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COG-320 - IBM Cognos Xcelerator and Advisor V.9 - Dump Information
Vendor | : | IBM |
Exam Code | : | COG-320 |
Exam Name | : | IBM Cognos Xcelerator and Advisor V.9 |
Questions and Answers | : | 180 Q & A |
Updated On | : | November 10, 2017 |
PDF Download Mirror | : | COG-320 Brain Dump |
Get Full Version | : | Pass4sure COG-320 Full Version |
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Answer: A
QUESTION: 173
When using Xcelerator, in which order are calculations performed in rules?
- Addition, Subtraction, Division, Multiplication, Exponentiation
- Addition, Subtraction, Exponentiation, Multiplication, Division
- Multiplication, Division, Addition, Subtraction, Exponentiation
- Exponentiation, Multiplication, Division, Addition, Subtraction
Answer: D
QUESTION: 174
Which
statement is used to force the TM1 consolidation engine to
always use the sparse consolidation engine in Xcelerator?
- FEEDERS
- STET
- CONTINUE
- SKIPCHECK
Answer: D
QUESTION: 175
A drill process is one of two main components of drill -through in Xcelerator. What is the other component of drill-through?
- drill folder
- query
- drill assignment rule
- cube reference Answer: C QUESTION: 176
Which
Turbo Integrator procedure, within the Advanced tab, may consist of a
series of actions that are to be executed before the data source is
processed in Xcelerator?
- epilog
- prolog
- parameters
- metadata
Answer: B
QUESTION: 177
When no qualifier is used in a rule, to which two types of elements does Xcelerator assume the rule applies? (Choose two.)
- leaf
- consolidation
- string
- text
Answer: A, B
QUESTION: 178
Which three characteristics are true when describing chores in Xcelerator? (Choose three.)
- You must select the process for which you want to create a chore.
- Chores can only be scheduled to execute twice a day.
- You must define the intervals at which the chore is executed.
- Once a chore is created it cannot be edited; you must re -create the chore in order to modify it.
- Chores will not be activated unless the Activate Chore box is checked.
Answer: A, C, E
QUESTION: 179
What are two reasons for building a cube in Xcelerator? (Choose two.)
- You want to conduct multi-dimensional analysis of your data.
- You want to collect data from various members of staff.
- You want a structure to replace a transactional database.
- You want to be able to create complex formatted reports for board members.
Answer: A, B
QUESTION: 180
It
is recommended that you develop a naming convention for your cubes to
make maintenance and expansion of your model easier. Which statement is
true regarding the order that cubes are displayed in Xcelerator?
- Cubes are displayed in the order that they are created.
- Cubes are displayed in alphabetical order.
- Cubes can be arranged into any order that is required.
- Cubes should always be prefixed with a number for correct ordering.
Answer: B
IBM COG-320 Exam (IBM Cognos Xcelerator and Advisor V.9) Detailed Information
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IBM COG-320
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MRI as a Biomarker of sickness development in a Therapeutic Trial of Milameline for ad Neurology. author manuscript; obtainable in PMC 2009 Sep 16.
published in last edited kind as:
PMCID: PMC2745302
NIHMSID: NIHMS136225
C. R. Jack, Jr., M.D., M. Slomkowski, Pharm.D., S. Gracon, D.V.M., T. M. Hoover, Ph.D., J. P. Felmlee, Ph.D., ok. Stewart, B.S., Y. Xu, M.D., Ph.D., M. Shiung, B.A., P. C. O'Brien, Ph.D., R. Cha, M.S., D. Knopman, M.D., and R. C. Petersen, Ph.D. M.D. Departments of Diagnostic Radiology (CRJ, YCX, JPF, YCX, KS, MS), Neurology (DK, RCP), and Biostatistics (PCO, RC) Mayo clinic and groundwork, 200 First street SW, Rochester, MN 55905. Pharmaceutical analysis (MS, SG, TMH) Parke-Davis (Pfizer), 2800 Plymouth road, Ann Arbor, MI 48105
Corresponding author: Clifford R. Jack Jr., M.D. Mayo medical institution Diagnostic Radiology 200 First street SW Rochester, MN 55905 cellphone: 507-284-8548 FAX: 507-284-2405 ; e mail: ude.oyam@droffilc.kcaj The publisher's last edited edition of this text is available at Neurology See different articles in PMC that cite the posted article. summary purpose
To investigate the feasibility of the
usage of magnetic resonance imaging (MRI) measurements as a surrogate
conclusion point for sickness progression in a therapeutic trial for
Alzheimer's disease (advert).
methods
Three-hundred-sixty-two sufferers with
possibly ad from 38 diverse centers participated in the MRI element of a
52 week randomized placebo controlled trial of milameline, a muscarinic
receptor agonist. The therapeutic trial itself become not achieved as a
result of projected lack of efficacy on intervening time analysis;
despite the fact, the MRI arm of the analyze changed into endured. Of
the 362 topics who underwent a baseline MRI analyze, 192 topics
underwent a second MRI one-year later. Hippocampal volume and temporal
horn quantity have been measured from the MRI scans.
outcomes
The annualized % trade in hippocampal
quantity (−four.9%) and temporal horn quantity (sixteen.1%) in the
analyze sufferers had been in step with statistics from prior single web
site experiences. Correlations between the rate of MRI volumetric trade
and alter in behavioral/cognitive measures were stronger for the
temporal horn than for the hippocampus. Decline over time changed into
greater constantly viewed with imaging measures, 99% of the time for the
hippocampus, than behavioral/cognitive measures (p<0.001). more
advantageous consistency in MRI than behavioral/medical measures
resulted in markedly reduce estimated pattern size necessities for
clinical trials. The estimated variety of topics per arm required to
discover a 50% reduction within the fee of decline over twelve months
are: ADAS-Cog 320; MMSE 241; hippocampal volume 21; temporal horn extent
fifty-4.
