scholarly journals Pilot Study of a Bayesian Approach To Estimate Vancomycin Exposure in Obese Patients with Limited Pharmacokinetic Sampling

2017 ◽  
Vol 61 (5) ◽  
Author(s):  
Joseph J. Carreno ◽  
Ben Lomaestro ◽  
John Tietjan ◽  
Thomas P. Lodise
Keyword(s):  
Medical Center ◽  
Estimation Method ◽  
Area Under The Curve ◽  
Predictive Performance ◽  
Good Precision ◽  
Obese Patients ◽  
Full Data ◽  
Data Set ◽  
The Best Approximation ◽  
The Impact

ABSTRACT This study evaluated the predictive performance of a Bayesian PK estimation method (ADAPT V) to estimate the 24-h vancomycin area under the curve (AUC) with limited pharmacokinetic (PK) sampling in adult obese patients receiving vancomycin for suspected or confirmed Gram-positive infections. This was an Albany Medical Center Institutional Review Board-approved prospective evaluation of 12 patients. Patients had a median (95% confidence interval) age of 61 years (39 to 71 years), a median creatinine clearance of 86 ml/min (75 to 120 ml/min), and a median body mass index of 45 kg/m2 (40 to 52 kg/m2). For each patient, five PK concentrations were measured, and four different vancomycin population PK models were used as Bayesian priors to estimate the vancomycin AUC (AUCFULL). Using each PK model as a prior, data-depleted PK subsets were used to estimate the 24-h AUC (i.e., peak and trough data [AUCPT], midpoint and trough data [AUCMT], and trough-only data [AUCT]). The 24-h AUC derived from the full data set (AUCFULL) was compared to the AUC derived from data-depleted subsets (AUCPT, AUCMT, and AUCT) for each model. For the four sets of analyses, AUCFULL estimates ranged from 437 to 489 mg·h/liter. The AUCPT provided the best approximation of the AUCFULL; AUCMT and AUCT tended to overestimate AUCFULL. Further prospective studies are needed to evaluate the impact of AUC monitoring in clinical practice, but the findings from this study suggest that the vancomycin AUC can be estimated with good precision and accuracy with limited PK sampling using Bayesian PK estimation software.

The impact of obesity on time to recurrence in ovarian cancer: A retrospective study.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 5055-5055
Author(s):  
Karina E Hew ◽  
Arvind Bakhru ◽  
Evan Harrison ◽  
Mehmet Ozhan Turan ◽  
Neil B. Rosenshein
Keyword(s):  
Ovarian Cancer ◽  
Adjuvant Chemotherapy ◽  
Epithelial Ovarian Cancer ◽  
Medical Center ◽  
Progression Free Survival ◽  
Obese Patients ◽  
Free Survival ◽  
Time To Recurrence ◽  
Primary Epithelial Ovarian Cancer ◽  
The Impact

5055 Background: There has been conflicting data regarding the relationship between obesity and progression free survival in patients with ovarian cancer. There has been some evidence to suggest that obesity results in altered tumor biology and a poorer prognosis in these patients. The aim of this study was to examine whether obesity is a risk factor for time to recurrence in primary epithelial ovarian cancer. Methods: A multicenter retrospective chart review was performed at Mercy Medical Center and University of Michigan Medical Center. 591 patients were diagnosed with primary epithelial ovarian cancer between 2004-2009. However, 221 patients were excluded from the analysis because of persistent or progressive disease, treatment with neoadjuvant chemotherapy, presence of synchronous tumors or incomplete follow-up data. 370 patients were eligible for analysis. Data collected included: height and weight at the time of surgery, age, race, medical co-morbid illnesses, tumor stage, grade and histology. Treatment related data such as number of cycles of adjuvant chemotherapy; and optimal versus suboptimal tumor debulking was also collected. Body mass index (BMI) was defined according to WHO 2004 criteria. Women with a BMI greater than 30 were categorized as obese. The diagnosis of recurrence was made by positive radiological or pathological diagnosis of cancer recurrence after patient had surgery, received adjuvant chemotherapy and had no clinical, radiological or serological evidence of recurrence during this time. The time to recurrence was then quantified in terms of months from the initial surgery. Survival analyses were performed with the Kaplan-Meier method and compared using log-rank testing. Time to recurrence was analyzed using Mann-Whitney U and Wilcox W tests. Results: 130 (35%) obese patients were compared with 240 (65%) non obese patients. A recurrence was documented in 125 (47.9%) non obese patients and 49 (37.7%) obese patients. Time to recurrence between both BMI groups was found to be identical, at 15 months (p=1.0). The progression free survival was similar in both obese and non obese subjects (p=0.118). Conclusions: Obesity does not impact the time to recurrence in patients with primary ovarian cancer.

