A Quantile Regression Approach to Estimating the Distribution of Anesthetic Procedure Time during Induction

Although procedure time analyses are important for operating room management, it is not easy to extract useful information from clinical procedure time data. A novel approach was proposed to analyze procedure time during anesthetic induction. A two-step regression analysis was performed to explore influential factors of anesthetic induction time (AIT). Linear regression with stepwise model selection was used to select significant correlates of AIT and then quantile regression was employed to illustrate the dynamic relationships between AIT and selected variables at distinct quantiles. A total of 1,060 patients were analyzed. The first and second-year residents (R1-R2) required longer AIT than the third and fourth-year residents and attending anesthesiologists (p = 0.006). Factors prolonging AIT included American Society of Anesthesiologist physical status ≧ III, arterial, central venous and epidural catheterization, and use of bronchoscopy. Presence of surgeon before induction would decrease AIT (p < 0.001). Types of surgery also had significant influence on AIT. Quantile regression satisfactorily estimated extra time needed to complete induction for each influential factor at distinct quantiles. Our analysis on AIT demonstrated the benefit of quantile regression analysis to provide more comprehensive view of the relationships between procedure time and related factors. This novel two-step regression approach has potential applications to procedure time analysis in operating room management.     

A Morpho-Density Approach to Estimating Neural Connectivity

Neuronal signal integration and information processing in cortical neuronal networks critically depend on the organization of synaptic connectivity. Because of the challenges involved in measuring a large number of neurons, synaptic connectivity is difficult to determine experimentally. Current computational methods for estimating connectivity typically rely on the juxtaposition of experimentally available neurons and applying mathematical techniques to compute estimates of neural connectivity. However, since the number of available neurons is very limited, these connectivity estimates may be subject to large uncertainties. We use a morpho-density field approach applied to a vast ensemble of model-generated neurons. A morpho-density field (MDF) describes the distribution of neural mass in the space around the neural soma. The estimated axonal and dendritic MDFs are derived from 100,000 model neurons that are generated by a stochastic phenomenological model of neurite outgrowth. These MDFs are then used to estimate the connectivity between pairs of neurons as a function of their inter-soma displacement. Compared with other density-field methods, our approach to estimating synaptic connectivity uses fewer restricting assumptions and produces connectivity estimates with a lower standard deviation. An important requirement is that the model-generated neurons reflect accurately the morphology and variation in morphology of the experimental neurons used for optimizing the model parameters. As such, the method remains subject to the uncertainties caused by the limited number of neurons in the experimental data set and by the quality of the model and the assumptions used in creating the MDFs and in calculating estimating connectivity. In summary, MDFs are a powerful tool for visualizing the spatial distribution of axonal and dendritic densities, for estimating the number of potential synapses between neurons with low standard deviation, and for obtaining a greater understanding of the relationship between neural morphology and network connectivity.     

A Biopsychosocial Approach to Surgical Evaluation and Outcome

There is increasing necessity for including an evaluation of psychosocial as well as biomedical factors when assessing the need for surgical intervention and its possible outcomes. Potential problems between patient and surgeon can arise when these factors are not taken into account. Recent behavioral science literature supports the use of a conceptual framework and concise clinical method for evaluating psychosocial factors and negotiating treatment with a patient. Such a method may be useful in reducing patient-surgeon conflicts and the negative outcomes (such as patient noncompliance, dissatisfaction, medical-legal suits and poor patient care) that can result when such an assessment is not mutually discussed.     

