Establishing a population-based patient-reported outcomes study (PROMs) using national cancer registries across two jurisdictions: The Prostate Cancer Treatment, your experience (PiCTure) study

Objective: To establish an international patient-reported outcomes (PROMs) study among prostate cancer survivors, up to 18 years postdiagnosis, in two countries with different healthcare systems and ethical frameworks. Design: A cross-sectional, postal survey of prostate cancer survivors sampled and recruited via two population-based cancer registries. Healthcare professionals (HCPs) evaluated patients for eligibility to participate. Questionnaires contained validated instruments to assess health-related quality of life and psychological well-being, including QLQ-C30, QLQPR-25, EQ-5D-5L, 21-question Depression, Anxiety and Stress Scale (DASS-21) and the Decisional Regret Scale. Setting: Republic of Ireland (RoI) and Northern Ireland (NI). Primary outcome measures: Registration completeness, predictors of eligibility and response, data missingness, unweighted and weighted PROMs. Results: Prostate cancer registration was 80% (95% CI 75% to 84%) and 91% (95% CI 89% to 93%) complete 2 years postdiagnosis in NI and RoI, respectively. Of 12 322 survivors sampled from registries, 53% (n=6559) were classified as eligible following HCP screening. In the multivariate analysis, significant predictors of eligibility were: being ≤59 years of age at diagnosis (p<0.001), short-term survivor (<5 years postdiagnosis; p<0.001) and from RoI (p<0.001). 3348 completed the questionnaire, yielding a 54% adjusted response rate. 13% of men or their families called the study freephone with queries for assistance with questionnaire completion or to talk about their experience. Significant predictors of response in multivariate analysis were: being ≤59 years at diagnosis (p<0.001) and from RoI (p=0.016). Mean number of missing questions in validated instruments ranged from 0.12 (SD 0.71; EQ-5D-5L) to 3.72 (SD 6.30; QLQ-PR25). Weighted and unweighted mean EQ-5D-5L, QLQ-C30 and QLQ-PR25 scores were similar, as were the weighted and unweighted prevalences of depression, anxiety and distress. Conclusions: It was feasible to perform PROMs studies across jurisdictions, using cancer registries as sampling frames; we amassed one of the largest, international, population-based data set of prostate cancer survivors. We highlight improvements which could inform future PROMs studies, including utilising general practitioners to assess eligibility and providing a freephone service.

WHO guidelines for a healthy diet and mortality from cardiovascular disease in European and American elderly: the CHANCES project

BACKGROUND: Cardiovascular disease (CVD) represents a leading cause of mortality worldwide, especially in the elderly. Lowering the number of CVD deaths requires preventive strategies targeted on the elderly.

OBJECTIVE: The objective was to generate evidence on the association between WHO dietary recommendations and mortality from CVD, coronary artery disease (CAD), and stroke in the elderly aged ≥60 y.

DESIGN: We analyzed data from 10 prospective cohort studies from Europe and the United States comprising a total sample of 281,874 men and women free from chronic diseases at baseline. Components of the Healthy Diet Indicator (HDI) included saturated fatty acids, polyunsaturated fatty acids, mono- and disaccharides, protein, cholesterol, dietary fiber, and fruit and vegetables. Cohort-specific HRs adjusted for sex, education, smoking, physical activity, and energy and alcohol intakes were pooled by using a random-effects model.

RESULTS: During 3,322,768 person-years of follow-up, 12,492 people died of CVD. An increase of 10 HDI points (complete adherence to an additional WHO guideline) was, on average, not associated with CVD mortality (HR: 0.94; 95% CI: 0.86, 1.03), CAD mortality (HR: 0.99; 95% CI: 0.85, 1.14), or stroke mortality (HR: 0.95; 95% CI: 0.88, 1.03). However, after stratification of the data by geographic region, adherence to the HDI was associated with reduced CVD mortality in the southern European cohorts (HR: 0.87; 95% CI: 0.79, 0.96; I(2) = 0%) and in the US cohort (HR: 0.85; 95% CI: 0.83, 0.87; I(2) = not applicable).

