36 research outputs found
PerfSONAR: A Service Oriented Architecture for Multi-domain Network Monitoring
Abstract. In the area of network monitoring a lot of tools are already available to measure a variety of metrics. However, these tools are often limited to a single administrative domain so that no established methodology for the monitoring of network connections spanning over multiple domains currently exists. In addition, these tools only monitor the network from a technical point of view without providing meaningful network performance indicators for different user groups. These indicators should be derived from the measured basic metrics. In this paper a Service Oriented Architecture is presented which is able to perform multi-domain measurements without being limited to specific kinds of metrics. A Service Oriented Architecture has been chosen as it allows for increased flexibility and scalability in comparison to traditional software engineering techniques. The resulting measurement framework will be applied for measurement
Extrinsic Rewards and Intrinsic Motives: Standard and Behavioral Approaches to Agency and Labor Markets
Employers structure pay and employment relationships to mitigate agency problems. A large literature in economics documents how the resolution of these problems shapes personnel policies and labor markets. For the most part, the study of agency in employment relationships relies on highly stylized assumptions regarding human motivation, e.g., that employees seek to earn as much money as possible with minimal effort. In this essay, we explore the consequences of introducing behavioral complexity and realism into models of agency within organizations. Specifically, we assess the insights gained by allowing employees to be guided by such motivations as the desire to compare favorably to others, the aspiration to contribute to intrinsically worthwhile goals, and the inclination to reciprocate generosity or exact retribution for perceived wrongs. More provocatively, from the standpoint of standard economics, we also consider the possibility that people are driven, in ways that may be opaque even to themselves, by the desire to earn social esteem or to shape and reinforce identity
Design and baseline characteristics of the finerenone in reducing cardiovascular mortality and morbidity in diabetic kidney disease trial
Background: Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials.
Patients and Methods: The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate >= 25 mL/min/1.73 m(2) and albuminuria (urinary albumin-to-creatinine ratio >= 30 to <= 5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level alpha = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure.
Conclusions: FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen.
Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049
Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study
Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28â2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65â3·22], p\textless0·0001), American Society of Anesthesiologists grades 3â5 versus grades 1â2 (2·35 [1·57â3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01â2·39], p=0·046), emergency versus elective surgery (1·67 [1·06â2·63], p=0·026), and major versus minor surgery (1·52 [1·01â2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research
Genetic variation at CYP3A is associated with age at menarche and breast cancer risk : a case-control study
Abstract
Introduction
We have previously shown that a tag single nucleotide polymorphism (rs10235235), which maps to the CYP3A locus (7q22.1), was associated with a reduction in premenopausal urinary estrone glucuronide levels and a modest reduction in risk of breast cancer in women age â€50 years.
Methods
We further investigated the association of rs10235235 with breast cancer risk in a large case control study of 47,346 cases and 47,570 controls from 52 studies participating in the Breast Cancer Association Consortium. Genotyping of rs10235235 was conducted using a custom Illumina Infinium array. Stratified analyses were conducted to determine whether this association was modified by age at diagnosis, ethnicity, age at menarche or tumor characteristics.
Results
We confirmed the association of rs10235235 with breast cancer risk for women of European ancestry but found no evidence that this association differed with age at diagnosis. Heterozygote and homozygote odds ratios (ORs) were OR = 0.98 (95% CI 0.94, 1.01; P = 0.2) and OR = 0.80 (95% CI 0.69, 0.93; P = 0.004), respectively (P
trend = 0.02). There was no evidence of effect modification by tumor characteristics. rs10235235 was, however, associated with age at menarche in controls (P
trend = 0.005) but not cases (P
trend = 0.97). Consequently the association between rs10235235 and breast cancer risk differed according to age at menarche (P
het = 0.02); the rare allele of rs10235235 was associated with a reduction in breast cancer risk for women who had their menarche age â„15 years (ORhet = 0.84, 95% CI 0.75, 0.94; ORhom = 0.81, 95% CI 0.51, 1.30; P
trend = 0.002) but not for those who had their menarche age â€11 years (ORhet = 1.06, 95% CI 0.95, 1.19, ORhom = 1.07, 95% CI 0.67, 1.72; P
trend = 0.29).
Conclusions
To our knowledge rs10235235 is the first single nucleotide polymorphism to be associated with both breast cancer risk and age at menarche consistent with the well-documented association between later age at menarche and a reduction in breast cancer risk. These associations are likely mediated via an effect on circulating hormone levels
"Economic Interests and EU Trade Policy-Making"
Studies of EU trade policymaking often suggest that delegation of trade authority from the national to the European level strengthened the autonomy of public actors in formulating trade policies. Little empirical research, however, has been undertaken to corroborate this contention. To improve on this situation, I carry out two case studies of the EUâs participation in the multilateral trade negotiations known as the Kennedy Round (1964-67) and the Doha Development Agenda (2001 onwards). The analysis reveals that in both cases the EUâs negotiating position was largely in line with the demands voiced by economic interests. Although this finding is no proof of economic interests actually determining EU trade policies, it casts some doubt on the autonomy thesis. I also discuss some factors that indicate that interest group influence may be the most plausible explanation for the finding
"Hard and Soft Bargaining in the EU: Negotiating the Financial Perspective, 2007-2013"
Under which circumstances do governments in intergovernmental negotiations in the EU resort to hard bargaining and when do they opt for soft tactics instead? We present a series of hypotheses that try to respond to this question. These hypotheses suggest variation in the choice of negotiation tactics across countries. A very preliminary analysis of the negotiations concerning the EUâs multi-annual financial framework for the period 2007-2013, which lasted from 2003 until 2006, allows us to examine the plausibility of these hypotheses. Future research along the lines set out in this paper is likely to contribute to the literature on international negotiations, which so far has given little attention to the determinants of negotiation strategies. The research also has the potential to shed new light on the internal workings of the European Council, an increasingly important negotiating forum in the EU
Towards multi-domain monitoring for the european research networks. TERENA Networking Conference
Abstract: We propose the creation of a multi-domain measurement framework with dynamic characteristics identical to that of the network as a whole. Our approach recognises and facilitates the ability of independent network entities to set policies and limits on the use of measurement resources locally while encouraging and facilitating the use of such resources by users interested in network paths that traverse remote administrative domains