimental treatments may be compared with placebo, or in combination therapy trials, a combination therapy may be compared with each of its constituent monotherapies. Such trials are typically designed using a balanced approach in which equal numbers of individuals are randomized to each arm, however, this can result in an inefficient use of resources. We provide a unified framework and new theoretical results for optimal design of such single-control multiple-comparator studies. We consider variance optimal designs based on D-, A-, and E-optimality criteria, using a general model that allows for heteroscedasticity and a range of effect measures that include both continuous and binary outcomes. We demonstrate the sensitivity of these designs to the type of optimality criterion by showing that the optimal allocation ratios are systematically ordered according to the optimality criterion. Given this sensitivity to the optimality criterion, we argue that power optimality is a more suitable approach when designing clinical trials where testing is the objective. Weighted variance optimal designs are also discussed, which, like power optimal designs, allow the treatment difference to play a major role in determining allocation ratios. We illustrate our methods using two real clinical trial examples taken from the medical literature. Some recommendations on the use of optimal designs in single-control multiple-comparator trials are also provided. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  14. Design and implementation of the modified signed digit multiplication routine on a ternary optical computer.

    Xu, Qun; Wang, Xianchao; Xu, Chao

    2017-06-01

    Multiplication with traditional electronic computers is faced with a low calculating accuracy and a long computation time delay. To overcome these problems, the modified signed digit (MSD) multiplication routine is established based on the MSD system and the carry-free adder. Also, its parallel algorithm and optimization techniques are studied in detail. With the help of a ternary optical computer's characteristics, the structured data processor is designed especially for the multiplication routine. Several ternary optical operators are constructed to perform M transformations and summations in parallel, which has accelerated the iterative process of multiplication. In particular, the routine allocates data bits of the ternary optical processor based on digits of multiplication input, so the accuracy of the calculation results can always satisfy the users. Finally, the routine is verified by simulation experiments, and the results are in full compliance with the expectations. Compared with an electronic computer, the MSD multiplication routine is not only good at dealing with large-value data and high-precision arithmetic, but also maintains lower power consumption and fewer calculating delays.

  15. Mobile Web for Pervasive environments - design webexperiences for multiple mobile devices

    Hansen, Thomas Riisgaard

    2008-01-01

    In this paper we present an architecture for designing web pages that uses multiple mobile and stationary devices to present web content. The architecture extends standard web technology with a number of functions for expressing how web content might migrate and use multiple displays....... The architecture is developed to support desktop applications, but in this paper we describe how the architecture can be extended to mobile devices by using AJAX technology. The paper also presents an implementation and presents a number of applications for mobile devices developed with this framework....

  16. Integrated conservation planning for coral reefs: Designing conservation zones for multiple conservation objectives in spatial prioritisation

    Rafael A. Magris

    2017-07-01

    Full Text Available Decision-makers focus on representing biodiversity pattern, maintaining connectivity, and strengthening resilience to global warming when designing marine protected area (MPA systems, especially in coral reef ecosystems. The achievement of these broad conservation objectives will likely require large areas, and stretch limited funds for MPA implementation. We undertook a spatial prioritisation of Brazilian coral reefs that considered two types of conservation zones (i.e. no-take and multiple use areas and integrated multiple conservation objectives into MPA planning, while assessing the potential impact of different sets of objectives on implementation costs. We devised objectives for biodiversity, connectivity, and resilience to global warming, determined the extent to which existing MPAs achieved them, and designed complementary zoning to achieve all objectives combined in expanded MPA systems. In doing so, we explored interactions between different sets of objectives, determined whether refinements to the existing spatial arrangement of MPAs were necessary, and tested the utility of existing MPAs by comparing their cost effectiveness with an MPA system designed from scratch. We found that MPAs in Brazil protect some aspects of coral reef biodiversity pattern (e.g. threatened fauna and ecosystem types more effectively than connectivity or resilience to global warming. Expanding the existing MPA system was as cost-effective as designing one from scratch only when multiple objectives were considered and management costs were accounted for. Our approach provides a comprehensive assessment of the benefits of integrating multiple objectives in the initial stages of conservation planning, and yields insights for planners of MPAs tackling multiple objectives in other regions.

  17. A prospective study of symptoms, function, and medication use during acute illness in nursing home residents: design, rationale and cohort description

    Liu Sophia

    2010-07-01

    Full Text Available Abstract Background Nursing home residents are at high risk for developing acute illnesses. Compared with community dwelling adults, nursing home residents are often more frail, prone to multiple medical problems and symptoms, and are at higher risk for adverse outcomes from acute illnesses. In addition, because of polypharmacy and the high burden of chronic disease, nursing home residents are particularly vulnerable to disruptions in transitions of care such as medication interruptions in the setting of acute illness. In order to better estimate the effect of acute illness on nursing home residents, we have initiated a prospective cohort which will allow us to observe patterns of acute illnesses and the consequence of acute illnesses, including symptoms and function, among nursing home residents. We also aim to examine the patterns of medication interruption, and identify patient, provider and environmental factors that influence continuity of medication prescribing at different points of care transition. Methods This is a prospective cohort of nursing home residents residing in two nursing homes in a metropolitan area. Baseline characteristics including age, gender, race, and comorbid conditions are recorded. Participants are followed longitudinally for a planned period of 3 years. We record acute illness incidence and characteristics, and measure symptoms including depression, pain, withdrawal symptoms, and function using standardized scales. Results 76 nursing home residents have been followed for a median of 666 days to date. At baseline, mean age of residents was 74.4 (± 11.9; 32% were female; 59% were white. The most common chronic conditions were dementia (41%, depression (38%, congestive heart failure (25% and chronic obstructive lung disease (27%. Mean pain score was 4.7 (± 3.6 on a scale of 0 to 10; Geriatric Depression Scale (GDS-15 score was 5.2 (± 4.4. During follow up, 138 acute illness episodes were identified, for an

  18. Rationale and design of South Asian Birth Cohort (START: a Canada-India collaborative study

    Anand Sonia S

    2013-01-01

    Full Text Available Abstract Background People who originate from the Indian subcontinent (South Asians suffer among the highest rates of type 2 diabetes in the world. Prior evidence suggests that metabolic risk factors develop early in life and are influenced by maternal and paternal behaviors, the intrauterine environment, and genetic factors. The South Asian Birth Cohort Study (START will investigate the environmental and genetic basis of adiposity among 750 South Asian offspring recruited from highly divergent environments, namely, rural and urban India and urban Canada. Methods Detailed information on health behaviors including diet and physical activity, and blood samples for metabolic parameters and DNA are collected from pregnant women of South Asian ancestry who are free of significant chronic disease. They also undergo a provocative test to diagnose impaired glucose tolerance and gestational diabetes. At delivery, cord blood and newborn anthropometric indices (i.e. birth weight, length, head circumference and skin fold thickness are collected. The mother and growing offspring are followed prospectively and information on the growth trajectory, adiposity and health behaviors will be collected annually up to age 3 years. Our aim is to recruit a minimum of 750 mother-infant pairs equally divided between three divergent environments: rural India, urban India, and Canada. Summary The START cohort will increase our understanding of the environmental and genetic determinants of adiposity and related metabolic abnormalities among South Asians living in India and Canada.

  19. The Danish Alzheimer Intervention Study: Rationale, Study Design and Baseline Characteristics of the Cohort

    Waldemar, G.; Waldorff, F.B.; Buss, D.V.

    2011-01-01

    There is a lack of appropriately designed trials investigating the efficacy of psychosocial interventions for patients with mild dementia and their family caregivers. This paper reports the rationale and design of the Danish Alzheimer Disease Intervention Study and baseline characteristics...

  20. Digital dashboard design using multiple data streams for disease surveillance with influenza surveillance as an example.

    Cheng, Calvin K Y; Ip, Dennis K M; Cowling, Benjamin J; Ho, Lai Ming; Leung, Gabriel M; Lau, Eric H Y

    2011-10-14

    Great strides have been made exploring and exploiting new and different sources of disease surveillance data and developing robust statistical methods for analyzing the collected data. However, there has been less research in the area of dissemination. Proper dissemination of surveillance data can facilitate the end user's taking of appropriate actions, thus maximizing the utility of effort taken from upstream of the surveillance-to-action loop. The aims of the study were to develop a generic framework for a digital dashboard incorporating features of efficient dashboard design and to demonstrate this framework by specific application to influenza surveillance in Hong Kong. Based on the merits of the national websites and principles of efficient dashboard design, we designed an automated influenza surveillance digital dashboard as a demonstration of efficient dissemination of surveillance data. We developed the system to synthesize and display multiple sources of influenza surveillance data streams in the dashboard. Different algorithms can be implemented in the dashboard for incorporating all surveillance data streams to describe the overall influenza activity. We designed and implemented an influenza surveillance dashboard that utilized self-explanatory figures to display multiple surveillance data streams in panels. Indicators for individual data streams as well as for overall influenza activity were summarized in the main page, which can be read at a glance. Data retrieval function was also incorporated to allow data sharing in standard format. The influenza surveillance dashboard serves as a template to illustrate the efficient synthesization and dissemination of multiple-source surveillance data, which may also be applied to other diseases. Surveillance data from multiple sources can be disseminated efficiently using a dashboard design that facilitates the translation of surveillance information to public health actions.

  1. Recruiting black Americans in a large cohort study: the Adventist Health Study-2 (AHS-2) design, methods and participant characteristics.

    Herring, R Patti; Butler, Terry; Hall, Sonja; Montgomery, Susanne B; Fraser, Gary E

    2010-01-01

    The goal of the prospective Adventist Health Study-2 (AHS-2) was to examine the relationship between diet and risk of breast, prostate and colon cancers in Black and White participants. This paper describes the study design, recruitment methods, response rates, and characteristics of Blacks in the AHS-2, thus providing insights about effective strategies to recruit Blacks to participate in research studies. We designed a church-based recruitment model and trained local recruiters who used various strategies to recruit participants in their churches. Participants completed a 50-page self-administered dietary and lifestyle questionnaire. Participants are Black Seventh-day Adventists, aged 30-109 years, and members of 1,209 Black churches throughout the United States and Canada. Approximately 48,328 Blacks from an estimated target group of over 90,000 signed up for the study and 25,087 completed the questionnaire, comprising about 26% of the larger 97,000 AHS-2-member cohort. Participants were diverse in age, geographic location, education, and income. Seventy percent were female with a median age of 59 years. In spite of many recruitment challenges and barriers, we successfully recruited a large cohort whose data should provide some answers as to why Blacks have poorer health outcomes than several other ethnic groups, and help explain existing health disparities.

  2. A concise revised myeloma comorbidity index as a valid prognostic instrument in a large cohort of 801 multiple myeloma patients

    M. Engelhardt (Monika); Domm, A.-S. (Anne-Saskia); Dold, S.M. (Sandra Maria); G. Ihorst (Gabriele); Reinhardt, H. (Heike); Zober, A. (Alexander); Hieke, S. (Stefanie); Baayen, C. (Corine); Müller, S.J. (Stefan Jürgen); H. Einsele (Hermann); P. Sonneveld (Pieter); O. Landgren; M. Schumacher (M.); R. Wäsch (Ralph)

    2017-01-01

    textabstractWith growing numbers of elderly multiple myeloma patients, reliable tools to assess their vulnerability are required. The objective of the analysis herein was to develop and validate an easy to use myeloma risk score (revised Myeloma Comorbidity Index) that allows for risk prediction of

  3. Ethanol, Neurodevelopment, Infant and Child Health (ENRICH prospective cohort: Study design considerations

    Ludmila N. Bakhireva

    2015-04-01

    Full Text Available Background: While intervention is the leading factor in reducing long-term disabilities in children with fetal alcohol spectrum disorder (FASD, early identification of children affected by prenatal alcohol exposure (PAE remains challenging. Deficits in higher-order cognitive domains (e.g. executive function might be more specific to FASD than global neurodevelopmental tests, yet these functions are not developed in very young children. Measures of early sensorimotor development may provide early indications of atypical brain development during the first two years of life. Methods: This paper describes the novel methodology of the Ethanol, Neurodevelopment, Infant and Child Health (ENRICH prospective cohort study of 120 maternal-infant pairs with a goal to identify early indices of functional brain impairment associated with PAE. The cohort is established by recruiting women early in pregnancy and classifying them into one of three study groups: patients on opioid-maintenance therapy who consume alcohol during pregnancy (Group 1, patients on opioid-maintenance therapy who abstain from alcohol during pregnancy (Group 2, and healthy controls (Group 3. After the initial prenatal assessment (Visit 1, patients are followed to Visit 2 occurring at delivery, and two comprehensive assessments of children at six (Visit 3 and 20 months (Visit 4 of age. ENRICH recruitment started in November 2013 and 87 women were recruited during the first year. During Year 1, the biospecimen (maternal whole blood, serum, urine, dry blood spots of a newborn collection rate was 100% at Visit 1, and 97.6% for those who completed Visit 2. Discussion: The tiered screening approach, evaluation of confounders, neurocognitive and magneto-/electro-encephalography (MEG/EEG outcomes, and ethical considerations are discussed.

  4. Self reported stressful life events and exacerbations in multiple sclerosis: prospective study

    D. Buljevac (Dragan); W.C.J. Hop (Wim); W. Reedeker; A.C.J.W. Janssens (Cécile); F.G.A. van der Meché (Frans); P.A. van Doorn (Pieter); R.Q. Hintzen (Rogier)

    2003-01-01

    textabstractOBJECTIVE: To study the relation between self reported stressful life events not related to multiple sclerosis and the occurrence of exacerbations in relapsing-remitting multiple sclerosis. DESIGN: Longitudinal, prospective cohort study. SETTING: Outpatient clinic of

  5. A SCHEDULING SCHEME WITH DYNAMIC FREQUENCY CLOCKING AND MULTIPLE VOLTAGES FOR LOW POWER DESIGNS

    Wen Dongxin; Wang Ling; Yang Xiaozong

    2007-01-01

    In this letter, a scheduling scheme based on Dynamic Frequency Clocking (DFC) and multiple voltages is proposed for low power designs under the timing and the resource constraints.Unlike the conventional methods at high level synthesis where only voltages of nodes were considered,the scheme based on a gain function considers both voltage and frequency simultaneously to reduce energy consumption. Experiments with a number of DSP benchmarks show that the proposed scheme achieves an effective energy reduction.

  6. Collaborative E-Learning with Multiple Imaginary Co-Learner: Design, Issues and Implementation

    Melvin Ballera; Mosbah Mohamed Elssaedi; Ahmed Khalil Zohdy

    2013-01-01

    Collaborative problem solving in e-learning can take in the form of discussion among learner, creating a highly social learning environment and characterized by participation and interactivity. This paper, designed a collaborative learning environment where agent act as co-learner, can play different roles during interaction. Since different roles have been assigned to the agent, learner will assume that multiple co-learner exists to help and guide him all throughout the ...

  7. Automatic differentiation for design sensitivity analysis of structural systems using multiple processors

    Nguyen, Duc T.; Storaasli, Olaf O.; Qin, Jiangning; Qamar, Ramzi

    1994-01-01

    An automatic differentiation tool (ADIFOR) is incorporated into a finite element based structural analysis program for shape and non-shape design sensitivity analysis of structural systems. The entire analysis and sensitivity procedures are parallelized and vectorized for high performance computation. Small scale examples to verify the accuracy of the proposed program and a medium scale example to demonstrate the parallel vector performance on multiple CRAY C90 processors are included.

  8. Design of e-Science platform for biomedical imaging research cross multiple academic institutions and hospitals

    Zhang, Jianguo; Zhang, Kai; Yang, Yuanyuan; Ling, Tonghui; Wang, Tusheng; Wang, Mingqing; Hu, Haibo; Xu, Xuemin

    2012-02-01

    More and more image informatics researchers and engineers are considering to re-construct imaging and informatics infrastructure or to build new framework to enable multiple disciplines of medical researchers, clinical physicians and biomedical engineers working together in a secured, efficient, and transparent cooperative environment. In this presentation, we show an outline and our preliminary design work of building an e-Science platform for biomedical imaging and informatics research and application in Shanghai. We will present our consideration and strategy on designing this platform, and preliminary results. We also will discuss some challenges and solutions in building this platform.

  9. Sequential, Multiple Assignment, Randomized Trial Designs in Immuno-oncology Research.

    Kidwell, Kelley M; Postow, Michael A; Panageas, Katherine S

    2018-02-15

    Clinical trials investigating immune checkpoint inhibitors have led to the approval of anti-CTLA-4 (cytotoxic T-lymphocyte antigen-4), anti-PD-1 (programmed death-1), and anti-PD-L1 (PD-ligand 1) drugs by the FDA for numerous tumor types. In the treatment of metastatic melanoma, combinations of checkpoint inhibitors are more effective than single-agent inhibitors, but combination immunotherapy is associated with increased frequency and severity of toxicity. There are questions about the use of combination immunotherapy or single-agent anti-PD-1 as initial therapy and the number of doses of either approach required to sustain a response. In this article, we describe a novel use of sequential, multiple assignment, randomized trial (SMART) design to evaluate immune checkpoint inhibitors to find treatment regimens that adapt within an individual based on intermediate response and lead to the longest overall survival. We provide a hypothetical example SMART design for BRAF wild-type metastatic melanoma as a framework for investigating immunotherapy treatment regimens. We compare implementing a SMART design to implementing multiple traditional randomized clinical trials. We illustrate the benefits of a SMART over traditional trial designs and acknowledge the complexity of a SMART. SMART designs may be an optimal way to find treatment strategies that yield durable response, longer survival, and lower toxicity. Clin Cancer Res; 24(4); 730-6. ©2017 AACR . ©2017 American Association for Cancer Research.

  10. Design of the cooling systems for the multiplicity and vertex detector

    Bernardin, J.D.; Cunningham, R.

    1997-11-01

    The PHENIX experiment at the Relativistic Heavy Ion Collider (RHIC) at Brookhaven National Laboratory is being constructed to investigate a phase of matter termed the quark-gluon plasma. The plasma will be produced through the collision of two heavy ions. The multiplicity and vertex detector (MVD) located in the center of PHENIX will characterize the events, determine the collision point, and act as a central trigger. This report presents the final mechanical designs of the cooling systems for the Multiplicity and Vertex Detector (MVD). In particular, the design procedure and layouts are discussed for two different air cooling systems for the multichip modules and MVD enclosure, and a liquid cooling system for the low dropout voltage regulators. First of all, experimental prototype cooling system test results used to drive the final mechanical designs are summarized and discussed. Next, the cooling system requirements and design calculation for the various subsystem components are presented along with detailed lists of supply vendors, components, and costs. Finally, safety measures incorporated in the final mechanical design and operation procedures for each of the subsystems are detailed

  11. Design of multiple sequence alignment algorithms on parallel, distributed memory supercomputers.

    Church, Philip C; Goscinski, Andrzej; Holt, Kathryn; Inouye, Michael; Ghoting, Amol; Makarychev, Konstantin; Reumann, Matthias

    2011-01-01

    The challenge of comparing two or more genomes that have undergone recombination and substantial amounts of segmental loss and gain has recently been addressed for small numbers of genomes. However, datasets of hundreds of genomes are now common and their sizes will only increase in the future. Multiple sequence alignment of hundreds of genomes remains an intractable problem due to quadratic increases in compute time and memory footprint. To date, most alignment algorithms are designed for commodity clusters without parallelism. Hence, we propose the design of a multiple sequence alignment algorithm on massively parallel, distributed memory supercomputers to enable research into comparative genomics on large data sets. Following the methodology of the sequential progressiveMauve algorithm, we design data structures including sequences and sorted k-mer lists on the IBM Blue Gene/P supercomputer (BG/P). Preliminary results show that we can reduce the memory footprint so that we can potentially align over 250 bacterial genomes on a single BG/P compute node. We verify our results on a dataset of E.coli, Shigella and S.pneumoniae genomes. Our implementation returns results matching those of the original algorithm but in 1/2 the time and with 1/4 the memory footprint for scaffold building. In this study, we have laid the basis for multiple sequence alignment of large-scale datasets on a massively parallel, distributed memory supercomputer, thus enabling comparison of hundreds instead of a few genome sequences within reasonable time.

  12. Sequential Multiple Assignment Randomized Trials: An Opportunity for Improved Design of Stroke Reperfusion Trials.

    Meurer, William J; Seewald, Nicholas J; Kidwell, Kelley

    2017-04-01

    Modern clinical trials in stroke reperfusion fall into 2 categories: alternative systemic pharmacological regimens to alteplase and "rescue" endovascular approaches using targeted thrombectomy devices and/or medications delivered directly for persistently occluded vessels. Clinical trials in stroke have not evaluated how initial pharmacological thrombolytic management might influence subsequent rescue strategy. A sequential multiple assignment randomized trial (SMART) is a novel trial design that can test these dynamic treatment regimens and lead to treatment guidelines that more closely mimic practice. To characterize a SMART design in comparison to traditional approaches for stroke reperfusion trials. We conducted a numerical simulation study that evaluated the performance of contrasting acute stroke clinical trial designs of both initial reperfusion and rescue therapy. We compare a SMART design where the same patients are followed through initial reperfusion and rescue therapy within 1 trial to a standard phase III design comparing 2 reperfusion treatments and a separate phase II futility design of rescue therapy in terms of sample size, power, and ability to address particular research questions. Traditional trial designs can be well powered and have optimal design characteristics for independent treatment effects. When treatments, such as the reperfusion and rescue therapies, may interact, commonly used designs fail to detect this. A SMART design, with similar sample size to standard designs, can detect treatment interactions. The use of SMART designs to investigate effective and realistic dynamic treatment regimens is a promising way to accelerate the discovery of new, effective treatments for stroke. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  13. Fibroid interventions: reducing symptoms today and tomorrow: extending generalizability by using a comprehensive cohort design with a randomized controlled trial.

    AbdElmagied, Ahmed M; Vaughan, Lisa E; Weaver, Amy L; Laughlin-Tommaso, Shannon K; Hesley, Gina K; Woodrum, David A; Jacoby, Vanessa L; Kohi, Maureen P; Price, Thomas M; Nieves, Angel; Miller, Michael J; Borah, Bijan J; Gorny, Krzysztof R; Leppert, Phyllis C; Lemens, Maureen A; Stewart, Elizabeth A

    2016-09-01

    Uterine fibroids are an important source of morbidity for reproductive-aged women. Despite an increasing number of alternatives, hysterectomies account for about 75% of all fibroid interventional treatments. Evidence is lacking to help women and their health care providers decide among alternatives to hysterectomy. Fibroid Interventions: Reducing Symptoms Today and Tomorrow (NCT00995878, clinicaltrials.gov) is a randomized controlled trial to compare the safety, efficacy, and economics of 2 minimally invasive alternatives to hysterectomy: uterine artery embolization and magnetic resonance imaging-guided focused ultrasound surgery. Although randomized trials provide the highest level of evidence, they have been difficult to conduct in the United States for interventional fibroid treatments. Thus, contemporaneously recruiting women declining randomization may have value as an alternative strategy for comparative effectiveness research. We sought to compare baseline characteristics of randomized participants with nonrandomized participants meeting the same enrollment criteria and to determine whether combining the 2 cohorts in a comprehensive cohort design would be useful for analysis. Premenopausal women with symptomatic uterine fibroids seeking interventional therapy at 3 US academic medical centers were randomized (1:1) in 2 strata based on calculated uterine volume (<700 and ≥700 cc(3)) to undergo embolization or focused ultrasound surgery. Women who met the same inclusion criteria but declined randomization were offered enrollment in a parallel cohort. Both cohorts were followed up for a maximum of 36 months after treatment. The measures addressed in this report were baseline demographics, symptoms, fibroid and uterine characteristics, and scores on validated quality-of-life measures. Of 723 women screened, 57 were randomized and 49 underwent treatment (27 with focused ultrasound and 22 with embolization). Seven of the 8 women randomized but not treated were

  14. Leukemia, lymphoma and multiple myeloma mortality (1950–1999) and incidence (1969–1999) in the Eldorado uranium workers cohort

    Zablotska, Lydia B., E-mail: Lydia.Zablotska@ucsf.edu [Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, CA 94118 (United States); Lane, Rachel S.D. [Radiation and Health Sciences Division, Directorate of Environmental and Radiation Protection and Assessment, Canadian Nuclear Safety Commission, Ottawa, ON, Canada K1P 5S9 (Canada); Frost, Stanley E. [Frost and Frost Consultants, Saskatoon, SK, Canada S7H 0A1 (Canada); Thompson, Patsy A. [Radiation and Health Sciences Division, Directorate of Environmental and Radiation Protection and Assessment, Canadian Nuclear Safety Commission, Ottawa, ON, Canada K1P 5S9 (Canada)

    2014-04-01

    Uranium workers are chronically exposed to low levels of radon decay products (RDP) and gamma (γ) radiation. Risks of leukemia from acute and high doses of γ-radiation are well-characterized, but risks from lower doses and dose-rates and from RDP exposures are controversial. Few studies have evaluated risks of other hematologic cancers in uranium workers. The purpose of this study was to analyze radiation-related risks of hematologic cancers in the cohort of Eldorado uranium miners and processors first employed in 1932–1980 in relation to cumulative RDP exposures and γ-ray doses. The average cumulative RDP exposure was 100.2 working level months and the average cumulative whole-body γ-radiation dose was 52.2 millisievert. We identified 101 deaths and 160 cases of hematologic cancers in the cohort. Overall, male workers had lower mortality and cancer incidence rates for all outcomes compared with the general Canadian male population, a likely healthy worker effect. No statistically significant association between RDP exposure or γ-ray doses, or a combination of both, and mortality or incidence of any hematologic cancer was found. We observed consistent but non-statistically significant increases in risks of chronic lymphocytic leukemia (CLL) and Hodgkin lymphoma (HL) incidence and non-Hodgkin lymphoma (NHL) mortality with increasing γ-ray doses. These findings are consistent with recent studies of increased risks of CLL and NHL incidence after γ-radiation exposure. Further research is necessary to understand risks of other hematologic cancers from low-dose exposures to γ-radiation. - Highlights: • We analyzed long-term follow-up for hematologic cancers of the Eldorado uranium workers. • Workers were exposed to a unique combination of radon decay products (RDP) and gamma (γ) ray doses. • Exposures to RDP and γ-ray doses were not associated with significantly increased risks of cancers. • Radiation risks of chronic lymphocytic leukemia (CLL) and

  15. Causal relationship between obesity and vitamin D status: bi-directional Mendelian randomization analysis of multiple cohorts.

    Karani S Vimaleswaran

    Full Text Available Obesity is associated with vitamin D deficiency, and both are areas of active public health concern. We explored the causality and direction of the relationship between body mass index (BMI and 25-hydroxyvitamin D [25(OHD] using genetic markers as instrumental variables (IVs in bi-directional Mendelian randomization (MR analysis.We used information from 21 adult cohorts (up to 42,024 participants with 12 BMI-related SNPs (combined in an allelic score to produce an instrument for BMI and four SNPs associated with 25(OHD (combined in two allelic scores, separately for genes encoding its synthesis or metabolism as an instrument for vitamin D. Regression estimates for the IVs (allele scores were generated within-study and pooled by meta-analysis to generate summary effects. Associations between vitamin D scores and BMI were confirmed in the Genetic Investigation of Anthropometric Traits (GIANT consortium (n = 123,864. Each 1 kg/m(2 higher BMI was associated with 1.15% lower 25(OHD (p = 6.52×10⁻²⁷. The BMI allele score was associated both with BMI (p = 6.30×10⁻⁶² and 25(OHD (-0.06% [95% CI -0.10 to -0.02], p = 0.004 in the cohorts that underwent meta-analysis. The two vitamin D allele scores were strongly associated with 25(OHD (p≤8.07×10⁻⁵⁷ for both scores but not with BMI (synthesis score, p = 0.88; metabolism score, p = 0.08 in the meta-analysis. A 10% higher genetically instrumented BMI was associated with 4.2% lower 25(OHD concentrations (IV ratio: -4.2 [95% CI -7.1 to -1.3], p = 0.005. No association was seen for genetically instrumented 25(OHD with BMI, a finding that was confirmed using data from the GIANT consortium (p≥0.57 for both vitamin D scores.On the basis of a bi-directional genetic approach that limits confounding, our study suggests that a higher BMI leads to lower 25(OHD, while any effects of lower 25(OHD increasing BMI are likely to be small. Population level interventions to

  16. VNM: An R Package for Finding Multiple-Objective Optimal Designs for the 4-Parameter Logistic Model

    Hyun, Seung Won; Wong, Weng Kee; Yang, Yarong

    2018-01-01

    A multiple-objective optimal design is useful for dose-response studies because it can incorporate several objectives at the design stage. Objectives can be of varying interests and a properly constructed multiple-objective optimal design can provide user-specified efficiencies, delivering higher efficiencies for the more important objectives. In this work, we introduce the VNM package written in R for finding 3-objective locally optimal designs for the 4-parameter logistic (4PL) model widely...

  17. Analyzing change in short-term longitudinal research using cohort-sequential designs.

    Anderson, E R

    1993-12-01

    This article illustrates a method for approximating longitudinal data analysis by combining information from different overlapping age groups to form a single developmental growth curve. Using this method, hypotheses about the form of growth, the extent of individual differences in growth, and factors that affect the rate and pattern of growth are investigated. The example used to illustrate this method examines the growth of externalizing behavior and of negativity in parent-child relationships during early adolescence using assessments from multiple methods and multiple informants. These 3 dimensions changed significantly during this period, with parental negativity increasing more rapidly after age 12. However, there were substantial individual differences in the pattern of change in these dimensions. Gender of child and type of family situation (nondivorced, divorced, and remarried) were investigated as possible factors affecting change.

  18. German new onset diabetes in the young incident cohort study: DiMelli study design and first-year results.

    Thümer, Leonore; Adler, Kerstin; Bonifacio, Ezio; Hofmann, Frank; Keller, Manfred; Milz, Christine; Munte, Axel; Ziegler, Anette-Gabriele

    2010-01-01

    Diabetes incidence in childhood and youth is increasing worldwide, including autoimmune and non-autoimmune cases. Recent findings suggest that there is a larger than expected proportion of type 2 diabetes in youth, and potential cases of intermediate diabetes phenotypes. Most pediatric diabetes registries focus on type 1 diabetes. Also, there is an absence of reliable data on type 2 diabetes incidence in youth. The DiMelli study aims to establish a diabetes incidence cohort registry of patients in Germany, diagnosed with diabetes mellitus before age 20 years. It will be used to characterize diabetes phenotypes by immunologic, metabolic, and genetic markers. DiMelli will assess the contribution of obesity and socio-demographic factors to the development of diabetes in childhood and youth. Recruitment of patients started in 2009, and is expected to continue at a rate of 250 patients per year. 84% of the 216 patients recruited within the first year were positive for multiple islet autoantibodies, 12% for one islet autoantibody, and 4% were islet autoantibody-negative. Patients with multiple islet autoantibodies were younger and had lower fasting C-peptide levels, compared to islet autoantibody-negative patients (median age 10.0 vs. 14.1 years, p < 0.01). Results from the first year of the study show that DiMelli will help to reveal new knowledge on the etiology of diabetes, and the contribution of genetic predisposition and environmental risk factors to the different types of diabetes.

  19. Current management and prognostic factors in physiotherapy practice for patients with shoulder pain: design of a prospective cohort study.

    Karel, Yasmaine H J M; Scholten-Peeters, Wendy G M; Thoomes-de Graaf, Marloes; Duijn, Edwin; Ottenheijm, Ramon P G; van den Borne, Maaike P J; Koes, Bart W; Verhagen, Arianne P; Dinant, Geert-Jan; Tetteroo, Eric; Beumer, Annechien; van Broekhoven, Joost B; Heijmans, Marcel

    2013-02-11

    Shoulder pain is disabling and has a considerable socio-economic impact. Over 50% of patients presenting in primary care still have symptoms after 6 months; moreover, prognostic factors such as pain intensity, age, disability level and duration of complaints are associated with poor outcome. Most shoulder complaints in this group are categorized as non-specific. Musculoskeletal ultrasound might be a useful imaging method to detect subgroups of patients with subacromial disorders.This article describes the design of a prospective cohort study evaluating the influence of known prognostic and possible prognostic factors, such as findings from musculoskeletal ultrasound outcome and working alliance, on the recovery of shoulder pain. Also, to assess the usual physiotherapy care for shoulder pain and examine the inter-rater reliability of musculoskeletal ultrasound between radiologists and physiotherapists for patients with shoulder pain. A prospective cohort study including an inter-rater reliability study. Patients presenting in primary care physiotherapy practice with shoulder pain are enrolled. At baseline validated questionnaires are used to measure patient characteristics, disease-specific characteristics and social factors. Physical examination is performed according to the expertise of the physiotherapists. Follow-up measurements will be performed 6, 12 and 26 weeks after inclusion. Primary outcome measure is perceived recovery, measured on a 7-point Likert scale. Logistic regression analysis will be used to evaluate the association between prognostic factors and recovery. The ShoCoDiP (Shoulder Complaints and using Diagnostic ultrasound in Physiotherapy practice) cohort study will provide information on current management of patients with shoulder pain in primary care, provide data to develop a prediction model for shoulder pain in primary care and to evaluate whether musculoskeletal ultrasound can improve prognosis.

  20. The Swiss Multiple Sclerosis Cohort-Study (SMSC: A Prospective Swiss Wide Investigation of Key Phases in Disease Evolution and New Treatment Options.

    Giulio Disanto

    Full Text Available The mechanisms leading to disability and the long-term efficacy and safety of disease modifying drugs (DMDs in multiple sclerosis (MS are unclear. We aimed at building a prospective cohort of MS patients with standardized collection of demographic, clinical, MRI data and body fluids that can be used to develop prognostic indicators and biomarkers of disease evolution and therapeutic response. The Swiss MS Cohort (SMSC is a prospective observational study performed across seven Swiss MS centers including patients with MS, clinically isolated syndrome (CIS, radiologically isolated syndrome or neuromyelitis optica. Neurological and radiological assessments and biological samples are collected every 6-12 months. We recruited 872 patients (clinically isolated syndrome [CIS] 5.5%, relapsing-remitting MS [RRMS] 85.8%, primary progressive MS [PPMS] 3.5%, secondary progressive MS [SPMS] 5.2% between June 2012 and July 2015. We performed 2,286 visits (median follow-up 398 days and collected 2,274 serum, plasma and blood samples, 152 cerebrospinal fluid samples and 1,276 brain MRI scans. 158 relapses occurred and expanded disability status scale (EDSS scores increased in PPMS, SPMS and RRMS patients experiencing relapses. Most RRMS patients were treated with fingolimod (33.4%, natalizumab (24.5% or injectable DMDs (13.6%. The SMSC will provide relevant information regarding DMDs efficacy and safety and will serve as a comprehensive infrastructure available for nested research projects.

  1. Benefit-risk perception of natalizumab therapy in neurologists and a large cohort of multiple sclerosis patients.

    Heesen, Christoph; Kleiter, Ingo; Meuth, Sven G; Krämer, Julia; Kasper, Jürgen; Köpke, Sascha; Gaissmaier, Wolfgang

    2017-05-15

    Natalizumab (NAT) is associated with the risk of progressive multifocal leukoencephalopathy (PML). Risk stratification algorithms have been developed, however, without detectable reduction of PML incidence. To evaluate to which extent patients and physicians understand and accept risks associated with NAT treatment. Prospective observational cohort study in German MS centers (n=73) among NAT-treated MS patients (n=801) and their neurologists (n=99). Patients included in this study had mean disease duration of 10.2years and a mean NAT treatment duration of 24months. More than 90% of patients and physicians voted for shared decision making or an informed choice decision making approach. Patients and physicians perceived a similar threat from MS as serious disease and both overestimated treatment benefits from NAT based on trial data. Men perceived MS more severe than women and perception of seriousness increased with age in both groups and in patients as well with increasing disability. Although patients evaluated their PML risk higher, their risk acceptance was significantly higher than of their neurologists. Risk stratification knowledge was good among neurologists and significantly lower among patients. While patients and physicians seem to have realistic risk perception of PML and knowledge of risk stratification concepts, the threat of MS and the perception of treatment benefits may explain the ongoing high acceptance of PML risk. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Multiple Autoantibodies Display Association with Lymphopenia, Proteinuria, and Cellular Casts in a Large, Ethnically Diverse SLE Patient Cohort

    Rufei Lu

    2012-01-01

    Full Text Available Purpose. This study evaluates high-throughput autoantibody screening and determines associated systemic lupus erythematosus (SLE clinical features in a large lupus cohort. Methods. Clinical and demographic information, along with serum samples, were obtained from each SLE study participant after appropriate informed consent. Serum samples were screened for 10 distinct SLE autoantibody specificities and examined for association with SLE ACR criteria and subcriteria using conditional logistic regression analysis. Results. In European-American SLE patients, autoantibodies against 52 kD Ro and RNP 68 are independently enriched in patients with lymphopenia, anti-La, and anti-ribosomal P are increased in patients with malar rash, and anti-dsDNA and anti-Sm are enriched in patients with proteinuria. In African-American SLE patients, cellular casts associate with autoantibodies against dsDNA, Sm, and Sm/nRNP. Conclusion. Using a high-throughput, bead-based method of autoantibody detection, anti-dsDNA is significantly enriched in patienets with SLE ACR renal criteria as has been previously described. However, lymphopenia is associated with several distinct autoantibody specificities. These findings offer meaningful information to allow clinicians and clinical investigators to understand which autoantibodies correlate with select SLE clinical manifestations across common racial groups using this novel methodology which is expanding in clinical use.

  3. Cohort profile

    Kreiberg, Michael; Bandak, Mikkel; Lauritsen, Jakob

    2018-01-01

    The cohort was set up in order to analyze late effects in long-term testicular cancer survivors (TCS) and to contribute to the design of future follow-up programs addressing and potentially preventing late effects. Data for this cross-sectional study were collected between January 1, 2014, and De...

  4. [Presentation of the "CDC de Canarias" cohort: objectives, design and preliminary results].

    Cabrera de León, Antonio; Rodríguez Pérez, Ma del Cristo; Almeida González, Delia; Domínguez Coello, Santiago; Aguirre Jaime, Armando; Brito Díaz, Buenaventura; González Hernández, Ana; Pérez Méndez, Lina I

    2008-01-01

    The Canary Islands rank first in Spain with respect to the ischaemic heart disease and diabetes mortality rates. The Islands female population leads the country in deaths from breast cancer. The "CDC de Canarias" is a general population cohort study in order to analyse the prevalence and incidence of these diseases and the exposure to their risk factors (RF) in the adult population of the archipelago. Prospective study with a random sampling of the general population, in which 6,729 individuals participated between 2000 and 2005 (aged 18-75). Anthropometric measurements were taken, and blood was drawn for the storage of serum and genetic samples. The following information was gathered through a questionnaire: eating habits, physical activity, personal and family medical history, exposure to occupational or environmental risk factors, smoking, etc. The prevalence of obesity is close to 30%, without differences between sexes, however, more male subjects were overweight than women (45 vs. 33%; p high blood pressure (43 vs. 33%; p high prevalence of exposure to risk factors for cardiovascular disease, diabetes and cancer, among which overweight, obesity and lack of exercise stand out particularly.

  5. An Application of Graphical Approach to Construct Multiple Testing Procedure in a Hypothetical Phase III Design

    Naitee eTing

    2014-01-01

    Full Text Available Many multiple testing procedures (MTP have been developed in recent years. Among these new procedures, the graphical approach is flexible and easy to communicate with non-statisticians. A hypothetical Phase III clinical trial design is introduced in this manuscript to demonstrate how graphical approach can be applied in clinical product development. In this design, an active comparator is used. It is thought that this test drug under development could potentially be superior to this comparator. For comparison of efficacy, the primary endpoint is well established and widely accepted by regulatory agencies. However, an important secondary endpoint based on Phase II findings looks very promising. The target dose may have a good opportunity to deliver superiority to the comparator. Furthermore, a lower dose is included in case the target dose may demonstrate potential safety concerns. This Phase III study is designed as a non-inferiority trial with two doses, and two endpoints. This manuscript will illustrate how graphical approach is applied to this design in handling multiple testing issues.

  6. Cross-Layer Design for Two-Way Relaying Networks with Multiple Antennas

    zhuo wu

    2015-10-01

    Full Text Available In this paper, we developed a cross-layer design for two-way relaying (TWR networks with multiple antennas, where two single antenna source nodes exchange information with the aid of one multiple antenna relay node. The proposed cross-layer design considers adaptive modulation (AM and space-time block coding (STBC at the physical layer with an automatic repeat request (ARQ protocol at the data link layer, in order to maximize the spectral efficiency under specific delay and packet error ratio (PER constraints. An MMSE-interference cancellation (IC receiver is employed at the relay node, to remove the interference in the fist phase of the TWR transmission. The transmission mode is updated for each phase of the TWR transmission on a frame-by-frame basis, to match the time-varying channel conditions and exploit the system performance and throughput gain. Simulation results show that retransmission at the data link layer could alleviate rigorous error-control requirements at the physical layer, and thereby allows higher data transmission. As a result, cross-layer design helps to achieve considerable system spectral efficiency gain for TWR networks, compared to those without cross-layer design.

  7. Using multiple decrement models to estimate risk and morbidity from specific AIDS illnesses. Multicenter AIDS Cohort Study (MACS).

    Hoover, D R; Peng, Y; Saah, A J; Detels, R R; Day, R S; Phair, J P

    A simple non-parametric approach is developed to simultaneously estimate net incidence and morbidity time from specific AIDS illnesses in populations at high risk for death from these illnesses and other causes. The disease-death process has four-stages that can be recast as two sandwiching three-state multiple decrement processes. Non-parametric estimation of net incidence and morbidity time with error bounds are achieved from these sandwiching models through modification of methods from Aalen and Greenwood, and bootstrapping. An application to immunosuppressed HIV-1 infected homosexual men reveals that cytomegalovirus disease, Kaposi's sarcoma and Pneumocystis pneumonia are likely to occur and cause significant morbidity time.

  8. The Norwegian Offender Mental Health and Addiction Study – Design and Implementation of a National Survey and Prospective Cohort Study

    Anne Bukten

    2015-01-01

    Full Text Available The Norwegian prison inmates are burdened by problems before they enter prison. Few studies have managed to assess this burden and relate it to what occurs for the inmates once they leave the prison. The Norwegian Offender Mental Health and Addiction (NorMA study is a large-scale longitudinal cohort study that combines national survey and registry data in order to understand mental health, substance use, and criminal activity before, during, and after custody among prisoners in Norway. The main goal of the study is to describe the criminal and health-related trajectories based on both survey and registry linkage information. Data were collected from 1,499 inmates in Norwegian prison facilities during 2013–2014. Of these, 741 inmates provided a valid personal identification number and constitute a cohort that will be examined retrospectively and prospectively, along with data from nationwide Norwegian registries. This study describes the design, procedures, and implementation of the ongoing NorMA study and provides an outline of the initial data.

  9. Dietary patterns derived with multiple methods from food diaries and breast cancer risk in the UK Dietary Cohort Consortium

    Pot, Gerda K; Stephen, Alison M; Dahm, Christina C; Key, Timothy J; Cairns, Benjamin J; Burley, Victoria J; Cade, Janet E; Greenwood, Darren C; Keogh, Ruth H; Bhaniani, Amit; McTaggart, Alison; Lentjes, Marleen AH; Mishra, Gita; Brunner, Eric J; Khaw, Kay Tee

    2015-01-01

    Background/ Objectives In spite of several studies relating dietary patterns to breast cancer risk, evidence so far remains inconsistent. This study aimed to investigate associations of dietary patterns derived with three different methods with breast cancer risk. Subjects/ Methods The Mediterranean Diet Score (MDS), principal components analyses (PCA) and reduced rank regression (RRR) were used to derive dietary patterns in a case-control study of 610 breast cancer cases and 1891 matched controls within 4 UK cohort studies. Dietary intakes were collected prospectively using 4-to 7-day food diaries and resulting food consumption data were grouped into 42 food groups. Conditional logistic regression models were used to estimate odds ratios (ORs) for associations between pattern scores and breast cancer risk adjusting for relevant covariates. A separate model was fitted for post-menopausal women only. Results The MDS was not associated with breast cancer risk (OR comparing 1st tertile with 3rd 1.20 (95% CI 0.92; 1.56)), nor the first PCA-derived dietary pattern, explaining 2.7% of variation of diet and characterized by cheese, crisps and savoury snacks, legumes, nuts and seeds (OR 1.18 (95% CI 0.91; 1.53)). The first RRR-derived pattern, a ‘high-alcohol’ pattern, was associated with a higher risk of breast cancer (OR 1.27; 95% CI 1.00; 1.62), which was most pronounced in post-menopausal women (OR 1.46 (95% CI 1.08; 1.98). Conclusions A ‘high-alcohol’ dietary pattern derived with RRR was associated with an increased breast cancer risk; no evidence of associations of other dietary patterns with breast cancer risk was observed in this study. PMID:25052230

  10. Use of the 2010 McDonald criteria can facilitate early diagnosis of pediatric multiple sclerosis in a predominantly black cohort.

    Williams, Mitchel T; Tapos, Daniela O; Juhász, Csaba

    2014-12-01

    Pediatric-onset multiple sclerosis represents around 3-5% of all patients with multiple sclerosis. Both the 2005 and 2010 McDonald criteria for multiple sclerosis have been suggested for the possible use in pediatric-onset multiple sclerosis. Modifications incorporated into the 2010 criteria enabled the fulfillment of dissemination in time to be met with the initial magnetic resonance imaging. The present study was designed to compare the diagnostic sensitivity of these criteria at initial presentation, the time to fulfilling them, and secondary effects of ethnicity in pediatric-onset multiple sclerosis. Twenty-five children with clinically definite multiple sclerosis (mean age, 14.6 ± 3.1 years; 15 girls) from a single center between 2005 and 2012 were analyzed using both the 2005 and 2010 McDonald criteria based on initial clinical presentation and neuroimaging findings comparing diagnostic sensitivity, time interval to meet diagnosis, and ethnicity. Initial multiple sclerosis diagnosis rates applying the 2005 McDonald criteria were 32% compared with 92% for the 2010 criteria (P = 0.0003). The mean time after initial signs until the 2005 and 2010 McDonald criteria for multiple sclerosis were met was 5.0 vs 0.7 months, respectively (P = 0.001). Time to diagnosis using the 2010 criteria was shorter in black children than the European white (P = 0.005). The 2010 McDonald criteria are an appropriate tool for the timely diagnosis of pediatric multiple sclerosis, especially in black children, potentially allowing an earlier initiation of disease-modifying therapy. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. A Methodology for the Design of Robotic Hands with Multiple Fingers

    Jorge Eduardo Parada Puig

    2008-11-01

    Full Text Available This paper presents a methodology that has been applied for a design process of anthropomorphic hands with multiple fingers. Biomechanical characteristics of human hand have been analysed so that ergonomic and anthropometric aspects have been used as fundamental references for obtaining grasping mechanisms. A kinematic analysis has been proposed to define the requirements for designing grasping functions. Selection of materials and actuators has been discussed too. This topic has been based on previous experiences with prototypes that have been developed at the Laboratory of Robotics and Mechatronics (LARM of the University of Cassino. An example of the application of the proposed method has been presented for the design of a first prototype of LARM Hand.

  12. Delayed Diagnosis, Range of Severity, and Multiple Sleep Comorbidities: A Clinical and Polysomnographic Analysis of 100 Patients of the Innsbruck Narcolepsy Cohort

    Frauscher, Birgit; Ehrmann, Laura; Mitterling, Thomas; Gabelia, David; Gschliesser, Viola; Brandauer, Elisabeth; Poewe, Werner; Högl, Birgit

    2013-01-01

    Study Objectives: Narcolepsy is reported to affect 26-56/100,000 in the general population. We aimed to describe clinical and polysomnographic features of a large narcolepsy cohort in order to comprehensively characterize the narcoleptic spectrum. Methods: We performed a chart- and polysomnographybased review of all narcolepsy patients of the Innsbruck narcolepsy cohort. Results: A total of 100 consecutive narcolepsy patients (87 with cataplexy [NC], 13 without cataplexy [N]) were included in the analysis. All subjects had either excessive daytime sleepiness or cataplexy as their initial presenting clinical feature. Age at symptom onset was 20 (6-69) years. Diagnostic delay was 6.5 (0-39) years. The complete narcolepsy tetrad was present in 36/100 patients; 28/100 patients had three cardinal symptoms; 29/100 had two; and 7/100 had only excessive daytime sleepiness. Severity varied broadly with respect to excessive daytime sleepiness (median Epworth Sleepiness Scale score: 18, range 10-24), cataplexy (8-point Likert scale: median 4.5, range 1-8), hypnagogic hallucinations (median 4.5, range 1-7), and sleep paralysis (median 3, range 1-7). Sleep comorbidity was highly prevalent and ranged from sleeprelated movement disorders (n = 55/100), parasomnias (n = 34/100), and sleeprelated breathing disorders (n = 24/100), to insomnia (n = 28/100). REM sleep without atonia or a periodic limb movement in sleep index > 5/h were present in most patients (90/100 and 75/100). A high percentage of narcoleptic patients in the present study had high frequency leg movements (35%) and excessive fragmentary myoclonus (22%). Of the narcolepsy patients with clinical features of REM sleep behavior disorder (RBD), 76.5% had EMG evidence for RBD on the multiple sleep latency test (MSLT), based on a standard cutoff of a minimum of 18% of 3-sec miniepochs. Conclusion: This study is one of the largest monocentric polysomnographic studies to date of patients with narcolepsy and confirms the

  13. Application of Probabilistic Multiple-Bias Analyses to a Cohort- and a Case-Control Study on the Association between Pandemrix™ and Narcolepsy.

    Kaatje Bollaerts

    Full Text Available An increase in narcolepsy cases was observed in Finland and Sweden towards the end of the 2009 H1N1 influenza pandemic. Preliminary observational studies suggested a temporal link with the pandemic influenza vaccine Pandemrix™, leading to a number of additional studies across Europe. Given the public health urgency, these studies used readily available retrospective data from various sources. The potential for bias in such settings was generally acknowledged. Although generally advocated by key opinion leaders and international health authorities, no systematic quantitative assessment of the potential joint impact of biases was undertaken in any of these studies.We applied bias-level multiple-bias analyses to two of the published narcolepsy studies: a pediatric cohort study from Finland and a case-control study from France. In particular, we developed Monte Carlo simulation models to evaluate a potential cascade of biases, including confounding by age, by indication and by natural H1N1 infection, selection bias, disease- and exposure misclassification. All bias parameters were evidence-based to the extent possible.Given the assumptions used for confounding, selection bias and misclassification, the Finnish rate ratio of 13.78 (95% CI: 5.72-28.11 reduced to a median value of 6.06 (2.5th- 97.5th percentile: 2.49-15.1 and the French odds ratio of 5.43 (95% CI: 2.6-10.08 to 1.85 (2.5th-97.5th percentile: 0.85-4.08.We illustrate multiple-bias analyses using two studies on the Pandemrix™-narcolepsy association and advocate their use to better understand the robustness of study findings. Based on our multiple-bias models, the observed Pandemrix™-narcolepsy association consistently persists in the Finnish study. For the French study, the results of our multiple-bias models were inconclusive.

