Sample records for multiple cohort design
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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
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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.
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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.
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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
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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
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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
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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.
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International Nuclear Information System (INIS)
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
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Directory of Open Access Journals (Sweden)
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.
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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.
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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.
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Secondary Analysis under Cohort Sampling Designs Using Conditional Likelihood
Directory of Open Access Journals (Sweden)
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.
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DEFF Research Database (Denmark)
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...
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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.
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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.
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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…
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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.
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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.
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The Copenhagen Oral Health Senior Cohort: design, population and dental health
DEFF Research Database (Denmark)
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...
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Multiple Sclerosis After Infectious Mononucleosis
DEFF Research Database (Denmark)
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...
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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.
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Anti-JC virus antibody prevalence in a multinational multiple sclerosis cohort
DEFF Research Database (Denmark)
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...
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Preliminary A ampersand PCT multiple detector design
International Nuclear Information System (INIS)
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
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Multiple-valued logic design based on the multiple-peak BiCMOS-NDR circuits
Directory of Open Access Journals (Sweden)
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.
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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
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Directory of Open Access Journals (Sweden)
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.
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Study Design and Cohort Description of DEFIB-WOMEN
DEFF Research Database (Denmark)
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...
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Free Material Design with Multiple Load Cases
DEFF Research Database (Denmark)
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....
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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
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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.
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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.
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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
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Revitalising the Metropolit 1953 Danish male birth cohort: background, aims and design
DEFF Research Database (Denmark)
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...
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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.
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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).
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DEFF Research Database (Denmark)
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...
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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...
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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.
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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.
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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.
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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.
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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.
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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
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Design of a Ku band miniature multiple beam klystron
Energy Technology Data Exchange (ETDEWEB)
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.
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Design and development of multiple sample counting setup
International Nuclear Information System (INIS)
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
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Multivariant design and multiple criteria analysis of building refurbishments
Energy Technology Data Exchange (ETDEWEB)
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)
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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.
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Methodology series module 1: Cohort studies
Directory of Open Access Journals (Sweden)
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.
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design, construction and performance evaluation of multiple casting
African Journals Online (AJOL)
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.
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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
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The Challenges of Designing Digital Services for Multiple Mobile Platforms
DEFF Research Database (Denmark)
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...
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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
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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
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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.
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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...
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DEFF Research Database (Denmark)
Frederiksen, J.L.; Madsen, H.O.; Ryder, L.P.
1997-01-01
OBJECTIVE: To study the association of brain magnetic resonance imaging (MRI) findings and HLA findings to clarify the relationship between monosymptomatic optic neuritis (ON) and ON as part of clinically definite multiple sclerosis (CDMS). DESIGN: Population-based cohort of patients with ON refe......OBJECTIVE: To study the association of brain magnetic resonance imaging (MRI) findings and HLA findings to clarify the relationship between monosymptomatic optic neuritis (ON) and ON as part of clinically definite multiple sclerosis (CDMS). DESIGN: Population-based cohort of patients......: The frequency of HLA-DR15 was significantly increased in patients with ON + CDMS (52%) and ON (47%) compared with control subjects (31%). The frequency of HLA-DR17 was almost equal in the ON + CDMS (18%), ON (23%), and control (23%) groups. The frequencies of HLA-DQA-1B (55% in ON + CDMS, 58% in ON) and HLA...
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Adaptive Waveform Design for Cognitive Radar in Multiple Targets Situations
Directory of Open Access Journals (Sweden)
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.
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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…
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Directory of Open Access Journals (Sweden)
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.
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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
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Directory of Open Access Journals (Sweden)
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.
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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.
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Directory of Open Access Journals (Sweden)
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.
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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
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On strength design using free material subjected to multiple load cases
DEFF Research Database (Denmark)
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...
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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.
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Directory of Open Access Journals (Sweden)
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.
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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…
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Multiple chronic conditions and life expectancy
DEFF Research Database (Denmark)
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....
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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
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Cohort studies in health sciences librarianship.
Eldredge, Jonathan
2002-10-01
What are the key characteristics of the cohort study design and its varied applications, and how can this research design be utilized in health sciences librarianship? The health, social, behavioral, biological, library, earth, and management sciences literatures were used as sources. All fields except for health sciences librarianship were scanned topically for either well-known or diverse applications of the cohort design. The health sciences library literature available to the author principally for the years 1990 to 2000, supplemented by papers or posters presented at annual meetings of the Medical Library Association. A narrative review for the health, social, behavioral, biological, earth, and management sciences literatures and a systematic review for health sciences librarianship literature for the years 1990 to 2000, with three exceptions, were conducted. The author conducted principally a manual search of the health sciences librarianship literature for the years 1990 to 2000 as part of this systematic review. The cohort design has been applied to answer a wide array of theoretical or practical research questions in the health, social, behavioral, biological, and management sciences. Health sciences librarianship also offers several major applications of the cohort design. The cohort design has great potential for answering research questions in the field of health sciences librarianship, particularly evidence-based librarianship (EBL), although that potential has not been fully explored.
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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...
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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...
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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...
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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...
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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...
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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...
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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...
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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...
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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...
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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...
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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...
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Does vagotomy protect against multiple sclerosis?
Sundbøll, Jens; Horváth-Puhó, Erzsébet; Adelborg, Kasper; Svensson, Elisabeth
2017-07-01
To examine the association between vagotomy and multiple sclerosis. We conducted a matched cohort study of all patients who underwent truncal or super-selective vagotomy and a comparison cohort, by linking Danish population-based medical registries (1977-1995). Hazard ratios (HRs) for multiple sclerosis, adjusting for potential confounders were computed by means of Cox regression analysis. Median age of multiple sclerosis onset corresponded to late onset multiple sclerosis. No association with multiple sclerosis was observed for truncal vagotomy (0-37 year adjusted HR=0.91, 95% confidence interval [CI]: 0.48-1.74) or super-selective vagotomy (0-37 year adjusted HR=1.28, 95% CI: 0.79-2.09) compared with the general population. We found no association between vagotomy and later risk of late onset multiple sclerosis. Copyright © 2017 Elsevier B.V. All rights reserved.
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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...
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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...
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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...
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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...
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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...
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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.
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Design of the cooling systems for the multiplicity and vertex detector
International Nuclear Information System (INIS)
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
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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.
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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.
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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.
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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.
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The Danish National Birth Cohort
DEFF Research Database (Denmark)
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....
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SAS Macros for Calculation of Population Attributable Fraction in a Cohort Study Design
Directory of Open Access Journals (Sweden)
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.
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Complementary Cohort Strategy for Multimodal Face Pair Matching
DEFF Research Database (Denmark)
Sun, Yunlian; Nasrollahi, Kamal; Sun, Zhenan
2016-01-01
Face pair matching is the task of determining whether two face images represent the same person. Due to the limited expressive information embedded in the two face images as well as various sources of facial variations, it becomes a quite difficult problem. Towards the issue of few available images...... provided to represent each face, we propose to exploit an extra cohort set (identities in the cohort set are different from those being compared) by a series of cohort list comparisons. Useful cohort coefficients are then extracted from both sorted cohort identities and sorted cohort images...... for complementary information. To augment its robustness to complicated facial variations, we further employ multiple face modalities owing to their complementary value to each other for the face pair matching task. The final decision is made by fusing the extracted cohort coefficients with the direct matching...
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Revisiting the Dedifferentiation Hypothesis with Longitudinal Multi-Cohort Data
de Frias, Cindy M.; Lovden, Martin; Lindenberger, Ulman; Nilsson, Lars-Goran
2007-01-01
The present longitudinal multi-cohort study examines whether interindividual variability in cognitive performance and change increases in old age, and whether associations among developments of different cognitive functions increase with adult age. Multivariate multiple-group latent growth modeling was applied to data from narrow cohorts separated…
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The HIV-Brazil cohort study: design, methods and participant characteristics.
Directory of Open Access Journals (Sweden)
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
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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...
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Directory of Open Access Journals (Sweden)
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.
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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.
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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.
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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.
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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.;
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
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de Groot, Vincent; Beckerman, Heleen; Uitdehaag, Bernard M.; Hintzen, Rogier Q.; Minneboo, Arjan; Heymans, Martijn W.; Lankhorst, Gustaaf J.; Polman, Chris H.; Bouter, Lex M.; IJzerman, Maarten Joost
2009-01-01
Objective To predict functioning after 3 years in patients with recently diagnosed multiple sclerosis (MS). Design Inception cohort with 3 years of follow-up. At baseline, predictors were obtained from medical history taking, neurologic examination, and magnetic resonance imaging (MRI). Setting
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Cross-Layer Design for Two-Way Relaying Networks with Multiple Antennas
Directory of Open Access Journals (Sweden)
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.
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The guinea pig maximization test--with a multiple dose design
DEFF Research Database (Denmark)
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...
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The guinea pig maximization test--with a multiple dose design
DEFF Research Database (Denmark)
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...
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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.
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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...
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BSDB: A New Consistent Designation Scheme for Identifying Objects in Binary and Multiple Stars
Directory of Open Access Journals (Sweden)
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.
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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.
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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.
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Design optimization of offshore wind farms with multiple types of wind turbines
DEFF Research Database (Denmark)
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...
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Directory of Open Access Journals (Sweden)
Josie Dickerson
2016-08-01
Full Text Available Abstract Background Early interventions are recognised as key to improving life chances for children and reducing inequalities in health and well-being, however there is a paucity of high quality research into the effectiveness of interventions to address childhood health and development outcomes. Planning and implementing standalone RCTs for multiple, individual interventions would be slow, cumbersome and expensive. This paper describes the protocol for an innovative experimental birth cohort: Born in Bradford’s Better Start (BiBBS that will simultaneously evaluate the impact of multiple early life interventions using efficient study designs. Better Start Bradford (BSB has been allocated £49 million from the Big Lottery Fund to implement 22 interventions to improve outcomes for children aged 0–3 in three key areas: social and emotional development; communication and language development; and nutrition and obesity. The interventions will be implemented in three deprived and ethnically diverse inner city areas of Bradford. Method The BiBBS study aims to recruit 5000 babies, their mothers and their mothers’ partners over 5 years from January 2016-December 2020. Demographic and socioeconomic information, physical and mental health, lifestyle factors and biological samples will be collected during pregnancy. Parents and children will be linked to their routine health and local authority (including education data throughout the children’s lives. Their participation in BSB interventions will also be tracked. BiBBS will test interventions using the Trials within Cohorts (TwiCs approach and other quasi-experimental designs where TwiCs are neither feasible nor ethical, to evaluate these early life interventions. The effects of single interventions, and the cumulative effects of stacked (multiple interventions on health and social outcomes during the critical early years will be measured. Discussion The focus of the BiBBS cohort is on
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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.
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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.
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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.
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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
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Caranci, Nicola; Di Girolamo, Chiara; Giorgi Rossi, Paolo; Spadea, Teresa; Pacelli, Barbara; Broccoli, Serena; Ballotari, Paola; Costa, Giuseppe; Zengarini, Nicolás; Agabiti, Nera; Bargagli, Anna Maria; Cacciani, Laura; Canova, Cristina; Cestari, Laura; Biggeri, Annibale; Grisotto, Laura; Terni, Gianna; Costanzo, Gianfranco; Mirisola, Concetta; Petrelli, Alessio
2018-04-20
The Italian Network of Longitudinal Metropolitan Studies (IN-LiMeS) is a system of integrated data on health outcomes, demographic and socioeconomic information, and represents a powerful tool to study health inequalities. IN-LiMeS is a multicentre and multipurpose pool of metropolitan population cohorts enrolled in nine Italian cities: Turin, Venice, Reggio Emilia, Modena, Bologna, Florence, Leghorn, Prato and Rome. Data come from record linkage of municipal population registries, the 2001 population census, mortality registers and hospital discharge archives. Depending on the source of enrolment, cohorts can be closed or open. The census-based closed cohort design includes subjects resident in any of the nine cities at the 2001 census day; 4 466 655 individuals were enrolled in 2001 in the nine closed cohorts. The open cohort design includes subjects resident in 2001 or subsequently registered by birth or immigration until the latest available follow-up (currently 31 December 2013). The open cohort design is available for Turin, Venice, Reggio Emilia, Modena, Bologna, Prato and Rome. Detailed socioeconomic data are available for subjects enrolled in the census-based cohorts; information on demographic characteristics, education and citizenship is available from population registries. The first IN-LiMeS application was the study of differentials in mortality between immigrants and Italians. Either using a closed cohort design (nine cities) or an open one (Turin and Reggio Emilia), individuals from high migration pressure countries generally showed a lower mortality risk. However, a certain heterogeneity between the nine cities was noted, especially among men, and an excess mortality risk was reported for some macroareas of origin and specific causes of death. We are currently working on the linkage of the 2011 population census data, the expansion of geographical coverage and the implementation of the open design in all the participating cohorts. © Article author
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DEFF Research Database (Denmark)
Basso, Olga; Campi, Rita; Frydenberg, Morten
2004-01-01
We investigated whether having children with multiple men is a risk factor for being diagnosed with multiple sclerosis (MS). We studied a cohort of 151,328 women, of whom 64,704 had different men fathering their children and 86,624 the same partner for all births. Women were included if they had ...
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Reproductive History and Risk of Multiple Sclerosis
DEFF Research Database (Denmark)
Nielsen, N. M.; Jorgensen, K. T.; Stenager, E.
2011-01-01
Background: It has been suggested that reproductive factors may be involved in the etiology of multiple sclerosis (MS). We studied associations of reproductive history with MS risk in a population-based setting. Methods: Using national databases, we established a cohort comprising 4.4 million...... Danish men and women born between 1935 and 1989 and alive in 1968 or later. We obtained information about their live-born children, pregnancy losses, pregnancy complications, and infertility diagnoses. MS cases in the cohort were identified through 2004 in the Danish Register of Multiple Sclerosis...
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Some remarks on the design of HIF current multiplication rings
International Nuclear Information System (INIS)
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)
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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.
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DEFF Research Database (Denmark)
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...
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Mobile Web for Pervasive environments - design webexperiences for multiple mobile devices
DEFF Research Database (Denmark)
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....
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Design of PH-based accelerated life testing plans under multiple-stress-type
International Nuclear Information System (INIS)
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
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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.
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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
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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...
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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...
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Immunoparesis in newly diagnosed Multiple Myeloma patients
DEFF Research Database (Denmark)
Sorrig, Rasmus; Klausen, Tobias W.; Salomo, Morten
2017-01-01
Immunoparesis (hypogammaglobulinemia) is associated to an unfavorable prognosis in newly diagnosed Multiple myeloma (MM) patients. However, this finding has not been validated in an unselected population-based cohort. We analyzed 2558 newly diagnosed MM patients in the Danish Multiple Myeloma...
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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.
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Vascular comorbidities in multiple sclerosis
DEFF Research Database (Denmark)
Thormann, Anja; Magyari, Melinda; Koch-Henriksen, Nils
2016-01-01
To investigate the occurrence of vascular comorbidities before and after the clinical onset of multiple sclerosis. In this combined case-control and cohort study, all Danish born citizens with onset of multiple sclerosis 1980-2005 were identified from the Danish Multiple Sclerosis Registry...... and randomly matched with controls regarding year of birth, gender, and municipality on January 1st in the year of multiple sclerosis (MS) onset (index date). Individual-level information on comorbidities was obtained from several independent nationwide registries and linked to the study population by unique...
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Directory of Open Access Journals (Sweden)
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.
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Directory of Open Access Journals (Sweden)
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
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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
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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.
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Mortality analysis in the French cohort of uranium miners
International Nuclear Information System (INIS)
Vacquier, B.
2008-10-01
The objective of this thesis is to contribute to the estimation of radiation-induced risks at low dose rates. This work is based on the cohort of uranium miners French presenting multiple exposures, contamination by internal (radon and uranium dust) and external exposure (gamma radiation). An analysis of the risk of death and the relationship risk exposure was carried out within the cohort of uranium miners after extension of the monitoring until 1999, for cancers diseases and non-cancers. In addition, an analysis taking into account multiple exposures to ionizing radiation was carried out within the framework of this thesis. This analysis has improved knowledge on the risk of mortality associated with low levels of exposure to radon. (author)
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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…
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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.
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A Sequential Circuit-Based IP Watermarking Algorithm for Multiple Scan Chains in Design-for-Test
Directory of Open Access Journals (Sweden)
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.
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Minimum weight design of composite laminates for multiple loads
International Nuclear Information System (INIS)
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
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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.
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Cohort profile: cerebral palsy in the Norwegian and Danish birth cohorts (MOBAND-CP)
Tollånes, Mette C; Strandberg-Larsen, Katrine; Forthun, Ingeborg; Petersen, Tanja Gram; Moster, Dag; Andersen, Anne-Marie Nybo; Stoltenberg, Camilla; Olsen, Jørn; Wilcox, Allen J
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 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 investigating various hypotheses regarding CP aetiology are currently on-going. Future plans Additional data can be harmonised as necessary to meet requirements of new projects. Biological specimens collected during pregnancy and at delivery are potentially available for assay, as are results from assays conducted on these specimens for other projects. The study size allows consideration of CP subtypes, which is rare in aetiological studies of CP. In addition, MOBAND-CP provides a platform within the context of a merged birth cohort of exceptional size that could, after appropriate permissions have been sought, be used for cohort and case-cohort studies of other relatively rare health conditions of infants and children. PMID:27591025
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A Methodology for the Design of Robotic Hands with Multiple Fingers
Directory of Open Access Journals (Sweden)
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.
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A birth cohort analysis of dental contact among elderly Americans.
Wolinsky, F D; Arnold, C L
1989-01-01
We applied standard cohort and multiple regression techniques to data on the dental utilization rates of 129,191 elderly individuals taken from the 1972, 1973, 1976, 1977, 1980, and 1981 Health Interview Surveys. The results indicate that the marked variation in dental contact rates is a reflection of cohort succession, and not a function of aging per se. Older cohorts having lower dental contact rates are being replaced by younger cohorts having higher dental contact rates. The dental contact rates of the individual birth cohorts themselves are quite stable over time. The results also indicate that economic barriers (especially liquid assets) have become more important than ever before, especially for the oldest-old. These findings have important implications for public policy about the oral health and health care of elderly Americans. PMID:2783297
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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.
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The multiplicity of the digital textbook as design object
DEFF Research Database (Denmark)
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....
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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,
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Marsh, Herbert W; Morin, Alexandre J; Parker, Philip D
2015-04-01
Elite athletes and nonathletes (N = 1,268) attending the same selective sport high school (4 high school age cohorts, grades 7-10, mean ages varying from 10.9 to 14.1) completed the same physical self-concept instrument 4 times over a 2-year period (multiple waves). We introduce a latent cohort-sequence analysis that provides a stronger basis for assessing developmental stability/change than either cross-sectional (multicohort, single occasion) or longitudinal (single-cohort, multiple occasion) designs, allowing us to evaluate latent means across 10 waves spanning a 5-year period (grades 7-11), although each participant contributed data for only 4 waves, spanning 2 of the 5 years. Consistent with the frame-of-reference effects embodied in the big-fish-little-pond effect (BFLPE), physical self-concepts at the start of high school were much higher for elite athletes than for nonathlete classmates, but the differences declined over time so that by the end of high school there were no differences in the 2 groups. Gender differences in favor of males had a negative linear and quadratic trajectory over time, but the consistently smaller gender differences for athletes than for nonathletes did not vary with time.
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National Research Council Canada - National Science Library
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...
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DEFF Research Database (Denmark)
Jensen, Rikke Beck; Thankamony, Ajay; Holst, Klaus K.
2018-01-01
OBJECTIVE: IGF-I may be a marker of later metabolic and cardiovascular disease. The interactions between IGF-I and glucose metabolism are multifactorial, and there is potential confounding from several secondary effects. In this study, we examined the interaction between IGF-I and glucose...... metabolism in a large cohort of clinically well-characterized elderly twins. DESIGN: A total of 303 twin pairs of the same gender (606 twins) were included in the study; 125 monozygotic and 178 dizygotic twin pairs. METHODS: A clinical examination including a standard oral glucose tolerance test (OGTT.......11). In a multiple regression analysis (adjusting for age, gender and twin status), there was a negative association between IGF-I and insulin sensitivity (B: -0.13, SE 0.03, P cohort of 606 twins. The associations between IGF...
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Directory of Open Access Journals (Sweden)
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.
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Thorsen, Steffen U; Mårild, Karl; Olsen, Sjurdur F; Holst, Klaus K; Tapia, German; Granström, Charlotta; Halldorsson, Thorhallur I; Cohen, Arieh S; Haugen, Margaretha; Lundqvist, Marika; Skrivarhaug, Torild; Njølstad, Pål R; Joner, Geir; Magnus, Per; Størdal, Ketil; Svensson, Jannet; Stene, Lars C
2018-06-01
Studies on vitamin D status during pregnancy and risk of type 1 diabetes mellitus (T1D) lack consistency and are limited by small sample sizes or single measures of 25-hydroxyvitamin D (25(OH)D). We investigated whether average maternal 25(OH)D plasma concentrations during pregnancy are associated with risk of childhood T1D. In a case-cohort design, we identified 459 children with T1D and a random sample (n = 1,561) from the Danish National Birth Cohort (n = 97,127) and Norwegian Mother and Child Cohort Study (n = 113,053). Participants were born between 1996 and 2009. The primary exposure was the estimated average 25(OH)D concentration, based on serial samples from the first trimester until delivery and on umbilical cord plasma. We estimated hazard ratios using weighted Cox regression adjusting for multiple confounders. The adjusted hazard ratio for T1D per 10-nmol/L increase in the estimated average 25(OH)D concentration was 1.00 (95% confidence interval: 0.90, 1.10). Results were consistent in both cohorts, in multiple sensitivity analyses, and when we analyzed mid-pregnancy or cord blood separately. In conclusion, our large study demonstrated that normal variation in maternal or neonatal 25(OH)D is unlikely to have a clinically important effect on risk of childhood T1D.
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DEFF Research Database (Denmark)
Palacios, Natalia; Alonso, Alvaro; Brønnum-Hansen, Henrik
2010-01-01
-dependent relationship exists between changing female-to male ratios of smoking and Multiple Sclerosis (MS) in worldwide birth cohorts from previously published studies. BACKGROUND: Smoking behavior in industrialized nations has changed dramatically over the second half of the 20th century, with diverging patterns...... in male and female smoking rates. During the same time period, an increase in the female to male ratio in MS incidence has been reported. We examined whether MS incidence in the two genders changed concomitantly with smoking, as would be expected if smoking truly increased MS risk. DESIGN/METHODS: We...... identified relevant studies reporting male and female age-specific incidence of MS throughout the world using within-country birth cohorts as units of observation. For each country and birth cohort, we then estimated the male to female ratio in MS incidence, and correlated these ratios with the corresponding...
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Zhuang, Jie; Randall, Billi; Stamatakis, Emmanuel A; Marslen-Wilson, William D; Tyler, Lorraine K
2011-12-01
Spoken word recognition involves the activation of multiple word candidates on the basis of the initial speech input--the "cohort"--and selection among these competitors. Selection may be driven primarily by bottom-up acoustic-phonetic inputs or it may be modulated by other aspects of lexical representation, such as a word's meaning [Marslen-Wilson, W. D. Functional parallelism in spoken word-recognition. Cognition, 25, 71-102, 1987]. We examined these potential interactions in an fMRI study by presenting participants with words and pseudowords for lexical decision. In a factorial design, we manipulated (a) cohort competition (high/low competitive cohorts which vary the number of competing word candidates) and (b) the word's semantic properties (high/low imageability). A previous behavioral study [Tyler, L. K., Voice, J. K., & Moss, H. E. The interaction of meaning and sound in spoken word recognition. Psychonomic Bulletin & Review, 7, 320-326, 2000] showed that imageability facilitated word recognition but only for words in high competition cohorts. Here we found greater activity in the left inferior frontal gyrus (BA 45, 47) and the right inferior frontal gyrus (BA 47) with increased cohort competition, an imageability effect in the left posterior middle temporal gyrus/angular gyrus (BA 39), and a significant interaction between imageability and cohort competition in the left posterior superior temporal gyrus/middle temporal gyrus (BA 21, 22). In words with high competition cohorts, high imageability words generated stronger activity than low imageability words, indicating a facilitatory role of imageability in a highly competitive cohort context. For words in low competition cohorts, there was no effect of imageability. These results support the behavioral data in showing that selection processes do not rely solely on bottom-up acoustic-phonetic cues but rather that the semantic properties of candidate words facilitate discrimination between competitors.
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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...
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Generation of synthetic time histories compatible with multiple-damping design response spectra
International Nuclear Information System (INIS)
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
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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.
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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.
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Directory of Open Access Journals (Sweden)
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
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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.
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Opium use and mortality in Golestan Cohort Study: prospective cohort study of 50 000 adults in Iran
Khademi, Hooman; Pourshams, Akram; Jafari, Elham; Salahi, Rasool; Semnani, Shahryar; Abaie, Behrooz; Islami, Farhad; Nasseri-Moghaddam, Siavosh; Etemadi, Arash; Byrnes, Graham; Abnet, Christian C; Dawsey, Sanford M; Day, Nicholas E; Pharoah, Paul D; Boffetta, Paolo; Kamangar, Farin
2012-01-01
Objectives To investigate the association between opium use and subsequent risk of death. Design Prospective cohort study. Setting The Golestan Cohort Study in north-eastern Iran collected detailed validated data on opium use and other exposures at baseline. Participants were enrolled between January 2004 and June 2008 and were followed to May 2011, with a follow-up success rate of over 99%. Participants 50 045 participants aged 40-75 at baseline. Main outcomes Mortality, all cause and major subcategories. Results 17% (n=8487) of the participants reported opium use, with a mean duration of 12.7 years. During the follow-up period 2145 deaths were reported. The adjusted hazard ratio for all cause mortality associated with ever use of opium was 1.86 (95% confidence interval 1.68 to 2.06). Opium consumption was significantly associated with increased risks of deaths from several causes including circulatory diseases (hazard ratio 1.81) and cancer (1.61). The strongest associations were seen with deaths from asthma, tuberculosis, and chronic obstructive pulmonary disease (11.0, 6.22, and 5.44, respectively). After exclusion of people who self prescribed opium after the onset of major chronic illnesses, the associations remained strong with a dose-response relation. Conclusion Opium users have an increased risk of death from multiple causes compared with non-users. Increased risks were also seen in people who used low amounts of opium for a long period and those who had no major illness before use. PMID:22511302
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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
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Directory of Open Access Journals (Sweden)
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
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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
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Residue-based Coordinated Selection and Parameter Design of Multiple Power System Stabilizers (PSSs)
DEFF Research Database (Denmark)
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...
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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.
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Multiple-Robot Systems for USAR: Key Design Attributes and Deployment Issues
Directory of Open Access Journals (Sweden)
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.
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Multiple-Robot Systems for USAR: Key Design Attributes and Deployment Issues
Directory of Open Access Journals (Sweden)
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.
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Directory of Open Access Journals (Sweden)
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
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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.
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DEFF Research Database (Denmark)
Burisch, Johan; Kiudelis, Gediminas; Kupcinskas, Limas
2018-01-01
OBJECTIVE: The Epi-IBD cohort is a prospective population-based inception cohort of unselected patients with inflammatory bowel disease from 29 European centres covering a background population of almost 10 million people. The aim of this study was to assess the 5-year outcome and disease course...... of patients with Crohn's disease (CD). DESIGN: Patients were followed up prospectively from the time of diagnosis, including collection of their clinical data, demographics, disease activity, medical therapy, surgery, cancers and deaths. Associations between outcomes and multiple covariates were analysed...... by Cox regression analysis. RESULTS: In total, 488 patients were included in the study. During follow-up, 107 (22%) patients received surgery, while 176 (36%) patients were hospitalised because of CD. A total of 49 (14%) patients diagnosed with non-stricturing, non-penetrating disease progressed...
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DEFF Research Database (Denmark)
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...
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Cohort Profile: The Danish Testicular Cancer Late Treatment Effects Cohort (DaTeCa-LATE
Directory of Open Access Journals (Sweden)
Michael Kreiberg
2018-02-01
Full Text Available 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 December 31, 2016, among living Danish TCS and 60% agreed to participate in the cohort (N = 2,572. Mean time since testicular cancer (TC diagnosis was 18 years (range 7–33 and mean age of participants was 53 years (range 25–95. Data consist of results of a questionnaire with patient reported outcomes which covers a broad range of items on late-effects. The study also included data obtained through linkages to Danish registries, a biobank, and clinical data from hospital files and pathology reports originating from the Danish Testicular Cancer Database (DaTeCa. The treatment during the observation period has been nearly the same for all stages of TC and is in agreement with today’s standard treatment, this allows for interesting analysis with a wide timespan. We have extensive data on non-responders and are able to validate our study findings. Data from a Danish reference population (N = 162,283 allow us to compare our findings with a Danish background population. The cohort can easily be extended to access more outcomes, or include new TCS. A limitation of the present study is the cross-sectional design and despite the large sample size, The Danish Testicular Cancer Late Treatment Effects Cohort (DaTeCa-LATE lacks statistical power to study very rare late effects. Since it was voluntary to participate in the study we have some selection bias, for instance, we lack responders who were not in a paired relationship, but we would still argue that this cohort of TCSs is representative for TCSs in Denmark.Collaboration and data accessResearches interested in collaboration with the DaTeCa-LATE study group please contact Professor Gedske Daugaard
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Directory of Open Access Journals (Sweden)
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.
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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.
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Directory of Open Access Journals (Sweden)
Joshua R. Ehrlich
2009-01-01
Results. Analyses demonstrated diminished survival among AB and ABS cohorts. However, when cohorts were substratified by stage, patients in the high-stage BS cohort appeared to have a survival advantage over high-stage BO patients. Conclusions. Bladder cancer patients with multiple malignancies have diminished survival. The survival advantage of high-stage BS patients is likely a statistical phenomenon. Such findings are important to shape future research and to improve our understanding of patients with multiple malignancies.
