Making and Acting Upon Trustworthiness Assessments in Buyer-Supplier Relations

http://deepblue.lib.umich.edu/bitstream/2027.42/51339/1/575.pd

A TECHNIQUE TO ESTIMATE INPUT PRODUCTIVITY FROM FARM DATA

Productivity Analysis,

Role of a plausible nuisance contributor in the declining obesity-mortality risks over time.

CONTEXT: Recent analyses of epidemiological data including the National Health and Nutrition Examination Survey (NHANES) have suggested that the harmful effects of obesity may have decreased over calendar time. The shifting BMI distribution over time coupled with the application of fixed broad BMI categories in these analyses could be a plausible nuisance contributor to this observed change in the obesity-associated mortality over calendar time. OBJECTIVE: To evaluate the extent to which observed temporal changes in the obesity-mortality association may be due to a shifting population distribution for body mass index (BMI), coupled with analyses based on static, broad BMI categories. DESIGN, SETTING, AND PARTICIPANTS: Simulations were conducted using data from NHANES I and III linked with mortality data. Data from NHANES I were used to fit a true model treating BMI as a continuous variable. Coefficients estimated from this model were used to simulate mortality for participants in NHANES III. Hence, the population-level association between BMI and mortality in NHANES III was fixed to be identical to the association estimated in NHANES I. Hazard ratios (HRs) for obesity categories based on BMI for NHANES III with simulated mortality data were compared to the corresponding estimated HRs from NHANES I. MAIN OUTCOME MEASURES: Change in hazard ratios for simulated data in NHANES III compared to observed estimates from NHANES I. RESULTS: On average, hazard ratios for NHANES III based on simulated mortality data were 29.3% lower than the estimates from NHANES I using observed mortality follow-up. This reduction accounted for roughly three-fourths of the apparent decrease in the obesity-mortality association observed in a previous analysis of these data. CONCLUSIONS: Some of the apparent diminution of the association between obesity and mortality may be an artifact of treating BMI as a categorical variable

Title Wave: The Diffusion of the CEO Title throughout the US Corporate Network

http://deepblue.lib.umich.edu/bitstream/2027.42/51340/1/576.pd

Errors in statistical analysis and questionable randomization lead to unreliable conclusions

Dear Editor,We read with interest the paper, “The effect of food service system modifications on staff body mass index in an industrial organization”[1]. We noticed several substantial issues with data and calculations, calling into question the randomized nature of the study and validity of analyses.The distribution of baseline weight was significantly differentbetween groups (p-value = “0.00”). We replicated the test using reported means and standard deviations (SDs) andobtained a p-value of approximately 1.9*10-17. It is extraordinarily unlikely that any variable would be that different between two groups if allocation was truly random. Even it was truly random, the stated method of “the samples were randomly divided into two groups”[1] does not describe the “method used to generate the random allocation sequence” and the “type of randomization; details of any restriction (such as blocking and block size)” details specified by Consolidated Standards of Reporting Trials (CONSORT)[2].Given the large difference in baseline weights, it is unusual that the difference in baseline body mass index (BMI) between groups is not more significant (p=0.032), raising the question of what the groups’ distributions of height were. Both groups have 30 males (58.8%), so sex differences are unlikely to explain this discrepancy. Height was not explicitly reported, but it was possible to estimate height utilizing geometric means from body weight and BMI[3,4]. We calculated the baseline control group geometric mean as 2.04 cm taller than the test group. These calculations also suggest the control group shrunk by 1.26 cm while the test group grew by 1.52 cm over the study. Neither change is explained by rounding error nor seems plausible for adult subjects over 40 days.Because there were no SDs of the change scores reported, we were unable to replicate the reported p-value (0.318) for the between-group test of weight change exactly. However, we were able to consider the pre and post-intervention SDs and calculate possible SDs of within-group change scores for a range of pre-post correlations. The largest p-value possible was 0.1282, calculated when each group had perfect negative pre-post correlation (correlation=-1), which is unlikely. If there was no or a positive correlation, the p-value would be much smaller (p=0.0449 when correlation=0 for each group) and plausibly indicates a significant difference between groups. Therefore, although the published results are impossible the correct analysis could make the intervention appear more effective than reported.The results section describes an initial sample size of 116 with 14 dropping out (p. 115). The tables report the remaining sample size to be 102, but the body of the text reports 101 subjects remained until study completion. It is unclear which values were correct; this lack of clarity also fails CONSORT guidelines[2].Considering that the reported findings are essentially impossible given the stated study design, we encourage the authors to explain the treatment allocationand make the raw data available, or the journal to act according to the Committee on Publication Ethics[5] in situations where findings are unreliabl

Impact of breast cancer subtypes on 3-year survival among adolescent and young adult women.

