Ethnic group differences in overweight and obese children and young people in England: cross sectional survey

Aims: To determine the percentage of children and young adults who are obese or overweight within different ethnic and socioeconomic groups.Methods: Secondary analysis of data on 5689 children and young adults aged 2 - 20 years from the 1999 Health Survey for England.Results: Twenty three per cent of children (n = 1311) were overweight, of whom 6% ( n = 358) were obese. More girls than boys were overweight ( 24% v 22%). Afro-Caribbean girls were more likely to be overweight ( odds ratio 1.73, 95% CI 1.29 to 2.33), and Afro-Caribbean and Pakistani girls were more likely to be obese than girls in the general population ( odds ratios 2.74 ( 95% CI 1.74 to 4.31) and 1.71 ( 95% CI 1.06 to 2.76), respectively). Indian and Pakistani boys were more likely to be overweight ( odds ratios 1.55 ( 95% CI 1.12 to 2.17) and 1.36 ( 95% CI 1.01 to 1.83), respectively). There were no significant differences in the prevalence of obese and overweight children from different social classes.Conclusion: The percentage of children and young adults who are obese and overweight differs by ethnic group and sex, but not by social class. British Afro-Caribbean and Pakistani girls have an increased risk of being obese and Indian and Pakistani boys have an increased risk of being overweight than the general population. These individuals may be at greater combined cumulative risk of morbidity and mortality from cardiovascular disease and so may be a priority for initiatives to target groups of children at particular risk of obesity

The Democratic Union for the Republic: To Survive De Gaulle

I. De Gaulle on Political Parties-- II. Style and Doctrine-- III. Leaders and Voters-- IV. Factionalism and Party Building-- V. Organization-- VI. Conclusion-- Note

The Value of Blood-Based Measures of Liver Function and Urate in Lung Cancer Risk Prediction: A Cohort Study and Health Economic Analysis

BACKGROUND: Several studies have reported associations between low-cost blood-based measurements and lung cancer but their role in risk prediction is unclear. We examined the value of expanding lung cancer risk models for targeting low-dose computed tomography (LDCT) to include blood measurements of liver function and urate. METHODS: We analysed a cohort of 388,199 UK Biobank participants with 1,873 events and calculated the c-index and fraction of new information (FNI) for models expanded to include combinations of blood measurements, lung function (forced expiratory volume in 1 second - FEV1), alcohol status and waist circumference. We calculated the hypothetical cost per lung cancer case detected by LDCT for different scenarios using a threshold of ≥ 1.51% risk at 6 years. RESULTS: The c-index was 0.805 (95%CI:0.794-0.816) for the model containing conventional predictors. Expanding to include blood measurements increased the c-index to 0.815 (95%CI: 0.804-0.826;p<0.0001;FNI:0.06). Expanding to include FEV1, alcohol status, and waist circumference increased the c-index to 0.811 (95%CI:0.800-0.822;p<0.0001;FNI:0.04). The c-index for the fully expanded model containing all variables was 0.819 (95%CI:0.808-0.830; p<0.0001;FNI:0.09). Model expansion had a greater impact on the c-index and FNI for people with a history of smoking cigarettes relative to the full cohort. Compared with the conventional risk model, the expanded models reduced the number of participants meeting the criteria for LDCT screening by 15-21%, and lung cancer cases detected by 7-8%. The additional cost per lung cancer case detected relative to the conventional model was £1,018 for the addition of blood tests and £9,775 for the fully expanded model. CONCLUSION: Blood measurements of liver function and urate improved lung cancer risk prediction compared with a model containing conventional risk factors. However, there was no evidence that model expansion would improve the cost per lung cancer case detected in UK health care settings

The value of blood-based measures of liver function and urate in lung cancer risk prediction: A cohort study and health economic analysis