scholarly journals The impact of incongruence and exogenous gene fragments on estimates of the eukaryote root

2021 ◽  
Author(s):  
Caesar Al Jewari ◽  
Sandra L Baldauf
Keyword(s):  
Phylogenetic Analyses ◽  
Single Gene ◽  
Evolutionary Model ◽  
Bootstrap Support ◽  
Gene Trees ◽  
Full Data ◽  
Data Set ◽  
Gene Level ◽  
The Impact ◽  
Exogenous Gene

Phylogenomics uses multiple genetic loci to reconstruct evolutionary trees, under the stipulation that all combined loci share a common phylogenetic history, i.e., they are congruent. Congruence is primarily evaluated via single-gene trees, but these trees invariably lack sufficient signal to resolve deep nodes making it difficult to assess congruence at these levels. Two methods were developed to systematically assess congruence in multi-locus data. Protocol 1 uses gene jackknifing to measure deviation from a central mean to identify taxon-specific incongruencies in the form of persistent outliers. Protocol_2 assesses congruence at the sub-gene level using a sliding window. Both protocols were tested on a controversial data set of 76 mitochondrial proteins previously used in various combinations to assess the eukaryote root. Protocol_1 showed a concentration of outliers in under-sampled taxa, including the pivotal taxon Discoba. Further analysis of Discoba using Protocol_2 detected a surprising number of apparently exogenous gene fragments, some of which overlap with Protocol_1 outliers and others that do not. Phylogenetic analyses of the full data using the static LG-gamma evolutionary model support a neozoan-excavate root for eukaryotes (Discoba sister), which rises to 99-100% bootstrap support with data masked according to either Protocol_1 or Protocol_2. In contrast, site-heterogeneous (mixture) models perform inconsistently with these data, yielding all three possible roots depending on presence/absence/type of masking and/or extent of missing data. The neozoan-excavate root places Amorphea (including animals and fungi) and Diaphoretickes (including plants) as more closely related to each other than either is to Discoba (Jakobida, Heterolobosea, and Euglenozoa), regardless of the presence/absence of additional taxa.

scholarly journals Convolutional Neural Network for Breast and Thyroid Nodules Diagnosis in Ultrasound Imaging

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Xiaowen Liang ◽  
Jinsui Yu ◽  
Jianyi Liao ◽  
Zhiyi Chen
Keyword(s):  
Predictive Value ◽  
Area Under The Curve ◽  
Roc Curves ◽  
Diagnostic Efficiency ◽  
Clinical Value ◽  
Data Set ◽  
Multiple Organs ◽  
Significant Difference ◽  
Segmented Images ◽  
The Impact

Objective. The incidence of superficial organ diseases has increased rapidly in recent years. New methods such as computer-aided diagnosis (CAD) are widely used to improve diagnostic efficiency. Convolutional neural networks (CNNs) are one of the most popular methods, and further improvements of CNNs should be considered. This paper aims to develop a multiorgan CAD system based on CNNs for classifying both thyroid and breast nodules and investigate the impact of this system on the diagnostic efficiency of different preprocessing approaches. Methods. The training and validation sets comprised randomly selected thyroid and breast nodule images. The data were subgrouped into 4 models according to the different preprocessing methods (depending on segmentation and the classification method). A prospective data set was selected to verify the clinical value of the CNN model by comparison with ultrasound guidelines. Diagnostic efficiency was assessed based on receiver operating characteristic (ROC) curves. Results. Among the 4 models, the CNN model using segmented images for classification achieved the best result. For the validation set, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, and area under the curve (AUC) of our CNN model were 84.9%, 69.0%, 62.5%, 88.2%, 75.0%, and 0.769, respectively. There was no statistically significant difference between the CNN model and the ultrasound guidelines. The combination of the two methods achieved superior diagnostic efficiency compared with their use individually. Conclusions. The study demonstrates the probability, feasibility, and clinical value of CAD in the ultrasound diagnosis of multiple organs. The use of segmented images and classification by the nature of the disease are the main factors responsible for the improvement of the CNN model. Moreover, the combination of the CNN model and ultrasound guidelines results in better diagnostic performance, which will contribute to the improved diagnostic efficiency of CAD systems.

