Variational Probabilistic Inference and the QMR-DT Network

We describe a variational approximation method for efficient inference in large-scale probabilistic models. Variational methods are deterministic procedures that provide approximations to marginal and conditional probabilities of interest. They provide alternatives to approximate inference methods based on stochastic sampling or search. We describe a variational approach to the problem of diagnostic inference in the `Quick Medical Reference' (QMR) network. The QMR network is a large-scale probabilistic graphical model built on statistical and expert knowledge. Exact probabilistic inference is infeasible in this model for all but a small set of cases. We evaluate our variational inference algorithm on a large set of diagnostic test cases, comparing the algorithm to a state-of-the-art stochastic sampling method

Exposure to animals and the risk of allergic asthma: a population-based cross-sectional study in Finnish and Russian children

<p>Abstract</p> <p>Background</p> <p>There is little information on potential differences in animal exposure between Finland and Russia and particularly on the effects of animal exposure on asthma among Russian children. The aim of the study was to compare the pet and farm animal exposures and to assess the relations of pre- and postnatal animal exposures to the occurrence of allergic asthma in Finnish and Russian school children.</p> <p>Methods</p> <p>We conducted a population-based cross-sectional study in neighbour towns on either side of the Finnish-Russian border; Imatra in Finland and Svetogorsk in Russia. The study population consisted of 512 Finnish and 581 Russian school children aged 7–16 years (response rate 79%). Multivariate logistic regression analysis was used to estimate adjusted odds ratios (OR) and 95% confidence intervals (CI) related to each exposure.</p> <p>Results</p> <p>Current indoor exposure to pets was more frequent among school children in Svetogorsk than in Imatra (67.5% vs. 56.0%, P < 0.001). Finnish children were exposed more frequently to dogs, whereas Russian children to cats during childhood and to farm animals during pregnancy and infancy. The risk of self-reported allergic asthma was inversely related to indoor dog keeping ever in Finland (adjusted OR 0.35, 95% CI 0.13, 0.95), whereas in Russia the risk of allergic asthma was increased in relation to combined indoor cat exposure during infancy and currently (4.56, 1.10, 18.91). The risk of asthma was elevated in relation to contact to farm animals during pregnancy (Finland: 1.95, 0.69, 5.50; Russia: 1.90, 0.70, 5.17) and early life (Finland: 2.05, 0.78, 5.40; Russia: 1.21, 0.39, 3.73).</p> <p>Conclusion</p> <p>Exposure to pets and farm animals during childhood differed significantly between Finland and Russia. Our study provides evidence that early-life exposure to cats increases the risk of asthma whereas exposure to dogs is protective. Our findings suggest that intermittent fetal and early-life exposure to farm animals increases the risk of allergic asthma in urban children visiting farms.</p

The effect of sampling height on grass pollen concentrations in different urban environments in the Helsinki Metropolitan Area, Finland

Introduction It is important to study potential differences in pollen concentrations between sampling heights because of diverse outdoor and indoor activity of humans (exposure) at different height levels in urban environments. Previous studies have investigated the effect of height on pollen concentrations based on just one or a few sampling points. We studied the effect of sampling height on grass pollen concentrations in several urban environments with different levels of urbanity. Methods This study was conducted in the Helsinki Metropolitan Area, Finland, in 2013 during the pollen season of grasses. Pollen grains were monitored in eight different points in the morning and afternoon. Rotorod-type samplers were attached on sampling poles at the heights of 1.5 meters and 4 meters. Results Grass pollen concentrations were on average higher at the height of 1.5 meters (Helsinki mean 5.24 grains / m3; Espoo mean 75.71 grains / m3) compared to the height of 4 meters (Helsinki mean 3.84 grains / m3; Espoo mean 37.42 grains / m3) with a difference of 1.40 grains / m3 (95% CI -0.21 to 3.01) in Helsinki, and 38.29 grains / m3 (7.52 to 69.07) in Espoo, although not always statistically significant. This was detected both in the morning and in the afternoon. However, in the most urban sites the levels were lower at 1.5 meters compared to 4 meters, whereas in the least urban sites the concentrations were higher at 1.5 meters. In linear regression models with interaction terms, the modifying effect of urbanity on concentration-height relation was statistically significant in both cities. The effect of urbanity on pollen concentrations at both heights was stronger in less urban Espoo. Conclusions The present study provides evidence that height affects the abundance and distribution of grass pollen in urban environments, but this effect depends on the level of urbanity.Peer reviewe