BACKGROUND: Several studies have reported associations between low-cost blood-based measurements and lung cancer but their role in risk prediction is unclear. We examined the value of expanding lung cancer risk models for targeting low-dose computed tomography (LDCT), including blood measurements of liver function and urate. METHODS: We analysed a cohort of 388,199 UK Biobank participants with 1873 events and calculated the c-index and fraction of new information (FNI) for models expanded to include combinations of blood measurements, lung function (forced expiratory volume in 1 s - FEV1), alcohol status and waist circumference. We calculated the hypothetical cost per lung cancer case detected by LDCT for different scenarios using a threshold of ≥ 1.51 % risk at 6 years. RESULTS: The c-index was 0.805 (95 %CI:0.794-0.816) for the model containing conventional predictors. Expanding to include blood measurements increased the c-index to 0.815 (95 %CI: 0.804-0.826;p < 0.0001;FNI:0.06). Expanding to include FEV1, alcohol status, and waist circumference increased the c-index to 0.811 (95 %CI: 0.800-0.822;p < 0.0001;FNI: 0.04). The c-index for the fully expanded model containing all variables was 0.819 (95 %CI:0.808-0.830;p < 0.0001;FNI:0.09). Model expansion had a greater impact on the c-index and FNI for people with a history of smoking cigarettes relative to the full cohort. Compared with the conventional risk model, the expanded models reduced the number of participants meeting the criteria for LDCT screening by 15-21 %, and lung cancer cases detected by 7-8 %. The additional cost per lung cancer case detected relative to the conventional model was £ 1018 for adding blood tests and £ 9775 for the fully expanded model. CONCLUSION: Blood measurements of liver function and urate made a modest improvement to lung cancer risk prediction compared with a model containing conventional risk factors. There was no evidence that model expansion would improve the cost per lung cancer case detected in UK healthcare settings

Business intelligence and contribution of entrepreneurial information architecture

We are witnessing the need for a quick and intelligent reaction from organizations to the level and speed of change in business processes. The arising problems can be: from wrong lasting information; systems not fully used or explored; slow reaction to change; etc. This requires two main confluent action methods: people to synchronize their visions, ideas and strategies in the whole organization; and, in that context, select the information that strictly answers to the performance factors at the right moment. The proposed methodology turns to the potential of approach to the entrepreneurial architecture as well as to the potential of the information system in order to integrate the data and resources needed for that performance. The modeling of an information architecture of the company and its business helps in the identification of critical information, the one which is according to the mission, prospects and business success factors

The French Army in politics, 1945-1962

(print) x, 427 p. ; 23 cm"A publication of the Mershon Center for Education in National Security."Part I : The "Great Mute" and the Beginnings of Its Demise, 1815-1945 -- I. The Parameters of Discipline 3 -- II. Foundations of Civilian Control 21 -- III. Disgrace through Discipline, 1939-1945 56 -- Part II : The Army and the Nation : Isolation and Estrangement -- IV. Reluctant Mercenaries 93 -- V. Social Origins and Politics 128 -- Part III : The Political Demands of Revolutionary-Guerrilla War -- VI. Political Challenge and Military Response 149 -- VII. Counterinsurgency and Military Politics 170 -- Part IV : Political Authority and Civilian Control -- VIII. Immobilisme and Delegation of Power 207 -- IX. Political Authority and Civilian Control in the Praetorian Years 240 -- Part V : Attitudes and Ideology -- X. The Rivals of Discipline 277 -- XI. The French Military Doctrine of La Guerre Revolutionnaire 308 -- XII. Cleavages within the Military Establishment 337 -- Conclusion 365 -- Bibliography 377 -- Index 40

The Abdominal Aortic Aneurysm Statistically Corrected Operative Risk Evaluation (AAA SCORE) for predicting mortality after open and endovascular interventions

BackgroundAccurate adjustment of surgical outcome data for risk is vital in an era of surgeon-level reporting. Current risk prediction models for abdominal aortic aneurysm (AAA) repair are suboptimal. We aimed to develop a reliable risk model for in-hospital mortality after intervention for AAA, using rigorous contemporary statistical techniques to handle missing data.MethodsUsing data collected during a 15-month period in the United Kingdom National Vascular Database, we applied multiple imputation methodology together with stepwise model selection to generate preoperative and perioperative models of in-hospital mortality after AAA repair, using two thirds of the available data. Model performance was then assessed on the remaining third of the data by receiver operating characteristic curve analysis and compared with existing risk prediction models. Model calibration was assessed by Hosmer-Lemeshow analysis.ResultsA total of 8088 AAA repair operations were recorded in the National Vascular Database during the study period, of which 5870 (72.6%) were elective procedures. Both preoperative and perioperative models showed excellent discrimination, with areas under the receiver operating characteristic curve of .89 and .92, respectively. This was significantly better than any of the existing models (area under the receiver operating characteristic curve for best comparator model, .84 and .88; P < .001 and P = .001, respectively). Discrimination remained excellent when only elective procedures were considered. There was no evidence of miscalibration by Hosmer-Lemeshow analysis.ConclusionsWe have developed accurate models to assess risk of in-hospital mortality after AAA repair. These models were carefully developed with rigorous statistical methodology and significantly outperform existing methods for both elective cases and overall AAA mortality. These models will be invaluable for both preoperative patient counseling and accurate risk adjustment of published outcome data