scholarly journals Decomposing variation in dairy profitability: the impact of output, inputs, prices, labour and management

2011 ◽  
Vol 149 (4) ◽  
pp. 507-517 ◽  
Author(s):  
P. WILSON
Keyword(s):  
Structural Change ◽  
Holistic Approach ◽  
Herd Size ◽  
Full Data ◽  
Price Variation ◽  
Data Set ◽  
Economic Return ◽  
Net Margin ◽  
The Uk ◽  
The Impact

SUMMARYThe UK dairy sector has undergone considerable structural change in recent years, with a decrease in the number of producers accompanied by an increased average herd size and increased concentrate use and milk yields. One of the key drivers to producers remaining in the industry is the profitability of their herds. The current paper adopts a holistic approach to decomposing the variation in dairy profitability through an analysis of net margin data explained by physical input–output measures, milk price variation, labour utilization and managerial behaviours and characteristics. Data are drawn from the Farm Business Survey (FBS) for England in 2007/08 for 228 dairy enterprises. Average yields are 7100 litres/cow/yr, from a herd size of 110 cows that use 0·56 forage ha/cow/yr and 43·2 labour h/cow/yr. An average milk price of 22·57 pence per litre (ppl) produced milk output of £1602/cow/yr, which after accounting for calf sales, herd replacements and quota leasing costs, gave an average dairy output of £1516/cow/yr. After total costs of £1464/cow/yr this left an economic return of £52/cow/yr (0·73 ppl) net margin profit. There is wide variation in performance, with the most profitable (as measured by net margin per cow) quartile of producers achieving 2000 litres/cow/yr more than the least profitable quartile, returning a net margin of £335/cow/yr compared to a loss of £361/cow/yr for the least profitable. The most profitable producers operate larger, higher yielding herds and achieve a greater milk price for their output. In addition, a significantly greater number of the most profitable producers undertake financial benchmarking within their businesses and operate specialist dairy farms. When examining the full data set, the most profitable enterprises included significantly greater numbers of organic producers. The most profitable tend to have a greater reliance on independent technical advice, but this finding is not statistically significant. Decomposing the variation in net margin performance between the most and least profitable groups, an approximate ratio of 65:23:12 is observed for higher yields: lower costs: higher milk price. This result indicates that yield differentials are the key performance driver in dairy profitability. Lower costs per cow are dominated by the significantly lower cost of farmer and spouse labour per cow of the most profitable group, flowing directly from the upper quartile expending 37·7 labour h/cow/yr in comparison with 58·8 h/cow/yr for the lower quartile. The upper quartile's greater milk price is argued to be achieved through contract negotiations and higher milk quality, and this accounts for 0·12 of the variation in net margin performance. The average economic return to the sample of dairy enterprises in this survey year was less than £6000/farm/yr. However, the most profitable quartile returned an average economic return of approximately £50 000 per farm/yr. Structural change in the UK dairy sector is likely to continue with the least profitable and typically smaller dairy enterprises being replaced by a smaller number of expanding dairy production units.

Application of Fitts' Law to Individuals with Cerebral Palsy

2002 ◽  
Vol 94 (3) ◽  
pp. 883-895 ◽  
Author(s):  
Alison Gump ◽  
Miriam Legare ◽  
Deborah L. Hunt
Keyword(s):  
Cerebral Palsy ◽  
Linear Models ◽  
Motor Behavior ◽  
Error Rates ◽  
Subject Group ◽  
Full Data ◽  
Data Set ◽  
Fitts Law ◽  
The Impact ◽  
Speed Accuracy

Cerebral palsy is a condition that results in motor abnormalities as a direct consequence of injury to the developing brain. Fitts' law, which describes a speed-accuracy tradeoff in visually guided movements, has been shown to characterize the motor behavior of normal subjects during aiming tasks. To assess whether Fitts' law can also describe the aimed movements of persons with cerebral palsy, eight cerebral palsied adults participated in an aimed movement study. 12 targets were used with Indices of Difficulty ranging from 2.19 to 6.00 bits. The impact of Gan and Hoffmann's 1988 ballistic movement factor, A, and Fitts' 1954 Index of Difficulty on subject's movement and reaction times was examined using multivariate linear models. The analysis of the full data set yielded a significant effect of A on movement times and no significant adherence to Fitts' law. However, high error rates that could be the result of oculomotor problems among the subject group were noted, and the method of handling errors had a large effect on the results. Tracking eye position during a Fitts' law task would provide information regarding the effect of oculomotor difficulties on aiming tasks in the cerebral palsied subject group.