Assessment of public health impact of work-related asthma

<p>Abstract</p> <p>Background</p> <p>Asthma is among the most common chronic diseases in working-aged populations and occupational exposures are important causal agents. Our aims were to evaluate the best methods to assess occurrence, public health impact, and burden to society related to occupational or work-related asthma and to achieve comparable estimates for different populations.</p> <p>Methods</p> <p>We addressed three central questions: <b>1: What is the best method to assess the occurrence of occupational asthma? </b>We evaluated: 1) assessment of the occurrence of occupational asthma <it>per se</it>, and 2) assessment of adult-onset asthma and the population attributable fractions due to specific occupational exposures. <b>2: What are the best methods to assess public health impact and burden to society related to occupational or work-related asthma? </b>We evaluated methods based on assessment of excess burden of disease due to specific occupational exposures. <b>3: How to achieve comparable estimates for different populations? </b>We evaluated comparability of estimates of occurrence and burden attributable to occupational asthma based on different methods.</p> <p>Results</p> <p>Assessment of the occurrence of occupational asthma <it>per se </it>can be used in countries with good coverage of the identification system for occupational asthma, i.e. countries with well-functioning occupational health services. Assessment based on adult-onset asthma and population attributable fractions due to specific occupational exposures is a good approach to estimate the occurrence of occupational asthma at the population level. For assessment of public health impact from work-related asthma we recommend assessing excess burden of disease due to specific occupational exposures, including excess incidence of asthma complemented by an assessment of disability from it. International comparability of estimates can be best achieved by methods based on population attributable fractions.</p> <p>Conclusions</p> <p>Public health impact assessment for occupational asthma is central in prevention and health policy planning and could be improved by purposeful development of methods for assessing health benefits from preventive actions. Registry-based methods are suitable for evaluating time-trends of occurrence at a given population but for international comparisons they face serious limitations. Assessment of excess burden of disease due to specific occupational exposure is a useful measure, when there is valid information on population exposure and attributable fractions.</p

Minor troponin T elevation and mortality in patients with atrial fibrillation presenting to the emergency department

Background There are limited data on the association of minor troponin elevation in unselected patients with atrial fibrillation (AF) presenting to the emergency department (ED) with adverse events. In this study, we sought to assess the early and mid-term mortality of these patients. Methods In this observational study, 2911 patients with AF were admitted to the ED. They were divided into 3 groups based on peak high-sensitivity troponin (TnT) levels: normal ( Results All-cause mortality was 6.7% (n = 196) at 30 days and 22.2% (n = 646) at 1 year. Mortality rate increased along with increasing levels of TnT irrespective of baseline covariates, primary discharge diagnosis and type of AF. A significant association between TnT levels and all-cause mortality was observed. The adjusted hazard ratio (HR) at 30 days was 6.02 (95% CI 2.62-13.83) for TnT 15-50 ng/L and 11.28 (95% CI 4.87-26.12) for TnT 51-100 ng/L (P Conclusions Among patients with AF admitted to the ED, increased TnT levels were associated with increased early and mid-term all-cause mortality irrespective of baseline covariates and type of AF.Peer reviewe

Differences in the Motor Coordination Abilities among Adolescent Gymnasts, Swimmers, and Ice Hockey Players

© 2017 Human Movement. Purpose. Motor coordination is proposed to be a relatively stable age-related construct, unlikely to be influenced by aligned experiential factors such as intensive sport-specific training. The purpose of the study is to investigate if there are differences in motor coordination abilities among young artistic gymnasts, swimmers, and ice hockey players. Methods. The participants of the study were 508 female and 258 male adolescents (age, M = 12.80, SD = 1.10) comprising artistic gymnasts (n = 463), swimmers (n = 70), and ice hockey players (n = 233). The KTK-test protocol was used to analyse their gross motor coordination abilities. Results. The results of the study demonstrated that gymnasts scored better than ice hockey players and swimmers in the test of walking backwards along a beam, and better than ice hockey players in total motor coordination, hopping over an obstacle, and the test of moving sideways on wooden boards. However, ice hockey players scored higher than swimmers and gymnasts in the test of jumping from side to side. Subsequently, swimmers obtained better results in the test of moving sideways on wooden boards as compared with ice hockey players. Conclusions. The study results indicate that intensive sport-specific training may extend young athletes′ motor coordination characteristics in the ability areas representative of the sport in which they engage

