Comparing a volume based template approach and ultrasound guided freehand approach in multicatheter interstitial accelerated partial breast irradiation.

PubMed

Koh, Vicky Y; Buhari, Shaik A; Tan, Poh Wee; Tan, Yun Inn; Leong, Yuh Fun; Earnest, Arul; Tang, Johann I

2014-06-01

Currently, there are two described methods of catheter insertion for women undergoing multicatheter interstitial accelerated partial breast irradiation (APBI). These are a volume based template approach (template) and a non-template ultrasound guidance freehand approach (non-template). We aim to compare dosimetric endpoints between the template and non-template approach. Twenty patients, who received adjuvant multicatheter interstitial APBI between August 2008 to March 2010 formed the study cohort. Dosimetric planning was based on the RTOG 04-13 protocol. For standardization, the planning target volume evaluation (PTV-Eval) and organs at risk were contoured with the assistance of the attending surgeon. Dosimetric endpoints include D90 of the PTV-Eval, Dose Homogeneity Index (DHI), V200, maximum skin dose (MSD), and maximum chest wall dose (MCD). A median of 18 catheters was used per patient. The dose prescribed was 34 Gy in 10 fractions BID over 5 days. The average breast volume was 846 cm(3) (526-1384) for the entire cohort and there was no difference between the two groups (p = 0.6). Insertion time was significantly longer for the non-template approach (mean 150 minutes) compared to the template approach (mean: 90 minutes) (p = 0.02). The planning time was also significantly longer for the non-template approach (mean: 240 minutes) compared to the template approach (mean: 150 minutes) (p < 0.01). The template approach yielded a higher D90 (mean: 95%) compared to the non-template approach (mean: 92%) (p < 0.01). There were no differences in DHI (p = 0.14), V200 (p = 0.21), MSD (p = 0.7), and MCD (p = 0.8). Compared to the non-template approach, the template approach offered significant shorter insertion and planning times with significantly improved dosimetric PTV-Eval coverage without significantly compromising organs at risk dosimetrically.

A Prospective Randomized Peri- and Post-Operative Comparison of the Minimally Invasive Anterolateral Approach Versus the Lateral Approach

PubMed Central

Landgraeber, Stefan; Quitmann, Henning; Güth, Sebastian; Haversath, Marcel; Kowalczyk, Wojciech; Kecskeméthy, Andrés; Heep, Hansjörg; Jäger, Marcus

2013-01-01

There is still controversy as to whether minimally invasive total hip arthroplasty enhances the postoperative outcome. The aim of this study was to compare the outcome of patients who underwent total hip replacement through an anterolateral minimally invasive (MIS) or a conventional lateral approach (CON). We performed a randomized, prospective study of 75 patients with primary hip arthritis, who underwent hip replacement through the MIS (n=36) or CON (n=39) approach. The Western Ontario and McMaster Universities Osteoarthritis Index and Harris Hip score (HHS) were evaluated at frequent intervals during the early postoperative follow-up period and then after 3.5 years. Pain sensations were recorded. Serological and radiological analyses were performed. In the MIS group the patients had smaller skin incisions and there was a significantly lower rate of patients with a positive Trendelenburg sign after six weeks postoperatively. After six weeks the HHS was 6.85 points higher in the MIS group (P=0.045). But calculating the mean difference between the baseline and the six weeks HHS we evaluated no significant differences. Blood loss was greater and the duration of surgery was longer in the MIS group. The other parameters, especially after the twelfth week, did not differ significantly. Radiographs showed the inclination of the acetabular component to be significantly higher in the MIS group, but on average it was within the same permitted tolerance range as in the CON group. Both approaches are adequate for hip replacement. Given the data, there appears to be no significant long term advantage to the MIS approach, as described in this study. PMID:24191179

Comparative study of the novel and conventional injection approach for inferior alveolar nerve block.

PubMed

Boonsiriseth, K; Sirintawat, N; Arunakul, K; Wongsirichat, N

2013-07-01

This study aimed to evaluate the efficacy of anesthesia obtained with a novel injection approach for inferior alveolar nerve block compared with the conventional injection approach. 40 patients in good health, randomly received each of two injection approaches of local anesthetic on each side of the mandible at two separate appointments. A sharp probe and an electric pulp tester were used to test anesthesia before injection, after injection when the patients' sensation changed, and 5 min after injection. This study comprised positive aspiration and intravascular injection 5% and neurovascular bundle injection 7.5% in the conventional inferior alveolar nerve block, but without occurrence in the novel injection approach. A visual analog scale (VAS) pain assessment was used during injection and surgery. The significance level used in the statistical analysis was p<0.05. For the novel injection approach compared with the conventional injection approach, no significant difference was found on the subjective onset, objective onset, operation time, duration of anesthesia and VAS pain score during operation, but the VAS pain score during injection was significantly different. The efficacy of inferior alveolar nerve block by the novel injection approach provided adequate anesthesia and caused less pain and greater safety during injection. Copyright © 2012 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Comparison of superior septal approach with left atriotomy in mitral valve surgery

PubMed Central

Aydin, Ebuzer; Arslan, Akin; Ozkokeli, Mehmet

2014-01-01

Objective In this study, we aimed to compare clinical outcomes of superior transseptal approach with the conventional left atriotomy in patients undergoing mitral valve surgery. Methods Between January 2010 and November 2012, a total of 91 consecutive adult patients (39 males, 52 females; mean age: 54.0±15.4 years; range, 16 to 82 years) who underwent mitral valve surgery in the Division of Cardiovascular Surgery at Koşuyolu Training Hospital were included. The patients were randomized to either superior transseptal approach (n=47) or conventional left atriotomy (n=44). Demographic characteristics of the patients, comorbidities, additional interventions, intraoperational data, pre- and postoperative electrophysiological study findings, and postoperative complications were recorded. Results Of all patients, 86.7% (n=79) were in New York Heart Association Class III, while 12 were in New York Heart Association Class IV. All patients underwent annuloplasty (42.9%) or valve replacement surgery (57.1%). There was no significant difference in pre- and postoperative electrocardiogram findings between the groups. Change from baseline in the cardiac rhythm was statistically significant in superior transseptal approach group alone (P<0.001). There was no statistically significant difference in mortality rate between the groups. Permanent pacemaker implantation was performed in 10.6% of the patients in superior transseptal approach group and 4.5% in the conventional left atriotomy group. No statistically significant difference in bleeding, total length of hospital and intensive care unit stay, the presence of low cardiac output syndrome was observed between the groups. Conclusion Our study results suggest that superior transseptal approach does not lead to serious or fatal adverse effects on sinus node function or atrial vulnerability, compared to conventional approach. PMID:25372911

Middle school science curriculum design and 8th grade student achievement in Massachusetts public schools

NASA Astrophysics Data System (ADS)

Clifford, Betsey A.

The Massachusetts Department of Elementary and Secondary Education (DESE) released proposed Science and Technology/Engineering standards in 2013 outlining the concepts that should be taught at each grade level. Previously, standards were in grade spans and each district determined the method of implementation. There are two different methods used teaching middle school science: integrated and discipline-based. In the proposed standards, the Massachusetts DESE uses grade-by-grade standards using an integrated approach. It was not known if there is a statistically significant difference in student achievement on the 8th grade science MCAS assessment for students taught with an integrated or discipline-based approach. The results on the 8th grade science MCAS test from six public school districts from 2010 -- 2013 were collected and analyzed. The methodology used was quantitative. Results of an ANOVA showed that there was no statistically significant difference in overall student achievement between the two curriculum models. Furthermore, there was no statistically significant difference for the various domains: Earth and Space Science, Life Science, Physical Science, and Technology/Engineering. This information is useful for districts hesitant to make the change from a discipline-based approach to an integrated approach. More research should be conducted on this topic with a larger sample size to better support the results.

A Critical Comparison of Transformation and Deep Approach Theories of Learning

ERIC Educational Resources Information Center

Howie, Peter; Bagnall, Richard

2015-01-01

This paper reports a critical comparative analysis of two popular and significant theories of adult learning: the transformation and the deep approach theories of learning. These theories are operative in different educational sectors, are significant, respectively, in each, and they may be seen as both touching on similar concerns with learning…

Superficial and deep learning approaches among medical students in an interdisciplinary integrated curriculum.

PubMed

Mirghani, Hisham M; Ezimokhai, Mutairu; Shaban, Sami; van Berkel, Henk J M

2014-01-01

Students' learning approaches have a significant impact on the success of the educational experience, and a mismatch between instructional methods and the learning approach is very likely to create an obstacle to learning. Educational institutes' understanding of students' learning approaches allows those institutes to introduce changes in their curriculum content, instructional format, and assessment methods that will allow students to adopt deep learning techniques and critical thinking. The objective of this study was to determine and compare learning approaches among medical students following an interdisciplinary integrated curriculum. This was a cross-sectional study in which an electronic questionnaire using the Biggs two-factor Study Process Questionnaire (SPQ) with 20 questions was administered. Of a total of 402 students at the medical school, 214 (53.2%) completed the questionnaire. There was a significant difference in the mean score of superficial approach, motive and strategy between students in the six medical school years. However, no significant difference was observed in the mean score of deep approach, motive and strategy. The mean score for years 1 and 2 showed a significantly higher surface approach, surface motive and surface strategy when compared with students in years 4-6 in medical school. The superficial approach to learning was mostly preferred among first and second year medical students, and the least preferred among students in the final clinical years. These results may be useful in creating future teaching, learning and assessment strategies aiming to enhance a deep learning approach among medical students. Future studies are needed to investigate the reason for the preferred superficial approach among medical students in their early years of study.

Effects of web-based electrocardiography simulation on strategies and learning styles.

PubMed

Granero-Molina, José; Fernández-Sola, Cayetano; López-Domene, Esperanza; Hernández-Padilla, José Manuel; Preto, Leonel São Romão; Castro-Sánchez, Adelaida María

2015-08-01

To identify the association between the use of web simulation electrocardiography and the learning approaches, strategies and styles of nursing degree students. A descriptive and correlational design with a one-group pretest-posttest measurement was used. The study sample included 246 students in a Basic and Advanced Cardiac Life Support nursing class of nursing degree. No significant differences between genders were found in any dimension of learning styles and approaches to learning. After the introduction of web simulation electrocardiography, significant differences were found in some item scores of learning styles: theorist (p < 0.040), pragmatic (p < 0.010) and approaches to learning. The use of a web electrocardiogram (ECG) simulation is associated with the development of active and reflexive learning styles, improving motivation and a deep approach in nursing students.

Robotic Thyroidectomy: Comparison of a Postauricular Facelift Approach with a Gasless Unilateral Axillary Approach.

PubMed

Sung, Eui Suk; Ji, Yong Bae; Song, Chang Myeon; Yun, Bo Ram; Chung, Won Sang; Tae, Kyung

2016-06-01

Robotic thyroidectomy using remote access approaches has gained popularity with patients seeking to avoid neck scarring and enhanced cosmetic satisfaction. The aim of this study was to compare the efficacy and advantages of a postauricular facelift approach vs a gasless unilateral axillary (GUA) approach in robotic thyroidectomy. Case series with chart review. University tertiary care hospital. We retrospectively analyzed the data of 65 patients who underwent robotic thyroidectomy with or without central neck dissection using a GUA approach (45 patients) or a postauricular facelift approach (20 patients) between September 2013 and December 2014. We excluded patients who underwent simultaneous lateral neck dissection or completion thyroidectomy. Robotic procedures were completed without being converted to an open procedure in all patients. There were no significant differences in terms of patient and tumor characteristics, extent of thyroidectomy and central neck dissection, operative time, complications, and postoperative pain between the 2 approaches, except the higher female ratio in the GUA approach group (female ratio, 95.6% vs 75%, P = .042). Cosmetic satisfaction evaluated by a questionnaire was not significantly different between the 2 groups, and most patients of both groups (85.7%) were satisfied with postoperative cosmesis. Both GUA and postauricular facelift approaches are feasible, with no significant adverse events in patients, and result in excellent cosmesis. However, a GUA approach seems to be superior when performing total thyroidectomy using a unilateral incision based on the preliminary result. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

Analysis of chronic aortic regurgitation by 2D and 3D echocardiography and cardiac MRI

PubMed Central

Stoebe, Stephan; Metze, Michael; Jurisch, Daniel; Tayal, Bhupendar; Solty, Kilian; Laufs, Ulrich; Pfeiffer, Dietrich; Hagendorff, Andreas

2018-01-01

Purpose The study compares the feasibility of the quantitative volumetric and semi-quantitative approach for quantification of chronic aortic regurgitation (AR) using different imaging modalities. Methods Left ventricular (LV) volumes, regurgitant volumes (RVol) and regurgitant fractions (RF) were assessed retrospectively by 2D, 3D echocardiography and cMRI in 55 chronic AR patients. Semi-quantitative parameters were assessed by 2D echocardiography. Results 22 (40%) patients had mild, 25 (46%) moderate and 8 (14%) severe AR. The quantitative volumetric approach was feasible using 2D, 3D echocardiography and cMRI, whereas the feasibility of semi-quantitative parameters varied considerably. LV volume (LVEDV, LVESV, SVtot) analyses showed good correlations between the different imaging modalities, although significantly increased LV volumes were assessed by cMRI. RVol was significantly different between 2D/3D echocardiography and 2D echocardiography/cMRI but was not significantly different between 3D echocardiography/cMRI. RF was not statistically different between 2D echocardiography/cMRI and 3D echocardiography/cMRI showing poor correlations (r < 0.5) between the different imaging modalities. For AR grading by RF, moderate agreement was observed between 2D/3D echocardiography and 2D echocardiography/cMRI and good agreement was observed between 3D echocardiography/cMRI. Conclusion Semi-quantitative parameters are difficult to determine by 2D echocardiography in clinical routine. The quantitative volumetric RF assessment seems to be feasible and can be discussed as an alternative approach in chronic AR. However, RVol and RF did not correlate well between the different imaging modalities. The best agreement for grading of AR severity by RF was observed between 3D echocardiography and cMRI. LV volumes can be verified by different approaches and different imaging modalities. PMID:29519957

A novel approach for data integration and disease subtyping

PubMed Central

Tagett, Rebecca; Diaz, Diana

2017-01-01

Advances in high-throughput technologies allow for measurements of many types of omics data, yet the meaningful integration of several different data types remains a significant challenge. Another important and difficult problem is the discovery of molecular disease subtypes characterized by relevant clinical differences, such as survival. Here we present a novel approach, called perturbation clustering for data integration and disease subtyping (PINS), which is able to address both challenges. The framework has been validated on thousands of cancer samples, using gene expression, DNA methylation, noncoding microRNA, and copy number variation data available from the Gene Expression Omnibus, the Broad Institute, The Cancer Genome Atlas (TCGA), and the European Genome-Phenome Archive. This simultaneous subtyping approach accurately identifies known cancer subtypes and novel subgroups of patients with significantly different survival profiles. The results were obtained from genome-scale molecular data without any other type of prior knowledge. The approach is sufficiently general to replace existing unsupervised clustering approaches outside the scope of bio-medical research, with the additional ability to integrate multiple types of data. PMID:29066617

Ultrasound-guided shoulder MR arthrography: comparison of rotator interval and posterior approach.

PubMed

Ogul, Hayri; Bayraktutan, Ummugulsum; Ozgokce, Mesut; Tuncer, Kutsi; Yuce, Ihsan; Yalcin, Ahmet; Pirimoglu, Berhan; Sagsoz, Erdem; Kantarci, Mecit

2014-01-01

The purpose of this study was to prospectively evaluate the two different ultrasound-guided injection techniques for magnetic resonance (MR) arthrography of the shoulder. This study included 100 patients [50 rotator interval group (n=50) vs. 50 posterior approach group (n=50)]. All procedures were performed by the same radiologist. The two injection techniques were compared. The discomfort during and after arthrography was evaluated. Extraarticular contrast media extravasation was graded according to the MRI findings. The number of injection attempts, effect of contrast media extravasation rate on diagnostic quality and procedure times were recorded. There were no significant difference between the posterior and rotator interval puncture groups with regard to pain (P=.915), procedure times (P=.401) or attempt scores (P=.182). There were significantly more contrast media extravasations with rotator interval approach than posterior approach (P<.05). Both techniques were successful and well tolerated by patients. Posterior injection technique provided a more effective route with decreased extravasation rate and easier approach compared to the rotator interval approach. © 2014.

Simplified Approach Charts Improve Data Retrieval Performance

PubMed Central

Stewart, Michael; Laraway, Sean; Jordan, Kevin; Feary, Michael S.

2016-01-01

The effectiveness of different instrument approach charts to deliver minimum visibility and altitude information during airport equipment outages was investigated. Eighteen pilots flew simulated instrument approaches in three conditions: (a) normal operations using a standard approach chart (standard-normal), (b) equipment outage conditions using a standard approach chart (standard-outage), and (c) equipment outage conditions using a prototype decluttered approach chart (prototype-outage). Errors and retrieval times in identifying minimum altitudes and visibilities were measured. The standard-outage condition produced significantly more errors and longer retrieval times versus the standard-normal condition. The prototype-outage condition had significantly fewer errors and shorter retrieval times than did the standard-outage condition. The prototype-outage condition produced significantly fewer errors but similar retrieval times when compared with the standard-normal condition. Thus, changing the presentation of minima may reduce risk and increase safety in instrument approaches, specifically with airport equipment outages. PMID:28491009

Metastatic Spine Tumor Surgery: A Comparative Study of Minimally Invasive Approach Using Percutaneous Pedicle Screws Fixation Versus Open Approach.

PubMed

Kumar, Naresh; Malhotra, Rishi; Maharajan, Karthikeyan; Zaw, Aye S; Wu, Pang Hung; Makandura, Milindu C; Po Liu, Gabriel Ka; Thambiah, Joseph; Wong, Hee-Kit

2017-10-01

Prospective cohort study. Minimally invasive spinal surgery (MISS) has been gaining recognition in patients with metastatic spine disease (MSD). The advantages are reduction in blood loss, hospital stay, and postoperative morbidity. Most of the studies were case series with very few comparing the outcomes of MISS to open approaches. To evaluate and compare the clinical and perioperative outcomes of MISS versus open approach in patients with symptomatic MSD, who underwent posterior spinal stabilization and/or decompression. Our study included 45 MSD patients; 27 managed by MISS and 18 by open approach. All patients had MSD presenting with symptoms of neurological deficit, spinal instability, or both. Preoperative, intraoperative, and postoperative data were collected for comparison of the 2 approaches. All patients were followed up until the end of study period (maximum up to 4 years from time of surgery) or till their demise. The clinical outcome measures were pain control, neurological and functional status, whereas perioperative outcomes were blood loss, operative time, length of hospital stay, and time taken to initiate radiotherapy/chemotherapy after index surgery. Majority of patients in both groups showed improvement in pain, neurological status, independent ambulation, and ECOG score in the postoperative period with no significant differences between the 2 groups. There was a significant reduction in intraoperative blood loss (621 mL less, P<0.001) in the MISS group. The average time to initiate radiotherapy after surgery was 13 days (range, 12-16 d) in MISS and 24 days (range, 16-40 d) in the open group. This difference was statistically significant (P<0.001). Operative time and duration of hospital stay were also favorable in the MISS group, although the differences were not significant. MISS is comparable with open approach demonstrating similar improvements in clinical outcomes, that is pain control, neurological and functional status. MISS approaches have also shown promising results due to lesser intraoperative blood loss and allowing earlier radiotherapy/chemotherapy.

Developmental differences in auditory detection and localization of approaching vehicles.

PubMed

Barton, Benjamin K; Lew, Roger; Kovesdi, Casey; Cottrell, Nicholas D; Ulrich, Thomas

2013-04-01

Pedestrian safety is a significant problem in the United States, with thousands being injured each year. Multiple risk factors exist, but one poorly understood factor is pedestrians' ability to attend to vehicles using auditory cues. Auditory information in the pedestrian setting is increasing in importance with the growing number of quieter hybrid and all-electric vehicles on America's roadways that do not emit sound cues pedestrians expect from an approaching vehicle. Our study explored developmental differences in pedestrians' detection and localization of approaching vehicles. Fifty children ages 6-9 years, and 35 adults participated. Participants' performance varied significantly by age, and with increasing speed and direction of the vehicle's approach. Results underscore the importance of understanding children's and adults' use of auditory cues for pedestrian safety and highlight the need for further research. Copyright © 2013 Elsevier Ltd. All rights reserved.

Running and Metabolic Demands of Elite Rugby Union Assessed Using Traditional, Metabolic Power, and Heart Rate Monitoring Methods

PubMed Central

Dubois, Romain; Paillard, Thierry; Lyons, Mark; McGrath, David; Maurelli, Olivier; Prioux, Jacques

2017-01-01

The aims of this study were (1) to analyze elite rugby union game demands using 3 different approaches: traditional, metabolic and heart rate-based methods (2) to explore the relationship between these methods and (3) to explore positional differences between the backs and forwards players. Time motion analysis and game demands of fourteen professional players (24.1 ± 3.4 y), over 5 European challenge cup games, were analyzed. Thresholds of 14.4 km·h-1, 20 W.kg-1 and 85% of maximal heart rate (HRmax) were set for high-intensity efforts across the three methods. The mean % of HRmax was 80.6 ± 4.3 % while 42.2 ± 16.5% of game time was spent above 85% of HRmax with no significant differences between the forwards and the backs. Our findings also show that the backs cover greater distances at high-speed than forwards (% difference: +35.2 ± 6.6%; p<0.01) while the forwards cover more distance than the backs (+26.8 ± 5.7%; p<0.05) in moderate-speed zone (10-14.4 km·h-1). However, no significant difference in high-metabolic power distance was found between the backs and forwards. Indeed, the high-metabolic power distances were greater than high-speed running distances of 24.8 ± 17.1% for the backs, and 53.4 ± 16.0% for the forwards with a significant difference (+29.6 ± 6.0% for the forwards; p<0.001) between the two groups. Nevertheless, nearly perfect correlations were found between the total distance assessed using the traditional approach and the metabolic power approach (r = 0.98). Furthermore, there is a strong association (r = 0.93) between the high-speed running distance (assessed using the traditional approach) and the high-metabolic power distance. The HR monitoring methods demonstrate clearly the high physiological demands of professional rugby games. The traditional and the metabolic-power approaches shows a close correlation concerning their relative values, nevertheless the difference in absolute values especially for the high-intensity thresholds demonstrates that the metabolic power approach may represent an interesting alternative to the traditional approaches used in evaluating the high-intensity running efforts required in rugby union games. Key points Elite/professional rugby union players Heart rate monitoring during official games Metabolic power approach PMID:28344455

[Comparison of transverse short-axis classic and oblique long-axis "Syringe-Free" approaches for internal jugular venous catheterization under ultrasound guidance].

PubMed

Ince, Ilker; Arı, Muhammet Ali; Sulak, Muhammet Mustafa; Aksoy, Mehmet

There are different ultrasound probe positions used for internal jugular venous catheter placement. Also, in-plane or out of plane needle approach may be used for catheterization. Transverse short-axis classic approach is the most popular performed approach in literature. "Syringe-Free" is a new described technique that is performed with oblique long-axis approach. We aimed to compare performance of these two approaches. This study was conducted as a prospective and randomized study. 80 patients were included the study and divided into two groups that were named Group C (transverse short-axis classic approach) and Group SF (oblique long-axis syringe-free approach) by a computer-generated randomization. The primary outcome was mean time that guidewire is seen in the internal jugular vein (performing time). The secondary outcomes were to compare number of needle pass, number of skin puncture and complications between two groups. Demographic and hemodynamic data were not significantly different. The mean performing time was 54.9±19.1s in Group C and 43.9±15.8s in Group SF. Significant differences were found between the groups (p=0.006). Mean number of needle pass was 3.2(±2.1) in Group C and 2.1(±1.6) in Group SF. There were statistically significant differences between two groups (p=0.002). The number of skin puncture was 1.6(±0.8) and 1.2(±0.5) in Group C and SF, respectively (p=0.027). "Syringe-Free" technique has lower performing time, number of needle pass and skin puncture. Also, it allows to follow progress of guide-wire under continuous ultrasound visualization and the procedure does not need assistance during catheter insertion. Namely, "Syringe-Free" is effective, safe and fast technique that may be used to place internal jugular venous catheter. Copyright © 2017 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

The enhancement of students' mathematical self-efficacy through teaching with metacognitive scaffolding approach

NASA Astrophysics Data System (ADS)

Prabawanto, S.

2018-05-01

This research aims to investigate the enhancement of students’ mathematical self- efficacy through teaching with metacognitive scaffolding approach. This research used a quasi- experimental design with pre-post respon control. The subjects were pre-service elementary school teachers in a state university in Bandung. In this study, there were two groups: experimental and control groups. The experimental group consists of 60 students who acquire teaching mathematics under metacognitive approach, while the control group consists of 58 students who acquire teaching mathematics under direct approach. Students were classified into three categories based on the mathematical prior ability, namely high, middle, and low. Data collection instruments consist of mathematical self-efficacy instruments. By using mean difference test, two conclusions of the research: (1) there is a significant difference in the enhancement of mathematical self-efficacy between the students who attended the course under metacognitive scaffolding approach and students who attended the course under direct approach, and (2) there is no significant interaction effect of teaching approaches and ability level based on the mathematical prior ability toward enhancement of students’ mathematical self-efficacy.

The enhancement of students' mathematical problem solving ability through teaching with metacognitive scaffolding approach

NASA Astrophysics Data System (ADS)

Prabawanto, Sufyani

2017-05-01

This research aims to investigate the enhancement of students' mathematical problem solving through teaching with metacognitive scaffolding approach. This research used a quasi-experimental design with pretest-posttest control. The subjects were pre-service elementary school teachers in a state university in Bandung. In this study, there were two groups: experimental and control groups. The experimental group consists of 60 studentswho acquire teaching mathematicsunder metacognitive scaffolding approach, while the control group consists of 58 studentswho acquire teaching mathematicsunder direct approach. Students were classified into three categories based on the mathematical prior ability, namely high, middle, and low. Data collection instruments consist of mathematical problem solving test instruments. By usingmean difference test, two conclusions of the research:(1) there is a significant difference in the enhancement of mathematical problem solving between the students who attended the course under metacognitive scaffolding approach and students who attended the course under direct approach, and(2) thereis no significant interaction effect of teaching approaches and ability level based on the mathematical prior ability toward enhancement of students' mathematical problem solving.

A comparison of approaches for estimating bottom-sediment mass in large reservoirs

USGS Publications Warehouse

Juracek, Kyle E.

2006-01-01

Estimates of sediment and sediment-associated constituent loads and yields from drainage basins are necessary for the management of reservoir-basin systems to address important issues such as reservoir sedimentation and eutrophication. One method for the estimation of loads and yields requires a determination of the total mass of sediment deposited in a reservoir. This method involves a sediment volume-to-mass conversion using bulk-density information. A comparison of four computational approaches (partition, mean, midpoint, strategic) for using bulk-density information to estimate total bottom-sediment mass in four large reservoirs indicated that the differences among the approaches were not statistically significant. However, the lack of statistical significance may be a result of the small sample size. Compared to the partition approach, which was presumed to provide the most accurate estimates of bottom-sediment mass, the results achieved using the strategic, mean, and midpoint approaches differed by as much as ?4, ?20, and ?44 percent, respectively. It was concluded that the strategic approach may merit further investigation as a less time consuming and less costly alternative to the partition approach.

Evaluating pictogram prediction in a location-aware augmentative and alternative communication system.

PubMed

Garcia, Luís Filipe; de Oliveira, Luís Caldas; de Matos, David Martins

2016-01-01

This study compared the performance of two statistical location-aware pictogram prediction mechanisms, with an all-purpose (All) pictogram prediction mechanism, having no location knowledge. The All approach had a unique language model under all locations. One of the location-aware alternatives, the location-specific (Spec) approach, made use of specific language models for pictogram prediction in each location of interest. The other location-aware approach resulted from combining the Spec and the All approaches, and was designated the mixed approach (Mix). In this approach, the language models acquired knowledge from all locations, but a higher relevance was assigned to the vocabulary from the associated location. Results from simulations showed that the Mix and Spec approaches could only outperform the baseline in a statistically significant way if pictogram users reuse more than 50% and 75% of their sentences, respectively. Under low sentence reuse conditions there were no statistically significant differences between the location-aware approaches and the All approach. Under these conditions, the Mix approach performed better than the Spec approach in a statistically significant way.

The impact of teachers' approaches to teaching and students' learning styles on students' approaches to learning in college online biology courses

NASA Astrophysics Data System (ADS)

Hong, Yuh-Fong

With the rapid growth of online courses in higher education institutions, research on quality of learning for online courses is needed. However, there is a notable lack of research in the cited literature providing evidence that online distance education promotes the quality of independent learning to which it aspires. Previous studies focused on academic outcomes and technology applications which do not monitor students' learning processes, such as their approaches to learning. Understanding students' learning processes and factors influencing quality of learning will provide valuable information for instructors and institutions in providing quality online courses and programs. The purpose of this study was to identify and investigate college biology teachers' approaches to teaching and students' learning styles, and to examine the impact of approaches to teaching and learning styles on students' approaches to learning via online instruction. Data collection included eighty-seven participants from five online biology courses at a community college in the southern area of Texas. Data analysis showed the following results. First, there were significant differences in approaches to learning among students with different learning styles. Second, there was a significant difference in students' approaches to learning between classes using different approaches to teaching. Three, the impact of learning styles on students' approaches to learning was not influenced by instructors' approaches to teaching. Two conclusions were obtained from the results. First, individuals with the ability to perceive information abstractly might be more likely to adopt deep approaches to learning than those preferring to perceive information through concrete experience in online learning environments. Second, Teaching Approach Inventory might not be suitable to measure approaches to teaching for online biology courses due to online instructional design and technology limitations. Based on the findings and conclusions of this study, implications for distance education and future research are described.

[Self-selection processes in the choice of the therapeutic training approach: differences in therapeutic attitudes, personality traits and attributional complexity].

PubMed

Taubner, Svenja; Munder, Thomas; Möller, Heidi; Hanke, Wiebke; Klasen, Jennifer

2014-06-01

Treatment approaches differ to a great extent in terms of basic psychological assumptions and practical procedures. This creates questions about the fitting of therapist and therapeutic approach. This paper examines the influence of therapeutic attitudes, mentalization interest and personality traits on the decision for an approach. 184 participants of training programs in one of the 3 licensed treatment approaches in Germany were examined with questionnaires at the beginning of their training. Participants significantly differed in terms of therapeutic attitudes and the metallization interest but not in personality traits except openness. Satisfaction with training was not related to the individual fit of participants to the therapeutic attitudes typical for their approach. Therapeutic attitudes, the extent of mentalization interest, and openness may play a role in self-selection processes in the choice of the approach. © Georg Thieme Verlag KG Stuttgart · New York.

The effects of storage and sterilization on de-cellularized and re-cellularized whole lung.

PubMed

Bonenfant, Nicholas R; Sokocevic, Dino; Wagner, Darcy E; Borg, Zachary D; Lathrop, Melissa J; Lam, Ying Wai; Deng, Bin; Desarno, Michael J; Ashikaga, Taka; Loi, Roberto; Weiss, Daniel J

2013-04-01

Despite growing interest on the potential use of de-cellularized whole lungs as 3-dimensional scaffolds for ex vivo lung tissue generation, optimal processing including sterilization and storage conditions, are not well defined. Further, it is unclear whether lungs need to be obtained immediately or may be usable even if harvested several days post-mortem, a situation mimicking potential procurement of human lungs from autopsy. We therefore assessed effects of delayed necropsy, prolonged storage (3 and 6 months), and of two commonly utilized sterilization approaches: irradiation or final rinse with peracetic acid, on architecture and extracellular matrix (ECM) protein characteristics of de-cellularized mouse lungs. These different approaches resulted in significant differences in both histologic appearance and in retention of ECM and intracellular proteins as assessed by immunohistochemistry and mass spectrometry. Despite these differences, binding and proliferation of bone marrow-derived mesenchymal stromal cells (MSCs) over a one month period following intratracheal inoculation was similar between experimental conditions. In contrast, significant differences occurred with C10 mouse lung epithelial cells between the different conditions. Therefore, delayed necropsy, duration of scaffold storage, sterilization approach, and cell type used for re-cellularization may significantly impact the usefulness of this biological scaffold-based model of ex vivo lung tissue regeneration. Copyright © 2013 Elsevier Ltd. All rights reserved.

Stalkers and harassers of British royalty: an exploration of proxy behaviours for violence.

PubMed

James, David V; Mullen, Paul E; Meloy, J Reid; Pathé, Michele T; Preston, Lulu; Darnley, Brian; Farnham, Frank R; Scalora, Mario J

2011-01-01

Study of risk factors for violence to prominent people is difficult because of low base rates. This study of harassers of the royal family examined factors suggested in the literature as proxies for violence--breaching security barriers, achieving proximity, approach with a weapon, and approach with homicidal ideation. A stratified sample of different types of approach behaviour was randomly extracted from 2,332 Royalty Protection Police files, which had been divided into behavioural types. The final sample size was 275. Significant differences in illness symptomatology and motivation were found for each proxy group. Querulants were significantly over-represented in three of the four groups. There was generally little overlap between the proxy groups. There is no evidence of the proxy items examined being part of a "pathway to violence". Different motivations may be associated with different patterns of risk. Risk assessment must incorporate knowledge of the interactions between motivation, mental state, and behaviour. Copyright © 2010 John Wiley & Sons, Ltd.

Commitment to philosophy, teacher efficacy, and burnout among teachers of children with autism.

PubMed

Jennett, Heather K; Harris, Sandra L; Mesibov, Gary B

2003-12-01

Variables that may be related to burnout in teachers of students with autism, including commitment to an underlying philosophy of a treatment and professional self-efficacy, were explored. Teachers using one of two different treatment approaches to autism participated: those using Applied Behavior Analysis (n = 34), and those using TEACCH (Treatment and Education of Autistic and Related Communication-Related Handicapped Children) (n = 30). Participants completed the Autism Treatment Philosophy Questionnaire, developed by the authors to differentiate between the philosophy of the approaches; Teacher Efficacy Scale, and Maslach Burnout Inventory. Results indicate a significant difference in philosophical commitment between the groups, but no differences in teaching efficacy or burnout. The relationship between a commitment to one's teaching approach and certain dimensions of teaching efficacy and burnout was found to be significant. Implications include the need for adequate training of teachers of students with autism.

Fusing metabolomics data sets with heterogeneous measurement errors

PubMed Central

Waaijenborg, Sandra; Korobko, Oksana; Willems van Dijk, Ko; Lips, Mirjam; Hankemeier, Thomas; Wilderjans, Tom F.; Smilde, Age K.

2018-01-01

Combining different metabolomics platforms can contribute significantly to the discovery of complementary processes expressed under different conditions. However, analysing the fused data might be hampered by the difference in their quality. In metabolomics data, one often observes that measurement errors increase with increasing measurement level and that different platforms have different measurement error variance. In this paper we compare three different approaches to correct for the measurement error heterogeneity, by transformation of the raw data, by weighted filtering before modelling and by a modelling approach using a weighted sum of residuals. For an illustration of these different approaches we analyse data from healthy obese and diabetic obese individuals, obtained from two metabolomics platforms. Concluding, the filtering and modelling approaches that both estimate a model of the measurement error did not outperform the data transformation approaches for this application. This is probably due to the limited difference in measurement error and the fact that estimation of measurement error models is unstable due to the small number of repeats available. A transformation of the data improves the classification of the two groups. PMID:29698490

Transaortic TAVI Is a Valid Alternative to Transapical Approach.

PubMed

O' Sullivan, Katie E; Hurley, Eoghan T; Segurado, Ricardo; Sugrue, Declan; Hurley, John P

2015-05-01

Transcatheter aortic valve implantation (TAVI) can be performed via a number of different anatomical approaches based on patient characteristics and operator choice. The aim of this study was to compare procedural outcomes between transaortic (TAo) and transapical (TA) approaches in an effort to establish whether any differences exist. A systematic review and meta-analysis of the current literature reporting outcomes for patients undergoing TAo and TA TAVI was performed to compare outcomes using each vascular approach to valve deployment. A total of 10 studies and 1736 patients were included. A total of 193 patients underwent TAo and 1543 TA TAVI. No significant difference in 30-day mortality was identified (TAo 9.4, TA 10.4 p = 0.7). There were no significant differences identified between TAo and TA TAVI in procedural success rate (96.3% vs. 93.7% p = 0.3), stroke and transient ischemic attack (TIA) incidence (1.8% vs. 2.3% p = 0.7), major bleed (5.8% vs. 5.5% p = 0.97) or pacemaker insertion rates (6.1% vs. 7.4% p = 0.56). In addition, the incidence of clinically significant paravalvular regurgitation (PVR) was the same between groups (6.7% vs. 11% p = 0.43). Comparison of TAo and TA approaches revealed equivalent outcomes in 30-day mortality, procedural success, major bleeding, stroke/TIA incidence, pacemaker insertion rates and paravalvular leak. Heart teams should be familiar with the use of both TA and TAo access and tailor their selection on a case-to-case basis. © 2015 Wiley Periodicals, Inc.

Endoscope-assisted approach to excision of branchial cleft cysts.

PubMed

Teng, Stephanie E; Paul, Benjamin C; Brumm, John D; Fritz, Mark; Fang, Yixin; Myssiorek, David

2016-06-01

The purpose of this study is to describe an endoscope-assisted surgical technique for the excision of branchial cleft cysts and compare it to the standard approach. Retrospective case series review. Twenty-seven cases described as branchial cleft excisions performed by a single surgeon at one academic medical center were identified between 2007 and 2014. Twenty-five cases (8 endoscopic, 17 standard approach) were included in the study. Cases were excluded if final pathology was malignant. Patient charts were reviewed, and two techniques were compared through analysis of incision size, operative time, and surgical outcomes. This study showed that the length of incision required for the endoscopic approach (mean = 2.13 ± 0.23) was significantly less than that of the standard approach (mean = 4.10 ± 1.46, P = 0.008) despite the fact that there was no significant difference in cyst size between the two groups (P = 0.09). The other variables examined, including operative time and surgical outcomes, were not significantly different between the two groups. This transcervical endoscope-assisted approach to branchial cleft cyst excision is a viable option for uncomplicated cases. It provides better cosmetic results than the standard approach and does not negatively affect outcomes, increase operative time, or result in recurrence. 4. Laryngoscope, 126:1339-1342, 2016. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

Similar Superior Patient-Reported Outcome Measures for Anterior and Posterolateral Approaches After Total Hip Arthroplasty: Postoperative Patient-Reported Outcome Measure Improvement After 3 months in 12,774 Primary Total Hip Arthroplasties Using the Anterior, Anterolateral, Straight Lateral, or Posterolateral Approach.

PubMed

Peters, Rinne M; van Beers, Loes W A H; van Steenbergen, Liza N; Wolkenfelt, Julius; Ettema, Harmen B; Ten Have, Bas L E F; Rijk, Paul C; Stevens, Martin; Bulstra, Sjoerd K; Poolman, Rudolf W; Zijlstra, Wierd P

2018-06-01

Patient-reported outcome measures (PROMs) are used to evaluate the outcome of total hip arthroplasty (THA). We determined the effect of surgical approach on PROMs after primary THA. All primary THAs, with registered preoperative and 3 months postoperative PROMs were selected from the Dutch Arthroplasty Register. Based on surgical approach, 4 groups were discerned: (direct) anterior, anterolateral, direct lateral, and posterolateral approaches. The following PROMs were recorded: Hip disability and Osteoarthritis Outcome Score Physical function Short form (HOOS-PS); Oxford Hip Score; EQ-5D index score; EQ-5D thermometer; and Numeric Rating Scale measuring pain, both active and in rest. The difference between preoperative and postoperative scores was calculated (delta-PROM) and used as primary outcome measure. Multivariable linear regression analysis was performed for comparisons. Cohen's d was calculated as measure of effect size. All examined 4 approaches resulted in a significant increase of PROMs after primary THA in the Netherlands (n = 12,274). The anterior and posterolateral approaches were associated with significantly more improvement in HOOS-PS scores compared with the anterolateral and direct lateral approaches. Furthermore, the posterolateral and anterior approaches showed greater improvement on Numeric Rating Scale pain scores compared with the anterolateral approach. No relevant differences in delta-PROM were seen between the anterior and posterolateral surgical approaches. Anterior and posterolateral surgical approaches showed more improvement in self-reported physical functioning (HOOS-PS) compared with anterolateral and direct lateral approaches in patients receiving a primary THA. However, clinical differences were only small. Copyright © 2018 Elsevier Inc. All rights reserved.

Uncertainty in Modeling Dust Mass Balance and Radiative Forcing from Size Parameterization

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

Zhao, Chun; Chen, Siyu; Leung, Lai-Yung R.

2013-11-05

This study examines the uncertainties in simulating mass balance and radiative forcing of mineral dust due to biases in the aerosol size parameterization. Simulations are conducted quasi-globally (180oW-180oE and 60oS-70oN) using the WRF24 Chem model with three different approaches to represent aerosol size distribution (8-bin, 4-bin, and 3-mode). The biases in the 3-mode or 4-bin approaches against a relatively more accurate 8-bin approach in simulating dust mass balance and radiative forcing are identified. Compared to the 8-bin approach, the 4-bin approach simulates similar but coarser size distributions of dust particles in the atmosphere, while the 3-mode pproach retains more finemore » dust particles but fewer coarse dust particles due to its prescribed og of each mode. Although the 3-mode approach yields up to 10 days longer dust mass lifetime over the remote oceanic regions than the 8-bin approach, the three size approaches produce similar dust mass lifetime (3.2 days to 3.5 days) on quasi-global average, reflecting that the global dust mass lifetime is mainly determined by the dust mass lifetime near the dust source regions. With the same global dust emission (~6000 Tg yr-1), the 8-bin approach produces a dust mass loading of 39 Tg, while the 4-bin and 3-mode approaches produce 3% (40.2 Tg) and 25% (49.1 Tg) higher dust mass loading, respectively. The difference in dust mass loading between the 8-bin approach and the 4-bin or 3-mode approaches has large spatial variations, with generally smaller relative difference (<10%) near the surface over the dust source regions. The three size approaches also result in significantly different dry and wet deposition fluxes and number concentrations of dust. The difference in dust aerosol optical depth (AOD) (a factor of 3) among the three size approaches is much larger than their difference (25%) in dust mass loading. Compared to the 8-bin approach, the 4-bin approach yields stronger dust absorptivity, while the 3-mode approach yields weaker dust absorptivity. Overall, on quasi-global average, the three size parameterizations result in a significant difference of a factor of 2~3 in dust surface cooling (-1.02~-2.87 W m-2) and atmospheric warming (0.39~0.96 W m-2) and in a tremendous difference of a factor of ~10 in dust TOA cooling (-0.24~-2.20 W m-2). An uncertainty of a factor of 2 is quantified in dust emission estimation due to the different size parameterizations. This study also highlights the uncertainties in modeling dust mass and number loading, deposition fluxes, and radiative forcing resulting from different size parameterizations, and motivates further investigation of the impact of size parameterizations on modeling dust impacts on air quality, climate, and ecosystem.« less

Comparison of retroperitoneoscopic and transperitoneal laparoscopic adrenalectomy for right-sided benign tumors: a single-institute experience.

PubMed

Chiang, Po Hui; Yu, Cheng Jen; Lee, Wei Ching; Wang, Hung Jen; Hsu, Wu Chi

2015-01-01

There is a lack of data regarding the appropriateness of transperitoneal and retroperitoneal approaches for right-sided laparoscopic adrenalectomy. The aim of this study was to determine whether there is any difference between right-sided transperitoneal laparoscopic adrenalectomy (TLA) and retroperitoneal laparoscopic adrenalectomy (RLA). Our surgery database was reviewed to identify patients who underwent right-sided laparoscopic adrenalectomy with a retroperitoneal or transperitoneal approach since 2000. Fifty-five patients were enrolled (31 RLA and 24 TLA). Patient characteristics, as well as operative and perioperative details, were compared between the two groups. There was no difference in patient characteristics between the groups. There was a statistically significant difference (p=0.02) in blood loss (31.7±16.4 vs. 56.9±65.5 ml) between RLA and TLA when the patient's BMI was >26. There was no significant difference in operative time, conversion to open surgery, length of hospitalization, or time to oral intake between the groups. Right-sided laparoscopic adrenalectomy can be performed safely and effectively via either RLA or TLA. Surgeons can adopt either approach with confidence depending on their preference if they are familiar with that approach. © 2015 S. Karger AG, Basel.

Does the surgical approach in cochlear implantation influence the occurrence of postoperative vertigo?

PubMed

Todt, Ingo; Basta, Dietmar; Ernst, Arne

2008-01-01

To investigate the impact of different cochleostomy techniques on vestibular receptor integrity and vertigo after cochlear implantation. Retrospective cohort study. A total of 62 patients (17 to 84 years of age) underwent implantation via an anterior or round window insertion approach. Two groups of cochlear implant patients were compared with respect to their pre- and postoperative vestibular function and the occurrence of postoperative vertigo. The data were related to the different cochleostomy techniques. The patients were tested by a questionnaire (dizziness handicap inventory, DIH), caloric irrigation (vestibulo-ocular reflex, VOR) for the function of the lateral SCC and by vestibular evoked myogenic potential (VEMP) recordings for saccular function. Significant differences of postoperative VEMP responses (50% vs 13%) and electromystagmography (ENG) results (42.9% vs 9.4%) were found with respect to the 2 different insertion techniques. The number of patients with vertigo after the surgery as evidenced by DHI (23% vs 12.5%) was significantly different. The used round window approach for electrode insertion should be preferred to decrease the risk of loss of vestibular function and the occurrence of vertigo.

Joint source based morphometry identifies linked gray and white matter group differences.

PubMed

Xu, Lai; Pearlson, Godfrey; Calhoun, Vince D

2009-02-01

We present a multivariate approach called joint source based morphometry (jSBM), to identify linked gray and white matter regions which differ between groups. In jSBM, joint independent component analysis (jICA) is used to decompose preprocessed gray and white matter images into joint sources and statistical analysis is used to determine the significant joint sources showing group differences and their relationship to other variables of interest (e.g. age or sex). The identified joint sources are groupings of linked gray and white matter regions with common covariation among subjects. In this study, we first provide a simulation to validate the jSBM approach. To illustrate our method on real data, jSBM is then applied to structural magnetic resonance imaging (sMRI) data obtained from 120 chronic schizophrenia patients and 120 healthy controls to identify group differences. JSBM identified four joint sources as significantly associated with schizophrenia. Linked gray-white matter regions identified in each of the joint sources included: 1) temporal--corpus callosum, 2) occipital/frontal--inferior fronto-occipital fasciculus, 3) frontal/parietal/occipital/temporal--superior longitudinal fasciculus and 4) parietal/frontal--thalamus. Age effects on all four joint sources were significant, but sex effects were significant only for the third joint source. Our findings demonstrate that jSBM can exploit the natural linkage between gray and white matter by incorporating them into a unified framework. This approach is applicable to a wide variety of problems to study linked gray and white matter group differences.

Explicit and implicit approach vs. avoidance tendencies towards high vs. low calorie food cues in patients with anorexia nervosa and healthy controls.

PubMed

Paslakis, Georgios; Kühn, Simone; Schaubschläger, Anke; Schieber, Katharina; Röder, Kathrin; Rauh, Elisabeth; Erim, Yesim

2016-12-01

Patients with anorexia nervosa (AN) have a strong ability to limit food intake. Thus, dysfunctional approach vs. avoidance behaviors towards food are evident in AN. We applied an approach-avoidance task (AAT), in which n = 41 AN patients and n = 42 controls either approached ("pull") or avoided ("push") high (HC) vs. low calorie (LC) food pictures based solely on the presented picture format (landscape vs. portrait). We tested the hypothesis that -in opposition to controls displaying an approach bias towards HC food cues- AN patients would show an avoidance bias (measured as different response times) towards HC food. Explicit ratings of food cues were also performed. We found a significant interaction "group" x "direction" (p = 0.03). rm-ANOVAs performed for each of the two groups separately showed a main effect for "direction" of motion in controls (p = 0.02), but not in AN patients (p = 0.40). The two groups did not differ in their reaction times (RTs) with regard to "push" (p = 0.27). However, RTs with regard to "pull" were significantly different between the groups (p = 0.04). Controls show a clear approach bias, expressed by significantly faster RTs for "pull" compared to "push", independent of "calorie" content of the food stimuli. This approach bias is absent in the group of AN patients. This is indicative of a global loss of incentive value of food in AN. Implicit trainings as add-on to psychotherapy in AN patients are asked for. Copyright © 2016 Elsevier Ltd. All rights reserved.

Ever Enrolled Medicare Population Estimates from the MCBS Access to Care Files

PubMed Central

Petroski, Jason; Ferraro, David; Chu, Adam

2014-01-01

Objective The Medicare Current Beneficiary Survey’s (MCBS) Access to Care (ATC) file is designed to provide timely access to information on the Medicare population, yet because of the survey’s complex sampling design and expedited processing it is difficult to use the file to make both “always-enrolled” and “ever-enrolled” estimates on the Medicare population. In this study, we describe the ATC file and sample design, and we evaluate and review various alternatives for producing “ever-enrolled” estimates. Methods We created “ever enrolled” estimates for key variables in the MCBS using three separate approaches. We tested differences between the alternative approaches for statistical significance and show the relative magnitude of difference between approaches. Results Even when estimates derived from the different approaches were statistically different, the magnitude of the difference was often sufficiently small so as to result in little practical difference among the alternate approaches. However, when considering more than just the estimation method, there are advantages to using certain approaches over others. Conclusion There are several plausible approaches to achieving “ever-enrolled” estimates in the MCBS ATC file; however, the most straightforward approach appears to be implementation and usage of a new set of “ever-enrolled” weights for this file. PMID:24991484

Cost in the use of enoxaparin compared with unfractionated heparin in patients with atrial fibrillation undergoing a transesophageal echocardiography-guided cardioversion (from Assessment of Cardioversion using Transesophageal Echocardiography [ACUTE] II randomized multicenter study).

PubMed

Zhao, Liping; Zhang, Zefeng; Kolm, Paul; Jasper, Susan; Lewis, Cheryl; Klein, Allan; Weintraub, William

2008-02-01

The ACUTE II study demonstrated that transesophageal echocardiographically guided cardioversion with enoxaparin in patients with atrial fibrillation was associated with shorter initial hospital stay, more normal sinus rhythm at 5 weeks, and no significant differences in stroke, bleeding, or death compared with unfractionated heparin (UFH). The present study evaluated resource use and costs in enoxaparin (n=76) and UFH (n=79) during 5-week follow-up. Resources included initial and subsequent hospitalizations, study drugs, outpatient services, and emergency room visits. Two costing approaches were employed for the hospitalization costing. The first approach was based on the UB-92 formulation of hospital bill and diagnosis-related group. The second approach was based on UB-92 and imputation using multivariable linear regression. Costs for outpatient and emergency room visits were determined from the Medicare fee schedule. Sensitivity analysis was performed to assess the robustness of the results. A bootstrap resample approach was used to obtain the confidence interval (CI) for the cost differences. Costs of initial and subsequent hospitalizations, outpatient procedures, and emergency room visits were lower in the enoxaparin group. Average total costs remained significantly lower for the enoxaparin group for the 2 costing approaches ($5,800 vs $8,167, difference $2,367, 95% CI 855 to 4,388, for the first approach; $7,942 vs $10,076, difference $2,134, 95% CI 437 to 4,207, for the second approach). Sensitivity analysis showed that cost differences between strategies are robust to variation of drug costs. In conclusion, the use of enoxaparin as a bridging therapy is a cost-saving strategy (similar clinical outcomes and lower costs) for atrial fibrillation.

Running and Metabolic Demands of Elite Rugby Union Assessed Using Traditional, Metabolic Power, and Heart Rate Monitoring Methods.

PubMed

Dubois, Romain; Paillard, Thierry; Lyons, Mark; McGrath, David; Maurelli, Olivier; Prioux, Jacques

2017-03-01

The aims of this study were (1) to analyze elite rugby union game demands using 3 different approaches: traditional, metabolic and heart rate-based methods (2) to explore the relationship between these methods and (3) to explore positional differences between the backs and forwards players. Time motion analysis and game demands of fourteen professional players (24.1 ± 3.4 y), over 5 European challenge cup games, were analyzed. Thresholds of 14.4 km·h -1 , 20 W.kg -1 and 85% of maximal heart rate (HR max ) were set for high-intensity efforts across the three methods. The mean % of HR max was 80.6 ± 4.3 % while 42.2 ± 16.5% of game time was spent above 85% of HR max with no significant differences between the forwards and the backs. Our findings also show that the backs cover greater distances at high-speed than forwards (% difference: +35.2 ± 6.6%; p<0.01) while the forwards cover more distance than the backs (+26.8 ± 5.7%; p<0.05) in moderate-speed zone (10-14.4 km·h -1 ). However, no significant difference in high-metabolic power distance was found between the backs and forwards. Indeed, the high-metabolic power distances were greater than high-speed running distances of 24.8 ± 17.1% for the backs, and 53.4 ± 16.0% for the forwards with a significant difference (+29.6 ± 6.0% for the forwards; p<0.001) between the two groups. Nevertheless, nearly perfect correlations were found between the total distance assessed using the traditional approach and the metabolic power approach (r = 0.98). Furthermore, there is a strong association (r = 0.93) between the high-speed running distance (assessed using the traditional approach) and the high-metabolic power distance. The HR monitoring methods demonstrate clearly the high physiological demands of professional rugby games. The traditional and the metabolic-power approaches shows a close correlation concerning their relative values, nevertheless the difference in absolute values especially for the high-intensity thresholds demonstrates that the metabolic power approach may represent an interesting alternative to the traditional approaches used in evaluating the high-intensity running efforts required in rugby union games.

Learning approaches as predictors of academic performance in first year health and science students.

PubMed

Salamonson, Yenna; Weaver, Roslyn; Chang, Sungwon; Koch, Jane; Bhathal, Ragbir; Khoo, Cheang; Wilson, Ian

2013-07-01

To compare health and science students' demographic characteristics and learning approaches across different disciplines, and to examine the relationship between learning approaches and academic performance. While there is increasing recognition of a need to foster learning approaches that improve the quality of student learning, little is known about students' learning approaches across different disciplines, and their relationships with academic performance. Prospective, correlational design. Using a survey design, a total of 919 first year health and science students studying in a university located in the western region of Sydney from the following disciplines were recruited to participate in the study - i) Nursing: n = 476, ii) Engineering: n = 75, iii) Medicine: n = 77, iv) Health Sciences: n = 204, and v) Medicinal Chemistry: n = 87. Although there was no statistically significant difference in the use of surface learning among the five discipline groups, there were wide variations in the use of deep learning approach. Furthermore, older students and those with English as an additional language were more likely to use deep learning approach. Controlling for hours spent in paid work during term-time and English language usage, both surface learning approach (β = -0.13, p = 0.001) and deep learning approach (β = 0.11, p = 0.009) emerged as independent and significant predictors of academic performance. Findings from this study provide further empirical evidence that underscore the importance for faculty to use teaching methods that foster deep instead of surface learning approaches, to improve the quality of student learning and academic performance. Copyright © 2013 Elsevier Ltd. All rights reserved.

Learning physics: A comparative analysis between instructional design methods

NASA Astrophysics Data System (ADS)

Mathew, Easow

The purpose of this research was to determine if there were differences in academic performance between students who participated in traditional versus collaborative problem-based learning (PBL) instructional design approaches to physics curricula. This study utilized a quantitative quasi-experimental design methodology to determine the significance of differences in pre- and posttest introductory physics exam performance between students who participated in traditional (i.e., control group) versus collaborative problem solving (PBL) instructional design (i.e., experimental group) approaches to physics curricula over a college semester in 2008. There were 42 student participants (N = 42) enrolled in an introductory physics course at the research site in the Spring 2008 semester who agreed to participate in this study after reading and signing informed consent documents. A total of 22 participants were assigned to the experimental group (n = 22) who participated in a PBL based teaching methodology along with traditional lecture methods. The other 20 students were assigned to the control group (n = 20) who participated in the traditional lecture teaching methodology. Both the courses were taught by experienced professors who have qualifications at the doctoral level. The results indicated statistically significant differences (p < .01) in academic performance between students who participated in traditional (i.e., lower physics posttest scores and lower differences between pre- and posttest scores) versus collaborative (i.e., higher physics posttest scores, and higher differences between pre- and posttest scores) instructional design approaches to physics curricula. Despite some slight differences in control group and experimental group demographic characteristics (gender, ethnicity, and age) there were statistically significant (p = .04) differences between female average academic improvement which was much higher than male average academic improvement (˜63%) in the control group which may indicate that traditional teaching methods are more effective in females, whereas there was no significant difference noted in the experimental group between male and female participants. There was a statistically significant and negative relationship (r = -.61, p = .01) between age and physics pretest scores in the control group. No statistical analyses yielded significantly different average academic performance values in either group as delineated by ethnicity.

Surgery-first orthognathic approach vs traditional orthognathic approach: Oral health-related quality of life assessed with 2 questionnaires.

PubMed

Pelo, Sandro; Gasparini, Giulio; Garagiola, Umberto; Cordaro, Massimo; Di Nardo, Francesco; Staderini, Edoardo; Patini, Romeo; de Angelis, Paolo; D'Amato, Giuseppe; Saponaro, Gianmarco; Moro, Alessandro

2017-08-01

The purposes of the study were to investigate and evaluate the differences detected by the patients between the traditional orthognathic approach and the surgery-first one in terms of level of satisfaction and quality of life. A total of 30 patients who underwent orthognathic surgery for correction of malocclusions were selected and included in this study. Fifteen patients were treated with the conventional orthognathic surgery approach, and 15 patients with the surgery-first approach. Variables were assessed through the Orthognathic Quality of Life Questionnaire and the Oral Health Impact Profile questionnaire and analyzed with 2-way repeated-measures analysis of variance. The results showed significant differences in terms of the Orthognathic Quality of Life Questionnaire (P <0.001) and the Oral Health Impact Profile (P <0.001) scores within groups between the first and last administrations of both questionnaires. Differences in the control group between first and second administrations were also significant. Questionnaire scores showed an immediate increase of quality of life after surgery in the surgery-first group and an initial worsening during orthodontic treatment in the traditional approach group followed by postoperative improvement. This study showed that the worsening of the facial profile during the traditional orthognathic surgery approach decompensation phase has a negative impact on the perception of patients' quality of life. Surgeons should consider the possibility of a surgery-first approach to prevent this occurrence. Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Comparison between the basic least squares and the Bayesian approach for elastic constants identification

NASA Astrophysics Data System (ADS)

Gogu, C.; Haftka, R.; LeRiche, R.; Molimard, J.; Vautrin, A.; Sankar, B.

2008-11-01

The basic formulation of the least squares method, based on the L2 norm of the misfit, is still widely used today for identifying elastic material properties from experimental data. An alternative statistical approach is the Bayesian method. We seek here situations with significant difference between the material properties found by the two methods. For a simple three bar truss example we illustrate three such situations in which the Bayesian approach leads to more accurate results: different magnitude of the measurements, different uncertainty in the measurements and correlation among measurements. When all three effects add up, the Bayesian approach can have a large advantage. We then compared the two methods for identification of elastic constants from plate vibration natural frequencies.

Combining approaches to on-line handwriting information retrieval

NASA Astrophysics Data System (ADS)

Peña Saldarriaga, Sebastián; Viard-Gaudin, Christian; Morin, Emmanuel

2010-01-01

In this work, we propose to combine two quite different approaches for retrieving handwritten documents. Our hypothesis is that different retrieval algorithms should retrieve different sets of documents for the same query. Therefore, significant improvements in retrieval performances can be expected. The first approach is based on information retrieval techniques carried out on the noisy texts obtained through handwriting recognition, while the second approach is recognition-free using a word spotting algorithm. Results shows that for texts having a word error rate (WER) lower than 23%, the performances obtained with the combined system are close to the performances obtained on clean digital texts. In addition, for poorly recognized texts (WER > 52%), an improvement of nearly 17% can be observed with respect to the best available baseline method.

Effectiveness of Neuromuscular Electrical Stimulation on Patients With Dysphagia With Medullary Infarction.

PubMed

Zhang, Ming; Tao, Tao; Zhang, Zhao-Bo; Zhu, Xiao; Fan, Wen-Guo; Pu, Li-Jun; Chu, Lei; Yue, Shou-Wei

2016-03-01

To evaluate and compare the effects of neuromuscular electrical stimulation (NMES) acting on the sensory input or motor muscle in treating patients with dysphagia with medullary infarction. Prospective randomized controlled study. Department of physical medicine and rehabilitation. Patients with dysphagia with medullary infarction (N=82). Participants were randomized over 3 intervention groups: traditional swallowing therapy, sensory approach combined with traditional swallowing therapy, and motor approach combined with traditional swallowing therapy. Electrical stimulation sessions were for 20 minutes, twice a day, for 5d/wk, over a 4-week period. Swallowing function was evaluated by the water swallow test and Standardized Swallowing Assessment, oral intake was evaluated by the Functional Oral Intake Scale, quality of life was evaluated by the Swallowing-Related Quality of Life (SWAL-QOL) Scale, and cognition was evaluated by the Mini-Mental State Examination (MMSE). There were no statistically significant differences between the groups in age, sex, duration, MMSE score, or severity of the swallowing disorder (P>.05). All groups showed improved swallowing function (P≤.01); the sensory approach combined with traditional swallowing therapy group showed significantly greater improvement than the other 2 groups, and the motor approach combined with traditional swallowing therapy group showed greater improvement than the traditional swallowing therapy group (P<.05). SWAL-QOL Scale scores increased more significantly in the sensory approach combined with traditional swallowing therapy and motor approach combined with traditional swallowing therapy groups than in the traditional swallowing therapy group, and the sensory approach combined with traditional swallowing therapy and motor approach combined with traditional swallowing therapy groups showed statistically significant differences (P=.04). NMES that targets either sensory input or motor muscle coupled with traditional therapy is conducive to recovery from dysphagia and improves quality of life for patients with dysphagia with medullary infarction. A sensory approach appears to be better than a motor approach. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

[Clinical studies of pedicle screw-rod fixation of thoracolumbar burst fractures through posterior unilateral approach after vertebrae corpectomy fusion].

PubMed

Hua, Yong-jun; Wang, Ren-yan; Guo, Zhi-hui; Shu, Cun-hong; Li, Chao-hua

2016-01-01

To compare the clinical curative effect of thoracolumbar burst fracture treated by the posterior unilateral approach corpectomy fusion screw-rod fixation and anterior corpectomy bone fusion screw plate fixation. From January 2008 to May 2014,36 cases of thoracolumbar burst fracture underwent operation of decompression, fusion, and internal fixation was retrospective analyzed. Among them, 16 patients were treated through posterior approach as posterior group, including 13 males and 3 females aged from 37 to 62 years old; 9 cases caused by falling injury, 3 cases by traffic accident injury,4 cases by heavy aboved;the injury segment was on T₁₂ in 2 cases, L₁ in 5 cases, L₂ in 7 cases, L₃ in 2 cases; according ASIA grade, 3 cases were grade A, 2 cases were grade B, 2 cases were grade C, 5 cases were grade D, 4 cases were grade E; the time between injury and operation ranged from 5 to 15 days. Other 20 patients were treated through anterior-lateral approach as anterior-lateral group, including 15 males and 5 females with age from 27 to 62 years old; 12 cases caused by falling injury, 4 cases by traffic accident injury, 4 cases by heavy aboved; the injury segment was on T₁₂ in 2 cases, L₁, in 7 cases, L₂ in 9 cases, L₃ in 2 cases; for ASIA grade: 4 cases were grade A, 2 cases were grade B, 4 cases were grade C, 6 cases were grade D, 4 cases were grade E; the time between injury and operation ranged from 4 to 12 days. The operation time, bleeding during operation and postoperative drainage volume were observed in two groups,and the changes of nerve function of ASIA grade, clinical efficacy,improved degree of thoracic and lumbar lordosis,and bony fusion were compared between two groups. All patients were followed up from 12 to 24 months with an average of (15.8 ± 3.3) months. The operation time, bleeding during operation, and postoperative drainage volume had no significant different between two groups (P > 0.05). As compared with preoperative, ASIA grade of two groups at last follow-up had statistically significantly different (P < 0.01), the neural function of two groups after operation was recovered for different extent. The JOA score of two groups was compared between last follow-up and preoperative, the difference had statistically significant (P < 0.01), the two groups showed good clinical effect. The clinical results of ASIA grade, JOA score and RIS had no significant differences between two groups. All patients of two groups were obtained fusion. Thoracic and lumbar lordosis angle improvement degree had no significant difference between two groups ,it bad significant difference had statistical significance compared with preoperative, the two approaches could effectively restore the spinal sequence. For patients with thoracolumbar burst fracture just treated by anterior decompression and reconstruction of anterior column, according to the degree of operation performer' skill proficiency and the patient' condition to choose, but for patients must performed the spinal canal decompression anterior and posterior, the three column-reconstruction to required anterior-posterior approach, the posterior unilateral approach corpectomy fusion screw-rod fixation obviously shorten operation time, reduce the operation wound, it is worth the clinical promotion.

Modeling and Optimization for Morphing Wing Concept Generation II. Part 1; Morphing Wing Modeling and Structural Sizing Techniques

NASA Technical Reports Server (NTRS)

Skillen, Michael D.; Crossley, William A.

2008-01-01

This report documents a series of investigations to develop an approach for structural sizing of various morphing wing concepts. For the purposes of this report, a morphing wing is one whose planform can make significant shape changes in flight - increasing wing area by 50% or more from the lowest possible area, changing sweep 30 or more, and / or increasing aspect ratio by as much as 200% from the lowest possible value. These significant changes in geometry mean that the underlying load-bearing structure changes geometry. While most finite element analysis packages provide some sort of structural optimization capability, these codes are not amenable to making significant changes in the stiffness matrix to reflect the large morphing wing planform changes. The investigations presented here use a finite element code capable of aeroelastic analysis in three different optimization approaches -a "simultaneous analysis" approach, a "sequential" approach, and an "aggregate" approach.

Atherosclerosis imaging using 3D black blood TSE SPACE vs 2D TSE

PubMed Central

Wong, Stephanie K; Mobolaji-Iawal, Motunrayo; Arama, Leron; Cambe, Joy; Biso, Sylvia; Alie, Nadia; Fayad, Zahi A; Mani, Venkatesh

2014-01-01

AIM: To compare 3D Black Blood turbo spin echo (TSE) sampling perfection with application-optimized contrast using different flip angle evolution (SPACE) vs 2D TSE in evaluating atherosclerotic plaques in multiple vascular territories. METHODS: The carotid, aortic, and femoral arterial walls of 16 patients at risk for cardiovascular or atherosclerotic disease were studied using both 3D black blood magnetic resonance imaging SPACE and conventional 2D multi-contrast TSE sequences using a consolidated imaging approach in the same imaging session. Qualitative and quantitative analyses were performed on the images. Agreement of morphometric measurements between the two imaging sequences was assessed using a two-sample t-test, calculation of the intra-class correlation coefficient and by the method of linear regression and Bland-Altman analyses. RESULTS: No statistically significant qualitative differences were found between the 3D SPACE and 2D TSE techniques for images of the carotids and aorta. For images of the femoral arteries, however, there were statistically significant differences in all four qualitative scores between the two techniques. Using the current approach, 3D SPACE is suboptimal for femoral imaging. However, this may be due to coils not being optimized for femoral imaging. Quantitatively, in our study, higher mean total vessel area measurements for the 3D SPACE technique across all three vascular beds were observed. No significant differences in lumen area for both the right and left carotids were observed between the two techniques. Overall, a significant-correlation existed between measures obtained between the two approaches. CONCLUSION: Qualitative and quantitative measurements between 3D SPACE and 2D TSE techniques are comparable. 3D-SPACE may be a feasible approach in the evaluation of cardiovascular patients. PMID:24876923

Ankle plantarflexion strength in rearfoot and forefoot runners: a novel clusteranalytic approach.

PubMed

Liebl, Dominik; Willwacher, Steffen; Hamill, Joseph; Brüggemann, Gert-Peter

2014-06-01

The purpose of the present study was to test for differences in ankle plantarflexion strengths of habitually rearfoot and forefoot runners. In order to approach this issue, we revisit the problem of classifying different footfall patterns in human runners. A dataset of 119 subjects running shod and barefoot (speed 3.5m/s) was analyzed. The footfall patterns were clustered by a novel statistical approach, which is motivated by advances in the statistical literature on functional data analysis. We explain the novel statistical approach in detail and compare it to the classically used strike index of Cavanagh and Lafortune (1980). The two groups found by the new cluster approach are well interpretable as a forefoot and a rearfoot footfall groups. The subsequent comparison study of the clustered subjects reveals that runners with a forefoot footfall pattern are capable of producing significantly higher joint moments in a maximum voluntary contraction (MVC) of their ankle plantarflexor muscles tendon units; difference in means: 0.28Nm/kg. This effect remains significant after controlling for an additional gender effect and for differences in training levels. Our analysis confirms the hypothesis that forefoot runners have a higher mean MVC plantarflexion strength than rearfoot runners. Furthermore, we demonstrate that our proposed stochastic cluster analysis provides a robust and useful framework for clustering foot strikes. Copyright © 2014 Elsevier B.V. All rights reserved.

Comparison of the coracoid and retroclavicular approaches for ultrasound-guided infraclavicular brachial plexus block.

PubMed

Kavrut Ozturk, Nilgun; Kavakli, Ali Sait

2017-08-01

This prospective randomized study compared the coracoid and retroclavicular approaches to ultrasound-guided infraclavicular brachial plexus block (IBPB) in terms of needle tip and shaft visibility and quality of block. We hypothesized that the retroclavicular approach would increase needle tip and shaft visibility and decrease the number of needle passes compared to the coracoid approach. A total of 100 adult patients who received IBPB block for upper limb surgery were randomized into two groups: a coracoid approach group (group C) and a retroclavicular approach group (group R). In group C, the needle was inserted 2 cm medial and 2 cm inferior to the coracoid process and directed from ventral to dorsal. In group R, the needle insertion point was posterior to the clavicle and the needle was advanced from cephalad to caudal. All ultrasound images were digitally stored for analysis. The primary aim of the present study was to compare needle tip and shaft visibility between the coracoid approach and retroclavicular approach in patients undergoing upper limb surgery. The secondary aim was to investigate differences between the two groups in the number of needle passes, sensory and motor block success rates, surgical success rate, block performance time, block performance-related pain, patient satisfaction, use of supplemental local anesthetic and analgesic, and complications. Needle tip visibility and needle shaft visibility were significantly better in group R (p = 0.040, p = 0.032, respectively). Block performance time and anesthesia-related time were significantly shorter in group R (p = 0.022, p = 0.038, respectively). Number of needle passes was significantly lower in group R (p = 0.044). Paresthesia during block performance was significantly higher in group C (p = 0.045). There were no statistically significant differences between the two groups in terms of sensory or motor block success, surgical success, block-related pain, and patient satisfaction. The retroclavicular approach is associated with better needle tip and shaft visibility, reduced performance time and anesthesia-related time, less paresthesia during block performance, and fewer needle passes than the coracoid approach. TRıAL REGISTRY NUMBER: Clinicaltrials.gov (no. NCT02673086).

Evaluating in Vitro Culture Medium of Gut Microbiome with Orthogonal Experimental Design and a Metaproteomics Approach.

PubMed

Li, Leyuan; Zhang, Xu; Ning, Zhibin; Mayne, Janice; Moore, Jasmine I; Butcher, James; Chiang, Cheng-Kang; Mack, David; Stintzi, Alain; Figeys, Daniel

2018-01-05

In vitro culture based approaches are time- and cost-effective solutions for rapidly evaluating the effects of drugs or natural compounds against microbiomes. The nutritional composition of the culture medium is an important determinant for effectively maintaining the gut microbiome in vitro. This study combines orthogonal experimental design and a metaproteomics approach to obtaining functional insights into the effects of different medium components on the microbiome. Our results show that the metaproteomic profile respond differently to medium components, including inorganic salts, bile salts, mucin, and short-chain fatty acids. Multifactor analysis of variance further revealed significant main and interaction effects of inorganic salts, bile salts, and mucin on the different functional groups of gut microbial proteins. While a broad regulating effect was observed on basic metabolic pathways, different medium components also showed significant modulations on cell wall, membrane, and envelope biogenesis and cell motility related functions. In particular, flagellar assembly related proteins were significantly responsive to the presence of mucin. This study provides information on the functional influences of medium components on the in vitro growth of microbiome communities and gives insight on the key components that must be considered when selecting and optimizing media for culturing ex vivo microbiotas.

Physics Learning with a Computer Algebra System: Towards a Learning Environment That Promotes Enhanced Problem Representations.

ERIC Educational Resources Information Center

Savelsbergh, Elwin R.; Ferguson-Hessler, Monica G. M.; de Jong, Ton

An approach to teaching problem-solving based on using the computer software Mathematica is applied to the study of electrostatics and is compared with the normal approach to the module. Learning outcomes for both approaches were not significantly different. The experimental course successfully addressed a number of misconceptions. Students in the…

Basic echocardiography for undergraduate students: a comparison of different peer-teaching approaches.

PubMed

Gradl-Dietsch, G; Menon, A K; Gürsel, A; Götzenich, A; Hatam, N; Aljalloud, A; Schrading, S; Hölzl, F; Knobe, M

2018-02-01

The aim of this study was to assess the impact of different teaching interventions in a peer-teaching environment on basic echocardiography skills and to examine the influence of gender on learning outcomes. We randomly assigned 79 s year medical students (55 women, 24 men) to one of four groups: peer teaching (PT), peer teaching using Peyton's four-step approach (PPT), team based learning (TBL) and video-based learning (VBL). All groups received theoretical and practical hands-on training according to the different approaches. Using a pre-post-design we assessed differences in theoretical knowledge [multiple choice (MC) exam], practical skills (Objective Structured Practical Examination, OSPE) and evaluation results with respect to gender. There was a significant gain in theoretical knowledge for all students. There were no relevant differences between the four groups regarding the MC exam and OSPE results. The majority of students achieved good or very good results. Acceptance of the peer-teaching concept was moderate and all students preferred medical experts to peer tutors even though the overall rating of the instructors was fairly good. Students in the Video group would have preferred a different training method. There was no significant effect of gender on evaluation results. Using different peer-teaching concepts proved to be effective in teaching basic echocardiography. Gender does not seem to have an impact on effectiveness of the instructional approach. Qualitative analysis revealed limited acceptance of peer teaching and especially of video-based instruction.

One step versus two step approach for gestational diabetes screening: systematic review and meta-analysis of the randomized trials.

PubMed

Saccone, Gabriele; Caissutti, Claudia; Khalifeh, Adeeb; Meltzer, Sara; Scifres, Christina; Simhan, Hyagriv N; Kelekci, Sefa; Sevket, Osman; Berghella, Vincenzo

2017-12-03

To compare both the prevalence of gestational diabetes mellitus (GDM) as well as maternal and neonatal outcomes by either the one-step or the two-step approaches. Electronic databases were searched from their inception until June 2017. We included all randomized controlled trials (RCTs) comparing the one-step with the two-step approaches for the screening and diagnosis of GDM. The primary outcome was the incidence of GDM. Three RCTs (n = 2333 participants) were included in the meta-analysis. 910 were randomized to the one step approach (75 g, 2 hrs), and 1423 to the two step approach. No significant difference in the incidence of GDM was found comparing the one step versus the two step approaches (8.4 versus 4.3%; relative risk (RR) 1.64, 95%CI 0.77-3.48). Women screened with the one step approach had a significantly lower risk of preterm birth (PTB) (3.7 versus 7.6%; RR 0.49, 95%CI 0.27-0.88), cesarean delivery (16.3 versus 22.0%; RR 0.74, 95%CI 0.56-0.99), macrosomia (2.9 versus 6.9%; RR 0.43, 95%CI 0.22-0.82), neonatal hypoglycemia (1.7 versus 4.5%; RR 0.38, 95%CI 0.16-0.90), and admission to neonatal intensive care unit (NICU) (4.4 versus 9.0%; RR 0.49, 95%CI 0.29-0.84), compared to those randomized to screening with the two step approach. The one and the two step approaches were not associated with a significant difference in the incidence of GDM. However, the one step approach was associated with better maternal and perinatal outcomes.

Girls' soccer performance and motivation: games vs technique approach.

PubMed

Chatzopoulos, Dimitris; Drakou, Amalia; Kotzamanidou, Marina; Tsorbatzoudis, Haralambos

2006-10-01

The purpose of this study was to investigate the effects of the Technique and Games approaches on girls' soccer performance and motivation. The Technique approach focuses on technique instruction using drills, whereas the Games approach places emphasis on tactic instruction with modified games. 37 girls, 12 to 13 years old, were taught 15 soccer lessons by the Technique approach and 35 girls by the Games approach. At the beginning and at the end of the research soccer matches were videotaped and evaluated by Oslin, Mitchell, and Griffin's Game Performance Assessment Instrument. Girls' motivation was assessed on the Intrinsic Motivation Inventory. The Games group had significantly better scores after training on tactical behaviour and intrinsic motivation than the Technique group. There were no significant differences in skill execution between groups trained under the two approaches. Considering the importance of intrinsic motivation for a lifelong, physically active lifestyle, researchers could focus study on the approaches and girls' motivation.

Prospective Nonrandomized Comparative Study of Laparoscopic Versus Open Surgical Staging for Endometrial Cancer in India.

PubMed

Ansar P P; Ayyappan S; Mahajan, Vikash

2018-06-01

Laparoscopic procedures to treat endometrial cancer are currently emerging. At present, we have evidence to do laparoscopic oncologic resections for endometrial cancer as proven by many prospective studies from abroad such as LAP2 by GOG. So, we have decided to assess the safety and feasibility of such a study in our population with the following as our primary objectives: (1) to study whether laparoscopy is better compared to open approach in terms of duration of hospital stay, perioperative morbidity and early recovery from surgical trauma and (2) to study whether the laparoscopic approach is noninferior to the open approach in terms of number of lymph nodes harvested in lymphadenectomy and rate of conversion to open surgery. We did a prospective nonrandomized comparative study of open versus laparoscopy approach for surgical staging of endometrial cancer from 16th May 2013 to 15th May 2015. To prove a significant difference in the hospital stay, we needed 29 patients in each arm. Thirty patients in each arm were enrolled for the study. The median duration of stay in the open arm was 7 days and in the laparoscopy arm it was 5 days. The advantage of 2 days in the laparoscopic arm was statistically significant ( P value 0.006). Forty percent of patients in the open arm had to stay in the hospital for more than 7 days whereas only 3% of patients in the laparoscopy arm required to stay for more than 7 days ( P value 0.001). This difference was statistically significant. There was no significant difference between the early complication rates between the two arms (20% in open vs. 13% in laparoscopy; P value 0.730). There was a conversion rate of 10% in laparoscopy. The median number of nodes harvested in open arm was 16.50 and in the laparoscopy arm, it was 13.50. The difference was not statistically significant ( P value 0.086). Laparoscopy approach for endometrial cancer staging is feasible in Indian patients and the short-term advantages are replicable with same oncologic safety as proved by randomized controlled trials.

Neighbour lists for smoothed particle hydrodynamics on GPUs

NASA Astrophysics Data System (ADS)

Winkler, Daniel; Rezavand, Massoud; Rauch, Wolfgang

2018-04-01

The efficient iteration of neighbouring particles is a performance critical aspect of any high performance smoothed particle hydrodynamics (SPH) solver. SPH solvers that implement a constant smoothing length generally divide the simulation domain into a uniform grid to reduce the computational complexity of the neighbour search. Based on this method, particle neighbours are either stored per grid cell or for each individual particle, denoted as Verlet list. While the latter approach has significantly higher memory requirements, it has the potential for a significant computational speedup. A theoretical comparison is performed to estimate the potential improvements of the method based on unknown hardware dependent factors. Subsequently, the computational performance of both approaches is empirically evaluated on graphics processing units. It is shown that the speedup differs significantly for different hardware, dimensionality and floating point precision. The Verlet list algorithm is implemented as an alternative to the cell linked list approach in the open-source SPH solver DualSPHysics and provided as a standalone software package.