scholarly journals SVhound: Detection of future Structural Variation hotspots

2021 ◽  
Author(s):  
Luis Felipe Paulin ◽  
Muthuswamy Raveendran ◽  
Ronald Alan Harris ◽  
Jeffrey Rogers ◽  
Arndt von Haeseler ◽  
...  
Keyword(s):  
Population Level ◽  
Model Organisms ◽  
Average Correlation ◽  
Full Data ◽  
Data Set ◽  
1000 Genomes ◽  
Unique Method ◽  
Project Data ◽  
The Impact

Recent population studies are ever growing in size of samples to investigate the diversity of a given population or species. These studies reveal ever new polymorphism that lead to important insights into the mechanisms of evolution, but are also important for the interpretation of these variations. Nevertheless, while the full catalog of variations across entire species remains unknown, we can predict which regions harbor additional variations that remain hidden and investigate their properties, thereby enhancing the analysis for potentially missed variants. To achieve this we implemented SVhound (https://github.com/lfpaulin/SVhound), which based on a population level SVs dataset can predict regions that harbor novel SV alleles. We tested SVhound using subsets of the 1000 genomes project data and showed that its correlation (average correlation of 2,800 tests r=0.7136) is high to the full data set. Next, we utilized SVhound to investigate potentially missed or understudied regions across 1KGP and CCDG that included multiple genes. Lastly we show the applicability for SVhound also on a small and novel SV call set for rhesus macaque (Macaca mulatta) and discuss the impact and choice of parameters for SVhound. Overall SVhound is a unique method to identify potential regions that harbor hidden diversity in model and non model organisms and can also be potentially used to ensure high quality of SV call sets.

scholarly journals GLP-1 Limits Adipocyte Inflammation and Its Low Circulating Pre-Operative Concentrations Predict Worse Type 2 Diabetes Remission after Bariatric Surgery in Obese Patients

2019 ◽  
Vol 8 (4) ◽  
pp. 479 ◽  
Author(s):  
Maitane Izaguirre ◽  
Javier Gómez-Ambrosi ◽  
Amaia Rodríguez ◽  
Beatriz Ramírez ◽  
Sara Becerril ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Bariatric Surgery ◽  
Area Under The Curve ◽  
Tolerance Test ◽  
Diabetes Remission ◽  
Oral Glucose ◽  
Mrna Levels ◽  
Obese Patients ◽  
The Impact

Objective: Glucagon-like peptide (GLP)-1 has been proposed as a key candidate in glucose improvements after bariatric surgery. Our aim was to explore the role of GLP-1 in surgically-induced type 2 diabetes (T2D) improvement and its capacity to regulate human adipocyte inflammation. Methods: Basal circulating concentrations of GLP-1 as well as during an oral glucose tolerance test (OGTT) were measured in lean and obese volunteers with and without T2D (n = 93). In addition, GLP-1 levels were determined before and after weight loss achieved by Roux-en-Y gastric bypass (RYGB) (n = 77). The impact of GLP-1 on inflammation signalling pathways was also evaluated. Results: We show that the reduced (p < 0.05) circulating levels of GLP-1 in obese T2D patients increased (p < 0.05) after RYGB. The area under the curve was significantly lower in obese patients with (p < 0.01) and without (p < 0.05) T2D compared to lean volunteers while obese patients with T2D exhibited decreased GLP-1 levels at baseline (p < 0.05) and 120 min (p < 0.01) after the OGTT. Importantly, higher (p < 0.05) pre-operative GLP-1 concentrations were found in patients with T2D remission after RYGB. We also revealed that exendin-4, a GLP-1 agonist, downregulated the expression of inflammation-related genes (IL1B, IL6, IL8, TNF) and, conversely, upregulated the mRNA levels of ADIPOQ in human visceral adipocytes. Furthermore, exendin-4 blocked (p < 0.05) LPS-induced inflammation in human adipocytes via downregulating the expression and secretion of key inflammatory markers. Conclusions: Our data indicate that GLP-1 may contribute to glycemic control and exert a role in T2D remission after RYGB. GLP-1 is also involved in limiting inflammation in human visceral adipocytes.

scholarly journals Bibliometric Indicators of Russian Journals by JCR-Science Edition, 1995-2010

