150 research outputs found

    Factor copula models for item response data

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    Factor or conditional independence models based on copulas are proposed for multivariate discrete data such as item responses. The factor copula models have interpretations of latent maxima/minima (in comparison with latent means) and can lead to more probability in the joint upper or lower tail compared with factor models based on the discretized multivariate normal distribution (or multidimensional normal ogive model). Details on maximum likelihood estimation of parameters for the factor copula model are given, as well as analysis of the behavior of the log-likelihood. Our general methodology is illustrated with several item response data sets, and it is shown that there is a substantial improvement on existing models both conceptually and in fit to data

    M & L Jaargang 4/3

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    RedactioneelJo Braeken De Sint-Antonius-van-Paduakerk in Brussel. [The Sint-Antonius-van Padua church in Brussels.]Johnny De Meulemeester Aardige aarden monumenten. [(Earthen monuments)]Herman Van den Bossche Het voormalig schoolmuseum en de plantentuin. Michel Thiery in Gent. [The former school museum and botanical school garden Michel Thiery in Ghent.]E. Goedleven - De vlag en het volkslied van de Vlaamse Gemeenschap. [The colours and anthem of the Flemish community.]SummaryM&L Binnenkran

    Prenatal stress exposure is associated with increased dyspnea perception in adulthood

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    The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.Dyspnoea is the aversive cardinal symptom in various prevalent conditions such as respiratory, cardiovascular and neuromuscular diseases and is associated with great individual and socioeconomic burden [1]. Over the past years, several physiological and also psychological factors have been demonstrated to affect the perception of dyspnoea [1, 2]. For example, high levels of anxiety in adulthood were associated with increased dyspnoea perception in patients with asthma or chronic obstructive pulmonary disease (COPD), but also in healthy controls [2]. Moreover, adverse, separation-related experiences in childhood were linked to the subsequent development of increased anxiety and dyspnoea [3]. However, the effects of adverse experiences in early, prenatal life on dyspnoea perception remain widely unknown, although prenatal exposure to maternal stress and anxiety has convincingly been related to the development of other health and behavioural problems later in life, including impairments of the respiratory control system and high anxiety levels [4–9]. Therefore, this study investigated the relationship between prenatal exposure to maternal stress and the perception of dyspnoea in adulthood 28 years later

    Differences between human auditory event-related potentials (AERP) measured at 2 and 4 months after birth

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    Infant auditory event-related potentials (AERP) show a series of marked changes during the first year of life. These AERP changes indicate important advances in early development. The current study examined AERP differences between 2- and 4-month-old infants. An auditory oddball paradigm was delivered to infants with a frequent repetitive tone and three rare auditory events. The three rare events included a shorter than the regular inter-stimulus interval (ISI-deviant), white noise segments, and environmental sounds. The results suggest that the N250 infantile AERP component emerges during this period in response to white noise but not to environmental sounds, possibly indicating a developmental step towards separating acoustic deviance from contextual novelty. The scalp distribution of the AERP response to both the white noise and the environmental sounds shifted towards frontal areas and AERP peak latencies were overall lower in infants at 4 compared to at 2 months of age. These observations indicate improvements in the speed of sound processing and maturation of the frontal attentional network in infants during this period

    Identifying youth-friendly service practices associated with adolescents’ use of reproductive healthcare services in post-conflict Burundi: a cross-sectional study

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    BACKGROUND: Very little is known about reproductive health service (RHS) availability and adolescents’ use of these services in post-conflict settings. Such information is crucial for targeted community interventions that aim to improve quality delivery of RHS and outcomes in post-conflict settings. The objectives of this study therefore was to examine the density of RHS availability; assess spatial patterns of RHC facilities; and identify youth-friendly practices associated with adolescents’ use of services in post-conflict Burundi. METHODS: A cross-sectional survey was conducted from a full census of all facilities (n = 892) and provider interviews in Burundi. Surveyed facilities included all public, private, religious and community association owned-centers and hospitals. At each facility efforts were made to interview the officer-in-charge and a group of his/her staff. We applied both geospatial and non-spatial analyses, to examine the density of RHS availability and density, and to explore the association between youth-friendly practices and adolescents’ use of RHS in post-conflict Burundi. RESULTS: High spatial patterning of distances of RHC facilities was observed, with facilities clustered predominantly in districts exhibiting persistent violence. But, use of services remained undeterred. We further found a stronger association between use of RHS and facility and programming characteristics. Community outreach, designated check-in/exam rooms, educational materials (posters, print, and pictures) in waiting rooms, privacy and confidentiality were significantly associated with adolescents’ use of RHS across all facility types. Cost was associated with use only at religious facilities and youth involvement at private facilities. No significant association was found between provider characteristics and use of RHS at any facility. CONCLUSIONS: Our findings indicate the need to improve youth-friendly service practices in the provision of RHS to adolescents in Burundi and suggest that current approaches to provider training may not be adequate for improving these vital practices. Our mixed methods approach and results are generalizable to other countries and post-conflict settings. In post-conflict settings, the methods can be used to identify service availability and spatial patterns of RHC facilities to plan for targeted service interventions, to increase demand and uptake of services by youth and young adults

