Ranking factors involved in diabetes remission after bariatric surgery using machine-learning integrating clinical and genomic biomarkers

AbstractAs weight-loss surgery is an effective treatment for the glycaemic control of type 2 diabetes in obese patients, yet not all patients benefit, it is valuable to find predictive factors for this diabetic remission. This will help elucidating possible mechanistic insights and form the basis for prioritising obese patients with dysregulated diabetes for surgery where diabetes remission is of interest. In this study, we combine both clinical and genomic factors using heuristic methods, informed by prior biological knowledge in order to rank factors that would have a role in predicting diabetes remission, and indeed in identifying patients who may have low likelihood in responding to bariatric surgery for improved glycaemic control. Genetic variants from the Illumina CardioMetaboChip were prioritised through single-association tests and then seeded a larger selection from protein–protein interaction networks. Artificial neural networks allowing nonlinear correlations were trained to discriminate patients with and without surgery-induced diabetes remission, and the importance of each clinical and genetic parameter was evaluated. The approach highlighted insulin treatment, baseline HbA1c levels, use of insulin-sensitising agents and baseline serum insulin levels, as the most informative variables with a decent internal validation performance (74% accuracy, area under the curve (AUC) 0.81). Adding information for the eight top-ranked single nucleotide polymorphisms (SNPs) significantly boosted classification performance to 84% accuracy (AUC 0.92). The eight SNPs mapped to eight genes — ABCA1, ARHGEF12, CTNNBL1, GLI3, PROK2, RYBP, SMUG1 and STXBP5 — three of which are known to have a role in insulin secretion, insulin sensitivity or obesity, but have not been indicated for diabetes remission after bariatric surgery before.</jats:p

Faciliteret Multi-Source Feedback som pædagogisk kompetenceudvikling – et dansk casestudie

De seneste års politiske og institutionelle fokus på kvalitetssikring i undervisningen på de videregående uddannelser har afdækket et behov for at anerkende undervisning på lige fod med forskning. Peer-review anvendes til anerkendelse af forskning, men kan en lignende metode også anvendes til anerkendelse af undervisning? Og hvad sker der i en organisationskultur, når peer-review af undervisningen introduceres som pædagogisk kompetenceudvikling? I denne artikel præsenteres resultaterne af et forskningsprojekt, der udviklede, afprøvede og undersøgte en pædagogisk kompetenceudviklingsmodel inspireret af peer-review – en Faciliteret Multi-Source Feedback-model (FMSF-model). I et kvalitativt interviewstudie undersøgte vi deltagernes (n=15) oplevelse af FMSF-modellen og dens anvendelighed i et organisatorisk læringsperspektiv. Resultaterne peger på, at FMSF-modellen kan facilitere handlingsorienteret refleksion til gavn for undervisernes pædagogiske kompetenceudvikling og understøtte en organisatorisk læringsstruktur qua dens målrettede og strukturerede feedbackformat. Modellens anvendelighed påvirkes dog af lokalt forankrede kulturelle normer og praksisser, f.eks. sparsom peer-feedback og -observation samt manglende transparens blandt deltagerne

Unge fodboldtalenters veje mod toppen - evolutionær eller strategisk talentudvikling?

Med udgangspunkt i en kvantitativ undersøgelse af fodboldspilleres vej mod toppen diskuterer artiklen tendenser i dansk elitefodbolds talentudvikling. Der kigges nærmer på den relative alderseffekt blandt spillerne og på den evolutionære og strategiske udviklingstankegangen. Mette Krogh Christensen: Young Football Talents’ Ways to the Top – Evolutionary or Strategic Talent Development? During the next four years the Danish government intends to spend 40 million Dkr. on talent development within Danish top-level sport. Like many other countries Denmark has chosen to use many resources on talent development in top-level sport expecting that the investment will »strengthen the exposure and increase the knowledge of Denmark« (The Danish Ministry of Culture, 2007). For that reason questions concerning how talent development in Denmark is managed and which modes of thought form the basis of talent development in top-level sport are highly topical. In this paper we will explore two modes of thought in Danish top-level football talent development: an evolutionary and a strategic mode of thought. An evolutionary mode of thought about talent development is characterized by giving a high priority to broad groups of talents as long as possible. The idea is that young football talents have the opportunity to develop in their own pace, to move in their well-known environments and to find their own peak compe186 tence (or qualification) after which experienced coaches select the footballers that they find appropriate. A strategic mode of thought about talent development is concerned with selecting and thinning out the broad group of talent at a much earlier stage. The selection is carried out on the basis of precise and distinct criteria and principles with the purpose of narrowing down the number of talents to a strategically selected group who are then given optimal conditions of development. The paper presents a retrospective, quantitative cohort study of 635 Danish youth football talents’ ways to the top (i.e. the national teams) from 1991-2006. The results showed among other things that relatively few talents from U/16 and U/17 national teams make their debut on the All-Denmark team, and that there is a massive flow of talents on the U/17 and U/18 national teams, which indicates an evolutionary mode of thought among the youth national team coaches. The results also showed a relative age effect among the younger talents, which might indicate a strategic mode of thought based on maturation as a performance determinant. On the background of the results from the study a pivotal dilemma in the investment in talent development in top-level sport is discussed: the dilemma between evolutionary and strategic talent development

Unge fodboldtalenters veje mod toppen - evolutionær eller strategisk talentudvikling?