A Novel Approach to Estimating Heterozygosity from Low-Coverage Genome Sequence

High-throughput shotgun sequence data make it possible in principle to accurately estimate population genetic parameters without confounding by SNP ascertainment bias. One such statistic of interest is the proportion of heterozygous sites within an individual’s genome, which is informative about inbreeding and effective population size. However, in many cases, the available sequence data of an individual are limited to low coverage, preventing the confident calling of genotypes necessary to directly count the proportion of heterozygous sites. Here, we present a method for estimating an individual’s genome-wide rate of heterozygosity from low-coverage sequence data, without an intermediate step that calls genotypes. Our method jointly learns the shared allele distribution between the individual and a panel of other individuals, together with the sequencing error distributions and the reference bias. We show our method works well, first, by its performance on simulated sequence data and, second, on real sequence data where we obtain estimates using low-coverage data consistent with those from higher coverage. We apply our method to obtain estimates of the rate of heterozygosity for 11 humans from diverse worldwide populations and through this analysis reveal the complex dependency of local sequencing coverage on the true underlying heterozygosity, which complicates the estimation of heterozygosity from sequence data. We show how we can use filters to correct for the confounding arising from sequencing depth. We find in practice that ratios of heterozygosity are more interpretable than absolute estimates and show that we obtain excellent conformity of ratios of heterozygosity with previous estimates from higher-coverage data.     

A Modeling Approach to Investigate Epizootic Outbreaks and Enzootic Maintenance of Rift Valley Fever Virus

We propose a mathematical model to investigate the transmission dynamics of Rift Valley fever (RVF) virus among ruminants. Our findings indicate that in endemic areas RVF virus maintains at a very low level among ruminants after outbreaks and subsequent outbreaks may occur when new susceptible ruminants are recruited into endemic areas or abundant numbers of mosquitoes emerge when herd immunity decreases. Many factors have been shown to have impacts on the severity of RVF outbreaks; a higher probability of death due to RVF among ruminants, a higher mosquito:ruminant ratio, or a shorter lifespan of animals can amplify the magnitude of the outbreaks; vaccination helps to reduce the magnitude of RVF outbreaks and the loss of animals efficiently, and the maximum vaccination effort (a high vaccination rate and a larger number of vaccinated animals) is recommended before the commencement of an outbreak but can be reduced later during the enzootic.     

Dupuytren's Contracture of the Fingers—A Simplified Approach to Surgical Treatment

Hematoma formation, delay in healing, pain, stiffened finger joints are complications that sometimes follow classical surgical approaches to Dupuytren''s contracture. A new surgical approach to the disease that can correct the contractures without the attendant morbidity is urgently needed. By treating Dupuytren''s as any other scar contracture (division of the contracting soft tissue at its point of maximal tension and interposing normal free full-thickness skin) postoperative morbidity can be greatly decreased. Full return of function was achieved within 21 days following operation in 85 percent of the cases in which finger contractures were present before operation. Contracture release of 100 joints was done by this means, with loss of only one graft and without recurrence of the disease. This technique offers simple surgical control of progressive and recurrent Dupuytren''s contracture of the fingers with minimal postoperative morbidity.     

介绍一种计算国家财富的新方法

介绍一种计算国家财富的新方法曹志平（北京农业大学生物学院,１０００９４）ＩｎｔｒｏｄｕｃｔｉｏｎｔｏａＮｅｗＡｐｐｒｏａｃｈｏｆＥｓｔｉｍａｔｉｎｇｔｈｅＮａｔｉｏｎａｌＷｅａｌｔｈ．ＣａｏＺｈｉｐｉｎｇ（ＣｏｌｌｅｇｅｏｆＢｉｏｌｏｇｙ,Ｂｅｉｊ...     

Estimating the Occupancy Rate of Spatially Rare or Hard to Detect Species: A Conditional Approach

Summary We consider the problem of estimating the occupancy rate of a target species in a region divided in spatial units (called quadrats); this quantity being defined as the proportion of quadrats occupied by this species. We mainly focus on spatially rare or hard to detect species that are typically detected in very few quadrats, and for which estimating the occupancy rate (with an acceptable precision) is problematic. We develop a conditional approach for estimating the quantity of interest; we condition on the presence of the target species in the region of study. We show that conditioning makes identifiable the occurrence and detectability parameters, regardless of the number of visits made in the sampled quadrats. Compared with an unconditional approach, it proves to be complementary, in that this allows us to deal with biological questions that cannot be addressed by the former. Two Bayesian analyses of the data are performed: one is noninformative, and the other takes advantage of the fact that some prior information on detectability is available. It emerges that taking such a prior into account significantly improves the precision of the estimate when the target species has been detected in few quadrats and is known to be easily detectable.     

