Sample records for accordion severity grading

  1. Accordion complication grading predicts short-term outcome after right colectomy.

    PubMed

    Klos, Coen L; Safar, Bashar; Hunt, Steven R; Wise, Paul E; Birnbaum, Elisa H; Mutch, Matthew G; Fleshman, James W; Dharmarajan, Sekhar

    2014-08-01

    The Accordion severity grading system is a novel system to score the severity of postoperative complications in a standardized fashion. This study aims to demonstrate the validity of the Accordion system in colorectal surgery by correlating severity grades with short-term outcomes after right colectomy for colon cancer. This is a retrospective cohort review of patients who underwent right colectomy for cancer between January 1, 2002, and January 31, 2007, at a single tertiary care referral center. Complications were categorized according to the Accordion severity grading system: grades 1 (mild), 2 (moderate), 3-5 (severe), and 6 (death). Outcome measures were hospital stay, 30-d readmission rate and 1-y survival. Correlation between Accordion grades and outcome measures is reflected by Spearman rho (ρ). One-year survival was obtained per Kaplan-Meier method and compared by logrank test for trend. Significance was set at P ≤ 0.05. Overall, 235 patients underwent right colectomy for cancer of which 122 (51.9%) had complications. In total, 52 (43%) had an Accordion grade 1 complication; 44 (36%) grade 2; four (3%) grade 3; 11 (9%) grade 4; seven (6%) grade 5; and four (3%) grade 6. There was significant correlation between Accordion grades and hospital stay (ρ = 0.495, P < 0.001) and 30-d readmission rate (ρ = 0.335, P < 0.001). There was a significant downward trend in 1-y survival as complication severity by Accordion grade increased (P = 0.02). The Accordion grading system is a useful tool to estimate short-term outcomes after right colectomy for cancer. High-grade Accordion complications are associated with longer hospital stay and increased risk of readmission and mortality. Published by Elsevier Inc.

  2. Tabs and Accordions

    EPA Pesticide Factsheets

    While tabs and accordions were once common across the Web, we no longer recommend their use on EPA pages. Research has demonstrated that the use of tabs and accordions on websites can cause a number of search, access, and usability problems.

  3. Resection of complex pancreatic injuries: Benchmarking postoperative complications using the Accordion classification

    PubMed Central

    Krige, Jake E; Jonas, Eduard; Thomson, Sandie R; Kotze, Urda K; Setshedi, Mashiko; Navsaria, Pradeep H; Nicol, Andrew J

    2017-01-01

    AIM To benchmark severity of complications using the Accordion Severity Grading System (ASGS) in patients undergoing operation for severe pancreatic injuries. METHODS A prospective institutional database of 461 patients with pancreatic injuries treated from 1990 to 2015 was reviewed. One hundred and thirty patients with AAST grade 3, 4 or 5 pancreatic injuries underwent resection (pancreatoduodenectomy, n = 20, distal pancreatectomy, n = 110), including 30 who had an initial damage control laparotomy (DCL) and later definitive surgery. AAST injury grades, type of pancreatic resection, need for DCL and incidence and ASGS severity of complications were assessed. Uni- and multivariate logistic regression analysis was applied. RESULTS Overall 238 complications occurred in 95 (73%) patients of which 73% were ASGS grades 3-6. Nineteen patients (14.6%) died. Patients more likely to have complications after pancreatic resection were older, had a revised trauma score (RTS) < 7.8, were shocked on admission, had grade 5 injuries of the head and neck of the pancreas with associated vascular and duodenal injuries, required a DCL, received a larger blood transfusion, had a pancreatoduodenectomy (PD) and repeat laparotomies. Applying univariate logistic regression analysis, mechanism of injury, RTS < 7.8, shock on admission, DCL, increasing AAST grade and type of pancreatic resection were significant variables for complications. Multivariate logistic regression analysis however showed that only age and type of pancreatic resection (PD) were significant. CONCLUSION This ASGS-based study benchmarked postoperative morbidity after pancreatic resection for trauma. The detailed outcome analysis provided may serve as a reference for future institutional comparisons. PMID:28396721

  4. Prevention of stone migration with the Accordion during endoscopic ureteral lithotripsy.

    PubMed

    Pagnani, Christopher J; El Akkad, Magdy; Bagley, Demetrius H

    2012-05-01

    Endoscopic lithotripsy is often prolonged secondary to the retrograde migration of calculous fragments. Various balloons, baskets, and other devices have been used to prevent this migration. Our purpose is to analyze the effect of the Accordion(®) on stone migration and overall efficiency during lithotripsy. We prospectively evaluated 21 patients with a total of 23 distal ureteral stones. Patients underwent lithotripsy using an endoscopic impact lithotriptor. The Accordion was randomly used in 11 of these 21 patients. Data were collected regarding stone migration, stone size, stone ablation, ureteral clearing, and lengths of time for various stages of each procedure. Patients who were treated with the Accordion device experienced significantly less retrograde migration during fragmentation (P=0.0064). When stone volume was taken into account (but not on a per stone basis), ablation and ureteral clearing were also expedited, and fewer lithotripter "hits" and basket "sweeps" were needed. The Accordion device is effective in preventing the migration of stone fragments during endoscopic ureteral lithotripsy. Our data suggest that this device may also increase efficiency of the fragmentation and clearance of ureteral calculi.

  5. SARA: a software environment for the analysis of relaxation data acquired with accordion spectroscopy

    PubMed Central

    Harden, Bradley J.

    2014-01-01

    We present SARA (Software for Accordion Relaxation Analysis), an interactive and user-friendly MATLAB software environment designed for analyzing relaxation data obtained with accordion spectroscopy. Accordion spectroscopy can be used to measure nuclear magnetic resonance (NMR) relaxation rates in a fraction of the time required by traditional methods, yet data analysis can be intimidating and no unified software packages are available to assist investigators. Hence, the technique has not achieved widespread use within the NMR community. SARA offers users a selection of analysis protocols spanning those presented in the literature thus far, with modifications permitting a more general application to crowded spectra such as those of proteins. We discuss the advantages and limitations of each fitting method and suggest a protocol combining the strengths of each procedure to achieve optimal results. In the end, SARA provides an environment for facile extraction of relaxation rates and should promote routine application of accordion relaxation spectroscopy. PMID:24408364

  6. The Accordion Sign in the Transplant Ureter: Ramifications During Balloon Dilation of Strictures

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kriegshauser, J. Scott, E-mail: skriegshauser@mayo.edu; Naidu, Sailen G.; Chang, Yu-Hui H.

    PurposeThis study was designed to demonstrate the accordion sign within the transplant ureter and evaluate its ramifications during balloon dilation of strictures.MethodsA retrospective electronic chart and imaging review included demographic characteristics, procedure reports, and complications of 28 renal transplant patients having ureteral strictures treated with percutaneous balloon dilation reported in our transplant nephrology database during an 8-year period. The accordion sign was deemed present or absent on the basis of an imaging review and was defined as present when a tortuous ureter became kinked and irregular when foreshortened after placement of a wire or a catheter. Procedure-related urine leaks weremore » categorized as occurring at the stricture if within 2 cm; otherwise, they were considered away from the stricture.ResultsThe accordion sign was associated with a significantly greater occurrence of leaks away from the stricture (P = 0.001) but not at the stricture (P = 0.34).ConclusionsThe accordion sign is an important consideration when performing balloon dilation procedures on transplant ureteral strictures, given the increased risk of leak away from the stricture. Its presence should prompt additional care during wire and catheter manipulations.« less

  7. Education, Social Capital and the Accordion Effect

    ERIC Educational Resources Information Center

    Vorhaus, John

    2014-01-01

    The "accordion effect" is an effect of language which allows us to describe one and the same thing more or less narrowly. Social capital has been conceived in terms of our access to institutional resources, but also in terms that extend to the levels of trust and related resources found in the social networks we are embedded in. The…

  8. ACCORDION MIND: results of the observational extension of the ACCORD MIND randomised trial.

    PubMed

    Murray, Anne M; Hsu, Fang-Chi; Williamson, Jeff D; Bryan, R Nick; Gerstein, Hertzel C; Sullivan, Mark D; Miller, Michael E; Leng, Iris; Lovato, Laura L; Launer, Lenore J

    2017-01-01

    The Memory in Diabetes (MIND) substudy of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study, a double 2x2 factorial parallel-group randomised clinical trial, tested whether intensive compared with standard management of hyperglycaemia, BP or lipid levels reduced cognitive decline and brain atrophy in 2977 people with type 2 diabetes. We describe the results of the observational extension study, ACCORDION MIND (ClinicalTrials.gov registration no. NCT00182910), which aimed to measure the long-term effects of the three ACCORD interventions on cognitive and brain structure outcomes approximately 4 years after the trial ended. Participants (mean diabetes duration 10 years; mean age 62 years at baseline) received a fourth cognitive assessment and a third brain MRI, targeted at 80 months post-randomisation. Primary outcomes were performance on the Digit Symbol Substitution Test (DSST) and total brain volume (TBV). The contrast of primary interest compared glycaemic intervention groups at the ACCORDION visit; secondary contrasts were the BP and lipid interventions. Of the surviving ACCORD participants eligible for ACCORDION MIND, 1328 (68%) were re-examined at the ACCORDION follow-up visit, approximately 47 months after the intensive glycaemia intervention was stopped. The significant differences in therapeutic targets for each of the three interventions (glycaemic, BP and lipid) were not sustained. We found no significant difference in 80 month mean change from baseline in DSST scores or in TBV between the glycaemic intervention groups, or the BP and lipid interventions. Sensitivity analyses of the sites with ≥70% participation at 80 months revealed consistent results. The ACCORD interventions did not result in long-term beneficial or adverse effects on cognitive or brain MRI outcomes at approximately 80 months follow-up. Loss of separation in therapeutic targets between treatment arms and loss to follow-up may have contributed to the lack of

  9. Assessing the impact of a fistula after a pancreaticoduodenectomy using the Post-operative Morbidity Index.

    PubMed

    Miller, Benjamin C; Christein, John D; Behrman, Stephen W; Callery, Mark P; Drebin, Jeffrey A; Kent, Tara S; Pratt, Wande B; Lewis, Russell S; Vollmer, Charles M

    2013-10-01

    The Post-operative Morbidity Index (PMI) is a quantitative utility measure of a complication burden created by severity weighting. The Fistula Risk Score (FRS) is a validated model that predicts whether a patient will develop a post-operative pancreatic fistula (POPF). These novel tools might provide further discrimination of the ISGPF grading system. From 2001 to 2012, 1021 pancreaticoduodenectomies were performed at four institutions. POPFs were categorized by ISGPF standards. PMI scores were calculated based on the Modified Accordion Severity Grading System. FRS scores were assigned according to the relative influence of four recognized factors for developing a clinically relevant POPF (CR-POPF). In total, 231 patients (22.6%) developed a POPF, of which 54.1% were CR-POPFs. The PMI differed significantly between the ISGPF grades and patients with no or non-fistulous complications (P < 0.001). 64.9% of POPFs and 84.0% of CR-POPFs contributed the highest Accordion grade to the PMI. Overall, the FRS correlated well with PMI (R(2) = 0.81, P < 0.001). These data quantitatively reinforce the ISGPF grades that were developed qualitatively around the concept of clinical severity. CR-POPFs usually reflect the patient's highest Accordion score whereas biochemical POPFs are often superseded. The correlation between FRS and PMI indicates that risk factors for a fistula contribute to overall pancreaticoduodenectomy morbidity. © 2013 International Hepato-Pancreato-Biliary Association.

  10. Use of Severity Grades to Characterize Histopathologic Changes

    EPA Science Inventory

    The severity grade is an important component of a histopathologic diagnosis in a nonclinical toxicity study that helps distinguish treatment-related effects from background findings and aids in determining adverse dose levels during hazard characterization. Severity grades should...

  11. Use of Severity Grades to Characterize Histopathologic Changes.

    PubMed

    Schafer, Kenneth A; Eighmy, John; Fikes, James D; Halpern, Wendy G; Hukkanen, Renee R; Long, Gerald G; Meseck, Emily K; Patrick, Daniel J; Thibodeau, Michael S; Wood, Charles E; Francke, Sabine

    2018-04-01

    The severity grade is an important component of a histopathologic diagnosis in a nonclinical toxicity study that helps distinguish treatment-related effects from background findings and aids in determining adverse dose levels during hazard characterization. Severity grades should be assigned based only on the extent (i.e., amount and complexity) of the morphologic change in the examined tissue section(s) and be clearly defined in the pathology report for critical lesions impacting study interpretation. However, the level of detail provided and criteria by which severity grades are assigned can vary, which can lead to inappropriate comparisons and confusion when evaluating pathology results. To help address this issue, a Working Group of the Society of Toxicologic Pathology's Scientific and Regulatory Policy Committee was formed to provide a "points to consider" article on the assignment and application of pathology severity grades. Overall, the Working Group supports greater transparency and consistency in the reporting of grading scales and provides recommendations to improve selection of diagnoses requiring more detailed severity criteria. This information should enhance the overall understanding by toxicologic pathologists, toxicologists, and regulatory reviewers of pathology findings and thereby improve effective communication in regulatory submissions.

  12. Grading Severity of Productive Cough Based on Symptoms and Airflow Obstruction.

    PubMed

    Vazquez Guillamet, Rodrigo; Petersen, Hans; Meek, Paula; Sood, Akshay; Tesfaigzi, Yohannes

    2018-04-26

    The binary approach to the diagnosis of Chronic Bronchitis (CB) is a major barrier to the study of the disease. We investigated whether severity of productive cough can be graded using symptoms and presence of fixed airflow obstruction (FAO), and whether the severity correlates with health status, exposures injurious to the lung, biomarkers of inflammation, and measures of airway wall thickening. Findings from a cross-sectional sample of 1,422 participants from the Lovelace Smokers Cohort (LSC) were validated in 4,488 participants from the COPDGene cohort (COPDGene). Health status was based on the St. George's Respiratory Questionnaire, and Medical Outcomes Study 36-Item Short Form Health Survey. Circulating CC16 levels were quantified by ELISA (LSC), and airway wall thickening was measured using computed tomography (COPDGene). FAO was defined as postbronchodilator FEV 1 /FVC <0.7. The presence and duration of productive cough and presence of FAO or wheeze were graded into Healthy Smokers, Productive Cough (PC), Chronic PC, PC with Signs of Airflow Obstruction, and Chronic PC with Signs of Airflow Obstruction. In both cohorts, higher grade of severity correlated with lower health status, greater frequency of injurious exposures, greater airway wall thickening, and lower circulating CC16 levels. Further, longitudinal follow-up suggested that disease resolution can occur at every grade of severity but is more common in groups of lower severity and least common once airway remodeling develops. Therefore, severity of productive cough can be graded based on symptoms and FAO and early intervention may benefit patients by changing the natural history of disease.

  13. "Accordion" deformity of a tortuous external iliac artery after stent-graft placement.

    PubMed

    Quinn, S F; Kim, J; Sheley, R C; Frankhouse, J H

    2001-02-01

    To identify a complication of endograft deployment in aneurysmal iliac arteries. A 71-year-old man was referred for endovascular treatment of a 60-mm-diameter right common iliac artery aneurysm; however, deployment of a homemade covered stent (Palmaz-Schatz and polytetrafluoroethylene) induced shortening of the tortuous external iliac artery, causing an "accordion" deformity. The anomaly proved difficult to treat with serial Wallstent deployment, because the convolution tightened and migrated caudally with each stent deployed, threatening outflow. Finally, after 3 Wallstents were implanted, the contour of the external iliac artery was straight, and flow was unimpeded. However, 3 weeks later, the external iliac artery had recoiled to its original redundant appearance, but flow remained satisfactory. The aneurysm remains excluded, with satisfactory distal flow after 24 months. Implanting endografts in redundant, tortuous arterial segments may prove problematic, since induced straightening by the device precipitates kinking in the redundant system. Although treatment may be required in some situations, the vessels may return to a noncompressed state by removing the delivery system and guidewire.

  14. Mild, Moderate, Severe Asthma: What Do Grades Mean?

    MedlinePlus

    ... Text Size Email Print Share Mild, Moderate, Severe Asthma: What Do Grades Mean? Page Content Article Body ... is when assessed at follow-up visits. Intermittent Asthma A child who has symptoms of wheezing and ...

  15. Measuring Anatomic Severity in Pediatric Appendicitis: Validation of the American Association for the Surgery of Trauma Appendicitis Severity Grade.

    PubMed

    Hernandez, Matthew C; Polites, Stephanie F; Aho, Johnathon M; Haddad, Nadeem N; Kong, Victor Y; Saleem, Humza; Bruce, John L; Laing, Grant L; Clarke, Damian L; Zielinski, Martin D

    2018-01-01

    To assess whether the American Association for the Surgery of Trauma (AAST) grading system accurately corresponds with appendicitis outcomes in a US pediatric population. This single-institution retrospective review included patients <18 years of age (n = 331) who underwent appendectomy for acute appendicitis from 2008 to 2012. Demographic, clinical, procedural, and follow-up data (primary outcome was measured as Clavien-Dindo grade of complication severity) were abstracted. AAST grades were generated based on intraoperative findings. Summary, univariate, and multivariable regression analyses were performed to compare AAST grade and outcomes. Overall, 331 patients (46% female) were identified with a median age of 12 (IQR, 8-15) years. Appendectomy was laparoscopic in 90% and open in 10%. AAST grades included: Normal (n = 13, 4%), I (n = 152, 46%), II (n = 90, 27%), III (n = 43, 13%), IV (n = 24 7.3%), and V (n = 9 2.7%). Increased AAST grade was associated with increased Clavien-Dindo severity, P =.001. The overall complication rate was 13.6% and was comprised by superficial surgical site infection (n = 13, 3.9%), organ space infection (n = 15, 4.5%), and readmission (n = 17, 5.1%). Median duration of stay increased with AAST grade (P < .0001). Nominal logistic regression identified the following as predictors of any complication (P < .05): AAST grade and febrile temperature at admission. The AAST appendicitis grading system is valid in a single-institution pediatric population. Increasing AAST grade incrementally corresponds with patient outcomes including increased risk of complications and severity of complications. Determination of the generalizability of this grading system is required. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Proposal for a Novel Severity Grading System for Pterygia Based on Corneal Topographic Data.

    PubMed

    Miyata, Kazunori; Minami, Keiichiro; Otani, Atsushi; Tokunaga, Tadatoshi; Tokuda, Shouta; Amano, Shiro

    2017-07-01

    To propose a grading system of pterygium severity based on corneal higher-order irregularity (HOI) and to evaluate postoperative changes in corneal irregularity of the graded pterygia. In 268 eyes of 226 patients undergoing excision surgery of primary nasal pterygium, Placido corneal topography images were taken before and until 6 months after surgery. The best-corrected visual acuity (BCVA) and pterygium size with respect to the corneal diameter were also measured. HOI components within 1.0-, 3.0-, and 5.0-mm diameters were obtained using Fourier harmonic analysis of corneal topography data. With threshold levels when the HOIs for 3 diameters steeply increased, 4 levels of grading from 0 (mild) to 3 (severe) were determined. Associations of the grades with the preoperative surface regularity index (SRI), irregular components (IRRs) obtained from the 3.0-mm diameter Fourier analysis, and BCVA were examined. Time-course changes in the indexes after surgery were evaluated for each grade. There were 62, 65, 41, and 100 eyes in grades 0 to 3, respectively. Preoperatively, the SRI in grade 3 was significantly higher than in the other grades (P < 0.001), and the IRR and BCVA varied with the grade (P < 0.001). Between 1 and 6 months postoperatively, grade 3 pterygia showed significant changes in the SRI and IRR (P = 0.013 and 0.017, respectively), whereas there was no change after 3 months postoperatively in the SRI, IRR, and BCVA for all other grades. The proposed grading effectively classified the severity of pterygia and evaluated postoperative restoration of corneal irregularity. Using corneal topographic data allowed for objective evaluation of pterygium severity.

  17. An efficient planar accordion-shaped micromixer: from biochemical mixing to biological application

    NASA Astrophysics Data System (ADS)

    Cosentino, Armando; Madadi, Hojjat; Vergara, Paola; Vecchione, Raffaele; Causa, Filippo; Netti, Paolo Antonio

    2015-12-01

    Micromixers are the key component that allow lab-on-a-chip and micro total analysis systems to reach the correct level of mixing for any given process. This paper proposes a novel, simple, passive micromixer design characterized by a planar accordion-shape geometry. The geometrical characteristics of the presented design were analyzed numerically in the range of 0.01 < Re < 100 based on the micromixer performance. The performance of the most efficient design was experimentally investigated by means of fluorescence microscopy for a range of low diffusion coefficients, 10-12 < D < 10-11 m2/s. The micromixer structure was fabricated in a simple single-step process using maskless lithography and soft lithography. The experimental results showed a very good agreement with the predicted numerical results. This micromixer design including a single serpentine unit (1-SERP) displayed an efficiency higher than 90% (mixing length = 6.4 mm) creating a pressure drop of about 500 Pa at Re = 0.1 and 60 kPa at Re = 10. A mixing efficiency of almost 100% was readily reached when three serpentine units were included (3-SERP). Finally, the potential diagnostic value of the presented microdevice was validated experimentally for Red Blood Cell (RBC) lysis.

  18. An efficient planar accordion-shaped micromixer: from biochemical mixing to biological application.

    PubMed

    Cosentino, Armando; Madadi, Hojjat; Vergara, Paola; Vecchione, Raffaele; Causa, Filippo; Netti, Paolo Antonio

    2015-12-14

    Micromixers are the key component that allow lab-on-a-chip and micro total analysis systems to reach the correct level of mixing for any given process. This paper proposes a novel, simple, passive micromixer design characterized by a planar accordion-shape geometry. The geometrical characteristics of the presented design were analyzed numerically in the range of 0.01 < Re < 100 based on the micromixer performance. The performance of the most efficient design was experimentally investigated by means of fluorescence microscopy for a range of low diffusion coefficients, 10(-12) < D < 10(-11) m(2)/s. The micromixer structure was fabricated in a simple single-step process using maskless lithography and soft lithography. The experimental results showed a very good agreement with the predicted numerical results. This micromixer design including a single serpentine unit (1-SERP) displayed an efficiency higher than 90% (mixing length = 6.4 mm) creating a pressure drop of about 500 Pa at Re = 0.1 and 60 kPa at Re = 10. A mixing efficiency of almost 100% was readily reached when three serpentine units were included (3-SERP). Finally, the potential diagnostic value of the presented microdevice was validated experimentally for Red Blood Cell (RBC) lysis.

  19. Driver injury severity related to inclement weather at highway-rail grade crossings in the United States.

    PubMed

    Hao, Wei; Daniel, Janice

    2016-01-01

    Previous studies on crash modeling at highway-rail grade crossings were aimed at exploring the factors that are likely to increase the crash frequencies at highway-rail grade crossings. In recent years, modeling driver's injury severity at highway-rail grade crossings has received interest. Because there were substantial differences among different weather conditions for driver's injury severity, this study attempts to explore the impact of weather influence on driver injury at highway-rail grade crossing. Utilizing the most recent 10 years (2002-2011) of highway-rail grade crossing accident data, this study applied a mixed logit model to explore the determinants of driver injury severity under different weather conditions at highway-rail grade crossing. Analysis results indicate that drivers' injury severity at highway-rail grade crossings is strongly different for different weather conditions. It was found that the factors significantly impacting driver injury severity at highway-rail grade crossings include motor vehicle speed, train speed, driver's age, gender, area type, lighting condition, highway pavement, traffic volume, and time of day. The findings of this study indicate that crashes are more prevalent if vehicle drivers are driving at high speed or the oncoming trains are high speed. Hence, a reduction in speed limit during inclement weather conditions could be particularly effective in moderating injury severity, allowing more reaction time for last-minute maneuvering and braking in moments before impacts. In addition, inclement weather-related crashes were more likely to occur in open areas and highway-rail grade crossings without pavement and lighting. Paved highway-rail grade crossings with installation of lights could be particularly effective in moderating injury severity.

  20. Difference in rural and urban driver-injury severities in highway-rail grade crossing accidents.

    PubMed

    Hao, Wei; Kamga, Camille

    2017-06-01

    Based on the Federal Railway Administration (FRA) database, there were 25,945 highway-rail crossing accidents in the United States between 2002 and 2011. With an extensive research, analysis results showed that there were substantial differences between rural and urban areas at highway-rail grade crossings. However, there is no published study specific on driver's injury severity at highway-rail grade crossings classified by area types. Using an ordered probit modelling approach, the study explores the determinants of driver-injury severity at rural highway-rail grade crossings compared with urban highway-rail grade crossings. The analysis found that motor vehicle driver's injury level at rural highway-rail grade crossing is extremely higher than urban area. Compared to collisions at urban area, collisions happened at rural area tend to result in more severe injuries. These crashes were more prevalent if vehicle drivers are driving at a high speed or the oncoming trains are high-speed. Moreover, highway-rail grade crossing accidents were more likely to occur at rural area without pavement and lighting.

  1. An efficient planar accordion-shaped micromixer: from biochemical mixing to biological application

    PubMed Central

    Cosentino, Armando; Madadi, Hojjat; Vergara, Paola; Vecchione, Raffaele; Causa, Filippo; Netti, Paolo Antonio

    2015-01-01

    Micromixers are the key component that allow lab-on-a-chip and micro total analysis systems to reach the correct level of mixing for any given process. This paper proposes a novel, simple, passive micromixer design characterized by a planar accordion-shape geometry. The geometrical characteristics of the presented design were analyzed numerically in the range of 0.01 < Re < 100 based on the micromixer performance. The performance of the most efficient design was experimentally investigated by means of fluorescence microscopy for a range of low diffusion coefficients, 10−12 < D < 10−11 m2/s. The micromixer structure was fabricated in a simple single-step process using maskless lithography and soft lithography. The experimental results showed a very good agreement with the predicted numerical results. This micromixer design including a single serpentine unit (1-SERP) displayed an efficiency higher than 90% (mixing length = 6.4 mm) creating a pressure drop of about 500 Pa at Re = 0.1 and 60 kPa at Re = 10. A mixing efficiency of almost 100% was readily reached when three serpentine units were included (3-SERP). Finally, the potential diagnostic value of the presented microdevice was validated experimentally for Red Blood Cell (RBC) lysis. PMID:26658848

  2. Classification of patients by severity grades during triage in the emergency department using data mining methods.

    PubMed

    Zmiri, Dror; Shahar, Yuval; Taieb-Maimon, Meirav

    2012-04-01

    To test the feasibility of classifying emergency department patients into severity grades using data mining methods. Emergency department records of 402 patients were classified into five severity grades by two expert physicians. The Naïve Bayes and C4.5 algorithms were applied to produce classifiers from patient data into severity grades. The classifiers' results over several subsets of the data were compared with the physicians' assessments, with a random classifier, and with a classifier that selects the maximal-prevalence class. Positive predictive value, multiple-class extensions of sensitivity and specificity combinations, and entropy change. The mean accuracy of the data mining classifiers was 52.94 ± 5.89%, significantly better (P < 0.05) than the mean accuracy of a random classifier (34.60 ± 2.40%). The entropy of the input data sets was reduced through classification by a mean of 10.1%. Allowing for classification deviations of one severity grade led to mean accuracy of 85.42 ± 1.42%. The classifiers' accuracy in that case was similar to the physicians' consensus rate. Learning from consensus records led to better performance. Reducing the number of severity grades improved results in certain cases. The performance of the Naïve Bayes and C4.5 algorithms was similar; in unbalanced data sets, Naïve Bayes performed better. It is possible to produce a computerized classification model for the severity grade of triage patients, using data mining methods. Learning from patient records regarding which there is a consensus of several physicians is preferable to learning from each physician's patients. Either Naïve Bayes or C4.5 can be used; Naïve Bayes is preferable for unbalanced data sets. An ambiguity in the intermediate severity grades seems to hamper both the physicians' agreement and the classifiers' accuracy. © 2010 Blackwell Publishing Ltd.

  3. Genomic comparison of closely related Giant Viruses supports an accordion-like model of evolution.

    PubMed

    Filée, Jonathan

    2015-01-01

    Genome gigantism occurs so far in Phycodnaviridae and Mimiviridae (order Megavirales). Origin and evolution of these Giant Viruses (GVs) remain open questions. Interestingly, availability of a collection of closely related GV genomes enabling genomic comparisons offer the opportunity to better understand the different evolutionary forces acting on these genomes. Whole genome alignment for five groups of viruses belonging to the Mimiviridae and Phycodnaviridae families show that there is no trend of genome expansion or general tendency of genome contraction. Instead, GV genomes accumulated genomic mutations over the time with gene gains compensating the different losses. In addition, each lineage displays specific patterns of genome evolution. Mimiviridae (megaviruses and mimiviruses) and Chlorella Phycodnaviruses evolved mainly by duplications and losses of genes belonging to large paralogous families (including movements of diverse mobiles genetic elements), whereas Micromonas and Ostreococcus Phycodnaviruses derive most of their genetic novelties thought lateral gene transfers. Taken together, these data support an accordion-like model of evolution in which GV genomes have undergone successive steps of gene gain and gene loss, accrediting the hypothesis that genome gigantism appears early, before the diversification of the different GV lineages.

  4. Grading Dysphagia as a Toxicity of Head and Neck Cancer: Differences in Severity Classification Based on MBS DIGEST and Clinical CTCAE Grades.

    PubMed

    Goepfert, Ryan P; Lewin, Jan S; Barrow, Martha P; Warneke, Carla L; Fuller, Clifton D; Lai, Stephen Y; Weber, Randal S; Hutcheson, Katherine A

    2018-04-01

    Clinician-reported toxicity grading through common terminology criteria for adverse events (CTCAE) stages dysphagia based on symptoms, diet, and tube dependence. The new dynamic imaging grade of swallowing toxicity (DIGEST) tool offers a similarly scaled five-point ordinal summary grade of pharyngeal swallowing as determined through results of a modified barium swallow (MBS) study. This study aims to inform clinicians on the similarities and differences between dysphagia severity according to clinical CTCAE and MBS-derived DIGEST grading. A cross-sectional sample of 95 MBS studies was randomly selected from a prospectively-acquired MBS database among patients treated with organ preservation strategies for head and neck cancer. MBS DIGEST and clinical CTCAE dysphagia grades were compared. DIGEST and CTCAE dysphagia grades had "fair" agreement per weighted κ of 0.358 (95% CI .231-.485). Using a threshold of DIGEST ≥ 3 as reference, CTCAE had an overall sensitivity of 0.50, specificity of 0.84, and area under the curve (AUC) of 0.67 to identify severe MBS-detected dysphagia. At less than 6 months, sensitivity was 0.72, specificity was 0.76, and AUC was 0.75 while at greater than 6 months, sensitivity was 0.22, specificity was 0.90, and AUC was 0.56 for CTCAE to detect dysphagia as determined by DIGEST. Classification of pharyngeal dysphagia on MBS using DIGEST augments our understanding of dysphagia severity according to the clinically-derived CTCAE while maintaining the simplicity of an ordinal scale. DIGEST likely complements CTCAE toxicity grading through improved specificity for physiologic dysphagia in the acute phase and improved sensitivity for dysphagia in the late-phase.

  5. Ratings of Severity of Life Events by Ninth-Grade Students.

    ERIC Educational Resources Information Center

    Hutton, Jerry B.; And Others

    1987-01-01

    Special education, basic, and honors ninth-grade students (n=60) rated the severity of stress for each of the life events on the Source of Stress Inventory (Chandler, 1981). There was a significant positive relationship between the Chandler rankings (teachers and mental health workers) and the student rankings. (Author/NB)

  6. The accordion gracilis muscle flap: a new design for coverage of recurrent and complicated ischeal pressure sores.

    PubMed

    El-Sabbagh, Ahmed H

    2011-10-01

    Management of patients with large or recurrent pressure ulcerations can be complicated by the lack of available local flap, whether already used or because adjacent lesions make such flap insufficient for complete coverage. In this article, the gracilis muscle was modified to cover large defects without help from its cutaneous territory. Twelve ischeal pressure sores were treated between August 2007 and 2009 with the modified gracilis muscle flap in a single-staged procedure. Five ulcers were recurrent and seven patients have associated pressure ulcers. All reconstructions were successful. Mean patient age was 35 years and nearly all patients had multiple significant comorbidities, including associated ulcers, diabetes and urethrocutaneous fistula. All flaps and donor sites healed uneventfully. There was one complication presented as cellulites at the donor site. Follow-up in some cases extend up to 1·5 years. No recurrence was observed. The accordion gracilis muscle flap is a handy, safe and fast flap for reconstruction of recurrent, difficult ischeal pressure sores. © 2011 The Author. © 2011 Blackwell Publishing Ltd and Medicalhelplines.com Inc.

  7. An Exploration of Several Structural Measurement Techniques for Usage with Functionally Graded Materials

    DTIC Science & Technology

    2006-12-01

    Welsch, and E.W. Collings, eds. Materials Properties Handbook: Titanium Alloys . ASM International: 1994. p. 179 Davis, Joseph, ed. Properties ...AN EXPLORATION OF SEVERAL STRUCTURAL MEASUREMENT TECHNIQUES FOR USAGE WITH FUNCTIONALLY GRADED...of Defense, or the United States Government. AFIT/GAE/ENY/07-D03 AN EXPLORATION OF SEVERAL STRUCTURAL MEASUREMENT TECHNIQUES FOR USAGE WITH

  8. Helping Students with Moderate and Severe Intellectual Disability Access Grade-Level Text

    ERIC Educational Resources Information Center

    Hudson, Melissa E.; Browder, Diane; Wakeman, Shawnee

    2013-01-01

    Teaching students with moderate and severe intellectual disability who are early readers or nonreaders to engage with grade-level text is challenging. For this reason, purposeful thought must be given to promoting text accessibility and teaching text comprehension. Whenever possible, text should be used as it is originally written without…

  9. Perceived Severity of Cyberbullying Behaviour: Differences between Genders, Grades and Participant Roles

    ERIC Educational Resources Information Center

    Chen, Li-Ming; Cheng, Ying-Yao

    2017-01-01

    This study aimed to develop a new scale to examine primary and secondary school students' perceptions of the severity of cyberbullying behaviours, and to explore further whether differences exist in the means of gender, grade and participant role. A total of 707 primary and secondary school students (M = 14.7) in Taiwan participated in this study.…

  10. Grades of Severity and the Validation of an Atopic Dermatitis Assessment Measure (ADAM).

    ERIC Educational Resources Information Center

    Charman, Denise P.; Varigos, George A.

    1999-01-01

    Studied the validity of the Atopic Dermatitis Assessment Measure (D. Charman and others, 1999) with 171 pediatric patients in Australia using partial credit analyses to produce clinically relevant "word pictures" of grades of severity for atopic dermatitis. Discusses implications for measurement in medicine. (SLD)

  11. A Novel Actinic Keratosis Field Assessment Scale for Grading Actinic Keratosis Disease Severity.

    PubMed

    Dréno, Brigitte; Cerio, Rino; Dirschka, Thomas; Nart, Ignasi Figueras; Lear, John T; Peris, Ketty; de Casas, Andrés Ruiz; Kaleci, Shaniko; Pellacani, Giovanni

    2017-10-02

    Actinic keratosis (AK) lesions are surrounded by field cancerization (areas of subclinical, non-visible sun damage). Existing AK grading tools rely on AK counts, which are not reproducible. An Actinic Keratosis Field Assessment Scale (AK-FAS) for grading the severity of AK/field was developed. Standardized photographs of patients representing the full range of AK severity were collected. Six investigators independently rated each photograph according to 3 criteria: AK area (total skin area affected by AK lesions), hyperkeratosis and sun damage. Inter-rater reproducibility was good for all 3 criteria. Validation of the AK-FAS showed good reproducibility for AK area and hyperkeratosis, even for dermatologists untrained on use of the scale. In conclusion, the AK-FAS is objective, easy to use and implement, and reproducible. It incorporates assessment of the entire field affected by AK instead of relying on lesion counts. Use of the AK-FAS may standardize AK diagnosis, making it relevant to routine clinical practice.

  12. Chinese New Year Dragons.

    ERIC Educational Resources Information Center

    Balgemann, Linda

    2000-01-01

    Presents an art project, used in a culturally diverse curriculum, in which second grade students create Chinese New Year dragons. Describes the process of creating the dragons, from the two-week construction of the head to the accordion-folded bodies. (CMK)

  13. Acne severity grading: determining essential clinical components and features using a Delphi consensus.

    PubMed

    Tan, Jerry; Wolfe, Barat; Weiss, Jonathan; Stein-Gold, Linda; Bikowski, Joseph; Del Rosso, James; Webster, Guy F; Lucky, Anne; Thiboutot, Diane; Wilkin, Jonathan; Leyden, James; Chren, Mary-Margaret

    2012-08-01

    There are multiple global scales for acne severity grading but no singular standard. Our objective was to determine the essential clinical components (content items) and features (property-related items) for an acne global grading scale for use in research and clinical practice using an iterative method, the Delphi process. Ten acne experts were invited to participate in a Web-based Delphi survey comprising 3 iterative rounds of questions. In round 1, the experts identified the following clinical components (primary acne lesions, number of lesions, extent, regional involvement, secondary lesions, and patient experiences) and features (clinimetric properties, ease of use, categorization of severity based on photographs or text, and acceptance by all stakeholders). In round 2, consensus for inclusion in the scale was established for primary lesions, number, sites, and extent; as well as clinimetric properties and ease of use. In round 3, consensus for inclusion was further established for categorization and acceptance. Patient experiences were excluded and no consensus was achieved for secondary lesions. The Delphi panel consisted solely of the United States (U.S.)-based acne experts. Using an established method for achieving consensus, experts in acne vulgaris concluded that an ideal acne global grading scale would comprise the essential clinical components of primary acne lesions, their quantity, extent, and facial and extrafacial sites of involvement; with features of clinimetric properties, categorization, efficiency, and acceptance. Copyright © 2011 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  14. Variations in definition and method of retrieval of complications influence outcomes statistics after pancreatoduodenectomy: comparison of NSQIP with non-NSQIP methods.

    PubMed

    Sanford, Dominic E; Woolsey, Cheryl A; Hall, Bruce L; Linehan, David C; Hawkins, William G; Fields, Ryan C; Strasberg, Steven M

    2014-09-01

    NSQIP and the Accordion Severity Grading System have recently been used to develop quantitative methods for measuring the burden of postoperative complications. However, other audit methods such as chart reviews and prospective institutional databases are commonly used to gather postoperative complications. The purpose of this study was to evaluate discordance between different audit methods in pancreatoduodenectomy--a common major surgical procedure. The chief aim was to determine how these different methods could affect quantitative evaluations of postoperative complications. Three common audit methods were compared with NSQIP in 84 patients who underwent pancreatoduodenectomy. The methods were use of a prospective database, a chart review based on discharge summaries only, and a detailed retrospective chart review. The methods were evaluated for discordance with NSQIP and among themselves. Severity grading was performed using the Modified Accordion System. Fifty-three complications were listed by NSQIP and 31 complications were identified that were not listed by NSQIP. There was poor agreement for NSQIP-type complications between NSQIP and the other audit methods for mild and moderate complications (kappa 0.381 to 0.744), but excellent agreement for severe complications (kappa 0.953 to 1.00). Discordance was usually due to variations in definition of the complications in non-NSQIP methods. There was good agreement among non-NSQIP methods for non-NSQIP complications for moderate and severe complications, but not for mild complications. There are important differences in perceived surgical outcomes based on the method of complication retrieval. The non-NSQIP methods used in this study could not be substituted for NSQIP in a quantitative analysis unless that analysis was limited to severe complications. Copyright © 2014 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  15. An Examination of Fifth Grade Students' Attitudes towards Social Studies Course in Terms of Severable Variables

    ERIC Educational Resources Information Center

    Ilgaz, Selçuk

    2018-01-01

    The aim of this research is to investigate the 5th grade students' attitude towards social studies course regarding several variables. The population of the study consisted of 4435 fifth grade students studying in public schools in Malatya, Yesilyurt. The sample group consisted of 362 students from 10 schools in the same district. The data used in…

  16. Reconsidering the logic of World Federation of Neurosurgical Societies grading in patients with severe subarachnoid hemorrhage.

    PubMed

    Fung, Christian; Inglin, Fabienne; Murek, Michael; Balmer, Mathias; Abu-Isa, Janine; Z'Graggen, Werner J; Ozdoba, Christoph; Gralla, Jan; Jakob, Stephan M; Takala, Jukka; Beck, Jürgen; Raabe, Andreas

    2016-02-01

    Current data show a favorable outcome in up to 50% of patients with World Federation of Neurosurgical Societies (WFNS) Grade V subarachnoid hemorrhage (SAH) and a rather poor prediction of worst cases. Thus, the usefulness of the current WFNS grading system for identifying the worst scenarios for clinical studies and for making treatment decisions is limited. One reason for this lack of differentiation is the use of "negative" or "silent" diagnostic signs as part of the WFNS Grade V definition. The authors therefore reevaluated the WFNS scale by using "positive" clinical signs and the logic of the Glasgow Coma Scale as a progressive herniation score. The authors performed a retrospective analysis of 182 patients with SAH who had poor grades on the WFNS scale. Patients were graded according to the original WFNS scale and additionally according to a modified classification, the WFNS herniation (hWFNS) scale (Grade IV, no clinical signs of herniation; Grade V, clinical signs of herniation). The prediction of poor outcome was compared between these two grading systems. The positive predictive values of Grade V for poor outcome were 74.3% (OR 3.79, 95% CI 1.94-7.54) for WFNS Grade V and 85.7% (OR 8.27, 95% CI 3.78-19.47) for hWFNS Grade V. With respect to mortality, the positive predictive values were 68.3% (OR 3.9, 95% CI 2.01-7.69) for WFNS Grade V and 77.9% (OR 6.22, 95% CI 3.07-13.14) for hWFNS Grade V. Limiting WFNS Grade V to the positive clinical signs of the Glasgow Coma Scale such as flexion, extension, and pupillary abnormalities instead of including "no motor response" increases the prediction of mortality and poor outcome in patients with severe SAH.

  17. Grading of severity of postdural puncture headache after 27-gauge Quincke and Whitacre needles.

    PubMed

    Corbey, M P; Bach, A B; Lech, K; Frørup, A M

    1997-06-01

    Small-gauge needles are reported to have a low incidence of complications. Pencil-point needles are associated with a lower frequency of postdural puncture headache (PDPH), but a higher failure rate than Quincke needles. The incidence of PDPH was investigated in 200 patients under the age of 45, undergoing day-care surgery, after spinal anaesthesia with either 27-gauge Quincke or Whitacre needle. The severity of headache was graded as I (mild), II (moderate) or III (severe) using a grading system based on the visual analogue scale (VAS) associated with a functional rating (FG). The frequency of PDPH following the Whitacre needle was 0% and 5.6% after the Quincke needle (P = 0.05). Two PDPHs were assessed as grade III, and three as grade II. All PDPHs occurred when the Quincke needle bevel was withdrawn perpendicular to the dural fibres following parallel insertion. No PDPH occurred when the bevel was inserted and removed parallel to the dural fibres (P < 0.05). There was no statistical difference (P > 0.08) in the incidence of PDPH and postdural puncture-related headaches (PDPR-H) in patients with recurrent headaches or migraine compared to patients with no previous history of headaches. We conclude that the 27-gauge Whitacre needle is the 'needle of choice' in patients with normal body stature. The incidence of PDPH following Quincke needles may not only be affected by the direction of the bevel during insertion but also during removal. Statistically, there was no gender variation in PDPH in this study (P = 0.5). A previous history of recurrent headache or migraine does not predispose to PDPH.

  18. Venous beading in two or more quadrants might not be a sensitive grading criterion for severe nonproliferative diabetic retinopathy.

    PubMed

    Chen, Ling; Zhang, Xiongze; Wen, Feng

    2018-06-01

    To determine whether venous beading (VB) in two or more quadrants is an appropriate grading criterion for severe nonproliferative diabetic retinopathy (NPDR). A hospital-based, retrospective, cross-sectional study. A total of 806 patients admitted with diabetic retinopathy (DR) from January 2014 to April 2017 were included in this study. DR severity was graded by the international grading criterion. The status of VB, intraretinal microvascular abnormalities (IRMA), capillary nonperfusion, arteriovenous nicking, and diabetic macular edema was evaluated based on fundus fluorescein angiography. The prevalence of VB in eyes with proliferative diabetic retinopathy (PDR), severe NPDR, and moderate NPDR was 41.3% (327/791), 5.9% (31/526), and 0% (0/295), respectively (p < 0.001). Moreover, the proportion of VB in two or more quadrants was even lower (27.1% for PDR and 2.1% for severe NPDR, p < 0.001), and among the total of 225 eyes with VB in two or more quadrants, 214 eyes (95.1%) were graded as PDR. Furthermore, VB formation was significantly correlated with capillary nonperfusion, duration of diabetes (both p < 0.001), and smoking (p < 0.05). After adjusting for age, sex, and other possible factors, VB (OR = 7.479, p < 0.001) and IRMA (OR = 2.433, p < 0.001) were determined as independent risk factors for developing PDR. Our study suggested that VB in two or more quadrants might not be a sensitive grading criterion for severe NPDR among a Chinese population with type 2 diabetes. Nevertheless, VB has a great specificity to define an advanced form of DR.

  19. Motor vehicle driver injury severity study under various traffic control at highway-rail grade crossings in the United States.

    PubMed

    Hao, Wei; Daniel, Janice

    2014-12-01

    Based on the Federal Railway Administration (FRA) database, approximately 62% of the collisions at highway-rail crossings occurred at locations with active controls (gate and flashing lights), followed by passive controls (cross bucks and stop signs) with approximately 28% of accidents. The study applied an ordered probit model to explore the determinants of driver injury severity under various control measures at highway-rail grade crossing in the United States. The analysis found that schedule factor (peak hour), visibility, motor vehicle speed, train speed, driver's age, area type, traffic volume and highway pavement impact driver injury severity at both active and passive highway-rail crossings. For both active and passive control highway-rail grade crossings, speed control for both trains and vehicles will significantly reduce driver injury severity. However, the level of influence by vehicle speed and train speed at passive control is higher compared with active control. Paving highways at highway-rail grade crossings will also help to reduce driver injury severity at highway-rail crossing accidents. Published by Elsevier Ltd.

  20. Impact of totally laparoscopic combined management of colorectal cancer with synchronous hepatic metastases on severity of complications: a propensity-score-based analysis.

    PubMed

    Ratti, Francesca; Catena, Marco; Di Palo, Saverio; Staudacher, Carlo; Aldrighetti, Luca

    2016-11-01

    Thanks to widespread diffusion of minimally invasive approach in the setting of both colorectal and hepatic surgeries, the interest in combined resections for colorectal cancer and synchronous liver metastases (SCLM) by totally laparoscopic approach (TLA) has increased. Aim of this study was to compare outcome of combined resections for SCLM performed by TLA or by open approach, in a propensity-score-based study. All 25 patients undergoing combined TLA for SCLM at San Raffaele Hospital in Milano were compared in a case-matched analysis with 25 out of 91 patients undergoing totally open approach (TOA group). Groups were matched with 1:2 ratio using propensity scores based on covariates representing disease severity. Main endpoints were postoperative morbidity and long-term outcome. The Modified Accordion Severity Grading System was used to quantify complications. The groups resulted comparable in terms of patients and disease characteristics. The TLA group, as compared to the TOA group, had lower blood loss (350 vs 600 mL), shorter postoperative stay (9 vs 12 days), lower postoperative morbidity index (0.14 vs 0.20) and severity score for complicated patients (0.60 vs 0.85). Colonic anastomosis leakage had the highest fractional complication burden in both groups. In spite of comparable long-term overall survival, the TLA group had better recurrence-free survival. TLA for combined resections is feasible, and its indications can be widened to encompass a larger population of patients, provided its benefits in terms of reduced overall risk and severity of complications, rapid functional recovery and favorable long-term outcomes.

  1. ICD-9-CM and ICD-10-CM mapping of the AAST Emergency General Surgery disease severity grading systems: Conceptual approach, limitations, and recommendations for the future.

    PubMed

    Utter, Garth H; Miller, Preston R; Mowery, Nathan T; Tominaga, Gail T; Gunter, Oliver; Osler, Turner M; Ciesla, David J; Agarwal, Suresh K; Inaba, Kenji; Aboutanos, Michel B; Brown, Carlos V R; Ross, Steven E; Crandall, Marie L; Shafi, Shahid

    2015-05-01

    The American Association for the Surgery of Trauma (AAST) recently established a grading system for uniform reporting of anatomic severity of several emergency general surgery (EGS) diseases. There are five grades of severity for each disease, ranging from I (lowest severity) to V (highest severity). However, the grading process requires manual chart review. We sought to evaluate whether International Classification of Diseases, 9th and 10th Revisions, Clinical Modification (ICD-9-CM, ICD-10-CM) codes might allow estimation of AAST grades for EGS diseases. The Patient Assessment and Outcomes Committee of the AAST reviewed all available ICD-9-CM and ICD-10-CM diagnosis codes relevant to 16 EGS diseases with available AAST grades. We then matched grades for each EGS disease with one or more ICD codes. We used the Official Coding Guidelines for ICD-9-CM and ICD-10-CM and the American Hospital Association's "Coding Clinic for ICD-9-CM" for coding guidance. The ICD codes did not allow for matching all five AAST grades of severity for each of the 16 diseases. With ICD-9-CM, six diseases mapped into four categories of severity (instead of five), another six diseases into three categories of severity, and four diseases into only two categories of severity. With ICD-10-CM, five diseases mapped into four categories of severity, seven diseases into three categories, and four diseases into two categories. Two diseases mapped into discontinuous categories of grades (two in ICD-9-CM and one in ICD-10-CM). Although resolution is limited, ICD-9-CM and ICD-10-CM diagnosis codes might have some utility in roughly approximating the severity of the AAST grades in the absence of more precise information. These ICD mappings should be validated and refined before widespread use to characterize EGS disease severity. In the long-term, it may be desirable to develop alternatives to ICD-9-CM and ICD-10-CM codes for routine collection of disease severity characteristics.

  2. Aerodynamic excitation and sound production of blown-closed free reeds without acoustic coupling: the example of the accordion reed.

    PubMed

    Ricot, Denis; Caussé, René; Misdariis, Nicolas

    2005-04-01

    The accordion reed is an example of a blown-closed free reed. Unlike most oscillating valves in wind musical instruments, self-sustained oscillations occur without acoustic coupling. Flow visualizations and measurements in water show that the flow can be supposed incompressible and potential. A model is developed and the solution is calculated in the time domain. The excitation force is found to be associated with the inertial load of the unsteady flow through the reed gaps. Inertial effect leads to velocity fluctuations in the reed opening and then to an unsteady Bernoulli force. A pressure component generated by the local reciprocal air movement around the reed is added to the modeled aerodynamic excitation pressure. Since the model is two-dimensional, only qualitative comparisons with air flow measurements are possible. The agreement between the simulated pressure waveforms and measured pressure in the very near-field of the reed is reasonable. In addition, an aeroacoustic model using the permeable Ffowcs Williams-Hawkings integral method is presented. The integral expressions of the far-field acoustic pressure are also computed in the time domain. In agreement with experimental data, the sound is found to be dominated by the dipolar source associated by the strong momentum fluctuations of the flow through the reed gaps.

  3. Aerodynamic excitation and sound production of blown-closed free reeds without acoustic coupling: The example of the accordion reed

    NASA Astrophysics Data System (ADS)

    Ricot, Denis; Caussé, René; Misdariis, Nicolas

    2005-04-01

    The accordion reed is an example of a blown-closed free reed. Unlike most oscillating valves in wind musical instruments, self-sustained oscillations occur without acoustic coupling. Flow visualizations and measurements in water show that the flow can be supposed incompressible and potential. A model is developed and the solution is calculated in the time domain. The excitation force is found to be associated with the inertial load of the unsteady flow through the reed gaps. Inertial effect leads to velocity fluctuations in the reed opening and then to an unsteady Bernoulli force. A pressure component generated by the local reciprocal air movement around the reed is added to the modeled aerodynamic excitation pressure. Since the model is two-dimensional, only qualitative comparisons with air flow measurements are possible. The agreement between the simulated pressure waveforms and measured pressure in the very near-field of the reed is reasonable. In addition, an aeroacoustic model using the permeable Ffowcs Williams-Hawkings integral method is presented. The integral expressions of the far-field acoustic pressure are also computed in the time domain. In agreement with experimental data, the sound is found to be dominated by the dipolar source associated by the strong momentum fluctuations of the flow through the reed gaps. .

  4. Bringing Image and Language Together: A Workshop at the Lehman College Art Gallery.

    ERIC Educational Resources Information Center

    Wexler, Alice

    2001-01-01

    Discusses a ten day workshop for kindergarten and fourth grade students that centered around the art exhibit "Contemporary Chinese Art and the Literary Culture of China" held at the Lehman College Art Gallery (Bronx, New York). Explains that students created accordion books based on Xing Fei's "Red Book." (CMK)

  5. Volumetric Nephrogram Represents Renal Function and Complements Aortic Anatomic Severity Grade in Predicting EVAR Outcomes.

    PubMed

    Balceniuk, Mark D; Trakimas, Lauren; Aghaie, Claudia; Mix, Doran; Rasheed, Khurram; Seaman, Matthew; Ellis, Jennifer; Glocker, Roan; Doyle, Adam; Stoner, Michael C

    2018-07-01

    Chronic kidney disease (CKD) is a predictor of poor outcomes for patients undergoing endovascular aortic aneurysm repair (EVAR). Anatomic severity grade (ASG) represents a quantitative mechanism for assessing anatomical suitability for endovascular aortic repair. Anatomic severity grade has been correlated with repair outcomes and resource utilization. The purpose of this study was to identify a novel renal perfusion metric as a way to assist ASG with predicting EVAR outcomes. Retrospective review of a prospectively maintained database identified elective infrarenal aortic aneurysm repair cases. Anatomic grading was undertaken by independent reviewers. Using volumetric software, kidney volume, and a novel measure of kidney functional volume, the volumetric nephrogram (VN) was recorded. Systematic evaluation of the relationship of kidney volume and VN to CKD and ASG was undertaken using linear regression and receiver-operator statistical tools. A total of 386 cases with patient and anatomic data were identified and graded. Mean age was 72.9 ± 0.4 years. Renal volume <281 mL correlated with CKD (area under the curve [AUC] = .708; P ≤ .0001). Volumetric nephrogram <22.5 HU·L correlated with CKD (AUC = 0.764; P ≤ .0001). High (≥15) ASG scores correlated with both renal volume (AUC = .628; P ≤ .0001) and VN (AUC = .628; P ≤ .0001). Regression analysis demonstrated a strong, inverse relationship between ASG and VN ( R 2 = .95). These data demonstrate that VN is a strong predictor of CKD in a large database of patients undergoing elective aneurysm repair. We demonstrate an inverse relationship between renal function and ASG that has not been previously described in the literature. Additionally, we have shown that VN complements ASG as a model of overall cardiovascular health and atherosclerotic burden. Outcomes in patients with poor renal function may be related to anatomical issues in addition to well-described systemic ramifications.

  6. Morbidity Assessment in Surgery: Refinement Proposal Based on a Concept of Perioperative Adverse Events

    PubMed Central

    Kazaryan, Airazat M.; Røsok, Bård I.; Edwin, Bjørn

    2013-01-01

    Background. Morbidity is a cornerstone assessing surgical treatment; nevertheless surgeons have not reached extensive consensus on this problem. Methods and Findings. Clavien, Dindo, and Strasberg with coauthors (1992, 2004, 2009, and 2010) made significant efforts to the standardization of surgical morbidity (Clavien-Dindo-Strasberg classification, last revision, the Accordion classification). However, this classification includes only postoperative complications and has two principal shortcomings: disregard of intraoperative events and confusing terminology. Postoperative events have a major impact on patient well-being. However, intraoperative events should also be recorded and reported even if they do not evidently affect the patient's postoperative well-being. The term surgical complication applied in the Clavien-Dindo-Strasberg classification may be regarded as an incident resulting in a complication caused by technical failure of surgery, in contrast to the so-called medical complications. Therefore, the term surgical complication contributes to misinterpretation of perioperative morbidity. The term perioperative adverse events comprising both intraoperative unfavourable incidents and postoperative complications could be regarded as better alternative. In 2005, Satava suggested a simple grading to evaluate intraoperative surgical errors. Based on that approach, we have elaborated a 3-grade classification of intraoperative incidents so that it can be used to grade intraoperative events of any type of surgery. Refinements have been made to the Accordion classification of postoperative complications. Interpretation. The proposed systematization of perioperative adverse events utilizing the combined application of two appraisal tools, that is, the elaborated classification of intraoperative incidents on the basis of the Satava approach to surgical error evaluation together with the modified Accordion classification of postoperative complication, appears to be an

  7. Is the grading system of the severity of the OSAHS used presently rational or not?: from the view of incidence of hypertension in different severity groups.

    PubMed

    Li, Jinrang; Chen, Xi; Sun, Jianjun

    2014-09-01

    The grading system of the severity of obstructive sleep apnea hypopnea syndrome (OSAHS) used presently showed that the severe OSAHS had an extensive range of apnea hypopnea index (AHI) (≥ 30, even over 100). So this grading system is not rational. From Jan 1999 to June 2011, there were 2,618 patients complaining of snoring took the polysomnography. The patients were divided into 11 groups according to their AHI. Frequencies of OSAHS with hypertension in each group were tested using crosstabs. The incidence of hypertension was increased as the increasing of AHI. Crosstab analysis showed that there were four cutoff points of AHI (5, 30, 50, 100). There was a significant difference in the incidence of hypertension between the groups of AHI more than the cutoff point and AHI less than the cutoff point. So from the view of hypertension in each group, we recommend that the AHI <5 should be considered as normal or simple snorer, AHI = 5-30 as mild degree of OSAHS, AHI = 30-50 as moderate degree of OSAHS, AHI = 50-100 as severe degree of OSAHS, and AHI ≥ 100 as profound degree of OSAHS.

  8. The effect of age and gender on motor vehicle driver injury severity at highway-rail grade crossings in the United States.

    PubMed

    Hao, Wei; Kamga, Camille; Daniel, Janice

    2015-12-01

    Based on the Federal Railway Administration (FRA) database, there were 25,945 highway-rail crossing accidents in the United States between 2002 and 2011. With an extensive database of highway-rail grade crossing accidents in the United States from 2002 to 2011, estimation results showed that there were substantial differences across age/gender groups for driver's injury severity. The study applied an ordered probit model to explore the determinants of driver injury severity for motor vehicle drivers at highway-rail grade crossings. The analysis found that there are important behavioral and physical differences between male and female drivers given a highway-rail grade crossing accident happened. Older drivers have higher fatality probabilities when driving in open space under passive control especially during bad weather condition. Younger male drivers are found to be more likely to have severe injuries at rush hour with high vehicle speed passing unpaved highway-rail grade crossings under passive control. Synthesizing these results led to the conclusion that the primary problem with young is risk-taking and lack of vehicle handling skills. The strength of older drivers lies in their aversion to risk, but physical degradation issues which result in longer reaction/perception times and degradation in vision and hearing often counterbalance this attribute. Copyright © 2015 Elsevier Ltd and National Safety Council. All rights reserved.

