Common values in assessing health outcomes from disease and injury: Disability weights measurement study for the Global Burden of Disease Study 2010

BACKGROUND Measurement of the global burden of disease with disability-adjusted life-years (DALYs) requires disability weights that quantify health losses for all non-fatal consequences of disease and injury. There has been extensive debate about a range of conceptual and methodological issues concerning the definition and measurement of these weights. Our primary objective was a comprehensive re-estimation of disability weights for the Global Burden of Disease Study 2010 through a large-scale empirical investigation in which judgments about health losses associated with many causes of disease and injury were elicited from the general public in diverse communities through a new, standardised approach. METHODS We surveyed respondents in two ways: household surveys of adults aged 18 years or older (face-to-face interviews in Bangladesh, Indonesia, Peru, and Tanzania; telephone interviews in the USA) between Oct 28, 2009, and June 23, 2010; and an open-access web-based survey between July 26, 2010, and May 16, 2011. The surveys used paired comparison questions, in which respondents considered two hypothetical individuals with different, randomly selected health states and indicated which person they regarded as healthier. The web survey added questions about population health equivalence, which compared the overall health benefits of different life-saving or disease-prevention programmes. We analysed paired comparison responses with probit regression analysis on all 220 unique states in the study. We used results from the population health equivalence responses to anchor the results from the paired comparisons on the disability weight scale from 0 (implying no loss of health) to 1 (implying a health loss equivalent to death). Additionally, we compared new disability weights with those used in WHO's most recent update of the Global Burden of Disease Study for 2004. FINDINGS 13,902 individuals participated in household surveys and 16,328 in the web survey. Analysis of paired comparison responses indicated a high degree of consistency across surveys: correlations between individual survey results and results from analysis of the pooled dataset were 0·9 or higher in all surveys except in Bangladesh (r=0·75). Most of the 220 disability weights were located on the mild end of the severity scale, with 58 (26%) having weights below 0·05. Five (11%) states had weights below 0·01, such as mild anaemia, mild hearing or vision loss, and secondary infertility. The health states with the highest disability weights were acute schizophrenia (0·76) and severe multiple sclerosis (0·71). We identified a broad pattern of agreement between the old and new weights (r=0·70), particularly in the moderate-to-severe range. However, in the mild range below 0·2, many states had significantly lower weights in our study than previously. INTERPRETATION This study represents the most extensive empirical effort as yet to measure disability weights. By contrast with the popular hypothesis that disability assessments vary widely across samples with different cultural environments, we have reported strong evidence of highly consistent results.

An analysis of DNA methylation in human adipose tissue reveals differential modification of obesity genes before and after gastric bypass and weight loss

Background Environmental factors can influence obesity by epigenetic mechanisms. Adipose tissue plays a key role in obesity-related metabolic dysfunction, and gastric bypass provides a model to investigate obesity and weight loss in humans. Results Here, we investigate DNA methylation in adipose tissue from obese women before and after gastric bypass and significant weight loss. In total, 485,577 CpG sites were profiled in matched, before and after weight loss, subcutaneous and omental adipose tissue. A paired analysis revealed significant differential methylation in omental and subcutaneous adipose tissue. A greater proportion of CpGs are hypermethylated before weight loss and increased methylation is observed in the 3′ untranslated region and gene bodies relative to promoter regions. Differential methylation is found within genes associated with obesity, epigenetic regulation and development, such as CETP, FOXP2, HDAC4, DNMT3B, KCNQ1 and HOX clusters. We identify robust correlations between changes in methylation and clinical trait, including associations between fasting glucose and HDAC4, SLC37A3 and DENND1C in subcutaneous adipose. Genes investigated with differential promoter methylation all show significantly different levels of mRNA before and after gastric bypass. Conclusions This is the first study reporting global DNA methylation profiling of adipose tissue before and after gastric bypass and associated weight loss. It provides a strong basis for future work and offers additional evidence for the role of DNA methylation of adipose tissue in obesity.

