651 research outputs found
Energy Efficiency Modeling and Analysis in Wireless Sensor Networks
We propose here an extended linear feedback model, taking the binary exponential backo® mechanism adopted in IEEE 802.15.4 CSMA/CA and analyse the energy consumption issues of the one hop sensor nodes. Numerical results show that the energy consumption in Wireless Sensor Networks (WSNs) can be reduced by applying CSMA protocol with ¯xed contention window size. Besides, an optimal contention window size can achieve the reasonable successful probability of the packet transmission without extra wastage of the battery power
Improving Type 2 Diabetes prevention and care in England - what can healthcare transformation achieve?: A qualitative study
Long-term excess risk of breast cancer after a single breast density measurement.
AIM: Breast density is a risk factor for breast cancer. As density changes across a woman's life span, we studied for how long a single density measurement taken in (post-)menopausal women remains informative. METHODS: We used data from Singaporean women who underwent a single mammography screen at age 50-64 years. For each case with breast cancer diagnosed at screening or in the subsequent 10 years, whether screen detected or diagnosed following symptoms, two age-matched controls were selected. We studied the excess risk of breast cancer, calculated as an odds ratio (OR) with conditional logistic regression and adjusted for body mass index, associated with 26-50% and with 51-100% density compared with ≤25% density by time since screening. RESULTS: In total, 490 women had breast cancer, of which 361 were diagnosed because of symptoms after screening. Women with 51-100% breast density had an excess risk of breast cancer that did not seem to attenuate with time. In 1-3 years after screening, the OR was 2.22 (95% confidence interval [CI]: 1.07-4.61); in 4-6 years after screening, the OR was 4.09 (95% CI: 2.21-7.58), and in 7-10 years after screening, the OR was 5.35 (95% CI: 2.57-11.15). Excess risk with a stable OR of about 2 was also observed for women with 26-50% breast density. These patterns were robust when the analyses were limited to post-menopausal women, non-users of hormonal replacement therapy and after stratification by age at density measurement. CONCLUSION: A single breast density measurement identifies women with an excess risk of breast cancer during at least the subsequent 10 years.Cancer Research UK (grant number: C8162/A16892)Singapore National Medical Research CouncilDepartment of Health Policy Research Programme (106/0001
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Are there valid proxy measures of clinical behaviour?
Background: Accurate measures of health professionals' clinical practice are critically important to guide health policy decisions, as well as for professional self-evaluation and for research-based investigation of clinical practice and process of care. It is often not feasible or ethical to measure behaviour through direct observation, and rigorous behavioural measures are difficult and costly to use. The aim of this review was to identify the current evidence relating to the relationships between proxy measures and direct measures of clinical behaviour. In particular, the accuracy of medical record review, clinician self-reported and patient-reported behaviour was assessed relative to directly observed behaviour.
Methods: We searched: PsycINFO; MEDLINE; EMBASE; CINAHL; Cochrane Central Register of Controlled Trials; science/social science citation index; Current contents (social & behavioural med/clinical med); ISI conference proceedings; and Index to Theses. Inclusion criteria: empirical, quantitative studies; and examining clinical behaviours. An independent, direct measure of behaviour (by standardised patient, other trained observer or by video/audio recording) was considered the 'gold standard' for comparison. Proxy measures of behaviour included: retrospective self-report; patient-report; or chart-review. All titles, abstracts, and full text articles retrieved by electronic searching were screened for inclusion and abstracted independently by two reviewers. Disagreements were resolved by discussion with a third reviewer where necessary.
Results: Fifteen reports originating from 11 studies met the inclusion criteria. The method of direct measurement was by standardised patient in six reports, trained observer in three reports, and audio/video recording in six reports. Multiple proxy measures of behaviour were compared in five of 15 reports. Only four of 15 reports used appropriate statistical methods to compare measures. Some direct measures failed to meet our validity criteria. The accuracy of patient report and chart review as proxy measures varied considerably across a wide range of clinical actions. The evidence for clinician self-report was inconclusive.
