Linear Trend In Proportions Research Articles

Social distancing as protection factor against COVID-19 in a non-metropolitan area in the State of Rio Grande do Sul, BrazilLas medidas de distanciamiento social como factor de protección contra la COVID-19 en el interior de Rio Grande do Sul, Brasil

RESUMOObjetivo.Investigar a soroprevalência de SARS-CoV-2 na região do Vale do Rio Pardo, Rio Grande do Sul, Brasil, e analisar a associação entre soroprevalência e adesão por parte da população às medidas de distanciamento social.Método.Este estudo transversal de base populacional compreendeu quatro etapas de coleta domiciliar de dados entre agosto e outubro de 2020. A soroprevalência foi avaliada utilizando teste rápido de anticorpos IgM e IgG. Foram coletados, ainda, dados demográficos, socioeconômicos, clínicos e comportamentais, com aplicação de um questionário de três perguntas sobre adesão a medidas de distanciamento social, com foco no nível de distanciamento social que o entrevistado conseguia praticar, rotina de atividades do entrevistado e circulação de pessoas na casa. A associação entre os dados sociodemográficos e a prática de distanciamento social foi avaliada pelo teste do qui-quadrado para tendência linear e heterogeneidade de proporções, e a associação entre o distanciamento social e a soroprevalência foi avaliada pela regressão de Poisson (intervalo de confiança de 95% [IC95%]; P < 0,05).Resultados.Dos 4 252 indivíduos testados e entrevistados, 11,8% (IC95%: 10,8; 12,8) não aderiram ao distanciamento social. A prevalência de teste rápido reagente foi de 4,7% entre aqueles que não realizaram distanciamento social e de 1,9% entre aqueles que realizaram distanciamento social (P < 0,05). As variáveis sexo masculino, faixa etária de 20 a 59 anos, ensino médio, renda familiar mensal de R$ 3 136,00 a R$ 6 270,00 e morar na zona urbana apresentaram associação com a não adesão ao distanciamento social (P < 0,05). A adesão a todas as medidas de distanciamento social foi fator de proteção contra a infecção de SARS-CoV-2 (razão de prevalência: 0,37; IC95%: 0,19; 0,73).Conclusões.Os resultados indicam uma redução da soroprevalência pelas medidas de distanciamento social.

Patterns and Trends of Childhood Cancer Incidence (0–14 Years) in Delhi, India: 1990–2014

To investigate the patterns and temporal trends of childhood cancer incidence (0-14 years) in Delhi from 1990 to 2014. The new childhood cancer cases diagnosed between 1990 and 2014 were extracted from the Delhi population-based cancer registry (PBCR). Joinpoint regression analysis was performed to assess the temporal behaviour of new childhood cancer. The magnitude of temporal trend was assessed by estimated annual percentage changes (EAPCs). The Delhi PBCR registered 12,637 cases (8484 boys and 4153 girls) during 1990-2014. The overall childhood cancer was twice in boys than girls (5.62% vs. 2.78%). The age-standardised incidence rates (ASIRs) of childhood cancer adjusted to the WHO World standard population distribution (year 2000) was 163 per one million in boys and 92 per one million in girls; median age at diagnosis being 6 and 7 years, respectively. Five-top childhood cancer sites was leukaemia, lymphoma, central nervous system (CNS), bone and retinoblastoma. A decreasing linear trend in proportion of new childhood cancer cases to total all age-group cancer was observed in both sexes during this period. The percentage increase in childhood cancer is similar in both sexes from 1990-94 to 2010-14 (97% vs. 93%). Increasing trend in ASIRs of childhood cancer was observed. The new childhood cancer cases observed increasing trend during 1990 to 2014. Boys had nearly double the number of childhood cancer cases than girls while population ratio of boys and girls during the same period was 1.14:1.

