Treating Eyres type IV and V coracoid fracture using the acromion osteotomy approach.

PubMed

Wu, Jin; Fu, Xi-jin; Sha, Mo; Liu, Hui; Chen, Zhi-da; Kang, Liang-qi

2016-02-01

To introduce a surgical method of treating Eyres type IV and V coracoid fracture using the acromion osteotomy approach and to further analyse the clinical effectiveness of this surgical procedure. Nine patients were included in this study with a mean follow-up time of 23.3 months (range, 14.0-34.0 months). Patients were evaluated with use of the Constant score, the Simple Shoulder Test (SST) score and a visual analogue scale (VAS) pain score. Moreover, the shoulder range of motion was also observed. The mean operation time was 91.6 min with a blood loss volume ranging from 310 to 530 ml. The fractures of eight patients had recovered between 10 and 12 weeks post operation with no signs of infection, screw loosening, plate breaking or other internal fixation failures, while one case had non-union at 34 months' follow-up. The mean Constant score increased from 75.6 points preoperatively to 91.0 points at follow-up. The mean VAS score decreased from 5.3 preoperatively to 1.0 at follow-up, while the average SST score increased from 7.1 points preoperatively to 10.0 points at follow-up. The mean abduction, forward flexion, external rotation, internal rotation and backward extension angles were 162°, 159° 50°, 55° and 47°. Five cases were classified as excellent, three cases were marked as good and one case was classified as fair. Treating coracoid fracture through the approach of acromion osteotomy could be an effective treatment option with minimise damages.

PROMIS Physical Function Computer Adaptive Test Compared With Other Upper Extremity Outcome Measures in the Evaluation of Proximal Humerus Fractures in Patients Older Than 60 Years.

PubMed

Morgan, Jordan H; Kallen, Michael A; Okike, Kanu; Lee, Olivia C; Vrahas, Mark S

2015-06-01

To compare the PROMIS Physical Function Computer Adaptive Test (PROMIS PF CAT) to commonly used traditional PF measures for the evaluation of patients with proximal humerus fractures. Prospective. Two Level I trauma centers. Forty-seven patients older than 60 years with displaced proximal humerus fractures treated between 2006 and 2009. Evaluation included completion of the PROMIS PF CAT, the Constant Shoulder Score, the Disabilities of the Arm, Shoulder, and Hand (DASH) and the Short Musculoskeletal Functional Assessment (SMFA). Observed correlations among the administered PF outcome measures. On average, patients responded to 86 outcome-related items for this study: 4 for the PROMIS PF CAT (range: 4-8 items), 6 for the Constant Shoulder Score, 30 for the DASH, and 46 for the SMFA. Time to complete the PROMIS PF CAT (median completion time = 98 seconds) was significantly less than that for the DASH (median completion time = 336 seconds, P < 0.001) and for the SMFA (median completion time = 482 seconds, P < 0.001). PROMIS PF CAT scores correlated statistically significantly and were of moderate-to-high magnitude with all other PF outcome measure scores administered. This study suggests using the PROMIS PF CAT as a sole PF outcome measure can yield an assessment of upper extremity function similar to those provided by traditional PF measures, while substantially reducing patient assessment time.

Biceps tenodesis is a viable option for salvage of failed SLAP repair.

PubMed

Werner, Brian C; Pehlivan, Hakan C; Hart, Joseph M; Lyons, Matthew L; Gilmore, C Jan; Garrett, Cara B; Carson, Eric W; Diduch, David R; Miller, Mark D; Brockmeier, Stephen F

2014-08-01

Outcomes of arthroscopic superior labral anterior-posterior (SLAP) repairs have been well reported with generally favorable outcomes. Unfortunately, a percentage of patients remain dissatisfied or suffer further injury after SLAP repair and may seek additional treatment. The purpose of this study was to evaluate the surgical outcomes of biceps tenodesis for failed SLAP repairs. A retrospective review of all patients undergoing biceps tenodesis was completed. Inclusion criteria were previous SLAP repair and subsequent revision biceps tenodesis. Exclusion criteria were additional shoulder procedures including rotator cuff repair, instability procedures, and preoperative frozen shoulder. Objective outcomes were postoperative assessments with Constant score, American Shoulder and Elbow Surgeons score, Single Assessment Numeric Evaluation, Simple Shoulder Test, and Veterans RAND 36-Item Health Survey. Physical examination was conducted to determine postoperative range of motion and strength compared with the nonoperative shoulder. A cohort of 24 patients was identified, and of these, 17 patients (71%) completed the study at 2 years' follow-up. The average postoperative Constant score was 84.4; American Shoulder and Elbow Surgeons score, 75.5; Single Assessment Numeric Evaluation score, 73.1%; Simple Shoulder Test score, 9.2; and Veterans RAND 36-Item Health Survey score, 76.1. Postoperative range of motion of the operative shoulder returned to near that of the asymptomatic nonoperative shoulder. Workers' compensation status led to inferior results. Options for patients with a failed prior SLAP repair are limited. As a salvage operation for failed SLAP repair, biceps tenodesis serves the majority of patients well, with favorable outcomes by validated measures and excellent shoulder range of motion and elbow strength at 2 years' follow-up. Workers' compensation status may predispose patients to poorer outcomes. Copyright © 2014 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

Effects of hook plate on shoulder function after treatment of acromioclavicular joint dislocation.

PubMed

Chen, Chang-Hong; Dong, Qi-Rong; Zhou, Rong-Kui; Zhen, Hua-Qing; Jiao, Ya-Jun

2014-01-01

Internal fixation with hook plate has been used to treat acromioclavicular joint dislocation. This study aims to evaluate the effect of its use on shoulder function, to further analyze the contributing factors, and provide a basis for selection and design of improved internal fixation treatment of the acromioclavicular joint dislocation in the future. A retrospective analysis was performed on patients treated with a hook plate for acromioclavicular joint dislocation in our hospital from January 2010 to February 2013. There were 33 cases in total, including 25 males and 8 females, with mean age of 48.27 ± 8.7 years. There were 29 cases of Rockwood type III acromioclavicular dislocation, 4 cases of type V. The Constant-Murley shoulder function scoring system was used to evaluate the shoulder function recovery status after surgery. Anteroposterior shoulder X-ray was used to assess the position of the hook plate, status of acromioclavicular joint reduction and the occurrence of postoperative complications. According to the Constant-Murley shoulder function scoring system, the average scores were 78 ± 6 points 8 to 12 months after the surgery and before the removal of the hook plate, the average scores were 89 ± 5 minutes two months after the removal of hook plate. Postoperative X-ray imaging showed osteolysis in 10 cases (30.3%), osteoarthritis in six cases (18.1%), osteolysis associated with osteoarthritis in four cases(12.1%), and steel hook broken in one case (3%). The use of hook plate on open reduction and internal fixation of the acromioclavicular joint dislocation had little adverse effect on shoulder function and is an effective method for the treatment of acromioclavicular joint dislocation. Osteoarthritis and osteolysis are the two common complications after hook plate use, which are associated with the impairment of shoulder function. Shoulder function will be improved after removal of the hook plate.

Effects of hook plate on shoulder function after treatment of acromioclavicular joint dislocation

PubMed Central

Chen, Chang-Hong; Dong, Qi-Rong; Zhou, Rong-Kui; Zhen, Hua-Qing; Jiao, Ya-Jun

2014-01-01

Introduction: Internal fixation with hook plate has been used to treat acromioclavicular joint dislocation. This study aims to evaluate the effect of its use on shoulder function, to further analyze the contributing factors, and provide a basis for selection and design of improved internal fixation treatment of the acromioclavicular joint dislocation in the future. Methods: A retrospective analysis was performed on patients treated with a hook plate for acromioclavicular joint dislocation in our hospital from January 2010 to February 2013. There were 33 cases in total, including 25 males and 8 females, with mean age of 48.27 ± 8.7 years. There were 29 cases of Rockwood type III acromioclavicular dislocation, 4 cases of type V. The Constant-Murley shoulder function scoring system was used to evaluate the shoulder function recovery status after surgery. Anteroposterior shoulder X-ray was used to assess the position of the hook plate, status of acromioclavicular joint reduction and the occurrence of postoperative complications. Results: According to the Constant-Murley shoulder function scoring system, the average scores were 78 ± 6 points 8 to 12 months after the surgery and before the removal of the hook plate, the average scores were 89 ± 5 minutes two months after the removal of hook plate. Postoperative X-ray imaging showed osteolysis in 10 cases (30.3%), osteoarthritis in six cases (18.1%), osteolysis associated with osteoarthritis in four cases(12.1%), and steel hook broken in one case (3%). Conclusion: The use of hook plate on open reduction and internal fixation of the acromioclavicular joint dislocation had little adverse effect on shoulder function and is an effective method for the treatment of acromioclavicular joint dislocation. Osteoarthritis and osteolysis are the two common complications after hook plate use, which are associated with the impairment of shoulder function. Shoulder function will be improved after removal of the hook plate. PMID:25356110

Continuous-flow cold therapy for outpatient anterior cruciate ligament reconstruction.

PubMed

Barber, F A; McGuire, D A; Click, S

1998-03-01

This prospective, randomized study evaluated continuous-flow cold therapy for postoperative pain in outpatient arthroscopic anterior cruciate ligament (ACL) reconstructions. In group 1, cold therapy was constant for 3 days then as needed in days 4 through 7. Group 2 had no cold therapy. Evaluations and diaries were kept at 1, 2, and 8 hours after surgery, and then daily. Pain was assessed using the VAS and Likert scales. There were 51 cold and 49 noncold patients included. Continuous passive movement (CPM) use averaged 54 hours for cold and 41 hours for noncold groups (P=.003). Prone hangs were done for 192 minutes in the cold group and 151 minutes in the noncold group. Motion at 1 week averaged 5/88 for the cold group and 5/79 the noncold group. The noncold group average visual analog scale (VAS) pain and Likert pain scores were always greater than the cold group. The noncold group average Vicodin use (Knoll, Mt. Olive, NJ) was always greater than the cold group use (P=.001). Continuous-flow cold therapy lowered VAS and Likert scores, reduced Vicodin use, increased prone hangs, CPM, and knee flexion. Continuous-flow cold therapy is safe and effective for outpatient ACL reconstruction reducing pain medication requirements.

Ultrasound-guided percutaneous irrigation in rotator cuff calcific tendinopathy: what is the evidence? A systematic review with proposals for future reporting.

PubMed

Lanza, Ezio; Banfi, Giuseppe; Serafini, Giovanni; Lacelli, Francesca; Orlandi, Davide; Bandirali, Michele; Sardanelli, Francesco; Sconfienza, Luca Maria

2015-07-01

We performed a systematic review of current evidence regarding ultrasound-guided percutaneous irrigation of calcific tendinopathy (US-PICT) in the shoulder aimed to: assess different published techniques; evaluate clinical outcome in a large combined cohort; and propose suggestions for homogeneous future reporting. Cochrane Collaboration for Systematic Reviews of Interventions Guidelines were followed. We searched MEDLINE/MEDLINE In-Process/EMBASE/Cochrane databases from 1992-2013 using the keywords 'ultrasound, shoulder, needling, calcification, lavage, rotator cuff' combined in appropriate algorithms. References of resulting papers were also screened. Risk of bias was assessed with a modified Newcastle-Ottawa Scale. Of 284 papers found, 15 were included, treating 1,450 shoulders in 1,403 patients (females, n = 838; mean age interval 40-63 years). There was no exclusion due to risk of bias. US-PICT of rotator cuff is a safe and effective procedure, with an estimated average 55% pain improvement at an average of 11 months, with a 10% minor complication rate. No evidence exists in favour of using a specific size/number of needles. Imaging follow-up should not be used routinely. Future studies should aim at structural uniformity, including the use of the Constant Score to assess outcomes and 1-year minimum follow-up. Alternatives to steroid injections should also be explored. • US-PICT of rotator cuff is a safe and effective procedure. • On average 55% pain improvement with 10% minor complication rate. • No evidence exists in favour of using a specific size/number of needles. • Future need to assess outcome using Constant Score with 1-year minimum follow-up.

Transforaminal endoscopic treatment of lumbar radiculopathy after instrumented lumbar spine fusion.

PubMed

Telfeian, Albert E; Jasper, Gabriele P; Francisco, Gina M

2015-01-01

Transforaminal endoscopic discectomy and foraminotomy is a well-described minimally invasive technique for surgically treating lumbar radiculopathy caused by a herniated disc and foraminal narrowing. To describe the technique and feasibility of transforaminal foraminoplasty for the treatment of lumbar radiculopathy in patients who have already undergone instrumented spinal fusion. Retrospective study. Hospital and ambulatory surgery center After Institutional Review Board approval, charts from 18 consecutive patients with lumbar radiculopathy and instrumented spinal fusions who underwent endoscopic procedures between 2008 and 2013 were reviewed. The average pain relief one year postoperatively was reported to be 67.0%, good results as defined by MacNab. The average preoperative VAS score was 9.14, indicated in our questionnaire as severe and constant pain. The average one year postoperative VAS score was 3.00, indicated in our questionnaire as mild and intermittent pain. This is a retrospective study and only offers one year follow-up data for patients with instrumented fusions who have undergone endoscopic spine surgery. Transforaminal endoscopic discectomy and foraminotomy could be used as a safe, yet, minimally invasive and innovative technique for the treatment of lumbar radiculopathy in the setting of previous instrumented lumbar fusion. IRB approval: Meridian Health: IRB Study # 201206071J

Rethinking the connection between working memory and language impairment.

PubMed

Archibald, Lisa M D; Harder Griebeling, Katherine

2016-05-01

Working memory deficits have been found for children with specific language impairment (SLI) on tasks imposing increasing short-term memory load with or without additional, consistent (and simple) processing load. To examine the processing function of working memory in children with low language (LL) by employing tasks imposing increasing processing loads with constant storage demands individually adjusted based on each participant's short-term memory capacity. School-age groups with LL (n = 17) and typical language with either average (n = 28) or above-average nonverbal intelligence (n = 15) completed complex working memory-span tasks varying processing load while keeping storage demands constant, varying storage demands while keeping processing load constant, simple storage-span tasks, and measures of language and nonverbal intelligence. Teachers completed questionnaires about cognition and learning. Significantly lower scores were found for the LL than either matched group on storage-based tasks, but no group differences were found on the tasks varying processing load. Teachers' ratings of oral expression and mathematics abilities discriminated those who did or did not complete the most challenging cognitive tasks. The results implicate a deficit in the phonological storage but not in the central executive component of working memory for children with LL. Teacher ratings may reveal personality traits related to perseverance of effort in cognitive research. © 2015 Royal College of Speech and Language Therapists.

Health care in the CIS countries : the case of hospitals in Ukraine.

PubMed

Pilyavsky, Anatoly; Staat, Matthias

2006-09-01

The study analyses the technical efficiency of community hospitals in Ukraine during 1997-2001. Hospital cost amount to two-thirds of Ukrainian spending on health care. Data are available on the number of beds, physicians and nurses employed, surgical procedures performed, and admissions and patient days. We employ data envelopment analysis to calculate the efficiency of hospitals and to assess productivity changes over time. The scores calculated with an output-oriented model assuming constant returns to scale range from 150% to 110%. Average relative inefficiency of the hospitals is initially above 30% and later drops to 15% or below. The average productivity change is positive but below 1%; a Malmquist index decomposition reveals that negative technological progress is overcompensated by positive catching-up.

A retrospective comparative study of arthroscopic fixation in acute Rockwood type IV acromioclavicular joint dislocation: single versus double paired Endobutton technique.

PubMed

Xu, Jian; Liu, Haifeng; Lu, Wei; Li, Dingfu; Zhu, Weimin; Ouyang, Kan; Wu, Bing; Peng, Liangquan; Wang, Daping

2018-05-24

Rockwood type IV acromioclavicular joint (ACJ) dislocation is a trauma usually needs surgical treatment. Paired EndoButton technique (PET) is used in treating such condition. However, the effect of using different types of PET (single versus double PET) for fixation remains controversial. This study aims to evaluate and compare the efficacy of single and double PET and to provide a suitable option for the surgeons. We retrospectively reviewed the charts of patients with acute Rockwood type IV ACJ dislocation who had undergone arthroscopic fixation using single or double PET fixation between March 2009 and March 2015. Seventy-eight consecutive patients identified from chart review were picked and were divided into the single and double PET group with 39 cases in each group. The indexes of visual analog scale score (VAS) for pain, the radiographs of the affected shoulder at different time points of the follow-up, the time of return to activities and sports, the constant functional score, and the Karlsson acromioclavicular joint (ACJ) score, were assessed in a minimum of 2 years postoperation. The average coracoclavicular (CC) and acromioclavicular (AC) distances of the affected joints in the double PET group were significantly smaller than those of the single PET group 2 years postoperation (P < 0.05). The average AC and CC distances in the healthy shoulder joints were significantly smaller than those of the affected joints in the single PET group (P < 0.05); however, these values were not significantly different from those of the affected joints in the double PET group (P > 0.05). The mean VAS pain score was not significantly different, while significant difference was found for the number and times of cases return to activities and sports, constant functional score, and Karlsson ACJ score (P < 0.05) between the two groups. Therefore, the double PET group has better outcome than the single PET group. Complications including redislocation, button slippage, erosion, or AC joint instability occurred in the single PET group, while the complication in the double PET group was rare. Compared with the single PET, the double PET group achieved better outcome with less complications in arthroscopically treating acute Rockwood type IV ACJ dislocation.

A critical assessment of the photodegradation of pharmaceuticals in aquatic environments: defining our current understanding and identifying knowledge gaps.

PubMed

Challis, Jonathan K; Hanson, Mark L; Friesen, Ken J; Wong, Charles S

2014-04-01

This work presents a critical assessment of the state and quality of knowledge around the aquatic photochemistry of human- and veterinary-use pharmaceuticals from laboratory experiments and field observations. A standardized scoring rubric was used to assess relevant studies within four categories: experimental design, laboratory-based direct and indirect photolysis, and field/solar photolysis. Specific metrics for each category are defined to evaluate various aspects of experimental design (e.g., higher scores are given for more appropriate characterization of light source wavelength distribution). This weight of evidence-style approach allowed for identification of knowledge strengths and gaps covering three areas: first, the general extent of photochemical data for specific pharmaceuticals and classes; second, the overall quality of existing data (i.e., strong versus weak); and finally, trends in the photochemistry research around these specific compounds, e.g. the observation of specific and consistent oversights in experimental design. In general, those drugs that were most studied also had relatively good quality data. The four pharmaceuticals studied experimentally at least ten times in the literature had average total scores (lab and field combined) of ≥29, considered decent quality; carbamazepine (13 studies; average score of 31), diclofenac (12 studies; average score of 31), sulfamethoxazole (11 studies; average score of 34), and propranolol (11 studies; average score of 29). Major oversights and errors in data reporting and/or experimental design included: lack of measurement and reporting of incident light source intensity, lack of appropriate controls, use of organic co-solvents in irradiation solutions, and failure to consider solution pH. Consequently, a number of these experimental parameters were likely a cause of inconsistent measurements of direct photolysis rate constants and quantum yields, two photochemical properties that were highly variable in the literature. Overall, the assessment rubric provides an objective and scientifically-defensible set of metrics for assessing the quality of a study. A major recommendation is the development of a method guideline, based on this rubric, for conducting and reporting on photochemical studies that would produce consistent and reliable data for quantitative comparison across studies. Furthermore, an emphasis should be placed on conducting more dual-fate studies involving controlled photolysis experiments in natural sunlight, and whole system fate studies in either natural or artificial systems. This would provide accurate data describing the actual contribution of photolysis to the overall fate of pharmaceuticals in the environment.

Hemiarthroplasty for proximal humerus fracture and consequences of a comminuted greater tubercle fragment.

PubMed

Hoel, S; Jensen, T G; Falster, O; Ulstrup, A

2016-04-01

A prerequisite for a satisfying functional result in the treatment of comminuted fractures of the proximal humerus with hemiarthroplasty is anatomical reduction, fixation and healing of the tuberculi around the prosthetic neck in order to restore normal function of the rotator cuff. This was a retrospective study to examine the outcome after hemiarthroplasty using a prosthetic stem designed to optimise re-attachment and healing of the tuberculi (Aequalis; Tornier and Global Fx, DePuy). A special emphasis was on the effect on outcome a comminuted greater tubercle might have. At follow-up, clinical results were evaluated using the Constant score and WOOS index. All patients had radiographs taken of the injured shoulder. Quality of tubercle healing and prosthetic height were estimated; acromiohumeral distance was registered as well as greater tubercle comminution and resorption. Thirty-four patients with 35 hemiarthroplasties were included. Mean age was 71 years (range 47-88) at the time of injury. At follow-up (mean 38 months, range 23-67), the mean Constant score was 44 points (range 18-87). The mean WOOS index was 58 (range 15-96). A comminuted tubercle was associated with tubercle resorption and superior migration of the arthroplasty. Also, there was a correlation for the functional Constant score, but for the WOOS index, there was none. Like several other studies, we generally saw a group of patients with limited pain but poor range of movement in the shoulder. Our hypothesis was that comminution of the greater tubercle would correlate with both rotator cuff arthropathic radiographical features and more detrimental functional scores than average. Thus, a subtype of fracture could be identified at the time of injury and perhaps be allocated to a different treatment than hemiarthroplasty. Due to a limited number of patients in this study, we are unable to make any strong statistically supported conclusions regarding this hypothesis. Level 4 evidence.

Clinical comparison of two different plating methods in minimally invasive plate osteosynthesis for clavicular midshaft fractures: A randomized controlled trial.

PubMed

Sohn, Hoon-Sang; Shon, Min Soo; Lee, Kyung-Hag; Song, Si-Jung

2015-11-01

The aim of this study was to compare the clinical and radiographic outcomes between two different plating methods (superior vs. anteroinferior) in minimally invasive plate osteosynthesis (MIPO) for acute displaced clavicular shaft fractures. A prospective, randomized controlled trial was performed in a single centre. Nineteen patients were treated with superior plating and 18 with anteroinferior plating using the MIPO technique. A 3.5-mm locking reconstruction plate was bent preoperatively and applied to either the anteroinferior or superior aspect of the clavicle through two separate incisions. The operating time, time to union, the proportional length difference, complications, and functional outcome of the shoulder joint were evaluated using the Constant score and the University of California Los Angeles (UCLA) score. There was no statistically significant difference in the Constant score and UCLA score. The mean time to union was 16.8 weeks for superior plating and 17.1 weeks for anteroinferior plating (p=0.866). The average operation time was 77.2min in superior plating and 79.4min in anteroinferior plating (p=0.491). One patient in the superior plating group showed plate failure. Despite no significant difference, one patient had nonunion in the superior plating group (p>0.999). From a clinical perspective, although MIPO with anteroinferior plating provides better outcomes especially in complications without statistically significant difference, both plating methods provided satisfactory clinical and radiographic outcomes. Level I, a single-centre, prospective, randomized controlled trial. Copyright © 2015 Elsevier Ltd. All rights reserved.

Prediction of consonant recognition in quiet for listeners with normal and impaired hearing using an auditory model.

PubMed

Jürgens, Tim; Ewert, Stephan D; Kollmeier, Birger; Brand, Thomas

2014-03-01

Consonant recognition was assessed in normal-hearing (NH) and hearing-impaired (HI) listeners in quiet as a function of speech level using a nonsense logatome test. Average recognition scores were analyzed and compared to recognition scores of a speech recognition model. In contrast to commonly used spectral speech recognition models operating on long-term spectra, a "microscopic" model operating in the time domain was used. Variations of the model (accounting for hearing impairment) and different model parameters (reflecting cochlear compression) were tested. Using these model variations this study examined whether speech recognition performance in quiet is affected by changes in cochlear compression, namely, a linearization, which is often observed in HI listeners. Consonant recognition scores for HI listeners were poorer than for NH listeners. The model accurately predicted the speech reception thresholds of the NH and most HI listeners. A partial linearization of the cochlear compression in the auditory model, while keeping audibility constant, produced higher recognition scores and improved the prediction accuracy. However, including listener-specific information about the exact form of the cochlear compression did not improve the prediction further.

Assessment of physical and mental health in male university students with varying sleep habits.

PubMed

Matsumoto, Yuuki; Toyomasu, Kouji; Uchimura, Naohisa

2011-01-01

Healthy sleep habits entail not only sleeping for a sufficient period (quantity) but also regularity of the sleep cycle and getting sound sleep (quality). University students often have erratic schedules that cause irregular sleep patterns even though sleep durations remain relatively constant. This study compared the physical and mental health of 90 male university students with different sleep habits. We created sleep habit scales using the Tokyo Metropolitan Institute for Neuroscience life habits inventory (TMIN-LHI; Miyashita, 1994) by performing a factor analysis and classifying sleeping habits based on regularity, quality, and quantity. Four types of sleep habits were identified by cluster analysis; good sleep was characterized by regular and high quality sleep but of relatively short sleep duration; long sleep was regular and relatively long but of low quality; short sleep was of high quality but short and irregular, while poor sleep was irregular, of low quality, and relatively long. The good sleep group had a significantly lower average waist circumference, and lower systolic and diastolic blood pressure. The long and poor sleep groups, which both had low quality sleep, scored lower than the national standard on the mental component summary (MCS) calculated from the Social Functioning-36 (SF-36) short-form health survey. Furthermore, the average MCS score of the poor sleep group was significantly lower than that of any other sleep habit group. Subjects with poor sleep also scored lowest on the Self-rating Depression Scale (SDS). In addition, the short and poor sleep groups were prone to glucose or lipid metabolism disorders. Maintaining good physical and mental health without sound sleep and a regular sleep cycle is difficult, even if sleeping hours are kept constant. Therefore, we included the assessment of regularity and quality in addition to hours of sleep in order to develop appropriate sleep guidelines for improved physical and mental health.

Arthroscopic removal of intraosseous and intratendinous deposits in calcifying tendinitis of the rotator cuff.

PubMed

Seyahi, Aksel; Demirhan, Mehmet

2009-06-01

The purpose of this study was to evaluate the surgical outcome of arthroscopic removal of intraosseous deposits in calcifying tendinitis of the rotator cuff. We studied the results of arthroscopic treatment in 30 shoulders in 28 patients with calcifying tendinitis (mean age, 48.3 years; age range, 26 to 83 years), with a mean follow-up of 38 months. According to the localization of calcification, the patients were divided into 2 groups: those with pure tendinous/soft-tissue involvement (n = 25) (group I) and those with tendinous/soft-tissue and osseous involvement (n = 5) (group II). After routine tendon debridement, debridement and curettage of the bone lesion were also performed in patients with bone involvement. Clinical outcome was evaluated by use of the pain score on a visual analog scale and the Constant score, and a special inquiry was used for self-assessment. The pain scores and functional Constant scores improved significantly after the operation in both groups (P = .043 for pain score and P = .0001 for Constant score in group I and P = .042 for pain score and P = .0001 for Constant score in group II). The median Constant score increased from 42 (range, 22 to 65) preoperatively to 100 (range, 80 to 100) postoperatively in group I and from 40 (range, 25 to 55) to 100 (range, 85 to 100) in group II. The mean pain score was 6.5 +/- 1.4 (range, 4 to 9) before treatment and 0.2 +/- 0.5 (range, 0 to 2) at follow-up in group I, and it was 6.2 +/- 1.48 (range, 4 to 8) and 0.4 +/- 0.55 (range, 0 to 1), respectively, in group II. There was no significant difference between the 2 groups in terms of the final Constant (P = .85) and pain scores (P = .26). Arthroscopic removal of intraosseous and intratendinous deposits to treat calcifying tendinitis with osseous involvement seems to be as safe and effective a treatment method as the arthroscopic removal of intratendinous deposits in cases of tendinous involvement only. Level IV, therapeutic case series.

[Transhumeral head plasty and massive osteocartilaginous allograft transplantation for the management of large hill-sachs lesions].

PubMed

Hart, R; Okál, F; Komzák, M

2010-10-01

The aim of this presentation is to inform the medical community about causal therapy (transhumeral head plasty or massive osteochondral allograft transplantation) for large Hill-Sachs lesions which frequently cause failure of anterior stabilisation following ventral shoulder dislocations. Seven men with an average age of 26 years (19 to 33 years) undergoing surgery in 2006 and 2007 were evaluated. The minimum follow-up was 18 months (41 to 18 months). Impressions on more than 30 % of the articular surface, or those whose critical size was larger than one-eighth of the humeral diameter (on CT scan) were taken as indications for surgery. Four patients had had previous surgery for anterior instability and three had a primary procedure. Four men underwent acute surgery and three had elective operations.Trans- humeral head plasty was used in five and massive osteochondral allograft in two patients. In the patients with large lesions in the anterior aspect of the shoulder joint, transhumeral head plasty involving repair of the ventral structures from the anterior approach was indicatedúúú in those with an isolated posterior bony defect, a massive osteochondral allograft was transplanted through the posterior approach. The Constant-Murley score was used to assess clinical status before (not in acute conditions) and after surgery. All patients reported improved clinical status. The average Constant-Murley score at final follow-up was 95.9 points (83-100 points). In the patients not having an acute procedure in whom pre-operative Constant-Murley scores were obtained, the average improvement was by 22.7 points (8 - 37 points). No general surgical complications were recorded. All patients reported subjective satisfaction and willingness to undergo surgery under the same conditions again. A Hill-Sachs lesion is a frequent injury to the humeral head resulting from anterior shoulder dislocation. To distinguish between major and minor defects in terms of clinical significance is essential for the choice of appropriate shoulder treatment. Up to now large lesions have mostly been managed by non-causal techniques affecting shoulder biomechanics. Transhumeral head plasty or transplantation of a massive osteochondral allograft, on the other hand, offers a causal treatment. However, these two methods have rarely been mentioned in the international literature, and usually only as case reports. Transhumeral head plasty and transplantation of a massive osteochondral allograft offer a causal therapy for the management of Hill-Sachs lesions that does not alter shoulder biomechanics. They are not associated with a higher percentage of post-operative complications. Neither technique is more demanding than non-causal procedures. Operations carried out as primary and not as "salvage" procedures restored the function of the shoulder joint to normal. After secondary surgery, occasional shoulder pain may persist as well as its restricted range of motion.

Detecting reliable cognitive change in individual patients with the MATRICS Consensus Cognitive Battery.

PubMed

Gray, Bradley E; McMahon, Robert P; Green, Michael F; Seidman, Larry J; Mesholam-Gately, Raquelle I; Kern, Robert S; Nuechterlein, Keith H; Keefe, Richard S; Gold, James M

2014-10-01

Clinicians often need to evaluate the treatment response of an individual person and to know that observed change is true improvement or worsening beyond usual week-to-week changes. This paper gives clinicians tools to evaluate individual changes on the MATRICS Consensus Cognitive Battery (MCCB). We compare three different approaches: a descriptive analysis of MCCB test-retest performance with no intervention, a reliable change index (RCI) approach controlling for average practice effects, and a regression approach. Data were gathered as part of the MATRICS PASS study (Nuechterlein et al., 2008). A total of 159 people with schizophrenia completed the MCCB at baseline and 4weeks later. Data were analyzed using an RCI and a regression formula establishing confidence intervals. The RCI and regression approaches agree within one point when baseline values are close to the sample mean. However, the regression approach offers more accurate limits for expected change at the tails of the distribution of baseline scores. Although both approaches have their merits, the regression approach provides the most accurate measure of significant change across the full range of scores. As the RCI does not account for regression to the mean and has confidence limits that remain constant across baseline scores, the RCI approach effectively gives narrower confidence limits around an inaccurately predicted average change value. Further, despite the high test-retest reliability of the MCCB, a change in an individual's score must be relatively large to be confident that it is beyond normal month-to-month variation. Copyright © 2014 Elsevier B.V. All rights reserved.

Minimally invasive reconstruction of acute type IV and Type V acromioclavicular separations.

PubMed

Katsenis, Dimitris L; Stamoulis, Dimitris; Begkas, Dimitris; Tsamados, Stamatis

2015-04-01

The goal of this study was to evaluate the midterm radiologic, clinical, and functional results of the early reconstruction of the severe acromioclavicular joint dislocation using the flipptack fixation button technique. Between December 2006 and December 2009, one hundred thirty-five consecutive patients with acromioclavicular joint separations were admitted to the authors' institution. Fifty patients were included in the study. According to Rockwood classification, 29 (58%) dislocations were type IV and 21 (42%) were type V. Surgery was performed at an average of 4.2 days (range, 0-12 days) after dislocation. All dislocations were treated with the flipptack fixation button technique. All patients were evaluated at a final postoperative follow-up of 42 months (range, 36-49 months). The clinical outcome was assessed using the Constant score. The functional limitation was assessed using the bother index of the short Musculoskeletal Function Assessment. Radiographs taken immediately postoperatively and at the final follow-up assessed acromioclavicular joint reduction, coracoclavicular distance, and joint arthrosis. At the final follow-up, mean Constant score was 93.04 (range, 84-100). The average (±SD) short Musculoskeletal Function Assessment bother index was 20.88±8.95 (range, 2.0-49). No statistically significant difference was found between the acromioclavicular joint dislocation type and the clinical result (P=.227; chi-square, 6.910, Kruskal Wallis test). The regression of the coracoclavicular distance at final follow-up was not statistically significant (P=.276; chi-square, 6.319, Kruskal Wallis test). The flipptack fixation button technique is an effective alternative for the treatment of severe acromioclavicular joint dislocation. Because all objectives of the treatment were obtained, the results do not deteriorate over time. Copyright 2015, SLACK Incorporated.

Quality of life in Chronic Pancreatitis is determined by constant pain, disability/unemployment, current smoking and associated co-morbidities

PubMed Central

Machicado, Jorge D.; Amann, Stephen T; Anderson, Michelle A.; Abberbock, Judah; Sherman, Stuart; Conwell, Darwin; Cote, Gregory A.; Singh, Vikesh K.; Lewis, Michele; Alkaade, Samer; Sandhu, Bimaljit S.; Guda, Nalini M.; Muniraj, Thiruvengadam; Tang, Gong; Baillie, John; Brand, Randall; Gardner, Timothy B.; Gelrud, Andres; Forsmark, Christopher E.; Banks, Peter A.; Slivka, Adam; Wilcox, C. Mel; Whitcomb, David C.; Yadav, Dhiraj

2018-01-01

Background Chronic pancreatitis (CP) has a profound independent effect on quality of life (QOL). Our aim was to identify factors that impact the QOL in CP patients. Methods We used data on 1,024 CP patients enrolled in the three NAPS2 studies. Information on demographics, risk factors, co-morbidities, disease phenotype and treatments was obtained from responses to structured questionnaires. Physical (PCS) and mental (MCS) component summary scores generated using responses to the Short Form-12 (SF-12) survey were used to assess QOL at enrollment. Multivariable linear regression models determined independent predictors of QOL. Results Mean PCS and MCS scores were 36.7±11.7 and 42.4±12.2, respectively. Significant (p<0.05) negative impact on PCS scores in multivariable analyses was noted due to constant mild-moderate pain with episodes of severe pain or constant severe pain (10 points), constant mild-moderate pain (5.2), pain-related disability/unemployment (5.1), current smoking (2.9 points) and medical co-morbidities. Significant (p<0.05) negative impact on MCS scores was related to constant pain irrespective of severity (6.8-6.9 points), current smoking (3.9 points) and pain-related disability/unemployment (2.4 points). In women, disability/unemployment resulted in an additional reduction 3.7 point reduction in MCS score. Final multivariable models explained 27% and 18% of the variance in PCS and MCS scores, respectively. Etiology, disease duration, pancreatic morphology, diabetes, exocrine insufficiency and prior endotherapy/pancreatic surgery had no significant independent effect on QOL. Conclusion Constant pain, pain-related disability/unemployment, current smoking, and concurrent co-morbidities significantly affect the QOL in CP. Further research is needed to identify factors impacting QOL not explained by our analyses. PMID:28244497

Quality of Life in Chronic Pancreatitis is Determined by Constant Pain, Disability/Unemployment, Current Smoking, and Associated Co-Morbidities.

PubMed

Machicado, Jorge D; Amann, Stephen T; Anderson, Michelle A; Abberbock, Judah; Sherman, Stuart; Conwell, Darwin L; Cote, Gregory A; Singh, Vikesh K; Lewis, Michele D; Alkaade, Samer; Sandhu, Bimaljit S; Guda, Nalini M; Muniraj, Thiruvengadam; Tang, Gong; Baillie, John; Brand, Randall E; Gardner, Timothy B; Gelrud, Andres; Forsmark, Christopher E; Banks, Peter A; Slivka, Adam; Wilcox, C Mel; Whitcomb, David C; Yadav, Dhiraj

2017-04-01

Chronic pancreatitis (CP) has a profound independent effect on quality of life (QOL). Our aim was to identify factors that impact the QOL in CP patients. We used data on 1,024 CP patients enrolled in the three NAPS2 studies. Information on demographics, risk factors, co-morbidities, disease phenotype, and treatments was obtained from responses to structured questionnaires. Physical and mental component summary (PCS and MCS, respectively) scores generated using responses to the Short Form-12 (SF-12) survey were used to assess QOL at enrollment. Multivariable linear regression models determined independent predictors of QOL. Mean PCS and MCS scores were 36.7±11.7 and 42.4±12.2, respectively. Significant (P<0.05) negative impact on PCS scores in multivariable analyses was noted owing to constant mild-moderate pain with episodes of severe pain or constant severe pain (10 points), constant mild-moderate pain (5.2), pain-related disability/unemployment (5.1), current smoking (2.9 points), and medical co-morbidities. Significant (P<0.05) negative impact on MCS scores was related to constant pain irrespective of severity (6.8-6.9 points), current smoking (3.9 points), and pain-related disability/unemployment (2.4 points). In women, disability/unemployment resulted in an additional 3.7 point reduction in MCS score. Final multivariable models explained 27% and 18% of the variance in PCS and MCS scores, respectively. Etiology, disease duration, pancreatic morphology, diabetes, exocrine insufficiency, and prior endotherapy/pancreatic surgery had no significant independent effect on QOL. Constant pain, pain-related disability/unemployment, current smoking, and concurrent co-morbidities significantly affect the QOL in CP. Further research is needed to identify factors impacting QOL not explained by our analyses.

Constant Current versus Constant Voltage Subthalamic Nucleus Deep Brain Stimulation in Parkinson's Disease.

PubMed

Ramirez de Noriega, Fernando; Eitan, Renana; Marmor, Odeya; Lavi, Adi; Linetzky, Eduard; Bergman, Hagai; Israel, Zvi

2015-02-18

Background: Subthalamic nucleus (STN) deep brain stimulation (DBS) is an established therapy for advanced Parkinson's disease (PD). Motor efficacy and safety have been established for constant voltage (CV) devices and more recently for constant current (CC) devices. CC devices adjust output voltage to provide CC stimulation irrespective of impedance fluctuation, while the current applied by CV stimulation depends on the impedance that may change over time. No study has directly compared the clinical effects of these two stimulation modalities. Objective: To compare the safety and clinical impact of CC STN DBS to CV STN DBS in patients with advanced PD 2 years after surgery. Methods: Patients were eligible for inclusion if they had undergone STN DBS surgery for idiopathic PD, had been implanted with a Medtronic Activa PC and if their stimulation program and medication had been stable for at least 1 year. This single-center trial was designed as a double-blind, randomized, prospective study with crossover after 2 weeks. Motor equivalence of the 2 modalities was confirmed utilizing part III of the Unified Parkinson's Disease Rating Scale (UPDRS). PD diaries and multiple subjective and objective evaluations of quality of life, depression, cognition and emotional processing were evaluated on both CV and on CC stimulation. Analysis using the paired t test with Bonferroni correction for multiple comparisons was performed to identify any significant difference between the stimulation modalities. Results: 8 patients were recruited (6 men, 2 women); 1 patient did not complete the study. The average age at surgery was 56.7 years (range 47-63). Disease duration at the time of surgery was 7.5 years (range 3-12). Patients were recruited 23.8 months (range 22.5-24) after surgery. At the postoperative study baseline, this patient group showed an average motor improvement of 69% (range 51-97) as measured by the change in UPDRS part III with stimulation alone. Levodopa equivalent medication was reduced on average by 67% (range 15-88). Patients were poorly compliant with PD diaries, and these did not yield useful information. The minor deterioration in quality-of-life scores (Parkinson's Disease Questionnaire-39, Quality of Life Enjoyment and Satisfaction Questionnaire) with CC stimulation were not statistically significant. Two measures of depression (Hamilton Rating Scale D17, Quick Inventory of Depressive Symptomatology - Self-Report) showed a nonsignificant lower score (less depression) with CC stimulation, but a third (Beck Depression Inventory) showed equivalence. Cognitive testing (Mini Mental State Examination) and emotional processing (Montreal Affective Voices) were equivalent for CC and CV. Conclusion: CC STN DBS is safe. For equivalent motor efficacy, no significant difference could be identified between CC and CV stimulation for nonmotor evaluations in PD patients 2 years after surgery. © 2015 S. Karger AG, Basel.

[Manipulative reduction and small splint fixation combined with micromovement exercise for treatment of humeral shaft fractures].

PubMed

Tang, Hao-chen; Xiang, Ming; Chen, Hang; Hu, Xiao-chuan; Yang, Guo-yong

2016-01-01

To investigate the therapeutic efficacy of bone-setting manipulative reduction and small splint fixation combined with micro-movement theory exercise for treatment of humeral shaft fractures. From March 2011 to February 2014, 64 cases of humeral shaft fractures were treated by bone-setting manipulative reduction and small splint fixation including 28 males and 36 females with an average age of 38.1 years old ranging from 22 to 67 years old. According to the classification of AO/OTA, there were 10 cases of type A1, 12 cases of type A2,11 cases of type A3,10 cases of type B1,12 cases of type B2, 7 cases of type B3, 2 cases of type C1, 1 case of type C2, 1 case of type C3. After close reduction early functional exercise performed according to micro-movement theory. All patients had no other parts of the fractures, neurovascular injury, and serious medical problems. Patients were followed up for fracture healing, shoulder and elbow joint function recovery, and curative effect. All patients were followed up from 10 to 12 months with an average of 10.3 months. Of them, 2 cases had a small amount of callus growth at 3 months after close reduction, so instead of operation; 2 cases appeared radial nerve symptoms after close reduction ,so instead of operation. Other patients were osseous healing, the time was 8 to 12 weeks with an average of 10.2 weeks. After osseous healing, according to Constant-Murley score system ,the average score was (93.5 ± 3.2) points, the result was excellent in 29 cases, good in 29 cases, fair in 6 cases, excellent and good rate was 90.3%; according to the Mayo score system, the average score was (93.7 ± 4.2) points, the result was excellent in 35 cases, good in 23 cases, fair in 6 cases, excellent and good rate was 91.9%. Bone-setting manipulative reduction and small splint fixation combined with micromovement theory exercise for treatment of humeral shaft fractures has advantage of positive effect, easy and inexpensive method, the treatment has relevant scientific basis and practical value, it can effectively reduce complications, promote patients early recovery.

Estimating Energy Conversion Efficiency of Thermoelectric Materials: Constant Property Versus Average Property Models

NASA Astrophysics Data System (ADS)

Armstrong, Hannah; Boese, Matthew; Carmichael, Cody; Dimich, Hannah; Seay, Dylan; Sheppard, Nathan; Beekman, Matt

2017-01-01

Maximum thermoelectric energy conversion efficiencies are calculated using the conventional "constant property" model and the recently proposed "cumulative/average property" model (Kim et al. in Proc Natl Acad Sci USA 112:8205, 2015) for 18 high-performance thermoelectric materials. We find that the constant property model generally predicts higher energy conversion efficiency for nearly all materials and temperature differences studied. Although significant deviations are observed in some cases, on average the constant property model predicts an efficiency that is a factor of 1.16 larger than that predicted by the average property model, with even lower deviations for temperature differences typical of energy harvesting applications. Based on our analysis, we conclude that the conventional dimensionless figure of merit ZT obtained from the constant property model, while not applicable for some materials with strongly temperature-dependent thermoelectric properties, remains a simple yet useful metric for initial evaluation and/or comparison of thermoelectric materials, provided the ZT at the average temperature of projected operation, not the peak ZT, is used.

Predictors of performance in an ophthalmology residency program.

PubMed

Alfawaz, Abdullah M; Al-Dahmash, Saad A

2016-06-01

To assess the value of current selection criteria and additional factors as predictors of performance in an ophthalmology residency training program. A retrospective study. Data were collected from the files of 166 residents who were collectively trained in an ophthalmology residency program from 2000 to 2013. The program's selection criteria included medical school grade point average (GPA), Saudi licensing examination (SLE) score, multiple-choice question ophthalmology selection (MCQ) examination score, and interview mark. Indicators of performance included average scores in the promotion examination for 4 years of training (average R), King Saud University fellowship examination (KSU) score, and Saudi Board in Ophthalmology examination (SBO) score. An average of KSU and SBO scores was also used as a performance indicator. Times of program completion and average performance score across all years in the residency program were used as second-level indicators of performance. There were strong correlations between the MCQ examination score and each training performance indicator (average R, KSU score, SBO score, and average of KSU and SBO scores; p = 0.002, 0.008, 0.05, and 0.002, respectively). The interview mark correlated well with average R (p = 0.001) but not with other indicators. The MCQ examination score and the interview mark were the only predictors of second-level indicators of performance (p = 0.009 and 0.029, respectively). The MCQ examination score and interview mark were the 2 best predictors of performance as an ophthalmology resident. GPA and SLE score were poor predictors of performance. Copyright © 2016 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

Use of Linear Perspective Scene Cues in a Simulated Height Regulation Task

NASA Technical Reports Server (NTRS)

Levison, W. H.; Warren, R.

1984-01-01

As part of a long-term effort to quantify the effects of visual scene cuing and non-visual motion cuing in flight simulators, an experimental study of the pilot's use of linear perspective cues in a simulated height-regulation task was conducted. Six test subjects performed a fixed-base tracking task with a visual display consisting of a simulated horizon and a perspective view of a straight, infinitely-long roadway of constant width. Experimental parameters were (1) the central angle formed by the roadway perspective and (2) the display gain. The subject controlled only the pitch/height axis; airspeed, bank angle, and lateral track were fixed in the simulation. The average RMS height error score for the least effective display configuration was about 25% greater than the score for the most effective configuration. Overall, larger and more highly significant effects were observed for the pitch and control scores. Model analysis was performed with the optimal control pilot model to characterize the pilot's use of visual scene cues, with the goal of obtaining a consistent set of independent model parameters to account for display effects.

Proximal humeral fractures: the role of calcium sulphate augmentation and extended deltoid splitting approach in internal fixation using locking plates.

PubMed

Somasundaram, K; Huber, C P; Babu, V; Zadeh, H

2013-04-01

The aim of our study is to analyse the results of our surgical technique for the treatment of proximal humeral fractures and fracture dislocations using locking plates in conjunction with calcium sulphate bone-substitute augmentation and tuberosity repair using high-strength sutures. We used the extended deltoid-splitting approach for fracture patterns involving displacement of both lesser and greater tuberosities and for fracture-dislocations. Optimal surgical management of proximal humeral fractures remains controversial. Locking plates have become a popular method of fixation. However, failure of fixation may occur if they are used as the sole method of fixation in comminuted fractures, especially in osteopenic bone. We retrospectively analysed 22 proximal humeral fractures in 21 patients; 10 were male and 11 female with an average age of 64.6 years (range 37-77). Average follow-up was 24 months. Eleven of these fractures were exposed by the extended deltoid-splitting approach. Fractures were classified according to Neer and Hertel systems. Preoperative radiographs and computed tomography (CT) scans in three- and four-part fractures were done to assess the displacement and medial calcar length for predicting the humeral head vascularity. According to the Neer classification, there were five two-part, six three-part, five four-part fractures and six fracture-dislocations (two anterior and four posterior). Results were assessed clinically with disabilities of the arm, shoulder and hand (DASH) scores, modified Constant and Murley scores and serial postoperative radiographs. The mean DASH score was 16.18 and the modified Constant and Murley score was 64.04 at the last follow-up. Eighteen out of twenty-two cases achieved good clinical outcome. All the fractures united with no evidence of infection, failure of fixation, malunion, tuberosity failure, avascular necrosis or adverse reaction to calcium sulphate bone substitute. There was no evidence of axillary nerve injury. Four patients had a longer recovery period due to stiffness, associated wrist fracture and elbow dislocation. The CaSO4 bone substitute was replaced by normal appearing trabecular bone texture at an average of 6 months in all patients. In our experience, we have found the use of locking plates, calcium sulphate bone substitute and tuberosity repair with high-strength sutures to be a safe and reliable method of internal fixation for complex proximal humeral fractures and fracture-dislocations. Furthermore, we have also found the use of the extended deltoid-splitting approach to be safe and to provide excellent exposure facilitating accurate reduction for fixation of the fracture patterns involving displacement of both lesser and greater tuberosities and for fracture-dislocations. Copyright © 2012 Elsevier Ltd. All rights reserved.

Fixation of 4-part fractures of the proximal humerus: Can we identify radiological criteria that support locking plates or IM nailing? Comparative, retrospective study of 107 cases.

PubMed

Gadea, F; Favard, L; Boileau, P; Cuny, C; d'Ollone, T; Saragaglia, D; Sirveaux, F

2016-12-01

No objective criteria exist to help surgeons choose between IM nailing and plate fixation for 4-part fractures of the proximal humerus. The goal of this study was to identify radiological criteria that would make one technique a better choice than the other. This was a comparative, multicentre, retrospective study of 54 cases of antegrade nailing and 53 cases of plating performed between 1st January 2009 and 31 December 2011 for 4-part fractures of the proximal humerus. All patients had a minimum radiological and clinical follow-up of 18 months. The functional outcomes were evaluated using the weighted Constant score; a poor result was defined as a weighted Constant score<70%. The following radiological criteria were evaluated during the preoperative assessment and at the last follow-up: initial displacement and reduction of humeral head and tuberosities; morphology of the medial column (i.e. calcar comminution, posteromedial hinge, size of metaphyseal head extension); occurrence of avascular necrosis (AVN). After an average follow-up of 42 months, the weighted Constant scores and rate of poor outcomes were 77% and 48% in the nail group and 81% and 38% in the plate group, respectively (ns). The humeral head was reduced into an anatomical position, valgus or varus in 57%, 30% and 13% of cases in the nail group, and 58%, 29% and 13% in the plate group, respectively. The tuberosities healed in an anatomical position in 72% of nail cases and 70% of plate cases (ns). Only the presence of a medial hinge preoperatively had an effect on the functional outcomes in the nail and plate groups: the weighted Constant scores (P=0.05) and rate of poor outcomes (P=0.02) were 82% and 52% in the nail group and 97% and 9% in the plate group, respectively. The complication rates were comparable: the rates of AVN and articular screw penetration were 17% and 11% in the nail group, and 15% and 11% in the plate group, respectively. The surgical revision rate was 18.5% in the nail group and 30% in the plate group. If the medial hinge is preserved, we recommend locking plate fixation. In other cases, either technique can be used as long as the general rules of internal fixation are applied: reduction of the tuberosities, varus correction and stabilization of the calcar area. IV, retrospective study. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Implementation of a module to promote competency in adverse drug reaction reporting in undergraduate medical students.

PubMed

Tripathi, Raakhi Kaliprasad; Jalgaonkar, Sharmila Vinayak; Sarkate, Pankaj V; Rege, Nirmala Narayan

2016-10-01

Underreporting and poor quality of adverse drug reaction (ADR) reports pose a challenge for the Pharmacovigilance Program of India. A module to impart knowledge and skills of ADR reporting to MBBS students was developed and evaluated. The module consisted of (a) e-mailing an ADR narrative and online filling of the "suspected ADR reporting form" (SARF) and (b) a week later, practical on ADR reporting was conducted followed by online filling of SARF postpractical at 1 and 6 months. SARF was an 18-item form with a total score of 36. The module was implemented in the year 2012-2013. Feedback from students and faculty was taken using 15-item prevalidated feedback questionnaires. The module was modified based on the feedback and implemented for the subsequent batch in the year 2013-2014. The evaluation consisted of recording the number of students responding and the scores achieved. A total of 171 students in 2012-2013 batch and 179 in 2013-2014 batch participated. In the 2012-2013 batch, the number of students filling the SARF decreased from basal: 171; 1 month: 122; 6 months: 17. The average scores showed improvement from basal 16.2 (45%) to 26.4 (73%) at 1 month and to 27.3 (76%) at 6 months. For the 2013-2014 batch, the number ( n = 179) remained constant throughout and the average score progressively increased from basal 10.5 (30%) to 27.8 (77%) at 1 month and 30.3 (84%) at 6 months. This module improved the accuracy of filling SARF by students and this subsequently will led to better ADR reporting. Hence, this module can be used to inculcate better ADR reporting practices in budding physicians.

A Probabilistic Model of Local Sequence Alignment That Simplifies Statistical Significance Estimation

PubMed Central

Eddy, Sean R.

2008-01-01

Sequence database searches require accurate estimation of the statistical significance of scores. Optimal local sequence alignment scores follow Gumbel distributions, but determining an important parameter of the distribution (λ) requires time-consuming computational simulation. Moreover, optimal alignment scores are less powerful than probabilistic scores that integrate over alignment uncertainty (“Forward” scores), but the expected distribution of Forward scores remains unknown. Here, I conjecture that both expected score distributions have simple, predictable forms when full probabilistic modeling methods are used. For a probabilistic model of local sequence alignment, optimal alignment bit scores (“Viterbi” scores) are Gumbel-distributed with constant λ = log 2, and the high scoring tail of Forward scores is exponential with the same constant λ. Simulation studies support these conjectures over a wide range of profile/sequence comparisons, using 9,318 profile-hidden Markov models from the Pfam database. This enables efficient and accurate determination of expectation values (E-values) for both Viterbi and Forward scores for probabilistic local alignments. PMID:18516236

[Treatment of complete acromioclavicular joint dislocation with transfer of the medial half of the coracoacromial ligament to reconstruct the coracoclavicular ligament].

PubMed

Dong, Wen-Wei; Shi, Zeng-Yuan; Liu, Zheng-Xin; Mao, Hai-Jiao

2015-04-01

To explore the operation methods and clinical effects of transfer of the medial half of the coracoacromial ligament to reconstruct the coracoclavicular ligament in treating complete acromioclavicular joint dislocation. From January 2006 to June 2012,26 patients with acute complete acromioclavicular joint dislocation underwent surgery. Transfer of the medial half of the coracoacromial ligament to reconstruct the coracoclavicular ligament, additional clavical hoot plate and Kirschner wires fixation, were performed in all the patients. Among the patients, 18 patients were male and 8 patients were female, with an average age of 36.7 years old (ranged from 25 to 51 years). The duration from injury to operation was from 3 to 12 days with an average of 5 days. According to the Rockwood classification, 4 cases were grade III and 22 cases were grade V . Clinical manifestation included local swelling, tenderness with snapping, limitation of shoulder joint motion. In preoperative bilateral shoulder joint X-rays, the injured coracoclavicular distance was (16.2 ± 5.0) mm which was significantly wider than that of uninjured sides (7.6 ± 1.0) mm. Clinical results were evaluated according to X-rays and Constant-Murley score. All incisions obtained primary healing after operation without complication of infection, internal fixation breakage, redislocation. All the patients were followed up from 12 to 30 months with an average of 18 months. Kirschner wires and internal fixation plate were removed at 1 month and 8-10 months after operation, respectively. At final follow-up, the motion of shoulder joint recovered to normal and a no pain joint was obtained. According to Constant-Murley score, 24 cases got excellent results and 2 cases good. There was no significant difference after operation between the injured coracoclavicular distance and the uninjured contralateral side [(7.7 ± 1.2) mm vs (7.6 ± 1.0) mm), P > 0.05]. Transfer of the medial half of the coracoacromial ligament to reconstruct the coracoclavicular ligament, additional fixation using hook plate and Kirschner wires is the effective surgical method in treating complete acute acromioclavicular joint dislocation.

Reverse shoulder arthroplasty for the treatment of acute complex proximal humeral fractures: Influence of greater tuberosity healing on the functional outcomes.

PubMed

Torrens, Carlos; Alentorn-Geli, Eduard; Mingo, Felipe; Gamba, Carlo; Santana, Fernando

2018-01-01

To investigate the influence of greater tuberosity healing on the functional outcomes of reverse shoulder arthroplasty (RSA) for the treatment of acute complex proximal humeral fractures (PHFs), and to investigate the influence of patient- and surgery-related factors in the healing of the greater tuberosity. Retrospective study including 41 consecutive PHFs treated using RSA with minimum 2-year follow-up. In all the cases, tuberosities were reattached with a standardized technique. All the patients were assessed at the last follow-up with constant score. Body mass index, surgery delay, comorbidities, polyethylene size, glenosphere size, overhanging of glenosphere, and scapular notch were recorded, and their influence in final constant score and in greater tuberosity healing was analyzed. Mean final constant score was of 60.7 points (standard deviation (SD) = 9.9). Greater tuberosity healed in proper position in 68% of the cases. There were no significant differences in constant score between patients with (mean = 61; SD = 9.5) and without (mean = 61; SD = 11.3) the healing of greater tuberosity. All patients scored above 90° in forward elevation. Scapular notch was reported in 14.6% of the cases. Age significantly affected the constant score ( p = 0.008). Comorbidities significantly interfered with greater tuberosity healing ( p = 0.03). There was one reoperation after dislocation. In spite of expecting good functional outcome with low complication rate after RSA for acute PHFs, the influence of greater tuberosity healing on shoulder function could not be demonstrated. The presence of comorbidities, but not age or gender, negatively influenced the healing of the greater tuberosity.

Long term changes of the throwing arm of former elite javelin throwers.

PubMed

Schmitt, H; Hansmann, H J; Brocai, D R; Loew, M

2001-05-01

The aim of this study was to determine long term changes in shoulder and elbow joints of former elite javelin throwers. Twenty-one elite javelin throwers were examined at an average of 19 years after the end of their high performance phase. Mean age at examination was 50 years. Functional assessment of both shoulders was determined by the Constant-score. The shoulder of the throwing arm was examined by magnetic resonance imaging. Both elbow joints were examined clinically and radiographically. Five athletes complained about transient shoulder pain in their throwing arm affecting activities of daily living, fourteen athletes had a deficit of internal rotation of at least ten degrees. Constant-scores of throwing arms were six points lower than those of non-throwing arms (P < 0.05). Complete ruptures and partial tears of the rotator cuff were frequent. Three athletes complained about transient elbow pain in their throwing arm affecting activities of daily living; ten athletes had a deficit of extension of more than five degrees. All dominant elbows had advanced arthrotic alterations (osteophytes, sclerosis) compared to the non-dominant side. Athletes who trained with weights of more than 3 kg had a significantly higher risk of degenerative changes than athletes who did not (P < 0.01). We therefore recommend to avoid throwing training with weights of more than 3 kg.

Glenoid wear after shoulder hemiarthroplasty: quantitative radiographic analysis.

PubMed

Parsons, I M; Millett, Peter J; Warner, Jon J P

2004-04-01

Symptomatic glenoid arthrosis may limit the long-term success of shoulder hemiarthroplasty in patients who are young and functionally demanding. The principal objective of the current study was to quantify glenoid wear after proximal humeral replacement in young, active subjects. Eight patients, ages 21 to 60 years (mean, 45 years), met inclusion criteria. The mean followup was 43 months. Functional scores for the cohort averaged 60% of age and gender-adjusted healthy subjects (range, 28%-84%). Glenohumeral joint space was measured on serial axillary radiographs using a Microscribe 3-DX digitizing device (measurement accuracy, 0.23 mm). Progressive glenoid wear was found in all eight patients. The mean decrease was 2 mm (range, 1.3-2.8 mm), a 68% decrease in glenohumeral joint space. Glenoid cartilage wear also was correlated with Constant and Murley scores. Patients with residual joint spaces less than 1 mm had a mean score of 50%, compared with a score of 71% for patients with joint spaces greater than 1 mm. There were no correlations between wear and mechanism of injury, duration of symptoms, and prior surgery. This study suggests that glenoid cartilage erosion can be expected routinely after humeral head replacement in young, active individuals, and that such wear may adversely affect function or necessitate conversion to total shoulder arthroplasty.

Averaging of elastic constants for polycrystals

DOE PAGES

Blaschke, Daniel N.

2017-10-13

Many materials of interest are polycrystals, i.e., aggregates of single crystals. Randomly distributed orientations of single crystals lead to macroscopically isotropic properties. Here in this paper, we briefly review strategies of calculating effective isotropic second and third order elastic constants from the single crystal ones. Our main emphasis is on single crystals of cubic symmetry. Specifically, the averaging of third order elastic constants has not been particularly successful in the past, and discrepancies have often been attributed to texturing of polycrystals as well as to uncertainties in the measurement of elastic constants of both poly and single crystals. While thismore » may well be true, we also point out here shortcomings in the theoretical averaging framework.« less

A full set of langatate high-temperature acoustic wave constants: elastic, piezoelectric, dielectric constants up to 900°C.

PubMed

Davulis, Peter M; da Cunha, Mauricio Pereira

2013-04-01

A full set of langatate (LGT) elastic, dielectric, and piezoelectric constants with their respective temperature coefficients up to 900°C is presented, and the relevance of the dielectric and piezoelectric constants and temperature coefficients are discussed with respect to predicted and measured high-temperature SAW propagation properties. The set of constants allows for high-temperature acoustic wave (AW) propagation studies and device design. The dielectric constants and polarization and conductive losses were extracted by impedance spectroscopy of parallel-plate capacitors. The measured dielectric constants at high temperatures were combined with previously measured LGT expansion coefficients and used to determine the elastic and piezoelectric constants using resonant ultrasound spectroscopy (RUS) measurements at temperatures up to 900°C. The extracted LGT piezoelectric constants and temperature coefficients show that e11 and e14 change by up to 62% and 77%, respectively, for the entire 25°C to 900°C range when compared with room-temperature values. The LGT high-temperature constants and temperature coefficients were verified by comparing measured and predicted phase velocities (vp) and temperature coefficients of delay (TCD) of SAW delay lines fabricated along 6 orientations in the LGT plane (90°, 23°, Ψ) up to 900°C. For the 6 tested orientations, the predicted SAW vp agree within 0.2% of the measured vp on average and the calculated TCD is within 9.6 ppm/°C of the measured value on average over the temperature range of 25°C to 900°C. By including the temperature dependence of both dielectric and piezoelectric constants, the average discrepancies between predicted and measured SAW properties were reduced, on average: 77% for vp, 13% for TCD, and 63% for the turn-over temperatures analyzed.

18F-FLT uptake kinetics in head and neck squamous cell carcinoma: a PET imaging study.

PubMed

Liu, Dan; Chalkidou, Anastasia; Landau, David B; Marsden, Paul K; Fenwick, John D

2014-04-01

To analyze the kinetics of 3(')-deoxy-3(')-[F-18]-fluorothymidine (18F-FLT) uptake by head and neck squamous cell carcinomas and involved nodes imaged using positron emission tomography (PET). Two- and three-tissue compartment models were fitted to 12 tumor time-activity-curves (TACs) obtained for 6 structures (tumors or involved nodes) imaged in ten dynamic PET studies of 1 h duration, carried out for five patients. The ability of the models to describe the data was assessed using a runs test, the Akaike information criterion (AIC) and leave-one-out cross-validation. To generate parametric maps the models were also fitted to TACs of individual voxels. Correlations between maps of different parameters were characterized using Pearson'sr coefficient; in particular the phosphorylation rate-constants k3-2tiss and k5 of the two- and three-tissue models were studied alongside the flux parameters KFLT- 2tiss and KFLT of these models, and standardized uptake values (SUV). A methodology based on expectation-maximization clustering and the Bayesian information criterion ("EM-BIC clustering") was used to distil the information from noisy parametric images. Fits of two-tissue models 2C3K and 2C4K and three-tissue models 3C5K and 3C6K comprising three, four, five, and six rate-constants, respectively, pass the runs test for 4, 8, 10, and 11 of 12 tumor TACs. The three-tissue models have lower AIC and cross-validation scores for nine of the 12 tumors. Overall the 3C6K model has the lowest AIC and cross-validation scores and its fitted parameter values are of the same orders of magnitude as literature estimates. Maps of KFLT and KFLT- 2tiss are strongly correlated (r = 0.85) and also correlate closely with SUV maps (r = 0.72 for KFLT- 2tiss, 0.64 for KFLT). Phosphorylation rate-constant maps are moderately correlated with flux maps (r = 0.48 for k3-2tiss vs KFLT- 2tiss and r = 0.68 for k5 vs KFLT); however, neither phosphorylation rate-constant correlates significantly with SUV. EM-BIC clustering reduces the parametric maps to a small number of levels--on average 5.8, 3.5, 3.4, and 1.4 for KFLT- 2tiss, KFLT, k3-2tiss, and k5. This large simplification is potentially useful for radiotherapy dose-painting, but demonstrates the high noise in some maps. Statistical simulations show that voxel level noise degrades TACs generated from the 3C6K model sufficiently that the average AIC score, parameter bias, and total uncertainty of 2C4K model fits are similar to those of 3C6K fits, whereas at the whole tumor level the scores are lower for 3C6K fits. For the patients studied here, whole tumor FLT uptake time-courses are represented better overall by a three-tissue than by a two-tissue model. EM-BIC clustering simplifies noisy parametric maps, providing the best description of the underlying information they contain and is potentially useful for radiotherapy dose-painting. However, the clustering highlights the large degree of noise present in maps of the phosphorylation rate-constantsk5 and k3-2tiss, which are conceptually tightly linked to cellular proliferation. Methods must be found to make these maps more robust-either by constraining other model parameters or modifying dynamic imaging protocols. © 2014 American Association of Physicists in Medicine.

12 CFR Appendix B to Subpart A of... - Conversion of Scorecard Measures into Score

Code of Federal Regulations, 2014 CFR

2014-01-01

... 327—Conversion of Scorecard Measures into Score 1. Weighted Average CAMELS Rating Weighted average CAMELS ratings between 1 and 3.5 are assigned a score between 25 and 100 according to the following equation: S = 25 + [(20/3) * (C 2 −1)], where: S = the weighted average CAMELS score; and C = the weighted...

12 CFR Appendix B to Subpart A of... - Conversion of Scorecard Measures into Score

Code of Federal Regulations, 2013 CFR

2013-01-01

... 327—Conversion of Scorecard Measures into Score 1. Weighted Average CAMELS Rating Weighted average CAMELS ratings between 1 and 3.5 are assigned a score between 25 and 100 according to the following equation: S = 25 + [(20/3) * (C 2 −1)], where: S = the weighted average CAMELS score; and C = the weighted...

12 CFR Appendix B to Subpart A of... - Conversion of Scorecard Measures into Score

Code of Federal Regulations, 2012 CFR

2012-01-01

... 327—Conversion of Scorecard Measures into Score 1. Weighted Average CAMELS Rating Weighted average CAMELS ratings between 1 and 3.5 are assigned a score between 25 and 100 according to the following equation: S = 25 + [(20/3) * (C 2 −1)], where: S = the weighted average CAMELS score; and C = the weighted...

The Impact of Adding Online Homework Assignments to an Introduction to Physical Geology Class

NASA Astrophysics Data System (ADS)

Brevik, Eric C.

2017-04-01

As instructors we are constantly looking for ways to improve student performance in the classroom. In an attempt to improve student performance in my GEOL 105 - Introduction to Physical Geology class, I added online homework assignments from the Pearson Mastering Geology program beginning in the Fall semester of 2014. There were several anticipated advantages to the online homework approach. If a student is struggling with a question they can get hints that don't tell them the answer, but are designed to stimulate their thinking and lead them towards the correct answer. The students also know immediately after submitting their answers which questions they got right and which were wrong, and they can go back to the wrong answers and try to determine the correct answer so they know what it is. This gives them much more rapid feedback than traditional paper homework, all of which makes this a more student-centered approach to learning. It is also my hope that the students find the online homework more interesting and interactive than paper-based homework, which I hope in turn will stimulate the students to be more likely to do the homework and take it seriously while also having some fun while doing it. As of the end of Fall semester 2016, I had been using the online homework assignments in my classes for three years. Therefore, I analyzed student performance in the three years prior to adopting the online homework and compared it to performance over the three years since adopting online homework. In the three years prior to adopting the online homework, the average grade in my classes was 73.8%; afterwards the average grade was 81.3%, for an improvement of 7.5% on average. Most of that improvement was in average test scores, which increased by 6.3% (67.4% prior to 73.6% after). The online homework did not improve the performance of the top students, but it did improve the performance of the other students. Prior to adopting the online homework, grade distribution in the class was 15% A (90-100% scores), 32% B (80-90%), 19% C (70-80%), 19% D (60-79%), and 15% F (<60%). After adopting the online homework, the grade distribution was 13% A, 48% B, 24% C, 13% D, and 2% F. Therefore, students who either passed the class but didn't excel or who struggled with the class prior to online homework adoption saw improvements in their performance, while students who showed truly outstanding performance remained constant. Test grades showed a similar trend. The average test scores for those who received an A in the class were 88.0% prior to and 88.6% after adopting the online homework, while test averages for students who received less than an A were 63.9% prior to and 71.4% (7.5% improvement) after adopting the online homework. I am always making small changes to my classes in an effort to improve them, but the only major change made to the class over the time period covered in this study was replacing paper homework assignments (which were not graded) with the online homework assignments. In addition, there was no statistical difference in scores in the Introduction to Physical Geology Laboratory over the same period (87.8% average before adoption, 85.7% after adoption). Students are required to take the lecture and laboratory at the same time, so the student populations were identical. The online homework applied to the lecture, where grades improved, but not to the laboratory, where grades remained consistent. Therefore, it was concluded that the addition of online homework to the Introduction to Physical Geology class had a strong positive effect on student scores. While students who would excel regardless of the format (those who received A grades) showed the same performance under both class formats, those who fell farther down the grade scale showed significant improvement with the use of the online homework assignments. Acknowledgement The integration of online homework assignments into the Introduction to Physical Geology class was funded by a Summer Faculty Fellowship from the North Dakota Space Grant Consortium.

A novel remaining tendon preserving repair technique leads to improved outcomes in special rotator cuff tear patterns.

