Pelvic organ prolapse (POP) represents a major health care burden in women, but its underlying pathophysiological mechanisms have not been elucidated. We first used a case-control design to perform... Show morePelvic organ prolapse (POP) represents a major health care burden in women, but its underlying pathophysiological mechanisms have not been elucidated. We first used a case-control design to perform an exome chip study in 526 women with POP and 960 control women to identify single nucleotide variants (SNVs) associated with the disease. We then integrated the functional interactions between the POP candidate proteins derived from the exome chip study and other POP candidate molecules into a molecular landscape. We found significant associations between POP and SNVs in 54 genes. The proteins encoded by 26 of these genes fit into the molecular landscape, together with 43 other POP candidate molecules. The POP landscape is located in and around epithelial cells and fibroblasts of the urogenital tract and harbors four interacting biological processes—epithelial-mesenchymal transition, immune response, modulation of the extracellular matrix, and fibroblast function—that are regulated by sex hormones and TGFB1. Our findings were corroborated by enrichment analyses of differential gene expression data from an independent POP cohort. Lastly, based on the landscape and using vaginal fibroblasts from women with POP, we predicted and showed that metformin alters gene expression in these fibroblasts in a beneficial direction. In conclusion, our integrated molecular landscape of POP provides insights into the biological processes underlying the disease and clues towards novel treatments. Show less
In this article, we introduce a novel procedure for improving power of multiple testing procedures (MTPs) of interval hypotheses. When testing interval hypotheses the null hypothesis P-values tend... Show moreIn this article, we introduce a novel procedure for improving power of multiple testing procedures (MTPs) of interval hypotheses. When testing interval hypotheses the null hypothesis P-values tend to be stochastically larger than standard uniform if the true parameter is in the interior of the null hypothesis. The new procedure starts with a set of P-values and discards those with values above a certain pre-selected threshold, while the rest are corrected (scaled-up) by the value of the threshold. Subsequently, a chosen family-wise error rate (FWER) or false discovery rate MTP is applied to the set of corrected P-values only. We prove the general validity of this procedure under independence of P-values, and for the special case of the Bonferroni method, we formulate several sufficient conditions for the control of the FWER. It is demonstrated that this "filtering" of P-values can yield considerable gains of power. Show less
Broeck, T. van den; Bergh, R.C.N. van den; Arfi, N.; Gross, T.; Moris, L.; Briers, E.; ... ; Mottet, N. 2019