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Exploring generational cohort work satisfaction in hospital nurses.
Gordon, Pamela Ann
2017-07-03
Purpose Although extensive research exists regarding job satisfaction, many previous studies used a more restrictive, quantitative methodology. The purpose of this qualitative study is to capture the perceptions of hospital nurses within generational cohorts regarding their work satisfaction. Design/methodology/approach A preliminary qualitative, phenomenological study design explored hospital nurses' work satisfaction within generational cohorts - Baby Boomers (1946-1964), Generation X (1965-1980) and Millennials (1981-2000). A South Florida hospital provided the venue for the research. In all, 15 full-time staff nurses, segmented into generational cohorts, participated in personal interviews to determine themes related to seven established factors of work satisfaction: pay, autonomy, task requirements, administration, doctor-nurse relationship, interaction and professional status. Findings An analysis of the transcribed interviews confirmed the importance of the seven factors of job satisfaction. Similarities and differences between the generational cohorts related to a combination of stages of life and generational attributes. Practical implications The results of any qualitative research relate only to the specific venue studied and are not generalizable. However, the information gleaned from this study is transferable and other organizations are encouraged to conduct their own research and compare the results. Originality/value This study is unique, as the seven factors from an extensively used and highly respected quantitative research instrument were applied as the basis for this qualitative inquiry into generational cohort job satisfaction in a hospital setting.
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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
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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.
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Directory of Open Access Journals (Sweden)
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.
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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
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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.
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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.
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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.
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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 ...
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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
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Multiple myeloma, leukemia, and breast cancer among the US radium dial workers
International Nuclear Information System (INIS)
Stebbings, J.H.; Lucas, H.F.; Stehney, A.F.
1984-01-01
The relationships of radium exposure to mortality from multiple myeloma, leukemia, and breast cancer were studied in three cohorts of female dial workers defined by year of first employment. A three-fold excess risk of multiple myeloma occurred in the pre-1930 cohort; however, analyses of body burdens and durations of employment suggest that external radiation was more likely to have been responsible than was internal radium. Leukemia incidence and mortality have not been elevated overall among the female dial workers, either in the pre-1930 or the post-1930 cohorts, but cases have tended to occur early and in subjects with higher body burdens of radium. Extensive analyses of breast cancer data have uncovered several observations weighing against a causal interpretation of the association between radium body burdens and breast cancer
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Analyzing occupational cohort data: application to US uranium miners
International Nuclear Information System (INIS)
Whittemore, A.S.; McMillan, A.
1982-01-01
This paper presents methodological issues concerning the analysis of occupational mortality data. It summarizes pros and cons of three types of analysis: the person-years method, the cohort method, and the case-control method, and notes the common theoretical basis underlying cohort and case-control methods. Both these methods assume that occupational exposures act multiplicatively on either: (a) age-specific mortality rates; or (b) odds-ratios of death during follow-up. Both methods allow relative risk estimation by maximizing a partial or conditional likelihood under assumption (a), and an unconditional likelihood under assumption (b). the case-control method involves less data handling and computation than does the cohort method. This feature, useful when dealing with very large cohorts whose exposures vary with time, is purchased at the price of some decreased sensitivity to detect moderate to large relative risks associated with infrequently occurring exposure categories. The paper illustrates the utility and limitations of the case-control approach by applying it to lung cancer mortality versus exposures to radon-daughters and cigarette smoke among US uranium miners
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Design and Analysis of Cooperative Cable Parallel Manipulators for Multiple Mobile Cranes
Directory of Open Access Journals (Sweden)
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.
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Handley, Margaret A; Schillinger, Dean; Shiboski, Stephen
2011-01-01
Although randomized controlled trials are often a gold standard for determining intervention effects, in the area of practice-based research (PBR), there are many situations in which individual randomization is not possible. Alternative approaches to evaluating interventions have received increased attention, particularly those that can retain elements of randomization such that they can be considered "controlled" trials. Methodological design elements and practical implementation considerations for two quasi-experimental design approaches that have considerable promise in PBR settings--the stepped-wedge design, and a variant of this design, a wait-list cross-over design, are presented along with a case study from a recent PBR intervention for patients with diabetes. PBR-relevant design features include: creation of a cohort over time that collects control data but allows all participants (clusters or patients) to receive the intervention; staggered introduction of clusters; multiple data collection points; and one-way cross-over into the intervention arm. Practical considerations include: randomization versus stratification, training run in phases; and extended time period for overall study completion. Several design features of practice based research studies can be adapted to local circumstances yet retain elements to improve methodological rigor. Studies that utilize these methods, such as the stepped-wedge design and the wait-list cross-over design, can increase the evidence base for controlled studies conducted within the complex environment of PBR.
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Kmetic, Andrew; Joseph, Lawrence; Berger, Claudie; Tenenhouse, Alan
2002-07-01
Nonresponse bias is a concern in any epidemiologic survey in which a subset of selected individuals declines to participate. We reviewed multiple imputation, a widely applicable and easy to implement Bayesian methodology to adjust for nonresponse bias. To illustrate the method, we used data from the Canadian Multicentre Osteoporosis Study, a large cohort study of 9423 randomly selected Canadians, designed in part to estimate the prevalence of osteoporosis. Although subjects were randomly selected, only 42% of individuals who were contacted agreed to participate fully in the study. The study design included a brief questionnaire for those invitees who declined further participation in order to collect information on the major risk factors for osteoporosis. These risk factors (which included age, sex, previous fractures, family history of osteoporosis, and current smoking status) were then used to estimate the missing osteoporosis status for nonparticipants using multiple imputation. Both ignorable and nonignorable imputation models are considered. Our results suggest that selection bias in the study is of concern, but only slightly, in very elderly (age 80+ years), both women and men. Epidemiologists should consider using multiple imputation more often than is current practice.
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DEFF Research Database (Denmark)
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....
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Directory of Open Access Journals (Sweden)
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.
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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.
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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
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Using the entire history in the analysis of nested case cohort samples.
Rivera, C L; Lumley, T
2016-08-15
Countermatching designs can provide more efficient estimates than simple matching or case-cohort designs in certain situations such as when good surrogate variables for an exposure of interest are available. We extend pseudolikelihood estimation for the Cox model under countermatching designs to models where time-varying covariates are considered. We also implement pseudolikelihood with calibrated weights to improve efficiency in nested case-control designs in the presence of time-varying variables. A simulation study is carried out, which considers four different scenarios including a binary time-dependent variable, a continuous time-dependent variable, and the case including interactions in each. Simulation results show that pseudolikelihood with calibrated weights under countermatching offers large gains in efficiency if compared to case-cohort. Pseudolikelihood with calibrated weights yielded more efficient estimators than pseudolikelihood estimators. Additionally, estimators were more efficient under countermatching than under case-cohort for the situations considered. The methods are illustrated using the Colorado Plateau uranium miners cohort. Furthermore, we present a general method to generate survival times with time-varying covariates. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.
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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...
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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.
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Defining Multiple Chronic Conditions for Quality Measurement.
Drye, Elizabeth E; Altaf, Faseeha K; Lipska, Kasia J; Spatz, Erica S; Montague, Julia A; Bao, Haikun; Parzynski, Craig S; Ross, Joseph S; Bernheim, Susannah M; Krumholz, Harlan M; Lin, Zhenqiu
2018-02-01
Patients with multiple chronic conditions (MCCs) are a critical but undefined group for quality measurement. We present a generally applicable systematic approach to defining an MCC cohort of Medicare fee-for-service beneficiaries that we developed for a national quality measure, risk-standardized rates of unplanned admissions for Accountable Care Organizations. To define the MCC cohort we: (1) identified potential chronic conditions; (2) set criteria for cohort conditions based on MCC framework and measure concept; (3) applied the criteria informed by empirical analysis, experts, and the public; (4) described "broader" and "narrower" cohorts; and (5) selected final cohort with stakeholder input. Subjects were patients with chronic conditions. Participants included 21.8 million Medicare fee-for-service beneficiaries in 2012 aged 65 years and above with ≥1 of 27 Medicare Chronic Condition Warehouse condition(s). In total, 10 chronic conditions were identified based on our criteria; 8 of these 10 were associated with notably increased admission risk when co-occurring. A broader cohort (2+ of the 8 conditions) included 4.9 million beneficiaries (23% of total cohort) with an admission rate of 70 per 100 person-years. It captured 53% of total admissions. The narrower cohort (3+ conditions) had 2.2 million beneficiaries (10%) with 100 admissions per 100 person-years and captured 32% of admissions. Most stakeholders viewed the broader cohort as best aligned with the measure concept. By systematically narrowing chronic conditions to those most relevant to the outcome and incorporating stakeholder input, we defined an MCC admission measure cohort supported by stakeholders. This approach can be used as a model for other MCC outcome measures.
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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.
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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.
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Head injury is not a risk factor for multiple sclerosis: a prospective cohort study
DEFF Research Database (Denmark)
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...
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Directory of Open Access Journals (Sweden)
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.
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Austin, Peter C; Mamdani, Muhammad M; Juurlink, David N; Hux, Janet E
2006-09-01
To illustrate how multiple hypotheses testing can produce associations with no clinical plausibility. We conducted a study of all 10,674,945 residents of Ontario aged between 18 and 100 years in 2000. Residents were randomly assigned to equally sized derivation and validation cohorts and classified according to their astrological sign. Using the derivation cohort, we searched through 223 of the most common diagnoses for hospitalization until we identified two for which subjects born under one astrological sign had a significantly higher probability of hospitalization compared to subjects born under the remaining signs combined (P<0.05). We tested these 24 associations in the independent validation cohort. Residents born under Leo had a higher probability of gastrointestinal hemorrhage (P=0.0447), while Sagittarians had a higher probability of humerus fracture (P=0.0123) compared to all other signs combined. After adjusting the significance level to account for multiple comparisons, none of the identified associations remained significant in either the derivation or validation cohort. Our analyses illustrate how the testing of multiple, non-prespecified hypotheses increases the likelihood of detecting implausible associations. Our findings have important implications for the analysis and interpretation of clinical studies.
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Study design of DIACORE (DIAbetes COhoRtE – a cohort study of patients with diabetes mellitus type 2
Directory of Open Access Journals (Sweden)
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.
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Analysis, Design, and Construction of a Base-Isolated Multiple Building Structure
Directory of Open Access Journals (Sweden)
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.
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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.
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DEFF Research Database (Denmark)
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...
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Physical and social environment and the risk of multiple sclerosis
DEFF Research Database (Denmark)
Magyari, Melinda; Koch-Henriksen, Nils; Pfleger, Claudia C.
2014-01-01
, or social environmental influence the risk of MS differently in women than in men. Methods: The cohort consists of all 1403 patients (939 women, 464 men) identified through Danish Multiple Sclerosis Registry aged 1-55 of years at clinical onset between 2000 and 2004, and up to 25 control persons for each...... case, matched by sex, year of birth and residential municipality. The same cohort was previously used to investigate the influence of the reproductive factors on the risk of MS. Results: By linkage to Danish population registers we found a slight albeit statistically significant excess for 6 female MS...... patients who had been employed in agriculture: OR 3.52; 95% CI 1.38-9.00, p=0.008 (0.046 when corrected for multiple significance) and a trend for exposure to outdoor work in 12 : OR 1.94, 95% CI 1.06-3.55, p=0.03 (0.09 when corrected for multiple significance), but the numbers of cases were small...
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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/.
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Conceptual design of multiple parallel switching controller
International Nuclear Information System (INIS)
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)
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DEFF Research Database (Denmark)
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...
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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
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COPD Exacerbation Biomarkers Validated Using Multiple Reaction Monitoring Mass Spectrometry.
Directory of Open Access Journals (Sweden)
Janice M Leung
Full Text Available Acute exacerbations of chronic obstructive pulmonary disease (AECOPD result in considerable morbidity and mortality. However, there are no objective biomarkers to diagnose AECOPD.We used multiple reaction monitoring mass spectrometry to quantify 129 distinct proteins in plasma samples from patients with COPD. This analytical approach was first performed in a biomarker cohort of patients hospitalized with AECOPD (Cohort A, n = 72. Proteins differentially expressed between AECOPD and convalescent states were chosen using a false discovery rate 1.2. Protein selection and classifier building were performed using an elastic net logistic regression model. The performance of the biomarker panel was then tested in two independent AECOPD cohorts (Cohort B, n = 37, and Cohort C, n = 109 using leave-pair-out cross-validation methods.Five proteins were identified distinguishing AECOPD and convalescent states in Cohort A. Biomarker scores derived from this model were significantly higher during AECOPD than in the convalescent state in the discovery cohort (p<0.001. The receiver operating characteristic cross-validation area under the curve (CV-AUC statistic was 0.73 in Cohort A, while in the replication cohorts the CV-AUC was 0.77 for Cohort B and 0.79 for Cohort C.A panel of five biomarkers shows promise in distinguishing AECOPD from convalescence and may provide the basis for a clinical blood test to diagnose AECOPD. Further validation in larger cohorts is necessary for future clinical translation.
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Multiple-Criteria Decision-Making in the Design of Innovative Lock Walls for Barge Impact; Phase 1
National Research Council Canada - National Science Library
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...
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Jit, Mark; Brisson, Marc
2018-02-15
Up to 2016, low- and middle-income countries mostly introduced routine human papillomavirus (HPV) vaccination for just a single age-cohort of girls each year. However, high-income countries have reported large reductions in HPV prevalence following "catch-up" vaccination of multiple age-cohorts in the year of HPV vaccine introduction. We used the mathematical model PRIME to project the incremental impact of vaccinating 10- to 14-year-old girls compared to routine HPV vaccination only in the same year that routine vaccination is expected to be introduced for 9-year-old girls across 73 low- and lower-middle-income countries. Adding multiple age-cohort vaccination could increase the number of cervical cancer deaths averted by vaccine introductions in 2015-2030 by 30-40% or an additional 1.23-1.79 million over the lifetime of the vaccinated cohorts. The number of girls needed to vaccinate to prevent one death is 101 in the most pessimistic scenario, which is only slightly greater than that for routine vaccination of 9-year-old girls (87). These results hold even when assuming that girls who have sexually debuted do not benefit from vaccination. Results suggest that multiple age-cohort vaccination of 9- to 14-year-old girls could accelerate HPV vaccine impact and be cost-effective. © 2018 The Authors International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.
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Challenges in translating end points from trials to observational cohort studies in oncology
Directory of Open Access Journals (Sweden)
Ording AG
2016-06-01
Full Text Available Anne Gulbech Ording,1 Deirdre Cronin-Fenton,1 Vera Ehrenstein,1 Timothy L Lash,1,2 John Acquavella,1 Mikael Rørth,1 Henrik Toft Sørensen1 1Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; 2Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA Abstract: Clinical trials are considered the gold standard for examining drug efficacy and for approval of new drugs. Medical databases and population surveillance registries are valuable resources for post-approval observational research, which are increasingly used in studies of benefits and risk of new cancer drugs. Here, we address the challenges in translating endpoints from oncology trials to observational studies. Registry-based cohort studies can investigate real-world safety issues – including previously unrecognized concerns – by examining rare endpoints or multiple endpoints at once. In contrast to clinical trials, observational cohort studies typically do not exclude real-world patients from clinical practice, such as old and frail patients with comorbidity. The observational cohort study complements the clinical trial by examining the effectiveness of interventions applied in clinical practice and by providing evidence on long-term clinical outcomes, which are often not feasible to study in a clinical trial. Various endpoints can be included in clinical trials, such as hard endpoints, soft endpoints, surrogate endpoints, and patient-reported endpoints. Each endpoint has it strengths and limitations for use in research studies. Endpoints used in oncology trials are often not applicable in observational cohort studies which are limited by the setting of standard clinical practice and by non-standardized endpoint determination. Observational studies can be more helpful moving research forward if they restrict focus to appropriate and valid endpoints. Keywords: endpoint determination, medical oncology
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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.
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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
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Directory of Open Access Journals (Sweden)
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.
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The risk of multiple sclerosis in nurses
DEFF Research Database (Denmark)
Stenager, Egon; Brønnum-Hansen, Henrik; Koch-Henriksen, Nils
2003-01-01
The incidence of multiple sclerosis (MS) in nurses during the period 1980-1996 was calculated in a nationwide study. The cohort consisted of 69,428 nurses, 2185 men and 67,243 women. Sixty (two men and 58 women) with definite MS were observed, whereas 69.3 were expected. We found no significant...
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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
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Johnson, Sara B; Little, Todd D; Masyn, Katherine; Mehta, Paras D; Ghazarian, Sharon R
2017-06-01
Characterizing the determinants of child health and development over time, and identifying the mechanisms by which these determinants operate, is a research priority. The growth of precision medicine has increased awareness and refinement of conceptual frameworks, data management systems, and analytic methods for multilevel data. This article reviews key methodological challenges in cohort studies designed to investigate multilevel influences on child health and strategies to address them. We review and summarize methodological challenges that could undermine prospective studies of the multilevel determinants of child health and ways to address them, borrowing approaches from the social and behavioral sciences. Nested data, variation in intervals of data collection and assessment, missing data, construct measurement across development and reporters, and unobserved population heterogeneity pose challenges in prospective multilevel cohort studies with children. We discuss innovations in missing data, innovations in person-oriented analyses, and innovations in multilevel modeling to address these challenges. Study design and analytic approaches that facilitate the integration across multiple levels, and that account for changes in people and the multiple, dynamic, nested systems in which they participate over time, are crucial to fully realize the promise of precision medicine for children and adolescents. Copyright © 2017 Elsevier Inc. All rights reserved.
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A review of the cohorts with environmental and occupational mineral fiber exposure.
Metintas, Selma; Ak, Guntulu; Metintas, Muzaffer
2018-04-20
The aim of the study was to examine factors associated with Malignant Mesothelioma (MM) incidence rate of the groups with occupational asbestos and environmental asbestos or erionite exposure in rural area. In this ecological study, a total of 21 cohort datasets (8 environmental and 13 occupational) were evaluated. Data were analyzed using a multiple linear regression analysis model. In environmental cohorts, the risk of MM incidence was higher in women and people exposed to erionite. In this cohort, the incidence rate of MM increased as the median exposure time increased, while the incidence decreased as the median cumulative exposure dose increased. In occupational cohorts, the incidence rate of MM was positively correlated with the median cumulative exposure dose. The risk of mesothelioma was lower in those exposed to tremolite than others. Environmental asbestos exposure is as important as occupational exposure to develop MM, and it has its own unique exposure features on the risk of MM.
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DEFF Research Database (Denmark)
Martinez-Lapiscina, Elena H; Arnow, Sam; Wilson, James A
2016-01-01
of disability worsening in a cohort of patients with multiple sclerosis who had at least one eye without optic neuritis available. METHODS: In this multicentre, cohort study, we collected data about patients (age ≥16 years old) with clinically isolated syndrome, relapsing-remitting multiple sclerosis...... with the risk of subsequent disability worsening by use of proportional hazards models that included OCT metrics and age, disease duration, disability, presence of previous unilateral optic neuritis, and use of disease-modifying therapies as covariates. FINDINGS: 879 patients with clinically isolated syndrome...
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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.
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Design of an Air Pollution Monitoring Campaign in Beijing for Application to Cohort Health Studies
Directory of Open Access Journals (Sweden)
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.
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Mortality in the French TRACY cohort of uranium cycle workers
International Nuclear Information System (INIS)
Nicolle-Mir, Laurence
2016-01-01
This first analysis of mortality in a new cohort of French uranium cycle workers observed a healthy worker effect, as shown by a large all-cause mortality deficit. The current reconstruction of exposure data (radiological, chemical, and physical) will make it possible to study the risks specific to internal uranium contamination in individuals exposed to multiple agents. (author)
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Crude incidence in two-phase designs in the presence of competing risks
Directory of Open Access Journals (Sweden)
Paola Rebora
2016-01-01
Full Text Available Abstract Background In many studies, some information might not be available for the whole cohort, some covariates, or even the outcome, might be ascertained in selected subsamples. These studies are part of a broad category termed two-phase studies. Common examples include the nested case-control and the case-cohort designs. For two-phase studies, appropriate weighted survival estimates have been derived; however, no estimator of cumulative incidence accounting for competing events has been proposed. This is relevant in the presence of multiple types of events, where estimation of event type specific quantities are needed for evaluating outcome. Methods We develop a non parametric estimator of the cumulative incidence function of events accounting for possible competing events. It handles a general sampling design by weights derived from the sampling probabilities. The variance is derived from the influence function of the subdistribution hazard. Results The proposed method shows good performance in simulations. It is applied to estimate the crude incidence of relapse in childhood acute lymphoblastic leukemia in groups defined by a genotype not available for everyone in a cohort of nearly 2000 patients, where death due to toxicity acted as a competing event. In a second example the aim was to estimate engagement in care of a cohort of HIV patients in resource limited setting, where for some patients the outcome itself was missing due to lost to follow-up. A sampling based approach was used to identify outcome in a subsample of lost patients and to obtain a valid estimate of connection to care. Conclusions A valid estimator for cumulative incidence of events accounting for competing risks under a general sampling design from an infinite target population is derived.
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Birth weight and stuttering: Evidence from three birth cohorts.
McAllister, Jan; Collier, Jacqueline
2014-03-01
Previous studies have produced conflicting results with regard to the association between birth weight and developmental stuttering. This study sought to determine whether birth weight was associated with childhood and/or adolescent stuttering in three British birth cohort samples. Logistic regression analyses were carried out on data from the Millenium Cohort Study (MCS), British Cohort Study (BCS70) and National Child Development Study (NCDS), whose initial cohorts comprised over 56,000 individuals. The outcome variables were parent-reported stuttering in childhood or in adolescence; the predictors, based on prior research, were birth weight, sex, multiple birth status, vocabulary score and mother's level of education. Birth weight was analysed both as a categorical variable (low birth weight, stuttering during childhood (age 3, 5 and 7 and MCS, BCS70 and NCDS, respectively) or at age 16, when developmental stuttering is likely to be persistent. None of the multivariate analyses revealed an association between birth weight and parent-reported stuttering. Sex was a significant predictor of stuttering in all the analyses, with males 1.6-3.6 times more likely than females to stutter. Our results suggest that birth weight is not a clinically useful predictor of childhood or persistent stuttering. Copyright © 2013 Elsevier Inc. All rights reserved.
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Does Multiple Intelligence Improve Performance? Evidence from a ...
African Journals Online (AJOL)
This study reports the findings of a study that investigated the relationship between multiple intelligence (MI) and academic performance in higher education. It addresses one question: does MI improve academic performance? Taking the case of the finalist cohort of the university's Faculty of Education of the academic year ...
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Premature death of adult adoptees: analyses of a case-cohort sample.
Petersen, Liselotte; Andersen, Per Kragh; Sørensen, Thorkild I A
2005-05-01
Genetic and environmental influence on risk of premature death in adulthood was investigated by estimating the associations in total and cause-specific mortality of adult Danish adoptees and their biological and adoptive parents. Among all 14,425 non-familial adoptions formally granted in Denmark during the period 1924 through 1947, we selected the study population according to a case-cohort sampling design. As the case-control design, the case-cohort design has the advantage of economic data collection and little loss in statistical efficiency, but the case-cohort sample has the additional advantages that rate ratio estimates may be obtained, and re-use of the cohort sample in future studies of other outcomes is possible. Analyses were performed using Kalbfleisch and Lawless's estimator for hazard ratio, and robust estimation for variances. In the main analyses the sample was restricted to birth years of the adoptees 1924 and after, and age of transfer to the adoptive parents before 7 years, and age at death was restricted to 16 to 70 years. The results showed a higher mortality among adoptees, whose biological parents died in the age range of 16 to 70 years; this was significant for deaths from natural causes, vascular causes and all causes. No influence was seen from early death of adoptive parents, regardless of cause of death. (c) 2005 Wiley-Liss, Inc.
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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.
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A Cohort Study on Long-Term Adverse Effects of Parental Drinking: Background and Study Design
Directory of Open Access Journals (Sweden)
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.
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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.
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International Nuclear Information System (INIS)
L'Abbe, K.A.; Howe, G.R.; Burch, J.D.; Miller, A.B.; Abbatt, J.; Band, P.; Choi, W.; Du, J.; Feather, J.; Gallagher, R.
1991-01-01
A nested case-control study within the Beaverlodge Uranium Miners Cohort was undertaken to assess any possible contribution of confounding by smoking and other mining experience to the risk estimate derived from the original cohort study. Next of kin have been interviewed for 46 lung cancer cases and 95 controls enrolled in the Beaverlodge Uranium Miners Cohort Study who died between 1950 and 1980. Confounding by cigarette smoking and other mining experience appears unlikely to have contributed to the relative risk coefficient for exposure to Rn decay products derived in the parent study. Data for smoking and exposure to Rn decay products are consistent with a multiplicative model, although considerable caution must be applied to this interpretation
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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
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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Comorbidity in multiple sclerosis is associated with diagnostic delays and increased mortality
DEFF Research Database (Denmark)
Thormann, Anja; Sorensen, Per Soelberg; Koch-Henriksen, Nils
2017-01-01
Objective: To investigate the effect of chronic comorbidity on the time of diagnosis of multiple sclerosis (MS) and on mortality in MS. Methods: We conducted a population-based, nationwide cohort study including all incident MS cases in Denmark with first MS symptom between 1980 and 2005. To inve......Objective: To investigate the effect of chronic comorbidity on the time of diagnosis of multiple sclerosis (MS) and on mortality in MS. Methods: We conducted a population-based, nationwide cohort study including all incident MS cases in Denmark with first MS symptom between 1980 and 2005.......007). Conclusions: An increased awareness of both the necessity of neurologic evaluation of new neurologic symptoms in persons with preexisting chronic disease and of optimum treatment of comorbidity in MS is critical....
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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.
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Cohort Profile: Antiretroviral Therapy Cohort Collaboration (ART-CC)
May, Margaret T; Ingle, Suzanne M; Costagliola, Dominique; Justice, Amy C; de Wolf, Frank; Cavassini, Matthias; D’Arminio Monforte, Antonella; Casabona, Jordi; Hogg, Robert S; Mocroft, Amanda; Lampe, Fiona C; Dabis, François; Fätkenheuer, Gerd; Sterling, Timothy R; del Amo, Julia; Gill, M John; Crane, Heidi M; Saag, Michael S; Guest, Jodie; Brodt, Hans-Reinhard; Sterne, Jonathan AC
2014-01-01
The advent of effective combination antiretroviral therapy (ART) in 1996 resulted in fewer patients experiencing clinical events, so that some prognostic analyses of individual cohort studies of human immunodeficiency virus-infected individuals had low statistical power. Because of this, the Antiretroviral Therapy Cohort Collaboration (ART-CC) of HIV cohort studies in Europe and North America was established in 2000, with the aim of studying the prognosis for clinical events in acquired immune deficiency syndrome (AIDS) and the mortality of adult patients treated for HIV-1 infection. In 2002, the ART-CC collected data on more than 12,000 patients in 13 cohorts who had begun combination ART between 1995 and 2001. Subsequent updates took place in 2004, 2006, 2008, and 2010. The ART-CC data base now includes data on more than 70 000 patients participating in 19 cohorts who began treatment before the end of 2009. Data are collected on patient demographics (e.g. sex, age, assumed transmission group, race/ethnicity, geographical origin), HIV biomarkers (e.g. CD4 cell count, plasma viral load of HIV-1), ART regimen, dates and types of AIDS events, and dates and causes of death. In recent years, additional data on co-infections such as hepatitis C; risk factors such as smoking, alcohol and drug use; non-HIV biomarkers such as haemoglobin and liver enzymes; and adherence to ART have been collected whenever available. The data remain the property of the contributing cohorts, whose representatives manage the ART-CC via the steering committee of the Collaboration. External collaboration is welcomed. Details of contacts are given on the ART-CC website (www.art-cohort-collaboration.org). PMID:23599235
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Regression analysis for secondary response variable in a case-cohort study.
Pan, Yinghao; Cai, Jianwen; Kim, Sangmi; Zhou, Haibo
2017-12-29
Case-cohort study design has been widely used for its cost-effectiveness. In any real study, there are always other important outcomes of interest beside the failure time that the original case-cohort study is based on. How to utilize the available case-cohort data to study the relationship of a secondary outcome with the primary exposure obtained through the case-cohort study is not well studied. In this article, we propose a non-parametric estimated likelihood approach for analyzing a secondary outcome in a case-cohort study. The estimation is based on maximizing a semiparametric likelihood function that is built jointly on both time-to-failure outcome and the secondary outcome. The proposed estimator is shown to be consistent, efficient, and asymptotically normal. Finite sample performance is evaluated via simulation studies. Data from the Sister Study is analyzed to illustrate our method. © 2017, The International Biometric Society.
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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.
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Male factor infertility and risk of multiple sclerosis
DEFF Research Database (Denmark)
Glazer, Clara Helene; Tøttenborg, Sandra Søgaard; Giwercman, Aleksander
2018-01-01
and prevalent as well as incident MS. METHOD: Our cohort was established by linkage of the Danish National in vitro fertilization (IVF) registry to The Danish Multiple Sclerosis Registry and consisted of 51,063 men whose partners had undergone fertility treatment in all public and private fertility clinics......BACKGROUND: Gender, possibly due to the influence of gonadal hormones, is presumed to play a role in the pathogenesis of multiple sclerosis (MS), but no studies have evaluated whether male infertility is associated with MS. OBJECTIVE: To study the association between male factor infertility...