IntroductionYoung women have poorer survival after breast cancer than do older women. It is unclear whether this survival difference relates to the unique distribution of hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2)-defined molecular breast cancer subtypes among adolescent and young adult (AYA) women aged 15 to 39 years. The purpose of our study was to examine associations between breast cancer subtypes and short-term survival in AYA women, as well as to determine whether the distinct molecular subtype distribution among AYA women explains the unfavorable overall breast cancer survival statistics reported for AYA women compared with older women.MethodsData for 5,331 AYA breast cancers diagnosed between 2005 and 2009 were obtained from the California Cancer Registry. Survival by subtype (triple-negative; HR+/HER2-; HR+/HER2+; HR-/HER2+) and age-group (AYA versus 40- to 64-year-olds) was analyzed with Cox proportional hazards regression with follow-up through 2010.ResultsWith up to 6 years of follow-up and a mean survival time of 3.1 years (SD = 1.5 years), AYA women diagnosed with HR-/HER + and triple-negative breast cancer experienced a 1.6-fold and 2.7-fold increased risk of death, respectively, from all causes (HR-/HER + hazard ratio: 1.55; 95% confidence interval (CI): 1.10 to 2.18; triple-negative HR: 2.75; 95% CI, 2.06 to 3.66) and breast cancer (HR-/HER + hazard ratio: 1.63; 95% CI, 1.12 to 2.36; triple-negative hazard ratio: 2.71; 95% CI, 1.98 to 3.71) than AYA women with HR+/HER2- breast cancer. AYA women who resided in lower socioeconomic status neighborhoods, had public health insurance, and were of Black, compared with White, race/ethnicity experienced worse survival. This race/ethnicity association was attenuated somewhat after adjusting for breast cancer subtypes (hazard ratio, 1.33; 95% CI, 0.98 to 1.82). AYA women had similar all-cause and breast cancer-specific short-term survival as older women for all breast cancer subtypes and across all stages of disease.ConclusionsAmong AYA women with breast cancer, short-term survival varied by breast cancer subtypes, with the distribution of breast cancer subtypes explaining some of the poorer survival observed among Black, compared with White, AYA women. Future studies should consider whether distribution of breast cancer subtypes and other factors, including differential receipt of treatment regimens, influences long-term survival in young compared with older women

A College and Career Readiness Framework for Secondary Students with Disabilities

In this qualitative study, a proposed organizing framework of college and career readiness for secondary students with disabilities was developed based on a synthesis of extant research articulating student success. The original proposed framework included six domains representing academic and nonacademic skills associated with college and career readiness: academic engagement, academic mind-sets, learning processes, critical thinking, social skills, and transition knowledge. Focus groups were conducted to examine perspectives among state-level stakeholders with knowledge and expertise regarding college and career readiness, drop-out prevention, and secondary transition. Through an iterative process, the focus group data were analyzed and the framework was refined based on findings. Implications for practice and suggestions for future research are discussed

Nonlinear aspects of the EEG during sleep in children

Electroencephalograph (EEG) analysis enables the neuronal behavior of a section of the brain to be examined. If the behavior is nonlinear then nonlinear tools can be used to glean information on brain behavior, and aid in the diagnosis of sleep abnormalities such as obstructive sleep apnea syndrome (OSAS). In this paper the sleep EEGs of a set of normal and mild OSAS children are evaluated for nonlinear behaviour. We consider how the behaviour of the brain changes with sleep stage and between normal and OSAS children.Comment: 9 pages, 2 figures, 4 table

Dietary patterns for adults with chronic kidney disease

This is the protocol for a review and there is no abstract. The objectives are as follows: This review will evaluate the benefits and harms of dietary patterns among adults with CKD (any stage including people with end-stage kidney disease (ESKD) treated with dialysis, transplantation or supportive care)

