Defining constipation to estimate its prevalence in the community: Results from a national survey

© 2019 The Author(s). Background: Different definitions of constipation have been used to estimate its prevalence in the community but this creates difficulties when comparing results from various studies. This study explores the impact of different definitions on prevalence estimates in the same population and compares the performance of simple definitions with the Rome III criteria. Methods: The prevalence of constipation in a large nationally representative sample of community-dwelling adults was estimated using five simple definitions of constipation and compared with definitions based on the Rome III criteria. The sensitivity, specificity, and positive and negative predictive values, were calculated for each definition using the Rome III criteria as the gold standards for chronic and sub-chronic constipation. Results: Prevalence estimates for the five simple definitions ranged from 9.4 to 58.9%, while the prevalence estimates using the Rome III criteria were 24.0% (95%CI: 22.1, 25.9) for chronic constipation and 39.6% (95%CI: 37.5, 41.7) for sub-chronic constipation. None of the simple definitions were adequate compared to the Rome III criteria. Self-reported constipation over the past 12 months had the highest sensitivity (91.1%, 95%CI: 88.8, 93.4) and negative predictive value (94.5%, 95%CI: 93.1, 96.1) compared to the Rome III criteria for chronic constipation but an unacceptably low specificity (51.3%, 95%CI: 48.8, 53.8) and positive predictive value (37.1%, 95%CI: 34.4, 39.9). Conclusions: The definition used to identify constipation within a population has a considerable impact on the prevalence estimate obtained. Simple definitions, commonly used in research, performed poorly compared with the Rome III criteria. Studies estimating population prevalence of constipation should use definitions based on the Rome criteria where possible

Combining Time-Triggered Plans with Priority Scheduled Task Sets

The final publication is available at Springer via http://dx.doi.org/10.1007/978-3-319-39083-3_13Time-triggered and concurrent priority-based scheduling are the two major approaches in use for real-time and embedded systems. Both approaches have their own advantages and drawbacks. On the one hand, priority-based systems facilitate separation of concerns between functional and timing requirements by relying on an underlying real- time operating system that takes all scheduling decisions at run time. But this is at the cost of indeterminism in the exact timing pattern of execution of activities, namely variable release jitter. On the other hand, time-triggered schedules are more intricate to design since all schedul- ing decisions must be taken beforehand in the design phase, but their advantage is determinism and more chances for minimisation of release jitter. In this paper we propose a software architecture that enables the combined and controlled execution of time-triggered plans and priority- scheduled tasks. We also describe the implementation of an Ada library supporting it. Our aim is to take advantage of the best of both ap- proaches by providing jitter-controlled execution of time-triggered tasks (e.g., control tasks), coexisting with a set of priority-scheduled tasks, with less demanding jitter requirements.This work has been partly supported by the Spanish Government’s project M2C2 (TIN2014-56158-C4-1-P-AR) and the European Commission’s project EMC2 (ARTEMIS-JU Call 2013 AIPP-5, Contract 621429).Real Sáez, JV.; Sáez Barona, S.; Crespo, A. (2016). Combining Time-Triggered Plans with Priority Scheduled Task Sets. En Reliable Software Technologies – Ada-Europe 2016. Springer. 195-212. https://doi.org/10.1007/978-3-319-39083-3_13S195212Liu, C., Layland, J.: Scheduling algorithms for multiprogramming in a hard real-time environment. J. ACM 20(1), 46–61 (1973)Martí, P., Fuertes, J., Fohler, G.: Jitter compensation for real-time control systems. In: Real-Time Systems Symposium (2001)Dobrin, R.: Combining off-line schedule construction and fixed priority scheduling in real-time computer systems. Ph.D. thesis. Mälardalen University (2005)Cervin, A.: Integrated control and real-time scheduling. Ph.D. thesis. Lund Institute of Technology, April 2003Balbastre, P., Ripoll, I., Vidal, J., Crespo, A.: A task model to reduce control delays. Real-Time Syst. 27(3), 215–236 (2004)Hong, S., Hu, X., Lemmon, M.: Reducing delay jitter of real-time control tasks through adaptive deadline adjustments. In: 22nd Euromicro Conference on Real-Time Systems - ECRTS, pp. 229–238. IEEE Computer Society (2010)ISO/IEC-JTC1-SC22-WG9: Ada Reference Manual ISO/IEC 8652:2012(E) (2012). http://www.ada-europe.org/manuals/LRM-2012.pdfBaker, T.P., Shaw, A.: The cyclic executive model and Ada. In: Proceedings IEEE Real Time Systems Symposium 1988, Huntsville, Alabama, pp. 120–129 (1988)Liu, J.W.S.: Real-Time Systems. Prentice-Hall Inc., Upper Saddle River (2000)Pont, M.J.: The Engineering of Reliable Embedded Systems: LPC1769. SafeTTy Systems Limited, Skelmersdale (2014). ISBN: 978-0-9930355-0-0Aldea Rivas, M., González Harbour, M.: MaRTE OS: an Ada kernel for real-time embedded applications. In: Strohmeier, A., Craeynest, D. (eds.) Ada-Europe 2001. LNCS, vol. 2043, pp. 305–316. Springer, Heidelberg (2001)Palencia, J., González-Harbour, M.: Schedulability analysis for tasks with static and dynamic offsets. In: 9th IEEE Real-Time Systems Symposium (1998)Wellings, A.J., Burns, A.: A framework for real-time utilities for Ada 2005. Ada Lett. XXVI XXVII(2), 41–47 (2007)Real, J., Crespo, A.: Incorporating operating modes to an Ada real-time framework. Ada Lett. 30(1), 73–85 (2010)Sáez, S., Terrasa, S., Crespo, A.: A real-time framework for multiprocessor platforms using Ada 2012. In: Romanovsky, A., Vardanega, T. (eds.) Ada-Europe 2011. LNCS, vol. 6652, pp. 46–60. Springer, Heidelberg (2011