  14. The Home Observation of Periconceptional Exposures (HOPE) study, a prospective cohort: aims, design, recruitment and compliance.

    Porucznik, Christina A; Cox, Kyley J; Schliep, Karen C; Wilkins, Diana G; Stanford, Joseph B

    2016-06-08

    To examine transient environmental exposures and their relationship with human fecundity, exposure assessment should occur optimally at the time of conception in both members of the couple. We performed an observational, prospective cohort study with biomonitoring in both members of a heterosexual couple trying to conceive. Couples collected urine, saliva, and semen specimens for up to two menstrual cycles on days corresponding to the time windows of fertilization, implantation, and early pregnancy, identified based on the woman's observations of her cervical fluid. Three hundred nine eligible couples were screened between 2011 and 2015, of which 183 enrolled. Eleven couples (6.0 %) withdrew or were lost to follow up. The most successful and cost effective recruiting strategies were word of mouth (40 % of participating couples), posters and flyers (37 %), and targeted Facebook advertising (13 %) with an overall investment of $37.35 spent on recruitment per couple. Both men and women collected ≥97.2 % of requested saliva samples, and men collected ≥89.9 % of requested semen samples. Within the periovulatory days (±3 days), there was at least one urine specimen collected by women in 97.1 % of cycles, and at least one by men in 91.7 % of cycles. Daily compliance with periovulatory urine specimens ranged from 66.5 to 92.4 % for women and from 55.7 to 75.0 % for men. Compliance was ≥88 % for questionnaire completion at specified time points. Couples planning to conceive can be recruited successfully for periconceptional monitoring, and will comply with intensive study protocols involving home collection of biospecimens and questionnaire data.

  15. Designed multiple ligands in metabolic disease research: from concept to platform.

    Gattrell, W; Johnstone, C; Patel, S; Smith, C Sambrook; Scheel, A; Schindler, M

    2013-08-01

    Type 2 diabetes mellitus (T2DM) is a multifactorial disease, and drug monotherapy typically results in unsatisfactory treatment outcomes for patients. Even when used in combination, existing therapies lack efficacy in the long term. Designed multiple ligands (DMLs) are compounds developed to modulate multiple targets relevant to a disease. DMLs offer the potential to yield greater efficacy over monotherapies, either by modulating different biological pathways, or by boosting a single one. However, examples of DMLs progressing into clinical trials, or onto the market are rare; DML drug discovery is challenging, and perceived by some to be almost impossible. Nevertheless, with the judicious selection of biological targets, both from a biological and chemical perspective, it is possible to develop drug-like DMLs. Copyright © 2013 Elsevier Ltd. All rights reserved.

  16. Optical design of multi-multiple expander structure of laser gas analysis and measurement device

    Fu, Xiang; Wei, Biao

    2018-03-01

    The installation and debugging of optical circuit structure in the application of carbon monoxide distributed laser gas analysis and measurement, there are difficult key technical problems. Based on the three-component expansion theory, multi-multiple expander structure with expansion ratio of 4, 5, 6 and 7 is adopted in the absorption chamber to enhance the adaptability of the installation environment of the gas analysis and measurement device. According to the basic theory of aberration, the optimal design of multi-multiple beam expander structure is carried out. By using image quality evaluation method, the difference of image quality under different magnifications is analyzed. The results show that the optical quality of the optical system with the expanded beam structure is the best when the expansion ratio is 5-7.

  17. Reliability and acceptability of the Multiple Sclerosis Quality of Life-29 questionnaire in an English-speaking cohort.

    Baker, Georgina; Nair, Krishnan Padmakumari Sivaraman; Baster, Kathleen; Rosato, Rosalba; Solari, Alessandra

    2018-05-01

    Multiple Sclerosis Quality-of-Life Questionnaire-54 (MSQoL-54) is a disease-specific instrument for assessing health-related quality of life (HRQoL). Due to the number of items, the time taken to complete it is long. A shorter 29-item version, Multiple Sclerosis Quality-of-Life Questionnaire-29 (MSQoL-29) is yet to be evaluated in English. To assess reliability and acceptability of English version of MSQoL-29. Among 100 participants with MS who first completed both MSQoL-54 and MSQoL-29, 91 completed MSQoL-29 after 4-8 weeks. We looked for internal consistency (Cronbach's alpha), acceptability, reliability (intraclass correlation coefficients (ICCs)) and agreement (Bland-Altman plots). ICCs were strongly positive between MSQoL-54 and MSQoL-29 (Physical Health Composite (PHC) -ICC = 0.914, confidence interval (CI) = 0.872-0.942; Mental Health Composite (MHC) - ICC = 0.875, CI = 0.814-0.916) and between the two MSQoL-29 (PHC - ICC = 0.970, CI = 0.955-0.980; MHC - ICC = 0.937, CI = 0.904-0.958). On Bland-Altman plots, the MSQoL-29 scores of 95% of participants during two visits were within the limits of agreement (LOAs). Time taken to complete MSQoL-29 was 7.2 ± 2.9 minutes and MSQoL-54 was 19.79 ± 5.4 minutes ( p = 0.0001). MSQoL-29 has good test-retest reliability in English-speaking population and was quicker to complete.

  18. Computed tomography in children: multicenter cohort study design for the evaluation of cancer risk

    Krille, L.; Jahnen, A.; Mildenberger, P.; Schneider, K.; Weisser, G.; Zeeb, H.; Blettner, M.

    2011-01-01

    Exposure to ionizing radiation is a known risk factor for cancer. Cancer risk is highest after exposure in childhood. The computed tomography is the major contributor to the average, individual radiation exposure. Until now the association has been addressed only in statistical modeling. We present the first feasible study design on childhood cancer risk after exposure to computed tomography.

  19. Exploiting the anti-HIV 6-desfluoroquinolones to design multiple ligands.

    Sancineto, Luca; Iraci, Nunzio; Barreca, Maria Letizia; Massari, Serena; Manfroni, Giuseppe; Corazza, Gianmarco; Cecchetti, Violetta; Marcello, Alessandro; Daelemans, Dirk; Pannecouque, Christophe; Tabarrini, Oriana

    2014-09-01

    It is getting clearer that many drugs effective in different therapeutic areas act on multiple rather than single targets. The application of polypharmacology concepts might have numerous advantages especially for disease such as HIV/AIDS, where the rapid emergence of resistance requires a complex combination of more than one drug. In this paper, we have designed three hybrid molecules combining WM5, a quinolone derivative we previously identified as HIV Tat-mediated transcription (TMT) inhibitor, with the tricyclic core of nevirapine and BILR 355BS (BILR) non-nucleoside reverse transcriptase inhibitors (NNRTIs) to investigate whether it could be possible to obtain molecules acting on both transcription steps of the HIV replicative cycle. One among the three designed multiple ligands, reached this goal. Indeed, compound 1 inhibited both TMT and reverse transcriptase (RT) activity. Unexpectedly, while the anti-TMT activity exerted by compound 1 resulted into a selective inhibition of HIV-1 reactivation from latently infected OM10.1 cells, the anti-RT properties shown by all of the synthesized compounds did not translate into an anti-HIV activity in acutely infected cells. Thus, we have herein produced the proof of concept that the design of dual TMT-RT inhibitors is indeed possible, but optimization efforts are needed to obtain more potent derivatives. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Generation of synthetic time histories compatible with multiple-damping design response spectra

    Lilhanand, K.; Tseng, W.S.

    1987-01-01

    Seismic design of nuclear power plants as currently practiced requires time history analyses be performed to generate floor response spectra for seismic qualification of piping, equipment, and components. Since design response spectra are normally prescribed in the form of smooth spectra, the generation of synthetic time histories whose response spectra closely match the ''target'' design spectra of multiple damping values, is often required for the seismic time history analysis purpose. Various methods of generation of synthetic time histories compatible with target response spectra have been proposed in the literature. Since the mathematical problem of determining a time history from a given set of response spectral values is not unique, an exact solution is not possible, and all the proposed methods resort to some forms of approximate solutions. In this paper, a new iteration scheme, is described which effectively removes the difficulties encountered by the existing methods. This new iteration scheme can not only improve the accuracy of spectrum matching for a single-damping target spectrum, but also automate the spectrum matching for multiple-damping target spectra. The applicability and limitations as well as the method adopted to improve the numerical stability of this new iteration scheme are presented. The effectiveness of this new iteration scheme is illustrated by two example applications

  1. Design of PH-based accelerated life testing plans under multiple-stress-type

    Elsayed, E.A.; Zhang Hao

    2007-01-01

    Accelerated life testing (ALT) is used to obtain failure time data quickly under high stress levels in order to predict product life performance under design stress conditions. Most of the previous work on designing ALT plans is focused on the application of a single stress. However, as components or products become more reliable due to technological advances, it becomes more difficult to obtain significant amount of failure data within reasonable amount of time using single stress only. Multiple-stress-type ALTs have been employed as a means of overcoming such difficulties. In this paper, we design optimum multiple-stress-type ALT plans based on the proportional hazards model. The optimum combinations of stresses and their levels are determined such that the variance of the reliability estimate of the product over a specified period of time is minimized. The use of the model is illustrated using numerical example, and sensitivity analysis shows that the resultant optimum ALT plan is robust to the deviation in model parameters

  2. Findings of multiple HPV genotypes in cervical carcinoma are associated with poor cancer-specific survival in a Swedish cohort of cervical cancer primarily treated with radiotherapy.

    Kaliff, Malin; Sorbe, Bengt; Mordhorst, Louise Bohr; Helenius, Gisela; Karlsson, Mats G; Lillsunde-Larsson, Gabriella

    2018-04-10

    Cervical cancer (CC) is one of the most common cancers in women and virtually all cases of CC are a result of a persistent infection of human papillomavirus (HPV). For disease detected in early stages there is curing treatment but when diagnosed late with recurring disease and metastasis there are limited possibilities. Here we evaluate HPV impact on treatment resistance and metastatic disease progression. Prevalence and distribution of HPV genotypes and HPV16 variants in a Swedish CC patient cohort (n=209) was evaluated, as well as HPV influence on patient prognosis. Tumor samples suitable for analysis (n=204) were genotyped using two different real-time PCR methods. HPV16 variant analysis was made using pyrosequencing. Results showed that HPV prevalence in the total series was 93%. Of the HPV-positive samples, 13% contained multiple infections, typically with two high-risk HPV together. Primary cure rate for the complete series was 95%. Recurrence rate of the complete series was 28% and distant recurrences were most frequent (20%). Patients with tumors containing multiple HPV-strains and particularly HPV genotypes belonging to the alpha 7 and 9 species together had a significantly higher rate of distant tumor recurrences and worse cancer-specific survival rate.

  3. Return-to-work for multiple jobholders with a work-related musculoskeletal disorder: A population-based, matched cohort in British Columbia.

    Maas, Esther T; Koehoorn, Mieke; McLeod, Christopher B

    2018-01-01

    Multiple jobholders (MJHs) have a higher risk of injury compared to single jobholders (SJHs), but it is unknown if return-to-work (RTW) after a work injury is affected by multiple jobholding. This study examined the association between multiple versus single jobholding and time to RTW for workers with a work-related musculoskeletal disorder (MSD). We used administrative workers' compensation data to identify injured workers with an accepted MSD lost-time claim between 2010-2014 in British Columbia, Canada (n = 125,639 SJHs and 9,029 MJHs). The outcome was days until RTW during twelve months after the first day of time-loss. The MJH and SJH cohorts were balanced using coarsened exact matching that yielded a final matched cohort of 8,389 MJHs and 8,389 SJHs. The outcome was estimated with Cox regression, using piecewise models, and the hazard ratios were stratified by type of MSD, a serious injury indicator, gender, weekly workdays preceding MSD, and wage categories. MJHs were less likely to RTW compared to SJHs within the first six months after the first time-loss day, with greater and longer lasting effects for males, workers with a serious injury, and a higher wage. No difference between MJHs and SJHs was found for workers who had a six- or seven-day work week preceding MSD, for workers with dislocations, and for workers who were still off work after six months. Overall, MJHs with a workweek of maximum five days are disadvantaged compared to SJHs in terms of RTW following a work-related MSD within the first six months after the first time-loss day. This difference might be caused by more precarious job contracts for MJHs that challenges RTW because of lack of support for modified work, higher workload, and reduced likelihood that MJHs file a workers' compensation claim. Despite adjusting for type of MSD, severity of injury and occupation, the differences persisted for the vast majority of the study sample.

  4. JIGSAW: Acquisition, Display and Analysis system designed to collect data from Multiple Gamma-Ray detectors

    Haywood, S.E.; Bamford, G.J.; Rester, A.C.; Coldwell, R.L.

    1992-01-01

    In this paper, the authors report on work performed to date on JIGSAW - a self contained data acquisition, display and analysis system designed to collect data form multiple gamma-ray detectors. The data acquisition system utilizes commercially available VMEbus and NIM hardware modules and the VME exec real time operating system. A Unix based software package, written in ANSI standard C and with the XII graphics routines, allows the user to view the acquired spectra. Analysis of the histograms can be performed in background during the run with the ROBFIT suite of curve fitting routines

  5. Multiple measures of adiposity are associated with mean leukocyte telomere length in the northern Finland birth cohort 1966.

    Jessica L Buxton

    Full Text Available Studies of leukocyte telomere length (LTL and adiposity have produced conflicting results, and the relationship between body mass index (BMI and telomere length throughout life remains unclear. We therefore tested association of adult LTL measured in 5,598 participants with: i childhood growth measures (BMI and age at adiposity rebound (AR; ii change in BMI from childhood to adulthood and iii adult BMI, waist-to-hip ratio (WHR, body adiposity index (BAI. Childhood BMI at AR was positively associated with LTL at 31 years in women (P = 0.041. Adult BMI and WHR in both men (P = 0.025 and P = 0.049, respectively and women (P = 0.029 and P = 0.008, respectively, and BAI in women (P = 0.021 were inversely associated with LTL at 31 years. An increase in standardised BMI between early childhood and adulthood was associated with shorter adult LTL in women (P = 0.008. We show that LTL is inversely associated with multiple measures of adiposity in both men and women. Additionally, BMI increase in women from childhood to adulthood is associated with shorter telomeres at age 31, potentially indicating accelerated biological ageing.

  6. No relevant impact of ambient temperature on disability measurements in a large cohort of patients with multiple sclerosis.

    Stellmann, J-P; Young, K L; Vettorazzi, E; Pöttgen, J; Heesen, C

    2017-06-01

    Many patients with multiple sclerosis (MS) report a worsening of symptoms due to high ambient temperatures, but objective data about this association are rare and contradictory. The aim of this study was to investigate the influence of ambient temperature on standard clinical tests. We extracted the Symbol Digit Modality Test, Nine Hole Peg Test, Timed 25 Foot Walk (T25FW), Timed Tandem Walk, Expanded Disability Status Scale (EDSS) and quality-of-life items on cognition, fatigue and depression from our clinical database and matched them to historical temperatures. We used linear mixed-effect models to investigate the association between temperature and outcomes. A total of 1254 patients with MS (mean age, 42.7 years; 69.9% females; 52.1% relapsing-remitting MS, mean EDSS, 3.8) had 5751 assessments between 1996 and 2012. We observed a worsening in the T25FW with higher ambient temperatures in moderately disabled patients (EDSS ≥ 4) but not in less disabled patients. However, an increase of 10°C prolonged the T25FW by just 0.4 s. Other outcomes were not associated with ambient temperatures. Higher ambient temperature might compromise walking capabilities in patients with MS with a manifest walking impairment. However, effects are small and not detectable in mildly disabled patients. Hand function, cognition, mood and fatigue do not appear to be correlated with ambient temperature. © 2017 EAN.

  7. An intelligent, knowledge-based multiple criteria decision making advisor for systems design

    Li, Yongchang

    In systems engineering, design and operation of systems are two main problems which always attract researcher's attentions. The accomplishment of activities in these problems often requires proper decisions to be made so that the desired goal can be achieved, thus, decision making needs to be carefully fulfilled in the design and operation of systems. Design is a decision making process which permeates through out the design process, and is at the core of all design activities. In modern aircraft design, more and more attention is paid to the conceptual and preliminary design phases so as to increase the odds of choosing a design that will ultimately be successful at the completion of the design process, therefore, decisions made during these early design stages play a critical role in determining the success of a design. Since aerospace systems are complex systems with interacting disciplines and technologies, the Decision Makers (DMs) dealing with such design problems are involved in balancing the multiple, potentially conflicting attributes/criteria, transforming a large amount of customer supplied guidelines into a solidly defined set of requirement definitions. Thus, one could state with confidence that modern aerospace system design is a Multiple Criteria Decision Making (MCDM) process. A variety of existing decision making methods are available to deal with this type of decision problems. The selection of the most appropriate decision making method is of particular importance since inappropriate decision methods are likely causes of misleading engineering design decisions. With no sufficient knowledge about each of the methods, it is usually difficult for the DMs to find an appropriate analytical model capable of solving their problems. In addition, with the complexity of the decision problem and the demand for more capable methods increasing, new decision making methods are emerging with time. These various methods exacerbate the difficulty of the selection

  8. Design and Analysis of Cooperative Cable Parallel Manipulators for Multiple Mobile Cranes

    Bin Zi

    2012-11-01

    Full Text Available The design, dynamic modelling, and workspace are presented in this paper concerning cooperative cable parallel manipulators for multiple mobile cranes (CPMMCs. The CPMMCs can handle complex tasks that are more difficult or even impossible for a single mobile crane. Kinematics and dynamics of the CPMMCs are studied on the basis of geometric methodology and d'Alembert's principle, and a mathematical model of the CPMMCs is developed and presented with dynamic simulation. The constant orientation workspace analysis of the CPMMCs is carried out additionally. As an example, a cooperative cable parallel manipulator for triple mobile cranes with 6 Degrees of Freedom is investigated on the basis of the above design objectives.

  9. Novel anti-HIV peptides containing multiple copies of artificially designed heptad repeat motifs

    Shi Weiguo; Qi Zhi; Pan Chungen; Xue Na; Debnath, Asim K.; Qie Jiankun; Jiang Shibo; Liu Keliang

    2008-01-01

    The peptidic anti-HIV drug T20 (Fuzeon) and its analog C34 share a common heptad repeat (HR) sequence, but they have different functional domains, i.e., pocket- and lipid-binding domains (PBD and LBD, respectively). We hypothesize that novel anti-HIV peptides may be designed by using artificial sequences containing multiple copies of HR motifs plus zero, one or two functional domains. Surprisingly, we found that the peptides containing only the non-natural HR sequences could significantly inhibit HIV-1 infection, while addition of PBD and/or LBD to the peptides resulted in significant improvement of anti-HIV-1 activity. These results suggest that these artificial HR sequences, which may serve as structural domains, could be used as templates for the design of novel antiviral peptides against HIV and other viruses with class I fusion proteins

  10. Development of a multicomponent Staphylococcus aureus vaccine designed to counter multiple bacterial virulence factors

    Anderson, Annaliesa S.; Miller, Alita A.; Donald, Robert G.K.; Scully, Ingrid L.; Nanra, Jasdeep S.; Cooper, David; Jansen, Kathrin U.

    2012-01-01

    Staphylococcus aureus is a major cause of healthcare-associated infections and is responsible for a substantial burden of disease in hospitalized patients. Despite increasingly rigorous infection control guidelines, the prevalence and corresponding negative impact of S. aureus infections remain considerable. Difficulties in controlling S. aureus infections as well as the associated treatment costs are exacerbated by increasing rates of resistance to available antibiotics. Despite ongoing efforts over the past 20 years, no licensed S. aureus vaccine is currently available. However, learnings from past clinical failures of vaccine candidates and a better understanding of the immunopathology of S. aureus colonization and infection have aided in the design of new vaccine candidates based on multiple important bacterial pathogenesis mechanisms. This review outlines important considerations in designing a vaccine for the prevention of S. aureus disease in healthcare settings. PMID:22922765

  11. Change in quality of life and predictors of change among patients with multiple sclerosis: a prospective cohort study.

    Tepavcevic, Darija Kisic; Pekmezovic, Tatjana; Stojsavljevic, Nebojsa; Kostic, Jelena; Basuroski, Irena Dujmovic; Mesaros, Sarlota; Drulovic, Jelena

    2014-04-01

    The aim of this study was to determine the changes in the health-related quality of life (HRQoL) and predictors of change among patients with multiple sclerosis (MS) at 3 and 6 years during the follow-up period. A group of 109 consecutive MS patients (McDonald's criteria) referred to the Clinic of Neurology, Belgrade, were enrolled in the study. At three time points during the study (baseline, and at 3 and 6 years during the follow-up period), the HRQoL (measured by MSQoL-54), Expanded Disability Status Scale, and Hamilton Rating Scale for Depression and Fatigue Severity Scale were assessed. During the study period, 93 patients provided both follow-up assessments. Statistically significant deterioration in the HRQoL at each subsequent time point was detected for all scales of the MSQoL-54 except for the pain and change in health scales. A higher level of education was a significant prognostic factor for a better HRQoL on the cognitive function scale throughout the entire period of observation, while marital status (single, including divorced and widowed) and increased age at the onset of MS had significant predictive values of poorer quality-of-life scores on the overall quality-of-life scale at 6-year follow-up. Higher levels of physical disability and depression at baseline were statistically significant prognostic markers for deterioration in HRQoL for the majority of MSQoL-54 scales during the entire follow-up period. Our study suggests that baseline demographic and clinical characteristics could be applied as prognostic markers of the HRQOL for patients diagnosed with MS.

  12. Lymphocytes with multiple chromosomal damages in a large cohort of West Siberia residents: Results of long-term monitoring

    Druzhinin, Vladimir [Kemerovo State University, Kemerovo (Russian Federation); Federal State Budget Scientific Institution «The Federal Research Center of Coal and Coal Chemistry of Siberian Branch of the Russian Academy of Sciences», Kemerovo (Russian Federation); Bakanova, Maria [Federal State Budget Scientific Institution «The Federal Research Center of Coal and Coal Chemistry of Siberian Branch of the Russian Academy of Sciences», Kemerovo (Russian Federation); Fucic, Aleksandra, E-mail: afucic@imi.hr [Institute for Medical Research and Occupational Health, Zagreb (Croatia); Golovina, Tatiana [Kemerovo State University, Kemerovo (Russian Federation); Savchenko, Yana [Federal State Budget Scientific Institution «The Federal Research Center of Coal and Coal Chemistry of Siberian Branch of the Russian Academy of Sciences», Kemerovo (Russian Federation); Sinitsky, Maxim; Volobaev, Valentin [Kemerovo State University, Kemerovo (Russian Federation)

    2016-02-15

    Highlights: • Study reports RC frequency in lymphocytes in the group of 3242 subjects. • The highest RC frequency was present in children environmentally exposed to radon. • In 85% of RCs double minutes were observed. • Results suggests that radon may be the leading factors causing RC. • RC may be a candidate biomarker for exposure to α-emitters. - Abstract: Cells with specific multiple chromosome aberrations, defined as rogue cells (RC) have been described in different populations, predominantly those exposed to radiation. The frequency, etiology and related health risks have still not been elucidated due to their low frequency of occurrences and rarely performed studies. This study reports RC frequency using chromosome aberration (CA) assay in peripheral lymphocytes in the group of 3242 subjects, during a 30-year long follow-up study in a general rural and urban population, children environmentally exposed to radon, occupationally exposed population and lung cancer patients from the Kemerovo region (Siberia, Russian Federation). Results show that the highest RC frequency was present in children environmentally exposed to radon and the lowest in the general urban population. Total frequency of CA did not correlate with frequency of RC. Genotoxic analysis of air and water samples excluded anthropogenic pollution as a possible cause of genome damage and RC frequency. In 85% of RCs, double minutes, observed in a large number of human tumors, were present. Results of CA analysis suggested that radon and its decay products (alpha-emitters) were the leading factors causing RC in subjects exposed to high LET radiation. Thus, RC may be a candidate biomarker for exposure to this type of radiation.

  13. Base Isolation for Seismic Retrofitting of a Multiple Building Structure: Design, Construction, and Assessment

    Massimiliano Ferraioli

    2017-01-01

    Full Text Available The paper deals with the seismic retrofit of a multiple building structure belonging to the Hospital Centre of Avellino (Italy. At first, the paper presents the preliminary investigations, the in situ measurements and laboratory tests, and the seismic assessment of the existing fixed-base structures. Having studied different strategies, base isolation proved to be the more appropriate, also for the possibility offered by the geometry of the building to easily create an isolation interface at the ground level. The paper presents the design project, the construction process, and the details of the isolation intervention. Some specific issues of base isolation for seismic retrofitting of multiple building structures were lightened. Finally, the seismic assessment of the base-isolated building was carried out. The seismic response was evaluated through nonlinear time-history analysis, using the well-known Bouc-Wen model as the constitutive law of the isolation bearings. For reliable dynamic analyses, a suite of natural accelerograms compatible with acceleration spectra of Italian Code was first selected and then applied along both horizontal directions. The results were finally used to address some of the critical issues of the seismic response of the base-isolated multiple building structure: accidental torsional effects and potential poundings during strong earthquakes.

  14. Multiple-Robot Systems for USAR: Key Design Attributes and Deployment Issues

    Choon Yue Wong

    2011-03-01

    Full Text Available The interaction between humans and robots is undergoing an evolution. Progress in this evolution means that humans are close to robustly deploying multiple robots. Urban search and rescue (USAR can benefit greatly from such capability. The review shows that with state of the art artificial intelligence, robots can work autonomously but still require human supervision. It also shows that multiple robot deployment (MRD is more economical, shortens mission durations, adds reliability as well as addresses missions impossible with one robot and payload constraints. By combining robot autonomy and human supervision, the benefits of MRD can be applied to USAR while at the same time minimizing human exposure to danger. This is achieved with a single-human multiple-robot system (SHMRS. However, designers of the SHMRS must consider key attributes such as the size, composition and organizational structure of the robot collective. Variations in these attributes also induce fluctuations in issues within SHMRS deployment such as robot communication and computational load as well as human cognitive workload and situation awareness (SA. Research is essential to determine how the attributes can be manipulated to mitigate these issues while meeting the requirements of the USAR mission.

  15. Multiple-Robot Systems for USAR: Key Design Attributes and Deployment Issues

    Choon Yue Wong

    2011-03-01

    Full Text Available The interaction between humans and robots is undergoing an evolution. Progress in this evolution means that humans are close to robustly deploying multiple robots. Urban search and rescue (USAR can benefit greatly from such capability. The review shows that with state of the art artificial intelligence, robots can work autonomously but still require human supervision. It also shows that multiple robot deployment (MRD is more economical, shortens mission durations, adds reliability as well as addresses missions impossible with one robot and payload constraints. By combining robot autonomy and human supervision, the benefits of MRD can be applied to USAR while at the same time minimizing human exposure to danger. This is achieved with a single-human multiple-robot system (SHMRS. However, designers of the SHMRS must consider key attributes such as the size, composition and organizational structure of the robot collective. Variations in these attributes also induce fluctuations in issues within SHMRS deployment such as robot communication and computational load as well as human cognitive workload and situation awareness (SA.Research is essential to determine how the attributes can be manipulated to mitigate these issues while meeting the requirements of the USAR mission.

  16. Free-space optical code-division multiple-access system design

    Jeromin, Lori L.; Kaufmann, John E.; Bucher, Edward A.

    1993-08-01

    This paper describes an optical direct-detection multiple access communications system for free-space satellite networks utilizing code-division multiple-access (CDMA) and forward error correction (FEC) coding. System performance is characterized by how many simultaneous users operating at data rate R can be accommodated in a signaling bandwidth W. The performance of two CDMA schemes, optical orthogonal codes (OOC) with FEC and orthogonal convolutional codes (OCC), is calculated and compared to information-theoretic capacity bounds. The calculations include the effects of background and detector noise as well as nonzero transmitter extinction ratio and power imbalance among users. A system design for 10 kbps multiple-access communications between low-earth orbit satellites is given. With near- term receiver technology and representative system losses, a 15 W peak-power transmitter provides 10-6 BER performance with seven interfering users and full moon background in the receiver FOV. The receiver employs an array of discrete wide-area avalanche photodiodes (APD) for wide field of view coverage. Issues of user acquisition and synchronization, implementation technology, and system scalability are also discussed.

  17. Design and protocol of a randomized multiple behavior change trial: Make Better Choices 2 (MBC2).

    Pellegrini, Christine A; Steglitz, Jeremy; Johnston, Winter; Warnick, Jennifer; Adams, Tiara; McFadden, H G; Siddique, Juned; Hedeker, Donald; Spring, Bonnie

    2015-03-01

    Suboptimal diet and inactive lifestyle are among the most prevalent preventable causes of premature death. Interventions that target multiple behaviors are potentially efficient; however the optimal way to initiate and maintain multiple health behavior changes is unknown. The Make Better Choices 2 (MBC2) trial aims to examine whether sustained healthful diet and activity change are best achieved by targeting diet and activity behaviors simultaneously or sequentially. Study design approximately 250 inactive adults with poor quality diet will be randomized to 3 conditions examining the best way to prescribe healthy diet and activity change. The 3 intervention conditions prescribe: 1) an increase in fruit and vegetable consumption (F/V+), decrease in sedentary leisure screen time (Sed-), and increase in physical activity (PA+) simultaneously (Simultaneous); 2) F/V+ and Sed- first, and then sequentially add PA+ (Sequential); or 3) Stress Management Control that addresses stress, relaxation, and sleep. All participants will receive a smartphone application to self-monitor behaviors and regular coaching calls to help facilitate behavior change during the 9 month intervention. Healthy lifestyle change in fruit/vegetable and saturated fat intakes, sedentary leisure screen time, and physical activity will be assessed at 3, 6, and 9 months. MBC2 is a randomized m-Health intervention examining methods to maximize initiation and maintenance of multiple healthful behavior changes. Results from this trial will provide insight about an optimal technology supported approach to promote improvement in diet and physical activity. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Influences of sodium carbonate on physicochemical properties of lansoprazole in designed multiple coating pellets.

    He, Wei; Yang, Min; Fan, Jun Hong; Feng, Cai Xia; Zhang, Su Juan; Wang, Jin Xu; Guan, Pei Pei; Wu, Wei

    2010-09-01

    Lansoprazole (LSP), a proton-pump inhibitor, belongs to class II drug. It is especially instable to heat, light, and acidic media, indicating that fabrication of a formulation stabilizing the drug is difficult. The addition of alkaline stabilizer is the most powerful method to protect the drug in solid formulations under detrimental environment. The purpose of the study was to characterize the designed multiple coating pellets of LSP containing an alkaline stabilizer (sodium carbonate) and assess the effect of the stabilizer on the physicochemical properties of the drug. The coated pellets were prepared by layer-layer film coating with a fluid-bed coater. In vitro release and acid-resistance studies were carried out in simulated gastric fluid and simulated intestinal fluid, respectively. Furthermore, the moisture-uptake test was performed to evaluate the influence of sodium carbonate on the drug stability. The results indicate that the drug exists in the amorphous state or small (nanometer size) particles without crystallization even after storage at 40°C/75% for 5 months. The addition of sodium carbonate to the pellet protects the drug from degradation in simulated gastric fluid in a dose-dependent manner. The moisture absorbed into the pellets has a detrimental effect on the drug stability. The extent of drug degradation is directly correlated with the content of moisture absorption. In conclusion, these results suggest that the presence of sodium carbonate influence the physicochemical properties of LSP, and the designed multiple coating pellets enhance the drug stability.

  19. Studying variability in human brain aging in a population-based German cohort – Rationale and design of 1000BRAINS

    Svenja eCaspers

    2014-07-01

    Full Text Available The ongoing 1000 brains study (1000BRAINS is an epidemiological and neuroscientific investigation of structural and functional variability in the human brain during aging. The two recruitment sources are the 10-year follow-up cohort of the German Heinz Nixdorf Recall (HNR Study, and the HNR MultiGeneration Study cohort, which comprises spouses and offspring of HNR subjects. The HNR is a longitudinal epidemiological investigation of cardiovascular risk factors, with a comprehensive collection of clinical, laboratory, socioeconomic, and environmental data from population-based subjects aged 45-75 years on inclusion. HNR subjects underwent detailed assessments in 2000, 2006, and 2011, and completed annual postal questionnaires on health status. 1000BRAINS accesses these HNR data and applies a separate protocol comprising: neuropsychological tests of attention, memory, executive functions & language; examination of motor skills; ratings of personality, life quality, mood & daily activities; analysis of laboratory and genetic data; and state-of-the-art magnetic resonance imaging (MRI, 3 Tesla of the brain. The latter includes (i 3D-T1- and 3D-T2-weighted scans for structural analyses and myelin mapping; (ii three diffusion imaging sequences optimized for diffusion tensor imaging, high-angular resolution diffusion imaging for detailed fibre tracking and for diffusion kurtosis imaging; (iii resting-state and task-based functional MRI; and (iv fluid-attenuated inversion recovery and MR angiography for the detection of vascular lesions and the mapping of white matter lesions. The unique design of 1000BRAINS allows: (i comprehensive investigation of various influences including genetics, environment and health status on variability in brain structure and function during aging; and (ii identification of the impact of selected influencing factors on specific cognitive subsystems and their anatomical correlates.

  20. More Stamina, a Gamified mHealth Solution for Persons with Multiple Sclerosis: Research Through Design

    Mylonopoulou, Vasiliki; Rivera Romero, Octavio

    2018-01-01

    Background Multiple sclerosis (MS) is one of the world’s most common neurologic disorders. Fatigue is one of most common symptoms that persons with MS experience, having significant impact on their quality of life and limiting their activity levels. Self-management strategies are used to support them in the care of their health. Mobile health (mHealth) solutions are a way to offer persons with chronic conditions tools to successfully manage their symptoms and problems. Gamification is a current trend among mHealth apps used to create engaging user experiences and is suggested to be effective for behavioral change. To be effective, mHealth solutions need to be designed to specifically meet the intended audience needs. User-centered design (UCD) is a design philosophy that proposes placing end users’ needs and characteristics in the center of design and development, involving users early in the different phases of the software life cycle. There is a current gap in mHealth apps for persons with MS, which presents an interesting area to explore. Objective The purpose of this study was to describe the design and evaluation process of a gamified mHealth solution for behavioral change in persons with MS using UCD. Methods Building on previous work of our team where we identified needs, barriers, and facilitators for mHealth apps for persons with MS, we followed UCD to design and evaluate a mobile app prototype aimed to help persons with MS self-manage their fatigue. Design decisions were evidence-driven and guided by behavioral change models (BCM). Usability was assessed through inspection methods using Nielsen’s heuristic evaluation. Results The mHealth solution More Stamina was designed. It is a task organization tool designed to help persons with MS manage their energy to minimize the impact of fatigue in their day-to-day life. The tool acts as a to-do list where users can input tasks in a simple manner and assign Stamina Credits, a representation of perceived

  1. More Stamina, a Gamified mHealth Solution for Persons with Multiple Sclerosis: Research Through Design.

    Giunti, Guido; Mylonopoulou, Vasiliki; Rivera Romero, Octavio

    2018-03-02

    Multiple sclerosis (MS) is one of the world's most common neurologic disorders. Fatigue is one of most common symptoms that persons with MS experience, having significant impact on their quality of life and limiting their activity levels. Self-management strategies are used to support them in the care of their health. Mobile health (mHealth) solutions are a way to offer persons with chronic conditions tools to successfully manage their symptoms and problems. Gamification is a current trend among mHealth apps used to create engaging user experiences and is suggested to be effective for behavioral change. To be effective, mHealth solutions need to be designed to specifically meet the intended audience needs. User-centered design (UCD) is a design philosophy that proposes placing end users' needs and characteristics in the center of design and development, involving users early in the different phases of the software life cycle. There is a current gap in mHealth apps for persons with MS, which presents an interesting area to explore. The purpose of this study was to describe the design and evaluation process of a gamified mHealth solution for behavioral change in persons with MS using UCD. Building on previous work of our team where we identified needs, barriers, and facilitators for mHealth apps for persons with MS, we followed UCD to design and evaluate a mobile app prototype aimed to help persons with MS self-manage their fatigue. Design decisions were evidence-driven and guided by behavioral change models (BCM). Usability was assessed through inspection methods using Nielsen's heuristic evaluation. The mHealth solution More Stamina was designed. It is a task organization tool designed to help persons with MS manage their energy to minimize the impact of fatigue in their day-to-day life. The tool acts as a to-do list where users can input tasks in a simple manner and assign Stamina Credits, a representation of perceived effort, to the task to help energy management

  2. Connect MDS/AML: design of the myelodysplastic syndromes and acute myeloid leukemia disease registry, a prospective observational cohort study.

    Steensma, David P; Abedi, Medrdad; Bejar, Rafael; Cogle, Christopher R; Foucar, Kathryn; Garcia-Manero, Guillermo; George, Tracy I; Grinblatt, David; Komrokji, Rami; Ma, Xiaomei; Maciejewski, Jaroslaw; Pollyea, Daniel A; Savona, Michael R; Scott, Bart; Sekeres, Mikkael A; Thompson, Michael A; Swern, Arlene S; Nifenecker, Melissa; Sugrue, Mary M; Erba, Harry

    2016-08-19

    Myelodysplastic syndromes (MDS) and acute myeloid leukemia (AML) are myeloid neoplasms in which outgrowth of neoplastic clones disrupts normal hematopoiesis. Some patients with unexplained persistent cytopenias may not meet minimal diagnostic criteria for MDS but an alternate diagnosis is not apparent; the term idiopathic cytopenia of undetermined significance (ICUS) has been used to describe this state. MDS and AML occur primarily in older patients who are often treated outside the clinical trial setting. Consequently, our understanding of the patterns of diagnostic evaluation, management, and outcomes of these patients is limited. Furthermore, there are few natural history studies of ICUS. To better understand how patients who have MDS, ICUS, or AML are managed in the routine clinical setting, the Connect MDS/AML Disease Registry, a multicenter, prospective, observational cohort study of patients newly diagnosed with these conditions has been initiated. The Connect MDS/AML Disease Registry will capture diagnosis, risk assessment, treatment, and outcomes data for approximately 1500 newly diagnosed patients from approximately 150 community and academic sites in the United States in 4 cohorts: (1) lower-risk MDS (International Prognostic Scoring System [IPSS] low and intermediate-1 risk), with and without del(5q); (2) higher-risk MDS (IPSS intermediate-2 and high risk); (3) ICUS; and (4) AML in patients aged ≥ 55 years (excluding acute promyelocytic leukemia). Diagnosis will be confirmed by central review. Baseline patient characteristics, diagnostic patterns, treatment patterns, clinical outcomes, health economics outcomes, and patient-reported health-related quality of life will be entered into an electronic data capture system at enrollment and quarterly for 8 years. A tissue substudy to explore the relationship between karyotypes, molecular markers, and clinical outcomes will be conducted, and is optional for patients. The Connect MDS/AML Disease

  3. Socioeconomic conditions across life related to multiple measures of the endocrine system in older adults: Longitudinal findings from a British birth cohort study.

    Bann, David; Hardy, Rebecca; Cooper, Rachel; Lashen, Hany; Keevil, Brian; Wu, Frederick C W; Holly, Jeff M P; Ong, Ken K; Ben-Shlomo, Yoav; Kuh, Diana

    2015-12-01

    Little is known about how socioeconomic position (SEP) across life impacts on different axes of the endocrine system which are thought to underlie the ageing process and its adverse consequences. We examined how indicators of SEP across life related to multiple markers of the endocrine system in late midlife, and hypothesized that lower SEP across life would be associated with an adverse hormone profile across multiple axes. Data were from a British cohort study of 875 men and 905 women followed since their birth in March 1946 with circulating free testosterone and insulin-like growth factor-I (IGF-I) measured at both 53 and 60-64 years, and evening cortisol at 60-64 years. Indicators of SEP were ascertained prospectively across life-paternal occupational class at 4, highest educational attainment at 26, household occupational class at 53, and household income at 60-64 years. Associations between SEP and hormones were investigated using multiple regression and logistic regression models. Lower SEP was associated with lower free testosterone among men, higher free testosterone among women, and lower IGF-I and higher evening cortisol in both sexes. For example, the mean standardised difference in IGF-I comparing the lowest with the highest educational attainment at 26 years (slope index of inequality) was -0.4 in men (95% CI -0.7 to -0.2) and -0.4 in women (-0.6 to -0.2). Associations with each hormone differed by SEP indicator used and sex, and were particularly pronounced when using a composite adverse hormone score. For example, the odds of having 1 additional adverse hormone concentration in the lowest compared with highest education level were 3.7 (95% CI: 2.1, 6.3) among men, and 1.6 (1.0, 2.7) among women (P (sex interaction) = 0.02). We found no evidence that SEP was related to apparent age-related declines in free testosterone or IGF-I. Lower SEP was associated with an adverse hormone profile across multiple endocrine axes. SEP differences in endocrine

  4. Multiple-Criteria Decision-Making in the Design of Innovative Lock Walls for Barge Impact; Phase 1

    Lambert, James

    2001-01-01

    .... This research project consists of two phases: Phase 1, which culminates with this report, investigated the use of multiple-criteria decision-making in the design process of lock approach walls to consider barge impact and earthquake loads...

  5. The HAPPY study (Holistic Approach to Pregnancy and the first Postpartum Year): design of a large prospective cohort study.

    Truijens, Sophie E M; Meems, Margreet; Kuppens, Simone M I; Broeren, Maarten A C; Nabbe, Karin C A M; Wijnen, Hennie A; Oei, S Guid; van Son, Maarten J M; Pop, Victor J M

    2014-09-08

    The HAPPY study is a large prospective longitudinal cohort study in which pregnant women (N ≈ 2,500) are followed during the entire pregnancy and the whole first year postpartum. The study collects a substantial amount of psychological and physiological data investigating all kinds of determinants that might interfere with general well-being during pregnancy and postpartum, with special attention to the effect of maternal mood, pregnancy-related somatic symptoms (including nausea and vomiting (NVP) and carpal tunnel syndrome (CTS) symptoms), thyroid function, and human chorionic gonadotropin (HCG) on pregnancy outcome of mother and foetus. During pregnancy, participants receive questionnaires at 12, 22 and 32 weeks of gestation. Apart from a previous obstetric history, demographic features, distress symptoms, and pregnancy-related somatic symptoms are assessed. Furthermore, obstetrical data of the obstetric record form and ultrasound data are collected during pregnancy. At 12 and 30 weeks, thyroid function is assessed by blood analysis of thyroid stimulating hormone (TSH), free thyroxine (FT4) and thyroid peroxidase antibodies (TPO-Ab), as well as HCG. Also, depression is assessed with special focus on the two key symptoms: depressed mood and anhedonia. After childbirth, cord blood, neonatal heel screening results and all obstetrical data with regard to start of labour, mode of delivery and complications are collected. Moreover, mothers receive questionnaires at one week, six weeks, four, eight, and twelve months postpartum, to investigate recovery after pregnancy and delivery, including postpartum mood changes, emotional distress, feeding and development of the newborn. The key strength of this large prospective cohort study is the holistic (multifactorial) approach on perinatal well-being combined with a longitudinal design with measurements during all trimesters of pregnancy and the whole first year postpartum, taking into account two physiological possible

  6. A note on “An alternative multiple attribute decision making methodology for solving optimal facility layout design selection problems”

    R. Venkata Rao

    2012-01-01

    A paper published by Maniya and Bhatt (2011) (An alternative multiple attribute decision making methodology for solving optimal facility layout design selection problems, Computers & Industrial Engineering, 61, 542-549) proposed an alternative multiple attribute decision making method named as “Preference Selection Index (PSI) method” for selection of an optimal facility layout design. The authors had claimed that the method was logical and more appropriate and the method gives directly the o...

  7. Multiplicative synergistic risk of hepatocellular carcinoma development among hepatitis B and C co-infected subjects in HBV endemic area: a community-based cohort study

    Oh, Jin-Kyoung; Shin, Hai-Rim; Lim, Min Kyung; Cho, Heeyoun; Kim, Dong-Il; Jee, Youngmee; Yun, Haesun; Yoo, Keun-Young

    2012-01-01

    There has been limited study on the effect of infection with different hepatitis C virus (HCV) genotypes on the risk of hepatocellular carcinoma (HCC) in hepatitis B virus (HBV) endemic regions of Asia. Hazard ratios of HCC development were estimated for HBV and HCV co-infected subjects among a community-based prospective cohort. HCV genotype was determined in HCV RNA-positive samples. Incident HCC cases were identified through linkage to the cancer registry. HCC incidence was 79 per 100,000 person-years in the study population (50 incident cases among 6,694 individuals within 63,170 person-years with an average of 9.4 years of follow-up); seroprevalence of HBsAg and anti-HCV was 5.2% and 5.6%. Adjusted hazard ratios of HCC by HBsAg positivity and anti-HCV positivity were 13.3 (CI: 7.3-24.4) and 6.7 (CI: 3.6-12.6). HRs of HBV and HCV monoinfection, and HBV/HCV coinfection were 17.1 (CI: 8.4-34.8), 10.4 (CI: 4.9-22.1) and 115.0 (CI: 32.5-407.3). Multiplicative synergistic effect of HBV/HCV coinfection on HCC risk was also observed (synergy index: 4.5, CI: 1.3-15.5). Infection with HCV genotype 1 (HR: 29.7, CI: 13.6-46.8) and mixed infection with genotype 1 and 2 (HR: 68.7, CI: 16.4-288.4) significantly elevated HCC risk, much higher than HBV infection. The effect of differences in HCV genotype and the multiplicative synergistic effect of HBV/HCV coinfection on HCC risk shown in the present study underline the need for comprehensive identification of hepatitis infection status in order to prevent and control HCC in this HBV endemic area

  8. Non-Orthogonal Multiple Access for Large-Scale 5G Networks: Interference Aware Design

    Ali, Konpal S.

    2017-09-18

    Non-orthogonal multiple access (NOMA) is promoted as a key component of 5G cellular networks. As the name implies, NOMA operation introduces intracell interference (i.e., interference arising within the cell) to the cellular operation. The intracell interference is managed by careful NOMA design (e.g., user clustering and resource allocation) along with successive interference cancellation. However, most of the proposed NOMA designs are agnostic to intercell interference (i.e., interference from outside the cell), which is a major performance limiting parameter in 5G networks. This article sheds light on the drastic negative-impact of intercell interference on the NOMA performance and advocates interference-aware NOMA design that jointly accounts for both intracell and intercell interference. To this end, a case study for fair NOMA operation is presented and intercell interference mitigation techniques for NOMA networks are discussed. This article also investigates the potential of integrating NOMA with two important 5G transmission schemes, namely, full duplex and device-to-device communication. This is important since the ambitious performance defined by the 3rd Generation Partnership Project (3GPP) for 5G is foreseen to be realized via seamless integration of several new technologies and transmission techniques.

  9. Optimal design of hydraulic excavator working device based on multiple surrogate models

    Qingying Qiu

    2016-05-01

    Full Text Available The optimal design of hydraulic excavator working device is often characterized by computationally expensive analysis methods such as finite element analysis. Significant difficulties also exist when using a sensitivity-based decomposition approach to such practical engineering problems because explicit mathematical formulas between the objective function and design variables are impossible to formulate. An effective alternative is known as the surrogate model. The purpose of this article is to provide a comparative study on multiple surrogate models, including the response surface methodology, Kriging, radial basis function, and support vector machine, and select the one that best fits the optimization of the working device. In this article, a new modeling strategy based on the combination of the dimension variables between hinge joints and the forces loaded on hinge joints of the working device is proposed. In addition, the extent to which the accuracy of the surrogate models depends on different design variables is presented. The bionic intelligent optimization algorithm is then used to obtain the optimal results, which demonstrate that the maximum stresses calculated by the predicted method and finite element analysis are quite similar, but the efficiency of the former is much higher than that of the latter.

  10. Approach and landing guidance design for reusable launch vehicle using multiple sliding surfaces technique

    Xiangdong LIU

    2017-08-01

    Full Text Available An autonomous approach and landing (A&L guidance law is presented in this paper for landing an unpowered reusable launch vehicle (RLV at the designated runway touchdown. Considering the full nonlinear point-mass dynamics, a guidance scheme is developed in three-dimensional space. In order to guarantee a successful A&L movement, the multiple sliding surfaces guidance (MSSG technique is applied to derive the closed-loop guidance law, which stems from higher order sliding mode control theory and has advantage in the finite time reaching property. The global stability of the proposed guidance approach is proved by the Lyapunov-based method. The designed guidance law can generate new trajectories on-line without any specific requirement on off-line analysis except for the information on the boundary conditions of the A&L phase and instantaneous states of the RLV. Therefore, the designed guidance law is flexible enough to target different touchdown points on the runway and is capable of dealing with large initial condition errors resulted from the previous flight phase. Finally, simulation results show the effectiveness of the proposed guidance law in different scenarios.

  11. An Optimal Design of Multiple Antenna Positions on Mobile Devices Based on Mutual Coupling Analysis

    Peerapong Uthansakul

    2011-01-01

    Full Text Available The topic of practical implementation of multiple antenna systems for mobile communications has recently gained a lot of attention. Due to the area constraint on a mobile device, the problem of how to design such a system in order to achieve the best benefit is still a huge challenge. In this paper, genetic algorithm (GA is used to find the optimal antenna positions on a mobile device. Two cases of 3×3 and 4×4 MIMO systems are undertaken. The effect of mutual coupling based on Z-parameter is the main factor to determine the MIMO capacity concerning the objective function of GA search. The results confirm the success of the proposed method to design MIMO antenna positions on a mobile device. Moreover, this paper introduces the method to design the antenna positions for the condition of nondeterministic channel. The concern of channel variation has been included in the process of finding optimal MIMO antenna positions. The results suggest that the averaging position from all GA solutions according to all channel conditions provides the most acceptable benefit.

  12. Analysis, Design, and Construction of a Base-Isolated Multiple Building Structure

    Stefano Sorace

    2014-01-01

    Full Text Available The analysis and design of a multiple residential building, seismically protected by a base isolation system incorporating double friction pendulum sliders as protective devices, are presented in the paper. The building, situated in the suburban area of Florence, is composed of four independent reinforced concrete framed structures, mutually separated by three thermal expansion joints. The plan is L-shaped, with dimensions of about 75 m in the longitudinal direction and about 30 m along the longest side of the transversal direction. These characteristics identify the structure as the largest example of a base-isolated “artificial ground” ever built in Italy. The base isolation solution guarantees lower costs, a much greater performance, and a finer architectural look, as compared to a conventional fixed-base antiseismic design. The characteristics of the building and the isolators, the mechanical properties and the experimental characterization campaign and preliminary sizing carried out on the latter, and the nonlinear time-history design and performance assessment analyses developed on the base isolated building are reported in this paper, along with details about the installation of the isolators and the plants and highlights of the construction works.