PubMed

Jeon, Yoon Sang; Kim, Rag Gyu; Shin, Sang-Jin

2018-05-16

The purpose of this study was to identify the tear pattern that could be anatomically repaired by preserving the remaining tendon on footprint and evaluate clinical outcomes of patients who underwent remaining tendon preserving cuff repair. Of 523 patients with full-thickness rotator cuff tears who underwent arthroscopic repair, 41 (7.8%) patients had repairable rotator cuff tear while preserving the remaining tendon. Among them, 31 patients were followed-up for more than 2 years, including 26 patients with posterior L-shaped tear and 5 patients with transtendinous tear patterns. Clinical outcomes were evaluated using ASES and Constant score, SANE score for patient satisfaction, and VAS for pain. MRI was taken for tendon integrity 6 months postoperatively. Of the 31 patients, 11 (35.5%) had previous injury history before rotator cuff tear, including 7 (26.9%) of the 26 patients with posterior L-shaped tear and 4 (80%) of the 5 patients with transtendinous tear. The average size of preoperative cuff tear was 17.8 ± 6.8 mm in anterior-to-posterior direction and 15.2 ± 5.1 mm in medial-to-lateral direction. ASES and Constant score, SANE score, and VAS for pain were significantly (p < 0.001) improved after remaining tendon preserving rotator cuff repair. Rotator cuff tendons of 22(84.6%) patients with posterior L-shaped tear and 4(80%) patients with transtendinous tear patterns were healed. Patients who underwent rotator cuff repair with preservation of the remaining tendon on the footprint obtained satisfactory functional outcomes. Rotator cuff tears in patients who had posterior L-shaped tear extending between supraspinatus and infraspinatus tendons or transtendinous tear pattern with substantial remaining tendon could be repaired using remaining tendon preserving repair technique. Anatomic reduction of torn cuff tendon without undue tension could be achieved using the remaining tendon preserving repair technique.

Using the Interpersonal Skills tool to assess interpersonal skills of internationally educated nurses.

PubMed

Shen, Jay J; Xu, Yu; Staples, Shelley; Bolstad, Anne L

2014-07-01

To assess interpersonal skills of internationally educated nurses (IEN) while interacting with standardized patients. Participants included 52 IEN at two community hospitals in the southwestern region of the USA. Standardized patients were used to create patient-nurse encounter. Seventeen items in four domains ("skills in interviewing and collecting information"; "skills in counseling and delivering information"; "rapport"; and "personal manner") in an Interpersonal Skills (IPS) instrument were measured by a Likert scale 1-4 with 4 indicating the best performance. The average composite score per domain and scores of the 17 items were compared across the domains. On 10 of the 17 items, the nurses received scores under 3. Counseling with an average score of 2.10 and closure with an average score of 2.44 in domain 2, small talk with an average score of 2.06 in domain 3, and physical exam with average score of 2.21 in domain 4 were below 2.5. The average composite score of domain 1 was 3.54, significantly higher than those of domains 2-4 (2.77, 2.81, and 2.71, respectively). Age was moderately related to the average score per domain with every 10 year increase in age resulting in a 0.1 increase in the average score. Sex and country of origin showed mixed results. The interpersonal skills of IEN in three of the four domains need improvement. Well-designed educational programs may facilitate the improvement, especially in areas of small talk, counseling, closure, and physical exam. Future research should examine relationships between the IPS and demographics factors. © 2013 The Authors. Japan Journal of Nursing Science © 2013 Japan Academy of Nursing Science.

Analysis of the reliability and validity of the Turkish version of the intermittent and constant osteoarthritis pain questionnaire.

PubMed

Erel, Suat; Şimşek, İbrahim Engin; Özkan, Hüseyin

2015-01-01

The aim of this study was to analyze the validity and reliability of the Turkish version (ICOAP-TR) of the intermittent and constant osteoarthritis pain (ICOAP) questionnaire in patients with knee osteoarthritis (OA). Thirty-eight volunteer patients diagnosed with knee OA answered the questionnaire twice with an interval of 2-4 days. The reliability of the measurement was assessed using Cronbach's alpha coefficient and intraclass correlation (ICC) for test-retest reliability. Criterion validity was tested against the Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain score and visual analog scale (VAS) designed to assess the perceived discomfort rated by the patient. Test-retest reliability was found to be ICC=0.942 for total score, 0.902 for constant pain subscale, and 0.945 for intermittent pain subscale. Internal consistency was tested using Cronbach's alpha and was found to be 0.970 for total score, 0.948 for constant pain subscale, and 0.972 for intermittent pain subscale. For criterion validity, the correlation between the total score of ICOAP-TR and WOMAC pain subscale was r=0.779 (p<0.05), and correlation between total score of ICOAP-TR and VAS was r=0.570 (p<0.05). The ICOAP-TR is a reliable and valid instrument to be used with patients with knee OA.

Concomitant SLAP repair does not influence the surgical outcome for arthroscopic Bankart repair of traumatic shoulder dislocations.

PubMed

Aydin, Nuri; Unal, Mehmet Bekir; Asansu, Mustafa; Tok, Okan

2017-01-01

Prior studies revealed the presence of superior labrum anterior-to-posterior (SLAP) injury together with Bankart lesions in some patients. The purpose of the study is to compare the clinical results of isolated Bankart repairs with the clinical results of Bankart repairs when performed with concomitant SLAP repairs. The patients who underwent arthroscopic surgery for treatment of anterior glenohumeral instability were evaluated retrospectively. Group 1 consisted of 19 patients who had arthroscopic SLAP repair together with Bankart repair. The mean age of the patients was 23. Group 2 consisted of 38 patients who underwent isolated Bankart repair. The mean age was 24. Knotless anchors were used in both groups. The mean follow-up was 34 months (range: 26-72). In group 1, the mean preoperative Constant score was 84 (range: 74-90, standard deviation (SD): 5.91) and Rowe score was 64.1 (range: 40-70, SD: 8.14). In group 2, the preoperative Constant score was 84.4 (range: 70-96, SD: 5.88) and Rowe score was 60 (range: 45-70, SD: 7.95). In group 1, the postoperative mean Constant score raised to 96.8 (range: 88-100, SD: 2.91) and the mean Rowe score raised to 92.3 (range: 85-100, SD: 5.17). In group 2, the postoperative mean Constant score was 94.9 (range: 88-100, SD: 3.70) and the mean Rowe score was 94.2 (range: 80-100, SD: 4.71). The difference between the scores of two groups was insignificant ( p > 0.05). When the numbers of redislocations and range of motion were compared, no significant difference was found ( p > 0.05). Accompanying SLAP repair in surgical treatment with Bankart repair for shoulder instability does not affect the results negatively. Properly repaired labral tears extending from anterior inferior to the posterior superior of the glenoid in instability treatment have the same outcome in overall results as repaired isolated Bankart lesions.

Profile and genetic parameters of dairy cattle locomotion score and lameness across lactation.

PubMed

Kougioumtzis, A; Valergakis, G E; Oikonomou, G; Arsenos, G; Banos, G

2014-01-01

This study investigated the profile of locomotion score and lameness before the first calving and throughout the first (n=237) and second (n=66) lactation of 303 Holstein cows raised on a commercial farm. Weekly heritability estimates of locomotion score and lameness, and their genetic and phenotypic correlations with milk yield, body condition score, BW and reproduction traits were derived. Daughter future locomotion score and lameness predictions from their sires��� breeding values for conformation traits were also calculated. First-lactation cows were monitored weekly from 6 weeks before calving to the end of lactation. Second-lactation cows were monitored weekly throughout lactation. Cows were locomotion scored on a scale from one (sound) to five (severely lame); a score greater than or equal to two defined presence of lameness. Cows��� weekly body condition score and BW was also recorded. These records were matched to corresponding milk yield records, where the latter were 7-day averages on the week of inspection. The total number of repeated records amounted to 12 221. Data were also matched to the farm���s reproduction database, from which five traits were derived. Statistical analyses were based on uni- and bivariate random regression models. The profile analysis showed that locomotion and lameness problems in first lactation were fewer before and immediately after calving, and increased as lactation progressed. The profile of the two traits remained relatively constant across the second lactation. Highest heritability estimates were observed in the weeks before first calving (0.66 for locomotion score and 0.54 for lameness). Statistically significant genetic correlations were found for first lactation weekly locomotion score and lameness with body condition score, ranging from ���0.31 to ���0.65 and from ���0.44 to ���0.76, respectively, suggesting that cows genetically pre-disposed for high body condition score have fewer locomotion and lameness issues. Negative (favourable) phenotypic correlations between first lactation weekly locomotion score/lameness and milk yield averaged ���0.27 and ���0.17, respectively, and were attributed to management factors. Also a phenotypic correlation between lameness and conception rate of ���0.19 indicated that lame cows were associated with lower success at conceiving. First-lactation daughter locomotion score and/or lameness predictions from sires��� estimated breeding values for conformation traits revealed a significant linear effect of rear leg side view, rear leg rear view, overall conformation, body condition score and locomotion, and a quadratic effect of foot angle.

Updating prognosis of cirrhosis by Cox's regression model using Child-Pugh score and aminopyrine breath test as time-dependent covariates.

PubMed

Merkel, C; Morabito, A; Sacerdoti, D; Bolognesi, M; Angeli, P; Gatta, A

1998-06-01

The determination of aminopyrine breath test on entry into the study was recently shown to improve the accuracy of prediction of death based on the Child-Pugh classification, but the possible usefulness of serial determinations of both parameters has not been assessed. In the present study, we aimed at evaluating whether serial determinations of aminopyrine breath test and Child-Pugh score improve prognostic accuracy in patients with cirrhosis, compared with determinations obtained only on admission. In 74 patients with liver cirrhosis aminopyrine breath test and Child-Pugh score were obtained upon entry into the study. Patients were followed with sequential aminopyrine breath tests and assessments of the Child-Pugh score every 4-6 months. A total number of 232 determinations were obtained. During follow-up 45 patients died, on average after 12 months of follow-up. Child-Pugh score improved in the beginning of follow-up, and then remained fairly constant; aminopyrine breath test showed no improvement in the beginning of follow-up, but rather a slowly progressive decline. In patients who died, both the Child-Pugh score and the metabolism of aminopyrine were significantly more impaired in the last year preceding death (p < 0.05). Applying Cox's regression model with time-dependent covariates, Child-Pugh score and aminopyrine breath test were independent significant predictors of survival. The model with time-dependent covariates explained the observed survival much better than the model with time-fixed covariates (chi-sq. explained by regression = 31.45 vs 11.97; d.f. = 2; p = 0.0000001 vs 0.003). These data suggest that serial determinations of Child-Pugh score and aminopyrine breath test can be used to efficiently update prognosis of cirrhosis.

Healing rates for challenging rotator cuff tears utilizing an acellular human dermal reinforcement graft

PubMed Central

Agrawal, Vivek

2012-01-01

Purpose: This study presents a retrospective case series of the clinical and structural outcomes (1.5 T MRI) of arthroscopic rotator cuff repair with acellular human dermal graft reinforcement performed by a single surgeon in patients with large, massive, and previously repaired rotator cuff tears. Materials and Methods: Fourteen patients with mean anterior to posterior tear size 3.87 ± 0.99 cm (median 4 cm, range 2.5–6 cm) were enrolled in the study and were evaluated for structural integrity using a high-field (1.5 T) MRI at an average of 16.8 months after surgery. The Constant-Murley scores, the Flexilevel Scale of Shoulder Function (Flex SF), scapular plane abduction, and strength were analyzed. Results: MRI results showed that the rotator cuff repair was intact in 85.7% (12/14) of the patients studied. Two patients had a Sugaya Type IV recurrent tear (2 of 14; 14.3%), which were both less than 1 cm. The Constant score increased from a preoperative mean of 49.72 (range 13–74) to a postoperative mean of 81.07 (range 45–92) (P value = 0.009). Flexilevel Scale of Shoulder Function (Flex SF) Score normalized to a 100-point scale improved from a preoperative mean of 53.69 to a postoperative mean of 79.71 (P value = 0.003). The Pain Score improved from a preoperative mean of 7.73 to a postoperative mean of 13.57 (P value = 0.008). Scapular plane abduction improved from a preoperative mean of 113.64° to a postoperative mean of 166.43° (P value = 0.010). The strength subset score improved from a preoperative mean of 1.73 kg to a postoperative mean of 7.52 kg (P value = 0.006). Conclusions: This study presents a safe and effective technique that may help improve the healing rates of large, massive, and revision rotator cuff tears with the use of an acellular human dermal allograft. This technique demonstrated favorable structural healing rates and statistically improved functional outcomes in the near term. Level of Evidence: 4. Retrospective case series. PMID:22787332

Technical and scale efficiency of public community hospitals in Eritrea: an exploratory study

PubMed Central

2013-01-01

Background Eritrean gross national income of Int$610 per capita is lower than the average for Africa (Int$1620) and considerably lower than the global average (Int$6977). It is therefore imperative that the country’s resources, including those specifically allocated to the health sector, are put to optimal use. The objectives of this study were (a) to estimate the relative technical and scale efficiency of public secondary level community hospitals in Eritrea, based on data generated in 2007, (b) to estimate the magnitudes of output increases and/or input reductions that would have been required to make relatively inefficient hospitals more efficient, and (c) to estimate using Tobit regression analysis the impact of institutional and contextual/environmental variables on hospital inefficiencies. Methods A two-stage Data Envelopment Analysis (DEA) method is used to estimate efficiency of hospitals and to explain the inefficiencies. In the first stage, the efficient frontier and the hospital-level efficiency scores are first estimated using DEA. In the second stage, the estimated DEA efficiency scores are regressed on some institutional and contextual/environmental variables using a Tobit model. In 2007 there were a total of 20 secondary public community hospitals in Eritrea, nineteen of which generated data that could be included in the study. The input and output data were obtained from the Ministry of Health (MOH) annual health service activity report of 2007. Since our study employs data that are five years old, the results are not meant to uncritically inform current decision-making processes, but rather to illustrate the potential value of such efficiency analyses. Results The key findings were as follows: (i) the average constant returns to scale technical efficiency score was 90.3%; (ii) the average variable returns to scale technical efficiency score was 96.9%; and (iii) the average scale efficiency score was 93.3%. In 2007, the inefficient hospitals could have become more efficient by either increasing their outputs by 20,611 outpatient visits and 1,806 hospital discharges, or by transferring the excess 2.478 doctors (2.85%), 9.914 nurses and midwives (0.98%), 9.774 laboratory technicians (9.68%), and 195 beds (10.42%) to primary care facilities such as health centres, health stations, and maternal and child health clinics. In the Tobit regression analysis, the coefficient for OPDIPD (outpatient visits as a proportion of inpatient days) had a negative sign, and was statistically significant; and the coefficient for ALOS (average length of stay) had a positive sign, and was statistically significant at 5% level of significance. Conclusions The findings from the first-stage analysis imply that 68% hospitals were variable returns to scale technically efficient; and only 42% hospitals achieved scale efficiency. On average, inefficient hospitals could have increased their outpatient visits by 5.05% and hospital discharges by 3.42% using the same resources. Our second-stage analysis shows that the ratio of outpatient visits to inpatient days and average length of inpatient stay are significantly correlated with hospital inefficiencies. This study shows that routinely collected hospital data in Eritrea can be used to identify relatively inefficient hospitals as well as the sources of their inefficiencies. PMID:23497525

Validity of four approaches of using repeaters' MCAT scores in medical school admissions to predict USMLE Step 1 total scores.

PubMed

Zhao, Xiaohui; Oppler, Scott; Dunleavy, Dana; Kroopnick, Marc

2010-10-01

This study investigated the validity of four approaches (the average, most recent, highest-within-administration, and highest-across-administration approaches) of using repeaters' Medical College Admission Test (MCAT) scores to predict Step 1 scores. Using the differential predication method, this study investigated the magnitude of differences in the expected Step 1 total scores between MCAT nonrepeaters and three repeater groups (two-time, three-time, and four-time test takers) for the four scoring approaches. For the average score approach, matriculants with the same MCAT average are expected to achieve similar Step 1 total scores regardless of whether the individual attempted the MCAT exam one or multiple times. For the other three approaches, repeaters are expected to achieve lower Step 1 scores than nonrepeaters; for a given MCAT score, as the number of attempts increases, the expected Step 1 decreases. The effect was strongest for the highest-across-administration approach, followed by the highest-within-administration approach, and then the most recent approach. Using the average score is the best approach for considering repeaters' MCAT scores in medical school admission decisions.

Tinnitus and hyperacusis in autism spectrum disorders with emphasis on high functioning individuals diagnosed with Asperger's Syndrome.

PubMed

Danesh, Ali A; Lang, Dustin; Kaf, Wafaa; Andreassen, William D; Scott, Jack; Eshraghi, Adrien A

2015-10-01

To evaluate the prevalence of tinnitus and hyperacusis in individuals with Asperger's Syndrome (AS). A home-developed case-history survey and three item-weighted questionnaires: Tinnitus Reaction Questionnaire (TRQ), Tinnitus Handicap Inventory (THI), and the Hyperacusis Questionnaire (HQ) were employed. These tools categorize the subjective response to tinnitus and hyperacusis. The research tools were mailed to a mailing list of individuals with Asperger's Syndrome. A total of 55 subjects diagnosed with AS were included in the analysis (15.5% response rate). Sixty-nine percent of all respondents (38/55) reported hyperacusis with an average HQ score of 20.7. Furthermore, 35% (19/55) reported perceiving tinnitus with average scores of 27 for the TRQ and 23 for the THI. Thirty-one percent (17/55) reported both hyperacusis and tinnitus. The prevalence of hyperacusis in the AS respondents remained relatively constant across age groups. Hyperacusis and tinnitus are more prevalent in the ASD population subgroup diagnosed with AS under DSM-IV criteria than in the general public. Hyperacusis also appears to be more prevalent in the AS population than in the ASD population at large. Future research is warranted to provide insight into the possible correlation between tinnitus and hyperacusis symptoms and the abnormal social interactions observed in this group. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Treatment and evolution of grade III acromioclavicular dislocations in soccer players.

PubMed

Pereira-Graterol, Ernesto; Álvarez-Díaz, Pedro; Seijas, Roberto; Ares, Oscar; Cuscó, Xavier; Cugat, Ramón

2013-07-01

To evaluate postoperative functional results in soccer players diagnosed with acute grade III acromioclavicular dislocation, stabilized with clavicular hook plate. Between 2006 and 2010, 11 soccer players were diagnosed with acute acromioclavicular dislocation. Mean age was 22.9 years. The clavicular hook plate was used for stabilization. The follow-up was 4 years (2-6 years). Constant score showed 82 % excellent results and 18 % good functional results. Average pain measured with VAS was 1.8 (±0.59) mm out of 10. We did not report any complication within the process. Use of the clavicular hook plate is considered adequate for the treatment of acute acromioclavicular dislocation in soccer players, allowing a quick return to sports. Retrospective case series, Level IV.

[Double Endobutto reconstituting coracoclavicular ligament combined with repairing acromioclavicular ligament at stage I for the treatment of acromioclavicular dislocation with Rockwood type III - V].

PubMed

Hu, Wen-yue; Yu, Chong; Huang, Zhong-ming; Han, Lei

2015-06-01

To explore clinical efficacy of double Endobutto reconstituting coracoclavicular ligament combined with repairing acromioclavicular ligament in stage I in treating acromioclavicular dislocation with Rockwood type III - V . From January 2010 to September 2013, 56 patients with Rockwood type III - V acromioclavicular dislocation were treated by operation, including 20 males and 36 femlaes, aged from 32 to 52 years old with an average of 38.5 years old. Twenty-five patients were on the left side and 31 cases on the right side. The time from injury to operation was from 3 to 14 days, averaged 7 days. All patients were diagnosed as acromioclavicular dislocation with Rockwood type III - V, and double Endobutto were used to reconstituting coracoclavicular ligament, line metal anchors were applied for repairing acromioclavicular ligament. Postoperative complications were observed, Karlsson and Constant-Murley evaluation standard were used to evaluate clinical effects. All patients were followed up from 8 to 24 months with average of 11 months. According to Karlsson evaluation standard at 6 months after operation,42 cases were grade A, 13 were grade B and 1 was grade C. Constant-Murley score were improved from (42.80±5.43) before operation to (91.75±4.27) at 6 months after operation. All items at 6 months after operation were better than that of preoperative items. Forty-eight patients got excellent results, 7 were moderate and only 1 with bad result. No shoulder joint adhesion, screw loosening or breakage were occurred during following up. Double Endobutto reconstituting coracoclavicular ligament combined with repairing acromioclavicular ligament in stage I for the treatment of acromioclavicular dislocation with Rockwood type III - V could obtain early staisfied clinical effects, and benefit for early recovery of shoulder joint function.

MID-LONG TERM RESULTS OF MANIPULATION AND ARTHROSCOPIC RELEASE IN FROZEN SHOULDER

PubMed Central

CELIK, HALUK; SECKIN, MUSTAFA FAIK; AKCAL, MEHMET AKIF; KARA, ADNAN; KILINC, BEKIR ERAY; AKMAN, SENOL

2017-01-01

ABSTRACT Objective: Surgical treatment options should be discussed in cases of frozen shoulder, which is usually treated in a conservative manner. In this study, we evaluated the efficacy of manipulation and arthroscopic release in cases of frozen shoulder which resisted conservative treatment. Methods: A total of 32 patients who underwent manipulation and arthroscopic capsular release in 34 shoulders were included in the study. The average follow-up period was 49.5 months (range: 24-90 months). No reason for onset could be found in 8 (25%) patients, who were classified as primary frozen shoulder; twenty-four (75%) patients were classified as secondary frozen shoulder due to underlying pathologies. The average pre-operative complaint period was 11 months (range: 3-24 months). After arthroscopic examination, manipulation was performed first, followed by arthroscopic capsular release. The range of motion in both shoulders was compared before the procedure and in the last follow-up visit. Constant and Oxford classifications were used to assess functional results, and the results were assessed statistically. Results: Patient values for passive elevation, abduction, adduction-external rotation, abduction-external rotation, and abduction-internal rotation increased in a statistically significant manner between the preoperative assessment and follow-up evaluation (p<0.01). The average change of 47.97±21.03 units observed in the patients’ values obtained in the control measurements against the pre-op Constant scores was determined to be statistically significant (p<0.01). According to the Oxford classification, 29 shoulders were sufficient. Conclusion: Successful results can be obtained with arthroscopic release performed after manipulation in patients with frozen shoulder resistant to conservative treatment. Level of Evidence IV, Case Series. PMID:29375258

MID-LONG TERM RESULTS OF MANIPULATION AND ARTHROSCOPIC RELEASE IN FROZEN SHOULDER.

PubMed

Celik, Haluk; Seckin, Mustafa Faik; Akcal, Mehmet Akif; Kara, Adnan; Kilinc, Bekir Eray; Akman, Senol

2017-01-01

Surgical treatment options should be discussed in cases of frozen shoulder, which is usually treated in a conservative manner. In this study, we evaluated the efficacy of manipulation and arthroscopic release in cases of frozen shoulder which resisted conservative treatment. A total of 32 patients who underwent manipulation and arthroscopic capsular release in 34 shoulders were included in the study. The average follow-up period was 49.5 months (range: 24-90 months). No reason for onset could be found in 8 (25%) patients, who were classified as primary frozen shoulder; twenty-four (75%) patients were classified as secondary frozen shoulder due to underlying pathologies. The average pre-operative complaint period was 11 months (range: 3-24 months). After arthroscopic examination, manipulation was performed first, followed by arthroscopic capsular release. The range of motion in both shoulders was compared before the procedure and in the last follow-up visit. Constant and Oxford classifications were used to assess functional results, and the results were assessed statistically. Patient values for passive elevation, abduction, adduction-external rotation, abduction-external rotation, and abduction-internal rotation increased in a statistically significant manner between the preoperative assessment and follow-up evaluation (p<0.01). The average change of 47.97±21.03 units observed in the patients' values obtained in the control measurements against the pre-op Constant scores was determined to be statistically significant (p<0.01). According to the Oxford classification, 29 shoulders were sufficient. Successful results can be obtained with arthroscopic release performed after manipulation in patients with frozen shoulder resistant to conservative treatment. Level of Evidence IV, Case Series.

A Framework for Evaluation and Use of Automated Scoring

ERIC Educational Resources Information Center

Williamson, David M.; Xi, Xiaoming; Breyer, F. Jay

2012-01-01

A framework for evaluation and use of automated scoring of constructed-response tasks is provided that entails both evaluation of automated scoring as well as guidelines for implementation and maintenance in the context of constantly evolving technologies. Consideration of validity issues and challenges associated with automated scoring are…

The Technical Efficiency of Earthquake Medical Rapid Response Teams Following Disasters: The Case of the 2010 Yushu Earthquake in China.

PubMed

Liu, Xu; Tang, Bihan; Yang, Hongyang; Liu, Yuan; Xue, Chen; Zhang, Lulu

2015-12-04

Performance assessments of earthquake medical rapid response teams (EMRRTs), particularly the first responders deployed to the hardest hit areas following major earthquakes, should consider efficient and effective use of resources. This study assesses the daily technical efficiency of EMRRTs in the emergency period immediately following the 2010 Yushu earthquake in China. Data on EMRRTs were obtained from official daily reports of the general headquarters for Yushu earthquake relief, the emergency office of the National Ministry of Health, and the Health Department of Qinghai Province, for a sample of data on 15 EMRRTs over 62 days. Data envelopment analysis was used to examine the technical efficiency in a constant returns to scale model, a variable returns to scale model, and the scale efficiency of EMRRTs. Tobit regression was applied to analyze the effects of corresponding influencing factors. The average technical efficiency scores under constant returns to scale, variable returns to scale, and the scale efficiency scores of the 62 units of analysis were 77.95%, 89.00%, and 87.47%, respectively. The staff-to-bed ratio was significantly related to global technical efficiency. The date of rescue was significantly related to pure technical efficiency. The type of institution to which an EMRRT belonged and the staff-to-bed ratio were significantly related to scale efficiency. This study provides evidence that supports improvements to EMRRT efficiency and serves as a reference for earthquake emergency medical rapid assistance leaders and teams.

[Case-control study on shoulder pain caused by hook palte for the treatment of acromioclavicular joint dislocation].

PubMed

Yang, Ying-guo; Cai, Xiao-bing; Wang, Xiao-min; Zhu, Yong-gan; Pan, He-yong

2015-06-01

To explore causes of shoulder pain and propose prevention measures in treating acromioclavicular joint dislocation. From January 2005 to January 2013, 86 patients with acromioclavicular joint dislocation (Tossy III) were treated with hook plate fixation, and were divided into two groups. Bsaed on recovery of shoulder function mostly, the patients who suffered from rest pain, motion pain were named as shoulder pain group, while the patients without pain were named as painless group. In shoulder pain group, there were 21 cases including 15 males and and 6 females ranging the age from 22 to 62 years old with an average of (40.6±11.2) years old. There were 8 cases were on the left side and 13 cases were on the right side. In painless group, there were 65 cases including 36 males and and 29 females ranging the age from 19 to 65 years old with an average of (40.0±11.3) years old. There were 33 cases were on the left side and 32 cases were on the right side. The time from injury to operation ranged from 3 h to 8 d with an average of 34.6 h. Shoulder function of all patients were normal before injuried. Postoperative pain, activity of daily living (ADL), range of motion, deltoid muscle strength were compared. Anteflexion,rear protraction, abduction and upthrow of shoulder joint were also compared. Postoperative complications between two groups were observed and compared. All patients were followed up from 12 to 48 months with an average of 18.5 months. Constant-Murley score were used to evaluate clinical efficacy at the least following up, and 13 cases got an excellent results, 5 moderate, 2 good and 1 poor in shoulder pain group ; while 61 cases were obtained excellent results, 3 moderate and 1 good in painless group. There were significantly differences between two groups in Constant-Murley score and activity of shoulder joint (P<0.05). In shoulder pain group, 3 cases were disconnected, 1 case occurred stress fracture, 9 cases were subacromial impingement syndrome, 5 cases occurred subluxation, 1 case occurred plate breakage and 11 cases were acromioclavicular arthritis. Chosing individual clavicular hook plate, fulfilling anatomic reset, paying attention to the repair of articular capsule ligament, and reducing hook and bone antagonism between stress is the key point of preventing and decreasing postoperative shoulder pain.

The normalization of data in the Constant-Murley score for the shoulder. A study conducted on 563 healthy subjects.

PubMed

Grassi, F A; Tajana, M S

2003-01-01

The study was conducted in order to evaluate the theoretical design of the Constant-Murley system and to reveal any difficulties in obtaining data when it is used in 563 subjects not affected with shoulder pathology. The total mean score for the subjects examined was 85.2 points (minimum 75, maximum 100 points). Values revealed a decreasing trend beginning at 50 years of age for men and 30 for women. Only 4 subjects achieved a maximum score of 100. The measurements taken allowed us to elaborate a reference table based on sex and age, which was required to calculate the correct score. These values differ from those reported by the inventors of the system and they reveal the need to compile personal tables for the normalization of scores.

Have Nursing Home Compare quality measure scores changed over time in response to competition?

PubMed

Castle, Nicholas G; Engberg, John; Liu, Darren

2007-06-01

Currently, the Centers for Medicare and Medicaid Services report on 15 Quality Measures (QMs) on the Nursing Home Compare (NHC) website. It is assumed that nursing homes are able to make improvements on these QMs, and in doing so they will attract more residents. In this investigation, we examine changes in QM scores, and whether competition and/or excess demand have influenced these change scores over a period of 1 year. Data come from NHC and the On-line Survey Certification And Recording (OSCAR) system. QM change scores are calculated using values from January 2003 to January 2004. A series of regression analyses are used to examine the association of competition and excess demand on QM scores. Eight QMs show an average decrease in scores (ie, better quality) and six QMs show an average increase in scores (ie, worse quality). However, for 13 of the 14 QMs these average changes averaged less than 1%. The regression analyses show an association between higher competition and improving QM scores and an association between lower occupancy and improving QM scores. As would be predicted based on the market-driven mechanism underlying quality improvements using report cards, we show that it is in the most competitive markets and those with the lowest average occupancy rates that improvements in the QM scores are more likely.

The Influence of Protein Supplementation on Muscle Hypertrophy

NASA Astrophysics Data System (ADS)

Fardi, A.; Welis, W.

2018-04-01

The problem of this study was the lack of knowledge about nutrition, so the use of protein supplements to support the occurrence of muscle hypertrophy is not optimal. The use of natural supplements is a substitute of the manufacturer's supplements. The purpose of this study was to determine the effect of natural protein supplementation to muscle hypertrophy.The method of the research was a quasi experiment. There are 26 subject and were divided two group. Instrument of this research is to use tape measure and skinfold to measure muscle rim and thickness of fat in arm and thigh muscle. Then to calculate the circumference of the arm and thigh muscles used the formula MTC - (3.14 x TSF). MTC is the arm muscle or thigh muscle and TSF is the thickness of the muscles of the arm or thigh muscles. Data analysis technique used was t test at 5% significant level. The result of the research showed that average score of arm muscle hypertrophy at pretest control group was 255.61 + 17.69 mm and posttest average score was 263.48.58 + 17.21 mm and average score of thigh muscle hypertrophy at pretest control group was 458.32 + 8.72 mm and posttest average score was 468.78 + 11.54 mm. Average score of arm muscle hypertrophy at pretest experiment group was 252.67 + 16.05 mm and posttest average score was 274.58 ± 16.89 mm and average score of thigh muscle hypertrophy at pretest experiment group was 459.49 ± 6.99 mm and posttest average score was 478.70 + 9.05 mm. It can be concluded that there was a significant effect of natural protein supplementation on muscle hypertrophy.

Nurses caring for ENT patients in a district general hospital without a dedicated ENT ward score significantly less in a test of knowledge than nurses caring for ENT patients in a dedicated ENT ward in a comparable district general hospital.

PubMed

Foxton, C R; Black, D; Muhlschlegel, J; Jardine, A

2014-12-01

To assess whether there is a difference in ENT knowledge amongst nurses caring for patients on a dedicated ENT ward and nurses caring for ENT patients in a similar hospital without a dedicated ENT ward. A test of theoretical knowledge of ENT nursing care was devised and administered to nurses working on a dedicated ENT ward and then to nurses working on generic non-subspecialist wards regularly caring for ENT patients in a hospital without a dedicated ENT ward. The test scores were then compared. A single specialist ENT/Maxillo-Facial/Opthalmology ward in hospital A and 3 generic surgical wards in hospital B. Both hospitals are comparable district general hospitals in the south west of England. Nursing staff working in hospital A and hospital B on the relevant wards were approached during the working day. 11 nurses on ward 1, 10 nurses on ward 2, 11 nurses on ward 3 and 10 nurses on ward 4 (the dedicated ENT ward). Each individual test score was used to generate an average score per ward and these scores compared to see if there was a significant difference. The average score out of 10 on ward 1 was 6.8 (+/-1.6). The average score on ward two was 4.8 (+/-1.6). The average score on ward three was 5.5 (+/-2.1). The average score on ward 4, which is the dedicated ENT ward, was 9.7 (+/-0.5). The differences in average test score between the dedicated ENT ward and all of the other wards are statistically significant. Nurses working on a dedicated ENT ward have an average higher score in a test of knowledge than nurses working on generic surgical wards. This difference is statistically significant and persists despite banding or training. © 2014 John Wiley & Sons Ltd.

Arthroscopic fixation of acute acromioclavicular joint disruption with TightRope™: Outcome and complications after minimum 2 (2-5) years follow-up.

PubMed

Zhang, Li-Feng; Yin, Bo; Hou, Su; Han, Bing; Huang, De-Fa

2017-01-01

To evaluate the midterm results of arthroscopic reconstruction of acute acromioclavicular (AC) joint disruption using TightRope™ system. We retrospectively assess the results of 24 patients of acute AC joint dislocation who were operated using TightRope system. Constant and University of California, Los Angeles (UCLA) scores and coracoclavicular distance were calculated pre- and postoperatively. Data was entered into MS excel and analyzed using the SPSS version 17. The mean follow-up was 39.45 months. Constant and UCLA scores were significantly increased postoperatively. Six patients had partial loss of reduction within 3-6 months and two patients had a failure of construct. Constant score was significantly lower in these patients. TightRope reconstruction of the AC joint is a reproducible and safe alternative to many other techniques of AC joint reconstruction. Early subluxation remains a concern and may reflect the need for technique modification.

Long-Term Efficacy of Constant Current Deep Brain Stimulation in Essential Tremor.

PubMed

Rezaei Haddad, Ali; Samuel, Michael; Hulse, Natasha; Lin, Hsin-Ying; Ashkan, Keyoumars

2017-07-01

Ventralis intermedius deep brain stimulation is an established intervention for medication-refractory essential tremor. Newer constant current stimulation technology offers theoretical advantage over the traditional constant voltage systems in terms of delivering a more biologically stable therapy. There are no previous reports on the outcomes of constant current deep brain stimulation in the treatment of essential tremor. This study aimed to evaluate the long-term efficacy of ventralis intermedius constant current deep brain stimulation in patients diagnosed with essential tremor. Essential tremor patients implanted with constant current deep brain stimulation for a minimum of three years were evaluated. Clinical outcomes were assessed using the Fahn-Tolosa-Marin tremor rating scale at baseline and postoperatively at the time of evaluation. The quality of life in the patients was assessed using the Quality of Life in Essential Tremor questionnaire. Ten patients were evaluated with a median age at evaluation of 74 years (range 66-79) and a mean follow up time of 49.7 (range 36-78) months since starting stimulation. Constant current ventralis intermedius deep brain stimulation was well tolerated and effective in all patients with a mean score improvement from 50.7 ± 5.9 to 17.4 ± 5.7 (p = 0.0020) in the total Fahn-Tolosa-Marin rating scale score (65.6%). Furthermore, the total combined mean Quality of Life in Essential Tremor score was improved from 56.2 ± 4.9 to 16.8 ± 3.5 (p value = 0.0059) (70.1%). This report shows that long-term constant current ventralis intermedius deep brain stimulation is a safe and effective intervention for essential tremor patients. © 2017 International Neuromodulation Society.

Lesson plan profile of senior high school biology teachers in Subang

NASA Astrophysics Data System (ADS)

Rohayati, E.; Diana, S. W.; Priyandoko, D.

2018-05-01

Lesson plan have important role for biology teachers in teaching and learning process. The aim of this study was intended to gain an overview of lesson plan of biology teachers’ at Senior High Schools in Subang which were the members of biology teachers association in Subang. The research method was descriptive method. Data was collected from 30 biology teachers. The result of study showed that lesson plan profile in terms of subject’s identity had good category with 83.33 % of average score. Analysis on basic competence in fair category with 74.45 % of average score. The compatibility of method/strategy was in fair category with average score 72.22 %. The compatibility of instrument, media, and learning resources in fair category with 71.11 % of average score. Learning scenario was in good category with 77.00 % of average score. The compatibility of evaluation was in low category with 56.39 % of average score. It can be concluded that biology teachers in Subang were good enough in making lesson plan, however in terms of the compatibility of evaluation needed to be fixed. Furthermore, teachers’ training for biology teachers’ association was recommended to increasing teachers’ skill to be professional teachers.

[Systematic Review of the Methodology Quality in Lung Cancer Screening Guidelines].

PubMed

Li, Jiang; Su, Kai; Li, Fang; Tang, Wei; Huang, Yao; Wang, Le; Huang, Huiyao; Shi, Jufang; Dai, Min

2016-10-20

Lung cancer is the most common malignancy and screening can decrease the mortality. High quality screening guideline is necessary and important for effective work. Our study is to review and evaluate the basic characteristics and methodology quality of the current global lung cancer screening guidelines so as to provide useful information for domestic study in the future. Electronic searches were done in English and Chinese databases including PubMed, the Cochrane Library, Web of Science, Embase, CNKI, CBM, Wanfang, and some cancer official websites. Articles were screened according to the predefined inclusion and exclusion criteria by two researchers. The quality of guidelines was assessed by AGREE II. At last, a total of 11 guidelines with methodology were included. The guidelines were issued mainly by USA (81%). Canada and China developed one, respectively. As for quality, the average score in the "Scale and objective" of all guidelines was 80, the average score in the "Participants" was 52, the average score in the "rigorism" was 50, the average score in the "clarity" was 76, the average score in the "application" was 43 and the average score in the "independence" was 59. The highest average score was found in 2013 and 2015. Canada guideline had higher quality in six domains. 7 guidelines were evaluated as A level. The number of clinical guidelines showed an increasing trend. Most guidelines were issued by developed countries with heavy burden. Multi-country contribution to one guideline was another trend. Evidence-based methodology was accepted globally in the guideline development.

Paramecia Swim with a constant propulsion in Solutions of Varying Viscosity

NASA Astrophysics Data System (ADS)

Valles, James M., Jr.; Jung, Ilyong; Mickalide, Harry; Park, Hojin; Powers, Thomas

2012-02-01

Paramecia swim through the coordinated beating of the 1000's of cilia covering their body. We have measured the swimming speed of populations of Paramecium Caudatam in solutions of different viscosity, η, to see how their propulsion changes with increased drag. We have found the average instantaneous speed, V to decrease monotonically with increasing η. The product ηv is roughly constant over a factor of 7 change in viscosity suggesting that paramecia swim at constant propulsion force. The distribution of swimming speeds is Gaussian. The width appears proportional to the average speed implying that both fast and slow swimmers exert a constant propulsion. We discuss the possibility that this behavior implies that the body cilia beat at constant force with varying viscosity.

Comparison of Measured and Calculated Stresses in Built-up Beams

NASA Technical Reports Server (NTRS)

Levin, L Ross; Nelson, David H

1946-01-01

Web stresses and flange stresses were measured in three built-up beams: one of constant depth with flanges of constant cross-section, one linearly tapered in depth with flanges of constant cross section, and one linearly tapered in depth with tapered flanges. The measured stresses were compared with the calculated stresses obtained by the methods outlined in order to determine the degree of accuracy that may be expected from the stress analysis formulas. These comparisons indicated that the average measured stresses for all points in the central section of the beams did not exceed the average calculated stresses by more than 5 percent. It also indicated that the difference between average measured flange stresses and average calculated flange stresses on the net area and a fully effective web did not exceed 6.1 percent.

Syntax and reading comprehension: a meta-analysis of different spoken-syntax assessments.

PubMed

Brimo, Danielle; Lund, Emily; Sapp, Alysha

2018-05-01

Syntax is a language skill purported to support children's reading comprehension. However, researchers who have examined whether children with average and below-average reading comprehension score significantly different on spoken-syntax assessments report inconsistent results. To determine if differences in how syntax is measured affect whether children with average and below-average reading comprehension score significantly different on spoken-syntax assessments. Studies that included a group comparison design, children with average and below-average reading comprehension, and a spoken-syntax assessment were selected for review. Fourteen articles from a total of 1281 reviewed met the inclusionary criteria. The 14 articles were coded for the age of the children, score on the reading comprehension assessment, type of spoken-syntax assessment, type of syntax construct measured and score on the spoken-syntax assessment. A random-effects model was used to analyze the difference between the effect sizes of the types of spoken-syntax assessments and the difference between the effect sizes of the syntax construct measured. There was a significant difference between children with average and below-average reading comprehension on spoken-syntax assessments. Those with average and below-average reading comprehension scored significantly different on spoken-syntax assessments when norm-referenced and researcher-created assessments were compared. However, when the type of construct was compared, children with average and below-average reading comprehension scored significantly different on assessments that measured knowledge of spoken syntax, but not on assessments that measured awareness of spoken syntax. The results of this meta-analysis confirmed that the type of spoken-syntax assessment, whether norm-referenced or researcher-created, did not explain why some researchers reported that there were no significant differences between children with average and below-average reading comprehension, but the syntax construct, awareness or knowledge, did. Thus, when selecting how to measure syntax among school-age children, researchers and practitioners should evaluate whether they are measuring children's awareness of spoken syntax or knowledge of spoken syntax. Other differences, such as participant diagnosis and the format of items on the spoken-syntax assessments, also were discussed as possible explanations for why researchers found that children with average and below-average reading comprehension did not score significantly differently on spoken-syntax assessments. © 2017 Royal College of Speech and Language Therapists.

Use of plate fixation without coracoclavicular ligament augmentation for unstable distal clavicle fractures.

PubMed

Shin, Sang-Jin; Ko, Young-Won; Lee, Juyeob; Park, Min-Gyue

2016-06-01

The purpose of this study was to evaluate the clinical and radiologic outcomes of unstable distal clavicle fractures treated with anatomic plate fixation without coracoclavicular ligament augmentation and to compare the outcome of Neer type IIA with that of type IIB. Twenty-five patients with unstable distal clavicle fractures who underwent anatomic plate fixation without coracoclavicular ligament augmentation were enrolled prospectively, including 9 patients of Neer type IIA and 16 patients of Neer type IIB. Clinical outcomes were evaluated using Constant and University of California-Los Angeles (UCLA) scores. Coracoclavicular distance was measured on plain radiographs. Bone union was achieved in all patients. Satisfactory clinical and radiologic outcomes were obtained regardless of fracture type. After operation, the mean coracoclavicular distance on the injured side was increased by 10% compared with the uninjured side. However, between the patients who showed an increased coracoclavicular distance >10% (Constant score, 89.4 ± 3.7; UCLA score, 32.6 ± 3) and the patients with increased coracoclavicular distance <10% of the uninjured side (Constant score, 88.7 ± 3.6; UCLA score, 31.9 ± 3), there was no statistically significant difference in clinical outcomes of Constant score (P = .934) and UCLA score (P = .598). In unstable distal clavicle fractures, precontoured anatomic plate fixation without coracoclavicular ligament augmentation showed satisfactory clinical outcomes and high union rates even with a small lateral fragment. Patients who had increased coracoclavicular distance also demonstrated satisfactory shoulder functional outcomes regardless of the fracture type. Therefore, anatomic plate fixation without additional coracoclavicular ligament augmentation can be considered one of the treatment options for unstable distal clavicle fracture. Level IV; Case Series; Treatment Study. Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Cross-cultural adaptation and validation of the Persian version of the Intermittent and Constant Osteoarthritis Pain Measure for the knee.

PubMed

Panah, Sara Hojat; Baharlouie, Hamze; Rezaeian, Zahra Sadat; Hawker, Gilian

2016-01-01

The present study aimed to translate and evaluate the reliability and validity of the Persian version of the 11-item Intermittent and Constant Osteoarthritis Pain (ICOAP) measure in Iranian subjects with Knee Osteoarthritis (KOA). The ICOAP questionnaire was translated according to the Manufacturers Alliance for Productivity and Innovation (MAPI) protocol. The procedure consisted of forward and backward translation, as well as the assessment of the psychometric properties of the Persian version of the questionnaire. A sample of 230 subjects with KOA was asked to complete the Persian versions of ICOAP and Knee injury and Osteoarthritis Outcome Score (KOOS). The ICOAP was readministered to forty subjects five days after the first visit. Test-retest reliability was assessed using Intraclass Correlation Coefficient (ICC), and internal consistency was assessed by Cronbach's alpha and item-total correlation. The correlation between ICOAP and KOOS was determined using Spearman's correlation coefficient. Subjects found the Persian-version of the ICOAP to be clear, simple, and unambiguous, confirming its face validity. Spearman correlations between ICOAP total and subscale scores with KOOS scores were between 0.5 and 0.7, confirming construct validity. Cronbach's alpha, used to assess internal consistency, was 0.89, 0.93, and 0.92 for constant pain, intermittent pain, and total pain scores, respectively. The ICC was 0.90 for constant pain and 0.91 for the intermittent pain and total pain score. The Persian version of the ICOAP is a reliable and valid outcome measure that can be used in Iranian subjects with KOA.

Clinical factors that affect perceived quality of life in arthroscopic reconstruction for acromioclavicular joint dislocation.

PubMed

Abat, F; Gich, I; Natera, L; Besalduch, M; Sarasquete, J

To analyse the results of arthroscopic repair of acromioclavicular dislocation in terms of health-related quality of life. Prospective study of patients with acromioclavicular dislocation Rockwood grade iii-v, treated arthroscopically with a mean follow up of 25.4 months. The demographics of the series were recorded and evaluations were performed preoperatively, at 3 months and 2 years with validated questionnaires as Short Form-36 Health Survey (SF-36), visual analogue scale (VAS), The Disabilities of the Arm, Shoulder and Hand (DASH), Constant-Murley Shoulder Outcome Score (Constant) and Walch-Duplay Score (WD). Twenty patients, 17 men and 3 women with a mean age of 36.1 years, were analysed. According to the classification of Rockwood, 3 patients were grade iii, 3 grade iv and 14 grade v. Functional and clinical improvement was detected in all clinical tests (SF-36, VAS and DASH) at 3 months and 2 years follow up (P<.001). The final Constant score was 95.3±2.4 and the WD was 1.8±0.62. It was not found that the health-related quality of life was affected by any variable studied except the evolution of DASH. The health-related quality of life (assessed by SF-36) in patients undergoing arthroscopic repair of acromioclavicular joint dislocation grades iii-v was not influenced by gender, age, grade, displacement, handedness, evolution of the VAS, scoring of the Constant or by the WD. However, it is correlated with the evolution in the DASH score. Copyright © 2017 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

Outcome of triple-tendon transfer, an Eden-Lange variant, to reconstruct trapezius paralysis.

PubMed

Elhassan, Bassem T; Wagner, Eric R

2015-08-01

This study describes the technique and evaluates the outcome of the triple-tendon (T3) transfer, an Eden-Lange variant, to the scapula to stabilize the scapulothoracic articulation in the treatment of symptomatic trapezius paralysis. T3 transfers were performed in 22 patients with a history of persistent trapezius paralysis secondary to spinal accessory nerve injury. The indications for surgery included shoulder pain and weakness and limited range of motion of the shoulder. The T3 transfer included transfer of the levator scapulae to the lateral aspect of the spine of the scapula, the rhomboid minor to the spine of the scapula just medial to the levator scapulae insertion, and the rhomboid major to the medial spine of the scapula, including all muscles bony insertions. At an average follow-up of 35 months, winging was corrected in all patients, with improvement of shoulder asymmetry. All patients had significant improvement of pain (P < .01) and range of motion, including active shoulder abduction that improved from an average of 71° preoperatively to 118° postoperatively (P < .02) and shoulder flexion from an average of 102° to 150° (P < .01). There were also significant improvements in aggregate Constant Shoulder Score (P < .01), subjective shoulder value (P < .01), and Disabilities of the Arm, Shoulder and Hand score (P < .01). All patients were very satisfied with the outcome of surgery. This study shows that the T3 transfer is effective in stabilizing the scapulothoracic articulation and restoring the function of the trapezius, and thus, in improving pain and shoulder function in patients with symptomatic trapezius paralysis. Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

[The effort of being male: a survey on gender and burnout].

PubMed

Maccacaro, G; Di Tommaso, Francesca; Ferrai, Paola; Bonatti, Daniela; Bombana, Susanna; Merseburger, Angela

2011-01-01

Stress at work affects more than 40 million people in the European Union - around 22% of workers - and is the second most reported work-related health problem. Gender does not seem to be a constant predictive factor for burnout: some studies showed that women suffer more from burnout than males, other studies proved that males report higher burnout scores while others did not detect any difference at all. These results may be due to gender-related stereotypes, or could even reiflect the preponderance of a specific gender in some jobs. To determine whether gender might be among the relevant variables in job burnout studies. In 2008-2009 a study on burnout was carried out in a Healthcare Trust in northern Italy. The Job Content Questionnaire (JCQ) and the Maslach Burnout Inventory (MBI) were distributed to physicians, administrative staff and auxiliary personnel of hospital departments and local services. A total of l, 604 JCQ's and 1,604 MBI's were analysed, corresponding to 37% of the distributed tests. Results of logistic regression showed that gender, shift work and a low score in relationships with superiors were significantly associated with burnout. Considering the tasks of physicians and nurses, the burnout frequency was 3.78% for physicians and 1.97% for nurses, with higher percentages in males than in females. Women with children reported an average burnout frequency that was lower than the average of the whole population studied while men with children had a double burnout frequency compared to the average. Male gender is significantly associated with a burnout condition. Moreover, our findings have shown that physicians experience an excess burnout compared to nurses although this excess did not achieve statistical significance when taking into account distribution according to gender in the two professions.

Longitudinal Long-term Magnetic Resonance Imaging and Clinical Follow-up After Single-Row Arthroscopic Rotator Cuff Repair: Clinical Superiority of Structural Tendon Integrity.

PubMed

Heuberer, Philipp R; Smolen, Daniel; Pauzenberger, Leo; Plachel, Fabian; Salem, Sylvia; Laky, Brenda; Kriegleder, Bernhard; Anderl, Werner

2017-05-01

The number of arthroscopic rotator cuff surgeries is consistently increasing. Although generally considered successful, the reported number of retears after rotator cuff repair is substantial. Short-term clinical outcomes are reported to be rarely impaired by tendon retears, whereas to our knowledge, there is no study documenting long-term clinical outcomes and tendon integrity after arthroscopic rotator cuff repair. To investigate longitudinal long-term repair integrity and clinical outcomes after arthroscopic rotator cuff reconstruction. Case series; Level of evidence, 4. Thirty patients who underwent arthroscopic rotator cuff repair with suture anchors for a full-tendon full-thickness tear of the supraspinatus or a partial-tendon full-thickness tear of the infraspinatus were included. Two and 10 years after initial arthroscopic surgery, tendon integrity was analyzed using magnetic resonance imaging (MRI). The University of California, Los Angeles (UCLA) score and Constant score as well as subjective questions regarding satisfaction with the procedure and return to normal activity were used to evaluate short- and long-term outcomes. At the early MRI follow-up, 42% of patients showed a full-thickness rerupture, while 25% had a partial rerupture, and 33% of tendons remained intact. The 10-year MRI follow-up (129 ± 11 months) showed 50% with a total rerupture, while the other half of the tendons were partially reruptured (25%) or intact (25%). The UCLA and Constant scores significantly improved from preoperatively (UCLA total: 50.6% ± 20.2%; Constant total: 44.7 ± 10.5 points) to 2 years (UCLA total: 91.4% ± 16.0% [ P < .001]; Constant total: 87.8 ± 15.3 points [ P < .001]) and remained significantly higher after 10 years (UCLA total: 89.7% ± 15.9% [ P < .001]; Constant total: 77.5 ± 15.6 points [ P < .001]). The Constant total score and Constant strength subscore, but not the UCLA score, were also significantly better at 10 years postoperatively in patients with intact tendons compared with patients with retorn tendons (Constant total: 89.0 ± 7.8 points vs 75.7 ± 14.1 points, respectively [ P = .034]; Constant strength: 18.0 ± 4.9 points vs 9.2 ± 5.2 points, respectively [ P = .006]). The majority of patients rated their satisfaction with the procedure as "excellent" (83.3%), and 87.5% returned to their normal daily activities. Arthroscopic rotator cuff repair showed good clinical long-term results despite a high rate of retears. Nonetheless, intact tendons provided significantly superior clinical long-term outcomes, making the improvement of tendon healing and repair integrity important goals of future research efforts.

Scheduled, intermittent stimulation of the thalamus reduces tics in Tourette syndrome.

PubMed

Rossi, P Justin; Opri, Enrico; Shute, Jonathan B; Molina, Rene; Bowers, Dawn; Ward, Herbert; Foote, Kelly D; Gunduz, Aysegul; Okun, Michael S

2016-08-01

Personalized, scheduled deep brain stimulation in Tourette syndrome (TS) may permit clinically meaningful tic reduction while reducing side effects and increasing battery life. Here, we evaluate scheduled DBS applied to TS at two-year follow-up. Five patients underwent bilateral centromedian thalamic (CM) region DBS. A cranially contained constant-current device delivering stimulation on a scheduled duty cycle, as opposed to the standard continuous DBS paradigm was utilized. Baseline vs. 24-month outcomes were collected and analyzed, and a responder analysis was performed. A 40% improvement in the Modified Rush Tic Rating Scale (MRTRS) total score or Yale Global Tic Severity Scale (YGTSS) total score defined a full responder. Three of the 4 patients followed to 24 months reached full responder criteria and had a mean stimulation time of 1.85 h per day. One patient lost to follow-up evaluated at the last time point (month 18) was a non-responder. Patients exhibited improvements in MRTRS score beyond the improvements previously reported for the 6 month endpoint; on average, MRTRS total score was 15.6% better at 24 months than at 6 months and YGTSS total score was 14.8% better. Combining the patients into a single cohort revealed significant improvements in the MRTRS total score (-7.6 [5.64]; p = 0.02). Electrical stimulation of the centromedian thalamic region in a scheduled paradigm was effective in suppressing tics, particularly phonic tics. Full responders were able to achieve the positive DBS effect with a mean of 2.3 ± 0.9 (SEM) hours of DBS per day. Copyright © 2016 Elsevier Ltd. All rights reserved.

On residents' satisfaction with community health services after health care system reform in Shanghai, China, 2011.

PubMed

Li, Zhijian; Hou, Jiale; Lu, Lin; Tang, Shenglan; Ma, Jin

2012-01-01

Health care system reform is a major issue in many countries and therefore how to evaluate the effects of changes is incredibly important. This study measured residents' satisfaction with community health care service in Shanghai, China, and aimed to evaluate the effect of recent health care system reform. Face-to-face interviews were performed with a stratified random sample of 2212 residents of the Shanghai residents using structured questionnaires. In addition, 972 valid responses were retrieved from internet contact. Controlling for sex, age, income and education, the study used logistic regression modeling to analyze factors associated with satisfaction and to explain the factors that affect the residents' satisfaction. Comparing current attitudes with those held at the initial implementation of the reform in this investigation, four dimensions of health care were analyzed: 1) the health insurance system; 2) essential drugs; 3) basic clinical services; and 4) public health services. Satisfaction across all dimensions improved since the reform was initiated, but differences of satisfaction level were found among most dimensions and groups. Residents currently expressed greater satisfaction with clinical service (average score=3.79, with 5 being most satisfied) and the public health/preventive services (average score=3.62); but less satisfied with the provision of essential drugs (average score=3.20) and health insurance schemes (average score=3.23). The disadvantaged groups (the elderly, the retired, those with only an elementary education, those with lower incomes) had overall poorer satisfaction levels on these four aspects of health care (P<0.01). 25.39% of the respondents thought that their financial burden had increased and 38.49% thought that drugs had become more expensive. The respondents showed more satisfaction with the clinical services (average score=3.79) and public health services/interventions (average score=3.79); and less satisfaction with the health insurance system (average score=3.23) and the essential drug system (average score=3.20). Disadvantaged groups showed lower satisfaction levels overall relative to non-disadvantaged groups.

A feasibility analysis of the employment of satellite imagery to monitor and inspect surface mining operations in western Kentucky, volume 1

NASA Technical Reports Server (NTRS)

Fish, B. R. (Principal Investigator)

1977-01-01

The author has identified the following significant results. Surface mining violation estimates were scaled by scores assigned by ten inspectors from western Kentucky to each violation. A sensitivity analysis was made by varying the violation costs; costs were varied by using three different average durations. These durations were: (1) best estimated duration; (2) longest possible duration as restricted by the one year permit renewal and bond release regulations, and (3) shortest possible duration when inspections were made. If a social cost cannot be reduced, then the value of the social cost is irrelevant. Indications from the increased inspection rate of 1975 were that the total amount of fines collected per year remains constant independent of the increased detection rate.

[Analysis of results of Assessment on National Parasitic Disease Control and Prevention Techniques in 2015].

PubMed

Yao, Ruan; Li-Ying, Wang; Ting-Jun, Zhu; Men-Bao, Qian; Chun-Li, Cao; Yu-Wan, Hao; Tian, Tian; Shi-Zhu, Li

2017-03-01

To assess the theoretical knowledge and practical skills of parasitic diseases among technicians from disease control and prevention institutions. The Assessment on National Parasitic Disease Control and Prevention Techniques was organized in September, 2015. Together, 124 subjects from disease control and prevention institutions at province, prefecture or county levels in 31 provinces joined the assessment. A database was built consisting of subjects' basic information and assessment scores. Statistical analysis was used to analyze the scores by gender, age, professional title, institutions and places of participants. The average total score of all the subjects was 123.3, with a passing rate of 57.3%. The average scores of male subjects (48 subjects) and female subjects (76 subjects) were 125.9 and 121.7 respectively; the average scores of the subjects aged under 30 years (57 subjects), between 30 and 40 years (61 subjects) and above 40 years (6 subjects) were 119.6, 128.1 and 111.2 respectively; the average scores of persons with junior (94 subjects), intermediate (28 subjects) and senior (2 subjects) professional titles were 119.2, 135.9 and 140.5 respectively. The average theoretical assessment score of all the subjects was 61.9, with a passing rate of 62.9%. The average practical skill assessment score of all the subjects was 61.4, with a passing rate of 58.1%. The theoretical assessment results range widely. The theoretical knowledge results of technicians from disease control and prevention institutions are low in general. Therefore, the specific training based on daily work needs to be enhanced.

Early growth patterns are associated with intelligence quotient scores in children born small-for-gestational age.

PubMed

Varella, Marcia H; Moss, William J

2015-08-01

To assess whether patterns of growth trajectory during infancy are associated with intelligence quotient (IQ) scores at 4 years of age in children born small-for-gestational age (SGA). Children in the Collaborative Perinatal Project born SGA were eligible for analysis. The primary outcome was the Stanford-Binet IQ score at 4 years of age. Growth patterns were defined based on changes in weight-for-age z-scores from birth to 4 months and 4 to 12 months of age and consisted of steady, early catch-up, late catch-up, constant catch-up, early catch-down, late catch-down, constant catch-down, early catch-up & late catch-down, and early catch-down & late catch-up. Multivariate linear regression was used to assess associations between patterns of growth and IQ. We evaluated patterns of growth and IQ in 5640 children. Compared with children with steady growth, IQ scores were 2.9 [standard deviation (SD)=0.54], 1.5 (SD=0.63), and 2.2 (SD=0.9) higher in children with early catch-up, early catch-up and later catch-down, and constant catch-up growth patterns, respectively, and 4.4 (SD=1.4) and 3.9 (SD=1.5) lower in children with early catch-down & late catch-up, and early catch-down growth patterns, respectively. Patterns in weight gain before 4 months of age were associated with differences in IQ scores at 4 years of age, with children with early catch-up having slightly higher IQ scores than children with steady growth and children with early catch-down having slightly lower IQ scores. These findings have implications for early infant nutrition in children born SGA. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Open Reduction and Internal Fixation versus Non-Surgical Treatment in Displaced Midshaft Clavicle Fractures: A Meta-Analysis.

PubMed

Ahmed, Abdulaziz F; Salameh, Motasem; AlKhatib, Nidal; Elmhiregh, Aissam; Ahmed, Ghalib O

2018-04-17

To compare open reduction and internal fixation (ORIF) and non-surgical treatment outcomes in displaced midshaft clavicle fractures. PubMed, MEDLINE, EMBASE, Web of Science, Cochrane Library, and ClinicalTrials.gov were searched in September 2017. Inclusion criteria were randomized controlled trials reporting nonunion, shoulder functional outcomes, and subsequent surgery rates or pain scores. We excluded studies with patients younger than 16 years, maximum follow-up less than nine months, and inaccessible full text. Extracted data included the first author, publication year, number of patients, number of nonunions, Constant scores, disabilities of the arm, shoulder and hand (DASH) scores, number of subsequent surgeries, and pain measured using the visual analogue analog scale. The risk ratio (RR) of nonunion was 0.15 (95% confidence interval [CI], 0.08, 0.31) in ORIF compared with that of non-surgical treatment. Constant and DASH scores were significantly better in ORIF up to 6 months. The mean difference (MD) in DASH scores at 12 months was statistically insignificant in both treatments (MD, -4.19; 95% CI, -9.34, 0.96). Constant scores remained significant in ORIF (MD, 4.39; 95% CI, 1.03, 7.75). Subsequent surgeries and pain scores were similar in both treatments. Significant reduction in nonunions and favorable early functional outcomes are associated with ORIF. Nevertheless, late functional outcomes, subsequent surgeries, and pain scores are similar to those of non-surgical treatment. Although patients treated with ORIF mainly had subsequent elective plate removals; non-surgically treated patients had more surgical fixations for nonunions. As a result, there remains inconsistent evidence regarding the best treatment for displaced midshaft clavicle fractures. Therapeutic Level I.

The Nation's Report Card Mathematics 2011 Trial Urban District Snapshot Report. School District of Philadelphia. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…

The Nation's Report Card Mathematics 2011 Trial Urban District Snapshot Report. Dallas Public Schools. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…

The Nation's Report Card Mathematics 2011 Trial Urban District Snapshot Report. Dallas Public Schools. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…

The Nation's Report Card Reading 2011 Trial Urban District Snapshot Report. Dallas Public Schools. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…

The Nation's Report Card Reading 2011 Trial Urban District Snapshot Report. Dallas Public Schools. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…

The Nation's Report Card Mathematics 2011 Trial Urban District Snapshot Report. Cleveland Metropolitan School District. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…

The Nation's Report Card Reading 2011 Trial Urban District Snapshot Report. San Diego Unified School District. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…

The Nation's Report Card Mathematics 2011 Trial Urban District Snapshot Report. San Diego Unified School District. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…

The Nation's Report Card Mathematics 2011 Trial Urban District Snapshot Report. San Diego Unified School District. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…

The Nation's Report Card Reading 2011 Trial Urban District Snapshot Report. San Diego Unified School District. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…

The Nation's Report Card Reading 2011 Trial Urban District Snapshot Report. Austin Independent School District. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…

The Nation's Report Card Reading 2011 Trial Urban District Snapshot Report. Austin Independent School District. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…

The Nation's Report Card Mathematics 2011 Trial Urban District Snapshot Report. Austin Independent School District. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…

The Nation's Report Card Mathematics 2011 Trial Urban District Snapshot Report. Austin Independent School District. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…

The Nation's Report Card Reading 2011 Trial Urban District Snapshot Report. Albuquerque Public Schools. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…

The Nation's Report Card Reading 2011 Trial Urban District Snapshot Report. Albuquerque Public Schools. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…

The Nation's Report Card Mathematics 2011 Trial Urban District Snapshot Report. Albuquerque Public Schools. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…

The Nation's Report Card Mathematics 2011 Trial Urban District Snapshot Report. Albuquerque Public Schools. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…

The Relationship between Academic Averages of Primary School Science and Technology Class and Test Sub-Test Scores of Placement Test of Science

ERIC Educational Resources Information Center

Guzeller, Cem Oktay

2012-01-01

In this research, the relationship between written exam scores of science and technology class of 6th, 7th, and 8th grades, project, participation in class activities and performance work, year-end academic success point averages and sub-test raw scores of LDT science of 6th, 7th and 8th grades. Academic success point averages were used as…

Shoulder strength value differences between genders and age groups.

PubMed

Balcells-Diaz, Eudald; Daunis-I-Estadella, Pepus

2018-03-01

The strength of a normal shoulder differs according to gender and decreases with age. Therefore, the Constant score, which is a shoulder function measurement tool that allocates 25% of the final score to strength, differs from the absolute values but likely reflects a normal shoulder. To compare group results, a normalized Constant score is needed, and the first step to achieving normalization involves statistically establishing the gender differences and age-related decline. In this investigation, we sought to verify the gender difference and age-related decline in strength. We obtained a randomized representative sample of the general population in a small to medium-sized Spanish city. We then invited this population to participate in our study, and we measured their shoulder strength. We performed a statistical analysis with a power of 80% and a P value < .05. We observed a statistically significant difference between the genders and a statistically significant decline with age. To the best of our knowledge, this is the first investigation to study a representative sample of the general population from which conclusions can be drawn regarding Constant score normalization. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Progressive glenoid bone loss caused by erosion in humeral head resurfacing.

PubMed

Werner, B S; Stehle, J; Abdelkawi, A; Plumhoff, P; Hudek, R; Gohlke, F

2017-12-01

Cementless surface replacement of the shoulder represents an alternative to conventional stemmed anatomic prostheses. Glenoid erosion is a well-known complication in hemiarthroplasty. However, there is limited data concerning radiographic evaluation and prognostic factors for this phenomenon. The aim of our study was to determine the development of glenoid erosion following shoulder resurfacing using a new measurement technique and detect potential prognostic factors. We performed a retrospective analysis on 38 shoulders undergoing humeral head resurfacing with a mean follow-up of 65.4 ± 43 months. Clinical and radiographic evaluation followed a standardized protocol including pre- and postoperative Constant score, active range of motion, and X‑rays in true anteroposterior view. Three independent observers performed measurements of glenoid erosion. We found good interobserver reliability for glenoid erosion measurements (intraclass correlation coefficient [ICC] 0.74-0.78). Progressive glenoid erosion was present in all cases, averaging 5.5 ± 3.9 mm at more than 5 years' follow-up. Male patients demonstrated increased glenoid bone loss within the first 5 years (p < 0.04). The mean Constant score improved to 55.4 ± 23.6 points at the latest follow-up. Younger age was correlated to increased functional outcome. Revision rate due to painful glenoid erosion was 37%. Glenoid erosion can be routinely expected in patients undergoing humeral head resurfacing. Painful glenoid erosion leads to deterioration in functional outcome and necessitates revision surgery in a high percentage of cases.

Using Time-on-Task Measurements to Understand Student Performance in a Physics Class: A Ten-Year Study

NASA Astrophysics Data System (ADS)

Stewart, John

2015-04-01

The amount of time spent on out-of-class activities such as working homework, reading, and studying for examinations is presented for 10 years of an introductory, calculus-based physics class at a large public university. While the class underwent significant change in the 10 years studied, the amount of time invested by students in weeks not containing an in-semester examination was constant and did not vary with the length of the reading or homework assignments. The amount of time spent preparing for examinations did change as the course was modified. The time spent on class assignments, both reading and homework, did not scale linearly with the length of the assignment. The time invested in both reading and homework per length of the assignment decreased as the assignments became longer. The class average time invested in examination preparation did change with the average performance on previous examinations in the same class, with more time spent in preparation for lower previous examination scores (R2 = 0 . 70).

Is the arthroscopic suture bridge technique suitable for full-thickness rotator cuff tears of any size?

PubMed

Lee, Sung Hyun; Kim, Jeong Woo; Kim, Tae Kyun; Kweon, Seok Hyun; Kang, Hong Je; Kim, Se Jin; Park, Jin Sung

2017-07-01

The purpose of this study was to compare functional outcomes and tendon integrity between the suture bridge and modified tension band techniques for arthroscopic rotator cuff repair. A consecutive series of 128 patients who underwent the modified tension band (MTB group; 69 patients) and suture bridge (SB group; 59 patients) techniques were enrolled. The pain visual analogue scale (VAS), Constant, and American Shoulder and Elbow Surgeons (ASES) scores were determined preoperatively and at the final follow-up. Rotator cuff hypotrophy was quantified by calculating the occupation ratio (OR). Rotator cuff integrity and the global fatty degeneration index were determined by using magnetic resonance imaging at 6 months postoperatively. The average VAS, Constant, and ASES scores improved significantly at the final follow-up in both groups (p < 0.05 for all scores). The retear rate of small-to-medium tears was similar in the modified tension band and suture bridge groups (7.0 vs. 6.8%, respectively; p = n.s.). The retear rate of large-to-massive tears was significantly lower in the suture bridge group than in the modified tension band group (33.3 vs. 70%; p = 0.035). Fatty infiltration (postoperative global fatty degeneration index, p = 0.022) and muscle hypotrophy (postoperative OR, p = 0.038) outcomes were significantly better with the suture bridge technique. The retear rate was lower with the suture bridge technique in the case of large-to-massive rotator cuff tears. Additionally, significant improvements in hypotrophy and fatty infiltration of the rotator cuff were obtained with the suture bridge technique, possibly resulting in better anatomical outcomes. The suture bridge technique was a more effective method for the repair of rotator cuff tears of all sizes as compared to the modified tension band technique. Retrospective Cohort Design, Treatment Study, level III.

Outcome Comparison Between in Situ Repair Versus Tear Completion Repair for Partial Thickness Rotator Cuff Tears.

PubMed

Kim, Yang-Soo; Lee, Hyo-Jin; Bae, Sung-Ho; Jin, Hyonki; Song, Hyun Seok

2015-11-01

To compare the clinical outcomes of arthroscopic in situ repair with the tear completion repair technique for partial-thickness rotator cuff tears (PT-RCTs). We prospectively enrolled 100 cases with articular-sided and bursal-sided PT-RCTs exceeding 50% of tendon thickness and allocated them randomly. An in situ repair was performed in group 1 (n = 50). Completion of the remaining cuff tissue and repair were performed in group 2 (n = 50). The medial row was knotted as transosseous repair (suture-bridge technique) in all cases. American Shoulder Elbow Society (ASES) score, Constant shoulder (CS) score, Simple shoulder (SS) score, and Korean shoulder (KS) score, and visual analog scale (VAS) for pain and range of motion were assessed at 3, 6, and 12 months and at the last visit. Repaired tendon integrity was determined at 6 to 12 months by magnetic resonance imaging. Eight cases were lost to follow-up. Ultimately, 92 cases were analyzed. The average follow-up was 19.1 months (range, 12 to 42 months). Significant improvements in the VAS for pain and functional outcomes were observed in both groups postoperatively (P = .001 for VAS; P < .001 for ASES score; P < .001 for CS score; P = .001 for SS score; P<.001 for KS score). No significant difference in the clinical results was observed at any time between the groups. No difference of retear rate on articular-sided PT-RCT was observed between the groups (P = .34). Retears on the bursal-sided PT-RCT were more frequent in group 2 (P = .02). Arthroscopic repair of PT-RCT exceeding 50% of the thickness provided functional improvements and pain relief regardless of the repair technique. The retear rate for bursal-sided PT-RCT was higher in group 2, although the retear rate for the articular-sided PT-RCT was not different. Level II, prospective comparative study. Copyright © 2015 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Platelet-rich plasma versus steroid injection for subacromial impingement syndrome.

