Obesity and risk of multiple myeloma: A case-control study

Introduction. Several studies have reported a positive association of body mass index (BMI) with multiple myeloma; however, the period of adulthood where BMI is most important remains unclear. In addition, it is well known that body fat is associated with both sex-steroid hormone storage and with increasing insulin levels; therefore, it was hypothesized that the association between obesity and multiple myeloma may be attributed to increased aromatization of androgen in adipose tissue. Objective. The overall objective of this case-control study was to determine whether multiple myeloma cases had higher BMI and greater adult weight gain relative to healthy controls. In addition, we tested the hypothesis that hormone replacement therapy use among women will further increase the association between BMI and risk of multiple myeloma. This study used data from a pilot case-control study at M.D. Anderson Cancer Center (MDACC), entitled Etiology of multiple myeloma, directed by Dr. Sara Strom and Dr. Sergio Giralt. Methods. The pilot study recruited a total of 122 cases of histopathologically confirmed multiple myeloma from MDACC. Controls (n=183) were selected from a database of random digit dialing controls accrued in the Department of Epidemiology at MDACC and were frequency matched to the cases on age (±5 years), gender, and race/ethnicity. Demographic and risk factor information were obtained from all participants who completed a self-administered questionnaire. Items included in the questionnaire include demographic information, height and weight at age 25, 40 and current/diagnosis, medical history, family history of cancer, smoking and alcohol use. Statistical analysis. Initial descriptive analysis included Student's t-test and Pearson's chi-squared tests. Odds ratios and 95% confidence intervals were calculated to quantify the association between the variables of interest and multiple myeloma. A multivariable model will be developed using unconditional logistic regression. Results. MM cases were 1.79 times (95% CI=0.99-3.32) more likely to have been overweight or obese (BMI > 25 kg/m2) at age 25 relative to healthy controls after controlling for age, gender, race/ethnicty, education and family history of cancer. Being overweight or obese at age 40 was not significantly associated with mutliple myeloma risk (OR=1.42, 95% CI=0.86-2.34) nor was being overweight or obses at diagnosis (OR=1.43, 95% CI=0.78, 2.63). We observed a statistically significant 2-fold increased odds of multiple myeloma in individuals who gained more than 4.7 kg during between 25 and 40 years (OR=1.97, 95% CI=1.15-3.39). When assessing HRT as a modifier of the BMI and multiple myeloma association among women (N=123), no association between obesity and MM status was observed among women who have never used HRT (OR=0.60, 95% CI=0.23-1.61; n=73). Yet among women who have ever used HRT (n=50), being overweight or obese was associated with an increase in MM risk (OR=2. 93, 95% CI=0.81-10.6) after adjusting for age; however, the association was not statistically significant. Significance. This study provides further evidence that increased BMI increases the risk of multiple myeloma. Furthermore, among women, HRT use may modify risk of disease. ^

A case-control study of medication-associated acute kidney injuries in hospitalized pediatric patients

Acute kidney Injury (AKI) in hospitalized pediatric patients can be a significant event that can result in increased patient morbidity and mortality. The incidence of medication associated AKI is increasing in the pediatric population. Currently, there are no data to quantify the risks of developing AKI for various potentially nephrotoxic medications. The primary objective of this study was to determine the odds of nephrotoxic medication exposure in hospitalized pediatric patients with AKI as defined by the pediatric modified pRIFLE criteria. A retrospective case-control study was performed with patients that developed AKI, as defined by the pediatric pRIFLE criteria, as cases, and patients without AKI as controls that were matched by age category, gender, and disease state. Patients between 1 day and 18 years of age, admitted to a non-intensive care unit at Texas Children's Hospital for at least 3 days, and had at least 2 serum creatinine values drawn were included. Patient data was analyzed with Student's t test, Mann-Whitney U test, Chi square analysis, ANOVA, and conditional logistic regression. ^ Out of 1,660 patients identified for inclusion, 561 (33.8%) patients had AKI, and 357 cases were matched with 357 controls to become pairs. Of the cases, 441 were category 'R', 117 category 'I', 3 patients were category 'F', and no patient died. Cases with AKI were significantly younger than controls (p < 0.05). Significantly longer hospital length of stays, increased hospital costs, and exposure to more nephrotoxic medications for a longer period of time were characteristics of patients with AKI compared to patient without AKI. Patients with AKI had greater odds of exposure to one or more nephrotoxic medication than patients without AKI (OR 1.3, 95% CI 1.1–1.4, p < 0.05). Percent changes in estimated creatinine clearance (eCCl) from baseline were greatest with increased number of nephrotoxic medication exposures. ^ Exposure to potentially nephrotoxic medications may place pediatric patients at greater risk of acute kidney injury. Multiple nephrotoxic medication exposure may confer a greater risk of development of acute kidney injury, and result in increased hospital costs and patient morbidity. Due to the high percentage of patients that were exposed to potentially nephrotoxic medications, monitoring and medication selection strategies may need to be altered to prevent or minimize risk.^