    Positive feedback and noise activate the stringent response regulator Rel in mycobacteria

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    Phenotypic heterogeneity in an isogenic, microbial population enables a subset of the population to persist under stress. In mycobacteria, stresses like nutrient and oxygen deprivation activate the stress response pathway involving the two-component system MprAB and the sigma factor, SigE. SigE in turn activates the expression of the stringent response regulator, rel. The enzyme polyphosphate kinase 1 (PPK1) regulates this pathway by synthesizing polyphosphate required for the activation of MprB. The precise manner in which only a subpopulation of bacterial cells develops persistence, remains unknown. Rel is required for mycobacterial persistence. Here we show that the distribution of rel expression levels in a growing population of mycobacteria is bimodal with two distinct peaks corresponding to low (L) and high (H) expression states, and further establish that a positive feedback loop involving the mprAB operon along with stochastic gene expression are responsible for the phenotypic heterogeneity. Combining single cell analysis by flow cytometry with theoretical modeling, we observe that during growth, noise-driven transitions take a subpopulation of cells from the L to the H state within a "window of opportunity" in time preceding the stationary phase. We find evidence of hysteresis in the expression of rel in response to changing concentrations of PPK1. Our results provide, for the first time, evidence that bistability and stochastic gene expression could be important for the development of "heterogeneity with an advantage" in mycobacteria.Comment: Accepted for publication in PLoS On

    Does parallel item content on WOMAC's Pain and Function Subscales limit its ability to detect change in functional status?

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    BACKGROUND: Although the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) is considered the leading outcome measure for patients with osteoarthritis of the lower extremity, recent work has challenged its factorial validity and the physical function subscale's ability to detect valid change when pain and function display different profiles of change. This study examined the etiology of the WOMAC's physical function subscale's limited ability to detect change in the presence of discordant changes for pain and function. We hypothesized that the duplication of some items on the WOMAC's pain and function subscales contributed to this shortcoming. METHODS: Two eight-item physical function scales were abstracted from the WOMAC's 17-item physical function subscale: one contained activities and themes that were duplicated on the pain subscale (SIMILAR-8); the other version avoided overlapping activities (DISSIMILAR-8). Factorial validity of the shortened measures was assessed on 310 patients awaiting hip or knee arthroplasty. The shortened measures' abilities to detect change were examined on a sample of 104 patients following primary hip or knee arthroplasty. The WOMAC and three performance measures that included activity specific pain assessments – 40 m walk test, stair test, and timed-up-and-go test – were administered preoperatively, within 16 days of hip or knee arthroplasty, and at an interval of greater than 20 days following the first post-surgical assessment. Standardized response means were used to quantify change. RESULTS: The SIMILAR-8 did not demonstrate factorial validity; however, the factorial structure of the DISSIMILAR-8 was supported. The time to complete the performance measures more than doubled between the preoperative and first postoperative assessments supporting the theory that lower extremity functional status diminished over this interval. The DISSIMILAR-8 detected this deterioration in functional status; however, no significant change was noted for the SIMILAR-8. The WOMAC pain scale demonstrated a slight reduction in pain and the performance specific pain measures did not reflect a change in pain. All measures showed substantial improvement over the second assessment interval. CONCLUSIONS: These findings support the hypothesis that activity overlap on the pain and function subscales plays a causal role in limiting the WOMAC physical function subscale's ability to detect change
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