PubMed

Say, F; Gurler, D; Bulbul, M

2016-04-01

To compare the 6-week and 6-month outcome in 60 patients who received a single-dose injection of platelet-rich plasma (PRP) or steroid for subacromial impingement syndrome (SIS). 22 men and 38 women (mean age, 49.7 years) opted to receive a single-dose injection of PRP (n=30) or steroid (n=30) for SIS that had not responded to conservative treatment for >3 months. The PRP or a mixture of 1 ml 40 mg methylprednisolone and 8 ml prilocaine was administered via a dorsolateral approach through the interval just beneath the dorsal acromial edge. Both groups were instructed to perform standard rotator cuff stretching and strengthening exercises for 6 weeks. The use of non-steroid anti-inflammatory drugs was prohibited. Patients were evaluated before and 6 weeks and 6 months after treatment using the Constant score, visual analogue scale (VAS) for pain, and range of motion (ROM) of the shoulder. No local or systemic complication occurred. Improvement in the Constant score and VAS for pain at week 6 and month 6 was significantly better following steroid than PRP injection. The difference in the Constant score was greater than the mean clinically important difference of 10.4. Nonetheless, the 2 groups were comparable for improvement in ROM of the shoulder. Steroid injection was more effective than PRP injection for treatment of SIS in terms of the Constant score and VAS for pain at 6 weeks and 6 months.

The Effect of Paid Leave on Maternal Mental Health.

PubMed

Mandal, Bidisha

2018-06-07

Objectives I examined the relationship between paid maternity leave and maternal mental health among women returning to work within 12 weeks of childbirth, after 12 weeks, and those returning specifically to full-time work within 12 weeks of giving birth. Methods I used data from 3850 women who worked full-time before childbirth from the Early Childhood Longitudinal Study-Birth Cohort. I utilized propensity score matching techniques to address selection bias. Mental health was measured using the Center for Epidemiologic Studies Depression (CESD) scale, with high scores indicating greater depressive symptoms. Results Returning to work after giving birth provided psychological benefits to women who used to work full-time before childbirth. The average CESD score of women who returned to work was 0.15 standard deviation (p < 0.01) lower than the average CESD score of all women who worked full-time before giving birth. Shorter leave, on the other hand, was associated with adverse effects on mental health. The average CESD score of women who returned within 12 weeks of giving birth was 0.13 standard deviation higher (p < 0.05) than the average CESD score of all women who rejoined labor market within 9 months of giving birth. However, receipt of paid leave was associated with an improved mental health outcome. Among all women who returned to work within 12 weeks of childbirth, those women who received some paid leave had a 0.17 standard deviation (p < 0.05) lower CESD score than the average CESD score. The result was stronger for women who returned to full-time work within 12 weeks of giving birth, with a 0.32 standard deviation (p < 0.01) lower CESD score than the average CESD score. Conclusions The study revealed that the negative psychological effect of early return to work after giving birth was alleviated when women received paid leave.

Bayesian Model Averaging for Propensity Score Analysis

ERIC Educational Resources Information Center

Kaplan, David; Chen, Jianshen

2013-01-01

The purpose of this study is to explore Bayesian model averaging in the propensity score context. Previous research on Bayesian propensity score analysis does not take into account model uncertainty. In this regard, an internally consistent Bayesian framework for model building and estimation must also account for model uncertainty. The…

Management of acute unstable distal clavicle fracture with a modified coracoclavicular stabilization technique using a bidirectional coracoclavicular loop system.

PubMed

Kanchanatawan, Wichan; Wongthongsalee, Ponrachai

2016-02-01

Fracture of the distal clavicle is not uncommon. Despite the vast literature available for the management of this fracture, there is no consensus regarding the gold standard treatment for this fracture. To assess the clinical and radiographic outcomes and complications of acute unstable distal clavicle fracture when treated by a modified coracoclavicular stabilization technique using a bidirectional coracoclavicular loop system. Thirty-nine patients (32 males, 7 females) with acute unstable distal clavicle fractures treated by modified coracoclavicular stabilization using the surgical technique of bidirectional coracoclavicular (CC) loops seated behind the coracoacromial (CA) ligament were retrospectively reviewed. Mean follow-up time was 35.7 months (range 24-47 months). The outcomes measured included union rate, union time, CC distances when compared to the patients' uninjured shoulders, and the Constant and ASES shoulder scores, which were evaluated 6 months after surgery. All fractures displayed clinical union within 13 weeks postoperatively. The mean union time was 9.2 weeks (range 7-13 weeks). At the time of union, the CC distances on the affected shoulders were on average 0.9 mm (range 0-1.6 mm) longer than the unaffected shoulders. At 6 months after surgery, the Constant and ASES scores were on average 93.4 (72-100) and 91.5 (75-100), respectively. No complications related to the fixation loops, musculocutaneous nerve injuries, or fractures of coracoid or clavicle were recorded. One case of surgical wound dehiscence was observed due to superficial infection. Enlargement of the clavicle drill hole without migration of the buttons was observed in 9 out of 16 cases at a follow-up time of at least 30 months after the original operation. Modified CC stabilization using bidirectional CC loops seated behind the CA ligament is a simple surgical technique that naturally restores stability to the distal clavicle fracture. It also produces predictable outcomes, a high union rate, good to excellent shoulder function, and a low complication rate. The buttons and suture loops were routinely removed in a second operation in order to prevent late stress fracture of the clavicle.

{sup 18}F-FLT uptake kinetics in head and neck squamous cell carcinoma: A PET imaging study

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

Liu, Dan, E-mail: dan.liu@oncology.ox.ac.uk; Fenwick, John D.; Chalkidou, Anastasia

2014-04-15

Purpose: To analyze the kinetics of 3{sup ′}-deoxy-3{sup ′}-[F-18]-fluorothymidine (18F-FLT) uptake by head and neck squamous cell carcinomas and involved nodes imaged using positron emission tomography (PET). Methods: Two- and three-tissue compartment models were fitted to 12 tumor time-activity-curves (TACs) obtained for 6 structures (tumors or involved nodes) imaged in ten dynamic PET studies of 1 h duration, carried out for five patients. The ability of the models to describe the data was assessed using a runs test, the Akaike information criterion (AIC) and leave-one-out cross-validation. To generate parametric maps the models were also fitted to TACs of individual voxels.more » Correlations between maps of different parameters were characterized using Pearson'sr coefficient; in particular the phosphorylation rate-constants k{sub 3-2tiss} and k{sub 5} of the two- and three-tissue models were studied alongside the flux parameters K{sub FLT-2tiss} and K{sub FLT} of these models, and standardized uptake values (SUV). A methodology based on expectation-maximization clustering and the Bayesian information criterion (“EM-BIC clustering”) was used to distil the information from noisy parametric images. Results: Fits of two-tissue models 2C3K and 2C4K and three-tissue models 3C5K and 3C6K comprising three, four, five, and six rate-constants, respectively, pass the runs test for 4, 8, 10, and 11 of 12 tumor TACs. The three-tissue models have lower AIC and cross-validation scores for nine of the 12 tumors. Overall the 3C6K model has the lowest AIC and cross-validation scores and its fitted parameter values are of the same orders of magnitude as literature estimates. Maps ofK{sub FLT} and K{sub FLT-2tiss} are strongly correlated (r = 0.85) and also correlate closely with SUV maps (r = 0.72 for K{sub FLT-2tiss}, 0.64 for K{sub FLT}). Phosphorylation rate-constant maps are moderately correlated with flux maps (r = 0.48 for k{sub 3-2tiss} vs K{sub FLT-2tiss} and r = 0.68 for k{sub 5} vs K{sub FLT}); however, neither phosphorylation rate-constant correlates significantly with SUV. EM-BIC clustering reduces the parametric maps to a small number of levels—on average 5.8, 3.5, 3.4, and 1.4 for K{sub FLT-2tiss}, K{sub FLT}, k{sub 3-2tiss}, and k{sub 5.} This large simplification is potentially useful for radiotherapy dose-painting, but demonstrates the high noise in some maps. Statistical simulations show that voxel level noise degrades TACs generated from the 3C6K model sufficiently that the average AIC score, parameter bias, and total uncertainty of 2C4K model fits are similar to those of 3C6K fits, whereas at the whole tumor level the scores are lower for 3C6K fits. Conclusions: For the patients studied here, whole tumor FLT uptake time-courses are represented better overall by a three-tissue than by a two-tissue model. EM-BIC clustering simplifies noisy parametric maps, providing the best description of the underlying information they contain and is potentially useful for radiotherapy dose-painting. However, the clustering highlights the large degree of noise present in maps of the phosphorylation rate-constantsk{sub 5} and k{sub 3-2tiss}, which are conceptually tightly linked to cellular proliferation. Methods must be found to make these maps more robust—either by constraining other model parameters or modifying dynamic imaging protocols.« less

Impact of Measurement Error on Statistical Power: Review of an Old Paradox.

ERIC Educational Resources Information Center

Williams, Richard H.; And Others

1995-01-01

The paradox that a Student t-test based on pretest-posttest differences can attain its greatest power when the difference score reliability is zero was explained by demonstrating that power is not a mathematical function of reliability unless either true score variance or error score variance is constant. (SLD)

Pledgeted repair of giant hiatal hernia provides excellent long-term results.

PubMed

Kang, Thomas; Urrego, Hernan; Gridley, Asahel; Richardson, William S

2014-10-01

Use of mesh in hiatal hernia repairs is a topic of debate. We present our experience in laparoscopic primary (nonmesh) repair of giant hiatal hernia. All laparoscopic antireflux procedures done by a single surgeon from November 1997 to October 2006 were retrospectively reviewed. Inclusion criteria were primary crural closure with pledgets and giant hiatal hernia (greater than one-third of the stomach in the chest by esophagram, greater than 5 cm in length endoscopically, or greater than one-third of the stomach in the chest operatively). We attempted to reach all patients who met inclusion criteria and administered the Reflux Symptom Index (RSI) and Quality of Life Scale for Gastroesophageal Reflux Disease (QLSGR) questionnaires. In total, 89 patients met inclusion criteria. The male-to-female ratio was 32:57. Average age was 62.7 years. Average body mass index was 29.3 kg/m(2). Average length of stay was 2 days, and mean clinic follow-up was 161 days. At the most recent follow-up, 62% of patients were asymptomatic. The most common postoperative symptoms were dysphagia (16%), reflux/emesis (5%), bloating (5%), nausea (4%), epigastric pain (4%), and heartburn (3%). There were six (6.7%) recurrences on esophagogastroduodenoscopy or upper gastrointestinal examination. Five patients with recurrence were symptomatic. Of the 89 patients, 29 (33%) completed the questionnaire, with a mean follow-up of 69.7 months. Average RSI score was 12 (maximum possible score, 45). In six of nine categories, the average score was less than 1 (possible score, 0-5). Average QLSGR score was 12 (maximum possible score, 45). For satisfaction with the present condition, the average score was 4.34 (maximum score, 5), and 82.7% of respondents were satisfied or very satisfied with their present condition. Laparoscopic primary repair of giant hiatal hernia provides excellent long-term results. We found that 62% of patients were asymptomatic at the last follow-up and that 82% of respondents were satisfied or very satisfied. The recurrence rate was 6.7%.

Peer Teaching to Foster Learning in Physiology.

PubMed

Srivastava, Tripti K; Waghmare, Lalitbhushan S; Mishra, Ved Prakash; Rawekar, Alka T; Quazi, Nazli; Jagzape, Arunita T

2015-08-01

Peer teaching is an effective tool to promote learning and retention of knowledge. By preparing to teach, students are encouraged to construct their own learning program, so that they can explain effectively to fellow learners. Peer teaching is introduced in present study to foster learning and pedagogical skills amongst first year medical under-graduates in physiology with a Hypothesis that teaching is linked to learning on part of the teacher. Non-randomized, Interventional study, with mixed methods design. Cases experienced peer teaching whereas controls underwent tutorials for four consecutive classes. Quantitative Evaluation was done through pre/post test score analysis for Class average normalized gain and tests of significance, difference in average score in surprise class test after one month and percentage of responses in closed ended items of feedback questionnaire. Qualitative Evaluation was done through categorization of open ended items and coding of reflective statements. The average pre and post test score was statistically significant within cases (p = 0.01) and controls (p = 0.023). The average post test scores was more for cases though not statistically significant. The class average normalized gain (g) for Tutorials was 49% and for peer teaching 53%. Surprise test had average scoring of 36 marks (out of 50) for controls and 41 marks for cases. Analysed section wise, the average score was better for Long answer question (LAQ) in cases. Section wise analysis suggested that through peer teaching, retention was better for descriptive answers as LAQ has better average score in cases. Feedback responses were predominantly positive for efficacy of peer teaching as a learning method. The reflective statements were sorted into reflection in action, reflection on action, claiming evidence, describing experience, and recognizing discrepancies. Teaching can stimulate further learning as it involves interplay of three processes: metacognitive awareness; deliberate practice, and self-explanation. Coupled with immediate feedback and reflective exercises, learning can be measurably enhanced along with improved teaching skills.

Peer Teaching to Foster Learning in Physiology

PubMed Central

Srivastava, Tripti K; Waghmare, Lalitbhushan S.; Mishra, Ved Prakash; Rawekar, Alka T; Quazi, Nazli; Jagzape, Arunita T

2015-01-01

Introduction Peer teaching is an effective tool to promote learning and retention of knowledge. By preparing to teach, students are encouraged to construct their own learning program, so that they can explain effectively to fellow learners. Peer teaching is introduced in present study to foster learning and pedagogical skills amongst first year medical under-graduates in physiology with a Hypothesis that teaching is linked to learning on part of the teacher. Materials and Methods Non-randomized, Interventional study, with mixed methods design. Cases experienced peer teaching whereas controls underwent tutorials for four consecutive classes. Quantitative Evaluation was done through pre/post test score analysis for Class average normalized gain and tests of significance, difference in average score in surprise class test after one month and percentage of responses in closed ended items of feedback questionnaire. Qualitative Evaluation was done through categorization of open ended items and coding of reflective statements. Results The average pre and post test score was statistically significant within cases (p = 0.01) and controls (p = 0.023). The average post test scores was more for cases though not statistically significant. The class average normalized gain (g) for Tutorials was 49% and for peer teaching 53%. Surprise test had average scoring of 36 marks (out of 50) for controls and 41 marks for cases. Analysed section wise, the average score was better for Long answer question (LAQ) in cases. Section wise analysis suggested that through peer teaching, retention was better for descriptive answers as LAQ has better average score in cases. Feedback responses were predominantly positive for efficacy of peer teaching as a learning method. The reflective statements were sorted into reflection in action, reflection on action, claiming evidence, describing experience, and recognizing discrepancies. Conclusion Teaching can stimulate further learning as it involves interplay of three processes: metacognitive awareness; deliberate practice, and self-explanation. Coupled with immediate feedback and reflective exercises, learning can be measurably enhanced along with improved teaching skills. PMID:26435969

General and disease-specific use of outcomes scores for the shoulder: a survey of AOSSM, AANA, and ISAKOS members.

PubMed

Provencher, Matthew T; Frank, Rachel M; Scuderi, Matthew G; Solomon, Daniel J; Ghodadra, Neil S; Bach, Bernard R; McCarty, Eric; Romeo, Anthony A

2014-09-01

To report on the knowledge and use of both general and disease-specific shoulder outcomes scores among orthopedic surgeons. A 22-question Internet survey was administered to members of the American Orthopaedic Society for Sports Medicine, the Arthroscopy Association of North American, and the International Society of Arthroscopy, Knee Surgery, and Orthopedic Sports Medicine via voluntary e-mail participation. Questions targeted demographic information, preferred surgical management of shoulder conditions, and the preferred use of shoulder outcomes instruments in clinical practice. Excluding defunct and duplicate e-mails among membership societies, a total of 3892 unique e-mails were sent, from which 1129 surveys were returned and were fully completed (29%). The largest number of respondents were in private practice (52%); 21% were in academia; and 26% were in a mix of settings. As for location, 74% practiced in the United States, 10% in Europe, 8% in Mexico/South America, and 6% in Asia. A total of 31% total respondents used scores all or most of the time, and 30% used scores at least some of the time. Respondents felt that the 3 most commonly utilized shoulder scores were the American Shoulder and Elbow Surgeons (ASES) score, the University of California at Los Angeles (UCLA) score, and the Constant score. The majority of respondents (76%) performed all-arthroscopic instability repairs. The ASES and Western Ontario Shoulder Instability Index (WOSI) scores were the most preferred measures to monitor instability patients, whether or not the scores were actually implemented in their practice. Most perform between 10 and 25 superior labrum anterior-posterior repairs per year and preferred the ASES, UCLA, and Constant scores for these repairs; rotator cuff repair preferred outcomes instruments were similar. When asked to choose 1 score for all shoulder conditions, the ASES was the clear favorite. This study reports the knowledge and utilization of shoulder scores for both general and disease-specific conditions. Most respondents preferred the ASES score for most shoulder conditions; however, other scores, such as the WOSI, the Constant, and the Short-Form (SF)-36/12, were popular. This information offers insight into the current and future use of shoulder outcomes both for general and disease-specific use.

Using Technology to Expand and Enhance Applied Behavioral Analysis Programs for Children with Autism in Military Families

DTIC Science & Technology

2013-07-01

on the BISWA on the pretest to an average score of 100% on the BISWA posttest , whereas the participants in the control group showed...only a 1% improvement from the pretest to the posttest . On the BISPA, participants in the test group improved from an average score of 0% during...the pretest to an average score of 100% during the posttest , whereas participants in the control group showed no improvement from pretest to

Clavicular hook plate for grade-III acromioclavicular dislocation.

PubMed

Steinbacher, Gilbert; Sallent, Andrea; Seijas, Roberto; Boffa, Juan Manuel; Espinosa, Wenceslao; Cugat, Ramón

2014-12-01

To review the outcomes of clavicular hook plate fixation for grade-III acromioclavicular (AC) dislocation in young athletes. Medical records of 14 male and 5 female athletes aged 18 to 49 (mean, 29) years who underwent fixation with a 3.5-mm-thick, 15-mm-long clavicular hook plate for acute grade-III AC dislocation were reviewed. The visual analogue score for pain and the Constant shoulder score were assessed. The mean follow-up was 4.2 years. The mean visual analogue score for pain was 1.8 (range, 1-3). The Constant shoulder score was excellent (≥ 90) in 14 patients and good (83-89) in 5 patients. All patients achieved range of motion equal to that of the contralateral side at week 5. Sports activities were resumed by month 6 at the latest. The clavicular hook plate for grade- III AC dislocation enables quick return to sports activities and achieves good-to-excellent functional outcome.

Genetic polymorphisms in varied environments.

PubMed

Powell, J R

1971-12-03

Thirteen experimenital populationis of Drosophila willistoni were maintained in cages, in some of which the environments were relatively constant and in others varied. After 45 weeks, the populations were assayed by gel electrophoresis for polymorphisms at 22 protein loci. The average heterozygosity per individual and the average unmber of alleles per locus were higher in populations maintained in heterogeneous environments than in populations in more constant enviroments.

Cosmological measure with volume averaging and the vacuum energy problem

NASA Astrophysics Data System (ADS)

Astashenok, Artyom V.; del Popolo, Antonino

2012-04-01

In this paper, we give a possible solution to the cosmological constant problem. It is shown that the traditional approach, based on volume weighting of probabilities, leads to an incoherent conclusion: the probability that a randomly chosen observer measures Λ = 0 is exactly equal to 1. Using an alternative, volume averaging measure, instead of volume weighting can explain why the cosmological constant is non-zero.

[Effects of training of human intestinal parasitic diseases for basic health staff in Jiangsu Province].

PubMed

Jiang, Wen-cai; Li, Jian; Xu, Xiang-zhen; Shen, Ming-xue; Jin, Xiao-lin

2013-08-01

To evaluate the effect of the training of human intestinal parasitic diseases for basic health staff. A workshop including theory courses and practical operations was carried out. At the end of the workshop, the effects were evaluated through the examinations of theory and film-reading. The total score of film-reading was one hundred including reading ten modified thick Kato-Katz slides in five minutes per slide. The results were analyzed statistically with SAS 9.0. There were 162 trainees from 13 cities. All of them took part in the final examination. The highest score of theory test was 99 and the lowest was 60 with the average of 86.3. The average score of the female was higher than that of the male, and the average score of 30-40 years' age group was higher than that of the other groups. The average score of the staff in Northern Jiangsu Province was higher than that of the staff in southern area and middle area of Jiangsu Province (P < 0.05). The highest score of film-reading was 100 and the lowest score was 20 with the average of 73.4. Among the total 9 species, the egg detection rates of five species were more than 60.00%. The detection rate of Trichuris trichiura was highest (88.17%) and the rate of Taenia was only 14.7%. The total average score of the staff in Nanjing City was highest (181.3) and the score of the staff in Changzhou City was lowest (138.3). There were significant differences among different regions (P < 0.05). The technical capability of examining the human intestinal parasitic diseases of basic health staff is different among the different regions of Jiangsu Province. We still need to strengthen the capability of pathogen detection for basic health staff.

Finite-Temperature Behavior of PdH x Elastic Constants Computed by Direct Molecular Dynamics

DOE PAGES

Zhou, X. W.; Heo, T. W.; Wood, B. C.; ...

2017-05-30

In this paper, robust time-averaged molecular dynamics has been developed to calculate finite-temperature elastic constants of a single crystal. We find that when the averaging time exceeds a certain threshold, the statistical errors in the calculated elastic constants become very small. We applied this method to compare the elastic constants of Pd and PdH 0.6 at representative low (10 K) and high (500 K) temperatures. The values predicted for Pd match reasonably well with ultrasonic experimental data at both temperatures. In contrast, the predicted elastic constants for PdH 0.6 only match well with ultrasonic data at 10 K; whereas, atmore » 500 K, the predicted values are significantly lower. We hypothesize that at 500 K, the facile hydrogen diffusion in PdH 0.6 alters the speed of sound, resulting in significantly reduced values of predicted elastic constants as compared to the ultrasonic experimental data. Finally, literature mechanical testing experiments seem to support this hypothesis.« less

Cochlear implantation: An assessment of quality and readability of web-based information aimed at patients.

PubMed

Seymour, Nicky; Lakhani, Raj; Hartley, Benjamin; Cochrane, Lesley; Jephson, Christopher

2015-01-01

Patients should have access to high-quality health information websites on which to base their decision-making. There are concerns regarding the accuracy and quality of some health websites. We aimed to objectively measure website quality related to cochlear implantation. Selected patient-information websites were scored, depending on how highly they ranked on search engines and if they were ranked on more than one of the search engines used. The top 40 websites from three major search engines were analysed. The quality of each website was scored using the DISCERN tool and the readability was scored using the Flesch-Kincaid reading ease and the Gunning-Fog index. The average Flesch-Kincaid score was 49.7, giving an average reading age of a 15-17 years old, and the average Gunning-fog score was 13.1, which equals that of an 18 years old. Internet-based information regarding cochlear implantation is of varied quality and is written above the expected reading level of an average person.

Readability assessment of online thyroid surgery patient education materials.

PubMed

Patel, Chirag R; Cherla, Deepa V; Sanghvi, Saurin; Baredes, Soly; Eloy, Jean Anderson

2013-10-01

Published guidelines recommend written health information be written at or below the sixth-grade level. We evaluate the readability of online materials related to thyroid surgery. Thyroid surgery materials were evaluated using Flesch Reading Ease Score (FRES), Flesch Kincaid Grade Level (FKGL), Gunning Frequency of Gobbledygook (GFOG), and Simple Measure of Gobbledygook (SMOG). Thirty-one documents were evaluated. FRES scores ranged from 29.3 to 67.8 (possible range = 0 to 100), and averaged 50.5. FKGL ranged from 6.9 to 14.9 (possible range = 3 to 12), and averaged 10.4. SMOG scores ranged from 11.8 to 14.5 (possible range = 3 to 19), and averaged 13.0. GFOG scores ranged from 10.6 to 18.0 (possible range = 3 to 19), and averaged 13.5. Readability scores for online thyroid surgery materials are higher (i.e., more difficult) than the recommended levels. However, readability is only one aspect of comprehension. Written information should be designed with that fact in mind. Copyright © 2013 Wiley Periodicals, Inc.

Diurnal variation in ruminal pH on the digestibility of highly digestible perennial ryegrass during continuous culture fermentation.

PubMed

Wales, W J; Kolver, E S; Thorne, P L; Egan, A R

2004-06-01

Dairy cows grazing high-digestibility pastures exhibit pronounced diurnal variation in ruminal pH, with pH being below values considered optimal for digestion. Using a dual-flow continuous culture system, the hypothesis that minimizing diurnal variation in pH would improve digestion of pasture when pH was low, but not at a higher pH, was tested. Four treatments were imposed, with pH either allowed to exhibit normal diurnal variation around an average pH of 6.1 or 5.6, or maintained at constant pH. Digesta samples were collected during the last 3 d of each of four, 9-d experimental periods. A constant pH at 5.6 compared with a constant pH of 6.1 reduced the digestibility of organic matter (OM), neutral detergent (NDF), and acid detergent fiber (ADF) by 7, 14, and 21%, respectively. When pH was allowed to vary (averaging 5.6), digestion of OM, NDF, and ADF were reduced by 15,30, and 36%, respectively, compared with pH varying at 6.1. There was little difference in digestion parameters when pH was either constant or varied with an average pH of 6.1. However, when average pH was 5.6, maintaining a constant pH significantly increased digestion of OM, NDF, and ADF by 5, 25, and 24% compared with a pH that exhibited normal diurnal variation. These in vitro results show that gains in digestibility and potential milk production can be made by minimizing diurnal variation in ruminal pH, but only when ruminal pH is low (5.6). However, larger gains in productivity can be achieved by increasing average daily ruminal pH from 5.6 to 6.1.

Rural Health, Center of Excellence for Remote and Medically Under-served Area (CERMUSA)

DTIC Science & Technology

2007-05-01

Pretest I Posttest of Cognitive Knowledge, • Pretest I Posttest of Knowledge (Self Perception), • VCS Feature Comparison. Pretest I Posttest of Cognitive...This measurement was the change between the pretest and posttest scores. Figure 6 represents the average pretest , posttest , and difference scores for...to the educational intervention, each case student’s average posttest scores increased over the pretest scores. Also, in each case, the

Childhood socioeconomic status amplifies genetic effects on adult intelligence.

PubMed

Bates, Timothy C; Lewis, Gary J; Weiss, Alexander

2013-10-01

Studies of intelligence in children reveal significantly higher heritability among groups with high socioeconomic status (SES) than among groups with low SES. These interaction effects, however, have not been examined in adults, when between-families environmental effects are reduced. Using 1,702 adult twins (aged 24-84) for whom intelligence assessment data were available, we tested for interactions between childhood SES and genetic effects, between-families environmental effects, and unique environmental effects. Higher SES was associated with higher mean intelligence scores. Moreover, the magnitude of genetic influences on intelligence was proportional to SES. By contrast, environmental influences were constant. These results suggest that rather than setting lower and upper bounds on intelligence, genes multiply environmental inputs that support intellectual growth. This mechanism implies that increasing SES may raise average intelligence but also magnifies individual differences in intelligence.

Exploring the relationship between population density and maternal health coverage.

PubMed

Hanlon, Michael; Burstein, Roy; Masters, Samuel H; Zhang, Raymond

2012-11-21

Delivering health services to dense populations is more practical than to dispersed populations, other factors constant. This engenders the hypothesis that population density positively affects coverage rates of health services. This hypothesis has been tested indirectly for some services at a local level, but not at a national level. We use cross-sectional data to conduct cross-country, OLS regressions at the national level to estimate the relationship between population density and maternal health coverage. We separately estimate the effect of two measures of density on three population-level coverage rates (6 tests in total). Our coverage indicators are the fraction of the maternal population completing four antenatal care visits and the utilization rates of both skilled birth attendants and in-facility delivery. The first density metric we use is the percentage of a population living in an urban area. The second metric, which we denote as a density score, is a relative ranking of countries by population density. The score's calculation discounts a nation's uninhabited territory under the assumption those areas are irrelevant to service delivery. We find significantly positive relationships between our maternal health indicators and density measures. On average, a one-unit increase in our density score is equivalent to a 0.2% increase in coverage rates. Countries with dispersed populations face higher burdens to achieve multinational coverage targets such as the United Nations' Millennial Development Goals.

Knowledge about primary health care among medical students from public and private medical universities of Karachi, Pakistan.

PubMed

Ehsan, Rubab; Hirani, Rahul; Bhesania, Nasha Homi; Zehra, Nosheen

2017-10-01

Primary health care (PHC) is the best approach to achieve health goals in a country. As medical students are a prominent part of future health care providers, it is important to assess their knowledge regarding basic concepts and functions of PHC. Total 400 medical students, 200 (50%) each from public and private medical universities responded in this study. Mean score was 15.21 ± 2.43 and 14.9 ± 2.89 respectively with no significant difference (P=0.370). On the basis of mean score the data is dichotomized into two groups i.e. above average and average (score > 15) and below average (score <15). Hence, 137 (68.5%) students from public and 131 (65.5%) students from the private university fell in the average and above average category. This study shows challenges related to the knowledge and the medical students' level of understanding of the functioning of PHC system.

Extra compressibility terms for Favre-averaged two-equation models of inhomogeneous turbulent flows

NASA Technical Reports Server (NTRS)

Rubesin, Morris W.

1990-01-01

Forms of extra-compressibility terms that result from use of Favre averaging of the turbulence transport equations for kinetic energy and dissipation are derived. These forms introduce three new modeling constants, a polytropic coefficient that defines the interrelationships of the pressure, density, and enthalpy fluctuations and two constants in the dissipation equation that account for the non-zero pressure-dilitation and mean pressure gradients.

Flooded area and plant zonation in isolated wetlands in well fields in the Northern Tampa Bay Region, Florida, following reductions in groundwater-withdrawal rates

USGS Publications Warehouse

Haag, Kim H.; Pfeiffer, William R.

2012-01-01

WAP scores and weighted average scores for wetland vegetation were generally consistent with the results of the flooded area analysis. The WAP scores and weighted average scores were higher overall and did not decline with time at four wetlands in well fields (W-33, W-56, Starkey N, and Starkey 108) during the years following reductions in groundwater-withdrawal rates. These four wetlands also had increases in the extent and duration of the flooded area during the post-reduction period. Scores for trees were more consistent than scores for shrubs and groundcover. WAP scores remained relatively low or generally declined at five well-field wetlands (Q-1, W-17, W-41, Starkey D, and Starkey E) during the years following reductions in groundwater-withdrawal rates, and weighted average scores either declined over time or remained low. These five wetlands either did not have an increase in the extent and duration of the flooded area, or if there was an increase, it was small.

The influence of community well-being on mortality among Registered First Nations people.

PubMed

Oliver, Lisa N; Penney, Chris; Peters, Paul A

2016-07-20

Living in a community with lower socioeconomic status is associated with higher mortality. However, few studies have examined associations between community socioeconomic characteristics and mortality among the First Nations population. The 1991-to-2006 Census Mortality and Cancer Cohort follow-up, which tracked a 15% sample of Canadians aged 25 or older, included 57,300 respondents who self-identified as Registered First Nations people or Indian band members. The Community Well-Being Index (CWB), a measure of the social and economic well-being of communities, consists of income, education, labour force participation, and housing components. A dichotomous variable was used to indicate residence in a community with a CWB score above or below the average for First Nations communities. Age-standardized mortality rates (ASMRs) were calculated for First Nations cohort members in communities with CWB scores above and below the First Nations average. Cox proportional hazards models examined the impact of CWB when controlling for individual characteristics. The ASMR for First Nations cohort members in communities with a below-average CWB was 1,057 per 100,000 person-years at risk, compared with 912 for those in communities with an above-average CWB score. For men, living in a community with below-average income and labour force participation CWB scores was associated with an increased hazard of death, even when individual socioeconomic characteristics were taken into account. Women in communities with below-average income scores had an increased hazard of death. First Nations people in communities with below-average CWB scores tended to have higher mortality rates. For some components of the CWB, effects remained even when individual socioeconomic characteristics were taken into account.

Falling Behind: New Evidence on the Black-White Achievement Gap

ERIC Educational Resources Information Center

Levitt, Steven D.; Fryer, Roland G.

2004-01-01

On average, black students typically score one standard deviation below white students on standardized tests--roughly the difference in performance between the average 4th grader and the average 8th grader. Historically, what has come to be known as the black-white test-score gap has emerged before children enter kindergarten and has tended to…

ACT Average Composite by State: 2000 ACT-Tested Graduates.

ERIC Educational Resources Information Center

American Coll. Testing Program, Iowa City, IA.

This table contains average composite scores by state for high school graduates who took the ACT Assessment in 2000. For each state the percentage of graduates taking the ACT Assessment and the average composite score are given, with the same information for those who completed the recommended core curriculum and those who did not, as well as for…

Nonadiabatic rate constants for proton transfer and proton-coupled electron transfer reactions in solution: Effects of quadratic term in the vibronic coupling expansion

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

Soudackov, Alexander V.; Hammes-Schiffer, Sharon

2015-11-21

Rate constant expressions for vibronically nonadiabatic proton transfer and proton-coupled electron transfer reactions are presented and analyzed. The regimes covered include electronically adiabatic and nonadiabatic reactions, as well as high-frequency and low-frequency proton donor-acceptor vibrational modes. These rate constants differ from previous rate constants derived with the cumulant expansion approach in that the logarithmic expansion of the vibronic coupling in terms of the proton donor-acceptor distance includes a quadratic as well as a linear term. The analysis illustrates that inclusion of this quadratic term in the framework of the cumulant expansion framework may significantly impact the rate constants at highmore » temperatures for proton transfer interfaces with soft proton donor-acceptor modes that are associated with small force constants and weak hydrogen bonds. The effects of the quadratic term may also become significant in these regimes when using the vibronic coupling expansion in conjunction with a thermal averaging procedure for calculating the rate constant. In this case, however, the expansion of the coupling can be avoided entirely by calculating the couplings explicitly for the range of proton donor-acceptor distances sampled. The effects of the quadratic term for weak hydrogen-bonding systems are less significant for more physically realistic models that prevent the sampling of unphysical short proton donor-acceptor distances. Additionally, the rigorous relation between the cumulant expansion and thermal averaging approaches is clarified. In particular, the cumulant expansion rate constant includes effects from dynamical interference between the proton donor-acceptor and solvent motions and becomes equivalent to the thermally averaged rate constant when these dynamical effects are neglected. This analysis identifies the regimes in which each rate constant expression is valid and thus will be important for future applications to proton transfer and proton-coupled electron transfer in chemical and biological processes.« less

[Intramedullary stabilisation of displaced midshaft clavicular fractures: does the fracture pattern (simple vs. complex) influence the anatomic and functional result].

PubMed

Langenhan, R; Reimers, N; Probst, A

2014-12-01

Displaced midshaft clavicular fractures are often treated operatively. The most common way of treatment is plating. Elastic stable intramedullary nailing (ESIN) is an alternative, but seldom used. Studies showed comparable or even better results for intramedullary nailing than for plating in simple 2- or 3-fragment midshaft fractures. The indication of ESIN for multifragmentary clavicular fractures is discussed critically in the literature because of reduced primary stability and danger of secondary shortening. Until now only few studies report functional results after fracture healing depending on the fracture type. To the best of our knowledge there is no study showing significantly worse functional scores for ESIN in complex displaced midshaft fractures. The objective of this study was to examine anatomic and functional results of simple (2 or 3 fragments, OTA type 15B1 and 15B2) and complex (multifragmentary, OTA type 15B3) displaced midshaft clavicula fractures after internal fixation. Between 2009 and 2012, 40 patients (female/male 10/30; mean age 33 [16-60] years) with closed displaced midshaft clavicular fractures were treated by open reduction and ESIN (Titanium Elastic Nail [TEN], Synthes, Umkirch, Germany). Thirty-seven patients were retrospectively analysed after a mean of 27 (12-43) months. Twenty patients (group A) had simple fractures (OTA type 15B1 and 15B2), 17 patients (group B) had complex fractures (OTA type 15B3). All shoulder joints were postoperatively treated functionally for six weeks without weight limited to 90° abduction/flexion. Both groups were comparable in gender, age, body mass index, months until metal removal, number of physiotherapy sessions and time until follow-up examination. Joint function (neutral zero method) and strength (standing patient with arm in 90° abduction, holding 1-12 kg for 5 sec) in both shoulders were documented. The distance between the centre of the jugulum and the lateral acromial border was measured for both sides. The DASH, Constant-Murley, Oxford shoulder and clavicular scores (Jubel) were calculated. Patients documented contentedness of outcome by VAS between 0 (absolute discontented) and 10 (very contented). Complications were recorded. Operatively treated displaced midshaft clavicular fractures. in comparison to the healthy side in group A had an average shortening of 5 (0-20) mm and in group B of 10 (3-25) mm, with a statistical significance between both groups. Patients of both groups were very contented with the results (VAS group A: 9.6; B: 9.5). DASH score (group A: 28; B: 3.1), Constant-Murley score (group A: 95.0; B: 93.8), Oxford shoulder score (group A: 46.2; B: 45.9) and the clavicula score (Jubel) (group A: 1.2; B: 2.1) were comparable between both groups without significance. In 4 patients (11%) complications occurred. Once (group B) an infection was seen, three times (group B) the ESIN had to be shortened on the medial side because of telescoping. Open ESIN of simple and complex displaced midshaft clavicular fractures leads after an average of 27 months to good or even excellent results. Healing of the clavicle in a modestly shortened position does not impair the patient. Georg Thieme Verlag KG Stuttgart · New York.

[Evaluation of the influence of humidity and temperature on the drug stability by initial average rate experiment].

PubMed

He, Ning; Sun, Hechun; Dai, Miaomiao

2014-05-01

To evaluate the influence of temperature and humidity on the drug stability by initial average rate experiment, and to obtained the kinetic parameters. The effect of concentration error, drug degradation extent, humidity and temperature numbers, humidity and temperature range, and average humidity and temperature on the accuracy and precision of kinetic parameters in the initial average rate experiment was explored. The stability of vitamin C, as a solid state model, was investigated by an initial average rate experiment. Under the same experimental conditions, the kinetic parameters obtained from this proposed method were comparable to those from classical isothermal experiment at constant humidity. The estimates were more accurate and precise by controlling the extent of drug degradation, changing humidity and temperature range, or by setting the average temperature closer to room temperature. Compared with isothermal experiments at constant humidity, our proposed method saves time, labor, and materials.

Outcome of locking compression plates in humeral shaft nonunions

PubMed Central

Kumar, Malhar N; Ravindranath, V Pratap; Ravishankar, MR

2013-01-01

Background: Nonunion of diaphyseal fractures of the humerus are frequently seen in clinical practice (incidence of up to 15% in certain studies) and osteosynthesis using dynamic compression plates, intra medullary nails and Ilizarov fixators have been reported previously. Locking compression plates (LCP) are useful in the presence of disuse osteoporosis, segmental bone loss and cortical defects that preclude strong fixation. We report a prospective followup study of the outcome of the use of LCP for humeral nonunion following failed internal fixation in which implants other than LCP had been used. Materials and Methods: Twenty four patients with nonunion of humeral shaft fractures following failed internal fixation were included in the study. The mean followup period was 3.4 years (range: 2.4 to 5.7 years) and the minimum followup period was 2 years. Mean age of the patients was 41.04 years (range: 24 to 57 years). All 24 patients underwent osteosynthesis using LCP and autologous bone grafting (cortico-cancellous iliac crest graft combined with or without fibular strut graft). Main outcome measurements included radiographic assessment of fracture union and pre and postoperative functional evaluation using the modified Constant and Murley scoring system. Results: 23 out of 24 fractures united following osteosynthesis. Average time to union was 16 weeks (range: 10 to 28 weeks). Complications included delayed union (n = 2), transient radial nerve palsy (n = 2) and persistent nonunion (n = 1). Functional evaluation using the Constant and Murley score showed excellent results in 11, good in 10, fair in two and poor outcome in one patient. Conclusions: Locking compression plating and cancellous bone grafting is a reliable option for achieving union in humeral diaphyseal nonunion with failed previous internal fixation and results in good functional outcome in patients with higher physiological demands. PMID:23682176

Customer care. Patient satisfaction in the prehospital setting.

PubMed

Doering, G T

1998-09-01

The focus of the study was to prioritize six emergency medical service treatment factors in terms of their impact upon patient satisfaction in the prehospital setting. The six treatment areas analyzed were: EMS response time; medical care provided on scene; explanation of care by the provider; the provider's ability to reduce patient anxiety; the provider's ability to meet the patient's non-medical needs; and the level of courtesy/politeness shown by the EMS provider toward the patient. Telephone interviews were conducted with both patients and bystanders to obtain their perception of how well the system met their needs. The study analyzed how the six issues were rated and then evaluated the impact an individual's low score in a category had on that person's overall rating of the service provided. The overall satisfaction rating is not a calculated score, but an overall score specified by the respondent. The effect each issue had on the respondent's overall rating was determined by averaging the overall ratings for a category's low scorers, averaging the overall ratings for high scorers and then measuring the difference. Results of the study indicate that the factor with the greatest negative impact on patient satisfaction came from a perceived lack of crew courtesy and politeness. Respondents who indicated a fair to poor score in this category decreased their overall score by 60.2%. Ratings in other categories yielded the following results: When respondents rated the response time as fair to poor, their average overall rating showed an 18.4% decrease. When respondents rated the quality of medical care as fair to poor, their average overall rating showed a decrease of 22.6%. When the crew's ability to explain what was happening to the patient was rated as fair to poor, the average overall score dropped 33.6%. When the EMT's and medic's ability to reduce the patient's anxiety was rated fair to poor, average overall score declined by 32.6%. Finally, when the crew's ability to satisfy a patient's non-medical needs was rated as fair to poor, the average overall score diminished by 37.4%.

Communication skills in pediatrics – the relationship between pediatrician and child

PubMed Central

Mărginean, Cristina Oana; Meliţ, Lorena Elena; Chinceşan, Mihaela; Mureşan, Simona; Georgescu, Anca Meda; Suciu, Nicoleta; Pop, Anisoara; Azamfirei, Leonard

2017-01-01

Abstract Interpersonal and communication skills are 2 essential qualities of every physician. These are separate and distinct parts of the professional character of every physician. In pediatrics these abilities present even a higher impact. We performed a survey-type prospective study based on questionnaires on 100 subjects, equally divided into 4 groups: 25 children, 25 pediatricians, 25 care-givers (parents, tutors, and relatives), and 25 health care staff, in a Tertiary Pediatric Clinic from Romania, between January 2017 and April 2017. We included 100 participants in our study, equally divided into 4 groups: pediatric patients, pediatricians, care-givers, and health care staff. The 1st group comprised 25 children diagnosed with different chronic conditions, presenting the age between 5 and 14 years. The male gender predominated among the children (57%). The lowest general average score for “Communication” section was encountered among pediatricians group, 3.8, while the other 3 groups presented the same average score for this section, that is, 4.6. The children and the health care staff offered the same average score for “Transparency,” that is, 4.6, while the pediatricians offered a score of 4.5, and the care-givers of 4.7. The lowest average score for the item “Hospital environment” was given by the doctors, that is, 3.3, followed by care-givers with a score of 3.6, health care staff 3.7, and children with an average score of 3.8. All the 4 groups included in the study offered a general average of 4.9 out of 5 for the “Intercultural issues” section. The lowest average score for “Time management” section was offered by both children and pediatricians, that is, 4.1, while care-givers and health care staff had a slightly better perception regarding this item, offering 4.2 and 4.3, respectively. The opinion among the 4 groups included in the study was generally similar regarding the 5 items assessed by our questionnaires. Therefore, the main aspects that need to be improved in the health care system in downward order are the following: hospital environment, time management, communication, transparency, and intercultural issues. PMID:29069036

Communication skills in pediatrics - the relationship between pediatrician and child.

PubMed

Mărginean, Cristina Oana; Meliţ, Lorena Elena; Chinceşan, Mihaela; Mureşan, Simona; Georgescu, Anca Meda; Suciu, Nicoleta; Pop, Anisoara; Azamfirei, Leonard

2017-10-01

Interpersonal and communication skills are 2 essential qualities of every physician. These are separate and distinct parts of the professional character of every physician. In pediatrics these abilities present even a higher impact.We performed a survey-type prospective study based on questionnaires on 100 subjects, equally divided into 4 groups: 25 children, 25 pediatricians, 25 care-givers (parents, tutors, and relatives), and 25 health care staff, in a Tertiary Pediatric Clinic from Romania, between January 2017 and April 2017.We included 100 participants in our study, equally divided into 4 groups: pediatric patients, pediatricians, care-givers, and health care staff. The 1st group comprised 25 children diagnosed with different chronic conditions, presenting the age between 5 and 14 years. The male gender predominated among the children (57%). The lowest general average score for "Communication" section was encountered among pediatricians group, 3.8, while the other 3 groups presented the same average score for this section, that is, 4.6. The children and the health care staff offered the same average score for "Transparency," that is, 4.6, while the pediatricians offered a score of 4.5, and the care-givers of 4.7. The lowest average score for the item "Hospital environment" was given by the doctors, that is, 3.3, followed by care-givers with a score of 3.6, health care staff 3.7, and children with an average score of 3.8. All the 4 groups included in the study offered a general average of 4.9 out of 5 for the "Intercultural issues" section. The lowest average score for "Time management" section was offered by both children and pediatricians, that is, 4.1, while care-givers and health care staff had a slightly better perception regarding this item, offering 4.2 and 4.3, respectively.The opinion among the 4 groups included in the study was generally similar regarding the 5 items assessed by our questionnaires. Therefore, the main aspects that need to be improved in the health care system in downward order are the following: hospital environment, time management, communication, transparency, and intercultural issues.

Department of Defense HIV/AIDS Prevention Program (DHAPP): 2010 Annual Report

DTIC Science & Technology

2011-04-01

training sessions that took place in FY10 to assess the program’s effectiveness. MEASURES OF EFFECTIVENESS Pretest and posttests have been developed with...competence level among the trainees. Pretest scores ranged from 32.5% to 67.5%, while posttest scores ranged from 65.0% to 75.0%, making it clear that...it was a valuable training. The average pretest score went from approximately 50% to a posttest average of 70%. Below is a table of scores, followed

The Apgar score has survived the test of time.

PubMed

Finster, Mieczyslaw; Wood, Margaret

2005-04-01

In 1953, Virginia Apgar, M.D. published her proposal for a new method of evaluation of the newborn infant. The avowed purpose of this paper was to establish a simple and clear classification of newborn infants which can be used to compare the results of obstetric practices, types of maternal pain relief and the results of resuscitation. Having considered several objective signs pertaining to the condition of the infant at birth she selected five that could be evaluated and taught to the delivery room personnel without difficulty. These signs were heart rate, respiratory effort, reflex irritability, muscle tone and color. Sixty seconds after the complete birth of the baby a rating of zero, one or two was given to each sign, depending on whether it was absent or present. Virginia Apgar reviewed anesthesia records of 1025 infants born alive at Columbia Presbyterian Medical Center during the period of this report. All had been rated by her method. Infants in poor condition scored 0-2, infants in fair condition scored 3-7, while scores 8-10 were achieved by infants in good condition. The most favorable score 1 min after birth was obtained by infants delivered vaginally with the occiput the presenting part (average 8.4). Newborns delivered by version and breech extraction had the lowest score (average 6.3). Infants delivered by cesarean section were more vigorous (average score 8.0) when spinal was the method of anesthesia versus an average score of 5.0 when general anesthesia was used. Correlating the 60 s score with neonatal mortality, Virginia found that mature infants receiving 0, 1 or 2 scores had a neonatal death rate of 14%; those scoring 3, 4, 5, 6 or 7 had a death rate of 1.1%; and those in the 8-10 score group had a death rate of 0.13%. She concluded that the prognosis of an infant is excellent if he receives one of the upper three scores, and poor if one of the lowest three scores.

Point-ahead limitation on reciprocity tracking. [in earth-space optical link

NASA Technical Reports Server (NTRS)

Shapiro, J. H.

1975-01-01

The average power received at a spacecraft from a reciprocity-tracking transmitter is shown to be the free-space diffraction-limited result times a gain-reduction factor that is due to the point-ahead requirement. For a constant-power transmitter, the gain-reduction factor is approximately equal to the appropriate spherical-wave mutual-coherence function. For a constant-average-power transmitter, an exact expression is obtained for the gain-reduction factor.

How the growth and freeboard of continents may relate to geometric and kinematic parameters of mid-ocean spreading ridges

USGS Publications Warehouse

Howell, D.G.

1989-01-01

If the volume of continents has been growing since 4 Ga then the area of the ocean basins must have been shrinking. Therefore, by inferring a constant continental freeboard, in addition to constant continental crustal thicknesses and seawater volume, it is possible to calculate the necessary combinations of increased ridge lengths and spreading rates required to displace the seawater in the larger oceans of the past in order to maintain the constant freeboard. A reasonable choice from the various possibilities is that at 4 Ga ago, the ridge length and spreading rates were ca. 2.5 times greater than the averages of these parameters during the past 200 Ma. By 2.5 Ga ago the ridge length and spreading rate decreased to about 1.8 times the recent average and by 1 Ga ago these features became reduced to approximately 1.4 times recent averages. ?? 1989.

Evaluation of shoulder function in clavicular fracture patients after six surgical procedures based on a network meta-analysis.

PubMed

Huang, Shou-Guo; Chen, Bo; Lv, Dong; Zhang, Yong; Nie, Feng-Feng; Li, Wei; Lv, Yao; Zhao, Huan-Li; Liu, Hong-Mei

2017-01-01

Purpose Using a network meta-analysis approach, our study aims to develop a ranking of the six surgical procedures, that is, Plate, titanium elastic nail (TEN), tension band wire (TBW), hook plate (HP), reconstruction plate (RP) and Knowles pin, by comparing the post-surgery constant shoulder scores in patients with clavicular fracture (CF). Methods A comprehensive search of electronic scientific literature databases was performed to retrieve publications investigating surgical procedures in CF, with the stringent eligible criteria, and clinical experimental studies of high quality and relevance to our area of interest were selected for network meta-analysis. Statistical analyses were conducted using Stata 12.0. Results A total of 19 studies met our inclusion criteria were eventually enrolled into our network meta-analysis, representing 1164 patients who had undergone surgical procedures for CF (TEN group = 240; Plate group = 164; TBW group  =  180; RP group  =  168; HP group  =  245; Knowles pin group  =  167). The network meta-analysis results revealed that RP significantly improved constant shoulder score in patients with CF when compared with TEN, and the post-operative constant shoulder scores in patients with CF after Plate, TBW, HP, Knowles pin and TEN were similar with no statistically significant differences. The treatment relative ranking of predictive probabilities of constant shoulder scores in patients with CF after surgery revealed the surface under the cumulative ranking curves (SUCRA) value is the highest in RP. Conclusion The current network meta-analysis suggests that RP may be the optimum surgical treatment among six inventions for patients with CF, and it can improve the shoulder score of patients with CF. Implications for Rehabilitation RP improves shoulder joint function after surgical procedure. RP achieves stability with minimal complications after surgery. RP may be the optimum surgical treatment for rehabilitation of patients with CF.

Ranking prediction model using the competition record of Ladies Professional Golf Association players.

PubMed

Chae, Jin Seok; Park, Jin; So, Wi-Young

2017-07-28

The purpose of this study was to suggest a ranking prediction model using the competition record of the Ladies Professional Golf Association (LPGA) players. The top 100 players on the tour money list from the 2013-2016 US Open were analyzed in this model. Stepwise regression analysis was conducted to examine the effect of performance and independent variables (i.e., driving accuracy, green in regulation, putts per round, driving distance, percentage of sand saves, par-3 average, par-4 average, par-5 average, birdies average, and eagle average) on dependent variables (i.e., scoring average, official money, top-10 finishes, winning percentage, and 60-strokes average). The following prediction model was suggested:Y (Scoring average) = 55.871 - 0.947 (Birdies average) + 4.576 (Par-4 average) - 0.028 (Green in regulation) - 0.012 (Percentage of sand saves) + 2.088 (Par-3 average) - 0.026 (Driving accuracy) - 0.017 (Driving distance) + 0.085 (Putts per round)Y (Official money) = 6628736.723 + 528557.907 (Birdies average) - 1831800.821 (Par-4 average) + 11681.739 (Green in regulation) + 6476.344 (Percentage of sand saves) - 688115.074 (Par-3 average) + 7375.971 (Driving accuracy)Y (Top-10 finish%) = 204.462 + 12.562 (Birdies average) - 47.745 (Par-4 average) + 1.633 (Green in regulation) - 5.151 (Putts per round) + 0.132 (Percentage of sand saves)Y (Winning percentage) = 49.949 + 3.191 (Birdies average) - 15.023 (Par-4 average) + 0.043 (Percentage of sand saves)Y (60-strokes average) = 217.649 + 13.978 (Birdies average) - 44.855 (Par-4 average) - 22.433 (Par-3 average) + 0.16 (Green in regulation)Scoring of the above five prediction models and the prediction of golf ranking in the 2016 Women's Golf Olympic competition in Rio revealed a significant correlation between the predicted and real ranking (r = 0.689, p < 0.001) and between the predicted and the real average score (r = 0.653, p < 0.001). Our ranking prediction model using LPGA data may help coaches and players to identify which players are likely to participate in Olympic and World competitions, based on their performance.

Comparison of TID Effects in Space-Like Variable Dose Rates and Constant Dose Rates

NASA Technical Reports Server (NTRS)

Harris, Richard D.; McClure, Steven S.; Rax, Bernard G.; Evans, Robin W.; Jun, Insoo

2008-01-01

The degradation of the LM193 dual voltage comparator has been studied at different TID dose rate profiles, including several different constant dose rates and a variable dose rate that simulates the behavior of a solar flare. A comparison of results following constant dose rate vs. variable dose rates is made to explore how well the constant dose rates used for typical part testing predict the performance during a simulated space-like mission. Testing at a constant dose rate equal to the lowest dose rate seen during the simulated flare provides an extremely conservative estimate of the overall amount of degradation. A constant dose rate equal to the average dose rate is also more conservative than the variable rate. It appears that, for this part, weighting the dose rates by the amount of total dose received at each rate (rather than the amount of time at each dose rate) results in an average rate that produces an amount of degradation that is a reasonable approximation to that received by the variable rate.

The SAT® Essay and College Performance: Understanding What Essay Scores Add to HSGPA and SAT. Research Report 2012-9 (REV: 4-2013)

ERIC Educational Resources Information Center

Shaw, Emily J.; Kobrin, Jennifer L.

2013-01-01

This study examines the relationship between students' SAT essay scores and college outcomes, including first-year grade point average (FYGPA) and first-year English course grade average (FY EngGPA), overall and by various demographic and academic performance subgroups. Results showed that the SAT essay score has a positive relationship with both…

Stresses and elastic constants of crystalline sodium, from molecular dynamics

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

Schiferl, S.K.

1985-02-01

The stresses and the elastic constants of bcc sodium are calculated by molecular dynamics (MD) for temperatures to T = 340K. The total adiabatic potential of a system of sodium atoms is represented by pseudopotential model. The resulting expression has two terms: a large, strictly volume-dependent potential, plus a sum over ion pairs of a small, volume-dependent two-body potential. The stresses and the elastic constants are given as strain derivatives of the Helmholtz free energy. The resulting expressions involve canonical ensemble averages (and fluctuation averages) of the position and volume derivatives of the potential. An ensemble correction relates the resultsmore » to MD equilibrium averages. Evaluation of the potential and its derivatives requires the calculation of integrals with infinite upper limits of integration, and integrand singularities. Methods for calculating these integrals and estimating the effects of integration errors are developed. A method is given for choosing initial conditions that relax quickly to a desired equilibrium state. Statistical methods developed earlier for MD data are extended to evaluate uncertainties in fluctuation averages, and to test for symmetry. 45 refs., 10 figs., 4 tabs.« less

Temperature dependence of (+)-catechin pyran ring proton coupling constants as measured by NMR and modeled using GMMX search methodology

Treesearch

Fred L. Tobiason; Stephen S. Kelley; M. Mark Midland; Richard W. Hemingway

1997-01-01

The pyran ring proton coupling constants for (+)-catechin have been experimentally determined in deuterated methanol over a temperature range of 213 K to 313 K. The experimental coupling constants were simulated to 0.04 Hz on the average at a 90 percent confidence limit using a LAOCOON method. The temperature dependence of the coupling constants was reproduced from the...

Primary Arthrodesis versus Open Reduction and Internal Fixation for Low-Energy Lisfranc Injuries in a Young Athletic Population.

PubMed

Cochran, Grant; Renninger, Christopher; Tompane, Trevor; Bellamy, Joseph; Kuhn, Kevin

2017-09-01

There are 2 Level I studies comparing open reduction and internal fixation (ORIF) and primary arthrodesis (PA) in high-energy Lisfranc injuries. There are no studies comparing ORIF and PA in young athletic patients with low-energy injuries. All operatively managed low-energy Lisfranc injuries sustained by active duty military personnel at a single institution were identified from 2010 to 2015. The injury pattern, method of treatment, and complications were reviewed. Implant removal rates, fitness test scores, return to military duty rates, and Foot and Ankle Ability Measure (FAAM) scores were compared. Thirty-two patients were identified with the average age of 28 years. PA was performed in 14 patients with ORIF in 18. The PA group returned to full duty at an average of 4.5 months whereas the ORIF group returned at an average of 6.7 months ( P = .0066). The PA group ran their fitness test an average of 9 seconds per mile slower than their preoperative average whereas the ORIF group ran it an average of 39 seconds slower per mile ( P = .032). There were no differences between the 2 groups in the FAAM scores at an average of 35 months. Implant removal was performed in 15 (83%) in the ORIF group and 2 (14%) in the PA group ( P = .005). Low-energy Lisfranc injuries treated with primary arthrodesis had a lower implant removal rate, an earlier return to full military activity, and better fitness test scores after 1 year, but there was no difference in FAAM scores after 3 years. Level III, comparative cohort study.

Medical Students’ Perception of Their Educational Environment

PubMed Central

Pai, Preethi G; Menezes, Vishma; Srikanth; Subramanian, Atreya M.; Shenoy, Jnaneshwara P.

2014-01-01

Background: Students’ perception of the environment within which they study has shown to have a significant impact on their behavior, academic progress and sense of well-being. This study was undertaken to evaluate the students’ perception of their learning environment in an Indian medical school following traditional curricula and to study differences, if any, between the students according to the stages of medical education, i.e., the pre-clinical and clinical stages. Methodology: In the present study, the Dundee Ready Education Environment Measure (DREEM) inventory was administered to undergraduate medical students of first (n = 227), third (n = 175), fifth (n = 171) and seventh (n = 123) semesters. Scores obtained were expressed as mean ± Standard Deviation (SD) and analyzed using one-way ANOVA and Dunnett’s test. P-value < 0.05 was considered as significant. Results: The mean DREEM score for our medical school was 123/200.The first-year students were found to be more satisfied with learning environment (indicated by their higher DREEM score) compared to other semester students. Progressive decline in scores with each successive semester was observed. Evaluating the sub-domains of perception, the registrars in all semesters had a more positive perception of learning (Average mean score: 29.44), their perception of course organizers moved in the right direction (Average mean score: 26.86), their academic self-perception was more on the positive side (Average mean score: 20.14), they had a more positive perception of atmosphere (Average mean score: 29.07) and their social self-perception could be graded as not too bad (Average mean score: 17.02). Conclusion: The present study revealed that all the groups of students perceived their learning environment positively. However, a few problematic areas of learning environment were perceived such as: students were stressed more often; they felt that the course organizers were authoritarian and emphasized factual learning. Implementing more problem-based learning, student counseling and workshops on teaching-learning for educators might enable us to remedy and enrich our learning environment. PMID:24596737

High Grazing Angle and High Resolution Sea Clutter: Correlation and Polarisation Analyses

DTIC Science & Technology

2007-03-01

the azimuthal correlation. The correlation between the HH and VV sea clutter data is low. A CA-CFAR ( cell average constant false-alarm rate...to calculate the power spectra of correlation profiles. The frequency interval of the traditional Discrete Fourier Transform is NT1 Hz, where N and...sea spikes, the Entropy-Alpha decomposition of sea spikes is shown in Figure 30. The process first locates spikes using a cell -average constant false

Open reduction and internal fixation of Ideberg IV and V glenoid intra-articular fractures through a Judet approach: a retrospective analysis of 11 cases.

PubMed

Hu, Chuanzhen; Zhang, Weibin; Qin, Hui; Shen, Yuhui; Xue, Zichao; Ding, Haoliang; An, Zhiquan

2015-02-01

To evaluate the methods and the outcomes of complex intra-articular glenoid fractures, treated by open reduction and internal fixations. The outcomes of 11 cases of complex intra-articular glenoid scapular fractures were retrospectively analyzed. The fractures were classified as type IV in five cases, type Va in two and Vb in four cases, according to Ideberg classification system. The mean step or gap between the main articular fragments was 6.3 ± 6.2 (4-25) mm. The fractures were openly reduced through a Judet approach and fixed with reconstructive plates or bands placed on the lateral and medial side of affected scapula, respectively. The main articular fragments were strengthened with a 4.0-mm cannulated screw in five cases. The bone union, the anterior flexion, the external and internal rotation of the shoulders were checked and recorded. The functional outcomes were evaluated using DASH questionnaire, Constant and UCLA shoulder score systems, respectively. 11 patients were followed up with an average of 28.2 ± 12.6 (12-50) months. All the fractures were united smoothly without second intervention. At the latest visiting, the mean anterior flexion of affected shoulder was 157.3 ± 7.37° (range 150°-170°), the mean external rotation of the affected shoulder was 58.2 ± 7.5° (range 50°-70°). When the shoulder in the internal rotation, the extended thumb reached to L4 or L1 or T10 or T7 in one case, to T12 in two cases and to T8 in four cases, respectively, the mean Constant score was 91.7 ± 2.8 (86-96) points. The mean UCLA score was 32.7 ± 1.7 (30-35) points, leading to four cases of excellent and seven cases of good results. The mean DASH score was 7.4 ± 3.3 (3.4-13) points. Good outcomes could be obtained when Ideberg IV and V glenoid fractures were treated by open reduction and internal fixation through a Judet approach.

Wideband MRE and static mechanical indentation of human liver specimen: sensitivity of viscoelastic constants to the alteration of tissue structure in hepatic fibrosis.

PubMed

Reiter, Rolf; Freise, Christian; Jöhrens, Korinna; Kamphues, Carsten; Seehofer, Daniel; Stockmann, Martin; Somasundaram, Rajan; Asbach, Patrick; Braun, Jürgen; Samani, Abbas; Sack, Ingolf

2014-05-07

Despite the success of elastography in grading hepatic fibrosis by stiffness related noninvasive markers the relationship between viscoelastic constants in the liver and tissue structure remains unclear. We therefore studied the mechanical properties of 16 human liver specimens with different degrees of fibrosis, inflammation and steatosis by wideband magnetic resonance elastography (MRE) and static indentation experiments providing the specimens׳ static Young׳s modulus (E), dynamic storage modulus (G') and dynamic loss modulus (G″). A frequency-independent shear modulus μ and a powerlaw exponent α were obtained by fitting G' and G″ using the two-parameter sprinpot model. The mechanical parameters were compared to the specimens׳ histology derived parameters such as degree of Fibrosis (F), inflammation score and fat score, amount of hydroxyproline (HYP) used for quantification of collagen, blood markers and presurgery in vivo function tests. The frequency averaged parameters G', G″ and μ were significantly correlated with F (G': R=0.762, G″: R=0.830; μ: R=0.744; all P<0.01) and HYP (G': R=0.712; G″: R=0.720; μ: R=0.731; all P<0.01). The powerlaw exponent α displayed an inverse correlation with F (R=-0.590, P=0.034) and a trend of inverse correlation with HYP (R=-0.470, P=0.089). The static Young׳s modulus E was less correlated with F (R=0.587, P=0.022) and not sensitive to HYP. Although inflammation was highly correlated with F (R=0.773, P<0.001), no interaction was discernable between inflammation and mechanical parameters measured in this study. Other histological and blood markers as well as liver function test were correlated with neither F nor the measured mechanical parameters. In conclusion, viscoelastic constants measured by wideband MRE are highly sensitive to histologically proven fibrosis. Our results suggest that, in addition to the amount of connective tissue, subtle structural changes of the viscoelastic matrix determine the sensitivity of mechanical tissue properties to hepatic fibrosis. Copyright © 2014 Elsevier Ltd. All rights reserved.

Infrared radiation of thin plastic films.

NASA Technical Reports Server (NTRS)

Tien, C. L.; Chan, C. K.; Cunnington, G. R.

1972-01-01

A combined analytical and experimental study is presented for infrared radiation characteristics of thin plastic films with and without a metal substrate. On the basis of the thin-film analysis, a simple analytical technique is developed for determining band-averaged optical constants of thin plastic films from spectral normal transmittance data for two different film thicknesses. Specifically, the band-averaged optical constants of polyethylene terephthalate and polyimide were obtained from transmittance measurements of films with thicknesses in the range of 0.25 to 3 mil. The spectral normal reflectance and total normal emittance of the film side of singly aluminized films are calculated by use of optical constants; the results compare favorably with measured values.

Foundational Performance Analyses of Pressure Gain Combustion Thermodynamic Benefits for Gas Turbines

NASA Technical Reports Server (NTRS)

Paxson, Daniel E.; Kaemming, Thomas A.

2012-01-01

A methodology is described whereby the work extracted by a turbine exposed to the fundamentally nonuniform flowfield from a representative pressure gain combustor (PGC) may be assessed. The method uses an idealized constant volume cycle, often referred to as an Atkinson or Humphrey cycle, to model the PGC. Output from this model is used as input to a scalable turbine efficiency function (i.e., a map), which in turn allows for the calculation of useful work throughout the cycle. Integration over the entire cycle yields mass-averaged work extraction. The unsteady turbine work extraction is compared to steady work extraction calculations based on various averaging techniques for characterizing the combustor exit pressure and temperature. It is found that averages associated with momentum flux (as opposed to entropy or kinetic energy) provide the best match. This result suggests that momentum-based averaging is the most appropriate figure-of-merit to use as a PGC performance metric. Using the mass-averaged work extraction methodology, it is also found that the design turbine pressure ratio for maximum work extraction is significantly higher than that for a turbine fed by a constant pressure combustor with similar inlet conditions and equivalence ratio. Limited results are presented whereby the constant volume cycle is replaced by output from a detonation-based PGC simulation. The results in terms of averaging techniques and design pressure ratio are similar.

Strategies Typically Developing Writers Use for Translating Thought into the Next Sentence and Evolving Text: Implications for Assessment and Instruction

PubMed Central

Jones, Jasmin Niedo; Berninger, Virginia Wise

2016-01-01

Three new approaches to writing assessment are introduced. First, strategies for generating the very next sentence are assessed in reference to the local level as well as the evolving text level of composing in progress. Second, strategies for translating thought into written language are coded with transcription (spelling) skill—low, average, or high—held constant. Third, instead of describing composing skill in reference to a single normed score for age or grade in a standardization sample at a static time in development, translation is studied longitudinally when children are in grades 1, 3, and 5 (ages 6, 8, 10) or grades 3, 5, and 7 (ages 8, 10, 12). Applications of the results are discussed for assessment and instruction grounded in levels and generativity of written language and normal variation in typically developing writers. PMID:28127525

State Test Score Trends through 2008-09, Part 1: Rising Scores on State Tests and NAEP. Nevada

ERIC Educational Resources Information Center

Center on Education Policy, 2010

2010-01-01

This paper profiles Nevada's test score trends through 2008-09. Between 2005 and 2009, the percentages of students reaching the proficient level on the state test and the basic level on NAEP increased in grade 8 reading and math. Average annual gains were larger on the state test than on NAEP in both subjects. Trends in average (mean) test scores…

Analysis of 2009-10 WCPSS SAT Scores. Measuring Up. E&R Report No. 10.25

ERIC Educational Resources Information Center

Holdzkom, David; Gilleland, Kevin

2010-01-01

Wake County Public School System (WCPSS) students continue to fare well on the SAT test as compared with students in the state and nation. While there was a decline in average test scores in 2009-10 as compared with the prior year, the posted scores continue a trend of measurable improvement over time. Over the past 20 years, the average SAT…

Clinical and structural outcomes after arthroscopic repair of full-thickness rotator cuff tears with and without platelet-rich product supplementation: a meta-analysis and meta-regression.

PubMed

Warth, Ryan J; Dornan, Grant J; James, Evan W; Horan, Marilee P; Millett, Peter J

2015-02-01

The purpose of this study was to perform a systematic review, meta-analysis, and meta-regression of all Level I and Level II studies comparing the clinical or structural outcomes, or both, after rotator cuff repair with and without platelet-rich product (PRP) supplementation. A literature search of the PubMed and EMBASE databases was performed to identify all Level I or II studies comparing the clinical or structural outcomes, or both, after arthroscopic repair of full-thickness rotator cuff tears with (PRP+ group) and without (PRP- group) PRP supplementation. Data included outcome scores (American Shoulder and Elbow Surgeons [ASES], University of California Los Angeles [UCLA], Constant, Simple Shoulder Test [SST] and visual analog scale [VAS] scores) and retears diagnosed with imaging studies. Meta-analyses compared preoperative, postoperative, and gain in outcome scores and relative risk ratios for retears. Meta-regression compared the effect of PRP treatment on outcome scores and retear rates according to 6 covariates. Minimum effect sizes that were detectable with 80% power were also calculated for each study. Eleven studies were included in this review and a maximum of 8 studies were used for meta-analyses according to data availability. There were no statistically significant differences between the PRP+ and PRP- groups for overall outcome scores or retear rates (P > .05). Overall gain in the Constant score was decreased when liquid PRP was injected over the tendon surface compared with PRP application at the tendon-bone interface (-6.88 points v +0.78 points, respectively; P = .046); however, this difference did not reach the previously reported minimum clinically important difference (MCID) for Constant scores. When the initial tear size was greater than 3 cm in anterior-posterior length, the PRP+ group exhibited decreased retear rates after double-row repairs when compared with the PRP- group (25.9% v 57.1%, respectively; P = .046). Sensitivity power analyses revealed that most included studies were only powered to detect large differences in outcome scores between groups. There were no statistically significant differences in overall gain in outcome scores or retear rates between treatment groups. Gain in Constant scores was significantly increased when PRPs were applied at the tendon-bone interface when compared with application over the top of the repaired tendon. Retear rates were significantly decreased when PRPs were used for the treatment of tears greater than 3 cm in anterior-posterior length using a double-row technique. Most of the included studies were only powered to detect large differences in outcome scores between treatment groups. In addition, an increased risk for selection, performance, and attrition biases was found. Level II, meta-analysis of Level I and Level II studies. Copyright © 2015 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Dielectric properties of single wall carbon nanotubes-based gelatin phantoms

NASA Astrophysics Data System (ADS)

Altarawneh, M. M.; Alharazneh, G. A.; Al-Madanat, O. Y.