Procedure for the identification of population characteristics for targeting intervention services on the basis of outcome-goal priorities: Case management services for the chronic mentally ill

Although the processes involved in rational patient targeting may be obvious for certain services, for others, both the appropriate sub-populations to receive services and the procedures to be used for their identification may be unclear. This project was designed to address several research questions which arise in the attempt to deliver appropriate services to specific populations. The related difficulties are particularly evident for those interventions about which findings regarding effectiveness are conflicting. When an intervention clearly is not beneficial (or is dangerous) to a large, diverse population, consensus regarding withholding the intervention from dissemination can easily be reached. When findings are ambiguous, however, conclusions may be impossible.^ When characteristics of patients likely to benefit from an intervention are not obvious, and when the intervention is not significantly invasive or dangerous, the strategy proposed herein may be used to identify specific characteristics of sub-populations which may benefit from the intervention. The identification of these populations may be used both in further informing decisions regarding distribution of the intervention and for purposes of planning implementation of the intervention by identifying specific target populations for service delivery.^ This project explores a method for identifying such sub-populations through the use of related datasets generated from clinical trials conducted to test the effectiveness of an intervention. The method is specified in detail and tested using the example intervention of case management for outpatient treatment of populations with chronic mental illness. These analyses were applied in order to identify any characteristics which distinguish specific sub-populations who are more likely to benefit from case management service, despite conflicting findings regarding its effectiveness for the aggregate population, as reported in the body of related research. However, in addition to a limited set of characteristics associated with benefit, the findings generated, a larger set of characteristics of patients likely to experience greater improvement without intervention. ^

Leukemia and occupational exposure to electromagnetic fields: An incident case-control study

The existence of an association between leukemia and electromagnetic fields (EMF) is still controversial. The results of epidemiologic studies of leukemia in occupational groups with exposure to EMF are inconsistent. Weak associations have been seen in a few studies. EMF assessment is lacking in precision. Reported dose-response relationships have been based on qualitative levels of exposure to EMF without regard to duration of employment or EMF intensity on the jobs. Furthermore, potential confounding factors in the associations were not often well controlled. The current study is an analysis of the data collected from an incident case-control study. The primary objective was to test the hypothesis that occupational exposure to EMF is associated with leukemia, including total leukemia (TL), myelogenous leukemia (MYELOG) and acute non-lymphoid leukemia (ANLL). Potential confounding factors: occupational exposure to benzene, age, smoking, alcohol consumption, and previous medical radiation exposures were controlled in multivariate logistic regression models. Dose-response relationships were estimated by cumulative occupational exposure to EMF, taking into account duration of employment and EMF intensity on the jobs. In order to overcome weaknesses of most previous studies, special efforts were made to improve the precision of EMF assessment. Two definitions of EMF were used and result discrepancies using the two definitions were observed. These difference raised a question as to whether the workers at jobs with low EMF exposure should be considered as non-exposed in future studies. In addition, the current study suggested use of lifetime cumulative EMF exposure estimates to determine dose-response relationship. The analyses of the current study suggest an association between ANLL and employment at selected jobs with high EMF exposure. The existence of an association between three types of leukemia and broader categories of occupational EMF exposure, is still undetermined. If an association does exist between occupational EMF exposure and leukemia, the results of the current study suggest that EMF might only be a potential factor in the promotion of leukemia, but not its initiation. ^

Motivational interviewing and feedback for college drinkers: Handling missing values with complete case analysis and multiple imputation

