Validación diagnóstica del test neural 1 para el síndrome de túnel del carpo

El objetivo de este estudio fue realizar una prueba de validez diagnostica del test neural 1 para el diagnóstico del Síndrome de Túnel del Carpo (STC) utilizando como prueba de referencia o de oro el test de conducción nerviosa. En este estudio participaron 115 sujetos, 230 manos con sospecha clínica de STC quienes fueron evaluados con el test de conducción nerviosa y el test neural 1. Se encontró una sensibilidad del 93.0% (IC 95%:88,21-96,79) y una especificidad del 6,67% (IC 95%:0,0-33,59), razón de verosimilitud positiva fue de 1,00 y razón de verosimilitud negativa de 1,05. Valor predictivo positivo de 86,9% y un valor predictivo negativo de 12,5%. Se concluye que el test neural 1 es una prueba clínica de alta sensibilidad y baja especificidad de gran utilidad para el monitoreo e identificación del STC. Es un procedimiento para el diagnóstico clínico de bajo costo que puede incluirse en los exámenes de rutina de los trabajadores como complemento a las pruebas clínicas sugeridas por las Gatiso para dar mayor precisión a la identificación temprana del STC. Se sugiere combinarla con otros test de mayor especificidad para ser aplicada en trabajadores en condiciones de riesgo o que presenten síntomas en miembros superiores y realizar otros estudios en donde participen sujetos sin diagnóstico clínico del STC.

Factores asociados a la asistencia al control prenatal en gestantes del municipio de Yopal Casanare, Colombia – 2011

Introducción: Según OMS en 2011, 536.000 mujeres murieron en el mundo por causas relacionadas al embarazo y el parto; obteniendo Colombia índices altos de mortalidad materna (Fondo de Población de las Naciones Unidas, 2010); mientras Casanare reportó cuatro casos en 2009, y Yopal en 2010 alcanzó una tasa de 66,5 por 100.000 NV (Plan de desarrollo municipio de Yopal); por tanto se busca identificar factores que afectan la adherencia al control prenatal. Metodología: Estudio observacional de prevalencia analítica realizado con datos de gestantes de Yopal (Casanare) canalizadas por Intervenciones Colectivas 2011, con una muestra de 621 gestantes en las semanas de gestación 8,12,16,20,24,28,32,36,38 y 40.. Resultados: La adherencia al control prenatal fue del 15% y los factores que mostraron asociación estadísticamente significativa con adherencia al control prenatal fueron: régimen de salud (P=0.010); semana de gestación (p=0.000); trimestre del embarazo, antecedentes de abortos, apoyo económico (OR=1.738; IC=95%; 1.026-2.945); embarazo planeado, soporte familiar, satisfacción de compartir tiempo y espacio con el cónyuge (p=0.009, 0.001, 0.006); convivencia con familia materna (P=0.032), razón de verosimilitud 0.046, y valor OR=0.444; IC=95%; 0.208 – 0.948; y se identificaron barreras como inoportunidad de citas e insatisfacción por los servicios, donde el 98,9% de gestantes que no las encontraron tuvieron adherencia al control prenatal. Conclusión: Es necesario fortalecer programas de promoción de salud materna, control prenatal, prevención del embarazo adolescente y derechos de la mujer; reforzando acciones de vigilancia para disminuir las barreras de aseguramiento y calidad de los servicios.

Hábitos alimentarios en la primera infancia : educación y prevención.

Aproximación a los hábitos de consumo de la población infantil escolarizada de 0-6 años, con atención preferente sobre los productos de baja calidad nutricional (BACAN), más conocidos como golosinas.Elaborar un programa de intervención dirigido a los distintos sectores de la comunidad educativa: centros, familias y niños, cuyo objetivo es reducir el consumo abusivo de productos de baja calidad nutricional. Muestra de 492 padres de niños matriculados en primer ciclo de los Centros de Educación Infantil, dependientes de la CARM y de segundo ciclo de EI de centros dependientes del MEC. Recogida de información mediante la aplicación de un cuestionario a los padres-madres. Análisis de datos. Elaboración de un programa de intervención en centros escolares. Cuestionario sobre consumo, de elaboración propia. Correlación entre variables. Estadísticos: Chi cuadrado de Pearson y de Likelihood Ratio. El consumo de productos BACAN no es homogéneo. Se diversifica y aumenta con la edad, excepción hecha con los fritos industriales cuyo consumo aparece a las edades más tempranas. La mayoría de las familias sitúan el consumo de sus hijos entre una y tres unidades de estos productos. Se ha constatado que los padres proporcionan estos productos a los hijos a pesar de estar informados de su perjuicio sobre la salud.