  13. A Historical Cohort Study on the Efficacy of Glucocorticoids and Riboflavin Among Patients with Late-onset Multiple Acyl-CoA Dehydrogenase Deficiency.

    Liu, Xin-Yi; Wang, Zhi-Qiang; Wang, Dan-Ni; Lin, Min-Ting; Wang, Ning

    2016-01-20

    Late-onset multiple acyl-CoA dehydrogenase deficiency (MADD) is the most common type of lipid storage myopathies in China. Most patients with late-onset MADD are well responsive to riboflavin. Up to now, these patients are often treated with glucocorticoids as the first-line drug because they are misdiagnosed as polymyositis without muscle biopsy or gene analysis. Although glucocorticoids seem to improve the fatty acid metabolism of late-onset MADD, the objective evaluation of their rationalization on this disorder and comparison with riboflavin treatment are unknown. We performed a historical cohort study on the efficacy of the two drugs among 45 patients with late-onset MADD, who were divided into glucocorticoids group and riboflavin group. Detailed clinical information of baseline and 1-month follow-up were collected. After 1-month treatment, a dramatic improvement of muscle strength was found in riboflavin group (P riboflavin group (P riboflavin group still presented high-level muscle enzymes and weak muscle strength after 1-month riboflavin treatment, meaning that 1-month treatment duration maybe insufficient and patients should keep on riboflavin supplement for a longer time. Our results provide credible evidences that the overall efficacy of riboflavin is superior to glucocorticoids, and a longer duration of riboflavin treatment is necessary for patients with late-onset MADD.

  14. Decreasing rate of multiple treatment modifications among individuals who initiated antiretroviral therapy in 1997-2009 in the Danish HIV Cohort Study

    Helleberg, Marie; Kronborg, Gitte; Larsen, Carsten S

    2012-01-01

    BACKGROUND: We hypothesized that rates and reasons for treatment modifications have changed since the implementation of combination antiretroviral therapy (cART) due to improvements in therapy. METHODS: From a nationwide population-based cohort study we identified all HIV-1 infected adults who...... initiated cART in Denmark 1997-2009 and were followed (3)1 year. Incidence rate ratios (IRR) and reasons for treatment modifications were estimated and compared between patients, who initiated treatment in 1997-1999, 2000-2004 and 2005-2009. Rates of discontinuation of individual antiretroviral drugs (ARVs......) were evaluated. RESULTS: 3,107 patients were followed median 7.3 years (IQR 3.8-10.8). Rates of first treatment modification ≤1 year after cART initiation did not change (IRR 0.88 (95% CI 0.78-1.01) and 1.03 (95% CI 0.90-1.18) in 2000-2004 and 2005-2009 compared to 1997-1999). Rates of multiple...

  15. Robust design method and thermostatic experiment for multiple piezoelectric vibration absorber system

    Nambu, Yohsuke; Takashima, Toshihide; Inagaki, Akiya

    2015-01-01

    This paper examines the effects of connecting multiplexing shunt circuits composed of inductors and resistors to piezoelectric transducers so as to improve the robustness of a piezoelectric vibration absorber (PVA). PVAs are well known to be effective at suppressing the vibration of an adaptive structure; their weakness is low robustness to changes in the dynamic parameters of the system, including the main structure and the absorber. In the application to space structures, the temperature-dependency of capacitance of piezoelectric ceramics is the factor that causes performance reduction. To improve robustness to the temperature-dependency of the capacitance, this paper proposes a multiple-PVA system that is composed of distributed piezoelectric transducers and several shunt circuits. The optimization problems that determine both the frequencies and the damping ratios of the PVAs are multi-objective problems, which are solved using a real-coded genetic algorithm in this paper. A clamped aluminum beam with four groups of piezoelectric ceramics attached was considered in simulations and experiments. Numerical simulations revealed that the PVA systems designed using the proposed method had tolerance to changes in the capacitances. Furthermore, experiments using a thermostatic bath were conducted to reveal the effectiveness and robustness of the PVA systems. The maximum peaks of the transfer functions of the beam with the open circuit, the single-PVA system, the double-PVA system, and the quadruple-PVA system at 20 °C were 14.3 dB, −6.91 dB, −7.47 dB, and −8.51 dB, respectively. The experimental results also showed that the multiple-PVA system is more robust than a single PVA in a variable temperature environment from −10 °C to 50 °C. In conclusion, the use of multiple PVAs results in an effective, robust vibration control method for adaptive structures. (paper)

  16. Damping-tunable energy-harvesting vehicle damper with multiple controlled generators: Design, modeling and experiments

    Xie, Longhan; Li, Jiehong; Li, Xiaodong; Huang, Ledeng; Cai, Siqi

    2018-01-01

    Hydraulic dampers are used to decrease the vibration of a vehicle, where vibration energy is dissipated as heat. In addition to resulting in energy waste, the damping coefficient in hydraulic dampers cannot be changed during operation. In this paper, an energy-harvesting vehicle damper was proposed to replace traditional hydraulic dampers. The goal is not only to recover kinetic energy from suspension vibration but also to change the damping coefficient during operation according to road conditions. The energy-harvesting damper consists of multiple generators that are independently controlled by switches. One of these generators connects to a tunable resistor for fine tuning the damping coefficient, while the other generators are connected to a control and rectifying circuit, each of which both regenerates electricity and provides a constant damping coefficient. A mathematical model was built to investigate the performance of the energy-harvesting damper. By controlling the number of switched-on generators and adjusting the value of the external tunable resistor, the damping can be fine tuned according to the requirement. In addition to the capability of damping tuning, the multiple controlled generators can output a significant amount of electricity. A prototype was built to test the energy-harvesting damper design. Experiments on an MTS testing system were conducted, with results that validated the theoretical analysis. Experiments show that changing the number of switched-on generators can obviously tune the damping coefficient of the damper and simultaneously produce considerable electricity.

  17. Performance of Cross-layer Design with Multiple Outdated Estimates in Multiuser MIMO System

    X. Yu

    2014-09-01

    Full Text Available By combining adaptive modulation (AM and automatic repeat request (ARQ protocol as well as user scheduling, the cross-layer design scheme of multiuser MIMO system with imperfect feedback is presented, and multiple outdated estimates method is proposed to improve the system performance. Based on this method and imperfect feedback information, the closed-form expressions of spectral efficiency (SE and packet error rate (PER of the system subject to the target PER constraint are respectively derived. With these expressions, the system performance can be effectively evaluated. To mitigate the effect of delayed feedback, the variable thresholds (VTs are also derived by means of the maximum a posteriori method, and these VTs include the conventional fixed thresholds (FTs as special cases. Simulation results show that the theoretical SE and PER are in good agreement with the corresponding simulation. The proposed CLD scheme with multiple estimates can obtain higher SE than the existing CLD scheme with single estimate, especially for large delay. Moreover, the CLD scheme with VTs outperforms that with conventional FTs.

  18. Design of a Flexible Hardware Interface for Multiple Remote Electronic practical Experiments of Virtual Laboratory

    Farah Said

    2012-03-01

    Full Text Available The objective of this work is to present a new design of a Flexible Hardware Interface (FHI based on PID control techniques to use in a virtual laboratory. This flexible hardware interface allows the easy implementation of different and multiple remote electronic practical experiments for undergraduate engineering classes. This interface can be viewed as opened hardware architecture to easily develop simple or complex remote experiments in the electronic domain. The philosophy of the use of this interface can also be expanded to many other domains as optic experiments for instance. It is also demonstrated that software can be developed to enable remote measurements of electronic circuits or systems using only Web site Interface. Using standard browsers (such as Internet explorer, Firefox, Chrome or Safari, different students can have a remote access to different practical experiments at a time.

  19. Adaptive Control Design for Autonomous Operation of Multiple Energy Storage Systems in Power Smoothing Applications

    Meng, Lexuan; Dragicevic, Tomislav; Guerrero, Josep M.

    2018-01-01

    -pass-filter (HPF) structure. It generates the power reference according to the fluctuating power and provides a stabilization effect. The power and energy supplied by ESS are majorly configured by the cut-off frequency and gain of the HPF. Considering the operational limits on ESS state-of-charge (SoC), this paper...... proposes an adaptive cut-off frequency design method to realize communication-less and autonomous operation of a system with multiple distributed ESS. The experimental results demonstrate that the SoCs of all ESS units are kept within safe margins, while the SoC level and power of the paralleled units...... converge to the final state, providing a natural plug-and-play function....

  20. Structural Design of Systems with Safe Behavior under Single and Multiple Faults

    Blanke, Mogens; Staroswiecki, Marcel

    2006-01-01

    Handling of multiple simultaneous faults is a complex issue in fault-tolerant control. The design task is particularly made difficult by to the numerous different cases that need be analyzed. Aiming at safe fault-handling, this paper shows how structural analysis can be applied to find...... to structural analysis to disclose which faults could be isolated from a structural point of view using active fault isolation. Results from application on a marine control system illustrate the concepts....... the analytical redundancy relations for all relevant combinations of faults, and can cope with the complexity and size of a real system. Being essential for fault-tolerant control schemes that shall handle particular cases of faults/failures, fault isolation is addressed. The paper introduces an extension...

  1. Farmers’ Cohort for Agricultural Work-Related Musculoskeletal Disorders (FARM) Study: Study Design, Methods, and Baseline Characteristics of Enrolled Subjects

    Jo, Hannae; Baek, Sora; Park, Hee-won; Lee, Sang-Ah; Moon, Jiyoung; Yang, Jae E.; Kim, Ki Sung; Kim, Jee Yong; Kang, Eun Kyoung

    2016-01-01

    Background The ongoing Farmers’ Cohort for Agricultural Work-related Musculoskeletal Disorders (FARM) study was developed to evaluate health status and related factors in farmers. Methods Farmers in Kangwon Province, South Korea, were recruited. Baseline characteristics were determined using questionnaires about sociodemographic and health characteristics and agricultural work-related factors. In addition, laboratory examinations (lumbar spinal radiography and serologic testing) were conducted. Results The FARM study covers eight rural areas and recruited 1013 subjects (534 women; mean [standard deviation {SD}] age, 57.2 [7.5] years). Musculoskeletal pain in multiple areas was reported by 925 subjects (91.3%), and low back pain (63.8%) was the most frequent site of pain. Farmer’s Stress Inventory (mean [SD], 77.7 [10.2]; range, 28–112] and subjective stress index (mean [SD], 5.3 [2.4]; range, 0–10) were above median scale values, reflecting a stressful condition, while the EuroQol-5D-3L index and the EuroQol-Visual Analog Scale scores were high (mean [SD], 0.9 [0.1]; range −0.171–1 and mean [SD], 67.7 [18.7]; range 0–100, respectively), reflecting good life quality. In total, 53% of participants had worked in farming for more than 30 years, and workers involved in dry-field farming comprised the largest subgroup (41.5%). Most participants (94.3%) had no more than a high school education, and families with annual income below 20 million won constituted the largest subgroup (36.3%). Conclusions The FARM study may provide data on the current health status and related sociodemographic and agricultural work-related risk factors in Korean farmers, with the goal of providing a scientific basis for developing coping interventions and preventive strategies. PMID:26235456

  2. Concurrent airline fleet allocation and aircraft design with profit modeling for multiple airlines

    Govindaraju, Parithi

    A "System of Systems" (SoS) approach is particularly beneficial in analyzing complex large scale systems comprised of numerous independent systems -- each capable of independent operations in their own right -- that when brought in conjunction offer capabilities and performance beyond the constituents of the individual systems. The variable resource allocation problem is a type of SoS problem, which includes the allocation of "yet-to-be-designed" systems in addition to existing resources and systems. The methodology presented here expands upon earlier work that demonstrated a decomposition approach that sought to simultaneously design a new aircraft and allocate this new aircraft along with existing aircraft in an effort to meet passenger demand at minimum fleet level operating cost for a single airline. The result of this describes important characteristics of the new aircraft. The ticket price model developed and implemented here enables analysis of the system using profit maximization studies instead of cost minimization. A multiobjective problem formulation has been implemented to determine characteristics of a new aircraft that maximizes the profit of multiple airlines to recognize the fact that aircraft manufacturers sell their aircraft to multiple customers and seldom design aircraft customized to a single airline's operations. The route network characteristics of two simple airlines serve as the example problem for the initial studies. The resulting problem formulation is a mixed-integer nonlinear programming problem, which is typically difficult to solve. A sequential decomposition strategy is applied as a solution methodology by segregating the allocation (integer programming) and aircraft design (non-linear programming) subspaces. After solving a simple problem considering two airlines, the decomposition approach is then applied to two larger airline route networks representing actual airline operations in the year 2005. The decomposition strategy serves

  3. Designs of Optoelectronic Trinary Signed-Digit Multiplication by use of Joint Spatial Encodings and Optical Correlation

    Cherri, Abdallah K.

    1999-02-01

    Trinary signed-digit (TSD) symbolic-substitution-based (SS-based) optical adders, which were recently proposed, are used as the basic modules for designing highly parallel optical multiplications by use of cascaded optical correlators. The proposed multiplications perform carry-free generation of the multiplication partial products of two words in constant time. Also, three different multiplication designs are presented, and new joint spatial encodings for the TSD numbers are introduced. The proposed joint spatial encodings allow one to reduce the SS computation rules involved in optical multiplication. In addition, the proposed joint spatial encodings increase the space bandwidth product of the spatial light modulators of the optical system. This increase is achieved by reduction of the numbers of pixels in the joint spatial encodings for the input TSD operands as well as reduction of the number of pixels used in the proposed matched spatial filters for the optical multipliers.

  4. The study design and methodology for the ARCHER study - adolescent rural cohort study of hormones, health, education, environments and relationships

    Steinbeck Katharine

    2012-09-01

    Full Text Available Abstract Background Adolescence is characterized by marked psychosocial, behavioural and biological changes and represents a critical life transition through which adult health and well-being are established. Substantial research confirms the role of psycho-social and environmental influences on this transition, but objective research examining the role of puberty hormones, testosterone in males and oestradiol in females (as biomarkers of puberty on adolescent events is lacking. Neither has the tempo of puberty, the time from onset to completion of puberty within an individual been studied, nor the interaction between age of onset and tempo. This study has been designed to provide evidence on the relationship between reproductive hormones and the tempo of their rise to adult levels, and adolescent behaviour, health and wellbeing. Methods/Design The ARCHER study is a multidisciplinary, prospective, longitudinal cohort study in 400 adolescents to be conducted in two centres in regional Australia in the State of New South Wales. The overall aim is to determine how changes over time in puberty hormones independently affect the study endpoints which describe universal and risk behaviours, mental health and physical status in adolescents. Recruitment will commence in school grades 5, 6 and 7 (10–12 years of age. Data collection includes participant and parent questionnaires, anthropometry, blood and urine collection and geocoding. Data analysis will include testing the reliability and validity of the chosen measures of puberty for subsequent statistical modeling to assess the impact over time of tempo and onset of puberty (and their interaction and mean-level repeated measures analyses to explore for significant upward and downward shifts on target outcomes as a function of main effects. Discussion The strengths of this study include enrollment starting in the earliest stages of puberty, the use of frequent urine samples in addition to annual

  5. Designing an Electronic Patient Management System for Multiple Sclerosis: Building a Next Generation Multiple Sclerosis Documentation System.

    Kern, Raimar; Haase, Rocco; Eisele, Judith Christina; Thomas, Katja; Ziemssen, Tjalf

    2016-01-08

    Technologies like electronic health records or telemedicine devices support the rapid mediation of health information and clinical data independent of time and location between patients and their physicians as well as among health care professionals. Today, every part of the treatment process from diagnosis, treatment selection, and application to patient education and long-term care may be enhanced by a quality-assured implementation of health information technology (HIT) that also takes data security standards and concerns into account. In order to increase the level of effectively realized benefits of eHealth services, a user-driven needs assessment should ensure the inclusion of health care professional perspectives into the process of technology development as we did in the development process of the Multiple Sclerosis Documentation System 3D. After analyzing the use of information technology by patients suffering from multiple sclerosis, we focused on the needs of neurological health care professionals and their handling of health information technology. Therefore, we researched the status quo of eHealth adoption in neurological practices and clinics as well as health care professional opinions about potential benefits and requirements of eHealth services in the field of multiple sclerosis. We conducted a paper-and-pencil-based mail survey in 2013 by sending our questionnaire to 600 randomly chosen neurological practices in Germany. The questionnaire consisted of 24 items covering characteristics of participating neurological practices (4 items), the current use of network technology and the Internet in such neurological practices (5 items), physicians' attitudes toward the general and MS-related usefulness of eHealth systems (8 items) and toward the clinical documentation via electronic health records (4 items), and physicians' knowledge about the Multiple Sclerosis Documentation System (3 items). From 600 mailed surveys, 74 completed surveys were returned

  6. Habitat selection and quality for multiple cohorts of young-of-the-year bluefish ( Pomatomus saltatrix): Comparisons between estuarine and ocean beaches in southern New Jersey

    Taylor, David L.; Nichols, Ryan S.; Able, Kenneth W.

    2007-07-01

    In this study, seasonal and annual variability in the use of estuarine and ocean beaches by young-of-the-year bluefish, Pomatomus saltatrix, was evaluated by indices of abundance in coastal areas of southern New Jersey (1998-2000). Biological and physical factors measured at specific sites were correlated with bluefish abundance to determine the mechanisms underlying habitat selection. In addition, integrative and discrete indicators of bluefish growth were used to examine spatio-temporal dynamics in habitat quality and its effect on habitat selection by multiple cohorts of bluefish. Intra-annual recruitment to coastal areas of southern New Jersey was episodic, and resulted from the ingress of spring-spawned bluefish (hatch-date ˜April) to estuarine beaches in late May to early June, followed by the recruitment of summer-spawned fish (hatch-date ˜early July) to ocean beaches from July to October. Bluefish utilized estuarine and ocean beaches in a facultative manner that was responsive to dynamics in prey composition and temperature conditions. The recruitment and residency of bluefish in the estuary (1998-1999) and ocean beaches (1998), for example, was coincidental with the presence of the Atlantic silverside Menidia menidia and bay anchovy Anchoa mitchilli, the principal prey species for bluefish occupying these respective habitat-types. Bluefish abundance in the estuary (2000) and ocean beaches (1999-2000) was also correlated with water temperature, with the greatest catches of juveniles coinciding with their optimal growth temperature (24 °C). Bluefish growth, estimated as the slope of age-length relationships and daily specific growth rates, equaled 1.27-2.63 mm fork length (FL) d -1 and 3.8-8.7% body length increase d -1, respectively. The growth of sagittal otoliths was also used as a proxy for changes in bluefish size during and shortly before their time of capture. Accordingly, otolith growth rates of summer-spawned bluefish were greater at ocean

  7. Barrier potential design criteria in multiple-quantum-well-based solar-cell structures

    Mohaidat, Jihad M.; Shum, Kai; Wang, W. B.; Alfano, R. R.

    1994-01-01

    The barrier potential design criteria in multiple-quantum-well (MQW)-based solar-cell structures is reported for the purpose of achieving maximum efficiency. The time-dependent short-circuit current density at the collector side of various MQW solar-cell structures under resonant condition was numerically calculated using the time-dependent Schroedinger equation. The energy efficiency of solar cells based on the InAs/Ga(y)In(1-y)As and GaAs/Al(x)Ga(1-x)As MQW structues were compared when carriers are excited at a particular solar-energy band. Using InAs/Ga(y)In(1-y)As MQW structures it is found that a maximum energy efficiency can be achieved if the structure is designed with barrier potential of about 450 meV. The efficiency is found to decline linearly as the barrier potential increases for GaAs/Al(x)Ga(1-x)As MQW-structure-based solar cells.

  8. Designing for multiple global user populations: increasing resource allocation efficiency for greater sustainability.

    Nadadur, G; Parkinson, M B

    2012-01-01

    This paper proposes a method to identify opportunities for increasing the efficiency of raw material allocation decisions for products that are simultaneously targeted at multiple user populations around the world. The values of 24 body measures at certain key percentiles were used to estimate the best-fitting anthropometric distributions for female and male adults in nine national populations, which were selected to represent the diverse target markets multinational companies must design for. These distributions were then used to synthesize body measure data for combined populations with a 1:1 female:male ratio. An anthropometric range metric (ARM) was proposed for assessing the variation of these body measures across the populations. At any percentile, ARM values were calculated as the percentage difference between the highest and lowest anthropometric values across the considered user populations. Based on their magnitudes, plots of ARM values computed between the 1st and 99 th percentiles for each body measure were grouped into low, medium, and high categories. This classification of body measures was proposed as a means of selecting the most suitable strategies for designing raw material-efficient products. The findings in this study and the contributions of subsequent work along these lines are expected to help achieve greater efficiencies in resource allocation in global product development.

  9. Stochastic production phase design for an open pit mining complex with multiple processing streams

    Asad, Mohammad Waqar Ali; Dimitrakopoulos, Roussos; van Eldert, Jeroen

    2014-08-01

    In a mining complex, the mine is a source of supply of valuable material (ore) to a number of processes that convert the raw ore to a saleable product or a metal concentrate for production of the refined metal. In this context, expected variation in metal content throughout the extent of the orebody defines the inherent uncertainty in the supply of ore, which impacts the subsequent ore and metal production targets. Traditional optimization methods for designing production phases and ultimate pit limit of an open pit mine not only ignore the uncertainty in metal content, but, in addition, commonly assume that the mine delivers ore to a single processing facility. A stochastic network flow approach is proposed that jointly integrates uncertainty in supply of ore and multiple ore destinations into the development of production phase design and ultimate pit limit. An application at a copper mine demonstrates the intricacies of the new approach. The case study shows a 14% higher discounted cash flow when compared to the traditional approach.

  10. Modern drug design: the implication of using artificial neuronal networks and multiple molecular dynamic simulations

    Yakovenko, Oleksandr; Jones, Steven J. M.

    2018-01-01

    We report the implementation of molecular modeling approaches developed as a part of the 2016 Grand Challenge 2, the blinded competition of computer aided drug design technologies held by the D3R Drug Design Data Resource (https://drugdesigndata.org/). The challenge was focused on the ligands of the farnesoid X receptor (FXR), a highly flexible nuclear receptor of the cholesterol derivative chenodeoxycholic acid. FXR is considered an important therapeutic target for metabolic, inflammatory, bowel and obesity related diseases (Expert Opin Drug Metab Toxicol 4:523-532, 2015), but in the context of this competition it is also interesting due to the significant ligand-induced conformational changes displayed by the protein. To deal with these conformational changes we employed multiple simulations of molecular dynamics (MD). Our MD-based protocols were top-ranked in estimating the free energy of binding of the ligands and FXR protein. Our approach was ranked second in the prediction of the binding poses where we also combined MD with molecular docking and artificial neural networks. Our approach showed mediocre results for high-throughput scoring of interactions.

  11. Optical design of a Michelson wide-field multiple-aperture telescope

    Cassaing, Frederic; Sorrente, Beatrice; Fleury, Bruno; Laubier, David

    2004-02-01

    Multiple-Aperture Optical Telescopes (MAOTs) are a promising solution for very high resolution imaging. In the Michelson configuration, the instrument is made of sub-telescopes distributed in the pupil and combined by a common telescope via folding periscopes. The phasing conditions of the sub-pupils lead to specific optical constraints in these subsystems. The amplitude of main contributors to the wavefront error (WFE) is given as a function of high level requirements (such as field or resolution) and free parameters, mainly the sub-telescope type, magnification and diameter. It is shown that for the periscopes, the field-to-resolution ratio is the main design driver and can lead to severe specifications. The effect of sub-telescopes aberrations on the global WFE can be minimized by reducing their diameter. An analytical tool for the MAOT design has been derived from this analysis, illustrated and validated in three different cases: LEO or GEO Earth observation and astronomy with extremely large telescopes. The last two cases show that a field larger than 10 000 resolution elements can be covered with a very simple MAOT based on Mersenne paraboloid-paraboloid sub-telescopes. Michelson MAOTs are thus a solution to be considered for high resolution wide-field imaging, from space or ground.

  12. Analysis of Multiple Choice Tests Designed by Faculty Members of Kermanshah University of Medical Sciences

    Reza Pourmirza Kalhori

    2013-12-01

    .14 and 23.99% (± 15.40, respectively. Comparison of the variances of qualitative and quantitative indices indicated significant differences between difficulty index, differ¬entiation index, reliability of the total test and percentage of taxonomy II among faculties (P_value<0.001, but this differences were not observed in taxonomies I and III. The results of Tukey multiple comparison test revealed a statistically significantly increase in the reliability of the medical faculty tests (P_value=0.001 and a statistically significantly decrease in the difficulty index of paramedi¬cal faculty tests compared to other faculties (P_value =0.041. Due to the lower differentiation index, the per¬centage of taxonomies II and III and the percentage of the questions with no structural problems compared to the standard criterion in some faculties, it is necessary to provide qualitative and quantitative feedback for the faculty members, as mentioned in previous studies (5 to promote their knowledge in designing the multiple-choice questions as an assessing tool of students.

  13. Multiple Mild Traumatic Brain Injuries Are Associated with Increased Rates of Health Symptoms and Gulf War Illness in a Cohort of 1990–1991 Gulf War Veterans

    Megan K. Yee

    2017-07-01

    Full Text Available Recent research demonstrated a relation between traumatic brain injury (TBI, health symptoms and diagnosis of Gulf War Illness (GWI in Gulf War Veterans, but no study has examined the impact of multiple mild TBIs (mTBIs. A total of 229 male Gulf War Veterans from the Ft Devens Cohort were categorized by a number of mTBIs reported. One-way ANOVA and chi-square test of independence were used to test for differences in total reported health symptoms and diagnosis of chronic multisymptom illness (CMI or Kansas GWI criteria, two of the most common case definitions of GWI. A total of 72 veterans reported no mTBIs (31.4%, 26 reported one mTBI (11.4%, 25 reported two mTBIs (10.9%, and 106 veterans reported sustaining three or more mTBIs (46.3%. Veterans reporting two or more mTBIs (p < 0.01 or three or more mTBIs (p < 0.001 endorsed significantly higher rates of health symptoms than Veterans reporting no mTBIs. Significantly higher rates of CMI (p = 0.035 and Kansas GWI criteria (p < 0.001 were seen in the three or more mTBI group. Results suggest two mTBIs increase risk of health symptoms, but three mTBIs may be the threshold needed to sustain chronic symptom reporting needed for a formal diagnosis. These findings highlight the importance of implementing policies and procedures monitoring head injuries in military personnel.

  14. Multiple pregnancies with complete mole and coexisting normal fetus in North and South America: A retrospective multicenter cohort and literature review.

    Lin, Lawrence H; Maestá, Izildinha; Braga, Antonio; Sun, Sue Y; Fushida, Koji; Francisco, Rossana P V; Elias, Kevin M; Horowitz, Neil; Goldstein, Donald P; Berkowitz, Ross S

    2017-04-01

    To determine the clinical characteristics of multiple gestation with complete mole and coexisting fetus (CHMCF) in North and South America. Retrospective non-concurrent cohorts compromised of CHMCF from New England Trophoblastic Disease Center (NETDC) (1966-2015) and four Brazilian Trophoblastic Disease Centers (BTDC) (1990-2015). From a total of 12,455 cases of gestational trophoblastic disease seen, 72 CHMCF were identified. Clinical characteristics were similar between BTDC (n=46) and NETDC (n=13) from 1990 to 2015, apart from a much higher frequency of potentially life-threatening conditions in Brazil (p=0.046). There were no significant changes in the clinical presentation or outcomes over the past 5 decades in NETDC (13 cases in 1966-1989 vs 13 cases in 1990-2015). Ten pregnancies were electively terminated and 35 cases resulted in viable live births (60% of 60 continued pregnancies). The overall rate of gestational trophoblastic neoplasia (GTN) was 46%; the cases which progressed to GTN presented with higher chorionic gonadotropin levels (p=0.026) and higher frequency of termination of pregnancy due to medical complications (p=0.006) when compared to those with spontaneous remission. The main regional difference in CHMCF presentation is related to a higher rate of potentially life-threatening conditions in South America. Sixty percent of the expectantly managed CHMCF delivered a viable infant, and the overall rate of GTN in this study was 46%. Elective termination of pregnancy did not influence the risk for GTN; however the need for termination due to complications and higher hCG levels were associated with development of GTN in CHMCF. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Association of the interferon signature metric with serological disease manifestations but not global activity scores in multiple cohorts of patients with SLE

    Kennedy, William P; Maciuca, Romeo; Wolslegel, Kristen; Tew, Wei; Abbas, Alexander R; Chaivorapol, Christina; Morimoto, Alyssa; McBride, Jacqueline M; Brunetta, Paul; Richardson, Bruce C; Davis, John C; Behrens, Timothy W; Townsend, Michael J

    2015-01-01

    Objectives The interferon (IFN) signature (IS) in patients with systemic lupus erythematosus (SLE) includes over 100 genes induced by type I IFN pathway activation. We developed a method to quantify the IS using three genes—the IS metric (ISM)—and characterised the clinical characteristics of patients with SLE with different ISM status from multiple clinical trials. Methods Blood microarray expression data from a training cohort of patients with SLE confirmed the presence of the IS and identified surrogate genes. We assayed these genes in a quantitative PCR (qPCR) assay, yielding an ISM from the IS. The association of ISM status with clinical disease characteristics was assessed in patients with extrarenal lupus and lupus nephritis from four clinical trials. Results Three genes, HERC5, EPSTI and CMPK2, correlated well with the IS (p>0.96), and composed the ISM qPCR assay. Using the 95th centile for healthy control data, patients with SLE from different studies were classified into two ISM subsets—ISM-Low and ISM-High—that are longitudinally stable over 36 weeks. Significant associations were identified between ISM-High status and higher titres of anti-dsDNA antibodies, presence of anti extractable nuclear antigen autoantibodies, elevated serum B cell activating factor of the tumour necrosis factor family (BAFF) levels, and hypocomplementaemia. However, measures of overall clinical disease activity were similar for ISM-High and ISM-Low groups. Conclusions The ISM is an IS biomarker that divides patients with SLE into two subpopulations—ISM-High and ISM-Low—with differing serological manifestations. The ISM does not distinguish between high and low disease activity, but may have utility in identifying patients more likely to respond to treatment(s) targeting IFN-α. Clinicaltrials.gov registration number NCT00962832. PMID:25861459

  16. A Historical Cohort Study on the Efficacy of Glucocorticoids and Riboflavin Among Patients with Late-onset Multiple Acyl-CoA Dehydrogenase Deficiency

    Xin-Yi Liu; Zhi-Qiang Wang; Dan-Ni Wang; Min-Ting Lin; Ning Wang

    2016-01-01

    Background:Late-onset multiple acyl-CoA dehydrogenase deficiency (MADD) is the most common type of lipid storage myopathies in China.Most patients with late-onset MADD are well responsive to riboflavin.Up to now,these patients are often treated with glucocorticoids as the first-line drug because they are misdiagnosed as polymyositis without muscle biopsy or gene analysis.Although glucocorticoids seem to improve the fatty acid metabolism of late-onset MADD,the objective evaluation of their rationalization on this disorder and comparison with riboflavin treatment are unknown.Methods:We performed a historical cohort study on the efficacy of the two drugs among 45 patients with late-onset MADD,who were divided into glucocorticoids group and riboflavin group.Detailed clinical information of baseline and 1-month follow-up were collected.Results:After 1-month treatment,a dramatic improvement of muscle strength was found in riboflavin group (P < 0.05).There was no significant difference in muscle enzymes between the two groups.Significantly,the number of patients with full recovery in glucocorticoids group was less than the number in riboflavin group (P < 0.05).On the other hand,almost half of the patients in riboflavin group still presented high-level muscle enzymes and weak muscle strength after 1-month riboflavin treatment,meaning that 1-month treatment duration maybe insufficient and patients should keep on riboflavin supplement for a longer time.Conclusions:Our results provide credible evidences that the overall efficacy of riboflavin is superior to glucocorticoids,and a longer duration of riboflavin treatment is necessary for patients with late-onset MADD.

  17. Ovarian response to 150 µg corifollitropin alfa in a GnRH-antagonist multiple-dose protocol: a prospective cohort study.

    Lerman, Tamara; Depenbusch, Marion; Schultze-Mosgau, Askan; von Otte, Soeren; Scheinhardt, Markus; Koenig, Inke; Kamischke, Axel; Macek, Milan; Schwennicke, Arne; Segerer, Sabine; Griesinger, Georg

    2017-05-01

    The incidence of low (18 oocytes) ovarian response to 150 µg corifollitropin alfa in relation to anti-Müllerian hormone (AMH) and other biomarkers was studied in a multi-centre (n = 5), multi-national, prospective, investigator-initiated, observational cohort study. Infertile women (n = 212), body weight >60 kg, underwent controlled ovarian stimulation in a gonadotrophin-releasing hormone-antagonist multiple-dose protocol. Demographic, sonographic and endocrine parameters were prospectively assessed on cycle day 2 or 3 of a spontaneous menstruation before the administration of 150 µg corifollitropin alfa. Serum AMH showed the best correlation with the number of oocytes obtained among all predictor variables. In receiver-operating characteristic analysis, AMH at a threshold of 0.91 ng/ml showed a sensitivity of 82.4%, specificity of 82.4%, positive predictive value 52.9%and negative predictive value 95.1% for predicting low response (area under the curve [AUC], 95% CI; P-value: 0.853, 0.769-0.936; <0.0001). For predicting high response, the optimal threshold for AMH was 2.58 ng/ml, relating to a sensitivity of 80.0%, specificity 82.1%, positive predictive value 42.5% and negative predictive value 96.1% (AUC, 95% CI; P-value: 0.871, 0.787-0.955; <0.0001). In conclusion, patients with serum AMH concentrations between approximately 0.9 and 2.6 ng/ml were unlikely to show extremes of response. Copyright © 2017. Published by Elsevier Ltd.

  18. Design, development and integration of a large scale multiple source X-ray computed tomography system

    Malcolm, Andrew A.; Liu, Tong; Ng, Ivan Kee Beng; Teng, Wei Yuen; Yap, Tsi Tung; Wan, Siew Ping; Kong, Chun Jeng

    2013-01-01

    X-ray Computed Tomography (CT) allows visualisation of the physical structures in the interior of an object without physically opening or cutting it. This technology supports a wide range of applications in the non-destructive testing, failure analysis or performance evaluation of industrial products and components. Of the numerous factors that influence the performance characteristics of an X-ray CT system the energy level in the X-ray spectrum to be used is one of the most significant. The ability of the X-ray beam to penetrate a given thickness of a specific material is directly related to the maximum available energy level in the beam. Higher energy levels allow penetration of thicker components made of more dense materials. In response to local industry demand and in support of on-going research activity in the area of 3D X-ray imaging for industrial inspection the Singapore Institute of Manufacturing Technology (SIMTech) engaged in the design, development and integration of large scale multiple source X-ray computed tomography system based on X-ray sources operating at higher energies than previously available in the Institute. The system consists of a large area direct digital X-ray detector (410 x 410 mm), a multiple-axis manipulator system, a 225 kV open tube microfocus X-ray source and a 450 kV closed tube millifocus X-ray source. The 225 kV X-ray source can be operated in either transmission or reflection mode. The body of the 6-axis manipulator system is fabricated from heavy-duty steel onto which high precision linear and rotary motors have been mounted in order to achieve high accuracy, stability and repeatability. A source-detector distance of up to 2.5 m can be achieved. The system is controlled by a proprietary X-ray CT operating system developed by SIMTech. The system currently can accommodate samples up to 0.5 x 0.5 x 0.5 m in size with weight up to 50 kg. These specifications will be increased to 1.0 x 1.0 x 1.0 m and 100 kg in future

  19. The effects of exercise and weight loss in overweight patients with hip osteoarthritis: design of a prospective cohort study

    van der Meer Klaas

    2009-02-01

    Full Text Available Abstract Background Hip osteoarthritis (OA is recognised as a substantial source of disability, with pain and loss of function as principal symptoms. An aging society and a growing number of overweight people, which is considered a risk factor for OA, contribute to the growing number of cases of hip OA. In knee OA patients, exercise as a single treatment is proven to be very effective towards counteracting pain and physical functionality, but the combination of weight loss and exercise is demonstrated to be even more effective. Exercise as a treatment for hip OA patients is also effective, however evidence is lacking for the combination of weight loss and exercise. Consequently, the aim of this study is to get a first impression of the potential effectiveness of exercise and weight loss in overweight patients suffering from hip OA. Methods/Design This is a prospective cohort study. Patients aged 25 or older, overweight (BMI > 25 or obese (BMI > 30, with clinical and radiographic evidence of OA of the hip and able to attend exercise sessions will be included. The intervention is an 8-month exercise and weight-loss lifestyle program. Main goal is to increase aerobic capacity, lose weight and stimulate a low-calorie and active lifestyle. Primary outcome is self-reported physical functioning. Secondary outcomes include pain, stiffness, health-related quality of life and habitual activity level. Weight loss in kilograms and percentage of fat-free mass will also be measured. Discussion The results of this study will give a first impression of potential effectiveness of exercise and weight loss as a combination program for patients with OA of the hip. Once this program is proven to be effective it may lead to postponing the moment of total hip replacement. Trial Registration number NTR1053

  20. Multiple Sclerosis After Infectious Mononucleosis

    Nielsen, Trine Rasmussen; Rostgaard, Klaus; Nielsen, Nete Munk

    2007-01-01

    BACKGROUND: Infectious mononucleosis caused by the Epstein-Barr virus has been associated with increased risk of multiple sclerosis. However, little is known about the characteristics of this association. OBJECTIVE: To assess the significance of sex, age at and time since infectious mononucleosis......, and attained age to the risk of developing multiple sclerosis after infectious mononucleosis. DESIGN: Cohort study using persons tested serologically for infectious mononucleosis at Statens Serum Institut, the Danish Civil Registration System, the Danish National Hospital Discharge Register, and the Danish...... Multiple Sclerosis Registry. SETTING: Statens Serum Institut. PATIENTS: A cohort of 25 234 Danish patients with mononucleosis was followed up for the occurrence of multiple sclerosis beginning on April 1, 1968, or January 1 of the year after the diagnosis of mononucleosis or after a negative Paul...

  1. Designing a solar powered Stirling heat engine based on multiple criteria: Maximized thermal efficiency and power

    Ahmadi, Mohammad Hossein; Sayyaadi, Hoseyn; Dehghani, Saeed; Hosseinzade, Hadi

    2013-01-01

    Highlights: • Thermodynamic model of a solar-dish Stirling engine was presented. • Thermal efficiency and output power of the engine were simultaneously maximized. • A final optimal solution was selected using several decision-making methods. • An optimal solution with least deviation from the ideal design was obtained. • Optimal solutions showed high sensitivity against variation of system parameters. - Abstract: A solar-powered high temperature differential Stirling engine was considered for optimization using multiple criteria. A thermal model was developed so that the output power and thermal efficiency of the solar Stirling system with finite rate of heat transfer, regenerative heat loss, conductive thermal bridging loss, finite regeneration process time and imperfect performance of the dish collector could be obtained. The output power and overall thermal efficiency were considered for simultaneous maximization. Multi-objective evolutionary algorithms (MOEAs) based on the NSGA-II algorithm were employed while the solar absorber temperature and the highest and lowest temperatures of the working fluid were considered the decision variables. The Pareto optimal frontier was obtained and a final optimal solution was also selected using various decision-making methods including the fuzzy Bellman–Zadeh, LINMAP and TOPSIS. It was found that multi-objective optimization could yield results with a relatively low deviation from the ideal solution in comparison to the conventional single objective approach. Furthermore, it was shown that, if the weight of thermal efficiency as one of the objective functions is considered to be greater than weight of the power objective, lower absorber temperature and low temperature ratio should be considered in the design of the Stirling engine

  2. Multiple-aperture optical design for micro-level cameras using 3D-printing method

    Peng, Wei-Jei; Hsu, Wei-Yao; Cheng, Yuan-Chieh; Lin, Wen-Lung; Yu, Zong-Ru; Chou, Hsiao-Yu; Chen, Fong-Zhi; Fu, Chien-Chung; Wu, Chong-Syuan; Huang, Chao-Tsung

    2018-02-01

    The design of the ultra miniaturized camera using 3D-printing technology directly printed on to the complementary metal-oxide semiconductor (CMOS) imaging sensor is presented in this paper. The 3D printed micro-optics is manufactured using the femtosecond two-photon direct laser writing, and the figure error which could achieve submicron accuracy is suitable for the optical system. Because the size of the micro-level camera is approximately several hundreds of micrometers, the resolution is reduced much and highly limited by the Nyquist frequency of the pixel pitch. For improving the reduced resolution, one single-lens can be replaced by multiple-aperture lenses with dissimilar field of view (FOV), and then stitching sub-images with different FOV can achieve a high resolution within the central region of the image. The reason is that the angular resolution of the lens with smaller FOV is higher than that with larger FOV, and then the angular resolution of the central area can be several times than that of the outer area after stitching. For the same image circle, the image quality of the central area of the multi-lens system is significantly superior to that of a single-lens. The foveated image using stitching FOV breaks the limitation of the resolution for the ultra miniaturized imaging system, and then it can be applied such as biomedical endoscopy, optical sensing, and machine vision, et al. In this study, the ultra miniaturized camera with multi-aperture optics is designed and simulated for the optimum optical performance.

  3. Imagery Rescripting for Body Dysmorphic Disorder: A Multiple-Baseline Single-Case Experimental Design.

    Willson, Rob; Veale, David; Freeston, Mark

    2016-03-01

    Individuals with body dysmorphic disorder (BDD) often experience negative distorted images of their appearance, and research suggests these may be linked to memories of adverse events such as bullying or teasing. This study evaluates imagery rescripting (ImR) as an intervention for BDD. In this article, we present a multiple-baseline single-case experimental design testing imagery rescripting as a brief, stand-alone intervention, with six individuals with BDD that related to aversive memories. The impact of the intervention was assessed by self-reported daily measures of symptom severity (preoccupation with appearance, appearance-related checking behaviors, appearance-related distress, and strength of belief that their main problem is their appearance) and standardized clinician ratings of BDD severity (Yale-Brown Obsessive Compulsive Scale modified for BDD). Four out of six of the participants responded positively to the intervention, with clinically meaningful improvement in symptomatology. Overall response was rapid; improvements began within the first week post-ImR intervention. From a small sample it is cautiously concluded that imagery rescripting may show promise as a module in cognitive-behavioral therapy for BDD, and is worthy of further investigation. Copyright © 2015. Published by Elsevier Ltd.

  4. Design of an image encryption scheme based on a multiple chaotic map

    Tong, Xiao-Jun

    2013-07-01

    In order to solve the problem that chaos is degenerated in limited computer precision and Cat map is the small key space, this paper presents a chaotic map based on topological conjugacy and the chaotic characteristics are proved by Devaney definition. In order to produce a large key space, a Cat map named block Cat map is also designed for permutation process based on multiple-dimensional chaotic maps. The image encryption algorithm is based on permutation-substitution, and each key is controlled by different chaotic maps. The entropy analysis, differential analysis, weak-keys analysis, statistical analysis, cipher random analysis, and cipher sensibility analysis depending on key and plaintext are introduced to test the security of the new image encryption scheme. Through the comparison to the proposed scheme with AES, DES and Logistic encryption methods, we come to the conclusion that the image encryption method solves the problem of low precision of one dimensional chaotic function and has higher speed and higher security.

  5. Design and implementation of a contactless multiple hand feature acquisition system

    Zhao, Qiushi; Bu, Wei; Wu, Xiangqian; Zhang, David

    2012-06-01

    In this work, an integrated contactless multiple hand feature acquisition system is designed. The system can capture palmprint, palm vein, and palm dorsal vein images simultaneously. Moreover, the images are captured in a contactless manner, that is, users need not to touch any part of the device when capturing. Palmprint is imaged under visible illumination while palm vein and palm dorsal vein are imaged under near infrared (NIR) illumination. The capturing is controlled by computer and the whole process is less than 1 second, which is sufficient for online biometric systems. Based on this device, this paper also implements a contactless hand-based multimodal biometric system. Palmprint, palm vein, palm dorsal vein, finger vein, and hand geometry features are extracted from the captured images. After similarity measure, the matching scores are fused using weighted sum fusion rule. Experimental results show that although the verification accuracy of each uni-modality is not as high as that of state-of-the-art, the fusion result is superior to most of the existing hand-based biometric systems. This result indicates that the proposed device is competent in the application of contactless multimodal hand-based biometrics.

  6. The Dynamics of Multiple Pair-Wise Collisions in a Chain for Designing Optimal Shock Amplifiers

    Bryan Rodgers

    2009-01-01

    Full Text Available The major focus of this work is to examine the dynamics of velocity amplification through pair-wise collisions between multiple masses in a chain, in order to develop useful machines. For instance low-cost machines based on this principle could be used for detailed, very-high acceleration shock-testing of MEMS devices. A theoretical basis for determining the number and mass of intermediate stages in such a velocity amplifier, based on simple rigid body mechanics, is proposed. The influence of mass ratios and the coefficient of restitution on the optimisation of the system is identified and investigated. In particular, two cases are examined: in the first, the velocity of the final mass in the chain (that would have the object under test mounted on it is maximised by defining the ratio of adjacent masses according to a power law relationship; in the second, the energy transfer efficiency of the system is maximised by choosing the mass ratios such that all masses except the final mass come to rest following impact. Comparisons are drawn between both cases and the results are used in proposing design guidelines for optimal shock amplifiers. It is shown that for most practical systems, a shock amplifier with mass ratios based on a power law relationship is optimal and can easily yield velocity amplifications of a factor 5–8 times. A prototype shock testing machine that was made using above principles is briefly introduced.

  7. Design and rationale of the HCC BRIDGE study in China: a longitudinal, multicenter cohort trial in hepatocellular carcinoma

    Qiao You-Lin

    2011-05-01

    Full Text Available Abstract Background More than 50% of the worldwide cases of hepatocellular carcinoma occur in China, and this malignancy currently represents the country's second leading cause of cancer death in cities and the leading cause in rural areas. Despite recent advances in the control and management of hepatocellular carcinoma within China, this disease remains a major health care issue. The global HCC BRIDGE study, designed to assess patterns of hepatocellular carcinoma therapy use and associated outcomes across real-world clinical practice, has recently been expanded as a national study in China, allowing a detailed analysis of hepatocellular carcinoma in this important country. Methods/Design The global HCC BRIDGE study is a multiregional longitudinal cohort trial including patients newly diagnosed with hepatocellular carcinoma between January 1, 2005, and June 30, 2011, who are receiving treatment for hepatocellular carcinoma via sites in the Asia-Pacific, European, and North American regions. The HCC BRIDGE China national study comprises the portion of the global HCC BRIDGE study conducted within mainland China. Patients will be followed from time of diagnosis of hepatocellular carcinoma (post-January 1, 2005 to time of death or December 31, 2011, whichever comes first. Data will be collected on demographic/clinical characteristics, relevant laboratory values, hepatocellular carcinoma/underlying liver disease treatment, tumor response, adverse events, hospitalizations, and overall survival. The primary study end point is overall survival; secondary end points are disease progression, treatment-limiting adverse events, and treatment failure. Results At the time of writing, 15 sites have selected for participation across all 7 traditional regions of China (North, North-East, East, South, South-West, North-West, and Central. The anticipated study population from the China national study is approximately 9000 patients. Discussion Findings from the

  8. Design of multiple representations e-learning resources based on a contextual approach for the basic physics course

    Bakri, F.; Muliyati, D.

    2018-05-01

    This research aims to design e-learning resources with multiple representations based on a contextual approach for the Basic Physics Course. The research uses the research and development methods accordance Dick & Carey strategy. The development carried out in the digital laboratory of Physics Education Department, Mathematics and Science Faculty, Universitas Negeri Jakarta. The result of the process of product development with Dick & Carey strategy, have produced e-learning design of the Basic Physics Course is presented in multiple representations in contextual learning syntax. The appropriate of representation used in the design of learning basic physics include: concept map, video, figures, data tables of experiment results, charts of data tables, the verbal explanations, mathematical equations, problem and solutions example, and exercise. Multiple representations are presented in the form of contextual learning by stages: relating, experiencing, applying, transferring, and cooperating.

  9. Control and design of multiple unmanned air vehicles for persistent surveillance

    Nigam, Nikhil

    Control of multiple autonomous aircraft for search and exploration, is a topic of current research interest for applications such as weather monitoring, geographical surveys, search and rescue, tactical reconnaissance, and extra-terrestrial exploration, and the need to distribute sensing is driven by considerations of efficiency, reliability, cost and scalability. Hence, this problem has been extensively studied in the fields of controls and artificial intelligence. The task of persistent surveillance is different from a coverage/exploration problem, in that all areas need to be continuously searched, minimizing the time between visitations to each region in the target space. This distinction does not allow a straightforward application of most exploration techniques to the problem, although ideas from these methods can still be used. The use of aerial vehicles is motivated by their ability to cover larger spaces and their relative insensitivity to terrain. However, the dynamics of Unmanned Air Vehicles (UAVs) adds complexity to the control problem. Most of the work in the literature decouples the vehicle dynamics and control policies, but their interaction is particularly interesting for a surveillance mission. Stochastic environments and UAV failures further enrich the problem by requiring the control policies to be robust, and this aspect is particularly important for hardware implementations. For a persistent mission, it becomes imperative to consider the range/endurance constraints of the vehicles. The coupling of the control policy with the endurance constraints of the vehicles is an aspect that has not been sufficiently explored. Design of UAVs for desirable mission performance is also an issue of considerable significance. The use of a single monolithic optimization for such a problem has practical limitations, and decomposition-based design is a potential alternative. In this research high-level control policies are devised, that are scalable, reliable

  10. Cohort description

    Dantoft, Thomas Meinertz; Ebstrup, Jeanette Frost; Linneberg, Allan

    2017-01-01

    -76 years from the general population examined from 2011 to 2015. The survey comprises screening questionnaires for five types of FSS, ie, fibromyalgia, whiplash-associated disorder, multiple chemical sensitivity, irritable bowel syndrome, and chronic fatigue syndrome, and for the unifying diagnostic......The Danish study of Functional Disorders (DanFunD) cohort was initiated to outline the epidemiology of functional somatic syndromes (FSS) and is the first larger coordinated epidemiological study focusing exclusively on FSS. FSS are prevalent in all medical settings and can be defined as syndromes...... category of bodily distress syndrome. Additional data included a telephone-based diagnostic interview assessment for FSS, questionnaires on physical and mental health, personality traits, lifestyle, use of health care services and social factors, and a physical examination with measures...

