Pregnancy incidence and outcome before and after cervical intraepithelial neoplasia: a retrospective cohort study

We performed a retrospective cohort study of 3530 women treated for cervical intraepithelial neoplasia (CIN) in Helsinki University Central Hospital, Finland, to investigate whether CIN treatment itself affects pregnancy incidence and outcome. We estimated the incidence of live births, miscarriages, extrauterine pregnancies, molar pregnancies, and termination of pregnancies (TOPs) before and after CIN treatment using nationwide registers. Women were followed up until death, emigration, sterilization, or the end of 2004. The comparison of incidence of pregnancy outcomes before and after the treatment was estimated by calculating hazard ratios (HRs) with conditional Poisson regression. After 76,162 woman-years of follow-up, the incidence of any pregnancy remained constant over CIN-treatment, HR 1.02 and 95% confidence interval (CI) 0.97-1.08, but the incidence of the first pregnancy was significantly elevated after treatment, HR 1.13, and 95% CI 1.03-1.23. The incidence of live births was significantly elevated after treatment, HR 1.08 and 95% CI 1.01-1.15. Incidence of miscarriages, TOPs, extrauterine pregnancies, and molar pregnancies was not elevated. TOPs was significantly increased in the first pregnancy, HR 1.40, 95% CI 1.15-1.72 and after treatment by the loop electrosurgical excision procedure (LEEP), HR 1.36, 95% CI 1.15-1.60. CIN treatment did not reduce pregnancy incidence and women had more live births after than before CIN treatment. TOPs was more common in the first pregnancy or after treatment by LEEP. We encourage research on the psychosocial consequences of CIN treatment also in other countries and settings

Approaches to predicting life expectancy in elderly coronary artery disease patients with comorbid conditions

The aim of the study was to develop a model for predicting the probability of survival up to 80 years of age for elderly and senile patients with coronary artery disease (CAD) and concomitant conditions. Materials and methods. A retrospective data analysis of elderly and senile CAD patients who were observed in the period 1997–2019 and died from a cardiovascular event. Results. Using binary logistic regression analysis, a model of the survival probability up to 80 years in CAD patients with comorbid conditions has been developed. The overall accuracy of the model was 83.12 % (χ2 = 6.70, p < 0.05), and the predictive accuracy of the model (AUC = 0.853, 95 % CI 0.802–0.896) was sufficiently high and adequate to use in clinical practice. Odds ratio has shown a greater contribution of arterial hypertension and diabetes mellitus to reduced probabilities of surviving to the age of 80, a less significant contribution – of chronic obstructive pulmonary disease and dyslipidemia. Conclusions. The developed model for predicting the survival probability up to 80 years for older age group patients with coronary artery disease and comorbid conditions can be used to evaluate the effectiveness and correct medical and preventive measures

Empirical Investigation on Agile Methods Usage: Issues Identified from Early Adopters in Malaysia

Agile Methods are a set of software practices that can help to produce products faster and at the same time deliver what customers want. Despite the benefits that Agile methods can deliver, however, we found few studies from the Southeast Asia region, particularly Malaysia. As a result, less empirical evidence can be obtained in the country making its implementation harder. To use a new method, experience from other practitioners is critical, which describes what is important, what is possible and what is not possible concerning Agile. We conducted a qualitative study to understand the issues faced by early adopters in Malaysia where Agile methods are still relatively new. The initial study involves 13 participants including project managers, CEOs, founders and software developers from seven organisations. Our study has shown that social and human aspects are important when using Agile methods. While technical aspects have always been considered to exist in software development, we found these factors to be less important when using Agile methods. The results obtained can serve as guidelines to practitioners in the country and the neighbouring regions

Changing situational contexts present a constant challenge to software developers.