Periodic Reordering

For many networks in nature, science and technology, it is possible to order the nodes so that most links are short-range, connecting near-neighbours, and relatively few long-range links, or shortcuts, are present. Given a network as a set of observed links (interactions), the task of finding an ordering of the nodes that reveals such a range-dependent structure is closely related to some sparse matrix reordering problems arising in scientific computation. The spectral, or Fiedler vector, approach for sparse matrix reordering has successfully been applied to biological data sets, revealing useful structures and subpatterns. In this work we argue that a periodic analogue of the standard reordering task is also highly relevant. Here, rather than encouraging nonzeros only to lie close to the diagonal of a suitably ordered adjacency matrix, we also allow them to inhabit the off-diagonal corners. Indeed, for the classic small-world model of Watts & Strogatz (1998, Collective dynamics of ‘small-world’ networks. Nature, 393, 440–442) this type of periodic structure is inherent. We therefore devise and test a new spectral algorithm for periodic reordering. By generalizing the range-dependent random graph class of Grindrod (2002, Range-dependent random graphs and their application to modeling large small-world proteome datasets. Phys. Rev. E, 66, 066702-1–066702-7) to the periodic case, we can also construct a computable likelihood ratio that suggests whether a given network is inherently linear or periodic. Tests on synthetic data show that the new algorithm can detect periodic structure, even in the presence of noise. Further experiments on real biological data sets then show that some networks are better regarded as periodic than linear. Hence, we find both qualitative (reordered networks plots) and quantitative (likelihood ratios) evidence of periodicity in biological networks.

Fixed point dual carrier modulation performance for wireless USB

Dual Carrier Modulation (DCM) is currently used as the higher data rate modulation scheme for Multiband Orthogonal Frequency Division Multiplexing (MB-OFDM) in the ECMA-368 defined Ultra-Wideband (UWB) radio platform. ECMA-368 has been chosen as the physical radio platform for many systems including Wireless USB (W-USB), Bluetooth 3.0 and Wireless HDMI; hence ECMA-368 is an important issue to consumer electronics and the user’s experience of these products. In this paper, Log Likelihood Ratio (LLR) demapping method is used for the DCM demaper implemented in fixed point model. Channel State Information (CSI) aided scheme coupled with the band hopping information is used as the further technique to improve the DCM demapping performance. The receiver performance for the fixed point DCM is simulated in realistic multi-path environments.

On the question of proportionality of the count of observed Scrapie cases and the size of holding

Background: The present paper investigates the question of a suitable basic model for the number of scrapie cases in a holding and applications of this knowledge to the estimation of scrapie-ffected holding population sizes and adequacy of control measures within holding. Is the number of scrapie cases proportional to the size of the holding in which case it should be incorporated into the parameter of the error distribution for the scrapie counts? Or, is there a different - potentially more complex - relationship between case count and holding size in which case the information about the size of the holding should be better incorporated as a covariate in the modeling? Methods: We show that this question can be appropriately addressed via a simple zero-truncated Poisson model in which the hypothesis of proportionality enters as a special offset-model. Model comparisons can be achieved by means of likelihood ratio testing. The procedure is illustrated by means of surveillance data on classical scrapie in Great Britain. Furthermore, the model with the best fit is used to estimate the size of the scrapie-affected holding population in Great Britain by means of two capture-recapture estimators: the Poisson estimator and the generalized Zelterman estimator. Results: No evidence could be found for the hypothesis of proportionality. In fact, there is some evidence that this relationship follows a curved line which increases for small holdings up to a maximum after which it declines again. Furthermore, it is pointed out how crucial the correct model choice is when applied to capture-recapture estimation on the basis of zero-truncated Poisson models as well as on the basis of the generalized Zelterman estimator. Estimators based on the proportionality model return very different and unreasonable estimates for the population sizes. Conclusion: Our results stress the importance of an adequate modelling approach to the association between holding size and the number of cases of classical scrapie within holding. Reporting artefacts and speculative biological effects are hypothesized as the underlying causes of the observed curved relationship. The lack of adjustment for these artefacts might well render ineffective the current strategies for the control of the disease.