Conclusion
The consistency of MRI measurements
obtained across sites, and the consistency between the multi-web page
milameline records and that bought in prior single web site reports,
exhibit the technical feasibility of the use of structural MRI measures
as a surrogate conclusion point of disease development in therapeutic
trials. besides the fact that children, validation of imaging as a
biomarker of therapeutic efficacy in ad still awaits a positive trial.
The fundamental result measurements for
therapeutic trials in Alzheimer's disease (advert) patients are
behavioral or cognitive. as a result of the inherent look at
various-retest variability in such measurements although, alternate
options were sought. Magnetic resonance imaging (MRI) measurements of
prices of entire mind or hippocampal atrophy had been, and are at the
moment getting used as influence measures in several therapeutic trials
for advert. although imaging has been utilized in medical trials on
advert and vascular sickness for diagnostic functions, to our knowledge,
no publication has regarded describing the MRI consequences of a
therapeutic trial wherein structural MRI turned into used as an outcomes
measure. MRI measures had been introduced to this trial to profit a
claim for results on disease development as adverse to just symptomatic
medicine in those situations the place medication impact was shown on
the behavioral/cognitive measures 1-7.
We document the MRI results of a therapeutic trial
of milameline, a centrally energetic muscarinic agonist. The therapeutic
goal turned into augmentation of the diminished cholinergic
characteristic attribute in ad eight,9. The therapeutic trial was no
longer completed as a result of a projected lack of efficacy on meantime
analysis. besides the fact that children, the MRI arm of the analyze
was persevered to be able to bring together records for reference
purposes. The aim of this manuscript therefore is not to report on the
scientific outcome of the therapeutic trial itself, but fairly the MRI
component of the trial to be able to illuminate methodologic issues, doc
feasibility, and function a tenet for future experiences the use of MRI
as an result measure. Demonstrating that the MR graphic records
obtained in this trial from numerous sites have been each internally
consistent and in line with reviews in prior single web site reports, we
trust documents the technical feasibility of the use of MRI as an
outcome measure of ailment development in therapeutic trials for
neurodegenerative illnesses.
strategies
look at Design
The study COG-320 become a fifty
two-week randomized double blind placebo controlled parallel
neighborhood multicenter trial of milameline, a muscarinic receptor
agonist. All sufferers were titrated as much as the highest tolerated
every day dose with a ceiling of 4mg/day. medical followup was at months
one, three, six, and twelve. The primary outcomes measure was the
Alzheimer's ailment assessment Scale-Cognitive sub-scale (ADAS-Cog). a
couple of secondary effect measures were employed including the
Mini-intellectual State examination (MMSE), world Deterioration Scale
(GDS), and MRI measurements of the fees of atrophy of the hippocampi,
and the fees of enlargement of the temporal horns10.
sufferers
All patients had probably ad of mild to
moderate severity and were stronger than 50 years historic. MMSE ratings
have been 10-27, inclusive. sufferers have been excluded for evidence
of great cerebral vascular sickness, non-ad dementia, essential
psychiatric problems, major or unstable scientific situations, seizure
ailment, Parkinson's sickness, substance abuse, principal head trauma,
or tumor.
planned enrollment turned into a complete of
450 topics; all from US websites with a normal of ten topics (latitude
10-15 highest) from each of 45 websites. The planned look at duration
became from June 1996 to December 1998.
MRI
so as to keep away from difficulties
linked to MRI company's proprietary information acquisition and storage
protocols, handiest these websites with a regular electric MR Imager
have been asked to sign up sufferers in the MRI element of the trial.
The genuine hardware and utility configuration of scanners at diverse
sites distinctive. All scanners had been 1.5T aside from a single web
page at 0.5T.
The particular person imaging sequences in the examination protocol were:
every site went via an preliminary qualifying part ahead of
scanning sufferers for the trial. The qualifying part had two
accessories. First, each site was required to function the heart beat
sequences distinct for the imaging protocol, film the examination, and
send the films to the principal analysis web site on the Mayo health
center. the pulse sequence parameters have been checked at the important
analysis web site to insure that each collaborating website could
execute the targeted imaging sequences as it should be. second, the
scanner on which study COG-320 patients could be imaged at each and
every web site underwent a top quality manage comparison. with a purpose
to start study COG-320ing sufferers, sign to noise ratio (SNR) and
geometric distortion analyses ought to had been achieved and evaluated
at the relevant web site, and should have fallen inside predetermined
necessities.
SNR and geometric distortion measurements had been made on
the designated scanner at every site both throughout the qualification
part, and all through the trial on a monthly groundwork. every web page
carried out and submitted to the crucial image analysis web page an
axial spin echo and sagittal, coronal, and axial gradient echo
acquisitions that have been especially designed to consider SNR and
geometric distortion. The fine manage (QC) imaging protocol changed into
about 15 minutes in duration, and become finished with a standardized
QC phantom provided through the brand. The phantom contained spatially
uniform regions where SNR measurements have been got and additionally
contained fiducial markers which have been used to examine geometric
distortion11. The statistics from the QC MR protocol turned into
transmitted to Mayo, where an ongoing checklist of SNR, image artifacts,
RF energy, and geometric distortion along all three axes turned into
kept for each scanner all the way through the period of the trial.
All graphic facts (each sufferers’ imaging
statistics and phantom QC imaging records) become sent with the aid of
both tape or disc to Mayo and archived electronically. For each and
every affected person the entire intracranial volume changed into
measured from the sagittal T1 sequence. The volumes of the appropriate
and left hippocampi and temporal horns were measured in line with in the
past described criteria 6,12,13 on the 3D SPGR sequence. the entire
measurements were accomplished at Mayo through a single individual over
two years. Intra-rater co-productive of version for serial hippocampal
measurements has been documented at 0.28% 6. The particular person
performing the MR graphic analyses was blinded to all scientific tips
including the middle and the scan date – ie whether each and every scan
turned into the 1st or 2nd in the pair. The order of first and 2d scans
changed into randomized.