A software process can take many forms and its optimality demands that it should be harmonised with the needs of the given software development situational context. This theoretical proposition is reasonably clear. However, the finer details of the interaction between the software process and the factors of the situational context are much less obvious. In previously published research, the authors have elaborated a reference framework that identifies the factors of a situational context that affect the software process [1]. In this paper, we report on the application of our reference framework in an examination of the changing nature of software development situational contexts. Our corresponding study of fifteen software development companies indicates that certain factors appear more subject to change than others. This finding is a potentially important insight that can help us with the recurring challenge of adapting the software process to changing circumstances

Some Findings Concerning Requirements in Agile Methodologies

gile methods have appeared as an attractive alternative to conventional methodologies. These methods try to reduce the time to market and, indirectly, the cost of the product through flexible development and deep customer involvement. The processes related to requirements have been extensively studied in literature, in most cases in the frame of conventional methods. However, conclusions of conventional methodologies could not be necessarily valid for Agile; in some issues, conventional and Agile processes are radically different. As recent surveys report, inadequate project requirements is one of the most conflictive issues in agile approaches and better understanding about this is needed. This paper describes some findings concerning requirements activities in a project developed under an agile methodology. The project intended to evolve an existing product and, therefore, some background information was available. The major difficulties encountered were related to non-functional needs and management of requirements dependencies

Empirical evaluation of prediction intervals for cancer incidence

BACKGROUND: Prediction intervals can be calculated for predicting cancer incidence on the basis of a statistical model. These intervals include the uncertainty of the parameter estimates and variations in future rates but do not include the uncertainty of assumptions, such as continuation of current trends. In this study we evaluated whether prediction intervals are useful in practice. METHODS: Rates for the period 1993–97 were predicted from cancer incidence rates in the five Nordic countries for the period 1958–87. In a Poisson regression model, 95% prediction intervals were constructed for 200 combinations of 20 cancer types for males and females in the five countries. The coverage level was calculated as the proportion of the prediction intervals that covered the observed number of cases in 1993–97. RESULTS: Overall, 52% (104/200) of the prediction intervals covered the observed numbers. When the prediction intervals were divided into quartiles according to the number of cases in the last observed period, the coverage level was inversely proportional to the frequency (84%, 52%, 46% and 26%). The coverage level varied widely among the five countries, but the difference declined after adjustment for the number of cases in each country. CONCLUSION: The coverage level of prediction intervals strongly depended on the number of cases on which the predictions were based. As the sample size increased, uncertainty about the adequacy of the model dominated, and the coverage level fell far below 95%. Prediction intervals for cancer incidence must therefore be interpreted with caution

Agile software development practices in Egypt SMEs : a grounded theory investigation

Agile information system development methods have been adopted by most software development organizations due to their proven benefits in terms of flexibility, reliability, and responsiveness. However, companies face significant challenges in adopting these approaches. Specifically, this research investigates challenges faced by software development companies in Egypt while transitioning to Agile. As little previous research is available targeting their concerns, we have conducted a grounded theory investigation. Key problem areas were found including lack of cadence in sprints planning, inadequate use of effort estimation and product quality issues. The developed grounded theory reflects on the key problem areas found with SMEs adopting agile practices and can be used by software development practitioners adopting agile methods in Egypt or similar developing countries as an outline for the common problem areas they are expected to find

Commissioning of the vacuum system of the KATRIN Main Spectrometer

The KATRIN experiment will probe the neutrino mass by measuring the beta-electron energy spectrum near the endpoint of tritium beta-decay. An integral energy analysis will be performed by an electro-static spectrometer (Main Spectrometer), an ultra-high vacuum vessel with a length of 23.2 m, a volume of 1240 m^3, and a complex inner electrode system with about 120000 individual parts. The strong magnetic field that guides the beta-electrons is provided by super-conducting solenoids at both ends of the spectrometer. Its influence on turbo-molecular pumps and vacuum gauges had to be considered. A system consisting of 6 turbo-molecular pumps and 3 km of non-evaporable getter strips has been deployed and was tested during the commissioning of the spectrometer. In this paper the configuration, the commissioning with bake-out at 300{\deg}C, and the performance of this system are presented in detail. The vacuum system has to maintain a pressure in the 10^{-11} mbar range. It is demonstrated that the performance of the system is already close to these stringent functional requirements for the KATRIN experiment, which will start at the end of 2016.Comment: submitted for publication in JINST, 39 pages, 15 figure