Investigating genetic architecture of complex traits in ancestrally diverse populations is imperative to understand the etiology of disease. However, the current paucity of genetic research in people ...of African and Latin American ancestry, Hispanic and indigenous peoples in the United States is likely to exacerbate existing health disparities for many common diseases. The Population Architecture using Genomics and Epidemiology, Phase II (PAGE II), Study was initiated in 2013 by the National Human Genome Research Institute to expand our understanding of complex trait loci in ethnically diverse and well characterized study populations. To meet this goal, the Multi-Ethnic Genotyping Array (MEGA) was designed to substantially improve fine-mapping and functional discovery by increasing variant coverage across multiple ethnicities at known loci for metabolic, cardiovascular, renal, inflammatory, anthropometric, and a variety of lifestyle traits. Studying the frequency distribution of clinically relevant mutations, putative risk alleles, and known functional variants across multiple populations will provide important insight into the genetic architecture of complex diseases and facilitate the discovery of novel, sometimes population-specific, disease associations. DNA samples from 51,650 self-identified African ancestry (17,328), Hispanic/Latino (22,379), Asian/Pacific Islander (8,640), and American Indian (653) and an additional 2,650 participants of either South Asian or European ancestry, and other reference panels have been genotyped on MEGA by PAGE II. MEGA was designed as a new resource for studying ancestrally diverse populations. Here, we describe the methodology for selecting trait-specific content for use in multi-ethnic populations and how enriching MEGA for this content may contribute to deeper biological understanding of the genetic etiology of complex disease.
The primary objective of this article was to describe recruitment, data collection, and methods for a longitudinal, multicenter study involving children with bilateral mild to severe hearing loss. ...The goals of this research program were to characterize the developmental outcomes of children with mild to severe bilateral hearing loss during infancy and the preschool years. Furthermore, the researchers examined how these outcomes were associated with the child's hearing loss and how home background and clinical interventions mediated and moderated these outcomes.
The participants in this study were children who are hard of hearing (CHH) and children with normal hearing (CNH) who provided comparison data. CHH were eligible for participation if (1) their chronological age was between 6 months and 7 years of age at the time of recruitment, (2) they had a better-ear pure-tone average of 25 to 75 dB HL, (3) they had not received a cochlear implant, (4) they were from homes where English was the primary language, and (5) they did not demonstrate significant cognitive or motor delays. Across the time span of recruitment, 430 parents of potential children with hearing loss made contact with the research group. This resulted in 317 CHH who qualified for enrollment. In addition, 117 CNH qualified for enrollment. An accelerated longitudinal design was used, in which multiple age cohorts were followed long enough to provide overlap. Specifically, children were recruited and enrolled continuously across an age span of 6.5 years and were followed for at least 3 years. This design allowed for tests of time (period) versus cohort age effects that could arise by changes in services and technology over time, yet still allowed for examination of important developmental relationships.
The distribution of degree of hearing loss for the CHH showed that the majority of CHH had moderate or moderate-to-severe hearing losses, indicating that the sample undersampled children with mild HL. For mothers of both CHH and CNH, the distribution of maternal education level showed that few mothers lacked at least a high school education and a slight majority had completed a bachelor's degree, suggesting that this sample of research volunteers was more advantaged than the United States population. The test battery consisted of a variety of measures concerning participants' hearing and behavioral development. These data were gathered in sessions during which the child was examined by an audiologist and a speech-language examiner. In addition, questionnaires concerning the child's behavior and development were completed by the parents.
The Outcomes of Children with Hearing Loss study was intended to examine the relationship between variation in hearing ability across children with normal and mild to severe hearing loss and variation in their outcomes across several domains of development. In addition, the research team sought to document important mediators and moderators that act between the hearing loss and the outcomes. Because the study design provided for the examination of outcomes throughout infancy and early childhood, it was necessary to employ a number of different measures of the same construct to accommodate changes in developmental performance across age. This resulted in a large matrix of measures across variable types and developmental levels, as described in this manuscript.
Purpose: Because of uncertainty about the level of hearing where hearing aids should be provided to children, the goal of the current study was to develop audibility-based hearing aid candidacy ...criteria based on the relationship between unaided hearing and language outcomes in a group of children with hearing loss who did not wear hearing aids. Method: Unaided hearing and language outcomes were examined for 52 children with mild-to-severe hearing losses. A group of 52 children with typical hearing matched for age, nonverbal intelligence, and socioeconomic status was included as a comparison group representing the range of optimal language outcomes. Two audibility-based criteria were considered: (a) the level of unaided hearing where unaided children with hearing loss fell below the median for children with typical hearing and (b) the level of unaided hearing where the slope of language outcomes changed significantly based on an iterative, piecewise regression modeling approach. Results: The level of unaided audibility for children with hearing loss that was associated with differences in language development from children with typical hearing or based on the modeling approach varied across outcomes and criteria but converged at an unaided speech intelligibility index of 80. Conclusions: Children with hearing loss who have unaided speech intelligibility index values less than 80 may be at risk for delays in language development without hearing aids. The unaided speech intelligibility index potentially could be used as a clinical criterion for hearing aid fitting candidacy for children with hearing loss.