Security Analysis of Randomize-Hash-then-Sign Digital Signatures

At CRYPTO 2006, Halevi and Krawczyk proposed two randomized hash function modes and analyzed the security of digital signature algorithms based on these constructions. They showed that the security of signature schemes based on the two randomized hash function modes relies on properties similar to the second preimage resistance rather than on the collision resistance property of the hash functions. One of the randomized hash function modes was named the RMX hash function mode and was recommended for practical purposes. The National Institute of Standards and Technology (NIST), USA standardized a variant of the RMX hash function mode and published this standard in the Special Publication (SP) 800-106. In this article, we first discuss a generic online birthday existential forgery attack of Dang and Perlner on the RMX-hash-then-sign schemes. We show that a variant of this attack can be applied to forge the other randomize-hash-then-sign schemes. We point out practical limitations of the generic forgery attack on the RMX-hash-then-sign schemes. We then show that these limitations can be overcome for the RMX-hash-then-sign schemes if it is easy to find fixed points for the underlying compression functions, such as for the Davies-Meyer construction used in the popular hash functions such as MD5 designed by Rivest and the SHA family of hash functions designed by the National Security Agency (NSA), USA and published by NIST in the Federal Information Processing Standards (FIPS). We show an online birthday forgery attack on this class of signatures by using a variant of Dean’s method of finding fixed point expandable messages for hash functions based on the Davies-Meyer construction. This forgery attack is also applicable to signature schemes based on the variant of RMX standardized by NIST in SP 800-106. We discuss some important applications of our attacks and discuss their applicability on signature schemes based on hash functions with ‘built-in’ randomization. Finally, we compare our attacks on randomize-hash-then-sign schemes with the generic forgery attacks on the standard hash-based message authentication code (HMAC).

On the Collision and Preimage Resistance of Certain Two-Call Hash Functions

In this paper we present concrete collision and preimage attacks on a large class of compression function constructions making two calls to the underlying ideal primitives. The complexity of the collision attack is above the theoretical lower bound for constructions of this type, but below the birthday complexity; the complexity of the preimage attack, however, is equal to the theoretical lower bound. We also present undesirable properties of some of Stam’s compression functions proposed at CRYPTO ’08. We show that when one of the n-bit to n-bit components of the proposed 2n-bit to n-bit compression function is replaced by a fixed-key cipher in the Davies-Meyer mode, the complexity of finding a preimage would be 2 n/3. We also show that the complexity of finding a collision in a variant of the 3n-bits to 2n-bits scheme with its output truncated to 3n/2 bits is 2 n/2. The complexity of our preimage attack on this hash function is about 2 n . Finally, we present a collision attack on a variant of the proposed m + s-bit to s-bit scheme, truncated to s − 1 bits, with a complexity of O(1). However, none of our results compromise Stam’s security claims.

On Randomizing Hash Functions to Strengthen the Security of Digital Signatures

Halevi and Krawczyk proposed a message randomization algorithm called RMX as a front-end tool to the hash-then-sign digital signature schemes such as DSS and RSA in order to free their reliance on the collision resistance property of the hash functions. They have shown that to forge a RMX-hash-then-sign signature scheme, one has to solve a cryptanalytical task which is related to finding second preimages for the hash function. In this article, we will show how to use Dean’s method of finding expandable messages for finding a second preimage in the Merkle-Damgård hash function to existentially forge a signature scheme based on a t-bit RMX-hash function which uses the Davies-Meyer compression functions (e.g., MD4, MD5, SHA family) in 2 t/2 chosen messages plus 2 t/2 + 1 off-line operations of the compression function and similar amount of memory. This forgery attack also works on the signature schemes that use Davies-Meyer schemes and a variant of RMX published by NIST in its Draft Special Publication (SP) 800-106. We discuss some important applications of our attack.