Objective: In this secondary data analysis, three statistical methodologies were implemented to handle cases with missing data in a motivational interviewing and feedback study. The aim was to evaluate the impact that these methodologies have on the data analysis. ^ Methods: We first evaluated whether the assumption of missing completely at random held for this study. We then proceeded to conduct a secondary data analysis using a mixed linear model to handle missing data with three methodologies (a) complete case analysis, (b) multiple imputation with explicit model containing outcome variables, time, and the interaction of time and treatment, and (c) multiple imputation with explicit model containing outcome variables, time, the interaction of time and treatment, and additional covariates (e.g., age, gender, smoke, years in school, marital status, housing, race/ethnicity, and if participants play on athletic team). Several comparisons were conducted including the following ones: 1) the motivation interviewing with feedback group (MIF) vs. the assessment only group (AO), the motivation interviewing group (MIO) vs. AO, and the intervention of the feedback only group (FBO) vs. AO, 2) MIF vs. FBO, and 3) MIF vs. MIO.^ Results: We first evaluated the patterns of missingness in this study, which indicated that about 13% of participants showed monotone missing patterns, and about 3.5% showed non-monotone missing patterns. Then we evaluated the assumption of missing completely at random by Little's missing completely at random (MCAR) test, in which the Chi-Square test statistic was 167.8 with 125 degrees of freedom, and its associated p-value was p=0.006, which indicated that the data could not be assumed to be missing completely at random. After that, we compared if the three different strategies reached the same results. For the comparison between MIF and AO as well as the comparison between MIF and FBO, only the multiple imputation with additional covariates by uncongenial and congenial models reached different results. For the comparison between MIF and MIO, all the methodologies for handling missing values obtained different results. ^ Discussions: The study indicated that, first, missingness was crucial in this study. Second, to understand the assumptions of the model was important since we could not identify if the data were missing at random or missing not at random. Therefore, future researches should focus on exploring more sensitivity analyses under missing not at random assumption.^

A case-comparison interview study of brain tumors and employment in occupations with presumed electric and magnetic field exposures

Results from epidemiologic studies suggest that persons working in occupations with presumed electric and magnetic field (EMF) exposures are at increased risk of brain cancer. This study utilized data from a completed, population-based, interview case-control study of central nervous system (CNS) tumors and employment in the petrochemical industry to test the hypothesis that employment in EMF-related occupations increases CNS tumor risk. A total of 375 male residents of the Texas-Louisiana Gulf Coast Area, age 20 to 79, with primary neuroglial CNS tumors diagnosed during the period 1980-84 were identified. A population-based comparison group of 450 age, race and geographically matched males was selected. Occupational histories and potential risk factor data were collected via personal interviews with study subjects or their next-of-kin.^ Adjusted odds ratios were less than 1.0 for persons ever employed in an electrical occupation (OR = 0.65; 95% CI = 0.40-1.09) or whose usual occupation was electrical (OR = 0.76; 95% CI = 0.33-1.73). Relative risk estimates did not increase significantly as time since first employment or duration of employment increased. Examination of CNS tumor risk by high (OR = 0.80), medium (OR = 0.88) and low (OR = 0.45) exposure categories for persons whose usual occupation was electrical did not indicate a dose-response pattern. In addition, the mean age of exposed cases was not significantly younger than that for unexposed cases. Analysis of risk by probability of exposure to EMFs showed non-significant elevations in the adjusted odds ratio for definite exposed workers defined by their usual occupation (OR = 1.78; 95% CI = 0.70-4.51) and ever/never employed status (OR = 1.54; 95% CI = 0.17-4.91).^ These findings suggest that employment in occupations with presumed EMF exposures does not increase CNS tumor risk as was suggested by previous investigations. The results of this study also do not support the EMF-tumor promotion hypothesis. ^

Association of processed red meat and prostate cancer stage in Mexican-Americans: A population based case-control study

