Non-Existence of Consistent Estimator Sequences and Unbiased Estimates: A Practical Example

It is often thought that identifiability implies existence of consistent estimator sequences. A rather artificial counter example is given in [7]. We here consider a case which often arises in experimental and survey practice. The example concerns a model with intraclass correlation ρ. For ρ negative an indefinitely large sequence of observations cannot arise from such a model and so the discussion of consistency is restricted to ρ \u3e 0. For any non-degenerate range of ρ we show that no unbiased estimate exists for the variance of the mean of the observations. Certain other aspects of estimation in models of this sort are considered in [4]

Driving pressure during general anesthesia for open abdominal surgery (DESIGNATION) : study protocol of a randomized clinical trial

Background Intraoperative driving pressure (Delta P) is associated with development of postoperative pulmonary complications (PPC). When tidal volume (V-T) is kept constant, Delta P may change according to positive end-expiratory pressure (PEEP)-induced changes in lung aeration. Delta P may decrease if PEEP leads to a recruitment of collapsed lung tissue but will increase if PEEP mainly causes pulmonary overdistension. This study tests the hypothesis that individualized high PEEP, when compared to fixed low PEEP, protects against PPC in patients undergoing open abdominal surgery. Methods The "Driving prESsure durIng GeNeral AnesThesIa for Open abdomiNal surgery trial" (DESIGNATION) is an international, multicenter, two-group, double-blind randomized clinical superiority trial. A total of 1468 patients will be randomly assigned to one of the two intraoperative ventilation strategies. Investigators screen patients aged >= 18 years and with a body mass index <= 40 kg/m(2), scheduled for open abdominal surgery and at risk for PPC. Patients either receive an intraoperative ventilation strategy with individualized high PEEP with recruitment maneuvers (RM) ("individualized high PEEP") or one in which PEEP of 5 cm H2O without RM is used ("low PEEP"). In the "individualized high PEEP" group, PEEP is set at the level at which Delta P is lowest. In both groups of the trial, V-T is kept at 8 mL/kg predicted body weight. The primary endpoint is the occurrence of PPC, recorded as a collapsed composite of adverse pulmonary events. Discussion DESIGNATION will be the first randomized clinical trial that is adequately powered to compare the effects of individualized high PEEP with RM versus fixed low PEEP without RM on the occurrence of PPC after open abdominal surgery. The results of DESIGNATION will support anesthesiologists in their decisions regarding PEEP settings during open abdominal surgery

A nationwide evaluation of deceased donor kidney transplantation indicates detrimental consequences of early graft loss

Early graft loss (EGL) is a feared outcome of kidney transplantation. Consequently, kidneys with an anticipated risk of EGL are declined for transplantation. In the most favorable scenario, with optimal use of available donor kidneys, the donor pool size is balanced by the risk of EGL, with a tradeoff dictated by the consequences of EGL. To gauge the consequence of EGL we systematically evaluated its impact in an observational study that included all 10,307 deceased-donor kidney transplantations performed in The Netherlands between 1990 and 2018. Incidence of EGL, defined as graft loss within 90 days, in primary transplantation was 8.2% (699/8,511). The main causes were graft rejection (30%), primary nonfunction (25%), and thrombosis or infarction (20%). EGL profoundly impacted short- and long-term patient survival (adjusted hazard ratio; 95% confidence interval: 8.2; 5.1-13.2 and 1.7; 1.3-2.1, respectively). Of the EGL recipients who survived 90 days after transplantation (617/699) only 440 of the 617 were relisted for re-transplantation. Of those relisted, only 298 were ultimately re-transplanted leading to an actual re-transplantation rate of 43%. Noticeably, re-transplantation was associated with a doubled incidence of EGL, but similar long-term graft survival (adjusted hazard ratio 1.1; 0.6-1.8). Thus, EGL after kidney transplantation is a medical catastrophe with high mortality rates, low relisting rates, and increased risk of recurrent EGL following re-transplantation. This implies that detrimental outcomes also involve convergence of risk factors in recipients with EGL. The 8.2% incidence of EGL minimally impacted population mortality, indicating this incidence is acceptable

Some like it bad: testing a model on perceiving and experiencing fictional characters

We developed an encompassing theory that explains how readers of fiction and spectators of motion pictures establish affective relationships with fictional characters (FCs). The perceiving and experiencing fictional characters (PEFiC) theory is anchored in art perception, psychological aesthetics, and social and emotion psychology and addresses both the complexity and intrinsic affectivity involved in media exposure. In a between-subject design (N = 312), engagement and appreciation were measured as a function of the ethics (good vs. bad), aesthetics (beautiful vs. ugly), and epistemics (realistic vs. unrealistic) of eight protagonists in feature movies. The PEFiC model best fit the data with a unipolarity of factors and outperformed traditional theories (identification, empathy): The trade-off between involvement and distance explained the appreciation of FCs better than either distance or involvement alone. The mediators similarity, relevance, and valence exerted significant (interaction) effects, thus complicating the results. Furthermore, the effects of mediated bad persons differed strongly from ethically good ones. Copyright © 2005, Lawrence Erlbaum Associates, Inc

Performance and calibration of the CHORUS scintillating fiber tracker and opto-electronics readout system

An essential component of the CERN WA95/CHORUS experiment is a scintillating fiber tracker system for precise track reconstruction of particles. The tracker design, its opto-electronics readout and calibration system are discussed. Performances of the detector are presented