Evaluating integrated sustainable urban development strategies: a methodological framework applied in Portugal

This paper debates the evolution and importance of the urban dimension of EU policies and in particular EU Cohesion Policy in the past three decades. It discusses the growing relevance for supporting a Urban Agenda for the EU, and the gradual adoption and implementation of Integrated Sustainable Urban Development Strategies (ISUDS), by pointing out their advantages vis-à-vis mainstream sectoral-focused policy strategies. In this light, the article proposes an evaluation framework to assess and compare ISUDS across Europe. Based on the Portuguese case-study this analysis argues that despite their limited impacts, EU financed urban programmes (URBAN, POLIS, ISUDS) contributed positively to promoting a policy integrated approach, and enhanced urban physical and social environment of deprived urban neighbourhoods. More concretely, the initial results from the recent implementation of the 103 Integrated Sustainable Urban Development Strategies reveal a gradual adoption by the urban and local authorities of more holistic and integrated urban development policy approaches to increasing policy effectiveness and efficiency.info:eu-repo/semantics/acceptedVersio

A proposal for informative default priors scaled by the standard error of estimates

If we have an unbiased estimate of some parameter of interest, then its absolute value is positively biased for the absolute value of the parameter. This bias is large when the signal-to-noise ratio (SNR) is small, and it becomes even larger when we condition on statistical significance; the winner's curse. This is a frequentist motivation for regularization or "shrinkage." To determine a suitable amount of shrinkage, we propose to estimate the distribution of the SNR from a large collection or "corpus" of similar studies and use this as a prior distribution. The wider the scope of the corpus, the less informative the prior, but a wider scope does not necessarily result in a more diffuse prior. We show that the estimation of the prior simplifies if we require that posterior inference is equivariant under linear transformations of the data. We demonstrate our approach with corpora of 86 replication studies from psychology and 178 phase 3 clinical trials. Our suggestion is not intended to be a replacement for a prior based on full information about a particular problem; rather, it represents a familywise choice that should yield better long-term properties than the current default uniform prior, which has led to systematic overestimates of effect sizes and a replication crisis when these inflated estimates have not shown up in later studies.Development and application of statistical models for medical scientific researc

Inwinteren, zorg op tijd voor voorraad

Aanwijzingen voor het inwinteren van een bijenvolk door de bereiding en langzame of snelle toediening van suikersiroo

Walking Behavior Change Detector for a “Smart” Walker

AbstractThis study investigates the design of a novel real-time system to detect walking behavior changes using an accelerometer on a rollator. No sensor is required on the user. We propose a new non-invasive approach to detect walking behavior based on the motion transfer by the user on the walker. Our method has two main steps; the first is to extract a gait feature vector by analyzing the three-axis accelerometer data in terms of magnitude, gait cycle and frequency. The second is to classify gait with the use of a decision tree of multilayer perceptrons. To assess the performance of our technique, we evaluated different sampling window lengths of 1, 3 an 5seconds and four different Neural Network architectures. The results revealed that the algorithm can distinguish walking behavior such as normal, slow and fast with an accuracy of about 86%. This research study is part of a project aiming at providing a simple and non-invasive walking behavior detector for elderly who use rollators

The statistical properties of RCTs and a proposal for shrinkage

We abstract the concept of a randomized controlled trial as a triple (beta,b,s), where beta is the primary efficacy parameter, b the estimate, and s the standard error (s>0). If the parameter beta is either a difference of means, a log odds ratio or a log hazard ratio, then it is reasonable to assume that b is unbiased and normally distributed. This then allows us to estimate the joint distribution of the z-value z=b/s and the signal-to-noise ratio SNR=beta/s from a sample of pairs (bi,si). We have collected 23 551 such pairs from the Cochrane database. We note that there are many statistical quantities that depend on (beta,b,s) only through the pair (z,SNR). We start by determining the estimated distribution of the achieved power. In particular, we estimate the median achieved power to be only 13%. We also consider the exaggeration ratio which is the factor by which the magnitude of beta is overestimated. We find that if the estimate is just significant at the 5% level, we would expect it to overestimate the true effect by a factor of 1.7. This exaggeration is sometimes referred to as the winner's curse and it is undoubtedly to a considerable extent responsible for disappointing replication results. For this reason, we believe it is important to shrink the unbiased estimator, and we propose a method for doing so. We show that our shrinkage estimator successfully addresses the exaggeration. As an example, we re-analyze the ANDROMEDA-SHOCK trial.Development and application of statistical models for medical scientific researc

Simultaneous confidence intervals for ranks using the partitioning principle

We consider the problem of constructing simultaneous confidence intervals (CIs) for the ranks of n means based on their estimates together with the (known) standard errors of those estimates. We present a generic method based on the partitioning principle in which the parameter space is partitioned into disjoint subsets and then each one of them is tested at level a. The resulting CIs have then a simultaneous coverage of 1 - alpha. We show that any procedure which produces simultaneous CIs for ranks can be written as a partitioning procedure. We present a first example where we test the partitions using the likelihood ratio (LR) test. Then, in a second example we show that a recently proposed method for simultaneous CIs for ranks using Tukey's honest significant difference test has an equivalent procedure based on the partitioning principle. By embedding these two methods inside our generic partitioning procedure, we obtain improved variants. We illustrate the performance of these methods through simulations and real data analysis on hotel ratings. While the novel method that uses the LR test and its variant produce shorter CIs when the number of means is small, the Tukey-based method and its variant produce shorter CIs when the number of means is high.Development and application of statistical models for medical scientific researc

Clinical Outcomes in Duchenne Muscular Dystrophy: A Study of 5345 Patients from the TREAT-NMD DMD Global Database