EFFECT OF SURPRISE INSPECTIONS ON THE CLEANLINESS OF INPATIENT AREAS OF A TERTIARY CARE HOSPITAL

BACKGROUND : Good housekeeping plays an important role not only for patient satisfaction, its role in prevention of hospital acquired infections has been established beyond doubt. Satisfaction surveys are ways to finding patients’ perception of cleanliness, but for improving cleanliness accountability and monitoring performance play important role. AIM: The objective of this study was to evaluate the impact of random surprise visual inspections/audits on cleanliness in the in-patient wards of a tertiary care hospital in the National Capital Territory, India. METHODS: Surprise inspections/audits were conducted based on key performance indicators to objectively assess the cleanliness at variable intervals of time in the various patient care areas like medical, paediatric, surgical, and critical care units. The areas were sub-classified into staff, patient and common sub-areas each with measurable element like cleaning of toilets, cleaning equipment, patient beds, etc. for which “yes” (=1) or “no” (=0) was marked. Percentages were calculated for the scores achieved. Analysis for Chi square linear trend in proportions was also done. Data which were non-normally distributed in two groups Wilcoxon sign rank test was used. RESULTS: Deficiencies observed in the first audit were poor general cleaning of toilets, non-availability of supplies, poor general cleanliness of nursing station, office and sanitation equipment, staff duty room, walls, floors, window panes, window sills, bedside screens and tables, curtains and fixtures. As audits progressed, there was a steady progress in the cleanliness observed, overall scores progressed from 47 % in August (n=1), 60 % in September (n=05), 78 % in October (n=11), 83 % in November (n=04) but dipped to 76% in December (n=07). CONCLUSION: Regular surprise hospital cleanliness inspections/audits led to significant improvement of cleanliness which was then sustained till the inspections were carried. Keywords: hospital, audit, cleaning, India Normal 0 false false false EN-US X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:Table Normal; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin-top:0cm; mso-para-margin-right:0cm; mso-para-margin-bottom:8.0pt; mso-para-margin-left:0cm; line-height:107%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:Calibri,sans-serif; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Times New Roman; mso-bidi-theme-font:minor-bidi;}

Orthodontic treatment in National Dental Centre of Singapore: Trends toward higher proportion of adult patients

Background Adult patients used to be daunted with the prospect of having fixed appliances to correct malocclusions. However, this has gradually changed and recent literature reported an increasing trend in adults receiving orthodontic treatment. To date, there has been no information regarding the trend of adult orthodontic patients in Singapore. Objective The objective of this study was to determine the changes in the proportion of adult patients seeking orthodontic treatment at the National Dental Centre Singapore (NDCS) from 2011 to 2017. Materials and Methods The study sample consists of all patients who commenced active orthodontic treatment from 2011 to 2017 at the NDCS. The data collected were analyzed for the number, gender, and proportion of adult orthodontic patients treated annually from 2011 to 2017. Linear-by-linear association test was used to test for any significant linear trend in proportion of adult orthodontic patients over the 7 years. Pearson’s Chi-squared test was used to test for any significant gender differences. Results There was a significant increasing linear trend (p = 0.001) in the proportion of adult orthodontic patients from 2011 to 2017. No significant difference (p = 0.770) between the proportions of male and female adults undergoing orthodontic treatment was found. The ages of adults undergoing orthodontic treatment ranged from 21 to 73 years old and majority (48.61%) of them was in the 21–25 years old age range. Conclusion There is a rising trend in adults seeking orthodontic treatment at the NDCS from 2011 to 2017. No statistically significant gender difference was observed in this rising trend.

PO-064 Early birth order and increased risk of lymphoid cancers and allergies in lymphoid cancer families

