Improving statistical analysis of matched case-control studies

Matched case–control research designs can be useful because matching can increase power due to reduced variability between subjects. However, inappropriate statistical analysis of matched data could result in a change in the strength of association between the dependent and independent variables or a change in the significance of the findings. We sought to ascertain whether matched case–control studies published in the nursing literature utilized appropriate statistical analyses. Of 41 articles identified that met the inclusion criteria, 31 (76%) used an inappropriate statistical test for comparing data derived from case subjects and their matched controls. In response to this finding, we developed an algorithm to support decision-making regarding statistical tests for matched case–control studies.

Risk factors for impaired respiratory function during nurse-administered procedural sedation and analgesia in the cardiac catheterisation laboratory : a matched case-control study

Background: Side effects of the medications used for procedural sedation and analgesia in the cardiac catheterisation laboratory are known to cause impaired respiratory function. Impaired respiratory function poses considerable risk to patient safety as it can lead to inadequate oxygenation. Having knowledge about the conditions that predict impaired respiratory function prior to the procedure would enable nurses to identify at-risk patients and selectively implement intensive respiratory monitoring. This would reduce the possibility of inadequate oxygenation occurring. Aim: To identify pre-procedure risk factors for impaired respiratory function during nurse-administered procedural sedation and analgesia in the cardiac catheterisation laboratory. Design: Retrospective matched case–control. Methods: 21 cases of impaired respiratory function were identified and matched to 113 controls from a consecutive cohort of patients over 18 years of age. Conditional logistic regression was used to identify risk factors for impaired respiratory function. Results: With each additional indicator of acute illness, case patients were nearly two times more likely than their controls to experience impaired respiratory function (OR 1.78; 95% CI 1.19–2.67; p = 0.005). Indicators of acute illness included emergency admission, being transferred from a critical care unit for the procedure or requiring respiratory or haemodynamic support in the lead up to the procedure. Conclusion: Several factors that predict the likelihood of impaired respiratory function were identified. The results from this study could be used to inform prospective studies investigating the effectiveness of interventions for impaired respiratory function during nurse-administered procedural sedation and analgesia in the cardiac catheterisation laboratory.

A bondgraph approach to formation control using relative state measurements

In this paper we apply port-Hamiltonian theory with the bondgraph modelling approach to the problem of formation control using partial measurements of relative positions. We present a control design that drives a group of vehicles to a desired formation without requiring inter-vehicle communications or global position and velocity measurements to be available. Our generic approach is applicable to any form of relative measurement between vehicles, but we specifically consider the important cases of relative bearings and relative distances. In the case of bearings, our theory closely relates to the field of image-based visual servo (IBVS) control. We present simulation results to support the developed theory.

Displacement motion prediction of a landing deck for recovery operations of rotary UAVs

This paper proposes a practical prediction procedure for vertical displacement of a Rotarywing Unmanned Aerial Vehicle (RUAV) landing deck in the presence of stochastic sea state disturbances. A proper time series model tending to capture characteristics of the dynamic relationship between an observer and a landing deck is constructed, with model orders determined by a novel principle based on Bayes Information Criterion (BIC) and coefficients identified using the Forgetting Factor Recursive Least Square (FFRLS) method. In addition, a fast-converging online multi-step predictor is developed, which can be implemented more rapidly than the Auto-Regressive (AR) predictor as it requires less memory allocations when updating coefficients. Simulation results demonstrate that the proposed prediction approach exhibits satisfactory prediction performance, making it suitable for integration into ship-helicopter approach and landing guidance systems in consideration of computational capacity of the flight computer.

Development and use of risk adjusted statistical process control tools for the monitoring and improvement of clinical outcomes in interventional cardiology

This thesis explored the development of statistical methods to support the monitoring and improvement in quality of treatment delivered to patients undergoing coronary angioplasty procedures. To achieve this goal, a suite of outcome measures was identified to characterise performance of the service, statistical tools were developed to monitor the various indicators and measures to strengthen governance processes were implemented and validated. Although this work focused on pursuit of these aims in the context of a an angioplasty service located at a single clinical site, development of the tools and techniques was undertaken mindful of the potential application to other clinical specialties and a wider, potentially national, scope.