Objective: The objective of this study is to investigate the association between processed and unprocessed red meat consumption and prostate cancer (PCa) stage in a homogenous Mexican-American population. Methods: This population-based case-control study had a total of 582 participants (287 cases with histologically confirmed adenocarcinoma of the prostate gland and 295 age and ethnicity-matched controls) that were all residing in the Southeast region of Texas from 1998 to 2006. All questionnaire information was collected using a validated data collection instrument. Statistical Analysis: Descriptive analyses included Student's t-test and Pearson's Chi-square tests. Odds ratios and 95% confidence intervals were calculated to quantify the association between nutritional factors and PCa stage. A multivariable model was used for unconditional logistic regression. Results: After adjusting for relevant covariates, those who consume high amounts of processed red meat have a non-significant increased odds of being diagnosed with localized PCa (OR = 1.60 95% CI: 0.85 - 3.03) and total PCa (OR = 1.43 95% CI: 0.81 - 2.52) but not for advanced PCa (OR = 0.91 95% CI: 1.37 - 2.23). Interestingly, high consumption of carbohydrates shows a significant reduction in the odds of being diagnosed with total PCa and advanced PCa (OR = 0.43 95% CI: 0.24 - 0.77; OR = 0.27 95% CI: 0.10 - 0.71, respectively). However, consuming high amounts of energy from protein and fat was shown to increase the odds of being diagnosed with advanced PCa (OR = 4.62 95% CI: 1.69 - 12.59; OR = 2.61 95% CI: 1.04 - 6.58, respectively). Conclusion: Mexican-Americans who consume high amounts of energy from protein and fat had increased odds of being diagnosed with advanced PCa, while high amounts of carbohydrates reduced the odds of being diagnosed with total and advanced PCa.^

Raven's progressive matrices test: scale construction and verification of "Flynn effect"

In this paper, the scales of Raven's Progressive Matrices Test, General Scale and Advanced Scale, Series II, for the student population (third cycle of EGB and Polimodal ) in the city of La Plata are presented. Considerations are made as regards both the increase in scores (Flynn effect) observed in relation to the previous scale (1964) and the different mean scores according to two age groups (13-16 and 17-18 years of age) and education mode. The findings enabled inferences related to the significance of the increase, particularly in the case of the higher scores in the population attending a special kind of educational institution.

Raven's progressive matrices test: scale construction and verification of "Flynn effect"

In this paper, the scales of Raven's Progressive Matrices Test, General Scale and Advanced Scale, Series II, for the student population (third cycle of EGB and Polimodal ) in the city of La Plata are presented. Considerations are made as regards both the increase in scores (Flynn effect) observed in relation to the previous scale (1964) and the different mean scores according to two age groups (13-16 and 17-18 years of age) and education mode. The findings enabled inferences related to the significance of the increase, particularly in the case of the higher scores in the population attending a special kind of educational institution.

Raven's progressive matrices test: scale construction and verification of "Flynn effect"

In this paper, the scales of Raven's Progressive Matrices Test, General Scale and Advanced Scale, Series II, for the student population (third cycle of EGB and Polimodal ) in the city of La Plata are presented. Considerations are made as regards both the increase in scores (Flynn effect) observed in relation to the previous scale (1964) and the different mean scores according to two age groups (13-16 and 17-18 years of age) and education mode. The findings enabled inferences related to the significance of the increase, particularly in the case of the higher scores in the population attending a special kind of educational institution.

Stable carbon and oxygen isotope ratios for different test sizes of live benthic foraminifera from the Arabian Sea

We determined the stable oxygen and carbon isotopic composition of live (Rose Bengal stained) tests belonging to different size classes of two benthic foraminiferal species from the Pakistan continental margin. Samples were taken at 2 sites, with water depth of about 135 and 275 m, corresponding to the upper boundary and upper part of the core region of the oxygen minimum zone (OMZ). For Uvigerina ex gr. U. semiornata and Bolivina aff. B. dilatata, delta13C and delta18O values increased significantly with increasing test size. In the case of U. ex gr. U. semiornata, delta13C increased linearly by about 0.105 per mil for each 100-µm increment in test size, whereas delta18O increased by 0.02 to 0.06 per mil per 100 µm increment. For B. aff. B. dilatata the relationship between test size and stable isotopic composition is better described by logarithmic equations. A strong positive linear correlation is observed between delta18O and delta13C values of both taxa, with a constant ratio of delta18O and delta13C values close to 2:1. This suggests that the strong ontogenetic effect is mainly caused by kinetic isotope fractionation during CO2 uptake. Our data underline the necessity to base longer delta18O and delta13C isotope records derived from benthic foraminifera on size windows of 100 µm or less. This is already common practice in down-core isotopic studies of planktonic foraminifera.