Comparison of Outcomes in 3 Surgical Approaches for Dystrophic Cervical Kyphosis in Patients with Neurofibromatosis 1.

PubMed

Lin, Tao; Shao, Wei; Zhang, Ke; Gao, Rui; Zhou, Xuhui

2018-03-01

To compare outcomes of anterior-only (AO), posterior-only (PO), and anteroposterior (AP) surgical approaches for treatment of dystrophic cervical kyphosis in patients with neurofibromatosis 1 (NF1). This retrospective observational study included 81 patients with dystrophic cervical kyphosis secondary to NF1. Length of kyphosis, duration of halo traction, Cobb angle, C2-7-sagittal vertical axis (SVA), T1 slope, Neck Disability Index score, and postoperative complications were evaluated before and, if possible, after each surgical approach. AP approach provided the best outcomes (average spinal Cobb angle was corrected from 61.2 ± 9.1° to 5.7 ± 3.2°, P < 0.05); there was no significant difference between AO and PO approaches (P > 0.05). With regard to cervical sagittal balance, AP approach had the most improvements of C2-7-SVA (mean C2-7-SVA was corrected from 3.2 ± 9.2 mm to 12.8 ± 2.6 mm, P < 0.05); the difference between AO and PO approaches was not significant (P > 0.05). T1 slope results were similar to C2-7-SVA. Neck Disability Index score of all patients improved significantly after surgery (P < 0.05); specifically, patients who had an AP approach constituted the largest portion of the satisfied patient group. Postoperative junctional kyphosis occurred in 11 patients (1 AP approach, 6 AO approach, 4 PO approach); these findings correlated with patients with ≤5 fused segments. AP approach surgery provided the best correction of dystrophic cervical kyphosis and sagittal balance for patients with NF1. Patients undergoing an AP approach were more satisfied with their outcomes. Junctional kyphosis can be prevented effectively using an AP approach in patients with >5 fused segments. Copyright © 2017 Elsevier Inc. All rights reserved.

Comparing geological and statistical approaches for element selection in sediment tracing research

NASA Astrophysics Data System (ADS)

Laceby, J. Patrick; McMahon, Joe; Evrard, Olivier; Olley, Jon

2015-04-01

Elevated suspended sediment loads reduce reservoir capacity and significantly increase the cost of operating water treatment infrastructure, making the management of sediment supply to reservoirs of increasingly importance. Sediment fingerprinting techniques can be used to determine the relative contributions of different sources of sediment accumulating in reservoirs. The objective of this research is to compare geological and statistical approaches to element selection for sediment fingerprinting modelling. Time-integrated samplers (n=45) were used to obtain source samples from four major subcatchments flowing into the Baroon Pocket Dam in South East Queensland, Australia. The geochemistry of potential sources were compared to the geochemistry of sediment cores (n=12) sampled in the reservoir. The geochemical approach selected elements for modelling that provided expected, observed and statistical discrimination between sediment sources. Two statistical approaches selected elements for modelling with the Kruskal-Wallis H-test and Discriminatory Function Analysis (DFA). In particular, two different significance levels (0.05 & 0.35) for the DFA were included to investigate the importance of element selection on modelling results. A distribution model determined the relative contributions of different sources to sediment sampled in the Baroon Pocket Dam. Elemental discrimination was expected between one subcatchment (Obi Obi Creek) and the remaining subcatchments (Lexys, Falls and Bridge Creek). Six major elements were expected to provide discrimination. Of these six, only Fe2O3 and SiO2 provided expected, observed and statistical discrimination. Modelling results with this geological approach indicated 36% (+/- 9%) of sediment sampled in the reservoir cores were from mafic-derived sources and 64% (+/- 9%) were from felsic-derived sources. The geological and the first statistical approach (DFA0.05) differed by only 1% (σ 5%) for 5 out of 6 model groupings with only the Lexys Creek modelling results differing significantly (35%). The statistical model with expanded elemental selection (DFA0.35) differed from the geological model by an average of 30% for all 6 models. Elemental selection for sediment fingerprinting therefore has the potential to impact modeling results. Accordingly is important to incorporate both robust geological and statistical approaches when selecting elements for sediment fingerprinting. For the Baroon Pocket Dam, management should focus on reducing the supply of sediments derived from felsic sources in each of the subcatchments.

Cervical interlaminar epidural steroid injection for unilateral cervical radiculopathy: comparison of midline and paramedian approaches for efficacy.

PubMed

Yoon, Ji Young; Kwon, Jong Won; Yoon, Young Cheol; Lee, Jongseok

2015-01-01

The objective of this study was to compare the clinical outcomes of the cervical interlaminar epidural steroid injection (CIESI) for unilateral radiculopathy by the midline or paramedian approaches and to determine the prognostic factors of CIESI. We retrospectively analyzed 182 patients who underwent CIESI from January 2009 to December 2012. Inclusion criteria were no previous spinal steroid injection, presence of a cross-sectional image, and presence of follow-up records. Exclusion criteria were patients with bilateral cervical radiculopathy and/or dominant cervical axial pain, combined peripheral neuropathy, and previous cervical spine surgery. Short-term clinical outcomes were evaluated at the first follow-up after CIESI. We compared the clinical outcomes between the midline and paramedian approaches. Possible prognostic factors for the outcome, such as age, gender, duration of radiculopathy, and cause of radiculopathy were also analyzed. Cervical interlaminar epidural steroid injections were effective in 124 of 182 patients (68.1%) at the first follow-up. There was no significant difference in the clinical outcomes of CIESI, between midline (69.6%) and paramedian (63.7%) approaches (p = 0.723). Cause of radiculopathy was the only significant factor affecting the efficacy of CIESI. Patients with disc herniation had significantly better results than patients with neural foraminal stenosis (82.9% vs. 56.0%) (p < 0.001). There is no significant difference in treatment efficacy between the midline and paramedian approaches in CIESI, for unilateral radiculopathy. The cause of the radiculopathy is significantly associated with the treatment efficacy; patients with disc herniation experience better pain relief than those with neural foraminal stenosis.

Meta-analysis of posterior versus medial approach for popliteal artery aneurysm repair.

PubMed

Phair, Alison; Hajibandeh, Shahin; Hajibandeh, Shahab; Kelleher, Damian; Ibrahim, Riza; Antoniou, George A

2016-10-01

Popliteal artery aneurysm is an uncommon vascular disease but one that can cause significant morbidity, the most severe being limb loss reported in 20% to 59% of cases. Two approaches to repair are described in the literature, the posterior and the medial; however, the "gold standard" method of repair remains controversial. A systematic review of electronic information sources was undertaken to identify papers comparing outcomes of posterior repair vs medial repair. The methodologic quality of the papers was assessed using the Newcastle-Ottawa Scale. Fixed-effect or random-effects models were applied to synthesize data. The search yielded seven articles eligible for inclusion. The total population comprised 1427 patients; 338 had posterior repair and 1089 had medial repair. There was no difference in the two groups in terms of postoperative nerve damage (odds ratio [OR], 1.01; 95% confidence interval [CI], 0.24-4.2) and 30-day postoperative complications (OR, 0.87; 95% CI, 0.43-1.77). Limb loss at 30 days occurred more frequently in the medial approach group, but the difference was not statistically significant (risk difference [RD], 0.02; 95% CI, -0.04 to 0.00). Thirty-day primary patency was not statistically different between groups (RD, -0.01; 95% CI, -0.04 to 0.02), but the 30-day secondary patency suggested superiority of the posterior approach (RD, 0.05; 95% CI, 0.02-0.07). Long-term primary and secondary patency both favored the posterior approach (OR, 1.61 [95% CI, 1.06-2.43] and OR, 1.73 [95% CI, 0.91-3.30], respectively). Aneurysm exclusion was also superior with the posterior approach (OR, 4.20; 95% CI, 1.40-12.60). The rate of reoperation favored the posterior approach (OR, 0.26; 95% CI, 0.09-0.72). Long-term risk of limb loss favored posterior repair, but no statistically significant difference was found (OR, 0.32; 95% CI, 0.43-1.77). High-level comparative data comparing posterior and medial repair for popliteal artery aneurysms are not available. Within the parameters of this review, however, superiority of the posterior approach for primary and secondary patency, aneurysm exclusion, and need for reoperation was noted. High-level evidence from randomized clinical trials is required to define the relative benefits of the posterior approach over the medial approach in selected patients. Copyright © 2016 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

Sex Role and Dating Orientation.

ERIC Educational Resources Information Center

McCabe, M. P.; Collins, J. K.

1979-01-01

Male and female subjects from three age groups completed questionnaires on sex roles and dating orientations. Males approached dating from both a psychoaffectional and psychobiological orientation, while females approached it from a psychoaffectional orientation. Significant differences were found in dating attitudes between male and female…

Bringing Creativity into Being: Underlying Assumptions That Influence Methods of Studying Organizational Creativity

ERIC Educational Resources Information Center

Taylor, Mark; Callahan, Jamie L.

2005-01-01

We compare different epistemological frameworks for the effective collection of creativity data. We suggest that researchers' epistemological approaches can significantly influence collection methods and subsequent outcomes. Classic sociological epistemological approaches--functionalism, interpretivism, radical humanism, and radical structuralism…

Joint source based morphometry identifies linked gray and white matter group differences

PubMed Central

Xu, Lai; Pearlson, Godfrey; Calhoun, Vince D.

2009-01-01

We present a multivariate approach called joint source based morphometry (jSBM), to identify linked gray and white matter regions which differ between groups. In jSBM, joint independent component analysis (jICA) is used to decompose preprocessed gray and white matter images into joint sources and statistical analysis is used to determine the significant joint sources showing group differences and their relationship to other variables of interest (e.g. age or sex). The identified joint sources are groupings of linked gray and white matter regions with common covariation among subjects. In this study, we first provide a simulation to validate the jSBM approach. To illustrate our method on real data, jSBM is then applied to structural magnetic resonance imaging (sMRI) data obtained from 120 chronic schizophrenia patients and 120 healthy controls to identify group differences. JSBM identified four joint sources as significantly associated with schizophrenia. Linked gray–white matter regions identified in each of the joint sources included: 1) temporal — corpus callosum, 2) occipital/frontal — inferior fronto-occipital fasciculus, 3) frontal/parietal/occipital/temporal —superior longitudinal fasciculus and 4) parietal/frontal — thalamus. Age effects on all four joint sources were significant, but sex effects were significant only for the third joint source. Our findings demonstrate that jSBM can exploit the natural linkage between gray and white matter by incorporating them into a unified framework. This approach is applicable to a wide variety of problems to study linked gray and white matter group differences. PMID:18992825

Choosing between endoscopic or microscopic removal of third ventricle colloid cysts.

PubMed

Haider, Ghani; Laghari, Altaf Ali; Shamim, Muhammad Shahzad

2017-09-01

Colloid cysts are benign lesions, found in the anterior part of the roof of the third ventricle. A PubMED search of literature was performed to identify the evidence on different treatment options and surgical approaches for removal of colloid cysts. Evidence on endoscopic versus microsurgical resection of colloid cysts showed that microsurgical approach had significantly higher rates of gross total resection, lower recurrence rate and lower re-operation rate. No significant difference with respect to the mortality rate or the need for a shunt was found between the two groups. However, the overall morbidity rate was lower for the endoscopic group. .

Use of Complementary Health Approaches for Musculoskeletal Pain Disorders Among Adults: United States, 2012.

PubMed

Clarke, Tainya C; Nahin, Richard L; Barnes, Patricia M; Stussman, Barbara J

2016-10-01

This report examines the use of complementary health approaches among U.S. adults aged 18 and over who had a musculoskeletal pain disorder. Prevalence of use among this population subgroup is compared with use by persons without a musculoskeletal disorder. Use for any reason, as well as specifically to treat musculoskeletal pain disorders, is examined. Using the 2012 National Health Interview Survey, estimates of the use of complementary health approaches for any reason, as well as use to treat musculoskeletal pain disorders, are presented. Statistical tests were performed to assess the significance of differences between groups of complementary health approaches used among persons with specific musculoskeletal pain disorders. Musculoskeletal pain disorders included lower back pain, sciatica, neck pain, joint pain or related conditions, arthritic conditions, and other musculoskeletal pain disorders not included in any of the previous categories. Respondents could report having more than one disorder. In 2012, 54.5% of U.S. adults had a musculoskeletal pain disorder. The use of any complementary health approach for any reason among persons with a musculoskeletal pain disorder (41.6%) was significantly higher than use among persons without a musculoskeletal pain disorder (24.1%). Among adults with any musculoskeletal pain disorder, the use of natural products for any reason (24.7%) was significantly higher than the use of mind and body approaches (15.3%), practitioner-based approaches (18.2%), or whole medical system approaches (5.3%). The pattern of use of the above-mentioned groups of complementary health approaches was similar for persons without a musculoskeletal disorder. However, prevalence of use among these persons was significantly lower compared with persons with a musculoskeletal disorder. For treatment, the use of practitioner-based approaches among persons with any musculoskeletal pain disorder (9.7%) was more than three times as high as the use of any other group of approaches (0.7%-3.1%). The patterns of use of specific groups of complementary health approaches also differed among specific musculoskeletal pain disorders. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

Comparing the Pre- and Posttest Scores in Relations to the Emporium and the Hands-on Instructional Approaches of Teaching Science in Prekindergarten

NASA Astrophysics Data System (ADS)

Headen, Patricia Ann

This quantitative, quasi-experimental research investigated if two instructional approaches, the Emporium Computer-Based (Group 2) versus the hands-on approach (Group 1), resulted any difference in student achievement in science for four-year-old prekindergarten students at a private childcare facility in North Carolina. Three research questions hypothesized these relationships: (a) Group 2 versus Group 1 assessed student achievement as theoretically based on Piaget and Vygotsky's perspectives of child development, (b) the instructional approaches related to gender, and (c) the instructional approaches interrelated to ethnicity. Using a two-factor ANOVA and ANCOVA techniques, involved a convenience sample of 126 four-year-old prekindergarten students of which a convenience sample of 126 participated. The Assessment of Measurements for Pre-K (AMP-K), pretest and posttest scores of each group of 63 students measured student achievement. The t tests determined if a significant difference in student achievement existed (dependent variable) with the Emporium Computer-Based versus hands-on instructional approaches (independent variables). The posttest scores of Group 2 (p = 0.00), indicated a significant difference in student achievement. However, gender and ethnicity variables had no effect on student achievement, male (M = 36.14, SD = 19.61) and female (M = 42.91, SD = 18.99) with (p = 0.49), and ethnicity resulted, F (1,125) = 1.65, (p = 0.20). These results suggested that further research on the Emporium Computer-Based instructional approach could improve students' intellectual abilities through more innovative practices.

Nonlinear elastic response of strong solids: First-principles calculations of the third-order elastic constants of diamond

DOE PAGES

Hmiel, A.; Winey, J. M.; Gupta, Y. M.; ...

2016-05-23

Accurate theoretical calculations of the nonlinear elastic response of strong solids (e.g., diamond) constitute a fundamental and important scientific need for understanding the response of such materials and for exploring the potential synthesis and design of novel solids. However, without corresponding experimental data, it is difficult to select between predictions from different theoretical methods. Recently the complete set of third-order elastic constants (TOECs) for diamond was determined experimentally, and the validity of various theoretical approaches to calculate the same may now be assessed. We report on the use of density functional theory (DFT) methods to calculate the six third-order elasticmore » constants of diamond. Two different approaches based on homogeneous deformations were used: (1) an energy-strain fitting approach using a prescribed set of deformations, and (2) a longitudinal stress-strain fitting approach using uniaxial compressive strains along the [100], [110], and [111] directions, together with calculated pressure derivatives of the second-order elastic constants. The latter approach provides a direct comparison to the experimental results. The TOECs calculated using the energy-strain approach differ significantly from the measured TOECs. In contrast, calculations using the longitudinal stress-uniaxial strain approach show good agreement with the measured TOECs and match the experimental values significantly better than the TOECs reported in previous theoretical studies. Lastly, our results on diamond have demonstrated that, with proper analysis procedures, first-principles calculations can indeed be used to accurately calculate the TOECs of strong solids.« less

Self-organization and clustering algorithms

NASA Technical Reports Server (NTRS)

Bezdek, James C.

1991-01-01

Kohonen's feature maps approach to clustering is often likened to the k or c-means clustering algorithms. Here, the author identifies some similarities and differences between the hard and fuzzy c-Means (HCM/FCM) or ISODATA algorithms and Kohonen's self-organizing approach. The author concludes that some differences are significant, but at the same time there may be some important unknown relationships between the two methodologies. Several avenues of research are proposed.

Comprehensive efficiency analysis of supercomputer resource usage based on system monitoring data

NASA Astrophysics Data System (ADS)

Mamaeva, A. A.; Shaykhislamov, D. I.; Voevodin, Vad V.; Zhumatiy, S. A.

2018-03-01

One of the main problems of modern supercomputers is the low efficiency of their usage, which leads to the significant idle time of computational resources, and, in turn, to the decrease in speed of scientific research. This paper presents three approaches to study the efficiency of supercomputer resource usage based on monitoring data analysis. The first approach performs an analysis of computing resource utilization statistics, which allows to identify different typical classes of programs, to explore the structure of the supercomputer job flow and to track overall trends in the supercomputer behavior. The second approach is aimed specifically at analyzing off-the-shelf software packages and libraries installed on the supercomputer, since efficiency of their usage is becoming an increasingly important factor for the efficient functioning of the entire supercomputer. Within the third approach, abnormal jobs – jobs with abnormally inefficient behavior that differs significantly from the standard behavior of the overall supercomputer job flow – are being detected. For each approach, the results obtained in practice in the Supercomputer Center of Moscow State University are demonstrated.

A comparison of different methods to implement higher order derivatives of density functionals

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

van Dam, Hubertus J.J.

Density functional theory is the dominant approach in electronic structure methods today. To calculate properties higher order derivatives of the density functionals are required. These derivatives might be implemented manually,by automatic differentiation, or by symbolic algebra programs. Different authors have cited different reasons for using the particular method of their choice. This paper presents work where all three approaches were used and the strengths and weaknesses of each approach are considered. It is found that all three methods produce code that is suffficiently performanted for practical applications, despite the fact that our symbolic algebra generated code and our automatic differentiationmore » code still have scope for significant optimization. The automatic differentiation approach is the best option for producing readable and maintainable code.« less

Glenohumeral joint injection: a comparative study of ultrasound and fluoroscopically guided techniques before MR arthrography.

PubMed

Rutten, Matthieu J C M; Collins, James M P; Maresch, Bas J; Smeets, Jacques H J M; Janssen, Caroline M M; Kiemeney, Lambertus A L M; Jager, Gerrit J

2009-03-01

To assess the variability in accuracy of contrast media introduction, leakage, required time and patient discomfort in four different centres, each using a different image-guided glenohumeral injection technique. Each centre included 25 consecutive patients. The ultrasound-guided anterior (USa) and posterior approach (USp), fluoroscopic-guided anterior (FLa) and posterior (FLp) approach were used. Number of injection attempts, effect of contrast leakage on diagnostic quality, and total room, radiologist and procedure times were measured. Pain was documented with a visual analogue scale (VAS) pain score. Access to the joint was achieved in all patients. A successful first attempt significantly occurred more often with US (94%) than with fluoroscopic guidance (72%). Leakage of contrast medium did not cause interpretative difficulties. With US guidance mean room, procedure and radiologist times were significantly shorter (p < 0.001). The USa approach was rated with the lowest pre- and post-injection VAS scores. The four image-guided injection techniques are successful in injection of contrast material into the glenohumeral joint. US-guided injections and especially the anterior approach are significantly less time consuming, more successful on the first attempt, cause less patient discomfort and obviate the need for radiation and iodine contrast.

Computing the Absorption and Emission Spectra of 5-Methylcytidine in Different Solvents: A Test-Case for Different Solvation Models.

PubMed

Martínez-Fernández, L; Pepino, A J; Segarra-Martí, J; Banyasz, A; Garavelli, M; Improta, R

2016-09-13

The optical spectra of 5-methylcytidine in three different solvents (tetrahydrofuran, acetonitrile, and water) is measured, showing that both the absorption and the emission maximum in water are significantly blue-shifted (0.08 eV). The absorption spectra are simulated based on CAM-B3LYP/TD-DFT calculations but including solvent effects with three different approaches: (i) a hybrid implicit/explicit full quantum mechanical approach, (ii) a mixed QM/MM static approach, and (iii) a QM/MM method exploiting the structures issuing from molecular dynamics classical simulations. Ab-initio Molecular dynamics simulations based on CAM-B3LYP functionals have also been performed. The adopted approaches all reproduce the main features of the experimental spectra, giving insights on the chemical-physical effects responsible for the solvent shifts in the spectra of 5-methylcytidine and providing the basis for discussing advantages and limitations of the adopted solvation models.

Adapted Physical Education Service Approaches and the Effects on the Perceived Efficacy Beliefs of General Physical Education Teachers

ERIC Educational Resources Information Center

Umhoefer, Donna L.; Vargas, Tiffanye M.; Beyer, Robbi

2015-01-01

The purpose of this study was to determine what effect the type of APE service approach had on GPE teachers' efficacy when working with students with disabilities. The three approaches of APE service delivery chosen for the study were (a) consultation, (b) itinerant, and (c) collaborative. Results indicate significant differences between levels of…

Learning styles and approaches to learning among medical undergraduates and postgraduates

PubMed Central

2013-01-01

Background The challenge of imparting a large amount of knowledge within a limited time period in a way it is retained, remembered and effectively interpreted by a student is considerable. This has resulted in crucial changes in the field of medical education, with a shift from didactic teacher centered and subject based teaching to the use of interactive, problem based, student centered learning. This study tested the hypothesis that learning styles (visual, auditory, read/write and kinesthetic) and approaches to learning (deep, strategic and superficial) differ among first and final year undergraduate medical students, and postgraduates medical trainees. Methods We used self administered VARK and ASSIST questionnaires to assess the differences in learning styles and approaches to learning among medical undergraduates of the University of Colombo and postgraduate trainees of the Postgraduate Institute of Medicine, Colombo. Results A total of 147 participated: 73 (49.7%) first year students, 40 (27.2%) final year students and 34(23.1%) postgraduate students. The majority (69.9%) of first year students had multimodal learning styles. Among final year students, the majority (67.5%) had multimodal learning styles, and among postgraduates, the majority were unimodal (52.9%) learners. Among all three groups, the predominant approach to learning was strategic. Postgraduates had significant higher mean scores for deep and strategic approaches than first years or final years (p < 0.05). Mean scores for the superficial approach did not differ significantly between groups. Conclusions The learning approaches suggest a positive shift towards deep and strategic learning in postgraduate students. However a similar difference was not observed in undergraduate students from first year to final year, suggesting that their curriculum may not have influenced learning methodology over a five year period. PMID:23521845

Learning styles and approaches to learning among medical undergraduates and postgraduates.

PubMed

Samarakoon, Lasitha; Fernando, Tharanga; Rodrigo, Chaturaka

2013-03-25

The challenge of imparting a large amount of knowledge within a limited time period in a way it is retained, remembered and effectively interpreted by a student is considerable. This has resulted in crucial changes in the field of medical education, with a shift from didactic teacher centered and subject based teaching to the use of interactive, problem based, student centered learning. This study tested the hypothesis that learning styles (visual, auditory, read/write and kinesthetic) and approaches to learning (deep, strategic and superficial) differ among first and final year undergraduate medical students, and postgraduates medical trainees. We used self administered VARK and ASSIST questionnaires to assess the differences in learning styles and approaches to learning among medical undergraduates of the University of Colombo and postgraduate trainees of the Postgraduate Institute of Medicine, Colombo. A total of 147 participated: 73 (49.7%) first year students, 40 (27.2%) final year students and 34(23.1%) postgraduate students. The majority (69.9%) of first year students had multimodal learning styles. Among final year students, the majority (67.5%) had multimodal learning styles, and among postgraduates, the majority were unimodal (52.9%) learners.Among all three groups, the predominant approach to learning was strategic. Postgraduates had significant higher mean scores for deep and strategic approaches than first years or final years (p < 0.05). Mean scores for the superficial approach did not differ significantly between groups. The learning approaches suggest a positive shift towards deep and strategic learning in postgraduate students. However a similar difference was not observed in undergraduate students from first year to final year, suggesting that their curriculum may not have influenced learning methodology over a five year period.

The Relationship between Anxiety and the Social Judgements of Approachability And Trustworthiness

PubMed Central

Willis, Megan L.; Dodd, Helen F.; Palermo, Romina

2013-01-01

The aim of the current study was to examine the relationship between individual differences in anxiety and the social judgements of trustworthiness and approachability. We assessed levels of state and trait anxiety in eighty-two participants who rated the trustworthiness and approachability of a series of unexpressive faces. Higher levels of trait anxiety (controlling for age, sex and state anxiety) were associated with the judgement of faces as less trustworthy. In contrast, there was no significant association between trait anxiety and judgements of approachability. These findings indicate that trait anxiety is a significant predictor of trustworthiness evaluations and illustrate the importance of considering the role of individual differences in the evaluation of trustworthiness. We propose that trait anxiety may be an important variable to control for in future studies assessing the cognitive and neural mechanisms underlying trustworthiness. This is likely to be particularly important for studies involving clinical populations who often experience atypical levels of anxiety. PMID:24098566

[Critic analysis of a comparative meta-analysis on the morbidity, functional and carcinologic results after radical prostatectomy according to surgical approach. Work of cancerology committee of the French urological association].

PubMed

Bastide, C; Rozet, F; Salomon, L; Mongiat-Artus, P; Beuzeboc, P; Cormier, L; Eiss, D; Gaschignard, N; Peyromaure, M; Richaud, P; Soulié, M

2010-09-01

Surgical approach for radical prostatectomy is even today a subject of debate in the urologic community. Many comparative studies between retropubic and laparoscopic approach (robotic assisted or not) were reported since 10 years without being able to decide between the supporters of retropubic or laparoscopic approach. The committee of cancer research of the French urological association took hold this question after a recent meta-analysis publication on this subject. Although imperfect, this meta-analysis exists and permits to conclude partially on the advantages and the inconveniences supposed for each surgical approach. Regarding morbidity after radical prostatectomy, the only significant difference reported concerns the hemorrhagic risk in favour of the laparoscopic approach. Regarding oncologic results, the only exploitable data concern positive surgical margins rate, which is identical whatever surgical approach. Concerning the functional results, no difference was reported in the literature between different surgical approaches. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

Comparison of Two Music Training Approaches on Music and Speech Perception in Cochlear Implant Users

PubMed Central

Fuller, Christina D.; Galvin, John J.; Maat, Bert; Başkent, Deniz; Free, Rolien H.

2018-01-01

In normal-hearing (NH) adults, long-term music training may benefit music and speech perception, even when listening to spectro-temporally degraded signals as experienced by cochlear implant (CI) users. In this study, we compared two different music training approaches in CI users and their effects on speech and music perception, as it remains unclear which approach to music training might be best. The approaches differed in terms of music exercises and social interaction. For the pitch/timbre group, melodic contour identification (MCI) training was performed using computer software. For the music therapy group, training involved face-to-face group exercises (rhythm perception, musical speech perception, music perception, singing, vocal emotion identification, and music improvisation). For the control group, training involved group nonmusic activities (e.g., writing, cooking, and woodworking). Training consisted of weekly 2-hr sessions over a 6-week period. Speech intelligibility in quiet and noise, vocal emotion identification, MCI, and quality of life (QoL) were measured before and after training. The different training approaches appeared to offer different benefits for music and speech perception. Training effects were observed within-domain (better MCI performance for the pitch/timbre group), with little cross-domain transfer of music training (emotion identification significantly improved for the music therapy group). While training had no significant effect on QoL, the music therapy group reported better perceptual skills across training sessions. These results suggest that more extensive and intensive training approaches that combine pitch training with the social aspects of music therapy may further benefit CI users. PMID:29621947

Comparison of Two Music Training Approaches on Music and Speech Perception in Cochlear Implant Users.

PubMed

Fuller, Christina D; Galvin, John J; Maat, Bert; Başkent, Deniz; Free, Rolien H

2018-01-01

In normal-hearing (NH) adults, long-term music training may benefit music and speech perception, even when listening to spectro-temporally degraded signals as experienced by cochlear implant (CI) users. In this study, we compared two different music training approaches in CI users and their effects on speech and music perception, as it remains unclear which approach to music training might be best. The approaches differed in terms of music exercises and social interaction. For the pitch/timbre group, melodic contour identification (MCI) training was performed using computer software. For the music therapy group, training involved face-to-face group exercises (rhythm perception, musical speech perception, music perception, singing, vocal emotion identification, and music improvisation). For the control group, training involved group nonmusic activities (e.g., writing, cooking, and woodworking). Training consisted of weekly 2-hr sessions over a 6-week period. Speech intelligibility in quiet and noise, vocal emotion identification, MCI, and quality of life (QoL) were measured before and after training. The different training approaches appeared to offer different benefits for music and speech perception. Training effects were observed within-domain (better MCI performance for the pitch/timbre group), with little cross-domain transfer of music training (emotion identification significantly improved for the music therapy group). While training had no significant effect on QoL, the music therapy group reported better perceptual skills across training sessions. These results suggest that more extensive and intensive training approaches that combine pitch training with the social aspects of music therapy may further benefit CI users.

Effects of robotic knee exoskeleton on human energy expenditure.

PubMed

Gams, Andrej; Petric, Tadej; Debevec, Tadej; Babic, Jan

2013-06-01

A number of studies discuss the design and control of various exoskeleton mechanisms, yet relatively few address the effect on the energy expenditure of the user. In this paper, we discuss the effect of a performance augmenting exoskeleton on the metabolic cost of an able-bodied user/pilot during periodic squatting. We investigated whether an exoskeleton device will significantly reduce the metabolic cost and what is the influence of the chosen device control strategy. By measuring oxygen consumption, minute ventilation, heart rate, blood oxygenation, and muscle EMG during 5-min squatting series, at one squat every 2 s, we show the effects of using a prototype robotic knee exoskeleton under three different noninvasive control approaches: gravity compensation approach, position-based approach, and a novel oscillator-based approach. The latter proposes a novel control that ensures synchronization of the device and the user. Statistically significant decrease in physiological responses can be observed when using the robotic knee exoskeleton under gravity compensation and oscillator-based control. On the other hand, the effects of position-based control were not significant in all parameters although all approaches significantly reduced the energy expenditure during squatting.

Comparison of student success using "atoms first" versus "traditional" curricula

NASA Astrophysics Data System (ADS)

Hillesheim, Christina S.

The purpose of this study was to investigate the difference between the "atoms first" and the "traditional" curricula. Specifically focusing on which curriculum better aligns to curricular expectations, leads to higher student success when students are grouped together, and when students are differentiated based on several factors. The main difference between the two approaches being the sequence of topics presented in the first semester general chemistry course. This study involves more than 9,500 general chemistry I and II students over 7 semesters with about half of them being taught using the "atoms first" approach. Student success was measured using the American Chemical Society's (ACS) final examination scores and the final letter grades. Alignment to curricular expectations was determined via a qualitative review of textbooks written for each of the approaches. This showed that the "atoms first" approach better aligns to research supported best practices. An analysis of covariance (ANCOVA) was performed to determine if there is a significant difference between the "atoms first" and the "traditional" curricula. The "traditional" approach was found to lead to higher student achievement for both measures of student success in both chemistry I and II courses. Lastly, multiple linear, multinomial logistic, and binary logistic regressions were run using all of the subgroups---gender, race/ethnicity, major, ACT composite, math ACT, overall GPA, and classroom size---as predictor variables to determine if any significant interactions between the curricular methods and the different subgroups existed. Results found that the relationship between gender, GPA, and classroom size groupings significantly impact student achievement in general chemistry. Specifically, the "traditional" approach lead to higher student success compared to the "atoms first" approach for males, females, below average GPA students, above average GPA students, and students in large classroom settings. However, there are several factors---final examination content, new teacher impact, teacher's view of science, and withdrawal rate and timing---that need to be taken into account when implementing these findings. Overall, the results of this study provides a cautionary reminder of the many impacts affecting curriculum implementation and the importance of professional development and training during a curriculum transitional period.

Clinical judgement in the era of big data and predictive analytics.

PubMed

Chin-Yee, Benjamin; Upshur, Ross

2018-06-01

Clinical judgement is a central and longstanding issue in the philosophy of medicine which has generated significant interest over the past few decades. In this article, we explore different approaches to clinical judgement articulated in the literature, focusing in particular on data-driven, mathematical approaches which we contrast with narrative, virtue-based approaches to clinical reasoning. We discuss the tension between these different clinical epistemologies and further explore the implications of big data and machine learning for a philosophy of clinical judgement. We argue for a pluralistic, integrative approach, and demonstrate how narrative, virtue-based clinical reasoning will remain indispensable in an era of big data and predictive analytics. © 2017 John Wiley & Sons, Ltd.

Influence of study approaches on academic outcomes during pre-clinical medical education.

PubMed

Ward, Peter J

2011-01-01

Different approaches to study lead to differing academic outcomes. Deep and strategic approaches have been linked to academic success while surface approaches lead to poorer understandings. This study sought to characterize how the approaches to study used by medical students impacted their academic success as measured by three outcomes: cumulative grades at the end of the first year, cumulative grades at the end of the second year, and performance on a medical licensing examination. The approaches and study skills inventory for students was administered to medical students to determine their predominant study approach (deep, strategic, superficial) at the beginning of their first year, end of first year, and end of second year. Each group's mean performance on each outcome measure was compared by ANOVA to find significant differences. For all three outcome measures, strategic approaches to study were associated with high performance while surface approaches with a poor one. Deep approaches were most popular at all times and were largely associated with adequate performance. Deep approaches to study are sufficient for success in the current paradigm of medical education but strategic ones may offer a selective advantage to those who use them. Surface approaches to study must be discouraged by instructors through deliberate course design.

Systematic comparison of jet energy-loss schemes in a realistic hydrodynamic medium

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

Bass, Steffen A.; Majumder, Abhijit; Gale, Charles

2009-02-15

We perform a systematic comparison of three different jet energy-loss approaches. These include the Armesto-Salgado-Wiedemann scheme based on the approach of Baier-Dokshitzer-Mueller-Peigne-Schiff and Zakharov (BDMPS-Z/ASW), the higher twist (HT) approach and a scheme based on the Arnold-Moore-Yaffe (AMY) approach. In this comparison, an identical medium evolution will be utilized for all three approaches: this entails not only the use of the same realistic three-dimensional relativistic fluid dynamics (RFD) simulation, but also the use of identical initial parton-distribution functions and final fragmentation functions. We are, thus, in a unique position to not only isolate fundamental differences between the various approaches butmore » also make rigorous calculations for different experimental measurements using state of the art components. All three approaches are reduced to versions containing only one free tunable parameter, this is then related to the well-known transport parameter q. We find that the parameters of all three calculations can be adjusted to provide a good description of inclusive data on R{sub AA} vs transverse momentum. However, we do observe slight differences in their predictions for the centrality and azimuthal angular dependence of R{sub AA} vs p{sub T}. We also note that the values of the transport coefficient q in the three approaches to describe the data differ significantly.« less

Cervical Interlaminar Epidural Steroid Injection for Unilateral Cervical Radiculopathy: Comparison of Midline and Paramedian Approaches for Efficacy

PubMed Central

Yoon, Ji Young; Yoon, Young Cheol; Lee, Jongseok

2015-01-01

Objective The objective of this study was to compare the clinical outcomes of the cervical interlaminar epidural steroid injection (CIESI) for unilateral radiculopathy by the midline or paramedian approaches and to determine the prognostic factors of CIESI. Materials and Methods We retrospectively analyzed 182 patients who underwent CIESI from January 2009 to December 2012. Inclusion criteria were no previous spinal steroid injection, presence of a cross-sectional image, and presence of follow-up records. Exclusion criteria were patients with bilateral cervical radiculopathy and/or dominant cervical axial pain, combined peripheral neuropathy, and previous cervical spine surgery. Short-term clinical outcomes were evaluated at the first follow-up after CIESI. We compared the clinical outcomes between the midline and paramedian approaches. Possible prognostic factors for the outcome, such as age, gender, duration of radiculopathy, and cause of radiculopathy were also analyzed. Results Cervical interlaminar epidural steroid injections were effective in 124 of 182 patients (68.1%) at the first follow-up. There was no significant difference in the clinical outcomes of CIESI, between midline (69.6%) and paramedian (63.7%) approaches (p = 0.723). Cause of radiculopathy was the only significant factor affecting the efficacy of CIESI. Patients with disc herniation had significantly better results than patients with neural foraminal stenosis (82.9% vs. 56.0%) (p < 0.001). Conclusion There is no significant difference in treatment efficacy between the midline and paramedian approaches in CIESI, for unilateral radiculopathy. The cause of the radiculopathy is significantly associated with the treatment efficacy; patients with disc herniation experience better pain relief than those with neural foraminal stenosis. PMID:25995690

Optimizing α for better statistical decisions: a case study involving the pace-of-life syndrome hypothesis: optimal α levels set to minimize Type I and II errors frequently result in different conclusions from those using α = 0.05.

PubMed

Mudge, Joseph F; Penny, Faith M; Houlahan, Jeff E

2012-12-01

Setting optimal significance levels that minimize Type I and Type II errors allows for more transparent and well-considered statistical decision making compared to the traditional α = 0.05 significance level. We use the optimal α approach to re-assess conclusions reached by three recently published tests of the pace-of-life syndrome hypothesis, which attempts to unify occurrences of different physiological, behavioral, and life history characteristics under one theory, over different scales of biological organization. While some of the conclusions reached using optimal α were consistent to those previously reported using the traditional α = 0.05 threshold, opposing conclusions were also frequently reached. The optimal α approach reduced probabilities of Type I and Type II errors, and ensured statistical significance was associated with biological relevance. Biologists should seriously consider their choice of α when conducting null hypothesis significance tests, as there are serious disadvantages with consistent reliance on the traditional but arbitrary α = 0.05 significance level. Copyright © 2012 WILEY Periodicals, Inc.

A comparison of two closely-related approaches to aerodynamic design optimization

NASA Technical Reports Server (NTRS)

Shubin, G. R.; Frank, P. D.

1991-01-01

Two related methods for aerodynamic design optimization are compared. The methods, called the implicit gradient approach and the variational (or optimal control) approach, both attempt to obtain gradients necessary for numerical optimization at a cost significantly less than that of the usual black-box approach that employs finite difference gradients. While the two methods are seemingly quite different, they are shown to differ (essentially) in that the order of discretizing the continuous problem, and of applying calculus, is interchanged. Under certain circumstances, the two methods turn out to be identical. We explore the relationship between these methods by applying them to a model problem for duct flow that has many features in common with transonic flow over an airfoil. We find that the gradients computed by the variational method can sometimes be sufficiently inaccurate to cause the optimization to fail.

Anterior approach versus posterior approach for Pipkin I and II femoral head fractures: A systemic review and meta-analysis.

PubMed

Wang, Chen-guang; Li, Yao-min; Zhang, Hua-feng; Li, Hui; Li, Zhi-jun

2016-03-01

We performed a meta-analysis, pooling the results from controlled clinical trials to compare the efficiency of anterior and posterior surgical approaches to Pipkin I and II fractures of the femoral head. Potential academic articles were identified from the Cochrane Library, Medline (1966-2015.5), PubMed (1966-2015.5), Embase (1980-2015.5) and ScienceDirect (1966-2015.5) databases. Gray studies were identified from the references of the included literature. Pooling of the data was performed and analyzed by RevMan software, version 5.1. Five case-control trials (CCTs) met the inclusion criteria. There were significant differences in the incidence of heterotopic ossification (HO) between the approaches, but no significant differences were found between the two groups regarding functional outcomes of the hip, general postoperative complications, osteonecrosis of the femoral head or post-traumatic arthritis. The present meta-analysis indicated that the posterior approach decreased the risk of heterotopic ossification compared with the anterior approach for the treatment of Pipkin I and II femoral head fractures. No other complications were related to anterior and posterior approaches. Future high-quality randomized, controlled trials (RCTs) are needed to determine the optimal surgical approach and to predict other postoperative complications. III. Copyright © 2016 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

Daily Physical Activity in Total Hip Arthroplasty Patients Undergoing Different Surgical Approaches: A Cohort Study.

PubMed

Engdal, Monika; Foss, Olav A; Taraldsen, Kristin; Husby, Vigdis S; Winther, Siri B

2017-07-01

Muscle weakness due to trauma from the surgical approach is anticipated to affect the ability of the patient to undertake daily physical activity early after total hip arthroplasty (THA). The objective of this study was to compare daily physical activity on days 1 to 4 after discharge, in patients following THA performed by 1 of 3 surgical approaches. A cohort study included 60 hip osteoarthritis patients, scheduled for THA, allocated to direct lateral approach, posterior approach, or anterior approach. Daily physical activity was measured by an accelerometer, with upright time per 24 hours as primary outcome and walking time, number of steps, and number of upright events per 24 hours as secondary outcomes. There were no statistically significant group differences in any of the measures of daily physical activity (P > 0.290) or between days of follow-up (P > 0.155). Overall, the median participant had 3.50 hours (interquartile range, 2.85-4.81 hours) of upright time, and participants showed wide variation in all outcomes of daily physical activity. There were no differences in daily physical activity between THA patients undergoing different surgical approaches. The surgical approach may not be a limiting factor for daily physical activity early after surgery in a fast-track treatment course.

Machine printed text and handwriting identification in noisy document images.

PubMed

Zheng, Yefeng; Li, Huiping; Doermann, David

2004-03-01

In this paper, we address the problem of the identification of text in noisy document images. We are especially focused on segmenting and identifying between handwriting and machine printed text because: 1) Handwriting in a document often indicates corrections, additions, or other supplemental information that should be treated differently from the main content and 2) the segmentation and recognition techniques requested for machine printed and handwritten text are significantly different. A novel aspect of our approach is that we treat noise as a separate class and model noise based on selected features. Trained Fisher classifiers are used to identify machine printed text and handwriting from noise and we further exploit context to refine the classification. A Markov Random Field-based (MRF) approach is used to model the geometrical structure of the printed text, handwriting, and noise to rectify misclassifications. Experimental results show that our approach is robust and can significantly improve page segmentation in noisy document collections.

Higher Education and Curriculum Innovation for Sustainable Development in India

ERIC Educational Resources Information Center

Chhokar, Kiran Banga

2010-01-01

Purpose: The purpose of this paper is to analyze and profile significant national developments in higher education for sustainable development in India and to compare different educational approaches emerging in connection with education for sustainable development. Design/methodology/approach: This is an evaluative review of contrasting…

Explaining the Significance of Participationist Approaches for Understanding Students' Knowledge Acquisition

ERIC Educational Resources Information Center

Dohn, Nina Bonderup

2016-01-01

This article aims to appraise insights from participationist approaches to learning for understanding students' knowledge acquisition. The first part explicates the concepts of positioning, recognition, and identity through presenting a common ground for participationists and discussing different views on (a) the relationship between learning the…

Phanerozoic marine diversity: rock record modelling provides an independent test of large-scale trends.

PubMed

Smith, Andrew B; Lloyd, Graeme T; McGowan, Alistair J

2012-11-07

Sampling bias created by a heterogeneous rock record can seriously distort estimates of marine diversity and makes a direct reading of the fossil record unreliable. Here we compare two independent estimates of Phanerozoic marine diversity that explicitly take account of variation in sampling-a subsampling approach that standardizes for differences in fossil collection intensity, and a rock area modelling approach that takes account of differences in rock availability. Using the fossil records of North America and Western Europe, we demonstrate that a modelling approach applied to the combined data produces results that are significantly correlated with those derived from subsampling. This concordance between independent approaches argues strongly for the reality of the large-scale trends in diversity we identify from both approaches.

A randomised controlled trial of a blended learning education intervention for teaching evidence-based medicine.

PubMed

Ilic, Dragan; Nordin, Rusli Bin; Glasziou, Paul; Tilson, Julie K; Villanueva, Elmer

2015-03-10

Few studies have been performed to inform how best to teach evidence-based medicine (EBM) to medical trainees. Current evidence can only conclude that any form of teaching increases EBM competency, but cannot distinguish which form of teaching is most effective at increasing student competency in EBM. This study compared the effectiveness of a blended learning (BL) versus didactic learning (DL) approach of teaching EBM to medical students with respect to competency, self-efficacy, attitudes and behaviour toward EBM. A mixed methods study consisting of a randomised controlled trial (RCT) and qualitative case study was performed with medical students undertaking their first clinical year of training in EBM. Students were randomly assigned to receive EBM teaching via either a BL approach or the incumbent DL approach. Competency in EBM was assessed using the Berlin questionnaire and the 'Assessing Competency in EBM' (ACE) tool. Students' self-efficacy, attitudes and behaviour was also assessed. A series of focus groups was also performed to contextualise the quantitative results. A total of 147 students completed the RCT, and a further 29 students participated in six focus group discussions. Students who received the BL approach to teaching EBM had significantly higher scores in 5 out of 6 behaviour domains, 3 out of 4 attitude domains and 10 out of 14 self-efficacy domains. Competency in EBM did not differ significantly between students receiving the BL approach versus those receiving the DL approach [Mean Difference (MD)=-0.68, (95% CI-1.71, 0.34), p=0.19]. No significant difference was observed between sites (p=0.89) or by student type (p=0.58). Focus group discussions suggested a strong student preference for teaching using a BL approach, which integrates lectures, online learning and small group activities. BL is no more effective than DL at increasing medical students' knowledge and skills in EBM, but was significantly more effective at increasing student attitudes toward EBM and self-reported use of EBM in clinical practice. Given the various learning styles preferred by students, a multifaceted approach (incorporating BL) may be best suited when teaching EBM to medical students. Further research on the cost-effectiveness of EBM teaching modalities is required.

Multivariate analysis of variance of designed chromatographic data. A case study involving fermentation of rooibos tea.

PubMed

Marini, Federico; de Beer, Dalene; Walters, Nico A; de Villiers, André; Joubert, Elizabeth; Walczak, Beata

2017-03-17

An ultimate goal of investigations of rooibos plant material subjected to different stages of fermentation is to identify the chemical changes taking place in the phenolic composition, using an untargeted approach and chromatographic fingerprints. Realization of this goal requires, among others, identification of the main components of the plant material involved in chemical reactions during the fermentation process. Quantitative chromatographic data for the compounds for extracts of green, semi-fermented and fermented rooibos form the basis of preliminary study following a targeted approach. The aim is to estimate whether treatment has a significant effect based on all quantified compounds and to identify the compounds, which contribute significantly to it. Analysis of variance is performed using modern multivariate methods such as ANOVA-Simultaneous Component Analysis, ANOVA - Target Projection and regularized MANOVA. This study is the first one in which all three approaches are compared and evaluated. For the data studied, all tree methods reveal the same significance of the fermentation effect on the extract compositions, but they lead to its different interpretation. Copyright © 2017 Elsevier B.V. All rights reserved.

Assessing Variability in Brain Tumor Segmentation to Improve Volumetric Accuracy and Characterization of Change.

PubMed

Rios Piedra, Edgar A; Taira, Ricky K; El-Saden, Suzie; Ellingson, Benjamin M; Bui, Alex A T; Hsu, William

2016-02-01

Brain tumor analysis is moving towards volumetric assessment of magnetic resonance imaging (MRI), providing a more precise description of disease progression to better inform clinical decision-making and treatment planning. While a multitude of segmentation approaches exist, inherent variability in the results of these algorithms may incorrectly indicate changes in tumor volume. In this work, we present a systematic approach to characterize variability in tumor boundaries that utilizes equivalence tests as a means to determine whether a tumor volume has significantly changed over time. To demonstrate these concepts, 32 MRI studies from 8 patients were segmented using four different approaches (statistical classifier, region-based, edge-based, knowledge-based) to generate different regions of interest representing tumor extent. We showed that across all studies, the average Dice coefficient for the superset of the different methods was 0.754 (95% confidence interval 0.701-0.808) when compared to a reference standard. We illustrate how variability obtained by different segmentations can be used to identify significant changes in tumor volume between sequential time points. Our study demonstrates that variability is an inherent part of interpreting tumor segmentation results and should be considered as part of the interpretation process.

Micro finite element analysis of dental implants under different loading conditions.

PubMed

Marcián, Petr; Wolff, Jan; Horáčková, Ladislava; Kaiser, Jozef; Zikmund, Tomáš; Borák, Libor

2018-05-01

Osseointegration is paramount for the longevity of dental implants and is significantly influenced by biomechanical stimuli. The aim of the present study was to assess the micro-strain and displacement induced by loaded dental implants at different stages of osseointegration using finite element analysis (FEA). Computational models of two mandible segments with different trabecular densities were constructed using microCT data. Three different implant loading directions and two osseointegration stages were considered in the stress-strain analysis of the bone-implant assembly. The bony segments were analyzed using two approaches. The first approach was based on Mechanostat strain intervals and the second approach was based on tensile/compression yield strains. The results of this study revealed that bone surrounding dental implants is critically strained in cases when only a partial osseointegration is present and when an implant is loaded by buccolingual forces. In such cases, implants also encounter high stresses. Displacements of partially-osseointegrated implant are significantly larger than those of fully-osseointegrated implants. It can be concluded that the partial osseointegration is a potential risk in terms of implant longevity. Copyright © 2018 Elsevier Ltd. All rights reserved.

Drug safety analyses in a rheumatoid arthritis registry: application of different approaches regarding timing of exposure and confounder measurement.

PubMed

Solomon, Daniel H; Shadick, Nancy A; Weinblatt, Michael E; Zak, Agnes; Frits, Michelle; Franklin, Jessica M

2017-06-13

Patient registry data serves an increasing role in drug safety and comparative effectiveness research, but registry databases often do not contain confounder information measured at the same time that treatments begin. This study evaluated a set of approaches for estimating confounder values at treatment initiation using actual data from a rheumatoid arthritis (RA) registry to examine the risk of infection associated with different biologic DMARDs (bDMARDs). We examined the risk of infection associated with starting a TNF inhibitor (TNFi) versus any of the other non-TNFi bDMARDs. Different confounder assessment approaches were tested. All approaches were tested in Cox proportional hazard regression models that used a propensity score (PS). The confounder of interest was the disease activity score (DAS28-CRP). The confounder assessment approaches utilized different temporal relationships between the DAS28-CRP measurement and the start of the treatments of interest. We included 219 subjects with RA with 269 initiations of either a TNFi or a different bDMARD or both. Among this group, 305 infections were reported and confirmed through chart review. The hazard ratio (HR) for the risk of infection associated with use of a non-TNFi bDMARD ranged from 1.17 to 3.03 using 13 different approaches; only the approach with the highest HR produced results significantly different than one, but this approach included the fewest subjects and infections. The relative risk of infection for TNFi and other non-TNFi bDMARDs was similar using various approaches regarding which DAS28-CRP score should be used as the baseline measure in adjusted analyses.

Comparison of a dietary intervention promoting high intakes of fruits and vegetables with a low-fat approach: long-term effects on dietary intakes, eating behaviours and body weight in postmenopausal women.

PubMed

Lapointe, Annie; Weisnagel, S John; Provencher, Véronique; Bégin, Catherine; Dufour-Bouchard, Andrée-Ann; Trudeau, Caroline; Lemieux, Simone

2010-10-01

The aim of the present study was to compare the long-term effects of two dietary approaches on changes in dietary intakes, eating behaviours and body weight: (1) approach using restrictive messages to limit high-fat foods (low-fat intake; LOFAT); (2) approach emphasising non-restrictive messages directed towards the inclusion of fruits and vegetables (high intake of fruits and vegetables; HIFV). A total of sixty-eight overweight or obese postmenopausal women were randomly assigned to one of the two dietary approaches. The 6-month dietary intervention included three group sessions and ten individual sessions with a dietitian. Dietary intakes, eating behaviours and anthropometrics were measured at baseline, at the end of the dietary intervention (T = 6) and 6 months and 12 months after the end of the intervention (T = 12 and T = 18). In the LOFAT group, energy and fat intakes were lower at T = 6 when compared with baseline and remained lower at T = 12 and T = 18. In the HIFV group, fruit and vegetable intakes increased significantly at T = 6 but were no longer significantly different from baseline at T = 12 and T = 18. Dietary restraint increased at T = 6 and remained higher than baseline at T = 18 in the LOFAT group while no significant change was observed in the HIFV group. At T = 6, body weight was significantly lower than baseline in both groups (LOFAT: - 3.7 (SD 2.8) kg; HIFV: - 1.8 (SD 3.0) kg) and no significant difference in body-weight change from baseline was found between groups at T = 18. We concluded that weight loss was similar at 1-year follow-up in both dietary approaches. Despite relatively good improvements in the short term, the adherence to a 6-month dietary intervention promoting high intakes of fruits and vegetables was difficult to maintain.

A risk based approach for SSTO/TSTO comparisons

NASA Astrophysics Data System (ADS)

Greenberg, Joel S.

1996-03-01

An approach has been developed for performing early comparisons of transportation architectures explicitly taking into account quantitative measures of uncertainty and resulting risk. Risk considerations are necessary since the transportation systems are likely to have significantly different levels of risk, both because of differing degrees of freedom in achieving desired performance levels and their different states of development and utilization. The approach considers the uncertainty of achievement of technology goals, effect that the achieved technology level will have on transportation system performance and the relationship between system performance/capability and the ability to accommodate variations in payload mass. The consequences of system performance are developed in terms of nonrecurring, recurring, and the present value of transportation system life cycle costs.

The Effect of Teaching Games of Understanding as a Coaching Instruction had on Adjust, Cover and Heart Rate among Malaysian and Indian Junior Hockey Players.

PubMed

Nathan, Sanmuga

2017-06-20

The field hockey coaching process across both Malaysia and India favours a traditional, coach-centred approach of mastering technical skills in terms of game play parameters, fitness, intensity, and load training, whereas a tactical- and player-centred pedagogical approach still takes a backseat. On the other hand, the Teaching Games for Understanding (TGfU) model offers tactical-cognitive instruction and is gaining international recognition for its ability to produce intelligent players via a problem-solving approach in game play. Therefore, the purpose of this quasi-experimental study was to investigate the effect of TGfU compared to skill mastery instruction, termed as Skill Drill Technical (SDT), among Malaysian and Indian elite junior hockey players in term of the game play attributes of adjust and cover in 5 vs. 5 small-sided game play and game play intensity via heart rate (HR) at different points of game play. A total of n = 60 players with an average age of 15 ± 1.03 was selected via simple random sampling from both countries involved in this study and assigned equally to groups, with 15 per group for TGfU and for SDT across Malaysia and India. Gathered data were analysed using the ANOVA and ANCOVA techniques. Findings indicated that there were no significant differences for adjust in 5 vs. 5 game play between TGfU and SDT across Malaysia and India after the intervention. For cover, there was significant improvement for Malaysian players using the TGfU model compared to SDT. In contrast, there was no significant difference between these two models among the Indian players after the intervention. There was significant difference between these two models in terms of warm-up HR across the two countries, and HR was higher via TGfU. For HR immediately after the 5 vs. 5 game play intervention and HR after three minutes' recovery, Indian players with TGfU recorded a higher and significant difference compared to SDT. However, findings indicated no significant difference between these two instruction types among Malaysians, although TGfU proved to have higher HR intensity. Therefore, these findings reiterated that TGfU is a useful approach for game play to enhance intensity and cardiac output. In conclusion, for TGfU to be more relevant to the coaching environment, future research should link game play and physiological parameters. TGfU should able to overcome the barriers of tradition and cultural background that may hinder its momentum.

Measurement of phase function of aerosol at different altitudes by CCD Lidar

NASA Astrophysics Data System (ADS)

Sun, Peiyu; Yuan, Ke'e.; Yang, Jie; Hu, Shunxing

2018-02-01

The aerosols near the ground are closely related to human health and climate change, the study on which has important significance. As we all know, the aerosol is inhomogeneous at different altitudes, of which the phase function is also different. In order to simplify the retrieval algorithm, it is usually assumed that the aerosol is uniform at different altitudes, which will bring measurement error. In this work, an experimental approach is demonstrated to measure the scattering phase function of atmospheric aerosol particles at different heights by CCD lidar system, which could solve the problem of the traditional CCD lidar system in assumption of phase function. The phase functions obtained by the new experimental approach are used to retrieve the aerosol extinction coefficient profiles. By comparison of the aerosol extinction coefficient retrieved by Mie-scattering aerosol lidar and CCD lidar at night, the reliability of new experimental approach is verified.

Biomechanical Comparison of an Open vs Arthroscopic Approach for Lateral Ankle Instability.

PubMed

Drakos, Mark C; Behrens, Steve B; Paller, Dave; Murphy, Conor; DiGiovanni, Christopher W

2014-08-01

The current clinical standard for the surgical treatment of ankle instability remains the open modified Broström procedure. Modern advents in arthroscopic technology have allowed physicians to perform certain foot and ankle procedures arthroscopically as opposed to traditional open approaches. Twenty matched lower extremity cadaver specimens were obtained. Steinman pins were inserted into the tibia and talus with 6 sensors affixed to each pin. Specimens were placed in a Telos ankle stress apparatus in an anteroposterior and then lateral position, while a 1.7 N-m load was applied. For each of these tests, movement of the sensors was measured in 3 planes using the Optotrak Computer Navigation System. Changes in position were calculated and compared with the unloaded state. The anteriortalofibular ligament and the calcaneofibular ligament were thereafter sectioned from the fibula. The aforementioned measurements in the loaded and unloaded states were repeated on the specimens. The sectioned ligaments were then repaired using 2 corkscrew anchors. Ten specimens were repaired using a standard open Broström-type repair, while the matched pairs were repaired using an arthroscopic technique. Measurements were repeated and compared using a paired t test. There was a statistically significant difference between the sectioned state and the other 3 states (P < .05). There were no statistically significant differences between the intact state and either the open or arthroscopic state (P > .05). There were no significant differences between the open and arthroscopic repairs with respect to translation and total combined motion during the talar tilt test (P > .05). Statistically significant differences were demonstrated between the 2 methods in 3 specific axes of movement during talar tilt (P = .04). Biomechanically effective ankle stabilization may be amenable to a minimally invasive approach. A minimally invasive, arthroscopic approach can be considered for treating patients with lateral ankle instability who have failed conservative treatment. © The Author(s) 2014.

Research design: qualitative, quantitative and mixed methods approaches Research design: qualitative, quantitative and mixed methods approaches Creswell John W Sage 320 £29 0761924426 0761924426 [Formula: see text].

PubMed

2004-09-01

The second edition of Creswell's book has been significantly revised and updated. The author clearly sets out three approaches to research: quantitative, qualitative and mixed methods. As someone who has used mixed methods in my research, it is refreshing to read a textbook that addresses this. The differences between the approaches are clearly identified and a rationale for using each methodological stance provided.

Interactive large-group teaching in a dermatology course.

PubMed

Ochsendorf, F R; Boehncke, W-H; Sommerlad, M; Kaufmann, R

2006-12-01

This is a prospective study to find out whether an interactive large-group case-based teaching approach combined with small-group bedside teaching improves student satisfaction and learning outcome in a practical dermatology course. During two consecutive terms a rotating system of large-group interactive case-study-method teaching with two tutors (one content expert, one process facilitator) and bedside teaching with randomly appointed tutors was evaluated with a nine-item questionnaire and multiple-choice test performed at the beginning and the end of the course (n = 204/231 students evaluable). The results of three different didactic approaches utilized over the prior year served as a control. The interactive course was rated significantly better (p < 0.0001) than the standard course with regard to all items. The aggregate mark given by the students for the whole course was 1.58-0.61 (mean +/- SD, range 1 (good)-5 (poor)). This was significantly better than the standard course (p < 0.0001) and not different from small-group teaching approaches. The mean test results in the final examination improved significantly (p < 0.01). The combination of large-group interactive teaching and small-group bedside teaching was well accepted, improved the learning outcome, was rated as good as a small-group didactic approach and needed fewer resources in terms of personnel.

An Integrated Experimental and Computational Approach for Characterizing the Kinetics and Mechanism of Triadimefon Racemization

EPA Science Inventory

Enantiomers of chiral molecules commonly exhibit different environmental fates, pharmacokinetics, and toxicities. Ignoring these differences can introduce significant uncertainty when modeling the physiological and environmental fate of chlral chemicals and evaluating their risk ...

Comparison of two approaches to quantify anthropogenic CO2 in the ocean: Results from the northern Indian Ocean

NASA Astrophysics Data System (ADS)

Coatanoan, C.; Goyet, C.; Gruber, N.; Sabine, C. L.; Warner, M.

2001-03-01

This study compares two recent estimates of anthropogenic CO2 in the northern Indian Ocean along the World Ocean Circulation Experiment cruise II [Goyet et al., 1999; Sabine et al., 1999]. These two studies employed two different approaches to separate the anthropogenic CO2 signal from the large natural background variability. Sabine et al. [1999] used the ΔC* approach first described by Gruber et al. [1996], whereas Goyet et al. [1999] used an optimum multiparameter mixing analysis referred to as the MIX approach. Both approaches make use of similar assumptions in order to remove variations due to remineralization of organic matter and the dissolution of calcium carbonates (biological pumps). However, the two approaches use very different hypotheses in order to account for variations due to physical processes including mixing and the CO2 solubility pump. Consequently, substantial differences exist in the upper thermocline approximately between 200 and 600 m. Anthropogenic CO2 concentrations estimated using the ΔC* approach average 12 ± 4 μmol kg-1 higher in this depth range than concentrations estimated using the MIX approach. Below ˜800 m, the MIX approach estimates slightly higher anthropogenic CO2 concentrations and a deeper vertical penetration. Despite this compensatory effect, water column inventories estimated in the 0-3000 m depth range by the ΔC* approach are generally ˜20% higher than those estimated by the MIX approach, with this difference being statistically significant beyond the 0.001 level. We examine possible causes for these differences and identify a number of critical additional measurements that will make it possible to discriminate better between the two approaches.

Robust climate policies under uncertainty: a comparison of robust decision making and info-gap methods.

PubMed

Hall, Jim W; Lempert, Robert J; Keller, Klaus; Hackbarth, Andrew; Mijere, Christophe; McInerney, David J

2012-10-01

This study compares two widely used approaches for robustness analysis of decision problems: the info-gap method originally developed by Ben-Haim and the robust decision making (RDM) approach originally developed by Lempert, Popper, and Bankes. The study uses each approach to evaluate alternative paths for climate-altering greenhouse gas emissions given the potential for nonlinear threshold responses in the climate system, significant uncertainty about such a threshold response and a variety of other key parameters, as well as the ability to learn about any threshold responses over time. Info-gap and RDM share many similarities. Both represent uncertainty as sets of multiple plausible futures, and both seek to identify robust strategies whose performance is insensitive to uncertainties. Yet they also exhibit important differences, as they arrange their analyses in different orders, treat losses and gains in different ways, and take different approaches to imprecise probabilistic information. The study finds that the two approaches reach similar but not identical policy recommendations and that their differing attributes raise important questions about their appropriate roles in decision support applications. The comparison not only improves understanding of these specific methods, it also suggests some broader insights into robustness approaches and a framework for comparing them. © 2012 RAND Corporation.

A comparison of email versus letter threat contacts toward members of the United States Congress.

PubMed

Schoeneman-Morris, Katherine A; Scalora, Mario J; Chang, Grace H; Zimmerman, William J; Garner, Yancey

2007-09-01

To better understand inappropriate correspondence sent to public officials, 301 letter cases and 99 email cases were randomly selected from the United States Capitol Police investigative case files and compared. Results indicate that letter writers were significantly more likely than emailers to exhibit indicators of serious mental illness (SMI), engage in target dispersion, use multiple methods of contact, and make a problematic approach toward their target. Emailers were significantly more likely than letter writers to focus on government concerns, use obscene language, and display disorganization in their writing. Also, letter writers tended to be significantly older, have more criminal history, and write longer communications. A multivariate model found that disorganization, SMI symptoms, problematic physical approach, and target dispersion significantly differentiated between the correspondence groups. The group differences illuminated by this study reveal that letter writers are engaging in behavior that is higher risk for problematic approach than are emailers.

Fifteen-month follow up of an assertive community treatment program for chronic patients with mental illness.

PubMed

Kim, Tae-Won; Jeong, Jong-Hyun; Kim, Young-Hee; Kim, Yura; Seo, Ho-Jun; Hong, Seung-Chul

2015-09-16

The aim of this study was to evaluate the effect of an Assertive Community Treatment (ACT) program on psychiatric symptoms, global functioning, life satisfaction, and recovery-promoting relationships among individuals with mental illness. Participants were patients at the Suwon Mental Health Center. Thirty-two patients were part of the ACT program and 32 patients matched for age, sex, and mental illness were in a standard case-management program and served as a control group. Follow-up with patients occurred every 3 months during the 15 months after a baseline interview. Participants completed the Brief Psychiatric Rating Scale (BPRS), Global Assessment of Functioning (GAF) Scale, Life Satisfaction Scale, and Recovery-Promoting Relationship Scale (RPRS). No significant differences were noted in the sociodemographic characteristics of the ACT and the case-management group. According to the BPRS, the ACT group showed a significant reduction in symptom severity, but the ACT program was not significantly more effective at reducing psychiatric symptoms from baseline to the 15-month follow-up compared to the case-management approach. The ACT group showed more significant improvement than the control group in terms of the GAF Scale. Both groups showed no significant differences in the change of life satisfaction and in the change of recovery-promoting relationships. We observed a significant increase in recovery-promoting relationships in the control group, but the degree of change of recovery-promoting relationships through time flow between groups was not significantly different. In this study, we observed that ACT was significantly better at improving the GAF than case management and that participation in ACT was associated with a significant decrease in BPRS scores. However, ACT did not demonstrate an absolute superiority over the standard case-management approach in terms of the BPRS and the measures of life satisfaction and recovery-promoting relationships. ACT may have some advantages over a standard case management approach.

The genomic architecture and association genetics of adaptive characters using a candidate SNP approach in boreal black spruce

PubMed Central

2013-01-01

Background The genomic architecture of adaptive traits remains poorly understood in non-model plants. Various approaches can be used to bridge this gap, including the mapping of quantitative trait loci (QTL) in pedigrees, and genetic association studies in non-structured populations. Here we present results on the genomic architecture of adaptive traits in black spruce, which is a widely distributed conifer of the North American boreal forest. As an alternative to the usual candidate gene approach, a candidate SNP approach was developed for association testing. Results A genetic map containing 231 gene loci was used to identify QTL that were related to budset timing and to tree height assessed over multiple years and sites. Twenty-two unique genomic regions were identified, including 20 that were related to budset timing and 6 that were related to tree height. From results of outlier detection and bulk segregant analysis for adaptive traits using DNA pool sequencing of 434 genes, 52 candidate SNPs were identified and subsequently tested in genetic association studies for budset timing and tree height assessed over multiple years and sites. A total of 34 (65%) SNPs were significantly associated with budset timing, or tree height, or both. Although the percentages of explained variance (PVE) by individual SNPs were small, several significant SNPs were shared between sites and among years. Conclusions The sharing of genomic regions and significant SNPs between budset timing and tree height indicates pleiotropic effects. Significant QTLs and SNPs differed quite greatly among years, suggesting that different sets of genes for the same characters are involved at different stages in the tree’s life history. The functional diversity of genes carrying significant SNPs and low observed PVE further indicated that a large number of polymorphisms are involved in adaptive genetic variation. Accordingly, for undomesticated species such as black spruce with natural populations of large effective size and low linkage disequilibrium, efficient marker systems that are predictive of adaptation should require the survey of large numbers of SNPs. Candidate SNP approaches like the one developed in the present study could contribute to reducing these numbers. PMID:23724860

Conceptions of learning and approaches to studying among White and ethnic minority students in distance education.

PubMed

Richardson, John T E

2010-12-01

The attainment of White students at UK institutions of higher education tends to be higher than that of students from other ethnic groups, but the causes of this are unclear. This study compared White students and students from other ethnic groups in their conceptions of learning, their approaches to studying, and their academic attainment. A stratified sample of 1,146 White students and 1,146 students from other ethnic groups taking courses by distance learning with the UK Open University. The Mental Models section of the Inventory of Learning Styles and the Revised Approaches to Studying Inventory were administered in a postal survey. The students' questionnaire scores were contaminated by response bias, which varied across different ethnic groups. When adjusted to control for response bias, the scores on the two questionnaires shared 37.2% of their variance and made a significant contribution to predicting the students' attainment. White students were more likely to exhibit a meaning-directed learning pattern, whereas Asian and Black students were more likely to exhibit a reproduction-directed learning pattern. However, the variation in attainment across different ethnic groups remained significant when their questionnaire scores and prior qualifications were taken into account. There is a strong relationship between students' conceptions of learning and their approaches to studying, and variations in conceptions of learning in different ethnic groups give rise to variations in approaches to studying. However, factors other than prior qualifications and conceptions of learning are responsible for variation in attainment across different ethnic groups.

Costs and benefits of different methods of esophagectomy for esophageal cancer.

PubMed

Yanasoot, Alongkorn; Yolsuriyanwong, Kamtorn; Ruangsin, Sakchai; Laohawiriyakamol, Supparerk; Sunpaweravong, Somkiat

2017-01-01

Background A minimally invasive approach to esophagectomy is being used increasingly, but concerns remain regarding the feasibility, safety, cost, and outcomes. We performed an analysis of the costs and benefits of minimally invasive, hybrid, and open esophagectomy approaches for esophageal cancer surgery. Methods The data of 83 consecutive patients who underwent a McKeown's esophagectomy at Prince of Songkla University Hospital between January 2008 and December 2014 were analyzed. Open esophagectomy was performed in 54 patients, minimally invasive esophagectomy in 13, and hybrid esophagectomy in 16. There were no differences in patient characteristics among the 3 groups Minimally invasive esophagectomy was undertaken via a thoracoscopic-laparoscopic approach, hybrid esophagectomy via a thoracoscopic-laparotomy approach, and open esophagectomy by a thoracotomy-laparotomy approach. Results Minimally invasive esophagectomy required a longer operative time than hybrid or open esophagectomy ( p = 0.02), but these patients reported less postoperative pain ( p = 0.01). There were no significant differences in blood loss, intensive care unit stay, hospital stay, or postoperative complications among the 3 groups. Minimally invasive esophagectomy incurred higher operative and surgical material costs than hybrid or open esophagectomy ( p = 0.01), but there were no significant differences in inpatient care and total hospital costs. Conclusion Minimally invasive esophagectomy resulted in the least postoperative pain but the greatest operative cost and longest operative time. Open esophagectomy was associated with the lowest operative cost and shortest operative time but the most postoperative pain. Hybrid esophagectomy had a shorter learning curve while sharing the advantages of minimally invasive esophagectomy.

Multi-contamination (heavy metals, polychlorinated biphenyls and polycyclic aromatic hydrocarbons) of littoral sediments and the associated ecological risk assessment in a large lake in France (Lake Bourget).

PubMed

Lécrivain, Nathalie; Aurenche, Vincent; Cottin, Nathalie; Frossard, Victor; Clément, Bernard

2018-04-01

The lake littoral sediment is exposed to a large array of contaminants that can exhibit significant spatial variability and challenge our ability to assess contamination at lake scale. In this study, littoral sediment contamination was characterized among ten different sites in a large peri-alpine lake (Lake Bourget) regarding three groups of contaminants: 6 heavy metals, 15 polycyclic aromatic hydrocarbons and 7 polychlorinated biphenyls. The contamination profiles significantly varied among sites and differed from those previously reported for the deepest zone of the lake. An integrative approach including chemical and biological analyses was conducted to relate site contamination to ecological risk. The chemical approach consisted in mean PEC quotient calculation (average of the ratios of the contaminants concentration to their corresponding Probable Effect Concentration values) and revealed a low and heterogeneous toxicity of the contaminant mixture along the littoral. Biological analysis including both laboratory (microcosm assays) and in situ (Acetylcholine Esterase (AChE) and Glutathione S-Transferase (GST) activity measurements) experiments highlighted significant differences among sites both in the field and in laboratory assays suggesting a spatial variation of the biota response to contamination. Linear regressions were performed between mean PEC quotients and biological results to assess whether littoral ecological risk was explained by the contamination profiles. The results highly depended on the study benthic or pelagic compartment. Regarding autochthonous Corbicula fluminea, no significant relationship between mean PEC quotients and biomarker activity was found while a significant increase in AChE was observed on autochthonous chironomids, suggesting different stress among benthic organisms. Both AChE and GST in caged pelagic Daphnia magna showed a significant positive relationship with mean PEC quotients. This study underlines the importance of accounting for spatial variations in lake littoral sediment contamination and the need for performing an integrative approach coupling chemical, field and laboratory analyses to assess the ecological risk. Copyright © 2017 Elsevier B.V. All rights reserved.

Concentrated Language Encounter Approach in Practice for Global Teaching of Literacy: Lighthouse Strategy Implementation

ERIC Educational Resources Information Center

Rattanavich, Saowalak

2015-01-01

This article presents the lighthouse literacy strategies model using the concentrated language encounter (CLE) approach that has been successfully replicated in many countries in different languages and cultures. A review of CLE research studies and the project implementation in Thailand showed highly significant results in students' literacy…

A Study of Electronic Detection and Pedagogical Approaches for Reducing Plagiarism

ERIC Educational Resources Information Center

Chao, Chia-An; Wilhelm, William J.; Neureuther, Brian D.

2009-01-01

Plagiarism is an increasing problem in high schools and universities. To address the issue of how to teach students not to plagiarize, this study examined several pedagogical approaches for reducing plagiarism and the use of Turnitin, an online plagiarism detection software. The study found a significant difference between the control group and…

Unidimensional versus Multidimensional Approaches to the Assessment of Acculturation for Asian American Populations.

ERIC Educational Resources Information Center

Abe-Kim, Jennifer; Okazaki, Sumie; Goto, Sharon G.

2001-01-01

Examines approaches to assessing acculturation among Asian Americans college students in relation to the cultural indicators of individualism-collectivism, self-construal, impression management, and loss of face. An uneven nature of these relationships was found which is significant in light of the fact that acculturation differences are often…

Constructivist Learning Approach in Science Teaching

ERIC Educational Resources Information Center

Demirci, Cavide

2009-01-01

Constructivism is not a new concept. It has its roots in philosophy and has been applied to sociology and anthropology, as well as cognitive psychology and education. The aim of this research is to reveal if there is a significant difference between the means of achievement and retention learning scores of constructivist learning approach applied…

Comparison of IRMS and NMR spectrometry for the determination of intramolecular 13C isotope composition: application to ethanol.

PubMed

Gilbert, Alexis; Hattori, Ryota; Silvestre, Virginie; Wasano, Nariaki; Akoka, Serge; Hirano, Satoshi; Yamada, Keita; Yoshida, Naohiro; Remaud, Gérald S

2012-09-15

Isotopic (13)C NMR is a relatively recent technique which allows the determination of intramolecular (13)C isotope composition at natural abundance. It has been used in various scientific fields such as authentication, counterfeiting or plant metabolism. Although its precision has already been evaluated, the determination of its trueness remains still challenging. To deal with that issue, a comparison with another normalized technique must be achieved. In this work, we compare the intramolecular (13)C isotope distribution of ethanol from different origins obtained using both Isotope Ratio Mass Spectrometry (IRMS) and Nuclear Magnetic Resonance (NMR) spectrometry techniques. The IRMS approach consists of the oxidation of ethanol to acetic acid followed by the degradation of the latter for the analysis of each fragments formed. We show here that the oxidation of ethanol to acetic acid does not bring any significant error on the determination of the site-specific δ(13)C (δ(13)C(i)) of ethanol using the IRMS approach. The difference between the data obtained for 16 samples from different origins using IRMS and NMR approaches is not statistically significant and remains below 0.3‰. These results are encouraging for the future studies using isotopic NMR, especially in combination with the IRMS approach. Copyright © 2012. Published by Elsevier B.V.

Quantification of functional mitral regurgitation by real-time 3D echocardiography: comparison with 3D velocity-encoded cardiac magnetic resonance.

PubMed

Marsan, Nina Ajmone; Westenberg, Jos J M; Ypenburg, Claudia; Delgado, Victoria; van Bommel, Rutger J; Roes, Stijntje D; Nucifora, Gaetano; van der Geest, Rob J; de Roos, Albert; Reiber, Johan C; Schalij, Martin J; Bax, Jeroen J

2009-11-01

The aim of this study was to evaluate feasibility and accuracy of real-time 3-dimensional (3D) echocardiography for quantification of mitral regurgitation (MR), in a head-to-head comparison with velocity-encoded cardiac magnetic resonance (VE-CMR). Accurate grading of MR severity is crucial for appropriate patient management but remains challenging. VE-CMR with 3D three-directional acquisition has been recently proposed as the reference method. A total of 64 patients with functional MR were included. A VE-CMR acquisition was applied to quantify mitral regurgitant volume (Rvol). Color Doppler 3D echocardiography was applied for direct measurement, in "en face" view, of mitral effective regurgitant orifice area (EROA); Rvol was subsequently calculated as EROA multiplied by the velocity-time integral of the regurgitant jet on the continuous-wave Doppler. To assess the relative potential error of the conventional approach, color Doppler 2-dimensional (2D) echocardiography was performed: vena contracta width was measured in the 4-chamber view and EROA calculated as circular (EROA-4CH); EROA was also calculated as elliptical (EROA-elliptical), measuring vena contracta also in the 2-chamber view. From these 2D measurements of EROA, the Rvols were also calculated. The EROA measured by 3D echocardiography was significantly higher than EROA-4CH (p < 0.001) and EROA-elliptical (p < 0.001), with a significant bias between these measurements (0.10 cm(2) and 0.06 cm(2), respectively). Rvol measured by 3D echocardiography showed excellent correlation with Rvol measured by CMR (r = 0.94), without a significant difference between these techniques (mean difference = -0.08 ml/beat). Conversely, 2D echocardiographic approach from the 4-chamber view significantly underestimated Rvol (p = 0.006) as compared with CMR (mean difference = 2.9 ml/beat). The 2D elliptical approach demonstrated a better agreement with CMR (mean difference = -1.6 ml/beat, p = 0.04). Quantification of EROA and Rvol of functional MR with 3D echocardiography is feasible and accurate as compared with VE-CMR; the currently recommended 2D echocardiographic approach significantly underestimates both EROA and Rvol.

[Sinus tarsi approach combined with medial distraction technique for treatment of intra-articular calcaneus fractures].

PubMed

Zhou, Haichao; Ren, Haoyang; Li, Bing; Yu, Tao; Yang, Yunfeng

2016-07-08

?To discuss the effectiveness of limited open reduction via sinus tarsi approach using medial distraction technique in the treatment of intra-articular calcaneus fractures by comparing with open reduction and internal fixation via extensile L-shaped incision. ?A retrospective analysis was made on the clinical data of 21 patients with intra-articular calcaneus fractures treated by sinus tarsi approach combined with medial distraction technique between April 2013 and November 2014 (minimally invasive group), and 32 patients treated by extensile L-shaped incision approach between June 2012 and September 2014 (extensile incision group). No significant difference was found in gender, age, injury pattern, fracture classification, time from injury to operation, preoperative Böhler angle, Gissane angle, calcaneal varus angle, the ankle and hind-foot score of American Orthopaedic Foot and Ankle Society (AOFAS), and visual analogue scale (VAS) score between 2 groups (P>0.05), which was comparable. The operation time, wound complications, and bone healing time were recorded. The postoperative function was also evaluated by AOFAS score and VAS score. The pre-and post-operative Böhler angle, Gissane angle, and calcaneal varus angle were measured on the X-ray films, and the corrective angle was calculated. ?Sixteen patients were followed up 6-18 months (mean, 11.5 months) in the minimally invasive group, and 23 patients for 6-24 months (mean, 13.5 months) in the extensile incision group. Difference was not significant in operation time between 2 groups (t=0.929, P=0.796). No complication occurred in the minimally invasive group; partial skin flap necrosis occurred in 3 cases of the extensile incision group, was cured after dressing change. There was no loosening of implants or reduction loss in 2 groups at last follow-up. Subtalar joint stiffness occurred in 1 case of the minimally invasive group and 4 cases of the extensile incision group, and 1 patient had discomfort for the implants in the extensile incision group. The bone healing time was (9.9±0.8) weeks in the minimally invasive group, and was (10.1±0.7) weeks in the extensile incision group, showing no significant difference (t=0.613, P=0.845 ). Böhler angle, Gissane angle, calcaneal varus angle, AOFAS score, and VAS score were significantly improved at last follow-up when compared with preoperative values in 2 groups (P<0.05), but there was no significant difference between 2 groups (P>0.05), and the corrective value of angle showed no significant difference between 2 groups (P>0.05). ?Limited open reduction via sinus tarsi approach for intra-articular calcaneus fractures could reduce the incidence of wound complications effectively. Meanwhile, the medial distraction technique is helpful to correct the heel varus deformity.