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The impact of comorbidity on mortality in multiple myeloma
DEFF Research Database (Denmark)
Gregersen, Henrik; Vangsted, Annette Juul; Abildgaard, Niels
2017-01-01
To describe the prevalence of comorbidity and its impact on survival in newly diagnosed multiple myeloma patients compared with population controls. Cases of newly diagnosed symptomatic multiple myeloma during the 2005-2012 period were identified in the Danish National Multiple Myeloma Registry....... For each myeloma patient, 10 members of the general population matched by age and sex were chosen from the national Civil Registration System. Data on comorbidity in the myeloma patients and the general population comparison cohort were collected by linkage to the Danish National Patient Registry (DNPR......). Cox proportional hazards regression models were used to evaluate the prognostic significance of comorbidity. The study included 2190 cases of multiple myeloma and 21,900 population controls. The comorbidity was increased in multiple myeloma patients compared with population controls, odds ratio (OR) 1...
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Multiple myeloma, leukemia, and breast cancer among the US radium dial workers
International Nuclear Information System (INIS)
Stebbings, J.H.; Lucas, H.F.; Stehney, A.F.
1983-01-01
The relationships of radium exposure to mortality from multiple myeloma, leukemia, and breast cancer were studied in three cohorts of female dial workers defined by year of first employment. Mortality was compared with that expected from US white female rates, with and without adjustment for local mortality rates. Dose-response relationships of these cancers to systemic intake of radium were determined in workers whose body burdens had been measured in vivo since 1955. Incident cases of multiple myeloma occurred in the pre-1930 cohort; however, analyses of body burdens and durations of employment suggest that external radiation was more likely to have been responsible than was internal radium. Leukemia incidence and mortality have not been elevated overall among the female dial workers, either in the pre-1930 or the post-1930 cohorts, but cases have tended to occur early and in subjects with higher body burdens. Extensive analyses of breast cancer data have uncovered several observations weighing against a causal interpretation of the association between radium and breast cancer
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Retinal layer segmentation in multiple sclerosis
DEFF Research Database (Denmark)
Petzold, Axel; Balcer, Laura J; Calabresi, Peter A
2017-01-01
BACKGROUND: Structural retinal imaging biomarkers are important for early recognition and monitoring of inflammation and neurodegeneration in multiple sclerosis. With the introduction of spectral domain optical coherence tomography (SD-OCT), supervised automated segmentation of individual retinal...... layers is possible. We aimed to investigate which retinal layers show atrophy associated with neurodegeneration in multiple sclerosis when measured with SD-OCT. METHODS: In this systematic review and meta-analysis, we searched for studies in which SD-OCT was used to look at the retina in people...... with multiple sclerosis with or without optic neuritis in PubMed, Web of Science, and Google Scholar between Nov 22, 1991, and April 19, 2016. Data were taken from cross-sectional cohorts and from one timepoint from longitudinal studies (at least 3 months after onset in studies of optic neuritis). We classified...
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Directory of Open Access Journals (Sweden)
Cronin-Fenton DP
2013-10-01
Full Text Available Deirdre P Cronin-Fenton,1 Sussie Antonsen,1 Karynsa Cetin,2 John Acquavella,2 Andre Daniels,3 Timothy L Lash1,4 1Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; 2Center for Observational Research, Amgen Incorporated, Thousand Oaks, CA, USA; 3Global Regulatory Affairs and Safety, Amgen Incorporated, Thousand Oaks, CA, USA; 4Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA Objectives: We describe several methodological issues that were addressed in conducting a Danish population-based matched cohort study comparing rates of new primary cancers (NPCs in men with and without prostate cancer (PC. Methods: We matched 30,220 men with PC to 151,100 men without PC (comparators on age (±2 years and PC diagnosis/index date. We focused on several methodological issues: 1 to address survival differences between the cohorts we compared rates with and without censoring comparators on the date their matched PC patient died or was censored; 2 to address diagnostic bias, we excluded men with a history of cancer from the comparator cohort; 3 to address prostate cancer immunity, we graphed the hazard of NPC in both cohorts, with and without prostate cancer as an outcome; 4 we used empirical Bayes methods to explore the effect of adjusting for multiple comparisons. Results: After 18 months of follow-up, cumulative person-time was lower in the PC than comparator cohort due to higher mortality among PC patients. Terminating person-time in comparators at the matched PC patient's death or loss to follow-up resulted in comparable person-time up to 30 months of follow-up and lower person-time among comparators thereafter. The hazard of NPC was lower among men with PC than comparators throughout follow-up. There was little difference in rates beyond the first four years of follow-up after removing PC as an outcome. Empirical Bayes adjustment for multiple comparisons had little effect on the
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International Nuclear Information System (INIS)
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
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The risk of venous thromboembolism in patients with multiple sclerosis
DEFF Research Database (Denmark)
Peeters, P J H L; Bazelier, M T; Uitdehaag, B M J
2014-01-01
BACKGROUND: In patients with multiple sclerosis (MS), disability and autoinflammatory processes may result in an increased risk of venous thromboembolism (VTE) OBJECTIVE: To evaluate the risk of VTE associated with MS. METHODS: We conducted an observational-cohort study within the Clinical Practice...
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Novel anti-HIV peptides containing multiple copies of artificially designed heptad repeat motifs
International Nuclear Information System (INIS)
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
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Understanding and Harnessing the Power of the Cohort Model in Preparing Educational Leaders.
Teitel, Lee
1997-01-01
The University of Massachusetts at Boston (UMB) shifted all of its school leadership programs to the cohort model. This article reviews UMB's school leadership programs, describes the survey methodology used to take stock of the program and its cohort design, then summarizes survey findings to identify five different types of impacts reported by…
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A SCHEDULING SCHEME WITH DYNAMIC FREQUENCY CLOCKING AND MULTIPLE VOLTAGES FOR LOW POWER DESIGNS
Institute of Scientific and Technical Information of China (English)
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.
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Prospectively Identified Incident Testicular Cancer Risk in a Familial Testicular Cancer Cohort.
Pathak, Anand; Adams, Charleen D; Loud, Jennifer T; Nichols, Kathryn; Stewart, Douglas R; Greene, Mark H
2015-10-01
Human testicular germ cell tumors (TGCT) have a strong genetic component and a high familial relative risk. However, linkage analyses have not identified a rare, highly penetrant familial TGCT (FTGCT) susceptibility locus. Currently, multiple low-penetrance genes are hypothesized to underlie the familial multiple-case phenotype. The observation that two is the most common number of affected individuals per family presents an impediment to FTGCT gene discovery. Clinically, the prospective TGCT risk in the multiple-case family context is unknown. We performed a prospective analysis of TGCT incidence in a cohort of multiple-affected-person families and sporadic-bilateral-case families; 1,260 men from 140 families (10,207 person-years of follow-up) met our inclusion criteria. Age-, gender-, and calendar time-specific standardized incidence ratios (SIR) for TGCT relative to the general population were calculated using SEER*Stat. Eight incident TGCTs occurred during prospective FTGCT cohort follow-up (versus 0.67 expected; SIR = 11.9; 95% CI, 5.1-23.4; excess absolute risk = 7.2/10,000). We demonstrate that the incidence rate of TGCT is greater among bloodline male relatives from multiple-case testicular cancer families than that expected in the general population, a pattern characteristic of adult-onset Mendelian cancer susceptibility disorders. Two of these incident TGCTs occurred in relatives of sporadic-bilateral cases (0.15 expected; SIR = 13.4; 95% CI, 1.6-48.6). Our data are the first to indicate that despite relatively low numbers of affected individuals per family, members of both multiple-affected-person FTGCT families and sporadic-bilateral TGCT families comprise high-risk groups for incident testicular cancer. Men at high TGCT risk might benefit from tailored risk stratification and surveillance strategies. ©2015 American Association for Cancer Research.
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Prospectively-Identified Incident Testicular Cancer Risk in a Familial Testicular Cancer Cohort
Pathak, Anand; Adams, Charleen D.; Loud, Jennifer T.; Nichols, Kathryn; Stewart, Douglas R.; Greene, Mark H.
2015-01-01
Background Human testicular germ cell tumors (TGCT) have a strong genetic component and a high familial relative risk. However, linkage analyses have not identified a rare, highly-penetrant familial TGCT (FTGCT) susceptibility locus. Currently, multiple low-penetrance genes are hypothesized to underlie the familial multiple-case phenotype. The observation that two is the most common number of affected individuals per family presents an impediment to FTGCT gene discovery. Clinically, the prospective TGCT risk in the multiple-case family context is unknown. Methods We performed a prospective analysis of TGCT incidence in a cohort of multiple-affected-person families and sporadic-bilateral-case families; 1,260 men from 140 families (10,207 person-years of follow-up) met our inclusion criteria. Age-, gender-, and calendar time-specific standardized incidence ratios (SIR) for TGCT relative to the general population were calculated using SEER*Stat. Results Eight incident TGCTs occurred during prospective FTGCT cohort follow-up (versus 0.67 expected; SIR=11.9; 95% confidence interval [CI]=5.1–23.4; excess absolute risk=7.2/10,000). We demonstrate that the incidence rate of TGCT is greater among bloodline male relatives from multiple-case testicular cancer families than that expected in the general population, a pattern characteristic of adult-onset Mendelian cancer susceptibility disorders. Two of these incident TGCTs occurred in relatives of sporadic-bilateral cases (0.15 expected; SIR=13.4; 95%CI=1.6–48.6). Conclusions Our data are the first indicating that despite relatively low numbers of affected individuals per family, members of both multiple-affected-person FTGCT families and sporadic-bilateral TGCT families comprise high-risk groups for incident testicular cancer. Impact Men at high TGCT risk might benefit from tailored risk stratification and surveillance strategies. PMID:26265202
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Optimal design of hydraulic excavator working device based on multiple surrogate models
Directory of Open Access Journals (Sweden)
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.
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International Nuclear Information System (INIS)
Bialkowski, J.; Moszynski, M.; Zagorski, A.
1981-01-01
The logic diagram principle of operation and some details of the design of the multiplicity logic unit are presented. This unit was specially designed to fulfil the requirements of a multidetector arrangement for gamma-ray multiplicity measurements. The unit is equipped with 16 inputs controlled by a common coincidence gate. It delivers a linear output pulse with the height proportional to the multiplicity of coincidences and logic pulses corresponding to 0, 1, ... up to >= 5-fold coincidences. These last outputs are used to steer the routing unit working with the multichannel analyser. (orig.)
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Quasi-Experiments in Schools: The Case for Historical Cohort Control Groups
Walser, Tamara M.
2014-01-01
There is increased emphasis on using experimental and quasi-experimental methods to evaluate educational programs; however, educational evaluators and school leaders are often faced with challenges when implementing such designs in educational settings. Use of a historical cohort control group design provides a viable option for conducting…
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Bateson, Thomas F; Kopylev, Leonid
2015-01-01
Recent meta-analyses of occupational epidemiology studies identified two important exposure data quality factors in predicting summary effect measures for asbestos-associated lung cancer mortality risk: sufficiency of job history data and percent coverage of work history by measured exposures. The objective was to evaluate different exposure parameterizations suggested in the asbestos literature using the Libby, MT asbestos worker cohort and to evaluate influences of exposure measurement error caused by historically estimated exposure data on lung cancer risks. Focusing on workers hired after 1959, when job histories were well-known and occupational exposures were predominantly based on measured exposures (85% coverage), we found that cumulative exposure alone, and with allowance of exponential decay, fit lung cancer mortality data similarly. Residence-time-weighted metrics did not fit well. Compared with previous analyses based on the whole cohort of Libby workers hired after 1935, when job histories were less well-known and exposures less frequently measured (47% coverage), our analyses based on higher quality exposure data yielded an effect size as much as 3.6 times higher. Future occupational cohort studies should continue to refine retrospective exposure assessment methods, consider multiple exposure metrics, and explore new methods of maintaining statistical power while minimizing exposure measurement error.
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Open Access in Higher Education–Strategies for Engaging Diverse Student Cohorts
Signor, Luisa; Moore, Catherine
2014-01-01
With growth in online education, students gain tertiary qualifications through a mode more suited to their demographics such as work and life balance, learning styles and geographical accessibility. Inevitably this has led to a growth in diversity within student cohorts.The case study described in this paper illustrates strategies based on informed learning design for educating diverse student cohorts in an online program offered by Swinburne University of Technology. The case, an open-access...
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Performance of Cross-layer Design with Multiple Outdated Estimates in Multiuser MIMO System
Directory of Open Access Journals (Sweden)
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.
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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.
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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
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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.
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Directory of Open Access Journals (Sweden)
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.
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Trends in adolescent alcohol use: Effects of age, sex and cohort on prevalence and heritability
Geels, L.M.; Bartels, M.; van Beijsterveldt, C.E.M.; Willemsen, G.; van der Aa, N.; Boomsma, D.I.; Vink, J.M.
2012-01-01
Aims To determine the effect of age, sex and cohort on the prevalence and genetic architecture of adolescent alcohol use (AAU). Design Survey study in participants registered with the Netherlands Twin Register. Setting Twins from the general population. Participants Two cohorts (data collected in
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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.
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New time-saving predictor algorithm for multiple breath washout in adolescents
DEFF Research Database (Denmark)
Grønbæk, Jonathan; Hallas, Henrik Wegener; Arianto, Lambang
2016-01-01
BACKGROUND: Multiple breath washout (MBW) is an informative but time-consuming test. This study evaluates the uncertainty of a time-saving predictor algorithm in adolescents. METHODS: Adolescents were recruited from the Copenhagen Prospective Study on Asthma in Childhood (COPSAC2000) birth cohort...
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Birth cohorts in Asia: The importance, advantages, and disadvantages of different-sized cohorts.
Kishi, Reiko; Araki, Atsuko; Minatoya, Machiko; Itoh, Sachiko; Goudarzi, Houman; Miyashita, Chihiro
2018-02-15
Asia contains half of the world's children, and the countries of Asia are the most rapidly industrializing nations on the globe. Environmental threats to the health of children in Asia are myriad. Several birth cohorts were started in Asia in early 2000, and currently more than 30 cohorts in 13 countries have been established for study. Cohorts can contain from approximately 100-200 to 20,000-30,000 participants. Furthermore, national cohorts targeting over 100,000 participants have been launched in Japan and Korea. The aim of this manuscript is to discuss the importance of Asian cohorts, and the advantages and disadvantages of different-sized cohorts. As for case, one small-sized (n=514) cohort indicate that even relatively low level exposure to dioxin in utero could alter birth size, neurodevelopment, and immune and hormonal functions. Several Asian cohorts focus prenatal exposure to perfluoroalkyo substances and reported associations with birth size, thyroid hormone levels, allergies and neurodevelopment. Inconsistent findings may possibly be explained by the differences in exposure levels and target chemicals, and by possible statistical errors. In a smaller cohort, novel hypotheses or preliminary examinations are more easily verifiable. In larger cohorts, the etiology of rare diseases, such as birth defects, can be analyzed; however, they require a large cost and significant human resources. Therefore, conducting studies in only one large cohort may not always be the best strategy. International collaborations, such as the Birth Cohort Consortium of Asia, would cover the inherent limitation of sample size in addition to heterogeneity of exposure, ethnicity, and socioeconomic conditions. Copyright © 2017 Elsevier B.V. All rights reserved.
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Socioeconomic Factors in Childhood and the Risk of Multiple Sclerosis
DEFF Research Database (Denmark)
Nielsen, N. M.; Jorgensen, K. T.; Bager, P.
2013-01-01
In a national cohort comprising 1.5 million Danes born from 1966 to 1992, we studied the association between childhood socioeconomic status (SES) and the risk of multiple sclerosis (MS) from 1981 to 2007 using information about household income and parental educational levels at the persons 15th ...
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Risk of cataract and glaucoma in patients with multiple sclerosis
Marloes Bazelier; Tjeerd van Staa; Bernard Uitdehaag; Sigrid Mueller-Schotte; Hubert Leufkens; Frank de Vries
2012-01-01
The aim of the study was to evaluate whether multiple sclerosis (MS) is associated with risk of cataract or glaucoma. We conducted a population-based cohort study utilizing the UK General Practice Research Database (1987–2009) linked to the national hospital registry of England (1997–2008). Incident
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Hypospadias in a cohort of 1072 Danish newborn boys
DEFF Research Database (Denmark)
Boisen, K A; Chellakooty, M; Schmidt, I M
2005-01-01
and reproductive hormone levels at 3 months of age. DESIGN: A prospective cohort study was conducted with 3-yr follow-up (1997-2004). SETTING: The population-based study was conducted at the University Hospital of Copenhagen. PARTICIPANTS: A total of 1072 Danish boys were consecutively recruited antenatally...... = 0.023) were significantly lower, and FSH was significantly higher (1.48 vs. 1.15 IU/liter; P = 0.007) in boys with hypospadias, compared with healthy boys. CONCLUSIONS: We found a surprisingly high total rate of hypospadias of 4.6% in this large prospective cohort study. Seventy-two percent...
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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.
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DEFF Research Database (Denmark)
Møller, Karina Lauenborg; Brauer, Charlotte; Mikkelsen, Sigurd
2017-01-01
PURPOSE: Copenhagen Airport Cohort 1990-2012 presents a unique data source for studies of health effects of occupational exposure to air pollution (ultrafine particles) and manual baggage handling among airport employees. We describe the extent of information in the cohort and in the follow...... covers 69 175 men in unskilled positions. The exposed cohort includes men in unskilled jobs employed at Copenhagen Airport in the period 1990-2012 either as baggage handlers or in other outdoor work. The reference cohort includes men in unskilled jobs working in the greater Copenhagen area. FINDINGS...... TO DATE: The cohort includes environmental Global Positioning System (GPS) measurements in Copenhagen Airport, information on job function/task for each calendar year of employment between 1990 and 2012, exposure to air pollution at residence, average weight of baggage lifted per day and lifestyle...
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Mountain, Jenny A; Nyaradi, Anett; Oddy, Wendy H; Glauert, Rebecca A; de Klerk, Nick H; Straker, Leon M; Stanley, Fiona J
2016-07-15
The Western Australian Data Linkage System is one of a few comprehensive, population-based data linkage systems worldwide, creating links between information from different sources relating to the same individual, family, place or event, while maintaining privacy. The Raine Study is an established cohort study with more than 2000 currently active participants. Individual consent was obtained from participants for information in publicly held databases to be linked to their study data. A waiver of consent was granted where it was impracticable to obtain consent. Approvals to link the datasets were obtained from relevant ethics committees and data custodians. The Raine Study dataset was subsequently linked to academic testing data collected by the Western Australian Department of Education. Examination of diet and academic performance showed that children who were predominantly breastfed for at least 6 months scored higher academically at age 10 than children who were breastfed for less than 6 months. A further study found that better diet quality at ages 1, 2 and 3 years was associated with higher academic scores at ages 10 and 12 years. Examination of nutritional intake at 14 years of age found that a better dietary pattern was associated with higher academic performance. The detailed longitudinal data collected in the Raine Study allowed for adjustment for multiple covariates and confounders. Data linkage reduces the burden on cohort participants by providing additional information without the need to contact participants. It can give information on participants who have been lost to follow-up; provide or complement missing data; give the opportunity for validation studies comparing recall of participants with administrative records; increase the population sample of studies by adding control participants from the general population; and allow for the adjustment of multiple covariates and confounders. The Raine Study dataset is extensive and detailed, and can be
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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.
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Balliu, Brunilda; Tsonaka, Roula; Boehringer, Stefan; Houwing-Duistermaat, Jeanine
2015-03-01
Integrative omics, the joint analysis of outcome and multiple types of omics data, such as genomics, epigenomics, and transcriptomics data, constitute a promising approach for powerful and biologically relevant association studies. These studies often employ a case-control design, and often include nonomics covariates, such as age and gender, that may modify the underlying omics risk factors. An open question is how to best integrate multiple omics and nonomics information to maximize statistical power in case-control studies that ascertain individuals based on the phenotype. Recent work on integrative omics have used prospective approaches, modeling case-control status conditional on omics, and nonomics risk factors. Compared to univariate approaches, jointly analyzing multiple risk factors with a prospective approach increases power in nonascertained cohorts. However, these prospective approaches often lose power in case-control studies. In this article, we propose a novel statistical method for integrating multiple omics and nonomics factors in case-control association studies. Our method is based on a retrospective likelihood function that models the joint distribution of omics and nonomics factors conditional on case-control status. The new method provides accurate control of Type I error rate and has increased efficiency over prospective approaches in both simulated and real data. © 2015 Wiley Periodicals, Inc.
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Folic acid knowledge and use in a multi-ethnic pregnancy cohort: the role of language proficiency
van Eijsden, M.; van der Wal, M. F.; Bonsel, G. J.
2006-01-01
OBJECTIVE: To investigate the role of language proficiency as determinant of folic acid knowledge and use in a multi-ethnic pregnancy cohort. DESIGN: Prospective cohort study. SETTING AND POPULATION: Pregnant women from Amsterdam attending obstetric care for their first antenatal visit. Number
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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
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Suicide and multiple sclerosis
DEFF Research Database (Denmark)
Stenager, E N; Stenager, Egon; Koch-Henriksen, N
1992-01-01
In a nationwide investigation the risk of death by suicide for patients with multiple sclerosis (MS) was assessed using records kept at the Danish Multiple Sclerosis Registry (DMSR) and the Danish National Register of Cause of Death. The investigation covers all MS patients registered with DSMR...... with an onset of the disease within the period 1953-85, or for whom MS was diagnosed in the same period. Fifty three of the 5525 cases in the onset cohort group committed suicide. Using the figures from the population death statistics by adjustment to number of subjects, duration of observation, sex, age......, and calendar year at the start of observation, the expected number of suicides was calculated to be nearly 29. The cumulative lifetime risk of suicide from onset of MS, using an actuarial method of calculation, was 1.95%. The standard mortality ratio (SMR) of suicide in MS was 1.83. It was highest for males...
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Structural Design of Systems with Safe Behavior under Single and Multiple Faults
DEFF Research Database (Denmark)
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...
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Serum metabolomic profiling in acute alcoholic hepatitis identifies multiple dysregulated pathways.
Rachakonda, Vikrant; Gabbert, Charles; Raina, Amit; Bell, Lauren N; Cooper, Sara; Malik, Shahid; Behari, Jaideep
2014-01-01
While animal studies have implicated derangements of global energy homeostasis in the pathogenesis of acute alcoholic hepatitis (AAH), the relevance of these findings to the development of human AAH remains unclear. Using global, unbiased serum metabolomics analysis, we sought to characterize alterations in metabolic pathways associated with severe AAH and identify potential biomarkers for disease prognosis. This prospective, case-control study design included 25 patients with severe AAH and 25 ambulatory patients with alcoholic cirrhosis. Serum samples were collected within 24 hours of the index clinical encounter. Global, unbiased metabolomics profiling was performed. Patients were followed for 180 days after enrollment to determine survival. Levels of 234 biochemicals were altered in subjects with severe AAH. Random-forest analysis, principal component analysis, and integrated hierarchical clustering methods demonstrated that metabolomics profiles separated the two cohorts with 100% accuracy. Severe AAH was associated with enhanced triglyceride lipolysis, impaired mitochondrial fatty acid beta oxidation, and upregulated omega oxidation. Low levels of multiple lysolipids and related metabolites suggested decreased plasma membrane remodeling in severe AAH. While most measured bile acids were increased in severe AAH, low deoxycholate and glycodeoxycholate levels indicated intestinal dysbiosis. Several changes in substrate utilization for energy homeostasis were identified in severe AAH, including increased glucose consumption by the pentose phosphate pathway, altered tricarboxylic acid (TCA) cycle activity, and enhanced peptide catabolism. Finally, altered levels of small molecules related to glutathione metabolism and antioxidant vitamin depletion were observed in patients with severe AAH. Univariable logistic regression revealed 15 metabolites associated with 180-day survival in severe AAH. Severe AAH is characterized by a distinct metabolic phenotype spanning
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Increasing occurrence of multiple sclerosis in women correlates to hygiene level
Directory of Open Access Journals (Sweden)
Wojciech Cendrowski
2014-12-01
Full Text Available Introduction: The increasing incidence of multiple sclerosis, particularly among women in Europe and North America, has a multifactorial aetiology. Method: The aim of the current study was to ascertain the relation between the hygiene level and occurrence of multiple sclerosis in women in Poland. The study was based on a large cohort of 14,200 multiple sclerosis individuals (male – 6,106, female – 8,094 who died in the years 1981–2010 in Poland. The female to male ratio (the F:M ratio in the multiple sclerosis group was calculated using the number of deaths per year. The rate of late mortality in infants (LMI per 1,000 live births yearly was used as a marker of the hygiene level. A correlation analysis was carried out between the rate of LMI and the F:M ratio in the multiple sclerosis cohort in the years 1981–2010. Demographic data were obtained from the Central Statistical Office in Warsaw. Results: The F:M ratio in the multiple sclerosis group evidently increased (range 1.08–1.79 in the years 1981–2010, showing increasing occurrence of multiple sclerosis in women (p < 0.0001. A significant, strong and inverse correlation was found between the marker of the hygiene level (LMI rate and the F:M ratio in the multiple sclerosis group over three decades: linear correlation coefficient by Pearson: r = –0.693, p < 0.0001. By contrast with this result, no correlation was established between the hygiene level marker and proportion of women to men in the general population on account of extremely low variance of the F:M ratio (0.000025. Conclusion: The improvement of the hygiene level showed association with the increasing occurrence of multiple sclerosis in women in the years 1981–2010. The higher the hygiene level was, the greater the occurrence of female multiple sclerosis in Poland.
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Novel multiple sclerosis susceptibility loci implicated in epigenetic regulation
Andlauer, Till F. M.; Buck, Dorothea; Antony, Gisela; Bayas, Antonios; Bechmann, Lukas; Berthele, Achim; Chan, Andrew; Gasperi, Christiane; Gold, Ralf; Graetz, Christiane; Haas, Jürgen; Hecker, Michael; Infante-Duarte, Carmen; Knop, Matthias; Kümpfel, Tania; Limmroth, Volker; Linker, Ralf A.; Loleit, Verena; Luessi, Felix; Meuth, Sven G.; Mühlau, Mark; Nischwitz, Sandra; Paul, Friedemann; Pütz, Michael; Ruck, Tobias; Salmen, Anke; Stangel, Martin; Stellmann, Jan-Patrick; Stürner, Klarissa H.; Tackenberg, Björn; Then Bergh, Florian; Tumani, Hayrettin; Warnke, Clemens; Weber, Frank; Wiendl, Heinz; Wildemann, Brigitte; Zettl, Uwe K.; Ziemann, Ulf; Zipp, Frauke; Arloth, Janine; Weber, Peter; Radivojkov-Blagojevic, Milena; Scheinhardt, Markus O.; Dankowski, Theresa; Bettecken, Thomas; Lichtner, Peter; Czamara, Darina; Carrillo-Roa, Tania; Binder, Elisabeth B.; Berger, Klaus; Bertram, Lars; Franke, Andre; Gieger, Christian; Herms, Stefan; Homuth, Georg; Ising, Marcus; Jöckel, Karl-Heinz; Kacprowski, Tim; Kloiber, Stefan; Laudes, Matthias; Lieb, Wolfgang; Lill, Christina M.; Lucae, Susanne; Meitinger, Thomas; Moebus, Susanne; Müller-Nurasyid, Martina; Nöthen, Markus M.; Petersmann, Astrid; Rawal, Rajesh; Schminke, Ulf; Strauch, Konstantin; Völzke, Henry; Waldenberger, Melanie; Wellmann, Jürgen; Porcu, Eleonora; Mulas, Antonella; Pitzalis, Maristella; Sidore, Carlo; Zara, Ilenia; Cucca, Francesco; Zoledziewska, Magdalena; Ziegler, Andreas; Hemmer, Bernhard; Müller-Myhsok, Bertram
2016-01-01
We conducted a genome-wide association study (GWAS) on multiple sclerosis (MS) susceptibility in German cohorts with 4888 cases and 10,395 controls. In addition to associations within the major histocompatibility complex (MHC) region, 15 non-MHC loci reached genome-wide significance. Four of these loci are novel MS susceptibility loci. They map to the genes L3MBTL3, MAZ, ERG, and SHMT1. The lead variant at SHMT1 was replicated in an independent Sardinian cohort. Products of the genes L3MBTL3, MAZ, and ERG play important roles in immune cell regulation. SHMT1 encodes a serine hydroxymethyltransferase catalyzing the transfer of a carbon unit to the folate cycle. This reaction is required for regulation of methylation homeostasis, which is important for establishment and maintenance of epigenetic signatures. Our GWAS approach in a defined population with limited genetic substructure detected associations not found in larger, more heterogeneous cohorts, thus providing new clues regarding MS pathogenesis. PMID:27386562
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Novel multiple sclerosis susceptibility loci implicated in epigenetic regulation.