In this work, we report the dielectric properties of Single wall Carbon Nanotubes (SWCNTs)-based phantom that is mainly composed of gelatin and water. The fabricated gelatin-based phantom with desired dielectric properties was fabricated and doped with different concentrations of SWCNTs (e.g., 0%, 0.05%, 0.10%, 0.15%, 0.2%, 0.4% and 0.6%). The dielectric constants (real ɛ‧ and imaginary ɛ‧‧) were measured at different positions for each sample as a function of frequency (0.5-20GHz) and concentrations of SWCNTs and their averages were found. The Cole-Cole plot (ɛ‧ versus ɛ‧‧) was obtained for each concentration of SWCNTs and was used to obtain the static dielectric constant ɛs, the dielectric constant at the high limit of frequency ɛ∞ and the average relaxation time τ. The measurements showed that the fabricated samples are in good homogeneity and the SWCNTs are dispersed well in the samples as an acceptable standard deviation is achieved. The study showed a linear increase in the static dielectric constant ɛs and invariance of the average relaxation time τ and the value of ɛ∞ at room temperature for the investigated concentrations of SWCNTs.

Predicting Long-Term College Success through Degree Completion Using ACT[R] Composite Score, ACT Benchmarks, and High School Grade Point Average. ACT Research Report Series, 2012 (5)

ERIC Educational Resources Information Center

Radunzel, Justine; Noble, Julie

2012-01-01

This study compared the effectiveness of ACT[R] Composite score and high school grade point average (HSGPA) for predicting long-term college success. Outcomes included annual progress towards a degree (based on cumulative credit-bearing hours earned), degree completion, and cumulative grade point average (GPA) at 150% of normal time to degree…

A simple method relating specific rate constants k(E,J) and Thermally averaged rate constants k(infinity)(T) of unimolecular bond fission and the reverse barrierless association reactions.

PubMed

Troe, J; Ushakov, V G

2006-06-01

This work describes a simple method linking specific rate constants k(E,J) of bond fission reactions AB --> A + B with thermally averaged capture rate constants k(cap)(T) of the reverse barrierless combination reactions A + B --> AB (or the corresponding high-pressure dissociation or recombination rate constants k(infinity)(T)). Practical applications are given for ionic and neutral reaction systems. The method, in the first stage, requires a phase-space theoretical treatment with the most realistic minimum energy path potential available, either from reduced dimensionality ab initio or from model calculations of the potential, providing the centrifugal barriers E(0)(J). The effects of the anisotropy of the potential afterward are expressed in terms of specific and thermal rigidity factors f(rigid)(E,J) and f(rigid)(T), respectively. Simple relationships provide a link between f(rigid)(E,J) and f(rigid)(T) where J is an average value of J related to J(max)(E), i.e., the maximum J value compatible with E > or = E0(J), and f(rigid)(E,J) applies to the transitional modes. Methods for constructing f(rigid)(E,J) from f(rigid)(E,J) are also described. The derived relationships are adaptable and can be used on that level of information which is available either from more detailed theoretical calculations or from limited experimental information on specific or thermally averaged rate constants. The examples used for illustration are the systems C6H6+ <==> C6H5+ + H, C8H10+ --> C7H7+ + CH3, n-C9H12+ <==> C7H7+ + C2H5, n-C10H14+ <==> C7H7+ + C3H7, HO2 <==> H + O2, HO2 <==> HO + O, and H2O2 <==> 2HO.

The effects of ground hydrology on climate sensitivity to solar constant variations

NASA Technical Reports Server (NTRS)

Chou, S. H.; Curran, R. J.; Ohring, G.

1979-01-01

The effects of two different evaporation parameterizations on the climate sensitivity to solar constant variations are investigated by using a zonally averaged climate model. The model is based on a two-level quasi-geostrophic zonally averaged annual mean model. One of the evaporation parameterizations tested is a nonlinear formulation with the Bowen ratio determined by the predicted vertical temperature and humidity gradients near the earth's surface. The other is the linear formulation with the Bowen ratio essentially determined by the prescribed linear coefficient.

Treatment of Partial Rotator Cuff Tear with Ultrasound-guided Platelet-rich Plasma.

PubMed

Sengodan, Vetrivel Chezian; Kurian, Sajith; Ramasamy, Raghupathy

2017-01-01

The treatment of symptomatic partial rotator cuff tear has presented substantial challenge to orthopaedic surgeons as it can vary from conservative to surgical repair. Researches have established the influence of platelet rich plasma in healing damaged tissue. Currently very few data are available regarding the evidence of clinical and radiological outcome of partial rotator cuff tear treated with ultrasound guided platelet rich plasma injection in English literature. 20 patients with symptomatic partial rotator cuff tears were treated with ultrasound guided platelet rich plasma injection. Before and after the injection of platelet rich plasma scoring was done with visual analogue score, Constant shoulder score, and UCLA shoulder score at 8 weeks and third month. A review ultrasound was performed 8 weeks after platelet rich plasma injection to assess the rotator cuff status. Our study showed statistically significant improvements in 17 patients in VAS pain score, constant shoulder score and UCLA shoulder score. No significant changes in ROM were noted when matched to the contra-lateral side ( P < 0.001) at the 3 month follow-up. The study also showed good healing on radiological evaluation with ultrasonogram 8 weeks after platelet rich plasma injection. Ultrasound guided platelet rich plasma injection for partial rotator cuff tears is an effective procedure that leads to significant decrease in pain, improvement in shoulder functions, much cost-effective and less problematic compared to a surgical treatment.

Verbal memory outcome in patients with normal preoperative verbal memory and left mesial temporal sclerosis.

PubMed

LoGalbo, Anthony; Sawrie, Stephen; Roth, David L; Kuzniecky, Ruben; Knowlton, Robert; Faught, Edward; Martin, Roy

2005-05-01

Previous studies have shown that structural integrity (i.e., presence/absence of mesial temporal sclerosis (MTS)) of the left mesial temporal lobe is associated with verbal memory outcome following left anterior temporal lobectomy (ATL). However, the functional integrity of the left temporal lobe, as exemplified by preoperative verbal memory performance, has also been associated with verbal memory outcome following surgery. We investigated the risk of verbal memory loss in patients with known structural abnormality (i.e., left mesial temporal sclerosis by MRI) and normal preoperative verbal memory performance who undergo left ATL. Seventeen patients with left temporal lobe epilepsy, MRI-based exclusive left MTS, and normal preoperative verbal memory were identified. Normal verbal memory was defined as performance on both Acquisition (learning across trials 1-5) and Retrieval (long delayed free recall) portions of the California Verbal Learning Test (CVLT) above a T score of 40 (>16%ile). Postoperative verbal memory outcome was established by incorporating standardized regression-based (SRB) change scores. Postoperative declines across both CVLT Retrieval T scores and Acquisition T scores (average 20% and average 15% declines from baseline scores, respectively) were measured for the group. The average CVLT Retrieval SRB change score was -2.5, and the average CVLT Acquisition SRB change score was -1.0. A larger proportion of patients demonstrated postoperative declines on Retrieval scores than Acquisition scores (64.7% vs 17.6%, respectively). Even in the presence of left MTS, patients exhibiting normal presurgical verbal memory are at risk for verbal memory declines following ATL. These results suggest that the functional integrity of the left mesial temporal lobe may play an important role in the verbal memory outcome in this patient group.

Written Comments Made by Anesthesia Residents When Providing Below Average Scores for the Supervision Provided by the Faculty Anesthesiologist.

PubMed

Dexter, Franklin; Szeluga, Debra; Masursky, Danielle; Hindman, Bradley J

2016-06-01

Anesthesia residents in our department evaluate the supervision provided by the faculty anesthesiologist with whom they worked the previous day. What advice managers can best provide to the faculty who receive below-average supervision scores is unknown. The residents provided numerical answers (1 "never," 2 "rarely," 3 "frequently," or 4 "always") to each of the 9 supervision questions, resulting in a total supervision score. A written comment could also be provided. Over 2.5 years, the response rate to requests for evaluation was 99.1%. There were 13,664 evaluations of 76 faculty including 1387 comments. There were 25 evaluations with a comment of disrespectful behavior. For all 25, the question evaluating whether "the faculty treated me respectfully" was answered <4 (i.e., not "always"). The supervision scores were less than for the other evaluations with comments (P < 0.0001). Each increase in the faculty's number of comments of being disrespectful was associated with a lesser mean score (P = 0.0002). A low supervision score (<3.00; i.e., less than "frequent") had an odds ratio of 85 for disrespectful faculty behavior (P < 0.0001). The predictive value of the supervision score not being low for absence of a comment of disrespectful behavior was 99%. That finding was especially useful because 94% of scores below average (<3.80) were not low (≥3.00). There were 6 evaluations with a comment of insufficient faculty presence. Those evaluations had lesser scores than the other evaluations with comments (P < 0.0001). The 6 faculty with 1 such comment had lesser mean scores than the other faculty (P = 0.0071). There were 34 evaluations with a comment about poor-quality teaching. The evaluations related to poor teaching had lesser scores than the other evaluations with comments (P < 0.0001). The faculty who each received such a comment had lesser mean scores than the other faculty (P < 0.0001). Each increase in the faculty's number of comments of poor-quality teaching was associated with a lesser mean score (P = 0.0002). The 9 supervision questions were internally consistent (Cronbach α = 0.948). A faculty with a comment about poor-quality teaching had significant odds of also having a comment about insufficient presence (P = 0.0044). A comment with negative sentiment had significant odds of being about poor-quality teaching rather than being about insufficient presence (odds ratio, 6.00; P < 0.0001). A faculty who has insufficient presence cannot be providing good teaching. Furthermore, there was negligible correlation between supervision scores and faculty clinical assignments. Thus, insufficient faculty presence accounted for a small proportion of below-average supervision scores and low-quality supervision. Furthermore, scores ≥3 have a predictive value for the absence of disrespectful behavior ≅99%. Approximately 94% of the faculty supervision scores that were below average were still ≥3. Consequently, for the vast majority of the faculty-resident-days, quality of teaching distinguished between below- versus above-average supervision scores. This result is consistent with our prior finding of a strong correlation between 6-month supervision scores and assessments of teaching effectiveness. Taken together, when individual faculty anesthesiologists are counseled about their clinical supervision scores, the attribute to emphasize is quality of clinical teaching.

Half-peroneus-longus-tendon graft augmentation for unqualified hamstring tendon graft of anterior cruciate ligament reconstruction.

PubMed

Liu, Chung-Ting; Lu, Yung-Chang; Huang, Chang-Hung

2015-09-01

In some situations, harvested hamstring tendon grafts are not qualified for anterior cruciate ligament (ACL) reconstruction. This study aimed to present a reinforcing method with additional half peroneus longus tendon (half-PLT) graft augmentation. Eight cases underwent ACL reconstruction with unqualified hamstring tendon grafts (diameter <7 mm) and were salvaged by additional half-PLT graft augmentation. The pivot shift test and KT-1000 tests were performed 3 years after surgery. Functional evaluation of subjective International Knee Documentation Committee (IKDC) and Lysholm scores was also done. In addition, Foot and Ankle Disability Index (FADI) scores were used to evaluate the function of the ankle donor site. The diameter of unqualified four-strand hamstring tendon grafts was 6.2 mm on average (range, 6.0-6.5 mm). The average diameter of hamstring grafts with half-PLT augmentation was 9.6 mm (range, 9.5-10.0 mm). The pivot shift test was negative in all patients. No significant differences between normal and abnormal knees were found by KT-1000. The average IKDC score was 86.0 (range, 83 to 89), and the average Lysholm score was 84.4 (range, 80-90). The average FADI score for the donor sites of half-PLT was 135.8 (range, 134-136). Additional half-PLT can successfully and safely reinforce unqualified hamstring tendon grafts for ACL reconstruction.

An examination of anxiety levels of nursing students caring for patients in terminal period

PubMed Central

Sancar, Behire; Yalcin, Ayse Saba; Acikgoz, Inci

2018-01-01

Objective: To investigate the anxiety levels of the nursing students who are caring for the patients in the terminal period and to determine whether there is a difference between 3rd, 4th grade in this direction. Methods: A 40-item “State and Trait Anxiety Scale” was used together with the questionnaire on “Determining the Level of Anxiety Levels of Nursing Students Caring for the Patient at the Terminal Period” for determining the data. Results: The mean scores and standard deviations of all students from the state and trait anxiety scales were respectively 41.95±5.06, 48.15±5.44. Averages of 3rd state anxiety scale score was 42.03 ± 5.26, trait anxiety scale averages were 48.08 ± 5.59; Averages of 4th state anxiety scale score was 41.85 ± 4.83, trait anxiety scale averages were 48.24 ± 5.30. Conclusion: In our study, it was found that there wasn't significant difference between the 3rd, 4th grade students related to ill patient care in terms of high level of state and trait anxiety during communication and patient care. The state and trait anxiety scores of the students in both grades were found to be higher than the average scores of the scale's previous applications. PMID:29643886

Clinical use of the ABO-Scoring Index: reliability and subtraction frequency.

PubMed

Lieber, William S; Carlson, Sean K; Baumrind, Sheldon; Poulton, Donald R

2003-10-01

This study tested the reliability and subtraction frequency of the study model-scoring system of the American Board of Orthodontists (ABO). We used a sample of 36 posttreatment study models that were selected randomly from six different orthodontic offices. Intrajudge and interjudge reliability was calculated using nonparametric statistics (Spearman rank coefficient, Wilcoxon, Kruskal-Wallis, and Mann-Whitney tests). We found differences ranging from 3 to 6 subtraction points (total score) for intrajudge scoring between two sessions. For overall total ABO score, the average correlation was .77. Intrajudge correlation was greatest for occlusal relationships and least for interproximal contacts. Interjudge correlation for ABO score averaged r = .85. Correlation was greatest for buccolingual inclination and least for overjet. The data show that some judges, on average, were much more lenient than others and that this resulted in a range of total scores between 19.7 and 27.5. Most of the deductions were found in the buccal segments and most were related to the second molars. We present these findings in the context of clinicians preparing for the ABO phase III examination and for orthodontists in their ongoing evaluation of clinical results.

Low agreement of visual rating for detailed quantification of pulmonary emphysema in whole-lung CT.

PubMed

Mascalchi, Mario; Diciotti, Stefano; Sverzellati, Nicola; Camiciottoli, Gianna; Ciccotosto, Cesareo; Falaschi, Fabio; Zompatori, Maurizio

2012-02-01

Multidetector spiral computed tomography (CT) has opened the possibility of quantitative evaluation of emphysema extent in the whole lung. Visual assessment can be used for such a purpose, but its reproducibility has not been established. To assess agreement of detailed assessment of pulmonary emphysema on whole-lung CT using a visual scale. Thirty patients with chronic obstructive pulmonary disease underwent whole-lung inspiratory CT. Four chest radiologists rated the same 22 ± 2 thin sections using a visual scale which defines a range of emphysema extent between 0 and 100. Two of them repeated the rating two months later. Inter- and intra-operator agreement was evaluated with the Bland and Altman method. In addition, the percentage of emphysema at -950 Hounsfield units in the whole lung was determined using fully automated commercially available software for 3D densitometry. In three of six operator pairs and in one of two intra-operator pairs the Kendall τ test showed a significant correlation between the difference and the average magnitude of visual scores. Among different operators the half-width of 95% limits of agreement (95% LoA) was wide ranging between a score of 14.2-27.7 for an average visual score of 20 and between 18.5-36.8 for an average visual score of 80. Within the same operator the half-width of 95% LoA ranged between a score of 10.9-21.0 for an average visual score of 20 and between 25.1-30.1 for an average visual score of 80. The visual scores of the four radiologists were correlated with the results of densitometry (P < 0.001; r = 0.65-0.81). The inter- and intra-operator agreement of detailed assessment of emphysema in the whole lung using a visual scale is low and decreases with increasing emphysema extent.

[COMPARISON OF EFFECTIVENESS BETWEEN TWO OPERATIVE TECHNIQUES OF CORACOCLAVICULAR LIGAMENT RECONSTRUCTION FOR TREATMENT OF Tossy TYPE III ACROMIOCLAVICULAR JOINT DISLOCATION].

PubMed

Tang, Hongwei; Gao, Sheng; Yin, Yong; Li, Yunfei; Han, Qingtian; Li, Huizhang

2015-11-01

To evaluate and compare the effectiveness of double Endobutton technique and suture anchor combined Endobutton plate in the treatment of Tossy type III acromioclavicular joint dislocation. Between May 2010 and March 2014, a retrospective study was preformed on 56 patients with Tossy type III acromioclavicular joint dislocation. The coracoclavicular ligament was reconstructed with double Endobutton technique in 31 cases (Endobutton group), and with suture anchor combined Endobutton plate in 25 cases (Anchor group). There was no significant difference in age, gender, injury causes, injury side, associated injury, medical comorbidities, and disease duration between 2 groups (P>0.05). The operation time, medical device expenses, postoperative complications, preoperative and postoperative Constant-Murley scores, and postoperative Karlsson grading of the injured shoulder were compared between 2 groups. The average operation time in Endobutton group was significantly greater than that in Anchor group (t = 4.285, P = 0.000); there was no significant difference in the medical device expenses between 2 groups (t = 1.555, P = 0.126). Primary healing of incision was obtained in all patients of 2 groups; no early complications of infection and skin necrosis occurred. All patients were followed up 15.6 months on average (range, 11-35 months). During follow-up, some loss of reduction and ectopic ossification in the coracoclavicular gap were observed in 1 case and 6 cases of Endobutton group, respectively. No recurrence of acromioclavicular joint dislocation, implant fixation loosening and broken, and secondary fractures occurred in the other patients. There was significant difference in the incidence of postoperative complications between 2 groups (P = 0.013). Constant-Murley scores of the injured shoulder significantly increased at 9 months after operation when compared with preoperative values in 2 groups (P < 0.05), but no significant difference was observed between 2 groups (P > 0.05). At last follow-up, there was no significant difference in Karlsson grading between 2 groups (Z = -0.628, P = 0.530). Both double Endobutton technique and suture anchor combined Endobutton plate have good effectiveness in the treatment of Tossy type III acromioclavicular joint dislocation. But the latter is associated with easier operation, less operation time, and less complications.

Perioperative risks associated with the operative treatment of clavicle fractures.

PubMed

d'Heurle, Albert; Le, Toan; Grawe, Brian; Casstevens, E Christopher; Edgington, Jon; Archdeacon, Michael T; Wyrick, John

2013-11-01

Clavicle fractures are a common injury among young adults who were historically treated non-operatively with satisfactory outcomes. However, more recent studies have shown a higher nonunion rate for displaced clavicle fractures treated conservatively. The purpose of this study is to investigate the midterm complications, clinical outcomes and overall patient satisfaction after osteosynthesis of midshaft clavicular fractures. A total of 37 patients treated for a clavicle fracture from January 2007 to December 2008 with at least 12 months' follow-up were identified from a billing code search. At the latest follow-up appointment, the patients completed the Constant Shoulder, the Disabilities of the Arm, Shoulder and Hand scale (DASH) and the Medical Outcomes Study 36-Item Short-Form Health Survey version 2.0 (SF36v2) functional outcome surveys as well as a custom questionnaire to assess hand dominance, employment status, the amount of time taken before returning to work, the presence of numbness around the incision site (a surrogate marker of a supraclavicular nerve palsy), whether the patient desired the plate removed and/or if it was worth another surgery. With regard to the functional outcome surveys, the average DASH score was 11.8 ± 16.4, the Constant score was 93.3 ± 7.2, the SF36v2 physical component summary (PCS) was 50.7 ± 10.1 and the SF36v2 mental component summary (MCS) 50.6 ± 11.2. From the custom questionnaire, 27 patients (73%) found their cosmetic appearance acceptable while the remaining 10 patients (27%) were bothered by the appearance of the plate. The average time to return to work was 82.1 ± 77.4 days. There were no infections, refractures or nonunions of the clavicle. As the relative indications for open reduction and internal fixation of clavicle fractures become more popular, such as cosmetic concerns or faster recovery, we wish to demonstrate that the procedure is not without risks, including implant discomfort requiring a subsequent operation for removal, numbness around the incision site and infection. Despite these risks, patients tend to be satisfied with the procedure and are able to function at levels equal to that of the general population. The purpose of this study is not to recommend for or against operative treatment of clavicle fractures but merely to demonstrate risks associated with the procedure. Copyright © 2013 Elsevier Ltd. All rights reserved.

A practical 3D printed simulator for endoscopic endonasal transsphenoidal surgery to improve basic operational skills.

PubMed

Wen, Guodao; Cong, ZiXiang; Liu, KaiDong; Tang, Chao; Zhong, Chunyu; Li, Liwen; Dai, XuJie; Ma, Chiyuan

2016-06-01

We aimed to present a practical three-dimensional (3D) printed simulator to comprehensively and effectively accelerate the learning curve of endoscopic endonasal transsphenoidal surgery (EETS). The 3D printed simulator consists of three parts: (1) skull frame, (2) the nasal passage and the nasal alar of the face, and (3) a modified sella turcica. We aimed to improve three basic operational skills of surgeons: drilling, curetting, and aspirating. Eighteen neurosurgeons and five post-graduates were recruited and consented for the training. For trainees, (1) as the training progressed, the scores increased gradually, (2) a significant increase in the average scores was observed in the tenth training compared to the first training, and (3) there is a significant decrease in trainee variability in the shortening of the gap. The 18 neurosurgeons were divided into three groups: experts, assistants, and observers. For all three basic operations, (1) the average score of experts was obviously higher than that of the assistants, observers, and trainees' tenth training and (2) the average scores of assistants and observers were obviously higher than that of trainees' first training. A significant high in the average score between the assistants and the observers was seen for aspirating, but not for drilling or curetting. For curetting and aspirating, the tenth training average score of trainees was obviously higher than that of assistants and observers. This 3D printed simulator allows different endoscopic basic operations to be simulated and improves the EETS techniques of surgeons. We believed it to be a practical, simple, and low-cost simulator.

Charged structure constants from modularity

NASA Astrophysics Data System (ADS)

Das, Diptarka; Datta, Shouvik; Pal, Sridip

2017-11-01

We derive a universal formula for the average heavy-heavy-light structure constants for 2 d CFTs with non-vanishing u(1) charge. The derivation utilizes the modular properties of one-point functions on the torus. Refinements in N=2 SCFTs, show that the resulting Cardy-like formula for the structure constants has precisely the same shifts in the central charge as that of the thermodynamic entropy found earlier. This analysis generalizes the recent results by Kraus and Maloney for CFTs with an additional global u(1) symmetry [1]. Our results at large central charge are also shown to match with computations from the holographic dual, which suggest that the averaged CFT three-point coefficient also serves as a useful probe of detecting black hole hair.

Assessing anxiety levels and empathic tendency in blood and platelet donors.

PubMed

Kılıç, Suar Çakı; Doğan, Erdoğan; Sevimligül, Gülgün; Yücel, Birsen; Bolat, Fatih; Kavakçı, Onder; Sencan, Mehmet

2013-06-01

In spite of a constantly-increasing requirement for blood transfusion in the world, blood donation does not exhibit an increase at the same rate. In Turkey with a population of 74 million, only 15 per 10,000 people donate blood regularly and rate of voluntary blood donation is very low compared to developed countries. The aim of this study is to determine empathic level of donors and anxiety levels of blood and platelet donors and also to enable comfort and motivation of donors by taking precautions for reducing their anxieties. This prospective and descriptive study was conducted with 100 voluntary donors (50 blood donors, 50 platelet donors) who admitted to Blood Centre of Cumhuriyet University Hospital between 15 March 2012 and 30 April 2012. Average age of these donors was 27 (19-48)years. The mean scores of donors from Empathic Tendency Scale (ETS), State Anxiety Invertory (SAI) and Trait Anxiety Inventory (TAI) were 70 (49-83), 40 (33-45) and 34 (30-44), respectively. ETS score of those donating blood/platelet for the first time was low, >1 is higher in those who donated previously. SAI and TAI scores of blood donors were higher than those of platelet donors (p<0.001) and TAI score was higher in those who donate for the first time (p<0.007) compared to previously donated precipitants. In conclusion, this study underscores that the request of the donor to help others is the most important factor for donation. People frequently donate blood to unfamiliar people and recurring blood donations increase the level of empathy. Donation made during the continuous disclosure is an important factor for being a donor. Copyright © 2013 Elsevier Ltd. All rights reserved.

Similar BCL-X but different BCL-2 levels in the two age groups of north African nasopharyngeal carcinomas.

PubMed

Khabir, Abdelmajid; Ghorbel, Abdelmoneem; Daoud, Jamel; Frikha, Mounir; Drira, Mohamed Mokhtar; Laplanche, Agnès; Busson, Pierre; Jlidi, Rachid

2003-01-01

Nasopharyngeal carcinomas (NPCs) are consistently associated with the Epstein-Barr virus (EBV). As Bcl-2 and Bcl-X are co-expressed in EBV-transformed B-lymphocytes, we attempted to determine their status in malignant NPC cells. A retrospective series of 100 NPC specimens from untreated Tunisian patients was investigated by immuno-histochemistry. Twenty seven of the patients were below 30 years old and therefore classified in the "juvenile" form of north African NPCs. Bcl-2 and Bcl-X expression was assessed semi-quantitatively using a score based on the percentage of positive cells and staining intensity. Intense Bcl-X expression was detected in malignant cells of 100% biopsy samples with similar scores for patients below 30 years or those aged 30 or over. Bcl-2 was detected in 89% biopsies but its expression differed considerably between the samples. The average Bcl-2 score was much lower for patients under 30 years (4.4+/-1.5 compared to 6.5+/-2 for older patients; P<10(-6)). Multivariate analysis demonstrated that no other clinical parameter, except the primary tumor size, was correlated to the Bcl-2 score. Bcl-X and Bcl-2 are co-expressed in 89% of NPCs whereas their expression is mutually exclusive in other head and neck carcinomas (particularly squamous cell carcinomas, SCC). The constantly high expression of Bcl-X is consistent with it being induced by the EBV protein Epstein-Barr nuclear antigen 1 (EBNA1), as recently reported in a murine model. The contrasted levels of Bcl-2 expression in the two age groups strengthen the hypothesis that these clinical forms result from distinct oncogenic mechanisms.

Quality of life of children and adolescents with cancer: revision of studies literature that used the Pediatric Quality Of Life Inventory.

PubMed

Queiroz, Débora Milena Farias; Amorim, Maria Helena Costa; Zandonade, Eliana; Miotto, Maria Helena Monteiro de Barros

2015-01-01

To assess the quality of life of children and adolescents with cancer of studies that applied the Pediatric Quality of Life Inventory 3.0 Cancer Module. The study was carried out on the basis of data Scopus Web of Science, BIREME, EBSCO host and Psychoinfo of articles in Spanish, English and Portuguese, and published from 1998 to 2013 that used the Pediatric Quality of life Inventory 3.0 Cancer Module. 21 articles were selected, of which 47.6% were carried out in America, and 61.9% of editions comprehended from 2011 to 2013. The scores variation by dimensions and in general was probably related for the selection of comparison groups, as the diversity of inclusion criteria and variants may be observed for the analysis in each study. The existence of a standard dimension could not be verified either for children ́s /adolescents reports or for parents. It is concluded that the scores averages by dimensions in general have not achieved values below 30 and the largest scores by dimension are above 80. It is suggested that the treatment anxiety dimension in children ́s and adolescents ́s reports may have obtained the largest scores within each study, that is lesser than the difficulty of the children and adolescents in face of the treatment and cancer. Nursing becomes a constant presence in the life of children and adolescents with cancer and it may provide a better quality of life for developing nursing activities and the team may demistify, clarify and help in all phases of the illness and treatment.

Motor ability and inhibitory processes in children with ADHD: a neuroelectric study.

PubMed

Hung, Chiao-Ling; Chang, Yu-Kai; Chan, Yuan-Shuo; Shih, Chia-Hao; Huang, Chung-Ju; Hung, Tsung-Min

2013-06-01

The purpose of the current study was to examine the relationship between motor ability and response inhibition using behavioral and electrophysiological indices in children with ADHD. A total of 32 participants were recruited and underwent a motor ability assessment by administering the Basic Motor Ability Test-Revised (BMAT) as well as the Go/No-Go task and event-related potential (ERP) measurements at the same time. The results indicated that the BMAT scores were positively associated with the behavioral and ERP measures. Specifically, the BMAT average score was associated with a faster reaction time and higher accuracy, whereas higher BMAT subset scores predicted a shorter P3 latency in the Go condition. Although the association between the BMAT average score and the No-Go accuracy was limited, higher BMAT average and subset scores predicted a shorter N2 and P3 latency and a larger P3 amplitude in the No-Go condition. These findings suggest that motor abilities may play roles that benefit the cognitive performance of ADHD children.

Selection criteria of residents for residency programs in Kuwait

PubMed Central

2013-01-01

Background In Kuwait, 21 residency training programs were offered in the year 2011; however, no data is available regarding the criteria of selecting residents for these programs. This study aims to provide information about the importance of these criteria. Methods A self-administered questionnaire was used to collect data from members (e.g. chairmen, directors, assistants …etc.) of residency programs in Kuwait. A total of 108 members were invited to participate. They were asked to rate the importance level (scale from 1 to 5) of criteria that may affect the acceptance of an applicant to their residency programs. Average scores were calculated for each criterion. Results Of the 108 members invited to participate, only 12 (11.1%) declined to participate. Interview performance was ranked as the most important criteria for selecting residents (average score: 4.63/5.00), followed by grade point average (average score: 3.78/5.00) and honors during medical school (average score: 3.67/5.00). On the other hand, receiving disciplinary action during medical school and failure in a required clerkship were considered as the most concerning among other criteria used to reject applicants (average scores: 3.83/5.00 and 3.54/5.00 respectively). Minor differences regarding the importance level of each criterion were noted across different programs. Conclusions This study provided general information about the criteria that are used to accept/reject applicants to residency programs in Kuwait. Future studies should be conducted to investigate each criterion individually, and to assess if these criteria are related to residents' success during their training. PMID:23331670

Diversity efforts, admissions, and national rankings: can we align priorities?

PubMed

Heller, Caren A; Rúa, Sandra Hurtado; Mazumdar, Madhu; Moon, Jennifer E; Bardes, Charles; Gotto, Antonio M

2014-01-01

Increasing student body diversity is a priority for national health education and professional organizations and for many medical schools. However, national rankings of medical schools, such as those published by U.S. News & World Report, place a heavy emphasis on grade point average (GPA) and Medical College Admissions Test (MCAT) scores, without considering student body diversity. These rankings affect organizational reputation and admissions outcomes, even though there is considerable controversy surrounding the predictive value of GPA and MCAT scores. Our aim in this article was to explore the relationship between standard admissions practices, which typically aim to attract students with the highest academic scores, and student body diversity. We examined how changes in GPA and MCAT scores over 5 years correlated with the percentage of enrolled students who are underrepresented in medicine. In a majority of medical schools in the United States from 2005 to 2009, average GPA and MCAT scores of applicants increased, whereas the percentage of enrolled students who are underrepresented in medicine decreased. Our findings suggest that efforts to increase the diversity of medical school student bodies may be complicated by a desire to maintain high average GPA and MCAT scores. We propose that U.S. News revise its ranking methodology by incorporating a new diversity score into its student selectivity score and by reducing the weight placed on GPA and MCAT scores.

The Effect of Buzz Group Technique and Clustering Technique in Teaching Writing at the First Class of SMA HKBP I Tarutung

ERIC Educational Resources Information Center

Pangaribuan, Tagor; Manik, Sondang

2018-01-01

This research held at SMA HKBP 1 Tarutung North Sumatra on the research result of test XI[superscript 2] and XI[superscript 2] students, after they got treatment in teaching writing in recount text by using buzz group and clustering technique. The average score (X) was 67.7 and the total score buzz group the average score (X) was 77.2 and in…

2009 Department of Defense HIV/AIDS Prevention Program (DHAPP)

DTIC Science & Technology

2010-05-01

FY08 to assess the program’s effectiveness. MEASURES OF EFFECTIVENESS Pretest and posttests have been developed with the expertise of the physicians...among the trainees. Pretest scores ranged from 55.0% to 80.0%, while posttest scores ranged from 72.5% to 82.5%, making it clear that it was a...valuable training for all participants. The average pretest score ranged from approximately 67.5% to a posttest average of 79.0%, showing clear

Enamel Hypomineralization in Children With Clefts and the Relationship to Treatment: A Cross-sectional Retrospective Study.

PubMed

Allam, Eman; Ghoneima, Ahmed; Tholpady, Sunil S; Kula, Katherine

2018-06-19

The aim of this study was to determine whether molar incisor hypomineralization (MIH) is greater in patients with cleft lip and palate (CLP) who underwent primary alveolar grafting (PAG) as compared with CLP waiting for secondary alveolar grafting (SAG) and with controls. A retrospective analysis of intraoral photographs of 13 CLP patients who underwent a PAG, 28 CLP prior to SAG, and 60 controls without CLP was performed. Mantel-Haenszel χ tests were used to compare the 3 groups for differences in MIH scores, and Wilcoxon rank sum tests were used to compare the groups for differences in average MIH scores. A 5% significance level was used for all tests. Molar incisor hypomineralization scores were significantly higher for the PAG and SAG groups compared with the control group (P < 0.001). The PAG group had significantly higher incisor MIH (P = 0.016) compared with the SAG group. Molar incisor hypomineralization average scores were significantly higher for the 2 graft groups compared with the controls (P < 0.0001). The PAG group had significantly higher average MIH score and average MIH score for incisors compared with the SAG group (P = 0.03). Cleft lip and palate patients have significantly greater MIH compared with controls, and CLP patients with PAGs have significantly greater MIH in the incisor region compared with CLP patients with SAGs, indicating that subjects with PAGs have more severely affected dentition.

Evaluation of patient compliance, quality of life impact and cost-effectiveness of a "test in-train out" exercise-based rehabilitation program for patients with intermittent claudication.

PubMed

Malagoni, Anna Maria; Vagnoni, Emidia; Felisatti, Michele; Mandini, Simona; Heidari, Mahdi; Mascoli, Francesco; Basaglia, Nino; Manfredini, Roberto; Zamboni, Paolo; Manfredini, Fabio

2011-01-01

Patients with intermittent claudication (IC) could benefit from low-cost, effective rehabilitative programs. This retrospective study evaluates compliance, impact on Quality of Life (QoL) and cost-effectiveness of a hospital prescribed, at-home performed (Test-in/Train-out) rehabilitative program for patients with IC. Two-hundred and eighty-nine patients with IC (71 ± 10.1 years, M = 210) were enrolled for a 2-year period. Two daily 10-min home walking sessions at maximal asymptomatic speed were prescribed, with serial check-ups at the hospital. Compliance with the program was assessed by assigning a score of 1 (lowest compliance) to 4 (highest compliance). The SF-36 questionnaire and a constant-load treadmill test were used to evaluate QoL and Initial/Absolute Claudication Distance, respectively. Both direct and indirect costs of the program were considered for cost-effectiveness analysis. Two-hundred and fifty patients (70.5 ± 9.2 years, M = 191), at Fontaine's II-B stage (86%), were included in the study. No adverse events were reported. The average compliance score was 3.1. At discharge, both SF-36 domains and walking performance significantly increased (P < 0.0001). A total of 1,839 in-hospital check-ups (7.36 /patient) were performed. Direct and indirect costs represented 93% and 7% of the total costs, respectively. The average costs of a visit and of a therapy cycle were C68.93 and C507.20, respectively. The cost to walk an additional meter before stopping was C9.22. A Test-in/Train-out program provided favourable patient compliance, QoL impact and cost-effectiveness in patients with IC.

20 years of trauma documentation in Germany--actual trends and developments.

PubMed

2014-10-01

The TraumaRegister DGU(®) has been founded 20 years ago. Although initially supported by larger hospitals and universities, it has recently become a representative registry for the care of severely injured patients in Germany. Based on the registry data some important trends and developments of the recent decades are presented. German trauma patients with an Injury Severity Score (ISS)≥ 16 were eligible if primary admitted from the scene. All cases documented between 1993 and 2012 (20 years) were eligible. For selected variables, an average change per years was calculated using linear regression analysis. A total of 49,801 patients was analysed. The mean age was 46.3 years, and 72% were males. The following relevant trends could be observed: The average age increased dramatically from 38 to 50 years. Pre-hospital intubation rate was halfed in patients with Glasgow Coma Scale (GCS)>8 but remained constant in unconscious patients (GCS ≤ 8; 90% intubation rate). Pre-hospital volume administration decreased as well, which led to less blood transfusions (from 45% to 16%). The use of helicopters for transportation into a trauma centre decreased as well but today still 27% of all cases are transported by air. Whole-body CT was performed in about 80% of patients; this value is stable in the last four years. Hospital mortality could be reduced and was 2-3% lower than expected in recent years. The Revised Injury Severity Classification (RISC) score used as a reference here was based on TR-DGU data from the 1990s. Standardised prospective registration of severely injured patients over 20years allows to empirically monitor trends and developments in acute trauma care. Copyright © 2014 Elsevier Ltd. All rights reserved.

Predicting heterocyclic ring coupling constants through a conformational search of tetra-O-methyl-(+)-catechin

Treesearch

Fred L. Tobiason; Richard W. Hemingway

1994-01-01

A GMMX conformational search routine gives a family of conformations that reflects the Boltzmann-averaged heterocyclic ring conformation as evidenced by accurate prediction of all three coupling constants observed for tetra-O-methyl-(+)-catechin.

Predicting heterocyclic ring coupling constants through a conformational search of tetra-o-methyl-(+)-catechin

Treesearch

Fred L. Tobiason; Richard w. Hemingway

1994-01-01

A GMMXe conformational search routine gives a family a conformations that reflects the boltzmann-averaged heterocyclic ring conformation as evidence by accurate prediction of all three coupling constants observed for tetra-O-methyl-(+)-catechin.

In vivo clinical and radiological effects of platelet-rich plasma on interstitial supraspinatus lesion: Case series.

PubMed

Lädermann, A; Zumstein, M A; Kolo, F C; Grosclaude, M; Koglin, L; Schwitzguebel, A J P

2016-12-01

Rotator cuff tear (RCT) is a frequent condition of clinical relevance that can be managed with a symptomatic conservative treatment, but surgery is often needed. Biological components like leukocytes and platelet rich plasma (L-PRP) could represent an alternative curative method for interstitial RCT. It has been hypothesized that an ultrasound guided L-PRP injection in supraspinatus interstitial RCT could induce radiological healing. A prospective case series including 25 patients was performed in order to assess the effect of L-PRP infiltration into supraspinatus interstitial RCTs. Primary outcome was tear size change determined by magnetic resonance imaging arthrogram (MRA) before and 6 months after L-PRP infiltration. Secondary outcomes were Constant score, SANE score, and pain visual analog scale (VAS) after L-PRP infiltration. Tear volume diminution was statistically significant (P=.007), and a >50% tear volume diminution was observed in 15 patients. A statistically significant improvement of Constant score (P<.001), SANE score (P=.001), and VAS (P<.001) was observed. In 21 patients, Constant score improvement reached the minimal clinical important difference of 10.4 points. We observed a statistically significant and clinically relevant effect on RCT size and clinical parameters after L-PRP infiltration. Such an important improvement of supraspinatus interstitial RCT with conservative management is uncommon, therefore intratendinous L-PRP infiltrations could have been beneficial. This encouraging result could pave the way for future randomized studies in order to formally determinate whether L-PRP infiltrations are a possible alternative to surgical treatment of interstitial RCT. Prospective observational study; Level of evidence II. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Short-term Results of Robinson Type 2B2 Clavicular Fractures Treated Conservatively or Surgically.

PubMed

Malkoc, Melih; Korkmaz, Ozgur; Bayram, Erhan; Ormeci, Tugrul; Isyar, Mehmet; Yilmaz, Murat; Seker, Ali

2016-01-01

The most frequently treated injuries, representing approximately 82% of all clavicular fractures, involve the midshaft clavicle. Historically, most acute displaced midshaft clavicular fractures were treated nonsurgically. However, the outcomes of nonsurgical treatment have recently been thought to be not as good as expected in the past, and the trend is to treat these fractures surgically. The goal of this study was to evaluate the short-term clinical outcomes of Robinson type 2B2 clavicular fractures treated conservatively vs with locked plate fixation. Among 59 patients included in the study, 30 patients (mean age, 45±13.7 years; range, 30-62 years) treated conservatively were designated as group A, and 29 patients (mean age, 38.8±11.1 years; range, 20-60 years) treated with locked plate fixation were designated as group B. All patients were evaluated using Oxford and Constant scoring systems at final follow-up. Mean follow-up was 18 months (range, 12-24 months). In group A, mean Constant score was 70.5±15.1 (range, 98-43) and mean Oxford score was 46.6±1.3 (range, 49-44) at final follow-up. In group B, mean Constant score was 89.2±8 (range, 100-77) and mean Oxford score was 46.5±1.2 (range, 48-44) at final follow-up. Callus was detected radiographically in both groups at 6-week follow-up. Patients in groups A and B started active range-of-motion exercises at weeks 6 and 3 after treatment, respectively. Locked plate fixation of Robinson type 2B2 clavicular fractures can be the first treatment option because of good clinical results, low complication rates, and good cosmesis. Copyright 2016, SLACK Incorporated.

Platelet-rich plasma supplementation in arthroscopic repair of full-thickness rotator cuff tears: a randomized clinical trial.

PubMed

D'Ambrosi, R; Palumbo, F; Paronzini, A; Ragone, V; Facchini, R M

2016-12-01

Results on the effectiveness of PRP supplementation in arthroscopic rotator cuff repair are conflicting, making it difficult to draw definitive conclusions. This was a prospective, randomized, and double-blind study with two groups of 20 patients each (PRP group and control group). Degenerative supraspinatus full-thickness tears grade C2-C3 were subjected to arthroscopic repair; PRP supplementation was given to patients in the PRP group. The outcomes were assessed by DASH, Constant scales, and ultrasound before and 6 months after surgery. Pain measured by VAS was evaluated preoperatively and 7 and 30 days after surgery. The two groups did not differ significantly by age, sex, and dominance of the affected side. In all surgical procedures, a long head of the biceps tenotomy and single-row repair were performed. The preoperative VAS was 5.6 ± 2.4 in PRP group and 6.4 ± 1.5 in the control group (p > 0.05). The group supplemented with PRP reported a VAS significantly better in the first week (2.5 ± 1.9 vs 5.3 ± 2.1, p < 0.05) and during the first month after surgery (1.5 ± 1.0 vs 3.2 ± 1.7, p < 0.05) compared to the control group. The preoperative Constant and DASH scores were 39.95 ± 12 and 51 ± 15.2, respectively, in the PRP group and 41 ± 11 (p > 0.05) and 45 ± 12.6 (p > 0.05) in the control group. The average Constant score improved significantly after 6 months to 81 ± 11.2 (p < 0.05) in the PRP group and 78.5 ± 9 (p < 0.05) in the control group. No differences were noted between the two groups (p > 0.05). The DASH score after 6 months was 17.4 ± 8 (p < 0.05) for the treatment group (the PRP group) and 21 ± 8.4 (p < 0.05) for the control group. No statistically significant differences were found as regards the DASH score in the two groups after 6 months (p > 0.05). The two groups showed no differences in the ultrasound evaluation after 6 months either. No re-ruptures occurred in either group. PRP leads to a reduction in pain during a short-term follow-up. Pain reduction allows for a more rapid recovery of mobilization and improvement in functionality. Randomized controlled trial, Level of evidence, 1.

Light induced apoptosis is accelerated in transgenic retina overexpressing human EAT/mcl-1, an anti-apoptotic bcl-2 related gene.

PubMed

Shinoda, K; Nakamura, Y; Matsushita, K; Shimoda, K; Okita, H; Fukuma, M; Yamada, T; Ohde, H; Oguchi, Y; Hata, J; Umezawa, A

2001-10-01

EAT/mcl-1 (EAT), an immediate early gene, functions in a similar way to bcl-2 in neutralising Bax mediated cytotoxicity, suggesting that EAT is a blocker of cell death. The aim of this study was to determine the effect of overexpression of the human EAT gene on light induced retinal cell apoptosis. EAT transgenic mice incorporating the EF-1alpha promoter were utilised, and expression of human EAT was detected by RT-PCR. Light damage was induced by raising mice under constant illumination. Two groups of animals, EAT transgenic mice (n=14) and littermates (n=13), were examined by ERG testing and histopathology at regular time points up to 20 weeks of constant light stimulation. Electrophysiological and histopathological findings were evaluated by established systems of arbitrary scoring as scores 0-2 and scores 0-3, respectively. The mean score (SD) of ERG response was significantly lower in EAT transgenic mice (0.79 (0.89)) than in littermates (1.69 (0.48)) (p<0.01). Although the differences between the two survival curves did not reach statistical significance (p=0.1156), the estimated incidence of electrophysiological retinal damage was higher in EAT mice (0.0495/mouse/week; 95% confidence interval (CI) 0.0347-0.0500) than in littermates (0. 0199/mouse/week; 95% CI 0.0035-0.0364). The mean scores (SD) for histopathological retinal degeneration were 2.31 (0.63) in littermates and 1.43 (1.22) in EAT transgenic mice (p=0.065). However, Kaplan-Meier curves for histopathological failure in two groups of mice showed that retinal photoreceptor cells were preserved significantly against constant light in the littermate compared with transgenic mice (p=0.0241). The estimated incidence of histopathological retinal damage was 0.0042/mouse/week in the littermates (95% CI 0-0.0120) and 0.0419/mouse/week in the EAT mice (95% CI 0.0286-0.0500). Retinal photoreceptor cell apoptosis under constant light stimulation is likely to be accelerated in transgenic retina overexpressing EAT.

Estimation of Uncertainties in the Global Distance Test (GDT_TS) for CASP Models.

PubMed

Li, Wenlin; Schaeffer, R Dustin; Otwinowski, Zbyszek; Grishin, Nick V

2016-01-01

The Critical Assessment of techniques for protein Structure Prediction (or CASP) is a community-wide blind test experiment to reveal the best accomplishments of structure modeling. Assessors have been using the Global Distance Test (GDT_TS) measure to quantify prediction performance since CASP3 in 1998. However, identifying significant score differences between close models is difficult because of the lack of uncertainty estimations for this measure. Here, we utilized the atomic fluctuations caused by structure flexibility to estimate the uncertainty of GDT_TS scores. Structures determined by nuclear magnetic resonance are deposited as ensembles of alternative conformers that reflect the structural flexibility, whereas standard X-ray refinement produces the static structure averaged over time and space for the dynamic ensembles. To recapitulate the structural heterogeneous ensemble in the crystal lattice, we performed time-averaged refinement for X-ray datasets to generate structural ensembles for our GDT_TS uncertainty analysis. Using those generated ensembles, our study demonstrates that the time-averaged refinements produced structure ensembles with better agreement with the experimental datasets than the averaged X-ray structures with B-factors. The uncertainty of the GDT_TS scores, quantified by their standard deviations (SDs), increases for scores lower than 50 and 70, with maximum SDs of 0.3 and 1.23 for X-ray and NMR structures, respectively. We also applied our procedure to the high accuracy version of GDT-based score and produced similar results with slightly higher SDs. To facilitate score comparisons by the community, we developed a user-friendly web server that produces structure ensembles for NMR and X-ray structures and is accessible at http://prodata.swmed.edu/SEnCS. Our work helps to identify the significance of GDT_TS score differences, as well as to provide structure ensembles for estimating SDs of any scores.

Establishing the minimal clinically important difference for the Questionnaire of Olfactory Disorders.

PubMed

Mattos, Jose L; Schlosser, Rodney J; Mace, Jess C; Smith, Timothy L; Soler, Zachary M

2018-05-02

Olfactory-specific quality of life (QOL) can be measured using the Questionnaire of Olfactory Disorders Negative Statements (QOD-NS). Changes in the QOD-NS after treatment can be difficult to interpret since there is no standardized definition of clinically meaningful improvement. Patients with chronic rhinosinusitis (CRS) completed the QOD-NS. Four distribution-based methods were used to calculate the minimal clinically important difference (MCID): (1) one-half standard deviation (SD); (2) standard error of the mean (SEM); (3) Cohen's effect size (d) of the smallest unit of change; and (4) minimal detectable change (MDC). We also averaged all 4 of the scores together. Finally, the likelihood of achieving a MCID after sinus surgery using these methods, as well as average QOD-NS scores, was stratified by normal vs abnormal baseline QOD-NS scores. Outcomes were examined on 128 patients. The mean ± SD improvement in QOD-NS score after surgery was 4.3 ± 11.0 for the entire cohort and 9.6 ± 12.9 for those with abnormal baseline scores (p < 0.001). The MCID values using the different techniques were: (1) SD = 6.5; (2) SEM = 3.1; (3) d = 2.6; and (4) MDC = 8.6. The MCID score was 5.2 on average. For the total cohort analysis, the likelihood of reporting a MCID ranged from 26% to 51%, and 49% to 70% for patients reporting preoperative abnormal olfaction. Distribution-based MCID values of the QOD-NS range between 2.6 and 8.6 points, with an average of 5.2. When stratified by preoperative QOD-NS scores the majority of patients reporting abnormal preoperative QOD-NS scores achieved a MCID. © 2018 ARS-AAOA, LLC.

Exploring the Gender Gap in the Conceptual Survey of Electricity and Magnetism

ERIC Educational Resources Information Center

Henderson, Rachel; Stewart, Gay; Stewart, John; Michaluk, Lynnette; Traxler, Adrienne

2017-01-01

The "gender gap" on various physics conceptual evaluations has been extensively studied. Men's average pretest scores on the Force Concept Inventory and Force and Motion Conceptual Evaluation are 13% higher than women's, and post-test scores are on average 12% higher than women's. This study analyzed the gender differences within the…

Calcifying tendinitis of the shoulder: midterm results after arthroscopic treatment.

PubMed

Balke, Maurice; Bielefeld, Rebecca; Schmidt, Carolin; Dedy, Nicolas; Liem, Dennis

2012-03-01

Calcifying tendinitis is a common and painful disorder of the shoulder characterized by the presence of calcific deposits in the tendons of the rotator cuff. When nonoperative treatment over a prolonged period of time fails, surgical treatment should be considered. Midterm success rates are inconsistent, and the role of subacromial decompression is still unclear. Our hypotheses were that the rate of supraspinatus tears after arthroscopic treatment of calcifying tendinitis is comparable with that in the contralateral uninvolved shoulder and that subacromial decompression does not have beneficial effects compared with calcium removal alone. Case series; Level of evidence, 4. In 70 shoulders of 62 patients with a mean age of 54 years, arthroscopic removal of calcium deposits of the supraspinatus tendon was performed. In 44 shoulders, additional subacromial decompression was performed. After a mean follow-up of 6 years (range, 2-13 years), patients were clinically investigated, and function was statistically evaluated using Constant and American Shoulder and Elbow Surgeons (ASES) scores. Affected and contralateral shoulders were examined by ultrasound in 48 shoulders, and rotator cuff tears were documented. The mean Constant scores of the operated shoulders were significantly lower than those of the healthy shoulders (P < .001). The ASES scores significantly (P < .001) increased after surgery but were still lower than the ASES scores of the healthy shoulders (P < .001). Concerning the additional subacromial decompression, there were no significant differences in the overall ASES and Constant scores; the subitem "pain" was significantly better in the subacromial decompression group (P = .048). Ultrasound examination at last follow-up (48 shoulders) showed a partial supraspinatus tendon tear in 11 operated and 3 contralateral shoulders. Although the good clinical results after arthroscopic treatment of calcifying tendinitis of the shoulder persist midterm, the affected shoulders present significantly lower clinical scores than healthy shoulders. The rate of partial supraspinatus tendon tears seems to be higher after calcium removal. Additional subacromial decompression seems to reduce postoperative pain.

Determination of the attractive force, adhesive force, adhesion energy and Hamaker constant of soot particles generated from a premixed methane/oxygen flame by AFM

NASA Astrophysics Data System (ADS)

Liu, Ye; Song, Chonglin; Lv, Gang; Chen, Nan; Zhou, Hua; Jing, Xiaojun

2018-03-01

Atomic force microscopy (AFM) was used to characterize the attractive force, adhesive force and adhesion energy between an AFM probe tip and nanometric soot particle generated by a premixed methane/oxygen flame. Different attractive force distributions were found when increasing the height above burner (HAB), with forces ranging from 1.1-3.5 nN. As the HAB was increased, the average attractive force initially increased, briefly decreased, and then underwent a gradual increase, with a maximum of 2.54 nN observed at HAB = 25 mm. The mean adhesive force was 6.5-7.5 times greater than the mean attractive force at the same HAB, and values were in the range of 13.5-24.5 nN. The adhesion energy was in the range of 2.0-5.6 × 10-17 J. The variations observed in the average adhesion energy with increasing HAB were different from those of the average adhesion force, implying that the stretched length of soot particles is an important factor affecting the average adhesion energy. The Hamaker constants of the soot particles generated at different HABs were determined from AFM force-separation curves. The average Hamaker constant exhibited a clear correlation with the graphitization degree of soot particles as obtained from Raman spectroscopy.

DETERMINATION OF HENRY'S LAW CONSTANTS OF SELECTED PRIORITY POLLUTANTS

EPA Science Inventory

The Henry's law constants (H) for 41 selected priority pollutants were determined to characterize these pollutants and provide information on their fate as they pass through wastewater treatment systems. All experimental values presented for H are averages of two or more replicat...

Automated Quantification of the Landing Error Scoring System With a Markerless Motion-Capture System.

PubMed

Mauntel, Timothy C; Padua, Darin A; Stanley, Laura E; Frank, Barnett S; DiStefano, Lindsay J; Peck, Karen Y; Cameron, Kenneth L; Marshall, Stephen W

2017-11-01

  The Landing Error Scoring System (LESS) can be used to identify individuals with an elevated risk of lower extremity injury. The limitation of the LESS is that raters identify movement errors from video replay, which is time-consuming and, therefore, may limit its use by clinicians. A markerless motion-capture system may be capable of automating LESS scoring, thereby removing this obstacle.   To determine the reliability of an automated markerless motion-capture system for scoring the LESS.   Cross-sectional study.   United States Military Academy.   A total of 57 healthy, physically active individuals (47 men, 10 women; age = 18.6 ± 0.6 years, height = 174.5 ± 6.7 cm, mass = 75.9 ± 9.2 kg).   Participants completed 3 jump-landing trials that were recorded by standard video cameras and a depth camera. Their movement quality was evaluated by expert LESS raters (standard video recording) using the LESS rubric and by software that automates LESS scoring (depth-camera data). We recorded an error for a LESS item if it was present on at least 2 of 3 jump-landing trials. We calculated κ statistics, prevalence- and bias-adjusted κ (PABAK) statistics, and percentage agreement for each LESS item. Interrater reliability was evaluated between the 2 expert rater scores and between a consensus expert score and the markerless motion-capture system score.   We observed reliability between the 2 expert LESS raters (average κ = 0.45 ± 0.35, average PABAK = 0.67 ± 0.34; percentage agreement = 0.83 ± 0.17). The markerless motion-capture system had similar reliability with consensus expert scores (average κ = 0.48 ± 0.40, average PABAK = 0.71 ± 0.27; percentage agreement = 0.85 ± 0.14). However, reliability was poor for 5 LESS items in both LESS score comparisons.   A markerless motion-capture system had the same level of reliability as expert LESS raters, suggesting that an automated system can accurately assess movement. Therefore, clinicians can use the markerless motion-capture system to reliably score the LESS without being limited by the time requirements of manual LESS scoring.

Surface Plasmon Resonance Evaluation of Colloidal Metal Aerogel Filters

NASA Technical Reports Server (NTRS)

Smith, David D.; Sibille, Laurent; Cronise, Raymond J.; Noever, David A.

1997-01-01

Surface plasmon resonance imaging has in the past been applied to the characterization of thin films. In this study we apply the surface plasmon technique not to determine macroscopic spatial variations but rather to determine average microscopic information. Specifically, we deduce the dielectric properties of the surrounding gel matrix and information concerning the dynamics of the gelation process from the visible absorption characteristics of colloidal metal nanoparticles contained in aerogel pores. We have fabricated aerogels containing gold and silver nanoparticles. Because the dielectric constant of the metal particles is linked to that of the host matrix at the surface plasmon resonance, any change 'in the dielectric constant of the material surrounding the metal nanoparticles results in a shift in the surface plasmon wavelength. During gelation the surface plasmon resonance shifts to the red as the average or effective dielectric constant of the matrix increases. Conversely, formation of an aerogel or xerogel through supercritical extraction or evaporation of the solvent produces a blue shift in the resonance indicating a decrease in the dielectric constant of the matrix. From the magnitude of this shift we deduce the average fraction of air and of silica in contact with the metal particles. The surface area of metal available for catalytic gas reaction may thus be determined.

Hyper-parenting is negatively associated with physical activity among 7-12year olds.

PubMed

Janssen, Ian

2015-04-01

To explore associations between helicopter, little emperor, tiger mom, and concerted cultivation hyper-parenting styles with child physical activity. 724 North American parents of 7-12 year olds completed a survey (May, 2014) that assessed their engagement in the hyper-parenting styles and the frequency that their child played outdoors, walked/bicycled, and played organized sports. Z-scores were generated for each hyper-parenting style and four groups were created: low (<-1 SD), below average (-1 to -0.49 SD), average (-0.50 to 0.50 SD), above average (0.51 to 0.1.0 SD), and high (>1 SD). Outdoor play, active transportation, and organized sport did not differ across helicopter parenting groups. Children in the low little emperor group had higher (P<0.005) outdoor play and active transportation scores than children in the average, above average, and high groups (exception: high group for outdoor play). Children in the low tiger mom and concerted cultivation groups had higher (P<0.005) outdoor play, active transportation, and organized sport scores than children in the average, above average, and high groups (exceptions: average and high tiger mom groups for organized sport). Little emperor, tiger mom, and concerted cultivation parenting styles were associated with lower physical activity among 7-12 year olds. Copyright © 2015. Published by Elsevier Inc.

Academic status and progress of deaf and hard-of-hearing students in general education classrooms.

PubMed

Antia, Shirin D; Jones, Patricia B; Reed, Susanne; Kreimeyer, Kathryn H

2009-01-01

The study participants were 197 deaf or hard-of-hearing students with mild to profound hearing loss who attended general education classes for 2 or more hours per day. We obtained scores on standardized achievement tests of math, reading, and language/writing, and standardized teacher's ratings of academic competence annually, for 5 years, together with other demographic and communication data. Results on standardized achievement tests indicated that, over the 5-year period, 63%-79% of students scored in the average or above-average range in math, 48%-68% in reading, and 55%-76% in language/writing. The standardized test scores for the group were, on average, half an SD below hearing norms. Average student progress in each subject area was consistent with or better than that made by the norm group of hearing students, and 79%-81% of students made one or more year's progress annually. Teachers rated 69%-81% of students as average or above average in academic competence over the 5 years. The teacher's ratings also indicated that 89% of students made average or above-average progress. Students' expressive and receptive communication, classroom participation, communication mode, and parental participation in school were significantly, but moderately, related to academic outcomes.

Perches and elevated platforms in commercial broiler farms: use and effect on walking ability, incidence of tibial dyschondroplasia and bone mineral content.

PubMed

Kaukonen, E; Norring, M; Valros, A

2017-05-01

Modern fast-growing broilers spend excessive periods resting and their activity further decreases with age. Inactivity has been suggested to increase impaired gait and the incidence of leg disorders. Tibial dyschondroplasia (TD) is a common leg pathology in broilers. A more complex environment might facilitate more activity and improve leg health. Perches or elevated platforms bring variety to broilers' environment and could motivate more locomotion. This study examined the impact of perches and elevated platforms on walking ability, the occurrence of TD and level of bone ash and mineral contents. The investigation was performed on four commercial broiler farms throughout six consecutive batches with platforms and four to five with perches. On each farm at least two separate houses were included, enabling the comparison of furnished flocks to control flocks during each batch. Plastic slats with ramp access elevated by 30 cm or wooden perches of 10 and 30 cm height were offered in the furnished house. Farmers recorded the platform and perch usage twice a week with a five-point scale. Gait was scored before slaughter on a six-point scale according to the Welfare Quality® assessment protocol for poultry. The severity of TD was determined using a four-point scale on farm from all birds gait scored as 3 and at slaughter from 200 birds/flock. Farmers estimated 50% to 100% of the platforms to be occupied in all flocks throughout the entire growing period. Only single birds were perching, thus perch structures were constantly evaluated to be empty. Due to the low use, the perch-equipped houses were excluded when analysing bone content, walking ability and TD. On average, 30% of the tested birds exhibited gait score ⩾3. Younger scoring age resulted in a lower mean gait score and a lower percentage of scores 3 and 4 to 5. Overall, 2.3% of the birds examined at slaughter and 3.5% of the birds with gait score 3 were affected by TD. Leg health was better in birds with access to platforms: mean gait score, the percentage of birds scoring 3, and TD percentage and severity were lower in birds in platform-equipped houses. Elevated structures such as platforms, offering additional possibilities for locomotion to broilers seem to improve their leg health.

Variations in a university subject pool as a function of earlier or later participation and self-report: a replication and extension.

PubMed

Bernard, Larry C; Walsh, R Patricia

2002-10-01

The present study replicated and extended earlier research on temporal sampling effects in university subject pools. Data were obtained from 236 participants, 79 men and 157 women, in a university subject pool during a 15-wk. semester. Without knowing the purpose of the study, participants self-selected to participate earlier (Weeks 4 and 5; n = 105) or later (Weeks 14 and 15; n = 131). Three hypotheses were investigated: (1) that the personality patterns of earlier and later participants on the NEO Personality Inventory-Revised and the Personality Research Form differ significantly, with earlier participants scoring higher on the latter scales reflecting social responsibility and higher on former Conscientiousness and Neuroticism scales; (2) that there are similar significant differences between participants in the earlier and later groups compared to the male and female college normative samples for the two tests: and (3) that earlier participants will have higher actual Scholastic Assessment Test scores and Grade Point Averages. Also investigated was whether participants' foreknowledge that their actual Scholastic Assessment Test scores and Grade Point Averages would be obtained would affect their accuracy of self-report. In contrast to prior research, neither the first nor second hypothesis was supported by the current study; there do not appear to be consistent differences on personality variables. However, the third hypothesis was supported. Earlier participants had higher actual high school Grade Point Average, college Grade Point Average, and Scholastic Assessment Test Verbal scores. Foreknowledge that actual Scholastic Assessment Test scores and Grade Point Averages would be obtained did not affect the accuracy of self-report. In addition, later participants significantly over-reported their scores, and significantly more women than men and more first-year than senior-year subjects participated in the early group.

Treatment of Partial Rotator Cuff Tear with Ultrasound-guided Platelet-rich Plasma

PubMed Central

Sengodan, Vetrivel Chezian; Kurian, Sajith; Ramasamy, Raghupathy

2017-01-01

Background: The treatment of symptomatic partial rotator cuff tear has presented substantial challenge to orthopaedic surgeons as it can vary from conservative to surgical repair. Researches have established the influence of platelet rich plasma in healing damaged tissue. Currently very few data are available regarding the evidence of clinical and radiological outcome of partial rotator cuff tear treated with ultrasound guided platelet rich plasma injection in English literature. Materials and Methods: 20 patients with symptomatic partial rotator cuff tears were treated with ultrasound guided platelet rich plasma injection. Before and after the injection of platelet rich plasma scoring was done with visual analogue score, Constant shoulder score, and UCLA shoulder score at 8 weeks and third month. A review ultrasound was performed 8 weeks after platelet rich plasma injection to assess the rotator cuff status. Results: Our study showed statistically significant improvements in 17 patients in VAS pain score, constant shoulder score and UCLA shoulder score. No significant changes in ROM were noted when matched to the contra-lateral side (P < 0.001) at the 3 month follow-up. The study also showed good healing on radiological evaluation with ultrasonogram 8 weeks after platelet rich plasma injection. Conclusion: Ultrasound guided platelet rich plasma injection for partial rotator cuff tears is an effective procedure that leads to significant decrease in pain, improvement in shoulder functions, much cost-effective and less problematic compared to a surgical treatment. PMID:28900553

[Shortening deformities of the clavicle after diaphyseal clavicular fractures : Influence on patient-oriented assessment of shoulder function].

PubMed

Jubel, A; Schiffer, G; Andermahr, J; Ries, C; Faymonville, C

2016-06-01

The aim of this study was the evaluation of patient-oriented outcome scores for shoulder function and residual complaints after diaphyseal clavicular fractures with respect to shortening deformities. The analysis was based on data of 172 adult patients (mean age 39 ± 14 years) with healed clavicular fractures treated operatively (n = 104) or conservatively (n = 67). The control population consisted of 35 healthy adults without shoulder problems and 25 patients with nonunion after conservative treatment. The subjective estimation of the level of pain was collated on a visual analog scale (VAS 1-100 points), together with the relative Constant and Murley score, the Cologne clavicle score, the disabilities of the arm, shoulder and hand (DASH) score and a bilateral comparison of the length difference of the clavicles. Patients with a clavicular length difference of > 2 cm had significantly (p < 0.001) more pain, a greater loss of mobility and significantly lower values in the scoring system of Constant and Murley, the DASH and Cologne clavicle scores compared to patients with clavicular length differences < 0.5 cm and healthy controls (p < 0.001). The results of this study showed that shortening deformities after clavicular fractures in adults have a large impact on the functional result and patient-oriented outcome scores. The aim of the therapy of diaphyseal clavicular fractures should therefore concentrate on reconstruction of the anatomical length of the clavicle.

Effectiveness of extracorporeal shockwave therapy in three major tendon diseases.

PubMed

Carulli, Christian; Tonelli, Filippo; Innocenti, Matteo; Gambardella, Bonaventura; Muncibì, Francesco; Innocenti, Massimo

2016-03-01

Extracorporeal shockwave therapy is a conservative treatment for several painful musculoskeletal disorders. The aim of the study was the assessment of the relief from pain by the shockwave therapy in a population of consecutive patients affected by specific pathologies. A group of consecutive patients were studied and treated. They were affected by calcific tendonitis of the shoulder (129 patients), chronic Achilles tendinopathy (102 patients), and lateral epicondylitis of the elbow (80 subjects). Each patient had 3 applications with a monthly interval, and was followed up at 1, 6, and 12 months after treatment. Results were evaluated by the numeric rating scale (NRS) in all cases, the Constant Murley Score for the assessment of the shoulder function, the American Orthopaedic Foot and Ankle Society Score for subjects affected by chronic Achilles tendinopathy, and the Oxford Elbow Score for those affected by a lateral epicondylitis of the elbow. One year after treatment, the results were considered satisfactory with an almost complete resolution of symptoms. There were statistically significant results at the 12-month follow-ups regarding the mean NRS score (from 6.25 to 0.2), the Constant Murley Score (from 66.7 to 79.4), the Oxford Elbow Score (from 28 to 46), and the AOFAS (from 71 to 86). Extracorporeal shockwave therapy may be considered a safe, economic, and effective treatment for several chronic musculoskeletal disorders, allowing satisfactory pain relief and improvement of function ability. Level IV.

Meta-analysis of Clinical and Radiographic Outcomes After Arthroscopic Single-Row Versus Double-Row Rotator Cuff Repair

PubMed Central

Perser, Karen; Godfrey, David; Bisson, Leslie

2011-01-01

Context: Double-row rotator cuff repair methods have improved biomechanical performance when compared with single-row repairs. Objective: To review clinical outcomes of single-row versus double-row rotator cuff repair with the hypothesis that double-row rotator cuff repair will result in better clinical and radiographic outcomes. Data Sources: Published literature from January 1980 to April 2010. Key terms included rotator cuff, prospective studies, outcomes, and suture techniques. Study Selection: The literature was systematically searched, and 5 level I and II studies were found comparing clinical outcomes of single-row and double-row rotator cuff repair. Coleman methodology scores were calculated for each article. Data Extraction: Meta-analysis was performed, with treatment effect between single row and double row for clinical outcomes and with odds ratios for radiographic results. The sample size necessary to detect a given difference in clinical outcome between the 2 methods was calculated. Results: Three level I studies had Coleman scores of 80, 74, and 81, and two level II studies had scores of 78 and 73. There were 156 patients with single-row repairs and 147 patients with double-row repairs, both with an average follow-up of 23 months (range, 12-40 months). Double-row repairs resulted in a greater treatment effect for each validated outcome measure in 4 studies, but the differences were not clinically or statistically significant (range, 0.4-2.2 points; 95% confidence interval, –0.19, 4.68 points). Double-row repairs had better radiographic results, but the differences were also not statistically significant (P = 0.13). Two studies had adequate power to detect a 10-point difference between repair methods using the Constant score, and 1 study had power to detect a 5-point difference using the UCLA (University of California, Los Angeles) score. Conclusions: Double-row rotator cuff repair does not show a statistically significant improvement in clinical outcome or radiographic healing with short-term follow-up. PMID:23016017

Meta-analysis of Clinical and Radiographic Outcomes After Arthroscopic Single-Row Versus Double-Row Rotator Cuff Repair.

PubMed

Perser, Karen; Godfrey, David; Bisson, Leslie

2011-05-01

Double-row rotator cuff repair methods have improved biomechanical performance when compared with single-row repairs. To review clinical outcomes of single-row versus double-row rotator cuff repair with the hypothesis that double-row rotator cuff repair will result in better clinical and radiographic outcomes. Published literature from January 1980 to April 2010. Key terms included rotator cuff, prospective studies, outcomes, and suture techniques. The literature was systematically searched, and 5 level I and II studies were found comparing clinical outcomes of single-row and double-row rotator cuff repair. Coleman methodology scores were calculated for each article. Meta-analysis was performed, with treatment effect between single row and double row for clinical outcomes and with odds ratios for radiographic results. The sample size necessary to detect a given difference in clinical outcome between the 2 methods was calculated. Three level I studies had Coleman scores of 80, 74, and 81, and two level II studies had scores of 78 and 73. There were 156 patients with single-row repairs and 147 patients with double-row repairs, both with an average follow-up of 23 months (range, 12-40 months). Double-row repairs resulted in a greater treatment effect for each validated outcome measure in 4 studies, but the differences were not clinically or statistically significant (range, 0.4-2.2 points; 95% confidence interval, -0.19, 4.68 points). Double-row repairs had better radiographic results, but the differences were also not statistically significant (P = 0.13). Two studies had adequate power to detect a 10-point difference between repair methods using the Constant score, and 1 study had power to detect a 5-point difference using the UCLA (University of California, Los Angeles) score. Double-row rotator cuff repair does not show a statistically significant improvement in clinical outcome or radiographic healing with short-term follow-up.

