Sample records for adjustment method suggested

  1. Cesarean delivery rates among family physicians versus obstetricians: a population-based cohort study using instrumental variable methods

    PubMed Central

    Dawe, Russell Eric; Bishop, Jessica; Pendergast, Amanda; Avery, Susan; Monaghan, Kelly; Duggan, Norah; Aubrey-Bassler, Kris

    2017-01-01

    Background: Previous research suggests that family physicians have rates of cesarean delivery that are lower than or equivalent to those for obstetricians, but adjustments for risk differences in these analyses may have been inadequate. We used an econometric method to adjust for observed and unobserved factors affecting the risk of cesarean delivery among women attended by family physicians versus obstetricians. Methods: This retrospective population-based cohort study included all Canadian (except Quebec) hospital deliveries by family physicians and obstetricians between Apr. 1, 2006, and Mar. 31, 2009. We excluded women with multiple gestations, and newborns with a birth weight less than 500 g or gestational age less than 20 weeks. We estimated the relative risk of cesarean delivery using instrumental-variable-adjusted and logistic regression. Results: The final cohort included 776 299 women who gave birth in 390 hospitals. The risk of cesarean delivery was 27.3%, and the mean proportion of deliveries by family physicians was 26.9% (standard deviation 23.8%). The relative risk of cesarean delivery for family physicians versus obstetricians was 0.48 (95% confidence interval [CI] 0.41-0.56) with logistic regression and 1.27 (95% CI 1.02-1.57) with instrumental-variable-adjusted regression. Interpretation: Our conventional analyses suggest that family physicians have a lower rate of cesarean delivery than obstetricians, but instrumental variable analyses suggest the opposite. Because instrumental variable methods adjust for unmeasured factors and traditional methods do not, the large discrepancy between these estimates of risk suggests that clinical and/or sociocultural factors affecting the decision to perform cesarean delivery may not be accounted for in our database. PMID:29233843

  2. Comparison of Methods for Adjusting Incorrect Assignments of Items to Subtests: Oblique Multiple Group Method versus Confirmatory Common Factor Method

    ERIC Educational Resources Information Center

    Stuive, Ilse; Kiers, Henk A. L.; Timmerman, Marieke E.

    2009-01-01

    A common question in test evaluation is whether an a priori assignment of items to subtests is supported by empirical data. If the analysis results indicate the assignment of items to subtests under study is not supported by data, the assignment is often adjusted. In this study the authors compare two methods on the quality of their suggestions to…

  3. Introducing conjoint analysis method into delayed lotteries studies: its validity and time stability are higher than in adjusting.

    PubMed

    Białek, Michał; Markiewicz, Łukasz; Sawicki, Przemysław

    2015-01-01

    The delayed lotteries are much more common in everyday life than are pure lotteries. Usually, we need to wait to find out the outcome of the risky decision (e.g., investing in a stock market, engaging in a relationship). However, most research has studied the time discounting and probability discounting in isolation using the methodologies designed specifically to track changes in one parameter. Most commonly used method is adjusting, but its reported validity and time stability in research on discounting are suboptimal. The goal of this study was to introduce the novel method for analyzing delayed lotteries-conjoint analysis-which hypothetically is more suitable for analyzing individual preferences in this area. A set of two studies compared the conjoint analysis with adjusting. The results suggest that individual parameters of discounting strength estimated with conjoint have higher predictive value (Study 1 and 2), and they are more stable over time (Study 2) compared to adjusting. We discuss these findings, despite the exploratory character of reported studies, by suggesting that future research on delayed lotteries should be cross-validated using both methods.

  4. Incorporating the sampling design in weighting adjustments for panel attrition

    PubMed Central

    Chen, Qixuan; Gelman, Andrew; Tracy, Melissa; Norris, Fran H.; Galea, Sandro

    2015-01-01

    We review weighting adjustment methods for panel attrition and suggest approaches for incorporating design variables, such as strata, clusters and baseline sample weights. Design information can typically be included in attrition analysis using multilevel models or decision tree methods such as the CHAID algorithm. We use simulation to show that these weighting approaches can effectively reduce bias in the survey estimates that would occur from omitting the effect of design factors on attrition while keeping the resulted weights stable. We provide a step-by-step illustration on creating weighting adjustments for panel attrition in the Galveston Bay Recovery Study, a survey of residents in a community following a disaster, and provide suggestions to analysts in decision making about weighting approaches. PMID:26239405

  5. Introducing conjoint analysis method into delayed lotteries studies: its validity and time stability are higher than in adjusting

    PubMed Central

    Białek, Michał; Markiewicz, Łukasz; Sawicki, Przemysław

    2015-01-01

    The delayed lotteries are much more common in everyday life than are pure lotteries. Usually, we need to wait to find out the outcome of the risky decision (e.g., investing in a stock market, engaging in a relationship). However, most research has studied the time discounting and probability discounting in isolation using the methodologies designed specifically to track changes in one parameter. Most commonly used method is adjusting, but its reported validity and time stability in research on discounting are suboptimal. The goal of this study was to introduce the novel method for analyzing delayed lotteries—conjoint analysis—which hypothetically is more suitable for analyzing individual preferences in this area. A set of two studies compared the conjoint analysis with adjusting. The results suggest that individual parameters of discounting strength estimated with conjoint have higher predictive value (Study 1 and 2), and they are more stable over time (Study 2) compared to adjusting. We discuss these findings, despite the exploratory character of reported studies, by suggesting that future research on delayed lotteries should be cross-validated using both methods. PMID:25674069

  6. Two Models of Caregiver Strain and Bereavement Adjustment: A Comparison of Husband and Daughter Caregivers of Breast Cancer Hospice Patients

    ERIC Educational Resources Information Center

    Bernard, Lori L.; Guarnaccia, Charles A.

    2003-01-01

    Purpose: Caregiver bereavement adjustment literature suggests opposite models of impact of role strain on bereavement adjustment after care-recipient death--a Complicated Grief Model and a Relief Model. This study tests these competing models for husband and adult-daughter caregivers of breast cancer hospice patients. Design and Methods: This…

  7. Effects of delay and probability combinations on discounting in humans

    PubMed Central

    Cox, David J.; Dallery, Jesse

    2017-01-01

    To determine discount rates, researchers typically adjust the amount of an immediate or certain option relative to a delayed or uncertain option. Because this adjusting amount method can be relatively time consuming, researchers have developed more efficient procedures. One such procedure is a 5-trial adjusting delay procedure, which measures the delay at which an amount of money loses half of its value (e.g., $1000 is valued at $500 with a 10-year delay to its receipt). Experiment 1 (n = 212) used 5-trial adjusting delay or probability tasks to measure delay discounting of losses, probabilistic gains, and probabilistic losses. Experiment 2 (n = 98) assessed combined probabilistic and delayed alternatives. In both experiments, we compared results from 5-trial adjusting delay or probability tasks to traditional adjusting amount procedures. Results suggest both procedures produced similar rates of probability and delay discounting in six out of seven comparisons. A magnitude effect consistent with previous research was observed for probabilistic gains and losses, but not for delayed losses. Results also suggest that delay and probability interact to determine the value of money. Five-trial methods may allow researchers to assess discounting more efficiently as well as study more complex choice scenarios. PMID:27498073

  8. The barriers to and enablers of providing reasonably adjusted health services to people with intellectual disabilities in acute hospitals: evidence from a mixed-methods study

    PubMed Central

    Tuffrey-Wijne, Irene; Goulding, Lucy; Giatras, Nikoletta; Abraham, Elisabeth; Gillard, Steve; White, Sarah; Edwards, Christine; Hollins, Sheila

    2014-01-01

    Objective To identify the factors that promote and compromise the implementation of reasonably adjusted healthcare services for patients with intellectual disabilities in acute National Health Service (NHS) hospitals. Design A mixed-methods study involving interviews, questionnaires and participant observation (July 2011–March 2013). Setting Six acute NHS hospital trusts in England. Methods Reasonable adjustments for people with intellectual disabilities were identified through the literature. Data were collected on implementation and staff understanding of these adjustments. Results Data collected included staff questionnaires (n=990), staff interviews (n=68), interviews with adults with intellectual disabilities (n=33), questionnaires (n=88) and interviews (n=37) with carers of patients with intellectual disabilities, and expert panel discussions (n=42). Hospital strategies that supported implementation of reasonable adjustments did not reliably translate into consistent provision of such adjustments. Good practice often depended on the knowledge, understanding and flexibility of individual staff and teams, leading to the delivery of reasonable adjustments being haphazard throughout the organisation. Major barriers included: lack of effective systems for identifying and flagging patients with intellectual disabilities, lack of staff understanding of the reasonable adjustments that may be needed, lack of clear lines of responsibility and accountability for implementing reasonable adjustments, and lack of allocation of additional funding and resources. Key enablers were the Intellectual Disability Liaison Nurse and the ward manager. Conclusions The evidence suggests that ward culture, staff attitudes and staff knowledge are crucial in ensuring that hospital services are accessible to vulnerable patients. The authors suggest that flagging the need for specific reasonable adjustments, rather than the vulnerable condition itself, may address some of the barriers. Further research is recommended that describes and quantifies the most frequently needed reasonable adjustments within the hospital pathways of vulnerable patient groups, and the most effective organisational infrastructure required to guarantee their use, together with resource implications. PMID:24740978

  9. A Simple and Computationally Efficient Sampling Approach to Covariate Adjustment for Multifactor Dimensionality Reduction Analysis of Epistasis

    PubMed Central

    Gui, Jiang; Andrew, Angeline S.; Andrews, Peter; Nelson, Heather M.; Kelsey, Karl T.; Karagas, Margaret R.; Moore, Jason H.

    2010-01-01

    Epistasis or gene-gene interaction is a fundamental component of the genetic architecture of complex traits such as disease susceptibility. Multifactor dimensionality reduction (MDR) was developed as a nonparametric and model-free method to detect epistasis when there are no significant marginal genetic effects. However, in many studies of complex disease, other covariates like age of onset and smoking status could have a strong main effect and may potentially interfere with MDR's ability to achieve its goal. In this paper, we present a simple and computationally efficient sampling method to adjust for covariate effects in MDR. We use simulation to show that after adjustment, MDR has sufficient power to detect true gene-gene interactions. We also compare our method with the state-of-art technique in covariate adjustment. The results suggest that our proposed method performs similarly, but is more computationally efficient. We then apply this new method to an analysis of a population-based bladder cancer study in New Hampshire. PMID:20924193

  10. Effects of delay and probability combinations on discounting in humans.

    PubMed

    Cox, David J; Dallery, Jesse

    2016-10-01

    To determine discount rates, researchers typically adjust the amount of an immediate or certain option relative to a delayed or uncertain option. Because this adjusting amount method can be relatively time consuming, researchers have developed more efficient procedures. One such procedure is a 5-trial adjusting delay procedure, which measures the delay at which an amount of money loses half of its value (e.g., $1000 is valued at $500 with a 10-year delay to its receipt). Experiment 1 (n=212) used 5-trial adjusting delay or probability tasks to measure delay discounting of losses, probabilistic gains, and probabilistic losses. Experiment 2 (n=98) assessed combined probabilistic and delayed alternatives. In both experiments, we compared results from 5-trial adjusting delay or probability tasks to traditional adjusting amount procedures. Results suggest both procedures produced similar rates of probability and delay discounting in six out of seven comparisons. A magnitude effect consistent with previous research was observed for probabilistic gains and losses, but not for delayed losses. Results also suggest that delay and probability interact to determine the value of money. Five-trial methods may allow researchers to assess discounting more efficiently as well as study more complex choice scenarios. Copyright © 2016 Elsevier B.V. All rights reserved.

  11. HIV quality report cards: impact of case-mix adjustment and statistical methods.

    PubMed

    Ohl, Michael E; Richardson, Kelly K; Goto, Michihiko; Vaughan-Sarrazin, Mary; Schweizer, Marin L; Perencevich, Eli N

    2014-10-15

    There will be increasing pressure to publicly report and rank the performance of healthcare systems on human immunodeficiency virus (HIV) quality measures. To inform discussion of public reporting, we evaluated the influence of case-mix adjustment when ranking individual care systems on the viral control quality measure. We used data from the Veterans Health Administration (VHA) HIV Clinical Case Registry and administrative databases to estimate case-mix adjusted viral control for 91 local systems caring for 12 368 patients. We compared results using 2 adjustment methods, the observed-to-expected estimator and the risk-standardized ratio. Overall, 10 913 patients (88.2%) achieved viral control (viral load ≤400 copies/mL). Prior to case-mix adjustment, system-level viral control ranged from 51% to 100%. Seventeen (19%) systems were labeled as low outliers (performance significantly below the overall mean) and 11 (12%) as high outliers. Adjustment for case mix (patient demographics, comorbidity, CD4 nadir, time on therapy, and income from VHA administrative databases) reduced the number of low outliers by approximately one-third, but results differed by method. The adjustment model had moderate discrimination (c statistic = 0.66), suggesting potential for unadjusted risk when using administrative data to measure case mix. Case-mix adjustment affects rankings of care systems on the viral control quality measure. Given the sensitivity of rankings to selection of case-mix adjustment methods-and potential for unadjusted risk when using variables limited to current administrative databases-the HIV care community should explore optimal methods for case-mix adjustment before moving forward with public reporting. Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2014. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  12. Mechanical design and analysis of focal plate for gravity deformation

    NASA Astrophysics Data System (ADS)

    Wang, Jianping; Chu, Jiaru; Hu, Hongzhuan; Li, Kexuan; Zhou, Zengxiang

    2014-07-01

    The surface accuracy of astronomical telescope focal plate is a key indicator to precision stellar observation. To conduct accurate deformation measurement for focal plate in different status, a 6-DOF hexapod platform was used for attitude adjustment. For the small adjustment range of a classic 6-DOF hexapod platform, an improved structural arrangement method was proposed in the paper to achieve ultimate adjustment of the focal plate in horizontal and vertical direction. To validate the feasibility of this method, an angle change model which used ball hinge was set up for the movement and base plate. Simulation results in MATLAB suggested that the ball hinge angle change of movement and base plate is within the range of the limiting angle in the process of the platform plate adjusting to ultimate attitude. The proposed method has some guiding significance for accurate surface measurement of focal plate.

  13. Social support and substitute voice acquisition on psychological adjustment among patients after laryngectomy.

    PubMed

    Kotake, Kumiko; Suzukamo, Yoshimi; Kai, Ichiro; Iwanaga, Kazuyo; Takahashi, Aya

    2017-03-01

    The objective is to clarify whether social support and acquisition of alternative voice enhance the psychological adjustment of laryngectomized patients and which part of the psychological adjustment structure would be influenced by social support. We contacted 1445 patients enrolled in a patient association using mail surveys and 679 patients agreed to participate in the study. The survey items included age, sex, occupation, post-surgery duration, communication method, psychological adjustment (by the Nottingham Adjustment Scale Japanese Laryngectomy Version: NAS-J-L), and the formal support (by Hospital Patient Satisfaction Questionnaire-25: HPSQ-25). Social support and communication methods were added to the three-tier structural model of psychological adjustment shown in our previous study, and a covariance structure analysis was conducted. Formal/informal supports and acquisition of alternative voice influence only the "recognition of oneself as voluntary agent", the first tier of the three-tier structure of psychological adjustment. The results suggest that social support and acquisition of alternative voice may enhance the recognition of oneself as voluntary agent and promote the psychological adjustment.

  14. Using referrals and priority-setting rules to risk adjust budgets: the case of regional psychiatric centers.

    PubMed

    Holman, Per Arne; Grepperud, Sverre; Tanum, Lars

    2011-03-01

    An important objective of many health care systems is to ensure equal access to health care services. One way of achieving this is by having universal coverage (low or absent out-of-pockets payments) combined with tax-financed transfers (block grants) to providers with a catchment area responsibility. However, a precondition for equal access in such systems is that providers have similar capacities -- meaning that budgets must be perfectly adjusted for variations in treatment costs not being under the control of providers (risk adjustment). This study presents a method that can be applied to adjust global budgets for variation in health risks. The method is flexible in the sense that it takes into account the possibility that variation in needs may depend on the degree of rationing in supplying health care services. The information being available from referrals is used to risk-adjust budgets. An expert panel ranks each individual on the basis of need. The ranking is performed according to priority-setting criteria for health care services. In addition, the panel suggests an adequate treatment profile (treatment category and treatment intensity) for each referral reviewed. By coupling the treatment profiles with cost information, risk-adjusted budgets are derived. Only individuals found to have a sufficiently high ranking (degree of need) will impact the derived risk-adjusted formula. The method is applied to four Regional Psychiatric Centers (RPC) supplying (i) outpatient services, (ii) day-patient care, and (iii) inpatient treatment for adults. The budget reallocations needed (positive and negative) to achieve an equal capacity across providers range between 10% and 42% of the current budgets. Our method can identify variations across providers when it comes to actual capacity and suggests budget reallocations that make the capacities to be equal across providers. In the case of the Regional Psychiatric Centers (RPCs) considered in this analysis, significant deviations in capacities are identified across providers and catchment areas. Thus, significant social gains can be gained, in terms of improved equal access, if our methodology is applied to risk adjust global budgets.

  15. Alternative evaluation metrics for risk adjustment methods.

    PubMed

    Park, Sungchul; Basu, Anirban

    2018-06-01

    Risk adjustment is instituted to counter risk selection by accurately equating payments with expected expenditures. Traditional risk-adjustment methods are designed to estimate accurate payments at the group level. However, this generates residual risks at the individual level, especially for high-expenditure individuals, thereby inducing health plans to avoid those with high residual risks. To identify an optimal risk-adjustment method, we perform a comprehensive comparison of prediction accuracies at the group level, at the tail distributions, and at the individual level across 19 estimators: 9 parametric regression, 7 machine learning, and 3 distributional estimators. Using the 2013-2014 MarketScan database, we find that no one estimator performs best in all prediction accuracies. Generally, machine learning and distribution-based estimators achieve higher group-level prediction accuracy than parametric regression estimators. However, parametric regression estimators show higher tail distribution prediction accuracy and individual-level prediction accuracy, especially at the tails of the distribution. This suggests that there is a trade-off in selecting an appropriate risk-adjustment method between estimating accurate payments at the group level and lower residual risks at the individual level. Our results indicate that an optimal method cannot be determined solely on the basis of statistical metrics but rather needs to account for simulating plans' risk selective behaviors. Copyright © 2018 John Wiley & Sons, Ltd.

  16. Adjusting for publication biases across similar interventions performed well when compared with gold standard data.

    PubMed

    Moreno, Santiago G; Sutton, Alex J; Ades, A E; Cooper, Nicola J; Abrams, Keith R

    2011-11-01

    To extend, apply, and evaluate a regression-based approach to adjusting meta-analysis for publication and related biases. The approach uses related meta-analyses to improve estimation by borrowing strength on the degree of bias. The proposed adjustment approach is described. Adjustments are applied both independently and by borrowing strength across journal-extracted data on the effectiveness of 12 antidepressant drugs from placebo-controlled trials. The methods are also applied to Food and Drug Administration (FDA) data obtained on the same 12 drugs. Results are compared, viewing the FDA observed data as gold standard. Estimates adjusted for publication biases made independently for each drug were very uncertain using both the journal and FDA data. Adjusted estimates were much more precise when borrowing strength across meta-analyses. Reassuringly, adjustments in this way made to the journal data agreed closely with the observed estimates from the FDA data, while the adjusted FDA results changed only minimally from those observed from the FDA data. The method worked well in the case study considered and therefore further evaluation is encouraged. It is suggested that this approach may be especially useful when adjusting several meta-analyses on similar interventions and outcomes, particularly when there are small numbers of studies. Copyright © 2011 Elsevier Inc. All rights reserved.

  17. The Taxometrics of Marriage: Is Marital Discord Categorical?

    PubMed Central

    Beach, Steven R. H.; Amir, Nader; Fincham, Frank D.; Leonard, Kenneth E.

    2014-01-01

    This study used taxometric methods to investigate the latent structure of the construct of marital adjustment as indexed by the Marital Adjustment Test (MAT; H. J. Locke & K. M. Wallace, 1959). That is, the authors examined whether marital adjustment is best thought of as a “dimension” of adjustment only or whether there also are categorical differences between “discordant” and “nondiscordant” couples. Analyses of data provided by 447 couples married for approximately 2 years provided converging evidence for a latent category of marital discord, suggesting that marital discord can be viewed as a qualitatively distinct state experienced by approximately 20% of the couples in the current sample. Implications for marital assessment are outlined. PMID:15982105

  18. A 5-trial adjusting delay discounting task: Accurate discount rates in less than 60 seconds

    PubMed Central

    Koffarnus, Mikhail N.; Bickel, Warren K.

    2014-01-01

    Individuals who discount delayed rewards at a high rate are more likely to engage in substance abuse, overeating, or problem gambling. Findings such as these suggest the value of methods to obtain an accurate and fast measurement of discount rate that can be easily deployed in variety of settings. In the present study, we developed and evaluated the 5-trial adjusting delay task, a novel method of obtaining discount rate in less than one minute. We hypothesized that discount rates from the 5-trial adjusting delay task would be similar and correlated with discount rates from a lengthier task we have used previously, and that four known effects relating to delay discounting would be replicable with this novel task. To test these hypotheses, the 5-trial adjusting delay task was administered to 111 college students six times to obtain discount rates for six different commodities, along with a lengthier adjusting amount discounting task. We found that discount rates were similar and correlated between the 5-trial adjusting delay task and the adjusting amount task. Each of the four known effects relating to delay discounting was replicated with the 5-trial adjusting delay task to varying degrees. First, discount rates were inversely correlated with amount. Second, discount rates between past and future outcomes were correlated. Third, discount rates were greater for consumable rewards than with money, although we did not control for amount in this comparison. Fourth, discount rates were lower when zero amounts opposing the chosen time point were explicitly described. Results indicate that the 5-trial adjusting delay task is a viable, rapid method to assess discount rate. PMID:24708144

  19. A 5-trial adjusting delay discounting task: accurate discount rates in less than one minute.

    PubMed

    Koffarnus, Mikhail N; Bickel, Warren K

    2014-06-01

    Individuals who discount delayed rewards at a high rate are more likely to engage in substance abuse, overeating, or problem gambling. Such findings suggest the value of methods to obtain an accurate and fast measurement of discount rate that can be easily deployed in variety of settings. In the present study, we developed and evaluated the 5-trial adjusting delay task, a novel method of obtaining a discount rate in less than 1 min. We hypothesized that discount rates from the 5-trial adjusting delay task would be similar and would correlate with discount rates from a lengthier task we have used previously, and that 4 known effects relating to delay discounting would be replicable with this novel task. To test these hypotheses, the 5-trial adjusting delay task was administered to 111 college students 6 times to obtain discount rates for 6 different commodities, along with a lengthier adjusting amount discounting task. We found that discount rates were similar and correlated between the 5-trial adjusting delay task and the adjusting amount task. Each of the 4 known effects relating to delay discounting was replicated with the 5-trial adjusting delay task to varying degrees. First, discount rates were inversely correlated with amount. Second, discount rates between past and future outcomes were correlated. Third, discount rates were greater for consumable rewards than with money, although we did not control for amount in this comparison. Fourth, discount rates were lower when $0 amounts opposing the chosen time point were explicitly described. Results indicate that the 5-trial adjusting delay task is a viable, rapid method to assess discount rate. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  20. Singularity-sensitive gauge-based radar rainfall adjustment methods for urban hydrological applications

    NASA Astrophysics Data System (ADS)

    Wang, L.-P.; Ochoa-Rodríguez, S.; Onof, C.; Willems, P.

    2015-09-01

    Gauge-based radar rainfall adjustment techniques have been widely used to improve the applicability of radar rainfall estimates to large-scale hydrological modelling. However, their use for urban hydrological applications is limited as they were mostly developed based upon Gaussian approximations and therefore tend to smooth off so-called "singularities" (features of a non-Gaussian field) that can be observed in the fine-scale rainfall structure. Overlooking the singularities could be critical, given that their distribution is highly consistent with that of local extreme magnitudes. This deficiency may cause large errors in the subsequent urban hydrological modelling. To address this limitation and improve the applicability of adjustment techniques at urban scales, a method is proposed herein which incorporates a local singularity analysis into existing adjustment techniques and allows the preservation of the singularity structures throughout the adjustment process. In this paper the proposed singularity analysis is incorporated into the Bayesian merging technique and the performance of the resulting singularity-sensitive method is compared with that of the original Bayesian (non singularity-sensitive) technique and the commonly used mean field bias adjustment. This test is conducted using as case study four storm events observed in the Portobello catchment (53 km2) (Edinburgh, UK) during 2011 and for which radar estimates, dense rain gauge and sewer flow records, as well as a recently calibrated urban drainage model were available. The results suggest that, in general, the proposed singularity-sensitive method can effectively preserve the non-normality in local rainfall structure, while retaining the ability of the original adjustment techniques to generate nearly unbiased estimates. Moreover, the ability of the singularity-sensitive technique to preserve the non-normality in rainfall estimates often leads to better reproduction of the urban drainage system's dynamics, particularly of peak runoff flows.

  1. An automatic step adjustment method for average power analysis technique used in fiber amplifiers

    NASA Astrophysics Data System (ADS)

    Liu, Xue-Ming

    2006-04-01

    An automatic step adjustment (ASA) method for average power analysis (APA) technique used in fiber amplifiers is proposed in this paper for the first time. In comparison with the traditional APA technique, the proposed method has suggested two unique merits such as a higher order accuracy and an ASA mechanism, so that it can significantly shorten the computing time and improve the solution accuracy. A test example demonstrates that, by comparing to the APA technique, the proposed method increases the computing speed by more than a hundredfold under the same errors. By computing the model equations of erbium-doped fiber amplifiers, the numerical results show that our method can improve the solution accuracy by over two orders of magnitude at the same amplifying section number. The proposed method has the capacity to rapidly and effectively compute the model equations of fiber Raman amplifiers and semiconductor lasers.

  2. Spatial contrast sensitivity - Effects of age, test-retest, and psychophysical method

    NASA Technical Reports Server (NTRS)

    Higgins, Kent E.; Jaffe, Myles J.; Caruso, Rafael C.; Demonasterio, Francisco M.

    1988-01-01

    Two different psychophysical methods were used to test the spatial contrast sensitivity in normal subjects from five age groups. The method of adjustment showed a decline in sensitivity with increasing age at all spatial frequencies, while the forced-choice procedure showed an age-related decline predominantly at high spatial frequencies. It is suggested that a neural component is responsible for this decline.

  3. Estimating vaccine effectiveness against severe influenza in England and Scotland 2011/2012: applying the screening method to data from intensive care surveillance systems.

    PubMed

    Thomas, H L; Andrews, N; Green, H K; Boddington, N L; Zhao, H; Reynolds, A; McMenamin, J; Pebody, R G

    2014-01-01

    Methods for estimating vaccine effectiveness (VE) against severe influenza are not well established. We used the screening method to estimate VE against influenza resulting in intensive care unit (ICU) admission in England and Scotland in 2011/2012. We extracted data on confirmed influenza ICU cases from severe influenza surveillance systems, and obtained their 2011/2012 trivalent influenza vaccine (TIV) status from primary care. We compared case vaccine uptake with population vaccine uptake obtained from routine monitoring systems, adjusting for age group, specific risk group, region and week. Of 60 influenza ICU cases reported, vaccination status was available for 56 (93%). Adjusted VE against ICU admission for those aged ≥ 65 years was -10% [95% confidence interval (CI) -207 to 60], consistent with evidence of poor protection from the 2011/2012 TIV in 2011/2012. Adjusted VE for those aged <65 years in risk groups was -296% (95% CI -930 to -52), suggesting significant residual confounding using the screening method in those subject to selective vaccination.

  4. Radiosonde Atmospheric Temperature Products for Assessing Climate (RATPAC): Towards a New Adjusted Radiosonde Dataset

    NASA Astrophysics Data System (ADS)

    Free, M. P.; Angell, J. K.; Durre, I.; Klein, S.; Lanzante, J.; Lawrimore, J.; Peterson, T.; Seidel, D.

    2002-05-01

    The objective of NOAA's RATPAC project is to develop climate-quality global, hemispheric and zonal upper-air temperature time series from the NCDC radiosonde database. Lanzante, Klein and Seidel (LKS) have produced an 87-station adjusted radiosonde dataset using a multifactor expert decision approach. Our goal is to extend this dataset spatially and temporally and to provide a method to update it routinely at NCDC. Since the LKS adjustment method is too labor-intensive for these purposes, we are investigating a first-difference method (Peterson et al., 1998) and an automated version of the LKS method. The first difference method (FD) can be used to combine large numbers of time series into spatial means, but also introduces a random error in the resulting large-scale averages. If the portions of the time series with suspect continuity are withheld from the calculations, it has the potential to reconstruct the real variability without the effects of the discontinuities. However, tests of FD on unadjusted radiosonde data and on reanalysis temperature data suggest that it must be used with caution when the number of stations is low and the number of data gaps is high. Because of these problems with the first difference approach, we are also considering an automated version of the LKS adjustment method using statistical change points, day-night temperature difference series, relationships between changes in adjacent atmospheric levels, and station histories to identify inhomogeneities in the temperature data.

  5. (abstract) A Comparison Between Measurements of the F-layer Critical Frequency and Values Derived from the PRISM Adjustment Algorithm Applied to Total Electron Content Data in the Equatorial Region

    NASA Technical Reports Server (NTRS)

    Mannucci, A. J.; Anderson, D. N.; Abdu, A. M.

    1994-01-01

    The Parametrized Real-Time Ionosphere Specification Model (PRISM) is a global ionospheric specification model that can incorporate real-time data to compute accurate electron density profiles. Time series of computed and measured data are compared in this paper. This comparison can be used to suggest methods of optimizing the PRISM adjustment algorithm for TEC data obtained at low altitudes.

  6. Uranium Associations with Kidney Outcomes Vary by Urine Concentration Adjustment Method

    PubMed Central

    Shelley, Rebecca; Kim, Nam-Soo; Parsons, Patrick J.; Lee, Byung-Kook; Agnew, Jacqueline; Jaar, Bernard G.; Steuerwald, Amy J.; Matanoski, Genevieve; Fadrowski, Jeffrey; Schwartz, Brian S.; Todd, Andrew C.; Simon, David; Weaver, Virginia M.

    2017-01-01

    Uranium is a ubiquitous metal that is nephrotoxic at high doses. Few epidemiologic studies have examined the kidney filtration impact of chronic environmental exposure. In 684 lead workers environmentally exposed to uranium, multiple linear regression was used to examine associations of uranium measured in a four-hour urine collection with measured creatinine clearance, serum creatinine- and cystatin-C-based estimated glomerular filtration rates, and N-acetyl-β-D-glucosaminidase (NAG). Three methods were utilized, in separate models, to adjust uranium levels for urine concentration - μg uranium/g creatinine; μg uranium/L and urine creatinine as separate covariates; and μg uranium/4 hr. Median urine uranium levels were 0.07 μg/g creatinine and 0.02 μg/4 hr and were highly correlated (rs =0.95). After adjustment, higher ln-urine uranium was associated with lower measured creatinine clearance and higher NAG in models that used urine creatinine to adjust for urine concentration but not in models that used total uranium excreted (μg/4 hr). These results suggest that, in some instances, associations between urine toxicants and kidney outcomes may be statistical, due to the use of urine creatinine in both exposure and outcome metrics, rather than nephrotoxic. These findings support consideration of non-creatinine-based methods of adjustment for urine concentration in nephrotoxicant research. PMID:23591699

  7. Clearing margin system in the futures markets—Applying the value-at-risk model to Taiwanese data

    NASA Astrophysics Data System (ADS)

    Chiu, Chien-Liang; Chiang, Shu-Mei; Hung, Jui-Cheng; Chen, Yu-Lung

    2006-07-01

    This article sets out to investigate if the TAIFEX has adequate clearing margin adjustment system via unconditional coverage, conditional coverage test and mean relative scaled bias to assess the performance of three value-at-risk (VaR) models (i.e., the TAIFEX, RiskMetrics and GARCH-t). For the same model, original and absolute returns are compared to explore which can accurately capture the true risk. For the same return, daily and tiered adjustment methods are examined to evaluate which corresponds to risk best. The results indicate that the clearing margin adjustment of the TAIFEX cannot reflect true risks. The adjustment rules, including the use of absolute return and tiered adjustment of the clearing margin, have distorted VaR-based margin requirements. Besides, the results suggest that the TAIFEX should use original return to compute VaR and daily adjustment system to set clearing margin. This approach would improve the funds operation efficiency and the liquidity of the futures markets.

  8. Gauge-adjusted rainfall estimates from commercial microwave links

    NASA Astrophysics Data System (ADS)

    Fencl, Martin; Dohnal, Michal; Rieckermann, Jörg; Bareš, Vojtěch

    2017-01-01

    Increasing urbanization makes it more and more important to have accurate stormwater runoff predictions, especially with potentially severe weather and climatic changes on the horizon. Such stormwater predictions in turn require reliable rainfall information. Especially for urban centres, the problem is that the spatial and temporal resolution of rainfall observations should be substantially higher than commonly provided by weather services with their standard rainfall monitoring networks. Commercial microwave links (CMLs) are non-traditional sensors, which have been proposed about a decade ago as a promising solution. CMLs are line-of-sight radio connections widely used by operators of mobile telecommunication networks. They are typically very dense in urban areas and can provide path-integrated rainfall observations at sub-minute resolution. Unfortunately, quantitative precipitation estimates (QPEs) from CMLs are often highly biased due to several epistemic uncertainties, which significantly limit their usability. In this manuscript we therefore suggest a novel method to reduce this bias by adjusting QPEs to existing rain gauges. The method has been specifically designed to produce reliable results even with comparably distant rain gauges or cumulative observations. This eliminates the need to install reference gauges and makes it possible to work with existing information. First, the method is tested on data from a dedicated experiment, where a CML has been specifically set up for rainfall monitoring experiments, as well as operational CMLs from an existing cellular network. Second, we assess the performance for several experimental layouts of ground truth from rain gauges (RGs) with different spatial and temporal resolutions. The results suggest that CMLs adjusted by RGs with a temporal aggregation of up to 1 h (i) provide precise high-resolution QPEs (relative error < 7 %, Nash-Sutcliffe efficiency coefficient > 0.75) and (ii) that the combination of both sensor types clearly outperforms each individual monitoring system. Unfortunately, adjusting CML observations to RGs with longer aggregation intervals of up to 24 h has drawbacks. Although it substantially reduces bias, it unfavourably smoothes out rainfall peaks of high intensities, which is undesirable for stormwater management. A similar, but less severe, effect occurs due to spatial averaging when CMLs are adjusted to remote RGs. Nevertheless, even here, adjusted CMLs perform better than RGs alone. Furthermore, we provide first evidence that the joint use of multiple CMLs together with RGs also reduces bias in their QPEs. In summary, we believe that our adjustment method has great potential to improve the space-time resolution of current urban rainfall monitoring networks. Nevertheless, future work should aim to better understand the reason for the observed systematic error in QPEs from CMLs.

  9. The Translucent Cadaver: A Follow-up Study to Gauge the Efficacy of Implementing Changes Suggested by Students

    ERIC Educational Resources Information Center

    Kotzé, Sanet Henriët; Driescher, Natasha Darné; Mole, Calvin Gerald

    2013-01-01

    In a study conducted in 2011, the use of full body digital X-ray images (Lodox® Statscan®) and drawings were described for surface anatomy education during which suggestions were made by students on how to improve the method. Educational innovations should continuously be adjusted and improved to provide the best possible scenario for student…

  10. Evaluation of terrestrial and streamside salamander monitoring techniques at Shenandoah National Park

    USGS Publications Warehouse

    Jung, R.E.; Droege, S.; Sauer, J.R.; Landy, R.B.

    2000-01-01

    In response to concerns about amphibian declines, a study evaluating and validating amphibian monitoring techniques was initiated in Shenandoah and Big Bend National Parks in the spring of 1998. We evaluate precision, bias, and efficiency of several sampling methods for terrestrial and streamside salamanders in Shenandoah National Park and assess salamander abundance in relation to environmental variables, notably soil and water pH. Terrestrial salamanders, primarily redback salamanders (Plethodon cinereus), were sampled by searching under cover objects during the day in square plots (10 to 35 m2). We compared population indices (mean daily and total counts) with adjusted population estimates from capture-recapture. Analyses suggested that the proportion of salamanders detected (p) during sampling varied among plots, necessitating the use of adjusted population estimates. However, adjusted population estimates were less precise than population indices, and may not be efficient in relating salamander populations to environmental variables. In future sampling, strategic use of capture-recapture to verify consistency of p's among sites may be a reasonable compromise between the possibility of bias in estimation of population size and deficiencies due to inefficiency associated with the estimation of p. The streamside two-lined salamander (Eurycea bislineata) was surveyed using four methods: leaf litter refugia bags, 1 m2 quadrats, 50 x 1 m visual encounter transects, and electric shocking. Comparison of survey methods at nine streams revealed congruent patterns of abundance among sites, suggesting that relative bias among the methods is similar, and that choice of survey method should be based on precision and logistical efficiency. Redback and two-lined salamander abundance were not significantly related to soil or water pH, respectively.

  11. The use of Quality-Adjusted Life Years in cost-effectiveness analyses in palliative care: Mapping the debate through an integrative review.

    PubMed

    Wichmann, Anne B; Adang, Eddy Mm; Stalmeier, Peep Fm; Kristanti, Sinta; Van den Block, Lieve; Vernooij-Dassen, Myrra Jfj; Engels, Yvonne

    2017-04-01

    In cost-effectiveness analyses in healthcare, Quality-Adjusted Life Years are often used as outcome measure of effectiveness. However, there is an ongoing debate concerning the appropriateness of its use for decision-making in palliative care. To systematically map pros and cons of using the Quality-Adjusted Life Year to inform decisions on resource allocation among palliative care interventions, as brought forward in the debate, and to discuss the Quality-Adjusted Life Year's value for palliative care. The integrative review method of Whittemore and Knafl was followed. Theoretical arguments and empirical findings were mapped. A literature search was conducted in PubMed, EMBASE, and CINAHL, in which MeSH (Medical Subject Headings) terms were Palliative Care, Cost-Benefit Analysis, Quality of Life, and Quality-Adjusted Life Years. Three themes regarding the pros and cons were identified: (1) restrictions in life years gained, (2) conceptualization of quality of life and its measurement, including suggestions to adapt this, and (3) valuation and additivity of time, referring to changing valuation of time. The debate is recognized in empirical studies, but alternatives not yet applied. The Quality-Adjusted Life Year might be more valuable for palliative care if specific issues are taken into account. Despite restrictions in life years gained, Quality-Adjusted Life Years can be achieved in palliative care. However, in measuring quality of life, we recommend to-in addition to the EQ-5D- make use of quality of life or capability instruments specifically for palliative care. Also, we suggest exploring the possibility of integrating valuation of time in a non-linear way in the Quality-Adjusted Life Year.

  12. The use of Quality-Adjusted Life Years in cost-effectiveness analyses in palliative care: Mapping the debate through an integrative review

    PubMed Central

    Wichmann, Anne B; Adang, Eddy MM; Stalmeier, Peep FM; Kristanti, Sinta; Van den Block, Lieve; Vernooij-Dassen, Myrra JFJ; Engels, Yvonne

    2017-01-01

    Background: In cost-effectiveness analyses in healthcare, Quality-Adjusted Life Years are often used as outcome measure of effectiveness. However, there is an ongoing debate concerning the appropriateness of its use for decision-making in palliative care. Aim: To systematically map pros and cons of using the Quality-Adjusted Life Year to inform decisions on resource allocation among palliative care interventions, as brought forward in the debate, and to discuss the Quality-Adjusted Life Year’s value for palliative care. Design: The integrative review method of Whittemore and Knafl was followed. Theoretical arguments and empirical findings were mapped. Data sources: A literature search was conducted in PubMed, EMBASE, and CINAHL, in which MeSH (Medical Subject Headings) terms were Palliative Care, Cost-Benefit Analysis, Quality of Life, and Quality-Adjusted Life Years. Findings: Three themes regarding the pros and cons were identified: (1) restrictions in life years gained, (2) conceptualization of quality of life and its measurement, including suggestions to adapt this, and (3) valuation and additivity of time, referring to changing valuation of time. The debate is recognized in empirical studies, but alternatives not yet applied. Conclusion: The Quality-Adjusted Life Year might be more valuable for palliative care if specific issues are taken into account. Despite restrictions in life years gained, Quality-Adjusted Life Years can be achieved in palliative care. However, in measuring quality of life, we recommend to—in addition to the EQ-5D— make use of quality of life or capability instruments specifically for palliative care. Also, we suggest exploring the possibility of integrating valuation of time in a non-linear way in the Quality-Adjusted Life Year. PMID:28190374

  13. Bayesian methods for uncertainty factor application for derivation of reference values.

    PubMed

    Simon, Ted W; Zhu, Yiliang; Dourson, Michael L; Beck, Nancy B

    2016-10-01

    In 2014, the National Research Council (NRC) published Review of EPA's Integrated Risk Information System (IRIS) Process that considers methods EPA uses for developing toxicity criteria for non-carcinogens. These criteria are the Reference Dose (RfD) for oral exposure and Reference Concentration (RfC) for inhalation exposure. The NRC Review suggested using Bayesian methods for application of uncertainty factors (UFs) to adjust the point of departure dose or concentration to a level considered to be without adverse effects for the human population. The NRC foresaw Bayesian methods would be potentially useful for combining toxicity data from disparate sources-high throughput assays, animal testing, and observational epidemiology. UFs represent five distinct areas for which both adjustment and consideration of uncertainty may be needed. NRC suggested UFs could be represented as Bayesian prior distributions, illustrated the use of a log-normal distribution to represent the composite UF, and combined this distribution with a log-normal distribution representing uncertainty in the point of departure (POD) to reflect the overall uncertainty. Here, we explore these suggestions and present a refinement of the methodology suggested by NRC that considers each individual UF as a distribution. From an examination of 24 evaluations from EPA's IRIS program, when individual UFs were represented using this approach, the geometric mean fold change in the value of the RfD or RfC increased from 3 to over 30, depending on the number of individual UFs used and the sophistication of the assessment. We present example calculations and recommendations for implementing the refined NRC methodology. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  14. Analysis of a piezoelectric power harvester with adjustable frequency by precise electric field method.

    PubMed

    Wang, Yujue; Lian, Ziyang; Yao, Mingge; Wang, Ji; Hu, Hongping

    2013-10-01

    A power harvester with adjustable frequency, which consists of a hinged-hinged piezoelectric bimorph and a concentrated mass, is studied by the precise electric field method (PEFM), taking into account a distribution of the electric field over the thickness. Usually, using the equivalent electric field method (EEFM), the electric field is approximated as a constant value in the piezoelectric layer. Charge on the upper electrode (UEC) of the bimorph is often assumed as output charge. However, different output charge can be obtained by integrating on electric displacement over the electrode with different thickness coordinates. Therefore, an average charge (AC) on thickness is often assumed as the output value. This method is denoted EEFM AC. The flexural vibration of the bimorph is calculated by the three methods and their results are compared. Numerical results illustrate that EEFM UEC overestimates resonant frequency, output power, and efficiency. EEFM AC can accurately calculate the output power and efficiency, but underestimates resonant frequency. The performance of the harvester, which depends on concentrated mass weight, position, and circuit load, is analyzed using PEFM. The resonant frequency can be modulated 924 Hz by moving the concentrated mass along the bimorph. This feature suggests that the natural frequency of the harvester can be adjusted conveniently to adapt to frequency fluctuation of the ambient vibration.

  15. What is the Best Way to Reduce Unintended Pregnancies? A Micro Simulation of Contraceptive Switching, Discontinuation and Failure Patterns in France

    PubMed Central

    Diamond-Smith, Nadia; Moreau, Caroline; Bishai, David

    2015-01-01

    Despite high rates of contraceptive use in France, over a third of pregnancies are unintended. We built a dynamic micro simulation model which applies data from the French COCON study on method switching, discontinuation, and failure rates to a hypothetical population of 20,000 women, followed for 5 years. We use the model to estimate the adjustment factor needed to make the survey data fit the demographic profile of France, by adjusting for underreporting of contraceptive non-use and abortions. We then test three behavior change scenarios which would aim to reduce unintended pregnancies: decreasing method failure, increasing time spent on effective methods, and increasing switching from less to more effective methods. Our model suggests that decreasing method failure is the most effective strategy for reducing unintended pregnancies, but all scenarios reduced unintended pregnancies by at least 25%. Dynamic micro simulations such as this may be useful for policy makers. PMID:25469928

  16. Reducing unintended pregnancies: a microsimulation of contraceptive switching, discontinuation, and failure patterns in france.

    PubMed

    Diamond-Smith, Nadia G; Moreau, Caroline; Bishai, David M

    2014-12-01

    Although the rate of contraceptive use in France is high, more than one-third of pregnancies are unintended. We built a dynamic microsimulation model that applies data from the French COCON study on method switching, discontinuation, and failure rates to a hypothetical population of 20,000 women, followed for five years. We use the model to estimate the adjustment factor needed to make the survey data fit the demographic profile of France by adjusting for underreporting of contraceptive nonuse and abortion. We then test three behavior-change scenarios that could reduce unintended pregnancies: decreasing method failure, increasing time using effective methods, and increasing switching from less effective to more effective methods. Our model suggests that decreasing method failure is the most effective means of reducing unintended pregnancies, but we found that all of the scenarios reduced unintended pregnancies by at least 25 percent. Dynamic microsimulations may have great potential in reproductive health research and prove useful for policymakers. © 2014 The Population Council, Inc.

  17. Correcting for Sample Contamination in Genotype Calling of DNA Sequence Data

    PubMed Central

    Flickinger, Matthew; Jun, Goo; Abecasis, Gonçalo R.; Boehnke, Michael; Kang, Hyun Min

    2015-01-01

    DNA sample contamination is a frequent problem in DNA sequencing studies and can result in genotyping errors and reduced power for association testing. We recently described methods to identify within-species DNA sample contamination based on sequencing read data, showed that our methods can reliably detect and estimate contamination levels as low as 1%, and suggested strategies to identify and remove contaminated samples from sequencing studies. Here we propose methods to model contamination during genotype calling as an alternative to removal of contaminated samples from further analyses. We compare our contamination-adjusted calls to calls that ignore contamination and to calls based on uncontaminated data. We demonstrate that, for moderate contamination levels (5%–20%), contamination-adjusted calls eliminate 48%–77% of the genotyping errors. For lower levels of contamination, our contamination correction methods produce genotypes nearly as accurate as those based on uncontaminated data. Our contamination correction methods are useful generally, but are particularly helpful for sample contamination levels from 2% to 20%. PMID:26235984

  18. Outcomes for youth residential treatment programs using administrative data from the child welfare system: a risk-adjustment application.

    PubMed

    McMillen, J Curtis; Lee, Bethany R; Jonson-Reid, Melissa

    2008-05-01

    This study assessed whether administrative data from the public child welfare system could be used to develop risk-adjusted performance reports for residential mental health programs for adolescents. Regression methods were used with 3,759 residential treatment spells for 2,784 children and youth to determine which outcomes could be adequately risk adjusted for case mix. Expected outcomes were created for each residential program given its case mix; then, expected and achieved outcomes were compared. For most programs, achieved results did not differ significantly from expected results for individual outcomes. Overall, outcomes achieved were not impressive. Only one quarter of spells resulted in a youth being maintained in a single less restrictive setting in the year following discharge. Methodological implications of this study suggest further refinements are needed for child welfare administrative data in order to develop risk-adjusted report cards of program performance.

  19. Validating a benchmarking tool for audit of early outcomes after operations for head and neck cancer.

    PubMed

    Tighe, D; Sassoon, I; McGurk, M

    2017-04-01

    INTRODUCTION In 2013 all UK surgical specialties, with the exception of head and neck surgery, published outcome data adjusted for case mix for indicator operations. This paper reports a pilot study to validate a previously published risk adjustment score on patients from separate UK cancer centres. METHODS A case note audit was performed of 1,075 patients undergoing 1,218 operations for head and neck squamous cell carcinoma under general anaesthesia in 4 surgical centres. A logistic regression equation predicting for all complications, previously validated internally at sites A-C, was tested on a fourth external validation sample (site D, 172 operations) using receiver operating characteristic curves, Hosmer-Lemeshow goodness of fit analysis and Brier scores. RESULTS Thirty-day complication rates varied widely (34-51%) between the centres. The predictive score allowed imperfect risk adjustment (area under the curve: 0.70), with Hosmer-Lemeshow analysis suggesting good calibration. The Brier score changed from 0.19 for sites A-C to 0.23 when site D was also included, suggesting poor accuracy overall. CONCLUSIONS Marked differences in operative risk and patient case mix captured by the risk adjustment score do not explain all the differences in observed outcomes. Further investigation with different methods is recommended to improve modelling of risk. Morbidity is common, and usually has a major impact on patient recovery, ward occupancy, hospital finances and patient perception of quality of care. We hope comparative audit will highlight good performance and challenge underperformance where it exists.

  20. Validating a benchmarking tool for audit of early outcomes after operations for head and neck cancer

    PubMed Central

    Sassoon, I; McGurk, M

    2017-01-01

    INTRODUCTION In 2013 all UK surgical specialties, with the exception of head and neck surgery, published outcome data adjusted for case mix for indicator operations. This paper reports a pilot study to validate a previously published risk adjustment score on patients from separate UK cancer centres. METHODS A case note audit was performed of 1,075 patients undergoing 1,218 operations for head and neck squamous cell carcinoma under general anaesthesia in 4 surgical centres. A logistic regression equation predicting for all complications, previously validated internally at sites A–C, was tested on a fourth external validation sample (site D, 172 operations) using receiver operating characteristic curves, Hosmer–Lemeshow goodness of fit analysis and Brier scores. RESULTS Thirty-day complication rates varied widely (34–51%) between the centres. The predictive score allowed imperfect risk adjustment (area under the curve: 0.70), with Hosmer–Lemeshow analysis suggesting good calibration. The Brier score changed from 0.19 for sites A–C to 0.23 when site D was also included, suggesting poor accuracy overall. CONCLUSIONS Marked differences in operative risk and patient case mix captured by the risk adjustment score do not explain all the differences in observed outcomes. Further investigation with different methods is recommended to improve modelling of risk. Morbidity is common, and usually has a major impact on patient recovery, ward occupancy, hospital finances and patient perception of quality of care. We hope comparative audit will highlight good performance and challenge underperformance where it exists. PMID:27917662

  1. Fast fringe pattern phase demodulation using FIR Hilbert transformers

    NASA Astrophysics Data System (ADS)

    Gdeisat, Munther; Burton, David; Lilley, Francis; Arevalillo-Herráez, Miguel

    2016-01-01

    This paper suggests the use of FIR Hilbert transformers to extract the phase of fringe patterns. This method is computationally faster than any known spatial method that produces wrapped phase maps. Also, the algorithm does not require any parameters to be adjusted which are dependent upon the specific fringe pattern that is being processed, or upon the particular setup of the optical fringe projection system that is being used. It is therefore particularly suitable for full algorithmic automation. The accuracy and validity of the suggested method has been tested using both computer-generated and real fringe patterns. This novel algorithm has been proposed for its advantages in terms of computational processing speed as it is the fastest available method to extract the wrapped phase information from a fringe pattern.

  2. Accounting for energy and protein reserve changes in predicting diet-allowable milk production in cattle.

    PubMed

    Tedeschi, L O; Seo, S; Fox, D G; Ruiz, R

    2006-12-01

    Current ration formulation systems used to formulate diets on farms and to evaluate experimental data estimate metabolizable energy (ME)-allowable and metabolizable protein (MP)-allowable milk production from the intake above animal requirements for maintenance, pregnancy, and growth. The changes in body reserves, measured via the body condition score (BCS), are not accounted for in predicting ME and MP balances. This paper presents 2 empirical models developed to adjust predicted diet-allowable milk production based on changes in BCS. Empirical reserves model 1 was based on the reserves model described by the 2001 National Research Council (NRC) Nutrient Requirements of Dairy Cattle, whereas empirical reserves model 2 was developed based on published data of body weight and composition changes in lactating dairy cows. A database containing 134 individually fed lactating dairy cows from 3 trials was used to evaluate these adjustments in milk prediction based on predicted first-limiting ME or MP by the 2001 Dairy NRC and Cornell Net Carbohydrate and Protein System models. The analysis of first-limiting ME or MP milk production without adjustments for BCS changes indicated that the predictions of both models were consistent (r(2) of the regression between observed and model-predicted values of 0.90 and 0.85), had mean biases different from zero (12.3 and 5.34%), and had moderate but different roots of mean square errors of prediction (5.42 and 4.77 kg/d) for the 2001 NRC model and the Cornell Net Carbohydrate and Protein System model, respectively. The adjustment of first-limiting ME- or MP-allowable milk to BCS changes improved the precision and accuracy of both models. We further investigated 2 methods of adjustment; the first method used only the first and last BCS values, whereas the second method used the mean of weekly BCS values to adjust ME- and MP-allowable milk production. The adjustment to BCS changes based on first and last BCS values was more accurate than the adjustment to BCS based on the mean of all BCS values, suggesting that adjusting milk production for mean weekly variations in BCS added more variability to model-predicted milk production. We concluded that both models adequately predicted the first-limiting ME- or MP-allowable milk after adjusting for changes in BCS.

  3. Real-time adjusting of rainfall estimates from commercial microwave links

    NASA Astrophysics Data System (ADS)

    Fencl, Martin; Dohnal, Michal; Bareš, Vojtěch

    2017-04-01

    Urban stormwater predictions require reliable rainfall information with space-time resolution higher than commonly provided by standard rainfall monitoring networks of national weather services. Rainfall data from commercial microwave links (CMLs) could fill this gap. CMLs are line-of-sight radio connections widely used by cellular operators which operate at millimeter bands, where radio waves are attenuated by raindrops. Attenuation data of each single CML in the cellular network can be remotely accessed in (near) real-time with virtually arbitrary sampling frequency and convert to rainfall intensity. Unfortunately, rainfall estimates from CMLs can be substantially biased. Fencl et al., (2017), therefore, proposed adjusting method which enables to correct for this bias. They used rain gauge (RG) data from existing rainfall monitoring networks, which would have otherwise insufficient spatial and temporal resolution for urban rainfall monitoring when used alone without CMLs. In this investigation, we further develop the method to improve its performance in a real-time setting. First, a shortcoming of the original algorithm which delivers unreliable results at the beginning of a rainfall event is overcome by introducing model parameter prior distributions estimated from previous parameter realizations. Second, weights reflecting variance between RGs are introduced into cost function, which is minimized when optimizing model parameters. Finally, RG data used for adjusting are preprocessed by moving average filter. The performance of improved adjusting method is evaluated on four short CMLs (path length < 2 km) located in the small urban catchment (2.3 km2) in Prague-Letnany (CZ). The adjusted CMLs are compared to reference rainfall calculated from six RGs in the catchment. The suggested improvements of the method lead on average to 10% higher Nash-Sutcliffe efficiency coefficient (median value 0.85) for CML adjustment to hourly RG data. Reliability of CML rainfall estimates is especially improved at the beginning of rainfall events and during strong convective rainfalls, whereas performance during longer frontal rainfalls is almost unchanged. Our results clearly demonstrate that adjusting of CMLs to existing RGs represents a viable approach with great potential for real-time applications in stormwater management. This work was supported by the project of Czech Science Foundation (GACR) No.17-16389S. References: Fencl, M., Dohnal, M., Rieckermann, J. and Bareš, V.: Gauge-Adjusted Rainfall Estimates from Commercial Microwave Links, Hydrol Earth Syst. Sci., 2017 (accepted).

  4. Family-level Coparenting Processes and Child Gender as Moderators of Family Stress and Toddler Adjustment

    PubMed Central

    Kolak, Amy M.; Vernon-Feagans, Lynne

    2009-01-01

    The goal of this multi-method study was to examine how child gender and coparenting processes influence associations between family stress and toddlers’ social adjustment. The participants, 104 dual-earner couples and their 2-year-old children, were videotaped in their home during a freeplay activity. Mothers and fathers completed questionnaires about stress in their roles as partners, workers, and parents and their child’s social–emotional adjustment. Consistent with previous research, higher levels of family stress were associated with poorer adjustment for children. Family harmony, represented by warmth and cooperation, was significantly associated with fewer internalizing problems for children even when family stress was considered. Conversely, coparental banter or ‘playful humour’ between parents moderated the nature of the association between family stress and children’s adjustment. Banter between parents was especially protective for girls suggesting that, even in families with toddler-aged children, gender plays an important role in family-level coparenting processes. Future research needs to consider more fully the impact that child characteristics, such as gender, have on the interplay between the family context and children’s development. PMID:19907670

  5. Family-level Coparenting Processes and Child Gender as Moderators of Family Stress and Toddler Adjustment.

    PubMed

    Kolak, Amy M; Vernon-Feagans, Lynne

    2008-01-01

    The goal of this multi-method study was to examine how child gender and coparenting processes influence associations between family stress and toddlers' social adjustment. The participants, 104 dual-earner couples and their 2-year-old children, were videotaped in their home during a freeplay activity. Mothers and fathers completed questionnaires about stress in their roles as partners, workers, and parents and their child's social-emotional adjustment. Consistent with previous research, higher levels of family stress were associated with poorer adjustment for children. Family harmony, represented by warmth and cooperation, was significantly associated with fewer internalizing problems for children even when family stress was considered. Conversely, coparental banter or 'playful humour' between parents moderated the nature of the association between family stress and children's adjustment. Banter between parents was especially protective for girls suggesting that, even in families with toddler-aged children, gender plays an important role in family-level coparenting processes. Future research needs to consider more fully the impact that child characteristics, such as gender, have on the interplay between the family context and children's development.

  6. Salt intake and the validity of a salt intake assessment system based on a 24-h dietary recall method in pregnant Japanese women.

    PubMed

    Satoh, Michihiro; Tanno, Yumi; Hosaka, Miki; Metoki, Hirohito; Obara, Taku; Asayama, Kei; Hoshi, Kazuhiko; Suzuki, Masakuni; Mano, Nariyasu; Imai, Yutaka

    2015-01-01

    Information regarding salt intake in pregnant women in Japan is limited. An electronic system for the assessment of salt intake using a 24-h dietary recall method has been developed in Japan. The objectives of the present study were to investigate salt intake in pregnant women and to compare the salt intake estimated by the electronic salt intake assessment system with that measured by 24-h urinary salt excretion (24-hUNaCl). Data were collected on 24-hUNaCl and salt intake estimated by the salt intake assessment system for 35 pregnant Japanese women at approximately 20 weeks of gestation. The adjusted 24-hUNaCl (24-hUNaCl/[the number of urinations during the examination day--the number of missing urine collections] × the number of urinations during the examination day, g/day) was used as a standard. The mean adjusted 24-hUNaCl was 7.7 ± 2.5 g/day, and mean systolic/diastolic blood pressure values were 106.1 ± 8.6/62.8 ± 6.5 mmHg. The adjusted 24-hUNaCl was significantly correlated with the salt intake estimated by the salt intake assessment system (r = 0.47, p = 0.004). Bland-Altman analysis showed no significant mean difference (adjusted 24-hUNaCl--salt intake estimated by the assessment system = -0.36 g/day, p = 0.4) and no significant proportional bias (p = 0.1). These results suggest that pregnant women in Japan restrict their salt intake, at least when they are being examined for salt intake. They also suggest that repeated use of the described system may be useful in estimating salt intake in pregnant women.

  7. Adjusting survival time estimates to account for treatment switching in randomized controlled trials--an economic evaluation context: methods, limitations, and recommendations.

    PubMed

    Latimer, Nicholas R; Abrams, Keith R; Lambert, Paul C; Crowther, Michael J; Wailoo, Allan J; Morden, James P; Akehurst, Ron L; Campbell, Michael J

    2014-04-01

    Treatment switching commonly occurs in clinical trials of novel interventions in the advanced or metastatic cancer setting. However, methods to adjust for switching have been used inconsistently and potentially inappropriately in health technology assessments (HTAs). We present recommendations on the use of methods to adjust survival estimates in the presence of treatment switching in the context of economic evaluations. We provide background on the treatment switching issue and summarize methods used to adjust for it in HTAs. We discuss the assumptions and limitations associated with adjustment methods and draw on results of a simulation study to make recommendations on their use. We demonstrate that methods used to adjust for treatment switching have important limitations and often produce bias in realistic scenarios. We present an analysis framework that aims to increase the probability that suitable adjustment methods can be identified on a case-by-case basis. We recommend that the characteristics of clinical trials, and the treatment switching mechanism observed within them, should be considered alongside the key assumptions of the adjustment methods. Key assumptions include the "no unmeasured confounders" assumption associated with the inverse probability of censoring weights (IPCW) method and the "common treatment effect" assumption associated with the rank preserving structural failure time model (RPSFTM). The limitations associated with switching adjustment methods such as the RPSFTM and IPCW mean that they are appropriate in different scenarios. In some scenarios, both methods may be prone to bias; "2-stage" methods should be considered, and intention-to-treat analyses may sometimes produce the least bias. The data requirements of adjustment methods also have important implications for clinical trialists.

  8. Estimating the "impact" of out-of-home placement on child well-being: approaching the problem of selection bias.

    PubMed

    Berger, Lawrence M; Bruch, Sarah K; Johnson, Elizabeth I; James, Sigrid; Rubin, David

    2009-01-01

    This study used data on 2,453 children aged 4-17 from the National Survey of Child and Adolescent Well-Being and 5 analytic methods that adjust for selection factors to estimate the impact of out-of-home placement on children's cognitive skills and behavior problems. Methods included ordinary least squares (OLS) regressions and residualized change, simple change, difference-in-difference, and fixed effects models. Models were estimated using the full sample and a matched sample generated by propensity scoring. Although results from the unmatched OLS and residualized change models suggested that out-of-home placement is associated with increased child behavior problems, estimates from models that more rigorously adjust for selection bias indicated that placement has little effect on children's cognitive skills or behavior problems.

  9. The Influence of Breast Self-Examination on Subsequent Mammography Participation

    PubMed Central

    Jelinski, Susan E.; Maxwell, Colleen J.; Onysko, Jay; Bancej, Christina M.

    2005-01-01

    Objectives. We evaluated whether breast self-examination (BSE) influences subsequent mammography participation. Methods. We evaluated associations between BSE and subsequent mammography participation, adjusting for baseline screening behaviors and sociodemographic, health, and lifestyle characteristics, among women aged 40 years and older using data from the longitudinal Canadian National Population Health Survey. Results. Regular performance of BSE at baseline was not associated with receipt of a recent mammogram at follow-up among all women (adjusted odds ratio [OR]=1.01; 95% confidence interval [CI]= 0.75, 1.35) or with mammography uptake among the subgroup of women reporting never use at baseline (adjusted OR=0.78; 95% CI=0.50, 1.22). Conclusions. The lack of association between performance of BSE and subsequent mammography participation suggests that not recommending BSE is unlikely to influence mammography participation. PMID:15727985

  10. Newcomer adjustment during organizational socialization: a meta-analytic review of antecedents, outcomes, and methods.

    PubMed

    Bauer, Talya N; Bodner, Todd; Erdogan, Berrin; Truxillo, Donald M; Tucker, Jennifer S

    2007-05-01

    The authors tested a model of antecedents and outcomes of newcomer adjustment using 70 unique samples of newcomers with meta-analytic and path modeling techniques. Specifically, they proposed and tested a model in which adjustment (role clarity, self-efficacy, and social acceptance) mediated the effects of organizational socialization tactics and information seeking on socialization outcomes (job satisfaction, organizational commitment, job performance, intentions to remain, and turnover). The results generally supported this model. In addition, the authors examined the moderating effects of methodology on these relationships by coding for 3 methodological issues: data collection type (longitudinal vs. cross-sectional), sample characteristics (school-to-work vs. work-to-work transitions), and measurement of the antecedents (facet vs. composite measurement). Discussion focuses on the implications of the findings and suggestions for future research. 2007 APA, all rights reserved

  11. Major Replicated Dimensions of Adjustment and Achievement: Cross-Cultural, Cross-Sectional and Longitudinal Research.

    ERIC Educational Resources Information Center

    Schaefer, Earl S.

    This paper reports the development of a Classroom Behavior Inventory and a series of studies which have developed and refined methods for collecting teacher ratings of children's social, emotional and task-oriented behavior from preschool through high school. Findings suggest that the Classroom Behavior Inventory is a relatively economical,…

  12. Adjustment of trendy, gaming and less assimilated tweens in the United States

    PubMed Central

    Comulada, W. Scott; Rotheram-Borus, Mary Jane; Carey, George; Poris, Michelle; Lord, Lynwood R.; Mayfield Arnold, Elizabeth

    2014-01-01

    Youth transitioning from childhood to adolescence (tweens) are exposed to increasing amounts of media and advertisement. Tweens have also emerged as a major marketing segment for corporate America with increasing buying power.We examine how tweens relate to popular culture messages and the association of different orientations to popular culture on adjustment. A secondary data analysis was conducted on a marketing survey of 3527 tweens, aged 10–14 years, obtained from 49 schools using stratified sampling methods. A sample of children nationwide described their preferences on popular culture and measures of psychosocial adjustment. Using cluster analysis, we identified three main clusters or adaptation styles of tweens: (1) those who enjoyed gaming, (2) trendy youth and (3) youth less assimilated into popular culture. There were differences in clusters based on adjustment indices. Gaming and trendy tweens reported higher self-perceptions of being smart, caring and confident compared to less assimilated tweens. However, gaming and trendy tweens worried more about fitting in than less assimilated tweens. Gaming and trendy tweens also endorsed future goals and traditional values more strongly than less assimilated tweens. Trendy tweens reported the strongest positive feelings about substance use. Results suggest that for each method of adaptation (gamer, trendy and less assimilated), there are unique differences in adjustment that can impact the child’s future. Parents and service providers must recognize the complexity of these decisions and be sensitive to the unique needs of youth as they move from childhood to adolescence. PMID:25580153

  13. Adjustment of trendy, gaming and less assimilated tweens in the United States.

    PubMed

    Comulada, W Scott; Rotheram-Borus, Mary Jane; Carey, George; Poris, Michelle; Lord, Lynwood R; Mayfield Arnold, Elizabeth

    2011-09-01

    Youth transitioning from childhood to adolescence (tweens) are exposed to increasing amounts of media and advertisement. Tweens have also emerged as a major marketing segment for corporate America with increasing buying power.We examine how tweens relate to popular culture messages and the association of different orientations to popular culture on adjustment. A secondary data analysis was conducted on a marketing survey of 3527 tweens, aged 10-14 years, obtained from 49 schools using stratified sampling methods. A sample of children nationwide described their preferences on popular culture and measures of psychosocial adjustment. Using cluster analysis, we identified three main clusters or adaptation styles of tweens: (1) those who enjoyed gaming, (2) trendy youth and (3) youth less assimilated into popular culture. There were differences in clusters based on adjustment indices. Gaming and trendy tweens reported higher self-perceptions of being smart, caring and confident compared to less assimilated tweens. However, gaming and trendy tweens worried more about fitting in than less assimilated tweens. Gaming and trendy tweens also endorsed future goals and traditional values more strongly than less assimilated tweens. Trendy tweens reported the strongest positive feelings about substance use. Results suggest that for each method of adaptation (gamer, trendy and less assimilated), there are unique differences in adjustment that can impact the child's future. Parents and service providers must recognize the complexity of these decisions and be sensitive to the unique needs of youth as they move from childhood to adolescence.

  14. 77 FR 13328 - Federal Acquisition Regulation; Information Collection; Davis Bacon Act-Price Adjustment (Actual...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-06

    ...; Information Collection; Davis Bacon Act--Price Adjustment (Actual Method) AGENCY: Department of Defense (DOD... approved information collection requirement concerning the Davis-Bacon Act price adjustment (actual method... Information Collection 9000- 0154, Davis Bacon Act--Price Adjustment (Actual Method), by any of the following...

  15. Estimation and modeling of electrofishing capture efficiency for fishes in wadeable warmwater streams

    USGS Publications Warehouse

    Price, A.; Peterson, James T.

    2010-01-01

    Stream fish managers often use fish sample data to inform management decisions affecting fish populations. Fish sample data, however, can be biased by the same factors affecting fish populations. To minimize the effect of sample biases on decision making, biologists need information on the effectiveness of fish sampling methods. We evaluated single-pass backpack electrofishing and seining combined with electrofishing by following a dual-gear, mark–recapture approach in 61 blocknetted sample units within first- to third-order streams. We also estimated fish movement out of unblocked units during sampling. Capture efficiency and fish abundances were modeled for 50 fish species by use of conditional multinomial capture–recapture models. The best-approximating models indicated that capture efficiencies were generally low and differed among species groups based on family or genus. Efficiencies of single-pass electrofishing and seining combined with electrofishing were greatest for Catostomidae and lowest for Ictaluridae. Fish body length and stream habitat characteristics (mean cross-sectional area, wood density, mean current velocity, and turbidity) also were related to capture efficiency of both methods, but the effects differed among species groups. We estimated that, on average, 23% of fish left the unblocked sample units, but net movement varied among species. Our results suggest that (1) common warmwater stream fish sampling methods have low capture efficiency and (2) failure to adjust for incomplete capture may bias estimates of fish abundance. We suggest that managers minimize bias from incomplete capture by adjusting data for site- and species-specific capture efficiency and by choosing sampling gear that provide estimates with minimal bias and variance. Furthermore, if block nets are not used, we recommend that managers adjust the data based on unconditional capture efficiency.

  16. TREATMENT SWITCHING: STATISTICAL AND DECISION-MAKING CHALLENGES AND APPROACHES.

    PubMed

    Latimer, Nicholas R; Henshall, Chris; Siebert, Uwe; Bell, Helen

    2016-01-01

    Treatment switching refers to the situation in a randomized controlled trial where patients switch from their randomly assigned treatment onto an alternative. Often, switching is from the control group onto the experimental treatment. In this instance, a standard intention-to-treat analysis does not identify the true comparative effectiveness of the treatments under investigation. We aim to describe statistical methods for adjusting for treatment switching in a comprehensible way for nonstatisticians, and to summarize views on these methods expressed by stakeholders at the 2014 Adelaide International Workshop on Treatment Switching in Clinical Trials. We describe three statistical methods used to adjust for treatment switching: marginal structural models, two-stage adjustment, and rank preserving structural failure time models. We draw upon discussion heard at the Adelaide International Workshop to explore the views of stakeholders on the acceptability of these methods. Stakeholders noted that adjustment methods are based on assumptions, the validity of which may often be questionable. There was disagreement on the acceptability of adjustment methods, but consensus that when these are used, they should be justified rigorously. The utility of adjustment methods depends upon the decision being made and the processes used by the decision-maker. Treatment switching makes estimating the true comparative effect of a new treatment challenging. However, many decision-makers have reservations with adjustment methods. These, and how they affect the utility of adjustment methods, require further exploration. Further technical work is required to develop adjustment methods to meet real world needs, to enhance their acceptability to decision-makers.

  17. Is the distinction between adjustment disorder with depressed mood and adjustment disorder with mixed anxious and depressed mood valid?

    PubMed

    Zimmerman, Mark; Martinez, Jennifer H; Dalrymple, Kristy; Martinez, Jennifer H; Chelminski, Iwona; Young, Diane

    2013-11-01

    In the DSM-IV, adjustment disorder is subtyped according to the predominant presenting feature. The different diagnostic code numbers assigned to each subtype suggest their significance in DSM-IV. However, little research has examined the validity of these subtypes. In the present report from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project, we compared the demographic and clinical profiles of patients diagnosed with adjustment disorder subtypes to determine whether there was enough empirical evidence supporting the retention of multiple adjustment disorder subtypes in future versions of the DSM. A total of 3,400 psychiatric patients presenting to the Rhode Island Hospital outpatient practice were evaluated with semistructured diagnostic interviews for DSM-IV Axis I and Axis II disorders and measures of psychosocial morbidity. Approximately 7% (224 of 3,400) of patients were diagnosed with current adjustment disorder. Adjustment disorder with depressed mood and with mixed anxious and depressed mood were the most common subtypes, accounting for 80% of the patients diagnosed with adjustment disorder. There was no significant difference between these 2 groups with regard to demographic variables, current comorbid Axis I or Axis II disorders, lifetime history of major depressive disorder or anxiety disorders, psychosocial morbidity, or family history of psychiatric disorders. The only difference between the groups was lifetime history of drug use, which was significantly higher in the patients diagnosed with adjustment disorder with depressed mood. There is no evidence supporting the retention of both of these adjustment disorder subtypes, and DSM-IV previously set a precedent for eliminating adjustment disorder subtypes in the absence of any data. Therefore, in the spirit of nosologic parsimony, consideration should be given to collapsing the 2 disorders into 1: adjustment disorder with depressed mood.

  18. Covariate Imbalance and Adjustment for Logistic Regression Analysis of Clinical Trial Data

    PubMed Central

    Ciolino, Jody D.; Martin, Reneé H.; Zhao, Wenle; Jauch, Edward C.; Hill, Michael D.; Palesch, Yuko Y.

    2014-01-01

    In logistic regression analysis for binary clinical trial data, adjusted treatment effect estimates are often not equivalent to unadjusted estimates in the presence of influential covariates. This paper uses simulation to quantify the benefit of covariate adjustment in logistic regression. However, International Conference on Harmonization guidelines suggest that covariate adjustment be pre-specified. Unplanned adjusted analyses should be considered secondary. Results suggest that that if adjustment is not possible or unplanned in a logistic setting, balance in continuous covariates can alleviate some (but never all) of the shortcomings of unadjusted analyses. The case of log binomial regression is also explored. PMID:24138438

  19. Performance optimization of marine propellers

    NASA Astrophysics Data System (ADS)

    Lee, Chang-Sup; Choi, Young-Dal; Ahn, Byoung-Kwon; Shin, Myoung-Sup; Jang, Hyun-Gil

    2010-12-01

    Recently a Wide Chord Tip (WCT) propeller has been developed and applied to a commercial ship by STX Offshore & Shipbuilding. It is reported that the WCT propeller significantly reduces pressure fluctuations and also ship's noise and vibration. On the sea trial, vibration magnitude in the accommodations at NCR was measured at 0.9mm/sec which is only 10% of international allowable magnitude of vibration (9mm/sec). In this paper, a design method for increasing performance of the marine propellers including the WCT propeller is suggested. It is described to maximize the performance of the propeller by adjusting expanded areas of the propeller blade. Results show that efficiency can be increased up to over 2% through the suggested design method.

  20. Adjusting case mix payment amounts for inaccurately reported comorbidity data.

    PubMed

    Sutherland, Jason M; Hamm, Jeremy; Hatcher, Jeff

    2010-03-01

    Case mix methods such as diagnosis related groups have become a basis of payment for inpatient hospitalizations in many countries. Specifying cost weight values for case mix system payment has important consequences; recent evidence suggests case mix cost weight inaccuracies influence the supply of some hospital-based services. To begin to address the question of case mix cost weight accuracy, this paper is motivated by the objective of improving the accuracy of cost weight values due to inaccurate or incomplete comorbidity data. The methods are suitable to case mix methods that incorporate disease severity or comorbidity adjustments. The methods are based on the availability of detailed clinical and cost information linked at the patient level and leverage recent results from clinical data audits. A Bayesian framework is used to synthesize clinical data audit information regarding misclassification probabilities into cost weight value calculations. The models are implemented through Markov chain Monte Carlo methods. An example used to demonstrate the methods finds that inaccurate comorbidity data affects cost weight values by biasing cost weight values (and payments) downward. The implications for hospital payments are discussed and the generalizability of the approach is explored.

  1. A comparison of administrative and physiologic predictive models in determining risk adjusted mortality rates in critically ill patients.

    PubMed

    Enfield, Kyle B; Schafer, Katherine; Zlupko, Mike; Herasevich, Vitaly; Novicoff, Wendy M; Gajic, Ognjen; Hoke, Tracey R; Truwit, Jonathon D

    2012-01-01

    Hospitals are increasingly compared based on clinical outcomes adjusted for severity of illness. Multiple methods exist to adjust for differences between patients. The challenge for consumers of this information, both the public and healthcare providers, is interpreting differences in risk adjustment models particularly when models differ in their use of administrative and physiologic data. We set to examine how administrative and physiologic models compare to each when applied to critically ill patients. We prospectively abstracted variables for a physiologic and administrative model of mortality from two intensive care units in the United States. Predicted mortality was compared through the Pearsons Product coefficient and Bland-Altman analysis. A subgroup of patients admitted directly from the emergency department was analyzed to remove potential confounding changes in condition prior to ICU admission. We included 556 patients from two academic medical centers in this analysis. The administrative model and physiologic models predicted mortalities for the combined cohort were 15.3% (95% CI 13.7%, 16.8%) and 24.6% (95% CI 22.7%, 26.5%) (t-test p-value<0.001). The r(2) for these models was 0.297. The Bland-Atlman plot suggests that at low predicted mortality there was good agreement; however, as mortality increased the models diverged. Similar results were found when analyzing a subgroup of patients admitted directly from the emergency department. When comparing the two hospitals, there was a statistical difference when using the administrative model but not the physiologic model. Unexplained mortality, defined as those patients who died who had a predicted mortality less than 10%, was a rare event by either model. In conclusion, while it has been shown that administrative models provide estimates of mortality that are similar to physiologic models in non-critically ill patients with pneumonia, our results suggest this finding can not be applied globally to patients admitted to intensive care units. As patients and providers increasingly use publicly reported information in making health care decisions and referrals, it is critical that the provided information be understood. Our results suggest that severity of illness may influence the mortality index in administrative models. We suggest that when interpreting "report cards" or metrics, health care providers determine how the risk adjustment was made and compares to other risk adjustment models.