The application of biomechanics to penalty corner drag-flick training: a case of Study

The penalty corner is one of the most important game situations in field hockey with one third of all goals resulting from this tactical situation. The aim of this study was to develop and apply a training method, based on previous studies, to improve the drag- flick skill on a young top-class field hockey player. A young top-class player exercised three times per week using specific drills over a four week period. A VICON optoelectronic system (Oxford Metrics, Oxford, UK) was employed to capture twenty drag-flicks, with six cameras sampling at 250 Hz, prior and after the training period. In order to analyze pre- and post-test differences a dependent t-test was carried out. Angular velocities and the kinematic sequence were similar to previous studies. The player improved (albeit not significantly) the angular velocity of the stick. The player increased front foot to the ball at T1 (p < 0.01) and the drag-flick distances. The range of motion from the front leg decreased from T1 to T6 after the training period (p < 0.01). The specific training sessions conducted with the player improved some features of this particular skill. This article shows how technical knowledge can help with the design of training programs and whether some drills are more effective than others.

Full scale test for explosion water barriers in small cross-section galleries

Underground coal mines explosions generally arise from the inflammation of a methane/air mixture. This explosion can also generate a subsequent coal dust explosion. Traditionally such explosions have being fought eliminating one or several of the factors needed by the explosion to take place. Although several preventive measures are taken to prevent explosions, other measures should be considered to reduce the effects or even to extinguish the flame front. Unlike other protection methods that remove one or two of the explosion triangle elements, namely; the ignition source, the oxidizing agent and the fuel, explosion barriers removes all of them: reduces the quantity of coal in suspension, cools the flame front and the steam generated by vaporization removes the oxygen present in the flame. Passive water barriers are autonomous protection systems against explosions that reduce to a satisfactory safety level the effects of methane and/or flammable dust explosions. The barriers are activated by the pressure wave provoked in the explosion destroying the barrier troughs and producing a uniform dispersion of the extinguishing agent throughout the gallery section in quantity enough to extinguish the explosion flame. Full scale tests have been carried out in Polish Barbara experimental mine at GIG Central Mining Institute in order to determine the requirements and the optimal installation conditions of these devices for small sections galleries which are very frequent in the Spanish coal mines. Full scale tests results have been analyzed to understand the explosion timing and development, in order to assess on the use of water barriers in the typical small crosssection Spanish galleries. Several arrangements of water barriers have been designed and tested to verify the effectiveness of the explosion suppression in each case. The results obtained demonstrate the efficiency of the water barriers in stopping the flame front even with smaller amounts of water than those established by the European standard. According to the tests realized, water barriers activation times are between 0.52 s and 0.78 s and the flame propagation speed are between 75 m/s and 80 m/s. The maximum pressures (Pmax) obtained in the full scale tests have varied between 0.2 bar and 1.8 bar. Passive barriers protect effectively against the spread of the flame but cannot be used as a safeguard of the gallery between the ignition source and the first row of water troughs or bags, or even after them, as the pressure could remain high after them even if the flame front has been extinguished.

Real-time reliability test for a CPV module based on a power degradation model

Models based on degradation are powerful and useful tools to evaluate the reliability of those devices in which failure happens because of degradation in the performance parameters. This paper presents a procedure for assessing the reliability of concentrator photovoltaic (CPV) modules operating outdoors in real-time conditions. With this model, the main reliability functions are predicted. This model has been applied to a real case with a module composed of GaAs single-junction solar cells and total internal reflection (TIR) optics

Aplicaciones de filtrado adaptativo LMS para mejorar la respuesta de acelerómetros