Exposure to benzene at work and the risk of leukemia: a systematic review and meta-analysis

Background A substantial number of epidemiologic studies have provided estimates of the relation between exposure to benzene at work and the risk of leukemia, but the results have been heterogeneous. To bridge this gap in knowledge, we synthesized the existing epidemiologic evidence on the relation between occupational exposure to benzene and the risk of leukemia, including all types combined and the four main subgroups acute myeloid leukemia (AML), acute lymphocytic leukemia (ALL), chronic lymphocytic leukemia (CLL), and chronic myeloid leukemia (CML). Methods A systematic literature review was carried out using two databases 'Medline' and 'Embase' from 1950 through to July 2009. We selected articles which provided information that can be used to estimate the relation between benzene exposure and cancer risk (effect size). Results In total 15 studies were identified in the search, providing 16 effect estimates for the main analysis. The summary effect size for any leukemia from the fixed-effects model was 1.40 (95% CI, 1.23-1.57), but the study-specific estimates were strongly heterogeneous (I2 = 56.5%, Q stat = 34.47, p = 0.003). The random-effects model yielded a summary- effect size estimate of 1.72 (95% CI, 1.37-2.17). Effect estimates from 9 studies were based on cumulative exposures. In these studies the risk of leukemia increased with a dose-response pattern with a summary-effect estimate of 1.64 (95% CI, 1.13-2.39) for low (< 40 ppm-years), 1.90 (95% CI, 1.26-2.89) for medium (40-99.9 ppm-years), and 2.62 (95% CI, 1.57-4.39) for high exposure category (> 100 ppm-years). In a meta-regression, the trend was statistically significant (P = 0.015). Use of cumulative exposure eliminated heterogeneity. The risk of AML also increased from low (1.94, 95% CI, 0.95-3.95), medium (2.32, 95% CI, 0.91-5.94) to high exposure category (3.20, 95% CI, 1.09-9.45), but the trend was not statistically significant. Conclusions Our study provides consistent evidence that exposure to benzene at work increases the risk of leukemia with a dose-response pattern. There was some evidence of an increased risk of AML and CLL. The meta-analysis indicated a lack of association between benzene exposure and the risk of CML

Effect of incremental amounts of camelina oil on milk fatty acid composition in lactating cows fed diets based on a mixture of grass and red clover silage and concentrates containing camelina expeller

Camelina is an ancient oilseed crop that produces an oil rich in cis-9,cis-12 18:2 (linoleic acid, LA) and cis9,cis-12, cis-15 18:3 (alpha-linolenic acid, ALA); however, reports on the use of camelina oil (CO) for ruminants are limited. The present study investigated the effects of incremental CO supplementation on animal performance, milk fatty acid (FA) composition, and milk sensory quality. Eight Finnish Ayrshire cows (91 d in milk) were used in replicated 4 x 4 Latin squares with 21-d periods. Treatments comprised 4 concentrates (12 kg/d on an air-dry basis) based on cereals and camelina expeller containing 0 (control), 2, 4, or 6% CO on an air-dry basis. Cows were offered a mixture of grass and red clover silage (RCS; 1:1 on a dry matter basis) ad libitum. Incremental CO supplementation linearly decreased silage and total dry matter intake, and linearly increased LA, ALA, and total FA intake. Treatments had no effect on whole-tract apparent organic matter or fiber digestibility and did not have a major influence on rumen fermentation. Supplements of CO quadratically decreased daily milk and lactose yields and linearly decreased milk protein yield and milk taste panel score from 4.2 to 3.6 [on a scale of 1 (poor) to 5 (excellent)], without altering milk fat yield. Inclusion of CO linearly decreased the proportions of saturated FA synthesized de novo (4:0 to 16:0), without altering milk fat 18:0, cis-9 18:1, LA, and ALA concentrations. Milk fat 18:0 was low (Peer reviewe