Background: Recent short-term clinical trials in patients with Duchenne Muscular Dystrophy (DMD) have indicated greater disease variability in terms of progression than expected. In addition, as average life-expectancy increases, reliable data is required on clinical progression in the older DMD population. Objective: To determine the effects of corticosteroids on major clinical outcomes of DMD in a large multinational cohort of genetically confirmed DMD patients. Methods: In this cross-sectional study we analysed clinical data from 5345 genetically confirmed DMD patients from 31 countries held within the TREAT-NMD global DMD database. For analysis patients were categorised by corticosteroid background and further stratified by age. Results: Loss of ambulation in non-steroid treated patients was 10 years and in corticosteroid treated patients 13 years old (p = 0.0001). Corticosteroid treated patients were less likely to need scoliosis surgery (p \u3c 0.001) or ventilatory support (p \u3c 0.001) and there was a mild cardioprotective effect of corticosteroids in the patient population aged 20 years and older (p = 0.0035). Patients with a single deletion of exon 45 showed an increased survival in contrast to other single exon deletions. Conclusions: This study provides data on clinical outcomes ofDMDacross many healthcare settings and including a sizeable cohort of older patients. Our data confirm the benefits of corticosteroid treatment on ambulation, need for scoliosis surgery, ventilation and, to a lesser extent, cardiomyopathy. This study underlines the importance of data collection via patient registries and the critical role of multi-centre collaboration in the rare disease field

Progression of motor subtypes in Huntington’s disease. a 6-year follow-up study

The objective of this study is to investigate the progression of predominantly choreatic and hypokinetic-rigid signs in Huntington's disease (HD) and their relationship with cognitive and general functioning over time. The motor signs in HD can be divided into predominantly choreatic and hypokinetic-rigid subtypes. It has been reported in cross-sectional studies that predominantly choreatic HD patients perform better on functional and cognitive assessments compared to predominantly hypokinetic-rigid HD patients. The course of these motor subtypes and their clinical profiles has not been investigated longitudinally. A total of 4135 subjects who participated in the European HD Network REGISTRY study were included and classified at baseline as either predominantly choreatic (n = 891), hypokinetic-rigid (n = 916), or mixed-motor (n = 2328), based on a previously used method. The maximum follow-up period was 6 years. The mixed-motor group was not included in the analyses. Linear mixed models were constructed to investigate changes in motor subtypes over time and their relationship with cognitive and functional decline. Over the 6-year follow-up period, the predominantly choreatic group showed a significant decrease in chorea, while hypokinetic-rigid symptoms slightly increased in the hypokinetic-rigid group. On the Total Functional Capacity, Stroop test, and Verbal fluency task the rate of change over time was significantly faster in the predominantly choreatic group, while on all other clinical assessments the decline was comparable for both groups. Our results suggest that choreatic symptoms decrease over time, whereas hypokinetic-rigid symptoms slightly increase in a large cohort of HD patients. Moreover, different motor subtypes can be related to different clinical profiles

Deriving reference values for nerve conduction studies from existing data using mixture model clustering

Objective: to obtain locally valid reference values (RVs) from existing nerve conduction study (NCS) data.Methods: we used age, sex, height and limb temperature-based mixture model clustering (MMC) to identify normal and abnormal measurements on NCS data from two university hospitals. We compared MMC-derived RVs to published data; examined the effect of using different variables; validated MMC-derived RVs using independent data from 26 healthy control subjects and investigated their clinical applicability for the diagnosis of polyneuropathy.Results: MMC-derived RVs were similar to published RVs. Clustering can be achieved using only sex and age as variables. MMC is likely to yield reliable results with fewer abnormal than normal measurements and when the total number of measurements is at least 300. Measurements from healthy controls fell within the 95% MMC-derived prediction interval in 97.4% of cases.Conclusions: MMC can be used to obtain RVs from existing data, providing a locally valid, accurate reflection of the (ab)normality of an NCS result.Significance: MMC can be used to generate locally valid RVs for any test for which sufficient data are available.(1) (C) 2021 International Federation of Clinical Neurophysiology. Published by Elsevier B.V.Development and application of statistical models for medical scientific researc

The prevalence of pain in Huntington’s Disease in a large worldwide cohort

Introduction: Pain could be an unknown non-motor symptom in Huntington's Disease (HD). The aim is therefore, to study the prevalence of pain interference, painful conditions and analgesic use across the different stages of HD and compare these levels to non-HD gene mutation carriers.Methods: A cross-sectional analysis of the Enroll-HD study was conducted in premanifest, manifest HD gene mutation carriers (n = 3989 and n = 7,485, respectively) and in non-HD gene mutation carriers (n = 3719). To investigate group differences, multivariable logistic regression analysis was performed with pairwise comparisons.Results: In the HD mutation carriers, the overall prevalence of pain interference was 34% (95% CI 31%-35%), of painful conditions 17% (95% CI 15%-19%) and analgesic use 13% (95% CI 11%-15%). Compared to non-mutation carriers, the prevalence of pain interference was significantly higher in the middle stage of HD (33% [95% CI 31%-35%] vs 42% [95% CI 39%-45%], P = 0,02), whereas the prevalence of painful conditions was significant lower in the late and middle stage of HD (17% [95% CI 16%-18%] vs 12% [95% CI 10%-14%], 15% [95% CI 13%-17%], P < 0,01]. No significant group difference was present in analgesic use.Conclusions: The prevalence of pain interference increases as HD progresses, however, the prevalence of painful conditions and analgesics do not increase accordingly. Further studies are necessary to investigate the aetiology of pain in HD and the risk for undertreatment of pain.Development and application of statistical models for medical scientific researc