Applying statistical methods in a registry dataset of cardiopulmonary resuscitation to predict probability of survival by chest compression time in children

The focus of this thesis was to apply advanced statistical methods to the American Heart Association Get With The Guidelines-Resuscitation (AHA GWTG-R) registry, a registry data set derived from a prospective multi-sites observational study, the American Heart Association’s National Registry of Cardiopulmonary Resuscitation (NRCPR). The data comprise comprehensive information related to the cardiopulmonary resuscitation (CPR) process, patients’ outcome, and characteristics of both the patients and the hospitals. The purpose of the registry data is to provide information that can be used to improve the outcomes of sudden cardiac arrest (SCA) patients and updates protocol of CPR. This thesis has two purposes. The first one is to investigate the relationship between the patients’ disease and survival for SCA patients receiving different durations of chest compression. The second one is to establish a model for predicting the probability of survival according to the duration of CPR. In the clinical setting, a categorized variable may provide more meaningful inferences. To explore this option, a Generalized additive model (GAM) was used to identify cutoff points for the categorization of chest compression duration. This categorized variable was then used for the development of prediction models for survival and the Net reclassification index (NRI) was used to select the appropriate predictors for this model. Logistic regression, generalized estimating equations (GEE), and a generalized linear mixed model (GLMM) were performed to obtain the estimates of parameters. Thereafter, the probability of survival was estimated based on the results of the regression model. Comprehensive registry data have been established for many healthcare problems, which include many observations and variables. A systematic process to analyze registry data is necessary. This thesis used multiple statistical techniques to create meaningful variables, select appropriate predictors, fit regression models, and predict the probabilities of outcome. The public health significance of this thesis is the identification of subgroups of SCA patients who may benefit from prolonged CPR duration and to assess significance of cluster effects in the registry data

Aislamiento de bacterias en el ambiente (techo, paredes y suelo), superficies (objetos) y manos del personal de salud en el servicio de diálisis peritoneal del Hospital Nacional San Juan de Dios de la ciudad de San Miguel, durante los meses de julio y agosto de 2007

La investigación se realizó en el Servicio de Diálisis Peritoneal del Hospital Nacional San Juan de Dios de la ciudad San Miguel, con el objetivo de aislar bacterias en el ambiente (techo, paredes y suelo) , superficies (máquina dializadora, gabacha de médicos, lavamano, toalla secamanos, aire acondicionado, bata de visitantes, mesa de enfermería, ropa de cama, mesita de paciente, expediente de paciente, carro de emergencia) y manos del personal de salud del servicio antes mencionado; para lo cual se tomaron 172 muestras y se aislaron 199 bacterias en los meses de julio y agosto de 2007. La investigación fue de tipo Prospectivo, Transversal, Analítica y de laboratorio; para dicha investigación las muestras se tomaron con un hisopo estéril, luego se inoculó en tubos que contenían Caldo Tripticasa Soya, para permitir la proliferación de las bacterias y luego a los tubos con Caldo turbio se les realizó las resiembras en Agar Sangre de Carnero (ASC) y Agar MacConkey(AMC), para su identificación bacteriana, lo que proporcionó los datos para la elaboración de cuadros y gráficos observándose los siguientes resultados: De los 199 cultivos procesados se obtuvieron 126 con bacterias patógenas y 73 con bacterias no patógenas. La Superficies con una media de 10.643 fue superior estadísticamente tanto al 0.05% como al 0.01% de probabilidad que las manos del personal de salud con una media de 2.214 y el ambiente con una media de 1.357 siendo estas dos últimos similares en el grado de contaminación del Servicio de Diálisis Peritoneal, la cual fue un factor predisponente de infección nosocomial. La bacteria que se aisló con mayor frecuencia, estadísticamente tanto al 0.05% como al 0.01% de probabilidad fue Bacillus subtilis, seguidamente de Staphylococcus spp, Enterobacter spp, Pseudomonas spp, Acinetobacter spp, Klebsiella spp, Enterobacter aerogenes, Enterococcus spp, Staphylococcus aureus, Enterobacter agglomerans, Streptococcus viridans, Citrobacter freundii y Acinetobacter baumannii. De acuerdo con los resultados y las conclusiones de la investigación se plantean algunas recomendaciones orientadas principalmente a dar seguimiento y brindar apoyo a este tipo de investigacione

