A simulation approach for power calculation in large cohort studies based on multistate models

Realistic power calculations for large cohort studies and nested case control studies are essential for successfully answering important and complex research questions in epidemiology and clinical medicine. For this, we provide a methodical framework for general realistic power calculations via simulations that we put into practice by means of an R‐based template. We consider staggered recruitment and individual hazard rates, competing risks, interaction effects, and the misclassification of covariates. The study cohort is assembled with respect to given age‐, gender‐, and community distributions. Nested case‐control analyses with a varying number of controls enable comparisons of power with a full cohort analysis. Time‐to‐event generation under competing risks, including delayed study‐entry times, is realized on the basis of a six‐state Markov model. Incidence rates, prevalence of risk factors and prefixed hazard ratios allow for the assignment of age‐dependent transition rates given in the form of Cox models. These provide the basis for a central simulation‐algorithm, which is used for the generation of sample paths of the underlying time‐inhomogeneous Markov processes. With the inclusion of frailty terms into the Cox models the Markov property is specifically biased. An “individual Markov process given frailty” creates some unobserved heterogeneity between individuals. Different left‐truncation‐ and right‐censoring patterns call for the use of Cox models for data analysis. p‐values are recorded over repeated simulation runs to allow for the desired power calculations. For illustration, we consider scenarios with a “testing” character as well as realistic scenarios. This enables the validation of a correct implementation of theoretical concepts and concrete sample size recommendations against an actual epidemiological background, here given with possible substudy designs within the German National Cohort.     

Rigorous conformational analysis of right and left DNA helices and junction between them

On the basis of complete scanning through conformational space of dihedral angles, twelve structural genera were obtained. Subsequent energy minimization within these genera yielded a limited set of duplexes with stacking: right-handed B-form (Wilkins type), B2-form (Watson and Crick type) and left-handed Ll-form (Sasisekharan type) and the new L2-form. In the polymeric DNA only right-handed double-helices are possible, the left-handed helices are forbidden due to poor 1–5 interchain contacts. In contrast, for short fragments the left- and right-handed helicek have practically the same energies providing some physical ground for side-by-side form, which biologically is possible as recombination form and may be as replication form.     

The behaviour of Dutch fresh water ecologists in response to environmental concern

Due to the rise of environmental concern ecologists have been asked for advice more frequently since the late 1960s. This article discusses how the changing relationship between ecologists and society has affected the behaviour of one particular group of ecologists, namely Dutch fresh water ecologists, by focussing on their behaviour towards job market control and public interest activities. The analysis has been based on interviews with 65 Dutch fresh water ecologists together with an analysis of their publications.In contrast with American ecologists, Dutch fresh water ecologists have made little effort to control their job market by formal arrangements such as formulating a code of ethics and certification procedures. Secondly, Dutch fresh water ecologists generally conceive of their own role in contributing to the solution of environmental problems in relation to that of the environmentalists by doing good research and reliable advisory work. Although a significant number of researchers also address lay publics by writing popular articles and/or holding lectures, only a minority actively participates in environmental politics.     

MPEG－SOD对急性低氧下鼠左心功能的保护作用

单甲氧基聚乙二醇（ＭＰＥＧ）活化后与超氧化物歧化酶（ＳＯＤ）偶联,经纯化后得到ＭＰＥＧ－ＳＯＤ,鉴定其分子量约为７．０×１０５Ｄａｔｉｏｎ。其在血液循环中酶活性半衰期超过３０ｈ,远大于天然ＳＯＤ（６－１０ｍｉｎ）。ＳＤ雄性大鼠分三组．对照组（ｎ＝８．由股静脉注入０．２ｍｌ生理盐水）、ＮａｔｉｖｅＳＯＤ组（ｎ＝８,注以０．２ｍｌ生理盐水配的８００ＵＳＯＤ）和ＭＰＥＧ－ＳＯＤ组（ｎ＝９,注以８００ＵＭＰＥＧ－ＳＯＤ）。低氧前三组鼠的心率（ＨＲ）、左室内峰压（ＬＶＰ）、左室压微分（ＬＶ±ｄｐ／ｄｔｍａｘ）和股动脉压（ＡＰ）均无统计学差别。在模拟６０００—６５００ｍ高度急性低氧１．８．１４ｍｉｎ记录上述各项指标,结果如下：除ＨＲ外,ＮａｔｉｖｅＳＯＤ组与对照组各指标均无统计学差别,ＭＰＥＧ－ＳＯＤ组的各项指标均明显高于对照组。表明ＭＰＥＧ－ＳＯＤ对急性低氧导致的左心室力学指标的减弱有明显保护作用,提示超氧自由基（Ｏ２－）在急性低氧导致左心室功能损伤中起重要作用,即可能是由Ｏ２－及其衍生的其它自由基损害心肌细胞生物膜系统所致。     