Dental students' perception of their approaches to learning in a PBL programme.

PubMed

Haghparast, H; Ghorbani, A; Rohlin, M

2017-08-01

To compare dental students' perceptions of their learning approaches between different years of a problem-based learning (PBL) programme. The hypothesis was that in a comparison between senior and junior students, the senior students would perceive themselves as having a higher level of deep learning approach and a lower level of surface learning approach than junior students would. This hypothesis was based on the fact that senior students have longer experience of a student-centred educational context, which is supposed to underpin student learning. Students of three cohorts (first year, third year and fifth year) of a PBL-based dental programme were asked to respond to a questionnaire (R-SPQ-2F) developed to analyse students' learning approaches, that is deep approach and surface approach, using four subscales including deep strategy, surface strategy, deep motive and surface motive. The results of the three cohorts were compared using a one-way analysis of variance (ANOVA). A P-value was set at <0.05 for statistical significance. The fifth-year students demonstrated a lower surface approach than the first-year students (P = 0.020). There was a significant decrease in surface strategy from the first to the fifth year (P = 0.003). No differences were found concerning deep approach or its subscales (deep strategy and deep motive) between the mean scores of the three cohorts. The results did not show the expected increased depth in learning approaches over the programme years. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Different binarization processes validated against manual counts of fluorescent bacterial cells.

PubMed

Tamminga, Gerrit G; Paulitsch-Fuchs, Astrid H; Jansen, Gijsbert J; Euverink, Gert-Jan W

2016-09-01

State of the art software methods (such as fixed value approaches or statistical approaches) to create a binary image of fluorescent bacterial cells are not as accurate and precise as they should be for counting bacteria and measuring their area. To overcome these bottlenecks, we introduce biological significance to obtain a binary image from a greyscale microscopic image. Using our biological significance approach we are able to automatically count about the same number of cells as an individual researcher would do by manual/visual counting. Using the fixed value or statistical approach to obtain a binary image leads to about 20% less cells in automatic counting. In our procedure we included the area measurements of the bacterial cells to determine the right parameters for background subtraction and threshold values. In an iterative process the threshold and background subtraction values were incremented until the number of particles smaller than a typical bacterial cell is less than the number of bacterial cells with a certain area. This research also shows that every image has a specific threshold with respect to the optical system, magnification and staining procedure as well as the exposure time. The biological significance approach shows that automatic counting can be performed with the same accuracy, precision and reproducibility as manual counting. The same approach can be used to count bacterial cells using different optical systems (Leica, Olympus and Navitar), magnification factors (200× and 400×), staining procedures (DNA (Propidium Iodide) and RNA (FISH)) and substrates (polycarbonate filter or glass). Copyright © 2016 Elsevier B.V. All rights reserved.

Preservice Teachers' Beliefs Regarding School Violence Prevention Training.

ERIC Educational Resources Information Center

Kandakai, Tina L.; King, Keith A.

2002-01-01

Investigated preservice teachers' beliefs about school violence prevention and intervention approaches, the effect of violence prevention training on the school environment, and differences in preservice teachers' beliefs by background and demographics. Overall, there were significant differences in beliefs about violence prevention interventions…

The Value of Intraoperative Magnetic Resonance Imaging in Endoscopic and Microsurgical Transsphenoidal Pituitary Adenoma Resection.

PubMed

Pal'a, Andrej; Knoll, Andreas; Brand, Christine; Etzrodt-Walter, Gwendolin; Coburger, Jan; Wirtz, Christian Rainer; Hlaváč, Michal

2017-06-01

The routine use of intraoperative magnetic resonance imaging (iMRI) helps to achieve gross total resection in transsphenoidal pituitary surgery. We compared the added value of iMRI for extent of resection in endoscopic versus microsurgical transsphenoidal adenomectomy. A total of 96 patients with pituitary adenoma were included. Twenty-eight consecutive patients underwent endoscopic transsphenoidal tumor resection. For comparison, we used a historic cohort of 68 consecutive patients treated microsurgically. We evaluated the additional resection after conducting iMRI using intraoperative and late postoperative volumetric tumor analysis 3 months after surgery. Demographic data, clinical symptoms, and complications as well as pituitary function were evaluated. We found significantly fewer additional resections after conducting iMRI in the endoscopic group (P = 0.042). The difference was even more profound in Knosp grade 0-2 adenomas (P = 0.029). There was no significant difference in Knosp grade 3-4 adenomas (P = 0.520). The endoscopic approach was associated with smaller intraoperative tumor volume (P = 0.023). No significant difference was found between both techniques in postoperative tumor volume (P = 0.228). Satisfactory results of pituitary function were significantly more often associated with an endoscopic approach in the multiple regression analysis (P = 0.007; odds ratio, 17.614; confidence interval 95%, 2.164-143.396). With the endoscopic approach, significantly more tumor volume reduction was achieved before conducting iMRI, decreasing the need for further resection. This finding was even more pronounced in adenomas graded Knosp 0-2. In the case of extensive and invasive adenomas with infiltration of cavernous sinus and suprasellar or parasellar extension, additional tumor resection and increase in the extent of resection was achieved with iMRI in both groups. The endoscopic approach seems to result in better endocrine outcomes, especially in Knosp grade 0-2 pituitary adenomas. Copyright © 2017 Elsevier Inc. All rights reserved.

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

Jordan, Dirk C.; Deceglie, Michael G.; Kurtz, Sarah R.

What is the best method to determine long-term PV system performance and degradation rates? Ideally, one universally applicable methodology would be desirable so that a single number could be derived. However, data sets vary in their attributes and evidence is presented that defining two methodologies may be preferable. Monte Carlo simulations of artificial performance data allowed investigation of different methodologies and their respective confidence intervals. Tradeoffs between different approaches were delineated, elucidating as to why two separate approaches may need to be included in a standard. Regression approaches tend to be preferable when data sets are less contaminated by seasonality,more » noise and occurrence of outliers although robust regression can significantly improve the accuracy when outliers are present. In the presence of outliers, marked seasonality, or strong soiling events, year-on-year approaches tend to outperform regression approaches.« less

Typologies in Comparative Vocational Education: Existing Models and a New Approach

ERIC Educational Resources Information Center

Pilz, Matthias

2016-01-01

The ways in which vocational education and training (VET) systems are structured vary significantly from country to country, both because different countries have different objectives for their VET systems and because VET is differently embedded within the education and labour market systems of any individual country. International research in…

Improved method for selection of the NOAEL.

PubMed

Calabrese, E J; Baldwin, L A

1994-02-01

The paper proposes that the NOAEL be defined as the highest dosage tested that is statistically significantly different from the control group while also being statistically significantly different from the LOAEL. This new definition requires that the NOAEL be defined from two points of reference rather than the current approach (i.e., single point of reference) in which the NOAEL represents only the highest dosage not statistically significantly different from the control group. This proposal is necessary in order to differentiate NOAELs which are statistically distinguishable from the LOAEL. Under the new regime only those satisfying both criteria would be designated a true NOAEL while those satisfying only one criteria (i.e., not statistically significant different from the control group) would be designated a "quasi" NOAEL and handled differently (i.e., via an uncertainty factor) for risk assessment purposes.

Differential Parenting and Risk for Psychopathology: A Monozygotic Twin Difference Approach

PubMed Central

Long, E.C.; Aggen, S. H.; Gardner, C.; Kendler, K. S.

2015-01-01

Purpose Consistent and non-specific associations have been found between parenting style and major depression, anxiety disorders, and externalizing behavior. Although often considered part of twins’ shared environment, parenting can also be conceptualized as non-shared environment. Non-shared environmental influences have important effects on development but are difficult to test and sort out because of the possible confounding effects of gene-environment interactions and evocative gene-environment correlations. The MZ differences approach is one way to analytically investigate non-shared environment. Methods The aim of the present study is to use the MZ differences approach to investigate the relationship between differential parenting among 1,303 twin pairs (mean age 36.69 +/− 8.56) and differences in total symptom counts of major depression (MD), generalized anxiety disorder (GAD), conduct disorder (CD), and anti-social behavior (ASB) during adulthood. Results Although effect sizes tended to be small, a number of results were significantly different from zero. Perceived differences in parental coldness was positively associated with internalizing disorders. Differences in protectiveness were negatively associated with MD, GAD, and ASB. Differences in authoritarianism were positively associated with MD and CD, but negatively associated with ASB. Conclusions Perceived differences in parenting style are associated with differences in MD, GAD, CD, and ASB outcomes in a sample of MZ twins. Despite the lack of a basis for making causal inferences about parenting style and psychopathology, these results are suggestive of such a relationship and show that non-shared environmental influence of parenting does in some cases significantly predict adult psychopathology. PMID:25940788

Gender bias in under-five mortality in low/middle-income countries.

PubMed

Costa, Janaína Calu; da Silva, Inacio Crochemore Mohnsam; Victora, Cesar Gomes

2017-01-01

Due to biological reasons, boys are more likely to die than girls. The detection of gender bias requires knowing the expected relation between male and female mortality rates at different levels of overall mortality, in the absence of discrimination. Our objective was to compare two approaches aimed at assessing excess female under-five mortality rate (U5MR) in low/middle-income countries. We compared the two approaches using data from 60 Demographic and Health Surveys (2005-2014). The prescriptive approach compares observed mortality rates with historical patterns in Western societies where gender discrimination was assumed to be low or absent. The descriptive approach is derived from global estimates of all countries with available data, including those affected by gender bias. The prescriptive approach showed significant excess female U5MR in 20 countries, compared with only one country according to the descriptive approach. Nevertheless, both models showed similar country rankings. The 13 countries with the highest and the 10 countries with the lowest rankings were the same according to both approaches. Differences in excess female mortality among world regions were significant, but not among country income groups. Both methods are useful for monitoring time trends, detecting gender-based inequalities and identifying and addressing its causes. The prescriptive approach seems to be more sensitive in the identification of gender bias, but needs to be updated using data from populations with current-day structures of causes of death.

[Status of ethical awareness based on 88 medical journals in China and combined evaluation].

PubMed

Chen, Liwen; Wang, Yiren; Li, Lingjiang

2015-09-01

To evaluate the status of ethical awareness of medical journals in China.
 We surveyed editorial awareness based on 88 medical journals by using self-made questionnaire. Five aspects were selected by literature and systematic analysis: Instruction for authors, the first review stage, the peer-review stage, the editing stage, as well as education and training, which covered 11 indexes in the system. Weight values of indexes were gained by scoring of senior editors, and analytic hierarchy process, TOPSIS method, and weight rank-sun ratio were used to evaluate the status of editorial awareness.
 Of the 88 biomedical journals, 56 (63.6%) had no ethical requirement in the instruction for authors in 2010, 14 (15.9%) were at high level of ethical awareness, 45 (51.1%) were at medium level, and 29(33.0%) were at low level. There were significant differences in the scores of instruction for authors and peer-review stage among the journals administrated by different authorities (H(C)=10.175, H=7.305, P<0.05). There were significant differences in the scores of instruction for authors, the first review stage, the peer-review stage, and the editing stage among the journals covered by different databases (H(C)=11.951, 7.661, 6.146, or 8.085, P<0.05), meanwhile, there was significant difference in the multi-level results of comprehensive evaluation for different databases covered journals (H(C)=6.109, P<0.05). The results from 3 comprehensive approaches were positively correlated.
 Ethical awareness of medical journals in China should be improved. Comprehensive approach is more reliable and practical than that of single approach.

Analysis of Tropical Cyclone Tracks in the North Indian Ocean

NASA Astrophysics Data System (ADS)

Patwardhan, A.; Paliwal, M.; Mohapatra, M.

2011-12-01

Cyclones are regarded as one of the most dangerous meteorological phenomena of the tropical region. The probability of landfall of a tropical cyclone depends on its movement (trajectory). Analysis of trajectories of tropical cyclones could be useful for identifying potentially predictable characteristics. There is long history of analysis of tropical cyclones tracks. A common approach is using different clustering techniques to group the cyclone tracks on the basis of certain characteristics. Various clustering method have been used to study the tropical cyclones in different ocean basins like western North Pacific ocean (Elsner and Liu, 2003; Camargo et al., 2007), North Atlantic Ocean (Elsner, 2003; Gaffney et al. 2007; Nakamura et al., 2009). In this study, tropical cyclone tracks in the North Indian Ocean basin, for the period 1961-2010 have been analyzed and grouped into clusters based on their spatial characteristics. A tropical cyclone trajectory is approximated as an open curve and described by its first two moments. The resulting clusters have different centroid locations and also differently shaped variance ellipses. These track characteristics are then used in the standard clustering algorithms which allow the whole track shape, length, and location to be incorporated into the clustering methodology. The resulting clusters have different genesis locations and trajectory shapes. We have also examined characteristics such as life span, maximum sustained wind speed, landfall, seasonality, many of which are significantly different across the identified clusters. The clustering approach groups cyclones with higher maximum wind speed and longest life span in to one cluster. Another cluster includes short duration cyclonic events that are mostly deep depressions and significant for rainfall over Eastern and Central India. The clustering approach is likely to prove useful for analysis of events of significance with regard to impacts.

The effect of a novel minimally invasive strategy for infected necrotizing pancreatitis.

PubMed

Tong, Zhihui; Shen, Xiao; Ke, Lu; Li, Gang; Zhou, Jing; Pan, Yiyuan; Li, Baiqiang; Yang, Dongliang; Li, Weiqin; Li, Jieshou

2017-11-01

Step-up approach consisting of multiple minimally invasive techniques has gradually become the mainstream for managing infected pancreatic necrosis (IPN). In the present study, we aimed to compare the safety and efficacy of a novel four-step approach and the conventional approach in managing IPN. According to the treatment strategy, consecutive patients fulfilling the inclusion criteria were put into two time intervals to conduct a before-and-after comparison: the conventional group (2010-2011) and the novel four-step group (2012-2013). The conventional group was essentially open necrosectomy for any patient who failed percutaneous drainage of infected necrosis. And the novel drainage approach consisted of four different steps including percutaneous drainage, negative pressure irrigation, endoscopic necrosectomy and open necrosectomy in sequence. The primary endpoint was major complications (new-onset organ failure, sepsis or local complications, etc.). Secondary endpoints included mortality during hospitalization, need of emergency surgery, duration of organ failure and sepsis, etc. Of the 229 recruited patients, 92 were treated with the conventional approach and the remaining 137 were managed with the novel four-step approach. New-onset major complications occurred in 72 patients (78.3%) in the two-step group and 75 patients (54.7%) in the four-step group (p < 0.001). For other important endpoints, although there was no statistical difference in mortality between the two groups (p = 0.403), significantly fewer patients in the four-step group required emergency surgery when compared with the conventional group [14.6% (20/137) vs. 45.6% (42/92), p < 0.001]. In addition, stratified analysis revealed that the four-step approach group presented significantly lower incidence of new-onset organ failure and other major complications in patients with the most severe type of AP. Comparing with the conventional approach, the novel four-step approach significantly reduced the rate of new-onset major complications and requirement of emergency operations in treating IPN, especially in those with the most severe type of acute pancreatitis.

Intervention efficacy and intensity for children with speech sound disorder.

PubMed

Allen, Melissa M

2013-06-01

Clinicians do not have an evidence base they can use to recommend optimum intervention intensity for preschool children who present with speech sound disorder (SSD). This study examined the effect of dose frequency on phonological performance and the efficacy of the multiple oppositions approach. Fifty-four preschool children with SSD were randomly assigned to one of three intervention conditions. Two intervention conditions received the multiple oppositions approach either 3 times per week for 8 weeks (P3) or once weekly for 24 weeks (P1). A control (C) condition received a storybook intervention. Percentage of consonants correct (PCC) was evaluated at 8 weeks and after 24 sessions. PCC gain was examined after a 6-week maintenance period. The P3 condition had a significantly better phonological outcome than the P1 and C conditions at 8 weeks and than the P1 condition after 24 weeks. There were no significant differences between the P1 and C conditions. There was no significant difference between the P1 and P3 conditions in PCC gain during the maintenance period. Preschool children with SSD who received the multiple oppositions approach made significantly greater gains when they were provided with a more intensive dose frequency and when cumulative intervention intensity was held constant.

Efficacy and toxicity differences in lung cancer populations in the era of clinical trials globalization: the 'common arm' approach.

PubMed

Mack, Philip C; Gandara, David R; Lara, Primo N

2012-12-01

Historically, notable variability has been observed in clinical trial outcomes between different regions and populations worldwide, even when employing the same cytotoxic regimen in lung cancer. These divergent results underscore the inherent challenges in interpreting trials conducted abroad and raise questions regarding the general applicability of transnational clinical trials. Various reasons have been postulated to account for these differences in efficacy and toxicity, including trial design, eligibility criteria, patient demographics and, perhaps most intriguingly, population-related pharmacogenomics. However, without methodology to control for such variables, these hypotheses remain largely untested. The authors previously developed the 'common arm' approach in order to directly compare efficacy and toxicity results of trials simultaneously performed in different countries. By standardizing clinical trial-associated variables such as treatment regimens (dose, schedule, and so on), eligibility, staging, response and toxicity criteria, this approach has the potential to determine the underlying reasons for divergences in trial outcomes across countries, and whether population-associated polymorphisms contribute to these differences. In the past decade, Japanese and US investigators have applied the common arm analytic method to trials in both extensive-stage small-cell lung cancer (SCLC) and advanced nonSCLC. In the SCLC analysis, a comparison of the cisplatin/irinotecan arms from both trials revealed significant differences in response rates and overall survival. Significant differences were also observed in the distribution of gender and performance status. The common arm analysis in nonSCLC included two trials from Japan and one from the USA, each containing a 'common' carboplatin/paclitaxel arm. Clinical results were similar in the two Japanese trials, but were significantly different from the US trial with regard to survival, neutropenia, febrile neutropenia and anemia. The underlying basis for these divergent outcomes is discussed. The common arm methodology provides a template for identifying and interpreting patient outcome differences across populations, and is an instructive lesson in the burgeoning era of clinical trials globalization.

Progress testing in the medical curriculum: students' approaches to learning and perceived stress.

PubMed

Chen, Yan; Henning, Marcus; Yielder, Jill; Jones, Rhys; Wearn, Andy; Weller, Jennifer

2015-09-11

Progress Tests (PTs) draw on a common question bank to assess all students in a programme against graduate outcomes. Theoretically PTs drive deep approaches to learning and reduce assessment-related stress. In 2013, PTs were introduced to two year groups of medical students (Years 2 and 4), whereas students in Years 3 and 5 were taking traditional high-stakes assessments. Staged introduction of PTs into our medical curriculum provided a time-limited opportunity for a comparative study. The main purpose of the current study was to compare the impact of PTs on undergraduate medical students' approaches to learning and perceived stress with that of traditional high-stakes assessments. We also aimed to investigate the associations between approaches to learning, stress and PT scores. Undergraduate medical students (N = 333 and N = 298 at Time 1 and Time 2 respectively) answered the Revised Study Process Questionnaire (R-SPQ-2F) and the Perceived Stress Scale (PSS) at two time points to evaluate change over time. The R-SPQ-2F generated a surface approach and a deep approach score; the PSS generated an overall perceived stress score. We found no significant differences between the two groups in approaches to learning at either time point, and no significant changes in approaches to learning over time in either cohort. Levels of stress increased significantly at the end of the year (Time 2) for students in the traditional assessment cohort, but not in the PT cohort. In the PT cohort, surface approach to learning, but not stress, was a significant negative predictor of students' PT scores. While confirming an association between surface approaches to learning and lower PT scores, we failed to demonstrate an effect of PTs on approaches to learning. However, a reduction in assessment-associated stress is an important finding.

Efficient computational nonlinear dynamic analysis using modal modification response technique

NASA Astrophysics Data System (ADS)

Marinone, Timothy; Avitabile, Peter; Foley, Jason; Wolfson, Janet

2012-08-01

Generally, structural systems contain nonlinear characteristics in many cases. These nonlinear systems require significant computational resources for solution of the equations of motion. Much of the model, however, is linear where the nonlinearity results from discrete local elements connecting different components together. Using a component mode synthesis approach, a nonlinear model can be developed by interconnecting these linear components with highly nonlinear connection elements. The approach presented in this paper, the Modal Modification Response Technique (MMRT), is a very efficient technique that has been created to address this specific class of nonlinear problem. By utilizing a Structural Dynamics Modification (SDM) approach in conjunction with mode superposition, a significantly smaller set of matrices are required for use in the direct integration of the equations of motion. The approach will be compared to traditional analytical approaches to make evident the usefulness of the technique for a variety of test cases.

GESFIDE-PROPELLER approach for simultaneous R2 and R2* measurements in the abdomen.

PubMed

Jin, Ning; Guo, Yang; Zhang, Zhuoli; Zhang, Longjiang; Lu, Guangming; Larson, Andrew C

2013-12-01

To investigate the feasibility of combining GESFIDE with PROPELLER sampling approaches for simultaneous abdominal R2 and R2* mapping. R2 and R2* measurements were performed in 9 healthy volunteers and phantoms using the GESFIDE-PROPELLER and the conventional Cartesian-sampling GESFIDE approaches. Images acquired with the GESFIDE-PROPELLER sequence effectively mitigated the respiratory motion artifacts, which were clearly evident in the images acquired using the conventional GESFIDE approach. There was no significant difference between GESFIDE-PROPELLER and reference MGRE R2* measurements (p=0.162) whereas the Cartesian-sampling based GESFIDE methods significantly overestimated R2* values compared to MGRE measurements (p<0.001). The GESFIDE-PROPELLER sequence provided high quality images and accurate abdominal R2 and R2* maps while avoiding the motion artifacts common to the conventional Cartesian-sampling GESFIDE approaches. © 2013 Elsevier Inc. All rights reserved.

GESFIDE-PROPELLER Approach for Simultaneous R2 and R2* Measurements in the Abdomen

PubMed Central

Jin, Ning; Guo, Yang; Zhang, Zhuoli; Zhang, Longjiang; Lu, Guangming; Larson, Andrew C.

2013-01-01

Purpose To investigate the feasibility of combining GESFIDE with PROPELLER sampling approaches for simultaneous abdominal R2 and R2* mapping. Materials and Methods R2 and R2* measurements were performed in 9 healthy volunteers and phantoms using the GESFIDE-PROPELLER and the conventional Cartesian-sampling GESFIDE approaches. Results Images acquired with the GESFIDE-PROPELLER sequence effectively mitigated the respiratory motion artifacts, which were clearly evident in the images acquired using the conventional GESFIDE approach. There were no significant difference between GESFIDE-PROPELLER and reference MGRE R2* measurements (p = 0.162) whereas the Cartesian-sampling based GESFIDE methods significantly overestimated R2* values compared to MGRE measurements (p < 0.001). Conclusion The GESFIDE-PROPELLER sequence provided high quality images and accurate abdominal R2 and R2* maps while avoiding the motion artifacts common to the conventional Cartesian-sampling GESFIDE approaches. PMID:24041478

The Effect of Stress Management Program Using Cognitive Behavior Approach on Mental Health of the Mothers of the Children With Attention Deficit Hyperactivity Disorder.

PubMed

Sharif, Farkhondeh; Zarei, Shekufe; Alavi Shooshtari, Ali; Vossoughi, Mehrdad

2015-06-01

Attention deficit hyperactivity disorder is one of the most common psychiatric disorders in children. The study aimed to evaluate the effectiveness of stress management program using cognitive behavior approach on mental health of the mothers of the children with attention deficit hyperactivity disorder. In this interventional study, 90 mothers of the children with attention deficit hyperactivity disorder were randomly allocated into three intervention, placebo, and control groups. The general health questionnaire was used to measure mental health. Besides, stress was assessed through the depression-anxiety-stress scale. The two instruments were completed at baseline, immediately after, and one month after the intervention by the mothers. Afterwards, within group comparisons were made using one-sample repeated measurement ANOVA. One-way ANOVA was used for inter group comparisons. Mothers in the placebo group only participated in meetings to talk and express feelings without receiving any interventions. At the baseline, no significant difference was found among the three groups regarding the means of stress, anxiety, depression, and mental health. However, a significant difference was observed in the mean score of stress immediately after the intervention (P = 0.033). The results also showed a significant difference among the three groups regarding the mean score of mental health (P < 0.001). One month after the intervention, the mean difference of mental health score remained significant only in the intervention group (P < 0.001). The study findings confirmed the effectiveness of stress management program utilizing cognitive behavior approach in mental health of the mothers of the children with attention deficit hyperactivity disorder.

The Effect of Stress Management Program Using Cognitive Behavior Approach on Mental Health of the Mothers of the Children With Attention Deficit Hyperactivity Disorder

PubMed Central

Sharif, Farkhondeh; Zarei, Shekufe; Alavi Shooshtari, Ali; Vossoughi, Mehrdad

2015-01-01

Background: Attention deficit hyperactivity disorder is one of the most common psychiatric disorders in children. Objectives: The study aimed to evaluate the effectiveness of stress management program using cognitive behavior approach on mental health of the mothers of the children with attention deficit hyperactivity disorder. Patients and Methods: In this interventional study, 90 mothers of the children with attention deficit hyperactivity disorder were randomly allocated into three intervention, placebo, and control groups. The general health questionnaire was used to measure mental health. Besides, stress was assessed through the depression-anxiety-stress scale. The two instruments were completed at baseline, immediately after, and one month after the intervention by the mothers. Afterwards, within group comparisons were made using one-sample repeated measurement ANOVA. One-way ANOVA was used for inter group comparisons. Mothers in the placebo group only participated in meetings to talk and express feelings without receiving any interventions. Results: At the baseline, no significant difference was found among the three groups regarding the means of stress, anxiety, depression, and mental health. However, a significant difference was observed in the mean score of stress immediately after the intervention (P = 0.033). The results also showed a significant difference among the three groups regarding the mean score of mental health (P < 0.001). One month after the intervention, the mean difference of mental health score remained significant only in the intervention group (P < 0.001). Conclusions: The study findings confirmed the effectiveness of stress management program utilizing cognitive behavior approach in mental health of the mothers of the children with attention deficit hyperactivity disorder. PMID:26199709

The study of effectiveness of blended learning approach for medical training courses.

PubMed

Karamizadeh, Z; Zarifsanayei, N; Faghihi, A A; Mohammadi, H; Habibi, M

2012-01-01

Blended learning as a method of learning that includes face to face learning, pure E-learning and didactic learning. This study aims to investigate the efficacy of medical education by this approach. This interventional study was performed in 130 students at different clinical levels participating in class sessions on "congenital adrenal hyperplasia and ambiguous genitalia". Sampling was done gradually during 6 months and all of them filled a pretest questionnaire and received an educational compact disk. One week later, a presence class session was held in a question and answer and problem solving method. Two to four weeks later, they filled a posttest questionnaire. There was a significant correlation between pretest and posttest scores and the posttest scores were significantly more than the pretest ones. Sub-specialized residents had the most and the students had the least attitude towards blended learning approach. There was a significant correlation between the research samples' accessibility to computer and their attitude and satisfaction to blended learning approach. Findings generally showed that the blended learning was an effective approach in making a profound learning of academic subjects.

Micro-CT evaluation of the marginal fit of CAD/CAM all ceramic crowns

NASA Astrophysics Data System (ADS)

Brenes, Christian

Objectives: Evaluate the marginal fit of CAD/CAM all ceramic crowns made from lithium disilicate and zirconia using two different fabrication protocols (model and model-less). METHODS: Forty anterior all ceramic restorations (20 lithium disilicate, 20 zirconia) were fabricated using a CEREC Bluecam scanner. Two different fabrication methods were used: a full digital approach and a printed model. Completed crowns were cemented and marginal gap was evaluated using Micro-CT. Each specimen was analyzed in sagittal and trans-axial orientations, allowing a 360° evaluation of the vertical and horizontal fit. RESULTS: Vertical measurements in the lingual, distal and mesial views had and estimated marginal gap from 101.9 to 133.9 microns for E-max crowns and 126.4 to 165.4 microns for zirconia. No significant differences were found between model and model-less techniques. CONCLUSION: Lithium disilicate restorations exhibited a more accurate and consistent marginal adaptation when compared to zirconia crowns. No statistically significant differences were observed when comparing model or model-less approaches.

Comparison of consumer perception and acceptability for steaks cooked to different endpoints: validation of photographic approach.

PubMed

Chan, Sheung-Hang; Moss, Bruce W; Farmer, Linda J; Gordon, Alan; Cuskelly, Geraldine J

2013-02-15

Photographs have been used to enhance consumer reporting of preference of meat doneness, however, the use of photographs has not been validated for this purpose. This study used standard cooking methods to produce steaks of five different degrees of doneness (rare medium, medium well, well done and very well done) to study the consumer's perception of doneness, from both the external and internal surface of the cooked steak and also from corresponding photographs of each sample. Consumers evaluated each surface of the cooked steaks in relation to doneness for acceptability, 'just about right' and perception of doneness. Data were analysed using a split plot ANOVA and least significant test. Perception scores (for both external and internal surfaces) between different presentation methods (steak samples and corresponding photos), were not significantly different (p>0.05). The result indicates that photographs can be used as a valid approach for assessing preference for meat doneness. Copyright © 2012 Elsevier Ltd. All rights reserved.

Improving the numerical integration solution of satellite orbits in the presence of solar radiation pressure using modified back differences

NASA Technical Reports Server (NTRS)

Lundberg, J. B.; Feulner, M. R.; Abusali, P. A. M.; Ho, C. S.

1991-01-01

The method of modified back differences, a technique that significantly reduces the numerical integration errors associated with crossing shadow boundaries using a fixed-mesh multistep integrator without a significant increase in computer run time, is presented. While Hubbard's integral approach can produce significant improvements to the trajectory solution, the interpolation method provides the best overall results. It is demonstrated that iterating on the point mass term correction is also important for achieving the best overall results. It is also shown that the method of modified back differences can be implemented with only a small increase in execution time.

Risk models of dating aggression across different adolescent relationships: a developmental psychopathology approach.

PubMed

Williams, Tricia S; Connolly, Jennifer; Pepler, Debra; Craig, Wendy; Laporte, Lise

2008-08-01

The present study examined physical dating aggression in different adolescent relationships and assessed linear, threshold, and moderator risk models for recurrent aggressive relationships. The 621 participants (59% girls, 41% boys) were drawn from a 1-year longitudinal survey of Canadian high school youths ranging from Grade 9 through Grade 12. Approximately 13% of participants reported recurrent dating aggression across 2 different relationships. Using peer and dyadic risk factors from Time 1 of the study, the authors confirmed a linear risk model, such that adolescents in 2 different violent relationships had significantly more contextual risk factors than did adolescents in 1 or no violent relationship. Further, structural equation modeling assessing moderation of contextual risk factors indicated that, for adolescents with high acceptance of dating aggression, peer aggression and delinquency significantly predicted recurrent aggression in a new relationship. In comparison, for adolescents with low acceptance of dating aggression, negative relationship characteristics significantly predicted recurrent aggression. Acceptance did not moderate concurrent associations between risk factors and aggression in 1 relationship. Results support a developmental psychopathological approach to the understanding of recurrent aggression and its associated risk factors. Copyright 2008 APA, all rights reserved.

An ecological approach to children's rights and participation: interrelationships and correlates of rights in different ecological systems.

PubMed

Ben-Arieh, Asher; Attar-Schwartz, Shalhevet

2013-01-01

Current knowledge emphasizes either a developmental or a cultural/contextual theoretical framework for understanding children's approaches to the concepts of rights and participation. This study, carried out among 1,753 Israeli adolescents (ages 15-17), uses a socioecological perspective instead to understand children's rights and participation. It examines adolescents' approaches to their rights and participation at 4 ecological levels-family, school, community, and the larger sociopolitical system-as well as a number of possible child, family, and societal correlates. It also looks at the interactions between some of these correlates. The findings show that different correlates have different links with various ecological circles. For example, girls reported higher levels of participation in the family and at school, but no significant differences were found between boys and girls in their participation in the community and at civic-political levels. Israeli Palestinians reported higher levels of participation in their schools and at the civic-political level but lower levels of participation in the family and the community compared with their Jewish counterparts. The significant interaction effect between nation and gender showed that, among Arab students, there were larger gaps between boys and girls in the different participation domains than there were among Jewish students. Furthermore, higher rates of participation in the family and lower rates of civic participation were found among students from single-parent families. This study shows that employing an ecological framework to the efforts to understand children's approaches to rights and participation is a first step in the right direction for fostering children's rights and participation. © 2013 American Orthopsychiatric Association.

Faculty Gender and Student-Centered Pedagogical Approaches in the Use of a Course Management System

ERIC Educational Resources Information Center

Solomon, Meghan E. Murphy

2011-01-01

The use of technology for instruction continues to increase and is playing a more significant role in higher education (DeAngelo et al., 2009). As instructional technology has become a more integral part of college and university teaching, researchers have noted gender-related differences in regard to faculty approach, perception, and…

Mechanisms before Reactions: A Mechanistic Approach to the Organic Chemistry Curriculum Based on Patterns of Electron Flow

ERIC Educational Resources Information Center

Flynn, Alison B.; Ogilvie, William W.

2015-01-01

A significant redesign of the introductory organic chemistry curriculum at the authors' institution is described. There are two aspects that differ greatly from a typical functional group approach. First, organic reaction mechanisms and the electron-pushing formalism are taught before students have learned a single reaction. The conservation of…

Many Treasure Soup: A School-Based Project for Pre-Service Teacher Educators

ERIC Educational Resources Information Center

Godinho, Sally; White, Julie; Hay, Trevor; St. Leger, Pamela

2007-01-01

This paper narrates the development of a project developed by four researchers with differing approaches to qualitative research. The aim of the study was to examine the value of a school-based approach to pedagogy and curriculum subjects for pre-service teachers. What emerged from our collaboration was the accommodation of significant differences…

Rethinking the Student Course Evaluation: How a Customized Approach Can Improve Teaching and Learning

ERIC Educational Resources Information Center

Hansen, W. Lee

2014-01-01

The standard evaluation forms used in most college and university courses are ill suited to assess courses and instructors whose goals and pedagogy differ significantly from the "chalk and talk" approach to undergraduate instruction. This article discusses an evaluation form that the author, a professor emeritus of economics at the…

Pedestrians' vulnerability in floodwaters: sensitivity to gender and age

NASA Astrophysics Data System (ADS)

Arrighi, Chiara; Castelli, Fabio

2017-04-01

Among the causes of fatalities during floods, the loss of stability is an aspect which has been usually investigated with conceptual models and laboratory experiments. The human body geometry has been often simplified to derive mechanical equilibrium conditions for toppling and sliding due to weight and hydrodynamic actions. Experimental activity produced water depth versus velocity diagrams showing the critical conditions for people partly immersed in floodwaters, whose scatter reflects the large variability of tested subjects (i.e. children, men and women with different physical characteristics). Nevertheless, the proposed hazard criteria based on the product number HV are not capable of distinguishing between different subjects. A dimensionless approach with a limited number of parameters and 3D numerical simulations highlight the significance of subject height and quantify the drag forces different subjects are able to withstand. From the mechanical point of view, this approach significantly reduces the experimental scatter. Differences in subjects' height are already an evidence of gender differences; however, many other parameters such as age and skeletal muscle mass may play a significant role in individual responses to floodwater actions, which can be responsible of the residual unexplained variance. In this work, a sensitivity analysis of critical instability conditions with respect to gender/age-related parameters is carried out and results and implications for flood risk management are discussed.

Spatial-temporal event detection in climate parameter imagery.

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

McKenna, Sean Andrew; Gutierrez, Karen A.

Previously developed techniques that comprise statistical parametric mapping, with applications focused on human brain imaging, are examined and tested here for new applications in anomaly detection within remotely-sensed imagery. Two approaches to analysis are developed: online, regression-based anomaly detection and conditional differences. These approaches are applied to two example spatial-temporal data sets: data simulated with a Gaussian field deformation approach and weekly NDVI images derived from global satellite coverage. Results indicate that anomalies can be identified in spatial temporal data with the regression-based approach. Additionally, la Nina and el Nino climatic conditions are used as different stimuli applied to themore » earth and this comparison shows that el Nino conditions lead to significant decreases in NDVI in both the Amazon Basin and in Southern India.« less

The use of supportive-educative and mutual goal-setting strategies to improve self-management for patients with heart failure.

PubMed

Kline, Kay Setter; Scott, Linda D; Britton, Agnes S

2007-09-01

This study examined the effects of 2 home healthcare nursing approaches--supportive-educative and mutual goal setting--on self-management for patients with heart failure. Both approaches are specifically related to participants' understanding of heart failure and self-efficacy in managing the condition. An experimental, longitudinal, repeated-measures design was used with a sample of 88 participants. Although no significant difference was demonstrated in participants' understanding of heart failure, the supportive-educative group showed a significantly increased self-efficacy in managing heart failure symptoms.

Effectiveness of e-learning in continuing medical education for occupational physicians.

PubMed

Hugenholtz, Nathalie I R; de Croon, Einar M; Smits, Paul B; van Dijk, Frank J H; Nieuwenhuijsen, Karen

2008-08-01

Within a clinical context e-learning is comparable to traditional approaches of continuing medical education (CME). However, the occupational health context differs and until now the effect of postgraduate e-learning among occupational physicians (OPs) has not been evaluated. To evaluate the effect of e-learning on knowledge on mental health issues as compared to lecture-based learning in a CME programme for OPs. Within the context of a postgraduate meeting for 74 OPs, a randomized controlled trial was conducted. Test assessments of knowledge were made before and immediately after an educational session with either e-learning or lecture-based learning. In both groups, a significant gain in knowledge on mental health care was found (P < 0.05). However, there was no significant difference between the two educational approaches. The effect of e-learning on OPs' mental health care knowledge is comparable to a lecture-based approach. Therefore, e-learning can be beneficial for the CME of OPs.

Medical Versus Interventional Treatment of Intra-Abdominal Abscess in Patients With Crohn Disease.

PubMed

Graham, Emily; Rao, Krishna; Cinti, Sandro

2017-01-01

Few studies exist to guide the treatment approach to intra-abdominal abscesses in Crohn disease, which can include antimicrobials alone or in conjunction with percutaneous drainage or surgery. The primary aim of this study is to review outcomes from different treatment approaches to intra-abdominal abscess in Crohn disease. Medical records were reviewed for patients admitted to the University of Michigan health care system with Crohn disease and intra-abdominal abscess over a 4-year period. Outcomes were compared among medical and interventional approaches. The χ 2 test was used to test for statistical significance. Of the 33 patients included, 13 were in the medical group and 20 were in the interventional group. Abscess recurrence/nonresolution occurred in 31% of patients in the medical group and 25% of patients in the interventional group ( P = .7). In this study, there was no significant difference in outcome between medical and interventional therapy for intra-abdominal abscess in Crohn disease.

Contrasting approaches to the response-contingent learning of young children with significant delays and their social-emotional consequences.

PubMed

Dunst, Carl J; Raab, Melinda; Hamby, Deborah W

2017-04-01

The purpose of the analyses described in this paper was to evaluate the direct and indirect effects of two different approaches to child response-contingent learning on rates of child learning and both concomitant and collateral child social-emotional behaviour. The participants were 71 children with significant developmental delays or multiple disabilities randomly assigned to either of the two contrasting approaches to interventions. Findings showed that an intervention which employed practices that built on existing child behaviour (asset-based practices) was more effective than an intervention focusing on teaching children missing skills (needs-based practices) for influencing changes in the rates of child learning as well as rates of child social-emotional behaviour mediated by differences in rates of child learning. Both the theoretical and practical importance of the results are described in terms of the extended social-emotional benefits of asset-based response-contingent learning games. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

The effect of improvisation-assisted desensitization, and music-assisted progressive muscle relaxation and imagery on reducing pianists' music performance anxiety.

PubMed

Kim, Youngshin

2008-01-01

The purpose of this study was to investigate the effects of two music therapy approaches, improvisation-assisted desensitization, and music-assisted progressive muscle relaxation and imagery on ameliorating the symptoms of music performance anxiety (MPA) among student pianists. Thirty female college pianists (N = 30) were randomly assigned to one of two conditions: (a) improvised music-assisted desensitization group (n = 15), or (b) music-assisted progressive muscle relaxation (PMR) and imagery group (n = 15). All participants received 6 weekly music therapy sessions according to their assigned group. Two lab performances were provided; one before and one after the 6 music therapy sessions, as the performance stimuli for MPA. All participants completed pretest and posttest measures that included four types of visual analogue scales (MPA, stress, tension, and comfort), the state portion of Spielberger's State-Trait Anxiety Inventory (STAI), and the Music Performance Anxiety Questionnaire (MPAQ) developed by Lehrer, Goldman, and Strommen (1990). Participants' finger temperatures were also measured. When results of the music-assisted PMR and imagery condition were compared from pretest to posttest, statistically significant differences occurred in 6 out of the 7 measures-MPA, tension, comfort, STAI, MPAQ, and finger temperature, indicating that the music-assisted PMR and imagery treatment was very successful in reducing MPA. For the improvisation-assisted desensitization condition, the statistically significant decreases in tension and STAI, with increases in finger temperature indicated that this approach was effective in managing MPA to some extent. When the difference scores for the two approaches were compared, there was no statistically significant difference between the two approaches for any of the seven measures. Therefore, no one treatment condition appeared more effective than the other. Although statistically significant differences were not found between the two groups, a visual analysis of mean difference scores revealed that the music-assisted PMR and imagery condition resulted in greater mean differences from pretest to posttest than the improvisation-assisted desensitization condition across all seven measures. This result may be due to the fact that all participants in the music-assisted PMR and imagery condition followed the procedure easily, while two of the 15 participants in the improvisation-assisted desensitization group had difficulty improvising.

A randomized controlled trial of a nurse-led case management programme for hospital-discharged older adults with co-morbidities

PubMed Central

Chow, Susan Ka Yee; Wong, Frances Kam Yuet

2014-01-01

Aim To examine the effects of a nurse-led case management programme for hospital-discharged older adults with co-morbidities. Background The most significant chronic conditions today involve diseases of the cardiovascular, respiratory, endocrine and renal systems. Previous studies have suggested that a nurse-led case management approach using either telephone follow-ups or home visits was able to improve clinical and patient outcomes for patients having a single, chronic disease, while the effects for older patients having at least two long-term conditions are unknown. A self-help programme using motivation and empowerment approaches is the framework of care in the study. Design Randomized controlled trial. Method The study was conducted from 2010–2012. Older patients having at least two chronic diseases were included for analysis. The participants were randomized into three arms: two study groups and one control group. Data were collected at baseline and at 4 and 12 weeks later. Results Two hundred and eighty-one patients completed the study. The interventions demonstrated significant differences in hospital readmission rates within 84 days post discharge. The two intervention groups had lower readmission rates than the control group. Patients in the two study arms had significantly better self-rated health and self-efficacy. There was significant difference between the groups in the physical composite score, but no significant difference in mental component score in SF-36 scale. Conclusion The postdischarge interventions led by the nurse case managers on self-management of disease using the empowerment approach were able to provide effective clinical and patient outcomes for older patients having co-morbidities. PMID:24617755

Quantification and Visualization of Variation in Anatomical Trees

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

Amenta, Nina; Datar, Manasi; Dirksen, Asger

This paper presents two approaches to quantifying and visualizing variation in datasets of trees. The first approach localizes subtrees in which significant population differences are found through hypothesis testing and sparse classifiers on subtree features. The second approach visualizes the global metric structure of datasets through low-distortion embedding into hyperbolic planes in the style of multidimensional scaling. A case study is made on a dataset of airway trees in relation to Chronic Obstructive Pulmonary Disease.

MO-C-17A-10: Comparison of Dose Deformable Accumulation by Using Parallel and Serial Approaches

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

Gao, Z; Li, M; Wong, J

Purpose: The uncertainty of dose accumulation over multiple CT datasets with deformable fusion may have significant impact on clinical decisions. In this study, we investigate the difference of two dose summation approaches involving deformable fusion. Methods: Five patients, four external beam and one brachytherapy(BT), were chosen for the study. The BT patient was treated with CT-based HDR. The CT image sets acquired in the imageguidance process (8-11 CTs/patient) were used to determine the dose delivered to the four external beam patients. (prostate, pelvis, lung and head and neck). For the HDR patient (cervix), five CT image sets and the correspondingmore » BT plans were used. In total 44 CT datasets and RT dose/plans were imported into the image fusion software MiM (6.0.4) for analysis.For each of the five clinical cases, the dose from each fraction was accumulated into the primary CT dataset by using both Parallel and Serial approaches. The dose-volume histogram (DVH) for CTV and selected organs-at-risks (OAR) were generated. The D95(CTV), OAR(mean) and OAR(max) for the four external beam cases the D90(CTV), and the max dose to bladder and rectum for the BT case were compared. Results: For the four external beam patients, the difference in D95(CTV) were <1.2% PD between the parallel and the serial approaches. The differences of the OAR(mean) and the OAR(max ) range from 0 to 3.7% and <1% PD respectively. For the HDR patient, the dose difference for D90 is 11% PD while that of the max dose to bladder and rectum were 11.5% and 23.3% respectively. Conclusion: For external beam treatments, the parallel and serial approaches have <5% difference probably because tumor volume and OAR have less changes from fraction to fraction. For the brachytherapy case, >10% dose difference between the two approaches was observed as significant volume changes of tumor and OAR were observed among treatment fractions.« less

Impact of passive and active promotional strategies on patient acceptance of medication therapy management services.

PubMed

Huet, Alison L; Frail, Caitlin K; Lake, Leslie M; Snyder, Margie E

2015-01-01

To assess the impact of passive and active promotional strategies on patient acceptance of medication therapy management (MTM) services, and to identify reasons for patient acceptance or refusal. Four promotional approaches were developed to offer MTM services to eligible patients, including letters and bag stuffers ("passive" approaches), and face-to-face offers and telephone calls ("active" approaches). Thirty pharmacies in a grocery store chain were randomized to one of the four approaches. Patient acceptance rates were compared among the four groups, and between active and passive approaches using hierarchical logistic regression techniques. Depending on their decision to accept or decline the service, patients were invited to take part in one of two brief telephone surveys. No significant differences were identified among the four promotional methods or between active and passive methods in the analyses. Patients' most frequent reasons for accepting MTM services were potential cost savings, review of how the medications were working, the expert opinion of the pharmacist, and education about medications. Patients' most frequent reasons for declining MTM services were that the participant already felt comfortable with their medications and felt their pharmacist provides these services on a regular basis. No significant difference was found among any of the four groups or between active or passive approaches. Further research is warranted to identify strategies for improving patient engagement in MTM services.

Modified multiblock partial least squares path modeling algorithm with backpropagation neural networks approach

NASA Astrophysics Data System (ADS)

Yuniarto, Budi; Kurniawan, Robert

2017-03-01

PLS Path Modeling (PLS-PM) is different from covariance based SEM, where PLS-PM use an approach based on variance or component, therefore, PLS-PM is also known as a component based SEM. Multiblock Partial Least Squares (MBPLS) is a method in PLS regression which can be used in PLS Path Modeling which known as Multiblock PLS Path Modeling (MBPLS-PM). This method uses an iterative procedure in its algorithm. This research aims to modify MBPLS-PM with Back Propagation Neural Network approach. The result is MBPLS-PM algorithm can be modified using the Back Propagation Neural Network approach to replace the iterative process in backward and forward step to get the matrix t and the matrix u in the algorithm. By modifying the MBPLS-PM algorithm using Back Propagation Neural Network approach, the model parameters obtained are relatively not significantly different compared to model parameters obtained by original MBPLS-PM algorithm.

Physical Processes in the MAGO/MFT Systems

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

Garanin, Sergey F; Reinovsky, Robert E.

2015-03-23

The Monograph is devoted to theoretical discussion of the physical effects, which are most significant for the alternative approach to the problem of controlled thermonuclear fusion (CTF): the MAGO/MTF approach. The book includes the description of the approach, its difference from the major CTF systems—magnetic confinement and inertial confinement systems. General physical methods of the processes simulation in this approach are considered, including plasma transport phenomena and radiation, and the theory of transverse collisionless shock waves, the surface discharges theory, important for such kind of research. Different flows and magneto-hydrodynamic plasma instabilities occurring in the frames of this approach aremore » also considered. In virtue of the general physical essence of the considered phenomena the presented results are applicable to a wide range of plasma physics and hydrodynamics processes. The book is intended for the plasma physics and hydrodynamics specialists, post-graduate students, and senior students-physicists.« less

Worse patient-reported outcome after lateral approach than after anterior and posterolateral approach in primary hip arthroplasty

PubMed Central

Havelin, Leif I; Furnes, Ove; Baste, Valborg; Nordsletten, Lars; Hovik, Oystein; Dimmen, Sigbjorn

2014-01-01

Background The surgical approach in total hip arthroplasty (THA) is often based on surgeon preference and local traditions. The anterior muscle-sparing approach has recently gained popularity in Europe. We tested the hypothesis that patient satisfaction, pain, function, and health-related quality of life (HRQoL) after THA is not related to the surgical approach. Patients 1,476 patients identified through the Norwegian Arthroplasty Register were sent questionnaires 1–3 years after undergoing THA in the period from January 2008 to June 2010. Patient-reported outcome measures (PROMs) included the hip disability osteoarthritis outcome score (HOOS), the Western Ontario and McMaster Universities osteoarthritis index (WOMAC), health-related quality of life (EQ-5D-3L), visual analog scales (VAS) addressing pain and satisfaction, and questions about complications. 1,273 patients completed the questionnaires and were included in the analysis. Results Adjusted HOOS scores for pain, other symptoms, activities of daily living (ADL), sport/recreation, and quality of life were significantly worse (p < 0.001 to p = 0.03) for the lateral approach than for the anterior approach and the posterolateral approach (mean differences: 3.2–5.0). These results were related to more patient-reported limping with the lateral approach than with the anterior and posterolateral approaches (25% vs. 12% and 13%, respectively; p < 0.001). Interpretation Patients operated with the lateral approach reported worse outcomes 1–3 years after THA surgery. Self-reported limping occurred twice as often in patients who underwent THA with a lateral approach than in those who underwent THA with an anterior or posterolateral approach. There were no significant differences in patient-reported outcomes after THA between those who underwent THA with a posterolateral approach and those who underwent THA with an anterior approach. PMID:24954494

Worse patient-reported outcome after lateral approach than after anterior and posterolateral approach in primary hip arthroplasty. A cross-sectional questionnaire study of 1,476 patients 1-3 years after surgery.

PubMed

Amlie, Einar; Havelin, Leif I; Furnes, Ove; Baste, Valborg; Nordsletten, Lars; Hovik, Oystein; Dimmen, Sigbjorn

2014-09-01

The surgical approach in total hip arthroplasty (THA) is often based on surgeon preference and local traditions. The anterior muscle-sparing approach has recently gained popularity in Europe. We tested the hypothesis that patient satisfaction, pain, function, and health-related quality of life (HRQoL) after THA is not related to the surgical approach. 1,476 patients identified through the Norwegian Arthroplasty Register were sent questionnaires 1-3 years after undergoing THA in the period from January 2008 to June 2010. Patient-reported outcome measures (PROMs) included the hip disability osteoarthritis outcome score (HOOS), the Western Ontario and McMaster Universities osteoarthritis index (WOMAC), health-related quality of life (EQ-5D-3L), visual analog scales (VAS) addressing pain and satisfaction, and questions about complications. 1,273 patients completed the questionnaires and were included in the analysis. Adjusted HOOS scores for pain, other symptoms, activities of daily living (ADL), sport/recreation, and quality of life were significantly worse (p < 0.001 to p = 0.03) for the lateral approach than for the anterior approach and the posterolateral approach (mean differences: 3.2-5.0). These results were related to more patient-reported limping with the lateral approach than with the anterior and posterolateral approaches (25% vs. 12% and 13%, respectively; p < 0.001). Patients operated with the lateral approach reported worse outcomes 1-3 years after THA surgery. Self-reported limping occurred twice as often in patients who underwent THA with a lateral approach than in those who underwent THA with an anterior or posterolateral approach. There were no significant differences in patient-reported outcomes after THA between those who underwent THA with a posterolateral approach and those who underwent THA with an anterior approach.

Surgical Outcome of Endoscopic Endonasal Surgery for Non-Functional Pituitary Adenoma by a Team of Neurosurgeons and Otolaryngologists Adenoma by a Team of Neurosurgeons and Otolaryngologists.

PubMed

Kikuchi, Ryogo; Toda, Masahiro; Tomita, Toshiki; Ogawa, Kaoru; Yoshida, Kazunari

2017-01-01

This study aimed to assess the efficacy of endoscopic endonasal surgery, conducted by a team of neurosurgeons and otolaryngologists. We studied 40 patients who were undergoing surgery for primary non-functional pituitary adenomas with Knosp grades 1 to 3, at Keio University Hospital between 2005 and 2012. We compared the endoscopic endonasal transsphenoidal approach (team-eTSS; T-eTSS), with a microscopic transsphenoidal approach (mTSS). Analyses were conducted for differences between the two groups in tumor resection rates, operating durations, and complications from the non-functional pituitary adenomas. We also compared the heminostril and binostril approaches for T-eTSS. Tumor resection rates were higher when the surgeries were conducted by T-eTSS than mTSS. In particular, when the maximum tumor diameter was more than 25 mm, resection rates were significantly higher for T-eTSS than for mTSS. There were no unexpected complications in either group. There was no significant difference in resection rates between the heminostril and binostril approaches when T-eTSS was performed. T-eTSS is an efficacious surgical option for non-functional pituitary adenomas, particularly when the adenoma is of large size. Benefits of the heminostril approach are evident.

Short-term corneal changes with gas-permeable contact lens wear in keratoconus subjects: a comparison of two fitting approaches.

PubMed

Romero-Jiménez, Miguel; Santodomingo-Rubido, Jacinto; Flores-Rodríguez, Patricia; González-Méijome, Jose-Manuel

2015-01-01

To evaluate changes in anterior corneal topography and higher-order aberrations (HOA) after 14-days of rigid gas-permeable (RGP) contact lens (CL) wear in keratoconus subjects comparing two different fitting approaches. Thirty-one keratoconus subjects (50 eyes) without previous history of CL wear were recruited for the study. Subjects were randomly fitted to either an apical-touch or three-point-touch fitting approach. The lens' back optic zone radius (BOZR) was 0.4mm and 0.1mm flatter than the first definite apical clearance lens, respectively. Differences between the baseline and post-CL wear for steepest, flattest and average corneal power (ACP) readings, central corneal astigmatism (CCA), maximum tangential curvature (KTag), anterior corneal surface asphericity, anterior corneal surface HOA and thinnest corneal thickness measured with Pentacam were compared. A statistically significant flattening was found over time on the flattest and steepest simulated keratometry and ACP in apical-touch group (all p<0.01). A statistically significant reduction in KTag was found in both groups after contact lens wear (all p<0.05). Significant reduction was found over time in CCA (p=0.001) and anterior corneal asphericity in both groups (p<0.001). Thickness at the thinnest corneal point increased significantly after CL wear (p<0.0001). Coma-like and total HOA root mean square (RMS) error were significantly reduced following CL wearing in both fitting approaches (all p<0.05). Short-term rigid gas-permeable CL wear flattens the anterior cornea, increases the thinnest corneal thickness and reduces anterior surface HOA in keratoconus subjects. Apical-touch was associated with greater corneal flattening in comparison to three-point-touch lens wear. Copyright © 2014 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

Hand-assisted versus straight laparoscopic sigmoid colectomy on a training simulator: what is the difference? A stepwise comparison of hand-assisted versus straight laparoscopic sigmoid colectomy performance on an augmented reality simulator.

PubMed

Leblanc, Fabien; Delaney, Conor P; Ellis, Clyde N; Neary, Paul C; Champagne, Bradley J; Senagore, Anthony J

2010-12-01

We hypothesized that simulator-generated metrics and intraoperative errors may be able to differentiate the technical differences between hand-assisted laparoscopic (HAL) and straight laparoscopic (SL) approaches. Thirty-eight trainees performed two laparoscopic sigmoid colectomies on an augmented reality simulator, randomly starting by a SL (n = 19) or HAL (n = 19) approach. Both approaches were compared according to simulator-generated metrics, and intraoperative errors were collected by faculty. Sixty-four percent of surgeons were experienced (>50 procedures) with open colon surgery. Fifty-five percent and 69% of surgeons were inexperienced (<10 procedures) with SL and HAL colon surgery, respectively. Time (P < 0.001), path length (P < 0.001), and smoothness (P < 0.001) were lower with the HAL approach. Operative times for sigmoid and splenic flexure mobilization and for the colorectal anastomosis were significantly shorter with the HAL approach. Time to control the vascular pedicle was similar between both approaches. Error rates were similar between both approaches. Operative time, path length, and smoothness correlated directly with the error rate for the HAL approach. In contrast, error rate inversely correlated with the operative time for the SL approach. A HAL approach for sigmoid colectomy accelerated colonic mobilization and anastomosis. The difference in correlation between both laparoscopic approaches and error rates suggests the need for different skills to perform the HAL and the SL sigmoid colectomy. These findings may explain the preference of some surgeons for a HAL approach early in the learning of laparoscopic colorectal surgery.

Semiautomated segmentation of head and neck cancers in 18F-FDG PET scans: A just-enough-interaction approach.

PubMed

Beichel, Reinhard R; Van Tol, Markus; Ulrich, Ethan J; Bauer, Christian; Chang, Tangel; Plichta, Kristin A; Smith, Brian J; Sunderland, John J; Graham, Michael M; Sonka, Milan; Buatti, John M

2016-06-01

The purpose of this work was to develop, validate, and compare a highly computer-aided method for the segmentation of hot lesions in head and neck 18F-FDG PET scans. A semiautomated segmentation method was developed, which transforms the segmentation problem into a graph-based optimization problem. For this purpose, a graph structure around a user-provided approximate lesion centerpoint is constructed and a suitable cost function is derived based on local image statistics. To handle frequently occurring situations that are ambiguous (e.g., lesions adjacent to each other versus lesion with inhomogeneous uptake), several segmentation modes are introduced that adapt the behavior of the base algorithm accordingly. In addition, the authors present approaches for the efficient interactive local and global refinement of initial segmentations that are based on the "just-enough-interaction" principle. For method validation, 60 PET/CT scans from 59 different subjects with 230 head and neck lesions were utilized. All patients had squamous cell carcinoma of the head and neck. A detailed comparison with the current clinically relevant standard manual segmentation approach was performed based on 2760 segmentations produced by three experts. Segmentation accuracy measured by the Dice coefficient of the proposed semiautomated and standard manual segmentation approach was 0.766 and 0.764, respectively. This difference was not statistically significant (p = 0.2145). However, the intra- and interoperator standard deviations were significantly lower for the semiautomated method. In addition, the proposed method was found to be significantly faster and resulted in significantly higher intra- and interoperator segmentation agreement when compared to the manual segmentation approach. Lack of consistency in tumor definition is a critical barrier for radiation treatment targeting as well as for response assessment in clinical trials and in clinical oncology decision-making. The properties of the authors approach make it well suited for applications in image-guided radiation oncology, response assessment, or treatment outcome prediction.

Semiautomated segmentation of head and neck cancers in 18F-FDG PET scans: A just-enough-interaction approach

PubMed Central

Beichel, Reinhard R.; Van Tol, Markus; Ulrich, Ethan J.; Bauer, Christian; Chang, Tangel; Plichta, Kristin A.; Smith, Brian J.; Sunderland, John J.; Graham, Michael M.; Sonka, Milan; Buatti, John M.

2016-01-01

Purpose: The purpose of this work was to develop, validate, and compare a highly computer-aided method for the segmentation of hot lesions in head and neck 18F-FDG PET scans. Methods: A semiautomated segmentation method was developed, which transforms the segmentation problem into a graph-based optimization problem. For this purpose, a graph structure around a user-provided approximate lesion centerpoint is constructed and a suitable cost function is derived based on local image statistics. To handle frequently occurring situations that are ambiguous (e.g., lesions adjacent to each other versus lesion with inhomogeneous uptake), several segmentation modes are introduced that adapt the behavior of the base algorithm accordingly. In addition, the authors present approaches for the efficient interactive local and global refinement of initial segmentations that are based on the “just-enough-interaction” principle. For method validation, 60 PET/CT scans from 59 different subjects with 230 head and neck lesions were utilized. All patients had squamous cell carcinoma of the head and neck. A detailed comparison with the current clinically relevant standard manual segmentation approach was performed based on 2760 segmentations produced by three experts. Results: Segmentation accuracy measured by the Dice coefficient of the proposed semiautomated and standard manual segmentation approach was 0.766 and 0.764, respectively. This difference was not statistically significant (p = 0.2145). However, the intra- and interoperator standard deviations were significantly lower for the semiautomated method. In addition, the proposed method was found to be significantly faster and resulted in significantly higher intra- and interoperator segmentation agreement when compared to the manual segmentation approach. Conclusions: Lack of consistency in tumor definition is a critical barrier for radiation treatment targeting as well as for response assessment in clinical trials and in clinical oncology decision-making. The properties of the authors approach make it well suited for applications in image-guided radiation oncology, response assessment, or treatment outcome prediction. PMID:27277044

Semiautomated segmentation of head and neck cancers in 18F-FDG PET scans: A just-enough-interaction approach

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

Beichel, Reinhard R., E-mail: reinhard-beichel@uiowa.edu; Iowa Institute for Biomedical Imaging, University of Iowa, Iowa City, Iowa 52242; Department of Internal Medicine, University of Iowa, Iowa City, Iowa 52242

Purpose: The purpose of this work was to develop, validate, and compare a highly computer-aided method for the segmentation of hot lesions in head and neck 18F-FDG PET scans. Methods: A semiautomated segmentation method was developed, which transforms the segmentation problem into a graph-based optimization problem. For this purpose, a graph structure around a user-provided approximate lesion centerpoint is constructed and a suitable cost function is derived based on local image statistics. To handle frequently occurring situations that are ambiguous (e.g., lesions adjacent to each other versus lesion with inhomogeneous uptake), several segmentation modes are introduced that adapt the behaviormore » of the base algorithm accordingly. In addition, the authors present approaches for the efficient interactive local and global refinement of initial segmentations that are based on the “just-enough-interaction” principle. For method validation, 60 PET/CT scans from 59 different subjects with 230 head and neck lesions were utilized. All patients had squamous cell carcinoma of the head and neck. A detailed comparison with the current clinically relevant standard manual segmentation approach was performed based on 2760 segmentations produced by three experts. Results: Segmentation accuracy measured by the Dice coefficient of the proposed semiautomated and standard manual segmentation approach was 0.766 and 0.764, respectively. This difference was not statistically significant (p = 0.2145). However, the intra- and interoperator standard deviations were significantly lower for the semiautomated method. In addition, the proposed method was found to be significantly faster and resulted in significantly higher intra- and interoperator segmentation agreement when compared to the manual segmentation approach. Conclusions: Lack of consistency in tumor definition is a critical barrier for radiation treatment targeting as well as for response assessment in clinical trials and in clinical oncology decision-making. The properties of the authors approach make it well suited for applications in image-guided radiation oncology, response assessment, or treatment outcome prediction.« less

New approach in bivariate drought duration and severity analysis

NASA Astrophysics Data System (ADS)

Montaseri, Majid; Amirataee, Babak; Rezaie, Hossein

2018-04-01

The copula functions have been widely applied as an advance technique to create joint probability distribution of drought duration and severity. The approach of data collection as well as the amount of data and dispersion of data series can last a significant impact on creating such joint probability distribution using copulas. Usually, such traditional analyses have shed an Unconnected Drought Runs (UDR) approach towards droughts. In other word, droughts with different durations would be independent of each other. Emphasis on such data collection method causes the omission of actual potentials of short-term extreme droughts located within a long-term UDR. Meanwhile, traditional method is often faced with significant gap in drought data series. However, a long-term UDR can be approached as a combination of short-term Connected Drought Runs (CDR). Therefore this study aims to evaluate systematically two UDR and CDR procedures in joint probability of drought duration and severity investigations. For this purpose, rainfall data (1971-2013) from 24 rain gauges in Lake Urmia basin, Iran were applied. Also, seven common univariate marginal distributions and seven types of bivariate copulas were examined. Compared to traditional approach, the results demonstrated a significant comparative advantage of the new approach. Such comparative advantages led to determine the correct copula function, more accurate estimation of copula parameter, more realistic estimation of joint/conditional probabilities of drought duration and severity and significant reduction in uncertainty for modeling.

Impact of Anterior vs Posterior Approach for Total Hip Arthroplasty on Post-Acute Care Service Utilization.

PubMed

L'Hommedieu, Coles E; Gera, James J; Rupp, Gerald; Salin, Jeffery W; Cox, John S; Duwelius, Paul J

2016-09-01

Controversy exists as to which surgical approach is best for total hip arthroplasty (THA). Previous studies suggested that the tissue-sparing anterior approach should result in a more rapid recovery requiring fewer postacute services, ultimately decreasing overall episodic cost. The purpose of this cross-sectional study was to determine if any significant differences exist between the anterior vs posterior approaches on postacute care service utilization, readmissions, or episodic cost. Claims data from 26,773 Medicare fee-for-service beneficiaries receiving elective THAs (Medical Severity-Diagnosis Related Groups (MS-DRGs) 469/470) were analyzed. Claims data were collected from the 2-year period, January 2013 through December 2014. The posterior surgical approach was performed on 23,653 patients while 3120 patients received the anterior approach. Data analysis showed negligible effect sizes in postacute care service utilization, readmission rate, and cost between the surgical approaches for elective THA (MS-DRG 469 and 470). Average THA total episode cost was negligibly higher for procedures using the anterior approach compared to the posterior approach ($22,517 and $22,068, respectively). Statistically significant differences were observed in inpatient rehab and home health cost and service utilization. However, the effect sizes of these comparisons are negligible when accounting for the large sample size. All other comparisons showed minimal and statistically insignificant variation. The results indicate that surgical approach alone is not the primary driver of postacute care service utilization, quality outcomes, or cost. Other factors such as physician-led patient-focused care pathways, care coordination, rapid rehabilitation protocols, perioperative pain management protocols, and patient education are integral for effective patient care. Copyright © 2016 Elsevier Inc. All rights reserved.

Networks’ Characteristics Matter for Systems Biology

PubMed Central

Rider, Andrew K.; Milenković, Tijana; Siwo, Geoffrey H.; Pinapati, Richard S.; Emrich, Scott J.; Ferdig, Michael T.; Chawla, Nitesh V.

2015-01-01

A fundamental goal of systems biology is to create models that describe relationships between biological components. Networks are an increasingly popular approach to this problem. However, a scientist interested in modeling biological (e.g., gene expression) data as a network is quickly confounded by the fundamental problem: how to construct the network? It is fairly easy to construct a network, but is it the network for the problem being considered? This is an important problem with three fundamental issues: How to weight edges in the network in order to capture actual biological interactions? What is the effect of the type of biological experiment used to collect the data from which the network is constructed? How to prune the weighted edges (or what cut-off to apply)? Differences in the construction of networks could lead to different biological interpretations. Indeed, we find that there are statistically significant dissimilarities in the functional content and topology between gene co-expression networks constructed using different edge weighting methods, data types, and edge cut-offs. We show that different types of known interactions, such as those found through Affinity Capture-Luminescence or Synthetic Lethality experiments, appear in significantly varying amounts in networks constructed in different ways. Hence, we demonstrate that different biological questions may be answered by the different networks. Consequently, we posit that the approach taken to build a network can be matched to biological questions to get targeted answers. More study is required to understand the implications of different network inference approaches and to draw reliable conclusions from networks used in the field of systems biology. PMID:26500772

Impact of cosmetic result on selection of surgical treatment in patients with localized prostate cancer.

PubMed

Rojo, María Alejandra Egui; Martinez-Salamanca, Juan Ignacio; Maestro, Mario Alvarez; Galarza, Ignacio Sola; Rodriguez, Joaquin Carballido

2014-01-01

To analyze the effect of cosmetic outcome as an isolated variable in patients undergoing surgical treatment based on the incision used in the 3 variants of radical prostatectomy: open (infraumbilical incision and Pfannestiel incision) and laparoscopic, or robotic (6 ports) surgery. 612 male patients 40 to 70 years of age with a negative history of prostate disease were invited to participate. Each patient was evaluated by questionnaire accompanied by a set of 6 photographs showing the cosmetic appearance of the 3 approaches, with and without undergarments. Participants ranked the approaches according to preference, on the basis of cosmesis. We also recorded demographic variables: age, body mass index, marital status, education level, and physical activity. Of the 577 patients who completed the questionnaries, the 6-port minimally invasive approach represents the option preferred by 52% of the participants, followed by the Pfannestiel incision (46%), and the infraumbilical incision (11%), respectively. The univariate and multivariate analyses did not show statistically significant differences when comparing the approach preferred by the patients and the sub-analyses for demographic variables, except for patients who exercised who preferred the Pfannestiel incision (58%) instead of minimally invasive approach (42%) with statistically significant differences. The minimally invasive approach was the approach of choice for the majority of patients in the treatment of prostate cancer. The Pfannestiel incision represents an acceptable alternative. More research and investment may be necesary to improve cosmetic outcomes.

Shear Elasticity and Shear Viscosity Imaging in Soft Tissue

NASA Astrophysics Data System (ADS)

Yang, Yiqun

In this thesis, a new approach is introduced that provides estimates of shear elasticity and shear viscosity using time-domain measurements of shear waves in viscoelastic media. Simulations of shear wave particle displacements induced by an acoustic radiation force are accelerated significantly by a GPU. The acoustic radiation force is first calculated using the fast near field method (FNM) and the angular spectrum approach (ASA). The shear waves induced by the acoustic radiation force are then simulated in elastic and viscoelastic media using Green's functions. A parallel algorithm is developed to perform these calculations on a GPU, where the shear wave particle displacements at different observation points are calculated in parallel. The resulting speed increase enables rapid evaluation of shear waves at discrete points, in 2D planes, and for push beams with different spatial samplings and for different values of the f-number (f/#). The results of these simulations show that push beams with smaller f/# require a higher spatial sampling rate. The significant amount of acceleration achieved by this approach suggests that shear wave simulations with the Green's function approach are ideally suited for high-performance GPUs. Shear wave elasticity imaging determines the mechanical parameters of soft tissue by analyzing measured shear waves induced by an acoustic radiation force. To estimate the shear elasticity value, the widely used time-of-flight method calculates the correlation between shear wave particle velocities at adjacent lateral observation points. Although this method provides accurate estimates of the shear elasticity in purely elastic media, our experience suggests that the time-of-flight (TOF) method consistently overestimates the shear elasticity values in viscoelastic media because the combined effects of diffraction, attenuation, and dispersion are not considered. To address this problem, we have developed an approach that directly accounts for all of these effects when estimating the shear elasticity. This new approach simulates shear wave particle velocities using a Green's function-based approach for the Voigt model, where the shear elasticity and viscosity values are estimated using an optimization-based approach that compares measured shear wave particle velocities with simulated shear wave particle velocities in the time-domain. The results are evaluated on a point-by-point basis to generate images. There is good agreement between the simulated and measured shear wave particle velocities, where the new approach yields much better images of the shear elasticity and shear viscosity than the TOF method. The new estimation approach is accelerated with an approximate viscoelastic Green's function model that is evaluated with shear wave data obtained from in vivo human livers. Instead of calculating shear waves with combinations of different shear elasticities and shear viscosities, shear waves are calculated with different shear elasticities on the GPU and then convolved with a viscous loss model, which accelerates the calculation dramatically. The shear elasticity and shear viscosity values are then estimated using an optimization-based approach by minimizing the difference between measured and simulated shear wave particle velocities. Shear elasticity and shear viscosity images are generated at every spatial point in a two-dimensional (2D) field-of-view (FOV). The new approach is applied to measured shear wave data obtained from in vivo human livers, and the results show that this new approach successfully generates shear elasticity and shear viscosity images from this data. The results also indicate that the shear elasticity values estimated with this approach are significantly smaller than the values estimated with the conventional TOF method and that the new approach demonstrates more consistent values for these estimates compared with the TOF method. This experience suggests that the new method is an effective approach for estimating the shear elasticity and the shear viscosity in liver and in other soft tissue.

Probing of multiple magnetic responses in magnetic inductors using atomic force microscopy.

PubMed

Park, Seongjae; Seo, Hosung; Seol, Daehee; Yoon, Young-Hwan; Kim, Mi Yang; Kim, Yunseok

2016-02-08

Even though nanoscale analysis of magnetic properties is of significant interest, probing methods are relatively less developed compared to the significance of the technique, which has multiple potential applications. Here, we demonstrate an approach for probing various magnetic properties associated with eddy current, coil current and magnetic domains in magnetic inductors using multidimensional magnetic force microscopy (MMFM). The MMFM images provide combined magnetic responses from the three different origins, however, each contribution to the MMFM response can be differentiated through analysis based on the bias dependence of the response. In particular, the bias dependent MMFM images show locally different eddy current behavior with values dependent on the type of materials that comprise the MI. This approach for probing magnetic responses can be further extended to the analysis of local physical features.

Quantitative perceptual differences among over-the-counter vaginal products using a standardized methodology: implications for microbicide development☆

PubMed Central

Mahan, Ellen D.; Morrow, Kathleen M.; Hayes, John E.

2015-01-01

Background Increasing prevalence of HIV infection among women worldwide has motivated the development of female-initiated prevention methods, including gel-based microbicides. User acceptability is vital for microbicide success; however, varying cultural vaginal practices indicate multiple formulations must be developed to appeal to different populations. Perceptual attributes of microbicides have been identified as primary drivers of acceptability; however, previous studies do not allow for direct comparison of these qualities between multiple formulations. Study Design Six vaginal products were analyzed ex vivo using descriptive analysis. Perceptual attributes of samples were identified by trained participants (n=10) and rated quantitatively using scales based on a panel-developed lexicon. Data were analyzed using two-way ANOVAs for each attribute; product differences were assessed via Tukey’s honestly significant difference test. Results Significant differences were found between products for multiple attributes. Patterns were also seen for attributes across intended product usage (i.e., contraceptive, moisturizer or lubricant). For example, Options© Gynol II® (Caldwell Consumer Health, LLC) was significantly stickier and grainier than other products. Conclusions Descriptive analysis, a quantitative approach that is based on consensus lexicon usage among participants, successfully quantified perceptual differences among vaginal products. Since perceptual attributes of products can be directly compared quantitatively, this study represents a novel approach that could be used to inform rational design of microbicides. PMID:21757061

Quantitative perceptual differences among over-the-counter vaginal products using a standardized methodology: implications for microbicide development.

PubMed

Mahan, Ellen D; Morrow, Kathleen M; Hayes, John E

2011-08-01

Increasing prevalence of HIV infection among women worldwide has motivated the development of female-initiated prevention methods, including gel-based microbicides. User acceptability is vital for microbicide success; however, varying cultural vaginal practices indicate multiple formulations must be developed to appeal to different populations. Perceptual attributes of microbicides have been identified as primary drivers of acceptability; however, previous studies do not allow for direct comparison of these qualities between multiple formulations. Six vaginal products were analyzed ex vivo using descriptive analysis. Perceptual attributes of samples were identified by trained participants (n=10) and rated quantitatively using scales based on a panel-developed lexicon. Data were analyzed using two-way ANOVAs for each attribute; product differences were assessed via Tukey's honestly significant difference test. Significant differences were found between products for multiple attributes. Patterns were also seen for attributes across intended product usage (i.e., contraceptive, moisturizer or lubricant). For example, Options© Gynol II® (Caldwell Consumer Health, LLC) was significantly stickier and grainier than other products. Descriptive analysis, a quantitative approach that is based on consensus lexicon usage among participants, successfully quantified perceptual differences among vaginal products. Since perceptual attributes of products can be directly compared quantitatively, this study represents a novel approach that could be used to inform rational design of microbicides. Copyright © 2011 Elsevier Inc. All rights reserved.

Sex differences present in auditory looming perception, absent in auditory recession

NASA Astrophysics Data System (ADS)

Neuhoff, John G.; Seifritz, Erich

2005-04-01

When predicting the arrival time of an approaching sound source, listeners typically exhibit an anticipatory bias that affords a margin of safety in dealing with looming objects. The looming bias has been demonstrated behaviorally in the laboratory and in the field (Neuhoff 1998, 2001), neurally in fMRI studies (Seifritz et al., 2002), and comparatively in non-human primates (Ghazanfar, Neuhoff, and Logothetis, 2002). In the current work, male and female listeners were presented with three-dimensional looming sound sources and asked to press a button when the source was at the point of closest approach. Females exhibited a significantly greater anticipatory bias than males. Next, listeners were presented with sounds that either approached or receded and then stopped at three different terminal distances. Consistent with the time-to-arrival judgments, female terminal distance judgments for looming sources were significantly closer than male judgments. However, there was no difference between male and female terminal distance judgments for receding sounds. Taken together with the converging behavioral, neural, and comparative evidence, the current results illustrate the environmental salience of looming sounds and suggest that the anticipatory bias for auditory looming may have been shaped by evolution to provide a selective advantage in dealing with looming objects.

Three-dimensional virtual planning in orthognathic surgery enhances the accuracy of soft tissue prediction.

PubMed

Van Hemelen, Geert; Van Genechten, Maarten; Renier, Lieven; Desmedt, Maria; Verbruggen, Elric; Nadjmi, Nasser

2015-07-01

Throughout the history of computing, shortening the gap between the physical and digital world behind the screen has always been strived for. Recent advances in three-dimensional (3D) virtual surgery programs have reduced this gap significantly. Although 3D assisted surgery is now widely available for orthognathic surgery, one might still argue whether a 3D virtual planning approach is a better alternative to a conventional two-dimensional (2D) planning technique. The purpose of this study was to compare the accuracy of a traditional 2D technique and a 3D computer-aided prediction method. A double blind randomised prospective study was performed to compare the prediction accuracy of a traditional 2D planning technique versus a 3D computer-aided planning approach. The accuracy of the hard and soft tissue profile predictions using both planning methods was investigated. There was a statistically significant difference between 2D and 3D soft tissue planning (p < 0.05). The statistically significant difference found between 2D and 3D planning and the actual soft tissue outcome was not confirmed by a statistically significant difference between methods. The 3D planning approach provides more accurate soft tissue planning. However, the 2D orthognathic planning is comparable to 3D planning when it comes to hard tissue planning. This study provides relevant results for choosing between 3D and 2D planning in clinical practice. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Diffusion-weighted imaging of breast lesions: Region-of-interest placement and different ADC parameters influence apparent diffusion coefficient values.

PubMed

Bickel, Hubert; Pinker, Katja; Polanec, Stephan; Magometschnigg, Heinrich; Wengert, Georg; Spick, Claudio; Bogner, Wolfgang; Bago-Horvath, Zsuzsanna; Helbich, Thomas H; Baltzer, Pascal

2017-05-01

To investigate the influence of region-of-interest (ROI) placement and different apparent diffusion coefficient (ADC) parameters on ADC values, diagnostic performance, reproducibility and measurement time in breast tumours. In this IRB-approved, retrospective study, 149 histopathologically proven breast tumours (109 malignant, 40 benign) in 147 women (mean age 53.2) were investigated. Three radiologists independently measured minimum, mean and maximum ADC, each using three ROI placement approaches:1 - small 2D-ROI, 2 - large 2D-ROI and 3 - 3D-ROI covering the whole lesion. One reader performed all measurements twice. Median ADC values, diagnostic performance, reproducibility, and measurement time were calculated and compared between all combinations of ROI placement approaches and ADC parameters. Median ADC values differed significantly between the ROI placement approaches (p < .001). Minimum ADC showed the best diagnostic performance (AUC .928-.956), followed by mean ADC obtained from 2D ROIs (.926-.94). Minimum and mean ADC showed high intra- (ICC .85-.94) and inter-reader reproducibility (ICC .74-.94). Median measurement time was significantly shorter for the 2D ROIs (p < .001). ROI placement significantly influences ADC values measured in breast tumours. Minimum and mean ADC acquired from 2D-ROIs are useful for the differentiation of benign and malignant breast lesions, and are highly reproducible, with rapid measurement. • Region of interest placement significantly influences apparent diffusion coefficient of breast tumours. • Minimum and mean apparent diffusion coefficient perform best and are reproducible. • 2D regions of interest perform best and provide rapid measurement times.