IntroductionLymphoid cancers are a heterogeneous group of neoplasms that arise from immune cells. Familial clustering of lymphoid cancers support a genetic contribution to cancer predisposition. Infectious diseases and some immune disorders have been associated with lymphoid cancers. The hygiene hypothesis proposes that a lower infectious burden during early life inhibits the immune system from maturing optimally, and may lead to disorders of the immune system.Material and methodsWe characterised atopic conditions in lymphoid affected sibships of 182 families with a history of lymphoid cancers. Early life data was collected from telephone interviews and questionnaires from multiple family members. When available, medical records, pathology slides and tissue blocks were used to confirm the lymphoid cancer diagnosis. Lymphoid cancers were classified according to the InterLymph hierarchical classification (Turner, 2010). A chi-squared test for a linear trend in proportions was performed on birth order data for lymphoid affected sibships. This test was also performed on birth order and allergies in lymphoid affected sibships.Results and discussionsWithin 182 families, 301 sibships had 392 lymphoid affected and 927 unaffected siblings. We observed an inverse relationship between birth order and risk of cancer for all lymphoid cancers collectively (p<0.0001), and separately for multiple myeloma (p=0.0015), non-Hodgkin lymphoma (p<0.0001) and individual B-cell subtypes including chronic lymphocytic leukaemia (p=0.0124), follicular (p=0.0217) and marginal zone lymphoma (p=0.0169). We also observed an inverse relationship between birth order and risk of allergies (p=0.0284), for both environmental allergies (p=0.0465) and multiple allergies (p=0.0114) in lymphoid affected individuals.ConclusionEarly life exposures that are dependent on birth order may play a role in immune dysregulation and subsequent risk of multiple types of lymphoid cancers, as well as allergies. The familial nature of the cancers implies shared genetic and/or environmental factors. There is a need for further evaluation of lifestyle factors that may protect against lymphoid cancers even in the familial context.

Efficacy of Indigo Naturalis in a Multicenter Randomized Controlled Trial of Patients With Ulcerative Colitis

Indigo naturalis (IN) is a traditional Chinese medicine that contains ligands for the aryl hydrocarbon receptor and promotes regeneration of the mucosa by inducing production of interleukin 22. IN might induce mucosal healing in patients with ulcerative colitis (UC). We performed a randomized controlled trial to investigate the safety and efficacy of IN in patients with UC. We performed a multicenter, double-blind trial evaluating the safety of 86 patients in Japan with active UC (Mayo scores of 6 or more), enrolled from March 30 through December 27, 2016. Patients were randomly assigned to groups and given a daily dose of 0.5, 1.0, or 2.0 g IN or placebo (1:1:1:1 ratio) for 8 weeks. The primary endpoint was the rate of clinical response at week 8, defined as a 3-point decrease in the Mayo score and a decrease of at least 30% from baseline, with a decrease of at least 1point for the rectal bleeding subscore or absolute rectal bleeding score of 0-1. The main secondary endpoint was the rate of clinical remission at week 8, defined as a Mayo score or ≤2 and no subscores with avalue >1. Mucosal healing was also assessed at week8. The trial was terminated because of an external reason: a report of pulmonary arterial hypertension in a patient who used self-purchased IN for 6months. In the intent-to-treat analysis, we observed a significant, dose-dependent linear trend in proportions of patients with clinical responses (13.6% with a clinical response to placebo; 69.6% to 0.5 g IN; 75.0% to 1.0g IN; and 81.0% to 2.0 gIN) (Cochran-Armitage trend test P<.0001 compared with placebo). Proportions of patients in clinical remission at week 8 were significantly higher in the 1.0 g IN group (55.0%, P=.0004) and the 2.0 g IN group (38.1%, (P=.0093) than in the placebo group (4.5%). Proportions of patients with mucosal healing were 13.6% in the placebo group, 56.5% in the 0.5 g IN group, 60.0% in the 1.0 g IN group, and 47.6% inthe 2.0 g IN group (P = .0278 compared with placebo). Although mild liver dysfunction was observed in 10 patients who received IN, no serious adverse events were observed. In a randomized, placebo-controlled trial, wefound 8 weeks of IN (0.5-2.0 g per day) to be effective ininducing a clinical response in patients with UC. However, IN should not yet be used because of the potential for adverseeffects, including pulmonary arterial hypertension. Clinical Trials Registry no: UMIN000021439 (http://www.umin.ac.jp/ctr/).

Maternal syphilis and accomplishing sexual partner treatment: still a huge gap.