Conclusion: Valid measures of clinical behaviour are of fundamental importance to accurately identify gaps in care delivery, improve quality of care, and ultimately to improve patient care. However, the evidence base for three commonly used proxy measures of clinicians' behaviour is very limited. Further research is needed to better establish the methods of development, application, and analysis for a range of both direct and proxy measures of behaviour
Recent translational research: stem cells as the roots of breast cancer
Common phenotypes of cancer and stem cells suggest that breast cancers arise from stem cells. Breast epithelial cells with stem cell phenotypes have been shown to be more susceptible to immortalization and neoplastic transformation. Breast tumor stem cells with CD44(+)/CD24(-/low)Lineage(- )markers have been isolated. The role of these cells in tumor progression and clinical outcome is not clear. The relationship between breast stem cell and tumor stem cell may be elucidated by further studies of carcinogenesis of nonadherent mammosphere cells with stem cell features and by derivation of CD44(+)/CD24(-/low )cells from an adherent breast epithelial stem cell type
Assessing risk of breast cancer in an ethnically South-East Asia population (results of a multiple ethnic groups study)
10.1186/1471-2407-12-529BMC Cancer12-BCMA
Do Asian breast cancer patients have poorer survival than their western counterparts? A comparison between Singapore and Stockholm
10.1186/bcr2219Breast Cancer Research111-BCRR
The Taiwan Birth Panel Study: a prospective cohort study for environmentally- related child health
<p>Abstract</p> <p>Background</p> <p>The Taiwan Birth Panel Study (TBPS) is a prospective follow-up study to investigate the development of child health and disease in relation to in-utero and/or early childhood environmental exposures. The rationale behind the establishment of such a cohort includes the magnitude of potential environmental exposures, the timing of exposure window, fatal and children's susceptibility to toxicants, early exposure delayed effects, and low-level or unknown neurodevelopmental toxicants.</p> <p>Methods</p> <p>A total of 486 mother-infant paired was enrolled from April 2004 to January 2005 in this study. Maternal blood before delivery, placenta and umbilical cord blood at birth, and mothers' urine after delivery were collected. The follow-up was scheduled at birth, 4, 6 months, and 1, 2, 3 and 5 years. The children's blood, urine, hair, and saliva were collected at 2 years of age and children's urine was collected at 5 years of age as well. The study has been approved by the ethical committee of National Taiwan University Hospital. All the subjects signed the inform consent on entering the study and each of the follow up.</p> <p>Results</p> <p>Through this prospective birth cohort, the main health outcomes were focused on child growth, neurodevelopment, behaviour problem and atopic diseases. We investigated the main prenatal and postnatal factors including smoking, heavy metals, perfluorinated chemicals, and non-persistent pesticides under the consideration of interaction of the environment and genes.</p> <p>Conclusions</p> <p>This cohort study bridges knowledge gaps and answers unsolved issues in the low-level, prenatal or postnatal, and multiple exposures, genetic effect modification, and the initiation and progression of "environmentally-related childhood diseases."</p
Global and regional estimates of cancer mortality and incidence by site: II. results for the global burden of disease 2000
BACKGROUND: Mortality estimates alone are not sufficient to understand the true magnitude of cancer burden. We present the detailed estimates of mortality and incidence by site as the basis for the future estimation of cancer burden for the Global Burden of Disease 2000 study. METHODS: Age- and sex- specific mortality envelope for all malignancies by region was derived from the analysis of country life-tables and cause of death. We estimated the site-specific cancer mortality distributions from vital records and cancer survival model. The regional cancer mortality by site is estimated by disaggregating the regional cancer mortality envelope based on the mortality distribution. Estimated incidence-to-mortality rate ratios were used to back calculate the final cancer incidence estimates by site. RESULTS: In 2000, cancer accounted for over 7 million deaths (13% of total mortality) and there were more than 10 million new cancer cases world wide in 2000. More than 60% of cancer deaths and approximately half of new cases occurred in developing regions. Lung cancer was the most common cancers in the world, followed by cancers of stomach, liver, colon and rectum, and breast. There was a significant variations in the distribution of site-specific cancer mortality and incidence by region. CONCLUSIONS: Despite a regional variation, the most common cancers are potentially preventable. Cancer burden estimation by taking into account both mortality and morbidity is an essential step to set research priorities and policy formulation. Also it can used for setting priorities when combined with data on costs of interventions against cancers
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