  11. The integration of occupational therapy into primary care: a multiple case study design

    2013-01-01

    Background For over two decades occupational therapists have been encouraged to enhance their roles within primary care and focus on health promotion and prevention activities. While there is a clear fit between occupational therapy and primary care, there have been few practice examples, despite a growing body of evidence to support the role. In 2010, the province of Ontario, Canada provided funding to include occupational therapists as members of Family Health Teams, an interprofessional model of primary care. The integration of occupational therapists into this model of primary care is one of the first large scale initiatives of its kind in North America. The objective of the study was to examine how occupational therapy services are being integrated into primary care teams and understand the structures supporting the integration. Methods A multiple case study design was used to provide an in-depth description of the integration of occupational therapy. Four Family Health Teams with occupational therapists as part of the team were identified. Data collection included in-depth interviews, document analyses, and questionnaires. Results Each Family Health Team had a unique organizational structure that contributed to the integration of occupational therapy. Communication, trust and understanding of occupational therapy were key elements in the integration of occupational therapy into Family Health Teams, and were supported by a number of strategies including co-location, electronic medical records and team meetings. An understanding of occupational therapy was critical for integration into the team and physicians were less likely to understand the occupational therapy role than other health providers. Conclusion With an increased emphasis on interprofessional primary care, new professions will be integrated into primary healthcare teams. The study found that explicit strategies and structures are required to facilitate the integration of a new professional group

  12. Influence of the Size of Cohorts in Adaptive Design for Nonlinear Mixed Effects Models: An Evaluation by Simulation for a Pharmacokinetic and Pharmacodynamic Model for a Biomarker in Oncology

    Lestini, Giulia; Dumont, Cyrielle; Mentré, France

    2015-01-01

    Purpose In this study we aimed to evaluate adaptive designs (ADs) by clinical trial simulation for a pharmacokinetic-pharmacodynamic model in oncology and to compare them with one-stage designs, i.e. when no adaptation is performed, using wrong prior parameters. Methods We evaluated two one-stage designs, ξ0 and ξ*, optimised for prior and true population parameters, Ψ0 and Ψ*, and several ADs (two-, three- and five-stage). All designs had 50 patients. For ADs, the first cohort design was ξ0. The next cohort design was optimised using prior information updated from the previous cohort. Optimal design was based on the determinant of the Fisher information matrix using PFIM. Design evaluation was performed by clinical trial simulations using data simulated from Ψ*. Results Estimation results of two-stage ADs and ξ* were close and much better than those obtained with ξ0. The balanced two-stage AD performed better than two-stage ADs with different cohort sizes. Three-and five-stage ADs were better than two-stage with small first cohort, but not better than the balanced two-stage design. Conclusions Two-stage ADs are useful when prior parameters are unreliable. In case of small first cohort, more adaptations are needed but these designs are complex to implement. PMID:26123680

  13. Learning Physics Teaching through Collaborative Design of Conceptual Multiple-Choice Questions

    Milner-Bolotin, Marina

    2015-01-01

    Increasing student engagement through Electronic Response Systems (clickers) has been widely researched. Its success largely depends on the quality of multiple-choice questions used by instructors. This paper describes a pilot project that focused on the implementation of online collaborative multiple-choice question repository, PeerWise, in a…

  14. Design and Delivery of Multiple Server-Side Computer Languages Course

    Wang, Shouhong; Wang, Hai

    2011-01-01

    Given the emergence of service-oriented architecture, IS students need to be knowledgeable of multiple server-side computer programming languages to be able to meet the needs of the job market. This paper outlines the pedagogy of an innovative course of multiple server-side computer languages for the undergraduate IS majors. The paper discusses…

  15. 76 FR 33762 - Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort

    2011-06-09

    ... Addition to the Special Exposure Cohort AGENCY: National Institute for Occupational Safety and Health... January 1, 1958 through December 31, 1959, for a number of work days aggregating at least 250 work days... Analysis and Support, National Institute for Occupational Safety and Health (NIOSH), 4676 Columbia Parkway...

  16. 76 FR 72928 - Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort

    2011-11-28

    ... Addition to the Special Exposure Cohort AGENCY: National Institute for Occupational Safety and Health... January 31, 1958, for a number of work days aggregating at least 250 work days, occurring either solely... Analysis and Support, National Institute for Occupational Safety and Health (NIOSH), 4676 Columbia Parkway...

  17. 75 FR 3470 - Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort

    2010-01-21

    ... Addition to the Special Exposure Cohort AGENCY: National Institute for Occupational Safety and Health... work days aggregating at least 250 work days, occurring either solely under this employment or in... for Occupational Safety and Health (NIOSH), 4676 Columbia Parkway, MS C-46, Cincinnati, OH 45226...

  18. 76 FR 33763 - Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort

    2011-06-09

    ... Addition to the Special Exposure Cohort AGENCY: National Institute for Occupational Safety and Health..., 1962, for a number of work days aggregating at least 250 work days, occurring either solely under this... Support, National Institute for Occupational Safety and Health (NIOSH), 4676 Columbia Parkway, MS C-46...

  19. 76 FR 34074 - Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort

    2011-06-10

    ... Addition to the Special Exposure Cohort AGENCY: National Institute for Occupational Safety and Health... January 31, 1975, for a number of work days aggregating at least 250 work days, occurring either solely... for Occupational Safety and Health (NIOSH), 4676 Columbia Parkway, MS C-46, [[Page 34075

  20. 77 FR 38834 - Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort

    2012-06-29

    ... Addition to the Special Exposure Cohort AGENCY: National Institute for Occupational Safety and Health... number of work days aggregating at least 250 work days, occurring either solely under this employment or... Occupational Safety and Health (NIOSH), 4676 Columbia Parkway, MS C-46, Cincinnati, OH 45226, Telephone 877-222...

  1. 77 FR 46438 - Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort

    2012-08-03

    ... Addition to the Special Exposure Cohort AGENCY: National Institute for Occupational Safety and Health... Fernald, Ohio, from January 1, 1968 through December 31, 1978, for a number of work days aggregating at..., Division of Compensation Analysis and Support, National Institute for Occupational Safety and Health (NIOSH...

  2. 75 FR 3469 - Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort

    2010-01-21

    ... Addition to the Special Exposure Cohort AGENCY: National Institute for Occupational Safety and Health... aggregating at least 250 work days or in combination with work days within the parameters established for one... Analysis and Support, National Institute for Occupational Safety and Health (NIOSH), 4676 Columbia Parkway...

  3. 76 FR 72929 - Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort

    2011-11-28

    ... Addition to the Special Exposure Cohort AGENCY: National Institute for Occupational Safety and Health... August 13, 1942 through December 31, 1970, for a number of work days aggregating at least 250 work days..., Division of Compensation Analysis and Support, National Institute for Occupational Safety and Health (NIOSH...

  4. 77 FR 38835 - Final Effect of Designation of a Class of Employees for Addition to the Special Exposure Cohort

    2012-06-29

    ... Addition to the Special Exposure Cohort AGENCY: National Institute for Occupational Safety and Health..., for a number of work days aggregating at least 250 work days, occurring either solely under this... Institute for Occupational Safety and Health (NIOSH), 4676 Columbia Parkway, MS C-46, Cincinnati, OH 45226...

  5. Design and implementation of the reconstruction software for the photon multiplicity detector in object oriented programming framework

    Chattopadhayay, Subhasis; Ghosh, Premomoy; Gupta, R.; Mishra, D.; Phatak, S.C.; Sood, G.

    2002-01-01

    High granularity photon multiplicity detector (PMD) is scheduled to take data in Relativistic Heavy Ion Collision(RHIC) this year. A detailed scheme has been designed and implemented in object oriented programming framework using C++ for the monitoring and reconstruction job of PMD data

  6. Towards Integration of CAx Systems and a Multiple-View Product Modeller in Mechanical Design

    H. Song

    2005-01-01

    Full Text Available This paper deals with the development of an integration framework and its implementation for the connexion of CAx systems and multiple-view product modelling. The integration framework is presented regarding its conceptual level and the implementation level is described currently with the connexion of a functional modeller, a multiple-view product modeller, an optimisation module and a CAD system. The integration between the multiple-view product modeller and CATIA V5 based on the STEP standard is described in detail. Finally, the presented works are discussed and future research developments are suggested. 

  7. Energy efficient design for MIMO two-way AF multiple relay networks

    Alsharoa, Ahmad M.; Ghazzai, Hakim; Alouini, Mohamed-Slim

    2014-01-01

    This paper studies the energy efficient transmission and the power allocation problem for multiple two-way relay networks equipped with multi-input multi-output antennas where each relay employs an amplify-and-forward strategy. The goal

  8. Optimal Reinsurance Design for Pareto Optimum: From the Perspective of Multiple Reinsurers

    Xing Rong

    2016-01-01

    Full Text Available This paper investigates optimal reinsurance strategies for an insurer which cedes the insured risk to multiple reinsurers. Assume that the insurer and every reinsurer apply the coherent risk measures. Then, we find out the necessary and sufficient conditions for the reinsurance market to achieve Pareto optimum; that is, every ceded-loss function and the retention function are in the form of “multiple layers reinsurance.”

  9. The Nightingale study: rationale, study design and baseline characteristics of a prospective cohort study on shift work and breast cancer risk among nurses

    2014-01-01

    Background Evidence for the carcinogenicity of shift work in humans is limited because of significant heterogeneity of the results, thus more in-depth research in needed. The Nightingale Study is a nationwide prospective cohort study on occupational exposures and risks of chronic diseases among female nurses and focuses on the potential association between shift work and risk of breast cancer. The study design, methods, and baseline characteristics of the cohort are described. Methods/Design The source population for the cohort comprised 18 to 65 year old women who were registered as having completed training to be a nurse in the nationwide register for healthcare professionals in the Netherlands. Eligible women were invited to complete a web-based questionnaire including full job history, a detailed section on all domains of shift work (shift system, cumulative exposure, and shift intensity) and potential confounding factors, and an informed consent form for linkage with national (disease) registries. Women were also asked to donate toenail clippings as a source of DNA for genetic analyses. Between October 6, 2011 and February 1, 2012, 31% of the 192,931 women who were invited to participate completed the questionnaire, yielding a sample size of 59,947 cohort members. The mean age of the participants was 46.9 year (standard deviation 11.0 years). Toenail clippings were provided by 23,439 participants (39%). Discussion Results from the Nightingale Study will contribute to the scientific evidence of potential shift work-related health risks among nurses and will help develop preventive measures and policy aimed at reducing these risks. PMID:24475944

  10. The International Childhood Cardiovascular Cohort (i3C) consortium outcomes study of childhood cardiovascular risk factors and adult cardiovascular morbidity and mortality: Design and recruitment.

    Sinaiko, Alan R; Jacobs, David R; Woo, Jessica G; Bazzano, Lydia; Burns, Trudy; Hu, Tian; Juonala, Markus; Prineas, Ronald; Raitakari, Olli; Steinberger, Julia; Urbina, Elaine; Venn, Alison; Jaquish, Cashell; Dwyer, Terry

    2018-04-22

    Although it is widely thought that childhood levels of cardiovascular (CV) risk factors are related to adult CV disease, longitudinal data directly linking the two are lacking. This paper describes the design and organization of the International Childhood Cardiovascular Cohort Consortium Outcomes Study (i3C Outcomes), the first longitudinal cohort study designed to locate adults with detailed, repeated, childhood biological, physical, and socioeconomic measurements and a harmonized database. I3C Outcomes uses a Heart Health Survey (HHS) to obtain information on adult CV endpoints, using mail, email, telephone, and clinic visits in the United States (U.S.) and Australia and a national health database in Finland. Microsoft Access, REsearch Data Capture (REDCap) (U.S.), LimeSurvey (Australia), and Medidata™ Rave data systems are used to collect, transfer and organize data. Self-reported CV events are adjudicated via hospital and doctor-released medical records. After the first two study years, participants (N = 10,968) were more likely to be female (56% vs. 48%), non-Hispanic white (90% vs. 80%), and older (10.4 ± 3.8 years vs. 9.4 ± 3.3 years) at their initial childhood study visit than the currently non-recruited cohort members. Over 48% of cohort members seen during both adulthood and childhood have been found and recruited, to date, vs. 5% of those not seen since childhood. Self-reported prevalences were 0.7% Type 1 Diabetes, 7.5% Type 2 Diabetes, 33% hypertension, and 12.8% CV event. 32% of CV events were judged to be true. I3C Outcomes is uniquely able to establish evidence-based guidelines for child health care and to clarify relations to adult CV disease. Copyright © 2018 Elsevier Inc. All rights reserved.

  11. Cohort Coefficients

    Kristensen, Gustav

    2013-01-01

    Cohorts are the aggregate of individuals who experience the same event within the same time interval. Cohorts can be based on people born in a given year, for example in 1940 or within a span of years, e.g. born in 1940-1944. The year of birth is here the defining event for cohorts. The health di...... differs between cohorts. This article focuses on the protective and detrimental cohort effect in relation to the risk of death from apoplexy. A dummy variable method is recommended to describe the changing cohort effect over a century....

  12. Design and conduct of an internet-based preconception cohort study in North America: Pregnancy Study Online (PRESTO)

    Wise, Lauren A; Rothman, Kenneth J.; Mikkelsen, Ellen M.; Stanford, Joseph B.; Wesselink, Amelia K.; McKinnon, Craig; Gruschow, Siobhan M.; Horgan, Casie E.; Wiley, Aleta S.; Hahn, Kristen A.; Sørensen, Henrik Toft; Hatch, Elizabeth E.

    2015-01-01

    Background We launched the Boston University Pregnancy Study Online (PRESTO) to assess the feasibility of carrying out an internet-based preconception cohort study in the U.S. and Canada. Methods We recruited female participants age 21–45 and their male partners through internet advertisements, word of mouth, and flyers. Female participants were randomized with 50% probability to receive a subscription to FertilityFriend.com (FF), a web-based program that collects real-time data on menstrual characteristics. We compared recruitment methods within PRESTO, assessed the cost-efficiency of PRESTO relative to its Danish counterpart (Snart-Gravid), and validated retrospectively-reported date of last menstrual period (LMP) against FF data. Results After 99 weeks of recruitment (2013–2015), 2,421 women enrolled; 1,384 (57%) invited their male partners to participate, of whom 693 (50%) enrolled. Baseline characteristics were balanced across randomization groups. Cohort retention was similar among those randomized vs. not randomized to FF (84% vs. 81%). At study enrollment, 56%, 22%, and 22% couples had been trying to conceive for cost per subject enrolled was $146 (2013 $US), which was similar to our companion Danish study and half that of a traditional cohort study. Among FF users who conceived, >97% reported their LMP on the PRESTO questionnaire within 1 day of the LMP recorded via FF. Conclusions Use of the internet as a method of recruitment and follow-up in a North American preconception cohort study was feasible and cost-effective. PMID:26111445

  13. Shaping the ROTC Cohort

    Rittenhouse, Wiley P; Kwinn, Jr, Michael J

    2005-01-01

    ...) - to meet the future needs of the Army for commissioned officers. It is designed to shape each cohort to meet the Army's specific needs in terms of component, academic disciplines, race/ethnic makeup goals, gender, and targeted missions...

  14. The design of an ultra-thin and multiple channels optical receiving antenna system with freeform lenses

    Zhang, Lingyun; Cheng, Dewen; Hu, Yuan; Song, Weitao; Wang, Yongtian

    2014-11-01

    Visible Light Communications (VLC) has become an emerging area of research since it can provide higher data transmission speed and wider bandwidth. The white LEDs are very important components of the VLC system, because it has the advantages of higher brightness, lower power consumption, and a longer lifetime. More importantly, their intensity and color are modulatable. Besides the light source, the optical antenna system also plays a very important role in the VLC system since it determines the optical gain, effective working area and transmission rate of the VLC system. In this paper, we propose to design an ultra-thin and multiple channels optical antenna system by tiling multiple off-axis lenses, each of which consists of two reflective and two refractive freeform surfaces. The tiling of multiple systems and detectors but with different band filters makes it possible to design a wavelength division multiplexing VLC system to highly improve the system capacity. The field of view of the designed antenna system is 30°, the entrance pupil diameter is 1.5mm, and the thickness of the system is under 4mm. The design methods are presented and the results are discussed in the last section of this paper. Besides the optical gain is analyzed and calculated. The antenna system can be tiled up to four channels but without the increase of thickness.

  15. A Sequential Circuit-Based IP Watermarking Algorithm for Multiple Scan Chains in Design-for-Test

    C. Wu

    2011-06-01

    Full Text Available In Very Large Scale Integrated Circuits (VLSI design, the existing Design-for-Test(DFT based watermarking techniques usually insert watermark through reordering scan cells, which causes large resource overhead, low security and coverage rate of watermark detection. A novel scheme was proposed to watermark multiple scan chains in DFT for solving the problems. The proposed scheme adopts DFT scan test model of VLSI design, and uses a Linear Feedback Shift Register (LFSR for pseudo random test vector generation. All of the test vectors are shifted in scan input for the construction of multiple scan chains with minimum correlation. Specific registers in multiple scan chains will be changed by the watermark circuit for watermarking the design. The watermark can be effectively detected without interference with normal function of the circuit, even after the chip is packaged. The experimental results on several ISCAS benchmarks show that the proposed scheme has lower resource overhead, probability of coincidence and higher coverage rate of watermark detection by comparing with the existing methods.

  16. Design of pulse waveform for waveform division multiple access UWB wireless communication system.

    Yin, Zhendong; Wang, Zhirui; Liu, Xiaohui; Wu, Zhilu

    2014-01-01

    A new multiple access scheme, Waveform Division Multiple Access (WDMA) based on the orthogonal wavelet function, is presented. After studying the correlation properties of different categories of single wavelet functions, the one with the best correlation property will be chosen as the foundation for combined waveform. In the communication system, each user is assigned to different combined orthogonal waveform. Demonstrated by simulation, combined waveform is more suitable than single wavelet function to be a communication medium in WDMA system. Due to the excellent orthogonality, the bit error rate (BER) of multiuser with combined waveforms is so close to that of single user in a synchronous system. That is to say, the multiple access interference (MAI) is almost eliminated. Furthermore, even in an asynchronous system without multiuser detection after matched filters, the result is still pretty ideal and satisfactory by using the third combination mode that will be mentioned in the study.

  17. First Simulations of Designing Stratospheric Sulfate Aerosol Geoengineering to Meet Multiple Simultaneous Climate Objectives: DESIGNING STRATOSPHERIC GEOENGINEERING

    Kravitz, Ben [Atmospheric Sciences and Global Change Division, Pacific Northwest National Laboratory, Richland WA USA; MacMartin, Douglas G. [Mechanical and Aerospace Engineering, Cornell University, Ithaca NY USA; Department of Computing and Mathematical Sciences, California Institute of Technology, Pasadena CA USA; Mills, Michael J. [Atmospheric Chemistry, Observations, and Modeling Laboratory, National Center for Atmospheric Research, Boulder CO USA; Richter, Jadwiga H. [Climate and Global Dynamics Laboratory, National Center for Atmospheric Research, Boulder CO USA; Tilmes, Simone [Atmospheric Chemistry, Observations, and Modeling Laboratory, National Center for Atmospheric Research, Boulder CO USA; Climate and Global Dynamics Laboratory, National Center for Atmospheric Research, Boulder CO USA; Lamarque, Jean-Francois [Atmospheric Chemistry, Observations, and Modeling Laboratory, National Center for Atmospheric Research, Boulder CO USA; Tribbia, Joseph J. [Climate and Global Dynamics Laboratory, National Center for Atmospheric Research, Boulder CO USA; Vitt, Francis [Atmospheric Chemistry, Observations, and Modeling Laboratory, National Center for Atmospheric Research, Boulder CO USA

    2017-12-07

    We describe the first simulations of stratospheric sulfate aerosol geoengineering using multiple injection locations to meet multiple simultaneous surface temperature objectives. Simulations were performed using CESM1(WACCM), a coupled atmosphere-ocean general circulation model with fully interactive stratospheric chemistry, dynamics (including an internally generated quasi-biennial oscillation), and a sophisticated treatment of sulfate aerosol formation, microphysical growth, and deposition. The objectives are defined as maintaining three temperature features at their 2020 levels against a background of the RCP8.5 scenario over the period 2020-2099. These objectives are met using a feedback mechanism in which the rate of sulfur dioxide injection at each of the four locations is adjusted independently every year of simulation. Even in the presence of uncertainties, nonlinearities, and variability, the objectives are met, predominantly by SO2 injection at 30°N and 30°S. By the last year of simulation, the feedback algorithm calls for a total injection rate of 51 Tg SO2 per year. The injections are not in the tropics, which results in a greater degree of linearity of the surface climate response with injection amount than has been found in many previous studies using injection at the equator. Because the objectives are defined in terms of annual mean temperature, the required geeongineering results in "overcooling" during summer and "undercooling" during winter. The hydrological cycle is also suppressed as compared to the reference values corresponding to the year 2020. The demonstration we describe in this study is an important step toward understanding what geoengineering can do and what it cannot do.

  18. Design and Analysis of a Forging Die for Manufacturing of Multiple Connecting Rods

    Megharaj, C. E.; Nagaraj, P. M.; Jeelan Pasha, K.

    2016-09-01

    This paper demonstrates to utilize the hammer capacity by modifying the die design such that forging hammer can manufacture more than one connecting rod in a given forging cycle time. To modify the die design study is carried out to understand the parameters that are required for forging die design. By considering these parameters, forging die is designed using design modelling tool solid edge. This new design now can produce two connecting rods in same capacity hammer. The new design is required to validate by verifying complete filing of metal in die cavities without any defects in it. To verify this, analysis tool DEFORM 3D is used in this project. Before start of validation process it is require to convert 3D generated models in to. STL file format to import the models into the analysis tool DEFORM 3D. After importing these designs they are analysed for material flow into the cavities and energy required to produce two connecting rods in new forging die design. It is found that the forging die design is proper without any defects and also energy graph shows that the forging energy required to produce two connecting rods is within the limit of that hammer capacity. Implementation of this project increases the production of connecting rods by 200% in less than previous cycle time.

  19. Preliminary trajectory design for a solar polar observatory using SEP and multiple gravity assists

    Corpaccioli, L.; Noomen, R.; De Smet, S.; Parker, J.S.; Herman, J.F.C.

    2015-01-01

    Satellite solar observatories have always been of central importance to heliophysics; while there have been numerous such missions, the solar poles have been extremely under-observed. This paper proposes to use low-thrust as well as multiple gravity assists to reach the enormous energies required

  20. Design of Multiple Trellis-Coded Multi-h CPM Based on Super Trellis

    X. Liu. A. Liu

    2012-12-01

    Full Text Available It has been shown that the multiple trellis code can perform better than the conventional trellis code over AWGN channels, at the cost of additional computations per trellis branch. Multiple trellis coded multi-h CPM schemes have been shown in the literature to have attractive power-bandwidth performance at the expense of increased receiver complexity. In this method, the multi-h format is made to be associated with the specific pattern and repeated rather than cyclically changed in time for successive symbol intervals, resulting in a longer effective length of the error event with better performance. It is well known that the rate (n-1/n multiple trellis codes combined with 2^n-level CPM have good power-bandwidth performance. In this paper, a scheme combining rate 1/2 and 2/3 multiple trellis codes with 4- and 8-level multi-h CPM is shown to have better power-bandwidth performance over the upper bound than the scheme with single-h.

  1. Qualification of new design of flexible pipe against singing: testing at multiple scales

    Golliard, J.; Lunde, K.; Vijlbrief, O.

    2016-01-01

    Flexible pipes for production of oil and gas typically present a corrugated inner surface. This has been identified as the cause of "singing risers": Flow-Induced Pulsations due to the interaction of sound waves with the shear layers at the small cavities present at each of the multiple

  2. The Nightingale study: rationale, study design and baseline characteristics of a prospective cohort study on shift work and breast cancer risk among nurses.

    Pijpe, Anouk; Slottje, Pauline; van Pelt, Cres; Stehmann, Floor; Kromhout, Hans; van Leeuwen, Flora E; Vermeulen, Roel C H; Rookus, Matti A

    2014-01-29

    Evidence for the carcinogenicity of shift work in humans is limited because of significant heterogeneity of the results, thus more in-depth research in needed. The Nightingale Study is a nationwide prospective cohort study on occupational exposures and risks of chronic diseases among female nurses and focuses on the potential association between shift work and risk of breast cancer. The study design, methods, and baseline characteristics of the cohort are described. The source population for the cohort comprised 18 to 65 year old women who were registered as having completed training to be a nurse in the nationwide register for healthcare professionals in the Netherlands. Eligible women were invited to complete a web-based questionnaire including full job history, a detailed section on all domains of shift work (shift system, cumulative exposure, and shift intensity) and potential confounding factors, and an informed consent form for linkage with national (disease) registries. Women were also asked to donate toenail clippings as a source of DNA for genetic analyses. Between October 6, 2011 and February 1, 2012, 31% of the 192,931 women who were invited to participate completed the questionnaire, yielding a sample size of 59,947 cohort members. The mean age of the participants was 46.9 year (standard deviation 11.0 years). Toenail clippings were provided by 23,439 participants (39%). Results from the Nightingale Study will contribute to the scientific evidence of potential shift work-related health risks among nurses and will help develop preventive measures and policy aimed at reducing these risks.

  3. Rationale, design, and profile of the Three-Prefecture Cohort in Japan: A 15-year follow-up

    Junya Sado

    2017-04-01

    Full Text Available Background: We reutilized the existing Three-Prefecture Cohort to evaluate the relationship between lifestyle factors and the incidence or mortality from non-communicable diseases. Methods: This study was a prospective population-based observation conducted from the 1980s to 2000 in three prefectures (Miyagi, Aichi, and Osaka in Japan. The study subjects were residents aged ≥40 years who received a questionnaire. The follow-up period was 15 years from the baseline survey in each study area. A self-administered questionnaire, which included items on participants' demographic factors and lifestyle characteristics, was administered. Vital status and date of death were collected from residence certificates by the local government, and cause of death was identified using vital statistics. Cancer incidence and the date of diagnosis were collected from local cancer registry data. Results: A total of 46,421 men and 54,189 women were eligible for our analysis. The person-years of follow-up for cancer incidence were 464,664 and 567,271 for men and women, respectively, and those for death were 527,940 and 648,601 for men and women, respectively. There were 8479 cancer incidences (5106 men and 3373 women and 20,240 total deaths (11,156 men and 9084 women. The stomach was the most common cancer incidence site for both men (25.6% and women (18.6%. The leading cause of death was cancer among men (35.0% and cardiovascular disease among women (41.0%. Conclusions: The Three-Prefecture Cohort Study enabled us to reveal the association of multiphasic lifestyle factors with cancer incidence and mortality. The study will also allow us to conduct a pooled analysis in combination with other large-scale cohorts.

  4. The Harbin Cohort Study on Diet, Nutrition and Chronic Non-communicable Diseases: study design and baseline characteristics.

    Lixin Na

    Full Text Available Diet and nutrition have been reported to be associated with many common chronic diseases and blood-based assessment would be vital to investigate the association and mechanism, however, blood-based prospective studies are limited. The Harbin Cohort Study on Diet, Nutrition and Chronic Non-communicable Diseases was set up in 2010. From 2010 to 2012, 9,734 participants completed the baseline survey, including demographic characteristics, dietary intake, lifestyles and physical condition, and anthropometrics. A re-survey on 490 randomly selected participants was done by using the same methods which were employed in the baseline survey. For all participants, the mean age was 50 years and 36% of them were men. Approximately 99.4 % of cohort members donated blood samples. The mean total energy intake was 2671.7 kcal/day in men and 2245.9 kcal/day in women, the mean body mass index was 25.7 kg/m2 in men and 24.6 kg/m2 in women, with 18.4% being obese (≥ 28 kg/m2, 12.7% being diabetic, and 29.5% being hypertensive. A good agreement was obtained for the physical measurements between the baseline survey and re-survey. The resources from the cohort and its fasting and postprandial blood samples collected both at baseline and in each follow-up will be valuable and powerful in investigating relationship between diet, nutrition and chronic diseases and discovering novel blood biomarkers and the metabolism of these biomarkers related to chronic diseases.

  5. How is brand experience designed in practice? : Results of a multiple-case study

    Bakker-Wu, S.; Calabretta, G.; Hultink, H.J.; Bohemia, E.; de Bont, C.; Svengren Holm, L.

    2017-01-01

    Brand experience is an important concept in marketing because it can affect brand loyalty, brand recall, and brand attitude. Brand experience design is therefore an important practice for companies to create favourable and meaningful experiences, through the design of various touchpoints that are in

  6. Design and selection of load control strategies using a multiple objective model and evolutionary algorithms

    Gomes, Alvaro; Antunes, Carlos Henggeler; Martins, Antonio Gomes

    2005-01-01

    This paper aims at presenting a multiple objective model to evaluate the attractiveness of the use of demand resources (through load management control actions) by different stakeholders and in diverse structure scenarios in electricity systems. For the sake of model flexibility, the multiple (and conflicting) objective functions of technical, economical and quality of service nature are able to capture distinct market scenarios and operating entities that may be interested in promoting load management activities. The computation of compromise solutions is made by resorting to evolutionary algorithms, which are well suited to tackle multiobjective problems of combinatorial nature herein involving the identification and selection of control actions to be applied to groups of loads. (Author)

  7. Design and performance of beam test electronics for the PHENIX multiplicity vertex detector

    Britton, C.L. Jr.; Bryan, W.L.; Emery, M.S.

    1996-01-01

    The system architecture and test results of the custom circuits and beam test system for the Multiplicity-Vertex Detector (MVD) for the PHENIX detector collaboration at the Relativistic Heavy Ion Collider (RHIC) are presented in this paper. The final detector per-channel signal processing chain will consist of a preamplifier-gain stage, a current-mode summed multiplicity discriminator, a 64-deep analog memory (simultaneous read-write), a post-memory analog correlator, and a 10-bit 5 μs ADC. The Heap Manager provides all timing control, data buffering, and data formatting for a single 256-channel multi-chip module (MCM). Each chip set is partitioned into 32-channel sets. Beam test (16-cell deep memory) performance for the various blocks will be presented as well as the ionizing radiation damage performance of the 1.2 μ n-well CMOS process used for preamplifier fabrication

  8. Design and use of multiple blade slurry sawing in a production atmosphere

    Lynah, F. P., Jr.; Ross, J. B.

    1982-01-01

    The technique and uses of the multiple blade slurry (MBS) saw are considered. Multiple bands of steel are arranged in a frame and the frame is reciprocated with the steel bands to a workpiece, while simultaneously applying abrasive at the point of contact. The blades wear slots in the workpiece and progress through the piece resulting in several parts of wafers. The transition to MBA from diamond slicing is justified by savings resulting from minimized kerf losses, minimized subsurface damage, and improved surface quality off the saw. This allows wafering much closer to finished thickness specifications. The current state of the art MBS technology must be significantly improved if the low cost solar array (LSA) goals are to be attained. It is concluded that although MBS will never be the answer to every wafering requirement, the economical production of wafers to LSA project specifications will be achieved.

  9. Experimental design and multiple response optimization. Using the desirability function in analytical methods development.

    Candioti, Luciana Vera; De Zan, María M; Cámara, María S; Goicoechea, Héctor C

    2014-06-01

    A review about the application of response surface methodology (RSM) when several responses have to be simultaneously optimized in the field of analytical methods development is presented. Several critical issues like response transformation, multiple response optimization and modeling with least squares and artificial neural networks are discussed. Most recent analytical applications are presented in the context of analytLaboratorio de Control de Calidad de Medicamentos (LCCM), Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, C.C. 242, S3000ZAA Santa Fe, ArgentinaLaboratorio de Control de Calidad de Medicamentos (LCCM), Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, C.C. 242, S3000ZAA Santa Fe, Argentinaical methods development, especially in multiple response optimization procedures using the desirability function. Copyright © 2014 Elsevier B.V. All rights reserved.

  10. Association of Multiple Melanocytic Naevi with Education, Sex and Skin Type. A Northern Finland Birth Cohort 1966 Study with 46 Years Follow-up.

    Sinikumpu, Suvi-Päivikki; Huilaja, Laura; Jokelainen, Jari; Auvinen, Juha; Timonen, Markku; Tasanen, Kaisa

    2017-02-08

    Having multiple melanocytic naevi (sex, socioeconomic status (education) in childhood and adulthood, skin type and sunbathing habits. The prevalence of multiple melanocytic naevi was 11.6% (223/1,930). Higher education (odds ratio (OR) 2.11, 95% confidence interval (95% CI) 1.51-2.96), male sex (OR 1.48, 95% CI 1.07-2.06), sun-sensitive skin type (OR 2.09, 95% CI 1.34-3.27) and regular use of sunscreen (OR 2.03, 95% CI 1.23-3.37) were associated with increased risk of multiple naevi. Inflammatory skin diseases decreased (OR 0.49, 95 CI% 0.33-0.72) the risk of multiple naevi. In conclusion, several risk factors were found for multiple naevi among adults living in high latitudes, in Northern Finland.

  11. A robust procedure for comparing multiple means under heteroscedasticity in unbalanced designs.

    Esther Herberich

    2010-03-01

    Full Text Available Investigating differences between means of more than two groups or experimental conditions is a routine research question addressed in biology. In order to assess differences statistically, multiple comparison procedures are applied. The most prominent procedures of this type, the Dunnett and Tukey-Kramer test, control the probability of reporting at least one false positive result when the data are normally distributed and when the sample sizes and variances do not differ between groups. All three assumptions are non-realistic in biological research and any violation leads to an increased number of reported false positive results. Based on a general statistical framework for simultaneous inference and robust covariance estimators we propose a new statistical multiple comparison procedure for assessing multiple means. In contrast to the Dunnett or Tukey-Kramer tests, no assumptions regarding the distribution, sample sizes or variance homogeneity are necessary. The performance of the new procedure is assessed by means of its familywise error rate and power under different distributions. The practical merits are demonstrated by a reanalysis of fatty acid phenotypes of the bacterium Bacillus simplex from the "Evolution Canyons" I and II in Israel. The simulation results show that even under severely varying variances, the procedure controls the number of false positive findings very well. Thus, the here presented procedure works well under biologically realistic scenarios of unbalanced group sizes, non-normality and heteroscedasticity.

  12. FireProt: Energy- and Evolution-Based Computational Design of Thermostable Multiple-Point Mutants.

    Bednar, David; Beerens, Koen; Sebestova, Eva; Bendl, Jaroslav; Khare, Sagar; Chaloupkova, Radka; Prokop, Zbynek; Brezovsky, Jan; Baker, David; Damborsky, Jiri

    2015-11-01

    There is great interest in increasing proteins' stability to enhance their utility as biocatalysts, therapeutics, diagnostics and nanomaterials. Directed evolution is a powerful, but experimentally strenuous approach. Computational methods offer attractive alternatives. However, due to the limited reliability of predictions and potentially antagonistic effects of substitutions, only single-point mutations are usually predicted in silico, experimentally verified and then recombined in multiple-point mutants. Thus, substantial screening is still required. Here we present FireProt, a robust computational strategy for predicting highly stable multiple-point mutants that combines energy- and evolution-based approaches with smart filtering to identify additive stabilizing mutations. FireProt's reliability and applicability was demonstrated by validating its predictions against 656 mutations from the ProTherm database. We demonstrate that thermostability of the model enzymes haloalkane dehalogenase DhaA and γ-hexachlorocyclohexane dehydrochlorinase LinA can be substantially increased (ΔTm = 24°C and 21°C) by constructing and characterizing only a handful of multiple-point mutants. FireProt can be applied to any protein for which a tertiary structure and homologous sequences are available, and will facilitate the rapid development of robust proteins for biomedical and biotechnological applications.

  13. FireProt: Energy- and Evolution-Based Computational Design of Thermostable Multiple-Point Mutants.

    David Bednar

    2015-11-01

    Full Text Available There is great interest in increasing proteins' stability to enhance their utility as biocatalysts, therapeutics, diagnostics and nanomaterials. Directed evolution is a powerful, but experimentally strenuous approach. Computational methods offer attractive alternatives. However, due to the limited reliability of predictions and potentially antagonistic effects of substitutions, only single-point mutations are usually predicted in silico, experimentally verified and then recombined in multiple-point mutants. Thus, substantial screening is still required. Here we present FireProt, a robust computational strategy for predicting highly stable multiple-point mutants that combines energy- and evolution-based approaches with smart filtering to identify additive stabilizing mutations. FireProt's reliability and applicability was demonstrated by validating its predictions against 656 mutations from the ProTherm database. We demonstrate that thermostability of the model enzymes haloalkane dehalogenase DhaA and γ-hexachlorocyclohexane dehydrochlorinase LinA can be substantially increased (ΔTm = 24°C and 21°C by constructing and characterizing only a handful of multiple-point mutants. FireProt can be applied to any protein for which a tertiary structure and homologous sequences are available, and will facilitate the rapid development of robust proteins for biomedical and biotechnological applications.

  14. Integrative study of pandemic A/H1N1 influenza infections: design and methods of the CoPanFlu-France cohort

    Lapidus Nathanael

    2012-06-01

    Full Text Available Abstract Background The risk of influenza infection depends on biological characteristics, individual or collective behaviors and the environmental context. The Cohorts for Pandemic Influenza (CoPanFlu France study was set up in 2009 after the identification of the novel swine-origin A/H1N1 pandemic influenza virus. This cohort of 601 households (1450 subjects representative for the general population aims at using an integrative approach to study the risk and characteristics of influenza infection as a complex combination of data collected from questionnaires regarding sociodemographic, medical, behavioral characteristics of subjects and indoor environment, using biological samples or environmental databases. Methods/Design Households were included between December 2009 and July 2010. The design of this study relies on systematic follow-up visits between influenza seasons and additional visits during influenza seasons, when an influenza-like illness is detected in a household via an active surveillance system. During systematic visits, a nurse collects individual and environmental data on questionnaires and obtains blood samples from all members of the household. When an influenza-like-illness is detected, a nurse visits the household three times during the 12 following days, and collects data on questionnaires regarding exposure and symptoms, and biological samples (including nasal swabs from all subjects in the household. The end of the follow-up period is expected in fall 2012. Discussion The large amount of data collected throughout the follow-up will permit a multidisciplinary study of influenza infections. Additional data is being collected and analyzed in this ongoing cohort. The longitudinal analysis of these households will permit integrative analyses of complex phenomena such as individual, collective and environmental risk factors of infection, routes of transmission, or determinants of the immune response to infection or vaccination.

  15. Low-cost design of next generation SONET/SDH networks with multiple constraints

    Karem, TR

    2007-07-01

    Full Text Available on constraints programming satisfaction technology is proposed. The algorithm is tested in OPNET simulation environment using different network models derived from a hypothetical case study of an optical network design for Bellville area in Cape Town, South...

  16. Control room conceptual design of nuclear power plant with multiple modular high temperature gas-cooled reactors

    Jia Qianqian; Qu Ronghong; Zhang Liangju

    2014-01-01

    A conceptual design of the control room layout for the nuclear power plant with multiple modular high temperature gas-cooled reactors has been developed. The modular high temperature gas-cooled reactors may need to be grouped to produce as much energy as a utility demands to realize the economic efficiency. There are many differences between the multi-modular plant and the current NPPs in the control room. These differences may include the staffing level, the human-machine interface design, the operation mode, etc. The potential challenges of the human factor engineering (HFE) in the control room of the multi-modular plant are analyzed, including the operation workload of the multi-modular tasks, how to help the crew to keep situation awareness of all modules, and how to support team work, the control of shared system between modules, etc. A concept design of control room for the multi-modular plant is presented based on the design aspect of HTR-PM (High temperature gas-cooled reactor pebble bed module). HFE issues are considered in the conceptual design of control room for the multi-modular plant and some design strategies are presented. As a novel conceptual design, verifications and validations are needed, and focus of further work is sketch out. (author)

  17. Out-of-pocket costs, primary care frequent attendance and sample selection: Estimates from a longitudinal cohort design.

    Pymont, Carly; McNamee, Paul; Butterworth, Peter

    2018-03-20

    This paper examines the effect of out-of-pocket costs on subsequent frequent attendance in primary care using data from the Personality and Total Health (PATH) Through Life Project, a representative community cohort study from Canberra, Australia. The analysis sample comprised 1197 respondents with two or more GP consultations, and uses survey data linked to administrative health service use (Medicare) data which provides data on the number of consultations and out-of-pocket costs. Respondents identified in the highest decile of GP use in a year were defined as Frequent Attenders (FAs). Logistic regression models that did not account for potential selection effects showed that out-of-pocket costs incurred during respondents' prior two consultations were significantly associated with subsequent FA status. Respondents who incurred higher costs ($15-$35; or >$35) were less likely to become FAs than those who incurred no or low (attenders. Copyright © 2018. Published by Elsevier B.V.

  18. Designing Websites for Displaying Large Data Sets and Images on Multiple Platforms

    Anderson, A.; Wolf, V. G.; Garron, J.; Kirschner, M.

    2012-12-01

    The desire to build websites to analyze and display ever increasing amounts of scientific data and images pushes for web site designs which utilize large displays, and to use the display area as efficiently as possible. Yet, scientists and users of their data are increasingly wishing to access these websites in the field and on mobile devices. This results in the need to develop websites that can support a wide range of devices and screen sizes, and to optimally use whatever display area is available. Historically, designers have addressed this issue by building two websites; one for mobile devices, and one for desktop environments, resulting in increased cost, duplicity of work, and longer development times. Recent advancements in web design technology and techniques have evolved which allow for the development of a single website that dynamically adjusts to the type of device being used to browse the website (smartphone, tablet, desktop). In addition they provide the opportunity to truly optimize whatever display area is available. HTML5 and CSS3 give web designers media query statements which allow design style sheets to be aware of the size of the display being used, and to format web content differently based upon the queried response. Web elements can be rendered in a different size, position, or even removed from the display entirely, based upon the size of the display area. Using HTML5/CSS3 media queries in this manner is referred to as "Responsive Web Design" (RWD). RWD in combination with technologies such as LESS and Twitter Bootstrap allow the web designer to build web sites which not only dynamically respond to the browser display size being used, but to do so in very controlled and intelligent ways, ensuring that good layout and graphic design principles are followed while doing so. At the University of Alaska Fairbanks, the Alaska Satellite Facility SAR Data Center (ASF) recently redesigned their popular Vertex application and converted it from a

  19. Human-Centered Design and Evaluation of Haptic Cueing for Teleoperation of Multiple Mobile Robots.

    Son, Hyoung Il; Franchi, Antonio; Chuang, Lewis L; Kim, Junsuk; Bulthoff, Heinrich H; Giordano, Paolo Robuffo

    2013-04-01

    In this paper, we investigate the effect of haptic cueing on a human operator's performance in the field of bilateral teleoperation of multiple mobile robots, particularly multiple unmanned aerial vehicles (UAVs). Two aspects of human performance are deemed important in this area, namely, the maneuverability of mobile robots and the perceptual sensitivity of the remote environment. We introduce metrics that allow us to address these aspects in two psychophysical studies, which are reported here. Three fundamental haptic cue types were evaluated. The Force cue conveys information on the proximity of the commanded trajectory to obstacles in the remote environment. The Velocity cue represents the mismatch between the commanded and actual velocities of the UAVs and can implicitly provide a rich amount of information regarding the actual behavior of the UAVs. Finally, the Velocity+Force cue is a linear combination of the two. Our experimental results show that, while maneuverability is best supported by the Force cue feedback, perceptual sensitivity is best served by the Velocity cue feedback. In addition, we show that large gains in the haptic feedbacks do not always guarantee an enhancement in the teleoperator's performance.

  20. Design and synthesis of multiple antigenic peptides and their application for dengue diagnosis.

    Rai, Reeta; Dubey, Sameer; Santosh, K V; Biswas, Ashutosh; Mehrotra, Vinit; Rao, D N

    2017-09-01

    Major difficulty in development of dengue diagnostics is availability of suitable antigens. To overcome this, we made an attempt to develop a peptide based diagnosis which offers significant advantage over other methods. With the help of in silico methods, two epitopes were selected from envelope protein and three from NS1 protein of dengue virus. These were synthesized in combination as three multiple antigenic peptides (MAPs). We have tested 157 dengue positive sera confirmed for NS1 antigen. MAP1 showed 96.81% sera positive for IgM and 68.15% positive for IgG. MAP2 detected 94.90% IgM and 59.23% IgG positive sera. MAP3 also detected 96.17% IgM and 59.87% IgG positive sera. To the best of our knowledge this is the first study describing the use of synthetic multiple antigenic peptides for the diagnosis of dengue infection. This study describes MAPs as a promising tool for the use in serodiagnosis of dengue. Copyright © 2017 International Alliance for Biological Standardization. Published by Elsevier Ltd. All rights reserved.

  1. Freed : a system for creating multiple views of a digital collection during the design process

    Mendels, P.; Overbeeke, C.J.; Frens, J.W.

    2011-01-01

    In this paper Freed is presented, a system that enables design students to spatially organize their digital collection, define relations between collection content and reflect on it. The system features a force-based layout that allows to explore spatial organizations, and hence to gain new

  2. Non-Orthogonal Multiple Access for Large-Scale 5G Networks: Interference Aware Design

    Ali, Konpal S.; Elsawy, Hesham; Chaaban, Anas; Alouini, Mohamed-Slim

    2017-01-01

    the cell), which is a major performance limiting parameter in 5G networks. This article sheds light on the drastic negative-impact of intercell interference on the NOMA performance and advocates interference-aware NOMA design that jointly accounts for both

  3. Multiple Pathways to Learning: An Examination of Universal Design and Online Strategic Learning in Higher Education

    Hicks, Maryruth Wilks

    2010-01-01

    The purpose of this study was to examine the effectiveness of universally designed (UD) instruction on strategic learning in an online, interactive learning environment (ILE). The research focused on the premise that the customizable, media-based framework of UD instruction might influence diverse online learning strategies. This study…

  4. Data-driven soft sensor design with multiple-rate sampled data: a comparative study

    Lin, Bao; Recke, Bodil; Schmidt, Torben M.

    2009-01-01

    to design quality soft sensors for cement kiln processes using data collected from a simulator and a plant log system. Preliminary results reveal that the WPLS approach is able to provide accurate one-step-ahead prediction. The regularized data lifting technique predicts the product quality of cement kiln...

  5. Multiple-bunch-length operating mode design for a storage ring using hybrid low alpha and harmonic cavity method

    Gao, Weiwei, E-mail: gaomqr@mail.ustc.edu.cn [College of Mathematics and Physics, Fujian University of Technology, Fuzhou 350118 (China); Wang, Lin; Li, Heting [National Synchrotron Radiation Laboratory, University of Science and Technology of China, Hefei 230029 (China)

    2017-03-11

    In this paper we design a simultaneous three bunch length operating mode at the HLS-II (Hefei Light Source II) storage ring by installing two harmonic cavities and minimizing the momentum compaction factor. The short bunches (2.6 mm) presented in this work will meet the requirement of coherent millimeter-wave and sub-THz radiation experiments, while the long bunches (20 mm) will efficiently increase the total beam current. Therefore, this multiple-bunch-length operating mode allows present synchrotron users and coherent millimeter-wave users (or sub THz users) to carry out their experiments simultaneously. Since the relatively low energy characteristic of HLS-II we achieve the multiple-bunch-length operating mode without multicell superconducting RF cavities, which is technically feasible.

  6. Design and Integration of an All-Magnetic Attitude Control System for FASTSAT-HSV01's Multiple Pointing Objectives

    DeKock, Brandon; Sanders, Devon; Vanzwieten, Tannen; Capo-Lugo, Pedro

    2011-01-01

    The FASTSAT-HSV01 spacecraft is a microsatellite with magnetic torque rods as it sole attitude control actuator. FASTSAT s multiple payloads and mission functions require the Attitude Control System (ACS) to maintain Local Vertical Local Horizontal (LVLH)-referenced attitudes without spin-stabilization, while the pointing errors for some attitudes be significantly smaller than the previous best-demonstrated for this type of control system. The mission requires the ACS to hold multiple stable, unstable, and non-equilibrium attitudes, as well as eject a 3U CubeSat from an onboard P-POD and recover from the ensuing tumble. This paper describes the Attitude Control System, the reasons for design choices, how the ACS integrates with the rest of the spacecraft, and gives recommendations for potential future applications of the work.

  7. Design Studies for a Multiple Application Thermal Reactor for Irradiation Experiments (MATRIX)

    Pope, Michael A.; Gougar, Hans D.; Ryskamp, J. M.

    2015-03-01

    The Advanced Test Reactor (ATR) is a high power density test reactor specializing in fuel and materials irradiation. For more than 45 years, the ATR has provided irradiations of materials and fuels testing along with radioisotope production. Should unforeseen circumstances lead to the decommissioning of ATR, the U.S. Government would be left without a large-scale materials irradiation capability to meet the needs of its nuclear energy and naval reactor missions. In anticipation of this possibility, work was performed under the Laboratory Directed Research and Development (LDRD) program to investigate test reactor concepts that could satisfy the current missions of the ATR along with an expanded set of secondary missions. A survey was conducted in order to catalogue the anticipated needs of potential customers. Then, concepts were evaluated to fill the role for this reactor, dubbed the Multi-Application Thermal Reactor Irradiation eXperiments (MATRIX). The baseline MATRIX design is expected to be capable of longer cycle lengths than ATR given a particular batch scheme. The volume of test space in In-Pile-Tubes (IPTs) is larger in MATRIX than in ATR with comparable magnitude of neutron flux. Furthermore, MATRIX has more locations of greater volume having high fast neutron flux than ATR. From the analyses performed in this work, it appears that the lead MATRIX design can be designed to meet the anticipated needs of the ATR replacement reactor. However, this design is quite immature, and therefore any requirements currently met must be re-evaluated as the design is developed further.

  8. Designing and using multiple-possibility physics problems in physics courses

    Shekoyan, Vazgen

    2012-02-01

    One important aspect of physics instruction is helping students develop better problem solving expertise. Besides enhancing the content knowledge, problems help students develop different cognitive abilities and skills. This presentation focuses on multiple-possibility problems (alternatively called ill-structured problems). These problems are different from traditional ``end of chapter'' single-possibility problems. They do not have one right answer and thus the student has to examine different possibilities, assumptions and evaluate the outcomes. To solve such problems one has to engage in a cognitive monitoring called epistemic cognition. It is an important part of thinking in real life. Physicists routinely use epistemic cognition when they solve problems. I have explored the instructional value of using such problems in introductory physics courses.

  9. Energy efficient design for MIMO two-way AF multiple relay networks

    Alsharoa, Ahmad M.

    2014-04-01

    This paper studies the energy efficient transmission and the power allocation problem for multiple two-way relay networks equipped with multi-input multi-output antennas where each relay employs an amplify-and-forward strategy. The goal is to minimize the total power consumption without degrading the quality of service of the terminals. In our analysis, we start by deriving closed-form expressions of the optimal powers allocated to terminals. We then employ a strong optimization tool based on the particle swarm optimization technique to find the optimal power allocated at each relay antenna. Our numerical results illustrate the performance of the proposed scheme and show that it achieves a sub-optimal solution very close to the optimal one.

