80 research outputs found

    Feedback Stabilization of a Class of Diagonal Infinite-Dimensional Systems with Delay Boundary Control

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    This paper studies the boundary feedback stabilization of a class of diagonal infinite-dimensional boundary control systems. In the studied setting, the boundary control input is subject to a constant delay while the open loop system might exhibit a finite number of unstable modes. The proposed control design strategy consists in two main steps. First, a finite-dimensional subsystem is obtained by truncation of the original Infinite-Dimensional System (IDS) via modal decomposition. It includes the unstable components of the infinite-dimensional system and allows the design of a finite-dimensional delay controller by means of the Artstein transformation and the pole-shifting theorem. Second, it is shown via the selection of an adequate Lyapunov function that 1) the finite-dimensional delay controller successfully stabilizes the original infinite-dimensional system; 2) the closed-loop system is exponentially Input-to-State Stable (ISS) with respect to distributed disturbances. Finally, the obtained ISS property is used to derive a small gain condition ensuring the stability of an IDS-ODE interconnection.Comment: Preprin

    Evaluación ética de la memoria económica de los contratos de ensayos clínicos con medicamentos en España

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    Objetivos: Analizar el grado de homogeneidad de la memoria económica incluida en los contratos de centros sanitarios españoles participantes en ensayos clínicos (EC) con medicamentos para detectar puntos de potencial conflicto de interés en la investigación clínica. Material y métodos: Se ha analizado, mediante un autocuestionario, la memoria económica de 40 contratos, 31 correspondientes a centros sanitarios privados y públicos seleccionados al azar y 9 correspondientes a las comunidades autónomas con modelo de contrato único. Resultados: El equipo investigador, en el 97,5% de los casos (39 contratos), es el destinatario mayoritario de la remuneración económica por participar en un EC. El porcentaje aportado difiere según el centro, siendo mayor si es público (p=0,021) pero sin especificarse en el 50% de los contratos. En 38 de los 40 contratos analizados no se proporciona un listado de precios de las pruebas complementarias. En el 57,5%, (23 contratos), no se especifica si los gastos de los pacientes son abonados por el promotor. En el 77,5% (31 casos) no se especifica si los gastos derivados de reuniones relacionadas con el EC se incluyen en la memoria económica. Conclusiones: Existe una elevada heterogeneidad en el contenido de la memoria económica. La implantación de un modelo de memoria económica que incluyera una cantidad económica de remuneración fija por cada paciente reclutado por parte del promotor, para todos los centros participantes, podría disminuir las desigualdades entre centros, los conflictos de intereses, y además, incrementaría la trasparencia y la calidad de los EC.Abstract: Objectives: To analyze the homogeneity of the economic report of the contracts of Spanish medical centers participating in clinical trials with medicinal products for detecting points of potential conflict of interest in clinical research. Material and methods: We analyzed, through a selfautoquestionnaire, the budgetary information of the 40 contracts, 31 of them corresponding to public and private healthcare centers, randomly selected, and 9 corresponding to the Spanish regions who have only a model contract. Results: The investigator team is the recipient majority (97.5% of cases) the economic remuneration for participating in a clinical trial. The percentage differs according to the center considered, being greater in the public setting (p=0.021) but no specified in 50% of the contracts. In 38 of the 40 contracts analyzed a price list of tests is not provided. In 57.5% of the patients are paid by the promoter. In 17.5% failed to mention that the comparative drug to be supplied free of charge. And, 77.5% did not specify whether the costs of meetings relating to the clinical trial or not to include in the expenses of the promoter. Conclusions: There is a high heterogeneity in the content of the budgetary information. The implementation of a single contract model would reduce the inequalities between schools, conflict of interest and increase transparency and quality of the clinical trial

    Estimating equations for biomarker based exposure estimation under non-steady-state conditions

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    Unrealistic steady-state assumptions are often used to estimate toxicant exposure rates from biomarkers. A biomarker may instead be modeled as a weighted sum of historical time-varying exposures. Estimating equations are derived for a zero-inflated gamma distribution for daily exposures with a known exposure frequency. Simulation studies suggest that the estimating equations can provide accurate estimates of exposure magnitude at any reasonable sample size, and reasonable estimates of the exposure variance at larger sample sizes

    Economic burden and comorbidities of attention-deficit/hyperactivity disorder among pediatric patients hospitalized in the United States