Reflections of Cultural Values in Advertising: A Cross-Cultural Perspective.

ERIC Educational Resources Information Center

Ahmed, Niaz

2001-01-01

Contributes to the debate on standardized versus specialized approaches to international advertising. Compares print advertising from the United States and India and examines how cultural values are manifest in advertising. Finds significant differences in the way these two countries produced advertising messages and that different cultural values…

Awkward or Amazing: Gender and Age Trends in First Intercourse Experiences

ERIC Educational Resources Information Center

Walsh, Jennifer L.; Ward, L. Monique; Caruthers, Allison; Merriwether, Ann

2011-01-01

Although research continues to highlight significant gender differences in first coital experiences, developmental approaches suggest that some of these patterns may be age-related. Therefore, this study investigated both gender and age differences in first intercourse experiences. Open-ended responses regarding reasons for, and descriptions of,…

Evaluation of the educational environment of postgraduate surgical teaching.

PubMed

Khan, Junaid Sarfraz

2008-01-01

Medical Education is becoming increasingly community-oriented, student-centred, self-learning and self & peer-assessing process especially in the undergraduate years. This is happening because of increasing patient awareness of their rights in our new healthcare world of increased consultant responsibility; and implementation in the U.K. health institutions of the 'European Working Time Directive' and 'Modernization of Medical Careers'. The study was conducted to determine the change if any in the education environment of postgraduate surgical teaching in a leading teaching hospital in London when a teacher-centred, old-fashioned postgraduate teaching approach was replaced with a student-centred, self-assessment, portfolio-based approach. Postgraduate Hospital Educational Environment Measure (PHEEM). Twenty postgraduate trainees filled in the questionnaire before and after the change in their learning/teaching pattern. The response rate was 100%. No statistically significant difference in the overall score for the two teaching environments (p = 0.8024, 95% CI = -5.549273 to 4.349273) was found, because the loss of on-call rooms, trainee's mess and catering services statistically significantly deteriorated the social support subscale of the PHEEM scale (p < 0.0001, 95% CI = 6.66752 to 13.03248) to counteract any statistically significant improvement in the teaching role perception subscale of the instrument (p = 0.001, 95% CI= -12.443896 to -4.856104). There was no statistically significant difference in the role autonomy perception subscale in the two methods (p = 0.3663, 95% CI = -5.870437 to 2.270437). A student-centred approach to postgraduate teaching is better than a teacher-centred approach. However, further studies will be needed to evaluate both postgraduate teaching and training environment.

Research-Based Teacher Education? Exploring the Meaning Potentials of Swedish Teacher Education

ERIC Educational Resources Information Center

Alvunger, Daniel; Wahlström, Ninni

2018-01-01

In this article, we explore the meaning potentials of teacher education in terms of the significance of a research-based approach and the different pedagogic identities that such an approach implies. The study's aim is to examine the important factors for education to be considered research-based and to identify and analyse the research base of…

Timestamp Offset Determination Between AN Actuated Laser Scanner and its Corresponding Motor

NASA Astrophysics Data System (ADS)

Voges, R.; Wieghardt, C. S.; Wagner, B.

2017-05-01

Motor actuated 2D laser scanners are key sensors for many robotics applications that need wide ranging but low cost 3D data. There exist many approaches on how to build a 3D laser scanner using this technique, but they often lack proper synchronization for the timestamps of the actuator and the laser scanner. However, to transform the measurement points into three-dimensional space an appropriate synchronization is mandatory. Thus, we propose two different approaches to accomplish the goal of calculating timestamp offsets between laser scanner and motor prior to and after data acquisition. Both approaches use parts of a SLAM algorithm but apply different criteria to find an appropriate solution. While the approach for offset calculation prior to data acquisition exploits the fact that the SLAM algorithm should not register motion for a stationary system, the approach for offset calculation after data acquisition evaluates the perceived clarity of a point cloud created by the SLAM algorithm. Our experiments show that both approaches yield the same results although operating independently on different data, which demonstrates that the results reflect reality with a high probability. Furthermore, our experiments exhibit the significance of a proper synchronization between laser scanner and actuator.

XV-15 Tiltrotor Low Noise Approach Operations

NASA Technical Reports Server (NTRS)

Conner, David A.; Marcolini, Michael A.; Decker, William A.; Cline, John H.; Edwards, Bryan D.; Nicks, Colby O.; Klein, Peter D.

1999-01-01

Acoustic data have been acquired for the XV-15 tiltrotor aircraft performing approach operations for a variety of different approach profile configurations. This flight test program was conducted jointly by NASA, the U.S. Army, and Bell Helicopter Textron, Inc. (BHTI) in June 1997. The XV-15 was flown over a large area microphone array, which was deployed to directly measure the noise footprint produced during actual approach operations. The XV-15 flew realistic approach profiles that culminated in IGE hover over a landing pad. Aircraft tracking and pilot guidance was provided by a Differential Global Positioning System (DGPS) and a flight director system developed at BHTI. Approach profile designs emphasized noise reduction while maintaining handling qualities sufficient for tiltrotor commercial passenger ride comfort and flight safety under Instrument Flight Rules (IFR) conditions. A discussion of the approach profile design philosophy is provided. Five different approach profiles are discussed in detail -- 3 deg., 6 deg., and 9 deg. approaches, and two very different 3 deg. to 9 deg. segmented approaches. The approach profile characteristics are discussed in detail, followed by the noise footprints and handling qualities. Sound exposure levels are also presented on an averaged basis and as a function of the sideline distance for a number of up-range distances from the landing point. A comparison of the noise contour areas is also provided. The results document the variation in tiltrotor noise due to changes in operating condition, and indicate the potential for significant noise reduction using the unique tiltrotor capability of nacelle tilt.

eLaunch Hypersonics: An Advanced Launch System

NASA Technical Reports Server (NTRS)

Starr, Stanley

2010-01-01

This presentation describes a new space launch system that NASA can and should develop. This approach can significantly reduce ground processing and launch costs, improve reliability, and broaden the scope of what we do in near earth orbit. The concept (not new) is to launch a re-usable air-breathing hypersonic vehicle from a ground based electric track. This vehicle launches a final rocket stage at high altitude/velocity for the final leg to orbit. The proposal here differs from past studies in that we will launch above Mach 1.5 (above transonic pinch point) which further improves the efficiency of air breathing, horizontal take-off launch systems. The approach described here significantly reduces cost per kilogram to orbit, increases safety and reliability of the boost systems, and reduces ground costs due to horizontal-processing. Finally, this approach provides significant technology transfer benefits for our national infrastructure.

Historical and Current Trends in Colon Trauma

PubMed Central

Causey, Marlin Wayne; Rivadeneira, David E.; Steele, Scott R.

2012-01-01

The authors discuss the evolution of the evaluation and management of colonic trauma, as well as the debate regarding primary repair versus fecal diversion. Their evidence-based review covers diagnosis, management, surgical approaches, and perioperative care of patients with colon-related trauma. The management of traumatic colon injuries has evolved significantly over the past 50 years; here the authors describe a practical approach to the treatment and management of traumatic injuries to the colon based on the most current research. However, management of traumatic colon injuries remains a challenge and continues to be associated with significant morbidity. Familiarity with the different methods to the approach and management of colonic injuries will allow surgeons to minimize unnecessary complications and mortality. PMID:24294119

The implementation of education for sustainable development in Sweden: investigating the sustainability consciousness among upper secondary students

NASA Astrophysics Data System (ADS)

Berglund, Teresa; Gericke, Niklas; Rundgren, Shu-Nu Chang

2014-09-01

Background: Sustainable development (SD) is a complex idea, based on environmental, economic and social dimensions. In line with SD, education for sustainable development (ESD) is an approach to teaching that combines cognitive and affective domains and aims to build empowerment abilities. Purpose: The purpose of this article is to investigate effects of the implementation of ESD in Sweden, in terms of developing students' sustainability consciousness (SC). Two groups of students were included: one was from schools with a profile of ESD and the other one was from comparable schools without explicit ESD-profile. Sample: A total of 638 students from upper secondary schools (grade 12) in science-related or social science-related programs participated in the study. Design and methods: A procedure was created for the selection of schools considered to be the most active in using an ESD approach as well as comparable schools with no explicit ESD approach. During spring 2013, the students responded to a questionnaire based on sustainability knowingness, attitudes and behaviors within the environmental, economic and social dimensions of SD that together constitute the concept of SC. Data were analyzed using SPSS software. Results: The results indicate that there are significant differences in SC between students from schools that teach with an ESD approach compared to students from regular schools. Furthermore, a significant difference between the two groups of students was found in the underlying economic dimension of SC. No significant differences were found in the environmental and social dimensions of SC. Conclusions: Although the results show that ESD-profiled schools have effect on students' SC, the effects are relatively small. Therefore, the effects and nature of the implementation of ESD are discussed.

Single-site Versus Multiport Robotic Hysterectomy in Benign Gynecologic Diseases: A Retrospective Evaluation of Surgical Outcomes and Cost Analysis.

PubMed

Bogliolo, Stefano; Ferrero, Simone; Cassani, Chiara; Musacchi, Valentina; Zanellini, Francesca; Dominoni, Mattia; Spinillo, Arsenio; Gardella, Barbara

2016-01-01

To compare the surgical outcomes and costs of robotic-assisted hysterectomy with the single-site (RSSH) or multiport approach (RH). A retrospective analysis of a prospectively collected database (Canadian Task Force classification II1). A university hospital. Consecutive women who underwent robotic-assisted total laparoscopic hysterectomy and bilateral salpingo-oophorectomy for the treatment of benign gynecologic diseases. Data on surgical approach, surgical outcomes, and costs were collected in a prospective database and retrospectively analyzed. The total operative time, console time, docking time, estimated blood loss, conversion rate, and surgical complications rate were compared between the 2 study groups. Cost analysis was performed. One hundred four patients underwent total robotic-assisted hysterectomy and bilateral salpingo-oophorectomy (45 RSSH and 59 RH). There was no significant difference in the indications for surgery and in the characteristics of the patients between the 2 study groups. There was no significant difference between the single-site and multiport approach in console time, surgical complication rate, conversion rate, and postoperative pain. The docking time was lower in the RH group (p = .0001). The estimated blood loss and length of hospitalization were lower in the RSSH group (p = .0008 and p = .009, respectively). The cost analysis showed significant differences in favor of RSSH. RSSH should be preferred to RH when hysterectomy is performed for benign disease because it could be at least as equally effective and safe with a potential cost reduction. However, because of the high cost and absence of clear advantages, the robotic approach should be considered only for selected patients. Copyright © 2016 AAGL. Published by Elsevier Inc. All rights reserved.

Influence of learning styles on the practical performance after the four-step basic life support training approach – An observational cohort study

PubMed Central

Henke, Alexandra; Stieger, Lina; Beckers, Stefan; Biermann, Henning; Rossaint, Rolf; Sopka, Saša

2017-01-01

Background Learning and training basic life support (BLS)—especially external chest compressions (ECC) within the BLS-algorithm—are essential resuscitation training for laypersons as well as for health care professionals. The objective of this study was to evaluate the influence of learning styles on the performance of BLS and to identify whether all types of learners are sufficiently addressed by Peyton’s four-step approach for BLS training. Methods A study group of first-year medical students (n = 334) without previous medical knowledge was categorized according to learning styles using the German Lernstilinventar questionnaire based on Kolb’s Learning Styles Inventory. Students’ BLS performances were assessed before and after a four-step BLS training approach lasting 4 hours. Standardized BLS training was provided by an educational staff consisting of European Resuscitation Council-certified advanced life support providers and instructors. Pre- and post-intervention BLS performance was evaluated using a single-rescuer-scenario and standardized questionnaires (6-point-Likert-scales: 1 = completely agree, 6 = completely disagree). The recorded points of measurement were the time to start, depth, and frequency of ECC. Results The study population was categorized according to learning styles: diverging (5%, n = 16), assimilating (36%, n = 121), converging (41%, n = 138), and accommodating (18%, n = 59). Independent of learning styles, both male and female participants showed significant improvement in cardiopulmonary resuscitation (CPR) performance. Based on the Kolb learning styles, no significant differences between the four groups were observed in compression depth, frequency, time to start CPR, or the checklist-based assessment within the baseline assessment. A significant sex effect on the difference between pre- and post-interventional assessment points was observed for mean compression depth and mean compression frequency. Conclusions The findings of this work show that the four-step-approach for BLS training addresses all types of learners independent of their learning styles and does not lead to significant differences in the performance of CPR. PMID:28542636

Predicted versus observed 30-day perioperative outcomes using the ACS NSQIP surgical risk calculator in patients undergoing partial nephrectomy for renal cell carcinoma.

PubMed

Blair, Brian M; Lehman, Erik B; Jafri, Syed M; Kaag, Matthew G; Raman, Jay D

2018-06-04

The purpose of the study was to evaluate the accuracy of the American College of Surgeons NSQIP Surgical Risk Calculator for predicting risk-adjusted 30-day outcomes for patients undergoing partial nephrectomy (PN) for renal cell carcinoma (RCC). A single institution, multi-surgeon, prospectively maintained database was queried for patients undergoing PN for RCC from 1998 to 2015. 21 preoperative factors were analyzed for each patient with predicted risk for 30-day complications, mortality, and length of stay (LOS) calculated. Differences between the mean predicted risk and observed rate of surgical outcomes were determined using two-sided one-sample t test with significance at p < 0.05. Subgroup analyses of outcomes stratified by surgical approach were also performed. 470 patients undergoing PN for RCC were analyzed. Comparing NSQIP predicted to observed outcomes, clinically significant underestimations occurred with rates of overall complications (9.16 vs. 16.81%, p < 0.001), surgical site infections [SSI] (1.65 vs. 2.77%, p < 0.001), urinary tract infection [UTI] (1.41 vs. 3.40%, p < 0.001), and LOS (3.25 vs. 3.73 days, p < 0.001). On subgroup analysis, 209 open PN and 261 minimally invasive PN (MIPN) were performed. The NSQIP calculator consistently underestimated overall complications, SSI, UTI, and LOS (p < 0.001) among both surgical approaches, while overestimating MIPN severe complications (p < 0.001). Clinically important differences persisted when stratifying the MIPN group by laparoscopic (N = 111) and robotic (N = 150) approaches. The ACS NSQIP Surgical Risk Calculator had significant discrepancies among observed and predicted outcomes. Additional analyses confirmed these differences remained significant irrespective of surgical approach. These findings emphasize the need for urologic oncology-specific calculators to better predict surgical outcomes in this complex patient population.

Influence of learning styles on the practical performance after the four-step basic life support training approach - An observational cohort study.

PubMed

Schröder, Hanna; Henke, Alexandra; Stieger, Lina; Beckers, Stefan; Biermann, Henning; Rossaint, Rolf; Sopka, Saša

2017-01-01

Learning and training basic life support (BLS)-especially external chest compressions (ECC) within the BLS-algorithm-are essential resuscitation training for laypersons as well as for health care professionals. The objective of this study was to evaluate the influence of learning styles on the performance of BLS and to identify whether all types of learners are sufficiently addressed by Peyton's four-step approach for BLS training. A study group of first-year medical students (n = 334) without previous medical knowledge was categorized according to learning styles using the German Lernstilinventar questionnaire based on Kolb's Learning Styles Inventory. Students' BLS performances were assessed before and after a four-step BLS training approach lasting 4 hours. Standardized BLS training was provided by an educational staff consisting of European Resuscitation Council-certified advanced life support providers and instructors. Pre- and post-intervention BLS performance was evaluated using a single-rescuer-scenario and standardized questionnaires (6-point-Likert-scales: 1 = completely agree, 6 = completely disagree). The recorded points of measurement were the time to start, depth, and frequency of ECC. The study population was categorized according to learning styles: diverging (5%, n = 16), assimilating (36%, n = 121), converging (41%, n = 138), and accommodating (18%, n = 59). Independent of learning styles, both male and female participants showed significant improvement in cardiopulmonary resuscitation (CPR) performance. Based on the Kolb learning styles, no significant differences between the four groups were observed in compression depth, frequency, time to start CPR, or the checklist-based assessment within the baseline assessment. A significant sex effect on the difference between pre- and post-interventional assessment points was observed for mean compression depth and mean compression frequency. The findings of this work show that the four-step-approach for BLS training addresses all types of learners independent of their learning styles and does not lead to significant differences in the performance of CPR.

Keyboarding Accuracy for a Student with Physical Disabilities: A Synergistic Approach

ERIC Educational Resources Information Center

Obringer, S. John; Coffey, Kenneth; McFadden, Gary; Etheridge, Jill; Pounder, Rebecca

2007-01-01

The purpose of this study was to examine a synergistic application of three different technologies to improve the keyboarding accuracy of an individual with significant motor disorders. Three keyboarding technologies were layered to measure the power of each technology independently and collectively. The results show a significant increase in…

Practice Pattern Variation in Pediatric Eosinophilic Esophagitis in the Carolinas EoE Collaborative: A Research Model in Community and Academic Practices.

PubMed

Huang, Kevin Z; Jensen, Elizabeth T; Chen, Hannah X; Landes, Lisa E; McConnell, Kristen A; Almond, M Angie; Johnston, Douglas T; Durban, Raquel; Jobe, Laura; Frost, Carrie; Donnelly, Sarah; Antonio, Brady; Safta, Anca M; Quiros, J Antonio; Markowitz, Jonathan E; Dellon, Evan S

2018-06-01

Differences in the initial management of pediatric eosinophilic esophagitis (EoE) by practice setting have not been well characterized. We aimed to characterize these differences for sites in the Carolinas EoE Collaborative (CEoEC), a multicenter network of academic and community practices. We performed a retrospective cohort study of pediatric EoE patients at five CEoEC sites: University of North Carolina (UNC) Hospital, Charlotte Asthma and Allergy Specialists, Greenville Health Systems, Wake Forest Baptist Medical Center, and the Medical University of South Carolina Hospital. Cases of EoE were defined by consensus guidelines. Data were extracted from electronic medical records. We tested for differences among sites and used a multinomial model (polytomous regression) to assess associations between treatment and site, adjusting on patient factors. We identified 464 children with EoE across the CEoEC sites. The median age was highest at Wake Forest (11.4 years), the median eosinophil count was highest at UNC (69 eos/hpf), and UNC had the most male patients (82%). UNC used topical steroids for initial treatment in 86% of cases, compared with <1% in Greenville ( P < 0.01). Greenville used dietary elimination more frequently than UNC (81% vs 2%, P < 0.01). Differences in treatment approach held after adjusting for potential baseline confounders. There was no significant association between patient factors and initial treatment approach. Significant differences in EoE patient factors and treatment approaches were identified across CEoEC sites and were not explained by patient or practice factors. This suggests that institutional or provider preferences drive initial treatment approaches, and that more data are needed to drive best practice decisions.

Time-dependent earthquake probabilities

USGS Publications Warehouse

Gomberg, J.; Belardinelli, M.E.; Cocco, M.; Reasenberg, P.

2005-01-01

We have attempted to provide a careful examination of a class of approaches for estimating the conditional probability of failure of a single large earthquake, particularly approaches that account for static stress perturbations to tectonic loading as in the approaches of Stein et al. (1997) and Hardebeck (2004). We have loading as in the framework based on a simple, generalized rate change formulation and applied it to these two approaches to show how they relate to one another. We also have attempted to show the connection between models of seismicity rate changes applied to (1) populations of independent faults as in background and aftershock seismicity and (2) changes in estimates of the conditional probability of failures of different members of a the notion of failure rate corresponds to successive failures of different members of a population of faults. The latter application requires specification of some probability distribution (density function of PDF) that describes some population of potential recurrence times. This PDF may reflect our imperfect knowledge of when past earthquakes have occurred on a fault (epistemic uncertainty), the true natural variability in failure times, or some combination of both. We suggest two end-member conceptual single-fault models that may explain natural variability in recurrence times and suggest how they might be distinguished observationally. When viewed deterministically, these single-fault patch models differ significantly in their physical attributes, and when faults are immature, they differ in their responses to stress perturbations. Estimates of conditional failure probabilities effectively integrate over a range of possible deterministic fault models, usually with ranges that correspond to mature faults. Thus conditional failure probability estimates usually should not differ significantly for these models. Copyright 2005 by the American Geophysical Union.

Child Gain Approach and Loss Avoidance Behavior: Relationships With Depression Risk, Negative Mood, and Anhedonia.

PubMed

Luking, Katherine R; Pagliaccio, David; Luby, Joan L; Barch, Deanna M

2015-08-01

Reduced reward responsiveness and altered response to loss of reward are observed in adults with major depressive disorder (MDD) and adolescents at increased risk for MDD based on family history. However, it is unclear whether altered behavioral responsiveness to reward/loss is a lifelong marker of MDD risk, which is evident before the normative adolescent increase in incentive responding. Healthy 7- to 10-year-old children of mothers with MDD (high risk: n = 27) or without MDD (low risk: n = 42) performed 2 signal detection tasks assessing response bias toward reward (approach) and away from loss (avoidance). Differences in approach/avoidance were related to MDD risk, child general depressive symptoms (maternal report), child-reported anhedonic symptoms, and child-reported negative mood symptoms via repeated-measures analysis of variance. MDD risk did not significantly relate to gain approach or loss avoidance. However, within high-risk children, higher numbers of maternal depressive episodes predicted blunted loss avoidance. Blunted gain approach was related to elevated anhedonic symptoms, whereas enhanced loss avoidance was related to elevated negative mood. Elevated negative mood was further related to blunted gain approach in high-risk children but related to enhanced gain approach in low-risk children. In children, individual differences in specific depressive symptoms and recurrence of maternal depression significantly predicted gain approach/loss avoidance, but the presence/absence of maternal MDD did not. Child depressive symptoms characterized by low positive affect (anhedonia) were related to blunted gain responsiveness, whereas elevated depressed/negative mood was related to enhanced loss responsiveness. Findings suggest that relations between gain approach and negative mood may be an important distinction between those at high versus low risk for MDD. Copyright © 2015 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Comparison of baseline-referenced versus norm-referenced analytical approaches for in-theatre assessment of mild traumatic brain injury neurocognitive impairment.

PubMed

Haran, F Jay; Dretsch, Michael N; Slaboda, Jill C; Johnson, Dagny E; Adam, Octavian R; Tsao, Jack W

2016-01-01

To examine differences between the baseline-referenced and norm-referenced approaches for determining decrements in Automated Neuropsychological Assessment Metrics Version 4 TBI-MIL (ANAM) performance following mild traumatic brain injury (mTBI). ANAM data were reviewed for 616 US Service members, with 528 of this sample having experienced an mTBI and 88 were controls. Post-injury change scores were calculated for each sub-test: (1) normative change score = in-theater score - normative mean and (2) baseline change score = in-theater score - pre-deployment baseline. Reliable change cut-scores were applied to the change and the resulting frequency distributions were compared using McNemar tests. Receiver operator curves (ROC) using both samples (i.e. mTBI and control) were calculated for the change scores for each approach to determine the discriminate ability of the ANAM. There were no statistical differences, p < 0.05 (Bonferonni-Holm corrected), between the approaches. When the area under the curve for the ROCs were averaged across sub-tests, there were no significant differences between either the norm-referenced (0.65) or baseline-referenced (0.66) approaches, p > 0.05. Overall, the findings suggest there is no clear advantage of using the baseline-referenced approach over norm-referenced approach.

Comparison of three different approaches in the treatment of chronic low back pain.

PubMed

Koldaş Doğan, Sebnem; Sonel Tur, Birkan; Kurtaiş, Yeşim; Atay, Mesut Birol

2008-07-01

Our aim is to investigate the effects of three therapeutic approaches in the chronic low back pain on pain, spinal mobility, disability, psychological state, and aerobic capacity. Sixty patients with chronic low back pain were randomized to three groups: group 1, aerobic exercise + home exercise; group 2, physical therapy (hot pack, ultrasound, TENS) + home exercise; group 3, home exercise only. Spinal mobility, pain severity, disability, and psychological disturbance of the patients were assessed before and after the treatment and at 1-month follow-up. Aerobic capacities of the patients were measured before and after treatment. All of the groups showed similar decrease in pain after the treatment and at 1-month follow-up, and there was no significant difference between the groups. In group 2, a significant decrease in Beck Depression Inventory scores was observed with treatment. At 1-month follow-up, group 1 and 2 showed significant decreases in General Health Assessment Questionnaire scores. In group 2, there was also a significant improvement in Roland Morris Disability scores. There were similar improvements in exercise test duration and the MET levels in all the three groups. All of the three therapeutic approaches were found to be effective in diminishing pain and thus increasing aerobic capacity in patients with chronic low back pain. On the other hand, physical therapy + home exercise was found to be more effective regarding disability and psychological disturbance.

Statistical significance of trace evidence matches using independent physicochemical measurements

NASA Astrophysics Data System (ADS)

Almirall, Jose R.; Cole, Michael; Furton, Kenneth G.; Gettinby, George

1997-02-01

A statistical approach to the significance of glass evidence is proposed using independent physicochemical measurements and chemometrics. Traditional interpretation of the significance of trace evidence matches or exclusions relies on qualitative descriptors such as 'indistinguishable from,' 'consistent with,' 'similar to' etc. By performing physical and chemical measurements with are independent of one another, the significance of object exclusions or matches can be evaluated statistically. One of the problems with this approach is that the human brain is excellent at recognizing and classifying patterns and shapes but performs less well when that object is represented by a numerical list of attributes. Chemometrics can be employed to group similar objects using clustering algorithms and provide statistical significance in a quantitative manner. This approach is enhanced when population databases exist or can be created and the data in question can be evaluated given these databases. Since the selection of the variables used and their pre-processing can greatly influence the outcome, several different methods could be employed in order to obtain a more complete picture of the information contained in the data. Presently, we report on the analysis of glass samples using refractive index measurements and the quantitative analysis of the concentrations of the metals: Mg, Al, Ca, Fe, Mn, Ba, Sr, Ti and Zr. The extension of this general approach to fiber and paint comparisons also is discussed. This statistical approach should not replace the current interpretative approaches to trace evidence matches or exclusions but rather yields an additional quantitative measure. The lack of sufficient general population databases containing the needed physicochemical measurements and the potential for confusion arising from statistical analysis currently hamper this approach and ways of overcoming these obstacles are presented.

Neural correlates of social approach and withdrawal in patients with major depression.

PubMed

Derntl, Birgit; Seidel, Eva-Maria; Eickhoff, Simon B; Kellermann, Thilo; Gur, Ruben C; Schneider, Frank; Habel, Ute

2011-01-01

Successful human interaction is based on correct recognition, interpretation, and appropriate reaction to facial affect. In depression, social skill deficits are among the most restraining symptoms leading to social withdrawal, thereby aggravating social isolation and depressive affect. Dysfunctional approach and withdrawal tendencies to emotional stimuli have been documented, but the investigation of their neural underpinnings has received limited attention. We performed an fMRI study including 15 depressive patients and 15 matched, healthy controls. All subjects performed two tasks, an implicit joystick task as well as an explicit rating task, both using happy, neutral, and angry facial expressions. Behavioral data analysis indicated a significant group effect, with depressed patients showing more withdrawal than controls. Analysis of the functional data revealed significant group effects for both tasks. Among other regions, we observed significant group differences in amygdala activation, with patients showing less response particularly during approach to happy faces. Additionally, significant correlations of amygdala activation with psychopathology emerged, suggesting that more pronounced symptoms are accompanied by stronger decreases of amygdala activation. Hence, our results demonstrate that depressed patients show dysfunctional social approach and withdrawal behavior, which in turn may aggravate the disorder by negative social interactions contributing to isolation and reinforcing cognitive biases.

Comparison of Exposure in the Kaplan Versus the Kocher Approach in the Treatment of Radial Head Fractures.

PubMed

Barnes, Leslie Fink; Lombardi, Joseph; Gardner, Thomas R; Strauch, Robert J; Rosenwasser, Melvin P

2018-01-01

The aim of this study was to compare the complete visible surface area of the radial head, neck, and coronoid in the Kaplan and Kocher approaches to the lateral elbow. The hypothesis was that the Kaplan approach would afford greater visibility due to the differential anatomy of the intermuscular planes. Ten cadavers were dissected with the Kaplan and Kocher approaches, and the visible surface area was measured in situ using a 3-dimensional digitizer. Six measurements were taken for each approach by 2 surgeons, and the mean of these measurements were analyzed. The mean surface area visible with the lateral collateral ligament (LCL) preserved in the Kaplan approach was 616.6 mm 2 in comparison with the surface area of 136.2 mm 2 visible in the Kocher approach when the LCL was preserved. Using a 2-way analysis of variance, the difference between these 2 approaches was statistically significant. When the LCL complex was incised in the Kocher approach, the average visible surface area of the Kocher approach was 456.1 mm 2 and was statistically less than the Kaplan approach. The average surface area of the coronoid visible using a proximally extended Kaplan approach was 197.8 mm 2 . The Kaplan approach affords significantly greater visible surface area of the proximal radius than the Kocher approach.

Assessment of Postoperative Pain in Cats After Ovariectomy by Laparoscopy, Median Celiotomy, or Flank Laparotomy.

PubMed

Gauthier, Olivier; Holopherne-Doran, Delphine; Gendarme, Thalia; Chebroux, Alexandre; Thorin, Chantal; Tainturier, Daniel; Bencharif, Djemil

2015-07-01

To compare postoperative pain, duration of surgery, and duration of anesthesia for 3 methods of ovariectomy in cats: (1) conventional ventral median open approach (Midline), (2) right flank approach (Flank), and (3) median 2-portal laparoscopic procedure (Lap). Randomized, prospective clinical trial. Healthy, sexually intact female cats (n = 60). Cats were randomly assigned to 1 of 3 groups: Midline (n = 20), Flank (20), and Lap (20) were evaluated 1, 2, 4, 6, and 12 hours after endotracheal extubation. Postoperative pain was scored using the 4A-vet pain scale that combines a subjective numerical pain rating and objective scoring of physiologic and behavioral variables including the response to stimulation of the surgical site. Pain scores (PS) were compared between groups. There was a significant difference in the PS between groups. PS for Midline and Flank were not significantly different but were both significantly higher compared with Lap. Depending on time, 5-20% of the cats had intense postoperative pain in both Midline and Flank groups. None of the Lap cats had intense postoperative pain. Laparoscopic ovariectomy, although slower, appeared less painful compared with conventional ventral midline and flank ovariectomy. Postoperative pain did not differ significantly between midline and flank groups. © Copyright 2014 by The American College of Veterinary Surgeons.

Medicare and Rural Health

MedlinePlus

... Toolkits Economic Impact Analysis Tool Community Health Gateway Sustainability Planning Tools Testing New Approaches Rural Health IT ... Beneficiaries (Chapter 5 of the June 2012 MedPAC report), there are not significant differences in the rates ...

A Voxel-Based Approach to Explore Local Dose Differences Associated With Radiation-Induced Lung Damage

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

Palma, Giuseppe; Monti, Serena; D'Avino, Vittoria

Purpose: To apply a voxel-based (VB) approach aimed at exploring local dose differences associated with late radiation-induced lung damage (RILD). Methods and Materials: An interinstitutional database of 98 patients who were Hodgkin lymphoma (HL) survivors treated with postchemotherapy supradiaphragmatic radiation therapy was analyzed in the study. Eighteen patients experienced late RILD, classified according to the Radiation Therapy Oncology Group scoring system. Each patient's computed tomographic (CT) scan was normalized to a single reference case anatomy (common coordinate system, CCS) through a log-diffeomorphic approach. The obtained deformation fields were used to map the dose of each patient into the CCS. Themore » coregistration robustness and the dose mapping accuracy were evaluated by geometric and dose scores. Two different statistical mapping schemes for nonparametric multiple permutation inference on dose maps were applied, and the corresponding P<.05 significance lung subregions were generated. A receiver operating characteristic (ROC)-based test was performed on the mean dose extracted from each subregion. Results: The coregistration process resulted in a geometrically robust and accurate dose warping. A significantly higher dose was consistently delivered to RILD patients in voxel clusters near the peripheral medial-basal portion of the lungs. The area under the ROC curves (AUC) from the mean dose of the voxel clusters was higher than the corresponding AUC derived from the total lung mean dose. Conclusions: We implemented a framework including a robust registration process and a VB approach accounting for the multiple comparison problem in dose-response modeling, and applied it to a cohort of HL survivors to explore a local dose–RILD relationship in the lungs. Patients with RILD received a significantly greater dose in parenchymal regions where low doses (∼6 Gy) were delivered. Interestingly, the relation between differences in the high-dose range and RILD seems to lack a clear spatial signature.« less

DASS-GUI: a user interface for identification and analysis of significant patterns in non-sequential data.

PubMed

Hollunder, Jens; Friedel, Maik; Kuiper, Martin; Wilhelm, Thomas

2010-04-01

Many large 'omics' datasets have been published and many more are expected in the near future. New analysis methods are needed for best exploitation. We have developed a graphical user interface (GUI) for easy data analysis. Our discovery of all significant substructures (DASS) approach elucidates the underlying modularity, a typical feature of complex biological data. It is related to biclustering and other data mining approaches. Importantly, DASS-GUI also allows handling of multi-sets and calculation of statistical significances. DASS-GUI contains tools for further analysis of the identified patterns: analysis of the pattern hierarchy, enrichment analysis, module validation, analysis of additional numerical data, easy handling of synonymous names, clustering, filtering and merging. Different export options allow easy usage of additional tools such as Cytoscape. Source code, pre-compiled binaries for different systems, a comprehensive tutorial, case studies and many additional datasets are freely available at http://www.ifr.ac.uk/dass/gui/. DASS-GUI is implemented in Qt.

Training community healthcare workers on the use of information and communication technologies: a randomised controlled trial of traditional versus blended learning in Malawi, Africa.

PubMed

Mastellos, Nikolaos; Tran, Tammy; Dharmayat, Kanika; Cecil, Elizabeth; Lee, Hsin-Yi; Wong, Cybele C Peng; Mkandawire, Winnie; Ngalande, Emmanuel; Wu, Joseph Tsung-Shu; Hardy, Victoria; Chirambo, Baxter Griphin; O'Donoghue, John Martin

2018-04-02

Despite the increasing uptake of information and communication technologies (ICT) within healthcare services across developing countries, community healthcare workers (CHWs) have limited knowledge to fully utilise computerised clinical systems and mobile apps. The 'Introduction to Information and Communication Technology and eHealth' course was developed with the aim to provide CHWs in Malawi, Africa, with basic knowledge and computer skills to use digital solutions in healthcare delivery. The course was delivered using a traditional and a blended learning approach. Two questionnaires were developed and tested for face validity and reliability in a pilot course with 20 CHWs. Those were designed to measure CHWs' knowledge of and attitudes towards the use of ICT, before and after each course, as well as their satisfaction with each learning approach. Following validation, a randomised controlled trial was conducted to assess the effectiveness of the two learning approaches. A total of 40 CHWs were recruited, stratified by position, gender and computer experience, and allocated to the traditional or blended learning group using block randomisation. Participants completed the baseline and follow-up questionnaires before and after each course to assess the impact of each learning approach on their knowledge, attitudes, and satisfaction. Per-item, pre-post and between-group, mean differences for each approach were calculated using paired and unpaired t-tests, respectively. Per-item, between-group, satisfaction scores were compared using unpaired t-tests. Scores across all scales improved after attending the traditional and blended learning courses. Self-rated ICT knowledge was significantly improved in both groups with significant differences between groups in seven domains. However, actual ICT knowledge scores were similar across groups. There were no significant differences between groups in attitudinal gains. Satisfaction with the course was generally high in both groups. However, participants in the blended learning group found it more difficult to follow the content of the course. This study shows that there is no difference between blended and traditional learning in the acquisition of actual ICT knowledge among community healthcare workers in developing countries. Given the human resource constraints in remote resource-poor areas, the blended learning approach may present an advantageous alternative to traditional learning.

A Randomized Control Trial for Evaluating Efficacies of Two Online Cognitive Interventions With and Without Fear-Appeal Imagery Approaches in Preventing Unprotected Anal Sex Among Chinese Men Who Have Sex with Men.

PubMed

Lau, Joseph T F; Lee, Annisa L; Tse, Wai S; Mo, Phoenix K H; Fong, Francois; Wang, Zixin; Cameron, Linda D; Sheer, Vivian

2016-09-01

Fear appeal approach has been used in health promotion, but its effectiveness has been mixed. It has not been well applied to HIV prevention among men who have sex with men (MSM). The present study developed and evaluated the relative efficacy of three online interventions (SC: STD-related cognitive approach, SCFI: STD-related cognitive plus fear appeal imagery approach, Control: HIV-related information based approach) in reducing prevalence of unprotected anal intercourse (UAI) among 396 MSM using a randomized controlled trial design. Participants' levels of fear-related emotions immediately after watching the assigned intervention materials were also assessed. Participants were evaluated at baseline and 3 months after the intervention. Results showed that participants in the SCFI scored significantly higher in the instrument assessing fear after the watching the intervention materials. However, no statistically significant differences were found across the three groups in terms of UAI at Month 3. Some significant within-group reductions in some measures of UAI were found in three groups. Further studies are warranted to test the role of fear appeal in HIV prevention.

Motion as motivation: using repetitive flexion movements to stimulate the approach system.

PubMed

Haeffel, Gerald J

2011-12-01

Research suggests that having a healthy approach system is critical for adaptive emotional functioning. The goal of the current study (n=186 undergraduates) was to determine the efficacy of an easy-to-disseminate and cost-efficient strategy for stimulating this system. The experiment tested the effects of repeated flexion movements (rFM) on approach system activation as measured by both self-report (BAS scales) and behavior. The results showed that rFM increased approach system motivation in men but not women. Men who completed the rFM task reported significantly greater levels of fun-seeking motivation than men in the control task. Moreover, the rFM task led to changes in actual behavior. Men who completed the rFM task exhibited significantly greater persistence on a difficult laboratory task than men in the control task. In contrast, women who completed the rFM task reported significantly lower levels of fun seeking and tended to exhibit less persistence on a difficult laboratory task than women in the control task. These results provide support for embodied theories of emotion as well as additional evidence for a gender difference in approach-avoidance tendencies. Copyright © 2011. Published by Elsevier Ltd.

Potential Use of γ-Secretase Modulators in the Treatment of Alzheimer Disease

PubMed Central

Wagner, Steven L.; Tanzi, Rudolph E.; Mobley, William C.; Galasko, Douglas

2013-01-01

Although significant progress has occurred in the past 20 years regarding our understanding of Alzheimer disease pathogenesis, we have yet to identify disease-modifying therapeutics capable of substantially altering the clinical course of this prevalent neurodegenerative disease. In this short review, we discuss 2 approaches that are currently being tested clinically (γ-secretase inhibition and γ-secretase modulation) and emphasize the significant differences between these 2 therapeutic approaches. We also discuss certain genetic- and biomarker-based translational and clinical trial paradigms that may assist in developing a useful therapeutic agent. PMID:22801784

Explaining outcomes in major system change: a qualitative study of implementing centralised acute stroke services in two large metropolitan regions in England.

PubMed

Fulop, Naomi J; Ramsay, Angus I G; Perry, Catherine; Boaden, Ruth J; McKevitt, Christopher; Rudd, Anthony G; Turner, Simon J; Tyrrell, Pippa J; Wolfe, Charles D A; Morris, Stephen

2016-06-03

Implementing major system change in healthcare is not well understood. This gap may be addressed by analysing change in terms of interrelated components identified in the implementation literature, including decision to change, intervention selection, implementation approaches, implementation outcomes, and intervention outcomes. We conducted a qualitative study of two cases of major system change: the centralisation of acute stroke services in Manchester and London, which were associated with significantly different implementation outcomes (fidelity to referral pathway) and intervention outcomes (provision of evidence-based care, patient mortality). We interviewed stakeholders at national, pan-regional, and service-levels (n = 125) and analysed 653 documents. Using a framework developed for this study from the implementation science literature, we examined factors influencing implementation approaches; how these approaches interacted with the models selected to influence implementation outcomes; and their relationship to intervention outcomes. London and Manchester's differing implementation outcomes were influenced by the different service models selected and implementation approaches used. Fidelity to the referral pathway was higher in London, where a 'simpler', more inclusive model was used, implemented with a 'big bang' launch and 'hands-on' facilitation by stroke clinical networks. In contrast, a phased approach of a more complex pathway was used in Manchester, and the network acted more as a platform to share learning. Service development occurred more uniformly in London, where service specifications were linked to financial incentives, and achieving standards was a condition of service launch, in contrast to Manchester. 'Hands-on' network facilitation, in the form of dedicated project management support, contributed to achievement of these standards in London; such facilitation processes were less evident in Manchester. Using acute stroke service centralisation in London and Manchester as an example, interaction between model selected and implementation approaches significantly influenced fidelity to the model. The contrasting implementation outcomes may have affected differences in provision of evidence-based care and patient mortality. The framework used in this analysis may support planning and evaluating major system changes, but would benefit from application in different healthcare contexts.

Sampling for area estimation: A comparison of full-frame sampling with the sample segment approach

NASA Technical Reports Server (NTRS)

Hixson, M.; Bauer, M. E.; Davis, B. J. (Principal Investigator)

1979-01-01

The author has identified the following significant results. Full-frame classifications of wheat and non-wheat for eighty counties in Kansas were repetitively sampled to simulate alternative sampling plans. Evaluation of four sampling schemes involving different numbers of samples and different size sampling units shows that the precision of the wheat estimates increased as the segment size decreased and the number of segments was increased. Although the average bias associated with the various sampling schemes was not significantly different, the maximum absolute bias was directly related to sampling size unit.

Concordance and discordance of sequence survey methods for molecular epidemiology

PubMed Central

Hasan, Nur A.; Cebula, Thomas A.; Colwell, Rita R.; Robison, Richard A.; Johnson, W. Evan; Crandall, Keith A.

2015-01-01

The post-genomic era is characterized by the direct acquisition and analysis of genomic data with many applications, including the enhancement of the understanding of microbial epidemiology and pathology. However, there are a number of molecular approaches to survey pathogen diversity, and the impact of these different approaches on parameter estimation and inference are not entirely clear. We sequenced whole genomes of bacterial pathogens, Burkholderia pseudomallei, Yersinia pestis, and Brucella spp. (60 new genomes), and combined them with 55 genomes from GenBank to address how different molecular survey approaches (whole genomes, SNPs, and MLST) impact downstream inferences on molecular evolutionary parameters, evolutionary relationships, and trait character associations. We selected isolates for sequencing to represent temporal, geographic origin, and host range variability. We found that substitution rate estimates vary widely among approaches, and that SNP and genomic datasets yielded different but strongly supported phylogenies. MLST yielded poorly supported phylogenies, especially in our low diversity dataset, i.e., Y. pestis. Trait associations showed that B. pseudomallei and Y. pestis phylogenies are significantly associated with geography, irrespective of the molecular survey approach used, while Brucella spp. phylogeny appears to be strongly associated with geography and host origin. We contrast inferences made among monomorphic (clonal) and non-monomorphic bacteria, and between intra- and inter-specific datasets. We also discuss our results in light of underlying assumptions of different approaches. PMID:25737810

Computer-Based Grammar Instruction in an EFL Context: Improving the Effectiveness of Teaching Adverbial Clauses

ERIC Educational Resources Information Center

Kiliçkaya, Ferit

2015-01-01

This study aims to find out whether there are any statistically significant differences in participants' achievements on three different types of instruction: computer-based instruction, teacher-driven instruction, and teacher-driven grammar supported by computer-based instruction. Each type of instruction follows the deductive approach. The…

Using the Madeline Hunter Direct Instruction Model to Improve Outcomes Assessments in Marketing Programs

ERIC Educational Resources Information Center

Steward, Michelle D.; Martin, Gregory S.; Burns, Alvin C.; Bush, Ronald F.

2010-01-01

This study introduces marketing educators to the Madeline Hunter Direct Instruction Model (HDIM) as an approach to significantly and substantially improve student learning through course-embedded assessment. The effectiveness of the method is illustrated in three different marketing courses taught by three different marketing professors. The…

Another Look at Gender-Related Differences in Leadership Behavior

ERIC Educational Resources Information Center

Winther, Dorothy; Green, Samuel, B.

1987-01-01

Examines self-related behavioral differences in terms of broad leadership styles. While male leaders used a more social style than female leaders, both male and female leaders used language that indicated a task-oriented approach to a significantly greater degree when instructing a female rather than a male subordinate. (Author/LHW)

[Approach and complications associated with suburethral synthetic slings in women: Systematic review and meta-analysis].

PubMed

Biardeau, X; Zanaty, M; Aoun, F; Benbouzid, S; Peyronnet, B

2016-03-01

We aim to assess the complications associated with different approaches used in female suburethral sling surgery. We performed a research on Medline using the following keywords: "suburethral slings", "complications", "safety" and "randomized". Only randomized clinical trials including women and reporting intra- and postoperative complications associated with the retropubic (RP) approach; TOT and/or TVT-O were included. The meta-analysis was conducted using the Review Manager (RevMan 5.3) software delivered by the "Cochrane Library". Out of 176 articles, 23 were included in synthesis. Risks of bladder perforation during surgery (60/1482 vs 5/1479; OR=6.44; 95% CI [3.32-12.50]) and postoperative urinary retention (48/1160 vs 24/1159; OR=1.93; 95% CI [1.26-3.12]) were significantly higher with the RP approach, when compared with the transobturator (TO) approach (TOT or TVT-O). Conversely, the risk of prolonged postoperative pain was significantly lower after RP approach, when compared with TO approach (24/1156 vs 69/1149; OR=0.36; 95% CI [0.23-0.56]). Risks of intraoperative urethral injury, postoperative erosion and de novo overactive bladder were comparable between the two approaches. Data regarding the comparison between TOT and TVT-O were scarce and did not allow us to conclude about complications associated with. The RP approach was associated with a significant risk of bladder perforation and postoperative urinary retention. The TO approach was associated with a higher risk of prolonged postoperative pain. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

A Comparison of Earth Science Science Classes Taught by Using Original Data in a Research-Approach Technique Versus Classes Taught by Conventional Approaches not Using Such Data

ERIC Educational Resources Information Center

Agne, Russell M.

1972-01-01

Students in classes using a self-instructional unit on meteorology and climatology which provided research data from which generalizations could be drawn increased their critical thinking skills more than groups using conventional earth science texts but did not differ significantly in performance on an achievement test. (AL)

Does a Math-Enhanced Curriculum and Instructional Approach Diminish Students' Attainment of Technical Skills? A Year-Long Experimental Study in Agricultural Power and Technology

ERIC Educational Resources Information Center

Young, R. Brent; Edwards, M. Craig; Leising, James G.

2009-01-01

The purpose of this study was to empirically test the posit that students who participated in a contextualized, mathematics-enhanced high school agricultural power and technology (APT) curriculum and aligned instructional approach would not differ significantly (p less than 0.05) in their technical competence from students who participated in the…

Is There Room in the Graduate Curriculum to Learn How to Be a Grad Student? An Approach Using a Graduate-Level Biochemical Engineering Course

ERIC Educational Resources Information Center

Aucoin, Marc G.; Jolicoeur, Mario

2009-01-01

Undergraduate and graduate engineering training differ significantly. The former looks to established protocols and formulas to design and control processes while the latter often involves questioning established protocols and formulas to better suit and describe phenomena. Although we do not dispute the benefits of practical hands-on approaches,…

[Antibiotic prophylaxis in oncologic pharyngolaryngeal surgery: ceftriaxone versus clindamycin and gentamycin].

PubMed

Subirana, F X; Lorente, J; Pérez, M; Quesada, J L; Grasa, J; Fortuny, P; Roselló, J; Quesada, P

2001-03-01

There are many papers comparing two antibiotic protocols for the profilaxis of head and neck infections after laryngeal surgery. We present one prospective and randomised study in 60 patients comparing the efficacy of two protocols. The comparison was between ceftriaxone versus the association of clindamicyn and gentamicyn. In our database we included the risk factors for infection, the surgical approach, the duration of surgery and the patient characteristics. We observed an incidence of 28% of infection, with a 23.3% in the clindamicyn + gentamicyn group and a 33.3% in the ceftriaxone group. The differences between the two groups were not statistically significant. In this study we observed a small difference between the amount of alcohol comsuption, the effectiveness of the surgical drainage, the surgical approach and the presence of wound infection. The difference was not statistical significant due to the small group of patients. The profilaxis was adequate for the total laryngectomy and cordectomy group, with a higher incidence of wound infection in patients treated with a supraglottic laryngectomy.

Effect of music therapy with emotional-approach coping on preprocedural anxiety in cardiac catheterization: a randomized controlled trial.

PubMed

Ghetti, Claire M

2013-01-01

Individuals undergoing cardiac catheterization are likely to experience elevated anxiety periprocedurally, with highest anxiety levels occurring immediately prior to the procedure. Elevated anxiety has the potential to negatively impact these individuals psychologically and physiologically in ways that may influence the subsequent procedure. This study evaluated the use of music therapy, with a specific emphasis on emotional-approach coping, immediately prior to cardiac catheterization to impact periprocedural outcomes. The randomized, pretest/posttest control group design consisted of two experimental groups--the Music Therapy with Emotional-Approach Coping group [MT/EAC] (n = 13), and a talk-based Emotional-Approach Coping group (n = 14), compared with a standard care Control group (n = 10). MT/EAC led to improved positive affective states in adults awaiting elective cardiac catheterization, whereas a talk-based emphasis on emotional-approach coping or standard care did not. All groups demonstrated a significant overall decrease in negative affect. The MT/EAC group demonstrated a statistically significant, but not clinically significant, increase in systolic blood pressure most likely due to active engagement in music making. The MT/EAC group trended toward shortest procedure length and least amount of anxiolytic required during the procedure, while the EAC group trended toward least amount of analgesic required during the procedure, but these differences were not statistically significant. Actively engaging in a session of music therapy with an emphasis on emotional-approach coping can improve the well-being of adults awaiting cardiac catheterization procedures.

Standardization of domestic frying processes by an engineering approach.

PubMed

Franke, K; Strijowski, U

2011-05-01

An approach was developed to enable a better standardization of domestic frying of potato products. For this purpose, 5 domestic fryers differing in heating power and oil capacity were used. A very defined frying process using a highly standardized model product and a broad range of frying conditions was carried out in these fryers and the development of browning representing an important quality parameter was measured. Product-to-oil ratio, oil temperature, and frying time were varied. Quite different color changes were measured in the different fryers although the same frying process parameters were applied. The specific energy consumption for water evaporation (spECWE) during frying related to product amount was determined for all frying processes to define an engineering parameter for characterizing the frying process. A quasi-linear regression approach was applied to calculate this parameter from frying process settings and fryer properties. The high significance of the regression coefficients and a coefficient of determination close to unity confirmed the suitability of this approach. Based on this regression equation, curves for standard frying conditions (SFC curves) were calculated which describe the frying conditions required to obtain the same level of spECWE in the different domestic fryers. Comparison of browning results from the different fryers operated at conditions near the SFC curves confirmed the applicability of the approach. © 2011 Institute of Food Technologists®

Comparative Analysis of Combined (First Anterior, Then Posterior) Versus Only Posterior Approach for Treating Severe Scoliosis

PubMed Central

Hero, Nikša; Vengust, Rok; Topolovec, Matevž

2017-01-01

Study Design. A retrospective, one center, institutional review board approved study. Objective. Two methods of operative treatments were compared in order to evaluate whether a two-stage approach is justified for correction of bigger idiopathic scoliosis curves. Two stage surgery, combined anterior approach in first operation and posterior instrumentation and correction in the second operation. One stage surgery included only posterior instrumentation and correction. Summary of Background Data. Studies comparing two-stage approach and only posterior approach are rather scarce, with shorter follow up and lack of clinical data. Methods. Three hundred forty eight patients with idiopathic scoliosis were operated using Cotrel–Dubousset (CD) hybrid instrumentation with pedicle screw and hooks. Only patients with curvatures more than or equal to 61° were analyzed and divided in two groups: two stage surgery (N = 30) and one stage surgery (N = 46). The radiographic parameters as well as duration of operation, hospitalization time, and number of segments included in fusion and clinical outcome were analyzed. Results. No statistically significant difference was observed in correction between two-stage group (average correction 69%) and only posterior approach group (average correction 66%). However, there were statistically significant differences regarding hospitalization time, duration of the surgery, and the number of instrumented segments. Conclusion. Two-stage surgery has only a limited advantage in terms of postoperative correction angle compared with the posterior approach. Posterior instrumentation and correction is satisfactory, especially taking into account that the patient is subjected to only one surgery. Level of Evidence: 3 PMID:28125525

Visualization of the Capitellum During Elbow Arthroscopy: A Comparison of 3 Portal Techniques.

PubMed

Trofa, David P; Gancarczyk, Stephanie M; Lombardi, Joseph M; Makhni, Eric C; Popkin, Charles A; Ahmad, Christopher S

2017-06-01

Capitellar osteochondritis dissecans (OCD) is a debilitating condition of unknown etiology for which various arthroscopic treatments are available. Prior data suggest that greater than 75% of the capitellum can be visualized arthroscopically through a dual lateral portal approach. However, there is no literature assessing arthroscopic visualization of the capitellum via alternative portals. To determine the percentage of capitellum visualized using the dual lateral, distal ulnar and soft spot, and posterolateral and soft spot portal configurations in a cadaver model. Descriptive laboratory study. Arthroscopy was performed on 12 fresh-frozen cadaver elbows, 4 for each of the following approaches: dual lateral, distal ulna, and posterolateral. Electrocautery was used to mark the most anterior, posterior, medial, and lateral points seen on the capitellum. The radiocapitellar joint was subsequently exposed through an extensile posterior dissection, and the surface anatomy was reconstructed using the Microscribe 3D digitizing system. Using Rhinoceros software, the percentage of capitellum surface area visualized by each approach was determined. The mean percentage of capitellum visualized for the dual lateral, distal ulna, and posterolateral approaches was approximately 68.8%, 66.3%, and 63.5%, respectively. There was no significant difference between the percentage of capitellum seen among approaches ( P = .68). On average, 66.5% of the capitellum was visible through these 3 arthroscopic approaches to the elbow. Approximately 66.5% of the capitellum is visualized through the popularized posterior arthroscopic portals, with no significant differences found between the 3 investigated approaches. As determined in this cadaveric model investigation, each portal technique provides equivalent visualization for capitellar OCD pathology.

Improving soil bacterial taxa–area relationships assessment using DNA meta-barcoding

PubMed Central

Terrat, S; Dequiedt, S; Horrigue, W; Lelievre, M; Cruaud, C; Saby, N P A; Jolivet, C; Arrouays, D; Maron, P-A; Ranjard, L; Chemidlin Prévost-Bouré, N

2015-01-01

The evaluation of the taxa–area relationship (TAR) with molecular fingerprinting data demonstrated the spatial structuration of soil microorganisms and provided insights into the processes shaping their diversity. The increasing use of massive sequencing technologies in biodiversity investigations has now raised the question of the advantages of such technologies over the fingerprinting approach for elucidation of the determinism of soil microbial community assembly in broad-scale biogeographic studies. Our objectives in this study were to compare DNA fingerprinting and meta-barcoding approaches for evaluating soil bacterial TAR and the determinism of soil bacterial community assembly on a broad scale. This comparison was performed on 392 soil samples from four French geographic regions with different levels of environmental heterogeneity. Both molecular approaches demonstrated a TAR with a significant slope but, because of its more sensitive description of soil bacterial community richness, meta-barcoding provided significantly higher and more accurate estimates of turnover rates. Both approaches were useful in evidencing the processes shaping bacterial diversity variations on a broad scale. When different taxonomic resolutions were considered for meta-barcoding data, they significantly influenced the estimation of turnover rates but not the relative importance of each component process. Altogether, DNA meta-barcoding provides a more accurate evaluation of the TAR and may lead to re-examination of the processes shaping soil bacterial community assembly. This should provide new insights into soil microbial ecology in the context of sustainable use of soil resources. PMID:25293875

New approach for simulating groundwater flow in discrete fracture network

NASA Astrophysics Data System (ADS)

Fang, H.; Zhu, J.

2017-12-01

In this study, we develop a new approach to calculate groundwater flowrate and hydraulic head distribution in two-dimensional discrete fracture network (DFN) where both laminar and turbulent flows co-exist in individual fractures. The cubic law is used to calculate hydraulic head distribution and flow behaviors in fractures where flow is laminar, while the Forchheimer's law is used to quantify turbulent flow behaviors. Reynolds number is used to distinguish flow characteristics in individual fractures. The combination of linear and non-linear equations is solved iteratively to determine flowrates in all fractures and hydraulic heads at all intersections. We examine potential errors in both flowrate and hydraulic head from the approach of uniform flow assumption. Applying the cubic law in all fractures regardless of actual flow conditions overestimates the flowrate when turbulent flow may exist while applying the Forchheimer's law indiscriminately underestimate the flowrate when laminar flows exist in the network. The contrast of apertures of large and small fractures in the DFN has significant impact on the potential errors of using only the cubic law or the Forchheimer's law. Both the cubic law and Forchheimer's law simulate similar hydraulic head distributions as the main difference between these two approaches lies in predicting different flowrates. Fracture irregularity does not significantly affect the potential errors from using only the cubic law or the Forchheimer's law if network configuration remains similar. Relative density of fractures does not significantly affect the relative performance of the cubic law and Forchheimer's law.

[Comparison of screw' inserting angle through the 11th and 12th rib anterior approaches for L1 burst fracture].

PubMed

Ma, Li-Tai; Liu, Hao; Li, Tao; Song, Yue-Ming; Pei, Fu-Xing; Liu, Li-Min; Gong, Quan; Zeng, Jian-Cheng; Feng, Gan-Jun; Zhou, Zhong-Jie

2012-12-01

To compare screw's inserting angle through the 11th and 12th rib in treating L1 burst fracture, explore effects on inserting screw and postoperative angle. From October 2007 to October 2010, 108 patients with L1 brust fracture treated through anterior approach were analyzed,including 68 males and 40 females, aged from 21 to 64 years (mean 38.22 years). All patients were divided into the 11th (A, 51 cases) and 12th (B, 57 cases) approach. The data of operation time,blood loss, duration of incision pain, JOA score, Oswestry score, VAS score, quality of life (SF-36), recovery of nervous function, coronal Cobb angle, included angle between screw and plate were observed. All patients were followed up for 9 to 37 months, mean 23 months. The operation time, blood loss, duration of incision pain, in group A were lower than group B (P<0.05), JOA score, Oswestry score, VAS score, SF-36, recovery of nervous function had no significant differences (P>0.05). There were no differences in Cobb angle before operation, but had significance after operation (P=0.000). There were statistically significance between two group in angle between screw and plate (P=0.000, P=0.003). The 11th rib approach for the treatment of L1 burst fracture has less effects on screw, less trauma and less angle between screw and plate.

Method for estimating the morphological significance of simple forms of crystals from X-ray data

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

Treivus, E. B., E-mail: sbobr1@bk.ru

2010-09-15

When developing V.I. Mikheev and I.I. Shafranovskii's method for estimating the morphological significance of faces of different simple forms from X-ray reflection intensities, a way to approximately evaluate the morphological significance of simple forms on crystals from the structure amplitudes of the corresponding atomic planes is proposed. The potential for this approach is demonstrated by the examples of marcasite and zircon.

A novel task-oriented optimal design for P300-based brain-computer interfaces.

PubMed

Zhou, Zongtan; Yin, Erwei; Liu, Yang; Jiang, Jun; Hu, Dewen

2014-10-01

Objective. The number of items of a P300-based brain-computer interface (BCI) should be adjustable in accordance with the requirements of the specific tasks. To address this issue, we propose a novel task-oriented optimal approach aimed at increasing the performance of general P300 BCIs with different numbers of items. Approach. First, we proposed a stimulus presentation with variable dimensions (VD) paradigm as a generalization of the conventional single-character (SC) and row-column (RC) stimulus paradigms. Furthermore, an embedding design approach was employed for any given number of items. Finally, based on the score-P model of each subject, the VD flash pattern was selected by a linear interpolation approach for a certain task. Main results. The results indicate that the optimal BCI design consistently outperforms the conventional approaches, i.e., the SC and RC paradigms. Specifically, there is significant improvement in the practical information transfer rate for a large number of items. Significance. The results suggest that the proposed optimal approach would provide useful guidance in the practical design of general P300-based BCIs.

A novel task-oriented optimal design for P300-based brain-computer interfaces

NASA Astrophysics Data System (ADS)

Zhou, Zongtan; Yin, Erwei; Liu, Yang; Jiang, Jun; Hu, Dewen

2014-10-01

Objective. The number of items of a P300-based brain-computer interface (BCI) should be adjustable in accordance with the requirements of the specific tasks. To address this issue, we propose a novel task-oriented optimal approach aimed at increasing the performance of general P300 BCIs with different numbers of items. Approach. First, we proposed a stimulus presentation with variable dimensions (VD) paradigm as a generalization of the conventional single-character (SC) and row-column (RC) stimulus paradigms. Furthermore, an embedding design approach was employed for any given number of items. Finally, based on the score-P model of each subject, the VD flash pattern was selected by a linear interpolation approach for a certain task. Main results. The results indicate that the optimal BCI design consistently outperforms the conventional approaches, i.e., the SC and RC paradigms. Specifically, there is significant improvement in the practical information transfer rate for a large number of items. Significance. The results suggest that the proposed optimal approach would provide useful guidance in the practical design of general P300-based BCIs.

Comparison of Student Achievement Using Didactic, Inquiry-Based, and the Combination of Two Approaches of Science Instruction

NASA Astrophysics Data System (ADS)

Foster, Hyacinth Carmen

Science educators and administrators support the idea that inquiry-based and didactic-based instructional strategies have varying effects on students' acquisition of science concepts. The research problem addressed whether incorporating the two approaches covered the learning requirements of all students in science classes, enabling them to meet state and national standards. The purpose of this quasiexperimental, posttest design research study was to determine if student learning and achievement in high school biology classes differed for each type of instructional method. Constructivism theory suggested that each learner creates knowledge over time because of the learners' interactions with the environment. The optimal teaching method, didactic (teacher-directed), inquiry-based, or a combination of two approaches instructional method, becomes essential if students are to discover ways to learn information. The research question examined which form of instruction had a significant effect on student achievement in biology. The data analysis consisted of single-factor, independent-measures analysis of variance (ANOVA) that tested the hypotheses of the research study. Locally, the results indicated greater and statistically significant differences in standardized laboratory scores for students who were taught using the combination of two approaches. Based on these results, biology instructors will gain new insights into ways of improving the instructional process. Social change may occur as the science curriculum leadership applies the combination of two instructional approaches to improve acquisition of science concepts by biology students.

In vivo comparison of biomimetic approaches for tissue regeneration of the scarred vocal fold.

PubMed

Thibeault, Susan L; Klemuk, Sarah A; Smith, Marshall E; Leugers, Cecilia; Prestwich, Glenn

2009-07-01

The objective of this study was to determine if three different biomimetic approaches could facilitate tissue regeneration and improve viscoelastic properties in the scarred vocal fold lamina propria extracellular matrix (ECM). Twenty rabbit vocal folds were biopsied bilaterally; 2 months postinjury rabbits were unilaterally treated with (i) autologous fibroblasts, (ii) a semisynthetic ECM (sECM), or (iii) autologous fibroblasts encapsulated in sECM. Saline was injected as a control into the contralateral fold. Animals were sacrificed 2 months after treatment. Outcomes measured were procollagen, collagen, and fibronectin levels in the lamina propria, and tissue viscosity and elasticity across three frequency decades. All treatment groups demonstrated accelerated proliferation of the ECM. Vocal fold lamina propria treated with autologous fibroblasts were found to have significantly improved viscosity (p = 0.0077) and elasticity (p = 0.0081) compared to saline. This treatment group had significantly elevated fibronectin levels. sECM and autologous fibroblasts/sECM groups had significantly elevated levels of procollagen, collagen, and fibronectin, indicating abundant matrix production as compared to saline with viscoelastic measures that did not differ statistically from controls. The use of autologous fibroblasts led to better restoration of the vocal fold lamina propria biomechanical properties. Optimization of cell-scaffold interactions and subsequent cell behavior is necessary for utilization of scaffold and scaffold-cell approaches.

Race and gender moderation of the relationship between cessation beliefs and intentions: is race or gender message segmentation necessary in anti-smoking campaigns?

PubMed Central

Parvanta, S.; Gibson, L.; Moldovan-Johnson, M.; Mallya, G.; Hornik, R. C.

2013-01-01

Debate persists over whether different message strategies in anti-smoking campaigns are needed for audiences of different races or genders. This study considers the need for ‘message segmentation’, which is the process of differentiating the beliefs that might be the focus of messages for population subgroups. We have two aims: (i) lay out an approach that yields evidence about the necessity for message segmentation and (ii) demonstrate and assess findings from this approach using the formative evaluation for the Philadelphia Anti-Smoking Campaign. We examine whether associations between beliefs about quitting smoking and intention to quit are moderated by race (black/white) or gender. Data came from a representative sample of 501 adult smokers (46% black; 56% female) surveyed in July 2010 for the campaign’s formative evaluation. Out of 26 beliefs about cessation, 8 were significantly related to cessation intention regardless of subgroup affiliation, suggesting that these would be promising beliefs for messages in a unified campaign. Four beliefs were significant for white smokers only, and three beliefs were significant for female smokers only. The evidence justified a unified message approach because subgroups shared enough beliefs that could become message strategies to increase cessation across smokers without the added costs associated with message segmentation. PMID:23720493

Unilateral frontal interhemispheric transfalcial approaches for the removal of olfactory groove meninjiomas.

PubMed

Musluman, Ahmet Murat; Yilmaz, Adem; R, Tufan Canseve; Cavusoglu, Halit; Kahyaoglu, Okan; Aydin, Yunus

2012-01-01

A unilateral subfrontal interhemispheric transfalcial approach for the removal of olfactory groove meningiomas (OGM) was evaluated in terms of surgical technique, complications, clinical outcomes, and recurrence rate. Twenty-four females and eighteen males with a mean age of 59 years were operated on for OGM within a 12- year (1996-2008) period. The pre- and post-operative Mini-Mental Test (MMT) scores, visual impairment scores (VIS), pre-operative clinical symptoms (headache, epileptic seizure and anosmia), Karnofsky performance scores (KPS), tumor size and tumor extensions were evaluated. The effects of the pre-operative parameters on post-operative MMT, VIS and KPS were investigated. Tumor size and pre-operative MMT significantly affected pre-operative KPS. Mean tumor diameter was 5.6±0.8 cm. Total excision was achieved in 97.6% of all cases. No peri-operative mortality was seen. Ten patients (23.8%) experienced surgery-related complications. The mean follow-up period of cases was 52 months, and the rate of residual tumor re-growth was 2.3%. No parameter showed any effect on post-operative KPS, as no significant difference was seen between pre- and post-operative KPS. A significant positive difference was detected between pre- and post-operative MMT and VIS. A unilateral subfrontal interhemispheric transfalcial approach can be the preferred modality for treating OGM.

Race and gender moderation of the relationship between cessation beliefs and intentions: is race or gender message segmentation necessary in anti-smoking campaigns?

PubMed

Parvanta, S; Gibson, L; Moldovan-Johnson, M; Mallya, G; Hornik, R C

2013-10-01

Debate persists over whether different message strategies in anti-smoking campaigns are needed for audiences of different races or genders. This study considers the need for 'message segmentation', which is the process of differentiating the beliefs that might be the focus of messages for population subgroups. We have two aims: (i) lay out an approach that yields evidence about the necessity for message segmentation and (ii) demonstrate and assess findings from this approach using the formative evaluation for the Philadelphia Anti-Smoking Campaign. We examine whether associations between beliefs about quitting smoking and intention to quit are moderated by race (black/white) or gender. Data came from a representative sample of 501 adult smokers (46% black; 56% female) surveyed in July 2010 for the campaign's formative evaluation. Out of 26 beliefs about cessation, 8 were significantly related to cessation intention regardless of subgroup affiliation, suggesting that these would be promising beliefs for messages in a unified campaign. Four beliefs were significant for white smokers only, and three beliefs were significant for female smokers only. The evidence justified a unified message approach because subgroups shared enough beliefs that could become message strategies to increase cessation across smokers without the added costs associated with message segmentation.

A novel anisotropic inversion approach for magnetotelluric data from subsurfaces with orthogonal geoelectric strike directions

NASA Astrophysics Data System (ADS)

Schmoldt, Jan-Philipp; Jones, Alan G.

2013-12-01

The key result of this study is the development of a novel inversion approach for cases of orthogonal, or close to orthogonal, geoelectric strike directions at different depth ranges, for example, crustal and mantle depths. Oblique geoelectric strike directions are a well-known issue in commonly employed isotropic 2-D inversion of MT data. Whereas recovery of upper (crustal) structures can, in most cases, be achieved in a straightforward manner, deriving lower (mantle) structures is more challenging with isotropic 2-D inversion in the case of an overlying region (crust) with different geoelectric strike direction. Thus, investigators may resort to computationally expensive and more limited 3-D inversion in order to derive the electric resistivity distribution at mantle depths. In the novel approaches presented in this paper, electric anisotropy is used to image 2-D structures in one depth range, whereas the other region is modelled with an isotropic 1-D or 2-D approach, as a result significantly reducing computational costs of the inversion in comparison with 3-D inversion. The 1- and 2-D versions of the novel approach were tested using a synthetic 3-D subsurface model with orthogonal strike directions at crust and mantle depths and their performance was compared to results of isotropic 2-D inversion. Structures at crustal depths were reasonably well recovered by all inversion approaches, whereas recovery of mantle structures varied significantly between the different approaches. Isotropic 2-D inversion models, despite decomposition of the electric impedance tensor and using a wide range of inversion parameters, exhibited severe artefacts thereby confirming the requirement of either an enhanced or a higher dimensionality inversion approach. With the anisotropic 1-D inversion approach, mantle structures of the synthetic model were recovered reasonably well with anisotropy values parallel to the mantle strike direction (in this study anisotropy was assigned to the mantle region), indicating applicability of the novel approach for basic subsurface cases. For the more complex subsurface cases, however, the anisotropic 1-D inversion approach is likely to yield implausible models of the electric resistivity distribution due to inapplicability of the 1-D approximation. Owing to the higher number of degrees of freedom, the anisotropic 2-D inversion approach can cope with more complex subsurface cases and is the recommended tool for real data sets recorded in regions with orthogonal geoelectric strike directions.

Evaluating the Impact of Parent-Reported Medical Home Status on Children's Health Care Utilization, Expenditures, and Quality: A Difference-in-Differences Analysis with Causal Inference Methods.

PubMed

Han, Bing; Yu, Hao; Friedberg, Mark W

2017-04-01

To evaluate the effects of the parent-reported medical home status on health care utilization, expenditures, and quality for children. Medical Expenditure Panel Survey (MEPS) during 2004-2012, including a total of 9,153 children who were followed up for 2 years in the survey. We took a causal difference-in-differences approach using inverse probability weighting and doubly robust estimators to study how changes in medical home status over a 2-year period affected children's health care outcomes. Our analysis adjusted for children's sociodemographic, health, and insurance statuses. We conducted sensitivity analyses using alternative statistical methods, different approaches to outliers and missing data, and accounting for possible common-method biases. Compared with children whose parents reported having medical homes in both years 1 and 2, those who had medical homes in year 1 but lost them in year 2 had significantly lower parent-reported ratings of health care quality and higher utilization of emergency care. Compared with children whose parents reported having no medical homes in both years, those who did not have medical homes in year 1 but gained them in year 2 had significantly higher ratings of health care quality, but no significant differences in health care expenditures and utilization. Having a medical home may help improve health care quality for children; losing a medical home may lead to higher utilization of emergency care. © Health Research and Educational Trust.

Practice Variations in the Management of Inflammatory Bowel Disease Between Pediatric and Adult Gastroenterologists.

PubMed

Assa, Amit; Avni, Irit; Ben-Bassat, Ofer; Niv, Yaron; Shamir, Raanan

2016-03-01

Different practice guidelines and consensus statements for both pediatric- and adult-onset inflammatory bowel disease exist. Although variations in medical care among gastroenterologists are common, it is unknown whether there are fundamental differences between disciplines. The primary aim of the present study was to investigate differences in common practices across disciplines. This was a prospective, questionnaire-based survey of gastroenterologists attending gastroenterology meetings in Israel. The questionnaire covered attitudes to medical resources, diagnostic and follow-up measures as well as therapeutic approaches. Overall, 120 (60%) of the approached adult gastroenterologists (AGs) and 49 (75%) pediatric gastroenterologists (PGs) completed the questionnaire. The 2 groups differed significantly in various practice areas. Pediatric patients are seen more frequently and for longer appointments. PGs tend to assess thiopurine metabolites (96% vs 47%) more often during treatment. There is a significant variation in practice between groups concerning infectious serology status and vaccinations. Methotrexate in Crohn patients is used more commonly by PGs (55% vs 22%). Long-term combination therapy of thiopurines and anti-tumor necrosis factorα agents is used more often by AGs. In patients with ulcerative colitis AGs use oral 5-aminosalicylic acid once daily (51% vs 21%) and add rectal agents from the first day of treatment (72% vs 35%) more often as compared with PGs. This study demonstrates that common practices in inflammatory bowel disease patients differ significantly between adult and pediatric practitioners. These findings call for investigating the reasons for these differences and promoting strategies to diminish these gaps.

Past and present in abdominal surgery management for Cushing's syndrome.

PubMed

Vilallonga, Ramon; Zafon, Carles; Fort, José Manuel; Mesa, Jordi; Armengol, Manel

2014-01-01

Data on specific abdominal surgery and Cushing's syndrome are infrequent and are usually included in the adrenalectomy reports. Current literature suggests the feasibility and reproducibility of the surgical adrenalectomies for patients diagnosed with non-functioning tumours and functioning adrenal tumours including pheochromocytoma, Conn's syndrome and Cushing's syndrome. Medical treatment for Cushing's syndrome is feasible but follow-up or clinical situations force the patient to undergo a surgical procedure. Laparoscopic surgery has become a gold standard nowadays in a broad spectrum of pathologies. Laparoscopic adrenalectomies are also standard procedures nowadays. However, despite the different characteristics and clinical disorders related to the laparoscopically removed adrenal tumours, the intraoperative and postoperative outcomes do not significantly differ in most cases between the different groups of patients, techniques and types of tumours. Tumour size, hormonal type and surgeon's experience could be different factors that predict intraoperative and postoperative complications. Transabdominal and retroperitoneal approaches can be considered. Outcomes for Cushing's syndrome do not differ depending on the surgical approach. Novel technologies and approaches such as single-port surgery or robotic surgery have proven to be safe and feasible. Laparoscopic adrenalectomy is a safe and feasible approach to adrenal pathology, providing the patients with all the benefits of minimally invasive surgery. Single-port access and robotic surgery can be performed but more data are required to identify their correct role between the different surgical approaches. Factors such as surgeon's experience, tumour size and optimal technique can affect the outcomes of this surgery.

Influence of thermodynamic parameter in Lanosterol 14alpha-demethylase inhibitory activity as antifungal agents: a QSAR approach.

PubMed

Vasanthanathan, Poongavanam; Lakshmi, Manickavasagam; Arockia Babu, Marianesan; Kaskhedikar, Sathish Gopalrao

2006-06-01

A quantitative structure activity relationship, Hansch approach was applied on twenty compounds of chromene derivatives as Lanosterol 14alpha-demethylase inhibitory activity against eight fungal organisms. Various physicochemical descriptors and reported minimum inhibitory concentration values of different fungal organisms were used as independent variables and dependent variable respectively. The best models for eight different fungal organisms were first validated by leave-one-out cross validation procedure. It was revealed that thermodynamic parameters were found to have overall significant correlationship with anti fungal activity and these studies provide an insight to design new molecules.

An economic growth model based on financial credits distribution to the government economy priority sectors of each regency in Indonesia using hierarchical Bayesian method

NASA Astrophysics Data System (ADS)

Yasmirullah, Septia Devi Prihastuti; Iriawan, Nur; Sipayung, Feronika Rosalinda

2017-11-01

The success of regional economic establishment could be measured by economic growth. Since the Act No. 32 of 2004 has been implemented, unbalance economic among the regency in Indonesia is increasing. This condition is contrary different with the government goal to build society welfare through the economic activity development in each region. This research aims to examine economic growth through the distribution of bank credits to each Indonesia's regency. The data analyzed in this research is hierarchically structured data which follow normal distribution in first level. Two modeling approaches are employed in this research, a global-one level Bayesian approach and two-level hierarchical Bayesian approach. The result shows that hierarchical Bayesian has succeeded to demonstrate a better estimation than a global-one level Bayesian. It proves that the different economic growth in each province is significantly influenced by the variations of micro level characteristics in each province. These variations are significantly affected by cities and province characteristics in second level.

Application of an untargeted metabolomics approach for the identification of compounds that may be responsible for observed differential effects in chickens fed an organic and a conventional diet.

PubMed

Ruiz-Aracama, A; Lommen, A; Huber, M; van de Vijver, L; Hoogenboom, R

2012-01-01

The aim of this study was to apply an untargeted NMR and LC-MS-based metabolomics approach to detect potential differences between an organically and a conventionally produced feed, which caused statistically significant differences in growth, in the response to an immunological challenge and in the gene expression profiles in the small intestine of laying hens. A fractionation procedure was set up to create multiple fractions of the feed, which were subsequently analysed by NMR and UPLC-TOF/MS operating in positive mode. Comparison of the profiles revealed that the most apparent differences came from the isoflavones in the soy as well as a compound with a molecular mass of 441.202 (M + 1)⁺, which was identified as N,N'-diferuloylputrescine (DFP) and came from the corn. Whether the observed differences in effects are due to the higher levels of isoflavones and DFP is unclear, as is the fact whether the observed differences are typical for organic or conventional produced corn and soy. However, this study shows that this metabolomics approach is suitable for detecting potential differences between products, even in levels of compounds that would have been overlooked with a more targeted approach. As such, the method is suitable for a more systematic study on differences between conventionally and organically produced food.

An Inviscid Decoupled Method for the Roe FDS Scheme in the Reacting Gas Path of FUN3D

NASA Technical Reports Server (NTRS)

Thompson, Kyle B.; Gnoffo, Peter A.

2016-01-01

An approach is described to decouple the species continuity equations from the mixture continuity, momentum, and total energy equations for the Roe flux difference splitting scheme. This decoupling simplifies the implicit system, so that the flow solver can be made significantly more efficient, with very little penalty on overall scheme robustness. Most importantly, the computational cost of the point implicit relaxation is shown to scale linearly with the number of species for the decoupled system, whereas the fully coupled approach scales quadratically. Also, the decoupled method significantly reduces the cost in wall time and memory in comparison to the fully coupled approach. This work lays the foundation for development of an efficient adjoint solution procedure for high speed reacting flow.

A tale of two health literacies: public health and clinical approaches to health literacy.

PubMed

Pleasant, Andrew; Kuruvilla, Shyama

2008-06-01

Public health concerns underlie a considerable portion of the global burden of disease, increasing the utility and need for promoting and assessing the knowledge about public health issues. Health literacy is generally agreed upon as a means to find, understand, analyze and use information to make better decisions about health and to ultimately reduce inequities in health. A public health literacy knowledge scale was tested in China, Mexico, Ghana and India. A somewhat unexpected finding, which was that experts 'scored' less on the scale than the general public, led to consideration of differences between clinical and public health approaches to health literacy and their implications. These differences in perspective, for instance consideration of single case effects versus impacts at the societal level, pose significant challenges to developing and assessing health literacy. We suggest that a comprehensive approach to health literacy will include both clinical and public health approaches.

