Estimating mark rate and its effect on the precision of estimates of survival rate for a long-term study of Hector’s dolphins (Cephalorhynchus hectori) at Banks Peninsula, NZ

An accurate and precise estimate of mark rate (the proportion of individuals with marks suitable for photo-ID) is essential for adjusting estimates of abundance from capture-recapture models to include the unmarked portion of the population. Capture-recapture analyses on marine mammals typically assume that mark rate is constant over time, but this may not be true if management has decreased the frequency of interactions with fishing gear (a known source of marks). Considering that mark rate of Hector’s dolphins may have changed due to expanded set net protections around Banks Peninsula, this research had three primary aims: (1) to estimate an updated mark rate (for 2016), (2) to determine whether mark rate has changed since protection measures have expanded, and (3) to explore the implications of a low mark rate on estimating a key demographic parameter, survival rate. To determine the 2016 mark rate, several different mark rate estimation strategies were trialled and compared. Mark rate was then compared to an earlier period when set net restrictions were still relatively new (1992 – 1996). To investigate whether a decreasing mark rate affects precision of survival rates in Hector’s dolphins, I simulated capture histories by resampling from the population’s original capture history dataset. The comparison of different mark rate estimation strategies suggests that past studies underestimate the variance of mark rate by assuming simple random sampling of individuals, when in reality dolphins are encountered in groups (meaning observations are not truly independent). Whether a change in mark rate was detected between the two periods was method dependent. The frequentist method did not detect a statistically significant difference, but results from the Bayesian model indicated a 98% probability that the mark rate in 2016 (0.069, 95% HDI: 0.049 – 0.090) is lower than the 1992 – 1996 period (0.107, 95% HDI: 0.080 – 0.137). The simulation showed that although there was no evidence a lower mark rate would bias estimates of survival rate, it is likely to result in reduced precision. This may affect the ability to track population trends and determine whether current management is adequate

Associations between Reoperations and Psychological Factors after Contralateral Risk-Reducing Mastectomy: A Two-Year Follow-Up Study

Introduction. The aim of the study was to investigate associations between reoperations after contralateral risk-reducing mastectomies (CRRM) and emotional problems, body image, sexuality, and health related quality of life (HRQoL) in women with breast cancer and hereditary high risk. Patients and Methods. Patients scheduled for CRRM with breast reconstruction between 1998 and 2010 completed questionnaires, comprised of SF-36, the Hospital Anxiety and Depression Scale, the Body Image Scale, and the Sexual Activity Questionnaire, preoperatively and two years after CRRM. Data on reoperations was collected from medical charts. Results. A total of 80 women participated, with a response rate of 61 (76%) preoperatively and 57 (71%) at the two-year followup. At the two-year assessment, 44 (55%) patients had undergone ≥1 reoperation (reoperation group), whereas 36 (45%) had not (no reoperation group). No statistically significant differences between the groups were found for HRQoL, sexuality, anxiety, or depression. A higher proportion of patients in the "reoperation group" reported being dissatisfied with their bodies (81% versus 48%, = 0.01). Conclusion. The results suggest associations between reoperation following CRRM with breast reconstruction and body image problems. Special attention should be paid to body image problems among women who are subject to reoperations after CRRM

Strategy and rationale for urine collection protocols employed in the NEPTUNE study

