Being Small for Gestational Age: Does it Matter for the Neurodevelopment of Premature Infants? A Cohort Study.

BACKGROUND: Whether being small for gestational age (SGA) increases the risk of adverse neurodevelopmental outcome in premature infants remains controversial. OBJECTIVE: to study the impact of SGA (birthweight < percentile 10) on cognition, behavior, neurodevelopmental impairment and use of therapy at 5 years old. METHODS: This population-based prospective cohort included infants born before 32 weeks of gestation. Cognition was evaluated with the K-ABC, and behavior with the Strengths and Difficulties Questionnaire (SDQ). Primary outcomes were cognitive and behavioral scores, as well as neurodevelopmental impairment (cognitive score < 2SD, hearing loss, blindness, or cerebral palsy). The need of therapy, an indirect indicator of neurodevelopmental impairment, was a secondary outcome. Linear and logistic regression models were used to analyze the association of SGA with neurodevelopment. RESULTS: 342/515 (76%) premature infants were assessed. SGA was significantly associated with hyperactivity scores of the SDQ (coefficient 0.81, p < 0.04), but not with cognitive scores, neurodevelopmental impairment or the need of therapy. Gestational age, socio-economic status, and major brain lesions were associated with cognitive outcome in the univariate and multivariate model, whereas asphyxia, sepsis and bronchopulmonary dysplasia were associated in the univariate model only. Severe impairment was associated with fetal tobacco exposition, asphyxia, gestational age and major brain lesions. Different neonatal factors were associated with the use of single or multiple therapies: children with one therapy were more likely to have suffered birth asphyxia or necrotizing enterocolitis, whereas the need for several therapies was predicted by major brain lesions. DISCUSSION: In this large cohort of premature infants, assessed at 5 years old with a complete panel of tests, SGA was associated with hyperactive behavior, but not with cognition, neurodevelopmental impairment or use of therapy. Birthweight <10th percentile alone does not appear to be an independent risk factor of neurodevelopmental adverse outcome in preterm children.

Business IT Alignment from Business Model to Enterprise Architecture

In this paper, we show how business model modelling can be connected to IT infrastructure, drawing parallels from enterprise architecture models such as ArchiMate. We then show how the proposed visualization based on enterprise architecture, with a strong focus on business model strategy, can help IT alignment, at both the business model and the IT infrastructure level.

L'exploitation des peintures en spray en criminalistique: mise en place d'une procédure de gestion et de comparaison des spectres infrarouges à l'aide des statistiques multivariées

