367 research outputs found
Factors Associated With End-of-Life Planning in Huntington Disease.
OBJECTIVE: Knowledge of one\u27s gene status for adult onset conditions provides opportunity to make advance end-of-life (EOL) plans. The purposes of these analyses were to (1) determine the prevalence of EOL plans, including advance directives (ADs) among persons across 3 stages of Huntington disease (HD) and (2) examine factors associated with having ADs in this sample.
METHODS: Data are from 503 participants in the HD Quality of Life study. Participants completed an online health-related quality-of-life survey that included questions regarding EOL planning and self-reported HD symptoms. Frequencies were calculated for EOL planning by the HD stage. Bivariate analysis and logistic regression were used to identify variables associated with having ADs.
RESULTS: A total of 38.2% of participants stated they had ADs and fewer than half had other EOL plans. Being older, increased HD stage, more years of education, lower anxiety, more swallowing symptoms, and higher meaning and purpose were associated with having ADs.
CONCLUSION: The prevalence of ADs in our sample is comparable to the general US population, but surprisingly low, considering the severity and long disease course of HD.
PRACTICE IMPLICATIONS: Health-care providers should develop specific interventions early in the disease process to increase ADs in this population
Report on the 2013 Rapid Assessment Survey of Marine Species at New England Bays and Harbors
Introduced species (i.e., non-native species that have become established in a new location) have increasingly been recognized as a concern as they have become more prevalent in marine and terrestrial environments (Mooney and Cleland 2001; Simberloff et al. 2005). The ability of introduced species to alter population, community, and ecosystem structure and function, as well as cause significant economic damage is well documented (Carlton 1989, 1996b, 2000; Cohen and Carlton 1995; Cohen et al. 1995; Elton 1958; Meinesz et al. 1993; Occhipinti-Ambrogi and Sheppard 2007; Pimentel et al. 2005; Thresher 2000). The annual economic costs incurred from managing the approximately 50,000 introduced species in the United States alone are estimated to be over $120 billion (Pimentel et al. 2005). Having a monitoring network in place to track new introductions and distributional changes of introduced species is critical for effective management, as these efforts may be more successful when species are detected before they have the chance to become established. A rapid assessment survey is one such method for early detection of introduced species. With rapid assessment surveys, a team of taxonomic experts record and monitor marine species–providing a baseline inventory of native, introduced, and cryptogenic (i.e., unknown origin) species (as defined by Carlton 1996a)–and document range expansions of previously identified species. Since 2000, five rapid assessment surveys have been conducted in New England. These surveys focus on recording species at marinas, which often are in close proximity to transportation vectors (i.e., recreational boats). Species are collected from floating docks and piers because these structures are accessible regardless of the tidal cycle. Another reason for sampling floating docks and other floating structures is that marine introduced species are often found to be more prevalent on artificial surfaces than natural surfaces (Glasby and Connell 2001; Paulay et al. 2002). The primary objectives of these surveys are to: (1) identify native, introduced, and cryptogenic marine species, (2) expand on data collected in past surveys, (3) assess the introduction status and range extensions of documented introduced species, and (4) detect new introductions. This report presents the introduced, cryptogenic, and native species recorded during the 2013 survey
Scale-free vortex cascade emerging from random forcing in a strongly coupled system
The notions of self-organised criticality (SOC) and turbulence are
traditionally considered to be applicable to disjoint classes of phenomena.