  9. Self-Grading and Peer-Grading for Formative and Summative Assessments in 3rd through 12th Grade Classrooms: A Meta-Analysis

    ERIC Educational Resources Information Center

    Sanchez, Carmen E.; Atkinson, Kayla M.; Koenka, Alison C.; Moshontz, Hannah; Cooper, Harris

    2017-01-01

    The "assessment 'for' learning" movement in education has increased attention to self-grading and peer-grading practices in primary and secondary schools. This research synthesis examined several questions pertaining to the use of self-grading and peer-grading in conjunction with criterion-referenced testing in 3rd- through…

  10. Comparison of Standardized Clinical Classification with Fundus Photograph Grading for the assessment of Diabetic Retinopathy and Diabetic Macular Edema Severity

    PubMed Central

    Gangaputra, Sapna; Lovato, James F.; Hubbard, Larry; Davis, Matthew D; Esser, Barbara A; Ambrosius, Walter T.; Chew, Emily Y.; Greven, Craig; Perdue, Letitia H; Wong, Wai T.; Condren, Audree; Wilkinson, Charles P.; Agrón, Elvira; Adler, Sharon; Danis, Ronald P

    2013-01-01

    Purpose To compare evaluation by clinical examination with image grading at a reading center (RC) for the classification of diabetic retinopathy (DR) and diabetic macular edema (DME). Methods ACCORD and FIND had similar methods of clinical and fundus photograph evaluation. For analysis purposes the photographic grading scales were condensed to correspond to the clinical scales and agreement between clinicians and reading center classification were compared. Results 6902 eyes of ACCORD participants and 3638 eyes of FIND participants were analyzed for agreement (percent, kappa) on DR on a 5 level scale. Exact agreement between clinicians and RC on DR severity category was 69% in ACCORD and 74% in FIND (Kappa 0.42 and 0.65). Sensitivity of the clinical grading to identify presence of mild nonproliferative retinopathy or worse was 0.53 in ACCORD and 0.84 in FIND. Specificities were 0.97 and 0.96, respectively. DME agreement in 6649 eyes of ACCORD participants and 3366 eyes of FIND participants was similar in both studies (Kappa 0.35 and 0.41). Sensitivities of the clinical grading to identify DME were 0.44 and 0.53 and specificities were 0.99 and 0.94, respectively. Conclusion Our results support the use of clinical information for defining broad severity categories, but not for documenting small to moderate changes in DR over time. PMID:23615341

  11. Accordian-folded boot shield for flexible swivel connection

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Hoh, J.C.

    1986-08-26

    This patent describes an apparatus for connecting a first boot section to a second boot section, the first and second boots having openings therethrough, the second boot having at least two adjacent accordion folds at the end having the opening. The second boot is positioned through the opening of the first boot such that a first of the accordion folds is within the first boot and a second of the accordion folds is outside of the first boot comprising: first and second annular discs, the first disc being positioned within and across the first accordion fold, the second disc beingmore » positioned within and across the second accordion fold such that the first boot is moveably and rigidly connected between the first and second accordion folds.« less

  12. A comparative study of rail-pedestrian trespassing crash injury severity between highway-rail grade crossings and non-crossings.

    PubMed

    Zhang, Meng; Khattak, Asad J; Liu, Jun; Clarke, David

    2018-08-01

    Rail-trespassing crashes that involve various levels of injuries to pedestrians are under-researched. Rail trespassing could occur at crossings where pedestrians are present at the wrong time and at non-crossings where pedestrians are not legally allowed to be present. This paper presents a comparative study examining rail-trespassing crashes in two contexts: highway-rail grade crossings vs. non-crossings. How pre-crash trespassing behaviors and other factors (e.g., crash time, locations, and socio-demographics) differ between grade crossings and non-crossings are explored. The analysis relies on a ten-year (2006-2015) database of rail-pedestrian trespassing crash records extracted from a Federal Railroad Administration safety database. Of these 7157 rail-pedestrian trespassing crashes, 6236 (87%) occurred at non-crossings, while 921 (13%) occurred at grade crossings. About 60% of the crashes were fatal at both crossings and non-crossings. The most prevalent pre-crash trespassing behavior is running or walking, 63% at grade crossings and 44% at non-crossings. Lying or sleeping account for 29% of non-crossing crashes, whereas they are 3.6% at grade crossings. A unique aspect of the study is that a diverse set of variables based on geographic variations across counties along with crash or injury data are modeled. Considering the data structure and heterogeneity that may exist due to unobserved factors, the multilevel mixed-effect ordered logistic regressions models are estimated. The results show that the correlates of injury severity differ across highway-rail grade crossings and non-crossings. For example, lying or sleeping on or near tracks contributed to higher chances of fatal injury in both contexts, however, they were relatively more injurious at grade crossings. The analytical results can provide guidance on railway safety improvement plans. Copyright © 2018. Published by Elsevier Ltd.

  13. How preschool executive functioning predicts several aspects of math achievement in Grades 1 and 3: A longitudinal study.

    PubMed

    Viterbori, Paola; Usai, M Carmen; Traverso, Laura; De Franchis, Valentina

    2015-12-01

    This longitudinal study analyzes whether selected components of executive function (EF) measured during the preschool period predict several indices of math achievement in primary school. Six EF measures were assessed in a sample of 5-year-old children (N = 175). The math achievement of the same children was then tested in Grades 1 and 3 using both a composite math score and three single indices of written calculation, arithmetical facts, and problem solving. Using previous results obtained from the same sample of children, a confirmatory factor analysis examining the latent EF structure in kindergarten indicated that a two-factor model provided the best fit for the data. In this model, inhibition and working memory (WM)-flexibility were separate dimensions. A full structural equation model was then used to test the hypothesis that math achievement (the composite math score and single math scores) in Grades 1 and 3 could be explained by the two EF components comprising the kindergarten model. The results indicate that the WM-flexibility component measured during the preschool period substantially predicts mathematical achievement, especially in Grade 3. The math composite scores were predicted by the WM-flexibility factor at both grade levels. In Grade 3, both problem solving and arithmetical facts were predicted by the WM-flexibility component. The results empirically support interventions that target EF as an important component of early childhood mathematics education. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Spatial frequency domain imaging of burn wounds in a preclinical model of graded burn severity

    NASA Astrophysics Data System (ADS)

    Nguyen, John Quan; Crouzet, Christian; Mai, Tuan; Riola, Kathleen; Uchitel, Daniel; Liaw, Lih-Huei; Bernal, Nicole; Ponticorvo, Adrien; Choi, Bernard; Durkin, Anthony J.

    2013-06-01

    Frequent monitoring of early-stage burns is necessary for deciding optimal treatment and management. Both superficial and full thickness burns are relatively easy to diagnose based on clinical observation. In between these two extremes are superficial-partial thickness and deep-partial thickness burns. These burns, while visually similar, differ dramatically in terms of clinical treatment and are known to progress in severity over time. The objective of this study was to determine the potential of spatial frequency domain imaging (SFDI) for noninvasively mapping quantitative changes in chromophore and optical properties that may be an indicative of burn wound severity. A controlled protocol of graded burn severity was developed and applied to 17 rats. SFDI data was acquired at multiple near-infrared wavelengths over a course of 3 h. Burn severity was verified using hematoxylin and eosin histology. From this study, we found that changes in water concentration (edema), deoxygenated hemoglobin concentration, and optical scattering (tissue denaturation) to be statistically significant at differentiating superficial partial-thickness burns from deep-partial thickness burns.

  15. Anatomic severity grading score predicts technical difficulty, early outcomes, and hospital resource utilization of endovascular aortic aneurysm repair.

    PubMed

    Ahanchi, Sadaf S; Carroll, Megan; Almaroof, Babatunde; Panneton, Jean M

    2011-11-01

    In 2002, a system for the grading of abdominal aortic aneurysms (AAAs) was developed by the Society for Vascular Surgery (SVS). Because the correlation of the anatomic severity grading (ASG) score to patient outcomes has yet to be validated, we provide our experience with calculating the ASG score using three-dimensional (3-D) image-rendering software and provide the practical translation of this score into early outcomes and hospital charges. All patients who underwent an endovascular aneurysm repair (EVAR) for infrarenal AAAs between 2009 and 2010 were retrospectively reviewed for demographics, intraoperative data, and 30-day outcomes. ASG scores were calculated from morphologic measurements, and two independent patient groups were created: those with a low ASG score (score <14) and a high ASG score (score ≥14). We identified 108 patients (mean age, 75 years), of whom 56 were in the low-score ASG group and 52 were in the high-score ASG group. Operative outcomes significantly different in the low-score group vs high-score group were number of endograft implants (three vs four, P = .001), operative time (113 vs 210 minutes, P < .0001), blood loss (227 vs 866 mL, P = .0002), and contrast volume (100 vs 131 mL, P = .032). In the low-score group compared with the high-score group, access site adjuncts were 14% vs 50% (P < .0001), and intraoperative adjuncts were 54% vs 80% (P = .004). Most adjuncts (75%) were endovascular. No EVARs were converted to open. Mean hospital stay was 2 days for the low-score group and 5 days for the high-score group (P = .012). The 30-day operative mortality was zero. No aneurysm-related deaths occurred during follow-up. In the low-score vs high-score groups, mean operating room supply charge was $16,646 vs $25,765 (P = .006), and the mean total hospital charge was $70,956 vs $105,153 (P = .016). The anatomic severity grading score can be easily and rapidly calculated from computed tomography images with the aid of 3-D image

  16. The Effects of a Tier 3 Intervention on the Mathematics Performance of Second Grade Students with Severe Mathematics Difficulties

    ERIC Educational Resources Information Center

    Bryant, Brian R.; Bryant, Diane Pedrotty; Porterfield, Jennifer; Dennis, Minyi Shih; Falcomata, Terry; Valentine, Courtney; Brewer, Chelsea; Bell, Kathy

    2016-01-01

    The purpose of this study was to determine the effectiveness of a systematic, explicit, intensive Tier 3 (tertiary) intervention on the mathematics performance of students in second grade with severe mathematics difficulties. A multiple-baseline design across groups of participants showed improved mathematics performance on number and operations…

  17. Application of a novel severity grading system for surgical complications after colorectal resection.

    PubMed

    Mazeh, Haggi; Samet, Yacov; Abu-Wasel, Bassam; Beglaibter, Nahum; Grinbaum, Ronit; Cohen, Tzeela; Pinto, Meir; Hamburger, Tamar; Freund, Herbert R; Nissan, Aviram

    2009-03-01

    Uniform and accurate reporting of surgical complications is the basis for quality control. We developed a computerized system for reporting and grading surgical complications in colorectal surgery. This study was conducted to evaluate this computerized reporting system. A retrospective chart review was conducted of all surgical complications in patients who underwent resection of the colon or rectum at our institution between the years 1999 and 2004 (n = 408). All complications were recorded using the computerized reporting system and compared with complications reported in the literature. Elective operations were performed in 75.7% of patients, and 24.3% required emergency operations. Of the 408 patients in the study, 239 (58.6%) had an uneventful recovery without complications. At least 1 complication was recorded in 169 (41.4%) patients. Grades 1 and 2 complications were recorded in 83 (20.3%) and 105 (25.7%) patients, respectively, requiring observation or medical treatment only, and 59 patients (14.5%) had grades 3 to 5 complications. The three leading complications were surgical site infection, intraabdominal abscess, and hemorrhage requiring blood transfusion. The grades 3 to 5 complication rate was within the range described in the literature, and the rate of grades 1 and 2 complications was substantially higher. These grades 1 and 2 complications were associated with a substantially longer hospital stay. This novel complication reporting system was found feasible and proved to have a higher sensitivity for recording minor but meaningful complications that tend to prolong hospital stay.

  18. Grade 3 ischemia on the admission electrocardiogram is associated with severe microvascular injury on cardiac magnetic resonance imaging after ST elevation myocardial infarction.

    PubMed

    Weaver, James C; Rees, David; Prasan, Ananth M; Ramsay, David D; Binnekamp, Maurits F; McCrohon, Jane A

    2011-01-01

    Grade 3 ischemia during ST elevation myocardial infarction (STEMI) is defined as ST elevation with distortion of the terminal portion of the QRS on electrocardiogram (ECG). The aim of this study was to evaluate the effect of ischemic grade on cardiac magnetic resonance (CMR) imaging infarct characteristics such as infarct size, microvascular obstruction (MVO), intramyocardial hemorrhage (IMH), and myocardial salvage. Patients with STEMI treated with primary percutaneous coronary intervention had a 12-lead ECG on presentation for analysis of ischemic grade. Gadolinium-enhanced CMR imaging was performed within 7 days to assess infarct size, MVO, IMH, and myocardial salvage. Of the 37 patients enrolled in the study, grade 3 ischemia was present in 32%. Those with grade 3 ischemia had higher peak troponin I levels (P = .013), more MVO (P < .001), more IMH (P < .001), larger infarct size (P = .025), and less myocardial salvage (P = .012). Regression analysis found that grade 3 ischemia, infarct size, and peak troponin I level were significantly associated with MVO and IMH. Grade 3 ischemia on the admission ECG during STEMI is closely associated with the development of severe microvascular damage on CMR imaging. Crown Copyright © 2011. Published by Elsevier Inc. All rights reserved.

  19. Timed Stair Climbing is the Single Strongest Predictor of Perioperative Complications in Patients Undergoing Abdominal Surgery

    PubMed Central

    Reddy, Sushanth; Contreras, Carlo M; Singletary, Brandon; Bradford, T Miller; Waldrop, Mary G; Mims, Andrew H; Smedley, W Andrew; Swords, Jacob A; Thomas N, Wang; Martin J, Heslin

    2016-01-01

    Background Current methods to predict patients' peri-operative morbidity utilize complex algorithms with multiple clinical variables focusing primarily on organ-specific compromise. The aim of the present study is to determine the value of a timed stair climb (SC) in predicting peri-operative complications for patients undergoing abdominal surgery. Study Design From March 2014 to July 2015, 362 patients attempted SC while being timed prior to undergoing elective abdominal surgery. Vital signs were measured before and after SC. Ninety day post-operative complications were assessed by the Accordion Severity Grading System. The prognostic value of SC was compared to the ACS NSQIP risk calculator. Results A total of 264 (97.4%) patients were able to complete SC. SC time directly correlated to changes in both mean arterial pressure and heart rate as an indicator of stress. An Accordion grade 2 or higher complication occurred in 84 (25%) patients. There were 8 mortalities (2.4%). Patients with slower SC times had an increased complication rate (P<0.0001). In multivariable analysis SC time was the single strongest predictor of complications (OR=1.029, P<0.0001), and no other clinical co-morbidity reached statistical significance. Receiver operative characteristic curves predicting post-operative morbidity by SC time was superior to that of the ACS risk calculator (AUC 0.81 vs. 0.62, P<0.0001). Additionally slower patients had a greater deviation from predicted length of hospital stay (P=0.034) Conclusions SC provides measurable stress, accurately predicts post-operative complications, and is easy to administer in patients undergoing abdominal surgery. Larger patient populations with a diverse group of operations will be needed to further validate the use of SC in risk prediction models. PMID:26920993

  20. TREEGRAD: a grading program for eastern hardwoods

    Treesearch

    J.W. Stringer; D.W. Cremeans

    1991-01-01

    Assigning tree grades to eastern hardwoods is often a difficult task for neophyte graders. Recently several "dichotomous keys" have been developed for training graders in the USFS hardwood tree grading system. TREEGRAD uses the Tree Grading Algorithm (TGA) for determining grades from defect location data and is designed to be used as a teaching aid.

  1. Do changing toll-like receptor profiles in different layers and grades of osteoarthritis cartilage reflect disease severity?

    PubMed

    Barreto, Gonçalo; Sillat, Tarvo; Soininen, Antti; Ylinen, Pekka; Salem, Abdelhakim; Konttinen, Yrjö T; Al-Samadi, Ahmed; Nordström, Dan C E

    2013-05-01

    Cartilage degeneration in osteoarthritis (OA) leads to release of potential danger signals. The aim of our study was to profile OA cartilage for the Toll-like receptor (TLR) danger signal receptors. Osteochondral cylinders from total knee replacements were graded using OA Research Society International score and stained for proteoglycans, collagenase-cleaved type II collagen, and TLR 1-10, which were analyzed histomorphometrically. Grade 1 OA lesions contained 22%-55% TLR 1-9-positive cells in the surface zone, depending on the TLR type. In Grade 2 TLR, immunoreactivity was 60%-100% (p < 0.01) and it was even higher in Grades 3 and 4 (p < 0.01 vs Grade 1). TLR-positive cells in Grade 1 middle zone were low, 0-19.9%, but were 5.1%-32.7% in Grade 2 (p < 0.01) and 34%-83% in Grades 3-4 samples (p < 0.001). TLR values in Grade 5 were low (14.3%-28.7%; p < 0.001). In Grades 3-4 OA, cartilage matrix stained strongly for TLR. In Grade 1, COL2-3/4M was restricted to chondrocytes, but was increasingly seen in matrix upon progress of OA to Grade 4, and then declined. Cells in the gliding surface zone are fully equipped with TLR in mild OA. Their proportion increases and extends to the middle or even the deep zone, reflecting OA progression. COL2A-3/4M staining suggests Endo180-mediated intake for intralysosomal degradation by cathepsins in Grade 1, but in higher grades this chondrocyte-mediated clearance fails and the matrix demonstrates extensive collagenase-induced damage. Detached and/or partially degraded matrix components can then act as endogenous danger signals (damage-associated molecular patterns or DAMP) and stimulate increasingly TLR-equipped chondrocytes to inflammation. At the peak inflammatory response, soluble TLR may exert negative feedback, explaining in part the low TLR levels in Grade 5 OA.

  2. Analyzing injury severity factors at highway railway grade crossing accidents involving vulnerable road users: A comparative study.

    PubMed

    Ghomi, Haniyeh; Bagheri, Morteza; Fu, Liping; Miranda-Moreno, Luis F

    2016-11-16

    The main objective of this study is to identify the main factors associated with injury severity of vulnerable road users (VRUs) involved in accidents at highway railroad grade crossings (HRGCs) using data mining techniques. This article applies an ordered probit model, association rules, and classification and regression tree (CART) algorithms to the U.S. Federal Railroad Administration's (FRA) HRGC accident database for the period 2007-2013 to identify VRU injury severity factors at HRGCs. The results show that train speed is a key factor influencing injury severity. Further analysis illustrated that the presence of illumination does not reduce the severity of accidents for high-speed trains. In addition, there is a greater propensity toward fatal accidents for elderly road users compared to younger individuals. Interestingly, at night, injury accidents involving female road users are more severe compared to those involving males. The ordered probit model was the primary technique, and CART and association rules act as the supporter and identifier of interactions between variables. All 3 algorithms' results consistently show that the most influential accident factors are train speed, VRU age, and gender. The findings of this research could be applied for identifying high-risk hotspots and developing cost-effective countermeasures targeting VRUs at HRGCs.

  3. Alternatives to Grading Student Writing.

    ERIC Educational Resources Information Center

    Tchudi, Stephen, Ed.

    The result of an investigation into the grading writing by the National Council of Teachers of English Committee on Alternatives to Grading Student Writing, this collection of essays offers the writing teacher several innovative and interesting options. Following an introduction by the editor (chair of the Committee), in which he delineates the…

  4. Grading System and Student Effort

    ERIC Educational Resources Information Center

    Paredes, Valentina

    2017-01-01

    Several papers have proposed that the grading system affects students' incentives to exert effort. In particular, the previous literature has compared student effort under relative and absolute grading systems, but the results are mixed and the implications of the models have not been empirically tested. In this paper, I build a model where…

  5. Does Education Corrupt? Theories of Grade Inflation

    ERIC Educational Resources Information Center

    Oleinik, Anton

    2009-01-01

    Several theories of grade inflation are discussed in this review article. It is argued that grade inflation results from the substitution of criteria specific to the search for truth by criteria of quality control generated outside of academia. Particular mechanisms of the grade inflation that occurs when a university is transformed into a…

  6. Identifying the heterogeneity of COPD by V/P SPECT: a new tool for improving the diagnosis of parenchymal defects and grading the severity of small airways disease.

    PubMed

    Bajc, M; Chen, Y; Wang, J; Li, X Y; Shen, W M; Wang, C Z; Huang, H; Lindqvist, A; He, X Y

    2017-01-01

    Airway obstruction and possible concomitant pulmonary diseases in COPD cannot be identified conventionally with any single diagnostic tool. We aimed to diagnose and grade COPD severity and identify pulmonary comorbidities associated with COPD with ventilation/perfusion single-photon emission computed tomography (V/P SPECT) using Technegas as the functional ventilation imaging agent. 94 COPD patients (aged 43-86 years, Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages I-IV) were examined with V/P SPECT and spirometry. Ventilation and perfusion defects were analyzed blindly according to the European guidelines. Penetration grade of Technegas in V SPECT measured the degree of obstructive small airways disease. Total preserved lung function and penetration grade of Technegas in V SPECT were assessed by V/P SPECT and compared to GOLD stages and spirometry. Signs of small airway obstruction in the ventilation SPECT images were found in 92 patients. Emphysema was identified in 81 patients. Two patients had no signs of COPD, but both of them had a pulmonary embolism, and in one of them we also suspected a lung tumor. The penetration grade of Technegas in V SPECT and total preserved lung function correlated significantly to GOLD stages ( r =0.63 and -0.60, respectively, P <0.0001). V/P SPECT identified pulmonary embolism in 30 patients (32%). A pattern typical for heart failure was present in 26 patients (28%). Parenchymal changes typical for pneumonia or lung tumor were present in several cases. V/P SPECT, using Technegas as the functional ventilation imaging agent, is a new tool to diagnose COPD and to grade its severity. Additionally, it revealed heterogeneity of COPD caused by pulmonary comorbidities. The characteristics of these comorbidities suggest their significant impact in clarifying symptoms, and also their influence on the prognosis.

  7. Estimating tree grades for Southern Appalachian natural forest stands

    Treesearch

    Jeffrey P. Prestemon

    1998-01-01

    Log prices can vary significantly by grade: grade 1 logs are often several times the price per unit of grade 3 logs. Because tree grading rules derive from log grading rules, a model that predicts tree grades based on tree and stand-level variables might be useful for predicting stand values. The model could then assist in the modeling of timber supply and in economic...

  8. Aortic anatomic severity grade correlates with resource utilization.

    PubMed

    Rasheed, Khurram; Cullen, John P; Seaman, Matthew J; Messing, Susan; Ellis, Jennifer L; Glocker, Roan J; Doyle, Adam J; Stoner, Michael C

    2016-03-01

    Potential cost effectiveness of endovascular aneurysm repair (EVAR) compared with open aortic repair (OAR) is offset by the use of intraoperative adjuncts (components) or late reinterventions. Anatomic severity grade (ASG) can be used preoperatively to assess abdominal aortic aneurysms, and provide a quantitative measure of anatomic complexity. The hypothesis of this study is that ASG is directly related to the use of intraoperative adjuncts and cost of aortic repair. Patients who undergo elective OAR and EVAR for abdominal aortic aneurysms were identified over a consecutive 3-year period. ASG scores were calculated manually using three-dimensional reconstruction software by two blinded reviewers. Statistical analysis of cost data was performed using a log transformation. Regression analyses, with a continuous or dichotomous outcome, used a generalized estimating equations approach with the sandwich estimator, being robust with respect to deviations from model assumptions. One hundred forty patients were identified for analysis, n = 33 OAR and n = 107 EVAR. The mean total cost (± standard deviation) for OAR was per thousand (k) $38.3 ± 49.3, length of stay (LOS) 13.5 ± 14.2 days, ASG score 18.13 ± 3.78; for EVAR, mean total cost was k $24.7 ± 13.0 (P = .016), LOS 3.0 ± 4.4 days (P = .012), ASG score 15.9 ± 4.13 (P = .010). In patients who underwent EVAR, 25.2% required intraoperative adjuncts, and analysis of this group revealed a mean total cost of k $31.5 ± 15.9, ASG score 18.48 ± 3.72, and LOS 3.9 ± 4.5, which were significantly greater compared with cases without adjunctive procedures. An ASG score of ≥15 correlated with an increased propensity for requirement of intraoperative adjuncts; odds ratio, 5.75 (95% confidence interval, 1.82-18.19). ASG >15 was also associated with chronic kidney disease, end stage renal disease, hypertension, female sex, increased cost, and use of adjunctive procedures. Complex aneurysm anatomy correlates with increased

  9. How Does the Severity of Injury Vary between Motorcycle and Automobile Accident Victims Who Sustain High-Grade Blunt Hepatic and/or Splenic Injuries? Results of a Retrospective Analysis.

    PubMed

    Hsieh, Ting-Min; Tsai, Tsung-Cheng; Liu, Yueh-Wei; Hsieh, Ching-Hua

    2016-07-21

    High-grade blunt hepatic and/or splenic injuries (BHSI) remain a great challenge for trauma surgeons. The main aim of this study was to investigate the characteristics, mortality rates, and outcomes of high-grade BHSI in motorcyclists and car occupants hospitalized for treatment of traumatic injuries in a Level I trauma center in southern Taiwan. High-grade BHSI are defined as grade III-VI blunt hepatic injuries and grade III-V blunt splenic injuries. This retrospective study reviewed the data of 101 motorcyclists and 32 car occupants who experienced a high-grade BHSI from 1 January 2011 to 31 December 2013. Two-sided Fisher's exact or Pearson's chi-square tests were used to compare categorical data, unpaired Student's t-test was used to analyze normally distributed continuous data, and Mann-Whitney's U test was used to compare non-normally distributed data. In this study, the majority (76%, 101/133) of high-grade BHSI were due to motorcycle crashes. Car occupants had a significantly higher injury severity score (ISS; 26.8 ± 10.9 vs. 20.7 ± 10.4, respectively, p = 0.005) and organ injured score (OIS; 3.8 ± 1.0 vs. 3.4 ± 0.6, respectively, p = 0.033), as well as a significantly longer hospital length of stay (LOS; 21.2 days vs. 14.6 days, respectively, p = 0.038) than did motorcyclists. Car occupants with high-grade BHSI also had worse clinical presentations than their motorcyclist counterparts, including a significantly higher incidence of hypotension, hyperpnea, tube thoracostomy, blood transfusion >4 units, LOS in intensive care unit >5 days, and complications. However, there were no differences in the percentage of angiography or laparotomy performed or mortality rate between these two groups of patients. This study demonstrated that car occupants with high-grade BHSI were injured more severely, had a higher incidence of worse clinical presentation, had a longer hospital LOS, and had a higher incidence of complications than motorcyclists. The results also

  10. How Does the Severity of Injury Vary between Motorcycle and Automobile Accident Victims Who Sustain High-Grade Blunt Hepatic and/or Splenic Injuries? Results of a Retrospective Analysis

    PubMed Central

    Hsieh, Ting-Min; Tsai, Tsung-Cheng; Liu, Yueh-Wei; Hsieh, Ching-Hua

    2016-01-01

    Background: High-grade blunt hepatic and/or splenic injuries (BHSI) remain a great challenge for trauma surgeons. The main aim of this study was to investigate the characteristics, mortality rates, and outcomes of high-grade BHSI in motorcyclists and car occupants hospitalized for treatment of traumatic injuries in a Level I trauma center in southern Taiwan. Methods: High-grade BHSI are defined as grade III-VI blunt hepatic injuries and grade III-V blunt splenic injuries. This retrospective study reviewed the data of 101 motorcyclists and 32 car occupants who experienced a high-grade BHSI from 1 January 2011 to 31 December 2013. Two-sided Fisher’s exact or Pearson’s chi-square tests were used to compare categorical data, unpaired Student’s t-test was used to analyze normally distributed continuous data, and Mann–Whitney’s U test was used to compare non-normally distributed data. Results: In this study, the majority (76%, 101/133) of high-grade BHSI were due to motorcycle crashes. Car occupants had a significantly higher injury severity score (ISS; 26.8 ± 10.9 vs. 20.7 ± 10.4, respectively, p = 0.005) and organ injured score (OIS; 3.8 ± 1.0 vs. 3.4 ± 0.6, respectively, p = 0.033), as well as a significantly longer hospital length of stay (LOS; 21.2 days vs. 14.6 days, respectively, p = 0.038) than did motorcyclists. Car occupants with high-grade BHSI also had worse clinical presentations than their motorcyclist counterparts, including a significantly higher incidence of hypotension, hyperpnea, tube thoracostomy, blood transfusion >4 units, LOS in intensive care unit >5 days, and complications. However, there were no differences in the percentage of angiography or laparotomy performed or mortality rate between these two groups of patients. Conclusions: This study demonstrated that car occupants with high-grade BHSI were injured more severely, had a higher incidence of worse clinical presentation, had a longer hospital LOS, and had a higher incidence of

  11. Grade Repetition in Honduran Primary Schools

    ERIC Educational Resources Information Center

    Marshall, Jeffery H.

    2003-01-01

    This paper looks at several dimensions of the grade failure issue in Honduras using a unique data set compiled by the UMCE evaluation project in 1998 and 1999. The analytical framework incorporates econometric analysis of standardized tests and teacher pass/fail decisions for roughly 13,000 second and fourth grade students. The results show that…

  12. Sawlog grades for eastern white pine

    Treesearch

    Myron D. Ostrander; Robert L. Brisbin; Robert L. Brisbin

    1971-01-01

    In 1957, the USDA Forest Service Log Grade Committee recommended a service-wide action program in log- and tree-grade research. Approval of the program in 1958 resulted in the establishment of five species-oriented timber-quality research projects covering several groups of commercially important timber species. The eastern softwood timber-quality project was activated...

  13. Tree grades for eastern white pine

    Treesearch

    Robert L. Brisbin; David L. Sonderman; David L. Sonderman

    1971-01-01

    In 1957 the Forest Service Log Grade Committee recommended a service-wide action program in log and tree grade research. Approval of the program late in 1958 resulted in the establishment of five species-oriented timber- quality research projects covering the several groups of commercially important timber species. The eastern softwood timber-quality project was...

  14. Functionally Graded Adhesives for Composite Joints

    NASA Technical Reports Server (NTRS)

    Stapleton, Scott E.; Waas, Anthony M.; Arnold, Steven M.

    2012-01-01

    Adhesives with functionally graded material properties are being considered for use in adhesively bonded joints to reduce the peel stress concentrations located near adherend discontinuities. Several practical concerns impede the actual use of such adhesives. These include increased manufacturing complications, alterations to the grading due to adhesive flow during manufacturing, and whether changing the loading conditions significantly impact the effectiveness of the grading. An analytical study is conducted to address these three concerns. An enhanced joint finite element, which uses an analytical formulation to obtain exact shape functions, is used to model the joint. Furthermore, proof of concept testing is conducted to show the potential advantages of functionally graded adhesives. In this study, grading is achieved by strategically placing glass beads within the adhesive layer at different densities along the joint.

  15. Should You Allow Your Students to Grade Their Own Homework?

    ERIC Educational Resources Information Center

    Simkin, Mark G.

    2015-01-01

    Allowing students to grade their own homework promises several advantages to both students and instructors. But does such a policy make sense? This paper reports the results of an experiment in which eight separate assignments completed by approximately 80 students were first graded by the students using a grading rubric, and then re-graded by a…

  16. The complex nature of discordant severe calcified aortic valve disease grading: new insights from combined Doppler echocardiographic and computed tomographic study.

    PubMed

    Clavel, Marie-Annick; Messika-Zeitoun, David; Pibarot, Philippe; Aggarwal, Shivani R; Malouf, Joseph; Araoz, Phillip A; Michelena, Hector I; Cueff, Caroline; Larose, Eric; Capoulade, Romain; Vahanian, Alec; Enriquez-Sarano, Maurice

    2013-12-17

    With concomitant Doppler echocardiography and multidetector computed tomography (MDCT) measuring aortic valve calcification (AVC) load, this study aimed at defining: 1) independent physiologic/structural determinants of aortic valve area (AVA)/mean gradient (MG) relationship; 2) AVC thresholds best associated with severe aortic stenosis (AS); and 3) whether, in AS with discordant MG, severe calcified aortic valve disease is generally detected. Aortic stenosis with discordant markers of severity, AVA in severe range but low MG, is a conundrum, unresolved by outcome studies. Patients (n = 646) with normal left ventricular ejection fraction AS underwent Doppler echocardiography and AVC measurement by MDCT. On the basis of AVA-indexed-to-body surface area (AVAi) and MG, patients were categorized as concordant severity grading (CG) with moderate AS (AVAi >0.6 cm²/m², MG <40 mm Hg), severe AS (AVAi ≤0.6 cm²/m², MG ≥ 40 mm Hg), discordant-severity-grading (DG) with low-MG (AVAi ≤0.6 cm(2)/m(2), MG <40 mm Hg), or high-MG (AVAi >0.6 cm(2)/m(2), MG ≥40 mm Hg). The MG (discordant in 29%) was strongly determined by AVA and flow but also independently and strongly influenced by AVC-load (p < 0.0001) and systemic arterial compliance (p < 0.0001). The AVC-load (median [interquartile range]) was similar within patients with DG (low-MG: 1,619 [965 to 2,528] arbitrary units [AU]; high-MG: 1,736 [1,209 to 2,894] AU; p = 0.49), higher than CG-moderate-AS (861 [427 to 1,519] AU; p < 0.0001) but lower than CG-severe-AS (2,931 [1,924 to 4,292] AU; p < 0.0001). The AVC-load thresholds separating severe/moderate AS were defined in CG-AS with normal flow (stroke-volume-index >35 ml/m(2)). The AVC-load, absolute or indexed, identified severe AS accurately (area under the curve ≥0.89, sensitivity ≥86%, specificity ≥79%) in men and women. Upon application of these criteria to DG-low MG, at least one-half of the patients were identified as severe calcified

  17. The Effects of a Tier 3 Intervention on the Mathematics Performance of Second Grade Students With Severe Mathematics Difficulties.

    PubMed

    Bryant, Brian R; Bryant, Diane Pedrotty; Porterfield, Jennifer; Dennis, Minyi Shih; Falcomata, Terry; Valentine, Courtney; Brewer, Chelsea; Bell, Kathy

    2016-01-01

    The purpose of this study was to determine the effectiveness of a systematic, explicit, intensive Tier 3 (tertiary) intervention on the mathematics performance of students in second grade with severe mathematics difficulties. A multiple-baseline design across groups of participants showed improved mathematics performance on number and operations concepts and procedures, which are the foundation for later mathematics success. In the previous year, 12 participants had experienced two doses (first and second semesters) of a Tier 2 intervention. In second grade, the participants continued to demonstrate low performance, falling below the 10th percentile on a researcher-designed universal screener and below the 16th percentile on a distal measure, thus qualifying for the intensive intervention. A project interventionist, who met with the students 5 days a week for 10 weeks (9 weeks for one group), conducted the intensive intervention. The intervention employed more intensive instructional design features than the previous Tier 2 secondary instruction, and also included weekly games to reinforce concepts and skills from the lessons. Spring results showed significantly improved mathematics performance (scoring at or above the 25th percentile) for most of the students, thus making them eligible to exit the Tier 3 intervention. © Hammill Institute on Disabilities 2014.

  18. Computer-Aided Grading of Lymphangioleiomyomatosis (LAM) using HRCT

    PubMed Central

    Yao, Jianhua; Avila, Nilo; Dwyer, Andrew; Taveira-DaSilva, Angelo M.; Hathaway, Olanda M.; Moss, Joel

    2010-01-01

    Lymphangioleiomyomatosis (LAM) is a multisystem disorder associated with proliferation of smooth muscle-like cells, which leads to destruction of lung parenchyma. Subjective grading of LAM on HRCT is imprecise and can be arduous especially in cases with severe involvement. We propose a computer-aided evaluation system that grades LAM involvement based on analysis of lung texture patterns. A committee of support vector machines is employed for classification. The system was tested on 36 patients. The computer grade demonstrates good correlation with subjective radiologist grade (R=0.91, p<0.0001) and pulmonary functional tests (R=0.85, p<0.0001). The grade also provides precise progression assessment of disease over time. PMID:21625320

  19. Evaluation of novel scoring system named 5-5-5 exacerbation grading scale for allergic conjunctivitis disease.

    PubMed

    Shoji, Jun; Inada, Noriko; Sawa, Mitsuru

    2009-12-01

    The objective of this study is to evaluate the practical usefulness of a scoring system using the 5-5-5 exacerbation grading scale for allergic conjunctivitis disease (ACD). Subjects were 103 patients with ACD including 40 patients with vernal keratoconjunctivitis (VKC), 20 patients with atopic keratoconjunctivitis (AKC), and 43 patients with allergic conjunctivitis (AC). The 5-5-5 exacerbation grading scale consists of the following 3 graded groups of clinical observations: the 100-point-grade group (100 points for each observation) includes active giant papillae, gelatinous infiltrates of the limbus, exfoliative epithelial keratopathy, shield ulcer and papillary proliferation at lower palpebral conjunctiva; the 10-point-grade group (10 points for each observation) includes blepharitis, papillary proliferation with velvety appearance, Horner-Trantas spots, edema of bulbal conjunctiva, and superficial punctate keratopathy; and the 1-point-grade group (1 point for each observation) includes papillae at upper palpebral conjunctiva, follicular lesion at lower palpebral conjunctiva, hyperemia of palpebral conjunctiva, hyperemia of bulbal conjunctiva, and lacrimal effusion. The total points in each grade group were determined as the severity score of the 5-5-5 exacerbation grading scale. The median severity scores of the 5-5-5 exacerbation grading scale in VKC, AKC and AC were 243 (range: 12-444), 32.5 (11-344), and 13 (2-33), respectively. The severity score of each ACD disease type was significantly different (P < 0.001, Kruskal-Wallis test). The severity of each type of ACD was classified as severe, moderate, or mild according to the severity score. The 5-5-5 exacerbation grading scale is a useful clinical tool for grading the severity of each type of ACD.

  20. The severity of attention deficit hyperactivity symptoms and its relationship with lifetime substance use and psychological variables among 10th grade students in Istanbul.

    PubMed

    Evren, Cuneyt; Dalbudak, Ercan; Evren, Bilge; Can, Yesim; Umut, Gokhan

    2014-10-01

    The aim of this study was to determine the severity of attention deficit hyperactivity symptoms (ADHS) and related psychological and behavioral variables among 10th grade students in Istanbul/Turkey. Cross-sectional online self-report survey conducted in 45 schools in 15 districts Istanbul. The questionnaire included sections about demographic data and use of substances including tobacco, alcohol and drugs. Also ADHS, depression, anxiety, anger and sensation seeking subscales of Psychological Screening Test for Adolescents (PSTA) were used. The analyses were conducted based on the 4938 subjects. Mean ADHS score was higher in females and among those with a lifetime use of tobacco, alcohol and drug, and having self-harming behavior and suicidal thoughts. ADHS score was correlated with depression, anxiety, anger and sensation seeking scores. In univariate covariance analysis (ANCOVA); depression, anxiety, anger, sensation seeking, lifetime alcohol use and suicidal thoughts predicted the severity of ADHS. The findings suggest that, since ADHS is associated with depression, anxiety, anger, sensation seeking, lifetime alcohol use and suicidal thoughts among 10th grade students, clinicians should screen suicidality and comorbid psychiatric symptoms routinely in adolescents with ADHS. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. Interim hardwood tree grades for factory lumber

    Treesearch

    Leland F. Hanks; Leland F. Hanks

    1971-01-01

    Hardwood trees have for many years been measured in such a way that tree volume could be estimated; and in recent years the prediction of tree quality by using tree grades has become of interest to owners, sellers, and buyers of timber. Several tree-grading systems have been developed, but none has been publicized and used on a widespread scale. The Forest Service...

  2. Detection of Potentially Severe Retinopathy of Prematurity by Remote Image Grading.

    PubMed

    Quinn, Graham E; Ying, Gui-Shuang; Pan, Wei; Baumritter, Agnieshka; Daniel, Ebenezer

    2017-09-01

    Telemedicine in retinopathy of prematurity (ROP) has the potential for delivering timely care to premature infants at risk for serious ROP. To describe the characteristics of eyes at risk for ROP to provide insights into what types of ROP are most easily detected early by image grading. Secondary analysis of eyes with referral-warranted (RW) ROP (stage 3 ROP, zone I ROP, plus disease) on diagnostic examination from the Telemedicine Approaches to Evaluating Acute-Phase Retinopathy of Prematurity (e-ROP) study was conducted from May 1, 2011, to October 31, 2013, in 1257 premature infants with birth weights less than 1251 g in 13 neonatal units in North America. Data analysis was performed between February 1, 2016, and June 5, 2017. Serial imaging sessions with concurrent diagnostic examinations for ROP. Time of detecting RW-ROP on image evaluation compared with clinical examination. In the e-ROP study, 246 infants (492 eyes) were included in the analysis; 138 (56.1%) were male. A total of 447 eyes had RW-ROP on diagnostic examination. Image grading in 123 infants (mean [SD] gestational age, 24.8 [1.4] weeks) detected RW-ROP earlier than diagnostic examination (early) in 191 (42.7%) eyes by about 15 days and detected RW-ROP in 123 infants (mean [SD] gestational age, 24.6 [1.5] weeks) at the same time (same) in 200 (44.7%) eyes. Most of the early eyes (153 [80.1%]) interpreted as being RW-ROP positive on imaging evaluation agreed with examination findings when the examination subsequently documented RW-ROP. At the sessions in which RW-ROP was first found by examination, stage 3 or more in 123 infants (mean [SD] gestational age, 24.8 [1.4] weeks) ROP was noted earlier on image evaluation in 151 of 191 early eyes (79.1%) and in 172 of 200 of same eyes (86.0%) (P = .08); the presence of zone I ROP was detected in 57 of 191 (29.8%) early eyes vs 64 of 200 (32.0%) same eyes (P = .90); and plus disease was noted in 30 of 191 (15.7%) early eyes and 45 of 200 (22

  3. Grade 1 Students Meet David Wiesner's "Three Pigs."

    ERIC Educational Resources Information Center

    Pantaleo, Sylvia

    2002-01-01

    Describes the oral, written, and visual arts responses of a group of Grade 1 children. Discusses first grade children's understandings of and responses to several Radical Change characteristics and metafictive techniques found in David Wiesner's "The Three Pigs" (2001), the 2002 Randolph Caldecott Medal winner. Explores the nature of the…

  4. Lumber grades from Douglas-fir peeler logs.

    Treesearch

    E.E. Matson

    1952-01-01

    Sawmill companies often must decide whether it is more economical to sort and sell peeler logs than to cut them into lumber. If the mill owners have reliable data on the grade of lumber that can be expected from these logs, they will be better prepared to make the decision. The Pacific Northwest Forest and Range Experiment Station has made several lumber grade recovery...

  5. Outcomes of Patellofemoral Arthroplasty Based on Radiographic Severity.

    PubMed

    deDeugd, Casey M; Pareek, Ayoosh; Krych, Aaron J; Cummings, Nancy M; Dahm, Diane L

    2017-04-01

    Patellofemoral arthroplasty (PFA) is increasingly performed for symptomatic patellofemoral arthritis. The purpose of this study was to evaluate the outcomes of PFA based on preoperative radiographic severity of patellofemoral arthritis. All patients who underwent PFA for isolated patellofemoral arthritis between 2002 and 2013 and had undergone preoperative magnetic resonance imaging were identified. Radiographic severity of patellofemoral arthritis was classified according to the Iwano classification system. Groups were divided between mild (grade 0-I) and moderate to severe (grade II-IV) patellofemoral arthritis. Clinical outcomes were evaluated using the Knee Society scores (KSS), University of California at Los Angeles (UCLA) and Tegner scores. Seventy-five knees in 55 patients met inclusion criteria. Mean age was 51 years (range, 36 to 81), and mean follow-up was 3 years (range, 2 to 10). All patients had grade IV patellofemoral chondromalacia and/or significant subchondral cyst formation and edema on magnetic resonance imaging. On plain radiographs, there were no patients with Iwano grade 0, 21 grade I, 15 grade II, 21 grade III, and 18 grade IV patellofemoral arthritis. There was significantly more improvement in KSS pain (P = .046), KSS function (P = .02), University of California at Los Angeles (UCLA) (P = .046) and Tegner (P = .008) scores in the Iwano grade II-IV group vs the Iwano grade I group. Patient-reported pain quality improved significantly more following PFA in the grade II-IV group (P = .04). Patients with evidence of mild patellofemoral arthritis on plain radiographs demonstrated less improvement in pain and function after PFA than those with more advanced patellofemoral arthritis. Caution should be used when considering PFA for patients with minimal radiographic evidence of patellofemoral arthritis. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. 7 CFR 810.105 - Grades and grade requirements.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Agriculture Regulations of the Department of Agriculture (Continued) GRAIN INSPECTION, PACKERS AND STOCKYARD ADMINISTRATION (FEDERAL GRAIN INSPECTION SERVICE), DEPARTMENT OF AGRICULTURE OFFICIAL UNITED STATES STANDARDS FOR GRAIN General Provisions Grades, Grade Requirements, and Grade Designations § 810.105 Grades and grade...

  7. Role of Survival Time and Injury Severity in Fatal Pulmonary Fat Embolism.

    PubMed

    Jarmer, Juliane; Ampanozi, Garyfalia; Thali, Michael J; Bolliger, Stephan A

    2017-03-01

    Pulmonary fat embolism (PFE) is frequent in blunt trauma and may occasionally lead to death. A correlation between fracture grade and severity and PFE grade has been described before, but no correlation between PFE and survival time, fat crushing extent, fat crush grade, or number of body regions with fractures could be noted in this small study. To further examine this, we decided to examine the aforementioned points in a far larger study group.Autopsy protocols of 188 nonresuscitated fatalities with blunt trauma and without right heart injury, which underwent whole body dissection, were retrospectively reviewed concerning the presence and the severity of PFE, injuries, survival time, age, sex, and the body mass index.The fracture grade, the fracture severity, and the number of the fractured regions correlated very well with the grade of PFE, but the crushed regions, crush grade, and crush severity did not. We observed a time correlation between survival time and PFE only in the sense that very rapid deaths were often PFE negative. High-grade PFE was observed most often in patients having died less than 6 hours after the incident, and PFE grades of 2 or more were occasionally noted even after 48 hours.

  8. Towards a Reference Curve for the Grades of Each Course

    ERIC Educational Resources Information Center

    Al-Saleh, Mohammad Fraiwan; Ali, Dareen; Dahshal, Laila

    2010-01-01

    A grade-reference curve (GRC) can be constructed for any course based on the grades of a course in the last several years. Among other things, the reference curve of a course can be used to test for any abnormality in the current semester's grades of a course. It can be a very important document about the course that serves students, teachers and…

  9. Improving Grading Consistency through Grade Lift Reporting

    ERIC Educational Resources Information Center

    Millet, Ido

    2010-01-01

    We define Grade Lift as the difference between average class grade and average cumulative class GPA. This metric provides an assessment of how lenient the grading was for a given course. In 2006, we started providing faculty members individualized Grade Lift reports reflecting their position relative to an anonymously plotted school-wide…

  10. Students' Distress over Grades: Entitlement or a Coping Response?

    ERIC Educational Resources Information Center

    Baer, Judith C.

    2011-01-01

    Faculties across disciplines have noted an increasing number of students who are highly distressed over grades, and this distress is accompanied by pervasive demands on professors. The student behavior takes several forms, including demands for higher grades, expectations of special accommodations by faculty, and the predictions of dire outcomes…

  11. Histopathologic grading of anaplasia in retinoblastoma.

    PubMed

    Mendoza, Pia R; Specht, Charles S; Hubbard, G Baker; Wells, Jill R; Lynn, Michael J; Zhang, Qing; Kong, Jun; Grossniklaus, Hans E

    2015-04-01

    To determine whether the degree of tumor anaplasia has prognostic value by evaluating its correlation with high-risk histopathologic features and clinical outcomes in a series of retinoblastoma patients. Retrospective clinicopathologic study. The clinical and pathologic findings in 266 patients who underwent primary enucleation for retinoblastoma were reviewed. The histologic degree of anaplasia was graded as retinocytoma, mild, moderate, or severe as defined by increasing cellular pleomorphism, number of mitoses, nuclear size, and nuclear hyperchromatism. Nuclear morphometric characteristics were measured. The clinical and pathologic data of 125 patients were compared using Kaplan-Meier estimates of survival. Fisher exact test and multivariate regression were used to analyze the association between anaplasia grade and high-risk histologic features. Increasing grade of anaplasia was associated with decreased overall survival (P = .003) and increased risk of metastasis (P = .0007). Histopathologic features that were associated with anaplasia included optic nerve invasion (P < .0001), choroidal invasion (P < .0001), and anterior segment invasion (P = .04). Multivariate analysis considering high-risk histopathology and anaplasia grading as predictors of distant metastasis and death showed that high-risk histopathology was statistically significant as an independent predictor (P = .01 for metastasis, P = .03 for death) but anaplasia was not (P = .63 for metastasis, P = .30 for death). In the absence of high-risk features, however, severe anaplasia identified an additional risk for metastasis (P = .0004) and death (P = .01). Grading of anaplasia may be a useful adjunct to standard histopathologic criteria in identifying retinoblastoma patients who do not have high-risk histologic features but still have an increased risk of metastasis and may need adjuvant therapy. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Semi-automation of Doppler Spectrum Image Analysis for Grading Aortic Valve Stenosis Severity.

    PubMed

    Niakšu, O; Balčiunaitė, G; Kizlaitis, R J; Treigys, P

    2016-01-01

    Doppler echocardiography analysis has become a golden standard in the modern diagnosis of heart diseases. In this paper, we propose a set of techniques for semi-automated parameter extraction for aortic valve stenosis severity grading. The main objectives of the study is to create echocardiography image processing techniques, which minimize manual image processing work of clinicians and leads to reduced human error rates. Aortic valve and left ventricle output tract spectrogram images have been processed and analyzed. A novel method was developed to trace systoles and to extract diagnostic relevant features. The results of the introduced method have been compared to the findings of the participating cardiologists. The experimental results showed the accuracy of the proposed method is comparable to the manual measurement performed by medical professionals. Linear regression analysis of the calculated parameters and the measurements manually obtained by the cardiologists resulted in the strongly correlated values: peak systolic velocity's and mean pressure gradient's R2 both equal to 0.99, their means' differences equal to 0.02 m/s and 4.09 mmHg, respectively, and aortic valve area's R2 of 0.89 with the two methods means' difference of 0.19 mm. The introduced Doppler echocardiography images processing method can be used as a computer-aided assistance in the aortic valve stenosis diagnostics. In our future work, we intend to improve precision of left ventricular outflow tract spectrogram measurements and apply data mining methods to propose a clinical decision support system for diagnosing aortic valve stenosis.

  13. Prospective Evaluation of Severe Skin Toxicity and Pain During Postmastectomy Radiation Therapy

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Pignol, Jean-Philippe, E-mail: j.p.pignol@erasmusmc.nl; Vu, Thi Trinh Thuc; Mitera, Gunita

    Purpose: To prospectively capture acute toxicities and pain associated with postmastectomy radiation therapy (PMRT), to analyze patient and treatment risk factors for severe side effects. Methods and Materials: Women referred for PMRT were prospectively enrolled and assessed weekly during and after radiation therapy. The endpoint included severe National Cancer Institute Common Terminology Criteria for Adverse Effects grade 3 moist desquamation, other skin symptoms, and pain. Results: Of 257 patients, 73 (28.4%) experienced extensive moist desquamation, 84 (32.7%) Common Terminology Criteria for Adverse Effects skin toxicity grade 3, and 57 (22.2%) a pain impacting on daily life activities. Among symptoms only grademore » 3 moist desquamation was significantly associated with severe pain (P<.001). On multivariate analysis, smoking, high-energy photons, and skin bolus were significantly associated with severe moist desquamation. Skin toxicity doubled for smokers, with 40% severe pain, 48% grade 3 moist desquamation, and 64% grade 3 skin toxicity. Without skin bolus 4.2% had severe pain, none moist desquamation, and 2.1% grade 3 skin toxicity. When skin bolus was used on alternate days, the frequency increased to 15% for pain, 22% for moist desquamation, and 26% for grade 3 skin toxicity. When bolus was used daily, 32% had pain, 41% moist desquamation, and 47% grade 3 skin toxicity. Symptoms peaked 1 to 2 weeks after the end of PMRT. Conclusions: The present cohort study suggests excessive radiation toxicity after PMRT. Among factors associated with an increase of toxicity are smoking habits and the use of skin bolus.« less

  14. New testing options for diagnosing and grading dry eye disease.

    PubMed

    Foulks, Gary N; Pflugfelder, Stephen C

    2014-06-01

    To describe new options for diagnosis and severity grading of dry eye disease. Perspective on technological advancements to identify tear dysfunction and their value in diagnosing and grading dry eye disease. Evidence is presented on new and evolving technologies to measure tear stability, composition, and meniscus height and their role in dry eye diagnosis and therapeutic efficacy grading is assessed. Evolving concepts regarding pathogenesis and new technologies to evaluate the tears and ocular surface have improved the ability to diagnose, classify, and grade the severity of dry eye disease. New technologies include noninvasive imaging of tear stability and tear meniscus height as a measure of tear volume and tear composition (osmolarity, lacrimal factors, inflammatory mediators, growth and differentiation factors). Approved tests, such as tear osmolarity and tear imaging, are being integrated into clinical practice and may eventually supplant certain traditional tests that have greater variability and less sensitivity. Other tests, such as molecular assays of tears and conjunctival cells, are currently being used in studies investigating pathogenesis and therapeutic mechanism of action. They may eventually translate to routine clinical practice. New technologies have emerged that can noninvasively evaluate the tears and measure disease-associated compositional changes. These tests are being integrated into clinical practice and therapeutic trials for diagnosis, classification, and severity grading of dry eye disease. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. Inter-rater agreement between trachoma graders: comparison of grades given in field conditions versus grades from photographic review

    PubMed Central

    Gebresillasie, Sintayehu; Tadesse, Zerihun; Shiferaw, Ayalew; Yu, Sun N.; Stoller, Nicole E.; Zhou, Zhaoxia; Emerson, Paul M.; Gaynor, Bruce D.; Lietman, Thomas M.; Keenan, Jeremy D.

    2016-01-01

    Purpose Trachoma surveillance is most commonly performed by direct observation, usually by non-ophthalmologists using the World Health Organization (WHO) simplified grading system. However, conjunctival photographs may offer several benefits over direct clinical observation, including the potential for greater inter-rater agreement. This study assesses whether inter-rater agreement of trachoma grading differs when trained graders review conjunctival photographs versus when they perform conjunctival examinations in the field. Methods 3 trained trachoma graders each performed an independent examination of the everted right tarsal conjunctiva of 269 children aged 0-9 years, and then reviewed photographs of these same conjunctivae in a random order. For each eye, the grader documented the presence or absence of follicular trachoma (TF) and intense trachomatous inflammation (TI) according to the WHO simplified grading system. Results Inter-rater agreement for grade of TF was significantly higher in the field (kappa coefficient, κ, 0.73, 95% confidence interval, CI 0.67-0.80) than by photographic review (κ=0.55, 95% CI 0.49-0.63; difference in κ between field grading and photo grading 0.18, 95% CI 0.09-0.26). When field and photographic grades were each assessed as the consensus grade from the 3 graders, agreement between in-field and photographic graders was high for TF (κ=0.75, 95% CI 0.68-0.84). Conclusions In an area with hyperendemic trachoma, inter-rater agreement was lower for photographic assessment of trachoma than for in-field assessment. However, the trachoma grade reached by a consensus of photographic graders agreed well with the grade given by a consensus of in-field graders. PMID:26158573

  16. 7 CFR 810.304 - Grades and grade requirements for canola.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 7 2010-01-01 2010-01-01 false Grades and grade requirements for canola. 810.304 Section 810.304 Agriculture Regulations of the Department of Agriculture (Continued) GRAIN INSPECTION... Grade Requirements § 810.304 Grades and grade requirements for canola. Grading factors Grades, U.S. Nos...

  17. 7 CFR 810.304 - Grades and grade requirements for canola.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 7 2011-01-01 2011-01-01 false Grades and grade requirements for canola. 810.304 Section 810.304 Agriculture Regulations of the Department of Agriculture (Continued) GRAIN INSPECTION... Grade Requirements § 810.304 Grades and grade requirements for canola. Grading factors Grades, U.S. Nos...

  18. Evaluation of open-graded "F" mixtures for water sensitivity : final report.

    DOT National Transportation Integrated Search

    1993-07-01

    The Oregon Department of Transportation (ODOT) has increased their use of open-graded paving mixtures. During the last five years, ODOT has constructed several hundred miles of highways with open-graded "F" asphalt concrete mixtures. These pavements ...

  19. Histopathologic Grading of Anaplasia in Retinoblastoma

    PubMed Central

    Mendoza, Pia R.; Specht, Charles S.; Hubbard, G. Baker; Wells, Jill R.; Lynn, Michael J.; Zhang, Qing; Kong, Jun; Grossniklaus, Hans E.

    2014-01-01

    Purpose To determine whether the degree of tumor anaplasia has prognostic value by evaluating its correlation with high-risk histopathologic features and clinical outcomes in a series of retinoblastoma patients. Design Retrospective clinicopathologic study. Methods The clinical and pathologic findings in 266 patients who underwent primary enucleation for retinoblastoma were reviewed. The histologic degree of anaplasia was graded as retinocytoma, mild, moderate, or severe as defined by increasing cellular pleomorphism, number of mitoses, nuclear size, and nuclear hyperchromatism. Nuclear morphometric characteristics were measured. The clinical and pathologic data of 125 patients were compared using Kaplan-Meier estimates of survival. Fisher's exact test and multivariate regression were used to analyze the association between anaplasia grade and high-risk histologic features. Results Increasing grade of anaplasia was associated with decreased overall survival (p=0.003) and increased risk of metastasis (p=0.0007). Histopathologic features that were associated with anaplasia included optic nerve invasion (p<0.0001), choroidal invasion (p=<0.0001), and anterior segment invasion (p=0.04). Multivariate analysis considering high-risk histopathology and anaplasia grading as predictors of distant metastasis and death showed that high-risk histopathology was statistically significant as an independent predictor (p=0.01 for metastasis, p=0.03 for death) but anaplasia was not (p=0.63 for metastasis, p=0.30 for death). In the absence of high-risk features, however, severe anaplasia identified an additional risk for metastasis (p=0.0004) and death (p=0.01). Conclusion Grading of anaplasia may be a useful adjunct to standard histopathologic criteria in identifying retinoblastoma patients who do not have high-risk histologic features but still have an increased risk of metastasis and may need adjuvant therapy. PMID:25528954

  20. Grading Rigor in Counselor Education: A Specifications Grading Framework

    ERIC Educational Resources Information Center

    Bonner, Matthew W.

    2016-01-01

    According to accreditation and professional bodies, evaluation and grading are a high priority in counselor education. Specifications grading, an evaluative tool, can be used to increase grading rigor. This article describes the components of specifications grading and applies the framework of specifications grading to a counseling theories course.

  1. FormScanner: Open-Source Solution for Grading Multiple-Choice Exams

    NASA Astrophysics Data System (ADS)

    Young, Chadwick; Lo, Glenn; Young, Kaisa; Borsetta, Alberto

    2016-01-01

    The multiple-choice exam remains a staple for many introductory physics courses. In the past, people have graded these by hand or even flaming needles. Today, one usually grades the exams with a form scanner that utilizes optical mark recognition (OMR). Several companies provide these scanners and particular forms, such as the eponymous "Scantron." OMR scanners combine hardware and software—a scanner and OMR program—to read and grade student-filled forms.

  2. Correlation of hyponatremia with hepatic encephalopathy and severity of liver disease.

    PubMed

    Qureshi, Muhammad Omar; Khokhar, Nasir; Saleem, Atif; Niazi, Tariq Khan

    2014-02-01

    To assess the frequency of low serum sodium levels and to correlate it with the severity of liver disease and hepatic encephalopathy (HE) in patients coming to the tertiary care hospital. Observational study. Shifa International Hospital, Islamabad, from January 2011 to January 2012. A total of 202 patients with hepatic encephalopathy and chronic liver disease had serum sodium measured. The HE was graded according to the West Haven classification (4 grades). Relationship of hyponatremia was correlated with severity grade of encephalopathy using Spearman rank correlation test. Out of 202 patients, 62 (30.7%) patients had serum sodium less than 130 meq/l. Out of 202, HE was present in 69 (34.15%) patients and out of these, 38 had grade III-IV HE and 31 had grade I - II HE. Out of 69 patients with HE 57 had sodium less than 135 (p < 0.001). Hyponatremia was a common feature in patients with cirrhosis and its severity increased with the severity of liver disease. The existence of serum sodium concentration < 135 mmol/L was associated with greater frequency of hepatic encephalopathy compared with patients with serum sodium concentration > 135 mmol/L.