Exoplanet Research with the Stratospheric Observatory for Infrared Astronomy (SOFIA)

When the Stratospheric Observatory for Infrared Astronomy (SOFIA) was conceived and its first science cases defined, exoplanets had not been detected. Later studies, however, showed that optical and near-infrared photometric and spectrophotometric follow-up observations during planetary transits and eclipses are feasible with SOFIA's instrumentation, in particular with the HIPO-FLITECAM and FPI+ optical and near infrared (NIR) instruments. Additionally, the airborne-based platform SOFIA has a number of unique advantages when compared to other ground- and space-based observatories in this field of research. Here we will outline these theoretical advantages, present some sample science cases and the results of two observations from SOFIA's first five observation cycles -- an observation of the Hot Jupiter HD 189733b with HIPO and an observation of the Super-Earth GJ 1214b with FLIPO and FPI+. Based on these early products available to this science case, we evaluate SOFIA's potential and future perspectives in the field of optical and infrared exoplanet spectrophotometry in the stratosphere.Comment: Invited review chapter, accepted for publication in "Handbook of Exoplanets" edited by H.J. Deeg and J.A. Belmonte, Springer Reference Work

Evidence for dark matter in the inner Milky Way

The ubiquitous presence of dark matter in the universe is today a central tenet in modern cosmology and astrophysics. Ranging from the smallest galaxies to the observable universe, the evidence for dark matter is compelling in dwarfs, spiral galaxies, galaxy clusters as well as at cosmological scales. However, it has been historically difficult to pin down the dark matter contribution to the total mass density in the Milky Way, particularly in the innermost regions of the Galaxy and in the solar neighbourhood. Here we present an up-to-date compilation of Milky Way rotation curve measurements, and compare it with state-of-the-art baryonic mass distribution models. We show that current data strongly disfavour baryons as the sole contribution to the galactic mass budget, even inside the solar circle. Our findings demonstrate the existence of dark matter in the inner Galaxy while making no assumptions on its distribution. We anticipate that this result will compel new model-independent constraints on the dark matter local density and profile, thus reducing uncertainties on direct and indirect dark matter searches, and will shed new light on the structure and evolution of the Galaxy.Comment: First submitted version of letter published in Nature Physics on Febuary 9, 2015: http://www.nature.com/nphys/journal/vaop/ncurrent/full/nphys3237.htm

Ages for exoplanet host stars

Age is an important characteristic of a planetary system, but also one that is difficult to determine. Assuming that the host star and the planets are formed at the same time, the challenge is to determine the stellar age. Asteroseismology provides precise age determination, but in many cases the required detailed pulsation observations are not available. Here we concentrate on other techniques, which may have broader applicability but also serious limitations. Further development of this area requires improvements in our understanding of the evolution of stars and their age-dependent characteristics, combined with observations that allow reliable calibration of the various techniques.Comment: To appear in "Handbook of Exoplanets", eds. Deeg, H.J. & Belmonte, J.A, Springer (2018

Circumstellar disks and planets. Science cases for next-generation optical/infrared long-baseline interferometers

We present a review of the interplay between the evolution of circumstellar disks and the formation of planets, both from the perspective of theoretical models and dedicated observations. Based on this, we identify and discuss fundamental questions concerning the formation and evolution of circumstellar disks and planets which can be addressed in the near future with optical and infrared long-baseline interferometers. Furthermore, the importance of complementary observations with long-baseline (sub)millimeter interferometers and high-sensitivity infrared observatories is outlined.Comment: 83 pages; Accepted for publication in "Astronomy and Astrophysics Review"; The final publication is available at http://www.springerlink.co