Med udgangspunkt i en kvantitativ undersøgelse af fodboldspilleres vej mod toppen diskuterer artiklen tendenser i dansk elitefodbolds talentudvikling. Der kigges nærmer på den relative alderseffekt blandt spillerne og på den evolutionære og strategiske udviklingstankegangen. Mette Krogh Christensen: Young Football Talents’ Ways to the Top – Evolutionary or Strategic Talent Development? During the next four years the Danish government intends to spend 40 million Dkr. on talent development within Danish top-level sport. Like many other countries Denmark has chosen to use many resources on talent development in top-level sport expecting that the investment will »strengthen the exposure and increase the knowledge of Denmark« (The Danish Ministry of Culture, 2007). For that reason questions concerning how talent development in Denmark is managed and which modes of thought form the basis of talent development in top-level sport are highly topical. In this paper we will explore two modes of thought in Danish top-level football talent development: an evolutionary and a strategic mode of thought. An evolutionary mode of thought about talent development is characterized by giving a high priority to broad groups of talents as long as possible. The idea is that young football talents have the opportunity to develop in their own pace, to move in their well-known environments and to find their own peak compe186 tence (or qualification) after which experienced coaches select the footballers that they find appropriate. A strategic mode of thought about talent development is concerned with selecting and thinning out the broad group of talent at a much earlier stage. The selection is carried out on the basis of precise and distinct criteria and principles with the purpose of narrowing down the number of talents to a strategically selected group who are then given optimal conditions of development. The paper presents a retrospective, quantitative cohort study of 635 Danish youth football talents’ ways to the top (i.e. the national teams) from 1991-2006. The results showed among other things that relatively few talents from U/16 and U/17 national teams make their debut on the All-Denmark team, and that there is a massive flow of talents on the U/17 and U/18 national teams, which indicates an evolutionary mode of thought among the youth national team coaches. The results also showed a relative age effect among the younger talents, which might indicate a strategic mode of thought based on maturation as a performance determinant. On the background of the results from the study a pivotal dilemma in the investment in talent development in top-level sport is discussed: the dilemma between evolutionary and strategic talent development

Unge fodboldtalenters veje mod toppen - evolutionær eller strategisk talentudvikling?

Med udgangspunkt i en kvantitativ undersøgelse af fodboldspilleres vej mod toppen diskuterer artiklen tendenser i dansk elitefodbolds talentudvikling. Der kigges nærmer på den relative alderseffekt blandt spillerne og på den evolutionære og strategiske udviklingstankegangen. Mette Krogh Christensen: Young Football Talents’ Ways to the Top – Evolutionary or Strategic Talent Development? During the next four years the Danish government intends to spend 40 million Dkr. on talent development within Danish top-level sport. Like many other countries Denmark has chosen to use many resources on talent development in top-level sport expecting that the investment will »strengthen the exposure and increase the knowledge of Denmark« (The Danish Ministry of Culture, 2007). For that reason questions concerning how talent development in Denmark is managed and which modes of thought form the basis of talent development in top-level sport are highly topical. In this paper we will explore two modes of thought in Danish top-level football talent development: an evolutionary and a strategic mode of thought. An evolutionary mode of thought about talent development is characterized by giving a high priority to broad groups of talents as long as possible. The idea is that young football talents have the opportunity to develop in their own pace, to move in their well-known environments and to find their own peak compe186 tence (or qualification) after which experienced coaches select the footballers that they find appropriate. A strategic mode of thought about talent development is concerned with selecting and thinning out the broad group of talent at a much earlier stage. The selection is carried out on the basis of precise and distinct criteria and principles with the purpose of narrowing down the number of talents to a strategically selected group who are then given optimal conditions of development. The paper presents a retrospective, quantitative cohort study of 635 Danish youth football talents’ ways to the top (i.e. the national teams) from 1991-2006. The results showed among other things that relatively few talents from U/16 and U/17 national teams make their debut on the All-Denmark team, and that there is a massive flow of talents on the U/17 and U/18 national teams, which indicates an evolutionary mode of thought among the youth national team coaches. The results also showed a relative age effect among the younger talents, which might indicate a strategic mode of thought based on maturation as a performance determinant. On the background of the results from the study a pivotal dilemma in the investment in talent development in top-level sport is discussed: the dilemma between evolutionary and strategic talent development

Replication of newly proposed TNM staging system for medullary thyroid carcinoma:a nationwide study

A recent study proposed new TNM groupings for better survival discrimination among stage groups for medullary thyroid carcinoma (MTC) and validated these groupings in a population-based cohort in the United States. However, it is unknown how well the groupings perform in populations outside the United States. Consequently, we conducted the first population-based study aiming to evaluate if the recently proposed TNM groupings provide better survival discrimination than the current American Joint Committee on Cancer (AJCC) TNM staging system (seventh and eighth edition) in a nationwide MTC cohort outside the United States. This retrospective cohort study included 191 patients identified from the nationwide Danish MTC cohort between 1997 and 2014. In multivariate analysis, hazard ratios for overall survival under the current AJCC TNM staging system vs the proposed TNM groupings with stage I as reference were 1.32 (95% CI: 0.38–4.57) vs 3.04 (95% CI: 1.38–6.67) for stage II, 2.06 (95% CI: 0.45–9.39) vs 3.59 (95% CI: 1.61–8.03) for stage III and 5.87 (95% CI: 2.02–17.01) vs 59.26 (20.53–171.02) for stage IV. The newly proposed TNM groupings appear to provide better survival discrimination in the nationwide Danish MTC cohort than the current AJCC TNM staging. Adaption of the proposed TNM groupings by the current AJCC TNM staging system may potentially improve accurateness in survival discrimination. However, before such an adaption further population-based studies securing external validity are needed