Acta Naturae ◽  
2013 ◽  
Vol 5 (3) ◽  
pp. 6-12 ◽  
Author(s):  
A. N. Libkind ◽  
V. A. Markusova ◽  
L. E. Mindeli
Keyword(s):  
Research Performance ◽  
Fold Increase ◽  
Full Data ◽  
Data Set ◽  
Journal Citation Reports ◽  
Time Period ◽  
Subject Categories ◽  
The Subject ◽  
The Impact

A representative empirical bibliometric analysis of Russian journals included in the Journal Citation Reports-Science Edition (JCR-SE) for the time period 19952010 was conducted at the macro level (excluding the subject categories). It was found that the growth in the number of articles covered by JCR (a 1.8-fold increase compared to 1995) is ahead of the growth rates of Russian publications (1.2-fold increase). Hence, the share of Russian articles covered by JCR-SE was down from 2.5% in 1995 to 1.7% in 2010. It was determined that the number of articles published in an average Russian journal reduced by 20% as compared to the number of articles in an average journal of the full data set. These facts could partly shed light on the question why Russian research performance is staggering (approximately 30,000 articles per year), although the coverage of Russian journals has expanded to 150 titles. Over the past 15 years, a twofold increase in the impact factor of the Russian journals has been observed, which is higher than that for the full data set of journals (a 1.4-fold increase). Measures to improve the quality of Russian journals are proposed.

scholarly journals The Impacts of Public Administrative Quality on Profitable Enterprises in Vietnam

2021 ◽  
Vol 2 (5) ◽  
pp. 28-43
Author(s):  
Bac Truong Cong ◽  
Doan Van Hoang
Keyword(s):  
International Development ◽  
Public Administration ◽  
Statistical Significance ◽  
Estimation Method ◽  
The United States ◽  
Negative Effects ◽  
Data Set ◽  
Panel Data Estimation ◽  
The Impact

This study aims to understand the relationship between the quality of public administration and the rate of profitable enterprises by locality in Vietnam in the period 2015 - 2019. With a combined data set from two sources including The first is the Provincial Competitiveness Index (PCI) dataset jointly implemented by the Vietnam Chamber of Commerce and Industry (VCCI) with the support of the United States Agency for International Development (USAID) in Vietnam, the second is the "White Book of Vietnamese Enterprises" compiled and published annually by the General Statistics Office of Vietnam. Combined with panel data estimation method to assess the impact of public administration quality indicators on the rate of profitable enterprises by locality. Research results show that there exists a relationship between the quality of public administration and the rate of profitable enterprises. Especially the indicators of Entry Costs, Policy Bias, and Labor and Training have both positive and negative effects with very strong statistical significance.

scholarly journals Improved Constraints on the Initial-to-final Mass Relation of White Dwarfs Using Wide Binaries

2021 ◽  
Vol 923 (2) ◽  
pp. 181
Author(s):  
Manuel Barrientos ◽  
Julio Chanamé
Keyword(s):  
White Dwarfs ◽  
Main Sequence ◽  
Mass Range ◽  
Mass Relation ◽  
Good Precision ◽  
Full Data ◽  
Data Set ◽  
Final Mass ◽  
Large Dispersion ◽  
Selection Of

Abstract We present observational constraints for the initial-to-final mass relation (IFMR) derived from 11 white dwarfs (WDs) in wide binaries (WBs) that contain a turnoff/subgiant primary. Because the components of WBs are coeval to a good approximation, the age of the WD progenitor can be determined from the study of its wide companion. However, previous works that used WBs to constrain the IFMR suffered from large uncertainties in the initial masses because their main-sequence primaries are difficult to age-date with good precision. Our selection of WBs with slightly evolved primaries avoids this problem by restricting to a region of parameter space where isochrone ages are significantly easier to determine with precision. The WDs of two of our originally selected binaries were found to be close double degenerates and are not used in the IFMR analysis. We obtained more precise constraints than existing ones in the mass range 1–2 M ⊙, corresponding to a previously poorly constrained region of the IFMR. Having introduced the use of turnoff/subgiant–WD binaries, the study of the IFMR is not limited anymore by the precision in initial mass, but now the pressure is on final mass, i.e., the mass of the WD today. Looking at the full data set, our results would suggest a relatively large dispersion in the IFMR at low initial masses. More precise determinations of the mass of the WD components of our targets are necessary for settling this question.

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