  2. Impact of Myopia on Corneal Biomechanics in Glaucoma and Nonglaucoma Patients

    PubMed Central

    Panpruk, Rawiphan; Manassakorn, Anita; Tantisevi, Visanee; Rojanapongpun, Prin; Hurst, Cameron P.; Lin, Shan C.

    2017-01-01

    Purpose We evaluated the impact of myopia on corneal biomechanical properties in primary open-angle glaucoma (POAG) and nonglaucoma patients, and the effect of modification of glaucoma on myopic eyes. Methods This cross-sectional study included 66 POAG eyes (33 myopia, 33 nonmyopia) and 66 normal eyes (33 myopia, 33 nonmyopia). Seven corneal biomechanical parameters were measured by ultra-high-speed Scheimpflug imaging, including corneal deformation amplitude (CDA), inward/outward corneal applanation length (ICA, OCA), inward/outward corneal velocity (ICV, OCV), radius, and peak distance (PD). Results Mean age (SD) of the 65 male (49%) and 67 female (51%) patients was 59 (9.82) years. Myopia was associated with significantly higher CDA (adjusted effect = 0.104, P = 0.001) and lower OCV (adjusted effect = −0.105, P < 0.001) in the POAG group. Within the nonglaucoma group, myopic eyes had a significantly lower OCV (adjusted effect = −0.086, P < 0.001) and higher CDA (adjusted effect = 0.079, P = 0.001). All parameters except PD suggested that glaucoma modified the effect of myopia on corneal biomechanics. Percentage differences in the adjusted myopic effect between POAG and nonglaucoma patients was 31.65, 27.27, 31.65, 50.00, 22.09, and 60.49 for CDA, ICA, OCA, ICV, OCV, and radius, respectively. Conclusions Myopia had a significant impact on corneal biomechanical properties in the POAG and nonglaucoma groups. The differences in corneal biomechanical parameters suggest that myopia is correlated with significantly lower ocular rigidity. POAG may enhance the effects of myopia on most of these parameters. PMID:28979996

  3. Price adjustment for traditional Chinese medicine procedures: Based on a standardized value parity model.

    PubMed

    Wang, Haiyin; Jin, Chunlin; Jiang, Qingwu

    2017-11-20

    Traditional Chinese medicine (TCM) is an important part of China's medical system. Due to the prolonged low price of TCM procedures and the lack of an effective mechanism for dynamic price adjustment, the development of TCM has markedly lagged behind Western medicine. The World Health Organization (WHO) has emphasized the need to enhance the development of alternative and traditional medicine when creating national health care systems. The establishment of scientific and appropriate mechanisms to adjust the price of medical procedures in TCM is crucial to promoting the development of TCM. This study has examined incorporating value indicators and data on basic manpower expended, time spent, technical difficulty, and the degree of risk in the latest standards for the price of medical procedures in China, and this study also offers a price adjustment model with the relative price ratio as a key index. This study examined 144 TCM procedures and found that prices of TCM procedures were mainly based on the value of medical care provided; on average, medical care provided accounted for 89% of the price. Current price levels were generally low and the current price accounted for 56% of the standardized value of a procedure, on average. Current price levels accounted for a markedly lower standardized value of acupuncture, moxibustion, special treatment with TCM, and comprehensive TCM procedures. This study selected a total of 79 procedures and adjusted them by priority. The relationship between the price of TCM procedures and the suggested price was significantly optimized (p < 0.01). This study suggests that adjustment of the price of medical procedures based on a standardized value parity model is a scientific and suitable method of price adjustment that can serve as a reference for other provinces and municipalities in China and other countries and regions that mainly have fee-for-service (FFS) medical care.

  4. Sugar-sweetened beverage intake and cardiovascular risk factor profile in youth with type 1 diabetes: application of measurement error methodology in the SEARCH Nutrition Ancillary Study.

    PubMed

    Liese, Angela D; Crandell, Jamie L; Tooze, Janet A; Kipnis, Victor; Bell, Ronny; Couch, Sarah C; Dabelea, Dana; Crume, Tessa L; Mayer-Davis, Elizabeth J

    2015-08-14

    The SEARCH Nutrition Ancillary Study aims to investigate the role of dietary intake on the development of long-term complications of type 1 diabetes in youth, and capitalise on measurement error (ME) adjustment methodology. Using the National Cancer Institute (NCI) method for episodically consumed foods, we evaluated the relationship between sugar-sweetened beverage (SSB) intake and cardiovascular risk factor profile, with the application of ME adjustment methodology. The calibration sample included 166 youth with two FFQ and three 24 h dietary recall data within 1 month. The full sample included 2286 youth with type 1 diabetes. SSB intake was significantly associated with higher TAG, total and LDL-cholesterol concentrations, after adjusting for energy, age, diabetes duration, race/ethnicity, sex and education. The estimated effect size was larger (model coefficients increased approximately 3-fold) after the application of the NCI method than without adjustment for ME. Compared with individuals consuming one serving of SSB every 2 weeks, those who consumed one serving of SSB every 2 d had 3.7 mg/dl (0.04 mmol/l) higher TAG concentrations and 4.0 mg/dl (0.10 mmol/l) higher total cholesterol and LDL-cholesterol concentrations, after adjusting for ME and covariates. SSB intake was not associated with measures of adiposity and blood pressure. Our findings suggest that SSB intake is significantly related to increased lipid levels in youth with type 1 diabetes, and that estimates of the effect size of SSB on lipid levels are severely attenuated in the presence of ME. Future studies in youth with diabetes should consider a design that will allow for the adjustment for ME when studying the influence of diet on health status.

  5. Application of acetate buffer in pH adjustment of sorghum mash and its influence on fuel ethanol fermentation.

    PubMed

    Zhao, Renyong; Bean, Scott R; Crozier-Dodson, Beth Ann; Fung, Daniel Y C; Wang, Donghai

    2009-01-01

    A 2 M sodium acetate buffer at pH 4.2 was tried to simplify the step of pH adjustment in a laboratory dry-grind procedure. Ethanol yields or conversion efficiencies of 18 sorghum hybrids improved significantly with 2.0-5.9% (3.9% on average) of relative increases when the method of pH adjustment changed from traditional HCl to the acetate buffer. Ethanol yields obtained using the two methods were highly correlated (R (2) = 0.96, P < 0.0001), indicating that the acetate buffer did not influence resolution of the procedure to differentiate sorghum hybrids varying in fermentation quality. Acetate retarded the growth of Saccharomyces cerevisiae, but did not affect the overall fermentation rate. With 41-47 mM of undissociated acetic acid in mash of a sorghum hybrid at pH 4.7, rates of glucose consumption and ethanol production were inhibited during exponential phase but promoted during stationary phase. The maximum growth rate constants (mu(max)) were 0.42 and 0.32 h(-1) for cells grown in mashes with pH adjusted by HCl and the acetate buffer, respectively. Viable cell counts of yeast in mashes with pH adjusted by the acetate buffer were 36% lower than those in mashes adjusted by HCl during stationary phase. Coupled to a 5.3% relative increase in ethanol, a 43.6% relative decrease in glycerol was observed, when the acetate buffer was substituted for HCl. Acetate helped to transfer glucose to ethanol more efficiently. The strain tested did not use acetic acid as carbon source. It was suggested that decreased levels of ATP under acetate stress stimulate glycolysis to ethanol formation, increasing its yield at the expense of biomass and glycerol production.

  6. Adjusting survival estimates for premature transmitter failure: A case study from the Sacramento-San Joaquin Delta

    USGS Publications Warehouse

    Holbrook, Christopher M.; Perry, Russell W.; Brandes, Patricia L.; Adams, Noah S.

    2013-01-01

    In telemetry studies, premature tag failure causes negative bias in fish survival estimates because tag failure is interpreted as fish mortality. We used mark-recapture modeling to adjust estimates of fish survival for a previous study where premature tag failure was documented. High rates of tag failure occurred during the Vernalis Adaptive Management Plan’s (VAMP) 2008 study to estimate survival of fall-run Chinook salmon (Oncorhynchus tshawytscha) during migration through the San Joaquin River and Sacramento-San Joaquin Delta, California. Due to a high rate of tag failure, the observed travel time distribution was likely negatively biased, resulting in an underestimate of tag survival probability in this study. Consequently, the bias-adjustment method resulted in only a small increase in estimated fish survival when the observed travel time distribution was used to estimate the probability of tag survival. Since the bias-adjustment failed to remove bias, we used historical travel time data and conducted a sensitivity analysis to examine how fish survival might have varied across a range of tag survival probabilities. Our analysis suggested that fish survival estimates were low (95% confidence bounds range from 0.052 to 0.227) over a wide range of plausible tag survival probabilities (0.48–1.00), and this finding is consistent with other studies in this system. When tags fail at a high rate, available methods to adjust for the bias may perform poorly. Our example highlights the importance of evaluating the tag life assumption during survival studies, and presents a simple framework for evaluating adjusted survival estimates when auxiliary travel time data are available.

  7. The Influence of Husbands' or Male Partners' Support on Women's Psychosocial Adjustment to Having an Ostomy Resulting from Colorectal Cancer

    PubMed Central

    Altschuler, Andrea; Ramirez, Michelle; Grant, Marcia; Wendel, Christopher; Hornbrook, Mark C.; Herrinton, Lisa; Krouse, Robert S.

    2009-01-01

    Objective Some patients with colorectal cancer (CRC) require a permanent ostomy, which changes bodily function and can create psychosocial distress. However, little is known about the influence of men's support on women's psychosocial adjustment to having an ostomy as a result of CRC. Methods Participants initially completed the City of Hope-CRC Quality of Life questionnaire. We then conducted in-depth interviews with 30 female participants. Interview questions focused on body image, gender, and sexuality. Interviews were recorded and transcribed. We used qualitative methods to analyze the interview data and compared global HRQOL quartile scores to the overall ways that women discussed husbands' or partners' support regarding psychosocial adjustments to having ostomies. Results Of 30 participants, 22 were married or partnered at the time of surgery and 8 were single. The non-partnered respondents are not included in this analysis. Of the 22 married/partnered women, 17 described positive support from husbands being central to their psychosocial adjustment, 3 described a lack or withdrawal of support negatively affecting adjustment, and 2 described support as neither positive nor negative. In 17 cases, women's high or low quantitative HRQOL scores matched the positive or negative qualitative findings. There were 3 cases in which there were positive qualitative data and low HRQOL scores, but each of these cases, women reported serious current co-morbidities. Conclusions These findings suggest that the provision or withdrawal of husbands' or partners' support can have a considerable impact on the psychosocial adjustment of female CRC patients with ostomies. These findings appear to be both short- and long-term. Survivorship assessments should include appraisals of women's relationships to spouses/partners. PMID:19448512

  8. Measuring Net Investment and Productivity in Timber Production

    Treesearch

    David N. Wear

    1994-01-01

    An index number approach is developed for measuring changes in inputs, outputs, and total factor productivity in a timber-producing sector. These methods are applied to timber production in the U.S. South for the period 1952 to 1985. Results suggest that development of the sector may be described by an adjustment phase between 1952 and 1962 and a growth phase between...

  9. Medicare changes create accounting, reporting, and auditing problems. Task Force on Federal Health Care Legislation, American Institute of Certified Public Accountants.

    PubMed

    1984-11-01

    Hospital auditors and financial officers must adjust and react to the changing financial healthcare environment brought about by PPS. A close review of accounting systems, reporting methods, auditing procedures, and internal control systems should be made to determine that assets are safe-guarded and financial information is presented in conformity with GAAP. This article identified new problems and suggested solutions. Old tasks may no longer be necessary. For example, retroactive adjustments are not as important as they used to be. Estimates for capital and outpatient costs may continue to be required, but elaborate cost-finding techniques may no longer be necessary to estimate retroactive adjustments for reimbursable items. We recommend that prior to beginning an audit of a hospital's financial statements, each hospital's financial officers and its auditors discuss the possible accounting, reporting, and auditing implications as a result of PPS.

  10. Comparison of Memory Function and MMPI-2 Profile between Post-traumatic Stress Disorder and Adjustment Disorder after a Traffic Accident

    PubMed Central

    Bae, Sung-Man; Hyun, Myoung-Ho

    2014-01-01

    Objective Differential diagnosis between post-traumatic stress disorder (PTSD) and adjustment disorder (AD) is rather difficult, but very important to the assignment of appropriate treatment and prognosis. This study investigated methods to differentiate PTSD and AD. Methods Twenty-five people with PTSD and 24 people with AD were recruited. Memory tests, the Minnesota Multiphasic Personality Inventory 2 (MMPI-2), and Beck's Depression Inventory were administered. Results There were significant decreases in immediate verbal recall and delayed verbal recognition in the participants with PTSD. The reduced memory functions of participants with PTSD were significantly influenced by depressive symptoms. Hypochondriasis, hysteria, psychopathic deviate, paranoia, schizophrenia, post-traumatic stress disorder scale of MMPI-2 classified significantly PTSD and AD group. Conclusion Our results suggest that verbal memory assessments and the MMPI-2 could be useful for discriminating between PTSD and AD. PMID:24851120

  11. Functional form and risk adjustment of hospital costs: Bayesian analysis of a Box-Cox random coefficients model.

    PubMed

    Hollenbeak, Christopher S

    2005-10-15

    While risk-adjusted outcomes are often used to compare the performance of hospitals and physicians, the most appropriate functional form for the risk adjustment process is not always obvious for continuous outcomes such as costs. Semi-log models are used most often to correct skewness in cost data, but there has been limited research to determine whether the log transformation is sufficient or whether another transformation is more appropriate. This study explores the most appropriate functional form for risk-adjusting the cost of coronary artery bypass graft (CABG) surgery. Data included patients undergoing CABG surgery at four hospitals in the midwest and were fit to a Box-Cox model with random coefficients (BCRC) using Markov chain Monte Carlo methods. Marginal likelihoods and Bayes factors were computed to perform model comparison of alternative model specifications. Rankings of hospital performance were created from the simulation output and the rankings produced by Bayesian estimates were compared to rankings produced by standard models fit using classical methods. Results suggest that, for these data, the most appropriate functional form is not logarithmic, but corresponds to a Box-Cox transformation of -1. Furthermore, Bayes factors overwhelmingly rejected the natural log transformation. However, the hospital ranking induced by the BCRC model was not different from the ranking produced by maximum likelihood estimates of either the linear or semi-log model. Copyright (c) 2005 John Wiley & Sons, Ltd.

  12. Marital Adjustment: A Valuable Resource for the Emotional Health of Individuals with Multiple Sclerosis.

    ERIC Educational Resources Information Center

    Rodgers, Jennifer; Calder, Peter

    1990-01-01

    Examined relationship of marital adjustment and level of disability of persons with multiple sclerosis (n=104) to emotional adjustment. Found emotional adjustment significantly related to perceived level of marital adjustment, but no relationship found for level of disability. Results suggest, although marital adjustment is important for emotional…

  13. 48 CFR 22.407 - Solicitation provision and contract clauses.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Adjustment (None or Separately Specified Pricing Method), in solicitations and contracts if the contract is... determines the most appropriate contract price adjustment method is the method at 22.404-12(c)(1) or (2); or....222-31, Davis-Bacon Act—Price Adjustment (Percentage Method), in solicitations and contracts if the...

  14. Ensemble of trees approaches to risk adjustment for evaluating a hospital's performance.

    PubMed

    Liu, Yang; Traskin, Mikhail; Lorch, Scott A; George, Edward I; Small, Dylan

    2015-03-01

    A commonly used method for evaluating a hospital's performance on an outcome is to compare the hospital's observed outcome rate to the hospital's expected outcome rate given its patient (case) mix and service. The process of calculating the hospital's expected outcome rate given its patient mix and service is called risk adjustment (Iezzoni 1997). Risk adjustment is critical for accurately evaluating and comparing hospitals' performances since we would not want to unfairly penalize a hospital just because it treats sicker patients. The key to risk adjustment is accurately estimating the probability of an Outcome given patient characteristics. For cases with binary outcomes, the method that is commonly used in risk adjustment is logistic regression. In this paper, we consider ensemble of trees methods as alternatives for risk adjustment, including random forests and Bayesian additive regression trees (BART). Both random forests and BART are modern machine learning methods that have been shown recently to have excellent performance for prediction of outcomes in many settings. We apply these methods to carry out risk adjustment for the performance of neonatal intensive care units (NICU). We show that these ensemble of trees methods outperform logistic regression in predicting mortality among babies treated in NICU, and provide a superior method of risk adjustment compared to logistic regression.

  15. Middle life crisis and industrial workers.

    PubMed

    Shwed, H

    1979-11-01

    Psychiatric consultation with a large utility company has uncovered a unique manifestation of the middle life syndrome. Employees with 20 or more years of service, referred to our psychiatric group, have in common such issues as "institutional transference," unfulfilled employee vocational dreams and fantasies, with concurrent inability to adjust to technological, geographical and personnel changes. The author suggests personnel programs and policies which might help to deal preventively with these problems before employees reach middle life. Methods are suggested in which corporation changes might be more sensitively instituted to meet the psychological needs of employees.

  16. Geographic disparities in colorectal cancer survival

    PubMed Central

    Henry, Kevin A; Niu, Xiaoling; Boscoe, Francis P

    2009-01-01

    Background Examining geographic variation in cancer patient survival can help identify important prognostic factors that are linked by geography and generate hypotheses about the underlying causes of survival disparities. In this study, we apply a recently developed spatial scan statistic method, designed for time-to-event data, to determine whether colorectal cancer (CRC) patient survival varies by place of residence after adjusting survival times for several prognostic factors. Methods Using data from a population-based, statewide cancer registry, we examined a cohort of 25,040 men and women from New Jersey who were newly diagnosed with local or regional stage colorectal cancer from 1996 through 2003 and followed to the end of 2006. Survival times were adjusted for significant prognostic factors (sex, age, stage at diagnosis, race/ethnicity and census tract socioeconomic deprivation) and evaluated using a spatial scan statistic to identify places where CRC survival was significantly longer or shorter than the statewide experience. Results Age, sex and stage adjusted survival times revealed several areas in the northern part of the state where CRC survival was significantly different than expected. The shortest and longest survival areas had an adjusted 5-year survival rate of 73.1% (95% CI 71.5, 74.9) and 88.3% (95% CI 85.4, 91.3) respectively, compared with the state average of 80.0% (95% CI 79.4, 80.5). Analysis of survival times adjusted for age, sex and stage as well as race/ethnicity and area socioeconomic deprivation attenuated the risk of death from CRC in several areas, but survival disparities persisted. Conclusion The results suggest that in areas where additional adjustments for race/ethnicity and area socioeconomic deprivation changed the geographic survival patterns and reduced the risk of death from CRC, the adjustment factors may be contributing causes of the disparities. Further studies should focus on specific and modifiable individual and neighborhood factors in the high risk areas that may affect a person's chance of surviving cancer. PMID:19627576

  17. An Illustration to Assist in Comparing and Remembering Several Multiplicity Adjustment Methods

    ERIC Educational Resources Information Center

    Hasler, Mario

    2017-01-01

    There are many well-known or new methods to adjust statistical tests for multiplicity. This article provides an illustration helping lecturers or consultants to remember the differences of three important multiplicity adjustment methods and to explain them to non-statisticians.

  18. Friends' knowledge of youth internalizing and externalizing adjustment: accuracy, bias, and the influences of gender, grade, positive friendship quality, and self-disclosure.

    PubMed

    Swenson, Lance P; Rose, Amanda J

    2009-08-01

    Some evidence suggests that close friends may be knowledgeable of youth's psychological adjustment. However, friends are understudied as reporters of adjustment. The current study examines associations between self- and friend-reports of internalizing and externalizing adjustment in a community sample of fifth-, eighth-, and eleventh-grade youth. The study extends prior work by considering the degree to which friends' reports of youth adjustment are accurate (i.e., predicted by youths' actual adjustment) versus biased (i.e., predicted by the friend reporters' own adjustment). Findings indicated stronger bias effects than accuracy effects, but the accuracy effects were significant for both internalizing and externalizing adjustment. Additionally, friends who perceived their relationships as high in positive quality, friends in relationships high in disclosure, and girls perceived youths' internalizing symptoms most accurately. Knowledge of externalizing adjustment was not influenced by gender, grade, relationship quality, or self-disclosure. Findings suggest that friends could play an important role in prevention efforts.

  19. Evaluation of trauma care using TRISS method: the role of adjusted misclassification rate and adjusted w-statistic.

    PubMed

    Llullaku, Sadik S; Hyseni, Nexhmi Sh; Bytyçi, Cen I; Rexhepi, Sylejman K

    2009-01-15

    Major trauma is a leading cause of death worldwide. Evaluation of trauma care using Trauma Injury and Injury Severity Score (TRISS) method is focused in trauma outcome (deaths and survivors). For testing TRISS method TRISS misclassification rate is used. Calculating w-statistic, as a difference between observed and TRISS expected survivors, we compare our trauma care results with the TRISS standard. The aim of this study is to analyze interaction between misclassification rate and w-statistic and to adjust these parameters to be closer to the truth. Analysis of components of TRISS misclassification rate and w-statistic and actual trauma outcome. The component of false negative (FN) (by TRISS method unexpected deaths) has two parts: preventable (Pd) and non-preventable (nonPd) trauma deaths. Pd represents inappropriate trauma care of an institution; otherwise nonpreventable trauma deaths represents errors in TRISS method. Removing patients with preventable trauma deaths we get an Adjusted misclassification rate: (FP + FN - Pd)/N or (b+c-Pd)/N. Substracting nonPd from FN value in w-statistic formula we get an Adjusted w-statistic: [FP-(FN - nonPd)]/N, respectively (FP-Pd)/N, or (b-Pd)/N). Because adjusted formulas clean method from inappropriate trauma care, and clean trauma care from the methods error, TRISS adjusted misclassification rate and adjusted w-statistic gives more realistic results and may be used in researches of trauma outcome.

  20. Norms and stigma around unintended pregnancy in Alabama: Associations with recent contraceptive use and dual method use among young women.

    PubMed

    Rice, Whitney S; Turan, Bulent; White, Kari; Turan, Janet M

    2017-12-14

    The role of unintended pregnancy norms and stigma in contraceptive use among young women is understudied. This study investigated relationships between anticipated reactions from others, perceived stigma, and endorsed stigma concerning unintended pregnancy, with any and dual contraceptive use in this population. From November 2014 to October 2015, young women aged 18-24 years (n = 390) and at risk for unintended pregnancy and sexually transmitted infections participated in a survey at a university and public health clinics in Alabama. Multivariable regression models examined associations of unintended pregnancy norms and stigma with contraceptive use, adjusted for demographic and psychosocial characteristics. Compared to nonusers, more any and dual method users, were White, nulliparous, and from the university and had higher income. In adjusted models, anticipated disapproval of unintended pregnancy by close others was associated with greater contraceptive use (adjusted Odds Ratio [aOR] = 1.54, 95 percent confidence interval [CI] = 1.03-2.30), and endorsement of stigma concerning unintended pregnancy was associated with lower odds of dual method use (aOR = 0.71, 95 percent CI = 0.51-1.00). Unintended pregnancy norms and stigma were associated with contraceptive behavior among young women in Alabama. Findings suggest the potential to promote effective contraceptive use in this population by leveraging close relationships and addressing endorsed stigma.

  1. 77 FR 29982 - Federal Acquisition Regulation; Submission for OMB Review; Davis Bacon Act-Price Adjustment...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-21

    ...; Submission for OMB Review; Davis Bacon Act-Price Adjustment (Actual Method) AGENCY: Department of Defense... (actual method). A notice was published in the Federal Register at 77 FR 13328, on March 6, 2012. No... Bacon Act-Price Adjustment (Actual Method), by any of the following methods: Regulations.gov : http...

  2. An improved bias correction method of daily rainfall data using a sliding window technique for climate change impact assessment

    NASA Astrophysics Data System (ADS)

    Smitha, P. S.; Narasimhan, B.; Sudheer, K. P.; Annamalai, H.

    2018-01-01

    Regional climate models (RCMs) are used to downscale the coarse resolution General Circulation Model (GCM) outputs to a finer resolution for hydrological impact studies. However, RCM outputs often deviate from the observed climatological data, and therefore need bias correction before they are used for hydrological simulations. While there are a number of methods for bias correction, most of them use monthly statistics to derive correction factors, which may cause errors in the rainfall magnitude when applied on a daily scale. This study proposes a sliding window based daily correction factor derivations that help build reliable daily rainfall data from climate models. The procedure is applied to five existing bias correction methods, and is tested on six watersheds in different climatic zones of India for assessing the effectiveness of the corrected rainfall and the consequent hydrological simulations. The bias correction was performed on rainfall data downscaled using Conformal Cubic Atmospheric Model (CCAM) to 0.5° × 0.5° from two different CMIP5 models (CNRM-CM5.0, GFDL-CM3.0). The India Meteorological Department (IMD) gridded (0.25° × 0.25°) observed rainfall data was considered to test the effectiveness of the proposed bias correction method. The quantile-quantile (Q-Q) plots and Nash Sutcliffe efficiency (NSE) were employed for evaluation of different methods of bias correction. The analysis suggested that the proposed method effectively corrects the daily bias in rainfall as compared to using monthly factors. The methods such as local intensity scaling, modified power transformation and distribution mapping, which adjusted the wet day frequencies, performed superior compared to the other methods, which did not consider adjustment of wet day frequencies. The distribution mapping method with daily correction factors was able to replicate the daily rainfall pattern of observed data with NSE value above 0.81 over most parts of India. Hydrological simulations forced using the bias corrected rainfall (distribution mapping and modified power transformation methods that used the proposed daily correction factors) was similar to those simulated by the IMD rainfall. The results demonstrate that the methods and the time scales used for bias correction of RCM rainfall data have a larger impact on the accuracy of the daily rainfall and consequently the simulated streamflow. The analysis suggests that the distribution mapping with daily correction factors can be preferred for adjusting RCM rainfall data irrespective of seasons or climate zones for realistic simulation of streamflow.

  3. Interconnection: A qualitative analysis of adjusting to living with renal cell carcinoma

    PubMed Central

    LEAL, ISABEL; MILBURY, KATHRIN; ENGEBRETSON, JOAN; MATIN, SURENA; JONASCH, ERIC; TANNIR, NIZAR; WOOD, CHRISTOPHER G.; COHEN, LORENZO

    2017-01-01

    Objective Adjusting to cancer is an ongoing process, yet few studies explore this adjustment from a qualitative perspective. The aim of our qualitative study was to understand how patients construct their experience of adjusting to living with cancer. Method Qualitative analysis was conducted of written narratives collected from four separate writing sessions as part of a larger expressive writing clinical trial with renal cell carcinoma patients. Thematic analysis and constant comparison were employed to code the primary patterns in the data into themes until thematic saturation was reached at 37 participants. A social constructivist perspective informed data interpretation. Results Interconnection described the overarching theme underlying the process of adjusting to cancer and involved four interrelated themes: (1) discontinuity—feelings of disconnection and loss following diagnosis; (2) reorientation—to the reality of cancer psychologically and physically; (3) rebuilding—struggling through existential distress to reconnect; and (4) expansion—finding meaning in interconnections with others. Participants related a dialectical movement in which disruption and loss catalyzed an ongoing process of finding meaning. Significance of results Our findings suggest that adjusting to living with cancer is an ongoing, iterative, nonlinear process. The dynamic interactions between the different themes in this process describe the transformation of meaning as participants move through and revisit prior themes in response to fluctuating symptoms and medical news. It is important that clinicians recognize the dynamic and ongoing process of adjusting to cancer to support patients in addressing their unmet psychosocial needs throughout the changing illness trajectory. PMID:28262086

  4. A survey of outcome of adjustable suture as first operation in patients with strabismus

    PubMed Central

    Razmjoo, Hasan; Attarzadeh, Hosein; Karbasi, Najmeh; Najarzadegan, Mohammad Reza; Salam, Hasan; Jamshidi, Aliraza

    2014-01-01

    Background: Adjustable suture used for years to improve the outcome of strabismus surgery. We surveyed outcome of our patients with strabismus who underwent adjustable suture. Materials and Methods: This retrospective study was performed at Ophthalmology Centre of Feiz Hospital in Isfahan on 95 participants that candidate for adjustable suture strabismus surgery. Patients were divided into three age groups: Under 10 years, 10-19 years, and 20 years and over. Outcome of adjustable suture surgery consequence of residual postoperative deviation was divided into four groups: Excellent, good, acceptable, and unacceptable. Results: Out of 95 patients studied, 51 (53.7%) were males and 44 (46.3%) were females. The mean of deviation angles were 53.8 ± 17.9 PD (Prism dioptres) in alt XT, 44.5 ± 12 PD in alt ET and 52 ± 13.5 PD in const ET, 47.1 ± 13.1PD in cons XT, respectively. There was no significant difference between the groups (P = 0.051). Results of surgery were in 38 patients (40%) excellent, in 31 patients (32.6%) good, in 19 patients (20%) acceptable, and in 7 patients (7.4%) unacceptable. Seven (7.4%) patients required reoperation. Conclusions: In the present study, the frequency of re-operation was much lower than other similar studies (7.4% vs. 30-50%). This suggests that the adjustable technique that used in our study can be associated with lower reoperation than other adjustable techniques used in the other similar studies. PMID:25250293

  5. Examining the Correlation between Objective Injury Parameters, Personality Traits, and Adjustment Measures among Burn Victims

    PubMed Central

    Weissman, Oren; Domniz, Noam; Petashnick, Yoel R.; Gilboa, Dalia; Raviv, Tal; Barzilai, Liran; Farber, Nimrod; Harats, Moti; Winkler, Eyal; Haik, Josef

    2015-01-01

    Background: Burn victims experience immense physical and mental hardship during their process of rehabilitation and regaining functionality. We examined different objective burn-related factors as well as psychological ones, in the form of personality traits that may affect the rehabilitation process and its outcome. Objective: To assess the influence and correlation of specific personality traits and objective injury-related parameters on the adjustment of burn victims post-injury. Methods: Sixty-two male patients admitted to our burn unit due to burn injuries were compared with 36 healthy male individuals by use of questionnaires to assess each group’s psychological adjustment parameters. Multivariate and hierarchical regression analysis was conducted to identify differences between the groups. Results: A significant negative correlation was found between the objective burn injury severity (e.g., total body surface area and burn depth) and the adjustment of burn victims (p < 0.05, p < 0.001, Table 3). Moreover, patients more severely injured tend to be more neurotic (p < 0.001), and less extroverted and agreeable (p < 0.01, Table 4). Conclusion: Extroverted burn victims tend to adjust better to their post-injury life while the neurotic patients tend to have difficulties adjusting. This finding may suggest new tools for early identification of maladjustment-prone patients and therefore provide them with better psychological support in a more dedicated manner. PMID:25874193

  6. Testing for Clinical Inertia in Medication Treatment of Bipolar Disorder

    PubMed Central

    Hodgkin, Dominic; Merrick, Elizabeth L.; O'Brien, Peggy L.; McGuire, Thomas G.; Lee, Sue; Deckersbach, Thilo; Nierenberg, Andrew A.

    2016-01-01

    Background Clinical inertia has been defined as lack of change in medication treatment at visits where a medication adjustment appears to be indicated. This paper seeks to identify the extent of clinical inertia in medication treatment of bipolar disorder. A second goal is to identify patient characteristics that predict this treatment pattern. Method Data describe 23,406 visits made by 1,815 patients treated for bipolar disorder during the STEP-BD practical clinical trial. Visits were classified in terms of whether a medication adjustment appears to be indicated, and also whether or not one occurred. Multivariable regression analyses were conducted to find which patient characteristics were predictive of whether adjustment occurred. Results 36% of visits showed at least 1 indication for adjustment. The most common indications were non-response to medication, side effects, and start of a new illness episode. Among visits with an indication for adjustment, no adjustment occurred 19% of the time, which may be suggestive of clinical inertia. In multivariable models, presence of any indication for medication adjustment was a predictor of receiving one (OR=1.125, 95% CI = 1.015, 1.246), although not as strong as clinical status measures. Limitations The associations observed are not necessarily causal, given the study design. The data also lack information about physician-patient communication. Conclusions Many patients remained on the same medication regimen despite indications of side effects or non-response to treatment. Although lack of adjustment does not necessarily reflect clinical inertia in all cases, the reasons for this treatment pattern merit further examination. PMID:27391267

  7. The ACCE method: an approach for obtaining quantitative or qualitative estimates of residual confounding that includes unmeasured confounding

    PubMed Central

    Smith, Eric G.

    2015-01-01

    Background:  Nonrandomized studies typically cannot account for confounding from unmeasured factors.  Method:  A method is presented that exploits the recently-identified phenomenon of  “confounding amplification” to produce, in principle, a quantitative estimate of total residual confounding resulting from both measured and unmeasured factors.  Two nested propensity score models are constructed that differ only in the deliberate introduction of an additional variable(s) that substantially predicts treatment exposure.  Residual confounding is then estimated by dividing the change in treatment effect estimate between models by the degree of confounding amplification estimated to occur, adjusting for any association between the additional variable(s) and outcome. Results:  Several hypothetical examples are provided to illustrate how the method produces a quantitative estimate of residual confounding if the method’s requirements and assumptions are met.  Previously published data is used to illustrate that, whether or not the method routinely provides precise quantitative estimates of residual confounding, the method appears to produce a valuable qualitative estimate of the likely direction and general size of residual confounding. Limitations:  Uncertainties exist, including identifying the best approaches for: 1) predicting the amount of confounding amplification, 2) minimizing changes between the nested models unrelated to confounding amplification, 3) adjusting for the association of the introduced variable(s) with outcome, and 4) deriving confidence intervals for the method’s estimates (although bootstrapping is one plausible approach). Conclusions:  To this author’s knowledge, it has not been previously suggested that the phenomenon of confounding amplification, if such amplification is as predictable as suggested by a recent simulation, provides a logical basis for estimating total residual confounding. The method's basic approach is straightforward.  The method's routine usefulness, however, has not yet been established, nor has the method been fully validated. Rapid further investigation of this novel method is clearly indicated, given the potential value of its quantitative or qualitative output. PMID:25580226

  8. Polymorphisms of pro-inflammatory cytokine genes and the risk for acute suppurative or chronic nonsuppurative apical periodontitis in a Colombian population.

    PubMed

    Amaya, M P; Criado, L; Blanco, B; Gómez, M; Torres, O; Flórez, L; González, C I; Flórez, O

    2013-01-01

    To determine the association of functional single nucleotide polymorphisms in genes of the pro-inflammatory cytokines tumour necrosis factor-α, interleukin-1β, interleukin-8 and interleukin-12B with the development of two clinical forms of apical periodontitis (AP): acute suppurative and chronic nonsuppurative. The study included 120 patients from Bucaramanga City, Colombia, 63 diagnosed with acute suppurative AP (ASAP) and 57 diagnosed with chronic nonsuppurative AP (CNAP). Genotyping for IL1B +3954 (rs1143634), IL8 / CXCL8 -251 (rs4073), IL12B +1188 (rs3212227) and TNFA -308 (rs1800629) was performed by the PCR-restriction fragment length polymorphisms method. The statistical analysis was performed using STATA 10.0 and PLINK V1.07 software. Significant differences in the distribution of IL8 / CXCL8 -251 A allele (P adjusted = 0.041; OR adjusted = 0.41, CI adjusted = 0.31-0.97) and IL8 / CXCL -251 TT genotype (P adjusted = 0.04; OR adjusted = 2.24, CI adjusted = 1.04-4.84) were observed comparing patients diagnosed with ASAP and CNAP. No association was observed in genotype and allele distribution for other genetic polymorphisms analysed. This study provides molecular epidemiological evidence that suggests in the present cohort that IL8 / CXCL8 -251 T allele, which is associated with higher production of IL8/CXCL8, is also associated with a higher risk of developing acute suppurative form of AP, whereas IL8 / CXCL8 -251 A allele, which is associated with lower production of IL8/CXCL8, is associated with chronic nonsuppurative form of AP. This suggests a pivotal role for IL-8/CXCL8 in periapical disease because of its ability to induce chemotaxis and modulating the directed migration of neutrophils to the site of inflammation in response to microbial infection of pulp. © 2012 International Endodontic Journal.

  9. Systems and methods for mirror mounting with minimized distortion

    NASA Technical Reports Server (NTRS)

    Antonille, Scott R. (Inventor); Wallace, Thomas E. (Inventor); Content, David A. (Inventor); Wake, Shane W. (Inventor)

    2012-01-01

    A method for mounting a mirror for use in a telescope includes attaching the mirror to a plurality of adjustable mounts; determining a distortion in the mirror caused by the plurality adjustable mounts, and, if the distortion is determined to be above a predetermined level: adjusting one or more of the adjustable mounts; and determining the distortion in the mirror caused by the adjustable mounts; and in the event the determined distortion is determined to be at or below the predetermined level, rigidizing the adjustable mounts.

  10. Level of education and multiple sclerosis risk after adjustment for known risk factors: The EnvIMS study

    PubMed Central

    Bjørnevik, Kjetil; Riise, Trond; Cortese, Marianna; Holmøy, Trygve; Kampman, Margitta T; Magalhaes, Sandra; Myhr, Kjell-Morten; Wolfson, Christina; Pugliatti, Maura

    2016-01-01

    Background: Several recent studies have found a higher risk of multiple sclerosis (MS) among people with a low level of education. This has been suggested to reflect an effect of smoking and lower vitamin D status in the social class associated with lower levels of education. Objective: The objective of this paper is to investigate the association between level of education and MS risk adjusting for the known risk factors smoking, infectious mononucleosis, indicators of vitamin D levels and body size. Methods: Within the case-control study on Environmental Factors In MS (EnvIMS), 953 MS patients and 1717 healthy controls from Norway reported educational level and history of exposure to putative environmental risk factors. Results: Higher level of education were associated with decreased MS risk (p trend = 0.001) with an OR of 0.53 (95% CI 0.41–0.68) when comparing those with the highest and lowest level of education. This association was only moderately reduced after adjusting for known risk factors (OR 0.61, 95% CI 0.44–0.83). The estimates remained similar when cases with disease onset before age 28 were excluded. Conclusion: These findings suggest that factors related to lower socioeconomic status other than established risk factors are associated with MS risk. PMID:26014605

  11. A Model to Predict Psychological- and Health-Related Adjustment in Men with Prostate Cancer: The Role of Post Traumatic Growth, Physical Post Traumatic Growth, Resilience and Mindfulness.

    PubMed

    Walsh, Deirdre M J; Morrison, Todd G; Conway, Ronan J; Rogers, Eamonn; Sullivan, Francis J; Groarke, AnnMarie

    2018-01-01

    Background: Post traumatic growth (PTG) can be defined as positive change following a traumatic event. The current conceptualization of PTG encompasses five main dimensions, however, there is no dimension which accounts for the distinct effect of a physical trauma on PTG. The purpose of the present research was to test the role of PTG, physical post traumatic growth (PPTG), resilience and mindfulness in predicting psychological and health related adjustment. Method: Ethical approval was obtained from relevant institutional ethics committees. Participants ( N = 241), who were at least 1 year post prostate cancer treatment, were invited to complete a battery of questionnaires either through an online survey or a paper and pencil package received in the post The sample ranged in age from 44 to 88 years ( M = 64.02, SD = 7.76). Data were analysis using confirmatory factor analysis and structural equation modeling. Results: The physical post traumatic growth inventory (P-PTGI) was used to evaluate the role of PPTG in predicting adjustment using structural equation modeling. P-PTGI predicted lower distress and improvement of quality of life, whereas conversely, the traditional PTG measure was linked with poor adjustment. The relationship between resilience and adjustment was found to be mediated by P-PTGI. Conclusion: Findings suggest the central role of PTG in the prostate cancer survivorship experience is enhanced by the inclusion of PPTG. Adjusting to a physical trauma such as illness (internal transgressor) is unlike a trauma with an external transgressor as the physical trauma creates an entirely different framework for adjustment. The current study demonstrates the impact of PPTG on adjustment. This significantly adds to the theory of the development of PTG by highlighting the interplay of resilience with PTG, PPTG, and adjustment.

  12. Outcomes of deliveries by family physicians or obstetricians: a population-based cohort study using an instrumental variable

    PubMed Central

    Aubrey-Bassler, Kris; Cullen, Richard M.; Simms, Alvin; Asghari, Shabnam; Crane, Joan; Wang, Peizhong Peter; Godwin, Marshall

    2015-01-01

    Background: Previous research has suggested that obstetric outcomes are similar for deliveries by family physicians and obstetricians, but many of these studies were small, and none of them adjusted for unmeasured selection bias. We compared obstetric outcomes between these provider types using an econometric method designed to adjust for unobserved confounding. Methods: We performed a retrospective population-based cohort study of all Canadian (except Quebec) hospital births with delivery by family physicians and obstetricians at more than 20 weeks gestational age, with birth weight greater than 500 g, between Apr. 1, 2006, and Mar. 31, 2009. The primary outcomes were the relative risks of in-hospital perinatal death and a composite of maternal mortality and major morbidity assessed with multivariable logistic regression and instrumental variable–adjusted multivariable regression. Results: After exclusions, there were 3600 perinatal deaths and 14 394 cases of maternal morbidity among 799 823 infants and 793 053 mothers at 390 hospitals. For deliveries by family physicians v. obstetricians, the relative risk of perinatal mortality was 0.98 (95% confidence interval [CI] 0.85–1.14) and of maternal morbidity was 0.81 (95% CI 0.70–0.94) according to logistic regression. The respective relative risks were 0.97 (95% CI 0.58–1.64) and 1.13 (95% CI 0.65–1.95) according to instrumental variable methods. Interpretation: After adjusting for both observed and unobserved confounders, we found a similar risk of perinatal mortality and adverse maternal outcome for obstetric deliveries by family physicians and obstetricians. Whether there are differences between these groups for other outcomes remains to be seen. PMID:26303244

  13. Multivariable confounding adjustment in distributed data networks without sharing of patient-level data.

    PubMed

    Toh, Sengwee; Reichman, Marsha E; Houstoun, Monika; Ding, Xiao; Fireman, Bruce H; Gravel, Eric; Levenson, Mark; Li, Lingling; Moyneur, Erick; Shoaibi, Azadeh; Zornberg, Gwen; Hennessy, Sean

    2013-11-01

    It is increasingly necessary to analyze data from multiple sources when conducting public health safety surveillance or comparative effectiveness research. However, security, privacy, proprietary, and legal concerns often reduce data holders' willingness to share highly granular information. We describe and compare two approaches that do not require sharing of patient-level information to adjust for confounding in multi-site studies. We estimated the risks of angioedema associated with angiotensin-converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs), and aliskiren in comparison with beta-blockers within Mini-Sentinel, which has created a distributed data system of 18 health plans. To obtain the adjusted hazard ratios (HRs) and 95% confidence intervals (CIs), we performed (i) a propensity score-stratified case-centered logistic regression analysis, a method identical to a stratified Cox regression analysis but needing only aggregated risk set data, and (ii) an inverse variance-weighted meta-analysis, which requires only the site-specific HR and variance. We also performed simulations to further compare the two methods. Compared with beta-blockers, the adjusted HR was 3.04 (95% CI: 2.81, 3.27) for ACEIs, 1.16 (1.00, 1.34) for ARBs, and 2.85 (1.34, 6.04) for aliskiren in the case-centered analysis. The corresponding HRs were 2.98 (2.76, 3.21), 1.15 (1.00, 1.33), and 2.86 (1.35, 6.04) in the meta-analysis. Simulations suggested that the two methods may produce different results under certain analytic scenarios. The case-centered analysis and the meta-analysis produced similar results without the need to share patient-level data across sites in our empirical study, but may provide different results in other study settings. Copyright © 2013 John Wiley & Sons, Ltd.

  14. Resolving the theory of planned behaviour's 'expectancy-value muddle' using dimensional salience.

    PubMed

    Newton, Joshua D; Ewing, Michael T; Burney, Sue; Hay, Margaret

    2012-01-01

    The theory of planned behaviour is one of the most widely used models of decision-making in the health literature. Unfortunately, the primary method for assessing the theory's belief-based expectancy-value models results in statistically uninterpretable findings, giving rise to what has become known as the 'expectancy-value muddle'. Moreover, existing methods for resolving this muddle are associated with various conceptual or practical limitations. This study addresses these issues by identifying and evaluating a parsimonious method for resolving the expectancy-value muddle. Three hundred and nine Australian residents aged 18-24 years rated the expectancy and value of 18 beliefs about posthumous organ donation. Participants also nominated their five most salient beliefs using a dimensional salience approach. Salient beliefs were perceived as being more likely to eventuate than non-salient beliefs, indicating that salient beliefs could be used to signify the expectancy component. The expectancy-value term was therefore represented by summing the value ratings of salient beliefs, an approach that predicted attitude (adjusted R2 = 0.21) and intention (adjusted R2 = 0.21). These findings suggest that the dimensional salience approach is a useful method for overcoming the expectancy-value muddle in applied research settings.

  15. Animal food intake and cooking methods in relation to endometrial cancer risk in Shanghai

    PubMed Central

    Xu, W-H; Dai, Q; Xiang, Y-B; Zhao, G-M; Zheng, W; Gao, Y-T; Ruan, Z-X; Cheng, J-R; Shu, X-O

    2006-01-01

    We evaluated animal food intake and cooking methods in relation to endometrial cancer risk in a population-based case–control study in Shanghai, China. A validated food frequency questionnaire was used to collect the usual dietary habits of 1204 cases and 1212 controls aged 30–69 years between 1997 and 2003. Statistical analyses were based on an unconditional logistic regression model adjusting for potential confounders. High intake of meat and fish was associated with an increased risk of endometrial cancer, with adjusted odds ratios for the highest vs the lowest quartile groups being 1.7 (95% confidence interval: 1.3–2.2) and 2.4 (1.8–3.1), respectively. The elevated risk was observed for all types of meat and fish intake. Intake of eggs and milk was not related to risk. Cooking methods and doneness levels for meat and fish were not associated with risk, nor did they modify the association with meat and fish consumption. Our study suggests that animal food consumption may play an important role in the aetiology of endometrial cancer, but cooking methods have minimal influence on risk among Chinese women. PMID:17060930

  16. Improved Horvitz-Thompson Estimation of Model Parameters from Two-phase Stratified Samples: Applications in Epidemiology

    PubMed Central

    Breslow, Norman E.; Lumley, Thomas; Ballantyne, Christie M; Chambless, Lloyd E.; Kulich, Michal

    2009-01-01

    The case-cohort study involves two-phase sampling: simple random sampling from an infinite super-population at phase one and stratified random sampling from a finite cohort at phase two. Standard analyses of case-cohort data involve solution of inverse probability weighted (IPW) estimating equations, with weights determined by the known phase two sampling fractions. The variance of parameter estimates in (semi)parametric models, including the Cox model, is the sum of two terms: (i) the model based variance of the usual estimates that would be calculated if full data were available for the entire cohort; and (ii) the design based variance from IPW estimation of the unknown cohort total of the efficient influence function (IF) contributions. This second variance component may be reduced by adjusting the sampling weights, either by calibration to known cohort totals of auxiliary variables correlated with the IF contributions or by their estimation using these same auxiliary variables. Both adjustment methods are implemented in the R survey package. We derive the limit laws of coefficients estimated using adjusted weights. The asymptotic results suggest practical methods for construction of auxiliary variables that are evaluated by simulation of case-cohort samples from the National Wilms Tumor Study and by log-linear modeling of case-cohort data from the Atherosclerosis Risk in Communities Study. Although not semiparametric efficient, estimators based on adjusted weights may come close to achieving full efficiency within the class of augmented IPW estimators. PMID:20174455

  17. 29 CFR 785.42 - Adjusting grievances.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Adjusting Grievances, Medical Attention, Civic and Charitable Work, and Suggestion Systems § 785.42 Adjusting grievances. Time spent in adjusting grievances between an employer and employees during the time the employees are required to be on the premises is hours worked, but in the event a bona fide union...

  18. The Relationship of Paternal Acceptance and Control to College Females' Personality Adjustment.

    ERIC Educational Resources Information Center

    Musser, John M.; Fleck, J. Roland

    1983-01-01

    Examined the relationship between father acceptance, father control, and personality adjustment of 72 college women. As expected, both paternal behavior dimensions were positively related to the daughters' level of personality adjustment, suggesting authoritarian fathers have daughters who rate themselves as better adjusted. (JAC)

  19. Is Weight-Based Adjustment of Automatic Exposure Control Necessary for the Reduction of Chest CT Radiation Dose?

    PubMed Central

    Prakash, Priyanka; Gilman, Matthew D.; Shepard, Jo-Anne O.; Digumarthy, Subba R.

    2010-01-01

    Objective To assess the effects of radiation dose reduction in the chest CT using a weight-based adjustment of the automatic exposure control (AEC) technique. Materials and Methods With Institutional Review Board Approval, 60 patients (mean age, 59.1 years; M:F = 35:25) and 57 weight-matched patients (mean age, 52.3 years, M:F = 25:32) were scanned using a weight-adjusted AEC and non-weight-adjusted AEC, respectively on a 64-slice multidetector CT with a 0.984:1 pitch, 0.5 second rotation time, 40 mm table feed/rotation, and 2.5 mm section thickness. Patients were categorized into 3 weight categories; < 60 kg (n = 17), 60-90 kg (n = 52), and > 90 kg (n = 48). Patient weights, scanning parameters, CT dose index volumes (CTDIvol) and dose length product (DLP) were recorded, while effective dose (ED) was estimated. Image noise was measured in the descending thoracic aorta. Data were analyzed using a standard statistical package (SAS/STAT) (Version 9.1, SAS institute Inc, Cary, NC). Results Compared to the non-weight-adjusted AEC, the weight-adjusted AEC technique resulted in an average decrease of 29% in CTDIvol and a 27% effective dose reduction (p < 0.0001). With weight-adjusted AEC, the CTDIvol decreased to 15.8, 15.9, and 27.3 mGy for the < 60, 60-90 and > 91 kg weight groups, respectively, compared to 20.3, 27.9 and 32.8 mGy, with non-weight-adjusted AEC. No significant difference was observed for objective image noise between the chest CT acquired with the non-weight-adjusted (15.0 ± 3.1) and weight-adjusted (16.1 ± 5.6) AEC techniques (p > 0.05). Conclusion The results of this study suggest that AEC should be tailored according to patient weight. Without weight-based adjustment of AEC, patients are exposed to a 17 - 43% higher radiation-dose from a chest CT. PMID:20046494

  20. Sequential and simultaneous SLAR block adjustment. [spline function analysis for mapping

    NASA Technical Reports Server (NTRS)

    Leberl, F.

    1975-01-01

    Two sequential methods of planimetric SLAR (Side Looking Airborne Radar) block adjustment, with and without splines, and three simultaneous methods based on the principles of least squares are evaluated. A limited experiment with simulated SLAR images indicates that sequential block formation with splines followed by external interpolative adjustment is superior to the simultaneous methods such as planimetric block adjustment with similarity transformations. The use of the sequential block formation is recommended, since it represents an inexpensive tool for satisfactory point determination from SLAR images.

  1. A Review on Methods of Risk Adjustment and their Use in Integrated Healthcare Systems

    PubMed Central

    Juhnke, Christin; Bethge, Susanne

    2016-01-01

    Introduction: Effective risk adjustment is an aspect that is more and more given weight on the background of competitive health insurance systems and vital healthcare systems. The objective of this review was to obtain an overview of existing models of risk adjustment as well as on crucial weights in risk adjustment. Moreover, the predictive performance of selected methods in international healthcare systems should be analysed. Theory and methods: A comprehensive, systematic literature review on methods of risk adjustment was conducted in terms of an encompassing, interdisciplinary examination of the related disciplines. Results: In general, several distinctions can be made: in terms of risk horizons, in terms of risk factors or in terms of the combination of indicators included. Within these, another differentiation by three levels seems reasonable: methods based on mortality risks, methods based on morbidity risks as well as those based on information on (self-reported) health status. Conclusions and discussion: After the final examination of different methods of risk adjustment it was shown that the methodology used to adjust risks varies. The models differ greatly in terms of their included morbidity indicators. The findings of this review can be used in the evaluation of integrated healthcare delivery systems and can be integrated into quality- and patient-oriented reimbursement of care providers in the design of healthcare contracts. PMID:28316544

  2. Enhanced TDMA Based Anti-Collision Algorithm with a Dynamic Frame Size Adjustment Strategy for Mobile RFID Readers

    PubMed Central

    Shin, Kwang Cheol; Park, Seung Bo; Jo, Geun Sik

    2009-01-01

    In the fields of production, manufacturing and supply chain management, Radio Frequency Identification (RFID) is regarded as one of the most important technologies. Nowadays, Mobile RFID, which is often installed in carts or forklift trucks, is increasingly being applied to the search for and checkout of items in warehouses, supermarkets, libraries and other industrial fields. In using Mobile RFID, since the readers are continuously moving, they can interfere with each other when they attempt to read the tags. In this study, we suggest a Time Division Multiple Access (TDMA) based anti-collision algorithm for Mobile RFID readers. Our algorithm automatically adjusts the frame size of each reader without using manual parameters by adopting the dynamic frame size adjustment strategy when collisions occur at a reader. Through experiments on a simulated environment for Mobile RFID readers, we show that the proposed method improves the number of successful transmissions by about 228% on average, compared with Colorwave, a representative TDMA based anti-collision algorithm. PMID:22399942

  3. One giant leap for mankind? A cost-utility analysis of abolishing the law of gravity

    PubMed Central

    Cyr, Claude; Lanthier, Luc

    2007-01-01

    Background Canada's Neo Rhino Party, a joke political party created in 2006 as a successor to the Parti Rhinocéros, is planning a new regulation to repeal the law of gravity, which could have an important impact on diseases attributable to gravity on earth. Methods We sought to estimate the number of quality-adjusted life-years that would be saved if the proposed regulation is passed and determine the cost-effectiveness of adapting Boris Volfson's antigravity machine1 for use on earth. We performed an economic analysis using a hidden Markov model. Results Our results suggest that a microgravity environment would save over 2 million quality-adjusted life-years. The cost for every quality-adjusted life-year saved is estimated to be $328. Interpretation Microgravity is the solution to the health care crisis in Canada. In addition, using technological, statistical and medical jargon gives us the opportunity to defy the laws of physics, mathematics and medicine. PMID:18056617

  4. Enhanced TDMA Based Anti-Collision Algorithm with a Dynamic Frame Size Adjustment Strategy for Mobile RFID Readers.

    PubMed

    Shin, Kwang Cheol; Park, Seung Bo; Jo, Geun Sik

    2009-01-01

    In the fields of production, manufacturing and supply chain management, Radio Frequency Identification (RFID) is regarded as one of the most important technologies. Nowadays, Mobile RFID, which is often installed in carts or forklift trucks, is increasingly being applied to the search for and checkout of items in warehouses, supermarkets, libraries and other industrial fields. In using Mobile RFID, since the readers are continuously moving, they can interfere with each other when they attempt to read the tags. In this study, we suggest a Time Division Multiple Access (TDMA) based anti-collision algorithm for Mobile RFID readers. Our algorithm automatically adjusts the frame size of each reader without using manual parameters by adopting the dynamic frame size adjustment strategy when collisions occur at a reader. Through experiments on a simulated environment for Mobile RFID readers, we show that the proposed method improves the number of successful transmissions by about 228% on average, compared with Colorwave, a representative TDMA based anti-collision algorithm.

  5. Is seeing believing? Expectant parents’ outlooks on coparenting and later coparenting solidarity

    PubMed Central

    McHale, James P.; Rotman, Tamir

    2007-01-01

    This study examined short- and longer-term sequelae of parents’ prenatal expectations of their future family process, and traced subsequent stability in coparenting solidarity from infancy through the toddler years. 110 couples expecting a first child participated in prenatal assessments of coparenting expectations and differences, and in 3 month post-partum evaluations. 45 couples completed subsequent assessments at 12 and 30 months. At each time point multi-method evaluations of coparental adjustment were obtained. Men’s and women’s expectancies during the pregnancy and the degree of difference between their self-reported beliefs about parenting predicted post-baby coparental adjustment, with latent class analyses suggesting aftereffects of prenatal expectancies up through 30 months for some couples. Coparental solidarity was also stable from 3 to 12 and from 12 to 30 months. Data indicate that the lens parents bring to bear on their emerging family system is not immaterial, and that early-emerging coparenting dynamics portend longer term coparenting adjustment. PMID:17292781

  6. 77 FR 13663 - Order Making Fiscal Year 2012 Mid-Year Adjustments to Transaction Fee Rates

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-07

    ... the Exchange Act establish a new method for annually adjusting the fee rates applicable under Sections... 31(j)(2) specifies the method for determining the mid-year adjustment for fiscal 2012. Specifically... the month ($4,797,592,302,406). Repeat the method to generate forecasts for subsequent months. \\14...

  7. [Effect of 2 methods of occlusion adjustment on occlusal balance and muscles of mastication in patient with implant restoration].

    PubMed

    Wang, Rong; Xu, Xin

    2015-12-01

    To compare the effect of 2 methods of occlusion adjustment on occlusal balance and muscles of mastication in patients with dental implant restoration. Twenty patients, each with a single edentulous posterior dentition with no distal dentition were selected, and divided into 2 groups. Patients in group A underwent original occlusion adjustment method and patients in group B underwent occlusal plane reduction technique. Ankylos implants were implanted in the edentulous space in each patient and restored with fixed prosthodontics single unit crown. Occlusion was adjusted in each restoration accordingly. Electromyograms were conducted to determine the effect of adjustment methods on occlusion and muscles of mastication 3 months and 6 months after initial restoration and adjustment. Data was collected and measurements for balanced occlusal measuring standards were obtained, including central occlusion force (COF), asymmetry index of molar occlusal force(AMOF). Balanced muscles of mastication measuring standards were also obtained including measurements from electromyogram for the muscles of mastication and the anterior bundle of the temporalis muscle at the mandibular rest position, average electromyogram measurements of the anterior bundle of the temporalis muscle at the intercuspal position(ICP), Astot, masseter muscle asymmetry index, and anterior temporalis asymmetry index (ASTA). Statistical analysis was performed using Student 's t test with SPSS 18.0 software package. Three months after occlusion adjustment, parameters of the original occlusion adjustment method were significantly different between group A and group B in balanced occlusal measuring standards and balanced muscles of mastication measuring standards. Six months after occlusion adjustment, parameters of the original occlusion adjustment methods were significantly different between group A and group B in balanced muscles of mastication measuring standards, but was no significant difference in balanced occlusal measuring standards. Using occlusion plane reduction adjustment technique, it is possible to obtain occlusion index and muscles of mastication's electromyogram index similar to the opposite side's natural dentition in patients with single unit fix prosthodontics crown and single posterior edentulous dentition without distal dentitions.

  8. CD8+ T cells and Risk for Bacterial Pneumonia and All-Cause Mortality Among HIV-infected Women

    PubMed Central

    Gohil, Shruti; Heo, Moonseong; Schoenbaum, Ellie; Celentano, David; Pirofski, Liise-anne

    2012-01-01

    Background Bacterial pneumonia risk is disproportionately high among those infected with Human Immunodeficiency Virus (HIV). This risk is present across all CD4+ T cell levels (TCL), suggesting additional factors govern susceptibility. This study examines CD8+ TCL and risk for HIV-associated bacterial pneumonia and all-cause mortality. Methods Demographic, clinical, and laboratory data were obtained for 885 HIV-infected (HIV+) women enrolled in the HIV Epidemiologic Research Study (HERS). Bacterial pneumonia cases were identified using clinical, microbiologic, and radiographic criteria. CD8+ TCLs were assessed at 6-month intervals. Statistical methods included Cox proportional hazards regression modeling and covariate-adjusted survival estimates. Results Relative to a referent CD8+ TCL 401–800 cells/mm3, risk for bacterial pneumonia was significantly higher when CD8+ TCLs were ≤ 400 (hazard ratio 1.65, p=0.017, 95% CI 1.10–2.49), after adjusting for age, CD4+ TCL, viral load, and antiretroviral use. There was also a significantly higher risk of death when CD8+ TCLs were ≤ 400 cells/mm3 (hazard ratio 1.45, p=0.04, 95% CI 1.02–2.06). Covariate-adjusted survival estimates revealed shorter time to pneumonia and death in this CD8+ TCL category and the overall association of the categorized CD8+TCL with bacterial pneumonia and all-cause mortality were each statistically significant (p=0.017 and p<0.0001, respectively). Conclusions CD8+ TCL ≤ 400 cells/mm3 was associated with increased risk for pneumonia and all-cause mortality in HIV-infected women in the HERS Cohort, suggesting that CD8+ TCL could serve as an adjunctive biomarker of pneumonia risk and mortality in HIV-infected individuals. PMID:22334070

  9. The effect of an interactive follow-up program on ostomy adjustment of inpatients after their discharge from surgical wards of the hospitals affiliated to Isfahan University of Medical Sciences.

    PubMed

    Hamidi, Yaser; Moeini, Mahin; Yousefi, Hojatollah

    2018-04-07

    Ostomy patients suffer from many physical and mental problems, which can be solved to a large extent with the help of education and follow-up programs. These follow-ups can be done in person or on the telephone by the nurses, or even, by sending a text message that is an easier way for the patients to adapt to their condition. This study aimed to investigate the effect of an interactive follow-up program on the adjustment of ostomy inpatients after being discharged. This study is a clinical trial, conducted on 64 ostomy patients who were discharged from the surgical wards of the hospital affiliated to Isfahan University of Medical Sciences. Subjects in the experimental group participated in a 6-week follow-up program via text message. The information about the patients were collected by Olbrisch Ostomy Adjustment Scale. The obtained results have suggested that 34.4% of the patients in the experimental group and 28.1% of the patients in the control group were female. Before the intervention, comparing the mean score of ostomy adjustment and its dimensions in the two groups showed no significant difference (P > 0.05). However, a significant difference was observed between the two groups immediately after the intervention (P < 0.05) and 1 month after the intervention, except for dimension of negative acceptance (P > 0.05). The findings of this study suggested that using SMS can be considered as a proper tool or method for following up the ostomy patients.

  10. Use of standard hypodermic needles for accessing laparoscopic adjustable gastric band ports.

    PubMed

    Bewsher, Samuel Mark; Azzi, Anthony; Wright, Timothy

    2010-06-01

    Laparoscopic adjustable gastric banding is a common and successful method of surgically treating morbid obesity. A recipient will have to attend their surgeon's rooms a number of times to optimally adjust the amount of fluid in the band and hence the amount of restriction. Manufacturers suggest that the ports should be accessed with special non-coring needles that may not always be available in regional or remote centers, and this could create a safety risk in cases where urgent band deflation is required. Ports of two different brands were repeatedly accessed over 100 times in the same location while containing fluid under pressure, using a standard beveled 21 g hypodermic needle (SN) and a 20 g Huber tipped non-coring needle (NCN). The path the needles types took through the port septum was also examined. There was no leakage of fluid from any of the ports tested. Neither SN nor NCN passed through the port septum down their axis, but rather in a direction closer to that of their beveled surface. There is no more risk of "coring" the septum with a SN than with a NCN. SN can be used safely and routinely to access laparoscopic adjustable gastric band ports.

  11. Effect of the 5-HTTLPR polymorphism on posttraumatic stress disorder, depression, anxiety, and quality of life among Iraq and Afghanistan veterans

    PubMed Central

    Kimbrel, Nathan A.; Morissette, Sandra B.; Meyer, Eric C.; Chrestman, Roberta; Jamroz, Robert; Silvia, Paul J.; Beckham, Jean C.; Young, Keith A.

    2015-01-01

    Background Posttraumatic stress disorder (PTSD), depression, anxiety, and stress are significant problems among returning veterans and are associated with reduced quality of life. Design A correlational design was used to examine the impact of a polymorphism (5-HTTLPR) in the serotonin transporter promoter gene on post-deployment adjustment among returning veterans. Methods A total of 186 returning Iraq and Afghanistan veterans were genotyped for the 5-HTTLPR polymorphism. Symptoms of PTSD, depression, general stress, and anxiety were assessed along with quality of life. Results After controlling for combat exposure, age, sex of the participant, and race, 5-HTTLPR had a significant multivariate effect on post-deployment adjustment, such that S′ carriers reported more post-deployment adjustment problems and worse quality of life than veterans homozygous for the L′ allele. This effect was larger when the analyses were restricted to veterans of European ancestry. Conclusions Our findings suggest that veterans who carry the S′ allele of the 5-HTTLPR polymorphism may be at increased risk for adjustment problems and reduced quality of life following deployments to war zones. PMID:25314020

  12. Fasting Glucose, Obesity, and Coronary Artery Calcification in Community-Based People Without Diabetes

    PubMed Central

    Rutter, Martin K.; Massaro, Joseph M.; Hoffmann, Udo; O’Donnell, Christopher J.; Fox, Caroline S.

    2012-01-01

    OBJECTIVE Our objective was to assess whether impaired fasting glucose (IFG) and obesity are independently related to coronary artery calcification (CAC) in a community-based population. RESEARCH DESIGN AND METHODS We assessed CAC using multidetector computed tomography in 3,054 Framingham Heart Study participants (mean [SD] age was 50 [10] years, 49% were women, 29% had IFG, and 25% were obese) free from known vascular disease or diabetes. We tested the hypothesis that IFG (5.6–6.9 mmol/L) and obesity (BMI ≥30 kg/m2) were independently associated with high CAC (>90th percentile for age and sex) after adjusting for hypertension, lipids, smoking, and medication. RESULTS High CAC was significantly related to IFG in an age- and sex-adjusted model (odds ratio 1.4 [95% CI 1.1–1.7], P = 0.002; referent: normal fasting glucose) and after further adjustment for obesity (1.3 [1.0–1.6], P = 0.045). However, IFG was not associated with high CAC in multivariable-adjusted models before (1.2 [0.9–1.4], P = 0.20) or after adjustment for obesity. Obesity was associated with high CAC in age- and sex-adjusted models (1.6 [1.3–2.0], P < 0.001) and in multivariable models that included IFG (1.4 [1.1–1.7], P = 0.005). Multivariable-adjusted spline regression models suggested nonlinear relationships linking high CAC with BMI (J-shaped), waist circumference (J-shaped), and fasting glucose. CONCLUSIONS In this community-based cohort, CAC was associated with obesity, but not IFG, after adjusting for important confounders. With the increasing worldwide prevalence of obesity and nondiabetic hyperglycemia, these data underscore the importance of obesity in the pathogenesis of CAC. PMID:22773705

  13. Method and apparatus for lead-unity-lag electric power generation system

    NASA Technical Reports Server (NTRS)

    Ganev, Evgeni (Inventor); Warr, William (Inventor); Salam, Mohamed (Arif) (Inventor)

    2013-01-01

    A method employing a lead-unity-lag adjustment on a power generation system is disclosed. The method may include calculating a unity power factor point and adjusting system parameters to shift a power factor angle to substantially match an operating power angle creating a new unity power factor point. The method may then define operation parameters for a high reactance permanent magnet machine based on the adjusted power level.

  14. The influence of pelvic adjustment on vertical jump height in female university students with functional leg length inequality.

    PubMed

    Gong, Wontae

    2015-01-01

    [Purpose] This study aimed to investigate the effect of pelvic adjustment on vertical jump height (VJH) in female university students with functional leg length inequality (FLLI). [Subjects] Thirty female university students with FLLI were divided into a pelvic adjustment group (n = 15) and a stretching (control) group (n = 15). [Methods] VJH was measured using an OptoGait. [Results] After the intervention, jump height improved significantly compared with the pre-intervention height only in the pelvic adjustment group, while FLLI showed statistically significant improvement in both groups. [Conclusion] Pelvic adjustment as per the Gonstead method can be applied as a method of reducing FLLI and increasing VJH.

  15. Income inequality and mortality: a multilevel prospective study of 521 248 individuals in 50 US states.

    PubMed

    Backlund, Eric; Rowe, Geoff; Lynch, John; Wolfson, Michael C; Kaplan, George A; Sorlie, Paul D

    2007-06-01

    Some of the most consistent evidence in favour of an association between income inequality and health has been among US states. However, in multilevel studies of mortality, only two out of five studies have reported a positive relationship with income inequality after adjustment for the compositional characteristics of the state's inhabitants. In this study, we attempt to clarify these mixed results by analysing the relationship within age-sex groups and by applying a previously unused analytical method to a database that contains more deaths than any multilevel study to date. The US National Longitudinal Mortality Study (NLMS) was used to model the relationship between income inequality in US states and mortality using both a novel and previously used methodologies that fall into the general framework of multilevel regression. We adjust age-sex specific models for nine socioeconomic and demographic variables at the individual level and percentage black and region at the state level. The preponderance of evidence from this study suggests that 1990 state-level income inequality is associated with a 40% differential in state level mortality rates (95% CI = 26-56%) for men 25-64 years and a 14% (95% CI = 3-27%) differential for women 25-64 years after adjustment for compositional factors. No such relationship was found for men or women over 65. The relationship between income inequality and mortality is only robust to adjustment for compositional factors in men and women under 65. This explains why income inequality is not a major driver of mortality trends in the United States because most deaths occur at ages 65 and over. This analysis does suggest, however, the certain causes of death that occur primarily in the population under 65 may be associated with income inequality. Comparison of analytical techniques also suggests coefficients for income inequality in previous multilevel mortality studies may be biased, but further research is needed to provide a definitive answer.

  16. Comparison on genomic predictions using three GBLUP methods and two single-step blending methods in the Nordic Holstein population

    PubMed Central

    2012-01-01

    Background A single-step blending approach allows genomic prediction using information of genotyped and non-genotyped animals simultaneously. However, the combined relationship matrix in a single-step method may need to be adjusted because marker-based and pedigree-based relationship matrices may not be on the same scale. The same may apply when a GBLUP model includes both genomic breeding values and residual polygenic effects. The objective of this study was to compare single-step blending methods and GBLUP methods with and without adjustment of the genomic relationship matrix for genomic prediction of 16 traits in the Nordic Holstein population. Methods The data consisted of de-regressed proofs (DRP) for 5 214 genotyped and 9 374 non-genotyped bulls. The bulls were divided into a training and a validation population by birth date, October 1, 2001. Five approaches for genomic prediction were used: 1) a simple GBLUP method, 2) a GBLUP method with a polygenic effect, 3) an adjusted GBLUP method with a polygenic effect, 4) a single-step blending method, and 5) an adjusted single-step blending method. In the adjusted GBLUP and single-step methods, the genomic relationship matrix was adjusted for the difference of scale between the genomic and the pedigree relationship matrices. A set of weights on the pedigree relationship matrix (ranging from 0.05 to 0.40) was used to build the combined relationship matrix in the single-step blending method and the GBLUP method with a polygenetic effect. Results Averaged over the 16 traits, reliabilities of genomic breeding values predicted using the GBLUP method with a polygenic effect (relative weight of 0.20) were 0.3% higher than reliabilities from the simple GBLUP method (without a polygenic effect). The adjusted single-step blending and original single-step blending methods (relative weight of 0.20) had average reliabilities that were 2.1% and 1.8% higher than the simple GBLUP method, respectively. In addition, the GBLUP method with a polygenic effect led to less bias of genomic predictions than the simple GBLUP method, and both single-step blending methods yielded less bias of predictions than all GBLUP methods. Conclusions The single-step blending method is an appealing approach for practical genomic prediction in dairy cattle. Genomic prediction from the single-step blending method can be improved by adjusting the scale of the genomic relationship matrix. PMID:22455934

  17. The effect of accuracy motivation on anchoring and adjustment: do people adjust from provided anchors?

    PubMed

    Simmons, Joseph P; LeBoeuf, Robyn A; Nelson, Leif D

    2010-12-01

    Increasing accuracy motivation (e.g., by providing monetary incentives for accuracy) often fails to increase adjustment away from provided anchors, a result that has led researchers to conclude that people do not effortfully adjust away from such anchors. We challenge this conclusion. First, we show that people are typically uncertain about which way to adjust from provided anchors and that this uncertainty often causes people to believe that they have initially adjusted too far away from such anchors (Studies 1a and 1b). Then, we show that although accuracy motivation fails to increase the gap between anchors and final estimates when people are uncertain about the direction of adjustment, accuracy motivation does increase anchor-estimate gaps when people are certain about the direction of adjustment, and that this is true regardless of whether the anchors are provided or self-generated (Studies 2, 3a, 3b, and 5). These results suggest that people do effortfully adjust away from provided anchors but that uncertainty about the direction of adjustment makes that adjustment harder to detect than previously assumed. This conclusion has important theoretical implications, suggesting that currently emphasized distinctions between anchor types (self-generated vs. provided) are not fundamental and that ostensibly competing theories of anchoring (selective accessibility and anchoring-and-adjustment) are complementary. PsycINFO Database Record (c) 2010 APA, all rights reserved.

  18. Nonlinear predictive control for adaptive adjustments of deep brain stimulation parameters in basal ganglia-thalamic network.

    PubMed

    Su, Fei; Wang, Jiang; Niu, Shuangxia; Li, Huiyan; Deng, Bin; Liu, Chen; Wei, Xile

    2018-02-01

    The efficacy of deep brain stimulation (DBS) for Parkinson's disease (PD) depends in part on the post-operative programming of stimulation parameters. Closed-loop stimulation is one method to realize the frequent adjustment of stimulation parameters. This paper introduced the nonlinear predictive control method into the online adjustment of DBS amplitude and frequency. This approach was tested in a computational model of basal ganglia-thalamic network. The autoregressive Volterra model was used to identify the process model based on physiological data. Simulation results illustrated the efficiency of closed-loop stimulation methods (amplitude adjustment and frequency adjustment) in improving the relay reliability of thalamic neurons compared with the PD state. Besides, compared with the 130Hz constant DBS the closed-loop stimulation methods can significantly reduce the energy consumption. Through the analysis of inter-spike-intervals (ISIs) distribution of basal ganglia neurons, the evoked network activity by the closed-loop frequency adjustment stimulation was closer to the normal state. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. A life domains perspective on acculturation and psychological adjustment: a study of refugees from the former Soviet Union.

    PubMed

    Birman, Dina; Simon, Corrina D; Chan, Wing Yi; Tran, Nellie

    2014-03-01

    The study articulates a contextual approach to research on acculturation of immigrants, suggesting that the relationship between acculturation and adjustment is dependent on the cultural demands of the life domains considered. Specifically, the study investigated the mediating effects of adjustment in occupational and social life domains on the relationship between acculturation and psychological adjustment for 391 refugees from the former Soviet Union. The study used bilinear measures of acculturation to the host (American) and heritage (Russian) cultures. Using Structural Equation Modeling, the study confirmed the hypothesized relationships, such that the positive effects of American acculturation on psychological adjustment were mediated by occupational adjustment, and the effects of Russian acculturation on psychological adjustment were mediated by satisfaction with co-ethnic social support. Psychological adjustment was measured in two ways, as psychological well-being, using a measure of life satisfaction, and as symptoms of depression and anxiety, using the Hopkins symptom checklist (HSCL). Life satisfaction served as a mediator between adjustment in occupational and social domains and HSCL, suggesting that it may be an intervening variable through which environmental stress associated with immigration contributes to the development of symptoms of mental disorder.

  20. Environmental Chemicals in Urine and Blood: Improving Methods for Creatinine and Lipid Adjustment

    PubMed Central

    O’Brien, Katie M.; Upson, Kristen; Cook, Nancy R.; Weinberg, Clarice R.

    2015-01-01

    Background Investigators measuring exposure biomarkers in urine typically adjust for creatinine to account for dilution-dependent sample variation in urine concentrations. Similarly, it is standard to adjust for serum lipids when measuring lipophilic chemicals in serum. However, there is controversy regarding the best approach, and existing methods may not effectively correct for measurement error. Objectives We compared adjustment methods, including novel approaches, using simulated case–control data. Methods Using a directed acyclic graph framework, we defined six causal scenarios for epidemiologic studies of environmental chemicals measured in urine or serum. The scenarios include variables known to influence creatinine (e.g., age and hydration) or serum lipid levels (e.g., body mass index and recent fat intake). Over a range of true effect sizes, we analyzed each scenario using seven adjustment approaches and estimated the corresponding bias and confidence interval coverage across 1,000 simulated studies. Results For urinary biomarker measurements, our novel method, which incorporates both covariate-adjusted standardization and the inclusion of creatinine as a covariate in the regression model, had low bias and possessed 95% confidence interval coverage of nearly 95% for most simulated scenarios. For serum biomarker measurements, a similar approach involving standardization plus serum lipid level adjustment generally performed well. Conclusions To control measurement error bias caused by variations in serum lipids or by urinary diluteness, we recommend improved methods for standardizing exposure concentrations across individuals. Citation O’Brien KM, Upson K, Cook NR, Weinberg CR. 2016. Environmental chemicals in urine and blood: improving methods for creatinine and lipid adjustment. Environ Health Perspect 124:220–227; http://dx.doi.org/10.1289/ehp.1509693 PMID:26219104

  1. Adjustment Costs, Firm Responses, and Micro vs. Macro Labor Supply Elasticities: Evidence from Danish Tax Records*

    PubMed Central

    Chetty, Raj; Friedman, John N.; Olsen, Tore; Pistaferri, Luigi

    2011-01-01

    We show that the effects of taxes on labor supply are shaped by interactions between adjustment costs for workers and hours constraints set by firms. We develop a model in which firms post job offers characterized by an hours requirement and workers pay search costs to find jobs. We present evidence supporting three predictions of this model by analyzing bunching at kinks using Danish tax records. First, larger kinks generate larger taxable income elasticities. Second, kinks that apply to a larger group of workers generate larger elasticities. Third, the distribution of job offers is tailored to match workers' aggregate tax preferences in equilibrium. Our results suggest that macro elasticities may be substantially larger than the estimates obtained using standard microeconometric methods. PMID:21836746

  2. Design and control of active vision based mechanisms for intelligent robots

    NASA Technical Reports Server (NTRS)

    Wu, Liwei; Marefat, Michael M.