Among the many potential risk factors influencing the development of bronchiolitis obliterans syndrome (BOS), acute cellular rejection is the most frequently identified. Despite the unique ...susceptibility of the lung allograft to pathogens, the association with respiratory tract infections remains unclear. In this study we analyze the role respiratory tract infections have on the development of BOS after lung transplantation.
Data from a single center were analyzed from 161 lung recipients transplanted from November 1990 to November 2005, and who survived >180 days. Univariate and multivariate Cox regression analyses were performed using BOS development and the time-scale was reported with hazard ratios (HRs) and confidence intervals (CIs).
Significant findings by univariate analysis per 100 patient-days prior to BOS onset included acute rejection, cytomegalovirus (CMV) pneumonitis, Gram-negative respiratory tract infections, Gram-positive respiratory tract infections and fungal pneumonias. Multivariate analysis indicated acute rejection, Gram-negative, Gram-positive and fungal pneumonias with HRs (CI) of 84 (23 to 309), 6.6 (1.2 to 37), 6,371 (84 to 485,000) and 314 (53 to 1,856) to be associated with BOS, respectively. Acute rejection, CMV pneumonitis, Gram-positive pneumonia and fungal pneumonitis in the first 100 days had HRs (CI) of 1.8 (1.1 to 3.2), 3.1 (1.3 to 6.9), 3.8 (1.5 to 9.4) and 2.1 (1.1 to 4.0), respectively, and acute rejection and fungal pneumonitis in the late post-operative period with HRs (CI) of 2.3 (1.2 to 4.4) and 1.5 (1.1 to 1.9), respectively.
In addition to acute rejection, pneumonias with GP, GN and fungal pathogens occurring prior to BOS are independent determinants of chronic allograft dysfunction. Early recognition and treatment of these pathogens in lung transplant recipients may improve long-term outcomes after transplantation.
Postoperative urinary incontinence after robot-assisted radical prostatectomy (RARP) represents a bothersome side effect, which may permanently affect patient's quality of life. Several studies have ...demonstrated that obstructive sleep apnea syndrome (OSAS) is associated with urinary symptoms such as urge incontinence, overactive bladder, and nocturia. In this study, we sought to further explore the effect of OSAS on urinary continence after RARP.
We queried our prospectively collected institutional RARP database and identified 82 patients with OSAS and 131 controls, which were matched for age and body mass index (BMI), with available follow-up data for continence. To minimize selection bias, we conducted a propensity score-matched analysis. Patient's characteristics and urinary continence outcomes were compared between the two groups before and after propensity-score matching. Kaplan-Meier curves were constructed to assess the difference in continence between the two groups. Results are presented as means with standard deviations and percentages with 95% confidence intervals (CIs).
A total of 213 patients were included in the analysis, of whom 82 with OSAS and 131 with non-OSAS (control group). The mean age of the total cohort was 61.7 ± 6.96 years, the mean BMI was 30.4 ± 5.36, and 52% of the cohort were classified as obese (BMI ≥30). In post-propensity score-matched analyses, there was no significant difference in baseline demographics and tumor characteristics between the two groups (included 82 cases in each group). The median time to continence was 6.6 months for the control group as compared with 13.0 months for the OSAS group (
< 0.001). At 12 months the continence rate for the OSAS group was 41.2% (95% CI: 28.9%-51.4%) as compared with 61.7% (95% CI: 28.5%-71.5%) for the control group. At 24 months the continence rate for the OSAS group was 68.7% (95% CI: 56%-77.7%) as compared with 90.8% (95% CI: 79%-96%) for the control group.
On matched analysis, we found that patients with OSAS tended to demonstrate worse urinary continence recovery as compared with patients without OSAS. Additional investigation will be necessary to confirm these initial findings.
Ectopic lipid storage is implicated in type 2 diabetes pathogenesis; hence, exercise to deplete stores (i.e., at the intensity that allows for maximal rate of lipid oxidation; MLO) might be optimal ...for restoring metabolic health. This intensity (“Fatmax”) is estimated during incremental exercise (“Fatmax test”). However, in “the field” general recommendations exist regarding a range of percentages of maximal heart rate (HR) to elicit MLO. The degree to which this range is aligned with measured Fatmax has not been investigated. We compared measured HR at Fatmax, with maximal HR percentages within the typically recommended range in a sample of 26 individuals (Female: n = 11, European ancestry: n = 17).
Subjects completed a modified Fatmax test with a 5-min warmup, followed by incremental stages starting at 15 W with work rate increased by 15 W every 5 min until termination criteria were reached. Pulmonary gas exchange was recorded and average values for V˙ o2 and V˙ co2 for the final minute of each stage were used to estimate substrate-oxidation rates. We modeled lipid-oxidation kinetics using a sinusoidal model and expressed MLO relative to peak V˙ o2 and HR. Bland-Altman analysis demonstrated lack of concordance between HR at Fatmax and at 50%, 70%, and 80% of age-predicted maximum with a mean difference of 23 b·min−1.
