Lower Urinary Tract Symptoms, Quality of Life and Coping Styles: the longitudinal Krimpen study in community-dwelling older men

During the past decades, a lot of knowledge about the epidemiology and natural history of lower urinary tract symptoms (LUTS) and the efficacy and safety of treatment approaches was gained from research published in the international literature. Worldwide the prevalence of men with LUTS is known, and the attention on the impact of LUTS on quality of life (QOL) is growing strongly. Remarkably, the most studies upon which this knowledge is based are cross sectional in study design. The Krimpen Study offers the opportunity to study factors associated with LUTS in a longitudinal study design. The aim of this thesis is to study the relationship between LUTS, QOL and coping styles. To study the clinical relevance of these factors also the relationship with general practitioner consultation and – policy was determined. Chapter 2 presents the study design of the Krimpen Study. In this study, all eligible men, 50 to 78 years living in Krimpen aan den IJssel, were invited to complete a 113-item questionnaire, a three-day-frequency-volume chart and to visit the health centre and the urology outpatient department of the Erasmus MC for additional measurements, including blood pressure, urinalyses, body height and weight, digital rectal examination, transrectal ultrasound of the prostate, uroflowmetry, post-void residual volume, and serum prostate specific antigen. After the baseline study three consecutive rounds of follow-up were performed with an average follow-up period of 2.1, 4.2 and 6.5 years. In each of these rounds all measurements were repeated. The visit to the health centre in Krimpen aan den IJssel was only at baseline. Men who did not respond at first or second-follow up and did not meet the exclusion criteria were nevertheless also re-invited for participation in the third follow-up round. After the last follow-up round data is assembled of the medical GP files of the participants and the pharmacy database

Optimal Quantum Metrology of Distant Black Bodies

Measurements of an object's temperature are important in many disciplines, from astronomy to engineering, as are estimates of an object's spatial configuration. We present the quantum optimal estimator for the temperature of a distant body based on the black body radiation received in the far-field. We also show how to perform separable quantum optimal estimates of the spatial configuration of a distant object, i.e. imaging. In doing so we necessarily deal with multi-parameter quantum estimation of incompatible observables, a problem that is poorly understood. We compare our optimal observables to the two mode analogue of lensed imaging and find that the latter is far from optimal, even when compared to measurements which are separable. To prove the optimality of the estimators we show that they minimise the cost function weighted by the quantum Fisher information---this is equivalent to maximising the average fidelity between the actual state and the estimated one.Comment: 12 pages, 6 figure

Universal Continuous Variable Quantum Computation in the Micromaser

We present universal continuous variable quantum computation (CVQC) in the micromaser. With a brief history as motivation we present the background theory and define universal CVQC. We then show how to generate a set of operations in the micromaser which can be used to achieve universal CVQC. It then follows that the micromaser is a potential architecture for CVQC but our proof is easily adaptable to other potential physical systems.Comment: 12 pages, 4 figures, accepted for a presentation at the 9th International Conference on Unconventional Computation (UC10) and LNCS proceedings

Automated assessment of COVID-19 reporting and data system and chest CT severity scores in patients suspected of having COVID-19 using artificial intelligence