The epidemiology of suicide and attempted suicide in Dutch general practice 1983–2003

BACKGROUND: Many patients attempting or committing suicide consult their general practitioner (GP) in the preceding period, indicating that GPs might play an important role in prevention. The aim of the present study was to analyse the epidemiology of suicidal behaviour in Dutch General Practice in order to find possible clues for prevention. METHOD: Description of trends in suicide and suicide attempts occurring from 1983–2003 in the Dutch General Practice Sentinel Network, representing 1% of the Dutch population. The data were analysed with regard to: 1) suicidal behaviour trends and their association with household situation; 2) presence of depression, treatment of depression and referral rate by GPs; 3) contact with GP before suicide or suicide attempt and discussion of suicidal ideation. RESULTS: Between 1983 and 2003 the annual number of suicide and suicide attempts decreased by 50%. Sixty percent of the patients who committed or attempted suicide were diagnosed as depressed, of whom 91% were treated by their GP with an antidepressant. Living alone was a risk factor for suicide (odds ratio 1.99; 95% CI 1.50 to 2.64), whereas living in a household of 3 or more persons was a relative risk for a suicide attempt (odds ratio 1.81; 95% CI 1.34 to 2.46). Referral to a psychiatrist or other mental health professionals occurred in 65% of the cases. GPs recalled having discussed suicidal ideation in only 7% of the cases, and in retrospect estimated that they had foreseen suicide or suicide attempts in 31% and 22% of the cases, respectively, if there had been contact in the preceding month. CONCLUSION: With regard to the prescription of antidepressants and referral of suicidal patients to a psychiatrist, Dutch GPs fulfil their role as gatekeeper satisfactorily. However, since few patients discuss their suicidal ideation with their GP, there is room for improvement. GPs should take the lead to make this subject debatable. It may improve early recognition of depressed patients at risk and accelerate their referral to mental health professionals

Auditing the Management of Vaccine-Preventable Disease Outbreaks: The Need for a Tool

Public health activities, especially infectious disease control, depend on effective teamwork. We present the results of a pilot audit questionnaire aimed at assessing the quality of public health services in the management of VPD outbreaks. Audit questionnaire with three main areas indicators (structure, process and results) was developed. Guidelines were set and each indicator was assessed by three auditors. Differences in indicator scores according to median size of outbreaks were determined by ANOVA (significance at p≤0.05). Of 154 outbreaks; eighteen indicators had a satisfactory mean score, indicator “updated guidelines” and “timely reporting” had a poor mean score (2.84±106 and 2.44±1.67, respectively). Statistically significant differences were found according to outbreak size, in the indicators “availability of guidelines/protocol updated less than 3 years ago” (p = 0.03) and “days needed for outbreak control” (p = 0.04). Improving availability of updated guidelines, enhancing timely reporting and adequate recording of control procedures taken is needed to allow for management assessment and improvement

An improved model to study tumor cell autonomous metastasis programs using MTLn3 cells and the Rag2−/− γc−/− mouse

The occurrence of metastases is a critical determinant of the prognosis for breast cancer patients. Effective treatment of breast cancer metastases is hampered by a poor understanding of the mechanisms involved in the formation of these secondary tumor deposits. To study the processes of metastasis, valid in vivo tumor metastasis models are required. Here, we show that increased expression of the EGF receptor in the MTLn3 rat mammary tumor cell-line is essential for efficient lung metastasis formation in the Rag mouse model. EGFR expression resulted in delayed orthotopic tumor growth but at the same time strongly enhanced intravasation and lung metastasis. Previously, we demonstrated the critical role of NK cells in a lung metastasis model using MTLn3 cells in syngenic F344 rats. However, this model is incompatible with human EGFR. Using the highly metastatic EGFR-overexpressing MTLn3 cell-line, we report that only Rag2−/−γc−/− mice, which lack NK cells, allow efficient lung metastasis from primary tumors in the mammary gland. In contrast, in nude and SCID mice, the remaining innate immune cells reduce MTLn3 lung metastasis formation. Furthermore, we confirm this finding with the orthotopic transplantation of the 4T1 mouse mammary tumor cell-line. Thus, we have established an improved in vivo model using a Rag2−/− γc−/− mouse strain together with MTLn3 cells that have increased levels of the EGF receptor, which enables us to study EGFR-dependent tumor cell autonomous mechanisms underlying lung metastasis formation. This improved model can be used for drug target validation and development of new therapeutic strategies against breast cancer metastasis formation