Approach-related lesions of the sympathetic chain in anterior correction and instrumentation of idiopathic scoliosis

PubMed Central

Adolphs, Bastian; Oberdiek, Denise; Osada, Nani; Liljenqvist, Ulf; Filler, Timm J.; Marziniak, Martin; Bullmann, Viola

2010-01-01

During anterior scoliosis instrumentation with a dual-rod system, the vertebrae are dissected anterolaterally. After surgery, some patients report a change in temperature perception and perspiration in the lower extremities. Sympathetic lesions might be an explanation for this. The aim of this clinical study was to investigate sympathetic function after anterior scoliosis instrumentation. A total of 24 female patients with idiopathic scoliosis (mean age at follow-up, 23.8 years) who had undergone anterior instrumentation on average 6.6 years earlier were included. Due to the suspected relevance of the sympathetic L2 ganglion, two groups were created: a T12 group, in which instrumentation down to T12 was carried out (n = 12), and an L3 group, in which instrumentation down to L3 was done (n = 12). Sympathetic function was assessed by measuring skin temperature at the back of the foot, a plantar ninhydrin sweat test and sympathetic skin responses (SSRs) following electrical stimulation. The side on which the surgical approach was carried out was compared with the contralateral, control side. Health-related quality of life was investigated using the Scoliosis Research Society SRS-22 patient questionnaire. In the T12 group, mean temperatures of 29.6°C on the side of the approach versus 29.5°C on the control side were measured (P > 0.05); in the L3 group, the mean temperatures were 33.2°C on the approach side versus 30.5°C on the control side (P = 0.001). A significant difference between the T12 group and the L3 group (P < 0.001) was observed on the approach side, but not on the control side (P = 0.15). The ninhydrin sweat test showed reduced perspiration in 11 of 12 patients in the L3 group on the approach side in comparison with the control side (P = 0.002). In the T12 group, no significant differences were noted between the left and right feet. SSRs differed significantly between the two groups (P = 0.005). They were detected in all nine analyzable patients in the T12 group on both sides. In the L3 group, they were found on the approach side only in 4 of 11 analyzable patients versus 11 patients on the control side. The results of the SRS-22 questionnaire did not show any significant differences between the two groups. In conclusion, anterior scoliosis instrumentation with a dual-rod system including vertebrae down to L3 regularly leads to lesions in the sympathetic trunk. These are detectable with an increase in temperature, reduced perspiration and reduced SSRs. The caudal level of instrumentation (T12 vs. L3) has an impact on the extent of impairment, supporting the suspected importance of the L2 ganglion. The clinical outcome does not seem to be significantly limited by sympathetic trunk lesions. PMID:20502925

Keeping Your Eye on the Rail: Gaze Behaviour of Horse Riders Approaching a Jump

PubMed Central

Hall, Carol; Varley, Ian; Kay, Rachel; Crundall, David

2014-01-01

The gaze behaviour of riders during their approach to a jump was investigated using a mobile eye tracking device (ASL Mobile Eye). The timing, frequency and duration of fixations on the jump and the percentage of time when their point of gaze (POG) was located elsewhere were assessed. Fixations were identified when the POG remained on the jump for 100 ms or longer. The jumping skill of experienced but non-elite riders (n = 10) was assessed by means of a questionnaire. Their gaze behaviour was recorded as they completed a course of three identical jumps five times. The speed and timing of the approach was calculated. Gaze behaviour throughout the overall approach and during the last five strides before take-off was assessed following frame-by-frame analyses. Differences in relation to both round and jump number were found. Significantly longer was spent fixated on the jump during round 2, both during the overall approach and during the last five strides (p<0.05). Jump 1 was fixated on significantly earlier and more frequently than jump 2 or 3 (p<0.05). Significantly more errors were made with jump 3 than with jump 1 (p = 0.01) but there was no difference in errors made between rounds. Although no significant correlations between gaze behaviour and skill scores were found, the riders who scored higher for jumping skill tended to fixate on the jump earlier (p = 0.07), when the horse was further from the jump (p = 0.09) and their first fixation on the jump was of a longer duration (p = 0.06). Trials with elite riders are now needed to further identify sport-specific visual skills and their relationship with performance. Visual training should be included in preparation for equestrian sports participation, the positive impact of which has been clearly demonstrated in other sports. PMID:24846055

Laparoscopic subtotal colectomy with antiperistaltic cecorectal anastomosis: a new step in the treatment of slow-transit constipation.

PubMed

Marchesi, Federico; Percalli, Luigi; Pinna, Ferdinando; Cecchini, Stefano; Ricco', Matteo; Roncoroni, Luigi

2012-06-01

Subtotal colectomy with antiperistaltic cecorectal anastomosis (SCCRA) has proved to be an effective alternative to total colectomy for the treatment of severe slow-transit constipation. The laparoscopic approach has made this procedure even more attractive. This is the first controlled trial on laparoscopic SCCRA. The study compares the laparoscopic and the open approach. Since 2001, all SCCRAs have been performed laparoscopically at our institution. Only severely symptomatic patients are offered surgery, after stringent patient selection. Laparoscopic SCCRA was performed following the same steps that we first described for the open approach, by utilizing a five-trocar technique. Outcome parameters were prospectively collected every 3 and 6 months. Wexner constipation and incontinence scales (WCS, WI) and gastrointestinal quality of life index (GIQLI) were adopted for functional results. We conducted a case-control study of 15 consecutive patients who underwent laparoscopic SCCRA (VL) and 15 patients previously operated on by the open approach (Op) to compare postoperative and functional outcomes. The VL group had better postoperative outcomes (pain, ileus) while complication rates were similar. Resolution of constipation was impressive in both groups, with no significant difference at follow-up. The VL group presented with a higher number of bowel movements at 3 months (3.8 vs. 2.8, p = 0.039), resulting in a significantly higher incontinence rate at 3 months (WI 6.4 vs. 2.73, p = 0.004), although the difference was no longer significant at 1-year follow-up. The quality of life was good for both groups; the VL group showed a significant improvement at 1-year follow-up (64.18 vs. 114.79, p < 0.01). Laparoscopic SCCRA confirmed the good functional results of the open approach, with no increase in morbidity rate and a faster postoperative recovery. An early higher incontinence rate did not affect quality of life.

Game-Based Approaches' Pedagogical Principles: Exploring Task Constraints in Youth Soccer.

PubMed

Serra-Olivares, Jaime; González-Víllora, Sixto; García-López, Luis Miguel; Araújo, Duarte

2015-06-27

This study tested the use of two pedagogical principles of Game-based approaches, representation and exaggeration, in the context of game performance of U10 soccer players. Twenty-one players participated in two 3 vs. 3 small-sided games. The first small-sided game was modified by representation. The second small-sided game was modified by enhancing the penetration of the defense tactical problem for invasion games. Decision-making and execution were assessed using the Game Performance Evaluation Tool. No significant differences were observed between games in the number of decision-making units related to keeping possession, nor in those related to penetrating the defense. No significant differences were observed in any execution ability (ball control, passing, dribbling and get free movements). The findings suggested that both games could provide similar degeneracy processes to the players for skill acquisition (specific and contextualized task constraints in which they could develop their game performance and the capability to achieve different outcomes in varying contexts). Probably both games had similar learner-environment dynamics leading players to develop their capabilities for adapting their behaviours to the changing performance situations. More research is necessary, from the ecological dynamics point of view, to determine how we should use small-sided games in Game-based approaches.

A dynamic approach for the impact of a toxic gas dispersion hazard considering human behaviour and dispersion modelling.

PubMed

Lovreglio, Ruggiero; Ronchi, Enrico; Maragkos, Georgios; Beji, Tarek; Merci, Bart

2016-11-15

The release of toxic gases due to natural/industrial accidents or terrorist attacks in populated areas can have tragic consequences. To prevent and evaluate the effects of these disasters different approaches and modelling tools have been introduced in the literature. These instruments are valuable tools for risk managers doing risk assessment of threatened areas. Despite the significant improvements in hazard assessment in case of toxic gas dispersion, these analyses do not generally include the impact of human behaviour and people movement during emergencies. This work aims at providing an approach which considers both modelling of gas dispersion and evacuation movement in order to improve the accuracy of risk assessment for disasters involving toxic gases. The approach is applied to a hypothetical scenario including a ship releasing Nitrogen dioxide (NO2) on a crowd attending a music festival. The difference between the results obtained with existing static methods (people do not move) and a dynamic approach (people move away from the danger) which considers people movement with different degrees of sophistication (either a simple linear path or more complex behavioural modelling) is discussed. Copyright © 2016 Elsevier B.V. All rights reserved.

Relationship between Achievement Goals and Students' Self-Reported Personal and Social Responsibility Behaviors.

PubMed

Agbuga, Bulent; Xiang, Ping; McBride, Ron E

2015-04-21

This study utilized the 2x2 achievement goal model (mastery-approach, mastery-avoidance, performance-approach, performance-avoidance goals) to explore the relationships between achievement goals and self-reported personal and social responsibility behaviors in high school physical education settings. Two hundred and twenty one Turkish students completed questionnaires assessing their achievement goals, personal and social responsibility behaviors. Results of the one-way repeated measures ANOVA revealed significant differences among the four achievement goals, F(3, 660) = 137.05, p < .001, η2 = .39. The result also revealed that students were more likely to endorse the mastery-approach goal than three other goals. The simple correlations revealed mastery-approach and performance-approach goals were positively related to students' self-reported personal (r = .54, p < .001; r = .37, p < .001, respectively) and social responsibility (r = .38, p < .001; r = .22, p < .001, respectively) behaviors. However, hierarchical regression analyses indicated only the mastery-approach goal emerged as the significant positive predictor, b = .52, t(216) = 7.19, p < .001 for personal responsibility behaviors, and b = .41, t(216) = 5.23, p < .001 for social responsibility behaviors. These findings seem to provide convergent evidence that mastery-approach goals are positively related to positive educational outcomes.

Left atriotomy versus right atriotomy trans-septal approach for left atrial myxoma.

PubMed

Hatemi, A C; Gürsoy, M; Tongut, A; Kiliçkesmez, K; Karaoğlu, K; Küçükoğlu, S; Kansiz, E

2010-01-01

The biatrial approach has been the classic means of access for left atrial myxoma resection. Increased surgical experience led cardiac surgeons to favour the uniatrial approach to reduce incisions and achieve adequate exposure. In this study, two unilateral surgical approaches were compared in 18 consecutive left atrial myxoma cases. Patients were divided into two groups according to the surgical approach: left atriotomy (group 1, n = 9) and right atriotomy trans-septal approach (group 2, n = 9). Comparison criteria included pre- and post-operative functional capacity, cardiac rhythm, left ventricular ejection fraction, pulmonary artery pressure, left atrial dimensions, cardiopulmonary bypass time, aortic cross-clamp time, drainage over 48 h post-operatively, units of blood transfused, extubation time and length of stay in the intensive care unit and hospital. No significant between-group difference was observed in any criteria except aortic cross-clamp time, which was significantly longer in group 2 than in group 1. No recurrence of myxoma occurred in either group for the 15 patients followed up. Right atrial trans-septal incision appears to be as safe and effective as the left atriotomy approach for left atrial myxoma resection.

MID-VASTUS VS MEDIAL PARA-PATELLAR APPROACH IN TOTAL KNEE REPLACEMENT—TIME TO DISCHARGE

PubMed Central

Mukherjee, P.; Press, J.; Hockings, M.

2009-01-01

Background It has been shown before that when compared with the medial para-patellar approach, the mid-vastus approach for TKR results in less post-operative pain for patients and more rapid recovery of straight leg raise. As far as we are aware the post-operative length of stay of the two groups of patients has not been compared. We postulated that the reduced pain and more rapid recovery of straight leg raise would translate into an earlier, safe, discharge home for the mid-vastus patients compared with those who underwent a traditional medial para-patellar approach. Methods Twenty patients operated on by each of five established knee arthroplasty surgeons were evaluated prospectively with regard to their pre and post-operative range of movement, time to achieve straight leg raise post-operatively and length of post-operative hospital stay. Only one of the surgeons performed the mid-vastus approach, and the measurements were recorded by physiotherapists who were blinded as to the approach used on each patient. Results The results were analysed using a standard statistical software package, and although the mean length of stay was lower for the mid-vastus patients, the difference did not reach a level of significance (p = 0.13). The time taken to achieve straight leg raise post-operatively was significantly less in the mid-vastus group (p<0.001). Conclusion Although this study confirms previous findings that the mid-vastus approach reduces the time taken for patients to achieve straight leg raise, when compared with the medial para-patellar approach, on its own it does not translate into a significantly shorter length of hospital stay. In order to reduce the length of post-operative hospital stay with an accelerated rehabilitation program for TKR, a multi-disciplinary approach is required. Patient expectations, GP support, physiotherapists and nursing staff all have a role to play and the mid-vastus approach, in permitting earlier straight leg raising, significantly contributes to this. PMID:19742080

Analytical investigation of different mathematical approaches utilizing manipulation of ratio spectra

NASA Astrophysics Data System (ADS)

Osman, Essam Eldin A.

2018-01-01

This work represents a comparative study of different approaches of manipulating ratio spectra, applied on a binary mixture of ciprofloxacin HCl and dexamethasone sodium phosphate co-formulated as ear drops. The proposed new spectrophotometric methods are: ratio difference spectrophotometric method (RDSM), amplitude center method (ACM), first derivative of the ratio spectra (1DD) and mean centering of ratio spectra (MCR). The proposed methods were checked using laboratory-prepared mixtures and were successfully applied for the analysis of pharmaceutical formulation containing the cited drugs. The proposed methods were validated according to the ICH guidelines. A comparative study was conducted between those methods regarding simplicity, limitations and sensitivity. The obtained results were statistically compared with those obtained from the reported HPLC method, showing no significant difference with respect to accuracy and precision.

Vibronic coupling simulations for linear and nonlinear optical processes: Theory

NASA Astrophysics Data System (ADS)

Silverstein, Daniel W.; Jensen, Lasse

2012-02-01

A comprehensive vibronic coupling model based on the time-dependent wavepacket approach is derived to simulate linear optical processes, such as one-photon absorbance and resonance Raman scattering, and nonlinear optical processes, such as two-photon absorbance and resonance hyper-Raman scattering. This approach is particularly well suited for combination with first-principles calculations. Expressions for the Franck-Condon terms, and non-Condon effects via the Herzberg-Teller coupling approach in the independent-mode displaced harmonic oscillator model are presented. The significance of each contribution to the different spectral types is discussed briefly.

The politics of risk in the Philippines: comparing state and NGO perceptions of disaster management.

PubMed

Bankoff, Greg; Hilhorst, Dorothea

2009-10-01

It is now generally appreciated that what constitutes vulnerability to one person is not necessarily perceived as such by the next. Different actors 'see' disasters as different types of events and as a result they prepare for, manage and record them in very different ways. This paper explores what different perceptions of vulnerability mean in terms of the understanding and practices of two significant sets of actors and stakeholders involved in disaster preparedness and management in the Philippines: the state and NGOs. Approaches to disaster are not just a function of people's perceptions of disaster risk but also of their understanding of the prevailing social order and social relations. Despite a shared vocabulary-which increasingly presents disasters as processes rather than events, takes a proactive rather than a reactive approach, and favours the inclusion of stakeholders rather than solely relying on technocratic management-different realities continue to make for different responses.

Accurate Simulation and Detection of Coevolution Signals in Multiple Sequence Alignments

PubMed Central

Ackerman, Sharon H.; Tillier, Elisabeth R.; Gatti, Domenico L.

2012-01-01

Background While the conserved positions of a multiple sequence alignment (MSA) are clearly of interest, non-conserved positions can also be important because, for example, destabilizing effects at one position can be compensated by stabilizing effects at another position. Different methods have been developed to recognize the evolutionary relationship between amino acid sites, and to disentangle functional/structural dependencies from historical/phylogenetic ones. Methodology/Principal Findings We have used two complementary approaches to test the efficacy of these methods. In the first approach, we have used a new program, MSAvolve, for the in silico evolution of MSAs, which records a detailed history of all covarying positions, and builds a global coevolution matrix as the accumulated sum of individual matrices for the positions forced to co-vary, the recombinant coevolution, and the stochastic coevolution. We have simulated over 1600 MSAs for 8 protein families, which reflect sequences of different sizes and proteins with widely different functions. The calculated coevolution matrices were compared with the coevolution matrices obtained for the same evolved MSAs with different coevolution detection methods. In a second approach we have evaluated the capacity of the different methods to predict close contacts in the representative X-ray structures of an additional 150 protein families using only experimental MSAs. Conclusions/Significance Methods based on the identification of global correlations between pairs were found to be generally superior to methods based only on local correlations in their capacity to identify coevolving residues using either simulated or experimental MSAs. However, the significant variability in the performance of different methods with different proteins suggests that the simulation of MSAs that replicate the statistical properties of the experimental MSA can be a valuable tool to identify the coevolution detection method that is most effective in each case. PMID:23091608

Enhancing Personal Hygiene Behavior and Competency of Elementary School Adolescents through Peer-Led Approach and School-Friendly: A Quasi-Experimental Study.

PubMed

Tamiru, Dessalegn; Argaw, Alemayehu; Gerbaba, Mulusew; Ayana, Girmay; Nigussie, Aderajew; Jisha, Hunduma; Belachew, Tefera

2017-05-01

Recent studies showed that poor personal hygiene practices play a major role in the increment of communicable disease burden in developing countries. In Ethiopia, 60% of the disease burden is related to poor sanitation practices. This school based study was aimed to assess the effectiveness of school-friendly and peer-led approach in improving personal hygiene practices of school adolescents in Jimma Zone, Southwest of Ethiopia. A total of 1000 students from 10 to 19 years were included into the study. The intervention was done using peer-led approach, health clubs and linking the school events with parents. Data were collected at baseline, midline and end-line using structured questionnaires. Repeated measurement analysis was done and statistical significance was considered at alpha 0.05. The findings of this study indicated that there was a significant difference in personal hygiene practices and knowledge between the intervention and control groups (P<0.001). A significant difference was also observed with the duration of time in the intervention schools (P<0.05). The proportion of adolescents who reported illness before the baseline survey was significantly high among the intervention schools (P<0.01). However, at midline of the survey, the proportion of self-reported illness was significantly high among the control group(P<0.001). The findings of this study showed that there was a significant improvement in personal hygiene knowledge and practice of students in the intervention schools. Therefore, there is a need for proper health education intervention through the framework of schools for the students to improve their personal hygiene knowledge and practices.

Different features of work systems in Indonesia and their consequent approaches.

PubMed

Manuaba, A

1997-12-01

Indonesia, with its ultimate development goal of "developing the people and the community as a whole," in fact is facing problems in the execution of this goal. With a population of more than 200 million persons, different in sociocultural background, educational level and environmental conditions, it is understandable that the process and results of technological choices and transfers for various target groups will be different. A wide range of work systems is found, from the simplest man-tool system to the most complex. The conditions are becoming even more complex, a phenomenon especially evident through studies of their sociocultural, psychological, and environmental factors. As a consequence, if success is to be gained in anticipating and understanding the role of Indonesia in the global competition that lies ahead, a very wise approach to the situation by using local values that are often based on traditional habits and customs in a modern context should be carried out. This approach will require an immense amount of time, dedication and effort. Improvement endeavors that have been carried out in different work systems in different types of activities and industries, showed that if the improvement to be sustained, a holistic, systemic, and interdisciplined participatory approach should be taken into consideration where the technical, economical, ergonomic, sociocultural, energy, and environmental factors will play significant roles.

Shining light on the differences in molecular structural chemical makeup and the cause of distinct degradation behavior between malting- and feed-type barley using synchrotron FTIR microspectroscopy: a novel approach.

PubMed

Yu, Peiqiang; Doiron, Kevin; Liu, Dasen

2008-05-14

The objective of this study was to use advanced synchrotron-sourced FTIR microspectroscopy (SFTIRM) as a novel approach to identify the differences in protein and carbohydrate molecular structure (chemical makeup) between these two varieties of barley and illustrate the exact causes for their significantly different degradation kinetics. Items assessed included (1) molecular structural differences in protein amide I to amide II intensities and their ratio within cellular dimensions, (2) molecular structural differences in protein secondary structure profile and their ratios, and (3) molecular structural differences in carbohydrate component peak profile. Our hypothesis was that molecular structure (chemical makeup) affects barley quality, fermentation, and degradation behavior in both humans and animals. Using SFTIRM, the protein and carbohydrate molecular structural chemical makeup of barley was revealed and identified. The protein molecular structural chemical makeup differed significantly between the two varieties of barleys. No difference in carbohydrate molecular structural chemical makeup was detected. Harrington was lower than Valier in protein amide I, amide II, and protein amide I to amide II ratio, while Harrington was relatively higher in model-fitted protein alpha-helix and beta-sheet, but lower in the others (beta-turn and random coil). These results indicated that it is the molecular structure of protein (chemical makeup) that may play a major role in the different degradation kinetics between the two varieties of barleys (not the molecular structure of carbohydrate). It is believed that use of the advanced synchrotron technology will make a significant step and an important contribution to research in examining the molecular structure (chemical makeup) of plant, feed, and seeds.

Clinically significant and practical! Enhancing precision does make a difference. Reply to McGlinchey and Jacobson, Hsu, and Speer.

PubMed

Hageman, W J; Arrindell, W A

1999-12-01

Based on a secondary analysis of the Jacobson and Truax [Jacobson, N.S. & Truax, P. (1991). a statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59, 12-19.] data using both their own traditional approach and the refined method advanced by Hageman and Arrindell [Hageman, W.J.J.M., & Arrindell, W.A. (1999). Establishing clinically significant change: increment of precision and the distinction between individual and group level of analysis. Behaviour Research and Therapy, 37, 1169-1193], McGlinchey and Jacobson [McGlinchey, J. B., & Jacobson, N. S. (1999). Clinically significant but impractical? A response to Hageman and Arrindell. Behaviour Research and Therapy, 37, 1211-1217.] reported practically identical findings on reliable and clinically significant change across the two approaches. This led McGlinchey and Jacobson to conclude that there is little practical gain in utilizing the refined method over the traditional approach. Close inspection of the data used by McGlinchey and Jacobson however revealed a serious mistake with respect to the value of the standard error of measurement that was employed in their calculations. When the proper index value was utilised, further re-analysis by the present authors disclosed clear differences (i.e. different classifications of S's) across the two approaches. Importantly, these differences followed exactly the same pattern as depicted in Table 2 in Hageman and Arrindell (1999). The theoretical advantages of the refined method, i.e. enhanced precision, appropriate distinction between analysis at the individual and group levels, and maximal comparability of findings across studies, exceed those of the traditional method. Application of the refined method may be carried out within approximately half an hour, which not only supports its practical manageability, but also challenges the suggestion of McGlinchey and Jacobson (1999) that the relevant method would be too complex (impractical) for the average scientist. The reader is offered the opportunity of obtaining an SPSS setup in the form of an ASCII text file by means of which the relevant calculations can be carried out. The ways in which the valuable commentaries by Hsu [Hsu, L. M. (1999). A comparison of three methods of identifying reliable and clinically significant client changes: commentary on Hageman and Arrindell. Behaviour Research and Therapy, 37, 1195-1202.] and Speer [Speer, D. C. (1999). What is the role of two-wave designs in clinical research? Comment on Hageman and Arrindell. Behaviour Research and Therapy, 37, 1203-1210.) contribute to a better understanding of the technical/statistical backgrounds of the traditional and refined methods were also discussed.

Contrasting performance of donor-acceptor copolymer pairs in ternary blend solar cells and two-acceptor copolymers in binary blend solar cells.

PubMed

Khlyabich, Petr P; Rudenko, Andrey E; Burkhart, Beate; Thompson, Barry C

2015-02-04

Here two contrasting approaches to polymer-fullerene solar cells are compared. In the first approach, two distinct semi-random donor-acceptor copolymers are blended with phenyl-C61-butyric acid methyl ester (PC61BM) to form ternary blend solar cells. The two poly(3-hexylthiophene)-based polymers contain either the acceptor thienopyrroledione (TPD) or diketopyrrolopyrrole (DPP). In the second approach, semi-random donor-acceptor copolymers containing both TPD and DPP acceptors in the same polymer backbone, termed two-acceptor polymers, are blended with PC61BM to give binary blend solar cells. The two approaches result in bulk heterojunction solar cells that have the same molecular active-layer components but differ in the manner in which these molecular components are mixed, either by physical mixing (ternary blend) or chemical "mixing" in the two-acceptor (binary blend) case. Optical properties and photon-to-electron conversion efficiencies of the binary and ternary blends were found to have similar features and were described as a linear combination of the individual components. At the same time, significant differences were observed in the open-circuit voltage (Voc) behaviors of binary and ternary blend solar cells. While in case of two-acceptor polymers, the Voc was found to be in the range of 0.495-0.552 V, ternary blend solar cells showed behavior inherent to organic alloy formation, displaying an intermediate, composition-dependent and tunable Voc in the range from 0.582 to 0.684 V, significantly exceeding the values achieved in the two-acceptor containing binary blend solar cells. Despite the differences between the physical and chemical mixing approaches, both pathways provided solar cells with similar power conversion efficiencies, highlighting the advantages of both pathways toward highly efficient organic solar cells.

Approaches for estimating minimal clinically important differences in systemic lupus erythematosus.

PubMed

Rai, Sharan K; Yazdany, Jinoos; Fortin, Paul R; Aviña-Zubieta, J Antonio

2015-06-03

A minimal clinically important difference (MCID) is an important concept used to determine whether a medical intervention improves perceived outcomes in patients. Prior to the introduction of the concept in 1989, studies focused primarily on statistical significance. As most recent clinical trials in systemic lupus erythematosus (SLE) have failed to show significant effects, determining a clinically relevant threshold for outcome scores (that is, the MCID) of existing instruments may be critical for conducting and interpreting meaningful clinical trials as well as for facilitating the establishment of treatment recommendations for patients. To that effect, methods to determine the MCID can be divided into two well-defined categories: distribution-based and anchor-based approaches. Distribution-based approaches are based on statistical characteristics of the obtained samples. There are various methods within the distribution-based approach, including the standard error of measurement, the standard deviation, the effect size, the minimal detectable change, the reliable change index, and the standardized response mean. Anchor-based approaches compare the change in a patient-reported outcome to a second, external measure of change (that is, one that is more clearly understood, such as a global assessment), which serves as the anchor. Finally, the Delphi technique can be applied as an adjunct to defining a clinically important difference. Despite an abundance of methods reported in the literature, little work in MCID estimation has been done in the context of SLE. As the MCID can help determine the effect of a given therapy on a patient and add meaning to statistical inferences made in clinical research, we believe there ought to be renewed focus on this area. Here, we provide an update on the use of MCIDs in clinical research, review some of the work done in this area in SLE, and propose an agenda for future research.

Support vector methods for survival analysis: a comparison between ranking and regression approaches.

PubMed

Van Belle, Vanya; Pelckmans, Kristiaan; Van Huffel, Sabine; Suykens, Johan A K

2011-10-01

To compare and evaluate ranking, regression and combined machine learning approaches for the analysis of survival data. The literature describes two approaches based on support vector machines to deal with censored observations. In the first approach the key idea is to rephrase the task as a ranking problem via the concordance index, a problem which can be solved efficiently in a context of structural risk minimization and convex optimization techniques. In a second approach, one uses a regression approach, dealing with censoring by means of inequality constraints. The goal of this paper is then twofold: (i) introducing a new model combining the ranking and regression strategy, which retains the link with existing survival models such as the proportional hazards model via transformation models; and (ii) comparison of the three techniques on 6 clinical and 3 high-dimensional datasets and discussing the relevance of these techniques over classical approaches fur survival data. We compare svm-based survival models based on ranking constraints, based on regression constraints and models based on both ranking and regression constraints. The performance of the models is compared by means of three different measures: (i) the concordance index, measuring the model's discriminating ability; (ii) the logrank test statistic, indicating whether patients with a prognostic index lower than the median prognostic index have a significant different survival than patients with a prognostic index higher than the median; and (iii) the hazard ratio after normalization to restrict the prognostic index between 0 and 1. Our results indicate a significantly better performance for models including regression constraints above models only based on ranking constraints. This work gives empirical evidence that svm-based models using regression constraints perform significantly better than svm-based models based on ranking constraints. Our experiments show a comparable performance for methods including only regression or both regression and ranking constraints on clinical data. On high dimensional data, the former model performs better. However, this approach does not have a theoretical link with standard statistical models for survival data. This link can be made by means of transformation models when ranking constraints are included. Copyright © 2011 Elsevier B.V. All rights reserved.

Single-port video-assisted thoracoscopic wedge resection: novel approaches in different genders.

PubMed

Xu, Kai; Bian, Wen; Xie, Hongya; Ma, Haitao; Ni, Bin

2016-08-01

To discuss the feasibility, safety and superiority of novel approaches in single-port video-assisted thoracoscopic wedge resection in different genders. The clinical data of patients who underwent thoracoscopic pulmonary wedge resection were analysed. A total of 197 consecutive male patients from January 2012 to December 2014, and 72 female patients from June 2013 to December 2014 were included retrospectively. Of the males, 65 received a transareolar single-port procedure (TASP Group) and 132 received a standard two-port procedure (Standard Group A). Among the females, 18 were treated with a subxiphoid single-port procedure (SXSP Group), and 54 were treated with the standard procedure (Standard Group B). The general clinical materials and surgical outcomes were evaluated. All patients underwent total thoracoscopic wedge resection successfully, and no severe complications were observed. In men, there were no significant differences in operation time, blood loss, postoperative drainage amount, chest drainage duration, postoperative hospital stay or pain score on the first postoperative day (P = 0.827; 0.423; 0.174; 0.440; 0.115; 0.159, respectively). The pain scores of the TASP Group on the day before and after removal of the chest tube were lower (P = 0.006; 0.023, respectively) than those of Standard Group A, and the incision-associated paraesthesia in the third and sixth month after operation was reduced (P = 0.041; 0.026, respectively). The incision satisfaction degree was significantly improved in the TASP Group (P = 0.001). In women, there were no significant differences in blood loss, drainage amount, chest drainage duration or postoperative hospital stay (P = 0.680; 0.757; 0.651; 0.608, respectively). The operation time of the SXSP Group was longer (P = 0.000), and the pain scores on the first postoperative day and the days before and after removal were all significantly lower (P = 0.000; 0.000; 0.000, respectively) than those of the Standard Group B. Furthermore, the incision paraesthesia 3 and 6 months after surgery was greatly reduced (P = 0.001; 0.001, respectively), although the patients were not very satisfied with the cosmetic results (P = 0.577). In single-port thoracoscopic pulmonary wedge resection, we performed 'individualized' procedures based on gender, namely, the transareolar approach in males and the subxiphoid approach in females. These procedures were considered feasible and safe, and showed superiority in reducing postoperative pain. However, the cosmetic results of the subxiphoid approach require further improvement. © The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

An easily implemented static condensation method for structural sensitivity analysis

NASA Technical Reports Server (NTRS)

Gangadharan, S. N.; Haftka, R. T.; Nikolaidis, E.

1990-01-01

A black-box approach to static condensation for sensitivity analysis is presented with illustrative examples of a cube and a car structure. The sensitivity of the structural response with respect to joint stiffness parameter is calculated using the direct method, forward-difference, and central-difference schemes. The efficiency of the various methods for identifying joint stiffness parameters from measured static deflections of these structures is compared. The results indicate that the use of static condensation can reduce computation times significantly and the black-box approach is only slightly less efficient than the standard implementation of static condensation. The ease of implementation of the black-box approach recommends it for use with general-purpose finite element codes that do not have a built-in facility for static condensation.

[Burnout prevalence in pediatricians of general hospitals].

PubMed

Gil-Monte, Pedro R; Marucco, Mariana A

2008-06-01

To assess the prevalence of burnout in pediatricians of general hospitals. Non-randomized cross-sectional study carried out in the city of Buenos Aires, Argentina, in 2006. The study sample comprised 123 pediatricians working in pediatrics services of general hospitals, 89 women (72.4%) and 34 men (27.6%). Data were gathered through an anonymous, self-administered questionnaire. Burnout was measured using the Maslach Burnout Inventory, and different approaches were employed to estimate burnout prevalence. The prevalence of burnout was different according to the approach used: the prevalence was 10.6% by the United States criteria; 24.4% by the Spanish criteria; 37.4% by the Argentinean criteria and 3.25% by the Dutch clinical criteria. Burnout prevalences varied significantly depending on the approach used due to cross-cultural influences.

Standardized Effect Sizes for Moderated Conditional Fixed Effects with Continuous Moderator Variables

PubMed Central

Bodner, Todd E.

2017-01-01

Wilkinson and Task Force on Statistical Inference (1999) recommended that researchers include information on the practical magnitude of effects (e.g., using standardized effect sizes) to distinguish between the statistical and practical significance of research results. To date, however, researchers have not widely incorporated this recommendation into the interpretation and communication of the conditional effects and differences in conditional effects underlying statistical interactions involving a continuous moderator variable where at least one of the involved variables has an arbitrary metric. This article presents a descriptive approach to investigate two-way statistical interactions involving continuous moderator variables where the conditional effects underlying these interactions are expressed in standardized effect size metrics (i.e., standardized mean differences and semi-partial correlations). This approach permits researchers to evaluate and communicate the practical magnitude of particular conditional effects and differences in conditional effects using conventional and proposed guidelines, respectively, for the standardized effect size and therefore provides the researcher important supplementary information lacking under current approaches. The utility of this approach is demonstrated with two real data examples and important assumptions underlying the standardization process are highlighted. PMID:28484404

Evaluating Individual Students' Perceptions of Instructional Quality: An Investigation of their Factor Structure, Measurement Invariance, and Relations to Educational Outcomes.

PubMed

Scherer, Ronny; Nilsen, Trude; Jansen, Malte

2016-01-01

Students' perceptions of instructional quality are among the most important criteria for evaluating teaching effectiveness. The present study evaluates different latent variable modeling approaches (confirmatory factor analysis, exploratory structural equation modeling, and bifactor modeling), which are used to describe these individual perceptions with respect to their factor structure, measurement invariance, and the relations to selected educational outcomes (achievement, self-concept, and motivation in mathematics). On the basis of the Programme for International Student Assessment (PISA) 2012 large-scale data sets of Australia, Canada, and the USA (N = 26,746 students), we find support for the distinction between three factors of individual students' perceptions and full measurement invariance across countries for all modeling approaches. In this regard, bifactor exploratory structural equation modeling outperformed alternative approaches with respect to model fit. Our findings reveal significant relations to the educational outcomes. This study synthesizes different modeling approaches of individual students' perceptions of instructional quality and provides insights into the nature of these perceptions from an individual differences perspective. Implications for the measurement and modeling of individually perceived instructional quality are discussed.

Integrated versus isolated training of the hemiparetic upper extremity in haptically rendered virtual environments.

PubMed

Qiu, Qinyin; Fluet, Gerard G; Saleh, Soha; Lafond, Ian; Merians, Alma S; Adamovich, Sergei V

2010-01-01

This paper describes the preliminary results of an ongoing study of the effects of two training approaches on motor function and learning in persons with hemi paresis due to cerebrovascular accidents. Eighteen subjects with chronic stroke performed eight, three-hour sessions of sensorimotor training in haptically renedered environments. Eleven subjects performed training activities that integrated hand and arm movement while another seven subjects performed activities that trained the hand and arm with separately. As a whole, the eighteen subjects made statistically significant improvements in motor function as evidenced by robust improvements in Wolf Motor Function Test times and corresponding improvements in Jebsen Test of Hand Function times. There were no significant between group effects for these tests. However, the two training approaches elicited different patterns and magnitudes of performance improvement that suggest that they may elicit different types of change in motor learning and or control.

A cross-cultural comparison of population gambling patterns and regulatory frameworks: France and Québec.

PubMed

Kairouz, Sylvia; Paradis, Catherine; Nadeau, Louise; Tovar, Marie-Line; Pousset, Maud

2016-12-01

Few empirical studies have examined the relationships between differing regulatory approaches and patterns of gambling behaviors. This article reports on a correlational cross-cultural comparison of differences in the regulatory approaches and gambling behavior among general adult populations in France and Québec, Canada. We drew data from two large population surveys conducted in France and Québec (N=27 653 and N=11 888, respectively). We found diverging and converging aspects of government regulatory policies. Statistical analyses demonstrated significantly higher participation rates and prevalence of 'assiduous gamblers' in Québec. In France, among assiduous gamblers, the proportion of moderate-risk and probable pathological gamblers is significantly higher. Future research should examine environmental conditions and varying gambling offerings, as well as gambling regulation, to determine their potential influence on gambling behaviors.

Response to Comment on "Does the Earth Have an Adaptive Infrared IRIS?"

NASA Technical Reports Server (NTRS)

Bell, Thomas L.; Chou, Ming-Dah; Lindzen, Richard S.; Hou, Arthur Y.

2001-01-01

Harrison's (2001) Comment on the Methodology in Lindzen et al (2001) has prompted re-examination of several aspects of study. Probably the most significant disagreement in our conclusions is due to our different approaches to minimizing the influence of long-time-scale variations in the variables A and T on the results. Given the strength of the annual cycle and the 20-month period covered by the data, we believe that removing monthly means is a better approach to minimizing the long-time-scale behavior of the data than removal of the linear trend, which might actually add spurious long- time- scale variability into the modified data. We have also indicated how our statistical methods of establishing statistical significance differ. More definitive conclusions may only possible after more data have been analyzed, but we feel that our results are robust enough to encourage further study of this phenomenon.

Definition of sampling units begets conclusions in ecology: the case of habitats for plant communities.

PubMed

Mörsdorf, Martin A; Ravolainen, Virve T; Støvern, Leif Einar; Yoccoz, Nigel G; Jónsdóttir, Ingibjörg Svala; Bråthen, Kari Anne

2015-01-01

In ecology, expert knowledge on habitat characteristics is often used to define sampling units such as study sites. Ecologists are especially prone to such approaches when prior sampling frames are not accessible. Here we ask to what extent can different approaches to the definition of sampling units influence the conclusions that are drawn from an ecological study? We do this by comparing a formal versus a subjective definition of sampling units within a study design which is based on well-articulated objectives and proper methodology. Both approaches are applied to tundra plant communities in mesic and snowbed habitats. For the formal approach, sampling units were first defined for each habitat in concave terrain of suitable slope using GIS. In the field, these units were only accepted as the targeted habitats if additional criteria for vegetation cover were fulfilled. For the subjective approach, sampling units were defined visually in the field, based on typical plant communities of mesic and snowbed habitats. For each approach, we collected information about plant community characteristics within a total of 11 mesic and seven snowbed units distributed between two herding districts of contrasting reindeer density. Results from the two approaches differed significantly in several plant community characteristics in both mesic and snowbed habitats. Furthermore, differences between the two approaches were not consistent because their magnitude and direction differed both between the two habitats and the two reindeer herding districts. Consequently, we could draw different conclusions on how plant diversity and relative abundance of functional groups are differentiated between the two habitats depending on the approach used. We therefore challenge ecologists to formalize the expert knowledge applied to define sampling units through a set of well-articulated rules, rather than applying it subjectively. We see this as instrumental for progress in ecology as only rules based on expert knowledge are transparent and lead to results reproducible by other ecologists.

Climate change adaptation and Integrated Water Resource Management in the water sector

NASA Astrophysics Data System (ADS)

Ludwig, Fulco; van Slobbe, Erik; Cofino, Wim

2014-10-01

Integrated Water Resources Management (IWRM) was introduced in 1980s to better optimise water uses between different water demanding sectors. However, since it was introduced water systems have become more complicated due to changes in the global water cycle as a result of climate change. The realization that climate change will have a significant impact on water availability and flood risks has driven research and policy making on adaptation. This paper discusses the main similarities and differences between climate change adaptation and IWRM. The main difference between the two is the focus on current and historic issues of IWRM compared to the (long-term) future focus of adaptation. One of the main problems of implementing climate change adaptation is the large uncertainties in future projections. Two completely different approaches to adaptation have been developed in response to these large uncertainties. A top-down approach based on large scale biophysical impacts analyses focussing on quantifying and minimizing uncertainty by using a large range of scenarios and different climate and impact models. The main problem with this approach is the propagation of uncertainties within the modelling chain. The opposite is the bottom up approach which basically ignores uncertainty. It focusses on reducing vulnerabilities, often at local scale, by developing resilient water systems. Both these approaches however are unsuitable for integrating into water management. The bottom up approach focuses too much on socio-economic vulnerability and too little on developing (technical) solutions. The top-down approach often results in an “explosion” of uncertainty and therefore complicates decision making. A more promising direction of adaptation would be a risk based approach. Future research should further develop and test an approach which starts with developing adaptation strategies based on current and future risks. These strategies should then be evaluated using a range of future scenarios in order to develop robust adaptation measures and strategies.

The effects of the use of children's literature as an instructional approach on the science knowledge achievement and attitudes of third-grade students

NASA Astrophysics Data System (ADS)

Royce, Christine Anne

This study examined three instructional approaches to determine the comparative effects of using children's literature on the development of factual and conceptual knowledge of third-grade students as well as their attitudes toward the method of instruction and science. Students from four intact classes were taught a six-week, researcher developed unit on the topic of invertebrates for 30 minutes per day that utilized the Directed Reading Approach (DRA). The Naive Comparison Group served as the control for this study and received no instruction on invertebrates. The Textbook Group obtained their information from the Houghton Mifflin Discovery Works textbook series. The Combined Group obtained their information from both textbook series and selected children's tradebooks. The Tradebook Group obtained their information from selected children's tradebooks. This study utilized an adaptation on a non-randomized Pretest-Posttest Group Design. All four intact groups took a pretest and posttest to measure their factual and conceptual knowledge of invertebrates. This data was scored and analyzed for significance at the.05 level using an ANCOVA. No significant differences were found between the four groups for the achievement test. All four intact groups took a pre- and post-attitude survey, which addressed their attitudes toward textbooks, tradebooks, and science. This data was scored and analyzed for significance at the .05 level using three separate, analyses of variance with repeated measures. There were no significant differences between the pre- and post-attitude surveys on the topic of textbooks or tradebooks. There was a significant difference between the pre- and post-attitude surveys for the students' attitudes toward science. It was concluded that the use of tradebooks in place of or in conjunction with textbooks is a viable alternative to the use of textbooks in the elementary science classroom.

Critical appraisal of the top-down approach for vesicoureteral reflux.

PubMed

Abdelhalim, Ahmed; Khoury, Antoine E

2017-06-01

Vesicoureteral reflux (VUR) has been linked to recurrent urinary tract infections (UTIs), renal scarring, hypertension, renal insufficiency and end-stage kidney disease. Different imaging strategies have been proposed to approach children presenting with UTI to sort out patients with significant VUR while minimizing patient morbidity, radiation exposure and financial burden. None of these imaging strategies is universally accepted. The"top-down approach" (TDA) aims at restricting the number of voiding cystourethrograms (VCUGs) and its associated morbidity while identifying patients with clinically-significant reflux. In this approach, children presenting with febrile UTIs are acutely investigated with dimercapto-succinic acid (DMSA) renal scans to identify patients with renal parenchymal inflammation. Those with evidence of renal affection are offered VCUG and late DMSA scan to identify VUR and permanent renal scarring, respectively. Although TDA could identify clinically-significant VUR with high sensitivity, it is not without limitations. The approach segregates patients based on the presence of DMSA cortical lesions omitting the morbidity and the economic burden of UTI. Additionally, some of DMSA lesions are attributed to congenital dysplasia and unrelated to UTI. Ionizing radiation exposure, financial costs, limited availability of DMSA scans in the acute setting, variability in interpreting the results and low yield of actionable findings on DMSA scans are some other limitations. In this review, we tried to address the drawbacks of the TDA and reinforce the value of patient-centered approach for VUR.

Surveying Turkish high school and university students' attitudes and approaches to physics problem solving

NASA Astrophysics Data System (ADS)

Balta, Nuri; Mason, Andrew J.; Singh, Chandralekha

2016-06-01

Students' attitudes and approaches to physics problem solving can impact how well they learn physics and how successful they are in solving physics problems. Prior research in the U.S. using a validated Attitude and Approaches to Problem Solving (AAPS) survey suggests that there are major differences between students in introductory physics and astronomy courses and physics experts in terms of their attitudes and approaches to physics problem solving. Here we discuss the validation, administration, and analysis of data for the Turkish version of the AAPS survey for high school and university students in Turkey. After the validation and administration of the Turkish version of the survey, the analysis of the data was conducted by grouping the data by grade level, school type, and gender. While there are no statistically significant differences between the averages of various groups on the survey, overall, the university students in Turkey were more expertlike than vocational high school students. On an item by item basis, there are statistically differences between the averages of the groups on many items. For example, on average, the university students demonstrated less expertlike attitudes about the role of equations and formulas in problem solving, in solving difficult problems, and in knowing when the solution is not correct, whereas they displayed more expertlike attitudes and approaches on items related to metacognition in physics problem solving. A principal component analysis on the data yields item clusters into which the student responses on various survey items can be grouped. A comparison of the responses of the Turkish and American university students enrolled in algebra-based introductory physics courses shows that on more than half of the items, the responses of these two groups were statistically significantly different, with the U.S. students on average responding to the items in a more expertlike manner.

Machiavellian Ways to Academic Cheating: A Mediational and Interactional Model

PubMed Central

Barbaranelli, Claudio; Farnese, Maria L.; Tramontano, Carlo; Fida, Roberta; Ghezzi, Valerio; Paciello, Marinella; Long, Philip

2018-01-01

Academic cheating has become a pervasive practice from primary schools to university. This study aims at investigating this phenomenon through a nomological network which integrates different theoretical frameworks and models, such as trait and social-cognitive theories and models regarding the approaches to learning and contextual/normative environment. Results on a sample of more than 200 Italian university students show that the Amoral Manipulation facet of Machiavellianism, Academic Moral Disengagement, Deep Approach to Learning, and Normative Academic Cheating are significantly associated with Individual Academic Cheating. Moreover, results show a significant latent interaction effect between Normative Academic Cheating and Amoral Manipulation Machiavellianism: “amoral Machiavellians” students are more prone to resort to Academic Cheating in contexts where Academic Cheating is adopted as a practice by their peers, while this effect is not significant in contexts where Academic Cheating is not normative. Results also show that Academic Moral Disengagement and Deep Approach to learning partially mediate the relationship between Amoral Manipulation and Academic Cheating. Practical implications of these results are discussed. PMID:29867663

On the distinction between large deformation and large distortion for anisotropic materials

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

BRANNON,REBECCA M.

2000-02-24

A motion involves large distortion if the ratios of principal stretches differ significantly from unity. A motion involves large deformation if the deformation gradient tensor is significantly different from the identity. Unfortunately, rigid rotation fits the definition of large deformation, and models that claim to be valid for large deformation are often inadequate for large distortion. An exact solution for the stress in an idealized fiber-reinforced composite is used to show that conventional large deformation representations for transverse isotropy give errant results. Possible alternative approaches are discussed.

Conservation planning for biodiversity and wilderness: a real-world example.

PubMed

Ceauşu, Silvia; Gomes, Inês; Pereira, Henrique Miguel

2015-05-01

Several of the most important conservation prioritization approaches select markedly different areas at global and regional scales. They are designed to maximize a certain biodiversity dimension such as coverage of species in the case of hotspots and complementarity, or composite properties of ecosystems in the case of wilderness. Most comparisons between approaches have ignored the multidimensionality of biodiversity. We analyze here the results of two species-based methodologies-hotspots and complementarity-and an ecosystem-based methodology-wilderness-at local scale. As zoning of protected areas can increase the effectiveness of conservation, we use the data employed for the management plan of the Peneda-Gerês National Park in Portugal. We compare the approaches against four criteria: species representativeness, wilderness coverage, coverage of important areas for megafauna, and for regulating ecosystem services. Our results suggest that species- and ecosystem-based approaches select significantly different areas at local scale. Our results also show that no approach covers well all biodiversity dimensions. Species-based approaches cover species distribution better, while the ecosystem-based approach favors wilderness, areas important for megafauna, and for ecosystem services. Management actions addressing different dimensions of biodiversity have a potential for contradictory effects, social conflict, and ecosystem services trade-offs, especially in the context of current European biodiversity policies. However, biodiversity is multidimensional, and management and zoning at local level should reflect this aspect. The consideration of both species- and ecosystem-based approaches at local scale is necessary to achieve a wider range of conservation goals.

Conservation Planning for Biodiversity and Wilderness: A Real-World Example

NASA Astrophysics Data System (ADS)

Ceauşu, Silvia; Gomes, Inês; Pereira, Henrique Miguel

2015-05-01

Several of the most important conservation prioritization approaches select markedly different areas at global and regional scales. They are designed to maximize a certain biodiversity dimension such as coverage of species in the case of hotspots and complementarity, or composite properties of ecosystems in the case of wilderness. Most comparisons between approaches have ignored the multidimensionality of biodiversity. We analyze here the results of two species-based methodologies—hotspots and complementarity—and an ecosystem-based methodology—wilderness—at local scale. As zoning of protected areas can increase the effectiveness of conservation, we use the data employed for the management plan of the Peneda-Gerês National Park in Portugal. We compare the approaches against four criteria: species representativeness, wilderness coverage, coverage of important areas for megafauna, and for regulating ecosystem services. Our results suggest that species- and ecosystem-based approaches select significantly different areas at local scale. Our results also show that no approach covers well all biodiversity dimensions. Species-based approaches cover species distribution better, while the ecosystem-based approach favors wilderness, areas important for megafauna, and for ecosystem services. Management actions addressing different dimensions of biodiversity have a potential for contradictory effects, social conflict, and ecosystem services trade-offs, especially in the context of current European biodiversity policies. However, biodiversity is multidimensional, and management and zoning at local level should reflect this aspect. The consideration of both species- and ecosystem-based approaches at local scale is necessary to achieve a wider range of conservation goals.

Plant Rhizosphere Selection of Plasmodiophorid Lineages from Bulk Soil: The Importance of “Hidden” Diversity

PubMed Central

Bass, David; van der Gast, Christopher; Thomson, Serena; Neuhauser, Sigrid; Hilton, Sally; Bending, Gary D.

2018-01-01

Microbial communities closely associated with the rhizosphere can have strong positive and negative impacts on plant health and growth. We used a group-specific amplicon approach to investigate local scale drivers in the diversity and distribution of plasmodiophorids in rhizosphere/root and bulk soil samples from oilseed rape (OSR) and wheat agri-systems. Plasmodiophorids are plant- and stramenopile-associated protists including well known plant pathogens as well as symptomless endobiotic species. We detected 28 plasmodiophorid lineages (OTUs), many of them novel, and showed that plasmodiophorid communities were highly dissimilar and significantly divergent between wheat and OSR rhizospheres and between rhizosphere and bulk soil samples. Bulk soil communities were not significantly different between OSR and wheat systems. Wheat and OSR rhizospheres selected for different plasmodiophorid lineages. An OTU corresponding to Spongospora nasturtii was positively selected in the OSR rhizosphere, as were two genetically distinct OTUs. Two novel lineages related to Sorosphaerula veronicae were significantly associated with wheat rhizosphere samples, indicating unknown plant-protist relationships. We show that group-targeted eDNA approaches to microbial symbiont-host ecology reveal significant novel diversity and enable inference of differential activity and potential interactions between sequence types, as well as their presence. PMID:29503632

Educational environment and approaches to learning of undergraduate nursing students in an Indonesian school of nursing.

PubMed

Rochmawati, Erna; Rahayu, Gandes Retno; Kumara, Amitya

2014-11-01

The aims of this study were to assess students' perceptions of their educational environment and approaches to learning, and determine if perceptions of learning environment associates with approaches to learning. A survey was conducted to collect data from a regional private university in Indonesia. A total of 232 nursing students completed two questionnaires that measured their perceptions of educational environment and approaches to learning. The measurement was based on Dundee Ready Education Environment Measurement (DREEM) and Approaches and Study Skills Inventory for Students (ASSIST). Five learning environments dimensions and three learning approaches dimensions from two measures were measured. The overall score of DREEM was 131.03/200 (SD 17.04), it was in the range considered to be favourable. The overall score is different significantly between years of study (p value = 0.01). This study indicated that the majority of undergraduate nursing students' adopt strategic approach (n = 139. 59.9%). The finding showed that perceived educational environment significantly associated with approaches to learning. This study implicated the need to maintain conducive learning environment. There is also a need to improve the management of learning activities that reflect the use of student-centered learning. Copyright © 2014 Elsevier Ltd. All rights reserved.

Benefit of cerebrospinal fluid spectrophotometry in the assessment of CT scan negative suspected subarachnoid haemorrhage: a diagnostic accuracy study.

PubMed

Hann, Angus; Chu, Kevin; Greenslade, Jaimi; Williams, Julian; Brown, Anthony

2015-01-01

This study aimed to determine if performing cerebrospinal fluid spectrophotometry in addition to visual inspection detects more ruptured cerebral aneurysms than performing cerebrospinal fluid visual inspection alone in patients with a normal head CT scan but suspected of suffering an aneurysmal subarachnoid haemorrhage (SAH). We performed a single-centre retrospective study of patients presenting to the emergency department of a tertiary hospital who underwent both head CT scan and lumbar puncture to exclude SAH. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of an approach utilising both spectrophotometry and visual inspection (combined approach) was compared to visual inspection alone. A total of 409 patients (mean age 37.8 years, 56.2% female) were recruited and six (1.5%) had a cerebral aneurysm on angiography. The sensitivity of visual inspection was 50% (95% confidence interval [CI]: 12.4-82.6%), specificity was 99% (95% CI: 97.5-99.7%), PPV was 42.9% (95% CI: 10.4-81.3%) and NPV was 99.2% (95% CI: 97.8-99.8%). The combined approach had a sensitivity of 100% (95% CI: 54.1-100%), specificity of 79.7% (95% CI: 75.4-83.5%), PPV of 6.8% (95% CI: 2.6-14.3%) and a NPV of 100% (95% CI: 98.8-100%). The sensitivity of the combined approach was not significantly different to that of visual inspection alone (p=0.25). Visual inspection had a significantly higher specificity than the combined approach (p<0.01). The combined approach detected more cases of aneurysmal SAH than visual inspection alone, however the difference in sensitivity was not statistically significant. Visual xanthochromia should prompt angiography because of a superior specificity and PPV. Due to its reduced sensitivity, caution should be applied when using only visual inspection of the supernatant. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

[Optimization of organizational approaches to management of patients with atherosclerosis].

PubMed

Barbarash, L S; Barbarash, O L; Artamonova, G V; Sumin, A N

2014-01-01

Despite undoubted achievements of modern cardiology in prevention and treatment of atherosclerosis, cardiologists, neurologists, and vascular surgeons are still facing severe stenotic atherosclerotic lesions in different vascular regions, both symptomatic and asymptomatic. As a rule hemodynamically significant stenoses of different locations are found after development of acute vascular events. In this regard, active detection of arterial stenoses localized in different areas just at primary contact of patients presenting with symptoms of ischemia of various locations with care providers appears to be crucial. Further monitoring of these stenoses is also important. The article is dedicated to innovative organizational approaches to provision of healthcare to patients suffering from circulatory system diseases that have contributed to improvement of demographic situation in Kuzbass.

A resilience approach can improve anadromous fish restoration

USGS Publications Warehouse

Waldman, John R.; Wilson, Karen A.; Mather, Martha E.; Snyder, Noah P.

2016-01-01

Most anadromous fish populations remain at low levels or are in decline despite substantial investments in restoration. We explore whether a resilience perspective (i.e., a different paradigm for understanding populations, communities, and ecosystems) is a viable alternative framework for anadromous fish restoration. Many life history traits have allowed anadromous fish to thrive in unimpacted ecosystems but have become contemporary curses as anthropogenic effects increase. This contradiction creates a significant conservation challenge but also makes these fish excellent candidates for a resilience approach. A resilience approach recognizes the need to maintain life history, population, and habitat characteristics that increase the ability of a population to withstand and recover from multiple disturbances. To evaluate whether a resilience approach represents a viable strategy for anadromous fish restoration, we review four issues: (1) how resilience theory can inform anadromous fish restoration, (2) how a resilience-based approach is fundamentally different than extant anadromous fish restoration strategies, (3) ecological characteristics that historically benefited anadromous fish persistence, and (4) examples of how human impacts harm anadromous fish and how a resilience approach might produce more successful outcomes. We close by suggesting new research and restoration directions for implementation of a resilience-based approach.

Sequence System Building Blocks: Using a Component Architecture for Sequencing Software

NASA Technical Reports Server (NTRS)

Streiffert, Barbara A.; O'Reilly, Taifun

2005-01-01

Over the last few years software engineering has made significant strides in making more flexible architectures and designs possible. However, at the same time, spacecraft have become more complex and flight software has become more sophisticated. Typically spacecraft are often one-of-a-kind entities that have different hardware designs, different capabilities, different instruments, etc. Ground software has become more complex and operations teams have had to learn a myriad of tools that all have different user interfaces and represent data in different ways. At Jet Propulsion Laboratory (JPL) these themes have collided to require an new approach to producing ground system software. Two different groups have been looking at tackling this particular problem. One group is working for the JPL Mars Technology Program in the Mars Science Laboratory (MSL) Focused Technology area. The other group is the JPL Multi-Mission Planning and Sequencing Group . The major concept driving these two approaches on a similar path is to provide software that can be a more cohesive flexible system that provides a act of planning and sequencing system of services. This paper describes the efforts that have been made to date to create a unified approach from these disparate groups.

Sequencing System Building Blocks: Using a Component Architecture for Sequencing Software

NASA Technical Reports Server (NTRS)

Streiffert, Barbara A.; O'Reilly, Taifun

2006-01-01

Over the last few years software engineering has made significant strides in making more flexible architectures and designs possible. However, at the same time, spacecraft have become more complex and flight software has become more sophisticated. Typically spacecraft are often one-of-a-kind entities that have different hardware designs, different capabilities, different instruments, etc. Ground software has become more complex and operations teams have had to learn a myriad of tools that all have different user interfaces and represent data in different ways. At Jet Propulsion Laboratory (JPL) these themes have collided to require a new approach to producing ground system software. Two different groups have been looking at tackling this particular problem. One group is working for the JPL Mars Technology Program in the Mars Science Laboratory (MSL) Focused Technology area. The other group is the JPL Multi-Mission Planning and Sequencing Group. The major concept driving these two approaches on a similar path is to provide software that can be a more cohesive flexible system that provides a set of planning and sequencing system of services. This paper describes the efforts that have been made to date to create a unified approach from these disparate groups.

Bayesian longitudinal segmentation of hippocampal substructures in brain MRI using subject-specific atlases

PubMed Central

Iglesias, Juan Eugenio; Van Leemput, Koen; Augustinack, Jean; Insausti, Ricardo; Fischl, Bruce; Reuter, Martin

2016-01-01

The hippocampal formation is a complex, heterogeneous structure that consists of a number of distinct, interacting subregions. Atrophy of these subregions is implied in a variety of neurodegenerative diseases, most prominently in Alzheimer’s disease (AD). Thanks to the increasing resolution of MR images and computational atlases, automatic segmentation of hippocampal subregions is becoming feasible in MRI scans. Here we introduce a generative model for dedicated longitudinal segmentation that relies on subject-specific atlases. The segmentations of the scans at the different time points are jointly computed using Bayesian inference. All time points are treated the same to avoid processing bias. We evaluate this approach using over 4,700 scans from two publicly available datasets (ADNI and MIRIAD). In test-retest reliability experiments, the proposed method yielded significantly lower volume differences and significantly higher Dice overlaps than the cross-sectional approach for nearly every subregion (average across subregions: 4.5% vs. 6.5%, Dice overlap: 81.8% vs. 75.4%). The longitudinal algorithm also demonstrated increased sensitivity to group differences: in MIRIAD (69 subjects: 46 with AD and 23 controls), it found differences in atrophy rates between AD and controls that the cross sectional method could not detect in a number of subregions: right parasubiculum, left and right presubiculum, right subiculum, left dentate gyrus, left CA4, left HATA and right tail. In ADNI (836 subjects: 369 with AD, 215 with early cognitive impairment – eMCI – and 252 controls), all methods found significant differences between AD and controls, but the proposed longitudinal algorithm detected differences between controls and eMCI and differences between eMCI and AD that the cross sectional method could not find: left presubiculum, right subiculum, left and right parasubiculum, left and right HATA. Moreover, many of the differences that the cross-sectional method already found were detected with higher significance. The presented algorithm will be made available as part of the open-source neuroimaging package FreeSurfer. PMID:27426838

Use of Complementary Health Approaches Among Children Aged 4–17 Years in the United States: National Health Interview Survey, 2007–2012

PubMed Central

Black, Lindsey I.; Clarke, Tainya C.; Barnes, Patricia M.; Stussman, Barbara J.; Nahin, Richard L.

2015-01-01

Objective This report presents national estimates of the use of complementary health approaches among children aged 4–17 years in the United States. Selected modalities are compared for 2007 and 2012 to examine changes over time. Methods Data from the 2007 and 2012 National Health Interview Survey (NHIS) were analyzed for this report. The combined sample included 17,321 interviews with knowledgeable adults about children aged 4–17 years. Point estimates and estimates of their variances were calculated using SUDAAN software to account for the complex sampling design of NHIS. Differences between percentages were evaluated using two-sided significance tests at the 0.05 level. Results The use of complementary health approaches among children did not change significantly since 2007 (from 12.0% in 2007 to 11.6% in 2012). However, one approach, the use of traditional healers, showed a statistically significant decrease in use, from 1.1% in 2007 to 0.1% in 2012. No other significant decreases were identified. An increase in the use of yoga was observed during this period (from 2.3% in 2007 to 3.1% in 2012). Nonvitamin, nonmineral dietary supplements; chiropractic or osteopathic manipulation; and yoga, tai chi, or qi gong were the most commonly used complementary health approaches in both 2007 and 2012. Also consistent between 2007 and 2012 was that complementary health approaches were most frequently used for back or neck pain, head or chest cold, anxiety or stress, and other musculoskeletal conditions. PMID:25671583

Weighting of the data and analytical approaches may account for differences in overcoming the inadequate representativeness of the respondents to the third wave of a cohort study.

PubMed

Taylor, Anne W; Dal Grande, Eleonora; Grant, Janet; Appleton, Sarah; Gill, Tiffany K; Shi, Zumin; Adams, Robert J

2013-04-01

Attrition in cohort studies can cause the data to be nonreflective of the original population. Although of little concern if intragroup comparisons are being made or cause and effect assessed, the assessment of bias was undertaken in this study so that intergroup or descriptive analyses could be undertaken. The North West Adelaide Health Study is a chronic disease and risk factor cohort study undertaken in Adelaide, South Australia. In the original wave (1999), clinical and self-report data were collected from 4,056 adults. In the third wave (2008-2010), 2,710 adults were still actively involved. Comparisons were made against two other data sources: Australian Bureau of Statistics Estimated Residential Population and a regular conducted chronic disease and risk factor surveillance system. Comparisons of demographics (age, sex, area, education, work status, and income) proved to be statistically significantly different. In addition, smoking status, body mass index, and general health status were statistically significant from the comparison group. No statistically significant differences were found for alcohol risk. Although the third wave of this cohort study is not representative of the broader population on the variables assessed, weighting of the data and analytical approaches can account for differences. Copyright © 2013 Elsevier Inc. All rights reserved.

Seasonal trends in Ceratitis capitata reproductive potential derived from live-caught females in Greece

PubMed Central

Kouloussis, Nikos A.; Papadopoulos, Nikos T.; Katsoyannos, Byron I.; Müller, Hans-Georg; Wang, Jane-Ling; Su, Yu-Ru; Molleman, Freerk; Carey, James R.

2012-01-01

Reproductive data of individual insects are extremely hard to collect under natural conditions, thus the study of research questions related to oviposition has not advanced. Patterns of oviposition are often inferred only indirectly, through monitoring of host infestation, whereas the influence of age structure and several other factors on oviposition remains unknown. Using a new approach, in this article, we live-trapped wild Ceratitis capitata (Wiedemann) (Diptera: Tephritidae) females on the Greek island of Chios during two field seasons. For their remaining lifetime, these females were placed individually in small cages and their daily oviposition was monitored. Reproduction rates between cohorts from different collection dates were then compared. The results showed that in the different captive cohorts the average remaining lifetime and reproduction were highly variable within and between seasons. Multivariate regression analysis showed that the month of capture had a significant effect on captive life span, average daily reproduction, and patterns of egg laying. The effect of year was significant on reproduction, but not on captive life span. These differences between sampling periods probably reflect differences in the availability of hosts and other factors that vary during the season and affect age structure and reproduction. Using a non-parametric generalized additive model, we found a statistically significant correlation between the captive life span and the average daily reproduction. These findings and the experimental approach have several important implications. PMID:22791908

Statistical Genomic Approach Identifies Association between FSHR Polymorphisms and Polycystic Ovary Morphology in Women with Polycystic Ovary Syndrome

PubMed Central

Du, Tao; Duan, Yu; Li, Kaiwen; Zhao, Xiaomiao; Ni, Renmin; Li, Yu; Yang, Dongzi

2015-01-01

Background. Single-nucleotide polymorphisms (SNPs) in the follicle stimulating hormone receptor (FSHR) gene are associated with PCOS. However, their relationship to the polycystic ovary (PCO) morphology remains unknown. This study aimed to investigate whether PCOS related SNPs in the FSHR gene are associated with PCO in women with PCOS. Methods. Patients were grouped into PCO (n = 384) and non-PCO (n = 63) groups. Genomic genotypes were profiled using Affymetrix human genome SNP chip 6. Two polymorphisms (rs2268361 and rs2349415) of FSHR were analyzed using a statistical approach. Results. Significant differences were found in the allele distributions of the GG genotype of rs2268361 between the PCO and non-PCO groups (27.6% GG, 53.4% GA, and 19.0% AA versus 33.3% GG, 36.5% GA, and 30.2% AA), while no significant differences were found in the allele distributions of the GG genotype of rs2349415. When rs2268361 was considered, there were statistically significant differences of serum follicle stimulating hormone, estradiol, and sex hormone binding globulin between genotypes in the PCO group. In case of the rs2349415 SNP, only serum sex hormone binding globulin was statistically different between genotypes in the PCO group. Conclusions. Functional variants in FSHR gene may contribute to PCO susceptibility in women with PCOS. PMID:26273622

Towards multilevel mental stress assessment using SVM with ECOC: an EEG approach.

PubMed

Al-Shargie, Fares; Tang, Tong Boon; Badruddin, Nasreen; Kiguchi, Masashi

2018-01-01

Mental stress has been identified as one of the major contributing factors that leads to various diseases such as heart attack, depression, and stroke. To avoid this, stress quantification is important for clinical intervention and disease prevention. This study aims to investigate the feasibility of exploiting electroencephalography (EEG) signals to discriminate between different stress levels. We propose a new assessment protocol whereby the stress level is represented by the complexity of mental arithmetic (MA) task for example, at three levels of difficulty, and the stressors are time pressure and negative feedback. Using 18-male subjects, the experimental results showed that there were significant differences in EEG response between the control and stress conditions at different levels of MA task with p values < 0.001. Furthermore, we found a significant reduction in alpha rhythm power from one stress level to another level, p values < 0.05. In comparison, results from self-reporting questionnaire NASA-TLX approach showed no significant differences between stress levels. In addition, we developed a discriminant analysis method based on multiclass support vector machine (SVM) with error-correcting output code (ECOC). Different stress levels were detected with an average classification accuracy of 94.79%. The lateral index (LI) results further showed dominant right prefrontal cortex (PFC) to mental stress (reduced alpha rhythm). The study demonstrated the feasibility of using EEG in classifying multilevel mental stress and reported alpha rhythm power at right prefrontal cortex as a suitable index.

The relationship between learning preferences (styles and approaches) and learning outcomes among pre-clinical undergraduate medical students.

PubMed

Liew, Siaw-Cheok; Sidhu, Jagmohni; Barua, Ankur

2015-03-11

Learning styles and approaches of individual undergraduate medical students vary considerably and as a consequence, their learning needs also differ from one student to another. This study was conducted to identify different learning styles and approaches of pre-clinical, undergraduate medical students and also to determine the relationships of learning preferences with performances in the summative examinations. A cross-sectional study was conducted among randomly selected 419 pre-clinical, undergraduate medical students of the International Medical University (IMU) in Kuala Lumpur. The number of students from Year 2 was 217 while that from Year 3 was 202. The Visual, Auditory, Read/Write, Kinesthetic (VARK) and the Approaches and Study Skills Inventory for Students (ASSIST) questionnaires were used for data collection. This study revealed that 343 students (81.9%) had unimodal learning style, while the remaining 76 (18.1%) used a multimodal learning style. Among the unimodal learners, a majority (30.1%) were of Kinesthetic (K) type. Among the middle and high achievers in summative examinations, a majority had unimodal (Kinaesthetic) learning style (30.5%) and were also strategic/deep learners (79.4%). However, the learning styles and approaches did not contribute significantly towards the learning outcomes in summative examinations. A majority of the students in this study had Unimodal (Kinesthetic) learning style. The learning preferences (styles and approaches) did not contribute significantly to the learning outcomes. Future work to re-assess the viability of these learning preferences (styles and approaches) after the incorporation of teaching-learning instructions tailored specifically to the students will be beneficial to help medical teachers in facilitating students to become more capable learners.

Visualization of the Capitellum During Elbow Arthroscopy: A Comparison of 3 Portal Techniques

PubMed Central

Trofa, David P.; Gancarczyk, Stephanie M.; Lombardi, Joseph M.; Makhni, Eric C.; Popkin, Charles A.; Ahmad, Christopher S.

2017-01-01

Background: Capitellar osteochondritis dissecans (OCD) is a debilitating condition of unknown etiology for which various arthroscopic treatments are available. Prior data suggest that greater than 75% of the capitellum can be visualized arthroscopically through a dual lateral portal approach. However, there is no literature assessing arthroscopic visualization of the capitellum via alternative portals. Purpose: To determine the percentage of capitellum visualized using the dual lateral, distal ulnar and soft spot, and posterolateral and soft spot portal configurations in a cadaver model. Study Design: Descriptive laboratory study. Methods: Arthroscopy was performed on 12 fresh-frozen cadaver elbows, 4 for each of the following approaches: dual lateral, distal ulna, and posterolateral. Electrocautery was used to mark the most anterior, posterior, medial, and lateral points seen on the capitellum. The radiocapitellar joint was subsequently exposed through an extensile posterior dissection, and the surface anatomy was reconstructed using the Microscribe 3D digitizing system. Using Rhinoceros software, the percentage of capitellum surface area visualized by each approach was determined. Results: The mean percentage of capitellum visualized for the dual lateral, distal ulna, and posterolateral approaches was approximately 68.8%, 66.3%, and 63.5%, respectively. There was no significant difference between the percentage of capitellum seen among approaches (P = .68). On average, 66.5% of the capitellum was visible through these 3 arthroscopic approaches to the elbow. Conclusion: Approximately 66.5% of the capitellum is visualized through the popularized posterior arthroscopic portals, with no significant differences found between the 3 investigated approaches. Clinical Relevance: As determined in this cadaveric model investigation, each portal technique provides equivalent visualization for capitellar OCD pathology. PMID:28680895

[The safety and effect of transhepatic hilar approach for the treatment of bismuth type Ⅲ and Ⅳ hilar cholangiocarcinoma].

PubMed

He, M; Wang, H L; Yan, J Y; Xu, S W; Chen, W; Wang, J

2018-05-01

Objective: To compare the efficiency between the transhepatic hilar approach and conventional approach for the surgical treatment of Bismuth type Ⅲ and Ⅳ hilar cholangiocarcinoma. Methods: There were 42 consecutive patients with hilar cholangiocarcinoma of Bismuth type Ⅲ and Ⅳ who underwent surgical treatment at Department of Biliary-Pancreatic Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University from January 2008 to December 2013.The transhepatic hilar approach was used in 19 patients and conventional approach was performed in 23 patients.There were no differences in clinical parameters between the two groups(all P >0.05). The t-test was used to analyze the measurement data, and the χ(2) test was used to analyze the count data.Kaplan-Meier analysis was used to analyze the survival period.Multivariate COX regression analysis was used to analyze the prognosis factors. Results: Among the 19 patients who underwent transhepatic hilar approach, 3 patients changed the operative planning after reevaluated by exposing the hepatic hilus.The intraoperative blood was 300(250-400)ml in the transhepatic hilar approach group, which was significantly less than the conventional approach group, 800(450-1 300)ml( t =4.276, P =0.00 1), meanwhile, the R0 resection rate was significantly higher in the transhepatic hilar approach group than in the conventional approach group(89.4% vs . 52.2; χ(2)=6.773, P =0.009) and the 3-year and 5-year cumulative survival rate was better in the transhepatic hilar approach group than in the conventional approach group(63.2% vs . 47.8%, 26.3% vs . 0; χ(2)=66.363, 127.185, P =0.000). On univariate analysis, transhepatic hilar approach, intraoperative blood loss, intraoperative blood transfusion, R0 resection and lymph node metastasis were significant risk factors for patient survival(all P <0.05). On multivariate analysis, use of transhepatic hilar approach, intraoperative blood loss, R0 resection and lymph node metastasis were significant independent risk factors for patient survival(all P <0.05). Conclusion: The transhepatic hilar approach is the preferred technique for surgical treatment for hilar cholangiocarcinoma because it can improve accuracy of surgical planning, safety of operation, R0 resection rate and survival rate compared with the conventional approach.

Bilateral versus unilateral interlaminar approach for bilateral decompression in patients with single-level degenerative lumbar spinal stenosis: a multicenter retrospective study of 175 patients on postoperative pain, functional disability, and patient satisfaction.

PubMed

den Boogert, Hugo F; Keers, Joost C; Marinus Oterdoom, D L; Kuijlen, Jos M A

2015-09-01

The bilateral and unilateral interlaminar techniques for bilateral decompression both demonstrate good results for the treatment of degenerative lumbar spinal stenosis (DLSS). Although there is some discussion about which approach is more effective, studies that directly compare these two popular techniques are rare. To address this shortcoming, this study compares postoperative functional disability, pain, and patient satisfaction among patients with single-level DLSS who underwent bilateral decompression using either a bilateral or unilateral approach. This retrospective study included patients who underwent operations between November 1, 2009, and October 1, 2011. These patients underwent single-level bilateral decompressive surgery using either the bilateral or unilateral interlaminar approach at one of 5 participating hospitals. Exclusion criteria included previous lumbar surgery, additional disc surgery, and spondylolisthesis requiring fusion surgery. Primary outcome measures included bodily pain (as reported using the visual analog scale [VAS]), the Roland-Morris Disability Questionnaire (RMDQ), and the Oswestry Disability Index (ODI). In addition, reductions in leg and back symptoms and the patient's general evaluation of the procedure were queried. Finally, patient satisfaction and surgical parameters were evaluated. Questionnaires were sent to each patient's home, and electronic patient files were used to collect the data. One hundred and seventy-five patients returned the questionnaire (74.4% response rate; 68 and 107 patients who underwent the bilateral or unilateral approach, respectively). Mean age at surgery was 68 years (range 34-89 years), and the mean follow-up period was 14.2 months (range 3.3-27.4 years). There were no significant differences in ODI (20.3 vs 22.6 for the bilateral and unilateral approaches, respectively), RMDQ (3.99 vs 4.8, respectively), or pain scores between treatment groups. Back symptoms were reduced in 74.8% (bilateral: 74.6% vs unilateral: 75%; not significant), and leg symptoms in 80.6% of the patients (bilateral: 73.1% vs unilateral: 85.4%; p = 0.048). In total, 72.1% (bilateral) and 80.0% (unilateral) of patients reported good overall treatment results (p = 0.226). Significantly more patients in the unilateral group reported a better overall satisfaction with the procedure (82.1% vs 69.1%; p = 0.047). There were no differences in postoperative functional disability and pain between the surgical techniques. The significant differences in patient satisfaction and reduction in leg symptoms were unrelated to surgical technique. The overall treatment results were satisfactory. Both techniques are safe and effective options for treating patients with single-level DLSS.

A Proof of Concept Study of Function-Based Statistical Analysis of fNIRS Data: Syntax Comprehension in Children with Specific Language Impairment Compared to Typically-Developing Controls.

PubMed

Fu, Guifang; Wan, Nicholas J A; Baker, Joseph M; Montgomery, James W; Evans, Julia L; Gillam, Ronald B

2016-01-01

Functional near infrared spectroscopy (fNIRS) is a neuroimaging technology that enables investigators to indirectly monitor brain activity in vivo through relative changes in the concentration of oxygenated and deoxygenated hemoglobin. One of the key features of fNIRS is its superior temporal resolution, with dense measurements over very short periods of time (100 ms increments). Unfortunately, most statistical analysis approaches in the existing literature have not fully utilized the high temporal resolution of fNIRS. For example, many analysis procedures are based on linearity assumptions that only extract partial information, thereby neglecting the overall dynamic trends in fNIRS trajectories. The main goal of this article is to assess the ability of a functional data analysis (FDA) approach for detecting significant differences in hemodynamic responses recorded by fNIRS. Children with and without SLI wore two, 3 × 5 fNIRS caps situated over the bilateral parasylvian areas as they completed a language comprehension task. FDA was used to decompose the high dimensional hemodynamic curves into the mean function and a few eigenfunctions to represent the overall trend and variation structures over time. Compared to the most popular GLM, we did not assume any parametric structure and let the data speak for itself. This analysis identified significant differences between the case and control groups in the oxygenated hemodynamic mean trends in the bilateral inferior frontal and left inferior posterior parietal brain regions. We also detected significant group differences in the deoxygenated hemodynamic mean trends in the right inferior posterior parietal cortex and left temporal parietal junction. These findings, using dramatically different approaches, experimental designs, data sets, and foci, were consistent with several other reports, confirming group differences in the importance of these two areas for syntax comprehension. The proposed FDA was consistent with the temporal characteristics of fNIRS, thus providing an alternative methodology for fNIRS analyses.

Algorithm for Correcting the Keratometric Error in the Estimation of the Corneal Power in Keratoconus Eyes after Accelerated Corneal Collagen Crosslinking

PubMed Central

Caravaca-Arens, Esteban; de Fez, Dolores; Blanes-Mompó, Francisco J.

2017-01-01

Purpose To analyze the errors associated to corneal power calculation using the keratometric approach in keratoconus eyes after accelerated corneal collagen crosslinking (CXL) surgery and to obtain a model for the estimation of an adjusted corneal refractive index (nkadj) minimizing such errors. Methods Potential differences (ΔPc) among keratometric (Pk) and Gaussian corneal power (PcGauss) were simulated. Three algorithms based on the use of nkadj for the estimation of an adjusted keratometric corneal power (Pkadj) were developed. The agreement between Pk(1.3375) (keratometric power using the keratometric index of 1.3375), PcGauss, and Pkadj was evaluated. The validity of the algorithm developed was investigated in 21 keratoconus eyes undergoing accelerated CXL. Results P k(1.3375) overestimated corneal power between 0.3 and 3.2 D in theoretical simulations and between 0.8 and 2.9 D in the clinical study (ΔPc). Three linear equations were defined for nkadj to be used for different ranges of r1c. In the clinical study, differences between Pkadj and PcGauss did not exceed ±0.8 D nk = 1.3375. No statistically significant differences were found between Pkadj and PcGauss (p > 0.05) and Pk(1.3375) and Pkadj (p < 0.001). Conclusions The use of the keratometric approach in keratoconus eyes after accelerated CXL can lead to significant clinical errors. These errors can be minimized with an adjusted keratometric approach. PMID:29201459

Considering Value in Rectal Cancer Surgery: An Analysis of Costs and Outcomes Based on the Open, Laparoscopic, and Robotic Approach for Proctectomy.