Andlauer, Till F M; Buck, Dorothea; Antony, Gisela; Bayas, Antonios; Bechmann, Lukas; Berthele, Achim; Chan, Andrew; Gasperi, Christiane; Gold, Ralf; Graetz, Christiane; Haas, Jürgen; Hecker, Michael; Infante-Duarte, Carmen; Knop, Matthias; Kümpfel, Tania; Limmroth, Volker; Linker, Ralf A; Loleit, Verena; Luessi, Felix; Meuth, Sven G; Mühlau, Mark; Nischwitz, Sandra; Paul, Friedemann; Pütz, Michael; Ruck, Tobias; Salmen, Anke; Stangel, Martin; Stellmann, Jan-Patrick; Stürner, Klarissa H; Tackenberg, Björn; Then Bergh, Florian; Tumani, Hayrettin; Warnke, Clemens; Weber, Frank; Wiendl, Heinz; Wildemann, Brigitte; Zettl, Uwe K; Ziemann, Ulf; Zipp, Frauke; Arloth, Janine; Weber, Peter; Radivojkov-Blagojevic, Milena; Scheinhardt, Markus O; Dankowski, Theresa; Bettecken, Thomas; Lichtner, Peter; Czamara, Darina; Carrillo-Roa, Tania; Binder, Elisabeth B; Berger, Klaus; Bertram, Lars; Franke, Andre; Gieger, Christian; Herms, Stefan; Homuth, Georg; Ising, Marcus; Jöckel, Karl-Heinz; Kacprowski, Tim; Kloiber, Stefan; Laudes, Matthias; Lieb, Wolfgang; Lill, Christina M; Lucae, Susanne; Meitinger, Thomas; Moebus, Susanne; Müller-Nurasyid, Martina; Nöthen, Markus M; Petersmann, Astrid; Rawal, Rajesh; Schminke, Ulf; Strauch, Konstantin; Völzke, Henry; Waldenberger, Melanie; Wellmann, Jürgen; Porcu, Eleonora; Mulas, Antonella; Pitzalis, Maristella; Sidore, Carlo; Zara, Ilenia; Cucca, Francesco; Zoledziewska, Magdalena; Ziegler, Andreas; Hemmer, Bernhard; Müller-Myhsok, Bertram
2016-06-01
We conducted a genome-wide association study (GWAS) on multiple sclerosis (MS) susceptibility in German cohorts with 4888 cases and 10,395 controls. In addition to associations within the major histocompatibility complex (MHC) region, 15 non-MHC loci reached genome-wide significance. Four of these loci are novel MS susceptibility loci. They map to the genes L3MBTL3, MAZ, ERG, and SHMT1. The lead variant at SHMT1 was replicated in an independent Sardinian cohort. Products of the genes L3MBTL3, MAZ, and ERG play important roles in immune cell regulation. SHMT1 encodes a serine hydroxymethyltransferase catalyzing the transfer of a carbon unit to the folate cycle. This reaction is required for regulation of methylation homeostasis, which is important for establishment and maintenance of epigenetic signatures. Our GWAS approach in a defined population with limited genetic substructure detected associations not found in larger, more heterogeneous cohorts, thus providing new clues regarding MS pathogenesis.
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International Nuclear Information System (INIS)
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)
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Major stressful life events in adulthood and risk of multiple sclerosis
DEFF Research Database (Denmark)
Nielsen, Nete Munk; Bager, Peter; Simonsen, Jacob
2014-01-01
It is unclear whether psychological stress is associated with increased risk of multiple sclerosis (MS). We studied the association between major stressful life events and MS in a nationwide cohort study using death of a child or a spouse or marital dissolution as indicators of severe stress....
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Work engagement and meaningful work across generational cohorts
Directory of Open Access Journals (Sweden)
Crystal Hoole
2015-08-01
Full Text Available Orientation: Engaging employees and providing employees with a sense of meaning at work is not a one-size-fits-all approach. Although research has shown that differences between work engagement and meaningful work amongst generational cohorts exist, results are still inconclusive. With age becoming increasingly more important as a diversity factor, a better understanding of the dynamics between work engagement and meaningful work across different generational cohorts is necessary to design the right strategy for each organisation’s unique parameters. Research purpose: The aim of this study was to determine whether there is a relationship between work engagement and meaningful work and whether there are significant variances between the levels of work engagement and meaningful work between different generational cohorts. Motivation for study: Work engagement has consistently been highlighted by researchers and human resources experts as a recommended solution to provide companies with the upper hand when it comes to creating a competitive edge. Yet, levels of work engagement are far from ideal, requiring intensified efforts to identify solutions towards raising overall engagement levels. In recent years, much of the focus in terms of generating engagement has been aimed in the direction of financial rewards and other benefits; some organisational experts are of the opinion that a shift is occurring towards meaningful work instead of monetary rewards as the driver of engagement. The changing nature of the work landscape also suggests that generational cohorts experience work engagement and meaningful work differently. Understanding these complexities is mandatory in creating solutions towards improving levels of engagement and meaningful work. Research approach, design and method: A cross-sectional quantitative research approach has been followed. The Utrecht Work Engagement Scale (UWES and Psychological Meaningful Scale (PMS were administered
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Cohort Learning Online in Graduate Higher Education: Constructing Knowledge in Cyber Community
Directory of Open Access Journals (Sweden)
Gabriele I. E. Strohschen
2004-01-01
Full Text Available This paper discusses a qualitative participatory action research study, which examined the nature of the cohort learning experience in an online masters program, from both faculty and student perspectives. After describing this online masters program in adult education designed from a social constructivist theoretical frame, this paper discusses two primary areas of findings related to cohort learning. First, were those related to the ongoing negotiation of the learning process: the importance of an opening residential; a consistent but flexible cohort structure; and building ongoing relationships. Second, were those related to the ongoing construction of knowledge: the role of team-teaching and the cohort model in transformative learning; the application of theory to real life practice, and the value of group support and collaboration in conducting research and constructing knowledge. Implications for practice are discussed.
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Cohort profile: the Spanish WORKing life Social Security (WORKss) cohort study.
López Gómez, María Andrée; Durán, Xavier; Zaballa, Elena; Sanchez-Niubo, Albert; Delclos, George L; Benavides, Fernando G
2016-03-07
The global economy is changing the labour market and social protection systems in Europe. The effect of both changes on health needs to be monitored in view of an ageing population and the resulting increase in prevalence of chronic health conditions. The Spanish WORKing life Social Security (WORKss) cohort study provides unique longitudinal data to study the impact of labour trajectories and employment conditions on health, in terms of sickness absence, permanent disability and death. The WORKss cohort originated from the Continuous Working Life Sample (CWLS) generated by the General Directorate for the Organization of the Social Security in Spain. The CWLS contains a 4% representative sample of all individuals in contact with the Social Security system. The WORKss cohort exclusively includes individuals with a labour trajectory from 1981 or later. In 2004, the cohort was initiated with 1,022 ,79 Social Security members: 840,770 (82.2%) contributors and 182,009 (17.8%) beneficiaries aged 16 and older. The WORKss cohort includes demographic characteristics, chronological data about employment history, retirement, permanent disability and death. These data make possible the measurement of incidence of permanent disability, the number of potential years of working life lost, and the number of contracts and inactive periods with the Social Security system. The WORKss cohort was linked to temporary sickness absence registries to study medical diagnoses that lead to permanent disability and consequently to an earlier exit from the labour market in unhealthy conditions. Thanks to its administrative source, the WORKss cohort study will continue follow-up in the coming years, keeping the representativeness of the Spanish population affiliated to the Social Security system. The linkage between the WORKss cohort and temporary sickness absence registries is envisioned to continue. Future plans include the linkage of the cohort with mortality registries. Published by the BMJ
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Prevalence and clinical outcomes of patients with multiple potential causes of syncope
Chen, Lin Y.; Gersh, Bernard J.; Hodge, David O.; Wieling, Wouter; Hammill, Stephen C.; Shen, Win-Kuang
2003-01-01
Objective: To determine the prevalence, predictors, and prognosis of patients with multiple potential causes of syncope. Patients and Methods: This is a retrospective cohort study with prospective follow-up of consecutive patients with syncope of uncertain cause who were referred to the
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Smoldering multiple myeloma risk factors for progression
DEFF Research Database (Denmark)
Sørrig, Rasmus; Klausen, Tobias W; Salomo, Morten
2016-01-01
Several risk scores for disease progression in Smoldering Multiple Myeloma (SMM) patients have been proposed, however, all have been developed using single center registries. To examine risk factors for time to progression (TTP) to Multiple Myeloma (MM) for SMM we analyzed a nationwide population......-based cohort of 321 newly diagnosed SMM patients registered within the Danish Multiple Myeloma Registry between 2005 and 2014. Significant univariable risk factors for TTP were selected for multivariable Cox regression analyses. We found that both an M-protein ≥ 30g/l and immunoparesis significantly influenced......-high risk of transformation to MM. Using only immunoparesis and M-protein ≥ 30g/l, we created a scoring system to identify low, intermediate and high risk SMM. This first population-based study of SMM patients confirms that an M-protein ≥ 30g/l and immunoparesis remain important risk factors for progression...
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International Nuclear Information System (INIS)
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)
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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.
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Radiological surveillance in multiple endocrine neoplasia type 1: a double-edged sword?
Directory of Open Access Journals (Sweden)
Ruth Therese Casey
2017-03-01
Full Text Available Context: Multiple endocrine neoplasia type 1 (MEN1 is a hereditary condition characterised by the predisposition to hyperplasia/tumours of endocrine glands. MEN1-related disease, moreover, malignancy related to MEN1, is increasingly responsible for death in up to two-thirds of patients. Although patients undergo radiological and biochemical surveillance, current recommendations for radiological monitoring are based on non-prospective data with little consensus or evidence demonstrating improved outcome from this approach. Here, we sought to determine whether cumulative radiation exposure as part of the recommended radiological screening programme posed a distinct risk in a cohort of patients with MEN1.Patients and study design: A retrospective review of 43 patients with MEN1 attending our institution between 2007 and 2015 was performed. Demographic and clinical information including phenotype was obtained for all patients. We also obtained details regarding all radiological procedures performed as part of MEN1 surveillance or disease localisation. An estimated effective radiation dose (ED for each individual patient was calculated.Results: The mean ED for the total patient cohort was 121 mSv, and the estimated mean lifetime risk of cancer secondary to radiation exposure was 0.49%. Patients with malignant neuroendocrine tumours (NETS had significantly higher ED levels compared to patients without metastatic disease (P < 0.0022.Conclusions: In MEN1, radiological surveillance is associated with clinically significant exposure to ionising radiation. In patients with MEN1, multi-modality imaging strategies designed to minimise this exposure should be considered.
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System for the analysis of cohort mortality data
International Nuclear Information System (INIS)
McLain, R.; Frome, E.L.
1986-01-01
A system is developed for the analysis of cohort mortality data. This Mortality Analysis System (MAS) is designed as a research tool in epidemiologic studies. The system allows a researcher to investigate the effect of one or more factors on the mortality of a study cohort. Variables can be categorized as factors to allow for stratification in the analysis. DATA steps and PROC MATRIX are incorporated in the system to produce the output. Person-years, observed deaths, and expected deaths are calculated and cross-classified by the levels of the factors. The resulting data set can be used to compute the standardized mortality ratios (SMR) for each stratum level. Poisson regression models can then be used for further statistical analysis
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Directory of Open Access Journals (Sweden)
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.
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Kassambara, Alboukadel; Hose, Dirk; Moreaux, Jérôme; Walker, Brian A.; Protopopov, Alexei; Reme, Thierry; Pellestor, Franck; Pantesco, Véronique; Jauch, Anna; Morgan, Gareth; Goldschmidt, Hartmut; Klein, Bernard
2012-01-01
Background Genetic abnormalities are common in patients with multiple myeloma, and may deregulate gene products involved in tumor survival, proliferation, metabolism and drug resistance. In particular, translocations may result in a high expression of targeted genes (termed spike expression) in tumor cells. We identified spike genes in multiple myeloma cells of patients with newly-diagnosed myeloma and investigated their prognostic value. Design and Methods Genes with a spike expression in multiple myeloma cells were picked up using box plot probe set signal distribution and two selection filters. Results In a cohort of 206 newly diagnosed patients with multiple myeloma, 2587 genes/expressed sequence tags with a spike expression were identified. Some spike genes were associated with some transcription factors such as MAF or MMSET and with known recurrent translocations as expected. Spike genes were not associated with increased DNA copy number and for a majority of them, involved unknown mechanisms. Of spiked genes, 36.7% clustered significantly in 149 out of 862 documented chromosome (sub)bands, of which 53 had prognostic value (35 bad, 18 good). Their prognostic value was summarized with a spike band score that delineated 23.8% of patients with a poor median overall survival (27.4 months versus not reached, Pband score was independent of other gene expression profiling-based risk scores, t(4;14), or del17p in an independent validation cohort of 345 patients. Conclusions We present a new approach to identify spike genes and their relationship to patients’ survival. PMID:22102711
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Directory of Open Access Journals (Sweden)
Olga eVoevodskaya
2014-10-01
Full Text Available In neurodegeneration research, normalization of regional volumes by intracranial volume (ICV is important to estimate the extent of disease-driven atrophy. There is little agreement as to whether raw volumes, volume-to-ICV fractions or regional volumes from which the ICV factor has been regressed out should be used for volumetric brain imaging studies. Using multiple regional cortical and subcortical volumetric measures generated by Freesurfer (51 in total, the main aim of this study was to elucidate the implications of these adjustment approaches. Magnetic resonance imaging (MRI data were analyzed from two large cohorts, the population-based PIVUS cohort (N=406, all subjects age 75 and the Alzheimer disease Neuroimaging Initiative (ADNI cohort (N=724. Further, we studied whether the chosen ICV normalization approach influenced the relationship between hippocampus and cognition in the three diagnostic groups of the ADNI cohort (Alzheimer’s disease, mild cognitive impairment and healthy individuals. The ability of raw vs adjusted hippocampal volumes to predict diagnostic status was also assessed. In both cohorts raw volumes correlate positively with ICV, but do not scale directly proportionally with it. The correlation direction is reversed for all volume-to-ICV fractions, except the lateral and third ventricles. Most grey matter fractions are larger in females, while lateral ventricle fractions are greater in males. Residual correction effectively eliminated the correlation between the regional volumes and ICV and removed gender differences. The association between hippocampal volumes and cognition was not altered by ICV normalization. Comparing prediction of diagnostic status using the different approaches, small but significant differences were found. The choice of normalization approach should be carefully considered when designing a volumetric brain imaging study.
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Directory of Open Access Journals (Sweden)
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.
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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
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How to investigate and adjust for selection bias in cohort studies
DEFF Research Database (Denmark)
Nohr, Ellen A; Liew, Zeyan
2018-01-01
National Birth Cohort (DNBC) as examples on how to quantify selection bias and also understand the underlying selection mechanisms. Although women who chose to participate in the cohort were typically of higher social status, healthier and with less disease than all those eligible for study, differential...... of the presented methods are applicable even with limited data on non-participants and those lost to follow-up, and can also be applied to other study designs such as case-control studies and surveys. This article is protected by copyright. All rights reserved.......Longitudinal cohort studies can provide important evidence about preventable causes of disease, but the success relies heavily on the commitment of their participants, both at recruitment and during follow-up. Initial participation rates have decreased in recent decades as have willingness...
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Feasibility of large-scale deployment of multiple wearable sensors in Parkinson's disease
Silva de Lima, A.L.; Hahn, T.; Evers, L.J.W.; Vries, N.M. de; Cohen, E.; Afek, M.; Bataille, L.; Daeschler, M.; Claes, K.; Boroojerdi, B.; Terricabras, D.; Little, M.A.; Baldus, H.; Bloem, B.R.; Faber, M.J.
2017-01-01
Wearable devices can capture objective day-to-day data about Parkinson's Disease (PD). This study aims to assess the feasibility of implementing wearable technology to collect data from multiple sensors during the daily lives of PD patients. The Parkinson@home study is an observational, two-cohort
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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
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Trends in preterm birth: singleton and multiple pregnancies in the Netherlands, 2000-2007
Schaaf, J. M.; Mol, B. W. J.; Abu-Hanna, A.; Ravelli, A. C. J.
2011-01-01
Several studies have reported increasing trends in preterm birth in developed countries, mainly attributable to an increase in medically indicated preterm births. Our aim was to describe trends in preterm birth among singleton and multiple pregnancies in the Netherlands. Prospective cohort study.
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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
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An Optimal Design of Multiple Antenna Positions on Mobile Devices Based on Mutual Coupling Analysis
Directory of Open Access Journals (Sweden)
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.
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Callaway, Libby; Enticott, Joanne; Farnworth, Louise; McDonald, Rachael; Migliorini, Christine; Willer, Barry
2017-06-01
Australia's National Disability Insurance Scheme (NDIS) is designed to influence home, social and economic participation for Scheme participants. Given the major disability reform underway, this pilot study aimed to: (i) examine community integration outcomes of people with spinal cord injury (SCI); (ii) compare findings with multiple matched controls and (iii) consider findings within the context of Australia's NDIS. Setting: Victoria, Australia. Matched analysis (people with and without SCI). Community Integration Questionnaire (CIQ). n = 40 adults with SCI (M age = 52.8 years; 61% male; 77% traumatic SCI). Matched analyses from each SCI subject aged integration (ρ = 0.02). Relative risk of low home integration was significant in the SCI cohort (conditional RR (95% CI) = 3.1 (1.5-6.3), ρ = 0.001). Relative risk of low CIQ total, social integration and productivity scores did not reach significance. This cohort of SCI participants was less integrated into home and productive occupations than matched norms, holding implications for planning and allocation of supports to influence outcomes within an NDIS. Further research is necessary to understand community integration outcomes in larger matched samples. © 2016 Occupational Therapy Australia.
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Can multiple-choice questions simulate free-response questions?
Lin, Shih-Yin; Singh, Chandralekha
2016-01-01
We discuss a study to evaluate the extent to which free-response questions could be approximated by multiple-choice equivalents. Two carefully designed research-based multiple-choice questions were transformed into a free-response format and administered on the final exam in a calculus-based introductory physics course. The original multiple-choice questions were administered in another similar introductory physics course on final exam. Findings suggest that carefully designed multiple-choice...
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Multiple sclerosis risk loci and disease severity in 7,125 individuals from 10 studies
DEFF Research Database (Denmark)
George, Michaela F; Briggs, Farren B S; Shao, Xiaorong
2016-01-01
associated with disease severity after accounting for cohort, sex, age at onset, and HLA-DRB1*15:01. After restricting analyses to cases with disease duration ≥10 years, associations were null (p value ≥0.05). No SNP was associated with disease severity after adjusting for multiple testing. CONCLUSIONS......OBJECTIVE: We investigated the association between 52 risk variants identified through genome-wide association studies and disease severity in multiple sclerosis (MS). METHODS: Ten unique MS case data sets were analyzed. The Multiple Sclerosis Severity Score (MSSS) was calculated using the Expanded...
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DEFF Research Database (Denmark)
Møller, Karina Lauenborg; Brauer, Charlotte; Mikkelsen, Sigurd
2017-01-01
TO DATE: The cohort includes environmental Global Positioning System (GPS) measurements in Copenhagen Airport, information on job function/task for each calendar year of employment between 1990 and 2012, exposure to air pollution at residence, average weight of baggage lifted per day and lifestyle...... covers 69 175 men in unskilled positions. The exposed cohort includes men in unskilled jobs employed at Copenhagen Airport in the period 1990-2012 either as baggage handlers or in other outdoor work. The reference cohort includes men in unskilled jobs working in the greater Copenhagen area. FINDINGS...
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International Nuclear Information System (INIS)
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
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Schuetze, Madlen; Boeing, Heiner; Pischon, Tobias; Rehm, Juergen; Kehoe, Tara; Gmel, Gerrit; Olsen, Anja; Tjonneland, Anne M.; Dahm, Christina C.; Overvad, Kim; Clavel-Chapelon, Francoise; Boutron-Ruault, Marie-Christine; Trichopoulou, Antonia; Benetou, Vasiliki; Zylis, Dimosthenis; Kaaks, Rudolf; Rohrmann, Sabine; Palli, Domenico; Berrino, Franco; Tumino, Rosario; Vineis, Paolo; Rodriguez, Laudina; Agudo, Antonio; Sanchez, Maria-Jose; Dorronsoro, Miren; Chirlaque, Maria-Dolores; Barricarte, Aurelio; Peeters, Petra H.; van Gils, Carla H.; Khaw, Kay-Tee; Wareham, Nick; Allen, Naomi E.; Key, Timothy J.; Boffetta, Paolo; Slimani, Nadia; Jenab, Mazda; Romaguera, Dora; Wark, Petra A.; Riboli, Elio; Bergmann, Manuela M.
2011-01-01
Objective To compute the burden of cancer attributable to current and former alcohol consumption in eight European countries based on direct relative risk estimates from a cohort study. Design Combination of prospective cohort study with representative population based data on alcohol exposure.
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Body Mass Index and Risk of Infections Among Women in the Danish National Birth Cohort
DEFF Research Database (Denmark)
Harpsøe, Maria C; Nielsen, Nete M; Friis-Møller, Nina
2016-01-01
baseline BMI and later hospitalization for 1) any infectious disease and 2) infections of the respiratory tract, whereas a dose-response relationship was seen for skin infections. The most pronounced associations were seen for acute upper respiratory infections at multiple and unspecified sites...... was observed among overweight (BMI 25-infections of the upper respiratory tract and skin.......We investigated the possible association between body mass index (BMI; weight (kg)/height (m)(2)) and hospitalization or treatment for acute infection in a prospective cohort study. We linked 75,001 women enrolled in the Danish National Birth Cohort from 1996 to 2002, who had information on BMI...
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Prognosis of acute low back pain: design of a prospective inception cohort study
Directory of Open Access Journals (Sweden)
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.
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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…
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Verhage, Vera; Noordik, Erik; Knorth, Erik J; Reijneveld, Sijmen A
2016-01-01
TAKECARE is a prospective cohort study designed in The Netherlands to obtain evidence on the care chain for children and adolescents with psychosocial problems, and its long-term outcomes. Little is known about the content of care as offered and on whether the care is adequate. The cohort consists
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Goldberg, Marcel; Carton, Matthieu; Descatha, Alexis; Leclerc, Annette; Roquelaure, Yves; Santin, Gaëlle; Zins, Marie
2017-01-01
WHY THE COHORT WAS SET UP?: CONSTANCES is a general-purpose cohort with a focus on occupational and environmental factors. CONSTANCES was designed as a randomly selected sample of French adults aged 18-69 years at inception; 200 000 participants will be included. At enrolment, the participants are invited to complete questionnaires and to attend a health screening centre (HSC) for a health examination. A biobank will be set up. The follow-up includes an yearly self-administered questionnaire, a periodic visit to an HSC and linkage to social and national health administrative databases. Data collected for participants include social and demographic characteristics, socioeconomic status, life events and behaviours. Regarding occupational and environmental factors, a wealth of data on organisational, chemical, biological, biomechanical and psychosocial lifelong exposure, as well as residential characteristics, are collected at enrolment and during follow-up. The health data cover a wide spectrum: self-reported health scales, reported prevalent and incident diseases, long-term chronic diseases and hospitalisations, sick-leaves, handicaps, limitations, disabilities and injuries, healthcare usage and services provided, and causes of death. To take into account non-participation and attrition, a random cohort of non-participants was set up and will be followed through the same national databases as participants. Inclusions begun at the end of 2012 and more than 110 000 participants were already included by September 2016. Several projects on occupational and environmental risks already applied to a public call for nested research projects. 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/.
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DEFF Research Database (Denmark)
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....
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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.
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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
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Lifestyle factors affecting fruit and vegetable consumption in the UK Women's Cohort Study.
Pollard, J; Greenwood, D; Kirk, S; Cade, J
2001-08-01
The UK Women's Cohort Study (UKWCS) was originally set up to look at morbidity and mortality data on subjects with a wide range of dietary intakes including vegans, lacto-ovo vegetarians, non-red meat eaters and red meat eaters. The aim of the present study was to investigate factors that affect fruit and vegetable consumption within this particular cohort of women. Females of ages 35-69 years, taking part in the UK Women's Cohort Study (N=35 367), provided health and lifestyle information including a 217-item food frequency questionnaire. In multiple logistic regression, the strongest predictors of a higher reported level of fruit and vegetable consumption were being a vegetarian or vegan, taking vitamin or mineral supplements, being married, educated to A-level or degree level and belonging to a higher socio-economic group. Conversely, smokers were found to be only half as likely as non-smokers to be high fruit and vegetable consumers. These lifestyle distinctions among three levels of reported fruit and vegetable consumption are relevant to the future targeting of health promotion strategies. Copyright 2000 Academic Press.
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Strabismus Incidence in a Danish Population-Based Cohort of Children
DEFF Research Database (Denmark)
Torp-Pedersen, Tobias; Boyd, Heather A; Skotte, Line
2017-01-01
, overall and by subtype, among children 7 years or younger. Design, Setting, and Participants: This population-based cohort study was conducted with data from 96 842 children enrolled in the Danish National Birth Cohort. Main Outcomes and Measures: Age-specific incidence and cumulative incidence and median...... identified in the cohort. We found an overall cumulative strabismus incidence of 2.56% (95% CI, 2.42-2.69) at 7 years. The overall incidence was similar among boys and girls. Two hundred sixteen participants (16.5%) (95% CI, 14.5-18.6) had congenital esotropia, 177 (13.5%) (95% CI, 11.7-15.5) had fully...... accommodative esotropia, 252 (19.3%) (95% CI, 17.1-21.5) had partially accommodative esotropia, and 181 (13.8%) (95% CI, 12.0-15.8) had exotropia. The esotropia:exotropia ratio was 5.4:1 (95% CI, 3.4:1 to 7.5:1). Age-specific incidence curves for congenital esotropia, fully accommodative esotropia, partially...
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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.
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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.
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Directory of Open Access Journals (Sweden)
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.
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Oral health in a life-course: birth-cohorts from 1929 to 2006 in Norway.
Holst, D; Schuller, A A
2012-06-01
The purpose of the work was to study the influence of the oral health environment at age 10, of adolescent and adulthood dental behaviours and of social status on oral health of three birth-cohorts in 1983 and two of the three birth-cohorts in 2006 in Norway. The material comprised data from random samples of three birth-cohorts living in the counties of Sør- and Nord-Trøndelag in 1983. The birth-cohorts were 1929-1938, 1939-1948 and 1959-1960. In 2006 two samples were drawn from the 1929-1938 and 1959-1960 birth-cohort. The data collection comprised standard clinical measurements and self-administered questionnaires. The early oral health environment and social status and gender were related to oral health in 1983 by multiple regressions. The impact of social status was studied in combined datafiles from 1983 and 2006. The oral health environment in childhood was important for adults' oral health. The attention from parents and the local environment lead to a better oral health outcome in adulthood. Social status affected choices leading to better oral health. Regular dental visits were important especially for the eldest birth-cohort. Good oral health behaviours early and during adulthood were also important for oral health. Judged by number of tooth surfaces the difference between social status groups had not increased by 2006. A life-course perspective provides an opportunity to understand oral health over time. The present study supports the assumption that oral health is continuously exposed to environmental and behavioural risks that lead to accumulated diseases in the dental tissues.
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Effects of ATX-MS-1467 immunotherapy over 16 weeks in relapsing multiple sclerosis.
Chataway, Jeremy; Martin, Keith; Barrell, Kevin; Sharrack, Basil; Stolt, Pelle; Wraith, David C
2018-03-13
To assess safety, tolerability, and efficacy of the antigen-specific immunotherapy ATX-MS-1467 in participants with relapsing multiple sclerosis using different treatment protocols to induce tolerance. Two open-label trials in adult participants with relapsing multiple sclerosis were conducted. Study 1 was a multicenter, phase 1b safety evaluation comparing intradermal (i.d.) (cohort 1) with subcutaneous (cohort 2) administration in 43 participants. Both cohorts received ATX-MS-1467 dosed at 25, 50, 100, 400, and 800 μg at 14-day intervals over 8 weeks, followed by 8 weeks with 4 additional 800-μg doses at 14-day intervals and 32 weeks off study medication. Study 2 was a phase 2a, multicenter, single-arm trial enrolling 37 participants. ATX-MS-1467 was titrated from 50 μg i.d. on day 1 to 200 μg on day 15 and 800 μg on day 29 followed by biweekly administration of 800 μg for 16 weeks and 16 weeks off study medication. Efficacy was evaluated on MRI parameters and clinical variables. Safety endpoints included treatment-emergent adverse events and injection-site reactions. In study 1, there was a significant decrease in new/persisting T1 gadolinium-enhanced (GdE) lesions in cohort 1 from baseline to week 16, returning to baseline values at week 48. In study 2, the number of T1 GdE lesions were significantly reduced on treatment and remained reduced at study completion. Safety results were unremarkable in both studies. Relatively slow ATX-MS-1467 titration and a longer full-dose i.d. treatment period is associated with reduction in GdE lesions and a sustained effect post treatment. Further trials of ATX-MS-1467 are warranted. This work provides Class IV evidence that for patients with relapsing multiple sclerosis, slow ATX-MS-1467 titration and a longer full-dose i.d. treatment period is associated with reduction in GdE lesions. © 2018 American Academy of Neurology.
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International Nuclear Information System (INIS)
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)
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Huijbregts, P.; Feskens, E.J.M.; Résénen, L.; Fidanza, F.; Nissinen, A.; Menotti, A.; Kromhout, D.
1997-01-01
OBJECTIVE: To investigate the association of dietary pattern and mortality in international data. DESIGN: Cohort study with 20 years' follow up of mortality. SETTING: Five cohorts in Finland, the Netherlands, and Italy. SUBJECTS: Population based random sample of 3045 men aged 50-70 years in 1970.
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van Boven, Job FM; van Raaij, Joost J; van der Galiën, Ruben; Postma, Maarten J; van der Molen, Thys; Dekhuijzen, PN Richard; Vegter, Stefan
2014-01-01
Background: With a growing availability of different devices and types of medication, additional evidence is required to assist clinicians in prescribing the optimal medication in relation to chronic obstructive pulmonary disease (COPD) patients’ persistence with long-acting β2-agonists (LABAs). Aims: To assess the impact of the type of inhaler device (multiple-dose versus single-dose inhalers) on 1-year persistence and switching patterns with LABAs. Methods: A retrospective observational cohort study was performed comparing a cohort of patients initiating multiple-dose inhalers and a cohort initiating single-dose inhalers. The study population consisted of long-acting bronchodilator naive COPD patients, initiating inhalation therapy with mono-LABAs (formoterol, indacaterol or salmeterol). Analyses were performed using pharmacy dispensing data from 1994 to 2012, obtained from the IADB.nl database. Study outcomes were 1-year persistence and switching patterns. Results were adjusted for initial prescriber, initial medication, dosing regimen and relevant comorbidities. Results: In all, 575 patients initiating LABAs were included in the final study cohort. Among them, 475 (83%) initiated a multiple-dose inhaler and 100 (17%) a single-dose inhaler. Further, 269 (47%) initiated formoterol, 9 (2%) indacaterol and 297 (52%) salmeterol. There was no significant difference in persistence between users of multiple-dose or single-dose inhalers (hazard ratio: 0.98, 95% confidence interval: 0.76–1.26, P=0.99). Over 80% re-started or switched medication. Conclusions: There seems no impact of inhaler device (multiple-dose versus single-dose inhalers) on COPD patients’ persistence with LABAs. Over 80% of patients who initially seemed to discontinue LABAs, re-started their initial medication or switched inhalers or medication within 1 year. PMID:25274453
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Peterson, Josh F.; Eden, Svetlana K.; Moons, Karel G.; Ikizler, T. Alp; Matheny, Michael E.