Abstract Background Glomerular diseases are potentially fatal, requiring aggressive interventions and close monitoring. Urine is a readily-accessible body fluid enriched in molecular signatures from the kidney and therefore particularly suited for routine clinical analysis as well as development of non-invasive biomarkers for glomerular diseases. Methods The Nephrotic Syndrome Study Network (NEPTUNE; ClinicalTrials.gov Identifier NCT01209000) is a North American multicenter collaborative consortium established to develop a translational research infrastructure for nephrotic syndrome. This includes standardized urine collections across all participating centers for the purpose of discovering non-invasive biomarkers for patients with nephrotic syndrome due to minimal change disease, focal segmental glomerulosclerosis, and membranous nephropathy. Here we describe the organization and methods of urine procurement and banking procedures in NEPTUNE. Results We discuss the rationale for urine collection and storage conditions, and demonstrate the performance of three experimental analytes (neutrophil gelatinase-associated lipocalin [NGAL], retinol binding globulin, and alpha-1 microglobulin) under these conditions with and without urine preservatives (thymol, toluene, and boric acid). We also demonstrate the quality of RNA and protein collected from the urine cellular pellet and exosomes. Conclusions The urine collection protocol in NEPTUNE allows robust detection of a wide range of proteins and RNAs from urine supernatant and pellets collected longitudinally from each patient over 5 years. Combined with the detailed clinical and histopathologic data, this provides a unique resource for exploration and validation of new or accepted markers of glomerular diseases. Trial registration ClinicalTrials.gov Identifier NCT01209000http://deepblue.lib.umich.edu/bitstream/2027.42/116023/1/12882_2015_Article_185.pd

Gaining the PROMIS perspective from children with nephrotic syndrome: a Midwest pediatric nephrology consortium study

Background and objectives Nephrotic syndrome (NS) represents a common disease in pediatric nephrology typified by a relapsing and remitting course and characterized by the presence of edema that can significantly affect the health-related quality of life in children and adolescents. The PROMIS pediatric measures were constructed to be publically available, efficient, precise, and valid across a variety of diseases to assess patient reports of symptoms and quality of life. This study was designed to evaluate the ability of children and adolescents with NS to complete the PROMIS assessment via computer and to initiate validity assessments of the short forms and full item banks in pediatric NS. Successful measurement of patient reported outcomes will contribute to our understanding of the impact of NS on children and adolescents. Design This cross-sectional study included 151 children and adolescents 8-17 years old with NS from 16 participating institutions in North America. The children completed the PROMIS pediatric depression, anxiety, social-peer relationships, pain interference, fatigue, mobility and upper extremity functioning measures using a web-based interface. Responses were compared between patients experiencing active NS (n = 53) defined by the presence of edema and patients with inactive NS (n = 96) defined by the absence of edema. Results All 151 children and adolescents were successfully able to complete the PROMIS assessment via computer. As hypothesized, the children and adolescents with active NS were significantly different on 4 self-reported measures (anxiety, pain interference, fatigue, and mobility). Depression, peer relationships, and upper extremity functioning were not different between children with active vs. inactive NS. Multivariate analysis showed that the PROMIS instruments remained sensitive to NS disease activity after adjusting for demographic characteristics. Conclusions Children and adolescents with NS were able to successfully complete the PROMIS instrument using a web-based interface. The computer based pediatric PROMIS measurement effectively discriminated between children and adolescents with active and inactive NS. The domain scores found in this study are consistent with previous reports investigating the health-related quality of life in children and adolescents with NS. This study establishes known-group validity and feasibility for PROMIS pediatric measures in children and adolescents with NS

Gaining the Patient Reported Outcomes Measurement Information System (PROMIS) perspective in chronic kidney disease: a Midwest Pediatric Nephrology Consortium study

Chronic kidney disease is a persistent chronic health condition commonly seen in pediatric nephrology programs. Our study aims to evaluate the sensitivity of the Patient Reported Outcomes Measurement Information System (PROMIS) pediatric instrument to indicators of disease severity and activity in pediatric chronic kidney disease

Rhinitis associated with asthma is distinct from rhinitis alone: TARIA‐MeDALL hypothesis

Asthma, rhinitis, and atopic dermatitis (AD) are interrelated clinical phenotypes that partly overlap in the human interactome. The concept of “one-airway-one-disease,” coined over 20 years ago, is a simplistic approach of the links between upper- and lower-airway allergic diseases. With new data, it is time to reassess the concept. This article reviews (i) the clinical observations that led to Allergic Rhinitis and its Impact on Asthma (ARIA), (ii) new insights into polysensitization and multimorbidity, (iii) advances in mHealth for novel phenotype definitions, (iv) confirmation in canonical epidemiologic studies, (v) genomic findings, (vi) treatment approaches, and (vii) novel concepts on the onset of rhinitis and multimorbidity. One recent concept, bringing together upper- and lower-airway allergic diseases with skin, gut, and neuropsychiatric multimorbidities, is the “Epithelial Barrier Hypothesis.” This review determined that the “one-airway-one-disease” concept does not always hold true and that several phenotypes of disease can be defined. These phenotypes include an extreme “allergic” (asthma) phenotype combining asthma, rhinitis, and conjunctivitis.info:eu-repo/semantics/publishedVersio