Congenital syphilis (CS) is a preventable epidemic disease for which control is hindered by socioeconomic and health system issues. Inadequately treated maternal syphilis (MaS) commonly has serious adverse obstetric outcomes. This study - which is a cross-sectional study in a Brazilian large urban public Mother and Child hospital, making use of secondary data - evaluated the occurrence of treatment of sexual partners (SP) among women with MaS. The results showed that 771 MaS cases were identified from 2007 to 2014. No information on SP treatment was available in 570 (73.9%) cases. Of the 201 cases presenting information, 25 (12.4%) SP were treated. Out of 164 women having six or more prenatal visits, 25 (15.2%) SP received treatment. Data analyzed biennially have shown a growing trend of cases without collected information, ranging from 27.2% in 2007-2008 to 87.5% in 2013-2014. No linear trend in proportions of treated SP (maximum 7.4% SP treated) was found. Thus, in this study, it has been concluded that the proportion of SP adequately treated was consistently low, and the quality of information deteriorated during the studied period. Prenatal care per se, as provided, was not effective in delivering adequate treatment of SP. Creative integrated services with SP active participation are greatly needed if CS is to be controlled.

High-risk alcohol use and anxiety and depression symptoms in adolescents and adults with type 1 diabetes mellitus: a cross-sectional study.

BackgroundThe medical literature shows that alcohol consumption is common among diabetic individuals and is associated with poor adherence to treatment, resulting in increased morbidity and mortality. However, no study has assessed the association between high-risk alcohol consumption and the presence of anxiety and depression in individuals with type 1 diabetes mellitus (1DM).MethodsThe present cross-sectional study was conducted in Uberlândia, Brazil, and it assessed 209 outpatients in relation to alcohol consumption and the presence of anxiety and depression symptoms, using the Alcohol Use Disorders Identification Test (AUDIT), the Hospital Anxiety and Depression (HAD) scale, and glycemic control, according to the levels of glycated hemoglobin (HbA1c). The chi-square test and logistic regression analysis were used to investigate the association between the investigated variables.ResultsThe prevalence of high-risk alcohol consumption (AUDIT ≥ 8) among individuals with 1DM was high, specifically 24.9% among the entire group of subjects, 12.9% among the adolescents, 14.7% among the females, and 34.6% among the males. In comparisons based on gender and age, the odds of high-risk drinking were higher among males and participants aged 30 to 40 years (33.9%). The frequency of high-risk alcohol consumption did not differ as a function of gender among adolescents (females: 9.0%, males: 16.2%; p = 0.374). There was a linear trend in proportions related to the scores of anxiety and depression symptoms with high-risk alcohol consumption scores, indicating the association of these variables (p = 0.0229 and p = 0.0262, respectively). Moreover, the odds of female subjects exhibiting anxiety and depression symptoms were higher (odds ratio – OR: 4.4 and OR: 7.4, respectively). Glycemic control did not exhibit an association between high-risk alcohol consumption and the presence of anxiety and depression symptoms.ConclusionsThe frequency of high-risk drinking increased along with age and was greater among males; however, this frequency did not exhibit differences in terms of gender among adolescents. There was a positive association between high risk alcohol consumption and anxiety and depression symptoms, although glycemic control was inadequate in most of the sample independent of alcohol consumption and the presence of anxiety and depression symptoms.

Tendencias de la prevalencia del VIH y de las conductas de riesgo asociadas en mujeres trabajadoras del sexo en Cataluña

ObjectivesTo describe trends in HIV prevalence, sexual risk behaviors and other sexual health indicators in female sex workers (SW) from 2005 to 2011. MethodsCross-sectional studies were conducted biennially among SW recruited in Catalonia (Spain) in the street, flats and clubs (n = 400). In addition to an anonymous questionnaire, oral fluid samples were collected to estimate HIV prevalence. Linear trends in proportions were assessed by the Mantel test. ResultsThe percentage of SW who used condoms inconsistently with clients (past 6 months) increased from 5.1% in 2005 to 9.9% in 2011 (p = 0.005); this percentage also increased with steady partners (86.2% in 2005 to 94.4% in 2011, p = 0.002). The prevalence of self-reported sexually transmitted infections (STI) increased from 14% in 2005 to 20.6% in 2011 (p = 0.001). The prevalence of HIV held constant over the years (about 2%), being higher in Spanish women (14.7% in 2011). DiscussionThe prevalence of HIV in SW remained stable over the years, being higher in Spanish SW. The increase in unprotected sex and in the prevalence of self-reported STI among SW from 2005 to 2011 highlights a possible relaxation in preventive behaviors in this group. Interventions to reduce the transmission of these infections, as well as unwanted pregnancies, should continue in Catalonia in SW.