    1994-01-01

    In this paper, we propose a design of an active vision system for intelligent robot application purposes. The system has the degrees of freedom of pan, tilt, vergence, camera height adjustment, and baseline adjustment with a hierarchical control system structure. Based on this vision system, we discuss two problems involved in the binocular gaze stabilization process: fixation point selection and vergence disparity extraction. A hierarchical approach to determining point of fixation from potential gaze targets using evaluation function representing human visual behavior to outside stimuli is suggested. We also characterize different visual tasks in two cameras for vergence control purposes, and a phase-based method based on binarized images to extract vergence disparity for vergence control is presented. A control algorithm for vergence control is discussed.

  3. Adjusting for multiple prognostic factors in the analysis of randomised trials

    PubMed Central

    2013-01-01

    Background When multiple prognostic factors are adjusted for in the analysis of a randomised trial, it is unclear (1) whether it is necessary to account for each of the strata, formed by all combinations of the prognostic factors (stratified analysis), when randomisation has been balanced within each stratum (stratified randomisation), or whether adjusting for the main effects alone will suffice, and (2) the best method of adjustment in terms of type I error rate and power, irrespective of the randomisation method. Methods We used simulation to (1) determine if a stratified analysis is necessary after stratified randomisation, and (2) to compare different methods of adjustment in terms of power and type I error rate. We considered the following methods of analysis: adjusting for covariates in a regression model, adjusting for each stratum using either fixed or random effects, and Mantel-Haenszel or a stratified Cox model depending on outcome. Results Stratified analysis is required after stratified randomisation to maintain correct type I error rates when (a) there are strong interactions between prognostic factors, and (b) there are approximately equal number of patients in each stratum. However, simulations based on real trial data found that type I error rates were unaffected by the method of analysis (stratified vs unstratified), indicating these conditions were not met in real datasets. Comparison of different analysis methods found that with small sample sizes and a binary or time-to-event outcome, most analysis methods lead to either inflated type I error rates or a reduction in power; the lone exception was a stratified analysis using random effects for strata, which gave nominal type I error rates and adequate power. Conclusions It is unlikely that a stratified analysis is necessary after stratified randomisation except in extreme scenarios. Therefore, the method of analysis (accounting for the strata, or adjusting only for the covariates) will not generally need to depend on the method of randomisation used. Most methods of analysis work well with large sample sizes, however treating strata as random effects should be the analysis method of choice with binary or time-to-event outcomes and a small sample size. PMID:23898993

  4. Monthly stumpage prices for the Pacific Northwest.

    Treesearch

    Richard W. Haynes

    1991-01-01

    Seasonal variation is found in monthly stumpage price data. Seasonal adjustments indicate that monthly adjustments improve the utility of estimates of monthly stumpage prices. Comparisons of adjusted and unadjusted prices suggest that the unadjusted price series are reasonably robust.

  5. Vitiligo linked to stigmatization in British South Asian women: a qualitative study of the experiences of living with vitiligo.

    PubMed

    Thompson, A R; Clarke, S A; Newell, R J; Gawkrodger, D J

    2010-09-01

    Vitiligo is a visible condition that is more noticeable in darker-skinned people. Beliefs about illness have been linked to psychosocial adjustment. There is some evidence that such beliefs may be influenced by cultural factors. Surprisingly little is known about beliefs in relation to vitiligo. The study sought to explore in depth the ways in which British Asian women manage and adjust psychosocially to vitiligo, and the potential role of ethnicity and culture in this process. In-depth semistructured interviews were conducted with seven British women of South Asian decent and analysed using the qualitative method of template analysis. Participants described feeling visibly different and all had experienced stigmatization to some extent. Avoidance and concealment were commonplace. Experiences of stigmatization were often perceived to be associated with cultural values related to appearance, status, and myths linked to the cause of the condition. The findings of this study present a unique in-depth analysis of British South Asians living with vitiligo and suggest there is a need for further research to explore cultural associations of disfigurement and of adjustment to chronic skin conditions. Furthermore, they suggest that in addition to individual therapeutic interventions there may be a need for community interventions aimed at dispelling myths and raising awareness of sources of support and treatment. © 2010 The Authors. Journal Compilation © 2010 British Association of Dermatologists.

  6. Use of the MoCA in Detecting Early Alzheimer's Disease in a Spanish-Speaking Population with Varied Levels of Education

    PubMed Central

    Zhou, Yan; Ortiz, Freddy; Nuñez, Christopher; Elashoff, David; Woo, Ellen; Apostolova, Liana G.; Wolf, Sheldon; Casado, Maria; Caceres, Nenette; Panchal, Hemali; Ringman, John M.

    2015-01-01

    Background/Aims Performance on the Montreal Cognitive Assessment (MoCA) has been demonstrated to be dependent on the educational level. The purpose of this study was to identify how to best adjust MoCA scores and to identify MoCA items most sensitive to cognitive decline in incipient Alzheimer's disease (AD) in a Spanish-speaking population with varied levels of education. Methods We analyzed data from 50 Spanish-speaking participants. We examined the pattern of diagnosis-adjusted MoCA residuals in relation to education and compared four alternative score adjustments using bootstrap sampling. Sensitivity and specificity analyses were performed for the raw and each adjusted score. The interval reliability of the MoCA as well as item discrimination and item validity were examined. Results We found that with progressive compensation added for those with lower education, unexplained residuals decreased and education-residual association moved to zero, suggesting that more compensation was necessary to better adjust MoCA scores in those with a lower educational level. Cube copying, sentence repetition, delayed recall, and orientation were most sensitive to cognitive impairment due to AD. Conclusion A compensation of 3-4 points was needed for <6 years of education. Overall, the Spanish version of the MoCA maintained adequate psychometric properties in this population. PMID:25873930

  7. Radar-raingauge data combination techniques: a revision and analysis of their suitability for urban hydrology.

    PubMed

    Wang, Li-Pen; Ochoa-Rodríguez, Susana; Simões, Nuno Eduardo; Onof, Christian; Maksimović, Cedo

    2013-01-01

    The applicability of the operational radar and raingauge networks for urban hydrology is insufficient. Radar rainfall estimates provide a good description of the spatiotemporal variability of rainfall; however, their accuracy is in general insufficient. It is therefore necessary to adjust radar measurements using raingauge data, which provide accurate point rainfall information. Several gauge-based radar rainfall adjustment techniques have been developed and mainly applied at coarser spatial and temporal scales; however, their suitability for small-scale urban hydrology is seldom explored. In this paper a review of gauge-based adjustment techniques is first provided. After that, two techniques, respectively based upon the ideas of mean bias reduction and error variance minimisation, were selected and tested using as case study an urban catchment (∼8.65 km(2)) in North-East London. The radar rainfall estimates of four historical events (2010-2012) were adjusted using in situ raingauge estimates and the adjusted rainfall fields were applied to the hydraulic model of the study area. The results show that both techniques can effectively reduce mean bias; however, the technique based upon error variance minimisation can in general better reproduce the spatial and temporal variability of rainfall, which proved to have a significant impact on the subsequent hydraulic outputs. This suggests that error variance minimisation based methods may be more appropriate for urban-scale hydrological applications.

  8. Improved automatic adjustment of density and contrast in FCR system using neural network

    NASA Astrophysics Data System (ADS)

    Takeo, Hideya; Nakajima, Nobuyoshi; Ishida, Masamitsu; Kato, Hisatoyo

    1994-05-01

    FCR system has an automatic adjustment of image density and contrast by analyzing the histogram of image data in the radiation field. Advanced image recognition methods proposed in this paper can improve the automatic adjustment performance, in which neural network technology is used. There are two methods. Both methods are basically used 3-layer neural network with back propagation. The image data are directly input to the input-layer in one method and the histogram data is input in the other method. The former is effective to the imaging menu such as shoulder joint in which the position of interest region occupied on the histogram changes by difference of positioning and the latter is effective to the imaging menu such as chest-pediatrics in which the histogram shape changes by difference of positioning. We experimentally confirm the validity of these methods (about the automatic adjustment performance) as compared with the conventional histogram analysis methods.

  9. Pixel-based speckle adjustment for noise reduction in Fourier-domain OCT images.

    PubMed

    Zhang, Anqi; Xi, Jiefeng; Sun, Jitao; Li, Xingde

    2017-03-01

    Speckle resides in OCT signals and inevitably effects OCT image quality. In this work, we present a novel method for speckle noise reduction in Fourier-domain OCT images, which utilizes the phase information of complex OCT data. In this method, speckle area is pre-delineated pixelwise based on a phase-domain processing method and then adjusted by the results of wavelet shrinkage of the original image. Coefficient shrinkage method such as wavelet or contourlet is applied afterwards for further suppressing the speckle noise. Compared with conventional methods without speckle adjustment, the proposed method demonstrates significant improvement of image quality.

  10. Study of micro piezoelectric vibration generator with added mass and capacitance suitable for broadband vibration

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

    He, Qing, E-mail: hqng@163.com; Mao, Xinhua, E-mail: 30400414@qq.com; Chu, Dongliang, E-mail: 569256386@qq.com

    This study proposes an optimized frequency adjustment method that uses a micro-cantilever beam-based piezoelectric vibration generator based on a combination of added mass and capacitance. The most important concept of the proposed method is that the frequency adjustment process is divided into two steps: the first is a rough adjustment step that changes the size of the mass added at the end of cantilever to adjust the frequency in a large-scale and discontinuous manner; the second step is a continuous but short-range frequency adjustment via the adjustable added capacitance. Experimental results show that when the initial natural frequency of amore » micro piezoelectric vibration generator is 69.8 Hz, then this natural frequency can be adjusted to any value in the range from 54.2 Hz to 42.1 Hz using the combination of the added mass and the capacitance. This method simply and effectively matches a piezoelectric vibration generator’s natural frequency to the vibration source frequency.« less

  11. Separation of pedogenic and lithogenic components of magnetic susceptibility in the Chinese loess/palaeosol sequence as determined by the CBD procedure and a mixing analysis

    NASA Astrophysics Data System (ADS)

    Vidic, Nataša. J.; TenPas, Jeff D.; Verosub, Kenneth L.; Singer, Michael J.

    2000-08-01

    Magnetic susceptibility variations in the Chinese loess/palaeosol sequences have been used extensively for palaeoclimatic interpretations. The magnetic signal of these sequences must be divided into lithogenic and pedogenic components because the palaeoclimatic record is primarily reflected in the pedogenic component. In this paper we compare two methods for separating the pedogenic and lithogenic components of the magnetic susceptibility signal: the citrate-bicarbonate-dithionite (CBD) extraction procedure, and a mixing analysis. Both methods yield good estimates of the pedogenic component, especially for the palaeosols. The CBD procedure underestimates the lithogenic component and overestimates the pedogenic component. The magnitude of this effect is moderately high in loess layers but almost negligible in palaeosols. The mixing model overestimates the lithogenic component and underestimates the pedogenic component. Both methods can be adjusted to yield better estimates of both components. The lithogenic susceptibility, as determined by either method, suggests that palaeoclimatic interpretations based only on total susceptibility will be in error and that a single estimate of the average lithogenic susceptibility is not an accurate basis for adjusting the total susceptibility. A long-term decline in lithogenic susceptibility with depth in the section suggests more intense or prolonged periods of weathering associated with the formation of the older palaeosols. The CBD procedure provides the most comprehensive information on the magnitude of the components and magnetic mineralogy of loess and palaeosols. However, the mixing analysis provides a sensitive, rapid, and easily applied alternative to the CBD procedure. A combination of the two approaches provides the most powerful and perhaps the most accurate way of separating the magnetic susceptibility components.

  12. Improved Conjugate Gradient Bundle Adjustment of Dunhuang Wall Painting Images

    NASA Astrophysics Data System (ADS)

    Hu, K.; Huang, X.; You, H.

    2017-09-01

    Bundle adjustment with additional parameters is identified as a critical step for precise orthoimage generation and 3D reconstruction of Dunhuang wall paintings. Due to the introduction of self-calibration parameters and quasi-planar constraints, the structure of coefficient matrix of the reduced normal equation is banded-bordered, making the solving process of bundle adjustment complex. In this paper, Conjugate Gradient Bundle Adjustment (CGBA) method is deduced by calculus of variations. A preconditioning method based on improved incomplete Cholesky factorization is adopt to reduce the condition number of coefficient matrix, as well as to accelerate the iteration rate of CGBA. Both theoretical analysis and experimental results comparison with conventional method indicate that, the proposed method can effectively conquer the ill-conditioned problem of normal equation and improve the calculation efficiency of bundle adjustment with additional parameters considerably, while maintaining the actual accuracy.

  13. Contact angle adjustment in equation-of-state-based pseudopotential model.

    PubMed

    Hu, Anjie; Li, Longjian; Uddin, Rizwan; Liu, Dong

    2016-05-01

    The single component pseudopotential lattice Boltzmann model has been widely applied in multiphase simulation due to its simplicity and stability. In many studies, it has been claimed that this model can be stable for density ratios larger than 1000. However, the application of the model is still limited to small density ratios when the contact angle is considered. The reason is that the original contact angle adjustment method influences the stability of the model. Moreover, simulation results in the present work show that, by applying the original contact angle adjustment method, the density distribution near the wall is artificially changed, and the contact angle is dependent on the surface tension. Hence, it is very inconvenient to apply this method with a fixed contact angle, and the accuracy of the model cannot be guaranteed. To solve these problems, a contact angle adjustment method based on the geometry analysis is proposed and numerically compared with the original method. Simulation results show that, with our contact angle adjustment method, the stability of the model is highly improved when the density ratio is relatively large, and it is independent of the surface tension.

  14. Contact angle adjustment in equation-of-state-based pseudopotential model

    NASA Astrophysics Data System (ADS)

    Hu, Anjie; Li, Longjian; Uddin, Rizwan; Liu, Dong

    2016-05-01

    The single component pseudopotential lattice Boltzmann model has been widely applied in multiphase simulation due to its simplicity and stability. In many studies, it has been claimed that this model can be stable for density ratios larger than 1000. However, the application of the model is still limited to small density ratios when the contact angle is considered. The reason is that the original contact angle adjustment method influences the stability of the model. Moreover, simulation results in the present work show that, by applying the original contact angle adjustment method, the density distribution near the wall is artificially changed, and the contact angle is dependent on the surface tension. Hence, it is very inconvenient to apply this method with a fixed contact angle, and the accuracy of the model cannot be guaranteed. To solve these problems, a contact angle adjustment method based on the geometry analysis is proposed and numerically compared with the original method. Simulation results show that, with our contact angle adjustment method, the stability of the model is highly improved when the density ratio is relatively large, and it is independent of the surface tension.

  15. Effect of Facet Displacement on Radiation Field and Its Application for Panel Adjustment of Large Reflector Antenna

    NASA Astrophysics Data System (ADS)

    Wang, Wei; Lian, Peiyuan; Zhang, Shuxin; Xiang, Binbin; Xu, Qian

    2017-05-01

    Large reflector antennas are widely used in radars, satellite communication, radio astronomy, and so on. The rapid developments in these fields have created demands for development of better performance and higher surface accuracy. However, low accuracy and low efficiency are the common disadvantages for traditional panel alignment and adjustment. In order to improve the surface accuracy of large reflector antenna, a new method is presented to determinate panel adjustment values from far field pattern. Based on the method of Physical Optics (PO), the effect of panel facet displacement on radiation field value is derived. Then the linear system is constructed between panel adjustment vector and far field pattern. Using the method of Singular Value Decomposition (SVD), the adjustment value for all panel adjustors are obtained by solving the linear equations. An experiment is conducted on a 3.7 m reflector antenna with 12 segmented panels. The results of simulation and test are similar, which shows that the presented method is feasible. Moreover, the discussion about validation shows that the method can be used for many cases of reflector shape. The proposed research provides the instruction to adjust surface panels efficiently and accurately.

  16. Effect of hypnotic suggestion on knee extensor neuromuscular properties in resting and fatigued states

    PubMed Central

    Antonini Philippe, Roberta; Guglielmo, Luiz Guilherme A.

    2018-01-01

    Purpose The aim of this study was to investigate whether hypnotic suggestions can alter knee extensor neuromuscular function at rest and during exercise. Methods Thirteen healthy volunteers (8 men and 5 women, 27 ± 3 years old) took part in this counterbalanced, crossover study including two experimental (hypnosis and control) sessions. Knee extensor neuromuscular function was tested before and after hypnosis suggestion by using a combination of voluntary contraction, transcutaneous femoral nerve electrical stimulation and transcranial magnetic stimulation (TMS). A fatiguing exercise (sustained submaximal contraction at 20% maximal voluntary contraction (MVC) force) was also performed to evaluate the potential influence of hypnosis on the extent and origin of neuromuscular adjustments. Results Hypnosis did not (p>0.05) alter MVC force or knee extensor neural properties. Corticospinal excitability, assessed with the amplitude of knee extensor motor evoked potentials, was also unchanged (p>0.05), as was the level of intracortical inhibition assessed with paired pulse TMS (short-interval intracortical inhibition, SICI). Time to task failure (~300 s) was not different (p>0.05) between the two sessions; accordingly, hypnosis did not influence neuromuscular adjustments measured during exercise and at task failure (p>0.05). Conclusion Hypnotic suggestions did not alter neuromuscular properties of the knee extensor muscles under resting condition or during/after exercise, suggesting that hypnosis-induced improvement in exercise performance and enhanced corticospinal excitability might be limited to highly susceptible participants. PMID:29684047

  17. [Economic impact of nosocomial bacteraemia. A comparison of three calculation methods].

    PubMed

    Riu, Marta; Chiarello, Pietro; Terradas, Roser; Sala, Maria; Castells, Xavier; Knobel, Hernando; Cots, Francesc

    2016-12-01

    The excess cost associated with nosocomial bacteraemia (NB) is used as a measurement of the impact of these infections. However, some authors have suggested that traditional methods overestimate the incremental cost due to the presence of various types of bias. The aim of this study was to compare three assessment methods of NB incremental cost to correct biases in previous analyses. Patients who experienced an episode of NB between 2005 and 2007 were compared with patients grouped within the same All Patient Refined-Diagnosis-Related Group (APR-DRG) without NB. The causative organisms were grouped according to the Gram stain, and whether bacteraemia was caused by a single or multiple microorganisms, or by a fungus. Three assessment methods are compared: stratification by disease; econometric multivariate adjustment using a generalised linear model (GLM); and propensity score matching (PSM) was performed to control for biases in the econometric model. The analysis included 640 admissions with NB and 28,459 without NB. The observed mean cost was €24,515 for admissions with NB and €4,851.6 for controls (without NB). Mean incremental cost was estimated at €14,735 in stratified analysis. Gram positive microorganism had the lowest mean incremental cost, €10,051. In the GLM, mean incremental cost was estimated as €20,922, and adjusting with PSM, the mean incremental cost was €11,916. The three estimates showed important differences between groups of microorganisms. Using enhanced methodologies improves the adjustment in this type of study and increases the value of the results. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  18. Village health volunteers’ social capital related to their performance in Lao People’s Democratic Republic: a cross-sectional study

    PubMed Central

    2014-01-01

    Background Improving the performance of community health workers (CHWs) is a global issue. The relationship between CHWs and their community may impact their performance. In Lao People’s Democratic Republic (Lao PDR), CHW are called village health volunteers (VHV). Lao PDR has a problem with VHV inactivity, especially in rural areas. This study focused on which aspects of social capital are related to VHV performance. Methods This research represents a cross-sectional study with a quantitative survey based primarily on interviews using a semi-structured questionnaire. Interviews were conducted with 149 VHVs living and working in the Sepon District. VHV performance evaluation was measured with scores on a 5-point scale, and the cutoff point for designating performance as good or poor was set at the median score. This evaluation of VHV performance was conducted as a self-evaluation by VHVs and by health center staff who were supervisors of the VHVs. Measurement of social capital was accomplished using the short version of the Adapted Social Capital Assessment Tool (SASCAT). For statistical analyses, logistic regression was used to calculate adjusted odds ratios (OR) and 95% confidence intervals (CI). Results The results of multiple logistic regression adjusted by moderator variables showed that citizenship activities in the structural social capital component of SASCAT were significantly related to performance in self-evaluation by VHVs (adjusted OR: 2.10, 95% CI: 1.19-3.71) and the evaluations by health center staff (adjusted OR: 1.67, 95% CI: 1.01-2.77). Support from groups (adjusted OR: 1.87, 95% CI: 1.27-2.76) and cognitive social capital (adjusted OR: 7.48, 95% CI: 2.14-26.10) were found to be significantly associated but only for VHV self-evaluation. Conclusions The results suggest that individuals who interact with important figures in the community and who cooperate with other villagers whenever problems arise, i.e., have social capital, exhibit good performance as VHVs. These findings suggest that increasing citizenship activities could increase the retention rate of CHWs and help improve their performance. Citizenship activities could also be used as a predictive indicator when selecting new CHWs. PMID:24620729

  19. Does spirituality facilitate adjustment and resilience among individuals and families after SCI?

    PubMed

    Jones, Kate; Simpson, Grahame Kenneth; Briggs, Lynne; Dorsett, Pat

    2016-01-01

    The purpose of this scoping review was to investigate the role of spirituality in facilitating adjustment and resilience after spinal cord injury (SCI) for the individual with SCI and their family members. METHOD-DATA SOURCES: Peer reviewed journals were identified using PsychInfo, MEDLINE, CINAHL, Embase and Sociological Abstracts search engines. After duplicates were removed, 434 abstracts were screened applying inclusion and exclusion criteria. The selected 28 studies were reviewed in detail and grouped according to methodological approach. Of the 28 studies relating to spirituality and related meaning-making constructs, 26 addressed the adjustment of the individual with SCI alone. Only two included family members as participants. Quantitative studies demonstrated that spirituality was positively associated with life satisfaction, quality of life, mental health and resilience. The utilisation of meaning-making and hope as coping strategies in the process of adjustment were highlighted within the qualitative studies. Clinical implications included recommendations that spirituality and meaning-making be incorporated in assessment and interventions during rehabilitation. The use of narratives and peer support was also suggested. Spirituality is an important factor in adjustment after SCI. Further research into the relationship between spirituality, family adjustment and resilience is needed. Higher levels of spirituality were associated with improved quality of life, life satisfaction, mental health, and resilience for individuals affected by spinal cord injury. Health professionals can enhance the role that spirituality plays in spinal rehabilitation by incorporating the spiritual beliefs of individuals and their family members into assessment and intervention. By drawing upon meaning-making tools, such as narrative therapy, incorporating peer support, and assisting clients who report a decline in spirituality, health professionals can provide additional support to individuals and their family members as they adjust to changes after spinal cord injury.

  20. Dentist practice patterns and therapeutic confidence in the treatment of pain related to temporomandibular disorders in a dental practice-based research network

    PubMed Central

    Kakudate, Naoki; Yokoyama, Yoko; Sumida, Futoshi; Matsumoto, Yuki; Gordan, Valeria V; Gilbert, Gregg H; Velly, Ana M; Schiffman, Eric L

    2018-01-01

    Aims This study quantified the practice pattern of Japanese dentists in the management of pain related to temporomandibular disorders (TMDs), and identified associations between dentist characteristics and the decision to perform occlusal adjustment for TMD-related pain. Methods A cross-sectional study was conducted consisting of a questionnaire survey of dentists affiliated with the Dental Practice-based Research Network Japan (JDPBRN) (n=148). Participants were asked how they diagnosed and treated TMD-related pain. Associations between dentist characteristics and their decision to perform occlusal adjustment were analyzed via multiple logistic regression. Results 113 clinicians responded the questionnaire for a 76% response rate. 81% of the participants (n=89) treated TMDs during the previous year. Dentists treated an average of 1.9±1.8 (SD) patients with TMD-related pain monthly. Most JDPBRN dentists used similar diagnostic protocols, including questions and examinations. The most frequent treatments were splints or mouthguards (97%), medications (85%), and self-care (69%). Fifty eight percent of the participants performed occlusal adjustment for TMD-related pain. Multiple logistic regression analysis identified two factors significantly associated with the decision to perform occlusal adjustment. Odds ratios (95%CI) were “dentist lack of confidence in curing TMD-related acute pain”, 5.60 (1.260–24.861) and “proportion of patients with severe TMD-related pain”, 0.95 (0.909–0.999). Conclusions The most common treatments for TMD-related pain were reversible treatments. However, over half of dentists performed occlusal adjustment for TMD-related pain. There was a significant association between the decision to perform occlusal adjustment and lack of therapeutic confidence. The results of this study suggest that an evidence-practice gap exists regarding occlusal adjustment for TMD-related pain. PMID:28437512

  1. Environmental Chemicals in Urine and Blood: Improving Methods for Creatinine and Lipid Adjustment.

    PubMed

    O'Brien, Katie M; Upson, Kristen; Cook, Nancy R; Weinberg, Clarice R

    2016-02-01

    Investigators measuring exposure biomarkers in urine typically adjust for creatinine to account for dilution-dependent sample variation in urine concentrations. Similarly, it is standard to adjust for serum lipids when measuring lipophilic chemicals in serum. However, there is controversy regarding the best approach, and existing methods may not effectively correct for measurement error. We compared adjustment methods, including novel approaches, using simulated case-control data. Using a directed acyclic graph framework, we defined six causal scenarios for epidemiologic studies of environmental chemicals measured in urine or serum. The scenarios include variables known to influence creatinine (e.g., age and hydration) or serum lipid levels (e.g., body mass index and recent fat intake). Over a range of true effect sizes, we analyzed each scenario using seven adjustment approaches and estimated the corresponding bias and confidence interval coverage across 1,000 simulated studies. For urinary biomarker measurements, our novel method, which incorporates both covariate-adjusted standardization and the inclusion of creatinine as a covariate in the regression model, had low bias and possessed 95% confidence interval coverage of nearly 95% for most simulated scenarios. For serum biomarker measurements, a similar approach involving standardization plus serum lipid level adjustment generally performed well. To control measurement error bias caused by variations in serum lipids or by urinary diluteness, we recommend improved methods for standardizing exposure concentrations across individuals.

  2. The Relationship between Perceived Coaching Behaviours, Motivation and Self-Efficacy in Wrestlers.

    PubMed

    Sarı, İhsan; Bayazıt, Betül

    2017-06-01

    The current study aimed to determine the relationship between perceived coaching behaviours, motivation, self-efficacy and general self-efficacy of wrestlers who competed in the Super National Wrestling League. The sample consisted of 289 wrestlers. The Self-Efficacy Scale was used to measure self-efficacy perception, the Sports Motivation Scale to measure the motivation of the athletes, the Leadership Scale for Sport to determine perceived leadership behaviours, and the General Self-Efficacy Scale to determine the general self-efficacy perceptions of the athletes. For data analyses, SPSS 17.0 software was used. According to the results of the regression analyses performed with the enter method, it was found that perceived training and instruction behaviour along with perceived social support behaviour significantly explained self-efficacy (adjusted R 2_ = .03), intrinsic motivation (adjusted R 2 = .04) and amotivation (adjusted R 2 = .05). Also, perceived training and instruction behaviour (β = .51), autocratic behaviour (β = -.17) and social support behaviour (β = -.27) significantly contributed to athletes' general self-efficacy (adjusted R 2 = .10). In light of these findings, it may be argued that perceived training and instruction behaviour may be beneficial for self-efficacy, general self-efficacy, intrinsic motivation, and amotivation. On the other hand, it could be stated that perceived autocratic behaviour may be detrimental for general self-efficacy of the athletes. As for social support behaviour, it may be suggested that it is negatively related to self-efficacy, general self-efficacy and intrinsic motivation. Lastly, a positive relationship was observed between perceived social support behaviour and amotivation in wrestlers. The results reveal the specific characteristics of wrestlers and suggest some implications for wrestling coaches.

  3. Non-alcoholic beverage and caffeine consumption and mortality: the Leisure World Cohort Study

    PubMed Central

    Paganini-Hill, Annlia; Kawas, Claudia H; Corrada, María M

    2007-01-01

    Objective To examine the effects of non-alcoholic beverage and caffeine consumption on all-cause mortality in older adults. Methods The Leisure World Cohort Study is a prospective study of residents of a California retirement community. A baseline postal health survey included details on coffee, tea, milk, soft drink, and chocolate consumption. Participants were followed for 23 years (1981–2004). Risk ratios (RRs) of death were calculated using Cox regression for 8644 women and 4980 men (median age at entry, 74 years) and adjusted for age, gender and multiple potential confounders. Results Caffeine consumption exhibited a U-shaped mortality curve. Moderate caffeine consumers had a significantly reduced risk of death (multivariable-adjusted RR=0.94, 95% CI: 0.90, 0.99 for 100–199 mg/day and RR=0.90, 95% CI: 0.85, 0.94 for 200–399 mg/day compared with those consuming <50 mg/day). Individuals who drank more than 1 can/week of artificially sweetened (but not sugar-sweetened) soft drink (cola and other) had a 8% increased risk (95% CI: 1.01–1.16). Neither milk nor tea had a significant effect on mortality after multivariable adjustment. Conclusions Moderate caffeine consumption appeared beneficial in risking risk of death. Attenuation in the observed associations between mortality and intake of tea and milk with adjustment for potential confounders suggests that such consumption identifies those with other mortality-associated lifestyle and health risks. The increased death risk with consumption of artificially sweetened, but not sugar-sweetened, soft drinks suggests an effect of the sweetener rather than other components of the soft drinks, although residual confounding remains a possibility. PMID:17275898

  4. Associations of sedentary time patterns and TV viewing time with inflammatory and endothelial function biomarkers in children

    PubMed Central

    Gabel, L.; Ridgers, N. D.; Della Gatta, P. A.; Arundell, L.; Cerin, E.; Robinson, S.; Daly, R. M.; Dunstan, D. W.

    2015-01-01

    Summary Objective Investigate associations of TV viewing time and accelerometry‐derived sedentary time with inflammatory and endothelial function biomarkers in children. Methods Cross‐sectional analysis of 164 7–10‐year‐old children. TV viewing time was assessed by parental proxy report and total and patterns of sedentary time accumulation (e.g. prolonged bouts) were assessed by accelerometry. C‐reactive protein (CRP), homeostasis model assessment of insulin resistance, interleukin‐2, ‐6, ‐8, ‐10, tumour necrosis factor alpha, adiponectin, resistin, brain‐derived neurotrophic factor, soluble intercellular and vascular adhesion molecule 1, plasminogen activator inhibitor 1 and soluble E‐selectin were assessed. Generalised linear models assessed the associations of TV viewing and sedentary time with biomarkers, adjusting for sex, waist circumference, moderate‐ to vigorous‐intensity physical activity and diet density. Results Each additional h week−1 of TV viewing was associated with 4.4% (95% CI: 2.1, 6.7) greater CRP and 0.6% (0.2, 1.0) greater sVCAM‐1 in the fully adjusted model. The association between frequency and duration of 5–10 min bouts of sedentary time and CRP was positive after adjustment for sex and waist circumference but attenuated after adjustment for diet density. Conclusions This study suggests that TV viewing was unfavourably associated with several markers of inflammation and endothelial dysfunction. The detrimental association between 5 and 10 min bouts of sedentary time and CRP approached significance, suggesting that further research with a stronger study design (longitudinal and/or experimental) is needed to better understand how the accumulation of sedentary time early in life may influence short and longer term health. PMID:26097139

  5. The Relationship between Perceived Coaching Behaviours, Motivation and Self-Efficacy in Wrestlers

    PubMed Central

    Sarı, İhsan; Bayazıt, Betül

    2017-01-01

    Abstract The current study aimed to determine the relationship between perceived coaching behaviours, motivation, self-efficacy and general self-efficacy of wrestlers who competed in the Super National Wrestling League. The sample consisted of 289 wrestlers. The Self-Efficacy Scale was used to measure self-efficacy perception, the Sports Motivation Scale to measure the motivation of the athletes, the Leadership Scale for Sport to determine perceived leadership behaviours, and the General Self-Efficacy Scale to determine the general self-efficacy perceptions of the athletes. For data analyses, SPSS 17.0 software was used. According to the results of the regression analyses performed with the enter method, it was found that perceived training and instruction behaviour along with perceived social support behaviour significantly explained self-efficacy (adjusted R2_ = .03), intrinsic motivation (adjusted R2 = .04) and amotivation (adjusted R2 = .05). Also, perceived training and instruction behaviour (β = .51), autocratic behaviour (β = -.17) and social support behaviour (β = -.27) significantly contributed to athletes’ general self-efficacy (adjusted R2 = .10). In light of these findings, it may be argued that perceived training and instruction behaviour may be beneficial for self-efficacy, general self-efficacy, intrinsic motivation, and amotivation. On the other hand, it could be stated that perceived autocratic behaviour may be detrimental for general self-efficacy of the athletes. As for social support behaviour, it may be suggested that it is negatively related to self-efficacy, general self-efficacy and intrinsic motivation. Lastly, a positive relationship was observed between perceived social support behaviour and amotivation in wrestlers. The results reveal the specific characteristics of wrestlers and suggest some implications for wrestling coaches. PMID:28713476

  6. “Time for dabs”: Analyzing Twitter data on marijuana concentrates across the U.S.

    PubMed Central

    Daniulaityte, Raminta; Nahhas, Ramzi W.; Wijeratne, Sanjaya; Carlson, Robert G.; Lamy, Francois R.; Martins, Silvia S.; Boyer, Edward W.; Smith, G. Alan; Sheth, Amit

    2015-01-01

    Aims Media reports suggest increasing popularity of marijuana concentrates (“dabs”; “earwax”; “budder”; “shatter; “butane hash oil”) that are typically vaporized and inhaled via a bong, vaporizer or electronic cigarette. However, data on the epidemiology of marijuana concentrate use remain limited. This study aims to explore Twitter data on marijuana concentrate use in the U.S. and identify differences across regions of the country with varying cannabis legalization policies. Methods Tweets were collected between October 20 and December 20, 2014, using Twitter's streaming API. Twitter data filtering framework was available through the eDrugTrends platform. Raw and adjusted percentages of dabs-related tweets per state were calculated. A permutation test was used to examine differences in the adjusted percentages of dabs-related tweets among U.S. states with different cannabis legalization policies. Results eDrugTrends collected a total of 125,255 tweets. Almost 22% (n=27,018) of these tweets contained identifiable state-level geolocation information. Dabs-related tweet volume for each state was adjusted using a general sample of tweets to account for different levels of overall tweeting activity for each state. Adjusted percentages of dabs-related tweets were highest in states that allowed recreational and/or medicinal cannabis use and lowest in states that have not passed medical cannabis use laws. The differences were statistically significant. Conclusions Twitter data suggest greater popularity of dabs in the states that legalized recreational and/or medical use of cannabis. The study provides new information on the epidemiology of marijuana concentrate use and contributes to the emerging field of social media analysis for drug abuse research. PMID:26338481

  7. Analysis of Observational Studies in the Presence of Treatment Selection Bias: Effects of Invasive Cardiac Management on AMI Survival Using Propensity Score and Instrumental Variable Methods

    PubMed Central

    Stukel, Thérèse A.; Fisher, Elliott S; Wennberg, David E.; Alter, David A.; Gottlieb, Daniel J.; Vermeulen, Marian J.

    2007-01-01

    Context Comparisons of outcomes between patients treated and untreated in observational studies may be biased due to differences in patient prognosis between groups, often because of unobserved treatment selection biases. Objective To compare 4 analytic methods for removing the effects of selection bias in observational studies: multivariable model risk adjustment, propensity score risk adjustment, propensity-based matching, and instrumental variable analysis. Design, Setting, and Patients A national cohort of 122 124 patients who were elderly (aged 65–84 years), receiving Medicare, and hospitalized with acute myocardial infarction (AMI) in 1994–1995, and who were eligible for cardiac catheterization. Baseline chart reviews were taken from the Cooperative Cardiovascular Project and linked to Medicare health administrative data to provide a rich set of prognostic variables. Patients were followed up for 7 years through December 31, 2001, to assess the association between long-term survival and cardiac catheterization within 30 days of hospital admission. Main Outcome Measure Risk-adjusted relative mortality rate using each of the analytic methods. Results Patients who received cardiac catheterization (n=73 238) were younger and had lower AMI severity than those who did not. After adjustment for prognostic factors by using standard statistical risk-adjustment methods, cardiac catheterization was associated with a 50% relative decrease in mortality (for multivariable model risk adjustment: adjusted relative risk [RR], 0.51; 95% confidence interval [CI], 0.50–0.52; for propensity score risk adjustment: adjusted RR, 0.54; 95% CI, 0.53–0.55; and for propensity-based matching: adjusted RR, 0.54; 95% CI, 0.52–0.56). Using regional catheterization rate as an instrument, instrumental variable analysis showed a 16% relative decrease in mortality (adjusted RR, 0.84; 95% CI, 0.79–0.90). The survival benefits of routine invasive care from randomized clinical trials are between 8% and 21 %. Conclusions Estimates of the observational association of cardiac catheterization with long-term AMI mortality are highly sensitive to analytic method. All standard risk-adjustment methods have the same limitations regarding removal of unmeasured treatment selection biases. Compared with standard modeling, instrumental variable analysis may produce less biased estimates of treatment effects, but is more suited to answering policy questions than specific clinical questions. PMID:17227979

  8. CORNAS: coverage-dependent RNA-Seq analysis of gene expression data without biological replicates.

    PubMed

    Low, Joel Z B; Khang, Tsung Fei; Tammi, Martti T

    2017-12-28

    In current statistical methods for calling differentially expressed genes in RNA-Seq experiments, the assumption is that an adjusted observed gene count represents an unknown true gene count. This adjustment usually consists of a normalization step to account for heterogeneous sample library sizes, and then the resulting normalized gene counts are used as input for parametric or non-parametric differential gene expression tests. A distribution of true gene counts, each with a different probability, can result in the same observed gene count. Importantly, sequencing coverage information is currently not explicitly incorporated into any of the statistical models used for RNA-Seq analysis. We developed a fast Bayesian method which uses the sequencing coverage information determined from the concentration of an RNA sample to estimate the posterior distribution of a true gene count. Our method has better or comparable performance compared to NOISeq and GFOLD, according to the results from simulations and experiments with real unreplicated data. We incorporated a previously unused sequencing coverage parameter into a procedure for differential gene expression analysis with RNA-Seq data. Our results suggest that our method can be used to overcome analytical bottlenecks in experiments with limited number of replicates and low sequencing coverage. The method is implemented in CORNAS (Coverage-dependent RNA-Seq), and is available at https://github.com/joel-lzb/CORNAS .

  9. Pixel-based speckle adjustment for noise reduction in Fourier-domain OCT images

    PubMed Central

    Zhang, Anqi; Xi, Jiefeng; Sun, Jitao; Li, Xingde

    2017-01-01

    Speckle resides in OCT signals and inevitably effects OCT image quality. In this work, we present a novel method for speckle noise reduction in Fourier-domain OCT images, which utilizes the phase information of complex OCT data. In this method, speckle area is pre-delineated pixelwise based on a phase-domain processing method and then adjusted by the results of wavelet shrinkage of the original image. Coefficient shrinkage method such as wavelet or contourlet is applied afterwards for further suppressing the speckle noise. Compared with conventional methods without speckle adjustment, the proposed method demonstrates significant improvement of image quality. PMID:28663860

  10. Precision of the anchor influences the amount of adjustment.

    PubMed

    Janiszewski, Chris; Uy, Dan

    2008-02-01

    The anchoring-and-adjustment heuristic has been used to account for a wide variety of numerical judgments. Five studies show that adjustment away from a numerical anchor is smaller if the anchor is precise than if it is rounded. Evidence suggests that precise anchors, compared with rounded anchors, are represented on a subjective scale with a finer resolution. If adjustment consists of a series of iterative mental movements along a subjective scale, then an adjustment from a precise anchor should result in a smaller overall correction than an adjustment from a rounded anchor.

  11. Acculturation, Psychological Adjustment, and Parenting Styles of Chinese Immigrant Mothers in the U.S.

    PubMed Central

    Yu, Jing; Cheah, Charissa S. L.; Calvin, Grace

    2016-01-01

    Objectives This study examined whether acculturation to American culture, maintenance of Chinese culture, and their interaction predicted Chinese immigrant parents’ psychological adjustment and parenting styles. We hypothesized that American orientation would be associated with more positive psychological well-being and fewer depressive symptoms in immigrant mothers, which in turn would be associated with more authoritative parenting and less authoritarian parenting. The examination of the roles of Chinese orientation and the interaction of the two cultural orientations in relation to psychological adjustment and parenting were exploratory. Methods Participants were 164 first-generation Chinese immigrant mothers in the U.S. (Mage = 37.80). Structural equation modeling was used to examine the direct and indirect effects of acculturation on psychological adjustment and parenting. Bootstrapping technique was used to explore the conditional indirect effects of acculturation on parenting as appropriate. Results American orientation was strongly associated with positive psychological well-being, which was in turn related to more authoritative parenting and less authoritarian parenting. Moreover, American and Chinese orientations interacted to predict depressive symptoms, which were in turn associated with more authoritarian parenting. Specifically, American orientation was negatively associated with depressive symptoms only at mean or high levels of Chinese orientation. Conclusions Results suggest acculturation as a distal contextual factor and psychological adjustment as one critical mechanism that transmits the effects of acculturation to parenting. Promoting immigrant parents’ ability and comfort in the new culture independently or in conjunction with encouraging biculturalism through policy intervention efforts appear crucial for the positive adjustment of Chinese immigrant parents and children. PMID:27077796

  12. The religiosity as social value hypothesis: A multi-method replication and extension across 65 countries and three levels of spatial aggregation.

    PubMed

    Gebauer, Jochen E; Sedikides, Constantine; Schönbrodt, Felix D; Bleidorn, Wiebke; Rentfrow, Peter J; Potter, Jeff; Gosling, Samuel D

    2017-09-01

    Are religious people psychologically better or worse adjusted than their nonreligious counterparts? Hundreds of studies have reported a positive relation between religiosity and psychological adjustment. Recently, however, a comparatively small number of cross-cultural studies has questioned this staple of religiosity research. The latter studies find that religious adjustment benefits are restricted to religious cultures. Gebauer, Sedikides, and Neberich (2012) suggested the religiosity as social value hypothesis (RASV) as one explanation for those cross-cultural differences. RASV states that, in religious cultures, religiosity possesses much social value, and, as such, religious people will feel particularly good about themselves. In secular cultures, however, religiosity possesses limited social value, and, as such, religious people will feel less good about themselves, if at all. Yet, previous evidence has been inconclusive regarding RASV and regarding cross-cultural differences in religious adjustment benefits more generally. To clarify matters, we conducted 3 replication studies. We examined the relation between religiosity and self-esteem (the most direct and appropriate adjustment indicator, according to RASV) in a self-report study across 65 countries (N = 2,195,301), an informant-report study across 36 countries (N = 560,264), and another self-report study across 1,932 urban areas from 243 federal states in 18 countries (N = 1,188,536). Moreover, we scrutinized our results against 7, previously untested, alternative explanations. Our results fully and firmly replicated and extended prior evidence for cross-cultural differences in religious adjustment benefits. These cross-cultural differences were best explained by RASV. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  13. Three methods to construct predictive models using logistic regression and likelihood ratios to facilitate adjustment for pretest probability give similar results.

    PubMed

    Chan, Siew Foong; Deeks, Jonathan J; Macaskill, Petra; Irwig, Les

    2008-01-01

    To compare three predictive models based on logistic regression to estimate adjusted likelihood ratios allowing for interdependency between diagnostic variables (tests). This study was a review of the theoretical basis, assumptions, and limitations of published models; and a statistical extension of methods and application to a case study of the diagnosis of obstructive airways disease based on history and clinical examination. Albert's method includes an offset term to estimate an adjusted likelihood ratio for combinations of tests. Spiegelhalter and Knill-Jones method uses the unadjusted likelihood ratio for each test as a predictor and computes shrinkage factors to allow for interdependence. Knottnerus' method differs from the other methods because it requires sequencing of tests, which limits its application to situations where there are few tests and substantial data. Although parameter estimates differed between the models, predicted "posttest" probabilities were generally similar. Construction of predictive models using logistic regression is preferred to the independence Bayes' approach when it is important to adjust for dependency of tests errors. Methods to estimate adjusted likelihood ratios from predictive models should be considered in preference to a standard logistic regression model to facilitate ease of interpretation and application. Albert's method provides the most straightforward approach.

  14. Prediction of WBGT-based clothing adjustment values from evaporative resistance

    PubMed Central

    BERNARD, Thomas E.; ASHLEY, Candi D.; GARZON, Ximena P.; KIM, Jung-Hyun; COCA, Aitor

    2017-01-01

    Wet bulb globe temperature (WBGT) index is used by many professionals in combination with metabolic rate and clothing adjustments to assess whether a heat stress exposure is sustainable. The progressive heat stress protocol is a systematic method to prescribe a clothing adjustment value (CAV) from human wear trials, and it also provides an estimate of apparent total evaporative resistance (Re,T,a). It is clear that there is a direct relationship between the two descriptors of clothing thermal effects with diminishing increases in CAV at high Re,T,a. There were data to suggest an interaction of CAV and Re,T,a with relative humidity at high evaporative resistance. Because human trials are expensive, manikin data can reduce the cost by considering the static total evaporative resistance (Re,T,s). In fact, as the static evaporative resistance increases, the CAV increases in a similar fashion as Re,T,a. While the results look promising that Re,T,s can predict CAV, some validation remains, especially for high evaporative resistance. The data only supports air velocities near 0.5 m/s. PMID:29033404

  15. Prediction of WBGT-based clothing adjustment values from evaporative resistance.

    PubMed

    Bernard, Thomas E; Ashley, Candi D; Garzon, Ximena P; Kim, Jung-Hyun; Coca, Aitor

    2017-12-07

    Wet bulb globe temperature (WBGT) index is used by many professionals in combination with metabolic rate and clothing adjustments to assess whether a heat stress exposure is sustainable. The progressive heat stress protocol is a systematic method to prescribe a clothing adjustment value (CAV) from human wear trials, and it also provides an estimate of apparent total evaporative resistance (R e,T,a ). It is clear that there is a direct relationship between the two descriptors of clothing thermal effects with diminishing increases in CAV at high R e,T,a . There were data to suggest an interaction of CAV and R e,T,a with relative humidity at high evaporative resistance. Because human trials are expensive, manikin data can reduce the cost by considering the static total evaporative resistance (R e,T,s ). In fact, as the static evaporative resistance increases, the CAV increases in a similar fashion as R e,T,a . While the results look promising that R e,T,s can predict CAV, some validation remains, especially for high evaporative resistance. The data only supports air velocities near 0.5 m/s.

  16. Nocturnal Eating: Association with Binge Eating, Obesity, and Psychological Distress

    PubMed Central

    Striegel-Moore, Ruth H.; Rosselli, Francine; Wilson, G. Terence; Perrin, Nancy; Harvey, Kate; DeBar, Lynn

    2009-01-01

    Objective To examine clinical correlates of nocturnal eating, a core behavioral symptom of night eating syndrome. Method Data from 285 women who had participated in a two-stage screening for binge eating were utilized. Women (n = 41) who reported one or more nocturnal eating episodes in the past 28 days on the Eating Disorder Examination and women who did not report nocturnal eating (n =244) were compared on eating disorder symptomatology, Body Mass Index (BMI), and on measures of psychosocial adjustment. Results Nocturnal eaters were significantly more likely to report binge eating and differed significantly from non-nocturnal eaters (with responses indicating greater disturbance) on weight and shape concern, eating concern, self-esteem, depression, and functional impairment, but not on BMI or dietary restraint. Group differences remained significant in analyses adjusting for binge eating. Conclusions This study confirms the association between nocturnal eating and binge eating previously found in treatment seeking samples yet also suggests that the elevated eating disorder symptoms and decreased psychosocial adjustment observed in nocturnal eaters is not simply a function of binge eating. PMID:19708071

  17. Precision mass measurements of some isotopes of tungsten and mercury for an adjustment to the mass table in the region A = 184 to A = 204

    NASA Astrophysics Data System (ADS)

    Barillari, Domenico K.

    This thesis concerns the precise re-measurement of mass values in the region of the mercury isotopes, such that important discrepancies in the high-mass end of the mass table could be resolved. Scope and contents. Four mass spectroscopic doublets involving a comparison between 201Hg, 199Hg and 183W (and using a chlorocarbon reference) are reported from measurements made with the upgraded Manitoba 11 deflection instrument. The measurements address the problem of a mass table mis-adjustment in the region of the valley of β-stability between the tungsten group and the noble metals. The results, forming a well-closed loop of mass differences, support the earlier results of Kozier [Ko(1977)] regarding the (stable) mercury isotope masses and confirm an approximate 20 μu discrepancy in the mass adjustment of Audi et al [Au(1993)]. A local least- square re-adjustment conducted using these and existing mass table data suggests that the error originates with mass differences pertaining to one or more other nuclide pairs, perhaps 193Ir-192Ir. The work on upgrading the precision voltage supply and potentiometry system of the Manitoba II instrument is also reported, as is a new assessment on the data processing method. (Abstract shortened by UMI.)

  18. Application of adjusted subpixel method (ASM) in HRCT measurements of the bronchi in bronchial asthma patients and healthy individuals.

    PubMed

    Mincewicz, Grzegorz; Rumiński, Jacek; Krzykowski, Grzegorz

    2012-02-01

    Recently, we described a model system which included corrections of high-resolution computed tomography (HRCT) bronchial measurements based on the adjusted subpixel method (ASM). To verify the clinical application of ASM by comparing bronchial measurements obtained by means of the traditional eye-driven method, subpixel method alone and ASM in a group comprised of bronchial asthma patients and healthy individuals. The study included 30 bronchial asthma patients and the control group comprised of 20 volunteers with no symptoms of asthma. The lowest internal and external diameters of the bronchial cross-sections (ID and ED) and their derivative parameters were determined in HRCT scans using: (1) traditional eye-driven method, (2) subpixel technique, and (3) ASM. In the case of the eye-driven method, lower ID values along with lower bronchial lumen area and its percentage ratio to total bronchial area were basic parameters that differed between asthma patients and healthy controls. In the case of the subpixel method and ASM, both groups were not significantly different in terms of ID. Significant differences were observed in values of ED and total bronchial area with both parameters being significantly higher in asthma patients. Compared to ASM, the eye-driven method overstated the values of ID and ED by about 30% and 10% respectively, while understating bronchial wall thickness by about 18%. Results obtained in this study suggest that the traditional eye-driven method of HRCT-based measurement of bronchial tree components probably overstates the degree of bronchial patency in asthma patients. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  19. Localization of an Underwater Control Network Based on Quasi-Stable Adjustment.

    PubMed

    Zhao, Jianhu; Chen, Xinhua; Zhang, Hongmei; Feng, Jie

    2018-03-23

    There exists a common problem in the localization of underwater control networks that the precision of the absolute coordinates of known points obtained by marine absolute measurement is poor, and it seriously affects the precision of the whole network in traditional constraint adjustment. Therefore, considering that the precision of underwater baselines is good, we use it to carry out quasi-stable adjustment to amend known points before constraint adjustment so that the points fit the network shape better. In addition, we add unconstrained adjustment for quality control of underwater baselines, the observations of quasi-stable adjustment and constrained adjustment, to eliminate the unqualified baselines and improve the results' accuracy of the two adjustments. Finally, the modified method is applied to a practical LBL (Long Baseline) experiment and obtains a mean point location precision of 0.08 m, which improves by 38% compared with the traditional method.

  20. Localization of an Underwater Control Network Based on Quasi-Stable Adjustment

    PubMed Central

    Chen, Xinhua; Zhang, Hongmei; Feng, Jie

    2018-01-01

    There exists a common problem in the localization of underwater control networks that the precision of the absolute coordinates of known points obtained by marine absolute measurement is poor, and it seriously affects the precision of the whole network in traditional constraint adjustment. Therefore, considering that the precision of underwater baselines is good, we use it to carry out quasi-stable adjustment to amend known points before constraint adjustment so that the points fit the network shape better. In addition, we add unconstrained adjustment for quality control of underwater baselines, the observations of quasi-stable adjustment and constrained adjustment, to eliminate the unqualified baselines and improve the results’ accuracy of the two adjustments. Finally, the modified method is applied to a practical LBL (Long Baseline) experiment and obtains a mean point location precision of 0.08 m, which improves by 38% compared with the traditional method. PMID:29570627

  1. Analysis of conditional genetic effects and variance components in developmental genetics.

    PubMed

    Zhu, J

    1995-12-01

    A genetic model with additive-dominance effects and genotype x environment interactions is presented for quantitative traits with time-dependent measures. The genetic model for phenotypic means at time t conditional on phenotypic means measured at previous time (t-1) is defined. Statistical methods are proposed for analyzing conditional genetic effects and conditional genetic variance components. Conditional variances can be estimated by minimum norm quadratic unbiased estimation (MINQUE) method. An adjusted unbiased prediction (AUP) procedure is suggested for predicting conditional genetic effects. A worked example from cotton fruiting data is given for comparison of unconditional and conditional genetic variances and additive effects.

  2. Analysis of Conditional Genetic Effects and Variance Components in Developmental Genetics

    PubMed Central

    Zhu, J.

    1995-01-01

    A genetic model with additive-dominance effects and genotype X environment interactions is presented for quantitative traits with time-dependent measures. The genetic model for phenotypic means at time t conditional on phenotypic means measured at previous time (t - 1) is defined. Statistical methods are proposed for analyzing conditional genetic effects and conditional genetic variance components. Conditional variances can be estimated by minimum norm quadratic unbiased estimation (MINQUE) method. An adjusted unbiased prediction (AUP) procedure is suggested for predicting conditional genetic effects. A worked example from cotton fruiting data is given for comparison of unconditional and conditional genetic variances and additive effects. PMID:8601500

  3. Relationship between agility and lower limb muscle strength, targeting university badminton players.

    PubMed

    Sonoda, Takuya; Tashiro, Yuto; Suzuki, Yusuke; Kajiwara, Yu; Zeidan, Hala; Yokota, Yuki; Kawagoe, Mirei; Nakayama, Yasuaki; Bito, Tsubasa; Shimoura, Kanako; Tatsumi, Masataka; Nakai, Kengo; Nishida, Yuichi; Yoshimi, Soyoka; Aoyama, Tomoki

    2018-02-01

    [Purpose] Targeting university badminton players, this study investigated the relationship between agility, which is associated with performance in badminton, and lower limb muscle strength, and examined which muscles influence agility. [Subjects and Methods] A total of 23 male university badminton players were evaluated for side-shuffle test scores and lower limb strength. The relationships between agility, lower limb strength, and duration of experience playing badminton were evaluated using a correlation analysis. Moreover, the relationship between agility and lower limb strength was evaluated by partial correlation analysis, adjusting for the effects of experience of each badminton player. [Results] The agility score correlated with hip extension and ankle plantar flexion strength, with adjustment for badminton experience. [Conclusion] This study suggests that hip extension training and improvement in ankle plantar flexion strength may improve agility.

  4. Combining autosomal and Y chromosome match probabilities using coalescent theory.

    PubMed

    Buckleton, John; Myers, Steven

    2014-07-01

    Walsh et al. outlined a method for adjusting autosomal coancestry values, θA, to take account of the existence of a Y chromosome match, θA|Y. The framework established by Walsh et al. is flexible and allows an investigation of some real world effects such as family structure. It also allows the effect of a Y chromosome match to be placed within the construct of existing casework practice. Most notable is the ability to deal with an assigned value for the autosomal coancestry coefficient and the fact that most casework statistics report a value for unrelated individuals unless case circumstances suggest differently. The values of θA|Y are not much larger than θA and a coherent argument could be made that any adjustment is unnecessary. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  5. Method and apparatus for control of a magnetic structure

    DOEpatents

    Challenger, Michael P.; Valla, Arthur S.

    1996-06-18

    A method and apparatus for independently adjusting the spacing between opposing magnet arrays in charged particle based light sources. Adjustment mechanisms between each of the magnet arrays and the supporting structure allow the gap between the two magnet arrays to be independently adjusted. In addition, spherical bearings in the linkages to the magnet arrays permit the transverse angular orientation of the magnet arrays to also be adjusted. The opposing magnet arrays can be supported above the ground by the structural support.

  6. Method for producing ceramic particles and agglomerates

    DOEpatents

    Phillips, Jonathan; Gleiman, Seth S.; Chen, Chun-Ku

    2001-01-01

    A method for generating spherical and irregularly shaped dense particles of ceramic oxides having a controlled particle size and particle size distribution. An aerosol containing precursor particles of oxide ceramics is directed into a plasma. As the particles flow through the hot zone of the plasma, they melt, collide, and join to form larger particles. If these larger particles remain in the hot zone, they continue melting and acquire a spherical shape that is retained after they exit the hot zone, cool down, and solidify. If they exit the hot zone before melting completely, their irregular shape persists and agglomerates are produced. The size and size distribution of the dense product particles can be controlled by adjusting several parameters, the most important in the case of powder precursors appears to be the density of powder in the aerosol stream that enters the plasma hot zone. This suggests that particle collision rate is responsible for determining ultimate size of the resulting sphere or agglomerate. Other parameters, particularly the gas flow rates and the microwave power, are also adjusted to control the particle size distribution.

  7. Error propagation in energetic carrying capacity models

    USGS Publications Warehouse

    Pearse, Aaron T.; Stafford, Joshua D.

    2014-01-01

    Conservation objectives derived from carrying capacity models have been used to inform management of landscapes for wildlife populations. Energetic carrying capacity models are particularly useful in conservation planning for wildlife; these models use estimates of food abundance and energetic requirements of wildlife to target conservation actions. We provide a general method for incorporating a foraging threshold (i.e., density of food at which foraging becomes unprofitable) when estimating food availability with energetic carrying capacity models. We use a hypothetical example to describe how past methods for adjustment of foraging thresholds biased results of energetic carrying capacity models in certain instances. Adjusting foraging thresholds at the patch level of the species of interest provides results consistent with ecological foraging theory. Presentation of two case studies suggest variation in bias which, in certain instances, created large errors in conservation objectives and may have led to inefficient allocation of limited resources. Our results also illustrate how small errors or biases in application of input parameters, when extrapolated to large spatial extents, propagate errors in conservation planning and can have negative implications for target populations.

  8. Decomposing Bias in Different Types of Simple Decisions

    ERIC Educational Resources Information Center

    White, Corey N.; Poldrack, Russell A.

    2014-01-01

    The ability to adjust bias, or preference for an option, allows for great behavioral flexibility. Decision bias is also important for understanding cognition as it can provide useful information about underlying cognitive processes. Previous work suggests that bias can be adjusted in 2 primary ways: by adjusting how the stimulus under…

  9. Marital Adjustment of Graduate Student Couples.

    ERIC Educational Resources Information Center

    McRoy, Sue; Fisher, Virginia L.

    1982-01-01

    Comparisons of graduate student couples indicated lower levels of marital adjustment (consensus and affection) for couples where only the husband was a student. Suggests variables other than student status may relate to marital adjustment. When only the wife was a student, family income was higher and couples were older. (Author)

  10. Detection technology research on the one-way clutch of automatic brake adjuster

    NASA Astrophysics Data System (ADS)

    Jiang, Wensong; Luo, Zai; Lu, Yi

    2013-10-01

    In this article, we provide a new testing method to evaluate the acceptable quality of the one-way clutch of automatic brake adjuster. To analysis the suitable adjusting brake moment which keeps the automatic brake adjuster out of failure, we build a mechanical model of one-way clutch according to the structure and the working principle of one-way clutch. The ranges of adjusting brake moment both clockwise and anti-clockwise can be calculated through the mechanical model of one-way clutch. Its critical moment, as well, are picked up as the ideal values of adjusting brake moment to evaluate the acceptable quality of one-way clutch of automatic brake adjuster. we calculate the ideal values of critical moment depending on the different structure of one-way clutch based on its mechanical model before the adjusting brake moment test begin. In addition, an experimental apparatus, which the uncertainty of measurement is ±0.1Nm, is specially designed to test the adjusting brake moment both clockwise and anti-clockwise. Than we can judge the acceptable quality of one-way clutch of automatic brake adjuster by comparing the test results and the ideal values instead of the EXP. In fact, the evaluation standard of adjusting brake moment applied on the project are still using the EXP provided by manufacturer currently in China, but it would be unavailable when the material of one-way clutch changed. Five kinds of automatic brake adjusters are used in the verification experiment to verify the accuracy of the test method. The experimental results show that the experimental values of adjusting brake moment both clockwise and anti-clockwise are within the ranges of theoretical results. The testing method provided by this article vividly meet the requirements of manufacturer's standard.

  11. Dynamic multiplexed analysis method using ion mobility spectrometer

    DOEpatents

    Belov, Mikhail E [Richland, WA

    2010-05-18

    A method for multiplexed analysis using ion mobility spectrometer in which the effectiveness and efficiency of the multiplexed method is optimized by automatically adjusting rates of passage of analyte materials through an IMS drift tube during operation of the system. This automatic adjustment is performed by the IMS instrument itself after determining the appropriate levels of adjustment according to the method of the present invention. In one example, the adjustment of the rates of passage for these materials is determined by quantifying the total number of analyte molecules delivered to the ion trap in a preselected period of time, comparing this number to the charge capacity of the ion trap, selecting a gate opening sequence; and implementing the selected gate opening sequence to obtain a preselected rate of analytes within said IMS drift tube.

  12. Methods for detecting, quantifying, and adjusting for dissemination bias in meta-analysis are described.

    PubMed

    Mueller, Katharina Felicitas; Meerpohl, Joerg J; Briel, Matthias; Antes, Gerd; von Elm, Erik; Lang, Britta; Motschall, Edith; Schwarzer, Guido; Bassler, Dirk

    2016-12-01

    To systematically review methodological articles which focus on nonpublication of studies and to describe methods of detecting and/or quantifying and/or adjusting for dissemination in meta-analyses. To evaluate whether the methods have been applied to an empirical data set for which one can be reasonably confident that all studies conducted have been included. We systematically searched Medline, the Cochrane Library, and Web of Science, for methodological articles that describe at least one method of detecting and/or quantifying and/or adjusting for dissemination bias in meta-analyses. The literature search retrieved 2,224 records, of which we finally included 150 full-text articles. A great variety of methods to detect, quantify, or adjust for dissemination bias were described. Methods included graphical methods mainly based on funnel plot approaches, statistical methods, such as regression tests, selection models, sensitivity analyses, and a great number of more recent statistical approaches. Only few methods have been validated in empirical evaluations using unpublished studies obtained from regulators (Food and Drug Administration, European Medicines Agency). We present an overview of existing methods to detect, quantify, or adjust for dissemination bias. It remains difficult to advise which method should be used as they are all limited and their validity has rarely been assessed. Therefore, a thorough literature search remains crucial in systematic reviews, and further steps to increase the availability of all research results need to be taken. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Three-dimensional interpretation of TEM soundings

    NASA Astrophysics Data System (ADS)

    Barsukov, P. O.; Fainberg, E. B.

    2013-07-01

    We describe the approach to the interpretation of electromagnetic (EM) sounding data which iteratively adjusts the three-dimensional (3D) model of the environment by local one-dimensional (1D) transformations and inversions and reconstructs the geometrical skeleton of the model. The final 3D inversion is carried out with the minimal number of the sought parameters. At each step of the interpretation, the model of the medium is corrected according to the geological information. The practical examples of the suggested method are presented.

  14. Bimodal Aldosterone Distribution in Low-Renin Hypertension

    PubMed Central

    2013-01-01

    BACKGROUND In low-renin hypertension (LRH), serum aldosterone levels are higher in those subjects with primary aldosteronism and may be lower in those with non-aldosterone mineralocorticoid excess or primary renal sodium retention. We investigated the hypothesis that the frequency distribution of aldosterone in LRH is bimodal. METHODS Of the 3,532 attendees at the sixth examination cycle of the Framingham Offspring Study, 1,831 were included in this cross-sectional analysis after we excluded those with conditions or taking medications such as antihypertensive drugs that might affect renin or aldosterone. RESULTS Three hundred three subjects (17%) had untreated hypertension (SBP ≥140mm Hg or DBP ≥90mm Hg). LRH, defined as plasma renin ≤5 mU/L, was present in 93 of those 303 hypertensive subjects (31%). Aldosterone values were adjusted statistically for age, sex, and the urinary sodium/creatinine ratio. In the subjects with LRH, the adjusted aldosterone distribution was bimodal (dip test for unimodality, P = 0.008). The adjusted aldosterone distribution was unimodal in the normal subjects (P = 0.98) and in the hypertensive subjects with normal plasma renin (P = 0.94). CONCLUSIONS In this community-based sample of white subjects, those with low-renin hypertension had a bimodal adjusted aldosterone distribution. Subjects with normal-renin hypertension and subjects with normal blood pressure had unimodal adjusted aldosterone distributions. These findings suggest 2 pathophysiological variants of LRH, one that is aldosterone-dependent and one that is non-aldosterone-dependent. PMID:23757402

  15. Prevalence of Fibromyalgia: A Population-Based Study in Olmsted County, Minnesota, Utilizing the Rochester Epidemiology Project

    PubMed Central

    Vincent, Ann; Lahr, Brian D; Wolfe, Frederick; Clauw, Daniel J; Whipple, Mary O; Oh, Terry H; Barton, Debra L; St Sauver, Jennifer

    2014-01-01

    Objective Our objective was to estimate and compare the prevalence of fibromyalgia by two different methods, in Olmsted County, Minnesota. Methods The first method was a retrospective review of medical records of potential cases of fibromyalgia in Olmsted County using Rochester Epidemiology Project (from January 1, 2005, to December 31, 2009) to estimate the prevalence of diagnosed fibromyalgia in clinical practice. The second method was a random survey of adults in Olmsted County using the fibromyalgia research survey criteria to estimate the percentage of responders who met fibromyalgia research survey criteria. Results Of the 3,410 potential patients identified by the first method, 1,115 had a fibromyalgia diagnosis documented in the medical record by a health care provider. The age- and sex-adjusted prevalence of diagnosed fibromyalgia by this method was 1.1%. By the second method, of the 2,994 people who received the survey by mail, 830 (27.6%) responded and 44 (5.3%) met fibromyalgia research survey criteria. The age- and sex-adjusted prevalence of fibromyalgia in the general population of Olmsted County by this method was estimated at 6.4%. Conclusion To the best of our knowledge, this is the first report of the rate at which fibromyalgia is being diagnosed in a community. This is also the first report of prevalence as assessed by the fibromyalgia research survey criteria. Our results suggest that patients, particularly men, who meet the fibromyalgia research survey criteria are unlikely to have been given a diagnosis of fibromyalgia. PMID:23203795

  16. Method and apparatus for analog pulse pile-up rejection

    DOEpatents

    De Geronimo, Gianluigi

    2013-12-31

    A method and apparatus for pulse pile-up rejection are disclosed. The apparatus comprises a delay value application constituent configured to receive a threshold-crossing time value, and provide an adjustable value according to a delay value and the threshold-crossing time value; and a comparison constituent configured to receive a peak-occurrence time value and the adjustable value, compare the peak-occurrence time value with the adjustable value, indicate pulse acceptance if the peak-occurrence time value is less than or equal to the adjustable value, and indicate pulse rejection if the peak-occurrence time value is greater than the adjustable value.

  17. Method and apparatus for analog pulse pile-up rejection

    DOEpatents

    De Geronimo, Gianluigi

    2014-11-18

    A method and apparatus for pulse pile-up rejection are disclosed. The apparatus comprises a delay value application constituent configured to receive a threshold-crossing time value, and provide an adjustable value according to a delay value and the threshold-crossing time value; and a comparison constituent configured to receive a peak-occurrence time value and the adjustable value, compare the peak-occurrence time value with the adjustable value, indicate pulse acceptance if the peak-occurrence time value is less than or equal to the adjustable value, and indicate pulse rejection if the peak-occurrence time value is greater than the adjustable value.

  18. Cross-Cultural Adjustment of Chinese Students in Japan: School Adjustment and Educational Support

    ERIC Educational Resources Information Center

    Li, Yuan Xiang; Sano, Hideki; Ahn, Ruth

    2013-01-01

    This study investigates Chinese immigrant students' cross-cultural and school adjustment issues in Japanese schools. Using a quantitative method, a survey which collected students' demographic information, cross-cultural adjustment, and school adjustment questions was administered to 143 Chinese junior high and high school students in Tokyo and…

  19. HIV prevalence, risk behaviors, health care use, and mental health status of transgender persons: implications for public health intervention.

    PubMed Central

    Clements-Nolle, K; Marx, R; Guzman, R; Katz, M

    2001-01-01

    OBJECTIVES: This study described HIV prevalence, risk behaviors, health care use, and mental health status of male-to-female and female-to-male transgender persons and determined factors associated with HIV. METHODS: We recruited transgender persons through targeted sampling, respondent-driven sampling, and agency referrals; 392 male-to-female and 123 female-to-male transgender persons were interviewed and tested for HIV. RESULTS: HIV prevalence among male-to-female transgender persons was 35%. African American race (adjusted odds ratio [OR] = 5.81; 95% confidence interval [CI] = 2.82, 11.96), a history of injection drug use (OR = 2.69; 95% CI = 1.56, 4.62), multiple sex partners (adjusted OR = 2.64; 95% CI = 1.50, 4.62), and low education (adjusted OR = 2.08; 95% CI = 1.17, 3.68) were independently associated with HIV. Among female-to-male transgender persons, HIV prevalence (2%) and risk behaviors were much lower. Most male-to-female (78%) and female-to-male (83%) transgender persons had seen a medical provider in the past 6 months. Sixty-two percent of the male-to-female and 55% of the female-to-male transgender persons were depressed; 32% of each population had attempted suicide. CONCLUSIONS: High HIV prevalence suggests an urgent need for risk reduction interventions for male-to-female transgender persons. Recent contact with medical providers was observed, suggesting that medical providers could provide an important link to needed prevention, health, and social services. PMID:11392934

  20. A REVIEW OF STATISTICAL METHODS FOR THE METEOROLOGICAL ADJUSTMENT OF TROPOSPHERIC OZONE

    EPA Science Inventory

    A variety of statistical methods for meteorological adjustment of ozone have been proposed in the literature over the last decade for purposes of forecasting, estimating ozone time trends, or investigating underlying mechanisms from an empirical perspective. The methods can be...

  1. 77 FR 69442 - Federal Acquisition Regulation; Information Collection; Economic Price Adjustment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-19

    ...; Information Collection; Economic Price Adjustment AGENCIES: Department of Defense (DOD), General Services... economic price adjustment. Public comments are particularly invited on: Whether this collection of..., Economic Price Adjustment by any of the following methods: Regulations.gov : http://www.regulations.gov...

  2. Direct comparison of risk-adjusted and non-risk-adjusted CUSUM analyses of coronary artery bypass surgery outcomes.

    PubMed

    Novick, Richard J; Fox, Stephanie A; Stitt, Larry W; Forbes, Thomas L; Steiner, Stefan

    2006-08-01

    We previously applied non-risk-adjusted cumulative sum methods to analyze coronary bypass outcomes. The objective of this study was to assess the incremental advantage of risk-adjusted cumulative sum methods in this setting. Prospective data were collected in 793 consecutive patients who underwent coronary bypass grafting performed by a single surgeon during a period of 5 years. The composite occurrence of an "adverse outcome" included mortality or any of 10 major complications. An institutional logistic regression model for adverse outcome was developed by using 2608 contemporaneous patients undergoing coronary bypass. The predicted risk of adverse outcome in each of the surgeon's 793 patients was then calculated. A risk-adjusted cumulative sum curve was then generated after specifying control limits and odds ratio. This risk-adjusted curve was compared with the non-risk-adjusted cumulative sum curve, and the clinical significance of this difference was assessed. The surgeon's adverse outcome rate was 96 of 793 (12.1%) versus 270 of 1815 (14.9%) for all the other institution's surgeons combined (P = .06). The non-risk-adjusted curve reached below the lower control limit, signifying excellent outcomes between cases 164 and 313, 323 and 407, and 667 and 793, but transgressed the upper limit between cases 461 and 478. The risk-adjusted cumulative sum curve never transgressed the upper control limit, signifying that cases preceding and including 461 to 478 were at an increased predicted risk. Furthermore, if the risk-adjusted cumulative sum curve was reset to zero whenever a control limit was reached, it still signaled a decrease in adverse outcome at 166, 653, and 782 cases. Risk-adjusted cumulative sum techniques provide incremental advantages over non-risk-adjusted methods by not signaling a decrement in performance when preoperative patient risk is high.

  3. A structural topological optimization method for multi-displacement constraints and any initial topology configuration

    NASA Astrophysics Data System (ADS)

    Rong, J. H.; Yi, J. H.

    2010-10-01

    In density-based topological design, one expects that the final result consists of elements either black (solid material) or white (void), without any grey areas. Moreover, one also expects that the optimal topology can be obtained by starting from any initial topology configuration. An improved structural topological optimization method for multi- displacement constraints is proposed in this paper. In the proposed method, the whole optimization process is divided into two optimization adjustment phases and a phase transferring step. Firstly, an optimization model is built to deal with the varied displacement limits, design space adjustments, and reasonable relations between the element stiffness matrix and mass and its element topology variable. Secondly, a procedure is proposed to solve the optimization problem formulated in the first optimization adjustment phase, by starting with a small design space and advancing to a larger deign space. The design space adjustments are automatic when the design domain needs expansions, in which the convergence of the proposed method will not be affected. The final topology obtained by the proposed procedure in the first optimization phase, can approach to the vicinity of the optimum topology. Then, a heuristic algorithm is given to improve the efficiency and make the designed structural topology black/white in both the phase transferring step and the second optimization adjustment phase. And the optimum topology can finally be obtained by the second phase optimization adjustments. Two examples are presented to show that the topologies obtained by the proposed method are of very good 0/1 design distribution property, and the computational efficiency is enhanced by reducing the element number of the design structural finite model during two optimization adjustment phases. And the examples also show that this method is robust and practicable.

  4. Longitudinal Associations between Keeping a Secret and Psychosocial Adjustment in Adolescence

    ERIC Educational Resources Information Center

    Frijns, Tom; Finkenauer, Catrin

    2009-01-01

    Increasing bodies of evidence suggest that keeping secrets may be detrimental to well-being and adjustment, whereas confiding secrets may alleviate the detriments of secrecy and benefit well-being and adjustment. However, few studies have addressed the consequences of keeping and confiding secrets simultaneously, and even fewer have done so…

  5. Psychological Adjustment of Children with Sickle Cell Disease: Stability and Change over a 10-Month Period.

    ERIC Educational Resources Information Center

    Thompson, Robert J.; And Others

    1994-01-01

    Describes investigation utilizing sickle cell disease subjects from a stress and coping project. Found little stability in classification of individuals' adjustment, low congruence in behavior problem patterns and diagnoses, and less stability in adjustment by child report than mother report. Suggests children's coping strategies are intervention…

  6. Predicting Adjustment during the Transition to College: Alexithymia, Perceived Stress, and Psychological Symptoms

    ERIC Educational Resources Information Center

    Kerr, Sandra; Johnson, Vanessa K.; Gans, Susan E.; Krumrine, Jodi

    2004-01-01

    Fifty-six incoming college students were assessed in a study of the contribution of alexithymia, stress, and psychological symptoms to college adjustment. Alexithymia predicted fall semester adjustment, suggesting that interventions aimed at encouraging awareness and discussion of emotions may improve academic and emotional well-being for students…

  7. Parenting and late adolescent emotional adjustment: mediating effects of discipline and gender.

    PubMed

    McKinney, Cliff; Milone, Mary Catherine; Renk, Kimberly

    2011-08-01

    Research suggests that parenting styles are related to the types of discipline parents utilize and that the coupling of parenting styles and discipline techniques are related to child outcomes. Although extant research examines the effects of parenting styles and discipline on child and early adolescent adjustment, less is known about adjustment in late adolescents, also described as emerging adults. Thus, the current study investigated the relationships among parenting styles (e.g., authoritative, authoritarian, permissive), discipline strategies (e.g., non-violent discipline, psychological aggression, physical assault), and emerging adult emotional adjustment (e.g., self-esteem, depression, and anxiety). The sample consisted of 526 participants ranging in age from 18 to 22 years. Results were analyzed with structural equation modeling and suggest that, although perceived parenting styles and discipline are both correlated with emerging adult emotional adjustment, perceived parenting is associated with emerging adult emotional adjustment for females but not males when examined simultaneously with perceived discipline. This finding demonstrates the importance of examining the direct and indirect relationships in the context of gender dyads.