Measuring Interaction Design before Building the System: a Model-Based Approach

Early prototyping of user interfaces is an established good practice in interactive system development. However, prototypes cover only some usage scenarios, and questions dealing with number of required steps, possible interaction paths or impact of possible user errors can be answered only for the specific scenarios and only after tedious manual inspection. We present a tool (MIGTool) that transforms models of the behavior of a user interface into a graph, upon which usage scenarios can be easily specified, and used by MIGTool to compute possible interaction paths. Metrics based on possible paths, with or without user navigation errors, can then be computed. For example, when analyzing four mail applications, we show that Gmail has 3 times more shortest routes, has twice more routes that include a single user error, has routes with 13\ufewer steps, but has also optimal routes with the smallest probability to be chosen. Without MIGTool, this kind of analysis could only be done after building some prototype of the system, and then only for specific scenarios by manually tracing user actions and relative changes to the screens. With MIGTool the exploration of suitability of a design with respect to different scenarios, or comparison of different design alternatives against a single scenario, can be done with just a partial specification of the user interface behavior. This is made possible by the ability to associate scenarios steps to required user actions as defined in the model, by an efficient strategy to identify complete execution traces that users can follow, and by computing a range of diverse metrics on these results

Nuclear Spin Relaxation for Higher Spin

We study the relaxation of a spin I that is weakly coupled to a quantum mechanical environment. Starting from the microscopic description, we derive a system of coupled relaxation equations within the adiabatic approximation. These are valid for arbitrary I and also for a general stationary non--equilibrium state of the environment. In the case of equilibrium, the stationary solution of the equations becomes the correct Boltzmannian equilibrium distribution for given spin I. The relaxation towards the stationary solution is characterized by a set of relaxation times, the longest of which can be shorter, by a factor of up to 2I, than the relaxation time in the corresponding Bloch equations calculated in the standard perturbative way.Comment: 4 pages, Latex, 2 figure

Intravenous Thrombolysis Before Mechanical Thrombectomy for Acute Ischemic Stroke: A Meta‐Analysis

Background: Whether intravenous thrombolysis before mechanical thrombectomy provides additional benefit for functional outcome in acute ischemic stroke remains uncertain. We performed a meta‐analysis to compare the outcomes of direct mechanical thrombectomy (dMT) to mechanical thrombectomy with bridging using intravenous thrombolysis (bridging therapy [BT]) in patients with acute ischemic stroke. / Methods and Results: We performed a literature search in the PubMed, Excerpta Medica database, and Cochrane Central Register of Controlled Trials from January 1, 2003, to April 26, 2021. We included randomized clinical trials and observational studies that reported the 90‐day functional outcome in patients with acute ischemic stroke undergoing dMT compared with BT. The 12 included studies (3 randomized controlled trials and 9 observational studies) yielded 3924 participants (mean age, 68.0 years [SD, 13.1 years]; women, 44.2%; 1887 participants who received dMT and 2037 participants who received BT). A meta‐analysis of randomized controlled trial and observational data revealed similar 90‐day functional independence (odds ratio [OR], 1.04; 95% CI, 0.90–1.19), mortality (OR, 1.03; 95% CI, 0.78–1.36), and successful recanalization (OR, 0.93; 95% CI, 0.76–1.14) for patients treated with dMT or BT. Compared with those in the BT group, patients in the dMT group were less likely to experience symptomatic intracranial hemorrhage (OR, 0.68; 95% CI, 0.51–0.91; P=0.008) or any intracranial hemorrhage (OR, 0.71; 95% CI, 0.61–0.84; P<0.001). / Conclusions: In this meta‐analysis of patients with acute ischemic stroke, we found no significant differences in 90‐day functional outcome or mortality between dMT and BT, but a lower rate of symptomatic intracranial hemorrhage for dMT. These findings support the use of dMT without intravenous thrombolysis bridging therapy. / Registration: URL: https://www.crd.york.ac.uk/prospero/; Unique identifier: 42021234664