Background: The coronavirus disease 2019 (COVID-19) pandemic has spread across the globe with alarming speed, morbidity, and mortality. Immediate triage of patients with chest infections suspected to be caused by COVID-19 using chest CT may be of assistance when results from definitive viral testing are delayed.Purpose: To develop and validate an artificial intelligence (AI) system to score the likelihood and extent of pulmonary COVID-19 on chest CT scans using the COVID-19 Reporting and Data System (CO-RADS) and CT severity scoring systems.Materials and Methods: The CO-RADS AI system consists of three deep-learning algorithms that automatically segment the five pulmonary lobes, assign a CO-RADS score for the suspicion of COVID-19, and assign a CT severity score for the degree of parenchymal involvement per lobe. This study retrospectively included patients who underwent a nonenhanced chest CT examination because of clinical suspicion of COVID-19 at two medical centers. The system was trained, validated, and tested with data from one of the centers. Data from the second center served as an external test set. Diagnostic performance and agreement with scores assigned by eight independent observers were measured using receiver operating characteristic analysis, linearly weighted kappa values, and classification accuracy.Results: A total of 105 patients (mean age, 62 years +/- 16 [standard deviation]; 61 men) and 262 patients (mean age, 64 years +/- 16; 154 men) were evaluated in the internal and external test sets, respectively. The system discriminated between patients with COVID-19 and those without COVID-19, with areas under the receiver operating characteristic curve of 0.95 (95% CI: 0.91, 0.98) and 0.88 (95% CI: 0.84, 0.93), for the internal and external test sets, respectively. Agreement with the eight human observers was moderate to substantial, with mean linearly weighted k values of 0.60 +/- 0.01 for CO-RADS scores and 0.54 +/- 0.01 for CT severity scores.Conclusion: With high diagnostic performance, the CO-RADS AI system correctly identified patients with COVID-19 using chest CT scans and assigned standardized CO-RADS and CT severity scores that demonstrated good agreement with findings from eight independent observers and generalized well to external data. (C) RSNA, 2020Cardiovascular Aspects of Radiolog

Gender differences in respiratory symptoms in 19-year-old adults born preterm

Objective: To study the prevalence of respiratory and atopic symptoms in (young) adults born prematurely, differences between those who did and did not develop Bronchopulmonary Disease (BPD) at neonatal age and differences in respiratory health between males and females. Methods: Design: Prospective cohort study. Setting: Nation wide follow-up study, the Netherlands. Participants: 690 adults (19 year old) born with a gestational age below 32 completed weeks and/or with a birth weight less than 1500g. Controls were Dutch participants of the European Community Respiratory Health Survey (ECRHS). Main outcome measures: Presence of wheeze, shortness of breath, asthma, hay fever and eczema using the ECRHS-questionnaire

Prevalence of hypertension in Ghanaian society: a systematic review, meta-analysis, and GRADE assessment

Background: Hypertension has become an important public health concern in the developing world owing to rising prevalence and its adverse impact on ailing health systems. Despite being a modifiable risk factor for cardiovascular disease, hypertension has not received the needed attention in Ghana as a result of various competing interests for scarce health resources. This systematic review and meta-analysis provides a comprehensive and updated summary of the literature on the prevalence of hypertension in Ghana.Methods: Major databases such as MEDLINE, EMBASE, and Google Scholar and local thesis repositories were accessed to identify population-based studies on hypertension among Ghanaians. Data extracted from retrieved reports were screened independently by two reviewers. The quality of eligible studies was evaluated and reported. A reliable pooled estimate of hypertension prevalence was calculated utilizing a random-effects model and reported according to the GRADE framework. Additionally, a meta-regression analysis was performed to analyze the contribution of study-level variables to variance in hypertension prevalence.Results: In general, a total of 45,470 subjects (n = 22,866 males and 22,604 females) were enrolled from urban (n = 12), rural (n = 8), and mixed populations (n = 7). Blood pressure (BP) was measured across studies according to a validated and clinically approved protocol by trained field workers or healthcare workers including nurses and physicians. A combined total of 30,033 participants across twenty studies reporting on the population prevalence of hypertension were pooled with 10,625 (35.4%) identified to satisfy study criteria for elevated BP. The pooled prevalence across 24 studies was 30.3% (95% CI 26.1-34.8%) after fitting a random effects model. Prevalence of hypertension was 30.1% (95% CI 25.6-36.0%) among females and 34.0% (95% CI 28.5-40.0%) among males. Significant differences in pooled estimates across regions emerged from subgroup comparisons of regional estimates with an increasing trend in the north-to-south direction and with increasing age. Compared to rural settings, the burden of hypertension in urban populations was significantly higher. Age structure and population type accounted for 65.0% of the observed heterogeneity in hypertension estimates.Conclusions: The prevalence of hypertension in Ghana is still high. The gap in hypertension prevalence between rural and urban populations is closing especially in elderly populations. These findings must claim the attention of public health authorities in Ghana to explore opportunities to reduce rural hypertension