MRI statistics analysis
changes of uncooked Hippocampal extent for complete Intracranial quantity
The uncooked hippocampal volumes in each
and every area were adjusted first via complete intracranial quantity
(TIV) after which 2d by using referencing the TIV adjusted uncooked
hippocampal extent in that area to age and gender particular percentile
values in a normal aged population13. Hippocampal volumes in cognitively
ordinary topics vary with head size, (individuals with higher TIV have
bigger hippocampi) and age (quantity declines with advancing age).
in order to identify the connection between hippocampal extent and
TIV in normals, free of the effect of growing old, the sagittal T1 and
coronal 3D SPGR pulse sequences had been carried out in seventy nine
younger topics between the age of 17 and forty five, who had been
documented to be free of neurologic sickness. the relationship between
hippocampus and TIV in these commonplace young individuals changed into
deduced the use of a regression evaluation of hippocampus on TIV. The
regression equations describing anticipated hippocampal volume as a
characteristic of measured TIV was derived one after the other for men
and women and are:the place H = uncooked unadjusted hippocampal quantity, and H’ = hippocampal quantity adjusted via TIV. From this statistics in young individuals we're able to assignment what the quantity of the hippocampi should still be for a given TIV in anybody unaffected by way of getting older.
Age and Gender particular aged Norms for TIV Adjusted Hippocampal extent
We next turned to hippocampal volumes
in standard elderly people. The sagittal and 3D SPGR pulse sequence had
been carried out in 181 usual elderly people (sixty one men and a
hundred and twenty women, suggest age eighty.four years, latitude 62-a
hundred years) as part of the continued scientific research protocols
within the Mayo medical institution Alzheimer's disease research core
(ADRC) and Alzheimer's sickness affected person Registry (ADPR). For
each and every of those standard elderly topics the TIV adjusted
hippocampal volume become computed in keeping with the relationship
between TIV and hippocampal volume that had been derived for the usual
younger cohort as described above. Age and gender certain normative
percentiles of this TIV adjusted hippocampal extent cost were then
computed for the regular aged cohort. The formulation for computing age
and gender certain normative percentiles for hippocampal volume changed
into identical to the method we now have in the past described 13, apart
from that here normative percentiles had been calculated in the elderly
topics for the TIV adjusted hippocampal extent.
Age and TIV Adjusted Hippocampal quantity in Milameline study COG-320 patients
The baseline hippocampal volumes in
the advert circumstances within the milameline analyze had been
expressed as W rankings, as we now have finished prior to now 13. The W
ranking corresponds to the percentile price in a typical standard
distribution. A W ranking of zero corresponds to the fiftieth percentile
of standard elderly individuals. A W rating of 1.645 corresponds to the
95th percentile of ordinary elderly individuals, and a W score of
−1.645 corresponds to the 5th percentile.
Serial MRI Measures in Milameline analyze sufferers
In every study COG-320 affected person
quantity measurements of the hippocampi have been acquired at two
diverse time elements. From these, the raw exchange in quantity (in
mm3), uncooked annualized change in mm3/yr, and annualized percent
alternate have been calculated. No relationship turned into discovered
between TIV and the rates of trade in hippocampal volume, and therefore
no TIV adjustment became needed6.
We didn't have measurements of temporal
horn quantity attainable in young normals, or old commonplace subjects.
because of this, adjustment of temporal horn volume for TIV, and the W
score components could not be developed for the temporal horn
measurements. We analyzed the annualized raw volumetric exchange, and
the annualized p.c change in temporal horn extent in a way just like
that described for the hippocampus.
Statistical evaluation
The variables of hobby within the
analyses were age, gender, training, ADAS-Cog score, MMSE, GDS, and MRI
volume variables. The MRI volume variables encompass raw facts in mm3
for the appropriate, left, and total hippocampus at baseline, W rating
of complete hippocampal volume at baseline, exchange in complete
hippocampal quantity, uncooked baseline temporal horn volumes, and
change in complete temporal horn quantity. Rank sum checks had been used
for skewed statistics, and two sample t exams had been used for
continually distributed information. Spearman correlation became used to
test for associations between MRI volume measurements and
behavioral/cognitive measures, training, gender, and age. Univariate and
multivariate modeling were used to check for associations between
baseline MRI volumes and both demographic and behavioral/cognitive
measures. Univariate and multivariate modeling had been used to check
for associations between change in MRI volumes and baseline MRI extent,
demographic, and behavioral/cognitive measures. Rank transformations
were used for all records within the multivariate modeling. one way
ANOVA was used to test for differences in baseline hippocampal W rating
between the distinctive facilities. The diploma to which serial
measures, imaging and behavioral/cognitive, declined perpetually over
time changed into compared the usage of the sign test.
pattern size calculations for scientific trials
because of the advantage hobby in the
usage of structural MRI as a biomarker of disorder progression in
scientific ad trials, we carried out pattern size calculations to become
aware of medicine effect in response to the annual alternate records in
MMSE, ADAS-Cog, hippocampus, and temporal horn (the GDS changed into
felt not to be a competitive metric). pattern measurement calculations
were in response to the belief of a 50% medication effect over three
hundred and sixty five days—i.e. a 50% discount within the exchange over
365 days in a handled vs. a placebo neighborhood. tests had been one
sided with vigour set at 90%.
consequences
Baseline Demographic, Behavioral/Cognitive, and MRI facts
Out of 453 topics enrolled within the drug
trial, 362 participated in the MRI component. evaluation of baseline
facts is limited to those topics (). amongst these 362 subjects, 188 had
been randomized to treatment and 174 to placebo. No ameliorations in
gender distribution (roughly 60% feminine), schooling,
behavioral/cognitive measures, or baseline MRI extent measures were
existing between the treated and placebo businesses.
