Promotion of faster weight gain in infants born small for gestational age - Is there an adverse effect on later blood pressure?

Background - Being born small for gestational age is associated with later risk factors for cardiovascular disease, such as high blood pressure. Promotion of postnatal growth has been proposed to ameliorate these effects. There is evidence in animals and infants born prematurely, however, that promotion of growth by increased postnatal nutrition increases rather than decreases later cardiovascular risk. We report the long-term impact of growth promotion in term infants born small for gestational age ( birth weight < 10th percentile).Methods and Results - Blood pressure was measured at 6 to 8 years in 153 of 299 ( 51%) of a cohort of children born small for gestational age and randomly assigned at birth to receive either a standard or a nutrient-enriched formula. The enriched formula contained 28% more protein than standard formula and promoted weight gain. Diastolic and mean ( but not systolic) blood pressure was significantly lower in children assigned to standard compared with nutrient-enriched formula ( unadjusted mean difference for diastolic blood pressure, - 3.2 mm Hg; 95% CI, - 5.8 to - 0.5; P = 0.02) independent of potential confounding factors ( adjusted difference, - 3.5 mm Hg; P = 0.01). In observational analyses, faster weight gain in infancy was associated with higher later blood pressure.Conclusions - In the present randomized study targeted to investigate the effect of early nutrition on long-term cardiovascular health, we found that a nutrient-enriched diet increased later blood pressure. These findings support an adverse effect of relative "overnutrition" in infancy on long-term cardiovascular disease risk, have implications for the early origins of cardiovascular disease hypothesis, and do not support the promotion of faster weight gain in infants born small for gestational age

Variance estimation for the instrumental variables approach to measurement error in generalized linear models

This paper derives and gives explicit formulas for a derived sandwich variance estimate. This variance estimate is appropriate for generalized linear additive measurement error models fitted using instrumental variables. We also generalize the known results for linear regression. As such, this article explains the theoretical justification for the sandwich estimate of variance utilized in the software for measurement error developed under the Small Business Innovation Research Grant (SBIR) by StataCorp. The results admit estimation of variance matrices for measurement error models where there is an instrument for the unknown covariate. Copyright 2003 by StataCorp LP.sandwich estimate of variance, measurement error, White's estimator, robust variance, generalized linear models, instrumental variables

Architectures for block Toeplitz systems

In this paper efficient VLSI architectures of highly concurrent algorithms for the solution of block linear systems with Toeplitz or near-to-Toeplitz entries are presented. The main features of the proposed scheme are the use of scalar only operations, multiplications/divisions and additions, and the local communication which enables the development of wavefront array architecture. Both the mean squared error and the total squared error formulations are described and a variety of implementations are given

An Index to Measure Health Status

In this study we developed a health status index using the commonly recorded health measures by doctors and hospitals. This health status index has a minimum possible value of 7 (the least healthy) and a maximum value of 21 (the healthiest). Using the NHANES data, we explored the relationship of this health status index and nutrient intakes, lifestyle, and demographics of the respondent. Regression results showed that as the age of the respondent, being non-Hispanic black, participants of food stamp programs, high percent of calories that came from fat intakes, high percent of calories in beverages that came from soft drinks, smoking, and on special diets are negatively related to the value of the health status index (i.e., the person became less healthy); household income, college education, eating breakfast, and the amount of exercise are positively related value of the health status index (the person became healthier). These results indicate that the health status index developed in this study had the desired properties.health index, HNANES, nutrients, Food Consumption/Nutrition/Food Safety,

Stepwise transformation of algorithms into array processor architectures by the decomp

A formal approach for the transformation of computation intensive digital signal processing algorithms into suitable array processor architectures is presented. It covers the complete design flow from algorithmic specifications in a high-level programming language to architecture descriptions in a hardware description language. The transformation itself is divided into manageable design steps and implemented in the CAD-tool DECOMP which allows the exploration of different architectures in a short time. With the presented approach data independent algorithms can be mapped onto array processor architectures. To allow this, a known mapping methodology for array processor design is extended to handle inhomogeneous dependence graphs with nonregular data dependences. The implementation of the formal approach in the DECOMP is an important step towards design automation for massively parallel systems

Methodology of a reevaluation of cardiovascular outcomes in the RECORD trial: study design and conduct

Background In 2010, after regulatory review of rosiglitazone licensing, the US Food and Drug Administration (FDA) requested a reevaluation of cardiovascular end points in the RECORD trial.&lt;p&gt;&lt;/p&gt; Methods Automated screening of the original clinical trial database and manual case report form review were performed to identify all potential cardiovascular and noncardiovascular deaths, and nonfatal myocardial infarction (MI) and stroke events. Search techniques were used to find participants lost to follow-up, and sites were queried for additional source documents. Suspected events underwent blinded adjudication using both original RECORD end point definitions and new FDA end point definitions, before analysis by the Duke Clinical Research Institute.&lt;p&gt;&lt;/p&gt; Results The reevaluation effort included an additional 328 person-years of follow-up. Automated screening identified 396 suspected deaths, 2,052 suspected MIs, and 468 suspected strokes. Manual review of documents by Duke Clinical Research Institute clinical events classification (CEC) coordinators identified an additional 31 suspected deaths, 49 suspected MIs, and 28 suspected strokes. There were 127 CEC queries issued requesting additional information on suspected deaths; 43 were closed with no site response, 61 were closed with a response that no additional data were available, and additional data were received for 23. Seventy CEC queries were issued requesting additional information for suspected MI and stroke events; 31 were closed with no site response, 20 were closed with a response that no additional data were available, and 19 resulted in additional data.&lt;p&gt;&lt;/p&gt; Conclusions Comprehensive procedures were used for rigorous event reascertainment and readjudication in a previously completed open-label, global clinical trial. These procedures used in this unique situation were consistent with other common approaches in the field, were enhanced to address the FDA concerns about the original RECORD trial results, and could be considered by clinical trialists designing event readjudication protocols for drug development programs that have been completed.&lt;p&gt;&lt;/p&gt