Effects of breast cancer hormone treatment on lipids and subsequent cardiovascular diseases

Selective estrogen receptor modulators (SERMs), the earliest breast cancer (BC) hormone treatment, improve survival of hormone positive (HR+) BC patients. Aromatase inhibitors (AIs) further prolong disease free survival (DFS) for postmenopausal HR+ BC patients, but their benefits in overall survival (OS) are inconclusive. An important factor that impacts OS but not DFS is non-BC death, and cardiovascular disease (CVD) is one of the major contributors. In addition to its high prevalence in the aging population, CVD may be associated with BC cancer treatment. BC hormone treatment influences serum estrogen concentration, which is related to the occurrence of CVD; therefore, it is critical to investigate the impact of BC hormone treatment on CVD, especially in the era when prolonged hormone treatment is increasingly popular in BC care. This dissertation consists of 3 projects: 1) enhancement of an existing Bayesian Network Meta-analysis (NMA) method by allowing more reporting formats, so more studies may be included and expanding an existing consistency check of direct and indirect evidence for a NMA to include longitudinal data; 2) a Bayesian NMA exploring the effects of BC hormone drugs on changes of lipid profiles during hormone treatment; and 3) a study examining the effects of hormone treatment on dyslipidemia/coronary heart disease (CHD) throughout the whole course of BC treatment using electronic medical records. The result from the second study showed that patients on SERMs had better lipid profiles and tended to reduce the risk of dyslipidemia/CHD. The third study revealed that the beneficial effects disappeared after discontinuing SERMs. NMA demonstrated that individual AIs impact changes of lipid profiles differently. However, the third study combining AIs as a whole did not reveal the significant impact on risk of dyslipidemia/CHD, which may be caused by mixed effects of individual AIs and insufficient statistical power due to few outcome events. The public health significance of this dissertation is to provide methods promoting applicability of NMA for longitudinal data, and to show the effects of BC hormone treatment on lipids and CHD. BC patients with pre-existing risk factors of CVD should be monitored more frequently when they are on hormone treatment

Associations among systemic blood pressure, microalbuminuria and albuminuria in dogs affected with pituitary- and adrenal-dependent hyperadrenocorticism

<p>Abstract</p> <p>Background</p> <p>Hypertension and proteinuria are medical complications associated with the multisystemic effects of long-term hypercortisolism in dogs with hyperadrenocorticism (HAC).</p> <p>Methods</p> <p>This study investigated the relationships among adrenocorticotropic hormone (ACTH)-stimulation test results, systemic blood pressure, and microalbuminuria in clinically-healthy dogs (n = 100), in dogs affected with naturally occurring pituitary-dependent (PDH; n = 40), or adrenal-dependent hyperadrenocorticism (ADH; n = 30).</p> <p>Results</p> <p>Mean systemic blood pressure was similar between clinically healthy dogs and dogs with HAC (<it>p </it>= 0.803). However the incidence of hypertension was highest in dogs with ADH (<it>p = 0.017</it>), followed by dogs with PDH, with the lowest levels in clinically healthy dogs (<it>p = 0.019</it>). Presence of microalbuminuria and albuminuria in clinically healthy dogs and dogs affected with HAC was significantly different (<it>p </it>< 0.001); incidences of albuminuria followed the same pattern of hypertension; highest incidence in dogs with ADH, and lowest level in clinically healthy dogs; but microalbuminuria showed a different pattern: clinically healthy dogs had highest incidences and dogs with ADH had lowest incidence. The presence of albuminuria was not associated with blood pressure values, regardless of whether dogs were clinically healthy or affected with ADH or PDH (<it>p </it>= 0.306).</p> <p>Conclusions</p> <p>Higher incidence of hypertension and albuminuria, not microalbuminuria was seen in dogs affected with HAC compared to clinically healthy dogs; incidence of hypertension and albuminuria was significantly higher in dogs affected with ADH compared to PDH. However, presence of albuminuria was not correlated with systemic blood pressure.</p