Baseline Demographic, Cognitive, and MRI facts by means of treatment community
ladies had much less schooling, (p =0.001) and worse
baseline cognitive efficiency on the ADAS-Cog (p =0.02) and MMSE (p =
0.01). The raw appropriate, left, and total hippocampal (p<0.001) and
temporal horn (p <0.001) volumes have been larger in men than
ladies. There changed into a trend toward more suitable hippocampal
atrophy (lower W rating and typical percentile rating) in women than
guys, but this did not attain value.
The correct hippocampus become
approximately a hundred-200 mm3 (roughly 5%) better than the left in
each treated and placebo businesses. besides the fact that children, no
right-left transformations were current in any of the correlations
between hippocampal or temporal horn volume and baseline demographic or
behavioral/cognitive measures, nor had been correct-left differences
current in correlations between exchange in MRI volumes and change in
behavioral/cognitive measures. therefore, all subsequent analyses of MRI
extent measures are said for the overall (sum of correct plus left)
quantity instead of appropriate or left volumes one after the other.
Correlation among Baseline Hippocampal quantity, Demographic, and Behavioral/Cognitive Measures
The placebo and handled companies have
been mixed for baseline correlation analyses since the baseline MRI and
behavioral/cognitive measures had been completed earlier than medication
initiation. Univariate correlations between baseline hippocampal W
score, age, gender, training, ADAS-Cog, MMSE and GDS had been carried
out. No colossal correlations had been existing except for that between
hippocampal W score and age (r = 0.15, p = 0.004). A collection of
multivariate fashions had been constructed with efficiency on the
behavioral/cognitive measures listed above as the stylish variable, and
baseline hippocampal W ranking, age, gender, and schooling as unbiased
variables. none of the partial correlations between baseline hippocampal
W ranking and baseline behavioral/cognitive performance had been
gigantic.
Normative temporal horn measurements have
been now not available and consequently a equipment for adjusting raw
baseline temporal horn volumes of milameline analyze sufferers for age
and gender in normals changed into not feasible. We hence did not
examine correlations amongst baseline temporal horn extent, demographic,
and behavioral/cognitive measures.
changes from Baseline
All analyses of change (change in MRI
volumes and alter in behavioral/cognitive scores) are in response to the
192 topics who had both a baseline and a second MRI scan (). No
difference in annual exchange was existing between the handled and
placebo businesses in any of the behavioral/cognitive measures, nor for
both of the MRI quantity variables. For each of those variables, despite
the fact, the median annualized alternate changed into distinctive from
0 (p < 0.001, for all, signed rank examine). in addition, all
variables in changed within the anticipated path over time – ie.
behavioral/cognitive efficiency worsened, hippocampal volume decreased,
and temporal extent extended.
Annual trade from Baseline in Behavioral/Cognitive and MRI Variables
To assess how invariably imaging and
behavioral/cognitive measures declined over time, we computed the share
of individuals in whom the measures in declined. Decline become defined
as a decrease in hippocampal extent, a rise in temporal horn quantity, a
lower in MMSE score, and an increase in the GDS and ADAS-Cog ratings.
The volume of the hippocampus reduced in 99% of subjects whereas most
effective 60.4% of topics ADAS-Cog and 66.2% of topics’ MMSE scores
declined. In pair-wise comparisons, the percentage of decliners become
more desirable for the hippocampus than any of the behavioral/cognitive
measures or the temporal horn (p<0.001). The percentage of decliners
changed into additionally better for the temporal horn (eighty
five.four%) than for any of the behavioral/cognitive measures (p
<0.001).
pattern measurement calculations for scientific trials
there were two outliers in the MMSE
statistics. After deleting these values for functions of computing
sample size requirements, the MMSE and temporal horn statistics have
been not incredibly skewed and transformations of these information had
been no longer obligatory. For these variables, we computed the effect
size to be 50% of the observed mean annual expense. The hippocampus and
ADAS-cog were particularly skewed and transformations of these facts
have been needed. For these we computed the impact dimension after
transformation as follows: converted(median) - converted(.5xmedian).
For ADAS-cog, we first changed to Y’ = Y− min+1 (min =
−fifty nine.9), then used Y’*10−2, the place “min” refers back to the
minimum accompanied cost.
For hippocampus, Y’ is defined as above (min = −15.2), and we used Y’*102.
note that we are the usage of a 50%
reduction in mean rate of alternate the place transformations aren't
required and a 50% discount within the median rate of alternate the
place transformations are required. After deletion of both outliers from
the MMSE records, the imply annual percent trade turned into 10.7%
(19.9). The sample size required to discover a 50% discount during this
fee of exchange in a 12 months placebo managed trial with vigor of
ninety% (one-sided t verify on the .05 level) is 241 per arm. For
ADAS-Cognitive, the statistics were incredibly skewed with a median of
16.4% (the linked SD of the converted information became sixty five.4).
in an effort to become aware of of 50% discount, N=320 per arm are
crucial. For the hippocampus, the records had been once again extremely
skewed with a median of −4.9% (the linked SD of the changed records
become 2.1). in order to detect a 50% reduction, N=21 per arm are
essential. The information for the temporal horn had been now not
skewed, with mean sixteen.1% (SD14.1), and N=fifty four per arm are
crucial.
factors that have an impact on alternate in MRI extent
in an effort to examine whether
demographic variables or baseline MRI quantity influenced the annualized
trade in extent, a multivariate model changed into constructed with the
raw annualized change in hippocampal volume (mm3) because the elegant
variable, and with age, gender, schooling, and baseline hippocampal W
rating as unbiased variables. The slope (Beta), standard error, partial
Spearman's correlation, and associated p cost for each of the four
unbiased variables during this mannequin seem in . Baseline hippocampal W
ratings have been inversely associated with prices of hippocampal
atrophy (ie smaller hippocampi at baseline had been linked to enhanced
quantity loss over time). Age, gender, and schooling at baseline were no
longer associated with the annualized rate of hippocampal atrophy.