Nevertheless, scale-free burst statistics is a feature shared by turbulent as
well as self-organised critical dynamics. It has also been suggested that
another shared feature is universal non-gaussian probability density functions
(PDFs) of global fluctuations. Here, we elucidate the unifying aspects through
analysis of data from a laboratory dusty plasma monolayer. We compare analysis
of experimental data with simulations of a two-dimensional (2D) many-body
system, of 2D fluid turbulence, and a 2D SOC model, all subject to random
forcing at small scales. The scale-free vortex cascade is apparent from
structure functions as well as spatio-temporal avalanche analysis, the latter
giving similar results for the experimental and all model systems studied. The
experiment exhibits global fluctuation statistics consistent with a
non-gaussian universal PDF, but the model systems yield this result only in a
restricted range of forcing conditions
Evaluating Cognition in Individuals with Huntington Disease: NeuroQoL Cognitive Functioning Measures
PURPOSE: Cognitive functioning impacts health-related quality of life (HRQOL) for individuals with Huntington disease (HD). The Neuro-QoL includes two patient-reported outcome (PRO) measures of cognition-Executive Function (EF) and General Concerns (GC). These measures have not previously been validated for use in HD. The purpose of this analysis is to evaluate the reliability and validity of the Neuro-QoL Cognitive Function measures for use in HD.
METHODS: Five hundred ten individuals with prodromal or manifest HD completed the Neuro-QoL Cognition measures, two other PRO measures of HRQOL (WHODAS 2.0 and EQ5D), and a depression measure (PROMIS Depression). Measures of functioning The Total Functional Capacity and behavior (Problem Behaviors Assessment) were completed by clinician interview. Objective measures of cognition were obtained using clinician-administered Symbol Digit Modalities Test and the Stroop Test (Word, Color, and Interference). Self-rated, clinician-rated, and objective composite scores were developed. We examined the Neuro-QoL measures for reliability, convergent validity, discriminant validity, and known-groups validity.
RESULTS: Excellent reliabilities (Cronbach\u27s alphas ≥ 0.94) were found. Convergent validity was supported, with strong relationships between self-reported measures of cognition. Discriminant validity was supported by less robust correlations between self-reported cognition and other constructs. Prodromal participants reported fewer cognitive problems than manifest groups, and early-stage HD participants reported fewer problems than late-stage HD participants.
CONCLUSIONS: The Neuro-QoL Cognition measures provide reliable and valid assessments of self-reported cognitive functioning for individuals with HD. Findings support the utility of these measures for assessing self-reported cognition
New measures to capture end of life concerns in Huntington disease: Meaning and Purpose and Concern with Death and Dying from HDQLIFE (a patient-reported outcomes measurement system).
PURPOSE: Huntington disease (HD) is an incurable terminal disease. Thus, end of life (EOL) concerns are common in these individuals. A quantitative measure of EOL concerns in HD would enable a better understanding of how these concerns impact health-related quality of life. Therefore, we developed new measures of EOL for use in HD.
METHODS: An EOL item pool of 45 items was field tested in 507 individuals with prodromal or manifest HD. Exploratory and confirmatory factor analyses (EFA and CFA, respectively) were conducted to establish unidimensional item pools. Item response theory (IRT) and differential item functioning analyses were applied to the identified unidimensional item pools to select the final items.
RESULTS: EFA and CFA supported two separate unidimensional sets of items: Concern with Death and Dying (16 items), and Meaning and Purpose (14 items). IRT and DIF supported the retention of 12 Concern with Death and Dying items and 4 Meaning and Purpose items. IRT data supported the development of both a computer adaptive test (CAT) and a 6-item, static short form for Concern with Death and Dying.
CONCLUSION: The HDQLIFE Concern with Death and Dying CAT and corresponding 6-item short form, and the 4-item calibrated HDQLIFE Meaning and Purpose scale demonstrate excellent psychometric properties. These new measures have the potential to provide clinically meaningful information about end-of-life preferences and concerns to clinicians and researchers working with individuals with HD. In addition, these measures may also be relevant and useful for other terminal conditions
Computational Physics on Graphics Processing Units
The use of graphics processing units for scientific computations is an
emerging strategy that can significantly speed up various different algorithms.