Age-dependence of the average and equivalent refractive indices of the crystalline lens

PubMed Central

Charman, W. Neil; Atchison, David A.

2013-01-01

Lens average and equivalent refractive indices are required for purposes such as lens thickness estimation and optical modeling. We modeled the refractive index gradient as a power function of the normalized distance from lens center. Average index along the lens axis was estimated by integration. Equivalent index was estimated by raytracing through a model eye to establish ocular refraction, and then backward raytracing to determine the constant refractive index yielding the same refraction. Assuming center and edge indices remained constant with age, at 1.415 and 1.37 respectively, average axial refractive index increased (1.408 to 1.411) and equivalent index decreased (1.425 to 1.420) with age increase from 20 to 70 years. These values agree well with experimental estimates based on different techniques, although the latter show considerable scatter. The simple model of index gradient gives reasonable estimates of average and equivalent lens indices, although refinements in modeling and measurements are required. PMID:24466474

Impact of Residency Training Redesign on Residents' Clinical Knowledge.

PubMed

Waller, Elaine; Eiff, M Patrice; Dexter, Eve; Rinaldo, Jason C B; Marino, Miguel; Garvin, Roger; Douglass, Alan B; Phillips, Robert; Green, Larry A; Carney, Patricia A

2017-10-01

The In-training Examination (ITE) is a frequently used method to evaluate family medicine residents' clinical knowledge. We compared family medicine ITE scores among residents who trained in the 14 programs that participated in the Preparing the Personal Physician for Practice (P4) Project to national averages over time, and according to educational innovations. The ITE scores of 802 consenting P4 residents who trained in 2007 through 2011 were obtained from the American Board of Family Medicine. The primary analysis involved comparing scores within each academic year (2007 through 2011), according to program year (PGY) for P4 residents to all residents nationally. A secondary analysis compared ITE scores among residents in programs that experimented with length of training and compared scores among residents in programs that offered individualized education options with those that did not. Release of ITE scores was consented to by 95.5% of residents for this study. Scores of P4 residents were higher compared to national scores in each year. For example, in 2011, the mean P4 score for PGY1 was 401.2, compared to the national average of 386. For PGY2, the mean P4 score was 443.1, compared to the national average of 427, and for PGY3, the mean P4 score was 477.0, compared to the national PGY3 score of 456. Scores of residents in programs that experimented with length of training were similar to those in programs that did not. Scores were also similar between residents in programs with and without individualized education options. Family medicine residency programs undergoing substantial educational changes, including experiments in length of training and individualized education, did not appear to experience a negative effect on resident's clinical knowledge, as measured by ITE scores. Further research is needed to study the effect of a wide range of residency training innovations on ITE scores over time.

Evaluation of Relationship Between Body Dysmorphic Disorder and Self-Esteem in Rhinoplasty Candidates.

PubMed

Baykal, Bahadir; Erdim, Ibrahim; Ozbay, Isa; Oghan, Fatih; Oncu, Fatih; Erdogdu, Zeynep; Kayhan, Fatma Tulin

2015-11-01

To investigate the relationship between body dysmorphic syndrome and self-esteem in rhinoplasty candidates. A negative statistical correlation was evident between Rosenberg Self-Esteem Scale (RSES) and Body Dysmorphic Disorder Examination-Self Report (BDDE-SR) scores. In terms of responses to the first Body Dysmorphic Disorder Questionnaire (BDDQ) question, which focuses on general attitude toward body dysmorphic syndrome, the average RSES "YES" score was significantly less than the "NO" score. No significant differences appeared between RSES scores and scores for the 4th subgroup of BDDQ questions (subgroups A, B, and C; these questions explore how much time is spent daily on maintenance of bodily appearance). However, significant differences appeared between scores for the 4th subgroup of BDDQ questions and BDDE-SR scores. The average BDD-SR score of subgroup A (less than 1 hour spent on bodily maintenance) was significantly lower than those of group B (1-3 hours) and group C (more than 3 hours). However, no significant differences appeared in average BDD-SR scores between subgroups B and C. In this prospective study, 56 patients (31 females and 25 males) were evaluated preoperatively using the BDDQ, the BDDE-SR, and the RSES. Patients younger than 15 years and those with deformities caused by trauma were excluded. Rhinoplasty candidates had higher levels of body dysmorphic disorder (BDD). Although patients with low RSES scores were more likely to have BDD, rhinoplasty candidates were not notably deficient in self-esteem. However, in rhinoplasty candidates with low RSES scores, the frequency of BDD was elevated. Therefore, the authors suggest that rhinoplasty candidates with low RSES scores should be investigated carefully in terms of BDD.

Assessing abstracts of Iranian systematic reviews and metaanalysis indexed in WOS and Scopus using PRISMA.

PubMed

Kazerani, Maryam; Davoudian, Atefeh; Zayeri, Farid; Soori, Hamid

2017-01-01

Background: Systematic reviews and meta-analysis have significant advantages over conventional reviews in that all available data should be presented. This study aimed to evaluate Iranian systematic reviews and meta-analysis abstracts indexed in WOS and Scopus during 2003-2012 based on PRISMA checklist. Methods: This is an analytical study. We evaluated 46 article abstracts indexed in WOS, 89 article abstracts indexed in Scopus and 158 article abstracts indexed in WOS and Scopus both (overlapped group). The quality of the abstracts was evaluated according to the PRISMA checklist for abstracts. Some indicators including distribution per year, total citation, average citations per year, average citations per documents and average citations per year in each article were determined through searching the WOS and Scopus Databases' analytical section. Then, the correlations between the abstract's PRISMA scores, average citations per year, and publication year were calculated. Results: The abstract's quality is not desirable as far as the PRISMA criteria are concerned. In other words, none of the articles' abstracts is in line with the PRISMA items. The average of scores of the current study was 5.9 while the maximum score was 12. The PRISMA criteria showed the highest compliance with "Objectives" (98.6%), the second highest with "Synthesis of result" (85%) and "Title" (80.2%) and the lowest compliance with "Registration" (2%). There was a positive correlation between the compliance of PRISMA score and the average citations per year while there was a negative correlation between PRISMA score and the publication year. Conclusion: It seems that the suggested criteria for reporting Iranian systematic reviews and meta-analysis are not considered adequately by the writers and even scientific journal editors.

Assessing abstracts of Iranian systematic reviews and metaanalysis indexed in WOS and Scopus using PRISMA

PubMed Central

Kazerani, Maryam; Davoudian, Atefeh; Zayeri, Farid; Soori, Hamid

2017-01-01

Background: Systematic reviews and meta-analysis have significant advantages over conventional reviews in that all available data should be presented. This study aimed to evaluate Iranian systematic reviews and meta-analysis abstracts indexed in WOS and Scopus during 2003-2012 based on PRISMA checklist. Methods: This is an analytical study. We evaluated 46 article abstracts indexed in WOS, 89 article abstracts indexed in Scopus and 158 article abstracts indexed in WOS and Scopus both (overlapped group). The quality of the abstracts was evaluated according to the PRISMA checklist for abstracts. Some indicators including distribution per year, total citation, average citations per year, average citations per documents and average citations per year in each article were determined through searching the WOS and Scopus Databases’ analytical section. Then, the correlations between the abstract's PRISMA scores, average citations per year, and publication year were calculated. Results: The abstract’s quality is not desirable as far as the PRISMA criteria are concerned. In other words, none of the articles’ abstracts is in line with the PRISMA items. The average of scores of the current study was 5.9 while the maximum score was 12. The PRISMA criteria showed the highest compliance with "Objectives" (98.6%), the second highest with "Synthesis of result" (85%) and "Title" (80.2%) and the lowest compliance with "Registration" (2%). There was a positive correlation between the compliance of PRISMA score and the average citations per year while there was a negative correlation between PRISMA score and the publication year. Conclusion: It seems that the suggested criteria for reporting Iranian systematic reviews and meta-analysis are not considered adequately by the writers and even scientific journal editors. PMID:28955668

Care and Justice orientations to moral decision making in veterinary students.

PubMed

Quinn, C; Kinnison, T; May, S A

2012-11-03

An adapted version of the Moral Justification Scale was used to assess moral decision-making orientation in veterinary students, comparing sex and year of study. The Scale consists of vignettes and related statements, each of which was classified as Justice, Care for People or Care for Animals. The importance of each statement in the decision-making process was rated by 204 students on a 10-point Likert Scale. An average score of importance for Justice, Care for People and Care for Animals related statements were calculated for each individual. General inclination scores were calculated by subtracting an individual's average Care score from their average Justice score. Inclination scores suggested that two-thirds of students have a balanced approach, using Justice and Care almost equally in approaching ethical dilemmas. The majority of students, however, show an overall Justice orientation. The attitude towards the importance of Justice did not vary between students of different years or sexes. Students' attitudes towards the importance of Care for People in their decision making were, however, significantly lower for final-year students. Reasons hypothesised include the start of placements. Care for Animals scores were affected by sex, whereby females give more importance to such statements than males.

[Prediction of the total Japanese cedar pollen counts based on male flower-setting conditions of standard trees].

PubMed

Yuta, Atsushi; Ukai, Kotaro; Sakakura, Yasuo; Tani, Hideshi; Matsuda, Fukiko; Yang, Tian-qun; Majima, Yuichi

2002-07-01

We made a prediction of the Japanese cedar (Cryptomeria japonica) pollen counts at Tsu city based on male flower-setting conditions of standard trees. The 69 standard trees from 23 kinds of clones, planted at Mie Prefecture Science and Technology Promotion Center (Hakusan, Mie) in 1964, were selected. Male flower-setting conditions for 276 faces (69 trees x 4 points of the compass) were scored from 0 to 3. The average of scores and total pollen counts from 1988 to 2000 was analyzed. As the results, the average scores from standard trees and total pollen counts except two mass pollen-scattered years in 1995 and 2000 had a positive correlation (r = 0.914) by linear function. On the mass pollen-scattered years, pollen counts were influenced from the previous year. Therefore, the score of the present year minus that of the previous year were used for analysis. The average scores from male flower-setting conditions and pollen counts had a strong positive correlation (r = 0.994) when positive scores by taking account of the previous year were analyzed. We conclude that prediction of pollen counts are possible based on the male flower-setting conditions of standard trees.

A new plan-scoring method using normal tissue complication probability for personalized treatment plan decisions in prostate cancer

NASA Astrophysics Data System (ADS)

Kim, Kwang Hyeon; Lee, Suk; Shim, Jang Bo; Yang, Dae Sik; Yoon, Won Sup; Park, Young Je; Kim, Chul Yong; Cao, Yuan Jie; Chang, Kyung Hwan

2018-01-01

The aim of this study was to derive a new plan-scoring index using normal tissue complication probabilities to verify different plans in the selection of personalized treatment. Plans for 12 patients treated with tomotherapy were used to compare scoring for ranking. Dosimetric and biological indexes were analyzed for the plans for a clearly distinguishable group ( n = 7) and a similar group ( n = 12), using treatment plan verification software that we developed. The quality factor ( QF) of our support software for treatment decisions was consistent with the final treatment plan for the clearly distinguishable group (average QF = 1.202, 100% match rate, n = 7) and the similar group (average QF = 1.058, 33% match rate, n = 12). Therefore, we propose a normal tissue complication probability (NTCP) based on the plan scoring index for verification of different plans for personalized treatment-plan selection. Scoring using the new QF showed a 100% match rate (average NTCP QF = 1.0420). The NTCP-based new QF scoring method was adequate for obtaining biological verification quality and organ risk saving using the treatment-planning decision-support software we developed for prostate cancer.

Definition of SMOS Level 3 Land Products for the Villafranca del Castillo Data Processing Centre (CP34)

NASA Astrophysics Data System (ADS)

Lopez-Baeza, E.; Monsoriu Torres, A.; Font, J.; Alonso, O.

2009-04-01

The ESA SMOS (Soil Moisture and Ocean Salinity) Mission is planned to be launched in July 2009. The satellite will measure soil moisture over the continents and surface salinity of the oceans at resolutions that are sufficient for climatological-type studies. This paper describes the procedure to be used at the Spanish SMOS Level 3 and 4 Data Processing Centre (CP34) to generate Soil Moisture and other Land Surface Product maps from SMOS Level 2 data. This procedure can be used to map Soil Moisture, Vegetation Water Content and Soil Dielectric Constant data into different pre-defined spatial grids with fixed temporal frequency. The L3 standard Land Surface Products to be generated at CP34 are: Soil Moisture products: maximum spatial resolution with no spatial averaging, temporal averaging of 3 days, daily generation maximum spatial resolution with no spatial averaging, temporal averaging of 10 days, generation frequency of once every 10 days. b': maximum spatial resolution with no spatial averaging, temporal averaging of monthly decades (1st to 10th of the month, 11th to 20th of the month, 21st to last day of the month), generation frequency of once every decade monthly average, temporal averaging from L3 decade averages, monthly generation Seasonal average, temporal averaging from L3 monthly averages, seasonally generation yearly average, temporal averaging from L3 monthly averages, yearly generation Vegetation Water Content products: maximum spatial resolution with no spatial averaging, temporal averaging of 10 days, generation frequency of once every 10 days. a': maximum spatial resolution with no spatial averaging, temporal averaging of monthly decades (1st to 10th of the month, 11th to 20th of the month, 21st to last day of the month) using simple averaging method over the L2 products in ISEA grid, generation frequency of once every decade monthly average, temporal averaging from L3 decade averages, monthly generation seasonal average, temporal averaging from L3 monthly averages, seasonally generation yearly average, temporal averaging from L3 monthly averages, yearly generation Dielectric Constant products: (the dielectric constant products are delivered together with soil moisture products, with the same averaging periods and generation frequency): maximum spatial resolution with no spatial averaging, temporal averaging of 3 days, daily generation maximum spatial resolution with no spatial averaging, temporal averaging of 10 days, generation frequency of once every 10 days. b': maximum spatial resolution with no spatial averaging, temporal averaging of monthly decades (1st to 10th of the month, 11th to 20th of the month, 21st to last day of the month), generation frequency of once every decade monthly average, temporal averaging from L3 decade averages, monthly generation seasonal average, temporal averaging from L3 monthly averages, seasonally generation yearly average, temporal averaging from L3 monthly averages, yearly generation.

Relationship between neighbor number and vibrational spectra in disordered colloidal clusters with attractive interactions

NASA Astrophysics Data System (ADS)

Yunker, Peter J.; Zhang, Zexin; Gratale, Matthew; Chen, Ke; Yodh, A. G.

2013-03-01

We study connections between vibrational spectra and average nearest neighbor number in disordered clusters of colloidal particles with attractive interactions. Measurements of displacement covariances between particles in each cluster permit calculation of the stiffness matrix, which contains effective spring constants linking pairs of particles. From the cluster stiffness matrix, we derive vibrational properties of corresponding "shadow" glassy clusters, with the same geometric configuration and interactions as the "source" cluster but without damping. Here, we investigate the stiffness matrix to elucidate the origin of the correlations between the median frequency of cluster vibrational modes and average number of nearest neighbors in the cluster. We find that the mean confining stiffness of particles in a cluster, i.e., the ensemble-averaged sum of nearest neighbor spring constants, correlates strongly with average nearest neighbor number, and even more strongly with median frequency. Further, we find that the average oscillation frequency of an individual particle is set by the total stiffness of its nearest neighbor bonds; this average frequency increases as the square root of the nearest neighbor bond stiffness, in a manner similar to the simple harmonic oscillator.

Concurrent Validity Between a Shared Curriculum, the Internal Medicine In-Training Examination, and the American Board of Internal Medicine Certifying Examination.

PubMed

Sisson, Stephen D; Bertram, Amanda; Yeh, Hsin-Chieh

2015-03-01

A core objective of residency education is to facilitate learning, and programs need more curricula and assessment tools with demonstrated validity evidence. We sought to demonstrate concurrent validity between performance on a widely shared, ambulatory curriculum (the Johns Hopkins Internal Medicine Curriculum), the Internal Medicine In-Training Examination (IM-ITE), and the American Board of Internal Medicine Certifying Examination (ABIM-CE). A cohort study of 443 postgraduate year (PGY)-3 residents at 22 academic and community hospital internal medicine residency programs using the curriculum through the Johns Hopkins Internet Learning Center (ILC). Total and percentile rank scores on ILC didactic modules were compared with total and percentile rank scores on the IM-ITE and total scores on the ABIM-CE. The average score on didactic modules was 80.1%; the percentile rank was 53.8. The average IM-ITE score was 64.1% with a percentile rank of 54.8. The average score on the ABIM-CE was 464. Scores on the didactic modules, IM-ITE, and ABIM-CE correlated with each other (P < .05). Residents completing greater numbers of didactic modules, regardless of scores, had higher IM-ITE total and percentile rank scores (P < .05). Resident performance on modules covering back pain, hypertension, preoperative evaluation, and upper respiratory tract infection was associated with IM-ITE percentile rank. Performance on a widely shared ambulatory curriculum is associated with performance on the IM-ITE and the ABIM-CE.

The effective propagation constants of SH wave in composites reinforced by dispersive parallel nanofibers

NASA Astrophysics Data System (ADS)

Qiang, FangWei; Wei, PeiJun; Li, Li

2012-07-01

In the present paper, the effective propagation constants of elastic SH waves in composites with randomly distributed parallel cylindrical nanofibers are studied. The surface stress effects are considered based on the surface elasticity theory and non-classical interfacial conditions between the nanofiber and the host are derived. The scattering waves from individual nanofibers embedded in an infinite elastic host are obtained by the plane wave expansion method. The scattering waves from all fibers are summed up to obtain the multiple scattering waves. The interactions among random dispersive nanofibers are taken into account by the effective field approximation. The effective propagation constants are obtained by the configurational average of the multiple scattering waves. The effective speed and attenuation of the averaged wave and the associated dynamical effective shear modulus of composites are numerically calculated. Based on the numerical results, the size effects of the nanofibers on the effective propagation constants and the effective modulus are discussed.

Students' anxiety in a senior thesis course.

PubMed

Wood, M R; Palm, L J

2000-06-01

The State-Trait Anxiety Inventory was administered on Weeks 8, 12, and 15 of a semester to 16 students enrolled in a senior thesis course. State anxiety scores were elevated when oral presentations began and declined following the presentations. Trait anxiety scores remained constant across test administrations. The influence of situational variables on students' anxiety was discussed.

The Validity of Two Neuromotor Assessments for Predicting Motor Performance at 12 Months in Preterm Infants.

PubMed

Song, You Hong; Chang, Hyun Jung; Shin, Yong Beom; Park, Young Sook; Park, Yun Hee; Cho, Eun Sol

2018-04-01

To evaluate the validity of the Test of Infant Motor Performance (TIMP) and general movements (GMs) assessment for predicting Alberta Infant Motor Scale (AIMS) score at 12 months in preterm infants. A total of 44 preterm infants who underwent the GMs and TIMP at 1 month and 3 months of corrected age (CA) and whose motor performance was evaluated using AIMS at 12 months CA were included. GMs were judged as abnormal on basis of poor repertoire or cramped-synchronized movements at 1 month CA and abnormal or absent fidgety movement at 3 months CA. TIMP and AIMS scores were categorized as normal (average and low average and >5th percentile, respectively) or abnormal (below average and far below average or <5th percentile, respectively). Correlations between GMs and TIMP scores at 1 month and 3 months CA and the AIMS classification at 12 months CA were examined. The TIMP score at 3 months CA and GMs at 1 month and 3 months CA were significantly correlated with the motor performance at 12 months CA. However, the TIMP score at 1 month CA did not correlate with the AIMS classification at 12 months CA. For infants with normal GMs at 3 months CA, the TIMP score at 3 months CA correlated significantly with the AIMS classification at 12 months CA. Our findings suggest that neuromotor assessment using GMs and TIMP could be useful to identify preterm infants who are likely to benefit from intervention.

Hemodynamic response to exercise and head-up tilt of patients implanted with a rotary blood pump: a computational modeling study.

PubMed

Lim, Einly; Salamonsen, Robert Francis; Mansouri, Mahdi; Gaddum, Nicholas; Mason, David Glen; Timms, Daniel L; Stevens, Michael Charles; Fraser, John; Akmeliawati, Rini; Lovell, Nigel Hamilton

2015-02-01

The present study investigates the response of implantable rotary blood pump (IRBP)-assisted patients to exercise and head-up tilt (HUT), as well as the effect of alterations in the model parameter values on this response, using validated numerical models. Furthermore, we comparatively evaluate the performance of a number of previously proposed physiologically responsive controllers, including constant speed, constant flow pulsatility index (PI), constant average pressure difference between the aorta and the left atrium, constant average differential pump pressure, constant ratio between mean pump flow and pump flow pulsatility (ratioP I or linear Starling-like control), as well as constant left atrial pressure ( P l a ¯ ) control, with regard to their ability to increase cardiac output during exercise while maintaining circulatory stability upon HUT. Although native cardiac output increases automatically during exercise, increasing pump speed was able to further improve total cardiac output and reduce elevated filling pressures. At the same time, reduced venous return associated with upright posture was not shown to induce left ventricular (LV) suction. Although P l a ¯ control outperformed other control modes in its ability to increase cardiac output during exercise, it caused a fall in the mean arterial pressure upon HUT, which may cause postural hypotension or patient discomfort. To the contrary, maintaining constant average pressure difference between the aorta and the left atrium demonstrated superior performance in both exercise and HUT scenarios. Due to their strong dependence on the pump operating point, PI and ratioPI control performed poorly during exercise and HUT. Our simulation results also highlighted the importance of the baroreflex mechanism in determining the response of the IRBP-assisted patients to exercise and postural changes, where desensitized reflex response attenuated the percentage increase in cardiac output during exercise and substantially reduced the arterial pressure upon HUT. Copyright © 2014 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

The Nation's Report Card Reading 2011 State Snapshot Report. Oregon. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 reading assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to other…

The Nation's Report Card Reading 2011 State Snapshot Report. Oregon. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 reading assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to other…

The Nation's Report Card Mathematics 2011 State Snapshot Report. Oregon. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 mathematics assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to…

The Nation's Report Card Mathematics 2011 State Snapshot Report. Oregon. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 mathematics assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to…

The Nation's Report Card Reading 2011 State Snapshot Report. Minnesota. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 reading assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to other…

The Nation's Report Card Mathematics 2011 State Snapshot Report. Minnesota. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 reading assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to other…

The Nation's Report Card Mathematics 2011 State Snapshot Report. Minnesota. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 mathematics assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to…

The Nation's Report Card Reading 2011 State Snapshot Report. Minnesota. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 reading assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to other…

The Nation's Report Card Mathematics 2011 State Snapshot Report. West Virginia. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 mathematics assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to…

The Nation's Report Card Reading 2011 State Snapshot Report. West Virginia. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 reading assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to other…

The Nation's Report Card Reading 2009 State Snapshot Report. West Virginia. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2010

2010-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2009 reading assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2009 to other…

The Nation's Report Card Mathematics 2011 State Snapshot Report. West Virginia. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 mathematics assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to…

The Nation's Report Card Reading 2009 State Snapshot Report. West Virginia. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2010

2010-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2009 reading assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2009 to other…

The Nation's Report Card Reading 2011 State Snapshot Report. West Virginia. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 reading assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to other…

Breaking the Glass Ceiling of Achievement for Low-Income Students and Students of Color. Shattering Expectations Series

ERIC Educational Resources Information Center

Bromberg, Marni; Theokas, Christina

2013-01-01

Typically, achievement gaps between groups of students are measured as either differences in average scores or differences in proficiency rates. But, practitioners, policymakers, and researchers have long recognized that these approaches don't tell the whole story. Average scores, for example, are good at summarizing trends but can mask real…

The Nation's Report Card Reading 2009 State Snapshot Report. Idaho. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2010

2010-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2009 reading assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2009 to other…

The Nation's Report Card Mathematics 2011 State Snapshot Report. Idaho. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 mathematics assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to…

The Nation's Report Card Reading 2009 State Snapshot Report. Idaho. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2010

2010-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2009 reading assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2009 to other…

The Nation's Report Card Reading 2011 State Snapshot Report. Idaho. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 reading assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to other…

The Nation's Report Card Reading 2011 State Snapshot Report. Idaho. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 reading assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to other…

The Nation's Report Card Mathematics 2011 State Snapshot Report. Idaho. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 reading assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to other…

The Nation's Report Card Reading 2011 State Snapshot Report. New Hampshire. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 reading assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to other…

The Nation's Report Card Reading 2011 State Snapshot Report. New Hampshire. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 reading assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to other…

The Nation's Report Card Mathematics 2011 State Snapshot Report. New Hampshire. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 reading assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to other…

The Nation's Report Card Reading 2009 State Snapshot Report. New Hampshire. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2010

2010-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2009 reading assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2009 to other…

The Nation's Report Card Mathematics 2011 State Snapshot Report. New Hampshire. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 mathematics assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to…

The Nation's Report Card Reading 2009 State Snapshot Report. New Hampshire. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2010

2010-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2009 reading assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2009 to other…

Predicting Academic Success in First-Year Mathematics Courses Using ACT Mathematics Scores and High School Grade Point Average

ERIC Educational Resources Information Center

Mayo, Sandra Sims

2012-01-01

Improving college performance and retention is a daunting task for colleges and universities. Many institutions are taking action to increase retention rates by exploring their academic programs. Regression analysis was used to compare the effectiveness of ACT mathematics scores, high school grade point averages (HSGPA), and demographic factors…

The Nation's Report Card Reading 2011 State Snapshot Report. Hawaii. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 reading assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to other…

The Nation's Report Card Reading 2009 State Snapshot Report. Hawaii. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2010

2010-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2009 reading assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2009 to other…

The Nation's Report Card Mathematics 2011 State Snapshot Report. Hawaii. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 mathematics assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to…

The Nation's Report Card Reading 2009 State Snapshot Report. Hawaii. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2010

2010-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2009 reading assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2009 to other…

The Nation's Report Card Reading 2011 State Snapshot Report. Hawaii. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 reading assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to other…

The Nation's Report Card Mathematics 2011 State Snapshot Report. Hawaii. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 reading assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to other…

The Nation's Report Card Reading 2011 State Snapshot Report. DoDEA. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 reading assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to other…

The Nation's Report Card Mathematics 2011 State Snapshot Report. DoDEA. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 mathematics assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to…

The Nation's Report Card Reading 2011 State Snapshot Report. DoDEA. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 reading assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to other…

The Nation's Report Card Reading 2009 State Snapshot Report. DoDEA. Grade 4, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2010

2010-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2009 reading assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2009 to other…

The Nation's Report Card Mathematics 2011 State Snapshot Report. DoDEA. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2011 mathematics assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2011 to…

The Nation's Report Card Reading 2009 State Snapshot Report. DoDEA. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2010

2010-01-01

Each state and jurisdiction that participated in the National Assessment of Educational Progress (NAEP) 2009 reading assessment receives a one-page snapshot report that presents key findings and trends in a condensed format. Overall results, achievement level percentages and average score results, comparison of the average score in 2009 to other…

Academic and Nonacademic Characteristics as Predictors of Persistence in an Associate Degree Nursing Program. AIR Forum 1981 Paper.

ERIC Educational Resources Information Center

Donsky, Aaron P.; Judge, Albert J., Jr.

Academic and nonacademic variables that may predict persistence in the nursing program at Lakeland Community College, Ohio, were studied. The academic variables included American College Testing program standard scores, National League for Nursing (NLN) rank scores, high school grade point average, and previous college grade point average. The…

Factors related to student performance in statistics courses in Lebanon

NASA Astrophysics Data System (ADS)

Naccache, Hiba Salim

The purpose of the present study was to identify factors that may contribute to business students in Lebanese universities having difficulty in introductory and advanced statistics courses. Two statistics courses are required for business majors at Lebanese universities. Students are not obliged to be enrolled in any math courses prior to taking statistics courses. Drawing on recent educational research, this dissertation attempted to identify the relationship between (1) students’ scores on Lebanese university math admissions tests; (2) students’ scores on a test of very basic mathematical concepts; (3) students’ scores on the survey of attitude toward statistics (SATS); (4) course performance as measured by students’ final scores in the course; and (5) their scores on the final exam. Data were collected from 561 students enrolled in multiple sections of two courses: 307 students in the introductory statistics course and 260 in the advanced statistics course in seven campuses across Lebanon over one semester. The multiple regressions results revealed four significant relationships at the introductory level: between students’ scores on the math quiz with their (1) final exam scores; (2) their final averages; (3) the Cognitive subscale of the SATS with their final exam scores; and (4) their final averages. These four significant relationships were also found at the advanced level. In addition, two more significant relationships were found between students’ final average and the two subscales of Effort (5) and Affect (6). No relationship was found between students’ scores on the admission math tests and both their final exam scores and their final averages in both the introductory and advanced level courses. On the other hand, there was no relationship between students’ scores on Lebanese admissions tests and their final achievement. Although these results were consistent across course formats and instructors, they may encourage Lebanese universities to assess the effectiveness of prerequisite math courses. Moreover, these findings may lead the Lebanese Ministry of Education to make changes to the admissions exams, course prerequisites, and course content. Finally, to enhance the attitude of students, new learning techniques, such as group work during class meetings can be helpful, and future research should aim to test the effectiveness of these pedagogical techniques on students’ attitudes toward statistics.

Outcomes After Dermal Allograft Reconstruction of Chronic or Subacute Pectoralis Major Tendon Ruptures.

PubMed

Neumann, Julie A; Klein, Christopher M; van Eck, Carola F; Rahmi, Hithem; Itamura, John M

2018-01-01

Avoiding delay in the surgical management of pectoralis major (PM) ruptures optimizes outcomes. However, this is not always possible, and when a tear becomes chronic or when a subacute tear has poor tissue quality, a graft can facilitate reconstruction. The primary aim was to evaluate the clinical outcomes of PM reconstruction with dermal allograft augmentation for chronic tears or for subacute tears with poor tissue quality. A second aim was to determine patient and surgical factors affecting outcome. Case series; Level of evidence, 4. Nineteen consecutive patients (19 PM ruptures) with a mean ± SD age of 39.1 ± 8.4 years were retrospectively reviewed at 26.4 ± 16.0 months following PM tendon reconstruction with dermal allograft. Surgery was performed at 19.2 ± 41.2 months after injury (median, 7.6 months; range, 1.1-185.4 months). Several outcome scores were recorded pre- and postoperatively, including Disabilities of the Arm, Shoulder, and Hand (DASH), as well as visual analog scale (VAS) (range, 0-10; 0 = no pain) and Single Assessment Numeric Evaluation (SANE). Range of motion, Constant score, American Shoulder and Elbow Surgeons (ASES) score, Simple Shoulder Test score, and complications/reoperations were recorded postoperatively. Scores improved significantly for the DASH (preoperative, 34.9; postoperative, 8.0; P < .001) and VAS (preoperative, 5.0; postoperative, 1.5; P = .011). There was a trend toward improved SANE scores (preoperative, 15.0; postoperative, 80.0; P = .097), but the difference was not statistically significant, likely because of the small number of patients having preoperative SANE scores for review. Increased age was associated with higher VAS scores ( r = 0.628, P = .016) and less forward flexion ( r = -0.502, P = .048) and external rotation ( r = -0.654, P = .006). Patients with workers' compensation had lower scores for 3 measures: SANE (75.8 vs 88.4, P = .040), Constant (86.7 vs 93.4, P = .019), and ASES (81.9 vs 97.4, P = .016). Operating on the dominant extremity resulted in lower Constant scores (87.8 vs 95.4, P = .012). A 2-head tendon tear (107.5° vs 123.3°, P = .033) and the use of >1 graft (105.0° vs 121.3°, P = .040) resulted in decreased abduction. This was the first large series to observe patients with chronic or subacute PM tendon tears treated with dermal allograft reconstruction. PM tendon reconstruction with dermal allografts resulted in good objective and subjective patient-reported outcomes.

Is reverse total shoulder arthroplasty a feasible treatment option for failed shoulder arthroplasty? A retrospective study of 44 cases with special regards to stemless and stemmed primary implants.

PubMed

Holschen, M; Franetzki, B; Witt, K-A; Liem, D; Steinbeck, J

2017-08-01

Is reverse total shoulder arthroplasty a feasible treatment option for failed shoulder arthroplasty? A retrospective study of 44 cases with special regards to stemless and stemmed primary implants. Due to humeral or glenoid bone-loss and rotator cuff insufficiency reverse total shoulder arthroplasty often means the only remaining treatment option in revision shoulder arthroplasty. This study investigates the clinical outcome of patients treated with a reverse total shoulder in revision cases with special regard to stemless and stemmed primary implants. From 2010 to 2012 60 failed shoulder arthroplasties were converted to reverse total shoulder arthroplasty. Forty-four patients were available for follow-up after a mean of 24 months. Patients were assessed with X-rays, Constant- and ASES Score and a questionnaire about their subjective satisfaction. The total number of observed complications was seven (16%). Ninety-eight percent of the patients were satisfied with their clinical result. Patients achieved a mean normalized constant score of 70.2% and a mean ASES Score of 65.3. Patients with stemless primary implants achieved a higher normalized constant score than patients with stemmed primary implants (82 vs. 61.8%; p = 0009). Reverse total shoulder arthroplasty provides satisfactory clinical results and a high patient satisfaction in revision shoulder arthroplasty. The complication rate needs to be considered and discussed with the patient prior to surgery. Presence or absence of a stem of revised shoulder arthroplasties interferes with the outcome. LEVEL OF EVIDENCE IV: (Retrospective study).

Poster — Thur Eve — 45: Comparison of different Monte Carlo methods of scoring linear energy transfer in modulated proton therapy beams

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

Granville, DA; Sawakuchi, GO

2014-08-15

In this work, we demonstrate inconsistencies in commonly used Monte Carlo methods of scoring linear energy transfer (LET) in proton therapy beams. In particle therapy beams, the LET is an important parameter because the relative biological effectiveness (RBE) depends on it. LET is often determined using Monte Carlo techniques. We used a realistic Monte Carlo model of a proton therapy nozzle to score proton LET in spread-out Bragg peak (SOBP) depth-dose distributions. We used three different scoring and calculation techniques to determine average LET at varying depths within a 140 MeV beam with a 4 cm SOBP and a 250more » MeV beam with a 10 cm SOBP. These techniques included fluence-weighted (Φ-LET) and dose-weighted average (D-LET) LET calculations from: 1) scored energy spectra converted to LET spectra through a lookup table, 2) directly scored LET spectra and 3) accumulated LET scored ‘on-the-fly’ during simulations. All protons (primary and secondary) were included in the scoring. Φ-LET was found to be less sensitive to changes in scoring technique than D-LET. In addition, the spectral scoring methods were sensitive to low-energy (high-LET) cutoff values in the averaging. Using cutoff parameters chosen carefully for consistency between techniques, we found variations in Φ-LET values of up to 1.6% and variations in D-LET values of up to 11.2% for the same irradiation conditions, depending on the method used to score LET. Variations were largest near the end of the SOBP, where the LET and energy spectra are broader.« less

A supplemental video teaching tool enhances splinting skills.

PubMed

Mehrpour, Saeed Reza; Aghamirsalim, Mohamadreza; Motamedi, Seyed Mohammad Kalantar; Ardeshir Larijani, Fatemeh; Sorbi, Reza

2013-02-01

The ability to apply casts and splints is a technical skill that requires practice and understanding of basic principles of musculoskeletal medicine. A video in which a given procedure is simulated on a dummy can represent reality under controlled conditions. A decrease in physician competency in musculoskeletal medicine is the result of educational deficiencies at the medical school level. We asked whether (1) a supplemental video educational program enhances performance of medical students' musculoskeletal clinical skills and (2) factors such as the proportion of orthopaedic professors to students, sex, age, and previous scores of medical students affected the clinical skills of medical students. We allocated 474 medical students into one of two groups: all participants received 90 minutes of lecture instruction on how to splint and cast but one group viewed the supplemental instructional video and the other did not. There were no differences in terms of sex, age, basic science exam scores, or grade point average of the groups. Thirteen specific skills in splinting an injured limb were evaluated. We recorded grade point averages. We developed a 10-point scoring system and graded each student on their splinting skills 6 months after the lectures. The medical students who watched the video had an average score of 7.6, whereas the control group's average score was 2.0. We observed a positive association between watching the educational video and clinical exam score. A higher professor-to-student ratio was associated with lower student Objective Structured Clinical Examination score. Our observations suggest a supplemental video instructional program improved the performance of musculoskeletal clinical skills in comparison to only a traditional lecture series.

Quality Evaluation Scores are no more Reliable than Gestalt in Evaluating the Quality of Emergency Medicine Blogs: A METRIQ Study.

PubMed

Thoma, Brent; Sebok-Syer, Stefanie S; Colmers-Gray, Isabelle; Sherbino, Jonathan; Ankel, Felix; Trueger, N Seth; Grock, Andrew; Siemens, Marshall; Paddock, Michael; Purdy, Eve; Kenneth Milne, William; Chan, Teresa M

2018-01-30

Construct: We investigated the quality of emergency medicine (EM) blogs as educational resources. Online medical education resources such as blogs are increasingly used by EM trainees and clinicians. However, quality evaluations of these resources using gestalt are unreliable. We investigated the reliability of two previously derived quality evaluation instruments for blogs. Sixty English-language EM websites that published clinically oriented blog posts between January 1 and February 24, 2016, were identified. A random number generator selected 10 websites, and the 2 most recent clinically oriented blog posts from each site were evaluated using gestalt, the Academic Life in Emergency Medicine (ALiEM) Approved Instructional Resources (AIR) score, and the Medical Education Translational Resources: Impact and Quality (METRIQ-8) score, by a sample of medical students, EM residents, and EM attendings. Each rater evaluated all 20 blog posts with gestalt and 15 of the 20 blog posts with the ALiEM AIR and METRIQ-8 scores. Pearson's correlations were calculated between the average scores for each metric. Single-measure intraclass correlation coefficients (ICCs) evaluated the reliability of each instrument. Our study included 121 medical students, 88 EM residents, and 100 EM attendings who completed ratings. The average gestalt rating of each blog post correlated strongly with the average scores for ALiEM AIR (r = .94) and METRIQ-8 (r = .91). Single-measure ICCs were fair for gestalt (0.37, IQR 0.25-0.56), ALiEM AIR (0.41, IQR 0.29-0.60) and METRIQ-8 (0.40, IQR 0.28-0.59). The average scores of each blog post correlated strongly with gestalt ratings. However, neither ALiEM AIR nor METRIQ-8 showed higher reliability than gestalt. Improved reliability may be possible through rater training and instrument refinement.

Magnetic resonance imaging-controlled results of the pectoralis major tendon transfer for irreparable anterosuperior rotator cuff tears performed with standard and modified fixation techniques.

PubMed

Lederer, Stefan; Auffarth, Alexander; Bogner, Robert; Tauber, Mark; Mayer, Michael; Karpik, Stefanie; Matis, Nicholas; Resch, Herbert

2011-10-01

Irreparable ruptures of the subscapularis tendon lead to impaired function of the shoulder joint. In such cases, transfer of the pectoralis major tendon has led to encouraging results. The procedure fails periodically, typically associated with insufficient in-growth of the transferred tissue. We hypothesized that tendon harvest with chips of cancellous bone would improve the tendon-bone interface. Of 62 consecutive pectoralis tendon transfers, 54 shoulders were followed-up at an average of 35 months. In all shoulders, the transferred tendon was rerouted behind the conjoint tendon and fixed by transosseous sutures. In 29 shoulders, the tendon was harvested with a cuff of cancellous bone. In 25 shoulders, the conventional technique with sharp detachment of the tendon was used. Apart from detailed clinical examination of all shoulders, a magnetic resonance image (MRI) was available in 52 shoulders. The overall Constant score had improved from an average of 38.8 points preoperatively to 63.4 points at follow-up. Shoulders treated with the new fixation technique scored 64.4 compared with 62.2 for the conventional fixations. The MRI showed intact tendons and muscles in 80.8% of shoulders. In 7 shoulders (13.5%), the transferred tendon was ruptured. Two of these were treated with the new fixation technique. Mean patient satisfaction score was 8.2 points. A secure method of fixation that avoids secondary ruptures despite insufficiency of the transferred tendon is of great importance. Also the rerouting of the transferred tendon under the conjoined tendon is essential to imitate the natural force vector and the function of an intact subscapularis tendon. Patients in this investigation were also monitored by MRI to verify the integrity of the transferred tendon. As a salvage procedure, the pectoralis major tendon transfer provides good results in most cases. Sufficient in-growth of the transferred tissue is essential for the success of the procedure. This seems to be facilitated by both methods. Copyright © 2011 Journal of Shoulder and Elbow Surgery Board of Trustees. All rights reserved.

Rapid Corner Detection Using FPGAs

NASA Technical Reports Server (NTRS)

Morfopoulos, Arin C.; Metz, Brandon C.

2010-01-01

In order to perform precision landings for space missions, a control system must be accurate to within ten meters. Feature detection applied against images taken during descent and correlated against the provided base image is computationally expensive and requires tens of seconds of processing time to do just one image while the goal is to process multiple images per second. To solve this problem, this algorithm takes that processing load from the central processing unit (CPU) and gives it to a reconfigurable field programmable gate array (FPGA), which is able to compute data in parallel at very high clock speeds. The workload of the processor then becomes simpler; to read an image from a camera, it is transferred into the FPGA, and the results are read back from the FPGA. The Harris Corner Detector uses the determinant and trace to find a corner score, with each step of the computation occurring on independent clock cycles. Essentially, the image is converted into an x and y derivative map. Once three lines of pixel information have been queued up, valid pixel derivatives are clocked into the product and averaging phase of the pipeline. Each x and y derivative is squared against itself, as well as the product of the ix and iy derivative, and each value is stored in a WxN size buffer, where W represents the size of the integration window and N is the width of the image. In this particular case, a window size of 5 was chosen, and the image is 640 480. Over a WxN size window, an equidistance Gaussian is applied (to bring out the stronger corners), and then each value in the entire window is summed and stored. The required components of the equation are in place, and it is just a matter of taking the determinant and trace. It should be noted that the trace is being weighted by a constant k, a value that is found empirically to be within 0.04 to 0.15 (and in this implementation is 0.05). The constant k determines the number of corners available to be compared against a threshold sigma to mark a valid corner. After a fixed delay from when the first pixel is clocked in (to fill the pipeline), a score is achieved after each successive clock. This score corresponds with an (x,y) location within the image. If the score is higher than the predetermined threshold sigma, then a flag is set high and the location is recorded.

[EFFECTIVENESS OF CLAVICULAR HOOK PLATE COMBINED WITH TRAPEZIUS MUSCLE FASCIA FOR RECONSTRUCTION OF ACROMIOCLAVICULAR AND CORACOCLAVICULAR LIGAMENTS TO TREAT COMPLETE ACROMIOCLAVICULAR JOINT DISLOCATION].

PubMed

Wang, Chaoliang; Wang, Yingzhen; Zhu, Tao; Sun, Xuesheng; Lin, Chu; Gao, Bo; Li, Xinxia

2015-02-01

To explore the effectiveness of the clavicular hook plate combined with trapezius muscle fascia for reconstruction of acromioclavicular and coracoclavicular ligaments to treat acute complete acromioclavicular dislocations. Between January 2008 and April 2012, 66 patients with acromioclavicular dislocation were treated with the clavicular hook plate combined with trapezius muscle fascia for reconstruction of acromioclavicular and coracoclavicular ligaments in 32 cases (experimental group) and with the clavicular hook plate in 34 cases (control group). There was no significant difference in gender, age, injured side, the cause of injury, and the time from injury to operation between 2 groups (P > 0.05). Visual analogue scale (VAS), Constant shoulder scores, and coracoid clavi-cledistance (CC. Dist) were measured at preoperation and at 2 years after operation. Signal/noise quotiem (SNQ) was measured by MRI at 2 years after operation. The operation complications were observed. The patients of 2 groups obtained primary healing of incision. The morbidity of complication in experimental group (12.5%, 4/32) was significantly lower than that in control group (91.2%, 31/34) (Χ2 = 40.96, P = 0.00). All the cases were followed up 2.8 years on average (range, 2 to 4 years). VAS scores and CC.Dist significantly decreased at 2 years after operation when compared with preoperative values in the 2 groups (P < 0.05). VAS scores and CC.Dist of the experimental group were significantly lower than those in the control group (P < 0.05). According to Constant shoulder scores at 2 years after operation, the results were excellent in 19 cases, good in 11 cases, and general in 2 cases with an excellent and good rate of 93.75% in the experimental group; the results were excellent in 7 cases, good in 8 cases, general in 16 cases, and poor in 3 cases with an excellent and good rate of 44.11% in the control group; and significant difference was shown between 2 groups (t = 2.30, P = 0.03). SNQ was significantly lower in experimental group than in control group at 2 years after operation (t = 55.03, P = 0.00), indicating that ligament healing was better in experimental group than control group. Compared with simple clavicular hook plate fixation, the clavicular hook plate combined with trapezius muscle fascia for reconstruction of acromioclavicular and coracoclavicular ligaments is successful in treating acute complete acromioclavicular dislocations, with the advantages of higher ligament healing, less complication, and early improvement of shoulder functions.

Comparing State and District Test Results to National Norms: Interpretations of Scoring "Above the National Average."

ERIC Educational Resources Information Center

Linn, Robert L.; And Others

Norm-referenced test results reported by states and school districts and factors related to those scores were studied through mail and telephone surveys of 35 states and a nationally representative sample of 153 school districts to determine the degree to which "above average" results were being reported. Part of the stimulus for this…

Financial Literacy Skills of Students in Urban and Rural High Schools

ERIC Educational Resources Information Center

Valentine, Gregory P.; Khayum, Mohammed

2005-01-01

The purpose of this study was to determine the affect of various demographic and economic socialization factors on the results of a personal finance literacy quiz administered to rural and urban high school students in Indiana. Urban students had an average score of 50% on the quiz and rural students had a an average score of 51%. Planning to…

Changes in Student Populations and Average Test Scores of Dutch Primary Schools

ERIC Educational Resources Information Center

Luyten, Hans; de Wolf, Inge

2011-01-01

This article focuses on the relation between student population characteristics and average test scores per school in the final grade of primary education from a dynamic perspective. Aggregated data of over 5,000 Dutch primary schools covering a 6-year period were used to study the relation between changes in school populations and shifts in mean…

Customer focus level following implementation of quality improvement model in Tehran social security hospitals.

PubMed

Mehrabi, F; Nasiripour, A; Delgoshaei, B

2008-01-01

The key factor for the success of total quality management programs in an organization is focusing on the customer. The purpose of this paper is to assess customer focus level following implementation of a quality improvement model in social security hospitals in Tehran Province. This research was descriptive-comparative in nature. The study population consisted of the implementers of quality improvement model in four Tehran social security hospitals. The data were gathered through a checklist addressing customer knowledge and customer satisfaction. The research findings indicated that the average scores on customer knowledge in Shahriar, Alborz, Milad, and Varamin hospitals were 64.1, 61.2, 54.1, and 46.6, respectively. The average scores on customer satisfaction in Shahriar, Alborz, Milad, and Varamin hospitals were 67.7, 65, 59.4, and 50, respectively. The customer focus average scores in Shahriar, Alborz, Milad, and Varamin hospitals were 66.3, 63.3, 57.3, and 48.6, respectively. The total average scores on customer knowledge, satisfaction and customer focus in the investigated hospitals proved to be 56.4, 60.5, and 58.9, respectively. The paper is of value in showing that implementation of the quality improvement model could considerably improve customer focus level.

How Do Changes in Speed Affect the Perception of Duration?

ERIC Educational Resources Information Center

Matthews, William J.

2011-01-01

Six experiments investigated how changes in stimulus speed influence subjective duration. Participants saw rotating or translating shapes in three conditions: constant speed, accelerating motion, and decelerating motion. The distance moved and average speed were the same in all three conditions. In temporal judgment tasks, the constant-speed…

Readability Assessment of Internet-Based Patient Education Materials Related to Parathyroid Surgery.

PubMed

Patel, Chirag R; Sanghvi, Saurin; Cherla, Deepa V; Baredes, Soly; Eloy, Jean Anderson

2015-07-01

Patient education is critical in obtaining informed consent and reducing preoperative anxiety. Written patient education material (PEM) can supplement verbal communication to improve understanding and satisfaction. Published guidelines recommend that health information be presented at or below a sixth-grade reading level to facilitate comprehension. We investigate the grade level of online PEMs regarding parathyroid surgery. A popular internet search engine was used to identify PEM discussing parathyroid surgery. Four formulas were used to calculate readability scores: Flesch Reading Ease (FRE), Flesch-Kincaid Grade Level (FKGL), Gunning Frequency of Gobbledygook (GFOG), and Simple Measure of Gobbledygook (SMOG). Thirty web-based articles discussing parathyroid surgery were identified. The average FRE score was 42.8 (±1 standard deviation [SD] 16.3; 95% confidence interval [CI], 36.6-48.8; range, 6.1-71.3). The average FKGL score was 11.7 (±1 SD 3.3; 95% CI, 10.5-12.9; range, 6.1-19.0). The SMOG scores averaged 14.2 (±1 SD 2.6; 95% CI, 13.2-15.2; range, 10.7-21.9), and the GFOG scores averaged 15.0 (±1 SD 3.5; 95% CI, 13.7-16.3; range, 10.6-24.8). Online PEM on parathyroid surgery is written above the recommended sixth-grade reading level. Improving readability of PEM may promote better health education and compliance. © The Author(s) 2015.

18F Fluorocholine Dynamic Time-of-Flight PET/MR Imaging in Patients with Newly Diagnosed Intermediate- to High-Risk Prostate Cancer: Initial Clinical-Pathologic Comparisons.

PubMed

Choi, Joon Young; Yang, Jaewon; Noworolski, Susan M; Behr, Spencer; Chang, Albert J; Simko, Jeffry P; Nguyen, Hao G; Carroll, Peter R; Kurhanewicz, John; Seo, Youngho

2017-02-01

Purpose To investigate the initial clinical value of fluorine 18 ( 18 F) fluorocholine (FCH) dynamic positron emission tomography (PET)/magnetic resonance (MR) imaging by comparing its parameters with clinical-pathologic findings in patients with newly diagnosed intermediate- to high-risk prostate cancer (PCa) who plan to undergo radical prostatectomy. Materials and Methods The institutional review board approved the study protocol, and informed written consent was obtained from all subjects for this HIPAA-compliant study. Twelve men (mean age ± standard deviation, 61.7 years ± 8.4; range, 46-74 years) with untreated intermediate- to high-risk PCa characterized according to Cancer of the Prostate Risk Assessment (CAPRA) underwent preoperative FCH dynamic PET/MR imaging followed by radical prostatectomy between April and November 2015. PET/MR imaging parameters including average and maximum K1 (delivery rate constant) and standardized uptake values (SUVs) and Prostate Imaging Reporting and Data System (PI-RADS) version 2 scores were measured and compared with clinical-pathologic characteristics. For statistical analysis, the Spearman rank correlation and Mann-Whitney U tests were performed. Results Of the PET parameters, maximum SUV of primary tumors showed significant correlations with several clinical-pathologic parameters including serum prostate-specific antigen level (ρ = 0.71, P = .01), pathologic stage (ρ = 0.59, P = .043), and postsurgical CAPRA score (ρ = 0.72, P = .008). The overall PI-RADS score showed significant correlations with pathologic tumor volume (ρ = 0.81, P < .001), percentage of tumor cells with Gleason scores greater than 3 (ρ = 0.59, P = .02), and postsurgical CAPRA score (ρ = 0.58, P = .046). The high-risk postsurgical CAPRA score patient group had a significantly higher maximum SUV than did the intermediate-risk group. Combined PET and MR imaging showed improved sensitivity (88%) for prediction of pathologic extraprostatic extension compared with that with MR imaging (50%) and PET (75%) performed separately. Conclusion Maximum SUVs and PI-RADS scores from FCH PET/MR imaging show good correlation with clinical-pathologic characteristics, such as postsurgical CAPRA score, which are related to prognosis in patients with newly diagnosed intermediate- to high-risk PCa. © RSNA, 2016 Online supplemental material is available for this article.

Admission interview scores are associated with clinical performance in an undergraduate physiotherapy course: an observational study.

PubMed

Edgar, Susan; Mercer, Annette; Hamer, Peter

2014-12-01

The purpose of this study was to determine if there is an association between admission interview score and subsequent academic and clinical performance, in a four-year undergraduate physiotherapy course. Retrospective observational study. 141 physiotherapy students enrolled in two entry year groups. Individual student performance in all course units, practical examinations, clinical placements as well as year level and overall Grade Point Average. Predictor variables included admission interview scores, admission academic scores and demographic data (gender, age and entry level). Interview score demonstrated a significant association with performance in three of six clinical placements through the course. This association was stronger than for any other admission criterion although effect sizes were small to moderate. Further, it was the only admission score to have a significant association with overall Clinical Grade Point Average for the two year groups analysed (r=0.322). By contrast, academic scores on entry showed significant associations with all year level Grade Point Averages except Year 4, the clinical year. This is the first study to review the predictive validity of an admission interview for entry into a physiotherapy course in Australia. The results show that performance in this admission interview is associated with overall performance in clinical placements through the course, while academic admission scoring is not. These findings suggest that there is a role for both academic and non-academic selection processes for entry into physiotherapy. Copyright © 2014 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Food hygiene, deprivation, types of premises and rates of gastrointestinal illnesses in the UK.

PubMed

Collins, Brendan

2015-01-01

To understand more about the relationship between economic deprivation, types of premises, food hygiene scores and rates of gastrointestinal illness in the UK. Data were extracted from the UK Food Standards Agency for about 300 000 UK premises which had hygiene scores based on visits from local authority food safety officers. These scores were analysed by type of premises, deprivation and local authority. Local authority-level average scores were mapped and compared with rates of laboratory-detected gastrointestinal illness from the Health Protection Agency. UK. UK premises (n 311 458) from 341 local authority areas that sell or produce food. There was a modest but statistically significant relationship between average food hygiene score and deprivation, which was caused by deprived areas having more of the categories of premises with significantly lower hygiene scores; these were pub/club (n 40 525), restaurant/café/canteen (n 73 052), small retailer (n 42 932) and takeaway (n 36 708). No relationship was established between local authority average food hygiene scores and rates of laboratory-detected gastrointestinal illness; however, this result does not preclude a relationship between food hygiene and rates of gastrointestinal illnesses, as laboratory-detected illness rates make up only a small proportion of actual rates of illness in the community. Certain types of UK premises are more likely to have low hygiene scores, which means that they should be targeted more for enforcement. These types of premises are more prevalent in the most economically deprived areas.

A comparison of sonography and radiography student scores in a cadaver anatomy class before and after the implementation of synchronous distance education.

PubMed

Bagley, Jennifer Elaine; Randall, K; Anderson, M P

2015-02-01

Distance education is a solution to expand medical imaging education to students who might not otherwise be able to obtain the education. It can be a mechanism to reduce the health care worker shortage in underserved areas. In some cases, distance education may be a disruptive technology, and might lower student performance. This study compares student scores in a cadaver anatomy course in the four cohorts preceding the implementation of distance education to the first three cohorts that took the course using a multiple campus design. The means and medians of the lecture exam average, the laboratory component score, and the final course score of the nondistance education cohorts were compared with those of the distance education cohorts using nonparametric statistical analysis. Scores in an anatomy course were compared by campus placement among the distance education cohorts, and the independent effect of distance education on the laboratory component, lecture examination average, and final course scores, while controlling for cumulative grade point average and site (originating/distant), was assessed. Students receiving the course in a nondistance education environment scored higher in the anatomy course than the students who took the course in a distance education environment. Students on the distant campus scored lower than students on the originating site. Distance education technology creates new opportunities for learning, but can be a disruptive technology. Programs seeking to implement distance education into their curriculum should do so with knowledge of the advantages and disadvantages.

Gender Differences in the Development of Dieting from Adolescence to Early Adulthood: A Longitudinal Study

ERIC Educational Resources Information Center

von Soest, Tilmann; Wichstrom, Lars

2009-01-01

This study examines gender differences in the development of dieting among a representative sample of 1,368 Norwegian boys and girls. The respondents were followed over 3 time points from ages 13/14 to 20/21. Latent growth curve analyses were conducted showing that girls' dieting scores increased while boys' scores remained constant. Gender…

Outcomes of rotator cuff augmentation surgery with autologous fascia lata.

PubMed

Rosales-Varo, A P; García-Espona, M A; Roda-Murillo, O

To evaluate whether augmentation grafts using autologous fascia lata improve functional results for rotator cuff repairs and reduce the retear rate compared to those without augmentation. This is a prospective evaluation comprising 20 patients with a complete symptomatic rotator cuff tear. The operations were carried out from a superior approach performing a total cuff repair, for 10 patients we used a suture augmented with an autologous graft taken from their own fascia lata while unaugmented sutures were used for the other 10 patients. The follow-up period lasted for one year post-intervention. We measured variables for tear type, functionality and pain, both baseline and at 6 and 12-month follow ups. We evaluated retear incidence in each group as well as each group's pain and functionality response. The improved pain levels in the non-graft group evolved gradually over time. Conversely, in the group with the augmentation grafts, average Constant-Murley shoulder outcome scores at six months were already above 10 and were maintained at 12 months. One retear occurred in the graft group and 2 in the group without grafts, thus presenting no significant differences. There were no significant changes in pain and function values at the one year follow up in either group. Our preliminary results regarding rotator cuff augmentation surgery with autologous fascia lata showed a significant improvement in pain levels after 6 months compared to the patients with no augmentation, who required 12 months to reach the same values. After a year of follow up, there were no differences between the mean Constant and pain scores in either intervention group The number of retears in the non-graft group was greater than that in the group with grafts although the difference was not significant. Copyright © 2018 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

Concurrent Validity Between a Shared Curriculum, the Internal Medicine In-Training Examination, and the American Board of Internal Medicine Certifying Examination

PubMed Central

Sisson, Stephen D.; Bertram, Amanda; Yeh, Hsin-Chieh

2015-01-01

Background A core objective of residency education is to facilitate learning, and programs need more curricula and assessment tools with demonstrated validity evidence. Objective We sought to demonstrate concurrent validity between performance on a widely shared, ambulatory curriculum (the Johns Hopkins Internal Medicine Curriculum), the Internal Medicine In-Training Examination (IM-ITE), and the American Board of Internal Medicine Certifying Examination (ABIM-CE). Methods A cohort study of 443 postgraduate year (PGY)-3 residents at 22 academic and community hospital internal medicine residency programs using the curriculum through the Johns Hopkins Internet Learning Center (ILC). Total and percentile rank scores on ILC didactic modules were compared with total and percentile rank scores on the IM-ITE and total scores on the ABIM-CE. Results The average score on didactic modules was 80.1%; the percentile rank was 53.8. The average IM-ITE score was 64.1% with a percentile rank of 54.8. The average score on the ABIM-CE was 464. Scores on the didactic modules, IM-ITE, and ABIM-CE correlated with each other (P < .05). Residents completing greater numbers of didactic modules, regardless of scores, had higher IM-ITE total and percentile rank scores (P < .05). Resident performance on modules covering back pain, hypertension, preoperative evaluation, and upper respiratory tract infection was associated with IM-ITE percentile rank. Conclusions Performance on a widely shared ambulatory curriculum is associated with performance on the IM-ITE and the ABIM-CE. PMID:26217421

The performance assessment of undergraduate students in physics laboratory by using guided inquiry

NASA Astrophysics Data System (ADS)

Mubarok, H.; Lutfiyah, A.; Kholiq, A.; Suprapto, N.; Putri, N. P.

2018-03-01

The performance assessment of basic physics experiment among undergraduate physics students which includes three stages: pre-laboratory, conducting experiment and final report was explored in this study. The research used a descriptive quantitative approach by utilizing guidebook of basic physics experiment. The findings showed that (1) the performance of pre-laboratory rate among undergraduate physics students in good category (average score = 77.55), which includes the ability of undergraduate physics students’ theory before they were doing the experiment. (2) The performance of conducting experiment was in good category (average score = 78.33). (3) While the performance of final report was in moderate category (average score = 73.73), with the biggest weakness at how to analyse and to discuss the data and writing the abstract.

Interobserver Reliability of the Total Body Score System for Quantifying Human Decomposition.

PubMed

Dabbs, Gretchen R; Connor, Melissa; Bytheway, Joan A

2016-03-01

Several authors have tested the accuracy of the Total Body Score (TBS) method for quantifying decomposition, but none have examined the reliability of the method as a scoring system by testing interobserver error rates. Sixteen participants used the TBS system to score 59 observation packets including photographs and written descriptions of 13 human cadavers in different stages of decomposition (postmortem interval: 2-186 days). Data analysis used a two-way random model intraclass correlation in SPSS (v. 17.0). The TBS method showed "almost perfect" agreement between observers, with average absolute correlation coefficients of 0.990 and average consistency correlation coefficients of 0.991. While the TBS method may have sources of error, scoring reliability is not one of them. Individual component scores were examined, and the influences of education and experience levels were investigated. Overall, the trunk component scores were the least concordant. Suggestions are made to improve the reliability of the TBS method. © 2016 American Academy of Forensic Sciences.

Ready to work or not quite? Self-perception of practical skills among medical students from Serbia ahead of graduation.

PubMed

Gazibara, Tatjana; Nurković, Selmina; Marić, Gorica; Kurtagić, Ilma; Kovačević, Nikolina; Kisić-Tepavčević, Darija; Pekmezović, Tatjana

2015-08-01

To assess final year medical students' self-perception of their practical skills. The study was conducted at the Faculty of Medicine in Belgrade during compulsory practical sessions in the period December 2-9, 2013 and 390 students agreed to participate (response rate 77.8%). The questionnaire included questions on demographic characteristics, 21 questions on students' self-perception of their practical skills, and 1 question on students' self-perceived readiness to start working with patients. Cronbach's α for the entire scale was 0.891. Students felt most confident about measuring arterial pulse and blood pressure and taking patients' history (average score 10 for all three skills) and least confident about placing a urinary catheter (average score 1) and suturing a wound (average score 2). They rated their readiness to work with patients with 5.0 out of 10.0 points. The total score did not correlate with students' average mark (Spearman's ρ=0.039; P=0.460) and the average mark did not correlate with the self-perceived readiness to work with patients (Spearman's ρ=-0.048; P=0.365). Our study suggests that medical students lack confidence to perform various clinical procedures, particularly those related to surgical interventions. To improve students' confidence, clinical curriculum should include either more hours of practical work or ensure closer supervision of practical training in wards.

Accounting for therapist variability in couple therapy outcomes: what really matters?

PubMed

Owen, Jesse; Duncan, Barry; Reese, Robert Jeff; Anker, Morten; Sparks, Jacqueline

2014-01-01

This study examined whether therapist gender, professional discipline, experience conducting couple therapy, and average second-session alliance score would account for the variance in outcomes attributed to the therapist. The authors investigated therapist variability in couple therapy with 158 couples randomly assigned to and treated by 18 therapists in a naturalistic setting. Consistent with previous studies in individual therapy, in this study therapists accounted for 8.0% of the variance in client outcomes and 10% of the variance in client alliance scores. Therapist average alliance score and experience conducting couple therapy were salient predictors of client outcomes attributed to therapist. In contrast, therapist gender and discipline did not significantly account for the variance in client outcomes attributed to therapists. Tests of incremental validity demonstrated that therapist average alliance score and therapist experience uniquely accounted for the variance in outcomes attributed to the therapist. Emphasis on improving therapist alliance quality and specificity of therapist experience in couple therapy are discussed.

Ponseti's manipulation in neglected clubfoot in children more than 7 years of age: a prospective evaluation of 25 feet with long-term follow-up.

PubMed

Khan, Shah Alam; Kumar, Ashok

2010-09-01

We wanted to evaluate the efficacy of Ponseti's technique in neglected clubfoot in children more than 7 years of age. The results of Ponseti's method were evaluated in 21 children (25 feet) with neglected club feet. Patients were evaluated using the Dimeglio scoring system. All patients underwent percutaneous tenotomy of the Achilles tendon. The mean age at the time of treatment was 8.9 years. The mean follow-up period was 4.7 years. The average Dimeglio score at the start of the treatment was 14.2 compared with an average score of 0.95 at the end of the treatment at 1-year follow-up. Eighteen feet (85.7%) had full correction. Recurrence was seen in six feet (24%). At 4-year follow-up, the average Dimeglio score for 19 feet was 0.18. We recommend that Ponseti's method should be the preferred initial treatment modality for neglected clubfeet.

Quality of life of caregivers: a cross-sectional study.

PubMed

Ovayolu, Ozlem; Ovayolu, Nimet; Tuna, Döndü; Serçe, Sibel; Sevinç, Alper; Pirbudak Çöçelli, Lütfiye

2014-08-01

This descriptive study was conducted to evaluate the quality of life of cancer caregivers. One hundred and seventy-eight caregivers of patients who were diagnosed with cancer in Gaziantep oncology hospital participated in the study. Data were collected by using a questionnaire and quality of life scale. The scale was scored between 0 and 10, where '10' indicated the best and '0' indicated the worst level. It was determined that the majority of caregivers were young and female, the overall total score average of quality of life was 4.5 ± 1.1, and the subdomain with the lowest value was the psychological subdomain. All quality of life subdomain score averages and the overall total score averages were observed to be low in women, as well as in those who provided care for their own children, who lived in the same house with the patient and who gave care for 19-24 h daily. © 2013 Wiley Publishing Asia Pty Ltd.

Genetic response to selection for weaning weight or yearling weight or yearling weight and muscle score in Hereford cattle: efficiency of gain, growth, and carcass characteristics.

PubMed

Koch, R M; Cundiff, L V; Gregory, K E; Van Vleck, L D

2004-03-01

An experiment involving crosses among selection and control lines was conducted to partition direct and maternal additive genetic response to 20 yr of selection for 1) weaning weight, 2) yearling weight, and 3) index of yearling weight and muscle score. Selection response was evaluated for efficiency of gain, growth from birth through market weight, and carcass characteristics. Heritability and genetic correlations among traits were estimated using animal model analyses. Over a time-constant interval, selected lines were heavier, gained more weight, consumed more ME, and had more gain/ME than the control. Over a weight-constant interval, selected lines required fewer days, consumed less ME, had more efficient gains, and required less energy for maintenance than control. Direct and maternal responses were estimated from reciprocal crosses among unselected sires and dams of control and selection lines. Most of the genetic response to selection in all three lines was associated with direct genetic effects, and the highest proportion was from postweaning gain. Indirect responses of carcass characteristics to selection over the 20 yr were increased weight of carcasses that had more lean meat, produced with less feed per unit of gain. At a constant carcass weight, selected lines had 1.32 to 1.85% more retail product and 1.62 to 2.24% less fat trim and 10/100 to 25/100 degrees less marbling than control. At a constant age, heritability of direct and maternal effects and correlations between them were as follows: market weight, 0.36, 0.14, and 0.10; carcass weight, 0.26, 0.15, and 0.03; longissimus muscle area, 0.33, 0.00, and 0.00; marbling, 0.36, 0.07, and -0.35; fat thickness, 0.41, 0.05, and -0.18; percentage of kidney, pelvic, and heart fat, 0.12, 0.08, and -0.76; percentage of retail product, 0.46, 0.05, and -0.29; retail product weight, 0.44, 0.08, -0.14; and muscle score, 0.37, 0.14, and -0.54. Selection criteria in all lines improved efficiency of postweaning gain and increased the amount of salable lean meat on an age- or weight-constant basis, but carcasses had slightly lower marbling scores.

Is USMLE Step 1 score a valid predictor of success in surgical residency?

PubMed

Sutton, Erica; Richardson, James David; Ziegler, Craig; Bond, Jordan; Burke-Poole, Molly; McMasters, Kelly M

2014-12-01

Many programs rely extensively on United States Medical Licensing Examination (USMLE) scores for interviews/selection of surgical residents. However, their predictive ability remains controversial. We examined the association between USMLE scores and success in surgical residency. We compared USMLE scores for 123 general surgical residents who trained in the past 20 years and their performance evaluation. Scores were normalized to the mean for the testing year and expressed as a ratio (1 = mean). Performances were evaluated by (1) rotation evaluations; (2) "dropouts;" (3) overall American Board of Surgery pass rate; (4) first-time American Board of Surgery pass rate; and (5) a retrospective comprehensive faculty evaluation. For the latter, 16 surgeons (average faculty tenure 22 years) rated residents on a 1 to 4 score (1 = fair; 4 = excellent). Rotation evaluations by faculty and "drop out" rates were not associated with USMLE score differences (dropouts had average above the mean). One hundred percent of general surgery practitioners achieved board certification regardless of USMLE score but trainees with an average above the mean had a higher first-time pass rate (P = .04). Data from the comprehensive faculty evaluations were conflicting: there was a moderate degree of correlation between board scores and faculty evaluations (r = .287, P = .001). However, a score above the mean was associated with a faculty ranking of 3 to 4 in only 51.7% of trainees. Higher USMLE scores were associated with higher faculty evaluations and first-time board pass rates. However, their positive predictive value was only 50% for higher faculty evaluations and a high overall board pass rate can be achieved regardless of USMLE scores. USMLE Step 1 score is a valid tool for selecting residents but caution might be indicated in using it as a single selection factor. Copyright © 2014 Elsevier Inc. All rights reserved.

A Study of Soft Neurological Signs and Its Correlates in Drug-Naive Patients with First Episode Psychosis.

PubMed

Gunasekaran, Vanishree; Venkatesh, V Mathan Kumar; Asokan, T V

2016-01-01

Soft neurological signs are minor, non localizing, objective abnormalities, thought to reflect damage in cortical and sub-cortical connections or connections within different cortical regions. Regional structural grey matter anomalies have already been observed and correlated with the presence of cognitive deficits and presence of soft neurological signs in schizophrenic patients. Drug naive patients presenting with first episode of psychosis (FEP)were clinically evaluated for soft neurological signs using the Cambridge Neurological Inventory. The soft neurological signs scores were compared with scores in healthy volunteers. In the patient group, this score was also correlated with demographic and disorder variables. Of the 30 patients with FEP, 60% were women. The average age of the participant was 36.2 years. The average duration of illness was 1.55 years. More than 50% of the patients had schizophrenia. 93.3% of patients with FEP had atleast one soft neurological sign compared to 16.6% of controls. The average score on BPRS was 25.86 and on PANSS was 39.29, and BPRS, PANSS scores had a significant correlation with total soft neurological signs score. There is a significantly higher incidence of soft neurological signs in patients with FEP, particularly schizophrenia. The presence of soft signs correlated with the severity of psychosis.

Better prognostic marker in ICU - APACHE II, SOFA or SAP II!