  10. A New Chaotic System with Multiple Attractors: Dynamic Analysis, Circuit Realization and S-Box Design

    Qiang Lai

    2017-12-01

    Full Text Available This paper reports about a novel three-dimensional chaotic system with three nonlinearities. The system has one stable equilibrium, two stable equilibria and one saddle node, two saddle foci and one saddle node for different parameters. One salient feature of this novel system is its multiple attractors caused by different initial values. With the change of parameters, the system experiences mono-stability, bi-stability, mono-periodicity, bi-periodicity, one strange attractor, and two coexisting strange attractors. The complex dynamic behaviors of the system are revealed by analyzing the corresponding equilibria and using the numerical simulation method. In addition, an electronic circuit is given for implementing the chaotic attractors of the system. Using the new chaotic system, an S-Box is developed for cryptographic operations. Moreover, we test the performance of this produced S-Box and compare it to the existing S-Box studies.

  11. Multiple-cohort genetic association study reveals CXCR6 as a new chemokine receptor involved in long-term nonprogression to AIDS

    Limou, Sophie; Coulonges, Cédric; Herbeck, Joshua T.; van Manen, Daniëlle; An, Ping; Le Clerc, Sigrid; Delaneau, Olivier; Diop, Gora; Taing, Lieng; Montes, Matthieu; van't Wout, Angélique B.; Gottlieb, Geoffrey S.; Therwath, Amu; Rouzioux, Christine; Delfraissy, Jean-François; Lelièvre, Jean-Daniel; Lévy, Yves; Hercberg, Serge; Dina, Christian; Phair, John; Donfield, Sharyne; Goedert, James J.; Buchbinder, Susan; Estaquier, Jérôme; Schächter, François; Gut, Ivo; Froguel, Philippe; Mullins, James I.; Schuitemaker, Hanneke; Winkler, Cheryl; Zagury, Jean-François

    2010-01-01

    Background. The compilation of previous genomewide association studies of AIDS shows a major polymorphism in the HCP5 gene associated with both control of the viral load and long-term nonprogression (LTNP) to AIDS. Methods. To look for genetic variants that affect LTNP without necessary control of the viral load, we reanalyzed the genomewide data of the unique LTNP Genomics of Resistance to Immunodeficiency Virus (GRIV) cohort by excluding “elite controller” patients, who were controlling the viral load at very low levels (<100 copies/mL). Results. The rs2234358 polymorphism in the CXCR6 gene was the strongest signal (P = 2.5 × 10−7; odds ratio, 1.85) obtained for the genomewide association study comparing the 186 GRIV LTNPs who were not elite controllers with 697 uninfected control subjects. This association was replicated in 3 additional independent European studies, reaching genomewide significance of Pcombined = 9.7 × 10−10. This association with LTNP is independent of the combined CCR2-CCR5 locus and the HCP5 polymorphisms. Conclusion. The statistical significance, the replication, and the magnitude of the association demonstrate that CXCR6 is likely involved in the molecular etiology of AIDS and, in particular, in LTNP, emphasizing the power of extreme-phenotype cohorts. CXCR6 is a chemokine receptor that is known as a minor coreceptor in human immunodeficiency virus type 1 infection but could participate in disease progression through its role as a mediator of inflammation. PMID:20704485

  12. A simple method for combining genetic mapping data from multiple crosses and experimental designs.

    Jeremy L Peirce

    Full Text Available BACKGROUND: Over the past decade many linkage studies have defined chromosomal intervals containing polymorphisms that modulate a variety of traits. Many phenotypes are now associated with enough mapping data that meta-analysis could help refine locations of known QTLs and detect many novel QTLs. METHODOLOGY/PRINCIPAL FINDINGS: We describe a simple approach to combining QTL mapping results for multiple studies and demonstrate its utility using two hippocampus weight loci. Using data taken from two populations, a recombinant inbred strain set and an advanced intercross population we demonstrate considerable improvements in significance and resolution for both loci. 1-LOD support intervals were improved 51% for Hipp1a and 37% for Hipp9a. We first generate locus-wise permuted P-values for association with the phenotype from multiple maps, which can be done using a permutation method appropriate to each population. These results are then assigned to defined physical positions by interpolation between markers with known physical and genetic positions. We then use Fisher's combination test to combine position-by-position probabilities among experiments. Finally, we calculate genome-wide combined P-values by generating locus-specific P-values for each permuted map for each experiment. These permuted maps are then sampled with replacement and combined. The distribution of best locus-specific P-values for each combined map is the null distribution of genome-wide adjusted P-values. CONCLUSIONS/SIGNIFICANCE: Our approach is applicable to a wide variety of segregating and non-segregating mapping populations, facilitates rapid refinement of physical QTL position, is complementary to other QTL fine mapping methods, and provides an appropriate genome-wide criterion of significance for combined mapping results.

  13. First Simulations of Designing Stratospheric Sulfate Aerosol Geoengineering to Meet Multiple Simultaneous Climate Objectives

    Kravitz, Ben; MacMartin, Douglas G.; Mills, Michael J.; Richter, Jadwiga H.; Tilmes, Simone; Lamarque, Jean-Francois; Tribbia, Joseph J.; Vitt, Francis

    2017-12-01

    We describe the first simulations of stratospheric sulfate aerosol geoengineering using multiple injection locations to meet multiple simultaneous surface temperature objectives. Simulations were performed using CESM1(WACCM), a coupled atmosphere-ocean general circulation model with fully interactive stratospheric chemistry, dynamics (including an internally generated quasi-biennial oscillation), and a sophisticated treatment of sulfate aerosol formation, microphysical growth, and deposition. The objectives are defined as maintaining three temperature features at their 2020 levels against a background of the RCP8.5 scenario over the period 2020-2099. These objectives are met using a feedback mechanism in which the rate of sulfur dioxide injection at each of the four locations is adjusted independently every year of simulation. Even in the presence of uncertainties, nonlinearities, and variability, the objectives are met, predominantly by SO2 injection at 30°N and 30°S. By the last year of simulation, the feedback algorithm calls for a total injection rate of 51 Tg SO2 per year. The injections are not in the tropics, which results in a greater degree of linearity of the surface climate response with injection amount than has been found in many previous studies using injection at the equator. Because the objectives are defined in terms of annual mean temperature, the required geongineering results in "overcooling" during summer and "undercooling" during winter. The hydrological cycle is also suppressed as compared to the reference values corresponding to the year 2020. The demonstration we describe in this study is an important step toward understanding what geoengineering can do and what it cannot do.

  14. The Argentina Premature Asthma and Respiratory Team (APART: objectives, design, and recruitment results of a prospective cohort study of viruses and wheezing in very low birth weight infants

    Tatyana Plachco

    2014-12-01

    Full Text Available Background: Asthma and wheezing account for a substantial disease burden around the world. Very low birth weight (VLBW, <1500 grams infants are at an increased risk for the development of severe acute respiratory illness (ARI and recurrent wheeze/asthma. The role of respiratory viruses in asthma predisposition in premature infants is not well understood. Preliminary evidence suggests that infection with human rhinovirus (RV early in life may contribute to greater burden of asthma later in life. Methods: A prospective cohort study of premature VLBW infants from Buenos Aires, Argentina, was enrolled year-round during a three-year period in the neonatal intensive care unit and followed during every ARI and with monthly well visits during the first year of life. Longitudinal follow-up up until age five years is ongoing. Results: This report describes the objectives, design, and recruitment results of this prospective cohort. Two hundred and five patients were enrolled from August 2011 through January 2014, and follow-up is ongoing. A total of 319 ARI episodes were observed from August 2011 to July 2014, and 910 well visits occurred during this time period. Conclusions: The Argentina Premature Asthma and Respiratory Team (APART is a unique cohort consisting of over 200 patients and over 1200 specimens who have been and will continue to be followed intensively from NICU discharge to capture baseline risk factors and every ARI, with interceding well visits during the first year of life, as well as longitudinal follow-up to age 5 years for asthma and atopy outcomes.

  15. Stepped-wedge cluster randomised controlled trials: a generic framework including parallel and multiple-level designs.

    Hemming, Karla; Lilford, Richard; Girling, Alan J

    2015-01-30

    Stepped-wedge cluster randomised trials (SW-CRTs) are being used with increasing frequency in health service evaluation. Conventionally, these studies are cross-sectional in design with equally spaced steps, with an equal number of clusters randomised at each step and data collected at each and every step. Here we introduce several variations on this design and consider implications for power. One modification we consider is the incomplete cross-sectional SW-CRT, where the number of clusters varies at each step or where at some steps, for example, implementation or transition periods, data are not collected. We show that the parallel CRT with staggered but balanced randomisation can be considered a special case of the incomplete SW-CRT. As too can the parallel CRT with baseline measures. And we extend these designs to allow for multiple layers of clustering, for example, wards within a hospital. Building on results for complete designs, power and detectable difference are derived using a Wald test and obtaining the variance-covariance matrix of the treatment effect assuming a generalised linear mixed model. These variations are illustrated by several real examples. We recommend that whilst the impact of transition periods on power is likely to be small, where they are a feature of the design they should be incorporated. We also show examples in which the power of a SW-CRT increases as the intra-cluster correlation (ICC) increases and demonstrate that the impact of the ICC is likely to be smaller in a SW-CRT compared with a parallel CRT, especially where there are multiple levels of clustering. Finally, through this unified framework, the efficiency of the SW-CRT and the parallel CRT can be compared. © 2014 The Authors. Statistics in Medicine Published by John Wiley & Sons Ltd.

  16. Concurrent topological design of composite structures and materials containing multiple phases of distinct Poisson's ratios

    Long, Kai; Yuan, Philip F.; Xu, Shanqing; Xie, Yi Min

    2018-04-01

    Most studies on composites assume that the constituent phases have different values of stiffness. Little attention has been paid to the effect of constituent phases having distinct Poisson's ratios. This research focuses on a concurrent optimization method for simultaneously designing composite structures and materials with distinct Poisson's ratios. The proposed method aims to minimize the mean compliance of the macrostructure with a given mass of base materials. In contrast to the traditional interpolation of the stiffness matrix through numerical results, an interpolation scheme of the Young's modulus and Poisson's ratio using different parameters is adopted. The numerical results demonstrate that the Poisson effect plays a key role in reducing the mean compliance of the final design. An important contribution of the present study is that the proposed concurrent optimization method can automatically distribute base materials with distinct Poisson's ratios between the macrostructural and microstructural levels under a single constraint of the total mass.

  17. An FPGA-Based Multiple-Axis Velocity Controller and Stepping Motors Drives Design

    Lai Chiu-Keng

    2016-01-01

    Full Text Available A Field Programmable Gate Array based system is a great hardware platform to support the implementation of hardware controllers such as PID controller and fuzzy controller. It is also programmed as hardware accelerator to speed up the mathematic calculation and greatly enhance the performance as applied to motor drive and motion control. Furthermore, the open structure of FPGA-based system is suitable for those designs with the ability of parallel processing or soft code processor embedded. In this paper, we apply the FPGA to a multi-axis velocity controller design. The developed system integrated three functions inside the FPGA chip, which are respectively the stepping motor drive, the multi-axis motion controller and the motion planning. Furthermore, an embedded controller with a soft code processor compatible to 8051 micro-control unit (MCU is built to handle the data transfer between the FPGA board and host PC. The MCU is also used to initialize the motion control and run the interpolator. The designed system is practically applied to a XYZ motion platform which is driven by stepping motors to verify its performance.

  18. Local Flexibility Market Design for Aggregators Providing Multiple Flexibility Services at Distribution Network Level

    Pol Olivella-Rosell

    2018-04-01

    Full Text Available This paper presents a general description of local flexibility markets as a market-based management mechanism for aggregators. The high penetration of distributed energy resources introduces new flexibility services like prosumer or community self-balancing, congestion management and time-of-use optimization. This work is focused on the flexibility framework to enable multiple participants to compete for selling or buying flexibility. In this framework, the aggregator acts as a local market operator and supervises flexibility transactions of the local energy community. Local market participation is voluntary. Potential flexibility stakeholders are the distribution system operator, the balance responsible party and end-users themselves. Flexibility is sold by means of loads, generators, storage units and electric vehicles. Finally, this paper presents needed interactions between all local market stakeholders, the corresponding inputs and outputs of local market operation algorithms from participants and a case study to highlight the application of the local flexibility market in three scenarios. The local market framework could postpone grid upgrades, reduce energy costs and increase distribution grids’ hosting capacity.

  19. Development of multiple performance indices and system parameter study for the design of a MEMS accelerometer

    Kim, Yong Il; Choi, Chan Kyu; Yoo, Hong Hee

    2012-01-01

    For the design of a MEMS accelerometer, proper performance indices should be defined and employed. Performance indices are obtained using either an experimental method or a numerical method. In the present study, a vibration analysis model of a MEMS accelerometer is introduced to calculate three performance indices: sensitivity, measurable acceleration range, and measurable frequency range. The accuracy of the vibration analysis model is first validated by comparing its modal and transient results with those of a commercial finite element code. Measurable acceleration and frequency ranges versus allowable errors for electrical and mechanical sensitivities are obtained and the effects of system parameter variations on the three performance indices are investigated

  20. A design of a wavelength-hopping time-spreading incoherent optical code division multiple access system

    Glesk, I.; Baby, V.

    2005-01-01

    We present the architecture and code design for a highly scalable, 2.5 Gb/s per user optical code division multiple access (OCDMA) system. The system is scalable to 100 potential and more than 10 simultaneous users, each with a bit error rate (BER) of less than 10 -9 . The system architecture uses a fast wavelength-hopping, time-spreading codes. Unlike frequency and phase sensitive coherent OCDMA systems, this architecture utilizes standard on off keyed optical pulses allocated in the time and wavelength dimensions. This incoherent OCDMA approach is compatible with existing WDM optical networks and utilizes off the shelf components. We discuss the novel optical subsystem design for encoders and decoders that enable the realization of a highly scalable incoherent OCDMA system with rapid reconfigurability. A detailed analysis of the scalability of the two dimensional code is presented and select network deployment architectures for OCDMA are discussed (Authors)

  1. Design of high-order all-optical temporal differentiators based on multiple-phase-shifted fiber Bragg gratings.

    Kulishov, Mykola; Azaña, José

    2007-05-14

    A simple and general approach for designing practical all-optical (all-fiber) arbitrary-order time differentiators is introduced here for the first time. Specifically, we demonstrate that the Nth time derivative of an input optical waveform can be obtained by reflection of this waveform in a single uniform fiber Bragg grating (FBG) incorporating N &pi-phase shifts properly located along its grating profile. The general design procedure of an arbitrary-order optical time differentiator based on a multiple-phase-shifted FBG is described and numerically demonstrated for up to fourth-order time differentiation. Our simulations show that the proposed approach can provide optical operation bandwidths in the tens-of-GHz regime using readily feasible FBG structures.

  2. Differences in mechanisms of failure, intraoperative findings, and surgical characteristics between single- and multiple-revision ACL reconstructions: a MARS cohort study.

    Chen, James L; Allen, Christina R; Stephens, Thomas E; Haas, Amanda K; Huston, Laura J; Wright, Rick W; Feeley, Brian T

    2013-07-01

    The factors that lead to patients failing multiple anterior cruciate ligament (ACL) reconstructions are not well understood. Multiple-revision ACL reconstruction will have different characteristics than first-time revision in terms of previous and current graft selection, mode of failure, chondral/meniscal injuries, and surgical charactieristics. Case-control study; Level of evidence, 3. A prospective multicenter ACL revision database was utilized for the time period from March 2006 to June 2011. Patients were divided into those who underwent a single-revision ACL reconstruction and those who underwent multiple-revision ACL reconstructions. The primary outcome variable was Marx activity level. Primary data analyses between the groups included a comparison of graft type, perceived mechanism of failure, associated injury (meniscus, ligament, and cartilage), reconstruction type, and tunnel position. Data were compared by analysis of variance with a post hoc Tukey test. A total of 1200 patients (58% men; median age, 26 years) were enrolled, with 1049 (87%) patients having a primary revision and 151 (13%) patients having a second or subsequent revision. Marx activity levels were significantly higher (9.77) in the primary-revision group than in those patients with multiple revisions (6.74). The most common cause of reruptures was a traumatic, noncontact ACL graft injury in 55% of primary-revision patients; 25% of patients had a nontraumatic, gradual-onset recurrent injury, and 11% had a traumatic, contact injury. In the multiple-revision group, a nontraumatic, gradual-onset injury was the most common cause of recurrence (47%), followed by traumatic noncontact (35%) and nontraumatic sudden onset (11%) (P < .01 between groups). Chondral injuries in the medial compartment were significantly more common in the multiple-revision group than in the single-revision group, as were chondral injuries in the patellofemoral compartment. Patients with multiple-revision ACL

  3. A methodology for the design of experiments in computational intelligence with multiple regression models.

    Fernandez-Lozano, Carlos; Gestal, Marcos; Munteanu, Cristian R; Dorado, Julian; Pazos, Alejandro

    2016-01-01

    The design of experiments and the validation of the results achieved with them are vital in any research study. This paper focuses on the use of different Machine Learning approaches for regression tasks in the field of Computational Intelligence and especially on a correct comparison between the different results provided for different methods, as those techniques are complex systems that require further study to be fully understood. A methodology commonly accepted in Computational intelligence is implemented in an R package called RRegrs. This package includes ten simple and complex regression models to carry out predictive modeling using Machine Learning and well-known regression algorithms. The framework for experimental design presented herein is evaluated and validated against RRegrs. Our results are different for three out of five state-of-the-art simple datasets and it can be stated that the selection of the best model according to our proposal is statistically significant and relevant. It is of relevance to use a statistical approach to indicate whether the differences are statistically significant using this kind of algorithms. Furthermore, our results with three real complex datasets report different best models than with the previously published methodology. Our final goal is to provide a complete methodology for the use of different steps in order to compare the results obtained in Computational Intelligence problems, as well as from other fields, such as for bioinformatics, cheminformatics, etc., given that our proposal is open and modifiable.

  4. A methodology for the design of experiments in computational intelligence with multiple regression models

    Carlos Fernandez-Lozano

    2016-12-01

    Full Text Available The design of experiments and the validation of the results achieved with them are vital in any research study. This paper focuses on the use of different Machine Learning approaches for regression tasks in the field of Computational Intelligence and especially on a correct comparison between the different results provided for different methods, as those techniques are complex systems that require further study to be fully understood. A methodology commonly accepted in Computational intelligence is implemented in an R package called RRegrs. This package includes ten simple and complex regression models to carry out predictive modeling using Machine Learning and well-known regression algorithms. The framework for experimental design presented herein is evaluated and validated against RRegrs. Our results are different for three out of five state-of-the-art simple datasets and it can be stated that the selection of the best model according to our proposal is statistically significant and relevant. It is of relevance to use a statistical approach to indicate whether the differences are statistically significant using this kind of algorithms. Furthermore, our results with three real complex datasets report different best models than with the previously published methodology. Our final goal is to provide a complete methodology for the use of different steps in order to compare the results obtained in Computational Intelligence problems, as well as from other fields, such as for bioinformatics, cheminformatics, etc., given that our proposal is open and modifiable.

  5. The Design of New HIV-IN Tethered Bifunctional Inhibitors using Multiple Microdomain Targeted Docking.

    Ciubotaru, Mihai; Musat, Mihaela Georgiana; Surleac, Marius; Ionita, Elena; Petrescu, Andrei Jose; Abele, Edgars; Abele, Ramona

    2018-04-05

    Currently used antiretroviral HIV therapy drugs exclusively target critical groups in the enzymes essential for the viral life cycle. Increased mutagenesis of their genes, changes these viral enzymes which once mutated can evade therapeutic targeting, effects which confer drug resistance. To circumvent this, our review addresses a strategy to design and derive HIV-Integrase (HIV-IN) inhibitors which simultaneously target two IN functional domains, rendering it inactive even if the enzyme accumulates many mutations. First we review the enzymatic role of IN to insert the copied viral DNA into a chromosome of the host T lymphocyte, highlighting its main functional and structural features to be subjected to inhibitory action. From a functional and structural perspective we present all classes of HIV-IN inhibitors with their most representative candidates. For each chosen compound we also explain its mechanism of IN inhibition. We use the recently resolved cryo EM IN tetramer intasome DNA complex [1] onto which we dock various reference IN inhibitory chemical scaffolds such as to target adjacent functional IN domains. Pairing compounds with complementary activity, which dock in the vicinity of a IN structural microdomain, we design bifunctional new drugs which may not only be more resilient to IN mutations but also may be more potent inhibitors than their original counterparts. In the end of our review we propose synthesis pathways to link such paired compounds with enhanced synergistic IN inhibitory effects. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  6. Examining Design and Inter-Rater Reliability of a Rubric Measuring Research Quality across Multiple Disciplines

    Marilee J. Bresciani

    2009-05-01

    Full Text Available The paper presents a rubric to help evaluate the quality of research projects. The rubric was applied in a competition across a variety of disciplines during a two-day research symposium at one institution in the southwest region of the United States of America. It was collaboratively designed by a faculty committee at the institution and was administered to 204 undergraduate, master, and doctoral oral presentations by approximately 167 different evaluators. No training or norming of the rubric was given to 147 of the evaluators prior to the competition. The findings of the inter-rater reliability analysis reveal substantial agreement among the judges, which contradicts literature describing the fact that formal norming must occur prior to seeing substantial levels of inter-rater reliability. By presenting the rubric along with the methodology used in its design and evaluation, it is hoped that others will find this to be a useful tool for evaluating documents and for teaching research methods.

  7. Multiple approaches to valuation of conservation design and low-impact development features in residential subdivisions.

    Bowman, Troy; Tyndall, John C; Thompson, Janette; Kliebenstein, James; Colletti, Joe P

    2012-08-15

    Residents, developers and civic officials are often faced with difficult decisions about appropriate land uses in and around metropolitan boundaries. Urban expansion brings with it the potential for negative environmental impacts, but there are alternatives, such as conservation subdivision design (CSD) or low-impact development (LID), which offer the possibility of mitigating some of these effects at the development site. Many urban planning jurisdictions across the Midwest do not currently have any examples of these designs and lack information to identify public support or barriers to use of these methods. This is a case study examining consumer value for conservation and low-impact design features in one housing market by using four different valuation techniques to estimate residents' willingness to pay for CSD and LID features in residential subdivisions. A contingent valuation survey of 1804 residents in Ames, IA assessed familiarity with and perceptions of subdivision development and used an ordered value approach to estimate willingness to pay for CSD and LID features. A majority of residents were not familiar with CSD or LID practices. Residents indicated a willingness to pay for most CSD and LID features with the exception of clustered housing. Gender, age, income, familiarity with LID practices, perceptions of attractiveness of features and the perceived effect of CSD and LID features on ease of future home sales were important factors influencing residents' willingness to pay. A hypothetical referendum measured willingness to pay for tax-funded conservation land purchases and estimated that a property tax of around $50 would be the maximum increase that would pass. Twenty-seven survey respondents participated in a subsequent series of experimental real estate negotiations that used an experimental auction mechanism to estimate willingness to pay for CSD and LID features. Participants indicated that clustered housing (with interspersed preserved forest

  8. Relevancies of multiple-interaction events and signal-to-noise ratio for Anger-logic based PET detector designs

    Peng, Hao

    2015-10-01

    A fundamental challenge for PET block detector designs is to deploy finer crystal elements while limiting the number of readout channels. The standard Anger-logic scheme including light sharing (an 8 by 8 crystal array coupled to a 2×2 photodetector array with an optical diffuser, multiplexing ratio: 16:1) has been widely used to address such a challenge. Our work proposes a generalized model to study the impacts of two critical parameters on spatial resolution performance of a PET block detector: multiple interaction events and signal-to-noise ratio (SNR). The study consists of the following three parts: (1) studying light output profile and multiple interactions of 511 keV photons within crystal arrays of different crystal widths (from 4 mm down to 1 mm, constant height: 20 mm); (2) applying the Anger-logic positioning algorithm to investigate positioning/decoding uncertainties (i.e., "block effect") in terms of peak-to-valley ratio (PVR), with light sharing, multiple interactions and photodetector SNR taken into account; and (3) studying the dependency of spatial resolution on SNR in the context of modulation transfer function (MTF). The proposed model can be used to guide the development and evaluation of a standard Anger-logic based PET block detector including: (1) selecting/optimizing the configuration of crystal elements for a given photodetector SNR; and (2) predicting to what extent additional electronic multiplexing may be implemented to further reduce the number of readout channels.

  9. Designing Kerr interactions using multiple superconducting qubit types in a single circuit

    Elliott, Matthew; Joo, Jaewoo; Ginossar, Eran

    2018-02-01

    The engineering of Kerr interactions is of great interest for processing quantum information in multipartite quantum systems and for investigating many-body physics in a complex cavity-qubit network. We study how coupling multiple different types of superconducting qubits to the same cavity modes can be used to modify the self- and cross-Kerr effects acting on the cavities and demonstrate that this type of architecture could be of significant benefit for quantum technologies. Using both analytical perturbation theory results and numerical simulations, we first show that coupling two superconducting qubits with opposite anharmonicities to a single cavity enables the effective self-Kerr interaction to be diminished, while retaining the number splitting effect that enables control and measurement of the cavity field. We demonstrate that this reduction of the self-Kerr effect can maintain the fidelity of coherent states and generalised Schrödinger cat states for much longer than typical coherence times in realistic devices. Next, we find that the cross-Kerr interaction between two cavities can be modified by coupling them both to the same pair of qubit devices. When one of the qubits is tunable in frequency, the strength of entangling interactions between the cavities can be varied on demand, forming the basis for logic operations on the two modes. Finally, we discuss the feasibility of producing an array of cavities and qubits where intermediary and on-site qubits can tune the strength of self- and cross-Kerr interactions across the whole system. This architecture could provide a way to engineer interesting many-body Hamiltonians and be a useful platform for quantum simulation in circuit quantum electrodynamics.

  10. Assessing Online Asynchronous Communication Strategies Designed to Enhance Large Student Cohort Engagement and Foster a Community of Learning

    Kebble, Paul G.

    2017-01-01

    With the increasing diversity of pedagogic models of delivery in higher education, universities are continually exploring practises of learning and teaching designed to enhance student experience and retention. The number of courses provided online continues to grow through, among other reasons, an escalation of higher education (HE) students…

  11. Apparently-Different Clearance Rates from Cohort Studies of Mycoplasma genitalium Are Consistent after Accounting for Incidence of Infection, Recurrent Infection, and Study Design.

    Timo Smieszek

    Full Text Available Mycoplasma genitalium is a potentially major cause of urethritis, cervicitis, pelvic inflammatory disease, infertility, and increased HIV risk. A better understanding of its natural history is crucial to informing control policy. Two extensive cohort studies (students in London, UK; Ugandan sex workers suggest very different clearance rates; we aimed to understand the reasons and obtain improved estimates by making maximal use of the data from the studies. As M. genitalium is a sexually-transmitted infectious disease, we developed a model for time-to-event analysis that incorporates the processes of (reinfection and clearance, and fitted to data from the two cohort studies to estimate incidence and clearance rates under different scenarios of sexual partnership dynamics and study design (including sample handling and associated test sensitivity. In the London students, the estimated clearance rate is 0.80 p.a. (mean duration 15 months, with incidence 1.31%-3.93% p.a. Without adjusting for study design, corresponding estimates from the Ugandan data are 3.44 p.a. (mean duration 3.5 months and 58% p.a. Apparent differences in clearance rates are probably mostly due to lower testing sensitivity in the Uganda study due to differences in sample handling, with 'true' clearance rates being similar, and adjusted incidence in Uganda being 28% p.a. Some differences are perhaps due to the sex workers having more-frequent antibiotic treatment, whilst reinfection within ongoing sexual partnerships might have caused some of the apparently-persistent infection in the London students. More information on partnership dynamics would inform more accurate estimates of natural-history parameters. Detailed studies in men are also required.

  12. The Tennessee Children's Respiratory Initiative: Objectives, design and recruitment results of a prospective cohort study investigating infant viral respiratory illness and the development of asthma and allergic diseases.

    Hartert, Tina V; Carroll, Kecia; Gebretsadik, Tebeb; Woodward, Kimberly; Minton, Patricia

    2010-05-01

    The 'attack rate' of asthma following viral lower respiratory tract infections (LRTI) is about 3-4 fold higher than that of the general population; however, the majority of children who develop viral LRTI during infancy do not develop asthma, and asthma incidence has been observed to continuously decrease with age. Thus, we do not understand how viral LRTI either predispose or serve as a marker of children to develop asthma. The Tennessee Children's Respiratory Initiative has been established as a longitudinal prospective investigation of infants and their biological mothers. The primary goals are to investigate both the acute and the long-term health consequences of varying severity and aetiology of clinically significant viral respiratory tract infections on early childhood outcomes. Over four respiratory viral seasons, 2004–2008, term, predominantly non-low weight previously healthy infants and their biological mothers were enrolled during an infant's acute viral respiratory illness.Longitudinal follow up to age 6 years is ongoing [corrected]. This report describes the study objectives, design and recruitment results of the over 650 families enrolled in this longitudinal investigation. The Tennessee Children's Respiratory Initiative is additionally unique because it is designed in parallel with a large retrospective birth cohort of over 95,000 mother-infant dyads with similar objectives to investigate the role of respiratory viral infection severity and aetiology in the development of asthma. Future reports from this cohort will help to clarify the complex relationship between infant respiratory viral infection severity, aetiology, atopic predisposition and the subsequent development of early childhood asthma and atopic diseases.

  13. Study of Use of Products and Exposure-Related Behaviors (SUPERB: study design, methods, and demographic characteristics of cohorts

    Hertz-Picciotto Irva

    2010-08-01

    Full Text Available Abstract Background Exposure to toxic chemicals in the home is a growing concern. This report presents an overview of the recruitment, methods for data collection, instruments used to collect data, and participant demographics for a study examining behaviors that influence exposure to environmental toxins in the home environment, also known as SUPERB (Study of Use of Products and Exposure Related Behaviors. Methods The methods involved three different platforms: telephone interviews, internet-based surveys, and home-based monitoring. The purposes of SUPERB were: first, to compare data collection platforms with regard to feasibility, acceptability and reliability; and second, to provide longitudinal population-based data characterizing seasonal and long-term changes in exposure-related behaviors including food consumption, temporal-spatial activity, and household product use. Results Two cohorts of households were enrolled: families (one parent and one child from northern California and older individuals (age 55+ from central California. Parents (n = 499 in Northern California families were on average 36 years of age, 47.1% were Latino or nonwhite, and 10.2% took the survey in Spanish. Most of the children enrolled (n = 566 were under 6 years (82.7%. The older adults enrolled (n = 156 were, on average, 66 years of age and 23.7% were Latino or nonwhite, but only 2.6% completed the survey in Spanish. Conclusions We found that oversampling was successful in improving recruitment of under-represented subgroups, such as those with low education, thereby increasing diversity of our study sample. Protocols that minimize participant time, e.g., use of bar scanners and scales rather than questionnaires regarding use of household products, and the implementation of these protocols by staff who built relationships of trust, resulted in high retention over a longitudinal data collection scheme. A relatively small fraction of those who volunteer for

  14. The Preschool Activity, Technology, Health, Adiposity, Behaviour and Cognition (PATH-ABC) cohort study: rationale and design.

    Cliff, Dylan P; McNeill, Jade; Vella, Stewart; Howard, Steven J; Kelly, Megan A; Angus, Douglas J; Wright, Ian M; Santos, Rute; Batterham, Marijka; Melhuish, Edward; Okely, Anthony D; de Rosnay, Marc

    2017-04-04

    Prevalence estimates internationally suggest that many preschool-aged children (3-5 years) are insufficiently physically active and engage in high levels of screen-based entertainment. Early childhood is the developmental period for which we know the least about the effects of physical activity on development and health. Likewise, rapid technological advancements in mobile electronic media have made screen-based forms of entertainment for young children ubiquitous, and research demonstrating the impacts on cognition, psychosocial well-being, and health has lagged behind the rate of adoption of these technologies. The purpose of the Preschool Activity, Technology, Health, Adiposity, Behaviour and Cognition (PATH-ABC) study is to investigate if physical activity and screen-based entertainment are independently associated with cognitive and psychosocial development, and health outcomes in young children, and if so, how much and which types of these behaviours might be most influential. The PATH-ABC study is a prospective cohort, aiming to recruit 430 3-5 year-old children. Children are recruited through and complete initial assessments at their Early Childhood Education and Care (ECEC) centre, and then 12-months later at their centre or school. Direct assessments are made of children's habitual physical activity using accelerometry, cognitive (executive function) and language development (expressive vocabulary), psychosocial development (emotional understanding, Theory of Mind, empathy, and heart rate variability), adiposity (body mass index and waist circumference), and cardiovascular health (blood pressure and retinal micro- vasculature). Educators report on children's psychological strengths and difficulties and self-regulation. Parents report on children's habitual use of electronic media and other child, parent and household characteristics. The PATH-ABC study aims to provide evidence to enhance understanding of how much and which types of physical activity and

  15. A Small Modular Reactor Design for Multiple Energy Applications: HTR50S

    Yan, X.; Tachibana, Y.; Ohashi, H.; Sato, H.; Tazawa, Y.; Kunitomi, K. [Japan Atomic Energy Agency, Ibaraki (Japan)

    2013-06-15

    HTR50S is a small modular reactor system based on HTGR. It is designed for a triad of applications to be implemented in successive stages. In the first stage, a base plant for heat and power is constructed of the fuel proven in JAEA's 950 .deg. C, 30MWt test reactor HTTR and a conventional steam turbine to minimize development risk. While the outlet temperature is lowered to 750 .deg. C for the steam turbine, thermal power is raised to 50MWt by enabling 40% greater power density in 20% taller core than the HTTR. However the fuel temperature limit and reactor pressure vessel diameter are kept. In second stage, a new fuel that is currently under development at JAEA will allow the core outlet temperature to be raised to 900 .deg. C for the purpose of demonstrating more efficient gas turbine power generation and high temperature heat supply. The third stage adds a demonstration of nuclear-heated hydrogen production by a thermochemical process. A licensing approach to coupling high temperature industrial process to nuclear reactor will be developed. The low initial risk and the high longer-term potential for performance expansion attract development of the HTR50S as a multipurpose industrial or distributed energy source.

  16. New Design for Rapid Prototyping of Digital Master Casts for Multiple Dental Implant Restorations.

    Romero, Luis; Jiménez, Mariano; Espinosa, María Del Mar; Domínguez, Manuel

    2015-01-01

    This study proposes the replacement of all the physical devices used in the manufacturing of conventional prostheses through the use of digital tools, such as 3D scanners, CAD design software, 3D implants files, rapid prototyping machines or reverse engineering software, in order to develop laboratory work models from which to finish coatings for dental prostheses. Different types of dental prosthetic structures are used, which were adjusted by a non-rotatory threaded fixing system. From a digital process, the relative positions of dental implants, soft tissue and adjacent teeth of edentulous or partially edentulous patients has been captured, and a maser working model which accurately replicates data relating to the patients oral cavity has been through treatment of three-dimensional digital data. Compared with the conventional master cast, the results show a significant cost savings in attachments, as well as an increase in the quality of reproduction and accuracy of the master cast, with the consequent reduction in the number of patient consultation visits. The combination of software and hardware three-dimensional tools allows the optimization of the planning of dental implant-supported rehabilitations protocol, improving the predictability of clinical treatments and the production cost savings of master casts for restorations upon implants.

  17. New Design for Rapid Prototyping of Digital Master Casts for Multiple Dental Implant Restorations.

    Luis Romero

    Full Text Available This study proposes the replacement of all the physical devices used in the manufacturing of conventional prostheses through the use of digital tools, such as 3D scanners, CAD design software, 3D implants files, rapid prototyping machines or reverse engineering software, in order to develop laboratory work models from which to finish coatings for dental prostheses. Different types of dental prosthetic structures are used, which were adjusted by a non-rotatory threaded fixing system.From a digital process, the relative positions of dental implants, soft tissue and adjacent teeth of edentulous or partially edentulous patients has been captured, and a maser working model which accurately replicates data relating to the patients oral cavity has been through treatment of three-dimensional digital data.Compared with the conventional master cast, the results show a significant cost savings in attachments, as well as an increase in the quality of reproduction and accuracy of the master cast, with the consequent reduction in the number of patient consultation visits. The combination of software and hardware three-dimensional tools allows the optimization of the planning of dental implant-supported rehabilitations protocol, improving the predictability of clinical treatments and the production cost savings of master casts for restorations upon implants.

  18. Design of a Soft Robot with Multiple Motion Patterns Using Soft Pneumatic Actuators

    Miao, Yu; Dong, Wei; Du, Zhijiang

    2017-11-01

    Soft robots are made of soft materials and have good flexibility and infinite degrees of freedom in theory. These properties enable soft robots to work in narrow space and adapt to external environment. In this paper, a 2-DOF soft pneumatic actuator is introduced, with two chambers symmetrically distributed on both sides and a jamming cylinder along the axis. Fibers are used to constrain the expansion of the soft actuator. Experiments are carried out to test the performance of the soft actuator, including bending and elongation characteristics. A soft robot is designed and fabricated by connecting four soft pneumatic actuators to a 3D-printed board. The soft robotic system is then established. The pneumatic circuit is built by pumps and solenoid valves. The control system is based on the control board Arduino Mega 2560. Relay modules are used to control valves and pressure sensors are used to measure pressure in the pneumatic circuit. Experiments are conducted to test the performance of the proposed soft robot.

  19. New Design for Rapid Prototyping of Digital Master Casts for Multiple Dental Implant Restorations

    Romero, Luis; Jiménez, Mariano; Espinosa, María del Mar; Domínguez, Manuel

    2015-01-01

    Aim This study proposes the replacement of all the physical devices used in the manufacturing of conventional prostheses through the use of digital tools, such as 3D scanners, CAD design software, 3D implants files, rapid prototyping machines or reverse engineering software, in order to develop laboratory work models from which to finish coatings for dental prostheses. Different types of dental prosthetic structures are used, which were adjusted by a non-rotatory threaded fixing system. Method From a digital process, the relative positions of dental implants, soft tissue and adjacent teeth of edentulous or partially edentulous patients has been captured, and a maser working model which accurately replicates data relating to the patients oral cavity has been through treatment of three-dimensional digital data. Results Compared with the conventional master cast, the results show a significant cost savings in attachments, as well as an increase in the quality of reproduction and accuracy of the master cast, with the consequent reduction in the number of patient consultation visits. The combination of software and hardware three-dimensional tools allows the optimization of the planning of dental implant-supported rehabilitations protocol, improving the predictability of clinical treatments and the production cost savings of master casts for restorations upon implants. PMID:26696528

  20. A personalized, intense physical rehabilitation program improves walking in people with multiple sclerosis presenting with different levels of disability: a retrospective cohort.

    Kalron, Alon; Nitzani, Dalia; Magalashvili, David; Dolev, Mark; Menascu, Shay; Stern, Yael; Rosenblum, Uri; Pasitselsky, Diana; Frid, Lior; Zeilig, Gabi; Barmatz, Caroline; Givon, Uri; Achiron, Anat

    2015-03-04

    People with multiple sclerosis (PwMS) endure walking limitations. To address this restriction, various physical rehabilitation programs have been implemented with no consensus regarding their efficacy. Our objective was to report on the efficacy of an integrated tailored physical rehabilitation program on walking in people with multiple sclerosis categorized according to their level of neurological disability. Retrospective data were examined and analyzed. Specifically, data obtained from all patients who participated in the Multiple Sclerosis Center's 3 week rehabilitation program were extracted for in depth exploration. The personalized rehabilitation program included three major components modified according to the patient's specific impairments and functional needs: (a) goal directed physical therapy (b) moderately intense aerobic exercise training on a bicycle ergometer and (c) aquatic therapy chiefly oriented to body structures appropriate to movement. Gait outcome measurements included the 10 meter, 20 meter, Timed up and go and 2 minute walking tests measured pre and post the rehabilitation program. Three hundred and twelve people with relapsing-remitting multiple sclerosis were included in the final analysis. Patients were categorized into mild (n = 87), moderate (n = 104) and severely (n = 121) disabled groups. All clinical walking outcome measurements demonstrated statistically significant improvements, however, only an increase in the 2 minute walking test was above the minimal clinical difference value. The moderate and severe groups considerably improved compared to the mild gait disability group. Mean change scores (%) of the pre-post intervention period of the 2 minute walking test were 19.0 (S.E. = 3.4) in the moderate group, 16.2 (S.E. = 5.4) in the severe group and 10.9 (S.E. = 2.3) in the mild gait disability group. We presented comprehensive evidence verifying the effects of an intense goal-directed physical

  1. Spatial Evaluation of Multiple Benefits to Encourage Multi-Functional Design of Sustainable Drainage in Blue-Green Cities

    Richard Fenner

    2017-12-01

    Full Text Available Urban drainage systems that incorporate elements of green infrastructure (SuDS/GI are central features in Blue-Green and Sponge Cities. Such approaches provide effective control of stormwater management whilst generating a range of other benefits. However these benefits often occur coincidentally and are not developed or maximised in the original design. Of all the benefits that may accrue, the relevant dominant benefits relating to specific locations and socio-environmental circumstances need to be established, so that flood management functions can be co-designed with these wider benefits to ensure both are achieved during system operation. The paper reviews a number of tools which can evaluate the multiple benefits of SuDS/GI interventions in a variety of ways and introduces new concepts of benefit intensity and benefit profile. Examples of how these concepts can be applied is provided in a case study of proposed SuDS/GI assets in the central area of Newcastle; UK. Ways in which SuDS/GI features can be actively extended to develop desired relevant dominant benefits are discussed; e.g., by (i careful consideration of tree and vegetation planting to trap air pollution; (ii extending linear SuDS systems such as swales to enhance urban connectivity of green space; and (iii managing green roofs for the effective attenuation of noise or carbon sequestration. The paper concludes that more pro-active development of multiple benefits is possible through careful co-design to achieve the full extent of urban enhancement SuDS/GI schemes can offer.

  2. Design and synthesis of an amphiphilic graft hydrogel having a hydrophobic domain formed by multiple interactions

    Nitta, Kyohei [Department of Life and Functional Material Science, Graduate School of Natural Science, Konan University, 8-9-1 Okamoto, Higashinada, Kobe 658-8501 (Japan); Japan Society for the Promotion of Science (DC1), Ichibancho, Chiyoda, Tokyo 102-8471 (Japan); Kimoto, Atsushi [Department of Chemistry of Functional Molecules, Faculty of Science and Engineering, Konan University, 8-9-1 Okamoto, Higashinada, Kobe 658-8501 (Japan); Watanabe, Junji, E-mail: junjiknd@konan-u.ac.jp [Department of Chemistry of Functional Molecules, Faculty of Science and Engineering, Konan University, 8-9-1 Okamoto, Higashinada, Kobe 658-8501 (Japan)

    2016-11-01

    A novel hydrogel having hydrophobic oligo segments and hydrophilic poly(acrylamidoglycolic acid) (PAGA) as pH responsive polymer segments was designed and synthesized to be used as a soft biomaterial. Poly(trimethylene carbonate) (PTMC) as the side chain, for which the degrees of polymerization were 9, 19, and 49, and the composition ratios were 1, 5, and 10 mol%, was used as the oligo segment in the hydrogel. The swelling ratio of the hydrogel was investigated under various changes in conditions such as pH, temperature, and hydrogen bonding upon urea addition. Under pH 2–11 conditions, the graft gel reversibly swelled and shrank due to the effect of PAGA main chain. The interior morphology and skin layer of the hydrogel was observed by a scanning electron microscope. The hydrogel composed of PAGA as the hydrophilic polymer backbone had a sponge-like structure, with a pore size of approximately 100 μm. On the other hand, upon increasing the ratio of trimethylene carbonate (TMC) units in the hydrogel, the pores became smaller or disappeared. Moreover, thickness of the skin layer significantly increased with the swelling ratio depended on the incorporation ratios of the PTMC macromonomer. Molecular incorporation in the hydrogel was evaluated using a dye as a model drug molecule. These features would play an important role in drug loading. Increasing the ratio of TMC units favored the adsorption of the dye and activation of the incorporation behavior. - Highlights: • Hydrogen bonding and hydrophobic interaction are dominant factor for forming hydrogels. • Hydrogel properties were tuned by changing in graft length and macromonomer content in feed. • The resulting graft gel could encapsulate and retain organic dye in the hydrogel. • Poly(trimethylene carbonate) segment in the hydrogel was dominant unit for hydrogel.

  3. Design and synthesis of an amphiphilic graft hydrogel having a hydrophobic domain formed by multiple interactions

    Nitta, Kyohei; Kimoto, Atsushi; Watanabe, Junji

    2016-01-01

    A novel hydrogel having hydrophobic oligo segments and hydrophilic poly(acrylamidoglycolic acid) (PAGA) as pH responsive polymer segments was designed and synthesized to be used as a soft biomaterial. Poly(trimethylene carbonate) (PTMC) as the side chain, for which the degrees of polymerization were 9, 19, and 49, and the composition ratios were 1, 5, and 10 mol%, was used as the oligo segment in the hydrogel. The swelling ratio of the hydrogel was investigated under various changes in conditions such as pH, temperature, and hydrogen bonding upon urea addition. Under pH 2–11 conditions, the graft gel reversibly swelled and shrank due to the effect of PAGA main chain. The interior morphology and skin layer of the hydrogel was observed by a scanning electron microscope. The hydrogel composed of PAGA as the hydrophilic polymer backbone had a sponge-like structure, with a pore size of approximately 100 μm. On the other hand, upon increasing the ratio of trimethylene carbonate (TMC) units in the hydrogel, the pores became smaller or disappeared. Moreover, thickness of the skin layer significantly increased with the swelling ratio depended on the incorporation ratios of the PTMC macromonomer. Molecular incorporation in the hydrogel was evaluated using a dye as a model drug molecule. These features would play an important role in drug loading. Increasing the ratio of TMC units favored the adsorption of the dye and activation of the incorporation behavior. - Highlights: • Hydrogen bonding and hydrophobic interaction are dominant factor for forming hydrogels. • Hydrogel properties were tuned by changing in graft length and macromonomer content in feed. • The resulting graft gel could encapsulate and retain organic dye in the hydrogel. • Poly(trimethylene carbonate) segment in the hydrogel was dominant unit for hydrogel.

  4. Natural abundant solid state NMR studies in designed tripeptides for differentiation of multiple conformers.

    Jayanthi, S; Chatterjee, Bhaswati; Raghothama, S

    2009-10-01

    Solid state NMR (SSNMR) experiments on heteronuclei in natural abundance are described for three synthetically designed tripeptides Piv-(L)Pro-(L)Pro-(L)Phe-OMe (1), Piv-(D)Pro-(L)Pro-(L)Phe-OMe (2), and Piv-(D)Pro-(L)Pro-(L)Phe-NHMe (3). These peptides exist in different conformation as shown by solution state NMR and single crystal X-ray analysis (Chatterjee et al., Chem Eur J 2008, 14, 6192). In this study, SSNMR has been used to probe the conformations of these peptides in their powder form. The (13)C spectrum of peptide (1) showed doubling of resonances corresponding to cis/cis form, unlike in solution where the similar doubling is attributed to cis/trans form. This has been confirmed by the chemical shift differences of C(beta) and C(gamma) carbon of Proline in peptide (1) both in solution and SSNMR. Peptide (2) and (3) provided single set of resonances which represented all trans form across the di-Proline segment. The results are in agreement with the X-ray analysis. Solid state (15)N resonances, especially from Proline residues provided additional information, which is normally not observable in solution state NMR. (1)H chemical shifts are also obtained from a two-dimensional heteronuclear correlation experiment between (1)H--(13)C. The results confirm the utility of NMR as a useful tool for identifying different conformers in peptides in the solid state. (c) 2009 Wiley Periodicals, Inc. Biopolymers 91: 851-860, 2009.

  5. Persistent and contemporaneous effects of job stressors on mental health: a study testing multiple analytic approaches across 13 waves of annually collected cohort data.

    Milner, Allison; Aitken, Zoe; Kavanagh, Anne; LaMontagne, Anthony D; Petrie, Dennis

    2016-11-01

    This study investigated the extent that psychosocial job stressors had lasting effects on a scaled measure of mental health. We applied econometric approaches to a longitudinal cohort to: (1) control for unmeasured individual effects; (2) assess the role of prior (lagged) exposures of job stressors on mental health and (3) the persistence of mental health. We used a panel study with 13 annual waves and applied fixed-effects, first-difference and fixed-effects Arellano-Bond models. The Short Form 36 (SF-36) Mental Health Component Summary score was the outcome variable and the key exposures included: job control, job demands, job insecurity and fairness of pay. Results from the Arellano-Bond models suggest that greater fairness of pay (β-coefficient 0.34, 95% CI 0.23 to 0.45), job control (β-coefficient 0.15, 95% CI 0.10 to 0.20) and job security (β-coefficient 0.37, 95% CI 0.32 to 0.42) were contemporaneously associated with better mental health. Similar results were found for the fixed-effects and first-difference models. The Arellano-Bond model also showed persistent effects of individual mental health, whereby individuals' previous reports of mental health were related to their reporting in subsequent waves. The estimated long-run impact of job demands on mental health increased after accounting for time-related dynamics, while there were more minimal impacts for the other job stressor variables. Our results showed that the majority of the effects of psychosocial job stressors on a scaled measure of mental health are contemporaneous except for job demands where accounting for the lagged dynamics was important. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  6. Study of Women, Infant feeding, and Type 2 diabetes mellitus after GDM pregnancy (SWIFT, a prospective cohort study: methodology and design

    Gunderson Erica P

    2011-12-01

    Full Text Available Abstract Background Women with history of gestational diabetes mellitus (GDM are at higher risk of developing type 2 diabetes within 5 years after delivery. Evidence that lactation duration influences incident type 2 diabetes after GDM pregnancy is based on one retrospective study reporting a null association. The Study of Women, Infant Feeding and Type 2 Diabetes after GDM pregnancy (SWIFT is a prospective cohort study of postpartum women with recent GDM within the Kaiser Permanente Northern California (KPNC integrated health care system. The primary goal of SWIFT is to assess whether prolonged, intensive lactation as compared to formula feeding reduces the 2-year incidence of type 2 diabetes mellitus among women with GDM. The study also examines whether lactation intensity and duration have persistent favorable effects on blood glucose, insulin resistance, and adiposity during the 2-year postpartum period. This report describes the design and methods implemented for this study to obtain the clinical, biochemical, anthropometric, and behavioral measurements during the recruitment and follow-up phases. Methods SWIFT is a prospective, observational cohort study enrolling and following over 1, 000 postpartum women diagnosed with GDM during pregnancy within KPNC. The study enrolled women at 6-9 weeks postpartum (baseline who had been diagnosed by standard GDM criteria, aged 20-45 years, delivered a singleton, term (greater than or equal to 35 weeks gestation live birth, were not using medications affecting glucose tolerance, and not planning another pregnancy or moving out of the area within the next 2 years. Participants who are free of type 2 diabetes and other serious medical conditions at baseline are screened for type 2 diabetes annually within the first 2 years after delivery. Recruitment began in September 2008 and ends in December 2011. Data are being collected through pregnancy and early postpartum telephone interviews, self

  7. Early incidence of occupational asthma among young bakers, pastry-makers and hairdressers: design of a retrospective cohort study

    Guéant-Rodriguez Rosa-Maria

    2010-04-01

    Full Text Available Abstract Background Occupational exposures are thought to be responsible for 10-15% of new-onset asthma cases in adults, with disparities across sectors. Because most of the data are derived from registries and cross-sectional studies, little is known about incidence of occupational asthma (OA during the first years after inception of exposure. This paper describes the design of a study that focuses on this early asthma onset period among young workers in the bakery, pastry making and hairdressing sectors in order to assess early incidence of OA in these "at risk" occupations according to exposure duration, and to identify risk factors of OA incidence. Methods/Design The study population is composed of subjects who graduated between 2001 and 2006 in these sectors where they experience exposure to organic or inorganic allergenic or irritant compounds (with an objective of 150 subjects by year and 250 young workers with no specific occupational exposure. A phone interview focusing on respiratory and 'Ear-Nose-Throat' (ENT work-related symptoms screen subjects considered as "possibly OA cases". Subjects are invited to participate in a medical visit to complete clinical and lung function investigations, including fractional exhaled nitric oxide (FENO and carbon monoxide (CO measurements, and to collect blood samples for IgE (Immunoglobulin E measurements (total IgE and IgE for work-related and common allergens. Markers of oxidative stress and genetic polymorphisms exploration are also assessed. A random sample of 200 "non-cases" (controls is also visited, following a nested case-control design. Discussion This study may allow to describ a latent period between inception of exposure and the rise of the prevalence of asthma symptoms, an information that would be useful for the prevention of OA. Such a time frame would be suited for conducting screening campaigns of this emergent asthma at a stage when occupational hygiene measures and adapted

  8. Early incidence of occupational asthma among young bakers, pastry-makers and hairdressers: design of a retrospective cohort study.

