Truncated quasi-score function in the 1-dependent and stationary case

The structure of the quasi-score function is investigated when the data is a realization of a 1-dependent and stationary sequence of random variables. A truncated quasi-score function is proposed, which leads to a simplified quasi-score without loss of efficiency.Location parameter m-Dependence Quasi-likelihood Stationarity

A comparison of statistical and machine-learning techniques in evaluating the association between dietary patterns and 10-year cardiometabolic risk (2002-2012): The ATTICA study

Statistical methods are usually applied in examining diet-disease associations, whereas factor analysis is commonly used for dietary pattern recognition. Recently, machine learning (ML) has been also proposed as an alternative technique in health classification. In this work, the predictive accuracy of statistical v. ML methodologies as regards the association of dietary patterns on CVD risk was tested. During 2001-2002, 3042 men and women (45 (sd 14) years) were enrolled in the ATTICA study. In 2011-2012, the 10-year CVD follow-up was performed among 2020 participants. Item Response Theory was applied to create a metric of combined 10-year cardiometabolic risk, the 'Cardiometabolic Health Score', that incorporated incidence of CVD, diabetes, hypertension and hypercholesterolaemia. Factor analysis was performed to extract dietary patterns, on the basis of either foods or nutrients consumed; linear regression analysis was used to assess their association with the cardiometabolic score. Two ML techniques (k-nearest-neighbor's algorithm and random-forests decision tree) were applied to evaluate participants' health based on dietary information. Factor analysis revealed five and three factors from foods and nutrients, respectively, explaining 54 and 65 % of the total variation in intake. Nutrient and food pattern regression models showed similar accuracy in correctly classifying an individual according to the cardiometabolic risk (R 2=9.6 % and R 2=8.3 %, respectively). ML techniques were superior compared with linear regression in correct classification of the individuals according to the Health Score (accuracy approximately 38 v. 6 %, respectively), whereas the two ML methods showed equal classification ability. Conclusively, ML methods could be a valuable tool in the field of nutritional epidemiology, leading to more accurate disease-risk evaluation. © The Authors 2018

Different effects of sensitization to mites and pollens on asthma symptoms and spirometric indices in children: a population-based cohort study

Background: We have previously shown that long-term exposure of children to a highly polluted urban compared with a rural environment is associated with subclinical airway narrowing and increased prevalence of atopy. Objective: To test the hypothesis that sensitization to indoor perennial, compared with seasonal, aeroallergens has distinct effects on asthma symptoms and/or spirometric indices. Methods: We evaluated the respiratory health of 478 and 342 children aged 8 to 10 years living in an urban and a rural area, respectively, during a period of 8 years. Children were evaluated by parental questionnaire in 3 phases, 1995 to 1996 (phase 1), 1999 to 2000 (phase 2), and 2003 to 2004 (phase 3), and by spirometry and skin prick testing to 9 common local aeroallergens in phases 1 and 2. Results: Sensitization to pollens was associated with current wheezing in phase I of the study (odds ratio [OR], 3.36; 95% confidence interval [CI], 1.71 to 6.62; P <.001) but not with spirometric indices. Sensitization to mites was negatively associated with forced expiratory volume in 1 second (95% CI, -7.26 to -0.90; P =.01) and forced expiratory flow at 50% of forced vital capacity (95% CI, - 10.80 to - 1.33; P =.01) in study phase 1 but not in phase 2. Conclusions: Our results indicate that sensitization to mites is associated with insidious involvement of large and small airways, whereas sensitization to pollens is associated with childhood wheezing at the age of 8 to 10 years. Subsequent loss of these associations implies that risk factors other than allergy influence airway disease at a later age

Increased sensitization in urban vs. rural environment - Rural protection or an urban living effect?

In a population-based longitudinal cohort study, we tested the hypothesis that children growing up in a high-traffic polluted urban area (UA) in the Athens' basin have higher prevalence of allergies and sensitization when compared with those growing up in a Greek provincial rural area (RA). We recruited 478 and 342 children aged 8-10 living in the UA and the RA, respectively. Respiratory health was assessed by a parent-completed questionnaire in three phases: 1995-96 (phase 1), 1999-2000 (phase 2), 2003-04 (phase 3) and skin-prick testing to common indoor and outdoor aeroallergens was performed at phases 1 and 2. Reported asthma and eczema did not differ between the two areas, whereas reported hay fever was persistently more prevalent in the UA than in the RA (16.5%, 17.0%, 18.2% vs. 7.0%, 8.3%, 9.6%, respectively). Sensitization was more prevalent in the UA at both phases (19.0% vs. 12.1% in phase 1, 20.0% vs. 14.1% in phase 2). Residential area contributed independently to sensitization to ≥1 aeroallergens (OR: 0.29; 95% CI: 0.13-0.66; p = 0.003) and to polysensitization (OR: 0.28; 95% CI: 0.10-0.82; p = 0.020) in phase 1. These associations were independent of farming practices. No significant contributions were found in phase 2. Our results suggest that long-term exposure to urban environment is associated with a higher prevalence of hay fever but not of asthma or eczema. The negative association between rural living and the risk of atopy during childhood, which is independent of farming practices, implies that it is mainly driven by an urban living effect. © 2007 The Authors