  8. Lower extremity EMG-driven modeling of walking with automated adjustment of musculoskeletal geometry

    PubMed Central

    Meyer, Andrew J.; Patten, Carolynn

    2017-01-01

    Neuromusculoskeletal disorders affecting walking ability are often difficult to manage, in part due to limited understanding of how a patient’s lower extremity muscle excitations contribute to the patient’s lower extremity joint moments. To assist in the study of these disorders, researchers have developed electromyography (EMG) driven neuromusculoskeletal models utilizing scaled generic musculoskeletal geometry. While these models can predict individual muscle contributions to lower extremity joint moments during walking, the accuracy of the predictions can be hindered by errors in the scaled geometry. This study presents a novel EMG-driven modeling method that automatically adjusts surrogate representations of the patient’s musculoskeletal geometry to improve prediction of lower extremity joint moments during walking. In addition to commonly adjusted neuromusculoskeletal model parameters, the proposed method adjusts model parameters defining muscle-tendon lengths, velocities, and moment arms. We evaluated our EMG-driven modeling method using data collected from a high-functioning hemiparetic subject walking on an instrumented treadmill at speeds ranging from 0.4 to 0.8 m/s. EMG-driven model parameter values were calibrated to match inverse dynamic moments for five degrees of freedom in each leg while keeping musculoskeletal geometry close to that of an initial scaled musculoskeletal model. We found that our EMG-driven modeling method incorporating automated adjustment of musculoskeletal geometry predicted net joint moments during walking more accurately than did the same method without geometric adjustments. Geometric adjustments improved moment prediction errors by 25% on average and up to 52%, with the largest improvements occurring at the hip. Predicted adjustments to musculoskeletal geometry were comparable to errors reported in the literature between scaled generic geometric models and measurements made from imaging data. Our results demonstrate that with appropriate experimental data, joint moment predictions for walking generated by an EMG-driven model can be improved significantly when automated adjustment of musculoskeletal geometry is included in the model calibration process. PMID:28700708

  9. Measurement Equivalence in ADL and IADL Difficulty Across International Surveys of Aging: Findings From the HRS, SHARE, and ELSA

    PubMed Central

    Kasper, Judith D.; Brandt, Jason; Pezzin, Liliana E.

    2012-01-01

    Objective. To examine the measurement equivalence of items on disability across three international surveys of aging. Method. Data for persons aged 65 and older were drawn from the Health and Retirement Survey (HRS, n = 10,905), English Longitudinal Study of Aging (ELSA, n = 5,437), and Survey of Health, Ageing and Retirement in Europe (SHARE, n = 13,408). Differential item functioning (DIF) was assessed using item response theory (IRT) methods for activities of daily living (ADL) and instrumental activities of daily living (IADL) items. Results. HRS and SHARE exhibited measurement equivalence, but 6 of 11 items in ELSA demonstrated meaningful DIF. At the scale level, this item-level DIF affected scores reflecting greater disability. IRT methods also spread out score distributions and shifted scores higher (toward greater disability). Results for mean disability differences by demographic characteristics, using original and DIF-adjusted scores, were the same overall but differed for some subgroup comparisons involving ELSA. Discussion. Testing and adjusting for DIF is one means of minimizing measurement error in cross-national survey comparisons. IRT methods were used to evaluate potential measurement bias in disability comparisons across three international surveys of aging. The analysis also suggested DIF was mitigated for scales including both ADL and IADL and that summary indexes (counts of limitations) likely underestimate mean disability in these international populations. PMID:22156662

  10. Method for preparing membranes with adjustable separation performance

    DOEpatents

    Peterson, E.S.; Orme, C.J.; Stone, M.L.

    1995-01-31

    Methods for adjustable separation of solutes and solvents involve the combination of the use of a maximally swollen membrane and subsequent vacuum depressurization exerted on the permeate side of that membrane. By adjusting the extent of depressurization it is possible to separate solvent from solutes and solutes from each other. Improved control of separation parameters as well as improved flux rates characterize the present invention. 2 figs.

  11. Method for preparing membranes with adjustable separation performance

    DOEpatents

    Peterson, Eric S.; Orme, Christopher J.; Stone, Mark L.

    1995-01-01

    Methods for adjustable separation of solutes and solvents involve the combination of the use of a maximally swollen membrane and subsequent vacuum depressurization exerted on the permeate side of that membrane. By adjusting the extent of depressurization it is possible to separate solvent from solutes and solutes from each other. Improved control of separation parameters as well as improved flux rates characterize the present invention.

  12. Aberrant error processing in relation to symptom severity in obsessive–compulsive disorder: A multimodal neuroimaging study

    PubMed Central

    Agam, Yigal; Greenberg, Jennifer L.; Isom, Marlisa; Falkenstein, Martha J.; Jenike, Eric; Wilhelm, Sabine; Manoach, Dara S.

    2014-01-01

    Background Obsessive–compulsive disorder (OCD) is characterized by maladaptive repetitive behaviors that persist despite feedback. Using multimodal neuroimaging, we tested the hypothesis that this behavioral rigidity reflects impaired use of behavioral outcomes (here, errors) to adaptively adjust responses. We measured both neural responses to errors and adjustments in the subsequent trial to determine whether abnormalities correlate with symptom severity. Since error processing depends on communication between the anterior and the posterior cingulate cortex, we also examined the integrity of the cingulum bundle with diffusion tensor imaging. Methods Participants performed the same antisaccade task during functional MRI and electroencephalography sessions. We measured error-related activation of the anterior cingulate cortex (ACC) and the error-related negativity (ERN). We also examined post-error adjustments, indexed by changes in activation of the default network in trials surrounding errors. Results OCD patients showed intact error-related ACC activation and ERN, but abnormal adjustments in the post- vs. pre-error trial. Relative to controls, who responded to errors by deactivating the default network, OCD patients showed increased default network activation including in the rostral ACC (rACC). Greater rACC activation in the post-error trial correlated with more severe compulsions. Patients also showed increased fractional anisotropy (FA) in the white matter underlying rACC. Conclusions Impaired use of behavioral outcomes to adaptively adjust neural responses may contribute to symptoms in OCD. The rACC locus of abnormal adjustment and relations with symptoms suggests difficulty suppressing emotional responses to aversive, unexpected events (e.g., errors). Increased structural connectivity of this paralimbic default network region may contribute to this impairment. PMID:25057466

  13. A demographic explanation for the recent rise in European fertility.

    PubMed

    Bongaarts, John; Sobotka, Tomáš

    2012-01-01

    Between 1998 and 2008 European countries experienced the first continent-wide increase in the period total fertility rate (TFR) since the 1960s. After discussing period and cohort influences on fertility trends, we examine the role of tempo distortions of period fertility and different methods for removing them. We highlight the usefulness of a new indicator: the tempo- and parity-adjusted total fertility rate (TFRp*). This variant of the adjusted total fertility rate proposed by Bongaarts and Feeney also controls for the parity composition of the female population and provides more stable values than the indicators proposed in the past. Finally, we estimate levels and trends in tempo and parity distribution distortions in selected countries in Europe. Our analysis of period and cohort fertility indicators in the Czech Republic, Netherlands, Spain, and Sweden shows that the new adjusted measure gives a remarkable fit with the completed fertility of women in prime childbearing years in a given period, which suggests that it provides an accurate adjustment for tempo and parity composition distortions. Using an expanded dataset for ten countries, we demonstrate that adjusted fertility as measured by TFRp* remained nearly stable since the late 1990s. This finding implies that the recent upturns in the period TFR in Europe are largely explained by a decline in the pace of fertility postponement. Other tempo-adjusted fertility indicators have not indicated such a large role for the diminishing tempo effect in these TFR upturns. As countries proceed through their postponement transitions, tempo effects will decline further and eventually disappear, thus putting continued upward pressure on period fertility. However, such an upward trend may be obscured for a few years by the effects of economic recession.

  14. The influence of husbands' or male partners' support on women's psychosocial adjustment to having an ostomy resulting from colorectal cancer.

    PubMed

    Altschuler, Andrea; Ramirez, Michelle; Grant, Marcia; Wendel, Christopher; Hornbrook, Mark C; Herrinton, Lisa; Krouse, Robert S

    2009-01-01

    Some patients with colorectal cancer (CRC) require a permanent ostomy, which changes bodily function and can create psychosocial distress. However, little is known about the influence of men's support on women's psychosocial adjustment to having an ostomy as a result of CRC. Participants initially completed the City of Hope-CRC Quality of Life questionnaire. We then conducted in-depth interviews with 30 female participants. Interview questions focused on body image, gender, and sexuality. Interviews were recorded and transcribed. We used qualitative methods to analyze the interview data and compared global health-related quality of life (HRQOL) quartile scores to the overall ways that women discussed husbands' or partners' support regarding psychosocial adjustments to having ostomies. Of 30 participants, 22 were married or partnered at the time of surgery and 8 were single. The nonpartnered respondents are not included in this analysis. Of the 22 married/partnered women, 17 described positive support from husbands being central to their psychosocial adjustment, 3 described a lack or withdrawal of support negatively affecting adjustment, and 2 described support as neither positive nor negative. In 17 cases, women's high or low quantitative HRQOL scores matched the positive or negative qualitative findings. There were 3 cases in which there were positive qualitative data and low HRQOL scores, but in each of these cases, women reported serious current comorbidities. These findings suggest that the provision or withdrawal of husbands' or partners' support can have a considerable impact on the psychosocial adjustment of female CRC patients with ostomies. These findings appear to be both short term and long term. Survivorship assessments should include appraisals of women's relationships to their spouses/partners.

  15. Surveillance of systemic autoimmune rheumatic diseases using administrative data.

    PubMed

    Bernatsky, S; Lix, L; Hanly, J G; Hudson, M; Badley, E; Peschken, C; Pineau, C A; Clarke, A E; Fortin, P R; Smith, M; Bélisle, P; Lagace, C; Bergeron, L; Joseph, L

    2011-04-01

    There is growing interest in developing tools and methods for the surveillance of chronic rheumatic diseases, using existing resources such as administrative health databases. To illustrate how this might work, we used population-based administrative data to estimate and compare the prevalence of systemic autoimmune rheumatic diseases (SARDs) across three Canadian provinces, assessing for regional differences and the effects of demographic factors. Cases of SARDs (systemic lupus erythematosus, scleroderma, primary Sjogren's, polymyositis/dermatomyositis) were ascertained from provincial physician billing and hospitalization data. We combined information from three case definitions, using hierarchical Bayesian latent class regression models that account for the imperfect nature of each case definition. Using methods that account for the imperfect nature of both billing and hospitalization databases, we estimated the over-all prevalence of SARDs to be approximately 2-3 cases per 1,000 residents. Stratified prevalence estimates suggested similar demographic trends across provinces (i.e. greater prevalence in females-versus-males, and in persons of older age). The prevalence in older females approached or exceeded 1 in 100, which may reflect the high burden of primary Sjogren's syndrome in this group. Adjusting for demographics, there was a greater prevalence in urban-versus-rural settings. In our work, prevalence estimates had good face validity and provided useful information about potential regional and demographic variations. Our results suggest that surveillance of some rheumatic diseases using administrative data may indeed be feasible. Our work highlights the usefulness of using multiple data sources, adjusting for the error in each.

  16. A Method of Dynamic Extended Reactive Power Optimization in Distribution Network Containing Photovoltaic-Storage System

    NASA Astrophysics Data System (ADS)

    Wang, Wu; Huang, Wei; Zhang, Yongjun

    2018-03-01

    The grid-integration of Photovoltaic-Storage System brings some undefined factors to the network. In order to make full use of the adjusting ability of Photovoltaic-Storage System (PSS), this paper puts forward a reactive power optimization model, which are used to construct the objective function based on power loss and the device adjusting cost, including energy storage adjusting cost. By using Cataclysmic Genetic Algorithm to solve this optimization problem, and comparing with other optimization method, the result proved that: the method of dynamic extended reactive power optimization this article puts forward, can enhance the effect of reactive power optimization, including reducing power loss and device adjusting cost, meanwhile, it gives consideration to the safety of voltage.

  17. Method to mosaic gratings that relies on analysis of far-field intensity patterns in two wavelengths

    NASA Astrophysics Data System (ADS)

    Hu, Yao; Zeng, Lijiang; Li, Lifeng

    2007-01-01

    We propose an experimental method to coherently mosaic two planar diffraction gratings. The method uses a Twyman-Green interferometer to guarantee the planar parallelism of the two sub-aperture gratings, and obtains the in-plane rotational error and the two translational errors from analysis of the far-field diffraction intensity patterns in two alignment wavelengths. We adjust the relative attitude and position of the two sub-aperture gratings to produce Airy disk diffraction patterns in both wavelengths. In our experiment, the repeatability of in-plane rotation adjustment was 2.35 μrad and that of longitudinal adjustment was 0.11 μm. The accuracy of lateral adjustment was about 2.9% of the grating period.

  18. Silver nanocrystal-decorated polyoxometalate single-walled nanotubes as nanoreactors for desulfurization catalysis at room temperature.

    PubMed

    Zhang, Hao; Xu, Xiaobin; Lin, Haifeng; Ud Din, Muhammad Aizaz; Wang, Haiqing; Wang, Xun

    2017-09-14

    Ultrathin nanocrystals generally provide a remarkable catalytic performance due to their high specific surface area and exposure of certain active sites. However, deactivation caused by growth and gathering limits the catalytic application of ultrathin nanocrystals. Here we report Ag nanocrystal-decorated polyoxometalate (Ag-POM) single-walled nanotubes assembled via a concise, surfactant-free soaking method as a new kind of well-defined core-sheath nanoreactor. The diameter of Ag nanocrystals inside polyoxometalate nanotubes can be controlled via simply adjusting the reactant concentration. Ag-POM provided outstanding oxidative desulfurization (ODS) catalytic performance for aromatic sulfocompounds at room temperature. It was suggested that Ag nanocrystals decorated on the inner surface played a key role in adjusting the electronic distribution and enhancing the catalytic activity. The as-prepared Ag-POM nanotubes are promising candidate catalysts with enhanced performance for practical catalytic applications in the gasoline desulfurization industry.

  19. Graphene/Ionic Liquid Composite Films and Ion Exchange

    PubMed Central

    Mo, Yufei; Wan, Yunfang; Chau, Alicia; Huang, Fuchuan

    2014-01-01

    Wettability of graphene is adjusted by the formation of various ionic surfaces combining ionic liquid (IL) self-assembly with ion exchange. The functionalized ILs were designed and synthesized with the goal of obtaining adjustable wettability. The wettability of the graphene surface bearing various anions was measured systematically. The effect of solvent systems on ion exchange ratios on the graphene surface has also been investigated. Meanwhile, the mechanical properties of the graphene/IL composite films were investigated on a nanometer scale. The elasticity and adhesion behavior of the thin film was determined with respected to the indentation deformation by colloid probe nanoindentation method. The results indicate that anions played an important role in determining graphene/IL composite film properties. In addition, surface wetting and mechanics can be quantitatively determined according to the counter-anions on the surface. This study might suggest an alternate way for quantity detection of surface ions by surface force. PMID:24970602

  20. Basic research for the geodynamics program

    NASA Technical Reports Server (NTRS)

    Mueller, Ivan I.

    1988-01-01

    Additional results are presented concerning a study that considers improvements over present Earth Rotation Parameter (ERP) determination methods by directly combining observations from various space geodetic systems in one adjustment. Earlier results are extended, showing that in addition to slight improvements in accuracy, substantial (a factor of three or more) improvements in precision and significant reductions in correlations between various parameters can be obtained (by combining Lunar Laser Ranging - LLR, Satellite Laser Ranging - SLR to Lageos, and Very Long Baseline Interferometry - VLBI data in one adjustment) as compared to results from individual systems. Smaller improvements are also seen over the weighted means of the individual system results. Although data transmission would not be significantly reduced, negligible additional computer time would be required if (standardized) normal equations were available from individual solutions. Suggestions for future work and implications for the New Earth Rotation Service (IERS) are also presented.

  1. Does Occupation Explain Gender and Other Differences in Work-Related Eye Injury Hospitalization Rates?

    PubMed Central

    Smith, Gordon S.; Lincoln, Andrew E.; Wong, Tien Y.; Bell, Nicole S.; Vinger, Paul F.; Amoroso, Paul J.; Lombardi, David A.

    2007-01-01

    Objective We sought to determine whether demographic differences in eye injury rates persist after adjusting for occupational exposure. Methods On-duty eye injury hospitalizations were linked to occupation among active-duty US Army personnel. Results Eye injury rates were higher for white solidiers, men, and for younger soldiers, even after adjusting for occupational group and specific job titles using multivariate models. Conclusions This finding contrasts with studies of other injuries, suggesting that occupation does not fully account for variations in eye injury risk. Because protective eyewear can prevent most serious eye injuries, we hypothesize that differences in protective eyewear use between men and women may contribute to differences in eye injury rates, although follow-up studies are needed to confirm this. Prevention efforts should consider targeting high-risk demographic groups in addition to high-risk occupations. PMID:15951724

  2. A Review of Propensity-Score Methods and Their Use in Cardiovascular Research.

    PubMed

    Deb, Saswata; Austin, Peter C; Tu, Jack V; Ko, Dennis T; Mazer, C David; Kiss, Alex; Fremes, Stephen E

    2016-02-01

    Observational studies using propensity-score methods have been increasing in the cardiovascular literature because randomized controlled trials are not always feasible or ethical. However, propensity-score methods can be confusing, and the general audience may not fully understand the importance of this technique. The objectives of this review are to describe (1) the fundamentals of propensity score methods, (2) the techniques to assess for propensity-score model adequacy, (3) the 4 major methods for using the propensity score (matching, stratification, covariate adjustment, and inverse probability of treatment weighting [IPTW]) using examples from previously published cardiovascular studies, and (4) the strengths and weaknesses of these 4 techniques. Our review suggests that matching or IPTW using the propensity score have shown to be most effective in reducing bias of the treatment effect. Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  3. The Researches on Cycle-Changeable Generation Settlement Method

    NASA Astrophysics Data System (ADS)

    XU, Jun; LONG, Suyan; LV, Jianhu

    2018-03-01

    Through the analysis of the business characteristics and problems of price adjustment, a cycle-changeable generation settlement method is proposed to support any time cycle settlement, and put forward a complete set of solutions, including the creation of settlement tasks, time power dismantle, generating fixed cycle of electricity, net energy split. At the same time, the overall design flow of cycle-changeable settlement is given. This method supports multiple price adjustments during the month, and also is an effective solution to the cost reduction of month-after price adjustment.

  4. A risk adjustment approach to estimating the burden of skin disease in the United States.

    PubMed

    Lim, Henry W; Collins, Scott A B; Resneck, Jack S; Bolognia, Jean; Hodge, Julie A; Rohrer, Thomas A; Van Beek, Marta J; Margolis, David J; Sober, Arthur J; Weinstock, Martin A; Nerenz, David R; Begolka, Wendy Smith; Moyano, Jose V

    2018-01-01

    Direct insurance claims tabulation and risk adjustment statistical methods can be used to estimate health care costs associated with various diseases. In this third manuscript derived from the new national Burden of Skin Disease Report from the American Academy of Dermatology, a risk adjustment method that was based on modeling the average annual costs of individuals with or without specific diseases, and specifically tailored for 24 skin disease categories, was used to estimate the economic burden of skin disease. The results were compared with the claims tabulation method used in the first 2 parts of this project. The risk adjustment method estimated the direct health care costs of skin diseases to be $46 billion in 2013, approximately $15 billion less than estimates using claims tabulation. For individual skin diseases, the risk adjustment cost estimates ranged from 11% to 297% of those obtained using claims tabulation for the 10 most costly skin disease categories. Although either method may be used for purposes of estimating the costs of skin disease, the choice of method will affect the end result. These findings serve as an important reference for future discussions about the method chosen in health care payment models to estimate both the cost of skin disease and the potential cost impact of care changes. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  5. Digital off-axis holographic interferometry with simulated wavefront.

    PubMed

    Belashov, A V; Petrov, N V; Semenova, I V

    2014-11-17

    The paper presents a novel algorithm based on digital holographic interferometry and being promising for evaluation of phase variations from highly noisy or modulated by speckle-structures digital holograms. The suggested algorithm simulates an interferogram in finite width fringes, by analogy with classical double exposure holographic interferometry. Thus obtained interferogram is then processed as a digital hologram. The advantages of the suggested approach are demonstrated in numerical experiments on calculations of differences in phase distributions of wave fronts modulated by speckle structure, as well as in a physical experiment on the analysis of laser-induced heating dynamics of an aqueous solution of a photosensitizer. It is shown that owing to the inherent capability of the approach to perform adjustable smoothing of compared wave fronts, the resulting difference undergoes noise filtering. This capability of adjustable smoothing may be used to minimize losses in spatial resolution. Since the method allows to vary an observation angle of compared wave fields, an opportunity to compensate misalignment of optical axes of these wave fronts arises. This feature can be required, for example, when using two different setups in comparative digital holography or for compensation of recording system displacements during a set of exposures in studies of dynamic processes.

  6. Self-adjusting grid methods for one-dimensional hyperbolic conservation laws

    NASA Technical Reports Server (NTRS)

    Harten, A.; Hyman, J. M.

    1983-01-01

    The automatic adjustment of a grid which follows the dynamics of the numerical solution of hyperbolic conservation laws is given. The grid motion is determined by averaging the local characteristic velocities of the equations with respect to the amplitudes of the signals. The resulting algorithm is a simple extension of many currently popular Godunov-type methods. Computer codes using one of these methods can be easily modified to add the moving mesh as an option. Numerical examples are given that illustrate the improved accuracy of Godunov's and Roe's methods on a self-adjusting mesh. Previously announced in STAR as N83-15008

  7. Reducing Aggressive Behavior and Increasing Motivation in School: The Evolution of an Intervention to Strengthen School Adjustment

    ERIC Educational Resources Information Center

    Hudley, Cynthia; Graham, Sandra; Taylor, April

    2007-01-01

    The pervasive links between problem behaviors and school adjustment suggest that effective intervention programs to enhance school adjustment must focus both on decreasing the motivation to aggress and increasing the motivation to achieve. We describe a program of intervention research to improve social behavior and academic motivation in…

  8. Material variability and repetitive member allowable property adjustments in forest products engineering

    Treesearch

    Steve Verrill; David Kretschmann

    2008-01-01

    It has been argued that repetitive member allowable property adjustments should be larger for high-variability material than for low-variability material. We report analytic calculations and simulations that suggest that the order of such adjustments should be reversed. That is, given the manner in which allowable properties are currently calculated, as the coefficient...

  9. The Relationship of Parental Control to Youth Adjustment: Do Youths' Feelings about Their Parents Play a Role?

    ERIC Educational Resources Information Center

    Kakihara, Fumiko; Tilton-Weaver, Lauree; Kerr, Margaret; Stattin, Hakan

    2010-01-01

    Recent research suggests that youths interpret parental control and that this may have implications for how control affects youths' adjustment. In this study, we propose that youths' feelings about being over-controlled by parents and feeling connected to parents are intermediary processes linking parental control and youths' adjustment. We used…

  10. Doing Well vs. Feeling Well: Understanding Family Dynamics and the Psychological Adjustment of Chinese Immigrant Adolescents

    ERIC Educational Resources Information Center

    Qin, Desiree Baolian

    2008-01-01

    Despite their average high levels of educational achievement, Asian American students often report poor psychological and social adjustment, suggesting an achievement/adjustment paradox. Yet, the reasons for this paradox remain unclear. Drawing on 5-year longitudinal qualitative interview data, this paper compares the family dynamics of two groups…

  11. Impact of video technology on efficiency of pharmacist-provided anticoagulation counseling and patient comprehension.

    PubMed

    Moore, Sarah J; Blair, Elizabeth A; Steeb, David R; Reed, Brent N; Hull, J Heyward; Rodgers, Jo Ellen

    2015-06-01

    Discharge anticoagulation counseling is important for ensuring patient comprehension and optimizing clinical outcomes. As pharmacy resources become increasingly limited, the impact of informational videos on the counseling process becomes more relevant. To evaluate differences in pharmacist time spent counseling and patient comprehension (measured by the Oral Anticoagulation Knowledge [OAK] test) between informational videos and traditional face-to-face (oral) counseling. This prospective, open, parallel-group study at an academic medical center randomized 40 individuals-17 warfarin-naïve ("New Start") and 23 with prior warfarin use ("Restart")-to receive warfarin discharge education by video or face-to-face counseling. "Teach-back" questions were used in both groups. Although overall pharmacist time was reduced in the video counseling group (P < 0.001), an interaction between prior warfarin use and counseling method (P = 0.012) suggests the difference between counseling methods was smaller in New Start participants. Following adjustment, mean total time was reduced 8.71 (95% CI = 5.15-12.26) minutes (adjusted P < 0.001) in Restart participants and 2.31 (-2.19 to 6.81) minutes (adjusted P = 0.472) in New Start participants receiving video counseling. Postcounseling OAK test scores did not differ. Age, gender, socioeconomic status, and years of education were not predictive of total time or OAK test score. Use of informational videos coupled with teach-back questions significantly reduced pharmacist time spent on anticoagulation counseling without compromising short-term patient comprehension, primarily in patients with prior warfarin use. Study results demonstrate that video technology provides an efficient method of anticoagulation counseling while achieving similar comprehension. © The Author(s) 2015.

  12. 48 CFR 14.408-4 - Economic price adjustment.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Economic price adjustment... CONTRACTING METHODS AND CONTRACT TYPES SEALED BIDDING Opening of Bids and Award of Contract 14.408-4 Economic price adjustment. (a) Bidder proposes economic price adjustment. (1) When a solicitation does not...

  13. 48 CFR 14.408-4 - Economic price adjustment.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 1 2011-10-01 2011-10-01 false Economic price adjustment... CONTRACTING METHODS AND CONTRACT TYPES SEALED BIDDING Opening of Bids and Award of Contract 14.408-4 Economic price adjustment. (a) Bidder proposes economic price adjustment. (1) When a solicitation does not...

  14. 48 CFR 14.408-4 - Economic price adjustment.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 1 2013-10-01 2013-10-01 false Economic price adjustment... CONTRACTING METHODS AND CONTRACT TYPES SEALED BIDDING Opening of Bids and Award of Contract 14.408-4 Economic price adjustment. (a) Bidder proposes economic price adjustment. (1) When a solicitation does not...

  15. 48 CFR 14.408-4 - Economic price adjustment.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 1 2014-10-01 2014-10-01 false Economic price adjustment... CONTRACTING METHODS AND CONTRACT TYPES SEALED BIDDING Opening of Bids and Award of Contract 14.408-4 Economic price adjustment. (a) Bidder proposes economic price adjustment. (1) When a solicitation does not...

  16. 48 CFR 14.408-4 - Economic price adjustment.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 1 2012-10-01 2012-10-01 false Economic price adjustment... CONTRACTING METHODS AND CONTRACT TYPES SEALED BIDDING Opening of Bids and Award of Contract 14.408-4 Economic price adjustment. (a) Bidder proposes economic price adjustment. (1) When a solicitation does not...

  17. Adjustment to College in Students with ADHD

    ERIC Educational Resources Information Center

    Rabiner, David L.; Anastopoulos, Arthur D.; Costello, Jane; Hoyle, Rick H.; Swartzwelder, H. Scott

    2008-01-01

    Objective: To examine college adjustment in students reporting an ADHD diagnosis and the effect of medication treatment on students' adjustment. Method: 1,648 first-semester freshmen attending a public and a private university completed a Web-based survey to examine their adjustment to college. Results: Compared with 200 randomly selected control…

  18. Application of adjusted data in calculating fission-product decay energies and spectra

    NASA Astrophysics Data System (ADS)

    George, D. C.; Labauve, R. J.; England, T. R.

    1982-06-01

    The code ADENA, which approximately calculates fussion-product beta and gamma decay energies and spectra in 19 or fewer energy groups from a mixture of U235 and Pu239 fuels, is described. The calculation uses aggregate, adjusted data derived from a combination of several experiments and summation results based on the ENDF/B-V fission product file. The method used to obtain these adjusted data and the method used by ADENA to calculate fission-product decay energy with an absorption correction are described, and an estimate of the uncertainty of the ADENA results is given. Comparisons of this approximate method are made to experimental measurements, to the ANSI/ANS 5.1-1979 standard, and to other calculational methods. A listing of the complete computer code (ADENA) is contained in an appendix. Included in the listing are data statements containing the adjusted data in the form of parameters to be used in simple analytic functions.

  19. Robotic follow system and method

    DOEpatents

    Bruemmer, David J [Idaho Falls, ID; Anderson, Matthew O [Idaho Falls, ID

    2007-05-01

    Robot platforms, methods, and computer media are disclosed. The robot platform includes perceptors, locomotors, and a system controller, which executes instructions for a robot to follow a target in its environment. The method includes receiving a target bearing and sensing whether the robot is blocked front. If the robot is blocked in front, then the robot's motion is adjusted to avoid the nearest obstacle in front. If the robot is not blocked in front, then the method senses whether the robot is blocked toward the target bearing and if so, sets the rotational direction opposite from the target bearing, and adjusts the rotational velocity and translational velocity. If the robot is not blocked toward the target bearing, then the rotational velocity is adjusted proportional to an angle of the target bearing and the translational velocity is adjusted proportional to a distance to the nearest obstacle in front.

  20. Social support and adjustment to cancer: reconciling descriptive, correlational, and intervention research.

    PubMed

    Helgeson, V S; Cohen, S

    1996-03-01

    Several research literatures are reviewed that address the associations of emotional, informational, and instrumental social support to psychological adjustment to cancer. Descriptive studies suggest that emotional support is most desired by patients, and correlational studies suggest that emotional support has the strongest associations with better adjustment. However, the evidence for the effectiveness of peer discussion groups aimed at providing emotional support is less than convincing. Moreover, educational groups aimed at providing informational support appear to be as effective as, if not more effective than, peer discussions. Reasons for inconsistencies between the correlational and intervention literatures are discussed, and future directions are outlined.

  1. Relative Validity of a Diet History Questionnaire Against a Four-Day Weighed Food Record among Older Men in Australia: The Concord Health and Ageing in Men Project (CHAMP).

    PubMed

    Rosilene, W V R; Cumming, R; Travison, T; Blyth, F; Naganathan, V; Allman-Farinelli, M; Hirani, V

    2015-06-01

    To evaluate the relative validity of the diet history questionnaire (DHQ) used in the Concord Health and Ageing in Men Project (CHAMP) against a four-day weighed food record (4dWFR) as the reference method. Detailed DHQ followed by a 4dWFR were completed between July 2012 and October of 2013. Burwood, Canada Bay and Strathfield in Sydney, Australia. Fifty six community- dwelling men aged 75 years and over (mean=79 years). DHQ estimates of intakes were generally higher than estimates from 4dWFR. Differences between the two methods were generally less than 20% with the exception of β-carotene (37%). Fixed and proportional biases were only present for retinol, β-carotene, magnesium, phosphorus and percentage of energy from protein; however, 95% limits of agreement were in some cases wide. Pearson correlation coefficient of log-transformed unadjusted values ranged from 0.15 (zinc) to 0.70 (alcohol), and from 0.06 (iron) to 0.63 (thiamin) after energy-adjustment. Spearman's correlation coefficients ranged from 0.16 (zinc) to 0.80 (alcohol) before energy adjustment, and from 0.15(zinc) to 0.81(alcohol) after energy adjustment. Our findings suggest that the DHQ used in CHAMP to measure the nutritional intake of its participants is appropriate to this age group and provides reasonably similar results to the 4dWFR for the majority of nutrients analysed.

  2. Assessing Pictograph Recognition: A Comparison of Crowdsourcing and Traditional Survey Approaches

    PubMed Central

    Argo, Lauren; Stoddard, Greg; Bray, Bruce E; Zeng-Treitler, Qing

    2015-01-01

    Background Compared to traditional methods of participant recruitment, online crowdsourcing platforms provide a fast and low-cost alternative. Amazon Mechanical Turk (MTurk) is a large and well-known crowdsourcing service. It has developed into the leading platform for crowdsourcing recruitment. Objective To explore the application of online crowdsourcing for health informatics research, specifically the testing of medical pictographs. Methods A set of pictographs created for cardiovascular hospital discharge instructions was tested for recognition. This set of illustrations (n=486) was first tested through an in-person survey in a hospital setting (n=150) and then using online MTurk participants (n=150). We analyzed these survey results to determine their comparability. Results Both the demographics and the pictograph recognition rates of online participants were different from those of the in-person participants. In the multivariable linear regression model comparing the 2 groups, the MTurk group scored significantly higher than the hospital sample after adjusting for potential demographic characteristics (adjusted mean difference 0.18, 95% CI 0.08-0.28, P<.001). The adjusted mean ratings were 2.95 (95% CI 2.89-3.02) for the in-person hospital sample and 3.14 (95% CI 3.07-3.20) for the online MTurk sample on a 4-point Likert scale (1=totally incorrect, 4=totally correct). Conclusions The findings suggest that crowdsourcing is a viable complement to traditional in-person surveys, but it cannot replace them. PMID:26678085

  3. Prostitutes and chimney sweeps both have problems: towards full integration of both sexes in the study of occupational health.

    PubMed

    Messing, K; Dumais, L; Romito, P

    1993-01-01

    Recently, natural and social scientists have pointed out that the need to make scientific results apply to both sexes is not met by simply adding women as research subjects. They suggest that the social and biological specificity of both sexes must be recognized and adjustments made to the ways questions are asked, hypotheses are generated, research subjects are chosen, and data are analysed. It is important to examine the definitions, concepts and methods used in research in occupational health to see whether they obstruct recognition of women's occupational health problems or interfere with gender-neutral standard setting. Unravelling the effects of sex on occupational health is complicated by the fact that women and men do not, by and large, work at the same jobs. Definitions of "work" must in some cases be adjusted to take account of women's occupations, just as definitions involving "health" must include women's biological specificity. Appropriate changes must be made to generate sex-inclusive definitions of exposures to occupational hazards and of health effects. Methods for evaluating exposures typical of women's work must be developed. Women and their work must be appropriately included when standards for occupational exposures are set. If these adjustments are not made, women's occupational health problems will be seriously underestimated and understanding of health problems of both sexes will be hindered. Sociological analysis should also be done to reveal the mechanisms by which biased concepts and procedures develop and are reinforced.

  4. The flaws in the detail of an observational study on transcatheter aortic valve implantation versus surgical aortic valve replacement in intermediate-risks patients.

    PubMed

    Barili, Fabio; Freemantle, Nick; Folliguet, Thierry; Muneretto, Claudio; De Bonis, Michele; Czerny, Martin; Obadia, Jean Francois; Al-Attar, Nawwar; Bonaros, Nikolaos; Kluin, Jolanda; Lorusso, Roberto; Punjabi, Prakash; Sadaba, Rafael; Suwalski, Piotr; Benedetto, Umberto; Böning, Andreas; Falk, Volkmar; Sousa-Uva, Miguel; Kappetein, Pieter A; Menicanti, Lorenzo

    2017-06-01

    The PARTNER group recently published a comparison between the latest generation SAPIEN 3 transcatheter aortic valve implantation (TAVI) system (Edwards Lifesciences, Irvine, CA, USA) and surgical aortic valve replacement (SAVR) in intermediate-risk patients, apparently demonstrating superiority of the TAVI and suggesting that TAVI might be the preferred treatment method in this risk class of patients. Nonetheless, assessment of the non-randomized methodology used in this comparison reveals challenges that should be addressed in order to elucidate the validity of the results. The study by Thourani and colleagues showed several major methodological concerns: suboptimal methods in propensity score analysis with evident misspecification of the propensity scores (PS; no adjustment for the most significantly different covariates: left ventricular ejection fraction, moderate-severe mitral regurgitation and associated procedures); use of PS quintiles rather than matching; inference on not-adjusted Kaplan-Meier curves, although the authors correctly claimed for the need of balancing score adjusting for confounding factors in order to have unbiased estimates of the treatment effect; evidence of poor fit; lack of data on valve-related death.These methodological flaws invalidate direct comparison between treatments and cannot support authors' conclusions that TAVI with SAPIEN 3 in intermediate-risk patients is superior to surgery and might be the preferred treatment alternative to surgery. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  5. Sex Differences in Functional Stress Test Versus CT Angiography in Symptomatic Patients With Suspected CAD: Insights From PROMISE

    PubMed Central

    Pagidipati, Neha J.; Hemal, Kshipra; Coles, Adrian; Mark, Daniel B.; Dolor, Rowena J.; Pellikka, Patricia A.; Hoffmann, Udo; Litwin, Sheldon E.; Udelson, James; Daubert, Melissa A.; Shah, Svati H.; Martinez, Beth; Lee, Kerry L.; Douglas, Pamela S.

    2016-01-01

    Background Risk stratification is an important goal of cardiac noninvasive tests (NITs), yet little contemporary data exist on the prognostic value of different NITs by patient sex. Objectives To compare the results and prognostic information derived from anatomic versus stress testing in stable men and women with suspected coronary artery disease. Methods In 8966 PROMISE trial patients tested as randomized (4500 computed tomographic angiography [CTA], 52% female; 4466 stress testing, 53% female), we assessed the relationship between sex and NIT results using logistic regression, and the relationship between sex and a composite of death, myocardial infarction, and unstable angina hospitalization using Cox proportional hazards models. Results In women, a positive CTA (≥70% stenosis) was less likely than a positive stress test (8% vs. 12%, adjusted OR 0.67 [95% CI 0.55-0.82]). Compared with negative tests, a positive CTA was more strongly associated with subsequent clinical events than a positive stress test (CTA adjusted HR 5.86 [95% CI 3.32-10.35]; stress adjusted HR 2.27 [95% CI 1.21-4.25]; adjusted p=0.028). Men were more likely to have a positive CTA than stress test (16% vs. 14%, adjusted OR 1.23 [95% CI 1.04-1.47]). Compared with negative tests, a positive CTA was less strongly associated with subsequent clinical events than a positive stress test in men, although this difference was not statistically significant (CTA adjusted HR 2.80 [95% CI 1.76-4.45]; stress adjusted HR 4.42 [95% CI 2.77-7.07]; adjusted p=0.168). Negative CTA and stress tests were equally likely to predict an event in both sexes (adjusted p-values=NS). A significant interaction between sex, NIT type, and test result (p=0.01) suggests that sex and NIT type jointly influence the relationship between test result and clinical events. Conclusions The prognostic value of an NIT result varies by test type and patient sex. Women appear to derive more prognostic information from a CTA, while men tend to derive similar prognostic value from both test types. PMID:27058908

  6. Gendered academic adjustment among Asian American adolescents in an emerging immigrant community.

    PubMed

    Kiang, Lisa; Supple, Andrew J; Stein, Gabriela L; Gonzalez, Laura M

    2012-03-01

    Research on the academic adjustment of immigrant adolescents has been predominately conducted in large cities among established migration areas. To broaden the field's restricted focus, data from 172 (58% female) Asian American adolescents who reside within a non-traditional or emerging immigrant community in the Southeastern US were used to examine gender differences in academic adjustment as well as school, family, and cultural variables as potential mediators of gender differences found. Results suggest that girls report significantly higher educational goals, intrinsic academic motivation, and utility value of school compared to boys. These gender differences are statistically mediated by ethnic exploration and family processes, most prominently, family respect. School connectedness and perceived discrimination are also associated with academic adjustment at the bivariate level, suggesting that academic success may be best promoted if multiple domains of influence can be targeted.

  7. Embracing additive manufacture: implications for foot and ankle orthosis design

    PubMed Central

    2012-01-01

    Background The design of foot and ankle orthoses is currently limited by the methods used to fabricate the devices, particularly in terms of geometric freedom and potential to include innovative new features. Additive manufacturing (AM) technologies, where objects are constructed via a series of sub-millimetre layers of a substrate material, may present the opportunity to overcome these limitations and allow novel devices to be produced that are highly personalised for the individual, both in terms of fit and functionality. Two novel devices, a foot orthosis (FO) designed to include adjustable elements to relieve pressure at the metatarsal heads, and an ankle foot orthosis (AFO) designed to have adjustable stiffness levels in the sagittal plane, were developed and fabricated using AM. The devices were then tested on a healthy participant to determine if the intended biomechanical modes of action were achieved. Results The adjustable, pressure relieving FO was found to be able to significantly reduce pressure under the targeted metatarsal heads. The AFO was shown to have distinct effects on ankle kinematics which could be varied by adjusting the stiffness level of the device. Conclusions The results presented here demonstrate the potential design freedom made available by AM, and suggest that it may allow novel personalised orthotic devices to be produced which are beyond the current state of the art. PMID:22642941

  8. Hope in the Context of Lung Cancer: Relationships of Hope to Symptoms and Psychological Distress

    PubMed Central

    Berendes, David; Keefe, Francis J.; Somers, Tamara J.; Kothadia, Sejal M.; Porter, Laura S.; Cheavens, Jennifer S.

    2010-01-01

    Context Hope may be important in explaining the variability in how patients adjust to lung cancer. Objectives The aim of this study was to examine how hope, as conceptualized by Snyder and colleagues, is associated with multiple indices of adjustment to lung cancer. This theoretical model of hope suggests that people with high levels of hope are able to think about the pathways to goals (pathways) and feel confident that they can pursue those pathways to reach their goals (agency). Methods We hypothesized that higher levels of hope, as measured by Snyder et al.’s hope scale, would be related to lower levels of pain and other lung cancer symptoms (i.e., fatigue, cough) and lower psychological distress (i.e., depression). Participants in this study included patients with a diagnosis of lung cancer (n = 51). All participants provided demographic and medical information and completed measures of hope, lung cancer symptoms, and psychological distress. Results Data analyses found that hope was inversely associated with major symptoms of cancer (i.e., pain, fatigue, cough) and psychological distress (i.e., depression), even after accounting for important demographic and medical variables (i.e., age, cancer stage). Conclusion The findings of this cross-sectional study highlight the potential importance of hope in understanding adjustment to lung cancer. Future longitudinal research could help reveal how hope and adjustment interact over the course of cancer survivorship. PMID:20579840

  9. The lack of theoretical support for using person trade-offs in QALY-type models.

    PubMed

    Østerdal, Lars Peter

    2009-10-01

    Considerable support for the use of person trade-off methods to assess the quality-adjustment factor in quality-adjusted life years (QALY) models has been expressed in the literature. The WHO has occasionally used similar methods to assess the disability weights for calculation of disability-adjusted life years (DALYs). This paper discusses the theoretical support for the use of person trade-offs in QALY-type measurement of (changes in) population health. It argues that measures of this type based on such quality-adjustment factors almost always violate the Pareto principle, and so lack normative justification.

  10. Investigation of methods for hydroclimatic data homogenization

    NASA Astrophysics Data System (ADS)

    Steirou, E.; Koutsoyiannis, D.

    2012-04-01

    We investigate the methods used for the adjustment of inhomogeneities of temperature time series covering the last 100 years. Based on a systematic study of scientific literature, we classify and evaluate the observed inhomogeneities in historical and modern time series, as well as their adjustment methods. It turns out that these methods are mainly statistical, not well justified by experiments and are rarely supported by metadata. In many of the cases studied the proposed corrections are not even statistically significant. From the global database GHCN-Monthly Version 2, we examine all stations containing both raw and adjusted data that satisfy certain criteria of continuity and distribution over the globe. In the United States of America, because of the large number of available stations, stations were chosen after a suitable sampling. In total we analyzed 181 stations globally. For these stations we calculated the differences between the adjusted and non-adjusted linear 100-year trends. It was found that in the two thirds of the cases, the homogenization procedure increased the positive or decreased the negative temperature trends. One of the most common homogenization methods, 'SNHT for single shifts', was applied to synthetic time series with selected statistical characteristics, occasionally with offsets. The method was satisfactory when applied to independent data normally distributed, but not in data with long-term persistence. The above results cast some doubts in the use of homogenization procedures and tend to indicate that the global temperature increase during the last century is between 0.4°C and 0.7°C, where these two values are the estimates derived from raw and adjusted data, respectively.

  11. A normalization method for combination of laboratory test results from different electronic healthcare databases in a distributed research network.

    PubMed

    Yoon, Dukyong; Schuemie, Martijn J; Kim, Ju Han; Kim, Dong Ki; Park, Man Young; Ahn, Eun Kyoung; Jung, Eun-Young; Park, Dong Kyun; Cho, Soo Yeon; Shin, Dahye; Hwang, Yeonsoo; Park, Rae Woong

    2016-03-01

    Distributed research networks (DRNs) afford statistical power by integrating observational data from multiple partners for retrospective studies. However, laboratory test results across care sites are derived using different assays from varying patient populations, making it difficult to simply combine data for analysis. Additionally, existing normalization methods are not suitable for retrospective studies. We normalized laboratory results from different data sources by adjusting for heterogeneous clinico-epidemiologic characteristics of the data and called this the subgroup-adjusted normalization (SAN) method. Subgroup-adjusted normalization renders the means and standard deviations of distributions identical under population structure-adjusted conditions. To evaluate its performance, we compared SAN with existing methods for simulated and real datasets consisting of blood urea nitrogen, serum creatinine, hematocrit, hemoglobin, serum potassium, and total bilirubin. Various clinico-epidemiologic characteristics can be applied together in SAN. For simplicity of comparison, age and gender were used to adjust population heterogeneity in this study. In simulations, SAN had the lowest standardized difference in means (SDM) and Kolmogorov-Smirnov values for all tests (p < 0.05). In a real dataset, SAN had the lowest SDM and Kolmogorov-Smirnov values for blood urea nitrogen, hematocrit, hemoglobin, and serum potassium, and the lowest SDM for serum creatinine (p < 0.05). Subgroup-adjusted normalization performed better than normalization using other methods. The SAN method is applicable in a DRN environment and should facilitate analysis of data integrated across DRN partners for retrospective observational studies. Copyright © 2015 John Wiley & Sons, Ltd.

  12. On the Importance of Age-Adjustment Methods in Ecological Studies of Social Determinants of Mortality

    PubMed Central

    Milyo, Jeffrey; Mellor, Jennifer M

    2003-01-01

    Objective To illustrate the potential sensitivity of ecological associations between mortality and certain socioeconomic factors to different methods of age-adjustment. Data Sources Secondary analysis employing state-level data from several publicly available sources. Crude and age-adjusted mortality rates for 1990 are obtained from the U.S. Centers for Disease Control. The Gini coefficient for family income and percent of persons below the federal poverty line are from the U.S. Bureau of Labor Statistics. Putnam's (2000) Social Capital Index was downloaded from ; the Social Mistrust Index was calculated from responses to the General Social Survey, following the method described in Kawachi et al. (1997). All other covariates are obtained from the U.S. Census Bureau. Study Design We use least squares regression to estimate the effect of several state-level socioeconomic factors on mortality rates. We examine whether these statistical associations are sensitive to the use of alternative methods of accounting for the different age composition of state populations. Following several previous studies, we present results for the case when only mortality rates are age-adjusted. We contrast these results with those obtained from regressions of crude mortality on age variables. Principal Findings Different age-adjustment methods can cause a change in the sign or statistical significance of the association between mortality and various socioeconomic factors. When age variables are included as regressors, we find no significant association between mortality and either income inequality, minority racial concentration, or social capital. Conclusions Ecological associations between certain socioeconomic factors and mortality may be extremely sensitive to different age-adjustment methods. PMID:14727797

  13. The new nordic diet – consumer expenditures and economic incentives estimated from a controlled intervention

    PubMed Central

    2013-01-01

    Background Several studies suggest that a healthy diet with high emphasis on nutritious, low-energy components such as fruits, vegetables, and seafood tends to be more costly for consumers. Derived from the ideas from the New Nordic Cuisine – and inspired by the Mediterranean diet, the New Nordic Diet (NND) has been developed as a palatable, healthy and sustainable diet based on products from the Nordic region. The objective of the study is to investigate economic consequences for the consumers of the NND, compared with an Average Danish Diet (ADD). Methods Combine quantity data from a randomized controlled ad libitum dietary 6 month intervention for central obese adults (18–65 years) and market retail price data of the products consumed in the intervention. Adjust consumed quantities to market price incentives using econometrically estimated price elasticities. Results Average daily food expenditure of the ADD as represented in the unadjusted intervention (ADD-i) amounted to 36.02 DKK for the participants. The daily food expenditure in the unadjusted New Nordic Diet (NND-i) costs 44.80 DKK per day per head, and is hence about 25% more expensive than the Average Danish Diet (or about 17% when adjusting for energy content of the diet). Adjusting for price incentives in a real market setting, the estimated cost of the Average Danish Diet is reduced by 2.50 DKK (ADD-m), compared to the unadjusted ADD-i diet, whereas the adjusted cost of the New Nordic Diet (NND-m) is reduced by about 3.50 DKK, compared to the unadjusted NND-i. The distribution of food cost is however much more heterogeneous among consumers within the NND than within the ADD. Conclusion On average, the New Nordic Diet is 24–25 per cent more expensive than an Average Danish Diet at the current market prices in Denmark (and 16–17 per cent, when adjusting for energy content). The relatively large heterogeneity in food costs in the NND suggests that it is possible to compose an NND where the cost exceeds that of ADD by less than the 24–25 per cent. PMID:24294977

  14. Adjustment method for embedded metrology engine in an EM773 series microcontroller.

    PubMed

    Blazinšek, Iztok; Kotnik, Bojan; Chowdhury, Amor; Kačič, Zdravko

    2015-09-01

    This paper presents the problems of implementation and adjustment (calibration) of a metrology engine embedded in NXP's EM773 series microcontroller. The metrology engine is used in a smart metering application to collect data about energy utilization and is controlled with the use of metrology engine adjustment (calibration) parameters. The aim of this research is to develop a method which would enable the operators to find and verify the optimum parameters which would ensure the best possible accuracy. Properly adjusted (calibrated) metrology engines can then be used as a base for variety of products used in smart and intelligent environments. This paper focuses on the problems encountered in the development, partial automatisation, implementation and verification of this method. Copyright © 2015 ISA. Published by Elsevier Ltd. All rights reserved.

  15. Active Ghrelin and the Postpartum

    PubMed Central

    Baker, Jessica H.; Pedersen, Cort; Leserman, Jane; Brownley, Kimberly A.

    2015-01-01

    Purpose Postpartum depression (PPD) occurs in 10%–15% of women. The appetite hormone ghrelin, which fluctuates during pregnancy, is associated with depression in nonpregnant samples. Here, we examine the association between PPD and active ghrelin from pregnancy to postpartum. We additionally examine whether ghrelin changes from pregnancy to postpartum and differs between breastfeeding and non-breastfeeding women. Methods Sixty women participated in a survey examining PPD and had information in regard to ghrelin concentrations were included in the study. The Edinburgh Postnatal Depression Scale was used to assess symptoms of PPD. Raw ghrelin levels and ghrelin levels adjusted for creatinine were included as outcomes. Results Women screening positive for PPD at 12-weeks postpartum had higher pregnancy ghrelin concentrations. Ghrelin concentrations significantly decreased from pregnancy to 6-weeks postpartum and this change differed based on pregnancy depression status. Finally, ghrelin levels were lower in women who breastfed compared with women who were bottle-feeding. No significant findings remained once ghrelin levels were adjusted for creatinine. Conclusions Although results do not suggest an association between PPD and ghrelin after adjusting for creatinine, future research should continue to explore this possibility extending further across the postpartum period with larger sample sizes. PMID:26424410

  16. Adverse Childhood Experiences and Risk of Binge Drinking and Drunkenness in Middle-Aged Finnish Men

    PubMed Central

    Kauhanen, Laura; Leino, Janne; Lakka, Hanna-Maaria; Lynch, John W.; Kauhanen, Jussi

    2011-01-01

    Objective. The purpose of this study was to investigate associations between adverse childhood experiences and binge drinking and drunkenness in adulthood using both historical and recalled data from childhood. Methods. Data on childhood adverse experiences were collected from school health records and questionnaires completed in adulthood. Adulthood data were obtained from the baseline examinations of the male participants (n = 2682) in the Kuopio Ischaemic Heart Disease Risk Factor Study (KIHD) in 1984–1989 from eastern Finland. School health records from the 1930s to 1950s were available for a subsample of KIHD men (n = 952). Results. According to the school health records, men who had adverse childhood experiences had a 1.51-fold (95% CI 1.05 to 2.18) age- and examination-year adjusted odds of binge drinking in adulthood. After adjustment for socioeconomic position in adulthood or behavioural factors in adulthood, the association remained unchanged. Adjustment for socioeconomic position in childhood attenuated these effects. Also the recalled data showed associations with adverse childhood experiences and binge drinking with different beverages. Conclusions. Our findings suggest that childhood adversities are associated with increased risk of binge drinking in adulthood. PMID:22111009

  17. How Noisy Does a Noisy Miner Have to Be? Amplitude Adjustments of Alarm Calls in an Avian Urban ‘Adapter’

    PubMed Central

    Lowry, Hélène; Lill, Alan; Wong, Bob B. M.

    2012-01-01

    Background Urban environments generate constant loud noise, which creates a formidable challenge for many animals relying on acoustic communication. Some birds make vocal adjustments that reduce auditory masking by altering, for example, the frequency (kHz) or timing of vocalizations. Another adjustment, well documented for birds under laboratory and natural field conditions, is a noise level-dependent change in sound signal amplitude (the ‘Lombard effect’). To date, however, field research on amplitude adjustments in urban environments has focused exclusively on bird song. Methods We investigated amplitude regulation of alarm calls using, as our model, a successful urban ‘adapter’ species, the Noisy miner, Manorina melanocephala. We compared several different alarm calls under contrasting noise conditions. Results Individuals at noisier locations (arterial roads) alarm called significantly more loudly than those at quieter locations (residential streets). Other mechanisms known to improve sound signal transmission in ‘noise’, namely use of higher perches and in-flight calling, did not differ between site types. Intriguingly, the observed preferential use of different alarm calls by Noisy miners inhabiting arterial roads and residential streets was unlikely to have constituted a vocal modification made in response to sound-masking in the urban environment because the calls involved fell within the main frequency range of background anthropogenic noise. Conclusions The results of our study suggest that a species, which has the ability to adjust the amplitude of its signals, might have a ‘natural’ advantage in noisy urban environments. PMID:22238684

  18. Uncertainty and psychological adjustment in patients with lung cancer

    PubMed Central

    Kurita, Keiko; Garon, Edward B.; Stanton, Annette L.; Meyerowitz, Beth E.

    2014-01-01

    Background For many patients with lung cancer, disease progression occurs without notice or with vague symptoms, and unfortunately, most treatments are not curative. Given this unpredictability, we hypothesized the following: (1) poorer psychological adjustment (specifically, more depressive symptoms, higher perceptions of stress, and poorer emotional well-being) would be associated with higher intolerance for uncertainty, higher perceived illness-related ambiguity, and their interaction; and (2) greater avoidance would mediate associations between higher intolerance of uncertainty and poorer psychological adjustment. Methods Participants (N = 49) diagnosed with lung cancer at least 6 months prior to enrollment completed the Center for Epidemiologic Studies – Depression Scale, the Functional Assessment of Cancer Therapy – Lung Emotional Well-being subscale, the Perceived Stress scale, the Intolerance of Uncertainty scale, the Mishel Uncertainty in Illness Scale Ambiguity subscale, the Impact of Event – Revised Avoidance subscale, and the Short-scale Eysenck Personality Questionnaire – Revised Neuroticism subscale. Mean age was 64.2 years (standard deviation [SD] = 11.0), mean years of education was 15.6 (SD = 3.1), and 71.4% were female. Hypotheses were tested with regression analyses, adjusted for neuroticism. Results Higher perceptions of stress and poorer emotional well-being were associated with higher levels of intolerance of uncertainty and higher perceived illness-related ambiguity. Non-somatic depressive symptoms were associated with higher levels of intolerance of uncertainty. Avoidance was found to mediate relations of intolerance of uncertainty with non-somatic depressive symptoms and emotional well-being only. Conclusions Findings suggest that interventions to address avoidance and intolerance of uncertainty in individuals with lung cancer may help improve psychological adjustment. PMID:22887017

  19. Declines in Outpatient Antimicrobial Use in Canada (1995–2010)

    PubMed Central

    Finley, Rita; Glass-Kaastra, Shiona K.; Hutchinson, Jim; Patrick, David M.; Weiss, Karl; Conly, John

    2013-01-01

    Background With rising reports of antimicrobial resistance in outpatient communities, surveillance of antimicrobial use is imperative for supporting stewardship programs. The primary objective of this article is to assess the levels of antimicrobial use in Canada over time. Methods Canadian antimicrobial use data from 1995 to 2010 were acquired and assessed by four metrics: population-adjusted prescriptions, Defined Daily Doses, spending on antimicrobials (inflation-adjusted), and average Defined Daily Doses per prescription. Linear mixed models were built to assess significant differences among years and antimicrobial groups, and to account for repeated measurements over time. Measures were also compared to published reports from European countries. Results Temporal trends in antimicrobial use in Canada vary by metric and antimicrobial grouping. Overall reductions were seen for inflation-adjusted spending, population-adjusted prescription rates and Defined Daily Doses, and increases were observed for the average number of Defined Daily Doses per prescription. The population-adjusted prescription and Defined Daily Doses values for 2009 were comparable to those reported by many European countries, while the average Defined Daily Dose per prescription for Canada ranked high. A significant reduction in the use of broad spectrum penicillins occurred between 1995 and 2004, coupled with increases in macrolide and quinolone use, suggesting that replacement of antimicrobial drugs may occur as new products arrive on the market. Conclusions There have been modest decreases of antimicrobial use in Canada over the past 15 years. However, continued surveillance of antimicrobial use coupled with data detailing antimicrobial resistance within bacterial pathogens affecting human populations is critical for targeting interventions and maintaining the effectiveness of these products for future generations. PMID:24146863

  20. Digital Inequalities of Family Life Information Seeking and Family Well-Being Among Chinese Adults in Hong Kong: A Population Survey

    PubMed Central

    2014-01-01

    Background Inequalities in Internet use and health information seeking are well documented, but less is known about information for family life activities. Objective We investigated the social determinants of online family life information seeking behaviors and its associations with family well-being among Chinese adults in Hong Kong. Methods A probability-based telephone survey was conducted in 2012 to record family life information seeking behaviors, including frequency of seeking and paying attention to family life information, levels of trust, and perceived usefulness of family life information. Family well-being was assessed using 3 single items on perceived family harmony, happiness, and health, with higher scores indicating greater well-being. Adjusted odds ratios for family life information seeking behaviors by socioeconomic characteristics and lifestyle behaviors, and adjusted beta coefficients for family well-being by family life information seeking behaviors were calculated. Results Of 1537 respondents, 57.57% (855/1537) had ever and 26.45% (407/1537) sought monthly family life information through the Internet. Lower educational attainment and household income, smoking, and physical inactivity were associated with less frequent seeking and paying attention (all P<.05). Greater perceived family health was associated with more frequent attention (adjusted β=.32, 95% CI.11-.52), greater levels of trust (adjusted β=.28, 95% CI .07-.48), and perceived usefulness (adjusted β=.23, 95% CI .01-.45) of family life information. Frequent attention and higher level of trust were also associated with greater family harmony (adjusted β=.22, 95% CI .002-.41) and happiness (adjusted β=.23, 95% CI .003-.42), respectively. Conclusions This is the first study investigating family life information seeking behaviors and suggested inequalities of online family life information seeking behaviors. The association between family life information seeking behavior and family well-being needs to be confirmed in prospective studies. PMID:25281831

  1. Heat index and adjusted temperature as surrogates for wet bulb globe temperature to screen for occupational heat stress.

    PubMed

    Bernard, Thomas E; Iheanacho, Ivory

    2015-01-01

    Ambient temperature and relative humidity are readily ava-ilable and thus tempting metrics for heat stress assessment. Two methods of using air temperature and relative humidity to create an index are Heat Index and Adjusted Temperature. The purposes of this article are: (1) to examine how well Heat Index and Adjusted Temperature estimated the wet bulb globe temperature (WBGT) index, and (2) to suggest how Heat Index and Adjusted Temperature can be used to screen for heat stress level. Psychrometric relationships were used to estimate values of actual WBGT for conditions of air temperature, relative humidity, and radiant heat at an air speed of 0.5 m/s. A relationship between Heat Index [°F] and WBGT [°C] was described by WBGT = -0.0034 HI(2) + 0.96 HI - 34. At lower Heat Index values, the equation estimated WBGTs that were ± 2 °C-WBGT around the actual value, and to about ± 0.5 °C-WBGT for Heat Index values > 100 °F. A relationship between Adjusted Temperature [°F] and WBGT [°C] was described by WBGT = 0.45 Tadj - 16. The actual WBGT was between 1 °C-WBGT below the estimated value and 1.4 °C-WBGT above. That is, there was a slight bias toward overestimating WBGT from Adjusted Temperature. Heat stress screening tables were constructed for metabolic rates of 180, 300, and 450 W. The screening decisions were divided into four categories: (1) < alert limit, (2) < exposure limit, (3) hourly time-weighted averages (TWAs) of work and recovery, and (4) a caution zone for an exposure > exposure limit at rest. The authors do not recommend using Heat Index or Adjusted Temperature instead of WBGT, but they may be used to screen for circumstances when a more detailed analysis using WBGT is appropriate. A particular weakness is accounting for radiant heat; and neither air speed nor clothing was considered.

  2. Uncertainty-based Estimation of the Secure Range for ISO New England Dynamic Interchange Adjustment

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

    Etingov, Pavel V.; Makarov, Yuri V.; Wu, Di

    2014-04-14

    The paper proposes an approach to estimate the secure range for dynamic interchange adjustment, which assists system operators in scheduling the interchange with neighboring control areas. Uncertainties associated with various sources are incorporated. The proposed method is implemented in the dynamic interchange adjustment (DINA) tool developed by Pacific Northwest National Laboratory (PNNL) for ISO New England. Simulation results are used to validate the effectiveness of the proposed method.

  3. Automatized alignment control of wing mechanization in aerodynamic contour of aircraft

    NASA Astrophysics Data System (ADS)

    Odnokurtsev, K. A.

    2018-05-01

    The method of automatized control of accuracy of an aircraft aerodynamic contour when mounting wing mechanization elements is described in the article. A control device in the stand of the wing assembling, equipped with the distance sensors, is suggested to be used. The measurement of control points’ inaccuracies is made automatically in a special computer program. Two kinds of sensor calibration are made in advance in order to increase the accuracy of measurements. As a result, the duration of control and adjustment of mechanization elements is reduced.

  4. Multidimensional change in psychotherapy.

    PubMed

    Jones, E E

    1980-04-01

    Assessed psychotherapy outcome for 177 patients who were seen for an average of 31 therapy hours with the Rating Scales for Outcome of Therapy and a Therapist Questionnaire. Results of a components analysis did not support Storrow's rational groupings of the Rating Scales into five dimensions and suggested that two general areas of psychological adjustment underlie the 11 scales. A second components analysis that included both outcome measures supports only in part the contention that when results from diverse outcome measures are factor analyzed, the factors necessarily are associated with method of measurement rather than substantive dimensions of change.

  5. Probing the big five in adolescence: personality and adjustment during a developmental transition.

    PubMed

    Graziano, W G; Ward, D

    1992-06-01

    The present study probed the links among Big Five personality differences, self-reported personality differences, and adjustment to school among young adolescents. We used a multimethod converging analysis, with three sources of data: (a) adolescent self-report on standardized personality inventories; (b) classroom teacher trait ratings and evaluations of adjustment; and (c) school guidance counselor evaluations of adjustment. Evaluations of adolescent adjustment were systematically related to Big Five personality differences, as assessed by both classroom teachers' and school counselors' ratings. For classroom teachers, adjustment was closely related to evaluations on the Big Five dimension of Conscientiousness. Adolescent self-report on several standardized measures was not related to adult evaluation of school adjustment. We suggest that the five-factor model may be a useful tool for probing adjustment during the transition to adolescence.

  6. A comparison of methods of estimating potential evapotranspiration from climatological data in arid and subhumid environments

    USGS Publications Warehouse

    Cruff, R.W.; Thompson, T.H.

    1967-01-01

    This study compared potential evapotranspiration, computed from climatological data by each of six empirical methods, with pan evaporation adjusted to equivalent lake evaporation by regional coefficients. The six methods tested were the Thornthwaite, U.S. Weather Bureau (a modification of the Permian method), Lowry-Johnson, Blaney-Criddle, Lane, and Hamon methods. The test was limited to 25 sites in the arid and subhumid parts of Arizona, California, and Nevada, where pan evaporation and concurrent climatological data were available. However, some of the sites lacked complete climatological data for the application of all six methods. Average values of adjusted pan evaporation and computed potential evapotransp4ration were compared for two periods---the calendar year and the 6-month period from May 1 through October 31. The 25 sites sampled a wide range of climatic conditions. Ten sites (group 1) were in a highly arid environment and four (group 2) were in an arid environment that was modified by extensive irrigation. The remaining 11 sites (group 3) were in a subhumid environment. Only the Weather Bureau method gave estimates of potential evapotranspiration that closely agreed with the adjusted pan evaporation at all sites where the method was used. However, lack of climatological data restricted the use of the Weather Bureau method to seven sites. Results obtained by use of the Thornthwaite, Lowry-Johnson, and Hamon methods were consistently low. Results obtained by use of the Lane method agreed with adjusted pan evaporation at the group 1 sites but were consistently high at the group 2 and 3 sites. During the analysis it became apparent that adjusted pan evaporation in an arid environment (group 1 sites) was a spurious standard for evaluating the reliability of .the methods that were tested. Group 1 data were accordingly not considered when making conclusions as ,to which of the six methods tested was best. The results of this study for group 2 and 3 data indicated that the Blaney-Criddle method, which uses climatological data that can be readily obtained or deduced, was the most practical of the six methods for estimating potential evapotranspiration. At all 15 sites in the two environments, potential evapotranspiration computed by the Blaney-Criddle method checked the adjusted pan evaporation within ?22 percent. This percentage range is generally considered to be the range of reliability for estimating lake evaporation from evaporation pans.

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

    Weaver, Virginia M., E-mail: vweaver@jhsph.edu; Johns Hopkins University School of Medicine, Baltimore, MD; Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD

    Positive associations between urine toxicant levels and measures of glomerular filtration rate (GFR) have been reported recently in a range of populations. The explanation for these associations, in a direction opposite that of traditional nephrotoxicity, is uncertain. Variation in associations by urine concentration adjustment approach has also been observed. Associations of urine cadmium, thallium and uranium in models of serum creatinine- and cystatin-C-based estimated GFR (eGFR) were examined using multiple linear regression in a cross-sectional study of adolescents residing near a lead smelter complex. Urine concentration adjustment approaches compared included urine creatinine, urine osmolality and no adjustment. Median age, bloodmore » lead and urine cadmium, thallium and uranium were 13.9 years, 4.0 μg/dL, 0.22, 0.27 and 0.04 g/g creatinine, respectively, in 512 adolescents. Urine cadmium and thallium were positively associated with serum creatinine-based eGFR only when urine creatinine was used to adjust for urine concentration (β coefficient=3.1 mL/min/1.73 m{sup 2}; 95% confidence interval=1.4, 4.8 per each doubling of urine cadmium). Weaker positive associations, also only with urine creatinine adjustment, were observed between these metals and serum cystatin-C-based eGFR and between urine uranium and serum creatinine-based eGFR. Additional research using non-creatinine-based methods of adjustment for urine concentration is necessary. - Highlights: • Positive associations between urine metals and creatinine-based eGFR are unexpected. • Optimal approach to urine concentration adjustment for urine biomarkers uncertain. • We compared urine concentration adjustment methods. • Positive associations observed only with urine creatinine adjustment. • Additional research using non-creatinine-based methods of adjustment needed.« less

  8. An imbalance in cluster sizes does not lead to notable loss of power in cross-sectional, stepped-wedge cluster randomised trials with a continuous outcome.

    PubMed

    Kristunas, Caroline A; Smith, Karen L; Gray, Laura J

    2017-03-07

    The current methodology for sample size calculations for stepped-wedge cluster randomised trials (SW-CRTs) is based on the assumption of equal cluster sizes. However, as is often the case in cluster randomised trials (CRTs), the clusters in SW-CRTs are likely to vary in size, which in other designs of CRT leads to a reduction in power. The effect of an imbalance in cluster size on the power of SW-CRTs has not previously been reported, nor what an appropriate adjustment to the sample size calculation should be to allow for any imbalance. We aimed to assess the impact of an imbalance in cluster size on the power of a cross-sectional SW-CRT and recommend a method for calculating the sample size of a SW-CRT when there is an imbalance in cluster size. The effect of varying degrees of imbalance in cluster size on the power of SW-CRTs was investigated using simulations. The sample size was calculated using both the standard method and two proposed adjusted design effects (DEs), based on those suggested for CRTs with unequal cluster sizes. The data were analysed using generalised estimating equations with an exchangeable correlation matrix and robust standard errors. An imbalance in cluster size was not found to have a notable effect on the power of SW-CRTs. The two proposed adjusted DEs resulted in trials that were generally considerably over-powered. We recommend that the standard method of sample size calculation for SW-CRTs be used, provided that the assumptions of the method hold. However, it would be beneficial to investigate, through simulation, what effect the maximum likely amount of inequality in cluster sizes would be on the power of the trial and whether any inflation of the sample size would be required.

  9. Self-reported Slower Eating Is Associated with a Lower Salt Intake: A Population-based Cross-sectional Study.

    PubMed

    Wakasugi, Minako; James Kazama, Junichiro; Narita, Ichiei

    2018-06-01

    Objective Evidence suggests that the eating rate is positively associated with the body weight and blood pressure. Furthermore, people who are overweight or obese tend to have higher salt intakes than those of normal weight. To investigate whether or not the eating rate is also associated with the salt intake, a cross-sectional study was conducted using health examination survey data collected in 2014 from 7,941 residents of Sado City, Niigata, Japan. Methods The eating rates were evaluated using a questionnaire; 11.7% of participants rated themselves as slow eaters, 65.6% as normal eaters, and 22.7% as fast eaters. The salt intake was estimated from sodium and creatinine spot urine measurements using Tanaka's formula. Associations with eating rate were evaluated using multivariate linear regression analyses, with normal eaters as the reference (set at 0). Results Self-reported eating rates were positively associated with the salt intake after adjustment for age and sex [β coefficient (95% confidence interval) for slow -0.51 (-0.67, -0.35); fast 0.18 (0.05, 0.30) ]. Further adjustment for the body mass index showed that slower eaters had lower salt intakes than normal eaters, but there was no marked difference in the salt intake between normal and fast eaters. The association between slower eating and a lower salt intake persisted after further adjustment for comorbidities [slow -0.33 (-0.49, -0.18) ]. Conclusion Our results suggest that reducing eating rates may be an effective strategy for reducing dietary salt intake as well as preventing obesity.

  10. Sunlight exposure and cardiovascular risk factors in the REGARDS study: a cross-sectional split-sample analysis

    PubMed Central

    2014-01-01

    Background Previous research has suggested that vitamin D and sunlight are related to cardiovascular outcomes, but associations between sunlight and risk factors have not been investigated. We examined whether increased sunlight exposure was related to improved cardiovascular risk factor status. Methods Residential histories merged with satellite, ground monitor, and model reanalysis data were used to determine previous-year sunlight radiation exposure for 17,773 black and white participants aged 45+ from the US. Exploratory and confirmatory analyses were performed by randomly dividing the sample into halves. Logistic regression models were used to examine relationships with cardiovascular risk factors. Results The lowest, compared to the highest quartile of insolation exposure was associated with lower high-density lipoprotein levels in adjusted exploratory (−2.7 mg/dL [95% confidence interval: −4.2, −1.2]) and confirmatory (−1.5 mg/dL [95% confidence interval: −3.0, −0.1]) models. The lowest, compared to the highest quartile of insolation exposure was associated with higher systolic blood pressure levels in unadjusted exploratory and confirmatory, as well as the adjusted exploratory model (2.3 mmHg [95% confidence interval: 0.8, 3.8]), but not the adjusted confirmatory model (1.6 mg/dL [95% confidence interval: −0.5, 3.7]). Conclusions The results of this study suggest that lower long-term sunlight exposure has an association with lower high-density lipoprotein levels. However, all associations were weak, thus it is not known if insolation may affect cardiovascular outcomes through these risk factors. PMID:24946776

  11. Association between work-family conflict and musculoskeletal pain among hospital patient care workers

    PubMed Central

    Kim, Seung-Sup; Okechukwu, Cassandra; Buxton, Orfeu M.; Dennerlein, Jack T.; Boden, Leslie I.; Hashimoto, Dean M.; Sorensen, Glorian

    2014-01-01

    Background A growing body of evidence suggests that work-family conflict is an important risk factor for workers' health and well-being. The goal of this study is to examine association between work-family conflict and musculoskeletal pain among hospital patient care workers. Methods We analyzed a cross-sectional survey of 1119 hospital patient care workers in 105 units in two urban, academic hospitals. Work-family conflict was measured by 5-item Work-Family Conflict Scale questionnaire. Multilevel logistic regression was applied to examine associations between work-family conflict and self-reported musculoskeletal pain in the past 3 months, adjusting for confounders including work-related psychosocial factors and physical work factors. Results In fully adjusted models, high work-family conflict was strongly associated with neck or shoulder pain (OR: 2.34, 95% CI: 1.64 - 3.34), arm pain (OR: 2.79, 95% CI: 1.64 - 4.75), lower extremity pain (OR: 2.20, 95% CI: 1.54- 3.15) and any musculoskeletal pain (OR: 2.45, 95% CI: 1.56 - 3.85), and a number of body areas in pain (OR: 2.47, 95% CI: 1.82 - 3.36) in the past 3 months. The association with low back pain was attenuated and became non-significant after adjusting for confounders. Conclusions Given the consistent associations between work-family conflict and self-reported musculoskeletal pains, the results suggest that work-family conflict could be an important domain for health promotion and workplace policy development among hospital patient care workers. PMID:23019044

  12. Social isolation, vital exhaustion, and incident heart failure: findings from the Atherosclerosis Risk in Communities Study.

    PubMed

    Cené, Crystal W; Loehr, Laura; Lin, Feng-Chang; Hammond, Wizdom Powell; Foraker, Randi E; Rose, Kathryn; Mosley, Thomas; Corbie-Smith, Giselle

    2012-07-01

    Prospective studies have shown that social isolation (i.e. lack of social contacts) predicts incident coronary heart disease (CHD), but it is unclear whether it predicts incident heart failure (HF) and what factors might mediate this association. HF patients may be more susceptible to social isolation as they tend to be older and may have disrupted social relationships due to life course factors (e.g. retirement or bereavement). We prospectively examined whether individuals with higher vs. low social isolation have a higher incidence of HF and determined whether this association is mediated by vital exhaustion. We estimated incident HF hospitalization or death among 14 348 participants from Visit 2 (1990-1992) in the Atherosclerosis Risk in Communities (ARIC) study using Cox proportional hazard models which were sequentially adjusted for age, race/study community, gender, current smoking, alcohol use, and co-morbidities. We conducted mediation analyses according to the Baron and Kenny method. After a median follow-up of 16.9 person-years, 1727 (13.0%) incident HF events occurred. The adjusted hazard of incident HF was greater for those in the higher vs. low social isolation risk group (hazard ratio 1.21, 95% confidence interval 1.08-1.35). Our data suggest that vital exhaustion strongly mediates the association between higher social isolation and incident HF (the percentage change in beta coefficient for higher vs. low social isolation groups after adjusting for vital exhaustion was 36%). These data suggest that greater social isolation is an independent risk factor for incident HF, and this association appears to be strongly mediated by vital exhaustion.

  13. Conflict adaptation in time: foreperiods as contextual cues for attentional adjustment.

    PubMed

    Wendt, Mike; Kiesel, Andrea

    2011-10-01

    Interference evoked by distractor stimulus information, such as flankers in the Eriksen task, is reduced when the proportion of conflicting stimuli is increased. This modulation is sensitive to contextual cues such as stimulus location or color, suggesting attentional adjustment to conflict contingencies on the basis of context information. In the present study, we explored whether conflict adjustment is modulated by temporal variation of conflict likelihood. To this end, we associated low and high proportions of conflict stimuli with foreperiods of different lengths. Flanker interference was higher with foreperiods associated with low conflict proportions, suggesting that participants use the foreperiod as a contextual cue for attentional adjustment. We conjecture that participants initially adopt the strategy useful for conflict contingencies associated with short foreperiods, and then readjust during the trial, in the absence of any additional exogenous cue, when the imperative stimulus has not occurred during a certain time interval.

  14. Exploring Mexican American adolescent romantic relationship profiles and adjustment

    PubMed Central

    Moosmann, Danyel A.V.; Roosa, Mark W.