2013-01-01
Summary Background and objectives Baseline creatinine (BCr) is frequently missing in AKI studies. Common surrogate estimates can misclassify AKI and adversely affect the study of related outcomes. This study examined whether multiple imputation improved accuracy of estimating missing BCr beyond current recommendations to apply assumed estimated GFR (eGFR) of 75 ml/min per 1.73 m2 (eGFR 75). Design, setting, participants, & measurements From 41,114 unique adult admissions (13,003 with and 28,111 without BCr data) at Vanderbilt University Hospital between 2006 and 2008, a propensity score model was developed to predict likelihood of missing BCr. Propensity scoring identified 6502 patients with highest likelihood of missing BCr among 13,003 patients with known BCr to simulate a “missing” data scenario while preserving actual reference BCr. Within this cohort (n=6502), the ability of various multiple-imputation approaches to estimate BCr and classify AKI were compared with that of eGFR 75. Results All multiple-imputation methods except the basic one more closely approximated actual BCr than did eGFR 75. Total AKI misclassification was lower with multiple imputation (full multiple imputation + serum creatinine) (9.0%) than with eGFR 75 (12.3%; Pcreatinine) (15.3%) versus eGFR 75 (40.5%; P<0.001). Multiple imputation improved specificity and positive predictive value for detecting AKI at the expense of modestly decreasing sensitivity relative to eGFR 75. Conclusions Multiple imputation can improve accuracy in estimating missing BCr and reduce misclassification of AKI beyond currently proposed methods. PMID:23037980
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Cohort Profile : LifeLines, a three-generation cohort study and biobank
Scholtens, Salome; Smidt, Nynke; Swertz, Morris A.; Bakker, Stephan J. L.; Dotinga, Aafje; Vonk, Judith M.; van Dijk, Freerk; van Zon, Sander K. R.; Wijmenga, Cisca; Wolffenbuttel, Bruce H. R.; Stolk, Ronald P.
The LifeLines Cohort Study is a large population-based cohort study and biobank that was established as a resource for research on complex interactions between environmental, phenotypic and genomic factors in the development of chronic diseases and healthy ageing. Between 2006 and 2013, inhabitants
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Health and function assessments in two adjacent Danish birth cohorts of centenarians
DEFF Research Database (Denmark)
Vestergaard, Sonja; Andersen-Ranberg, Karen; Skytthe, Axel
2016-01-01
Using the results from measures of functional ability, cognitive and physical performance from two adjacent birth cohorts of 100-year-old adults, we aimed to elucidate the possible impact of difference in participation rates, design, and interviewer mode. Participants were birth cohort members born...... proportions of DK-1911 independently performed all activities of daily living (ADL) compared to DK-1910, but only significantly for toileting, bathing, and feeding (all p examination (MMSE) score was higher in DK-1911 than in DK-1910 (23.5 vs. 21.0; p
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Directory of Open Access Journals (Sweden)
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.
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The Alberta Pregnancy Outcomes and Nutrition (APrON) cohort study: rationale and methods.
Kaplan, Bonnie J; Giesbrecht, Gerald F; Leung, Brenda M Y; Field, Catherine J; Dewey, Deborah; Bell, Rhonda C; Manca, Donna P; O'Beirne, Maeve; Johnston, David W; Pop, Victor J; Singhal, Nalini; Gagnon, Lisa; Bernier, Francois P; Eliasziw, Misha; McCargar, Linda J; Kooistra, Libbe; Farmer, Anna; Cantell, Marja; Goonewardene, Laki; Casey, Linda M; Letourneau, Nicole; Martin, Jonathan W
2014-01-01
The Alberta Pregnancy Outcomes and Nutrition (APrON) study is an ongoing prospective cohort study that recruits pregnant women early in pregnancy and, as of 2012, is following up their infants to 3 years of age. It has currently enrolled approximately 5000 Canadians (2000 pregnant women, their offspring and many of their partners). The primary aims of the APrON study were to determine the relationships between maternal nutrient intake and status, before, during and after gestation, and (1) maternal mood; (2) birth and obstetric outcomes; and (3) infant neurodevelopment. We have collected comprehensive maternal nutrition, anthropometric, biological and mental health data at multiple points in the pregnancy and the post-partum period, as well as obstetrical, birth, health and neurodevelopmental outcomes of these pregnancies. The study continues to follow the infants through to 36 months of age. The current report describes the study design and methods, and findings of some pilot work. The APrON study is a significant resource with opportunities for collaboration. © 2012 John Wiley & Sons Ltd.
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RN work engagement in generational cohorts: the view from rural US hospitals.
Sullivan Havens, Donna; Warshawsky, Nora E; Vasey, Joseph
2013-10-01
To describe staff nurse work engagement, identify predictors by generational cohort, present implications for nurse managers and suggest future research. A global nurse shortage looms. While an adequate supply of nurses is needed to ensure access to care, access to quality care may be enhanced by an adequate supply of highly engaged nurses-those who are dedicated, energized, and absorbed. Nurses have long reported the presence of energy depleting practice environments. Nurses practicing in professional practice environments may be more engaged. A non-experimental survey design was executed. Direct care Registered Nurses (n = 747) working in five rural acute care hospitals completed questionnaires to assess work engagement (Utrecht Work Engagement Scale-9), decisional involvement (Decisional Involvement Scale), relational coordination (Relational Coordination Survey) and the nursing practice environment (Practice Environment Scale of the Nursing Work Index). Descriptive, correlational and regression analyses examined work engagement and predictors by generational cohort. With the exception of the absorption component, no statistically significant differences in engagement emerged across generational cohorts. Predictors of engagement differed by cohort, however across all cohorts, professional nursing practice environments predicted nurse work engagement. Professional nursing practice environments are significantly associated with nurse work engagement. Enhancing nurse work engagement is a complex challenge. Generational cohorts may respond to different strategies to enhance engagement. © 2013 John Wiley & Sons Ltd.
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DEFF Research Database (Denmark)
Choi, M. Y.; Clarke, A. E.; St Pierre, Y.
2017-01-01
, clinical, and autoantibody associations. Patients were enrolled in the Systemic Lupus International Collaborating Clinics (SLICC) inception cohort within 15 months of diagnosis. The association between anti-DFS70 and multiple parameters in 1137 patients was assessed using univariate and multivariate...
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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.
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Schomaker, Michael; Hogger, Sara; Johnson, Leigh F; Hoffmann, Christopher J; Bärnighausen, Till; Heumann, Christian
2015-09-01
Both CD4 count and viral load in HIV-infected persons are measured with error. There is no clear guidance on how to deal with this measurement error in the presence of missing data. We used multiple overimputation, a method recently developed in the political sciences, to account for both measurement error and missing data in CD4 count and viral load measurements from four South African cohorts of a Southern African HIV cohort collaboration. Our knowledge about the measurement error of ln CD4 and log10 viral load is part of an imputation model that imputes both missing and mismeasured data. In an illustrative example, we estimate the association of CD4 count and viral load with the hazard of death among patients on highly active antiretroviral therapy by means of a Cox model. Simulation studies evaluate the extent to which multiple overimputation is able to reduce bias in survival analyses. Multiple overimputation emphasizes more strongly the influence of having high baseline CD4 counts compared to both a complete case analysis and multiple imputation (hazard ratio for >200 cells/mm vs. <25 cells/mm: 0.21 [95% confidence interval: 0.18, 0.24] vs. 0.38 [0.29, 0.48], and 0.29 [0.25, 0.34], respectively). Similar results are obtained when varying assumptions about measurement error, when using p-splines, and when evaluating time-updated CD4 count in a longitudinal analysis. The estimates of the association with viral load are slightly more attenuated when using multiple imputation instead of multiple overimputation. Our simulation studies suggest that multiple overimputation is able to reduce bias and mean squared error in survival analyses. Multiple overimputation, which can be used with existing software, offers a convenient approach to account for both missing and mismeasured data in HIV research.
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Directory of Open Access Journals (Sweden)
Matt Brown
2014-10-01
Full Text Available The 1970 British Cohort Study (BCS70 is one of Britain’s world famous national longitudinal birth cohort studies, three of which are run by the Centre for Longitudinal Studies at the Institute of Education, University of London. BCS70 follows the lives of more than 17,000 people born in England, Scotland and Wales in a single week of 1970. Over the course of cohort members lives, the BCS70 has collected information on health, physical, educational and social development, and economic circumstances among other factors. Since the birth survey in 1970, there have been nine ‘sweeps’ of all cohort members at ages 5, 10, 16, 26, 30, 34, 38 and most recently at 42. Data has been collected from a number of different sources (the midwife present at birth, parents of the cohort members, head and class teachers, school health service personnel and the cohort members themselves. The data has been collected in a variety of ways including via paper and electronic questionnaires, clinical records, medical examinations, physical measurements, tests of ability, educational assessments and diaries. The majority of BCS70 survey data can be accessed by bona fide researchers through the UK Data Service at the University of Essex.
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Rubio-Álvarez, Ana; Molina-Alarcón, Milagros; Arias-Arias, Ángel; Hernández-Martínez, Antonio
2018-03-01
postpartum haemorrhage is one of the leading causes of maternal morbidity and mortality worldwide. Despite the use of uterotonics agents as preventive measure, it remains a challenge to identify those women who are at increased risk of postpartum bleeding. to develop and to validate a predictive model to assess the risk of excessive bleeding in women with vaginal birth. retrospective cohorts study. "Mancha-Centro Hospital" (Spain). the elaboration of the predictive model was based on a derivation cohort consisting of 2336 women between 2009 and 2011. For validation purposes, a prospective cohort of 953 women between 2013 and 2014 were employed. Women with antenatal fetal demise, multiple pregnancies and gestations under 35 weeks were excluded METHODS: we used a multivariate analysis with binary logistic regression, Ridge Regression and areas under the Receiver Operating Characteristic curves to determine the predictive ability of the proposed model. there was 197 (8.43%) women with excessive bleeding in the derivation cohort and 63 (6.61%) women in the validation cohort. Predictive factors in the final model were: maternal age, primiparity, duration of the first and second stages of labour, neonatal birth weight and antepartum haemoglobin levels. Accordingly, the predictive ability of this model in the derivation cohort was 0.90 (95% CI: 0.85-0.93), while it remained 0.83 (95% CI: 0.74-0.92) in the validation cohort. this predictive model is proved to have an excellent predictive ability in the derivation cohort, and its validation in a latter population equally shows a good ability for prediction. This model can be employed to identify women with a higher risk of postpartum haemorrhage. Copyright © 2017 Elsevier Ltd. All rights reserved.
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Coffee drinking and mortality in 10 European countries : A multinational cohort study
Gunter, Marc J.; Murphy, Neil; Cross, Amanda J.; Dossus, Laure; Dartois, Laureen; Fagherazzi, Guy; Kaaks, Rudolf; Kühn, Tilman; Boeing, Heiner; Aleksandrova, Krasimira; Tjønneland, Anne; Olsen, Anja; Overvad, Kim; Larsen, Sofus Christian; Cornejo, Maria Luisa Redondo; Agudo, Antonio; Pérez, María José Sánchez; Altzibar, Jone M.; Navarro, Carmen; Ardanaz, Eva; Khaw, Kay Tee; Butterworth, Adam; Bradbury, Kathryn E.; Trichopoulou, Antonia; Lagiou, Pagona; Trichopoulos, Dimitrios; Palli, Domenico; Grioni, Sara; Vineis, Paolo; Panico, Salvatore; Tumino, Rosario; Bueno-De-Mesquita, Bas; Siersema, Peter; Leenders, Max; Beulens, Joline W.J.; Uiterwaal, Cuno U.; Wallström, Peter; Nilsson, Lena Maria; Landberg, Rikard; Weiderpass, Elisabete; Skeie, Guri; Braaten, Tonje; Brennan, Paul; Licaj, Idlir; Muller, David C.; Sinha, Rashmi; Wareham, Nick; Riboli, Elio
2017-01-01
Background: The relationship between coffee consumption and mortality in diverse European populations with variable coffee preparation methods is unclear. Objective: To examine whether coffee consumption is associated with all-cause and cause-specific mortality. Design: Prospective cohort study.
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Energy Technology Data Exchange (ETDEWEB)
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.
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Plasma Biomarkers Discriminate Clinical Forms of Multiple Sclerosis
Tejera-Alhambra, Marta; Casrouge, Armanda; de Andrés, Clara; Seyfferth, Ansgar; Ramos-Medina, Rocío; Alonso, Bárbara; Vega, Janet; Fernández-Paredes, Lidia; Albert, Matthew L.; Sánchez-Ramón, Silvia
2015-01-01
Multiple sclerosis, the most common cause of neurological disability in young population after trauma, represents a significant public health burden. Current challenges associated with management of multiple sclerosis (MS) patients stem from the lack of biomarkers that might enable stratification of the different clinical forms of MS and thus prompt treatment for those patients with progressive MS, for whom there is currently no therapy available. In the present work we analyzed a set of thirty different plasma cytokines, chemokines and growth factors present in circulation of 129 MS patients with different clinical forms (relapsing remitting, secondary progressive and primary progressive MS) and 53 healthy controls, across two independent cohorts. The set of plasma analytes was quantified with Luminex xMAP technology and their predictive power regarding clinical outcome was evaluated both individually using ROC curves and in combination using logistic regression analysis. Our results from two independent cohorts of MS patients demonstrate that the divergent clinical and histology-based MS forms are associated with distinct profiles of circulating plasma protein biomarkers, with distinct signatures being composed of chemokines and growth/angiogenic factors. With this work, we propose that an evaluation of a set of 4 circulating biomarkers (HGF, Eotaxin/CCL11, EGF and MIP-1β/CCL4) in MS patients might serve as an effective tool in the diagnosis and more personalized therapeutic targeting of MS patients. PMID:26039252
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Directory of Open Access Journals (Sweden)
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.
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Santos,Michele Devido; Gagliardi,Rubens José; Mac-Kay,Ana Paula Machado Goyano; Boggio,Paulo Sergio; Lianza,Roberta; Fregni,Felipe
2013-01-01
CONTEXT AND OBJECTIVE: Previous animal and human studies have shown that transcranial direct current stimulation can induce significant and lasting neuroplasticity and may improve language recovery in patients with aphasia. The objective of the study was to describe a cohort of patients with aphasia after stroke who were treated with transcranial direct current stimulation. DESIGN AND SETTING: Prospective cohort study developed in a public university hospital. METHODS: Nineteen patients with ...
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DEFF Research Database (Denmark)
Andreasen, John
Multiple stages 2: theatrical futures, set design, community plays, cultural capitals, democracy & drama, WWII dramas, performance on adoption, promenade about emigration, qualities in political theatre, performance analysis, dramaturgical education, Toulmin Variations...
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Hu, Danqing; Flick, Randall P; Zaccariello, Michael J; Colligan, Robert C; Katusic, Slavica K; Schroeder, Darrell R; Hanson, Andrew C; Buenvenida, Shonie L; Gleich, Stephen J; Wilder, Robert T; Sprung, Juraj; Warner, David O
2017-08-01
Exposure of young animals to general anesthesia causes neurodegeneration and lasting behavioral abnormalities; whether these findings translate to children remains unclear. This study used a population-based birth cohort to test the hypothesis that multiple, but not single, exposures to procedures requiring general anesthesia before age 3 yr are associated with adverse neurodevelopmental outcomes. A retrospective study cohort was assembled from children born in Olmsted County, Minnesota, from 1996 to 2000 (inclusive). Propensity matching selected children exposed and not exposed to general anesthesia before age 3 yr. Outcomes ascertained via medical and school records included learning disabilities, attention-deficit/hyperactivity disorder, and group-administered ability and achievement tests. Analysis methods included proportional hazard regression models and mixed linear models. For the 116 multiply exposed, 457 singly exposed, and 463 unexposed children analyzed, multiple, but not single, exposures were associated with an increased frequency of both learning disabilities and attention-deficit/hyperactivity disorder (hazard ratio for learning disabilities = 2.17 [95% CI, 1.32 to 3.59], unexposed as reference). Multiple exposures were associated with decreases in both cognitive ability and academic achievement. Single exposures were associated with modest decreases in reading and language achievement but not cognitive ability. These findings in children anesthetized with modern techniques largely confirm those found in an older birth cohort and provide additional evidence that children with multiple exposures are more likely to develop adverse outcomes related to learning and attention. Although a robust association was observed, these data do not determine whether anesthesia per se is causal.
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Directory of Open Access Journals (Sweden)
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.
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Milk intake and risk of mortality and fractures in women and men : cohort studies
Michaëlsson, Karl; Wolk, Alicja; Langenskiöld, Sophie; Basu, Samar; Warensjö Lemming, Eva; Melhus, Håkan; Byberg, Liisa
2014-01-01
OBJECTIVE: To examine whether high milk consumption is associated with mortality and fractures in women and men. DESIGN: Cohort studies. SETTING: Three counties in central Sweden. PARTICIPANTS: Two large Swedish cohorts, one with 61 433 women (39-74 years at baseline 1987-90) and one with 45 339 men (45-79 years at baseline 1997), were administered food frequency questionnaires. The women responded to a second food frequency questionnaire in 1997. MAIN OUTCOME MEASURE: Multivariable survival ...
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Directory of Open Access Journals (Sweden)
Rosalia D'Angelo
2011-01-01
Full Text Available Multiple sclerosis (MS disease is carried through inflammatory and degenerative stages. Based on clinical feaures, it can be subdivided into three groups: relapsing-remitting MS, secondary progressive MS, and primary progressive MS. Multiple sclerosis has a multifactorial etiology with an interplay of genetic predisposition, environmental factors, and autoimmune inflammatory mechanism in which play a key role CC-chemokines and its receptors. In this paper, we studied the frequency of CCR5 gene Δ32 allele in a cohort of Sicilian RR-MS patients comparing with general Sicilian population. Also, we evaluate the association between this commonly polymorphism and disability development and age of disease onset in the same cohort. Our results show that presence of CCR5Δ32 is significantly associated with expanded disability status scale score (EDSS but not with age of disease onset.
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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.
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Agaba, Patricia A; Genberg, Becky L; Sagay, Atiene S; Agbaji, Oche O; Meloni, Seema T; Dadem, Nancin Y; Kolawole, Grace O; Okonkwo, Prosper; Kanki, Phyllis J; Ware, Norma C
2018-01-01
Objective Differentiated care refers collectively to flexible service models designed to meet the differing needs of HIV-infected persons in resource-scarce settings. Decentralization is one such service model. Retention is a key indicator for monitoring the success of HIV treatment and care programs. We used multiple measures to compare retention in a cohort of patients receiving HIV care at “hub” (central) and “spoke” (decentralized) sites in a large public HIV treatment program in north central Nigeria. Methods This retrospective cohort study utilized longitudinal program data representing central and decentralized levels of care in the Plateau State Decentralization Initiative, north central Nigeria. We examined retention with patient- level (retention at fixed times, loss-to-follow-up [LTFU]) and visit-level (gaps-in-care, visit constancy) measures. Regression models with generalized estimating equations (GEE) were used to estimate the effect of decentralization on visit-level measures. Patient-level measures were examined using survival methods with Cox regression models, controlling for baseline variables. Results Of 15,650 patients, 43% were enrolled at the hub. Median time in care was 3.1 years. Hub patients were less likely to be LTFU (adjusted hazard ratio (AHR)=0.91, 95% CI: 0.85-0.97), compared to spoke patients. Visit constancy was lower at the hub (−4.5%, 95% CI: −3.5, −5.5), where gaps in care were also more likely to occur (adjusted odds ratio=1.95, 95% CI: 1.83-2.08). Conclusion Decentralized sites demonstrated better retention outcomes using visit-level measures, while the hub achieved better retention outcomes using patient-level measures. Retention estimates produced by incorporating multiple measures showed substantial variation, confirming the influence of measurement strategies on the results of retention research. Future studies of retention in HIV care in sub-Saharan Africa will be well-served by including multiple measures
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Cohort profile: the Boston Area Community Health (BACH) survey.
Piccolo, Rebecca S; Araujo, Andre B; Pearce, Neil; McKinlay, John B
2014-02-01
The Boston Area Community Health (BACH) Survey is a community-based, random sample, epidemiologic cohort of n = 5502 Boston (MA) residents. The baseline BACH Survey (2002-05) was designed to explore the mechanisms conferring increased health risks on minority populations with a particular focus on urologic signs/symptoms and type 2 diabetes. To this end, the cohort was designed to include adequate numbers of US racial/ethnic minorities (Black, Hispanic, White), both men and women, across a broad age of distribution. Follow-up surveys were conducted ∼5 (BACH II, 2008) and 7 (BACH III, 2010) years later, which allows for both within- and between-person comparisons over time. The BACH Survey's measures were designed to cover the following seven broad categories: socio-demographics, health care access/utilization, lifestyles, psychosocial factors, health status, physical measures and biochemical parameters. The breadth of measures has allowed BACH researchers to identify disparities and quantify contributions to social disparities in a number of health conditions including urologic conditions (e.g. nocturia, lower urinary tract symptoms, prostatitis), type 2 diabetes, obesity, bone mineral content and density, and physical function. BACH I data are available through the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Central Repositories (www.niddkrepository.org). Further inquiries can be made through the New England Research Institutes Inc. website (www.neriscience.com/epidemiology).
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Recovery of standing balance in postacute stroke patients: a rehabilitation cohort study
de Haart, Mirjam; Geurts, Alexander C.; Huidekoper, Steven C.; Fasotti, Luciano; van Limbeek, Jacques
2004-01-01
OBJECTIVE: To identify and interrelate static and dynamic characteristics of the restoration of quiet standing balance in a representative sample of stroke survivors in the Netherlands during their inpatient rehabilitation. DESIGN: Exploratory study using an inception cohort with findings related to
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Male sleep duration and fecundability in a North American preconception cohort study
DEFF Research Database (Denmark)
Wise, Lauren Anne; Rothman, Kenneth Jay; Wesselink, Amelia Kent
2018-01-01
OBJECTIVE: To evaluate prospectively the association between male sleep duration and fecundability. DESIGN: Pregnancy Online Study (PRESTO), a Web-based prospective cohort study of North American couples enrolled during the preconception period (2013-2017). SETTING: Not applicable. PATIENT(S): Male...
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Adverse drug reactions to tocolytic treatment for preterm labour: Prospective cohort study
R. de Heus (Roel); B.W.J. Mol (Ben); J.J.H.M. Erwich; H.P. van Geijn (Herman); W.J. Gyselaers (Wilfried); M. Hanssens (Myriam); L. Harmark (Linda); C.D. van Holsbeke (Caroline); J.J. Duvekot (Hans); F. Famschobben; H. Wolf (Hans Uwe); G.H. Visser (Gerhard Henk)
2009-01-01
textabstractObjective To evaluate the incidence of serious maternal complications after the use of various tocolytic drugs for the treatment of preterm labour in routine clinical situations. Design Prospective cohort study. Setting 28 hospitals in the Netherlands and Belgium. Participants 1920
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Challet-Bouju, Gaëlle; Hardouin, Jean-Benoit; Vénisse, Jean-Luc; Romo, Lucia; Valleur, Marc; Magalon, David; Fatséas, Mélina; Chéreau-Boudet, Isabelle; Gorsane, Mohamed-Ali; Grall-Bronnec, Marie
2014-08-20
There is abundant literature on how to distinguish problem gambling (PG) from social gambling, but there are very few studies of the long-term evolution of gambling practice. As a consequence, the correlates of key state changes in the gambling trajectory are still unknown. The objective of the JEU cohort study is to identify the determinants of key state changes in the gambling practice, such as the emergence of a gambling problem, natural recovery from a gambling problem, resolution of a gambling problem with intermediate care intervention, relapses or care recourse. The present study was designed to overcome the limitations of previous cohort study on PG. Indeed, this longitudinal case-control cohort is the first which plans to recruit enough participants from different initial gambling severity levels to observe these rare changes. In particular, we plan to recruit three groups of gamblers: non-problem gamblers, problem gamblers without treatment and problem gamblers seeking treatment.Recruitment takes place in various gambling places, through the press and in care centers. Cohort participants are gamblers of both sexes who reported gambling on at least one occasion in the previous year and who were aged between 18 and 65. They were assessed through a structured clinical interview and self-assessment questionnaires at baseline and then once a year for five years. Data collection comprises sociodemographic characteristics, gambling habits (including gambling trajectory), the PG section of the DSM-IV, the South Oaks Gambling Screen, the Gambling Attitudes and Beliefs Survey - 23, the Mini International Neuropsychiatric Interview, the Wender-Utah Rating Scale-Child, the Adult ADHD Self-report Scale, somatic comorbidities (especially current treatment and Parkinson disease) and the Temperament and Character Inventory - 125. The JEU cohort study is the first study which proposes to identify the predictive factors of key state changes in gambling practice. This is
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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
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FB-line neutron multiplicity counter operation manual
International Nuclear Information System (INIS)
Langner, D.G.; Sweet, M.R.; Salazar, S.D.; Kroncke, K.E.
1998-01-01
This manual describes the design features, performance, and operating characteristics for the FB-Line Neutron Multiplicity Counter (FBLNMC). The FBLNMC counts neutron multiplicities to quantitatively assay plutonium in many forms, including impure scrap and waste. Monte Carlo neutronic calculations were used to design the high-efficiency (57%) detector that has 113 3 H tubes in a high-density polyethylene body. The new derandomizer circuit is included in the design to reduce deadtime. The FBLNMC can be applied to plutonium masses in the range from a few tens of grams to 5 kg; both conventional coincidence counting and multiplicity counting can be used as appropriate. This manual gives the performance data and preliminary calibration parameters for the FBLNMC
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The Congenital Heart Disease Genetic Network Study: Cohort description.
Directory of Open Access Journals (Sweden)
Thanh T Hoang
Full Text Available The Pediatric Cardiac Genomics Consortium (PCGC designed the Congenital Heart Disease Genetic Network Study to provide phenotype and genotype data for a large congenital heart defects (CHDs cohort. This article describes the PCGC cohort, overall and by major types of CHDs (e.g., conotruncal defects and subtypes of conotrucal heart defects (e.g., tetralogy of Fallot and left ventricular outflow tract obstructions (e.g., hypoplastic left heart syndrome. Cases with CHDs were recruited through ten sites, 2010-2014. Information on cases (N = 9,727 and their parents was collected through interviews and medical record abstraction. Four case characteristics, eleven parental characteristics, and thirteen parent-reported neurodevelopment outcomes were summarized using counts and frequencies and compared across CHD types and subtypes. Eleven percent of cases had a genetic diagnosis. Among cases without a genetic diagnosis, the majority had conotruncal heart defects (40% or left ventricular outflow tract obstruction (21%. Across CHD types, there were significant differences (p<0.05 in the distribution of all four case characteristics (e.g., sex, four parental characteristics (e.g., maternal pregestational diabetes, and five neurodevelopmental outcomes (e.g., learning disabilities. Several characteristics (e.g., sex were also significantly different across CHD subtypes. The PCGC cohort is one of the largest CHD cohorts available for the study of genetic determinants of risk and outcomes. The majority of cases do not have a genetic diagnosis. This description of the PCGC cohort, including differences across CHD types and subtypes, provides a reference work for investigators who are interested in collaborating with or using publically available resources from the PCGC.
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Prado, Elizabeth L; Abbeddou, Souheila; Adu-Afarwuah, Seth; Arimond, Mary; Ashorn, Per; Ashorn, Ulla; Bendabenda, Jaden; Brown, Kenneth H; Hess, Sonja Y; Kortekangas, Emma; Lartey, Anna; Maleta, Kenneth; Oaks, Brietta M; Ocansey, Eugenia; Okronipa, Harriet; Ouédraogo, Jean Bosco; Pulakka, Anna; Somé, Jérôme W; Stewart, Christine P; Stewart, Robert C; Vosti, Stephen A; Yakes Jimenez, Elizabeth; Dewey, Kathryn G
2017-11-01
Previous reviews have identified 44 risk factors for poor early child development (ECD) in low- and middle-income countries. Further understanding of their relative influence and pathways is needed to inform the design of interventions targeting ECD. We conducted path analyses of factors associated with 18-month language and motor development in four prospective cohorts of children who participated in trials conducted as part of the International Lipid-Based Nutrient Supplements (iLiNS) Project in Ghana (n = 1,023), Malawi (n = 675 and 1,385), and Burkina Faso (n = 1,122). In two cohorts, women were enrolled during pregnancy. In two cohorts, infants were enrolled at 6 or 9 months. In multiple linear regression and structural equation models (SEM), we examined 22 out of 44 factors identified in previous reviews, plus 12 additional factors expected to be associated with ECD. Out of 42 indicators of the 34 factors examined, 6 were associated with 18-month language and/or motor development in 3 or 4 cohorts: child linear and ponderal growth, variety of play materials, activities with caregivers, dietary diversity, and child hemoglobin/iron status. Factors that were not associated with child development were indicators of maternal Hb/iron status, maternal illness and inflammation during pregnancy, maternal perceived stress and depression, exclusive breastfeeding during 6 months postpartum, and child diarrhea, fever, malaria, and acute respiratory infections. Associations between socioeconomic status and language development were consistently mediated to a greater extent by caregiving practices than by maternal or child biomedical conditions, while this pattern for motor development was not consistent across cohorts. Key elements of interventions to ensure quality ECD are likely to be promotion of caregiver activities with children, a variety of play materials, and a diverse diet, and prevention of faltering in linear and ponderal growth and improvement in child
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Multiple Silent Lacunes Are Associated with Recurrent Ischemic Stroke
DEFF Research Database (Denmark)
Andersen, Søren Due; Skjøth, Flemming; Yavarian, Yousef
2016-01-01
ackground: Silent lacunes are a common finding on brain imaging in ischemic stroke patients, but the prognostic significance of these lesions is uncertain. We aimed at investigating the association of silent lacunes and the risk of ischemic stroke recurrence, death, and cardiovascular events...... in a cohort of patients with incident ischemic stroke and no atrial fibrillation (AF). Methods: We included 786 patients (mean age 59.5 (SD 14.0); 42.9% females) in a registry-based, observational cohort study on patients with first-ever ischemic stroke. On brain MRI we assessed the number of silent lacunes...... as none, single, or multiple and we calculated stratified incidence rates of the outcomes. Cox proportional hazard ratios (HRs) adjusted for age, gender, congestive heart failure, hypertension, diabetes, and vascular disease were calculated with no silent lacunes as reference. In additional analyses, we...