European Judo Championships: impact of the new rule changes on points and penalties

In 2013 the International Judo Federation started to test new rules to judo competitions with the objective of make judo more attractive for the general public and to promote which has been denominated “positive judo”, i.e., a more combative style. The aim of the present investigation was to compare two consecutive European Judo Championships (2012 and 2013, i.e., before and after the rule changes, respectively) in terms of scores and penalties. Statistics involved chi-square, analysis for linear trends in proportions and odds-ratio (OR), using 5% as significance level. The rules changes resulted in the increase of penalties and in the decrease of waza-ari (males, χ2=8.76, P=0.003, OR=0.55; females, χ2=3.79, P=0.050, OR=0.61) and yuko (males, χ2=38.93, P<0.001, OR=0.31; females, χ2=6.84, P=0.009, OR=0.56) scores for both males and females, while increasing ippon only for males (χ2=5.03, P=0.025). The total number of shido also increased for both groups (males, χ2=14.21, P<0.001, OR=1.53; females, χ2=6.63, P=0.010, OR=1.43), while the prevalence of hansoku-make increased only for males (χ2=5.78, P=0.016, OR=8.43). Thus, the rules change did not achieve the goal established of increasing scores and decreasing penalties.

A Test of Non Null Hypothesis for Linear Trends in Proportions

Usual tests for trends stand under null hypothesis. This article presents a test of non null hypothesis for linear trends in proportions. A weighted least squares method is used to estimate the regression coefficient of proportions. A non null hypothesis is defined as its expectation equal to a prescribed regression coefficient margin. Its variance is used to construct an equation of basic relationship for linear trends in proportions along the asymptotic normal method. Then follow derivations for the sample size formula, the power function, and the test statistic. The expected power is obtained from the power function and the observed power is exhibited by Monte Carlo method. It reduces to the classical test for linear trends in proportions on setting the margin equal to zero. The agreement between the expected and the observed power is excellent. It is the non null hypothesis test matched with the classical test and can be applied to assess the clinical significance of trends among several proportions. By contrast, the classical test is restricted in testing the statistical significance. A set of data from a website is used to illustrate the methodology.

HIV Seroprevalence Among Surgical Specialty Outpatients at a Teaching Hospital

Background: HIV infection rate is higher in densely populated and heavily industrialized communities like Kano. The risk of transmission of the infection from patients to health workers, and from mother to child is very high among antenatal women and surgical patients if their HIV status is not known, because of the higher probability of breaching the universal precautions. Objective: To determine the sero-prevalence of Human Immunodeficiency Virus (HIV) infection among Surgical Specialty outpatients Clinic attendees (Antenatal and Surgical Outpatient Clinics) Methodology: A prospective observational study of all the clinic attendees who consented to be included in this study between January and December 2004 was carried out at Aminu Kano Teaching Hospital, Kano, Nigeria. The clinic attendees had pre-test counseling, followed by voluntary testing and post test counseling for those who were sero-positive and negative. The data obtained were analyzed using chi-square test, and analysis for linear trend in proportions was done using chi-square test for linear trend. Odds ratio and 95% Confidence Interval were determined where appropriate. Results: The sero-prevalence of HIV infection among the clinic attendees that were screened was 37.5%. There was higher prevalence of the infection among the low socio-economic class (X2trend= 53.028, P= 0.0000). The prevalence of the infection increased with increasing age up to 50 years, and thereafter decreased with increasing age (X2trend = 8.597, P= 0.00337). Ambulatory status (OR= 0.78, CI= 0.60-1.01, P &gt; 0.05), and sex (OR= 1.01, CI= 0.80- 1.28, P &gt; 0.05) of the patients did not show statistically significant difference in the prevalence of the infection. Conclusion: The high prevalence of HIV infection among the clinic attendees that were screened, call for mandatory screening of all antenatal and surgical patients, especially before a procedure is carried out.Key words: HIV sero-prevalence, surgical specialty outpatients, ELISA,

Asymptomatic Bacteriuria in Pregnancy: Much Ado about Nothing?