  3. 7 CFR 51.1575 - U.S. Grade A Small; U.S. Grade A Medium; U.S. Grade A Medium to Large; U.S. Grade A Large.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false U.S. Grade A Small; U.S. Grade A Medium; U.S. Grade A Medium to Large; U.S. Grade A Large. 51.1575 Section 51.1575 Agriculture Regulations of the Department of... Potatoes Grades § 51.1575 U.S. Grade A Small; U.S. Grade A Medium; U.S. Grade A Medium to Large; U.S. Grade...

  4. 7 CFR 51.1576 - U.S. Grade B Small; U.S. Grade B Medium; U.S. Grade B Medium to Large; U.S. Grade B Large.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 2 2012-01-01 2012-01-01 false U.S. Grade B Small; U.S. Grade B Medium; U.S. Grade B Medium to Large; U.S. Grade B Large. 51.1576 Section 51.1576 Agriculture Regulations of the Department of... Potatoes Grades § 51.1576 U.S. Grade B Small; U.S. Grade B Medium; U.S. Grade B Medium to Large; U.S. Grade...

  5. 7 CFR 51.1575 - U.S. Grade A Small; U.S. Grade A Medium; U.S. Grade A Medium to Large; U.S. Grade A Large.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 2 2012-01-01 2012-01-01 false U.S. Grade A Small; U.S. Grade A Medium; U.S. Grade A Medium to Large; U.S. Grade A Large. 51.1575 Section 51.1575 Agriculture Regulations of the Department of... Potatoes Grades § 51.1575 U.S. Grade A Small; U.S. Grade A Medium; U.S. Grade A Medium to Large; U.S. Grade...

  6. 7 CFR 51.1576 - U.S. Grade B Small; U.S. Grade B Medium; U.S. Grade B Medium to Large; U.S. Grade B Large.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 2 2011-01-01 2011-01-01 false U.S. Grade B Small; U.S. Grade B Medium; U.S. Grade B Medium to Large; U.S. Grade B Large. 51.1576 Section 51.1576 Agriculture Regulations of the Department of... Potatoes Grades § 51.1576 U.S. Grade B Small; U.S. Grade B Medium; U.S. Grade B Medium to Large; U.S. Grade...

  7. 7 CFR 51.1575 - U.S. Grade A Small; U.S. Grade A Medium; U.S. Grade A Medium to Large; U.S. Grade A Large.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 2 2011-01-01 2011-01-01 false U.S. Grade A Small; U.S. Grade A Medium; U.S. Grade A Medium to Large; U.S. Grade A Large. 51.1575 Section 51.1575 Agriculture Regulations of the Department of... Potatoes Grades § 51.1575 U.S. Grade A Small; U.S. Grade A Medium; U.S. Grade A Medium to Large; U.S. Grade...

  8. 7 CFR 51.1576 - U.S. Grade B Small; U.S. Grade B Medium; U.S. Grade B Medium to Large; U.S. Grade B Large.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false U.S. Grade B Small; U.S. Grade B Medium; U.S. Grade B Medium to Large; U.S. Grade B Large. 51.1576 Section 51.1576 Agriculture Regulations of the Department of... Potatoes Grades § 51.1576 U.S. Grade B Small; U.S. Grade B Medium; U.S. Grade B Medium to Large; U.S. Grade...

  9. Secondary Principals' Perceptions of Grading and Grade Reporting Practices

    ERIC Educational Resources Information Center

    Akins, Jeremie

    2016-01-01

    Effective grading practices in the classroom as well as reporting practices such as standards-based grading (SBG) is one way to report learning (Marzano, 2010). The focus of this particular study was to address alternative ways to tackle the issue of grading and grade reporting in comparison to the traditional grading methods. Specifically, this…

  10. Severe hepatic trauma: nonoperative management, definitive repair, or damage control surgery?

    PubMed

    Leppäniemi, Ari K; Mentula, Panu J; Streng, Mari H; Koivikko, Mika P; Handolin, Lauri E

    2011-12-01

    Management of severe liver injuries has evolved to include the options for nonoperative management and damage control surgery. The present study analyzes the criteria for choosing between nonoperative management and early surgery, and definitive repair versus damage control strategy during early surgery. In a retrospective analysis of 144 patients with severe (AAST grade III-V) liver injuries (94% blunt trauma), early laparotomy was performed in 50 patients. Initial management was nonoperative in 94 blunt trauma patients with 8 failures. Uni- and multivariate analyses were used to calculate predictor odds ratios (OR) with 95% confidence intervals (CI). Factors associated with early laparotomy in blunt trauma included shock on admission, associated grade IV-V splenic injury, grade IV-V head injury, and grade V liver injury. Only shock was an independent predictor (OR, 26.1; 95% CI, 8.9-77.1; P < 0.001). The presence of a grade IV-V splenic injury predicted damage control strategy (OR infinite; P = 0.021). Failed nonoperative management was associated with grade IV-V splenic injury (OR, 14.00; 95% CI, 1.67-117.55), and shock (OR, 6.82; 95% CI, 1.49-31.29). The hospital mortality rate was 15%; 8 of 21 deaths were liver-related. Shock (OR, 9.3; 95% CI, 2.4-35.8; P = 0.001) and severe head injury (OR, 9.25; 95% CI, 3.0-28.9; P = 0.000) were independent predictors for mortality. In patients with severe liver injury, associated severe splenic injury favors early laparotomy and damage control strategy. Patients who arrive in shock or have an associated severe splenic injury should not be managed nonoperatively. In addition to severe head injury, uncontrollable bleeding from the liver injury is still a major cause of early death.

  11. Analysis of 4th Grade Students' Problem Solving Skills in Terms of Several Variables

    ERIC Educational Resources Information Center

    Sungur, Gülcan; Bal, Pervin Nedim

    2016-01-01

    The aim of this study is to examine if the level of primary school students in solving problems differs according to some demographic variables. The research is descriptive type in the general survey method, it was carried out with quantitative research techniques. The sample of the study consisted of 587 primary school students in Grade 4. The…

  12. Predicting eczema severity beyond childhood.

    PubMed

    Hon, Kam Lun; Tsang, Yin-Ching K; Poon, Terence Chuen W; Pong, Nga Hin; Kwan, Matthew; Lau, Shirley; Chiu, Yuen-Chun; Wong, Hin-Hei; Leung, Ting-Fan

    2016-02-01

    We evaluated factors associated with eczema severity in adolescence. Nottingham Eczema Severity Score (NESS), family and personal history of atopy, skin prick test for common food and aeroallergens, highest serum IgE level and eosinophil count were evaluated. Patients with paired NESSs (childhood-NESS is NESS performed at <10 years of age; adolescence-NESS is NESS performed at age >10 years) were further analyzed. Adolescence-NESS (n=383 patients) was associated with eczema onset in infancy, dust mite and food allergen sensitization, dietary avoidance, use of wet wrap, traditional Chinese medicine, immunomodulant (azathioprine or cyclosporine), high IgE level, eosinophil count, but not with family/personal history of atopy. Eighty-two patients had both childhood-NESS and adolescence-NESS (mean follow-up of 6.8 years) showing that adolescence-NESS was associated with childhood- NESS severity grades (P=0.034). Of these patients, 48% remained in the same severity grades, whereas 39% improved, and 13% deteriorated from childhood to adolescence. It is not possible to assure parents that their child can outgrow eczema. In eczema prognosis research, long-term follow-up is warranted.

  13. The "1-3-5 cough test": comparing the severity of urodynamic stress incontinence with severity measures of subjective perception of stress urinary incontinence.

    PubMed

    Grigoriadis, Themos; Giannoulis, George; Zacharakis, Dimitris; Protopapas, Athanasios; Cardozo, Linda; Athanasiou, Stavros

    2016-03-01

    The purpose of the study was to examine whether a test performed during urodynamics, the "1-3-5 cough test", could determine the severity of urodynamic stress incontinence (USI). We included women referred for urodynamics who were diagnosed with USI. The "1-3-5 cough test" was performed to grade the severity of USI at the completion of filling cystometry. A diagnosis of "severe", "moderate" or "mild" USI was given if urine leakage was observed after one, three or five consecutive coughs respectively. We examined the associations between grades of USI severity and measures of subjective perception of stress urinary incontinence (SUI): International Consultation of Incontinence Modular Questionnaire-Female Lower Urinary Tract Symptom (ICIQ-FLUTS), King's Health Questionnaire (KHQ), Urinary Distress Inventory-6 (UDI-6), Urinary Impact Questionnaire-7 (UIQ-7). A total of 1,181 patients completed the ICIQ-FLUTS and KHQ and 612 completed the UDI-6 and UIQ-7 questionnaires. There was a statistically significant association of higher grades of USI severity with higher scores of the incontinence domain of the ICIQ-FLUTS. The scores of the UDI-6, UIQ-7 and of all KHQ domains (with the exception of general health perception and personal relationships) had statistically significant larger mean values for higher USI severity grade. Groups of higher USI severity had statistically significant associations with higher scores of most of the subjective measures of SUI. Severity of USI, as defined by the "1-3-5 cough test", was associated with the severity of subjective measures of SUI. This test may be a useful tool for the objective interpretation of patients with SUI who undergo urodynamics.

  14. A single stage liposuction and dermopexy for grade 3b and grade 4 pseudogynecomastia after massive weight loss: an observational study.

    PubMed

    El-Khatib, Hamdy A

    2007-06-01

    Nineteen middle-aged males with grade 3b and grade 4 pseudogynecomastia following severe weight loss were treated by liposuction and simultaneous skin reduction. From 1997 through 2005 nine males with grade 3 and ten with grade 4 pseudogynecomastia were included in this study. Ages ranged from 23 to 48 years. Author used two techniques for skin reduction: 1-the dermal mastopexy (keyhole design) for grade 4, and 2-the complete circum-areolar technique (concentric reduction) with de-epithelialization for grade 3b. The current technique offers a proper treatment for the pendulous female-like breast with inelastic and redundant skin. It obviates the need for secondary revision by providing a viable nipple-areola complex at the desired location and eliminating the dish-type deformity that may result from subcutaneous mastectomy. Patients were monitored for the following 18 to 39 months. While reviewing the literature other methods are compared and discussed but it is suggested that the method reported here has a number of advantages and is the treatment of choice in many such cases.

  15. On groupoid gradings

    NASA Astrophysics Data System (ADS)

    Calderón Martín, Antonio Jesús; Martín González, Cándido; Ndoye, Daouda

    2018-01-01

    We introduce the notion of groupoid grading, give some nontrivial examples and prove that groupoid gradings on simple commutative or anti-commutative algebras are necessarily group gradings. We also take advantage of the structure of groupoids to prove some results about groupoid gradings and certain coarsenings of these which turn out to be group gradings. We also study set gradings on arbitrary algebras, by characterizing their homogeneous semisimplicity and their homogeneous simplicity in terms of a property satisfied by the supports of the gradings, and also relate set gradings with groupoid gradings via coarsenings. Finally we study a class of set gradings on Mn(C) , the orthogonal gradings, and show that all of them which are fine are necessarily groupoid gradings.

  16. [Inadequacy of the paradigms of special education to subjects with severe and profound grade intellectual disability - the need for pragmatic realism in psychiatry and special pedagogy].

    PubMed

    Sipowicz, Kasper; Żuraw, Hanna; Witusik, Andrzej; Mokros, Łukasz; Najbert, Edyta; Pietras, Tadeusz

    2018-05-25

    People with severe and profound grade disabilities are the subject of interest in psychiatry, clinical psychology and special pedagogy. Unfortunately, the paradigmatic approach to special education based on postmodern philosophy is in contrast to the biomedical approach that is based on the positivist and Cartesian models. The paper is an attempt to systematize the similarities and differences between the humanistic approach and the modern biomedical model, which, despite the apparent differences, do not differ so much from each other. Work with a person disabled intellectually in the severe or profound degree is governed by the principles of methodical realism, taking into account to an equal extent the principal deficits, the concomitant diseases, limitations and the social context. The deeper the impairment and disability is, the smaller is the role of the humanistic paradigm in work with the client in the medical management and educational process. Changing the paradigms of special pedagogy has drawn attention to the social context of disability, separating, however, special pedagogy from modern medicine and psychology, cognitive-oriented and psychometry-based. The postmodern paradigm has become an ideology, which makes it difficult to work with deeply disabled people. Only the multidirectional approach including a variety of paradigms makes it possible to provide integrational aid to people with severe and profound grade intellectual disabilities. Working with such a disabled person should take into account equally the biomedical and humanistic aspects. © 2018 MEDPRESS.

  17. Physical Properties of Normal Grade Biodiesel and Winter Grade Biodiesel

    PubMed Central

    Sadrolhosseini, Amir Reza; Moksin, Mohd Maarof; Nang, Harrison Lau Lik; Norozi, Monir; Yunus, W. Mahmood Mat; Zakaria, Azmi

    2011-01-01

    In this study, optical and thermal properties of normal grade and winter grade palm oil biodiesel were investigated. Surface Plasmon Resonance and Photopyroelectric technique were used to evaluate the samples. The dispersion curve and thermal diffusivity were obtained. Consequently, the variation of refractive index, as a function of wavelength in normal grade biodiesel is faster than winter grade palm oil biodiesel, and the thermal diffusivity of winter grade biodiesel is higher than the thermal diffusivity of normal grade biodiesel. This is attributed to the higher palmitic acid C16:0 content in normal grade than in winter grade palm oil biodiesel. PMID:21731429

  18. Two-Piece Screens for Decontaminating Granular Material

    NASA Technical Reports Server (NTRS)

    Backes, Douglas; Poulter, Clay; Godfrey, Max; Dutton, Melinda; Tolman, Dennis

    2009-01-01

    Two-piece screens have been designed specifically for use in filtering a granular material to remove contaminant particles that are significantly wider or longer than are the desired granules. In the original application for which the twopiece screens were conceived, the granular material is ammonium perchlorate and the contaminant particles tend to be wires and other relatively long, rigid strands. The basic design of the twopiece screens can be adapted to other granular materials and contaminants by modifying critical dimensions to accommodate different grain and contaminant- particle sizes. A two-piece screen of this type consists mainly of (1) a top flat plate perforated with circular holes arranged in a hexagonal pattern and (2) a bottom plate that is also perforated with circular holes (but not in a pure hexagonal pattern) and is folded into an accordion structure. Fabrication of the bottom plate begins with drilling circular holes into a flat plate in a hexagonal pattern that is interrupted, at regular intervals, by parallel gaps. The plate is then folded into the accordion structure along the gaps. Because the folds are along the gaps, there are no holes at the peaks and valleys of the accordion screen. The top flat plate and the bottom accordion plate are secured within a metal frame. The resulting two-piece screen is placed at the bottom opening of a feed hopper containing the granular material to be filtered. Tests have shown that such long, rigid contaminant strands as wires readily can pass through a filter consisting of the flat screen alone and that the addition of the accordion screen below the flat screen greatly increases the effectiveness of removal of wires and other contaminant strands. Part of the reason for increased effectiveness is in the presentation of the contaminant to the filter surface. Testing has shown that wire type contamination will readily align itself parallel to the material direction flow. Since this direction of flow is

  19. MRI differentiation of low-grade from high-grade appendicular chondrosarcoma.

    PubMed

    Douis, Hassan; Singh, Leanne; Saifuddin, Asif

    2014-01-01

    To identify magnetic resonance imaging (MRI) features which differentiate low-grade chondral lesions (atypical cartilaginous tumours/grade 1 chondrosarcoma) from high-grade chondrosarcomas (grade 2, grade 3 and dedifferentiated chondrosarcoma) of the major long bones. We identified all patients treated for central atypical cartilaginous tumours and central chondrosarcoma of major long bones (humerus, femur, tibia) over a 13-year period. The MRI studies were assessed for the following features: bone marrow oedema, soft tissue oedema, bone expansion, cortical thickening, cortical destruction, active periostitis, soft tissue mass and tumour length. The MRI-features were compared with the histopathological tumour grading using univariate, multivariate logistic regression and receiver operating characteristic curve (ROC) analyses. One hundred and seventy-nine tumours were included in this retrospective study. There were 28 atypical cartilaginous tumours, 79 grade 1 chondrosarcomas, 36 grade 2 chondrosarcomas, 13 grade 3 chondrosarcomas and 23 dedifferentiated chondrosarcomas. Multivariate analysis demonstrated that bone expansion (P = 0.001), active periostitis (P = 0.001), soft tissue mass (P < 0.001) and tumour length (P < 0.001) were statistically significant differentiating factors between low-grade and high-grade chondral lesions with an area under the ROC curve of 0.956. On MRI, bone expansion, active periostitis, soft tissue mass and tumour length can reliably differentiate high-grade chondrosarcomas from low-grade chondral lesions of the major long bones. • Accurate differentiation of low-grade from high-grade chondrosarcomas is essential before surgery • MRI can reliably differentiate high-grade from low-grade chondrosarcomas of long bone • Differentiating features are bone expansion, periostitis, soft tissue mass and tumour length • Presence of these four MRI features demonstrated a diagnostic accuracy (AUC) of 95.6 % • The findings

  20. Heartburn Severity Does Not Predict Disease Severity in Patients With Erosive Esophagitis

    PubMed Central

    Fennerty, M. Brian; Johnson, David A.

    2006-01-01

    Background For patients with gastroesophageal reflux disease (GERD), it is often assumed by treating physicians that the severity of heartburn correlates with the severity of erosive esophagitis (EE). Objective This is a post hoc analysis of data from 5 clinical trials that investigate the relationship between the baseline severity of heartburn and the baseline severity of EE. Methods Patients with endoscopically confirmed EE were assessed for heartburn symptoms with a 4-point scale at baseline and during treatment for 8 weeks with various proton pump inhibitors in 5 double-blind trials in which esomeprazole was the common comparator. EE was graded with the Los Angeles (LA) classification system. In these trials, healing and symptom response were evaluated by endoscopy and questionnaire after 4 weeks of treatment. Patients who were not healed were treated for an additional 4 weeks and reevaluated. Results A total of 11,945 patients with endoscopically confirmed EE participated in the 5 trials, with patients receiving esomeprazole 40 mg (n = 5068), esomeprazole 20 mg (n = 1243), omeprazole 20 mg (n = 3018), or lansoprazole 30 mg (n = 2616). Approximately one quarter of the 11,945 GERD patients in these 5 trials had severe EE (defined as LA grades C or D), regardless of their baseline heartburn severity. Conclusion The severity of GERD symptoms does not correlate well with disease severity. These findings indicate that endoscopy may have value in GERD patients in identifying those with EE, and if empirical therapy is chosen, then longer courses (4-8 weeks) of antisecretory therapy may be necessary to ensure healing of unrecognized esophagitis. PMID:16926745

  1. FormScanner: Open-Source Solution for Grading Multiple-Choice Exams

    ERIC Educational Resources Information Center

    Young, Chadwick; Lo, Glenn; Young, Kaisa; Borsetta, Alberto

    2016-01-01

    The multiple-choice exam remains a staple for many introductory physics courses. In the past, people have graded these by hand or even flaming needles. Today, one usually grades the exams with a form scanner that utilizes optical mark recognition (OMR). Several companies provide these scanners and particular forms, such as the eponymous…

  2. 7 CFR 51.1576 - U.S. Grade B Small; U.S. Grade B Medium; U.S. Grade B Medium to Large; U.S. Grade B Large.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 2 2013-01-01 2013-01-01 false U.S. Grade B Small; U.S. Grade B Medium; U.S. Grade B Medium to Large; U.S. Grade B Large. 51.1576 Section 51.1576 Agriculture Regulations of the Department of...) United States Consumer Standards for Potatoes Grades § 51.1576 U.S. Grade B Small; U.S. Grade B Medium; U...

  3. 7 CFR 51.1575 - U.S. Grade A Small; U.S. Grade A Medium; U.S. Grade A Medium to Large; U.S. Grade A Large.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 2 2014-01-01 2014-01-01 false U.S. Grade A Small; U.S. Grade A Medium; U.S. Grade A Medium to Large; U.S. Grade A Large. 51.1575 Section 51.1575 Agriculture Regulations of the Department of...) United States Consumer Standards for Potatoes Grades § 51.1575 U.S. Grade A Small; U.S. Grade A Medium; U...

  4. 7 CFR 51.1576 - U.S. Grade B Small; U.S. Grade B Medium; U.S. Grade B Medium to Large; U.S. Grade B Large.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 2 2014-01-01 2014-01-01 false U.S. Grade B Small; U.S. Grade B Medium; U.S. Grade B Medium to Large; U.S. Grade B Large. 51.1576 Section 51.1576 Agriculture Regulations of the Department of...) United States Consumer Standards for Potatoes Grades § 51.1576 U.S. Grade B Small; U.S. Grade B Medium; U...

  5. 7 CFR 51.1575 - U.S. Grade A Small; U.S. Grade A Medium; U.S. Grade A Medium to Large; U.S. Grade A Large.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 2 2013-01-01 2013-01-01 false U.S. Grade A Small; U.S. Grade A Medium; U.S. Grade A Medium to Large; U.S. Grade A Large. 51.1575 Section 51.1575 Agriculture Regulations of the Department of...) United States Consumer Standards for Potatoes Grades § 51.1575 U.S. Grade A Small; U.S. Grade A Medium; U...

  6. NEW ULTRA-WIDE-FIELD ANGIOGRAPHIC GRADING SCHEME FOR RADIATION RETINOPATHY AFTER IODINE-125 BRACHYTHERAPY FOR UVEAL MELANOMA.

    PubMed

    McCannel, Tara A; Kim, EunAh; Kamrava, Mitchell; Lamb, James; Caprioli, Joseph; Yang, Dong; McCannel, Colin A

    2017-10-06

    Radiation retinopathy remains incompletely characterized and may cause severe vision loss. Ultra-wide-field fluorescein angiography provides a pan-fundus view of vascular alterations caused by radiation treatment and may predict visual and ocular outcomes. We have developed a grading scheme to describe pan-fundus severity and to predict the progression of radiation retinopathy in patients treated for uveal melanoma with iodine-125 brachytherapy. A retrospective review of patients treated with standard iodine-125 brachytherapy for uveal melanoma at the Ophthalmic Oncology Center at the University of California, Los Angeles, who had undergone both baseline and postbrachytherapy ultra-wide-field fluorescein angiography. A grading scheme was devised based on observations of vascular leakage, retinal perfusion status, and retinal proliferation. The correlation of grade severity with patient characteristics, tumor features, visual acuity, optical coherence tomography findings, and neovascular glaucoma was measured with chi-square and one-way analysis of variance analyses. Sixty-seven patients were identified for review. Consistent wide-field angiographic patterns after brachytherapy were observed and graded as follows: Grade 0: normal; Grade 1: late foveal leakage; Grade 2: late peripheral leakage; Grade 3: presence of nonperfusion; and Grade 4: retinal neovascularization. Six eyes (8.9%) were Grade 0; 16 (23.8%) were Grade 1; 25 (37.3%) were Grade 2; 16 (23.4%) were Grade 3; and 4 (6.0%) were Grade 4. Higher grade radiation severity correlated significantly with duration of follow-up (P < 0.02); younger age (P = 0.035); worse visual acuity (P = 0.001); cystoid macular edema or atrophy on optical coherence tomography (P < 0.0001); and neovascular glaucoma (P = 0.003). Wide-field fluorescein angiography revealed distinct fundus-wide patterns of vascular damage, which were progressive in nature in eyes treated with iodine-125 brachytherapy for uveal melanoma and correlated

  7. 7 CFR 810.804 - Grades and grade requirements for mixed grain.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 7 2014-01-01 2014-01-01 false Grades and grade requirements for mixed grain. 810.804... OFFICIAL UNITED STATES STANDARDS FOR GRAIN United States Standards for Mixed Grain Grades and Grade Requirements § 810.804 Grades and grade requirements for mixed grain. (a) U.S. Mixed Grain (grade). Mixed grain...

  8. 7 CFR 810.804 - Grades and grade requirements for mixed grain.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 7 2010-01-01 2010-01-01 false Grades and grade requirements for mixed grain. 810.804... OFFICIAL UNITED STATES STANDARDS FOR GRAIN United States Standards for Mixed Grain Grades and Grade Requirements § 810.804 Grades and grade requirements for mixed grain. (a) U.S. Mixed Grain (grade). Mixed grain...

  9. 7 CFR 810.804 - Grades and grade requirements for mixed grain.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 7 2012-01-01 2012-01-01 false Grades and grade requirements for mixed grain. 810.804... OFFICIAL UNITED STATES STANDARDS FOR GRAIN United States Standards for Mixed Grain Grades and Grade Requirements § 810.804 Grades and grade requirements for mixed grain. (a) U.S. Mixed Grain (grade). Mixed grain...

  10. 7 CFR 810.804 - Grades and grade requirements for mixed grain.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 7 2013-01-01 2013-01-01 false Grades and grade requirements for mixed grain. 810.804... OFFICIAL UNITED STATES STANDARDS FOR GRAIN United States Standards for Mixed Grain Grades and Grade Requirements § 810.804 Grades and grade requirements for mixed grain. (a) U.S. Mixed Grain (grade). Mixed grain...

  11. 7 CFR 810.804 - Grades and grade requirements for mixed grain.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 7 2011-01-01 2011-01-01 false Grades and grade requirements for mixed grain. 810.804... OFFICIAL UNITED STATES STANDARDS FOR GRAIN United States Standards for Mixed Grain Grades and Grade Requirements § 810.804 Grades and grade requirements for mixed grain. (a) U.S. Mixed Grain (grade). Mixed grain...

  12. Students' Self-Grading, Professor's Grading and Negotiated Final Grading at Three University Programmes: Analysis of Reliability and Grade Difference Ranges and Tendencies

    ERIC Educational Resources Information Center

    Lopez-Pastor, Victor M.; Fernandez-Balboa, Juan-Miguel; Santos Pastor, Maria L.; Aranda, Antonio Fraile

    2012-01-01

    This study was undertaken at three teacher education programmes and was designed to determine the following within each programme: (1) the reliability correlations among students' self-grade (SSG), the grade granted by the professor (PG) and the negotiated final grade (NFG); (2) the range and frequency of grade differences between SSG and PG; and…

  13. 42 CFR 21.29 - Eligibility; grades above senior assistant grade.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Eligibility; grades above senior assistant grade... PERSONNEL COMMISSIONED OFFICERS Appointment § 21.29 Eligibility; grades above senior assistant grade. Every candidate for examination for appointment in grades above that of senior assistant shall meet the...

  14. 7 CFR 810.404 - Grades and grade requirements for corn.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 7 2011-01-01 2011-01-01 false Grades and grade requirements for corn. 810.404... OFFICIAL UNITED STATES STANDARDS FOR GRAIN United States Standards for Corn Principles Governing the Application of Standards § 810.404 Grades and grade requirements for corn. Grade Minimum test weight per...

  15. 7 CFR 810.404 - Grades and grade requirements for corn.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 7 2010-01-01 2010-01-01 false Grades and grade requirements for corn. 810.404... OFFICIAL UNITED STATES STANDARDS FOR GRAIN United States Standards for Corn Principles Governing the Application of Standards § 810.404 Grades and grade requirements for corn. Grade Minimum test weight per...

  16. Natural history of severe atheromatous disease of the thoracic aorta: a transesophageal echocardiographic study.

    PubMed

    Montgomery, D H; Ververis, J J; McGorisk, G; Frohwein, S; Martin, R P; Taylor, W R

    1996-01-01

    This study sought to prospectively observe the morphologic and clinical natural history of severe atherosclerotic disease of the thoracic aorta as defined by transesophageal echocardiography. Atherosclerosis of the thoracic aorta has been shown to be highly associated with risk for embolic events in transesophageal studies, but the natural history of the disease under clinical conditions has not been reported. During a 20-month period, 191 of 264 patients undergoing transesophageal echocardiography had adequate visualization of the aorta to allow atherosclerotic severity to be graded as follows: grade I = normal (44 patients); grade II = intimal thickening (52 patients); grade III = atheroma < 5 mm (62 patients); grade IV = atheroma > or = 5 mm (19 patients); grade V = mobile lesion (14 patients). All available patients with grades IV (8 patients) and V (10 patients) disease as well as a subgroup of 12 patients with grade III disease had follow-up transesophageal echocardiographic studies (mean [+/- SD] 11.7 +/- 0.9 months, range 6 to 22). Of 30 patients undergoing follow-up transesophageal echocardiographic studies, 20 (66%) had no change in atherosclerotic severity grade. Of the remaining 10 patients, atherosclerotic severity progressed one grade in 7 and decreased in 3 with resolved mobile lesions. Of 18 patients with grade IV or V disease of the aorta who underwent a follow-up study, 11 (61%) demonstrated formation of new mobile lesions. Of 10 patients with grade V disease on initial study who underwent follow-up study, 7 (70%) demonstrated resolution of a specific previously documented mobile lesion. However, seven patients (70%) with grade V disease also demonstrated development of a new mobile lesion. Of 33 patients with grade IV or V disease, 8 (24%) died during the study period, and 1 (3%) had a clinical embolic event. The presence of severe atherosclerotic disease of the thoracic aorta as defined by transesophageal echocardiography is associated with a

  17. [Grades evaluation of Scutellariae Radix slices based on quality constant].

    PubMed

    Deng, Zhe; Zhang, Jun; Jiao, Meng-Jiao; Zhong, Wen; Cui, Wen-Jin; Cheng, Jin-Tang; Chen, Sha; Wang, Yue-Sheng; Liu, An

    2017-05-01

    By measuring the morphological indexes and the marker components content of 22 batches of Scutellariae Radix slices as well as calculating the quality constant, this research was aimed to establish a new method of evaluating the specifications and grades of Scutellariae Radix slices. The quality constants of these samples were in the range of 0.04-0.49, which can be divided into several grades based on the real requirement. If they were divided into three grades, the quality constant was ≥0.39 for the first grade, <0.39 but ≥0.24 for the second grade, and <0.24 for the third grade. This work indicated that the quality constants characterizing both apparent parameters and intrinsic quality can be used as a comprehensive evaluation index to classify the grades of traditional Chinese medicine quantitatively, clearly and objectively. The research results in this paper would provide new ideas and references for evaluating the specifications and grades of traditional Chinese medicines. Copyright© by the Chinese Pharmaceutical Association.

  18. Severe Hemifacial Spasm is a Predictor of Severe Indentation and Facial Palsy after Microdecompression Surgery.

    PubMed

    Na, Boo Suk; Cho, Jin Whan; Park, Kwan; Kwon, Soonwook; Kim, Ye Sel; Kim, Ji Sun; Youn, Jinyoung

    2018-04-27

    Hemifacial spasm (HFS) is mostly caused by the compression of the facial nerve by cerebral vessels, but the significance of spasm severity remains unclear. We investigated the clinical significance of spasm severity in patients with HFS who underwent microvascular decompression (MVD). We enrolled 636 patients with HFS who underwent MVD between May 2010 and December 2013 at Samsung Medical Center (SMC), Seoul, Korea. Subjects were divided into two groups based on spasm severity: severe (SMC grade 3 or 4) and mild (SMC grade 1 or 2). We compared demographic, clinical, and surgical data between these two groups. The severe-spasm group was older and had a longer disease duration at the time of MVD compared to the mild-spasm group. Additionally, hypertension and diabetes mellitus were more common in the severe-spasm group than in the mild-spasm group. Regarding surgical findings, there were more patients with multiple offending vessels and more-severe indentations in the severe-spasm group than in the mild-spasm group. Even though the surgical outcomes did not differ, the incidence of delayed facial palsy after MVD was higher in the severe-spasm group than in the mild-spasm group. Logistic regression analysis showed that severe-spasm was correlated with longer disease duration, hypertension, severe indentation, multiple offending vessels, and delayed facial palsy after MVD. Spasm severity does not predict surgical outcomes, but it can be used as a marker of pathologic compression in MVD for HFS, and be considered as a predictor of delayed facial palsy after MVD. Copyright © 2018 Korean Neurological Association.

  19. Glycohemoglobin levels with severity of periodontitis in non-diabetic population.

    PubMed

    Ghalaut, Pankaj; Sharma, Tarun Kumar; Ghalaut, Veena Singh; Singh, Ragini; Ghalaut, P S

    2013-01-01

    Periodontal disease is closely related to type 2 diabetes and is an important complication of diabetes. There are few studies about the relationship the glycohemoglobin levels with severity of periodontitis in non-diabetic population. We therefore planned this study to evaluate the glycohemoglobin levels with severity of periodontitis in non-diabetic population. This study was conducted on 50 age and gender matched subjects in each of the three groups (according to the grades of mobility in periodontitis), a total of 150 non-diabetic periodontitis patients (Grade 1, Grade 2, and Grade 3 mobility) and 50 non-diabetic periodontitis patients with Grade 0 mobility (controls), in collaboration with the Department of Periodontics of Dental College and Department of Biochemistry, PGIMS, Rohtak, Haryana. After obtaining informed consent, fasting venous blood samples of all the non-diabetic periodontitis patients of all grades were collected aseptically for HbA1c, plasma glucose, and serum C-reactive protein (CRP) estimation. A total of 150 non-diabetic periodontitis patients (Grade 1, Grade 2, and Grade 3 mobility) and 50 age and gender matched controls participated in the study. There was no significant difference in fasting plasma glucose and postprandial plasma glucose in non-diabetic periodontitis patients with Grade 1, Grade 2, and Grade 3 mobility as compared to controls, non-diabetic periodontitis patients with Grade 1 mobility as compared to Grade 2, non-diabetic periodontitis patients with Grade 1 mobility as compared to Grade 3 and non-diabetic periodontitis patients with Grade 2 mobility as compared to Grade 3. Glycohemoglobin and serum C-reactive protein levels were significantly increased in non-diabetic periodontitis patients with Grade 1, Grade 2, and Grade 3 mobility as compared to controls, non-diabetic periodontitis patients with Grade 1 mobility as compared to Grade 3 and non-diabetic periodontitis patients with Grade 2 mobility as compared to Grade 3

  20. Lumber grades from old-growth Douglas-fir sawmill logs.

    Treesearch

    E.E. Matson

    1956-01-01

    The Pacific Northwest Forest and Range Experiment Station has made in recent years several studies to determine the grades of lumber that could be expected from various sizes and grades of logs. Data on No. 2 and No. 3 Sawmill logs obtained in four Oregon old-growth Douglas-fir studies have been analyzed and combined in this report. Included in this analysis are data...

  1. ["The severe degree of negligence" and its application in the settle of medical malpractice].

    PubMed

    Wang, You-Min; Zhang, Qin-Chu

    2006-04-01

    To found the quantifiable index of "The severe degree of negligence" in describing the general severity degree of medical malpractice or medical dispute. "The severe degree of negligence" can be calculated by the way of multiplying the coefficient of medical malpractice's grade by the coefficient of responsibility degree. There are 15 grades of "The severe degree of negligence" through calculation, from the severest degree of 1 to the lightest degree of 20. "The severe degree of negligence" can give an order of severe degree to different grade and different responsibility of medical malpractice. According to this order, the operation of medical malpractice and medical dispute settle will be easier and more rationality.

  2. Acute cholecystitis: comparing clinical outcomes with TG13 severity and intended laparoscopic versus open cholecystectomy in difficult operative cases.

    PubMed

    Gerard, Justin; Luu, Minh B; Poirier, Jennifer; Deziel, Daniel J

    2018-03-09

    The revised Tokyo Guidelines include criteria for determining the severity of acute cholecystitis with treatment algorithms based on severity. The aim of this study was to investigate the relationship of the revised Tokyo Guidelines severity grade to clinical outcomes of cholecystectomy for acute cholecystitis. We identified 66 patients with acute cholecystitis from a prior study of difficult cholecystectomy cases. We examined the relationship between severity grade and multiple variables related to perioperative and postoperative outcomes. A more severe revised Tokyo Guidelines grade was associated with a higher number of complications (p = 0.03) and a higher severity of complications (p = 0.01). Severity grade did not predict operative time, estimated blood loss, intensive care unit admission or length of stay. Compared to planned open cholecystectomy, intended laparoscopic cholecystectomy was associated with significantly fewer total and Clavien-Dindo grade 3 complications, fewer intensive care unit admissions, and shorter length of stay (p values range from 0.03 to < 0.0001). In technically difficult operations for acute cholecystitis, the revised Tokyo guidelines severity grade correlates with the number and severity of complications. However, intended performance of laparoscopic cholecystectomy rather than open cholecystectomy in difficult operations predicts broader beneficial outcomes than severity grade.

  3. A novel clinical grading scale to guide the management of crusted scabies.

    PubMed

    Davis, Joshua S; McGloughlin, Steven; Tong, Steven Y C; Walton, Shelley F; Currie, Bart J

    2013-01-01

    Crusted scabies, or hyperinfestation with Sarcoptes scabiei, occurs in people with an inadequate immune response to the mite. In recent decades, data have emerged suggesting that treatment of crusted scabies with oral ivermectin combined with topical agents leads to lower mortality, but there are no generally accepted tools for describing disease severity. Here, we describe a clinical grading scale for crusted scabies and its utility in real world practice. In 2002, Royal Darwin Hospital (RDH), a hospital in tropical Australia developed and began using a clinical grading scale to guide the treatment of crusted scabies. We conducted a retrospective observational study including all episodes of admission to RDH for crusted scabies during the period October 2002-December 2010 inclusive. Patients who were managed according to the grading scale were compared with those in whom the scale was not used at the time of admission but was calculated retrospectively. There were 49 admissions in 30 patients during the study period, of which 49 (100%) were in Indigenous Australians, 29 (59%) were male and the median age was 44.1 years. According to the grading scale, 8 (16%) episodes were mild, 24 (49%) were moderate, and 17 (35%) were severe. Readmission within the study period was significantly more likely with increasing disease severity, with an odds ratio (95% CI) of 12.8 (1.3-130) for severe disease compared with mild. The patients managed according to the grading scale (29 episodes) did not differ from those who were not (20 episodes), but they received fewer doses of ivermectin and had a shorter length of stay (11 vs. 16 days, p = 0.02). Despite this the outcomes were no different, with no deaths in either group and a similar readmission rate. Our grading scale is a useful tool for the assessment and management of crusted scabies.

  4. Prospective validation of a surgical complications grading system in a cohort of 2114 patients.

    PubMed

    Mazeh, Haggi; Cohen, Oded; Mizrahi, Ido; Hamburger, Tamar; Stojadinovic, Alexander; Abu-Wasel, Bassam; Alaiyan, Bilal; Freund, Herbert R; Eid, Ahmed; Nissan, Aviram

    2014-05-01

    We recently reported a grading system for surgical complications. This system proved to have a high sensitivity for recording minor but meaningful complications prolonging hospital stay in patients after colorectal surgery. We aimed to prospectively validate the complication grading system in a general surgery department over 1 year. All surgical procedures and related complications were prospectively recorded between January 1st and December 31st, 2009. Surgical complications were graded on a severity scale of 1-5. The system classifies short-term outcome by grade emphasizing intensity of therapy required for treatment of the defined complication. During the study period, 2114 patients underwent surgery. Elective and oncological surgeries were performed in 1606 (76%) and 465 (22%) patients, respectively. There were 422 surgical complications in 304 (14%) patients (Grade 1/2: 203 [67%]; Grade 3/4: 90 [29%]; Grade 5: 11 [4%]). Median length of stay correlated significantly with complication severity: 2.3 d for no complication, 6.2 and 11.8 d for Grades 1/2 and 3/4, respectively (P < 0.001). Older age (OR 2.75, P < 0.001), comorbidities (OR 1.44, P = 0.02), American Society of Anesthesiology score >2 (OR 2.07, P < 0.001), contamination Grade (OR 1.85, P = 0.001), oncological (OR 2.82, P < 0.001), open (OR 1.22, P = 0.03), prolonged >120 min (OR 2.08, P < 0.001), and emergency surgery (OR 1.42, P = 0.02) independently predicted postoperative complications. This system of grading surgical complications permits standardized reporting of surgical morbidity according to the severity of impact. Prospective validation of this system supports its use in a general surgery setting as a tool for surgical outcome assessment and quality assurance. Copyright © 2014 Elsevier Inc. All rights reserved.

  5. Contributing factors of crash injury severity at public highway-railroad grade crossings in the U.S.

    PubMed

    Haleem, Kirolos; Gan, Albert

    2015-06-01

    The Moving Ahead for Progress in the 21st Century (MAP-21) includes a separate program that supports safety improvements to reduce the number of fatalities and injuries at public highway-railroad grade crossings (HRGCs). This study identifies the significant factors affecting crash injury severity at public HRGCs in the United States. Crashes from 2009 through 2013 on 5,528 public HRGCs, extracted from the Federal Railroad Administration database, were used in the analysis. A comprehensive list of risk factors was explored. Examples include predictors related to geographic region of crash, geometry (e.g., area type and pavement marking type), railroad (e.g., warning device type and railroad class), traffic (e.g., train speed and vehicles annual average daily traffic "AADT"), highway user (e.g., driver age and gender), and environment (e.g., lighting and weather conditions). The study used the mixed logit model to better capture the complex highway user behavior at HRGCs. Female highway users were at higher risk of involvement in injuries and fatalities compared to males. Higher train speeds, very old drivers, open areas, concrete road surface types, and railroad equipment striking highway users before crash, were all found to increase the injury likelihood. On the other hand, young and middle-age drivers, non-passing of standing vehicles at HRGCs, industrial areas, and presence of warning bells were found to reduce injuries and fatalities. The mixed logit model succeeded in identifying contributing factors of crash severity at public HRGCs and potential countermeasures to reduce both fatalities and injuries are suggested. It is important to install warning bells at public HRGCs, especially at those with high number of injury and fatality crashes. Enforcement of traffic nearby HRGCs is necessary to prevent vehicles from overtaking of standing vehicles. Copyright © 2015 Elsevier Ltd. and National Safety Council. Published by Elsevier Ltd. All rights reserved.

  6. Myostatin serum concentrations are correlated with the severity of knee osteoarthritis.

    PubMed

    Zhao, Chang; Shao, Yan; Lin, Chuangxin; Zeng, Chun; Fang, Hang; Pan, Jianying; Cai, Daozhang

    2017-09-01

    Myostatin, a member of the transforming growth factor-β family, contributes to joint deterioration in mice. Thus, we aimed to assess the correlation of myostatin concentrations with the presence and severity of knee osteoarthritis (OA). We determined serum and synovial fluid (SF) myostatin concentrations in a population of 184 patients with knee OA and 109 healthy controls. The knee OA group presented with higher serum myostatin concentrations than the controls. Knee OA patients with KL grade 4 showed higher serum and SF myostatin concentrations compared with those with KL grade 2 and 3. Knee OA patients with KL grade 3 had higher serum and SF myostatin concentrations compared with those with KL grade 2. Serum and SF myostatin concentrations were significantly correlated with KL grading. Serum and SF myostatin concentrations were correlated with the presence and severity of knee OA. © 2016 Wiley Periodicals, Inc.

  7. Hardwood log grades and lumber grade yields for factory lumber logs

    Treesearch

    Leland F. Hanks; Glenn L. Gammon; Robert L. Brisbin; Everette D. Rast

    1980-01-01

    The USDA Forest Service Standard Grades for Hardwood Factory Lumber Logs are described, and lumber grade yields for 16 species and 2 species groups are presented by log grade and log diameter. The grades enable foresters, log buyers, and log sellers to select and grade those log suitable for conversion into standard factory grade lumber. By using the apropriate lumber...

  8. Retroillumination photography analysis enhances clinical definition of severe Fuchs Corneal Dystrophy

    PubMed Central

    Eghrari, Allen O.; Garrett, Brian S.; Mumtaz, Aisha A.; Edalati, Armand E.; Meadows, Danielle N.; McGlumphy, Elyse J.; Iliff, Benjamin W.; Gottsch, John D.

    2015-01-01

    Purpose Retroillumination photography analysis (RPA) provides objective assessment of the number and distribution of guttae in Fuchs Corneal Dystrophy. Here, we assess its correlation with clinical grading using slit-lamp biomicroscopy across varying levels of severity. Methods Retroillumination photographs were conducted of 95 affected corneas with slit-lamp flash photography after pupillary dilation. Individual guttae were counted manually and the position of individual points recorded. Clinical grading using the Krachmer scale was documented for each eye during examination, and regression analyses were performed to identify the strength of association with number of guttae. We assessed range at each stage of clinical grading, and utilized the Mann-Whitney U test to assess whether clinical grading levels demonstrated successively higher numbers of guttae. Results Krachmer score ranged from 1 to 5, with mean of 2.6. Mean numbers of guttae at each level of severity were 289 (1+), 999 (2+), 2669 (3+), 5474 (4+), and 7133 (5+). Each stage demonstrated significantly higher numbers of guttae than its preceding level except from 4+ to 5+ (p=0.30), consistent with the definition of 4+ as the highest level defined by presence of guttae. Higher levels of clinical grading were associated with larger ranges of guttae (p<0.01). A linear regression model resulted in a strong fit between RPA and Krachmer score (r=0.81). Conclusion In this largest study of RPA data and comparison with subjective clinical grading of FCD severity, RPA correlates strongly and demonstrates enhanced definition of severity at advanced stages of disease. PMID:26488628

  9. Retroillumination Photography Analysis Enhances Clinical Definition of Severe Fuchs Corneal Dystrophy.

    PubMed

    Eghrari, Allen O; Garrett, Brian S; Mumtaz, Aisha A; Edalati, Armand E; Meadows, Danielle N; McGlumphy, Elyse J; Iliff, Benjamin W; Gottsch, John D

    2015-12-01

    Retroillumination photography analysis (RPA) provides an objective assessment of the number and distribution of guttae in Fuchs corneal dystrophy. Here, we assess its correlation with clinical grading using slit-lamp biomicroscopy across varying levels of severity. Retroillumination photographs were conducted for 95 affected corneas with slit-lamp flash photography after pupillary dilation. Individual guttae were counted manually and the position of individual points recorded. Clinical grading using the Krachmer scale was documented for each eye during examination, and regression analyses were performed to identify the strength of association with number of guttae. We assessed range at each stage of clinical grading and used the Mann-Whitney U test to assess whether clinical grading levels demonstrated successively higher numbers of guttae. Krachmer score ranged from 1 to 5, with mean of 2.6. Mean numbers of guttae at each level of severity were 289 (1+), 999 (2+), 2669 (3+), 5474 (4+), and 7133 (5+). Each stage demonstrated significantly higher numbers of guttae than its preceding level except from 4+ to 5+ (P = 0.30), consistent with the definition of 4+ as the highest level defined by the presence of guttae. Higher levels of clinical grading were associated with larger ranges of guttae (P < 0.01). A linear regression model resulted in a strong fit between RPA and Krachmer score (r = 0.81). In this largest study of RPA data and comparison with subjective clinical grading of Fuchs dystrophy severity, RPA correlates strongly and demonstrates enhanced definition of severity at advanced stages of disease.

  10. Numerical predictors of arithmetic success in grades 1-6.

    PubMed

    Lyons, Ian M; Price, Gavin R; Vaessen, Anniek; Blomert, Leo; Ansari, Daniel

    2014-09-01

    Math relies on mastery and integration of a wide range of simpler numerical processes and concepts. Recent work has identified several numerical competencies that predict variation in math ability. We examined the unique relations between eight basic numerical skills and early arithmetic ability in a large sample (N = 1391) of children across grades 1-6. In grades 1-2, children's ability to judge the relative magnitude of numerical symbols was most predictive of early arithmetic skills. The unique contribution of children's ability to assess ordinality in numerical symbols steadily increased across grades, overtaking all other predictors by grade 6. We found no evidence that children's ability to judge the relative magnitude of approximate, nonsymbolic numbers was uniquely predictive of arithmetic ability at any grade. Overall, symbolic number processing was more predictive of arithmetic ability than nonsymbolic number processing, though the relative importance of symbolic number ability appears to shift from cardinal to ordinal processing. © 2014 John Wiley & Sons Ltd.

  11. Quantitative assessment of graded burn wounds using a commercial and research grade laser speckle imaging (LSI) system

    NASA Astrophysics Data System (ADS)

    Ponticorvo, A.; Rowland, R.; Yang, B.; Lertsakdadet, B.; Crouzet, C.; Bernal, N.; Choi, B.; Durkin, A. J.

    2017-02-01

    Burn wounds are often characterized by injury depth, which then dictates wound management strategy. While most superficial burns and full thickness burns can be diagnosed through visual inspection, clinicians experience difficulty with accurate diagnosis of burns that fall between these extremes. Accurately diagnosing burn severity in a timely manner is critical for starting the appropriate treatment plan at the earliest time points to improve patient outcomes. To address this challenge, research groups have studied the use of commercial laser Doppler imaging (LDI) systems to provide objective characterization of burn-wound severity. Despite initial promising findings, LDI systems are not commonplace in part due to long acquisition times that can suffer from artifacts in moving patients. Commercial LDI systems are being phased out in favor of laser speckle imaging (LSI) systems that can provide similar information with faster acquisition speeds. To better understand the accuracy and usefulness of commercial LSI systems in burn-oriented research, we studied the performance of a commercial LSI system in three different sample systems and compared its results to a research-grade LSI system in the same environments. The first sample system involved laboratory measurements of intralipid (1%) flowing through a tissue simulating phantom, the second preclinical measurements in a controlled burn study in which wounds of graded severity were created on a Yorkshire pig, and the third clinical measurements involving a small sample of clinical patients. In addition to the commercial LSI system, a research grade LSI system that was designed and fabricated in our labs was used to quantitatively compare the performance of both systems and also to better understand the "Perfusion Unit" output of commercial systems.

  12. On-Demand Grades: The Effect of Online Grade Book Access on Student Mastery and Performance Goal Orientations, Grade Orientation, Academic Self Efficacy, and Grades

    ERIC Educational Resources Information Center

    Seldow, Adam Lowell

    2010-01-01

    With the widespread growth of broadband Internet access, teachers, and in many cases, schools and school districts are transitioning from traditional paper-based grade books to student accessible online (Web-based) grade books. Online grade books offer students 24/7, on demand access to grades and various other student data, and have the potential…

  13. 7 CFR 810.1804 - Grades and grade requirements for sunflower seed.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 7 2010-01-01 2010-01-01 false Grades and grade requirements for sunflower seed. 810... AGRICULTURE OFFICIAL UNITED STATES STANDARDS FOR GRAIN United States Standards for Sunflower Seed Principles Governing the Application of Standards § 810.1804 Grades and grade requirements for sunflower seed. Grade...

  14. 7 CFR 810.1804 - Grades and grade requirements for sunflower seed.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 7 2011-01-01 2011-01-01 false Grades and grade requirements for sunflower seed. 810... AGRICULTURE OFFICIAL UNITED STATES STANDARDS FOR GRAIN United States Standards for Sunflower Seed Principles Governing the Application of Standards § 810.1804 Grades and grade requirements for sunflower seed. Grade...

  15. Association of Irisin and CRP Levels with the Radiographic Severity of Knee Osteoarthritis.

    PubMed

    Mao, Yongtao; Xu, Wei; Xie, Zonggang; Dong, Qirong

    2016-02-01

    Irisin, a recently identified myokine, is implicated in protecting mice from obesity. This study was designed to examine the relation of irisin levels in serum and synovial fluid (SF) with the radiographic severity of osteoarthritis (OA). Our study included 215 patients with knee OA. Irisin levels in serum and SF were evaluated using an enzyme-linked immunosorbent assay. The progression of OA was assessed using Kellgren-Lawrence grading system. Knee OA patients had lower serum irisin concentrations and increased serum C-reactive protein (CRP) levels compared with healthy controls. There were markedly decreased irisin levels in both the serum and the SF, as well as increased serum CRP levels of knee OA patients with Kellgren and Lawrence (KL) grade 4 compared with patients classified as KL grade 2 and 3. Furthermore, patients with KL grade 3 showed markedly reduced serum and SF levels of irisin, as well as increased serum CRP levels compared with patients classified as KL grade 2. Irisin levels in serum and SF of knee OA patients were negatively correlated with disease severity evaluated by KL grading criteria. Irisin levels in the serum and SF of knee OA patients were negatively correlated with disease severity evaluated by the radiographic KL grading criteria.

  16. Steroid treatment of acute graft-versus-host disease grade I: a randomized trial.

    PubMed

    Bacigalupo, Andrea; Milone, Giuseppe; Cupri, Alessandra; Severino, Antonio; Fagioli, Franca; Berger, Massimo; Santarone, Stella; Chiusolo, Patrizia; Sica, Simona; Mammoliti, Sonia; Sorasio, Roberto; Massi, Daniela; Van Lint, Maria Teresa; Raiola, Anna Maria; Gualandi, Francesca; Selleri, Carmine; Sormani, Maria Pia; Signori, Alessio; Risitano, Antonio; Bonifazi, Francesca

    2017-12-01

    Patients with acute graft- versus -host disease (GvHD) grade I were randomized to an observation arm (n=85) or to a treatment arm (n=86) consisting of 6-methylprednisolone 1 mg/kg/day, after stratification for age and donor type. The primary end point was development of grade II-IV GvHD. The cumulative incidence of grade II-IV GvHD was 50% in the observation arm and 33% in the treatment arm ( P =0.005). However, grade III-IV GvHD was comparable (13% vs 10%, respectively; P =0.6), and this was true for sibling and alternative donor transplants. Moderate/severe chronic GvHD was also comparable (17% vs 9%). In multivariate analysis, an early interval between transplant and randomization (grade III-IV GvHD. Patients in the observation arm had less infectious bacterial episodes (12 vs 25; P =0.04), less severe infectious fungal episodes (0 vs 3; P =0.04), and less severe adverse events (3 vs 11; P =0.07). At five years, non-relapse mortality was 20% versus 26% ( P =0.2), relapse-related mortality 25% versus 21%, and actuarial survival was 51% versus 41% ( P =0.3) in the observation and treatment arms, respectively. In multivariate analysis, advanced disease phase, older age and an early onset of GvHD were significant negative predictors of survival, independent of the randomization arm. In conclusion, steroid treatment of acute grade I GvHD prevents progression to grade II but not to grade III-IV GvHD, and there is no effect on non-relapse mortality and survival. Patients treated with steroids are at a higher risk of developing infections and have more adverse events. ( Trial registered as EUDTRACT 2008-000413-29 ). Copyright© 2017 Ferrata Storti Foundation.

  17. Grading for Understanding--Standards-Based Grading

    ERIC Educational Resources Information Center

    Zimmerman, Todd

    2017-01-01

    Standards-based grading (SBG), sometimes called learning objectives-based assessment (LOBA), is an assessment model that relies on students demonstrating mastery of learning objectives (sometimes referred to as standards). The goal of this grading system is to focus students on mastering learning objectives rather than on accumulating points. I…

  18. A multivariate model and statistical method for validating tree grade lumber yield equations

    Treesearch

    Donald W. Seegrist

    1975-01-01

    Lumber yields within lumber grades can be described by a multivariate linear model. A method for validating lumber yield prediction equations when there are several tree grades is presented. The method is based on multivariate simultaneous test procedures.

  19. Student Attitudes Toward Grades and Grading Practices.

    ERIC Educational Resources Information Center

    Stallings, William M.; Leslie, Elwood K.

    The result of a study designed to assess student attitudes toward grading practices are discussed. Questionnaire responses of 3439 students in three institutions were tabulated. Responses were generally negative toward conventional grading systems. (MS)

  20. 7 CFR 810.405 - Special grades and special grade requirements.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... OFFICIAL UNITED STATES STANDARDS FOR GRAIN United States Standards for Corn Special Grades and Special Grade Requirements § 810.405 Special grades and special grade requirements. (a) Flint corn. Corn that consists of 95 percent or more of flint corn. (b) Flint and dent corn. Corn that consists of a mixture of...

  1. 7 CFR 810.405 - Special grades and special grade requirements.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... OFFICIAL UNITED STATES STANDARDS FOR GRAIN United States Standards for Corn Special Grades and Special Grade Requirements § 810.405 Special grades and special grade requirements. (a) Flint corn. Corn that consists of 95 percent or more of flint corn. (b) Flint and dent corn. Corn that consists of a mixture of...

  2. Correlation Between Severity Of Portal Hypertensive Gastropathy And Size Of Oesophageal Varices In Cirrhotic Hepatitis-C Patients.

    PubMed

    Saleem, Khurram; Baig, Faisal Amin; Nida, Mahwish; Javed, Munaza

    2018-01-01

    Portal hypertension can lead to oesophageal varices (EV) and portal hypertensive gastropathy (PHG). The aim of this study is to determine the relationship between severity of Portal hypertensive gastropathy and size of oesophageal varices. One hundred and ninety-five patients of hepatitis C positive chronic liver disease having oesophageal varices were assessed for severity of portal hypertensive gastropathy. Mild Portal Hypertensive Gastropathy was observed in 16 (8.2 %), moderate in 54 (27.7 %) and severe in 120 (61.6 %) patients. Grade 1 Oesophageal Varices were present in 79 (40.5%) patients, grade 2 in 44 (21.9%) patients, grade 3 in 62 (31.8%) and grade 4 in 10 (5.2%) patients. No significant correlation was observed between grades of gastropathy and size of varices. The frequency of portal hypertensive gastropathy was 97.5% in Hepatitis C positive cirrhotic patients having oesophageal varices. Severity of gastropathy is not related to the grade or size of oesophageal varices.

  3. Osteoporosis Risk Factors in Eighth Grade Students.

    ERIC Educational Resources Information Center

    Lysen, Victoria C.; Walker, Robert

    1997-01-01

    Presents findings from food frequency questionnaires and surveys of 138 Midwestern eighth-grade student-parent pairs. The study examined the incidence of modifiable and nonmodifiable osteoporosis risk factors and compared gender differences. Data analysis indicated that many adolescents possessed several modifiable and nonmodifiable risk factors…

  4. Classification and grading of muscle injuries: a narrative review

    PubMed Central

    Hamilton, Bruce; Valle, Xavier; Rodas, Gil; Til, Luis; Grive, Ricard Pruna; Rincon, Josep Antoni Gutierrez; Tol, Johannes L

    2015-01-01

    A limitation to the accurate study of muscle injuries and their management has been the lack of a uniform approach to the categorisation and grading of muscle injuries. The goal of this narrative review was to provide a framework from which to understand the historical progression of the classification and grading of muscle injuries. We reviewed the classification and grading of muscle injuries in the literature to critically illustrate the strengths, weaknesses, contradictions or controversies. A retrospective, citation-based methodology was applied to search for English language literature which evaluated or utilised a novel muscle classification or grading system. While there is an abundance of literature classifying and grading muscle injuries, it is predominantly expert opinion, and there remains little evidence relating any of the clinical or radiological features to an established pathology or clinical outcome. While the categorical grading of injury severity may have been a reasonable solution to a clinical challenge identified in the middle of the 20th century, it is time to recognise the complexity of the injury, cease trying to oversimplify it and to develop appropriately powered research projects to answer important questions. PMID:25394420

  5. Murmur intensity in adult dogs with pulmonic and subaortic stenosis reflects disease severity.

    PubMed

    Caivano, D; Dickson, D; Martin, M; Rishniw, M

    2018-03-01

    The aims of this study were to determine whether murmur intensity in adult dogs with pulmonic stenosis or subaortic stenosis reflects echocardiographic disease severity and to determine whether a six-level murmur grading scheme provides clinical advantages over a four-level scheme. In this retrospective multi-investigator study on adult dogs with pulmonic stenosis or subaortic stenosis, murmur intensity was compared to echocardiographically determined pressure gradient across the affected valve. Disease severity, based on pressure gradients, was assessed between sequential murmur grades to identify redundancy in classification. A simplified four-level murmur intensity classification scheme ('soft', 'moderate', 'loud', 'palpable') was evaluated. In total, 284 dogs (153 with pulmonic stenosis, 131 with subaortic stenosis) were included; 55 dogs had soft, 59 had moderate, 72 had loud and 98 had palpable murmurs. 95 dogs had mild stenosis, 46 had moderate stenosis, and 143 had severe stenosis. No dogs with soft murmurs of either pulmonic or subaortic stenosis had transvalvular pressure gradients greater than 50 mmHg. Dogs with loud or palpable murmurs mostly, but not always, had severe stenosis. Stenosis severity increased with increasing murmur intensity. The traditional six-level murmur grading scheme provided no additional clinical information than the four-level descriptive murmur grading scheme. A simplified descriptive four-level murmur grading scheme differentiated stenosis severity without loss of clinical information, compared to the traditional six-level scheme. Soft murmurs in dogs with pulmonic or subaortic stenosis are strongly indicative of mild lesions. Loud or palpable murmurs are strongly suggestive of severe stenosis. © 2017 British Small Animal Veterinary Association.

