Validation of a short form Wisconsin Upper Respiratory Symptom Survey (WURSS-21)

<p>Abstract</p> <p>Background</p> <p>The Wisconsin Upper Respiratory Symptom Survey (WURSS) is an illness-specific health-related quality-of-life questionnaire outcomes instrument.</p> <p>Objectives</p> <p>Research questions were: 1) How well does the WURSS-21 assess the symptoms and functional impairments associated with common cold? 2) How well can this instrument measure change over time (responsiveness)? 3) What is the minimal important difference (MID) that can be detected by the WURSS-21? 4) What are the descriptive statistics for area under the time severity curve (AUC)? 5) What sample sizes would trials require to detect MID or AUC criteria? 6) What does factor analysis tell us about the underlying dimensional structure of the common cold? 7) How reliable are items, domains, and summary scores represented in WURSS? 8) For each of these considerations, how well does the WURSS-21 compare to the WURSS-44, Jackson, and SF-8?</p> <p>Study Design and Setting</p> <p>People with Jackson-defined colds were recruited from the community in and around Madison, Wisconsin. Participants were enrolled within 48 hours of first cold symptom and monitored for up to 14 days of illness. Half the sample filled out the WURSS-21 in the morning and the WURSS-44 in the evening, with the other half reversing the daily order. External comparators were the SF-8, a 24-hour recall general health measure yielding separate physical and mental health scores, and the eight-item Jackson cold index, which assesses symptoms, but not functional impairment or quality of life.</p> <p>Results</p> <p>In all, 230 participants were monitored for 2,457 person-days. Participants were aged 14 to 83 years (mean 34.1, SD 13.6), majority female (66.5%), mostly white (86.0%), and represented substantive education and income diversity. WURSS-21 items demonstrated similar performance when embedded within the WURSS-44 or in the stand-alone WURSS-21. Minimal important difference (MID) and Guyatt's responsiveness index were 10.3, 0.71 for the WURSS-21 and 18.5, 0.75 for the WURSS-44. Factorial analysis suggested an eight dimension structure for the WURSS-44 and a three dimension structure for the WURSS-21, with composite reliability coefficients ranging from 0.87 to 0.97, and Cronbach's alpha ranging from 0.76 to 0.96. Both WURSS versions correlated significantly with the Jackson scale (W-21 R = 0.85; W-44 R = 0.88), with the SF-8 physical health (W-21 R = -0.79; W-44 R = -0.80) and SF-8 mental health (W-21 R = -0.55; W-44 R = -0.60).</p> <p>Conclusion</p> <p>The WURSS-44 and WURSS-21 perform well as illness-specific quality-of-life evaluative outcome instruments. Construct validity is supported by the data presented here. While the WURSS-44 covers more symptoms, the WURSS-21 exhibits similar performance in terms of reliability, responsiveness, importance-to-patients, and convergence with other measures.</p

Strategisches Management in Kommunen: Entstehung, Inhalte und Wirkungen von Digitalisierungs- und Nachhaltigkeitsstrategien

Der Beitrag untersucht Praxen des strategischen Managements in deutschen Kommunalverwaltungen am Beispiel von Digitalisierungs- und Nachhaltigkeitsstrategien. Es werden drei Forschungsfragen bearbeitet: 1. Was sind typische Inhalte und Strukturen solcher Strategien? 2. Wie und warum entstehen solche Strategien? 3. Welche Erfahrungen machen Kommunen mit diesen Strategien?

Queer In AI: A Case Study in Community-Led Participatory AI

We present Queer in AI as a case study for community-led participatory design in AI. We examine how participatory design and intersectional tenets started and shaped this community's programs over the years. We discuss different challenges that emerged in the process, look at ways this organization has fallen short of operationalizing participatory and intersectional principles, and then assess the organization's impact. Queer in AI provides important lessons and insights for practitioners and theorists of participatory methods broadly through its rejection of hierarchy in favor of decentralization, success at building aid and programs by and for the queer community, and effort to change actors and institutions outside of the queer community. Finally, we theorize how communities like Queer in AI contribute to the participatory design in AI more broadly by fostering cultures of participation in AI, welcoming and empowering marginalized participants, critiquing poor or exploitative participatory practices, and bringing participation to institutions outside of individual research projects. Queer in AI's work serves as a case study of grassroots activism and participatory methods within AI, demonstrating the potential of community-led participatory methods and intersectional praxis, while also providing challenges, case studies, and nuanced insights to researchers developing and using participatory methods.Comment: To appear at FAccT 202

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Definitive Radiation Therapy and Survival in Clinically Node-Positive Prostate Cancer.

