Summary Background In patients with non-valvular atrial fibrillation, embolic stroke is thought to be associated with left atrial appendage (LAA) thrombi. We assessed the efficacy and safety of ...percutaneous closure of the LAA for prevention of stroke compared with warfarin treatment in patients with atrial fibrillation. Methods Adult patients with non-valvular atrial fibrillation were eligible for inclusion in this multicentre, randomised non-inferiority trial if they had at least one of the following: previous stroke or transient ischaemic attack, congestive heart failure, diabetes, hypertension, or were 75 years or older. 707 eligible patients were randomly assigned in a 2:1 ratio by computer-generated randomisation sequence to percutaneous closure of the LAA and subsequent discontinuation of warfarin (intervention; n=463) or to warfarin treatment with a target international normalised ratio between 2·0 and 3·0 (control; n=244). Efficacy was assessed by a primary composite endpoint of stroke, cardiovascular death, and systemic embolism. We selected a one-sided probability criterion of non-inferiority for the intervention of at least 97·5%, by use of a two-fold non-inferiority margin. Serious adverse events that constituted the primary endpoint for safety included major bleeding, pericardial effusion, and device embolisation. Analysis was by intention to treat. This study is registered with Clinicaltrials.gov , number NCT00129545. Findings At 1065 patient-years of follow-up, the primary efficacy event rate was 3·0 per 100 patient-years (95% credible interval CrI 1·9–4·5) in the intervention group and 4·9 per 100 patient-years (2·8–7·1) in the control group (rate ratio RR 0·62, 95% CrI 0·35–1·25). The probability of non-inferiority of the intervention was more than 99·9%. Primary safety events were more frequent in the intervention group than in the control group (7·4 per 100 patient-years, 95% CrI 5·5–9·7, vs 4·4 per 100 patient-years, 95% CrI 2·5–6·7; RR 1·69, 1·01–3·19). Interpretation The efficacy of percutaneous closure of the LAA with this device was non-inferior to that of warfarin therapy. Although there was a higher rate of adverse safety events in the intervention group than in the control group, events in the intervention group were mainly a result of periprocedural complications. Closure of the LAA might provide an alternative strategy to chronic warfarin therapy for stroke prophylaxis in patients with non-valvular atrial fibrillation. Funding Atritech.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Gathering labeled data to train well-performing machine learning models is one of the critical challenges in many applications. Active learning aims at reducing the labeling costs by an efficient and ...effective allocation of costly labeling resources. In this article, we propose a decision-theoretic selection strategy that (1) directly optimizes the gain in misclassification error, and (2) uses a Bayesian approach by introducing a conjugate prior distribution to determine the class posterior to deal with uncertainties. By reformulating existing selection strategies within our proposed model, we can explain which aspects are not covered in current state-of-the-art and why this leads to the superior performance of our approach. Extensive experiments on a large variety of datasets and different kernels validate our claims.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Juvenile Anoplopoma fimbria (mean length 16.8 ± 2.2 cm, and mean weight 72.8 ± 5.4 g) were exposed for 2 months with different levels of ammonia (0, 0.25, 0.50, 0.75, 1.00, and 1.25 mg/L). Growth ...performances such as daily length gain, daily weight gain, condition factor, and hepatosomatic index were significantly decreased by ammonia exposure. Hematological parameters such as red blood cell (RBC) count, hematocrit, and hemoglobin were also significantly decreased. In plasma inorganic components, calcium and magnesium were significantly decreased by ammonia exposure. In plasma organic components, there was no alteration in cholesterol and total protein. In enzyme plasma components, glutamic oxalate transaminase (GOT) and glutamic pyruvate transaminase (GPT) were significantly increased. The results of this study indicated that ammonia exposure can induce significant growth reduction and blood biochemistry alterations of A. fimbria.
Children's eating behavior does not necessarily align with dietary recommendations, and there is a need for better understanding the factors underlying their food choices. The aim of this study was ...to investigate children's self-reported reasons for accepting and rejecting foods. A questionnaire was developed with reasons based on prior research and in-depth interviews. A set of various food stimuli covering different types was evaluated by 106 girls and 99 boys aged 10-13 years by checking all reasons that apply (CATA) for either accepting or rejecting them. Results showed gender differences among reasons for both food acceptance and rejection, but also in liking and willingness to re-taste the stimuli. The most common reason for food acceptance was good taste in boys and curiosity in girls; for food rejection they were bad taste, bad smell and dislike of appearance in boys and bad taste, bad smell, dislike of appearance and texture in girls. Overall, boys liked the food stimuli more than girls and were more willing to re-taste them. Future research should focus more on the role of sensory properties in both acceptance and rejection, and the potential of children's curiosity as a driver in tasting foods should be further explored.