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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.
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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…
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Infectious mononucleosis and multiple sclerosis - Updated review on associated risk.
Sheik-Ali, Sharaf
2017-05-01
There has been substantial evidence accumulating on the role of infectious mononucleosis (IM) and the subsequent risk of obtaining Multiple Sclerosis (MS). Up to date studies not previously explored were reviewed by the author to further clarify the association. Medline and Web of Science were searched with no time constraints for articles exploring an association between Multiple Sclerosis and Infectious Mononucleosis. 24 articles were found, totalling 1063 cases and 13,227 cohort/controls. 23/24 (96%) articles reported a significant association of Infectious Mononucleosis on the risk of subsequent multiple sclerosis. Overall, new literature on IM and risk of MS categorically supports the association. Future work should focus on other risk factors such as age and gender on IM and subsequent risk of MS. Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.
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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.
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Falls in people with chronic obstructive pulmonary disease: An observational cohort study
DEFF Research Database (Denmark)
Roig, Marc; Eng, Janice J; MacIntyre, Donna L
2011-01-01
STUDY OBJECTIVE: To investigate incidence, risk factors and impact of falls on health related quality of life (HRQoL) in patients with chronic obstructive pulmonary disease (COPD). DESIGN: Observational cohort study. METHODS: Patients completed these questionnaires at baseline and at 6-months...
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Use of fertility drugs and risk of ovarian cancer: Danish population based cohort study
Jensen, Allan; Sharif, Heidi; Frederiksen, Kirsten; Kj?r, Susanne Kr?ger
2009-01-01
Objective To examine the effects of fertility drugs on overall risk of ovarian cancer using data from a large cohort of infertile women. Design Population based cohort study. Setting Danish hospitals and private fertility clinics. Participants 54?362 women with infertility problems referred to all Danish fertility clinics during 1963-98. The median age at first evaluation of infertility was 30 years (range 16-55 years), and the median age at the end of follow-up was 47 (range 18-81) years. In...
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The LifeLines Cohort Study: Prevalence and treatment of cardiovascular disease and risk factors
van der Ende, M. Yldau; Hartman, Minke H. T.; Hagemeijer, Yanick; Meems, Laura M. G.; de Vries, Hendrik Sierd; Stolk, Ronald P.; de Boer, Rudolf A.; Sijtsma, Anna; van der Meer, Peter; Rienstra, Michiel; van der Harst, Pim
2017-01-01
Background: The LifeLines Cohort Study is a large three-generation prospective study and Biobank. Recruitment and data collection started in 2006 and follow-up is planned for 30 years. The central aim of LifeLines is to understand healthy ageing in the 21st century. Here, the study design, methods, baseline and major cardiovascular phenotypes of the LifeLines Cohort Study are presented. Methods and results: Baseline cardiovascular phenotypeswere defined in 9700 juvenile (8-18 years) and 152,1...
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Risk of respiratory morbidity in term infants delivered by elective caesarean section: cohort study
DEFF Research Database (Denmark)
Hansen, Anne Kirkeby; Wisborg, Kirsten; Uldbjerg, Niels
2007-01-01
OBJECTIVE: To investigate the association between elective caesarean sections and neonatal respiratory morbidity and the importance of timing of elective caesarean sections. DESIGN: Cohort study with prospectively collected data from the Aarhus birth cohort, Denmark. SETTING: Obstetric department...... and neonatal department of a university hospital in Denmark. PARTICIPANTS: All liveborn babies without malformations, with gestational ages between 37 and 41 weeks, and delivered between 1 January 1998 and 31 December 2006 (34 458 babies). MAIN OUTCOME MEASURES: Respiratory morbidity (transitory tachypnoea...
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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
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Directory of Open Access Journals (Sweden)
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
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Reedijk, Marije; Lenters, Virissa; Slottje, Pauline; Pijpe, Anouk; Peeters, Petra H; Korevaar, Joke C; Bueno-de-Mesquita, Bas; Verschuren, W M Monique; Verheij, Robert A; Pieterson, Inka; van Leeuwen, Flora E; Rookus, Matti A; Kromhout, Hans; Vermeulen, Roel C H
2018-02-03
LIFEWORK is a large federated prospective cohort established in the Netherlands to quantify the health effects of occupational and environmental exposures. This cohort is also the Dutch contribution to the international Cohort Study of Mobile Phone Use and Health (COSMOS). In this paper, we describe the study design, ongoing data collection, baseline characteristics of participants and the repeatability of key questionnaire items. 88 466 participants were enrolled in three cohort studies in 2011-2012. Exposure information was collected by a harmonised core questionnaire, or modelled based on occupational and residential histories; domains include air pollution (eg, nitrogen dioxide (NO 2 ), particulate matter with diameter ≤2.5 µm (PM 2.5 )), noise, electromagnetic fields (EMF), mobile phone use, shift work and occupational chemical exposures. Chronic and subacute health outcomes are assessed by self-report and through linkage with health registries. Participants had a median age of 51 years at baseline (range 19-87), and the majority are female (90%), with nurses being over-represented. Median exposure levels of NO 2 , PM 2.5 , EMF from base stations and noise at the participants' home addresses at baseline were 22.9 µg/m 3 , 16.6 µg/m 3 , 0.003 mWm 2 and 53.1 dB, respectively. Twenty-two per cent of participants reported to have started using a mobile phone more than 10 years prior to baseline. Repeatability for self-reported exposures was moderate to high (weighted kappa range: 0.69-1) for a subset of participants (n=237) who completed the questionnaire twice. We are actively and passively observing participants; we plan to administer a follow-up questionnaire every 4-5 years-the first follow-up will be completed in 2018-and linkage to cause-of-death and cancer registries occurs on a (bi)annual basis. This prospective cohort offers a unique, large and rich resource for research on contemporary occupational and environmental health risks and will
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A role for VAV1 in experimental autoimmune encephalomyelitis and multiple sclerosis
DEFF Research Database (Denmark)
Jagodic, Maja; Colacios, Celine; Nohra, Rita
2009-01-01
Multiple sclerosis, the most common cause of progressive neurological disability in young adults, is a chronic inflammatory disease. There is solid evidence for a genetic influence in multiple sclerosis, and deciphering the causative genes could reveal key pathways influencing the disease. A genome...... region on rat chromosome 9 regulates experimental autoimmune encephalomyelitis, a model for multiple sclerosis. Using interval-specific congenic rat lines and association of single-nucleotide polymorphisms with inflammatory phenotypes, we localized the gene of influence to Vav1, which codes for a signal......-transducing protein in leukocytes. Analysis of seven human cohorts (12,735 individuals) demonstrated an association of rs2546133-rs2617822 haplotypes in the first VAV1 intron with multiple sclerosis (CA: odds ratio, 1.18; CG: odds ratio, 0.86; TG: odds ratio, 0.90). The risk CA haplotype also predisposed for higher...
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Directory of Open Access Journals (Sweden)
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.
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Directory of Open Access Journals (Sweden)
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.
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Life-course pathways to psychological distress: A cohort study
Von Stumm, S.; Deary, I. J.; Hagger-Johnson, G.
2013-01-01
Abstract: Objectives: Early life factors, like intelligence and socioeconomic status (SES), are associated with health outcomes in adulthood. Fitting comprehensive life-course models, we tested (1) the effect of childhood intelligence and SES, education and adulthood SES on psychological distress at midlife, and (2) compared alternative measurement specifications (reflective and formative) of SES. Design: Prospective cohort study (the Aberdeen Children of the 1950s). Setting: Aberdeen, Scotla...
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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.
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Capkun, Gorana; Dahlke, Frank; Lahoz, Raquel; Nordstrom, Beth; Tilson, Hugh H; Cutter, Gary; Bischof, Dorina; Moore, Alan; Simeone, Jason; Fraeman, Kathy; Bancken, Fabrice; Geissbühler, Yvonne; Wagner, Michael; Cohan, Stanley
2015-11-01
Data are limited for mortality and comorbidities in patients with multiple sclerosis (MS). Compare mortality rates and event rates for comorbidities in MS (n=15,684) and non-MS (n=78,420) cohorts from the US Department of Defense (DoD) database. Comorbidities and all-cause mortality were assessed using the database. Causes of death (CoDs) were assessed through linkage with the National Death Index. Cohorts were compared using mortality (MRR) and event (ERR) rate ratios. All-cause mortality was 2.9-fold higher in the MS versus non-MS cohort (MRR, 95% confidence interval [CI]: 2.9, 2.7-3.2). Frequent CoDs in the MS versus non-MS cohort were infectious diseases (6.2, 4.2-9.4), diseases of the nervous (5.8, 3.7-9.0), respiratory (5.0, 3.9-6.4) and circulatory (2.1, 1.7-2.7) systems and suicide (2.6, 1.3-5.2). Comorbidities including sepsis (ERR, 95% CI: 5.7, 5.1-6.3), ischemic stroke (3.8, 3.5-4.2), attempted suicide (2.4, 1.3-4.5) and ulcerative colitis (2.0, 1.7-2.3), were higher in the MS versus non-MS cohort. The rate of cancers was also higher in the MS versus the non-MS cohort, including lymphoproliferative disorders (2.2, 1.9-2.6) and melanoma (1.7, 1.4-2.0). Rates of mortality and several comorbidities are higher in the MS versus non-MS cohort. Early recognition and management of comorbidities may reduce premature mortality and improve quality of life in patients with MS. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.
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Opium use and mortality in Golestan Cohort Study: prospective cohort study of 50,000 adults in Iran.
Khademi, Hooman; Malekzadeh, Reza; Pourshams, Akram; Jafari, Elham; Salahi, Rasool; Semnani, Shahryar; Abaie, Behrooz; Islami, Farhad; Nasseri-Moghaddam, Siavosh; Etemadi, Arash; Byrnes, Graham; Abnet, Christian C; Dawsey, Sanford M; Day, Nicholas E; Pharoah, Paul D; Boffetta, Paolo; Brennan, Paul; Kamangar, Farin
2012-04-17
To investigate the association between opium use and subsequent risk of death. Prospective cohort study. The Golestan Cohort Study in north-eastern Iran collected detailed validated data on opium use and other exposures at baseline. Participants were enrolled between January 2004 and June 2008 and were followed to May 2011, with a follow-up success rate of over 99%. 50,045 participants aged 40-75 at baseline. Mortality, all cause and major subcategories. 17% (n = 8487) of the participants reported opium use, with a mean duration of 12.7 years. During the follow-up period 2145 deaths were reported. The adjusted hazard ratio for all cause mortality associated with ever use of opium was 1.86 (95% confidence interval 1.68 to 2.06). Opium consumption was significantly associated with increased risks of deaths from several causes including circulatory diseases (hazard ratio 1.81) and cancer (1.61). The strongest associations were seen with deaths from asthma, tuberculosis, and chronic obstructive pulmonary disease (11.0, 6.22, and 5.44, respectively). After exclusion of people who self prescribed opium after the onset of major chronic illnesses, the associations remained strong with a dose-response relation. Opium users have an increased risk of death from multiple causes compared with non-users. Increased risks were also seen in people who used low amounts of opium for a long period and those who had no major illness before use.
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Chen, Tianle; Zeng, Donglin
2015-01-01
Summary Predicting disease risk and progression is one of the main goals in many clinical research studies. Cohort studies on the natural history and etiology of chronic diseases span years and data are collected at multiple visits. Although kernel-based statistical learning methods are proven to be powerful for a wide range of disease prediction problems, these methods are only well studied for independent data but not for longitudinal data. It is thus important to develop time-sensitive prediction rules that make use of the longitudinal nature of the data. In this paper, we develop a novel statistical learning method for longitudinal data by introducing subject-specific short-term and long-term latent effects through a designed kernel to account for within-subject correlation of longitudinal measurements. Since the presence of multiple sources of data is increasingly common, we embed our method in a multiple kernel learning framework and propose a regularized multiple kernel statistical learning with random effects to construct effective nonparametric prediction rules. Our method allows easy integration of various heterogeneous data sources and takes advantage of correlation among longitudinal measures to increase prediction power. We use different kernels for each data source taking advantage of the distinctive feature of each data modality, and then optimally combine data across modalities. We apply the developed methods to two large epidemiological studies, one on Huntington's disease and the other on Alzheimer's Disease (Alzheimer's Disease Neuroimaging Initiative, ADNI) where we explore a unique opportunity to combine imaging and genetic data to study prediction of mild cognitive impairment, and show a substantial gain in performance while accounting for the longitudinal aspect of the data. PMID:26177419
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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
2016-01-01
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. This cohort study was performed between December 2012
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Goodarzi, Mark O; Jones, Michelle R; Li, Xiaohui; Chua, Angela K; Garcia, Obed A; Chen, Yii-Der I; Krauss, Ronald M; Rotter, Jerome I; Ankener, Wendy; Legro, Richard S; Azziz, Ricardo; Strauss, Jerome F; Dunaif, Andrea; Urbanek, Margrit
2012-02-01
Polycystic ovary syndrome (PCOS) is a complex endocrine disorder with a strong familial component. PCOS is characterised by hyperandrogenaemia and irregular menses. A recent genome-wide association study (GWAS) of PCOS in a Chinese cohort identified three reproducible PCOS susceptibility loci mapping to 2p16.3 (luteinising hormone/choriogonadotropin receptor; LHCGR), 2p21 (thyroid associated protein; THADA), and 9q33.3 (DENN/MADD domain containing 1A; DENNDIA). The impact of these loci in non-Chinese PCOS cohorts remains to be determined. The study tested association with PCOS of seven single nucleotide polymorphisms mapping to the three Chinese PCOS loci in two European derived PCOS cohorts (cohort A = 939 cases and 957 controls; cohort B = 535 cases and 845 controls). Cases fulfilled the National Institute of Child Health & Human Development criteria for PCOS. Variation in DENND1A was strongly associated with PCOS in the study cohort (p(combined cohorts)=10(-8)); multiple variants in THADA were also associated with PCOS, while there was no significant evidence for association of LHCGR variation with PCOS. The present study had >80% power to detect an effect of similar size as was observed by Chen et al for DENND1A and THADA, but reduced power (at PCOS susceptibility loci identified in the Chinese PCOS GWAS (DENND1A and THADA) are also associated with PCOS in European derived populations, and are therefore likely to be important in the aetiology of PCOS regardless of ethnicity. The analysis of the LHCGR gene was not sufficiently powered to detect modest effects.
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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.
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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
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International Nuclear Information System (INIS)
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
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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...
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Klonsky, E. David; Kotov, Roman; Bakst, Shelly; Rabinowitz, Jonathan; Bromet, Evelyn J.
2012-01-01
Little is known about the longitudinal relationship of hopelessness to attempted suicide in psychotic disorders. This study addresses this gap by assessing hopelessness and attempted suicide at multiple time-points over 10 years in a first-admission cohort with psychosis (n = 414). Approximately one in five participants attempted suicide during…
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The human early-life exposome (HELIX): project rationale and design.
Vrijheid, Martine; Slama, Rémy; Robinson, Oliver; Chatzi, Leda; Coen, Muireann; van den Hazel, Peter; Thomsen, Cathrine; Wright, John; Athersuch, Toby J; Avellana, Narcis; Basagaña, Xavier; Brochot, Celine; Bucchini, Luca; Bustamante, Mariona; Carracedo, Angel; Casas, Maribel; Estivill, Xavier; Fairley, Lesley; van Gent, Diana; Gonzalez, Juan R; Granum, Berit; Gražulevičienė, Regina; Gutzkow, Kristine B; Julvez, Jordi; Keun, Hector C; Kogevinas, Manolis; McEachan, Rosemary R C; Meltzer, Helle Margrete; Sabidó, Eduard; Schwarze, Per E; Siroux, Valérie; Sunyer, Jordi; Want, Elizabeth J; Zeman, Florence; Nieuwenhuijsen, Mark J
2014-06-01
Developmental periods in early life may be particularly vulnerable to impacts of environmental exposures. Human research on this topic has generally focused on single exposure-health effect relationships. The "exposome" concept encompasses the totality of exposures from conception onward, complementing the genome. The Human Early-Life Exposome (HELIX) project is a new collaborative research project that aims to implement novel exposure assessment and biomarker methods to characterize early-life exposure to multiple environmental factors and associate these with omics biomarkers and child health outcomes, thus characterizing the "early-life exposome." Here we describe the general design of the project. In six existing birth cohort studies in Europe, HELIX will estimate prenatal and postnatal exposure to a broad range of chemical and physical exposures. Exposure models will be developed for the full cohorts totaling 32,000 mother-child pairs, and biomarkers will be measured in a subset of 1,200 mother-child pairs. Nested repeat-sampling panel studies (n = 150) will collect data on biomarker variability, use smartphones to assess mobility and physical activity, and perform personal exposure monitoring. Omics techniques will determine molecular profiles (metabolome, proteome, transcriptome, epigenome) associated with exposures. Statistical methods for multiple exposures will provide exposure-response estimates for fetal and child growth, obesity, neurodevelopment, and respiratory outcomes. A health impact assessment exercise will evaluate risks and benefits of combined exposures. HELIX is one of the first attempts to describe the early-life exposome of European populations and unravel its relation to omics markers and health in childhood. As proof of concept, it will form an important first step toward the life-course exposome.
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Shopping behavior for ADHD drugs: results of a cohort study in a pharmacy database.
Cepeda, M Soledad; Fife, Daniel; Berwaerts, Joris; Yuan, Yingli; Mastrogiovanni, Greg
2014-09-01
Attention-deficit hyperactivity disorder (ADHD) medications are subject to abuse, misuse, and diversion. Obtaining ADHD prescriptions from multiple prescribers or filled across multiple pharmacies, known as 'doctor shopping', may reflect such unsanctioned use. We sought to create a definition of shopping behavior that differentiated ADHD medications from medications with low risk of diversion, i.e. asthma medications, and describe the incidence, frequency, and demography of shopping behavior. This was a retrospective cohort study in a pharmacy database-LRx-covering 65 % of US retail pharmacies. Subjects had ADHD or asthma medication dispensed between February 2011 and January 2012. We followed subjects for 18 months to assess the number with overlapping dispensings from different prescribers, and the number of prescribers and pharmacies involved in those dispensings. We included 4,402,464 subjects who were dispensed ADHD medications, and 6,128,025 subjects who were dispensed asthma medications. Overlapping prescriptions from two or more prescribers dispensed by three or more pharmacies was four times more frequent in the ADHD cohort than in the asthma cohort. Using this definition, ADHD medication shopping behavior was more common among experienced users than naïve users, and was most common in subjects aged 10-39 years. Among subjects who shopped, 57.4 % shopped only once (accounting for 22.4 % of episodes), and 9.2 % shopped six or more times (accounting for 42.0 % of episodes). Shoppers more often received stimulant ADHD drugs than non-stimulants. Overlapping prescriptions by different prescribers and filled at three or more pharmacies defines ADHD medication shopping. Shopping behavior is most common in adolescents and younger adults. A small proportion of shoppers is responsible for a large number of shopping episodes.
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Facilitating Multiple Intelligences Through Multimodal Learning Analytics
Directory of Open Access Journals (Sweden)
Ayesha PERVEEN
2018-01-01
Full Text Available This paper develops a theoretical framework for employing learning analytics in online education to trace multiple learning variations of online students by considering their potential of being multiple intelligences based on Howard Gardner’s 1983 theory of multiple intelligences. The study first emphasizes the need to facilitate students as multiple intelligences by online education systems and then suggests a framework of the advanced form of learning analytics i.e., multimodal learning analytics for tracing and facilitating multiple intelligences while they are engaged in online ubiquitous learning. As multimodal learning analytics is still an evolving area, it poses many challenges for technologists, educationists as well as organizational managers. Learning analytics make machines meet humans, therefore, the educationists with an expertise in learning theories can help technologists devise latest technological methods for multimodal learning analytics and organizational managers can implement them for the improvement of online education. Therefore, a careful instructional design based on a deep understanding of students’ learning abilities, is required to develop teaching plans and technological possibilities for monitoring students’ learning paths. This is how learning analytics can help design an adaptive instructional design based on a quick analysis of the data gathered. Based on that analysis, the academicians can critically reflect upon the quick or delayed implementation of the existing instructional design based on students’ cognitive abilities or even about the single or double loop learning design. The researcher concludes that the online education is multimodal in nature, has the capacity to endorse multiliteracies and, therefore, multiple intelligences can be tracked and facilitated through multimodal learning analytics in an online mode. However, online teachers’ training both in technological implementations and
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Ali, Syed Haris; Carr, Patrick A.; Ruit, Kenneth G.
2016-01-01
Plausible distractors are important for accurate measurement of knowledge via multiple-choice questions (MCQs). This study demonstrates the impact of higher distractor functioning on validity and reliability of scores obtained on MCQs. Freeresponse (FR) and MCQ versions of a neurohistology practice exam were given to four cohorts of Year 1 medical…
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Directory of Open Access Journals (Sweden)
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.
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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.
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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...
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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
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Furlotte, Nicholas A; Eskin, Eleazar
2015-05-01
Multiple-trait association mapping, in which multiple traits are used simultaneously in the identification of genetic variants affecting those traits, has recently attracted interest. One class of approaches for this problem builds on classical variance component methodology, utilizing a multitrait version of a linear mixed model. These approaches both increase power and provide insights into the genetic architecture of multiple traits. In particular, it is possible to estimate the genetic correlation, which is a measure of the portion of the total correlation between traits that is due to additive genetic effects. Unfortunately, the practical utility of these methods is limited since they are computationally intractable for large sample sizes. In this article, we introduce a reformulation of the multiple-trait association mapping approach by defining the matrix-variate linear mixed model. Our approach reduces the computational time necessary to perform maximum-likelihood inference in a multiple-trait model by utilizing a data transformation. By utilizing a well-studied human cohort, we show that our approach provides more than a 10-fold speedup, making multiple-trait association feasible in a large population cohort on the genome-wide scale. We take advantage of the efficiency of our approach to analyze gene expression data. By decomposing gene coexpression into a genetic and environmental component, we show that our method provides fundamental insights into the nature of coexpressed genes. An implementation of this method is available at http://genetics.cs.ucla.edu/mvLMM. Copyright © 2015 by the Genetics Society of America.
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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.
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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.
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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.
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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.
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Employment Trajectories After Spinal Cord Injury : Results From a 5-Year Prospective Cohort Study
Ferdiana, Astri; Post, Marcel W.; Hoekstra, Trynke; van der Woude, Luccas H.; van der Klink, Jac J.; Bultmann, Ute
Objectives: To identify different employment trajectories in individuals with spinal cord injury (SCI) after discharge from initial rehabilitation and to determine predictors of different trajectories from demographic, injury, functional, and psychological characteristics. Design: Prospective cohort
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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.
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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...
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DEFF Research Database (Denmark)
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....
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Can Free-Response Questions Be Approximated by Multiple-Choice Equivalents?
Lin, Shih-Yin; Singh, Chandralekha
2016-01-01
We discuss a study to evaluate the extent to which free-response questions can be approximated by multiple-choice equivalents. Two carefully designed research-based multiple-choice questions were transformed into a free-response format and administered on the final exam in a calculus-based introductory physics course. The original multiple-choice questions were administered in another, similar introductory physics course on the final exam. Our findings suggest that carefully designed multiple...
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O'Keeffe, Linda M; Kearney, Patricia M; McCarthy, Fergus P; Khashan, Ali S; Greene, Richard A; North, Robyn A; Poston, Lucilla; McCowan, Lesley M E; Baker, Philip N; Dekker, Gus A; Walker, James J; Taylor, Rennae; Kenny, Louise C
2015-07-06
To compare the prevalence and predictors of alcohol use in multiple cohorts. Cross-cohort comparison of retrospective and prospective studies. Population-based studies in Ireland, the UK, Australia and New Zealand. 17,244 women of predominantly Caucasian origin from two Irish retrospective studies (Growing up in Ireland (GUI) and Pregnancy Risk Assessment Monitoring System Ireland (PRAMS Ireland)), and one multicentre prospective international cohort, Screening for Pregnancy Endpoints (SCOPE) study. Prevalence of alcohol use pre-pregnancy and during pregnancy across cohorts. Sociodemographic factors associated with alcohol consumption in each cohort. Alcohol consumption during pregnancy in Ireland ranged from 20% in GUI to 80% in SCOPE, and from 40% to 80% in Australia, New Zealand and the UK. Levels of exposure also varied substantially among drinkers in each cohort ranging from 70% consuming more than 1-2 units/week in the first trimester in SCOPE Ireland, to 46% and 15% in the retrospective studies. Smoking during pregnancy was the most consistent predictor of gestational alcohol use in all three cohorts, and smokers were 17% more likely to drink during pregnancy in SCOPE, relative risk (RR)=1.17 (95% CI 1.12 to 1.22), 50% more likely to drink during pregnancy in GUI, RR=1.50 (95% CI 1.36 to 1.65), and 42% more likely to drink in PRAMS, RR=1.42 (95% CI 1.18 to 1.70). Our data suggest that alcohol use during pregnancy is prevalent and socially pervasive in the UK, Ireland, New Zealand and Australia. New policy and interventions are required to reduce alcohol prevalence both prior to and during pregnancy. Further research on biological markers and conventions for measuring alcohol use in pregnancy is required to improve the validity and reliability of prevalence estimates. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
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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
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Injuries in Professional Male Soccer Players in the Netherlands: A Prospective Cohort Study
Stubbe, J.H.; Beijsterveldt, A.M. van; Knaap, S. van der; Stege, J.; Verhagen, E.; Mechelen, W. van; Backx, F.J.G.
2015-01-01
Context : Injuries are a major adverse event in a soccer player's career. Reducing injury incidence requires a thorough knowledge of the epidemiology of soccer injuries. Objective : To investigate the incidence and characteristics of injuries in the Dutch premier soccer league. Design : Cohort
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Injuries in Professional Male Soccer Players in the Netherlands: A Prospective Cohort Study
Stubbe, J.H.; van Beijsterveldt, A.M.M.C.; van der Knaap, S.; Stege, J.; Verhagen, E.A.L.M.; van Mechelen, W.; Backx, F.J.G.
2015-01-01
Context: Injuries are a major adverse event in a soccer player's career. Reducing injury incidence requires a thorough knowledge of the epidemiology of soccer injuries. Objective: To investigate the incidence and characteristics of injuries in the Dutch premier soccer league. Design: Cohort study.
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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...
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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 ...
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DEFF Research Database (Denmark)
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...
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Directory of Open Access Journals (Sweden)
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.
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Hasselhorn, Hans Martin; Peter, Richard; Rauch, Angela; Schröder, Helmut; Swart, Enno; Bender, Stefan; du Prel, Jean-Baptist; Ebener, Melanie; March, Stefanie; Trappmann, Mark; Steinwede, Jacob; Müller, Bernd Hans
2014-12-01
The lidA Cohort Study (German Cohort Study on Work, Age, Health and Work Participation) was set up to investigate and follow the effects of work and work context on the physical and psychological health of the ageing workforce in Germany and subsequently on work participation. Cohort participants are initially employed people subject to social security contributions and born in either 1959 (n = 2909) or 1965 (n = 3676). They were personally interviewed in their homes in 2011 and will be visited every 3 years. Data collection comprises socio-demographic data, work and private exposures, work ability, work and work participation attitudes, health, health-related behaviour, personality and attitudinal indicators. Employment biographies are assessed using register data. Subjective health reports and physical strength measures are complemented by health insurance claims data, where permission was given. A conceptual framework has been developed for the lidA Cohort Study within which three confirmatory sub-models assess the interdependencies of work and health considering age, gender and socioeconomic status. The first set of the data will be available to the scientific community by 2015. Access will be given by the Research Data Centre of the German Federal Employment Agency at the Institute for Employment Research (http://fdz.iab.de/en.aspx). © The Author 2014. Published by Oxford University Press on behalf of the International Epidemiological Association.
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Age-period-cohort analysis of suicides among Japanese 1950-2003: a Bayesian cohort model analysis.
Ooe, Yosuke; Ohno, Yuko; Nakamura, Takashi
2009-07-01
The suicide rate in Japan is one of the highest in the world and presents us with a considerable challenge. Demographic statistics show that the number of suicides is on the rise, and at roughly 30,000 people per year have committed suicide since 1998. Suicide trends are not only related to economic boom and bust but also to certain generations and age groups. During the 1950s, there was a remarkably high suicide rate among people in their 20s, and this cohort was identical to that of the middle-age generation in the 1980s. It is important to separately understand both the trend of suicide rates and the numbers analyzed to determine the different factors that influence suicide. These include age, time period, cohort, interaction between age and time period, and changes in population composition. We performed an age-period-cohort analysis of annual trends of suicide rates by age group in Japan using a Bayesian cohort model. With the help of the Nakamura method, we have been able to break down the effects of age, time period, cohort, and the age-by-period interaction. The cohort comprised of people born in the 1930s demonstrated a relatively high suicide rate. Men currently in their 50s also belong to a high suicide rate cohort. Regarding the period effect, business cycles and by-period interaction effect, it became apparent that the high suicide rate among young adults in their early 20s around 1960 was slowing, especially among men. Instead, there was an obvious recent trend for men in their late 50s to have the highest suicide rate. This study confirmed that age-period-cohort analysis can describe these trends of suicide mortality of the Japanese.