Confirmation that Xq27 and Xq28 are susceptibility loci for migraine in independent pedigrees and a case-control cohort

Investigations into migraine genetics have suggested that susceptibility loci exist on the X chromosome. These reports are supported by evidence that demonstrates male probands as having a higher proportion of affected first-degree relatives as well as the female preponderance of 3:1 that the disorder displays. We have previously implicated the Xq24-28 locus in migraine using two independent multigenerational Australian pedigrees that demonstrated excess allele sharing at the Xq24, Xq27 and Xq28 loci. Here, we expand this work to investigate a further six independent migraine pedigrees using 11 microsatellite markers spanning the Xq27–28 region. Furthermore, 11 candidate genes are investigated in an Australian case-control cohort consisting of 500 cases and 500 controls. Microsatellite analysis showed evidence of excess allele sharing to the Xq27 marker DXS8043 (LOD* 1.38 P = 0.005) in MF879 whilst a second independent pedigree showed excess allele sharing to DXS8061 at Xq28 (LOD* 1.5 P = 0.004). Furthermore, analysis of these key markers in a case control cohort showed significant association to migraine in females at the DXS8043 marker (T1 P = 0.009) and association with MO at DXS8061 (T1 P = 0.05). Further analysis of 11 key genes across these regions showed significant association of a three-marker risk haplotype in the NSDHL gene at Xq28 (P = 0.0082). The results of this study add further support to the presence of migraine susceptibility loci on chromosome Xq27 and Xq28 as well as point to potential candidate genes in the regions that warrant further investigation.

Single nucleotide polymorphism in hsa-mir-196a-2 and breast cancer risk : a case control study

microRNAs are small, non-coding RNAs that influence gene expression on a post-transcriptional level. They participate in diverse biological pathways and may act as either tumor suppressor genes or oncogenes. As they may have an effect on thousands of target mRNAs, single-nucleotide polymorphisms in microRNA genes might have major functional consequences, because the microRNA's properties and/or maturation may change. miR-196a has been reported to be aberrantly expressed in breast cancer tissue. Additionally, the SNP rs11614913 in hsa-mir-196a-2 has been found to be associated with breast cancer risk in some studies although not in others. This study evaluated the association between rs11614913 and breast cancer risk in a Caucasian case-control cohort in Queensland, Australia. Results do not support an association of the tested hsa-mir-196a-2 polymorphism with breast cancer susceptibility in this cohort. As there is a discrepancy between our results and previous findings, it is important to assess the role of rs11614913 in breast cancer by further larger studies investigating different ethnic groups.

The estrogen receptor 1 G594A polymorphism is associated with migraine susceptibility in two independent case/control groups

Migraine is a painful and debilitating disorder with a significant genetic component. Steroid hormones, in particular estrogen, have long been considered to play a role in migraine, as variations in hormone levels are associated with migraine onset in many sufferers of the disorder. Steroid hormones mediate their activity via hormone receptors, which have a wide tissue distribution. Estrogen receptors have been localized to the brain in regions considered to be involved in migraine pathogenesis. Hence it is possible that genetic variation in the estrogen receptor gene may play a role in migraine susceptibility. This study thus examined the estrogen receptor 1 (ESRα) gene for a potential role in migraine pathogenesis and susceptibility. A population-based cohort of 224 migraine sufferers and 224 matched controls were genotyped for the G594A polymorphism located in exon 8 of the ESR1 gene. Statistical analysis indicated a significant difference between migraineurs and non-migraineurs in both the allele frequencies (P=0.003) and genotype distributions (P=0.008) in this sample. An independent follow-up study was then undertaken using this marker in an additional population-based cohort of 260 migraine sufferers and 260 matched controls. This resulted in a significant association between the two groups with regard to allele frequencies (P=8×10−6) and genotype distributions (P=4×10−5). Our findings support the hypothesis that genetic variation in hormone receptors, in particular the ESR1 gene, may play a role in migraine.

A nonlinear position controller for maritime operations of Rotary-wing UAVs

This paper presents a disturbance attenuation controller for horizontal position stabilization for hover and automatic landings of a Rotary-wing Unmanned Aerial Vehicle (RUAV) operating in rough seas. Based on a helicopter model representing aerodynamics during the landing phase, a nonlinear state feedback H-infinity controller is designed to achieve rapid horizontal position tracking in a gusty environment. The resultant control variables are further treated in consideration of practical constraints (flapping dynamics, servo dynamics and time lag effect) for implementation purpose. The high-fidelity closed-loop simulation using parameters of the Vario helicopter verifies performance of the proposed position controller. It not only increases the disturbance attenuation capability of the RUAV, but also enables rapid position response when gusts occur. Comparative studies show that the H-infinity controller exhibits great performance improvement and can be applied to ship/RUAV landing systems.