Objectives: To determine the incidence, influence of socio-demographic characteristics and trimesters on the incidence and pattern of bacterial infection at Aminu Kano Teaching Hospital, Kano, Nigeria. Patients and Methods: This cohort study of asymptomatic bacteriuria among antenatal women was carried out between 1st January 2006 and 31st December 2006. The study variables of interest were the incidence and socio-demographic characteristics of the women that were followed up, incidence of asymptomatic bacteriuria in the three trimesters, and pattern of bacterial infection. The results obtained were recorded using tables and pie chart. Chi-square test and analysis for linear trend in proportions were used to determine association between qualitative variables, and a P-value of less than 0.05 was considered significant. Results: The incidence of asymptomatic bacteriuria among the recruited pregnant women was 8.0%. Escherichia coli (E coli) and Klebsiella were the commonest microbial organisms that were isolated. Age (X2 trend= 94.91, P < 0.05), parity (X2 trend= 21.28, P

Reducing Adverse Self-Medication Behaviors in Older Adults with Hypertension: Results of an e-health Clinical Efficacy Trial.

A randomized controlled efficacy trial targeting older adults with hypertension (age 60 and over) provided an e-health, tailored intervention with the “next generation” of the Personal Education Program (PEP-NG). Eleven primary care practices with advanced practice registered nurse (APRN) providers participated. Participants (N = 160) were randomly assigned by the PEP-NG (accessed via a wireless touchscreen tablet computer) to either control (entailing data collection and four routine APRN visits) or tailored intervention (involving PEP-NG intervention and four focused APRN visits) group. Compared to patients in the control group, patients receiving the PEP-NG e-health intervention achieved significant increases in both self-medication knowledge and self-efficacy measures, with large effect sizes. Among patients not at BP targets upon entry to the study, therapy intensification in controls (increased antihypertensive dose and/or an additional antihypertensive) was significant (p = .001) with an odds ratio of 21.27 in the control compared to the intervention group. Among patients not at BP targets on visit 1, there was a significant declining linear trend in proportion of the intervention group taking NSAIDs 21–31 days/month (p = 0.008). Satisfaction with the PEP-NG and the APRN provider relationship was high in both groups. These results suggest that the PEP-NG e-health intervention in primary care practices is effective in increasing knowledge and self-efficacy, as well as improving behavior regarding adverse self-medication practices among older adults with hypertension.

Incremento en la prevalencia del VIH y en las conductas de riesgo asociadas en hombres que tienen sexo con hombres: 12 años de encuestas de vigilancia conductual en Cataluña

Objectives To describe trends in HIV prevalence, in risk behaviors associated with HIV transmission, and in knowledge and attitudes related to antiretroviral therapy (ART) among men who have sex with men (MSM) recruited in Catalonia between 1995 and 2006. Methods Biannual cross-sectional surveys were performed. An opportunistic sample of MSM was recruited in saunas, sex shops, bars and a cruising site in a public park. In addition, an anonymous self-administered questionnaire was sent by mail to all members of a gay and lesbian association (Coordinadora Gai-Lesbiana). Oral fluid samples were collected to determine HIV prevalence. Linear trends in proportions were assessed by the χ 2 test, stratified by age. Results The overall prevalence of HIV infection increased from 8.5% (1995) to 14.1% (2006) among men aged less than 30 years old ( p=0.162) and from 18.2% (1995) to 21.2% (2006) among those aged 30 years old or more ( p=0.07). Consistent condom use in anal intercourse with occasional partners decreased from 72.9% to 58.7% in men aged less than 30 years old ( p <0.05) and from 77.2% to 65.6% in those aged 30 years old or more ( p<0.001). The proportion of men who reported they chose riskier behaviors because of ART increased from 9.2% to 19.4% in men aged less than 30 years old and from 8.3% to 16.7% in those aged 30 years old or more ( p<0.05). Conclusions An increasing trend in the prevalence of HIV and associated risk behaviors was found in Catalonia among MSM. Therefore, preventive programs targeting this population should be intensified and should include new risk reduction strategies, as well as other educational messages about ART.