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Tan, Lindsay; Hong, Miyoung; Albert, Taneshia West
2017-10-01
This case study explores the influence of the healthcare design studio experience on students' short-term professional goals as measured through rates of healthcare-related certification and internship/employment. The value and relevance of interior design is evident in the healthcare design sector. However, interior design students may not perceive this value if it is not communicated through their design education. Students' experience in the design studio plays a crucial role in determining career choices, and students may be more committed to career goals when there is clear connection between major coursework and professional practice. The authors compared healthcare-related certification and internship/employment levels between two student cohorts in a capstone undergraduate interior design healthcare design studio course. The first cohort was led by the existing curriculum. The second cohort was led by the revised curriculum that specifically aimed at encouraging students to commit to healthcare-related design practice. When measured at 3 months from graduation, the second cohort, led by the revised curriculum, saw a 30% increase in Evidence-based Design Accreditation and Certification exam pass rates and a 40% increase in healthcare-related internship/employment. The challenge of interior design education is to instill in emerging professionals not only professional competence but also those professional attitudes that will make them better prepared to design spaces that improve quality of life, particularly in healthcare environments. The results exceeded the project goals, and so this could be considered a promising practice for courses focused on healthcare design education.
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Wesnes, Stian Langeland; Hunskår, Steinar; Bø, Kari; Rørtveit, Guri
2009-01-01
Objective: The objectives of this study were to investigate prevalence of urinary incontinence at 6 months postpartum and to study how continence status during pregnancy and mode of delivery influence urinary incontinence at 6 months postpartum in primiparous women.Design: Cohort study.Setting: Pregnant women attending routine ultrasound examination were recruited to the Norwegian Mother and Child Cohort Study (MoBa).Population A total of 12 679 primigravidas who were contin...
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Directory of Open Access Journals (Sweden)
Catherine J. Moody
2017-08-01
Full Text Available Despite a wealth of activity across the globe in the area of longitudinal population cohorts, surprisingly little information is available on the natural biomedical history of a number of age-related neurodegenerative diseases (ND, and the scope for intervention studies based on these cohorts is only just beginning to be explored. The Joint Programming Initiative on Neurodegenerative Disease Research (JPND recently developed a novel funding mechanism to rapidly mobilize scientists to address these issues from a broad, international community perspective. Ten expert Working Groups, bringing together a diverse range of community members and covering a wide ND landscape [Alzheimer's, Parkinson's, frontotemporal degeneration, amyotrophic lateral sclerosis (ALS, Lewy-body and vascular dementia] were formed to discuss and propose potential approaches to better exploiting and coordinating cohort studies. The purpose of this work is to highlight the novel funding process along with a broad overview of the guidelines and recommendations generated by the ten groups, which include investigations into multiple methodologies such as cognition/functional assessment, biomarkers and biobanking, imaging, health and social outcomes, and pre-symptomatic ND. All of these were published in reports that are now publicly available online.
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Practical Design of Delta-Sigma Multiple Description Audio Coding
DEFF Research Database (Denmark)
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 ...
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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...
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Directory of Open Access Journals (Sweden)
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
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Sibship characteristics and risk of multiple sclerosis
DEFF Research Database (Denmark)
Bager, P.; Nielsen, N.M.; Bihrmann, K.
2006-01-01
sibling, or exposure to younger siblings under 2 years of age and risk of MS later in life. There was no association of MS risk with multiple birth (vs. singleton birth) or with the age of the mother or father at birth. These results do not lend support to the hypothesis that number of older siblings......It has been hypothesized that age at infection with a common microbial agent may be associated with the risk of multiple sclerosis (MS). The authors addressed this hypothesis by using number of older siblings and other sibship characteristics as an approximation of age at exposure to common...... Sclerosis Register. The cohort of 1.9 million Danes was followed for 28.1 million person-years; during that time, 1,036 persons developed MS. Overall, there was no association between number of older siblings, number of younger siblings, total number of siblings, age distance from the nearest younger...
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Chronic Stress in Young German Adults: Who Is Affected? A Prospective Cohort Study
Herrera, Ronald; Berger, Ursula; Genuneit, Jon; Gerlich, Jessica; Nowak, Dennis; Schlotz, Wolff; Vogelberg, Christian; Mutius, Erika von; Weinmayr, Gudrun; Windstetter, Doris; Weigl, Matthias; Radon, Katja
2017-01-01
We aimed to prospectively assess changes in chronic stress among young adults transitioning from high school to university or working life. A population-based cohort in Munich and Dresden (Germany) was followed from age 16–18 (2002–2003) to age 20–23 (2007–2009) (n = 1688). Using the Trier Inventory for the Assessment of Chronic Stress, two dimensions of stress at university or work were assessed: work overload and work discontent. In the multiple ordinal generalized estimating equations, soc...
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Multiple sclerosis and organic solvents
DEFF Research Database (Denmark)
Mortensen, J T; Brønnum-Hansen, Henrik; Rasmussen, K
1998-01-01
We investigated a possible causal relation between exposure to organic solvents in Danish workers (housepainters, typographers/printers, carpenters/cabinetmakers) and onset of multiple sclerosis. Data on men included in the Danish Multiple Sclerosis Register (3,241 men) were linked with data from......, and butchers. Over a follow-up period of 20 years, we observed no increase in the incidence of multiple sclerosis among men presumed to be exposed to organic solvents. It was not possible to obtain data on potential confounders, and the study design has some potential for selection bias. Nevertheless......, the study does not support existing hypotheses regarding an association between occupational exposure to organic solvents and multiple sclerosis....
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Extending Data Worth Analyses to Select Multiple Observations Targeting Multiple Forecasts
DEFF Research Database (Denmark)
Vilhelmsen, Troels Norvin; Ferre, Ty Paul
2017-01-01
. In the present study, we extend previous data worth analyses to include: simultaneous selection of multiple new measurements and consideration of multiple forecasts of interest. We show how the suggested approach can be used to optimize data collection. This can be used in a manner that suggests specific...... measurement sets or that produces probability maps indicating areas likely to be informative for specific forecasts. Moreover, we provide examples documenting that sequential measurement election approaches often lead to suboptimal designs and that estimates of data covariance should be included when...
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Mayhew, Matthew J.; Pascarella, Ernest T.; Trolian, Teniell; Selznick, Benjamin
2015-01-01
The purpose of this paper was to examine differences between undergraduate students who had multiple exposures to an assessment of moral reasoning development (DIT-2) and students of the same cohort who had fewer exposures to the same assessment. Controlling for a host of individual covariates, the analysis determined that students who took the…
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International Childhood Cancer Cohort Consortium
An alliance of several large-scale prospective cohort studies of children to pool data and biospecimens from individual cohorts to study various modifiable and genetic factors in relation to cancer risk
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Silicon photonic thermometer operating on multiple polarizations
DEFF Research Database (Denmark)
Guan, Xiaowei; Wang, Xiaoyan; Frandsen, Lars Hagedorn
2016-01-01
A silicon photonics optical thermometer simultaneously operating on the multiple polarizations is designed and experimentally demonstrated. Measured sensitivities are 86pm/°C and 48pm/°C for the transverse-electric and transverse-magnetic polarizations, respectively.......A silicon photonics optical thermometer simultaneously operating on the multiple polarizations is designed and experimentally demonstrated. Measured sensitivities are 86pm/°C and 48pm/°C for the transverse-electric and transverse-magnetic polarizations, respectively....
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Directory of Open Access Journals (Sweden)
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.
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Sorel, J. C.; Façee Schaeffer, M.; Homan, A. S.; Scholtes, V. A B; Kempen, D. H R; Ham, S. J.
2016-01-01
Aims We report a prospective cohort study of the midterm results of surgical dislocation of the hip (according to Ganz) to perform resection of osteochondromas involving the femoral neck in patients with multiple hereditary exostoses (MHE). Methods Hip range of movement (ROM) was assessed pre-and
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Kemp, Matthew W; Lazarus, Benjamin M; Perron, Gabriel G; Hanage, William P; Chapman, Elaine
2014-01-01
The ability to form multiple learning relationships is a key element of the doctoral learning environment in the biomedical sciences. Of these relationships, that between student and supervisor has long been viewed as key. There are, however, limited data to describe the student perspective on what makes this relationship valuable. In the present study, we discuss the findings of semi-structured interviews with biomedical Ph.D. students from the United Kingdom and the United States to: i) determine if the learning relationships identified in an Australian biomedical Ph.D. cohort are also important in a larger international student cohort; and ii) improve our understanding of student perceptions of value in their supervisory relationships. 32 students from two research intensive universities, one in the United Kingdom (n = 17), and one in the United States (n = 15) were recruited to participate in a semi-structured interview. Verbatim transcripts were transcribed, validated and analysed using a Miles and Huberman method for thematic analysis. Students reported that relationships with other Ph.D. students, post-doctoral scientists and supervisors were all essential to their learning. Effective supervisory relationships were perceived as the primary source of high-level project guidance, intellectual support and confidence. Relationships with fellow students were viewed as essential for the provision of empathetic emotional support. Technical learning was facilitated, almost exclusively, by relationships with postdoctoral staff. These data make two important contributions to the scholarship of doctoral education in the biomedical sciences. Firstly, they provide further evidence for the importance of multiple learning relationships in the biomedical doctorate. Secondly, they clarify the form of a 'valued' supervisory relationship from a student perspective. We conclude that biomedical doctoral programs should be designed to contain a minimum level of formalised
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Directory of Open Access Journals (Sweden)
Matthew W Kemp
Full Text Available The ability to form multiple learning relationships is a key element of the doctoral learning environment in the biomedical sciences. Of these relationships, that between student and supervisor has long been viewed as key. There are, however, limited data to describe the student perspective on what makes this relationship valuable. In the present study, we discuss the findings of semi-structured interviews with biomedical Ph.D. students from the United Kingdom and the United States to: i determine if the learning relationships identified in an Australian biomedical Ph.D. cohort are also important in a larger international student cohort; and ii improve our understanding of student perceptions of value in their supervisory relationships.32 students from two research intensive universities, one in the United Kingdom (n = 17, and one in the United States (n = 15 were recruited to participate in a semi-structured interview. Verbatim transcripts were transcribed, validated and analysed using a Miles and Huberman method for thematic analysis.Students reported that relationships with other Ph.D. students, post-doctoral scientists and supervisors were all essential to their learning. Effective supervisory relationships were perceived as the primary source of high-level project guidance, intellectual support and confidence. Relationships with fellow students were viewed as essential for the provision of empathetic emotional support. Technical learning was facilitated, almost exclusively, by relationships with postdoctoral staff.These data make two important contributions to the scholarship of doctoral education in the biomedical sciences. Firstly, they provide further evidence for the importance of multiple learning relationships in the biomedical doctorate. Secondly, they clarify the form of a 'valued' supervisory relationship from a student perspective. We conclude that biomedical doctoral programs should be designed to contain a minimum level
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Educational achievements of children of parents with multiple sclerosis
DEFF Research Database (Denmark)
Moberg, Julie Yoon; Magyari, Melinda; Koch-Henriksen, N.
2016-01-01
Little is known about the impact of parental multiple sclerosis (MS) on offspring’s educational attainment. The objective of the study was to examine educational achievements in offspring of parents with MS compared with matched children of parents without MS in a nationwide register-based cohort...... from the Civil Registration System without parental MS matched 8:1 to the MS offspring by sex and year of birth. Information about education was linked to the cohorts from nationwide educational registries. We included 4177 children of MS parents and 33,416 reference persons. Children of MS parents.......20). There was a trend toward more MS offspring attaining health-related educations (OR 1.10; 95 % CI 1.00–1.21; p = 0.06). In conclusion, children of MS parents showed a small advantage in grade point average in final examinations in basic school, and they more often tended toward health-related educations. This study...
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Miniaturization of Multiple-Layer Folded Patch Antennas
DEFF Research Database (Denmark)
Zhang, Jiaying; Breinbjerg, Olav
2009-01-01
A new folded patch antenna with multiple layers was developed in this paper, by folding the patch in a proper way, and a highly miniaturized antenna can be realized. The multiple layer patch with 4-layer and 6-layer are designed and evaluated at 2.4 GHz, 915 MHz, and 415 MHz respectively. Then a 4...... layer patch is fabricated and measured to validate the design method. The theoretical analysis, design and simulations, fabrications, as well as the measurements are presented in this paper. All the results show that the folded patch antenna is a good candidate in making a highly miniaturized compact...
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Production System Design for Multiple Brands
DEFF Research Database (Denmark)
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....
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Second-site prosthetic joint infection in patients with multiple prosthetic joints.
Clesham, Kevin; Hughes, Andrew J; O' hEireamhoin, Sven; Fleming, Catherine; Murphy, Colin G
2018-04-10
Prosthetic joint infections (PJIs) are among the most serious complications in arthroplasty. A second-site PJI in patients with multiple prosthetic joints increases morbidity, with many requiring further revision procedures. We aimed to establish why some patients with multiple joints develop second-site infections. Our institution's arthroplasty database was reviewed from 2004 to 2017. All PJIs were identified, and all patients with more than one prosthetic joint in situ were included. We recorded risk factors, causative organisms, number of procedures and length of stay. Forty-four patients meeting the criteria were identified. Four patients (9.1%) developed second-site infection. Eight patients (18.2%) developed re-infection of the primary PJI. Positive MRSA carrier status and PJI of a total knee replacement were associated with an increased risk of a second episode of infection. Patients who developed further infection had more frequent admission and longer lengths of stay than isolated PJIs. Higher morbidity and use of hospital resources are associated with this cohort of patients. PJIs in total knee replacements and positive MRSA status are associated with higher rates of second infection. Identifying this vulnerable cohort of patients at an early stage is critical to ensure measures are taken to reduce the risks of further infection.
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Rationale, design, and profile of the Three-Prefecture Cohort in Japan: A 15-year follow-up
Directory of Open Access Journals (Sweden)
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.
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DEFF Research Database (Denmark)
Knudsen, Marina K H; Rasmussen, Peter K; Coupland, Sarah E
2017-01-01
Importance: To our knowledge, the clinical features of ocular adnexal mantle-cell lymphoma (OA-MCL) have not previously been evaluated in a large multicenter cohort. Objective: To characterize the clinical features of OA-MCL. Design, Setting, and Participants: This retrospective multicenter study...... included patient data collected from January 1, 1980, through December 31, 2015, at 6 eye cancer centers in 4 countries. Medical records of 55 patients with OA-MCL were reviewed; the median length of follow-up was 33 months. Main Outcomes and Measures: Overall survival, disease-specific survival....... Overall survival rates for the entire cohort were 65% at 3 years (95% CI, 52%-78%) and 34% at 5 years (95% CI, 21%-47%). Disease-specific survival after 5 years was 38% for the entire cohort (95% CI, 25%-51%); the disease-specific survival adjusted by eye cancer center was better in patients who had...
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Rationale and design of South Asian Birth Cohort (START: a Canada-India collaborative study
Directory of Open Access Journals (Sweden)
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.
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International Nuclear Information System (INIS)
Schlett, C.L.; Weckbach, S.; Hendel, T.
2016-01-01
The MRI study within the German National Cohort, a large-scale, population-based, longitudinal study in Germany, comprises comprehensive characterization and phenotyping of a total of 30 000 participants using 3-Tesla whole-body MR imaging. A multi-centric study design was established together with dedicated core facilities for e.g. managing incidental findings or providing quality assurance. As such, the study represents a unique opportunity to substantially impact imaging-based risk stratification leading to personalized and precision medicine. Supported by the developments in the field of computational science, the newly developing scientific field of radiomics has large potential for the future. In the present article we provide an overview on population-based imaging and Radiomics and conceptualize the rationale and design of the MRI study within the German National Cohort.
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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.
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Meditation as an Adjunct to the Management of Multiple Sclerosis
Directory of Open Access Journals (Sweden)
Adam B. Levin
2014-01-01
Full Text Available Background. Multiple sclerosis (MS disease course is known to be adversely affected by several factors including stress. A proposed mechanism for decreasing stress and therefore decreasing MS morbidity and improving quality of life is meditation. This review aims to critically analyse the current literature regarding meditation and MS. Methods. Four major databases were used to search for English language papers published before March 2014 with the terms MS, multiple sclerosis, meditation, and mindfulness. Results. 12 pieces of primary literature fitting the selection criteria were selected: two were randomised controlled studies, four were cohort studies, and six were surveys. The current literature varies in quality; however common positive effects of meditation include improved quality of life (QOL and improved coping skills. Conclusion. All studies suggest possible benefit to the use of meditation as an adjunct to the management of multiple sclerosis. Additional rigorous clinical trials are required to validate the existing findings and determine if meditation has an impact on disease course over time.
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Design of Multiple Trellis-Coded Multi-h CPM Based on Super Trellis
Directory of Open Access Journals (Sweden)
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.
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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
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Bredeweg, Steef W.; Kluitenberg, Bas; Bessem, Bram; Buist, Ida
Objectives: This prospective study examined differences in kinetic variables between injured and noninjured novice female and male runners and their potential contribution to RRIs. Design: A prospective cohort study. Methods: At baseline vertical ground reaction forces were assessed with an
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Wach, Achim; Dembowsky, Klaus; Dale, Glenn E
2018-04-01
Murepavadin is the first in class of the outer membrane protein-targeting antibiotics (OMPTA) and a pathogen-specific peptidomimetic antibacterial with a novel, nonlytic mechanism of action targeting Pseudomonas aeruginosa Murepavadin is being developed for the treatment of hospital-acquired bacterial pneumonia (HABP) and ventilator-associated bacterial pneumonia (VABP). The pharmacokinetics (PK) and safety of single and multiple doses of murepavadin were investigated in healthy male subjects. Part A of the study was a double-blind, randomized, placebo-controlled, single-ascending-dose investigation in 10 sequential cohorts where each cohort comprised 6 healthy male subjects; 4 subjects were randomized to murepavadin, and 2 subjects were randomized to placebo. Part B was a double-blind, randomized, placebo-controlled, multiple-ascending-dose investigation in 3 sequential cohorts. After a single dose of murepavadin, the geometric mean half-life (2.52 to 5.30 h), the total clearance (80.1 to 114 ml/h/kg), and the volume of distribution (415 to 724 ml/kg) were consistent across dose levels. The pharmacokinetics of the dosing regimens evaluated were dose proportional and linear. Murepavadin was well tolerated, adverse events were transient and generally mild, and no dose-limiting toxicity was identified. Copyright © 2018 American Society for Microbiology.
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Multiple sporadic colorectal cancers display a unique methylation phenotype.
Directory of Open Access Journals (Sweden)
Victoria Gonzalo
Full Text Available Epigenetics are thought to play a major role in the carcinogenesis of multiple sporadic colorectal cancers (CRC. Previous studies have suggested concordant DNA hypermethylation between tumor pairs. However, only a few methylation markers have been analyzed. This study was aimed at describing the epigenetic signature of multiple CRC using a genome-scale DNA methylation profiling. We analyzed 12 patients with synchronous CRC and 29 age-, sex-, and tumor location-paired patients with solitary tumors from the EPICOLON II cohort. DNA methylation profiling was performed using the Illumina Infinium HM27 DNA methylation assay. The most significant results were validated by Methylight. Tumors samples were also analyzed for the CpG Island Methylator Phenotype (CIMP; KRAS and BRAF mutations and mismatch repair deficiency status. Functional annotation clustering was performed. We identified 102 CpG sites that showed significant DNA hypermethylation in multiple tumors with respect to the solitary counterparts (difference in β value ≥0.1. Methylight assays validated the results for 4 selected genes (p = 0.0002. Eight out of 12(66.6% multiple tumors were classified as CIMP-high, as compared to 5 out of 29(17.2% solitary tumors (p = 0.004. Interestingly, 76 out of the 102 (74.5% hypermethylated CpG sites found in multiple tumors were also seen in CIMP-high tumors. Functional analysis of hypermethylated genes found in multiple tumors showed enrichment of genes involved in different tumorigenic functions. In conclusion, multiple CRC are associated with a distinct methylation phenotype, with a close association between tumor multiplicity and CIMP-high. Our results may be important to unravel the underlying mechanism of tumor multiplicity.
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Chronic comorbidities in children with type 1 diabetes : a population-based cohort study
Fazelifarsani, Soulmaz; Souverein, Patrick C|info:eu-repo/dai/nl/243074948; van der Vorst, Marja M J; Knibbe, Catherijne A J; de Boer, Anthonius|info:eu-repo/dai/nl/075097346; Mantel-Teeuwisse, Aukje K|info:eu-repo/dai/nl/266775098
OBJECTIVE: To determine the incidence of chronic comorbidities among children with type 1 diabetes (T1D) and to compare incidences with a group of children without diabetes. DESIGN: Population-based cohort study. SETTING: Dutch PHARMO database (1998-2010). PATIENTS: All patients (<19 years old) with
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Japanese Legacy Cohorts: The Life Span Study Atomic Bomb Survivor Cohort and Survivors’ Offspring
Directory of Open Access Journals (Sweden)
Kotaro Ozasa
2018-04-01
Full Text Available Cohorts of atomic bomb survivors—including those exposed in utero—and children conceived after parental exposure were established to investigate late health effects of atomic bomb radiation and its transgenerational effects by the Atomic Bomb Casualty Commission (ABCC in the 1950s. ABCC was reorganized to the Radiation Effects Research Foundation (RERF in 1975, and all work has been continued at RERF. The Life Span Study, the cohort of survivors, consists of about 120,000 subjects and has been followed since 1950. Cohorts of in utero survivors and the survivors’ children include about 3,600 and 77,000 subjects, respectively, and have been followed since 1945. Atomic bomb radiation dose was estimated for each subject based on location at the time of the bombing and shielding conditions from exposure, which were obtained through enormous efforts of investigators and cooperation of subjects. Outcomes include vital status, cause of death, and cancer incidence. In addition, sub-cohorts of these three cohorts were constructed to examine clinical features of late health effects, and the subjects have been invited to periodic health examinations at clinics of ABCC and RERF. They were also asked to donate biosamples for biomedical investigations. Epidemiological studies have observed increased radiation risks for malignant diseases among survivors, including those exposed in utero, and possible risks for some non-cancer diseases. In children of survivors, no increased risks due to parental exposure to radiation have been observed for malignancies or other diseases, but investigations are continuing, as these cohorts are still relatively young.
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Japanese Legacy Cohorts: The Life Span Study Atomic Bomb Survivor Cohort and Survivors' Offspring.
Ozasa, Kotaro; Grant, Eric J; Kodama, Kazunori
2018-04-05
Cohorts of atomic bomb survivors-including those exposed in utero-and children conceived after parental exposure were established to investigate late health effects of atomic bomb radiation and its transgenerational effects by the Atomic Bomb Casualty Commission (ABCC) in the 1950s. ABCC was reorganized to the Radiation Effects Research Foundation (RERF) in 1975, and all work has been continued at RERF. The Life Span Study, the cohort of survivors, consists of about 120,000 subjects and has been followed since 1950. Cohorts of in utero survivors and the survivors' children include about 3,600 and 77,000 subjects, respectively, and have been followed since 1945. Atomic bomb radiation dose was estimated for each subject based on location at the time of the bombing and shielding conditions from exposure, which were obtained through enormous efforts of investigators and cooperation of subjects. Outcomes include vital status, cause of death, and cancer incidence. In addition, sub-cohorts of these three cohorts were constructed to examine clinical features of late health effects, and the subjects have been invited to periodic health examinations at clinics of ABCC and RERF. They were also asked to donate biosamples for biomedical investigations. Epidemiological studies have observed increased radiation risks for malignant diseases among survivors, including those exposed in utero, and possible risks for some non-cancer diseases. In children of survivors, no increased risks due to parental exposure to radiation have been observed for malignancies or other diseases, but investigations are continuing, as these cohorts are still relatively young.
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Japanese Legacy Cohorts: The Life Span Study Atomic Bomb Survivor Cohort and Survivors’ Offspring
Grant, Eric J; Kodama, Kazunori
2018-01-01
Cohorts of atomic bomb survivors—including those exposed in utero—and children conceived after parental exposure were established to investigate late health effects of atomic bomb radiation and its transgenerational effects by the Atomic Bomb Casualty Commission (ABCC) in the 1950s. ABCC was reorganized to the Radiation Effects Research Foundation (RERF) in 1975, and all work has been continued at RERF. The Life Span Study, the cohort of survivors, consists of about 120,000 subjects and has been followed since 1950. Cohorts of in utero survivors and the survivors’ children include about 3,600 and 77,000 subjects, respectively, and have been followed since 1945. Atomic bomb radiation dose was estimated for each subject based on location at the time of the bombing and shielding conditions from exposure, which were obtained through enormous efforts of investigators and cooperation of subjects. Outcomes include vital status, cause of death, and cancer incidence. In addition, sub-cohorts of these three cohorts were constructed to examine clinical features of late health effects, and the subjects have been invited to periodic health examinations at clinics of ABCC and RERF. They were also asked to donate biosamples for biomedical investigations. Epidemiological studies have observed increased radiation risks for malignant diseases among survivors, including those exposed in utero, and possible risks for some non-cancer diseases. In children of survivors, no increased risks due to parental exposure to radiation have been observed for malignancies or other diseases, but investigations are continuing, as these cohorts are still relatively young. PMID:29553058
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Use of fertility drugs and risk of ovarian cancer: Danish Population Based Cohort Study
DEFF Research Database (Denmark)
Jensen, Allan; Sharif, Heidi; Frederiksen, Kirsten
2009-01-01
OBJECTIVE: To examine the effects of fertility drugs on overall risk of ovarian cancer using data from a large cohort of infertile women. DESIGN: Population based cohort study. SETTING: Danish hospitals and private fertility clinics. PARTICIPANTS: 54,362 women with infertility problems referred...... confounding factors. RESULTS: Analyses within cohort showed no overall increased risk of ovarian cancer after any use of gonadotrophins (rate ratio 0.83, 95% confidence interval 0.50 to 1.37), clomifene (1.14, 0.79 to 1.64), human chorionic gonadotrophin (0.89, 0.62 to 1.29), or gonadotrophin releasing...... hormone (0.80, 0.42 to 1.51). Furthermore, no associations were found between all four groups of fertility drugs and number of cycles of use, length of follow-up, or parity. CONCLUSION: No convincing association was found between use of fertility drugs and risk of ovarian cancer....
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Occupational factors and reproductive outcomes among a cohort of female veterinarians.
Wilkins, J R; Steele, L L
1998-07-01
To estimate absolute and relative risks of preterm delivery (PTD) and small-for-gestational-age (SGA) births among a cohort of female veterinarians in relation to selected occupational factors, including clinical practice type (CPT). Retrospective cohort survey. 2,997 female graduates from US veterinary colleges between 1970 and 1980. Relevant health and occupational data were collected through a self-administered mail questionnaire with telephone follow-up of nonrespondents. Absolute and relative risks of PTD and SGA births were estimated in relation to maternal CPT at the time of conception and exposure to 13 occupational factors. Attempts were made to control confounding by use of multiple logistic regression analyses. Absolute and relative risks of PTD were highest for veterinarians employed in exclusively equine clinical practice. Although several increased, none of the CPT-specific relative risk estimates were significantly different from the null value of 1. Exposure-specific analyses indicated that occupational involvement with solvents among exclusively small animal practitioners was associated with the highest relative risk of PTD. A small number of SGA births limited information that could be obtained from these analyses. Overall absolute risks of PTD and SGA births among cohort members were much lower in comparison with the general female population. Given the large number of women currently practicing and entering the profession of veterinary medicine, clinical tasks associated with potential reproductive hazards should be approached with heightened awareness and increased caution, especially activities that may involve exposure to solvents.
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Is Child Abuse Associated with Adolescent Obesity? A Population Cohort Study.
Hawton, Katherine; Norris, Tom; Crawley, Esther; Shield, Julian P H
Child abuse is associated with obesity in adulthood through multiple mechanisms. However, little is known about the relationship between abuse and obesity during adolescence. The aim of this study was to investigate, using a birth cohort, whether there is an association between child abuse and overweight or obesity in adolescence. This study utilizes data from the Avon Longitudinal Study of Parents and Children, a prospective cohort study based in South West England. Using data from the 4205 children with complete data at 13 and 16 years, we analyzed body mass index (BMI) and anonymous parental report of abuse. Abuse was categorized as emotional, physical, or sexual. A sub-sample of 3429 had BMI recorded at 18 years, enabling a longitudinal analysis of BMI trajectories. Using linear and logistic regression analysis, adjusting for sex and family adversity, no association was found between child abuse and BMI, BMI Z-scores, overweight, or obesity, at 13 or 16 years, with all confidence intervals straddling the null. There was weak evidence of a negative association between physical and emotional abuse and BMI trajectories between 13 and 18 years. No relationship was found between child abuse and adolescent obesity in this cohort. This challenges the assumption that adolescent obesity is linked to previous child abuse, as demonstrated for obesity in adult life. A further longitudinal study utilizing both parental and child reports with data record linkage, to improve reporting of abuse, and including neglect as an abuse category, would be desirable.
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Nested Cohort - R software package
NestedCohort is an R software package for fitting Kaplan-Meier and Cox Models to estimate standardized survival and attributable risks for studies where covariates of interest are observed on only a sample of the cohort.
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Towards personalized therapy for multiple sclerosis: prediction of individual treatment response.
