Prognostic variables and scores identifying the last year of life in COPD: a systematic review protocol

Introduction People living with advanced chronic obstructive pulmonary disease (COPD) suffer from significant morbidity, reduced quality of life and high mortality, and are likely to benefit from many aspects of a palliative care approach. Prognostic estimates are a meaningful part of decision-making and better evidence for such estimates would facilitate advance care planning. We aim to provide quality evidence on known prognostic variables and scores which predict a prognosis in COPD of <12 months for use in the community. Methods and analysis We will conduct a systematic review of randomised or quasi-randomised controlled trials, prospective and retrospective longitudinal cohort and case–control studies on prognostic variables, multivariate scores or models for COPD. The search will cover the period up to April 2016. Study selection will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, with data extraction using fields from the Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies (CHARMS) checklist for multivariate models, and study quality will be assessed using a modified version of the Quality In Prognosis Studies (QUIPS) tool. Ethics and dissemination The results will be disseminated through peer-reviewed publications and national and international conference presentations

Estimating causal structure using conditional DAG models

©2016 Chris. J. Oates, Jim. Q. Smith and Sach Mukherjee. This paper considers inference of causal structure in a class of graphical models called conditional DAGs. These are directed acyclic graph (DAG) models with two kinds of variables, primary and secondary. The secondary variables are used to aid in the estimation of the structure of causal relationships between the primary variables. We prove that, under certain assumptions, such causal structure is identifiable from the joint observational distribution of the primary and secondary variables. We give causal semantics for the model class, put forward a score-based approach for estimation and establish consistency results. Empirical results demonstrate gains compared with formulations that treat all variables on an equal footing, or that ignore secondary variables. The methodology is motivated by applications in biology that involve multiple data types and is illustrated here using simulated data and in an analysis of molecular data from the Cancer Genome Atlas

Gaussian tree constraints applied to acoustic linguistic functional data

Evolutionary models of languages are usually considered to take the form of trees. With the development of so-called tree constraints the plausibility of the tree model assumptions can be addressed by checking whether the moments of observed variables lie within regions consistent with trees. In our linguistic application, the data set comprises acoustic samples (audio recordings) from speakers of five Romance languages or dialects. We wish to assess these functional data for compatibility with a hereditary tree model at the language level. A novel combination of canonical function analysis (CFA) with a separable covariance structure provides a method for generating a representative basis for the data. This resulting basis is formed of components which emphasize language differences whilst maintaining the integrity of the observational language-groupings. A previously unexploited Gaussian tree constraint is then applied to component-by-component projections of the data to investigate adherence to an evolutionary tree. The results indicate that while a tree model is unlikely to be suitable for modeling all aspects of the acoustic linguistic data, certain features of the spoken Romance languages highlighted by the separable-CFA basis may indeed be suitably modeled as a tree.NS acknowledges the support of Economics and Social Science Research Council grant ES/I90427/1. JADA acknowledges the support of UK Engineering and Physical Sciences Research Council grant EP/K021672/2. JSC acknowledges the support of UK Arts and Humanities Research Council grant AH/M002993/1.This is the final version of the article. It first appeared from Elsevier via https://doi.org/10.1016/j.jmva.2016.09.01

The Dynamic Chain Event Graph

In this paper we develop a formal dynamic version of Chain Event Graphs (CEGs), a particularly expressive family of discrete graph- ical models. We demonstrate how this class links to semi-Markov models and provides a convenient generalization of the Dynamic Bayesian Network (DBN). In particular we develop a repeating time-slice Dynamic CEG providing a useful and simpler model in this family. We demonstrate how the Dynamic CEG’s graphical formulation exhibits asymmetric conditional independence statements and also how each model can be estimated in a closed form enabling fast model search over the class. The expressive power of this model class together with its estimation is illustrated throughout by a variety of examples that include the risk of childhood hospitalization and the efficacy of a flu vaccine

Seeking the Real Adam Smith and Milton Friedman

In this paper we will analyze the relationship between free market principles and ethics through an exploration of how too many business managers often approach the ideas of Adam Smith and Milton Friedman. In doing so, we aim to provide a thoughtful foundation for future discussions of how we ought to navigate this intersection. We briefly examine questions such as: What is the relationship between the “best” economy in terms of efficiency and the common good for society? Is pursuing one’s individual economic advantage the same as promoting the general interest? As we analyze and discuss these questions, specifically in the context of Smith and Friedman, we also make some alternative normative assertions, grounded in social welfare, about adopting a broader societal perspective for the purpose of business