  6. Novel clinical grading of delayed neurologic sequelae after carbon monoxide poisoning and factors associated with outcome.

    PubMed

    Kuroda, Hiroshi; Fujihara, Kazuo; Kushimoto, Shigeki; Aoki, Masashi

    2015-05-01

    Delayed neurologic sequelae (DNS) after carbon monoxide (CO) poisoning manifest as a relapse of neurologic deficits. However, the long-term outcome of DNS has not been fully clarified. Myelin basic protein (MBP) levels in the cerebrospinal fluid (CSF) have been reported to be elevated in DNS. However, the precise timing and clinical value of the CSF examination have not been fully evaluated. We aimed to clarify the long-term outcome and the factors predicting the outcome of DNS and to evaluate the utility of CSF-MBP for predicting the development and severity of DNS. This work was designed as a single-center, prospective, observational study. We graded DNS severity as Grade 1 (consistent independence), Grade 2 (temporary dependence), or Grade 3 (persistent dependence). We analyzed the percentage categorized in each grade and the parameters associated with outcome. Of 100 patients experiencing acute CO poisoning (median age: 46 years; 69% male), 20 (20%) developed DNS, including six Grade 1 (30%), ten Grade 2 (50%), and four Grade 3 (20%) cases. The Grade 3 patients [median: 77 years; interquartile range (IQR): 76-82] were older than the Grade 1 patients [42; 30-46] (P<0.01); the DNS onset of the Grade 1 patients [median interval after poisoning: 35 days; IQR: 32-56] occurred later than that of the Grade 3 patients [10; 9-13] P<0.001) and the Grade 2 patients [25; 23-27] (P<0.05). The CSF-MBP levels of the DNS patients were higher than those of the non-DNS patients (P<0.0001). The 1-month CSF-MBP levels of the Grade 3 patients were higher than those of the Grade 1 patients (P<0.05); the MBP index, defined as [(Age)×(1-month CSF-MBP)], was higher in the Grade 3 patients than in the Grade 1 patients (P<0.01). Severe DNS were associated with advanced age (>72.5 years), earlier onset (<18 days), higher 1-month CSF-MBP (>252 pg/ml), and higher MBP index (>20.9 year × ng/ml). Poor DNS outcomes were associated with advanced age and earlier onset. CSF-MBP can serve as a

  7. [Prostate cancer. Part 2: Review of the various tumor grading systems over the years 1966-2015 and future perspectives of the new grading of the International Society of Urological Pathology (ISUP)].

    PubMed

    Helpap, B; Bubendorf, L; Kristiansen, G

    2016-02-01

    The continued development of methods in needle biopsies and radical prostatectomy for treatment of prostate cancer has given special emphasis to the question of the prognostic relevance of the various systems of grading. The classical purely histological grading system of Gleason has been modified several times in the past decades and cleared the way for a new grading system by the prognostic grading of Epstein. Assessment of the old and also modified combined histological and cytological grading of Mostofi, the World health Organization (WHO) and the urologic-pathological working group of prostate cancer in connection with the Gleason grading (combined Gleason-Helpap grading), has led to considerably improved rates of concordance between biopsy and radical prostatectomy and to improved estimations of prognosis beside its contribution to the development of a more practicable grading system for clinical use.

  8. Novel, improved grading system(s) for IDH-mutant astrocytic gliomas.

    PubMed

    Shirahata, Mitsuaki; Ono, Takahiro; Stichel, Damian; Schrimpf, Daniel; Reuss, David E; Sahm, Felix; Koelsche, Christian; Wefers, Annika; Reinhardt, Annekathrin; Huang, Kristin; Sievers, Philipp; Shimizu, Hiroaki; Nanjo, Hiroshi; Kobayashi, Yusuke; Miyake, Yohei; Suzuki, Tomonari; Adachi, Jun-Ichi; Mishima, Kazuhiko; Sasaki, Atsushi; Nishikawa, Ryo; Bewerunge-Hudler, Melanie; Ryzhova, Marina; Absalyamova, Oksana; Golanov, Andrey; Sinn, Peter; Platten, Michael; Jungk, Christine; Winkler, Frank; Wick, Antje; Hänggi, Daniel; Unterberg, Andreas; Pfister, Stefan M; Jones, David T W; van den Bent, Martin; Hegi, Monika; French, Pim; Baumert, Brigitta G; Stupp, Roger; Gorlia, Thierry; Weller, Michael; Capper, David; Korshunov, Andrey; Herold-Mende, Christel; Wick, Wolfgang; Louis, David N; von Deimling, Andreas

    2018-04-23

    According to the 2016 World Health Organization Classification of Tumors of the Central Nervous System (2016 CNS WHO), IDH-mutant astrocytic gliomas comprised WHO grade II diffuse astrocytoma, IDH-mutant (AII IDHmut ), WHO grade III anaplastic astrocytoma, IDH-mutant (AAIII IDHmut ), and WHO grade IV glioblastoma, IDH-mutant (GBM IDHmut ). Notably, IDH gene status has been made the major criterion for classification while the manner of grading has remained unchanged: it is based on histological criteria that arose from studies which antedated knowledge of the importance of IDH status in diffuse astrocytic tumor prognostic assessment. Several studies have now demonstrated that the anticipated differences in survival between the newly defined AII IDHmut and AAIII IDHmut have lost their significance. In contrast, GBM IDHmut still exhibits a significantly worse outcome than its lower grade IDH-mutant counterparts. To address the problem of establishing prognostically significant grading for IDH-mutant astrocytic gliomas in the IDH era, we undertook a comprehensive study that included assessment of histological and genetic approaches to prognosis in these tumors. A discovery cohort of 211 IDH-mutant astrocytic gliomas with an extended observation was subjected to histological review, image analysis, and DNA methylation studies. Tumor group-specific methylation profiles and copy number variation (CNV) profiles were established for all gliomas. Algorithms for automated CNV analysis were developed. All tumors exhibiting 1p/19q codeletion were excluded from the series. We developed algorithms for grading, based on molecular, morphological and clinical data. Performance of these algorithms was compared with that of WHO grading. Three independent cohorts of 108, 154 and 224 IDH-mutant astrocytic gliomas were used to validate this approach. In the discovery cohort several molecular and clinical parameters were of prognostic relevance. Most relevant for overall survival (OS

  9. A patient-specific model of the biomechanics of hip reduction for neonatal Developmental Dysplasia of the Hip: Investigation of strategies for low to severe grades of Developmental Dysplasia of the Hip.

    PubMed

    Huayamave, Victor; Rose, Christopher; Serra, Sheila; Jones, Brendan; Divo, Eduardo; Moslehy, Faissal; Kassab, Alain J; Price, Charles T

    2015-07-16

    A physics-based computational model of neonatal Developmental Dysplasia of the Hip (DDH) following treatment with the Pavlik Harness (PV) was developed to obtain muscle force contribution in order to elucidate biomechanical factors influencing the reduction of dislocated hips. Clinical observation suggests that reduction occurs in deep sleep involving passive muscle action. Consequently, a set of five (5) adductor muscles were identified as mediators of reduction using the PV. A Fung/Hill-type model was used to characterize muscle response. Four grades (1-4) of dislocation were considered, with one (1) being a low subluxation and four (4) a severe dislocation. A three-dimensional model of the pelvis-femur lower limb of a representative 10 week-old female was generated based on CT-scans with the aid of anthropomorphic scaling of anatomical landmarks. The model was calibrated to achieve equilibrium at 90° flexion and 80° abduction. The hip was computationally dislocated according to the grade under investigation, the femur was restrained to move in an envelope consistent with PV restraints, and the dynamic response under passive muscle action and the effect of gravity was resolved. Model results with an anteversion angle of 50° show successful reduction Grades 1-3, while Grade 4 failed to reduce with the PV. These results are consistent with a previous study based on a simplified anatomically-consistent synthetic model and clinical reports of very low success of the PV for Grade 4. However our model indicated that it is possible to achieve reduction of Grade 4 dislocation by hyperflexion and the resultant external rotation. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Is the Sky Falling? Grade Inflation and the Signaling Power of Grades

    PubMed Central

    Pattison, Evangeleen; Grodsky, Eric; Muller, Chandra

    2014-01-01

    Grades are the fundamental currency of our educational system; they signal academic achievement and non-cognitive skills to parents, employers, postsecondary gatekeepers, and students themselves. Grade inflation compromises the signaling value of grades, undermining their capacity to achieve the functions for which they are intended. We challenge the ‘increases in grade point average’ definition of grade inflation and argue that grade inflation must be understood in terms of the signaling power of grades. Analyzing data from four nationally representative samples, we find that in the decades following 1972: (a) grades have risen at high schools and dropped at four-year colleges, in general, and selective four-year institutions, in particular; and (b) the signaling power of grades has attenuated little, if at all. PMID:25288826

  11. Lumber stress grades and design properties

    Treesearch

    David E. Kretschmann; David W. Green

    1999-01-01

    Lumber sawn from a log, regardless of species and size, is quite variable in mechanical properties. Pieces may differ in strength by several hundred percent. For simplicity and economy in use, pieces of lumber of similar mechanical properties are placed in categories called stress grades, which are characterized by (a) one or more sorting criteria, (b) a set of...

  12. A Novel Clinical Grading Scale to Guide the Management of Crusted Scabies

    PubMed Central

    Tong, Steven Y. C.; Walton, Shelley F.; Currie, Bart J.

    2013-01-01

    Background Crusted scabies, or hyperinfestation with Sarcoptes scabiei, occurs in people with an inadequate immune response to the mite. In recent decades, data have emerged suggesting that treatment of crusted scabies with oral ivermectin combined with topical agents leads to lower mortality, but there are no generally accepted tools for describing disease severity. Here, we describe a clinical grading scale for crusted scabies and its utility in real world practice. Methodology/Principal Findings In 2002, Royal Darwin Hospital (RDH), a hospital in tropical Australia developed and began using a clinical grading scale to guide the treatment of crusted scabies. We conducted a retrospective observational study including all episodes of admission to RDH for crusted scabies during the period October 2002–December 2010 inclusive. Patients who were managed according to the grading scale were compared with those in whom the scale was not used at the time of admission but was calculated retrospectively. There were 49 admissions in 30 patients during the study period, of which 49 (100%) were in Indigenous Australians, 29 (59%) were male and the median age was 44.1 years. According to the grading scale, 8 (16%) episodes were mild, 24 (49%) were moderate, and 17 (35%) were severe. Readmission within the study period was significantly more likely with increasing disease severity, with an odds ratio (95% CI) of 12.8 (1.3–130) for severe disease compared with mild. The patients managed according to the grading scale (29 episodes) did not differ from those who were not (20 episodes), but they received fewer doses of ivermectin and had a shorter length of stay (11 vs. 16 days, p = 0.02). Despite this the outcomes were no different, with no deaths in either group and a similar readmission rate. Conclusions/Significance Our grading scale is a useful tool for the assessment and management of crusted scabies. PMID:24069468

  13. Fuel characteristics pertinent to the design of aircraft fuel systems, Supplement I : additional information on MIL-F-7914(AER) grade JP-5 fuel and several fuel oils

    NASA Technical Reports Server (NTRS)

    Barnett, Henry C; Hibbard, Robert R

    1953-01-01

    Since the release of the first NACA publication on fuel characteristics pertinent to the design of aircraft fuel systems (NACA-RM-E53A21), additional information has become available on MIL-F7914(AER) grade JP-5 fuel and several of the current grades of fuel oils. In order to make this information available to fuel-system designers as quickly as possible, the present report has been prepared as a supplement to NACA-RM-E53A21. Although JP-5 fuel is of greater interest in current fuel-system problems than the fuel oils, the available data are not as extensive. It is believed, however, that the limited data on JP-5 are sufficient to indicate the variations in stocks that the designer must consider under a given fuel specification. The methods used in the preparation and extrapolation of data presented in the tables and figures of this supplement are the same as those used in NACA-RM-E53A21.

  14. Management of High-Grade Penile Curvature Associated With Hypospadias in Children

    PubMed Central

    Moscardi, Paulo R. M.; Gosalbez, Rafael; Castellan, Miguel Alfedo

    2017-01-01

    Penile curvature is a frequent feature associated with hypospadias with also a great variability of severity among each patient. While the low-grade curvature (<30°) can be relatively easily corrected by simple techniques like penile degloving and dorsal plication, severe cases often demand more complex maneuvers to manage it. A great number of surgical techniques have been developed to adequately correct curvatures greater than 30°; however, each one of them should be individualized to different patients and local conditions encountered. In this article, we will review the evaluation of the pediatric patient with penile curvature associated with hypospadias with a special attention to high-grade cases, their management, indications for surgical treatment, and several surgical options for their definitive treatment. PMID:28929092

  15. Design, Manufacturing and Characterization of Functionally Graded Flextensional Piezoelectric Actuators

    NASA Astrophysics Data System (ADS)

    Amigo, R. C. R.; Vatanabe, S. L.; Silva, E. C. N.

    2013-03-01

    Previous works have been shown several advantages in using Functionally Graded Materials (FGMs) for the performance of flextensional devices, such as reduction of stress concentrations and gains in reliability. In this work, the FGM concept is explored in the design of graded devices by using the Topology Optimization Method (TOM), in order to determine optimal topologies and gradations of the coupled structures of piezoactuators. The graded pieces are manufactured by using the Spark Plasma Sintering (SPS) technique and are bonded to piezoelectric ceramics. The graded actuators are then tested by using a modular vibrometer system for measuring output displacements, in order to validate the numerical simulations. The technological path developed here represents the initial step toward the manufacturing of an integral piezoelectric device, constituted by piezoelectric and non-piezoelectric materials without bonding layers.

  16. Grading the teacher

    NASA Astrophysics Data System (ADS)

    Swartz, Clifford E.

    2000-04-01

    Several fads ago there was a movement to grade teachers in terms of their competency — competency-based testing. Everyone knows that there are good teachers and there are bad teachers. The trouble is, it's hard to define the categories. It's like the Supreme Court justice who couldn't define pornography, but knew it when he saw it. In New York State, prospective teachers must take tests in both pedagogy and subject material. That seems reasonable. There ought to be some minimum standards, so I thought that I would try my hand at setting up such requirements.

  17. [Application of grading evaluation on facial nerve function of Bell's palsy treated with electroacupuncture].

    PubMed

    Zhou, Zhang-Ling; Zuo, Cong; Cheng, Shu-Luo; Shao, Wei-Wei; Liu, Li-Ping

    2013-08-01

    To explore the correlation of facial nerve injury degree with facial contraction degree induced by electric stimulation in the treatment of Bell's palsy with electroacupuncture, and the significance in elec tric reaction grading evaluation. Sixty-eight cases of Bell's palsy were enrolled. The positive and negative electrodes of the acupuncture treatment apparatus were attached to the needle handles at the 3 groups of points, named Taiyang (EX-HN 5)-Yangbai(GB 14), Xiaguan (ST 7)-Quanliao (SI 18) and Heliao (LI 19)-Jiachengjiang (Extra). The disperse-dense wave was applied. According to the severity of local muscle contraction after needling, the electric reaction was divided into 4 grades, named superior, moderate, poor and no reaction. After acupuncture and electroacupuncture, the efficacy was evaluated in accordance with the different electric reaction grades. The curative rate was 100.0% (44/44) in patients with superior electric reaction, was 100.0% (7/7) in patients with moderate electric reaction, was 18.2% (2/11) in patients with poor electric reaction and was 0 (0/6) in patients with noelectric reaction. The difference was significant statistically in comparison of 4 groups (P<0.01). The superiority correlation presented between the efficacy and electric reaction grade (P< 0.001). The higher the superiority of electric reaction grade was, the better the efficacy was. The difference in the efficacy among different electric reaction grades was significant statistically (P<0.001). And the course of treatment was the shortest for those with the high superiority of electric reaction. The reaction grade of electric stimulation is conform to the facial nerve injury grading in Bell's palsy. The contraction degree of facial mimetic muscle induced by electroacupuncture stimulation is closely correlated with severity of disease. Based on the electric reaction, the facial nerve injury severity can be understood generally and the prognosis be judged.

  18. Cervical arthroplasty for moderate to severe disc degeneration: clinical and radiological assessments after a minimum follow-up of 18 months--Pfirrmann grade and cervical arthroplasty.

    PubMed

    Oh, Chang Hyun; Kim, Do Yeon; Ji, Gyu Yeul; Kim, Yeo Ju; Yoon, Seung Hwan; Hyun, Dongkeun; Kim, Eun Young; Park, Hyeonseon; Park, Hyeong-Chun

    2014-07-01

    Clinical outcomes and radiologic results after cervical arthroplasty have been reported in many articles, yet relatively few studies after cervical arthroplasty have been conducted in severe degenerative cervical disc disease. Sixty patients who underwent cervical arthroplasty (Mobi-C®) between April 2006 and November 2011 with a minimum follow-up of 18 months were enrolled in this study. Patients were divided into two groups according to Pfirrmann classification on preoperative cervical MR images: group A (Pfirrmann disc grade III, n=38) and group B (Pfirrmann disc grades IV or V, n=22). Visual analogue scale (VAS) scores of neck and arm pain, modified Oswestry Disability Index (mODI) score, and radiological results including cervical range of motion (ROM) were assessed before and after surgery. VAS and mean mODI scores decreased after surgery from 5.1 and 57.6 to 2.7 and 31.5 in group A and from 6.1 and 59.9 to 3.7 and 38.4 in group B, respectively. In both groups, VAS and mODI scores significantly improved postoperatively (p<0.001), although no significant intergroup differences were found. Also, cervical dynamic ROM was preserved or gradually improved up to 18 months after cervical arthroplasty in both groups. Global, segmental and adjacent ROM was similar for both groups during follow-up. No cases of device subsidence or extrusion were recorded. Clinical and radiological results following cervical arthroplasty in patients with severe degenerative cervical disc disease were no different from those in patients with mild degenerative cervical disc disease after 18 months of follow-up.

  19. Higher-Order Theory for Functionally Graded Materials

    NASA Technical Reports Server (NTRS)

    Aboudi, Jacob; Pindera, Marek-Jerzy; Arnold, Steven M.

    1999-01-01

    This paper presents the full generalization of the Cartesian coordinate-based higher-order theory for functionally graded materials developed by the authors during the past several years. This theory circumvents the problematic use of the standard micromechanical approach, based on the concept of a representative volume element, commonly employed in the analysis of functionally graded composites by explicitly coupling the local (microstructural) and global (macrostructural) responses. The theoretical framework is based on volumetric averaging of the various field quantities, together with imposition of boundary and interfacial conditions in an average sense between the subvolumes used to characterize the composite's functionally graded microstructure. The generalization outlined herein involves extension of the theoretical framework to enable the analysis of materials characterized by spatially variable microstructures in three directions. Specialization of the generalized theoretical framework to previously published versions of the higher-order theory for materials functionally graded in one and two directions is demonstrated. In the applications part of the paper we summarize the major findings obtained with the one-directional and two-directional versions of the higher-order theory. The results illustrate both the fundamental issues related to the influence of microstructure on microscopic and macroscopic quantities governing the response of composites and the technologically important applications. A major issue addressed herein is the applicability of the classical homogenization schemes in the analysis of functionally graded materials. The technologically important applications illustrate the utility of functionally graded microstructures in tailoring the response of structural components in a variety of applications involving uniform and gradient thermomechanical loading.

  20. Efficacy of early physical therapy in severe Bell's palsy: a randomized controlled trial.

    PubMed

    Nicastri, Maria; Mancini, Patrizia; De Seta, Daniele; Bertoli, Gianantonio; Prosperini, Luca; Toni, Danilo; Inghilleri, Maurizio; Filipo, Roberto

    2013-01-01

    Bell's palsy (BP) is the most frequent form of peripheral palsy of the facial nerve. Prognosis for recovery is good for most patients; in the remaining cases, different grades of residual impairment persist. Physical therapy, in association with drug administration, aims to improve outcomes. To assess the efficacy of early physical therapy in association with standard drug administration versus pharmacological therapy only, in terms of time to maximum gains and grade of recovery of function, and to examine who will most benefit from rehabilitation. From June 2008 to May 2010, 232 individuals were evaluated. The 87 patients meeting the eligibility criteria were randomly assigned to the experimental group (prednisone and valacyclovir plus physical therapy, n = 39) or the control group (pharmacological therapy, n = 48) within 10 days of onset. Intention-to-treat analyses were done. The physical therapy had a significant effect on grade (P = .038) and time (P = .044) to recovery only in patients presenting with severe facial palsy (House-Brackmann [HB] grade V/VI). No significant differences were found between the study and control groups for outcome of synkinesis. Physical therapy appears to be effective only in the more severe BP (baseline HB grade V/VI), whereas less severe BP (baseline HB grade IV) results in complete spontaneous recovery, regardless of physical therapy.

  1. Grading Multiple Choice Exams with Low-Cost and Portable Computer-Vision Techniques

    ERIC Educational Resources Information Center

    Fisteus, Jesus Arias; Pardo, Abelardo; García, Norberto Fernández

    2013-01-01

    Although technology for automatic grading of multiple choice exams has existed for several decades, it is not yet as widely available or affordable as it should be. The main reasons preventing this adoption are the cost and the complexity of the setup procedures. In this paper, "Eyegrade," a system for automatic grading of multiple…

  2. Lumber Grade Yields for Graded Aspen Logs and Trees

    Treesearch

    Leland F. Hanks; Robert L. Brisbin

    1978-01-01

    Green lumber grade yields for aspen were determined for use with the U.S. Forest Service hardwood log and tree grades. The yields for logs are expressed in percent of total lumber tally volume, and those for trees are expressed in board feet. Overruns for the International 1/4-inch and Scribner log rules along with lumber recovery factors are shown by log grade.

  3. Teachers' Grading Decision Making

    ERIC Educational Resources Information Center

    Isnawati, Ida; Saukah, Ali

    2017-01-01

    This study investigated teachers' grading decision making, focusing on their beliefs underlying their grading decision making, their grading practices and assessment types, and factors they considered in grading decision making. Two teachers from two junior high schools applying different curriculum policies in grade reporting in Indonesian…

  4. Design Document for 12th Grade NAEP Preparedness Research Judgmental Standard Setting Studies: Setting Standards on the National Assessment of Educational Progress in Reading and Mathematics for 12th Grade Preparedness

    ERIC Educational Resources Information Center

    National Assessment Governing Board, 2010

    2010-01-01

    The National Assessment Governing Board adopted a Program of Preparedness Research in March 2009. Several categories of research studies were recommended to produce results for reporting 12th grade preparedness for the 2009 grade 12 National Assessment of Educational Progress (NAEP) in reading and mathematics. The categories included content…

  5. Profile of vemurafenib-induced severe skin toxicities.

    PubMed

    Peuvrel, L; Quéreux, G; Saint-Jean, M; Brocard, A; Nguyen, J M; Khammari, A; Knol, A C; Varey, E; Dréno, B

    2016-02-01

    Vemurafenib, a BRAF inhibitor, is commonly associated with skin toxicity. The impact of severe forms is unknown. To determine the rate of permanent vemurafenib discontinuation due to grade 3-4 skin toxicity, features of these toxicities, their recurrence rate after a switch to dabrafenib and their impact on overall survival. Retrospective cohort study of 131 patients treated with vemurafenib for melanoma between November 2010 and December 2014. Data on skin toxicities, the need for vemurafenib adjustment and the impact of switching to dabrafenib were collected. Regarding survival analysis, a conditional landmark analysis was performed to correct lead-time bias. Among the 131 vemurafenib-treated patients, 26% developed grade 3-4 skin toxicity. Forty-four percent of them permanently discontinued their treatment, mainly due to rash and classic skin adverse reactions (Steven-Johnson syndrome, Drug Reaction with Eosinophilia and Systemic Symptoms). Conversely, photosensitivity and carcinomas rarely required treatment adjustment. Grade 3-4 rashes were associated with clinical or biological abnormalities in 94% of patients. Among the 10 patients who subsequently switched to dabrafenib, skin toxicity recurred only in one patient. Overall survival was significantly prolonged in case of severe skin toxicity emerging within the first 4 (P = 0.014) and 8 weeks (P = 0.038) on vemurafenib, with only a trend at 12 weeks (P = 0.052). Median overall survival was also prolonged in case of severe rash. In this study, vemurafenib was continued in 56% of patients with grade 3-4 skin toxicity, which was associated with prolonged overall survival when emerging within the first 4 and 8 weeks of treatment. While developing severe skin adverse reactions permanently contraindicates vemurafenib use, other rashes should lead to retreatment attempts with dose reduction. In case of recurrence, dabrafenib seems to be an interesting option. For other skin toxicities, including photosensitivity and

  6. The Grades Transfer from One Grading Scale to Other Algorithmization

    ERIC Educational Resources Information Center

    Lieponiene, Jurgita; Kulvietiene, Regina

    2011-01-01

    The article presents the consideration of grading scales used for education outcomes in different countries, describes likeness and differences of applied grading scales. Application of the European Credit Transfer and Accumulation System (ECTS) grading scale is investigated according of the analysis of scientific literature as well as cases of…

  7. Graft-versus-Host Disease of the Gut: A Histologic Activity Grading System and Validation.

    PubMed

    Myerson, David; Steinbach, Gideon; Gooley, Ted A; Shulman, Howard M

    2017-09-01

    The pathologic interpretation of gut biopsies in hematopoietic cell transplant recipients to assess graft-versus-host disease (GVHD) is well accepted and supplements clinical and endoscopic findings. However, the histologic activity grading of GVHD is controversial, with attempts to predict prognosis or response to treatment largely unsuccessful. GVHD is being diagnosed earlier in its course, raising the possibility that the pathologic grading system can be profitably modified. We developed a histologic activity grading system designed to replace the commonly used modified Lerner grading systems. Our system stratifies the low-level Lerner grade I category into 4 activity grade categories, based on the average frequency of apoptotic cells. The results are expressed as ordinal categories: GVHD of minimal, mild, moderate, severe histologic activity, or severe histologic activity with destruction (activity grades 1 to 5). In a retrospective study, we studied 87 consecutive cases with 201 post-transplantation specimens (median, 48 days; range, 18 to 1479 days) of stomach, duodenum, and colorectum, which had been activity graded at the time of the original diagnosis. Most of the biopsies diagnosed as GVHD were low grade-minimal (11%) or mild (71%) histologic activity. We hypothesized that the higher activity grades would be associated with more therapeutic intervention. The odds of increased therapy in the combined all-site specimens were increased as activity grade increased (odds ratio, 2.9 [95% confidence interval {CI}, 1.9 to 4.5]; P = < .0001). Thus, our grading system was validated. To investigate whether the activity grade was associated with therapy within the formerly undivided Lerner grade I category, the analysis was restricted to these 174 all-site specimens. The validation result was similar (odds ratio, 3.1 [95% CI, 1.3 to 7.2]; P = .009). This result interestingly suggests that there is useful information hidden in the Lerner grade I category

  8. Comparison of severity classification in Japanese patients with antineutrophil cytoplasmic antibody-associated vasculitis in a nationwide, prospective, inception cohort study.

    PubMed

    Sada, Ken-Ei; Harigai, Masayoshi; Amano, Koichi; Atsumi, Tatsuya; Fujimoto, Shouichi; Yuzawa, Yukio; Takasaki, Yoshinari; Banno, Shogo; Sugihara, Takahiko; Kobayashi, Masaki; Usui, Joichi; Yamagata, Kunihiro; Homma, Sakae; Dobashi, Hiroaki; Tsuboi, Naotake; Ishizu, Akihiro; Sugiyama, Hitoshi; Okada, Yasunori; Arimura, Yoshihiro; Matsuo, Seiichi; Makino, Hirofumi

    2016-09-01

    To compare disease severity classification systems for six-month outcome prediction in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). Patients with newly diagnosed AAV from 53 tertiary institutions were enrolled. Six-month remission, overall survival, and end-stage renal disease (ESRD)-free survival were evaluated. According to the European Vasculitis Study Group (EUVAS)-defined disease severity, the 321 enrolled patients were classified as follows: 14, localized; 71, early systemic; 170, generalized; and 66, severe disease. According to the rapidly progressive glomerulonephritis (RPGN) clinical grading system, the patients were divided as follows: 60, grade I; 178, grade II; 66, grade III; and 12, grade IV. According to the Five-Factor Score (FFS) 2009, 103, 109, and 109 patients had ≤1, 2, and ≥3 points, respectively. No significant difference in remission rates was found in any severity classification. The overall and ESRD-free survival rates significantly differed between grades I/II, III, and IV, regardless of renal involvement. Severe disease was a good predictor of six-month overall and ESRD-free survival. The FFS 2009 was useful to predict six-month ESRD-free survival but not overall survival. The RPGN grading system was more useful to predict six-month overall and ESRD-free survival than the EUVAS-defined severity or FFS 2009.

  9. Evaluation of Grade 120 Granulated Ground blast Furnace Slag.

    DOT National Transportation Integrated Search

    1999-06-01

    This study evaluates Grade 120 Granulated Ground Blast Furnace Slag (GGBFS) and its effect on the properties of hydraulic cement concretes used in structural and pavement construction. Several mix designs, structural and pavement, were used for this ...

  10. Test-Enhanced Learning in Third-Grade Children

    ERIC Educational Resources Information Center

    Jaeger, Antonio; Eisenkraemer, Raquel Eloísa; Stein, Lilian Milnitsky

    2015-01-01

    Several recent studies have shown that retrieval is more efficient than restudy in enhancing the long-term retention of memories. However, studies investigating this effect in children are still rare. Here, we report an experiment in which third-grade children initially read a brief encyclopaedic text twice and then either performed a cued recall…

  11. Does Social Background Influence Political Science Grades?

    ERIC Educational Resources Information Center

    Tiruneh, Gizachew

    2013-01-01

    This paper tests a hypothesized linear relationship between social background and final grades in several political science courses that I taught at the University of Central Arkansas. I employ a cross-sectional research design and ordinary least square (OLS) estimators to test the foregoing hypothesis. Relying on a sample of up to 204…

  12. Correlation of fat embolism severity and subcutaneous fatty tissue crushing and bone fractures.

    PubMed

    Bolliger, Stephan Andreas; Muehlematter, Karin; Thali, Michael Josef; Ampanozi, Garyfalia

    2011-05-01

    Pulmonary fat embolism (PFE) is frequently encountered in blunt trauma. The clinical manifestation ranges from no impairment in light cases to death due to right-sided heart failure or hypoxaemia in severe cases. Occasionally, pulmonary fat embolism can give rise to a fat embolism syndrome (FES), which is marked by multiorgan failure, respiratory disorders, petechiae and often death. It is well known that fractures of long bones can lead to PFE. Several authors have argued that PFE can arise due to mere soft tissue injury in the absence of fractures, a claim other authors disagree upon. In this study, we retrospectively examined 50 victims of blunt trauma with regard to grade and extent of fractures and crushing of subcutaneous fatty tissue and presence and severity of PFE. Our results indicate that PFE can arise due to mere crushing of subcutaneous fat and that the fracture grade correlated well with PFE severity (p = 0.011). The correlation between PFE and the fracture severity (body regions affected by fractures and fracture grade) showed a lesser significant correlation (p = 0.170). The survival time (p = 0.567), the amount of body regions affected by fat crushing (p = 0.336) and the fat crush grade (p = 0.485) did not correlate with the PFE grade, nor did the amount of body regions affected by fractures. These results may have clinical implications for the assessment of a possible FES development, as, if the risk of a PFE is known, preventive steps can be taken.

  13. Objective assessment of isotretinoin-associated cheilitis: Isotretinoin Cheilitis Grading Scale.

    PubMed

    Ornelas, Jennifer; Rosamilia, Lorraine; Larsen, Larissa; Foolad, Negar; Wang, Quinlu; Li, Chin-Shang; Sivamani, Raja K

    2016-01-01

    Isotretinoin remains an effective treatment for severe acne. Despite its effectiveness, it includes many side effects, of which cheilitis is the most common. To develop an objective grading scale for assessment of isotretinoin-associated cheilitis. Cross-sectional clinical grading study. UC Davis Dermatology clinic. Subjects were older than 18 years old and actively treated with oral isotretinoin. Oral Isotretinoin. We developed an Isotretinoin Cheilitis Grading Scale (ICGS) incorporating the following four characteristics: erythema, scale/crust, fissures and inflammation of the commissures. Three board-certified dermatologists independently graded photographs of the subjects. The Kendall's coefficient of concordance (KCC) for the ICGS was 0.88 (p < 0.0001). The Kendall's coefficient was ≥0.72 (p < 0.0001) for each of the four characteristics included in the grading scale. An image-based measurement for lip roughness statistically significantly correlated with the lip scale/crusting assessment (r = 0.52, p < 0.05). The ICGS is reproducible and relatively simple to use. It can be incorporated as an objective tool to aid in the assessment of isotretinoin associated cheilitis.

  14. Evaluating the impacts of grades on vehicular speeds on interstate highways.

    PubMed

    Chen, Xinqiang; Li, Zhibin; Wang, Yinhai; Cui, Zhiyong; Shi, Chaojian; Wu, Huafeng

    2017-01-01

    Grade variation on interstate highways affects the roadway geometric design, vehicle performance and driver behavior, thus possibly exerting an unexpected effect on vehicular speed. Hence, determining the internal relationship between grade and speed is important and useful for drivers, traffic regulators and other traffic participants. However, the problem with performing this research is the lack of large-scale gradient and speed data. Google Earth (GE) provides an application programming interface for extracting elevation data worldwide. The elevation dataset from GE can be easily converted to grade data. In addition, our team has collected and stored speed series data for different freeways over several years. Based on the above obtainable grade and speed datasets, we conducted research on the effect of grades on free flow speeds from two perspectives. First, the influence of grades on speed was analyzed from both quantitative and qualitative aspects. The analysis of the distributions of four typical types of speeds demonstrated a decreasing tendency as the speed increased. Steeper grades generated a more intense speed fluctuation in terms of the four types of speeds. Second, a model based on the Student's t-test was developed to evaluate the level of significant difference among speed series under neighboring grades. The Student's t-test demonstrated that adjacent grades do not significantly influence the speeds. In summary, speeds under different grades showed obviously different tendencies. The findings of this study can help transport authorities set more reasonable speed limits and improve the geometric design of interstates with grade variation constraints.

  15. Evaluating the impacts of grades on vehicular speeds on interstate highways

    PubMed Central

    Li, Zhibin; Wang, Yinhai; Cui, Zhiyong; Shi, Chaojian; Wu, Huafeng

    2017-01-01

    Grade variation on interstate highways affects the roadway geometric design, vehicle performance and driver behavior, thus possibly exerting an unexpected effect on vehicular speed. Hence, determining the internal relationship between grade and speed is important and useful for drivers, traffic regulators and other traffic participants. However, the problem with performing this research is the lack of large-scale gradient and speed data. Google Earth (GE) provides an application programming interface for extracting elevation data worldwide. The elevation dataset from GE can be easily converted to grade data. In addition, our team has collected and stored speed series data for different freeways over several years. Based on the above obtainable grade and speed datasets, we conducted research on the effect of grades on free flow speeds from two perspectives. First, the influence of grades on speed was analyzed from both quantitative and qualitative aspects. The analysis of the distributions of four typical types of speeds demonstrated a decreasing tendency as the speed increased. Steeper grades generated a more intense speed fluctuation in terms of the four types of speeds. Second, a model based on the Student’s t-test was developed to evaluate the level of significant difference among speed series under neighboring grades. The Student’s t-test demonstrated that adjacent grades do not significantly influence the speeds. In summary, speeds under different grades showed obviously different tendencies. The findings of this study can help transport authorities set more reasonable speed limits and improve the geometric design of interstates with grade variation constraints. PMID:28863157

  16. Construction-grade plywood from grade 3 Appalachian oak

    Treesearch

    E. Paul Craft; E. Paul Craft

    1970-01-01

    In an effort to find a use for a large volume of the low-grade oak logs of Appalachia, we processed a sample of these logs in a typical southern-pine sheathing plant and determined the feasibility of converting them into construction grade plywood.

  17. Making the Grade.

    ERIC Educational Resources Information Center

    Dahlgren, Sally

    2000-01-01

    Explains the importance of choosing wood flooring for athletic facilities and why the grade of wood specified can significantly impact sports-facility aesthetics. The three types of wood grades are explained along with thoughts on why choosing the priciest grade may not be satisfactory. (GR)

  18. Design of New-Generation Open-Graded Friction Courses (Revised)

    DOT National Transportation Integrated Search

    1999-12-01

    Open-graded friction course (OGFC) has been used by several state departments of transportation (DOT) since 1950. While many DOTs report good performance, many other states stopped using OGFC due to unacceptable performance and/or lack of adequate du...

  19. Severe Blunt Hepatic Trauma in Polytrauma Patient - Management and Outcome.

    PubMed

    Doklestić, Krstina; Djukić, Vladimir; Ivančević, Nenad; Gregorić, Pavle; Lončar, Zlatibor; Stefanović, Branislava; Jovanović, Dušan; Karamarković, Aleksandar

    2015-01-01

    Despite the fact that treatment of liver injuries has dramatically evolved, severe liver traumas in polytraumatic patients still have a significant morbidity and mortality. The purpose of this study was to determine the options for surgical management of severe liver trauma as well as the outcome. In this retrospective study 70 polytraumatic patients with severe (American Association for the Surgery of Trauma [AAST] grade III-V) blunt liver injuries were operated on at the Clinic for Emergency Surgery. Mean age of patients was 48.26±16.80 years; 82.8% of patients were male. Road traffic accident was the leading cause of trauma, seen in 63 patients (90.0%). Primary repair was performed in 36 patients (51.4%), while damage control with perihepatic packing was done in 34 (48.6%). Complications related to the liver occurred in 14 patients (20.0%). Liver related mortality was 17.1%. Non-survivors had a significantly higher AAST grade (p=0.0001), higher aspartate aminotransferase level (p=0.01), lower hemoglobin level (p=0.0001), associated brain injury (p=0.0001), perioperative complications (p=0.001) and higher transfusion score (p=0.0001). The most common cause of mortality in the "early period" was uncontrolled bleeding, in the "late period" mortality was caused by sepsis and acute respiratory distress syndrome. Patients with high-grade liver trauma who present with hemorrhagic shock and associated severe injury should be managed operatively. Mortality from liver trauma is high for patients with higher AAST grade of injury, associated brain injury and massive transfusion score.

  20. Increased anatomic severity in appendicitis is associated with outcomes in a South African population.

    PubMed

    Hernandez, Matthew C; Kong, Victor Y; Aho, Johnathon M; Bruce, John L; Polites, Stephanie F; Laing, Grant L; Zielinski, Martin D; Clarke, Damian L

    2017-07-01

    Severity of emergency general surgery (EGS) diseases has not been standardized until recently. The American Association for the Surgery of Trauma (AAST) proposed an anatomic severity grading system for EGS diseases to facilitate communication and quality comparisons between providers and hospitals. Previous work has demonstrated validity of the system for appendicitis in the United States. To demonstrate generalizability, we aim to externally validate this grading system in South African patients with appendicitis. Patients with acute appendicitis during 2010 to 2016 were identified at multi-institutional sites within South Africa. Baseline demographics and procedure types were recorded, and AAST grades were assigned based on intraoperative findings. Outcomes included duration of stay, mortality, and Clavien-Dindo complications. Summary statistical univariate and nominal logistic regression analyses were performed to compare AAST grade and outcomes. A total of 1,415 patients with a median (interquartile range) age of 19 years (14-28 years) were included (55% men). One hundred percent underwent appendectomy: 63.5% completed via midline laparotomy, 36.5% via limited incision (31.8% via McBurney incision and 4.7% via laparoscopy). Overall, 30-day mortality rate was 1.4% with an overall complication rate of 44%. Most common complications included surgical site infection (n = 147, 10.4%), pneumonia (n = 105, 7.4%), and renal failure (n = 64, 4.5%). Distribution of AAST grade is as follows: Grade 0 (10, 0.7%), Grade 1 (247, 17.4%), Grade 2 (280, 19.8%), Grade 3 (158, 11.3%), Grade 4 (179, 12.6%), and Grade 5 (541, 38.2%). Increased median (interquartile range) AAST grades were recorded in patients with complications, 5 (3-5) compared with those without (2 [1-3], p = 0.001). Duration of stay was increased for patients with higher AAST grades: 4 and 5 (10.6 ± 5.9 days) versus I and II (3.6 ± 4.3 days; p = 0.001). Area under the receiver operating characteristic analysis

  1. Green lumber grade yields from factory grade logs of three oak species

    Treesearch

    Daniel A. Yaussy

    1986-01-01

    Multivariate regression models were developed to predict green board foot yields for the seven common factory lumber grades processed from white, black, and chestnut oak factory grade logs. These models use the standard log measurements of grade, scaling diameter, log length, and proportion of scaling defect. Any combination of lumber grades (such as 1 Common and...

  2. Micronuclei: An essential biomarker in oral exfoliated cells for grading of oral squamous cell carcinoma.

    PubMed

    Jadhav, Kiran; Gupta, Nidhi; Ahmed, Mujib Br

    2011-01-01

    Micronuclei in exfoliated oral epithelial cells have been shown in some studies to correlate with severity of this genotoxic damage. This severity can be measured in terms of grading of the lesions. To correlate frequency of micronuclei (MN) in oral exfoliated cells in clinically diagnosed cases of oral squamous cell carcinoma (OSCC) followed by a histopathological grading. The study subjects consisted of clinically diagnosed cases of OSCC. Healthy subjects without any tobacco consumption habits formed the control group. The cytosmears from both groups were stained with rapid Papanicolaou stain. MN were identified according to the criteria given by Countryman and Heddle with some modifications. The frequency of MN was three to four times higher in patients with OSCC as compared to patients in the control group and the difference was found to be highly significant. In 75% cases, the cytological grade as determined by the frequency of micronuclei correlated with the histopathological grade and this observation was statistically significant. MN can be a candidate to serve as a biomarker for prediction of the grade of OSCC.

  3. Sixth Grade Student Self-Regulation in Science

    NASA Astrophysics Data System (ADS)

    Reid, Lisa J.

    The positive relationship between self-regulation and student achievement has been repeatedly supported through research. Key considerations that have resulted from prior research include instructor feedback and explicit expectations, student perception of their control of their progress, accurate self-calibration, reflection, goal-setting, age, and methods by which a cycle which integrates all of these can be put in place. While research provides evidence for that fact that it is possible to support student success in several of these areas, many questions are left as to how guided, active self-regulation impacts students perception of their control over their performance, their ability to accurately assess and act upon their strengths and weaknesses, and, ultimately, their overall progress at different developmental stages. This study intended to provide a better understanding of how guidance in the self-regulation strategies of sixth grade science students can impact their attitudes toward learning. Specifically, this study investigated the question, "What is the effect of active reflection, graphing of grades, and goal setting on sixth-grade students' locus of control and ability to self-regulate?"

  4. Improving patient safety via automated laboratory-based adverse event grading.

    PubMed

    Niland, Joyce C; Stiller, Tracey; Neat, Jennifer; Londrc, Adina; Johnson, Dina; Pannoni, Susan

    2012-01-01

    The identification and grading of adverse events (AEs) during the conduct of clinical trials is a labor-intensive and error-prone process. This paper describes and evaluates a software tool developed by City of Hope to automate complex algorithms to assess laboratory results and identify and grade AEs. We compared AEs identified by the automated system with those previously assessed manually, to evaluate missed/misgraded AEs. We also conducted a prospective paired time assessment of automated versus manual AE assessment. We found a substantial improvement in accuracy/completeness with the automated grading tool, which identified an additional 17% of severe grade 3-4 AEs that had been missed/misgraded manually. The automated system also provided an average time saving of 5.5 min per treatment course. With 400 ongoing treatment trials at City of Hope and an average of 1800 laboratory results requiring assessment per study, the implications of these findings for patient safety are enormous.

  5. Teachers' Grade Assignment and the Predictive Validity of Criterion-Referenced Grades

    ERIC Educational Resources Information Center

    Thorsen, Cecilia; Cliffordson, Christina

    2012-01-01

    Research has found that grades are the most valid instruments for predicting educational success. Why grades have better predictive validity than, for example, standardized tests is not yet fully understood. One possible explanation is that grades reflect not only subject-specific knowledge and skills but also individual differences in other…

  6. Cluster headache - clinical pattern and a new severity scale in a Swedish cohort.

    PubMed

    Steinberg, Anna; Fourier, Carmen; Ran, Caroline; Waldenlind, Elisabet; Sjöstrand, Christina; Belin, Andrea Carmine

    2018-06-01

    Background The aim of this study was to investigate clinical features of a cluster headache cohort in Sweden and to construct and test a new scale for grading severity. Methods Subjects were identified by screening medical records for the ICD 10 code G44.0, that is, cluster headache. Five hundred participating research subjects filled in a questionnaire including personal, demographic and medical aspects. We constructed a novel scale for grading cluster headache in this cohort: The Cluster Headache Severity Scale, which included number of attacks per day, attack and period duration. The lowest total score was three and the highest 12, and we used the Cluster Headache Severity Scale to grade subjects suffering from cluster headache. We further implemented the scale by defining a cluster headache maximum severity subgroup with a high Cluster Headache Severity Scale score ≥ 9. Results A majority (66.7%) of the patients reported that attacks appear at certain time intervals. In addition, cluster headache patients who were current tobacco users or had a history of tobacco consumption had a later age of disease onset (31.7 years) compared to non-tobacco users (28.5 years). The Cluster Headache Severity Scale score was higher in the patient group reporting sporadic or no alcohol intake than in the groups reporting an alcohol consumption of three to four standard units per week or more. Maximum severity cluster headache patients were characterised by higher age at disease onset, greater use of prophylactic medication, reduced hours of sleep, and lower alcohol consumption compared to the non-cluster headache maximum severity group. Conclusion There was a wide variation of severity grade among cluster headache patients, with a very marked impact on daily living for the most profoundly affected.

  7. Objective Assessment of Isotretinoin-Associated Cheilitis: Isotretinoin Cheilitis Grading Scale

    PubMed Central

    Ornelas, Jennifer; Rosamilia, Lorraine; Larsen, Larissa; Foolad, Negar; Wang, Quinlu; Li, Chin-Shang; Sivamani, Raja K.

    2016-01-01

    Importance Isotretinoin remains an effective treatment for severe acne. Despite its effectiveness, it includes many side effects, of which cheilitis is the most common. Objective To develop an objective grading scale for assessment of isotretinoin-associated cheilitis, Design Cross-sectional clinical grading study. Setting UC Davis Dermatology clinic. Participants Subjects were older than 18 years old and actively treated with oral isotretinoin. Exposures Oral Isotretinoin. Main outcomes and Measures We developed an isotretinoin cheilitis grading scale (ICGS) incorporating the following four characteristics: erythema, scale/crust, fissures, and inflammation of the commissures. Three board-certified dermatologists independently graded photographs of the subjects. Results The Kendall’s coefficient of concordance (KCC) for the ICGS was 0.88 (p<0.0001). The Kendall’s coefficient was ≥ 0.72 (p<0.0001) for each of the four characteristics included in the grading scale. An image-based measurement for lip roughness statistically significantly correlated with the lip scale/crusting assessment (r = 0.52, p <0.05). Conclusion and Relevance The ICGS is reproducible and relatively simple to use. It can be incorporated as an objective tool to aid in the assessment of isotretinoin associated cheilitis. PMID:26395167

  8. What's in a Grade?

    ERIC Educational Resources Information Center

    Hughey, Jim D.; Harper, Bena

    A study explored the processes and attitudes that occur when assigning students a final course grade. The final grades for 1,578 students in a basic communication course were used in discriminant analyses. The level (the mean of all grades given) and the spread (standard deviation of all grades given) were estimated for each of 17 instructors. The…

  9. Identification of risk factors of severe hypersensitivity reactions in general anaesthesia.

    PubMed

    Mirone, Corrado; Preziosi, Donatella; Mascheri, Ambra; Micarelli, Gianluigi; Farioli, Laura; Balossi, Luca G; Scibilia, Joseph; Schroeder, Jan; Losappio, Laura M; Aversano, Maria G; Stafylaraki, Chrysi; Nichelatti, Michele; Pastorello, Elide A

    2015-01-01

    Hypersensitivity reactions to anaesthetic agents are rare but often severe, with a mortality ranging from 4 to 9% in IgE-mediated events. Identification of the risk factors may contribute to limit the incidence of these reactions. The aim of our study was to search for possible risk factors of severe perioperative hypersensitivity reactions in our study population. For this study we retrospectively reviewed data from 193 patients who experienced drug hypersensitivity reactions during general anaesthesia. The diagnostic protocol consisted of 1) history of the reaction, 2) measurement of serum baseline tryptase and specific IgE-assays for latex, beta-lactams and succinylcholine, 3) skin tests for the agents listed in the anaesthesia chart and for others likely to be safe for future use, latex, and others medications administered during the perioperative period (i.e. antibiotics), 4) subdivision of our patients on the basis of two criteria: a) grade of severity of clinical reactions according to the Ring and Messmer classification; b) results of skin tests and/or serum specific IgE-assays. One hundred of 193 patients had reactions of grade I, 32/193 patients had reactions of grade II, 55/193 patients had reactions of grade III and 6/193 patients had reactions of grade IV. A diagnosis of IgE-mediated reaction was established in 55 cases (28.50%); the most common causes were neuromuscular blocking agents, followed by latex and beta-lactams. Severe reactions were associated with older age (p = 0.025), asthma (p = 0.042), history of hypertension (p = 0.001), intake of serum angiotensin converting enzyme inhibitor medication (p = 0.012) or serum angiotensin II antagonist (p = 0.033), higher levels of basal tryptase (p = 0.0211). Cardiovascular symptoms (p = 0.006) and history of hypersensitivity to antibiotics (p = 0.029) were more frequently reported in IgE-mediated reactions. We confirmed the relevance of several clinical features as risk

  10. Virginia method for the design of dense-graded emulsion mixes.

    DOT National Transportation Integrated Search

    1982-01-01

    An investigation into the Illinois method for the design of dense-graded emulsion base mixes had resulted in a report offering several modifications to that procedure. The Bituminous Research Advisory Committee then recommended that the Illinois meth...

  11. Cognitive behavioural therapy with optional graded exercise therapy in patients with severe fatigue with myotonic dystrophy type 1: a multicentre, single-blind, randomised trial.

    PubMed

    Okkersen, Kees; Jimenez-Moreno, Cecilia; Wenninger, Stephan; Daidj, Ferroudja; Glennon, Jeffrey; Cumming, Sarah; Littleford, Roberta; Monckton, Darren G; Lochmüller, Hanns; Catt, Michael; Faber, Catharina G; Hapca, Adrian; Donnan, Peter T; Gorman, Gráinne; Bassez, Guillaume; Schoser, Benedikt; Knoop, Hans; Treweek, Shaun; van Engelen, Baziel G M

    2018-06-18

    Myotonic dystrophy type 1 is the most common form of muscular dystrophy in adults and leads to severe fatigue, substantial physical functional impairment, and restricted social participation. In this study, we aimed to determine whether cognitive behavioural therapy optionally combined with graded exercise compared with standard care alone improved the health status of patients with myotonic dystrophy type 1. We did a multicentre, single-blind, randomised trial, at four neuromuscular referral centres with experience in treating patients with myotonic dystrophy type 1 located in Paris (France), Munich (Germany), Nijmegen (Netherlands), and Newcastle (UK). Eligible participants were patients aged 18 years and older with a confirmed genetic diagnosis of myotonic dystrophy type 1, who were severely fatigued (ie, a score of ≥35 on the checklist-individual strength, subscale fatigue). We randomly assigned participants (1:1) to either cognitive behavioural therapy plus standard care and optional graded exercise or standard care alone. Randomisation was done via a central web-based system, stratified by study site. Cognitive behavioural therapy focused on addressing reduced patient initiative, increasing physical activity, optimising social interaction, regulating sleep-wake patterns, coping with pain, and addressing beliefs about fatigue and myotonic dystrophy type 1. Cognitive behavioural therapy was delivered over a 10-month period in 10-14 sessions. A graded exercise module could be added to cognitive behavioural therapy in Nijmegen and Newcastle. The primary outcome was the 10-month change from baseline in scores on the DM1-Activ-c scale, a measure of capacity for activity and social participation (score range 0-100). Statistical analysis of the primary outcome included all participants for whom data were available, using mixed-effects linear regression models with baseline scores as a covariate. Safety data were presented as descriptives. This trial is registered

  12. Investigation of asphalt content design for open-graded bituminous mixes.

    DOT National Transportation Integrated Search

    1974-01-01

    Several design procedures associated with determining the proper asphalt content for open-graded bituminous mixes were investigated. Also considered was the proper amount of tack coat that should be placed on the old surface prior to paving operation...

  13. Grade Inflation Marches On: Grade Increases from the 1990s to 2000s

    ERIC Educational Resources Information Center

    Kostal, Jack W.; Kuncel, Nathan R.; Sackett, Paul R.

    2016-01-01

    Grade inflation threatens the integrity of college grades as indicators of academic achievement. In this study, we contribute to the literature on grade inflation by providing the first estimate of the size of grade increases at the student level between the mid-1990s and mid-2000s. By controlling for student characteristics and course-taking…

  14. Making GRADE accessible: a proposal for graphic display of evidence quality assessments.

    PubMed

    Khan, Khalid S; Borowiack, Ewa; Roos, Carolien; Kowalska, Monika; Zapalska, Anna; Mol, Ben W; Mignini, Luciano; Meads, Catherine; Walczak, Jacek

    2011-06-01

    When generating guidelines, quality of evidence is frequently reported in tabulated form capturing several domains, for example, study design, risk of bias and heterogeneity. Increasingly, this is done using the Grading of Recommendations Assessment, Development and Evaluation approach. As assimilating large amount of tabulated data across several comparisons and outcomes spread over many pages (sometimes hundreds) is not easy, there is a need to present evidence summaries in a more effective way. A graphic display plotting the several domains used in evidence grading on equiangular spokes starting from the same point, the data length of each spoke proportional to the magnitude of the quality, succinctly captures tabulated information. These plots allow easy identification of deficiencies, outliers and similarities in evidence quality for individual and multiple comparisons and outcomes, paving the way for their routine use alongside tabulated information.

  15. Micronuclei: An essential biomarker in oral exfoliated cells for grading of oral squamous cell carcinoma

    PubMed Central

    Jadhav, Kiran; Gupta, Nidhi; Ahmed, Mujib BR

    2011-01-01

    Background: Micronuclei in exfoliated oral epithelial cells have been shown in some studies to correlate with severity of this genotoxic damage. This severity can be measured in terms of grading of the lesions. Aim: To correlate frequency of micronuclei (MN) in oral exfoliated cells in clinically diagnosed cases of oral squamous cell carcinoma (OSCC) followed by a histopathological grading. Materials and Methods: The study subjects consisted of clinically diagnosed cases of OSCC. Healthy subjects without any tobacco consumption habits formed the control group. The cytosmears from both groups were stained with rapid Papanicolaou stain. MN were identified according to the criteria given by Countryman and Heddle with some modifications. Results: The frequency of MN was three to four times higher in patients with OSCC as compared to patients in the control group and the difference was found to be highly significant. In 75% cases, the cytological grade as determined by the frequency of micronuclei correlated with the histopathological grade and this observation was statistically significant. Conclusions: MN can be a candidate to serve as a biomarker for prediction of the grade of OSCC. PMID:21552400

  16. Quantitative assessment of emphysema from whole lung CT scans: comparison with visual grading

    NASA Astrophysics Data System (ADS)

    Keller, Brad M.; Reeves, Anthony P.; Apanosovich, Tatiyana V.; Wang, Jianwei; Yankelevitz, David F.; Henschke, Claudia I.

    2009-02-01

    Emphysema is a disease of the lungs that destroys the alveolar air sacs and induces long-term respiratory dysfunction. CT scans allow for imaging of the anatomical basis of emphysema and for visual assessment by radiologists of the extent present in the lungs. Several measures have been introduced for the quantification of the extent of disease directly from CT data in order to add to the qualitative assessments made by radiologists. In this paper we compare emphysema index, mean lung density, histogram percentiles, and the fractal dimension to visual grade in order to evaluate the predictability of radiologist visual scoring of emphysema from low-dose CT scans through quantitative scores, in order to determine which measures can be useful as surrogates for visual assessment. All measures were computed over nine divisions of the lung field (whole lung, individual lungs, and upper/middle/lower thirds of each lung) for each of 148 low-dose, whole lung scans. In addition, a visual grade of each section was also given by an expert radiologist. One-way ANOVA and multinomial logistic regression were used to determine the ability of the measures to predict visual grade from quantitative score. We found that all measures were able to distinguish between normal and severe grades (p<0.01), and between mild/moderate and all other grades (p<0.05). However, no measure was able to distinguish between mild and moderate cases. Approximately 65% prediction accuracy was achieved from using quantitative score to predict visual grade, with 73% if mild and moderate cases are considered as a single class.

  17. Paperless Grades and Faculty Development.

    ERIC Educational Resources Information Center

    Hardy, James C.; Jones, Dennis; Turner, Sandy

    2003-01-01

    Provides overview of process of switching from paper-based grade reporting to computer-based grading. Authors found that paperless grading decreased number of errors, made student access more immediate, and reduced costs incurred by purchasing and storing grade-scanning sheets. Authors also argue that direct entry grading encourages faculty to…

  18. Is the Sky Falling? Grade Inflation and the Signaling Power of Grades

    ERIC Educational Resources Information Center

    Pattison, Evangeleen; Grodsky, Eric; Muller, Chandra

    2013-01-01

    Grades are the fundamental currency of our educational system; they signal academic achievement and noncognitive skills to parents, employers, postsecondary gatekeepers, and students themselves. Grade inflation compromises the signaling value of grades and undermines their capacity to achieve the functions for which they are intended. We challenge…

  19. Colorado Student Assessment Program: 2001 Released Passages, Items, and Prompts. Grade 4 Reading and Writing, Grade 4 Lectura y Escritura, Grade 5 Mathematics and Reading, Grade 6 Reading, Grade 7 Reading and Writing, Grade 8 Mathematics, Reading and Science, Grade 9 Reading, and Grade 10 Mathematics and Reading and Writing.

    ERIC Educational Resources Information Center

    Colorado State Dept. of Education, Denver.

    This document contains released reading comprehension passages, test items, and writing prompts from the Colorado Student Assessment Program for 2001. The sample questions and prompts are included without answers or examples of student responses. Test materials are included for: (1) Grade 4 Reading and Writing; (2) Grade 4 Lectura y Escritura…

  20. Evaluation of Open-Graded Friction Courses : Construction, Maintenance, and Performance

    DOT National Transportation Integrated Search

    2012-10-01

    The South Carolina Department of Transportation (SCDOT) has been using open graded friction courses (OGFC) since the mid-1970s to reduce accidents on high volume routes. While the permeability of OGFC has several advantages, there are also concerns a...