El proyecto, “Aplicaciones de filtrado adaptativo LMS para mejorar la respuesta de acelerómetros”, se realizó con el objetivo de eliminar señales no deseadas de la señal de información procedentes de los acelerómetros para aplicaciones automovilísticas, mediante los algoritmos de los filtros adaptativos LMS. Dicho proyecto, está comprendido en tres áreas para su realización y ejecución, los cuales fueron ejecutados desde el inicio hasta el último día de trabajo. En la primera área de aplicación, diseñamos filtros paso bajo, paso alto, paso banda y paso banda eliminada, en lo que son los filtros de butterworth, filtros Chebyshev, de tipo uno como de tipo dos y filtros elípticos. Con esta primera parte, lo que se quiere es conocer, o en nuestro caso, recordar el entorno de Matlab, en sus distintas ecuaciones prediseñadas que nos ofrece el mencionado entorno, como también nos permite conocer un poco las características de estos filtros. Para posteriormente probar dichos filtros en el DSP. En la segunda etapa, y tras recordar un poco el entorno de Matlab, nos centramos en la elaboración y/o diseño de nuestro filtro adaptativo LMS; experimentado primero con Matlab, para como ya se dijo, entender y comprender el comportamiento del mismo. Cuando ya teníamos claro esta parte, procedimos a “cargar” el código en el DSP, compilarlo y depurarlo, realizando estas últimas acciones gracias al Visual DSP. Resaltaremos que durante esta segunda etapa se empezó a excitar las entradas del sistema, con señales provenientes del Cool Edit Pro, y además para saber cómo se comportaba el filtro adaptativo LMS, se utilizó señales provenientes de un generador de funciones, para obtener de esta manera un desfase entre las dos señales de entrada; aunque también se utilizó el propio Cool Edit Pro para obtener señales desfasadas, pero debido que la fase tres no podíamos usar el mencionado software, realizamos pruebas con el generador de funciones. Finalmente, en la tercera etapa, y tras comprobar el funcionamiento deseado de nuestro filtro adaptativo DSP con señales de entrada simuladas, pasamos a un laboratorio, en donde se utilizó señales provenientes del acelerómetro 4000A, y por supuesto, del generador de funciones; el cual sirvió para la formación de nuestra señal de referencia, que permitirá la eliminación de una de las frecuencias que se emitirá del acelerómetro. Por último, cabe resaltar que pudimos obtener un comportamiento del filtro adaptativo LMS adecuado, y como se esperaba. Realizamos pruebas, con señales de entrada desfasadas, y obtuvimos curiosas respuestas a la salida del sistema, como son que la frecuencia a eliminar, mientras más desfasado estén estas señales, mas se notaba. Solucionando este punto al aumentar el orden del filtro. Finalmente podemos concluir que pese a que los filtros digitales probados en la primera etapa son útiles, para tener una respuesta lo más ideal posible hay que tener en cuenta el orden del filtro, el cual debe ser muy alto para que las frecuencias próximas a la frecuencia de corte, no se atenúen. En cambio, en los filtros adaptativos LMS, si queremos por ejemplo, eliminar una señal de entre tres señales, sólo basta con introducir la frecuencia a eliminar, por una de las entradas del filtro, en concreto la señal de referencia. De esta manera, podemos eliminar una señal de entre estas tres, de manera que las otras dos, no se vean afectadas por el procedimiento. Abstract The project, "LMS adaptive filtering applications to improve the response of accelerometers" was conducted in order to remove unwanted signals from the information signal from the accelerometers for automotive applications using algorithms LMS adaptive filters. The project is comprised of three areas for implementation and execution, which were executed from the beginning until the last day. In the first area of application, we design low pass filters, high pass, band pass and band-stop, as the filters are Butterworth, Chebyshev filters, type one and type two and elliptic filters. In this first part, what we want is to know, or in our case, remember the Matlab environment, art in its various equations offered by the mentioned environment, as well as allows us to understand some of the characteristics of these filters. To further test these filters in the DSP. In the second stage, and recalling some Matlab environment, we focus on the development and design of our LMS adaptive filter; experimented first with Matlab, for as noted above, understand the behavior of the same. When it was clear this part, proceeded to "load" the code in the DSP, compile and debug, making these latest actions by the Visual DSP. Will highlight that during this second stage began to excite the system inputs, with signals from the Cool Edit Pro, and also for how he behaved the LMS adaptive filter was used signals from a function generator, to thereby obtain a gap between the two input signals, but also used Cool Edit Pro himself for phase signals, but due to phase three could not use such software, we test the function generator. Finally, in the third stage, and after checking the desired performance of our DSP adaptive filter with simulated input signals, we went to a laboratory, where we used signals from the accelerometer 4000A, and of course, the function generator, which was used for the formation of our reference signal, enabling the elimination of one of the frequencies to be emitted from the accelerometer. Note that they were able to obtain a behavior of the LMS adaptive filter suitable as expected. We test with outdated input signals, and got curious response to the output of the system, such as the frequency to remove, the more outdated are these signs, but noticeable. Solving this point with increasing the filter order. We can conclude that although proven digital filters in the first stage are useful, to have a perfect answer as possible must be taken into account the order of the filter, which should be very high for frequencies near the frequency cutting, not weakened. In contrast, in the LMS adaptive filters if we for example, remove a signal from among three signals, only enough to eliminate the frequency input on one of the inputs of the filter, namely the reference signal. Thus, we can remove a signal between these three, so that the other two, not affected by the procedure.