    2015-01-01

    Although Mexican Americans are the largest ethnic minority group in the nation, knowledge is limited regarding this population's adolescent romantic relationships. This study explored whether 12th grade Mexican Americans’ (N = 218; 54% female) romantic relationship characteristics, cultural values, and gender created unique latent classes and if so, whether they were linked to adjustment. Latent class analyses suggested three profiles including, relatively speaking, higher, satisfactory, and lower quality romantic relationships. Regression analyses indicated these profiles had distinct associations with adjustment. Specifically, adolescents with higher and satisfactory quality romantic relationships reported greater future family expectations, higher self-esteem, and fewer externalizing symptoms than those with lower quality romantic relationships. Similarly, adolescents with higher quality romantic relationships reported greater academic self-efficacy and fewer sexual partners than those with lower quality romantic relationships. Overall, results suggested higher quality romantic relationships were most optimal for adjustment. Future research directions and implications are discussed. PMID:26141198

  15. Context matters: the benefits and costs of expressing positive emotion among survivors of childhood sexual abuse.

    PubMed

    Bonanno, George A; Colak, Deniz M; Keltner, Dacher; Shiota, Michelle N; Papa, Anthony; Noll, Jennie G; Putnam, Frank W; Trickett, Penelope K

    2007-11-01

    Positive emotions promote adjustment to aversive life events. However, evolutionary theory and empirical research on trauma disclosure suggest that in the context of stigmatized events, expressing positive emotions might incur social costs. To test this thesis, the authors coded genuine (Duchenne) smiling and laughter and also non-Duchenne smiling from videotapes of late-adolescent and young adult women, approximately half with documented histories of childhood sexual abuse (CSA), as they described the most distressing event of their lives. Consistent with previous studies, genuine positive emotional expression was generally associated with better social adjustment two years later. However, as anticipated, CSA survivors who expressed positive emotion in the context of describing a past CSA experience had poorer long-term social adjustment, whereas CSA survivors who expressed positive emotion while describing a nonabuse experience had improved social adjustment. These findings suggest that the benefits of positive emotional expression may often be context specific.

  16. High-bandwidth prefetcher for high-bandwidth memory

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

    Mehta, Sanyam; Kohn, James Robert; Ernst, Daniel Jonathan

    A method for prefetching data into a cache is provided. The method allocates an outstanding request buffer ("ORB"). The method stores in an address field of the ORB an address and a number of blocks. The method issues prefetch requests for a degree number of blocks starting at the address. When a prefetch response is received for all the prefetch requests, the method adjusts the address of the next block to prefetch and adjusts the number of blocks remaining to be retrieved and then issues prefetch requests for a degree number of blocks starting at the adjusted address. The prefetchingmore » pauses when a maximum distance between the reads of the prefetched blocks and the last prefetched block is reached. When a read request for a prefetched block is received, the method resumes prefetching when a resume criterion is satisfied.« less

  17. Smart light random memory sprays Retinex: a fast Retinex implementation for high-quality brightness adjustment and color correction.

    PubMed

    Banić, Nikola; Lončarić, Sven

    2015-11-01

    Removing the influence of illumination on image colors and adjusting the brightness across the scene are important image enhancement problems. This is achieved by applying adequate color constancy and brightness adjustment methods. One of the earliest models to deal with both of these problems was the Retinex theory. Some of the Retinex implementations tend to give high-quality results by performing local operations, but they are computationally relatively slow. One of the recent Retinex implementations is light random sprays Retinex (LRSR). In this paper, a new method is proposed for brightness adjustment and color correction that overcomes the main disadvantages of LRSR. There are three main contributions of this paper. First, a concept of memory sprays is proposed to reduce the number of LRSR's per-pixel operations to a constant regardless of the parameter values, thereby enabling a fast Retinex-based local image enhancement. Second, an effective remapping of image intensities is proposed that results in significantly higher quality. Third, the problem of LRSR's halo effect is significantly reduced by using an alternative illumination processing method. The proposed method enables a fast Retinex-based image enhancement by processing Retinex paths in a constant number of steps regardless of the path size. Due to the halo effect removal and remapping of the resulting intensities, the method outperforms many of the well-known image enhancement methods in terms of resulting image quality. The results are presented and discussed. It is shown that the proposed method outperforms most of the tested methods in terms of image brightness adjustment, color correction, and computational speed.

  18. Cycling Empirical Antibiotic Therapy in Hospitals: Meta-Analysis and Models

    PubMed Central

    Abel, Sören; Viechtbauer, Wolfgang; Bonhoeffer, Sebastian

    2014-01-01

    The rise of resistance together with the shortage of new broad-spectrum antibiotics underlines the urgency of optimizing the use of available drugs to minimize disease burden. Theoretical studies suggest that coordinating empirical usage of antibiotics in a hospital ward can contain the spread of resistance. However, theoretical and clinical studies came to different conclusions regarding the usefulness of rotating first-line therapy (cycling). Here, we performed a quantitative pathogen-specific meta-analysis of clinical studies comparing cycling to standard practice. We searched PubMed and Google Scholar and identified 46 clinical studies addressing the effect of cycling on nosocomial infections, of which 11 met our selection criteria. We employed a method for multivariate meta-analysis using incidence rates as endpoints and find that cycling reduced the incidence rate/1000 patient days of both total infections by 4.95 [9.43–0.48] and resistant infections by 7.2 [14.00–0.44]. This positive effect was observed in most pathogens despite a large variance between individual species. Our findings remain robust in uni- and multivariate metaregressions. We used theoretical models that reflect various infections and hospital settings to compare cycling to random assignment to different drugs (mixing). We make the realistic assumption that therapy is changed when first line treatment is ineffective, which we call “adjustable cycling/mixing”. In concordance with earlier theoretical studies, we find that in strict regimens, cycling is detrimental. However, in adjustable regimens single resistance is suppressed and cycling is successful in most settings. Both a meta-regression and our theoretical model indicate that “adjustable cycling” is especially useful to suppress emergence of multiple resistance. While our model predicts that cycling periods of one month perform well, we expect that too long cycling periods are detrimental. Our results suggest that “adjustable cycling” suppresses multiple resistance and warrants further investigations that allow comparing various diseases and hospital settings. PMID:24968123

  19. Associations between the self-reported frequency of hearing chemical alarms in theater and regional brain volume in Gulf War Veterans

    PubMed Central

    Chao, Linda L.; Reeb, Rosemary; Esparza, Iva L.; Abadjian, Linda R.

    2017-01-01

    Background We previously reported evidence of reduced cortical gray matter (GM), white matter (WM), and hippocampal volume in Gulf War (GW) veterans with predicted exposure to low-levels of nerve agent according to the 2000 Khamisiyah plume model analysis. Because there is suggestive evidence that other nerve agent exposures may have occurred during the Gulf War, we examined the association between the self-reported frequency of hearing chemical alarms sound during deployment in the Gulf War and regional brain volume in GW veterans. Methods Ninety consecutive GW veterans (15 female, mean age: 52±8 years) participating in a VA-funded study underwent structural magnetic resonance imaging (MRI) on a 3 T scanner. Freesurfer (version 5.1) was used to obtain regional measures of cortical GM, WM, hippocampal, and insula volume. Multiple linear regression was used to determine the association between the self-reported frequencies of hearing chemical alarms during the Gulf War and regional brain volume. Results There was an inverse association between the self-reported frequency of hearing chemical alarms sound and total cortical GM (adjusted p = 0.007), even after accounting for potentially confounding demographic and clinical variables, the veterans’ current health status, and other concurrent deployment-related exposures that were correlated with hearing chemical alarms. Post-hoc analyses extended the inverse relationship between the frequency of hearing chemical alarms to GM volume in the frontal (adjusted p = 0.02), parietal (adjusted p = 0.01), and occipital (adjusted p = 0.001) lobes. In contrast, regional brain volumes were not significantly associated with predicted exposure to the Khamisiyah plume or with Gulf War Illness status defined by the Kansas or Centers for Disease Control and Prevention criteria. Conclusions Many veterans reported hearing chemical alarms sound during the Gulf War. The current findings suggest that exposure to substances that triggered those chemical alarms during the Gulf War likely had adverse neuroanatomical effects. PMID:26920621

  20. Hemodynamic variables and progression of acute kidney injury in critically ill patients with severe sepsis: data from the prospective observational FINNAKI study

    PubMed Central

    2013-01-01

    Introduction Knowledge of the association of hemodynamics with progression of septic acute kidney injury (AKI) is limited. However, some recent data suggest that mean arterial pressure (MAP) exceeding current guidelines (60–65 mmHg) may be needed to prevent AKI. We hypothesized that higher MAP during the first 24 hours in the intensive care unit (ICU), would be associated with a lower risk of progression of AKI in patients with severe sepsis. Methods We identified 423 patients with severe sepsis and electronically recorded continuous hemodynamic data in the prospective observational FINNAKI study. The primary endpoint was progression of AKI within the first 5 days of ICU admission defined as new onset or worsening of AKI by the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. We evaluated the association of hemodynamic variables with this endpoint. We included 53724 10-minute medians of MAP in the analysis. We analysed the ability of time-adjusted MAP to predict progression of AKI by receiver operating characteristic (ROC) analysis. Results Of 423 patients, 153 (36.2%) had progression of AKI. Patients with progression of AKI had significantly lower time-adjusted MAP, 74.4 mmHg [68.3-80.8], than those without progression, 78.6 mmHg [72.9-85.4], P < 0.001. A cut-off value of 73 mmHg for time-adjusted MAP best predicted the progression of AKI. Chronic kidney disease, higher lactate, higher dose of furosemide, use of dobutamine and time-adjusted MAP below 73 mmHg were independent predictors of progression of AKI. Conclusions The findings of this large prospective multicenter observational study suggest that hypotensive episodes (MAP under 73 mmHg) are associated with progression of AKI in critically ill patients with severe sepsis. PMID:24330815

  1. Device and Method for Continuously Equalizing the Charge State of Lithium Ion Battery Cells

    NASA Technical Reports Server (NTRS)

    Schwartz, Paul D. (Inventor); Roufberg, Lewis M. (Inventor); Martin, Mark N. (Inventor)

    2015-01-01

    A method of equalizing charge states of individual cells in a battery includes measuring a previous cell voltage for each cell, measuring a previous shunt current for each cell, calculating, based on the previous cell voltage and the previous shunt current, an adjusted cell voltage for each cell, determining a lowest adjusted cell voltage from among the calculated adjusted cell voltages, and calculating a new shunt current for each cell.

  2. Human sense utilization method on real-time computer graphics

    NASA Astrophysics Data System (ADS)

    Maehara, Hideaki; Ohgashi, Hitoshi; Hirata, Takao

    1997-06-01

    We are developing an adjustment method of real-time computer graphics, to obtain effective ones which give audience various senses intended by producer, utilizing human sensibility technologically. Generally, production of real-time computer graphics needs much adjustment of various parameters, such as 3D object models/their motions/attributes/view angle/parallax etc., in order that the graphics gives audience superior effects as reality of materials, sense of experience and so on. And it is also known it costs much to adjust such various parameters by trial and error. A graphics producer often evaluates his graphics to improve it. For example, it may lack 'sense of speed' or be necessary to be given more 'sense of settle down,' to improve it. On the other hand, we can know how the parameters in computer graphics affect such senses by means of statistically analyzing several samples of computer graphics which provide different senses. We paid attention to these two facts, so that we designed an adjustment method of the parameters by inputting phases of sense into a computer. By the way of using this method, it becomes possible to adjust real-time computer graphics more effectively than by conventional way of trial and error.

  3. Optimal level of continuous positive airway pressure: auto-adjusting titration versus titration with a predictive equation.

    PubMed

    Choi, Ji Ho; Jun, Young Joon; Oh, Jeong In; Jung, Jong Yoon; Hwang, Gyu Ho; Kwon, Soon Young; Lee, Heung Man; Kim, Tae Hoon; Lee, Sang Hag; Lee, Seung Hoon

    2013-05-01

    The aims of the present study were twofold. We sought to compare two methods of titrating the level of continuous positive airway pressure (CPAP) - auto-adjusting titration and titration using a predictive equation - with full-night manual titration used as the benchmark. We also investigated the reliability of the two methods in patients with obstructive sleep apnea syndrome (OSAS). Twenty consecutive adult patients with OSAS who had successful, full-night manual and auto-adjusting CPAP titration participated in this study. The titration pressure level was calculated with a previously developed predictive equation based on body mass index and apnea-hypopnea index. The mean titration pressure levels obtained with the manual, auto-adjusting, and predictive equation methods were 9.0 +/- 3.6, 9.4 +/- 3.0, and 8.1 +/- 1.6 cm H2O,respectively. There was a significant difference in the concordance within the range of +/- 2 cm H2O (p = 0.019) between both the auto-adjusting titration and the titration using the predictive equation compared to the full-night manual titration. However, there was no significant difference in the concordance within the range of +/- 1 cm H2O (p > 0.999). When compared to full-night manual titration as the standard method, auto-adjusting titration appears to be more reliable than using a predictive equation for determining the optimal CPAP level in patients with OSAS.

  4. Algorithm and Application of Gcp-Independent Block Adjustment for Super Large-Scale Domestic High Resolution Optical Satellite Imagery

    NASA Astrophysics Data System (ADS)

    Sun, Y. S.; Zhang, L.; Xu, B.; Zhang, Y.

    2018-04-01

    The accurate positioning of optical satellite image without control is the precondition for remote sensing application and small/medium scale mapping in large abroad areas or with large-scale images. In this paper, aiming at the geometric features of optical satellite image, based on a widely used optimization method of constraint problem which is called Alternating Direction Method of Multipliers (ADMM) and RFM least-squares block adjustment, we propose a GCP independent block adjustment method for the large-scale domestic high resolution optical satellite image - GISIBA (GCP-Independent Satellite Imagery Block Adjustment), which is easy to parallelize and highly efficient. In this method, the virtual "average" control points are built to solve the rank defect problem and qualitative and quantitative analysis in block adjustment without control. The test results prove that the horizontal and vertical accuracy of multi-covered and multi-temporal satellite images are better than 10 m and 6 m. Meanwhile the mosaic problem of the adjacent areas in large area DOM production can be solved if the public geographic information data is introduced as horizontal and vertical constraints in the block adjustment process. Finally, through the experiments by using GF-1 and ZY-3 satellite images over several typical test areas, the reliability, accuracy and performance of our developed procedure will be presented and studied in this paper.

  5. Evaluation of the occlusal contact of crowns fabricated with the bite impression method.

    PubMed

    Makino, Sachi; Okada, Daizo; Shin, Chiharu; Ogura, Reiko; Ikeda, Masaomi; Miura, Hiroyuki

    2013-09-30

    In prosthodontic treatment, reconstruction of a proper occlusal contact relationship is very important as well as reconstruction of a proper interproximal relationship and marginal fitness. Unfortunately, occlusal relationships are sometimes lost in the process of occlusal adjustment of crowns. The purpose of this study was to compare the occlusal contacts of single crown fabricated by two different types of impression techniques. Nine subjects, whose molars required treatment with crown restoration, were enrolled in this study. Full cast crowns were fabricated using two types of impression techniques: the conventional impression method (CIM) and the bite impression method (BIM). The occlusal contacts of crowns were precisely evaluated at the following stages: after occlusal adjustment on the articulator (Step 0), before occlusal adjustment in the mouth (Step 1), after occlusal adjustment at the intercuspal position (Step 2), and after occlusal adjustment during lateral and protrusive excursions (Step 3). The number of occlusal contacts of the crowns on the functional cusps fabricated with BIM was significantly greater than that with CIM after occlusal adjustment. For this reason, the crowns fabricated with BIM might have a more functionally desirable occlusal surface compared to the crowns fabricated with CIM.

  6. Evaluation of Rapid Adjustments to Radiative Forcing for Five Climate Forcing Agents in the Precipitation Driver Response Model Intercomparison Project (PDRMIP)

    NASA Astrophysics Data System (ADS)

    Smith, C. J.; Forster, P.; Richardson, T.; Myhre, G.

    2016-12-01

    Effective radiative forcing (ERF), rather than "traditional" radiative forcing (RF), has become an increasingly popular metric in recent years, as it more closely links the difference in the earth's top-of-atmosphere (TOA) energy budget to equilibrium near-surface temperature rise. One method to diagnose ERF is to take the difference of TOA radiative fluxes from two climate model runs (a perturbation and a control) with prescribed sea-surface temperatures and sea-ice coverage. ERF can be thought of as the sum of a direct forcing, which is the pure radiative effect of a forcing agent, plus rapid adjustments, which are changes in climate state triggered by the forcing agent that themselves affect the TOA energy budget and are unrelated to surface temperature changes.In addition to the classic experiment of doubling of CO2 (2xCO2), we analyse rapid adjustments to a tripling of methane (3xCH4), a quintupling of sulphate aerosol (5xSul), a ten times increase in black carbon (10xBC) and a 2% increase in the solar constant (2%Sol). We use CMIP-style climate model diagnostics from six participating models of the Precipitation Driver Response Model Intercomparison Project (PDRMIP).Assuming approximately linear contributions to the TOA flux differences, the rapid adjustments from changes in atmospheric temperature, surface temperature, surface albedo and water vapour can be cleanly and simply separated from the direct forcing by radiative kernels. The rapid adjustments are in turn decomposed into stratospheric and tropospheric components. We introduce kernels based on the HadGEM2 climate model and find similar results to those based on other models. Cloud adjustments are evaluated as a residual of the TOA radiative fluxes between all-sky and clear-sky runs once direct forcing and rapid adjustments have been subtracted. The cloud adjustments are also calculated online within the HadGEM2 model using the ISCCP simulator. For aerosol forcing experiments, rapid adjustments vary substantially between models. Much of the contribution to this model spread is in the cloud adjustments. We also notice a spread in the model calculations of direct forcing for greenhouse gases, which suggest differences in the radiative transfer parameterisations used by each model.

  7. Relationship Between Central and Peripheral Atherosclerosis and Left Ventricular Dysfunction in a Community Population

    PubMed Central

    Tsao, Connie W.; Gona, Philimon; Salton, Carol; Murabito, Joanne M.; Oyama, Noriko; Danias, Peter G.; O’Donnell, Christopher J.; Manning, Warren J.; Yeon, Susan B.

    2011-01-01

    We aimed to determine the relationships between resting left ventricular (LV) wall motion abnormalities (WMAs), aortic plaque, and PAD in a community cohort. 1726 Framingham Heart Study Offspring Cohort participants (806 males, 65±9 years) underwent cardiovascular magnetic resonance with quantification of aortic plaque volume and assessment of regional LV systolic function. Claudication, lower extremity revascularization, and ankle-brachial index (ABI) were recorded at Examination 7. WMAs were associated with greater aortic plaque burden, decreased ABI, and claudication in age- and sex-adjusted analyses (all p<0.001), which were not significant after adjustment for cardiovascular risk factors. In age- and sex-adjusted analyses, both the presence (p<0.001) and volume of aortic plaque were associated with decreased ABI (p<0.001). After multivariable adjustment, ABI≤0.9 or prior revascularization was associated with a three-fold odds of aortic plaque (p=0.0083). Plaque volume significantly increased with decreasing ABI in multivariable-adjusted analyses (p<0.0001). In this free-living population, associations of WMAs with aortic plaque burden and clinical measures of PAD were attenuated after adjustment for coronary heart disease risk factors. Aortic plaque volume and ABI remained strongly negatively correlated after multivariable adjustment. Our findings suggest that the association between coronary heart disease and non-coronary atherosclerosis is explained by cardiovascular risk factors. Aortic atherosclerosis and PAD remain strongly associated after multivariable adjustment suggesting shared mechanisms beyond those captured by traditional risk factors. PMID:21708875

  8. SU-F-J-96: Comparison of Frame-Based and Mutual Information Registration Techniques for CT and MR Image Sets

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

    Popple, R; Bredel, M; Brezovich, I

    Purpose: To compare the accuracy of CT-MR registration using a mutual information method with registration using a frame-based localizer box. Methods: Ten patients having the Leksell head frame and scanned with a modality specific localizer box were imported into the treatment planning system. The fiducial rods of the localizer box were contoured on both the MR and CT scans. The skull was contoured on the CT images. The MR and CT images were registered by two methods. The frame-based method used the transformation that minimized the mean square distance of the centroids of the contours of the fiducial rods frommore » a mathematical model of the localizer. The mutual information method used automated image registration tools in the TPS and was restricted to a volume-of-interest defined by the skull contours with a 5 mm margin. For each case, the two registrations were adjusted by two evaluation teams, each comprised of an experienced radiation oncologist and neurosurgeon, to optimize alignment in the region of the brainstem. The teams were blinded to the registration method. Results: The mean adjustment was 0.4 mm (range 0 to 2 mm) and 0.2 mm (range 0 to 1 mm) for the frame and mutual information methods, respectively. The median difference between the frame and mutual information registrations was 0.3 mm, but was not statistically significant using the Wilcoxon signed rank test (p=0.37). Conclusion: The difference between frame and mutual information registration techniques was neither statistically significant nor, for most applications, clinically important. These results suggest that mutual information is equivalent to frame-based image registration for radiosurgery. Work is ongoing to add additional evaluators and to assess the differences between evaluators.« less

  9. A statistical method for the conservative adjustment of false discovery rate (q-value).

    PubMed

    Lai, Yinglei

    2017-03-14

    q-value is a widely used statistical method for estimating false discovery rate (FDR), which is a conventional significance measure in the analysis of genome-wide expression data. q-value is a random variable and it may underestimate FDR in practice. An underestimated FDR can lead to unexpected false discoveries in the follow-up validation experiments. This issue has not been well addressed in literature, especially in the situation when the permutation procedure is necessary for p-value calculation. We proposed a statistical method for the conservative adjustment of q-value. In practice, it is usually necessary to calculate p-value by a permutation procedure. This was also considered in our adjustment method. We used simulation data as well as experimental microarray or sequencing data to illustrate the usefulness of our method. The conservativeness of our approach has been mathematically confirmed in this study. We have demonstrated the importance of conservative adjustment of q-value, particularly in the situation that the proportion of differentially expressed genes is small or the overall differential expression signal is weak.

  10. Applications of Monte Carlo method to nonlinear regression of rheological data

    NASA Astrophysics Data System (ADS)

    Kim, Sangmo; Lee, Junghaeng; Kim, Sihyun; Cho, Kwang Soo

    2018-02-01

    In rheological study, it is often to determine the parameters of rheological models from experimental data. Since both rheological data and values of the parameters vary in logarithmic scale and the number of the parameters is quite large, conventional method of nonlinear regression such as Levenberg-Marquardt (LM) method is usually ineffective. The gradient-based method such as LM is apt to be caught in local minima which give unphysical values of the parameters whenever the initial guess of the parameters is far from the global optimum. Although this problem could be solved by simulated annealing (SA), the Monte Carlo (MC) method needs adjustable parameter which could be determined in ad hoc manner. We suggest a simplified version of SA, a kind of MC methods which results in effective values of the parameters of most complicated rheological models such as the Carreau-Yasuda model of steady shear viscosity, discrete relaxation spectrum and zero-shear viscosity as a function of concentration and molecular weight.

  11. Adjustment Following Disability: Representative Case Studies.

    ERIC Educational Resources Information Center

    Heinemann, Allen W.; Shontz, Franklin C.

    1984-01-01

    Examined adjustment following physical disability using the representative case method with two persons with quadriplegia. Results highlighted the importance of previously established coping styles as well as the role of the environment in adjustment. Willingness to mourn aided in later growth. (JAC)

  12. Association between DNA Methylation in Whole Blood and Measures of Glucose Metabolism: KORA F4 Study

    PubMed Central

    Wahl, Simone; Kunze, Sonja; Molnos, Sophie; Volkova, Nadezda; Schramm, Katharina; Carstensen-Kirberg, Maren; Waldenberger, Melanie; Gieger, Christian; Peters, Annette; Illig, Thomas; Prokisch, Holger; Roden, Michael; Grallert, Harald

    2016-01-01

    Epigenetic regulation has been postulated to affect glucose metabolism, insulin sensitivity and the risk of type 2 diabetes. Therefore, we performed an epigenome-wide association study for measures of glucose metabolism in whole blood samples of the population-based Cooperative Health Research in the Region of Augsburg F4 study using the Illumina HumanMethylation 450 BeadChip. We identified a total of 31 CpG sites where methylation level was associated with measures of glucose metabolism after adjustment for age, sex, smoking, and estimated white blood cell proportions and correction for multiple testing using the Benjamini-Hochberg (B-H) method (four for fasting glucose, seven for fasting insulin, 25 for homeostasis model assessment-insulin resistance [HOMA-IR]; B-H-adjusted p-values between 9.2x10-5 and 0.047). In addition, DNA methylation at cg06500161 (annotated to ABCG1) was associated with all the aforementioned phenotypes and 2-hour glucose (B-H-adjusted p-values between 9.2x10-5 and 3.0x10-3). Methylation status of additional three CpG sites showed an association with fasting insulin only after additional adjustment for body mass index (BMI) (B-H-adjusted p-values = 0.047). Overall, effect strengths were reduced by around 30% after additional adjustment for BMI, suggesting that this variable has an influence on the investigated phenotypes. Furthermore, we found significant associations between methylation status of 21 of the aforementioned CpG sites and 2-hour insulin in a subset of samples with seven significant associations persisting after additional adjustment for BMI. In a subset of 533 participants, methylation of the CpG site cg06500161 (ABCG1) was inversely associated with ABCG1 gene expression (B-H-adjusted p-value = 1.5x10-9). Additionally, we observed an enrichment of the top 1,000 CpG sites for diabetes-related canonical pathways using Ingenuity Pathway Analysis. In conclusion, our study indicates that DNA methylation and diabetes-related traits are associated and that these associations are partially BMI-dependent. Furthermore, the interaction of ABCG1 with glucose metabolism is modulated by epigenetic processes. PMID:27019061

  13. Treatment Retention Among Patients Participating in Coordinated Specialty Care for First-Episode Psychosis: a Mixed-Methods Analysis.

    PubMed

    Hamilton, Jane E; Srivastava, Devika; Womack, Danica; Brown, Ashlie; Schulz, Brian; Macakanja, April; Walker, April; Wu, Mon-Ju; Williamson, Mark; Cho, Raymond Y

    2018-06-05

    Young adults experiencing first-episode psychosis have historically been difficult to retain in mental health treatment. Communities across the United States are implementing Coordinated Specialty Care to improve outcomes for individuals experiencing first-episode psychosis. This mixed-methods research study examined the relationship between program services and treatment retention, operationalized as the likelihood of remaining in the program for 9 months or more. In the adjusted analysis, male gender and participation in home-based cognitive behavioral therapy were associated with an increased likelihood of remaining in treatment. The key informant interview findings suggest the shared decision-making process and the breadth, flexibility, and focus on functional recovery of the home-based cognitive behavioral therapy intervention may have positively influenced treatment retention. These findings suggest the use of shared decision-making and improved access to home-based cognitive behavioral therapy for first-episode psychosis patients may improve outcomes for this vulnerable population.

  14. Temperature Variability during Delirium in ICU Patients: An Observational Study

    PubMed Central

    van der Kooi, Arendina W.; Kappen, Teus H.; Raijmakers, Rosa J.; Zaal, Irene J.; Slooter, Arjen J. C.

    2013-01-01

    Introduction Delirium is an acute disturbance of consciousness and cognition. It is a common disorder in the intensive care unit (ICU) and associated with impaired long-term outcome. Despite its frequency and impact, delirium is poorly recognized by ICU-physicians and –nurses using delirium screening tools. A completely new approach to detect delirium is to use monitoring of physiological alterations. Temperature variability, a measure for temperature regulation, could be an interesting component to monitor delirium, but whether temperature regulation is different during ICU delirium has not yet been investigated. The aim of this study was to investigate whether ICU delirium is related to temperature variability. Furthermore, we investigated whether ICU delirium is related to absolute body temperature. Methods We included patients who experienced both delirium and delirium free days during ICU stay, based on the Confusion Assessment method for the ICU conducted by a research- physician or –nurse, in combination with inspection of medical records. We excluded patients with conditions affecting thermal regulation or therapies affecting body temperature. Daily temperature variability was determined by computing the mean absolute second derivative of the temperature signal. Temperature variability (primary outcome) and absolute body temperature (secondary outcome) were compared between delirium- and non-delirium days with a linear mixed model and adjusted for daily mean Richmond Agitation and Sedation Scale scores and daily maximum Sequential Organ Failure Assessment scores. Results Temperature variability was increased during delirium-days compared to days without delirium (βunadjusted=0.007, 95% confidence interval (CI)=0.004 to 0.011, p<0.001). Adjustment for confounders did not alter this result (βadjusted=0.005, 95% CI=0.002 to 0.008, p<0.001). Delirium was not associated with absolute body temperature (βunadjusted=-0.03, 95% CI=-0.17 to 0.10, p=0.61). This did not change after adjusting for confounders (βadjusted=-0.03, 95% CI=-0.17 to 0.10, p=0.63). Conclusions Our study suggests that temperature variability is increased during ICU delirium. PMID:24194955

  15. Comparative Efficacy of Daratumumab Monotherapy and Pomalidomide Plus Low-Dose Dexamethasone in the Treatment of Multiple Myeloma: A Matching Adjusted Indirect Comparison.

    PubMed

    Van Sanden, Suzy; Ito, Tetsuro; Diels, Joris; Vogel, Martin; Belch, Andrew; Oriol, Albert

    2018-03-01

    Daratumumab (a human CD38-directed monoclonal antibody) and pomalidomide (an immunomodulatory drug) plus dexamethasone are both relatively new treatment options for patients with heavily pretreated multiple myeloma. A matching adjusted indirect comparison (MAIC) was used to compare absolute treatment effects of daratumumab versus pomalidomide + low-dose dexamethasone (LoDex; 40 mg) on overall survival (OS), while adjusting for differences between the trial populations. The MAIC method reduces the risk of bias associated with naïve indirect comparisons. Data from 148 patients receiving daratumumab (16 mg/kg), pooled from the GEN501 and SIRIUS studies, were compared separately with data from patients receiving pomalidomide + LoDex in the MM-003 and STRATUS studies. The MAIC-adjusted hazard ratio (HR) for OS of daratumumab versus pomalidomide + LoDex was 0.56 (95% confidence interval [CI], 0.38-0.83; p  = .0041) for MM-003 and 0.51 (95% CI, 0.37-0.69; p  < .0001) for STRATUS. The treatment benefit was even more pronounced when the daratumumab population was restricted to pomalidomide-naïve patients (MM-003: HR, 0.33; 95% CI, 0.17-0.66; p  = .0017; STRATUS: HR, 0.41; 95% CI, 0.21-0.79; p  = .0082). An additional analysis indicated a consistent trend of the OS benefit across subgroups based on M-protein level reduction (≥50%, ≥25%, and <25%). The MAIC results suggest that daratumumab improves OS compared with pomalidomide + LoDex in patients with heavily pretreated multiple myeloma. This matching adjusted indirect comparison of clinical trial data from four studies analyzes the survival outcomes of patients with heavily pretreated, relapsed/refractory multiple myeloma who received either daratumumab monotherapy or pomalidomide plus low-dose dexamethasone. Using this method, daratumumab conferred a significant overall survival benefit compared with pomalidomide plus low-dose dexamethasone. In the absence of head-to-head trials, these indirect comparisons provide useful insights to clinicians and reimbursement authorities around the relative efficacy of treatments. © AlphaMed Press 2017.

  16. Relative efficiency and sample size for cluster randomized trials with variable cluster sizes.

    PubMed

    You, Zhiying; Williams, O Dale; Aban, Inmaculada; Kabagambe, Edmond Kato; Tiwari, Hemant K; Cutter, Gary

    2011-02-01

    The statistical power of cluster randomized trials depends on two sample size components, the number of clusters per group and the numbers of individuals within clusters (cluster size). Variable cluster sizes are common and this variation alone may have significant impact on study power. Previous approaches have taken this into account by either adjusting total sample size using a designated design effect or adjusting the number of clusters according to an assessment of the relative efficiency of unequal versus equal cluster sizes. This article defines a relative efficiency of unequal versus equal cluster sizes using noncentrality parameters, investigates properties of this measure, and proposes an approach for adjusting the required sample size accordingly. We focus on comparing two groups with normally distributed outcomes using t-test, and use the noncentrality parameter to define the relative efficiency of unequal versus equal cluster sizes and show that statistical power depends only on this parameter for a given number of clusters. We calculate the sample size required for an unequal cluster sizes trial to have the same power as one with equal cluster sizes. Relative efficiency based on the noncentrality parameter is straightforward to calculate and easy to interpret. It connects the required mean cluster size directly to the required sample size with equal cluster sizes. Consequently, our approach first determines the sample size requirements with equal cluster sizes for a pre-specified study power and then calculates the required mean cluster size while keeping the number of clusters unchanged. Our approach allows adjustment in mean cluster size alone or simultaneous adjustment in mean cluster size and number of clusters, and is a flexible alternative to and a useful complement to existing methods. Comparison indicated that we have defined a relative efficiency that is greater than the relative efficiency in the literature under some conditions. Our measure of relative efficiency might be less than the measure in the literature under some conditions, underestimating the relative efficiency. The relative efficiency of unequal versus equal cluster sizes defined using the noncentrality parameter suggests a sample size approach that is a flexible alternative and a useful complement to existing methods.

  17. Health-Based Capitation Risk Adjustment in Minnesota Public Health Care Programs

    PubMed Central

    Gifford, Gregory A.; Edwards, Kevan R.; Knutson, David J.

    2004-01-01

    This article documents the history and implementation of health-based capitation risk adjustment in Minnesota public health care programs, and identifies key implementation issues. Capitation payments in these programs are risk adjusted using an historical, health plan risk score, based on concurrent risk assessment. Phased implementation of capitation risk adjustment for these programs began January 1, 2000. Minnesota's experience with capitation risk adjustment suggests that: (1) implementation can accelerate encounter data submission, (2) administrative decisions made during implementation can create issues that impact payment model performance, and (3) changes in diagnosis data management during implementation may require changes to the payment model. PMID:25372356

  18. Psychological adjustment of Yoruba adolescents as influenced by family type: a research note.

    PubMed

    Oyefeso, A O; Adegoke, A R

    1992-05-01

    This research examines the influence of family type on the psychological adjustment of Yoruba adolescents. Using a sample of 116 adolescents, 69 males and 47 females, with mean age of 17.8 years of age (S.D. = 1.72), the results reveal that male adolescents from monogamous families experience better psychological adjustment than their polygynous counterparts, whereas no such difference exists in the levels of psychological adjustment of female adolescents from both family types. These findings suggest that (i) sex-role prescription influences psychological adjustment of adolescents in Yoruba societies, and (ii) female children enjoy more protective upbringing in polygynous families than their male counterparts.

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

    Tittiranonda, P.; Burastero, S.; Shih, M.

    This study presents an evaluation of the Apple Adjustable Keyboard based on subjective preference and observed joint angles during typing. Thirty five keyboard users were asked to use the Apple adjustable keyboard for 7--14 days and rate the various characteristics of the keyboard. Our findings suggest that the most preferred opening angles range from 11--20{degree}. The mean ulnar deviation on the Apple Adjustable keyboard is 11{degree}, compared to 16{degree} on the standard keyboard. The mean extension was decreased from 24{degree} to 16{degree} when using the adjustable keyboard. When asked to subjectively rate the adjustable keyboard in comparison to the standard,more » the average subject felt that the Apple Adjustable Keyboard was more comfortable and easier to use than the standard flat keyboard.« less

  20. Prefrontal, posterior parietal and sensorimotor network activity underlying speed control during walking

    PubMed Central

    Bulea, Thomas C.; Kim, Jonghyun; Damiano, Diane L.; Stanley, Christopher J.; Park, Hyung-Soon

    2015-01-01

    Accumulating evidence suggests cortical circuits may contribute to control of human locomotion. Here, noninvasive electroencephalography (EEG) recorded from able-bodied volunteers during a novel treadmill walking paradigm was used to assess neural correlates of walking. A systematic processing method, including a recently developed subspace reconstruction algorithm, reduced movement-related EEG artifact prior to independent component analysis and dipole source localization. We quantified cortical activity while participants tracked slow and fast target speeds across two treadmill conditions: an active mode that adjusted belt speed based on user movements and a passive mode reflecting a typical treadmill. Our results reveal frequency specific, multi-focal task related changes in cortical oscillations elicited by active walking. Low γ band power, localized to the prefrontal and posterior parietal cortices, was significantly increased during double support and early swing phases, critical points in the gait cycle since the active controller adjusted speed based on pelvis position and swing foot velocity. These phasic γ band synchronizations provide evidence that prefrontal and posterior parietal networks, previously implicated in visuo-spatial and somotosensory integration, are engaged to enhance lower limb control during gait. Sustained μ and β band desynchronization within sensorimotor cortex, a neural correlate for movement, was observed during walking thereby validating our methods for isolating cortical activity. Our results also demonstrate the utility of EEG recorded during locomotion for probing the multi-regional cortical networks which underpin its execution. For example, the cortical network engagement elicited by the active treadmill suggests that it may enhance neuroplasticity for more effective motor training. PMID:26029077

  1. Adjusted Wald Confidence Interval for a Difference of Binomial Proportions Based on Paired Data

    ERIC Educational Resources Information Center

    Bonett, Douglas G.; Price, Robert M.

    2012-01-01

    Adjusted Wald intervals for binomial proportions in one-sample and two-sample designs have been shown to perform about as well as the best available methods. The adjusted Wald intervals are easy to compute and have been incorporated into introductory statistics courses. An adjusted Wald interval for paired binomial proportions is proposed here and…

  2. [Implication of inverse-probability weighting method in the evaluation of diagnostic test with verification bias].

    PubMed

    Kang, Leni; Zhang, Shaokai; Zhao, Fanghui; Qiao, Youlin

    2014-03-01

    To evaluate and adjust the verification bias existed in the screening or diagnostic tests. Inverse-probability weighting method was used to adjust the sensitivity and specificity of the diagnostic tests, with an example of cervical cancer screening used to introduce the Compare Tests package in R software which could be implemented. Sensitivity and specificity calculated from the traditional method and maximum likelihood estimation method were compared to the results from Inverse-probability weighting method in the random-sampled example. The true sensitivity and specificity of the HPV self-sampling test were 83.53% (95%CI:74.23-89.93)and 85.86% (95%CI: 84.23-87.36). In the analysis of data with randomly missing verification by gold standard, the sensitivity and specificity calculated by traditional method were 90.48% (95%CI:80.74-95.56)and 71.96% (95%CI:68.71-75.00), respectively. The adjusted sensitivity and specificity under the use of Inverse-probability weighting method were 82.25% (95% CI:63.11-92.62) and 85.80% (95% CI: 85.09-86.47), respectively, whereas they were 80.13% (95%CI:66.81-93.46)and 85.80% (95%CI: 84.20-87.41) under the maximum likelihood estimation method. The inverse-probability weighting method could effectively adjust the sensitivity and specificity of a diagnostic test when verification bias existed, especially when complex sampling appeared.

  3. Lipid Adjustment for Chemical Exposures: Accounting for Concomitant Variables

    PubMed Central

    Li, Daniel; Longnecker, Matthew P.; Dunson, David B.

    2013-01-01

    Background Some environmental chemical exposures are lipophilic and need to be adjusted by serum lipid levels before data analyses. There are currently various strategies that attempt to account for this problem, but all have their drawbacks. To address such concerns, we propose a new method that uses Box-Cox transformations and a simple Bayesian hierarchical model to adjust for lipophilic chemical exposures. Methods We compared our Box-Cox method to existing methods. We ran simulation studies in which increasing levels of lipid-adjusted chemical exposure did and did not increase the odds of having a disease, and we looked at both single-exposure and multiple-exposures cases. We also analyzed an epidemiology dataset that examined the effects of various chemical exposures on the risk of birth defects. Results Compared with existing methods, our Box-Cox method produced unbiased estimates, good coverage, similar power, and lower type-I error rates. This was the case in both single- and multiple-exposure simulation studies. Results from analysis of the birth-defect data differed from results using existing methods. Conclusion Our Box-Cox method is a novel and intuitive way to account for the lipophilic nature of certain chemical exposures. It addresses some of the problems with existing methods, is easily extendable to multiple exposures, and can be used in any analyses that involve concomitant variables. PMID:24051893

  4. Incidence, prevalence, and hybrid approaches to calculating disability-adjusted life years

    PubMed Central

    2012-01-01

    When disability-adjusted life years are used to measure the burden of disease on a population in a time interval, they can be calculated in several different ways: from an incidence, pure prevalence, or hybrid perspective. I show that these calculation methods are not equivalent and discuss some of the formal difficulties each method faces. I show that if we don’t discount the value of future health, there is a sense in which the choice of calculation method is a mere question of accounting. Such questions can be important, but they don’t raise deep theoretical concerns. If we do discount, however, choice of calculation method can change the relative burden attributed to different conditions over time. I conclude by recommending that studies involving disability-adjusted life years be explicit in noting what calculation method is being employed and in explaining why that calculation method has been chosen. PMID:22967055

  5. Evaluation of paediatric cardiosurgical model in Croatia by using the Aristotle basic complexity score and the risk adjustment for congenital cardiac surgery-1 method.

    PubMed

    Dilber, Daniel; Malcic, Ivan

    2010-08-01

    The Aristotle basic complexity score and the risk adjustment in congenital cardiac surgery-1 method were developed and used to compare outcomes of congenital cardiac surgery. Both methods were used to compare results of procedures performed on our patients in Croatian cardiosurgical centres and results of procedures were taken abroad. The study population consisted of all patients with congenital cardiac disease born to Croatian residents between 1 October, 2002 and 1 October, 2007 undergoing a cardiovascular operation during this period. Of the 556 operations, the Aristotle basic complexity score could be assigned to 553 operations and the risk adjustment in congenital cardiac surgery-1 method to 536 operations. Procedures were performed in two institutions in Croatia and seven institutions abroad. The average complexity for cardiac procedures performed in Croatia was significantly lower. With both systems, along with the increase in complexity, there is also an increase in mortality before discharge and postoperative length of stay. Only after the adjustment for complexity there are marked differences in mortality and occurrence of postoperative complications. Both, the Aristotle basic complexity score and the risk adjustment in congenital cardiac surgery-1 method were predictive of in-hospital mortality as well as prolonged postoperative length to stay, and can be used as a tool in our country to evaluate a cardiosurgical model and recognise potential problems.

  6. The Storm and Stress (or Calm) of Early Adolescent Self-Concepts: Within- and Between-Person Variability

    PubMed Central

    Molloy, Lauren E.; Ram, Nilam; Gest, Scott D.

    2014-01-01

    This study uses intraindividual variability and change methods to test theoretical accounts of self-concept and its change across time and context, and the developmental implications of this variability. The five-year longitudinal study of 541 youth in a rural Pennsylvania community from 3rd through 7th grade included twice-yearly assessments of self-concept (academic and social), corresponding external evaluations of competence (e.g., teacher-rated academic skills, peer-nominated “likeability”), and multiple measures of youths' overall adjustment. Multiphase growth models replicate previous research, suggesting significant decline in academic self-concept during middle school, but modest growth in social self-concept from 3rd through 7th grade. Next, a new contribution is made to the literature by quantifying the amount of within-person variability (i.e., “lability”) around these linear self-concept trajectories as a between-person characteristic. Self-concept lability was found to associate with a general profile of poorer competence and adjustment, and to predict poorer academic and social competence at the end of 7th grade above and beyond level of self-concept. Finally, there was substantial evidence that wave-to-wave changes in youths' self-concepts correspond to teacher and peer evaluations of youths' competence, that attention to peer feedback may be particularly strong during middle school, and that these relations may be moderated by between-person indicators of youths' general adjustment. Overall, findings highlight the utility of methods sensitive to within-person variation for clarifying the dynamics of youths' self-system development. PMID:21928883

  7. Thraustochytrids can be grown in low-salt media without affecting PUFA production.

    PubMed

    Shabala, Lana; McMeekin, Tom; Shabala, Sergey

    2013-08-01

    Marine microheterotrophs thraustochytrids are emerging as a potential source for commercial production of polyunsaturated fatty acids (PUFA) that have nutritional and pharmacological values. With prospective demand for PUFAs increasing, biotechnological companies are looking for potential increases in those valuable products. However, high levels of NaCl in the culture media required for optimal thraustochytrid growth and PUFA production poses a significant problem to the biotechnological industry due to corrosion of fermenters calling for a need to reduce the amount of NaCl in the culture media, without imposing penalties on growth and yield of cultured organisms. Earlier, as reported by Shabala et al. (Environ Microbiol 11:1835-1843, 2009), we have shown that thraustochytrids use sodium predominantly for osmotic adjustment purposes and, as such, can be grown in low-salt environment without growth penalties, providing the media osmolality is adjusted. In this study, we verify if that conclusion, made for one specific strain and osmolyte only, is applicable to the larger number of strains and organic osmotica, as well as address the issue of yield quality (e.g., PUFA production in low-saline media). Using mannitol and sucrose for osmotic adjustment of the growth media enabled us to reduce NaCl concentration down to 1 mM; this is 15-100-fold lower than any method proposed so far. At the same time, the yield of essential PUFAs was increased by 15 to 20 %. Taken together, these results suggest that the proposed method can be used in industrial fermenters for commercial PUFA production.

  8. Methods for automatic trigger threshold adjustment

    DOEpatents

    Welch, Benjamin J; Partridge, Michael E

    2014-03-18

    Methods are presented for adjusting trigger threshold values to compensate for drift in the quiescent level of a signal monitored for initiating a data recording event, thereby avoiding false triggering conditions. Initial threshold values are periodically adjusted by re-measuring the quiescent signal level, and adjusting the threshold values by an offset computation based upon the measured quiescent signal level drift. Re-computation of the trigger threshold values can be implemented on time based or counter based criteria. Additionally, a qualification width counter can be utilized to implement a requirement that a trigger threshold criterion be met a given number of times prior to initiating a data recording event, further reducing the possibility of a false triggering situation.

  9. The association of parental education with childhood undernutrition in low- and middle-income countries: comparing the role of paternal and maternal education

    PubMed Central

    Vollmer, Sebastian; Bommer, Christian; Krishna, Aditi; Harttgen, Kenneth; Subramanian, SV

    2017-01-01

    Abstract Background: Most existing research on the association of parental education with childhood undernutrition focuses on maternal education and often ignores paternal education. We systematically investigate differences in maternal and paternal education and their association with childhood undernutrition. Methods: One hundred and eighty Demographic and Health Surveys from 62 countries performed between 1990 and 2014 were analysed. We used linear-probability models to predict childhood undernutrition prevalences, measured as stunting, underweight and wasting, for all combinations of maternal and paternal attainment in school. Models were adjusted for demographic and socio-economic covariates for the child, mother and household, country-level fixed effects and clustering. Additional specifications adjust for local area characteristics instead of country fixed effects. Results: Both higher maternal and paternal education levels are associated with lower childhood undernutrition. In regressions adjusted for child age and sex as well as country-level fixed effects, the association is stronger for maternal education than for paternal education when their combined level of education is held constant. In the fully adjusted models, the observed differences in predicted undernutrition prevalences are strongly attenuated, suggesting a similar importance of maternal and paternal education. These findings are confirmed by the analysis of composite schooling indicators. Conclusions: We find that paternal education is similarly important for reducing childhood undernutrition as maternal education and should therefore receive increased attention in the literature. PMID:27501820

  10. Corporal Punishment, Maternal Warmth, and Child Adjustment: A Longitudinal Study in Eight Countries

    PubMed Central

    Lansford, Jennifer E.; Sharma, Chinmayi; Malone, Patrick S.; Woodlief, Darren; Dodge, Kenneth A.; Oburu, Paul; Pastorelli, Concetta; Skinner, Ann T.; Sorbring, Emma; Tapanya, Sombat; Tirado, Liliana Maria Uribe; Zelli, Arnaldo; Al-Hassan, Suha M.; Alampay, Liane Peña; Bacchini, Dario; Bombi, Anna Silvia; Bornstein, Marc H.; Chang, Lei; Deater-Deckard, Kirby; Di Giunta, Laura

    2014-01-01

    Objective Two key tasks facing parents across cultures are managing children’s behaviors (and misbehaviors) and conveying love and affection. Previous research has found that corporal punishment generally is related to worse child adjustment, whereas parental warmth is related to better child adjustment. This study examined whether the association between corporal punishment and child adjustment problems (anxiety and aggression) is moderated by maternal warmth in a diverse set of countries that vary in a number of sociodemographic and psychological ways. Method Interviews were conducted with 7- to 10-year-old children (N = 1,196; 51% girls) and their mothers in eight countries: China, Colombia, Italy, Jordan, Kenya, the Philippines, Thailand, and the United States. Follow-up interviews were conducted one and two years later. Results Corporal punishment was related to increases, and maternal warmth was related to decreases, in children’s anxiety and aggression over time; however, these associations varied somewhat across groups. Maternal warmth moderated the effect of corporal punishment in some countries, with increases in anxiety over time for children whose mothers were high in both warmth and corporal punishment. Conclusions The findings illustrate the overall association between corporal punishment and child anxiety and aggression as well as patterns specific to particular countries. Results suggest that clinicians across countries should advise parents against using corporal punishment, even in the context of parent-child relationships that are otherwise warm, and should assist parents in finding other ways to manage children’s behaviors. PMID:24885184

  11. Magnesium intake, plasma C-peptide, and colorectal cancer incidence in US women: a 28-year follow-up study

    PubMed Central

    Zhang, X; Giovannucci, E L; Wu, K; Smith-Warner, S A; Fuchs, C S; Pollak, M; Willett, W C; Ma, J

    2012-01-01

    Background: Laboratory studies suggest a possible role of magnesium intake in colorectal carcinogenesis but epidemiological evidence is inconclusive. Method: We tested magnesium–colorectal cancer hypothesis in the Nurses' Health Study, in which 85 924 women free of cancer in 1980 were followed until June 2008. Cox proportional hazards regression models were used to estimate multivariable relative risks (MV RRs, 95% confidence intervals). Results: In the age-adjusted model, magnesium intake was significantly inversely associated with colorectal cancer risk; the RRs from lowest to highest decile of total magnesium intake were 1.0 (ref), 0.93, 0.81, 0.72, 0.74, 0.77, 0.72, 0.75, 0.80, and 0.67 (Ptrend<0.001). However, in the MV model adjusted for known dietary and non-dietary risk factors for colorectal cancer, the association was significantly attenuated; the MV RRs were 1.0 (ref), 0.96, 0.85, 0.78, 0.82, 0.86, 0.84, 0.91, 1.02, and 0.93 (Ptrend=0.77). Similarly, magnesium intakes were significantly inversely associated with concentrations of plasma C-peptide in age-adjusted model (Ptrend=0.002) but not in multivariate-adjusted model (Ptrend=0.61). Results did not differ by subsite or modified by calcium intakes or body mass index. Conclusion: These prospective results do not support an independent association of magnesium intake with either colorectal cancer risk or plasma C-peptide levels in women. PMID:22415230

  12. [Effect of stock abundance and environmental factors on the recruitment success of small yellow croaker in the East China Sea].

    PubMed

    Liu, Zun-lei; Yuan, Xing-wei; Yang, Lin-lin; Yan, Li-ping; Zhang, Hui; Cheng, Jia-hua

    2015-02-01

    Multiple hypotheses are available to explain recruitment rate. Model selection methods can be used to identify the best model that supports a particular hypothesis. However, using a single model for estimating recruitment success is often inadequate for overexploited population because of high model uncertainty. In this study, stock-recruitment data of small yellow croaker in the East China Sea collected from fishery dependent and independent surveys between 1992 and 2012 were used to examine density-dependent effects on recruitment success. Model selection methods based on frequentist (AIC, maximum adjusted R2 and P-values) and Bayesian (Bayesian model averaging, BMA) methods were applied to identify the relationship between recruitment and environment conditions. Interannual variability of the East China Sea environment was indicated by sea surface temperature ( SST) , meridional wind stress (MWS), zonal wind stress (ZWS), sea surface pressure (SPP) and runoff of Changjiang River ( RCR). Mean absolute error, mean squared predictive error and continuous ranked probability score were calculated to evaluate the predictive performance of recruitment success. The results showed that models structures were not consistent based on three kinds of model selection methods, predictive variables of models were spawning abundance and MWS by AIC, spawning abundance by P-values, spawning abundance, MWS and RCR by maximum adjusted R2. The recruitment success decreased linearly with stock abundance (P < 0.01), suggesting overcompensation effect in the recruitment success might be due to cannibalism or food competition. Meridional wind intensity showed marginally significant and positive effects on the recruitment success (P = 0.06), while runoff of Changjiang River showed a marginally negative effect (P = 0.07). Based on mean absolute error and continuous ranked probability score, predictive error associated with models obtained from BMA was the smallest amongst different approaches, while that from models selected based on the P-value of the independent variables was the highest. However, mean squared predictive error from models selected based on the maximum adjusted R2 was highest. We found that BMA method could improve the prediction of recruitment success, derive more accurate prediction interval and quantitatively evaluate model uncertainty.

  13. Factors protecting against the development of adjustment difficulties in young adults exposed to childhood sexual abuse.

    PubMed

    Lynskey, M T; Fergusson, D M

    1997-12-01

    The aims of this study were to identify the factors which discriminated young people exposed to childhood sexual abuse (CSA) who developed psychiatric disorder or adjustment difficulties in young adulthood from those young people exposed to CSA who did not develop psychiatric disorder or adjustment difficulties by age 18. Data were gathered on a birth cohort of 1,025 New Zealand children studied from birth to the age of 18 on (a) exposure to CSA; (b) patterns of psychiatric disorder and adjustment difficulties at age 18 years; (c) factors that may have influenced responses to CSA including characteristics of the abuse, parental bonding, parental characteristics, and adolescent peer affiliations. Just over 10% of the cohort reported CSA. Those reporting CSA were at increased risks of a range of difficulties at age 18 (depression, anxiety, conduct disorder, alcohol abuse/dependence, other substance abuse/dependence, post sexual abuse trauma, attempted suicide). However, not all of those exposed to CSA developed difficulties and approximately a quarter of those exposed to CSA did not meet criteria for any adjustment difficulty. Further analysis suggested that the extent of adjustment difficulties in those exposed to CSA was influenced by two additional factors: (a) the extent of affiliations with delinquent or substance using peers in adolescence; and (b) the extent of paternal care or support in childhood. The findings of this study suggest that while young people exposed to CSA are at increased risks of psychiatric disorder and adjustment difficulties in young adulthood, not all individuals exposed to CSA will develop adjustment difficulties. Important factors protecting against the development of adjustment difficulties in young people experiencing CSA appear to be the nature and quality of peer and family relationships.

  14. A REVIEW OF STATISTICAL METHODS FOR THE METEOROLOGICAL ADJUSTMENT OF TROPOSPHERIC OZONE. (R825173)

    EPA Science Inventory

    Abstract

    A variety of statistical methods for meteorological adjustment of ozone have been proposed in the literature over the last decade for purposes of forecasting, estimating ozone time trends, or investigating underlying mechanisms from an empirical perspective. T...

  15. Methods, systems and apparatus for adjusting modulation index to improve linearity of phase voltage commands

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

    Gallegos-Lopez, Gabriel; Perisic, Milun; Kinoshita, Michael H.

    2017-03-14

    Embodiments of the present invention relate to methods, systems and apparatus for controlling operation of a multi-phase machine in a motor drive system. The disclosed embodiments provide a mechanism for adjusting modulation index of voltage commands to improve linearity of the voltage commands.

  16. 48 CFR 52.222-32 - Construction Wage Rate Requirements-Price Adjustment (Actual Method).

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 2 2014-10-01 2014-10-01 false Construction Wage Rate... CLAUSES Text of Provisions and Clauses 52.222-32 Construction Wage Rate Requirements—Price Adjustment (Actual Method). As prescribed in 22.407(g), insert the following clause: Construction Wage Rate...

  17. The adjusting factor method for weight-scaling truckloads of mixed hardwood sawlogs

    Treesearch

    Edward L. Adams

    1976-01-01

    A new method of weight-scaling truckloads of mixed hardwood sawlogs systematically adjusts for changes in the weight/volume ratio of logs coming into a sawmill. It uses a conversion factor based on the running average of weight/volume ratios of randomly selected sample loads. A test of the method indicated that over a period of time the weight-scaled volume should...

  18. Estimation of Leakage Potential of Selected Sites in Interstate and Tri-State Canals Using Geostatistical Analysis of Selected Capacitively Coupled Resistivity Profiles, Western Nebraska, 2004

    USGS Publications Warehouse

    Vrabel, Joseph; Teeple, Andrew; Kress, Wade H.

    2009-01-01

    With increasing demands for reliable water supplies and availability estimates, groundwater flow models often are developed to enhance understanding of surface-water and groundwater systems. Specific hydraulic variables must be known or calibrated for the groundwater-flow model to accurately simulate current or future conditions. Surface geophysical surveys, along with selected test-hole information, can provide an integrated framework for quantifying hydrogeologic conditions within a defined area. In 2004, the U.S. Geological Survey, in cooperation with the North Platte Natural Resources District, performed a surface geophysical survey using a capacitively coupled resistivity technique to map the lithology within the top 8 meters of the near-surface for 110 kilometers of the Interstate and Tri-State Canals in western Nebraska and eastern Wyoming. Assuming that leakage between the surface-water and groundwater systems is affected primarily by the sediment directly underlying the canal bed, leakage potential was estimated from the simple vertical mean of inverse-model resistivity values for depth levels with geometrically increasing layer thickness with depth which resulted in mean-resistivity values biased towards the surface. This method generally produced reliable results, but an improved analysis method was needed to account for situations where confining units, composed of less permeable material, underlie units with greater permeability. In this report, prepared by the U.S. Geological Survey in cooperation with the North Platte Natural Resources District, the authors use geostatistical analysis to develop the minimum-unadjusted method to compute a relative leakage potential based on the minimum resistivity value in a vertical column of the resistivity model. The minimum-unadjusted method considers the effects of homogeneous confining units. The minimum-adjusted method also is developed to incorporate the effect of local lithologic heterogeneity on water transmission. Seven sites with differing geologic contexts were selected following review of the capacitively coupled resistivity data collected in 2004. A reevaluation of these sites using the mean, minimum-unadjusted, and minimum-adjusted methods was performed to compare the different approaches for estimating leakage potential. Five of the seven sites contained underlying confining units, for which the minimum-unadjusted and minimum-adjusted methods accounted for the confining-unit effect. Estimates of overall leakage potential were lower for the minimum-unadjusted and minimum-adjusted methods than those estimated by the mean method. For most sites, the local heterogeneity adjustment procedure of the minimum-adjusted method resulted in slightly larger overall leakage-potential estimates. In contrast to the mean method, the two minimum-based methods allowed the least permeable areas to control the overall vertical permeability of the subsurface. The minimum-adjusted method refined leakage-potential estimation by additionally including local lithologic heterogeneity effects.

  19. Spatial analysis of gastroschisis in Massachusetts and Texas

    PubMed Central

    Yazdy, Mahsa M.; Werler, Martha M.; Anderka, Marlene; Langlois, Peter H.; Vieira, Veronica M.

    2014-01-01

    Purpose Previous research has suggested gastroschisis, a congenital malformation, may be linked to environmental or infectious factors and cases can occur in clusters. The objective of this study was to identify geographic areas of elevated gastroschisis risk. Methods Cases of gastroschisis were identified from birth defect registries in Massachusetts and Texas. Random samples of live births were selected as controls. Generalized additive models were used to create a continuous map surface of odds ratios (OR) by smoothing over latitude and longitude. Maternal age, race/ethnicity, education, cigarette smoking, and insurance status (MA only) were assessed for confounding. We used permutation tests to identify statistically significant areas of increased risk. Results An area of increased risk was identified in north-central Massachusetts, but was not significant after adjustment (p-value=0.07; OR=2.0). In Texas, two statistically significant areas of increased risk were identified after adjustment (p-value=0.02; OR=1.3 and 1.2). Texas had sufficient data to assess the combination of space and time, which identified an increased risk in 2003 and 2004. Conclusion This study suggests there were areas of elevated gastroschisis risk in Massachusetts and Texas that cannot be explained by the risk factors we assessed. Additional exploration of underlying artifactual, environmental, infectious, or behavioral factors may further our understanding of gastroschisis. PMID:25454289

  20. Self-Assessed Hearing Handicap in Older Adults With Poorer-Than-Predicted Speech Recognition in Noise

    PubMed Central

    Matthews, Lois J.; Dubno, Judy R.

    2017-01-01

    Purpose Even older adults with relatively mild hearing loss report hearing handicap, suggesting that hearing handicap is not completely explained by reduced speech audibility. Method We examined the extent to which self-assessed ratings of hearing handicap using the Hearing Handicap Inventory for the Elderly (HHIE; Ventry & Weinstein, 1982) were significantly associated with measures of speech recognition in noise that controlled for differences in speech audibility. Results One hundred sixty-two middle-aged and older adults had HHIE total scores that were significantly associated with audibility-adjusted measures of speech recognition for low-context but not high-context sentences. These findings were driven by HHIE items involving negative feelings related to communication difficulties that also captured variance in subjective ratings of effort and frustration that predicted speech recognition. The average pure-tone threshold accounted for some of the variance in the association between the HHIE and audibility-adjusted speech recognition, suggesting an effect of central and peripheral auditory system decline related to elevated thresholds. Conclusion The accumulation of difficult listening experiences appears to produce a self-assessment of hearing handicap resulting from (a) reduced audibility of stimuli, (b) declines in the central and peripheral auditory system function, and (c) additional individual variation in central nervous system function. PMID:28060993

  1. Urban Sprawl and Body Mass Index Among Displaced Hurricane Katrina Survivors

    PubMed Central

    Arcaya, Mariana; James, Peter; Rhodes, Jean; Waters, Mary C; Subramanian, S V

    2014-01-01

    Objective Existing research suggests that walkable environments are protective against weight gain, while sprawling neighborhoods may pose health risks. Using prospective data on displaced Hurricane Katrina survivors, we provide the first natural experimental data on sprawl and body mass index (BMI). Methods The analysis uses prospectively collected pre- (2003–2005) and post-hurricane (2006–2007) data from the Resilience in Survivors of Katrina (RISK) project on 280 displaced Hurricane Katrina survivors who had little control over their neighborhood placement immediately after the disaster. The county sprawl index, a standardized measure of built environment, was used to predict BMI at follow-up, adjusted for baseline BMI and sprawl; Hurricane-related trauma; and demographic and economic characteristics. Results Respondents from 8 New Orleans-area counties were dispersed to 76 counties post-Katrina. Sprawl increased by an average of 1.5 standard deviations (30 points) on the county sprawl index. Each one point increase in sprawl was associated with approximately .05 kg/m2 higher BMI in unadjusted models (95%CI: .01–.08), and the relationship was not attenuated after covariate adjustment. Conclusions We find a robust association between residence in a sprawling county and higher BMI unlikely to be caused by self-selection into neighborhoods, suggesting that the built environment may foster changes in weight. PMID:24732717

  2. The left inferior frontal gyrus is involved in adjusting response bias during a perceptual decision-making task

    PubMed Central

    Reckless, Greg E; Ousdal, Olga T; Server, Andres; Walter, Henrik; Andreassen, Ole A; Jensen, Jimmy

    2014-01-01

    Introduction Changing the way we make decisions from one environment to another allows us to maintain optimal decision-making. One way decision-making may change is how biased one is toward one option or another. Identifying the regions of the brain that underlie the change in bias will allow for a better understanding of flexible decision-making. Methods An event-related, perceptual decision-making task where participants had to detect a picture of an animal amongst distractors was used during functional magnetic resonance imaging. Positive and negative financial motivation were used to affect a change in response bias, and changes in decision-making behavior were quantified using signal detection theory. Results Response bias became relatively more liberal during both positive and negative motivated trials compared to neutral trials. For both motivational conditions, the larger the liberal shift in bias, the greater the left inferior frontal gyrus (IFG) activity. There was no relationship between individuals' belief that they used a different strategy and their actual change in response bias. Conclusions The present findings suggest that the left IFG plays a role in adjusting response bias across different decision environments. This suggests a potential role for the left IFG in flexible decision-making. PMID:24944869

  3. Firearm and Nonfirearm Homicide in 5 South African Cities: A Retrospective Population-Based Study

    PubMed Central

    Thompson, Mary Lou; Myers, Jonathan E.

    2014-01-01

    Objective. We assessed the effectiveness of South Africa’s Firearm Control Act (FCA), passed in 2000, on firearm homicide rates compared with rates of nonfirearm homicide across 5 South African cities from 2001 to 2005. Methods. We conducted a retrospective population-based study of 37 067 firearm and nonfirearm homicide cases. Generalized linear models helped estimate and compare time trends of firearm and nonfirearm homicides, adjusting for age, sex, race, day of week, city, year of death, and population size. Results. There was a statistically significant decreasing trend regarding firearm homicides from 2001, with an adjusted year-on-year homicide rate ratio of 0.864 (95% confidence interval [CI] = 0.848, 0.880), representing a decrease of 13.6% per annum. The year-on-year decrease in nonfirearm homicide rates was also significant, but considerably lower at 0.976 (95% CI = 0.954, 0.997). Results suggest that 4585 (95% CI = 4427, 4723) lives were saved across 5 cities from 2001 to 2005 because of the FCA. Conclusions. Strength, timing and consistent decline suggest stricter gun control mediated by the FCA accounted for a significant decrease in homicide overall, and firearm homicide in particular, during the study period. PMID:24432917

  4. ABO Blood Type A Is Associated With Increased Risk of ARDS in Whites Following Both Major Trauma and Severe Sepsis

    PubMed Central

    Meyer, Nuala J.; Shashaty, Michael G. S.; Feng, Rui; Lanken, Paul N.; Gallop, Robert; Kaplan, Sandra; Herlim, Maximilian; Oz, Nathaniel L.; Hiciano, Isabel; Campbell, Ana; Holena, Daniel N.; Reilly, Muredach P.; Christie, Jason D.

    2014-01-01

    Background: ABO glycosyltransferases catalyze antigen modifications on various glycans and glycoproteins and determine the ABO blood types. Blood type A has been associated with increased risk of vascular diseases and differential circulating levels of proteins related to inflammation and endothelial function. The objective of this study was to determine the association of ABO blood types with ARDS risk in patients with major trauma and severe sepsis. Methods: We conducted prospective cohort studies in two populations at an urban tertiary referral, level I trauma center. Critically ill patients (n = 732) presenting after major trauma were followed for 5 days for ARDS development. Additionally, 976 medical patients with severe sepsis were followed for 5 days for ARDS. Multivariable logistic regression was used to adjust for confounders. Results: ARDS developed in 197 of the 732 trauma patients (27%). Blood type A was associated with increased ARDS risk among whites (37% vs 24%; adjusted OR, 1.88; 95% CI, 1.14-3.12; P = .014), but not blacks (adjusted OR, 0.61; 95% CI, 0.33-1.13; P = .114). ARDS developed in 222 of the 976 patients with severe sepsis (23%). Blood type A was also associated with an increased ARDS risk among whites (31% vs 21%; adjusted OR, 1.67; 95% CI, 1.08-2.59; P = .021) but, again, not among blacks (adjusted OR, 1.17; 95% CI, 0.59-2.33; P = .652). Conclusions: Blood type A is associated with an increased risk of ARDS in white patients with major trauma and severe sepsis. These results suggest a role for ABO glycans and glycosyltransferases in ARDS susceptibility. PMID:24385226

  5. Impact of disasters on child stunting in Nepal

    PubMed Central

    Gaire, Surya; Delbiso, Tefera Darge; Pandey, Srijana; Guha-Sapir, Debarati

    2016-01-01

    Background Stunting is a major public health problem that results from inadequate nutritional intake over a long period of time. Disasters have major implications in poor and vulnerable children. The aim of this study was, therefore, to assess the impact of disasters on child stunting in Nepal. Method A sample consisting of 2,111 children aged 6–59 months was obtained from the 2011 Nepal Demographic and Health Survey. We used bivariate and multivariate analyses to examine moderate and severe stunting against disaster, controlling for all possible confounders. Result Out of the total study sample, 43% were stunted (17.1% severely and 25.9% moderately). The final model, after adjusting for confounders, showed that epidemics have no impact on child stunting (adjusted odds ratio [OR] =1.14, 95% confidence interval [CI]: 0.66, 1.97 and adjusted OR =1.04, 95% CI: 0.66, 1.65 for severe and moderate stunting, respectively). Floods have impact on child stunting (adjusted OR =0.57, 95% CI: 0.31, 0.96 and adjusted OR =0.66, 95% CI: 0.41, 0.94 for severe and moderate stunting, respectively). However, children aged 6–11 months, nonvaccinated children, children of working women, children who live in mountainous areas, and children from the poorest households were more likely to be moderately stunted. Similarly, children aged 36–47 months, Dalit and other ethnic groups, children from rural settings, and children from the poorest households were more likely to be severely stunted. Conclusion This article illustrates the need to rethink about child stunting in Nepal. This study suggests need for further research, integration of disaster data in the Nepal Demography Health Survey, educational interventions, public awareness, promotion of vaccination, and equity in health service delivery. PMID:27354834

  6. Household Debt and Relation to Intimate Partner Violence and Husbands' Attitudes Toward Gender Norms: A Study Among Young Married Couples in Rural Maharashtra, India

    PubMed Central

    Donta, Balaiah; Dasgupta, Anindita; Ghule, Mohan; Battala, Madhusudana; Nair, Saritha; Silverman, Jay G.; Jadhav, Arun; Palaye, Prajakta; Saggurti, Niranjan; Raj, Anita

    2015-01-01

    Objective Evidence has linked economic hardship with increased intimate partner violence (IPV) perpetration among males. However, less is known about how economic debt or gender norms related to men's roles in relationships or the household, which often underlie IPV perpetration, intersect in or may explain these associations. We assessed the intersection of economic debt, attitudes toward gender norms, and IPV perpetration among married men in India. Methods Data were from the evaluation of a family planning intervention among young married couples (n=1,081) in rural Maharashtra, India. Crude and adjusted logistic regression models for dichotomous outcome variables and linear regression models for continuous outcomes were used to examine debt in relation to husbands' attitudes toward gender-based norms (i.e., beliefs supporting IPV and beliefs regarding male dominance in relationships and the household), as well as sexual and physical IPV perpetration. Results Twenty percent of husbands reported debt. In adjusted linear regression models, debt was associated with husbands' attitudes supportive of IPV (b=0.015, p=0.004) and norms supporting male dominance in relationships and the household (b=0.006, p=0.003). In logistic regression models adjusted for relevant demographics, debt was associated with perpetration of physical IPV (adjusted odds ratio [AOR] = 1.4, 95% confidence interval [CI] 1.1, 1.9) and sexual IPV (AOR=1.6, 95% CI 1.1, 2.1) from husbands. These findings related to debt and relation to IPV were slightly attenuated when further adjusted for men's attitudes toward gender norms. Conclusion Findings suggest the need for combined gender equity and economic promotion interventions to address high levels of debt and related IPV reported among married couples in rural India. PMID:26556938

  7. Neighborhood-Level Racial/Ethnic Residential Segregation and Incident Cardiovascular Disease: The Multi-Ethnic Study of Atherosclerosis

    PubMed Central

    Kershaw, Kiarri N.; Osypuk, Theresa L.; Do, D. Phuong; De Chavez, Peter J.; Roux, Ana V. Diez

    2014-01-01

    Background Previous research suggests neighborhood-level racial/ethnic residential segregation is linked to health, but it has not been studied prospectively in relation to cardiovascular disease (CVD). Methods and Results Participants were 1,595 non-Hispanic Black, 2,345 non-Hispanic White, and 1,289 Hispanic adults from the Multi-Ethnic Study of Atherosclerosis free of CVD at baseline (ages 45-84). Own-group racial/ethnic residential segregation was assessed using the Gi∗ statistic, a measure of how the neighborhood racial/ethnic composition deviates from surrounding counties’ racial/ethnic composition. Multivariable Cox proportional hazards modeling was used to estimate hazard ratios (HR) for incident CVD (first definite angina, probable angina followed by revascularization, myocardial infarction, resuscitated cardiac arrest, CHD death, stroke, or stroke death) over 10.2 median years of follow-up. Among Blacks, each standard deviation increase in Black segregation was associated with a 12% higher hazard of developing CVD after adjusting for demographics (95% Confidence Interval (CI): 1.02, 1.22). This association persisted after adjustment for neighborhood-level characteristics, individual socioeconomic position, and CVD risk factors (HR: 1.12; 95% CI: 1.02, 1.23). For Whites, higher White segregation was associated with lower CVD risk after adjusting for demographics (HR: 0.88; 95% CI: 0.81, 0.96), but not after further adjustment for neighborhood characteristics. Segregation was not associated with CVD risk among Hispanics. Similar results were obtained after adjusting for time-varying segregation and covariates. Conclusions The association of residential segregation with cardiovascular risk varies according to race/ethnicity. Further work is needed to better characterize the individual- and neighborhood-level pathways linking segregation to CVD risk. PMID:25447044

  8. Childhood self-control and adult outcomes: results from a 30-year longitudinal study.

    PubMed

    Fergusson, David M; Boden, Joseph M; Horwood, L John

    2013-07-01

    A study by Moffitt et al. reported pervasive associations between childhood self-control and adult outcomes. The current study attempts to replicate the findings reported by Moffitt et al., adjusting these results for the confounding influence of childhood conduct problems. Data were gathered from the Christchurch Health and Development Study, a longitudinal birth cohort studied to age 30 years. Self-control during ages 6 to 12 years was measured analogously to that in Moffitt et al., using parent-, teacher-, and self-report methods. Outcome measures to age 30 included criminal offending, substance use, education/employment, sexual behavior, and mental health. Associations between self-control and outcomes were adjusted for possible confounding by gender, socioeconomic status (SES), IQ, and childhood conduct problems (ages 6-10). In confirmation of the findings of Moffitt et al., all outcomes except major depression were significantly (p < .05) associated with childhood self-control. Adjustment for gender, SES, and IQ reduced to some extent the magnitude of the associations. However, adjustment for childhood conduct disorder further reduced the magnitude of many of these associations, with only 4 of the 14 outcomes remaining statistically significantly (p < .05) associated with self-control. After adjustment for gender, SES, IQ, and conduct problems, those individuals who scored higher in self-control had lower odds of violent offending and welfare dependence, were more likely to have obtained a university degree, and had higher income levels. The findings from this study suggest that observed linkages between a measure of childhood self-control and outcomes in adulthood were largely explained by the correlated effects of childhood conduct problems, SES, IQ, and gender. Copyright © 2013 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

  9. A simple mechanism for measuring and adjusting distraction forces during maxillary advancement.

    PubMed

    Suzuki, Eduardo Yugo; Suzuki, Boonsiva

    2009-10-01

    Direct measurement of distraction forces on the craniofacial skeleton has never been reported. The present report describes the development of a method of assessing and adjusting traction forces applied through maxillary distraction osteogenesis. A simple mechanism to measure and adjust tension force during maxillary distraction osteogenesis was developed and connected bilaterally to the traction screws of a rigid external distraction device. Measurements were carried out before and after activation using a Shimpo (Nidec-Shimpo America Corporation, Itasca, IL) force gauge in 4 patients (2 with unilateral cleft lip and/or palate, 1 with bilateral cleft lip and palate, and 1 with noncleft) during the distraction process. Activation was performed twice a day at a rate of 1 mm/day. The average maximum force applied throughout the distraction period was 42.5 N (range 16.4 to 65.3 N), with increments, after activation, averaging 10.5 N (range 7.9 to 15.7 N). In patients with unilateral cleft lip and/or palate, distraction forces on the larger segment were 65.1% higher than on the lesser segment. A differential pattern of forces was also observed in the patients with asymmetric noncleft. However, the differential forces between lateral segments were not observed in the patient with bilateral cleft lip and palate. During the activation period, distraction forces progressively increased, whereas the amount of maxillary movement decreased. Pain and discomfort were reported with high forces. Through this mechanism, direct measurement and adjustment of distraction forces during maxillary advancement was possible. The unbalanced pattern of forces observed in patients with cleft suggests the necessity of individual adjustments for controlling pain and clinical symptoms. Accordingly, assessment of distraction forces during maxillary distraction osteogenesis is extremely helpful in understanding the biomechanics of the distraction process.