PubMed

Naqvi, Iftikhar Haider; Mahmood, Khalid; Ziaullaha, Syed; Kashif, Syed Mohammad; Sharif, Asim

2016-01-01

This study was designed to determine the comparative efficacy of different scoring system in assessing the prognosis of critically ill patients. This was a retrospective study conducted in medical intensive care unit (MICU) and high dependency unit (HDU) Medical Unit III, Civil Hospital, from April 2012 to August 2012. All patients over age 16 years old who have fulfilled the criteria for MICU admission were included. Predictive mortality of APACHE II, SAP II and SOFA were calculated. Calibration and discrimination were used for validity of each scoring model. A total of 96 patients with equal gender distribution were enrolled. The average APACHE II score in non-survivors (27.97+8.53) was higher than survivors (15.82+8.79) with statistically significant p value (<0.001). The average SOFA score in non-survivors (9.68+4.88) was higher than survivors (5.63+3.63) with statistically significant p value (<0.001). SAP II average score in non-survivors (53.71+19.05) was higher than survivors (30.18+16.24) with statistically significant p value (<0.001). All three tested scoring models (APACHE II, SAP II and SOFA) would be accurate enough for a general description of our ICU patients. APACHE II has showed better calibration and discrimination power than SAP II and SOFA.

Comparing Real-time Versus Delayed Video Assessments for Evaluating ACGME Sub-competency Milestones in Simulated Patient Care Environments

PubMed Central

Stiegler, Marjorie; Hobbs, Gene; Martinelli, Susan M; Zvara, David; Arora, Harendra; Chen, Fei

2018-01-01

Background Simulation is an effective method for creating objective summative assessments of resident trainees. Real-time assessment (RTA) in simulated patient care environments is logistically challenging, especially when evaluating a large group of residents in multiple simulation scenarios. To date, there is very little data comparing RTA with delayed (hours, days, or weeks later) video-based assessment (DA) for simulation-based assessments of Accreditation Council for Graduate Medical Education (ACGME) sub-competency milestones. We hypothesized that sub-competency milestone evaluation scores obtained from DA, via audio-video recordings, are equivalent to the scores obtained from RTA. Methods Forty-one anesthesiology residents were evaluated in three separate simulated scenarios, representing different ACGME sub-competency milestones. All scenarios had one faculty member perform RTA and two additional faculty members perform DA. Subsequently, the scores generated by RTA were compared with the average scores generated by DA. Variance component analysis was conducted to assess the amount of variation in scores attributable to residents and raters. Results Paired t-tests showed no significant difference in scores between RTA and averaged DA for all cases. Cases 1, 2, and 3 showed an intraclass correlation coefficient (ICC) of 0.67, 0.85, and 0.50 for agreement between RTA scores and averaged DA scores, respectively. Analysis of variance of the scores assigned by the three raters showed a small proportion of variance attributable to raters (4% to 15%). Conclusions The results demonstrate that video-based delayed assessment is as reliable as real-time assessment, as both assessment methods yielded comparable scores. Based on a department’s needs or logistical constraints, our findings support the use of either real-time or delayed video evaluation for assessing milestones in a simulated patient care environment. PMID:29736352

Nursing activities score.

PubMed

Miranda, Dinis Reis; Nap, Raoul; de Rijk, Angelique; Schaufeli, Wilmar; Iapichino, Gaetano

2003-02-01

The instruments used for measuring nursing workload in the intensive care unit (e.g., Therapeutic Intervention Scoring System-28) are based on therapeutic interventions related to severity of illness. Many nursing activities are not necessarily related to severity of illness, and cost-effectiveness studies require the accurate evaluation of nursing activities. The aim of the study was to determine the nursing activities that best describe workload in the intensive care unit and to attribute weights to these activities so that the score describes average time consumption instead of severity of illness. To define by consensus a list of nursing activities, to determine the average time consumption of these activities by use of a 1-wk observational cross-sectional study, and to compare these results with those of the Therapeutic Intervention Scoring System-28. A total of 99 intensive care units in 15 countries. Consecutive admissions to the intensive care units. Daily recording of nursing activities at a patient level and random multimoment recording of these activities. A total of five new items and 14 subitems describing nursing activities in the intensive care unit (e.g., monitoring, care of relatives, administrative tasks) were added to the list of therapeutic interventions in Therapeutic Intervention Scoring System-28. Data from 2,041 patients (6,451 nursing days and 127,951 multimoment recordings) were analyzed. The new activities accounted for 60% of the average nursing time; the new scoring system (Nursing Activities Score) explained 81% of the nursing time (vs. 43% in Therapeutic Intervention Scoring System-28). The weights in the Therapeutic Intervention Scoring System-28 are not derived from the use of nursing time. Our study suggests that the Nursing Activities Score measures the consumption of nursing time in the intensive care unit. These results should be validated in independent databases.

Scale-invariant Green-Kubo relation for time-averaged diffusivity

NASA Astrophysics Data System (ADS)

Meyer, Philipp; Barkai, Eli; Kantz, Holger

2017-12-01

In recent years it was shown both theoretically and experimentally that in certain systems exhibiting anomalous diffusion the time- and ensemble-averaged mean-squared displacement are remarkably different. The ensemble-averaged diffusivity is obtained from a scaling Green-Kubo relation, which connects the scale-invariant nonstationary velocity correlation function with the transport coefficient. Here we obtain the relation between time-averaged diffusivity, usually recorded in single-particle tracking experiments, and the underlying scale-invariant velocity correlation function. The time-averaged mean-squared displacement is given by 〈δ2¯〉 ˜2 DνtβΔν -β , where t is the total measurement time and Δ is the lag time. Here ν is the anomalous diffusion exponent obtained from ensemble-averaged measurements 〈x2〉 ˜tν , while β ≥-1 marks the growth or decline of the kinetic energy 〈v2〉 ˜tβ . Thus, we establish a connection between exponents that can be read off the asymptotic properties of the velocity correlation function and similarly for the transport constant Dν. We demonstrate our results with nonstationary scale-invariant stochastic and deterministic models, thereby highlighting that systems with equivalent behavior in the ensemble average can differ strongly in their time average. If the averaged kinetic energy is finite, β =0 , the time scaling of 〈δ2¯〉 and 〈x2〉 are identical; however, the time-averaged transport coefficient Dν is not identical to the corresponding ensemble-averaged diffusion constant.

Neonatal Magnetic Resonance Imaging Without Sedation Correlates With Injury Severity in Brachial Plexus Birth Palsy.

PubMed

Bauer, Andrea S; Shen, Peter Y; Nidecker, Anna E; Lee, Paul S; James, Michelle A

2017-05-01

Which infants with brachial plexus birth palsy (BPBP) should undergo microsurgical plexus reconstruction remains controversial. The current gold standard for the decision for plexus reconstruction is serial clinical examinations, but this approach obviates the possibility of early surgical treatment. We hypothesize that a new technique using 3-dimensional volumetric proton density magnetic resonance imaging (MRI) without sedation can evaluate the severity of BPBP injury earlier than serial clinical examinations. Infants were prospectively enrolled prior to 12 weeks of age and imaged using 3 Tesla MRI without sedation. Clinical scores were collected at all visits. The imaging findings were graded based on the number of injured levels and the severity of each injury, and a radiological score was calculated. All infants were followed at least until the decision for surgery was made based on clinical examination. Nine infants completed the MRI scan and clinical follow-up. The average Toronto score at presentation was 4.4 out of 10 (range, 0-8.2); the average Active Movement Scale score was 50 out of 105 (range, 0-86). Four infants required surgery: 2 because of a flail limb and Horner syndrome and 2 owing to failure to recover antigravity elbow flexion by age 6 months. Radiological scores ranged from 0 to 18 out of a maximum score of 25. The average radiological score for those infants who required surgery was 12 (range, 6.5-18), whereas the average score for infants who did not require surgery was 3.5 (range, 0-8). Three-dimensional proton density MRI can evaluate spinal nerve roots in infants without the need for radiation, contrast agents, or sedation. These data suggest that MRI can help determine the severity of injury earlier than clinical examination in infants with BPBP, although further study of a larger sample of infants with varying severity of disease is necessary. Diagnostic II. Copyright © 2017 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Wound Infiltration With Extended-Release Versus Short-Acting Bupivacaine Before Laparoscopic Hysterectomy: A Randomized Controlled Trial.

PubMed

Barron, Kenneth I; Lamvu, Georgine M; Schmidt, R Cole; Fisk, Matthew; Blanton, Emily; Patanwala, Insiyyah

2017-02-01

To evaluate if preincision infiltration with extended-release liposomal bupivacaine provides improved overall pain relief compared with 0.25% bupivacaine after laparoscopic or robotic-assisted hysterectomy. A single-center double-masked randomized controlled trial (Canadian Task Force Classification I). A tertiary-care community hospital. Patients recruited from July 2015 through January 2016. Sixty-four patients were randomized, and 59 were analyzed for the primary outcome. Women scheduled to undergo multiport laparoscopic or robotic-assisted total hysterectomy for benign indications were randomized to receive preincision infiltration with undiluted liposomal bupivacaine or 0.25% bupivacaine. The primary outcome was overall average pain intensity by numeric rating scale (0-10) using the Brief Pain Inventory (BPI) via telephone survey on postoperative day (POD) 3. A sample size of 28 per group (N = 56) was planned to detect a 30% change in pain scores. Secondary outcomes were overall average and worst numeric pain scores on PODs 1, 2, and 14; pain scores in hospital; BPI pain interference scores; and total opioid use. There were no demographic differences between the 2 groups. For the primary outcome, we found a decrease in the average (p = .02) pain scores on POD 3 in the liposomal bupivacaine group. We also found a decrease in worst pain scores on POD 2 (p = .03) and POD 3 (p = .01). There were no differences in pain scores while in the hospital or on POD 1 or POD 14. There were no differences in BPI pain interference scores, opioid use, or reported adverse effects. For laparoscopic and robotic-assisted multiport hysterectomies, there is evidence of decreased average postoperative pain with liposomal bupivacaine compared with 0.25% bupivacaine for port-site analgesia on POD 3, but no difference in opioid use or measures of functioning. Published by Elsevier Inc.

The Effect of Prerequisite Pharmacodynamics Course Timing on Student Performance in Pharmacotherapy Courses.

PubMed

Kelsch, Michael P; Sylvester, Robert K

2016-08-25

Objective. To evaluate the impact that decreasing the time from 12 to three months between prerequisite pharmacodynamics courses and their corresponding pharmacotherapy courses had on overall student performance in the pharmacotherapy courses measured by course examination scores. Methods. Two cohorts of second-professional year (P2) and third professional year (P3) classes, respectively, following different curriculum plans, simultaneously took two pharmacotherapy courses (infectious disease and neoplastic disease). Admission data (age, gender, prior bachelor's degree status, grade point average (GPA), Pharmacy College Admission Test (PCAT) score, and interview score) were collected to establish baseline characteristics between the two cohorts. Examination scores in the corresponding prerequisite pharmacodynamics and pharmacotherapy courses were also collected. The variable was the difference in time each cohort experienced between the prerequisite pharmacodynamics courses and the subsequent pharmacotherapy courses. Results. No difference was found in baseline admission characteristics between the two cohorts, except for increased average age, which favored the P2 cohort. In the infectious disease pharmacotherapy course, the P3 cohort performed better than the P2 cohort as measured by average examination scores. In the neoplastic disease pharmacotherapy course, the P3 cohort also achieved significant higher average examination scores than the P2 cohort. The P3 cohort achieved higher overall scores than the P2 cohort in both courses despite a longer interval between the applicable pharmacodynamic and pharmacotherapy courses (12 months vs 3 months, respectively). Conclusion. Shortening the time interval from 12 months to three months between prerequisite and requisite courses did not result in improved, or even equivalent, academic performance relative to the P2 cohort that had only a 3-month interval between courses. Placing like content closer together, as the only intervention, is not enough to ensure improved student performance measured by examination scores in corresponding requisite courses.

The Effect of Prerequisite Pharmacodynamics Course Timing on Student Performance in Pharmacotherapy Courses

PubMed Central

Sylvester, Robert K.

2016-01-01

Objective. To evaluate the impact that decreasing the time from 12 to three months between prerequisite pharmacodynamics courses and their corresponding pharmacotherapy courses had on overall student performance in the pharmacotherapy courses measured by course examination scores. Methods. Two cohorts of second-professional year (P2) and third professional year (P3) classes, respectively, following different curriculum plans, simultaneously took two pharmacotherapy courses (infectious disease and neoplastic disease). Admission data (age, gender, prior bachelor’s degree status, grade point average (GPA), Pharmacy College Admission Test (PCAT) score, and interview score) were collected to establish baseline characteristics between the two cohorts. Examination scores in the corresponding prerequisite pharmacodynamics and pharmacotherapy courses were also collected. The variable was the difference in time each cohort experienced between the prerequisite pharmacodynamics courses and the subsequent pharmacotherapy courses. Results. No difference was found in baseline admission characteristics between the two cohorts, except for increased average age, which favored the P2 cohort. In the infectious disease pharmacotherapy course, the P3 cohort performed better than the P2 cohort as measured by average examination scores. In the neoplastic disease pharmacotherapy course, the P3 cohort also achieved significant higher average examination scores than the P2 cohort. The P3 cohort achieved higher overall scores than the P2 cohort in both courses despite a longer interval between the applicable pharmacodynamic and pharmacotherapy courses (12 months vs 3 months, respectively). Conclusion. Shortening the time interval from 12 months to three months between prerequisite and requisite courses did not result in improved, or even equivalent, academic performance relative to the P2 cohort that had only a 3-month interval between courses. Placing like content closer together, as the only intervention, is not enough to ensure improved student performance measured by examination scores in corresponding requisite courses. PMID:27667836

Evaluation of an exercise concept focusing on eccentric strength training of the rotator cuff for patients with subacromial impingement syndrome.

PubMed

Bernhardsson, Susanne; Klintberg, Ingrid Hultenheim; Wendt, Gunilla Kjellby

2011-01-01

To evaluate the effect on pain intensity and function of an exercise concept focusing on specific eccentric strength training of the rotator cuff in patients with subacromial impingement syndrome. Single-subject research design with baseline and treatment phases (AB design). Home-based training programme supervised and supported by visits to physiotherapy clinic. Ten patients, mean (SD) age 54 (8.6) years, symptom duration 12 (9.1) months. Daily eccentric strengthening exercises of the rotator cuff during 12 weeks. Pain intensity, assessed with a visual analogue scale, and function, using the Patient-Specific Functional Scale. Shoulder function evaluated with the Constant score, and shoulder-related quality of life evaluated with the Western Ontario Rotator Cuff Index. Pain intensity decreased significantly in eight of the ten subjects. Function improved significantly in all ten subjects. Constant score increased in nine subjects and Western Ontario Rotator Cuff Index increased in seven subjects. Mean Constant score for the whole group increased significantly from 44 to 69 points (P = 0.008). Mean Western Ontario Rotator Cuff Index increased from 51 to 71% (P = 0.021). A 12-week eccentric strengthening programme targeting the rotator cuff and incorporating scapular control and correct movement pattern can be effective in decreasing pain and increasing function in patients with subacromial impingement syndrome. A randomized controlled trial is necessary to provide stronger evidence of the method.

Changes in animal performance and profitability of Holstein dairy operations after introduction of crossbreeding with Montbéliarde, Normande, and Scandinavian Red.

PubMed

Dezetter, C; Bareille, N; Billon, D; Côrtes, C; Lechartier, C; Seegers, H

2017-10-01

An individual-based mechanistic, stochastic, and dynamic simulation model was developed to assess economic effects resulting from changes in performance for milk yield and solid contents, reproduction, health, and replacement, induced by the introduction of crossbreeding in Holstein dairy operations. Three crossbreeding schemes, Holstein × Montbéliarde, Holstein × Montbéliarde × Normande, and Holstein × Montbéliarde × Scandinavian Red, were implemented in Holstein dairy operations and compared with Holstein pure breeding. Sires were selected based on their estimated breeding value for milk. Two initial operations were simulated according to the prevalence (average or high) of reproductive and health disorders in the lactating herd. Evolution of operations was simulated during 15 yr under 2 alternative managerial goals (constant number of cows or constant volume of milk sold). After 15 yr, breed percentages reached equilibrium for the 2-breed but not for the 3-breed schemes. After 5 yr of simulation, all 3 crossbreeding schemes reduced average milk yield per cow-year compared with the pure Holstein scheme. Changes in other animal performance (milk solid contents, reproduction, udder health, and longevity) were always in favor of crossbreeding schemes. Under an objective of constant number of cows, margin over variable costs in average discounted value over the 15 yr of simulation was slightly increased by crossbreeding schemes, with an average prevalence of disorders up to €32/cow-year. In operations with a high prevalence of disorders, crossbreeding schemes increased the margin over variable costs up to €91/cow-year. Under an objective of constant volume of milk sold, crossbreeding schemes improved margin over variable costs up to €10/1,000L (corresponding to around €96/cow-year) for average prevalence of disorders, and up to €13/1,000L (corresponding to around €117/cow-year) for high prevalence of disorders. Under an objective of constant number of cows, an unfavorable pricing context (milk price vs. concentrates price) increased slightly crossbreeding positive effects on margin over variable costs. Under an objective of constant volume of milk, only very limited changes in differences of margins were found between the breeding schemes. Our results, obtained conditionally to the parameterization values used here, suggest that dairy crossbreeding should be considered as a relevant option for Holstein dairy operations with a production level until 9,000 kg/cow-year in France, and possibly in other countries. Copyright © 2017 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Thalamic DBS with a constant-current device in essential tremor: A controlled clinical trial.

PubMed

Wharen, Robert E; Okun, Michael S; Guthrie, Barton L; Uitti, Ryan J; Larson, Paul; Foote, Kelly; Walker, Harrison; Marshall, Frederick J; Schwalb, Jason; Ford, Blair; Jankovic, Joseph; Simpson, Richard; Dashtipour, Khashayar; Phibbs, Fenna; Neimat, Joseph S; Stewart, R Malcolm; Peichel, DeLea; Pahwa, Rajesh; Ostrem, Jill L

2017-07-01

This study of thalamic deep brain stimulation (DBS) investigated whether a novel constant-current device improves tremor and activities of daily living (ADL) in patients with essential tremor (ET). A prospective, controlled, multicenter study was conducted at 12 academic centers. We investigated the safety and efficacy of unilateral and bilateral constant-current DBS of the ventralis intermedius (VIM) nucleus of the thalamus in patients with essential tremor whose tremor was inadequately controlled by medications. The primary outcome measure was a rater-blinded assessment of the change in the target limb tremor score in the stimulation-on versus stimulation-off state six months following surgery. Multiple secondary outcomes were assessed at one-year follow-up, including motor, mood, and quality-of-life measures. 127 patients were implanted with VIM DBS. The blinded, primary outcome variable (n = 76) revealed a mean improvement of 1.25 ± 1.26 points in the target limb tremor rating scale (TRS) score in the arm contralateral to DBS (p < 0.001). Secondary outcome variables at one year revealed significant improvements (p ≤ 0.001) in quality of life, depression symptoms, and ADL scores. Forty-seven patients had a second contralateral VIM-DBS, and this group demonstrated reduction in second-sided tremor at 180 days (p < 0.001). Serious adverse events related to the surgery included infection (n = 3), intracranial hemorrhage (n = 3), and device explantation (n = 3). Unilateral and bilateral constant-current VIM DBS significantly improves upper extremity tremor, ADL, quality of life, and depression in patients with severe ET. Copyright © 2017 Elsevier Ltd. All rights reserved.

An Empirical Investigation of Change in MCAT Scores upon Retest.

ERIC Educational Resources Information Center

Hynes, Kevin; Givner, Nathaniel

1980-01-01

An investigation of Medical College Admission Test (MCAT) retest scores indicates that limited retest improvement may result when initial scores are fairly low or below what might be predicted based on grade point averages. However, when initial scores approach the national, standardized MCAT mean, or are above what might be predicted, significant…

Overestimation Bias in Self-Reported SAT Scores

ERIC Educational Resources Information Center

Mayer, Richard E.; Stull, Andrew T.; Campbell, Julie; Almeroth, Kevin; Bimber, Bruce; Chun, Dorothy; Knight, Allan

2007-01-01

The authors analyzed self-reported SAT scores and actual SAT scores for five different samples of college students (N = 650). Students overestimated their actual SAT scores by an average of 25 points (SD = 81, d = 0.31), with 10% under-reporting, 51% reporting accurately, and 39% over-reporting, indicating a systematic bias towards over-reporting.…

Equivalent Electromagnetic Constants for Microwave Application to Composite Materials for the Multi-Scale Problem

PubMed Central

Fujisaki, Keisuke; Ikeda, Tomoyuki

2013-01-01

To connect different scale models in the multi-scale problem of microwave use, equivalent material constants were researched numerically by a three-dimensional electromagnetic field, taking into account eddy current and displacement current. A volume averaged method and a standing wave method were used to introduce the equivalent material constants; water particles and aluminum particles are used as composite materials. Consumed electrical power is used for the evaluation. Water particles have the same equivalent material constants for both methods; the same electrical power is obtained for both the precise model (micro-model) and the homogeneous model (macro-model). However, aluminum particles have dissimilar equivalent material constants for both methods; different electric power is obtained for both models. The varying electromagnetic phenomena are derived from the expression of eddy current. For small electrical conductivity such as water, the macro-current which flows in the macro-model and the micro-current which flows in the micro-model express the same electromagnetic phenomena. However, for large electrical conductivity such as aluminum, the macro-current and micro-current express different electromagnetic phenomena. The eddy current which is observed in the micro-model is not expressed by the macro-model. Therefore, the equivalent material constant derived from the volume averaged method and the standing wave method is applicable to water with a small electrical conductivity, although not applicable to aluminum with a large electrical conductivity. PMID:28788395

Characteristics of Minority Students Who Excel on the SAT and in the Classroom. Policy Information Report

ERIC Educational Resources Information Center

Bridgeman, Brent; Wendler, Cathy

2004-01-01

After a few decades of keeping a watchful eye, substantial gaps in the average standardized test scores of White and some minority group students persist. The average group differences on the SAT are among the most visible examples of this pattern, but when we focus only on mean score differences among students, we tend to overlook the relatively…

Relative importance of first and second derivatives of nuclear magnetic resonance chemical shifts and spin-spin coupling constants for vibrational averaging.

PubMed

Dracínský, Martin; Kaminský, Jakub; Bour, Petr

2009-03-07

Relative importance of anharmonic corrections to molecular vibrational energies, nuclear magnetic resonance (NMR) chemical shifts, and J-coupling constants was assessed for a model set of methane derivatives, differently charged alanine forms, and sugar models. Molecular quartic force fields and NMR parameter derivatives were obtained quantum mechanically by a numerical differentiation. In most cases the harmonic vibrational function combined with the property second derivatives provided the largest correction of the equilibrium values, while anharmonic corrections (third and fourth energy derivatives) were found less important. The most computationally expensive off-diagonal quartic energy derivatives involving four different coordinates provided a negligible contribution. The vibrational corrections of NMR shifts were small and yielded a convincing improvement only for very accurate wave function calculations. For the indirect spin-spin coupling constants the averaging significantly improved already the equilibrium values obtained at the density functional theory level. Both first and complete second shielding derivatives were found important for the shift corrections, while for the J-coupling constants the vibrational parts were dominated by the diagonal second derivatives. The vibrational corrections were also applied to some isotopic effects, where the corrected values reasonably well reproduced the experiment, but only if a full second-order expansion of the NMR parameters was included. Contributions of individual vibrational modes for the averaging are discussed. Similar behavior was found for the methane derivatives, and for the larger and polar molecules. The vibrational averaging thus facilitates interpretation of previous experimental results and suggests that it can make future molecular structural studies more reliable. Because of the lengthy numerical differentiation required to compute the NMR parameter derivatives their analytical implementation in future quantum chemistry packages is desirable.

[Clinical research of arthroscopic separate double-layer suture bridge technique for delaminated rotator cuff tear].

PubMed

Ren, Jiangtao; Xu, Cong; Liu, Xianglin; Wang, Jiansong; Li, Zhihuai; Lü, Yongming

2017-10-01

To explore the effectiveness of the arthroscopic separate double-layer suture bridge technique in treatment of the delaminated rotator cuff tear. Between May 2013 and May 2015, 54 patients with the delaminated rotator cuff tears were recruited in the study. They were randomly allocated into 2 groups to receive repair either using arthroscopic separate double-layer suture bridge technique (trial group, n =28) or using arthroscopic whole-layer suture bridge technique (control group, n =26). There was no significant difference in gender, age, injured side, tear type, and preoperative visual analogue scale (VAS) score, Constants score, American Shoulder and Elbow Surgeons (ASES) score, University of California Los Angeles (UCLA) score, and the range of motion of shoulder joint between 2 groups ( P >0.05). Postoperative functional scores, range of motion, and recurrence rate of tear in 2 groups were observed and compared. The operation time was significant longer in trial group than in control group ( t =8.383, P =0.000). All incisions healed at stage Ⅰ without postoperative complication. All the patients were followed up 12 months. At 12 months postoperatively, the UCLA score, ASES score, VAS score, Constant score, and the range of motion were significantly improved when compared with the preoperative values in 2 groups ( P <0.05). However there was no significant difference in above indexes between 2 groups ( P >0.05). Four cases (14.3%) of rotator cuff tear recurred in trial group while 5 cases (19.2%) in control group, showing no significant difference ( χ 2 =0.237, P =0.626). Compared with the arthroscopic whole-layer suture bridge technique, arthroscopic separate double-layer suture bridge technique presents no significant difference in the shoulder function score, the range of motion, and recurrence of rotator cuff tear, while having a longer operation time.

Opening-wedge high tibial osteotomy with a locked low-profile plate: surgical technique.

PubMed

Kolb, Werner; Guhlmann, Hanno; Windisch, Christoph; Koller, Heiko; Grützner, Paul; Kolb, Klaus

2010-09-01

High tibial osteotomy has been recognized as a beneficial treatment for osteoarthritis of the medial compartment of the knee. The purpose of this prospective study was to assess the short-term results of opening-wedge high tibial osteotomies with locked plate fixation. From September 2002 to November 2005, fifty-one consecutive medial opening-wedge high tibial osteotomies were performed. The mean age of the patients at the time of the index operation was forty-nine years. The preoperative and postoperative factors analyzed included the grade of arthritis of the tibiofemoral compartment (the Ahlbäck radiographic grade), the anatomic tibiofemoral angle, patellar height, the Hospital for Special Surgery rating system score, and the Lysholm and Gillquist knee score. Postoperatively, one superficial wound infection occurred. Fifty of the fifty-one osteotomies healed after an average period of 12.9 weeks (range, eight to sixteen weeks) without bone grafts. A nonunion developed in a sixty-two-year-old patient who was a cigarette smoker. The average postoperative tibiofemoral angle was 9° of valgus. Forty-nine patients were followed for a mean of fifty-two months. The average score on the Hospital for Special Surgery rating system was 86 points at the time of the most recent follow-up. The rating was excellent in twenty-eight patients (57%), good in twelve (24%), fair in four (8%), and poor in five (10%). The average score on the Lysholm and Gillquist knee-scoring scale was 83 points. According to these scores, the outcome was excellent in nine patients (18%), good in thirty-one (63%), fair in three (6%), and poor in six (12%). Four knees failed after an average of thirty-six months. Our results suggest that an opening-wedge high tibial osteotomy with locked plate fixation allows a correct valgus angle to be achieved with good short-term results.

Association Between Low IQ Scores and Early Mortality in Men and Women: Evidence From a Population-Based Cohort Study.

PubMed

Maenner, Matthew J; Greenberg, Jan S; Mailick, Marsha R

2015-05-01

Lower (versus higher) IQ scores have been shown to increase the risk of early mortality, however, the underlying mechanisms are poorly understood and previous studies underrepresent individuals with intellectual disability (ID) and women. This study followed one third of all senior-year students (approximately aged 17) attending public high school in Wisconsin, U.S. in 1957 (n  =  10,317) until 2011. Men and women with the lowest IQ test scores (i.e., IQ scores ≤ 85) had increased rates of mortality compared to people with the highest IQ test scores, particularly for cardiovascular disease. Importantly, when educational attainment was held constant, people with lower IQ test scores did not have higher mortality by age 70 than people with higher IQ test scores. Individuals with lower IQ test scores likely experience multiple disadvantages throughout life that contribute to increased risk of early mortality.

VO2 kinetics in supra-anaerobic threshold constant tests allow the visualization and quantification of the O2 saving after cytochrome c oxidase inhibition by aerobic training or nitrate administration.

PubMed

Maione, D; Cicero, A Fg; Bacchelli, S; Cosentino, E; Degli Esposti, D; Senaldi, R; Strocchi, E; D'Addato, S; Borghi, C

2013-01-01

We tested whether the known cytochrome c oxidase (COX) inhibition by nitric oxide (NO) could be quantified by VO(2) kinetics during constant load supra-Anaerobic Threshold (AT) exercises in healthy trained or untrained subjects following aerobic training or nitrate administration. In cycle ergometer constant load exercises supra-AT, identified in previous incremental tests, VO(2) kinetics describe a double exponential curve, one rapid and one appreciably slower, allowing the area between them to be calculate in O(2) l. After training, with increased NO availability, this area decreases in inverse ratio to treatment efficacy. In fact, in 11 healthy subjects after aerobic training for 6-7 weeks, area was decreased on average by 51 %. In 11 untrained subjects, following the assumption of an NO donor, 20 mg isosorbide 5 mononitrate, area was decreased on average by 53 %. In conclusion, supra-AT VO(2) kinetics in constant load exercises permit the quantification of the inhibitory effect NO-dependent on COX after either physical training or nitrate assumption.

Pre-admission factors and utilization of tutoring services in health professions educational programs.

PubMed

Olivares-Urueta, Mayra; Williamson, Jon W

2013-01-01

Pre-admission factors tend to serve as indicators of student success in health professions educational programs, but less is known about the effects that academic assistance programs have on student success. This study sought to determine whether specific pre-admission factors could help to identify students who may require academic support during their health professions education. This retrospective analysis aimed to identify differences in pre-admission variables between those students requiring tutoring and a matched sample of students who did not require tutoring. One-way ANOVA was used to assess differences for dependent variables-age, cumulative GPA (cGPA), science GPA (sGPA), verbal graduate record examination (GRE) score, quantitative GRE score, analytical GRE score and combined GRE score, community college hours, average credit hours per semester, and highest semester credit hour load-across three groups of students who received no tutoring (NT 0 hrs), some tutoring (ST <8 hrs), and more tutoring (MT >8 hrs). Total GRE and average semester hours differentiated NT from ST from MT (p<0.05). A linear regression model with these pre-admission factors found only four of the independent variables to be significant (r2=0.41; p<0.05) in predicting hours of tutoring: quantitative GRE, sGPA, cGPA and average semester hours taken. The combination of lower GRE scores and lighter average semester course load were most predictive of the need for academic assistance as defined by hours of tutoring. While the value of the GRE in admissions processes is generally accepted, the average semester hour load in college can also provide important information regarding academic preparation and the need for tutoring services.

Outcomes of Thermal Pulsation Treatment for Dry Eye Syndrome in Patients With Sjogren Disease.

PubMed

Godin, Morgan R; Stinnett, Sandra S; Gupta, Preeya K

2018-04-26

To evaluate the clinical outcomes of thermal pulsation treatment in patients with meibomian gland dysfunction (MGD) and dry eye secondary to Sjogren disease. Twenty-four eyes from 13 patients with previously diagnosed Sjogren disease who presented to our institution with dry eye symptoms and had thermal pulsation treatment were prospectively followed up. Patients underwent comprehensive slit-lamp examination, including MGD grading, gland oil flow, corneal and conjunctival staining scores, and tear break-up time (TBUT). Tear osmolarity was tested before and after treatment. The average patient age was 62.4 years (range, 31-78 yrs); 12 were women and 1 a man. The average meibomian gland oil flow score showed an increase from pretreatment 0.71 to 1.75 at 1 year posttreatment (range 9-15 months) (P = 0.001). The average corneal staining score decreased from a pretreatment grade of 1.04 to a posttreatment grade of 0.36 (P < 0.001). The average conjunctival staining score decreased from a pretreatment grade of 1.5 to a posttreatment grade of 0.48 (P < 0.001). The average tear break-up time improved from 3.8 seconds before treatment to 7.5 seconds after thermal pulsation treatment (P < 0.001). There was no statistically significant change in the tear osmolarity or Ocular Surface Disease Index score. Our findings suggest that MGD is an important contributor to dry eye disease in patients with Sjogren disease and should not be overlooked when considering treatment options. Thermal pulsation is a therapeutic option for patients with Sjogren disease who have MGD and dry eye symptoms. After a single treatment, patients exhibited increased oil flow and tear break-up time with an associated decrease in corneal and conjunctival staining.

Impaired reading comprehension and mathematical abilities in male adolescents with average or above general intellectual abilities are associated with comorbid and future psychopathology.

PubMed

Weiser, Mark; Reichenberg, Abraham; Rabinowitz, Jonathan; Nahon, Daniella; Kravitz, Efrat; Lubin, Gad; Knobler, Haim Y; Davidson, Michael; Noy, Shlomo

2007-11-01

Research indicates that persons with learning disorders often suffer from psychopathology. We assessed current and future psychopathology in male adolescents with discrete impairments in reading comprehension (IRC) or arithmetic abilities (IAA) but with average or above-average general intellectual abilities. Subjects were a population-based cohort of 174,994 male adolescents screened by the Israeli Draft Board with average or above-average intellectual abilities but with low scores (8.6th and 10th lowest percentile respectively) on reading or arithmetic tests. They were compared with adolescents who scored in the 10th percentile and above on these tests (comparison group). Relative to the comparison group, male adolescents with IRC, IAA, or IRC and IAA (0.69%), had poorer scores on most behavioral assessments and higher prevalence of current psychopathology: 4.2% (comparison group), 8.0% (IRC), 7.0% (IAA), and 9.8% (IRC and IAA). Adolescents with IRC were also at increased risk for later hospitalization for schizophrenia (hazard ratios = 1.8, 95% confidence interval: 1.3-2.6). Male adolescents with average and above-average general intellectual abilities but with IRC or IAA are more likely to have current and future psychopathology. Impairments in intellectual functioning and abnormal behaviors leading to mental illnesses may share common neurobiological substrates. The results support screening male adolescents with learning disorders for psychopathology.

FAST TRACK COMMUNICATION: Evaluation of the In concentration of an InxGa1-xSb alloy layer in cross-sectional HRTEM images of III-V semiconductor superlattices

NASA Astrophysics Data System (ADS)

Quan, Maohua; Guo, Fengyun; Li, Meicheng; Zhao, Liancheng

2010-08-01

Atomic-scale positional resolved lattice spacing measurement is used to study the In concentration of the alloy layer in InAs/InxGa1-xSb superlattices by the molecular beam epitaxy techniques. The unstrained lattice distance d along three directions, [0 0 1], [1 1 0] and [1 1 1], was measured and the average lattice constant was calculated. The experimental lattice constants of InAs layers are almost equal to the theoretical ones. We have found that the average lattice constant of In0.25Ga0.75Sb alloy layers is in good agreement with previously reported Vegard's values, being slightly larger. The results indicate that the In concentration of x = 0.18 has a larger deviation compared with the designed values.

Effect of positive pulse charge waveforms on the energy efficiency of lead-acid traction cells

NASA Technical Reports Server (NTRS)

Smithrick, J. J.

1981-01-01

The effects of four different charge methods on the energy conversion efficiency of 300 ampere hour lead acid traction cells were investigated. Three of the methods were positive pulse charge waveforms; the fourth, a constant current method, was used as a baseline of comparison. The positive pulse charge waveforms were: 120 Hz full wave rectified sinusoidal; 120 Hz silicon controlled rectified; and 1 kHz square wave. The constant current charger was set at the time average pulse current of each pulse waveform, which was 150 amps. The energy efficiency does not include charger losses. The lead acid traction cells were charged to 70 percent of rated ampere hour capacity in each case. The results of charging the cells using the three different pulse charge waveforms indicate there was no significant difference in energy conversion efficiency when compared to constant current charging at the time average pulse current value.

LINEAR COUNT-RATE METER

DOEpatents

Henry, J.J.

1961-09-01

A linear count-rate meter is designed to provide a highly linear output while receiving counting rates from one cycle per second to 100,000 cycles per second. Input pulses enter a linear discriminator and then are fed to a trigger circuit which produces positive pulses of uniform width and amplitude. The trigger circuit is connected to a one-shot multivibrator. The multivibrator output pulses have a selected width. Feedback means are provided for preventing transistor saturation in the multivibrator which improves the rise and decay times of the output pulses. The multivibrator is connected to a diode-switched, constant current metering circuit. A selected constant current is switched to an averaging circuit for each pulse received, and for a time determined by the received pulse width. The average output meter current is proportional to the product of the counting rate, the constant current, and the multivibrator output pulse width.

Five Methods to Score the Teacher Observation of Classroom Adaptation Checklist and to Examine Group Differences

ERIC Educational Resources Information Center

Wang, Ze; Rohrer, David; Chuang, Chi-ching; Fujiki, Mayo; Herman, Keith; Reinke, Wendy

2015-01-01

This study compared 5 scoring methods in terms of their statistical assumptions. They were then used to score the Teacher Observation of Classroom Adaptation Checklist, a measure consisting of 3 subscales and 21 Likert-type items. The 5 methods used were (a) sum/average scores of items, (b) latent factor scores with continuous indicators, (c)…

[A study of proximal humerus fractures using close reduction and percutaneous minimally invasive fixation].

PubMed

Liu, Yin-wen; Kuang, Yong; Gu, Xin-feng; Zheng, Yu-xin; Li, Zhi-qiang; Wei, Xiao-en; Lu, Wei-da; Zhan, Hong-sheng; Shi, Yin-yu

2011-11-01

To investigate the clinical effects of close reduction and percutaneous minimally invasive fixation in the treatment of proximal humerus fractures. From April 2008 to March 2010, 28 patients with proximal humerus fracture were treated with close reduction and percutaneous minimally invasive fixation. There were 21 males and 7 females, ranging in age from 22 to 78 years,with an average of 42.6 years. The mean time from suffering injuries to the operation was 1.7 d. Nineteen cases caused by falling down, 9 cases by traffic accident. The main clinical manifestation was swelling, pain and limited mobility of shoulders. According to Neer classification, two part fractures were in 17 cases and three part fractures in 11 cases. The locking proximal humerus plate was used to minimally fixation through deltoid muscle under acromion. The operating time,volume of blood loss, the length of incision and Constant-Murley assessment were applied to evaluate the therapeutic effects. The mean operating time was 40 min, the mean blood loss was 110 ml, and the mean length of incision was about 5.6 cm. The postoperative X-ray showed excellent reduction and the plate and screws were successfully place. Twenty-eight patients were followed up for 6 to 24 months (averaged 14.2 months). The healing time ranged from 6 to 8 weeks and all incision was primarily healed. There were no cases with necrosis head humerus, 24 cases without omalgia, and 4 cases with o-malgia occasionally. All the patients can complete the daily life. The mean score of Constant-Murley assessment was 91.0 +/- 5.8, 24 cases got an excellent result, 3 good and 1 fair. Close reduction and percutaneous minimally invasive fixation, not only can reduce surgical invasive, but also guarantee the early function activities. It has the advantages of less invasive, fixed well and less damage of blood circulation.

Annealed importance sampling with constant cooling rate

NASA Astrophysics Data System (ADS)

Giovannelli, Edoardo; Cardini, Gianni; Gellini, Cristina; Pietraperzia, Giangaetano; Chelli, Riccardo

2015-02-01

Annealed importance sampling is a simulation method devised by Neal [Stat. Comput. 11, 125 (2001)] to assign weights to configurations generated by simulated annealing trajectories. In particular, the equilibrium average of a generic physical quantity can be computed by a weighted average exploiting weights and estimates of this quantity associated to the final configurations of the annealed trajectories. Here, we review annealed importance sampling from the perspective of nonequilibrium path-ensemble averages [G. E. Crooks, Phys. Rev. E 61, 2361 (2000)]. The equivalence of Neal's and Crooks' treatments highlights the generality of the method, which goes beyond the mere thermal-based protocols. Furthermore, we show that a temperature schedule based on a constant cooling rate outperforms stepwise cooling schedules and that, for a given elapsed computer time, performances of annealed importance sampling are, in general, improved by increasing the number of intermediate temperatures.

The effect of high medical expenses on household income in South Korea: a longitudinal study using propensity score matching.

PubMed

Choi, Jae Woo; Park, Eun Cheol; Yoo, Ki Bong; Lee, Sang Gyu; Jang, Sung In; Kim, Tae Hyun

2015-09-10

Almost 97% of the Korean population is covered by National Health Insurance and are entitled to receive the same level of insurance benefits, regardless of how much each enrollee contributes to the system. However, the percentage of out-of-pocket payments is still high. This study examines whether the incurrence of high medical expenses affects household income. We use the Korea Welfare Panel and select 4,962 households to measure repeatedly over 5 years. Using propensity score matching, we set households with medical expenses of three times the annual average as "occurrence households" while "non-occurrence households" are those below the cut-off but with all other factors, such as income, held constant. We analyze whether the income of occurrence households differs significantly from the comparison group using a linear mixed effect model. After the occurrence of high medical expenditure, occurrence households (n = 825) had US$ 1,737 less income than non-occurrence households. In addition, the income of households (n = 200) that incurred high medical costs repeatedly for 2 years was US$ 3,598 lower than the non-occurrence group. Although it is important for the government to focus on medical assistance for households that have medical expense burdens, it needs to consider providing income indemnity insurance to protect them.

Factors associated with clinical and structural outcomes after arthroscopic rotator cuff repair with a suture bridge technique in medium, large, and massive tears.

PubMed

Choi, Sungwook; Kim, Myung Ku; Kim, Gyeong Min; Roh, Young-Ho; Hwang, Im Kyung; Kang, Hyunseong

2014-11-01

This study was conducted to evaluate clinical outcomes, maintenance of repair integrity, and retear rate after arthroscopic rotator cuff repair by a suture bridge technique among patients with medium, large, and massive rotator cuff tears. We evaluated 147 patients who had undergone arthroscopic rotator cuff repair. Clinical and functional evaluations were performed with the Constant and University of California-Los Angeles scores. All patients were confirmed to have magnetic resonance imaging evidence of tendon healing at least 12 months postoperatively. The average postoperative time to follow-up magnetic resonance imaging was 23.4 months (range, 12-48 months). A total of 25 (17.0%) retears were observed. All clinical outcome scores were improved significantly at follow-up. Larger intraoperative tear sizes were correlated with higher retear rates. The incidence of retear was also higher in cases in which the preoperative fatty degeneration grade was higher. The incidence of retear increased with age and in the heavy worker group (e.g., farmers, carriers, car mechanics) but was not statistically significant. Arthroscopic rotator cuff repair by a suture bridge technique yields improvements in clinical outcome measures and a relatively high degree of patient satisfaction despite the fact that repair integrity is not maintained in many cases. Copyright © 2014 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Performance of a light fluorescence device for the detection of microbial plaque and gingival inflammation.

PubMed

Rechmann, Peter; Liou, Shasan W; Rechmann, Beate M T; Featherstone, John D B

2016-01-01

The hypothesis to be tested was that using the SOPROCARE system in fluorescence perio-mode allows scoring of microbial plaque that is comparable to the Turesky modification of the Quigley Hein plaque index (T-QH) and scoring of gingival inflammation comparable to the Silness and Löe gingival inflammation index (GI). Fifty-five subjects with various amounts of microbial plaque were recruited. The T-QH and GI index were recorded. SOPROCARE pictures were recorded in fluorescence perio-mode and in daylight mode. Finally, conventional digital photographs were taken. All pictures were assessed using the same criteria as described for the clinical indices. The average T-QH was 1.1 ± 1.2 (mean ± SD). Scoring with SOPROCARE perio-mode led to a slightly higher average than the T-QH scores. SOPROCARE daylight mode and digital photography showed the highest plaque scores. The average GI index was 0.7 ± 0.9. SOPROCARE in perio-mode scored slightly lower. Linear regression fits between the different clinical indices and SOPROCARE scores were significantly different from zero demonstrating high goodness of fit. The study demonstrated that the SOPROCARE fluorescence assessment tool in perio-mode allows reliable judgment of microbial plaque and gingival inflammation levels similar to the established Turesky-modified Quigley Hein index and the Silness and Löe gingival inflammation index. Training on plaque-free teeth will actually reduce scoring errors. The SOPROCARE fluorescence tool in perio-mode provides reliable evaluation of microbial plaque and gingival inflammation for the dental clinician.

A comparison of sonography and radiography student scores in a cadaver anatomy class before and after the implementation of synchronous distance education

PubMed Central

Randall, K; Anderson, MP

2015-01-01

Distance education is a solution to expand medical imaging education to students who might not otherwise be able to obtain the education. It can be a mechanism to reduce the health care worker shortage in underserved areas. In some cases, distance education may be a disruptive technology, and might lower student performance. This study compares student scores in a cadaver anatomy course in the four cohorts preceding the implementation of distance education to the first three cohorts that took the course using a multiple campus design. The means and medians of the lecture exam average, the laboratory component score, and the final course score of the nondistance education cohorts were compared with those of the distance education cohorts using nonparametric statistical analysis. Scores in an anatomy course were compared by campus placement among the distance education cohorts, and the independent effect of distance education on the laboratory component, lecture examination average, and final course scores, while controlling for cumulative grade point average and site (originating/distant), was assessed. Students receiving the course in a nondistance education environment scored higher in the anatomy course than the students who took the course in a distance education environment. Students on the distant campus scored lower than students on the originating site. Distance education technology creates new opportunities for learning, but can be a disruptive technology. Programs seeking to implement distance education into their curriculum should do so with knowledge of the advantages and disadvantages. PMID:27433237

Average vs item response theory scores: an illustration using neighbourhood measures in relation to physical activity in adults with arthritis.

PubMed

Mielenz, T J; Callahan, L F; Edwards, M C

2017-01-01

Our study had two main objectives: 1) to determine whether perceived neighbourhood physical features are associated with physical activity levels in adults with arthritis; and 2) to determine whether the conclusions are more precise when item response theory (IRT) scores are used instead of average scores for the perceived neighbourhood physical features scales. Information on health outcomes, neighbourhood characteristics, and physical activity levels were collected using a telephone survey of 937 participants with self-reported arthritis. Neighbourhood walkability and aesthetic features and physical activity levels were measured by self-report. Adjusted proportional odds models were constructed separately for each neighbourhood physical features scale. We found that among adults with arthritis, poorer perceived neighbourhood physical features (both walkability and aesthetics) are associated with decreased physical activity level compared to better perceived neighbourhood features. This association was only observed in our adjusted models when IRT scoring was employed with the neighbourhood physical feature scales (walkability scale: odds ratio [OR] 1.20, 95% confidence interval [CI] 1.02, 1.41; aesthetics scale: OR 1.32, 95% CI 1.09, 1.62), not when average scoring was used (walkability scale: OR 1.14, 95% CI 1.00, 1.30; aesthetics scale: OR 1.16, 95% CI 1.00, 1.36). In adults with arthritis, those reporting poorer walking and aesthetics features were found to have decreased physical activity levels compared to those reporting better features when IRT scores were used, but not when using average scores. This study may inform public health physical environmental interventions implemented to increase physical activity, especially since arthritis prevalence is expected to be close to 20% of the population in 2020. Based on NIH initiatives, future health research will utilize IRT scores. The differences found in this study may be a precursor for research on how past and future treatment effects may vary between these two types of measurement scores. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Undergraduate GPAs, MCAT scores, and academic performance the first 2 years in podiatric medical school at Des Moines University.

PubMed

Yoho, Robert M; Antonopoulos, Kosta; Vardaxis, Vassilios

2012-01-01

This study was performed to determine the relationship between undergraduate academic performance and total Medical College Admission Test score and academic performance in the podiatric medical program at Des Moines University. The allopathic and osteopathic medical professions have published educational research examining this relationship. To our knowledge, no such educational research has been published for podiatric medical education. The undergraduate cumulative and science grade point averages and total Medical College Admission Test scores of four podiatric medical classes (2007-2010, N = 169) were compared with their academic performance in the first 2 years of podiatric medical school using pairwise Pearson product moment correlations and multiple regression analysis. Significant low to moderate positive correlations were identified between undergraduate cumulative and science grade point averages and student academic performance in years 1 and 2 of podiatric medical school for each of the four classes (except one) and the pooled data. There was no significant correlation between Medical College Admission Test score and academic performance in years 1 and 2 (except one) and the pooled data. These results identify undergraduate cumulative grade point average as the strongest cognitive admissions variable in predicting academic performance in the podiatric medicine program at Des Moines University, followed by undergraduate science grade point average. These results also suggest limitations of the total Medical College Admission Test score in predicting academic performance. Information from this study can be used in the admissions process and to monitor student progress.

Genetic parameter estimates among scale activity score and farrowing disposition with reproductive traits in swine.

PubMed

Schneider, J F; Rempel, L A; Rohrer, G A; Brown-Brandl, T M

2011-11-01

The primary objective of this study was to determine if certain behavior traits were genetically correlated with reproduction. If 1 or both of the behavior traits were found to be correlated, a secondary objective was to determine if the behavior traits could be useful in selecting for more productive females. A scale activity score taken at 5 mo of age and a farrowing disposition score taken at farrowing were selected as the behavioral traits. Scale activity score ranged from 1 to 5 and farrowing disposition ranged from 1 to 3. Reproductive traits included age at puberty, number born alive, number born dead, litter birth weight, average piglet birth weight, number weaned, litter weaning weight, average weaning weight, wean-to-estrus interval, ovulation rate including gilts, and postweaning ovulation rate. Genetic correlations between scale activity score and reproduction ranged from -0.79 to 0.61. Three of the correlations, number born alive (P < 0.01), average piglet birth weight (P < 0.001), and wean-to-estrus interval (P = 0.014), were statistically significant but included both favorable and antagonistic correlations. In contrast, all but 1 of the farrowing disposition correlations was favorable and ranged from -0.66 to 0.67. Although only the correlation with litter birth weight was significant (P = 0.018), the consistent favorable direction of all farrowing disposition correlations, except average weaning weight, shows a potential for inclusion of farrowing disposition into a selection program.

Association of gingivitis with dental calculus thickness or dental calculus coverage and subgingival bacteria in feline leukemia virus- and feline immunodeficiency virus-negative cats.

PubMed

Thengchaisri, Naris; Steiner, Jörg M; Suchodolski, Jan S; Sattasathuchana, Panpicha

2017-01-01

Periodontal disease is the most common oral disease in cats. The objectives of this study were to determine the relationships between gingivitis and dental calculus thickness (DCT), or dental calculus coverage (DCC); determine the association of gingivitis scores and types of oral bacteria; and to evaluate bacterial co-infection in cats with periodontal disease. Twelve cats that were not infected with feline leukemia or feline immunodeficiency viruses were enrolled in the study. Gingivitis, DCT, and DCC were scored and recorded. A Kruskal-Wallis test was used to compare scores among canine, 2nd premolar, 3rd premolar, 4th premolar, and 1st molar teeth. The relationship between gingivitis and DCT or DCC scores was determined using the Spearman rank sum test (ρ). Subgingival bacteria were cultured and the association between bacterial species and gingivitis score was evaluated using a Fisher's exact test. The average gingivitis, DCT, and DCC scores for the caudal maxillary teeth were higher for the caudal mandibular teeth and more severe for the 3rd premolar, 4th premolar, and 1st molar teeth than for the canine teeth. A strong relationship between average DCT or DCC score and average gingivitis score was found (ρ = 0.96 and 1, respectively). Aerobic and anaerobic bacterial infections were identified in a large number of cats with periodontal disease (71.1% and 28.9%, respectively). In conclusion, severe gingivitis scores were associated with anaerobic bacterial infection. The caudal teeth are affected with more severe gingivitis, DCT, and DCC than the other teeth. Antibiotic prophylaxis should be prescribed in cats with periodontal disease.

Fast-food menu offerings vary in dietary quality, but are consistently poor.

PubMed

Kirkpatrick, Sharon I; Reedy, Jill; Kahle, Lisa L; Harris, Jennifer L; Ohri-Vachaspati, Punam; Krebs-Smith, Susan M

2014-04-01

To evaluate five popular fast-food chains' menus in relation to dietary guidance. Menus posted on chains' websites were coded using the Food and Nutrient Database for Dietary Studies and MyPyramid Equivalents Database to enable Healthy Eating Index-2005 (HEI-2005) scores to be assigned. Dollar or value and kids' menus and sets of items promoted as healthy or nutritious were also assessed. Five popular fast-food chains in the USA. Not applicable. Full menus scored lower than 50 out of 100 possible points on the HEI-2005. Scores for Total Fruit, Whole Grains and Sodium were particularly dismal. Compared with full menus, scores on dollar or value menus were 3 points higher on average, whereas kids' menus scored 10 points higher on average. Three chains marketed subsets of items as healthy or nutritious; these scored 17 points higher on average compared with the full menus. No menu or subset of menu items received a score higher than 72 out of 100 points. The poor quality of fast-food menus is a concern in light of increasing away-from-home eating, aggressive marketing to children and minorities, and the tendency for fast-food restaurants to be located in low-income and minority areas. The addition of fruits, vegetables and legumes; replacement of refined with whole grains; and reformulation of offerings high in sodium, solid fats and added sugars are potential strategies to improve fast-food offerings. The HEI may be a useful metric for ongoing monitoring of fast-food menus.

Daily mood ratings via text message as a proxy for clinic based depression assessment.

PubMed

Aguilera, Adrian; Schueller, Stephen M; Leykin, Yan

2015-04-01

Mobile and automated technologies are increasingly becoming integrated into mental health care and assessment. The purpose of this study was to determine how automated daily mood ratings are related to the Patient Health Questionnaire-9 (PHQ-9), a standard measure in the screening and tracking of depressive symptoms. There was a significant relationship between daily mood scores and PHQ-9 scores, and between one-week average mood scores and PHQ-9 scores, controlling for linear change in depression scores. PHQ-9 scores were not related to the average of two week mood ratings. This study also constructed models using variance, maximum, and minimum values of mood ratings in the preceding week and two-week periods as predictors of PHQ-9. None of these variables significantly predicted PHQ-9 scores when controlling for daily mood ratings and the corresponding averages for each period. This study only assessed patients who were in treatment for depression, therefore findings might not generalize to the relationship between text message mood ratings for those who are not depressed. The sample was also predominantly Spanish speaking and low-income making generalizability to other populations uncertain. Our results show that automatic text message based mood ratings can be a clinically useful proxy for the PHQ-9. Importantly, this approach avoids the limitations of the PHQ-9 administration, which include length and a higher requirement for literacy. Copyright © 2015 Elsevier B.V. All rights reserved.

Towards reporting standards for neuropsychological study results: A proposal to minimize communication errors with standardized qualitative descriptors for normalized test scores.

PubMed

Schoenberg, Mike R; Rum, Ruba S

2017-11-01

Rapid, clear and efficient communication of neuropsychological results is essential to benefit patient care. Errors in communication are a lead cause of medical errors; nevertheless, there remains a lack of consistency in how neuropsychological scores are communicated. A major limitation in the communication of neuropsychological results is the inconsistent use of qualitative descriptors for standardized test scores and the use of vague terminology. PubMed search from 1 Jan 2007 to 1 Aug 2016 to identify guidelines or consensus statements for the description and reporting of qualitative terms to communicate neuropsychological test scores was conducted. The review found the use of confusing and overlapping terms to describe various ranges of percentile standardized test scores. In response, we propose a simplified set of qualitative descriptors for normalized test scores (Q-Simple) as a means to reduce errors in communicating test results. The Q-Simple qualitative terms are: 'very superior', 'superior', 'high average', 'average', 'low average', 'borderline' and 'abnormal/impaired'. A case example illustrates the proposed Q-Simple qualitative classification system to communicate neuropsychological results for neurosurgical planning. The Q-Simple qualitative descriptor system is aimed as a means to improve and standardize communication of standardized neuropsychological test scores. Research are needed to further evaluate neuropsychological communication errors. Conveying the clinical implications of neuropsychological results in a manner that minimizes risk for communication errors is a quintessential component of evidence-based practice. Copyright © 2017 Elsevier B.V. All rights reserved.

A Tale of Two Curricula: The performance of two thousand students in introductory electromagnetism

NASA Astrophysics Data System (ADS)

Schatz, Michael; Kohlmyer, Matthew; Caballero, Marcos; Chabay, Ruth; Sherwood, Bruce; Catrambone, Richard; Marr, Marcus; Haugen, Mark; Ding, Lin

2009-03-01

Student performance in introductory calculus-based electromagnetism (E&M) courses at four large research universities was measured using the Brief Electricity and Magnetism Assessment (BEMA). Two different curricula were used at these universities: a traditional E&M curriculum and the Matter & Interactions (M&I) curriculum. At each university, post-instruction BEMA test averages were significantly higher for the M&I curriculum than for the traditional curriculum. The differences in post-test averages cannot be explained by differences in variables such as pre-instruction BEMA scores, grade point average, or SAT scores.

Relating illness complexity to reimbursement in CKD patients.

PubMed

Bessette, Russell W; Carter, Randy L

2011-01-01

Despite significant investments of federal and state dollars to transition patient medical records to an all-electronic system, a chasm still exists between health care quality and payment for it. A major reason for this gap is the difficulty in evaluating health care outcomes based on claims data. Since both payers and patients may not appreciate how illness complexity impacts treatment outcomes, it is difficult to determine fair provider compensation. Chronic kidney disease (CKD) typifies these problems and is often associated with comorbidities that impact cost, health, and work productivity. Thus, the objective of this study was to evaluate an illness complexity score (ICS) based on a linear regression of select blood values that might assist in predicting average monthly reimbursements in CKD patients. A second objective was to compare the results of this ICS prediction to results obtained by prediction of average monthly reimbursement using CKD stage. A third objective was to analyze the relationship between the change in ICS, estimated glomerular filtration rate (eGFR), and CKD stage over time to average monthly reimbursement. We calculated parsimonious values for select variables associated with CKD patients and compared the ICS to ordinal staging of renal disease. Data from 177 de-identified patients over 13 months was collected, which included 15 blood chemistry observations along with complete claims data for all medical expenses. To test for the relationship between average blood chemistry values, stages of CKD, age, and average monthly reimbursement, we modeled an association through a linear regression function of age, eGFR, and the Z-scores calculated from average monthly values of phosphorus, parathyroid hormone, glucose, hemoglobin, bicarbonate, albumin, creatinine, blood urea nitrogen, potassium, calcium, sodium, alkaline phosphatase, alanine aminotransferase, and white blood cells. The results of our study demonstrated that the association between average ICS values throughout the entire study period predicted average monthly reimbursements with an R(2) value of 0.41. Comparing that value to the association between the average CKD stage and average monthly reimbursement demonstrated an R(2) value of 0.08. Thus, ICS offers five times greater sensitivity over CKD staging as a measure of illness complexity. Sorting the patient population by changes in CKD stage or ICS over the entire study period revealed significant differences between the two scoring methods. Groups scored by ICS demonstrated greater sensitivity by capturing dysfunction in other organ systems and had a better association with reimbursement than groups scored by CKD staging.

The effect of short-term workshop on improving clinical reasoning skill of medical students

PubMed Central

Yousefichaijan, Parsa; Jafari, Farshad; Kahbazi, Manijeh; Rafiei, Mohammad; Pakniyat, AbdolGhader

2016-01-01

Background: Clinical reasoning process leads clinician to get purposeful steps from signs and symptoms toward diagnosis and treatment. This research intends to investigate the effect of teaching clinical reasoning on problem-solving skills of medical students. Methods: This research is a semi-experimental study. Nineteen Medical student of the pediatric ward as case group participated in a two-day workshop for training clinical reasoning. Before the workshop, they filled out Diagnostic Thinking Inventory (DTI) questionnaires. Fifteen days after the workshop the DTI questionnaire completed and "key feature" (KF) test and "clinical reasoning problem" (CRP) test was held. 23 Medical student as the control group, without passing the clinical reasoning workshop DTI questionnaire completed, and KF test and CRP test was held. Results: The average score of the DTI questionnaire in the control group was 162.04 and in the case group before the workshop was 153.26 and after the workshop was 181.68. Compare the average score of the DTI questionnaire before and after the workshop there is a significant difference. The difference between average KF test scores in the control and the case group was not significant but between average CRP test scores was significant. Conclusion: Clinical reasoning workshop is effectiveness in promoting problem-solving skills of students. PMID:27579286

Assessment for apraxia in mild cognitive impairment and Alzheimer's dise

PubMed Central

Ward, Mirela; Cecato, Juliana F.; Aprahamian, Ivan; Martinelli, José Eduardo

2015-01-01

Objective To evaluate apraxia in healthy elderly and in patients diagnosed with Alzheimer's disease (AD) and Mild cognitive impairment (MCI). Methods We evaluated 136 subjects with an average age of 75.74 years (minimum 60 years old, maximum 92 years old) and average schooling of 9 years (minimum of 7 and a maximum of 12 years), using the Mini-Mental State examination (MMSE), Cambridge Cognitive Examination (CAMCOG) and the Clock Drawing Test. For the analysis of the presence of apraxia, eight subitems from the CAMCOG were selected: the drawings of the pentagon, spiral, house, clock; and the tasks of putting a piece of paper in an envelope; the correct one hand waiving "Goodbye" movements; paper cutting using scissors; and brushing teeth. Results Elder controls had an average score of 11.51, compared to MCI (11.13), and AD patients, whose average apraxia test scores were the lowest (10.23). Apraxia scores proved able to differentiate the three groups studied (p=0.001). In addition, a negative correlation was observed between apraxia and MMSE scores. Conclusion We conclude that testing for the presence of apraxia is important in the evaluation of patients with cognitive impairments and may help to differentiate elderly controls, MCI and AD. PMID:29213944

The effect of short-term workshop on improving clinical reasoning skill of medical students.

PubMed

Yousefichaijan, Parsa; Jafari, Farshad; Kahbazi, Manijeh; Rafiei, Mohammad; Pakniyat, AbdolGhader

2016-01-01

Clinical reasoning process leads clinician to get purposeful steps from signs and symptoms toward diagnosis and treatment. This research intends to investigate the effect of teaching clinical reasoning on problem-solving skills of medical students. This research is a semi-experimental study. Nineteen Medical student of the pediatric ward as case group participated in a two-day workshop for training clinical reasoning. Before the workshop, they filled out Diagnostic Thinking Inventory (DTI) questionnaires. Fifteen days after the workshop the DTI questionnaire completed and "key feature" (KF) test and "clinical reasoning problem" (CRP) test was held. 23 Medical student as the control group, without passing the clinical reasoning workshop DTI questionnaire completed, and KF test and CRP test was held. The average score of the DTI questionnaire in the control group was 162.04 and in the case group before the workshop was 153.26 and after the workshop was 181.68. Compare the average score of the DTI questionnaire before and after the workshop there is a significant difference. The difference between average KF test scores in the control and the case group was not significant but between average CRP test scores was significant. Clinical reasoning workshop is effectiveness in promoting problem-solving skills of students.

Early results for treatment of two- and three-part fractures of the proximal humerus using Contours PHP (proximal humeral plate).

PubMed

Biazzo, Alessio; Cardile, Carlo; Brunelli, Luca; Ragni, Paolo; Clementi, Daniele

2017-04-28

The management of displaced 2- and 3-part fractures of the proximal humerus is controversial, both in younger and in elderly patients. The purpose of this paper is to evaluate the functional results of the Contours Proximal Humerus Plate (OrthofixR, Bussolengo,Verona, Italy), for the treatment of displaced 2- and 3-part fractures of the proximal humerus. We retrospectively reviewed 55 patients with proximal humerus fractures, who underwent osteosynthesis with Contours Proximal Humerus Plate from December 2011 to March 2015. We had 21 patients with 2-part fractures and with an average age of 67.1 years and 34 patients with 3-part fractures, with average age of 63.6 years. The average union time was 3 months. The mean Constant score was 67 for 2-part fracture group and 64.9 for 3-part fracture group. The difference was not statistically significant (p = 0.18). The overall complication rate was 14.5 %. Six patients underwent additional surgery (10.9%). The most frequent major complication was secondary loss of reduction following varus collapse of the fracture (2 cases). In these patients, there was loss of medial hinge integrity due to impaction and osteoporosis. The placement of the main locking screw in the calcar area to provide inferomedial support is the rational of the Contours Proximal Humerus Plate. Osteosynthesis with Contours Proximal Humerus Plate is a safe system for treating displaced 2- and 3-part fractures of the proximal humerus, with good functional results and complication rates comparable to those reported in the literature.

On determining dose rate constants spectroscopically.

PubMed

Rodriguez, M; Rogers, D W O

2013-01-01

To investigate several aspects of the Chen and Nath spectroscopic method of determining the dose rate constants of (125)I and (103)Pd seeds [Z. Chen and R. Nath, Phys. Med. Biol. 55, 6089-6104 (2010)] including the accuracy of using a line or dual-point source approximation as done in their method, and the accuracy of ignoring the effects of the scattered photons in the spectra. Additionally, the authors investigate the accuracy of the literature's many different spectra for bare, i.e., unencapsulated (125)I and (103)Pd sources. Spectra generated by 14 (125)I and 6 (103)Pd seeds were calculated in vacuo at 10 cm from the source in a 2.7 × 2.7 × 0.05 cm(3) voxel using the EGSnrc BrachyDose Monte Carlo code. Calculated spectra used the initial photon spectra recommended by AAPM's TG-43U1 and NCRP (National Council of Radiation Protection and Measurements) Report 58 for the (125)I seeds, or TG-43U1 and NNDC(2000) (National Nuclear Data Center, 2000) for (103)Pd seeds. The emitted spectra were treated as coming from a line or dual-point source in a Monte Carlo simulation to calculate the dose rate constant. The TG-43U1 definition of the dose rate constant was used. These calculations were performed using the full spectrum including scattered photons or using only the main peaks in the spectrum as done experimentally. Statistical uncertainties on the air kerma/history and the dose rate/history were ≤0.2%. The dose rate constants were also calculated using Monte Carlo simulations of the full seed model. The ratio of the intensity of the 31 keV line relative to that of the main peak in (125)I spectra is, on average, 6.8% higher when calculated with the NCRP Report 58 initial spectrum vs that calculated with TG-43U1 initial spectrum. The (103)Pd spectra exhibit an average 6.2% decrease in the 22.9 keV line relative to the main peak when calculated with the TG-43U1 rather than the NNDC(2000) initial spectrum. The measured values from three different investigations are in much better agreement with the calculations using the NCRP Report 58 and NNDC(2000) initial spectra with average discrepancies of 0.9% and 1.7% for the (125)I and (103)Pd seeds, respectively. However, there are no differences in the calculated TG-43U1 brachytherapy parameters using either initial spectrum in both cases. Similarly, there were no differences outside the statistical uncertainties of 0.1% or 0.2%, in the average energy, air kerma/history, dose rate/history, and dose rate constant when calculated using either the full photon spectrum or the main-peaks-only spectrum. Our calculated dose rate constants based on using the calculated on-axis spectrum and a line or dual-point source model are in excellent agreement (0.5% on average) with the values of Chen and Nath, verifying the accuracy of their more approximate method of going from the spectrum to the dose rate constant. However, the dose rate constants based on full seed models differ by between +4.6% and -1.5% from those based on the line or dual-point source approximations. These results suggest that the main value of spectroscopic measurements is to verify full Monte Carlo models of the seeds by comparison to the calculated spectra.

Outcomes and radiographic findings of anatomic press-fit radial head arthroplasty.

PubMed

Levy, Jonathan C; Formaini, Nathan T; Kurowicki, Jennifer

2016-05-01

Radial head arthroplasty (RHA) is a popular method of treatment for complex fractures of the radial head. The purpose of this study was to investigate patient outcomes and radiographic findings associated with a single anatomic monopolar press-fit radial head system commonly used for the treatment of radial head fractures. A retrospective review of prospectively collected data was performed for a consecutive series of patients treated with a press-fit anatomically designed RHA between November 2007 and April 2014. The most recent radiographs were evaluated for loosening, stress shielding, and instability. Postoperative motion and outcomes were reported at most recent follow-up. At an average follow-up of 30 months, 6 of the 15 patients (40%) demonstrated radiographic loosening. Six of the 9 patients (67%) without loosening demonstrated stress shielding (average, 6 mm). Functional outcome scores included a mean American Shoulder and Elbow Surgeons score of 70, Mayo Elbow Performance Score of 85, visual analog scale score for pain of 2, visual analog scale score for function of 7, and Single Assessment Numeric Evaluation score of 75. Average flexion-extension arc was 14° to 138°, and average pronation-supination was 75° to 74°. All 6 of the patients with radiographic loosening had undergone RHA with an associated ligamentous injury repair. Satisfaction among patients was high as no patient reported an unsatisfactory outcome. The use of an anatomic, press-fit monopolar RHA in the management of acute complex radial head fractures has yielded excellent clinical outcomes despite high rates of radiographic loosening and stress shielding. Press-fit RHA in the setting of ligamentous injury warrants further investigation because of a high rate of implant loosening observed. Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

A study of the impact of collaborative learning on student learning of major concepts in a microbiology laboratory exercise

NASA Astrophysics Data System (ADS)

Baumgarten, Kristyne A.

This study investigated the possible relationship between collaborative learning strategies and the learning of core concepts. This study examined the differences between two groups of nursing students enrolled in an introductory microbiology laboratory course. The control group consisted of students enrolled in sections taught in the traditional method. The experimental group consisted of those students enrolled in the sections using collaborative learning strategies. The groups were assessed on their degrees of learning core concepts using a pre-test/post-test method. Scores from the groups' laboratory reports were also analyzed. There was no difference in the two group's pre-test scores. The post-test scores of the experimental group averaged 11 points higher than the scores of the control group. The lab report scores of the experimental group averaged 15 points higher than those scores of the control group. The data generated from this study demonstrated that collaborative learning strategies can be used to increase students learning of core concepts in microbiology labs.

Sequential Neighborhood Effects: The Effect of Long-Term Exposure to Concentrated Disadvantage on Children's Reading and Math Test Scores.

PubMed

Hicks, Andrew L; Handcock, Mark S; Sastry, Narayan; Pebley, Anne R

2018-02-01

Prior research has suggested that children living in a disadvantaged neighborhood have lower achievement test scores, but these studies typically have not estimated causal effects that account for neighborhood choice. Recent studies used propensity score methods to account for the endogeneity of neighborhood exposures, comparing disadvantaged and nondisadvantaged neighborhoods. We develop an alternative propensity function approach in which cumulative neighborhood effects are modeled as a continuous treatment variable. This approach offers several advantages. We use our approach to examine the cumulative effects of neighborhood disadvantage on reading and math test scores in Los Angeles. Our substantive results indicate that recency of exposure to disadvantaged neighborhoods may be more important than average exposure for children's test scores. We conclude that studies of child development should consider both average cumulative neighborhood exposure and the timing of this exposure.