Investigating the Knowledge-Sharing Behavior ina Professional Virtual Community

This research aims at investigating the knowledge sharing-behaviors in a teachers’ professional virtual community. Logs data in the entire community and in special interest groups (SIGs) were analyzed. Some typical behaviors were identified by the clustering analysis in this study. The largest group of member belongs to inactive users. They rarely log in the system, are passive in uploading or downloading teaching materials, and almost never post or reply messages. Another group is active in receiving knowledge while reluctant to give knowledge or to respond. The third group frequently login the system, is the most active in sharing knowledge, and actively searching knowledge. However, the third group contains only a small number of members. Furthermore, fifty-five members of the knowledge-sharing group were interviewed using focus group technique to find out qualitative information as to why they are willing to share information and what are their concerns in sharing information. The results indicated that knowledge sharing is not a common behavior in professional virtual community, and knowledge-sharing culture is difficult to promote even in non-competitive professional communities. Secondly, knowledge cannot flow easily throughout the community even when certain knowledge flow promoting mechanism is provided. Thirdly, professional autonomy may hinder the frequency of interactions with others in professional virtual community. Fourthly, attitudes regarding information ownership are important factors in knowledge sharing of a professional virtual community. Finally, teaching and IT usage experiences are not major factors affecting knowledge-sharing behavior in pro fessional virtual communities

2013-2014 Music of the Mind: From the Studio of Roberta Rust

https://spiral.lynn.edu/conservatory_otherseasonalconcerts/1012/thumbnail.jp

6-Mercaptopurine attenuates tumor necrosis factor-α production in microglia through Nur77-mediated transrepression and PI3K/Akt/mTOR signaling-mediated translational regulation

Physical interaction between Nur77 and p65. BV-2 cells were pretreated with 6-MP (50 μM) for 16 h followed by exposure to LPS (100 ng/ml) for 60 min. Nuclear extracts were harvested for immunoprecipitation (IP) experiments using anti-Nur77 and anti-p65 antibodies. Immunoblot (IB) analyses of the immunoprecipitates were performed using these antibodies. The immunoblots are representative of three independent experiments. (TIF 280 kb

A new analysis tool for individual-level allele frequency for genomic studies

<p>Abstract</p> <p>Background</p> <p>Allele frequency is one of the most important population indices and has been broadly applied to genetic/genomic studies. Estimation of allele frequency using genotypes is convenient but may lose data information and be sensitive to genotyping errors.</p> <p>Results</p> <p>This study utilizes a unified intensity-measuring approach to estimating individual-level allele frequencies for 1,104 and 1,270 samples genotyped with the single-nucleotide-polymorphism arrays of the Affymetrix Human Mapping 100K and 500K Sets, respectively. Allele frequencies of all samples are estimated and adjusted by coefficients of preferential amplification/hybridization (CPA), and large ethnicity-specific and cross-ethnicity databases of CPA and allele frequency are established. The results show that using the CPA significantly improves the accuracy of allele frequency estimates; moreover, this paramount factor is insensitive to the time of data acquisition, effect of laboratory site, type of gene chip, and phenotypic status. Based on accurate allele frequency estimates, analytic methods based on individual-level allele frequencies are developed and successfully applied to discover genomic patterns of allele frequencies, detect chromosomal abnormalities, classify sample groups, identify outlier samples, and estimate the purity of tumor samples. The methods are packaged into a new analysis tool, ALOHA (<b>A</b>llele-frequency/<b>L</b>oss-<b>o</b>f-<b>h</b>eterozygosity/<b>A</b>llele-imbalance).</p> <p>Conclusions</p> <p>This is the first time that these important genetic/genomic applications have been simultaneously conducted by the analyses of individual-level allele frequencies estimated by a unified intensity-measuring approach. We expect that additional practical applications for allele frequency analysis will be found. The developed databases and tools provide useful resources for human genome analysis via high-throughput single-nucleotide-polymorphism arrays. The ALOHA software was written in R and R GUI and can be downloaded at <url>http://www.stat.sinica.edu.tw/hsinchou/genetics/aloha/ALOHA.htm</url>.</p