An Adjusted Likelihood Ratio Approach Analysing Distribution of Food Products to Assist the Investigation of Foodborne Outbreaks

In order to facilitate foodborne outbreak investigations there is a need to improve the methods for identifying the food products that should be sampled for laboratory analysis. The aim of this study was to examine the applicability of a likelihood ratio approach previously developed on simulated data, to real outbreak data. We used human case and food product distribution data from the Norwegian enterohaemorrhagic Escherichia coli outbreak in 2006. The approach was adjusted to include time, space smoothing and to handle missing or misclassified information. The performance of the adjusted likelihood ratio approach on the data originating from the HUS outbreak and control data indicates that the adjusted approach is promising and indicates that the adjusted approach could be a useful tool to assist and facilitate the investigation of food borne outbreaks in the future if good traceability are available and implemented in the distribution chain. However, the approach needs to be further validated on other outbreak data and also including other food products than meat products in order to make a more general conclusion of the applicability of the developed approach.     

Blood Pressure-Lowering Peptides from Neo-Fermented Buckwheat Sprouts: A New Approach to Estimating ACE-Inhibitory Activity

Neo-fermented buckwheat sprouts (neo-FBS) contain angiotensin-converting enzyme (ACE) inhibitors and vasodilators with blood pressure-lowering (BPL) properties in spontaneously hypertensive rats (SHRs). In this study, we investigated antihypertensive mechanisms of six BPL peptides isolated from neo-FBS (FBPs) by a vasorelaxation assay and conventional in vitro, in vivo, and a new ex vivo ACE inhibitory assays. Some FBPs demonstrated moderate endothelium-dependent vasorelaxation in SHR thoracic aorta and all FBPs mildly inhibited ACE in vitro. Orally administered FBPs strongly inhibited ACE in SHR tissues. To investigate detailed ACE-inhibitory mechanism of FBPs in living body tissues, we performed the ex vivo assay by using endothelium-denuded thoracic aorta rings isolated from SHRs, which demonstrated that FBPs at low concentration effectively inhibited ACE in thoracic aorta tissue and suppressed angiotensin II-mediated vasoconstriction directly associated with BPL. These results indicate that the main BPL mechanism of FBP was ACE inhibition in living body tissues, suggesting that high FBP''s bioavailability including absorption, tissue affinity, and tissue accumulation was responsible for the superior ACE inhibition in vivo. We propose that our ex vivo assay is an efficient and reliable method for evaluating ACE-inhibitory mechanism responsible for BPL activity in vivo.     

Application of Molecular Diagnostics to the Evaluation of the Surgical Approach to Thyroid Cancer

Recent important studies that include long-term follow-up have shown that BRAF and RAS mutations can have negative implications for disease recurrence and survival. BRAF positivity has been shown to be associated with decreased survival and is an independent predictor of poor prognosis. Reliable pre-operative identification of high-risk papillary thyroid cancer (PTC) patients may productively guide initial surgical management since reoperative neck surgery is associated with increased morbidity. However, it is probably too early to conclude that at present it is possible to tailor surgical therapy patient by patient only on the basis of their mutational status. Other important parameters, not including molecular testing, represented by some specific morphological aspects, still play an important role, probably still more significant than molecular diagnostics, such as neck ultrasonography. Pre-operative knowledge of BRAF-positive PTC could alter the initial surgical treatment for at least 20% of patients and can potentially prevent the increased morbidity associated with reoperative neck exploration. However, additional multi-institutional and randomized studies will be needed to further define the role of the pre-operative identification of BRAF positivity to guide not only the initial extent of total thyroidectomy (TT) but also the need for and extent of lymphadenectomy.