Security Analysis of salt||password Hashes

Protection of passwords used to authenticate computer systems and networks is one of the most important application of cryptographic hash functions. Due to the application of precomputed memory look up attacks such as birthday and dictionary attacks on the hash values of passwords to find passwords, it is usually recommended to apply hash function to the combination of both the salt and password, denoted salt||password, to prevent these attacks. In this paper, we present the first security analysis of salt||password hashing application. We show that when hash functions based on the compression functions with easily found fixed points are used to compute the salt||password hashes, these hashes are susceptible to precomputed offline birthday attacks. For example, this attack is applicable to the salt||password hashes computed using the standard hash functions such as MD5, SHA-1, SHA-256 and SHA-512 that are based on the popular Davies-Meyer compression function. This attack exposes a subtle property of this application that although the provision of salt prevents an attacker from finding passwords, salts prefixed to the passwords do not prevent an attacker from doing a precomputed birthday attack to forge an unknown password. In this forgery attack, we demonstrate the possibility of building multiple passwords for an unknown password for the same hash value and salt. Interestingly, password||salt (i.e. salts suffixed to the passwords) hashes computed using Davies-Meyer hash functions are not susceptible to this attack, showing the first security gap between the prefix-salt and suffix-salt methods of hashing passwords.

Age-related changes to adenosine in rat coronary resistance vessels

1. The vasodilator effects of adenosine receptor agonists, isoprenaline and histamine were examined in perfused heart preparations from young (4–6 weeks) and mature (12–20 weeks) rats. 2. Adenosine induced a biphasic concentration-dependent decrease in KCl (35 mM) raised coronary perfusion pressure in hearts from young and mature rats, suggesting the presence of both high- and low-affinity sites for adenosine receptors in the two age groups tested. In heart preparations from mature rats, vasodilator responses to adenosine were significantly reduced compared with responses observed in young rats. 3. Responses to 5′-N-ethylcarboxamidoadenosine (NECA) and 2-p-(2-carboxyethyl)phenethylamino-5′-N-ethylcarboxamidoadenosine hydrochloride (CGS-21680) were reduced in preparations from mature rats, whereas the vasodilator actions of N6-cyclopentyladenosine (CPA) and N6-2-(4-aminophenyl)ethyladenosine (APNEA) did not change with age. 4. The results presented in this study suggest that several adenosine receptor subtypes mediate vasodilator responses in the coronary circulation of the rat and that a reduction in response to adenosine with age may be due to changes in the high-affinity receptor site.

Engaging students (and their teachers) in STEM through robotics

Robotics@QUT is a university outreach program aimed at building pre- and in-service teacher capacity to encourage interest in Science, Technology, Engineering and Mathematics (STEM) subjects with school children from low socio-economic status areas. Currently over 35 schools are involved in the outreach program. Professional Development workshops are provided to teachers to build their knowledge in implementing robotics-based STEM activities in their classrooms, robotics loan kits are provided, and pre-service teacher visits arranged to provide the teachers with on-going support. The program also provides opportunities for school students to engage in robotics-based on-campus activities and competitions and is seen as a way to build aspirations for university. This paper presents an interim evaluation that examines the value of the Robotics@QUT program for the teachers, pre-service teachers and school students participating in the program. Surveys were administered to determine the participants’ perceived benefits of being involved and their perceptions of the program. The data gathered from the teachers showed that they had gained knowledge and confidence and felt that the Robotics@QUT program had assisted them to deliver engaging robotics-based STEM activities in their classrooms. The pre-service teachers’ responses focused on benefits for themselves, for their future teaching careers and for the school students involved. The school students’ responses focused on their increased knowledge and confidence to pursue future STEM studies and careers.

Common genetic variants influence human subcortical brain structures

The highly complex structure of the human brain is strongly shaped by genetic influences. Subcortical brain regions form circuits with cortical areas to coordinate movement, learning, memory and motivation, and altered circuits can lead to abnormal behaviour and disease. To investigate how common genetic variants affect the structure of these brain regions, here we conduct genome-wide association studies of the volumes of seven subcortical regions and the intracranial volume derived from magnetic resonance images of 30,717 individuals from 50 cohorts. We identify five novel genetic variants influencing the volumes of the putamen and caudate nucleus. We also find stronger evidence for three loci with previously established influences on hippocampal volume and intracranial volume. These variants show specific volumetric effects on brain structures rather than global effects across structures. The strongest effects were found for the putamen, where a novel intergenic locus with replicable influence on volume (rs945270; P = 1.08×10 -33; 0.52% variance explained) showed evidence of altering the expression of the KTN1 gene in both brain and blood tissue. Variants influencing putamen volume clustered near developmental genes that regulate apoptosis, axon guidance and vesicle transport. Identification of these genetic variants provides insight into the causes of variability in human brain development, and may help to determine mechanisms of neuropsychiatric dysfunction.