Kalincik, Tomas; Manouchehrinia, Ali; Sobisek, Lukas; Jokubaitis, Vilija; Spelman, Tim; Horakova, Dana; Havrdova, Eva; Trojano, Maria; Izquierdo, Guillermo; Lugaresi, Alessandra; Girard, Marc; Prat, Alexandre; Duquette, Pierre; Grammond, Pierre; Sola, Patrizia; Hupperts, Raymond; Grand'Maison, Francois; Pucci, Eugenio; Boz, Cavit; Alroughani, Raed; Van Pesch, Vincent; Lechner-Scott, Jeannette; Terzi, Murat; Bergamaschi, Roberto; Iuliano, Gerardo; Granella, Franco; Spitaleri, Daniele; Shaygannejad, Vahid; Oreja-Guevara, Celia; Slee, Mark; Ampapa, Radek; Verheul, Freek; McCombe, Pamela; Olascoaga, Javier; Amato, Maria Pia; Vucic, Steve; Hodgkinson, Suzanne; Ramo-Tello, Cristina; Flechter, Shlomo; Cristiano, Edgardo; Rozsa, Csilla; Moore, Fraser; Luis Sanchez-Menoyo, Jose; Laura Saladino, Maria; Barnett, Michael; Hillert, Jan; Butzkueven, Helmut
2017-09-01
Timely initiation of effective therapy is crucial for preventing disability in multiple sclerosis; however, treatment response varies greatly among patients. Comprehensive predictive models of individual treatment response are lacking. Our aims were: (i) to develop predictive algorithms for individual treatment response using demographic, clinical and paraclinical predictors in patients with multiple sclerosis; and (ii) to evaluate accuracy, and internal and external validity of these algorithms. This study evaluated 27 demographic, clinical and paraclinical predictors of individual response to seven disease-modifying therapies in MSBase, a large global cohort study. Treatment response was analysed separately for disability progression, disability regression, relapse frequency, conversion to secondary progressive disease, change in the cumulative disease burden, and the probability of treatment discontinuation. Multivariable survival and generalized linear models were used, together with the principal component analysis to reduce model dimensionality and prevent overparameterization. Accuracy of the individual prediction was tested and its internal validity was evaluated in a separate, non-overlapping cohort. External validity was evaluated in a geographically distinct cohort, the Swedish Multiple Sclerosis Registry. In the training cohort (n = 8513), the most prominent modifiers of treatment response comprised age, disease duration, disease course, previous relapse activity, disability, predominant relapse phenotype and previous therapy. Importantly, the magnitude and direction of the associations varied among therapies and disease outcomes. Higher probability of disability progression during treatment with injectable therapies was predominantly associated with a greater disability at treatment start and the previous therapy. For fingolimod, natalizumab or mitoxantrone, it was mainly associated with lower pretreatment relapse activity. The probability of
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Hak, E; Wei, F; Grobbee, D E; Nichol, K L
OBJECTIVE: In the absence of trial results that are applicable to the target population, nested case-control studies might be an alternative to full-cohort analysis. We compared relative and absolute estimates of associations in an influenza vaccine study using both designs. STUDY DESIGN AND
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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
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Abandonment of nicotine dependence treatment: A cohort study
Directory of Open Access Journals (Sweden)
Maritza Muzzi Cardozo Pawlina
Full Text Available CONTEXT AND OBJECTIVE: Non-adherence to treatment is one of the hindering factors in the process of smoking cessation. This study aimed to compare sociodemographic characteristics, smoking status and motivation among smokers who maintained or abandoned treatment to stop smoking, and to analyze associations between sociodemographic factors and smoking. DESIGN AND SETTING: Cohort study on 216 smokers who were attended at healthcare units in Cuiabá, Mato Grosso. METHODS: The instruments used were the Fagerström, URICA and CAGE questionnaires. Data from the initial evaluation was analyzed using the two-proportion test (α < 0.05. The patients were monitored for six months and those who abandoned treatment were accounted for. Bivariate analysis was conducted, using crude prevalence ratios and 5% significance level (P < 0.05, with abandonment of treatment as the outcome variable. Associations with P < 0.20 were selected for multiple robust Poisson regression (RPa. RESULTS: The abandonment rate was 34.26%. Males and individuals in the 20-39 age group, in employment, with low motivation, with shorter time smoking and lower tobacco intake predominated in the dropout group. In the final model, gender (RPa 1.47; 95% CI: 1.03-2.10 and age group (RPa 3.77; 95% CI: 1.47-9.67 remained associated with abandonment. CONCLUSION: Males and individuals in the 20-39 age group, in employment, with low motivation, with shorter time smoking and lower tobacco intake more frequently abandoned the treatment. Male gender and younger age group were associated with abandonment of nicotine dependence treatment.
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A nationwide registry-based cohort study of incidence of tonsillectomy in Denmark, 1991-2012
DEFF Research Database (Denmark)
Juul, Marie Louise; Rasmussen, Eva Rye; Rasmussen, Stig Hebbelstrup Rye
2018-01-01
OBJECTIVE: To update tonsillectomy incidence rates in Denmark and identify whether the incidence rates vary between geographical areas in the country during the period 1991-2012. DESIGN: This was a retrospective nationwide cohort study using data from the comprehensive Danish patient registries. ...
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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
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Ferguson, C J; Meehan, D C
2011-01-01
Discussions and debate about youth smoking, alcohol use, and illegal substance use (collectively referred to as youth substance use) continue to receive wide attention among researchers, policymakers, and the general public. Previous research has suggested that peer delinquency is a particularly strong correlate of youth substance use. The current study focuses on the influence of delinquent peers on substance use, and how peer delinquency influences change across age cohorts of youth. The current study examines multiple correlates for youth substance use in a sample of 8,256 youth (mean age 14), with the goal of identifying the influence of delinquent peers across age cohorts while controlling for other correlates. Data was collected from the Ohio version of the Youth Risk Behavior Surveillance System (YRBSS) developed by the Centers for Disease Control. Results from multiple regression analyses identified peer delinquency as the strongest correlate of youth substance use even when other relevant factors related to family, neighborhood, and media use were controlled. Correlations between peer delinquency and substance use behavior increased across age cohorts and for individuals who first used in middle teen years (13-16) irrespective of current age. Age appears to be a moderating factor regarding the correlation between peer delinquency and youth substance abuse. Primary and secondary prevention and intervention strategies that focus on peers are potentially more likely to reduce youth substance use and improve peer relationships than those focused on other areas such as schools or media. Copyright © 2010 Elsevier Masson SAS. All rights reserved.
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Reedijk, M.; Lenters, V.; Slottje, P.; Pijpe, A.; Peeters, P.H.; Korevaar, J.C.; Bueno-de-Mesquita, B.; Verschuren, W.M.M.; Verheij, R.A.; Pieterson, I.; Leeuwen, F.E. van; Rookus, M.A.; Kromhout, H.; Vermeulen, R.C.H.
2017-01-01
Purpose LIFEWORK is a large federated prospective cohort established in the Netherlands to quantify the health effects of occupational and environmental exposures. This cohort is also the Dutch contribution to the international Cohort Study of Mobile Phone Use and Health (COSMOS). In this paper, we
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Multiple myeloma among atomic bomb survivors, Hiroshima and Nagasaki, 1950 - 76
International Nuclear Information System (INIS)
Ichimaru, Michito; Ishimaru, Toranosuke; Mikami, Motoko; Matsunaga, Masako.
1979-10-01
The relationship between atomic bomb exposure and the occurrence of multiple myeloma has been evaluated in a fixed cohort of approximately 100,000 A-bomb survivors and nonexposed controls during the period from October 1950 to December 1976. Analysis of these data revealed the standardized relative risk adjusted for city, sex, and age at the time of the bombs (ATB) to be significantly greater in the group of individuals who received 100 rad or more of radiation than in their controls. An excess risk became apparent in the high dose group about 20 years after exposure. The excess risk of multiple myeloma in those persons aged 20 - 59 ATB is estimated to be approximately 0.24 per million person-years per rad (PYR) in kerma dose and approximately 0.48 per million PYR in bone marrow dose. The interval between radiation exposure and the occurrence of an excess risk for multiple myeloma in the high dose population is considerably longer than that for leukemia. The cases of multiple myeloma observed in the high dose group showed no unusual clinical features. (author)
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Directory of Open Access Journals (Sweden)
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
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Wong, Anselm; Sivilotti, Marco L A; Graudins, Andis
2017-06-01
The paracetamol-aminotransferase multiplication product (APAP × ALT) is a risk predictor of hepatotoxicity that is somewhat independent of time and type of ingestion. However, its accuracy following ingestion of modified-release formulations is not known, as the product has been derived and validated after immediate-release paracetamol overdoses. The aim of this retrospective cohort study was to evaluate the accuracy of the multiplication product to predict hepatotoxicity in a cohort of patients with modified-release paracetamol overdose. We assessed all patients with modified-release paracetamol overdose presenting to our hospital network from October 2009 to July 2016. Ingestion of a modified-release formulation was identified by patient self-report or retrieval of the original container. Hepatotoxicity was defined as peak alanine aminotransferase ≥1000 IU/L, and acute liver injury (ALI) as a doubling of baseline ALT to more than 50 IU/L. Of 1989 paracetamol overdose presentations, we identified 73 modified-release paracetamol exposures treated with acetylcysteine. Five patients developed hepatotoxicity, including one who received acetylcysteine within eight hours of an acute ingestion. No patient with an initial multiplication product paracetamol overdose treated with acetylcysteine, the paracetamol-aminotransferase multiplication product demonstrated similar accuracy and temporal profile to previous reports involving mostly immediate-release formulations. Above a cut-point of 10,000 mg/L × IU/L, it was very strongly associated with the development of acute liver injury and hepatotoxicity, especially when calculated more than eight hours post-ingestion. When below 1500 mg/L × IU/L the likelihood of developing hepatotoxicity was very low. Persistently high serial multiplication product calculations were associated with the greatest risk of hepatotoxicity.
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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.
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Seong, Sang Cheol; Kim, Yeon-Yong; Park, Sue K; Khang, Young Ho; Kim, Hyeon Chang; Park, Jong Heon; Kang, Hee-Jin; Do, Cheol-Ho; Song, Jong-Sun; Lee, Eun-Joo; Ha, Seongjun; Shin, Soon Ae; Jeong, Seung-Lyeal
2017-09-24
The National Health Insurance Service-Health Screening Cohort (NHIS-HEALS) is a cohort of participants who participated in health screening programmes provided by the NHIS in the Republic of Korea. The NHIS constructed the NHIS-HEALS cohort database in 2015. The purpose of this cohort is to offer relevant and useful data for health researchers, especially in the field of non-communicable diseases and health risk factors, and policy-maker. To construct the NHIS-HEALS database, a sample cohort was first selected from the 2002 and 2003 health screening participants, who were aged between 40 and 79 in 2002 and followed up through 2013. This cohort included 514 866 health screening participants who comprised a random selection of 10% of all health screening participants in 2002 and 2003. The age-standardised prevalence of anaemia, diabetes mellitus, hypertension, obesity, hypercholesterolaemia and abnormal urine protein were 9.8%, 8.2%, 35.6%, 2.7%, 14.2% and 2.0%, respectively. The age-standardised mortality rate for the first 2 years (through 2004) was 442.0 per 100 000 person-years, while the rate for 10 years (through 2012) was 865.9 per 100 000 person-years. The most common cause of death was malignant neoplasm in both sexes (364.1 per 100 000 person-years for men, 128.3 per 100 000 person-years for women). This database can be used to study the risk factors of non-communicable diseases and dental health problems, which are important health issues that have not yet been fully investigated. The cohort will be maintained and continuously updated by the NHIS. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
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Gilsing, Anne M J; Weijenberg, Matty P; Goldbohm, R Alexandra; Dagnelie, Pieter C; van den Brandt, Piet A; Schouten, Leo J
2013-11-29
Vegetarian diets have been associated with lower risk of chronic disease, but little is known about the health effects of low meat diets and the reliability of self-reported vegetarian status. We aimed to establish an analytical cohort over-represented with vegetarians, pescetarians and 1 day/week meat consumers, and to describe their lifestyle and dietary characteristics. In addition, we were able to compare self-reported vegetarians with vegetarians whose status has been confirmed by their response on the extensive food frequency questionnaire (FFQ). Embedded within the Netherlands Cohort Study (n = 120,852; including 1150 self-reported vegetarians), the NLCS-Meat Investigation Cohort (NLCS-MIC) was defined by combining all FFQ-confirmed-vegetarians (n = 702), pescetarians (n = 394), and 1 day/week meat consumers (n = 1,396) from the total cohort with a random sample of 2-5 days/week- and 6-7 days/week meat consumers (n = 2,965 and 5,648, respectively). Vegetarians, pescetarians, and 1 day/week meat consumers had more favorable dietary intakes (e.g., higher fiber/vegetables) and lifestyle characteristics (e.g. lower smoking rates) compared to regular meat consumers in both sexes. Vegetarians adhered to their diet longer than pescetarians and 1 day/week meat consumers. 75% of vegetarians with a prevalent cancer at baseline had changed to this diet after diagnosis. 50% of self-reported vegetarians reported meat or fish consumption on the FFQ. Although the misclassification that occurred in terms of diet and lifestyle when merely relying on self-reporting was relatively small, the impact on associations with disease risk remains to be studied. We established an analytical cohort over-represented with persons at the lower end of the meat consumption spectrum which should facilitate prospective studies of major cancers and causes of death using ≥20.3 years of follow-up.
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Environmental exposure assessment in European birth cohorts: results from the ENRIECO project
Directory of Open Access Journals (Sweden)
Gehring Ulrike
2013-01-01
Full Text Available Abstract Environmental exposures during pregnancy and early life may have adverse health effects. Single birth cohort studies often lack statistical power to tease out such effects reliably. To improve the use of existing data and to facilitate collaboration among these studies, an inventory of the environmental exposure and health data in these studies was made as part of the ENRIECO (Environmental Health Risks in European Birth Cohorts project. The focus with regard to exposure was on outdoor air pollution, water contamination, allergens and biological organisms, metals, pesticides, smoking and second hand tobacco smoke (SHS, persistent organic pollutants (POPs, noise, radiation, and occupational exposures. The review lists methods and data on environmental exposures in 37 European birth cohort studies. Most data is currently available for smoking and SHS (N=37 cohorts, occupational exposures (N=33, outdoor air pollution, and allergens and microbial agents (N=27. Exposure modeling is increasingly used for long-term air pollution exposure assessment; biomonitoring is used for assessment of exposure to metals, POPs and other chemicals; and environmental monitoring for house dust mite exposure assessment. Collaborative analyses with data from several birth cohorts have already been performed successfully for outdoor air pollution, water contamination, allergens, biological contaminants, molds, POPs and SHS. Key success factors for collaborative analyses are common definitions of main exposure and health variables. Our review emphasizes that such common definitions need ideally be arrived at in the study design phase. However, careful comparison of methods used in existing studies also offers excellent opportunities for collaborative analyses. Investigators can use this review to evaluate the potential for future collaborative analyses with respect to data availability and methods used in the different cohorts and to identify potential partners
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Directory of Open Access Journals (Sweden)
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.
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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.
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Socioeconomic status and stomach cancer incidence in men: Results from the Netherlands Cohort Study
Loon, A.J.M. van; Goldbohm, R.A.; Brandt, P.A. van den
1998-01-01
Study objective - To study the association between socioeconomic status (SES) and stomach cancer incidence (cardia and non-cardia) and the role of lifestyle factors in explaining this association. Design - Prospective cohort study on diet and cancer that started in 1986. Data were collected by means
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Cognitive Implications of Deep Gray Matter Iron in Multiple Sclerosis.
Fujiwara, E; Kmech, J A; Cobzas, D; Sun, H; Seres, P; Blevins, G; Wilman, A H
2017-05-01
Deep gray matter iron accumulation is increasingly recognized in association with multiple sclerosis and can be measured in vivo with MR imaging. The cognitive implications of this pathology are not well-understood, especially vis-à-vis deep gray matter atrophy. Our aim was to investigate the relationships between cognition and deep gray matter iron in MS by using 2 MR imaging-based iron-susceptibility measures. Forty patients with multiple sclerosis (relapsing-remitting, n = 16; progressive, n = 24) and 27 healthy controls were imaged at 4.7T by using the transverse relaxation rate and quantitative susceptibility mapping. The transverse relaxation rate and quantitative susceptibility mapping values and volumes (atrophy) of the caudate, putamen, globus pallidus, and thalamus were determined by multiatlas segmentation. Cognition was assessed with the Brief Repeatable Battery of Neuropsychological Tests. Relationships between cognition and deep gray matter iron were examined by hierarchic regressions. Compared with controls, patients showed reduced memory ( P processing speed ( P = .02) and smaller putamen ( P deep gray matter iron accumulation in the current multiple sclerosis cohort. Atrophy and iron accumulation in deep gray matter both have negative but separable relationships to cognition in multiple sclerosis. © 2017 by American Journal of Neuroradiology.
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Case series and descriptive cohort studies in neurosurgery: the confusion and solution.
Esene, Ignatius N; Ngu, Julius; El Zoghby, Mohamed; Solaroglu, Ihsan; Sikod, Anna M; Kotb, Ali; Dechambenoit, Gilbert; El Husseiny, Hossam
2014-08-01
Case series (CS) are well-known designs in contemporary use in neurosurgery but are sometimes used in contexts that are incompatible with their true meaning as defined by epidemiologists. This inconsistent, inappropriate and incorrect use, and mislabeling impairs the appropriate indexing and sorting of evidence. Using PubMed, we systematically identified published articles that had "case series" in the "title" in 15 top-ranked neurosurgical journals from January 2008 to December 2012. The abstracts and/or full articles were scanned to identify those with descriptions of the principal method as being "case series" and then classified as "true case series" or "non-case series" by two independent investigators with 100 % inter-rater agreement. Sixty-four articles had the label "case series" in their "titles." Based on the definition of "case series" and our appraisal of the articles using Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines, 18 articles (28.13 %) were true case series, while 46 (71.87 %) were mislabeled. Thirty-five articles (54.69 %) mistook retrospective (descriptive) cohorts for CS. CS are descriptive with an outcome-based sampling, while "descriptive cohorts" have an exposure-based sampling of patients, followed over time to assess outcome(s). A comparison group is not a defining feature of a cohort study and distinguishes descriptive from analytic cohorts. A distinction between a case report, case series, and descriptive cohorts is absolutely necessary to enable the appropriate indexing, sorting, and application of evidence. Researchers need better training in methods and terminology, and editors and reviewers should scrutinize more carefully manuscripts claiming to be "case series" studies.
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Kerkhoff, Andrew D.; Wood, Robin; Cobelens, Frank G.; Gupta-Wright, Ankur; Bekker, Linda-Gail; Lawn, Stephen D.
2015-01-01
Low haemoglobin concentrations may be predictive of incident tuberculosis (TB) and death in HIV-infected patients receiving antiretroviral therapy (ART), but data are limited and inconsistent. We examined these relationships retrospectively in a long-term South African ART cohort with multiple
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Cohort profile: seek, test, treat and retain United States criminal justice cohort.
Chandler, Redonna; Gordon, Michael S; Kruszka, Bridget; Strand, Lauren N; Altice, Frederick L; Beckwith, Curt G; Biggs, Mary L; Cunningham, William; Chris Delaney, J A; Flynn, Patrick M; Golin, Carol E; Knight, Kevin; Kral, Alex H; Kuo, Irene; Lorvick, Jennifer; Nance, Robin M; Ouellet, Lawrence J; Rich, Josiah D; Sacks, Stanley; Seal, David; Spaulding, Anne; Springer, Sandra A; Taxman, Faye; Wohl, David; Young, Jeremy D; Young, Rebekah; Crane, Heidi M
2017-05-16
The STTR treatment cascade provides a framework for research aimed at improving the delivery of services, care and outcomes of PLWH. The development of effective approaches to increase HIV diagnoses and engage PLWH in subsequent steps of the treatment cascade could lead to earlier and sustained ART treatment resulting in viral suppression. There is an unmet need for research applying the treatment cascade to improve outcomes for those with criminal justice involvement. The Seek, Test, Treat, and Retain (STTR) criminal justice (CJ) cohort combines data from 11 studies across the HIV treatment cascade that focused on persons involved in the criminal justice system, often but not exclusively for reasons related to substance use. The studies were conducted in a variety of CJ settings and collected information across 11 pre-selected domains: demographic characteristics, CJ involvement, HIV risk behaviors, HIV and/or Hepatitis C infections, laboratory measures of CD4 T-cell count (CD4) and HIV RNA viral load (VL), mental illness, health related quality of life (QoL), socioeconomic status, health care access, substance use, and social support. The STTR CJ cohort includes data on 11,070 individuals with and without HIV infection who range in age from 18 to 77 years, with a median age at baseline of 37 years. The cohort reflects racial, ethnic and gender distributions in the U.S. CJ system, and 64% of participants are African-American, 12% are Hispanic and 83% are men. Cohort members reported a wide range of HIV risk behaviors including history of injection drug use and, among those who reported on pre-incarceration sexual behaviors, the prevalence of unprotected sexual intercourse ranged across studies from 4% to 79%. Across all studies, 53% percent of the STTR CJ cohort reported recent polysubstance use. The STTR CJ cohort is comprised of participants from a wide range of CJ settings including jail, prison, and community supervision who report considerable diversity in
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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.
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Towards a privacy preserving cohort discovery framework for clinical research networks.
Yuan, Jiawei; Malin, Bradley; Modave, François; Guo, Yi; Hogan, William R; Shenkman, Elizabeth; Bian, Jiang
2017-02-01
empirical results indicate that the proposed PPCD can execute cohort discovery queries in a reasonable amount of time, with query runtime in the range of 165-262s for the 3 use cases, with zero compromise in accuracy. We further show that the search performance is practical because it supports a highly parallelized design for secure evaluation over encrypted records. Additionally, our security analysis shows that the proposed construction is resilient to standard adversaries. PPCD services can be designed for clinical research networks. The security construction presented in this work specifically achieves high privacy guarantees by preventing both threats originating from within and beyond the network. Copyright © 2016 Elsevier Inc. All rights reserved.
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Institute of Scientific and Technical Information of China (English)
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.
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Study on the multiple cancer in A-bomb survivors
International Nuclear Information System (INIS)
Wakabayashi, Toshiro; Yamamoto, Tsutomu.
1984-01-01
Autopsy data from cohort studies performed on A-bomb victims revealed that the incidence rate of multiple cancer was 7.8% (193 of 2,472 cancer A-bomb victims), being higher than that (5.8%) found from the tumor registry in Hiroshima and Nagasaki. Multiple cancer occurred more frequently in women than in men in both Nagasaki and Hiroshima. The incidence of multiple cancer was 1.5 times higher in the victims exposed to more than 100 rad (Vsub(+) group) than in those exposed to less than one rad (V 0 group), suggesting that there might be dose-response relationship, although this was not statistically significant between the exposed groups. According to the organs, relative risk ratio of developing cancer in the Vsub(+) group to that in the V 0 group was high in the colon and rectum, bladder, lungs, and testes in men; in the thyroid gland, lungs, colon and rectum, bladder, and breast in women, although no statistically significant differences were observed between the groups. This was suggestive of cancer that arises frequently in the lungs of men in the Vsub(+) group. Occult cancer of the thyroid gland and testes was also discussed in relation to the incidence of multiple cancer. (Namekawa, K.)
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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.
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Prenatal Phthalate Exposures and Childhood Fat Mass in a New York City Cohort.
Buckley, Jessie P; Engel, Stephanie M; Mendez, Michelle A; Richardson, David B; Daniels, Julie L; Calafat, Antonia M; Wolff, Mary S; Herring, Amy H
2016-04-01
Experimental animal studies and limited epidemiologic evidence suggest that prenatal exposure to phthalates may be obesogenic, with potential sex-specific effects of phthalates having anti-androgenic activity. We aimed to assess associations between prenatal phthalate exposures and childhood fat mass in a prospective cohort study. We measured phthalate metabolite concentrations in third-trimester maternal urine in a cohort of women enrolled in New York City between 1998 and 2002 (n = 404). Among 180 children (82 girls and 98 boys), we evaluated body composition using a Tanita scale at multiple follow-up visits between ages 4 and 9 years (363 total visits). We estimated associations of standard deviation differences or tertiles of natural log phthalate metabolite concentrations with percent fat mass using linear mixed-effects regression models with random intercepts for repeated outcome measurements. We assessed associations in multiple metabolite models and adjusted for covariates including prepregnancy body mass index, gestational weight gain, maternal smoking during pregnancy, and breastfeeding. We did not observe associations between maternal urinary phthalate concentrations and percent body fat in models examining continuous exposures. Fat mass was 3.06% (95% CI: -5.99, -0.09%) lower among children in the highest tertile of maternal urinary concentrations of summed di(2-ethylhexyl) phthalate (ΣDEHP) metabolites than in children in the lowest tertile. Though estimates were imprecise, there was little evidence that associations between maternal urinary phthalate concentrations and percent fat mass were modified by child's sex. Prenatal phthalate exposures were not associated with increased body fat among children 4-9 years of age, though high prenatal DEHP exposure may be associated with lower fat mass in childhood. Buckley JP, Engel SM, Mendez MA, Richardson DB, Daniels JL, Calafat AM, Wolff MS, Herring AH. 2016. Prenatal phthalate exposures and childhood fat
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Olsen, Sjurdur F; Birgisdottir, Bryndis Eva; Halldorsson, Thorhallur I; Brantsaeter, Anne Lise; Haugen, Margaretha; Torjusen, Hanne; Petersen, Sesilje B; Strøm, Marin; Meltzer, Helle Margrete
2014-11-01
To elucidate the research possibilities when merging data on maternal diet from the Danish National Birth Cohort (DNBC) and the Norwegian Mother and Child Cohort Study (MoBa), through comparison of (i) the methodology used for dietary assessment and (ii) the estimated intake of selected food groups in the two cohorts. Qualitative and quantitative comparison of the two dietary databases. Two national prospective pregnancy cohorts. Denmark, Norway. Comparison of food intake using food frequency questionnaires (FFQs). The FFQs had overlapping time windows and a majority of the questions in the two FFQs were comparable. Calculation principles shared similar features, including the software used and use of global questions to calibrate intakes of different food groups. A total of 63 food groups were defined that could be compared across the two cohorts; these were further aggregated down to 31 broader groups. A comparison of food intakes (grams/d) showed 39, 74 and 141% lower daily intakes of fish, potatoes and rice, respectively, in DNBC vs. MoBa and 39, 54 and 65% higher daily intakes of milk, butter and potatoes in DNBC vs. MoBa. For most other food groups, differences in consumption data were below 20%. The two FFQs are to a large extent compatible and substantial differences in dietary habits were observed between the two cohorts. This may strengthen studies using pooled analysis to examine diet-disease relations. This is a conclusion of great importance given the colossal and costly task involved to establish each of these two cohorts. © 2014 Nordic Federation of Societies of Obstetrics and Gynecology.
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Extending Data Worth Analyses to Select Multiple Observations Targeting Multiple Forecasts.
Vilhelmsen, Troels N; Ferré, Ty P A
2017-09-15
Hydrological models are often set up to provide specific forecasts of interest. Owing to the inherent uncertainty in data used to derive model structure and used to constrain parameter variations, the model forecasts will be uncertain. Additional data collection is often performed to minimize this forecast uncertainty. Given our common financial restrictions, it is critical that we identify data with maximal information content with respect to forecast of interest. In practice, this often devolves to qualitative decisions based on expert opinion. However, there is no assurance that this will lead to optimal design, especially for complex hydrogeological problems. Specifically, these complexities include considerations of multiple forecasts, shared information among potential observations, information content of existing data, and the assumptions and simplifications underlying model construction. In the present study, we extend previous data worth analyses to include: simultaneous selection of multiple new measurements and consideration of multiple forecasts of interest. We show how the suggested approach can be used to optimize data collection. This can be used in a manner that suggests specific measurement sets or that produces probability maps indicating areas likely to be informative for specific forecasts. Moreover, we provide examples documenting that sequential measurement election approaches often lead to suboptimal designs and that estimates of data covariance should be included when selecting future measurement sets. © 2017, National Ground Water Association.
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Design and Design Thinking in Business and Management Higher Education
Matthews, Judy; Wrigley, Cara
2017-01-01
Design and design thinking have been identified as making valuable contributions to business and management, and the numbers of higher education programs that teach design thinking to business students, managers and executives are growing. However multiple definitions of design thinking and the range of perspectives have created some confusion…
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Testicular cancer risk and maternal parity: a population-based cohort study.
Westergaard, T; Andersen, P K; Pedersen, J B; Frisch, M; Olsen, J H; Melbye, M
1998-04-01
The aim was to study, in a population-based cohort design, whether first-born sons run a higher risk of testicular cancer than later born sons; to investigate whether this difference in risk was affected by birth cohort, age of the son, maternal age, interval to previous delivery and other reproductive factors; and, finally, to evaluate to what extent changes in women's parity over time might explain the increasing incidence of testicular cancer. By using data from the Civil Registration System, a database was established of all women born in Denmark since 1935 and all their children alive in 1968 or born later. Sons with testicular cancer were identified in the Danish Cancer Registry. Among 1015994 sons followed for 15981 967 person-years, 626 developed testicular cancer (443 non-seminomas, 183 seminomas). Later born sons had a decreased risk of testicular cancer (RR = 0.80, 95% CI = 0.67-0.95) compared with first-born sons. The RR was 0.79 (95% CI = 0.64-0.98) for non-seminomas and 0.81 (95% CI = 0.58-1.13) for seminomas. There was no association between testicular cancer risk and overall parity of the mother, maternal or paternal age at the birth of the son, or maternal age at first birth. The decreased risk of testicular cancer among later born sons was not modified by age, birth cohort, interval to the previous birth, sex of the first-born child, or maternal age at birth of the son or at first birth. The increased proportion of first-borns from birth cohort 1946 to birth cohort 1969 only explained around 3% of an approximated two-fold increase in incidence between the cohorts. Our data document a distinctly higher risk of testicular cancer in first-born compared with later born sons and suggest that the most likely explanation should be sought among exposures in utero. The increase in the proportion of first-borns in the population has only contributed marginally to the increase in testicular cancer incidence.