CONCLUSION: Overall, greater adherence to the WHO dietary guidelines was not significantly associated with CVD mortality, but the results varied across regions. Clear inverse associations were observed in elderly populations in southern Europe and the United States.

Memory Cost Analysis for OpenFlow Multiple Table Lookup

Multiple Table Lookup architectures in Software Defined Networking (SDN) open the door for exciting new network applications. The development of the OpenFlow protocol supported the SDN paradigm. However, the first version of the OpenFlow protocol specified a single table lookup model with the associated constraints in flow entry numbers and search capabilities. With the introduction of multiple table lookup in OpenFlow v1.1, flexible and efficient search to support SDN application innovation became possible. However, implementation of multiple table lookup in hardware to meet high performance requirements is non-trivial. One possible approach involves the use of multi-dimensional lookup algorithms. A high lookup performance can be achieved by using embedded memory for flow entry storage. A detailed study of OpenFlow flow filters for multi-dimensional lookup is presented in this paper. Based on a proposed multiple table lookup architecture, the memory consumption and update performance using parallel single field searches are evaluated. The results demonstrate an efficient multi-table lookup implementation with minimum memory usage.

Putting chromatin immunoprecipitation into context

Chromatin immunoprecipitation (ChIP), when paired with sequencing or arrays, has become a method of choice for the unbiased identification of genomic-binding sites for transcription factors and epigenetic marks in various model systems. The data generated is often then interpreted by groups seeking to link these binding sites to the expression of adjacent or distal genes, and more broadly to the evolution of species, cell fate/differentiation or even cancer development. Against this backdrop is an ongoing debate over the relative importance DNA sequence versus chromatin structure and modification in the regulation of gene expression (Anon. 2008a Nature 454: 795; Anon. 2008b Nature 454: 711-715; Henikoff et al. 2008 Science 322: 853; Madhani et al. 2008 Science 322: 43-44). Rationally there is a synergy between the two and the goal of a biologist is to characterise both comprehensively enough to explain a cellular phenotype or a developmental process. If this is truly our goal then the critical factor in good science is an awareness of the constraints and potential of the biological models used. The reality however is often that this discussion is polarised by funding imperatives and the need to align to a transcription factor or epigenetic camp. This article will discuss the extrapolations involved in using ChIP data to draw conclusions about these themes and the discoveries that have resulted.

Age-Related Macular Degeneration-Associated Genes in Alzheimer Disease

Objectives: Given the clinical and pathological similarities between age-relatedmacular degeneration (AMD) and Alzheimer disease (AD), to assess whether AMDassociatedsingle nucleotide polymorphisms (SNPs), including those from complementrelatedgenes, are associated with AD. 
Design: A case-control association study-typedesign. 
Setting: A UK tertiary care dementia clinic. 
Participants: 322 cognitivelynormal participants and 258 cases with a clinical diagnosis of AD.
Measurements:Polymorphisms in the following genes were studied: CFH, ARMS2, C2/CFB, C3, CFI/PLA2G12a, SERPING1, TLR3, TLR4, CRP, APOE, and TOMM40. Haplotypes were analysedfor CFH, TOMM40, and APOE. Univariate analysis was performed for each geneticchange and case-comparator status, and then correction for multiple testing performed. 
Results: The presence of an ε4 APOE allele was significantly associated with AD. Noassociation was evident between CFH SNPs or haplotypes, or other AMD-associated SNPstested, and AD. The exceptions were TOMM40 SNPs, which were associated with AD evenafter correction for multiple comparisons. The associations disappeared, however, whenentered into a regression model including APOE genotypes. 
Conclusions: The resultsfor most SNPs tested, as well as CFH haplotypes, are novel. The functional effects ofabnormal complement activity in AD’s pathogenesis may be contradictory, butmethodological reasons may underlie the lack of association—for example, geneticchanges other than SNPs being involved.