Identification of common variants associated with human hippocampal and intracranial volumes

Identifying genetic variants influencing human brain structures may reveal new biological mechanisms underlying cognition and neuropsychiatric illness. The volume of the hippocampus is a biomarker of incipient Alzheimer's disease and is reduced in schizophrenia, major depression and mesial temporal lobe epilepsy. Whereas many brain imaging phenotypes are highly heritable, identifying and replicating genetic influences has been difficult, as small effects and the high costs of magnetic resonance imaging (MRI) have led to underpowered studies. Here we report genome-wide association meta-analyses and replication for mean bilateral hippocampal, total brain and intracranial volumes from a large multinational consortium. The intergenic variant rs7294919 was associated with hippocampal volume (12q24.22; N = 21,151; P = 6.70 × 10 -16) and the expression levels of the positional candidate gene TESC in brain tissue. Additionally, rs10784502, located within HMGA2, was associated with intracranial volume (12q14.3; N = 15,782; P = 1.12 × 10 -12). We also identified a suggestive association with total brain volume at rs10494373 within DDR2 (1q23.3; N = 6,500; P = 5.81 × 10 -7).

The ENIGMA Consortium: Large-scale collaborative analyses of neuroimaging and genetic data

The Enhancing NeuroImaging Genetics through Meta-Analysis (ENIGMA) Consortium is a collaborative network of researchers working together on a range of large-scale studies that integrate data from 70 institutions worldwide. Organized into Working Groups that tackle questions in neuroscience, genetics, and medicine, ENIGMA studies have analyzed neuroimaging data from over 12,826 subjects. In addition, data from 12,171 individuals were provided by the CHARGE consortium for replication of findings, in a total of 24,997 subjects. By meta-analyzing results from many sites, ENIGMA has detected factors that affect the brain that no individual site could detect on its own, and that require larger numbers of subjects than any individual neuroimaging study has currently collected. ENIGMA's first project was a genome-wide association study identifying common variants in the genome associated with hippocampal volume or intracranial volume. Continuing work is exploring genetic associations with subcortical volumes (ENIGMA2) and white matter microstructure (ENIGMA-DTI). Working groups also focus on understanding how schizophrenia, bipolar illness, major depression and attention deficit/hyperactivity disorder (ADHD) affect the brain. We review the current progress of the ENIGMA Consortium, along with challenges and unexpected discoveries made on the way.

Service composition and binding

Service composition enables the creation of services previously unavailable through the aggregation of existing services. The result is called a service composition. Exposing a service composition as a service, the result is called a composed service. It can be distinguished from atomic services. Service composition approaches can be differentiated along two axes: point in time of composition and degree of automation. With design-time and run-time we can identify two different points in time for doing a composition. Additionally we can distinguish between three different degrees of automation: manual, assisted, and automated service composition. © 2008 Springer Berlin Heidelberg.

'I love PEMCO' : Creating conversation worthy buzz in the insurance industry with word of mouth marketing

Surveys by PR-COM, a communications agency, indicate that leading German companies (1) have not recognized the relevance of social media yet or (2) have difficulties with implementing the concept (Meiners et al. 2010). For example, a survey among DAX-companies indicates that their social media activities are “lückenhaft und halbherzig” (PR-COM 2009). Another survey in the German IT industry shows that less than a third had a German and/or English blog (PR-COM 2010), even though blogging is considered a key tool for marketing communications. However, firms “that are not present on social media run the risk of not being in the position to build a positive reputation or to correct negative comments” (Meiners et al. 2010).