  10. Cost-effectiveness of biological treatment sequences for fistulising Crohn’s disease across Europe

    PubMed Central

    Baji, Petra; Gulácsi, László; Brodszky, Valentin; Végh, Zsuzsanna; Danese, Silvio; Irving, Peter M; Peyrin-Biroulet, Laurent; Schreiber, Stefan; Rencz, Fanni; Lakatos, Péter L; Péntek, Márta

    2017-01-01

    Background In clinical practice, treatment sequences of biologicals are applied for active fistulising Crohn’s disease, however underlying health economic analyses are lacking. Objective The purpose of this study was to analyse the cost-effectiveness of different biological sequences including infliximab, biosimilar-infliximab, adalimumab and vedolizumab in nine European countries. Methods A Markov model was developed to compare treatment sequences of one, two and three biologicals from the payer’s perspective on a five-year time horizon. Data on effectiveness and health state utilities were obtained from the literature. Country-specific costs were considered. Calculations were performed with both official list prices and estimated real prices of biologicals. Results Biosimilar-infliximab is the most cost-effective treatment against standard care across the countries (with list prices: €34684–€72551/quality adjusted life year; with estimated real prices: €24364–€56086/quality adjusted life year). The most cost-effective two-agent sequence, except for Germany, is the biosimilar-infliximab–adalimumab therapy compared with single biosimilar-infliximab (with list prices: €58533–€133831/quality adjusted life year; with estimated prices: €45513–€105875/quality adjusted life year). The cost-effectiveness of the biosimilar-infliximab–adalimumab–vedolizumab three-agent sequence compared wit biosimilar-infliximab –adalimumab is €87214–€152901/quality adjusted life year. Conclusions The suggested first-choice biological treatment is biosimilar-infliximab. In case of treatment failure, switching to adalimumab then to vedolizumab provides meaningful additional health gains but at increased costs. Inter-country differences in cost-effectiveness are remarkable due to significant differences in costs. PMID:29511561

  11. Factors Mediating the Adjustment to Involuntary Childlessness.

    ERIC Educational Resources Information Center

    Sabatelli, Ronald M.; And Others

    1988-01-01

    Explored stressors that accompany experience of involuntary childlessness and examined mediators of adjustment to infertility in married individuals. Data showed deleterious effect that coping with infertility can have on couple's sexual relationship. Findings suggest important relationship between self-esteem, marital commitment, and positive…

  12. A comparison of methods for adjusting biomarkers of iron, zinc, and selenium status for the effect of inflammation in an older population: a case for interleukin 6.

    PubMed

    MacDonell, Sue O; Miller, Jody C; Harper, Michelle J; Reid, Malcolm R; Haszard, Jillian J; Gibson, Rosalind S; Houghton, Lisa A

    2018-05-14

    Older people are at risk of micronutrient deficiencies, which can be under- or overestimated in the presence of inflammation. Several methods have been proposed to adjust for the effect of inflammation; however, to our knowledge, none have been investigated in older adults in whom chronic inflammation is common. We investigated the influence of various inflammation-adjustment methods on micronutrient biomarkers associated with anemia in older people living in aged-care facilities in New Zealand. Blood samples were collected from 289 New Zealand aged-care residents aged >65 y. Serum ferritin, soluble transferrin receptor (sTfR), total body iron (TBI), plasma zinc, and selenium as well as the inflammatory markers high-sensitivity C-reactive protein (CRP), α1-acid glycoprotein (AGP), and interleukin 6 (IL-6) were measured. Four adjustment methods were applied to micronutrient concentrations: 1) internal correction factors based on stages of inflammation defined by CRP and AGP, 2) external correction factors derived from the literature, 3) a regression correction model in which reference CRP and AGP were set to the maximum of the lowest decile, and 4) a regression correction model in which reference IL-6 was set to the maximum of the lowest decile. Forty percent of participants had elevated concentrations of CRP, AGP, or both, and 37% of participants had higher than normal concentrations of IL-6. Adjusted geometric mean values for serum ferritin, sTfR, and TBI were significantly lower (P < 0.001), and plasma zinc and selenium were significantly higher (P < 0.001), than the unadjusted values regardless of the method applied. The greatest inflammation adjustment was observed with the regression correction that used IL-6. Subsequently, the prevalence of zinc and selenium deficiency decreased (-13% and -14%, respectively; P < 0.001), whereas iron deficiency remained unaffected. Adjustment for inflammation should be considered when evaluating micronutrient status in this aging population group; however, the approaches used require further investigation, particularly the influence of adjustment for IL-6.

  13. Relationship between central and peripheral atherosclerosis and left ventricular dysfunction in a community population.

    PubMed

    Tsao, Connie W; Gona, Philimon; Salton, Carol; Murabito, Joanne M; Oyama, Noriko; Danias, Peter G; O'Donnell, Christopher J; Manning, Warren J; Yeon, Susan B

    2011-08-01

    We aimed to determine the relationships between resting left ventricular (LV) wall motion abnormalities (WMAs), aortic plaque, and peripheral artery disease (PAD) in a community cohort. A total of 1726 Framingham Heart Study Offspring Cohort participants (806 males, 65 ± 9 years) underwent cardiovascular magnetic resonance with quantification of aortic plaque volume and assessment of regional left ventricular systolic function. Claudication, lower extremity revascularization, and ankle-brachial index (ABI) were recorded at the most contemporaneous examination visit. WMAs were associated with greater aortic plaque burden, decreased ABI, and claudication in age- and sex-adjusted analyses (all p < 0.001), which were not significant after adjustment for cardiovascular risk factors. In age- and sex-adjusted analyses, both the presence (p < 0.001) and volume of aortic plaque were associated with decreased ABI (p < 0.001). After multivariable adjustment, an ABI ≤ 0.9 or prior revascularization was associated with a threefold odds of aortic plaque (p = 0.0083). Plaque volume significantly increased with decreasing ABI in multivariable-adjusted analyses (p < 0.0001). In this free-living population, associations of WMAs with aortic plaque burden and clinical measures of PAD were attenuated after adjustment for coronary heart disease risk factors. Aortic plaque volume and ABI remained strongly negatively correlated after multivariable adjustment. Our findings suggest that the association between coronary heart disease and non-coronary atherosclerosis is explained by cardiovascular risk factors. Aortic atherosclerosis and PAD remain strongly associated after multivariable adjustment, suggesting shared mechanisms beyond those captured by traditional risk factors.

  14. Improving the Process of Adjusting the Parameters of Finite Element Models of Healthy Human Intervertebral Discs by the Multi-Response Surface Method.

    PubMed

    Gómez, Fátima Somovilla; Lorza, Rubén Lostado; Bobadilla, Marina Corral; García, Rubén Escribano

    2017-09-21

    The kinematic behavior of models that are based on the finite element method (FEM) for modeling the human body depends greatly on an accurate estimate of the parameters that define such models. This task is complex, and any small difference between the actual biomaterial model and the simulation model based on FEM can be amplified enormously in the presence of nonlinearities. The current paper attempts to demonstrate how a combination of the FEM and the MRS methods with desirability functions can be used to obtain the material parameters that are most appropriate for use in defining the behavior of Finite Element (FE) models of the healthy human lumbar intervertebral disc (IVD). The FE model parameters were adjusted on the basis of experimental data from selected standard tests (compression, flexion, extension, shear, lateral bending, and torsion) and were developed as follows: First, three-dimensional parameterized FE models were generated on the basis of the mentioned standard tests. Then, 11 parameters were selected to define the proposed parameterized FE models. For each of the standard tests, regression models were generated using MRS to model the six stiffness and nine bulges of the healthy IVD models that were created by changing the parameters of the FE models. The optimal combination of the 11 parameters was based on three different adjustment criteria. The latter, in turn, were based on the combination of stiffness and bulges that were obtained from the standard test FE simulations. The first adjustment criteria considered stiffness and bulges to be equally important in the adjustment of FE model parameters. The second adjustment criteria considered stiffness as most important, whereas the third considered the bulges to be most important. The proposed adjustment methods were applied to a medium-sized human IVD that corresponded to the L3-L4 lumbar level with standard dimensions of width = 50 mm, depth = 35 mm, and height = 10 mm. Agreement between the kinematic behavior that was obtained with the optimized parameters and that obtained from the literature demonstrated that the proposed method is a powerful tool with which to adjust healthy IVD FE models when there are many parameters, stiffnesses, and bulges to which the models must adjust.

  15. A methodological approach to identify external factors for indicator-based risk adjustment illustrated by a cataract surgery register

    PubMed Central

    2014-01-01

    Background Risk adjustment is crucial for comparison of outcome in medical care. Knowledge of the external factors that impact measured outcome but that cannot be influenced by the physician is a prerequisite for this adjustment. To date, a universal and reproducible method for identification of the relevant external factors has not been published. The selection of external factors in current quality assurance programmes is mainly based on expert opinion. We propose and demonstrate a methodology for identification of external factors requiring risk adjustment of outcome indicators and we apply it to a cataract surgery register. Methods Defined test criteria to determine the relevance for risk adjustment are “clinical relevance” and “statistical significance”. Clinical relevance of the association is presumed when observed success rates of the indicator in the presence and absence of the external factor exceed a pre-specified range of 10%. Statistical significance of the association between the external factor and outcome indicators is assessed by univariate stratification and multivariate logistic regression adjustment. The cataract surgery register was set up as part of a German multi-centre register trial for out-patient cataract surgery in three high-volume surgical sites. A total of 14,924 patient follow-ups have been documented since 2005. Eight external factors potentially relevant for risk adjustment were related to the outcome indicators “refractive accuracy” and “visual rehabilitation” 2–5 weeks after surgery. Results The clinical relevance criterion confirmed 2 (“refractive accuracy”) and 5 (“visual rehabilitation”) external factors. The significance criterion was verified in two ways. Univariate and multivariate analyses revealed almost identical external factors: 4 were related to “refractive accuracy” and 7 (6) to “visual rehabilitation”. Two (“refractive accuracy”) and 5 (“visual rehabilitation”) factors conformed to both criteria and were therefore relevant for risk adjustment. Conclusion In a practical application, the proposed method to identify relevant external factors for risk adjustment for comparison of outcome in healthcare proved to be feasible and comprehensive. The method can also be adapted to other quality assurance programmes. However, the cut-off score for clinical relevance needs to be individually assessed when applying the proposed method to other indications or indicators. PMID:24965949

  16. Improving the Process of Adjusting the Parameters of Finite Element Models of Healthy Human Intervertebral Discs by the Multi-Response Surface Method

    PubMed Central

    Somovilla Gómez, Fátima

    2017-01-01

    The kinematic behavior of models that are based on the finite element method (FEM) for modeling the human body depends greatly on an accurate estimate of the parameters that define such models. This task is complex, and any small difference between the actual biomaterial model and the simulation model based on FEM can be amplified enormously in the presence of nonlinearities. The current paper attempts to demonstrate how a combination of the FEM and the MRS methods with desirability functions can be used to obtain the material parameters that are most appropriate for use in defining the behavior of Finite Element (FE) models of the healthy human lumbar intervertebral disc (IVD). The FE model parameters were adjusted on the basis of experimental data from selected standard tests (compression, flexion, extension, shear, lateral bending, and torsion) and were developed as follows: First, three-dimensional parameterized FE models were generated on the basis of the mentioned standard tests. Then, 11 parameters were selected to define the proposed parameterized FE models. For each of the standard tests, regression models were generated using MRS to model the six stiffness and nine bulges of the healthy IVD models that were created by changing the parameters of the FE models. The optimal combination of the 11 parameters was based on three different adjustment criteria. The latter, in turn, were based on the combination of stiffness and bulges that were obtained from the standard test FE simulations. The first adjustment criteria considered stiffness and bulges to be equally important in the adjustment of FE model parameters. The second adjustment criteria considered stiffness as most important, whereas the third considered the bulges to be most important. The proposed adjustment methods were applied to a medium-sized human IVD that corresponded to the L3–L4 lumbar level with standard dimensions of width = 50 mm, depth = 35 mm, and height = 10 mm. Agreement between the kinematic behavior that was obtained with the optimized parameters and that obtained from the literature demonstrated that the proposed method is a powerful tool with which to adjust healthy IVD FE models when there are many parameters, stiffnesses, and bulges to which the models must adjust. PMID:28934161

  17. Integral method for transient He II heat transfer in a semi-infinite domain

    NASA Astrophysics Data System (ADS)

    Baudouy, B.

    2002-05-01

    Integral methods are suited to solve a non-linear system of differential equations where the non-linearity can be found either in the differential equations or in the boundary conditions. Though they are approximate methods, they have proven to give simple solutions with acceptable accuracy for transient heat transfer in He II. Taking in account the temperature dependence of thermal properties, direct solutions are found without the need of adjusting a parameter. Previously, we have presented a solution for the clamped heat flux and in the present study this method is used to accommodate the clamped-temperature problem. In the case of constant thermal properties, this method yields results that are within a few percent of the exact solution for the heat flux at the axis origin. We applied this solution to analyze recovery from burnout and find an agreement within 10% at low heat flux, whereas at high heat flux the model deviates from the experimental data suggesting the need for a more refined thermal model.

  18. Application of coordinate transform on ball plate calibration

    NASA Astrophysics Data System (ADS)

    Wei, Hengzheng; Wang, Weinong; Ren, Guoying; Pei, Limei

    2015-02-01

    For the ball plate calibration method with coordinate measurement machine (CMM) equipped with laser interferometer, it is essential to adjust the ball plate parallel to the direction of laser beam. It is very time-consuming. To solve this problem, a method based on coordinate transformation between machine system and object system is presented. With the fixed points' coordinates of the ball plate measured in the object system and machine system, the transformation matrix between the coordinate systems is calculated. The laser interferometer measurement data error due to the placement of ball plate can be corrected with this transformation matrix. Experimental results indicate that this method is consistent with the handy adjustment method. It avoids the complexity of ball plate adjustment. It also can be applied to the ball beam calibration.

  19. Height adjustment in assessing dual energy x-ray absorptiometry measurements of bone mass and density in children.

    PubMed

    Zemel, Babette S; Leonard, Mary B; Kelly, Andrea; Lappe, Joan M; Gilsanz, Vicente; Oberfield, Sharon; Mahboubi, Soroosh; Shepherd, John A; Hangartner, Thomas N; Frederick, Margaret M; Winer, Karen K; Kalkwarf, Heidi J

    2010-03-01

    In children, bone mineral content (BMC) and bone mineral density (BMD) measurements by dual-energy x-ray absorptiometry (DXA) are affected by height status. No consensus exists on how to adjust BMC or BMD (BMC/BMD) measurements for short or tall stature. The aim of this study was to compare various methods to adjust BMC/BMD for height in healthy children. Data from the Bone Mineral Density in Childhood Study (BMDCS) were used to develop adjustment methods that were validated using an independent cross-sectional sample of healthy children from the Reference Data Project (RDP). We conducted the study in five clinical centers in the United States. We included 1546 BMDCS and 650 RDP participants (7 to 17 yr of age, 50% female). No interventions were used. We measured spine and whole body (WB) BMC and BMD Z-scores for age (BMC/BMD(age)), height age (BMC/BMD(height age)), height (BMC(height)), bone mineral apparent density (BMAD(age)), and height-for-age Z-score (HAZ) (BMC/BMD(haz)). Spine and WB BMC/BMD(age)Z and BMAD(age)Z were positively (P < 0.005; r = 0.11 to 0.64) associated with HAZ. Spine BMD(haz) and BMC(haz)Z were not associated with HAZ; WB BMC(haz)Z was modestly associated with HAZ (r = 0.14; P = 0.0003). All other adjustment methods were negatively associated with HAZ (P < 0.005; r = -0.20 to -0.34). The deviation between adjusted and BMC/BMD(age) Z-scores was associated with age for most measures (P < 0.005) except for BMC/BMD(haz). Most methods to adjust BMC/BMD Z-scores for height were biased by age and/or HAZ. Adjustments using HAZ were least biased relative to HAZ and age and can be used to evaluate the effect of short or tall stature on BMC/BMD Z-scores.

  20. Ups and downs of the expatriate experience? Understanding work adjustment trajectories and career outcomes.

    PubMed

    Zhu, Jing; Wanberg, Connie R; Harrison, David A; Diehn, Erica W

    2016-04-01

    We examine changes in work adjustment among 179 expatriates from 3 multinational organizations from predeparture through the first 9 months of a new international assignment. Our 10-wave results challenge classic U-shaped theories of expatriate adjustment (e.g., Torbiorn, 1982). Consistent with uncertainty reduction theory, our results instead suggest that expatriates typically experience a gradual increase in work adjustment over time. Two resources that expatriates bring to their assignments (previous culture-specific work experience and core self-evaluations) moderate the trajectory of work adjustment. Trajectory of adjustment predicts Month 9 career instrumentality and turnover intention, as well as career advancement (job promotion) 1.5 years further. Implications for theory, as well as for changes in expatriate management practices, are discussed. (c) 2016 APA, all rights reserved).

  1. The method ADAMONT v1.0 for statistical adjustment of climate projections applicable to energy balance land surface models

    NASA Astrophysics Data System (ADS)

    Verfaillie, Deborah; Déqué, Michel; Morin, Samuel; Lafaysse, Matthieu

    2017-11-01

    We introduce the method ADAMONT v1.0 to adjust and disaggregate daily climate projections from a regional climate model (RCM) using an observational dataset at hourly time resolution. The method uses a refined quantile mapping approach for statistical adjustment and an analogous method for sub-daily disaggregation. The method ultimately produces adjusted hourly time series of temperature, precipitation, wind speed, humidity, and short- and longwave radiation, which can in turn be used to force any energy balance land surface model. While the method is generic and can be employed for any appropriate observation time series, here we focus on the description and evaluation of the method in the French mountainous regions. The observational dataset used here is the SAFRAN meteorological reanalysis, which covers the entire French Alps split into 23 massifs, within which meteorological conditions are provided for several 300 m elevation bands. In order to evaluate the skills of the method itself, it is applied to the ALADIN-Climate v5 RCM using the ERA-Interim reanalysis as boundary conditions, for the time period from 1980 to 2010. Results of the ADAMONT method are compared to the SAFRAN reanalysis itself. Various evaluation criteria are used for temperature and precipitation but also snow depth, which is computed by the SURFEX/ISBA-Crocus model using the meteorological driving data from either the adjusted RCM data or the SAFRAN reanalysis itself. The evaluation addresses in particular the time transferability of the method (using various learning/application time periods), the impact of the RCM grid point selection procedure for each massif/altitude band configuration, and the intervariable consistency of the adjusted meteorological data generated by the method. Results show that the performance of the method is satisfactory, with similar or even better evaluation metrics than alternative methods. However, results for air temperature are generally better than for precipitation. Results in terms of snow depth are satisfactory, which can be viewed as indicating a reasonably good intervariable consistency of the meteorological data produced by the method. In terms of temporal transferability (evaluated over time periods of 15 years only), results depend on the learning period. In terms of RCM grid point selection technique, the use of a complex RCM grid points selection technique, taking into account horizontal but also altitudinal proximity to SAFRAN massif centre points/altitude couples, generally degrades evaluation metrics for high altitudes compared to a simpler grid point selection method based on horizontal distance.

  2. Testing the limits of temporal stability: Willingness to pay values among Grand Canyon whitewater boaters across decades

    USGS Publications Warehouse

    Neher, Chris J.; Duffield, John; Bair, Lucas S.; Patterson, David A.; Neher, Katherine

    2017-01-01

    We directly compare trip willingness to pay (WTP) values between 1985 and 2015 stated preference surveys of private party Grand Canyon boaters using identically designed valuation methods. The temporal gap of 30 years between these two studies is well beyond that of any tests of WTP temporal stability in the literature. Comparisons were made of mean WTP estimates for four hypothetical Colorado River flow level scenarios. WTP values from the 1985 survey were adjusted to 2015 levels using the consumer price index. Mean WTP precision was estimated through simulation. No statistically significant differences were detected between the adjusted Bishop et al. (1987) and the current study mean WTP estimates. Examination of pooled models of the data from the studies suggest that while the estimated WTP values are stable over time, the underlying valuation functions may not be, particularly when the data and models are corrected to account for differing bid structures and possible panel effects.

  3. Evidence-based Assessment in Pediatric Psychology: Measures of Psychosocial Adjustment and Psychopathology

    PubMed Central

    Thill, Azure Welborn; Bachanas, Pamela; Garber, Judy; Miller, Karen Bearman; Abad, Mona; Bruno, Elizabeth Franks; Carter, Jocelyn Smith; David-Ferdon, Corinne; Jandasek, Barbara; Mennuti-Washburn, Jean E.; O’Mahar, Kerry; Zukerman, Jill

    2008-01-01

    Objective To provide an evidence-based review of measures of psychosocial adjustment and psychopathology, with a specific focus on their use in the field of pediatric psychology. Methods As part of a larger survey of pediatric psychologists from the Society of Pediatric Psychology e-mail listserv (American Psychological Association, APA, Division 54), 37 measures were selected for this psychometric review. Measures that qualified for the review fell into one of the following three categories: (a) internalizing or externalizing rating scales, (b) broad-band rating scales, and (c) self-related rating scales. Results Psychometric characteristics (i.e., three types of reliability, two types of validity) were strong for the majority of measures reviewed, with 34 of the 37 measures meeting “well-established” evidence-based assessment (EBA) criteria. Strengths and weaknesses of existing measures were noted. Conclusions Recommendations for future work in this area of assessment are presented, including suggestions that more fine-grained EBA criteria be developed and that evidence-based “profiles” be devised for each measure. PMID:17728305

  4. Musculoskeletal disorders among Thai women in construction-related work.

    PubMed

    Hanklang, Suda; Kaewboonchoo, Orawan; Silpasuwan, Pimpan; Mungarndee, Suriyaphun S

    2014-03-01

    A cross-sectional study was conducted to determine the prevalence of musculoskeletal disorder symptoms and its risk factors among women rebar workers. A simple random sampling method was used and data were collected by face-to-face interview and ergonomic assessment from February to March 2011. A total of 272 women rebar workers with at least 6 months' job experience participated in this study. The findings revealed that 57.7% of workers reported musculoskeletal disorder symptoms with low back and shoulders as the most common body parts affected (46.0%). Multiple logistic regression analysis indicated 2 variables that are significantly associated with musculoskeletal disorders: prolonged working hours (adjusted odds ratio = 7.63; 95% confidence interval = 2.06-28.31) and awkward posture (adjusted odds ratio = 43.79; 95% confidence interval = 17.09-112.20). The high prevalence of musculoskeletal disorders among women rebar workers suggests that an appropriate ergonomic workstation design and ergonomic training for women rebar workers are necessary.

  5. Risk adjustment policy options for casemix funding: international lessons in financing reform.

    PubMed

    Antioch, Kathryn M; Ellis, Randall P; Gillett, Steve; Borovnicar, Daniel; Marshall, Ric P

    2007-09-01

    This paper explores modified hospital casemix payment formulae that would refine the diagnosis-related group (DRG) system in Victoria, Australia, which already makes adjustments for teaching, severity and demographics. We estimate alternative casemix funding methods using multiple regressions for individual hospital episodes from 2001 to 2003 on 70 high-deficit DRGs, focussing on teaching hospitals where the largest deficits have occurred. Our casemix variables are diagnosis- and procedure-based severity markers, counts of diagnoses and procedures, disease types, complexity, day outliers, emergency admission and "transfers in." The results are presented for four policy options that vary according to whether all of the dollars or only some are reallocated, whether all or some hospitals are used and whether the alternatives augment or replace existing payments. While our approach identifies variables that help explain patient cost variations, hospital-level simulations suggest that the approaches explored would only reduce teaching hospital underpayment by about 10%. The implications of various policy options are discussed.

  6. Polymer brush covalently attached to OH-functionalized mica surface via surface-initiated ATRP: control of grafting density and polymer chain length.

    PubMed

    Lego, Béatrice; François, Marion; Skene, W G; Giasson, Suzanne

    2009-05-05

    The controlled grafting density of poly(tert-butyl acrylate) was studied on OH-activated mica substrates via surface-initiated atom-transfer radical polymerization (ATRP). By properly adjusting parameters such as the immobilization reaction time and the concentration of an ATRP initiator, a wide range of initiator surface coverages and hence polymer densities on mica were possible. The covalently immobilized initiator successfully promoted the polymerization of tert-butyl acrylate on mica surfaces. The resulting polymer layer thickness was measured by AFM using a step-height method. Linear relationships of the polymer thickness with respect to the molecular weight of the free polymer and with respect to the monomer conversion were observed, suggesting that ATRP is well controlled and relatively densely end-grafted layers were obtained. The polymer grafting density controlled by adjusting the initiator surface coverage was confirmed by the polymer layer swelling capacity and film thickness measurements.

  7. Leptin to adiponectin ratio in preeclampsia.

    PubMed

    Khosrowbeygi, A; Ahmadvand, H

    2013-04-01

    The aim of the present study was to assess leptin/adiponectin ratio in preeclamptic patients compared with normal pregnant women. A cross-sectional study was designed. The study population consisted of 30 preeclamptic patients and 30 healthy pregnant women. Serum levels of total leptin and adiponectin were assessed using commercially available enzyme-linked immunosorbent assay methods. The one-way ANOVA and Student's t tests and Pearson's correlation analysis were used for statistical calculations. Levels of leptin and adiponectin were also adjusted for BMI. A p-value < 0.05 was considered statistically significant. The leptin/adiponectin ratio was increased significantly in preeclamptic patients. The leptin/adiponectin ratio was significantly higher in severe preeclamptic patient than in mild preeclampsia. Adjusted leptin/adiponectin ratio was also significantly increased in preeclamptic patients than in normal pregnant women. The findings of the present study suggest that the leptin/adiponectin ratio was increased in preeclamsia and imbalance between the adipocytokines could be involved in the pathogenesis of preeclampsia.

  8. Testing the Limits of Temporal Stability: Willingness to Pay Values among Grand Canyon Whitewater Boaters Across Decades

    NASA Astrophysics Data System (ADS)

    Neher, Chris; Duffield, John; Bair, Lucas; Patterson, David; Neher, Katherine

    2017-12-01

    We directly compare trip willingness to pay (WTP) values between 1985 and 2015 stated preference surveys of private party Grand Canyon boaters using identically designed valuation methods. The temporal gap of 30 years between these two studies is well beyond that of any tests of WTP temporal stability in the literature. Comparisons were made of mean WTP estimates for four hypothetical Colorado River flow level scenarios. WTP values from the 1985 survey were adjusted to 2015 levels using the consumer price index. Mean WTP precision was estimated through simulation. No statistically significant differences were detected between the adjusted Bishop et al. (1987) and the current study mean WTP estimates. Examination of pooled models of the data from the studies suggest that while the estimated WTP values are stable over time, the underlying valuation functions may not be, particularly when the data and models are corrected to account for differing bid structures and possible panel effects.

  9. Association of 1,5-anhydroglucitol with diabetes and microvascular conditions

    PubMed Central

    Selvin, Elizabeth; Rawlings, Andreea M.; Grams, Morgan; Klein, Ronald; Steffes, Michael; Coresh, Josef

    2014-01-01

    Background 1,5-anhydroglucitol (1,5-AG) is inversely related to hyperglycemia and may be a useful indicator of short-term (1-2 week) hyperglycemia and glycemic excursions but its prognostic value is unclear. We sought to evaluate the associations of 1,5-AG with risk of diabetes and microvascular disease. Methods We measured 1,5-AG in blood samples from over 10,000 participants in the ARIC Study (baseline, 1990-1992) and characterized the independent associations with prevalent retinopathy, and with incident chronic kidney disease and incident diabetes during approximately 20 years of follow-up. Results We found that 1,5-AG was associated with prevalent retinopathy, driven primarily by the strong association in persons with diagnosed diabetes: adjusted OR 11.26 (95%CI 6.17-20.53) for <6 ug/mL compared to 1,5-AG ≥10 ug/mL. This result remained significant after further adjustment for HbA1c (OR 4.85, 95%CI 2.42-9.74). In persons with diagnosed diabetes: low 1,5-AG (<6 ug/mL vs ≥10 ug/mL) was also associated with a greater than 2-fold increased risk of incident chronic kidney disease (adjusted HR 2.83, 95% CI 2.15-3.74) and remained significant after adjustment for HbA1c (HR 1.43, 95%CI 1.02-2.00). Nondiabetic participants with high 1,5-AG (≥ 10 ug/mL) had the lowest prevalence of retinopathy and lowest risk of kidney disease. In persons without diagnosed diabetes at baseline, 1,5-AG <10 ug/mL was also associated with incident diabetes (adjusted HR 2.29, 95%CI 2.03-2.58). Conclusions 1,5-AG was associated with long-term risk of important microvascular outcomes, particularly in persons with diagnosed diabetes and even after adjustment for HbA1c. Our results suggest 1,5-AG may capture risk information associated with hyperglycemic excursions. PMID:25200356

  10. Should Studies of Diabetes Treatment Stratification Correct for Baseline HbA1c?

    PubMed Central

    Jones, Angus G.; Lonergan, Mike; Henley, William E.; Pearson, Ewan R.; Hattersley, Andrew T.; Shields, Beverley M.

    2016-01-01

    Aims Baseline HbA1c is a major predictor of response to glucose lowering therapy and therefore a potential confounder in studies aiming to identify other predictors. However, baseline adjustment may introduce error if the association between baseline HbA1c and response is substantially due to measurement error and regression to the mean. We aimed to determine whether studies of predictors of response should adjust for baseline HbA1c. Methods We assessed the relationship between baseline HbA1c and glycaemic response in 257 participants treated with GLP-1R agonists and assessed whether it reflected measurement error and regression to the mean using duplicate ‘pre-baseline’ HbA1c measurements not included in the response variable. In this cohort and an additional 2659 participants treated with sulfonylureas we assessed the relationship between covariates associated with baseline HbA1c and treatment response with and without baseline adjustment, and with a bias correction using pre-baseline HbA1c to adjust for the effects of error in baseline HbA1c. Results Baseline HbA1c was a major predictor of response (R2 = 0.19,β = -0.44,p<0.001).The association between pre-baseline and response was similar suggesting the greater response at higher baseline HbA1cs is not mainly due to measurement error and subsequent regression to the mean. In unadjusted analysis in both cohorts, factors associated with baseline HbA1c were associated with response, however these associations were weak or absent after adjustment for baseline HbA1c. Bias correction did not substantially alter associations. Conclusions Adjustment for the baseline HbA1c measurement is a simple and effective way to reduce bias in studies of predictors of response to glucose lowering therapy. PMID:27050911

  11. Is the maturity of hospitals' quality improvement systems associated with measures of quality and patient safety?

    PubMed Central

    2011-01-01

    Background Previous research addressed the development of a classification scheme for quality improvement systems in European hospitals. In this study we explore associations between the 'maturity' of the hospitals' quality improvement system and clinical outcomes. Methods The maturity classification scheme was developed based on survey results from 389 hospitals in eight European countries. We matched the hospitals from the Spanish sample (113 hospitals) with those hospitals participating in a nation-wide, voluntary hospital performance initiative. We then compared sample distributions and explored associations between the 'maturity' of the hospitals' quality improvement system and a range of composite outcomes measures, such as adjusted hospital-wide mortality, -readmission, -complication and -length of stay indices. Statistical analysis includes bivariate correlations for parametrically and non-parametrically distributed data, multiple robust regression models and bootstrapping techniques to obtain confidence-intervals for the correlation and regression estimates. Results Overall, 43 hospitals were included. Compared to the original sample of 113, this sample was characterized by a higher representation of university hospitals. Maturity of the quality improvement system was similar, although the matched sample showed less variability. Analysis of associations between the quality improvement system and hospital-wide outcomes suggests significant correlations for the indicator adjusted hospital complications, borderline significance for adjusted hospital readmissions and non-significance for the adjusted hospital mortality and length of stay indicators. These results are confirmed by the bootstrap estimates of the robust regression model after adjusting for hospital characteristics. Conclusions We assessed associations between hospitals' quality improvement systems and clinical outcomes. From this data it seems that having a more developed quality improvement system is associated with lower rates of adjusted hospital complications. A number of methodological and logistic hurdles remain to link hospital quality improvement systems to outcomes. Further research should aim at identifying the latent dimensions of quality improvement systems that predict quality and safety outcomes. Such research would add pertinent knowledge regarding the implementation of organizational strategies related with quality of care outcomes. PMID:22185479

  12. Relay protection features of frequency-adjustable electric drive

    NASA Astrophysics Data System (ADS)

    Kuprienko, V. V.

    2018-03-01

    The features of relay protection of high-voltage electric motors in composition of the frequency-adjustable electric drive are considered in the article. The influence of frequency converters on the stability of the operation of various types of relay protection used on electric motors is noted. Variants of circuits for connecting relay protection devices are suggested. The need to develop special relay protection devices for a frequency-adjustable electric drive is substantiated.

  13. Adjusting Pulse Amplitude During Transcutaneous Electrical Nerve Stimulation Does Not Provide Greater Hypoalgesia.

    PubMed

    Bergeron-Vézina, Kayla; Filion, Camille; Couture, Chantal; Vallée, Élisabeth; Laroche, Sarah; Léonard, Guillaume

    2018-03-01

    Transcutaneous electrical nerve stimulation (TENS) is an electrotherapeutic modality commonly used in rehabilitation to relieve pain. Adjusting pulse amplitude (intensity) during TENS treatment has been suggested to overcome nerve habituation. However, it is still unclear if this procedure leads to greater hypoalgesia. The aim of this study was to determine if the hypoalgesic effect of TENS is greater when pulse amplitude is adjusted throughout the TENS treatment session in chronic low-back pain patients. Randomized double-blind crossover study. Recruitment and assessment were conducted at the Clinique universitaire de réadaptation de l'Estrie (CURE) of the Faculty of Medicine and Health Sciences of the Université de Sherbrooke. Twenty-one volunteers with chronic low-back pain were enrolled and completed this investigation. Each patient received two high-frequency TENS treatments on two separate sessions: (1) with adjustment of pulse amplitude and (2) without pulse amplitude adjustment. Pain intensity and unpleasantness were assessed before, during, and after TENS application with a 10 cm visual analog scale. Both TENS conditions (with and without adjustment of intensity) decreased pain intensity and unpleasantness when compared with baseline. No difference was observed between the two stimulation conditions for both pain intensity and unpleasantness. The current results suggest that adjustment of pulse amplitude during TENS application does not provide greater hypoalgesia in individuals with chronic low-back pain. Future studies are needed to confirm these findings in other pain populations.

  14. A preliminary investigation of Stroop-related intrinsic connectivity in cocaine dependence: Associations with treatment outcomes

    PubMed Central

    Mitchell, Marci R.; Balodis, Iris M.; DeVito, Elise E.; Lacadie, Cheryl M.; Yeston, Jon; Scheinost, Dustin; Constable, R. Todd; Carroll, Kathleen M.; Potenza, Marc N.

    2013-01-01

    Background Cocaine-dependent individuals demonstrate neural and behavioral differences compared to healthy comparison subjects when performing the Stroop color-word inference test. Stroop measures also relate to treatment outcome for cocaine dependence. Intrinsic connectivity analyses assess the extent to which task-related regional brain activations are related to each other in the absence of defining a priori regions-of-interest. Objective This study examined: 1) the extent to which cocaine-dependent and non-addicted individuals differed on measures of intrinsic connectivity during fMRI Stroop performance; and, 2) the relationships between fMRI Stroop intrinsic connectivity and treatment outcome in cocaine dependence. Methods Sixteen treatment-seeking cocaine-dependent patients and matched non-addicted comparison subjects completed an fMRI Stroop task. Between-group differences in intrinsic connectivity were assessed and related to self-reported and urine-toxicology-based cocaine-abstinence measures. Results Cocaine-dependent patients vs. comparison subjects showed less intrinsic connectivity in cortical and sub-cortical regions. When adjusting for individual degree of intrinsic connectivity, cocaine-dependent vs. comparison subjects showed relatively greater intrinsic connectivity in the ventral striatum, putamen, inferior frontal gyrus, anterior insula, thalamus, and substantia nigra. Non-mean-adjusted intrinsic-connectivity measures in the midbrain, thalamus, ventral striatum, substantia nigra, insula, and hippocampus negatively correlated with measures of cocaine abstinence. Conclusion The diminished intrinsic connectivity in cocaine-dependent vs. comparison subjects suggests poorer communication across brain regions during cognitive-control processes. In mean-adjusted analyses, the cocaine-dependent group displayed relatively greater Stroop-related connectivity in regions implicated in motivational processes in addictions. The relationships between treatment outcomes and connectivity in the midbrain and basal ganglia suggest that connectivity represents a potential treatment target. PMID:24200209

  15. Risk factors for eczema in infants born in Cuba: a population-based cross-sectional study

    PubMed Central

    2014-01-01

    Background There is a concern that allergic disease in childhood is higher than expected in Cuba. The aim of this study was to determine the risk factors for eczema of infants aged 12–15 months living in Havana. Methods We used a cross-sectional epidemiological study design. Data on eczema symptoms and a wide range of lifestyle factors were collected by researcher administered questionnaires. Results Data were collected on 1956 children (96% response rate), of whom 672 (34%) were reported as having had eczema. Independent risk factors for eczema included young maternal age (adjusted odds ratio (OR) 0.98 per additional year of age; 95% confidence interval (CI) 0.97-0.99), child’s weight (OR 1.13 per additional kg; 95% CI: 1.03-1.25), insect sting allergy (OR 2.11; 95% CI: 1.33-3.35), rodents in the home (OR 1.39; 95% CI: 1.10-1.76), attendance at childcare facilities (OR 1.34: 95% CI: 1.05-1.70) and self-reported mould in the home (OR 1.23; 95% CI: 1.07-1.41). Infant exposure to paracetamol was associated with an increased risk of eczema even after adjustment for wheeze (OR 1.22; 95% CI: 1.03-1.46). Conclusion Despite a very different culture and environment, the consistency of these findings with those from more economically developed countries suggests potential causal associations. The association with paracetamol, even after adjustment for wheeze, suggests that intervention studies are required in young infants, to ascertain if this commonly used anti-pyretic medication increases allergic disease. PMID:24666750

  16. Relationships between social isolation, neighborhood poverty, and cancer mortality in a population-based study of US adults

    PubMed Central

    Illescas, Alex H.; Hohl, Bernadette C.; Llanos, Adana A. M.

    2017-01-01

    Background Social isolation is an important determinant of all-cause mortality, with evidence suggesting an association with cancer-specific mortality as well. In this study, we examined the associations between social isolation and neighborhood poverty (independently and jointly) on cancer mortality in a population-based sample of US adults. Methods Using data from the Third National Health and Nutrition Examination Survey (NHANES III; 1988–1994), NHANES III Linked Mortality File (through 2011) and 1990 Census, we estimated the relationship between social isolation and high neighborhood poverty and time-to-cancer death using multivariable-adjusted Cox proportional hazards models. We examined the associations of each factor independently and explored the multiplicative and additive interaction effects on cancer mortality risk and also analyzed these associations by sex. Results Among 16 044 US adults with 17–23 years of follow-up, there were 1133 cancer deaths. Social isolation (HR 1.25, 95% CI: 1.01–1.54) and high neighborhood poverty (HR 1.31, 95% CI: 1.08–1.60) were associated with increased risk of cancer mortality adjusting for age, sex, and race/ethnicity; in sex-specific estimates this increase in risk was evident among females only (HR 1.39, 95% CI: 1.04–1.86). These associations were attenuated upon further adjustment for socioeconomic status. There was no evidence of joint effects of social isolation and high neighborhood poverty on cancer mortality overall or in the sex-stratified models. Conclusions These findings suggest that social isolation and higher neighborhood poverty are independently associated with increased risk of cancer mortality, although there is no evidence to support our a priori hypothesis of a joint effect. PMID:28273125

  17. Differences in Allergic Sensitization by Self-reported Race and Genetic Ancestry

    PubMed Central

    Yang, James J.; Burchard, Esteban G.; Choudhry, Shweta; Johnson, Christine C.; Ownby, Dennis R.; Favro, David; Chen, Justin; Akana, Matthew; Ha, Connie; Kwok, Pui-Yan; Krajenta, Richard; Havstad, Suzanne L.; Joseph, Christine L.; Seibold, Max A.; Shriver, Mark D.; Williams, L. Keoki

    2010-01-01

    Background Many allergic conditions occur more frequently in African-American patients when compared with white patients; however it is not known whether this represents genetic predisposition or disparate environmental exposures. Objective To assess the relationship of self-reported race and genetic ancestry to allergic sensitization. Methods We included 601 women enrolled in a population-based cohort study whose self-reported race was African-American or white. Genetic ancestry was estimated using markers that differentiate West African and European ancestry. We assessed the relationship between allergic sensitization (defined as ≥1 allergen-specific IgE result) and both self-reported race and genetic ancestry. Regression models adjusted for socio-demographic variables, environmental exposures, and location of residence. Results The average proportion of West African ancestry in African-American participants was 0.69, whereas the mean proportion of European ancestry in white participants was 0.79. Self-reported African-American race was associated with allergic sensitization when compared with those who reported being white (adjusted odds ratio [aOR] 2.19; 95% confidence interval [CI] 1.22 – 3.93) even after adjusting for other variables. Genetic ancestry was not significantly associated with allergic sensitization after accounting for location of residence (aOR 2.09 for urban vs. suburban residence, 95% CI 1.32 −3.31). Conclusion Self-reported race and location of residence appeared to be more important predictors of allergic sensitization when compared with genetic ancestry, suggesting that the disparity in allergic sensitization by race may be primarily due to environmental factors rather than genetic differences. Clinical Implications These data suggest that efforts to eliminate disparities in allergic sensitization should focus on contributing environmental factors. PMID:19014772

  18. Socioeconomic Status, Not Race, Is Associated With Reduced Survival in Esophagectomy Patients.

    PubMed

    Erhunmwunsee, Loretta; Gulack, Brian C; Rushing, Christel; Niedzwiecki, Donna; Berry, Mark F; Hartwig, Matthew G

    2017-07-01

    Black patients with esophageal cancer have worse survival than white patients. This study examines this racial disparity in conjunction with socioeconomic status (SES) and explores whether race-based outcome differences exist using a national database. The associations between race and SES with overall survival of patients treated with esophagectomy for stages I to III esophageal cancer between 2003 and 2011 in the National Cancer Data Base were investigated using the Kaplan-Meier method and proportional hazards analyses. Median income by zip code and proportion of the zip code residents without a high school diploma were grouped into income and education quartiles, respectively and used as surrogates for SES. The association between race and overall survival stratified by SES is explored. Of 11,599 esophagectomy patients who met study criteria, 3,503 (30.2%) were in the highest income quartile, 2,847 (24.5%) were in the highest education quartile, and 610 patients (5%) were black. Before adjustment for SES, black patients had worse overall survival than white patients (median survival 23.0 versus 34.7 months, log rank p < 0.001), and overall, survival times improved with increasing income and education (p < 0.001 for both). After adjustment for putative prognostic factors, SES was associated with overall survival, whereas race was not. Prior studies have suggested that survival of esophageal cancer patients after esophagectomy is associated with race. Our study suggests that race is not significantly related to overall survival when adjusted for other prognostic variables. Socioeconomic status, however, remains significantly related to overall survival in our model. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  19. Prenatal Exposure to the Pesticide DDT and Hypertension Diagnosed in Women before Age 50: A Longitudinal Birth Cohort Study

    PubMed Central

    Cirillo, Piera M.; Terry, Mary Beth; Krigbaum, Nickilou Y.; Flom, Julie D.; Cohn, Barbara A.

    2013-01-01

    Background: Elevated levels of the pesticide DDT (dichlorodiphenyltrichloroethane) have been positively associated with blood pressure and hypertension in studies among adults. Accumulating epidemiologic and toxicologic evidence suggests that hypertension during adulthood may also be affected by earlier life and possibly the prenatal environment. Objectives: We assessed whether prenatal exposure to the pesticide DDT increases risk of adult hypertension. Methods: We examined concentrations of DDT (p,p´- and o,p´-) and its metabolite p,p´-DDE (dichlorodiphenyldichloroethylene) in prenatal serum samples from a subset of women (n = 527) who had participated in the prospective Child Health and Development Studies birth cohort in the San Francisco Bay area while they were pregnant between 1959 and 1967. We surveyed daughters 39–47 years of age by telephone interview from 2005 to 2008 to obtain information on self-reported physician-diagnosed hypertension and use of hypertensive medication. We used multivariable regression analysis of time to hypertension based on the Cox proportional hazards model to estimate relative rates for the association between prenatal DDT exposures and hypertension treated with medication in adulthood, with adjustment for potential confounding by maternal, early-life, and adult exposures. Results: Prenatal p,p´-DDT exposure was associated with hypertension [adjusted hazard ratio (aHR) = 3.6; 95% CI: 1.8, 7.2 and aHR = 2.5; 95% CI: 1.2, 5.3 for middle and high tertiles of p,p´-DDT relative to the lowest tertile, respectively]. These associations between p,p´-DDT and hypertension were robust to adjustment for independent hypertension risk factors as well as sensitivity analyses. Conclusions: These findings suggest that the association between DDT exposure and hypertension may have its origins early in development. PMID:23591545

  20. pncA gene expression and prediction factors on pyrazinamide resistance in Mycobacterium tuberculosis

    PubMed Central

    Sheen, Patricia; Lozano, Katherine; Gilman, Robert H.; Valencia, Hugo J.; Loli, Sebastian; Fuentes, Patricia; Grandjean, Louis; Zimic, Mirko

    2013-01-01

    Summary Background Mutations in the pyrazinamidase (PZAse) coding gene, pncA, have been considered as the main cause of pyrazinamide (PZA) resistance in Mycobacterium tuberculosis. However, recent studies suggest there is no single mechanism of resistance to PZA. The pyrazinoic acid (POA) efflux rate is the basis of the PZA susceptibility Wayne test, and its quantitative measurement has been found to be a highly sensitive and specific predictor of PZA resistance. Based on biological considerations, the POA efflux rate is directly determined by the PZAse activity, the level of pncA expression, and the efficiency of the POA efflux pump system. Objective This study analyzes the individual and the adjusted contribution of PZAse activity, pncA expression and POA efflux rate on PZA resistance. Methods Thirty M. tuberculosis strains with known microbiological PZA susceptibility or resistance were analyzed. For each strain, PZAse was recombinantly produced and its enzymatic activity measured. The level of pncA mRNA was estimated by quantitative RT-PCR, and the POA efflux rate was determined. Mutations in the pncA promoter were detected by DNA sequencing. All factors were evaluated by multiple regression analysis to determine their adjusted effects on the level of PZA resistance. Findings Low level of pncA expression associated to mutations in the pncA promoter region was observed in pncA wild type resistant strains. POA efflux rate was the best predictor after adjusting for the other factors, followed by PZAse activity. These results suggest that tests which rely on pncA mutations or PZAse activity are likely to be less predictive of real PZA resistance than tests which measure the rate of POA efflux. This should be further analyzed in light of the development of alternate assays to determine PZA resistance. PMID:23867321

  1. Intercomparison of an Aerosol Chemical Speciation Monitor (ACSM) with ambient fine aerosol measurements in downtown Atlanta, Georgia

    NASA Astrophysics Data System (ADS)

    Budisulistiorini, S. H.; Canagaratna, M. R.; Croteau, P. L.; Baumann, K.; Edgerton, E. S.; Kollman, M. S.; Ng, N. L.; Verma, V.; Shaw, S. L.; Knipping, E. M.; Worsnop, D. R.; Jayne, J. T.; Weber, R. J.; Surratt, J. D.

    2014-07-01

    Currently, there are a limited number of field studies that evaluate the long-term performance of the Aerodyne Aerosol Chemical Speciation Monitor (ACSM) against established monitoring networks. In this study, we present seasonal intercomparisons of the ACSM with collocated fine aerosol (PM2.5) measurements at the Southeastern Aerosol Research and Characterization (SEARCH) Jefferson Street (JST) site near downtown Atlanta, GA, during 2011-2012. Intercomparison of two collocated ACSMs resulted in strong correlations (r2 > 0.8) for all chemical species, except chloride (r2 = 0.21) indicating that ACSM instruments are capable of stable and reproducible operation. In general, speciated ACSM mass concentrations correlate well (r2 > 0.7) with the filter-adjusted continuous measurements from JST, although the correlation for nitrate is weaker (r2 = 0.55) in summer. Correlations of the ACSM NR-PM1 (non-refractory particulate matter with aerodynamic diameter less than or equal to 1 μm) plus elemental carbon (EC) with tapered element oscillating microbalance (TEOM) PM2.5 and Federal Reference Method (FRM) PM1 mass are strong with r2 > 0.7 and r2 > 0.8, respectively. Discrepancies might be attributed to evaporative losses of semi-volatile species from the filter measurements used to adjust the collocated continuous measurements. This suggests that adjusting the ambient aerosol continuous measurements with results from filter analysis introduced additional bias to the measurements. We also recommend to calibrate the ambient aerosol monitoring instruments using aerosol standards rather than gas-phase standards. The fitting approach for ACSM relative ionization for sulfate was shown to improve the comparisons between ACSM and collocated measurements in the absence of calibrated values, suggesting the importance of adding sulfate calibration into the ACSM calibration routine.

  2. Investigating the Impact of Off-Nominal Events on High-Density "Green" Arrivals

    NASA Technical Reports Server (NTRS)

    Callatine, Todd J.; Cabrall, Christopher; Kupfer, Michael; Martin, Lynne; Mercer, Joey; Palmer, Everett A.

    2012-01-01

    Trajectory-based controller tools developed to support a schedule-based terminal-area air traffic management (ATM) concept have been shown effective for enabling green arrivals along Area Navigation (RNAV) routes in moderately high-density traffic conditions. A recent human-in-the-loop simulation investigated the robustness of the concept and tools to off-nominal events events that lead to situations in which runway arrival schedules require adjustments and controllers can no longer use speed control alone to impose the necessary delays. Study participants included a terminal-area Traffic Management Supervisor responsible for adjusting the schedules. Sector-controller participants could issue alternate RNAV transition routes to absorb large delays. The study also included real-time winds/wind-forecast changes. The results indicate that arrival spacing accuracy, schedule conformance, and tool usage and usefulness are similar to that observed in simulations of nominal operations. However, the time and effort required to recover from an off-nominal event is highly context-sensitive, and impacted by the required schedule adjustments and control methods available for managing the evolving situation. The research suggests ways to bolster the off-nominal recovery process, and highlights challenges related to using human-in-the-loop simulation to investigate the safety and robustness of advanced ATM concepts.

  3. Previous Violent Events and Mental Health Outcomes in Guatemala

    PubMed Central

    Puac-Polanco, Victor D.; Lopez-Soto, Victor A.; Kohn, Robert; Xie, Dawei; Richmond, Therese S.

    2015-01-01

    Objectives. We analyzed a probability sample of Guatemalans to determine if a relationship exists between previous violent events and development of mental health outcomes in various sociodemographic groups, as well as during and after the Guatemalan Civil War. Methods. We used regression modeling, an interaction test, and complex survey design adjustments to estimate prevalences and test potential relationships between previous violent events and mental health. Results. Many (20.6%) participants experienced at least 1 previous serious violent event. Witnessing someone severely injured or killed was the most common event. Depression was experienced by 4.2% of participants, with 6.5% experiencing anxiety, 6.4% an alcohol-related disorder, and 1.9% posttraumatic stress disorder (PTSD). Persons who experienced violence during the war had 4.3 times the adjusted odds of alcohol-related disorders (P < .05) and 4.0 times the adjusted odds of PTSD (P < .05) compared with the postwar period. Women, indigenous Maya, and urban dwellers had greater odds of experiencing postviolence mental health outcomes. Conclusions. Violence that began during the civil war and continues today has had a significant effect on the mental health of Guatemalans. However, mental health outcomes resulting from violent events decreased in the postwar period, suggesting a nation in recovery. PMID:25713973

  4. Differences in Self-Reported Physical Limitation Among Older Women and Men in Ismailia, Egypt

    PubMed Central

    2012-01-01

    Objectives. This study explores the reasons for gender differences in self-reported physical limitation among older adults in Ismailia, Egypt. Method. 435 women and 448 men, 50 years and older in Ismailia, Egypt, participated in a social survey and tests of physical performance. Ordered logit models were estimated to compare unadjusted gender differences in reported disability with these differences adjusted sequentially for (a) age and objective measures of physical performance, (b) self-reported morbidities and health care use, and (c) social and economic attributes. Results. Compared with men, women more often reported higher levels of limitation in activities of daily living (ADLs), upper-extremity range of motion (ROM), and lower-extremity gross mobility (GM). Adjusting for age and objective measures of physical performance, women and men had similar odds of self-reporting difficulty with ADLs. With sequential adjustments for the remaining variables, women maintained significantly higher odds of self-reported difficulty with upper-extremity ROM and lower-extremity GM. Discussion. Cross-culturally, gender differences in self-reported disability may arise from objective and subjective perceptions of disability. Collectively, these results and those from prior studies in Bangladesh and the United States suggest that gender gaps in self-reported physical limitation may be associated with the degree of gender equality in society. PMID:22929399

  5. Simultaneous displacement and slope measurement in electronic speckle pattern interferometry using adjustable aperture multiplexing.

    PubMed

    Lu, Min; Wang, Shengjia; Aulbach, Laura; Koch, Alexander W

    2016-08-01

    This paper suggests the use of adjustable aperture multiplexing (AAM), a method which is able to introduce multiple tunable carrier frequencies into a three-beam electronic speckle pattern interferometer to measure the out-of-plane displacement and its first-order derivative simultaneously. In the optical arrangement, two single apertures are located in the object and reference light paths, respectively. In cooperation with two adjustable mirrors, virtual images of the single apertures construct three pairs of virtual double apertures with variable aperture opening sizes and aperture distances. By setting the aperture parameter properly, three tunable spatial carrier frequencies are produced within the speckle pattern and completely separate the information of three interferograms in the frequency domain. By applying the inverse Fourier transform to a selected spectrum, its corresponding phase difference distribution can thus be evaluated. Therefore, we can obtain the phase map due to the deformation as well as its slope of the test surface from two speckle patterns which are recorded at different loading events. By this means, simultaneous and dynamic measurements are realized. AAM has greatly simplified the measurement system, which contributes to improving the system stability and increasing the system flexibility and adaptability to various measurement requirements. This paper presents the AAM working principle, the phase retrieval using spatial carrier frequency, and preliminary experimental results.

  6. The protective value of school enrolment against sexually transmitted disease: a study of high‐risk African American adolescent females

    PubMed Central

    Crosby, Richard A; DiClemente, Ralph J; Wingood, Gina M; Salazar, Laura F; Rose, Eve; Sales, Jessica M

    2007-01-01

    Objective To identify whether school enrolment is protective against laboratory‐confirmed diagnosis of sexually transmitted diseases (STDs) and against a spectrum of sexual risk factors. Methods A cross‐sectional study of 715 African‐American adolescent females (15–21 years old) was conducted. Data collection included an audio‐computer‐assisted self‐interview lasting about 60 min and a self‐collected vaginal swab for nucleic acid amplification testing of Trichomonas vaginalis, Chlamydia trachomatis and Neisseria gonorrhoeae. Results In total, 65% were enrolled in school. After adjusting for age and whether adolescents resided with a family member, those not enrolled were twice as likely to test positive for one of the three STDs compared with those enrolled (adjusted OR2; 95% CI 1.38 to 2.91). Similarly, school enrolment was protective against risk factors contributing to STD acquisition. The measures of sexual risk behaviour of 8 of 10, retained significance after adjusting for the covariates, and 2 of the 3 psychosocial mediators retained significance. Conclusion This study provides initial evidence suggesting that keeping high‐risk African‐American adolescent females in school (including forms of school that occur after high‐school graduation) may be important from a public health standpoint. PMID:17569721

  7. Temperament and character effects on late adolescents’ well-being and emotional-behavioural difficulties

    PubMed Central

    Garzitto, Marco; Paschetto, Andrea; Brambilla, Paolo; Fabbro, Franco

    2018-01-01

    Background Research on adults points to personality as a crucial determinant of well-being. The present study investigates the question of personality’s relation to well-being and psychosocial adjustment in adolescence. Methods We assessed the role of temperament and character (Temperament and Character Inventory, TCI-125), on psychological well-being (PWB; Psychological Well-Being scales), subjective well-being (SWB; Positive and Negative Affect, PA and NA, respectively), and psychosocial adjustment (emotional-behavioural problems measured by the Strengths and Difficulties Questionnaire for Adolescents, SDQ-A), in 72 Italian late adolescents (aged 17.5 ± 0.75). Multiple regressions were conducted to predict PWB, SWB, and SDQ-A scores using TCI-125 scales as predictors. Results Character maturity, and in particular Self-Directedness, had a widespread protective effect on well-being and psychosocial adjustment, while different strengths and emotional-behavioural difficulties were associated to specific temperamental and character traits. For example, Harm-Avoidance and Novelty-Seeking positively predicted internalized and externalized problems, respectively. Discussion The present results suggest the usefulness of continuing to evaluate temperament and, in particular, character dimensions in investigations focused on adolescents’ well-being and psychosocial functioning, especially in the contexts of potential interventions aimed at enhancing development of adolescents’ character dimensions at the intrapersonal, interpersonal, and transpersonal levels. PMID:29607254

  8. Interleukin-6 is associated with cognitive function: the Northern Manhattan Study

    PubMed Central

    Wright, C.B.; Sacco, R.L.; Rundek, T.R.; Delman, J.B.; Rabbani, L.E.; Elkind, M.S.V.

    2006-01-01

    Background and purpose Inflammation has been linked to cognitive decline and dementia but the mechanism is not clear and few studies have included Hispanic and black subjects that may be at increased risk of these disorders. Methods We performed a cross-sectional analysis of the association between inflammatory marker levels and cognition in the stroke-free population-based cohort of the Northern Manhattan Study. Mini Mental State Exam (MMSE) scores were the continuous outcome and we adjusted for sociodemographic and vascular risk factors as well as subclinical atherosclerosis. Results Of the inflammatory markers, only interleukin (IL)-6 levels were associated with the MMSE. In univariate analysis age, hypertension, diabetes, smoking, moderate alcohol use, total homocysteine, carotid intima media thickness, and body mass index were positively associated with IL-6 levels. Hispanics compared to whites, those with less than a high school education, hypertension, cardiac disease, and total homocysteine were associated with lower MMSE scores. In a multivariate linear regression model, IL-6 was negatively associated with MMSE score adjusting for sociodemographic and vascular risk factors. Conclusions IL-6 levels were negatively associated with performance on the MMSE in this multiethnic cohort. Adjusting for vascular disease and subclinical atherosclerosis did not attenuate the association, suggesting a direct effect on the brain. PMID:16501663

  9. Fast exposure time decision in multi-exposure HDR imaging

    NASA Astrophysics Data System (ADS)

    Piao, Yongjie; Jin, Guang

    2012-10-01

    Currently available imaging and display system exists the problem of insufficient dynamic range, and the system cannot restore all the information for an high dynamic range (HDR) scene. The number of low dynamic range(LDR) image samples and fastness of exposure time decision impacts the real-time performance of the system dramatically. In order to realize a real-time HDR video acquisition system, this paper proposed a fast and robust method for exposure time selection in under and over exposure area which is based on system response function. The method utilized the monotony of the imaging system. According to this characteristic the exposure time is adjusted to an initial value to make the median value of the image equals to the middle value of the system output range; then adjust the exposure time to make the pixel value on two sides of histogram be the middle value of the system output range. Thus three low dynamic range images are acquired. Experiments show that the proposed method for adjusting the initial exposure time can converge in two iterations which is more fast and stable than average gray control method. As to the exposure time adjusting in under and over exposed area, the proposed method can use the dynamic range of the system more efficiently than fixed exposure time method.

  10. Accounting for Uncertainty in Decision Analytic Models Using Rank Preserving Structural Failure Time Modeling: Application to Parametric Survival Models.

    PubMed

    Bennett, Iain; Paracha, Noman; Abrams, Keith; Ray, Joshua

    2018-01-01

    Rank Preserving Structural Failure Time models are one of the most commonly used statistical methods to adjust for treatment switching in oncology clinical trials. The method is often applied in a decision analytic model without appropriately accounting for additional uncertainty when determining the allocation of health care resources. The aim of the study is to describe novel approaches to adequately account for uncertainty when using a Rank Preserving Structural Failure Time model in a decision analytic model. Using two examples, we tested and compared the performance of the novel Test-based method with the resampling bootstrap method and with the conventional approach of no adjustment. In the first example, we simulated life expectancy using a simple decision analytic model based on a hypothetical oncology trial with treatment switching. In the second example, we applied the adjustment method on published data when no individual patient data were available. Mean estimates of overall and incremental life expectancy were similar across methods. However, the bootstrapped and test-based estimates consistently produced greater estimates of uncertainty compared with the estimate without any adjustment applied. Similar results were observed when using the test based approach on a published data showing that failing to adjust for uncertainty led to smaller confidence intervals. Both the bootstrapping and test-based approaches provide a solution to appropriately incorporate uncertainty, with the benefit that the latter can implemented by researchers in the absence of individual patient data. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  11. Standardizing the evaluation criteria on treatment outcomes of mandibular implant overdentures: a systematic review

    PubMed Central

    Kim, Ha-Young; Shin, Sang-Wan

    2014-01-01

    PURPOSE The aim of this review was to analyze the evaluation criteria on mandibular implant overdentures through a systematic review and suggest standardized evaluation criteria. MATERIALS AND METHODS A systematic literature search was conducted by PubMed search strategy and hand-searching of relevant journals from included studies considering inclusion and exclusion criteria. Randomized clinical trials (RCT) and clinical trial studies comparing attachment systems on mandibular implant overdentures until December, 2011 were selected. Twenty nine studies were finally selected and the data about evaluation methods were collected. RESULTS Evaluation criteria could be classified into 4 groups (implant survival, peri-implant tissue evaluation, prosthetic evaluation, and patient satisfaction). Among 29 studies, 21 studies presented implant survival rate, while any studies reporting implant failure did not present cumulative implant survival rate. Seventeen studies evaluating peri-implant tissue status presented following items as evaluation criteria; marginal bone level (14), plaque Index (13), probing depth (8), bleeding index (8), attachment gingiva level (8), gingival index (6), amount of keratinized gingiva (1). Eighteen studies evaluating prosthetic maintenance and complication also presented following items as evaluation criteria; loose matrix (17), female detachment (15), denture fracture (15), denture relining (14), abutment fracture (14), abutment screw loosening (11), and occlusal adjustment (9). Atypical questionnaire (9), Visual analog scales (VAS) (4), and Oral Health Impact Profile (OHIP) (1) were used as the format of criteria to evaluate patients satisfaction in 14 studies. CONCLUSION For evaluation of implant overdenture, it is necessary to include cumulative survival rate for implant evaluation. It is suggested that peri-implant tissue evaluation criteria include marginal bone level, plaque index, bleeding index, probing depth, and attached gingiva level. It is also suggested that prosthetic evaluation criteria include loose matrix, female detachment, denture fracture, denture relining, abutment fracture, abutment screw loosening, and occlusal adjustment. Finally standardized criteria like OHIP-EDENT or VAS are required for patient satisfaction. PMID:25352954

  12. Stress, Coping, and Psychological Adjustment of Adults with Sickle Cell Disease.

    ERIC Educational Resources Information Center

    Thompson, Robert J., Jr.; And Others

    1992-01-01

    Examined psychological adjustment to sickle cell disease (SCD) among 109 African-American adults. Good psychological adjustment was associated with lower levels of perceived daily stress and stress regarding SCD illness tasks, higher efficacy expectations, less use of palliative coping methods and negative thinking/passive adherence pain-coping…

  13. 26 CFR 1.163-10T - Qualified residence interest (temporary).

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...)Example. (6)Highest principal balance. (7)Other methods provided by the Commissioner. (8)Anti-abuse rule... adjusted purchase price and fair market value. (1)Adjusted purchase price. (i)In general. (ii)Adjusted purchase price of a qualified residence acquired incident to divorce. (iii)Examples. (2)Fair market value...

  14. 26 CFR 1.163-10T - Qualified residence interest (temporary).

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...)Example. (6)Highest principal balance. (7)Other methods provided by the Commissioner. (8)Anti-abuse rule... adjusted purchase price and fair market value. (1)Adjusted purchase price. (i)In general. (ii)Adjusted purchase price of a qualified residence acquired incident to divorce. (iii)Examples. (2)Fair market value...

  15. 26 CFR 1.163-10T - Qualified residence interest (temporary).

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...)Example. (6)Highest principal balance. (7)Other methods provided by the Commissioner. (8)Anti-abuse rule... adjusted purchase price and fair market value. (1)Adjusted purchase price. (i)In general. (ii)Adjusted purchase price of a qualified residence acquired incident to divorce. (iii)Examples. (2)Fair market value...

  16. Social and Emotional Adjustment of Siblings of Children with Autism

    ERIC Educational Resources Information Center

    Pilowsky, Tammy; Yirmiya, Nurit; Doppelt, Osnat; Gross-Tsur, Varda; Shalev, Ruth S.

    2004-01-01

    Background: Social and emotional adjustment of siblings of children with autism was examined, to explore their risk or resilience to effects of genetic liability and environmental factors involved in having a sibling with autism. Method: Social-emotional adjustment, behavior problems, socialization skills, and siblings' relationships were compared…

  17. Adjustment of High School Dropouts in Closed Religious Communities

    ERIC Educational Resources Information Center

    Itzhaki, Yael; Itzhaky, Haya; Yablon, Yaacov B.

    2018-01-01

    Background: While extensive research has been done on high-school dropouts' adjustment, there is little data on dropouts from closed religious communities. Objective: This study examines the contribution of personal and social resources to the adjustment of high school dropouts in Ultraorthodox Jewish communities in Israel. Method: Using a…

  18. Maladjustment of Bully-Victims: Validation with Three Identification Methods

    ERIC Educational Resources Information Center

    Yang, An; Li, Xiang; Salmivalli, Christina

    2016-01-01

    Although knowledge on the psychosocial (mal)adjustment of bully-victims, children who bully others and are victimised by others, has been increasing, the findings have been principally gained utilising a single method to identify bully-victims. The present study examined the psychosocial adjustment of bully-victims (as compared with pure bullies…

  19. Adjusting slash pine growth and yield for silvicultural treatments

    Treesearch

    Stephen R. Logan; Barry D. Shiver

    2006-01-01

    With intensive silvicultural treatments such as fertilization and competition control now commonplace in today's slash pine (Pinus elliottii Engelm.) plantations, a method to adjust current growth and yield models is required to accurately account for yield increases due to these practices. Some commonly used ad-hoc methods, such as raising site...

  20. 198 AAAAI Survey on Immunotherapy Practice Patterns Concerning Dosing, Dose-Adjustment after Missed Doses and Duration of Immunotherapy

    PubMed Central

    Linnemann, Désirée Larenas; Gupta, Payel; Mithani, Sima; Ponda, Punita

    2012-01-01

    Background Several practical issues dealing with the exact application of allergen immunotherapy (AIT) among European and US allergists are not well known. Guidelines on AIT give recommendations and suggestions for only some of them. We present this unique survey with worldwide response. Methods The AAAAI immunotherapy committee conducted a web-based practice patterns survey (program: Survey Monkey) among all members in&outside US on dosing, dose-adjustment after missed doses and duration of AIT. Results 1201 Returned questionnaires (almost 25% response rate). 21% were non-US-Canada members. Maintenance doses in USCan are (mean/median): Dermatophagoides farinae (Df) combined with Dermatophagoides pteronyssinus (Dpt): 2155/1000AU; Df solo 2484/1000AU. Dpt when combined with Df 1937/1000AU; Dpt solo: 2183/1000AU.Cat 3224/2000BAU. Grass 11,410/4000BAU. 57-65% of the dosing falls within the recommended Practice Parameters recommended ranges. Non-USCan allergists expressed maintenance doses in many different units making analysis impossible. Dose-adjustment after missed doses is based on ‘time elapsed since the last applied dose’ by 77% of USCan and 58% of non-USCan allergists and on ‘time since missed scheduled dose’ by the rest. Doses are adjusted when a patient comes in more than 14 d/5 wk after the last administration at build-up/maintenance by both USCan and non-USCan colleagues. The mostly followed dose-adjustment schedules after 1, 2, 3 missed doses are: Build-up: repeat last dose, reduce by one dose, reduce by 2 doses; maintenance: reduce by one dose, reduce by 2 doses, reduce by 3 doses. 26% uses a different approach reducing doses by a certain percentage or volume. AIT is restarted after a gap in build-up of >30 days and of >12 weeks during maintenance in both groups (median). Outside USCan AIT is prescribed for 3 years (Median). However, 75% of USCan allergists prescribes AIT for 5 years. Main reasons why to continue AIT beyond 5 years: ‘symptoms came back after stopping’ or “patient afraid to relapse.” Conclusions These results show regional differences on some points (especially AIT duration) and they suggest in which direction to plan further research in 2 areas to establish universal dose-adjustment plans for missed applications and define the usefulness (or lack of) of long-term AIT. Moreover, there is still room for improvement in the way AIT is dosed.

  1. A Novel Method to Increase LinLog CMOS Sensors’ Performance in High Dynamic Range Scenarios

    PubMed Central

    Martínez-Sánchez, Antonio; Fernández, Carlos; Navarro, Pedro J.; Iborra, Andrés

    2011-01-01

    Images from high dynamic range (HDR) scenes must be obtained with minimum loss of information. For this purpose it is necessary to take full advantage of the quantification levels provided by the CCD/CMOS image sensor. LinLog CMOS sensors satisfy the above demand by offering an adjustable response curve that combines linear and logarithmic responses. This paper presents a novel method to quickly adjust the parameters that control the response curve of a LinLog CMOS image sensor. We propose to use an Adaptive Proportional-Integral-Derivative controller to adjust the exposure time of the sensor, together with control algorithms based on the saturation level and the entropy of the images. With this method the sensor’s maximum dynamic range (120 dB) can be used to acquire good quality images from HDR scenes with fast, automatic adaptation to scene conditions. Adaptation to a new scene is rapid, with a sensor response adjustment of less than eight frames when working in real time video mode. At least 67% of the scene entropy can be retained with this method. PMID:22164083

  2. A novel method to increase LinLog CMOS sensors' performance in high dynamic range scenarios.

    PubMed

    Martínez-Sánchez, Antonio; Fernández, Carlos; Navarro, Pedro J; Iborra, Andrés

    2011-01-01

    Images from high dynamic range (HDR) scenes must be obtained with minimum loss of information. For this purpose it is necessary to take full advantage of the quantification levels provided by the CCD/CMOS image sensor. LinLog CMOS sensors satisfy the above demand by offering an adjustable response curve that combines linear and logarithmic responses. This paper presents a novel method to quickly adjust the parameters that control the response curve of a LinLog CMOS image sensor. We propose to use an Adaptive Proportional-Integral-Derivative controller to adjust the exposure time of the sensor, together with control algorithms based on the saturation level and the entropy of the images. With this method the sensor's maximum dynamic range (120 dB) can be used to acquire good quality images from HDR scenes with fast, automatic adaptation to scene conditions. Adaptation to a new scene is rapid, with a sensor response adjustment of less than eight frames when working in real time video mode. At least 67% of the scene entropy can be retained with this method.

  3. Dietary and Behavioral Adjustments to Manage Bowel Dysfunction After Surgery in Long-Term Colorectal Cancer Survviors

    PubMed Central

    Sun, Virginia; Grant, Marcia; Wendel, Christopher S.; McMullen, Carmit K.; Bulkley, Joanna E.; Altschuler, Andrea; Ramirez, Michelle; Baldwin, Carol M.; Herrinton, Lisa J.; Hornbrook, Mark C.; Krouse, Robert S.

    2015-01-01

    BACKGROUND Bowel dysfunction is a known complication of colorectal cancer (CRC) surgery. Poor bowel control has a detrimental impact on survivors’ health-related quality of life (HRQOL). This analysis describes the dietary and behavioral adjustments used by CRC survivors to manage bowel dysfunction and compares adjustments used by survivors with permanent ostomy to those with anastomosis. METHODS This mixed-methods analysis included pooled data from several studies that assessed HRQOL in CRC survivors. In all studies, CRC survivors with or without permanent ostomies (N=856) were surveyed using the City of Hope Quality of Life Colorectal Cancer tool. Dietary adjustments were compared by ostomy status and by overall HRQOL score (high versus low). Qualitative data from 13 focus groups and 30 interviews were analyzed to explore specific strategies used by survivors to manage bowel dysfunction. RESULTS CRC survivors made substantial, permanent dietary and behavioral adjustments after surgery, regardless of ostomy status. Survivors who took longer after surgery to become comfortable with their diet or regain their appetite were more likely to report worse HRQOL. Adjustments to control bowel function were divided into four major strategies: dietary adjustments, behavioral adjustments, exercise, and medication use. CONCLUSIONS CRC survivors struggled with unpredictable bowel function and may fail to find a set of management strategies to achieve regularity. Understanding the myriad adjustments used by CRC survivors may lead to evidence-based interventions to foster positive adjustments after surgery and through long-term survivorship. PMID:26159443

  4. Adjusted regression trend test for a multicenter clinical trial.

    PubMed

    Quan, H; Capizzi, T

    1999-06-01

    Studies using a series of increasing doses of a compound, including a zero dose control, are often conducted to study the effect of the compound on the response of interest. For a one-way design, Tukey et al. (1985, Biometrics 41, 295-301) suggested assessing trend by examining the slopes of regression lines under arithmetic, ordinal, and arithmetic-logarithmic dose scalings. They reported the smallest p-value for the three significance tests on the three slopes for safety assessments. Capizzi et al. (1992, Biometrical Journal 34, 275-289) suggested an adjusted trend test, which adjusts the p-value using a trivariate t-distribution, the joint distribution of the three slope estimators. In this paper, we propose an adjusted regression trend test suitable for two-way designs, particularly for multicenter clinical trials. In a step-down fashion, the proposed trend test can be applied to a multicenter clinical trial to compare each dose with the control. This sequential procedure is a closed testing procedure for a trend alternative. Therefore, it adjusts p-values and maintains experimentwise error rate. Simulation results show that the step-down trend test is overall more powerful than a step-down least significant difference test.

  5. IC layout adjustment method and tool for improving dielectric reliability at interconnects

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

    Kahng, Andrew B.; Chan, Tuck Boon

    Method for adjusting a layout used in making an integrated circuit includes one or more interconnects in the layout that are susceptible to dielectric breakdown are selected. One or more selected interconnects are adjusted to increase via to wire spacing with respect to at least one via and one wire of the one or more selected interconnects. Preferably, the selecting analyzes signal patterns of interconnects, and estimates the stress ratio based on state probability of routed signal nets in the layout. An annotated layout is provided that describes distances by which one or more via or wire segment edges aremore » to be shifted. Adjustments can include thinning and shifting of wire segments, and rotation of vias.« less

  6. Factoring socioeconomic status into cardiac performance profiling for hospitals: does it matter?

    PubMed

    Alter, David A; Austin, Peter C; Naylor, C David; Tu, Jack V

    2002-01-01

    Critics of "scorecard medicine" often highlight the incompleteness of risk-adjustment methods used when accounting for baseline patient differences. Although socioeconomic status is a highly important determinant of adverse outcome for patients admitted to the hospital with acute myocardial infarction, it has not been used in most risk-adjustment models for cardiovascular report cards. To determine the incremental impact of socioeconomic status adjustments on age, sex, and illness severity for hospital-specific 30-day mortality rates after acute myocardial infarction. The authors compared the absolute and relative hospital-specific 30-day acute myocardial infarction mortality rates in 169 hospitals throughout Ontario between April 1, 1994 and March 31, 1997. Patient socioeconomic status was characterized by median neighborhood income using postal codes and 1996 Canadian census data. They examined two risk-adjustment models: the first adjusted for age, sex, and illness severity (standard), whereas the second adjusted for age, sex, illness severity, and median neighborhood income level (socioeconomic status). There was an extremely strong correlation between 'standard' and 'socioeconomic status' risk-adjusted mortality rates (r = 0.99). Absolute differences in 30-day risk-adjusted mortality rates between the socioeconomic status and standard risk-adjustment models were small (median, 0.1%; 25th-75th percentile, 0.1-0.2). The agreement in the quintile rankings of hospitals between the socioeconomic status and standard risk-adjustment models was high (weighted kappa = 0.93). Despite its importance as a determinant of patient outcomes, the effect of socioeconomic status on hospital-specific mortality rates over and above standard risk-adjustment methods for acute myocardial infarction hospital profiling in Ontario was negligible.

