A partial dependence factorial analysis to deal with selection bias in observational studis

This thesis presents a creative and practical approach to dealing with the problem of selection bias. Selection bias may be the most important vexing problem in program evaluation or in any line of research that attempts to assert causality. Some of the greatest minds in economics and statistics have scrutinized the problem of selection bias, with the resulting approaches – Rubin’s Potential Outcome Approach(Rosenbaum and Rubin,1983; Rubin, 1991,2001,2004) or Heckman’s Selection model (Heckman, 1979) – being widely accepted and used as the best fixes. These solutions to the bias that arises in particular from self selection are imperfect, and many researchers, when feasible, reserve their strongest causal inference for data from experimental rather than observational studies. The innovative aspect of this thesis is to propose a data transformation that allows measuring and testing in an automatic and multivariate way the presence of selection bias. The approach involves the construction of a multi-dimensional conditional space of the X matrix in which the bias associated with the treatment assignment has been eliminated. Specifically, we propose the use of a partial dependence analysis of the X-space as a tool for investigating the dependence relationship between a set of observable pre-treatment categorical covariates X and a treatment indicator variable T, in order to obtain a measure of bias according to their dependence structure. The measure of selection bias is then expressed in terms of inertia due to the dependence between X and T that has been eliminated. Given the measure of selection bias, we propose a multivariate test of imbalance in order to check if the detected bias is significant, by using the asymptotical distribution of inertia due to T (Estadella et al. 2005) , and by preserving the multivariate nature of data. Further, we propose the use of a clustering procedure as a tool to find groups of comparable units on which estimate local causal effects, and the use of the multivariate test of imbalance as a stopping rule in choosing the best cluster solution set. The method is non parametric, it does not call for modeling the data, based on some underlying theory or assumption about the selection process, but instead it calls for using the existing variability within the data and letting the data to speak. The idea of proposing this multivariate approach to measure selection bias and test balance comes from the consideration that in applied research all aspects of multivariate balance, not represented in the univariate variable- by-variable summaries, are ignored. The first part contains an introduction to evaluation methods as part of public and private decision process and a review of the literature of evaluation methods. The attention is focused on Rubin Potential Outcome Approach, matching methods, and briefly on Heckman’s Selection Model. The second part focuses on some resulting limitations of conventional methods, with particular attention to the problem of how testing in the correct way balancing. The third part contains the original contribution proposed , a simulation study that allows to check the performance of the method for a given dependence setting and an application to a real data set. Finally, we discuss, conclude and explain our future perspectives.

Isospin dependence of the Ar+Ni fusion-evaporation cross section

The fundamental goal of this thesis is the determination of the isospin dependence of the Ar+Ni fusion-evaporation cross section. Three Ar isotope beams, with energies of about 13AMeV, have been accelerated and impinged onto isotopically enriched Ni targets, in order to produce Pd nuclei, with mass number varying from 92 to 104. The measurements have been performed by the high performance 4pi detector INDRA, coupled with the magnetic spectrometer VAMOS. Even if the results are very preliminary, the obtained fusion-evaporation cross sections behaviour gives a hint at the possible isospin dependence of the fusion-evaporation cross sections.

Mathematical Modeling to Investigate Antiarrhythmic Drug Side Effects: Rate-Dependence Role in Ionic Currents and Action Potentials Shape in the O’Hara Model