factors That impact exchange in MRI Volumes
similar modeling became carried out the use of the uncooked
annualized alternate in temporal horn extent (mm3) because the dependent
variable, and age, gender, training, and baseline temporal horn
quantity as predictor variables. as a result of W ratings had been not
purchasable for temporal horn measurements, the uncooked temporal horn
quantity in mm3 at baseline become used as the unbiased baseline extent
variable. more youthful age at baseline became associated with a greater
annualized exchange in temporal horn volume (i.e., a superior price of
atrophy). a bigger temporal horn extent at baseline become additionally
linked to a larger annualized trade in temporal horn quantity.
similar modeling changed into carried out
the usage of the raw annualized exchange in quantity (hippocampal and
temporal horn) as the based variable, and age, gender, education, and
baseline behavioral/cognitive variables as predictor variables. not one
of the baseline behavioral/cognitive variables had been associated with
the annualized exchange in hippocampal extent. ADAS-Cog became the only
baseline cognitive variable linked to the annualized change in temporal
horn volume (r = 0.38, p<0.001).
Correlation between MRI Volumes and change in Behavioral/Cognitive Measures
Univariate Analyses
To investigate the association between
trade in behavioral/cognitive efficiency and baseline hippocampal and
temporal horn extent, univariate analyses were carried out with the
annual percent alternate in every of the three behavioral/cognitive
measures as dependent variables and each baseline MR structure's extent
as the impartial variable. With one exception (MMSE exchange rating and
baseline temporal horn volume) none of these correlations were huge (
and ).
Correlation Between Annual percent exchange In Behavioral/Cognitive Variables and Hippocampal extent changeCorrelation Between Annual % alternate in Behavioral/Cognitive Variables and Temporal Horn volume alternate
To check the affiliation between exchange
in behavioral/cognitive performance and alter in hippocampal volume or
temporal horn quantity over the equal time duration, a series of
univariate analyses had been performed with the annualized p.c exchange
in each of the behavioral/cognitive measures as based variables, and the
annualized raw alternate in MR extent (mm3) as the unbiased variables.
None of those correlations were giant for hippocampal extent. alternate
in all three cognitive variables turned into associated with the annual
uncooked alternate of temporal horn extent ( and ).
Multivariate Analyses
Multivariate models had been then
developed, one for each and every of the three behavioral/cognitive
variables. In each and every mannequin, the annualized p.c alternate in
behavioral/cognitive performance become the dependent variable, and the
independent variables were age, gender, training, MRI quantity at
baseline, and the annualized uncooked alternate in MRI extent (mm3). For
baseline volumes, simplest baseline hippocampal W rating become big and
best with trade scores on the GDS.
In multi-variate modeling, enhanced
annualized trade in temporal horn extent (i.e. stronger price of
atrophy) changed into associated with a more advantageous trade (worse
cognitive performance) on all three behavioral/cognitive measures. In
distinction, annualized exchange in hippocampal volume become not linked
to exchange scores of any of the cognitive behavioral measures.
MRI best manage Measures
All 38 collaborating sites eventually met
qualifying standards from the standpoint of MRI fine control. despite
the fact, over the direction of the look at, effects of QC analysis
warranted site contact 19 times. most of the QC alerts took place all
through the one-month qualifying phase, which preceded genuine
enrollment of patients. the nature of the QC signals have been: gradient
coil error (i.e., geometric distortion), nine alerts at seven sites;
low SNR, five signals at four websites; noise strains, three indicators
at three websites; other, two alerts at two sites.
yet another measure of first-rate manage is
the consistency of measured volumes throughout sites. The mean
hippocampal W rating throughout all sites changed into −1.seventy eight
(SD 0.ninety seven). Hippocampal W rating did range amongst websites (a
method ANOVA, p = 0.04). We then used the pupil-Newman-Keuls distinctive
range check to do pairwise comparisons, and no pairwise difference
between websites became found. We estimated the add-ons of variance:
variance coming up from change among sites (VA) and variance coming up
from change amongst patients within websites (VW). there were VA − 0.04
and VW − 0.90, and the % of total variance (VT = VA + VW) as a result of
variability amongst sites changed into four.seventy one% (VA/VT*one
hundred%). Stepping down multivariate regression become used with
hippocampal W score as the dependent variable; age at MRI scan, female
gender, medicine, site, baseline ADAS-Cog rating, baseline MMSE rating,
and baseline GDS score because the independent variables. only 1 web
page was enormously distinct from the others during this analysis.
dialogue
an important aim of these analyses became
to validate the technical feasibility of using MRI as an influence
measure of disorder progression in multi-web page reports of
neurodegenerative disease. One measure of the validity of multicenter
facts, is the diploma to which it is concordant with equivalent facts
got from a single core or centers. Single center records is less likely
to be corrupted by means of technical non-uniformity than multicenter
statistics. in the milameline analyze patients, the appropriate
hippocampus turned into roughly 5% greater than the left. This identical
facet to aspect volume difference has been found many times in analyses
of normals and patient groups during the age spectrum by means of our
group and others and is a mirrored image of general right-left asymmetry
in hippocampal extent 12,14-20. The uncooked hippocampal and temporal
horn volumes within the milameline sufferers are in close agreement with
these values suggested up to now in ad subjects from our personal
middle 12,13. The standard hippocampal W score and corresponding
percentile rating of the milameline look at patients, third percentile
of commonplace controls, corresponds very carefully to the published W
rankings of light to moderately demented advert sufferers in our own
core 13.