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    <p>Abstract</p> <p>Background</p> <p>This retrospective database analysis used data from the Healthcare Cost and Utilization Project's Nationwide Inpatient Sample (NIS) to examine common primary diagnoses among children and adolescents hospitalized with a secondary diagnosis of attention- deficit/hyperactivity disorder (ADHD) and assessed the burden of ADHD.</p> <p>Methods</p> <p>Hospitalized children (aged 6-11 years) and adolescents (aged 12-17 years) with a secondary diagnosis of ADHD were identified. The 10 most common primary diagnoses (using the first 3 digits of the ICD-9-CM code) were reported for each age group. Patients with 1 of these conditions were selected to analyze demographics, length of stay (LOS), and costs. Control patients were selected if they had 1 of the 10 primary diagnoses and no secondary ADHD diagnosis. Patient and hospital characteristics were reported by cohort (i.e., patients with ADHD vs. controls), and LOS and costs were reported by primary diagnosis. Multivariable linear regression analyses were undertaken to adjust LOS and costs based on patient and hospital characteristics.</p> <p>Results</p> <p>A total of 126,056 children and 204,176 adolescents were identified as having a secondary diagnosis of ADHD. Among children and adolescents with ADHD, the most common diagnoses tended to be mental health related (i.e., affective psychoses, emotional disturbances, conduct disturbances, depressive disorder, or adjustment reaction). Other common diagnoses included general symptoms, asthma (in children only), and acute appendicitis. Among patients with ADHD, a higher percentage were male, white, and covered by Medicaid. LOS and costs were higher among children with ADHD and a primary diagnosis of affective psychoses (by 0.61 days and 51),adjustmentreaction(by1.71daysand51), adjustment reaction (by 1.71 days and 940), or depressive disorder (by 0.41 days and 124)versuscontrols.LOSandcostswerehigheramongadolescentswithADHDandaprimarydiagnosisofaffectivepsychoses(by1.04daysand124) versus controls. LOS and costs were higher among adolescents with ADHD and a primary diagnosis of affective psychoses (by 1.04 days and 352), depressive disorder (by 0.94 days and 517),conductdisturbances(by0.86daysand517), conduct disturbances (by 0.86 days and 1,330), emotional disturbances (by 1.45 days and 1,626),adjustmentreaction(by1.25daysand1,626), adjustment reaction (by 1.25 days and 702), and neurotic disorders (by 1.60 days and $541) versus controls.</p> <p>Conclusion</p> <p>Clinicians and health care decision makers should be aware of the potential impact of ADHD on hospitalized children and adolescents.</p

    Generalized linear model for interval mapping of quantitative trait loci

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    We developed a generalized linear model of QTL mapping for discrete traits in line crossing experiments. Parameter estimation was achieved using two different algorithms, a mixture model-based EM (expectation–maximization) algorithm and a GEE (generalized estimating equation) algorithm under a heterogeneous residual variance model. The methods were developed using ordinal data, binary data, binomial data and Poisson data as examples. Applications of the methods to simulated as well as real data are presented. The two different algorithms were compared in the data analyses. In most situations, the two algorithms were indistinguishable, but when large QTL are located in large marker intervals, the mixture model-based EM algorithm can fail to converge to the correct solutions. Both algorithms were coded in C++ and interfaced with SAS as a user-defined SAS procedure called PROC QTL

    An Evolutionary Framework for Association Testing in Resequencing Studies

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    Sequencing technologies are becoming cheap enough to apply to large numbers of study participants and promise to provide new insights into human phenotypes by bringing to light rare and previously unknown genetic variants. We develop a new framework for the analysis of sequence data that incorporates all of the major features of previously proposed approaches, including those focused on allele counts and allele burden, but is both more general and more powerful. We harness population genetic theory to provide prior information on effect sizes and to create a pooling strategy for information from rare variants. Our method, EMMPAT (Evolutionary Mixed Model for Pooled Association Testing), generates a single test per gene (substantially reducing multiple testing concerns), facilitates graphical summaries, and improves the interpretation of results by allowing calculation of attributable variance. Simulations show that, relative to previously used approaches, our method increases the power to detect genes that affect phenotype when natural selection has kept alleles with large effect sizes rare. We demonstrate our approach on a population-based re-sequencing study of association between serum triglycerides and variation in ANGPTL4

    Age, period, and cohort analysis of regular dental care behavior and edentulism: A marginal approach

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    <p>Abstract</p> <p>Background</p> <p>To analyze the regular dental care behavior and prevalence of edentulism in adult Danes, reported in sequential cross-sectional oral health surveys by the application of a marginal approach to consider the possible clustering effect of birth cohorts.</p> <p>Methods</p> <p>Data from four sequential cross-sectional surveys of non-institutionalized Danes conducted from 1975-2005 comprising 4330 respondents aged 15+ years in 9 birth cohorts were analyzed. The key study variables were seeking dental care on an annual basis (ADC) and edentulism. For the analysis of ADC, survey year, age, gender, socio-economic status (SES) group, denture-wearing, and school dental care (SDC) during childhood were considered. For the analysis of edentulism, only respondents aged 35+ years were included. Survey year, age, gender, SES group, ADC, and SDC during childhood were considered as the independent factors. To take into account the clustering effect of birth cohorts, marginal logistic regressions with an independent correlation structure in generalized estimating equations (GEE) were carried out, with PROC GENMOD in SAS software.</p> <p>Results</p> <p>The overall proportion of people seeking ADC increased from 58.8% in 1975 to 86.7% in 2005, while for respondents aged 35 years or older, the overall prevalence of edentulism (35+ years) decreased from 36.4% in 1975 to 5.0% in 2005. Females, respondents in the higher SES group, in more recent survey years, with no denture, and receiving SDC in all grades during childhood were associated with higher probability of seeking ADC regularly (<it>P </it>< 0.05). The interaction of SDC and age (<it>P </it>< 0.0001) was significant. The probabilities of seeking ADC were even higher among subjects with SDC in all grades and aged 45 years or older. Females, older age group, respondents in earlier survey years, not seeking ADC, lower SES group, and not receiving SDC in all grades were associated with higher probability of being edentulous (<it>P </it>< 0.05).</p> <p>Conclusions</p> <p>With the use of GEE, the potential clustering effect of birth cohorts in sequential cross-sectional oral health survey data could be appropriately considered. The success of Danish dental health policy was demonstrated by a continued increase of regular dental visiting habits and tooth retention in adults because school dental care was provided to Danes in their childhood.</p
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