La spectroscopie infrarouge (FTIR) est une technique de choix dans l'analyse des peintures en spray (traces ou bonbonnes de référence), grâce à son fort pouvoir discriminant, sa sensibilité, et ses nombreuses possibilités d'échantillonnage. La comparaison des spectres obtenus est aujourd'hui principalement faite visuellement, mais cette procédure présente des limitations telles que la subjectivité de la prise de décision car celle-ci dépend de l'expérience et de la formation suivie par l'expert. De ce fait, de faibles différences d'intensités relatives entre deux pics peuvent être perçues différemment par des experts, même au sein d'un même laboratoire. Lorsqu'il s'agit de justifier ces différences, certains les expliqueront par la méthode analytique utilisée, alors que d'autres estimeront plutôt qu'il s'agit d'une variabilité intrinsèque à la peinture et/ou à son vécu (par exemple homogénéité, sprayage, ou dégradation). Ce travail propose d'étudier statistiquement les différentes sources de variabilité observables dans les spectres infrarouges, de les identifier, de les comprendre et tenter de les minimiser. Le deuxième objectif principal est de proposer une procédure de comparaison des spectres qui soit davantage transparente et permette d'obtenir des réponses reproductibles indépendamment des experts interrogés. La première partie du travail traite de l'optimisation de la mesure infrarouge et des principaux paramètres analytiques. Les conditions nécessaires afin d'obtenir des spectres reproductibles et minimisant la variation au sein d'un même échantillon (intra-variabilité) sont présentées. Par la suite une procédure de correction des spectres est proposée au moyen de prétraitements et de sélections de variables, afin de minimiser les erreurs systématiques et aléatoires restantes, et de maximiser l'information chimique pertinente. La seconde partie présente une étude de marché effectuée sur 74 bonbonnes de peintures en spray représentatives du marché suisse. Les capacités de discrimination de la méthode FTIR au niveau de la marque et du modèle sont évaluées au moyen d'une procédure visuelle, et comparées à diverses procédures statistiques. Les limites inférieures de discrimination sont testées sur des peintures de marques et modèles identiques mais provenant de différents lots de production. Les résultats ont montré que la composition en pigments était particulièrement discriminante, à cause des étapes de corrections et d'ajustement de la couleur subies lors de la production. Les particularités associées aux peintures en spray présentes sous forme de traces (graffitis, gouttelettes) ont également été testées. Trois éléments sont mis en évidence et leur influence sur le spectre infrarouge résultant testée : 1) le temps minimum de secouage nécessaire afin d'obtenir une homogénéité suffisante de la peinture et, en conséquence, de la surface peinte, 2) la dégradation initiée par le rayonnement ultra- violet en extérieur, et 3) la contamination provenant du support lors du prélèvement. Finalement une étude de population a été réalisée sur 35 graffitis de la région lausannoise et les résultats comparés à l'étude de marché des bonbonnes en spray. La dernière partie de ce travail s'est concentrée sur l'étape de prise de décision lors de la comparaison de spectres deux-à-deux, en essayant premièrement de comprendre la pratique actuelle au sein des laboratoires au moyen d'un questionnaire, puis de proposer une méthode statistique de comparaison permettant d'améliorer l'objectivité et la transparence lors de la prise de décision. Une méthode de comparaison basée sur la corrélation entre les spectres est proposée, et ensuite combinée à une évaluation Bayesienne de l'élément de preuve au niveau de la source et au niveau de l'activité. Finalement des exemples pratiques sont présentés et la méthodologie est discutée afin de définir le rôle précis de l'expert et des statistiques dans la procédure globale d'analyse des peintures. -- Infrared spectroscopy (FTIR) is a technique of choice for analyzing spray paint speciments (i.e. traces) and reference samples (i.e. cans seized from suspects) due to its high discriminating power, sensitivity and sampling possibilities. The comparison of the spectra is currently carried out visually, but this procedure has limitations such as the subjectivity in the decision due to its dependency on the experience and training of the expert. This implies that small differences in the relative intensity of two peaks can be perceived differently by experts, even between analysts working in the same laboratory. When it comes to justifying these differences, some will explain them by the analytical technique, while others will estimate that the observed differences are mostly due to an intrinsic variability from the paint sample and/or its acquired characteristics (for example homogeneity, spraying, or degradation). This work proposes to statistically study the different sources of variability observed in infrared spectra, to identify them, understand them and try to minimize them. The second goal is to propose a procedure for spectra comparison that is more transparent, and allows obtaining reproducible answers being independent from the expert. The first part of the manuscript focuses on the optimization of infrared measurement and on the main analytical parameters. The necessary conditions to obtain reproducible spectra with a minimized variation within a sample (intra-variability) are presented. Following that a procedure of spectral correction is then proposed using pretreatments and variable selection methods, in order to minimize systematic and random errors, and increase simultaneously relevant chemical information. The second part presents a market study of 74 spray paints representative of the Swiss market. The discrimination capabilities of FTIR at the brand and model level are evaluated by means of visual and statistical procedures. The inferior limits of discrimination are tested on paints coming from the same brand and model, but from different production batches. The results showed that the pigment composition was particularly discriminatory, because of the corrections and adjustments made to the paint color during its manufacturing process. The features associated with spray paint traces (graffitis, droplets) were also tested. Three elements were identified and their influence on the resulting infrared spectra were tested: 1) the minimum shaking time necessary to obtain a sufficient homogeneity of the paint and subsequently of the painted surface, 2) the degradation initiated by ultraviolet radiation in an exterior environment, and 3) the contamination from the support when paint is recovered. Finally a population study was performed on 35 graffitis coming from the city of Lausanne and surroundings areas, and the results were compared to the previous market study of spray cans. The last part concentrated on the decision process during the pairwise comparison of spectra. First, an understanding of the actual practice among laboratories was initiated by submitting a questionnaire. Then, a proposition for a statistical method of comparison was advanced to improve the objectivity and transparency during the decision process. A method of comparison based on the correlation between spectra is proposed, followed by the integration into a Bayesian framework at both source and activity levels. Finally, some case examples are presented and the recommended methodology is discussed in order to define the role of the expert as well as the contribution of the tested statistical approach within a global analytical sequence for paint examinations.

Swiss medical centres vary significantly when it comes to outcomes of neonates with a very low gestational age.

AIM: This study quantified the impact of perinatal predictors and medical centre on the outcome of very low-gestational-age neonates (VLGANs) born at <32 completed weeks in Switzerland. METHODS: Using prospectively collected data from a 10-year cohort of VLGANs, we developed logistic regression models for three different time points: delivery, NICU admission and seven days of age. The data predicted survival to discharge without severe neonatal morbidity, such as major brain injury, moderate or severe bronchopulmonary dysplasia, retinopathy of prematurity (≥stage three) or necrotising enterocolitis (≥stage three). RESULTS: From 2002 to 2011, 6892 VLGANs were identified: 5854 (85%) of the live-born infants survived and 84% of the survivors did not have severe neonatal complications. Predictors for adverse outcome at delivery and on NICU admission were low gestational age, low birthweight, male sex, multiple birth, birth defects and lack of antenatal corticosteroids. Proven sepsis was an additional risk factor on day seven of life. The medical centre remained a statistically significant factor at all three time points after adjusting for perinatal predictors. CONCLUSION: After adjusting for perinatal factors, the survival of Swiss VLGANs without severe neonatal morbidity was strongly influenced by the medical centre that treated them.