Quantum internet using code division multiple access

A crucial open problem in large-scale quantum networks is how to efficiently transmit quantum data among many pairs of users via a common data-transmission medium. We propose a solution by developing a quantum code division multiple access (q-CDMA) approach in which quantum information is chaotically encoded to spread its spectral content, and then decoded via chaos synchronization to separate different sender-receiver pairs. In comparison to other existing approaches, such as frequency division multiple access (FDMA), the proposed q-CDMA can greatly increase the information rates per channel used, especially for very noisy quantum channels.Comment: 29 pages, 6 figure

Sensory neurons derived from diabetic rats have diminished internal Ca2+ stores linked to impaired re-uptake by the endoplasmic reticulum

Distal symmetrical sensory neuropathy in diabetes involves the dying back of axons, and the pathology equates with axonal dystrophy generated under conditions of aberrant Ca2+ signalling. Previous work has described abnormalities in Ca2+ homoeostasis in sensory and dorsal horn neurons acutely isolated from diabetic rodents. We extended this work by testing the hypothesis that sensory neurons exposed to long-term Type 1 diabetes in vivo would exhibit abnormal axonal Ca2+ homoeostasis and focused on the role of SERCA (sarcoplasmic/endoplasmic reticulum Ca2+-ATPase). DRG (dorsal root ganglia) sensory neurons from age-matched normal and 3–5-month-old STZ (streptozotocin)-diabetic rats (an experimental model of Type 1 diabetes) were cultured. At 1–2 days in vitro an array of parameters were measured to investigate Ca2+ homoeostasis including (i) axonal levels of intracellular Ca2+, (ii) Ca2+ uptake by the ER (endoplasmic reticulum), (iii) assessment of Ca2+ signalling following a long-term thapsigargin-induced blockade of SERCA and (iv) determination of expression of ER mass and stress markers using immunocytochemistry and Western blotting. KCl- and caffeine-induced Ca2+ transients in axons were 2-fold lower in cultures of diabetic neurons compared with normal neurons indicative of reduced ER calcium loading. The rate of uptake of Ca2+ into the ER was reduced by 2-fold (P<0.05) in diabetic neurons, while markers for ER mass and ER stress were unchanged. Abnormalities in Ca2+ homoeostasis in diabetic neurons could be mimicked via long-term inhibition of SERCA in normal neurons. In summary, axons of neurons from diabetic rats exhibited aberrant Ca2+ homoeo<1?show=[fo]?>stasis possibly triggered by sub-optimal SERCA activity that could contribute to the distal axonopathy observed in diabetes

Extraperitoneal urine leak after renal transplantation: the role of radionuclide imaging and the value of accompanying SPECT/CT - a case report

<p>Abstract</p> <p>Background</p> <p>The differentiation of the nature of a fluid collection as a complication of kidney transplantation is important for management and treatment planning. Early and delayed radionuclide renography can play an important role in the evaluation of a urine leak. However, it is sometimes limited in the evaluation of the exact location and extent of a urine leak.</p> <p>Case Presentation</p> <p>A 71-year-old male who had sudden anuria, scrotal swelling and elevated creatinine level after cadaveric renal transplantation performed Tc-99 m MAG3 renography to evaluate the renal function, followed by an ultrasound which was unremarkable. An extensive urine leak was evident on the planar images. However, an exact location of the urine leak was unknown. Accompanying SPECT/CT images confirmed a urine leak extending from the lower aspect of the transplant kidney to the floor of the pelvic cavity, presacral region and the scrotum via right inguinal canal as well as to the right abdominal wall.</p> <p>Conclusions</p> <p>Renal scintigraphy is very useful to detect a urine leak after renal transplantation. However, planar imaging is sometimes limited in evaluating the anatomical location and extent of a urine leak accurately. In that case accompanying SPECT/CT images are very helpful and valuable to evaluate the anatomical relationships exactly.</p

AN ECOSYSTEM APPROACH TO FISHERIES IN THE SOUTHERN BENGUELA CONTEXT

The 2001 Reykjavík Declaration on Responsible Fisheries in the Marine Ecosystem and the Plan of Implementation of the 2002 World Summit on Sustainable Development highlighted the need in fisheries to look beyond considering only the target species and to consider in fisheries management the impacts of fishing on the ecosystem as a whole, as well as the impacts of the ecosystem on fisheries. This paper examines the practical implications of progressing towards ecosystem approaches by reference, in particular, to the FAO technical guidelines on the topic. It goes on to examine the major fishery types in South Africa and the southern Benguela, and to consider the probable impacts of those fisheries on target species, bycatch species and the ecosystem, as well as the indirect impacts on other ffected species. The review reveals that all fisheries have impacts beyond the target species and that an ecosystem approach is required in order to ensure the long-term sustainability of the living marine resources of the southern Benguela and the ecosystem as a whole. Finally, the likely obstacles to successful implementation of an ecosystem approach to fisheries in the southern Benguela are discussed.Afr. J. mar. Sci. 26: 9–3