    Rémen, Thomas; Coevoet, Vincent; Acouetey, Dovi-Stéphanie; Guéant, Jean-Louis; Guéant-Rodriguez, Rosa-Maria; Paris, Christophe; Zmirou-Navier, Denis

    2010-04-26

    Occupational exposures are thought to be responsible for 10-15% of new-onset asthma cases in adults, with disparities across sectors. Because most of the data are derived from registries and cross-sectional studies, little is known about incidence of occupational asthma (OA) during the first years after inception of exposure. This paper describes the design of a study that focuses on this early asthma onset period among young workers in the bakery, pastry making and hairdressing sectors in order to assess early incidence of OA in these "at risk" occupations according to exposure duration, and to identify risk factors of OA incidence. The study population is composed of subjects who graduated between 2001 and 2006 in these sectors where they experience exposure to organic or inorganic allergenic or irritant compounds (with an objective of 150 subjects by year) and 250 young workers with no specific occupational exposure. A phone interview focusing on respiratory and 'Ear-Nose-Throat' (ENT) work-related symptoms screen subjects considered as "possibly OA cases". Subjects are invited to participate in a medical visit to complete clinical and lung function investigations, including fractional exhaled nitric oxide (FENO) and carbon monoxide (CO) measurements, and to collect blood samples for IgE (Immunoglobulin E) measurements (total IgE and IgE for work-related and common allergens). Markers of oxidative stress and genetic polymorphisms exploration are also assessed. A random sample of 200 "non-cases" (controls) is also visited, following a nested case-control design. This study may allow to describ a latent period between inception of exposure and the rise of the prevalence of asthma symptoms, an information that would be useful for the prevention of OA. Such a time frame would be suited for conducting screening campaigns of this emergent asthma at a stage when occupational hygiene measures and adapted therapeutic interventions might be effective. Clinical trial

  9. After Action Report:Idaho National Laboratory (INL) 2014 Multiple Facility Beyond Design Basis (BDBE) Evaluated Drill October 21, 2014

    Barnes, V. Scott [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2014-12-01

    On October 21, 2014, Idaho National Laboratory (INL), in coordination with local jurisdictions, and Department of Energy (DOE) Idaho Operations Office (DOE ID) conducted an evaluated drill to demonstrate the ability to implement the requirements of DOE O 151.1C, “Comprehensive Emergency Management System” when responding to a beyond design basis event (BDBE) scenario as outlined in the Office of Health, Safety, and Security Operating Experience Level 1 letter (OE-1: 2013-01). The INL contractor, Battelle Energy Alliance, LLC (BEA), in coordination with CH2M-WG Idaho, LLC (CWI), and Idaho Treatment Group LLC (ITG), successfully demonstrated appropriate response measures to mitigate a BDBE event that would impact multiple facilities across the INL while protecting the health and safety of personnel, the environment, and property. Offsite response organizations participated to demonstrate appropriate response measures.

  10. Mechanical design of multiple zone plates precision alignment apparatus for hard X-ray focusing in twenty-nanometer scale

    Shu, Deming; Liu, Jie; Gleber, Sophie C.; Vila-Comamala, Joan; Lai, Barry; Maser, Jorg M.; Roehrig, Christian; Wojcik, Michael J.; Vogt, Franz Stefan

    2017-04-04

    An enhanced mechanical design of multiple zone plates precision alignment apparatus for hard x-ray focusing in a twenty-nanometer scale is provided. The precision alignment apparatus includes a zone plate alignment base frame; a plurality of zone plates; and a plurality of zone plate holders, each said zone plate holder for mounting and aligning a respective zone plate for hard x-ray focusing. At least one respective positioning stage drives and positions each respective zone plate holder. Each respective positioning stage is mounted on the zone plate alignment base frame. A respective linkage component connects each respective positioning stage and the respective zone plate holder. The zone plate alignment base frame, each zone plate holder and each linkage component is formed of a selected material for providing thermal expansion stability and positioning stability for the precision alignment apparatus.

  11. Academic and Behavioral Design Parameters for Cluster Randomized Trials in Kindergarten: An Analysis of the Early Childhood Longitudinal Study 2011 Kindergarten Cohort (ECLS-K 2011).

    Hedberg, E C

    2016-06-28

    There is an increased focus on randomized trials for proximal behavioral outcomes in early childhood research. However, planning sample sizes for such designs requires extant information on the size of effect, variance decomposition, and effectiveness of covariates. The purpose of this article is to employ a recent large representative sample of early childhood longitudinal study kindergartners to estimate design parameters for use in planning cluster randomized trials. A secondary objective is to compare the results of math and reading with the previous kindergartner cohort of 1999. For each measure, fall-spring gains in effect size units are calculated. In addition, multilevel models are fit to estimate variance components that are used to calculate intraclass correlations (ICCs) and R 2 statistics. The implications of the reported parameters are summarized in tables of required school sample sizes to detect small effects. The outcomes include information about student scores regarding learning behaviors, general behaviors, and academic abilities. Aside from math and reading, there were small gains in these measures from fall to spring, leading to effect sizes between about .1 and .2. In addition, the nonacademic ICCs are smaller than the academic ICCs but are still nontrivial. Use of a pretest covariate is generally effective in reducing the required sample size in power analyses. The ICCs for math and reading are smaller for the current sample compared with the 1999 sample. © The Author(s) 2016.

  12. Multiplicative disadvantage of being an unmarried and inadequately insured woman living in poverty with colon cancer: historical cohort exploration in California.

    Levitz, Naomi R; Haji-Jama, Sundus; Munro, Tonya; Gorey, Kevin M; Luginaah, Isaac N; Bartfay, Emma; Zou, Guangyong; Wright, Frances C; Kanjeekal, Sindu M; Hamm, Caroline; Balagurusamy, Madhan K; Holowaty, Eric J

    2015-01-01

    Many Americans diagnosed with colon cancer do not receive indicated chemotherapy. Certain unmarried women may be particularly disadvantaged. A 3-way interaction of the multiplicative disadvantages of being an unmarried and inadequately insured woman living in poverty was explored. California registry data were analyzed for 2,319 women diagnosed with stage II to IV colon cancer between 1996 and 2000 and followed until 2014. Socioeconomic data from the 2000 census classified neighborhoods as high poverty (≥30% of households poor), middle (5-29%) or low poverty (Primary health insurance was private, Medicare, Medicaid or none. Comparisons of chemotherapy rates used standardized rate ratios (RR). We respectively used logistic and Cox regression models to assess chemotherapy and survival. A statistically significant 3-way marital status by health insurance by poverty interaction effect on chemotherapy receipt was observed. Chemotherapy rates did not differ between unmarried (39.0%) and married (39.7%) women who lived in lower poverty neighborhoods and were privately insured. But unmarried women (27.3%) were 26% less likely to receive chemotherapy than were married women (37.1%, RR = 0.74, 95% CI 0.58, 0.95) who lived in high poverty neighborhoods and were publicly insured or uninsured. When this interaction and the main effects of health insurance, poverty and chemotherapy were accounted for, survival did not differ by marital status. The multiplicative barrier to colon cancer care that results from being inadequately insured and living in poverty is worse for unmarried than married women. Poverty is more prevalent among unmarried women and they have fewer assets so they are probably less able to absorb the indirect and direct, but uncovered, costs of colon cancer care. There seem to be structural inequities related to the institutions of marriage, work and health care that particularly disadvantage unmarried women that policy makers ought to be cognizant of as

  13. Evaluation of primary care midwifery in the Netherlands: design and rationale of a dynamic cohort study (DELIVER

    Manniën Judith

    2012-03-01

    Full Text Available Abstract Background In the Netherlands, midwives are autonomous medical practitioners and 78% of pregnant women start their maternity care with a primary care midwife. Scientific research to support evidence-based practice in primary care midwifery in the Netherlands has been sparse. This paper describes the research design and methodology of the multicenter multidisciplinary prospective DELIVER study which is the first large-scale study evaluating the quality and provision of primary midwifery care. Methods/Design Between September 2009 and April 2011, data were collected from clients and their partners, midwives and other healthcare professionals across the Netherlands. Clients from twenty midwifery practices received up to three questionnaires to assess the expectations and experiences of clients (e.g. quality of care, prenatal screening, emotions, health, and lifestyle. These client data were linked to data from the Netherlands Perinatal Register and electronic client records kept by midwives. Midwives and practice assistants from the twenty participating practices recorded work-related activities in a diary for one week, to assess workload. Besides, the midwives were asked to complete a questionnaire, to gain insight into collaboration of midwives with other care providers, their tasks and attitude towards their job, and the quality of the care they provide. Another questionnaire was sent to all Dutch midwifery practices which reveals information regarding the organisation of midwifery practices, provision of preconception care, collaboration with other care providers, and provision of care to ethnic minorities. Data at client, midwife and practice level can be linked. Additionally, partners of pregnant women and other care providers were asked about their expectations and experiences regarding the care delivered by midwives and in six practices client consults were videotaped to objectively assess daily practice. Discussion In total, 7685

  14. Precarious employment is a risk factor for poor mental health in young individuals in Sweden: a cohort study with multiple follow-ups.

    Canivet, Catarina; Bodin, Theo; Emmelin, Maria; Toivanen, Susanna; Moghaddassi, Mahnaz; Östergren, Per-Olof

    2016-08-02

    The globalisation of the economy and the labour markets has resulted in a growing proportion of individuals who find themselves in a precarious labour market situation, especially among the young. This pertains also to the Nordic countries, despite their characterisation as well developed welfare states with active labour market policies. This should be viewed against the background of a number of studies, which have shown that several aspects of precarious employment are detrimental to mental health. However, longitudinal studies from the Nordic region that examine the impact of precarious labour market conditions on mental health in young individuals are currently lacking. The present study aims to examine this impact in a general cohort of Swedish young people. Postal questionnaires were sent out in 1999/2000 to a stratified random sample of the Scania population, Sweden; the response rate was 58 %. All of those who responded at baseline were invited to follow-ups after 5 and 10 years. Employment precariousness was determined based on detailed questions about present employment, previous unemployment, and self-rated risk of future unemployment. Mental health was assessed by GHQ-12. For this study individuals in the age range of 18-34 years at baseline, who were active in the labour market (employed or seeking job) and had submitted complete data from 1999/2000, 2005, and 2010 on employment precariousness and mental health status, were selected (N = 1135). Forty-two percent of the participants had a precarious employment situation at baseline. Labour market trajectories that included precarious employment in 1999/2000 or 2005 predicted poor mental health in 2010: the incidence ratio ratio was 1.4 (95 % CI: 1.1-2.0) when excluding all individuals with mental health problems at baseline and adjusting for age, gender, social support, social capital, and economic difficulties in childhood. The population attributable fraction regarding poor mental health in the

  15. Precarious employment is a risk factor for poor mental health in young individuals in Sweden: a cohort study with multiple follow-ups

    Catarina Canivet

    2016-08-01

    Full Text Available Abstract Background The globalisation of the economy and the labour markets has resulted in a growing proportion of individuals who find themselves in a precarious labour market situation, especially among the young. This pertains also to the Nordic countries, despite their characterisation as well developed welfare states with active labour market policies. This should be viewed against the background of a number of studies, which have shown that several aspects of precarious employment are detrimental to mental health. However, longitudinal studies from the Nordic region that examine the impact of precarious labour market conditions on mental health in young individuals are currently lacking. The present study aims to examine this impact in a general cohort of Swedish young people. Methods Postal questionnaires were sent out in 1999/2000 to a stratified random sample of the Scania population, Sweden; the response rate was 58 %. All of those who responded at baseline were invited to follow-ups after 5 and 10 years. Employment precariousness was determined based on detailed questions about present employment, previous unemployment, and self-rated risk of future unemployment. Mental health was assessed by GHQ-12. For this study individuals in the age range of 18–34 years at baseline, who were active in the labour market (employed or seeking job and had submitted complete data from 1999/2000, 2005, and 2010 on employment precariousness and mental health status, were selected (N = 1135. Results Forty-two percent of the participants had a precarious employment situation at baseline. Labour market trajectories that included precarious employment in 1999/2000 or 2005 predicted poor mental health in 2010: the incidence ratio ratio was 1.4 (95 % CI: 1.1–2.0 when excluding all individuals with mental health problems at baseline and adjusting for age, gender, social support, social capital, and economic difficulties in childhood. The population

  16. Self-administered structured food record for measuring individual energy and nutrient intake in large cohorts: Design and validation.

    García, Silvia M; González, Claudio; Rucci, Enzo; Ambrosino, Cintia; Vidal, Julia; Fantuzzi, Gabriel; Prestes, Mariana; Kronsbein, Peter

    2018-06-05

    Several instruments developed to assess dietary intake of groups or populations have strengths and weaknesses that affect their specific application. No self-administered, closed-ended dietary survey was previously used in Argentina to assess current food and nutrient intake on a daily basis. To design and validate a self-administered, structured food record (NutriQuid, NQ) representative of the adult Argentine population's food consumption pattern to measure individual energy and nutrient intake. Records were loaded onto a database using software that checks a regional nutrition information system (SARA program), automatically quantifying energy and nutrient intake. NQ validation included two phases: (1) NQ construct validity comparing records kept simultaneously by healthy volunteers (45-75 years) and a nutritionist who provided meals (reference), and (2) verification of whether NQ reflected target population consumption (calories and nutrients), week consumption differences, respondent acceptability, and ease of data entry/analysis. Data analysis included descriptive statistics, repeated measures ANOVA, intraclass correlation coefficient, nonparametric regression, and cross-classification into quintiles. The first validation (study group vs. reference) showed an underestimation (10%) of carbohydrate, fat, and energy intake. Second validation: 109 volunteers (91% response) completed the NQ for seven consecutive days. Record completion took about 9min/day, and data entry 3-6min. Mean calorie intake was 2240±119kcal/day (42% carbohydrates, 17% protein, and 41% fat). Intake significantly increased in the weekend. NQ is a simple and efficient tool to assess dietary intake in large samples. Copyright © 2018 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.

  17. What is the benefit of treatment with multiple lines of chemotherapy for patients with metastatic breast cancer? A retrospective cohort study.

    Bakker, J L; Wever, K; van Waesberghe, J H; Beeker, A; Meijers-Heijboer, H; Konings, I R; Verheul, H M W

    2015-12-01

    Despite the extensive clinical experience, it is still under debate to what extent patients with metastatic breast cancer (MBC) benefit from multiple lines of chemotherapy beyond standard first or second line treatment. Selection of patients with MBC who will benefit from treatment is crucial to improve outcome and reduce unnecessary toxicity. In this retrospective study, systemic treatment outcome for patients with metastatic MBC is being evaluated. We evaluated to what extent the clinical benefit of prior chemotherapy can predict the success of a subsequent treatment line. Ninety-one patients treated with chemotherapy for MBC between January 2005 and January 2009 were included in this study. Clinical characteristics of patients, choices of chemotherapy and response at first evaluation of every treatment line was evaluated based on radiologic and clinical data. Patients received multiple systemic cytotoxic and biological (combination) therapies. 30% of these patients received more than five consecutive systemic (combination) treatments. First line chemotherapy was mostly anthracycline-based, followed by taxanes, capecitabine and vinorelbine. The response rate (RR, complete response plus partial response according to RECIST 1.1) decreased from 20% (95% CI 11-28%) upon first line of treatment to 0% upon the fourth line. The clinical benefit rate (combining RR and stable disease) decreased from 85% (95% CI 78-93%) in the first to 54% (95% CI 26-67) upon the fourth line. 24% of the patients with clinical benefit at first evaluation did not receive a subsequent line of treatment when progressive disease occurred, while sixty-one percent of the patients with progressive disease at first evaluation of a treatment did not receive a subsequent line of chemotherapy. When applied, the efficacy of a subsequent line of treatment was similar for patients independent of previous treatment benefit. The clinical benefit at first evaluation from systemic treatment in MBC does not

  18. Managing cancer pain at the end of life with multiple strong opioids: a population-based retrospective cohort study in primary care.

    Wei Gao

    Full Text Available End-of-life cancer patients commonly receive more than one type of strong opioid. The three-step analgesic ladder framework of the World Health Organisation (WHO provides no guidance on multiple opioid prescribing and there is little epidemiological data available to inform practice. This study aims to investigate the time trend of such cases and the associated factors.Strong opioid prescribing in the last three months of life of cancer patients were extracted from the General Practice Research Database (GPRD. The outcome variable was the number of different types of prescribed non-rescue doses of opioids (1 vs 2-4, referred to as a complex case. Associated factors were evaluated using prevalence ratios (PR derived from multivariate log-binomial model, adjusting for clustering effects and potential confounding variables.Overall, 26.4% (95% CI: 25.6-27.1% of 13,427 cancer patients (lung 41.7%, colorectal 19.1%, breast 18.6%, prostate 15.5%, head and neck 5.0% were complex cases. Complex cases increased steadily over the study period (1.02% annually, 95%CI: 0.42-1.61%, p = 0.048 but with a small dip (7.5% reduction, 95%CI: -0.03 to 17.8% around the period of the Shipman case, a British primary care doctor who murdered his patients with opioids. The dip significantly affected the correlation of the complex cases with persistent increasing background opioid prescribing (weighted correlation coefficients pre-, post-Shipman periods: 0.98(95%CI: 0.67-1.00, p = 0.011; 0.14 (95%CI: -0.85 to 0.91, p = 0.85. Multivariate adjusted analysis showed that the complex cases were predominantly associated with year of death (PRs vs 2000: 1.05-1.65, not other demographic and clinical factors except colorectal cancer (PR vs lung cancer: 1.24, 95%CI: 1.12-1.37.These findings suggest that prescribing behaviour, rather than patient factors, plays an important role in multiple opioid prescribing at the end of life; highlighting the need for training and

  19. Design of all-optical high-order temporal integrators based on multiple-phase-shifted Bragg gratings.

    Asghari, Mohammad H; Azaña, José

    2008-07-21

    In exact analogy with their electronic counterparts, photonic temporal integrators are fundamental building blocks for constructing all-optical circuits for ultrafast information processing and computing. In this work, we introduce a simple and general approach for realizing all-optical arbitrary-order temporal integrators. We demonstrate that the N(th) cumulative time integral of the complex field envelope of an input optical waveform can be obtained by simply propagating this waveform through a single uniform fiber/waveguide Bragg grating (BG) incorporating N pi-phase shifts along its axial profile. We derive here the design specifications of photonic integrators based on multiple-phase-shifted BGs. We show that the phase shifts in the BG structure can be arbitrarily located along the grating length provided that each uniform grating section (sections separated by the phase shifts) is sufficiently long so that its associated peak reflectivity reaches nearly 100%. The resulting designs are demonstrated by numerical simulations assuming all-fiber implementations. Our simulations show that the proposed approach can provide optical operation bandwidths in the tens-of-GHz regime using readily feasible photo-induced fiber BG structures.

  20. Evaluation of primary care midwifery in The Netherlands: design and rationale of a dynamic cohort study (DELIVER).

    Manniën, Judith; Klomp, Trudy; Wiegers, Therese; Pereboom, Monique; Brug, Johannes; de Jonge, Ank; van der Meijde, Margreeth; Hutton, Eileen; Schellevis, Francois; Spelten, Evelien

    2012-03-20

    In the Netherlands, midwives are autonomous medical practitioners and 78% of pregnant women start their maternity care with a primary care midwife. Scientific research to support evidence-based practice in primary care midwifery in the Netherlands has been sparse. This paper describes the research design and methodology of the multicenter multidisciplinary prospective DELIVER study which is the first large-scale study evaluating the quality and provision of primary midwifery care. Between September 2009 and April 2011, data were collected from clients and their partners, midwives and other healthcare professionals across the Netherlands. Clients from twenty midwifery practices received up to three questionnaires to assess the expectations and experiences of clients (e.g. quality of care, prenatal screening, emotions, health, and lifestyle). These client data were linked to data from the Netherlands Perinatal Register and electronic client records kept by midwives. Midwives and practice assistants from the twenty participating practices recorded work-related activities in a diary for one week, to assess workload. Besides, the midwives were asked to complete a questionnaire, to gain insight into collaboration of midwives with other care providers, their tasks and attitude towards their job, and the quality of the care they provide. Another questionnaire was sent to all Dutch midwifery practices which reveals information regarding the organisation of midwifery practices, provision of preconception care, collaboration with other care providers, and provision of care to ethnic minorities. Data at client, midwife and practice level can be linked. Additionally, partners of pregnant women and other care providers were asked about their expectations and experiences regarding the care delivered by midwives and in six practices client consults were videotaped to objectively assess daily practice. In total, 7685 clients completed at least one questionnaire, 136 midwives and

  1. Cohort profile

    Maret-Ouda, John; Wahlin, Karl; Artama, Miia

    2017-01-01

    Purpose: To describe a newly created all-Nordic cohort of patients with gastro-oesophageal reflux disease (GORD), entitled the Nordic Antireflux Surgery Cohort (NordASCo), which will be used to compare participants having undergone antireflux surgery with those who have not regarding risk...... age at primary antireflux surgery ranged from 47 to 52 years in the different countries. The coding practices of GORD seem to have differed between the Nordic countries. Future plans: The NordASCo will initially be used to analyse the risk of developing known or potential GORD-related cancers, that is......, tumours of the oesophagus, stomach, larynx, pharynx and lung, and to evaluate the mortality in the short-term and long-term perspectives. Additionally, the cohort will be used to evaluate the risk of non-malignant respiratory conditions that might be caused by aspiration of gastric contents....

  2. Prenatal exposure to multiple pesticides is associated with auditory brainstem response at 9months in a cohort study of Chinese infants.

    Sturza, Julie; Silver, Monica K; Xu, Lin; Li, Mingyan; Mai, Xiaoqin; Xia, Yankai; Shao, Jie; Lozoff, Betsy; Meeker, John

    2016-01-01

    exposure on ABR latency delay, suggesting an additive or multiplicative effect. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Cohort Profile

    Jespersen, Sanne; Hønge, Bo Langhoff; Oliveira, Inés

    2014-01-01

    The West African country Guinea-Bissau is home to the world’s highest prevalence of HIV-2, and its HIV-1 prevalence is rising. Other chronic viral infections like human T-lymphotropic virus type 1 (HTLV-1) and hepatitis B virus are common as well. The Bissau HIV Cohort was started in 2007 to gain...... new insights into the overall effect of introducing antiretroviral treatment in a treatment-naı ̈ve population with concomitant infection with three retroviruses (HIV-1, HIV-2 and HTLV-1) and tuberculosis. The cohort includes patients from the HIV clinic at Hospital Nacional Sima ̃ o Mendes, the main...

  4. Methodology Series Module 1: Cohort Studies.

    Setia, Maninder Singh

    2016-01-01

    Cohort design is a type of nonexperimental or observational study design. In a cohort study, the participants do not have the outcome of interest to begin with. They are selected based on the exposure status of the individual. They are then followed over time to evaluate for the occurrence of the outcome of interest. Some examples of cohort studies are (1) Framingham Cohort study, (2) Swiss HIV Cohort study, and (3) The Danish Cohort study of psoriasis and depression. These studies may be prospective, retrospective, or a combination of both of these types. Since at the time of entry into the cohort study, the individuals do not have outcome, the temporality between exposure and outcome is well defined in a cohort design. If the exposure is rare, then a cohort design is an efficient method to study the relation between exposure and outcomes. A retrospective cohort study can be completed fast and is relatively inexpensive compared with a prospective cohort study. Follow-up of the study participants is very important in a cohort study, and losses are an important source of bias in these types of studies. These studies are used to estimate the cumulative incidence and incidence rate. One of the main strengths of a cohort study is the longitudinal nature of the data. Some of the variables in the data will be time-varying and some may be time independent. Thus, advanced modeling techniques (such as fixed and random effects models) are useful in analysis of these studies.

  5. Methodology series module 1: Cohort studies

    Maninder Singh Setia

    2016-01-01

    Full Text Available Cohort design is a type of nonexperimental or observational study design. In a cohort study, the participants do not have the outcome of interest to begin with. They are selected based on the exposure status of the individual. They are then followed over time to evaluate for the occurrence of the outcome of interest. Some examples of cohort studies are (1 Framingham Cohort study, (2 Swiss HIV Cohort study, and (3 The Danish Cohort study of psoriasis and depression. These studies may be prospective, retrospective, or a combination of both of these types. Since at the time of entry into the cohort study, the individuals do not have outcome, the temporality between exposure and outcome is well defined in a cohort design. If the exposure is rare, then a cohort design is an efficient method to study the relation between exposure and outcomes. A retrospective cohort study can be completed fast and is relatively inexpensive compared with a prospective cohort study. Follow-up of the study participants is very important in a cohort study, and losses are an important source of bias in these types of studies. These studies are used to estimate the cumulative incidence and incidence rate. One of the main strengths of a cohort study is the longitudinal nature of the data. Some of the variables in the data will be time-varying and some may be time independent. Thus, advanced modeling techniques (such as fixed and random effects models are useful in analysis of these studies.

  6. The Danish National Birth Cohort

    Andersen, Anne-Marie Nybo; Olsen, Jørn

    2011-01-01

    , physical exercise, working conditions, medication and infections during pregnancy, and environmental possible toxins. The study designs cover straightforward cohort analyses, case-control studies and sub-cohort analyses with enriched data collection. CONCLUSION: So far, the Danish National Birth Cohort has......INTRODUCTION: In this review a selection of studies published during the period 2002-2010, based on data from the Danish National Birth Cohort linked with other health registers, is described. Illustrative examples of studies addressing perinatal health outcomes (pregnancy complications and fetal...... that this investment in epidemiologic infrastructure was well spent. The existence of the Danish National Birth Cohort together with other cohorts and national registers has given Denmark a leading position in reproductive epidemiology....

  7. Comparison of Multiple Linear Regressions and Neural Networks based QSAR models for the design of new antitubercular compounds.

    Ventura, Cristina; Latino, Diogo A R S; Martins, Filomena

    2013-01-01

    The performance of two QSAR methodologies, namely Multiple Linear Regressions (MLR) and Neural Networks (NN), towards the modeling and prediction of antitubercular activity was evaluated and compared. A data set of 173 potentially active compounds belonging to the hydrazide family and represented by 96 descriptors was analyzed. Models were built with Multiple Linear Regressions (MLR), single Feed-Forward Neural Networks (FFNNs), ensembles of FFNNs and Associative Neural Networks (AsNNs) using four different data sets and different types of descriptors. The predictive ability of the different techniques used were assessed and discussed on the basis of different validation criteria and results show in general a better performance of AsNNs in terms of learning ability and prediction of antitubercular behaviors when compared with all other methods. MLR have, however, the advantage of pinpointing the most relevant molecular characteristics responsible for the behavior of these compounds against Mycobacterium tuberculosis. The best results for the larger data set (94 compounds in training set and 18 in test set) were obtained with AsNNs using seven descriptors (R(2) of 0.874 and RMSE of 0.437 against R(2) of 0.845 and RMSE of 0.472 in MLRs, for test set). Counter-Propagation Neural Networks (CPNNs) were trained with the same data sets and descriptors. From the scrutiny of the weight levels in each CPNN and the information retrieved from MLRs, a rational design of potentially active compounds was attempted. Two new compounds were synthesized and tested against M. tuberculosis showing an activity close to that predicted by the majority of the models. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  8. A police education programme to integrate occupational safety and HIV prevention: protocol for a modified stepped-wedge study design with parallel prospective cohorts to assess behavioural outcomes

    Strathdee, Steffanie A; Arredondo, Jaime; Rocha, Teresita; Abramovitz, Daniela; Rolon, Maria Luisa; Patiño Mandujano, Efrain; Rangel, Maria Gudelia; Olivarria, Horcasitas Omar; Gaines, Tommi; Patterson, Thomas L; Beletsky, Leo

    2015-01-01

    Introduction Policing practices are key drivers of HIV among people who inject drugs (PWID). This paper describes the protocol for the first study to prospectively examine the impact of a police education programme (PEP) to align law enforcement and HIV prevention. PEPs incorporating HIV prevention (including harm reduction programmes like syringe exchange) have been successfully piloted in several countries but were limited to brief pre–post assessments; the impact of PEPs on policing behaviours and occupational safety is unknown. Objectives Proyecto ESCUDO (SHIELD) aims to evaluate the efficacy of the PEP on uptake of occupational safety procedures, as assessed through the incidence of needle stick injuries (NSIs) (primary outcome) and changes in knowledge of transmission, prevention and treatment of HIV and viral hepatitis; attitudes towards PWID, adverse behaviours that interfere with HIV prevention and protective behaviours (secondary outcomes). Methods/analysis ESCUDO is a hybrid type I design that simultaneously tests an intervention and an implementation strategy. Using a modified stepped-wedge design involving all active duty street-level police officers in Tijuana (N=∼1200), we will administer one 3 h PEP course to groups of 20–50 officers until the entire force is trained. NSI incidence and geocoded arrest data will be assessed from department-wide de-identified data. Of the consenting police officers, a subcohort (N=500) will be randomly sampled from each class to undergo pre-PEP and post-PEP surveys with a semiannual follow-up for 2 years to assess self-reported NSIs, attitudes and behaviour changes. The impact on PWIDs will be externally validated through a parallel cohort of Tijuana PWIDs. Ethics/dissemination Research ethics approval was obtained from the USA and Mexico. Findings will be disseminated through open access to protocol materials through the Law Enforcement and HIV Network. Trial registration number NCT02444403. PMID:26260350

  9. Improving return-to-work after childbirth: design of the Mom@Work study, a randomised controlled trial and cohort study.

    Stomp-van den Berg, Suzanne G M; van Poppel, Mireille N M; Hendriksen, Ingrid J M; Bruinvels, David J; Uegaki, Kimi; de Bruijne, Martine C; van Mechelen, Willem

    2007-03-29

    Many women suffer from health problems after giving birth, which can lead to sick leave. About 30% of Dutch workers are on sick leave after maternity leave. Structural contact of supervisors with employees on maternity leave, supported by early medical advice of occupational physicians, may increase the chances of return-to-work after maternity leave. In addition, to understand the process of sick leave and return-to-work after childbirth it is important to gain insight into which factors hinder return-to-work after childbirth, as well, as which prognostic factors lead to the development of postpartum health complaints. In this paper, the design of the Mom@Work study is described. The Mom@Work study is simultaneously a randomised controlled trial and a cohort study. Pregnant women working for at least 12 hours a week at one of the 15 participating companies are eligible to participate. The supervisors of these pregnant employees are randomised at 35 weeks pregnancy into the intervention group or control group. During maternity leave, supervisors in the intervention group contact their employee six weeks after delivery using a structured interview. When employees do not expect to return to their jobs at the end of their scheduled maternity leave due to health problems, the supervisor offers early support of the occupational physician. Supervisors in the control group have no structural contact with their employees during maternity leave. Measurements take place at 30 weeks pregnancy and at 6, 12, 24 and 52 weeks postpartum. In addition, cost data are collected. For the RCT, primary outcome measures are sick leave and return-to-work, and secondary outcome measures are costs, health, satisfaction with intervention and global feelings of recovery. Outcome measures for the cohort are pregnancy-related pelvic girdle pain, fatigue and depression. Finally, a number of prognostic factors for return-to-work and for the development of complaints will be measured. The Mom

  10. Improving return-to-work after childbirth: design of the Mom@Work study, a randomised controlled trial and cohort study

    Bruinvels David J

    2007-03-01

    Full Text Available Abstract Background Many women suffer from health problems after giving birth, which can lead to sick leave. About 30% of Dutch workers are on sick leave after maternity leave. Structural contact of supervisors with employees on maternity leave, supported by early medical advice of occupational physicians, may increase the chances of return-to-work after maternity leave. In addition, to understand the process of sick leave and return-to-work after childbirth it is important to gain insight into which factors hinder return-to-work after childbirth, as well, as which prognostic factors lead to the development of postpartum health complaints. In this paper, the design of the Mom@Work study is described. Methods The Mom@Work study is simultaneously a randomised controlled trial and a cohort study. Pregnant women working for at least 12 hours a week at one of the 15 participating companies are eligible to participate. The supervisors of these pregnant employees are randomised at 35 weeks pregnancy into the intervention group or control group. During maternity leave, supervisors in the intervention group contact their employee six weeks after delivery using a structured interview. When employees do not expect to return to their jobs at the end of their scheduled maternity leave due to health problems, the supervisor offers early support of the occupational physician. Supervisors in the control group have no structural contact with their employees during maternity leave. Measurements take place at 30 weeks pregnancy and at 6, 12, 24 and 52 weeks postpartum. In addition, cost data are collected. For the RCT, primary outcome measures are sick leave and return-to-work, and secondary outcome measures are costs, health, satisfaction with intervention and global feelings of recovery. Outcome measures for the cohort are pregnancy-related pelvic girdle pain, fatigue and depression. Finally, a number of prognostic factors for return-to-work and for the

  11. Drug adherence and multidisciplinary care in patients with multiple sclerosis: Protocol of a prospective, web-based, patient-centred, nation-wide, Dutch cohort study in glatiramer acetate treated patients (CAIR study

    Siepman Theodora

    2011-03-01

    Full Text Available Abstract Background Multiple sclerosis (MS is a chronic inflammatory demyelinating disease of the central nervous system, for which no definitive treatment is available. Most patients start with a relapsing-remitting course (RRMS. Disease-modifying drugs (DMDs reduce relapses and disability progression. First line DMDs include glatiramer acetate (GA, interferon-beta (INFb-1a and INFb-1b, which are all administered via injections. Effectiveness of DMD treatment depends on adequate adherence, meaning year-long continuation of injections with a minimum of missed doses. In real-life practice DMD-treated patients miss 30% of doses. The 6-month discontinuation rate is up to 27% and most patients who discontinue do so in the first 12 months. Treatment adherence is influenced by the socio-economic situation, health care and caregivers, disease, treatment and patient characteristics. Only a few studies have dealt with adherence-related factors in DMD-treated patients. Self-efficacy expectations were found to be related to GA adherence. Patient education and optimal support improve adherence in general. Knowledge of the aspects of care that significantly relate to adherence could lead to adherence-improving measures. Moreover, identification of patients at risk of inadequate adherence could lead to more efficient care. In the near future new drugs will become available for RRMS. Detailed knowledge on factors prognostic of adherence and on care aspects that are associated with adequate adherence will improve the chances of these drugs becoming effective treatments. We investigate in RRMS patients the relationship between drug adherence and multidisciplinary care, as well as factors associated with adherence. Given the differences in the frequency of administration and in the side effects between the DMDs we decided to study patients treated with the same DMD, GA. Methods/design The Correlative analyses of Adherence In Relapsing remitting MS (CAIR study is

  12. H-Shaped Multiple Linear Motor Drive Platform Control System Design Based on an Inverse System Method

    Caiyan Qin

    2017-12-01

    Full Text Available Due to its simple mechanical structure and high motion stability, the H-shaped platform has been increasingly widely used in precision measuring, numerical control machining and semiconductor packaging equipment, etc. The H-shaped platform is normally driven by multiple (three permanent magnet synchronous linear motors. The main challenges for H-shaped platform-control include synchronous control between the two linear motors in the Y direction as well as total positioning error of the platform mover, a combination of position deviation in X and Y directions. To deal with the above challenges, this paper proposes a control strategy based on the inverse system method through state feedback and dynamic decoupling of the thrust force. First, mechanical dynamics equations have been deduced through the analysis of system coupling based on the platform structure. Second, the mathematical model of the linear motors and the relevant coordinate transformation between dq-axis currents and ABC-phase currents are analyzed. Third, after the main concept of inverse system method being explained, the inverse system model of the platform control system has been designed after defining relevant system variables. Inverse system model compensates the original nonlinear coupled system into pseudo-linear decoupled linear system, for which typical linear control methods, like PID, can be adopted to control the system. The simulation model of the control system is built in MATLAB/Simulink and the simulation result shows that the designed control system has both small synchronous deviation and small total trajectory tracking error. Furthermore, the control program has been run on NI controller for both fixed-loop-time and free-loop-time modes, and the test result shows that the average loop computation time needed is rather small, which makes it suitable for real industrial applications. Overall, it proves that the proposed new control strategy can be used in

  13. Evaluation of multiple hydraulic models in generating design/near-real time flood inundation extents under various geophysical settings

    Liu, Z.; Rajib, M. A.; Jafarzadegan, K.; Merwade, V.

    2015-12-01

    Application of land surface/hydrologic models within an operational flood forecasting system can provide probable time of occurrence and magnitude of streamflow at specific locations along a stream. Creating time-varying spatial extent of flood inundation and depth requires the use of a hydraulic or hydrodynamic model. Models differ in representing river geometry and surface roughness which can lead to different output depending on the particular model being used. The result from a single hydraulic model provides just one possible realization of the flood extent without capturing the uncertainty associated with the input or the model parameters. The objective of this study is to compare multiple hydraulic models toward generating ensemble flood inundation extents. Specifically, relative performances of four hydraulic models, including AutoRoute, HEC-RAS, HEC-RAS 2D, and LISFLOOD are evaluated under different geophysical conditions in several locations across the United States. By using streamflow output from the same hydrologic model (SWAT in this case), hydraulic simulations are conducted for three configurations: (i) hindcasting mode by using past observed weather data at daily time scale in which models are being calibrated against USGS streamflow observations, (ii) validation mode using near real-time weather data at sub-daily time scale, and (iii) design mode with extreme streamflow data having specific return periods. Model generated inundation maps for observed flood events both from hindcasting and validation modes are compared with remotely sensed images, whereas the design mode outcomes are compared with corresponding FEMA generated flood hazard maps. The comparisons presented here will give insights on probable model-specific nature of biases and their relative advantages/disadvantages as components of an operational flood forecasting system.

  14. Substrate-Integrated Waveguide PCB Leaky-Wave Antenna Design Providing Multiple Steerable Beams in the V-Band

    Matthias Steeg

    2017-12-01

    Full Text Available A periodic leaky-wave antenna (LWA design based on low loss substrate-integrated waveguide (SIW technology with inset half-wave microstrip antennas is presented. The developed LWA operates in the V-band between 50 and 70 GHz and has been fabricated using standard printed circuit board (PCB technology. The presented LWA is highly functional and very compact supporting 1D beam steering and multibeam operation with only a single radio frequency (RF feeding port. Within the operational 50–70 GHz bandwidth, the LWA scans through broadside, providing over 40° H-plane beam steering. When operated within the 57–66 GHz band, the maximum steering angle is 18.2°. The maximum gain of the fabricated LWAs is 15.4 dBi with only a small gain variation of +/−1.5 dB across the operational bandwidth. The beam steering and multibeam capability of the fabricated LWA is further utilized to support mobile users in a 60 GHz hot-spot. For a single user, a maximum wireless on-off keying (OOK data rate of 2.5 Gbit/s is demonstrated. Multibeam operation is achieved using the LWA in combination with multiple dense wavelength division multiplexing (WDM channels and remote optical heterodyning. Experimentally, multibeam operation supporting three users within a 57–66 GHz hot-spot with a total wireless cell capacity of 3 Gbit/s is achieved.

  15. Design of six pulse bridge multiplication converter model for current harmonic elimination of three phase ac-dc converter

    Soomro, M.A.; Helepoto, I.A.

    2014-01-01

    The recent development of semiconductor technology and wide spread use of power electronic devices in power system have open the era of the power system harmonics due to increasing penetration of non-linear loads. Harmonics are widely admitted as most important issues of power quality which must be eliminated to maintain power system reliability. The tolerable THD (Total Harmonic Distortion) values must be bounded in well-defined limits recognized by IEEE-519 standard. In this work, in order to eliminate the current harmonics produced by non-linear loads, six pulse multiplication converter technique in conjunction with STSSHPE (Single Tuned Shunt Harmonic Passive Filter) is proposed. The proposed model has the capacity of harmonic cancellation of the dominant 3rd order harmonics. Besides that, the 5th and 7th order harmonics are also reduced to a diminishing level. The hardware model has been experimentally tested by PQA (Power Quality Analyzer) and simulation model is designed using MATLAB software. The acquired results have been measured by considering THD values in terms of current and voltage. Furthermore, they have been compared against IEEE-519 performance standards. The prosed model, successfully bounds the total harmonic distortion under defined limits by IEEE-519 standard. (author)

  16. Incorporating 3D-printing technology in the design of head-caps and electrode drives for recording neurons in multiple brain regions.

    Headley, Drew B; DeLucca, Michael V; Haufler, Darrell; Paré, Denis

    2015-04-01

    Recent advances in recording and computing hardware have enabled laboratories to record the electrical activity of multiple brain regions simultaneously. Lagging behind these technical advances, however, are the methods needed to rapidly produce microdrives and head-caps that can flexibly accommodate different recording configurations. Indeed, most available designs target single or adjacent brain regions, and, if multiple sites are targeted, specially constructed head-caps are used. Here, we present a novel design style, for both microdrives and head-caps, which takes advantage of three-dimensional printing technology. This design facilitates targeting of multiple brain regions in various configurations. Moreover, the parts are easily fabricated in large quantities, with only minor hand-tooling and finishing required. Copyright © 2015 the American Physiological Society.

  17. Design of a biomass-to-biorefinery logistics system through bio-inspired metaheuristic optimization considering multiple types of feedstocks

    Trueba, Isidoro

    fossil fuels to biofuels. In many ways biomass is a unique renewable resource. It can be stored and transported relatively easily in contrast to renewable options such as wind and solar, which create intermittent electrical power that requires immediate consumption and a connection to the grid. This thesis presents two different models for the design optimization of a biomass-to-biorefinery logistics system through bio-inspired metaheuristic optimization considering multiple types of feedstocks. This work compares the performance and solutions obtained by two types of metaheuristic approaches; genetic algorithm and ant colony optimization. Compared to rigorous mathematical optimization methods or iterative algorithms, metaheuristics do not guarantee that a global optimal solution can be found on some class of problems. Problems with similar characteristics to the one presented in this thesis have been previously solved using linear programming, integer programming and mixed integer programming methods. However, depending on the type of problem, these mathematical or complete methods might need exponential computation time in the worst-case. This often leads to computation times too high for practical purposes. Therefore, this thesis develops two types of metaheuristic approaches for the design optimization of a biomass-to-biorefinery logistics system considering multiple types of feedstocks and shows that metaheuristics are highly suitable to solve hard combinatorial optimization problems such as the one addressed in this research work.

  18. Multiple inflammatory biomarker detection in a prospective cohort study: a cross-validation between well-established single-biomarker techniques and an electrochemiluminescense-based multi-array platform.

    Bas C T van Bussel

    Full Text Available BACKGROUND: In terms of time, effort and quality, multiplex technology is an attractive alternative for well-established single-biomarker measurements in clinical studies. However, limited data comparing these methods are available. METHODS: We measured, in a large ongoing cohort study (n = 574, by means of both a 4-plex multi-array biomarker assay developed by MesoScaleDiscovery (MSD and single-biomarker techniques (ELISA or immunoturbidimetric assay, the following biomarkers of low-grade inflammation: C-reactive protein (CRP, serum amyloid A (SAA, soluble intercellular adhesion molecule 1 (sICAM-1 and soluble vascular cell adhesion molecule 1 (sVCAM-1. These measures were realigned by weighted Deming regression and compared across a wide spectrum of subjects' cardiovascular risk factors by ANOVA. RESULTS: Despite that both methods ranked individuals' levels of biomarkers very similarly (Pearson's r all≥0.755 absolute concentrations of all biomarkers differed significantly between methods. Equations retrieved by the Deming regression enabled proper realignment of the data to overcome these differences, such that intra-class correlation coefficients were then 0.996 (CRP, 0.711 (SAA, 0.895 (sICAM-1 and 0.858 (sVCAM-1. Additionally, individual biomarkers differed across categories of glucose metabolism, weight, metabolic syndrome and smoking status to a similar extent by either method. CONCLUSIONS: Multiple low-grade inflammatory biomarker data obtained by the 4-plex multi-array platform of MSD or by well-established single-biomarker methods are comparable after proper realignment of differences in absolute concentrations, and are equally associated with cardiovascular risk factors, regardless of such differences. Given its greater efficiency, the MSD platform is a potential tool for the quantification of multiple biomarkers of low-grade inflammation in large ongoing and future clinical studies.

  19. Design and Control of a Multiple Input DC/DC Converter for Battery/Ultra-capacitor Based Electric Vehicle Power System

    Schaltz, Erik; Li, Zhihao; Onar, Omer

    2009-01-01

    Battery/Ultra-capacitor based electrical vehicles (EV) combine two energy sources with different voltage levels and current characteristics. This paper focuses on design and control of a multiple input DC/DC converter, to regulate output voltage from different inputs. The proposed multi-input con......Battery/Ultra-capacitor based electrical vehicles (EV) combine two energy sources with different voltage levels and current characteristics. This paper focuses on design and control of a multiple input DC/DC converter, to regulate output voltage from different inputs. The proposed multi...

  20. Circulating 25-Hydroxyvitamin D and the Risk of Rarer Cancers: Design and Methods of the Cohort Consortium Vitamin D Pooling Project of Rarer Cancers

    Gallicchio, Lisa; Helzlsouer, Kathy J.; Chow, Wong-Ho; Freedman, D. Michal; Hankinson, Susan E.; Hartge, Patricia; Hartmuller, Virginia; Harvey, Chinonye; Hayes, Richard B.; Horst, Ronald L.; Koenig, Karen L.; Kolonel, Laurence N.; Laden, Francine; McCullough, Marjorie L.; Parisi, Dominick

    2010-01-01

    The Cohort Consortium Vitamin D Pooling Project of Rarer Cancers (VDPP), a consortium of 10 prospective cohort studies from the United States, Finland, and China, was formed to examine the associations between circulating 25-hydroxyvitamin D (25(OH)D) concentrations and the risk of rarer cancers. Cases (total n = 5,491) included incident primary endometrial (n = 830), kidney (n = 775), ovarian (n = 516), pancreatic (n = 952), and upper gastrointestinal tract (n = 1,065) cancers and non-Hodgki...

  1. The design, rationale, and baseline characteristics of a nationwide cohort registry in China: blood pressure and clinical outcome in TIA or ischemic stroke.

    Xu, Jie; Liu, Yi; Tao, Yongli; Xie, Xuewei; Gu, Hongqiu; Pan, Yuesong; Zhao, Xingquan; Wang, Yongjun; Yan, Aoshuang; Wang, Yilong

    2016-01-01

    The relationship between poststroke blood pressure (BP) and clinical outcomes in ischemic stroke (IS) is still controversial. However, there is no large BP database for IS or transient ischemic attack (TIA) in China. This study aims to describe the rationale, study design, and baseline characteristics of a nationwide BP database in IS or TIA patients in China. The BOSS (blood pressure and clinical outcome in TIA or ischemic stroke) study was a hospital-based, prospective cohort study aiming to assess BP parameters and clinical outcome in IS/TIA patients. BP parameters were based on office BP, ambulatory BP, and home BP. Clinical outcomes included stroke recurrence, combined vascular events, and disability. Electronic case-report forms were used to record baseline and follow-up data. The patients were followed up for clinical outcomes at 3 months through face-to-face interview and at 12 months by telephone. Between October 2012 and February 2014, the BOSS registry recruited 2,608 patients from 61 hospitals, with a mean age of 62.5 years, 32.4% of whom were female, 88.9% with an entry diagnosis of IS, and 86% diagnosed with hypertension. The rates of patients lost-to-follow-up were 3.1% at 3 months and 5.1% at 1 year; 93% of patients completed ambulatory BP monitoring during hospitalization and 94.7% finished a 3-month BP diary. The BOSS registry will provide important evidence about BP management in the acute phase and secondary prevention for IS/TIA patients.

  2. The rationale/design of the Guimarães/Vizela study: a multimodal population-based cohort study to determine global cardiovascular risk and disease.

    Cunha, Pedro Guimarães; Cotter, Jorge; Oliveira, Pedro; Vila, Isabel; Sousa, Nuno

    2014-06-01

    Cardiovascular disease and dementia are growing medical and social problems in aging societies. Appropriate knowledge of cardiovascular disease and cognitive decline risk factors (RFs) are critical for global CVR health preventive intervention. Many epidemiological studies use case definition based on data collected/measured in a single visit, a fact that can overestimate prevalence rates and distant from clinical practice demanding criteria. Portugal displays an elevated stroke mortality rate. However, population's global CV risk characterization is limited, namely, considering traditional/nontraditional RF and new intermediate phenotypes of CV and renal disease. Association of hemodynamic variables (pulse wave velocity and central blood pressure) with global CVR stratification, cognitive performance, and kidney disease are practically inexistent at a dwelling population level. After reviewing published data, we designed a population-based cohort study to analyze the prevalence of these cardiovascular RFs and intermediate phenotypes, using random sampling of adult dwellers living in 2 adjacent cities. Strict definition of phenotypes was planned: subjects were observed twice, and several hemodynamic and other biological variables measured at least 3 months apart. Three thousand thirty-eight subjects were enrolled, and extensive data collection (including central and peripheral blood pressure, pulse wave velocity), sample processing, and biobank edification were carried out. One thousand forty-seven cognitive evaluations were performed. Seeking for CV risk reclassification, early identification of subjects at risk, and evidence of early vascular aging and cognitive and renal function decline, using the strict daily clinical practice criteria, will lead to better resource allocation in preventive measures at a population level.