Distributional anchor regression Kook, Lucas; Sick, Beate; Bühlmann, Peter
Statistics and computing,
2022/6, Volume:
32, Issue:
3
Journal Article
Peer reviewed
Open access
Prediction models often fail if train and test data do not stem from the same distribution. Out-of-distribution (OOD) generalization to unseen, perturbed test data is a desirable but ...difficult-to-achieve property for prediction models and in general requires strong assumptions on the data generating process (DGP). In a causally inspired perspective on OOD generalization, the test data arise from a specific class of interventions on exogenous random variables of the DGP, called anchors. Anchor regression models, introduced by Rothenhäusler et al. (J R Stat Soc Ser B 83(2):215–246, 2021.
https://doi.org/10.1111/rssb.12398
), protect against distributional shifts in the test data by employing causal regularization. However, so far anchor regression has only been used with a squared-error loss which is inapplicable to common responses such as censored continuous or ordinal data. Here, we propose a distributional version of anchor regression which generalizes the method to potentially censored responses with at least an ordered sample space. To this end, we combine a flexible class of parametric transformation models for distributional regression with an appropriate causal regularizer under a more general notion of residuals. In an exemplary application and several simulation scenarios we demonstrate the extent to which OOD generalization is possible.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Post COVID-19 Syndrome (PCS) is the persistence of symptoms after an infection with SARS-CoV-2 in both hospitalized and non-hospitalized COVID-19 survivors. Exercise was proposed as a rehabilitation ...measure for PCS and early studies focused on patients post-hospital discharge. The objective of this review is to summarize the results of trials investigating exercise interventions in non-hospitalized subjects with PCS and propose practical recommendations concerning safe exercise programming. A literature search in the databases MEDLINE and Scopus was conducted until 26 July 2023 and resulted in seven studies that met the criteria. In total, 935 subjects with PCS were investigated. Exercise enhanced aerobic fitness and physical function and relieved symptoms of dyspnea, fatigue and depression. Participants reported lower Post COVID-19 Functional Status scores post-intervention. The exercise programs were well tolerated with no adverse events. To ensure safety, medical examinations should take place in advance and there should be a regular evaluation of the individual responses to the training. Caution is advised when working with patients suffering from post-exertional malaise or diagnosed with myalgic encephalomyelitis/chronic fatigue syndrome. There is a growing need for additional randomized controlled trials to investigate the effectiveness and safety of exercise in individuals with PCS.
Communication skills among healthcare professionals are a necessary component in ensuring quality outcomes for patients. This report describes the design and curricular implementation of an ...interprofessional escape room, an innovative way to promote communication and positive team dynamics among students. In this interactive, serious game, teams of approximately eight interprofessional participants were provided with a fictitious patient case in a simulated hospital environment. Within a 45-minute time limit, students needed to use objects in the room to solve a series of puzzles to successfully complete the room by addressing all the patient's needs. A facilitated debrief following the activity allowed participants to reflect on their communication skills and teamwork during the experience. A total of thirty students across seven professions piloted the activity, and 181 students across five professions participated in the activity as part of an academic course. Feedback from students was collected on a seven-point Likert scale and revealed the value of an interprofessional escape room in academia. This report, which describes what appears to be the first interprofessional health care escape room within an IPE curriculum, demonstrates the value of the escape room in encouraging teamwork, facilitating communication, and promoting interprofessionalism.
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DOBA, IJS, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
Prostate cancer is one of the most common non-skin cancers in men. Amygdalin is one of the nitrilosides, natural cyanide-containing substances abundant in the seeds of plants of the prunasin family ...that have been used to treat cancers and relieve pain. In particular, D-amygdalin (D-mandelonitrile-β-D-gentiobioside) is known to exhibit selective killing effect on cancer cells. Apoptosis, programmed cell death, is an important mechanism in cancer treatment. In the present study, we prepared the aqueous extract of the amygdalin from Armeniacae semen and investigated whether this extract induces apoptotic cell death in human DU145 and LNCaP prostate cancer cells. In the present results, DU145 and LNCaP cells treated with amygdalin exhibited several morphological characteristics of apoptosis. Treatment with amygdalin increased expression of Bax, a pro-apoptotic protein, decreased expression of Bcl-2, an anti-apoptotic protein, and increased caspase-3 enzyme activity in DU145 and LNCaP prostate cancer cells. Here, we have shown that amygdalin induces apoptotic cell death in human DU145 and LNCaP prostate cancer cells by caspase-3 activation through down-regulation of Bcl-2 and up-regulation of Bax. The present study reveals that amygdalin may offer a valuable option for the treatment of prostate cancers.
As the global resource base is in need to move from fossil towards bio-based raw materials, different supply chains as well as existing technology platforms become increasingly interconnected. The ...therefore needed creation and exchange of new knowledge across scientific disciplines require R&D and target technology development and innovation, linking the knowledge-based bioeconomy to technology and innovation management research. In order to get an overview of the current research landscape dealing with the bioeconomy, a publication analysis is conducted. As the number of empirical studies, particularly in management research, is low, our study reveals that the evolution of the bioeconomy is still on a strategic level. Existing studies focus on knowledge networks, open innovation and technologies applicable across value chains to enable a holistic view on organizing future resource allocation and biomass flows. Scientific research in several dimensions is needed to elaborate the bioeconomy concept to make its implementation manageable.
Value chains, particularly of the agri-food, industrial products and energy sector, will increasingly converge due to the shift to bio-based raw materials leading to a mutual dependence and triggering new material flows and food processing technologies. This paper suggests that essential innovation management related research frames might contribute to a sustainable evolution of the bioeconomy by addressing the major challenges.
•Review of existing research on bioeconomy•Depiction of challenges currently hindering the transition to a bio-based economy•Overview on technology and innovation management related research frames
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
The article presents the result from a Danish survey on access and use of green areas and the impact on experienced stress and obesity. The statistical results indicate that access to a garden or ...short distances to green areas from the dwelling are associated with less stress and a lower likelihood of obesity. The number of visits cannot explain the effects of green areas on the health indicators. It is suggested that the significance of distance to green areas is mainly derived from its correlation with the character of the neighbourhood and its conduciveness to outdoor activities and “healthy” modes of travel.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
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