Risk-aware Planning in BDI Agents

The ability of an autonomous agent to select rational actions is vital in enabling it to achieve its goals. To do so effectively in a high-stakes setting, the agent must be capable of considering the risk and potential reward of both immediate and future actions. In this paper we provide a novel method for calculating risk alongside utility in online planning algorithms. We integrate such a risk-aware planner with a BDI agent, allowing us to build agents that can set their risk aversion levels dynamically based on their changing beliefs about the environment. To guide the design of a risk-aware agent we propose a number of principles which such an agent should adhere to and show how our proposed framework satisfies these principles. Finally, we evaluate our approach and demonstrate that a dynamically risk-averse agent is capable of achieving a higher success rate than an agent that ignores risk, while obtaining a higher utility than an agent with a static risk attitude.

Influence of trace substances on methanation catalysts used in dynamic biogas upgrading

The aim of this work was to study the possible deactivation effects of biogas trace ammonia concentrations on methanation catalysts. It was found that small amounts of ammonia led to a slight decrease in the catalyst activity. A decrease in the catalyst deactivation by carbon formation was also observed, with ammonia absorbed on the active catalyst sites. This was via a suppression of the carbon formation and deposition on the catalyst, since it requires a higher number of active sites than for the methanation of carbon oxides. From the paper findings, no special pretreatment for ammonia removal from the biogas fed to a methanation process is required.

A population-based study of visual impairment among pre-school children in Beijing: the Beijing study of visual impairment in children.

PURPOSE: To evaluate the prevalence and causes of visual impairment among Chinese children aged 3 to 6 years in Beijing. DESIGN: Population-based prevalence survey. METHODS: Presenting and pinhole visual acuity were tested using picture optotypes or, in children with pinhole vision < 6/18, a Snellen tumbling E chart. Comprehensive eye examinations and cycloplegic refraction were carried out for children with pinhole vision < 6/18 in the better-seeing eye. RESULTS: All examinations were completed on 17,699 children aged 3 to 6 years (95.3% of sample). Subjects with bilateral correctable low vision (presenting vision < 6/18 correctable to >or= 6/18) numbered 57 (0.322%; 95% confidence interval [CI], 0.237% to 0.403%), while 14 (0.079%; 95% CI, 0.038% to 0.120%) had bilateral uncorrectable low vision (best-corrected vision of < 6/18 and >or= 3/60), and 5 subjects (0.028%; 95% CI, 0.004% to 0.054%) were bilaterally blind (best-corrected acuity < 3/60). The etiology of 76 cases of visual impairment included: refractive error in 57 children (75%), hereditary factors (microphthalmos, congenital cataract, congenital motor nystagmus, albinism, and optic nerve disease) in 13 children (17.1 %), amblyopia in 3 children (3.95%), and cortical blindness in 1 child (1.3%). The cause of visual impairment could not be established in 2 (2.63%) children. The prevalence of visual impairment did not differ by gender, but correctable low vision was significantly (P < .0001) more common among urban as compared with rural children. CONCLUSION: The leading causes of visual impairment among Chinese preschool-aged children are refractive error and hereditary eye diseases. A higher prevalence of refractive error is already present among urban as compared with rural children in this preschool population.

Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19·2 million participants

Background: Underweight and severe and morbid obesity are associated with highly elevated risks of adverse health outcomes. We estimated trends in mean body-mass index (BMI), which characterises its population distribution, and in the prevalences of a complete set of BMI categories for adults in all countries.