So Many Correlated Tests, So Little Time! Rapid Adjustment of P Values for Multiple Correlated Tests

Contemporary genetic association studies may test hundreds of thousands of genetic variants for association, often with multiple binary and continuous traits or under more than one model of inheritance. Many of these association tests may be correlated with one another because of linkage disequilibrium between nearby markers and correlation between traits and models. Permutation tests and simulation-based methods are often employed to adjust groups of correlated tests for multiple testing, since conventional methods such as Bonferroni correction are overly conservative when tests are correlated. We present here a method of computing P values adjusted for correlated tests (P(ACT)) that attains the accuracy of permutation or simulation-based tests in much less computation time, and we show that our method applies to many common association tests that are based on multiple traits, markers, and genetic models. Simulation demonstrates that P(ACT) attains the power of permutation testing and provides a valid adjustment for hundreds of correlated association tests. In data analyzed as part of the Finland-United States Investigation of NIDDM Genetics (FUSION) study, we observe a near one-to-one relationship (r(2)>.999) between P(ACT) and the corresponding permutation-based P values, achieving the same precision as permutation testing but thousands of times faster.

Turnover of passerine birds on islands in the Aegean Sea (Greece)

AbstractAim We wish to determine the effect of migratory status on turnover rates in island birds. Because turnover is influenced by factors other than migratory status, we also considered the influence of body size and physical characteristics of the islands inhabited on the probabilities of extinction and immigration.Location The Mediterranean islands of Delos, Astypalea, Paros, Naxos and Lesvos in the Aegean Sea, Greece.Methods The passerine birds of these islands were surveyed between 1954 and 1961 by G.E. Watson, and were resurveyed between 1988 and 1992. The effects of migratory status and body size on the probabilities of extinction and immigration were examined by G‐tests of linear trend in proportion, and analysis of variance, respectively. A combined analysis of migratory status, body size and physical characteristics of the islands was carried out using logistic regressions of the probabilities of extinction and immigration on these factors.Results Species number on each island changed little between surveys, with no island's species number changing by more than one species. Twelve population extinctions and 11 immigrations were recorded. The smallest island, Delos (6 km2), had the highest annualized relative turnover rate (1.08), while the four larger islands (96–1614 km2) had lower and mutually similar rates (0.21–0.27). Populations on higher elevation islands were less likely to go extinct. There is no evidence for an effect of body size on the probabilities of extinction or immigration. Migratory status affected extinction and immigration probabilities differently: migratory species were more likely to immigrate, but less likely to go extinct.Main conclusions The position of the Aegean islands along a major north–south flyway may account for the observed effects of migratory status. The annual passage of large numbers of migrants may, via the rescue effect, decrease the chances of extinction, while at the same time increasing the chances of colonization of unoccupied islands. The likelihood of both extinction and immigration involves a complex interaction between life‐history traits and island characteristics. The effects of migratory status will depend not only on consideration of vagility, vulnerability and stochasticity identified by previous authors, but also upon the location of the islands in relationship to migratory pathways.

Long-term follow-up of renal transplantation in children: a Dutch cohort study.

Few data exist on long-term morbidity, overall survival, and graft survival of pediatric renal transplantation. The authors performed a long-term cohort study in all Dutch patients, born before 1979, with onset of end-stage renal disease (ESRD) between 1972 and 1992 at age 0 to 15 years. Data on graft survival and determinants of outcome were obtained by reviewing all medical charts. The health status was assessed by cross-sectional examination of surviving patients. Three hundred ninety-seven transplantations were performed in 231 of all 249 patients, of whom 25 died with a functioning graft. Cardiovascular disease was the most prominent cause of death. Graft survival estimates for all transplantations were 59.2%, 45.3%, 35.4%, and 30.3% at 5, 10, 15, and 20 years, respectively. In comparison with azathioprine, cyclosporine as the immunosuppressant was associated with increased graft survival in retransplantations but not in first transplantations. Cross-sectional examination was performed on 110 patients. In 44 patients, the most recent graft survival exceeded 15 years. Co-morbidity was found in 40% of all patients; motor, hearing, or visual disabilities were found in 19%. Bone disease, headaches, itching, and tremors were the most reported disabling problems. Cyclosporine use was associated with hypertension and a history of epilepsy. Compared with all age-matched Dutch inhabitants, the educational attainment was low, and unemployment and parental dependency were high. The authors' results emphasize the need for reducing cardiovascular disease and metabolic bone disease in pediatric ESRD, a policy toward less toxic antirejection therapy, a more strict treatment of hypertension, and more attention for schooling and social development toward independence.