  3. Age, time period, and birth cohort differences in self-esteem: Reexamining a cohort-sequential longitudinal study.

    Twenge, Jean M; Carter, Nathan T; Campbell, W Keith

    2017-05-01

    Orth, Trzesniewski, and Robins (2010) concluded that the nationally representative Americans' Changing Lives (ACL) cohort-sequential study demonstrated moderate to large age differences in self-esteem, and no birth cohort (generational) differences in the age trajectory. In a reanalysis of these data using 2 different statistical techniques, we find significant increases in self-esteem that could be attributed to birth cohort or time period. First, hierarchical linear modeling analyses with birth cohort as a continuous variable (vs. the multiple group formulation used by Orth et al.) find that birth cohort has a measurable influence on self-esteem through its interaction with age. Participants born in later years (e.g., 1960) were higher in self-esteem and were more likely to increase in self-esteem as they aged than participants born in earlier years (e.g., 1920). However, the estimated age trajectory up to age 60 is similar in Orth et al.'s results and in the results from our analyses including cohort. Second, comparing ACL respondents of the same age in 1986 versus 2002 (a time-lag design) yields significant birth cohort differences in self-esteem, with 2002 participants of the same age higher in self-esteem than those in 1986. Combined with some previous studies finding significant increases in self-esteem and positive self-views over time, these results suggest that cultural change in the form of cohort and time period cannot be ignored as influences in cross-sectional and longitudinal studies. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  4. Predicting the outcome of chronic kidney disease by the estimated nephron number: The rationale and design of PRONEP, a prospective, multicenter, observational cohort study

    Imasawa Toshiyuki

    2012-03-01

    Full Text Available Abstract Background The nephron number is thought to be associated with the outcome of chronic kidney disease (CKD. If the nephron number can be estimated in the clinical setting, it could become a strong tool to predict renal outcome. This study was designed to estimate the nephron number in CKD patients and to establish a method to predict the outcome by using the estimated nephron number. Methods/Design The hypothesis of this study is that the estimated nephron number can predict the outcome of a CKD patient. This will be a multicenter, prospective (minimum 3 and maximum 5 years follow-up study. The subjects will comprise CKD patients aged over 14 years who have undergone a kidney biopsy. From January 2011 to March 2013, we will recruit 600 CKD patients from 10 hospitals belonging to the National Hospital Organization of Japan. The primary parameter for assessment is the composite of total mortality, renal death, cerebro-cardiovascular events, and a 50% reduction in the eGFR. The secondary parameter is the rate of eGFR decline per year. The nephron number will be estimated by the glomerular density in biopsy specimens and the renal cortex volume. This study includes one sub-cohort study to establish the equation to calculate the renal cortex volume. Enrollment will be performed at the time of the kidney biopsy, and the data will consist of a medical interview, ultrasound for measurement of the kidney size, blood or urine test, and the pathological findings of the kidney biopsy. Patients will continue to have medical consultations and receive examinations and/or treatment as usual. The data from the patients will be collected once a year after the kidney biopsy until March 2016. All data using this study are easily obtained in routine clinical practice. Discussion This study includes the first trials to estimate the renal cortex volume and nephron number in the general clinical setting. Furthermore, this is the first prospective study to

  5. Trajectories of disposable income among people of working ages diagnosed with multiple sclerosis: a nationwide register-based cohort study in Sweden 7 years before to 4 years after diagnosis with a population-based reference group.

    Murley, Chantelle; Mogard, Olof; Wiberg, Michael; Alexanderson, Kristina; Karampampa, Korinna; Friberg, Emilie; Tinghög, Petter

    2018-05-09

    To describe how disposable income (DI) and three main components changed, and analyse whether DI development differed from working-aged people with multiple sclerosis (MS) to a reference group from 7 years before to 4 years after diagnosis in Sweden. Population-based cohort study, 12-year follow-up (7 years before to 4 years after diagnosis). Swedish working-age population with microdata linked from two nationwide registers. Residents diagnosed with MS in 2009 aged 25-59 years (n=785), and references without MS (n=7847) randomly selected with stratified matching (sex, age, education and country of birth). DI was defined as the annual after tax sum of incomes (earnings and benefits) to measure individual economic welfare. Three main components of DI were analysed as annual sums: earnings, sickness absence benefits and disability pension benefits. We found no differences in mean annual DI between people with and without MS by independent t-tests (p values between 0.15 and 0.96). Differences were found for all studied components of DI from diagnosis year by independent t-tests, for example, in the final study year (2013): earnings (-64 867 Swedish Krona (SEK); 95% CI-79 203 to -50 528); sickness absence benefits (13 330 SEK; 95% CI 10 042 to 16 500); and disability pension benefits (21 360 SEK; 95% CI 17 380 to 25 350). A generalised estimating equation evaluated DI trajectory development between people with and without MS to find both trajectories developed in parallel, both before (-4039 SEK; 95% CI -10 536 to 2458) and after (-781 SEK; 95% CI -6988 to 5360) diagnosis. The key finding of parallel DI trajectory development between working-aged MS and references suggests minimal economic impact within the first 4 years of diagnosis. The Swedish welfare system was responsive to the observed reductions in earnings around MS diagnosis through balancing DI with morbidity-related benefits. Future decreases in economic welfare may be experienced as the

  6. Design and development of an ethnically-diverse imaging informatics-based eFolder system for multiple sclerosis patients.

    Ma, Kevin C; Fernandez, James R; Amezcua, Lilyana; Lerner, Alex; Shiroishi, Mark S; Liu, Brent J

    2015-12-01

    MRI has been used to identify multiple sclerosis (MS) lesions in brain and spinal cord visually. Integrating patient information into an electronic patient record system has become key for modern patient care in medicine in recent years. Clinically, it is also necessary to track patients' progress in longitudinal studies, in order to provide comprehensive understanding of disease progression and response to treatment. As the amount of required data increases, there exists a need for an efficient systematic solution to store and analyze MS patient data, disease profiles, and disease tracking for both clinical and research purposes. An imaging informatics based system, called MS eFolder, has been developed as an integrated patient record system for data storage and analysis of MS patients. The eFolder system, with a DICOM-based database, includes a module for lesion contouring by radiologists, a MS lesion quantification tool to quantify MS lesion volume in 3D, brain parenchyma fraction analysis, and provide quantitative analysis and tracking of volume changes in longitudinal studies. Patient data, including MR images, have been collected retrospectively at University of Southern California Medical Center (USC) and Los Angeles County Hospital (LAC). The MS eFolder utilizes web-based components, such as browser-based graphical user interface (GUI) and web-based database. The eFolder database stores patient clinical data (demographics, MS disease history, family history, etc.), MR imaging-related data found in DICOM headers, and lesion quantification results. Lesion quantification results are derived from radiologists' contours on brain MRI studies and quantified into 3-dimensional volumes and locations. Quantified results of white matter lesions are integrated into a structured report based on DICOM-SR protocol and templates. The user interface displays patient clinical information, original MR images, and viewing structured reports of quantified results. The GUI also

  7. Design and performance of multiple effect basin type solar still; Basin-taju koyo fukugogata taiyonetsu joryuki no kaihatsu

    Tanaka, H; Nosoko, T; Nagata, T [Univ. of the Ryukyus, Okinawa (Japan)

    1997-11-25

    A seawater desalinating still was devised, which utilizes solar heat and combines a basin type still with a multiple effect type still. The devised still has a triangular cross section, has a seawater basin at its bottom, wherein the slope facing the sun has a double glass window, and the other slope is arranged with a multiple effect still (three-step effect system). The sun light that has permeated the double glass window heats and evaporates seawater on the basin. Majority of the generated steam is condensed at the lower face of a lowermost partition of the multiple effect section, and its latent heat evaporates the seawater contained in a wick on the rear side. The steam is condensed at the lower face of the second partition, this action is repeated sequentially to upper plates, and the heat is discharged finally into the surrounding air from the uppermost face of the multiple effect section. Seawater is supplied from the upper part onto the wick in each partition, which is evaporated, condensed and recovered at the lower part. The condensate is recovered at the lower part of each plate. The construction is simpler than the conventional downward indirect heating multiple effect type still, and the distilling efficiency is improved by 30%. Technological difficulty in the upward direct heating multiple effect type still can also be improved. 6 refs., 6 figs., 2 tabs.

  8. Effect of a combined education and eHealth programme on the control of oral anticoagulation patients (PORTALS study): a parallel cohort design in Dutch primary care.

    Talboom-Kamp, Esther P W A; Verdijk, Noortje A; Kasteleyn, Marise J; Harmans, Lara M; Talboom, Irvin J S H; Numans, Mattijs E; Chavannes, Niels H

    2017-09-27

    To analyse the effect on therapeutic control and self-management skills of the implementation of self-management programmes, including eHealth by e-learning versus group training. Primary Care Thrombosis Service Center. Of the 247 oral anticoagulation therapy (OAT) patients, 63 started self-management by e-learning, 74 self-management by group training and 110 received usual care. Parallel cohort design with two randomised self-management groups (e-learning and group training) and a group receiving usual care. The effect of implementation of self-management on time in therapeutic range (TTR) was analysed with multilevel linear regression modelling. Usage of a supporting eHealth platform and the impact on self-efficacy (Generalised Self-Efficacy Scale (GSES)) and education level were analysed with linear regression analysis. After intervention, TTR was measured in three time periods of 6 months. (1) TTR, severe complications,(2) usage of an eHealth platform,(3) GSES, education level. Analysis showed no significant differences in TTR between the three time periods (p=0.520), the three groups (p=0.460) or the groups over time (p=0.263). Comparison of e-learning and group training showed no significant differences in TTR between the time periods (p=0.614), the groups (p=0.460) or the groups over time (p=0.263). No association was found between GSES and TTR (p=0.717) or education level and TTR (p=0.107). No significant difference was found between the self-management groups in usage of the platform (0-6 months p=0.571; 6-12 months p=0.866; 12-18 months p=0.260). The percentage of complications was low in all groups (3.2%; 1.4%; 0%). No differences were found between OAT patients trained by e-learning or by a group course regarding therapeutic control (TTR) and usage of a supporting eHealth platform. The TTR was similar in self-management and regular care patients. With adequate e-learning or group training, self-management seems safe and reliable for a selected

  9. Circulating 25-hydroxyvitamin D and the risk of rarer cancers: Design and methods of the Cohort Consortium Vitamin D Pooling Project of Rarer Cancers.

    Gallicchio, Lisa; Helzlsouer, Kathy J; Chow, Wong-Ho; Freedman, D Michal; Hankinson, Susan E; Hartge, Patricia; Hartmuller, Virginia; Harvey, Chinonye; Hayes, Richard B; Horst, Ronald L; Koenig, Karen L; Kolonel, Laurence N; Laden, Francine; McCullough, Marjorie L; Parisi, Dominick; Purdue, Mark P; Shu, Xiao-Ou; Snyder, Kirk; Stolzenberg-Solomon, Rachael Z; Tworoger, Shelley S; Varanasi, Arti; Virtamo, Jarmo; Wilkens, Lynne R; Xiang, Yong-Bing; Yu, Kai; Zeleniuch-Jacquotte, Anne; Zheng, Wei; Abnet, Christian C; Albanes, Demetrius; Bertrand, Kimberly; Weinstein, Stephanie J

    2010-07-01

    The Cohort Consortium Vitamin D Pooling Project of Rarer Cancers (VDPP), a consortium of 10 prospective cohort studies from the United States, Finland, and China, was formed to examine the associations between circulating 25-hydroxyvitamin D (25(OH)D) concentrations and the risk of rarer cancers. Cases (total n = 5,491) included incident primary endometrial (n = 830), kidney (n = 775), ovarian (n = 516), pancreatic (n = 952), and upper gastrointestinal tract (n = 1,065) cancers and non-Hodgkin lymphoma (n = 1,353) diagnosed in the participating cohorts. At least 1 control was matched to each case on age, date of blood collection (1974-2006), sex, and race/ethnicity (n = 6,714). Covariate data were obtained from each cohort in a standardized manner. The majority of the serum or plasma samples were assayed in a central laboratory using a direct, competitive chemiluminescence immunoassay on the DiaSorin LIAISON platform (DiaSorin, Inc., Stillwater, Minnesota). Masked quality control samples included serum standards from the US National Institute of Standards and Technology. Conditional logistic regression analyses were conducted using clinically defined cutpoints, with 50-<75 nmol/L as the reference category. Meta-analyses were also conducted using inverse-variance weights in random-effects models. This consortium approach permits estimation of the association between 25(OH)D and several rarer cancers with high accuracy and precision across a wide range of 25(OH)D concentrations.

  10. Game Design and Learning: A Conjectural Analysis of How Massively Multiple Online Role-Playing Games (MMORPGs) Foster Intrinsic Motivation

    Dickey, Michele D.

    2007-01-01

    During the past two decades, the popularity of computer and video games has prompted games to become a source of study for educational researchers and instructional designers investigating how various aspects of game design might be appropriated, borrowed, and re-purposed for the design of educational materials. The purpose of this paper is to…

  11. Establishing a birth cohort to investigate the course and aetiology of asthma and allergies across three generations - rationale, design, and methods of the ACROSSOLAR study.

    Weinmann, Tobias; Gerlich, Jessica; Heinrich, Sabine; Nowak, Dennis; Gerdes, Jennifer; Schlichtiger, Jenny; von Mutius, Erika; Schaub, Bianca; Vogelberg, Christian; Roller, Diana; Radon, Katja

    2015-12-04

    Atopic diseases are a major burden of disease on a global scale. Regarding their aetiology, the early years of life are assumed to play a crucial role. In addition, there is growing evidence that elucidating the impact of cross-generational effects and epigenetic mechanisms such as DNA methylation can substantially widen the scientific knowledge of the occurrence and progression of these diseases. We are thus aiming at following the course of asthma, allergies, and potential risk factors for their occurrence across three generations by establishing a birth cohort in the offspring of an existing population-based cohort. 2051 young adults who have been recruited in 1995 for Phase II of the International Study of Asthma and Allergies in Childhood (ISAAC) and who have subsequently been followed-up by the Study on Occupational Allergy Risks (SOLAR) are asked bi-annually since 2009 if they conceived a child in the meantime. If parenthood is reported, parents are invited to enrol along with their children in the ACROSSOLAR cohort. Participation involves completing a questionnaire assessing general and health-related information about the course of the pregnancy and the first year of life of their children. Subsequently, the children are followed up until primary school age when asthma and allergies can be diagnosed reliably. In addition, DNA for epigenetic analysis will be collected and analysed. Longitudinal data analysis techniques will then be used to assess potential associations between early-life exposures and onset of childhood asthma and allergies taking into account epigenetics. Birth cohorts are especially suited to elucidate the impact of genetic predisposition, epigenetics, exposures during the first years of life, and gene-environment interactions on the occurrence and progression of asthma and allergies. By building upon an existing cohort, ACROSSOLAR offers a unique and cost-effective opportunity to investigate the aetiology of atopic disease in a

  12. Assessing Hepatitis C Burden and Treatment Effectiveness through the British Columbia Hepatitis Testers Cohort (BC-HTC): Design and Characteristics of Linked and Unlinked Participants.

    Janjua, Naveed Zafar; Kuo, Margot; Chong, Mei; Yu, Amanda; Alvarez, Maria; Cook, Darrel; Armour, Rosemary; Aiken, Ciaran; Li, Karen; Mussavi Rizi, Seyed Ali; Woods, Ryan; Godfrey, David; Wong, Jason; Gilbert, Mark; Tyndall, Mark W; Krajden, Mel

    2016-01-01

    The British Columbia (BC) Hepatitis Testers Cohort (BC-HTC) was established to assess and monitor hepatitis C (HCV) epidemiology, cost of illness and treatment effectiveness in BC, Canada. In this paper, we describe the cohort construction, data linkage process, linkage yields, and comparison of the characteristics of linked and unlinked individuals. The BC-HTC includes all individuals tested for HCV and/or HIV or reported as a case of HCV, hepatitis B (HBV), HIV or active tuberculosis (TB) in BC linked with the provincial health insurance client roster, medical visits, hospitalizations, drug prescriptions, the cancer registry and mortality data using unique personal health numbers. The cohort includes data since inception (1990/1992) of each database until 2012/2013 with plans for annual updates. We computed linkage rates by year and compared the characteristics of linked and unlinked individuals. Of 2,656,323 unique individuals available in the laboratory and surveillance data, 1,427,917(54%) were included in the final linked cohort, including about 1.15 million tested for HCV and about 1.02 million tested for HIV. The linkage rate was 86% for HCV tests, 89% for HCV cases, 95% for active TB cases, 48% for HIV tests and 36% for HIV cases. Linkage rates increased from 40% for HCV negatives and 70% for HCV positives in 1992 to ~90% after 2005. Linkage rates were lower for males, younger age at testing, and those with unknown residence location. Linkage rates for HCV testers co-infected with HIV, HBV or TB were very high (90-100%). Linkage rates increased over time related to improvements in completeness of identifiers in laboratory, surveillance, and registry databases. Linkage rates were higher for HCV than HIV testers, those testing positive, older individuals, and females. Data from the cohort provide essential information to support the development of prevention, care and treatment initiatives for those infected with HCV.

  13. Assessing Hepatitis C Burden and Treatment Effectiveness through the British Columbia Hepatitis Testers Cohort (BC-HTC: Design and Characteristics of Linked and Unlinked Participants.

    Naveed Zafar Janjua

    Full Text Available The British Columbia (BC Hepatitis Testers Cohort (BC-HTC was established to assess and monitor hepatitis C (HCV epidemiology, cost of illness and treatment effectiveness in BC, Canada. In this paper, we describe the cohort construction, data linkage process, linkage yields, and comparison of the characteristics of linked and unlinked individuals.The BC-HTC includes all individuals tested for HCV and/or HIV or reported as a case of HCV, hepatitis B (HBV, HIV or active tuberculosis (TB in BC linked with the provincial health insurance client roster, medical visits, hospitalizations, drug prescriptions, the cancer registry and mortality data using unique personal health numbers. The cohort includes data since inception (1990/1992 of each database until 2012/2013 with plans for annual updates. We computed linkage rates by year and compared the characteristics of linked and unlinked individuals.Of 2,656,323 unique individuals available in the laboratory and surveillance data, 1,427,917(54% were included in the final linked cohort, including about 1.15 million tested for HCV and about 1.02 million tested for HIV. The linkage rate was 86% for HCV tests, 89% for HCV cases, 95% for active TB cases, 48% for HIV tests and 36% for HIV cases. Linkage rates increased from 40% for HCV negatives and 70% for HCV positives in 1992 to ~90% after 2005. Linkage rates were lower for males, younger age at testing, and those with unknown residence location. Linkage rates for HCV testers co-infected with HIV, HBV or TB were very high (90-100%.Linkage rates increased over time related to improvements in completeness of identifiers in laboratory, surveillance, and registry databases. Linkage rates were higher for HCV than HIV testers, those testing positive, older individuals, and females. Data from the cohort provide essential information to support the development of prevention, care and treatment initiatives for those infected with HCV.

  14. Assessing Hepatitis C Burden and Treatment Effectiveness through the British Columbia Hepatitis Testers Cohort (BC-HTC): Design and Characteristics of Linked and Unlinked Participants

    Janjua, Naveed Zafar; Kuo, Margot; Chong, Mei; Yu, Amanda; Alvarez, Maria; Cook, Darrel; Armour, Rosemary; Aiken, Ciaran; Li, Karen; Mussavi Rizi, Seyed Ali; Woods, Ryan; Godfrey, David; Wong, Jason; Gilbert, Mark; Tyndall, Mark W.; Krajden, Mel

    2016-01-01

    Background The British Columbia (BC) Hepatitis Testers Cohort (BC-HTC) was established to assess and monitor hepatitis C (HCV) epidemiology, cost of illness and treatment effectiveness in BC, Canada. In this paper, we describe the cohort construction, data linkage process, linkage yields, and comparison of the characteristics of linked and unlinked individuals. Methods The BC-HTC includes all individuals tested for HCV and/or HIV or reported as a case of HCV, hepatitis B (HBV), HIV or active tuberculosis (TB) in BC linked with the provincial health insurance client roster, medical visits, hospitalizations, drug prescriptions, the cancer registry and mortality data using unique personal health numbers. The cohort includes data since inception (1990/1992) of each database until 2012/2013 with plans for annual updates. We computed linkage rates by year and compared the characteristics of linked and unlinked individuals. Results Of 2,656,323 unique individuals available in the laboratory and surveillance data, 1,427,917(54%) were included in the final linked cohort, including about 1.15 million tested for HCV and about 1.02 million tested for HIV. The linkage rate was 86% for HCV tests, 89% for HCV cases, 95% for active TB cases, 48% for HIV tests and 36% for HIV cases. Linkage rates increased from 40% for HCV negatives and 70% for HCV positives in 1992 to ~90% after 2005. Linkage rates were lower for males, younger age at testing, and those with unknown residence location. Linkage rates for HCV testers co-infected with HIV, HBV or TB were very high (90–100%). Conclusion Linkage rates increased over time related to improvements in completeness of identifiers in laboratory, surveillance, and registry databases. Linkage rates were higher for HCV than HIV testers, those testing positive, older individuals, and females. Data from the cohort provide essential information to support the development of prevention, care and treatment initiatives for those infected with HCV

  15. Damping Improvement of Multiple Damping Controllers by Using Optimal Coordinated Design Based on PSS and FACTS-POD in a Multi-Machine Power System

    Ali Nasser Hussain

    2016-09-01

    Full Text Available The aim of this study is to present a comprehensive comparison and assessment of the damping function improvement of power system oscillation for the multiple damping controllers using the simultaneously coordinated design based on Power System Stabilizer (PSS and Flexible AC Transmission System (FACTS devices. FACTS devices can help in the enhancing the stability of the power system by adding supplementary damping controller to the control channel of the FACTS input to implement the task of Power Oscillation Damping (FACT POD controller. Simultaneous coordination can be performed in different ways. First, the dual coordinated designs between PSS and FACTS POD controller or between different FACTS POD controllers are arranged in a multiple FACTS devices without PSS. Second, the simultaneous coordination has been extended to triple coordinated design among PSS and different FACTS POD controllers. The parameters of the damping controllers have been tuned in the individual controllers and coordinated designs by using a Chaotic Particle Swarm Optimization (CPSO algorithm that optimized the given eigenvalue-based objective function. The simulation results for a multi-machine power system show that the dual coordinated design provide satisfactory damping performance over the individual control responses. Furthermore, the triple coordinated design has been shown to be more effective in damping oscillations than the dual damping controllers.

  16. H-Shaped Multiple Linear Motor Drive Platform Control System Design Based on an Inverse System Method

    Qin, Caiyan; Zhang, Chaoning; Lu, H.

    2017-01-01

    Due to its simple mechanical structure and high motion stability, the H-shaped platform has been increasingly widely used in precision measuring, numerical control machining and semiconductor packaging equipment, etc. The H-shaped platform is normally driven by multiple (three) permanent magnet

  17. Designing for Multiple Stakeholder Interests within the Humanitarian Market: The Case of Off-Grid Energy Devices

    Nielsen, Brita Fladvad; Rodrigues Santos, Ana Laura

    2013-01-01

    A "humanitarian market" for off-grid renewable energy technologies for displaced populations in remote areas has emerged. Within this market, there are multiple stakeholder agendas. End-user needs and sustainable development goals are currently not considered through the customer-enterprise relationship and the applied product and…

  18. Childhood aggression and the co-occurrence of behavioural and emotional problems: results across ages 3-16 years from multiple raters in six cohorts in the EU-ACTION project.

    Bartels, Meike; Hendriks, Anne; Mauri, Matteo; Krapohl, Eva; Whipp, Alyce; Bolhuis, Koen; Conde, Lucia Colodro; Luningham, Justin; Fung Ip, Hill; Hagenbeek, Fiona; Roetman, Peter; Gatej, Raluca; Lamers, Audri; Nivard, Michel; van Dongen, Jenny; Lu, Yi; Middeldorp, Christel; van Beijsterveldt, Toos; Vermeiren, Robert; Hankemeijer, Thomas; Kluft, Cees; Medland, Sarah; Lundström, Sebastian; Rose, Richard; Pulkkinen, Lea; Vuoksimaa, Eero; Korhonen, Tellervo; Martin, Nicholas G; Lubke, Gitta; Finkenauer, Catrin; Fanos, Vassilios; Tiemeier, Henning; Lichtenstein, Paul; Plomin, Robert; Kaprio, Jaakko; Boomsma, Dorret I

    2018-05-29

    Childhood aggression and its resulting consequences inflict a huge burden on affected children, their relatives, teachers, peers and society as a whole. Aggression during childhood rarely occurs in isolation and is correlated with other symptoms of childhood psychopathology. In this paper, we aim to describe and improve the understanding of the co-occurrence of aggression with other forms of childhood psychopathology. We focus on the co-occurrence of aggression and other childhood behavioural and emotional problems, including other externalising problems, attention problems and anxiety-depression. The data were brought together within the EU-ACTION (Aggression in Children: unravelling gene-environment interplay to inform Treatment and InterventiON strategies) project. We analysed the co-occurrence of aggression and other childhood behavioural and emotional problems as a function of the child's age (ages 3 through 16 years), gender, the person rating the behaviour (father, mother or self) and assessment instrument. The data came from six large population-based European cohort studies from the Netherlands (2x), the UK, Finland and Sweden (2x). Multiple assessment instruments, including the Child Behaviour Checklist (CBCL), the Strengths and Difficulties Questionnaire (SDQ) and Multidimensional Peer Nomination Inventory (MPNI), were used. There was a good representation of boys and girls in each age category, with data for 30,523 3- to 4-year-olds (49.5% boys), 20,958 5- to 6-year-olds (49.6% boys), 18,291 7- to 8-year-olds (49.0% boys), 27,218 9- to 10-year-olds (49.4% boys), 18,543 12- to 13-year-olds (48.9% boys) and 10,088 15- to 16-year-olds (46.6% boys). We replicated the well-established gender differences in average aggression scores at most ages for parental ratings. The gender differences decreased with age and were not present for self-reports. Aggression co-occurred with the majority of other behavioural and social problems, from both externalising and

  19. Preliminary design study of removable integral steam generator units of the multiple helically wound tube type for a 1250 MW(th) H.T.G.C. reactor

    Gilli, P.V.; Fritz, K.; Lippitsch, J.; Sandri, A.H.; Weiss, B.

    1965-11-01

    The possibilities of designing a multiple steam generator for a 1250 MW(th) High Temperature Gas-Cooled Reactor, consisting of 18 units which are able to pass through 5 ft diam. holes in the integral prestressed concrete pressure vessel are investigated. A lay-out and design with bundles of multi-start helical tubes is evolved, particular attention being paid to the questions of tube blanking and removal of the unit, and of selection of materials for superheater and reheater tubes. Thermal and stress calculations have been carried out, using the Waagner-Biro Computer Code ADURHELIX. (author)

  20. Chinese college freshmen’s mental health problems and their subsequent help-seeking behaviors: A cohort design (2005-2011)

    Liu, Fenge; Cao, Hongjian; Fang, Xiaoyi; Deng, Linyuan; Chen, Wenrui; Lin, Xiuyun; Liu, Lu; Zhao, Huichun

    2017-01-01

    Based on cohort data obtained from 13,085 college freshmen’s (2005 to 2011) SCL-90 (the Symptom Check-List-90) reports and their subsequent 4-year psychological counseling help-seeking records, this study examined the association between college students’ mental health problems and help-seeking behaviors across four college years. Female students’ mental health problems and help-seeking behaviors increased from the 2005 to the 2011 cohorts and no changes emerged for male students across cohorts. Overall, male students reported higher levels of mental health problems than did female students in the first college year, whereas female students reported more help-seeking behaviors than did male students in the following four college years. College students’ mental health problems was associated positively with help-seeking behaviors. College students were more likely to seek help from the college psychological counselling center when they experienced relatively few or quite a lot of mental health issues (i.e., an inversed U shape). Implications for future studies and practices are discussed. PMID:29040266

  1. Detection of anorectal and cervicovaginal Chlamydia trachomatis infections following azithromycin treatment: prospective cohort study with multiple time-sequential measures of rRNA, DNA, quantitative load and symptoms.

    Nicole H T M Dukers-Muijrers

    Full Text Available Determination of Chlamydia trachomatis (Ct treatment success is hampered by current assessment methods, which involve a single post-treatment measurement only. Therefore, we evaluated Ct detection by applying multiple laboratory measures on time-sequential post-treatment samples.A prospective cohort study was established with azithromycin-treated (1000 mg Ct patients (44 cervicovaginal and 15 anorectal cases. Each patient provided 18 self-taken samples pre-treatment and for 8 weeks post-treatment (response: 96%; 1,016 samples. Samples were tested for 16S rRNA (TMA, bacterial load (quantitative PCR; Chlamydia plasmid DNA and type (serovar and multilocus sequence typing. Covariates (including behavior, pre-treatment load, anatomic site, symptoms, age, and menstruation were tested for their potential association with positivity and load at 3-8 weeks using regression analyses controlling for repeated measures.By day 9, Ct positivity decreased to 20% and the median load to 0.3 inclusion-forming units (IFU per ml (pre-treatment: 170 IFU/ml. Of the 35 cases who reported no sex, sex with a treated partner or safe sex with a new partner, 40% had detection, i.e. one or more positive samples from 3-8 weeks (same Ct type over time, indicating possible antimicrobial treatment failure. Cases showed intermittent positive detection and the number of positive samples was higher in anorectal cases than in cervicovaginal cases. The highest observed bacterial load between 3-8 weeks post-treatment was 313 IFU/ml, yet the majority (65% of positive samples showed a load of ≤ 2 IFU/ml. Pre-treatment load was found to be associated with later load in anorectal cases.A single test at 3-8 weeks post-treatment frequently misses Ct. Detection reveals intermittent low loads, with an unknown risk of later complications or transmission. These findings warrant critical re-evaluation of the clinical management of single dose azithromycin-treated Ct patients and fuel the debate

  2. Multiple roads lead to Rome: combined high-intensity aerobic and strength training vs. gross motor activities leads to equivalent improvement in executive functions in a cohort of healthy older adults.

    Berryman, Nicolas; Bherer, Louis; Nadeau, Sylvie; Lauzière, Séléna; Lehr, Lora; Bobeuf, Florian; Lussier, Maxime; Kergoat, Marie Jeanne; Vu, Thien Tuong Minh; Bosquet, Laurent

    2014-01-01

    The effects of physical activity on cognition in older adults have been extensively investigated in the last decade. Different interventions such as aerobic, strength, and gross motor training programs have resulted in improvements in cognitive functions. However, the mechanisms underlying the relationship between physical activity and cognition are still poorly understood. Recently, it was shown that acute bouts of exercise resulted in reduced executive control at higher relative exercise intensities. Considering that aging is characterized by a reduction in potential energy ([Formula: see text] max - energy cost of walking), which leads to higher relative walking intensity for the same absolute speed, it could be argued that any intervention aimed at reducing the relative intensity of the locomotive task would improve executive control while walking. The objective of the present study was to determine the effects of a short-term (8 weeks) high-intensity strength and aerobic training program on executive functions (single and dual task) in a cohort of healthy older adults. Fifty-one participants were included and 47 (age, 70.7 ± 5.6) completed the study which compared the effects of three interventions: lower body strength + aerobic training (LBS-A), upper body strength + aerobic training (UBS-A), and gross motor activities (GMA). Training sessions were held 3 times every week. Both physical fitness (aerobic, neuromuscular, and body composition) and cognitive functions (RNG) during a dual task were assessed before and after the intervention. Even though the LBS-A and UBS-A interventions increased potential energy to a higher level (Effect size: LBS-A-moderate, UBS-A-small, GMA-trivial), all groups showed equivalent improvement in cognitive function, with inhibition being more sensitive to the intervention. These findings suggest that different exercise programs targeting physical fitness and/or gross motor skills may lead to equivalent improvement in

  3. Risk factors for low birth weight according to the multiple logistic regression model. A retrospective cohort study in José María Morelos municipality, Quintana Roo, Mexico.

    Franco Monsreal, José; Tun Cobos, Miriam Del Ruby; Hernández Gómez, José Ricardo; Serralta Peraza, Lidia Esther Del Socorro

    2018-01-17

    Low birth weight has been an enigma for science over time. There have been many researches on its causes and its effects. Low birth weight is an indicator that predicts the probability of a child surviving. In fact, there is an exponential relationship between weight deficit, gestational age, and perinatal mortality. Multiple logistic regression is one of the most expressive and versatile statistical instruments available for the analysis of data in both clinical and epidemiology settings, as well as in public health. To assess in a multivariate fashion the importance of 17 independent variables in low birth weight (dependent variable) of children born in the Mayan municipality of José María Morelos, Quintana Roo, Mexico. Analytical observational epidemiological cohort study with retrospective temporality. Births that met the inclusion criteria occurred in the "Hospital Integral Jose Maria Morelos" of the Ministry of Health corresponding to the Maya municipality of Jose Maria Morelos during the period from August 1, 2014 to July 31, 2015. The total number of newborns recorded was 1,147; 84 of which (7.32%) had low birth weight. To estimate the independent association between the explanatory variables (potential risk factors) and the response variable, a multiple logistic regression analysis was performed using the IBM SPSS Statistics 22 software. In ascending numerical order values of odds ratio > 1 indicated the positive contribution of explanatory variables or possible risk factors: "unmarried" marital status (1.076, 95% confidence interval: 0.550 to 2.104); age at menarche ≤ 12 years (1.08, 95% confidence interval: 0.64 to 1.84); history of abortion(s) (1.14, 95% confidence interval: 0.44 to 2.93); maternal weight < 50 kg (1.51, 95% confidence interval: 0.83 to 2.76); number of prenatal consultations ≤ 5 (1.86, 95% confidence interval: 0.94 to 3.66); maternal age ≥ 36 years (3.5, 95% confidence interval: 0.40 to 30.47); maternal age ≤ 19 years (3

  4. Pessary placement in the prevention of preterm birth in multiple pregnancies : a propensity score analysis

    Monfrance, Maurice J M; Schuit, Ewoud; Groenwold, Rolf H; Oudijk, Martijn A; de Graaf, Irene M; Bax, Caroline J; Bekedam, Dick J; Mol, Ben Willem; Langenveld, Josje

    OBJECTIVE: In asymptomatic women with a multiple pregnancy and short cervix prophylactic use of a cervical pessary might reduce preterm birth. We assessed the possible treatment effects of pessary use in pregnancy duration and for poor perinatal outcome. STUDY DESIGN: This cohort study was performed

  5. Preterm birth in singleton and multiple pregnancies : evaluation of costs and perinatal outcomes

    van Baaren, Gert J.; Peelen, Myrthe J. C. S.; Schuit, Ewoud; van der Post, Joris A. M.; Mol, Ben W. J.; Kok, Marjolein; Hajenius, Petra J.

    Objective: To estimate costs of preterm birth in singleton and multiple pregnancies. Study design: Cost analysis based on data from a prospective cohort study and three multicentre randomised controlled trials (2006-2012) in a Dutch nationwide consortium for women's health research. Women with

  6. System and method for design and optimization of grid connected photovoltaic power plant with multiple photovoltaic module technologies

    Thomas, Bex George; Elasser, Ahmed; Bollapragada, Srinivas; Galbraith, Anthony William; Agamy, Mohammed; Garifullin, Maxim Valeryevich

    2016-03-29

    A system and method of using one or more DC-DC/DC-AC converters and/or alternative devices allows strings of multiple module technologies to coexist within the same PV power plant. A computing (optimization) framework estimates the percentage allocation of PV power plant capacity to selected PV module technologies. The framework and its supporting components considers irradiation, temperature, spectral profiles, cost and other practical constraints to achieve the lowest levelized cost of electricity, maximum output and minimum system cost. The system and method can function using any device enabling distributed maximum power point tracking at the module, string or combiner level.

  7. Design of Spiking Central Pattern Generators for Multiple Locomotion Gaits in Hexapod Robots by Christiansen Grammar Evolution.

    Espinal, Andres; Rostro-Gonzalez, Horacio; Carpio, Martin; Guerra-Hernandez, Erick I; Ornelas-Rodriguez, Manuel; Sotelo-Figueroa, Marco

    2016-01-01

    This paper presents a method to design Spiking Central Pattern Generators (SCPGs) to achieve locomotion at different frequencies on legged robots. It is validated through embedding its designs into a Field-Programmable Gate Array (FPGA) and implemented on a real hexapod robot. The SCPGs are automatically designed by means of a Christiansen Grammar Evolution (CGE)-based methodology. The CGE performs a solution for the configuration (synaptic weights and connections) for each neuron in the SCPG. This is carried out through the indirect representation of candidate solutions that evolve to replicate a specific spike train according to a locomotion pattern (gait) by measuring the similarity between the spike trains and the SPIKE distance to lead the search to a correct configuration. By using this evolutionary approach, several SCPG design specifications can be explicitly added into the SPIKE distance-based fitness function, such as looking for Spiking Neural Networks (SNNs) with minimal connectivity or a Central Pattern Generator (CPG) able to generate different locomotion gaits only by changing the initial input stimuli. The SCPG designs have been successfully implemented on a Spartan 6 FPGA board and a real time validation on a 12 Degrees Of Freedom (DOFs) hexapod robot is presented.

  8. Human-centered approaches in geovisualization design: investigating multiple methods through a long-term case study.

    Lloyd, David; Dykes, Jason

    2011-12-01

    Working with three domain specialists we investigate human-centered approaches to geovisualization following an ISO13407 taxonomy covering context of use, requirements and early stages of design. Our case study, undertaken over three years, draws attention to repeating trends: that generic approaches fail to elicit adequate requirements for geovis application design; that the use of real data is key to understanding needs and possibilities; that trust and knowledge must be built and developed with collaborators. These processes take time but modified human-centred approaches can be effective. A scenario developed through contextual inquiry but supplemented with domain data and graphics is useful to geovis designers. Wireframe, paper and digital prototypes enable successful communication between specialist and geovis domains when incorporating real and interesting data, prompting exploratory behaviour and eliciting previously unconsidered requirements. Paper prototypes are particularly successful at eliciting suggestions, especially for novel visualization. Enabling specialists to explore their data freely with a digital prototype is as effective as using a structured task protocol and is easier to administer. Autoethnography has potential for framing the design process. We conclude that a common understanding of context of use, domain data and visualization possibilities are essential to successful geovis design and develop as this progresses. HC approaches can make a significant contribution here. However, modified approaches, applied with flexibility, are most promising. We advise early, collaborative engagement with data – through simple, transient visual artefacts supported by data sketches and existing designs – before moving to successively more sophisticated data wireframes and data prototypes. © 2011 IEEE

  9. Spreading Sequence Design for Multiple Cell Synchronous DS-CDMA Systems under Total Weighted Squared Correlation Criterion

    Cotae Paul

    2004-01-01

    Full Text Available An algorithm for designing spreading sequences for an overloaded multicellular synchronous DS-CDMA system on uplink is introduced. The criterion used to measure the optimality of the design is the total weighted square correlation (TWSC assuming the channel state information known perfectly at both transmitter and receiver. By using this algorithm it is possible to obtain orthogonal generalized WBE sequences sets for any processing gain. The bandwidth of initial generalized WBE signals of each cell is preserved in the extended signal space associated to multicellular system. Mathematical formalism is illustrated by selected numerical examples.

  10. Solving the Problem of Multiple-Criteria Building Design Decisions with respect to the Fire Safety of Occupants: An Approach Based on Probabilistic Modelling

    Egidijus Rytas Vaidogas

    2015-01-01

    Full Text Available The design of buildings may include a comparison of alternative architectural and structural solutions. They can be developed at different levels of design process. The alternative design solutions are compared and ranked by applying methods of multiple-criteria decision-making (MCDM. Each design is characterised by a number of criteria used in a MCDM problem. The paper discusses how to choose MCDM criteria expressing fire safety related to alternative designs. Probability of a successful evacuation of occupants from a building fire and difference between evacuation time and time to untenable conditions are suggested as the most important criteria related to fire safety. These two criteria are treated as uncertain quantities expressed by probability distributions. Monte Carlo simulation of fire and evacuation processes is natural means for an estimation of these distributions. The presence of uncertain criteria requires applying stochastic MCDM methods for ranking alternative designs. An application of the safety-related criteria is illustrated by an example which analyses three alternative architectural floor plans prepared for a reconstruction of a medical building. A MCDM method based on stochastic simulation is used to solve the example problem.

  11. Case-Based Instructional Practices: A Multiple-Case Study from Torts, Marketing, and Online Instructional Design Classes

    Jung, Ji yoon

    2017-01-01

    The purpose of this study is to provide a comprehensive account on case-based instructional practices. Semester-long participant observation records in torts, marketing, and online instructional design classes, instructor interviews, course syllabi and teaching materials were used to describe the within-class complexity of the practices in terms…

  12. Solving advanced multi-objective robust designs by means of multiple objective evolutionary algorithms (MOEA): A reliability application

    Salazar A, Daniel E. [Division de Computacion Evolutiva (CEANI), Instituto de Sistemas Inteligentes y Aplicaciones Numericas en Ingenieria (IUSIANI), Universidad de Las Palmas de Gran Canaria. Canary Islands (Spain)]. E-mail: danielsalazaraponte@gmail.com; Rocco S, Claudio M. [Universidad Central de Venezuela, Facultad de Ingenieria, Caracas (Venezuela)]. E-mail: crocco@reacciun.ve

    2007-06-15

    This paper extends the approach proposed by the second author in [Rocco et al. Robust design using a hybrid-cellular-evolutionary and interval-arithmetic approach: a reliability application. In: Tarantola S, Saltelli A, editors. SAMO 2001: Methodological advances and useful applications of sensitivity analysis. Reliab Eng Syst Saf 2003;79(2):149-59 [special issue

  13. An Examination of Fluoxetine for the Treatment of Selective Mutism Using a Nonconcurrent Multiple-Baseline Single-Case Design Across 5 Cases.

    Barterian, Justin A; Sanchez, Joel M; Magen, Jed; Siroky, Allison K; Mash, Brittany L; Carlson, John S

    2018-01-01

    This study examined the utility of fluoxetine in the treatment of 5 children, aged 5 to 14 years, diagnosed with selective mutism who also demonstrated symptoms of social anxiety. A nonconcurrent, randomized, multiple-baseline, single-case design with a single-blind placebo-controlled procedure was used. Parents and the study psychiatrist completed multiple methods of assessment including Direct Behavior Ratings and questionnaires. Treatment outcomes were evaluated by calculating effect sizes for each participant as an individual and for the participants as a group. Information regarding adverse effects with an emphasis on behavioral disinhibition and ratings of parental acceptance of the intervention was gathered. All 5 children experienced improvement in social anxiety, responsive speech, and spontaneous speech with medium to large effect sizes; however, children still met criteria for selective mutism at the end of the study. Adverse events were minimal, with only 2 children experiencing brief occurrences of minor behavioral disinhibition. Parents found the treatment highly acceptable.

  14. In Silico Design and Experimental Validation of siRNAs Targeting Conserved Regions of Multiple Hepatitis C Virus Genotypes.

    Mahmoud ElHefnawi

    Full Text Available RNA interference (RNAi is a post-transcriptional gene silencing mechanism that mediates the sequence-specific degradation of targeted RNA and thus provides a tremendous opportunity for development of oligonucleotide-based drugs. Here, we report on the design and validation of small interfering RNAs (siRNAs targeting highly conserved regions of the hepatitis C virus (HCV genome. To aim for therapeutic applications by optimizing the RNAi efficacy and reducing potential side effects, we considered different factors such as target RNA variations, thermodynamics and accessibility of the siRNA and target RNA, and off-target effects. This aim was achieved using an in silico design and selection protocol complemented by an automated MysiRNA-Designer pipeline. The protocol included the design and filtration of siRNAs targeting highly conserved and accessible regions within the HCV internal ribosome entry site, and adjacent core sequences of the viral genome with high-ranking efficacy scores. Off-target analysis excluded siRNAs with potential binding to human mRNAs. Under this strict selection process, two siRNAs (HCV353 and HCV258 were selected based on their predicted high specificity and potency. These siRNAs were tested for antiviral efficacy in HCV genotype 1 and 2 replicon cell lines. Both in silico-designed siRNAs efficiently inhibited HCV RNA replication, even at low concentrations and for short exposure times (24h; they also exceeded the antiviral potencies of reference siRNAs targeting HCV. Furthermore, HCV353 and HCV258 siRNAs also inhibited replication of patient-derived HCV genotype 4 isolates in infected Huh-7 cells. Prolonged treatment of HCV replicon cells with HCV353 did not result in the appearance of escape mutant viruses. Taken together, these results reveal the accuracy and strength of our integrated siRNA design and selection protocols. These protocols could be used to design highly potent and specific RNAi-based therapeutic

  15. Toward 3D-IPTV: design and implementation of a stereoscopic and multiple-perspective video streaming system

    Petrovic, Goran; Farin, Dirk; de With, Peter H. N.

    2008-02-01

    3D-Video systems allow a user to perceive depth in the viewed scene and to display the scene from arbitrary viewpoints interactively and on-demand. This paper presents a prototype implementation of a 3D-video streaming system using an IP network. The architecture of our streaming system is layered, where each information layer conveys a single coded video signal or coded scene-description data. We demonstrate the benefits of a layered architecture with two examples: (a) stereoscopic video streaming, (b) monoscopic video streaming with remote multiple-perspective rendering. Our implementation experiments confirm that prototyping 3D-video streaming systems is possible with today's software and hardware. Furthermore, our current operational prototype demonstrates that highly heterogeneous clients can coexist in the system, ranging from auto-stereoscopic 3D displays to resource-constrained mobile devices.

  16. Design Research on Mathematics Education: Investigating The Progress of Indonesian Fifth Grade Students’ Learning on Multiplication of Fractions With Natural Numbers

    Nenden Octavarulia Shanty

    2011-07-01

    Full Text Available This study aimed at investigating the progress of students’ learning onmultiplication fractions with natural numbers through the five activitylevels based on Realistic Mathematics Education (RME approachproposed by Streefland. Design research was chosen to achieve thisresearch goal. In design research, the Hypothetical Learning Trajectory(HLT plays important role as a design and research instrument. ThisHLT tested to thirty-seven students of grade five primary school (i.e.SDN 179 Palembang.The result of the classroom practices showed that measurement (lengthactivity could stimulate students’ to produce fractions as the first levelin learning multiplication of fractions with natural numbers.Furthermore, strategies and tools used by the students in partitioninggradually be developed into a more formal mathematics in whichnumber line be used as the model of measuring situation and the modelfor more formal reasoning. The number line then could bring thestudents to the last activity level, namely on the way to rules formultiplying fractions with natural numbers. Based on this findings, it is suggested that Streefland’s five activity levels can be used as aguideline in learning multiplication of fractions with natural numbers in which the learning process become a more progressive learning.

  17. Birth cohorts

    Andersen, Anne-Marie Nybo; Madsen, Mia

    2009-01-01

    on children and vice versa, or siblings provide information about each other. Examples of how family-based studies have been used in understanding the life course epidemiology of cardiovascular disease, mental health, and reproductive health illustrate the applicability of the research to these areas......Family-based studies, including intergenerational, sibling, and twin studies, are increasingly being used to explore life course epidemiology. However, there are issues relating to study design and the statistical analysis of family-based studies that are still not well understood...

  18. Mechanical design implementation and mathematical considerations for ultra precise diamond turning of multiple freeform mirrors on a common substrate

    Hartung, Johannes; Beier, Matthias; Peschel, Thomas; Gebhardt, Andreas; Risse, Stefan

    2015-09-01

    For optical systems consisting of metal (in general freeform) mirrors there exist several diamond turning fabrication approaches. These are distuingished by the effort in manufacturing and integration of the later system. The more work one puts into the manufacturing stage the less complicated is the alignment and integration afterwards. For example the most degrees of freedom have to be aligned in integration phase if every mirror of the system is fabricated as a single optical component. For a three mirror anastigmat with three freeform mirrors the degrees of freedom sum up to 18. Therefore the mirror fabrication itself is more or less easy, but the integration is very difficult. There are three major parts in the design and manufacturing process chain to be considered for tackling this integration problem. At the first position in the process chain there is the optical design occuring. At this stage a negotiation between manufacturing and design could improve manufacturability because of more possible integration approaches. The second stage is the mechanical design. Here the appropriate manufacturing approach is already chosen, but may be revisited due to incompatiblities with, e.g., stress specifications. The third level is the manufacturing stage. Here are different clamping approaches and fabrication methods possible. The current article will focus on an approach ("snap-together") where two mirrors are fabricated on one substrate and therefore a reduction of the number of degrees of freedom to be aligned are reduced to six. This improves the amount of time needed for the system integration significantly in contrast to a single mirror fabrication.

  19. "Cure" for multiple sclerosis (MS)-Evolving views of therapy goals in patients on different stages of the disease: A pilot study in a cohort of Polish MS patients.

    Chacińska, Weronika; Brzostowska, Marta; Nojszewska, Monika; Podlecka-Piętowska, Aleksandra; Jędrzejczak, Wiesław W; Snarski, Emilian

    2017-06-01

    New aggressive treatments promise improvement of results in the treatment of multiple sclerosis (MS), however, with high risk of serious complications. In this study, we analyzed patients' acceptance for risks connected with the MS treatment. The study was designed as a prospective nonanonymous online questionnaire. Responders were asked about the definition of the "cure" for MS and crucial goals in the treatment. One hundred and eighty patients filled in the questionnaire (129 women and 51 men), and the mean age was 33 years ( SD  = 10.29). The MS forms were as follows: relapsing-remitting (65%), secondary progressive (14%), primary progressive (10%), and other (11%), with mean EDSS score of 3 points ( SD  = 2.6). For 50% of the patients, relief of symptoms such as fatigue (72%), paresis (66%), and balance disorders (65%) was synonymous with "cure." The patients with faster progression of the disease were likely to accept risky "curative" treatments-with average 68% accepted mortality risk ( p  = .003). Over 81% of patients accepted mortality rates over 1% for the treatment that achieves self-defined cure. The study shows that the MS patients are likely to accept even very risky treatments as long as they promise patient-defined "cure."

  20. Rationale and design of three observational, prospective cohort studies including biobanking to evaluate and improve diagnostics, management strategies and risk stratification in venous thromboembolism: the VTEval Project.