Sudden cardiac death due to ventricular arrhythmia is one of the leading causes of mortality in the world. In the last decades, it has proven that anti-arrhythmic drugs, which prolong the refractory period by means of prolongation of the cardiac action potential duration (APD), play a good role in preventing of relevant human arrhythmias. However, it has long been observed that the “class III antiarrhythmic effect” diminish at faster heart rates and that this phenomenon represent a big weakness, since it is the precise situation when arrhythmias are most prone to occur. It is well known that mathematical modeling is a useful tool for investigating cardiac cell behavior. In the last 60 years, a multitude of cardiac models has been created; from the pioneering work of Hodgkin and Huxley (1952), who first described the ionic currents of the squid giant axon quantitatively, mathematical modeling has made great strides. The O’Hara model, that I employed in this research work, is one of the modern computational models of ventricular myocyte, a new generation began in 1991 with ventricular cell model by Noble et al. Successful of these models is that you can generate novel predictions, suggest experiments and provide a quantitative understanding of underlying mechanism. Obviously, the drawback is that they remain simple models, they don’t represent the real system. The overall goal of this research is to give an additional tool, through mathematical modeling, to understand the behavior of the main ionic currents involved during the action potential (AP), especially underlining the differences between slower and faster heart rates. In particular to evaluate the rate-dependence role on the action potential duration, to implement a new method for interpreting ionic currents behavior after a perturbation effect and to verify the validity of the work proposed by Antonio Zaza using an injected current as a perturbing effect.

Measurement of the helicity dependence of deuteron photodisintegration for photon energies below 450 MeV

In 1998 a pilot experiment was carried out to study the helicity dependence of photoreaction cross sections using circularly polarized real photons on longitudinally polarized deuterons in a deuterated butanol target. The knowledge of these cross sections is required to test the validity of the Gerasimov-Drell-Hearn sum rule on the deuteron and the neutron. The focus of this thesis is on the results for the differential and total cross sections for the photodisintegration reaction for various photon energies in the range from 200 to 450 MeV using data taken with the detector system DAPHNE. The current understanding of the NN interaction as represented by the calculations by M. Schwamb could be confirmed within the given uncertainties. In addition, the detector DAPHNE has been prepared for the main experiment in 2003. The according work is presented together with results of the quality-test measurements of the renewed detector components.

Study of the helicity dependence of single pion photoproduction on the deuteron

Der erste experimentelle Test der GDH-Summenregel für das Proton wurde 1998 am MAMI-Beschleuniger der Universität Mainz durchgeführt. Ferner wurde ein Pilot-Experiment mit einem polarisierten Deuteron-Target vorgenommen. Dieselbe Kollaboration führte 2003 ein auf das Deuteron ausgerichtetes Experiment durch mit der Absicht, die GDH-Summenregel für das Neutron zu untersuchen. Der in beiden Experimenten verwendete Aufbau erlaubt nicht nur die Messung des totalen Wirkungsquerschnitts, sondern auch gleichzeitig einzelne Teilreaktionen zu studieren. In dieser Arbeit werden die Daten des Deuteron-Pilot-Experiments von 1998 analysiert. Desweiteren wird eine Studie der Helizitätsabhängigkeit der differenziellen Wirkungsquerschnitte für drei Pion-Photoproduktionskanäle des Deuterons in der oberen Hälfte der Delta-Resonanz präsentiert. Diese Ergebnisse werden mit einem theoretischen Modell verglichen. Dabei wurde eine hinreichend gute Übereinstimmung für die unpolarisierten Reaktionen gefunden, während für die polarisierten Kanäle kleinere Diskrepanzen beobachtet wurden. Der Targetpolarisationsgrad ist einer der relevanten Parameter, der für eine absolute Normalisierung der Wirkungsquerschnitte notwendig ist. Die Analyse dieses Parameters für die 2003er Daten wird in der vorliegenden Arbeit vorgestellt. Zur Zeit ist in Mainz ein Frozen-Spin-Target im Bau. Es wird als Target für polarisierte Protonen oder polarisierte Deuteronen für zukünftige Experimente mit dem Crystal Ball zur Verfügung stehen. Die Vorbereitungen der verschiedenen Subsysteme dieses Aufbaus stellten einen wichtigen Teil dieser Arbeit dar. Die fundamentalen Grundlagen der Methode und deren technische Umsetzung, sowie der momentane Status der Aufbauarbeiten am Target werden im Detail präsentiert.