  1. Exploiting ensemble learning for automatic cataract detection and grading.

    PubMed

    Yang, Ji-Jiang; Li, Jianqiang; Shen, Ruifang; Zeng, Yang; He, Jian; Bi, Jing; Li, Yong; Zhang, Qinyan; Peng, Lihui; Wang, Qing

    2016-02-01

    Cataract is defined as a lenticular opacity presenting usually with poor visual acuity. It is one of the most common causes of visual impairment worldwide. Early diagnosis demands the expertise of trained healthcare professionals, which may present a barrier to early intervention due to underlying costs. To date, studies reported in the literature utilize a single learning model for retinal image classification in grading cataract severity. We present an ensemble learning based approach as a means to improving diagnostic accuracy. Three independent feature sets, i.e., wavelet-, sketch-, and texture-based features, are extracted from each fundus image. For each feature set, two base learning models, i.e., Support Vector Machine and Back Propagation Neural Network, are built. Then, the ensemble methods, majority voting and stacking, are investigated to combine the multiple base learning models for final fundus image classification. Empirical experiments are conducted for cataract detection (two-class task, i.e., cataract or non-cataractous) and cataract grading (four-class task, i.e., non-cataractous, mild, moderate or severe) tasks. The best performance of the ensemble classifier is 93.2% and 84.5% in terms of the correct classification rates for cataract detection and grading tasks, respectively. The results demonstrate that the ensemble classifier outperforms the single learning model significantly, which also illustrates the effectiveness of the proposed approach. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  2. Tiers of Intervention in Kindergarten Through Third Grade

    ERIC Educational Resources Information Center

    O'Connor, Rollanda E.; Harty, Kristin R.; Fulmer, Deborah

    2005-01-01

    This study measured the effects of increasing levels of intervention in reading for a cohort of children in Grades K through 3 to determine whether the severity of reading disability (RD) could be significantly reduced in the catchment schools. Tier 1 consisted of professional development for teachers of reading. The focus of this study is on…

  3. Intraventricular Hemorrhage in Moderate to Severe Congenital Heart Disease.

    PubMed

    Ortinau, Cynthia M; Anadkat, Jagruti S; Smyser, Christopher D; Eghtesady, Pirooz

    2018-01-01

    Determine the prevalence of intraventricular hemorrhage in infants with moderate to severe congenital heart disease, investigate the impact of gestational age, cardiac diagnosis, and cardiac intervention on intraventricular hemorrhage, and compare intraventricular hemorrhage rates in preterm infants with and without congenital heart disease. A single-center retrospective review. A tertiary care children's hospital. All infants admitted to St. Louis Children's Hospital from 2007 to 2012 with moderate to severe congenital heart disease requiring cardiac intervention in the first 90 days of life and all preterm infants without congenital heart disease or congenital anomalies/known genetic diagnoses admitted during the same time period. None. Cranial ultrasound data were reviewed for presence/severity of intraventricular hemorrhage. Head CT and brain MRI data were also reviewed in the congenital heart disease infants. Univariate analyses were undertaken to determine associations with intraventricular hemorrhage, and a final multivariate logistic regression model was performed. There were 339 infants with congenital heart disease who met inclusion criteria and 25.4% were born preterm. Intraventricular hemorrhage was identified on cranial ultrasound in 13.3% of infants, with the majority of intraventricular hemorrhage being low-grade (grade I/II). The incidence increased as gestational age decreased such that intraventricular hemorrhage was present in 8.7% of term infants, 19.2% of late preterm infants, 26.3% of moderately preterm infants, and 53.3% of very preterm infants. There was no difference in intraventricular hemorrhage rates between cardiac diagnoses. Additionally, the rate of intraventricular hemorrhage did not increase after cardiac intervention, with only three infants demonstrating new/worsening high-grade (grade III/IV) intraventricular hemorrhage after surgery. In a multivariate model, only gestational age at birth and African-American race were predictors

  4. T2* mapping of hip joint cartilage in various histological grades of degeneration.

    PubMed

    Bittersohl, B; Miese, F R; Hosalkar, H S; Herten, M; Antoch, G; Krauspe, R; Zilkens, C

    2012-07-01

    To evaluate T2* values in various histological severities of osteoarthritis (OA). Magnetic resonance imaging (MRI) and T2* mapping including a three-dimensional (3D) double-echo steady-state (DESS) sequence for morphological cartilage assessment and a 3D multiecho data image combination (MEDIC) sequence for T2* mapping were conducted in 21 human femoral head specimens with varying severities of OA. Subsequently, histological assessment was undertaken in all specimens to correlate the observations of T2* mapping with histological analyses. According to the Mankin score, four grades of histological changes were determined: grade 0 (Mankin scores of 0-4), grade I (scores of 5-8), grade II (scores of 9-10), and grade III (scores of 11-14). For reliability assessment, cartilage T2* measurements were repeated after 4 weeks in 10 randomly selected femoral head specimens. T2* values decreased significantly with increasing cartilage degeneration (total P-values <0.001) ranging from 36.3 ± 4.3 ms in grade 0 regions to 22.8 ± 4.3 ms in regions with grade III changes. Pearson correlation analysis proved a fair correlation between T2* values and Mankin score (correlation coefficient = -0.362) that was statistically significant (P-value <0.001). Intra-class correlation (ICC) analysis demonstrated high intra-observer reproducibility for the T2* measurement (ICC: 0.949, P < 0.001). Given the advantages of the T2* mapping technique with no need for contrast medium, high image resolution and ability to perform 3D biochemically sensitive imaging, T2* mapping may be a strong addition to the currently evolving era of cartilage biochemical imaging. Copyright © 2012 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  5. What's in a Grade? Grading Policies and Practices in Principles of Economics

    ERIC Educational Resources Information Center

    Walstad, William B.; Miller, Laurie A.

    2016-01-01

    Survey results from a national sample of economics instructors describe the grading policies and practices in principles of economics courses. The survey results provide insights about absolute and relative grading systems used by instructors, the course components and their weights that determine grades, and the type of assessment items used for…

  6. Exploratory double-blind, parallel-group, placebo-controlled study of edaravone (MCI-186) in amyotrophic lateral sclerosis (Japan ALS severity classification: Grade 3, requiring assistance for eating, excretion or ambulation).

    PubMed

    2017-10-01

    Our objective was to explore the efficacy and safety of edaravone in amyotrophic lateral sclerosis (ALS) patients with a Japan ALS severity classification of Grade 3. In a 24-week, double-blind, randomized study, 25 patients who met all of the following criteria were enrolled: Japan ALS severity classification Grade 3; definite, probable, or probable-laboratory supported ALS (El Escorial/revised Airlie House); forced vital capacity (%FVC) ≥60%; duration of disease ≤3 years at consent; and change in the revised ALS functional rating scale (ALSFRS-R) score of -1 to -4 points during the 12-week pre-observation period. Patients received edaravone (n = 13) or placebo (n = 12) for six cycles. The efficacy outcome was change in the ALSFRS-R score. The least-squares mean change in the ALSFRS-R score ± standard error during the 24-week treatment was -6.52 ± 1.78 in the edaravone group and -6.00 ± 1.83 in the placebo group; the difference of -0.52 ± 2.46 was not statistically significant (p = 0.835). Incidence of adverse events was 92.3% (12/13) in the edaravone group and 100.0% (12/12) in the placebo group. There was no intergroup difference in the changes in the ALSFRS-R score. The incidences of adverse events were similar in the two groups.

  7. PET AND SPECT STUDIES IN CHILDREN WITH HEMISPHERIC LOW-GRADE GLIOMAS

    PubMed Central

    Juhász, Csaba; Bosnyák, Edit

    2016-01-01

    Molecular imaging is playing an increasing role in the pre-treatment evaluation of low-grade gliomas. While glucose positron emission tomography (PET) can be helpful to differentiate low-grade from high-grade tumors, PET imaging with amino acid radiotracers has several advantages, such as better differentiation between tumors and non-tumorous lesions, optimized biopsy targeting and improved detection of tumor recurrence. This review provides a brief overview of single photon emission computed tomography (SPECT) studies followed by a more detailed review of clinical applications of glucose and amino acid PET imaging in low-grade hemispheric gliomas. We discuss key differences in the performance of the most commonly utilized PET radiotracers and highlight the advantage of PET/MRI fusion to obtain optimal information about tumor extent, heterogeneity and metabolism. Recent data also suggest that simultaneous acquisition of PET/MR images and the combination of advanced MRI techniques with quantitative PET can further improve the pre- and post-treatment evaluation of pediatric brain tumors. PMID:27659825

  8. PET and SPECT studies in children with hemispheric low-grade gliomas.

    PubMed

    Juhász, Csaba; Bosnyák, Edit

    2016-10-01

    Molecular imaging is playing an increasing role in the pretreatment evaluation of low-grade gliomas. While glucose positron emission tomography (PET) can be helpful to differentiate low-grade from high-grade tumors, PET imaging with amino acid radiotracers has several advantages, such as better differentiation between tumors and non-tumorous lesions, optimized biopsy targeting, and improved detection of tumor recurrence. This review provides a brief overview of single-photon emission computed tomography (SPECT) studies followed by a more detailed review of the clinical applications of glucose and amino acid PET imaging in low-grade hemispheric gliomas. We discuss key differences in the performance of the most commonly utilized PET radiotracers and highlight the advantage of PET/MRI fusion to obtain optimal information about tumor extent, heterogeneity, and metabolism. Recent data also suggest that simultaneous acquisition of PET/MR images and the combination of advanced MRI techniques with quantitative PET can further improve the pretreatment and post-treatment evaluation of pediatric brain tumors.

  9. 7 CFR 810.604 - Grades and grade requirements for flaxseed.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Section 810.604 Agriculture Regulations of the Department of Agriculture (Continued) GRAIN INSPECTION, PACKERS AND STOCKYARD ADMINISTRATION (FEDERAL GRAIN INSPECTION SERVICE), DEPARTMENT OF AGRICULTURE OFFICIAL UNITED STATES STANDARDS FOR GRAIN United States Standards for Flaxseed Grades and Grade...

  10. Interobserver Agreement in Clinical Grading of Vitreous Haze Using Alternative Grading Scales

    PubMed Central

    Hornbeak, Dana M; Payal, Abhishek; Pistilli, Maxwell; Biswas, Jyotirmay; Ganesh, Sudha K; Gupta, Vishali; Rathinam, Sivakumar R; Davis, Janet L; Kempen, John H

    2014-01-01

    Purpose To evaluate the reliability of clinical grading of vitreous haze using a new 9-step ordinal scale vs. the existing 6-step ordinal scale. Design Evaluation of Diagnostic Test (interobserver agreement study). Participants 119 consecutive patients (204 uveitic eyes) presenting for uveitis subspecialty care on the study day at one of three large uveitis centers. Methods Five pairs of uveitis specialists clinically graded vitreous haze in the same eyes, one after the other using the same equipment, using the 6- and 9-step scales. Main Outcome Measures Agreement in vitreous haze grade between each pair of specialists was evaluated by the κ statistic (exact agreement and agreement within one or two grades). Results The scales correlated well (Spearman’s ρ=0.84). Exact agreement was modest using both the 6-step and 9-step scales: average κ=0.46 (range 0.28–0.81) and κ=0.40 (range 0.15–0.63), respectively. Within-1-grade agreement was slightly more favorable for the scale with fewer steps, but values were excellent for both scales: κ=0.75 (range 0.66–0.96) and κ=0.62 (range 0.38–0.87), respectively. Within-2-grade agreement for the 9-step scale also was excellent [κ=0.85 (range 0.79–0.92)]. Two-fold more cases were potentially clinical trial eligible based on the 9- than the 6-step scale (p<0.001). Conclusions Both scales are sufficiently reproducible using clinical grading for clinical and research use with the appropriate threshold (a ≥2 and ≥3 step differences for the 6-step and 9-step scales respectively). The results suggest that more eyes are likely to meet eligibility criteria for trials using the 9-step scale. The 9-step scale appears to have higher reproducibility with Reading Center grading than clinical grading, suggesting Reading Center grading may be preferable for clinical trials. PMID:24697913

  11. Stapled haemorrhoidectomy in the operative treatment of grade III and IV haemorrhoids.

    PubMed

    Shrestha, S; Pradhan, G B N; Shrestha, R; Poudel, P; Bhattachan, C L

    2014-09-01

    Stapled haemorrhoidectomy (SH) is a minimally invasive intervention that uses a stapling device which avoids the need for wounds in the sensitive anal area and reduces the pain after surgery. This study was undertaken in Nepal Medical College Teaching Hospital from January 2010 to December 2012 to evaluate the efficacy of this modality of treatment among patients (32) who presented in the Surgery OPD with grade III and grade IV haemorrhoids. The results of SH were evaluated by the relief of symptoms, severity of post operative pain, and complications of SH. Twenty five (78.1%) patients had grade III and 7 (21.9%) presented with grade IV hemorrhoids. The most frequent presentation reported in our study was bleeding per rectum with perianal prolapse. Mean operating time was 40-60 minutes whereas mean hospital stay was 1.9 days. Urinary retention was the most common complication found in 12 (37.5%) patients in the immediate post operative period. SH is a safe, rapid, and convenient surgical remedy for grade III and grade IV hemorrhoids with low rate of complications, minimal postoperative pain, and shorter hospital stay.

  12. Nebraska Science Standards: Grades K-12

    ERIC Educational Resources Information Center

    Nebraska Department of Education, 2010

    2010-01-01

    This publication presents the Nebraska Science Standards for Grades K-12. The standards are presented according to the following grades: (1) Grades K-2; (2) Grades 3-5; (3) Grades 6-8; and (4) Grades 9-12.

  13. 7 CFR 51.304 - Combination grades.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Standards for Grades of Apples Grades § 51.304 Combination grades. (a) Combinations of the above grades may... permitted in connection with the U.S. apple grades. When Combination grades are packed, at least 50 percent of the apples in any lot shall meet the requirements of the higher grade in the combination. (See...

  14. 7 CFR 51.304 - Combination grades.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Standards for Grades of Apples Grades § 51.304 Combination grades. (a) Combinations of the above grades may... permitted in connection with the U.S. apple grades. When Combination grades are packed, at least 50 percent of the apples in any lot shall meet the requirements of the higher grade in the combination. (See...

  15. 7 CFR 51.304 - Combination grades.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Standards for Grades of Apples Grades § 51.304 Combination grades. (a) Combinations of the above grades may... permitted in connection with the U.S. apple grades. When Combination grades are packed, at least 50 percent of the apples in any lot shall meet the requirements of the higher grade in the combination. (See...

  16. The evaluation of lumbosacral dysplasia in young patients with lumbosacral spondylolisthesis: comparison with controls and relationship with the severity of slip.

    PubMed

    Pawar, Abhijit; Labelle, Hubert; Mac-Thiong, Jean-Marc

    2012-11-01

    Comparison of lumbosacral dysplasia between normal individuals and patients with low and high grade spondylolisthesis has not been done previously. The objective of this study is to evaluate the relationship between lumbosacral dysplasia and severity of slip in young patients with lumbosacral spondylolisthesis. Postero-anterior and lateral radiographs of 120 normal individuals and 131 patients with developmental spondylolisthesis (91 low and 40 high grades) were reviewed. Quantitative evaluation of lumbosacral dysplasia was done using 6 criteria involving the degree of laminar dysplasia, degree of facet dysplasia, size of L5 transverse processes, L5/S1 disc height, type of sacral doming and L5 lumbar index. Subjects were categorized as having no/low, moderate or severe dysplasia based on the total dysplasia score. Comparisons in total dysplasia score between normal, low grade and high grade groups were performed and the correlation between degree of dysplasia and percentage of slip was assessed. Most normal individuals (88.3%) had no/low dysplasia; most patients with low grade spondylolisthesis (61.5%) had moderate dysplasia, while most patients with high grade spondylolisthesis (72.5%) had severe dysplasia. There was a significant difference in dysplasia between normal individuals and patients with spondylolisthesis. Dysplasia also varied significantly between low and high grade spondylolisthesis. There was a strong positive correlation (r = 0.63) between severity of dysplasia and percentage of slip. There is a significant relationship between the severity of spondylolisthesis and lumbosacral dysplasia, with mainly no/low dysplasia observed in controls and increasing total dysplasia scores in higher grades of spondylolisthesis. In addition, a variable degree of dysplasia was found within groups with low or high grade spondylolisthesis, suggesting that different subgroups of patients exist with regard to dysplasia. Thus the degree of dysplasia varies in

  17. Lumber grade-yields for factory-grade northern red oak sawlogs

    Treesearch

    James G. Schroeder; Leland F. Hanks

    1967-01-01

    A report on results of sawing 556 northern red oak sawlogs at four sawmills in West Virginia and Virginia, and the distribution of grades for the standard factory lumber produced. Tabular data on actual yield and curved grade-yield percentages.

  18. Grading--Why Are School Policies Necessary? What Are the Issues?

    ERIC Educational Resources Information Center

    Thomas, William C.

    1986-01-01

    Argues that current grading practices in some schools lack consistency in several critical areas, including criteria for failure, absolute or relative standards, and motivation of slower students. Policies are suggested that will help educators develop fairer and more humane marking systems. (TE)

  19. The Frequency and Severity of Magnetic Resonance Imaging Abnormalities in Infants with Mild Neonatal Encephalopathy.

    PubMed

    Walsh, Brian H; Neil, Jeffrey; Morey, JoAnn; Yang, Edward; Silvera, Michelle V; Inder, Terrie E; Ortinau, Cynthia

    2017-08-01

    To assess and contrast the incidence and severity of abnormalities on cerebral magnetic resonance imaging (MRI) between infants with mild, moderate, and severe neonatal encephalopathy who received therapeutic hypothermia. This retrospective cohort studied infants with mild, moderate, and severe neonatal encephalopathy who received therapeutic hypothermia at a single tertiary neonatal intensive care unit between 2013 and 2015. Two neuroradiologists masked to the clinical condition evaluated brain MRIs for cerebral injury after therapeutic hypothermia using the Barkovich classification system. Additional abnormalities not included in this classification system were also noted. The rate, pattern, and severity of abnormalities/injury were compared across the grades of neonatal encephalopathy. Eighty-nine infants received therapeutic hypothermia and met study criteria, 48 with mild neonatal encephalopathy, 35 with moderate neonatal encephalopathy, and 6 with severe neonatal encephalopathy. Forty-eight infants (54%) had an abnormality on MRI. There was no difference in the rate of overall MRI abnormalities by grade of neonatal encephalopathy (mild neonatal encephalopathy 54%, moderate neonatal encephalopathy 54%, and severe neonatal encephalopathy 50%; P= .89). Basal ganglia/thalamic injury was more common in those with severe neonatal encephalopathy (mild neonatal encephalopathy 4%, moderate neonatal encephalopathy 9%, severe neonatal encephalopathy 34%; P = .03). In contrast, watershed injury did not differ between neonatal encephalopathy grades (mild neonatal encephalopathy 36%, moderate neonatal encephalopathy 32%, severe neonatal encephalopathy 50%; P = .3). Mild neonatal encephalopathy is commonly associated with MRI abnormalities after therapeutic hypothermia. The grade of neonatal encephalopathy during the first hours of life may not discriminate adequately between infants with and without cerebral injury noted on MRI after therapeutic hypothermia

  20. Pterygium in Indonesia: prevalence, severity and risk factors

    PubMed Central

    Gazzard, G; Saw, S-M; Farook, M; Koh, D; Widjaja, D; Chia, S-E; Hong, C-Y; Tan, D T H

    2002-01-01

    Aim: To determine prevalence rates, severity, and risk factors for pterygium in adults in provincial Indonesia and to validate a clinical grading scheme in a population based setting. Methods: A population based prevalence survey of 1210 adults aged 21 years and above was conducted in five rural villages and one provincial town in Riau province, Sumatra, Indonesia, an area near to the equator. A one stage household cluster sampling procedure was employed: 100 households were randomly selected from each village or town. Pterygia were graded for severity (T1 to T3, by visibility of episcleral vessels) and the basal and apical extent measured by an ophthalmologist (GG) with a hand held slit lamp. Refraction was measured by hand held autorefractor (Retinomax). Face to face household interviews assessed outdoor activity, occupation, and smoking. The participation rate was 96.7%. Results: The mean age was 36.6 years (SD 13.1), 612 were male. The age adjusted prevalence rate of any pterygium was 10.0% (95% confidence intervals (CI) 8.2 to 11.7) and of bilateral pterygia was 4.1% (95% CI 2.9 to 5.3). There was a significant dose-response relation with age (2.9% (95% CI 0.4 to 5.8) for 21–29 years versus 17.3% (95% CI 10.4 to 24.2) 50 years and above; p for trend <0.001) and occupations with more time outdoors (p for trend = 0.02). This was true for both sexes, all grades of lesion (T1 to T3), and bilateral disease. A multivariate logistic regression model showed pterygium was independently related to increasing age and outdoor activity 10 years earlier. The mean basal diameter = 3.3 mm (SD 1.51, range 0.1–9.5) and extent from limbus = 1.4 mm (SD 1.18, range 0.1–8.0). Higher grade pterygia were larger for basal and apical extent (p for trend <0.001). The presence of pterygium was associated with astigmatism (defined as cylinder at least −0.5 dioptres (D); p <0.001). This association increased with increasing grade of lesion (p for trend <0.001). Median cylinder for

  1. Determinants for grading Malaysian rice

    NASA Astrophysics Data System (ADS)

    ChePa, Noraziah; Yusoff, Nooraini; Ahmad, Norhayati

    2016-08-01

    Due to un-uniformity of rice grading practices in Malaysia, zones which actively producing rice in Malaysia are using their own way of grading rice. Rice grading is important in determining rice quality and its subsequent price in the market. It is an important process applied in the rice production industry with the purpose of ensuring that the rice produced for the market meets the quality requirements of consumer. Two important aspects that need to be considered in determining rice grades are grading technique and determinants to be used for grading (usually referred as rice attributes). This article proposes the list of determinants to be used in grading Malaysian rice. Determinants were explored through combination of extensive literature review and series of interview with the domain experts and practitioners. The proposed determinants are believed to be beneficial to BERNAS in improving the current Malaysian rice grading process.

  2. Graded Aerobic Treadmill Testing in Adolescent Traumatic Brain Injury Patients.

    PubMed

    Cordingley, Dean M; Girardin, Richard; Morissette, Marc P; Reimer, Karen; Leiter, Jeff; Russell, Kelly; Ellis, Michael J

    2017-11-01

    To examine the safety and tolerability of clinical graded aerobic treadmill testing in recovering adolescent moderate and severe traumatic brain injury (TBI) patients referred to a multidisciplinary pediatric concussion program. We completed a retrospective case series of two moderate and five severe TBI patients (mean age, 17.3 years) who underwent initial Buffalo Concussion Treadmill Testing at a mean time of 71.6 days (range, 55-87) postinjury. Six patients completed one graded aerobic treadmill test each and one patient underwent initial and repeat testing. There were no complications. Five initial treadmill tests were completely tolerated and allowed an accurate assessment of exercise tolerance. Two initial tests were terminated early by the treatment team because of neurological and cardiorespiratory limitations. As a result of testing, two patients were cleared for aerobic exercise as tolerated and four patients were treated with individually tailored submaximal aerobic exercise programs resulting in subjective improvement in residual symptoms and/or exercise tolerance. Repeat treadmill testing in one patient performed after 1 month of treatment with submaximal aerobic exercise prescription was suggestive of improved exercise tolerance. One patient was able to tolerate aerobic exercise following surgery for posterior glottic stenosis. Preliminary results suggest that graded aerobic treadmill testing is a safe, well tolerated, and clinically useful tool to assess exercise tolerance in appropriately selected adolescent patients with TBI. Future prospective studies are needed to evaluate the effect of tailored submaximal aerobic exercise prescription on exercise tolerance and patient outcomes in recovering adolescent moderate and severe TBI patients.

  3. Pass-fail grading: laying the foundation for self-regulated learning.

    PubMed

    White, Casey B; Fantone, Joseph C

    2010-10-01

    Traditionally, medical schools have tended to make assumptions that students will "automatically" engage in self-education effectively after graduation and subsequent training in residency and fellowships. In reality, the majority of medical graduates out in practice feel unprepared for learning on their own. Many medical schools are now adopting strategies and pedagogies to help students become self-regulating learners. Along with these changes in practices and pedagogy, many schools are eliminating a cornerstone of extrinsic motivation: discriminating grades. To study the effects of the switch from discriminating to pass-fail grading in the second year of medical school, we compared internal and external assessments and evaluations for a second-year class with a discriminating grading scale (Honors, High Pass, Pass, Fail) and for a second-year class with a pass-fail grading scale. Of the measures we compared (MCATs, GPAs, means on second-year examinations, USMLE Step 1 scores, residency placement, in which there were no statistically significant changes), the only statistically significant decreases (lower performance with pass fail) were found in two of the second-year courses. Performance in one other course also improved significantly. Pass-fail grading can meet several important intended outcomes, including "leveling the playing field" for incoming students with different academic backgrounds, reducing competition and fostering collaboration among members of a class, more time for extracurricular interests and personal activities. Pass-fail grading also reduces competition and supports collaboration, and fosters intrinsic motivation, which is key to self-regulated, lifelong learning.

  4. The Neurological Outcome of Isolated PVL and Severe IVH in Preterm Infants: Is It Fair to Compare?

    PubMed

    Al Rifai, Muhammad T; Al Tawil, Khalil I

    2015-11-01

    We compared the neurological outcome of isolated periventricular leukomalacia and severe intraventricular hemorrhage in a cohort of very low birth weight infants born and managed at single tertiary-care center in Saudi Arabia. We undertook a descriptive retrospective chart review of the neurological status of very low birth weight infants who were born and managed over a 5-year period at King Abdulaziz Medical City, Riyadh. The neurological outcome of neonates with isolated periventricular leukomalacia and severe intraventricular hemorrhage (grades III and IV) was studied and compared in relation to developmental delay and cerebral palsy. A total of 20 patients with isolated periventricular leukomalacia and 26 with severe intraventricular hemorrhage (grades III and IV) were identified for this study. Of 20 patients with isolated periventricular leukomalacia, 9 (45%) had good developmental outcome and 11 (55%) had bad developmental outcome. Of 26 patients of severe intraventricular hemorrhage, 14 (54%) had good developmental outcome and 12 (46%) had bad developmental outcome (P = 0.55). Significant motor neurological deficit affecting function is distributed as follows: 11/20 (55%) in the isolated periventricular leukomalacia group and 7/26 (27%) in the severe intraventricular hemorrhage group (P = 0.05). Cerebral palsy was diplegic in 7/11 (64%) and quadriplegic in 4/11 (36%) in the isolated periventricular leukomalacia group, and hemiplegic 3/7 (43%), diplegic in 1/7 (14%), and quadriplegic in 3/7 (43%) in the severe intraventricular hemorrhage group (P = 0.03). Distribution of the neurological outcome according to periventricular leukomalacia grade was as follows: for periventricular leukomalacia grade I (n = 8), 6/8 (75%) had good neurological outcome and 2/8 (25%) had bad neurological outcome. In periventricular leukomalacia grade II (n = 4), good neurological outcome was seen in three patients (75%) and bad neurological outcome was seen in one

  5. Gleason grading system

    MedlinePlus

    ... medlineplus.gov/ency/patientinstructions/000920.htm Gleason grading system To use the sharing features on this page, ... score of between 5 and 7. Gleason Grading System Sometimes, it can be hard to predict how ...

  6. The effectiveness of graded activity for low back pain in occupational healthcare.

    PubMed

    Steenstra, I A; Anema, J R; Bongers, P M; de Vet, H C W; Knol, D L; van Mechelen, W

    2006-11-01

    Low back pain is a common medical and social problem associated with disability and absence from work. Knowledge on effective return to work (RTW) interventions is scarce. To determine the effectiveness of graded activity as part of a multistage RTW programme. Randomised controlled trial. Occupational healthcare. 112 workers absent from work for more than eight weeks due to low back pain were randomised to either graded activity (n = 55) or usual care (n = 57). Graded activity, a physical exercise programme aimed at RTW based on operant-conditioning behavioural principles. The number of days off work until first RTW for more then 28 days, total number of days on sick leave during follow up, functional status, and severity of pain. Follow up was 26 weeks. Graded activity prolonged RTW. Median time until RTW was equal to the total number of days on sick leave and was 139 (IQR = 69) days in the graded activity group and 111 (IQR = 76) days in the usual care group (hazard ratio = 0.52, 95% CI 0.32 to 0.86). An interaction between a prior workplace intervention and graded activity, together with a delay in the start of the graded activity intervention, explained most of the delay in RTW (hazard ratio = 0.86, 95% CI 0.40 to 1.84 without prior intervention and 0.39, 95% CI 0.19 to 0.81 with prior intervention). Graded activity did not improve pain or functional status clinically significantly. Graded activity was not effective for any of the outcome measures. Different interventions combined can lead to a delay in RTW. Delay in referral to graded activity delays RTW. In implementing graded activity special attention should be paid to the structure and process of care.

  7. A CURRICULUM FOR ENGLISH, GRADE 3, UNITS 23-33.

    ERIC Educational Resources Information Center

    Nebraska Univ., Lincoln. Curriculum Development Center.

    THE NEBRASKA ENGLISH CURRICULUM FOR GRADE THREE CONTINUES TO CENTER ON THE READING OF LITERATURE, WITH RELATED LANGUAGE AND COMPOSITION ACTIVITIES. TO STRENGTHEN CHILDREN'S AWARENESS OF THE ORAL AND REPETITIVE PATTERNS IN FOLK LITERATURE AND OF THE LITERARY PURPOSES OF THESE DEVICES, SEVERAL GRIMM FAIRY TALES ARE READ AND THEN COMPARED WITH MODERN…

  8. 7 CFR 810.2204 - Grades and grade requirements for wheat.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... filth 1 1 1 1 1 Castor beans 1 1 1 1 1 Crotalaria seeds 2 2 2 2 2 Glass 0 0 0 0 0 Stones 3 3 3 3 3... beans, crotalaria seeds, glass, stones, or unknown foreign substance. (b) Grades and grade requirements...

  9. The Case against Grades

    ERIC Educational Resources Information Center

    Kohn, Alfie

    2011-01-01

    Decades of research shows that grades diminish students' interest in whatever they're learning, discourage students from taking academic risks, and reduce the quality of students' thinking, writes Kohn. Contrary to what many people assume, grades are not necessary to promote achievement. Attempts to "improve" grading--such as standards-based…

  10. Violence from young women involuntarily admitted for severe drug abuse.

    PubMed

    Palmstierna, T; Olsson, D

    2007-01-01

    To simultaneously evaluate actuarial and dynamic predictors of severe in-patient violence among women involuntarily admitted for severe drug abuse. All patients admitted to special facilities for involuntary treatment of absconding-prone, previously violent, drug abusing women in Sweden were assessed with the Staff Observation Aggression Scale, revised. Actuarial data on risk factors for violence were collected and considered in an extended Cox proportional hazards model with multiple events and daily assessments of the Broset Violence Checklist as time-dependent covariates. Low-grade violence and being influenced by illicit drugs were the best predictors of severe violence within 24 h. Significant differences in risk for violence between different institutions were also found. In-patient violence risk is rapidly varying over time with being influenced by illicit drugs and exhibiting low-grade violence being significant dynamic predictors. Differences in violence between patients could not be explained by patient characteristics.

  11. Methodological considerations of the GRADE method.

    PubMed

    Malmivaara, Antti

    2015-02-01

    The GRADE method (Grading of Recommendations, Assessment, Development, and Evaluation) provides a tool for rating the quality of evidence for systematic reviews and clinical guidelines. This article aims to analyse conceptually how well grounded the GRADE method is, and to suggest improvements. The eight criteria for rating the quality of evidence as proposed by GRADE are here analysed in terms of each criterion's potential to provide valid information for grading evidence. Secondly, the GRADE method of allocating weights and summarizing the values of the criteria is considered. It is concluded that three GRADE criteria have an appropriate conceptual basis to be used as indicators of confidence in research evidence in systematic reviews: internal validity of a study, consistency of the findings, and publication bias. In network meta-analyses, the indirectness of evidence may also be considered. It is here proposed that the grade for the internal validity of a study could in some instances justifiably decrease the overall grade by three grades (e.g. from high to very low) instead of the up to two grade decrease, as suggested by the GRADE method.

  12. Eight Steps to Meaningful Grading

    ERIC Educational Resources Information Center

    Deddeh, Heather; Main, Erin; Fulkerson, Sharon Ratzlaff

    2010-01-01

    A group of teachers at Clifford Smart Middle School in Michigan's Walled Lake Consolidated School District have broken free from traditional grading in order to embrace a more meaningful grading practice. Using standards-based grading practices, they believe their grading now accurately communicates to students and parents the student's mastery…

  13. Arizona Academic Standards, Grade 3

    ERIC Educational Resources Information Center

    Arizona Department of Education, 2009

    2009-01-01

    This publication contains Arizona public schools' academic standards for grade 3. The contents of this document include the following: (1) The Arts Standard 2006--Grade 3; (2) Comprehensive Health Education/Physical Activity Standards 1997--Foundations (Grades 1-3); (3) Foreign and Native Language Standards 1997--Foundations (Grades 1-3); (4)…

  14. Arizona Academic Standards, Grade 1

    ERIC Educational Resources Information Center

    Arizona Department of Education, 2009

    2009-01-01

    This publication contains Arizona public schools' academic standards for Grade 1. The contents of this document include the following: (1) The Arts Standard 2006--Grade 1; (2) Comprehensive Health Education/Physical Activity Standards 1997--Foundations (Grades 1-3); (3) Foreign and Native Language Standards 1997--Foundations (Grades 1-3); (4)…

  15. Arizona Academic Standards: Grade 7

    ERIC Educational Resources Information Center

    Arizona Department of Education, 2009

    2009-01-01

    This document contains the Arizona academic standards for Grade 7. The following 11 standards are reviewed: (1) The Arts Standard 2006 --Grade 7; (2) Comprehensive Health Education/Physical Activity Standards 1997--Essentials (Grades 4-8); (3) Foreign and Native Language Standards 1997--Essentials (Grades 4-8); (4) Reading Standard Articulated by…

  16. Arizona Academic Standards, Grade 2

    ERIC Educational Resources Information Center

    Arizona Department of Education, 2009

    2009-01-01

    This publication contains Arizona public schools' academic standards for grade 2. The contents of this document include the following: (1) The Arts Standard 2006--Grade 2; (2) Comprehensive Health Education/Physical Activity Standards 1997--Foundations (Grades 1-3); (3) Foreign and Native Language Standards 1997--Foundations (Grades 1-3); (4)…

  17. A comparative study using WHO and binary oral epithelial dysplasia grading systems in actinic cheilitis.

    PubMed

    Câmara, P R; Dutra, S N; Takahama Júnior, A; Fontes, Kbfc; Azevedo, R S

    2016-09-01

    To evaluate comparatively the influence of histopathological features on epithelial dysplasia (ED) and the effectiveness in usage of WHO and binary grading systems in actinic cheilitis (AC). Cytological and architectural alterations established by WHO for ED were evaluated in 107 cases of AC. Epithelial dysplasia was graded using WHO and binary systems. The comparisons were performed using kappa, chi-square, and phi coefficient tests (P < 0.05). Most cases were classified as mild ED (44.5%) in the WHO system and as low risk for malignant transformation (64.5%) in the binary system. There was a positive correlation between WHO and binary systems (k = 0.33; P < 0.0002). Loss of basal cell polarity (P < 0.001) was associated with severity of ED grade in the WHO system. Anisonucleosis (P < 0.0001), nuclear pleomorphism (P < 0.0001), anisocytosis (P = 0.03), cell pleomorphism (P = 0.002) increased nuclear/cytoplasm ratio (P < 0.0001), increased nuclear size (P < 0.0001), increased number of mitotic figures (P = 0.0006), and dyskeratosis (P = 0.008) were associated with severity of ED grade in the binary system. It seems that usage of binary ED grading system in AC may be more precise because there is correlation between many of cytological and some of architectural microscopic alterations with increased grade of ED. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  18. Intervention Provided to Linguistically Diverse Middle School Students with Severe Reading Difficulties

    ERIC Educational Resources Information Center

    Denton, Carolyn A.; Wexler, Jade; Vaughn, Sharon; Bryan, Deanna

    2008-01-01

    This study investigated the effectiveness of a multicomponent reading intervention implemented with middle school students with severe reading difficulties, all of whom had received remedial and/or special education for several years with minimal response to intervention. Participants were 38 students in grades 6-8 who had severe deficits in word…

  19. 42 CFR 21.29 - Eligibility; grades above senior assistant grade.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Eligibility; grades above senior assistant grade. 21.29 Section 21.29 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES... in special fields related to public health, the Surgeon General may specify that a candidate for...

  20. 42 CFR 21.29 - Eligibility; grades above senior assistant grade.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Eligibility; grades above senior assistant grade. 21.29 Section 21.29 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES... in special fields related to public health, the Surgeon General may specify that a candidate for...

  1. 42 CFR 21.29 - Eligibility; grades above senior assistant grade.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Eligibility; grades above senior assistant grade. 21.29 Section 21.29 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES... in special fields related to public health, the Surgeon General may specify that a candidate for...

  2. 42 CFR 21.29 - Eligibility; grades above senior assistant grade.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Eligibility; grades above senior assistant grade. 21.29 Section 21.29 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES... in special fields related to public health, the Surgeon General may specify that a candidate for...

  3. Reversible grade 4 hyperbilirubinemia in a patient with UGT1A1 7/7 genotype treated with irinotecan and cetuximab.

    PubMed

    Gupta, Bhavna; LeVea, Charles; Litwin, Alan; Fakih, Marwan G

    2007-03-01

    Irinotecan-induced gastrointestinal toxicities are common and typically present in the form of diarrhea or nausea and vomiting. However, severe hyperbilirubinemia (grade 3/4) has not been previously reported in association with this chemotherapeutic agent. We report a case of prolonged grade 4 hyperbilirubinemia after a single dose of irinotecan at 125 mg/m(2). This severe toxicity was attributed to a UGT1A1 7/7 genotype and resolved to grade 2 after 8 weeks of supportive care. This case outlines the possibility of severe hepatic toxicity with moderate doses of irinotecan in patients with a UGT1A1 7/7 genotype. Despite the severity and prolonged duration of the associated irinotecan-induced hepatic toxicity, the management of similar cases should focus on intensive supportive measures because the toxicity is likely to resolve eventually.

  4. Design, Construction, and Performance of New-generation Open-graded Friction Courses

    DOT National Transportation Integrated Search

    2000-04-01

    Open-graded friction course (OGFC) has been used by several state departments of transportation (DOT) since 1950. While many DOTs report good performance, many other states stopped using OGFC due to unacceptable performance and/or lack of adequate du...

  5. Baseline Severity as Predictor of Change in St George’s Respiratory Questionnaire Scores in Trials of Long-acting Bronchodilators with COPD Patients

    PubMed Central

    Jones, Paul W.; Gelhorn, Heather; Karlsson, Niklas; Menjoge, Shailendra; Müllerova, Hana; Rennard, Stephen I.; Tal-Singer, Ruth; Wilson, Hilary; Merrill, Debora; Tabberer, Maggie

    2017-01-01

    Background: In trials oflong-acting bronchodilators, health status is an important trial outcome, however the influence of baseline severity on response measured by St George’s Respiratory Questionnaire (SGRQ) is not known. We have compared SGRQ changes between patients with chronic obstructive pulmonary disease (COPD) of mild-moderate severity or dyspnea (Global initiative for chronic Obstructive Lung disease [GOLD] grades 1 and 2; modified Medical Research Council [mMRC] grades 1 and 2) to those with severe-very severe severity or dyspnea (GOLD grades 3 and 4; mMRC grades 3 and 4). Methods: Combined individual patient data from the COPD Biomarkers Qualification Consortium database (trials of long-acting bronchodilators) were used comprising of patients from short-term (≤1-year duration; n=10802) and medium-term (2-4 years’ duration; n=8963) studies. A repeated measures analysis of variance (ANOVA) was used to determine the effects of baseline severity (GOLD/mMRC) on SGRQ response to treatment. All treatment arms were combined. Results: In short-term studies, milder patients showed a greater response than those with more severe disease in terms of GOLD grade (partial Eta2 = 0.03, p < 0.0001) and mMRC grade (partial Eta2 = 0.05, p < 0.0001). Similar results were seen in the medium-term studies (partial Eta2 = 0.02, p < 0.0001; mMRC: partial Eta2 = 0.05, p < 0.0001,). Conclusions: Patients with less severe airflow limitation and less severe dyspnea showed larger improvements in SGRQ score than more severely obstructed or dyspneic patients. Although these severity influences are small (2%-5% of the variance in SGRQ score), they do suggest that pre-specified separate analyses are warranted to test for differences in response, based on baseline severity. PMID:28848922

  6. Arizona Academic Standards, Grade 8

    ERIC Educational Resources Information Center

    Arizona Department of Education, 2009

    2009-01-01

    This publication contains the updated academic standards of Arizona for Grade 8. The contents of this document include the following: (1) The Arts Standard 2006--Grade 8; (2) Comprehensive Health Education/Physical Activity Standards 1997--Essentials (Grades 4-8); (3) Foreign and Native Language Standards 1997--Essentials (Grades 4-8); (4) Reading…

  7. Sonographic findings of high-grade and non-high-grade ductal carcinoma in situ of the breast.

    PubMed

    Park, Ji-Sung; Park, Young-Mi; Kim, Eun-Kyung; Kim, Suk-Jung; Han, Sang-Suk; Lee, Sun-Joo; In, Hyun-Sin; Ryu, Ji-Hwa

    2010-12-01

    The purpose of this study was to differentiate between high-grade and non-high-grade ductal carcinoma in situ (DCIS) of the breast on sonography. From October 2003 to August 2009, 76 DCIS lesions in 73 women who underwent sonography and mammography were included in this study. Lesions were confirmed by mastectomy, breast-conserving surgery, or surgical biopsy. Images were analyzed by 2 radiologists with consensus and were correlated with histologic grades. Of the 76 lesions, 44 were classified as high--grade and 32 as non-high-grade DCIS. Fifty-seven lesions (75.0%) were identified on sonography, which revealed a mass in 30 cases, microcalcifications in 20, ductal changes in 4, and architectural distortion in 3. All cases with false-negative findings on sonography (n = 19) showed microcalcifications on mammography. On sonography, masses were more frequently found in non-high-grade (62.5%) than high-grade DCIS (22.7%; P < .01). No significant difference was seen in the sonographic features of masses between high-grade and non-high-grade DCIS. Microcalcifications were more common in high-grade (43.2%) than non-high-grade (3.1%) DCIS (P = .02). Most sonographically visible microcalcifications had associated findings such as ductal changes (n = 11), a mass (n = 7), or a hypoechoic area (n = 5). The detection rate of microcalcifications on sonography was higher in high-grade (62.9%) than non-high-grade DCIS (25.0%; P = .023). Microcalcifications with associated ductal changes (11 of 31 [35.5%]) were the most common sonographic findings in high-grade DCIS. An irregular hypoechoic mass with an indistinct and microlobulated margin (13 of 26 [50.0%]) was the most frequent finding in non-high-grade DCIS.

  8. Tiers of intervention in kindergarten through third grade.

    PubMed

    O'Connor, Rollanda E; Harty, Kristin R; Fulmer, Deborah

    2005-01-01

    This study measured the effects of increasing levels of intervention in reading for a cohort of children in Grades K through 3 to determine whether the severity of reading disability (RD) could be significantly reduced in the catchment schools. Tier 1 consisted of professional development for teachers of reading. The focus of this study is on additional instruction that was provided as early as kindergarten for children whose achievement fell below average. Tier 2 intervention consisted of small-group reading instruction 3 times per week, and Tier 3 of daily instruction delivered individually or in groups of two. A comparison of the reading achievement of third-grade children who were at risk in kindergarten showed moderate to large differences favoring children in the tiered interventions in decoding, word identification, fluency, and reading comprehension.

  9. Minesoil grading and ripping affect black walnut growth and survival

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Josiah, S.J.

    In 1980 and 1981, the Botany Department of Southern Illinois University and Sahara Coal Company, Inc. of Harrisburg, Illinois established a series of experimental tree plantings, including black walnut, on a variety of minesoils to explore the effects of different intensities of grading on tree growth. Subsequent walnut stem and root growth were examined during 1985 on five different mine sites: unmined former agricultural land, graded minespoil, replaced (with pan scrapers) topsoil over graded spoil, ripped-graded spoil, and ungraded spoil. Soil bulk density, resistance to penetration, and spoil/soil fertility levels were also measured. The most vigorous trees were found onmore » sites having the lowest soil bulk density and soil strength and lacking horizontal barriers to root growth - the ungraded and ripped sites. Topsoiled sites had the poorest growth and survival, and the greatest stem dieback of any site measured, probably attributable to the confinement of root growth to the upper 15 cm of friable soil above the severely compacted zone. The overall results indicate that most of the minesoil construction techniques examined in this study, which are representative of techniques commonly used in the midwestern US, cause severe minesoil compaction and do not create the proper soil conditions necessary for the survival and vigorous growth of black walnut. Ripping compacted spoil in this and other studies proved to be very effective in alleviating the negative impacts of minesoil compaction. When planning surface mine reclamation activities, ripping should be considered as a possible ameliorative technique when compaction of mined lands is unavoidable and trees are the desired vegetative cover. 4 figures.« less

  10. Music Handbook for Primary Grades.

    ERIC Educational Resources Information Center

    Bowman, Doris; And Others

    GRADES OR AGES: Primary grades (1, 2, and 3). SUBJECT MATTER: Music. ORGANIZATION AND PHYSICAL APPEARANCE: This guide contains a detailed outline of the basic music concepts for elementary grades with suggestions for activities which may develop understanding of the concepts. The pages of activities are color coded by grade level. There are three…

  11. Improving reading in the primary grades.

    PubMed

    Duke, Nell K; Block, Meghan K

    2012-01-01

    Almost fifteen years have passed since the publication of the National Research Council's seminal report Preventing Reading Difficulties in Young Children, which provided research-based recommendations on what could be done to better position students in prekindergarten through third grade for success in grade four and above. This article by Nell Duke and Meghan Block first examines whether specific key recommendations from the report have been implemented in U.S. classrooms. They find that recommendations regarding increased access to kindergarten and greater attention to and improvement of students' word-reading skills have been widely adopted. Others have not. Vocabulary and comprehension, long neglected in the primary grades, still appear to be neglected. Contrary to the report's recommendations, attention to building conceptual and content knowledge in science and social studies has actually decreased in the past fifteen years. In other words, the easier-to-master skills are being attended to, but the broader domains of accomplishment that constitute preparation for comprehension and learning in the later grades--vocabulary knowledge, comprehension strategy use, and conceptual and content knowledge--are being neglected. Near stagnation in fourth-grade students' comprehension achievement is thus unsurprising. The authors then turn to research and reviews of research on improving primary-grade reading published since 1998, when Preventing Reading Difficulties was issued. They discuss several instructional approaches identified as effective in improving word-reading skill, vocabulary and conceptual knowledge, comprehension strategies, and reading outside of school; they discuss advances in interventions for struggling readers, and in whole-school literacy reform. Duke and Block then identify three key obstacles that have prevented widespread adoption of these best practices in teaching reading. The first obstacle is a short-term orientation toward instruction and

  12. A Computer Application for Severely Handicapped Children.

    ERIC Educational Resources Information Center

    Huenergard, Cliff; Albertson, Greg

    A severely physically disabled (quadriplegic) third grade student with high average intellectual abilities was fitted with a computer system adapted for maximum student independence. A scanner, the face of which is an integrated circuit board, was constructed to allow accessibility to the computer by a single switch operated by the student's…

  13. Investigation of distracted driving activities at highway-rail grade crossings (HRGC).

    DOT National Transportation Integrated Search

    2013-12-01

    Safety at highway : - : rail grade crossings (HRGCs) is a major concern for various agencies due to the high probability of : severe injuries and fatalities associated with such locations. In the : year 2010, 2,055 crashes and 227 fatalities were rep...

  14. Teachers' Experiences of Unfair Grading

    ERIC Educational Resources Information Center

    Alm, Fredrik; Colnerud, Gunnel

    2015-01-01

    Grading is often perceived as one of a teacher's most difficult tasks. Despite most teachers endeavoring to grade their students as objectively as possible, many students feel that they are subject to unfair grading. The aim of this study is to describe what it is about a teacher's grading that contributes to the perception of unfairness. This…

  15. Serving Grades Over the Internet.

    ERIC Educational Resources Information Center

    Harris, James K.

    This paper demonstrates a grade server that allows college students to access their grades over the Internet from the instructor's home page. Using a CGI (common gateway interface) program written in Visual Basic, the grades are read directly from an Excel spreadsheet and presented to the requester after he/she enters a password. The grade for…

  16. High-Grade Hydronephrosis Predicts Poor Outcomes After Radical Cystectomy in Patients with Bladder Cancer

    PubMed Central

    Kim, Dong Suk; Cho, Kang Su; Lee, Young Hoon; Cho, Nam Hoon; Oh, Young Taek

    2010-01-01

    We examined whether the presence and severity of preoperative hydronephrosis have prognostic significance in patients who underwent radical cystectomy for transitional cell carcinoma of the bladder. The medical records of 457 patients who underwent radical cystectomy for bladder cancer between 1986 and 2005 were retrospectively reviewed. Following the Society for Fetal Urology grading system, patients were divided into low-, and high-grade hydronephrosis groups. Clinicopathologic factors associated with preoperative hydronephrosis and survival were evaluated. Of a total of 406 patients, unilateral hydronephrosis was found in 74 (18.2%), bilateral hydronephrosis in 11 (2.7%), and no hydronephoris in 321 (79.1%). Low-grade hydronephrosis was found in 57 (12.2%) patients and high-grade hydronephrosis in 28 (6%). Preoperative hydronephrosis was related to higher pT stage and lymph node invasion. In univariate analysis, the presence of hydronephrosis, hydronephrosis grade, age, pT and pN stage, tumor grade, surgical margin, number of retrieved nodes, carcinoma in situ, and lymphovascular invasion were significant prognostic factors for cancer-specific survival. In multivariate analysis, bilateral hydronephrosis and high-grade hydronephrosis remained significant predictors for decreased survival. The presence of preoperative hydronephrosis, and high-grade hydronephrosis are significant prognostic factors in patients with bladder cancer after radical cystectomy. PMID:20191034

  17. Common peroneal nerve palsy after grade I inversion ankle sprain.

    PubMed

    Mitsiokapa, Evanthia A; Mavrogenis, Andreas F; Antonopoulos, Dimitris; Tzanos, George; Papagelopoulos, Panayiotis J

    2012-01-01

    This case report presents a 28-year-old man with foot drop 48 hours after a grade I inversion ankle sprain. Clinical examination and electrodiagnostic studies showed common peroneal nerve palsy. The patient was managed with conservative treatment and rehabilitation and recovered completely 4 months after the injury. Physicians should be aware of the possibility of delayed peroneal nerve injury after grade I ankle sprain. Function of the peroneal nerve should be evaluated in all patients with inversion ankle sprain as part of initial and follow-up evaluations. Early electrodiagnostic studies are helpful to localize and provide indications of the severity of the injury.

  18. Investigating Predictors of Listening Comprehension in Third-, Seventh-, and Tenth-Grade Students: A Dominance Analysis Approach

    PubMed Central

    Tighe, Elizabeth L.; Spencer, Mercedes; Schatschneider, Christopher

    2015-01-01

    This study rank ordered the contributive importance of several predictors of listening comprehension for third, seventh, and tenth graders. Principal components analyses revealed that a three-factor solution with fluency, reasoning, and working memory components provided the best fit across grade levels. Dominance analyses indicated that fluency and reasoning were the strongest predictors of third grade listening comprehension. Reasoning emerged as the strongest predictor of seventh and tenth grade listening comprehension. These findings suggest a shift in the contributive importance of predictors to listening comprehension across development (i.e., grade levels). The implications of our findings for educators and researchers are discussed. PMID:26877573

  19. How Minimal Grade Goals and Self-Control Capacity Interact in Predicting Test Grades

    ERIC Educational Resources Information Center

    Bertrams, Alex

    2012-01-01

    The present research examined the prediction of school students' grades in an upcoming math test via their minimal grade goals (i.e., the minimum grade in an upcoming test one would be satisfied with). Due to its significance for initiating and maintaining goal-directed behavior, self-control capacity was expected to moderate the relation between…

  20. Is coxa valga a predictor for the severity of knee osteoarthritis? A cross-sectional study.

    PubMed

    Coskun Benlidayi, Ilke; Guzel, Rengin; Basaran, Sibel; Aksungur, Erol H; Seydaoglu, Gulsah

    2015-05-01

    In the present study, we aimed to evaluate the affect of the variations in hip anatomy and pelvic geometry on the severity of knee OA. Idiopathic knee OA patients fulfilling the clinical criteria of American College of Rheumatology for OA were enrolled in the study. Several measurements regarding the hip and pelvis were performed on pelvic radiographs. Each knee was graded according to the Kellgren and Lawrence (KL) radiographic system (0-4) along with a categorization in accordance with the medial tibiofemoral joint space widths (JSW). The study group consisted of 111 subjects. The inner and outer pelvic diameters were getting wider as the JSW grade increased. Likewise, among the hip measurements, femoral head, neck and shaft diameters and hip axis lengths were linked with KL grade. There were significant differences in neck-shaft angle (NSA) between groups of JSW with a highest NSA in JSW grade 3. The optimal cut-off value for NSA in predicting the severity of knee OA was 134.4°. Furthermore, NSA beyond 134.4° was found to increase the risk of severe knee OA eightfold. Variations in pelvic geometry and hip anatomy are associated with the severity of knee OA. People with NSA of above 134.4° have eightfold increased risk of developing severe knee OA. Pelvic radiographies could be evaluated at younger ages-particularly in people with high genetic predispositions-to identify the individuals at high risk and in turn, to tailor the preventive measures to these subjects.

  1. On-line prediction of yield grade, longissimus muscle area, preliminary yield grade, adjusted preliminary yield grade, and marbling score using the MARC beef carcass image analysis system.

    PubMed

    Shackelford, S D; Wheeler, T L; Koohmaraie, M

    2003-01-01

    The present experiment was conducted to evaluate the ability of the U.S. Meat Animal Research Center's beef carcass image analysis system to predict calculated yield grade, longissimus muscle area, preliminary yield grade, adjusted preliminary yield grade, and marbling score under commercial beef processing conditions. In two commercial beef-processing facilities, image analysis was conducted on 800 carcasses on the beef-grading chain immediately after the conventional USDA beef quality and yield grades were applied. Carcasses were blocked by plant and observed calculated yield grade. The carcasses were then separated, with 400 carcasses assigned to a calibration data set that was used to develop regression equations, and the remaining 400 carcasses assigned to a prediction data set used to validate the regression equations. Prediction equations, which included image analysis variables and hot carcass weight, accounted for 90, 88, 90, 88, and 76% of the variation in calculated yield grade, longissimus muscle area, preliminary yield grade, adjusted preliminary yield grade, and marbling score, respectively, in the prediction data set. In comparison, the official USDA yield grade as applied by online graders accounted for 73% of the variation in calculated yield grade. The technology described herein could be used by the beef industry to more accurately determine beef yield grades; however, this system does not provide an accurate enough prediction of marbling score to be used without USDA grader interaction for USDA quality grading.

  2. Differences in Attitudes toward the Handicapped between Caring-Sharing Peer Tutors and Their Sixth Grade Classmates.

    ERIC Educational Resources Information Center

    Gay, Judith A.

    The study compared attitudes of nine 6th grade students (eight female and one male) who volunteered to participate in a peer tutoring swimming program for moderately and severely handicapped children with the attitudes of the remainder of the sixth grade class (N=15) who had not volunteered. All students had previously completed a curriculum…

  3. The molecular biology of WHO grade I astrocytomas.

    PubMed

    Marko, Nicholas F; Weil, Robert J

    2012-12-01

    World Health Organization (WHO) grade I astrocytomas include pilocytic astrocytoma (PA) and subependymal giant cell astrocytoma (SEGA). As technologies in pharmacologic neo-adjuvant therapy continue to progress and as molecular characteristics are progressively recognized as potential markers of both clinically significant tumor subtypes and response to therapy, interest in the biology of these tumors has surged. An updated review of the current knowledge of the molecular biology of these tumors is needed. We conducted a Medline search to identify published literature discussing the molecular biology of grade I astrocytomas. We then summarized this literature and discuss it in a logical framework through which the complex biology of these tumors can be clearly understood. A comprehensive review of the molecular biology of WHO grade I astrocytomas is presented. The past several years have seen rapid progress in the level of understanding of PA in particular, but the molecular literature regarding both PA and SEGA remains nebulous, ambiguous, and occasionally contradictory. In this review we provide a comprehensive discussion of the current understanding of the chromosomal, genomic, and epigenomic features of both PA and SEGA and provide a logical framework in which these data can be more readily understood.

  4. Mechanical grading of oak timbers

    Treesearch

    David E. Kretschmann; David W. Green

    1999-01-01

    For many wood species, the grading of timbers [>76 mm (>4-in.) thick] has not changed in decades. Most timbers are still visually graded by methods that originated in the 1930s. Mechanical grading procedures used to accurately grade 38-mm (2-in. nominal) dimension lumber have not been adapted for use with timbers. Furthermore, the only reliable timber test data...

  5. Comparing Dropout Predictors for Two State-Level Panels Using Grade 6 and Grade 8 Data

    ERIC Educational Resources Information Center

    Franklin, Bobby J.; Trouard, Stephen B.

    2016-01-01

    The purpose of this study was to examine the effectiveness of dropout predictors across time. Two state-level high school graduation panels were selected to begin with the seventh and ninth grades but end at the same time. The first panel (seventh grade) contained 29,554 students and used sixth grade predictors. The second panel (ninth grade)…

  6. The Relationship of Grade Span in 9th Grade to Math Achievement in High School

    ERIC Educational Resources Information Center

    West, John; Miller, Mary Lou; Myers, Jim; Norton, Timothy

    2015-01-01

    Purpose, Scope, and Method of Study: The purpose of this study was to determine if a correlation exists between grade span for ninth grade and gains in math achievement test scores in 10th grade and 12th grade. A quantitative, longitudinal, correlational research design was employed to investigate the research questions. The population was high…

  7. [GRADE system: classification of quality of evidence and strength of recommendation].

    PubMed

    Aguayo-Albasini, José Luis; Flores-Pastor, Benito; Soria-Aledo, Víctor

    2014-02-01

    The acquisition and classification of scientific evidence, and subsequent formulation of recommendations constitute the basis for the development of clinical practice guidelines. There are several systems for the classification of evidence and strength of recommendations; the most commonly used nowadays is the Grading of Recommendations, Assessment, Development and Evaluation system (GRADE). The GRADE system initially classifies the evidence into high or low, coming from experimental or observational studies; subsequently and following a series of considerations, the evidence is classified into high, moderate, low or very low. The strength of recommendations is based not only on the quality of the evidence, but also on a series of factors such as the risk/benefit balance, values and preferences of the patients and professionals, and the use of resources or costs. Copyright © 2013 AEC. Published by Elsevier Espana. All rights reserved.

  8. Evaluation of Biomarkers in Egyptian Patients with Different Grades of Nonalcoholic Fatty Liver Disease.

    PubMed

    Borai, Ibrahim H; Shaker, Yehia; Kamal, Maha Moustafa; Ezzat, Wafaa M; Ashour, Esmat; Afify, Mie; Gouda, Weaam; Elbrashy, Maha M

    2017-06-28

    Background and Aims: Nonalcoholic fatty liver disease (NAFLD) is a silent disease; its spectrum includes simple steatosis, nonalcoholic steatohepatitis and fibrosis. Pro- and anti-inflammatory cytokines play roles in the pathogenesis of NAFLD and insulin resistance (IR). Moreover, plasma cell antigen-1 (PC-1) is related to IR and associated with NAFLD progression. Therefore, we aimed to detect biomarkers, ultrasonographic and anthropometric findings capable of differentiating NAFLD grades, since most previous investigators were concerned more with NAFLD patients without classifying them into grades. Methods: A total of 87 NAFLD patients (31 with grade 1 (mild NAFLD), 26 with grade 2 (moderate NAFLD) and 30 with grade 3 (severe NAFLD) were included in the study, in addition to 47 controls (grade 0). All subjects underwent ultrasonographic examination for NAFLD diagnosis. Serum interleukin-10 (IL-10), plasma interleukin-18 (IL-18) and plasma PC-1 levels were determined using enzyme-linked immunosorbent assay. Results: Homoeostasis model assessment (HOMA)-IR was higher in different NAFLD grades than in controls. Ultrasonographic and anthropometric findings and lipid profile indices (except for high-density lipoprotein cholesterol, which was decreased) were increased with NAFLD progression. Grade 3 patients showed significant increase in levels of IL-18 and significant decrease in IL-10 and PC-1 levels when compared to grade 1 patients. Conclusion: Anthropometric and ultrasonographic findings were valuable in differentiating NAFLD grades. IR is very important in NAFLD pathogenesis. IL-18, HOMA-index and PC-1 levels could be used to differentiate between NAFLD grades, together with other measurements.