Non-linear position control for hover and automatic landing of unmanned aerial vehicles

This study presents a disturbance attenuation controller for horizontal position stabilisation for hover and automatic landings of a rotary-wing unmanned aerial vehicle (RUAV) operating close to the landing deck in rough seas. Based on a helicopter model representing aerodynamics during the landing phase, a non-linear state feedback H∞ controller is designed to achieve rapid horizontal position tracking in a gusty environment. Practical constraints including flapping dynamics, servo dynamics and time lag effect are considered. A high-fidelity closed-loop simulation using parameters of the Vario XLC gas-turbine helicopter verifies performance of the proposed horizontal position controller. The proposed controller not only increases the disturbance attenuation capability of the RUAV, but also enables rapid position response when gusts occur. Comparative studies show that the H∞ controller exhibits performance improvement and can be applied to ship/RUAV landing systems.

Development and validation of an instrument to measure organizational cultures' support of business process management

The purpose of Business Process Management (BPM) is to increase the efficiency and effectiveness of organizational processes through improvement and innovation. Despite a common understanding that culture is an important element in these efforts, there is a dearth of theoretical and empirical research on culture as a facilitator of successful BPM. We develop the BPM culture construct and propose a validated instrument with which to measure organizational cultures’ support of BPM. The operationalization of the BPM culture concept provides a theoretical foundation for future research and a tool to assist organizations in developing a cultural environment that supports successful BPM.

More naturalness, less control: The effect of natural mapping on the co-located player experience

In the past years, there has been a surge in game controllers that allow players to play in a more physical, more natural way. In this paper we present an experimental study of the effect of gaming using these naturally mapped controllers on the player experience in a social setting. Results support the hypothesis that more naturally mapped controllers augment spatial presence. Furthermore, the results suggest that gaming with more naturally mapped controllers augment social presence for female players, but not for male players. However, gaming via naturally mapped controllers decreases perceived control and actual performance. Hence, users with high performance expectations might not benefit from gaming via naturally mapped controllers.

Protocol for a randomised blocked design study using telephone and text-messaging to support cardiac patients with diabetes : a cross cultural international collaborative project

Background The prevalence of type 2 diabetes is rising internationally. Patients with diabetes have a higher risk of cardiovascular events accounting for substantial premature morbidity and mortality, and health care expenditure. Given healthcare workforce limitations, there is a need to improve interventions that promote positive self-management behaviours that enable patients to manage their chronic conditions effectively, across different cultural contexts. Previous studies have evaluated the feasibility of including telephone and Short Message Service (SMS) follow up in chronic disease self-management programs, but only for single diseases or in one specific population. Therefore, the aim of this study is to evaluate the feasibility and short-term efficacy of incorporating telephone and text messaging to support the care of patients with diabetes and cardiac disease, in Australia and in Taiwan. Methods/design A randomised controlled trial design will be used to evaluate a self-management program for people with diabetes and cardiac disease that incorporates the use of simple remote-access communication technologies. A sample size of 180 participants from Australia and Taiwan will be recruited and randomised in a one-to-one ratio to receive either the intervention in addition to usual care (intervention) or usual care alone (control). The intervention will consist of in-hospital education as well as follow up utilising personal telephone calls and SMS reminders. Primary short term outcomes of interest include self-care behaviours and self-efficacy assessed at baseline and four weeks. Discussion If the results of this investigation substantiate the feasibility and efficacy of the telephone and SMS intervention for promoting self management among patients with diabetes and cardiac disease in Australia and Taiwan, it will support the external validity of the intervention. It is anticipated that empirical data from this investigation will provide valuable information to inform future international collaborations, while providing a platform for further enhancements of the program, which has potential to benefit patients internationally.

Improved catalyst, particularly for emission control

A catalyst comprising a catalytic material supported on a support, characterized in that the support comprises particles predominantly having a max. particle size of less than 1000 nm and an aspect ratio of greater than, and the. catalytic material is mainly present in the form of discrete islands of catalytic material supported on the support, with a substantial proportion of the islands of catalytic material being sep. and isolated from other islands of catalytic material. The islands of catalytic material are sep. and isolated from other islands of catalytic material such that diffusion and growth of the islands of catalytic material at elevated temp. is minimized or avoided. The disclosure and examples pertain to emission control catalysts. [on SciFinder(R)]

Method for making a material, particularly for emission control catalyst

A method for forming a material comprising a metal oxide supported on a support particle comprising the steps of: (a) providing a precursor mixt. comprising a soln. contg. one or more metal cations and (i) a surfactant; or (ii) a hydrophilic polymer; said precursor mixt. further including support particles; and (b) treating the precursor mixt. from (a) above by heating to remove the surfactant or hydrophilic polymer and form metal oxide having nanosized grains, wherein at least some of the metal oxide formed in step (b) is deposited on or supported by the support particles and the metal oxide has an oxide matrix that includes metal atoms derived solely from sources other than the support particles. The disclosure and examples pertain to emission control catalysts. [on SciFinder(R)]