Global burden of thermal burns, 1990–2017: Unbalanced distributions and temporal trends assessed from the Global Burden of Disease Study 2017

BackgroundMany studies demonstrate that being burned has both physical and psychological sequelae that affect quality of life. Further, these effects may be more prevalent in some regions and populations. We sought to access the unbalanced distributions and temporal trends concerning the health burden of thermal burns.MethodsData were collected from the Global Burden of Disease Study 2017, and the disability-adjusted life year (DALY)¹ was used as a measure of health burden. Linear regression was used to evaluate the relationship between the age-standardized DALY rate and socio-demographic index.² Joinpoint regression analysis and comparison line charts were all applied to assess the temporal trends of burns.ResultsThe age-standardized DALY rate of global thermal burns decreased by 43.7%, from 197 (95% CI: 152–228) per 100,000 in 1990 to 111 (95% CI: 93–129) per 100,000 in 2017. The burden was borne mainly by children 1–4 years of age and people over 80 years. Socio-demographic index was negatively correlated with the age-standardized DALY rate. In low-middle and low socio-demographic index regions, the decreasing trends were slower than other regions with an average annual percentage change of ?2.1% (95% CI: ?2.2 to ?2.0) and ?2.1% (95% CI: ?2.1 to ?2.0), respectively. Among six geographical regions, Africa presented the highest age-standardized DALY rates of 352 (95% CI: 275–410) per 100,000 in 1990 and 208 (95% CI: 175–236) per 100,000 in 2017, and also the slowest average decreasing trend, with an average annual percentage change of ?1.9% (95% CI: ?2 to ?1.8).ConclusionsThe global burden of thermal burns shows a downward trend from 1990 to 2017, and regions with lower socio-demographic index and Africa show greater burdens and smaller downward trends.     

A weighted rule based method for predicting malignancy of pulmonary nodules by nodule characteristics

Predicting malignancy of solitary pulmonary nodules from computer tomography scans is a difficult and important problem in the diagnosis of lung cancer. This paper investigates the contribution of nodule characteristics in the prediction of malignancy. Using data from Lung Image Database Consortium (LIDC) database, we propose a weighted rule based classification approach for predicting malignancy of pulmonary nodules. LIDC database contains CT scans of nodules and information about nodule characteristics evaluated by multiple annotators. In the first step of our method, votes for nodule characteristics are obtained from ensemble classifiers by using image features. In the second step, votes and rules obtained from radiologist evaluations are used by a weighted rule based method to predict malignancy. The rule based method is constructed by using radiologist evaluations on previous cases. Correlations between malignancy and other nodule characteristics and agreement ratio of radiologists are considered in rule evaluation. To handle the unbalanced nature of LIDC, ensemble classifiers and data balancing methods are used. The proposed approach is compared with the classification methods trained on image features. Classification accuracy, specificity and sensitivity of classifiers are measured. The experimental results show that using nodule characteristics for malignancy prediction can improve classification results.     

Sensitive DIP-STR markers for the analysis of unbalanced mixtures from “touch” DNA samples

Casework samples collected for forensic DNA analysis can produce genomic mixtures in which the DNA of the alleged offender is masked by high quantities of DNA coming from the victim. DIP-STRs are novel genetic markers specifically developed to enable the target analysis of a DNA of interest in the presence of exceeding quantities of a second DNA (up to 1000-fold). The genotyping system, which is based on allele-specific amplifications of haplotypes formed by a deletion/insertion polymorphism (DIP) and a short tandem repeat (STR), combines the capacity of targeting the DNA of an individual with a strong identification power. Finally, DIP-STRs are autosomal markers therefore they can be applied to any combination of major and minor DNA.In this study we aimed to assess the ability of DIP-STRs to detect the minor contributor on challenging “touch” DNA samples simulated with representative crime-associated substrates and to compare their performance to commonly used male-specific markers (Y-STRs). As part of a comprehensive study on the relative DNA contribution of two persons handling the same object, we selected 71 unbalanced contact traces of which 14 comprised a male minor DNA contributor mixed to a female major DNA contributor. Using a set of six DIP-STRs, one to four markers were found to be informative for the minor DNA detection across traces. When compared to Y-STRs (14 traces), the DIP-STRs showed similar sensitivity in detecting the minor DNA across substrate materials with a similar occurrence of allele drop-out. Conversely, because of the sex combination of the two users of the object, 57 remaining traces could only be investigated by DIP-STRs. Of these, 30 minor DNA contributors could be detected by all informative markers while 12 traces showed events of allele drop-out. Finally, 15 traces showed no amplification of the minor DNA. These last 15 samples were mostly characterized by a combination of short handling time of the object, low DNA recovery and/or one single informative DIP-STR.In conclusion, the DIP-STRs represent alternative markers to help solving unbalanced two-source DNA mixtures, and also those produced from contact stains. These markers, in addition to a novel set of 10 DIP-STRs specifically developed according to forensic technical standards, will offer a valuable tool complementary to Y-STR markers.     