The observed inverse correlation between uncooked
hippocampal extent and age is in keeping with our personal facts and
that of others for each advert patients and normals1,5,12,13,21,22. We
interpret the decline in hippocampal W rating with advancing age as an
impact of disease length. greater age should on usual correspond to more
suitable sickness period that in turn will correspond to smaller (more
atrophic) hippocampi. The adjustment for age in computing the W rating
correction handiest accounts for the effect of commonplace getting old
on hippocampal extent. It doesn't account for the impact of more
suitable disorder length in older advert sufferers (vs younger ad
sufferers). The proven fact that no correlations have been observed
between baseline hippocampal extent and international
behavioral/cognitive examine efficiency in the milameline look at topics
might also initially seem to be counter intuitive. youngsters, here's
in line with our previous event when radiologic-cognitive correlations
are constrained to a single medical neighborhood - as an example advert
sufferers simplest or ordinary topics only. We believe that the
inability of correlation during this circumstance is as a result of the
truncated range of values for both baseline hippocampal quantity and
cognitive performance. In past reports, when normals were mixed with
advert topics, thereby expanding the range of quantity and cognitive
efficiency values, tremendously significant correlations have been
current 23.
As indicated in , no treatment impact of milameline turned
into accompanied in the MRI statistics. This become an anticipated
discovering as a result of the lack of treatment efficacy accompanied on
period in-between analysis and sufferers randomized to medication had
discontinued the drug earlier than completing the entire 12-month course
when the 2nd MRI become acquired. The annualized rates of hippocampal
atrophy in the ad subjects in this trial on ordinary had been just
beneath 5%. here's just a little greater than the annualized fees of
hippocampal atrophy followed in our own neighborhood/referral advert
patients that had been just under 4%6,7. One believable cause of this
moderate change is that our group/referral based ad sufferers regular
around eighty years of age, whereas the standard age within the
milameline analyze turned into 74 years. It may well be that a younger
group of advert sufferers have a just a little extra aggressive medical
course, and hence a a little improved cost of atrophy.
it is going to be referred to that monstrous overlap in
atrophy fees exists between advert sufferers in the milameline look at
and cognitively normal aged topics from our own core 6. The latitude of
annualized % alternate rates in our common topics was −four.8% to 0.2%
for hippocampus, and −7.7% to 26.3% for temporal horn 6. the usage of
these values, 90/192 (forty seven%) of the milameline advert sufferers’
hippocampal quotes and 142/192 (seventy four%) of the milameline ad
sufferers’ temporal horn fees overlapped into the regular latitude.
The behavioral/cognitive and MRI measures in all modified
within the expected route over time. it really is, as
behavioral/cognitive efficiency worsened, hippocampal quantity declined,
and temporal horn quantity elevated. besides the fact that children,
decline turned into much greater constantly viewed with imaging,
specifically the hippocampus, than with behavioral/cognitive measures.
definitely whereas ninety nine% of subjects showed the anticipated
decline in hippocampal volume over time, simplest 60% worsened on the
ADAS-Cog and sixty six% on the MMSE and most effective 39% on the GDS.
consistent consequences and high verify re-check reproducibility are
desirable traits for an outcome measure in therapeutic trials, given
that the measure is delicate to the biologic points of activity. since
the drug trial itself became now not completed, these facts don't handle
no matter if MRI measures are stronger or worse than regular
cognitive/behavioral measures as an influence metric in therapeutic
trials. besides the fact that children, these records do display that
MRI measures greater at all times comply with the anticipated decline
because of sickness development, than standard behavioral/cognitive
measures obtained within the identical group of subjects over the same
duration of time.
Assuming a standard common of a 50% reduction within the fee
of decline over 12 months for all measures, the impact size
calculations point out that sample dimension required for scientific
trials should still be extensively smaller for the MRI measures vs these
commonly used clinical/psychometric measures. In apply, attrition would
need to be developed into sample size estimates, which we didn't do in
these calculations. additionally, one might argue that the annual price
of decline accompanied for every individual measure in cognitively
normal aged subjects should still be subtracted from the rate in ad
patients with a view to assess the fee of alternate due notably to
ailment progression and hence “attainable for therapeutic change”. We
did not build this into the impact size calculations either. finally,
the analyses were in accordance with a 50% reduction within the fee of
decline over one year, which may well be excessively confident.
youngsters, the goal of the analysis was to evaluate the measures
head-to-head using a typical standards in the identical community of
patents, and in these information, the MRI measures outperformed the
clinical/psychometric measures.
Smaller baseline hippocampal volume become linked to a
improved price of hippocampal atrophy. Older age changed into associated
with a more advantageous price of temporal horn enlargement. however,
the magnitude of each of those relationships became handiest modest,
with slopes of −0.15 and −0.19. the most amazing relationship in the
analyses in took place between baseline temporal horn extent and the
expense of temporal horn expansion. larger temporal horn volume at
baseline was linked to a superior price of temporal horn expansion, and
the magnitude of this relationship turned into gigantic with a slope of
0.53. It is not clear why patients with better atrophy at baseline
confirmed enhanced rates of atrophy over the direction of the study
COG-320, but it might be that baseline temporal horn quantity is a
trademark of these patients who've extra aggressive pathologic
development.
The absence of consistent correlation between the trade in
behavioral/cognitive measures and alter in hippocampal quantity changed
into sudden (). We anticipated to locate a powerful correlation between
worsening cognitive performance and superior prices of hippocampal
atrophy. One reason behind a failure to study COG-320 this kind of
correlation, other than noise within the statistics itself, rests with
truncation of the latitude of values in each charges of hippocampal
atrophy and in quotes of trade in cognitive performance in these
uniformly selected advert sufferers. It could even be authentic that in
sufferers with based advert, the most gigantic pathologic sickness
progression happens outside the hippocampus, and for this reason
hippocampal change measurements and cognitive/behavioral trade are
easily not strongly correlated. this suggests that dissimilar measures
should still be evaluated in future clinical trials, as the suggestions
supplied by using diverse imaging measures may well be orthogonal to
each one more.
on the outset, the principal emphasis became on hippocampal
volume with temporal horn extent representing a secondary MRI measure.