Estimating mark rate and its effect on the precision of estimates of survival rate for a long-term study of Hector’s dolphins (Cephalorhynchus hectori) at Banks Peninsula, NZ

An accurate and precise estimate of mark rate (the proportion of individuals with marks suitable for photo-ID) is essential for adjusting estimates of abundance from capture-recapture models to include the unmarked portion of the population. Capture-recapture analyses on marine mammals typically assume that mark rate is constant over time, but this may not be true if management has decreased the frequency of interactions with fishing gear (a known source of marks). Considering that mark rate of Hector’s dolphins may have changed due to expanded set net protections around Banks Peninsula, this research had three primary aims: (1) to estimate an updated mark rate (for 2016), (2) to determine whether mark rate has changed since protection measures have expanded, and (3) to explore the implications of a low mark rate on estimating a key demographic parameter, survival rate. To determine the 2016 mark rate, several different mark rate estimation strategies were trialled and compared. Mark rate was then compared to an earlier period when set net restrictions were still relatively new (1992 – 1996). To investigate whether a decreasing mark rate affects precision of survival rates in Hector’s dolphins, I simulated capture histories by resampling from the population’s original capture history dataset. The comparison of different mark rate estimation strategies suggests that past studies underestimate the variance of mark rate by assuming simple random sampling of individuals, when in reality dolphins are encountered in groups (meaning observations are not truly independent). Whether a change in mark rate was detected between the two periods was method dependent. The frequentist method did not detect a statistically significant difference, but results from the Bayesian model indicated a 98% probability that the mark rate in 2016 (0.069, 95% HDI: 0.049 – 0.090) is lower than the 1992 – 1996 period (0.107, 95% HDI: 0.080 – 0.137). The simulation showed that although there was no evidence a lower mark rate would bias estimates of survival rate, it is likely to result in reduced precision. This may affect the ability to track population trends and determine whether current management is adequate

Patient-reported outcomes and 3-dimensional surface imaging after risk-reducing mastectomy and immediate breast reconstruction

The cosmetic results after risk-reducing mastectomy (RRM) and immediate breast reconstruction (IBR) are intended to be long-lasting. Long-term follow-up of the cosmetic outcome can be evaluated subjectively by the women themselves through patient-reported outcome measures such as questionnaires, or by using data from three-dimensional surface imaging (3D-SI) to calculate the volume, shape, and symmetry of the reconstructed breasts as a more objective cosmetic evaluation. The study aim was to evaluate the correspondence between patient-reported measures and 3D-SI measurements. Methods: Questionnaires (EORTC QLQ-BRECON23 and BIS) were sent to women on average 13 [7-20] years after RRM and IBR. Items were preselected for comparison with 3D measurements of women imaged using the VECTRA XT 3D-imaging system at the long-term follow-up. Results: Questionnaire responses and 3D images of 58 women, 36 without and 22 with previous breast cancer (where 15 also received radiotherapy) before RRM and IBR, were analyzed. Median age at follow-up was 57 [41-73] years. Patient-reported satisfaction with the cosmetic outcome was positive for both groups. 3D measurements indicated more symmetrical cosmetic results for women without previous breast cancer. No statistically significant associations between patient-reported satisfaction and 3D measurements were found. Conclusions: Satisfaction with the long-term cosmetic outcome after RRM and IBR was, in general, positive when evaluated by the women. 3D-SI could be used as a more objective approach to assess the cosmetic outcome in terms of volume and shape-symmetry; however, it does not directly translate to the patient-reported satisfaction