Comparative Treatment Outcomes for Patients With Idiopathic Subglottic Stenosis.

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked DownloadImportance: Surgical treatment comparisons in rare diseases are difficult secondary to the geographic distribution of patients. Fortunately, emerging technologies offer promise to reduce these barriers for research. Objective: To prospectively compare the outcomes of the 3 most common surgical approaches for idiopathic subglottic stenosis (iSGS), a rare airway disease. Design, setting, and participants: In this international, prospective, 3-year multicenter cohort study, 810 patients with untreated, newly diagnosed, or previously treated iSGS were enrolled after undergoing a surgical procedure (endoscopic dilation [ED], endoscopic resection with adjuvant medical therapy [ERMT], or cricotracheal resection [CTR]). Patients were recruited from clinician practices in the North American Airway Collaborative and an online iSGS community on Facebook. Main outcomes and measures: The primary end point was days from initial surgical procedure to recurrent surgical procedure. Secondary end points included quality of life using the Clinical COPD (chronic obstructive pulmonary disease) Questionnaire (CCQ), Voice Handicap Index-10 (VHI-10), Eating Assessment Test-10 (EAT-10), the 12-Item Short-Form Version 2 (SF-12v2), and postoperative complications. Results: Of 810 patients in this cohort, 798 (98.5%) were female and 787 (97.2%) were white, with a median age of 50 years (interquartile range, 43-58 years). Index surgical procedures were ED (n = 603; 74.4%), ERMT (n = 121; 14.9%), and CTR (n = 86; 10.6%). Overall, 185 patients (22.8%) had a recurrent surgical procedure during the 3-year study, but recurrence differed by modality (CTR, 1 patient [1.2%]; ERMT, 15 [12.4%]; and ED, 169 [28.0%]). Weighted, propensity score-matched, Cox proportional hazards regression models showed ED was inferior to ERMT (hazard ratio [HR], 3.16; 95% CI, 1.8-5.5). Among successfully treated patients without recurrence, those treated with CTR had the best CCQ (0.75 points) and SF-12v2 (54 points) scores and worst VHI-10 score (13 points) 360 days after enrollment as well as the greatest perioperative risk. Conclusions and relevance: In this cohort study of 810 patients with iSGS, endoscopic dilation, the most popular surgical approach for iSGS, was associated with a higher recurrence rate compared with other procedures. Cricotracheal resection offered the most durable results but showed the greatest perioperative risk and the worst long-term voice outcomes. Endoscopic resection with medical therapy was associated with better disease control compared with ED and had minimal association with vocal function. These results may be used to inform individual patient treatment decision-making.Patient-Centered Outcomes Research Institute - PCOR

Some Remarks on Copula Estimation and a New

The purpose of this paper is twofold: Fisrt, we review briefly the methods often used for copula estimation in the context of independent, identically distributed random variables and discuss their use for time series data. Secondly, we propose a new procedure, based on wavelet expansions. The proposed estimators are based on empirical copulas. Simulations and applications to real data are also given

Transfer Function Models with Time-Varying Coefficients

We consider a transfer function model with time-varying coefficients. We propose an estimation procedure, based on the least squares method and wavelet expansions of the time-varying coefficients. We discuss some statistical properties of the estimators and assess the validity of the methodology through a simulation study. We also present an application of the proposed procedure to a real pair of series

Corresponding author. Tel.: 1-510-642-2781; fax: 1-510-642-7892.

This work considers signals whose values are discrete states. It proceeds by expressing the transition probabilities of a nonstationary Markov chain by means of models involving wavelet expansions and then, given part of a realization of such a process, proceeds to estimate the coe$cients of the expansion and the probabilities themselves. Through choice of the number of and which wavelet terms to include, the approach provides a #exible method for handling discretevalued signals in the nonstationary case. In particular, the method appears useful for detecting abrupt or steady changes in the structure of Markov chains and the order of the chains. The method is illustrated by means of data sets concerning music, rainfall and sleep. In the examples both direct and improved estimates are computed. The models include explanatory variables in each case. The approach is implemented by means of statistical programs for "tting generalized linear models. The Markov assumption and the presence of nonstationarity are assessed both by change of deviance and graphically via periodogram plots of residuals. # 2000 Elsevier Science B.V. All rights reserved

Temperature preference can bias parental genome retention during hybrid evolution.