Dual carrier modulation demapping methods and performances for wireless USB

Dual Carrier Modulation (DCM) was chosen as the higher data rate modulation scheme for MB-OFDM (Multiband Orthogonal Frequency Division Multiplexing) in the UWB (Ultra-Wide Band) radio platform ECMA-368. ECMA-368 has been chosen as the physical implementation for high data rate Wireless USB (W-USB) and Bluetooth 3.0. In this paper, different demapping methods for the DCM demapper are presented, being Soft Bit, Maximum Likely (ML) Soft Bit and Log Likelihood Ratio (LLR). Frequency diversity and Channel State Information (CSI) are further techniques to enhance demapping methods. The system performance for those DCM demapping methods simulated in realistic multi-path environments are provided and compared.

A comparison between feature-based and EM-based contour tracking

Most active-contour methods are based either on maximizing the image contrast under the contour or on minimizing the sum of squared distances between contour and image 'features'. The Marginalized Likelihood Ratio (MLR) contour model uses a contrast-based measure of goodness-of-fit for the contour and thus falls into the first class. The point of departure from previous models consists in marginalizing this contrast measure over unmodelled shape variations. The MLR model naturally leads to the EM Contour algorithm, in which pose optimization is carried out by iterated least-squares, as in feature-based contour methods. The difference with respect to other feature-based algorithms is that the EM Contour algorithm minimizes squared distances from Bayes least-squares (marginalized) estimates of contour locations, rather than from 'strongest features' in the neighborhood of the contour. Within the framework of the MLR model, alternatives to the EM algorithm can also be derived: one of these alternatives is the empirical-information method. Tracking experiments demonstrate the robustness of pose estimates given by the MLR model, and support the theoretical expectation that the EM Contour algorithm is more robust than either feature-based methods or the empirical-information method. (c) 2005 Elsevier B.V. All rights reserved.

Relatedness testing in subdivided populations

Assigning probabilities to alleged relationships, given DNA profiles, requires, among other things, calculation of a likelihood ratio (LR). Such calculations usually assume independence of genes: this assumption is not appropriate when the tested individuals share recent ancestry due to population substructure. Adjusted LR formulae, incorporating the coancestry coefficient F(ST), are presented here for various two-person relationships, and the issue of mutations in parentage testing is also addressed.

Multiband OFDM modulation and demodulation for ultra wideband communications

This chapter considers the Multiband Orthogonal Frequency Division Multiplexing (MB- OFDM) modulation and demodulation with the intention to optimize the Ultra-Wideband (UWB) system performance. OFDM is a type of multicarrier modulation and becomes the most important aspect for the MB-OFDM system performance. It is also a low cost digital signal component efficiently using Fast Fourier Transform (FFT) algorithm to implement the multicarrier orthogonality. Within the MB-OFDM approach, the OFDM modulation is employed in each 528 MHz wide band to transmit the data across the different bands while also using the frequency hopping technique across different bands. Each parallel bit stream can be mapped onto one of the OFDM subcarriers. Quadrature Phase Shift Keying (QPSK) and Dual Carrier Modulation (DCM) are currently used as the modulation schemes for MB-OFDM in the ECMA-368 defined UWB radio platform. A dual QPSK soft-demapper is suitable for ECMA-368 that exploits the inherent Time-Domain Spreading (TDS) and guard symbol subcarrier diversity to improve the receiver performance, yet merges decoding operations together to minimize hardware and power requirements. There are several methods to demap the DCM, which are soft bit demapping, Maximum Likelihood (ML) soft bit demapping, and Log Likelihood Ratio (LLR) demapping. The Channel State Information (CSI) aided scheme coupled with the band hopping information is used as a further technique to improve the DCM demapping performance. ECMA-368 offers up to 480 Mb/s instantaneous bit rate to the Medium Access Control (MAC) layer, but depending on radio channel conditions dropped packets unfortunately result in a lower throughput. An alternative high data rate modulation scheme termed Dual Circular 32-QAM that fits within the configuration of the current standard increasing system throughput thus maintaining the high rate throughput even with a moderate level of dropped packets.