Sequential Neighborhood Effects: The Effect of Long-Term Exposure to Concentrated Disadvantage on Children's Reading and Math Test Scores

PubMed Central

Hicks, Andrew L.; Handcock, Mark S.; Sastry, Narayan

2018-01-01

Prior research has suggested that children living in a disadvantaged neighborhood have lower achievement test scores, but these studies typically have not estimated causal effects that account for neighborhood choice. Recent studies used propensity score methods to account for the endogeneity of neighborhood exposures, comparing disadvantaged and nondisadvantaged neighborhoods. We develop an alternative propensity function approach in which cumulative neighborhood effects are modeled as a continuous treatment variable. This approach offers several advantages. We use our approach to examine the cumulative effects of neighborhood disadvantage on reading and math test scores in Los Angeles. Our substantive results indicate that recency of exposure to disadvantaged neighborhoods may be more important than average exposure for children's test scores. We conclude that studies of child development should consider both average cumulative neighborhood exposure and the timing of this exposure. PMID:29192386

47 CFR 15.403 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... power control level. Power must be summed across all antennas and antenna elements. The average must not... symbols, during which the average symbol envelope power is constant. (q) RLAN. Radio Local Area Network. (r) Transmit Power Control (TPC). A feature that enables a U-NII device to dynamically switch between...

Exploring relationships between hospital patient safety culture and Consumer Reports safety scores.

PubMed

Smith, Scott Alan; Yount, Naomi; Sorra, Joann

2017-02-16

A number of private and public companies calculate and publish proprietary hospital patient safety scores based on publicly available quality measures initially reported by the U.S. federal government. This study examines whether patient safety culture perceptions of U.S. hospital staff in a large national survey are related to publicly reported patient safety ratings of hospitals. The Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture (Hospital SOPS) assesses provider and staff perceptions of hospital patient safety culture. Consumer Reports (CR), a U.S. based non-profit organization, calculates and shares with its subscribers a Hospital Safety Score calculated annually from patient experience survey data and outcomes data gathered from federal databases. Linking data collected during similar time periods, we analyzed relationships between staff perceptions of patient safety culture composites and the CR Hospital Safety Score and its five components using multiple multivariate linear regressions. We analyzed data from 164 hospitals, with patient safety culture survey responses from 140,316 providers and staff, with an average of 856 completed surveys per hospital and an average response rate per hospital of 56%. Higher overall Hospital SOPS composite average scores were significantly associated with higher overall CR Hospital Safety Scores (β = 0.24, p < 0.05). For 10 of the 12 Hospital SOPS composites, higher patient safety culture scores were associated with higher CR patient experience scores on communication about medications and discharge. This study found a relationship between hospital staff perceptions of patient safety culture and the Consumer Reports Hospital Safety Score, which is a composite of patient experience and outcomes data from federal databases. As hospital managers allocate resources to improve patient safety culture within their organizations, their efforts may also indirectly improve consumer-focused, publicly reported hospital rating scores like the Consumer Reports Hospital Safety Score.

A Study of Soft Neurological Signs and Its Correlates in Drug-Naive Patients with First Episode Psychosis

PubMed Central

Gunasekaran, Vanishree; Venkatesh, V. Mathan Kumar; Asokan, T. V.

2016-01-01

Background: Soft neurological signs are minor, non localizing, objective abnormalities, thought to reflect damage in cortical and sub-cortical connections or connections within different cortical regions. Regional structural grey matter anomalies have already been observed and correlated with the presence of cognitive deficits and presence of soft neurological signs in schizophrenic patients. Materials and Methods: Drug naive patients presenting with first episode of psychosis (FEP)were clinically evaluated for soft neurological signs using the Cambridge Neurological Inventory. The soft neurological signs scores were compared with scores in healthy volunteers. In the patient group, this score was also correlated with demographic and disorder variables. Results: Of the 30 patients with FEP, 60% were women. The average age of the participant was 36.2 years. The average duration of illness was 1.55 years. More than 50% of the patients had schizophrenia. 93.3% of patients with FEP had atleast one soft neurological sign compared to 16.6% of controls. The average score on BPRS was 25.86 and on PANSS was 39.29, and BPRS, PANSS scores had a significant correlation with total soft neurological signs score. Conclusion: There is a significantly higher incidence of soft neurological signs in patients with FEP, particularly schizophrenia. The presence of soft signs correlated with the severity of psychosis. PMID:27833222

Measurement of Nonverbal IQ in Autism Spectrum Disorder: Scores in Young Adulthood Compared to Early Childhood

ERIC Educational Resources Information Center

Bishop, Somer L.; Farmer, Cristan; Thurm, Audrey

2015-01-01

Nonverbal IQ (NVIQ) was examined in 84 individuals with autism spectrum disorder (ASD) followed from age 2 to 19. Most adults who scored in the range of intellectual disability also received scores below 70 as children, and the majority of adults with scores in the average range had scored in this range by age 3. However, within the lower ranges…

Pig carcass tail lesions: the influence of record keeping through an advisory service and the relationship with farm performance parameters.

PubMed

van Staaveren, N; Teixeira, D L; Hanlon, A; Boyle, L A

2017-01-01

Tail lesions are important pig welfare indicators that could be recorded during meat inspection as they are more visible on the carcass than on the live animal. Tail biting is associated with reduced performance in the bitten pig, but it is not clear whether problems with tail biting are reflected in general farm performance figures. Farm advisory services aim to improve farm productivity which could be associated with improvements in pig welfare. Record keeping forms an integral part of such advisory services. The aim of this study was to examine the influence of record keeping in the Teagasc eProfit Monitor (ePM herds) on the prevalence of tail lesion severity scores in Irish slaughter pigs. In addition, we investigated associations between the prevalence of tail lesion scores and production parameters at farm level in ePM herds. Pigs were observed after scalding/dehairing and tail lesion score (0 to 4), sex and farm identification were recorded. Tail lesion scores were collapsed into none/mild lesions (score ⩽1), moderate lesions (score 2) and severe lesions (score ⩾3). The effect of record keeping (ePM herd) on the different tail lesion outcomes was analysed at batch level using the events/trials structure in generalized linear mixed models (PROC GLIMMIX). Spearman's rank correlations were calculated between average tail lesion score of a batch and production parameters. A total of 13 133 pigs were assessed from 73 batches coming from 61 farms. In all, 23 farms were identified as ePM herds. The average prevalence of moderate tail lesions was 26.8% and of severe tail lesions was 3.4% in a batch. Batches coming from ePM herds had a lower prevalence of moderate tail lesions than non-ePM herds (P<0.001). Average tail lesion score was negatively associated with age (P<0.05) and weight (P<0.05) at sale/transfer of weaners, and tended to be positively associated with the number of finishing days (P=0.06). In addition, the prevalence of severe tail lesions was negatively associated with average daily gain in weaners (P<0.05) and tended to do so with average daily gain in finishers (P=0.08). This study provides the first indication that record keeping through an advisory service may help to lower the risk of tail biting, which is associated with improved farm performance.

Chance performance and floor effects: threats to the validity of the Wechsler Memory Scale--fourth edition designs subtest.

PubMed

Martin, Phillip K; Schroeder, Ryan W

2014-06-01

The Designs subtest allows for accumulation of raw score points by chance alone, creating the potential for artificially inflated performances, especially in older patients. A random number generator was used to simulate the random selection and placement of cards by 100 test naive participants, resulting in a mean raw score of 36.26 (SD = 3.86). This resulted in relatively high-scaled scores in the 45-54, 55-64, and 65-69 age groups on Designs II. In the latter age group, in particular, the mean simulated performance resulted in a scaled score of 7, with scores 1 SD below and above the performance mean translating to scaled scores of 5 and 8, respectively. The findings indicate that clinicians should use caution when interpreting Designs II performance in these age groups, as our simulations demonstrated that low average to average range scores occur frequently when patients are relying solely on chance performance. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Does application of moderately concentrated platelet-rich plasma improve clinical and structural outcome after arthroscopic repair of medium-sized to large rotator cuff tear? A randomized controlled trial.

PubMed

Pandey, Vivek; Bandi, Atul; Madi, Sandesh; Agarwal, Lipisha; Acharya, Kiran K V; Maddukuri, Satish; Sambhaji, Charudutt; Willems, W Jaap

2016-08-01

Platelet-rich plasma (PRP) has the potential to improve tendon-bone healing. The evidence is still controversial as to whether PRP application after repair of medium-sized to large cuff tears leads to superior structural and clinical outcome, especially after single-row repair. In a randomized study, 102 patients (PRP group, 52 patients; control group, 50 patients) with medium-sized and large degenerative posterosuperior tears were included for arthroscopic repair with a minimum follow-up of 2 years. Patients were evaluated with clinical scores (visual analog scale score, Constant-Murley score, University of California-Los Angeles score, and American Shoulder and Elbow Surgeons score) and ultrasound to assess retear and vascularity pattern of the cuff. Visual analog scale scores were significantly lower in the PRP group than in controls at 1 month, 3 months, and 6 months but not later. Constant-Murley scores were significantly better in the PRP group compared with controls at 12 and 24 months, whereas University of California-Los Angeles scores were significantly higher in the PRP group at 6 and 12 months (P < .05). The American Shoulder and Elbow Surgeons score in both groups was comparable at all the times. At 24 months, retear in the PRP group (n = 2; 3.8%) was significantly lower than in the control group (n = 10; 20%; P = .01). The retear difference was significant only for large tears (PRP:control group, 1:6; P = .03). Doppler ultrasound examination showed significant vascularity in the PRP group repair site at 3 months postoperatively (P < .05) and in peribursal tissue until 12 months. Application of moderately concentrated PRP improves clinical and structural outcome in large cuff tears. PRP also enhances vascularity around the repair site in the early phase. Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Comparative effects of constant versus fluctuating thermal regimens on yellow perch growth, feed conversion and survival

USDA-ARS?s Scientific Manuscript database

The effects of fluctuating or constant thermal regimens on growth, mortality, and feed conversion were determined for juvenile yellow perch (Perca flavescens). Yellow perch averaging 156mm total length and 43g body weight were held in replicate 288L circular tanks for 129 days under: 1) a diel therm...

Gas sorption and barrier properties of polymeric membranes from molecular dynamics and Monte Carlo simulations.

PubMed

Cozmuta, Ioana; Blanco, Mario; Goddard, William A

2007-03-29

It is important for many industrial processes to design new materials with improved selective permeability properties. Besides diffusion, the molecule's solubility contributes largely to the overall permeation process. This study presents a method to calculate solubility coefficients of gases such as O2, H2O (vapor), N2, and CO2 in polymeric matrices from simulation methods (Molecular Dynamics and Monte Carlo) using first principle predictions. The generation and equilibration (annealing) of five polymer models (polypropylene, polyvinyl alcohol, polyvinyl dichloride, polyvinyl chloride-trifluoroethylene, and polyethylene terephtalate) are extensively described. For each polymer, the average density and Hansen solubilities over a set of ten samples compare well with experimental data. For polyethylene terephtalate, the average properties between a small (n = 10) and a large (n = 100) set are compared. Boltzmann averages and probability density distributions of binding and strain energies indicate that the smaller set is biased in sampling configurations with higher energies. However, the sample with the lowest cohesive energy density from the smaller set is representative of the average of the larger set. Density-wise, low molecular weight polymers tend to have on average lower densities. Infinite molecular weight samples do however provide a very good representation of the experimental density. Solubility constants calculated with two ensembles (grand canonical and Henry's constant) are equivalent within 20%. For each polymer sample, the solubility constant is then calculated using the faster (10x) Henry's constant ensemble (HCE) from 150 ps of NPT dynamics of the polymer matrix. The influence of various factors (bad contact fraction, number of iterations) on the accuracy of Henry's constant is discussed. To validate the calculations against experimental results, the solubilities of nitrogen and carbon dioxide in polypropylene are examined over a range of temperatures between 250 and 650 K. The magnitudes of the calculated solubilities agree well with experimental results, and the trends with temperature are predicted correctly. The HCE method is used to predict the solubility constants at 298 K of water vapor and oxygen. The water vapor solubilities follow more closely the experimental trend of permeabilities, both ranging over 4 orders of magnitude. For oxygen, the calculated values do not follow entirely the experimental trend of permeabilities, most probably because at this temperature some of the polymers are in the glassy regime and thus are diffusion dominated. Our study also concludes large confidence limits are associated with the calculated Henry's constants. By investigating several factors (terminal ends of the polymer chains, void distribution, etc.), we conclude that the large confidence limits are intimately related to the polymer's conformational changes caused by thermal fluctuations and have to be regarded--at least at microscale--as a characteristic of each polymer and the nature of its interaction with the solute. Reducing the mobility of the polymer matrix as well as controlling the distribution of the free (occupiable) volume would act as mechanisms toward lowering both the gas solubility and the diffusion coefficients.

Outcomes for a large metaphyseal volume hemiarthroplasty in complex fractures of the proximal humerus.

PubMed

White, Jonathan J E; Soothill, John R; Morgan, Marie; Clark, David I; Espag, Marius P; Tambe, Amol A

2017-03-01

A large metaphyseal volume shoulder hemiarthroplasty has been in use within our department since 2008; however, no clinical outcome data are available for this prosthesis apart from the designer surgeon series. During a 5-year period, data were collected for 40 patients (30 women, 10 men) treated consecutively with the Zimmer Anatomical Shoulder Fracture hemiarthroplasty system (Zimmer, Warsaw, IN, USA). The final analysis included 26 patients. The median age was 79 years (range, 58-91 years), and the median follow-up was 3.7 years (range, 2.0-5.8 years). The median Constant Score was 34 points (range, 16-70 points), and the median Oxford Shoulder Score was 27 points (range, 5-46 points). The greater tuberosity healed satisfactorily in 12 patients. Resorption of the greater tuberosity was seen radiologically in 18 patients. The presence of resorption had no significant effect on the Constant Score (P = .264) or the Oxford Shoulder Score (P = .469). Three patients (12%) required revision. This is the first report from a nondesigner center for outcomes for this prosthesis to date. The results demonstrate reduced functional performance compared with the designer series. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

An Algorithm for Creating Virtual Controls Using Integrated and Harmonized Longitudinal Data.

PubMed

Hansen, William B; Chen, Shyh-Huei; Saldana, Santiago; Ip, Edward H

2018-06-01

We introduce a strategy for creating virtual control groups-cases generated through computer algorithms that, when aggregated, may serve as experimental comparators where live controls are difficult to recruit, such as when programs are widely disseminated and randomization is not feasible. We integrated and harmonized data from eight archived longitudinal adolescent-focused data sets spanning the decades from 1980 to 2010. Collectively, these studies examined numerous psychosocial variables and assessed past 30-day alcohol, cigarette, and marijuana use. Additional treatment and control group data from two archived randomized control trials were used to test the virtual control algorithm. Both randomized controlled trials (RCTs) assessed intentions, normative beliefs, and values as well as past 30-day alcohol, cigarette, and marijuana use. We developed an algorithm that used percentile scores from the integrated data set to create age- and gender-specific latent psychosocial scores. The algorithm matched treatment case observed psychosocial scores at pretest to create a virtual control case that figuratively "matured" based on age-related changes, holding the virtual case's percentile constant. Virtual controls matched treatment case occurrence, eliminating differential attrition as a threat to validity. Virtual case substance use was estimated from the virtual case's latent psychosocial score using logistic regression coefficients derived from analyzing the treatment group. Averaging across virtual cases created group estimates of prevalence. Two criteria were established to evaluate the adequacy of virtual control cases: (1) virtual control group pretest drug prevalence rates should match those of the treatment group and (2) virtual control group patterns of drug prevalence over time should match live controls. The algorithm successfully matched pretest prevalence for both RCTs. Increases in prevalence were observed, although there were discrepancies between live and virtual control outcomes. This study provides an initial framework for creating virtual controls using a step-by-step procedure that can now be revised and validated using other prevention trial data.

40 CFR 57.302 - Performance level of interim constant controls.

Code of Federal Regulations, 2011 CFR

2011-07-01

... exceed the following: (i) For sulfuric acid plants on copper smelters, 12-hour running average; (ii) For sulfuric acid plants on lead smelters, 6-hour running average; (iii) For sulfuric acid plants on zinc... limitation shall take into account unavoidable catalyst deterioration in sulfuric acid plants, but may...

A Logistic Regression Analysis of Turkey's 15-Year-Olds' Scoring above the OECD Average on the PISA'09 Reading Assessment

ERIC Educational Resources Information Center

Kasapoglu, Koray

2014-01-01

This study aims to investigate which factors are associated with Turkey's 15-year-olds' scoring above the OECD average (493) on the PISA'09 reading assessment. Collected from a total of 4,996 15-year-old students from Turkey, data were analyzed by logistic regression analysis in order to model the data of students who were split into two: (1)…

Development of website for studying modern physics

NASA Astrophysics Data System (ADS)

Saehana, S.; Wahyono, U.; Darmadi, I. W.; Kendek, Y.; Widyawati, W.

2018-03-01

The purpose of this study is to produce a website in modern physics courses in order to increase student interest in physics learning. To determine the feasibility level of learning media then feasibility test to the product. The feasibility test carried out on the product is divided into three parts: material feasibility test, media feasibility test, and student response test. Based on the results of the test conducted the material obtained an average score of 3.72 and categorized very well. The result of media test that was obtained got the average score of 3.25 and categorized well. The result of the analysis of student's response to the twenty students of class A (fifth semester) of physics education program FKIP UniversitasTadulako obtained an average score of 3.16 with the good category. The results showed that the website developed can be used as one of the learning media that can support the learning process of students.

Physical fitness and academic performance: a pilot investigation in USU medical students.

PubMed

Stephens, Mark B; Dong, Ting; Durning, Steven J

2015-04-01

This study examined the correlations between physical fitness parameters and standard measures of academic performance in a cohort of students at the Uniformed Services University. Significant positive correlations were noted between the average aerobic fitness score and preclerkship grade point average (GPA; r = 0.37, p < 0.05) and cumulative GPA (r = 0.38, p < 0.05). Positive correlations were also noted between the average overall fitness score and preclerkship GPA (r = 0.34, p < 0.05), medical school cumulative GPA (r = 0.34, p < 0.05), and the score on Step 1 of the national board examination (r = -0.33, p < 0.05). Physical fitness may serve as one indicator to predict which students will succeed in medical school and to identify those who are at risk for poor performance and might benefit from a wellness intervention. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

Mental health, well-being, and poverty: A study in urban and rural communities in Northeastern Brazil.

PubMed

Nepomuceno, Bárbara Barbosa; Cardoso, Antonio Alan Vieira; Ximenes, Verônica Morais; Barros, João Paulo Pereira; Leite, Jáder Ferreira

2016-01-01

This article analyzes the relations between mental health and well-being in urban and rural contexts marked by poverty. The analysis takes as its basis a quantitative research conducted with 417 adult inhabitants of two communities, one rural and the other urban, in Northeastern Brazil. The data were constructed using questionnaires composed of sociodemographic data, the Personal Wellbeing Index and Self Report Questionnaire (SRQ-20) scales. We found significant differences between the inhabitants of the rural and urban communities regarding well-being and the prevalence of common mental disorders (CMD), with a higher average well-being score in the rural context; the urban sample had a higher average regarding the prevalence of CMD. The variable income significantly influenced the SRQ-20 average scores; the same was not observed with well-being scores. Besides, it was observed that there is a negative correlation with well-being and CMD.

Quality of life and complications at the different stages of bone transport for treatment infected nonunion of the tibia.

PubMed

Wang, Hu; Wei, Xing; Liu, Ping; Fu, Ya-Hui; Wang, Peng-Fei; Cong, Yu-Xuan; Zhang, Bin-Fei; Li, Zhong; Lei, Jin-Lai; Zhang, Kun; Zhuang, Yan

2017-11-01

The aim of this study was to assess Physical Component Summary (PCS), Mental Component Summary (MCS) of the Mos 36-item Short Form Health Survey (SF-36) score, and the virtual Analogue Scale (VAS) of pain during the treatment period and the complication rate associated with infected nonunion of the tibia managed surgically by bone transport.This is a retrospective analysis of prospectively collected data in a consecutive patient cohort. Patients suffering from infected nonunion of the tibia were treated by bone transport from 2012 to 2014. Follow-up was for at least 2 years after complete osseous consolidation. Standardized treatment included bacterial eradication by segmental resection, bone transport using Ilizarov apparatus, and docking maneuver. The main outcome measurements consisted of the quality of life (PCS and MCS scores) and the VAS of pain during the different stages of therapy. In addition, all complications were documented.Our series comprised 12 men and 3 women with an average age of 36.9 years (range: 20-55 years). All patients previously undergone an average of 2.9 operations (range: 1-6 operations). In all patients, bone defects were present with a mean size of 7.5 cm (range: 3-12 cm), and all patients were suffering from soft tissue defects (range: 5-17 cm). The mean external fixator time (EFT) was 48 weeks (range: 30-62 weeks) and the mean external fixation index was 43.1 days/cm (range: 33-62 days/cm). All patients achieved bone union, and no recurrence of infection was observed. According to the Paley classification, patients suffered 15 minor and 13 major complications. The average complication rate per patient comprised of 1.0 minor and 0.9 major complications. Bone grafting was required in 6 cases at the docking site. One patient suffered from equinus deformity, and refused any further surgical procedures. We performed 28 operations in 15 patients (average 1.9 operations per patient). After the period of bone transport, PCS and MCS scores increased continuously. After completed consolidation, the average MCS score was comparable to a normal collective, and the average VAS score was 1.87 (range: 0-3).Bone transport is a safe option for the treatment of infected nonunion of the tibia despite the high complication rate. The arduous and demanding nature of this treatment subjects patient to considerable the pain, mental, and physical stress. The average VAS scores, PCS, and MCS scores significantly improve at final follow-up. It is essential to communicate this fact to the patients and their relatives before the application of the frame in order to increase their compliance with the long and emotionally draining treatment.

Performance of the libraries in Isfahan University of Medical Sciences based on the EFQM model.

PubMed

Karimi, Saeid; Atashpour, Bahareh; Papi, Ahmad; Nouri, Rasul; Hasanzade, Akbar

2014-01-01

Performance measurement is inevitable for university libraries. Hence, planning and establishing a constant and up-to-date measurement system is required for the libraries, especially the university libraries. The primary studies and analyses reveal that the EFQM Excellence Model has been efficient, and the administrative reform program has focused on the implementation of this model. Therefore, on the basis of these facts as well as the need for a measurement system, the researchers measured the performance of libraries in schools and hospitals supported by Isfahan University of Medical Sciences, using the EFQM Organizational Excellence Model. This descriptive research study was carried out by a cross-sectional survey method in 2011. This research study included librarians and library directors of Isfahan University of Medical Sciences (70 people). The validity of the instrument was measured by the specialists in the field of Management and Library Science. To measure the reliability of the questionnaire, the Cronbach's alpha coefficient value was measured (0.93). The t-test, ANOVA, and Spearman's rank correlation coefficient were used for measurements. The data were analyzed by SPSS. Data analysis revealed that the mean score of the performance measurement for the libraries under study and between nine dimensions the highest score was 65.3% for leadership dimension and the lowest scores were 55.1% for people and 55.1% for society results. In general, using the ninth EFQM model the average level of all dimensions, which is in good agreement with normal values, was assessed. However, compared to other results, the criterion people and society results were poor. It is Recommended by forming the expert committee on criterion people and society results by individuals concerned with the various conferences and training courses to improve the aspects.

Performance of the libraries in Isfahan University of Medical Sciences based on the EFQM model

PubMed Central

Karimi, Saeid; Atashpour, Bahareh; Papi, Ahmad; Nouri, Rasul; Hasanzade, Akbar

2014-01-01

Introduction: Performance measurement is inevitable for university libraries. Hence, planning and establishing a constant and up-to-date measurement system is required for the libraries, especially the university libraries. The primary studies and analyses reveal that the EFQM Excellence Model has been efficient, and the administrative reform program has focused on the implementation of this model. Therefore, on the basis of these facts as well as the need for a measurement system, the researchers measured the performance of libraries in schools and hospitals supported by Isfahan University of Medical Sciences, using the EFQM Organizational Excellence Model. Materials and Methods: This descriptive research study was carried out by a cross-sectional survey method in 2011. This research study included librarians and library directors of Isfahan University of Medical Sciences (70 people). The validity of the instrument was measured by the specialists in the field of Management and Library Science. To measure the reliability of the questionnaire, the Cronbach's alpha coefficient value was measured (0.93). The t-test, ANOVA, and Spearman's rank correlation coefficient were used for measurements. The data were analyzed by SPSS. Results: Data analysis revealed that the mean score of the performance measurement for the libraries under study and between nine dimensions the highest score was 65.3% for leadership dimension and the lowest scores were 55.1% for people and 55.1% for society results. Conclusion: In general, using the ninth EFQM model the average level of all dimensions, which is in good agreement with normal values, was assessed. However, compared to other results, the criterion people and society results were poor. It is Recommended by forming the expert committee on criterion people and society results by individuals concerned with the various conferences and training courses to improve the aspects. PMID:25540795

Distance measurements from supernovae and dark energy constraints

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

Wang Yun

2009-12-15

Constraints on dark energy from current observational data are sensitive to how distances are measured from Type Ia supernova (SN Ia) data. We find that flux averaging of SNe Ia can be used to test the presence of unknown systematic uncertainties, and yield more robust distance measurements from SNe Ia. We have applied this approach to the nearby+SDSS+ESSENCE+SNLS+HST set of 288 SNe Ia, and the 'Constitution' set of 397 SNe Ia. Combining the SN Ia data with cosmic microwave background anisotropy data from Wilkinson Microwave Anisotropy Probe 5 yr observations, the Sloan Digital Sky Survey baryon acoustic oscillation measurements, themore » data of 69 gamma-ray bursts (GRBs) , and the Hubble constant measurement from the Hubble Space Telescope project SHOES, we measure the dark energy density function X(z){identical_to}{rho}{sub X}(z)/{rho}{sub X}(0) as a free function of redshift (assumed to be a constant at z>1 or z>1.5). Without the flux averaging of SNe Ia, the combined data using the Constitution set of SNe Ia seem to indicate a deviation from a cosmological constant at {approx}95% confidence level at 0 < or apporx. z < or approx. 0.8; they are consistent with a cosmological constant at {approx}68% confidence level when SNe Ia are flux averaged. The combined data using the nearby+SDSS+ESSENCE+SNLS+HST data set of SNe Ia are consistent with a cosmological constant at 68% confidence level with or without flux averaging of SNe Ia, and give dark energy constraints that are significantly more stringent than that using the Constitution set of SNe Ia. Assuming a flat Universe, dark energy is detected at >98% confidence level for z{<=}0.75 using the combined data with 288 SNe Ia from nearby+SDSS+ESSENCE+SNLS+HST, independent of the assumptions about X(z{>=}1). We quantify dark energy constraints without assuming a flat Universe using the dark energy figure of merit for both X(z) and a dark energy equation-of-state linear in the cosmic scale factor.« less

Effectiveness of Multimedia for Transplant Preparation for Kidney Transplant Waiting List Patients.

PubMed

Charoenthanakit, C; Junchotikul, P; Sittiudomsuk, R; Saiyud, A; Pratumphai, P

2016-04-01

A multimedia program could effectively advise patients about preparing for transplantation while on the waiting list for a kidney transplant. This study aimed to compare knowledge about transplant preparation for patients on a kidney transplant waiting list before and after participating in a multimedia program, and to evaluate patient satisfaction with the multimedia program. Research design was quasiexperimental with the use of 1 group. Subjects were 186 patients on the kidney transplant waiting list after HLA matching in Ramathibodi Hospital. The questionnaires were developed by the researchers. The statistical tools used were basic statistics, percentage, average, standard deviation, and the difference of score between before and after participation in the multimedia program (t test). The evaluation knowledge for transplant preparation for kidney transplant waiting list patients after participating in the multimedia program averaged 85.40%, and there was an increased improvement of score by an average 3.27 out of a possible full score of 20 (P < .05). The result of patient satisfaction for the multimedia program had good average, 4.58. Copyright © 2016 Elsevier Inc. All rights reserved.

Quality assessment of online patient education resources for peripheral neuropathy.

PubMed

Hansberry, David R; Suresh, Ragha; Agarwal, Nitin; Heary, Robert F; Goldstein, Ira M

2013-03-01

Given its practicality, the internet is a primary resource for patients afflicted with diseases like peripheral neuropathy. Therefore, it is important that the readily available online resources on peripheral neuropathy are tailored to the general public, particularly concerning readability. Patient education resources were downloaded from the US National Library of Medicine, Mayo Clinic, National Institute of Neurological Disorders and Stroke, Neuropathy.org, GBS/CIDP Foundation International, Hereditary Neuropathy Foundation, Charcot-Marie-Tooth Association, Foundation for Peripheral Neuropathy, and Neuropathy Action Foundation websites. All patient education material related to peripheral neuropathy was evaluated for its level of readability using the Flesch Reading Ease (FRE) and Flesch-Kincaid Grade Level. The FRE scores averaged 43.4 with only the US National Library of Medicine scoring above 60 (76.5). The Flesch-Kincaid Grade Level scores averaged 11.0. All scores were above a seventh-grade level except the US National Library of Medicine, which had a score of a fifth-grade reading level. Most Americans may not fully benefit from patient education resources concerning peripheral neuropathy education on many of the websites. Only the US National Library of Medicine, which is written at a fifth-grade level, is likely to benefit the average American. © 2013 Peripheral Nerve Society.

Emotional intelligence and clinical performance/retention of nursing students

PubMed Central

Marvos, Chelsea; Hale, Frankie B.

2015-01-01

Objective: This exploratory, quantitative, descriptive study was undertaken to explore the relationship between clinical performance and anticipated retention in nursing students. Methods: After approval by the university's Human Subjects Committee, a sample of 104 nursing students were recruited for this study, which involved testing with a valid and reliable emotional intelligence (EI) instrument and a self-report survey of clinical competencies. Results: Statistical analysis revealed that although the group average for total EI score and the 6 score subsets were in the average range, approximately 30% of the individual total EI scores and 30% of two branch scores, identifying emotions correctly and understanding emotions, fell in the less than average range. This data, as well as the analysis of correlation with clinical self-report scores, suggest recommendations applicable to educators of clinical nursing students. Conclusions: Registered nurses make-up the largest segment of the ever-growing healthcare workforce. Yet, retention of new graduates has historically been a challenge for the profession. Given the projected employment growth in nursing, it is important to identify factors which correlate with high levels of performance and job retention among nurses. There is preliminary evidence that EI a nontraditional intelligence measure relates positively not only with retention of clinical staff nurses, but with overall clinical performance as well. PMID:27981096

Emotional intelligence and clinical performance/retention of nursing students.

PubMed

Marvos, Chelsea; Hale, Frankie B

2015-01-01

This exploratory, quantitative, descriptive study was undertaken to explore the relationship between clinical performance and anticipated retention in nursing students. After approval by the university's Human Subjects Committee, a sample of 104 nursing students were recruited for this study, which involved testing with a valid and reliable emotional intelligence (EI) instrument and a self-report survey of clinical competencies. Statistical analysis revealed that although the group average for total EI score and the 6 score subsets were in the average range, approximately 30% of the individual total EI scores and 30% of two branch scores, identifying emotions correctly and understanding emotions, fell in the less than average range. This data, as well as the analysis of correlation with clinical self-report scores, suggest recommendations applicable to educators of clinical nursing students. Registered nurses make-up the largest segment of the ever-growing healthcare workforce. Yet, retention of new graduates has historically been a challenge for the profession. Given the projected employment growth in nursing, it is important to identify factors which correlate with high levels of performance and job retention among nurses. There is preliminary evidence that EI a nontraditional intelligence measure relates positively not only with retention of clinical staff nurses, but with overall clinical performance as well.

Association between online social networking and depression in high school students: behavioral physiology viewpoint.

PubMed

Pantic, Igor; Damjanovic, Aleksandar; Todorovic, Jovana; Topalovic, Dubravka; Bojovic-Jovic, Dragana; Ristic, Sinisa; Pantic, Senka

2012-03-01

Frequent use of Facebook and other social networks is thought to be associated with certain behavioral changes, and some authors have expressed concerns about its possible detrimental effect on mental health. In this work, we investigated the relationship between social networking and depression indicators in adolescent population. Total of 160 high school students were interviewed using an anonymous, structured questionnaire and Back Depression Inventory - second edition (BDI-II-II). Apart from BDI-II-II, students were asked to provide the data for height and weight, gender, average daily time spent on social networking sites, average time spent watching TV, and sleep duration in a 24-hour period. Average BDI-II-II score was 8.19 (SD=5.86). Average daily time spent on social networking was 1.86 h (SD=2.08 h), and average time spent watching TV was 2.44 h (SD=1.74 h). Average body mass index of participants was 21.84 (SD=3.55) and average sleep duration was 7.37 (SD=1.82). BDI-II-II score indicated minimal depression in 104 students, mild depression in 46 students, and moderate depression in 10 students. Statistically significant positive correlation (p<0.05, R=0.15) was found between BDI-II-II score and the time spent on social networking. Our results indicate that online social networking is related to depression. Additional research is required to determine the possible causal nature of this relationship.

Perceptions of orthodontic case complexity among orthodontists, general practitioners, orthodontic residents, and dental students.

PubMed

Heath, Elizabeth M; English, Jeryl D; Johnson, Cleverick D; Swearingen, Elizabeth B; Akyalcin, Sercan

2017-02-01

Our aims were to assess the perceptions of orthodontic case complexity among orthodontists, general dentists, orthodontic residents, and dental students and to compare their perceptions with the American Board of Orthodontics Discrepancy Index (DI). Orthodontists, general dentists, orthodontic residents, and dental students (n = 343) participated in a Web-based survey. Pretreatment orthodontic records of 29 cases with varying DI scores were obtained. Respondents were asked to evaluate case complexity on a 100-point visual analog scale. Additional information was collected on participants' orthodontic education and orthodontic treatment preferences. Pearson correlation coefficients were used to assess the relationship between the average complexity score and the DI score. Repeated measures analysis with linear mixed models was used to assess the association between the average complexity score and the DI score and whether the association between the 2 scores varied by level of difficulty or panel group. The level of significance for all analyses was set at P <0.05. The results showed that 71.6% of general dentists provided some orthodontic services, with 21.0% providing full fixed appliances and 38.3% providing clear aligners. DI score was significantly associated with complexity perceptions (P = 0.0168). Associations between average complexity and DI score varied significantly by provider group (P = 0.0033), with orthodontists and residents showing the strongest associations. When the DI score was greater than 15, orthodontists and residents perceived cases as more complex than did the other provider groups. Orthodontists and orthodontic residents had better judgments for evaluating orthodontic case complexity. The high correlation between orthodontic professionals' perceptions and DI scores suggested that additional orthodontic education and training have an influence on the ability to recognize case complexity. Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Web-based pathology practice examination usage.

PubMed

Klatt, Edward C

2014-01-01

General and subject specific practice examinations for students in health sciences studying pathology were placed onto a free public internet web site entitled web path and were accessed four clicks from the home web site menu. Multiple choice questions were coded into. html files with JavaScript functions for web browser viewing in a timed format. A Perl programming language script with common gateway interface for web page forms scored examinations and placed results into a log file on an internet computer server. The four general review examinations of 30 questions each could be completed in up to 30 min. The 17 subject specific examinations of 10 questions each with accompanying images could be completed in up to 15 min each. The results of scores and user educational field of study from log files were compiled from June 2006 to January 2014. The four general review examinations had 31,639 accesses with completion of all questions, for a completion rate of 54% and average score of 75%. A score of 100% was achieved by 7% of users, ≥90% by 21%, and ≥50% score by 95% of users. In top to bottom web page menu order, review examination usage was 44%, 24%, 17%, and 15% of all accessions. The 17 subject specific examinations had 103,028 completions, with completion rate 73% and average score 74%. Scoring at 100% was 20% overall, ≥90% by 37%, and ≥50% score by 90% of users. The first three menu items on the web page accounted for 12.6%, 10.0%, and 8.2% of all completions, and the bottom three accounted for no more than 2.2% each. Completion rates were higher for shorter 10 questions subject examinations. Users identifying themselves as MD/DO scored higher than other users, averaging 75%. Usage was higher for examinations at the top of the web page menu. Scores achieved suggest that a cohort of serious users fully completing the examinations had sufficient preparation to use them to support their pathology education.

Improvement of the diagnostic accuracy of MRA with subtraction technique in cerebral vasospasm.

PubMed

Hamaguchi, Akiyoshi; Fujima, Noriyuki; Yoshida, Daisuke; Hamaguchi, Naoko; Kodera, Shuichi

2014-01-01

Vasospasm has been considered the most severe acute complication after subarachnoid hemorrhage (SAH). MRA is not considered ideal for detecting cerebral vasospasm because of background including the hemorrhage. The aim of this study is to evaluate the efficacy of Subtraction MRA (SMRA) by comparing it to that of conventional MRA (CMRA) for diagnosis of cerebral vasospasm. Arteries were assigned to one of three categories based on the degree of MRA diagnostic quality of vasospasm (quality score): 0, bad … 2, good. Furthermore each artery was assigned to one of four categories based on the degree of vasospasm severity (SV score): 0, no vasospasm … 3, severe. The value of the difference between DSA-SV score and MRA-SV score was defined as the DIF score. CMRA and SMRA were compared for each arterial region with regard to quality score and DIF score. The average CMRA and SMRA quality score were 1.46 and 1.79; the difference was statistically significant. The average CMRA and SMRA DIF score were 1.08 and .60; the difference was statistically significant. Diagnosis of cerebral vasospasm is more accurate by SMRA than by CMRA. The advantages are its noninvasive nature and its ability to detect cerebral vasospasm. Copyright © 2014 by the American Society of Neuroimaging.

Assessing Technical Performance and Determining the Learning Curve in Cleft Palate Surgery Using a High-Fidelity Cleft Palate Simulator.

PubMed

Podolsky, Dale J; Fisher, David M; Wong Riff, Karen W; Szasz, Peter; Looi, Thomas; Drake, James M; Forrest, Christopher R

2018-06-01

This study assessed technical performance in cleft palate repair using a newly developed assessment tool and high-fidelity cleft palate simulator through a longitudinal simulation training exercise. Three residents performed five and one resident performed nine consecutive endoscopically recorded cleft palate repairs using a cleft palate simulator. Two fellows in pediatric plastic surgery and two expert cleft surgeons also performed recorded simulated repairs. The Cleft Palate Objective Structured Assessment of Technical Skill (CLOSATS) and end-product scales were developed to assess performance. Two blinded cleft surgeons assessed the recordings and the final repairs using the CLOSATS, end-product scale, and a previously developed global rating scale. The average procedure-specific (CLOSATS), global rating, and end-product scores increased logarithmically after each successive simulation session for the residents. Reliability of the CLOSATS (average item intraclass correlation coefficient (ICC), 0.85 ± 0.093) and global ratings (average item ICC, 0.91 ± 0.02) among the raters was high. Reliability of the end-product assessments was lower (average item ICC, 0.66 ± 0.15). Standard setting linear regression using an overall cutoff score of 7 of 10 corresponded to a pass score for the CLOSATS and the global score of 44 (maximum, 60) and 23 (maximum, 30), respectively. Using logarithmic best-fit curves, 6.3 simulation sessions are required to reach the minimum standard. A high-fidelity cleft palate simulator has been developed that improves technical performance in cleft palate repair. The simulator and technical assessment scores can be used to determine performance before operating on patients.

Fast-food menu offerings vary in dietary quality, but are consistently poor

PubMed Central

Kirkpatrick, Sharon I; Reedy, Jill; Kahle, Lisa L; Harris, Jennifer L; Ohri-Vachaspati, Punam; Krebs-Smith, Susan M

2013-01-01

Objective To evaluate five popular fast-food chains’ menus in relation to dietary guidance. Design Menus posted on chains’ websites were coded using the Food and Nutrient Database for Dietary Studies and MyPyramid Equivalents Database to enable Healthy Eating Index-2005 (HEI-2005) scores to be assigned. Dollar or value and kids’ menus and sets of items promoted as healthy or nutritious were also assessed. Setting Five popular fast-food chains in the USA. Subjects Not applicable. Results Full menus scored lower than 50 out of 100 possible points on the HEI-2005. Scores for Total Fruit, Whole Grains and Sodium were particularly dismal. Compared with full menus, scores on dollar or value menus were 3 points higher on average, whereas kids’ menus scored 10 points higher on average. Three chains marketed subsets of items as healthy or nutritious; these scored 17 points higher on average compared with the full menus. No menu or subset of menu items received a score higher than 72 out of 100 points. Conclusions The poor quality of fast-food menus is a concern in light of increasing away-from-home eating, aggressive marketing to children and minorities, and the tendency for fast-food restaurants to be located in low-income and minority areas. The addition of fruits, vegetables and legumes; replacement of refined with whole grains; and reformulation of offerings high in sodium, solid fats and added sugars are potential strategies to improve fast-food offerings. The HEI may be a useful metric for ongoing monitoring of fast-food menus. PMID:23317511

Oral azithromycin for treatment of posterior blepharitis.

PubMed

Igami, Thais Zamudio; Holzchuh, Ricardo; Osaki, Tammy Hentona; Santo, Ruth Miyuki; Kara-Jose, Newton; Hida, Richard Y

2011-10-01

To evaluate the effects of oral azithromycin in patients with posterior blepharitis. Twenty-six eyes of 13 patients with posterior blepharitis diagnosed by a qualified ophthalmologist were enrolled in this study. Patients were instructed to use oral azithromycin 500 mg per day for 3 days in 3 cycles with 7-day intervals. Subjective clinical outcomes were graded and scored 1 day before and 30 days after the end of the treatment (53 days after initiating the treatment) based on severity scores of: (1) eyelid debris; (2) eyelid telangiectasia; (3) swelling of the eyelid margin; (4) redness of the eyelid margin; and (5) ocular mucus secretion. For the assessment of global efficacy, patients were asked by the investigator to rate the subjective symptoms (eyelid itching, ocular itching, eyelid hyperemia, ocular hyperemia, ocular mucus secretion, photophobia, foreign body sensation, and dry eye sensation) on a scale of 0 (no symptoms) to 5 (severe symptoms). Break-up time, Schirmer I test, corneal fluorescein staining score, and rose bengal staining score were also performed in all patients. All clinical outcomes scoring showed statistically significant improvement after oral azithromycin, except for eyelid swelling. Average subjective symptom grading improved statistically after treatment with oral azithromycin, except for eyelid hyperemia, photophobia, and foreign body sensation. Average tear film break-up time values showed statistically significant improvement after the treatment with oral azithromycin. No statistically significant improvement was observed on average values of Schirmer I test, corneal fluorescein staining score, and rose bengal staining score. The combination of multiple clinical parameters shown in this study supports the clinical efficacy of pulsed oral azithromycin therapy for the management of posterior blepharitis.

The quantitative and functional relation between insulin-like growth factor-I (IGF) and IGF-binding proteins during human osteoarthritis.

PubMed

Morales, Teresa I

2008-04-01

A previous hypothesis stated that during osteoarthritis (OA) increased insulin-like growth factor (IGF) binding proteins (IGFBPs) sequester IGFs and limit their access to the cell. The objective of this article was to test this by: (1) quantifying IGF and IGFBP-3 as well as their ratios in human OA cartilages, and (2) measuring the metabolic responses of diseased cartilage to IGF-I and its IGFBP-insensitive analogs. Knee or hip OA cartilages were staged for OA by histology. Cartilage slices were either extracted for assays of IGF proteins, or maintained intact as organ cultures. Proteoglycan (PG) metabolism +/- IGFs was measured by use of the (35)S-sulfate precursor. IGFBP-3 (ng/mg protein) was weakly correlated with OA score by regression analysis (R(2) = 0.122; p = 0.040; n = 35). IGF-I (ng/mg protein) was constant across all OA groups (ANOVA; p = .428, n = 18) and the IGF-I/IGFBP-3 ratios were > 1 in most samples. All OA cartilages responded to hrIGF-I by increasing PG synthesis [average 2.29-fold +/- 0.55 (+/-SD) at saturation, n = 12] irrespective of OA score. The des (1-3) IGF-I analog (which lacks the three N-terminal amino acids) had similar maximal effects (average 2.23-fold stimulation +/- 0.71, n = 10), but it was more effective in two out of three samples at suboptimal doses. The effect of hrIGF-I, des (1-3) IGF-I, or the B-chain analog on degradation was minimal. In summary, catabolism was insensitive to IGF-I, and this was probably not due to IGFBPs. By contrast, IGF-I exerted a robust stimulation of anabolism at sufficiently high doses, even though IGFBPs could tone down the ligand effect at low doses. (c) 2007 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

Arthroscopic repair of anterior-inferior glenohumeral instability using a portal at the 5:30-o'clock position: analysis of the effects of age, fixation method, and concomitant shoulder injury on surgical outcomes.

PubMed

Imhoff, Andreas B; Ansah, Patrick; Tischer, Thomas; Reiter, Christoph; Bartl, Christoph; Hench, Maximilian; Spang, Jeffrey T; Vogt, Stephan

2010-09-01

Traumatic anterior-inferior shoulder joint dislocations are common injuries among the young athletic population. The aim of this study was to assess which factors, including concomitant injury (rotator cuff tears, superior labral anterior posterior [SLAP] lesions), patient age, and fixation methods, led to redislocation after arthroscopic stabilization. There are several risk factors for the outcome after arthroscopic anterior-inferior glenohumeral stabilization. Cohort Study; Level of evidence, 3. Between 1996 and 2000, 221 patients were treated with arthroscopic stabilization for anterior-inferior shoulder dislocation. Of these 221 consecutive patients, 190 (140 male, 50 female) with an average age of 28.0 years (range, 14.4-59.2 years) were available for follow-up (average follow-up, 37.4 +/- 15.8 months). Fixation methods were FASTak (n = 138), Suretac (n = 28), or Panalok (n = 24) anchors. Concomitant SLAP lesions were seen in 38 of 190 cases (20%). Redislocation rates varied between anchor systems (FASTak, 6.5%; Suretac, 25%; Panalok, 16.8%). Superior labral anterior posterior lesions, when treated, did not influence clinical outcomes or redislocation rate. A concomitant rotator cuff tear did not influence redislocation rate. Postoperative outcomes (Rowe score, Constant score, American Shoulder and Elbow Surgeons [ASES] shoulder index, 12-item questionnaire) in patients with a partial tear were also not altered. On the other hand, the redislocation rate correlated with patient age and number of prior dislocations. Return to sports at preinjury level was possible in 80% of cases. Arthroscopic repair of anterior-inferior instability using the 5:30-o'clock portal is dependent on anchor type and can show good to excellent results. Because of several coinjuries in anterior-inferior instability, an arthroscopic approach may be required to identify and treat such lesions.

A comparison between two double-button endoscopically assisted surgical techniques for the treatment acute acromioclavicular dislocations.

PubMed

Vulliet, P; Le Hanneur, M; Cladiere, V; Loriaut, P; Boyer, P

2018-04-01

To compare clinical and radiological outcomes between two endoscopically assisted double-button techniques in high-grade acute acromioclavicular separations. A retrospective single-center study was conducted in patients with acute acromioclavicular joint dislocation Rockwood types III and V, from 2009 to 2014. All were treated endoscopically, with a 1-year minimum follow-up. Two consecutive series were conducted; the first (TR group) received the TightRope ® system, whereas last series (DB group) was treated with the Dog Bone ® button technology (Arthrex, Naples, FL, USA). Primary endpoints were last follow-up values of Constant score (CS) and Quick-DASH (QD) score. Moreover, the posttraumatic displacement and its evolution were assessed on bilateral Zanca radiographs. A displacement of 5 mm or greater the day after surgery was considered as a lack of reduction; the same difference on last follow-up X-rays was considered as a loss of reduction. Forty patients were reviewed: 22 in the TR group and 18 in the DB group. After a mean follow-up of 27.7 ± 8.3 months, CS and QD averaged, respectively, 94.3 ± 4.4 and 2.0 ± 2.6 in the TR series, whereas they averaged, respectively, 95 ± 6.1 and 3.4 ± 3.3 in the DB series after a mean follow-up of 24.1 ± 5 months (PCS = 0.16, PQDS = 0.08). Lack of reduction and loss of reduction rates were significantly higher in the DB group, with P = 0.0005 and P < 0.0001, respectively. Both techniques provided good to excellent functional outcomes. However, considering inferior radiological results using the Dog Bone ® device, we would prefer the TightRope ® device in acute acromioclavicular dislocations. IV: Therapeutic study-cases series.

Flat-panel-detector chest radiography: effect of tube voltage on image quality.

PubMed

Uffmann, Martin; Neitzel, Ulrich; Prokop, Mathias; Kabalan, Nahla; Weber, Michael; Herold, Christian J; Schaefer-Prokop, Cornelia

2005-05-01

To compare the visibility of anatomic structures in direct-detector chest radiographs acquired with different tube voltages at equal effective doses to the patient. The study protocol was approved by the institutional internal review board, and written informed consent was obtained from all patients. Posteroanterior chest radiographs of 48 consecutively selected patients were obtained at 90, 121, and 150 kVp by using a flat-panel-detector unit that was based on cesium iodide technology and automated exposure control. Monte Carlo simulations were used to verify that the effective dose for all kilovoltage settings was equal. Five radiologists subjectively and independently rated the delineation of anatomic structures on hard-copy images by using a five-point scale. They also ranked image quality in a blinded side-by-side comparison. Average ranking scores were compared by using one-way analysis of variance with repeated measures. Data were analyzed for the entire patient group and for two patient subgroups that were formed according to body mass index (BMI). The visibility scores of most anatomic structures were significantly superior with the 90-kVp images (mean score, 3.11), followed by the 121-kVp (mean score, 2.95) and 150-kVp images (mean score, 2.80). Differences did not reach significance (P > .05) only for the delineation of the peripheral vessels, the heart contours, and the carina. This was also true for the subgroup of patients (n = 24) with a BMI greater than and the subgroup of patients (n = 24) with a BMI less than the mean BMI (26.9 kg/m(2)). At side-by-side comparison, the readers rated 90-kVp images as having superior image quality in the majority of image triplets; the percentage of 90-kVp images rated as "first choice" ranged from 60% (29 of 48 patients) to 90% (43 of 48 patients), with a median of 88% (42 of 48 patients), among the readers. Delineation of most anatomic structures and overall image quality were ranked superior in digital radiographs acquired with lower kilovoltage at a constant effective patient dose. (c) RSNA, 2005.

The Stagger-grid: A grid of 3D stellar atmosphere models. II. Horizontal and temporal averaging and spectral line formation

NASA Astrophysics Data System (ADS)

Magic, Z.; Collet, R.; Hayek, W.; Asplund, M.

2013-12-01

Aims: We study the implications of averaging methods with different reference depth scales for 3D hydrodynamical model atmospheres computed with the Stagger-code. The temporally and spatially averaged (hereafter denoted as ⟨3D⟩) models are explored in the light of local thermodynamic equilibrium (LTE) spectral line formation by comparing spectrum calculations using full 3D atmosphere structures with those from ⟨3D⟩ averages. Methods: We explored methods for computing mean ⟨3D⟩ stratifications from the Stagger-grid time-dependent 3D radiative hydrodynamical atmosphere models by considering four different reference depth scales (geometrical depth, column-mass density, and two optical depth scales). Furthermore, we investigated the influence of alternative averages (logarithmic, enforced hydrostatic equilibrium, flux-weighted temperatures). For the line formation we computed curves of growth for Fe i and Fe ii lines in LTE. Results: The resulting ⟨3D⟩ stratifications for the four reference depth scales can be very different. We typically find that in the upper atmosphere and in the superadiabatic region just below the optical surface, where the temperature and density fluctuations are highest, the differences become considerable and increase for higher Teff, lower log g, and lower [Fe / H]. The differential comparison of spectral line formation shows distinctive differences depending on which ⟨3D⟩ model is applied. The averages over layers of constant column-mass density yield the best mean ⟨3D⟩ representation of the full 3D models for LTE line formation, while the averages on layers at constant geometrical height are the least appropriate. Unexpectedly, the usually preferred averages over layers of constant optical depth are prone to increasing interference by reversed granulation towards higher effective temperature, in particular at low metallicity. Appendix A is available in electronic form at http://www.aanda.orgMean ⟨3D⟩ models are available at the CDS via anonymous ftp to http://cdsarc.u-strasbg.fr (ftp://130.79.128.5) or via http://cdsarc.u-strasbg.fr/viz-bin/qcat?J/A+A/560/A8 as well as at http://www.stagger-stars.net

The Validity of ITBS Reading Comprehension Test Scores for Learning Disabled and Non Learning Disabled Students under Extended-Time Conditions.

ERIC Educational Resources Information Center

Huesman, Ronald L., Jr.; Frisbie, David A.

This study investigated the effect of extended-time limits in terms of performance levels and score comparability for reading comprehension scores on the Iowa Tests of Basic Skills (ITBS). The first part of the study compared the average reading comprehension scores on the ITBS of 61 sixth-graders with learning disabilities and 397 non learning…

The utility of the KJOC score in professional baseball in the United States.

PubMed

Franz, Justin O; McCulloch, Patrick C; Kneip, Chris J; Noble, Philip C; Lintner, David M

2013-09-01

The Kerlan-Jobe Orthopaedic Clinic (KJOC) Shoulder and Elbow questionnaire has been shown by previous studies to be more sensitive than other validated subjective measurement tools in the detection of upper extremity dysfunction in overhead-throwing athletes. The primary objective was to establish normative data for KJOC scores in professional baseball players in the United States. The secondary objectives were to evaluate the effect of player age, playing position, professional competition level, history of injury, history of surgery, and time point of administration on the KJOC score. Cross-sectional study; Level of evidence, 3. From 2011 to 2012, a total of 203 major league and minor league baseball players within the Houston Astros professional baseball organization completed the KJOC questionnaire. The questionnaire was administered at 3 time points: spring training 2011, end of season 2011, and spring training 2012. The KJOC scores were analyzed for significant differences based on player age, injury history, surgery history, fielding position, competition level, self-reported playing status, and time point of KJOC administration. The average KJOC score among healthy players with no history of injury was 97.1 for major league players and 96.8 for minor league players. The time point of administration did not significantly affect the final KJOC score (P = .224), and KJOC outcomes did not vary with player age (r = -0.012; P = .867). Significantly lower average KJOC scores were reported by players with a history of upper extremity injury (86.7; P < .001) and upper extremity surgery (75.4; P < .0001). The KJOC results did vary with playing position (P = .0313), with the lowest average scores being reported by pitchers (90.9) and infielders (91.3). This study establishes a quantitative baseline for the future evaluation of professional baseball players with the KJOC score. Age and time of administration had no significant effect on the outcome of the KJOC score. Missed practices or games within the previous year because of injury were the most significant demographic predictors of lower KJOC scores. The KJOC score was shown to be a sensitive measurement tool for detecting subtle changes in the upper extremity performance of the professional baseball population studied.

Is there a complex relation between social anxiety disorder, childhood traumatic experiences and dissociation?

PubMed

Belli, Hasan; Akbudak, Mahir; Ural, Cenk; Solmaz, Mustafa; Dogan, Zuhal; Konkan, Ramazan

2017-01-01

A possible relationship has been suggested between social anxiety and dissociation. Traumatic experiences, especially childhood abuse, play an important role in the aetiology of dissociation. This study assesses childhood trauma history, dissociative symptoms, and dissociative disorder comorbidity in patients with social anxiety disorder (SAD). The 94 psychotropic drug-naive patients participating in the study had to meet DSM-IV criteria for SAD. Participants were assessed using the Structured Clinical Interview for DSM-IV Dissociative Disorders (SCID-D), the Dissociation Questionnaire (DIS-Q), the Liebowitz Social Anxiety Scale (LSAS), and the Childhood Trauma Questionnaire (CTQ). Patients were divided into two groups using the DIS-Q, and the two groups were compared. The evaluation found evidence of at least one dissociative disorder in 31.91% of participating patients. The most prevalent disorders were dissociative disorder not otherwise specified (DDNOS), dissociative amnesia, and depersonalization disorders. Average scores on LSAS and fear and avoidance sub-scale averages were significantly higher among the high DIS-Q group (p < .05). In a logistic regression taking average LSAS scores as the dependent variable, the five independent variables DIS-Q, CTQ-53 total score, emotional abuse, sexual abuse, and emotional neglect were associated with average LSAS scores among patients with SAD (p < .05). It is concluded that, on detecting SAD symptoms during hospitalization, the clinician should not neglect underlying dissociative processes and traumatic experiences among these patients.

Profile of students’ generated representations and creative thinking skill in problem solving in vocational school

NASA Astrophysics Data System (ADS)

Fikri, P. M.; Sinaga, P.; Hasanah, L.; Solehat, D.

2018-05-01

This study aims to determine profile of students’ generated representations and creative thinking skill on problem solving in vocational school. This research is a descriptive research to get an idea of comprehend students’ generated representations and creative thinking skill on problem solving of vocational school in Bandung. Technique of collecting data is done by test method, observation, and interview. Representation is something that represents, describes or symbolizes an object or process. To evaluate the multi-representation skill used essay test with rubric of scoring was used to assess multi-depressant student skills. While creative thinking skill on problem solving used essay test which contains the components of skills in finding facts, problem finding skills, idea finding skills and solution finding skills. The results showed generated representations is still relatively low, this is proven by average student answers explanation is mathematically correct but there is no explanation verbally or graphically. While creative thinking skill on problem solving is still relatively low, this is proven by average score for skill indicator in finding the student problem is 1.52 including the non-creative category, average score for the skill indicator in finding the student idea is 1.23 including the non-creative category, and the average score of the students skill in finding this solution is 0.72 belongs to a very uncreative category.

Zero-point corrections and temperature dependence of HD spin-spin coupling constants of heavy metal hydride and dihydrogen complexes calculated by vibrational averaging.

PubMed

Mort, Brendan C; Autschbach, Jochen

2006-08-09

Vibrational corrections (zero-point and temperature dependent) of the H-D spin-spin coupling constant J(HD) for six transition metal hydride and dihydrogen complexes have been computed from a vibrational average of J(HD) as a function of temperature. Effective (vibrationally averaged) H-D distances have also been determined. The very strong temperature dependence of J(HD) for one of the complexes, [Ir(dmpm)Cp*H2]2 + (dmpm = bis(dimethylphosphino)methane) can be modeled simply by the Boltzmann average of the zero-point vibrationally averaged JHD of two isomers. For this complex and four others, the vibrational corrections to JHD are shown to be highly significant and lead to improved agreement between theory and experiment in most cases. The zero-point vibrational correction is important for all complexes. Depending on the shape of the potential energy and J-coupling surfaces, for some of the complexes higher vibrationally excited states can also contribute to the vibrational corrections at temperatures above 0 K and lead to a temperature dependence. We identify different classes of complexes where a significant temperature dependence of J(HD) may or may not occur for different reasons. A method is outlined by which the temperature dependence of the HD spin-spin coupling constant can be determined with standard quantum chemistry software. Comparisons are made with experimental data and previously calculated values where applicable. We also discuss an example where a low-order expansion around the minimum of a complicated potential energy surface appears not to be sufficient for reproducing the experimentally observed temperature dependence.

Atrial rhythm influences catheter tissue contact during radiofrequency catheter ablation of atrial fibrillation: comparison of contact force between sinus rhythm and atrial fibrillation.

PubMed

Matsuda, Hisao; Parwani, Abdul Shokor; Attanasio, Philipp; Huemer, Martin; Wutzler, Alexander; Blaschke, Florian; Haverkamp, Wilhelm; Boldt, Leif-Hendrik

2016-09-01

Catheter tissue contact force (CF) is an important factor for durable lesion formation during radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF). Since CF varies in the beating heart, atrial rhythm during RFCA may influence CF. A high-density map and RFCA points were obtained in 25 patients undergoing RFCA of AF using a CF-sensing catheter (Tacticath, St. Jude Medical). The operators were blinded to the CF information. Contact type was classified into three categories: constant, variable, and intermittent contact. Average CF and contact type were analyzed according to atrial rhythm (SR vs. AF) and anatomical location. A total of 1364 points (891 points during SR and 473 points during AF) were analyzed. Average CFs showed no significant difference between SR (17.2 ± 11.3 g) and AF (17.2 ± 13.3 g; p = 0.99). The distribution of points with an average CF of ≥20 and <10 g also showed no significant difference. However, the distribution of excessive CF (CF ≥40 g) was significantly higher during AF (7.4 %) in comparison with SR (4.2 %; p < 0.05). At the anterior area of the right inferior pulmonary vein (RIPV), the average CF during AF was significantly higher than during SR (p < 0.05). Constant contact was significantly higher during AF (32.2 %) when compared to SR (9.9 %; p < 0.01). Although the average CF was not different between atrial rhythms, constant contact was more often achievable during AF than it was during SR. However, excessive CF also seems to occur more frequently during AF especially at the anterior part of RIPV.

Effects of correlations and fees in random multiplicative environments: Implications for portfolio management.

PubMed

Alper, Ofer; Somekh-Baruch, Anelia; Pirvandy, Oz; Schaps, Malka; Yaari, Gur

2017-08-01

Geometric Brownian motion (GBM) is frequently used to model price dynamics of financial assets, and a weighted average of multiple GBMs is commonly used to model a financial portfolio. Diversified portfolios can lead to an increased exponential growth compared to a single asset by effectively reducing the effective noise. The sum of GBM processes is no longer a log-normal process and has a complex statistical properties. The nonergodicity of the weighted average process results in constant degradation of the exponential growth from the ensemble average toward the time average. One way to stay closer to the ensemble average is to maintain a balanced portfolio: keep the relative weights of the different assets constant over time. To keep these proportions constant, whenever assets values change, it is necessary to rebalance their relative weights, exposing this strategy to fees (transaction costs). Two strategies that were suggested in the past for cases that involve fees are rebalance the portfolio periodically and rebalance it in a partial way. In this paper, we study these two strategies in the presence of correlations and fees. We show that using periodic and partial rebalance strategies, it is possible to maintain a steady exponential growth while minimizing the losses due to fees. We also demonstrate how these redistribution strategies perform in a phenomenal way on real-world market data, despite the fact that not all assumptions of the model hold in these real-world systems. Our results have important implications for stochastic dynamics in general and to portfolio management in particular, as we show that there is a superior alternative to the common buy-and-hold strategy, even in the presence of correlations and fees.

Effects of correlations and fees in random multiplicative environments: Implications for portfolio management

NASA Astrophysics Data System (ADS)

Alper, Ofer; Somekh-Baruch, Anelia; Pirvandy, Oz; Schaps, Malka; Yaari, Gur

2017-08-01

Geometric Brownian motion (GBM) is frequently used to model price dynamics of financial assets, and a weighted average of multiple GBMs is commonly used to model a financial portfolio. Diversified portfolios can lead to an increased exponential growth compared to a single asset by effectively reducing the effective noise. The sum of GBM processes is no longer a log-normal process and has a complex statistical properties. The nonergodicity of the weighted average process results in constant degradation of the exponential growth from the ensemble average toward the time average. One way to stay closer to the ensemble average is to maintain a balanced portfolio: keep the relative weights of the different assets constant over time. To keep these proportions constant, whenever assets values change, it is necessary to rebalance their relative weights, exposing this strategy to fees (transaction costs). Two strategies that were suggested in the past for cases that involve fees are rebalance the portfolio periodically and rebalance it in a partial way. In this paper, we study these two strategies in the presence of correlations and fees. We show that using periodic and partial rebalance strategies, it is possible to maintain a steady exponential growth while minimizing the losses due to fees. We also demonstrate how these redistribution strategies perform in a phenomenal way on real-world market data, despite the fact that not all assumptions of the model hold in these real-world systems. Our results have important implications for stochastic dynamics in general and to portfolio management in particular, as we show that there is a superior alternative to the common buy-and-hold strategy, even in the presence of correlations and fees.

Parents' Reactions to Finding Out That Their Children Have Average or above Average IQ Scores.

ERIC Educational Resources Information Center

Dirks, Jean; And Others

1983-01-01

Parents of 41 children who had been given an individually-administered intelligence test were contacted 19 months after testing. Parents of average IQ children were less accurate in their memory of test results. Children with above average IQ experienced extremely low frequencies of sibling rivalry, conceit or pressure. (Author/HLM)

Spike-frequency adaptation in the inferior colliculus.

PubMed

Ingham, Neil J; McAlpine, David

2004-02-01

We investigated spike-frequency adaptation of neurons sensitive to interaural phase disparities (IPDs) in the inferior colliculus (IC) of urethane-anesthetized guinea pigs using a stimulus paradigm designed to exclude the influence of adaptation below the level of binaural integration. The IPD-step stimulus consists of a binaural 3,000-ms tone, in which the first 1,000 ms is held at a neuron's least favorable ("worst") IPD, adapting out monaural components, before being stepped rapidly to a neuron's most favorable ("best") IPD for 300 ms. After some variable interval (1-1,000 ms), IPD is again stepped to the best IPD for 300 ms, before being returned to a neuron's worst IPD for the remainder of the stimulus. Exponential decay functions fitted to the response to best-IPD steps revealed an average adaptation time constant of 52.9 +/- 26.4 ms. Recovery from adaptation to best IPD steps showed an average time constant of 225.5 +/- 210.2 ms. Recovery time constants were not correlated with adaptation time constants. During the recovery period, adaptation to a 2nd best-IPD step followed similar kinetics to adaptation during the 1st best-IPD step. The mean adaptation time constant at stimulus onset (at worst IPD) was 34.8 +/- 19.7 ms, similar to the 38.4 +/- 22.1 ms recorded to contralateral stimulation alone. Individual time constants after stimulus onset were correlated with each other but not with time constants during the best-IPD step. We conclude that such binaurally derived measures of adaptation reflect processes that occur above the level of exclusively monaural pathways, and subsequent to the site of primary binaural interaction.

Writing, self-reflection, and medical school performance: the Human Context of Health Care.

PubMed

Stephens, Mark B; Reamy, Brian V; Anderson, Denise; Olsen, Cara; Hemmer, Paul A; Durning, Steven J; Auster, Simon

2012-09-01

Finding ways to improve communication and self-reflection skills is an important element of medical education and continuing professional development. This study examines the relationship between self-reflection and educational outcomes. We correlate performance in a preclinical course that focuses on self-reflection as it relates to contextual elements of patient care (Human Context of Health Care), with educational measures such as overall grade point average, clinical clerkship scores, and Medical College Admission Test (MCAT) scores. Student performance in Human Context of Health Care correlated with MCAT-Verbal scores, MCAT-writing sample scores, clerkship grades, and overall medical school grade point average (R = 0.3; p < 0.001). Writing and self-reflection skills are often neglected in undergraduate medical curricula. Our findings suggest that these skills are important and correlate with recognized long-term educational outcomes.

Outcome Analysis of Intra-Articular Scapula Fracture Fixation with Distal Radius Plate: A Multicenter Prospective Study.

PubMed

Panigrahi, Ranajit; Madharia, Divya; Das, Dibya Singha; Samant, Saswat; Biswal, Manas Ranjan

2016-12-01

Scapula fractures occur in approximately 1% of all fractures and constitute about 3% - 5% of all injuries of the shoulder joint. This study aimed to evaluate the clinical outcomes of 20 surgically treated patients with displaced glenoid fractures after stabilization with distal radius plate. Between 2012 and 2015, at 2 centers (HMCH & SHCE) of Bhubaneswar Odisha, we stabilized 20 scapular intra-articular fractures surgically with distal radius locking plate and studied the outcome of the surgeries. The outcome of the 20 fractures was determined using the Constant and Murley score. Both shoulders were assessed and the score on the injured side was given as a percentage of that on the uninjured side. The median score was 88% (mean 65%, range 30 to 100). The median score for strength was 21/25 (mean 19, range 0 to 25) and that for pain 11/15 (mean 11, range 5 to 15). The median functional score was 16/20 (mean 15, range 0 to 20). The mean range of active abduction of the shoulder was 135° (20 to 180), the mean range of flexion 138° (20 to 180) and the mean range of external rotation 38° (0 to 100). Five patients showed excellent result; 11 patients showed good result; three patients showed fair result and one patient had poor outcome according to the Constant-Murley score. A superficial infection settled with antibiotics after operation in one patient whose score at final follow-up was 96%. In one patient, delayed healing was reported because of infection. One patient with stiffness of the shoulder at six weeks underwent manipulation under anesthesia with a follow-up score of 81%. Various fixation modalities have been described in the literature, however fixation of intra-articular fracture of glenoid with distal radius locking plate for articular reconstruction in the presented series provides good functional outcome with early restoration of the range of motion of the shoulder.

Medialized repair for retracted rotator cuff tears.

PubMed

Kim, Young-Kyu; Jung, Kyu-Hak; Won, Jun-Sung; Cho, Seung-Hyun

2017-08-01

The purpose of this study was to evaluate the functional outcomes of medialized rotator cuff repair and the continuity of repaired tendon in chronic retracted rotator cuff tears. Thirty-five consecutive patients were selected from 153 cases that underwent arthroscopic rotator cuff repair for more than medium-sized posterosuperior rotator cuff tears between July 2009 and July 2012 performed with the medialized repair. All cases were available for at least 2 years of postoperative follow-up. The visual analog scale of pain, muscle strength, Constant score, American Shoulder and Elbow Surgeons (ASES) score, and University of California-Los Angeles score were evaluated. At the final follow-up, all clinical outcomes were significantly improved. The visual analog scale score for pain improved from 6 ± 1 preoperatively to 2 ± 1 postoperatively. The range of motion increased from preoperatively to postoperatively: active forward elevation, from 134° ± 49° to 150° ± 16°; active external rotation at the side, from 47° ± 15° to 55° ± 10°; and active internal rotation, from L3 to L1. The shoulder score also improved: Constant score, from 53.5 ± 16.7 to 79 ± 10; American Shoulder and Elbow Surgeons score, from 51 ± 15 to 82 ± 8; and University of California-Los Angeles score, from 14 ± 4 to 28 ± 4. The retear cases at the final follow-up were 6 (17%). Medialized repair may be useful in cases in which anatomic bone-to-tendon repair would be difficult because of the excessive tension of the repaired tendon and a torn tendon that does not reach the anatomic insertion. Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Minimally Invasive Osteosynthesis with a Bridge Plate Versus a Functional Brace for Humeral Shaft Fractures: A Randomized Controlled Trial.