Methods: We analysed, with use of a consistent protocol, population-based studies that had measured height and weight in adults aged 18 years and older. We applied a Bayesian hierarchical model to these data to estimate trends from 1975 to 2014 in mean BMI and in the prevalences of BMI categories (<18·5 kg/m2 [underweight], 18·5 kg/m2 to <20 kg/m2, 20 kg/m2 to <25 kg/m2, 25 kg/m2 to <30 kg/m2, 30 kg/m2 to <35 kg/m2, 35 kg/m2 to <40 kg/m2, ≥40 kg/m2 [morbid obesity]), by sex in 200 countries and territories, organised in 21 regions. We calculated the posterior probability of meeting the target of halting by 2025 the rise in obesity at its 2010 levels, if post-2000 trends continue.
Findings: We used 1698 population-based data sources, with more than 19·2 million adult participants (9·9 million men and 9·3 million women) in 186 of 200 countries for which estimates were made. Global age-standardised mean BMI increased from 21·7 kg/m2 (95% credible interval 21·3–22·1) in 1975 to 24·2 kg/m2 (24·0–24·4) in 2014 in men, and from 22·1 kg/m2 (21·7–22·5) in 1975 to 24·4 kg/m2 (24·2–24·6) in 2014 in women. Regional mean BMIs in 2014 for men ranged from 21·4 kg/m2 in central Africa and south Asia to 29·2 kg/m2 (28·6–29·8) in Polynesia and Micronesia; for women the range was from 21·8 kg/m2 (21·4–22·3) in south Asia to 32·2 kg/m2 (31·5–32·8) in Polynesia and Micronesia. Over these four decades, age-standardised global prevalence of underweight decreased from 13·8% (10·5–17·4) to 8·8% (7·4–10·3) in men and from 14·6% (11·6–17·9) to 9·7% (8·3–11·1) in women. South Asia had the highest prevalence of underweight in 2014, 23·4% (17·8–29·2) in men and 24·0% (18·9–29·3) in women. Age-standardised prevalence of obesity increased from 3·2% (2·4–4·1) in 1975 to 10·8% (9·7–12·0) in 2014 in men, and from 6·4% (5·1–7·8) to 14·9% (13·6–16·1) in women. 2·3% (2·0–2·7) of the world's men and 5·0% (4·4–5·6) of women were severely obese (ie, have BMI ≥35 kg/m2). Globally, prevalence of morbid obesity was 0·64% (0·46–0·86) in men and 1·6% (1·3–1·9) in women.

Interpretation: If post-2000 trends continue, the probability of meeting the global obesity target is virtually zero. Rather, if these trends continue, by 2025, global obesity prevalence will reach 18% in men and surpass 21% in women; severe obesity will surpass 6% in men and 9% in women. Nonetheless, underweight remains prevalent in the world's poorest regions, especially in south Asia.

Evaluation of 'Dementia Friends' programme for undergraduate nursing students: Innovative practice.

The ‘dementia friends’ programme was launched by the Alzheimer’s Society in the UK two years ago with the purpose of educating members of the public about the things they can do which can enhance the lives of people living with dementia. The aim of this project was to deliver a two-hour ‘Dementia Friendly Community Workshop’ written by the Alzheimer’s Society, to an entire cohort of first-year undergraduate nursing students in one Higher Education Institutions in Northern Ireland. Following delivery of the programme, students were asked to complete a short questionnaire on their knowledge and confidence in relation to dementia care before and after the Dementia Friendly Community programme. A total of 322 undergraduate first-year nursing students took part in the Dementia Friendly Community programme. Of these, 304 returned questionnaires; 31.25% of students stated their perceived improvement in dementia knowledge was ‘good’ while 49.01% stated their perceived improvement in dementia knowledge was ‘very good’ and 13.49% stated their perceived improvement in dementia knowledge was ‘excellent’. In relation to confidence in engaging with people with dementia, 31.91% stated ‘good’ improvement, 40.79% stated ‘very good’ improvement and 11.84% stated ‘excellent’ improvement. The Dementia Friendly Community programme was positively reviewed by the undergraduate students as it enhanced knowledge and confidence in relation to care of someone living with dementia.