Interaction between vitamin D receptor gene polymorphisms and 25-hydroxyvitamin D concentrations on metabolic and cardiovascular disease outcomes

AIM: 25-hydroxyvitamin D (25OHD) concentrations have been shown to be associated with major clinical outcomes, with a suggestion that individual risk may vary according to common genetic differences in the vitamin D receptor (VDR) gene. Hence, we tested for the interactions between two previously studied VDR polymorphisms and 25OHD on metabolic and cardiovascular disease-related outcomes in a large population-based study. METHODS: Interactions between two previously studied VDR polymorphisms (rs7968585 and rs2239179) and 25OHD concentrations on metabolic and cardiovascular disease-related outcomes such as obesity- (body mass index, waist circumference, waist-hip ratio (WHR)), cardiovascular- (systolic and diastolic blood pressure), lipid- (high- and low-density lipoprotein, triglycerides, total cholesterol), inflammatory- (C-reactive protein, fibrinogen, insulin growth factor-1, tissue plasminogen activator) and diabetes- (glycated haemoglobin) related markers were examined in the 1958 British Birth cohort (n up to 5160). Interactions between each SNP and 25OHD concentrations were assessed using linear regression and the likelihood ratio test. RESULTS: After Bonferroni correction, none of the interactions reached statistical significance except for the interaction between the VDR SNP rs2239179 and 25OHD concentrations on waist-hip ratio (WHR) (P=0.03). For every 1nmol/L higher 25OHD concentrations, the association with WHR was stronger among those with two major alleles (-4.0%, P=6.26e-24) compared to those with either one or no major alleles (-2.3%, P≤8.201e-07, for both) of the VDR SNP rs2239179. CONCLUSION: We found no evidence for VDR polymorphisms acting as major modifiers of the association between 25OHD concentrations and cardio-metabolic risk. Interaction between VDR SNP rs2239179 and 25OHD on WHR warrants further confirmation.

Interaction between allelic variations in vitamin D receptor and retinoid X receptor genes on metabolic traits

BACKGROUND: Low vitamin D status has been shown to be a risk factor for several metabolic traits such as obesity, diabetes and cardiovascular disease. The biological actions of 1, 25-dihydroxyvitamin D, are mediated through the vitamin D receptor (VDR), which heterodimerizes with retinoid X receptor, gamma (RXRG). Hence, we examined the potential interactions between the tagging polymorphisms in the VDR (22 tag SNPs) and RXRG (23 tag SNPs) genes on metabolic outcomes such as body mass index, waist circumference, waist-hip ratio (WHR), high- and low-density lipoprotein (LDL) cholesterols, serum triglycerides, systolic and diastolic blood pressures and glycated haemoglobin in the 1958 British Birth Cohort (1958BC, up to n = 5,231). We used Multifactor- dimensionality reduction (MDR) program as a non-parametric test to examine for potential interactions between the VDR and RXRG gene polymorphisms in the 1958BC. We used the data from Northern Finland Birth Cohort 1966 (NFBC66, up to n = 5,316) and Twins UK (up to n = 3,943) to replicate our initial findings from 1958BC. RESULTS: After Bonferroni correction, the joint-likelihood ratio test suggested interactions on serum triglycerides (4 SNP - SNP pairs), LDL cholesterol (2 SNP - SNP pairs) and WHR (1 SNP - SNP pair) in the 1958BC. MDR permutation model testing analysis showed one two-way and one three-way interaction to be statistically significant on serum triglycerides in the 1958BC. In meta-analysis of results from two replication cohorts (NFBC66 and Twins UK, total n = 8,183), none of the interactions remained after correction for multiple testing (Pinteraction >0.17). CONCLUSIONS: Our results did not provide strong evidence for interactions between allelic variations in VDR and RXRG genes on metabolic outcomes; however, further replication studies on large samples are needed to confirm our findings.