  9. Evaluation of Biomarkers in Egyptian Patients with Different Grades of Nonalcoholic Fatty Liver Disease

    PubMed Central

    Borai, Ibrahim H.; Shaker, Yehia; Kamal, Maha Moustafa; Ezzat, Wafaa M.; Ashour, Esmat; Afify, Mie; Gouda, Weaam; Elbrashy, Maha M.

    2017-01-01

    Abstract Background and Aims: Nonalcoholic fatty liver disease (NAFLD) is a silent disease; its spectrum includes simple steatosis, nonalcoholic steatohepatitis and fibrosis. Pro- and anti-inflammatory cytokines play roles in the pathogenesis of NAFLD and insulin resistance (IR). Moreover, plasma cell antigen-1 (PC-1) is related to IR and associated with NAFLD progression. Therefore, we aimed to detect biomarkers, ultrasonographic and anthropometric findings capable of differentiating NAFLD grades, since most previous investigators were concerned more with NAFLD patients without classifying them into grades. Methods: A total of 87 NAFLD patients (31 with grade 1 (mild NAFLD), 26 with grade 2 (moderate NAFLD) and 30 with grade 3 (severe NAFLD) were included in the study, in addition to 47 controls (grade 0). All subjects underwent ultrasonographic examination for NAFLD diagnosis. Serum interleukin-10 (IL-10), plasma interleukin-18 (IL-18) and plasma PC-1 levels were determined using enzyme-linked immunosorbent assay. Results: Homoeostasis model assessment (HOMA)-IR was higher in different NAFLD grades than in controls. Ultrasonographic and anthropometric findings and lipid profile indices (except for high-density lipoprotein cholesterol, which was decreased) were increased with NAFLD progression. Grade 3 patients showed significant increase in levels of IL-18 and significant decrease in IL-10 and PC-1 levels when compared to grade 1 patients. Conclusion: Anthropometric and ultrasonographic findings were valuable in differentiating NAFLD grades. IR is very important in NAFLD pathogenesis. IL-18, HOMA-index and PC-1 levels could be used to differentiate between NAFLD grades, together with other measurements. PMID:28660148

  10. Improvement of the Effectiveness of Motorist Warnings at Railroad-Highway Grade Crossings

    DOT National Transportation Integrated Search

    1977-02-01

    Flashing red incandescent lamps have formed the primary motorist warning device at grade crossings for several decades, in spite of technical constraints that inherently limit the overall effectiveness possible. In this report an examination of appro...

  11. PROPERTIES OF FOOD GRADE (EDIBLE) SURFACTANTS AFFECTING SUBSURFACE REMEDIATION OF CHLORINATED SOLVENTS

    EPA Science Inventory

    In this research, several food grade (edible) surfactants are systematically evaluated for various loss mechanisms: precipitation, adsorption, and coacervation (for nonionic surfactants). Cloud points for the polyethoxylate sorbitan (T-MAZ) surfactants are much higher than aquife...

  12. 7 CFR 51.304 - Combination grades.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ..., CERTIFICATION, AND STANDARDS) United States Standards for Grades of Apples Grades § 51.304 Combination grades...) Combinations other than these are not permitted in connection with the U.S. apple grades. When Combination grades are packed, at least 50 percent of the apples in any lot shall meet the requirements of the higher...

  13. 7 CFR 51.304 - Combination grades.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ..., CERTIFICATION, AND STANDARDS) United States Standards for Grades of Apples Grades § 51.304 Combination grades...) Combinations other than these are not permitted in connection with the U.S. apple grades. When Combination grades are packed, at least 50 percent of the apples in any lot shall meet the requirements of the higher...

  14. Association of Grade Configuration with School Climate for 7th and 8th Grade Students

    ERIC Educational Resources Information Center

    Malone, Marisa; Cornell, Dewey; Shukla, Kathan

    2017-01-01

    Educational authorities have questioned whether middle schools provide the best school climate for 7th and 8th grade students, and proposed that other grade configurations such as K-8th grade schools may provide a better learning environment. The purpose of this study was to compare 7th and 8th grade students' perceptions of 4 key features of…

  15. Smartphone-based grading of apple quality

    NASA Astrophysics Data System (ADS)

    Li, Xianglin; Li, Ting

    2018-02-01

    Apple quality grading is a critical issue in apple industry which is one economical pillar of many countries. Artificial grading is inefficient and of poor accuracy. Here we proposed to develop a portable, convenient, real-time, and low cost method aimed at grading apple. Color images of the apples were collected with a smartphone and the grade of sampled apple was assessed by a customized smartphone app, which offered the functions translating RGB color values of the apple to color grade and translating the edge of apple image to weight grade. The algorithms are based on modeling with a large number of apple image at different grades. The apple grade data evaluated by the smartphone are in accordance with the actual data. This study demonstrated the potential of smart phone in apple quality grading/online monitoring at gathering and transportation stage for apple industry.

  16. [Grading of gynecological tumors : Current aspects].

    PubMed

    Horn, L-C; Mayr, D; Brambs, C E; Einenkel, J; Sändig, I; Schierle, K

    2016-07-01

    Histopathological assessment of the tumor grade and cell type is central to the management and prognosis of various gynecological malignancies. Conventional grading systems for squamous carcinomas and adenocarcinomas of the vulva, vagina and cervix are poorly defined. For endometrioid tumors of the female genital tract as well as for mucinous endometrial, ovarian and seromucinous ovarian carcinomas, the 3‑tiered FIGO grading system is recommended. For uterine neuroendocrine tumors the grading system of the gastrointestinal counterparts has been adopted. Uterine leiomyosarcomas are not graded. Endometrial stromal sarcomas are divided into low and high grades, based on cellular morphology, immunohistochemical and molecular findings. A chemotherapy response score was established for chemotherapeutically treated high-grade serous pelvic cancer. For non-epithelial ovarian malignancies, only Sertoli-Leydig cell tumors and immature teratomas are graded. At this time molecular profiling has no impact on the grading of tumors of the female genital tract.

  17. Acceptability of Adaptations for Struggling Writers: A National Survey with Primary-Grade Teachers

    ERIC Educational Resources Information Center

    Graham, Steve; Harris, Karen R.; Bartlett, Brendan J.; Popadopoulou, Eleni; Santoro, Julia

    2016-01-01

    One hundred twenty-five primary-grade teachers randomly selected from across the United States indicated how frequently they made 20 instructional adaptations for the struggling writers in their classroom. The measure of frequency ranged from never, several times a year, monthly, weekly, several times a week, and daily. Using a 6-point Likert-type…

  18. The reliability and predictive value of an amniotic fluid scoring system in severe second-trimester oligohydramnios.

    PubMed

    Moore, T R; Longo, J; Leopold, G R; Casola, G; Gosink, B B

    1989-05-01

    Sixty-two cases of oligohydramnios diagnosed by ultrasound between 13-28 weeks' gestation were reviewed. Three experienced ultrasonographers used a subjective scale to rate the oligohydramnios as mild, moderate, severe, or anhydramniotic. Interobserver reliability was excellent (intraclass correlation coefficient 0.81). The overall perinatal mortality rate was 43%, and the incidence of pulmonary hypoplasia was 33%. One-third had lethal congenital anomalies. The frequency of adverse outcome correlated strongly with the most severe degrees of oligohydramnios; 88% of the fetuses with severe oligohydramnios or anhydramnios had lethal outcomes, compared with 11% in the mild/moderate group. The presence of an anuric urinary tract anomaly was associated with the most severe grades of oligohydramnios and was uniformly fatal. Pulmonary hypoplasia was diagnosed in 60% of the severe group versus 6% in the moderate group. We conclude that subjective grading of oligohydramnios by experienced observers is both reliable and predictive of outcome. The finding of severe oligohydramnios in the second trimester is highly predictive of poor fetal outcome and should stimulate a thorough search for etiology and consideration of intervention. Moderate grades of reduced amniotic fluid may be managed with relative optimism.

  19. Predisposing factors to severe external root resorption associated to orthodontic treatment.

    PubMed

    Picanço, Gracemia Vasconcelos; de Freitas, Karina Maria Salvatore; Cançado, Rodrigo Hermont; Valarelli, Fabricio Pinelli; Picanço, Paulo Roberto Barroso; Feijão, Camila Pontes

    2013-01-01

    The aim of this study was to evaluate predisposing factors among patients who developed moderate or severe external root resorption (Malmgren's grades 3 and 4), on the maxillary incisors, during fixed orthodontic treatment in the permanent dentition. Ninety-nine patients who underwent orthodontic treatment with fixed edgewise appliances were selected. Patients were divided into two groups: G1 - 50 patients with no root resorption or presenting only apical irregularities (Malmgren's grades 0 and 1) at the end of the treatment, with mean initial age of 16.79 years and mean treatment time of 3.21 years; G2 - 49 patients presenting moderate or severe root resorption (Malmgren's grades 3 and 4) at the end of treatment on the maxillary incisors, with mean initial age of 19.92 years and mean treatment time of 3.98 years. Periapical radiographs and lateral cephalograms were evaluated. Factors that could influence the occurrence of severe root resorption were also recorded. Statistical analysis included chi-square tests, Fisher's exact test and independent t tests. The results demonstrated significant difference between the groups for the variables: Extractions, initial degree of root resorption, root length and crown/root ratio at the beginning, and cortical thickness of the alveolar bone. It can be concluded that: Presence of root resorption before the beginning of treatment, extractions, reduced root length, decreased crown/root ratio and thin alveolar bone represent risk factors for severe root resorption in maxillary incisors during orthodontic treatment.

  20. Classroom: Efficient Grading

    ERIC Educational Resources Information Center

    Shaw, David D.; Pease, Leonard F., III.

    2014-01-01

    Grading can be accelerated to make time for more effective instruction. This article presents specific time management strategies selected to decrease administrative time required of faculty and teaching assistants, including a multiple answer multiple choice interface for exams, a three-tier grading system for open ended problem solving, and a…

  1. Diabetic retinopathy grading by digital curvelet transform.

    PubMed

    Hajeb Mohammad Alipour, Shirin; Rabbani, Hossein; Akhlaghi, Mohammad Reza

    2012-01-01

    One of the major complications of diabetes is diabetic retinopathy. As manual analysis and diagnosis of large amount of images are time consuming, automatic detection and grading of diabetic retinopathy are desired. In this paper, we use fundus fluorescein angiography and color fundus images simultaneously, extract 6 features employing curvelet transform, and feed them to support vector machine in order to determine diabetic retinopathy severity stages. These features are area of blood vessels, area, regularity of foveal avascular zone, and the number of micro-aneurisms therein, total number of micro-aneurisms, and area of exudates. In order to extract exudates and vessels, we respectively modify curvelet coefficients of color fundus images and angiograms. The end points of extracted vessels in predefined region of interest based on optic disk are connected together to segment foveal avascular zone region. To extract micro-aneurisms from angiogram, first extracted vessels are subtracted from original image, and after removing detected background by morphological operators and enhancing bright small pixels, micro-aneurisms are detected. 70 patients were involved in this study to classify diabetic retinopathy into 3 groups, that is, (1) no diabetic retinopathy, (2) mild/moderate nonproliferative diabetic retinopathy, (3) severe nonproliferative/proliferative diabetic retinopathy, and our simulations show that the proposed system has sensitivity and specificity of 100% for grading.

  2. SEVERITY OF DIABETIC RETINOPATHY AND HEALTH-RELATED QUALITY OF LIFE: THE LOS ANGELES LATINO EYE STUDY

    PubMed Central

    Mazhar, Kashif; Varma, Rohit; Choudhury, Farzana; McKean-Cowdin, Roberta; Shtir, Corina J.; Azen, Stanley P.

    2010-01-01

    Objective To assess the impact of diabetic retinopathy (DR) and its severity on health-related quality of life (HRQOL) in a population-based sample of Latinos with type 2 diabetes mellitus. Design Cross-sectional population-based study, the Los Angeles Latino Eye Study (LALES). Participants 1,064 LALES participants with diabetes mellitus. Methods HRQOL was measured by the 25 item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) and the Medical Outcomes Study 12-Item Short Form Health Survey (SF-12). DR was assessed by masked standardized grading of stereoscopic photographs from 7 standard fields. Severity of DR in eyes was graded using a modified Airlie House classification. The severity scores from each eye were then concatenated to create a single per person grade ranging from 1(no DR in either eye) to 15 (bilateral PDR). Multiple linear regression analyses were performed to determine the independent relationship between severity of DR and HRQOL after adjusting for covariates. Main Outcome Measures NEI-VFQ-25 and SF-12 scores. Results More severe DR was associated with worse HRQOL scores on all of the NEI VFQ-25 and SF-12 subscales (P<0.05). Individuals with DR from grade 2 (minimum NPDR) through grade 8 (unilateral moderate NPDR) show a modest decline in HRQOL. However, the decline become significantly steeper between steps 8 (unilateral moderate NPDR) and 9-15 (bilateral moderate NPDR to bilateral PDR). The domains with the most significant impact were for vision-related daily activities, dependency and mental health. Conclusion Greater severity of DR was associated with lower general and vision-specific HRQOL. Persons with bilateral moderate NPDR had the most substantial decrease in quality of life compared to those with less severe DR. The prevention of incident DR and more importantly its progression from unilateral to bilateral NPDR is likely to have a positive impact on a person’s HRQOL and should be considered an important goal in

  3. Rapid Grading of Fundus Photographs for Diabetic Retinopathy Using Crowdsourcing

    PubMed Central

    Villanti, Andrea C; Pearson, Jennifer L; Kirchner, Thomas R; Gupta, Omesh P; Shah, Chirag P

    2014-01-01

    Background Screening for diabetic retinopathy is both effective and cost-effective, but rates of screening compliance remain suboptimal. As screening improves, new methods to deal with screening data may help reduce the human resource needs. Crowdsourcing has been used in many contexts to harness distributed human intelligence for the completion of small tasks including image categorization. Objective Our goal was to develop and validate a novel method for fundus photograph grading. Methods An interface for fundus photo classification was developed for the Amazon Mechanical Turk crowdsourcing platform. We posted 19 expert-graded images for grading by Turkers, with 10 repetitions per photo for an initial proof-of-concept (Phase I). Turkers were paid US $0.10 per image. In Phase II, one prototypical image from each of the four grading categories received 500 unique Turker interpretations. Fifty draws of 1-50 Turkers were then used to estimate the variance in accuracy derived from randomly drawn samples of increasing crowd size to determine the minimum number of Turkers needed to produce valid results. In Phase III, the interface was modified to attempt to improve Turker grading. Results Across 230 grading instances in the normal versus abnormal arm of Phase I, 187 images (81.3%) were correctly classified by Turkers. Average time to grade each image was 25 seconds, including time to review training images. With the addition of grading categories, time to grade each image increased and percentage of images graded correctly decreased. In Phase II, area under the curve (AUC) of the receiver-operator characteristic (ROC) indicated that sensitivity and specificity were maximized after 7 graders for ratings of normal versus abnormal (AUC=0.98) but was significantly reduced (AUC=0.63) when Turkers were asked to specify the level of severity. With improvements to the interface in Phase III, correctly classified images by the mean Turker grade in four-category grading

  4. Middle school science grades: Can they be used to forecast performance on standardized tests?

    NASA Astrophysics Data System (ADS)

    Hubbard, Gary L.

    2007-12-01

    The purpose of this study was to determine if classroom science grades could be used to forecast standardized testing readiness for the Florida Comprehensive Assessment Test (FCAT). Participants for this study consisted of 647 eighth grade students assigned to a public middle school in Florida. Using annual classroom science grades and the corresponding year's FCAT Science scale scores for each student, scatter plot graphs and Pearson product-moment correlations were used to determine their relationships. Correlation strengths were determined for several segmented student populations. First, the grade and FCAT score relationship for the entire middle school population was calculated and, then, the relationship between grades and FCAT scores for students grouped by their individual assigned science teacher was determined. Next, a second look at students grouped as above was conducted, this time focusing only on students with unacceptable FCAT scores (levels 1 and 2). The correlation between grades and FCAT scores for the entire middle school was moderate and ranged from high to weak for students assigned to individual science teachers. The relationship of grades and FCAT scores for middle school students that scored at levels 1 and 2 was weakly correlated and ranged from moderate to weak for students as they were assigned to their science teachers. Generally, classroom grades were found to be inefficient predictors for standardized testing readiness for students assigned to this middle school.

  5. Controlling Grade Inflation

    ERIC Educational Resources Information Center

    Stanoyevitch, Alexander

    2008-01-01

    In this article concerning grade inflation, the author restricts his attention to the college and university level, although many of the tools and ideas developed here should be useful for high schools as well. The author considers the relationships between grades instructors assign and scores they receive on end-of-the semester student…

  6. On the union of graded prime ideals

    NASA Astrophysics Data System (ADS)

    Uregen, Rabia Nagehan; Tekir, Unsal; Hakan Oral, Kursat

    2016-01-01

    In this paper we investigate graded compactly packed rings, which is defined as; if any graded ideal I of R is contained in the union of a family of graded prime ideals of R, then I is actually contained in one of the graded prime ideals of the family. We give some characterizations of graded compactly packed rings. Further, we examine this property on h - Spec(R). We also define a generalization of graded compactly packed rings, the graded coprimely packed rings. We show that R is a graded compactly packed ring if and only if R is a graded coprimely packed ring whenever R be a graded integral domain and h - dim R = 1.

  7. Congenital factor V deficiency: comparison of the severity of clinical presentations among patients with rare bleeding disorders.

    PubMed

    Naderi, Majid; Tabibian, Shadi; Alizadeh, Shaban; Hosseini, Soudabeh; Zaker, Farhad; Bamedi, Taregh; Shamsizadeh, Morteza; Dorgalaleh, Akbar

    2015-01-01

    Factor V deficiency (FVD) is a rare bleeding disorder (RBD) mostly present in regions with a high rate of consanguinity. FVD after FXIII deficiency is the next more prevalent RBD in Sistan and Baluchistan (S&B) in southeastern Iran. The aim of this study was to evaluate the clinical manifestations and severity of bleeding diathesis in patients with FVD. This descriptive study was conducted on 23 patients with FVD in S&B province. FVD was diagnosed by clinical findings and routine laboratory tests. Bleeding diatheses were classified into three grades (I-III) depending on the severity of symptoms. The severity of bleeding episodes in our patients was compared with other RBDs. Based on residual plasma FV activity, 6 (26%), 16 (69.5%) and 1 (4.5%) patients had mild, moderate and severe factor deficiency, respectively. 24% of the patients had grade III life-threatening bleeding episodes which in comparison with FVII deficiency (17.4%) and FI deficiency (21%) had a higher incidence, and in comparison with FX deficiency (41.7%) and FXIII deficiency (63.1) had a lower incidence. Grade II and grade I bleeding diathesis were observed in 56.2 and 16.7% of the patients, respectively. FVD is the second most common type of RBD in S&B province and grade II bleeding episodes were the major bleeding presentation and observed in more than half of the patients. © 2014 S. Karger AG, Basel.

  8. Azelaic acid 20 % cream: effects on quality of life and disease severity in adult female acne patients.

    PubMed

    Kainz, Julius Thomas; Berghammer, Gabriele; Auer-Grumbach, Piet; Lackner, Verena; Perl-Convalexius, Sylvia; Popa, Rodica; Wolfesberger, Barbara

    2016-12-01

    Data on the efficacy of acne treatments and their impact on quality of life (QoL) in adult patients is sketchy. Assessment of the efficacy of azelaic acid 20 % cream (Skinoren ® ) on acne severity and disease-related QoL. Noninterventional study in adult female patients with mild to moderate acne. Efficacy variables included DLQI and acne severity on the face, chest, and back using the Investigator's Global Assessment (IGA) scale (grade 1 = nearly clear skin; 2 = mild acne; 3 = moderate acne). Visits were scheduled at baseline, at 4-8 weeks, and at twelve weeks. Of the 251 women enrolled, 59 % had grade 1 acne at baseline; 31 %, grade 2; and 10 %, grade 3; the most commonly affected area of the body was the face (IGA grades 2 or 3: 79 %). After twelve weeks, there was significant improvement of acne on the face (IGA grades 0 or 1: 82 %), chest, and back. Median DLQI decreased from nine at baseline to five after twelve weeks. Ninety percent of physicians and patients rated the tolerability of the treatment as very good or good. Treatment with azelaic acid 20 % cream significantly improves acne severity and disease-related QoL in adult women. © 2016 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

  9. Instrumentation | Center for Cancer Research

    Cancer.gov

    Instrumentation [accordion collapsed] Circular Dichroism (CD) Spectroscopy Instrument: J-1500 CD Spectrophotometer (Jasco) Applications: Conformational analysis of biomolecules Protein thermal stability Binding studies Major Specifications:

  10. Environmental Education Curriculum Development, Grades K-1, For St. Martin Parish.

    ERIC Educational Resources Information Center

    Saint Martin Parish School Board, St. Martinville, LA.

    This environmental education curriculum guide is designed for teacher use in kindergarten and first grade. It contains six units, which aim to develop environmental concepts related to the bio-physical environment. Each unit, which is based on several concepts, includes behavioral objectives, activities, student worksheets, diagrams,…

  11. Grade Expectations: Redux

    ERIC Educational Resources Information Center

    Miley, William M.; Gonsalves, Sonia

    2004-01-01

    We surveyed undergraduate students taking upper level psychology courses about their course and grade expectations as an extension of the work of Gaultney and Cann (2001) with introductory psychology students. More students believed success in a course was measured by good grades rather than by mastery of new material. They wanted effort to play a…

  12. TCGA_LowerGradeGliomas

    Cancer.gov

    TCGA researchers analyzed nearly 300 cases of diffuse low- and intermediate-grade gliomas, which together comprise lower-grade gliomas. LGGs occur mainly in adults and include astrocytomas, oligodendrogliomas and oligoastrocytomas.

  13. Total enbloc spondylectomy for metastatic high grade spinal tumors: Early results

    PubMed Central

    Patil, Sanganagouda S; Nene, Abhay M

    2016-01-01

    Background: High grade metastatic spinal tumors are most common and are invasive. These patients can succumb to disease progression if not treated timely. Although considered as invasive and morbid, total enbloc spondylectomy (TES) in selected cases has better survival rates. The authors describe the results of TES for high grade metastatic spinal tumors. Materials and Methods: Five patients (four females and one male) underwent TES for solitary metastatic vertebral lesion between November 2012 and January 2014. These patients presented to us with spinal instability, unrelenting severe spinal pain and/or with severe progressive radiculopathy. Average age was 46.2 years (range 39–62 years). After complete investigations, computed tomography scan, magnetic resonance imaging scan and positron emission tomography (PET) scan, it was confirmed that these patients had high grade solitary vertebral metastatic tumor. Results: Average duration of followup was 18 months (range 16–20 months). The average preoperative visual analog scale score of 9.4 (range 9–10) improved to 2 (range 1–4) at last followup. Average blood loss was 1440 mL (range 1000–2000 mL). Average duration of surgery was 198 min (range 180–240 min). Significant pain relief was noticed in each patient in the immediate postoperative period and during followups. These patients attained complete functional activities of daily living with in a month. The imaging showed implants in situ, no recurrence of tumor, and no activity on PET scan at the final followup. Conclusion: The present series shows favorable short term results of TES for solitary, metastatic, high grade vertebral body tumors by a team approach. PMID:27512215

  14. Assessing Agreement between Multiple Raters with Missing Rating Information, Applied to Breast Cancer Tumour Grading

    PubMed Central

    Ellis, Ian O.; Green, Andrew R.; Hanka, Rudolf

    2008-01-01

    Background We consider the problem of assessing inter-rater agreement when there are missing data and a large number of raters. Previous studies have shown only ‘moderate’ agreement between pathologists in grading breast cancer tumour specimens. We analyse a large but incomplete data-set consisting of 24177 grades, on a discrete 1–3 scale, provided by 732 pathologists for 52 samples. Methodology/Principal Findings We review existing methods for analysing inter-rater agreement for multiple raters and demonstrate two further methods. Firstly, we examine a simple non-chance-corrected agreement score based on the observed proportion of agreements with the consensus for each sample, which makes no allowance for missing data. Secondly, treating grades as lying on a continuous scale representing tumour severity, we use a Bayesian latent trait method to model cumulative probabilities of assigning grade values as functions of the severity and clarity of the tumour and of rater-specific parameters representing boundaries between grades 1–2 and 2–3. We simulate from the fitted model to estimate, for each rater, the probability of agreement with the majority. Both methods suggest that there are differences between raters in terms of rating behaviour, most often caused by consistent over- or under-estimation of the grade boundaries, and also considerable variability in the distribution of grades assigned to many individual samples. The Bayesian model addresses the tendency of the agreement score to be biased upwards for raters who, by chance, see a relatively ‘easy’ set of samples. Conclusions/Significance Latent trait models can be adapted to provide novel information about the nature of inter-rater agreement when the number of raters is large and there are missing data. In this large study there is substantial variability between pathologists and uncertainty in the identity of the ‘true’ grade of many of the breast cancer tumours, a fact often ignored in

  15. Efficacy of pirfenidone and disease severity of idiopathic pulmonary fibrosis: Extended analysis of phase III trial in Japan.

    PubMed

    Taguchi, Yoshio; Ebina, Masahito; Hashimoto, Seishu; Ogura, Takashi; Azuma, Arata; Taniguchi, Hiroyuki; Kondoh, Yasuhiro; Suga, Moritaka; Takahashi, Hiroki; Nakata, Koichiro; Sugiyama, Yukihiko; Kudoh, Shoji; Nukiwa, Toshihiro

    2015-11-01

    A phase III clinical trial of pirfenidone in patients with idiopathic pulmonary fibrosis (IPF) in Japan has revealed that pirfenidone attenuated the decline in vital capacity (VC) and improved progression-free survival (PFS). We conducted an extended analysis of the pirfenidone trial to investigate its efficacy with respect to IPF severity in the trial population. Patients in the phase III trial were stratified by baseline pulmonary functions including %VC predicted, %diffusion capacity for carbon monoxide predicted, and oxygen saturation by pulse oximetry on exertion and were categorized into mild, moderate, and severe groups of functional impairment. The efficacy of pirfenidone for VC and PFS over 52 weeks was compared among the three sub-populations. Of 264 patients, 102 (39%), 90 (34%), and 72 patients (27%) were classified as having mild, moderate, and severe grades of functional impairment, respectively. This classification was associated with arterial oxygen partial pressure at rest and degree of dyspnea at baseline. While pirfenidone attenuated VC decline at all grades of severity, covariance analysis revealed pirfenidone to have better efficacy in the sub-population with mild-grade IPF. Mixed model repeated measures analysis confirmed that pirfenidone markedly attenuated VC decline in patients with mild-grade IPF compared to its effects in patients with moderate or severe IPF. Pirfenidone also improved PFS markedly in patients with mild-grade IPF. This extended analysis suggested that pirfenidone exerted better therapeutic effects in patients with milder IPF. Further analysis with a larger population is needed to confirm these results. Copyright © 2015. Published by Elsevier B.V.

  16. Does Learning-Centered Teaching Promote Grade Improvement?

    ERIC Educational Resources Information Center

    Mostrom, Alison M.; Blumberg, Phyllis

    2012-01-01

    When the grade distribution within a course shifts towards higher grades, it may be due to grade inflation or grade improvement. If the positive shift is accompanied by an increase in achievement or learning, it should be considered grade improvement, "not" grade inflation. Effective learning-centered teaching is designed to promote student…

  17. Safety of repair for severe duodenal injuries.

    PubMed

    Velmahos, George C; Constantinou, Constantinos; Kasotakis, George

    2008-01-01

    There is ongoing debate about the management of severe duodenal injuries (SDIs), and earlier studies have recommended pyloric exclusion. The objective of this study was to compare primary repair with pyloric exclusion to examine if primary repair can be safely used in SDIs. The medical records of 193 consecutive patients who were admitted between August 1992 and January 2004 with duodenal injuries were reviewed. After excluding early deaths (n = 50), low-grade duodenal injuries (n = 81), and pancreatoduodenectomies for catastrophic trauma (n = 12), a total of 50 patients with SDIs (grade III, IV, or V) were analyzed. Primary repair (PR--simple duodenorrhaphy or resection and primary anastomosis) was performed in 34 (68%) and pyloric exclusion (PE) in 16 (32%). Characteristics and outcomes of these two groups were compared. PE and PR patients were similar for age, injury severity score, abdominal abbreviated injury score, physiologic status on admission, time to operation, and most abdominal organs injured. PE patients had more pancreatic injuries (63% vs. 24%, p < 0.01), a higher frequency of injuries to the first and second part of the duodenum (79% vs. 42%, p = 0.02), and a nonsignificant trend toward more grade IV and V injuries (37% vs. 18%, p = 0.11). There was no difference in morbidity (including complications specific to the duodenal repair), mortality, and intensive care unit and hospital length of stay between the two groups. Pyloric exclusion is not necessary for all patients with SDIs, as previously suggested. Selected SDI patients can be safely managed by simple primary repair.

  18. Using 4+ to grade near-normal muscle strength does not improve agreement.

    PubMed

    O'Neill, Søren; Jaszczak, Sofie Louise Thomsen; Steffensen, Anne Katrine Søndergaard; Debrabant, Birgit

    2017-01-01

    Manual assessment of muscle strength is often graded using the ordinal Medical Research Council (MRC) scale. The scale has a number of inherent weaknesses, including poorly defined limits between grades '4' and '5' and very large differences in the span of muscle strength encompassed by each of the six grades. It is not necessarily obvious how to convert a manual muscle test finding into an MRC grade. Several modifications which include intermediate grades have been suggested to improve the MRC scale and the current study examines whether agreement improves and variation in ratings decrease, with an intermediate grade between '4' and '5', in circumstances where such a grade would seem appropriate. The present study examined the hypothesis, that a modified MRC-scale which included the commonly used '4+' option, resulted in greater agreement between clinicians compared to the standard MRC-scale. A questionnaire containing five simple clinical cases were distributed to a large convenience sample of chiropractors in Northern Europe, with instructions to grade the described muscle strength findings using the MRC scale. The scale was adapted (with/without an intermediate '4+' grade) depending on the preference of the individual respondent. The cases were designed in such a way as to suggest a muscle weakness in the grey area between '4' and '5', i.e. grade '4+' on the modified MRC scale. A total of 225 questionnaires were returned (7% response rate). The average percentage agreement (across cases) in the standard MRC group was 64% [range 51%: 73%] (grade '4' in all cases). In the modified MRC group, the corresponding findings was 48% [38%: 74%] (grade '4' or '4+' in all cases). The mean average deviation analogue in the standard MRC group was 0.34 (range 0.34: 0.40), compared to 0.51 (range 0.39: 0.73) in the modified MRC group, indicating greater dispersion of scores in the modified MRC group. The Fleiss kappa was 0.02 ( p  < 0.001) and 0.13 ( p  < 0

  19. Graded Multiple Choice Questions: Rewarding Understanding and Preventing Plagiarism

    NASA Astrophysics Data System (ADS)

    Denyer, G. S.; Hancock, D.

    2002-08-01

    This paper describes an easily implemented method that allows the generation and analysis of graded multiple-choice examinations. The technique, which uses standard functions in user-end software (Microsoft Excel 5+), can also produce several different versions of an examination that can be employed to prevent the reward of plagarism. The manuscript also discusses the advantages of having a graded marking system for the elimination of ambiguities, use in multi-step calculation questions, and questions that require extrapolation or reasoning. The advantages of the scrambling strategy, which maintains the same question order, is discussed with reference to student equity. The system provides a non-confrontational mechanism for dealing with cheating in large-class multiple-choice examinations, as well as providing a reward for problem solving over surface learning.

  20. Post-hepatectomy haemorrhage: a definition and grading by the International Study Group of Liver Surgery (ISGLS).

    PubMed

    Rahbari, Nuh N; Garden, O James; Padbury, Robert; Maddern, Guy; Koch, Moritz; Hugh, Thomas J; Fan, Sheung Tat; Nimura, Yuji; Figueras, Joan; Vauthey, Jean-Nicolas; Rees, Myrddin; Adam, Rene; Dematteo, Ronald P; Greig, Paul; Usatoff, Val; Banting, Simon; Nagino, Masato; Capussotti, Lorenzo; Yokoyama, Yukihiro; Brooke-Smith, Mark; Crawford, Michael; Christophi, Christopher; Makuuchi, Masatoshi; Büchler, Markus W; Weitz, Jürgen

    2011-08-01

    A standardized definition of post-hepatectomy haemorrhage (PHH) has not yet been established. An international study group of hepatobiliary surgeons from high-volume centres was convened and a definition of PHH was developed together with a grading of severity considering the impact on patients' clinical management. The definition of PHH varies strongly within the hepatic surgery literature. PHH is defined as a drop in haemoglobin level > 3 g/dl post-operatively compared with the post-operative baseline level and/or any post-operative transfusion of packed red blood cells (PRBC) for a falling haemoglobin and/or the need for radiological intervention (such as embolization) and/or re-laparotomy to stop bleeding. Evidence of intra-abdominal bleeding should be obtained by imaging or blood loss via the abdominal drains if present. Transfusion of up to two units of PRBC is considered as being Grade A PHH. Grade B PHH requires transfusion of more than two units of PRBC, whereas the need for invasive re-intervention such as embolization and/ or re-laparotomy defines Grade C PHH. The proposed definition and grading of severity of PHH enables valid comparisons of results from different studies. It is easily applicable in clinical routine and should be applied in future trials to standardize reporting of complications. © 2011 International Hepato-Pancreato-Biliary Association.

  1. Natural history of nonoperative management for grade 4 and 5 liver and spleen injuries in children.

    PubMed

    Yang, Jeannie C; Sharp, Susan W; Ostlie, Daniel J; Holcomb, George W; St Peter, Shawn D

    2008-12-01

    Nonoperative management is standard treatment of blunt liver or spleen injuries. However, there are few reports outlining the natural history and outcomes of severe blunt hepatic and splenic trauma. Therefore, we reviewed our experience with nonoperative management of grade 4 or 5 liver and spleen injuries. A retrospective analysis was performed on patients with grade 4 or 5 (high-grade) blunt liver and/or spleen injuries from April 1997 to July 2007 at our children's hospital. Demographics, hospital course data, and follow-up data were analyzed. There were 74 high-grade injuries in 72 patients. There were 30 high-grade liver and 44 high-grade spleen injuries. Two patients had both a liver and splenic injury. High-grade liver injuries had a significantly longer length of intensive care and hospital stay compared to high-grade spleen injuries. There were also a significantly higher number of transfusions, radiographs, and total charges in the high-grade liver injuries when compared to the high-grade splenic injuries. The only mortality from solid organ injury was a grade 4 liver injury with portal vein disruption. In contrast, there was only one complication from a high-grade splenic injury-a pleural effusion treated with thoracentesis. There were 5 patients with complications from their liver injury requiring 18 therapeutic procedures. Three patients (10%) with liver injury required readmission as follows: one 5 times, one 3 times, and another one time. Patients with high-grade liver injuries have a longer recovery, more complications, and greater use of resources than in patients with similar injuries to the spleen.

  2. There were no differences in serum HBV DNA level between HBeAg-positive and HBeAg-negative chronic hepatitis B with same liver histological necroinflammation grade but differences among grades 1, 2, 3 and 4 apportioned by the same hepatic parenchyma cell volume.

    PubMed

    Ke, W-M; Xie, S-B; Li, X-J; Zhang, S-Q; Lai, J; Ye, Y-N; Gao, Z-L; Chen, P-J

    2011-09-01

    Hepatitis B virus (HBV) DNA levels and liver histological necroinflammation grades are correlated with the antiviral efficacy. It is necessary to clarify the relationship between HBV replication levels apportioned by the same hepatic parenchyma cell volume and severity of liver histological necroinflammation grades in both hepatitis B e antigen (HBeAg)-positive and HBeAg-negative chronic hepatitis B. The serum HBV DNA levels apportioned by the same hepatic parenchyma cell volume were compared between HBeAg-positive and HBeAg-negative chronic hepatitis B as well as among liver histological necroinflammation grades 1, 2, 3 and 4, respectively. There were no differences in the serum HBV DNA levels between HBeAg-positive and HBeAg-negative chronic hepatitis B as well as among liver histological necroinflammation grades 1, 2, 3 and 4. However, there were differences in the serum HBV DNA levels apportioned by the same hepatic parenchyma cell volume among liver histological necroinflammation grades 1, 2, 3 and 4 in both HBeAg-positive and HBeAg-negative chronic hepatitis B, respectively. There were no differences in HBV DNA levels with the same liver histological necroinflammation grade activated by HBV wild-type and variant strains. After the differences in hepatic parenchyma cell volume for HBV replication of the same liver histological necroinflammation grade accompanied by different hepatic fibrosis stages were adjusted, the serum HBV DNA level apportioned by the same hepatic parenchyma cell volume was correlated with the severity of liver histological necroinflammation grade. © 2011 Blackwell Publishing Ltd.

  3. Successful management of severe blunt hepatic trauma by angiographic embolization.

    PubMed

    Kanakis, Meletios A; Thomas, Theodoros; Martinakis, Vassilios G; Brountzos, Elias; Varsamidakis, Nicholas

    2012-12-01

    We present the case of an 18-year-old female with severe liver trauma after a motorcycle accident. Due to initial hemodynamic instability, fluid resuscitation and transfusion of two units of red packed cells was required. After stabilization, a CT scan was performed, showing grade V liver injuries according to the American Association for the Surgery of Trauma grading system. Angiography revealed multiple extravasations during the early arterial phase, as well as active extravasation from the proximal left hepatic artery in the late arterial phase. The patient was successfully treated by arterial embolization using metal microcoils, after which no further need for blood transfusion ensued. This report highlights that, in carefully selected cases, arterial embolization can improve the clinical condition of patients, reduce the need for blood transfusion and lessen the possibility of an operation, even if severe liver trauma has ensued.

  4. 2J, 3J-HMBC: A New Long-Range Heteronuclear Shift Correlation Technique Capable of Differentiating 2JCH from 3JCH Correlations to Protonated Carbons

    NASA Astrophysics Data System (ADS)

    Krishnamurthy, V. V.; Russell, David J.; Hadden, Chad E.; Martin, Gary E.

    2000-09-01

    The development of a series of new, accordion-optimized long-range heteronuclear shift correlation techniques has been reported. A further derivative of the constant time variable delay introduced in the IMPEACH-MBC experiment, a STAR (Selectively Tailored Accordion F1 Refocusing) operator is described in the present report. Incorporation of the STAR operator with the capability of user-selected homonuclear modulation scaling as in the CIGAR-HMBC experiment, into a long-range heteronuclear shift correlation pulse sequence, 2J,3J-HMBC, affords for the first time in a proton-detected experiment the means of unequivocally differentiating two-bond (2JCH) from three-bond (3JCH) long-range correlations to protonated carbons.

  5. Arizona Academic Standards, Grade 5

    ERIC Educational Resources Information Center

    Arizona Department of Education, 2009

    2009-01-01

    This publication contains an updated academic standards of Arizona public schools for grade 5. The contents of this document include the following: (1) The Arts Standard 2006--Grade 5; (2) Comprehensive Health Education/Physical Activity Standards 1997--Essentials (Grades 4-8); (3) Foreign and Native Language Standards 1997--Foundations (Grades…

  6. Arizona Academic Standards, Grade 6

    ERIC Educational Resources Information Center

    Arizona Department of Education, 2009

    2009-01-01

    This publication contains an updated academic standards of Arizona public schools for grade 6. The contents of this document include the following: (1) The Arts Standard 2006--Grade 6; (2) Comprehensive Health Education/Physical Activity Standards 1997--Essentials (Grades 4-8); (3) Foreign and Native Language Standards 1997--Essentials (Grades…

  7. The Grades Game

    ERIC Educational Resources Information Center

    Fleenor, Andy; Lamb, Sarah; Anton, Jennifer; Stinson, Todd; Donen, Tony

    2011-01-01

    It can be quite alarming (and eye-opening) to see exactly how many of the grades students receive are based on their behaviors rather than their learning. Students should be assessed on what they know and can use rather than on their behavior. The reality, unfortunately, is that the opposite is often the case. Grades for students who work hard are…

  8. Making Grading Work.

    ERIC Educational Resources Information Center

    Lotto, Edward; Smith, Bruce

    Two teachers have developed a procedure for grading student compositions that seems fairer to both them and their students. The students are given a choice of which papers they wish to submit for grading, and when they do submit work, the papers are identified by a number only (chosen by the student and indexed in a class card file). Each teacher…

  9. 10 CFR 830.7 - Graded approach.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 4 2013-01-01 2013-01-01 false Graded approach. 830.7 Section 830.7 Energy DEPARTMENT OF ENERGY NUCLEAR SAFETY MANAGEMENT § 830.7 Graded approach. Where appropriate, a contractor must use a graded approach to implement the requirements of this part, document the basis of the graded approach...

  10. 10 CFR 830.7 - Graded approach.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 4 2012-01-01 2012-01-01 false Graded approach. 830.7 Section 830.7 Energy DEPARTMENT OF ENERGY NUCLEAR SAFETY MANAGEMENT § 830.7 Graded approach. Where appropriate, a contractor must use a graded approach to implement the requirements of this part, document the basis of the graded approach...

  11. 10 CFR 830.7 - Graded approach.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Graded approach. 830.7 Section 830.7 Energy DEPARTMENT OF ENERGY NUCLEAR SAFETY MANAGEMENT § 830.7 Graded approach. Where appropriate, a contractor must use a graded approach to implement the requirements of this part, document the basis of the graded approach...

  12. 10 CFR 830.7 - Graded approach.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 4 2011-01-01 2011-01-01 false Graded approach. 830.7 Section 830.7 Energy DEPARTMENT OF ENERGY NUCLEAR SAFETY MANAGEMENT § 830.7 Graded approach. Where appropriate, a contractor must use a graded approach to implement the requirements of this part, document the basis of the graded approach...

  13. Correlation between severity of ultrasonographic nonalcoholic fatty liver disease and cardiometabolic risk among Filipino wellness patients

    PubMed Central

    Cuenza, Lucky R.; Razon, Tamara Louise J.; Dayrit, Juan Carlo

    2017-01-01

    Introduction: Nonalcoholic fatty liver disease (NAFLD) is a prevalent condition which is known to be related to factors that predispose to the development of coronary artery disease as well as development of metabolic syndrome. The study aimed to determine the association between ultrasound-based grading of hepatic steatosis with metabolic profile and estimated cardiovascular risk using the Framingham Risk Score (FRS). Methods: This was a cross-sectional study on 100 Filipino patients without established cardiovascular disease who underwent a general wellness health evaluation. Cases with NAFLD diagnosed on the basis of ultrasound grading were analyzed. Comparison of demographics and metabolic parameters between grades of hepatic steatosis was performed using Kruskal Wallis test. FRS was used to assess cardiovascular risk with Spearman rank test for correlation with the degree of NAFLD. Results: Mean age was 47 ± 9.6 years, with 70% males. Mean body mass index (BMI) was 28.7 ± 5.1. Most patients had grade I NAFLD (53%), 34% were grade II, and 13% were grade III. BMI (P =0.034), liver enzymes (alanine aminotransferase [ALT], P = 0.001; aspartate aminotransferase [AST], P = 0.00), triglycerides (P = 0.047), and fasting blood sugar [FBS] (P = 0.049) were associated with fatty liver grade. No association was noted with total cholesterol (P = 0.569), high density lipoprotein (HDL) (P = 0.220), and low density lipoprotein (LDL) (P = 0.792). Using the FRS 43% were stratified as low (<10% risk), 45% as intermediate (10%-20% risk) and 12% as high risk (>20% risk). Severity of fatty liver was directly correlated with the FRS (Spearman rank 0.741, P = 0.009). Conclusion: Ultrasound-based grading of the severity of NAFLD is associated with abnormalities in the metabolic profile of patients. The FRS is correlated with increasing severity of NAFLD based on ultrasound. These findings suggest that the presence of NAFLD may be a marker for the presence of increased cardiovascular

  14. Methods and reproducibility of grading optimized digital color fundus photographs in the Age-Related Eye Disease Study 2 (AREDS2 Report Number 2).

    PubMed

    Danis, Ronald P; Domalpally, Amitha; Chew, Emily Y; Clemons, Traci E; Armstrong, Jane; SanGiovanni, John Paul; Ferris, Frederick L

    2013-07-08

    To establish continuity with the grading procedures and outcomes from the historical data of the Age-Related Eye Disease Study (AREDS), color photographic imaging and evaluation procedures for the assessment of age-related macular degeneration (AMD) were modified for digital imaging in the AREDS2. The reproducibility of the grading of index AMD lesion components and for the AREDS severity scale was tested at the AREDS2 reading center. Digital color stereoscopic fundus photographs from 4203 AREDS2 subjects collected at baseline and annual follow-up visits were optimized for tonal balance and graded according to a standard protocol slightly modified from AREDS. The reproducibility of digital grading of AREDS2 images was assessed by reproducibility exercises, temporal drift (regrading a subset of baseline annually, n = 88), and contemporaneous masked regrading (ongoing, monthly regrade on 5% of submissions, n = 1335 eyes). In AREDS2, 91% and 96% of images received replicate grades within two steps of the baseline value on the AREDS severity scale for temporal drift and contemporaneous assessment, respectively (weighted Kappa of 0.73 and 0.76). Historical data for temporal drift in replicate gradings on the AREDS film-based images were 88% within two steps (weighted Kappa = 0.88). There was no difference in AREDS2-AREDS concordance for temporal drift (exact P = 0.57). Digital color grading has nearly the same reproducibility as historical film grading. There is substantial agreement for testing the predictive utility of the AREDS severity scale in AREDS2 as a clinical trial outcome. (ClinicalTrials.gov number, NCT00345176.)

  15. Study on service performance of 880 MPa-grade and 980 MPa-grade rail steels

    NASA Astrophysics Data System (ADS)

    Zhu, M.; Xu, G.; Zhou, J. H.; Wang, R. M.; Gan, X. L.

    2017-09-01

    With the rapid development of economy in China, the requirement for railway passenger and cargo transportation becomes higher and higher. Increasing speed and developing heavy-haul transportation can effectively improve the transportation capacity of railway. The requirement for rail steels with higher ability of abrasion resistance becomes urgent. Two kinds of rails, i.e., 880 MPa-grade and 980 MPa-grade rail steels, were laid on cargo line with 500 m short radius curve. The service performances of the tested steels were continuously tracked and analyzed during operation of total 22.5 million tons loads. Macro morphology, light band width, surface hardness and profile of rails were investigated. The results show that the performance of 980 MPa-grade rail steel is superior to that of 880 MPa-grade rail steel at same circumstance. Therefore, 980 MPa-grade rail should be selected in the cargo line with small radius curve.

  16. Four Steps in Grading Reform

    ERIC Educational Resources Information Center

    Guskey, Thomas R.; Jung, Lee Ann

    2012-01-01

    The field of education is moving rapidly toward a standards-based approach to grading. School leaders have become increasingly aware of the tremendous variation that exists in grading practices, even among teachers of the same courses in the same department in the same school. Consequently, students' grades often have little relation to their…

  17. Building a knowledge base of severe adverse drug events based on AERS reporting data using semantic web technologies.

    PubMed

    Jiang, Guoqian; Wang, Liwei; Liu, Hongfang; Solbrig, Harold R; Chute, Christopher G

    2013-01-01

    A semantically coded knowledge base of adverse drug events (ADEs) with severity information is critical for clinical decision support systems and translational research applications. However it remains challenging to measure and identify the severity information of ADEs. The objective of the study is to develop and evaluate a semantic web based approach for building a knowledge base of severe ADEs based on the FDA Adverse Event Reporting System (AERS) reporting data. We utilized a normalized AERS reporting dataset and extracted putative drug-ADE pairs and their associated outcome codes in the domain of cardiac disorders. We validated the drug-ADE associations using ADE datasets from SIDe Effect Resource (SIDER) and the UMLS. We leveraged the Common Terminology Criteria for Adverse Event (CTCAE) grading system and classified the ADEs into the CTCAE in the Web Ontology Language (OWL). We identified and validated 2,444 unique Drug-ADE pairs in the domain of cardiac disorders, of which 760 pairs are in Grade 5, 775 pairs in Grade 4 and 2,196 pairs in Grade 3.

  18. Validity of histopathological grading of articular cartilage from osteoarthritic knee joints

    PubMed Central

    Ostergaard, K.; Andersen, C.; Petersen, J.; Bendtzen, K.; Salter, D.

    1999-01-01

    OBJECTIVES—To determine the validity of the histological-histochemical grading system (HHGS) for osteoarthritic (OA) articular cartilage.
METHODS—Human articular cartilage was obtained from macroscopically normal (n = 13) and OA (n = 21) knee joints. Sections of central and peripheral regions of normal samples were produced. Sections of regions containing severe, moderate, and mild OA changes were produced from each OA sample. A total of 89 sections were graded by means of the HHGS (0-14) twice by three observers.
RESULTS—Average scores for regions designated severe (8.64) and moderate (5.83) OA were less than the expected (10-14 and 6-9, respectively) according to the HHGS, whereas average scores for the region designated mild (5.29) OA and central and peripheral regions (2.19) of normal cartilage were higher than expected (2-5 and 0-1, respectively). The HHGS was capable of differentiating between articular cartilage from macroscopically normal and OA joints and between the region designated severe OA and other regions. However, the HHGS did not adequately differentiate between regions designated mild and moderate OA. Values for sensitivity, specificity, and efficiency for all regions varied considerably.
CONCLUSION—The HHGS is valid for normal and severe OA cartilage, but does not permit distinction between mild and moderate OA changes in articular cartilage.

 Keywords: histopathology; osteoarthritis; reliability; validity PMID:10364898

  19. Are Flunkers Social Outcasts? A Multilevel Study of Grade Retention Effects on Same-Grade Friendships

    ERIC Educational Resources Information Center

    Demanet, Jannick; Van Houtte, Mieke

    2016-01-01

    We examine the association between grade retention and the number of same-grade friendships. Moreover, we investigate the effect of a school's proportion of retained students on these friendships and the moderating effect of this school characteristic on the relationship between retention and the number of same-grade friendships. Multilevel…

  20. The Timing of Grade Skipping

    ERIC Educational Resources Information Center

    Kuo, Yi-Lung; Lohman, David F.

    2011-01-01

    The purposes of this study were to investigate the following: (a) the impact of sex, ethnicity, socioeconomic status, and family income on the likelihood of whole-grade skipping between kindergarten and Grade 7 and (b) the effects of grade skipping during elementary or middle school on students' academic achievement in high school. The authors…

  1. Debate-Proof Grades: Experiences and Challenges of Using a Grading Rubric in a Social Welfare Policy Course

    ERIC Educational Resources Information Center

    Adedoyin, Christson A.

    2013-01-01

    This article discusses the experiences and challenges of a graduate teaching assistant in using a grading rubric in a social welfare policy course. Using a grading rubric as a debate-proof strategy against the grade entitlement of students is expatiated. In addition, the benefits of using grading rubrics to achieve CSWE/EPAS competency…

  2. A Longitudinal Investigation of Direct and Indirect Links between Reading Skills in Kindergarten and Reading Comprehension in Tenth Grade

    ERIC Educational Resources Information Center

    Stanley, Christopher T.; Petscher, Yaacov; Catts, Hugh

    2018-01-01

    In this study, researchers examined the extent to which several fundamental measures of reading proficiency from kindergarten students (N = 3180) were linked to reading comprehension in tenth grade while controlling for third grade vocabulary and oral reading fluency. Analyses tested the direct and indirect relations between and among…

  3. Developing a Nuclear Grade of Alloy 617 for Gen IV Nuclear Energy Systems

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Ren, Weiju; Swindeman, Robert W; Santella, Michael L

    2010-01-01

    Alloy 617, an attractive material not particularly developed for nuclear use, is now being considered as a leading candidate alloy by several countries for applications in the Gen IV Nuclear Energy Systems. An extensive review of its existing data suggests that it would be beneficial to refine the alloy s specification to a nuclear grade for the intended Gen IV systems. In this paper, rationale for developing a nuclear grade of the alloy is first discussed through an analysis on existing data from various countries. Then initial experiments for refining the alloy specification are described. Preliminary results have suggested themore » feasibility of the refinement approach, as well as the possibility for achieving a desirable nuclear grade. Based on the results, further research activities are recommended.« less

  4. Histopathologic grading of medulloblastomas: a Pediatric Oncology Group study.

    PubMed

    Eberhart, Charles G; Kepner, James L; Goldthwaite, Patricia T; Kun, Larry E; Duffner, Patricia K; Friedman, Henry S; Strother, Douglas R; Burger, Peter C

    2002-01-15

    Medulloblastomas are small cell embryonal tumors of the cerebellum found predominantly in children, only slightly more than half of whom survive. Predicting favorable outcome has been difficult, and improved stratification clearly is required to avoid both undertreatment and overtreatment. Patients currently are staged clinically, but no pathologic staging system is in use. Two rare subtypes at extreme ends of the histologic spectrum, i.e., medulloblastomas with extensive nodularity and large cell/anaplastic medulloblastomas, are associated with better and worse clinical outcomes, respectively. However, there is little data about correlations between histologic features and clinical outcome for most patients with medulloblastomas that fall between these histologic extremes of nodularity and anaplasia. Therefore, the authors evaluated the clinical effects of increasing anaplasia and nodularity in a large group of children with medulloblastomas, hypothesizing that increasing nodularity would predict better clinical outcomes and that increasing anaplasia would presage less favorable results. Medulloblastomas from 330 Pediatric Oncology Group patients were evaluated histologically with respect to extent of nodularity, presence of desmoplasia, grade of anaplasia, and extent of anaplasia. Pathologic and clinical data were then compared using Kaplan-Meier and log-rank analyses. Increasing grade of anaplasia and extent of anaplasia were associated strongly with progressively worse clinical outcomes (P < 0.0001 for both). Significant anaplasia (moderate or severe) was identified in 24% of medulloblastoma specimens. Neither increasing degrees of nodularity nor desmoplasia were associated significantly with longer survival. Moderate anaplasia and severe anaplasia were associated with aggressive clinical behavior in patients with medulloblastomas and were detected in a significant number of specimens (24%). Pathologic grading of medulloblastomas with respect to anaplasia may

  5. Impact of tumor grade on prognosis in pancreatic cancer: should we include grade in AJCC staging?

    PubMed

    Wasif, Nabil; Ko, Clifford Y; Farrell, James; Wainberg, Zev; Hines, Oscar J; Reber, Howard; Tomlinson, James S

    2010-09-01

    AJCC staging of pancreatic cancer (PAC) is used to determine prognosis, yet survival within each stage shows wide variation and remains unpredictable. We hypothesized that tumor grade might be responsible for some of this variation and that the addition of grade to current AJCC staging would provide improved prognostication. The Surveillance, Epidemiology, and End Results (SEER) database (1991-2005) was used to identify 8082 patients with resected PAC. The impact of grade on overall and stage-specific survival was assessed using Cox regression analysis. Variables in the model were age, sex, tumor size, lymph node status, and tumor grade. For each AJCC stage, survival was significantly worse for high-grade versus low-grade tumors. On multivariate analysis, high tumor grade was an independent predictor of survival for the entire cohort (hazard ratio [HR] 1.40, 95% confidence interval [95% CI] 1.31-1.48) as well as for stage I (HR 1.28, 95% CI 1.07-1.54), stage IIA (HR 1.43, 95% CI 1.26-1.61), stage IIB (HR 1.38, 95% CI 1.27-1.50), stage III (HR 1.28, 95% CI 1.02-1.59), and stage IV (HR 1.58, 95% CI 1.21-2.05) patients. The addition of grade to staging results in a statistically significant survival discrimination between all stages. Tumor grade is an important prognostic variable of survival in PAC. We propose a novel staging system incorporating grade into current AJCC staging for pancreas cancer. The improved prognostication is more reflective of tumor biology and may impact therapy decisions and stratification of future clinical trials.

  6. Prevalence and severity of atopic dermatitis in Jeju Island: a cross-sectional study of 4,028 Korean elementary schoolchildren by physical examination utilizing the three-item severity score.

    PubMed

    Kim, Dae Suk; Lee, Ju Hee; Lee, Kwang Hoon; Lee, Min-Geol

    2012-09-01

    The objective of this study was to evaluate the precise prevalence of atopic dermatitis (AD) in schoolchildren in Jeju Island in South Korea examined in 2009. Nine elementary schools were randomly selected from Jeju Island and a total of 4,028 schoolchildren were examined by a dermatologist. AD was diagnosed based on the Korean Atopic Dermatitis Research Group criteria for the disease. The severity of AD was measured with the three-item severity score (TIS). The point prevalence of AD was 9.5% overall. The prevalence among higher graders (age 9-12 years) was significantly lower than that in lower graders (age 6-9 years) (7.5% vs. 11.9%, < 0.00001). AD prevalence in girls (11.1%) was higher than that in boys (8.1%) (<0.005). In each grade, more than 50% of those affected had the mild form (TIS score 1 or 2). There were no apparent differences in severity of AD between grades or genders. This is the first Asian study of prevalence in schoolchildren using TIS score for evaluating AD severity.

  7. Improving the Efficiency and Effectiveness of Grading through the Use of Computer-Assisted Grading Rubrics

    ERIC Educational Resources Information Center

    Anglin, Linda; Anglin, Kenneth; Schumann, Paul L.; Kaliski, John A.

    2008-01-01

    This study tests the use of computer-assisted grading rubrics compared to other grading methods with respect to the efficiency and effectiveness of different grading processes for subjective assignments. The test was performed on a large Introduction to Business course. The students in this course were randomly assigned to four treatment groups…

  8. The Impact of Early Exposure of Eighth Grade Math Standards on End of Grade Assessments

    ERIC Educational Resources Information Center

    Robertson, Tonjai E.

    2016-01-01

    The purpose of this study was to examine the Cumberland County Schools district-wide issue surrounding the disproportional performance of eighth grade Math I students' proficiency scores on standardized end-of-grade and end-of-course assessments. The study focused on the impact of the school district incorporating eighth grade math standards in…

  9. Energy and Economics for the Elementary Grades. Unit I (Grades K-6). Lessons and Activities for the Elementary Grades.

    ERIC Educational Resources Information Center

    Backler, Alan

    Six lessons for students in grades K-3 and six lessons for students in grades 4-6 are presented. These lessons are designed to help students become more aware of the energy choices that they must make in the present and for the future and to understand that the costs of maintaining a specific standard of living and thriving national economy can be…

  10. Cytological surveillance compared with immediate referral for colposcopy in management of women with low grade cervical abnormalities: multicentre randomised controlled trial.

    PubMed

    2009-07-28

    To examine the effectiveness of cytological surveillance in primary care compared with immediate referral for colposcopic examination in women with low grade abnormal results on cervical cytology tests. Multicentre individually randomised controlled trial. NHS cervical screening programmes in Grampian, Tayside, and Nottingham. 4439 women, aged 20-59, with a cytology result showing borderline nuclear abnormalities or mild dyskaryosis, October 1999-October 2002. Cytological screening every six months in primary care (n=2223) or referral for colposcopy and related interventions (n=2216). All women were followed for three years, concluding with an exit appointment at which colposcopic examination was undertaken. Colposcopists assessing outcome at this appointment were blinded to randomisation. Primary end point: cumulative incidence of cervical intraepithelial neoplasia grade II or more severe disease. Other end points: cervical intraepithelial neoplasia grade III or worse, clinically significant anxiety and depression, other self reported after effects, and rates of non-attendance. Analysis was by intention to treat; all those randomised were included. The cumulative incidence of cervical intraepithelial neoplasia grade II or worse was 79 per 1000 person years in the colposcopy arm and 58 per 1000 person years in the cytological surveillance arm (relative risk 1.37, 95% confidence interval 1.19 to 1.57). This difference was less marked for cervical intraepithelial neoplasia grade III or more severe disease, but the incidence was still higher in the colposcopy arm (relative risk 1.26, 1.04 to 1.53). Among women randomised to immediate colposcopy, 79% (74.9% to 82.5%) of cases of cervical intraepithelial neoplasia grade II or worse were diagnosed at the time of the immediate colposcopy, while among women randomised to cytological surveillance, 77% (72.1% to 81.2%) of cases were detected by surveillance cytology and related interventions. Similar proportions of women

  11. 7 CFR 51.1578 - Off-Grade potatoes.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Off-Grade potatoes. 51.1578 Section 51.1578... STANDARDS) United States Consumer Standards for Potatoes Off-Grade § 51.1578 Off-Grade potatoes. Potatoes which fail to meet the requirements of any of the foregoing grades shall be Off-Grade potatoes...

