Quantile regression for mixed models with an application to examine blood pressure trends in China

Cardiometabolic diseases have substantially increased in China in the past 20 years and blood pressure is a primary modifiable risk factor. Using data from the China Health and Nutrition Survey, we examine blood pressure trends in China from 1991 to 2009, with a concentration on age cohorts and urbanicity. Very large values of blood pressure are of interest, so we model the conditional quantile functions of systolic and diastolic blood pressure. This allows the covariate effects in the middle of the distribution to vary from those in the upper tail, the focal point of our analysis. We join the distributions of systolic and diastolic blood pressure using a copula, which permits the relationships between the covariates and the two responses to share information and enables probabilistic statements about systolic and diastolic blood pressure jointly. Our copula maintains the marginal distributions of the group quantile effects while accounting for within-subject dependence, enabling inference at the population and subject levels. Our population-level regression effects change across quantile level, year and blood pressure type, providing a rich environment for inference. To our knowledge, this is the first quantile function model to explicitly model within-subject autocorrelation and is the first quantile function approach that simultaneously models multivariate conditional response. We find that the association between high blood pressure and living in an urban area has evolved from positive to negative, with the strongest changes occurring in the upper tail. The increase in urbanization over the last twenty years coupled with the transition from the positive association between urbanization and blood pressure in earlier years to a more uniform association with urbanization suggests increasing blood pressure over time throughout China, even in less urbanized areas. Our methods are available in the R package BSquare.Comment: Published at http://dx.doi.org/10.1214/15-AOAS841 in the Annals of Applied Statistics (http://www.imstat.org/aoas/) by the Institute of Mathematical Statistics (http://www.imstat.org

Quality of life in the five years after intensive care : a cohort study

Peer reviewedPublisher PD

A randomized prospective long-term (\u3e 1 year) clinical trial comparing the efficacy and safety of radiofrequency ablation to 980nm laser ablation of the great saphenous vein

Purpose To compare the short- and long-term (\u3e1 year) efficacy and safety of radiofrequency ablation (ClosureFAST™) versus endovenous laser ablation (980 nm diode laser) for the treatment of superficial venous insufficiency of the great saphenous vein. Materials and methods Two hundred patients with superficial venous insufficiency of the great saphenous vein were randomized to receive either radiofrequency ablation or endovenous laser ablation (and simultaneous adjunctive therapies for surface varicosities when appropriate). Post-treatment sonographic and clinical assessment was conducted at one week, six weeks, and six months for closure, complications, and patient satisfaction. Clinical assessment of each patient was conducted at one year and then at yearly intervals for patient satisfaction. Results Post-procedure pain (p \u3c 0.0001) and objective post-procedure bruising (p = 0.0114) were significantly lower in the radiofrequency ablation group. Improvements in venous clinical severity score were noted through six months in both groups (endovenous laser ablation 6.6 to 1; radiofrequency ablation 6.2 to 1) with no significant difference in venous clinical severity score (p = 0.4066) or measured adverse effects; 89 endovenous laser ablation and 87 radiofrequency patients were interviewed at least 12 months out with a mean long-term follow-up of 44 and 42 months (p = 0.1096), respectively. There were four treatment failures in each group, and every case was correctable with further treatment. Overall, there were no significant differences with regard to patient satisfaction between radiofrequency ablation and endovenous laser ablation (p = 0.3009). There were no cases of deep venous thrombosis in either group at any time during this study. Conclusions Radiofrequency ablation and endovenous laser ablation are highly effective and safe from both anatomic and clinical standpoints over a multi-year period and neither modality achieved superiority over the other

Mte1 interacts with Mph1 and promotes crossover recombination and telomere maintenance

Mph1 is a member of the conserved FANCM family of DNA motor proteins that play key roles in genome maintenance processes underlying Fanconi anemia, a cancer predisposition syndrome in humans. Here, we identify Mte1 as a novel interactor of the Mph1 helicase in Saccharomyces cerevisiae. In vitro, Mte1 (Mph1-associated telomere maintenance protein 1) binds directly to DNA with a preference for branched molecules such as D loops and fork structures. In addition, Mte1 stimulates the helicase and fork regression activities of Mph1 while inhibiting the ability of Mph1 to dissociate recombination intermediates. Deletion of MTE1 reduces crossover recombination and suppresses the sensitivity of mph1Δ mutant cells to replication stress. Mph1 and Mte1 interdependently colocalize atDNAdamage-induced foci and dysfunctional telomeres, and MTE1 deletion results in elongated telomeres. Taken together, our data indicate that Mte1 plays a role in regulation of crossover recombination, response to replication stress, and telomere maintenance

Integrated Laboratory Demonstrations of Multi-Object Adaptive Optics on a Simulated 10-Meter Telescope at Visible Wavelengths

One important frontier for astronomical adaptive optics (AO) involves methods such as Multi-Object AO and Multi-Conjugate AO that have the potential to give a significantly larger field of view than conventional AO techniques. A second key emphasis over the next decade will be to push astronomical AO to visible wavelengths. We have conducted the first laboratory simulations of wide-field, laser guide star adaptive optics at visible wavelengths on a 10-meter-class telescope. These experiments, utilizing the UCO/Lick Observatory's Multi-Object / Laser Tomography Adaptive Optics (MOAO/LTAO) testbed, demonstrate new techniques in wavefront sensing and control that are crucial to future on-sky MOAO systems. We (1) test and confirm the feasibility of highly accurate atmospheric tomography with laser guide stars, (2) demonstrate key innovations allowing open-loop operation of Shack-Hartmann wavefront sensors (with errors of ~30 nm) as will be needed for MOAO, and (3) build a complete error budget model describing system performance. The AO system maintains a performance of 32.4% Strehl on-axis, with 24.5% and 22.6% at 10" and 15", respectively, at a science wavelength of 710 nm (R-band) over the equivalent of 0.8 seconds of simulation. The MOAO-corrected field of view is ~25 times larger in area than that limited by anisoplanatism at R-band. Our error budget is composed of terms verified through independent, empirical experiments. Error terms arising from calibration inaccuracies and optical drift are comparable in magnitude to traditional terms like fitting error and tomographic error. This makes a strong case for implementing additional calibration facilities in future AO systems, including accelerometers on powered optics, 3D turbulators, telescope and LGS simulators, and external calibration ports for deformable mirrors.Comment: 29 pages, 11 figures, submitted to PAS