Development and validation of a parent report measure for detection of cognitive delay in infancy

Aim To develop a brief, parent-completed instrument (‘ERIC’) for detection of cognitive delay in 10-24 month-olds born preterm, or with low birth weight, or with perinatal complications, and to establish its diagnostic properties. Method Scores were collected from parents of 317 children meeting ≥1 inclusion criteria (birth weight <1500g; gestational age <34 completed weeks; 5-minute Apgar <7; presence of hypoxic-ischemic encephalopathy) and meeting no exclusion criteria. Children were assessed for cognitive delay using a criterion score on the Bayley Scales of Infant and Toddler Development Cognitive Scale III1 <80. Items were retained according to their individual associations with delay. Sensitivity, specificity, Positive and Negative Predictive Values were estimated and a truncated ERIC was developed for use <14 months. Results ERIC detected 17 out of 18 delayed children in the sample, with 94.4% sensitivity (95% CI [confidence interval] 83.9-100%), 76.9% specificity (72.1-81.7%), 19.8% positive predictive value (11.4-28.2%); 99.6% negative predictive value (98.7-100%); 4.09 likelihood ratio positive; and 0.07 likelihood ratio negative; the associated Area under the Curve was .909 (.829-.960). Interpretation ERIC has potential value as a quickly-administered diagnostic instrument for the absence of early cognitive delay in preterm or premature infants of 10-24 months, and as a screen for cognitive delay. Further research may be needed before ERIC can be recommended for wide-scale use.

Interactions between uncoupling protein 2 gene polymorphisms, obesity and alcohol intake on liver function: a large meta-analysed population-based study

BACKGROUND AND OBJECTIVE: Given the role of uncoupling protein 2 (UCP2) in the accumulation of fat in the hepatocytes and in the enhancement of protective mechanisms in acute ethanol intake, we hypothesised that UCP2 polymorphisms are likely to cause liver disease through their interactions with obesity and alcohol intake. To test this hypothesis, we investigated the interaction between tagging polymorphisms in the UCP2 gene (rs2306819, rs599277 and rs659366), alcohol intake and obesity traits such as BMI and waist circumference (WC) on alanine aminotransferase (ALT) and gamma glutamyl transferase (GGT) in a large meta-analysis of data sets from three populations (n=20 242). DESIGN AND METHODS: The study populations included the Northern Finland Birth Cohort 1966 (n=4996), Netherlands Study of Depression and Anxiety (n=1883) and LifeLines Cohort Study (n=13 363). Interactions between the polymorphisms and obesity and alcohol intake on dichotomised ALT and GGT levels were assessed using logistic regression and the likelihood ratio test. RESULTS: In the meta-analysis of the three cohorts, none of the three UCP2 polymorphisms were associated with GGT or ALT levels. There was no evidence for interaction between the polymorphisms and alcohol intake on GGT and ALT levels. In contrast, the association of WC and BMI with GGT levels varied by rs659366 genotype (Pinteraction=0.03 and 0.007, respectively; adjusted for age, gender, high alcohol intake, diabetes, hypertension and serum lipid concentrations). CONCLUSION: In conclusion, our findings in 20 242 individuals suggest that UCP2 gene polymorphisms may cause liver dysfunction through the interaction with body fat rather than alcohol intake.

A cautionary note on the use of Ornstein Uhlenbeck models in macroevolutionary studies

Phylogenetic comparative methods are increasingly used to give new insights into the dynamics of trait evolution in deep time. For continuous traits the core of these methods is a suite of models that attempt to capture evolutionary patterns by extending the Brownian constant variance model. However, the properties of these models are often poorly understood, which can lead to the misinterpretation of results. Here we focus on one of these models – the Ornstein Uhlenbeck (OU) model. We show that the OU model is frequently incorrectly favoured over simpler models when using Likelihood ratio tests, and that many studies fitting this model use datasets that are small and prone to this problem. We also show that very small amounts of error in datasets can have profound effects on the inferences derived from OU models. Our results suggest that simulating fitted models and comparing with empirical results is critical when fitting OU and other extensions of the Brownian model. We conclude by making recommendations for best practice in fitting OU models in phylogenetic comparative analyses, and for interpreting the parameters of the OU model.