    Frank, Bernd; Ariza, Liana; Lamparter, Heidrun; Grossmann, Vera; Prochaska, Jürgen H; Ullmann, Alexander; Kindler, Florentina; Weisser, Gerhard; Walter, Ulrich; Lackner, Karl J; Espinola-Klein, Christine; Münzel, Thomas; Konstantinides, Stavros V; Wild, Philipp S

    2015-07-01

    Venous thromboembolism (VTE) with its two manifestations deep vein thrombosis (DVT) and pulmonary embolism (PE) is a major public health problem. The VTEval Project aims to investigate numerous research questions on diagnosis, clinical management, treatment and prognosis of VTE, which have remained uncertain to date. The VTEval Project consists of three observational, prospective cohort studies on VTE comprising cohorts of individuals with a clinical suspicion of acute PE (with or without DVT), with a clinical suspicion of acute DVT (without symptomatic PE) and with an incidental diagnosis of VTE (PE or DVT). The VTEval Project expects to enrol a total of approximately 2000 individuals with subsequent active and passive follow-up investigations over a time period of 5 years per participant. Time points for active follow-up investigations are at months 3, 6, 12, 24 and 36 after diagnosis (depending on the disease cohort); passive follow-up investigations via registry offices and the cancer registry are performed 48 and 60 months after diagnosis for all participants. Primary short-term outcome is defined by overall mortality (PE-related death and all other causes of death), primary long-term outcome by symptomatic VTE (PE-related death, recurrence of non-fatal PE or DVT). The VTEval Project includes three 'all-comer' studies and involves the standardised acquisition of high-quality data, covering the systematic assessment of VTE including symptoms, risk profile, psychosocial, environmental and lifestyle factors as well as clinical and subclinical disease, and it builds up a large state-of-the-art biorepository containing various materials from serial blood samplings. The VTEval Project has been approved by the local data safety commissioner and the responsible ethics committee (reference no. 837.320.12 (8421-F)). Trial results will be published in peer-reviewed journals and presented at national and international scientific meetings. NCT02156401. Published by the

  1. Cognitive and imaging markers in non-demented subjects attending a memory clinic: study design and baseline findings of the MEMENTO cohort.

    Dufouil, Carole; Dubois, Bruno; Vellas, Bruno; Pasquier, Florence; Blanc, Frédéric; Hugon, Jacques; Hanon, Olivier; Dartigues, Jean-François; Harston, Sandrine; Gabelle, Audrey; Ceccaldi, Mathieu; Beauchet, Olivier; Krolak-Salmon, Pierre; David, Renaud; Rouaud, Olivier; Godefroy, Olivier; Belin, Catherine; Rouch, Isabelle; Auguste, Nicolas; Wallon, David; Benetos, Athanase; Pariente, Jérémie; Paccalin, Marc; Moreaud, Olivier; Hommet, Caroline; Sellal, François; Boutoleau-Bretonniére, Claire; Jalenques, Isabelle; Gentric, Armelle; Vandel, Pierre; Azouani, Chabha; Fillon, Ludovic; Fischer, Clara; Savarieau, Helen; Operto, Gregory; Bertin, Hugo; Chupin, Marie; Bouteloup, Vincent; Habert, Marie-Odile; Mangin, Jean-François; Chêne, Geneviève

    2017-08-29

    The natural history and disease mechanisms of Alzheimer's disease and related disorders (ADRD) are still poorly understood. Very few resources are available to scrutinise patients as early as needed and to use integrative approaches combining standardised, repeated clinical investigations and cutting-edge biomarker measurements. In the nationwide French MEMENTO cohort study, participants were recruited in memory clinics and screened for either isolated subjective cognitive complaints (SCCs) or mild cognitive impairment (MCI; defined as test performance 1.5 SD below age, sex and education-level norms) while not demented (Clinical Dementia Rating [CDR] <1). Baseline data collection included neurological and physical examinations as well as extensive neuropsychological testing. To be included in the MEMENTO cohort, participants had to agree to undergo both brain magnetic resonance imaging (MRI) and blood sampling. Cerebral 18 F-fluorodeoxyglucose positon emission tomography and lumbar puncture were optional. Automated analyses of cerebral MRI included assessments of volumes of whole-brain, hippocampal and white matter lesions. The 2323 participants, recruited from April 2011 to June 2014, were aged 71 years, on average (SD 8.7), and 62% were women. CDR was 0 in 40% of participants, and 30% carried at least one apolipoprotein E ε4 allele. We observed that more than half (52%) of participants had amnestic mild cognitive impairment (17% single-domain aMCI), 32% had non-amnestic mild cognitive impairment (16.9% single-domain naMCI) and 16% had isolated SCCs. Multivariable analyses of neuroimaging markers associations with cognitive categories showed that participants with aMCI had worse levels of imaging biomarkers than the others, whereas participants with naMCI had markers at intermediate levels between SCC and aMCI. The burden of white matter lesions tended to be larger in participants with aMCI. Independently of CDR, all neuroimaging and neuropsychological markers

  2. Multiple inflammatory biomarker detection in a prospective cohort study: a cross-validation between well-established single-biomarker techniques and electrochemiluminescense-based multi-array platform

    Bussel, van B.C.T.; Ferreira, I.; Waarenburg, M.P.H.; Greevenbroek, van M.M.J.; Kallen, van der C.J.H.; Henry, R.M.A.; Feskens, E.J.M.; Stehouwer, C.D.A.; Schalkwijk, C.G.

    2013-01-01

    Background - In terms of time, effort and quality, multiplex technology is an attractive alternative for well-established single-biomarker measurements in clinical studies. However, limited data comparing these methods are available. Methods - We measured, in a large ongoing cohort study (n = 574),

  3. Design and simulations of a spectral efficient optical code division multiple access scheme using alternated energy differentiation and single-user soft-decision demodulation

    A. Garba, Aminata

    2017-01-01

    This paper presents a new approach to optical Code Division Multiple Access (CDMA) network transmission scheme using alternated amplitude sequences and energy differentiation at the transmitters to allow concurrent and secure transmission of several signals. The proposed system uses error control encoding and soft-decision demodulation to reduce the multi-user interference at the receivers. The design of the proposed alternated amplitude sequences, the OCDMA energy modulators and the soft decision, single-user demodulators are also presented. Simulation results show that the proposed scheme allows achieving spectral efficiencies higher than several reported results for optical CDMA and much higher than the Gaussian CDMA capacity limit.

  4. Design

    Volf, Mette

    This publication is unique in its demystification and operationalization of the complex and elusive nature of the design process. The publication portrays the designer’s daily work and the creative process, which the designer is a part of. Apart from displaying the designer’s work methods...... and design parameters, the publication shows examples from renowned Danish design firms. Through these examples the reader gets an insight into the designer’s reality....

  5. A Prospective Cohort Study in Patients with Type 2 Diabetes Mellitus for Validation of Biomarkers (PROVALID – Study Design and Baseline Characteristics

    Susanne Eder

    2018-02-01

    Full Text Available Background/Aims: The prevalence of diabetes mellitus type 2 and kidney disease in these patients varies widely between European countries. Methods: In addition to store bio-samples the “Prospective cohort study in patients with type 2 diabetes mellitus for validation of biomarkers” collects information on history, physical status, laboratory measurements and medication in 4000 patients with diabetes mellitus type 2, being taken care of at the primary level of healthcare in 5 European countries (Austria, Hungary, Netherlands, Poland and Scotland. Next to comparing the rate of loss of eGFR between the countries, a further objective of the PROVALID study is to determine the 5-year cumulative incidence of renal and cardiovascular outcomes. Results: The mean age of the population recruited is 62.9±10 years, 54.6% are male and the mean BMI is 30.9±5.4 kg/m2. Metabolic control (median HBA1c 6.8 % (6.2; 7.5 is achieved via administration of metformin in 67.4% of the patients and insulin in 30.3%. Median systolic and diastolic blood pressure at recruitment is 135 (125; 146 and 80 (72; 85 mmHg, 65.4% of subjects received RAAS blocking agents. Mean eGFR is 80.7±29.2 ml/min/1.73m2 and median baseline albumin/creatinine ratio 8.3 mg (IQR: 3.8 and 25.1. Conclusion: PROVALID will provide information on incidence and progression of renal and cardiovascular disease and therapy in patients with type 2 diabetes mellitus in different European countries. Thus, in contrast to many other cohort studies we will be able to associate national clinical practise pattern with outcome in this highly vulnerable patient population.

  6. Design, implementation, and evaluation at entry of a prospective cohort study of homosexual and bisexual HIV-1-negative men in Belo Horizonte, Brazil: Project Horizonte.

    Carneiro, M; de Figueiredo Antunes, C M; Greco, M; Oliveira, E; Andrade, J; Lignani, L; Greco, D B

    2000-10-01

    Project Horizonte, an open cohort of homosexual and bisexual HIV-1-negative men, is a component of the Minas Gerais AIDS Vaccine Program of the Federal University of Minas Gerais, Belo Horizonte, Brazil. Its objectives included the evaluation of seroincidence of HIV, to ascertain the role of counseling on behavior modification and to assess their willingness to participate in future HIV vaccine trials. Various means of recruitment were used, including pamphlets, notices in community newspapers, radio, and television, at anonymous testing centers, and by word of mouth. From October 1994 to May 1999, 470 volunteers were enrolled. Their mean age was 26 years and over 70% of them had high school or college education. During the follow-up, they were seen every 6 months, when they received counseling and condoms, and when HIV testing was done. Eighteen seroconversions were observed, and the incidence rates estimates were 1.75 per 100 and 1.99 per 100 person-years, for 36 and 48 months of follow-up, respectively. During the entire period, 139 volunteers were lost to follow-up. Among them, 59 (42.4%) never returned after the initial visit and 51 (36.7) came only once after their initial visit. No losses were observed for those observed during follow-up for more than 3 years. At enrollment, 50% of participants said they would participate in a vaccine trial, and 30% said they might participate. The results obtained up to this moment confirm the feasibility of following this type of cohort for an extended period, estimating HIV incidence rate, and evaluating counseling for safe sexual practices in preparation for clinical trials with candidate HIV vaccines in Brazil.

  7. Enhancing the Predictive Potential of Personality: Isolating Multiple Components of Trait Expression via a Single Administration Design

    2015-03-01

    109 8.0 Arts, Design, Entertainment, Media, Sports , and Recreation 100 7.4 Information Technology 86 6.3 Office and Administrative Support 74 5.5...55 4.1 Government and Public Administration 35 2.6 Community and Social Service 29 2.1 Manufacturing 29 2.1 Hospitality and Tourism 25 1.8...playing a sport ; exercising; or doing yard work or housework. % Not descriptive of me % Somewhat descriptive of me % Very descriptive of me N/A

  8. Design, Simulation, Fabrication and Testing of a Bio-Inspired Amphibious Robot with Multiple Modes of Mobility

    2012-01-01

    tail. 8. Discussion 8.1. General Mobility and Stair Climbing Maximum speed and turning radius compare favorably to our past WhegsTM robots . It should be...SeaDog. Climbing three or more stairs is difficult for the robot . The robot’s zero turn radius and the intermittent nature of the wheel-legs make it...Int. J. of Design and Nature, Vol.4, No.4, pp. 1-18, 2009. [18] M. Eich, F. Grimminger, and F. Kirchner, “A Versatile Stair - Climb - ing Robot for

  9. Design of a hybrid reconfigurable Software Defined Radio transceiver based on frequency shift keying using multiple encoding schemes

    Nikhil Marriwala

    2016-03-01

    The aim of this paper was to analyze Frequency Shift Keying (FSK Transceiver built using Laboratory Virtual Instrumentation Engineering Workbench (LabVIEW and to measure the reduction in data errors in the presence of Forward Error Correction (FEC channel coding algorithms namely the Convolution and the Turbo Codes. Through this design a graphical representation of Bit Error Rate (BER vs Eb/N0 where (Eb is Energy per bit and (N0 is Spectral noise density has been given in the presence of Additive White Gaussian Noise (AWGN introduced in the channel. FSK is widely used for data transmission over band pass channels; hence, we have chosen FSK for the implementation of SDR. The SDR transceiver module designed has been fully implemented and has the ability to navigate over a wide range of frequencies with programmable channel bandwidth and modulation characteristics. We are able to build an interactive FSK based SDR transceiver in a shorter time with the use of LabVIEW. The outputs achieved show a low BER for very high data rates in the presence of AWGN noise.

  10. Design and commissioning of an aberration-corrected ultrafast spin-polarized low energy electron microscope with multiple electron sources.

    Wan, Weishi; Yu, Lei; Zhu, Lin; Yang, Xiaodong; Wei, Zheng; Liu, Jefferson Zhe; Feng, Jun; Kunze, Kai; Schaff, Oliver; Tromp, Ruud; Tang, Wen-Xin

    2017-03-01

    We describe the design and commissioning of a novel aberration-corrected low energy electron microscope (AC-LEEM). A third magnetic prism array (MPA) is added to the standard AC-LEEM with two prism arrays, allowing the incorporation of an ultrafast spin-polarized electron source alongside the standard cold field emission electron source, without degrading spatial resolution. The high degree of symmetries of the AC-LEEM are utilized while we design the electron optics of the ultrafast spin-polarized electron source, so as to minimize the deleterious effect of time broadening, while maintaining full control of electron spin. A spatial resolution of 2nm and temporal resolution of 10ps (ps) are expected in the future time resolved aberration-corrected spin-polarized LEEM (TR-AC-SPLEEM). The commissioning of the three-prism AC-LEEM has been successfully finished with the cold field emission source, with a spatial resolution below 2nm. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Beam breakup considerations in the design of multiple off-axis gaps in an induction accelerator cell for SLIA

    Edighoffer, J.

    1991-01-01

    Measurements of the transverse impedances of the SLIA prototype cell were performed using the bead pull technique. These measurements were compared to a computer model (BBUS) of the prototype cell. The R/Q's measured are reasonably close to the computer model in most cases. The R can be reduced to below the design limit of 30 ohm/cm if the mode Q's can be damped to the range of less than about 23 and 70, for the main modes. With the use of the ring and cone dampers, Q's less than 17 and 48, respectively, should be achieved. Thus, the BBU problem for the difficult off-axis shielded gap geometry of the SLIA accelerator should be within design tolerances, even for 150 gaps. In particular, the 18 cm anode insertion choice should have transverse impedances of about 22 and 21 ohms/cm, respectively, for the main modes. For comparison, the ATA accelerator at Livermore has about a 12 ohm/cm transverse impedance on a 6.7 cm pipe, which roughly scaled to the SLIA 4.5 cm pipe would be equivalent to 27 ohm/cm

  12. Relative Efficiencies of a Three-Stage Versus a Two-Stage Sample Design For a New NLS Cohort Study. 22U-884-38.

    Folsom, R. E.; Weber, J. H.

    Two sampling designs were compared for the planned 1978 national longitudinal survey of high school seniors with respect to statistical efficiency and cost. The 1972 survey used a stratified two-stage sample of high schools and seniors within schools. In order to minimize interviewer travel costs, an alternate sampling design was proposed,…

  13. Design and Control of the PowerTake-Off System for a Wave Energy Converter with Multiple Absorbers

    Hansen, Rico Hjerm

    waves. This enables a comparison of the performance of the wave power extraction methods according to PTO requirements. The framework also allows comparing performance of fundamentally different PTOs. The idea of reactive control for increasing power absorption dates back to the 1970’s, and today its...... techniques. The research leads to three potential PTO systems, where one is a magnetic gear based PTO. The gear is based on implementing the function of a screw and nut magnetically by placing permanent magnets in a helical pattern. A PTO layout with the magnetic lead screw is found and analysed using...... simulations. The feasibility leads to having a group of master students designing a working prototype at a scale of 17kN with a half meter stroke. The magnetic lead screw is able to directly convert a linear motion of 0.5m/s to a rotational motion above 1000rpm, driving a conventional generator. Two other...

  14. Design and First Results of an UAV-Borne L-Band Radiometer for Multiple Monitoring Purposes

    Rene Acevo-Herrera

    2010-06-01

    Full Text Available UAV (unmanned Aerial Vehicle platforms represent a challenging opportunity for the deployment of a number of remote sensors. These vehicles are a cost-effective option in front of manned aerial vehicles (planes and helicopters, are easy to deploy due to the short runways needed, and they allow users to meet the critical requirements of the spatial and temporal resolutions imposed by the instruments. L-band radiometers are an interesting option for obtaining soil moisture maps over local areas with relatively high spatial resolution for precision agriculture, coastal monitoring, estimation of the risk of fires, flood prevention, etc. This paper presents the design of a light-weight, airborne L-band radiometer for deployment in a small UAV, including the hardware and specific software developed for calibration, geo-referencing, and soil moisture retrieval. First results and soil moisture retrievals from different field experiments are presented.

  15. Designing an electricity tax system in presence of international regulations and multiple public goals: An empirical assessment

    Bjertnaes, Geir H.; Faehn, Taran; Aasness, Jorgen

    2008-01-01

    The European competition rules restrict governments' opportunity to differentiate terms of energy accessibility among firms and industries. This easily runs counter with regional and industrial goals of national energy policies. Norway levies a tax on use of electricity, but exempts main industrial usages. This analysis assesses alternative, internationally legal, designs of the system in terms of their effects on efficiency and distribution, including industrial objectives. Among the reforms we explore, removing the exemptions would be the most effective way of raising revenue, but it would be politically costly by deteriorating the competitiveness of today's favoured industries. An entire abolishment of the electricity tax, and replacing revenue by increased VAT, would generate a more equal distribution of standard of living and, at the same time, avoid the trade-off between efficiency and competitiveness

  16. A design study for the use of a multiple aperture deployable antenna for soil moisture remote sensing satellite applications

    Foldes, P.

    1986-01-01

    The instrumentation problems associated with the measurement of soil moisture with a meaningful spatial and temperature resolution at a global scale are addressed. For this goal only medium term available affordable technology will be considered. The study while limited in scope, will utilize a large scale antenna structure, which is being developed presently as an experimental model. The interface constraints presented by a singel Space Transportation System (STS) flight will be assumed. Methodology consists of the following steps: review of science requirements; analyze effects of these requirements; present basic system engineering considerations and trade-offs related to orbit parameters, number of spacecraft and their lifetime, observation angles, beamwidth, crossover and swath, coverage percentage, beam quality and resolution, instrument quantities, and integration time; bracket the key system characteristics and develop an electromagnetic design of the antenna-passive radiometer system. Several aperture division combinations and feed array concepts are investigated to achieve maximum feasible performacne within the stated STS constraints.

  17. Saccharomyces cerevisiae single-copy plasmids for auxotrophy compensation, multiple marker selection, and for designing metabolically cooperating communities [version 1; referees: 2 approved

    Michael Mülleder

    2016-09-01

    Full Text Available Auxotrophic markers are useful tools in cloning and genome editing, enable a large spectrum of genetic techniques, as well as facilitate the study of metabolite exchange interactions in microbial communities. If unused background auxotrophies are left uncomplemented however, yeast cells need to be grown in nutrient supplemented or rich growth media compositions, which precludes the analysis of biosynthetic metabolism, and which leads to a profound impact on physiology and gene expression. Here we present a series of 23 centromeric plasmids designed to restore prototrophy in typical Saccharomyces cerevisiae laboratory strains. The 23 single-copy plasmids complement for deficiencies in HIS3, LEU2, URA3, MET17 or LYS2 genes and in their combinations, to match the auxotrophic background of the popular functional-genomic yeast libraries that are based on the S288c strain. The plasmids are further suitable for designing self-establishing metabolically cooperating (SeMeCo communities, and possess a uniform multiple cloning site to exploit multiple parallel selection markers in protein expression experiments.

  18. Data Base Design with GIS in Ecosystem Based Multiple Use Forest Management in Artvin, Turkey: A Case Study in Balcı Forest Management Planning Unit.

    Yolasığmaz, Hacı Ahmet; Keleş, Sedat

    2009-01-01

    In Turkey, the understanding of planning focused on timber production has given its place on Multiple Use Management (MUM). Because the whole infrastructure of forestry with inventory system leading the way depends on timber production, some cases of bottle neck are expected during the transition period. Database design, probably the most important stage during the transition to MUM, together with the digital basic maps making up the basis of this infrastructure constitute the main point of this article. Firstly, the forest management philosophy of Turkey in the past was shortly touched upon in the article. Ecosystem Based Multiple Use Forest Management (EBMUFM) approaches was briefly introduced. The second stage of the process of EBMUFM, database design was described by examining the classical planning infrastructure and the coverage to be produced and consumed were suggested in the form of lists. At the application stage, two different geographical databases were established with GIS in Balcı Planning Unit of the years 1984 and 2006. Following that the related basic maps are produced. Timely diversity of the planning unit of 20 years is put forward comparatively with regard to the stand parameters such as tree types, age class, development stage, canopy closure, mixture, volume and increment.

  19. The design, implementation and acceptability of an integrated intervention to address multiple behavioral and psychosocial risk factors among pregnant African American women

    Rossi Maryann

    2008-06-01

    Full Text Available Abstract Background African American women are at increased risk for poor pregnancy outcomes compared to other racial-ethnic groups. Single or multiple psychosocial and behavioral factors may contribute to this risk. Most interventions focus on singular risks. This paper describes the design, implementation, challenges faced, and acceptability of a behavioral counseling intervention for low income, pregnant African American women which integrated multiple targeted risks into a multi-component format. Methods Six academic institutions in Washington, DC collaborated in the development of a community-wide, primary care research study, DC-HOPE, to improve pregnancy outcomes. Cigarette smoking, environmental tobacco smoke exposure, depression and intimate partner violence were the four risks targeted because of their adverse impact on pregnancy. Evidence-based models for addressing each risk were adapted and integrated into a multiple risk behavior intervention format. Pregnant women attending six urban prenatal clinics were screened for eligibility and risks and randomized to intervention or usual care. The 10-session intervention was delivered in conjunction with prenatal and postpartum care visits. Descriptive statistics on risk factor distributions, intervention attendance and length (i.e., with Results Forty-eight percent of women screened were eligible based on presence of targeted risks, 76% of those eligible were enrolled, and 79% of those enrolled were retained postpartum. Most women reported a single risk factor (61%; 39% had multiple risks. Eighty-four percent of intervention women attended at least one session (60% attended ≥ 4 sessions without disruption of clinic scheduling. Specific risk factor content was delivered as prescribed in 80% or more of the sessions; 78% of sessions were fully completed (where all required risk content was covered. Ninety-three percent of the subsample of intervention women had a positive view of their

  20. Design and validation of realistic breast models for use in multiple alternative forced choice virtual clinical trials.

    Elangovan, Premkumar; Mackenzie, Alistair; Dance, David R; Young, Kenneth C; Cooke, Victoria; Wilkinson, Louise; Given-Wilson, Rosalind M; Wallis, Matthew G; Wells, Kevin

    2017-04-07

    A novel method has been developed for generating quasi-realistic voxel phantoms which simulate the compressed breast in mammography and digital breast tomosynthesis (DBT). The models are suitable for use in virtual clinical trials requiring realistic anatomy which use the multiple alternative forced choice (AFC) paradigm and patches from the complete breast image. The breast models are produced by extracting features of breast tissue components from DBT clinical images including skin, adipose and fibro-glandular tissue, blood vessels and Cooper's ligaments. A range of different breast models can then be generated by combining these components. Visual realism was validated using a receiver operating characteristic (ROC) study of patches from simulated images calculated using the breast models and from real patient images. Quantitative analysis was undertaken using fractal dimension and power spectrum analysis. The average areas under the ROC curves for 2D and DBT images were 0.51  ±  0.06 and 0.54  ±  0.09 demonstrating that simulated and real images were statistically indistinguishable by expert breast readers (7 observers); errors represented as one standard error of the mean. The average fractal dimensions (2D, DBT) for real and simulated images were (2.72  ±  0.01, 2.75  ±  0.01) and (2.77  ±  0.03, 2.82  ±  0.04) respectively; errors represented as one standard error of the mean. Excellent agreement was found between power spectrum curves of real and simulated images, with average β values (2D, DBT) of (3.10  ±  0.17, 3.21  ±  0.11) and (3.01  ±  0.32, 3.19  ±  0.07) respectively; errors represented as one standard error of the mean. These results demonstrate that radiological images of these breast models realistically represent the complexity of real breast structures and can be used to simulate patches from mammograms and DBT images that are indistinguishable from

  1. Rationale and design of a multicenter echocardiographic study to assess the relationship between cardiac structure and function and heart failure risk in a biracial cohort of community-dwelling elderly persons: the Atherosclerosis Risk in Communities study.

    Shah, Amil M; Cheng, Susan; Skali, Hicham; Wu, Justina; Mangion, Judy R; Kitzman, Dalane; Matsushita, Kunihiro; Konety, Suma; Butler, Kenneth R; Fox, Ervin R; Cook, Nakela; Ni, Hanyu; Coresh, Josef; Mosley, Thomas H; Heiss, Gerardo; Folsom, Aaron R; Solomon, Scott D

    2014-01-01

    Heart failure is an important public health concern, particularly among persons>65 years of age. Women and blacks are critically understudied populations that carry a sizeable portion of the heart failure burden. Limited normative and prognostic data exist on measures of cardiac structure, diastolic function, and novel measures of systolic deformation in older adults living in the community. The Atherosclerosis Risk in Communities (ARIC) study is a large, predominantly biracial, National Heart, Lung, and Blood Institute-sponsored epidemiological cohort study. Between 2011 and 2013, ≈6000 surviving participants, now in their seventh to ninth decade of life, are expected to return for a fifth study visit during which comprehensive 2-dimensional, Doppler, tissue Doppler, and speckle-tracking echocardiography will be performed uniformly in all cohort clinic visit participants. The following objectives will be addressed: (1) to characterize cardiac structural and functional abnormalities among the elderly and to determine how they differ by sex and race/ethnicity, (2) to determine the relationship between ventricular and vascular abnormalities, and (3) to prospectively examine the extent to which these noninvasive measures associate with incident heart failure. We describe the design, imaging acquisition and analysis methods, and quality assurance metrics for echocardiography in visit 5 of the ARIC cohort. A better understanding of the differences in cardiac structure and function through the spectrum of heart failure stages in elderly persons generally, and between sexes and racial/ethnic groups specifically, will deepen our understanding of the pathophysiology driving heart failure progression in these at-risk populations and may inform novel prevention or therapeutic strategies.

  2. The MOBILIZE Boston Study: Design and methods of a prospective cohort study of novel risk factors for falls in an older population

    Hannan Marian T

    2008-07-01

    Full Text Available Abstract Background Falls are the sixth leading cause of death in elderly people in the U.S. Despite progress in understanding risk factors for falls, many suspected risk factors have not been adequately studied. Putative risk factors for falls such as pain, reductions in cerebral blood flow, somatosensory deficits, and foot disorders are poorly understood, in part because they pose measurement challenges, particularly for large observational studies. Methods The MOBILIZE Boston Study (MBS, an NIA-funded Program Project, is a prospective cohort study of a unique set of risk factors for falls in seniors in the Boston area. Using a door-to-door population-based recruitment, we have enrolled 765 persons aged 70 and older. The baseline assessment was conducted in 2 segments: a 3-hour home interview followed within 4 weeks by a 3-hour clinic examination. Measures included pain, cerebral hemodynamics, and foot disorders as well as established fall risk factors. For the falls follow-up, participants return fall calendar postcards to the research center at the end of each month. Reports of falls are followed-up with a telephone interview to assess circumstances and consequences of each fall. A second assessment is performed 18 months following baseline. Results Of the 2382 who met all eligibility criteria at the door, 1616 (67.8% agreed to participate and were referred to the research center for further screening. The primary reason for ineligibility was inability to communicate in English. Results from the first 600 participants showed that participants are largely representative of seniors in the Boston area in terms of age, sex, race and Hispanic ethnicity. The average age of study participants was 77.9 years (s.d. 5.5 and nearly two-thirds were women. The study cohort was 78% white and 17% black. Many participants (39% reported having fallen at least once in the year before baseline. Conclusion Our results demonstrate the feasibility of conducting

  3. Innovative Teaching of IC Design and Manufacture Using the Superchip Platform

    Wilson, P. R.; Wilcock, R.; McNally, I.; Swabey, M.

    2010-01-01

    This paper describes how an intelligent chip architecture has allowed a large cohort of undergraduate (UG) students to be given effective practical insight into integrated circuit (IC) design by designing and manufacturing their own ICs. To achieve this, an efficient chip architecture, the "Superchip," was developed, which allows multiple student…

  4. Computer-aided design of multifrequency eddy-current tests for layered conductors with multiple property variations

    Deeds, W E; Dodd, C V; Scott, G W

    1979-10-01

    Our program is part of a larger project designed to develop multifrequency eddy-current inspection techniques for multilayered conductors with parallel planar boundaries. To reduce the need to specially program each new problem, a family of programs that handle a large class of related problems with only minor editorial and interactive changes were developed. Programs for two types of cylindrical coil probes were developed: the reflection probe, which contains the driver and pickup coils and is used from one side of the specimen, and the through-transmission probe set, which places the driver and pickup coils on opposite sides of the conductor stack. The programs perform the following basic functions: (1) simulation of an ideal instrument's response to specific conductor and defect configurations, (2) control of an eddy-current instrument interfaced to a minicomputer to acquire and record actual instrument responses to test specimens, (3) construction of complex function expansions to relate instrument response to conductor and defect properties by using measured or computed responses and properties, and (4) simulation of a microcomputer on board the instrument by the interfaced minicomputer to test the analytical programming for the microcomputer. The report contains the basic equations for the computations, the main and subroutine programs, instructions for editorial changes and program execution, analyses of the main programs, file requirements, and other miscellaneous aids for the user.

  5. Objectives and Design of BLEEDS: A Cohort Study to Identify New Risk Factors and Predictors for Major Bleeding during Treatment with Vitamin K Antagonists.

    van Rein, Nienke; Lijfering, Willem M; Bos, Mettine H A; Herruer, Martien H; Vermaas, Helga W; van der Meer, Felix J M; Reitsma, Pieter H

    2016-01-01

    Risk scores for patients who are at high risk for major bleeding complications during treatment with vitamin K antagonists (VKAs) do not perform that well. BLEEDS was initiated to search for new biomarkers that predict bleeding in these patients. To describe the outline and objectives of BLEEDS and to examine whether the study population is generalizable to other VKA treated populations. A cohort was created consisting of all patients starting VKA treatment at three Dutch anticoagulation clinics between January-2012 and July-2014. We stored leftover plasma and DNA following analysis of the INR. Of 16,706 eligible patients, 16,570 (99%) were included in BLEEDS and plasma was stored from 13,779 patients (83%). Patients had a mean age of 70 years (SD 14), 8713 were male (53%). The most common VKA indications were atrial fibrillation (10,876 patients, 66%) and venous thrombosis (3920 patients, 24%). 326 Major bleeds occurred during 17,613 years of follow-up (incidence rate 1.85/100 person years, 95%CI 1.66-2.06). The risk for major bleeding was highest in the initial three months of VKA treatment and increased when the international normalized ratio increased. These results and characteristics are in concordance with results from other VKA treated populations. BLEEDS is generalizable to other VKA treated populations and will permit innovative and unbiased research of biomarkers that may predict major bleeding during VKA treatment.

  6. Design and studies of multiple mechanism of anti-Candida activity of a new potent Trp-rich peptide dendrimers.

    Zielińska, Paulina; Staniszewska, Monika; Bondaryk, Małgorzata; Koronkiewicz, Mirosława; Urbańczyk-Lipkowska, Zofia

    2015-11-13

    Eight peptide dendrimers were designed as structural mimics of natural cationic amphiphilic peptides with antifungal activity and evaluated for their anti-Candida potential against the wild type strains and mutants. Dendrimer 14 containing four Trp residues and dodecyl tail and a slightly smaller dendrimer 9 decorated with four N-methylated Trp that displayed 100 and 99.7% of growth inhibition at 16 μg/mL respectively, were selected for evaluation against the Candida albicans mutants with disabled biosynthesis of aspartic proteases responsible for host tissue colonization and morphogenesis during biofilm formation (sessile model). Flow cytometry method was employed to detect apoptotic cells with membrane alterations (phosphatidylserine translocation), and differentiation of apoptotic from necrotic cells was also performed. Simultaneous staining of cell surface phosphatidylserine with Annexin-V-Fluorescein and necrotic cells with propidium iodide was conducted. 14 at 16 μg/mL caused C. albicans cells to undergo cellular apoptosis but its increasing concentrations induced necrosis. 14 influenced C. albicans biofilm viability as well as hyphal and cell wall morphology. Confocal microscopy and cell wall staining with calcofluor white revealed that in epithelial model the cell surface structure was perturbed at MIC of peptide dendrimer. It appears that tryptophan or 1-methyltryptophan groups displayed at the surface and positive charges hidden in the dendrimer tree along with hydrocarbon tail located at C-terminus are important for the anti-Candida activity since dendrimers containing tryptamine at C-terminus showed only a moderate activity. Our results suggest that membranolytic dendrimer 14, targeting cellular apoptotic pathway and impairing the cell wall formation in mature biofilm, may be a potential multifunctional antifungal lead compound for the control of C. albicans infections. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  7. Design and baseline characteristics of a coronary heart disease prospective cohort: two-year experience from the strategy of registry of acute coronary syndrome study (ERICO study

    Alessandra C. Goulart

    2013-01-01

    Full Text Available OBJECTIVES: To describe the ERICO study (Strategy of Registry of Acute Coronary Syndrome, a prospective cohort to investigate the epidemiology of acute coronary syndrome. METHODS: The ERICO study, which is being performed at a secondary general hospital in São Paulo, Brazil, is enrolling consecutive acute coronary syndrome patients who are 35 years old or older. The sociodemographic information, medical assessments, treatment data and blood samples are collected at admission. After 30 days, the medical history is updated, and additional blood and urinary samples are collected. In addition, a retinography, carotid intima-media thickness, heart rate variability and pulse-wave velocity are performed. Questionnaires about food frequency, physical activity, sleep apnea and depression are also applied. At six months and annually after an acute event, information is collected by telephone. RESULTS: From February 2009 to September 2011, 738 patients with a diagnosis of an acute coronary syndrome were enrolled. Of these, 208 (28.2% had ST-elevation myocardial infarction (STEMI, 288 (39.0% had non-ST-elevation myocardial infarction (NSTEMI and 242 (32.8% had unstable angina (UA. The mean age was 62.7 years, 58.5% were men and 77.4% had 8 years or less of education. The most common cardiovascular risk factors were hypertension (76% and sedentarism (73.4%. Only 29.2% had a prior history of coronary heart disease. Compared with the ST-elevation myocardial infarction subgroup, the unstable angina and non-ST-elevation myocardial infarction patients had higher frequencies of hypertension, diabetes, prior coronary heart disease (p<0.001 and dyslipidemia (p = 0.03. Smoking was more frequent in the ST-elevation myocardial infarction patients (p = 0.006. CONCLUSIONS: Compared with other hospital registries, our findings revealed a higher burden of CV risk factors and less frequent prior CHD history.

  8. Resourse Use and Disease Couse in dementia - Nursing Home (REDIC-NH), a longitudinal cohort study; design and patient characteristics at admission to Norwegian nursing homes.

    Røen, Irene; Selbæk, Geir; Kirkevold, Øyvind; Engedal, Knut; Testad, Ingelin; Bergh, Sverre

    2017-05-22

    Earlier studies of nursing home patients show a high prevalence of dementia, neuropsychiatric symptoms (NPS), pain, and dependency in activities of daily living. The REDIC-NH cohort was set up to study the disease course and the resources used in patients with dementia in Norway. The aim of this paper was to describe the methods and the data collection, and to present selected data about patients at admission to a nursing home. We included 696 patients at admission to a nursing home and followed them with biannual assessments until death. Baseline data were collected between March 2012 and November 2014. In October 2016, patients had either completed an 18-month follow-up (n = 349), passed 18 months without assessments (n = 22), or left the study (n = 324). Data on demographics, cognition, NPS, activities of daily living (ADL) functioning, physical health, medication, Quality of Life (QoL), resource use, and caregiver burden, in addition to DNA samples were collected. Mean age of the participants at inclusion was 84.5 years (SD 7.5, range 50 - 105), 63.9% were women. According to data collected in the study, 83.8% had dementia, but only 55.9% of them had a diagnosis of dementia registered in their records. The most frequent dementia diagnosis was Alzheimer's disease, which was present in 71% of those with dementia. Patients with dementia more often experienced delusions, hallucinations, agitation, anxiety, disinhibition, irritability, and aberrant motor behaviour compared to patients without dementia. Depression and anxiety were the most common NPS symptoms. Dementia and NPS were highly prevalent among persons admitted to nursing homes. Only 55.9% of the patients with dementia had a diagnosis of dementia registered in their records.

  9. Flight controller design of unmanned airplane for radiation monitoring system via structured robust controller design using multiple model approach. Radiation monitoring flight in Namie-machi in Fukushima prefecture

    Sato, Masayuki; Muraoka, Koji; Hozumi, Koki; Sanada, Yukihisa; Yamada, Tsutomu; Torii, Tatsuo

    2015-01-01

    Due to the tragic accident of radioactive contaminant spread from Fukushima Dai-ichi nuclear power plant, the necessity of unmanned systems for radiation monitoring has been increasing. This paper concerns the flight controller design of an unmanned airplane which has been developed for radiation monitoring around the power plant. The flight controller consists of conventional control elements, i.e. Stability/Control Augmentation System (S/CAS) with PI controllers and guidance loops with PID controllers. The gains in these controllers are designed by minimizing appropriately defined cost functions for several possible models and disturbances to produce structured robust flight controllers. (This method is called as 'multiple model approach'.) Control performance of our flight controller was evaluated through flight tests and a primitive flight of radiation monitoring in Namie-machi in Fukushima prefecture was conducted in Jan. 2014. Flight results are included in this paper. (author)

  10. Rational design of a conformation-switchable Ca2+- and Tb3+-binding protein without the use of multiple coupled metal-binding sites.

    Li, Shunyi; Yang, Wei; Maniccia, Anna W; Barrow, Doyle; Tjong, Harianto; Zhou, Huan-Xiang; Yang, Jenny J

    2008-10-01

    Ca2+, as a messenger of signal transduction, regulates numerous target molecules via Ca2+-induced conformational changes. Investigation into the determinants for Ca2+-induced conformational change is often impeded by cooperativity between multiple metal-binding sites or protein oligomerization in naturally occurring proteins. To dissect the relative contributions of key determinants for Ca2+-dependent conformational changes, we report the design of a single-site Ca2+-binding protein (CD2.trigger) created by altering charged residues at an electrostatically sensitive location on the surface of the host protein rat Cluster of Differentiation 2 (CD2).CD2.trigger binds to Tb3+ and Ca2+ with dissociation constants of 0.3 +/- 0.1 and 90 +/- 25 microM, respectively. This protein is largely unfolded in the absence of metal ions at physiological pH, but Tb3+ or Ca2+ binding results in folding of the native-like conformation. Neutralization of the charged coordination residues, either by mutation or protonation, similarly induces folding of the protein. The control of a major conformational change by a single Ca2+ ion, achieved on a protein designed without reliance on sequence similarity to known Ca2+-dependent proteins and coupled metal-binding sites, represents an important step in the design of trigger proteins.

  11. Multiple chronic conditions and life expectancy

    DuGoff, Eva H; Canudas-Romo, Vladimir; Buttorff, Christine

    2014-01-01

    BACKGROUND: The number of people living with multiple chronic conditions is increasing, but we know little about the impact of multimorbidity on life expectancy. OBJECTIVE: We analyze life expectancy in Medicare beneficiaries by number of chronic conditions. RESEARCH DESIGN: A retrospective cohort...... study using single-decrement period life tables. SUBJECTS: Medicare fee-for-service beneficiaries (N=1,372,272) aged 67 and older as of January 1, 2008. MEASURES: Our primary outcome measure is life expectancy. We categorize study subjects by sex, race, selected chronic conditions (heart disease, cancer...... and increasing numbers of comorbid conditions. CONCLUSIONS: Social Security and Medicare actuaries should account for the growing number of beneficiaries with multiple chronic conditions when determining population projections and trust fund solvency....

  12. Treatment of fatigue with methylphenidate, modafinil and amantadine in multiple sclerosis (TRIUMPHANT-MS): Study design for a pragmatic, randomized, double-blind, crossover clinical trial.

    Nourbakhsh, Bardia; Revirajan, Nisha; Waubant, Emmanuelle

    2018-01-01

    Fatigue is the most common symptom of multiple sclerosis (MS). Amantadine, modafinil and amphetamine-like stimulants are commonly used in clinical practice for treatment of fatigue; however, the evidence supporting their effectiveness is sparse and conflicting. To describe the design of a trial study funded by Patient-Centered Outcome Research Institute (PCORI) that will compare the efficacy of commonly used fatigue medications in patients with MS. The study is a randomized, placebo-controlled, crossover, four-sequence, four-period, double-blind, multicenter trial of three commonly used medications for the treatment of MS-related fatigue (amantadine, modafinil, methylphenidate) versus placebo in fatigued subjects with MS. Adult patients with MS, with an Expanded Disability Status Scale of MS-related fatigue. Clinicaltrials.gov registration number: NCT03185065. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Cardiovascular RiskprofilE - IMaging and gender-specific disOrders (CREw-IMAGO): rationale and design of a multicenter cohort study.

    Zoet, Gerbrand A; Meun, Cindy; Benschop, Laura; Boersma, Eric; Budde, Ricardo P J; Fauser, Bart C J M; de Groot, Christianne J M; van der Lugt, Aad; Maas, Angela H E M; Moons, Karl G M; Roeters van Lennep, Jeanine E; Roos-Hesselink, Jolien W; Steegers, Eric A P; van Rijn, Bas B; Laven, Joop S E; Franx, Arie; Velthuis, Birgitta K

    2017-08-07

    Reproductive disorders, such as polycystic ovary syndrome (PCOS), primary ovarian insufficiency (POI) and hypertensive pregnancy disorders (HPD) like pre-eclampsia (PE), are associated with an increased risk of cardiovascular disease (CVD). Detection of early signs of cardiovascular disease (CVD), as well as identification of risk factors among women of reproductive age which improve cardiovascular risk prediction, is a challenge and current models might underestimate long-term health risks. The aim of this study is to assess cardiovascular disease in patients with a history of a reproductive disorder by low-dose computed tomography (CT). Women of 45 - 55 years, who experienced a reproductive disorder (PCOS, POI, HPD), are invited to participate in this multicenter, prospective, cohort study. Women will be recruited after regular cardiovascular screening, including assessment of classical cardiovascular risk factors. CT of the coronary arteries (both coronary artery calcium scoring (CACS), and contrast-enhanced coronary CT angiography (CCTA)) and carotid siphon calcium scoring (CSC) is planned in 300 women with HPD and 300 women with PCOS or POI. In addition, arterial stiffness (non-invasive pulse wave velocity (PWV)) measurement and cell-based biomarkers (inflammatory circulating cells) will be obtained. Initial inclusion is focused on women of 45 - 55 years. However, the age range (40 - 45 years and/or ≥ 55 years) and group composition may be adjusted based on the findings of the interim analysis. Participants can potentially benefit from information obtained in this study concerning their current cardiovascular health and expected future risk of cardiovascular events. The results of this study will provide insights in the development of CVD in women with a history of reproductive disorders. Ultimately, this study may lead to improved cardiovascular prediction models and will provide an opportunity for timely adjustment of preventive

  14. Prognostic Classification Factors Associated With Development of Multiple Autoantibodies, Dysglycemia, and Type 1 Diabetes?A Recursive Partitioning Analysis

    Xu, Ping; Krischer, Jeffrey P.

    2016-01-01

    OBJECTIVE To define prognostic classification factors associated with the progression from single to multiple autoantibodies, multiple autoantibodies to dysglycemia, and dysglycemia to type 1 diabetes onset in relatives of individuals with type 1 diabetes. RESEARCH DESIGN AND METHODS Three distinct cohorts of subjects from the Type 1 Diabetes TrialNet Pathway to Prevention Study were investigated separately. A recursive partitioning analysis (RPA) was used to determine the risk classes. Clini...

  15. International Network of Chronic Kidney Disease cohort studies (iNET-CKD): a global network of chronic kidney disease cohorts.

    Dienemann, Thomas; Fujii, Naohiko; Orlandi, Paula; Nessel, Lisa; Furth, Susan L; Hoy, Wendy E; Matsuo, Seiichi; Mayer, Gert; Methven, Shona; Schaefer, Franz; Schaeffner, Elke S; Solá, Laura; Stengel, Bénédicte; Wanner, Christoph; Zhang, Luxia; Levin, Adeera; Eckardt, Kai-Uwe; Feldman, Harold I

    2016-09-02

    Chronic kidney disease (CKD) is a global health burden, yet it is still underrepresented within public health agendas in many countries. Studies focusing on the natural history of CKD are challenging to design and conduct, because of the long time-course of disease progression, a wide variation in etiologies, and a large amount of clinical variability among individuals with CKD. With the difference in health-related behaviors, healthcare delivery, genetics, and environmental exposures, this variability is greater across countries than within one locale and may not be captured effectively in a single study. Studies were invited to join the network. Prerequisites for membership included: 1) observational designs with a priori hypotheses and defined study objectives, patient-level information, prospective data acquisition and collection of bio-samples, all focused on predialysis CKD patients; 2) target sample sizes of 1,000 patients for adult cohorts and 300 for pediatric cohorts; and 3) minimum follow-up of three years. Participating studies were surveyed regarding design, data, and biosample resources. Twelve prospective cohort studies and two registries covering 21 countries were included. Participants age ranges from >2 to >70 years at inclusion, CKD severity ranges from stage 2 to stage 5. Patient data and biosamples (not available in the registry studies) are measured yearly or biennially. Many studies included multiple ethnicities; cohort size ranges from 400 to more than 13,000 participants. Studies' areas of emphasis all include but are not limited to renal outcomes, such as progression to ESRD and death. iNET-CKD (International Network of CKD cohort studies) was established, to promote collaborative research, foster exchange of expertise, and create opportunities for research training. Participating studies have many commonalities that will facilitate comparative research; however, we also observed substantial differences. The diversity we observed across

  16. Design

    Volf, Mette

    Design - proces & metode iBog®  er enestående i sit fokus på afmystificering og operationalisering af designprocessens flygtige og komplekse karakter. Udgivelsen går bag om designerens daglige arbejde og giver et indblik i den kreative skabelsesproces, som designeren er en del af. Udover et bredt...... indblik i designerens arbejdsmetoder og designparametre giver Design - proces & metode en række eksempler fra anerkendte designvirksomheder, der gør det muligt at komme helt tæt på designerens virkelighed....

  17. Design

    Buchanan, Richard; Cross, Nigel; Durling, David; Nelson, Harold; Owen, Charles; Valtonen, Anna; Boling, Elizabeth; Gibbons, Andrew; Visscher-Voerman, Irene

    2013-01-01

    Scholars representing the field of design were asked to identify what they considered to be the most exciting and imaginative work currently being done in their field, as well as how that work might change our understanding. The scholars included Richard Buchanan, Nigel Cross, David Durling, Harold Nelson, Charles Owen, and Anna Valtonen. Scholars…

  18. Multiple Target Laser Designator (MTLD)

    2007-03-01

    Optimized Liquid Crystal Scanning Element Optimize the Nonimaging Predictive Algorithm for Target Ranging, Tracking, and Position Estimation...commercial potential. 3.0 PROGRESS THIS QUARTER 3.1 Optimization of Nonimaging Holographic Antenna for Target Tracking and Position Estimation (Task 6) In

  19. Use of the International Classification of Functioning, Disability and Health to describe patient-reported disability: a comparison of Guillain Barré syndrome with multiple sclerosis in a community cohort.

    Khan, Fary; Amatya, Bhasker; Ng, Louisa

    2010-09-01

    To use the International Classification of Functioning, Disability and Health (ICF) to describe and compare patient-reported disability in Guillain-Barré syndrome survivors and persons with multiple sclerosis, and to identify relevant environmental factors. Cross-sectional survey of 77 survivors of Guillain-Barré syndrome in the community. Their Guillain-Barré syndrome-related problems were linked with ICF categories (second level) using an open-ended questionnaire, consensus between health professionals and the "linking rules", and compared with similar data collected previously for 101 persons with multiple sclerosis. Guillain-Barré syndrome survivors were male (59%) and older than persons with multiple sclerosis (mean age 55 vs 49 years). Of 170 ICF categories, 113 were relevant for Guillain-Barré syndrome survivors (mean number 30 vs 18 for persons with multiple sclerosis). The linked categories for Guillain-Barré syndrome included: body function 27 (56%) compared with 48 (42%) for persons with multiple sclerosis; body structure 11 (68%) vs 16 (34%); activities and participation 48 (70%) and 68 (58%); and for environmental factors 27 (71%) compared with 38 (51%) for persons with multiple sclerosis. The main areas linked in the activities and participation domain were mobility, major life areas and interpersonal relationships; and environmental factors included support and relationships, attitudes and products and technology. This is the first study to use ICF in Guillain-Barré syndrome survivors and towards development of the ICF Core Set for Guillain-Barré syndrome from a broader international perspective.

  20. Rationale and design of the East-West late lumen loss study: Comparison of late lumen loss between Eastern and Western drug-eluting stent study cohorts.

    Harrison, Robert W; Radhakrishnan, Vaishnavi; Lam, Peter S; Allocco, Dominic J; Brar, Sandeep; Fahy, Martin; Fisher, Rebecca; Ikeno, Fumiaki; Généreux, Philippe; Kimura, Takeshi; Liu, Minglei; Lye, Weng Kit; Mintz, Gary S; Nagai, Hirofumi; Suzuki, Yuka; White, Roseann; Allen, John C; Krucoff, Mitchell W

    2016-12-01

    The contemporary evaluation of novel drug-eluting stents (DES) includes mechanistic observations that characterize postdeployment stent behavior. Quantification of late lumen loss due to neointimal hyperplasia 8-13 months after stent implantation, via quantitative coronary angiography (QCA), constitutes such an observation and is required by most regulatory authorities. Late lumen loss, as determined by QCA, has been validated as a surrogate for clinical endpoints such as target vessel revascularization. The mechanistic response to DES has not been directly compared across predominantly Asian or Western populations, whereas understanding their comparability across geographic populations could enhance global DES evaluation. The East-West late lumen loss study is designed to demonstrate whether the residual differences in late lumen loss, as assessed by QCA, is different between Eastern and Western DES recipients from studies with protocol angiography at 8-13 months of follow-up. Data from independent core laboratories that have characterized angiographic late lumen loss in DES clinical trials with protocol follow-up angiography will be compiled and dichotomized into Eastern and Western populations. A prospectively developed propensity score model incorporating clinical and anatomic variables affecting late lumen loss will be used to adjust comparisons of QCA measurements. Documentation of whether there are clinically meaningful differences in mechanistic response to DES implantation across genetically unique geographies could facilitate both the quality and efficiency of global device evaluation requiring invasive follow-up for novel stent designs. Copyright © 2016 Elsevier Inc. All rights reserved.