In this review, we discuss advances made in the field of computational physics,
focusing on classical molecular dynamics, and on quantum simulations for
electronic structure calculations using the density functional theory, wave
function techniques, and quantum field theory.Comment: Proceedings of the 11th International Conference, PARA 2012,
Helsinki, Finland, June 10-13, 201
A Path Algorithm for Constrained Estimation
Many least squares problems involve affine equality and inequality
constraints. Although there are variety of methods for solving such problems,
most statisticians find constrained estimation challenging. The current paper
proposes a new path following algorithm for quadratic programming based on
exact penalization. Similar penalties arise in regularization in model
selection. Classical penalty methods solve a sequence of unconstrained problems
that put greater and greater stress on meeting the constraints. In the limit as
the penalty constant tends to , one recovers the constrained solution.
In the exact penalty method, squared penalties are replaced by absolute value
penalties, and the solution is recovered for a finite value of the penalty
constant. The exact path following method starts at the unconstrained solution
and follows the solution path as the penalty constant increases. In the
process, the solution path hits, slides along, and exits from the various
constraints. Path following in lasso penalized regression, in contrast, starts
with a large value of the penalty constant and works its way downward. In both
settings, inspection of the entire solution path is revealing. Just as with the
lasso and generalized lasso, it is possible to plot the effective degrees of
freedom along the solution path. For a strictly convex quadratic program, the
exact penalty algorithm can be framed entirely in terms of the sweep operator
of regression analysis. A few well chosen examples illustrate the mechanics and
potential of path following.Comment: 26 pages, 5 figure
Altruism can proliferate through group/kin selection despite high random gene flow
The ways in which natural selection can allow the proliferation of
cooperative behavior have long been seen as a central problem in evolutionary
biology. Most of the literature has focused on interactions between pairs of
individuals and on linear public goods games. This emphasis led to the
conclusion that even modest levels of migration would pose a serious problem to
the spread of altruism in group structured populations. Here we challenge this
conclusion, by analyzing evolution in a framework which allows for complex
group interactions and random migration among groups. We conclude that
contingent forms of strong altruism can spread when rare under realistic group
sizes and levels of migration. Our analysis combines group-centric and
gene-centric perspectives, allows for arbitrary strength of selection, and
leads to extensions of Hamilton's rule for the spread of altruistic alleles,
applicable under broad conditions.Comment: 5 pages, 2 figures. Supplementary material with 50 pages and 26
figure
HDQLIFE: Development and Assessment of Health-Related Quality of Life in Huntington Disease (HD)
PURPOSE: Huntington disease (HD) is a chronic, debilitating genetic disease that affects physical, emotional, cognitive, and social health. Existing patient-reported outcomes (PROs) of health-related quality of life (HRQOL) used in HD are neither comprehensive, nor do they adequately account for clinically meaningful changes in function. While new PROs examining HRQOL (i.e., Neuro-QoL-Quality of Life in Neurological Disorders and PROMIS-Patient-Reported Outcomes Measurement Information System) offer solutions to many of these shortcomings, they do not include HD-specific content, nor have they been validated in HD. HDQLIFE addresses this by validating 12 PROMIS/Neuro-QoL domains in individuals with HD and by using established PROMIS methodology to develop new, HD-specific content.
METHODS: New item pools were developed using cognitive debriefing with individuals with HD, and expert, literacy, and translatability reviews. Existing item banks and new item pools were field tested in 536 individuals with prodromal, early-, or late-stage HD.
RESULTS: Moderate to strong relationships between Neuro-QoL/PROMIS measures and generic self-report measures of HRQOL, and moderate relationships between Neuro-QoL/PROMIS and clinician-rated measures of similar constructs supported the validity of Neuro-QoL/PROMIS in individuals with HD. Exploratory and confirmatory factor analysis, item response theory, and differential item functioning analyses were utilized to develop new item banks for Chorea, Speech Difficulties, Swallowing Difficulties, and Concern with Death and Dying, with corresponding six-item short forms. A four-item short form was developed for Meaning and Purpose.
CONCLUSIONS: HDQLIFE encompasses both validated Neuro-QoL/PROMIS measures, as well as five new scales in order to provide a comprehensive assessment of HRQOL in HD
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