An update on ECARUCA,the European Cytogeneticists Association Register of Unbalanced Chromosome Aberrations

The European Cytogeneticists Association Register of Unbalanced Chromosome Aberrations (ECARUCA, www.ecaruca.net) is an online database initiated in 2003 that collects and provides detailed, curated clinical and molecular information on rare unbalanced chromosome aberrations. ECARUCA now contains over 4800 cases with a total of more than 6600 genetic aberrations and has over 3000 account holders worldwide. Recently, the ECARUCA web site was renewed, including the presentation of interesting case reports in collaboration with the European Journal of Medical Genetics. This article gives an overview of the current status and future plans of the online ECARUCA database.     

A case of an atypically large proximal 15q deletion as cause for Prader–Willi syndrome arising from a de novo unbalanced translocation

We describe an 11 month old female with Prader–Willi syndrome (PWS) resulting from an atypically large deletion of proximal 15q due to a de novo 3;15 unbalanced translocation. The 10.6 Mb deletion extends from the chromosome 15 short arm and is not situated in a region previously reported as a common distal breakpoint for unbalanced translocations. There was no deletion of the reciprocal chromosome 3q subtelomeric region detected by either chromosomal microarray or FISH. The patient has hypotonia, failure to thrive, and typical dysmorphic facial features for PWS. The patient also has profound global developmental delay consistent with an expanded, more severe, phenotype.     

Detecting rare events using extreme value statistics applied to epileptic convulsions in children

ObjectiveNocturnal home monitoring of epileptic children is often not feasible due to the cumbersome manner of seizure detection with the standard method of video electroencephalography monitoring. The goal of this paper is to propose a method for hypermotor seizure detection based on accelerometers that are attached to the extremities.MethodsSupervised methods that are commonly used in literature need annotation of data and hence require expert (neurologist) interaction resulting in a substantial cost. In this paper an unsupervised method is proposed that uses extreme value statistics and seizure detection based on a model of normal behavior that is estimated using all recorded and unlabeled data. In this way the expensive interaction can be avoided.ResultsWhen applying this method to a labeled dataset, acquired from 7 patients, all hypermotor seizures are detected in 5 of the 7 patients with an average positive predictive value (PPV) of 53%. For evaluating the performance on an unlabeled dataset, seizure events are presented to the system as normal movement events. Since hypermotor seizures are rare compared to normal movements, the very few abnormal events have a negligible effect on the quality of the model. In this way, it was possible to evaluate the system for 3 of the 7 patients when 3% of the training set was composed of seizure events. This resulted in sensitivity scores of 80%, 22% and 90% and a PPV of 89%, 21% and 44% respectively. These scores are comparable with a state-of-the-art supervised machine learning based approach which requires a labeled dataset.ConclusionsA person-dependent epileptic seizure detection method has been designed that requires little human interaction. In contrast to traditional machine learning approaches, the imbalance of the dataset does not cause substantial difficulties.     

联合应用超声心动图与血气分析诊治肺心病的价值

目的 阐述联合应用彩色多普勒超声心动图(CDE)和血气分析诊治肺心病(COP)的重要价值。方法 对51例肺心病之急性发作期的住院患者应用CDE对心脏病变进行检测，同时应用血气分析仪进行酸碱失衡的测定并分型，以后者7种主要检测类型为基础对比分析CT3E心脏异常的超声表现。结果 血气分析主要检测为7种不同类型的酸碱失衡：呼吸性酸中毒(呼酸，31％)，呼酸并代谢性碱中毒(代碱)(16％)，代碱(12％)，呼吸性碱中毒(呼碱，10%)，呼酸并代谢性酸中毒(代酸)(4％)，代酸(4％)，以及代酸并呼碱(2％)。各种类型下CDE显示心脏不同程度的异常表现。结论 两种诊查技术联合应用，为早期治疗肺心病提供全面而准确的CDE心脏异常信息和血气分析结果，指导临床用药。     

The effect of unbalanced randomization on the progressively censored savage test

Equal allocation of patients to treatment in a randomized clinical trial may have disadvantages ethically if the new treatment is believed to be at least as beneficial as the standard treatment. Others have considered, in a non-sequential setting, unbalanced randomized designs which allocate fewer patients to the potentially inferior standard treatment. This paper examines unbalanced randomized designs in a sequential comparison of two exponential survival distributions using the progressively censored Savage test. The results reveal no substantial sacrifice in asymptotic power or early stopping properties.     

Power for <Emphasis Type="Italic">T</Emphasis>-test comparisons of unbalanced cluster exposure studies

Studies of individuals sampled in unbalanced clusters have become common in health services and epidemiological research, but available tools for power/sample size estimation and optimal design are currently limited. This paper presents and illustrates power estimation formulas for t-test comparisons of effect of an exposure at the cluster level on continuous outcomes in unbalanced studies with unequal numbers of clusters and/or unequal numbers of subjects per cluster in each exposure arm. Iterative application of these power formulas obtains minimal sample size needed and/or minimal detectable difference. SAS subroutines to implement these algorithms are given in the Appendices. When feasible, power is optimized by having the same number of clusters in each arm k _A =k _B and (irrespective of numbers of clusters in each arm) the same total number of subjects in each arm n _A k _A =n _B k _B . Cost beneficial upper limits for numbers of subjects per cluster may be approximately (5/ρ) −5 or less where ρ is the intraclass correlation. The methods presented here for simple cluster designs may be extended to some settings involving complex hierarchical weighted cluster samples.