Dietary interventions for adults with chronic kidney disease

Background: Dietary changes are routinely recommended in people with chronic kidney disease (CKD) on the basis of randomised evidence in the general population and non-randomised studies in CKD that suggest certain healthy eating patterns may prevent cardiovascular events and lower mortality. People who have kidney disease have prioritised dietary modifications as an important treatment uncertainty. Objectives: This review evaluated the benefits and harms of dietary interventions among adults with CKD including people with end-stage kidney disease (ESKD) treated with dialysis or kidney transplantation. Search methods: We searched the Cochrane Kidney and Transplant Specialised Register (up to 31 January 2017) through contact with the Information Specialist using search terms relevant to this review. Studies contained in the Specialised Register are identified through search strategies specifically designed for CENTRAL, MEDLINE, and EMBASE; handsearching conference proceedings; and searching the International Clinical Trials Register (ICTRP) Search Portal and ClinicalTrials.gov. Selection criteria: Randomised controlled trials (RCTs) or quasi-randomised RCTs of dietary interventions versus other dietary interventions, lifestyle advice, or standard care assessing mortality, cardiovascular events, health-related quality of life, and biochemical, anthropomorphic, and nutritional outcomes among people with CKD. Data collection and analysis: Two authors independently screened studies for inclusion and extracted data. Results were summarised as risk ratios (RR) for dichotomous outcomes or mean differences (MD) or standardised MD (SMD) for continuous outcomes, with 95% confidence intervals (CI) or in descriptive format when meta-analysis was not possible. Confidence in the evidence was assessed using GRADE. Main results: We included 17 studies involving 1639 people with CKD. Three studies enrolled 341 people treated with dialysis, four studies enrolled 168 kidney transplant recipients, and 10 studies enrolled 1130 people with CKD stages 1 to 5. Eleven studies (900 people) evaluated dietary counselling with or without lifestyle advice and six evaluated dietary patterns (739 people), including one study (191 people) of a carbohydrate-restricted low-iron, polyphenol enriched diet, two studies (181 people) of increased fruit and vegetable intake, two studies (355 people) of a Mediterranean diet and one study (12 people) of a high protein/low carbohydrate diet. Risks of bias in the included studies were generally high or unclear, lowering confidence in the results. Participants were followed up for a median of 12 months (range 1 to 46.8 months). Studies were not designed to examine all-cause mortality or cardiovascular events. In very-low quality evidence, dietary interventions had uncertain effects on all-cause mortality or ESKD. In absolute terms, dietary interventions may prevent one person in every 3000 treated for one year avoiding ESKD, although the certainty in this effect was very low. Across all 17 studies, outcome data for cardiovascular events were sparse. Dietary interventions in low quality evidence were associated with a higher health-related quality of life (2 studies, 119 people: MD in SF-36 score 11.46, 95% CI 7.73 to 15.18; I = 0%). Adverse events were generally not reported. Dietary interventions lowered systolic blood pressure (3 studies, 167 people: MD -9.26 mm Hg, 95% CI -13.48 to -5.04; I = 80%) and diastolic blood pressure (2 studies, 95 people: MD -8.95, 95% CI -10.69 to -7.21; I = 0%) compared to a control diet. Dietary interventions were associated with a higher estimated glomerular filtration rate (eGFR) (5 studies, 219 people: SMD 1.08; 95% CI 0.26 to 1.97; I = 88%) and serum albumin levels (6 studies, 541 people: MD 0.16 g/dL, 95% CI 0.07 to 0.24; I = 26%). A Mediterranean diet lowered serum LDL cholesterol levels (1 study, 40 people: MD -1.00 mmol/L, 95% CI -1.56 to -0.44). Authors' conclusions: Dietary interventions have uncertain effects on mortality, cardiovascular events and ESKD among people with CKD as these outcomes were rarely measured or reported. Dietary interventions may increase health-related quality of life, eGFR, and serum albumin, and lower blood pressure and serum cholesterol levels. Based on stakeholder prioritisation of dietary research in the setting of CKD and preliminary evidence of beneficial effects on risks factors for clinical outcomes, large-scale pragmatic RCTs to test the effects of dietary interventions on patient outcomes are required