  7. Observational intensity bias associated with illness adjustment: cross sectional analysis of insurance claims

    PubMed Central

    Staiger, Douglas O; Sharp, Sandra M; Gottlieb, Daniel J; Bevan, Gwyn; McPherson, Klim; Welch, H Gilbert

    2013-01-01

    Objective To determine the bias associated with frequency of visits by physicians in adjusting for illness, using diagnoses recorded in administrative databases. Setting Claims data from the US Medicare program for services provided in 2007 among 306 US hospital referral regions. Design Cross sectional analysis. Participants 20% sample of fee for service Medicare beneficiaries residing in the United States in 2007 (n=5 153 877). Main outcome measures The effect of illness adjustment on regional mortality and spending rates using standard and visit corrected illness methods for adjustment. The standard method adjusts using comorbidity measures based on diagnoses listed in administrative databases; the modified method corrects these measures for the frequency of visits by physicians. Three conventions for measuring comorbidity are used: the Charlson comorbidity index, Iezzoni chronic conditions, and hierarchical condition categories risk scores. Results The visit corrected Charlson comorbidity index explained more of the variation in age, sex, and race mortality across the 306 hospital referral regions than did the standard index (R2=0.21 v 0.11, P<0.001) and, compared with sex and race adjusted mortality, reduced regional variation, whereas adjustment using the standard Charlson comorbidity index increased it. Although visit corrected and age, sex, and race adjusted mortality rates were similar in hospital referral regions with the highest and lowest fifths of visits, adjustment using the standard index resulted in a rate that was 18% lower in the highest fifth (46.4 v 56.3 deaths per 1000, P<0.001). Age, sex, and race adjusted spending as well as visit corrected spending was more than 30% greater in the highest fifth of visits than in the lowest fifth, but only 12% greater after adjustment using the standard index. Similar results were obtained using the Iezzoni and the hierarchical condition categories conventions for measuring comorbidity. Conclusion The rates of visits by physicians introduce substantial bias when regional mortality and spending rates are adjusted for illness using comorbidity measures based on the observed number of diagnoses recorded in Medicare’s administrative database. Adjusting without correction for regional variation in visit rates tends to make regions with high rates of visits seem to have lower mortality and lower costs, and vice versa. Visit corrected comorbidity measures better explain variation in age, sex, and race mortality than observed measures, and reduce observational intensity bias. PMID:23430282

  8. The SLUScore: A Novel Method for Detecting Hazardous Hypotension in Adult Patients Undergoing Noncardiac Surgical Procedures

    PubMed Central

    Yuan, Hui; Dryden, Jefferson K.; Strehl, Kristen E.; Cywinski, Jacek B.; Ehrenfeld, Jesse M.; Bromley, Pamela

    2017-01-01

    BACKGROUND: It has been suggested that longer-term postsurgical outcome may be adversely affected by less than severe hypotension under anesthesia. However, evidence-based guidelines are unavailable. The present study was designed to develop a method for identifying patients at increased risk of death within 30 days in association with the severity and duration of intraoperative hypotension. METHODS: Intraoperative mean arterial blood pressure recordings of 152,445 adult patients undergoing noncardiac surgery were analyzed for periods of time accumulated below each one of the 31 thresholds between 75 and 45 mm Hg (hypotensive exposure times). In a development cohort of 35,904 patients, the associations were sought between each of these 31 cumulative hypotensive exposure times and 30-day postsurgical mortality. On the basis of covariable-adjusted percentage increases in the odds of mortality per minute elapsed of hypotensive exposure time, certain sets of exposure time limits were calculated that portended certain percentage increases in the odds of mortality. A novel risk-scoring method was conceived by counting the number of exposure time limits that had been exceeded within each respective set, one of them being called the SLUScore. The validity of this new method in identifying patients at increased risk was tested in a multicenter validation cohort consisting of 116,541 patients from Cleveland Clinic, Vanderbilt and Saint Louis Universities. Data were expressed as 95% confidence interval, P < .05 considered significant. RESULTS: Progressively greater hypotensive exposures were associated with greater 30-day mortality. In the development cohort, covariable-adjusted (age, Charlson score, case duration, history of hypertension) exposure limits were identified for time accumulated below each of the thresholds that portended certain identical (5%–50%) percentage expected increases in the odds of mortality. These exposure time limit sets were shorter in patients with a history of hypertension. A novel risk score, the SLUScore (range 0–31), was conceived as the number of exposure limits exceeded for one of these sets (20% set). A SLUScore > 0 (average 13.8) was found in 40% of patients who had twice the mortality, adjusted odds increasing by 5% per limit exceeded. When tested in the validation cohort, a SLUScore > 0 (average 14.1) identified 35% of patients who had twice the mortality, each incremental limit exceeded portending a 5% compounding increase in adjusted odds of mortality, independent of age and Charlson score (C = 0.73, 0.72–0.74, P < .05). CONCLUSIONS: The SLUScore represents a novel method for identifying nearly 1 in every 3 patients experiencing greater 30-day mortality portended by more severe intraoperative hypotensive exposures. PMID:28107274

  9. [The methods within the evaluation of disease management programmes in control-group designs using the example of diabetes mellitus - a systematic literature review].

    PubMed

    Drabik, A; Sawicki, P T; Müller, D; Passon, A; Stock, S

    2012-08-01

    Disease management programmes (DMPs) were implemented in Germany in 2002. Their evaluation is required by law. Beyond the mandatory evaluation, a growing number of published studies evaluate the DMP for diabetes mellitus type 2 in a control-group design. As patients opt into the programme on a voluntary basis it is necessary to adjust the inherent selection bias between groups. The aim of this study is to review published studies which evaluate the diabetes DMP using a control-group design with respect to the methods used. A systematic literature review of electronic databases (PUBMED, Cochrane Library, EMBASE, MEDPILOT) and a hand search of reference lists of the relevant publications was conducted to identify studies evaluating the DMP diabetes mellitus in a control-group design. 8 studies were included in the systematic literature review. 4 studies gathered retrospective claims data from sickness funds, one from physician's records, one study used prospective data from ambulatory care, and 2 studies were based on one patient survey. Methods used for adjustment of selection bias included exact matching, matching using propensity score methods, age-adjusted and sex-separated analysis, and adjustment in a regression model/analysis of covariance. One study did not apply adjustment methods. The intervention period ranged from 1 day to 4 years. Considered outcomes of studies (surrogate parameter, diabetes complications, mortality, quality of life, and claim data) depended on the database. In the evaluation of the DMP diabetes mellitus based on a control-group design neither the database nor the methods used for selection bias adjustment were consistent in the available studies. Effectiveness of DMPs cannot be judged based on this review due to heterogeneity of study designs. To allow for a comprehensive programme evaluation standardised minimum requirements for the evaluation of DMPs in the control group design are required. © Georg Thieme Verlag KG Stuttgart · New York.

  10. Linking data sources for measurement of effective coverage in maternal and newborn health: what do we learn from individual- vs ecological-linking methods?

    PubMed

    Willey, Barbara; Waiswa, Peter; Kajjo, Darious; Munos, Melinda; Akuze, Joseph; Allen, Elizabeth; Marchant, Tanya

    2018-06-01

    Improving maternal and newborn health requires improvements in the quality of facility-based care. This is challenging to measure: routine data may be unreliable; respondents in population surveys may be unable to accurately report on quality indicators; and facility assessments lack population level denominators. We explored methods for linking access to skilled birth attendance (SBA) from household surveys to data on provision of care from facility surveys with the aim of estimating population level effective coverage reflecting access to quality care. We used data from Mayuge District, Uganda. Data from household surveys on access to SBA were linked to health facility assessment census data on readiness to provide basic emergency obstetric and newborn care (BEmONC) in the same district. One individual- and two ecological-linking methods were applied. All methods used household survey reports on where care at birth was accessed. The individual-linking method linked this to data about facility readiness from the specific facility where each woman delivered. The first ecological-linking approach used a district-wide mean estimate of facility readiness. The second used an estimate of facility readiness adjusted by level of health facility accessed. Absolute differences between estimates derived from the different linking methods were calculated, and agreement examined using Lin's concordance correlation coefficient. A total of 1177 women resident in Mayuge reported a birth during 2012-13. Of these, 664 took place in facilities within Mayuge, and were eligible for linking to the census of the district's 38 facilities. 55% were assisted by a SBA in a facility. Using the individual-linking method, effective coverage of births that took place with an SBA in a facility ready to provide BEmONC was just 10% (95% confidence interval CI 3-17). The absolute difference between the individual- and ecological-level linking method adjusting for facility level was one percentage point (11%), and tests suggested good agreement. The ecological method using the district-wide estimate demonstrated poor agreement. The proportion of women accessing appropriately equipped facilities for care at birth is far lower than the coverage of facility delivery. To realise the life-saving potential of health services, countries need evidence to inform actions that address gaps in the provision of quality care. Linking household and facility-based information provides a simple but innovative method for estimating quality of care at the population level. These encouraging findings suggest that linking data sets can result in meaningful evidence even when the exact location of care seeking is not known.

  11. Group versus individual family planning counseling in Ghana: a randomized, noninferiority trial.

    PubMed

    Schwandt, Hilary M; Creanga, Andreea A; Danso, Kwabena A; Adanu, Richard M K; Agbenyega, Tsiri; Hindin, Michelle J

    2013-08-01

    Group, rather than individual, family planning counseling has the potential to increase family planning knowledge and use through more efficient use of limited human resources. A randomized, noninferiority study design was utilized to identify whether group family planning counseling is as effective as individual family planning counseling in Ghana. Female gynecology patients were enrolled from two teaching hospitals in Ghana in June and July 2008. Patients were randomized to receive either group or individual family planning counseling. The primary outcome in this study was change in modern contraceptive method knowledge. Changes in family planning use intention before and after the intervention and intended method type were also explored. Comparisons between the two study arms suggest that randomization was successful. The difference in change in modern contraceptive methods known from baseline to follow-up between the two study arms (group-individual), adjusted for study site, was -0.21, (95% confidence interval: -0.53 to 0.12) suggesting no difference between the two arms. Group family planning counseling was as effective as individual family planning counseling in increasing modern contraceptive knowledge among female gynecology patients in Ghana. Copyright © 2013 Elsevier Inc. All rights reserved.

  12. Earning and Learning: Role Congruence, State/Trait Factors and Adjustment to University Life

    ERIC Educational Resources Information Center

    Swanson, Vivien; Broadbridge, Adelina; Karatzias, Athanasios

    2006-01-01

    Background: Undertaking term-time employment is increasingly commonplace for university students. Much research suggests that combining "earning and learning" may be detrimental to university life, generating role conflicts, increasing stress and reducing academic success, participation and overall adjustment to university. Potential…

  13. Psychological Adjustment and Homosexuality.

    ERIC Educational Resources Information Center

    Gonsiorek, John C.

    In this paper, the diverse literature bearing on the topic of homosexuality and psychological adjustment is critically reviewed and synthesized. The first chapter discusses the most crucial methodological issue in this area, the problem of sampling. The kinds of samples used to date are critically examined, and some suggestions for improved…

  14. How effective are geometric morphometric techniques for assessing functional shape variation? An example from the great ape temporomandibular joint.

    PubMed

    Terhune, Claire E

    2013-08-01

    Functional shape analyses have long relied on the use of shape ratios to test biomechanical hypotheses. This method is powerful because of the ease with which results are interpreted, but these techniques fall short in quantifying complex morphologies that may not have a strong biomechanical foundation but may still be functionally informative. In contrast, geometric morphometric methods are continually being adopted for quantifying complex shapes, but they tend to prove inadequate in functional analyses because they have little foundation in an explicit biomechanical framework. The goal of this study was to evaluate the intersection of these two methods using the great ape temporomandibular joint as a case study. Three-dimensional coordinates of glenoid fossa and mandibular condyle shape were collected using a Microscribe digitizer. Linear distances extracted from these landmarks were analyzed using a series of one-way ANOVAs; further, the landmark configurations were analyzed using geometric morphometric techniques. Results suggest that the two methods are broadly similar, although the geometric morphometric data allow for the identification of shape differences among taxa that were not immediately apparent in the univariate analyses. Furthermore, this study suggests several new approaches for translating these shape data into a biomechanical context by adjusting the data using a biomechanically relevant variable. Copyright © 2013 Wiley Periodicals, Inc.

  15. Associations of Mothers’ Friendship Quality with Adolescents’ Friendship Quality and Emotional Adjustment

    PubMed Central

    Glick, Gary C.; Rose, Amanda J.; Swenson, Lance P.; Waller, Erika M.

    2012-01-01

    Little research has examined the association of parents’ friendships with adolescent’s well-being, perhaps because the association was considered too distal. However, developmental theories suggest that contexts in which parents, but not their children, are situated may be related to child development (Bronfenbrenner, 1979; 1986). The current work examined associations between the quality of mothers’ own friendships and their adolescent children’s friendship quality and emotional adjustment. Fifth-, eighth-, and eleventh-graders (N = 172) whose mothers’ friendships were characterized by conflict and antagonism reported having friendships that were high in negative friendship qualities as well as elevated internalizing symptoms. These associations held after controlling for mother-child relationship quality, suggesting that mothers’ friendships may have a unique association with adolescents’ adjustment. PMID:24348001

  16. Adolescents' relationship with God and internalizing adjustment over time: the moderating role of maternal religious coping.

    PubMed

    Goeke-Morey, Marcie C; Taylor, Laura K; Merrilees, Christine E; Shirlow, Peter; Cummings, E Mark

    2014-12-01

    A growing literature supports the importance of understanding the link between religiosity and youths' adjustment and development, but in the absence of rigorous, longitudinal designs, questions remain about the direction of effect and the role of family factors. This paper investigates the bidirectional association between adolescents' relationship with God and their internalizing adjustment. Results from 2-wave, SEM cross-lag analyses of data from 667 mother/adolescent dyads in Belfast, Northern Ireland (50% male, M age = 15.75 years old) supports a risk model suggesting that greater internalizing problems predict a weaker relationship with God 1 year later. Significant moderation analyses suggest that a stronger relationship with God predicted fewer depression and anxiety symptoms for youth whose mothers used more religious coping.

  17. Adolescents’ relationship with God and internalizing adjustment over time: The moderating role of maternal religious coping

    PubMed Central

    Goeke-Morey, Marcie C.; Taylor, Laura K.; Merrilees, Christine E.; Shirlow, Peter; Cummings, E. Mark

    2015-01-01

    A growing literature supports the importance of understanding the link between religiosity and youths’ adjustment and development, but in the absence of rigorous, longitudinal designs, questions remain about the direction of effect and the role of family factors. This paper investigates the bi-directional association between adolescents’ relationship with God and their internalizing adjustment. Results from two-wave, SEM cross-lag analyses of data from 667 mother/adolescent dyads in Belfast, Northern Ireland (50% male, M age = 15.75 years old) supports a risk model suggesting that greater internalizing problems predicts a weaker relationship with God one year later. Significant moderation analyses suggest that a stronger relationship with God predicted fewer depression and anxiety symptoms for youth whose mothers used more religious coping. PMID:24955590

  18. Task feedback effects on conflict monitoring and executive control: relationship to subclinical measures of depression.

    PubMed

    Holmes, Avram J; Pizzagalli, Diego A

    2007-02-01

    Emerging evidence suggests that depression is associated with executive dysfunction, particularly after committing errors or receiving negative performance feedback. To test this hypothesis, 57 participants performed two executive tasks known to elicit errors (the Simon and Stroop Tasks) during positive or negative performance feedback. Participants with elevated depressive symptoms (Beck Depression Inventory scores >or= 13) were characterized by impaired posterror and postconflict performance adjustments, especially during emotionally negative task-related feedback. Additionally, for both tasks, depressive symptoms were inversely related to postconflict reaction time adjustments following negative, but not positive, feedback. These findings suggest that subclinical depression is associated with impairments in behavioral adjustments after internal (perceived failure) and external feedback about deficient task performance. (c) 2007 APA, all rights reserved.

  19. Fast and Accurate Approximation to Significance Tests in Genome-Wide Association Studies

    PubMed Central

    Zhang, Yu; Liu, Jun S.

    2011-01-01

    Genome-wide association studies commonly involve simultaneous tests of millions of single nucleotide polymorphisms (SNP) for disease association. The SNPs in nearby genomic regions, however, are often highly correlated due to linkage disequilibrium (LD, a genetic term for correlation). Simple Bonferonni correction for multiple comparisons is therefore too conservative. Permutation tests, which are often employed in practice, are both computationally expensive for genome-wide studies and limited in their scopes. We present an accurate and computationally efficient method, based on Poisson de-clumping heuristics, for approximating genome-wide significance of SNP associations. Compared with permutation tests and other multiple comparison adjustment approaches, our method computes the most accurate and robust p-value adjustments for millions of correlated comparisons within seconds. We demonstrate analytically that the accuracy and the efficiency of our method are nearly independent of the sample size, the number of SNPs, and the scale of p-values to be adjusted. In addition, our method can be easily adopted to estimate false discovery rate. When applied to genome-wide SNP datasets, we observed highly variable p-value adjustment results evaluated from different genomic regions. The variation in adjustments along the genome, however, are well conserved between the European and the African populations. The p-value adjustments are significantly correlated with LD among SNPs, recombination rates, and SNP densities. Given the large variability of sequence features in the genome, we further discuss a novel approach of using SNP-specific (local) thresholds to detect genome-wide significant associations. This article has supplementary material online. PMID:22140288

  20. Improving Causal Inferences in Meta-analyses of Longitudinal Studies: Spanking as an Illustration.

    PubMed

    Larzelere, Robert E; Gunnoe, Marjorie Lindner; Ferguson, Christopher J

    2018-05-24

    To evaluate and improve the validity of causal inferences from meta-analyses of longitudinal studies, two adjustments for Time-1 outcome scores and a temporally backwards test are demonstrated. Causal inferences would be supported by robust results across both adjustment methods, distinct from results run backwards. A systematic strategy for evaluating potential confounds is also introduced. The methods are illustrated by assessing the impact of spanking on subsequent externalizing problems (child age: 18 months to 11 years). Significant results indicated a small risk or a small benefit of spanking, depending on the adjustment method. These meta-analytic methods are applicable for research on alternatives to spanking and other developmental science topics. The underlying principles can also improve causal inferences in individual studies. © 2018 Society for Research in Child Development.

  1. The adaptive problems of female teenage refugees and their behavioral adjustment methods for coping

    PubMed Central

    Mhaidat, Fatin

    2016-01-01

    This study aimed at identifying the levels of adaptive problems among teenage female refugees in the government schools and explored the behavioral methods that were used to cope with the problems. The sample was composed of 220 Syrian female students (seventh to first secondary grades) enrolled at government schools within the Zarqa Directorate and who came to Jordan due to the war conditions in their home country. The study used the scale of adaptive problems that consists of four dimensions (depression, anger and hostility, low self-esteem, and feeling insecure) and a questionnaire of the behavioral adjustment methods for dealing with the problem of asylum. The results indicated that the Syrian teenage female refugees suffer a moderate degree of adaptation problems, and the positive adjustment methods they have used are more than the negatives. PMID:27175098

  2. Relaxation method of compensation in an optical correlator

    NASA Technical Reports Server (NTRS)

    Juday, Richard D.; Daiuto, Brian J.

    1987-01-01

    An iterative method is proposed for the sharpening of programmable filters in a 4-f optical correlator. Continuously variable spatial light modulators (SLMs) permit the fine adjustment of optical processing filters so as to compensate for the departures from ideal behavior of a real optical system. Although motivated by the development of continuously variable phase-only SLMs, the proposed sharpening method is also applicable to amplitude modulators and, with appropriate adjustments, to binary modulators as well. A computer simulation is presented that illustrates the potential effectiveness of the method: an image is placed on the input to the correlator, and its corresponding phase-only filter is adjusted (allowed to relax) so as to produce a progressively brighter and more centralized peak in the correlation plane. The technique is highly robust against the form of the system's departure from ideal behavior.

  3. Simulation of Changes in Diffusion Related to Different Pathologies at Cellular Level After Traumatic Brain Injury

    PubMed Central

    Lin, Mu; He, Hongjian; Schifitto, Giovanni; Zhong, Jianhui

    2016-01-01

    Purpose The goal of the current study was to investigate tissue pathology at the cellular level in traumatic brain injury (TBI) as revealed by Monte Carlo simulation of diffusion tensor imaging (DTI)-derived parameters and elucidate the possible sources of conflicting findings of DTI abnormalities as reported in the TBI literature. Methods A model with three compartments separated by permeable membranes was employed to represent the diffusion environment of water molecules in brain white matter. The dynamic diffusion process was simulated with a Monte Carlo method using adjustable parameters of intra-axonal diffusivity, axon separation, glial cell volume fraction, and myelin sheath permeability. The effects of tissue pathology on DTI parameters were investigated by adjusting the parameters of the model corresponding to different stages of brain injury. Results The results suggest that the model is appropriate and the DTI-derived parameters simulate the predominant cellular pathology after TBI. Our results further indicate that when edema is not prevalent, axial and radial diffusivity have better sensitivity to axonal injury and demyelination than other DTI parameters. Conclusion DTI is a promising biomarker to detect and stage tissue injury after TBI. The observed inconsistencies among previous studies are likely due to scanning at different stages of tissue injury after TBI. PMID:26256558

  4. Exploring the willingness to pay for a quality-adjusted life-year in the state of Penang, Malaysia

    PubMed Central

    Shafie, Asrul Akmal; Lim, Yen Wei; Chua, Gin Nie; Hassali, Mohammed Azmi Ahmad

    2014-01-01

    Introduction The incremental cost-effectiveness ratio (ICER) is typically compared with a reference value to support the cost-effectiveness of a decision. One method for estimating this value is to estimate the willingness-to-pay (WTP) for a quality-adjusted life-year (QALY). This study was conducted to explore the WTP for a QALY in the Malaysian population. Methods A cross-sectional, contingent valuation study was conducted in Penang, Malaysia. Respondents were selected from randomly chosen geographical grids of Penang. Respondents’ sociodemographic information, qualities of life, and WTP for one additional QALY were collected using predesigned questionnaires in face-to-face interviews. WTP values were elicited using a double-bound dichotomous choice via a bidding game approach. The Heckman selection model was applied to the analysis of the mean WTP/QALY values, where the “protest zero” values, which may contribute to selection bias, were excluded. Results The mean value of WTP for an additional QALY gained was estimated to be MYR (Malaysian Ringgit) 29,080 (~USD 9,000). Key factors that affected the WTP include ethnicity and estimated monthly household income. Conclusion The study findings suggested that the cost-effectiveness threshold value as studied in Penang, Malaysia was estimated to be MYR 29,080. PMID:25364267

  5. A Fully Conserved Minimal Adjustment Scheme with (T, S) Coherency for Stabilization of Hydrographic Profiles

    DTIC Science & Technology

    2012-12-01

    positive definite approximation of the Hessian is updated according to the modified Broyden–Fletcher–Goldfarb– Shanno method (Powell 1978). 3. Data Evident...averaged observational hydrographic data . This method adjusts the temperature and salinity profiles fDTk,DSk,k5 1, 2, . . . ,Kg simultaneously and...in data assimilations since it does not simply reject profiles with static instability. This method edits the profiles with the inequality constraint

  6. Geosat crossover analysis in the tropical Pacific. Part 1: Constrained sinusoidal crossover adjustment

    NASA Technical Reports Server (NTRS)

    Tai, Chang-Kou

    1988-01-01

    A new method (constrained sinusoidal crossover adjustment) for removing the orbit error in satellite altimetry is tested (using crossovers accumulated in the first 91 days of the Geosat non-repeat era in the tropical Pacific) and found to have excellent qualities. Two features distinguish the new method from the conventional bias-and-tilt crossover adjustment. First, a sine wave (with wavelength equaling the circumference of the Earth) is used to represent the orbit error for each satellite revolution, instead of the bias-and-tilt (and curvature, if necessary) approach for each segment of the satellite ground track. Secondly, the indeterminacy of the adjustment process is removed by a simple constraint minimizing the amplitudes of the sine waves, rather than by fixing selected tracks. Overall the new method is more accurate, more efficient, and much less cumbersome than the old. The idea of restricting the crossover adjustment to crossovers between tracks that are less than certain days apart in order to preserve the large-scale long-term oceanic variability is also tested with inconclusive results because the orbit error was unusually nonstationary in the initial 91 days of the GEOSAT mission.

  7. [Evaluation of the adjusted amino acid score by digestibility for estimating the protein quality and protein available in food and diets].

    PubMed

    Pak, N; Vera, G; Araya, H

    1985-03-01

    The purpose of the present study was to evaluate the amino acid score adjusted by digestibility to estimate protein quality and utilizable protein in foods and diets, considering net protein utilization (NPU) as a biological reference method. Ten foods of vegetable origin and ten of animal origin, as well as eight mixtures of foods of vegetable and animal origin were studied. When all the foods were considered, a positive (r = 0.83) and highly significant correlation (p less than 0.001) between NPU and the amino acid score adjusted by digestibility was found. When the foods were separated according to their origin, this correlation was positive only for the foods of vegetable origin (r = 0.93) and statistically significant (p less than 0.001). Also, only in those foods were similar values found between NPU and amino acid score adjusted by digestibility, as well as in utilizable protein estimated considering both methods. Caution is required to interpret protein quality and utilizable protein values of foods of animal origin and mixtures of foods of vegetable and animal origin when the amino acid score method adjusted by digestibility, or NPU, are utilized.

  8. Using the principle of entropy maximization to infer genetic interaction networks from gene expression patterns.

    PubMed

    Lezon, Timothy R; Banavar, Jayanth R; Cieplak, Marek; Maritan, Amos; Fedoroff, Nina V

    2006-12-12

    We describe a method based on the principle of entropy maximization to identify the gene interaction network with the highest probability of giving rise to experimentally observed transcript profiles. In its simplest form, the method yields the pairwise gene interaction network, but it can also be extended to deduce higher-order interactions. Analysis of microarray data from genes in Saccharomyces cerevisiae chemostat cultures exhibiting energy metabolic oscillations identifies a gene interaction network that reflects the intracellular communication pathways that adjust cellular metabolic activity and cell division to the limiting nutrient conditions that trigger metabolic oscillations. The success of the present approach in extracting meaningful genetic connections suggests that the maximum entropy principle is a useful concept for understanding living systems, as it is for other complex, nonequilibrium systems.

  9. Factors discriminating among profiles of resilience and psychopathology in children exposed to intimate partner violence (IPV).

    PubMed

    Graham-Bermann, Sandra A; Gruber, Gabrielle; Howell, Kathryn H; Girz, Laura

    2009-09-01

    To evaluate the social and emotional adjustment of 219 children in families with varying levels of intimate partner violence (IPV) using a model of risk and protection. To explore factors that differentiate children with poor adjustment from those with resilience. Mothers who experienced IPV in the past year and their children ages 6-12 were interviewed. Standardized measures assessed family violence, parenting, family functioning, maternal mental health, and children's adjustment and beliefs. Using cluster analysis, all cases with valid data on the Child Behavior Checklist, Child Depression Inventory, General Self-Worth and Social Self-Competence measures were described by four profiles of children's adjustment: Severe Adjustment Problems (24%); children who were Struggling (45%); those with Depression Only (11%); and Resilient (20%) with high competence and low adjustment problems. Multinomial logistic regression analyses showed children in the Severe Problems cluster witnessed more family violence and had mothers higher in depression and trauma symptoms than other children. Resilient and Struggling children had mothers with better parenting, more family strengths and no past violent partner. Parents of children with Severe Problems were lacking these attributes. The Depressed profile children witnessed less violence but had greater fears and worries about mother's safety. Factors related to the child, to the mother and to the family distinguish different profiles of adjustment for children exposed to IPV who are living in the community. Resilient children have less violence exposure, fewer fears and worries, and mothers with better mental health and parenting skills, suggesting avenues for intervention with this population. Findings suggest that child adjustment is largely influenced by parent functioning. Thus, services should be targeted at both the child and the parent. Clinical interventions shaped to the unique needs of the child might also be tested with this population.

  10. Emotion recognition and social adjustment in school-aged girls and boys.

    PubMed

    Leppänen, J M; Hietanen, J K

    2001-12-01

    The present study investigated emotion recognition accuracy and its relation to social adjustment in 7-10 year-old children. The ability to recognize basic emotions from facial and vocal expressions was measured and compared to peer popularity and to teacher-rated social competence. The results showed that emotion recognition was related to these measures of social adjustment, but the gender of a child and emotion category affected this relationship. Emotion recognition accuracy was significantly related to social adjustment for the girls, but not for the boys. For the girls, especially the recognition of surprise was related to social adjustment. Together, these results suggest that the ability to recognize others' emotional states from nonverbal cues is an important socio-cognitive ability for school-aged girls.

  11. Does Fall History Influence Residential Adjustments?

    ERIC Educational Resources Information Center

    Leland, Natalie; Porell, Frank; Murphy, Susan L.

    2011-01-01

    Purpose of the study: To determine whether reported falls at baseline are associated with an older adult's decision to make a residential adjustment (RA) and the type of adjustment made in the subsequent 2 years. Design and Methods: Observations (n = 25,036) were from the Health and Retirement Study, a nationally representative sample of…

  12. Self calibration of the stereo vision system of the Chang'e-3 lunar rover based on the bundle block adjustment

    NASA Astrophysics Data System (ADS)

    Zhang, Shuo; Liu, Shaochuang; Ma, Youqing; Qi, Chen; Ma, Hao; Yang, Huan

    2017-06-01

    The Chang'e-3 was the first lunar soft landing probe of China. It was composed of the lander and the lunar rover. The Chang'e-3 successful landed in the northwest of the Mare Imbrium in December 14, 2013. The lunar rover completed the movement, imaging and geological survey after landing. The lunar rover equipped with a stereo vision system which was made up of the Navcam system, the mast mechanism and the inertial measurement unit (IMU). The Navcam system composed of two cameras with the fixed focal length. The mast mechanism was a robot with three revolute joints. The stereo vision system was used to determine the position of the lunar rover, generate the digital elevation models (DEM) of the surrounding region and plan the moving paths of the lunar rover. The stereo vision system must be calibrated before use. The control field could be built to calibrate the stereo vision system in the laboratory on the earth. However, the parameters of the stereo vision system would change after the launch, the orbital changes, the braking and the landing. Therefore, the stereo vision system should be self calibrated on the moon. An integrated self calibration method based on the bundle block adjustment is proposed in this paper. The bundle block adjustment uses each bundle of ray as the basic adjustment unit and the adjustment is implemented in the whole photogrammetric region. The stereo vision system can be self calibrated with the proposed method under the unknown lunar environment and all parameters can be estimated simultaneously. The experiment was conducted in the ground lunar simulation field. The proposed method was compared with other methods such as the CAHVOR method, the vanishing point method, the Denavit-Hartenberg method, the factorization method and the weighted least-squares method. The analyzed result proved that the accuracy of the proposed method was superior to those of other methods. Finally, the proposed method was practical used to self calibrate the stereo vision system of the Chang'e-3 lunar rover on the moon.

  13. Surface passivation for CdTe devices

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

    Reese, Matthew O.; Perkins, Craig L.; Burst, James M.

    2017-08-01

    In one embodiment, a method for surface passivation for CdTe devices is provided. The method includes adjusting a stoichiometry of a surface of a CdTe material layer such that the surface becomes at least one of stoichiometric or Cd-rich; and reconstructing a crystalline lattice at the surface of the CdTe material layer by annealing the adjusted surface.

  14. Children's Perceptions of Corporal Punishment, Caretaker Acceptance, and Psychological Adjustment in a Poor, Biracial Southern Community.

    ERIC Educational Resources Information Center

    Rohner, Ronald P.; And Others

    1996-01-01

    Explores interrelationships among physical punishment, perceived caretaker acceptance-rejection, and youths' psychological adjustment. Administered self-report questionnaires to 281 school children in grades 3 through 12. Results suggest that physical punishment is associated with children's psychological maladjustment only if youths perceive…

  15. An Exposition of Fischer's Model of Overlapping Contracts.

    ERIC Educational Resources Information Center

    Fields, T. Windsor; Hart, William R.

    1992-01-01

    Suggests how the classic model of overlapping contracts can be incorporated into the contract wage model of aggregate supply. Illustrates dynamics of macroeconomic adjustment following a shock to aggregate demand. Concludes that overlapping contracts do not prolong the adjustment process; rather, the longest remaining contract determines the time…

  16. Electronic and School-Based Victimization: Unique Contexts for Adjustment Difficulties during Adolescence

    ERIC Educational Resources Information Center

    Fredstrom, Bridget K.; Adams, Ryan E.; Gilman, Rich

    2011-01-01

    Previous research suggests that school-based and electronic victimization have similar negative consequences, yet it is unclear whether these two contexts offer overlapping or unique associations with adolescents' adjustment. 802 ninth-graders (43% male, mean age = 15.84 years), majority being Caucasian (82%), completed measures assessing the…

  17. ESTIMATION OF EMISSION ADJUSTMENTS FROM THE APPLICATION OF FOUR-DIMENSIONAL DATA ASSIMILATION TO PHOTOCHEMICAL AIR QUALITY MODELING. (R826372)

    EPA Science Inventory

    Four-dimensional data assimilation applied to photochemical air quality modeling is used to suggest adjustments to the emissions inventory of the Atlanta, Georgia metropolitan area. In this approach, a three-dimensional air quality model, coupled with direct sensitivity analys...

  18. The Impact of Divorce: A Multivariate Study.

    ERIC Educational Resources Information Center

    Kolevzon, Michael S.; Gottlieb, Susan J.

    1983-01-01

    Surveyed 157 divorced parents to assess phases of emotional adjustment following divorce. Findings provided no evidence to suggest that particular dimensions of emotional adjustment represent challenges unique to particular stages of divorce. The intensity and the duration of emotional challenges were affected by a number of intervening variables.…

  19. New School Blues: Helping Children Adjust After a Family Move.

    ERIC Educational Resources Information Center

    Anderson, Marilyn

    2001-01-01

    Presents suggestions for parents to help their children make the adjustment to a new school, focusing on: understanding how moving affects children, teens, and in-betweens; meeting the school counselor or psychologist; looking for warning signs (e.g., prolonged anxiety, depression, or interrupted sleeping); and providing reassurance. A sidebar…

  20. "Why Me?" An Attributional Theory of Adjustment to Victimization.

    ERIC Educational Resources Information Center

    Shaffer, Leigh S.; And Others

    Studies on victimization suggest that victims, whether of crime, accident, disease, or natural disaster, ask "why me?" questions and that finding answers to these questions seems related to the victims' adjustment. An attributional theory of victims' search for meaning in their misfortune proposes that victims perceive their misfortunes as…

  1. Estimating Concentrations of Road-Salt Constituents in Highway-Runoff from Measurements of Specific Conductance

    USGS Publications Warehouse

    Granato, Gregory E.; Smith, Kirk P.

    1999-01-01

    Discrete or composite samples of highway runoff may not adequately represent in-storm water-quality fluctuations because continuous records of water stage, specific conductance, pH, and temperature of the runoff indicate that these properties fluctuate substantially during a storm. Continuous records of water-quality properties can be used to maximize the information obtained about the stormwater runoff system being studied and can provide the context needed to interpret analyses of water samples. Concentrations of the road-salt constituents calcium, sodium, and chloride in highway runoff were estimated from theoretical and empirical relations between specific conductance and the concentrations of these ions. These relations were examined using the analysis of 233 highwayrunoff samples collected from August 1988 through March 1995 at four highway-drainage monitoring stations along State Route 25 in southeastern Massachusetts. Theoretically, the specific conductance of a water sample is the sum of the individual conductances attributed to each ionic species in solution-the product of the concentrations of each ion in milliequivalents per liter (meq/L) multiplied by the equivalent ionic conductance at infinite dilution-thereby establishing the principle of superposition. Superposition provides an estimate of actual specific conductance that is within measurement error throughout the conductance range of many natural waters, with errors of less than ?5 percent below 1,000 microsiemens per centimeter (?S/cm) and ?10 percent between 1,000 and 4,000 ?S/cm if all major ionic constituents are accounted for. A semi-empirical method (adjusted superposition) was used to adjust for concentration effects-superposition-method prediction errors at high and low concentrations-and to relate measured specific conductance to that calculated using superposition. The adjusted superposition method, which was developed to interpret the State Route 25 highway-runoff records, accounts for contributions of constituents other than calcium, sodium, and chloride in dilute waters. The adjusted superposition method also accounts for the attenuation of each constituent's contribution to conductance as ionic strength increases. Use of the adjusted superposition method generally reduced predictive error to within measurement error throughout the range of specific conductance (from 37 to 51,500 ?S/cm) in the highway runoff samples. The effects of pH, temperature, and organic constituents on the relation between concentrations of dissolved constituents and measured specific conductance were examined but these properties did not substantially affect interpretation of the Route 25 data set. Predictive abilities of the adjusted superposition method were similar to results obtained by standard regression techniques, but the adjusted superposition method has several advantages. Adjusted superposition can be applied using available published data about the constituents in precipitation, highway runoff, and the deicing chemicals applied to a highway. This semi-empirical method can be used as a predictive and diagnostic tool before a substantial number of samples are collected, but the power of the regression method is based upon a large number of water-quality analyses that may be affected by a bias in the data.

  2. Kinematic synthesis of adjustable robotic mechanisms

    NASA Astrophysics Data System (ADS)

    Chuenchom, Thatchai

    1993-01-01

    Conventional hard automation, such as a linkage-based or a cam-driven system, provides high speed capability and repeatability but not the flexibility required in many industrial applications. The conventional mechanisms, that are typically single-degree-of-freedom systems, are being increasingly replaced by multi-degree-of-freedom multi-actuators driven by logic controllers. Although this new trend in sophistication provides greatly enhanced flexibility, there are many instances where the flexibility needs are exaggerated and the associated complexity is unnecessary. Traditional mechanism-based hard automation, on the other hand, neither can fulfill multi-task requirements nor are cost-effective mainly due to lack of methods and tools to design-in flexibility. This dissertation attempts to bridge this technological gap by developing Adjustable Robotic Mechanisms (ARM's) or 'programmable mechanisms' as a middle ground between high speed hard automation and expensive serial jointed-arm robots. This research introduces the concept of adjustable robotic mechanisms towards cost-effective manufacturing automation. A generalized analytical synthesis technique has been developed to support the computational design of ARM's that lays the theoretical foundation for synthesis of adjustable mechanisms. The synthesis method developed in this dissertation, called generalized adjustable dyad and triad synthesis, advances the well-known Burmester theory in kinematics to a new level. While this method provides planar solutions, a novel patented scheme is utilized for converting prescribed three-dimensional motion specifications into sets of planar projections. This provides an analytical and a computational tool for designing adjustable mechanisms that satisfy multiple sets of three-dimensional motion specifications. Several design issues were addressed, including adjustable parameter identification, branching defect, and mechanical errors. An efficient mathematical scheme for identification of adjustable member was also developed. The analytical synthesis techniques developed in this dissertation were successfully implemented in a graphic-intensive user-friendly computer program. A physical prototype of a general purpose adjustable robotic mechanism has been constructed to serve as a proof-of-concept model.

  3. Surgical volume and postoperative mortality rate at a referral hospital in Western Uganda: Measuring the Lancet Commission on Global Surgery indicators in low-resource settings.

    PubMed

    Anderson, Geoffrey A; Ilcisin, Lenka; Abesiga, Lenard; Mayanja, Ronald; Portal Benetiz, Noralis; Ngonzi, Joseph; Kayima, Peter; Shrime, Mark G

    2017-06-01

    The Lancet Commission on Global Surgery recommends that every country report its surgical volume and postoperative mortality rate. Little is known, however, about the numbers of operations performed and the associated postoperative mortality rate in low-income countries or how to best collect these data. For one month, every patient who underwent an operation at a referral hospital in western Uganda was observed. These patients and their outcomes were followed until discharge. Prospective data were compared with data obtained from logbooks and patient charts to determine the validity of using retrospective methods for collecting these metrics. Surgical volume at this regional hospital in Uganda is 8,515 operations/y, compared to 4,000 operations/y reported in the only other published data. The postoperative mortality rate at this hospital is 2.4%, similar to other hospitals in low-income countries. Finding patient files in the medical records department was time consuming and yielded only 62% of the files. Furthermore, a comparison of missing versus found charts revealed that the missing charts were significantly different from the found charts. Logbooks, on the other hand, captured 99% of the operations and 94% of the deaths. Our results describe a simple, reproducible, accurate, and inexpensive method for collection of the Lancet Commission on Global Surgery variables using logbooks that already exist in most hospitals in low-income countries. While some have suggested using risk-adjusted postoperative mortality rate as a more equitable variable, our data suggest that only a limited amount of risk adjustment is possible given the limited available data. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Willingness to pay for a quality-adjusted life year: an evaluation of attitudes towards risk and preferences

    PubMed Central

    2014-01-01

    Background This paper examines the Willingness to Pay (WTP) for a quality-adjusted life year (QALY) expressed by people who attended the healthcare system as well as the association of attitude towards risk and other personal characteristics with their response. Methods Health-state preferences, measured by EuroQol (EQ-5D-3L), were combined with WTP for recovering a perfect health state. WTP was assessed using close-ended, iterative bidding, contingent valuation method. Data on demographic and socioeconomic characteristics, as well as usage of health services by the subjects were collected. The attitude towards risk was evaluated by collecting risky behaviors data, by the subject’s self-evaluation, and through lottery games. Results Six hundred and sixty two subjects participated and 449 stated a utility inferior to 1. WTP/QALY ratios varied significantly when payments with personal money (mean €10,119; median €673) or through taxes (mean €28,187; median €915) were suggested. Family income, area income, higher education level, greater use of healthcare services, and the number of co-inhabitants were associated with greater WTP/QALY ratios. Age and female gender were associated with lower WTP/QALY ratios. Risk inclination was independently associated with a greater WTP/QALY when “out of pocket” payments were suggested. Clear discrepancies were demonstrated between linearity and neutrality towards risk assumptions and experimental results. Conclusions WTP/QALY ratios vary noticeably based on demographic and socioeconomic characteristics of the subject, but also on their attitude towards risk. Knowing the expression of preferences by patients from this outcome measurement can be of interest for health service planning. PMID:24989615

  5. International ranking systems for universities and institutions: a critical appraisal

    PubMed Central

    Ioannidis, John PA; Patsopoulos, Nikolaos A; Kavvoura, Fotini K; Tatsioni, Athina; Evangelou, Evangelos; Kouri, Ioanna; Contopoulos-Ioannidis, Despina G; Liberopoulos, George

    2007-01-01

    Background Ranking of universities and institutions has attracted wide attention recently. Several systems have been proposed that attempt to rank academic institutions worldwide. Methods We review the two most publicly visible ranking systems, the Shanghai Jiao Tong University 'Academic Ranking of World Universities' and the Times Higher Education Supplement 'World University Rankings' and also briefly review other ranking systems that use different criteria. We assess the construct validity for educational and research excellence and the measurement validity of each of the proposed ranking criteria, and try to identify generic challenges in international ranking of universities and institutions. Results None of the reviewed criteria for international ranking seems to have very good construct validity for both educational and research excellence, and most don't have very good construct validity even for just one of these two aspects of excellence. Measurement error for many items is also considerable or is not possible to determine due to lack of publication of the relevant data and methodology details. The concordance between the 2006 rankings by Shanghai and Times is modest at best, with only 133 universities shared in their top 200 lists. The examination of the existing international ranking systems suggests that generic challenges include adjustment for institutional size, definition of institutions, implications of average measurements of excellence versus measurements of extremes, adjustments for scientific field, time frame of measurement and allocation of credit for excellence. Conclusion Naïve lists of international institutional rankings that do not address these fundamental challenges with transparent methods are misleading and should be abandoned. We make some suggestions on how focused and standardized evaluations of excellence could be improved and placed in proper context. PMID:17961208

  6. The role of premorbid adjustment in schizophrenia: Focus on cognitive remediation outcome.

    PubMed

    Buonocore, Mariachiara; Bosinelli, Francesca; Bechi, Margherita; Spangaro, Marco; Piantanida, Marco; Cocchi, Federica; Bianchi, Laura; Guglielmino, Carmelo; Mastromatteo, Antonella Rita; Cavallaro, Roberto; Bosia, Marta

    2018-02-19

    Premorbid adjustment has been associated with several outcomes in schizophrenia and has been proposed as an index of cognitive reserve. This study aims to comprehensively analyse the relation between premorbid adjustment and clinical, neurocognitive, socio-cognitive and functional assessments, as well as to investigate the effect of premorbid adjustment on cognitive improvements after a cognitive remediation therapy protocol. Seventy-nine clinically stabilised outpatients with schizophrenia underwent a combined intervention consisting of cognitive remediation therapy added to standard rehabilitation therapy. All patients were assessed at baseline for psychopathology, premorbid adjustment, intellectual level, cognition and functioning. Cognitive evaluations were also repeated after the intervention. At baseline, significant correlations were observed between premorbid adjustment and working memory. The global cognitive improvement after treatment was significantly predicted by age and premorbid adjustment. This study confirms the association between premorbid adjustment and cognitive impairment and is the first to highlight the possible role of premorbid adjustment on the capacity to recover from cognitive deficits through a cognitive remediation therapy protocol. The data suggest that cognitive remediation may be particularly effective for people in the early course and that the assessment of premorbid adjustment could be of value to design individualised interventions.

  7. Compatibility of pedigree-based and marker-based relationship matrices for single-step genetic evaluation.

    PubMed

    Christensen, Ole F

    2012-12-03

    Single-step methods provide a coherent and conceptually simple approach to incorporate genomic information into genetic evaluations. An issue with single-step methods is compatibility between the marker-based relationship matrix for genotyped animals and the pedigree-based relationship matrix. Therefore, it is necessary to adjust the marker-based relationship matrix to the pedigree-based relationship matrix. Moreover, with data from routine evaluations, this adjustment should in principle be based on both observed marker genotypes and observed phenotypes, but until now this has been overlooked. In this paper, I propose a new method to address this issue by 1) adjusting the pedigree-based relationship matrix to be compatible with the marker-based relationship matrix instead of the reverse and 2) extending the single-step genetic evaluation using a joint likelihood of observed phenotypes and observed marker genotypes. The performance of this method is then evaluated using two simulated datasets. The method derived here is a single-step method in which the marker-based relationship matrix is constructed assuming all allele frequencies equal to 0.5 and the pedigree-based relationship matrix is constructed using the unusual assumption that animals in the base population are related and inbred with a relationship coefficient γ and an inbreeding coefficient γ / 2. Taken together, this γ parameter and a parameter that scales the marker-based relationship matrix can handle the issue of compatibility between marker-based and pedigree-based relationship matrices. The full log-likelihood function used for parameter inference contains two terms. The first term is the REML-log-likelihood for the phenotypes conditional on the observed marker genotypes, whereas the second term is the log-likelihood for the observed marker genotypes. Analyses of the two simulated datasets with this new method showed that 1) the parameters involved in adjusting marker-based and pedigree-based relationship matrices can depend on both observed phenotypes and observed marker genotypes and 2) a strong association between these two parameters exists. Finally, this method performed at least as well as a method based on adjusting the marker-based relationship matrix. Using the full log-likelihood and adjusting the pedigree-based relationship matrix to be compatible with the marker-based relationship matrix provides a new and interesting approach to handle the issue of compatibility between the two matrices in single-step genetic evaluation.

  8. Posttraumatic Growth and Dyadic Adjustment among War Veterans and their Wives

    PubMed Central

    Lahav, Yael; Kanat-Maymon, Yaniv; Solomon, Zahava

    2017-01-01

    The controversy regarding the nature of posttraumatic growth includes two main competing claims: one which argues that posttraumatic growth reflects authentic positive changes and the other which argues that posttraumatic growth reflects illusory defenses. While the former might suggest that posttraumatic growth enhances intimacy and close relationships, the latter might imply that posttraumatic growth hinders interpersonal relations. The present study aimed to test these claims by investigating the association between posttraumatic growth and dyadic adjustment over time at both the individual and dyadic levels, and the potential role of posttraumatic stress symptoms. Former prisoners of war and comparable war veterans and their wives (n = 229) were assessed twice, 30–31 (T1) and 35–38 (T2) years after the 1973 Yom Kippur War in Israel, with regard to posttraumatic growth, posttraumatic stress symptoms and dyadic adjustment. Results indicated that posttraumatic growth was associated with both elevated posttraumatic stress symptoms and low dyadic adjustment among both husbands and wives. Posttraumatic stress symptoms at T1 and T2 mediated the association between posttraumatic growth and dyadic adjustment. Wives' posttraumatic growth at T1 predicted posttraumatic growth and dyadic adjustment of the husbands at T2. The higher the wives' posttraumatic growth, the higher the posttraumatic growth and the lower the dyadic adjustment of the husbands in the subsequent measure. The findings suggest that posttraumatic growth reflects defensive beliefs which undermine marital relationships and that posttraumatic growth might be transmitted between spouses and implicated in the deterioration of the marital relationship over time. PMID:28713307

  9. Mesothelioma and lung cancer mortality: a historical cohort study among asbestosis workers in Hong Kong.

    PubMed

    Chen, Minghui; Tse, Lap Ah; Au, Ronald K F; Yu, Ignatius T S; Wang, Xiao-rong; Lao, Xiang-qian; Au, Joseph Siu-kei

    2012-05-01

    To investigate the mortality pattern among a cohort of workers with asbestosis in Hong Kong, with special emphases on mesothelioma and lung cancer. All 124 male workers with confirmed asbestosis in Hong Kong during 1981-2008 were followed up to December 31, 2008 to ascertain the vital status and causes of death. Standardized mortality ratio (SMR) for each underlying cause of death was calculated by using person-year method. Axelson's indirect method was applied to adjust for the potential confounding effect of cigarette smoking. A total of 86 deaths were observed after 432.8 person-years of observations. The SMR for overall mortality (6.06, 95% CI: 4.90-7.51) increased significantly. The elevated risk of deaths from all cancers (7.53, 95% CI: 5.38-10.25) was mainly resulted from a significantly excess risk from lung cancer (SMR=7.91, 95% CI: 4.32-13.29, 14 deaths) and mesothelioma (SMR=6013.63, 95% CI: 3505.95-9621.81, 17 deaths). The SMR for lung cancer retained statistically significant after adjustment of smoking. An increased smoking adjusted SMR was also suggested for all heart diseases (2.32, 95% CI: 0.93-4.79, 7 deaths) and acute myocardial infarction (3.10, 95% CI: 0.84-7.94, 4 deaths), though the statistical significance was borderline. We found a positive association with net years of exposure to asbestos for mesothelioma and lung cancer. Our study provided further evidence on the carcinogenesis of asbestos/asbestosis with the risk of deaths from lung cancer and mesothelioma. This study also provided a preliminary support for a possible link between asbestosis and heart disease, but power is limited. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  10. Measurement of macrocyclic trichothecene in floor dust of water-damaged buildings using gas chromatography/tandem mass spectrometry—dust matrix effects

    PubMed Central

    Saito, Rena; Park, Ju-Hyeong; LeBouf, Ryan; Green, Brett J.; Park, Yeonmi

    2017-01-01

    Gas chromatography-tandem mass spectrometry (GC-MS/MS) was used to detect fungal secondary metabolites. Detection of verrucarol, the hydrolysis product of Stachybotrys chartarum macrocyclic trichothecene (MCT), was confounded by matrix effects associated with heterogeneous indoor environmental samples. In this study, we examined the role of dust matrix effects associated with GC-MS/ MS to better quantify verrucarol in dust as a measure of total MCT. The efficiency of the internal standard (ISTD, 1,12-dodecanediol), and application of a matrix-matched standard correction method in measuring MCT in floor dust of water-damaged buildings was additionally examined. Compared to verrucarol, ISTD had substantially higher matrix effects in the dust extracts. The results of the ISTD evaluation showed that without ISTD adjustment, there was a 280% ion enhancement in the dust extracts compared to neat solvent. The recovery of verrucarol was 94% when the matrix-matched standard curve without the ISTD was used. Using traditional calibration curves with ISTD adjustment, none of the 21 dust samples collected from water damaged buildings were detectable. In contrast, when the matrix-matched calibration curves without ISTD adjustment were used, 38% of samples were detectable. The study results suggest that floor dust of water-damaged buildings may contain MCT. However, the measured levels of MCT in dust using the GC-MS/MS method could be significantly under- or overestimated, depending on the matrix effects, the inappropriate ISTD, or combination of the two. Our study further shows that the routine application of matrix-matched calibration may prove useful in obtaining accurate measurements of MCT in dust derived from damp indoor environments, while no isotopically labeled verrucarol is available. PMID:26853932

  11. Measurement of macrocyclic trichothecene in floor dust of water-damaged buildings using gas chromatography/tandem mass spectrometry-dust matrix effects.

    PubMed

    Saito, Rena; Park, Ju-Hyeong; LeBouf, Ryan; Green, Brett J; Park, Yeonmi

    2016-01-01

    Gas chromatography-tandem mass spectrometry (GC-MS/MS) was used to detect fungal secondary metabolites. Detection of verrucarol, the hydrolysis product of Stachybotrys chartarum macrocyclic trichothecene (MCT), was confounded by matrix effects associated with heterogeneous indoor environmental samples. In this study, we examined the role of dust matrix effects associated with GC-MS/MS to better quantify verrucarol in dust as a measure of total MCT. The efficiency of the internal standard (ISTD, 1,12-dodecanediol), and application of a matrix-matched standard correction method in measuring MCT in floor dust of water-damaged buildings was additionally examined. Compared to verrucarol, ISTD had substantially higher matrix effects in the dust extracts. The results of the ISTD evaluation showed that without ISTD adjustment, there was a 280% ion enhancement in the dust extracts compared to neat solvent. The recovery of verrucarol was 94% when the matrix-matched standard curve without the ISTD was used. Using traditional calibration curves with ISTD adjustment, none of the 21 dust samples collected from water damaged buildings were detectable. In contrast, when the matrix-matched calibration curves without ISTD adjustment were used, 38% of samples were detectable. The study results suggest that floor dust of water-damaged buildings may contain MCT. However, the measured levels of MCT in dust using the GC-MS/MS method could be significantly under- or overestimated, depending on the matrix effects, the inappropriate ISTD, or combination of the two. Our study further shows that the routine application of matrix-matched calibration may prove useful in obtaining accurate measurements of MCT in dust derived from damp indoor environments, while no isotopically labeled verrucarol is available.

  12. Systematic review and quality assessment of cost-effectiveness analysis of pharmaceutical therapies for advanced colorectal cancer.

    PubMed

    Leung, Henry W C; Chan, Agnes L F; Leung, Matthew S H; Lu, Chin-Li

    2013-04-01

    To systematically review and assess the quality of cost-effectiveness analyses (CEAs) of pharmaceutical therapies for metastatic colorectal cancer (mCRC). The MEDLINE, EMBASE, Cochrane, and EconLit databases were searched for the Medical Subject Headings or text key words quality-adjusted, QALY, life-year gained (LYG), and cost-effectiveness (January 1, 1999-December 31, 2009). Original CEAs of mCRC pharmacotherapy published in English were included. CEAs that measured health effects in units other than quality-adjusted life years or LYG and letters to the editor, case reports, posters, and editorials were excluded. Each article was independently assessed by 2 trained reviewers according to a quality checklist created by the Panel on Cost-Effectiveness in Health and Medicine. Twenty-four CEA studies pertaining to pharmaceutical therapies for mCRC were identified. All studies showed a wide variation in methodologic approaches, which resulted in a different range of incremental cost-effectiveness ratios reported for each regimen. We found common methodologic flaws in a significant number of CEA studies, including lack of clear description for critique of data quality; lack of method for adjusting costs for inflation and methods for obtaining expert judgment; no results of model validation; wide differences in the types of perspective, time horizon, study design, cost categories, and effect outcomes; and no quality assessment of data (cost and effectiveness) for the interventions evaluation. This study has shown a wide variation in the methodology and quality of cost-effectiveness analysis for mCRC. Improving quality and harmonization of CEA for cancer treatment is needed. Further study is suggested to assess the quality of CEA methodology outside the mCRC disease state.

  13. Adjustment Disorder: epidemiology, diagnosis and treatment

    PubMed Central

    2009-01-01

    Background Adjustment Disorder is a condition strongly tied to acute and chronic stress. Despite clinical suggestion of a large prevalence in the general population and the high frequency of its diagnosis in the clinical settings, there has been relatively little research reported and, consequently, very few hints about its treatments. Methods the authors gathered old and current information on the epidemiology, clinical features, comorbidity, treatment and outcome of adjustment disorder by a systematic review of essays published on PUBMED. Results After a first glance at its historical definition and its definition in the DSM and ICD systems, the problem of distinguishing AD from other mood and anxiety disorders, the difficulty in the definition of stress and the implied concept of 'vulnerability' are considered. Comorbidity of AD with other conditions, and outcome of AD are then analyzed. This review also highlights recent data about trends in the use of antidepressant drugs, evidence on their efficacy and the use of psychotherapies. Conclusion AD is a very common diagnosis in clinical practice, but we still lack data about its rightful clinical entity. This may be caused by a difficulty in facing, with a purely descriptive methods, a "pathogenic label", based on a stressful event, for which a subjective impact has to be considered. We lack efficacy surveys concerning treatment. The use of psychotropic drugs such as antidepressants, in AD with anxious or depressed mood is not properly supported and should be avoided, while the usefulness of psychotherapies is more solidly supported by clinical evidence. To better determine the correct course of therapy, randomized-controlled trials, even for the combined use of drugs and psychotherapies, are needed vitally, especially for the resistant forms of AD. PMID:19558652

  14. Adjusting for treatment switching in randomised controlled trials - A simulation study and a simplified two-stage method.

    PubMed

    Latimer, Nicholas R; Abrams, K R; Lambert, P C; Crowther, M J; Wailoo, A J; Morden, J P; Akehurst, R L; Campbell, M J

    2017-04-01

    Estimates of the overall survival benefit of new cancer treatments are often confounded by treatment switching in randomised controlled trials (RCTs) - whereby patients randomised to the control group are permitted to switch onto the experimental treatment upon disease progression. In health technology assessment, estimates of the unconfounded overall survival benefit associated with the new treatment are needed. Several switching adjustment methods have been advocated in the literature, some of which have been used in health technology assessment. However, it is unclear which methods are likely to produce least bias in realistic RCT-based scenarios. We simulated RCTs in which switching, associated with patient prognosis, was permitted. Treatment effect size and time dependency, switching proportions and disease severity were varied across scenarios. We assessed the performance of alternative adjustment methods based upon bias, coverage and mean squared error, related to the estimation of true restricted mean survival in the absence of switching in the control group. We found that when the treatment effect was not time-dependent, rank preserving structural failure time models (RPSFTM) and iterative parameter estimation methods produced low levels of bias. However, in the presence of a time-dependent treatment effect, these methods produced higher levels of bias, similar to those produced by an inverse probability of censoring weights method. The inverse probability of censoring weights and structural nested models produced high levels of bias when switching proportions exceeded 85%. A simplified two-stage Weibull method produced low bias across all scenarios and provided the treatment switching mechanism is suitable, represents an appropriate adjustment method.

  15. Access to Money and Relation to Women's Use of Family Planning Methods Among Young Married Women in Rural India.

    PubMed

    Reed, Elizabeth; Donta, Balaiah; Dasgupta, Anindita; Ghule, Mohan; Battala, Madhusudana; Nair, Saritha; Silverman, Jay; Jadhav, Arun; Palaye, Prajakta; Saggurti, Niranjan; Raj, Anita

    2016-06-01

    Objectives The social positioning (i.e. social status and autonomy) of women in the household facilitates women's access to and decision-making power related to family planning (FP). Women's access to spending money, which may be an indicator of greater social positioning in the household, may also be greater among women who engage in income generating activities for their families, regardless of women's status in the household. However, in both scenarios, access to money may independently afford greater opportunity to obtain family planning services among women. This study seeks to assess whether access to money is associated with FP outcomes independently of women's social positioning in their households. Methods Using survey data from married couples in rural Maharashtra, India (n = 855), crude and adjusted regression was used to assess women's access to their own spending money in relation to past 3 month use of condoms and other forms of contraceptives (pills, injectables, intrauterine device). Results Access to money (59 %) was associated with condom and other contraceptive use (AORs ranged 1.5-1.8). These findings remained significant after adjusting for women's FP decision-making power in the household and mobility to seek FP services. Conclusion While preliminary, findings suggest that access to money may increase women's ability to obtain FP methods, even in contexts where social norms to support women's power in FP decision-making may not be readily adopted.

  16. Development and evaluation of an automatically adjusting coarse-grained force field for a β-O-4 type lignin from atomistic simulations

    NASA Astrophysics Data System (ADS)

    Li, Wenzhuo; Zhao, Yingying; Huang, Shuaiyu; Zhang, Song; Zhang, Lin

    2017-01-01

    This goal of this work was to develop a coarse-grained (CG) model of a β-O-4 type lignin polymer, because of the time consuming process required to achieve equilibrium for its atomistic model. The automatic adjustment method was used to develop the lignin CG model, which enables easy discrimination between chemically-varied polymers. In the process of building the lignin CG model, a sum of n Gaussian functions was obtained by an approximation of the corresponding atomistic potentials derived from a simple Boltzmann inversion of the distributions of the structural parameters. This allowed the establishment of the potential functions of the CG bond stretching and angular bending. To obtain the potential function of the CG dihedral angle, an algorithm similar to a Fourier progression form was employed together with a nonlinear curve-fitting method. The numerical potentials of the nonbonded portion of the lignin CG model were obtained using a potential inversion iterative method derived from the corresponding atomistic nonbonded distributions. The study results showed that the proposed CG model of lignin agreed well with its atomistic model in terms of the distributions of bond lengths, bending angles, dihedral angles and nonbonded distances between the CG beads. The lignin CG model also reproduced the static and dynamic properties of the atomistic model. The results of the comparative evaluation of the two models suggested that the designed lignin CG model was efficient and reliable.

  17. Matched Comparison Group Design Standards in Systematic Reviews of Early Childhood Interventions.

    PubMed

    Thomas, Jaime; Avellar, Sarah A; Deke, John; Gleason, Philip

    2017-06-01

    Systematic reviews assess the quality of research on program effectiveness to help decision makers faced with many intervention options. Study quality standards specify criteria that studies must meet, including accounting for baseline differences between intervention and comparison groups. We explore two issues related to systematic review standards: covariate choice and choice of estimation method. To help systematic reviews develop/refine quality standards and support researchers in using nonexperimental designs to estimate program effects, we address two questions: (1) How well do variables that systematic reviews typically require studies to account for explain variation in key child and family outcomes? (2) What methods should studies use to account for preexisting differences between intervention and comparison groups? We examined correlations between baseline characteristics and key outcomes using Early Childhood Longitudinal Study-Birth Cohort data to address Question 1. For Question 2, we used simulations to compare two methods-matching and regression adjustment-to account for preexisting differences between intervention and comparison groups. A broad range of potential baseline variables explained relatively little of the variation in child and family outcomes. This suggests the potential for bias even after accounting for these variables, highlighting the need for systematic reviews to provide appropriate cautions about interpreting the results of moderately rated, nonexperimental studies. Our simulations showed that regression adjustment can yield unbiased estimates if all relevant covariates are used, even when the model is misspecified, and preexisting differences between the intervention and the comparison groups exist.

  18. Access to Money and Relation to Women’s Use of Family Planning Methods among Young Married Women in Rural India

    PubMed Central

    Reed, Elizabeth; Donta, Balaiah; Dasgupta, Anindita; Ghule, Mohan; Battala, Madhusudana; Nair, Saritha; Silverman, Jay; Jadhav, Arun; Palaye, Prajakta; Saggurti, Niranjan; Raj, Anita

    2016-01-01

    Objectives The social positioning (i.e. social status and autonomy) of women in the household facilitates women’s access to and decision-making power related to family planning (FP). Women’s access to spending money, which may be an indicator of greater social positioning in the household, may also be greater among women who engage in income generating activities for their families, regardless of women’s status in the household. However, in both scenarios, access to money may independently afford greater opportunity to obtain family planning services among women. This study seeks to assess whether access to money is associated with FP outcomes independently of women’s social positioning in their households. Methods Using survey data from married couples in rural Maharashtra, India (n=855), crude and adjusted regression was used to assess women’s access to their own spending money in relation to past 3 month use of condoms and other forms of contraceptives (pills, injectables, intrauterine device). Results Access to money (59%) was associated with condom and other contraceptive use (AORs ranged: 1.5 – 1.8). These findings remained significant after adjusting for women’s FP decision-making power in the household and mobility to seek FP services. Conclusion While preliminary, findings suggest that access to money may increase women’s ability to obtain FP methods, even in contexts where social norms to support women’s power in FP decision-making may not be readily adopted. PMID:26971270

  19. Contrast Enhancement Algorithm Based on Gap Adjustment for Histogram Equalization

    PubMed Central

    Chiu, Chung-Cheng; Ting, Chih-Chung

    2016-01-01

    Image enhancement methods have been widely used to improve the visual effects of images. Owing to its simplicity and effectiveness histogram equalization (HE) is one of the methods used for enhancing image contrast. However, HE may result in over-enhancement and feature loss problems that lead to unnatural look and loss of details in the processed images. Researchers have proposed various HE-based methods to solve the over-enhancement problem; however, they have largely ignored the feature loss problem. Therefore, a contrast enhancement algorithm based on gap adjustment for histogram equalization (CegaHE) is proposed. It refers to a visual contrast enhancement algorithm based on histogram equalization (VCEA), which generates visually pleasing enhanced images, and improves the enhancement effects of VCEA. CegaHE adjusts the gaps between two gray values based on the adjustment equation, which takes the properties of human visual perception into consideration, to solve the over-enhancement problem. Besides, it also alleviates the feature loss problem and further enhances the textures in the dark regions of the images to improve the quality of the processed images for human visual perception. Experimental results demonstrate that CegaHE is a reliable method for contrast enhancement and that it significantly outperforms VCEA and other methods. PMID:27338412

  20. State-of-the-Art: DTM Generation Using Airborne LIDAR Data

    PubMed Central

    Chen, Ziyue; Gao, Bingbo; Devereux, Bernard

    2017-01-01

    Digital terrain model (DTM) generation is the fundamental application of airborne Lidar data. In past decades, a large body of studies has been conducted to present and experiment a variety of DTM generation methods. Although great progress has been made, DTM generation, especially DTM generation in specific terrain situations, remains challenging. This research introduces the general principles of DTM generation and reviews diverse mainstream DTM generation methods. In accordance with the filtering strategy, these methods are classified into six categories: surface-based adjustment; morphology-based filtering, triangulated irregular network (TIN)-based refinement, segmentation and classification, statistical analysis and multi-scale comparison. Typical methods for each category are briefly introduced and the merits and limitations of each category are discussed accordingly. Despite different categories of filtering strategies, these DTM generation methods present similar difficulties when implemented in sharply changing terrain, areas with dense non-ground features and complicated landscapes. This paper suggests that the fusion of multi-sources and integration of different methods can be effective ways for improving the performance of DTM generation. PMID:28098810

  1. Stabilization of time domain acoustic boundary element method for the exterior problem avoiding the nonuniqueness.

    PubMed

    Jang, Hae-Won; Ih, Jeong-Guon

    2013-03-01

    The time domain boundary element method (TBEM) to calculate the exterior sound field using the Kirchhoff integral has difficulties in non-uniqueness and exponential divergence. In this work, a method to stabilize TBEM calculation for the exterior problem is suggested. The time domain CHIEF (Combined Helmholtz Integral Equation Formulation) method is newly formulated to suppress low order fictitious internal modes. This method constrains the surface Kirchhoff integral by forcing the pressures at the additional interior points to be zero when the shortest retarded time between boundary nodes and an interior point elapses. However, even after using the CHIEF method, the TBEM calculation suffers the exponential divergence due to the remaining unstable high order fictitious modes at frequencies higher than the frequency limit of the boundary element model. For complete stabilization, such troublesome modes are selectively adjusted by projecting the time response onto the eigenspace. In a test example for a transiently pulsating sphere, the final average error norm of the stabilized response compared to the analytic solution is 2.5%.

  2. Wavelet-based unsupervised learning method for electrocardiogram suppression in surface electromyograms.

    PubMed

    Niegowski, Maciej; Zivanovic, Miroslav

    2016-03-01

    We present a novel approach aimed at removing electrocardiogram (ECG) perturbation from single-channel surface electromyogram (EMG) recordings by means of unsupervised learning of wavelet-based intensity images. The general idea is to combine the suitability of certain wavelet decomposition bases which provide sparse electrocardiogram time-frequency representations, with the capacity of non-negative matrix factorization (NMF) for extracting patterns from images. In order to overcome convergence problems which often arise in NMF-related applications, we design a novel robust initialization strategy which ensures proper signal decomposition in a wide range of ECG contamination levels. Moreover, the method can be readily used because no a priori knowledge or parameter adjustment is needed. The proposed method was evaluated on real surface EMG signals against two state-of-the-art unsupervised learning algorithms and a singular spectrum analysis based method. The results, expressed in terms of high-to-low energy ratio, normalized median frequency, spectral power difference and normalized average rectified value, suggest that the proposed method enables better ECG-EMG separation quality than the reference methods. Copyright © 2015 IPEM. Published by Elsevier Ltd. All rights reserved.

  3. Predicting urban stormwater runoff with quantitative precipitation estimates from commercial microwave links

    NASA Astrophysics Data System (ADS)

    Pastorek, Jaroslav; Fencl, Martin; Stránský, David; Rieckermann, Jörg; Bareš, Vojtěch

    2017-04-01

    Reliable and representative rainfall data are crucial for urban runoff modelling. However, traditional precipitation measurement devices often fail to provide sufficient information about the spatial variability of rainfall, especially when heavy storm events (determining design of urban stormwater systems) are considered. Commercial microwave links (CMLs), typically very dense in urban areas, allow for indirect precipitation detection with desired spatial and temporal resolution. Fencl et al. (2016) recognised the high bias in quantitative precipitation estimates (QPEs) from CMLs which significantly limits their usability and, in order to reduce the bias, suggested a novel method for adjusting the QPEs to existing rain gauge networks. Studies evaluating the potential of CMLs for rainfall detection so far focused primarily on direct comparison of the QPEs from CMLs to ground observations. In contrast, this investigation evaluates the suitability of these innovative rainfall data for stormwater runoff modelling on a case study of a small ungauged (in long-term perspective) urban catchment in Prague-Letňany, Czech Republic (Fencl et al., 2016). We compare the runoff measured at the outlet from the catchment with the outputs of a rainfall-runoff model operated using (i) CML data adjusted by distant rain gauges, (ii) rainfall data from the distant gauges alone and (iii) data from a single temporary rain gauge located directly in the catchment, as it is common practice in drainage engineering. Uncertainties of the simulated runoff are analysed using the Bayesian method for uncertainty evaluation incorporating a statistical bias description as formulated by Del Giudice et al. (2013). Our results show that adjusted CML data are able to yield reliable runoff modelling results, primarily for rainfall events with convective character. Performance statistics, most significantly the timing of maximal discharge, reach better (less uncertain) values with the adjusted CML data than with the distant rain gauges. When the relative error of the volume discharged during the maximum flow period is concerned, the adjusted CMLs perform even better than the rain gauge in the catchment. This seem to be very promising, especially for urban catchments with sparse rain gauge networks. References: Del Giudice, D., Honti, M., Scheidegger, A., Albert, C., Reichert, P., and Rieckermann, J. 2013. Improving uncertainty estimation in urban hydrological modeling by statistically describing bias. Hydrology and Earth System Sciences 17, 4209-4225. Fencl, M., Dohnal, M., Rieckermann, J., and Bareš, V. 2016. Gauge-Adjusted Rainfall Estimates from Commercial Microwave Links, Hydrology and Earth System Sciences Discussions, doi:10.5194/hess-2016- 397, in review. Acknowledgements to the Czech Science Foundation projects No. 14-22978S and No. 17-16389S.

  4. Individual and crossover effects of stress on adjustment in medical student marriages.

    PubMed

    Katz, J; Monnier, J; Libet, J; Shaw, D; Beach, S R

    2000-07-01

    High-stress individuals may benefit from social support, although their support providers may be adversely affected via stress crossover effects. Individual and crossover effects of perceived stress within medical student marriages (n = 30) were investigated. Perceived spousal support was positively associated with individuals' own marital and emotional adjustment, attenuating stress effects. With regard to crossover effects, medical students' perceived stress was significantly associated with their spouses' emotional adjustment. Further, medical students' own emotional adjustment fully mediated this crossover effect. Results suggest that the contagion of negative affect may serve as a key mechanism through which stress crossover effects operate in marriage.

  5. Selective attention in perceptual adjustments to voice.

    PubMed

    Mullennix, J W; Howe, J N

    1999-10-01

    The effects of perceptual adjustments to voice information on the perception of isolated spoken words were examined. In two experiments, spoken target words were preceded or followed within a trial by a neutral word spoken in the same voice or in a different voice as the target. Over-all, words were reproduced more accurately on trials on which the voice of the neutral word matched the voice of the spoken target word, suggesting that perceptual adjustments to voice interfere with word processing. This result, however, was mediated by selective attention to voice. The results provide further evidence of a close processing relationship between perceptual adjustments to voice and spoken word recognition.

  6. A parabolic function to modify Thornthwaite estimates of potential evapotranspiration for the eastern United States

    USGS Publications Warehouse

    McCabe, G.J.

    1989-01-01

    Errors of the Thornthwaite model can be analyzed using adjusted pan evaporation as an index of potential evapotranspiration. An examination of ratios of adjusted pan evaporation to Thornthwaite potential evapotranspiration indicates that the ratios are highest in the winter and lowest during summer months. This trend suggests a parabolic pattern. In this study a parabolic function is used to adjust Thornthwaite estimates of potential evapotranspiration. Forty locations east of the Rocky Mountains are analyzed. -from Author

  7. Age of first arrest varies by gambling status in a cohort of young adults

    PubMed Central

    Martins, Silvia S.; Lee, Grace P.; Santaella, Julian; Liu, Weiwei; Ialongo, Nicholas S.; Storr, Carla L.

    2015-01-01

    Background and objectives To describe the association between social and problem gambling and first criminal arrest by age 23 in a cohort of urban, mainly African-American youth. Methods: Data for this study was derived from several annual interviews being completed on a community sample of 617 participants during late adolescence until age 23. Information on gambling status, engagement in deviant behaviors, illegal drug use, and arrest history were collected through yearly interviews. Analysis was carried out using Nelson-Aalen cumulative hazard models and simple and adjusted Cox proportional hazards models. Results More problem gamblers had been arrested before age 23 than social gamblers and non-gamblers, i.e. 65% of problem gamblers were arrested before age 23, compared to 38% of social gamblers and 24% non-gamblers. Social gambling was only significantly associated with the hazard of first arrest by age 23 in the unadjusted model (HR: 1.6, p<.001), but not after adjustment for covariates (HR: 1.1, p=0.47). Problem gambling was significantly associated with the hazard of first arrest by age 23 years in the unadjusted (HR: 3.6,p<.001) and adjusted models (HR:1.6, p=0.05). Conclusions and Scientific Significance Problem gambling was significantly associated with earlier age of being arrested. Dilution effects after adjustment for several deviant behaviors and illegal drug use by age 17 suggest that youth exposed to certain common factors may result in engagement in multiple risky behaviors, including problem gambling. Studies are needed to investigate the developmental pathways that lead to these combined behaviors among youth. PMID:24628694

  8. Age-adjusted Charlson comorbidity index score as predictor of survival of patients with digestive system cancer who have undergone surgical resection.

    PubMed

    Tian, Yaohua; Jian, Zhong; Xu, Beibei; Liu, Hui

    2017-10-03

    Comorbidities have considerable effects on survival outcomes. The primary objective of this retrospective study was to examine the association between age-adjusted Charlson comorbidity index (ACCI) score and postoperative in-hospital mortality in patients with digestive system cancer who have undergone surgical resection of their cancers. Using electronic hospitalization summary reports, we identified 315,464 patients who had undergone surgery for digestive system cancer in top-rank (Grade 3A) hospitals in China between 2013 and 2015. The Cox proportional hazard regression model was applied to evaluate the effect of ACCI score on postoperative mortality, with adjustments for sex, type of resection, anesthesia methods, and caseload of each healthcare institution. The postoperative in-hospital mortality rate in the study cohort was 1.2% (3,631/315,464). ACCI score had a positive graded association with the risk of postoperative in-hospital mortality for all cancer subtypes. The adjusted HRs for postoperative in-hospital mortality scores ≥ 6 for esophagus, stomach, colorectum, pancreas, and liver and gallbladder cancer were 2.05 (95% CI: 1.45-2.92), 2.00 (95% CI: 1.60-2.49), 2.54 (95% CI: 2.02-3.21), 2.58 (95% CI: 1.68-3.97), and 4.57 (95% CI: 3.37-6.20), respectively, compared to scores of 0-1. These findings suggested that a high ACCI score is an independent predictor of postoperative in-hospital mortality in Chinese patients with digestive system cancer who have undergone surgical resection.