Detecting patterns of species diversification in the presence of both rate shifts and mass extinctions.

BACKGROUND: Recent methodological advances allow better examination of speciation and extinction processes and patterns. A major open question is the origin of large discrepancies in species number between groups of the same age. Existing frameworks to model this diversity either focus on changes between lineages, neglecting global effects such as mass extinctions, or focus on changes over time which would affect all lineages. Yet it seems probable that both lineages differences and mass extinctions affect the same groups. RESULTS: Here we used simulations to test the performance of two widely used methods under complex scenarios of diversification. We report good performances, although with a tendency to over-predict events with increasing complexity of the scenario. CONCLUSION: Overall, we find that lineage shifts are better detected than mass extinctions. This work has significance to assess the methods currently used to estimate changes in diversification using phylogenetic trees. Our results also point toward the need to develop new models of diversification to expand our capabilities to analyse realistic and complex evolutionary scenarios.

Liberal alcohol legislation: does it amplify the effects among Swiss men of person-related risk factors on heavy alcohol use?

AIM: To estimate the statistical interactions between alcohol policy strength and the person-related risk factors of sensation-seeking, antisocial personality disorder and attention-deficit/hyperactivity disorder related to heavy alcohol use. DESIGN: Cross-sectional survey. SETTING: Young Swiss men living within 21 jurisdictions across Switzerland. PARTICIPANTS: A total of 5701 Swiss men (mean age 20 years) participating in the Cohort Study on Substance Use Risk Factors (C-SURF). MEASUREMENTS: Outcome measures were alcohol use disorder (AUD) as defined in the DSM-5 and risky single-occasion drinking (RSOD). Independent variables were sensation-seeking, antisocial personality disorder (ASPD), attention-deficit/hyperactivity disorder (ADHD) and an index of alcohol policy strength. FINDINGS: Alcohol policy strength was protective against RSOD [odds ratio (OR) = 0.91 (0.84-0.99)], while sensation-seeking and ASPD were risk factors for both RSOD [OR = 1.90 (1.77-2.04); OR = 1.69 (1.44-1.97)] and AUD [OR = 1.58 (1.47-1.71); OR = 2.69 (2.30-3.14)] and ADHD was a risk factor for AUD [OR = 1.08 (1.06-1.10)]. Significant interactions between alcohol policy strength and sensation-seeking were identified for RSOD [OR = 1.06 (1.01-1.12)] and AUD [OR = 1.06 (1.01-1.12)], as well as between alcohol policy strength and ASPD for both RSOD [OR = 1.17 (1.03-1.31)] and AUD [OR = 1.15 (1.02-1.29)]. These interactions indicated that the protective effects of alcohol policy strength on RSOD and AUD were lost in men with high levels of sensation-seeking or an ASPD. No interactions were detected between alcohol policy strength and ADHD. CONCLUSION: Stronger alcohol legislation protects against heavy alcohol use in young Swiss men, but this protective effect is lost in individuals with high levels of sensation-seeking or having an antisocial personality disorder.

Coev-web: a web platform designed to simulate and evaluate coevolving positions along a phylogenetic tree.

BACKGROUND: Available methods to simulate nucleotide or amino acid data typically use Markov models to simulate each position independently. These approaches are not appropriate to assess the performance of combinatorial and probabilistic methods that look for coevolving positions in nucleotide or amino acid sequences. RESULTS: We have developed a web-based platform that gives a user-friendly access to two phylogenetic-based methods implementing the Coev model: the evaluation of coevolving scores and the simulation of coevolving positions. We have also extended the capabilities of the Coev model to allow for the generalization of the alphabet used in the Markov model, which can now analyse both nucleotide and amino acid data sets. The simulation of coevolving positions is novel and builds upon the developments of the Coev model. It allows user to simulate pairs of dependent nucleotide or amino acid positions. CONCLUSIONS: The main focus of our paper is the new simulation method we present for coevolving positions. The implementation of this method is embedded within the web platform Coev-web that is freely accessible at http://coev.vital-it.ch/, and was tested in most modern web browsers.

Maladie de Whipple: quand y penser [Whipple's disease, when to think about it?].

Whipple's disease is a chronic, systemic, bacterial infection caused by Tropheryma whipplei. Its cardinal symptoms include intermittent and recurrent arthralgia or arthritis together with chronic diarrhoea, abdominal pain and weight loss. It may mimick many chronic inflammatory diseases, and the diagnosis remains a challenge. Salivary and faecal quantitative PCR for T. whipplei should be ensued, if positive, by an upper endoscopy for duodenal biopsies. The treatment consists of a combination of oral doxycycline and hydroxychloroquine for 12 months followed by life-long doxycycline. Whipple's disease, although rare, is an entity that should be considered regularly, as its progression may be fatal if left untreated.