  12. Grading of Student's Attainment: Purposes and Functions.

    ERIC Educational Resources Information Center

    Lysne, Anders

    1984-01-01

    Traces the history of grading and discusses the complex problem of evaluation and grading of student achievement. Reviews the various reference measures and notes the type of functions grades are supposed to serve. Cites seven alternatives to traditional grading. Concludes that "grades are the tail that wags the dog." (BRR)

  13. 7 CFR 51.1578 - Off-Grade potatoes.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 2 2011-01-01 2011-01-01 false Off-Grade potatoes. 51.1578 Section 51.1578... STANDARDS) United States Consumer Standards for Potatoes Off-Grade § 51.1578 Off-Grade potatoes. Potatoes which fail to meet the requirements of any of the foregoing grades shall be Off-Grade potatoes...

  14. 7 CFR 51.1578 - Off-Grade potatoes.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 2 2012-01-01 2012-01-01 false Off-Grade potatoes. 51.1578 Section 51.1578... STANDARDS) United States Consumer Standards for Potatoes Off-Grade § 51.1578 Off-Grade potatoes. Potatoes which fail to meet the requirements of any of the foregoing grades shall be Off-Grade potatoes...

  15. Higher-Order Theory for Functionally Graded Materials

    NASA Technical Reports Server (NTRS)

    Aboudi, J.; Pindera, M. J.; Arnold, Steven M.

    2001-01-01

    Functionally graded materials (FGM's) are a new generation of engineered materials wherein the microstructural details are spatially varied through nonuniform distribution of the reinforcement phase(s). Engineers accomplish this by using reinforcements with different properties, sizes, and shapes, as well as by interchanging the roles of the reinforcement and matrix phases in a continuous manner (ref. 1). The result is a microstructure that produces continuously or discretely changing thermal and mechanical properties at the macroscopic or continuum scale. This new concept of engineering the material's microstructure marks the beginning of a revolution both in the materials science and mechanics of materials areas since it allows one, for the first time, to fully integrate the material and structural considerations into the final design of structural components. Functionally graded materials are ideal candidates for applications involving severe thermal gradients, ranging from thermal structures in advanced aircraft and aerospace engines to computer circuit boards. Owing to the many variables that control the design of functionally graded microstructures, full exploitation of the FGM's potential requires the development of appropriate modeling strategies for their response to combined thermomechanical loads. Previously, most computational strategies for the response of FGM's did not explicitly couple the material's heterogeneous microstructure with the structural global analysis. Rather, local effective or macroscopic properties at a given point within the FGM were first obtained through homogenization based on a chosen micromechanics scheme and then subsequently used in a global thermomechanical analysis.

  16. Osteoarthritis Severity Determination using Self Organizing Map Based Gabor Kernel

    NASA Astrophysics Data System (ADS)

    Anifah, L.; Purnomo, M. H.; Mengko, T. L. R.; Purnama, I. K. E.

    2018-02-01

    The number of osteoarthritis patients in Indonesia is enormous, so early action is needed in order for this disease to be handled. The aim of this paper to determine osteoarthritis severity based on x-ray image template based on gabor kernel. This research is divided into 3 stages, the first step is image processing that is using gabor kernel. The second stage is the learning stage, and the third stage is the testing phase. The image processing stage is by normalizing the image dimension to be template to 50 □ 200 image. Learning stage is done with parameters initial learning rate of 0.5 and the total number of iterations of 1000. The testing stage is performed using the weights generated at the learning stage. The testing phase has been done and the results were obtained. The result shows KL-Grade 0 has an accuracy of 36.21%, accuracy for KL-Grade 2 is 40,52%, while accuracy for KL-Grade 2 and KL-Grade 3 are 15,52%, and 25,86%. The implication of this research is expected that this research as decision support system for medical practitioners in determining KL-Grade on X-ray images of knee osteoarthritis.

  17. Fatigue and multidimensional disease severity in chronic obstructive pulmonary disease.

    PubMed

    Inal-Ince, Deniz; Savci, Sema; Saglam, Melda; Calik, Ebru; Arikan, Hulya; Bosnak-Guclu, Meral; Vardar-Yagli, Naciye; Coplu, Lutfi

    2010-06-30

    Fatigue is associated with longitudinal ratings of health in patients with chronic obstructive pulmonary disease (COPD). Although the degree of airflow obstruction is often used to grade disease severity in patients with COPD, multidimensional grading systems have recently been developed. The aim of this study was to investigate the relationship between perceived and actual fatigue level and multidimensional disease severity in patients with COPD. Twenty-two patients with COPD (aged 52-74 years) took part in the study. Multidimensional disease severity was measured using the SAFE and BODE indices. Perceived fatigue was assessed using the Fatigue Severity Scale (FSS) and the Fatigue Impact Scale (FIS). Peripheral muscle endurance was evaluated using the number of sit-ups, squats, and modified push-ups that each patient could do. Thirteen patients (59%) had severe fatigue, and their St George's Respiratory Questionnaire scores were significantly higher (p < 0.05). The SAFE index score was significantly correlated with the number of sit-ups, number of squats, FSS score and FIS score (p < 0.05). The BODE index was significantly associated with the numbers of sit-ups, squats and modified push-ups, and with the FSS and FIS scores (p < 0.05). Peripheral muscle endurance and fatigue perception in patients with COPD was related to multidimensional disease severity measured with both the SAFE and BODE indices. Improvements in perceived and actual fatigue levels may positively affect multidimensional disease severity and health status in COPD patients. Further research is needed to investigate the effects of fatigue perception and exercise training on patients with different stages of multidimensional COPD severity.

  18. 7 CFR 51.1905 - Off-Grade tomatoes.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Off-Grade tomatoes. 51.1905 Section 51.1905... STANDARDS) United States Consumer Standards for Fresh Tomatoes Off-Grade § 51.1905 Off-Grade tomatoes. Tomatoes which fail to meet the requirements of either of the foregoing grades shall be Off-Grade tomatoes...

  19. Murmur intensity in small-breed dogs with myxomatous mitral valve disease reflects disease severity.

    PubMed

    Ljungvall, I; Rishniw, M; Porciello, F; Ferasin, L; Ohad, D G

    2014-11-01

    To determine whether murmur intensity in small-breed dogs with myxomatous mitral valve disease reflects clinical and echocardiographic disease severity. Retrospective multi-investigator study. Records of adult dogs Ä20 kg with myxomatous mitral valve disease were examined. Murmur intensity and location were recorded and compared with echocardiographic variables and functional disease status. Murmur intensities in consecutive categories were compared for prevalences of congestive heart failure, pulmonary hypertension and cardiac remodelling. 578 dogs [107 with "soft" (30 Grade I/VI and 77 II/VI), 161 with "moderate" (Grade III/VI), 160 with "loud" (Grade IV/VI) and 150 with "thrilling" (Grade V/VI or VI/VI) murmurs] were studied. No dogs with soft murmurs had congestive heart failure, and 90% had no remodelling. However, 56% of dogs with "moderate", 29% of dogs with "loud" and 8% of dogs with "thrilling" murmurs and subclinical myxomatous mitral valve disease also had no remodelling. Probability of a dog having congestive heart failure or pulmonary hypertension increased with increasing murmur intensity. A 4-level murmur grading scheme separated clinically meaningful outcomes in small-breed dogs with myxomatous mitral valve disease. Soft murmurs in small-breed dogs are strongly indicative of subclinical heart disease. Thrilling murmurs are associated with more severe disease. Other murmurs are less informative on an individual basis. © 2014 British Small Animal Veterinary Association.

  20. Grades and Incentives: Assessing Competing Grade Point Average Measures and Postgraduate Outcomes

    ERIC Educational Resources Information Center

    Bailey, Michael A.; Rosenthal, Jeffrey S.; Yoon, Albert H.

    2016-01-01

    In many educational settings, students may have an incentive to take courses where high grades are easier to achieve, potentially corroding student learning, evaluation of student achievement, and the fairness and efficiency of post-graduation labor outcomes. A grading system that takes into account heterogeneity of teacher standards and student…

  1. Investigating Grade Nine Textbook Problems for Characteristics Related to Mathematical Literacy

    ERIC Educational Resources Information Center

    Gatabi, Abolfazl Rafiepour; Stacey, Kaye; Gooya, Zahra

    2012-01-01

    This study presents a content analysis of the new Iranian Grade 9 mathematics textbook and two Australian Year 9 mathematics textbooks, examining the extent to which the problems show characteristics associated in the literature with promoting mathematical literacy. The new Iranian book was produced to meet a range of needs including several well…

  2. Qualitative grading of disc degeneration by magnetic resonance in the lumbar and cervical spine: lack of correlation with histology in surgical cases.

    PubMed

    Davies, B M; Atkinson, R A; Ludwinski, F; Freemont, A J; Hoyland, J A; Gnanalingham, K K

    2016-08-01

    Clinically, magnetic resonance (MR) imaging is the most effective non-invasive tool for assessing IVD degeneration. Histological examination of the IVD provides a more detailed assessment of the pathological changes at a tissue level. However, very few reports have studied the relationship between these techniques. Identifying a relationship may allow more detailed staging of IVD degeneration, of importance in targeting future regenerative therapies. To investigate the relationship between MR and histological grading of IVD degeneration in the cervical and lumbar spine in patients undergoing discectomy. Lumbar (N = 99) and cervical (N = 106) IVD samples were obtained from adult patients undergoing discectomy surgery for symptomatic IVD herniation and graded to ascertain a histological grade of degeneration. The pre-operative MR images from these patients were graded for the degree of IVD (MR grade) and vertebral end-plate degeneration (Modic Changes, MC). The relationship between histological and MR grades of degeneration were studied. In lumbar and cervical IVD the majority of samples (93%) exhibited moderate levels of degeneration (ie MR grades 3-4) on pre-operative MR scans. Histologically, most specimens displayed moderate to severe grades of degeneration in lumbar (99%) and cervical spine (93%). MR grade was weakly correlated with patient age in lumbar and cervical study groups. MR and histological grades of IVD degeneration did not correlate in lumbar or cervical study groups. MC were more common in the lumbar than cervical spine (e.g. 39 versus 20% grade 2 changes; p < 0.05), but failed to correlate with MR or histological grades for degeneration. In this surgical series, the resected IVD tissue displayed moderate to severe degeneration, but there is no correlation between MR and histological grades using a qualitative classification system. There remains a need for a quantitative, non-invasive, pre-clinical measure of IVD degeneration that

  3. Spectral grading and Gleason grading of malignant prostate tissue using Stokes shift spectra

    NASA Astrophysics Data System (ADS)

    Al Salhi, M.; Masilamani, V.; Rabah, D.; Farhat, K.; Liu, C. H.; Pu, Y.; Alfano, R. R.

    2012-01-01

    Gleason score is the most common method of grading the virulence of prostate malignancy and is based on the pathological assessment of morphology of cellular matrix. Since this involves the excision of the tissue, we are working on a new, minimally invasive, non contact, procedure of spectral diagnosis of prostate malignancy. In this preliminary in vitro study reported here, we have analyzed 27 tissue samples (normal control =7: benign=8: malignant =12) by Stokes' shift spectra (SSS) to establish a one- to- one correlation between spectral grading and Gleason grading.

  4. Children with Co-occurring Academic and Behavior Problems in First grade: Distal Outcomes in Twelfth Grade

    PubMed Central

    Darney, Dana; Reinke, Wendy M.; Herman, Keith C.; Stormont, Melissa; Ialongo, Nicholas S.

    2012-01-01

    The aim of the current study was to evaluate the eleven year longitudinal association between students identified in first grade as having academic and behavior problems and distal outcomes in twelfth grade. The study extends prior research that identified latent classes of academic and behavior problems in a longitudinal community sample of 678 predominately African American first-grade students. The type and number of classes identified in first grade differed by gender, but results indicated that students within the classes of behavior and academic problems had long-term negative outcomes in the twelfth grade. The class with co-occurring academic and behavior problems in first grade had the greatest risk for negative distal outcomes for both boys and girls including higher likelihood of special education placement, mental health service use, poor academic achievement, and school dropout. Implications for prevention, early intervention, and current practices in schools are discussed. PMID:23375176

  5. Galectin-3 Reflects the Echocardiographic Grades of Left Ventricular Diastolic Dysfunction.

    PubMed

    Ansari, Uzair; Behnes, Michael; Hoffmann, Julia; Natale, Michele; Fastner, Christian; El-Battrawy, Ibrahim; Rusnak, Jonas; Kim, Seung Hyun; Lang, Siegfried; Hoffmann, Ursula; Bertsch, Thomas; Borggrefe, Martin; Akin, Ibrahim

    2018-07-01

    The level of Galectin-3 (Gal-3) protein purportedly reflects an ongoing cardiac fibrotic process and has been associated with ventricular remodeling, which is instrumental in the development of heart failure with preserved ejection fraction (HFpEF) syndrome. The aim of this study was to investigate the potential use of Gal-3 in improved characterization of the grades of diastolic dysfunction as defined by echocardiography. Seventy HFpEF patients undergoing routine echocardiography were prospectively enrolled in the present monocentric study. Blood samples for measurements of Gal-3 and amino-terminal pro-brain natriuretic peptide (NT-proBNP) were collected within 24 hours pre- or post-echocardiographic examination. The classification of patients into subgroups based on diastolic dysfunction grade permitted detailed statistical analyses of the derived data. The Gal-3 serum levels of all patients corresponded to echocardiographic indices, suggesting HFpEF (E/A, P=0.03 and E/E', P=0.02). Gal-3 was also associated with progressive diastolic dysfunction, and increased levels corresponded to the course of disease (P=0.012). Detailed analyses of ROC curves suggested that Gal-3 levels could discriminate patients with grade III diastolic dysfunction (area under the curve [AUC]=0.770, P=0.005). Gal-3 demonstrates remarkable effectiveness in the diagnosis of patients suffering from severe grade diastolic dysfunction. Increasing levels of Gal-3 possibly reflect the progressive course of HFpEF, as classified by the echocardiographic grades of diastolic dysfunction. © The Korean Society for Laboratory Medicine.

  6. Prospective evaluation of the Sunshine Appendicitis Grading System score.

    PubMed

    Reid, Fiona; Choi, Julian; Williams, Marli; Chan, Steven

    2017-05-01

    Although there is a wealth of information predicting risk of post-operative intra-abdominal collection and guiding antibiotic therapy following appendicectomy, confusion remains because of lack of consensus on the clinical severity and definition of 'complicated' appendicitis. This study aimed to develop a standardized intra-operative grading system: Sunshine Appendicitis Grading System (SAGS) for acute appendicitis that correlates independently with the risk of intra-abdominal collections. Two-hundred and forty-six patients undergoing emergency laparoscopy for suspected appendicitis were prospectively scored according to the severity of appendicitis and followed up for complications including intra-abdominal collection. After termination of the study, the SAGS score was repeated by an independent surgeon based on operation notes and intra-operative photography to determine inter-rater agreement. The primary outcome measure was incidence of intra-abdominal collection, secondary outcome measures were all complications and length of stay. SAGS score demonstrated good inter-rater agreement (kappa K w 0.869; 95% CI 0.796-0.941; P < 0.001). A risk ratio of 2.594 (95% CI 0.655-4.065; P < 0.001) for intra-abdominal collection was found using SAGS score as a predictor. The discriminative ability of SAGS score was supported by an area under the curve value of 0.850 (95% CI 0.799-0.892; P < 0.001). SAGS score can be used to simply and accurately classify the severity of appendicitis and to independently predict the risk of intra-abdominal collection. It can therefore be used to stratify risk, guide antibiotic therapy, follow-up and standardize the definitions of appendicitis severity for future research. © 2015 Royal Australasian College of Surgeons.

  7. Language Arts Curriculum Guide. Grades 7-9

    ERIC Educational Resources Information Center

    Duval County Schools, Jacksonville, FL.

    This language arts curriculum guide was developed for use in grades 7, 8 and 9 in the Duval County Public Schools, Jacksonville, Florida. The courses covered are English (separate courses for grades 7, 8, and 9), Debate (grades 9-12), Oral Communication/Public Speaking (grades 9-12), and Advanced English (separate courses for grades 7, 8, and 9).…

  8. 7 CFR 56.66 - Appeal grading certificates.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... AGRICULTURAL MARKETING ACT OF 1946 AND THE EGG PRODUCTS INSPECTION ACT (CONTINUED) VOLUNTARY GRADING OF SHELL EGGS Grading of Shell Eggs Appeal of A Grading Or Decision § 56.66 Appeal grading certificates...

  9. 7 CFR 56.19 - Prerequisites to grading.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... AGRICULTURAL MARKETING ACT OF 1946 AND THE EGG PRODUCTS INSPECTION ACT (CONTINUED) VOLUNTARY GRADING OF SHELL EGGS Grading of Shell Eggs Licensed and Authorized Graders § 56.19 Prerequisites to grading. Grading of...

  10. 7 CFR 56.66 - Appeal grading certificates.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... AGRICULTURAL MARKETING ACT OF 1946 AND THE EGG PRODUCTS INSPECTION ACT (CONTINUED) VOLUNTARY GRADING OF SHELL EGGS Grading of Shell Eggs Appeal of A Grading Or Decision § 56.66 Appeal grading certificates...

  11. 7 CFR 56.19 - Prerequisites to grading.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... AGRICULTURAL MARKETING ACT OF 1946 AND THE EGG PRODUCTS INSPECTION ACT (CONTINUED) VOLUNTARY GRADING OF SHELL EGGS Grading of Shell Eggs Licensed and Authorized Graders § 56.19 Prerequisites to grading. Grading of...

  12. Non-operative management versus operative management in high-grade blunt hepatic injury.

    PubMed

    Cirocchi, Roberto; Trastulli, Stefano; Pressi, Eleonora; Farinella, Eriberto; Avenia, Stefano; Morales Uribe, Carlos Hernando; Botero, Ana Maria; Barrera, Luis M

    2015-08-24

    Surgery used to be the treatment of choice in cases of blunt hepatic injury, but this approach gradually changed over the last two decades as increasing non-operative management (NOM) of splenic injury led to its use for hepatic injury. The improvement in critical care monitoring and computed tomographic scanning, as well as the more frequent use of interventional radiology techniques, has helped to bring about this change to non-operative management. Liver trauma ranges from a small capsular tear, without parenchymal laceration, to massive parenchymal injury with major hepatic vein/retrohepatic vena cava lesions. In 1994, the Organ Injury Scaling Committee of the American Association for the Surgery of Trauma (AAST) revised the Hepatic Injury Scale to have a range from grade I to VI. Minor injuries (grade I or II) are the most frequent liver injuries (80% to 90% of all cases); severe injuries are grade III-V lesions; grade VI lesions are frequently incompatible with survival. In the medical literature, the majority of patients who have undergone NOM have low-grade liver injuries. The safety of NOM in high-grade liver lesions, AAST grade IV and V, remains a subject of debate as a high incidence of liver and collateral extra-abdominal complications are still described. To assess the effects of non-operative management compared to operative management in high-grade (grade III-V) blunt hepatic injury. The search for studies was run on 14 April 2014. We searched the Cochrane Injuries Group's Specialised Register, The Cochrane Library, Ovid MEDLINE(R), Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations, Ovid MEDLINE(R) Daily and Ovid OLDMEDLINE(R), Embase Classic+Embase (Ovid), PubMed, ISI WOS (SCI-EXPANDED, SSCI, CPCI-S & CPSI-SSH), clinical trials registries, conference proceedings, and we screened reference lists. All randomised trials that compare non-operative management versus operative management in high-grade blunt hepatic injury. Two authors independently

  13. Gaining Ground in the Middle School Grades: Why Some Schools Do Better. A Large-Scale Study of Middle Grades Practices and Student Outcomes. The Informed Educator Series

    ERIC Educational Resources Information Center

    Educational Research Service, 2011

    2011-01-01

    This "Informed Educator" draws content from several reports as well as a PowerPoint presentation that describe findings from a study conducted by EdSource and its research partners from Stanford University and the American Institutes for Research. The project--Gaining Ground in the Middle Grades: Why Some Schools Do Better--focused on…

  14. Novel grading system for quantification of cystic macular lesions in Usher syndrome.

    PubMed

    Sliesoraityte, Ieva; Peto, Tunde; Mohand-Said, Saddek; Sahel, Jose Alain

    2015-12-10

    To evaluate novel grading system used to quantify optical coherence tomography (OCT) scans for cystic macular lesions (CML) in Usher syndrome (USH) patients, focusing on CML associated alterations in MOY7A and USH2A mutations. Two readers evaluated 76 patients' (mean age 42 ± 14 years) data prospectively uploaded on Eurush database. OCT was used to obtain high quality cross-sectional images through the fovea. The CML was graded as none, mild, moderate or severe, depending on the following features set: subretinal fluid without clearly detectable CML boundaries; central macular thickness; largest diameter of CML; calculated mean of all detectable CML; total number of detectable CML; retinal layers affected by CML. Intra-and inter-grader reproducibility was evaluated. CML were observed in 37 % of USH eyes, while 45 % were observed in MYO7A and 29 % in USH2A cases. Of those with CML: 52 % had mild, 22 % had moderate and 26 % had severe changes, respectively. CML were found in following retinal layers: 50 % inner nuclear layer, 44 % outer nuclear layer, 6 % retinal ganglion cell layer. For the inter-grader repeatability analysis, agreements rates for CML were 97 % and kappa statistics was 0.91 (95 % CI 0.83-0.99). For the intra-grader analysis, agreement rates for CML were 98 %, while kappa statistics was 0.96 (95 % CI 0.92-0.99). The novel grading system is a reproducible tool for grading OCT images in USH complicated by CML, and potentially could be used for objective tracking of macular pathology in clinical therapy trials.

  15. Reliability of clinical impact grading by healthcare professionals of common prescribing error and optimisation cases in critical care patients.

    PubMed

    Bourne, Richard S; Shulman, Rob; Tomlin, Mark; Borthwick, Mark; Berry, Will; Mills, Gary H

    2017-04-01

    To identify between and within profession-rater reliability of clinical impact grading for common critical care prescribing error and optimisation cases. To identify representative clinical impact grades for each individual case. Electronic questionnaire. 5 UK NHS Trusts. 30 Critical care healthcare professionals (doctors, pharmacists and nurses). Participants graded severity of clinical impact (5-point categorical scale) of 50 error and 55 optimisation cases. Case between and within profession-rater reliability and modal clinical impact grading. Between and within profession rater reliability analysis used linear mixed model and intraclass correlation, respectively. The majority of error and optimisation cases (both 76%) had a modal clinical severity grade of moderate or higher. Error cases: doctors graded clinical impact significantly lower than pharmacists (-0.25; P < 0.001) and nurses (-0.53; P < 0.001), with nurses significantly higher than pharmacists (0.28; P < 0.001). Optimisation cases: doctors graded clinical impact significantly lower than nurses and pharmacists (-0.39 and -0.5; P < 0.001, respectively). Within profession reliability grading was excellent for pharmacists (0.88 and 0.89; P < 0.001) and doctors (0.79 and 0.83; P < 0.001) but only fair to good for nurses (0.43 and 0.74; P < 0.001), for optimisation and error cases, respectively. Representative clinical impact grades for over 100 common prescribing error and optimisation cases are reported for potential clinical practice and research application. The between professional variability highlights the importance of multidisciplinary perspectives in assessment of medication error and optimisation cases in clinical practice and research. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  16. Increased anatomic severity predicts outcomes: validation of the American Association for the Surgery of Trauma's emergency general surgery score in appendicitis

    PubMed Central

    Hernandez, Matthew; Aho, Johnathan M.; Habermann, Elizabeth B.; Choudhry, Asad; Morris, David; Zielinski, Martin

    2016-01-01

    Background Determination and reporting of disease severity in emergency general surgery (EGS) lacks standardization. Recently, the American Association for the Surgery of Trauma (AAST) proposed an anatomic severity grading system. We aimed to validate this system in patients with appendicitis, and determine if cross sectional imaging correlates with disease severity at operation. Methods Patients 18 years or older undergoing treatment for acute appendicitis between 2013 and 2015 were identified. Baseline demographics, procedure types were recorded, and AAST grades were assigned based on intraoperative and radiologic findings. Outcomes including length of stay, 30 day mortality, and complications based on Clavien-Dindo categories and National Surgical Quality Improvement Program variables. Summary statistical univariate, nominal logistic and standard least squares analyses were performed comparing AAST grade with key outcomes. Bland-Altman analysis compared operative findings to preoperative cross sectional imaging to compare assigning grades. Results 334 patients with mean (±SD) age of 39.3 years (±16.5) were included (53% male) and all patients had cross sectional imaging. 299 underwent appendectomy, and 85% completed laparoscopic. 30 day mortality rate was 0.9%, complication rate 21%. Increased median [IQR] AAST grade was recorded in patients with complications 2 [1-4] compared to those without 1 [1-1], p=0.001. For operative management, a median [IQR] AAST grades were significantly associated with procedure type: laparoscopic 1 [1-1], open 4 [2-5] conversion to open 3 [1-4], p=0.001. Increased median [IQR] AAST grades were significantly associated in non-operative management: patients having a complication had a higher median AAST grade of 4 [3-5], compared to those without 3 [2-3], p=0.001. Bland Altman analysis comparing AAST grade and cross sectional imaging demonstrated no difference; −0.02 ±0.02 p = 0.2 coefficient of repeatability 0.9. Conclusions The

  17. Fatigue associated with prolonged graded running.

    PubMed

    Giandolini, Marlene; Vernillo, Gianluca; Samozino, Pierre; Horvais, Nicolas; Edwards, W Brent; Morin, Jean-Benoît; Millet, Guillaume Y

    2016-10-01

    Scientific experiments on running mainly consider level running. However, the magnitude and etiology of fatigue depend on the exercise under consideration, particularly the predominant type of contraction, which differs between level, uphill, and downhill running. The purpose of this review is to comprehensively summarize the neurophysiological and biomechanical changes due to fatigue in graded running. When comparing prolonged hilly running (i.e., a combination of uphill and downhill running) to level running, it is found that (1) the general shape of the neuromuscular fatigue-exercise duration curve as well as the etiology of fatigue in knee extensor and plantar flexor muscles are similar and (2) the biomechanical consequences are also relatively comparable, suggesting that duration rather than elevation changes affects neuromuscular function and running patterns. However, 'pure' uphill or downhill running has several fatigue-related intrinsic features compared with the level running. Downhill running induces severe lower limb tissue damage, indirectly evidenced by massive increases in plasma creatine kinase/myoglobin concentration or inflammatory markers. In addition, low-frequency fatigue (i.e., excitation-contraction coupling failure) is systematically observed after downhill running, although it has also been found in high-intensity uphill running for different reasons. Indeed, low-frequency fatigue in downhill running is attributed to mechanical stress at the interface sarcoplasmic reticulum/T-tubule, while the inorganic phosphate accumulation probably plays a central role in intense uphill running. Other fatigue-related specificities of graded running such as strategies to minimize the deleterious effects of downhill running on muscle function, the difference of energy cost versus heat storage or muscle activity changes in downhill, level, and uphill running are also discussed.

  18. Metabolic profiling of hepatitis B virus-related hepatocellular carcinoma with diverse differentiation grades.

    PubMed

    Zhang, Lei; Huang, Ya; Lian, Mingjian; Fan, Zhijuan; Tian, Yaqiong; Wang, Yufan; Kang, Hua; Liu, Shuang; Liu, Shuye; Li, Tong; Shan, Zhongqiang

    2017-03-01

    The most effective diagnostic tool for the majority of hepatocellular carcinoma (HCC) patients is determining the differentiation grade of their tumors. However liver biopsies, which are currently the most effective way of determining tumor differentiation grade, have several limitations. The present study was designed to select serum characteristic metabolites that correlate with the differentiation grades of hepatitis B virus (HBV)-related HCC, and so could be used in the clinic as a non-invasive method of differentiating patients with different grades of HCC. A total of 58 patients with HBV-related HCC were included in the present study, and divided into three groups according to their tumor differentiation grade. A further 20 patients with HBV-related liver cirrhosis and 19 healthy volunteers were enrolled. Ultra-performance liquid chromatography-mass spectrometry was used to analyze endogenous metabolites. Multivariate statistical analysis was used to examine the data using MZmine 2.0 software. The 14 metabolites that were highly correlated with specific differentiation grades of HCC were then selected for additional study. Receiver operator characteristic curve analysis was used to evaluate their clinical value. In total, 5 metabolites were finally identified, including lysophosphatidylcholine (16:0), oleamide, monoglyceride (0:0/15:0/0:0), lysophosphatidylcholine (18:0) and lysophosphatidylcholine [22:5(7Z,10Z,13Z,16Z,19Z)]. All these metabolites exhibited an excellent ability to distinguish different types of HCC with various differentiation grades and the area under the curve of these metabolites was up to 0.942, showing promising clinical value.

  19. Genetic variation in mitotic regulatory pathway genes is associated with breast tumor grade

    PubMed Central

    Purrington, Kristen S.; Slettedahl, Seth; Bolla, Manjeet K.; Michailidou, Kyriaki; Czene, Kamila; Nevanlinna, Heli; Bojesen, Stig E.; Andrulis, Irene L.; Cox, Angela; Hall, Per; Carpenter, Jane; Yannoukakos, Drakoulis; Haiman, Christopher A.; Fasching, Peter A.; Mannermaa, Arto; Winqvist, Robert; Brenner, Hermann; Lindblom, Annika; Chenevix-Trench, Georgia; Benitez, Javier; Swerdlow, Anthony; Kristensen, Vessela; Guénel, Pascal; Meindl, Alfons; Darabi, Hatef; Eriksson, Mikael; Fagerholm, Rainer; Aittomäki, Kristiina; Blomqvist, Carl; Nordestgaard, Børge G.; Nielsen, Sune F.; Flyger, Henrik; Wang, Xianshu; Olswold, Curtis; Olson, Janet E.; Mulligan, Anna Marie; Knight, Julia A.; Tchatchou, Sandrine; Reed, Malcolm W.R.; Cross, Simon S.; Liu, Jianjun; Li, Jingmei; Humphreys, Keith; Clarke, Christine; Scott, Rodney; Fostira, Florentia; Fountzilas, George; Konstantopoulou, Irene; Henderson, Brian E.; Schumacher, Fredrick; Le Marchand, Loic; Ekici, Arif B.; Hartmann, Arndt; Beckmann, Matthias W.; Hartikainen, Jaana M.; Kosma, Veli-Matti; Kataja, Vesa; Jukkola-Vuorinen, Arja; Pylkäs, Katri; Kauppila, Saila; Dieffenbach, Aida Karina; Stegmaier, Christa; Arndt, Volker; Margolin, Sara; Balleine, Rosemary; Arias Perez, Jose Ignacio; Pilar Zamora, M.; Menéndez, Primitiva; Ashworth, Alan; Jones, Michael; Orr, Nick; Arveux, Patrick; Kerbrat, Pierre; Truong, Thérèse; Bugert, Peter; Toland, Amanda E.; Ambrosone, Christine B.; Labrèche, France; Goldberg, Mark S.; Dumont, Martine; Ziogas, Argyrios; Lee, Eunjung; Dite, Gillian S.; Apicella, Carmel; Southey, Melissa C.; Long, Jirong; Shrubsole, Martha; Deming-Halverson, Sandra; Ficarazzi, Filomena; Barile, Monica; Peterlongo, Paolo; Durda, Katarzyna; Jaworska-Bieniek, Katarzyna; Tollenaar, Robert A.E.M.; Seynaeve, Caroline; Brüning, Thomas; Ko, Yon-Dschun; Van Deurzen, Carolien H.M.; Martens, John W.M.; Kriege, Mieke; Figueroa, Jonine D.; Chanock, Stephen J.; Lissowska, Jolanta; Tomlinson, Ian; Kerin, Michael J.; Miller, Nicola; Schneeweiss, Andreas; Tapper, William J.; Gerty, Susan M.; Durcan, Lorraine; Mclean, Catriona; Milne, Roger L.; Baglietto, Laura; dos Santos Silva, Isabel; Fletcher, Olivia; Johnson, Nichola; Van'T Veer, Laura J.; Cornelissen, Sten; Försti, Asta; Torres, Diana; Rüdiger, Thomas; Rudolph, Anja; Flesch-Janys, Dieter; Nickels, Stefan; Weltens, Caroline; Floris, Giuseppe; Moisse, Matthieu; Dennis, Joe; Wang, Qin; Dunning, Alison M.; Shah, Mitul; Brown, Judith; Simard, Jacques; Anton-Culver, Hoda; Neuhausen, Susan L.; Hopper, John L.; Bogdanova, Natalia; Dörk, Thilo; Zheng, Wei; Radice, Paolo; Jakubowska, Anna; Lubinski, Jan; Devillee, Peter; Brauch, Hiltrud; Hooning, Maartje; García-Closas, Montserrat; Sawyer, Elinor; Burwinkel, Barbara; Marmee, Frederick; Eccles, Diana M.; Giles, Graham G.; Peto, Julian; Schmidt, Marjanka; Broeks, Annegien; Hamann, Ute; Chang-Claude, Jenny; Lambrechts, Diether; Pharoah, Paul D.P.; Easton, Douglas; Pankratz, V. Shane; Slager, Susan; Vachon, Celine M.; Couch, Fergus J.

    2014-01-01

    Mitotic index is an important component of histologic grade and has an etiologic role in breast tumorigenesis. Several small candidate gene studies have reported associations between variation in mitotic genes and breast cancer risk. We measured associations between 2156 single nucleotide polymorphisms (SNPs) from 194 mitotic genes and breast cancer risk, overall and by histologic grade, in the Breast Cancer Association Consortium (BCAC) iCOGS study (n = 39 067 cases; n = 42 106 controls). SNPs in TACC2 [rs17550038: odds ratio (OR) = 1.24, 95% confidence interval (CI) 1.16–1.33, P = 4.2 × 10−10) and EIF3H (rs799890: OR = 1.07, 95% CI 1.04–1.11, P = 8.7 × 10−6) were significantly associated with risk of low-grade breast cancer. The TACC2 signal was retained (rs17550038: OR = 1.15, 95% CI 1.07–1.23, P = 7.9 × 10−5) after adjustment for breast cancer risk SNPs in the nearby FGFR2 gene, suggesting that TACC2 is a novel, independent genome-wide significant genetic risk locus for low-grade breast cancer. While no SNPs were individually associated with high-grade disease, a pathway-level gene set analysis showed that variation across the 194 mitotic genes was associated with high-grade breast cancer risk (P = 2.1 × 10−3). These observations will provide insight into the contribution of mitotic defects to histological grade and the etiology of breast cancer. PMID:24927736

  20. ADVANCES IN IMAGING TECHNOLOGIES IN THE EVALUATION OF HIGH-GRADE BLADDER CANCER

    PubMed Central

    Zlatev, Dimitar V.; Altobelli, Emanuela; Liao, Joseph C.

    2015-01-01

    Bladder cancer is a heterogeneous disease that ranges from low-grade variant with an indolent course, to high-grade subtype with a recurrent, progressive, and potentially lethal outcome. Accurate assessment for individualized treatment depends critically on the diagnostic accuracy of white light cystoscopy. Despite its central role, white light cystoscopy has several well-documented shortcomings including difficult flat lesion detection, imprecise tumor delineation that limits complete resection, differentiation between inflammation and malignancy, and grade and stage determination. As the limitations of white light cystoscopy contribute to the risk of cancer persistence, recurrence, and progression, there is a need for improved visualization of flat, multifocal, high-grade, and muscle-invasive lesions. Optical imaging technologies have emerged as an adjunct to white light cystoscopy with the goal to guide more effective treatment by improving cancer detection and patient stratification on the basis of grade and stage. Photodynamic diagnosis and narrow band imaging are macroscopic imaging modalities similar to white light cystoscopy, but provide additional contrast enhancement of bladder tumors and have been shown to improve detection rates. Confocal laser endomicroscopy and optical coherence tomography are microscopic imaging technologies that enable real-time high resolution, subsurface tissue characterization with spatial resolutions similar to histology. Molecular imaging offers the potential for the combination of optical imaging technologies with cancer-specific molecular agents to improve the specificity of disease detection. PMID:25882557

  1. Children with co-occurring academic and behavior problems in first grade: distal outcomes in twelfth grade.

    PubMed

    Darney, Dana; Reinke, Wendy M; Herman, Keith C; Stormont, Melissa; Ialongo, Nicholas S

    2013-02-01

    The aim of the current study was to evaluate the eleven year longitudinal association between students identified in first grade as having academic and behavior problems and distal outcomes in twelfth grade. The study extends prior research that identified latent classes of academic and behavior problems in a longitudinal community sample of 678 predominately African American first-grade students. The type and number of classes identified in first grade differed by gender, but results indicated that students within the classes of behavior and academic problems had long-term negative outcomes in the twelfth grade. The class with co-occurring academic and behavior problems in first grade had the greatest risk for negative distal outcomes for both boys and girls including higher likelihood of special education placement, mental health service use, poor academic achievement, and school dropout. Implications for prevention, early intervention, and current practices in schools are discussed. Published by Elsevier Ltd.

  2. Banff schema for grading pancreas allograft rejection: working proposal by a multi-disciplinary international consensus panel.

    PubMed

    Drachenberg, C B; Odorico, J; Demetris, A J; Arend, L; Bajema, I M; Bruijn, J A; Cantarovich, D; Cathro, H P; Chapman, J; Dimosthenous, K; Fyfe-Kirschner, B; Gaber, L; Gaber, O; Goldberg, J; Honsová, E; Iskandar, S S; Klassen, D K; Nankivell, B; Papadimitriou, J C; Racusen, L C; Randhawa, P; Reinholt, F P; Renaudin, K; Revelo, P P; Ruiz, P; Torrealba, J R; Vazquez-Martul, E; Voska, L; Stratta, R; Bartlett, S T; Sutherland, D E R

    2008-06-01

    Accurate diagnosis and grading of rejection and other pathological processes are of paramount importance to guide therapeutic interventions in patients with pancreas allograft dysfunction. A multi-disciplinary panel of pathologists, surgeons and nephrologists was convened for the purpose of developing a consensus document delineating the histopathological features for diagnosis and grading of rejection in pancreas transplant biopsies. Based on the available published data and the collective experience, criteria for the diagnosis of acute cell-mediated allograft rejection (ACMR) were established. Three severity grades (I/mild, II/moderate and III/severe) were defined based on lesions known to be more or less responsive to treatment and associated with better- or worse-graft outcomes, respectively. The features of chronic rejection/graft sclerosis were reassessed, and three histological stages were established. Tentative criteria for the diagnosis of antibody-mediated rejection were also characterized, in anticipation of future studies that ought to provide more information on this process. Criteria for needle core biopsy adequacy and guidelines for pathology reporting were also defined. The availability of a simple, reproducible, clinically relevant and internationally accepted schema for grading rejection should improve the level of diagnostic accuracy and facilitate communication between all parties involved in the care of pancreas transplant recipients.

  3. Is diagnosing exposed dentine a suitable tool for grading erosive loss?

    PubMed Central

    Ganss, Carolina

    2008-01-01

    Quantifying tooth wear in general and erosion in particular mostly is made by distinguishing between lesions restricted to enamel and lesions reaching the underlying dentine. Various scores for grading have been used, but in all systems, higher scores are given in cases of exposed dentine, thus, indicating a more severe stage of the condition. Clinical diagnosis of exposed dentine is made by assessing changes in colour or optical properties of the hard tissues. This paper aims to review the literature and discuss critically problems arising form this approach. It appears that classifying the severity of erosion by the area or depth of exposed dentine is difficult and poorly reproducible, and taking into account the variation of enamel thickness, the amount of tissue lost often is not related simply to the area of exposed dentine. There has still been very little longitudinal investigation of the significance of exposed dentine as a prognostic indicator. Further work and discussion is needed to reevaluate the explanative power of current grading procedures. PMID:18228063

  4. GRADE equity guidelines 4: considering health equity in GRADE guideline development: evidence to decision process.

    PubMed

    Pottie, Kevin; Welch, Vivian; Morton, Rachael; Akl, Elie A; Eslava-Schmalbach, Javier H; Katikireddi, Vittal; Singh, Jasvinder; Moja, Lorenzo; Lang, Eddy; Magrini, Nicola; Thabane, Lehana; Stanev, Roger; Matovinovic, Elizabeth; Snellman, Alexandra; Briel, Matthias; Shea, Beverly; Tugwell, Peter; Schunemann, Holger; Guyatt, Gordon; Alonso-Coello, Pablo

    2017-10-01

    The aim of this paper is to provide detailed guidance on how to incorporate health equity within the GRADE (Grading Recommendations Assessment and Development Evidence) evidence to decision process. We developed this guidance based on the GRADE evidence to decision framework, iteratively reviewing and modifying draft documents, in person discussion of project group members and input from other GRADE members. Considering the impact on health equity may be required, both in general guidelines and guidelines that focus on disadvantaged populations. We suggest two approaches to incorporate equity considerations: (1) assessing the potential impact of interventions on equity and (2) incorporating equity considerations when judging or weighing each of the evidence to decision criteria. We provide guidance and include illustrative examples. Guideline panels should consider the impact of recommendations on health equity with attention to remote and underserviced settings and disadvantaged populations. Guideline panels may wish to incorporate equity judgments across the evidence to decision framework. This is the fourth and final paper in a series about considering equity in the GRADE guideline development process. This series is coming from the GRADE equity subgroup. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Making the Grade: Do Nebraska Teachers and Administrators Working in Public Schools in 7th-12th Grade Settings Agree about What Constitutes Sound Grading Practice?

    ERIC Educational Resources Information Center

    Olson, Mark E.

    2013-01-01

    In this study, the researcher sought to determine whether Nebraska teachers and administrators agreed about what constitutes sound grading practice. The results of this study indicated that Nebraska teachers and administrators working in public schools in 7th-12th grade settings did not always agree about what constituted sound grading practice.…

  6. Grading Practices and Distributions Across Internal Medicine Clerkships.

    PubMed

    Fazio, Sara B; Torre, Dario M; DeFer, Thomas M

    2016-01-01

    Clerkship evaluation and grading practices vary widely between U.S. medical schools. Grade inflation continues to exist, and grade distribution is likely to be different among U.S. medical schools. Increasing the number of available grades curtails "grade inflation." A national survey of all Clerkship Directors in Internal Medicine members was administered in 2011. The authors assessed key aspects of grading. Response rate was 76%. Among clerkship directors (CDs), 61% of respondents agreed that grade inflation existed in the internal medicine clerkship at their school, and 43% believed that it helped students obtain better residency positions. With respect to grading practices, 79% of CDs define specific behaviors needed to achieve each grade, and 36% specify an ideal grade distribution. In addition, 44% have a trained core faculty responsible for evaluating students, 35% describe formal grading meetings, and 39% use the Reporter-Interpreter-Manager-Educator (RIME) scheme. Grading scales were described as follows: 4% utilize a pass/fail system, 13% a 3-tier (e.g., Honors/Pass/Fail), 45% 4-tier, 35% 5-tier, and 4% 6+-tier system. There was a trend to higher grades with more tiers available. Grade inflation continues in the internal medicine clerkship. Almost half of CDs feel that this practice assists students to obtain better residency positions. A minority of programs have a trained core faculty who are responsible for evaluation. About one third have formal grading meetings and use the RIME system; both have been associated with more robust and balanced grading practices. In particular, there is a wide variation between schools in the percentage of students who are awarded the highest grade, which has implications for residency applications. Downstream users of clinical clerkship grades must be fully aware of these variations in grading in order to appropriately judge medical student performance.

  7. A Study of the Effect of the Implementation of the Plus/Minus Grading System on Graduate Student Grades.

    ERIC Educational Resources Information Center

    Malone, Bobby G.; Nelson, Jacquelyn S.; Nelson, C. Van

    The implementation of a plus/minus system of grading to replace the traditional A through F grading system for graduate students was studied at a midsize Midwestern university. Decimal equivalents were established to enable the computation of grade point averages (GPAs) that reflected the dispersion of grades through the plus/minus system. A…

  8. Graded activity for low back pain in occupational health care: a randomized, controlled trial.

    PubMed

    Staal, J Bart; Hlobil, Hynek; Twisk, Jos W R; Smid, Tjabe; Köke, Albère J A; van Mechelen, Willem

    2004-01-20

    Low back pain is a common medical and social problem frequently associated with disability and absence from work. However, data on effective return to work after interventions for low back pain are scarce. To determine the effectiveness of a behavior-oriented graded activity program compared with usual care. Randomized, controlled trial. Occupational health services department of an airline company in the Netherlands. 134 workers who were absent from work because of low back pain were randomly assigned to either graded activity (n = 67) or usual care (n = 67). Graded activity, a physical exercise program based on operant-conditioning behavioral principles, to stimulate a rapid return to work. Outcomes were the number of days of absence from work because of low back pain, functional status (Roland Disability Questionnaire), and severity of pain (11-point numerical scale). The median number of days of absence from work over 6 months of follow-up was 58 days in the graded activity group and 87 days in the usual care group. From randomization onward, graded activity was effective after 50 days of absence from work (hazard ratio, 1.9 [95% CI, 1.2 to 3.2]; P = 0.009). The graded activity group was more effective in improving functional status and pain than the usual care group. The effects, however, were small and not statistically significant. Graded activity was more effective than usual care in reducing the number of days of absence from work because of low back pain.

  9. A Guide to Hardwood Log Grading

    Treesearch

    Everette D. Rast; David L. Sonderman; Glenn L. Gammon

    1973-01-01

    A guide to hardwood log grading (revised) was developed as a teaching aid and field reference in grading hardwood logs. Outlines basic principles and gives detailed practical applications, with illustrations, in grading hardwood logs. Includes standards for various use classes.

  10. The Relationship between Delivery Models and the Grade-Level Reading Development of Sixth-Grade English Learners

    ERIC Educational Resources Information Center

    Arnold, Holly Weber

    2013-01-01

    This study examines the relationship between delivery models (the class size reduction model and the sheltered instruction model) and language development levels on the grade-level reading development of sixth-grade English learners (ELs) attending public middle schools in metro Atlanta, Georgia. The instrument used to measure grade-level mastery…

  11. Verification of the new grading scale for ocular chronic graft-versus-host disease developed by the German-Austrian-Swiss consensus conference on chronic GVHD.

    PubMed

    Blecha, Christiane; Wolff, Daniel; Holler, Barbara; Holler, Ernst; Weber, Daniela; Vogt, Regine; Helbig, Horst; Dietrich-Ntoukas, Tina

    2016-02-01

    The purpose of the study was to validate a recently proposed new grading system for ocular manifestations of chronic graft-versus-host disease (cGVHD). Diagnosis of cGVHD was based on the NIH consensus criteria. In addition, a grading scale was applied, which has been developed by the German-Austrian-Swiss Consensus Conference on Clinical Practice in cGVHD. Sixty-six patients (male n = 46, female n = 20, mean age 48 years) with ocular cGVHD were included. Application of the proposed Consensus Conference grading revealed inflammatory activity in all patients with mild (33 %), moderate (44 %), or severe inflammation (23 %). Clinical scoring by the NIH scoring system showed that 6 % of patients had mild symptoms; 59 % of patients had moderate dry eye symptoms partially affecting activities of daily living, without vision impairment; and 35 % of patients had severe dry eye symptoms significantly affecting daily activities. Clinical characterization and grading by the Consensus Conference grading scale revealed that ocular cGVHD (1) frequently leads to severe ocular surface disease based on impaired function of the lacrimal glands and involvement of cornea, conjunctiva, and lids; (2) is mostly associated with ongoing inflammatory activity; (3) often leads to functional impairment and reduced quality of life; and (4) is associated with an increased risk for severe, sight-threatening complications.

  12. Low-grade serous ovarian cancer: A review.

    PubMed

    Kaldawy, Anis; Segev, Yakir; Lavie, Ofer; Auslender, Ron; Sopik, Victoria; Narod, Steven A

    2016-11-01

    Epithelial ovarian cancers can be divided into the more common, aggressive type II cancers and the less common, slow-growing type I cancers. Under this model, serous ovarian carcinomas can be subdivided into high-grade (type II) and low-grade (type I) tumours. The two-tier system for grading serous ovarian carcinomas is superior to more detailed grading systems in terms of predicting survival. Low-grade serous carcinomas typically present in young women and have a relatively good prognosis, despite being resistant to chemotherapy. Low-grade serous cancers have a high prevalence of KRAS and BRAF mutations, but a low prevalence of TP53 mutations (which are characteristic of high-grade serous cancers). Among women with low-grade serous ovarian cancer, the presence of a KRAS/BRAF mutation is a favorable prognostic factor. Studies of the mitogen-activated protein kinase (MAPK) inhibitor in low-grade serous ovarian cancer suggest that identifying MAPK mutations might eventually be useful in guiding treatment. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Clinical and Dosimetric Predictors of Acute Severe Lymphopenia During Radiation Therapy and Concurrent Temozolomide for High-Grade Glioma

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Huang, Jiayi, E-mail: jhuang@radonc.wustl.edu; DeWees, Todd A.; Badiyan, Shahed N.

    Purpose: Acute severe lymphopenia (ASL) frequently develops during radiation therapy (RT) and concurrent temozolomide (TMZ) for high-grade glioma (HGG) and is associated with decreased survival. The current study was designed to identify potential predictors of ASL, with a focus on actionable RT-specific dosimetric parameters. Methods and Materials: From January 2007 to December 2012, 183 patients with HGG were treated with RT+TMZ and had available data including total lymphocyte count (TLC) and radiation dose-volume histogram parameters. ASL was defined as TLC of <500/μL within the first 3 months from the start of RT. Stepwise logistic regression analysis was used to determine themore » most important predictors of ASL. Results: Fifty-three patients (29%) developed ASL. Patients with ASL had significantly worse overall survival than those without (median: 12.5 vs 20.2 months, respectively, P<.001). Stepwise logistic regression analysis identified female sex (odds ratio [OR]: 5.30; 95% confidence interval [CI]: 2.46-11.41), older age (OR: 1.05; 95% CI: 1.02-1.09), lower baseline TLC (OR: 0.92; 95% CI: 0.87-0.98), and higher brain volume receiving 25 Gy (V{sub 25Gy}) (OR: 1.03; 95% CI: 1.003-1.05) as the most significant predictors for ASL. Brain V{sub 25Gy} <56% appeared to be the optimal threshold (OR: 2.36; 95% CI: 1.11-5.01), with an ASL rate of 38% versus 20% above and below this threshold, respectively (P=.006). Conclusions: Female sex, older age, lower baseline TLC, and higher brain V{sub 25Gy} are significant predictors of ASL during RT+TMZ therapy for HGG. Maintaining the V{sub 25Gy} of brain below 56% may reduce the risk of ASL.« less

  14. Comparison of graded exercise and graded exposure clinical outcomes for patients with chronic low back pain.

    PubMed

    George, Steven Z; Wittmer, Virgil T; Fillingim, Roger B; Robinson, Michael E

    2010-11-01

    Quasi-experimental clinical trial. This study compared outcomes from graded exercise and graded exposure activity prescriptions for patients participating in a multidisciplinary rehabilitation program for chronic low back pain. Our primary purpose was to investigate whether pain and disability outcomes differed based on treatment received (graded exercise or graded exposure). Our secondary purpose was to investigate if changes in selected psychological factors were associated with pain and disability outcomes. Behavioral interventions have been advocated for decreasing pain and disability from low back pain, yet relatively few comparative studies have been reported in the literature. Consecutive sample with chronic low back pain recruited over a 16-month period from an outpatient chronic pain clinic. Patients received physical therapy supplemented with either graded exercise (n=15) or graded exposure (n=18) principles. Graded exercise included general therapeutic activities and was progressed with a quota-based system. Graded exposure included specific activities that were feared due to back pain and was progressed with a hierarchical exposure paradigm. Psychological measures were pain-related fear (Fear-Avoidance Beliefs Questionnaire, Tampa Scale for Kinesiophobia, Fear of Pain Questionnaire), pain catastrophizing (Coping Strategies Questionnaire), and depressive symptoms (Beck Depression Inventory). Primary outcome measures were pain intensity (visual analog scale) and self-report of disability (modified Oswestry Disability Questionnaire). Statistically significant improvements (P<.01) were observed for pain intensity and disability at discharge. The rate of improvement did not differ based on behavioral intervention received (P>.05 for these comparisons). Overall, 50% of patients met criterion for minimally important change for pain intensity, while 30% met this criterion for disability. Change in depressive symptoms was associated with change in pain intensity

  15. Practical target location and accuracy indicator in digital close range photogrammetry using consumer grade cameras

    NASA Astrophysics Data System (ADS)

    Moriya, Gentaro; Chikatsu, Hirofumi

    2011-07-01

    Recently, pixel numbers and functions of consumer grade digital camera are amazingly increasing by modern semiconductor and digital technology, and there are many low-priced consumer grade digital cameras which have more than 10 mega pixels on the market in Japan. In these circumstances, digital photogrammetry using consumer grade cameras is enormously expected in various application fields. There is a large body of literature on calibration of consumer grade digital cameras and circular target location. Target location with subpixel accuracy had been investigated as a star tracker issue, and many target location algorithms have been carried out. It is widely accepted that the least squares models with ellipse fitting is the most accurate algorithm. However, there are still problems for efficient digital close range photogrammetry. These problems are reconfirmation of the target location algorithms with subpixel accuracy for consumer grade digital cameras, relationship between number of edge points along target boundary and accuracy, and an indicator for estimating the accuracy of normal digital close range photogrammetry using consumer grade cameras. With this motive, an empirical testing of several algorithms for target location with subpixel accuracy and an indicator for estimating the accuracy are investigated in this paper using real data which were acquired indoors using 7 consumer grade digital cameras which have 7.2 mega pixels to 14.7 mega pixels.

  16. Stress grades and design properties for lumber, round timber, and ties

    Treesearch

    David E. Kretschmann

    2010-01-01

    Round timbers, ties, and lumber sawn from a log, regardless of species and size, are quite variable in mechanical properties. Pieces may differ in strength by several hundred percent. For simplicity and economy in use, pieces of wood of similar mechanical properties are placed in categories called stress grades, which are characterized by (a) one or more sorting...

  17. Power-grade butanol recovery and utilization

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Noon, R.

    1982-02-12

    As an alternative to the traditional recovery systems, it was proposed in a previous publication that the n-butanol/acetone/ethanol fermentation products could be recovered as a power grade fuel blend and used directly as a fuel. This would affect a savings in process energy requirements because each chemical component would not have to be processed individually to technical grade purity. Further, some residual water could be tolerated in the fuel blend. To develop such a power grade fuel recovery scheme beyond the conceptual stage, the Energy Research and Resource Division of the Kansas Energy Office undertook a two-fold program to demonstratemore » and test a power grade butanol/acetone/ethanol fuel recovery system, and further to demonstrate the feasibility of using the fuel blend in a standard type engine. A development program was initiated to accomplish the following objectives: design and test an operational power grade butanol recovery plant that would operate at one liter per hour output; and test and assess the performance of power grade butanol in a spark ignition automotive engine. This project has demonstrated that recovery of a power grade butanol fuel blend is simple and can be accomplished at a considered energy advantage over ethanol. It was further demonstrated that such a power grade blend works well in a typical spark ignition engine.« less

  18. The Benefits of Standards-Based Grading: A Critical Evaluation of Modern Grading Practices

    ERIC Educational Resources Information Center

    Iamarino, Danielle L.

    2014-01-01

    This paper explores the methodology and application of an assessment philosophy known as standards-based grading, via a critical comparison of standards-based grading to other assessment philosophies commonly employed at the elementary, secondary, and post-secondary levels of education. Evidenced by examples of increased student engagement and…

  19. Aerobic Training Improved Low-Grade Inflammation in Obese Women with Intellectual Disability

    ERIC Educational Resources Information Center

    Ordonez, F. J.; Rosety, M. A.; Camacho, A.; Rosety, I.; Diaz, A. J.; Fornieles, G.; Garcia, N.; Rosety-Rodriguez, M.

    2014-01-01

    Background: Obesity is a major health problem in people with intellectual disabilities. It is also widely accepted that low-grade systemic inflammation associated to obesity plays a key role in the pathogenic mechanism of several disorders. Fortunately, physical activity has shown to improve inflammation in people with metabolic syndrome and type…

  20. The Effectiveness of Four Readiness Tests As Predictors of First Grade Academic Achievement

    ERIC Educational Resources Information Center

    Telegdy, Gabriel A.

    1975-01-01

    Results suggest that the STAR or MRT, coupled with teacher observations and the BGT, can provide a school system with an adequate screening readiness battery. Of the several skills measured by readiness tests, letter knowledge is the most predictive of actual first grade achievement. (Author)

  1. Associations of Temperament Traits and Mathematics Grades in Adolescents Are Dependent on the Rater but Independent of Motivation and Cognitive Ability

    ERIC Educational Resources Information Center

    Hintsanen, Mirka; Alatupa, Saija; Jokela, Markus; Lipsanen, Jari; Hintsa, Taina; Leino, Mare

    2012-01-01

    The current study examines associations between self- and teacher-rated temperament traits (activity, inhibition, negative emotionality, persistence, distractibility, and mood) and mathematics grades. The sample includes 310 ninth grade students (mean age 15.0) from several schools in Finland. Analyses were conducted with multilevel modeling.…

  2. Grain Grading and Handling.

    ERIC Educational Resources Information Center

    Rendleman, Matt; Legacy, James

    This publication provides an introduction to grain grading and handling for adult students in vocational and technical education programs. Organized in five chapters, the booklet provides a brief overview of the jobs performed at a grain elevator and of the techniques used to grade grain. The first chapter introduces the grain industry and…

  3. Let Grades Be Emphasized.

    ERIC Educational Resources Information Center

    Bell, Andrew John

    Though many would like to see a de-emphasis on grades in American higher education, three major reasons prevent this: student motivation, student perception, and the nature of American society. Students need extrinsic motivation and grades are the most effective of all student motivational tools. In addition, as evaluation is always oriented…

  4. Are Math Grades Cyclical?

    ERIC Educational Resources Information Center

    Adams, Gerald J.; Dial, Micah

    1998-01-01

    The cyclical nature of mathematics grades was studied for a cohort of elementary school students from a large metropolitan school district in Texas over six years (average cohort size of 8495). The study used an autoregressive integrated moving average (ARIMA) model. Results indicate that grades do exhibit a significant cyclical pattern. (SLD)

  5. Grading: Why You Should Trust Your Judgment

    ERIC Educational Resources Information Center

    Guskey, Thomas R.; Jung, Lee Ann

    2016-01-01

    Many educators consider grades calculated from statistical algorithms more accurate, objective, and reliable than grades they calculate themselves. But in this research, the authors first asked teachers to use their professional judgment to choose a summary grade for hypothetical students. When the researchers compared the teachers' grade with the…

  6. Low-grade salivary duct carcinoma or low-grade intraductal carcinoma? Review of the literature.

    PubMed

    Kuo, Ying-Ju; Weinreb, Ilan; Perez-Ordonez, Bayardo

    2013-07-01

    Low-grade salivary duct carcinoma (LG-SDC) is a rare neoplasm characterized by predominant intraductal growth, luminal ductal phenotype, bland microscopic features, and favorable clinical behavior with an appearance reminiscent of florid to atypical ductal hyperplasia to low grade intraductal breast carcinoma. LG-SDC is composed of multiple cysts, cribriform architecture with "Roman Bridges", "pseudocribriform" proliferations with floppy fenestrations or irregular slits, micropapillae with epithelial tufts, fibrovascular cores, and solid areas. Most of the tumor cells are small to medium sized with pale eosinophilic cytoplasm, and round to oval nuclei, which may contain finely dispersed or dark condensed chromatin. Foci of intermediate to high grade atypia, and invasive carcinoma or micro-invasion have been reported in up to 23 % of cases. The neoplastic cells have a ductal phenotype with coexpression of keratins and S100 protein and are surrounded by a layer of myoepithelial cells in non-invasive cases. The main differential diagnosis of LG-SDC includes cystadenoma, cystadenocarcinoma, sclerosing polycystic adenosis, salivary duct carcinoma in situ/high-grade intraductal carcinoma, and papillary-cystic variant of acinic cell carcinoma. There is no published data supporting the continuous classification of LG-SDC as a variant of cystadenocarcinoma. Given that most LG-SDC are non-invasive neoplasms; the terms "cribriform cystadenocarcinoma" and LG-SDC should be replaced by "low-grade intraductal carcinoma" (LG-IDC) of salivary gland or "low-grade intraductal carcinoma with areas of invasive carcinoma" in those cases with evidence of invasive carcinoma.