Accesibilidad cognitiva. Modelo para diseñar espacios accesibles 2ª Edición

Este libro único por su innovación y carácter pionero en la accesibilidad cognitiva, pone culmen a casi dieciocho años de investigación de la arquitecta argentina residente en Madrid, Berta Liliana Brusilovsky Filer, que tras hacer un curso online inédito de esta materia con La Ciudad Accesible, se volvió a reactivar en la sociedad española esta temática de estudio que estaba fuera de interés. El libro se ha realizado de manera totalmente gratuita por La Ciudad Accesible para difundir el mensaje de accesibilidad cognitiva y hacer que llegue a todo el mundo ya que no hay publicaciones especializadas al respecto y puede contribuir a un desarrollo más humano de la sociedad para que no excluya a otras personas por la ausencia de la implementación de criterios de accesibilidad cognitiva. En esta segunda edición se incorporan dos nuevos capítulos – y se enriquece el glosario – con experiencias llevadas a cabo en universidades y una selección de proyectos realizados entre los años 2014 y 2015. Con estos contenidos se demuestra la validez del modelo y la demostración de que la accesibilidad cognitiva tiene un marco teórico y metodológico que está a disposición de todos aquellos que aspiren a trabajar en Accesibilidad Universal

Geoquímica dos granitóides de Aguiar da Beira, norte de Portugal

A área de Aguiar da Beira está integrada nos terrenos autóctones da Zona Centro-ibérica e é constituída essencialmente por rochas granitóides variscas instaladas durante e após a terceira fase de deformação (D3). As relações de campo mostram que estes granitóides intruíram formações metassedimentares de idade proterozóica superior-câmbrica e as sequências do Ordovícico e do Carbónico do sinclinal Porto-Sátão, cujo extremo SE aflora na área de estudo. Com base na cartografia publicada e nos dados de campo colhidos no âmbito deste trabalho, foi possível individualizar oito intrusões distintas: o granodiorito -granito biotítico de Sernancelhe, o granito gnaissoso de duas micas, o granito moscovítico-biotítico de Vila Nova de Paiva, o granodiorito-granito biotítico-moscovítico de Lagares e os granitos de Touro (biotítico-moscovítico), Aguiar da Beira (moscovítico-biotítico), Pera Velha / Vila da Ponte (biotítico-moscovítico) e Rei Mouro (moscovítico-biotítico). A presença de encraves microgranulares em cinco dos granitóides estudados sugere que os processos de mistura de magmas desempenharam um papel importante na sua petrogénese. As datações U-Pb obtidas em zircões e monazites durante o presente estudo permitiram subdividir os granitóides de Aguiar da Beira em três grupos, de acordo com as suas relações com a terceira fase de deformação (D3): granitóides sin-tectónicos (Sernancelhe e granito gnaissoso; 322-317 Ma), tardi-tectónicos (Vila Nova de Paiva, Lagares e Touro; 308-306 Ma), e tardi- a pós-tectónicos (Aguiar da Beira, Pera Velha / Vila da Ponte e Rei Mouro; 303297 Ma). As assinaturas geoquímicas de elementos maiores e traço dos granitóides estudados, em conjunto com os dados isotópicos Sr-Nd e δ18 (rocha total e zircão) apontam para uma contribuição significativa de protólitos crustais na génese destes magmas. Á excepção do granito gnaissoso, todos os granitóides possuem um carácter transicional entre os granitos do tipo I e do tipo S, o que apoiado pelos dados de geoquímica de rocha total e isotópica, e pela presença de encraves microgranulares de composição mais máfica presentes em muitos deles, indicia uma forte intervenção de processos de hibridização de líquidos de proveniência distinta (crustais e mantélicos), em diferentes proporções, na sua origem. Pelo contrário, as características geoquímicas e isotópicas do granito gnaissoso revelam claras afinidades com os granitos do tipo S, e sugerem que tenha derivado da anatexia de fontes exclusivamente supracrustais. No entanto, parte da variabilidade geoquímica e isotópica observada em todos os granitóides estudados só poderá ser explicada pela actuação de processos de cristalização fraccionada, especialmente intensos no caso do granito gnaissoso e dos granitos tardi- a PÓS-D3.

Ecfrasis

Programa y lista de lecturas del curso Ecfrasis. Seminario de Estudios Teóricos del Posgrado en Letras para el semestre 2009-2

La migración mexica: ¿invención o historia?

Se discute la relación entre mito e historia en las tradiciones históricas relativas a la migración de los mexicas de Aztlan a México-Tenochtitlan, buscando superar la dicotomía que intenta clasificar estos relatos en alguna de estas dos categorías.