An sudden outcomes, therefore, become that basic correlations between
alternate in cognitive performance and alter in MRI volume have been
improved with the temporal horn than with the hippocampus (). however
modest in magnitude with slopes lower than 0.30, correlations had been
existing between rate of temporal horn enlargement and all
behavioral/cognitive measures (). all of the correlations had been in
the anticipated path, it is greater charges of temporal horn enlargement
corresponded to greater charges of behavioral/cognitive decline.
apparently, giant correlations have been most effective current in the
multivariate models, which managed for age, gender, training, and
baseline temporal horn extent. here's logical, as alternate in temporal
horn extent become particularly associated with baseline temporal horn
volume (). One viable explanation for this discrepancy between
accompanied correlations with the hippocampus vs the temporal horn, is
that of both measures, the temporal horn should still be extra sensitive
to cerebral atrophy backyard the medial temporal lobe24. Temporal horn
growth occurs no longer just with atrophy of the hippocampus however
additionally as a reflection of atrophy in different medial temporal
lobe limbic areas just like the entorhinal cortex as neatly because the
last temporal lobe including neocortical association areas. seeing that
all patients during this look at had been within the light to moderate
section of advert, all doubtless had pathologic involvement that
prolonged neatly beyond the hippocampus.
12 months temporal horn enlargementAnnual change in ADAS-Cog vs. temporal horn
regardless of established ongoing quality control classes at
each of the collaborating sites, 19 indicators have been triggered by
using undetected QC problems 11. We conclude from this event that
centrally orchestrated MRI QC surveillance is each possible and
imperative in a multi-site trial using MRI as outcome measure.
We compared baseline hippocampal W scores across centers to
examine the consistency of statistics acquire from numerous websites.
The proven fact that just one outlier changed into identified when
comparing baseline W scores across facilities, illustrates that MR
information will also be got at multiple websites and analyzed centrally
without obvious systematic blunders.
Most posted MRI studies were derived from a
single institution. We don't seem to be aware about any publications
that have validated the feasibility of multi-website acquisition and
imperative analysis of structural MRI facts as an result measure in an
ad therapeutic trial. there are lots of causes to suspect a priori that
mult-website MRI data might no longer be internally consistent --
ameliorations in scanner hardware, application, scanner QC maintenance
courses, and so forth. We trust the statistics supplied in this paper
validates the technical feasibility of the usage of MRI as an outcomes
measure of disorder progression in multi-middle ad therapeutic trials.
This look at does not, however, show that imaging measures represent
valid biomarkers of therapeutic efficacy. this could require a favorable
therapeutic trial that has included serial imaging measures in the
examine design.
Acknowledgments
Supported by Parke-Davis Corp.
Appendix: examine members
1. Geoffrey Ahern, M.D., Ph.D. The university of Arizona Tucson, AZ 85724-5023
2. Fred Allen, M.D. Carolina Neurological sanatorium, PA Charlotte, NC 28203
3. Piero Antuono, M.D. Froedtert Memorial Lutheran medical institution Milwaukee, WI 53226-3522
4. Jeff Apter, M.D. Princeton Biomedical analysis, PA
5. Stephen Asher, M.D. Anderson Plaza medical constructing Boise, id 83702-6130
6. Nancy Barbas, M.D. school of Michigan medical center Ann Arbor, MI 48109-0005
7. James Burke, M.D., Ph.D. Duke university clinical middle Durham, NC 27710-0001
eight. Gastone Celesia, M.D. Loyola tuition medical center
9. David J. Coffey, M.D. Dartmouth-Hitchcock clinical core
10. Cal Cohn, M.D. The Cohn center Psychiatry Houston, TX 77074
11. Kirk R. Daffner, M.D. Reisa Sperling, M.D. Brigham Behavioral Neurology neighborhood
12. Alan Dengiz, M.D. St. Joseph Mercy Hopsital Ann Arbor, MI 48106
13. David Drachman, M.D. tuition of Massachusetts scientific faculty
14. Barry Gordon, M.D., Ph.D. Johns Hopkins tuition
15. Neill Graff-Radford, M.D. Mayo health facility-Jacksonville
sixteen. Linda Hershey, M.D. BVAMC Buffalo, new york 14215
17. Marc Hertzman, M.D. Crain Towers Glen Burnie, MD 21061
18. Mustafa Husain, M.D. Southwestern scientific core Dallas, TX 75235-9070
19. William Jagust, M.D. UC Davis clinical middle
20. Jeffrey Kaye, M.D. Oregon health Sciences college
21. Arifulla Khan, M.D. Northwest clinical analysis center Kirland, WA 98034
22. Ranga Krishnan, M.D. Duke college clinical core
23. Dennis McMannus, M.D. SIU college of medicine Springfield, IL 62794-1413
24. Jacob Mintzer, M.D. scientific institution of South Carolina Charleston, South Carolina 29425-0742
25. Jorg Pahl, M.D. Pahl brain friends, P.C. Oklahoma city, adequate 73120
26. Murray Rosenthal, DO Behavioral medication materials San Diego, CA 92123
27. Carl Sadowsky, M.D. Palm beach Neurological group West Palm beach, FL 33407-2441
28. Frederick Schaerf, M.D. feet. Meyers, FL 33907
29. Douglas Scharre, M.D. Ohio State institution Columbus, OH 43210
30. Rachel Schindler, MD Pfizer Inc. long island, big apple 10017
31. Joshua Shua-Haim, M.D. Monmouth scientific core lengthy department, N 07740
32. Paul Soloman, Ph.D. memory problems hospital Bennington, VT 05201
33. Steven Targum, M.D. CNS Philadelphia Philadelphia, PA 19106
34. Christopher Van Dyck, M.D. Yale tuition school of drugs
35. Troy Williams, M.D. Peoria, AZ 85381
36. William Pendlebury, M.D. tuition of Vermont
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Investigation of grime Storms getting into Western Iran the usage of Remotely Sensed facts and Synoptic evaluation465 viewed in figure 9C and 9D, cyclonic and anti-cyclonic cir-
466 culations are fashioned respectively under the front and
467 again of trough. right through dusty days of the western and
468 south western Iraq, a trough lies at 500 hPa level which
469 leads to the formation of cyclonic (low drive) and
470 anti-cyclonic (excessive pressure) circulations in Iran and
471 jap shores of the Mediterranean sea. basically, the filth
472 supply is strengthened through being located between low and
473 excessive-pressure centres and due to this fact, being affected
474 via pre-bloodless front (bloodless sector), west–east, excessive-
475 speed winds. while trough receives deeper, cyclonic circula-
476 tion relocates towards reduce latitudes on Saudi Arabia. In
477 these cases, speedy winds causing huge dust storms
478 will kind in heat sector of the cyclone with a roughly
479 south–north direction.