  9. Posttraumatic growth and adjustment to spinal cord injury: Moderated by posttraumatic depreciation?

    PubMed

    Kunz, Simon; Joseph, Stephen; Geyh, Szilvia; Peter, Claudio

    2017-07-01

    Findings on the relationship of posttraumatic growth (PTG) with adjustment to potentially traumatic events are inconsistent, whereupon posttraumatic depreciation (PTD) has been suggested as a possible moderator. The objective of this study is to investigate the associations between PTG and PTD on one side and life satisfaction and indicators of mental and physical health on the other side in individuals with spinal cord injury (SCI). The primary study aim is to test whether PTD moderates the relationships of PTG and different adjustment indicators. A total of 141 patients administered to one of the four Swiss SCI rehabilitation centers completed questionnaires assessing PTG and PTD and different indicators of mental and physical health as well as life satisfaction at discharge from first rehabilitation. Correlational and regression methods were used to examine the research question. PTG and PTD were significantly positively correlated (rs = .47). PTD was significantly associated with lower mental and physical health and lower life satisfaction, with small to large effect sizes. PTD moderated the associations of PTG with symptoms of depression and life satisfaction (β of interaction term = -.18 and .24, respectively). PTG was significantly related to lower levels of symptoms of depression and higher life satisfaction in individuals experiencing moderate to high levels of PTD. In contrast, PTG was not significantly related to these outcomes in individuals with low PTD levels. The neglect of PTD in research partially explains mixed findings on the relationship of PTG and adjustment to potentially traumatic events. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  10. Impact of Neighborhood Socioeconomic Conditions on the Risk of Stroke in Japan

    PubMed Central

    Honjo, Kaori; Iso, Hiroyasu; Nakaya, Tomoki; Hanibuchi, Tomoya; Ikeda, Ai; Inoue, Manami; Sawada, Norie; Tsugane, Shoichiro

    2015-01-01

    Background Neighborhood deprivation has been shown in many studies to be an influential factor in cardiovascular disease risk. However, no previous studies have examined the effect of neighborhood socioeconomic conditions on the risk of stroke in Asian countries. Methods This study investigated whether neighborhood deprivation was associated with the risk of stroke and stroke death using data from the Japan Public Health Center-based Prospective Study. We calculated the adjusted hazard ratios of stroke mortality (mean follow-up, 16.4 years) and stroke incidence (mean follow-up, 15.4 years) according to the area deprivation index (ADI) among 90 843 Japanese men and women aged 40–69 years. A Cox proportional-hazard regression model using a shared frailty model was applied. Results The adjusted hazard ratios of stroke incidence, in order of increasing deprivation with reference to the least deprived area, were 1.16 (95% CI, 1.04–1.29), 1.12 (95% CI, 1.00–1.26), 1.18 (95% CI, 1.02–1.35), and 1.19 (95% CI, 1.01–1.41), after adjustment for individual socioeconomic conditions. Behavioral and psychosocial factors attenuated the association, but the association remained significant. The associations were explained by adjusting for biological cardiovascular risk factors. No significant association with stroke mortality was identified. Conclusions Our results indicate that the neighborhood deprivation level influences stroke incidence in Japan, suggesting that area socioeconomic conditions could be a potential target for public health intervention to reduce the risk of stroke. PMID:25757802

  11. Lifetime Alcohol Use & Cognitive Performance in Older Adults

    PubMed Central

    Kalapatapu, Raj K.; Ventura, Maria I.; Barnes, Deborah E.

    2016-01-01

    Background Substance use is an important clinical issue in the older adult population. As older adults are susceptible to cognitive disorders, the intersection of the fields of substance use and cognitive neuroscience is an active area of research. Prior studies of alcohol use and cognitive performance are mixed, and inconsistencies may be due to under- or over-adjustment for confounders. Aim This manuscript adds to this literature by conducting a secondary analysis of self-reported lifetime history of alcohol use and cognitive performance in older adults (n = 133). We hypothesized that current alcohol users would have poorer cognitive performance compared to never/minimal and former alcohol users. Methods Older adult participants were classified into never/minimal alcohol users, former alcohol users, and current alcohol users. A neurocognitive battery included a global cognitive measure and individual measures of attention, memory, fluency, and executive function. A directed acyclic graph (DAG)-based approach was used to select variables to be included in the multiple linear regression models. Results Though unadjusted analyses showed some significant associations between alcohol use and cognitive performance, all associations between alcohol use and cognitive performance were eliminated after adjusting for age, education, sex, race and smoking pack years. Alcohol drink years were not significantly associated with cognitive performance among current and former alcohol users. Discussion These results suggest that lifetime alcohol use is not significantly associated with cognitive performance in older adults after adjustment for key confounders. Inconsistencies in prior studies may be due to uncontrolled confounding and/or unnecessary adjustment of mediators and/or colliders. PMID:27719514

  12. Geographic Model and Biomarker-Derived Measures of Pesticide Exposure and Parkinson’s Disease

    PubMed Central

    RITZ, BEATE; COSTELLO, SADIE

    2013-01-01

    For more than two decades, reports have suggested that pesticides and herbicides may be an etiologic factor in idiopathic Parkinson’s disease (PD). To date, no clear associations with any specific pesticide have been demonstrated from epidemiological studies perhaps, in part, because methods of reliably estimating exposures are lacking. We tested the validity of a Geographic Information Systems (GIS)-based exposure assessment model that estimates potential environmental exposures at residences from pesticide applications to agricultural crops based on California Pesticide Use Reports (PUR). Using lipid-adjusted dichlorodiphenyldichloroethylene (DDE) serum levels as the “gold standard” for pesticide exposure, we conducted a validation study in a sample taken from an ongoing, population-based case–control study of PD in Central California. Residential, occupational, and other risk factor data were collected for 22 cases and 24 controls from Kern county, California. Environmental GIS–PUR-based organochlorine (OC) estimates were derived for each subject and compared to lipid-adjusted DDE serum levels. Relying on a linear regression model, we predicted log-transformed lipid-adjusted DDE serum levels. GIS–PUR-derived OC measure, body mass index, age, gender, mixing and loading pesticides by hand, and using pesticides in the home, together explained 47% of the DDE serum level variance (adjusted r2 = 0.47). The specificity of using our environmental GIS–PUR-derived OC measures to identify those with high-serum DDE levels was reasonably good (87%). Our environmental GIS–PUR-based approach appears to provide a valid model for assessing residential exposures to agricultural pesticides. PMID:17119217

  13. Exposure to traffic noise and air pollution and risk for febrile seizure: a cohort study.

    PubMed

    Hjortebjerg, Dorrit; Nybo Andersen, Anne-Marie; Ketzel, Matthias; Raaschou-Nielsen, Ole; Sørensen, Mette

    2018-03-25

    Objectives Exposure to traffic noise and air pollution is suspected to increase susceptibility to viral infections - the main triggering factor for febrile seizures. No studies have examined these two exposures in relation to febrile seizures. We aimed to investigate whether exposure to road traffic noise and air pollution are associated with risk of febrile seizures in childhood. Methods From our study base of 51 465 singletons from a national birth cohort, we identified 2175 cases with febrile seizures using a nationwide registry. Residential address history from conception to six years of age were found in national registers, and road traffic noise (L den ) and air pollution (NO 2 ) were modeled for all addresses. Analyses were done using Cox proportional hazard model with adjustment for potential confounders, including mutual exposure adjustment. Results An interquartile range (IQR) increase in childhood exposure to road traffic noise and air pollution was associated with an 11% [incidence rate ratio (IRR) 1.11, 95% confidence interval (CI) 1.04-1.19) and 5% (IRR 1.05, 95% CI 1.02-1.07) higher risk for febrile seizures, respectively, after adjustment for potential confounders. Weaker tendencies were seen for pregnancy exposure. In models with mutual exposure adjustment, the estimates were slightly lower, with IRR of 1.08 (95% CI 1.00-1.16) and 1.03 (95% CI 0.99-1.06) per IQR increase in childhood exposure to road traffic noise and air pollution, respectively. Conclusions This study suggests that residential exposure to road traffic noise and air pollution is associated with higher risk for febrile seizures.

  14. Simulation of dental collisions and occlusal dynamics in the virtual environment.

    PubMed

    Stavness, I K; Hannam, A G; Tobias, D L; Zhang, X

    2016-04-01

    Semi-adjustable articulators have often been used to simulate occlusal dynamics, but advances in intra-oral scanning and computer software now enable dynamics to be modelled mathematically. Computer simulation of occlusal dynamics requires accurate virtual casts, records to register them and methods to handle mesh collisions during movement. Here, physical casts in a semi-adjustable articulator were scanned with a conventional clinical intra-oral scanner. A coordinate measuring machine was used to index their positions in intercuspation, protrusion, right and left laterotrusion, and to model features of the articulator. Penetrations between the indexed meshes were identified and resolved using restitution forces, and the final registrations were verified by distance measurements between dental landmarks at multiple sites. These sites were confirmed as closely approximating via measurements made from homologous transilluminated vinylpolysiloxane interocclusal impressions in the mounted casts. Movements between the indexed positions were simulated with two models in a custom biomechanical software platform. In model DENTAL, 6 degree-of-freedom movements were made to minimise deviation from a straight line path and also shaped by dynamic mesh collisions detected and resolved mathematically. In model ARTIC, the paths were further constrained by surfaces matching the control settings of the articulator. Despite these differences, the lower mid-incisor point paths were very similar in both models. The study suggests that mathematical simulation utilising interocclusal 'bite' registrations can closely replicate the primary movements of casts mounted in a semi-adjustable articulator. Additional indexing positions and appropriate software could, in some situations, replace the need for mechanical semi-adjustable articulation and/or its virtual representation. © 2015 John Wiley & Sons Ltd.

  15. HIV Prevalence and Risks Associated with HIV Infection among Transgender Individuals in Cambodia.

    PubMed

    Weissman, Amy; Ngak, Song; Srean, Chhim; Sansothy, Neth; Mills, Stephen; Ferradini, Laurent

    2016-01-01

    Recognizing transgender individuals have a high risk of HIV acquisition, and to inform policies and programming, we conducted an HIV prevalence and risk behaviors survey among transgender individuals in Cambodia. Cross-sectional survey using a respondent driven sampling method with self-administered audio-computer assisted interviews. HIV testing was performed prior to the questionnaire with results available immediately after. Eligible participants were ≥18 years, identified as male at birth and self-identified/expressed as a different gender, and reported having sex with at least one male partner in past year. From six major urban centers of Cambodia, 891 transgender individuals were recruited. The majority of the 891 participants self-identified as third gender or female (94.5%), were young (median age 23, IQR [20-27]), had secondary education or higher (80.5%), not married (89.7%), and employed (90.2%). The majority had first sex before 18 years (66.8%), with a male (79.9%), 37.9% having been paid or paying for this first sex. The rate of HIV positivity among participants was found to be 4.15%. Consistent condom use with male and female partners was low with all partner types, but particularly low with male partners when paying for sex (20.3%). The majority of participants reported having experienced discrimination in their lifetime (54.8%) and 30.3% had been assaulted. Multivariate analysis revealed that older age (adjusted OR = 14.73 [4.20, 51.67] for age 35-44 and adjusted OR = 7.63 [2.55, 22.81] for age 30-34), only having a primary school education or no schooling at all (adjusted OR = 2.62 [1.18, 5.80], being a resident of Siem Reap (adjusted OR = 7.44 [2.37, 23.29], receiving payment at first sex (adjusted OR = 2.26 [1.00, 5.11], having sex during/after using drugs (adjusted OR = 2.90 [1.09, 7.73]), inconsistent condom use during last anal sex (adjusted OR = 3.84 [1.58, 9.33]), and reporting low self-esteem (adjusted OR = 3.25 [1.35, 7.85]) were independently associated with HIV infection. This study confirms transgender individuals as one of the highest-risk groups for HIV infection in Cambodia. It suggests the need for programmatic strategies that mitigate identified associated risks and facilitate access to HIV care for this population.

  16. Predictors of Chikungunya rheumatism: a prognostic survey ancillary to the TELECHIK cohort study

    PubMed Central

    2013-01-01

    Introduction Long-lasting relapsing or lingering rheumatic musculoskeletal pain (RMSP) is the hallmark of Chikungunya virus (CHIKV) rheumatism (CHIK-R). Little is known on their prognostic factors. The aim of this prognostic study was to search the determinants of lingering or relapsing RMSP indicative of CHIK-R. Methods Three hundred and forty-six infected adults (age ≥ 15 years) having declared RMSP at disease onset were extracted from the TELECHIK cohort study, Reunion island, and analyzed using a multinomial logistic regression model. We also searched for the predictors of CHIKV-specific IgG titres, assessed at the time of a serosurvey, using multiple linear regression analysis. Results Of these, 111 (32.1%) reported relapsing RMSP, 150 (43.3%) lingering RMSP, and 85 (24.6%) had fully recovered (reference group) on average two years after acute infection. In the final model controlling for gender, the determinants of relapsing RMSP were the age 45-59 years (adjusted OR: 2.9, 95% CI: 1.0, 8.6) or greater or equal than 60 years (adjusted OR: 10.4, 95% CI: 3.5, 31.1), severe rheumatic involvement (fever, at least six joints plus four other symptoms) at presentation (adjusted OR: 3.6, 95% CI: 1.5, 8.2), and CHIKV-specific IgG titres (adjusted OR: 3.2, 95% CI: 1.8, 5.5, per one unit increase). Prognostic factors for lingering RMSP were age 45-59 years (adjusted OR: 6.4, 95% CI: 1.8, 22.1) or greater or equal than 60 years (adjusted OR: 22.3, 95% CI: 6.3, 78.1), severe initial rheumatic involvement (adjusted OR: 5.5, 95% CI: 2.2, 13.8) and CHIKV-specific IgG titres (adjusted OR: 6.2, 95% CI: 2.8, 13.2, per one unit increase). CHIKV specific IgG titres were positively correlated with age, female gender and the severity of initial rheumatic symptoms. Conclusions Our data support the roles of age, severity at presentation and CHIKV specific IgG titres for predicting CHIK-R. By identifying the prognostic value of the humoral immune response of the host, this work also suggest a significant contribution of the adaptive immune response to the physiopathology of CHIK-R and should help to reconsider the paradigm of this chronic infection primarily shifted towards the involvement of the innate immune response. PMID:23302155

  17. Orthodontics for the dog. Treatment methods.

    PubMed

    Ross, D L

    1986-09-01

    This article considers the prevention of orthodontic problems, occlusal adjustments, simple tooth movements, rotational techniques, tipping problems, adjustment of crown height, descriptions of common orthodontic appliances, and problems associated with therapy.

  18. Use of screening tests to assess cancer risk and to estimate the risk of adult T-cell leukemia/lymphoma.

    PubMed Central

    Yanagawa, T; Tokudome, S

    1990-01-01

    We developed methods to assess the cancer risks by screening tests. These methods estimate the size of the high risk group adjusted for the characteristics of screening tests and estimate the incidence rates of cancer among the high risk group adjusted for the characteristics of the tests. A method was also developed for selecting the cut-off point of a screening test. Finally, the methods were applied to estimate the risk of the adult T-cell leukemia/lymphoma. PMID:2269244

  19. Optimizing ACS NSQIP modeling for evaluation of surgical quality and risk: patient risk adjustment, procedure mix adjustment, shrinkage adjustment, and surgical focus.

    PubMed

    Cohen, Mark E; Ko, Clifford Y; Bilimoria, Karl Y; Zhou, Lynn; Huffman, Kristopher; Wang, Xue; Liu, Yaoming; Kraemer, Kari; Meng, Xiangju; Merkow, Ryan; Chow, Warren; Matel, Brian; Richards, Karen; Hart, Amy J; Dimick, Justin B; Hall, Bruce L

    2013-08-01

    The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) collects detailed clinical data from participating hospitals using standardized data definitions, analyzes these data, and provides participating hospitals with reports that permit risk-adjusted comparisons with a surgical quality standard. Since its inception, the ACS NSQIP has worked to refine surgical outcomes measurements and enhance statistical methods to improve the reliability and validity of this hospital profiling. From an original focus on controlling for between-hospital differences in patient risk factors with logistic regression, ACS NSQIP has added a variable to better adjust for the complexity and risk profile of surgical procedures (procedure mix adjustment) and stabilized estimates derived from small samples by using a hierarchical model with shrinkage adjustment. New models have been developed focusing on specific surgical procedures (eg, "Procedure Targeted" models), which provide opportunities to incorporate indication and other procedure-specific variables and outcomes to improve risk adjustment. In addition, comparative benchmark reports given to participating hospitals have been expanded considerably to allow more detailed evaluations of performance. Finally, procedures have been developed to estimate surgical risk for individual patients. This article describes the development of, and justification for, these new statistical methods and reporting strategies in ACS NSQIP. Copyright © 2013 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  20. On-demand Reporting of Risk-adjusted and Smoothed Rates for Quality Profiling in ACS NSQIP.

    PubMed

    Cohen, Mark E; Liu, Yaoming; Huffman, Kristopher M; Ko, Clifford Y; Hall, Bruce L

    2016-12-01

    Surgical quality improvement depends on hospitals having accurate and timely information about comparative performance. Profiling accuracy is improved by risk adjustment and shrinkage adjustment to stabilize estimates. These adjustments are included in ACS NSQIP reports, where hospital odds ratios (OR) are estimated using hierarchical models built on contemporaneous data. However, the timeliness of feedback remains an issue. We describe an alternative, nonhierarchical approach, which yields risk- and shrinkage-adjusted rates. In contrast to our "Traditional" NSQIP method, this approach uses preexisting equations, built on historical data, which permits hospitals to have near immediate access to profiling results. We compared our traditional method to this new "on-demand" approach with respect to outlier determinations, kappa statistics, and correlations between logged OR and standardized rates, for 12 models (4 surgical groups by 3 outcomes). When both methods used the same contemporaneous data, there were similar numbers of hospital outliers and correlations between logged OR and standardized rates were high. However, larger differences were observed when the effect of contemporaneous versus historical data was added to differences in statistical methodology. The on-demand, nonhierarchical approach provides results similar to the traditional hierarchical method and offers immediacy, an "over-time" perspective, application to a broader range of models and data subsets, and reporting of more easily understood rates. Although the nonhierarchical method results are now available "on-demand" in a web-based application, the hierarchical approach has advantages, which support its continued periodic publication as the gold standard for hospital profiling in the program.

  1. Apparatus and method for controlling autotroph cultivation

    DOEpatents

    Fuxman, Adrian M; Tixier, Sebastien; Stewart, Gregory E; Haran, Frank M; Backstrom, Johan U; Gerbrandt, Kelsey

    2013-07-02

    A method includes receiving at least one measurement of a dissolved carbon dioxide concentration of a mixture of fluid containing an autotrophic organism. The method also includes determining an adjustment to one or more manipulated variables using the at least one measurement. The method further includes generating one or more signals to modify the one or more manipulated variables based on the determined adjustment. The one or more manipulated variables could include a carbon dioxide flow rate, an air flow rate, a water temperature, and an agitation level for the mixture. At least one model relates the dissolved carbon dioxide concentration to one or more manipulated variables, and the adjustment could be determined by using the at least one model to drive the dissolved carbon dioxide concentration to at least one target that optimize a goal function. The goal function could be to optimize biomass growth rate, nutrient removal and/or lipid production.

  2. 26 CFR 1.9001 - Statutory provisions; Retirement-Straight Line Adjustment Act of 1958.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... line property on his 1956 adjustment date may elect to have this section apply. Such an election shall... beginning after December 31, 1940, and before January 1, 1956, changed from the retirement to the straight line method of computing the allowance of deductions for depreciation. (d) Basis adjustments as of 1956...

  3. RESIDENTIAL RADON AND BIRTH DEFECTS: A POPULATION-BASED ASSESSMENT

    PubMed Central

    Langlois, Peter H; Lee, MinJae; Lupo, Philip J; Rahbar, Mohammad H; Cortez, Ruben K

    2015-01-01

    BACKGROUND Associations have been reported between maternal radiation exposure and birth defects. No such studies were found on radon. Our objective was to determine if there is an association between living in areas with higher radon levels and birth defects. METHODS The Texas Birth Defects Registry provided data on all birth defects from 1999–2009 from the entire state. Mean radon levels by geologic region came from the Texas Indoor Radon Survey. The association between radon and birth defects was estimated using multilevel mixed effect Poisson regression. RESULTS Birth defects overall were not associated with residential radon levels. Of the 100 other birth defect groups with at least 500 cases, 14 were significantly elevated in areas with high mean radon level in crude analyses, and 9 after adjustment for confounders. Cleft lip with/without cleft palate had an adjusted prevalence ratio (aPR) of 1.16 per 1 picoCurie/liter (pCi/l) increase in exposure to region mean radon, 95% confidence interval (CI) 1.08, 1.26. Cystic hygroma / lymphangioma had an aPR of 1.22 per 1 pCi/l increase, 95% CI 1.02, 1.46. Other associations were suggested but not as consistent: three skeletal defects, Down syndrome, other specified anomalies of the brain, and other specified anomalies of the bladder and urethra. CONCLUSIONS In the first study of residential radon and birth defects, we found associations with cleft lip w/wo cleft palate and cystic hygroma / lymphangioma. Other associations were suggested. The ecological nature of this study and multiple comparisons suggest that our results be interpreted with caution. PMID:25846606

  4. Determinants of Captan Air and Dermal Exposures among Orchard Pesticide Applicators in the Agricultural Health Study

    PubMed Central

    Hines, Cynthia J.; Deddens, James A.; Coble, Joseph; Kamel, Freya; Alavanja, Michael C. R.

    2011-01-01

    Objectives: To identify and quantify determinants of captan exposure among 74 private orchard pesticide applicators in the Agricultural Health Study (AHS). To adjust an algorithm used for estimating pesticide exposure intensity in the AHS based on these determinants and to compare the correlation of the adjusted and unadjusted algorithms with urinary captan metabolite levels. Methods: External exposure metrics included personal air, hand rinse, and dermal patch samples collected from each applicator on 2 days in 2002–2003. A 24-h urine sample was also collected. Exposure determinants were identified for each external metric using multiple linear regression models via the NLMIXED procedure in SAS. The AHS algorithm was adjusted, consistent with the identified determinants. Mixed-effect models were used to evaluate the correlation between the adjusted and unadjusted algorithm and urinary captan metabolite levels. Results: Consistent determinants of captan exposure were a measure of application size (kilogram of captan sprayed or application method), wearing chemical-resistant (CR) gloves and/or a coverall/suit, repairing spray equipment, and product formulation. Application by airblast was associated with a 4- to 5-fold increase in exposure as compared to hand spray. Exposure reduction to the hands, right thigh, and left forearm from wearing CR gloves averaged ∼80%, to the right and left thighs and right forearm from wearing a coverall/suit by ∼70%. Applicators using wettable powder formulations had significantly higher air, thigh, and forearm exposures than those using liquid formulations. Application method weights in the AHS algorithm were adjusted to nine for airblast and two for hand spray; protective equipment reduction factors were adjusted to 0.2 (CR gloves), 0.3 (coverall/suit), and 0.1 (both). Conclusions: Adjustment of application method, CR glove, and coverall weights in the AHS algorithm based on our exposure determinant findings substantially improved the correlation between the AHS algorithm and urinary metabolite levels. PMID:21427168

  5. 10 CFR Appendix N to Subpart B of... - Uniform Test Method for Measuring the Energy Consumption of Furnaces and Boilers

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... furnaces without stack dampers with adjustable fan control—cool-down test. For a furnace with adjustable... 10 Energy 3 2010-01-01 2010-01-01 false Uniform Test Method for Measuring the Energy Consumption... CONSERVATION ENERGY CONSERVATION PROGRAM FOR CONSUMER PRODUCTS Test Procedures Pt. 430, Subpt. B, App. N...

  6. 26 CFR 1.381(c)(21)-1 - Pre-1954 adjustments resulting from change in method of accounting.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 26 Internal Revenue 4 2010-04-01 2010-04-01 false Pre-1954 adjustments resulting from change in method of accounting. 1.381(c)(21)-1 Section 1.381(c)(21)-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES Insolvency Reorganizations § 1.381...

  7. 76 FR 59713 - Notice of Submission of Proposed Information Collection to OMB Annual Adjustment Factors (AAF...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-27

    ... subject proposal. Owners of project-based section 8 contracts that utilize the AAF as the method of rent.... Description of the Need for the Information and its Proposed Use: Owners of project-based section 8 contracts that utilize the AAF as the method of rent adjustment provide this information which is necessary to...

  8. Effortful control and school adjustment: The moderating role of classroom chaos.

    PubMed

    Berger, Rebecca H; Valiente, Carlos; Eisenberg, Nancy; Hernandez, Maciel M; Thompson, Marilyn; Spinrad, Tracy; VanSchyndel, Sarah; Silva, Kassondra; Southworth, Jody

    2017-11-01

    Guided by the person by environment framework, the primary goal of this study was to determine whether classroom chaos moderated the relation between effortful control and kindergarteners' school adjustment. Classroom observers reported on children's ( N = 301) effortful control in the fall. In the spring, teachers reported on classroom chaos and school adjustment outcomes (teacher-student relationship closeness and conflict, and school liking and avoidance). Cross-level interactions between effortful control and classroom chaos predicting school adjustment outcomes were assessed. A consistent pattern of interactions between effortful control and classroom chaos indicated that the relations between effortful control and the school adjustment outcomes were strongest in high chaos classrooms. Post-hoc analyses indicated that classroom chaos was associated with poor school adjustment when effortful control was low, suggesting that the combination of high chaos and low effortful control was associated with the poorest school outcomes.

  9. Optimism, Social Support, and Adjustment in African American Women with Breast Cancer

    PubMed Central

    Shelby, Rebecca A.; Crespin, Tim R.; Wells-Di Gregorio, Sharla M.; Lamdan, Ruth M.; Siegel, Jamie E.; Taylor, Kathryn L.

    2013-01-01

    Past studies show that optimism and social support are associated with better adjustment following breast cancer treatment. Most studies have examined these relationships in predominantly non-Hispanic White samples. The present study included 77 African American women treated for nonmetastatic breast cancer. Women completed measures of optimism, social support, and adjustment within 10-months of surgical treatment. In contrast to past studies, social support did not mediate the relationship between optimism and adjustment in this sample. Instead, social support was a moderator of the optimism-adjustment relationship, as it buffered the negative impact of low optimism on psychological distress, well-being, and psychosocial functioning. Women with high levels of social support experienced better adjustment even when optimism was low. In contrast, among women with high levels of optimism, increasing social support did not provide an added benefit. These data suggest that perceived social support is an important resource for women with low optimism. PMID:18712591

  10. Pathways from emotional adjustment to glycemic control in youths with diabetes in Hong Kong.

    PubMed

    Stewart, S M; Lee, P W; Low, L C; Cheng, A; Yeung, W; Huen, K F; O'Donnell, D

    2000-09-01

    To examine factors that influence emotional adjustment, adherence to diabetic care, and glycemic control in Hong Kong youths with insulin-dependent diabetes mellitus (IDDM). Seventy youths, their mothers, and matched controls provided information on health beliefs, authoritarian parenting style, parent-child conflict, emotional adjustment, and adherence to medical regimen. Glycosylated hemoglobin levels were obtained to measure glycemic control. Predictors explained 34% of the variance in emotional adjustment and 39% of the variance in glycemic control. The data supported a pathway from emotional adjustment to self-efficacy to adherence behaviors to glycemic control. In contrast to Western culture and consistent with prediction, parenting style did not associate with negative outcomes, and even relatively low levels of parent-child conflict correlated negatively with emotional adjustment in this culture. Management of conflict and self-efficacy enhancing interactions are suggested interventions to enhance adherence to diabetic care in Hong Kong youths with IDDM.

  11. Complementary nonparametric analysis of covariance for logistic regression in a randomized clinical trial setting.

    PubMed

    Tangen, C M; Koch, G G

    1999-03-01

    In the randomized clinical trial setting, controlling for covariates is expected to produce variance reduction for the treatment parameter estimate and to adjust for random imbalances of covariates between the treatment groups. However, for the logistic regression model, variance reduction is not obviously obtained. This can lead to concerns about the assumptions of the logistic model. We introduce a complementary nonparametric method for covariate adjustment. It provides results that are usually compatible with expectations for analysis of covariance. The only assumptions required are based on randomization and sampling arguments. The resulting treatment parameter is a (unconditional) population average log-odds ratio that has been adjusted for random imbalance of covariates. Data from a randomized clinical trial are used to compare results from the traditional maximum likelihood logistic method with those from the nonparametric logistic method. We examine treatment parameter estimates, corresponding standard errors, and significance levels in models with and without covariate adjustment. In addition, we discuss differences between unconditional population average treatment parameters and conditional subpopulation average treatment parameters. Additional features of the nonparametric method, including stratified (multicenter) and multivariate (multivisit) analyses, are illustrated. Extensions of this methodology to the proportional odds model are also made.

  12. Cholinesterase Inhibitors and Hospitalization for Bradycardia: A Population-Based Study

    PubMed Central

    Park-Wyllie, Laura Y.; Mamdani, Muhammad M.; Li, Ping; Gill, Sudeep S.; Laupacis, Andreas; Juurlink, David N.

    2009-01-01

    Background Cholinesterase inhibitors are commonly used to treat dementia. These drugs enhance the effects of acetylcholine, and reports suggest they may precipitate bradycardia in some patients. We aimed to examine the association between use of cholinesterase inhibitors and hospitalization for bradycardia. Methods and Findings We examined the health care records of more than 1.4 million older adults using a case-time-control design, allowing each individual to serve as his or her own control. Case patients were residents of Ontario, Canada, aged 67 y or older hospitalized for bradycardia between January 1, 2003 and March 31, 2008. Control patients (3∶1) were not hospitalized for bradycardia, and were matched to the corresponding case on age, sex, and a disease risk index. All patients had received cholinesterase inhibitor therapy in the 9 mo preceding the index hospitalization. We identified 1,009 community-dwelling older persons hospitalized for bradycardia within 9 mo of using a cholinesterase inhibitor. Of these, 161 cases informed the matched analysis of discordant pairs. Of these, 17 (11%) required a pacemaker during hospitalization, and six (4%) died prior to discharge. After adjusting for temporal changes in drug utilization, hospitalization for bradycardia was associated with recent initiation of a cholinesterase inhibitor (adjusted odds ratio [OR] 2.13, 95% confidence interval [CI] 1.29–3.51). The risk was similar among individuals with pre-existing cardiac disease (adjusted OR 2.25, 95% CI 1.18–4.28) and those receiving negative chronotropic drugs (adjusted OR 2.34, 95% CI 1.16–4.71). We found no such association when we replicated the analysis using proton pump inhibitors as a neutral exposure. Despite hospitalization for bradycardia, more than half of the patients (78 of 138 cases [57%]) who survived to discharge subsequently resumed cholinesterase inhibitor therapy. Conclusions Among older patients, initiation of cholinesterase inhibitor therapy was associated with a more than doubling of the risk of hospitalization for bradycardia. Resumption of therapy following discharge was common, suggesting that the cardiovascular toxicity of cholinesterase inhibitors is underappreciated by clinicians. Please see later in the article for the Editors' Summary PMID:19787032

  13. A spatially explicit approach to the study of socio-demographic inequality in the spatial distribution of trees across Boston neighborhoods.

    PubMed

    Duncan, Dustin T; Kawachi, Ichiro; Kum, Susan; Aldstadt, Jared; Piras, Gianfranco; Matthews, Stephen A; Arbia, Giuseppe; Castro, Marcia C; White, Kellee; Williams, David R

    2014-04-01

    The racial/ethnic and income composition of neighborhoods often influences local amenities, including the potential spatial distribution of trees, which are important for population health and community wellbeing, particularly in urban areas. This ecological study used spatial analytical methods to assess the relationship between neighborhood socio-demographic characteristics (i.e. minority racial/ethnic composition and poverty) and tree density at the census tact level in Boston, Massachusetts (US). We examined spatial autocorrelation with the Global Moran's I for all study variables and in the ordinary least squares (OLS) regression residuals as well as computed Spearman correlations non-adjusted and adjusted for spatial autocorrelation between socio-demographic characteristics and tree density. Next, we fit traditional regressions (i.e. OLS regression models) and spatial regressions (i.e. spatial simultaneous autoregressive models), as appropriate. We found significant positive spatial autocorrelation for all neighborhood socio-demographic characteristics (Global Moran's I range from 0.24 to 0.86, all P =0.001), for tree density (Global Moran's I =0.452, P =0.001), and in the OLS regression residuals (Global Moran's I range from 0.32 to 0.38, all P <0.001). Therefore, we fit the spatial simultaneous autoregressive models. There was a negative correlation between neighborhood percent non-Hispanic Black and tree density (r S =-0.19; conventional P -value=0.016; spatially adjusted P -value=0.299) as well as a negative correlation between predominantly non-Hispanic Black (over 60% Black) neighborhoods and tree density (r S =-0.18; conventional P -value=0.019; spatially adjusted P -value=0.180). While the conventional OLS regression model found a marginally significant inverse relationship between Black neighborhoods and tree density, we found no statistically significant relationship between neighborhood socio-demographic composition and tree density in the spatial regression models. Methodologically, our study suggests the need to take into account spatial autocorrelation as findings/conclusions can change when the spatial autocorrelation is ignored. Substantively, our findings suggest no need for policy intervention vis-à-vis trees in Boston, though we hasten to add that replication studies, and more nuanced data on tree quality, age and diversity are needed.

  14. The Effect of Serum Sodium on Survival in Patients Treated by Peritoneal Dialysis in the United Kingdom.

    PubMed

    Al-Chidadi, Asmaa; Nitsch, Dorothea; Davenport, Andrew

    ♦ BACKGROUND: Studies in hemodialysis patients suggest that hyponatremia is associated with increased mortality. However, results from peritoneal dialysis (PD) patients are discordant. We wished to establish whether there was an association between serum sodium and mortality risk in PD patients. ♦ METHODS: We analyzed 3,108 PD patients enrolled at day 90 of renal replacement therapy (RRT) into the UK Renal Registry (UKRR) data base with available serum sodium measurements (in 3 groups: ≤ 137, 138 - 140, ≥ 141 mmol/L) who were then followed up until death or the censoring date (31 December 2012). Analysis used Cox-regression with adjustment for age, sex, year of starting RRT, primary renal disease, serum albumin, smoking, and comorbidities. ♦ RESULTS: Unadjusted mortality rates were 118.6/1,000 person-years (py), 83.4/1,000 py, and 83.5/1,000 py for the lowest, middle, and highest serum sodium tertiles, respectively. After adjustment for covariates, patients in the lowest serum sodium group had almost 50% increased risk of dying compared with those with the highest serum sodium (hazard ratio [HR] 1.49, confidence interval [CI]:1.28 - 1.74), with a graded association between serum sodium and mortality. The association of serum sodium with mortality varied by age (p interaction < 0.001), and whilst this association attenuated after adjustment for confounding variables in the older age groups (55 - 64, and > 65 years), it remained in the younger age group of 18 - 54 years (HR 2.24 [1.36 - 3.70] in the lowest compared with the highest sodium tertile). ♦ CONCLUSIONS: Lower serum sodium concentrations at the start of RRT in PD patients are associated with increased risk of mortality. Whilst this association may well be due to confounding in the older age groups, the persistent strong association between hyponatremia and mortality in the younger age group after adjustment for the available confounders suggests that prospective studies are required to assess whether active intervention to maintain serum sodium changes outcomes. Copyright © 2017 International Society for Peritoneal Dialysis.

  15. Genetic Correlation between Body Fat Percentage and Cardiorespiratory Fitness Suggests Common Genetic Etiology

    PubMed Central

    Gjesing, Anette P.; Sandholt, Camilla H.; Jonsson, Anna; Mahendran, Yuvaraj; Have, Christian T.; Ekstrøm, Claus T.; Bjerregaard, Anne-Louise; Brage, Soren; Witte, Daniel R.; Jørgensen, Marit E.; Aadahl, Mette; Thuesen, Betina H.; Linneberg, Allan; Eiberg, Hans; Pedersen, Oluf; Grarup, Niels; Kilpeläinen, Tuomas O.; Hansen, Torben

    2016-01-01

    Objectives It has long been discussed whether fitness or fatness is a more important determinant of health status. If the same genetic factors that promote body fat percentage (body fat%) are related to cardiorespiratory fitness (CRF), part of the concurrent associations with health outcomes could reflect a common genetic origin. In this study we aimed to 1) examine genetic correlations between body fat% and CRF; 2) determine whether CRF can be attributed to a genetic risk score (GRS) based on known body fat% increasing loci; and 3) examine whether the fat mass and obesity associated (FTO) locus associates with CRF. Methods Genetic correlations based on pedigree information were examined in a family based cohort (n = 230 from 55 families). For the genetic association analyses, we examined two Danish population-based cohorts (ntotal = 3206). The body fat% GRS was created by summing the alleles of twelve independent risk variants known to associate with body fat%. We assessed CRF as maximal oxygen uptake expressed in millilitres of oxygen uptake per kg of body mass (VO2max), per kg fat-free mass (VO2maxFFM), or per kg fat mass (VO2maxFM). All analyses were adjusted for age and sex, and when relevant, for body composition. Results We found a significant negative genetic correlation between VO2max and body fat% (ρG = -0.72 (SE ±0.13)). The body fat% GRS associated with decreased VO2max (β = -0.15 mL/kg/min per allele, p = 0.0034, age and sex adjusted). The body fat%-increasing FTO allele was associated with a 0.42 mL/kg/min unit decrease in VO2max per allele (p = 0.0092, age and sex adjusted). Both associations were abolished after additional adjustment for body fat%. The fat% increasing GRS and FTO risk allele were associated with decreased VO2maxFM but not with VO2maxFFM. Conclusions Our findings suggest a shared genetic etiology between whole body fat% and CRF. PMID:27846319

  16. Back home: a qualitative study exploring re-entering cross-cultural missionary aid workers' loss and grief.

    PubMed

    Selby, Susan; Moulding, Nicole; Clark, Sheila; Jones, Alison; Braunack-Mayer, Annette; Beilby, Justin

    2009-01-01

    Over 200 Australian, American, and British Non-Government Organizations send aid workers overseas including missionaries. On re-entry, they may suffer psychological distress; however, there is little research about their psychosocial issues and management in the family practice setting. Research suggests loss and grief as a suitable paradigm for family practitioners dealing with psychosocial issues. The aim of this study was to explore loss and grief issues for adult Australian missionary cross-cultural aid workers during their re-entry adjustment. Mixed methods were used and this study reports the qualitative method: semi-structured interviews conducted with 15 participants. Results were analyzed using framework analysis. Themes of re-entry loss and grief were identified with sub-themes of multiple varied losses, mechanisms of loss, loss of control, common grief phenomena, disenfranchised grief, and reactivation of past grief. Theoretical and clinical implications are discussed. Findings of this study suggest that loss and grief is an appropriate paradigm for the management of these workers in the family practice setting. Further research is needed to enable appropriate care.

  17. Estimating pregnancy-related mortality from census data: experience in Latin America

    PubMed Central

    Queiroz, Bernardo L; Wong, Laura; Plata, Jorge; Del Popolo, Fabiana; Rosales, Jimmy; Stanton, Cynthia

    2009-01-01

    Abstract Objective To assess the feasibility of measuring maternal mortality in countries lacking accurate birth and death registration through national population censuses by a detailed evaluation of such data for three Latin American countries. Methods We used established demographic techniques, including the general growth balance method, to evaluate the completeness and coverage of the household death data obtained through population censuses. We also compared parity to cumulative fertility data to evaluate the coverage of recent household births. After evaluating the data and adjusting it as necessary, we calculated pregnancy-related mortality ratios (PRMRs) per 100 000 live births and used them to estimate maternal mortality. Findings The PRMRs for Honduras (2001), Nicaragua (2005) and Paraguay (2002) were 168, 95 and 178 per 100 000 live births, respectively. Surprisingly, evaluation of the data for Nicaragua and Paraguay showed overreporting of adult deaths, so a downward adjustment of 20% to 30% was required. In Honduras, the number of adult female deaths required substantial upward adjustment. The number of live births needed minimal adjustment. The adjusted PRMR estimates are broadly consistent with existing estimates of maternal mortality from various data sources, though the comparison varies by source. Conclusion Census data can be used to measure pregnancy-related mortality as a proxy for maternal mortality in countries with poor death registration. However, because our data were obtained from countries with reasonably good statistical systems and literate populations, we cannot be certain the methods employed in the study will be equally useful in more challenging environments. Our data evaluation and adjustment methods worked, but with considerable uncertainty. Ways of quantifying this uncertainty are needed. PMID:19551237

  18. System and method for tuning adjusting the central frequency of a laser while maintaining frequency stabilization to an external reference

    NASA Technical Reports Server (NTRS)

    Livas, Jeffrey (Inventor); Thorpe, James I. (Inventor); Numata, Kenji (Inventor)

    2011-01-01

    A method and system for stabilizing a laser to a frequency reference with an adjustable offset. The method locks a sideband signal generated by passing an incoming laser beam through the phase modulator to a frequency reference, and adjusts a carrier frequency relative to the locked sideband signal by changing a phase modulation frequency input to the phase modulator. The sideband signal can be a single sideband (SSB), dual sideband (DSB), or an electronic sideband (ESB) signal. Two separate electro-optic modulators can produce the DSB signal. The two electro-optic modulators can be a broadband modulator and a resonant modulator. With a DSB signal, the method can introduce two sinusoidal phase modulations at the phase modulator. With ESB signals, the method can further drive the optical phase modulator with an electrical signal with nominal frequency OMEGA(sub 1) that is phase modulated at a frequency OMEGA(sub 2)

  19. Impact of statistical adjustment for frequency of venue attendance in a venue-based survey of men who have sex with men.

    PubMed

    Gustafson, Paul; Gilbert, Mark; Xia, Michelle; Michelow, Warren; Robert, Wayne; Trussler, Terry; McGuire, Marissa; Paquette, Dana; Moore, David M; Gustafson, Reka

    2013-05-15

    Venue sampling is a common sampling method for populations of men who have sex with men (MSM); however, men who visit venues frequently are more likely to be recruited. While statistical adjustment methods are recommended, these have received scant attention in the literature. We developed a novel approach to adjust for frequency of venue attendance (FVA) and assess the impact of associated bias in the ManCount Study, a venue-based survey of MSM conducted in Vancouver, British Columbia, Canada, in 2008-2009 to measure the prevalence of human immunodeficiency virus and other infections and associated behaviors. Sampling weights were determined from an abbreviated list of questions on venue attendance and were used to adjust estimates of prevalence for health and behavioral indicators using a Bayesian, model-based approach. We found little effect of FVA adjustment on biological or sexual behavior indicators (primary outcomes); however, adjustment for FVA did result in differences in the prevalence of demographic indicators, testing behaviors, and a small number of additional variables. While these findings are reassuring and lend credence to unadjusted prevalence estimates from this venue-based survey, adjustment for FVA did shed important insights on MSM subpopulations that were not well represented in the sample.

  20. Method and system for dual resolution translation stage

    DOEpatents

    Halpin, John Michael

    2014-04-22

    A dual resolution translation stage includes a stage assembly operable to receive an optical element and a low resolution adjustment device mechanically coupled to the stage assembly. The dual resolution stage also includes an adjustable pivot block mechanically coupled to the stage assembly. The adjustable pivot block includes a pivot shaft. The dual resolution stage further includes a lever arm mechanically coupled to the adjustable pivot block. The lever arm is operable to pivot about the pivot shaft. The dual resolution stage additionally includes a high resolution adjustment device mechanically coupled to the lever arm and the stage assembly.

  1. Considerations for automated machine learning in clinical metabolic profiling: Altered homocysteine plasma concentration associated with metformin exposure.

    PubMed

    Orlenko, Alena; Moore, Jason H; Orzechowski, Patryk; Olson, Randal S; Cairns, Junmei; Caraballo, Pedro J; Weinshilboum, Richard M; Wang, Liewei; Breitenstein, Matthew K

    2018-01-01

    With the maturation of metabolomics science and proliferation of biobanks, clinical metabolic profiling is an increasingly opportunistic frontier for advancing translational clinical research. Automated Machine Learning (AutoML) approaches provide exciting opportunity to guide feature selection in agnostic metabolic profiling endeavors, where potentially thousands of independent data points must be evaluated. In previous research, AutoML using high-dimensional data of varying types has been demonstrably robust, outperforming traditional approaches. However, considerations for application in clinical metabolic profiling remain to be evaluated. Particularly, regarding the robustness of AutoML to identify and adjust for common clinical confounders. In this study, we present a focused case study regarding AutoML considerations for using the Tree-Based Optimization Tool (TPOT) in metabolic profiling of exposure to metformin in a biobank cohort. First, we propose a tandem rank-accuracy measure to guide agnostic feature selection and corresponding threshold determination in clinical metabolic profiling endeavors. Second, while AutoML, using default parameters, demonstrated potential to lack sensitivity to low-effect confounding clinical covariates, we demonstrated residual training and adjustment of metabolite features as an easily applicable approach to ensure AutoML adjustment for potential confounding characteristics. Finally, we present increased homocysteine with long-term exposure to metformin as a potentially novel, non-replicated metabolite association suggested by TPOT; an association not identified in parallel clinical metabolic profiling endeavors. While warranting independent replication, our tandem rank-accuracy measure suggests homocysteine to be the metabolite feature with largest effect, and corresponding priority for further translational clinical research. Residual training and adjustment for a potential confounding effect by BMI only slightly modified the suggested association. Increased homocysteine is thought to be associated with vitamin B12 deficiency - evaluation for potential clinical relevance is suggested. While considerations for clinical metabolic profiling are recommended, including adjustment approaches for clinical confounders, AutoML presents an exciting tool to enhance clinical metabolic profiling and advance translational research endeavors.

  2. ADJUSTMENT, MAINTENANCE, AND REPAIR OF CROP HARVESTING MACHINERY. AGRICULTURAL MACHINERY--SERVICE OCCUPATIONS, MODULE NUMBER 11.

    ERIC Educational Resources Information Center

    Ohio State Univ., Columbus. Center for Vocational and Technical Education.

    ONE OF A SERIES DESIGNED FOR HELPING TEACHERS PREPARE POSTSECONDARY-LEVEL STUDENTS FOR AGRICULTURAL MACHINERY SERVICE OCCUPATIONS AS PARTS MEN, MECHANICS, MECHANIC'S HELPERS, AND SERVICE SUPERVISORS, THIS GUIDE AIMS TO DEVELOP STUDENT COMPETENCY IN ADJUSTING, REPAIRING, AND MAINTAINING CROP HARVESTING MACHINERY. SUGGESTIONS FOR INTRODUCTION OF THE…

  3. Parenting and Late Adolescent Emotional Adjustment: Mediating Effects of Discipline and Gender

    ERIC Educational Resources Information Center

    McKinney, Cliff; Milone, Mary Catherine; Renk, Kimberly

    2011-01-01

    Research suggests that parenting styles are related to the types of discipline parents utilize and that the coupling of parenting styles and discipline techniques are related to child outcomes. Although extant research examines the effects of parenting styles and discipline on child and early adolescent adjustment, less is known about adjustment…

  4. Preschoolers' Self-Regulation Moderates Relations between Mothers' Representations and Children's Adjustment to School

    ERIC Educational Resources Information Center

    Sher-Censor, Efrat; Khafi, Tamar Y.; Yates, Tuppett M.

    2016-01-01

    Consistent with models of environmental sensitivity (Pluess, 2015), research suggests that the effects of parents' behaviors on child adjustment are stronger among children who struggle to regulate their thoughts, feelings, and behaviors compared with children with better self-regulation. This study extended prior research by assessing maternal…

  5. Battered Women: The Relationship of Stress, Support and Coping to Adjustment.

    ERIC Educational Resources Information Center

    Mitchell, Roger E.; Hodson, Christine A.

    Recent research on domestic violence has sought to provide insight into the psychological consequences of such violence. A conceptual framework, which suggests that both situational and person-centered factors contribute to adjustment to violence and affect a woman's personal and social resources, was formulated to examine the impact of stress,…

  6. Adjusting to New Places: International Student Adjustment and Place Attachment

    ERIC Educational Resources Information Center

    Terrazas-Carrillo, Elizabeth C.; Hong, Ji Y.; Pace, Terry M.

    2014-01-01

    Using data obtained from in-depth semistructured interviews, we examined international students' attachments to place in the local American Midwestern community where they have attended college for at least 2 years. The results of this study suggest that participants engage in a process of renegotiation of meanings attached to new places in ways…

  7. Divorce Stress and Adjustment Model: Locus of Control and Demographic Predictors.

    ERIC Educational Resources Information Center

    Barnet, Helen Smith

    This study depicts the divorce process over three time periods: predivorce decision phase, divorce proper, and postdivorce. Research has suggested that persons with a more internal locus of control experience less intense and shorter intervals of stress during the divorce proper and better postdivorce adjustment than do persons with a more…

  8. The Decision-Making Process and Its Relationship to Relocation Adjustment in Old People.

    ERIC Educational Resources Information Center

    Beaver, Marion L.

    1979-01-01

    Describes how older people arrive at a decision to move and identifies some of the correlates of successful adjustment to relocation. Findings suggest that while the stress of moving should not be underestimated, neither should the resilience of the older person to participate in a decision that concerns him. (Author)

  9. Role Taking Ability, Nonverbal Sensitivity, Language and Social Adjustment of Deaf Adolescents.

    ERIC Educational Resources Information Center

    Weisel, Amatzia; Bar-Lev, Hagit

    1992-01-01

    Presents study results regarding the social cognitive abilities of deaf adolescents. Explains that role taking ability and nonverbal sensitivity was evaluated in a series of tests. Reports low performance in social cognitive abilities. Suggests that language plays a role in social adjustment. Concludes that nonverbal sensitivity is an important…

  10. Indonesian Postgraduate Students Studying in Australia: An Examination of Their Academic, Social and Cultural Experiences

    ERIC Educational Resources Information Center

    Novera, Isvet Amri

    2004-01-01

    Prior studies suggest that adjustment is a significant contributor to the academic success of international students, and cultural differences can lead to adjustment problems. However, while Australia takes many international students from Indonesia, and there are substantial cultural differences between Indonesia and Australia, there has been…

  11. Facilitating Children's Divorce Adjustment: Guidelines for Parents and Practitioners. Issues in Education.

    ERIC Educational Resources Information Center

    Langenbrunner, Mary

    2000-01-01

    Provides guidelines to facilitate children's emotional adjustment to their parents' divorce. Suggestions include avoiding arguing in front of children, allowing children to spend quality time with both parents, keeping children's daily routines as normal as possible, avoiding putting children in the middle or in the "missing parent" role, allowing…

  12. Reasonable Adjustments in Learning Programs: Teaching Length, Mass and Capacity to Students with Intellectual Disability

    ERIC Educational Resources Information Center

    Du Plessis, Jelene; Ewing, Bronwyn

    2017-01-01

    Developed in concert with twelve special schools (Prep to Year 12) in Queensland, this paper regarding reasonable adjustments that promote quality differentiated teaching practice in special education math classrooms represents the knowledge and expertise of fifty teachers in special education. Survey responses and empirical evidence suggest that…

  13. Longitudinal and Integrative Tests of Family Stress Model Effects on Mexican Origin Adolescents

    ERIC Educational Resources Information Center

    White, Rebecca M. B.; Liu, Yu; Nair, Rajni L.; Tein, Jenn-Yun

    2015-01-01

    The family stress model represents a common framework through which to examine the effects of environmental stressors on adolescent adjustment. The model suggests that economic and neighborhood stressors influence youth adjustment via disruptions to parenting. Incorporating integrative developmental theory, we examined the degree to which parents'…

  14. Brief Report: No Association between Premorbid Adjustment in Adult-Onset Schizophrenia and Genetic Variation in Dysbindin

    ERIC Educational Resources Information Center

    Schirmbeck, Frederike; Georgi, Alexander; Strohmaier, Jana; Schmael, Christine; Boesshenz, Katja V.; Muhleisen, Thomas W.; Herms, Stefan; Hoffmann, Per; Jamra, Rami Abou; Schumacher, Johannes; Maier, Wolfgang; Propping, Peter; Nothen, Markus M.; Cichon, Sven; Rietschel, Marcella; Schulze, Thomas G.

    2008-01-01

    Whereas "Dysbindin" is considered a schizophrenia vulnerability gene, there is no consistency of findings. Phenotype refinement approaches may help to increase the genetic homogeneity and thus reconcile conflicting results. Premorbid adjustment (PMA) has been suggested to aid the phenotypic dissection. Gornick et al. ("J Autism Dev…

  15. Using risk adjustment approaches in child welfare performance measurement: Applications and insights from health and mental health settings

    PubMed Central

    Raghavan, Ramesh

    2014-01-01

    Federal policymaking in the last decade has dramatically expanded performance measurement within child welfare systems, and states are currently being fiscally penalized for poor performance on defined outcomes. However, in contrast to performance measurement in health settings, current policy holds child welfare systems solely responsible for meeting outcomes, largely without taking into account the effects of factors at the level of the child, and his or her social ecology, that might undermine the performance of child welfare agencies. Appropriate measurement of performance is predicated upon the ability to disentangle individual, as opposed to organizational, determinants of outcomes, which is the goal of risk adjustment methodologies. This review briefly conceptualizes and examines risk adjustment approaches in health and child welfare, suggests approaches to expanding its use to appropriately measure the performance of child welfare agencies, and highlights research gaps that diminish the appropriate use of risk adjustment approaches – and which consequently suggest the need for caution – in policymaking around performance measurement of child welfare agencies. PMID:25253917

  16. Empirical evidence for resource-rational anchoring and adjustment.

    PubMed

    Lieder, Falk; Griffiths, Thomas L; M Huys, Quentin J; Goodman, Noah D

    2018-04-01

    People's estimates of numerical quantities are systematically biased towards their initial guess. This anchoring bias is usually interpreted as sign of human irrationality, but it has recently been suggested that the anchoring bias instead results from people's rational use of their finite time and limited cognitive resources. If this were true, then adjustment should decrease with the relative cost of time. To test this hypothesis, we designed a new numerical estimation paradigm that controls people's knowledge and varies the cost of time and error independently while allowing people to invest as much or as little time and effort into refining their estimate as they wish. Two experiments confirmed the prediction that adjustment decreases with time cost but increases with error cost regardless of whether the anchor was self-generated or provided. These results support the hypothesis that people rationally adapt their number of adjustments to achieve a near-optimal speed-accuracy tradeoff. This suggests that the anchoring bias might be a signature of the rational use of finite time and limited cognitive resources rather than a sign of human irrationality.

  17. Curved adjustable fibre-optic diode laser in microscopic cholesteatoma surgery: description of use and review of the relevant literature.

    PubMed

    McCaffer, C J; Pabla, L; Watson, C

    2018-04-01

    The use of lasers in cholesteatoma surgery is common and well accepted. The most commonly used laser fibres are straight and non-adjustable; these have several limitations. This paper describes the use of an alternative laser fibre. This 'How I Do It' paper describes and illustrates the use of an alternative curved adjustable fibre-optic diode laser in microscopic cholesteatoma surgery. The curved, adjustable laser fibre allows accurate and atraumatic disease removal when the use of a straight laser fibre may be less effective or accurate. It reduces potential damage to delicate structures without the need for extra drilling or bone removal. It is suggested that the curved adjustable laser fibre is superior to the traditional straight fibre for cholesteatoma surgery.

  18. Money illusion among health care providers: should we adjust for inflation in analyses of provider behavior?

    PubMed

    Mayer, M L; Rozier, R G

    2000-08-01

    This analysis questions the appropriateness of inflation adjustment in analyses of provider behavior by comparing results from estimations using adjusted financial variables with those from estimations using unadjusted financial variables. Using Medicaid claims from 1984-1991, we explored the effects of Medicaid reimbursement increases on dentists' participation. Using results from inflation adjusted analyses, we would conclude that a 23% nominal increase in Medicaid reimbursement rates yields no increase in the number of Medicaid children seen by dentists. In contrast, estimations based on unadjusted reimbursement rates suggest that this same 23% nominal increase in reimbursement leads to an expected 16-person (15.4%) increase in the number of Medicaid patients seen per provider per year. These analyses demonstrate that results are sensitive to adjustment for inflation. While adjusting for inflation is a generally accepted practice in health services research, doing so without evidence that providers respond to adjusted reimbursement may be unjustified. More research is needed to determine the appropriateness of inflation adjustment in analyses of provider behavior, and the circumstances under which it should or should not be done.

  19. Adjustment of Adaptive Gain with Bounded Linear Stability Analysis to Improve Time-Delay Margin for Metrics-Driven Adaptive Control

    NASA Technical Reports Server (NTRS)

    Bakhtiari-Nejad, Maryam; Nguyen, Nhan T.; Krishnakumar, Kalmanje Srinvas

    2009-01-01

    This paper presents the application of Bounded Linear Stability Analysis (BLSA) method for metrics driven adaptive control. The bounded linear stability analysis method is used for analyzing stability of adaptive control models, without linearizing the adaptive laws. Metrics-driven adaptive control introduces a notion that adaptation should be driven by some stability metrics to achieve robustness. By the application of bounded linear stability analysis method the adaptive gain is adjusted during the adaptation in order to meet certain phase margin requirements. Analysis of metrics-driven adaptive control is evaluated for a linear damaged twin-engine generic transport model of aircraft. The analysis shows that the system with the adjusted adaptive gain becomes more robust to unmodeled dynamics or time delay.

  20. Automatic dynamic range adjustment for ultrasound B-mode imaging.

    PubMed

    Lee, Yeonhwa; Kang, Jinbum; Yoo, Yangmo

    2015-02-01

    In medical ultrasound imaging, dynamic range (DR) is defined as the difference between the maximum and minimum values of the displayed signal to display and it is one of the most essential parameters that determine its image quality. Typically, DR is given with a fixed value and adjusted manually by operators, which leads to low clinical productivity and high user dependency. Furthermore, in 3D ultrasound imaging, DR values are unable to be adjusted during 3D data acquisition. A histogram matching method, which equalizes the histogram of an input image based on that from a reference image, can be applied to determine the DR value. However, it could be lead to an over contrasted image. In this paper, a new Automatic Dynamic Range Adjustment (ADRA) method is presented that adaptively adjusts the DR value by manipulating input images similar to a reference image. The proposed ADRA method uses the distance ratio between the log average and each extreme value of a reference image. To evaluate the performance of the ADRA method, the similarity between the reference and input images was measured by computing a correlation coefficient (CC). In in vivo experiments, the CC values were increased by applying the ADRA method from 0.6872 to 0.9870 and from 0.9274 to 0.9939 for kidney and liver data, respectively, compared to the fixed DR case. In addition, the proposed ADRA method showed to outperform the histogram matching method with in vivo liver and kidney data. When using 3D abdominal data with 70 frames, while the CC value from the ADRA method is slightly increased (i.e., 0.6%), the proposed method showed improved image quality in the c-plane compared to its fixed counterpart, which suffered from a shadow artifact. These results indicate that the proposed method can enhance image quality in 2D and 3D ultrasound B-mode imaging by improving the similarity between the reference and input images while eliminating unnecessary manual interaction by the user. Copyright © 2014 Elsevier B.V. All rights reserved.

  1. A regional method for craniofacial reconstruction based on coordinate adjustments and a new fusion strategy.

    PubMed

    Deng, Qingqiong; Zhou, Mingquan; Wu, Zhongke; Shui, Wuyang; Ji, Yuan; Wang, Xingce; Liu, Ching Yiu Jessica; Huang, Youliang; Jiang, Haiyan

    2016-02-01

    Craniofacial reconstruction recreates a facial outlook from the cranium based on the relationship between the face and the skull to assist identification. But craniofacial structures are very complex, and this relationship is not the same in different craniofacial regions. Several regional methods have recently been proposed, these methods segmented the face and skull into regions, and the relationship of each region is then learned independently, after that, facial regions for a given skull are estimated and finally glued together to generate a face. Most of these regional methods use vertex coordinates to represent the regions, and they define a uniform coordinate system for all of the regions. Consequently, the inconsistence in the positions of regions between different individuals is not eliminated before learning the relationships between the face and skull regions, and this reduces the accuracy of the craniofacial reconstruction. In order to solve this problem, an improved regional method is proposed in this paper involving two types of coordinate adjustments. One is the global coordinate adjustment performed on the skulls and faces with the purpose to eliminate the inconsistence of position and pose of the heads; the other is the local coordinate adjustment performed on the skull and face regions with the purpose to eliminate the inconsistence of position of these regions. After these two coordinate adjustments, partial least squares regression (PLSR) is used to estimate the relationship between the face region and the skull region. In order to obtain a more accurate reconstruction, a new fusion strategy is also proposed in the paper to maintain the reconstructed feature regions when gluing the facial regions together. This is based on the observation that the feature regions usually have less reconstruction errors compared to rest of the face. The results demonstrate that the coordinate adjustments and the new fusion strategy can significantly improve the craniofacial reconstructions. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  2. The association between obesity, depression, and educational attainment in women: The mediating role of body image dissatisfaction

    PubMed Central

    Gavin, Amelia R.; Simon, Greg E.; Ludman, Evette J.

    2011-01-01

    Objective We examine the mediating role of body image dissatisfaction (BID) on the association between obesity and depression and the variation of this association as a function of years of education among a population-based sample of women aged 40–65 years. Methods A series of sample-weighted logistic regression models were used to estimate the associations between obesity, BID, and depression, stratified by educational attainment. Data were obtained from a structured telephone interview of 4543 female health plan enrollees, including self-reported height and weight, the Patient Health Questionnaire assessment of depression, and a single-item measure of BID. Results Among those with <16 years of education, in both the unadjusted and adjusted models, obesity and BID were significantly associated with depression. Similarly, among those with ≥16 years of education, obesity and BID were significantly associated with depression in the unadjusted models. However, in the adjusted model, only BID was associated with depression. A formal test for mediation suggests that the association between obesity and depression was mediated by BID regardless of level of education. Conclusions Our data suggest that BID-mediated the obesity-depression association. In addition, obesity and BID may be salient risk factors for depression among middle-aged women as a function of the level of education. PMID:21109045

  3. An online supervised learning method based on gradient descent for spiking neurons.

    PubMed

    Xu, Yan; Yang, Jing; Zhong, Shuiming

    2017-09-01

    The purpose of supervised learning with temporal encoding for spiking neurons is to make the neurons emit a specific spike train encoded by precise firing times of spikes. The gradient-descent-based (GDB) learning methods are widely used and verified in the current research. Although the existing GDB multi-spike learning (or spike sequence learning) methods have good performance, they work in an offline manner and still have some limitations. This paper proposes an online GDB spike sequence learning method for spiking neurons that is based on the online adjustment mechanism of real biological neuron synapses. The method constructs error function and calculates the adjustment of synaptic weights as soon as the neurons emit a spike during their running process. We analyze and synthesize desired and actual output spikes to select appropriate input spikes in the calculation of weight adjustment in this paper. The experimental results show that our method obviously improves learning performance compared with the offline learning manner and has certain advantage on learning accuracy compared with other learning methods. Stronger learning ability determines that the method has large pattern storage capacity. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. Contrast-dependent saturation adjustment for outdoor image enhancement.

    PubMed

    Wang, Shuhang; Cho, Woon; Jang, Jinbeum; Abidi, Mongi A; Paik, Joonki

    2017-01-01

    Outdoor images captured in bad-weather conditions usually have poor intensity contrast and color saturation since the light arriving at the camera is severely scattered or attenuated. The task of improving image quality in poor conditions remains a challenge. Existing methods of image quality improvement are usually effective for a small group of images but often fail to produce satisfactory results for a broader variety of images. In this paper, we propose an image enhancement method, which makes it applicable to enhance outdoor images by using content-adaptive contrast improvement as well as contrast-dependent saturation adjustment. The main contribution of this work is twofold: (1) we propose the content-adaptive histogram equalization based on the human visual system to improve the intensity contrast; and (2) we introduce a simple yet effective prior for adjusting the color saturation depending on the intensity contrast. The proposed method is tested with different kinds of images, compared with eight state-of-the-art methods: four enhancement methods and four haze removal methods. Experimental results show the proposed method can more effectively improve the visibility and preserve the naturalness of the images, as opposed to the compared methods.

  5. The importance of decision onset

    PubMed Central

    Grinband, Jack; Ferrera, Vincent

    2015-01-01

    The neural mechanisms of decision making are thought to require the integration of evidence over time until a response threshold is reached. Much work suggests that response threshold can be adjusted via top-down control as a function of speed or accuracy requirements. In contrast, the time of integration onset has received less attention and is believed to be determined mostly by afferent or preprocessing delays. However, a number of influential studies over the past decade challenge this assumption and begin to paint a multifaceted view of the phenomenology of decision onset. This review highlights the challenges involved in initiating the integration of evidence at the optimal time and the potential benefits of adjusting integration onset to task demands. The review outlines behavioral and electrophysiolgical studies suggesting that the onset of the integration process may depend on properties of the stimulus, the task, attention, and response strategy. Most importantly, the aggregate findings in the literature suggest that integration onset may be amenable to top-down regulation, and may be adjusted much like response threshold to exert cognitive control and strategically optimize the decision process to fit immediate behavioral requirements. PMID:26609111

  6. Importance of curvature evaluation scale for predictive simulations of dynamic gas-liquid interfaces

    NASA Astrophysics Data System (ADS)

    Owkes, Mark; Cauble, Eric; Senecal, Jacob; Currie, Robert A.

    2018-07-01

    The effect of the scale used to compute the interfacial curvature on the prediction of dynamic gas-liquid interfaces is investigated. A new interface curvature calculation methodology referred to herein as the Adjustable Curvature Evaluation Scale (ACES) is proposed. ACES leverages a weighted least squares regression to fit a polynomial through points computed on the volume-of-fluid representation of the gas-liquid interface. The interface curvature is evaluated from this polynomial. Varying the least squares weight with distance from the location where the curvature is being computed, adjusts the scale the curvature is evaluated on. ACES is verified using canonical static test cases and compared against second- and fourth-order height function methods. Simulations of dynamic interfaces, including a standing wave and oscillating droplet, are performed to assess the impact of the curvature evaluation scale for predicting interface motions. ACES and the height function methods are combined with two different unsplit geometric volume-of-fluid (VoF) schemes that define the interface on meshes with different levels of refinement. We find that the results depend significantly on curvature evaluation scale. Particularly, the ACES scheme with a properly chosen weight function is accurate, but fails when the scale is too small or large. Surprisingly, the second-order height function method is more accurate than the fourth-order variant for the dynamic tests even though the fourth-order method performs better for static interfaces. Comparing the curvature evaluation scale of the second- and fourth-order height function methods, we find the second-order method is closer to the optimum scale identified with ACES. This result suggests that the curvature scale is driving the accuracy of the dynamics. This work highlights the importance of studying numerical methods with realistic (dynamic) test cases and that the interactions of the various discretizations is as important as the accuracy of one part of the discretization.

  7. Tunable plasmon-induced transparency based on graphene nanoring coupling with graphene nanostrips

    NASA Astrophysics Data System (ADS)

    Liao, Chang-Long; Fu, Guang-Lai; Xia, Sheng-Xuan; Li, Hong-Ju; Zhai, Xiang; Wang, Ling-Ling

    2018-02-01

    We numerically and theoretically demonstrate a plasmon-induced transparency (PIT) at the mid-infrared region with finite-difference time-domain method. The system consists of an optically bright dipole mode and a dark quadrupole mode, which are supported by the graphene nanoring and graphene nanostrips, respectively. The coupling between the two modes introduces transparency window and large group delays. The pronounced PIT resonance can be easily modified by adjusting the geometric parameters and the Fermi level of graphene nanostructure. Our results suggest that the demonstrated PIT effect may be applicated in the slow-light device, active plasmonic switching, and optical sensing.

  8. The evolution of active region loop plasma

    NASA Technical Reports Server (NTRS)

    Krall, K. R.; Antiochos, S. K.

    1980-01-01

    The adjustment of coronal active-region loops to changes in their heating rate is investigated numerically. The one-dimensional hydrodynamic equations are solved subject to boundary conditions in which heat flux-induced mass exchange between coronal and chromospheric components is allowed. The calculated evolution of physical parameters suggests that (1) mass supplied during chromospheric evaporation is much more effective in moderating coronal temperature excursions than when downward heat flux is dissipated by a static chromosphere, and (2) the method by which the chromosphere responds to changing coronal conditions can significantly influence coronal readjustment time scales. Observations are cited which illustrate the range of possible fluctuations in the heating rates.

  9. Investment appraisal using quantitative risk analysis.

    PubMed

    Johansson, Henrik

    2002-07-01

    Investment appraisal concerned with investments in fire safety systems is discussed. Particular attention is directed at evaluating, in terms of the Bayesian decision theory, the risk reduction that investment in a fire safety system involves. It is shown how the monetary value of the change from a building design without any specific fire protection system to one including such a system can be estimated by use of quantitative risk analysis, the results of which are expressed in terms of a Risk-adjusted net present value. This represents the intrinsic monetary value of investing in the fire safety system. The method suggested is exemplified by a case study performed in an Avesta Sheffield factory.

  10. Robust statistical methods for hit selection in RNA interference high-throughput screening experiments.

    PubMed

    Zhang, Xiaohua Douglas; Yang, Xiting Cindy; Chung, Namjin; Gates, Adam; Stec, Erica; Kunapuli, Priya; Holder, Dan J; Ferrer, Marc; Espeseth, Amy S

    2006-04-01

    RNA interference (RNAi) high-throughput screening (HTS) experiments carried out using large (>5000 short interfering [si]RNA) libraries generate a huge amount of data. In order to use these data to identify the most effective siRNAs tested, it is critical to adopt and develop appropriate statistical methods. To address the questions in hit selection of RNAi HTS, we proposed a quartile-based method which is robust to outliers, true hits and nonsymmetrical data. We compared it with the more traditional tests, mean +/- k standard deviation (SD) and median +/- 3 median of absolute deviation (MAD). The results suggested that the quartile-based method selected more hits than mean +/- k SD under the same preset error rate. The number of hits selected by median +/- k MAD was close to that by the quartile-based method. Further analysis suggested that the quartile-based method had the greatest power in detecting true hits, especially weak or moderate true hits. Our investigation also suggested that platewise analysis (determining effective siRNAs on a plate-by-plate basis) can adjust for systematic errors in different plates, while an experimentwise analysis, in which effective siRNAs are identified in an analysis of the entire experiment, cannot. However, experimentwise analysis may detect a cluster of true positive hits placed together in one or several plates, while platewise analysis may not. To display hit selection results, we designed a specific figure called a plate-well series plot. We thus suggest the following strategy for hit selection in RNAi HTS experiments. First, choose the quartile-based method, or median +/- k MAD, for identifying effective siRNAs. Second, perform the chosen method experimentwise on transformed/normalized data, such as percentage inhibition, to check the possibility of hit clusters. If a cluster of selected hits are observed, repeat the analysis based on untransformed data to determine whether the cluster is due to an artifact in the data. If no clusters of hits are observed, select hits by performing platewise analysis on transformed data. Third, adopt the plate-well series plot to visualize both the data and the hit selection results, as well as to check for artifacts.

  11. An approach to adjustment of relativistic mean field model parameters

    NASA Astrophysics Data System (ADS)

    Bayram, Tuncay; Akkoyun, Serkan

    2017-09-01

    The Relativistic Mean Field (RMF) model with a small number of adjusted parameters is powerful tool for correct predictions of various ground-state nuclear properties of nuclei. Its success for describing nuclear properties of nuclei is directly related with adjustment of its parameters by using experimental data. In the present study, the Artificial Neural Network (ANN) method which mimics brain functionality has been employed for improvement of the RMF model parameters. In particular, the understanding capability of the ANN method for relations between the RMF model parameters and their predictions for binding energies (BEs) of 58Ni and 208Pb have been found in agreement with the literature values.

  12. 26 CFR 1.734-1 - Optional adjustment to basis of undistributed partnership property.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... partner. See § 1.460-4(k)(2)(iv)(D) for a rule determining the partnership's basis in a long-term contract accounted for under a long-term contract method of accounting. The provisions of this paragraph (b)(1) are... which the adjustment has been allocated. (e) Recovery of adjustments to basis of partnership property—(1...

  13. Toward the Development of Integrative Risk-Adjusted Measures of Quality Using Large Clinical Data Bases: The Case of Anesthesia Services.

    ERIC Educational Resources Information Center

    Fleming, Steven T.

    1992-01-01

    The concept of risk-adjusted measures of quality is discussed, and a methodology is proposed for risk-adjusting and integrating multiple adverse outcomes of anesthesia services into measures for quality assurance and quality improvement programs. Although designed for a new anesthesiology database, the methods should apply to other health…

  14. Child, Parent and Family Factors as Predictors of Adjustment for Siblings of Children with a Disability

    ERIC Educational Resources Information Center

    Giallo, R.; Gavidia-Payne, S.

    2006-01-01

    Background: Siblings adjust to having a brother or sister with a disability in diverse ways. This study investigated a range of child, parent and family factors as predictors of sibling adjustment outcomes. Methods: Forty-nine siblings (aged 7-16 years) and parents provided information about (1) sibling daily hassles and uplifts; (2) sibling…

  15. 48 CFR 52.222-31 - Davis-Bacon Act-Price Adjustment (Percentage Method).

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... the Davis-Bacon Act to provide for an increase in wages and fringe benefits at the exercise of each... exercise of each option to extend the term of the contract. This adjustment is the only adjustment that the Contracting Officer will make to cover any increases in wages and benefits as a result of— (1) Incorporation...

  16. Impact of Socio-Emotional Adjustment on Academic Achievement of Adolescent Girls in Jammu and Kashmir

    ERIC Educational Resources Information Center

    Gul, Showkeen Bilal Ahmad

    2015-01-01

    The study examined the impact of socio-emotional adjustment on academic achievement of adolescent girls of Jammu and Kashmir. The purpose of the investigation was to study the relationship and effect of socio-emotional adjustment on academic achievement among adolescent girls. The descriptive survey research method was used for the study and the…

  17. A Machine Learning Framework for Plan Payment Risk Adjustment.

    PubMed

    Rose, Sherri

    2016-12-01

    To introduce cross-validation and a nonparametric machine learning framework for plan payment risk adjustment and then assess whether they have the potential to improve risk adjustment. 2011-2012 Truven MarketScan database. We compare the performance of multiple statistical approaches within a broad machine learning framework for estimation of risk adjustment formulas. Total annual expenditure was predicted using age, sex, geography, inpatient diagnoses, and hierarchical condition category variables. The methods included regression, penalized regression, decision trees, neural networks, and an ensemble super learner, all in concert with screening algorithms that reduce the set of variables considered. The performance of these methods was compared based on cross-validated R 2 . Our results indicate that a simplified risk adjustment formula selected via this nonparametric framework maintains much of the efficiency of a traditional larger formula. The ensemble approach also outperformed classical regression and all other algorithms studied. The implementation of cross-validated machine learning techniques provides novel insight into risk adjustment estimation, possibly allowing for a simplified formula, thereby reducing incentives for increased coding intensity as well as the ability of insurers to "game" the system with aggressive diagnostic upcoding. © Health Research and Educational Trust.

  18. An evaluation of bias in propensity score-adjusted non-linear regression models.

    PubMed

    Wan, Fei; Mitra, Nandita

    2018-03-01

    Propensity score methods are commonly used to adjust for observed confounding when estimating the conditional treatment effect in observational studies. One popular method, covariate adjustment of the propensity score in a regression model, has been empirically shown to be biased in non-linear models. However, no compelling underlying theoretical reason has been presented. We propose a new framework to investigate bias and consistency of propensity score-adjusted treatment effects in non-linear models that uses a simple geometric approach to forge a link between the consistency of the propensity score estimator and the collapsibility of non-linear models. Under this framework, we demonstrate that adjustment of the propensity score in an outcome model results in the decomposition of observed covariates into the propensity score and a remainder term. Omission of this remainder term from a non-collapsible regression model leads to biased estimates of the conditional odds ratio and conditional hazard ratio, but not for the conditional rate ratio. We further show, via simulation studies, that the bias in these propensity score-adjusted estimators increases with larger treatment effect size, larger covariate effects, and increasing dissimilarity between the coefficients of the covariates in the treatment model versus the outcome model.

  19. Poor adjustment to college life mediates the relationship between drinking motives and alcohol consequences: a look at college adjustment, drinking motives, and drinking outcomes.

    PubMed

    LaBrie, Joseph W; Ehret, Phillip J; Hummer, Justin F; Prenovost, Katherine

    2012-04-01

    The current study examined whether the relationship between drinking motives and alcohol-related outcomes was mediated by college adjustment. Participants (N=253) completed an online survey that assessed drinking motives, degree of both positive and negative college adjustment, typical weekly drinking, and past month negative alcohol-related consequences. Structural equation modeling examined negative alcohol consequences as a function of college adjustment, drinking motives, and weekly drinking behavior in college students. Negative college adjustment mediated the relationship between coping drinking motives and drinking consequences. Positive college adjustment was not related to alcohol consumption or consequences. Positive reinforcement drinking motives (i.e. social and enhancement) not only directly predicted consequences, but were partially mediated by weekly drinking and degree of negative college adjustment. Gender specific models revealed that males exhibited more variability in drinking and their positive reinforcement drinking motives were more strongly associated with weekly drinking. Uniquely for females, coping motives were directly and indirectly (via negative adjustment) related to consequences. These findings suggest that interventions which seek to decrease alcohol-related risk may wish to incorporate discussions about strategies for decreasing stress and increasing other factors associated with better college adjustment. Copyright © 2011 Elsevier Ltd. All rights reserved.

  20. Automatic allograft bone selection through band registration and its application to distal femur.

    PubMed

    Zhang, Yu; Qiu, Lei; Li, Fengzan; Zhang, Qing; Zhang, Li; Niu, Xiaohui

    2017-09-01

    Clinical reports suggest that large bone defects could be effectively restored by allograft bone transplantation, where allograft bone selection acts an important role. Besides, there is a huge demand for developing the automatic allograft bone selection methods, as the automatic methods could greatly improve the management efficiency of the large bone banks. Although several automatic methods have been presented to select the most suitable allograft bone from the massive allograft bone bank, these methods still suffer from inaccuracy. In this paper, we propose an effective allograft bone selection method without using the contralateral bones. Firstly, the allograft bone is globally aligned to the recipient bone by surface registration. Then, the global alignment is further refined through band registration. The band, defined as the recipient points within the lifted and lowered cutting planes, could involve more local structure of the defected segment. Therefore, our method could achieve robust alignment and high registration accuracy of the allograft and recipient. Moreover, the existing contour method and surface method could be unified into one framework under our method by adjusting the lift and lower distances of the cutting planes. Finally, our method has been validated on the database of distal femurs. The experimental results indicate that our method outperforms the surface method and contour method.

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