Study of the helicity dependence of pi 0 photoproduction on proton at MAMI

The excitation spectrum is one of the fundamental properties of every spatially extended system. The excitations of the building blocks of normal matter, i.e., protons and neutrons (nucleons), play an important role in our understanding of the low energy regime of the strong interaction. Due to the large coupling, perturbative solutions of quantum chromodynamics (QCD) are not appropriate to calculate long-range phenomena of hadrons. For many years, constituent quark models were used to understand the excitation spectra. Recently, calculations in lattice QCD make first connections between excited nucleons and the fundamental field quanta (quarks and gluons). Due to their short lifetime and large decay width, excited nucleons appear as resonances in scattering processes like pion nucleon scattering or meson photoproduction. In order to disentangle individual resonances with definite spin and parity in experimental data, partial wave analyses are necessary. Unique solutions in these analyses can only be expected if sufficient empirical information about spin degrees of freedom is available. The measurement of spin observables in pion photoproduction is the focus of this thesis. The polarized electron beam of the Mainz Microtron (MAMI) was used to produce high-intensity, polarized photon beams with tagged energies up to 1.47 GeV. A "frozen-spin" Butanol target in combination with an almost 4π detector setup consisting of the Crystal Ball and the TAPS calorimeters allowed the precise determination of the helicity dependence of the γp → π0p reaction. In this thesis, as an improvement of the target setup, an internal polarizing solenoid has been constructed and tested. A magnetic field of 2.32 T and homogeneity of 1.22×10−3 in the target volume have been achieved. The helicity asymmetry E, i.e., the difference of events with total helicity 1/2 and 3/2 divided by the sum, was determined from data taken in the years 2013-14. The subtraction of background events arising from nucleons bound in Carbon and Oxygen was an important part of the analysis. The results for the asymmetry E are compared to existing data and predictions from various models. The results show a reasonable agreement to the models in the energy region of the ∆(1232)-resonance but large discrepancies are observed for energy above 600 MeV. The expansion of the present data in terms of Legendre polynomials, shows the sensitivity of the data to partial wave amplitudes up to F-waves. Additionally, a first, preliminary multipole analysis of the present data together with other results from the Crystal Ball experiment has been as been performed.

A 10-year retrospective analysis of marginal bone-level changes around implants in periodontally healthy and periodontally compromised tobacco smokers

to compare the 10-year marginal bone loss rates around implants supporting single-unit crowns in tobacco smokers with and without a history of treated periodontitis.

Oral mucosal findings related to tobacco use and alcohol consumption: a study on Swiss army recruits involving self-reported and clinical data

PURPOSE: The aim of the present study was to assess the oral mucosal health status of young male adults (aged 18 to 24 years) in Switzerland and to correlate their clinical findings with self-reported risk factors such as tobacco use and alcohol consumption. MATERIALS AND METHODS: Data on the oral health status of 615 Swiss Army recruits were collected using a standardised self-reported questionnaire, followed by an intraoral examination. Positive clinical findings were classified as (1) common conditions and anatomical variants, (2) reactive lesions, (3) benign tumour lesions and (4) premalignant lesions. The main locations of the oral mucosal findings were recorded on a topographical classification chart. Using correlational statistics, the findings were further associated with the known risk factors such as tobacco use and alcohol consumption. RESULTS: A total of 468 findings were diagnosed in 327 (53.17%) of the 615 subjects. In total, 445 findings (95.09%) were classified as common conditions, anatomical variants and reactive soft-tissue lesions. In the group of reactive soft-tissue lesions, there was a significantly higher percentage of smokers (P < 0.001) and subjects with a combination of smoking and alcohol consumption (P < 0.001). Eight lesions were clinically diagnosed as oral leukoplakias associated with smokeless tobacco. The prevalence of precursor lesions in the population examined was over 1%. CONCLUSIONS: Among young male adults in Switzerland, a significant number of oral mucosal lesions can be identified, which strongly correlate with tobacco use. To improve primary and secondary prevention, young adults should therefore be informed more extensively about the negative effects of tobacco use on oral health.