PubMed

Silva-Velazco, Jorge; Dietz, David W; Stocchi, Luca; Costedio, Meagan; Gorgun, Emre; Kalady, Matthew F; Kessler, Hermann; Lavery, Ian C; Remzi, Feza H

2017-05-01

The aim of the study was to compare value (outcomes/costs) of proctectomy in patients with rectal cancer by 3 approaches: open, laparoscopic, and robotic. The role of minimally invasive proctectomy in rectal cancer is controversial. In the era of value-based medicine, costs must be considered along with outcomes. Primary rectal cancer patients undergoing curative intent proctectomy at our institution between 2010 and 2014 were included. Patients were grouped by approach [open surgery, laparoscopic surgery, and robotic surgery (RS)] on an intent-to-treat basis. Groups were compared by direct costs of hospitalization for the primary resection, 30-day readmissions, and ileostomy closure and for short-term outcomes. A total of 488 patients were evaluated; 327 were men (67%), median age was 59 (27-93) years, and restorative procedures were performed in 333 (68.2%). Groups were similar in demographics, tumor characteristics, and treatment details. Significant outcome differences between groups were found in operative and anesthesia times (longer in the RS group), and in estimated blood loss, intraoperative transfusion, length of stay, and postoperative complications (all higher in the open surgery group). No significant differences were found in short-term oncologic outcomes. Direct cost of the hospitalization for primary resection and total direct cost (including readmission/ileostomy closure hospitalizations) were significantly greater in the RS group. The laparoscopic and open approaches to proctectomy in patients with rectal cancer provide similar value. If robotic proctectomy is to be widely applied in the future, the costs of the procedure must be reduced.

Individual differences in posttraumatic distress: problems with the DSM-IV model.

PubMed

Bowman, M L

1999-02-01

To evaluate the evidence concerning the role of threatening life events in accounting for clinically significant posttraumatic stress responses. Research was examined to review the epidemiology, evidence of dose-response relations, and individual difference factors in accounting for variations in conditions, including posttraumatic stress disorder, after exposure to threatening events. The evidence is significantly discrepant from the clinical Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) model. Greater distress arises from individual differences than from event characteristics. Important individual differences that interact with threat exposures include trait negative affectivity (neuroticism); beliefs about emotions, the self, the world, and the sources and consequences of danger; and prevent acts, disorders, and intelligence. Reasons for the discrepancies between the evidence and the current model of posttraumatic distress are proposed. In accounting for responses to threatening life events, the relatively minor contribution of event qualities compared with individual differences has significant treatment implications. Treatment approaches assuming that toxic event exposure creates a posttraumatic disorder fail to consider individual differences that could improve treatment efficacy.

Comparison of peer-tutoring learning model through problem-solving approach and traditional learning model on the cognitive ability of grade 10 students at SMKN 13 Bandung on the topic of Stoichiometry

NASA Astrophysics Data System (ADS)

Hayat, A. Z.; Wahyu, W.; Kurnia

2018-05-01

This study aims to find out the improvement of cognitive ability of students on the implementation of cooperative learning model of peer-tutoring by using problem-solving approach. The research method used is mix method of Sequential Explanatory strategy and pretest post-test non-equivalent control group design. The participants involved in this study were 68 grade 10 students of Vocational High School in Bandung that consisted of 34 samples of experimental class and 34 samples of control class. The instruments used include written test and questionnaires. The improvement of cognitive ability of students was calculated using the N- gain formula. Differences of two average scores were calculated using t-test at significant level of α = 0.05. The result of study shows that the improvement of cognitive ability in experimental class was significantly different compared to the improvement in the control class at significant level of α = 0.05. The improvement of cognitive ability in experimental class is higher than in control class.

The Engineering and Science Issues Test (ESIT): a discipline-specific approach to assessing moral judgment.

PubMed

Borenstein, Jason; Drake, Matthew J; Kirkman, Robert; Swann, Julie L

2010-06-01

To assess ethics pedagogy in science and engineering, we developed a new tool called the Engineering and Science Issues Test (ESIT). ESIT measures moral judgment in a manner similar to the Defining Issues Test, second edition, but is built around technical dilemmas in science and engineering. We used a quasi-experimental approach with pre- and post-tests, and we compared the results to those of a control group with no overt ethics instruction. Our findings are that several (but not all) stand-alone classes showed a significant improvement compared to the control group when the metric includes multiple stages of moral development. We also found that the written test had a higher response rate and sensitivity to pedagogy than the electronic version. We do not find significant differences on pre-test scores with respect to age, education level, gender or political leanings, but we do on whether subjects were native English speakers. We did not find significant differences on pre-test scores based on whether subjects had previous ethics instruction; this could suggest a lack of a long-term effect from the instruction.

New basic approach to treat non-small cell lung cancer based on RNA-interference.

PubMed

Makowiecki, Christina; Nolte, Andrea; Sutaj, Besmire; Keller, Timea; Avci-Adali, Meltem; Stoll, Heidi; Schlensak, Christian; Wendel, Hans Peter; Walker, Tobias

2014-03-01

To date the therapy for non-small cell lung cancer (NSCLC) is associated with severe side effects, frustrating outcomes, and does not consider different tumor characteristics. The RNA-interference (RNAi) pathway represents a potential new approach to treat NSCLC. With small interfering ribonucleic acids (siRNAs), it is possible to reduce the expression of proliferation-dependent proteins in tumor cells, leading to their apoptosis. We propose that siRNAs could be adapted to the tumor type and may cause fewer side effects than current therapy. Four NSCLC cell lines were cultured under standard conditions and transfected with three different concentrations of siRNAs targeted against the hypoxia-inducible factors 1α and 2α (HIF1α and HIF2α) and signal transducer and activator of transcription 3 (STAT3). The expression was observed by quantitative real-time polymerase chain reaction and western blots. For the analysis of cell growth three days after transfection, the cell number was detected using a CASY cell counter system. The results of the silencing of the analyzed factors differ in each cell line. Cell growth was significantly reduced in all cell lines after transfection with HIF1α- and STAT3-siRNA. The silencing of HIF2α resulted in a significant effect on cell growth in squamous, and large-cell lung cancer. This study shows that the knockdown and viability to siRNA transfection differ in each tumor type according to the used siRNA. This implies that the tumor types differ among themselves and should be treated differently. Therefore, the authors suggest a possible approach to a more personalized treatment of NSCLC.

Inverse modeling of hydrologic parameters using surface flux and runoff observations in the Community Land Model

NASA Astrophysics Data System (ADS)

Sun, Y.; Hou, Z.; Huang, M.; Tian, F.; Leung, L. Ruby

2013-12-01

This study demonstrates the possibility of inverting hydrologic parameters using surface flux and runoff observations in version 4 of the Community Land Model (CLM4). Previous studies showed that surface flux and runoff calculations are sensitive to major hydrologic parameters in CLM4 over different watersheds, and illustrated the necessity and possibility of parameter calibration. Both deterministic least-square fitting and stochastic Markov-chain Monte Carlo (MCMC)-Bayesian inversion approaches are evaluated by applying them to CLM4 at selected sites with different climate and soil conditions. The unknowns to be estimated include surface and subsurface runoff generation parameters and vadose zone soil water parameters. We find that using model parameters calibrated by the sampling-based stochastic inversion approaches provides significant improvements in the model simulations compared to using default CLM4 parameter values, and that as more information comes in, the predictive intervals (ranges of posterior distributions) of the calibrated parameters become narrower. In general, parameters that are identified to be significant through sensitivity analyses and statistical tests are better calibrated than those with weak or nonlinear impacts on flux or runoff observations. Temporal resolution of observations has larger impacts on the results of inverse modeling using heat flux data than runoff data. Soil and vegetation cover have important impacts on parameter sensitivities, leading to different patterns of posterior distributions of parameters at different sites. Overall, the MCMC-Bayesian inversion approach effectively and reliably improves the simulation of CLM under different climates and environmental conditions. Bayesian model averaging of the posterior estimates with different reference acceptance probabilities can smooth the posterior distribution and provide more reliable parameter estimates, but at the expense of wider uncertainty bounds.

Robotic and endoscopic transaxillary thyroidectomies may be cost prohibitive when compared to standard cervical thyroidectomy: a cost analysis.

PubMed

Cabot, Jennifer C; Lee, Cho Rok; Brunaud, Laurent; Kleiman, David A; Chung, Woong Youn; Fahey, Thomas J; Zarnegar, Rasa

2012-12-01

This study presents a cost analysis of the standard cervical, gasless transaxillary endoscopic, and gasless transaxillary robotic thyroidectomy approaches based on medical costs in the United States. A retrospective review of 140 patients who underwent standard cervical, transaxillary endoscopic, or transaxillary robotic thyroidectomy at 2 tertiary centers was conducted. The cost model included operating room charges, anesthesia fee, consumables cost, equipment depreciation, and maintenance cost. Sensitivity analyses assessed individual cost variables. The mean operative times for the standard cervical, transaxillary endoscopic, and transaxillary robotic approaches were 121 ± 18.9, 185 ± 26.0, and 166 ± 29.4 minutes, respectively. The total cost for the standard cervical, transaxillary endoscopic, and transaxillary robotic approaches were $9,028 ± $891, $12,505 ± $1,222, and $13,670 ± $1,384, respectively. Transaxillary approaches were significantly more expensive than the standard cervical technique (standard cervical/transaxillary endoscopic, P < .0001; standard cervical/transaxillary robotic, P < .0001; and transaxillary endoscopic/transaxillary robotic, P = .001). The transaxillary and standard cervical techniques became equivalent in cost when transaxillary endoscopic operative time decreased to 111 minutes and transaxillary robotic operative time decreased to 68 minutes. Increasing the case load did not resolve the cost difference. Transaxillary endoscopic and transaxillary robotic thyroidectomies are significantly more expensive than the standard cervical approach. Decreasing operative times reduces this cost difference. The greater expense may be prohibitive in countries with a flat reimbursement schedule. Copyright © 2012 Mosby, Inc. All rights reserved.

A new method for achieving enhanced dielectric response over a wide temperature range

DOE PAGES

Maurya, Deepam; Sun, Fu -Chang; Pamir Alpay, S.; ...

2015-10-19

We report a novel approach for achieving high dielectric response over a wide temperature range. In this approach, multilayer ceramic heterostructures with constituent compositions having strategically tuned Curie points (TC) were designed and integrated with varying electrical connectivity. Interestingly, these multilayer structures exhibited different dielectric behavior in series and parallel configuration due to variations in electrical boundary conditions resulting in the differences in the strength of the electrostatic coupling. The results are explained using nonlinear thermodynamic model taking into account electrostatic interlayer interaction. We believe that present work will have huge significance in design of high performance ceramic capacitors.

A new method for achieving enhanced dielectric response over a wide temperature range

PubMed Central

Maurya, Deepam; Sun, Fu-Chang; Pamir Alpay, S.; Priya, Shashank

2015-01-01

We report a novel approach for achieving high dielectric response over a wide temperature range. In this approach, multilayer ceramic heterostructures with constituent compositions having strategically tuned Curie points (TC) were designed and integrated with varying electrical connectivity. Interestingly, these multilayer structures exhibited different dielectric behavior in series and parallel configuration due to variations in electrical boundary conditions resulting in the differences in the strength of the electrostatic coupling. The results are explained using nonlinear thermodynamic model taking into account electrostatic interlayer interaction. We believe that present work will have huge significance in design of high performance ceramic capacitors. PMID:26477391

Measuring the difference in mean willingness to pay when dichotomous choice contingent valuation responses are not independent

Treesearch

Gregory L. Poe; Michael P. Welsh; Patricia A. Champ

1997-01-01

Dichotomous choice contingent valuation surveys frequently elicit multiple values in a single questionnaire. If individual responses are correlated across scenarios, the standard approach of estimating willingness to pay (WTP) functions independently for each scenario may result in biased estimates of the significance of the difference in mean WTP values. This paper...

Early clinical effects of the Dynesys system plus transfacet decompression through the Wiltse approach for the treatment of lumbar degenerative diseases

PubMed Central

Liu, Chao; Wang, Lei; Tian, Ji-wei

2014-01-01

Background This study investigated early clinical effects of Dynesys system plus transfacet decompression through the Wiltse approach in treating lumbar degenerative diseases. Material/Methods 37 patients with lumbar degenerative disease were treated with the Dynesys system plus transfacet decompression through the Wiltse approach. Results Results showed that all patients healed from surgery without severe complications. The average follow-up time was 20 months (9–36 months). Visual Analogue Scale and Oswestry Disability Index scores decreased significantly after surgery and at the final follow-up. There was a significant difference in the height of the intervertebral space and intervertebral range of motion (ROM) at the stabilized segment, but no significant changes were seen at the adjacent segments. X-ray scans showed no instability, internal fixation loosening, breakage, or distortion in the follow-up. Conclusions The Dynesys system plus transfacet decompression through the Wiltse approach is a therapeutic option for mild lumbar degenerative disease. This method can retain the structure of the lumbar posterior complex and the motion of the fixed segment, reduce the incidence of low back pain, and decompress the nerve root. PMID:24859831

A stage of change approach to reducing occupational ill health.

PubMed

Whysall, Z; Haslam, C; Haslam, R

2006-11-01

Interventions targeted by stage of change have been shown to improve the efficacy of public health promotion initiatives in areas such as smoking cessation, alcohol reduction, and mammography screening. Targeted interventions are designed to tackle the key attitudes, beliefs, and intentions that underpin an individual's health-related behavior. Work-related ill health is an increasingly serious issue, the most common cause of which in both the UK and the US is musculoskeletal disorders. This study examined whether the stage approach could be applied to workplace interventions aimed at improving occupational health. A total of 24 multi-component occupational interventions aimed at reducing musculoskeletal disorders were monitored over a period of 4-6 months. In half of these cases, approaches were targeted according to workers' stage of change. Targeted interventions were found to be significantly more effective in promoting risk awareness and desired behavior change among workers. Significant reductions were also found in self-reported musculoskeletal discomfort among workers having received targeted interventions. No significant differences were found in self-reported musculoskeletal discomfort among workers following standard interventions. Stage-matched approaches may offer scope for substantially improving the efficacy of occupational health and safety interventions by increasing the uptake, implementation, and maintenance of risk-reducing measures.

Feasibility and preliminary efficacy of a telerehabilitation approach to group adapted tango instruction for people with Parkinson disease.

PubMed

Seidler, Katie J; Duncan, Ryan P; McNeely, Marie E; Hackney, Madeleine E; Earhart, Gammon M

2017-09-01

People with Parkinson disease (PD) demonstrate improvements in motor function following group tango classes, but report long commutes as a barrier to participation. To increase access, we investigated a telerehabilitation approach to group tango instruction. Twenty-six people with mild-to-moderate PD were assigned based on commute distance to either the telerehabilitation group (Telerehab) or an in-person instruction group (In-person). Both groups followed the same twice-weekly, 12-week curriculum with the same instructor. Feasibility metrics were participant retention, attendance and adverse events. Outcomes assessed were balance, PD motor sign severity and gait. Participant retention was 85% in both groups. Attendance was 87% in the Telerehab group and 84% in the In-person group. No adverse events occurred. Balance and motor sign severity improved significantly over time ( p < 0.001) in both groups, with no significant group × time effects. Gait did not significantly change. Since a priori feasibility criteria were met or exceeded, and there were no notable outcome differences between the two instruction approaches, this pilot study suggests a telerehabilitation approach to group tango class for people with PD is feasible and may have similar outcomes to in-person instruction.

West Antarctic Balance Fluxes: Impact of Smoothing, Algorithm and Topography.

NASA Astrophysics Data System (ADS)

Le Brocq, A.; Payne, A. J.; Siegert, M. J.; Bamber, J. L.

2004-12-01

Grid-based calculations of balance flux and velocity have been widely used to understand the large-scale dynamics of ice masses and as indicators of their state of balance. This research investigates a number of issues relating to their calculation for the West Antarctic Ice Sheet (see below for further details): 1) different topography smoothing techniques; 2) different grid based flow-apportioning algorithms; 3) the source of the flow direction, whether from smoothed topography, or smoothed gravitational driving stress; 4) different flux routing techniques and 5) the impact of different topographic datasets. The different algorithms described below lead to significant differences in both ice stream margins and values of fluxes within them. This encourages caution in the use of grid-based balance flux/velocity distributions and values, especially when considering the state of balance of individual ice streams. 1) Most previous calculations have used the same numerical scheme (Budd and Warner, 1996) applied to a smoothed topography in order to incorporate the longitudinal stresses that smooth ice flow. There are two options to consider when smoothing the topography, the size of the averaging filter and the shape of the averaging function. However, this is not a physically-based approach to incorporating smoothed ice flow and also introduces significant flow artefacts when using a variable weighting function. 2) Different algorithms to apportion flow are investigated; using 4 or 8 neighbours, and apportioning flow to all down-slope cells or only 2 (based on derived flow direction). 3) A theoretically more acceptable approach of incorporating smoothed ice flow is to use the smoothed gravitational driving stress in x and y components to derive a flow direction. The flux can then be apportioned using the flow direction approach used above. 4) The original scheme (Budd and Warner, 1996) uses an elevation sort technique to calculate the balance flux contribution from all cells to each individual cell. However, elevation sort is only successful when ice cannot flow uphill. Other possible techniques include using a recursive call for each neighbour or using a sparse matrix solution. 5) Two digital elevation models are used as input data, which have significant differences in coastal and mountainous areas and therefore lead to different calculations. Of particular interest is the difference in the Rutford Ice Stream/Carlson Inlet and Kamb Ice Stream (Ice Stream C) fluxes.

The effect of using Indonesian realistic mathematics education (PMRI) approach on the mathematics achievement amongst primary school students

NASA Astrophysics Data System (ADS)

Zubainur, Cut Morina; Veloo, Arsaythamby; Khalid, Rozalina

2015-05-01

This study aims to determine the effects of the Indonesian Realistic Mathematics Education (PMRI) in Aceh primary schools, Indonesia. Although a plethora of research evidence highlights significant outcomes of the incorporation PMRI in mathematics, its use in the teaching and learning process is limited. Total of 50 standard five students from public primary school participated in this study; 25 students in the experimental group and 25 in the control group. The teaching approaches varied between the groups. While the experimental group experienced the PMRI approach, the control group encountered the conventional teaching approach of chalk and talk. Data was collected at two points namely the pre-test and post-test that lasted for five weeks. The results showed significant differences in mathematics achievement among primary students. In addition, PMRI also creates an active learning environment in solving exercises, and discussions among students and teachers. This study provides evidence that learning mathematics with PMRI benefits primary school students.

A statistical assessment of seismic models of the U.S. continental crust using Bayesian inversion of ambient noise surface wave dispersion data

NASA Astrophysics Data System (ADS)

Olugboji, T. M.; Lekic, V.; McDonough, W.

2017-07-01

We present a new approach for evaluating existing crustal models using ambient noise data sets and its associated uncertainties. We use a transdimensional hierarchical Bayesian inversion approach to invert ambient noise surface wave phase dispersion maps for Love and Rayleigh waves using measurements obtained from Ekström (2014). Spatiospectral analysis shows that our results are comparable to a linear least squares inverse approach (except at higher harmonic degrees), but the procedure has additional advantages: (1) it yields an autoadaptive parameterization that follows Earth structure without making restricting assumptions on model resolution (regularization or damping) and data errors; (2) it can recover non-Gaussian phase velocity probability distributions while quantifying the sources of uncertainties in the data measurements and modeling procedure; and (3) it enables statistical assessments of different crustal models (e.g., CRUST1.0, LITHO1.0, and NACr14) using variable resolution residual and standard deviation maps estimated from the ensemble. These assessments show that in the stable old crust of the Archean, the misfits are statistically negligible, requiring no significant update to crustal models from the ambient noise data set. In other regions of the U.S., significant updates to regionalization and crustal structure are expected especially in the shallow sedimentary basins and the tectonically active regions, where the differences between model predictions and data are statistically significant.

Does Context, Practice or Competition affect Female Athletes’ Achievement Goal Dominance, Goal Pursuit, Burnout and Motivation?

PubMed Central

Fernández-Rio, Javier; Cecchini, Jose A.; Méndez-Giménez, Antonio

2017-01-01

Abstract The goal of this study was to assess the effects of two different achievement sport contexts, practice and competition, on the motivational profile of professional/semi-professional athletes. Forty-eight Spanish national/international-level female athletes (basketball = 18; handball = 12; soccer = 11; volleyball = 7), mean age 25.14 ± 3.43 years, agreed to participate in the study. They completed a questionnaire, prior and after training and competition, to assess achievement goals, achievement goal dominance, goal pursuit, motivational climate, motivation, burnout and perceived recovery-exertion. Data analyses revealed that, both in practice and competition, these team-sport athletes overwhelmingly showed a strong mastery-approach achievement goal in dominance as well as in pursuit. A significant finding was that this group of national/international-level, professional/semi-professional athletes not only adopted a mastery-approach achievement goal, but they also actively pursued it. It is also remarkable that this profile remained stable at post-tests, even after a painful defeat in competition, which produced a significant negative effect on the athletes’ burnout (emotional and physical exhaustion and devaluation of sport participation) and self-determined motivation. As expected, the difference between total recovery and perceived exertion significantly increased after practice and competition. National/international-level team-sport professional/semi-professional female athletes held and pursue stable mastery-approach goal dominance. PMID:29134051

Effective teaching of manual skills to physiotherapy students: a randomised clinical trial.

PubMed

Rossettini, Giacomo; Rondoni, Angie; Palese, Alvisa; Cecchetto, Simone; Vicentini, Marco; Bettale, Fernanda; Furri, Laura; Testa, Marco

2017-08-01

To date, despite the relevance of manual skills laboratories in physiotherapy education, evidence on the effectiveness of different teaching methods is limited. Peyton's four-step and the 'See one, do one' approaches were compared for their effectiveness in teaching manual skills. A cluster randomised controlled trial was performed among final-year, right-handed physiotherapy students, without prior experience in manual therapy or skills laboratories. The manual technique of C1-C2 passive right rotation was taught by different experienced physiotherapist using Peyton's four-step approach (intervention group) and the 'See one, do one' approach (control group). Participants, teachers and assessors were blinded to the aims of the study. Primary outcomes were quality of performance at the end of the skills laboratories, and after 1 week and 1 month. Secondary outcomes were time required to teach, time required to perform the procedure and student satisfaction. A total of 39 students were included in the study (21 in the intervention group and 18 in the control group). Their main characteristics were homogeneous at baseline. The intervention group showed better quality of performance in the short, medium and long terms (F 1,111  = 35.91, p < 0.001). Both groups demonstrated decreased quality of performance over time (F 2,111  = 12.91, p < 0.001). The intervention group reported significantly greater mean ± standard deviation satisfaction (4.31 ± 1.23) than the control group (4.03 ± 1.31) (p < 0.001). Although there was no significant difference between the two methods in the time required for teaching, the time required by the intervention group to perform the procedure was significantly lower immediately after the skills laboratories and over time (p < 0.001). Peyton's four-step approach is more effective than the 'See one, do one' approach in skills laboratories aimed at developing physiotherapy student competence in C1-C2 passive mobilisation. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

Assessing age-related gray matter decline with voxel-based morphometry depends significantly on segmentation and normalization procedures

PubMed Central

Callaert, Dorothée V.; Ribbens, Annemie; Maes, Frederik; Swinnen, Stephan P.; Wenderoth, Nicole

2014-01-01

Healthy ageing coincides with a progressive decline of brain gray matter (GM) ultimately affecting the entire brain. For a long time, manual delineation-based volumetry within predefined regions of interest (ROI) has been the gold standard for assessing such degeneration. Voxel-Based Morphometry (VBM) offers an automated alternative approach that, however, relies critically on the segmentation and spatial normalization of a large collection of images from different subjects. This can be achieved via different algorithms, with SPM5/SPM8, DARTEL of SPM8 and FSL tools (FAST, FNIRT) being three of the most frequently used. We complemented these voxel based measurements with a ROI based approach, whereby the ROIs are defined by transforms of an atlas (containing different tissue probability maps as well as predefined anatomic labels) to the individual subject images in order to obtain volumetric information at the level of the whole brain or within separate ROIs. Comparing GM decline between 21 young subjects (mean age 23) and 18 elderly (mean age 66) revealed that volumetric measurements differed significantly between methods. The unified segmentation/normalization of SPM5/SPM8 revealed the largest age-related differences and DARTEL the smallest, with FSL being more similar to the DARTEL approach. Method specific differences were substantial after segmentation and most pronounced for the cortical structures in close vicinity to major sulci and fissures. Our findings suggest that algorithms that provide only limited degrees of freedom for local deformations (such as the unified segmentation and normalization of SPM5/SPM8) tend to overestimate between-group differences in VBM results when compared to methods providing more flexible warping. This difference seems to be most pronounced if the anatomy of one of the groups deviates from custom templates, a finding that is of particular importance when results are compared across studies using different VBM methods. PMID:25002845

Rights versus morality: online debate about decriminalization of gay sex in Singapore.

PubMed

Detenber, Benjamin H; Cenite, Mark; Zhou, Shuhua; Malik, Shelly; Neo, Rachel L

2014-01-01

This article presents a quantitative content analysis of 10,473 comments from two opposing online petitions related to the legal status of a section of the penal code in Singapore used to ban sex between men. Results indicate numerous significant differences in how the two sides discussed the law and its significance. In particular, they used different types of arguments to support their views and expressed different kinds of concerns over the potential impact of changing or maintaining the law. The patterns of language use seem to reflect distinctly different approaches to the debate and suggest the difficulty of finding common ground amid this contentious social issue, but they also reveal similarities to how Western cultures have framed the debate.

Addressing the mischaracterization of extreme rainfall in regional climate model simulations - A synoptic pattern based bias correction approach

NASA Astrophysics Data System (ADS)

Li, Jingwan; Sharma, Ashish; Evans, Jason; Johnson, Fiona

2018-01-01

Addressing systematic biases in regional climate model simulations of extreme rainfall is a necessary first step before assessing changes in future rainfall extremes. Commonly used bias correction methods are designed to match statistics of the overall simulated rainfall with observations. This assumes that change in the mix of different types of extreme rainfall events (i.e. convective and non-convective) in a warmer climate is of little relevance in the estimation of overall change, an assumption that is not supported by empirical or physical evidence. This study proposes an alternative approach to account for the potential change of alternate rainfall types, characterized here by synoptic weather patterns (SPs) using self-organizing maps classification. The objective of this study is to evaluate the added influence of SPs on the bias correction, which is achieved by comparing the corrected distribution of future extreme rainfall with that using conventional quantile mapping. A comprehensive synthetic experiment is first defined to investigate the conditions under which the additional information of SPs makes a significant difference to the bias correction. Using over 600,000 synthetic cases, statistically significant differences are found to be present in 46% cases. This is followed by a case study over the Sydney region using a high-resolution run of the Weather Research and Forecasting (WRF) regional climate model, which indicates a small change in the proportions of the SPs and a statistically significant change in the extreme rainfall over the region, although the differences between the changes obtained from the two bias correction methods are not statistically significant.

Comparison of different deep learning approaches for parotid gland segmentation from CT images

NASA Astrophysics Data System (ADS)

Hänsch, Annika; Schwier, Michael; Gass, Tobias; Morgas, Tomasz; Haas, Benjamin; Klein, Jan; Hahn, Horst K.

2018-02-01

The segmentation of target structures and organs at risk is a crucial and very time-consuming step in radiotherapy planning. Good automatic methods can significantly reduce the time clinicians have to spend on this task. Due to its variability in shape and often low contrast to surrounding structures, segmentation of the parotid gland is especially challenging. Motivated by the recent success of deep learning, we study different deep learning approaches for parotid gland segmentation. Particularly, we compare 2D, 2D ensemble and 3D U-Net approaches and find that the 2D U-Net ensemble yields the best results with a mean Dice score of 0.817 on our test data. The ensemble approach reduces false positives without the need for an automatic region of interest detection. We also apply our trained 2D U-Net ensemble to segment the test data of the 2015 MICCAI head and neck auto-segmentation challenge. With a mean Dice score of 0.861, our classifier exceeds the highest mean score in the challenge. This shows that the method generalizes well onto data from independent sites. Since appropriate reference annotations are essential for training but often difficult and expensive to obtain, it is important to know how many samples are needed to properly train a neural network. We evaluate the classifier performance after training with differently sized training sets (50-450) and find that 250 cases (without using extensive data augmentation) are sufficient to obtain good results with the 2D ensemble. Adding more samples does not significantly improve the Dice score of the segmentations.

A New Approach for the Calculation of Total Corneal Astigmatism Considering the Magnitude and Orientation of Posterior Corneal Astigmatism and Thickness.

PubMed

Piñero, David P; Caballero, María T; Nicolás-Albujer, Juan M; de Fez, Dolores; Camps, Vicent J

2018-06-01

To evaluate a new method of calculation of total corneal astigmatism based on Gaussian optics and the power design of a spherocylindrical lens (C) in the healthy eye and to compare it with keratometric (K) and power vector (PV) methods. A total of 92 healthy eyes of 92 patients (age, 17-65 years) were enrolled. Corneal astigmatism was calculated in all cases using K, PV, and our new approach C that considers the contribution of corneal thickness. An evaluation of the interchangeability of our new approach with the other 2 methods was performed using Bland-Altman analysis. Statistically significant differences between methods were found in the magnitude of astigmatism (P < 0.001), with the highest values provided by K. These differences in the magnitude of astigmatism were clinically relevant when K and C were compared [limits of agreement (LoA), -0.40 to 0.62 D), but not for the comparison between PV and C (LoA, -0.03 to 0.01 D). Differences in the axis of astigmatism between methods did not reach statistical significance (P = 0.408). However, they were clinically relevant when comparing K and C (LoA, -5.48 to 15.68 degrees) but not for the comparison between PV and C (LoA, -1.68 to 1.42 degrees). The use of our new approach for the calculation of total corneal astigmatism provides astigmatic results comparable to the PV method, which suggests that the effect of pachymetry on total corneal astigmatism is minimal in healthy eyes.

Ultrasound and thyroiditis in patient candidates for thyroidectomy.

PubMed

Del Rio, P; De Simone, B; Fumagalli, M; Viani, L; Totaro, A; Sianesi, M

2015-03-01

Thyroiditis is often associated with nodules based on the Bethesda classification system, and the presence of thyroiditis can make thyroid surgery difficult using both conventional techniques and minimally invasive videoassisted approaches (MIVAT). We analyzed 326 patients who underwent total thyroidectomy in 2012. We collected all data in dedicated database. The patients were divided in 4 groups: group 1 no affected by thyroiditis, group 2 affected by thyroiditis, group 3 only histological diagnosis of thyroiditis, group 4all patients affected by thyroiditis. Group 1 included 201 cases, group 2 included 64 patients, group 3 included 61 patients. No statistically significant difference between group 2 and 3 about Ultrasound (US) examination. Statistically significant difference in incidence of "THYR 3-4" between group 1 and group 4. No differences in MIVAT vs. Conventional group. US examination of the thyroid is essential for the diagnostic study of the gland also in the selection of a surgical approach. Thyroiditis is a relative contraindication to MIVAT but the experience of the endocrine surgeon is the most important factor to reduce intra and postoperative complications together a correct collaboration in multidisciplinart endocrinological team.

Coarse kMC-based replica exchange algorithms for the accelerated simulation of protein folding in explicit solvent.

PubMed

Peter, Emanuel K; Shea, Joan-Emma; Pivkin, Igor V

2016-05-14

In this paper, we present a coarse replica exchange molecular dynamics (REMD) approach, based on kinetic Monte Carlo (kMC). The new development significantly can reduce the amount of replicas and the computational cost needed to enhance sampling in protein simulations. We introduce 2 different methods which primarily differ in the exchange scheme between the parallel ensembles. We apply this approach on folding of 2 different β-stranded peptides: the C-terminal β-hairpin fragment of GB1 and TrpZip4. Additionally, we use the new simulation technique to study the folding of TrpCage, a small fast folding α-helical peptide. Subsequently, we apply the new methodology on conformation changes in signaling of the light-oxygen voltage (LOV) sensitive domain from Avena sativa (AsLOV2). Our results agree well with data reported in the literature. In simulations of dialanine, we compare the statistical sampling of the 2 techniques with conventional REMD and analyze their performance. The new techniques can reduce the computational cost of REMD significantly and can be used in enhanced sampling simulations of biomolecules.

Patterns of innovation in weapons acquisition decisions: the case of the long-range cruise missile

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

Ockenden, S.E.

1987-01-01

This study was conducted to determine why organizations can appear innovative on some occasions, and non-innovative on others. The particular focus of the study concerns two comparable organizations - the US Air Force and the US Navy - which responded differently to the opportunity for weapons innovation presented by a promising technology, the long-range cruise missile. Explanations for weapons innovation and acquisition decisions are traditionally found in four approaches: arms-race models; rational actor models; bureaucratic and cybernetics models; and idiographic case studies. None of these approaches is sufficient to offer general, stable, and consistent predictions about weapons innovation. Research outsidemore » of political science offers some insights. This literature was reviewed to develop a four-fold matrix describing patterns of behavior when a given organization confronts an opportunity to innovate at a given time. Because of significant differences between the two organizations in terms of goal consensus, significant differences in behavior were found. The air Force strongly resisted the cruise missile, while the Navy incrementally adopted it. While the entire matrix could not be tested, conclusions could be drawn.« less

Mapping dominant runoff processes: an evaluation of different approaches using similarity measures and synthetic runoff simulations

NASA Astrophysics Data System (ADS)

Antonetti, Manuel; Buss, Rahel; Scherrer, Simon; Margreth, Michael; Zappa, Massimiliano

2016-07-01

The identification of landscapes with similar hydrological behaviour is useful for runoff and flood predictions in small ungauged catchments. An established method for landscape classification is based on the concept of dominant runoff process (DRP). The various DRP-mapping approaches differ with respect to the time and data required for mapping. Manual approaches based on expert knowledge are reliable but time-consuming, whereas automatic GIS-based approaches are easier to implement but rely on simplifications which restrict their application range. To what extent these simplifications are applicable in other catchments is unclear. More information is also needed on how the different complexities of automatic DRP-mapping approaches affect hydrological simulations. In this paper, three automatic approaches were used to map two catchments on the Swiss Plateau. The resulting maps were compared to reference maps obtained with manual mapping. Measures of agreement and association, a class comparison, and a deviation map were derived. The automatically derived DRP maps were used in synthetic runoff simulations with an adapted version of the PREVAH hydrological model, and simulation results compared with those from simulations using the reference maps. The DRP maps derived with the automatic approach with highest complexity and data requirement were the most similar to the reference maps, while those derived with simplified approaches without original soil information differed significantly in terms of both extent and distribution of the DRPs. The runoff simulations derived from the simpler DRP maps were more uncertain due to inaccuracies in the input data and their coarse resolution, but problems were also linked with the use of topography as a proxy for the storage capacity of soils. The perception of the intensity of the DRP classes also seems to vary among the different authors, and a standardised definition of DRPs is still lacking. Furthermore, we argue not to use expert knowledge for only model building and constraining, but also in the phase of landscape classification.

Different analytical approaches in assessing antibacterial activity and the purity of commercial lysozyme preparations for dairy application.

PubMed

Brasca, Milena; Morandi, Stefano; Silvetti, Tiziana; Rosi, Veronica; Cattaneo, Stefano; Pellegrino, Luisa

2013-05-21

Hen egg-white lysozyme (LSZ) is currently used in the food industry to limit the proliferation of lactic acid bacteria spoilage in the production of wine and beer, and to inhibit butyric acid fermentation in hard and extra hard cheeses (late blowing) caused by the outgrowth of clostridial spores. The aim of this work was to evaluate how the enzyme activity in commercial preparations correlates to the enzyme concentration and can be affected by the presence of process-related impurities. Different analytical approaches, including turbidimetric assay, SDS-PAGE and HPLC were used to analyse 17 commercial preparations of LSZ marketed in different countries. The HPLC method adopted by ISO allowed the true LSZ concentration to be determined with accuracy. The turbidimetric assay was the most suitable method to evaluate LSZ activity, whereas SDS-PAGE allowed the presence of other egg proteins, which are potential allergens, to be detected. The analytical results showed that the purity of commercially available enzyme preparations can vary significantly, and evidenced the effectiveness of combining different analytical approaches in this type of control.

Patients' preferences when comparing analogue implant impressions using a polyether impression material versus digital impressions (Intraoral Scan) of dental implants.

PubMed

Wismeijer, Daniel; Mans, Ronny; van Genuchten, Michiel; Reijers, Hajo A

2014-10-01

The primary objective of this clinical study was to assess the patients' perception of the difference between an analogue impression approach on the one hand and an intra-oral scan (IO scan) on the other when restoring implants in the non-aesthetic zone. A second objective was to analyse the difference in time needed to perform these two procedures. Thirty consecutive patients who had received 41 implants (Straumann tissue level) in the non-aesthetic zone in an implant-based referral practice setting in the Netherlands. As they were to receive crown and or bridge work on the implants, in one session, the final impressions were taken with both an analogue technique and with an intraoral scan. Patients were also asked if, directly after the treatment was carried out, they would be prepared to fill out a questionnaire on their perception of both techniques. The time involved following these two procedures was also recorded. The preparatory activities of the treatment, the taste of the impression material and the overall preference of the patients were significantly in favour of the IO scan. The bite registration, the scan head and gag reflex positively tended to the IO scan, but none of these effects were significant. The overall time involved with the IO scan was more negatively perceived than the analogue impression. Overall less time was involved when following the analogue impression technique than with the IO scan. The overall preference of the patients in our sample is significantly in favour of the approach using the IO scan. This preference relates mainly to the differences between the compared approaches with respect to taste effects and their preparatory activities. The patients did perceive the duration of IO scan more negatively than the analogue impression approach. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Comparison of Safety and Effectiveness Between Right Versus Left Radial Arterial Access in Primary Percutaneous Coronary Intervention for Acute ST Segment Elevation Myocardial Infarction.

PubMed

Elmahdy, Mahmoud Farouk; ElMaghawry, Mohamed; Hassan, Mohamed; Kassem, Hussien Heshmat; Said, Karim; Elfaramawy, Amr AbdelAziz

2017-01-01

Transradial approach (TRA) is now considered the standard of care in many centres for elective and primary percutaneous intervention (PCI). The use of the radial approach in ST segment elevation myocardial infarction (STEMI) patients has been associated with a significant reduction in major adverse cardiac events. However, it is still unclear if the side of radial access (right vs. left) has impact on safety and effectiveness of TRA in primary PCI. So this study was conducted to compare the safety, feasibility, and outcomes of right radial access (RRA) vs. left radial access (LRA) in the setting of primary PCI. We retrospectively analysed the data of 400 consecutive patients presenting to our institution with STEMI for whom primary PCIs were performed via RRA and LRA. Mean age of the whole studied population was 57±12.8 years, with male predominance (77.2%). There were 202 cases in the RRA group and 198 in the LRA group, with no significant difference in demographics and clinical characteristics for patients included in both groups. There was no significant difference in procedure success rate (97.5% for RRA vs. 98.4% for LRA; P=0.77). In addition, no significant difference between both approaches was observed in the contrast volume, number of catheters, fluoroscopy time (FT), needle-to-balloon time, post-procedure vascular complications, in hospital reinfarction, stroke/transient ischaemic attack (TIA) or death. Right radial access and LRA are equally safe and effective in the setting of primary PCI. Both approaches have a high success rate and comparable needle-to-balloon time. Copyright © 2016 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

Anatomical and computed tomographic analysis of the transcochlear and endoscopic transclival approaches to the petroclival region.

PubMed

Mason, Eric; Van Rompaey, Jason; Carrau, Ricardo; Panizza, Benedict; Solares, C Arturo

2014-03-01

Advances in the field of skull base surgery aim to maximize anatomical exposure while minimizing patient morbidity. The petroclival region of the skull base presents numerous challenges for surgical access due to the complex anatomy. The transcochlear approach to the region provides adequate access; however, the resection involved sacrifices hearing and results in at least a grade 3 facial palsy. An endoscopic endonasal approach could potentially avoid negative patient outcomes while providing a desirable surgical window in a select patient population. Cadaveric study. Endoscopic access to the petroclival region was achieved through an endonasal approach. For comparison, a transcochlear approach to the clivus was performed. Different facets of the dissections, such as bone removal volume and exposed surface area, were computed using computed tomography analysis. The endoscopic endonasal approach provided a sufficient corridor to the petroclival region with significantly less bone removal and nearly equivalent exposure of the surgical target, thus facilitating the identification of the relevant anatomy. The lateral approach allowed for better exposure from a posterolateral direction until the inferior petrosal sinus; however, the endonasal approach avoided labyrinthine/cochlear destruction and facial nerve manipulation while providing an anteromedial viewpoint. The endonasal approach also avoided external incisions and cosmetic deficits. The endonasal approach required significant sinonasal resection. Endoscopic access to the petroclival region is a feasible approach. It potentially avoids hearing loss, facial nerve manipulation, and cosmetic damage. © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

Analysis of oral narratives of children who stutter and their fluent peers: kindergarten through second grade.

PubMed

Bajaj, Amit

2007-03-01

Measures of language sample length (in c-units) and morphological, syntactic, and narrative abilities were obtained from oral narrative transcripts of 22 children who stutter and 22 children who do not stutter; participants attended kindergarten, first, and second grades. A two-way MANOVA yielded significant main effects for grade, with significant differences on some measures evidenced between participants in kindergarten and second grades. No significant differences between groups or group-grade interaction effects on the measures were obtained. Grade-wise comparisons (through t-tests) indicated that the performance of children who stutter did not differ significantly from their typically fluent peers on all dependent measures; however, kindergarten children who stutter obtained the most discrepant (lower) scores than their grade-matched fluent peers on the Narrative Scoring Scheme measure, with group differences approaching statistical significance on this measure. The findings suggest that children who do and do not stutter evidence similar expressive language abilities, even as subgroups of children who stutter may lag behind their grade-matched fluent peers in particular language domains.

Hemiarch versus total aortic arch replacement in acute type A dissection: a systematic review and meta-analysis

PubMed Central

Poon, Shi Sum; Theologou, Thomas; Harrington, Deborah; Kuduvalli, Manoj; Oo, Aung

2016-01-01

Background Despite recent advances in aortic surgery, acute type A aortic dissection remains a surgical emergency associated with high mortality and morbidity. Appropriate management is crucial to achieve satisfactory outcomes but the optimal surgical approach is controversial. The present systematic review and meta-analysis sought to access cumulative data from comparative studies between hemiarch and total aortic arch replacement in patients with acute type A aortic dissection. Methods A systematic review of the literature using six databases. Eligible studies include comparative studies on hemiarch versus total arch replacement reporting short, medium and long term outcomes. A meta-analysis was performed on eligible studies reporting outcome of interest to quantify the effects of hemiarch replacement on mortality and morbidity risk compared to total arch replacement. Result Fourteen retrospective studies met the inclusion criteria and 2,221 patients were included in the final analysis. Pooled analysis showed that hemiarch replacement was associated with a lower risk of post-operative renal dialysis [risk ratio (RR) =0.72; 95% confidence interval (CI): 0.56–0.94; P=0.02; I2=0%]. There was no significant difference in terms of in-hospital mortality between the two groups (RR =0.84; 95% CI: 0.65–1.09; P=0.20; I2=0%). Cardiopulmonary bypass, aortic cross clamp and circulatory arrest times were significantly longer in total arch replacement. During follow up, no significant difference was reported from current studies between the two operative approaches in terms of aortic re-intervention and freedom from aortic reoperation. Conclusions Within the context of publication bias by high volume aortic centres and non-randomized data sets, there was no difference in mortality outcomes between the two groups. This analysis serves to demonstrate that for those centers doing sufficient total aortic arch activity to allow for publication, excellent and equivalent outcomes are achievable. Conclusions on differences in longer term outcome data are required. We do not, however, advocate total arch as a primary approach by all centers and surgeons irrespective of patient characteristics, but rather, a tailored approach based on surgeon and center experience and patient presentation. PMID:27386403

Software design by reusing architectures

NASA Technical Reports Server (NTRS)

Bhansali, Sanjay; Nii, H. Penny

1992-01-01

Abstraction fosters reuse by providing a class of artifacts that can be instantiated or customized to produce a set of artifacts meeting different specific requirements. It is proposed that significant leverage can be obtained by abstracting software system designs and the design process. The result of such an abstraction is a generic architecture and a set of knowledge-based, customization tools that can be used to instantiate the generic architecture. An approach for designing software systems based on the above idea are described. The approach is illustrated through an implemented example, and the advantages and limitations of the approach are discussed.

Data-Mining and Informatics Approaches for Environmental Contaminants

EPA Science Inventory

New and emerging environmental contaminants are chemicals that have not been previously detected or that are being detected at levels significantly different from those expected in both biological and ecological arenas (that is, human, wildlife, and environment). Many chemicals c...

An integrated experimental and computational approach for characterizing the kinetics and mechanism of triadimefon racemization.

EPA Science Inventory

Enantiomers of chiral molecules commonly exhibit differing pharmacokinetics and toxicities, which can introduce significant uncertainty when evaluating biological and environmental fates and potential risks to humans and the environment. However, racemization (the irreversible tr...

Activation of different split functionalities upon re-association of RNA-DNA hybrids

PubMed Central

Afonin, Kirill A.; Viard, Mathias; Martins, Angelica N.; Lockett, Stephen J.; Maciag, Anna E.; Freed, Eric O.; Heldman, Eliahu; Jaeger, Luc; Blumenthal, Robert; Shapiro, Bruce A.

2013-01-01

Split-protein systems, an approach that relies on fragmentation of proteins with their further conditional re-association to form functional complexes, are increasingly used for various biomedical applications. This approach offers tight control of the protein functions and improved detection sensitivity. Here we show a similar technique based on a pair of RNA-DNA hybrids that can be generally used for triggering different split functionalities. Individually, each hybrid is inactive but when two cognate hybrids re-associate, different functionalities are triggered inside mammalian cells. As a proof of concept this work is mainly focused on activation of RNA interference; however the release of other functionalities (resonance energy transfer and RNA aptamer) is also shown. Furthermore, in vivo studies demonstrate a significant uptake of the hybrids by tumors together with specific gene silencing. This split-functionality approach presents a new route in the development of “smart” nucleic acids based nanoparticles and switches for various biomedical applications. PMID:23542902

A holistic approach to determine tree structural complexity based on laser scanning data and fractal analysis.

PubMed

Seidel, Dominik

2018-01-01

The three-dimensional forest structure affects many ecosystem functions and services provided by forests. As forests are made of trees it seems reasonable to approach their structure by investigating individual tree structure. Based on three-dimensional point clouds from laser scanning, a newly developed holistic approach is presented that enables to calculate the box dimension as a measure of structural complexity of individual trees using fractal analysis. It was found that the box dimension of trees was significantly different among the tested species, among trees belonging to the same species but exposed to different growing conditions (at gap vs. forest interior) or to different kinds of competition (intraspecific vs. interspecific). Furthermore, it was shown that the box dimension is positively related to the trees' growth rate. The box dimension was identified as an easy to calculate measure that integrates the effect of several external drivers of tree structure, such as competition strength and type, while simultaneously providing information on structure-related properties, like tree growth.

Role of 5-HTTLPR polymorphism in the development of the inward/outward personality organization: a genetic association study.

PubMed

Nardi, Bernardo; Marini, Alessandra; Turchi, Chiara; Arimatea, Emidio; Tagliabracci, Adriano; Bellantuono, Cesario

2013-01-01

Reciprocity with primary caregivers affects subjects' adaptive abilities toward the construction of the most useful personal meaning organization (PMO) with respect to their developmental environment. Within cognitive theory the post-rationalist approach has outlined two basic categories of identity construction and of regulation of cognitive and emotional processes: the Outward and the Inward PMO. The presence of different, consistent clinical patterns in Inward and Outward subjects is paralleled by differences in cerebral activation during emotional tasks on fMRI and by different expression of some polymorphisms in serotonin pathways. Since several lines of evidence support a role for the 5-HTTLPR polymorphism in mediating individual susceptibility to environmental emotional stimuli, this study was conducted to investigate its influence in the development of the Inward/Outward PMO. PMO was assessed and the 5-HTTLPR polymorphism investigated in 124 healthy subjects who were subdivided into an Inward (n = 52) and an Outward (n = 72) group. Case-control comparisons of short allele (S) frequencies showed significant differences between Inwards and Outwards (p = 0.036, χ2 test; p = 0.026, exact test). Genotype frequencies were not significantly different although values slightly exceeded p ≤ 0.05 (p = 0.056, χ2 test; p = 0.059, exact test). Analysis of the 5-HTTLPR genotypes according to the recessive inheritance model showed that the S/S genotype increased the likelihood of developing an Outward PMO (p = 0.0178, χ2 test; p = 0.0143, exact test; OR = 3.43, CI (95%) = 1.188-9.925). A logistic regression analysis confirmed the association between short allele and S/S genotypes with the Outward PMO also when gender and age were considered. However none of the differences remained significant after correction for multiple testing, even though using the recessive model they approach significance. Overall our data seem to suggest a putative genetic basis for interindividual differences in PMO development.

Role of 5-HTTLPR Polymorphism in the Development of the Inward/Outward Personality Organization: A Genetic Association Study

PubMed Central

Nardi, Bernardo; Marini, Alessandra; Turchi, Chiara; Arimatea, Emidio; Tagliabracci, Adriano; Bellantuono, Cesario

2013-01-01

Reciprocity with primary caregivers affects subjects' adaptive abilities toward the construction of the most useful personal meaning organization (PMO) with respect to their developmental environment. Within cognitive theory the post-rationalist approach has outlined two basic categories of identity construction and of regulation of cognitive and emotional processes: the Outward and the Inward PMO. The presence of different, consistent clinical patterns in Inward and Outward subjects is paralleled by differences in cerebral activation during emotional tasks on fMRI and by different expression of some polymorphisms in serotonin pathways. Since several lines of evidence support a role for the 5-HTTLPR polymorphism in mediating individual susceptibility to environmental emotional stimuli, this study was conducted to investigate its influence in the development of the Inward/Outward PMO. PMO was assessed and the 5-HTTLPR polymorphism investigated in 124 healthy subjects who were subdivided into an Inward (n = 52) and an Outward (n = 72) group. Case-control comparisons of short allele (S) frequencies showed significant differences between Inwards and Outwards (p = 0.036, χ2 test; p = 0.026, exact test). Genotype frequencies were not significantly different although values slightly exceeded p≤0.05 (p = 0.056, χ2 test; p = 0.059, exact test). Analysis of the 5-HTTLPR genotypes according to the recessive inheritance model showed that the S/S genotype increased the likelihood of developing an Outward PMO (p = 0.0178, χ2 test; p = 0.0143, exact test; OR = 3.43, CI (95%) = 1.188–9.925). A logistic regression analysis confirmed the association between short allele and S/S genotypes with the Outward PMO also when gender and age were considered. However none of the differences remained significant after correction for multiple testing, even though using the recessive model they approach significance. Overall our data seem to suggest a putative genetic basis for interindividual differences in PMO development. PMID:24358153

Hip joint center localisation: A biomechanical application to hip arthroplasty population

PubMed Central

Bouffard, Vicky; Begon, Mickael; Champagne, Annick; Farhadnia, Payam; Vendittoli, Pascal-André; Lavigne, Martin; Prince, François

2012-01-01

AIM: To determine hip joint center (HJC) location on hip arthroplasty population comparing predictive and functional approaches with radiographic measurements. METHODS: The distance between the HJC and the mid-pelvis was calculated and compared between the three approaches. The localisation error between the predictive and functional approach was compared using the radiographic measurements as the reference. The operated leg was compared to the non-operated leg. RESULTS: A significant difference was found for the distance between the HJC and the mid-pelvis when comparing the predictive and functional method. The functional method leads to fewer errors. A statistical difference was found for the localization error between the predictive and functional method. The functional method is twice more precise. CONCLUSION: Although being more individualized, the functional method improves HJC localization and should be used in three-dimensional gait analysis. PMID:22919569

Vascular system modeling in parallel environment - distributed and shared memory approaches

PubMed Central

Jurczuk, Krzysztof; Kretowski, Marek; Bezy-Wendling, Johanne

2011-01-01

The paper presents two approaches in parallel modeling of vascular system development in internal organs. In the first approach, new parts of tissue are distributed among processors and each processor is responsible for perfusing its assigned parts of tissue to all vascular trees. Communication between processors is accomplished by passing messages and therefore this algorithm is perfectly suited for distributed memory architectures. The second approach is designed for shared memory machines. It parallelizes the perfusion process during which individual processing units perform calculations concerning different vascular trees. The experimental results, performed on a computing cluster and multi-core machines, show that both algorithms provide a significant speedup. PMID:21550891

Population-based comparison of two feeding tube approaches for head and neck cancer patients receiving concurrent systemic-radiation therapy: is a prophylactic feeding tube approach harmful or helpful?

PubMed

Olson, Robert; Karam, Irene; Wilson, Gavin; Bowman, Angela; Lee, Christopher; Wong, Frances

2013-12-01

The purpose of this study is to compare patient outcomes between a therapeutic versus a prophylactic gastrostomy tube (GT) placement approach in patients treated with concurrent systemic and radiation (SRT) therapy for head and neck cancer (HNC). Outcomes were compared between all HNC patients treated with concurrent SRT from January 2001 to June 2009 from a center that only places GTs therapeutically when clinically necessary (center A) versus a center that generally places them prophylactically (center B). A total of 445 patients with HNC were identified, with 63 % from center A. As anticipated, GTs were placed less commonly in center A compared to B (31 versus 88 %; p < 0.001). Center B had a significantly higher number of GT complications (p < 0.001), including infection (16 versus 5 %), leakage (10 versus 2 %), and blockage (3 versus 1 %). Conversely, center A had a higher admission rate (27 versus 13 %, p = 0.001), most prominent for GT-related issues (15 versus 6 %). Center B had higher GT dependence at 90 days post-radiation therapy (34 versus 12 %; p < 0.001), but not at 1 year (11 versus 10 %; p = 0.74). There was no significant difference in the proportion of head and neck patients who had a 10 % weight loss at 1 year (compared to baseline) between centers A and B (42 versus 53 %, p = 0.07). There was no significant difference in the overall survival (A versus B, HR = 0.99; p = 0.96). A prophylactic GT approach results in exposing higher number of patients to GT complications. The higher rate of hospitalizations using a therapeutic approach suggests that patients are sicker when GTs are required. Given the similar weight loss and survival, a therapeutic approach at an earlier stage of need may be a preferable approach, when access to prompt GT placement is available.

Peyton's four-step approach for teaching complex spinal manipulation techniques - a prospective randomized trial.

PubMed

Gradl-Dietsch, Gertraud; Lübke, Cavan; Horst, Klemens; Simon, Melanie; Modabber, Ali; Sönmez, Tolga T; Münker, Ralf; Nebelung, Sven; Knobe, Matthias

2016-11-03

The objectives of this prospective randomized trial were to assess the impact of Peyton's four-step approach on the acquisition of complex psychomotor skills and to examine the influence of gender on learning outcomes. We randomly assigned 95 third to fifth year medical students to an intervention group which received instructions according to Peyton (PG) or a control group, which received conventional teaching (CG). Both groups attended four sessions on the principles of manual therapy and specific manipulative and diagnostic techniques for the spine. We assessed differences in theoretical knowledge (multiple choice (MC) exam) and practical skills (Objective Structured Practical Examination (OSPE)) with respect to type of intervention and gender. Participants took a second OSPE 6 months after completion of the course. There were no differences between groups with respect to the MC exam. Students in the PG group scored significantly higher in the OSPE. Gender had no additional impact. Results of the second OSPE showed a significant decline in competency regardless of gender and type of intervention. Peyton's approach is superior to standard instruction for teaching complex spinal manipulation skills regardless of gender. Skills retention was equally low for both techniques.

Examining the Value of a Scaffolded Critique Framework to Promote Argumentative and Explanatory Writings Within an Argument-Based Inquiry Approach

NASA Astrophysics Data System (ADS)

Jang, Jeong-yoon; Hand, Brian

2017-12-01

This study investigated the value of using a scaffolded critique framework to promote two different types of writing—argumentative writing and explanatory writing—with different purposes within an argument-based inquiry approach known as the Science Writing Heuristic (SWH) approach. A quasi-experimental design with sixth and seventh grade students taught by two teachers was used. A total of 170 students participated in the study, with 87 in the control group (four classes) and 83 in the treatment group (four classes). All students used the SWH templates as an argumentative writing to guide their written work and completed these templates during the SWH investigations of each unit. After completing the SWH investigations, both groups of students were asked to complete the summary writing task as an explanatory writing at the end of each unit. All students' writing samples were scored using analytical frameworks developed for the study. The results indicated that the treatment group performed significantly better on the explanatory writing task than the control group. In addition, the results of the partial correlation suggested that there is a very strong significantly positive relationship between the argumentative writing and the explanatory writing.

Quantification of downscaled precipitation uncertainties via Bayesian inference

NASA Astrophysics Data System (ADS)

Nury, A. H.; Sharma, A.; Marshall, L. A.

2017-12-01

Prediction of precipitation from global climate model (GCM) outputs remains critical to decision-making in water-stressed regions. In this regard, downscaling of GCM output has been a useful tool for analysing future hydro-climatological states. Several downscaling approaches have been developed for precipitation downscaling, including those using dynamical or statistical downscaling methods. Frequently, outputs from dynamical downscaling are not readily transferable across regions for significant methodical and computational difficulties. Statistical downscaling approaches provide a flexible and efficient alternative, providing hydro-climatological outputs across multiple temporal and spatial scales in many locations. However these approaches are subject to significant uncertainty, arising due to uncertainty in the downscaled model parameters and in the use of different reanalysis products for inferring appropriate model parameters. Consequently, these will affect the performance of simulation in catchment scale. This study develops a Bayesian framework for modelling downscaled daily precipitation from GCM outputs. This study aims to introduce uncertainties in downscaling evaluating reanalysis datasets against observational rainfall data over Australia. In this research a consistent technique for quantifying downscaling uncertainties by means of Bayesian downscaling frame work has been proposed. The results suggest that there are differences in downscaled precipitation occurrences and extremes.

Discrimination of various paper types using diffuse reflectance ultraviolet-visible near-infrared (UV-Vis-NIR) spectroscopy: forensic application to questioned documents.

PubMed

Kumar, Raj; Kumar, Vinay; Sharma, Vishal

2015-06-01

Diffuse reflectance ultraviolet-visible-near-infrared (UV-Vis-NIR) spectroscopy is applied as a means of differentiating various types of writing, office, and photocopy papers (collected from stationery shops in India) on the basis of reflectance and absorbance spectra that otherwise seem to be almost alike in different illumination conditions. In order to minimize bias, spectra from both sides of paper were obtained. In addition, three spectra from three different locations (from one side) were recorded covering the upper, middle, and bottom portions of the paper sample, and the mean average reflectivity of both the sides was calculated. A significant difference was observed in mean average reflectivity of Side A and Side B of the paper using Student's pair >t-test. Three different approaches were used for discrimination: (1) qualitative features of the whole set of samples, (2) principal component analysis, and (3) a combination of both approaches. On the basis of the first approach, i.e., qualitative features, 96.49% discriminating power (DP) was observed, which shows highly significant results with the UV-Vis-NIR technique. In the second approach the discriminating power is further enhanced by incorporating the principal component analysis (PCA) statistical method, where this method describes each UV-Vis spectrum in a group through numerical loading values connected to the first few principal components. All components described 100% variance of the samples, but only the first three PCs are good enough to explain the variance (PC1 = 51.64%, PC2 = 47.52%, and PC3 = 0.54%) of the samples; i.e., the first three PCs described 99.70% of the data, whereas in the third approach, the four samples, C, G, K, and N, out of a total 19 samples, which were not differentiated using qualitative features (approach no. 1), were therefore subjected to PCA. The first two PCs described 99.37% of the spectral features. The discrimination was achieved by using a loading plot between PC1 and PC2. It is therefore concluded that maximum discrimination of writing, office, and photocopy paper could be achieved on the basis of the second approach. Hence, the present inexpensive analytical method can be appropriate for application to routine questioned document examination work in forensic laboratories because it provides nondestructive, quantitative, reliable, and repeatable results.

Characterization of Inclusion Populations in Mn-Si Deoxidized Steel

NASA Astrophysics Data System (ADS)

García-Carbajal, Alfonso; Herrera-Trejo, Martín; Castro-Cedeño, Edgar-Ivan; Castro-Román, Manuel; Martinez-Enriquez, Arturo-Isaias

2017-12-01

Four plant heats of Mn-Si deoxidized steel were conducted to follow the evolution of the inclusion population through ladle furnace (LF) treatment and subsequent vacuum treatment (VT). The liquid steel was sampled, and the chemical composition and size distribution of the inclusion populations were characterized. The Gumbel generalized extreme-value (GEV) and generalized Pareto (GP) distributions were used for the statistical analysis of the inclusion size distributions. The inclusions found at the beginning of the LF treatment were mostly fully liquid SiO2-Al2O3-MnO inclusions, which then evolved into fully liquid SiO2-Al2O3-CaO-MgO and partly liquid SiO2-CaO-MgO-(Al2O3-MgO) inclusions detected at the end of the VT. The final fully liquid inclusions had a desirable chemical composition for plastic behavior in subsequent metallurgical operations. The GP distribution was found to be undesirable for statistical analysis. The GEV distribution approach led to shape parameter values different from the zero value hypothesized from the Gumbel distribution. According to the GEV approach, some of the final inclusion size distributions had statistically significant differences, whereas the Gumbel approach predicted no statistically significant differences. The heats were organized according to indicators of inclusion cleanliness and a statistical comparison of the size distributions.

Comparing different stimulus configurations for population receptive field mapping in human fMRI

PubMed Central

Alvarez, Ivan; de Haas, Benjamin; Clark, Chris A.; Rees, Geraint; Schwarzkopf, D. Samuel

2015-01-01

Population receptive field (pRF) mapping is a widely used approach to measuring aggregate human visual receptive field properties by recording non-invasive signals using functional MRI. Despite growing interest, no study to date has systematically investigated the effects of different stimulus configurations on pRF estimates from human visual cortex. Here we compared the effects of three different stimulus configurations on a model-based approach to pRF estimation: size-invariant bars and eccentricity-scaled bars defined in Cartesian coordinates and traveling along the cardinal axes, and a novel simultaneous “wedge and ring” stimulus defined in polar coordinates, systematically covering polar and eccentricity axes. We found that the presence or absence of eccentricity scaling had a significant effect on goodness of fit and pRF size estimates. Further, variability in pRF size estimates was directly influenced by stimulus configuration, particularly for higher visual areas including V5/MT+. Finally, we compared eccentricity estimation between phase-encoded and model-based pRF approaches. We observed a tendency for more peripheral eccentricity estimates using phase-encoded methods, independent of stimulus size. We conclude that both eccentricity scaling and polar rather than Cartesian stimulus configuration are important considerations for optimal experimental design in pRF mapping. While all stimulus configurations produce adequate estimates, simultaneous wedge and ring stimulation produced higher fit reliability, with a significant advantage in reduced acquisition time. PMID:25750620

Assessment of noise in the airplane cabin environment.

PubMed

Zevitas, Christopher D; Spengler, John D; Jones, Byron; McNeely, Eileen; Coull, Brent; Cao, Xiaodong; Loo, Sin Ming; Hard, Anna-Kate; Allen, Joseph G

2018-03-15

To measure sound levels in the aircraft cabin during different phases of flight. Sound level was measured on 200 flights, representing six aircraft groups using continuous monitors. A linear mixed-effects model with random intercept was used to test for significant differences in mean sound level by aircraft model and across each flight phase as well as by flight phase, airplane type, measurement location and proximity to engine noise. Mean sound levels across all flight phases and aircraft groups ranged from 37.6 to >110 dB(A) with a median of 83.5 dB(A). Significant differences in noise levels were also observed based on proximity to the engines and between aircraft with fuselage- and wing mounted engines. Nine flights (4.5%) exceeded the recommended 8-h TWA exposure limit of 85 dB(A) by the NIOSH and ACGIH approach, three flights (1.5%) exceeded the 8-h TWA action level of 85 dB(A) by the OSHA approach, and none of the flights exceeded the 8-h TWA action level of 90 dB(A) by the OSHA PEL approach. Additional characterization studies, including personal noise dosimetry, are necessary to document accurate occupational exposures in the aircraft cabin environment and identify appropriate response actions. FAA should consider applying the more health-protective NIOSH/ACGIH occupational noise recommendations to the aircraft cabin environment.

Attention and Off-Topic Speech in the Recounts of Middle-Age and Elderly Adults: A Pilot Investigation

PubMed Central

Wills, Courtney L.; Capilouto, Gilson J.; Wright, Heather Harris

2013-01-01

Purpose The discourse of healthy older adults is commonly described as being lengthy and off-topic and is thought to be associated with a general cognitive decline that accompanies healthy aging. The purpose of this preliminary study was to investigate the overall decline in attention associated with healthy aging and its relationship to instances of off-topic speech (OTS). Method Thirty cognitively healthy adults divided into 5 age cohorts (40–80) completed cognitive measures of attention and several discourse tasks that included recounting personal events. Results Cohorts differed significantly with respect to the measures of attention. However, no significant differences in the incidence of OTS were detected between the cohorts. Attention and the incidence of OTS were not significantly correlated within any of the cohorts. Conclusion No significant differences in the incidence of OTS and its relation to attention measures were found. However, the relationship between age-related declines in attention and increased OTS approached significance, suggesting the need for further study. PMID:23420319

Validating predictions from climate envelope models

USGS Publications Warehouse

Watling, J.; Bucklin, D.; Speroterra, C.; Brandt, L.; Cabal, C.; Romañach, Stephanie S.; Mazzotti, Frank J.

2013-01-01

Climate envelope models are a potentially important conservation tool, but their ability to accurately forecast species’ distributional shifts using independent survey data has not been fully evaluated. We created climate envelope models for 12 species of North American breeding birds previously shown to have experienced poleward range shifts. For each species, we evaluated three different approaches to climate envelope modeling that differed in the way they treated climate-induced range expansion and contraction, using random forests and maximum entropy modeling algorithms. All models were calibrated using occurrence data from 1967–1971 (t1) and evaluated using occurrence data from 1998–2002 (t2). Model sensitivity (the ability to correctly classify species presences) was greater using the maximum entropy algorithm than the random forest algorithm. Although sensitivity did not differ significantly among approaches, for many species, sensitivity was maximized using a hybrid approach that assumed range expansion, but not contraction, in t2. Species for which the hybrid approach resulted in the greatest improvement in sensitivity have been reported from more land cover types than species for which there was little difference in sensitivity between hybrid and dynamic approaches, suggesting that habitat generalists may be buffered somewhat against climate-induced range contractions. Specificity (the ability to correctly classify species absences) was maximized using the random forest algorithm and was lowest using the hybrid approach. Overall, our results suggest cautious optimism for the use of climate envelope models to forecast range shifts, but also underscore the importance of considering non-climate drivers of species range limits. The use of alternative climate envelope models that make different assumptions about range expansion and contraction is a new and potentially useful way to help inform our understanding of climate change effects on species.

Tau-U: A Quantitative Approach for Analysis of Single-Case Experimental Data in Aphasia.

PubMed

Lee, Jaime B; Cherney, Leora R

2018-03-01

Tau-U is a quantitative approach for analyzing single-case experimental design (SCED) data. It combines nonoverlap between phases with intervention phase trend and can correct for a baseline trend (Parker, Vannest, & Davis, 2011). We demonstrate the utility of Tau-U by comparing it with the standardized mean difference approach (Busk & Serlin, 1992) that is widely reported within the aphasia SCED literature. Repeated writing measures from 3 participants with chronic aphasia who received computer-based writing treatment are analyzed visually and quantitatively using both Tau-U and the standardized mean difference approach. Visual analysis alone was insufficient for determining an effect between the intervention and writing improvement. The standardized mean difference yielded effect sizes ranging from 4.18 to 26.72 for trained items and 1.25 to 3.20 for untrained items. Tau-U yielded significant (p < .05) effect sizes for 2 of 3 participants for trained probes and 1 of 3 participants for untrained probes. A baseline trend correction was applied to data from 2 of 3 participants. Tau-U has the unique advantage of allowing for the correction of an undesirable baseline trend. Although further study is needed, Tau-U shows promise as a quantitative approach to augment visual analysis of SCED data in aphasia.

Multiplex biomarker approach to cardiovascular diseases.

PubMed

Adamcova, Michaela; Šimko, Fedor

2018-04-12

Personalized medicine is partly based on biomarker-guided diagnostics, therapy and prognosis, which is becoming an unavoidable concept in modern cardiology. However, the clinical significance of single biomarker studies is rather limited. A promising novel approach involves combining multiple markers into a multiplex panel, which could refine the management of a particular patient with cardiovascular pathology. Two principally different assay formats have been developed to facilitate simultaneous quantification of multiple antigens: planar array assays and microbead assays. These approaches may help to better evaluate the complexity and dynamic nature of pathologic processes and offer substantial cost and sample savings compared with traditional enzyme-linked immunosorbent assay (ELISA) measurements. However, a multiplex multimarker approach cannot become a generally disseminated method until analytical problems are solved and further studies confirming improved clinical outcomes are accomplished. These drawbacks underlie the fact that a limited number of systematic studies are available regarding the use of a multiplex biomarker approach in cardiovascular medicine to date. Our perspective underscores the significant potential of the use of the multiplex approach in a wider conceptual framework under the close cooperation of clinical and experimental cardiologists, pathophysiologists and biochemists so that the personalized approach based on standardized multimarker testing may improve the management of various cardiovascular pathologies and become a ubiquitous partner of population-derived evidence-based medicine.

Integrated carbon and chlorine isotope modeling: applications to chlorinated aliphatic hydrocarbons dechlorination.

PubMed

Jin, Biao; Haderlein, Stefan B; Rolle, Massimo

2013-02-05

We propose a self-consistent method to predict the evolution of carbon and chlorine isotope ratios during degradation of chlorinated hydrocarbons. The method treats explicitly the cleavage of isotopically different C-Cl bonds and thus considers, simultaneously, combined carbon-chlorine isotopologues. To illustrate the proposed modeling approach we focus on the reductive dehalogenation of chlorinated ethenes. We compare our method with the currently available approach, in which carbon and chlorine isotopologues are treated separately. The new approach provides an accurate description of dual-isotope effects regardless of the extent of the isotope fractionation and physical characteristics of the experimental system. We successfully applied the new approach to published experimental results on dehalogenation of chlorinated ethenes both in well-mixed systems and in situations where mass-transfer limitations control the overall rate of biodegradation. The advantages of our self-consistent dual isotope modeling approach proved to be most evident when isotope fractionation factors of carbon and chlorine differed significantly and for systems with mass-transfer limitations, where both physical and (bio)chemical transformation processes affect the observed isotopic values.

Different Antibiotic No Culture Eradicating (DANCE) strategy: an easy way to manage H. pylori eradication.

PubMed

Roccarina, Davide; Franceschi, Francesco; Zocco, Maria Assunta; Garcovich, Matteo; Gasbarrini, Giovanni; Gasbarrini, Antonio

2012-11-01

Treatment of Helicobacter pylori infection is becoming a very relevant problem especially in industrialized Countries. Although different therapeutic regimens are currently available, treatment failure remains a growing problem in daily medical practice. Several factors could play a role in the eradication failure, but the most relevant are antibiotic resistance and patient's compliance. While Helicobacter pylori resistance to amoxicillin is rare, clarithromycin and metronidazole resistance varies significantly from close to zero up to 25%. However, metronidazole in vitro resistance exhibits a lower impact on eradication success because resistance in vitro does not reflect that in vivo. Specific guidelines have then been published, mostly based on antibiotic resistance among different geographic areas. Basically, first-line and second-line regimens have been well defined; concerning third-line treatment Maastricht III guidelines suggest to adopt a culture-based approach. Culture is, however, expensive, invasive and available only in few specialized centres. An alternative approach may be to use an empirical strategy, based on the avoidance of repeating similar eradicating schemes in the same patients during the course of different eradicating regimens. For this approach we propose the acronym DANCE (Different Antibiotic No Culture Eradicating) strategy. When correctly applied, this approach showed to reach successful eradication in up to 99.5% of Helicobacter pylori-positive patients. Copyright © 2012 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Tinnitus school: an educational approach to tinnitus management based on a stress-reaction tinnitus model.

PubMed

Alpini, Dario; Cesarani, Antonio; Hahn, Ales

2007-01-01

Stress is a significant factor influencing the clinical course of tinnitus. The auditory system is particularly sensitive to the effects of various stress factors (chemical, oxidative, emotional, etc.). Different stages of reaction (alarm, resistance, exhaustion) lead to different characteristics of tinnitus and to different therapeutic approaches. Individual characteristics of stress reaction may explain different aspects of tinnitus in various patients with different responses to treatment, despite similar audiological and etiological factors. A model based on individual reactions to stress factors (stress-reaction tinnitus model, or SRTM) could explain tinnitus as an alarm signal. In each patient, stressors have to be identified during the alarm phase to prevent an evolution toward the resistance and exhaustion phases. In the exhaustion phase, chronic tinnitus is due to the organization of a paradoxical auditory memory and a pathologically shifted attention to tinnitus. The aim of our study is to describe a therapeutic proposal based on the SRTM by taking an educational approach to management of chronic tinnitus. The educational aspect is emphasized; thus, we named our approach tinnitus school. Selection of appropriate patients and follow-up is based on psychometrics of tinnitus and stress questionnaires, including a tinnitus reaction questionnaire, a tinnitus cognitive questionnaire, and a 20-item perceived stress questionnaire. Tinnitus school is a three-phase program: counseling, training, and home training. Training is based on a tinnitus-fitted physiotherapeutic protocol.

Latent class models for joint analysis of disease prevalence and high-dimensional semicontinuous biomarker data.

PubMed

Zhang, Bo; Chen, Zhen; Albert, Paul S

2012-01-01

High-dimensional biomarker data are often collected in epidemiological studies when assessing the association between biomarkers and human disease is of interest. We develop a latent class modeling approach for joint analysis of high-dimensional semicontinuous biomarker data and a binary disease outcome. To model the relationship between complex biomarker expression patterns and disease risk, we use latent risk classes to link the 2 modeling components. We characterize complex biomarker-specific differences through biomarker-specific random effects, so that different biomarkers can have different baseline (low-risk) values as well as different between-class differences. The proposed approach also accommodates data features that are common in environmental toxicology and other biomarker exposure data, including a large number of biomarkers, numerous zero values, and complex mean-variance relationship in the biomarkers levels. A Monte Carlo EM (MCEM) algorithm is proposed for parameter estimation. Both the MCEM algorithm and model selection procedures are shown to work well in simulations and applications. In applying the proposed approach to an epidemiological study that examined the relationship between environmental polychlorinated biphenyl (PCB) exposure and the risk of endometriosis, we identified a highly significant overall effect of PCB concentrations on the risk of endometriosis.

Examples of current radar technology and applications, chapter 5, part B

NASA Technical Reports Server (NTRS)

1975-01-01

Basic principles and tradeoff considerations for SLAR are summarized. There are two fundamental types of SLAR sensors available to the remote sensing user: real aperture and synthetic aperture. The primary difference between the two types is that a synthetic aperture system is capable of significant improvements in target resolution but requires equally significant added complexity and cost. The advantages of real aperture SLAR include long range coverage, all-weather operation, in-flight processing and image viewing, and lower cost. The fundamental limitation of the real aperture approach is target resolution. Synthetic aperture processing is the most practical approach for remote sensing problems that require resolution higher than 30 to 40 m.

Effects of dose and duration of Robot-Assisted Gait Training on walking ability of children affected by cerebral palsy.

PubMed

Peri, Elisabetta; Turconi, Anna Carla; Biffi, Emilia; Maghini, Cristina; Panzeri, Daniele; Morganti, Roberta; Pedrocchi, Alessandra; Gagliardi, Chiara

2017-08-09

Robot-Assisted Gait Training (RAGT) is a widespread approach for locomotion rehabilitation but information about intervention frequency and duration is still lacking. To evaluate the effect of frequency and duration of a RAGT on motor outcome of children affected by Cerebral Palsy (CP). Forty-four CP children (age 4-17) underwent one among four different intensive trainings with equal dose of intervention, combining Task-Oriented Physiotherapy (TOP) and RAGT: 40 sessions (4 sessions/week) over 10 weeks of sole TOP (group1) or RAGT (group2) or RAGT and TOP (2 + 2 sessions/week; group3); 40 sessions in shorter period (4 weeks) of RAGT and TOP (5 + 5 sessions/week; group4). Each child was assessed before, after the training and after 3 months with: Ashworth, gross motor function measure (GMFM)-88, GMFM-66, six minutes walking test and gait analysis. No differences among the 4 protocols were highlighted although both groups with exclusive physiotherapy and RAGT obtained significant improvements in GMFM-88, GMFM-E and GMFM-66 while the mixed approaches did not show significant changes. Single-treatment approaches seem to be more effective than mixed approaches, independently from the duration (4 or 10 weeks). RAGT seems to have similar effect with respect to the traditional TOP, at least over 10 weeks.

A Comparative Study of Dorsal Buccal Mucosa Graft Substitution Urethroplasty by Dorsal Urethrotomy Approach versus Ventral Sagittal Urethrotomy Approach.

PubMed

Pahwa, Mrinal; Gupta, Sanjeev; Pahwa, Mayank; Jain, Brig D K; Gupta, Manu

2013-01-01

Objectives. To compare the outcome of dorsal buccal mucosal graft (BMG) substitution urethroplasty by dorsal urethrotomy approach with ventral urethrotomy approach in management of stricture urethra. Methods and Materials. A total of 40 patients who underwent dorsal BMG substitution urethroplasty were randomized into two groups. 20 patients underwent dorsal onlay BMG urethroplasty as described by Barbagli, and the other 20 patients underwent dorsal BMG urethroplasty by ventral urethrotomy as described by Asopa. Operative time, success rate, satisfaction rate, and complications were compared between the two groups. Mean follow-up was 12 months (6-24 months). Results. Ventral urethrotomy group had considerably lesser operative time although the difference was not statistically significant. Patients in dorsal group had mean maximum flow rate of 19.6 mL/min and mean residual urine of 27 mL, whereas ventral group had a mean maximum flow rate of 18.8 and residual urine of 32 mL. Eighteen out of twenty patients voided well in each group, and postoperative imaging study in these patients showed a good lumen with no evidence of leak or extravasation. Conclusion. Though ventral sagittal urethrotomy preserves the blood supply of urethra and intraoperative time was less than dorsal urethrotomy technique, there was no statistically significant difference in final outcome using either technique.

A Comparative Study of Dorsal Buccal Mucosa Graft Substitution Urethroplasty by Dorsal Urethrotomy Approach versus Ventral Sagittal Urethrotomy Approach

PubMed Central

Pahwa, Mrinal; Gupta, Sanjeev; Pahwa, Mayank; Jain, Brig D. K.; Gupta, Manu

2013-01-01

Objectives. To compare the outcome of dorsal buccal mucosal graft (BMG) substitution urethroplasty by dorsal urethrotomy approach with ventral urethrotomy approach in management of stricture urethra. Methods and Materials. A total of 40 patients who underwent dorsal BMG substitution urethroplasty were randomized into two groups. 20 patients underwent dorsal onlay BMG urethroplasty as described by Barbagli, and the other 20 patients underwent dorsal BMG urethroplasty by ventral urethrotomy as described by Asopa. Operative time, success rate, satisfaction rate, and complications were compared between the two groups. Mean follow-up was 12 months (6–24 months). Results. Ventral urethrotomy group had considerably lesser operative time although the difference was not statistically significant. Patients in dorsal group had mean maximum flow rate of 19.6 mL/min and mean residual urine of 27 mL, whereas ventral group had a mean maximum flow rate of 18.8 and residual urine of 32 mL. Eighteen out of twenty patients voided well in each group, and postoperative imaging study in these patients showed a good lumen with no evidence of leak or extravasation. Conclusion. Though ventral sagittal urethrotomy preserves the blood supply of urethra and intraoperative time was less than dorsal urethrotomy technique, there was no statistically significant difference in final outcome using either technique. PMID:24194754

Primary Definitive Procedure versus Conventional Three-staged Procedure for the Management of Low-type Anorectal Malformation in Females: A Randomized Controlled Trial.