PurposeThe survival benefit of combined radiation therapy (RT) and androgen deprivation therapy (ADT) compared with ADT alone for clinically lymph node-positive prostate cancer remains controversial.Methods and materialsWe identified patients with clinically node-positive, nonmetastatic prostate cancer diagnosed between 2000 and 2015 and treated with ADT (n&nbsp;=&nbsp;450) or ADT-RT (n&nbsp;=&nbsp;198) from a national Veterans Affairs database. We compared prostate cancer-specific mortality (PCSM) and all-cause mortality (ACM) between treatment groups using multivariable competing-risks regression and Cox regression, respectively. An interaction term between ADT-RT and prostate-specific antigen (PSA) level (dichotomized about the median) was included in the multivariable models.ResultsADT-RT was associated with improved PCSM among patients with PSA levels less than the median of 26&nbsp;ng/mL (sub-distribution hazard ratio, 0.50; 95% confidence interval [CI] 0.28-0.88; P&nbsp;=&nbsp;.02) but not greater than the median (hazard ratio [HR], 1.15; 95% CI 0.67-1.96; P&nbsp;=&nbsp;.62) (P&nbsp;=&nbsp;.038 for interaction).&nbsp;ADT-RT was also associated with improved ACM among patients with PSA levels less than the median (HR, 0.38; 95% CI 0.25-0.57; P&nbsp;&lt;&nbsp;.001) but not greater than the median (HR, 0.91; 95% CI 0.60-1.38; P&nbsp;=&nbsp;.66) (P&nbsp;=&nbsp;.004 for interaction).ConclusionsDefinitive treatment with ADT-RT is associated with improved PCSM and ACM among patients with clinically node-positive prostate cancer and lower baseline PSA levels. Patients with clinically node-positive disease appear to be a heterogeneous cohort, with a subset who may achieve long-term survival with combined RT and ADT

Impact of age on treatment response in men with prostate cancer treated with radiotherapy.

ObjectiveTo analyse the effect of age at diagnosis on clinical outcomes of localized prostate cancer (PCa) treated with radiation therapy.Subjects and methodsWe identified 12 784 patients with intermediate- or high-risk localized PCa treated with radiation therapy (RT) and neoadjuvant androgen deprivation therapy (ADT) between 2000 and 2015 from nationwide Veterans Affairs data. Patients were grouped into three age categories (≤59, 60-69, and ≥70 years old). Outcomes included immediate PSA response (3-month post-RT PSA and 2-year PSA nadir, grouped into &lt;0.10&nbsp;ng/ml, 0.10-0.49 ng/ml, and ≥0.50 ng/ml), biochemical recurrence, and PCa-specific mortality. Multivariable regression models included ordinal logistic regression for short-term PSA outcomes, Cox regression for biochemical recurrence, and Fine-Gray competing risks regression for PCa-specific mortality.ResultsA total of 2136 patients (17%) were ≤59 years old at diagnosis, 6107 (48%) were 60-69 years old, and 4541 (36%) were ≥70 years old. Median follow-up was 6.3&nbsp;years. Younger age was associated with greater odds of higher 3-month PSA group (≤59 vs. ≥70: adjusted odds ratio [aOR] 1.90, 95% CI 1.64-2.20; p &lt; 0.001) and higher 2-year PSA nadir group (≤59 vs. ≥70: aOR 1.89, 95% CI 1.62-2.19, p &lt; 0.001). Younger age was associated with greater risk of biochemical recurrence (≤59 vs. ≥70: adjusted hazard ratio 1.45, 95% CI 1.26-1.67, p &lt; 0.001) but not PCa-specific mortality (p = 0.16).ConclusionIn a large nationwide sample of US veterans treated with ADT and RT for localized PCa, younger age was associated with inferior short-term PSA response and higher risk of biochemical recurrence

Geometric and dosimetric evaluation of atlas based auto-segmentation of cardiac structures in breast cancer patients

Auto-segmentation represents an efficient tool to segment organs on CT imaging. Primarily used in clinical setting, auto-segmentation plays an increasing role in research, particularly when analyzing thousands of images in the "big data" era. In this study we evaluate the accuracy of cardiac dosimetric endpoints derived from atlas based auto-segmentation compared to gold standard manual segmentation. Heart and cardiac substructures were manually delineated on 54 breast cancer patients. Twenty-seven patients were used to build the auto-segmentation atlas, the other 27 to validate performance. We evaluated accuracy of the auto-segmented contours with standard geometric indices and assessed dosimetric endpoints. Auto-segmented contours overlapped geometrically with manual contours of the heart and chambers with Dice-similarity coefficients of 0.93 ± 0.02 (mean ± standard deviation) and 0.79 ± 0.07 respectively. Similarly, there was a strong link between dosimetric parameters derived from auto-segmented and manual contours (R  = 0.955-1.000). On the other hand, the left anterior descending artery had little geometric overlap (Dice-similarity coefficient 0.09 ± 0.07), though acceptable representation of dosimetric parameters (R  = 0.646-0.992). The atlas based auto-segmentation approach delineates heart structures with sufficient accuracy for research purposes. Our results indicate that quality of auto-segmented contours cannot be determined by geometric values only