A ross-sectional study for assessing perceived symptoms, depression and quality of life in advanced lung cancer patients

Purpose: The purpose of the present study was to assess the perceived symptoms, depression and quality of life (QoL) in advanced lung cancer patients undergoing chemotherapy. Methods: The study was cross sectional and was conducted in the oncology department of General Hospital "George Papanikolaou", Thessaloniki, Greece. The sample was convenient and consisted of 76 advanced lung cancer patients. A questionnaire including instruments such as Center for Epidemiologic Studies Depression Scale- CES-D, Revised Edmonton Symptom Assessment Scale r-ESAS, EORTC QLQC30 and demographic and clinical information was used to collect data. Results: The most frequently observed symptoms were tiredness, shortness of breath, anxiety and well-being. The vast majority of patients (75.3%) had total score in CESdepression higher than 16. The type of residence affected ESAS emotional score (p=0.010). Gender affected the level of depression (p=0.014) and the type of lung cancer affected depression (p=0.036). The type of residence affected emotional functioning (p=0.010), the type of treatment influenced the score of global health status (p=0.007), the role functioning (p=0.032) and social functioning (p=0.024). Multivariate regression analysis was conducted to identify the predictors of overall QoL and depression. The statistically significant factors for QoL were pain (p<0.001) and tiredness (p=0.003), while the type of lung cancer (p<0.007), the type of insurance (p<0.025) and the type of treatment (p<0.041) influenced depression as well. Conclusions: Advanced lung cancer patients experienced moderate level in QoL and mild levels of symptoms. Demographic and clinical characteristics influenced depression and QoL. © 2021 Zerbinis Publications. All rights reserved

Different effects of urban and rural environments in the respiratory status of Greek schoolchildren

We hypothesized that asthma symptoms and lung function of schoolchildren living in Athens urban area are adversely affected as compared to others living in a rural environment, over a period of 8 years. We recruited 478 and 342 children aged 8-10 years living within a short radius around the urban and rural area monitoring stations, respectively. Respiratory health was assessed by a parent-completed questionnaire in three phases: 1995-1996 (phase-1), 1999-2000 (phase-2), 2003-2004 (phase-3) and by spirometry in phases-1 and 2. Reported asthma and wheeze did not differ in the two areas, whereas cough was more prevalent in the urban area in phase-1. Children from the rural environment had tower levels of percent-predicted forced vital capacity (FVC%) in phase-1 and higher of percent-predicted-forced expiratory flow at mid-FVC (FEF50%) in both phases. Independent associations were detected between FVC% as-well-as FEF50% and residential area. High FVC% was associated with outdoor systemic athletic activities; there was lower FVC% growth in the urban versus the rural area. Nitrogen dioxide and sulfur dioxide were higher in the urban area, whereas ozone concentrations differed less between the two areas. These results suggest that tong-term exposure to urban environment is associated with sub-clinical airway narrowing and slower rate of FVC growth. (c) 2006 Elsevier Ltd. All rights reserved

The Role of Anxiety in Simulation-Based Dexterity and Overall Performance: Does It Really Matter?

Background: Essential Skills in the Management of Surgical Cases (ESMSC) is an international undergraduate surgical masterclass which combines ex vivo, dry lab and high fidelity in vivo simulation-based learning (SBL). It consists of 32 stations of skills-based learning, including open reduction internal fixation (ORIF) of fractures. Current literature suggests early involvement in skills-based learning at the undergraduate level is vital. Aims: To compare students&apos; dexterity and skills-based performance with demographic and educational background parameters. Methods: 112 medical students from European Union countries including the United Kingdom, Germany, Greece, Cyprus, Germany, and Bulgaria were selected from a competitive pool of candidates to attend the course. Students undertook ORIF in an ex vivo swine model, and in a simulated fracture on a bamboo rod. Skills-based performance was assessed by two consultant surgeons with validated direct observation of procedural skills (DOPS) forms. Anxiety was self-assessed using the Westside Anxiety Scale prior to the ORIF stations. Dexterity was measured with the O&apos;Connor tweezer dexterity test. Results: Female students had significantly higher dexterity scores (median difference 7, p =.003). Right-handed students achieved higher dexterity than left-handed students (median difference 7, p =.043). There was no difference in students&apos; performance across different medical schools, and across year groups (p &lt;.05 for any correlation). Self-reported anxiety was not correlated with high fidelity skills-based performance (r = 0.032, p =.74). Conclusion: Anxiety does not seem to play a significant role in Simulation Skills-Based learning. Undergraduate surgical curricula should incorporate SBL-based modules to enhance practical skills learning and motivate future orthopedic surgeons. © 2017, Copyright © 2017 Taylor &amp; Francis Group, LLC