PubMed

Gupta, Alisha; Agarwala, Sandeep; Sreenivas, Vishnubhatla; Srinivas, Madhur; Bhatnagar, Veereshwar

2017-01-01

Females with Krickenbeck low-type anorectal malformations - vestibular fistula (VF) and perineal fistula (PF) - are managed either by a primary definitive or conventional three-staged approach. Ultimate outcome in these children may be affected by wound dehiscence leading to healing by fibrosis. Most of the literature favors one approach over other based on retrospective analysis of their outcomes. Whether a statistically significant difference in wound dehiscence rates between these approaches exists needed to be seen. A randomized controlled trial for girls <14 years with VF or PF was done. Random tables were used to randomize 33 children to Group I (primary procedure) and 31 to Group II (three-staged procedure). Statistical analysis was done for significance of difference ( P < 0.05) in the primary outcome (wound dehiscence) and secondary outcomes (immediate and early postoperative complications). Of the 64 children randomized, 54 (84%) had VF. Both groups were comparable in demography, clinical profile and age at surgery. The incidence of wound dehiscence (39.4% vs. 18.2%; P = 0.04), immediate postoperative complications (51.5% vs. 12.9%; P = 0.001), and early postoperative complications (42.4% vs. 12.9%; P = 0.01) was significantly higher in Group I as compared to Group II. Six of 13 children (46.2%) with dehiscence in Group I required a diverting colostomy to be made. Females with VF or PF undergoing primary definitive procedure have a significantly higher incidence of wound dehiscence ( P = 0.04), immediate ( P = 0.001) and early postoperative complications ( P = 0.01).

Do gingival soft tissues benefit from the application of a papilla preservation flap technique in endodontic surgery?

PubMed

Taschieri, Silvio; Corbella, Stefano; Del Fabbro, Massimo

2014-10-01

A healthy gingival condition after endodontic surgery may depend on adequate soft tissue management. The aim of this study was to compare 2 incision techniques, papilla base incision (PBI) and intrasulcular flap (IS), which are currently used in endodontic surgery. In the present nonrandomized controlled clinical trial, patients requiring endodontic surgery on a single tooth were enrolled. PBI was used in 1 group and IS was used in the other group. The primary outcomes were changes in periodontal probing depth, gingival recession, and height of the interproximal mesial and distal papillae. Outcome variables were assessed preoperatively and 6 months after surgery. Between-group differences were evaluated through appropriate statistical analysis, with significance set at a P value equal to .05. Each group was composed of 12 patients and the 2 groups were comparable at baseline. Two weeks after surgery, papilla height decreased significantly in the IS group (2.05 and 1.80 mm at the mesial and distal aspects, respectively), whereas no significant decrease in papilla height was observed in the PBI group (0.10 and 0.20 mm). No statistically significant difference between groups was observed after 6 months. No significant difference between groups was found for gingival recession or probing depth at any follow-up time. Better soft tissue preservation in the early postoperative period was achieved using the PBI approach compared with the IS approach. The PBI can be recommended for endodontic surgical procedures involving esthetic regions. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

The impact of nursing students' chemistry learning performance assessment in Taiwan: competitive versus non-competitive student team achievement division approaches

NASA Astrophysics Data System (ADS)

Wang, Kai-Ping

2012-07-01

Purpose: The purpose of this study was to determine the effectiveness of competitive Student Team Achievement Division (STAD), non-competitive STAD, and traditional learning on chemistry learning and learning perceptions. Sample, design and methods: By adopting the STAD approach, this study examined 144 nursing students at a five-year junior college in northern Taiwan during the first semester (totaling 18 weeks) of the 2008 academic year. Results: The findings reveal that both a heterogeneous group with external pressure (involving competitive STAD) and a friendship group with affective pressure (involving traditional learning) enhance group cohesion and assist students' meaningful learning; the heterogeneous group without extra pressure (involving non-competitive STAD), by contrast, fails because of apathy and lassitude. Moreover, learning effectiveness will obviously predominate until the learning strategy continues for a long period or at least one semester. Conclusions: This study revealed that the learning performance level of the competitive STAD group is significantly different from that of the non-competitive STAD group; and the learning performance level of the traditional group is significantly different from that of the non-competitive STAD group. Both the competitive STAD group and traditional group of medium ability students are significantly different from the non-competitive STAD group. Low-ability students from the competitive STAD group are significantly different from those of the non-competitive STAD, though no significant differences were found in learning perception. However, both a lack of friendship and a lack of ability in using algorithms may affect students' chemistry learning. Furthermore, gender imbalance, educational culture, and group emotions are factors that may influence student learning performance. Further study should focus on the use of grouping, improve responsibility in group discussion, and investigate group interaction patterns to determine the factors that influence learning performance of students working in groups.

A frequency-domain approach to improve ANNs generalization quality via proper initialization.

PubMed

Chaari, Majdi; Fekih, Afef; Seibi, Abdennour C; Hmida, Jalel Ben

2018-08-01

The ability to train a network without memorizing the input/output data, thereby allowing a good predictive performance when applied to unseen data, is paramount in ANN applications. In this paper, we propose a frequency-domain approach to evaluate the network initialization in terms of quality of training, i.e., generalization capabilities. As an alternative to the conventional time-domain methods, the proposed approach eliminates the approximate nature of network validation using an excess of unseen data. The benefits of the proposed approach are demonstrated using two numerical examples, where two trained networks performed similarly on the training and the validation data sets, yet they revealed a significant difference in prediction accuracy when tested using a different data set. This observation is of utmost importance in modeling applications requiring a high degree of accuracy. The efficiency of the proposed approach is further demonstrated on a real-world problem, where unlike other initialization methods, a more conclusive assessment of generalization is achieved. On the practical front, subtle methodological and implementational facets are addressed to ensure reproducibility and pinpoint the limitations of the proposed approach. Copyright © 2018 Elsevier Ltd. All rights reserved.

Combined acute ecotoxicity of malathion and deltamethrin to Daphnia magna (Crustacea, Cladocera): comparison of different data analysis approaches.

PubMed

Toumi, Héla; Boumaiza, Moncef; Millet, Maurice; Radetski, Claudemir Marcos; Camara, Baba Issa; Felten, Vincent; Masfaraud, Jean-François; Férard, Jean-François

2018-04-19

We studied the combined acute effect (i.e., after 48 h) of deltamethrin (a pyrethroid insecticide) and malathion (an organophosphate insecticide) on Daphnia magna. Two approaches were used to examine the potential interaction effects of eight mixtures of deltamethrin and malathion: (i) calculation of mixture toxicity index (MTI) and safety factor index (SFI) and (ii) response surface methodology coupled with isobole-based statistical model (using generalized linear model). According to the calculation of MTI and SFI, one tested mixture was found additive while the two other tested mixtures were found no additive (MTI) or antagonistic (SFI), but these differences between index responses are only due to differences in terminology related to these two indexes. Through the surface response approach and isobologram analysis, we concluded that there was a significant antagonistic effect of the binary mixtures of deltamethrin and malathion that occurs on D. magna immobilization, after 48 h of exposure. Index approaches and surface response approach with isobologram analysis are complementary. Calculation of mixture toxicity index and safety factor index allows identifying punctually the type of interaction for several tested mixtures, while the surface response approach with isobologram analysis integrates all the data providing a global outcome about the type of interactive effect. Only the surface response approach and isobologram analysis allowed the statistical assessment of the ecotoxicological interaction. Nevertheless, we recommend the use of both approaches (i) to identify the combined effects of contaminants and (ii) to improve risk assessment and environmental management.

Traditional surgical planning of liver surgery is modified by 3D interactive quantitative surgical planning approach: a single-center experience with 305 patients.

PubMed

Wang, Xue-Dong; Wang, Hong-Guang; Shi, Jun; Duan, Wei-Dong; Luo, Ying; Ji, Wen-Bin; Zhang, Ning; Dong, Jia-Hong

2017-06-01

Decision making and surgical planning are to achieve the precise balance of maximal removal of target lesion, maximal sparing of functional liver remnant volume, and minimal surgical invasiveness and therefore, crucial in liver surgery. The aim of this prospective study was to validate the accuracy and predictability of 3D interactive quantitative surgical planning approach (IQSP), and to evaluate the impact of IQSP on traditional surgical plans based on 2D images. A total of 305 consecutive patients undergoing hepatectomy were included in this study. Surgical plans were created by traditional 2D approach using picture archiving and communication system (PACS) and 3D approach using IQSP respectively by two groups of physicians who did not know the surgical plans of the other group. The two surgical plans were submitted to the chief surgeon for selection before operation. The specimens were weighed. The two surgical plans were compared and analyzed retrospectively based on the operation results. The two surgical plans were successfully developed in all 305 patients and all the 3D IQSP surgical plans were selected as the final decision. Total 278 patients successfully underwent surgery, including 147 uncomplex hepatectomy and 131 complex hepatectomy. Twenty-seven patients were withdrawn from hepatectomy. In the uncomplex group, the two surgical plans were the same in all 147 patients and no statistically significant difference was found among 2D calculated resection volume (2D-RV), 3D IQSP calculated resection volume (IQSP-RV) and the specimen volume. In the complex group, the two surgical plans were different in 49 patients (49/131, 37.4%). According to the significance of differences, the 49 different patients were classified into three grades. No statistically significant difference was found between IQSP-RV and specimen volume. The coincidence rate of territory analysis of IQSP with operation was 92.1% (93/101) for 101 patients of anatomic hepatectomy. The accuracy and predictability of 3D IQSP were validated. Compared with traditional surgical planning, 3D IQSP can provide more quantitative information of anatomic structure. With the assistance of 3D IQSP, traditional surgical plans were modified to be more radical and safe.

Abdominal pain endpoints currently recommended by the FDA and EMA for adult patients with irritable bowel syndrome may not be reliable in children.

PubMed

Saps, M; Lavigne, J V

2015-06-01

The Food and Drug Administration (FDA) recommended ≥30% decrease on patient-reported outcomes for pain be considered clinically significant in clinical trials for adults with irritable bowel syndrome. This percent change approach may not be appropriate for children. We compared three alternate approaches to determining clinically significant reductions in pain among children. 80 children with functional abdominal pain participated in a study of the efficacy of amitriptyline. Endpoints included patient-reported estimates of feeling better, and pain Visual Analog Scale (VAS). The minimum clinically important difference in pain report was calculated as (i) mean change in VAS score for children reporting being 'better'; (ii) percent changes in pain (≥30% and ≥50%) on the VAS; and (iii) statistically reliable changes on the VAS for 68% and 95% confidence intervals. There was poor agreement between the three approaches. 43.6% of the children who met the FDA ≥30% criterion for clinically significant change did not achieve a reliable level of improvement (95% confidence interval). Children's self-reported ratings of being better may not be statistically reliable. A combined approach in which children must report improvement as better and achieve a statistically significant change may be more appropriate for outcomes in clinical trials. © 2015 John Wiley & Sons Ltd.

Quantitative Analysis of Mutant Subclones in Chronic Myeloid Leukemia: Comparison of Different Methodological Approaches

PubMed Central

Preuner, Sandra; Barna, Agnes; Frommlet, Florian; Czurda, Stefan; Konstantin, Byrgazov; Alikian, Mary; Machova Polakova, Katerina; Sacha, Tomasz; Richter, Johan; Lion, Thomas; Gabriel, Christian

2016-01-01

Identification and quantitative monitoring of mutant BCR-ABL1 subclones displaying resistance to tyrosine kinase inhibitors (TKIs) have become important tasks in patients with Ph-positive leukemias. Different technologies have been established for patient screening. Various next-generation sequencing (NGS) platforms facilitating sensitive detection and quantitative monitoring of mutations in the ABL1-kinase domain (KD) have been introduced recently, and are expected to become the preferred technology in the future. However, broad clinical implementation of NGS methods has been hampered by the limited accessibility at different centers and the current costs of analysis which may not be regarded as readily affordable for routine diagnostic monitoring. It is therefore of interest to determine whether NGS platforms can be adequately substituted by other methodological approaches. We have tested three different techniques including pyrosequencing, LD (ligation-dependent)-PCR and NGS in a series of peripheral blood specimens from chronic myeloid leukemia (CML) patients carrying single or multiple mutations in the BCR-ABL1 KD. The proliferation kinetics of mutant subclones in serial specimens obtained during the course of TKI-treatment revealed similar profiles via all technical approaches, but individual specimens showed statistically significant differences between NGS and the other methods tested. The observations indicate that different approaches to detection and quantification of mutant subclones may be applicable for the monitoring of clonal kinetics, but careful calibration of each method is required for accurate size assessment of mutant subclones at individual time points. PMID:27136541

Obtaining identical results with double precision global accuracy on different numbers of processors in parallel particle Monte Carlo simulations

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

Cleveland, Mathew A., E-mail: cleveland7@llnl.gov; Brunner, Thomas A.; Gentile, Nicholas A.

2013-10-15

We describe and compare different approaches for achieving numerical reproducibility in photon Monte Carlo simulations. Reproducibility is desirable for code verification, testing, and debugging. Parallelism creates a unique problem for achieving reproducibility in Monte Carlo simulations because it changes the order in which values are summed. This is a numerical problem because double precision arithmetic is not associative. Parallel Monte Carlo, both domain replicated and decomposed simulations, will run their particles in a different order during different runs of the same simulation because the non-reproducibility of communication between processors. In addition, runs of the same simulation using different domain decompositionsmore » will also result in particles being simulated in a different order. In [1], a way of eliminating non-associative accumulations using integer tallies was described. This approach successfully achieves reproducibility at the cost of lost accuracy by rounding double precision numbers to fewer significant digits. This integer approach, and other extended and reduced precision reproducibility techniques, are described and compared in this work. Increased precision alone is not enough to ensure reproducibility of photon Monte Carlo simulations. Non-arbitrary precision approaches require a varying degree of rounding to achieve reproducibility. For the problems investigated in this work double precision global accuracy was achievable by using 100 bits of precision or greater on all unordered sums which where subsequently rounded to double precision at the end of every time-step.« less

Quantitative Analysis of Mutant Subclones in Chronic Myeloid Leukemia: Comparison of Different Methodological Approaches.

PubMed

Preuner, Sandra; Barna, Agnes; Frommlet, Florian; Czurda, Stefan; Konstantin, Byrgazov; Alikian, Mary; Machova Polakova, Katerina; Sacha, Tomasz; Richter, Johan; Lion, Thomas; Gabriel, Christian

2016-04-29

Identification and quantitative monitoring of mutant BCR-ABL1 subclones displaying resistance to tyrosine kinase inhibitors (TKIs) have become important tasks in patients with Ph-positive leukemias. Different technologies have been established for patient screening. Various next-generation sequencing (NGS) platforms facilitating sensitive detection and quantitative monitoring of mutations in the ABL1-kinase domain (KD) have been introduced recently, and are expected to become the preferred technology in the future. However, broad clinical implementation of NGS methods has been hampered by the limited accessibility at different centers and the current costs of analysis which may not be regarded as readily affordable for routine diagnostic monitoring. It is therefore of interest to determine whether NGS platforms can be adequately substituted by other methodological approaches. We have tested three different techniques including pyrosequencing, LD (ligation-dependent)-PCR and NGS in a series of peripheral blood specimens from chronic myeloid leukemia (CML) patients carrying single or multiple mutations in the BCR-ABL1 KD. The proliferation kinetics of mutant subclones in serial specimens obtained during the course of TKI-treatment revealed similar profiles via all technical approaches, but individual specimens showed statistically significant differences between NGS and the other methods tested. The observations indicate that different approaches to detection and quantification of mutant subclones may be applicable for the monitoring of clonal kinetics, but careful calibration of each method is required for accurate size assessment of mutant subclones at individual time points.

Dosimetric Advantages of Midventilation Compared With Internal Target Volume for Radiation Therapy of Pancreatic Cancer

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

Lens, Eelco, E-mail: e.lens@amc.uva.nl; Horst, Astrid van der; Versteijne, Eva

2015-07-01

Purpose: The midventilation (midV) approach can be used to take respiratory-induced pancreatic tumor motion into account during radiation therapy. In this study, the dosimetric consequences for organs at risk and tumor coverage of using a midV approach compared with using an internal target volume (ITV) were investigated. Methods and Materials: For each of the 18 patients, 2 treatment plans (25 × 2.0 Gy) were created, 1 using an ITV and 1 using a midV approach. The midV dose distribution was blurred using the respiratory-induced motion from 4-dimensional computed tomography. The resulting planning target volume (PTV) coverage for this blurred dosemore » distribution was analyzed; PTV coverage was required to be at least V{sub 95%} >98%. In addition, the change in PTV size and the changes in V{sub 10Gy}, V{sub 20Gy}, V{sub 30Gy}, V{sub 40Gy}, D{sub mean} and D{sub 2cc} for the stomach and for the duodenum were analyzed; differences were tested for significance using the Wilcoxon signed-rank test. Results: Using a midV approach resulted in sufficient target coverage. A highly significant PTV size reduction of 13.9% (P<.001) was observed. Also, all dose parameters for the stomach and duodenum, except the D{sub 2cc} of the duodenum, improved significantly (P≤.002). Conclusions: By using the midV approach to account for respiratory-induced tumor motion, a significant PTV reduction and significant dose reductions to the stomach and to the duodenum can be achieved when irradiating pancreatic tumors.« less

Prevention of the spread of infection--the need for a family-centred approach to hygiene promotion.

PubMed

Bloomfield, S; Exner, M; Fara, G M; Scott, E A

2008-05-29

Infectious diseases circulating in the home and community are a continuing and significant burden on the health and prosperity of the European community. They could, however, be significantly reduced by better standards of hygiene. Across Europe, public health is currently structured such that the separate aspects of hygiene in different settings (food hygiene, personal hygiene, handwashing, pandemic flu preparedness, patient empowerment etc.) are dealt with by separate agencies. If efforts to promote hygiene at community level are to be successful in changing behaviour, we need a concerted family-centred approach to ensure that a basic understanding of infectious disease agents and their mechanisms of spread, together with an understanding of a risk-based approach to hygiene, are promoted as part of the school curriculum and as part of public health campaigns. Alongside this, we also need unambiguous communication with the public on issues such as the hygiene hypothesis and environmental issues.

Linear Relationship between Resilience, Learning Approaches, and Coping Strategies to Predict Achievement in Undergraduate Students

PubMed Central

de la Fuente, Jesús; Fernández-Cabezas, María; Cambil, Matilde; Vera, Manuel M.; González-Torres, Maria Carmen; Artuch-Garde, Raquel

2017-01-01

The aim of the present research was to analyze the linear relationship between resilience (meta-motivational variable), learning approaches (meta-cognitive variables), strategies for coping with academic stress (meta-emotional variable) and academic achievement, necessary in the context of university academic stress. A total of 656 students from a southern university in Spain completed different questionnaires: a resiliency scale, a coping strategies scale, and a study process questionnaire. Correlations and structural modeling were used for data analyses. There was a positive and significant linear association showing a relationship of association and prediction of resilience to the deep learning approach, and problem-centered coping strategies. In a complementary way, these variables positively and significantly predicted the academic achievement of university students. These results enabled a linear relationship of association and consistent and differential prediction to be established among the variables studied. Implications for future research are set out. PMID:28713298

Interhemispheric differences of the correlation dimension in a human sleep electroencephalogram.

PubMed

Kobayashi, Toshio; Madokoro, Shigeki; Misaki, Kiwamu; Murayama, Jyunichi; Nakagawa, Hiroki; Wada, Yuji

2002-06-01

The interhemispheric differences of the correlation dimension (D2) in the sleep electroencephalogram (EEG) of eight healthy right-handed students was investigated. During slow wave sleep (SWS) the D2 of the central EEG and the temporal left hemisphere (LH) EEG were significantly higher than those in the right hemisphere (RH) EEG; but during rapid eye movement (REM) sleep, the D2 of the central EEG and the occipital RH EEG were significantly higher. The D2 of EEG in the left temporal site during REM sleep were significantly higher than in the right during the first and third sleep cycles, but these were significantly lower during the fourth and fifth sleep cycles. During REM sleep, temporal brain activity may shift from the LH to the RH as morning approaches.

Characterization of road freight transportation and its impact on the national emission inventory in China

NASA Astrophysics Data System (ADS)

Yang, X. F.; Liu, H.; Man, H. Y.; He, K. B.

2014-06-01

Mobile source emission inventories serve as critical input for atmospheric chemical transport models, which are used to simulate air quality and understand the role of mobile source emissions. The significance of mobile sources is even more important in China because the country has the largest vehicle population in the world, and that population continues to grow rapidly. Estimating emissions from diesel trucks is a critical work in mobile source emission inventories due to the importance and difficulties associated with estimating emissions from diesel trucks. Although diesel trucks are major contributors of nitrogen oxide (NOx) and primary particulate matter smaller than 2.5 μm (PM2.5), there are still more obstacles on the existing estimation of diesel truck emissions compared with that of cars; long-range freight transportation activities are complicated, and much of the basic data remain unclear. Most of existing inventories were based on local registration number. However, according to our research, a large number of trucks are conducting long-distance inter-city or inter province transportation. Instead of the local registration number based approach, a road emission intensity-based (REIB) approach is introduced in this research. To provide efficient data for the REIB approach, 1060 questionnaire responses and approximately 1.7 million valid seconds of onboard GPS monitoring data were collected. Both the questionnaire answers and GPS monitoring results indicated that the driving conditions on different types of road have significant impacts on the emission levels of freight trucks. We present estimated emissions of NOx and primary PM2.5 from diesel freight trucks for China in 2011. Using the REIB approach, the activity level and distribution data are obtained from the questionnaire answers. Emission factors are calculated with the International Vehicle Emission (IVE) model that interpolated local on-board measurement results in China according to the GPS monitoring data on different roads. Depending on the results in this research, the largest differences among the emission factors (in g km-1) on different roads exceed 70 and 50% for NOx and PM2.5, respectively. The differences were caused by different driving conditions that we monitored via GPS. The estimated NOx and PM2.5 emissions from diesel freight trucks in China were 5.0 (4.8-7.2) million t and 0.20 (0.17-0.22) million t, respectively, via the REIB approach in 2011. Another implication of this research is that different road infrastructure would have different impacts for NOx and PM2.5 emissions. A region with more inter-city freeways or national roads tends to have more NOx emissions, while urban streets play a more important role in primary PM2.5 emissions from freight trucks. Compared with former studies, which allocate emissions according to local truck registration number and neglect inter-region long distance transport trips, the REIB approach has advantages regarding the allocation of diesel truck emissions into the provinces. Furthermore, the different driving conditions on the different roads types are no longer overlooked with this approach.

Brain Type or Sex Differences? A Structural Equation Model of the Relation between Brain Type, Sex, and Motivation to Learn Science

ERIC Educational Resources Information Center

Zeyer, Albert; Bolsterli, Katrin; Brovelli, Dorothee; Odermatt, Freia

2012-01-01

Sex is considered to be one of the most significant factors influencing attitudes towards science. However, the so-called brain type approach from cognitive science suggests that the difference in motivation to learn science does not primarily differentiate the girls from the boys, but rather the so-called systemisers from the empathizers. The…

Pre-Columbian Curriculum Motivators: An Approach to Bi-cultural Instruction.

ERIC Educational Resources Information Center

Jimenez, Randall Cosme

A process that could facilitate a cross-cultural learning environment was designed. The process involved (1) developing motivational devices using an historical selection process that incorporated a "significant difference", evaluated reconstructed historical materials, devices that prevent a "past-present" dichotomy,…

Effects of intrusions on grades and contents of gold and other metals in volcanogenic massive sulfide deposits

USGS Publications Warehouse

Singer, Donald A.; Berger, Vladimir; Mosier, Dan L.

2011-01-01

The reason some VMS deposits contain more gold or other metals than others might be due to the influence of intrusions. A new approach examining this possibility is based on examining the information about many VMS deposits to test statistically if those with associated intrusions have significantly different grades or amounts of metals. A set of 632 VMS deposits with reported grades, tonnages, and information about the observed presence or absence of subvolcanic or plutonic intrusive bodies emplaced at or after VMS mineralization is statistically analyzed.Deposits with syn-mineralization or post-mineralization intrusions nearby have higher tonnages than deposits without reported intrusions, but the differences are not statistically significant. When both kinds of intrusions are reported, VMS deposit sizes are significantly higher than in the deposits without any intrusions. Gold, silver, zinc, lead, and copper average grades are not significantly different in the VMS deposits with nearby intrusions compared to deposits without regardless of relative age of intrusive. Only zinc and copper contents are significantly higher in VMS deposits with both kinds of intrusive reported. These differences in overall metal content are due to significantly larger deposit sizes of VMS deposits where both intrusive kinds are observed and reported, rather than any difference in metal grades.

Active war in Sri Lanka: Children's war exposure, coping, and posttraumatic stress disorder symptom severity.

PubMed

Soysa, Champika K; Azar, Sandra T

2016-01-01

Posttraumatic stress disorder (PTSD) in response to active war is understudied among Sinhalese children in Sri Lanka. We investigated PTSD symptom severity in children using child (n = 60) and mother (n = 60) reports; child-reported war exposure and coping; as well as self-reported maternal PTSD symptom severity. The study addressed active war in 2 rural locations (acute and chronic community war exposure). Child-reports were significantly greater than mother-reports of child PTSD symptom severity. Furthermore, children's war exposure, child-reported and mother-reported child PTSD symptom severity, and maternal PTSD symptom severity were significantly greater in the acute versus chronic community war exposure location, but children's approach and avoidance coping did not significantly differ, indicating a potential ceiling effect. Children's war exposure significantly, positively predicted child-reported child PTSD symptom severity, controlling for age, gender, and maternal PTSD symptom severity, but only maternal PTSD symptom severity significantly, positively predicted mother-reported child PTSD symptom severity. Avoidance coping (in both acute and chronic war) significantly positively mediated the children's war exposure-child-reported child PTSD symptom severity relation, but not mother-reports of the same. Approach coping (in chronic but not acute war) significantly, positively mediated the children's war exposure-child-reported and mother-reported child PTSD symptom severity relations. We advanced the literature on long-term active war by confirming the value of children's self-reports, establishing that both approach and avoidance coping positively mediated the war-exposure-PTSD symptom severity relation, and that the mediation effect of approach coping was situationally moderated by acute verses chronic community war exposure among Sri Lankan children. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Green, Rapid, and Universal Preparation Approach of Graphene Quantum Dots under Ultraviolet Irradiation.

PubMed

Zhu, Jinli; Tang, Yanfeng; Wang, Gang; Mao, Jiarong; Liu, Zhiduo; Sun, Tongming; Wang, Miao; Chen, Da; Yang, Yucheng; Li, Jipeng; Deng, Yuan; Yang, Siwei

2017-04-26

It is of great significance and importance to explore a mild, clean, and highly efficient universal approach for the synthesis of graphene quantum dots. Herein, we introduced a new green, rapid, and universal preparation approach for graphene quantum dots via the free-radical polymerization of oxygen-containing aromatic compounds under ultraviolet irradiation. This approach had a high yield (86%), and the byproducts are only H 2 O and CO 2 . The obtained graphene quantum dots were well-crystallized and showed remarkable optical and biological properties. The colorful, different-sized graphene quantum dots can be used in fluorescent bioimaging in vitro and in vivo. This approach is suitable not only for the preparation of graphene quantum dots but also for heteroatom-doped graphene quantum dots.

The Effect of Screen Size on Mobile Phone User Comprehension of Health Information and Application Structure: An Experimental Approach.

PubMed

Al Ghamdi, Ebtisam; Yunus, Faisal; Da'ar, Omar; El-Metwally, Ashraf; Khalifa, Mohamed; Aldossari, Bakheet; Househ, Mowafa

2016-01-01

This research analyzes the impact of mobile phone screen size on user comprehension of health information and application structure. Applying experimental approach, we asked randomly selected users to read content and conduct tasks on a commonly used diabetes mobile application using three different mobile phone screen sizes. We timed and tracked a number of parameters, including correctness, effectiveness of completing tasks, content ease of reading, clarity of information organization, and comprehension. The impact of screen size on user comprehension/retention, clarity of information organization, and reading time were mixed. It is assumed on first glance that mobile screen size would affect all qualities of information reading and comprehension, including clarity of displayed information organization, reading time and user comprehension/retention of displayed information, but actually the screen size, in this experimental research, did not have significant impact on user comprehension/retention of the content or on understanding the application structure. However, it did have significant impact on clarity of information organization and reading time. Participants with larger screen size took shorter time reading the content with a significant difference in the ease of reading. While there was no significant difference in the comprehension of information or the application structures, there were a higher task completion rate and a lower number of errors with the bigger screen size. Screen size does not directly affect user comprehension of health information. However, it does affect clarity of information organization, reading time and user's ability to recall information.

Novel strategy of endoscopic submucosal dissection using an insulation-tipped knife for early gastric cancer: near-side approach method

PubMed Central

Mori, Genki; Nonaka, Satoru; Oda, Ichiro; Abe, Seiichiro; Suzuki, Haruhisa; Yoshinaga, Shigetaka; Nakajima, Takeshi; Saito, Yutaka

2015-01-01

Background and study aims: Endoscopic submucosal dissection (ESD) using insulation-tipped knives (IT knives) to treat gastric lesions located on the greater curvature of the gastric body remains technically challenging because of the associated bleeding, control of which can be difficult and time consuming. To eliminate these difficulties, we developed a novel strategy which we have called the “near-side approach method” and assessed its utility. Patients and methods: We reviewed patients who underwent ESD for solitary early gastric cancer located on the greater curvature of the gastric body from January 2003 to September 2014. The technical results of ESD were compared between the group treated with the novel near-side approach method and the group treated with the conventional method. Results: This study included 238 patients with 238 lesions, 118 of which were removed using the near-side approach method and 120 of which were removed using the conventional method. The median procedure time was 92 minutes for the near-side approach method and 120 minutes for the conventional method. The procedure time was significantly shorter in the near-side approach method arm. Although, the procedure time required by an experienced endoscopist was not significantly different between the two groups (100 vs. 110 minutes), the near-side approach group showed significantly shorter procedure time for a less-experienced endoscopist (90 vs. 120 minutes). Conclusions: The near-side approach method appears to require less time to complete gastric ESD than the conventional method using IT knives for technically challenging lesions located on the greater curvature of the gastric body, especially if the procedure is performed by less-experienced endoscopists. PMID:26528496

"Yummy" versus "Yucky"! Explicit and implicit approach-avoidance motivations towards appealing and disgusting foods.

PubMed

Piqueras-Fiszman, Betina; Kraus, Alexandra A; Spence, Charles

2014-07-01

Wanting and rejecting food are natural reactions that we humans all experience, often unconsciously, on a daily basis. However, in the food domain, the focus to date has primarily been on the approach tendency, and researchers have tended not to study the two opposing tendencies in a balanced manner. Here, we develop a methodology with which to understand people's implicit and explicit reactions to both positive (appealing) and negative (disgusting) foods. It consists of a combination of direct and indirect computer-based tasks, as well as a validated food image stimulus set, specifically designed to investigate motivational approach and avoidance responses towards foods. Fifty non-dieting participants varying in terms of their hunger state (hungry vs. not hungry) reported their explicit evaluations of pleasantness, wanting, and disgust towards the idea of tasting each of the food images that were shown. Their motivational tendencies towards those food items were assessed indirectly using a joystick-based approach-avoidance procedure. For each of the food images that were presented, the participants had to move the joystick either towards or away from themselves (approach and avoidance movements, respectively) according to some unrelated instructions, while their reaction times were recorded. Our findings demonstrated the hypothesised approach-avoidance compatibility effect: a significant interaction of food valence and direction of movement. Furthermore, differences between the experimental groups were observed. The participants in the no-hunger group performed avoidance (vs. approach) movements significantly faster; and their approach movements towards positive (vs. negative) foods were significantly faster. As expected, the self-report measures revealed a strong effect of the food category on the three dependent variables and a strong main effect of the hunger state on wanting and to a lesser extent on pleasantness. Copyright © 2014 Elsevier Ltd. All rights reserved.

Buccal sulcus versus intranasal approach for postoperative periorbital oedema and ecchymosis in lateral nasal osteotomy.

PubMed

Ghazipour, Ali; Alani, Nadereh; Ghavami Lahiji, Shervin; Akbari Dilmaghani, Nader

2014-10-01

Lateral osteotomies are used in rhinoplasty to narrow the nasal bones, close the open roof deformity after hump removal, and achieve symmetry of an asymmetrical framework. But this procedure causes periorbital oedema & ecchymosis. Different techniques have been described for lateral osteotomy. To compare the postoperative ecchymosis and oedema after buccal sulcus lateral osteotomy versus intranasal lateral osteotomy. In a prospective experimental study, buccal sulcus approach was performed on the right side and an intranasal approach performed on the left side of patients randomly. Then blind analysis of postoperative photographs was performed to determine the incidence of oedema and ecchymosis on each side. Fifty patients were enrolled in the study after exclusion of unfit patients. On the right side (buccal approach osteotomies), a significantly lower incidence of upper and lower eyelid oedema and upper eyelid ecchymosis was seen on both the 2nd day and after 7th day (P < 0.05). The odds ratio of progression of ecchymosis was 2.66 (OR = 2.66, 95% CI: 1.09-5.52, p = 0.048) in intranasal group compare to buccal sulcus group. No significant complication observed. The buccal sulcus approach is a safe method for lateral osteotomy with a lower rate of postoperative oedema and ecchymosis and no significant complications. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Aerothermodynamic Design Sensitivities for a Reacting Gas Flow Solver on an Unstructured Mesh Using a Discrete Adjoint Formulation

NASA Astrophysics Data System (ADS)

Thompson, Kyle Bonner

An algorithm is described to efficiently compute aerothermodynamic design sensitivities using a decoupled variable set. In a conventional approach to computing design sensitivities for reacting flows, the species continuity equations are fully coupled to the conservation laws for momentum and energy. In this algorithm, the species continuity equations are solved separately from the mixture continuity, momentum, and total energy equations. This decoupling simplifies the implicit system, so that the flow solver can be made significantly more efficient, with very little penalty on overall scheme robustness. Most importantly, the computational cost of the point implicit relaxation is shown to scale linearly with the number of species for the decoupled system, whereas the fully coupled approach scales quadratically. Also, the decoupled method significantly reduces the cost in wall time and memory in comparison to the fully coupled approach. This decoupled approach for computing design sensitivities with the adjoint system is demonstrated for inviscid flow in chemical non-equilibrium around a re-entry vehicle with a retro-firing annular nozzle. The sensitivities of the surface temperature and mass flow rate through the nozzle plenum are computed with respect to plenum conditions and verified against sensitivities computed using a complex-variable finite-difference approach. The decoupled scheme significantly reduces the computational time and memory required to complete the optimization, making this an attractive method for high-fidelity design of hypersonic vehicles.

Critical appraisal of the top-down approach for vesicoureteral reflux

PubMed Central

Abdelhalim, Ahmed

2017-01-01

Vesicoureteral reflux (VUR) has been linked to recurrent urinary tract infections (UTIs), renal scarring, hypertension, renal insufficiency and end-stage kidney disease. Different imaging strategies have been proposed to approach children presenting with UTI to sort out patients with significant VUR while minimizing patient morbidity, radiation exposure and financial burden. None of these imaging strategies is universally accepted. The“top-down approach” (TDA) aims at restricting the number of voiding cystourethrograms (VCUGs) and its associated morbidity while identifying patients with clinically-significant reflux. In this approach, children presenting with febrile UTIs are acutely investigated with dimercapto-succinic acid (DMSA) renal scans to identify patients with renal parenchymal inflammation. Those with evidence of renal affection are offered VCUG and late DMSA scan to identify VUR and permanent renal scarring, respectively. Although TDA could identify clinically-significant VUR with high sensitivity, it is not without limitations. The approach segregates patients based on the presence of DMSA cortical lesions omitting the morbidity and the economic burden of UTI. Additionally, some of DMSA lesions are attributed to congenital dysplasia and unrelated to UTI. Ionizing radiation exposure, financial costs, limited availability of DMSA scans in the acute setting, variability in interpreting the results and low yield of actionable findings on DMSA scans are some other limitations. In this review, we tried to address the drawbacks of the TDA and reinforce the value of patient-centered approach for VUR. PMID:28612056

Evaluating Individual Students' Perceptions of Instructional Quality: An Investigation of their Factor Structure, Measurement Invariance, and Relations to Educational Outcomes

PubMed Central

Scherer, Ronny; Nilsen, Trude; Jansen, Malte

2016-01-01

Students' perceptions of instructional quality are among the most important criteria for evaluating teaching effectiveness. The present study evaluates different latent variable modeling approaches (confirmatory factor analysis, exploratory structural equation modeling, and bifactor modeling), which are used to describe these individual perceptions with respect to their factor structure, measurement invariance, and the relations to selected educational outcomes (achievement, self-concept, and motivation in mathematics). On the basis of the Programme for International Student Assessment (PISA) 2012 large-scale data sets of Australia, Canada, and the USA (N = 26,746 students), we find support for the distinction between three factors of individual students' perceptions and full measurement invariance across countries for all modeling approaches. In this regard, bifactor exploratory structural equation modeling outperformed alternative approaches with respect to model fit. Our findings reveal significant relations to the educational outcomes. This study synthesizes different modeling approaches of individual students' perceptions of instructional quality and provides insights into the nature of these perceptions from an individual differences perspective. Implications for the measurement and modeling of individually perceived instructional quality are discussed. PMID:26903917

Very long-term sequelae of craniopharyngioma.

PubMed

Wijnen, Mark; van den Heuvel-Eibrink, Marry M; Janssen, Joseph A M J L; Catsman-Berrevoets, Coriene E; Michiels, Erna M C; van Veelen-Vincent, Marie-Lise C; Dallenga, Alof H G; van den Berge, J Herbert; van Rij, Carolien M; van der Lely, Aart-Jan; Neggers, Sebastian J C M M

2017-06-01

Studies investigating long-term health conditions in patients with craniopharyngioma are limited by short follow-up durations and generally do not compare long-term health effects according to initial craniopharyngioma treatment approach. In addition, studies comparing long-term health conditions between patients with childhood- and adult-onset craniopharyngioma report conflicting results. The objective of this study was to analyse a full spectrum of long-term health effects in patients with craniopharyngioma according to initial treatment approach and age group at craniopharyngioma presentation. Cross-sectional study based on retrospective data. We studied a single-centre cohort of 128 patients with craniopharyngioma treated from 1980 onwards (63 patients with childhood-onset disease). Median follow-up since craniopharyngioma presentation was 13 years (interquartile range: 5-23 years). Initial craniopharyngioma treatment approaches included gross total resection ( n  = 25), subtotal resection without radiotherapy ( n  = 44), subtotal resection with radiotherapy ( n  = 25), cyst aspiration without radiotherapy ( n  = 8), and 90 Yttrium brachytherapy ( n  = 21). Pituitary hormone deficiencies (98%), visual disturbances (75%) and obesity (56%) were the most common long-term health conditions observed. Different initial craniopharyngioma treatment approaches resulted in similar long-term health effects. Patients with childhood-onset craniopharyngioma experienced significantly more growth hormone deficiency, diabetes insipidus, panhypopituitarism, morbid obesity, epilepsy and psychiatric conditions compared with patients with adult-onset disease. Recurrence-/progression-free survival was significantly lower after initial craniopharyngioma treatment with cyst aspiration compared with other therapeutic approaches. Survival was similar between patients with childhood- and adult-onset craniopharyngioma. Long-term health conditions were comparable after different initial craniopharyngioma treatment approaches and were generally more frequent in patients with childhood- compared with adult-onset disease. © 2017 European Society of Endocrinology.

Study of the effect of mixing approach on cross-linking efficiency of hyaluronic acid-based hydrogel cross-linked with 1,4-butanediol diglycidyl ether.

PubMed

Al-Sibani, Mohammed; Al-Harrasi, Ahmed; Neubert, Reinhard H H

2016-08-25

Regardless of various strategies reported for cross-linking hyaluronic acid (HA) with 1,4-butanediol diglycidyl ether (BDDE), seeking new strategies that enhance cross-linking efficiency with a low level of cross-linker is essential. In this work, we studied the influence of mixing approach on two cross-linked BDDE-HA hydrogels prepared by two different mixing approaches; the large-batch mixing approach in which the hydrogel quantities were all mixed as a single lump in one container (hydrogel 1), and the small-batches mixing approach in which the hydrogel quantities were divided into smaller batches, mixed separately at various HA/BDDE ratios then combined in one reaction mixture (hydrogel 2). The result showed that the cross-linking reaction was mixing process-dependent. Degradation tests proved that, in relation to hydrogel 1, hydrogel 2 was more stable, and exhibited a higher resistance towards hyaluronidase activity. The swelling ratio of hydrogel 1 was significantly higher than that of hydrogel 2 in distilled water; however, in phosphate buffer saline, both hydrogels showed no significant difference. SEM images demonstrated that hydrogel 2 composite showed a denser network structure and smaller pore-size than hydrogel 1. In comparison to native HA, the occurrence of chemical modification in the cross-linked hydrogels was confirmed by FTIR and NMR distinctive peaks. These peaks also provided evidence that hydrogel 2 exhibited a higher degree of modification than hydrogel 1. In conclusion, the small-batches mixing approach proved to be more effective than large-batch mixing in promoting HA-HA entanglement and increasing the probability of BDDE molecules for binding with HA chains. Copyright © 2016 Elsevier B.V. All rights reserved.

Acceleration estimation using a single GPS receiver for airborne scalar gravimetry

NASA Astrophysics Data System (ADS)

Zhang, Xiaohong; Zheng, Kai; Lu, Cuixian; Wan, Jiakuan; Liu, Zhanke; Ren, Xiaodong

2017-11-01

Kinematic acceleration estimated using the global positioning system (GPS) is significant for airborne scalar gravimetry. As the conventional approach based on the differential global positioning system (DGPS) presents several drawbacks, including additional cost or the impracticality of setting up nearby base stations in challenging environments, we introduce an alternative approach, Modified Kin-VADASE (MKin-VADASE), based on a modified Kin-VADASE approach without the requirement to have ground-base stations. In this approach, the aircraft velocities are first estimated with the modified Kin-VADASE. Then the accelerations are obtained from velocity estimates using the Taylor approximation differentiator. The impact of carrier-phase measurement noise and satellite ephemeris errors on acceleration estimates are investigated carefully in the frequency domain with the Fast Fourier Transform Algorithm (FFT). The results show that the satellite clock products have a significant impact on the acceleration estimates. Then, the performance of MKin-VADASE, PPP, and DGPS are validated using flight tests carried out in Shanxi Province, China. The accelerations are estimated using the three approaches, then used to calculate the gravity disturbances. Finally, the analysis of crossover difference and the terrestrial gravity data are used to evaluate the accuracy of gravity disturbance estimates. The results show that the performances of MKin-VADASE, PPP and DGPS are comparable, but the computational complexity of MKin-VADASE is greatly reduced with regard to PPP and DGPS. For the results of the three approaches, the RMS of crossover differences of gravity disturbance estimates is approximately 1-1.5 mGal at a spatial resolution of 3.5 km (half wavelength) after crossover adjustment, and the accuracy is approximately 3-4 mGal with respect to terrestrial gravity data.

The case-only test for gene-environment interaction is not uniformly powerful: an empirical example

PubMed Central

Wu, Chen; Chang, Jiang; Ma, Baoshan; Miao, Xiaoping; Zhou, Yifeng; Liu, Yu; Li, Yun; Wu, Tangchun; Hu, Zhibin; Shen, Hongbing; Jia, Weihua; Zeng, Yixin; Lin, Dongxin; Kraft, Peter

2016-01-01

The case-only test has been proposed as a more powerful approach to detect gene-environment (G×E) interactions. This approach assumes that the genetic and environmental factors are independent. While it is well known that Type I error rate will increase if this assumption is violated, it is less widely appreciated that gene-environment correlation can also lead to power loss. We illustrate this phenomenon by comparing the performance of the case-only test to other approaches to detect G×E interactions in a genome-wide association study of esophageal squamous carcinoma (ESCC) in Chinese populations. Some of these approaches do not use information on the correlation between exposure and genotype (standard logistic regression), while others seek to use this information in a robust fashion to boost power without increasing Type I error (two-step, empirical Bayes and cocktail methods). G×E interactions were identified involving drinking status and two regions containing genes in the alcohol metabolism pathway, 4q23 and 12q24. Although the case-only test yielded the most significant tests of G×E interaction in the 4q23 region, the case-only test failed to identify significant interactions in the 12q24 region which were readily identified using other approaches. The low power of the case-only test in the 12q24 region is likely due to the strong inverse association between the SNPs in this region and drinking status. This example underscores the need to consider multiple approaches to detect gene-environment interactions, as different tests are more or less sensitive to different alternative hypotheses and violations of the gene-environment independence assumption. PMID:23595356

The management of newborns with esophageal atresia and right aortic arch: A systematic review or still unsolved problem.

PubMed

Parolini, Filippo; Armellini, Andrea; Boroni, Giovanni; Bagolan, Pietro; Alberti, Daniele

2016-02-01

The management of newborns with esophageal atresia (EA) and right aortic arch (RAA) is still an unsolved problem. This study provides a systematic review of epidemiology, diagnosis, management and short-term results of children with EA and RAA. The PubMed database was searched for original studies on children with EA and RAA. In each study, data were extracted for the following outcomes: number of patients, associated anomalies, type of surgical repair, morbidity and mortality rate. Eight studies were selected, including 54 patients with EA and RAA. RAA was encountered in 3.6% of infants. Preoperative detection of RAA was reported in 7 of them. In these patients, primary anastomosis was achieved through the right approach in 3 (thoracotomy in 2 and thoracoscopy in 1) while the left approach was the primary choice in 4 (thoracotomy in 2 and thoracoscopy in 2). No significant differences were found between the right and left approaches with regard to leaks (P=0.89), strictures (P=1) or mortality (P=1). In 47/54 patients (87%) RAA was noted during right thoracotomy, and primary anastomosis was achieved through the same approach in 29 (61.7%); conversion to other approaches (left thoracotomy or esophageal substitution) was performed in 15 children (38.3%). No significant differences were found between primary left thoracotomy (LT) and LT after RT with regard to leaks (P=0.89), strictures (P=1) or mortality (P=1). Skills and preferences of the surgeon still guide the choice of surgical approach even when preoperatively faced with RAA. A multicenter, prospective randomized study is strongly required. Copyright © 2016 Elsevier Inc. All rights reserved.

Soil salinity assessment through satellite thermography for different irrigated and rainfed crops

NASA Astrophysics Data System (ADS)

Ivushkin, Konstantin; Bartholomeus, Harm; Bregt, Arnold K.; Pulatov, Alim; Bui, Elisabeth N.; Wilford, John

2018-06-01

The use of canopy thermography is an innovative approach for salinity stress detection in plants. But its applicability for landscape scale studies using satellite sensors is still not well investigated. The aim of this research is to test the satellite thermography soil salinity assessment approach on a study area with different crops, grown both in irrigated and rainfed conditions, to evaluate whether the approach has general applicability. Four study areas in four different states of Australia were selected to give broad representation of different crops cultivated under irrigated and rainfed conditions. The soil salinity map was prepared by the staff of Geoscience Australia and CSIRO Land and Water and it is based on thorough soil sampling together with environmental modelling. Remote sensing data was captured by the Landsat 5 TM satellite. In the analysis we used vegetation indices and brightness temperature as an indicator for canopy temperature. Applying analysis of variance and time series we have investigated the applicability of satellite remote sensing of canopy temperature as an approach of soil salinity assessment for different crops grown under irrigated and rainfed conditions. We concluded that in all cases average canopy temperatures were significantly correlated with soil salinity of the area. This relation is valid for all investigated crops, grown both irrigated and rainfed. Nevertheless, crop type does influence the strength of the relations. In our case cotton shows only minor temperature difference compared to other vegetation classes. The strongest relations between canopy temperature and soil salinity were observed at the moment of a maximum green biomass of the crops which is thus considered to be the best time for application of the approach.

Adherence to CPAP therapy: comparing the effect of three educational approaches in patients with obstructive sleep apnoea.

PubMed

Delanote, Isabelle; Borzée, Pascal; Belge, Catharina; Buyse, Bertien; Testelmans, Dries

2018-01-01

Continuous positive airway pressure (CPAP)-therapy is the first-line treatment for moderate to severe obstructive sleep apnoea (OSA). A significant limitation of CPAP treatment is the poor therapy adherence, compromising the beneficial effects. This study evaluates three different educational approaches and their effect on therapy adherence. This single-center, retrospective study compared three groups of 100 consecutive, CPAP-naive patients with moderate to severe OSA who were started on CPAP therapy. Group 1 and 2 received the same individual structured education on two consecutive days with an extra phone call 7 to 10 days after CPAP start in group 2. Group 3 received individual structured education on the first day and participated in a group education using a slide presentation open for discussion on the second day. Re-evaluation was performed after 24 weeks. Baseline characteristics did not differ significantly between groups. During the 24 weeks follow-up there was a drop-out rate of 16% (group 1), 12% (group 2) and 5% (group 3). In the patients still on CPAP after 24 weeks, the mean nightly CPAP usage was, respectively, 4.7 ± 1.8, 5.2 ± 2.3 and 5.7 ± 2.1 h/night. In group 3 both the drop-out rate and mean CPAP usage were significantly different (P values, respectively, P < 0.05 and P < 0.01) compared with group 1. Improving CPAP adherence is an ongoing challenge. This study shows that a multi-modality approach, using a combination of individual and group education using a slide presentation open for discussion resulted in improved therapy adherence. © 2016 John Wiley & Sons Ltd.

Detecting altered connectivity patterns in HIV associated neurocognitive impairment using mutual connectivity analysis

NASA Astrophysics Data System (ADS)

Abidin, Anas Zainul; D'Souza, Adora M.; Nagarajan, Mahesh B.; Wismüller, Axel

2016-03-01

The use of functional Magnetic Resonance Imaging (fMRI) has provided interesting insights into our understanding of the brain. In clinical setups these scans have been used to detect and study changes in the brain network properties in various neurological disorders. A large percentage of subjects infected with HIV present cognitive deficits, which are known as HIV associated neurocognitive disorder (HAND). In this study we propose to use our novel technique named Mutual Connectivity Analysis (MCA) to detect differences in brain networks in subjects with and without HIV infection. Resting state functional MRI scans acquired from 10 subjects (5 HIV+ and 5 HIV-) were subject to standard preprocessing routines. Subsequently, the average time-series for each brain region of the Automated Anatomic Labeling (AAL) atlas are extracted and used with the MCA framework to obtain a graph characterizing the interactions between them. The network graphs obtained for different subjects are then compared using Network-Based Statistics (NBS), which is an approach to detect differences between graphs edges while controlling for the family-wise error rate when mass univariate testing is performed. Applying this approach on the graphs obtained yields a single network encompassing 42 nodes and 65 edges, which is significantly different between the two subject groups. Specifically connections to the regions in and around the basal ganglia are significantly decreased. Also some nodes corresponding to the posterior cingulate cortex are affected. These results are inline with our current understanding of pathophysiological mechanisms of HIV associated neurocognitive disease (HAND) and other HIV based fMRI connectivity studies. Hence, we illustrate the applicability of our novel approach with network-based statistics in a clinical case-control study to detect differences connectivity patterns.

Protein differences between human trapezius and vastus lateralis muscles determined with a proteomic approach.

PubMed

Hadrévi, Jenny; Hellström, Fredrik; Kieselbach, Thomas; Malm, Christer; Pedrosa-Domellöf, Fatima

2011-08-10

The trapezius muscle is a neck muscle that is susceptible to chronic pain conditions associated with repetitive tasks, commonly referred to as chronic work-related myalgia, hence making the trapezius a muscle of clinical interest. To provide a basis for further investigations of the proteomic traits of the trapezius muscle in disease, two-dimensional difference gel electrophoresis (2D-DIGE) was performed on the healthy trapezius using vastus lateralis as a reference. To obtain as much information as possible from the vast proteomic data set, both one-way ANOVA, with and without false discovery rate (FDR) correlation, and partial least square projection to latent structures with discriminant analysis (PLS-DA) were combined to compare the outcome of the analysis. The trapezius and vastus lateralis showed significant differences in metabolic, contractile and regulatory proteins, with different results depending on choice of statistical approach and pre-processing technique. Using the standard method, FDR correlated one-way ANOVA, 42 protein spots differed significantly in abundance between the two muscles. Complementary analysis using immunohistochemistry and western blot confirmed the results from the 2D-DIGE analysis. The proteomic approach used in the present study combining 2D-DIGE and multivariate modelling provided a more comprehensive comparison of the protein profiles of the human trapezius and vastus lateralis muscle, than previously possible to obtain with immunohistochemistry or SDS-PAGE alone. Although 2D-DIGE has inherent limitations it is particularly useful to comprehensively screen for important structural and metabolic proteins, and appears to be a promising tool for future studies of patients suffering from chronic work related myalgia or other muscle diseases.

Modeling users, context and devices for ambient assisted living environments.

PubMed

Castillejo, Eduardo; Almeida, Aitor; López-de-Ipiña, Diego; Chen, Liming

2014-03-17

The participation of users within AAL environments is increasing thanks to the capabilities of the current wearable devices. Furthermore, the significance of considering user's preferences, context conditions and device's capabilities help smart environments to personalize services and resources for them. Being aware of different characteristics of the entities participating in these situations is vital for reaching the main goals of the corresponding systems efficiently. To collect different information from these entities, it is necessary to design several formal models which help designers to organize and give some meaning to the gathered data. In this paper, we analyze several literature solutions for modeling users, context and devices considering different approaches in the Ambient Assisted Living domain. Besides, we remark different ongoing standardization works in this area. We also discuss the used techniques, modeled characteristics and the advantages and drawbacks of each approach to finally draw several conclusions about the reviewed works.

Modeling Users, Context and Devices for Ambient Assisted Living Environments

PubMed Central

Castillejo, Eduardo; Almeida, Aitor; López-de-Ipiña, Diego; Chen, Liming

2014-01-01

The participation of users within AAL environments is increasing thanks to the capabilities of the current wearable devices. Furthermore, the significance of considering user's preferences, context conditions and device's capabilities help smart environments to personalize services and resources for them. Being aware of different characteristics of the entities participating in these situations is vital for reaching the main goals of the corresponding systems efficiently. To collect different information from these entities, it is necessary to design several formal models which help designers to organize and give some meaning to the gathered data. In this paper, we analyze several literature solutions for modeling users, context and devices considering different approaches in the Ambient Assisted Living domain. Besides, we remark different ongoing standardization works in this area. We also discuss the used techniques, modeled characteristics and the advantages and drawbacks of each approach to finally draw several conclusions about the reviewed works. PMID:24643006

Systemic inflammatory response after endoscopic (TEP) vs Shouldice groin hernia repair.

PubMed

Schwab, R; Eissele, S; Brückner, U B; Gebhard, F; Becker, H P

2004-08-01

Endoscopic techniques are commonly used for many different types of surgery. It is claimed that videoendoscopic procedures have the advantage of being less traumatic and of offering higher postoperative patient comfort than conventional open techniques. The extent of tissue trauma can be evaluated on the basis of the inflammatory response observed in the wake of surgery. Available studies that have compared endoscopic and conventional techniques suggest that endoscopic cholecystectomy, laparoscopic colorectal resection, and thoracoscopic pulmonary resection have immunologic advantages over conventional approaches. The objective of this prospective study was to determine whether endoscopic hernia repair techniques are also preferable to conventional procedures and to what extent the anesthetic technique (local or general anesthesia) influences the postoperative inflammatory response. For this purpose, biochemical monitoring of cytokine activity [C-reactive protein (CRP), prostaglandin F1alpha (PGF1alpha), neopterin, interleukin-6 (IL-6)] was done prospectively in 101 patients [totally extraperitoneal approach (TEP) n=32, unilateral n=12, bilateral n=20; Shouldice n=69, local anesthesia (LA) n=23, general anesthesia (GA) n=46] before and until 3 days after surgery. The parameters IL-6 and PGF1alpha suggested that the immune trauma immediately after surgery was significantly higher in the group of patients with endoscopic hernia repair than in the group of patients who received a Shouldice repair. No significant differences were observed after the first postoperative day. A comparison between the TEP group and the patients who received conventional surgery under local anesthesia showed that the TEP approach was also associated with a higher postoperative neopterin level. Within the first 3 days after surgical intervention, bilateral endoscopic hernia repair induced no significantly higher inflammatory response than the surgical treatment of unilateral conditions. The anesthetic procedure that was used in the Shouldice operation had no significant effect on inflammatory response. Unlike other types of endoscopic surgery, the repair of groin hernias using an endoscopic technique cannot be regarded as a minimally invasive procedure that is less traumatic than conventional approaches. Instead, the conventional Shouldice procedure appears to cause the lowest inflammatory response and to be the least traumatic approach to hernia repair, especially when it is performed under local anesthesia.

The Schiff angular bremsstrahlung distribution from composite media

NASA Astrophysics Data System (ADS)

Taylor, M. L.; Dalton, B.; Franich, R. D.

2012-12-01

The Schiff differential for the angular distribution of bremsstrahlung is widely employed, but calculations involving composite materials (i.e. compounds and mixtures) are often undertaken in a somewhat ad hoc fashion. In this work, we suggest an alternative approach to power-law estimates of the effective atomic number utilising Seltzer and Berger's combined approach in order to generate single-valued effective atomic numbers applicable over a large energy range (in the worst case deviation from constancy of about 2% between 10 keV and 1 GeV). Differences with power-law estimates of Z for composites are potentially significant, particularly for low-Z media such as biological or surrogate materials as relevant within the context of medical physics. As an example, soft tissue differs by >70% and cortical bone differs by >85%, while for high-Z composites such as a tungsten-rhenium alloy the difference is of the order of 1%. Use of the normalised Schiff formula for shape only does not exhibit strong Z dependence. Consequently, in such contexts the differences are negligible - the power-law approach overestimates the magnitude by 1.05% in the case of water and underestimates it by <0.1% for the high-Z alloys. The differences in the distribution are most pronounced for small angles and where the bremsstrahlung quanta are low energy.

Influence of Meibomian Gland Expression Methods on Human Lipid Analysis Results.

PubMed

Kunnen, Carolina M E; Brown, Simon H J; Lazon de la Jara, Percy; Holden, Brien A; Blanksby, Stephen J; Mitchell, Todd W; Papas, Eric B

2016-01-01

To compare the lipid composition of human meibum across three different meibum expression techniques. Meibum was collected from five healthy non-contact lens wearers (aged 20-35 years) after cleaning the eyelid margin using three meibum expression methods: cotton buds (CB), meibomian gland evaluator (MGE) and meibomian gland forceps (MGF). Meibum was also collected using cotton buds without cleaning the eyelid margin (CBn). Lipids were analyzed by chip-based, nano-electrospray mass spectrometry (ESI-MS). Comparisons were made using linear mixed models. Tandem MS enabled identification and quantification of over 200 lipid species across ten lipid classes. There were significant differences between collection techniques in the relative quantities of polar lipids obtained (P<.05). The MGE method returned smaller polar lipid quantities than the CB approaches. No significant differences were found between techniques for nonpolar lipids. No significant differences were found between cleaned and non-cleaned eyelids for polar or nonpolar lipids. Meibum expression technique influences the relative amount of phospholipids in the resulting sample. The highest amounts of phospholipids were detected with the CB approaches and the lowest with the MGE technique. Cleaning the eyelid margin prior to expression was not found to affect the lipid composition of the sample. This may be a consequence of the more forceful expression resulting in cell membrane contamination or higher risk of tear lipid contamination as a result of reflex tearing. Copyright © 2016 Elsevier Inc. All rights reserved.

Survivorship of standard versus modified posterior surgical approaches in metal-on-metal hip resurfacing.

PubMed

M Takamura, K; Maher, P; Nath, T; Su, E P

2014-05-01

Metal-on-metal hip resurfacing (MOMHR) is available as an alternative option for younger, more active patients. There are failure modes that are unique to MOMHR, which include loosening of the femoral head and fractures of the femoral neck. Previous studies have speculated that changes in the vascularity of the femoral head may contribute to these failure modes. This study compares the survivorship between the standard posterior approach (SPA) and modified posterior approach (MPA) in MOMHR. A retrospective clinical outcomes study was performed examining 351 hips (279 male, 72 female) replaced with Birmingham Hip Resurfacing (BHR, Smith and Nephew, Memphis, Tennessee) in 313 patients with a pre-operative diagnosis of osteoarthritis. The mean follow-up period for the SPA group was 2.8 years (0.1 to 6.1) and for the MPA, 2.2 years (0.03 to 5.2); this difference in follow-up period was statistically significant (p < 0.01). Survival analysis was completed using the Kaplan-Meier method. At four years, the Kaplan-Meier survival curve for the SPA was 97.2% and 99.4% for the MPA; this was statistically significant (log-rank; p = 0.036). There were eight failures in the SPA and two in the MPA. There was a 3.5% incidence of femoral head collapse or loosening in the SPA and 0.4% in the MPA, which represented a significant difference (p = 0.041). There was a 1.7% incidence of fractures of the femoral neck in the SPA and none in the MPA (p = 0.108). This study found a significant difference in survivorship at four years between the SPA and the MPA (p = 0.036). The clinical outcomes of this study suggest that preserving the vascularity of the femoral neck by using the MPA results in fewer vascular-related failures in MOMHRs. Cite this article: Bone Joint Res 2014;3:150-4. ©2014 The British Editorial Society of Bone & Joint Surgery.

Survivorship of standard versus modified posterior surgical approaches in metal-on-metal hip resurfacing

PubMed Central

M. Takamura, K.; Maher, P.; Nath, T.; Su, E. P.

2014-01-01

Objectives Metal-on-metal hip resurfacing (MOMHR) is available as an alternative option for younger, more active patients. There are failure modes that are unique to MOMHR, which include loosening of the femoral head and fractures of the femoral neck. Previous studies have speculated that changes in the vascularity of the femoral head may contribute to these failure modes. This study compares the survivorship between the standard posterior approach (SPA) and modified posterior approach (MPA) in MOMHR. Methods A retrospective clinical outcomes study was performed examining 351 hips (279 male, 72 female) replaced with Birmingham Hip Resurfacing (BHR, Smith and Nephew, Memphis, Tennessee) in 313 patients with a pre-operative diagnosis of osteoarthritis. The mean follow-up period for the SPA group was 2.8 years (0.1 to 6.1) and for the MPA, 2.2 years (0.03 to 5.2); this difference in follow-up period was statistically significant (p < 0.01). Survival analysis was completed using the Kaplan–Meier method. Results At four years, the Kaplan–Meier survival curve for the SPA was 97.2% and 99.4% for the MPA; this was statistically significant (log-rank; p = 0.036). There were eight failures in the SPA and two in the MPA. There was a 3.5% incidence of femoral head collapse or loosening in the SPA and 0.4% in the MPA, which represented a significant difference (p = 0.041). There was a 1.7% incidence of fractures of the femoral neck in the SPA and none in the MPA (p = 0.108). Conclusion This study found a significant difference in survivorship at four years between the SPA and the MPA (p = 0.036). The clinical outcomes of this study suggest that preserving the vascularity of the femoral neck by using the MPA results in fewer vascular-related failures in MOMHRs. Cite this article: Bone Joint Res 2014;3:150–4 PMID:24842931

Surgical instrument similarity metrics and tray analysis for multi-sensor instrument identification

NASA Astrophysics Data System (ADS)

Glaser, Bernhard; Schellenberg, Tobias; Franke, Stefan; Dänzer, Stefan; Neumuth, Thomas

2015-03-01

A robust identification of the instrument currently used by the surgeon is crucial for the automatic modeling and analysis of surgical procedures. Various approaches for intra-operative surgical instrument identification have been presented, mostly based on radio-frequency identification (RFID) or endoscopic video analysis. A novel approach is to identify the instruments on the instrument table of the scrub nurse with a combination of video and weight information. In a previous article, we successfully followed this approach and applied it to multiple instances of an ear, nose and throat (ENT) procedure and the surgical tray used therein. In this article, we present a metric for the suitability of the instruments of a surgical tray for identification by video and weight analysis and apply it to twelve trays of four different surgical domains (abdominal surgery, neurosurgery, orthopedics and urology). The used trays were digitized at the central sterile services department of the hospital. The results illustrate that surgical trays differ in their suitability for the approach. In general, additional weight information can significantly contribute to the successful identification of surgical instruments. Additionally, for ten different surgical instruments, ten exemplars of each instrument were tested for their weight differences. The samples indicate high weight variability in instruments with identical brand and model number. The results present a new metric for approaches aiming towards intra-operative surgical instrument detection and imply consequences for algorithms exploiting video and weight information for identification purposes.

Desert Dust Satellite Retrieval Intercomparison

NASA Technical Reports Server (NTRS)

Carboni, E.; Thomas, G. E.; Sayer, A. M.; Siddans, R.; Poulsen, C. A.; Grainger, R. G.; Ahn, C.; Antoine, D.; Bevan, S.; Braak, R.;

Improving Pediatric Basic Life Support Performance Through Blended Learning With Web-Based Virtual Patients: Randomized Controlled Trial.

PubMed

Lehmann, Ronny; Thiessen, Christiane; Frick, Barbara; Bosse, Hans Martin; Nikendei, Christoph; Hoffmann, Georg Friedrich; Tönshoff, Burkhard; Huwendiek, Sören

2015-07-02

E-learning and blended learning approaches gain more and more popularity in emergency medicine curricula. So far, little data is available on the impact of such approaches on procedural learning and skill acquisition and their comparison with traditional approaches. This study investigated the impact of a blended learning approach, including Web-based virtual patients (VPs) and standard pediatric basic life support (PBLS) training, on procedural knowledge, objective performance, and self-assessment. A total of 57 medical students were randomly assigned to an intervention group (n=30) and a control group (n=27). Both groups received paper handouts in preparation of simulation-based PBLS training. The intervention group additionally completed two Web-based VPs with embedded video clips. Measurements were taken at randomization (t0), after the preparation period (t1), and after hands-on training (t2). Clinical decision-making skills and procedural knowledge were assessed at t0 and t1. PBLS performance was scored regarding adherence to the correct algorithm, conformance to temporal demands, and the quality of procedural steps at t1 and t2. Participants' self-assessments were recorded in all three measurements. Procedural knowledge of the intervention group was significantly superior to that of the control group at t1. At t2, the intervention group showed significantly better adherence to the algorithm and temporal demands, and better procedural quality of PBLS in objective measures than did the control group. These aspects differed between the groups even at t1 (after VPs, prior to practical training). Self-assessments differed significantly only at t1 in favor of the intervention group. Training with VPs combined with hands-on training improves PBLS performance as judged by objective measures.

The effectiveness of an integrated conceptual approach to teaching middle school science: A mixed methods investigation

NASA Astrophysics Data System (ADS)

Frampton, Susan K.

This study was designed to compare the effectiveness of using traditional and integrated instructional strategies to increase student understanding of the core concepts of energy. There are mixed messages in the literature as to the success of using an integrated approach to teach science content, despite suggestions its use improves student achievement and attitudes toward science. This study used a mixed-method approach. The quantitative portion was a quasi-experimental non-equivalent control group design, and the qualitative portion included teacher journals, teacher interviews and student journals. There were three teacher participants, two in the treatment group from a district in Sussex County, Delaware. The third teacher participant, from a different district in Sussex County, Delaware was in the control group. The treatment group consisted of 180 students and the control group consisted of 124 students. The results of this study show that the treatment group had significantly less anxiety in science following the treatment, than students in the control group. The F value of 10.89 was significant at p = 0.001. Students in the treatment group also had more enjoyment of and motivation in science than did students in the control group. The F value of 25.025 was significant at a p = 0.000 for the subscale enjoyment of science. The F value of 14.1 was significant at a p = 0.000 for the subscale of motivation in science. Students in the treatment group performed significantly better on the achievement tests, the Integrated Summative Energy Assessment (ISEA) and the science portion of the Delaware State Testing Program (DSTP). The treatment group performed significantly better on the ISEA than did the control group, with an F value of 407.7 significant at p = 0.000. The treatment group performed significantly better on the science DSTP than the control group, with an F value of 65.81 which was significant at p = 0.000. The use of an integrated approach to science instruction decreases student anxiety, increases enjoyment of science and motivation in science more than a traditional approach to teaching science. The use of an integrated approach to science instruction increases student achievement on extended response assessments that measure integrated conceptual knowledge and increases student achievement on traditional summative assessments.

Response of soil physico-chemical properties to restoration approaches and submergence in the water level fluctuation zone of the Danjiangkou Reservoir, China.

PubMed

Shu, Xiao; Zhang, KeRong; Zhang, QuanFa; Wang, WeiBo

2017-11-01

With the completion of the Danjiangkou Dam, the impoundment and drainage of dams can significantly alter shorelines, hydrological regime, and sediment and can result in the loss of soil and original riparian vegetation. Revegetation may affect soil properties and have broad important implications both for ecological services and soil recovery. In this work, we investigated the soil properties under different restoration approaches, and before and after submergence in the water level fluctuation zone (WLFZ) of the Danjiangkou Reservoir. Soil physical (bulk density and soil moisture), chemical (pH, soil organic carbon, nitrogen, phosphorus and potassium contents), and heavy metals were determined. This study reported that restoration approaches have impacts on soil moisture, pH, N, soil organic carbon, P, K and heavy metals in the WLFZ of the Danjiangkou Reservoir. Our results indicated that different restoration approaches could increase the soil moisture while decrease soil pH. Higher soil organic carbon in propagule banks transplantation (PBT) and shrubs restoration (SR) indicate that PBT and SR may provide soil organic matter more quickly than trees restoration (TR). SR and TR could significantly improve the soil total P and available P. PBT and SR could improve the soil total K and available K. SR and TR could significantly promote Cu and Zn adsorption, and Pb and Fe release by plant. Submergence could significantly affect the soil pH, NO 3 － -N, NH 4 ＋ -N, total P and available P. Submergence could promote NO 3 － -N and available P adsorption, and NH 4 ＋ -N and total P release by soil. The soil quality index (SQI) values implied that TR and PBT greatly improved soil quality. The present study suggests that PBT and TR could be effective for soil restoration in WLFZ of the Danjiangkou Reservoir. Copyright © 2017 Elsevier Inc. All rights reserved.

Longitudinal Study-Based Dementia Prediction for Public Health

PubMed Central

Kim, HeeChel; Chun, Hong-Woo; Kim, Seonho; Coh, Byoung-Youl; Kwon, Oh-Jin; Moon, Yeong-Ho

2017-01-01

The issue of public health in Korea has attracted significant attention given the aging of the country’s population, which has created many types of social problems. The approach proposed in this article aims to address dementia, one of the most significant symptoms of aging and a public health care issue in Korea. The Korean National Health Insurance Service Senior Cohort Database contains personal medical data of every citizen in Korea. There are many different medical history patterns between individuals with dementia and normal controls. The approach used in this study involved examination of personal medical history features from personal disease history, sociodemographic data, and personal health examinations to develop a prediction model. The prediction model used a support-vector machine learning technique to perform a 10-fold cross-validation analysis. The experimental results demonstrated promising performance (80.9% F-measure). The proposed approach supported the significant influence of personal medical history features during an optimal observation period. It is anticipated that a biomedical “big data”-based disease prediction model may assist the diagnosis of any disease more correctly. PMID:28867810

Recent developments of the quantum chemical cluster approach for modeling enzyme reactions.

PubMed

Siegbahn, Per E M; Himo, Fahmi

2009-06-01

The quantum chemical cluster approach for modeling enzyme reactions is reviewed. Recent applications have used cluster models much larger than before which have given new modeling insights. One important and rather surprising feature is the fast convergence with cluster size of the energetics of the reactions. Even for reactions with significant charge separation it has in some cases been possible to obtain full convergence in the sense that dielectric cavity effects from outside the cluster do not contribute to any significant extent. Direct comparisons between quantum mechanics (QM)-only and QM/molecular mechanics (MM) calculations for quite large clusters in a case where the results differ significantly have shown that care has to be taken when using the QM/MM approach where there is strong charge polarization. Insights from the methods used, generally hybrid density functional methods, have also led to possibilities to give reasonable error limits for the results. Examples are finally given from the most extensive study using the cluster model, the one of oxygen formation at the oxygen-evolving complex in photosystem II.

Segmentation of Brain Lesions in MRI and CT Scan Images: A Hybrid Approach Using k-Means Clustering and Image Morphology

NASA Astrophysics Data System (ADS)

Agrawal, Ritu; Sharma, Manisha; Singh, Bikesh Kumar

2018-04-01

Manual segmentation and analysis of lesions in medical images is time consuming and subjected to human errors. Automated segmentation has thus gained significant attention in recent years. This article presents a hybrid approach for brain lesion segmentation in different imaging modalities by combining median filter, k means clustering, Sobel edge detection and morphological operations. Median filter is an essential pre-processing step and is used to remove impulsive noise from the acquired brain images followed by k-means segmentation, Sobel edge detection and morphological processing. The performance of proposed automated system is tested on standard datasets using performance measures such as segmentation accuracy and execution time. The proposed method achieves a high accuracy of 94% when compared with manual delineation performed by an expert radiologist. Furthermore, the statistical significance test between lesion segmented using automated approach and that by expert delineation using ANOVA and correlation coefficient achieved high significance values of 0.986 and 1 respectively. The experimental results obtained are discussed in lieu of some recently reported studies.

Criteria for evaluating programme theory diagrams in quality improvement initiatives: a structured method for appraisal.

PubMed

Issen, Laurel; Woodcock, Thomas; McNicholas, Christopher; Lennox, Laura; Reed, Julie E

2018-04-09

Despite criticisms that many quality improvement (QI) initiatives fail due to incomplete programme theory, there is no defined way to evaluate how programme theory has been articulated. The objective of this research was to develop, and assess the usability and reliability of scoring criteria to evaluate programme theory diagrams. Criteria development was informed by published literature and QI experts. Inter-rater reliability was tested between two evaluators. About 63 programme theory diagrams (42 driver diagrams and 21 action-effect diagrams) were reviewed to establish whether the criteria could support comparative analysis of different approaches to constructing diagrams. Components of the scoring criteria include: assessment of overall aim, logical overview, clarity of components, cause-effect relationships, evidence and measurement. Independent reviewers had 78% inter-rater reliability. Scoring enabled direct comparison of different approaches to developing programme theory; action-effect diagrams were found to have had a statistically significant but moderate improvement in programme theory quality over driver diagrams; no significant differences were observed based on the setting in which driver diagrams were developed. The scoring criteria summarise the necessary components of programme theory that are thought to contribute to successful QI projects. The viability of the scoring criteria for practical application was demonstrated. Future uses include assessment of individual programme theory diagrams and comparison of different approaches (e.g. methodological, teaching or other QI support) to produce programme theory. The criteria can be used as a tool to guide the production of better programme theory diagrams, and also highlights where additional support for QI teams could be needed.

Endoscopic versus surgical treatment of ampullary adenomas: a systematic review and meta-analysis

PubMed Central

Mendonça, Ernesto Quaresma; Bernardo, Wanderley Marques; de Moura, Eduardo Guimarães Hourneaux; Chaves, Dalton Marques; Kondo, André; Pu, Leonardo Zorrón Cheng Tao; Baracat, Felipe Iankelevich

2016-01-01

The aim of this study is to address the outcomes of endoscopic resection compared with surgery in the treatment of ampullary adenomas. A systematic review and meta-analysis were performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. For this purpose, the Medline, Embase, Cochrane, Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Scopus and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases were scanned. Studies included patients with ampullary adenomas and data considering endoscopic treatment compared with surgery. The entire analysis was based on a fixed-effects model. Five retrospective cohort studies were selected (466 patients). All five studies (466 patients) had complete primary resection data available and showed a difference that favored surgical treatment (risk difference [RD] = -0.24, 95% confidence interval [CI] = -0.44 to -0.04). Primary success data were identified in all five studies as well. Analysis showed that the surgical approach outperformed endoscopic treatment for this outcome (RD = -0.37, 95% CI = -0.50 to -0.24). Recurrence data were found in all studies (466 patients), with a benefit indicated for surgical treatment (RD = 0.10, 95% CI = -0.01 to 0.19). Three studies (252 patients) presented complication data, but analysis showed no difference between the approaches for this parameter (RD = -0.15, 95% CI = -0.53 to 0.23). Considering complete primary resection, primary success and recurrence outcomes, the surgical approach achieves significantly better results. Regarding complication data, this systematic review concludes that rates are not significantly different. PMID:26872081

Gender and practical skill performance in science

NASA Astrophysics Data System (ADS)

Lock, Roger

The performance of 18 boys and 18 girls on four problem-solving tasks set in science contexts was compared. The tasks were administered in a one-to-one testing situation and assessments were made by direct observation, questioning, and by using written records. The tasks were valid and reliable, and the samples of boys and girls were matched for ability and curriculum background. Past studies have identified gender differences in performance on science tasks; however, this study found little evidence to support these findings. Few significant differences in performance were found. No gender differences were detected in observation, reporting, or planning skills, and there was no differential performance on the use of scientific language. Girls performed less well in relation to self-reliance, and performance differences on the interpretation skill approached significance with boys' performance superior.

Responses to music and movement in the development of children with Down's syndrome.

PubMed

Stratford, B; Ching, E Y

1989-02-01

Physical responses to rhythmic stimuli and music, of different degrees of complexity were registered from 25 children with Down's syndrome and 25 other mentally handicapped children. Required performances were taught and then recorded on video-tape, after which they were assessed by experienced teacher/judges. Whilst there were no overall significant differences between the groups, important differences were detected between the children in different schools with attendant implications for differential treatment. Apart from an overall and general assessment of performance, analysis was made of demographic variables, for example, sex, intelligence, age and social development. It is concluded that specific teaching approaches can significantly effect the development of children with Down's syndrome in such creative aspects of the curriculum as music, movement and dance.

Effects of traditional and discovery instructional approaches on learning outcomes for learners of different intellectual development: A study of chemistry students in Zambia

NASA Astrophysics Data System (ADS)

Mulopo, Moses M.; Seymour Fowler, H.

This study examined the differential effectiveness of traditional and discovery methods of instruction for the teaching of science concepts, understandings about science, and scientific attitudes, to learners at the concrete and formal level of cognitive development. The dependent variables were achievement, understanding science, and scientific attitude; assessed through the use of the ACS Achievement Test (high school chemistry, Form 1979), the Test on Understanding Science (Form W), and the Test on Scientific Attitude, respectively. Mode of instruction and cognitive development were the independent variables. Subjects were 120 Form IV (11th grade) males enrolled in chemistry classes in Lusaka, Zambia. Sixty of these were concrete reasoners (mean age = 18.23) randomly selected from one of the two schools. The remaining 60 subjects were formal reasoners (mean age 18.06) randomly selected from a second boys' school. Each of these two groups was randomly split into two subgroups with 30 subjects. Traditional and discovery approaches were randomly assigned to the two subgroups of concrete reasoners and to the two subgroups of formal reasoners. Prior to instruction, the subjects were pretested using the ACS Achievement Test, the Test on Understanding Science, and the Test on Scientific Attitude. Subjects received instruction covering eight chemistry topics during approximately 10 weeks. Posttests followed using the same standard tests. Two-way analysis of covariance, with pretest scores serving as covariates was used and 0.05 level of significant was accepted. Tukey WSD technique was used as a follow-up test where applicable. It was found that (1) for the formal reasoners, the discovery group earned significantly higher understanding science scores than the traditional group. For the concrete reasoners mode of instruction did not make a difference; (2) overall, formal reasoners earned significantly higher achievement scores than concrete reasoners; (3) in general, subjects taught by the discovery approach earned significantly higher scientific attitude scores than those taught by the traditional approach. The traditional group outperformed the discovery group in achievement scores. It was concluded that the traditional approach might be an efficient instructional mode for the teaching of scientific facts and principles to high school students, while the discovery approach seemed to be more suitable for teaching scientific attitudes and for promoting understanding about science and scientists among formal operational learners.

A pedagogical shift from direct instruction: Technology-assisted inquiry learning (TAIL) in chemistry

NASA Astrophysics Data System (ADS)

Lou, Rena Zhihong

The purpose of this study was to develop a student-centered Technology-Assisted Inquiry Learning (TAIL) pedagogical approach and compare it with the traditional, teacher-centered, direct instruction approach in a chemistry classroom. The study investigated how the TAIL approach affected community college chemistry students' (n = 21) learning gains and perceptions during a 1.5-hour intervention when compared with the direct instruction approach. A mixed methodology was used that included both quantitative and qualitative analyses. Results led to the following three key findings for novice learners: (a) TAIL had a statistically significant effect on students' procedural application skills improvement when compared with direct instruction; (b) The magnitude of the between-group difference (Cohen's d = 1.41) indicated that TAIL had a cumulative effect on students' learning gains due to its ability to incorporate multiple components including Inquiry, Guidance, Technology, and Collaboration; (c) When combining measures of students' performance and perceived mental effort, TAIL demonstrated high-instructional efficiency with a significant difference in teaching factual knowledge and procedural applications when compared with direct instruction. In summary, the outcome of this study demonstrated both the effectiveness and efficiency of the TAIL approach as a student-centered pedagogy in teaching a basic scientific topic. This study provided a practical demonstration of the pedagogical shift in teaching science from teacher-centered direct instruction to student-centered learning by using computer software as a pedagogical agent. The results of the study contribute to the literature in the fields of guided inquiry learning pedagogy and technology-assisted science teaching.