Interspecific hybridization can introduce genetic variation that aids in adaptation to new or changing environments. Here, we investigate how hybrid adaptation to temperature and nutrient limitation may alter parental genome representation over time. We evolved Saccharomyces cerevisiae x Saccharomyces uvarum hybrids in nutrient-limited continuous culture at 15°C for 200 generations. In comparison to previous evolution experiments at 30°C, we identified a number of responses only observed in the colder temperature regime, including the loss of the S. cerevisiae allele in favor of the cryotolerant S. uvarum allele for several portions of the hybrid genome. In particular, we discovered a genotype by environment interaction in the form of a loss of heterozygosity event on chromosome XIII; which species' haplotype is lost or maintained is dependent on the parental species' temperature preference and the temperature at which the hybrid was evolved. We show that a large contribution to this directionality is due to a temperature dependent fitness benefit at a single locus, the high affinity phosphate transporter gene PHO84. This work helps shape our understanding of what forces impact genome evolution after hybridization, and how environmental conditions may promote or disfavor the persistence of hybrids over time

Haar-Fisz estimation of evolutionary wavelet spectra

We propose a new 'Haar–Fisz' technique for estimating the time-varying, piecewise constant local variance of a locally stationary Gaussian time series. We apply our technique to the estimation of the spectral structure in the locally stationary wavelet model. Our method combines Haar wavelets and the variance stabilizing Fisz transform. The resulting estimator is mean square consistent, rapidly computable and easy to implement, and performs well in practice. We also introduce the 'Haar–Fisz transform', a device for stabilizing the variance of scaled χ2-data and bringing their distribution close to Gaussianity

Additional file 1: Figure S1. of The Yin/Yan of CCL2: a minor role in neutrophil anti-tumor activity in vitro but a major role on the outgrowth of metastatic breast cancer lesions in the lung in vivo

Naïve BALB/c neutrophils can kill PyMT (FVB) tumor cells, but CCL2 does not increase killing. PyMT cells from FVB mice seeded with and without naïve BALB/c neutrophils (30 neutrophils: 1 tumor cell), in the absence and presence of CCL2. After 18-h at 37 °C, cells were lysed and luciferase was measured to determine tumor cell killing. Although from a different mouse strain, naïve BALB/c neutrophils were able to kill FVB PyMT tumor cells (p = 0.005). However, CCL2 did not enhance this effect (p = 0.347), Kruskal-Wallis test with Dunn’s test for multiple comparisons. Values are graphed as mean ± SD. Figure S2. Entrainment properties of less aggressive PyMT tumor cells on the metastatic outgrowth of more aggressive TGFβR2 knock out PyMT tumors. Female FVB mice (10 weeks old) were injected with either 15,000 PyMT breast cancer cells (MFP) or PBS (Non-tumor bearing) in the 4th mammary fat pad. Two weeks later either 1 × 106 TGFβR2 knockout PyMT (TbR2KO) breast cancer cells or PBS alone (in 200 μl) were delivered by tail vein injection to mice bearing PyMT tumors or into non-tumor bearing mice (t.v. TbR2KO). Three weeks later, mice were sacrificed and lungs were removed, fixed, H&E stained and the number of metastases counted. Analysis of variance with blocking (two experiments) was performed for an overall comparison (p < 0.001). Tukey’s honestly significant difference (HSD) for multiple comparisons among groups (adj. p = 0.009 for MFP-PBS vs. MFP + TbR2KO, adj. p < 0.001 for MFP-PBS vs. t.v. TbR2KO). NS = not significant, p < 0.1, *p < 0.05, **p < 0.01, ***p < 0.001. Values are graphed as mean ± SD. Figure S3. Intranasal delivery of CCL2 facilitates the recruitment of leukocytes into BAL fluid. 3A. BAL fluid isolated from mice receiving intranasal delivery of CCL2 showed an increase in CD8+ T cells as CCL2 delivery increased from 100 ng to 1000 ng. Data are shown as % CD45+ cells and as % total cells. 3B. BAL fluid from mice receiving intranasal delivery of CCL2 exhibited a trend toward increased numbers of neutrophils and NK cells with increasing concentrations. Data are shown as % live cells in BAL fluid. Figure S4. Blocking antibody to CCL2 reverses the neutrophil killing of 67NR cells in vitro. 67NR cells(T) expressing luciferase were seeded with and without neutrophils (E for effector cells) at a ratio of 30 neutrophils: 1 tumor cell in the presence of control IgG or blocking antibody to CCL2. After an 18-hs at 37 °C, cells were lysed and luciferase was measured to determine tumor cell killing. Anti-CCL2 (50 ng/ml BD Biosciences) reversed the 67NR tumor cell killing of BALB/c TEN, p < 0.01, Student’s t test, n = 5 per group. (PPTX 124 kb