Bootlegging on a desert mountain: The political ecology of Agave (Agave spp.) demographic change in the Sonora river valley,Sonora, Mexico

Recent studies suggest that wild agave (Agavespp.) plants in Sonora, Mexico, are being over-harvested by mescal makers on communal lands. Using the conceptual framework of regional political ecology (Blaikie and Brookfield, 1987), I discuss the ecological processes of agave depletion, and investigate the social, economic, and political contexts in which unsustainable harvest practices arise. Whereas all the mescal makers have knowledge of sustainable harvest methods, population growth, expansion of agriculture onto ecologically marginal lands, and increasing dependence on wild harvested products from communal lands created the socioeconomic context for increased demand for mescal income. The ideology of household autonomy, and the belief that the village has no right to internally regulate use of the commons, created the political context for rapid, unsustainable harvesting—a tragedy of the commons. However, recent cultural changes have caused a reversal of this trend, and some wild agave populations may be recovering.     

Matching models of left ventricle and systemic artery

To reveal how the matching models of the left ventricle and its afterload affect the pressure and flow in the aortic root, the differences between the measured pressure and flow waveforms and those determined by three kinds of matching model were compared. The results showed that, compared with the results by both matching models 1 and 2, the pressure and flow waveforms determined by matching model 3 established in this work were in the closest agreement with the corresponding experimental waveforms, therefore indicating that matching model 3 was a matching model that closely and rationally characterized the match between the left ventricle and the systemic artery.     

高原人体左心室舒张功能和顺应性的改变

应用同步描记心电图、心音图、颈动脉搏动图和心尖搏动图以测定高原人体的左心室舒张功能和顺应性。在4个不同海拔高度进行实验,即76m(海平对照)、2161m、3270m和4179m,每一高度40名健康男性青年,高原3组世居、移居各20名。结果显示:随着海拔增高,主动舒张时间指数(TRTI)有减小趋势,RF波相对振幅(F/H)逐渐降低,A波相对振幅(A/D)则渐趋增大,3270m以上增大明显(p<0.05),舒张振幅时间指数(DATI)逐渐降低,3270m以上差异极显著(p<0.001)。高原世居与移居者相比,在海拔4179m出现明显差别,移居组TRTI、DATI、F/H较低而A/D较高(D<0.05)。测定射血前期与左室射血时间比值(PEP/LVET)、射血分数(EF)及左室周径纤维平均缩短速度(mVcf)3项指标作对照,显示在此高度左室收缩功能仍能保持。高原慢性心肌缺氧可能是导致左室舒张功能和顺应性轻度降低的原因。     

Anticoagulation for the Acute Management of Ischemic Stroke

Few prospective studies support the use of anticoagulation during the acute phase of ischemic stroke, though observational data suggest a role in certain populations. Depending on the mechanism of stroke, systemic anticoagulation may prevent recurrent cerebral infarction, but concomitantly carries a risk of hemorrhagic transformation. In this article, we describe a case where anticoagulation shows promise for ischemic stroke and review the evidence that has discredited its use in some circumstances while showing its potential in others.     

Neural Correlates of Body Integrity Dysphoria

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基于文化与政治生态学的社会生态系统演进机制研究 ——以杭州与西湖为例

科学认识社会生态系统演进机制是对其进行有效管理的重要基础。以文化与政治生态学为理论基础,提出适合杭州—西湖社会生态系统的综合研究框架,识别了杭州—西湖社会生态系统的5个演进阶段,并分析出系统演进中的3种潜在状态。自然、政治、经济以及社会驱动力是影响杭州—西湖社会生态系统的主导因素,人类行为影响整个生态系统中扰动的频率、大小和形式并改变西湖生态系统的结构与功能,进而影响西湖为城市提供生态系统服务的潜能。在不同历史时期,基于自然、社会、经济、文化等多层面的需求,西湖在不同系统状态下为城市供给不同类别和质量的生态系统服务,总体而言供给与调节服务比例逐渐下降,文化服务逐渐上升,并且后者逐步成为最主要的生态系统服务类别。杭州与西湖在长期的互馈共生中建立了社会生态系统的自适应性调节机制,其背后的生态智慧可为现代风景园林规划提供重要启示。