480 Conclusion
481 The latest analysis makes use of numerous facts and strategies to
482 determine the origin of the grime storms affecting the west-
483 ern Iran. by way of analysing the corresponding satellite tv for pc photographs,
484 three main paths of dust paths were identified:
485 –direction 1: the northwest-southeast direction, from the
486 north-western Iraq and the south japanese Syria,
487 to western Iran,
488 –direction 2: the second pathway with jap-western
489 direction, from Iraq-Jordan borders prolonged
490 to the western Iran,
491 –direction three: the final direction from southern banks
492 of Persian Gulf to western Iran via a
493 south–north directing.
494 The function of the first course in the mobility of dirt parti-
495 cles to the western Iran is a whole lot extra giant than
496 other two paths. The temporal distribution of western
497 Iran dust movements suggests that the primary grime route and its
498 grime source have been activated from 2005 and
499 hit a top in 2008. therefore, this course and its grime-
500 inclined regions may also be regarded because the leading foundation of
501 fresh filth storms coming into western Iran. grime events in
502 paths one and two don't show enormous upward push in contemporary
503 years. dust movements relocated from northwest-southeast
504 direction in particular occur within the heat periods of the year. In
505 distinction, the paths of two and three have highest sea-
506 sonal actions in the cold months. The latest research
507 has used soil guidance, the type of land covers,
508 and wind speed and path of sea level drive
509 to find the grime sources extra exactly. Analysing theses
510 advice, we discovered four main grime-inclined areas
511 which affect western Iran:
512 –supply 1: the jap banks of Euphrates and the
513 western banks of Tigris as leading western Iran
514 filth sources,
515–source 2: the western and south western Iraq, and
516also small components of Syria and Jordan,
517–supply three: the japanese and south-eastern deserts of
518Arabia called Rub-Al-Khali wasteland,
519–supply four: the south-eastern Iraq, as a secondary supply.
520The examination of the atmospheric situations gov-
521erning each and every dirt supply shows that synoptic patterns
522during dirt routine originating from source one have
523been specifically littered with the surface diabatic approaches.
524Whereas, filth storm in sources two and three are
525caused by way of cyclonic and anti-cyclonic circulations and are
526largely outcomes of dynamic approaches of westerly winds.
527Endnotes
528
a
reasonable resolution Imaging Spectroradiometer.
529
b
Brightness Temperature difference.
530
c
Q1http://rapidfire.sci.gsfc.nasa.gov/realtime.
531
d
Q2www.esa.int/due/ionia/globcover.
532
e
Temperature anomaly = (each day temperature –regular
533daily temperature).
534Competing interests
535The authors declare that they have no competing pastimes.
536Authors’contributions
537The most materials of this study COG-320 including: research scheme, data evaluation, and
538manuscript instruction were applied by means of first two authors. Third author
539has helped to locate an effective filth detection algorithm and make it
540convenient with the aid of programing in MATLAB software. other authors have
541accompanied in editing, cohesion and translating presented paper.
542All authors read COG-320 and permitted the remaining manuscript.
543Acknowledgements
544This analysis paper is made possible in the course of the help and economic aid
545from science and know-how affairs of Islamic republic of Iran.
546Author details
547
1
department of far off Sensing & GIS & Geoinformatics analysis Institute
548(GRI), school of Tehran, Tehran, Iran.
2
Geoinformatics research Institute
549(GRI), tuition of Tehran and branch of Geography and Regional
550Research, college of Vienna, Vienna, Austria.
three
department of Soil Science,
551Tarbiat Modares school, Tehran, Iran.
4
school of electrical and laptop,
552Tarbiat Modares school, Tehran, Iran.
5
Geoinformatics research Institute
553(GRI), institution of Tehran, Tehran, Iran.
554Received: 12 February 2013 approved: 14 October 2014
555
556References
1.
557
Goudie AS, Middleton N: wilderness filth within the world gadget. ny:
558
Springer Berlin Heidelberg; 2006.
2.
559
Shao Y, Wyrwoll KH, Chappell A, Huang J, Lin Z, McTainsh GH, Mikami M,
560
Tanaka TY, Wangh X, Yoon S: dust cycle: an emerging core theme in
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earth device science. Aeolian Res 2011, 2:181–204.
3.
562
Ardehjani SS: I.R of Iran national record on regional motion plan to
563
combat dirt and sand storm.
Q3
http://icap.atmos.und.edu/AERP/meeting
564
PDFs/RemoteSensing/Shirkani_Iran_Dust_Reportp.c20(NXPowerLite).pdf.
4.
565
Ozsoy E, Nilgun ok: A hemispheric grime storm affecting the Atlantic and
566
Mediterranean in April 1994: Analyses, modeling, ground-primarily based
567
measurements and satellite observations. J Geophys Res 2001,
568
106:18439–18460.
5.
569
El-Askary HM, Sarkar S, Kafatos M, El-Ghazawi TA: A multisensor strategy
570
to dirt storm monitoring over the Nile Delta. Geosci far flung Sens 2003,
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