  7. Student and Faculty Perceptions of Plus/Minus Grading and Its Effect on Course Grade Point Averages

    ERIC Educational Resources Information Center

    Edgar, Leslie D.; Johnson, Donald M.; Graham, Donna L.; Dixon, Bruce L.

    2014-01-01

    In fall 2005, the Dale Bumpers College of Agricultural, Food and Life Sciences at the University of Arkansas authorized the optional use of a plus/minus grading system. Since 2005, approximately one-half of courses have been graded using plus/minus and one-half using the straight letter grade system. This study examined student (n = 338) and…

  8. Hardwood log grading scale stick improved

    Treesearch

    M. D. Ostrander; G. H. Englerth

    1953-01-01

    In February 1952 the Northeastern Forest Experiment Station described ( Research Note 13) a new log-grading scale stick developed by the Station for use as a visual aid in grading hardwood factory logs. It was based on the U. S. Forest Products Laboratory's log-grade specifications.

  9. The 2014 International Society of Urological Pathology (ISUP) Consensus Conference on Gleason Grading of Prostatic Carcinoma: Definition of Grading Patterns and Proposal for a New Grading System.

    PubMed

    Epstein, Jonathan I; Egevad, Lars; Amin, Mahul B; Delahunt, Brett; Srigley, John R; Humphrey, Peter A

    2016-02-01

    In November, 2014, 65 prostate cancer pathology experts, along with 17 clinicians including urologists, radiation oncologists, and medical oncologists from 19 different countries gathered in a consensus conference to update the grading of prostate cancer, last revised in 2005. The major conclusions were: (1) Cribriform glands should be assigned a Gleason pattern 4, regardless of morphology; (2) Glomeruloid glands should be assigned a Gleason pattern 4, regardless of morphology; (3) Grading of mucinous carcinoma of the prostate should be based on its underlying growth pattern rather than grading them all as pattern 4; and (4) Intraductal carcinoma of the prostate without invasive carcinoma should not be assigned a Gleason grade and a comment as to its invariable association with aggressive prostate cancer should be made. Regarding morphologies of Gleason patterns, there was clear consensus on: (1) Gleason pattern 4 includes cribriform, fused, and poorly formed glands; (2) The term hypernephromatoid cancer should not be used; (3) For a diagnosis of Gleason pattern 4, it needs to be seen at 10x lens magnification; (4) Occasional/seemingly poorly formed or fused glands between well-formed glands is insufficient for a diagnosis of pattern 4; (5) In cases with borderline morphology between Gleason pattern 3 and pattern 4 and crush artifacts, the lower grade should be favored; (6) Branched glands are allowed in Gleason pattern 3; (7) Small solid cylinders represent Gleason pattern 5; (8) Solid medium to large nests with rosette-like spaces should be considered to represent Gleason pattern 5; and (9) Presence of unequivocal comedonecrosis, even if focal is indicative of Gleason pattern 5. It was recognized by both pathologists and clinicians that despite the above changes, there were deficiencies with the Gleason system. The Gleason grading system ranges from 2 to 10, yet 6 is the lowest score currently assigned. When patients are told that they have a Gleason score 6 out

  10. GRADE equity guidelines 1: considering health equity in GRADE guideline development: introduction and rationale.

    PubMed

    Welch, Vivian A; Akl, Elie A; Guyatt, Gordon; Pottie, Kevin; Eslava-Schmalbach, Javier; Ansari, Mohammed T; de Beer, Hans; Briel, Matthias; Dans, Tony; Dans, Inday; Hultcrantz, Monica; Jull, Janet; Katikireddi, Srinivasa Vittal; Meerpohl, Joerg; Morton, Rachael; Mosdol, Annhild; Petkovic, Jennifer; Schünemann, Holger J; Sharaf, Ravi N; Singh, Jasvinder A; Stanev, Roger; Tonia, Thomy; Tristan, Mario; Vitols, Sigurd; Watine, Joseph; Tugwell, Peter

    2017-10-01

    This article introduces the rationale and methods for explicitly considering health equity in the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology for development of clinical, public health, and health system guidelines. We searched for guideline methodology articles, conceptual articles about health equity, and examples of guidelines that considered health equity explicitly. We held three meetings with GRADE Working Group members and invited comments from the GRADE Working Group listserve. We developed three articles on incorporating equity considerations into the overall approach to guideline development, rating certainty, and assembling the evidence base and evidence to decision and/or recommendation. Clinical and public health guidelines have a role to play in promoting health equity by explicitly considering equity in the process of guideline development. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  11. 7 CFR 51.1578 - Off-Grade potatoes.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 2 2014-01-01 2014-01-01 false Off-Grade potatoes. 51.1578 Section 51.1578... (INSPECTION, CERTIFICATION, AND STANDARDS) United States Consumer Standards for Potatoes Off-Grade § 51.1578 Off-Grade potatoes. Potatoes which fail to meet the requirements of any of the foregoing grades shall...

  12. 7 CFR 51.1578 - Off-Grade potatoes.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 2 2013-01-01 2013-01-01 false Off-Grade potatoes. 51.1578 Section 51.1578... (INSPECTION, CERTIFICATION, AND STANDARDS) United States Consumer Standards for Potatoes Off-Grade § 51.1578 Off-Grade potatoes. Potatoes which fail to meet the requirements of any of the foregoing grades shall...

  13. Graded levels of FGF protein span the midbrain and can instruct graded induction and repression of neural mapping labels

    PubMed Central

    Chen, Yao; Mohammadi, Moosa; Flanagan, John G.

    2009-01-01

    Summary Graded guidance labels are widely used in neural map formation, but it is not well understood which potential strategy leads to their graded expression. In midbrain tectal map development, FGFs can induce an entire midbrain, but their protein distribution is unclear, nor is it known whether they may act instructively to produce graded gene expression. Using a receptor-alkaline phosphatase fusion probe, we find a long-range posterior>anterior FGF protein gradient spanning the midbrain. Heparan sulfate proteoglycan (HSPG) is required for this gradient. To test whether graded FGF concentrations can instruct graded gene expression, a quantitative tectal explant assay was developed. Engrailed-2 and ephrin-As, normally in posterior>anterior tectal gradients, showed graded upregulation. Moreover, EphAs, normally in anterior>posterior countergradients, showed coordinately graded downregulation. These results provide a mechanism to establish graded mapping labels, and more generally provide a developmental strategy to coordinately induce a structure and pattern its cell properties in gradients. PMID:19555646

  14. Beef grading by ultrasound

    NASA Technical Reports Server (NTRS)

    Gammell, P. M.

    1981-01-01

    Reflections in ultrasonic A-scan signatures of beef carcasses indicate USDA grade. Since reflections from within muscle are determined primarily by fat/muscle interface, richness of signals is direct indication of degree of marbling and quality. Method replaces subjective sight and feel tests by individual graders and is applicable to grade analysis of live cattle.

  15. Skill Schemes: Sixth Grade.

    ERIC Educational Resources Information Center

    Kempf, Jerry

    The sixth grade instructional unit, part of a field-tested grade school level career education series, is designed to assist learners in understanding how present experiences relate to past and future ones. Before the main body of the lessons is described, field testing results are reported and key items are presented: the concepts, the estimated…

  16. Functionally graded Ti6Al4V and Inconel 625 by Laser Metal Deposition

    NASA Astrophysics Data System (ADS)

    Pulugurtha, Syamala R.

    The objective of the current work was to fabricate a crack-free functionally graded Ti6Al4V and Inconel 625 thin wall structure by Laser Metal Deposition (LMD). One potential application for the current material system is the ability to fabricate a functionally graded alloy that can be used in a space heat exchanger. The two alloys, Inconel 625 and Ti6Al4V are currently used for aerospace applications. They were chosen as candidates for grading because functionally grading those combines the properties of high strength/weight ratio of Ti6Al4V and high temperature oxidation resistance of Inconel 625 into one multifunctional material for the end application. However, there were challenges associated with the presence of Ni-Ti intermetallic phases (IMPs). The study focused on several critical areas such as (1) understanding microstructural evolution, (2) reducing macroscopic cracking, and (3) reducing mixing between graded layers. Finite element analysis (FEA) was performed to understand the effect of process conditions on multilayer claddings for simplified material systems such as SS316L and Inconel 625 where complex microstructures did not form. The thermo-mechanical models were developed using Abaqus(TM) (and some of them experimentally verified) to predict temperature-gradients; remelt layer depths and residual stresses. Microstructure evolution along the functionally graded Ti6Al4V and Inconel 625 was studied under different processing and grading conditions. Thermodynamic modeling using Factsage (v 6.1) was used to construct phase diagrams and predict the possible equilibrium major/minor phases (verified experimentally by XRD) that may be present along the functionally graded Ti6Al4V and Inconel 625 thin wall structures.

  17. Back pain in the German adult population: prevalence, severity, and sociodemographic correlates in a multiregional survey.

    PubMed

    Schmidt, Carsten Oliver; Raspe, Heiner; Pfingsten, Michael; Hasenbring, Monika; Basler, Heinz Dieter; Eich, Wolfgang; Kohlmann, Thomas

    2007-08-15

    A population-based cross-sectional multiregion postal survey. To provide a descriptive epidemiology of the prevalence and severity of back pain in German adults and to analyze sociodemographic correlates for disabling back pain within and across regions. Back pain is a leading health problem in Germany. However, comprehensive population-based evidence on the severity of back pain is still fragmentary for this country. Despite earlier findings concerning large prevalence differences across regions, systematic explanations remain to be ascertained. Questionnaire data were collected for 9263 subjects in 5 German cities and regions (population-based random samples, postal questionnaire). Point, 1-year, and lifetime prevalence were assessed using direct questions, and graded back pain was determined using the Graded Chronic Pain Scale. Poststratification was applied to adjust for cross-regional sociodemographic differences. Point-prevalence was 37.1%, 1-year prevalence 76.0%, and lifetime prevalence 85.5%. A substantial minority had severe (Grade II, 8.0%) or disabling back pain (Grade III-IV, 11.2%). Subjects with a low educational level reported substantially more disabling back pain. This variable was an important predictor for large cross-regional differences in the burden of back pain. Back pain is a highly prevalent condition in Germany. Disabling back pain in this country may be regarded as part of a social disadvantage syndrome. Educational level should receive greater attention in future cross-regional comparisons of back pain.

  18. Changes in verbal and visuospatial working memory from Grade 1 to Grade 3 of primary school: Population longitudinal study.

    PubMed

    Nicolaou, E; Quach, J; Lum, J; Roberts, G; Spencer-Smith, M; Gathercole, S; Anderson, P J; Mensah, F K; Wake, M

    2018-05-01

    Adaptive working memory training is being implemented without an adequate understanding of developmental trajectories of working memory. We aimed to quantify from Grade 1 to Grade 3 of primary school (1) changes in verbal and visuospatial working memory and (2) whether low verbal and visuospatial working memory in Grade 1 predicts low working memory in Grade 3. The study design includes a population-based longitudinal study of 1,802 children (66% uptake from all 2,747 Grade 1 students) at 44 randomly selected primary schools in Melbourne, Australia. Backwards Digit Recall (verbal working memory) and Mister X (visuospatial working memory) screening measures from the Automated Working Memory Assessment (M = 100; SD = 15) were used to assess Grades 1 and 3 (ages 6-7 and 8-9 years) students. Low working memory was defined as ≥1 standard deviation below the standard score mean. Descriptive statistics addressed Aim 1, and predictive parameters addressed Aim 2. One thousand seventy (59%) of 1802 Grade 1 participants were reassessed in Grade 3. As expected for typically developing children, group mean standard scores were similar in Grades 1 and 3 for verbal, visuospatial, and overall working memory, but group mean raw scores increased markedly. Compared to "not low" children, those classified as having low working memory in Grade 1 showed much larger increases in both standard and raw scores across verbal, visuospatial, and overall working memory. Sensitivity was very low for Grade 1 low working memory predicting Grade 3 low classifications. Although mean changes in working memory standard scores between Grades 1 and 3 were minimal, we found that individual development varied widely, with marked natural resolution by Grade 3 in children who initially had low working memory. This may render brain-training interventions ineffective in the early school year ages, particularly if (as population-based programmes usually mandate) selection occurs within a screening

  19. 7 CFR 52.772 - Grades.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... PROCESSED FRUITS AND VEGETABLES, PROCESSED PRODUCTS THEREOF, AND CERTAIN OTHER PROCESSED FOOD PRODUCTS 1 United States Standards for Grades of Canned Red Tart Pitted Cherries 1 Identity and Grades § 52.772...

  20. 7 CFR 52.772 - Grades.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... PROCESSED FRUITS AND VEGETABLES, PROCESSED PRODUCTS THEREOF, AND CERTAIN OTHER PROCESSED FOOD PRODUCTS 1 United States Standards for Grades of Canned Red Tart Pitted Cherries 1 Identity and Grades § 52.772...

  1. Science for Iowa Schools, Grades 4-6.

    ERIC Educational Resources Information Center

    Nice, Karl; And Others

    This guide includes four units for use in each of grades 4 through 6. The fourth grade units are entitled Measurement Systems, Classification Systems, Bio-Control Systems, and Hydrologic Systems; the fifth grade units are Chemical Systems, Force Systems, Bio-Systems, and Astro-Systems; and the sixth grade units are Equilibrium Systems,…

  2. Grading Practices--Watching Out for Land Mines.

    ERIC Educational Resources Information Center

    Nottingham, Marv

    1988-01-01

    The A to F grading pattern is a highly subjective practice that demands great expertise and assumes a high degree of test validity. This article discusses the merits of extra credit assignments, homework, and "pop" quizzes; outlines defensible grading procedures; and discusses common grading problems, such as using grades as weapons. (MLH)

  3. Grade Inflation: Metaphor and Reality

    ERIC Educational Resources Information Center

    Kamber, Richard; Biggs, Mary

    2003-01-01

    Grade inflation has become a general term for teachers and administrators in recent times and is an ambiguous denomination which needs to be identified. The allegory and reality of grade inflation is discussed.

  4. Pallet part grading trainer

    Treesearch

    Deborah F. Cook; Philip A. Araman; Matthew F. Winn

    2000-01-01

    A computerized pallet grading training system was developed to facilitate the production of higher quality pallets. Higher quality pallets would be more durable and could be re-used many times, resulting in long-term savings. Schmoldt et al. (1993) evaluated the economic impact of grading and sorting pallet parts. They determined that higher quality pallets produced by...

  5. Grades out, Badges in

    ERIC Educational Resources Information Center

    Young, Jeffrey R.

    2012-01-01

    Grades are broken. Students grub for them, pick classes where good ones come easily, and otherwise hustle to win the highest scores for the least learning. As a result, college grades are inflated to the point of meaninglessness--especially to employers who want to know which diploma-holder is best qualified for their jobs. An alternative is to…

  6. Pediatric airway study: Endoscopic grading system for quantifying tonsillar size in comparison to standard adenotonsillar grading systems.

    PubMed

    Patel, Neha A; Carlin, Kristen; Bernstein, Joseph M

    Current grading systems may not allow clinicians to reliably document and communicate adenotonsillar size in the clinical setting. A validated endoscopic grading system may be useful for reporting tonsillar size in future clinical outcome studies. This is especially important as tonsillar enlargement is the cause of a substantial health care burden on children. To propose and validate an easy-to-use flexible fiberoptic endoscopic grading system that provides physicians with a more accurate sense of the three-dimensional relationship of the tonsillar fossa to the upper-airway. 50 consecutive pediatric patients were prospectively recruited between February 2015 and February 2016 at a pediatric otolaryngology outpatient clinic. The patients had no major craniofacial abnormalities and were aged 1 to 16years. Each patient had data regarding BMI, Friedman palate position, OSA-18 survey results collected. For each child, digital video clips of fiberoptic nasopharyngeal, oropharyngeal and laryngeal exams were presented to 2 examiners. Examiners were asked to independently use the proposed Endoscopic tonsillar grading system, the Brodsky tonsillar grading scale, the Modified Brodsky tonsillar grading scale with a tongue depressor, and the Parikh adenoid grading system to rate adenotonsillar hypertrophy. Cohen's Kappa and weighted Kappa scores were used to assess interrater reliability for each of the four grading scales. The Spearman correlation was used to test the associations between each scale and OSA-18 scores, as well as Body Mass Index (BMI). 50 pediatric patients were included in this study (mean age 6.1years, range of 1year to 16years). The average BMI was 20. The average OSA-18 score was 61.7. The average Friedman palate position score was 1.34. Twelve percent of the patients had a Friedman palate position score≥3, which made traditional Brodsky grading of their tonsils impossible without a tongue depressor. All four scales showed strong agreement between the

  7. 7 CFR 868.312 - Grade and grade requirements for the class Screenings Milled Rice. (See also § 868.315.)

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Milled Rice. (See also § 868.315.) 868.312 Section 868.312 Agriculture Regulations of the Department of... United States Standards for Milled Rice Principles Governing Application of Standards § 868.312 Grade and grade requirements for the class Screenings Milled Rice. (See also § 868.315.) Grades, Grade...

  8. 7 CFR 868.313 - Grades and grade requirements for the class Brewers Milled Rice. (See also § 868.315.)

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Milled Rice. (See also § 868.315.) 868.313 Section 868.313 Agriculture Regulations of the Department of... United States Standards for Milled Rice Principles Governing Application of Standards § 868.313 Grades and grade requirements for the class Brewers Milled Rice. (See also § 868.315.) Grades, Grade...

  9. 7 CFR 868.312 - Grade and grade requirements for the class Screenings Milled Rice. (See also § 868.315.)

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Milled Rice. (See also § 868.315.) 868.312 Section 868.312 Agriculture Regulations of the Department of... United States Standards for Milled Rice Principles Governing Application of Standards § 868.312 Grade and grade requirements for the class Screenings Milled Rice. (See also § 868.315.) Grades, Grade...

  10. 7 CFR 868.313 - Grades and grade requirements for the class Brewers Milled Rice. (See also § 868.315.)

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Milled Rice. (See also § 868.315.) 868.313 Section 868.313 Agriculture Regulations of the Department of... United States Standards for Milled Rice Principles Governing Application of Standards § 868.313 Grades and grade requirements for the class Brewers Milled Rice. (See also § 868.315.) Grades, Grade...

  11. Does Competition among Schools Encourage Grade Inflation?

    ERIC Educational Resources Information Center

    Walsh, Patrick

    2010-01-01

    This paper considers whether high schools in competitive environments use grade inflation to attract and retain families, perhaps in addition to more constructive responses. Two measures of grade inflation are used: the cutoffs used by each school to assign a letter grade to a percent score and high school grade point average after controlling for…

  12. Teaching More by Grading Less (or Differently)

    ERIC Educational Resources Information Center

    Schinske, Jeffrey; Tanner, Kimberly

    2014-01-01

    This article explores a brief history of grading in higher education in the United States. Authors, Schinske and Tanner then follow up with considerations of the potential purposes of grading and insights from research literature that has explored the influence of grading on teaching and learning. Schinske and Tanner then ask: Does grading provide…

  13. Acute posterior cruciate ligament injuries: effect of location, severity, and associated injuries on surgical management.

    PubMed

    Anderson, Mark A; Simeone, F Joseph; Palmer, William E; Chang, Connie Y

    2018-06-01

    To correlate MRI findings of patients with posterior cruciate ligament (PCL) injury and surgical management. A retrospective search yielded 79 acute PCL injuries (36 ± 16 years old, 21 F, 58 M). Two independent readers graded PCL tear location (proximal, middle, or distal third) and severity (low-grade or high-grade partial/complete) and evaluated injury of other knee structures. When available, operative reports were examined and the performed surgical procedure was compared with injury grade, location, and presence of associated injuries. The most commonly injured knee structures in acute PCL tears were posterolateral corner (58/79, 73%) and anterior cruciate ligament (ACL) (48/79, 61%). Of the 64 patients with treatment information, 31/64 (48%) were managed surgically: 12/31 (39%) had PCL reconstruction, 13/31 (42%) had ACL reconstruction, 10/31 (32%) had posterolateral corner reconstruction, 9/31 (29%) had LCL reconstruction, 8/31 (26%) had meniscectomy, and 8/31 (26%) had fixation of a fracture. Proximal third PCL tear and multiligamentous injury were more commonly associated with surgical management (P < 0.05). Posterolateral and posteromedial corner, ACL, collateral ligament, meniscus, patellar retinaculum, and gastrocnemius muscle injury, and fracture were more likely to result in surgical management (P < 0.05). Patients with high-grade partial/complete PCL tear were more likely to have PCL reconstruction as a portion of surgical management (P < 0.05). Location of PCL tear and presence of other knee injuries were associated with surgical management while high-grade/complete PCL tear grade was associated with PCL reconstruction. MRI reporting of PCL tear location, severity, and of other knee structure injuries is important for guiding clinical management.

  14. 7 CFR 28.464 - Leaf Grade 4.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 2 2013-01-01 2013-01-01 false Leaf Grade 4. 28.464 Section 28.464 Agriculture..., TESTING, AND STANDARDS Standards Official Cotton Standards of the United States for the Leaf Grade of American Upland Cotton § 28.464 Leaf Grade 4. Leaf Grade 4 is leaf which is within the range represented by...

  15. 7 CFR 28.465 - Leaf Grade 5.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 2 2011-01-01 2011-01-01 false Leaf Grade 5. 28.465 Section 28.465 Agriculture..., TESTING, AND STANDARDS Standards Official Cotton Standards of the United States for the Leaf Grade of American Upland Cotton § 28.465 Leaf Grade 5. Leaf Grade 5 is leaf which is within the range represented by...

  16. 7 CFR 28.467 - Leaf Grade 7.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 2 2014-01-01 2014-01-01 false Leaf Grade 7. 28.467 Section 28.467 Agriculture..., TESTING, AND STANDARDS Standards Official Cotton Standards of the United States for the Leaf Grade of American Upland Cotton § 28.467 Leaf Grade 7. Leaf Grade 7 is leaf which is within the range represented by...

  17. 7 CFR 28.463 - Leaf Grade 3.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 2 2013-01-01 2013-01-01 false Leaf Grade 3. 28.463 Section 28.463 Agriculture..., TESTING, AND STANDARDS Standards Official Cotton Standards of the United States for the Leaf Grade of American Upland Cotton § 28.463 Leaf Grade 3. Leaf Grade 3 is leaf which is within the range represented by...

  18. 7 CFR 28.462 - Leaf Grade 2.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 2 2012-01-01 2012-01-01 false Leaf Grade 2. 28.462 Section 28.462 Agriculture..., TESTING, AND STANDARDS Standards Official Cotton Standards of the United States for the Leaf Grade of American Upland Cotton § 28.462 Leaf Grade 2. Leaf Grade 2 is leaf which is within the range represented by...

  19. 7 CFR 28.462 - Leaf Grade 2.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 2 2011-01-01 2011-01-01 false Leaf Grade 2. 28.462 Section 28.462 Agriculture..., TESTING, AND STANDARDS Standards Official Cotton Standards of the United States for the Leaf Grade of American Upland Cotton § 28.462 Leaf Grade 2. Leaf Grade 2 is leaf which is within the range represented by...

  20. 7 CFR 28.465 - Leaf Grade 5.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Leaf Grade 5. 28.465 Section 28.465 Agriculture..., TESTING, AND STANDARDS Standards Official Cotton Standards of the United States for the Leaf Grade of American Upland Cotton § 28.465 Leaf Grade 5. Leaf Grade 5 is leaf which is within the range represented by...

  1. 7 CFR 28.464 - Leaf Grade 4.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 2 2014-01-01 2014-01-01 false Leaf Grade 4. 28.464 Section 28.464 Agriculture..., TESTING, AND STANDARDS Standards Official Cotton Standards of the United States for the Leaf Grade of American Upland Cotton § 28.464 Leaf Grade 4. Leaf Grade 4 is leaf which is within the range represented by...

  2. 7 CFR 28.462 - Leaf Grade 2.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Leaf Grade 2. 28.462 Section 28.462 Agriculture..., TESTING, AND STANDARDS Standards Official Cotton Standards of the United States for the Leaf Grade of American Upland Cotton § 28.462 Leaf Grade 2. Leaf Grade 2 is leaf which is within the range represented by...

  3. 7 CFR 28.465 - Leaf Grade 5.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 2 2013-01-01 2013-01-01 false Leaf Grade 5. 28.465 Section 28.465 Agriculture..., TESTING, AND STANDARDS Standards Official Cotton Standards of the United States for the Leaf Grade of American Upland Cotton § 28.465 Leaf Grade 5. Leaf Grade 5 is leaf which is within the range represented by...

  4. 7 CFR 28.463 - Leaf Grade 3.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 2 2011-01-01 2011-01-01 false Leaf Grade 3. 28.463 Section 28.463 Agriculture..., TESTING, AND STANDARDS Standards Official Cotton Standards of the United States for the Leaf Grade of American Upland Cotton § 28.463 Leaf Grade 3. Leaf Grade 3 is leaf which is within the range represented by...

  5. 7 CFR 28.462 - Leaf Grade 2.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 2 2013-01-01 2013-01-01 false Leaf Grade 2. 28.462 Section 28.462 Agriculture..., TESTING, AND STANDARDS Standards Official Cotton Standards of the United States for the Leaf Grade of American Upland Cotton § 28.462 Leaf Grade 2. Leaf Grade 2 is leaf which is within the range represented by...

  6. 7 CFR 28.464 - Leaf Grade 4.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 2 2011-01-01 2011-01-01 false Leaf Grade 4. 28.464 Section 28.464 Agriculture..., TESTING, AND STANDARDS Standards Official Cotton Standards of the United States for the Leaf Grade of American Upland Cotton § 28.464 Leaf Grade 4. Leaf Grade 4 is leaf which is within the range represented by...

  7. 7 CFR 28.463 - Leaf Grade 3.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Leaf Grade 3. 28.463 Section 28.463 Agriculture..., TESTING, AND STANDARDS Standards Official Cotton Standards of the United States for the Leaf Grade of American Upland Cotton § 28.463 Leaf Grade 3. Leaf Grade 3 is leaf which is within the range represented by...

  8. 7 CFR 28.466 - Leaf Grade 6.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 2 2012-01-01 2012-01-01 false Leaf Grade 6. 28.466 Section 28.466 Agriculture..., TESTING, AND STANDARDS Standards Official Cotton Standards of the United States for the Leaf Grade of American Upland Cotton § 28.466 Leaf Grade 6. Leaf Grade 6 is leaf which is within the range represented by...

  9. 7 CFR 28.461 - Leaf Grade 1.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 2 2011-01-01 2011-01-01 false Leaf Grade 1. 28.461 Section 28.461 Agriculture..., TESTING, AND STANDARDS Standards Official Cotton Standards of the United States for the Leaf Grade of American Upland Cotton § 28.461 Leaf Grade 1. Leaf Grade 1 is leaf which is within the range represented by...

  10. 7 CFR 28.461 - Leaf Grade 1.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Leaf Grade 1. 28.461 Section 28.461 Agriculture..., TESTING, AND STANDARDS Standards Official Cotton Standards of the United States for the Leaf Grade of American Upland Cotton § 28.461 Leaf Grade 1. Leaf Grade 1 is leaf which is within the range represented by...

  11. 7 CFR 28.461 - Leaf Grade 1.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 2 2012-01-01 2012-01-01 false Leaf Grade 1. 28.461 Section 28.461 Agriculture..., TESTING, AND STANDARDS Standards Official Cotton Standards of the United States for the Leaf Grade of American Upland Cotton § 28.461 Leaf Grade 1. Leaf Grade 1 is leaf which is within the range represented by...

  12. 7 CFR 28.465 - Leaf Grade 5.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 2 2012-01-01 2012-01-01 false Leaf Grade 5. 28.465 Section 28.465 Agriculture..., TESTING, AND STANDARDS Standards Official Cotton Standards of the United States for the Leaf Grade of American Upland Cotton § 28.465 Leaf Grade 5. Leaf Grade 5 is leaf which is within the range represented by...

  13. 7 CFR 28.463 - Leaf Grade 3.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 2 2012-01-01 2012-01-01 false Leaf Grade 3. 28.463 Section 28.463 Agriculture..., TESTING, AND STANDARDS Standards Official Cotton Standards of the United States for the Leaf Grade of American Upland Cotton § 28.463 Leaf Grade 3. Leaf Grade 3 is leaf which is within the range represented by...

  14. 7 CFR 28.467 - Leaf Grade 7.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 2 2011-01-01 2011-01-01 false Leaf Grade 7. 28.467 Section 28.467 Agriculture..., TESTING, AND STANDARDS Standards Official Cotton Standards of the United States for the Leaf Grade of American Upland Cotton § 28.467 Leaf Grade 7. Leaf Grade 7 is leaf which is within the range represented by...

  15. 7 CFR 28.467 - Leaf Grade 7.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 2 2013-01-01 2013-01-01 false Leaf Grade 7. 28.467 Section 28.467 Agriculture..., TESTING, AND STANDARDS Standards Official Cotton Standards of the United States for the Leaf Grade of American Upland Cotton § 28.467 Leaf Grade 7. Leaf Grade 7 is leaf which is within the range represented by...

  16. 7 CFR 28.466 - Leaf Grade 6.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 2 2014-01-01 2014-01-01 false Leaf Grade 6. 28.466 Section 28.466 Agriculture..., TESTING, AND STANDARDS Standards Official Cotton Standards of the United States for the Leaf Grade of American Upland Cotton § 28.466 Leaf Grade 6. Leaf Grade 6 is leaf which is within the range represented by...

  17. 7 CFR 28.465 - Leaf Grade 5.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 2 2014-01-01 2014-01-01 false Leaf Grade 5. 28.465 Section 28.465 Agriculture..., TESTING, AND STANDARDS Standards Official Cotton Standards of the United States for the Leaf Grade of American Upland Cotton § 28.465 Leaf Grade 5. Leaf Grade 5 is leaf which is within the range represented by...

  18. 7 CFR 28.462 - Leaf Grade 2.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 2 2014-01-01 2014-01-01 false Leaf Grade 2. 28.462 Section 28.462 Agriculture..., TESTING, AND STANDARDS Standards Official Cotton Standards of the United States for the Leaf Grade of American Upland Cotton § 28.462 Leaf Grade 2. Leaf Grade 2 is leaf which is within the range represented by...

  19. 7 CFR 28.463 - Leaf Grade 3.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 2 2014-01-01 2014-01-01 false Leaf Grade 3. 28.463 Section 28.463 Agriculture..., TESTING, AND STANDARDS Standards Official Cotton Standards of the United States for the Leaf Grade of American Upland Cotton § 28.463 Leaf Grade 3. Leaf Grade 3 is leaf which is within the range represented by...

  20. 7 CFR 28.464 - Leaf Grade 4.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 2 2012-01-01 2012-01-01 false Leaf Grade 4. 28.464 Section 28.464 Agriculture..., TESTING, AND STANDARDS Standards Official Cotton Standards of the United States for the Leaf Grade of American Upland Cotton § 28.464 Leaf Grade 4. Leaf Grade 4 is leaf which is within the range represented by...

  1. 7 CFR 28.461 - Leaf Grade 1.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 2 2013-01-01 2013-01-01 false Leaf Grade 1. 28.461 Section 28.461 Agriculture..., TESTING, AND STANDARDS Standards Official Cotton Standards of the United States for the Leaf Grade of American Upland Cotton § 28.461 Leaf Grade 1. Leaf Grade 1 is leaf which is within the range represented by...

  2. 7 CFR 28.466 - Leaf Grade 6.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Leaf Grade 6. 28.466 Section 28.466 Agriculture..., TESTING, AND STANDARDS Standards Official Cotton Standards of the United States for the Leaf Grade of American Upland Cotton § 28.466 Leaf Grade 6. Leaf Grade 6 is leaf which is within the range represented by...

  3. 7 CFR 28.464 - Leaf Grade 4.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Leaf Grade 4. 28.464 Section 28.464 Agriculture..., TESTING, AND STANDARDS Standards Official Cotton Standards of the United States for the Leaf Grade of American Upland Cotton § 28.464 Leaf Grade 4. Leaf Grade 4 is leaf which is within the range represented by...

  4. 7 CFR 28.466 - Leaf Grade 6.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 2 2011-01-01 2011-01-01 false Leaf Grade 6. 28.466 Section 28.466 Agriculture..., TESTING, AND STANDARDS Standards Official Cotton Standards of the United States for the Leaf Grade of American Upland Cotton § 28.466 Leaf Grade 6. Leaf Grade 6 is leaf which is within the range represented by...

  5. 7 CFR 28.466 - Leaf Grade 6.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 2 2013-01-01 2013-01-01 false Leaf Grade 6. 28.466 Section 28.466 Agriculture..., TESTING, AND STANDARDS Standards Official Cotton Standards of the United States for the Leaf Grade of American Upland Cotton § 28.466 Leaf Grade 6. Leaf Grade 6 is leaf which is within the range represented by...

  6. 7 CFR 28.467 - Leaf Grade 7.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 2 2012-01-01 2012-01-01 false Leaf Grade 7. 28.467 Section 28.467 Agriculture..., TESTING, AND STANDARDS Standards Official Cotton Standards of the United States for the Leaf Grade of American Upland Cotton § 28.467 Leaf Grade 7. Leaf Grade 7 is leaf which is within the range represented by...

  7. 7 CFR 28.461 - Leaf Grade 1.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 2 2014-01-01 2014-01-01 false Leaf Grade 1. 28.461 Section 28.461 Agriculture..., TESTING, AND STANDARDS Standards Official Cotton Standards of the United States for the Leaf Grade of American Upland Cotton § 28.461 Leaf Grade 1. Leaf Grade 1 is leaf which is within the range represented by...

  8. 7 CFR 28.467 - Leaf Grade 7.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Leaf Grade 7. 28.467 Section 28.467 Agriculture..., TESTING, AND STANDARDS Standards Official Cotton Standards of the United States for the Leaf Grade of American Upland Cotton § 28.467 Leaf Grade 7. Leaf Grade 7 is leaf which is within the range represented by...

  9. Damage tolerant functionally graded materials for advanced wear and friction applications

    NASA Astrophysics Data System (ADS)

    Prchlik, Lubos

    The research work presented in this dissertation focused on processing effects, microstructure development, characterization and performance evaluation of composite and graded coatings used for friction and wear control. The following issues were addressed. (1) Definition of prerequisites for a successful composite and graded coating formation by means of thermal spraying. (2) Improvement of characterization methods available for homogenous thermally sprayed coating and their extension to composite and graded materials. (3) Development of novel characterization methods specifically for FGMs, with a focus on through thickness property measurement by indentation and in-situ curvature techniques. (4) Design of composite materials with improved properties compared to homogenous coatings. (5) Fabrication and performance assessment of FGM with improved wear and impact damage properties. Materials. The materials studied included several material systems relevant to low friction and contact damage tolerant applications: MO-Mo2C, WC-Co cermets as materials commonly used sliding components of industrial machinery and NiCrAlY/8%-Yttria Partially Stabilized Zirconia composites as a potential solution for abradable sections of gas turbines and aircraft engines. In addition, uniform coatings such as molybdenum and Ni5%Al alloy were evaluated as model system to assess the influence of microstructure variation onto the mechanical property and wear response. Methods. The contact response of the materials was investigated through several techniques. These included methods evaluating the relevant intrinsic coating properties such as elastic modulus, residual stress, fracture toughness, scratch resistance and tests measuring the abrasion and friction-sliding behavior. Dry-sand and wet two-body abrasion testing was performed in addition to traditional ball on disc sliding tests. Among all characterization techniques the spherical indentation deserved most attention and enabled to

  10. Increased anatomic severity predicts outcomes: Validation of the American Association for the Surgery of Trauma's Emergency General Surgery score in appendicitis.

    PubMed

    Hernandez, Matthew C; Aho, Johnathon M; Habermann, Elizabeth B; Choudhry, Asad J; Morris, David S; Zielinski, Martin D

    2017-01-01

    Determination and reporting of disease severity in emergency general surgery lacks standardization. Recently, the American Association for the Surgery of Trauma (AAST) proposed an anatomic severity grading system. We aimed to validate this system in patients with appendicitis and determine if cross-sectional imaging correlates with disease severity at operation. Patients 18 years or older undergoing treatment for acute appendicitis between 2013 and 2015 were identified. Baseline demographics, procedure types were recorded, and AAST grades were assigned based on intraoperative and radiologic findings. Outcomes including length of stay, 30-day mortality, and complications based on Clavien-Dindo categories and National Surgical Quality Improvement Program variables. Summary statistical univariate, nominal logistic, and standard least squares analyses were performed comparing AAST grade with key outcomes. Bland-Altman analysis compared operative findings with preoperative cross-sectional imaging to compare assigning grades. Three hundred thirty-four patients with mean (±SD) age of 39.3 years (±16.5) were included (53% men), and all patients had cross-sectional imaging. Two hundred ninety-nine underwent appendectomy, and 85% completed laparoscopic. Thirty-day mortality rate was 0.9%, complication rate was 21%. Increased (median [interquartile range, IQR]) AAST grade was recorded in patients with complications (2 [1-4]) compared with those without (1 [1-1], p = 0.001). For operative management, (median [IQR]) AAST grades were significantly associated with procedure type: laparoscopic (1 [1-1]), open (4 [2-5]), conversion to open (3 [1-4], p = 0.001). Increased (median [IQR]) AAST grades were significantly associated in nonoperative management: patients having a complication had a higher median AAST grade (4 [3-5]) compared with those without (3 [2-3], p = 0.001). Bland-Altman analysis comparing AAST grade and cross-sectional imaging demonstrated no difference (-0.02

  11. 55. Virginia Route 688 grade separation structure. This structure, built ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    55. Virginia Route 688 grade separation structure. This structure, built in 1960, is an example of several concrete box culverts built primarily in the late 1950's and early 1960's. They are simply plain concrete with now ornamentation. These structures were used only on lesser used secondary paved roads or dirt roads. View is looking south. - Blue Ridge Parkway, Between Shenandoah National Park & Great Smoky Mountains, Asheville, Buncombe County, NC

  12. Hyperthyroid vs hypothyroid eye disease: the same severity and activity

    PubMed Central

    Kashkouli, M B; Pakdel, F; Kiavash, V; Heidari, I; Heirati, A; Jam, S

    2011-01-01

    Purpose To compare demographics, severity, and activity of thyroid eye disease (TED) in patients with hyperthyroidism (Hr-TED) vs primary hypothyroidism (Ho-TED). Patients and Methods In a cross-sectional study, demographics, complete eye examination, severity score (NOSPECS, total hundred eye score), clinical activity score, and Rundle grading were recorded for patients with TED and different thyroid disorders referred from an endocrinology clinic from 2003 to 2006. Results TED was clinically found in 303 patients (303/851, 35.6%). The majority of them (280/303, 92.4%) had Graves' hyperthyroidism and 23 (23/303, 7.5%) had primary hypothyroidism. Mean age, gender, mean severity score, mean activity score, Rundle grade, unilateral presentation of TED, smoking habit, mean duration of eye disease, and mean interval time of thyroid to TED were not significantly different between the two groups (0.06severity and activity scores for Hr-TED and Ho-TED imply that both groups present the same category of eye disease. PMID:21818129

  13. 7 CFR 56.4 - Basis of grading service.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... AGRICULTURAL MARKETING ACT OF 1946 AND THE EGG PRODUCTS INSPECTION ACT (CONTINUED) VOLUNTARY GRADING OF SHELL EGGS Grading of Shell Eggs General § 56.4 Basis of grading service. (a) Any grading service in... the basis of the “United States Standards, Grades, and Weight Classes for Egg Shells.” However...

  14. 7 CFR 56.4 - Basis of grading service.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... AGRICULTURAL MARKETING ACT OF 1946 AND THE EGG PRODUCTS INSPECTION ACT (CONTINUED) VOLUNTARY GRADING OF SHELL EGGS Grading of Shell Eggs General § 56.4 Basis of grading service. (a) Any grading service in... the basis of the “United States Standards, Grades, and Weight Classes for Egg Shells.” However...

  15. Serum C-reactive protein level in COPD patients stratified according to GOLD 2011 grading classification

    PubMed Central

    Lin, Yi-Hua; Wang, Wan-Yu; Hu, Su-Xian; Shi, Yong-Hong

    2016-01-01

    Background and Objective: The Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2011 grading classification has been used to evaluate the severity of patients with chronic obstructive pulmonary disease (COPD). However, little is known about the relationship between the systemic inflammation and this classification. We aimed to study the relationship between serum CRP and the components of the GOLD 2011 grading classification. Methods: C-reactive protein (CRP) levels were measured in 391 clinically stable COPD patients and in 50 controls from June 2, 2015 to October 31, 2015 in the First Affiliated Hospital of Xiamen University. The association between CRP levels and the components of the GOLD 2011 grading classification were assessed. Results: Correlation was found with the following variables: GOLD 2011 group (0.240), age (0.227), pack year (0.136), forced expiratory volume in one second % predicted (FEV1%; -0.267), forced vital capacity % predicted (-0.210), number of acute exacerbations in the past year (0.265), number of hospitalized exacerbations in the past year (0.165), British medical Research Council dyspnoea scale (0.121), COPD assessment test score (CAT, 0.233). Using multivariate analysis, FEV1% and CAT score manifested the strongest negative association with CRP levels. Conclusions: CRP levels differ in COPD patients among groups A-D based on GOLD 2011 grading classification. CRP levels are associated with several important clinical variables, of which FEV1% and CAT score manifested the strongest negative correlation. PMID:28083044

  16. Interrelation between the Poisoning Severity Score, carboxyhaemoglobin levels and in-hospital clinical course of carbon monoxide poisoning.

    PubMed

    Cevik, A A; Unluoglu, I; Yanturali, S; Kalkan, S; Sahin, A

    2006-12-01

    The aim of the present study is to evaluate the relationship between the Poisoning Severity Score (PSS) and carboxyhaemoglobin (COHb) levels in patients with carbon monoxide poisoning (COP) using outcome as the measure. The study was designed as a retrospective chart review of patients with final diagnosis of COP. Correlation of PSS and COHb levels at presentation was evaluated with collected data. Majority of the cases were grade 1 (minor) PSS (134 cases, 73.6%) and 93.4% of these patients made a complete recovery. There were six deaths (mortality 3.3%) and six in-hospital major complications (IHMCs) (3.3%) (please specify whether the complications were in the patients who died). There is moderate correlation between PSS and outcome (p < 0.001, r = 0.493). Grade 3 (severe) PSS was significantly different from other grades for outcome (six mortalities and three IHMCs). Patients classified as grade 3 and patients who died had a significantly higher mean age (p < 0.05, 41.8 +/- 23.6 and p < 0.01, 60.1 +/- 20.3, respectively). Mean COHb level of grade 3 (33.2 +/- 13.9%) was significantly higher than that of other grades (p < 0.05). COHb levels according to outcome were not different (? within the patients in grade 3). Decreased level of consciousness, acidosis, tachycardia, high glucose and leucocyte levels showed significant relation with higher PSS, COHb level and adverse outcome. We conclude that the PSS is a reliable guide in COP. Value of the PSS in COP may be enhanced if additional factors and investigations are included.

  17. Fair & Accurate Grading for Exceptional Learners

    ERIC Educational Resources Information Center

    Jung, Lee Ann; Guskey, Thomas R.

    2011-01-01

    Despite the many changes in education over the past century, grading and reporting practices have essentially remained the same. In part, this is because few teacher preparation programs offer any guidance on sound grading practices. As a result, most current grading practices are grounded in tradition, rather than research on best practice. In an…

  18. Clinicopathological relevance of tumour grading in canine osteosarcoma.

    PubMed

    Loukopoulos, P; Robinson, W F

    2007-01-01

    Tumour grading assesses biological aggressiveness and is of prognostic significance in many malignancies. The clinicopathological features of 140 primary canine osteosarcomas and their metastases were analysed, and the interrelations between them and an established grading system and its constituent parameters (mitotic index, necrosis, pleomorphism) were examined. Of these tumours, 35% were grade III (high-grade), 37% grade II and 28% grade I. Primary tumours that had metastasized were of significantly higher grade than non-metastatic osteosarcomas. Osteosarcomas belonging to the osteoblastic minimally productive subtype, but not chondroblastic or telangiectatic subtypes, differed from fibroblastic osteosarcomas in being associated with a significantly higher number of high-grade cases. Dogs younger than 4 years of age had osteosarcomas with higher grade, score and mitotic index than did older animals. Appendicular differed from axial tumours in having a higher mitotic index; distal differed from proximal tumours in being of higher grade; cranial tumours differed from tumours in most other sites in being of lower grade and lower mitotic index. Rib osteosarcomas showed a particularly high degree of necrosis. The mitotic index varied widely between tumour locations. Pleomorphism did not have prognostic merit when examined separately, as most osteosarcomas were highly pleomorphic.

  19. [The WHO/ISUP grading system for renal carcinoma].

    PubMed

    Moch, H

    2016-07-01

    Histological tumor grading is an accepted prognostic parameter of renal cell carcinoma (RCC). In 2012, the International Society of Urologic Pathologists (ISUP) proposed a novel grading system for RCC, mainly based on the evaluation of nucleoli: grade 1 tumors have nucleoli that are inconspicuous and basophilic at ×400 magnification; grade 2 tumors have nucleoli that are clearly visible at ×400 magnification and eosinophilic; grade 3 tumors have clearly visible nucleoli at ×100 magnification; and grade 4 tumors have extreme pleomorphism or rhabdoid and/or sarcomatoid morphology. This grading system was validated for clear cell renal cell carcinoma and papillary renal cell carcinoma. At the same time, the ISUP proposed not grading chromophobe renal cell carcinomas according to this system. At a consensus conference in Zurich the World Health Organization (WHO) recommended the ISUP grading system; thus, the WHO/ISUP grading system is now going to be implemented internationally. The ISUP/WHO grading system has not been validated as a prognostic parameter for other tumor subtypes, but can be used for descriptive purposes.

  20. 7 CFR 28.451 - Below Color Grade Cotton.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 2 2012-01-01 2012-01-01 false Below Color Grade Cotton. 28.451 Section 28.451... REGULATIONS COTTON CLASSING, TESTING, AND STANDARDS Standards Below Color Grade Cotton § 28.451 Below Color Grade Cotton. Below color grade cotton is American Upland cotton which is lower in color grade than Good...

  1. 7 CFR 28.471 - Below Leaf Grade Cotton.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 2 2013-01-01 2013-01-01 false Below Leaf Grade Cotton. 28.471 Section 28.471... REGULATIONS COTTON CLASSING, TESTING, AND STANDARDS Standards Below Leaf Grade Cotton § 28.471 Below Leaf Grade Cotton. Below leaf grade cotton is American Upland cotton which is lower in leaf grade than Leaf...

  2. 7 CFR 28.471 - Below Leaf Grade Cotton.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Below Leaf Grade Cotton. 28.471 Section 28.471... REGULATIONS COTTON CLASSING, TESTING, AND STANDARDS Standards Below Leaf Grade Cotton § 28.471 Below Leaf Grade Cotton. Below leaf grade cotton is American Upland cotton which is lower in leaf grade than Leaf...

  3. 7 CFR 28.451 - Below Color Grade Cotton.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 2 2011-01-01 2011-01-01 false Below Color Grade Cotton. 28.451 Section 28.451... REGULATIONS COTTON CLASSING, TESTING, AND STANDARDS Standards Below Color Grade Cotton § 28.451 Below Color Grade Cotton. Below color grade cotton is American Upland cotton which is lower in color grade than Good...

  4. 7 CFR 28.451 - Below Color Grade Cotton.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 2 2013-01-01 2013-01-01 false Below Color Grade Cotton. 28.451 Section 28.451... REGULATIONS COTTON CLASSING, TESTING, AND STANDARDS Standards Below Color Grade Cotton § 28.451 Below Color Grade Cotton. Below color grade cotton is American Upland cotton which is lower in color grade than Good...

  5. 7 CFR 28.471 - Below Leaf Grade Cotton.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 2 2011-01-01 2011-01-01 false Below Leaf Grade Cotton. 28.471 Section 28.471... REGULATIONS COTTON CLASSING, TESTING, AND STANDARDS Standards Below Leaf Grade Cotton § 28.471 Below Leaf Grade Cotton. Below leaf grade cotton is American Upland cotton which is lower in leaf grade than Leaf...

  6. 7 CFR 28.471 - Below Leaf Grade Cotton.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 2 2014-01-01 2014-01-01 false Below Leaf Grade Cotton. 28.471 Section 28.471... REGULATIONS COTTON CLASSING, TESTING, AND STANDARDS Standards Below Leaf Grade Cotton § 28.471 Below Leaf Grade Cotton. Below leaf grade cotton is American Upland cotton which is lower in leaf grade than Leaf...

  7. 7 CFR 28.471 - Below Leaf Grade Cotton.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 2 2012-01-01 2012-01-01 false Below Leaf Grade Cotton. 28.471 Section 28.471... REGULATIONS COTTON CLASSING, TESTING, AND STANDARDS Standards Below Leaf Grade Cotton § 28.471 Below Leaf Grade Cotton. Below leaf grade cotton is American Upland cotton which is lower in leaf grade than Leaf...

  8. 7 CFR 28.451 - Below Color Grade Cotton.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 2 2014-01-01 2014-01-01 false Below Color Grade Cotton. 28.451 Section 28.451... REGULATIONS COTTON CLASSING, TESTING, AND STANDARDS Standards Below Color Grade Cotton § 28.451 Below Color Grade Cotton. Below color grade cotton is American Upland cotton which is lower in color grade than Good...

  9. 7 CFR 28.451 - Below Color Grade Cotton.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Below Color Grade Cotton. 28.451 Section 28.451... REGULATIONS COTTON CLASSING, TESTING, AND STANDARDS Standards Below Color Grade Cotton § 28.451 Below Color Grade Cotton. Below color grade cotton is American Upland cotton which is lower in color grade than Good...

  10. A Curriculum Unit on Africa for the Seventh Grade. An Instructional Unit for Seventh Grade Language Arts and Eighth Grade Remedial English.

    ERIC Educational Resources Information Center

    Wilcox, Elizabeth Anne

    The document presents a unit on Africa and Ghana for seventh grade language arts and eighth grade remedial English classes. It is one of a number of interdisciplinary products developed by a summer workshop for teachers on African curriculum development. The objectives are to help rid students of stereotypes and to make them aware of the diversity…

  11. How Grading Reform Changed Our School

    ERIC Educational Resources Information Center

    Erickson, Jeffrey A.

    2011-01-01

    In the early 2000s, Minnetonka High School decided that it needed to develop a more consistent, transparent system of grading. The school focused its grading reform efforts on one principle: Grades should reflect only what a student knows and is able to do. As the school staff analyzed their policies and practices, they discovered many practices…

  12. The comprehension and production of quantifiers in isiXhosa-speaking Grade 1 learners

    PubMed Central

    Southwood, Frenette

    2016-01-01

    Background Quantifiers form part of the discourse-internal linguistic devices that children need to access and produce narratives and other classroom discourse. Little is known about the development - especially the prodiction - of quantifiers in child language, specifically in speakers of an African language. Objectives The study aimed to ascertain how well Grade 1 isiXhosa first language (L1) learners perform at the beginning and at the end of Grade 1 on quantifier comprehension and production tasks. Method Two low socioeconomic groups of L1 isiXhosa learners with either isiXhosa or English as language of learning and teaching (LOLT) were tested in February and November of their Grade 1 year with tasks targeting several quantifiers. Results The isiXhosa LOLT group comprehended no/none, any and all fully either in February or then in November of Grade 1, and they produced all assessed quantifiers in February of Grade 1. For the English LOLT group, neither the comprehension nor the production of quantifiers was mastered by the end of Grade 1, although there was a significant increase in both their comprehension and production scores. Conclusion The English LOLT group made significant progress in comprehension and production of quantifiers, but still performed worse than peers who had their L1 as LOLT. Generally, children with no or very little prior knowledge of the LOLT need either, (1) more deliberate exposure to quantifier-rich language or, (2) longer exposure to general classroom language before quantifiers can be expected to be mastered sufficiently to allow access to quantifier-related curriculum content. PMID:27245132

  13. Acne prevalence, severity and risk factors among medical students in Malaysia.

    PubMed

    Muthupalaniappen, L; Tan, H C; Puah, J W D; Apipi, M; Sohaimi, A E; Mahat, N F; Rafee, N M

    2014-01-01

    Acne is a common skin disorder which can cause physical scaring and impact the quality of life. The aim of this study is to determine the prevalence, severity and the risk factors for developing acne among medical students in Universiti Kebangsaan Malaysia (UKM). A cross sectional study among UKM medical students from academic year 1 to 5 was conducted from July 2011 to May 2012. A total of 361 students were selected by stratified cluster sampling method. Baseline data of the students, risk factors, height and weight were recorded. Acne severity was graded using the Comprehensive Acne Severity Scale (CASS). The prevalence of acne among medical students is 68.1% (n=246). Males and females were almost equally affected (1:1.1). Majority students with acne were graded as almost clear (55.7%, n=137), mild (35.0%, n=86), moderate (7.7%, n=19), and severe (1.6%, n=4). More than half of them had developed acne scars (59.0%, n= 213). Males were found to be at higher risk of developing acne compared to females (p<0.05, OR=4.734; 95%CL=2.726-8.222). They are also at higher risk of developing moderate and severe grades of acne compared to females (p=0.001). The odds for developing acne was higher when mother (p=0.029; OR=1.752; 95%CL=1.058-2.902) or father (p=0.027; OR=1.852; 95%CL=1.072-3.201) had acne. When both parents were affected by acne the odds of developing acne was 3 times. (p=0.025; OR=3.056; 95%CL=1.153-8.094). This study shows that the prevalence of acne among medical students is high. Hence, it is important to identify those at risk and provide optimal treatment to prevent scarring and possible low self esteem among these future doctors.

  14. High incidence of rickets in extremely low birth weight infants with severe parenteral nutrition-associated cholestasis and bronchopulmonary dysplasia.

    PubMed

    Lee, Soon Min; Namgung, Ran; Park, Min Soo; Eun, Ho Sun; Park, Kook In; Lee, Chul

    2012-12-01

    Risk factors for rickets of prematurity have not been re-examined since introduction of high mineral formula, particularly in ELBW infants. We analyzed the incidence and the risk factors of rickets in extremely low birth weight (ELBW) infants. As a retrospective case-control study from 2004 to 2008, risk factors were analyzed in 24 patients with rickets versus 31 patients without. The frequency of rickets in ELBW infants was 24/55 (44%). Infants with rickets were diagnosed at 48.2 ± 16.1 days of age, and improved by 85.3 ± 25.3 days. By radiologic evaluation, 29% were grade 1 rickets, 58% grade 2 and 13% grade 3. In univariate analysis, infants with rickets had significantly higher incidence of patent ductus arteriosus, parenteral nutrition associated cholestasis (PNAC), severe PNAC and moderate/severe bronchopulmonary dysplasia (BPD). In multiple regression analysis, after adjustment for gestation and birth weight, rickets significantly correlated with severe PNAC and with moderate/severe BPD. Serum peak alkaline phosphatase levels were significantly elevated in rickets (P < 0.001). In ELBW infants, the incidence of rickets of prematurity remains high and the incidence of severe PNAC and moderate/severe BPD was significantly increased 18 and 3 times, respectively.

  15. High Incidence of Rickets in Extremely Low Birth Weight Infants with Severe Parenteral Nutrition-Associated Cholestasis and Bronchopulmonary Dysplasia

    PubMed Central

    Lee, Soon Min; Park, Min Soo; Eun, Ho Sun; Park, Kook In; Lee, Chul

    2012-01-01

    Risk factors for rickets of prematurity have not been re-examined since introduction of high mineral formula, particularly in ELBW infants. We analyzed the incidence and the risk factors of rickets in extremely low birth weight (ELBW) infants. As a retrospective case-control study from 2004 to 2008, risk factors were analyzed in 24 patients with rickets versus 31 patients without. The frequency of rickets in ELBW infants was 24/55 (44%). Infants with rickets were diagnosed at 48.2 ± 16.1 days of age, and improved by 85.3 ± 25.3 days. By radiologic evaluation, 29% were grade 1 rickets, 58% grade 2 and 13% grade 3. In univariate analysis, infants with rickets had significantly higher incidence of patent ductus arteriosus, parenteral nutrition associated cholestasis (PNAC), severe PNAC and moderate/severe bronchopulmonary dysplasia (BPD). In multiple regression analysis, after adjustment for gestation and birth weight, rickets significantly correlated with severe PNAC and with moderate/severe BPD. Serum peak alkaline phosphatase levels were significantly elevated in rickets (P < 0.001). In ELBW infants, the incidence of rickets of prematurity remains high and the incidence of severe PNAC and moderate/severe BPD was significantly increased 18 and 3 times, respectively. PMID:23255857

  16. 7 CFR 56.31 - Report of grading work.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... AGRICULTURAL MARKETING ACT OF 1946 AND THE EGG PRODUCTS INSPECTION ACT (CONTINUED) VOLUNTARY GRADING OF SHELL EGGS Grading of Shell Eggs Reports § 56.31 Report of grading work. Reports of grading work performed...

  17. Low-grade osteosarcoma arising from cemento-ossifying fibroma: a case report.

    PubMed

    Lee, Yong Bin; Kim, Nam-Kyoo; Kim, Jae-Young; Kim, Hyung Jun

    2015-02-01

    Cemento-ossifying fibromas are benign tumors, and, although cases of an aggressive type have been reported, no cases of cemento-ossifying fibroma transforming into osteosarcoma have been documented previously. Low-grade osteosarcoma is a rare type of primary bone tumor, representing 1%-2% of all osteosarcomas. A 45-year-old female patient was diagnosed with cemento-ossifying fibroma, treated with mass excision several times over a period of two years and eight months, and followed up. After biopsy gathered because of signs of recurrence, she was diagnosed with low-grade osteosarcoma. The patient underwent wide excision, segmental mandibulectomy, and reconstruction with fibula free flap. The aim of this report is to raise awareness of the possibility that cemento-ossifying fibroma can transform into osteosarcoma and of the consequent necessity for careful diagnosis and treatment planning.

  18. A Comparison of Four Techniques for Producing High-Grade Furniture Core Material From Low-Grade Yellow-Poplar

    Treesearch

    Philip A. Araman

    1978-01-01

    Four Methods of converting low-grade yellow-poplar lumber into high-grade furniture core material (lumber core) were compared. High-grade core material is used in tops, shelves, doors, and drawer fronts and only minor defects are allowed. Three gang-rip first and the conventional crosscut-first manufacturing sequences were evaluated in combination with 1 Common, 2A...

  19. Fungal Tests

    MedlinePlus

    ... preparation is needed. See More See Less Accordion Title Common Questions How is it used? Fungal tests ... involving skin, nails, or mucous membranes appear, for example: Itchy, red, scaly areas of skin Nails that ...

  20. Choosing Safe Baby Gear

    MedlinePlus

    ... wall. Do not use the diamond-shaped, accordion-style gates. Your child can be seriously injured by ... Childbirth Women Men Seniors Your Health Resources Healthcare Management End-of-Life Issues Insurance & Bills Self Care ...