Erectile dysfunction is strongly linked with decreased libido in diabetic men

Erectile dysfunction frequently occurs with diabetes mellitus. A survey of diabetic men was conducted by anonymous questionnaire to investigate the associations of erectile dysfunction with various predictive factors. A total of 112 diabetic males without an obvious history of erectile dysfunction were available for analyses. The mean age and duration of diabetes were 53.7?±?12.2 years and 10.2?±?8.6 years (mean?±?standard deviation), respectively. The questionnaire included questions on the presence or absence of smoking, hypertension, libido and subjective symptoms of diabetic neuropathy that may be associated with erectile dysfunction. Analysis of the answers to the questionnaire revealed that 40% of the patients complained of erectile dysfunction (erection ‘always insufficient’). Erectile dysfunction was significantly correlated with age (p?=?0.005), but not with duration of diabetes (p?=?0.25), adjusted for age. Erectile dysfunction was also associated with sensory neuropathy and reduced libido, independently of age. The logistic regression analysis revealed that erectile dysfunction was positively associated with reduced libido and age. The odds ratio of erectile dysfunction for reduced compared to unreduced libido was 18.21, suggesting that psychogenic factors have a marked influence on erectile dysfunction. It is concluded that the presence of erectile dysfunction should be considered when symptoms related to diabetic neuropathy are observed; psychological approaches, such as sexual counseling, could be applied for the treatment of erectile dysfunction.     

Higher-order moments,cumulants and spectral densities of the NGINAR(1) process

The motivation for time series with geometric marginal distributions arises from noting that the Poisson distribution is not always suitable for the modeling and analysis of integer-valued time series. The NGINAR(1) process that has been introduced by Risti? et al. (2009) represents a class of such time series. Joint higher-order (factorial) moments and cumulants with some other related statistical measures of the NGINAR(1) process are constructed. Also, the spectral and bispectral density functions of this process are investigated, including their nonparametric estimators, using the multitapering method. A real data example of the nonparametric multitaper spectral estimates is investigated, with a discussion of the results obtained.     

Impact of Empowerment Training on the Professional Work of Family Peer Advocates

A pilot study using a prospective design examined the impact of a collaboratively developed training model, called the Parent Empowerment Program (PEP), for professionally-employed family peer advocates who work with caregivers of children with mental health needs. This training used a combination of didactic, practice exercises, and group discussion. It targeted specific mental health knowledge content and collaborative skills to facilitate the work of family peer advocates in empowering caregivers. Co-delivered by a family peer advocate and clinician, the training consisted of a 40-hour face-to-face training, followed by six monthly face-to-face booster sessions. A total of 15 advocates participated in assessments conducted at baseline and post-training. This group of experienced family peer advocates showed no significant increase in knowledge about mental health content, but post-training assessments indicated increased collaborative skills and mental health services self-efficacy. This initial evaluation has implications for expanding training and support for the emergent workforce of professionally-employed family peer advocates in children's mental health.     

Prediction based classification for longitudinal biomarkers

Assessment of circulating CD4 count change over time in HIV-infected subjects on antiretroviral therapy (ART) is a central component of disease monitoring. The increasing number of HIV-infected subjects starting therapy and the limited capacity to support CD4 count testing within resource-limited settings have fueled interest in identifying correlates of CD4 count change such as total lymphocyte count, among others. The application of modeling techniques will be essential to this endeavor due to the typically non-linear CD4 trajectory over time and the multiple input variables necessary for capturing CD4 variability. We propose a prediction based classification approach that involves first stage modeling and subsequent classification based on clinically meaningful thresholds. This approach draws on existing analytical methods described in the receiver operating characteristic curve literature while presenting an extension for handling a continuous outcome. Application of this method to an independent test sample results in greater than 98% positive predictive value for CD4 count change. The prediction algorithm is derived based on a cohort of n = 270 HIV-1 infected individuals from the Royal Free Hospital, London who were followed for up to three years from initiation of ART. A test sample comprised of n = 72 individuals from Philadelphia and followed for a similar length of time is used for validation. Results suggest that this approach may be a useful tool for prioritizing limited laboratory resources for CD4 testing after subjects start antiretroviral therapy.     

A closed loop automatic scheduling system (CLASS)

Abstract

CLASS is a production scheduling system, that is designed to function in either a stand-alone manner, or in conjunction with an MRP system. MRP systems innately do not have 'closed loop’ capability in the sense of being able to produce master schedules and order releases that are consistent and that respect capacity constraints. True closed loop performance requires detailed scheduling. In addition to interfacing with MRP systems, CLASS is designed to produce schedules that can be used in conventional shops or can be downloaded to automated facilities. The design goals for the system, its internal architecture, and its role in manufacturing control systems are described. The modelling and decision capabilities     

Competence and consent to research: A critique of the recommendations of the national bioethics advisory commission*

Concern about the participation of incompetent subjects in psychiatric research has grown in the last several years. In response, the National Bioethics Advisory Commission (NBAC) recommended in its recent report that all investigations involving persons with mental disorders that may be associated with cognitive impairment that may pose greater than minimal risk to subjects utilize independent assessors to verify the capacities of subjects prior to entry into the study. This recommendation poses several problems for the conduct of research and the protection of research subjects. First, it fails to target that group of subjects most likely to be at risk for incapacity. Second, it focuses on too broad a range of research projects, many of which pose little risk to participants. The substantial costs of this approach are therefore not likely to be outweighed by concomitant benefits. In place of the NBAC recommendation, the author proposes a more flexible system of capacity assessment, designed to balance the costs with a greater likelihood of achieving meaningful protection for research subjects with mental disorders.     

A modified subset selection formulation with special reference to one-way and two-way layout experiments

The usual formulation of subset selection due to Gupta (1956) requires a minimum guaranteed probability of a correct selection. The modified formulation of the present paper includes an additional requirement that the expected number of the nonbest populations be bounded above by a specified constant when the best and the next best populations are ‘sufficiently’ apart. A class of procedures is defined and the determination of the minimum sample size required is discussed. The specific problems discussed for normal populations include selection in terms of means and variances, and selection in terms of treatment effects in a two-way layout.