Our results indicate that estimated “fat-burning” heart rate zones are inappropriate for prescribing exercise to elicit MLO and we recommend direct individual exercise lipid oxidation measurements to elicit these values.
The purpose of providing amplification for children with hearing loss is to make speech audible across a range of frequencies and intensities. Children with hearing aids (HAs) that closely ...approximate prescriptive targets have better audibility than peers with HA output below prescriptive targets. Poor aided audibility puts children with hearing loss at risk for delays in communication, social, and academic development.
The goals of this study were to determine how well HAs match prescriptive targets across ranges of frequency and intensity of speech and to determine how level- and frequency-dependent deviations from prescriptive target affect speech recognition in quiet and in background noise.
One-hundred sixty-six children with permanent mild to severe hearing loss who were between 6 months and 8 years of age and who wore HAs participated in the study.
Hearing aid verification and speech recognition data were collected as part of a longitudinal study of communication development in children with HAs. Hearing aid output at levels of soft and average speech and maximum power output were compared with each child's prescriptive targets. The deviations from prescriptive target were quantified based on the root-mean-square (RMS) error and absolute deviation from target for octave frequencies. Children were classified into groups based on the number of level-dependent deviations from prescriptive target. Frequency-specific deviations from prescriptive target and sensation levels (SLs) were used to estimate the proximity of fittings across the frequency range. Lexical Neighborhood Test (LNT) word recognition in quiet and Computer-Assisted Speech Perception Assessment (CASPA) phoneme recognition in noise were compared across level-dependent error groups and as a function of SL at 4 kHz.
Children who had deviations from prescriptive target at all three input levels had poorer LNT word recognition in quiet than children who had fittings that matched prescriptive target within 5 dB RMS at all three input levels. Children with lower 4 kHz SLs through their HAs had poorer LNT recognition in quiet and CASPA phoneme recognition in noise than children with higher aided SLs.
Children with HAs fitted to provide audibility for speech across a range of inputs and frequencies had better speech recognition outcomes than peers with HAs that were not optimally fitted to prescriptive targets.
Radio Tomography for Roadside Surveillance Anderson, Christopher R.; Martin, Richard K.; Walker, T. Owens ...
IEEE journal of selected topics in signal processing,
2014-Feb., 2014-2-00, 20140201, Letnik:
8, Številka:
1
Journal Article
Recenzirano
Odprti dostop
Radio tomographic imaging (RTI) has recently been proposed for tracking object location via radio waves without requiring the objects to transmit or receive radio signals. The position is extracted ...by inferring which voxels are obstructing a subset of radio links in a dense wireless sensor network. This paper proposes a variety of modeling and algorithmic improvements to RTI for the scenario of roadside surveillance. These include the use of a more physically motivated weight matrix, a method for mitigating negative (aphysical) data due to noisy observations, and a method for combining frames of a moving vehicle into a single image. The proposed approaches are used to show improvement in both imaging (useful for human-in-the-loop target recognition) and automatic target recognition in a measured data set.
Quasi-experimental.
To explore for associations between demographic, patient history, and physical examination variables and short-term improvement in self-reported disability following dry needling ...therapy performed on individuals with low back pain (LBP).
Dry needling is an intervention used with increasing frequency in patients with LBP; however, the characteristics of patients who are most likely to respond are not known.
Seventy-two volunteers with mechanical LBP participated in the study. Potential prognostic factors were collected from baseline questionnaires, patient history, and physical examination tests. Treatment consisted of dry needling to the lumbar multifidus muscles bilaterally, administered during a single treatment session. Improvement was based on percent change on the Oswestry Disability Index at 1 week. The univariate and multivariate associations between 33 potential prognostic factors and improved disability were assessed with correlation coefficients and multivariate linear regression.
Increased LBP with the multifidus lift test (rpb = 0.31, P = .01) or during passive hip flexion performed with the patient supine (rpb = 0.23, P = .06), as well as positive beliefs about acupuncture/dry needling (rho = 0.22, P = .07), demonstrated univariate associations with Oswestry Disability Index improvement. Aggravation of LBP with standing (rpb = -0.27, P = .03), presence of leg pain (rpb = -0.29, P = .02), and any perception of hypermobility in the lumbar spine (rpb = -0.21, P = .09) were associated with less improvement. The multivariate model identified 2 predictors of improved disability with dry needling: pain with the multifidus lift test and no aggravation with standing (R(2) = 0.16, P = .01).
Increased LBP with the multifidus lift test was the strongest predictor of improved disability after dry needling, suggesting that the finding of pain during muscle contraction should be studied in future dry needling studies.
Prognosis, level 1b.
PDF
