Common variants at the MHC locus and at chromosome 16q24.1 predispose to Barrett's esophagus

Barrett's esophagus is an increasingly common disease that is strongly associated with reflux of stomach acid and usually a hiatus hernia, and it strongly predisposes to esophageal adenocarcinoma (EAC), a tumor with a very poor prognosis. We report the first genome-wide association study on Barrett's esophagus, comprising 1,852 UK cases and 5,172 UK controls in the discovery stage and 5,986 cases and 12,825 controls in the replication stage. Variants at two loci were associated with disease risk: chromosome 6p21, rs9257809 (P(combined) = 4.09 × 10(-9); odds ratio (OR) = 1.21, 95% confidence interval (CI) =1.13-1.28), within the major histocompatibility complex locus, and chromosome 16q24, rs9936833 (P(combined) = 2.74 × 10(-10); OR = 1.14, 95% CI = 1.10-1.19), for which the closest protein-coding gene is FOXF1, which is implicated in esophageal development and structure. We found evidence that many common variants of small effect contribute to genetic susceptibility to Barrett's esophagus and that SNP alleles predisposing to obesity also increase risk for Barrett's esophagus.

Systolic array system for vector quantization using transformed sub-band coding.

The use of bit-level systolic arrays in the design of a vector quantized transformed subband coding system for speech signals is described. It is shown how the major components of this system can be decomposed into a small number of highly regular building blocks that interface directly to one another. These include circuits for the computation of the discrete cosine transform, the inverse discrete cosine transform, and vector quantization codebook search.

Application of artificial neural network techniques to low bit-rate speech coding

Research has been undertaken to investigate the use of artificial neural network (ANN) techniques to improve the performance of a low bit-rate vector transform coder. Considerable improvements in the perceptual quality of the coded speech have been obtained. New ANN-based methods for vector quantiser (VQ) design and for the adaptive updating of VQ codebook are introduced for use in speech coding applications.

HIGH-FIDELITY MUSIC CODING AT 4 BITS.

A very high-quality sub-band ADPCM music coding scheme which compresses high-fidelity music signals, bandlimited to 15kHz, to an equivalent PCM representation of only 4 bits per sample, is described. By processing music sampled at 32 kHz, this coder exhibits a total bit rate of only 128kbit/s and is consequently applicable to the ISDN. Subjective tests conducted with this coder have shown that music recovered from the compression scheme is essentially indistinguishable from the original material. The results obtained are of major importance, not only for ISDN and broadcasting, but also for other digital audio technology such as compact disc (CD) and digital audio tape.

VLSI architectures for digital image coding

A number of high-performance VLSI architectures for real-time image coding applications are described. In particular, attention is focused on circuits for computing the 2-D DCT (discrete cosine transform) and for 2-D vector quantization. The former circuits are based on Winograd algorithms and comprise a number of bit-level systolic arrays with a bit-serial, word-parallel input. The latter circuits exhibit a similar data organization and consist of a number of inner product array circuits. Both circuits are highly regular and allow extremely high data rates to be achieved through extensive use of parallelism.

INDEPENDENT EVALUATION OF THE PERFORMANCE OF THE CCITT G. 722 WIDEBAND CODING RECOMMENDATION.

The subjective performance of the G. 722 7-kHz wideband speech coding recommendation using music signals is described. A number of audible distortions specific to music signals were found to be present in real-time evaluations of the coder. As a result, three modifications are proposed which are found to improve the performance for music signals. These modifications are compatible with the G. 722 system configuration. Modifications made to G. 722 to alleviate the most serious aspects of the noise modulation are described: (1) an adaptive bit allocation scheme is used to reduce short and long-term nonoptimality; (2) spectral noise shaping is incorporated, significantly enhancing the subjective performance of certain modes; and (3) backward block adaptive prediction is used.

INDEPENDENT EVALUATION OF THE PERFORMANCE OF THE CCITT G. 722 WIDEBAND CODING RECOMMENDATION USING MUSIC SIGNALS.

The subjective performance of the G. 722 7-kHz wideband speech-coding recommendation using music signals is described. A number of audible distortions specific to music signals were found to be present in real-time evaluations of the coder. As a result, three modifications are proposed which are found to improve the performance for music signals. These modifications are compatible with the G. 722 system configuration. The results obtained clearly demonstrate the very high coding efficiency of subband ADPCM (adaptive differential pulse-code modulation) with comparison to digitally companding and ADM schemes when applied to music signals.

Neonatal Facial Coding System for assessing postoperative pain in infants:item reduction is valid and feasible

The objectives of this study were to: (1). evaluate the validity of the Neonatal Facial Coding System (NFCS) for assessment of postoperative pain and (2). explore whether the number of NFCS facial actions could be reduced for assessing postoperative pain.

Bedside application of the Neonatal Facial Coding System in pain assessment of premature neonates

Assessment of infant pain is a pressing concern, especially within the context of neonatal intensive care where infants may be exposed to prolonged and repeated pain during lengthy hospitalization. In the present study the feasibility of carrying out the complete Neonatal Facial Coding System (NFCS) in real time at bedside, specifically reliability, construct and concurrent validity, was evaluated in a tertiary level Neonatal Intensive Care Unit (NICU). Heel lance was used as a model of procedural pain, and observed with n = 40 infants at 32 weeks gestational age. Infant sleep/wake state, NFCS facial activity and specific hand movements were coded during baseline, unwrap, swab, heel lance, squeezing and recovery events. Heart rate was recorded continuously and digitally sampled using a custom designed computer system. Repeated measures analysis of variance (ANOVA) showed statistically significant differences across events for facial activity (P <0.0001) and heart rate (P <0.0001). Planned comparisons showed facial activity unchanged during baseline, swab and unwrap, then increased significantly during heel lance (P <0.0001), increased further during squeezing (P <0.003), then decreased during recovery (P <0.0001). Systematic shifts in sleep/wake state were apparent. Rise in facial activity was consistent with increased heart rate, except that facial activity more closely paralleled initiation of the invasive event. Thus facial display was more specific to tissue damage compared with heart rate. Inter-observer reliability was high. Construct validity of the NFCS at bedside was demonstrated as invasive procedures were distinguished from tactile. While bedside coding of behavior does not permit raters to be blind to events, mechanical recording of heart rate allowed for an independent source of concurrent validation for bedside application of the NFCS scale.

The role of private care in the interval between diagnosis and treatment of breast cancer in Northern Ireland: an analysis of Registry data

Objective: To examine the differences in the interval between diagnosis and initiation of treatment among women with breast cancer in Northern Ireland.

Design: A cross-sectional observational study.
Setting: All breast cancer care patients in the Northern Ireland Cancer Registry in 2006.
Participants: All women diagnosed and treated for breast cancer in Northern Ireland in 2006.
Main outcome measure: The number of days between diagnosis and initiation of treatment for breast cancer.

Results: The mean (median) interval between diagnosis and initiation of treatment among public patients was 19 (15) compared with 14 (12) among those whose care involved private providers. The differences between individual public providers were as marked as those between the public and private sector - the mean (median) ranging between 14 (12) and 25 (22) days. Multivariate models revealed that the differences were evident when a range of patient characteristics were controlled for including cancer stage.

Conclusions: A relatively small number of women received care privately in Northern Ireland but experienced shorter intervals between diagnosis and initiation of treatment than those who received care wholly in the public system. The variation among public providers was as great as that between the public and private providers. The impact of such differences on survival and in light of waiting time targets introduced in Northern Ireland warrants investigation.