Education of tobacco use prevention and cessation for dental professionals--a paradigm shift

The use of tobacco continues to be a substantial risk factor in the development and progression of oral cancer, periodontitis, implant failure and poor wound healing. Dental and dental hygiene education providers have made great advances towards the incorporation of tobacco education into their curricula in recent years. Unfortunately, however, both medical and dental education research has consistently reported schools providing only basic knowledge-based curricula that rarely incorporate more effective, behaviourally-based components affecting long-term change. The limited training of oral healthcare students, at least in part, is reflected in practising dental professionals continuing to report offering incomplete tobacco interventions. In order to prepare the next generation of oral healthcare providers, this paper proposes a paradigm shift in how tobacco use prevention and cessation (TUPAC) may be incorporated into existing curricula. It is suggested that schools should carefully consider: to what level of competency should TUPAC be trained in dental and dental hygiene schools; the importance of establishing rapport through good communication skills; the core knowledge level for TUPAC; suggested instructional and assessment strategies; the importance of continuing professional education for the enhancement of TUPAC.

Consensus Report: 2nd European Workshop on Tobacco Use Prevention and Cessation for Oral Health Professionals

Tobacco use has been identified as a major risk factor for oral disorders such as cancer and periodontal disease. Tobacco use cessation (TUC) is associated with the potential for reversal of precancer, enhanced outcomes following periodontal treatment, and better periodontal status compared to patients who continue to smoke. Consequently, helping tobacco users to quit has become a part of both the responsibility of oral health professionals and the general practice of dentistry. TUC should consist of behavioural support, and if accompanied by pharmacotherapy, is more likely to be successful. It is widely accepted that appropriate compensation of TUC counselling would give oral health professionals greater incentives to provide these measures. Therefore, TUC-related compensation should be made accessible to all dental professionals and be in appropriate relation to other therapeutic interventions. International and national associations for oral health professionals are urged to act as advocates to promote population, community and individual initiatives in support of tobacco use prevention and cessation (TUPAC) counselling, including integration in undergraduate and graduate dental curricula. In order to facilitate the adoption of TUPAC strategies by oral health professionals, we propose a level of care model which includes 1) basic care: brief interventions for all patients in the dental practice to identify tobacco users, assess readiness to quit, and request permission to re-address at a subsequent visit, 2) intermediate care: interventions consisting of (brief) motivational interviewing sessions to build on readiness to quit, enlist resources to support change, and to include cessation medications, and 3) advanced care: intensive interventions to develop a detailed quit plan including the use of suitable pharmacotherapy. To ensure that the delivery of effective TUC becomes part of standard care, continuing education courses and updates should be implemented and offered to all oral health professionals on a regular basis.

Oral health risks of tobacco use and effects of cessation

The purpose of this paper is to review the epidemiologic evidence for the effects of tobacco use and tobacco use cessation on a variety of oral diseases and conditions. Exposures considered include cigarette and bidi smoking, pipe and cigar smoking, and smokeless tobacco use. Oral diseases and disorders considered include oral cancer and precancer, periodontal disease, caries and tooth loss, gingival recession and other benign mucosal disorders as well as implant failure. Particular attention is given to the impact of tobacco use cessation on oral health outcomes. We conclude that robust epidemiologic evidence exists for adverse oral health effects of tobacco smoking and other types of tobacco use. In addition, there is compelling evidence to support significant benefits of tobacco use cessation with regard to various oral health outcomes. Substantial oral health benefits can be expected from abstention and successful smoking cessation in a variety of populations across all ages.

Strategies for evaluating the economic value of drugs in alcohol dependence treatment

To assess existing health economic strategies, which are used to evaluate the economic value of drugs to treat alcohol dependence (AD) such as acamprosate, naltrexone and any other pharmaceuticals.