Laparoscopic versus robotic surgery for hepatocellular carcinoma: the first 46 consecutive cases.

PubMed

Magistri, Paolo; Tarantino, Giuseppe; Guidetti, Cristiano; Assirati, Giacomo; Olivieri, Tiziana; Ballarin, Roberto; Coratti, Andrea; Di Benedetto, Fabrizio

2017-09-01

Hepatocellular carcinoma has a growing incidence worldwide, and represents a leading cause of death in patients with cirrhosis. Nowadays, minimally invasive approaches are spreading in every field of surgery and in liver surgery as well. We retrospectively reviewed demographics, clinical, and pathologic characteristics and short-term outcomes of patients who had undergone minimally invasive resections for hepatocellular carcinoma at our institution between June 2012 and May 2016. No significant differences in demographics and comorbidities were found between patients in the laparoscopic (n = 24) and robotic (n = 22) groups, except for the rates of cirrhotic patients (91.7% and 68.2%, respectively, P = 0.046). Perioperative data analysis showed that the operative time (mean, 211 and 318 min, respectively, P < 0.001) was the only parameter in favor of laparoscopy. Conversely, robotic-assisted resections were related to less Clavien I-II postoperative complications (22 cases versus 13 cases; P = 0.03). As regards resection margins, the two groups were similar with no statistically significant differences in rates of disease-free resection margins. A modern hepatobiliary center should offer both open and minimally invasive approaches to liver disease to provide the best care for each patient, according to the individual comorbidities, risk factors, and personal quality of life expectations. Our results show that the robotic approach is a reliable tool for accurate oncologic surgery, comparable to the laparoscopic approach. Robotic surgery also allows the surgeon to safely approach liver segments that are difficult to resect in laparoscopy, namely segments I-VII-VIII. Copyright © 2017 Elsevier Inc. All rights reserved.

Minimally invasive versus standard approach in LeFort 1 osteotomy in patients with history of cleft lip and palate.

PubMed

Séblain, D; Bourlet, J; Sigaux, N; Khonsari, R H; Chauvel Picard, J; Gleizal, A

2018-06-01

Compare literature-reported efficiency and complications of the standard maxillary advancement surgery with those of a minimally invasive mucosal approach in patients with CL/P requiring Le Fort 1 osteotomy. Meta-analysis vs. retrospective analysis of 18 consecutive cases. Department of maxillofacial surgery at a tertiary-level public general hospital. The meta-analysis encompassed Medline, Embase and Cochrane, years 1990 to 2014, inclusive. The local series concerned all squeletally mature adolescents with non-syndromic CL/P who underwent orthognathic surgery between 30 April 2004 and 27 January 2012. Minimally invasive approach and perioperative orthodontics including intermaxillary fixation for 3 months after surgery. Assessment of complications. Standard lateral cephalograms were taken before surgery, then <1 week and 12 months after surgery. Delaire's cephalometric analysis was performed and the position of the maxilla was recorded. There were no significant differences between the literature and our series regarding sex and type of deformity (P=0.634 and 0.779, respectively). The mean horizontal and vertical relapse rates were 0.61 and 1.17mm (vs. 1.29 and 1.48mm in the meta-analysis) and the overall complication rate was 22.2% (vs. 12.76% but P=0.271). There was a significant difference regarding the palatal fistula rate (0 here vs. 21.43% in meta-analysis, P=0.028). The minimally invasive approach showed trends toward less relapse and less complications than conventional approaches. This technique seems adapted to the management of patients with CL/P sequelae. Other benefiting groups are underway. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Robot-assisted approach improves surgical outcomes in obese patients undergoing partial nephrectomy.

PubMed

Malkoc, Ercan; Maurice, Matthew J; Kara, Onder; Ramirez, Daniel; Nelson, Ryan J; Caputo, Peter A; Mouracade, Pascal; Stein, Robert; Kaouk, Jihad H

2017-02-01

To assess the impact of approach on surgical outcomes in otherwise healthy obese patients undergoing partial nephrectomy for small renal masses. Using our institutional partial nephrectomy database, we abstracted data on otherwise healthy (Charlson comorbidity score ≤1 and bilateral kidneys), obese patients (body mass index >30 kg/m 2 ) with small renal masses (<4 cm) treated between 2011 and 2015. The primary outcomes were intra-operative transfusion, operating time, length of hospital stay (LOS), and postoperative complications. The association between approach, open (OPN) vs robot-assisted partial nephrectomy (RAPN), and outcomes was assessed by univariable and multivariable logistic regression analyses. Covariates included age, gender, obesity severity, tumour size and tumour complexity. Of 237 obese patients undergoing partial nephrectomy, 25% underwent OPN and 75% underwent RAPN. Apart from larger tumour size in the OPN group (2.8 vs 2.5 cm; P = 0.02), there was no significant difference between groups. The rate of intra-operative blood transfusion (1.1 vs 10%; P = 0.01), the median operating time (180 vs 207 min; P < 0.01) and the median ischaemia time (19.5 vs 27 min; P < 0.01) were all greater for OPN. The LOS was significantly shorter for RAPN (3 vs 4 days; P < 0.01). While the overall complication rate was higher for OPN (15.8 vs 31.7%; P < 0.01), major complications were not significantly different (5.6 vs 1.7%; P = 0.20). On multivariable analyses, OPN independently predicted longer operating time, longer length of stay, and more overall complications. At a high-volume centre, the robot-assisted approach offers less blood transfusion, shorter operating time, faster recovery, and fewer peri-operative complications compared with the open approach in obese patients undergoing partial nephrectomy for small renal masses. In this setting, RAPN may be a preferable treatment option. © 2016 The Authors BJU International © 2016 BJU International Published by John Wiley & Sons Ltd.

The Contribution of Art Therapy to the Dissociative Disorders.

ERIC Educational Resources Information Center

Murphy, Patricia S.

1994-01-01

Explored concepts of brain hemispheric lateralization and distinct right brain functioning in extensive dissociation by administering Dissociative Experiences Scale to 114 engineering students and 92 university drawing students. Chi-square calculation found differences in dissociative scoring levels between groups that approached significance at…

Reducing cognitive load while teaching complex instruction to occupational therapy students.

PubMed

Pociask, Fredrick D; DiZazzo-Miller, Rosanne; Samuel, Preethy S

2013-01-01

Cognitive load theory is a field of research used to improve the learning of complex cognitive tasks by matching instruction to the learner's cognitive architecture. We used an experimental posttest control-group design to test the effectiveness of instruction designed to reduce cognitive load (CL) and improve instructional effectiveness in teaching complex instruction to 24 first-year master's students under authentic classroom conditions. We modified historically taught instruction using an isolated-to-interacting-elements sequencing approach intended to reduce high CL levels. We compared control and modified instructional formats using written assessment scores, subjective ratings of CL, and task completion times. Analysis of variance revealed significant differences for postinstruction, posttest CL ratings, and delayed written posttest scores (p < .05). No significant differences were identified for posttest completion times. Findings suggest that this approach can be used to improve instructional efficiency in teaching human locomotion to occupational therapy students. Copyright © 2013 by the American Occupational Therapy Association, Inc.

Low Boom Configuration Analysis with FUN3D Adjoint Simulation Framework

NASA Technical Reports Server (NTRS)

Park, Michael A.

2011-01-01

Off-body pressure, forces, and moments for the Gulfstream Low Boom Model are computed with a Reynolds Averaged Navier Stokes solver coupled with the Spalart-Allmaras (SA) turbulence model. This is the first application of viscous output-based adaptation to reduce estimated discretization errors in off-body pressure for a wing body configuration. The output adaptation approach is compared to an a priori grid adaptation technique designed to resolve the signature on the centerline by stretching and aligning the grid to the freestream Mach angle. The output-based approach produced good predictions of centerline and off-centerline measurements. Eddy viscosity predicted by the SA turbulence model increased significantly with grid adaptation. Computed lift as a function of drag compares well with wind tunnel measurements for positive lift, but predicted lift, drag, and pitching moment as a function of angle of attack has significant differences from the measured data. The sensitivity of longitudinal forces and moment to grid refinement is much smaller than the differences between the computed and measured data.

The effect of women's suggestive clothing on men's behavior and judgment: a field study.

PubMed

Guéguen, Nicolas

2011-10-01

Numerous studies have shown that men overestimate the sexual intent of women based on their clothing style; however, this hypothesis has not been assessed empirically in a natural setting. This small field study measured the time it took for men to approach two female confederates sitting in a tavern, one wearing suggestive clothes and one wearing more conservative clothes. The behavior of 108 men was observed over 54 periods on 16 different nights in two different taverns. The time it took for the men to approach after initial eye contact was significantly shorter in the suggestive clothing condition. The men were also asked by male confederates to rate the likelihood of having a date with the women, and having sex on the first date. The men rated their chances to have a date and to have sex significantly higher in the suggestive clothing condition. Results are discussed with respect to men's possible misinterpretation that women's clothing indicates sexual interest, and the risks associated with the misinterpretation.

The effect of visitor number and spice provisioning in pacing expression by jaguars evaluated through a case study.

PubMed

Vidal, L S; Guilherme, F R; Silva, V F; Faccio, M C S R; Martins, M M; Briani, D C

2016-06-01

Captive animals exhibit stereotypic pacing in response to multiple causes, including the inability to escape from human contact. Environmental enrichment techniques can minimize pacing expression. By using an individual-based approach, we addressed whether the amount of time two males and a female jaguar (Panthera onca) devote to pacing varied with the number of visitors and tested the effectiveness of cinnamon and black pepper in reducing pacing. The amount of time that all jaguars engaged in pacing increased significantly with the number of visitors. Despite the difference between the males regarding age and housing conditions, both devoted significantly less time to pacing following the addition of both spices, which indicates their suitability as enrichment techniques. Mean time devoted to pacing among the treatments did not differ for the female. Our findings pointed out to the validity of individual-based approaches, as they can reveal how suitable olfactory stimuli are to minimizing stereotypies irrespective of particular traits.

Lightning Scaling Laws Revisited

NASA Technical Reports Server (NTRS)

Boccippio, D. J.; Arnold, James E. (Technical Monitor)

2000-01-01

Scaling laws relating storm electrical generator power (and hence lightning flash rate) to charge transport velocity and storm geometry were originally posed by Vonnegut (1963). These laws were later simplified to yield simple parameterizations for lightning based upon cloud top height, with separate parameterizations derived over land and ocean. It is demonstrated that the most recent ocean parameterization: (1) yields predictions of storm updraft velocity which appear inconsistent with observation, and (2) is formally inconsistent with the theory from which it purports to derive. Revised formulations consistent with Vonnegut's original framework are presented. These demonstrate that Vonnegut's theory is, to first order, consistent with observation. The implications of assuming that flash rate is set by the electrical generator power, rather than the electrical generator current, are examined. The two approaches yield significantly different predictions about the dependence of charge transfer per flash on storm dimensions, which should be empirically testable. The two approaches also differ significantly in their explanation of regional variability in lightning observations.

Genito-Urinary Function and Quality of Life after Elective Totally Laparoscopic Sigmoidectomy after at Least One Episode of Complicated Diverticular Disease According to Two Different Vascular Approaches: the IMA Low Ligation or the IMA Preservation.

PubMed

Mari, Giulio; Crippa, Jacopo; Costanzi, Andrea; Mazzola, Michele; Magistro, Carmelo; Ferrari, Giovanni; Maggioni, Dario

2017-01-01

The arterial ligation during elective laparoscopic sigmoidectomy for diverticular disease can affect genito-urinary function injuring the superior hypogastric plexus, and can weaken the distal colonic stump arterial perfusion. Ligation of the inferior mesenteric artery distal to the left colic artery or the complete preservation of the inferior mesenteric artery can therefore be compared in terms of preservation of the descending sympathetic fibres running along the aorta to the rectum resulting in a different post operative genito urinary function. From January 2015 to March 2016, 66 patients underwent elective laparoscopic sigmoidectomy for diverticular disease among two enrolling hospitals. In one centre 35 patients underwent laparoscopic sigmoidectomy with the ligation of the inferior mesenteric artery distal to the left colic artery (low ligation). In the other centre 31 patient were operated on the same procedure with complete inferior mesenteric artery preservation (IMA preservation). There was no difference in terms of major complication occurred, first passage of stool and length of hospital stay between the two groups. Time of surgery was significantly shorter in LL group compared to IMA preserving group and intra operative blood loss was significantly lower in the LL group. There were no differences in the genito urinary function between the two group pre operatively, at 1 and 9 months post operatively. Genito urinary function did not significantly change across surgery in each groups. The low ligation and the IMA preserving vascular approach are safe end feasible techniques in elective laparoscopic sigmoidectomy for diverticular disease. They both prevent from genito-urinary post-operative disfunction and allow good post operative quality of life. The low ligation approach is related to shorter operative time and slower intra operative blood loss. Celsius.

Knee extensor dynamics in the volleyball approach jump: the influence of patellar tendinopathy.

PubMed

Sorenson, Shawn C; Arya, Shruti; Souza, Richard B; Pollard, Christine D; Salem, George J; Kulig, Kornelia

2010-09-01

Controlled laboratory study using a cross-sectional design. To evaluate knee joint dynamics in elite volleyball players with and without a history of patellar tendinopathy, focusing on mechanical energy absorption and generation. We hypothesized that tendinopathy would be associated withreduced net joint work and net joint power. Patellar tendinopathy is a common, debilitating injury affecting competitive volleyball players. Thirteen elite male players with and without a history of patellar tendinopathy (mean ± SD age, 27 ± 7 years) performed maximum-effort volleyball approach jumps. Sagittal plane knee joint kinematics, kinetics, and energetics were quantified in the lead limb, using data obtained from a force platform and an 8-camera motion analysis system. Vertical ground reaction forces and pelvis vertical velocity at takeoff were examined. Independent sample t tests were used to evaluate group differences (α = .05). The tendinopathy group, compared to controls, demonstrated significant reductions (approximately 30%) in net joint work and net joint power during the eccentric phase of the jump, with no differences in the concentric phase. Positive to-negative net joint work and net joint power ratios were significantly higher in the tendinopathy group, which had a net joint work ratio of 1.00 (95% CI: 0.77, 1.24) versus 0.76 (95% CI: 0.64, 0.88) for controls, and a net joint power ratio of 1.62 (95% CI: 1.15, 2.10) versus 1.00 (95% CI: 0.80, 1.21) for controls. There were no significant differences in net joint moment, angular velocity, or range of motion. Peak vertical ground reaction forces were lower for the tendinopathy group, while average vertical ground reaction forces and pelvis vertical velocity were similar. Patellar tendinopathy is associated with differences in sagittal plane mechanical energy absorption at the knee during maximum-effort volleyball approach jumps. Net joint work and net joint power may help define underlying mechanisms, adaptive effects, or rehabilitative strategies for individuals with patellar tendinopathy.

"When 'Bad' is 'Good'": Identifying Personal Communication and Sentiment in Drug-Related Tweets.

PubMed

Daniulaityte, Raminta; Chen, Lu; Lamy, Francois R; Carlson, Robert G; Thirunarayan, Krishnaprasad; Sheth, Amit

2016-10-24

To harness the full potential of social media for epidemiological surveillance of drug abuse trends, the field needs a greater level of automation in processing and analyzing social media content. The objective of the study is to describe the development of supervised machine-learning techniques for the eDrugTrends platform to automatically classify tweets by type/source of communication (personal, official/media, retail) and sentiment (positive, negative, neutral) expressed in cannabis- and synthetic cannabinoid-related tweets. Tweets were collected using Twitter streaming Application Programming Interface and filtered through the eDrugTrends platform using keywords related to cannabis, marijuana edibles, marijuana concentrates, and synthetic cannabinoids. After creating coding rules and assessing intercoder reliability, a manually labeled data set (N=4000) was developed by coding several batches of randomly selected subsets of tweets extracted from the pool of 15,623,869 collected by eDrugTrends (May-November 2015). Out of 4000 tweets, 25% (1000/4000) were used to build source classifiers and 75% (3000/4000) were used for sentiment classifiers. Logistic Regression (LR), Naive Bayes (NB), and Support Vector Machines (SVM) were used to train the classifiers. Source classification (n=1000) tested Approach 1 that used short URLs, and Approach 2 where URLs were expanded and included into the bag-of-words analysis. For sentiment classification, Approach 1 used all tweets, regardless of their source/type (n=3000), while Approach 2 applied sentiment classification to personal communication tweets only (2633/3000, 88%). Multiclass and binary classification tasks were examined, and machine-learning sentiment classifier performance was compared with Valence Aware Dictionary for sEntiment Reasoning (VADER), a lexicon and rule-based method. The performance of each classifier was assessed using 5-fold cross validation that calculated average F-scores. One-tailed t test was used to determine if differences in F-scores were statistically significant. In multiclass source classification, the use of expanded URLs did not contribute to significant improvement in classifier performance (0.7972 vs 0.8102 for SVM, P=.19). In binary classification, the identification of all source categories improved significantly when unshortened URLs were used, with personal communication tweets benefiting the most (0.8736 vs 0.8200, P<.001). In multiclass sentiment classification Approach 1, SVM (0.6723) performed similarly to NB (0.6683) and LR (0.6703). In Approach 2, SVM (0.7062) did not differ from NB (0.6980, P=.13) or LR (F=0.6931, P=.05), but it was over 40% more accurate than VADER (F=0.5030, P<.001). In multiclass task, improvements in sentiment classification (Approach 2 vs Approach 1) did not reach statistical significance (eg, SVM: 0.7062 vs 0.6723, P=.052). In binary sentiment classification (positive vs negative), Approach 2 (focus on personal communication tweets only) improved classification results, compared with Approach 1, for LR (0.8752 vs 0.8516, P=.04) and SVM (0.8800 vs 0.8557, P=.045). The study provides an example of the use of supervised machine learning methods to categorize cannabis- and synthetic cannabinoid-related tweets with fairly high accuracy. Use of these content analysis tools along with geographic identification capabilities developed by the eDrugTrends platform will provide powerful methods for tracking regional changes in user opinions related to cannabis and synthetic cannabinoids use over time and across different regions.

Defensive pessimism, self-esteem and achievement goals: A person-centered approach.

PubMed

Ferradás Canedo, María M; Freire Rodríguez, Carlos; Regueiro Fernández, Bibiana; Valle Arias, Antonio

2018-02-01

The relationship between defensive pessimism, self-esteem, and achievement goals is a controversial issue. The main contribution of this research is the adoption of a person-centered approach to explore the existence of differentiated profiles of university students, which combine self-esteem and defensive pessimism. In addition, we analyze whether these profiles differ in their achievement goals (learning, performance-approach, performance-avoidance, and work-avoidance). 1,028 university students took part in the study. Four student profiles were identified: (a) HSE/MDP (high self-esteem and moderate defensive pessimism); (b) LSE/LDP (low self-esteem and low defensive pessimism); (c) HSE/LDP (high self-esteem and low defensive pessimism); and (d) LSE/HDP (low self-esteem and high defensive pessimism). These four profiles differ significantly in their achievement goals. The use of defensive pessimism may involve students with either low or high self-esteem, although the two profiles follow differentiated motivational achievement trajectories.

Discriminative segmentation of microscopic cellular images.

PubMed

Cheng, Li; Ye, Ning; Yu, Weimiao; Cheah, Andre

2011-01-01

Microscopic cellular images segmentation has become an important routine procedure in modern biological research, due to the rapid advancement of fluorescence probes and robotic microscopes in recent years. In this paper we advocate a discriminative learning approach for cellular image segmentation. In particular, three new features are proposed to capture the appearance, shape and context information, respectively. Experiments are conducted on three different cellular image datasets. Despite the significant disparity among these datasets, the proposed approach is demonstrated to perform reasonably well. As expected, for a particular dataset, some features turn out to be more suitable than others. Interestingly, we observe that a further gain can often be obtained on top of using the "good" features, by also retaining those features that perform poorly. This might be due to the complementary nature of these features, as well as the capacity of our approach to better integrate and exploit different sources of information.

Quantum Ensemble Classification: A Sampling-Based Learning Control Approach.

PubMed

Chen, Chunlin; Dong, Daoyi; Qi, Bo; Petersen, Ian R; Rabitz, Herschel

2017-06-01

Quantum ensemble classification (QEC) has significant applications in discrimination of atoms (or molecules), separation of isotopes, and quantum information extraction. However, quantum mechanics forbids deterministic discrimination among nonorthogonal states. The classification of inhomogeneous quantum ensembles is very challenging, since there exist variations in the parameters characterizing the members within different classes. In this paper, we recast QEC as a supervised quantum learning problem. A systematic classification methodology is presented by using a sampling-based learning control (SLC) approach for quantum discrimination. The classification task is accomplished via simultaneously steering members belonging to different classes to their corresponding target states (e.g., mutually orthogonal states). First, a new discrimination method is proposed for two similar quantum systems. Then, an SLC method is presented for QEC. Numerical results demonstrate the effectiveness of the proposed approach for the binary classification of two-level quantum ensembles and the multiclass classification of multilevel quantum ensembles.

Mammogram registration using the Cauchy-Navier spline

NASA Astrophysics Data System (ADS)

Wirth, Michael A.; Choi, Christopher

2001-07-01

The process of comparative analysis involves inspecting mammograms for characteristic signs of potential cancer by comparing various analogous mammograms. Factors such as the deformable behavior of the breast, changes in breast positioning, and the amount/geometry of compression may contribute to spatial differences between corresponding structures in corresponding mammograms, thereby significantly complicating comparative analysis. Mammogram registration is a process whereby spatial differences between mammograms can be reduced. Presented in this paper is a nonrigid approach to matching corresponding mammograms based on a physical registration model. Many of the earliest approaches to mammogram registration used spatial transformations which were innately rigid or affine in nature. More recently algorithms have incorporated radial basis functions such as the Thin-Plate Spline to match mammograms. The approach presented here focuses on the use of the Cauchy-Navier Spline, a deformable registration model which offers approximate nonrigid registration. The utility of the Cauchy-Navier Spline is illustrated by matching both temporal and bilateral mammograms.

Estimating biogas production of biologically treated municipal solid waste.

PubMed

Scaglia, Barbara; Confalonieri, Roberto; D'Imporzano, Giuliana; Adani, Fabrizio

2010-02-01

In this work, a respirometric approach, i.e., Dynamic Respiration Index (DRI), was used to predict the anaerobic biogas potential (ABP), studying 46 waste samples coming directly from MBT full-scale plants. A significant linear regression model was obtained by a jackknife approach: ABP=(34.4+/-2.5)+(0.109+/-0.003).DRI. The comparison of the model of this work with those of the previous works using a different respirometric approach (Sapromat-AT(4)), allowed obtaining similar results and carrying out direct comparison of different limits to accept treated waste in landfill, proposed in the literature. The results indicated that on an average, MBT treatment allowed 56% of ABP reduction after 4weeks of treatment, and 79% reduction after 12weeks of treatment. The obtainment of another regression model allowed transforming Sapromat-AT(4) limit in DRI units, and achieving a description of the kinetics of DRI and the corresponding ABP reductions vs. MBT treatment-time.

[Pierre Janet's views on the etiology, pathogenesis and therapy of dissociative and conversion disorders ("hysterias")].

PubMed

Bühler, Karl-Ernst; Heim, Gerhard

2010-01-01

Pierre Janet (1859-1947) is one of those more or less forgotten authors whose approach differed significantly from Freud's psychoanalysis. In the first part of this paper, Janet's conception of hysteria is discussed and his place in French psychiatry described. Different aspects of Janet's diathesis-stress-approach are presented (particularly his important pathogenic concept of fixed ideas) which refer not only to a conception of hysteria, but also to traumatic (stress) disorders and other psychological disturbances. The second part of the paper details the varieties of Janetian therapeutic treatments for these disorders: the 'liquidation' of fixed ideas by hypnosis and suggestion, confrontation techniques which resemble contemporary cognitive behavioural approaches, and special cognitive ("logagogic") interventions. Finally, we also discuss the various treatment strategies Janet proposes for dealing with symptoms, such as asthenic or depressive states, from his psycho-economic perspective.

Artificial neural networks for document analysis and recognition.

PubMed

Marinai, Simone; Gori, Marco; Soda, Giovanni; Society, Computer

2005-01-01

Artificial neural networks have been extensively applied to document analysis and recognition. Most efforts have been devoted to the recognition of isolated handwritten and printed characters with widely recognized successful results. However, many other document processing tasks, like preprocessing, layout analysis, character segmentation, word recognition, and signature verification, have been effectively faced with very promising results. This paper surveys the most significant problems in the area of offline document image processing, where connectionist-based approaches have been applied. Similarities and differences between approaches belonging to different categories are discussed. A particular emphasis is given on the crucial role of prior knowledge for the conception of both appropriate architectures and learning algorithms. Finally, the paper provides a critical analysis on the reviewed approaches and depicts the most promising research guidelines in the field. In particular, a second generation of connectionist-based models are foreseen which are based on appropriate graphical representations of the learning environment.

Olfactory Groove Meningiomas: Comparison of Extent of Frontal Lobe Changes After Lateral and Bifrontal Approaches.

PubMed

Nanda, Anil; Maiti, Tanmoy K; Bir, Shyamal C; Konar, Subhas K; Guthikonda, Bharat

2016-10-01

Olfactory groove meningiomas often are behaviorally silent. Numerous surgical approaches have been described in the literature for the successful removal of these meningiomas. Lateral (pterional/frontolateral) and anterior (bifrontal/fronto-orbito-basal) approaches with their various modifications remain the 2 major corridors in resecting them. In this study, we discuss our experience in microsurgical treatment of these tumors at our institution and assess the extent of frontal lobe damage after the resection of tumor. We reviewed the medical records of patients who underwent surgical excision of olfactory groove meningiomas from 1990 to 2014. To measure the extent of frontal lobe damage via lateral and anterior approaches, we measured the volume of porencephalic cave in the postoperative magnetic resonance imaging by using Brainlab software. The ratio of volume of porencephalic cave to tumor was measured between 2 sides and 2 approaches. Fifty-seven patients with olfactory groove meningiomas, who underwent 62 microsurgical resection procedures in 1990-2014 were included in the study (74% were more than 5 cm at presentation). Pterional and bifrontal craniotomies were the most commonly used approaches. At follow-up, the volume of porencephalic cave after lateral approach was significantly less in the side contralateral to craniotomy irrespective of tumor size. The difference between ratio of volume of porencephalic cave and initial tumor was significantly less after lateral approaches, when compared to anterior approaches. Lateral approaches (pterional/frontolateral) resulted in less frontal lobe change and better olfactory preservation in comparison to anterior approaches in present series. Published by Elsevier Inc.

A methodology for the design of experiments in computational intelligence with multiple regression models.

PubMed

Fernandez-Lozano, Carlos; Gestal, Marcos; Munteanu, Cristian R; Dorado, Julian; Pazos, Alejandro

2016-01-01

The design of experiments and the validation of the results achieved with them are vital in any research study. This paper focuses on the use of different Machine Learning approaches for regression tasks in the field of Computational Intelligence and especially on a correct comparison between the different results provided for different methods, as those techniques are complex systems that require further study to be fully understood. A methodology commonly accepted in Computational intelligence is implemented in an R package called RRegrs. This package includes ten simple and complex regression models to carry out predictive modeling using Machine Learning and well-known regression algorithms. The framework for experimental design presented herein is evaluated and validated against RRegrs. Our results are different for three out of five state-of-the-art simple datasets and it can be stated that the selection of the best model according to our proposal is statistically significant and relevant. It is of relevance to use a statistical approach to indicate whether the differences are statistically significant using this kind of algorithms. Furthermore, our results with three real complex datasets report different best models than with the previously published methodology. Our final goal is to provide a complete methodology for the use of different steps in order to compare the results obtained in Computational Intelligence problems, as well as from other fields, such as for bioinformatics, cheminformatics, etc., given that our proposal is open and modifiable.

A methodology for the design of experiments in computational intelligence with multiple regression models

PubMed Central

Gestal, Marcos; Munteanu, Cristian R.; Dorado, Julian; Pazos, Alejandro

2016-01-01

The design of experiments and the validation of the results achieved with them are vital in any research study. This paper focuses on the use of different Machine Learning approaches for regression tasks in the field of Computational Intelligence and especially on a correct comparison between the different results provided for different methods, as those techniques are complex systems that require further study to be fully understood. A methodology commonly accepted in Computational intelligence is implemented in an R package called RRegrs. This package includes ten simple and complex regression models to carry out predictive modeling using Machine Learning and well-known regression algorithms. The framework for experimental design presented herein is evaluated and validated against RRegrs. Our results are different for three out of five state-of-the-art simple datasets and it can be stated that the selection of the best model according to our proposal is statistically significant and relevant. It is of relevance to use a statistical approach to indicate whether the differences are statistically significant using this kind of algorithms. Furthermore, our results with three real complex datasets report different best models than with the previously published methodology. Our final goal is to provide a complete methodology for the use of different steps in order to compare the results obtained in Computational Intelligence problems, as well as from other fields, such as for bioinformatics, cheminformatics, etc., given that our proposal is open and modifiable. PMID:27920952

Next generation DRM: cryptography or forensics?

NASA Astrophysics Data System (ADS)

Robert, Arnaud

2009-02-01

Current content protection systems rely primarily on applied cryptographic techniques but there is an increased use of forensic solutions in images, music and video distribution alike. The two approaches differ significantly, both in terms of technology and in terms of strategy, and thus it begs the question: will one approach take over in the long run, and if so which one? Discussing the evolution of both cryptographic and forensic solutions, we conclude that neither approach is ideal for all constituents, and that in the video space at least they will continue to co-exist for the foreseeable future - even if this may not be the case for other media types. We also analyze shortcomings of these approaches, and suggest that new solutions are necessary in this still emerging marketplace.

Can 18F-FDG-PET response during radiotherapy be used as a predictive factor for the outcome of head and neck cancer patients?

PubMed

Farrag, Ashraf; Ceulemans, Gaëtane; Voordeckers, Mia; Everaert, Hendrik; Storme, Guy

2010-06-01

We investigated if (18F) fluoro-2-deoxy-D-glucose positron emission tomography (F-FDG-PET) during radiotherapy or concurrent chemoradiotherapy adds information about the treatment outcome compared with an FDG-PET study before treatment. Forty-three patients with head and neck cancer were treated with helical tomotherapy. F-FDG-PET was performed at baseline and during the treatment after 47 Gy. Tracer accumulation at the tumor site was assessed visually and semiquantitatively using the maximal standardized uptake values (SUV(max)). With median SUV(max) of both the studies as cutoff, patients were categorized into low and high SUV(max) groups. For visual analysis, two independent observers classified patients as complete metabolic responders (CMR) or noncomplete metabolic responders (NCMR). At baseline the median SUV(max) was 8.11 (2.41-15.13). The overall survival (OS) and disease-free survival (DFS) were 81 and 67% versus 50 and 40% for the low and high SUV(max), respectively. OS was significantly different (P=0.027). During therapy, median SUV(max) was 4.03 (1.94-7.58). OS and DFS were 82 and 63%, versus 47 and 42% for the low and high SUV(max) group, respectively. OS was significantly different (P=0.026). No significant differences between CMR versus NCMR in OS (72 vs. 60%), and DFS (56 vs. 49%) were found. Categorizing patients on the basis of a semiquantitative approach resulted in significant differences in OS for both the scans before and during therapy. Future work on a larger number of patients is warranted to determine SUV(max) cutoff values which could be used for the early identification of patients with poor treatment outcome or perhaps other therapeutic approaches.

Effectiveness of Transactional Analysis Group Therapy on Addiction Intensity of Woman Patients Treated with Methadone.

PubMed

Etemadi-Chardah, Niloofar; Matinpour, Bahman; Heshmati, Rasoul

2017-07-01

Addiction brings about severe and profound physical, psychological and social damages such as divorce, crime, and unemployment. The present study was to investigate the effectiveness of transactional analysis (TA) therapy on addiction intensity of woman patients treated with methadone. The research design was quasi-experimental with a pretest-posttest and a control group. The statistical population consisted of all the addicted women who referred to any drug rehabilitation center of Tehran, Iran, in 2016. They were selected using available sampling. Forty addicted patients were placed randomly in both the experimental and control groups. Addiction severity index (ASI) and demographic questionnaires were used. Group therapy using TA approach was executed on the experimental group for 10 sessions, each session for 2 hours (one session per week). The results of covariance analysis after controlling pretest showed that the difference between test and control group was significant for three subscales of psychological, drug abuse and alcohol consumption status (P < 0.001). The difference between test and control groups was significant considering the seven-variable centroid (P < 0.001). The difference in dimensions of addiction intensity between the two groups was significant (P < 0.001). Also, analysis of the variables separately showed significant differences in psychiatric condition, drug and alcohol use dimensions (P < 0.001). Based on these findings, it seems that group therapy using TA approach is effective in reducing addiction intensity of woman patients treated with methadone. Therefore, it can be concluded that TA group interventions account for 76% of the changes in psychological status, 43% of the changes in drug abuse status, and 49% of the changes in alcohol consumption status in woman patients under methadone treatment.

Comparing sports vision among three groups of soft tennis adolescent athletes: Normal vision, refractive errors with and without correction.

PubMed

Chang, Shih-Tsun; Liu, Yen-Hsiu; Lee, Jiahn-Shing; See, Lai-Chu

2015-09-01

The effect of correcting static vision on sports vision is still not clear. To examine whether sports vision (depth perception [DP], dynamic visual acuity [DVA], eye movement [EM], peripheral vision [PV], and momentary vision [MV],) were different among soft tennis adolescent athletes with normal vision (Group A), with refractive error and corrected with (Group B) and without eyeglasses (Group C). A cross-section study was conducted. Soft tennis athletes aged 10-13 who played softball tennis for 2-5 years, and who were without any ocular diseases and without visual training for the past 3 months were recruited. DPs were measured in an absolute deviation (mm) between a moving rod and fixing rod (approaching at 25 mm/s, receding at 25 mm/s, approaching at 50 mm/s, receding at 50 mm/s) using electric DP tester. A smaller deviation represented better DP. DVA, EM, PV, and MV were measured on a scale from 1 (worse) to 10 (best) using ATHLEVISION software. Chi-square test and Kruskal-Wallis test was used to compare the data among the three study groups. A total of 73 athletes (37 in Group A, 8 in Group B, 28 in Group C) were enrolled in this study. All four items of DP showed significant difference among the three study groups (P = 0.0051, 0.0004, 0.0095, 0.0021). PV displayed significant difference among the three study groups (P = 0.0044). There was no significant difference in DVA, EM, and MV among the three study groups. Significant better DP and PV were seen among soft tennis adolescent athletes with normal vision than those with refractive error regardless whether they had eyeglasses corrected. On the other hand, DVA, EM, and MV were similar among the three study groups.

Cost-effectiveness of a classification-based system for sub-acute and chronic low back pain.

PubMed

Apeldoorn, Adri T; Bosmans, Judith E; Ostelo, Raymond W; de Vet, Henrica C W; van Tulder, Maurits W

2012-07-01

Identifying relevant subgroups in patients with low back pain (LBP) is considered important to guide physical therapy practice and to improve outcomes. The aim of the present study was to assess the cost-effectiveness of a modified version of Delitto's classification-based treatment approach compared with usual physical therapy care in patients with sub-acute and chronic LBP with 1 year follow-up. All patients were classified using the modified version of Delitto's classification-based system and then randomly assigned to receive either classification-based treatment or usual physical therapy care. The main clinical outcomes measured were; global perceived effect, intensity of pain, functional disability and quality of life. Costs were measured from a societal perspective. Multiple imputations were used for missing data. Uncertainty surrounding cost differences and incremental cost-effectiveness ratios was estimated using bootstrapping. Cost-effectiveness planes and cost-effectiveness acceptability curves were estimated. In total, 156 patients were included. The outcome analyses showed a significantly better outcome on global perceived effect favoring the classification-based approach, and no differences between the groups on pain, disability and quality-adjusted life-years. Mean total societal costs for the classification-based group were 2,287, and for the usual physical therapy care group 2,020. The difference was 266 (95% CI -720 to 1,612) and not statistically significant. Cost-effectiveness analyses showed that the classification-based approach was not cost-effective in comparison with usual physical therapy care for any clinical outcome measure. The classification-based treatment approach as used in this study was not cost-effective in comparison with usual physical therapy care in a population of patients with sub-acute and chronic LBP.

[Efficacy of the program "Testas's (mis)adventures" to promote the deep approach to learning].

PubMed

Rosário, Pedro; González-Pienda, Julio Antonio; Cerezo, Rebeca; Pinto, Ricardo; Ferreira, Pedro; Abilio, Lourenço; Paiva, Olimpia

2010-11-01

This paper provides information about the efficacy of a tutorial training program intended to enhance elementary fifth graders' study processes and foster their deep approaches to learning. The program "Testas's (mis)adventures" consists of a set of books in which Testas, a typical student, reveals and reflects upon his life experiences during school years. These life stories are nothing but an opportunity to present and train a wide range of learning strategies and self-regulatory processes, designed to insure students' deeper preparation for present and future learning challenges. The program has been developed along a school year, in a one hour weekly tutorial sessions. The training program had a semi-experimental design, included an experimental group (n=50) and a control one (n=50), and used pre- and posttest measures (learning strategies' declarative knowledge, learning approaches and academic achievement). Data suggest that the students enrolled in the training program, comparing with students in the control group, showed a significant improvement in their declarative knowledge of learning strategies and in their deep approach to learning, consequently lowering their use of a surface approach. In spite of this, in what concerns to academic achievement, no statistically significant differences have been found.

Effects of physical education, extracurricular sports activities, and leisure satisfaction on adolescent aggressive behavior: A latent growth modeling approach.

PubMed

Park, Sanghyun; Chiu, Weisheng; Won, Doyeon

2017-01-01

The present study aimed to investigate the longitudinal influence of physical education classes, extracurricular sports activities, and leisure satisfaction on aggressive behavior among South Korean adolescents. Data were drawn from the Korea Youth Panel Survey. We used latent growth curve modeling to explain the growth trajectory of adolescent aggressive behaviors and a multi-group analysis to investigate gender differences in aggressive behavior. The results indicated that adolescents' aggressive behavior significantly changed with age. There were significant gender-based differences in the level of and changes in aggressive behavior over time. Both extracurricular sports activities and leisure satisfaction had significant influences on the changes in adolescents' aggressive behavior with age, whereas physical education classes did not.

Accuracy of glenohumeral joint injections: comparing approach and experience of provider.

PubMed

Tobola, Allison; Cook, Chad; Cassas, Kyle J; Hawkins, Richard J; Wienke, Jeffrey R; Tolan, Stefan; Kissenberth, Michael J

2011-10-01

The purpose of this study was to prospectively evaluate the accuracy of three different approaches used for glenohumeral injections. In addition, the accuracy of the injection was compared to the experience and confidence of the provider. One-hundred six consecutive patients with shoulder pain underwent attempted intra-articular injection either posteriorly, supraclavicularly, or anteriorly. Each approach was performed by an experienced and inexperienced provider. A musculoskeletal radiologist blinded to technique used and provider interpreted fluoroscopic images to determine accuracy. Providers were blinded to these results. The accuracy of the anterior approach regardless of experience was 64.7%, the posterior approach was 45.7%, and the supraclavicular approach was 45.5%. With each approach, experience did not provide an advantage. For the anterior approach, the experienced provider was 50% accurate compared to 85.7%. For the posterior approach, the experienced provider had a 42.1% accuracy rate compared to 50%. The experienced provider was accurate 50% of the time in the supraclavicular approach compared to 38.5%. The providers were not able to predict their accuracy regardless of experience. The experienced providers, when compared to those who were less experienced, were more likely to be overconfident, particularly with the anterior and supraclavicular approaches. There was no statistically significant difference between the 3 approaches. The anterior approach was the most accurate, independent of the experience level of the provider. The posterior approach produced the lowest level of confidence regardless of experience. The experienced providers were not able to accurately predict the results of their injections, and were more likely to be overconfident with the anterior and supraclavicular approaches. Copyright © 2011 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

The Ability of Different Imputation Methods to Preserve the Significant Genes and Pathways in Cancer.

PubMed

Aghdam, Rosa; Baghfalaki, Taban; Khosravi, Pegah; Saberi Ansari, Elnaz

2017-12-01

Deciphering important genes and pathways from incomplete gene expression data could facilitate a better understanding of cancer. Different imputation methods can be applied to estimate the missing values. In our study, we evaluated various imputation methods for their performance in preserving significant genes and pathways. In the first step, 5% genes are considered in random for two types of ignorable and non-ignorable missingness mechanisms with various missing rates. Next, 10 well-known imputation methods were applied to the complete datasets. The significance analysis of microarrays (SAM) method was applied to detect the significant genes in rectal and lung cancers to showcase the utility of imputation approaches in preserving significant genes. To determine the impact of different imputation methods on the identification of important genes, the chi-squared test was used to compare the proportions of overlaps between significant genes detected from original data and those detected from the imputed datasets. Additionally, the significant genes are tested for their enrichment in important pathways, using the ConsensusPathDB. Our results showed that almost all the significant genes and pathways of the original dataset can be detected in all imputed datasets, indicating that there is no significant difference in the performance of various imputation methods tested. The source code and selected datasets are available on http://profiles.bs.ipm.ir/softwares/imputation_methods/. Copyright © 2017. Production and hosting by Elsevier B.V.

Two different approaches to the affective profiles model: median splits (variable-oriented) and cluster analysis (person-oriented).

PubMed

Garcia, Danilo; MacDonald, Shane; Archer, Trevor

2015-01-01

Background. The notion of the affective system as being composed of two dimensions led Archer and colleagues to the development of the affective profiles model. The model consists of four different profiles based on combinations of individuals' experience of high/low positive and negative affect: self-fulfilling, low affective, high affective, and self-destructive. During the past 10 years, an increasing number of studies have used this person-centered model as the backdrop for the investigation of between and within individual differences in ill-being and well-being. The most common approach to this profiling is by dividing individuals' scores of self-reported affect using the median of the population as reference for high/low splits. However, scores just-above and just-below the median might become high and low by arbitrariness, not by reality. Thus, it is plausible to criticize the validity of this variable-oriented approach. Our aim was to compare the median splits approach with a person-oriented approach, namely, cluster analysis. Method. The participants (N = 2, 225) were recruited through Amazons' Mechanical Turk and asked to self-report affect using the Positive Affect Negative Affect Schedule. We compared the profiles' homogeneity and Silhouette coefficients to discern differences in homogeneity and heterogeneity between approaches. We also conducted exact cell-wise analyses matching the profiles from both approaches and matching profiles and gender to investigate profiling agreement with respect to affectivity levels and affectivity and gender. All analyses were conducted using the ROPstat software. Results. The cluster approach (weighted average of cluster homogeneity coefficients = 0.62, Silhouette coefficients = 0.68) generated profiles with greater homogeneity and more distinctive from each other compared to the median splits approach (weighted average of cluster homogeneity coefficients = 0.75, Silhouette coefficients = 0.59). Most of the participants (n = 1,736, 78.0%) were allocated to the same profile (Rand Index = .83), however, 489 (21.98%) were allocated to different profiles depending on the approach. Both approaches allocated females and males similarly in three of the four profiles. Only the cluster analysis approach classified men significantly more often than chance to a self-fulfilling profile (type) and females less often than chance to this very same profile (antitype). Conclusions. Although the question whether one approach is more appropriate than the other is still without answer, the cluster method allocated individuals to profiles that are more in accordance with the conceptual basis of the model and also to expected gender differences. More importantly, regardless of the approach, our findings suggest that the model mirrors a complex and dynamic adaptive system.

Cochlear Implantation in Patients With CHARGE Syndrome.

PubMed

Rah, Yoon Chan; Lee, Ji Young; Suh, Myung-Whan; Park, Moo Kyun; Lee, Jun Ho; Chang, Sun O; Oh, Seung-Ha

2016-11-01

To determine the optimal surgical approach for cochlear implantation (CI) preoperatively based on the spatial relation of a displaced facial nerve (FN) and middle ear structures and to analyze clinical outcomes of CHARGE syndrome. Facial nerve displacement and associated deviation of inner ear structures were analyzed in 13 patients (17 ears) with CHARGE syndrome who underwent CI. Surgical accessibility through the facial recess was assessed based on anatomical landmarks. Postoperative speech performance and associated clinical characteristics were analyzed. The most consistently identified ear anomalies were semicircular canal aplasia (100%), ossicular anomaly (100%), and vestibular hypoplasia (88%). Facial nerve displacement was found in 77% of cases (anteroinferior: 47%, anterior: 24%, inferior: 6%). The width of available surgical space around facial recess was significantly greater in cases of facial recess approach (2.85 ± 0.9 mm) than those of alternative approach (0.12 ± 0.29 mm, P = .02). Postoperatively, 53% achieved better than category 4 on the categories of auditory perception (CAP) scale. The CAP category was significantly correlated with internal auditory canal diameter (P = .025) and did not differ according to the applied surgical approach. Preoperative determination of surgical accessibility through facial recess would be useful for safe surgical approach, and successful hearing rehabilitation was achievable by applying appropriate surgical approaches. © The Author(s) 2016.

A Comparative Study of Rat Lung Decellularization by Chemical Detergents for Lung Tissue Engineering

PubMed Central

Tebyanian, Hamid; Karami, Ali; Motavallian, Ebrahim; Aslani, Jafar; Samadikuchaksaraei, Ali; Arjmand, Babak; Nourani, Mohammad Reza

2017-01-01

BACKGROUND: Lung disease is the most common cause of death in the world. The last stage of pulmonary diseases is lung transplantation. Limitation and shortage of donor organs cause to appear tissue engineering field. Decellularization is a hope for producing intact ECM in the development of engineered organs. AIM: The goal of the decellularization process is to remove cellular and nuclear material while retaining lung three-dimensional and molecular proteins. Different concentration of detergents was used for finding the best approach in lung decellularization. MATERIAL AND METHODS: In this study, three-time approaches (24, 48 and 96 h) with four detergents (CHAPS, SDS, SDC and Triton X-100) were used for decellularizing rat lungs for maintaining of three-dimensional lung architecture and ECM protein composition which have significant roles in differentiation and migration of stem cells. This comparative study determined that variable decellularization approaches can cause significantly different effects on decellularized lungs. RESULTS: Results showed that destruction was increased with increasing the detergent concentration. Single detergent showed a significant reduction in maintaining of three-dimensional of lung and ECM proteins (Collagen and Elastin). But, the best methods were mixed detergents of SDC and CHAPS in low concentration in 48 and 96 h decellularization. CONCLUSION: Decellularized lung tissue can be used in the laboratory to study various aspects of pulmonary biology and physiology and also, these results can be used in the continued improvement of engineered lung tissue. PMID:29362610

A Prospective Comparison of Intraluminal and Extraluminal Placement of the 9-French Arndt Bronchial Blocker in Adult Thoracic Surgery Patients.

PubMed

Templeton, T Wesley; Morris, Benjamin N; Goenaga-Diaz, Eduardo J; Forest, Daniel J; Hadley, Rhett; Moore, Blake A; Bryan, Yvon F; Royster, Roger L

2017-08-01

To compare the standard intraluminal approach with the placement of the 9-French Arndt endobronchial blocker with an extraluminal approach by measuring the time to positioning and other relevant intraoperative and postoperative parameters. A prospective, randomized, controlled trial. University hospital. The study comprised 41 patients (20 intraluminal, 21 extraluminal) undergoing thoracic surgery. Placement of a 9-French Arndt bronchial blocker either intraluminally or extraluminally. Comparisons between the 2 groups included the following: (1) time for initial placement, (2) quality of isolation at 1-hour intervals during one-lung ventilation, (3) number of repositionings during one-lung ventilation, and (4) presence or absence of a sore throat on postoperative days 1 and 2 and, if present, its severity. Median time to placement (min:sec) in the extraluminal group was statistically faster at 2:42 compared with 6:24 in the intraluminal group (p < 0.05). Overall quality of isolation was similar between groups, even though a significant number of blockers in both groups required repositioning (extraluminal 47%, intraluminal 40%, p > 0.05), and 1 blocker ultimately had to be replaced intraoperatively. No differences in the incidence or severity of sore throat postoperatively were observed. A statistically significant reduction in time to placement using the extraluminal approach without any differences in the rate of postoperative sore throat was observed. Whether placed intraluminally or extraluminally, a significant percentage of Arndt endobronchial blockers required at least one intraoperative repositioning. Copyright © 2017 Elsevier Inc. All rights reserved.

Prediction of Patient-Controlled Analgesic Consumption: A Multimodel Regression Tree Approach.

PubMed

Hu, Yuh-Jyh; Ku, Tien-Hsiung; Yang, Yu-Hung; Shen, Jia-Ying

2018-01-01

Several factors contribute to individual variability in postoperative pain, therefore, individuals consume postoperative analgesics at different rates. Although many statistical studies have analyzed postoperative pain and analgesic consumption, most have identified only the correlation and have not subjected the statistical model to further tests in order to evaluate its predictive accuracy. In this study involving 3052 patients, a multistrategy computational approach was developed for analgesic consumption prediction. This approach uses data on patient-controlled analgesia demand behavior over time and combines clustering, classification, and regression to mitigate the limitations of current statistical models. Cross-validation results indicated that the proposed approach significantly outperforms various existing regression methods. Moreover, a comparison between the predictions by anesthesiologists and medical specialists and those of the computational approach for an independent test data set of 60 patients further evidenced the superiority of the computational approach in predicting analgesic consumption because it produced markedly lower root mean squared errors.

Recent Evolution of Endoscopic Endonasal Surgery for Treatment of Pituitary Adenomas

PubMed Central

NISHIOKA, Hiroshi

2017-01-01

For the treatment of pituitary tumors, microscopic transsphenoidal surgery has been considered the “gold standard” since the late 1960s. Over the last two decades, however, a worldwide shift towards endoscopic endonasal surgery is in progress for many reasons. These include a wide panoramic view, improved illumination, an ability to look around anatomical corners using angled tip and, in addition, application to the extended approaches for parasellar tumors. Both endoscopic and microscopic approaches appear equally effective for nonfunctioning adenomas without significant suprasellar or lateral extensions, whereas the endoscopic approach may improve outcomes associated with the extent of resection and postoperative complications for larger tumors. Despite many theoretical benefits in the endoscopic surgery, remission rates of functioning adenomas do not substantially differ between the approaches in experienced hands. The endoscopic approach is a valid alternative to the microscopic approach for adenomas. The benefits will be more appreciated in the extended surgery for parasellar tumors. PMID:28239067

The effect of computer-assisted therapeutic practice for children with handwriting deficit: a comparison with the effect of the traditional sensorimotor approach.

PubMed

Chang, Shao-Hsia; Yu, Nan-Ying

2014-07-01

The objective of this study was to compare the effect of computer-assisted practice with the sensorimotor approach on the remediation of handwriting problems in children with dysgraphia. In a randomized controlled trial, experiments were conducted to verify the intervention effect. Forty two children with handwriting deficit were assigned to computer-assisted instruction, sensorimotor training, or a control group. Handwriting performance was measured using the elementary reading/writing test and computerized handwriting evaluation before and after 6 weeks of intervention. Repeated-measures ANOVA of changed scores were conducted to show whether statistically significant differences across the three groups were present. Significant differences in the elementary reading/writing test were found among the three groups. The computer group showed more significant improvements than the other two groups did. In the kinematic and kinetic analyses, the computer group showed promising results in the remediation of handwriting speed and fluency. This study provided clinical evidence for applying a computer-assisted handwriting program for children with dysgraphia. Clinicians and school teachers are provided with a systematic intervention for the improvement of handwriting difficulties. Copyright © 2014 Elsevier Ltd. All rights reserved.

Route learning in amnesia: a comparison of trial-and-error and errorless learning in patients with the Korsakoff syndrome.

PubMed

Kessels, Roy P C; van Loon, Eke; Wester, Arie J

2007-10-01

To examine the errorless learning approach using a procedural memory task (i.e. learning of actual routes) in patients with amnesia, as compared to trial-and-error learning. Counterbalanced self-controlled cases series. Psychiatric hospital (Korsakoff clinic). A convenience sample of 10 patients with the Korsakoff amnestic syndrome. All patients learned a route in four sessions on separate days using an errorless approach and a different route using trial-and-error. Error rate was scored during route learning and standard neuro-psychological tests were administered (i.e. subtest route recall of the Rivermead Behavioural Memory Test (RBMT) and the Dutch version of the California Verbal Learning Test (VLGT)). A significant learning effect was found in the trial-and-error condition over consecutive sessions (P = 0.006), but no performance difference was found between errorless and trial-and-error learning of the routes. VLGT performance was significantly correlated with a trial-and-error advantage (P < 0.05); no significant correlation was found between the RBMT subtest and the learning conditions. Errorless learning was no more successful than trial-and-error learning of a procedural spatial task in patients with the Korsakoff syndrome (severe amnesia).

Creating a National Framework for Cybersecurity: An Analysis of Issues and Options

DTIC Science & Technology

2005-02-22

of those measures; and the associated field of professional endeavor. Virtually any element of cyberspace can be at risk , and the degree of...weaknesses in U.S. cybersecurity is an area of some controversy. However, some components appear to be sources of potentially significant risk because either...security into enterprise architecture, using risk management, and using metrics. These different approaches all have different strengths and weaknesses

Comparison of the different approaches to generate holograms from data acquired with a Kinect sensor

NASA Astrophysics Data System (ADS)

Kang, Ji-Hoon; Leportier, Thibault; Ju, Byeong-Kwon; Song, Jin Dong; Lee, Kwang-Hoon; Park, Min-Chul

2017-05-01

Data of real scenes acquired in real-time with a Kinect sensor can be processed with different approaches to generate a hologram. 3D models can be generated from a point cloud or a mesh representation. The advantage of the point cloud approach is that computation process is well established since it involves only diffraction and propagation of point sources between parallel planes. On the other hand, the mesh representation enables to reduce the number of elements necessary to represent the object. Then, even though the computation time for the contribution of a single element increases compared to a simple point, the total computation time can be reduced significantly. However, the algorithm is more complex since propagation of elemental polygons between non-parallel planes should be implemented. Finally, since a depth map of the scene is acquired at the same time than the intensity image, a depth layer approach can also be adopted. This technique is appropriate for a fast computation since propagation of an optical wavefront from one plane to another can be handled efficiently with the fast Fourier transform. Fast computation with depth layer approach is convenient for real time applications, but point cloud method is more appropriate when high resolution is needed. In this study, since Kinect can be used to obtain both point cloud and depth map, we examine the different approaches that can be adopted for hologram computation and compare their performance.

Symmetrical Location Characteristics of Corticospinal Tract Associated With Hand Movement in the Human Brain: A Probabilistic Diffusion Tensor Tractography.

PubMed

Lee, Dong-Hoon; Lee, Do-Wan; Han, Bong-Soo

2016-04-01

The purpose of this study is to elucidate the symmetrical characteristics of corticospinal tract (CST) related with hand movement in bilateral hemispheres using probabilistic fiber tracking method. Seventeen subjects were participated in this study. Fiber tracking was performed with 2 regions of interest, hand activated functional magnetic resonance imaging (fMRI) results and pontomedullary junction in each cerebral hemisphere. Each subject's extracted fiber tract was normalized with a brain template. To measure the symmetrical distributions of the CST related with hand movement, the laterality and anteriority indices were defined in upper corona radiata (CR), lower CR, and posterior limb of internal capsule. The measured laterality and anteriority indices between the hemispheres in each different brain location showed no significant differences with P < 0.05. There were significant differences in the measured indices among 3 different brain locations in each cerebral hemisphere with P < 0.001. Our results clearly showed that the hand CST had symmetric structures in bilateral hemispheres. The probabilistic fiber tracking with fMRI approach demonstrated that the hand CST can be successfully extracted regardless of crossing fiber problem. Our analytical approaches and results seem to be helpful for providing the database of CST somatotopy to neurologists and clinical researches.

The mammalian bony labyrinth reconsidered, introducing a comprehensive geometric morphometric approach

PubMed Central

Gunz, Philipp; Ramsier, Marissa; Kuhrig, Melanie; Hublin, Jean-Jacques; Spoor, Fred

2012-01-01

The bony labyrinth in the temporal bone houses the sensory systems of balance and hearing. While the overall structure of the semicircular canals and cochlea is similar across therian mammals, their detailed morphology varies even among closely related groups. As such, the shape of the labyrinth carries valuable functional and phylogenetic information. Here we introduce a new, semilandmark-based three-dimensional geometric morphometric approach to shape analysis of the labyrinth, as a major improvement upon previous metric studies based on linear measurements and angles. We first provide a detailed, step-by-step description of the measurement protocol. Subsequently, we test our approach using a geographically diverse sample of 50 recent modern humans and 30 chimpanzee specimens belonging to Pan troglodytes troglodytes and P. t. verus. Our measurement protocol can be applied to CT scans of different spatial resolutions because it primarily quantifies the midline skeleton of the bony labyrinth. Accurately locating the lumen centre of the semicircular canals and the cochlea is not affected by the partial volume and thresholding effects that can make the comparison of the outer border problematic. After virtually extracting the bony labyrinth from CT scans of the temporal bone, we computed its midline skeleton by thinning the encased volume. On the resulting medial axes of the semicircular canals and cochlea we placed a sequence of semilandmarks. After Procrustes superimposition, the shape coordinates were analysed using multivariate statistics. We found statistically significant shape differences between humans and chimpanzees which corroborate previous analyses of the labyrinth based on traditional measurements. As the geometric relationship among the semilandmark coordinates was preserved throughout the analysis, we were able to quantify and visualize even small-scale shape differences. Notably, our approach made it possible to detect and visualize subtle, yet statistically significant (P = 0.009), differences between two chimpanzee subspecies in the shape of their semicircular canals. The ability to discriminate labyrinth shape at the subspecies level demonstrates that the approach presented here has great potential in future taxonomic studies of fossil specimens. PMID:22404255

The impact of varicocelectomy on sperm parameters: a meta-analysis.

PubMed

Schauer, Ingrid; Madersbacher, Stephan; Jost, Romy; Hübner, Wilhelm Alexander; Imhof, Martin

2012-05-01

We determined the impact of 3 surgical techniques (high ligation, inguinal varicocelectomy and the subinguinal approach) for varicocelectomy on sperm parameters (count and motility) and pregnancy rates. By searching the literature using MEDLINE and the Cochrane Library with the last search performed in February 2011, focusing on the last 20 years, a total of 94 articles published between 1975 and 2011 reporting on sperm parameters before and after varicocelectomy were identified. Inclusion criteria for this meta-analysis were at least 2 semen analyses (before and 3 or more months after the procedure), patient age older than 19 years, clinical subfertility and/or abnormal semen parameters, and a clinically palpable varicocele. To rule out skewing factors a bias analysis was performed, and statistical analysis was done with RevMan5(®) and SPSS 15.0(®). A total of 14 articles were included in the statistical analysis. All 3 surgical approaches led to significant or highly significant postoperative improvement of both parameters with only slight numeric differences among the techniques. This difference did not reach statistical significance for sperm count (p = 0.973) or sperm motility (p = 0.372). After high ligation surgery sperm count increased by 10.85 million per ml (p = 0.006) and motility by 6.80% (p <0.00001) on the average. Inguinal varicocelectomy led to an improvement in sperm count of 7.17 million per ml (p <0.0001) while motility changed by 9.44% (p = 0.001). Subinguinal varicocelectomy provided an increase in sperm count of 9.75 million per ml (p = 0.002) and sperm motility by 12.25% (p = 0.001). Inguinal varicocelectomy showed the highest pregnancy rate of 41.48% compared to 26.90% and 26.56% after high ligation and subinguinal varicocelectomy, respectively, and the difference was statistically significant (p = 0.035). This meta-analysis suggests that varicocelectomy leads to significant improvements in sperm count and motility regardless of surgical technique, with the inguinal approach offering the highest pregnancy rate. Copyright © 2012 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Psychosocial factors and therapeutic approaches in the context of sexual history taking in men: a study conducted among Swiss general practitioners and urologists.

PubMed

Platano, Giacomo; Margraf, Jürgen; Alder, Judith; Bitzer, Johannes

2008-11-01

Male sexual dysfunction is a common medical condition, which is addressed mainly from a biomedical perspective by Swiss general practitioners (GPs) and urologists as the results of part I of our study showed. A psychosocial orientation in sexual history taking (SHT) leads to a truly patient-centered approach and is crucial for improving therapy decisions related to sexual dysfunction. To analyze to what extent Swiss GPs and urologists have a psychosocial orientation in SHT, and what therapeutic options they focus on when confronted with male sexual dysfunction. A semistructured interview was developed and used in face-to-face encounters with 25 GPs and 25 urologists. Content and frequency of interview responses. The GPs and urologists differed significantly from each other in 5 out of 22 psychosocial factors. Summarizing these psychosocial factors in four domains showed a difference between the GPs and urologists in only one domain. Both groups focus on an open conversation as their approach in SHT. No GP and only a minority of urologists based their diagnosis on criteria of the International Classification of Diseases (10th edition) (ICD-10) or Diagnostic and Statistical Manual of Mental Disorders (4th edition) (DSM-IV). The GPs and urologists differed significantly from each other in 4 out of 16 combinations resulting from the given therapeutic options and form of sexual dysfunction. The urologists focus more strongly on medication as a therapeutic option. The results of part II additionally justify establishing guidelines and training resources related to SHT in Switzerland. Swiss physicians should be encouraged to apply a more psychosocial orientation in SHT. This will contribute to a better patient-centered approach with positive consequences on physicians' therapeutic decisions. Optimizing the approach in SHT and the choice of therapeutic options may better facilitate real sexual satisfaction for the patient and ultimately result in fewer health insurance costs.

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

Góra, Joanna, E-mail: joanna.gora@akhwien.at; EBG MedAustron GmbH, Wiener Neustadt; Stock, Markus

Purpose: To investigate robust margin strategies in intensity modulated proton therapy to account for interfractional organ motion in prostate cancer. Methods and Materials: For 9 patients, one planning computed tomography (CT) scan and daily and weekly cone beam CTs (CBCTs) were acquired and coregistered. The following planning target volume (PTV) approaches were investigated: a clinical target volume (CTV) delineated on the planning CT (CTV{sub ct}) plus 10-mm margin (PTV{sub 10mm}); a reduced PTV (PTV{sub Red}): CTV{sub ct} plus 5 mm in the left-right (LR) and anterior-posterior (AP) directions and 8 mm in the inferior-superior (IS) directions; and a PTV{sub Hull}more » method: the sum of CTV{sub ct} and CTVs from 5 CBCTs from the first week plus 3 mm in the LR and IS directions and 5 mm in the AP direction. For each approach, separate plans were calculated using a spot-scanning technique with 2 lateral fields. Results: Each approach achieved excellent target coverage. Differences were observed in volume receiving 98% of the prescribed dose (V{sub 98%}) where PTV{sub Hull} and PTV{sub Red} results were superior to the PTV{sub 10mm} concept. The PTV{sub Hull} approach was more robust to organ motion. The V{sub 98%} for CTVs was 99.7%, whereas for PTV{sub Red} and PTV{sub 10mm} plans, V{sub 98%} was 98% and 96.1%, respectively. Doses to organs at risk were higher for PTV{sub Hull} and PTV{sub 10mm} plans than for PTV{sub Red}, but only differences between PTV{sub 10mm} and PTV{sub Red} were significant. Conclusions: In terms of organ sparing, the PTV{sub 10mm} method was inferior but not significantly different from the PTV{sub Red} and PTV{sub Hull} approaches. PTV{sub Hull} was most insensitive to target motion.« less

The contribution of psychological factors to recovery after mild traumatic brain injury: is cluster analysis a useful approach?

PubMed

Snell, Deborah L; Surgenor, Lois J; Hay-Smith, E Jean C; Williman, Jonathan; Siegert, Richard J

2015-01-01

Outcomes after mild traumatic brain injury (MTBI) vary, with slow or incomplete recovery for a significant minority. This study examines whether groups of cases with shared psychological factors but with different injury outcomes could be identified using cluster analysis. This is a prospective observational study following 147 adults presenting to a hospital-based emergency department or concussion services in Christchurch, New Zealand. This study examined associations between baseline demographic, clinical, psychological variables (distress, injury beliefs and symptom burden) and outcome 6 months later. A two-step approach to cluster analysis was applied (Ward's method to identify clusters, K-means to refine results). Three meaningful clusters emerged (high-adapters, medium-adapters, low-adapters). Baseline cluster-group membership was significantly associated with outcomes over time. High-adapters appeared recovered by 6-weeks and medium-adapters revealed improvements by 6-months. The low-adapters continued to endorse many symptoms, negative recovery expectations and distress, being significantly at risk for poor outcome more than 6-months after injury (OR (good outcome) = 0.12; CI = 0.03-0.53; p < 0.01). Cluster analysis supported the notion that groups could be identified early post-injury based on psychological factors, with group membership associated with differing outcomes over time. Implications for clinical care providers regarding therapy targets and cases that may benefit from different intensities of intervention are discussed.

Spectral reconstruction for shifted-excitation Raman difference spectroscopy (SERDS).

PubMed

Guo, Shuxia; Chernavskaia, Olga; Popp, Jürgen; Bocklitz, Thomas

2018-08-15

Fluorescence emission is one of the major obstacles to apply Raman spectroscopy in biological investigations. It is usually several orders more intense than Raman scattering and hampers further analysis. In cases where the fluorescence emission is too intense to be efficiently removed via routine mathematical baseline correction algorithms, an alternative approach is needed. One alternative approach is shifted-excitation Raman difference spectroscopy (SERDS), where two Raman spectra are recorded with two slightly different excitation wavelengths. Ideally, the fluorescence emission at the two excitations does not change while the Raman spectrum shifts according to the excitation wavelength. Hence the fluorescence is removed in the difference of the two recorded Raman spectra. For better interpretability a spectral reconstruction procedure is necessary to recover the fluorescence-free Raman spectrum. This is challenging due to the intensity variations between the two recorded Raman spectra caused by unavoidable experimental changes as well as the presence of noise. Existent approaches suffer from drawbacks like spectral resolution loss, fluorescence residual, and artefacts. In this contribution, we proposed a reconstruction method based on non-negative least squares (NNLS), where the intensity variations between the two measurements are utilized in the reconstruction model. The method achieved fluorescence-free reconstruction on three real-world SERDS datasets without significant information loss. Thereafter, we quantified the performance of the reconstruction based on artificial datasets from four aspects: reconstructed spectral resolution, precision of reconstruction, signal-to-noise-ratio (SNR), and fluorescence residual. The artificial datasets were constructed with varied Raman to fluorescence intensity ratio (RFIR), SNR, full-width at half-maximum (FWHM), excitation wavelength shift, and fluorescence variation between the two spectra. It was demonstrated that the NNLS approach provides a faithful reconstruction without significantly changing the spectral resolution. Meanwhile, the reconstruction is almost robust to fluorescence variations between the two spectra. Last but not the least the SNR was improved after reconstruction for extremely noisy SERDS datasets. Copyright © 2018 Elsevier B.V. All rights reserved.

Phrenic nerve block caused by interscalene brachial plexus block: breathing effects of different sites of injection.

PubMed

Bergmann, Lars; Martini, Stefan; Kesselmeier, Miriam; Armbruster, Wolf; Notheisen, Thomas; Adamzik, Michael; Eichholz, Rϋdiger

2016-07-29

Interscalene brachial plexus (ISB) block is often associated with phrenic nerve block and diaphragmatic paresis. The goal of our study was to test if the anterior or the posterior ultrasound guided approach of the ISB is associated with a lower incidence of phrenic nerve blocks and impaired lung function. This was a prospective, randomized and single-blinded study of 84 patients scheduled for elective shoulder surgery who fullfilled the inclusion and exclusion critereria. Patients were randomized in two groups to receive either the anterior (n = 42) or the posterior (n = 42) approach for ISB. Clinical data were recorded. In both groups patients received ISB with a total injection volume of 15 ml of ropivacaine 1 %. Spirometry was conducted at baseline (T0) and 30 min (T30) after accomplishing the block. Changes in spirometrical variables between T0 and T30 were investigated by Wilcoxon signed-rank test for each puncture approach. The temporal difference between the posterior and the anterior puncture approach groups were again analyzed by the Wilcoxon-Mann-Whitney test. The spirometric results showed a significant decrease in vital capacity, forced expiratory volume per second, and maximum nasal inspiratory breathing after the Interscalene brachial plexus block; indicating a phrenic nerve block (p <0.001, Wilcoxon signed-rank). A significant difference in the development of the spirometric parameters between the anterior and the posterior group could not be identified (Wilcoxon-Mann-Whitney test). Despite the changes in spirometry, no cases of dyspnea were reported. A different site of injection (anterior or posterior) did not show an effect in reducing the cervical block spread of the local anesthetic and the incidence of phrenic nerve blocks during during ultrasound guided Interscalene brachial plexus block. Clinical breathing effects of phrenic nerve blocks are, however, usually well compensated, and subjective dyspnea did not occur in our patients. German Clinical Trials Register (DRKS number 00009908 , registered 26 January 2016).

A Comparison of Alkaline Water and Mediterranean Diet vs Proton Pump Inhibition for Treatment of Laryngopharyngeal Reflux.

PubMed

Zalvan, Craig H; Hu, Shirley; Greenberg, Barbara; Geliebter, Jan

2017-10-01

Laryngopharyngeal reflux (LPR) is a common disorder with protean manifestations in the head and neck. In this retrospective study, we report the efficacy of a wholly dietary approach using alkaline water, a plant-based, Mediterranean-style diet, and standard reflux precautions compared with that of the traditional treatment approach of proton pump inhibition (PPI) and standard reflux precautions. To determine whether treatment with a diet-based approach with standard reflux precautions alone can improve symptoms of LPR compared with treatment with PPI and standard reflux precautions. This was a retrospective medical chart review of 2 treatment cohorts. From 2010 to 2012, 85 patients with LPR that were treated with PPI and standard reflux precautions (PS) were identified. From 2013 to 2015, 99 patients treated with alkaline water (pH >8.0), 90% plant-based, Mediterranean-style diet, and standard reflux precautions (AMS) were identified. The outcome was based on change in Reflux Symptom Index (RSI). Recorded change in the RSI after 6 weeks of treatment. Of the 184 patients identified in the PS and AMS cohorts, the median age of participants in each cohort was 60 years (95% CI, 18-82) and 57 years (95% CI, 18-93), respectively (47 [56.3%] and 61 [61.7%] were women, respectively). The percentage of patients achieving a clinically meaningful (≥6 points) reduction in RSI was 54.1% in PS-treated patients and 62.6% in AMS-treated patients (difference between the groups, 8.05; 95% CI, -5.74 to 22.76). The mean reduction in RSI was 27.2% for the PS group and 39.8% in the AMS group (difference, 12.10; 95% CI, 1.53 to 22.68). Our data suggest that the effect of PPI on the RSI based on proportion reaching a 6-point reduction in RSI is not significantly better than that of alkaline water, a plant-based, Mediterranean-style diet, and standard reflux precautions, although the difference in the 2 treatments could be clinically meaningful in favor of the dietary approach. The percent reduction in RSI was significantly greater with the dietary approach. Because the relationship between percent change and response to treatment has not been studied, the clinical significance of this difference requires further study. Nevertheless, this study suggests that a plant-based diet and alkaline water should be considered in the treatment of LPR. This approach may effectively improve symptoms and could avoid the costs and adverse effects of pharmacological intervention as well as afford the additional health benefits associated with a healthy, plant-based diet.

Bayesian longitudinal segmentation of hippocampal substructures in brain MRI using subject-specific atlases.

PubMed

Iglesias, Juan Eugenio; Van Leemput, Koen; Augustinack, Jean; Insausti, Ricardo; Fischl, Bruce; Reuter, Martin

2016-11-01

The hippocampal formation is a complex, heterogeneous structure that consists of a number of distinct, interacting subregions. Atrophy of these subregions is implied in a variety of neurodegenerative diseases, most prominently in Alzheimer's disease (AD). Thanks to the increasing resolution of MR images and computational atlases, automatic segmentation of hippocampal subregions is becoming feasible in MRI scans. Here we introduce a generative model for dedicated longitudinal segmentation that relies on subject-specific atlases. The segmentations of the scans at the different time points are jointly computed using Bayesian inference. All time points are treated the same to avoid processing bias. We evaluate this approach using over 4700 scans from two publicly available datasets (ADNI and MIRIAD). In test-retest reliability experiments, the proposed method yielded significantly lower volume differences and significantly higher Dice overlaps than the cross-sectional approach for nearly every subregion (average across subregions: 4.5% vs. 6.5%, Dice overlap: 81.8% vs. 75.4%). The longitudinal algorithm also demonstrated increased sensitivity to group differences: in MIRIAD (69 subjects: 46 with AD and 23 controls), it found differences in atrophy rates between AD and controls that the cross sectional method could not detect in a number of subregions: right parasubiculum, left and right presubiculum, right subiculum, left dentate gyrus, left CA4, left HATA and right tail. In ADNI (836 subjects: 369 with AD, 215 with early cognitive impairment - eMCI - and 252 controls), all methods found significant differences between AD and controls, but the proposed longitudinal algorithm detected differences between controls and eMCI and differences between eMCI and AD that the cross sectional method could not find: left presubiculum, right subiculum, left and right parasubiculum, left and right HATA. Moreover, many of the differences that the cross-sectional method already found were detected with higher significance. The presented algorithm will be made available as part of the open-source neuroimaging package FreeSurfer. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Effects of multisensory resources on the achievement and science attitudes of seventh-grade suburban students taught science concepts on and above grade level

NASA Astrophysics Data System (ADS)

Roberts, Patrice Helen

This research was designed to determine the relationships among students' achievement scores on grade-level science content, on science content that was three years above-grade level, on attitudes toward instructional approaches, and learning-styles perceptual preferences when instructional approaches were multisensory versus traditional. The dependent variables for this investigation were scores on achievement posttests and scores on the attitude survey. The independent variables were the instructional strategy and students' perceptual preferences. The sample consisted of 74 educationally oriented seventh-grade students. The Learning Styles Inventory (LSI) (Dunn, Dunn, & Price, 1990) was administered to determine perceptual preferences. The control group was taught seventh-grade and tenth-grade science units using a traditional approach and the experimental group was instructed on the same units using multisensory instructional resources. The Semantic Differential Scale (SDS) (Pizzo, 1981) was administered to reveal attitudinal differences. The traditional unit included oral reading from the textbook, completing outlines, labeling diagrams, and correcting the outlines and diagrams as a class. The multisensory unit included five instructional stations established in different sections of the classroom to allow students to learn by: (a) manipulating Flip Chutes, (b) using Electroboards, (c) assembling Task Cards, (d) playing a kinesthetic Floor Game, and (e) reading an individual Programmed Learning Sequence. Audio tapes and scripts were provided at each location. Students circulated in groups of four from station to station. The data subjected to statistical analyses supported the use of a multisensory, rather than a traditional approach, for teaching science content that is above-grade level. T-tests revealed a positive and significant impact on achievement scores (p < 0.0007). No significance was detected on grade-level achievement nor on the perceptual-preference effect. Furthermore, the students indicated significantly more positive attitudes when instructed with a multisensory approach on either grade-level or above-grade level science content (p < 0.0001). The findings supported using a multisensory approach when teaching science concepts that are new to and difficult for students (Martini, 1986).

Modulating the Release Kinetics of Paclitaxel from Membrane-Covered Stents Using Different Loading Strategies

PubMed Central

Sydow-Plum, Georg; Haidar, Ziyad S.; Merhi, Yahye; Tabrizian, Maryam

2008-01-01

Membrane-covered Express2TM Monorail® stents composed of chitosan (CH) blended with polyethylene oxide (PEO) in 70:30% wt (CH-PEO) were coated with a monolayer of hyaluronic acid (HA). This significantly improved the resistance to platelet adhesion and demonstrated excellent mechanical properties, resisting the harsh conditions during stent crimping and subsequent inflation. CH-PEO/HA membrane was then combined with a paclitaxel (Pac) delivery system via three different approaches for comparison of release profiles of Pac. The activity of Pac in these systems was confirmed since its presence in the membrane significantly decreased cell viability of U937 macrophages. Presented results are promising for applications requiring different release patterns of hydrophobic drugs.

Computationally efficient finite-difference modal method for the solution of Maxwell's equations.

PubMed

Semenikhin, Igor; Zanuccoli, Mauro

2013-12-01

In this work, a new implementation of the finite-difference (FD) modal method (FDMM) based on an iterative approach to calculate the eigenvalues and corresponding eigenfunctions of the Helmholtz equation is presented. Two relevant enhancements that significantly increase the speed and accuracy of the method are introduced. First of all, the solution of the complete eigenvalue problem is avoided in favor of finding only the meaningful part of eigenmodes by using iterative methods. Second, a multigrid algorithm and Richardson extrapolation are implemented. Simultaneous use of these techniques leads to an enhancement in terms of accuracy, which allows a simple method such as the FDMM with a typical three-point difference scheme to be significantly competitive with an analytical modal method.

Mindsets of Leadership Education Undergraduates: An Approach to Program Assessment

ERIC Educational Resources Information Center

Ho, Sarah P.; Odom, Summer F.

2015-01-01

Students (N = 313) in undergraduate leadership degree programs at Texas A&M University were surveyed to determine their leadership mindset using hierarchical and systemic thinking preferences. Significant differences in thinking were found between gender and academic classification. Male leadership students scored greater in hierarchical…

Why Service-Learning?

ERIC Educational Resources Information Center

Speck, Bruce W.

2001-01-01

Describes two significant theoretical approaches to service learning (philanthropic and civil) so that professors are aware of two different impulses that inform service learning. In addition, addresses three critical concerns about service learning: it takes too much time and too many resources, it should not be required, and it should be…

"Chasing a Passion": First-Generation College Graduates at Work

ERIC Educational Resources Information Center

Olson, Joann S.

2016-01-01

Purpose: The purpose of this paper is to describe the college-to-work transition as experienced by first-generation college (FGC) graduates. First-generation graduates are often adjusting to workplaces that are significantly different from parents' work environments. Design/methodology/approach: This phenomenological study explored the…

Significance of a Pronator Quadratus–Sparing Approach for Volar Locking Plate Fixation of Comminuted Intra-articular Fractures of the Distal Radius

PubMed Central

Itoh, Soichiro; Yumoto, Myu; Kanai, Misa; Yoshida, Wataru; Yoshioka, Taro

2016-01-01

Background: The preservation of the integrity of the pronator quadratus (PQ) muscle is expected to have many benefits, particularly in cases of highly comminuted intra-articular fractures of the distal radius. Therefore, we examined the significance of a PQ muscle–sparing approach for volar locking plate (VLP) fixation of these types of fractures. Methods: Sixty-five patients who sustained AO Foundation and Orthopaedic Trauma Association (AO/OTA) type C2 and C3 distal radius fractures were treated with VLP fixation using either a PQ muscle release and repair (PQ-releasing group, n = 30) or a PQ muscle–sparing approach (PQ-sparing group, n = 35). Radiographic parameters, active range of motion (ROM), percentage of the grip power of the injured hand compared with that of the opposite hand, wrist pain visual analog scale (VAS) score, and Quick Disability of the Arm, Shoulder, and Hand (DASH) score (disability/symptom) were evaluated monthly up to 12 months after surgery. Results: The mean VAS score was significantly lower in the PQ-sparing group at 2, 3, and 4 months postoperatively than in the PQ-releasing group. Furthermore, the mean Quick DASH score in the PQ-sparing group was significantly lower than that in the PQ-releasing group at 1 and 2 months postoperatively. There were no significant differences, however, in the other functional parameters in the groups through the observation period. Conclusions: The PQ muscle–sparing approach appears to achieve satisfactory results in patients undergoing VLP fixation of comminuted intra-articular fractures of the distal radius. PMID:27418895