Serological surveillance of measles in blood donors in Rio de Janeiro, Brazil.

To estimate the proportion of individuals seronegative for measles antibody among blood donors from a blood bank in the city of Rio de Janeiro, Brazil, and to describe their social and demographic characteristics, with the goal of exploring the potential use of plasma banks to supplement serological surveillance with relevant data in order to support the program of measles elimination in the city of Rio de Janeiro and elsewhere. Plasma samples from 1 101 consecutive blood donations made in November 2000 at HEMORIO, the largest blood bank in the state of Rio de Janeiro, were tested for measles immunoglobulin G, using a commercial enzyme immunoassay and a plaque reduction neutralization test. We calculated the proportion (and 95% confidence interval (CI)) of samples seronegative for measles antibody for the total sample of blood donors and also for subgroups categorized by age, sex, neighborhood of residence, education, and occupation. We used the chi-square test to assess the statistical significance of differences in proportions and linear trends in proportions. Of the total group of blood donors, 6.9% of them (95% CI: 5.4%-8.4%) were seronegative for measles. Women had a higher proportion (10.1%; 95% CI: 6.8%-13.4%) of seronegative results than did men (5.6%; 95% CI: 4.0%-7.2%). In terms of age, 86.8% of seronegative individuals were born between 1971 and 1982. Seronegativity was inversely proportional to age (chi-square = 58.0; P < 0.0001). With regard to occupation, students had the highest proportion of seronegative individuals (17.8%). In terms of education, most of the susceptible persons were in the categories of "incomplete university degree" or "incomplete high school." For the various areas of residence the proportions ranged from 2.1% to 11.4%. Blood bank plasma may constitute a useful and convenient source of complementary data for serological surveillance in adults of measles and other infections for which immunization and surveillance activities are implemented. This approach could be beneficial to other areas in Brazil and other countries where plasma from blood donors is available for surveillance. The use of residual sera from patients and plasma from blood donors represents a tradeoff between representativeness and timeliness as well as economy of resources.

Trends in Antibacterial Susceptibility of Mastitis Pathogens During a Seven-Year Period

Milk samples collected from dairy cattle suspected of having mastitis were submitted to the Microbiology Laboratory of the Animal Health Diagnostic Laboratory, Michigan State University, for bacteriologic culture. A total of 2778 isolates, from the years 1994 to 2000, were isolated, identified, and subjected to in vitro antimicrobial susceptibility testing using the disk diffusion method, in accordance with National Committee on Clinical Laboratory Standards (NCCLS) standards. Isolates included in this study were Streptococcus uberis, Streptococcus dysgalactiae, Streptococcus agalactiae, Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Serratia marcesens, and Pseudomonas aeruginosa. The proportion of bacterial isolates determined to be susceptible did not change during the 7-yr period for the majority of bacterial-antibacterial interactions tested. However, analysis for linear trend in proportions determined that there were increases in the proportion of S. aureus isolates that were susceptible to ampicillin, penicillin, and erythromycin. For Strep. uberis, increases in the proportion of susceptible isolates occurred for oxacillin, sulfa-trimethoprim, gentamicin and pirlimycin, and a decrease in the proportion of susceptible isolates occurred with penicillin. For Strep. dysgalactiae, increases in the proportion of susceptible isolates occurred with erythromycin, gentamicin, sulfa-trimethoprim, and tetracycline. For Strep. agalactiae, increases in the proportion of susceptible isolates occurred with sulfa-trimethoprim. Among E. coli isolates, there was an increase in the proportion that were susceptible to ampicillin and cephalothin. Among K. pneumoniae isolates, there was an increase in the proportion that were susceptible to ceftiofur. Overall, there was no indication of increased resistance Of mastitis isolates to antibacterials that are commonly Used in dairy cattle.