PubMed

Matsunaga, Fabio Teruo; Tamaoki, Marcel Jun Sugawara; Matsumoto, Marcelo Hide; Netto, Nicola Archetti; Faloppa, Flavio; Belloti, Joao Carlos

2017-04-05

Nonoperative treatment has historically been considered the standard for fractures of the shaft of the humerus. Minimally invasive bridge-plate osteosynthesis for isolated humeral shaft fractures has been proven to be a safe technique, with good and reproducible results. This study was designed to compare clinical and radiographic outcomes between patients who had been treated with bridge plate osteosynthesis and those who had been managed nonoperatively with a functional brace. A prospective randomized trial was designed and included 110 patients allocated to 1 of 2 groups: surgery with a bridge plate or nonoperative treatment with a functional brace. The primary outcome was the Disabilities of the Arm, Shoulder and Hand (DASH) score at 6 months. The score on the Short Form-36 (SF-36) life-quality questionnaire, complications of treatment, Constant-Murley score for the shoulder, pain level, and radiographic results were assessed as secondary outcomes. Participants were assessed at 2 weeks; 1, 2, and 6 months; and 1 year after the interventions. The mean DASH score of the bridge plate group was statistically superior to that of the functional brace group (mean scores, 10.9 and 16.9, respectively; p = 0.046) only at 6 months. The bridge plate group also had a significantly more favorable nonunion rate (0% versus 15%) and less mean residual angular displacement seen on the anteroposterior radiograph (2.0° versus 10.5°) (both p < 0.05). No difference between the groups was detected with regard to the SF-36 score, pain level, Constant-Murley score, or angular displacement seen on the lateral radiograph. This trial demonstrates that, compared with functional bracing, surgical treatment with a bridge plate has a statistically significant advantage, of uncertain clinical benefit, with respect to self-reported outcome (DASH score) at 6 months, nonunion rate, and residual deformity in the coronal plane as seen on radiographs. Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

Comparing Vibrationally Averaged Nuclear Shielding Constants by Quantum Diffusion Monte Carlo and Second-Order Perturbation Theory.

PubMed

Ng, Yee-Hong; Bettens, Ryan P A

2016-03-03

Using the method of modified Shepard's interpolation to construct potential energy surfaces of the H2O, O3, and HCOOH molecules, we compute vibrationally averaged isotropic nuclear shielding constants ⟨σ⟩ of the three molecules via quantum diffusion Monte Carlo (QDMC). The QDMC results are compared to that of second-order perturbation theory (PT), to see if second-order PT is adequate for obtaining accurate values of nuclear shielding constants of molecules with large amplitude motions. ⟨σ⟩ computed by the two approaches differ for the hydrogens and carbonyl oxygen of HCOOH, suggesting that for certain molecules such as HCOOH where big displacements away from equilibrium happen (internal OH rotation), ⟨σ⟩ of experimental quality may only be obtainable with the use of more sophisticated and accurate methods, such as quantum diffusion Monte Carlo. The approach of modified Shepard's interpolation is also extended to construct shielding constants σ surfaces of the three molecules. By using a σ surface with the equilibrium geometry as a single data point to compute isotropic nuclear shielding constants for each descendant in the QDMC ensemble representing the ground state wave function, we reproduce the results obtained through ab initio computed σ to within statistical noise. Development of such an approach could thereby alleviate the need for any future costly ab initio σ calculations.

Temporal Context in Concurrent Chains: I. Terminal-Link Duration

ERIC Educational Resources Information Center

Grace, Randolph C.

2004-01-01

Two experiments are reported in which the ratio of the average times spent in the terminal and initial links ("Tt/Ti") in concurrent chains was varied. In Experiment 1, pigeons responded in a three-component procedure in which terminal-link variable-interval schedules were in constant ratio, but their average duration increased across components…

Elastic properties of uniaxial-fiber reinforced composites - General features

NASA Astrophysics Data System (ADS)

Datta, Subhendu; Ledbetter, Hassel; Lei, Ming

The salient features of the elastic properties of uniaxial-fiber-reinforced composites are examined by considering the complete set of elastic constants of composites comprising isotropic uniaxial fibers in an isotropic matrix. Such materials exhibit transverse-isotropic symmetry and five independent elastic constants in Voigt notation: C(11), C(33), C(44), C(66), and C(13). These C(ij) constants are calculated over the entire fiber-volume-fraction range 0.0-1.0, using a scattered-plane-wave ensemple-average model. Some practical elastic constants such as the principal Young moduli and the principal Poisson ratios are considered, and the behavior of these constants is discussed. Also presented are the results for the four principal sound velocities used to study uniaxial-fiber-reinforced composites: v(11), v(33), v(12), and v(13).

Simulation-based medical education training improves short and long-term competency in, and knowledge of central venous catheter insertion: A before and after intervention study.

PubMed

Cartier, Vanessa; Inan, Cigdem; Zingg, Walter; Delhumeau, Cecile; Walder, Bernard; Savoldelli, Georges L

2016-08-01

Multimodal educational interventions have been shown to improve short-term competency in, and knowledge of central venous catheter (CVC) insertion. To evaluate the effectiveness of simulation-based medical education training in improving short and long-term competency in, and knowledge of CVC insertion. Before and after intervention study. University Geneva Hospital, Geneva, Switzerland, between May 2008 and January 2012. Residents in anaesthesiology aware of the Seldinger technique for vascular puncture. Participants attended a half-day course on CVC insertion. Learning objectives included work organization, aseptic technique and prevention of CVC complications. CVC insertion competency was tested pretraining, posttraining and then more than 2 years after training (sustainability phase). The primary study outcome was competency as measured by a global rating scale of technical skills, a hand hygiene compliance score and a checklist compliance score. Secondary outcome was knowledge as measured by a standardised pretraining and posttraining multiple-choice questionnaire. Statistical analyses were performed using paired Student's t test or Wilcoxon signed-rank test. Thirty-seven residents were included; 18 were tested in the sustainability phase (on average 34 months after training). The average global rating of skills was 23.4 points (±SD 4.08) before training, 32.2 (±4.51) after training (P < 0.001 for comparison with pretraining scores) and 26.5 (±5.34) in the sustainability phase (P = 0.040 for comparison with pretraining scores). The average hand hygiene compliance score was 2.8 (±1.0) points before training, 5.0 (±1.04) after training (P < 0.001 for comparison with pretraining scores) and 3.7 (±1.75) in the sustainability phase (P = 0.038 for comparison with pretraining scores). The average checklist compliance was 14.9 points (±2.3) before training, 19.9 (±1.06) after training (P < 0.001 for comparison with pretraining scores) and 17.4 (±1.41) (P = 0.002 for comparison with pretraining scores). The percentage of correct answers in the multiple-choice questionnaire increased from 76.0% (±7.9) before training to 87.7% (±4.4) after training (P < 0.001). Simulation-based medical education training was effective in improving short and long-term competency in, and knowledge of CVC insertion.

Effects of packaging and heat transfer kinetics on drug-product stability during storage under uncontrolled temperature conditions.

PubMed

Nakamura, Toru; Yamaji, Takayuki; Takayama, Kozo

2013-05-01

To predict the stability of pharmaceutical preparations under uncontrolled temperature conditions accurately, a method to compute the average reaction rate constant taking into account the heat transfer from the atmosphere to the product was developed. The average reaction rate constants computed with taken into consideration heat transfer (κ(re) ) were then compared with those computed without taking heat transfer into consideration (κ(in) ). The apparent thermal diffusivity (κ(a) ) exerted some influence on the average reaction rate constant ratio (R, R = κ(re) /κ(in) ). In the regions where the κ(a) was large (above 1 h(-1) ) or very small, the value of R was close to 1. On the contrary, in the middle region (0.001-1 h(-1) ), the value of R was less than 1.The κ(a) of the central part of a large-size container and that of the central part of a paper case of 10 bottles of liquid medicine (100 mL) fell within this middle region. On the basis of the above-mentioned considerations, heat transfer may need to be taken into consideration to enable a more accurate prediction of the stability of actual pharmaceutical preparations under nonisothermal atmospheres. Copyright © 2013 Wiley Periodicals, Inc.

Predicting Success for Actuarial Students in Undergraduate Mathematics Courses

ERIC Educational Resources Information Center

Smith, Richard Manning; Schumacher, Phyllis A.

2005-01-01

A study of undergraduate actuarial graduates found that math SAT scores, verbal SAT scores, percentile rank in high school graduating class, and percentage score on a college mathematics placement exam had some relevance to forecasting the students' grade point averages in their major. For both males and females, percentile rank in high school…

A Comparison of Item-Level and Scale-Level Multiple Imputation for Questionnaire Batteries

ERIC Educational Resources Information Center

Gottschall, Amanda C.; West, Stephen G.; Enders, Craig K.

2012-01-01

Behavioral science researchers routinely use scale scores that sum or average a set of questionnaire items to address their substantive questions. A researcher applying multiple imputation to incomplete questionnaire data can either impute the incomplete items prior to computing scale scores or impute the scale scores directly from other scale…

Biologic resurfacing arthroplasty with acellular human dermal allograft and platelet-rich plasma (PRP) in young patients with glenohumeral arthritis-average of 60 months of at mid-term follow-up.

PubMed

Lo, Eddie Y; Flanagin, Brody A; Burkhead, Wayne Z

2016-07-01

The treatment of young patients with glenohumeral arthritis has been challenging. Alternative treatment options include activity modification, arthroscopic débridement, and arthroplasty. Addressing the glenoid during arthroplasty in this population of patients continues to be a significant challenge. In this study, we evaluated the midterm outcomes of hemiarthroplasty with biologic resurfacing of the glenoid with human dermal matrix allograft. Between 2004 and 2011, 55 patients underwent hemiarthroplasty and biologic resurfacing of the glenoid with human dermal matrix allograft. The average age was 50 ± 9 years. Subjective evaluation was performed with the Western Ontario Osteoarthritis of the Shoulder Index, American Shoulder and Elbow Surgeons score, visual analog scale, and Single Assessment Numeric Evaluation. Patients returned to the clinic for clinical examination and radiographic evaluation. The average follow-up was 60 months. The average postoperative American Shoulder and Elbow Surgeons score was 76 ± 22, and the Western Ontario Osteoarthritis of the Shoulder Index score was 76% ± 22%. The visual analog scale score was 2.4 ± 2.6. The average preoperative Single Assessment Numeric Evaluation score was 33% ± 22%, which significantly improved to 72% ± 22% postoperatively. Eighty-one percent of the patients were satisfied (10/47) or highly satisfied (28/47) with their result. With radiographic evaluation, the average joint space was 1 ± 1 mm preoperatively and 2 ± 1 mm postoperatively. A total of 5 cases (9.1%) were revised to anatomic total shoulder arthroplasty with implantation of a glenoid component. Hemiarthroplasty with biologic resurfacing of the glenoid using human dermal matrix allograft can lead to successful midterm outcomes with satisfactory complication and revision rates. Both patient satisfaction and clinical outcome remain high regardless of radiographic outcome. Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Rogue waves of the Kundu-Eckhaus equation in a chaotic wave field.

PubMed

Bayindir, Cihan

2016-03-01

In this paper we study the properties of the chaotic wave fields generated in the frame of the Kundu-Eckhaus equation (KEE). Modulation instability results in a chaotic wave field which exhibits small-scale filaments with a free propagation constant, k. The average velocity of the filaments is approximately given by the average group velocity calculated from the dispersion relation for the plane-wave solution; however, direction of propagation is controlled by the β parameter, the constant in front of the Raman-effect term. We have also calculated the probabilities of the rogue wave occurrence for various values of propagation constant k and showed that the probability of rogue wave occurrence depends on k. Additionally, we have showed that the probability of rogue wave occurrence significantly depends on the quintic and the Raman-effect nonlinear terms of the KEE. Statistical comparisons between the KEE and the cubic nonlinear Schrödinger equation have also been presented.

[Drying characteristics and apparent change of sludge granules during drying].

PubMed

Ma, Xue-Wen; Weng, Huan-Xin; Zhang, Jin-Jun

2011-08-01

Three different weight grades of sludge granules (2.5, 5, 10 g) were dried at constant temperature of 100, 200, 300, 400 and 500 degrees C, respectively. Then characteristics of weight loss and change of apparent form during sludge drying were analyzed. Results showed that there were three stages during sludge drying at 100-200 degrees C: acceleration phase, constant-rate phase, and falling-rate phase. At 300-500 degrees C, there were no constant-rate phase, but due to lots of cracks generated at sludge surface, average drying rates were still high. There was a quadratic nonlinear relationship between average drying rate and drying temperature. At 100-200 degrees C, drying processes of different weight grade sludge granules were similar. At 300-500 degrees C, drying processes of same weight grade of sludge granules were similar. Little organic matter decomposed till sludge burning at 100-300 degrees C, while some organic matter began to decompose at the beginning of sludge drying at 400-500 degrees C.

Heuristic approach to capillary pressures averaging

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

Coca, B.P.

1980-10-01

Several methods are available to average capillary pressure curves. Among these are the J-curve and regression equations of the wetting-fluid saturation in porosity and permeability (capillary pressure held constant). While the regression equation seem completely empiric, the J-curve method seems to be theoretically sound due to its expression based on a relation between the average capillary radius and the permeability-porosity ratio. An analysis is given of each of these methods.

[The effectiveness of smoking cessation program in a workplace with high risk].

PubMed

Coşkun Beyan, Ayşe; Varol, Yelda

2016-06-01

Initiatives for smoking cessation (SC) at workplace have become more prominent due to both health and safety risks associated with smoking. We aimed to determine 6-month successful SC rates of a group of employees who participated in a SC program as they worked in a workplace that exhibited high risk of fire and explosion. Having delivered a compulsory smoking training to the paint manufacturing department with 276 employees, we invited 147 smoker employees to participate in a SC initiative (SCI) program. The SCI program was implemented by the occupational health and safety (OHS) staff. Employees were administered a self-reported questionnaire including the age at starting smoking, number of cigarettes smoked (pack years), family members' attitudes towards smoking, reasons for smoking and harms of smoking. Nicotine addiction levels were assessed with Fagerström Nicotine Dependence Test (FNDT). 276 employees (270 male and 6 female) had an average age of 36.8 ± 8.4 years. 144 active smokers presented an average age of 38.4 ± 6.9 and smoked on average 18.5 ± 12.8 pack/year. Active smokers started smoking at the age of 19.8 ± 4.9 on average. Their average score in FNDT was 6.6 ± 1.9 points. Fifty-one (35.4%) employees participated in the SCIs. The participants in the SCP training exhibited statistically significant differences with respect to the following parameters: chronic disease (p= 0.03), pack/year (p< 0.001), age at starting smoking (p= 0.001), attempted methods to SC (p= 0.002), average score in self-reported harms of smoking (p< 0.001), average FNDT score (p< 0.001), average score of self-reported smoking addiction (p= 0.001), and whether the smoker considers smoking a means of socialization (p≤ 0.001). After six months, we observed that 12 (23%) of the participants, and 4 (4%) of the non-participants employees quitted smoking (p< 0.001). In our study, participants in the SCI exhibited higher SC rates compared to the non-participants. Further studies are required to standardize such initiatives, which improve occupational health.

Stiffness and relaxation components of the exponential and logistic time constants may be used to derive a load-independent index of isovolumic pressure decay.

PubMed

Shmuylovich, Leonid; Kovács, Sándor J

2008-12-01

In current practice, empirical parameters such as the monoexponential time constant tau or the logistic model time constant tauL are used to quantitate isovolumic relaxation. Previous work indicates that tau and tauL are load dependent. A load-independent index of isovolumic pressure decline (LIIIVPD) does not exist. In this study, we derive and validate a LIIIVPD. Recently, we have derived and validated a kinematic model of isovolumic pressure decay (IVPD), where IVPD is accurately predicted by the solution to an equation of motion parameterized by stiffness (Ek), relaxation (tauc), and pressure asymptote (Pinfinity) parameters. In this study, we use this kinematic model to predict, derive, and validate the load-independent index MLIIIVPD. We predict that the plot of lumped recoil effects [Ek.(P*max-Pinfinity)] versus resistance effects [tauc.(dP/dtmin)], defined by a set of load-varying IVPD contours, where P*max is maximum pressure and dP/dtmin is the minimum first derivative of pressure, yields a linear relation with a constant (i.e., load independent) slope MLIIIVPD. To validate the load independence, we analyzed an average of 107 IVPD contours in 25 subjects (2,669 beats total) undergoing diagnostic catheterization. For the group as a whole, we found the Ek.(P*max-Pinfinity) versus tauc.(dP/dtmin) relation to be highly linear, with the average slope MLIIIVPD=1.107+/-0.044 and the average r2=0.993+/-0.006. For all subjects, MLIIIVPD was found to be linearly correlated to the subject averaged tau (r2=0.65), tauL(r2=0.50), and dP/dtmin (r2=0.63), as well as to ejection fraction (r2=0.52). We conclude that MLIIIVPD is a LIIIVPD because it is load independent and correlates with conventional IVPD parameters. Further validation of MLIIIVPD in selected pathophysiological settings is warranted.

Prospective study of Dietary Approaches to Stop Hypertension- and Mediterranean-style dietary patterns and age-related cognitive change: the Cache County Study on Memory, Health and Aging.

PubMed

Wengreen, Heidi; Munger, Ronald G; Cutler, Adele; Quach, Anna; Bowles, Austin; Corcoran, Christopher; Tschanz, Joann T; Norton, Maria C; Welsh-Bohmer, Kathleen A

2013-11-01

Healthy dietary patterns may protect against age-related cognitive decline, but results of studies have been inconsistent. We examined associations between Dietary Approaches to Stop Hypertension (DASH)- and Mediterranean-style dietary patterns and age-related cognitive change in a prospective, population-based study. Participants included 3831 men and women ≥65 y of age who were residents of Cache County, UT, in 1995. Cognitive function was assessed by using the Modified Mini-Mental State Examination (3MS) ≤4 times over 11 y. Diet-adherence scores were computed by summing across the energy-adjusted rank-order of individual food and nutrient components and categorizing participants into quintiles of the distribution of the diet accordance score. Mixed-effects repeated-measures models were used to examine 3MS scores over time across increasing quintiles of dietary accordance scores and individual food components that comprised each score. The range of rank-order DASH and Mediterranean diet scores was 1661-25,596 and 2407-26,947, respectively. Higher DASH and Mediterranean diet scores were associated with higher average 3MS scores. People in quintile 5 of DASH averaged 0.97 points higher than those in quintile 1 (P = 0.001). The corresponding difference for Mediterranean quintiles was 0.94 (P = 0.001). These differences were consistent over 11 y. Higher intakes of whole grains and nuts and legumes were also associated with higher average 3MS scores [mean quintile 5 compared with 1 differences: 1.19 (P < 0.001), 1.22 (P < 0.001), respectively]. Higher levels of accordance with both the DASH and Mediterranean dietary patterns were associated with consistently higher levels of cognitive function in elderly men and women over an 11-y period. Whole grains and nuts and legumes were positively associated with higher cognitive functions and may be core neuroprotective foods common to various healthy plant-centered diets around the globe.

Evaluation of gastric emptying time, gastrointestinal transit time, sedation score, and nausea score associated with intravenous constant rate infusion of lidocaine hydrochloride in clinically normal dogs.

PubMed

Johnson, Rebecca A; Kierski, Katharine R; Jones, Brian G

2017-05-01

OBJECTIVE To quantify nausea and sedation scores, gastric emptying time, and gastrointestinal transit time after IV administration of a lidocaine hydrochloride bolus followed by a constant rate infusion (CRI) in clinically normal dogs. ANIMALS 6 Beagles. PROCEDURES In a crossover study, dogs were fed thirty 1.5-mm barium-impregnated spheres (BIPS) and received a saline (0.9% NaCl) solution bolus (0.05 mL/kg) IV (time 0) followed by a CRI at 10 mL/h, a lidocaine bolus (1 mg/kg) IV followed by a CRI at 25 μg/kg/min, or a lidocaine bolus (1 mg/kg) IV followed by a CRI at 50 μg/kg/min; CRIs were for 12 hours. Nausea and sedation scores were assessed and abdominal radiographs obtained immediately after feeding of BIPS and every hour for 12 hours and again 16 hours after CRI start. Percentage of BIPSs in the small and large intestines, gastric emptying time, and gastrointestinal transit time were assessed. RESULTS Gastric emptying time did not differ significantly among treatments. Significantly more BIPS were in the large intestine 4 to 7 hours after treatment start for the 50-μg/kg/min treatment than for the other 2 treatments. Six hours after treatment start, significantly more BIPS were in the large intestine for the 25-μg/kg/min treatment than for the saline solution treatment. Higher sedation and nausea scores were associated with the 50-μg/kg/min CRI. CONCLUSIONS AND CLINICAL RELEVANCE In clinically normal dogs, lidocaine CRI did not significantly affect gastric emptying. However, gastrointestinal transit time was mildly decreased and sedation and nausea scores increased in dogs administered a lidocaine CRI at clinically used doses.

A Midterm Evaluation of Postoperative Platelet-Rich Plasma Injections on Arthroscopic Supraspinatus Repair: A Randomized Controlled Trial.

PubMed

Ebert, Jay R; Wang, Allan; Smith, Anne; Nairn, Robert; Breidahl, William; Zheng, Ming Hao; Ackland, Timothy

2017-11-01

Platelet-rich plasma (PRP) has been applied as an adjunct to rotator cuff repair to improve tendon-bone healing and potentially reduce the incidence of subsequent tendon retears. To investigate whether the midterm clinical and radiographic outcomes of arthroscopic supraspinatus repair are enhanced after repeated postoperative applications of PRP. Randomized controlled trial; Level of evidence, 1. A total of 60 patients (30 control; 30 PRP) were initially randomized to receive 2 ultrasound-guided injections of PRP to the tendon repair site at 7 and 14 days after double-row arthroscopic supraspinatus repair or not. A total of 55 patients (91.7%) underwent a clinical review and magnetic resonance imaging (MRI) at a mean of 3.5 years after surgery (range, 36-51 months). Patient-reported outcome measures (PROMs) included the Constant score, Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire, Oxford Shoulder Score (OSS), and visual analog scale (VAS) for pain. Global rating of change (GRC) scale and patient satisfaction scores were evaluated. Structural integrity of the surgical repair was assessed via MRI using the Sugaya classification system. At the midterm review, there was no difference between the groups for any of the PROMs. No differences between the groups were demonstrated for the subjective and range of motion subscales of the Constant score, although a significantly higher Constant strength subscale score was observed in the PRP group (3.3 points; 95% CI, 1.0-5.7; P = .006). There was no evidence for any group differences in MRI scores or retear rates, with 66.7% of PRP patients and 64.3% of control patients rated as Sugaya grade 1. Two control patients had symptomatic retears (both full thickness) within the first 16 weeks after surgery compared with 2 PRP patients, who suffered symptomatic retears (both partial thickness) between 16 weeks and a mean 3.5-year follow-up. Significant postoperative clinical improvements and high levels of patient satisfaction were observed in patients at the midterm review after supraspinatus repair. While pain-free, maximal abduction strength was greater in the midterm after PRP treatment, repeated applications of PRP delivered at 7 and 14 days after surgery provided no additional benefit to tendon integrity.

Decreased shoulder function and pain common in recreational badminton players.

PubMed

Fahlström, M; Söderman, K

2007-06-01

The aim of this study was to describe the prevalence and consequences of painful conditions in the shoulder region in recreational badminton players. A questionnaire study was performed on 99 players, of whom 57 were also assessed with Constant score. Previous or present pain in the dominant shoulder was reported by 52% of the players. Sixteen percent of the players had on-going shoulder pain associated with badminton play. A majority of these players reported that their training habits were affected by the pain. Total Constant score was lower in the painful shoulders. Furthermore, range of active pain-free shoulder abduction was decreased. However, isometric shoulder strength test showed no differences when compared with pain-free shoulders. Even though the pain caused functional problems, the players were still playing with on-going symptoms. The diagnoses were mostly unknown, although history and clinical tests indicate problems resembling subacromial impingement.

Arthroscopic procedures for the treatment of anterior shoulder instability: local experiences.

PubMed

Choi, S T; Tse, P Y T

2005-04-01

To review the outcomes of arthroscopic stabilisation procedures for the treatment of recurrent anterior shoulder dislocation. Retrospective study. Regional hospital, Hong Kong. Patients receiving arthroscopic stabilisation procedures for recurrent anterior shoulder dislocation between 1999 and 2003. Functional outcomes including pain, range of motion, and activity level were assessed using the Constant score. Intra-operative findings were also discussed. A total of 18 arthroscopic stabilisation procedures were performed for the treatment of recurrent shoulder instability. Two cases converted to open procedures were excluded from this review. The overall outcomes were good and seven patients reported a full recovery. Fourteen out of 16 patients reported minimal or no pain, and the mean Constant score was 80. There were no cases of re-dislocation and no major complication was noted. All the reviewed patients had a satisfactory functional recovery. Therefore, we believe that the use of arthroscopic stabilisation procedure can produce a favourable outcome for appropriate shoulder pathologies.

SEX DIFFERENCES ON THE WECHSLER INTELLIGENCE SCALE FOR CHILDREN-III IN BAHRAIN AND THE UNITED STATES.

PubMed

Bakhiet, Salaheldin Farah Attallah; Lynn, Richard

2015-12-01

Sex differences on the Wechsler Intelligence Scale for Children-III (WISC-III) are reported for children in Bahrain and the United States. The results for the two samples were consistent in showing no significant differences in Verbal, Performance, and Full Scale IQs, higher average scores by boys on the Block design and Mazes subtests of spatial ability, and higher average scores by girls on Coding. There was also greater variability in boys than in girls.

Personality Factors in the Long Life Family Study

PubMed Central

2013-01-01

Objectives. To evaluate personality profiles of Long Life Family Study participants relative to population norms and offspring of centenarians from the New England Centenarian Study. Method. Personality domains of agreeableness, conscientiousness, extraversion, neuroticism, and openness were assessed with the NEO Five-Factor Inventory in 4,937 participants from the Long Life Family Study (mean age 70 years). A linear mixed model of age and gender was implemented adjusting for other covariates. Results. A significant age trend was found in all five personality domains. On average, the offspring generation of long-lived families scored low in neuroticism, high in extraversion, and within average values for the other three domains. Older participants tended to score higher in neuroticism and lower in the other domains compared with younger participants, but the estimated scores generally remained within average population values. No significant differences were found between long-lived family members and their spouses. Discussion. Personality factors and more specifically low neuroticism and high extraversion may be important for achieving extreme old age. In addition, personality scores of family members were not significantly different from those of their spouses, suggesting that environmental factors may play a significant role in addition to genetic factors. PMID:23275497

Distribution Development for STORM Ingestion Input Parameters

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

Fulton, John

The Sandia-developed Transport of Radioactive Materials (STORM) code suite is used as part of the Radioisotope Power System Launch Safety (RPSLS) program to perform statistical modeling of the consequences due to release of radioactive material given a launch accident. As part of this modeling, STORM samples input parameters from probability distributions with some parameters treated as constants. This report described the work done to convert four of these constant inputs (Consumption Rate, Average Crop Yield, Cropland to Landuse Database Ratio, and Crop Uptake Factor) to sampled values. Consumption rate changed from a constant value of 557.68 kg / yr tomore » a normal distribution with a mean of 102.96 kg / yr and a standard deviation of 2.65 kg / yr. Meanwhile, Average Crop Yield changed from a constant value of 3.783 kg edible / m 2 to a normal distribution with a mean of 3.23 kg edible / m 2 and a standard deviation of 0.442 kg edible / m 2 . The Cropland to Landuse Database ratio changed from a constant value of 0.0996 (9.96%) to a normal distribution with a mean value of 0.0312 (3.12%) and a standard deviation of 0.00292 (0.29%). Finally the crop uptake factor changed from a constant value of 6.37e -4 (Bq crop /kg)/(Bq soil /kg) to a lognormal distribution with a geometric mean value of 3.38e -4 (Bq crop /kg)/(Bq soil /kg) and a standard deviation value of 3.33 (Bq crop /kg)/(Bq soil /kg)« less

12 CFR 3.41 - Operational requirements for securitization exposures.

Code of Federal Regulations, 2014 CFR

2014-01-01

... loans 30, 60, and 90 days past due; default rates; prepayment rates; loans in foreclosure; property types; occupancy; average credit score or other measures of creditworthiness; average LTV ratio; and...

12 CFR 324.41 - Operational requirements for securitization exposures.

Code of Federal Regulations, 2014 CFR

2014-01-01

... loans 30, 60, and 90 days past due; default rates; prepayment rates; loans in foreclosure; property types; occupancy; average credit score or other measures of creditworthiness; average LTV ratio; and...

Black-white achievement gap and family wealth.

PubMed

Yeung, W Jean; Conley, Dalton

2008-01-01

This article examines the extent to which family wealth affects the Black-White test score gap for young children based on data from the Panel Study of Income Dynamics (aged 3-12). This study found little evidence that wealth mediated the Black-White test scores gaps, which were eliminated when child and family demographic covariates were held constant. However, family wealth had a stronger association with cognitive achievement of school-aged children than that of preschoolers and a stronger association with school-aged children's math than on their reading scores. Liquid assets, particularly holdings in stocks or mutual funds, were positively associated with school-aged children's test scores. Family wealth was associated with a higher quality home environment, better parenting behavior, and children's private school attendance.

[Clinical characteristics and surgical management of Eyres type V coracoid fracture combined with superior shoulder suspensory complex injury].

PubMed

Liu, Hongzhi; Qiu, Changmao; Liu, Zhaojie; Zhang, Yinguang; Tian, Wei; Jia, Jian

2014-12-01

To investigate the clinical characteristics of Eyres type V coracoid fracture combined with superior shoulder suspensory complex (SSSC) injuries, and the effectiveness of open reduction and fixation. Between March 2004 and July 2012, 13 patients with Eyres type V coracoid fracture and SSSC injuries were treated. There were 10 males and 3 females with an average age of 41 years (range, 23-59 years). Injury was caused by falling from height in 4 cases, by traffic accident in 6 cases, and by impact of the heavy weight in 3 cases. The interval from injury to operation was 3-10 days (mean, 5.2 days). SSSC injuries included 9 cases of acromioclavicular joint dislocation, 5 cases of clavicular fractures, and 4 cases of acromion fractures. The coracoid fractures were fixed with cannulated screws; the acromioclavicular joint dislocations were fixed with hook plate (6 cases) or Kirschner wires (2 case) except 1 untreated case; the clavicular fractures were fixed with anatomical locking plate (3 cases) and hook plate (2 cases); the acromion fractures were fixed with cannulated screws (1 case), Kirschner wires (2 cases), or both of them (1 case). The mean operation time was 158.0 minutes (range, 100-270 minutes), and the mean intraoperative blood loss was 207.7 mL (range, 150-300 mL). The other patients obtained primary healing of incision except 1 patient who had inflammation around incision, which was cured after change dressing. All patients were followed up for 22.6 months on average (range, 17-35 months). All fractures achieved union at a mean time of 3.6 months (range, 2-6 months). No nerve injury and implant fixation failure complications were observed. At last follow-up, the Constant score and the disability of the arm, shoulder, and hand (DASH) score had a significant improvement when compared with scores at pre-operation (P < 0.05). The shoulder range of motion in flexion, abduction, and external rotation at last follow-up were significantly higher than those at pre-operation (P < 0.05). Eyres type V coracoid fracture associated with SSSC injuries usually results in the instability of the shoulder. With individual surgical treatment, the satisfactory function and good effectiveness can be obtained.

Computer-Assisted Automated Scoring of Polysomnograms Using the Somnolyzer System.

PubMed

Punjabi, Naresh M; Shifa, Naima; Dorffner, Georg; Patil, Susheel; Pien, Grace; Aurora, Rashmi N

2015-10-01

Manual scoring of polysomnograms is a time-consuming and tedious process. To expedite the scoring of polysomnograms, several computerized algorithms for automated scoring have been developed. The overarching goal of this study was to determine the validity of the Somnolyzer system, an automated system for scoring polysomnograms. The analysis sample comprised of 97 sleep studies. Each polysomnogram was manually scored by certified technologists from four sleep laboratories and concurrently subjected to automated scoring by the Somnolyzer system. Agreement between manual and automated scoring was examined. Sleep staging and scoring of disordered breathing events was conducted using the 2007 American Academy of Sleep Medicine criteria. Clinical sleep laboratories. A high degree of agreement was noted between manual and automated scoring of the apnea-hypopnea index (AHI). The average correlation between the manually scored AHI across the four clinical sites was 0.92 (95% confidence interval: 0.90-0.93). Similarly, the average correlation between the manual and Somnolyzer-scored AHI values was 0.93 (95% confidence interval: 0.91-0.96). Thus, interscorer correlation between the manually scored results was no different than that derived from manual and automated scoring. Substantial concordance in the arousal index, total sleep time, and sleep efficiency between manual and automated scoring was also observed. In contrast, differences were noted between manually and automated scored percentages of sleep stages N1, N2, and N3. Automated analysis of polysomnograms using the Somnolyzer system provides results that are comparable to manual scoring for commonly used metrics in sleep medicine. Although differences exist between manual versus automated scoring for specific sleep stages, the level of agreement between manual and automated scoring is not significantly different than that between any two human scorers. In light of the burden associated with manual scoring, automated scoring platforms provide a viable complement of tools in the diagnostic armamentarium of sleep medicine. © 2015 Associated Professional Sleep Societies, LLC.

Assessing Chemical Retention Process Controls in Ponds

NASA Astrophysics Data System (ADS)

Torgersen, T.; Branco, B.; John, B.

2002-05-01

Small ponds are a ubiquitous component of the landscape and have earned a reputation as effective chemical retention devices. The most common characterization of pond chemical retention is the retention coefficient, Ri= ([Ci]inflow-[Ci] outflow)/[Ci]inflow. However, this parameter varies widely in one pond with time and among ponds. We have re-evaluated literature reported (Borden et al., 1998) monthly average retention coefficients for two ponds in North Carolina. Employing a simple first order model that includes water residence time, the first order process responsible for species removal have been separated from the water residence time over which it acts. Assuming the rate constant for species removal is constant within the pond (arguable at least), the annual average rate constant for species removal is generated. Using the annual mean rate constant for species removal and monthly water residence times results in a significantly enhanced predictive capability for Davis Pond during most months of the year. Predictive ability remains poor in Davis Pond during winter/unstratified periods when internal loading of P and N results in low to negative chemical retention. Predictive ability for Piedmont Pond (which has numerous negative chemical retention periods) is improved but not to the same extent as Davis Pond. In Davis Pond, the rate constant for sediment removal (each month) is faster than the rate constant for water and explains the good predictability for sediment retention. However, the removal rate constant for P and N is slower than the removal rate constant for sediment (longer water column residence time for P,N than for sediment). Thus sedimentation is not an overall control on nutrient retention. Additionally, the removal rate constant for P is slower than for TOC (TOC is not the dominate removal process for P) and N is removed slower than P (different in pond controls). For Piedmont Pond, sediment removal rate constants are slower than the removal rate constant for water indicating significant sediment resuspension episodes. It appears that these sediment resuspension events are aperiodic and control the loading and the chemical retention capability of Piedmont Pond for N,P,TOC. These calculated rate constants reflect the differing internal loading processes for each component and suggest means and mechanisms for the use of ponds in water quality management.

Clinical competency evaluation of Brazilian chiropractic interns

PubMed Central

Facchinato, Ana Paula A.; Benedicto, Camila C.; Mora, Aline G.; Cabral, Dayane M.C.; Fagundes, Djalma J.

2015-01-01

Objective This study compares the results of an objective structured clinical examination (OSCE) between 2 groups of students before an internship and after 6 months of clinical practice in an internship. Methods Seventy-two students participated, with 36 students in each cohort. The OSCEs were performed in the simulation laboratory before the participants' clinical practice internship and after 6 months of the internship. Students were tested in 9 stations for clinical skills and knowledge. The same procedures were repeated for both cohorts. The t test was used for unpaired parametric samples and Fisher's exact test was used for comparison of proportions. Results There was no difference in the mean final score between the 2 groups (p = .34 for test 1; p = .08 for test 2). The performance of the students in group 1 was not significantly different when performed before and after 6 months of clinical practice, but in group 2 there was a significant decrease in the average score after 6 months of clinical practice. Conclusions There was no difference in the cumulative average score for the 2 groups before and after 6 months of clinical practice in the internship. There were differences within the cohorts, however, with a significant decrease in the average score in group 2. Issues pertaining to test standardization and student motivation for test 2 may have influenced the scores. PMID:25588200

Impact of complications and bladder cancer stage on quality of life in patients with different types of urinary diversions.

PubMed

Prcic, Alden; Aganovic, Damir; Hadziosmanovic, Osman

2013-12-01

Determine correlation between complications and stage of the disease and their impact on quality of life in patients with different types of ileal urinary derivation after radical cystectomy, and upon estimation of acquired results, to suggest the most acceptable type of urinary diversion. In five year period a prospective clinical study was performed on 106 patients, to whom a radical cystectomy was performed due to bladder cancer. Patients were divided into two groups, 66 patients with ileal conduit derivation and 40 patients with orthotopic derivation, whereby in each group a comparison between reflux and anti-reflux technique of orthotopic bladder was made. All patients from both groups filled the Sickness Impact Profile score six months after the operation. All patients had CT urography or Intravenous urography performed, as well as standard laboratory, vitamin B12 blood values, in order to evaluate early (ileus or subileus, wound dehiscence, bladder fistula, rupture of orthotopic bladder, urine extravazation) and late complications (VUR, urethral stricture, ureter stenosis, metabolic acidosis, mineral dis-balance, hypovitaminosis of vitamin B12, increased resorption of bone calcium, urinary infection, kidney damage, relapse of primary disease), so as disease stage and it's impact on quality of life. From gained results we observe that each category of SIP score correlates with different rate of correlation with the type of operation, group, T, N, and R grade, except work category. Average value of SIP score rises depending on the type of operation and T stage. It is notable that there is no difference in T1 stage, no matter the type of operation. So the average value of SIP score in T1 stage for conduit was 20.3, for Abol-Enein and Ghoneim 17.25 and Hautmann 18.75 respectively. Average value of SIP score in T2 stage for conduit was 31, for Abol-Enein and Ghoneim 19.1 and Hautmann 17.8. Average value of SIP score in T3 stage for conduit was 38.03, for Abol-Enein and Ghoneim 18.75 and Hautmann 19.5. SIP score for T4 was present only in patients with conduit performed and average value od SIP score was 40.42. There is a high level of correlation of late complications and psychosocial and physical dimension with their parameters, while for an independent dimension of correlation is not significant. Early complications have insignificant correlation in all categories of SIP score. Upon analyzing quality of life and morbidity, significant advantage is given to orthotopic derivations, especially Hautmann derivation with Chimney modification, unless there are no absolute contraindications for performing this type of operation. Factors which mostly influence quality of life are cancer stage, type of derivation, late complications and patient age. SIP score, as a well validated questionnaire, are applicable in this kind of research.

Knowledge of Prenatal Healthcare among Pregnant Women in Boyer-Ahmad and Dena County of Kohgiluyeh and Boyer-Ahmad Province, Iran.

PubMed

Safari, Mitra; Bahadornegad, Mohammad Hosien; Yazdanpanah, Behrouz; Safari, Marjan

Prenatal care knowledge is critical for pregnant women's use of antenatal services. The aim of the study was to assess the extent of prenatal healthcare knowledge among pregnant women of the Boyer-Ahmad and Dena County of Kohgiluyeh and Boyer-Ahmad Province, Iran. A cross-sectional survey was conducted between April and June 2013. Pregnant women who came for delivery to the only available public hospital were interviewed by trained research assistants. Interview questions were designed to assess their knowledge on five broad categories of prenatal care practices of immunization, diet, supplementation, antenatal checkups and warning signs. Collected information was converted into numerical scores and average score for each individual was calculated. Independent-samples t-test, analysis of variance and multiple comparison tests were used to compare scores among groups with different demographic and socioeconomic status. A total of 400 pregnant women with 66.8% illiterate or lowly educated and an average age of 28.5 ± 6.1 years participated in the study. The average care knowledge score was 16.8 out of a maximum of 30. The highest awareness was observed on immunization (54.4%) and the lowest for prenatal checkup (20.3%).The average knowledge scores were significantly different among age groups, educational level, number of gravidity, type of occupation, place of residence and time of starting of prenatal care. There were no significant differences between women with and without obstetric complications. Not surprisingly, the level of education was the most significant factor influencing women's knowledge of parental healthcare, reinforcing the need for the improvement in literacy and expansion of health education among pregnant women using various educational methods.

Botox combined with myofascial release physical therapy as a treatment for myofascial pelvic pain

PubMed Central

Scott, Lauren; Wyman, Allison; Mora, Nelsi; Miladinovic, Branko; Bassaly, Renee; Hoyte, Lennox

2017-01-01

Purpose To report the effects of combined onabotulinumtoxinA (Botox) injections and myofascial release physical therapy on myofascial pelvic pain (MFPP) by comparing pre- and posttreatment average pelvic pain scores, trigger points, and patient self-reported pelvic pain. Secondary outcomes were to examine posttreatment complications and determine demographic differences between patients with/without an improvement in pain. Materials and Methods This was an Institutional Review Board approved retrospective case series on women over 18 years with MFPP who received Botox and physical therapy between July 2006 and November 2014. Presence of trigger points and pelvic pain scores were determined by digital palpation of the iliococcygeus, puborectalis, obturator internus, and rectus muscles. Average pelvic pain scores (0–10) reflected an average of the scores obtained from palpation of each muscle. Self-reported improvement in pain was recorded as yes/no. Results Fifty women met the inclusion/exclusion criteria. Posttreatment, patients had lower average pelvic pain scores (3.7±4.0 vs. 6.4±1.8, p=0.005), and fewer trigger points (44% vs. 100%, p<0.001). Fifty-eight percent of patients (95% confidence interval, 44–72) noted an improvement in self-reported pain. Patients most likely to report no improvement in pain had chronic bowel disorders, while those most likely to report an improvement in pain had a history of past incontinence sling (p=0.03). Posttreatment complications included: constipation (8%), worsening urinary retention (2%), and urinary tract infection (4%). Conclusions Botox combined with soft tissue myofascial release physical therapy under anesthesia can be effective in treating women with chronic pelvic pain secondary to MFPP. PMID:28261683

The effect of age-at-testing on verbal memory among children following severe traumatic brain injury.

PubMed

Silberg, Tamar; Ahonniska-Assa, Jaana; Levav, Miriam; Eliyahu, Roni; Peleg-Pilowsky, Tamar; Brezner, Amichai; Vakil, Eli

2016-01-01

Memory deficits are a common sequelae following childhood traumatic brain injury (TBI), which often have serious implications on age-related academic skills. The current study examined verbal memory performance using the Rey Auditory Verbal Learning Test (RAVLT) in a pediatric TBI sample. Verbal memory abilities as well as the effect of age at-testing on performance were examined. A sample of 67 children following severe TBI (age average = 12.3 ± 2.74) and 67 matched controls were evaluated using the RAVLT. Age effect at assessment was examined using two age groups: above and below 12 years of age during evaluation. Differences between groups were examined via the 9 RAVLT learning trials and the 7 composite scores conducted out of them. Children following TBI recalled significantly less words than controls on all RAVLT trials and had significantly lower scores on all composite scores. However, all of these scores fell within the low average range. Further analysis revealed significantly lower than average performance among the older children (above 12 years), while scores of the younger children following TBI fell within average limits. To conclude, verbal memory deficits among children following severe TBI demonstrate an age-at-testing effect with more prominent problems occurring above 12 years at the time of evaluation. Yet, age-appropriate performance among children below 12 years of age may not accurately describe memory abilities at younger ages following TBI. It is therefore recommended that clinicians address child's age at testing and avoid using a single test as an indicator of verbal memory functioning post TBI.

The Impacts of Exposure to Environmental Risk on Physical and Mental Health in a Small Geographic Community in Houston, TX.

PubMed

Sansom, Garett; Parras, Juan; Parras, Ana; Nieto, Yudith; Arellano, Yvette; Berke, Philip; McDonald, Thomas; Shipp, Eva; Horney, Jennifer A

2017-08-01

Previous research has shown that communities with low average socioeconomic status (SES) and majority minority populations are more likely to be exposed to industrial buildings, waste facilities, and poor infrastructure compared to white communities with higher average SES. While some studies have demonstrated linkages between exposures to specific environmental contaminates within these communities and negative health outcomes, little research has analyzed the effects of environmental contaminants on the mental and physical health of these populations. A cross-sectional survey collected data from residents of Manchester, a small neighborhood in Houston, TX, that is characterized by industrial sites, unimproved infrastructure, nuisance flooding, and poor air quality. Our study (N = 109) utilized the 12 item Short Form Health Survey version 2 (SF12v2) to assess the general mental and physical health of the community. The community as a whole had reduced physical health scores compared to U.S. national averages. The time residents had lived in the neighborhood was also correlated with a reported reduction in physical health scores (r2 = 0.136; p-value <0.001). The association between time lived in the neighborhood and poorer health scores remained after adjusting for age, race, and gender (coef = -0.27, p-value <0.001). Mental health scores were within national averages and time spent living in the neighborhood did not appear to negatively impact respondent's mental health scores. These findings point to the need for more research to determine the potential for additive physical and mental health impacts in long-term residents in neighborhoods characterized by environmental justice issues.

Anomaly Detection and Life Pattern Estimation for the Elderly Based on Categorization of Accumulated Data

NASA Astrophysics Data System (ADS)

Mori, Taketoshi; Ishino, Takahito; Noguchi, Hiroshi; Shimosaka, Masamichi; Sato, Tomomasa

2011-06-01

We propose a life pattern estimation method and an anomaly detection method for elderly people living alone. In our observation system for such people, we deploy some pyroelectric sensors into the house and measure the person's activities all the time in order to grasp the person's life pattern. The data are transferred successively to the operation center and displayed to the nurses in the center in a precise way. Then, the nurses decide whether the data is the anomaly or not. In the system, the people whose features in their life resemble each other are categorized as the same group. Anomalies occurred in the past are shared in the group and utilized in the anomaly detection algorithm. This algorithm is based on "anomaly score." The "anomaly score" is figured out by utilizing the activeness of the person. This activeness is approximately proportional to the frequency of the sensor response in a minute. The "anomaly score" is calculated from the difference between the activeness in the present and the past one averaged in the long term. Thus, the score is positive if the activeness in the present is higher than the average in the past, and the score is negative if the value in the present is lower than the average. If the score exceeds a certain threshold, it means that an anomaly event occurs. Moreover, we developed an activity estimation algorithm. This algorithm estimates the residents' basic activities such as uprising, outing, and so on. The estimation is shown to the nurses with the "anomaly score" of the residents. The nurses can understand the residents' health conditions by combining these two information.

[Impact of intrauterine device insertion surgery on women's mental state].

PubMed

Chu, Guang-hua; Zou, Yan; Wang, Xiao-ye; Li, Su-xia; Huang, Zi-rong; Fang, Ai-hua; Tian, Ai-ping

2013-06-01

To evaluate the impact of the intrauterine device (IUD) insertion on the mental state of women. From Jan. 2009 to Jun. 2010, a multi-center clinical observational study was performed. Totally 641 women were selected in the six provinces' 18 family planning service stations and hospitals for IUD insertion surgery study. Analysis of the change of women's mental state which was evaluated by symptom checklist-90 (SCL-90) scale before and after IUD insertion surgery. Before and after IUD insertion surgery, 10 factors' scores in SCL-90 of the observed objects were between 1.1 to 1.2, total scores were 107±27 and 105±25, respectively. Before and after surgery, total average score both were 1.2, the average score of positive items both were 2.1. The difference of the above results were not statistically significance (all P>0.05). Preoperative and postoperative, the rate of positive items was 9.2%-19.6% and 7.7%-17.6%, respectively.In addition to anxiety and fear, the rate of other factors' positive items postoperative was significantly lower than those in the preoperative (all P<0.05). The incidence of the observed objects postoperative of each factor score, "deteriorated" was in the range of 4.9% to 23.0%, "improved" was in the range of 26.3%-50.1%. The incidence of total scores, "deterioration" was 28.8% (166/575), "improved" was 45.6% (262/575). The incidence of the average score of positive items, "deterioration" was 3.7% (21/575), "improved" was 52.3% (301/575). Logistic analysis showed that, in addition to unit level, there were no other significant influencing factors for women' mental state of postoperative (all P>0.05). IUD insertion surgery has no adverse effect on women's mental state.

[Analysis of effect of prevention and control technique training of human important parasitic diseases in Jiangsu Province in 2017].

PubMed

Bi-Xian, Ni; Xiang-Zhen, Xu; Xiao-Ting, Wang; Ming-Xue, Sheng; Yang, Dai; Xiao-Lin, Jin

2017-07-24

To evaluate the effect of the prevention and control technique training of human important parasitic diseases for basic professional and technical personnel in Jiangsu Province in 2017. A workshop including theory courses and practical operations was carried out for the basic professional and technical personnel. At the end of the workshop, the effects were evaluated through the theoretical and microscopic examinations. There were 132 trainees from 13 cities, and all of them took part in the final examinations. The average score of total was 118.36. There were significant differences among different regions ( χ 2 = 13.38, P < 0.01). The pass rate of the theory test was 92.4% with the average score of 79.05. There were significant differences of theory scores among different regions ( χ 2 =14.51, P < 0.01). The theory score of Northern Jiangsu Province was significantly higher than the scores of Southern and Central Jiangsu Province ( P < 0.001, P = 0.009). The pass rate of microscopic examinations was 89.4% with the average score of 39.32. There was no significant difference of micro-scopic examination scores among different regions ( F = 2.37, P = 0.09). Among the total 7 species, the detection rate of Paragonimus westermani was the highest (75％) and the rates of Schistosoma japonicum and Fasciolopsis buski were only 51.5％ and 54.5% respectively. The detection rates of eggs of Trichuris trichiura , unfertilized Ascaris lumbricoides , Clonorchis sinensis and Taenia solium were 71.2%, 65.9%, 72.7% and 72.0% respectively. The training course has promoted the capability of prevention and control of parasitic diseases for basic technical personnel. Also it provides the technical supports for parasitic disease monitoring, control and risk assessment in the next step.

Intravitreal injection anesthesia--comparison of different topical agents: a prospective randomized controlled trial.

PubMed

Yau, Gary L; Jackman, Christopher S; Hooper, Philip L; Sheidow, Tom G

2011-02-01

To compare the anesthetic effectiveness of 3 topical agents used for intravitreal injections. Randomized, triple-armed, double-blinded, prospective, single-centered trial in patients receiving intravitreal ranibizumab for neovascular age-related macular degeneration. Patients were randomized 1:1:1 to receive 0.5% tetracaine hydrochloride drops and a 4% lidocaine pledget (n = 31), 0.5% tetracaine hydrochloride drops alone (n = 31), or 4% cocaine (+ epinephrine 1/100,000) drops alone (n = 31). Patients were asked to score their pain experience using a visual analogue scale (VAS) immediately following and 15 minutes after their injection. The average of these scores was used as the primary outcome. The physician performing the procedure separately scored his perception of the patients' pain using the Wong-Baker FACES scale. Means of the averaged VAS pain score for Groups 1, 2, and 3 were: 19 (95% confidence interval [CI] 12-26), 21 (95% CI 13-29), and 21 (95% CI 16-27) respectively. Mean Wong-Baker pain scores for Groups 1, 2, and 3 were 1.9 (95% CI 1.3-2.6), 2.1 (95% CI 1.4-2.7), and 2.3 (95% CI 1.6-3.1) respectively. There was no significant difference (P = .549) between groups for average VAS pain score. Similarly, there was no significant difference (P = .790) for the physician-perceived pain score between groups. There was no clinical difference in patient pain experience between the 3 anesthetic options tested. The addition of a 4% lidocaine pledget offered no clinical advantage in pain relief compared to 0.5% tetracaine or 4% cocaine (+ epinephrine 1/100,000) drops alone. Copyright © 2011 Elsevier Inc. All rights reserved.

The Changes of Ethical Dilemmas in Palliative Care A Lesson Learned from Comparison Between 1998 and 2013 in Taiwan

PubMed Central

Chih, An-Hsuan; Su, Peijen; Hu, Wen-Yu; Yao, Chien-An; Cheng, Shao-Yi; Lin, Yen-Chun; Chiu, Tai-Yuan

2016-01-01

Abstract The current ethical dilemmas met by healthcare professionals were never compared with those 15 years ago when the palliative care system was newly developing in Taiwan. The aim of the study was to investigate the ethical dilemmas met by palliative care physicians and nurses in 2013 and compare the results with the survey in 1998. This cross-sectional study surveyed 213 physicians and nurses recruited from 9 representative palliative care units across Taiwan in 2013. The compared survey in 1998 studied 102 physicians and nurses from the same palliative care units. All participants took a questionnaire to survey the “frequency” and “difficulty” of 20 frequently encountered ethical dilemmas, which were grouped into 4 domains by factor analysis. The “ethical dilemma” scores were calculated and then compared across 15 years by Student's t tests. A general linear model analysis was used to identify significant factors relating to a high average “ethical dilemma” score in each domain. All of the highest-ranking ethical dilemmas in 2013 were related to insufficient resources. Physicians with less clinical experience had a higher average “ethical dilemma” score in clinical management. Physicians with dissatisfaction in providing palliative care were associated a higher average “ethical dilemma” score in communication. Nurses reported higher “ethical dilemma” scores in all items of resource allocation in 2013. Further analysis confirmed that, in 2013, nurses had a higher average “ethical dilemma” score in resource allocation after adjustment for other relating factors. Palliative care nursing staff in Taiwan are more troubled by ethical dilemmas related to insufficient resources than they were 15 years ago. Training of decision making in nurses under the framework of ethical principles and community palliative care programs may improve the problems. To promote the dignity of terminal cancer patients, long-term fundraising plans are recommended for countries in which the palliative care system is in its early stages of development. PMID:26735533

Failure after reverse total shoulder arthroplasty: what is the success of component revision?

PubMed

Black, Eric M; Roberts, Susanne M; Siegel, Elana; Yannopoulos, Paul; Higgins, Laurence D; Warner, Jon J P

2015-12-01

Complication rates remain high after reverse total shoulder arthroplasty (RTSA). Salvage options after implant failure have not been well defined. This study examines the role of reimplantation and revision RTSA after failed RTSA, reporting outcomes and complications of this salvage technique. Sixteen patients underwent component revision and reimplantation after a prior failed RTSA from 2004 to 2011. Indications included baseplate failure (7 patients, 43.8%), instability (6 patients, 37.5%), infection (2 patients, 12.5%), and humeral loosening (1 patient, 6.3%). The average age of the patient during revision surgery was 68.6 years. Outcomes information at follow-up was recorded, including visual analog scale score for pain, subjective shoulder value, American Shoulder and Elbow Surgeons score, and Simple Shoulder Test score, and these were compared with pre-revision values. Repeated surgeries and complications were noted. Average time to follow-up from revision was 58.9 months (minimum, 2 years; range, 24-103 months). The average postoperative visual analog scale score for pain was 1.7/10 (7.5/10 preoperatively; P < .0001), and the subjective shoulder value was 62% (17% preoperatively; P < .0001). The average postoperative American Shoulder and Elbow Surgeons score was 66.7, and the Simple Shoulder Test score was 52.6. Fourteen patients (88%) noted that they felt "better" postoperatively than before their original RTSA and would go through the procedure again if given the option. Nine patients suffered major complications (56%), and 6 of these ultimately underwent further procedures (38% of cohort). Salvage options after failure of RTSA remain limited. Component revision and reimplantation can effectively relieve pain and improve function compared with baseline values, and patient satisfaction levels are moderately high. However, complication rates and reoperation rates are significant. Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

The Changes of Ethical Dilemmas in Palliative Care. A Lesson Learned from Comparison Between 1998 and 2013 in Taiwan.

PubMed

Chih, An-Hsuan; Su, Peijen; Hu, Wen-Yu; Yao, Chien-An; Cheng, Shao-Yi; Lin, Yen-Chun; Chiu, Tai-Yuan

2016-01-01

The current ethical dilemmas met by healthcare professionals were never compared with those 15 years ago when the palliative care system was newly developing in Taiwan. The aim of the study was to investigate the ethical dilemmas met by palliative care physicians and nurses in 2013 and compare the results with the survey in 1998. This cross-sectional study surveyed 213 physicians and nurses recruited from 9 representative palliative care units across Taiwan in 2013. The compared survey in 1998 studied 102 physicians and nurses from the same palliative care units. All participants took a questionnaire to survey the "frequency" and "difficulty" of 20 frequently encountered ethical dilemmas, which were grouped into 4 domains by factor analysis. The "ethical dilemma" scores were calculated and then compared across 15 years by Student's t tests. A general linear model analysis was used to identify significant factors relating to a high average "ethical dilemma" score in each domain. All of the highest-ranking ethical dilemmas in 2013 were related to insufficient resources. Physicians with less clinical experience had a higher average "ethical dilemma" score in clinical management. Physicians with dissatisfaction in providing palliative care were associated a higher average "ethical dilemma" score in communication. Nurses reported higher "ethical dilemma" scores in all items of resource allocation in 2013. Further analysis confirmed that, in 2013, nurses had a higher average "ethical dilemma" score in resource allocation after adjustment for other relating factors. Palliative care nursing staff in Taiwan are more troubled by ethical dilemmas related to insufficient resources than they were 15 years ago. Training of decision making in nurses under the framework of ethical principles and community palliative care programs may improve the problems. To promote the dignity of terminal cancer patients, long-term fundraising plans are recommended for countries in which the palliative care system is in its early stages of development.

Retrospective outcome analyses for headaches in a pain rehabilitation interdisciplinary program.

PubMed

Zheng, Yuxi; Tepper, Stewart J; Covington, Edward C; Mathews, Manu; Scheman, Judith

2014-03-01

Incapacitating chronic migraine and other severe headaches can have significant impact on peoples' lives, including family and occupational functioning. Although a number of reports have investigated the prevalence and medical treatment of chronic headache, few have reported on the efficacy of treating these disorders within a comprehensive, intensive chronic pain rehabilitation program (CPRP), instead of a headache-specific program. CPRPs provide treatment of headache by focusing not only on physical pain, but also its association with impaired mood and function. We examined the efficacy of CPRP in patients with chronic headache via a retrospective analysis of 123 patients (76.4% female), ages 21 to 85, who completed the CPRP at the Cleveland Clinic between January 2007 and December 2011, and were diagnosed using International Classification of Headache Disorders, 2nd edition and International Classification of Headache Disorders, 2nd edition revision, with migraine or headache as a major complaint. Outcome measures included: pain intensity scores present at the moment of questioning where 10 is the maximal (0-10/10), Depression Anxiety Stress Scale (DASS) scores, (measuring mood), and Pain Disability Index scores (measuring function). Repeated measures t-tests were used. Average pain score on admission was 6.4, and 3.4 upon discharge. Average function on admission was moderately impaired, and normalized on discharge. The average depression score was in the moderate range, and had normalized on discharge. The average anxiety score on admission was in the severe range and was in the mild range on discharge. Results indicate that individuals had statistically and clinically meaningful improvement in pain, mood, and function. Data suggest that an interdisciplinary CPRP approach for patients diagnosed with headache can be effective in helping to decrease pain, as well as normalize mood and function. Thus, CPRPs serve as an alternative treatment to multidisciplinary headache programs, interventional pain techniques, and primary care standard headache care. © 2013 American Headache Society.

Beliefs of Turkish female teaching staff regarding mammography scanning.

PubMed

Temel, Ayla Bayik; Ardahan, Melek; Sesli, Esra

2010-01-01

To our knowledge, there has hitherto been no research to determine the beliefs of female teaching staff, who are highly educated and form a special risk group regarding breast cancer, towards mammography scanning in Turkey. Definitive research was planned to determine the beliefs of the female teaching staff working in a university. Data were collected by researchers via face-to-face interview using a sociodemographic questionnaire and " Health Belief Model ". The point average of the teaching staff in the mammography benefits sub-scale is 19.6 ± 3.87, their average item score is 3.91. The point average of the teaching staff in the mammography obstacles sub-scale is 21.17 ± 6.87, their average item score is 1.92. They agree on the benefits of the mammography, but they do not agree on the obstacles to mammography.

The relation of severe malnutrition in infancy to the intelligence of school children with differing life histories.

PubMed

Richardson, S A

1976-01-01

The IQ's of Jamaican boys aged 6-10 were associated significantly with the presence or absence of severe malnutrition in infancy, with height at time of IQ testing, and with a measure of the boys' social background. A multiple correlation coefficient of 0.674 was obtained between IQ and the three factors. Social background contributed 0.294 of the variance, height 0.112, and severe malnutrition 0.049. The two extreme groups of boys, i.e., those malnourished, small at follow-up, and with unfavorable social backgrounds and those not malnourished, tall at follow-up, and with favorable social backgrounds had average IQ's of 49.4 and 74.9, respectively (from Table 5). Only two of the boys in the most advantaged group had IQ scores that overlapped with the most disadvantaged group. Boys with severe malnutrition in infancy, but who are tall at follow-up and have a favorable social background have an average IQ 11 points higher than boys who did not experience severe malnutrition, but who are short at follow-up and have a unfavorable social background. The difference in IQ between boys who did and did not experience severe malnutrition in infancy varies under different conditions of height and social background when those are held constant for both groups. Under the most favorable conditions of being tall and having an advantageous social history the average IQ of the malnourtished boys in only 2 points lower than those not malnourished. Unde the most unfavorable conditions of short stature and a disadvantageous social background the IQ of the malnourished boys is 9 points lower than those not malnourished (Table 6 and Fig. 1).

A 3-Month Aerobic Training Program Improves Brain Energy Metabolism in Mild Alzheimer's Disease: Preliminary Results from a Neuroimaging Study.

PubMed

Castellano, Christian-Alexandre; Paquet, Nancy; Dionne, Isabelle J; Imbeault, Hélène; Langlois, Francis; Croteau, Etienne; Tremblay, Sébastien; Fortier, Mélanie; Matte, J Jacques; Lacombe, Guy; Fülöp, Tamás; Bocti, Christian; Cunnane, Stephen C

2017-01-01

Aerobic training has some benefits for delaying the onset or progression of Alzheimer's disease (AD). Little is known about the implication of the brain's two main fuels, glucose and ketones (acetoacetate), associated with thesebenefits. To determine whether aerobic exercise training modifies brain energy metabolism in mild AD. In this uncontrolled study, ten patients with mild AD participated in a 3-month, individualized, moderate-intensity aerobic training on a treadmill (Walking). Quantitative measurement of brain uptake of glucose (CMRglu) and acetoacetate (CMRacac) using neuroimaging and cognitive testing were done before and after the Walking program. Four men and six women with an average global cognitive score (MMSE) of 26/30 and an average age of 73 y completed the Walking program. Average total distance and treadmill speed were 8 km/week and 4 km/h, respectively. Compared to the Baseline, after Walking, CMRacac was three-fold higher (0.6±0.4 versus 0.2±0.1 μmol/100 g/min; p = 0.01). Plasma acetoacetate concentration and the blood-to-brain acetoacetate influx rate constant were also increased by 2-3-fold (all p≤0.03). CMRglu was unchanged after Walking (28.0±0.1 μmol/100 g/min; p = 0.96). There was a tendency toward improvement in the Stroop-color naming test (-10% completion time, p = 0.06). Performance on the Trail Making A&B tests was also directly related to plasma acetoacetate and CMRacac (all p≤0.01). In mild AD, aerobic training improved brain energy metabolism by increasing ketone uptake and utilization while maintaining brain glucose uptake, and could potentially be associated with some cognitive improvement.

DELTOID FLAP for MANAGEMENT of MASSIVE IRREPARABLE ROTATOR CUFF TEARS: Case Series.

PubMed

Roukoz, Sami; Nabhane, Linda; Aidibi, Ali al-rida; Sebaaly, Amer

2016-01-01

Muscle transfer has been reported as a good surgical option to reconstruct the deficient rotator cuff. The purpose of this study is to report the outcome of deltoid muscle flap transfer to restore shoulder function in patients with massive irreparable rotator cuff tear. This is a retrospective descriptive case series. Included patients had a lesion of two or more tendons of the rotator cuff or lesion of one tendon of more than 5 cm in width and no lesion to the subscapularis. Evaluation was done using the Constant score, visual analog scale for satisfaction and quality of life. Twenty patients met the inclusion criteria. Three patients were lost to follow-up. The remaining (9 males and 8 females) had a mean follow-up period of 40.5 months. The mean age at surgery was 61.3 years. Thirty-five percent of patients were involved in heavy labor while the lesions affected the dominant side in 70% of the cases. Mean preoperative Constant score was 40.8 and increased to 78.8 (p < 0.05) with a difference of +38 points on the raw Constant score and an improvement rate of 64%. The greatest improvement involved essentially pain and quality of life (improvement rate of 82%) (p < 0.05). Eighty-nine percent of patients have good and excellent self-reported results. More than just a salvage procedure, deltoid muscle flap seems to be an adequate option in terms of appropriate pain relief, function recovery as well as patient satisfaction. Keywords: massive rotator cuff tears, deltoid muscle flap

Anatomical principles for minimally invasive reconstruction of the acromioclavicular joint with anchors.

PubMed

Xiong, Chuanzhi; Lu, Yaojia; Wang, Qiang; Chen, Gang; Hu, Hansheng; Lu, Zhihua

2016-11-01

The aim of this study was to evaluate the outcome of a minimally invasive surgical technique for the treatment of patients with acromioclavicular joint dislocation. Sixteen patients with complete acromioclavicular joint dislocation were enrolled in this study. All patients were asked to follow the less active rehabilitation protocol post-operatively. Computed tomography with 3-D reconstruction of the injured shoulder was performed on each patient post operatively for the assessment of the accuracy of the suture anchor placement in the coracoid process and the reduction of the acromioclavicular joint. Radiographs of Zanca view and axillary view of both shoulders were taken for evaluating the maintenance of the acromioclavicular joint reduction at each follow-up visit. The Constant shoulder score was used for function assessment at the final follow-up. Twenty seven of the 32 anchors implanted in the coracoid process met the criteria of good position. One patient developed complete loss of reduction and another had partial loss of reduction in the anteroposterior plane. For the other 14 patients, the mean Constant score was 90 (range, 82-95). For the patients with partial and complete loss of reduction, the Constant score were 92 and 76 respectively. All of them got nearly normal range of motion of the shoulders and restored to pre-operative life and works. With this minimally invasive approach and limited exposure of the coracoid, a surgeon can place the suture anchors at the anatomical insertions of the coracoclavicular ligament and allow the dislocated joint reduced and maintained well. Level IV, Case series; therapeutic study.

Correlation of Patient-Reported Outcomes Measurement Information System (PROMIS) scores with legacy patient-reported outcome scores in patients undergoing rotator cuff repair.

PubMed

Patterson, Brendan M; Orvets, Nathan D; Aleem, Alexander W; Keener, Jay D; Calfee, Ryan P; Nixon, Devon C; Chamberlain, Aaron M

2018-06-01

The Patient-Reported Outcomes Measurement Information System (PROMIS) is being used to assess outcomes in many patient populations despite limited validation. The purpose of this study was to investigate the relationship between American Shoulder and Elbow Surgeons (ASES) and Simple Shoulder Test (SST) scores and PROMIS Physical Function (PF) and Upper Extremity (UE) function scores collected preoperatively in patients undergoing rotator cuff repair. This cross-sectional study analyzed 164 consecutive patients undergoing arthroscopic rotator cuff repair. Study inclusion required preoperative completion of the ASES and SST evaluations, as well as the PROMIS PF, UE, and Pain Interference computerized adaptive tests. Descriptive statistics were produced, and Pearson correlation coefficients were calculated between each of the outcome measures. Average PROMIS UE scores indicated greater impairment than PROMIS PF scores (34 vs 44). Three percent of patients reached the PROMIS UE ceiling score of 56. PROMIS PF scores demonstrated a weak correlation with ASES scores (r = 0.43, P < .001) and a moderate correlation with SST scores (r = 0.51, P < .001). PROMIS UE scores demonstrated a moderate correlation with both ASES scores (r = 0.59, P < .001) and SST scores (r = 0.62, P < .001). PROMIS Pain Interference scores demonstrated weak negative correlations with both ASES scores (r = -0.43, P < .001) and SST scores (r = -0.41, P < .001). Patients answered fewer questions on average using the PROMIS PF and UE instruments as compared with the ASES and SST instruments. PROMIS UE scores indicate greater impairment and demonstrate a stronger correlation with the legacy shoulder scores than PROMIS PF scores in patients with symptomatic rotator cuff tears. PROMIS computerized adaptive tests allow for more efficient patient-reported outcome data collection compared with traditional outcome scores. Copyright © 2018 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Exploring the relationship between population density and maternal health coverage

PubMed Central

2012-01-01

Background Delivering health services to dense populations is more practical than to dispersed populations, other factors constant. This engenders the hypothesis that population density positively affects coverage rates of health services. This hypothesis has been tested indirectly for some services at a local level, but not at a national level. Methods We use cross-sectional data to conduct cross-country, OLS regressions at the national level to estimate the relationship between population density and maternal health coverage. We separately estimate the effect of two measures of density on three population-level coverage rates (6 tests in total). Our coverage indicators are the fraction of the maternal population completing four antenatal care visits and the utilization rates of both skilled birth attendants and in-facility delivery. The first density metric we use is the percentage of a population living in an urban area. The second metric, which we denote as a density score, is a relative ranking of countries by population density. The score’s calculation discounts a nation’s uninhabited territory under the assumption those areas are irrelevant to service delivery. Results We find significantly positive relationships between our maternal health indicators and density measures. On average, a one-unit increase in our density score is equivalent to a 0.2% increase in coverage rates. Conclusions Countries with dispersed populations face higher burdens to achieve multinational coverage targets such as the United Nations’ Millennial Development Goals. PMID:23170895

The Predictive Validity of the University Student Selection Examination

ERIC Educational Resources Information Center

Karakaya, Ismail; Tavsancil, Ezel

2008-01-01

The main purpose of this study is to investigate the predictive validity of the 2003 University Student Selection Examination (OSS). For this purpose, freshman grade point average (FGPA) in higher education was predicted by raw scores, standard scores, and placement scores (YEP). This study has been conducted on a research group. In this study,…

Many Children Left Behind? Textbooks and Test Scores in Kenya. NBER Working Paper No. 13300

ERIC Educational Resources Information Center

Glewwe, Paul; Kremer, Michael; Moulin, Sylvie

2007-01-01

A randomized evaluation suggests that a program which provided official textbooks to randomly selected rural Kenyan primary schools did not increase test scores for the average student. In contrast, the previous literature suggests that textbook provision has a large impact on test scores. Disaggregating the results by students' initial academic…

Longitudinal effects of medical students' communication skills on future performance.

PubMed

Dong, Ting; LaRochelle, Jeffrey S; Durning, Steven J; Saguil, Aaron; Swygert, Kimberly; Artino, Anthony R

2015-04-01

The Essential Elements of Communication (EEC) were developed from the Kalamazoo consensus statement on physician-patient communication. The Uniformed Services University of the Health Sciences (USU) has adopted a longitudinal curriculum to use the EEC both as a learning tool during standardized patient encounters and as an evaluation tool culminating with the end of preclerkship objective-structured clinical examinations (OSCE). Medical educators have recently emphasized the importance of teaching communication skills, as evidenced by the United States Medical Licensing Examination testing both the integrated clinical encounter (ICE) and communication and interpersonal skills (CIS) within the Step 2 Clinical Skills exam (CS). To determine the associations between students' EEC OSCE performance at the end of the preclerkship period with later communication skills assessment and evaluation outcomes in the context of a longitudinal curriculum spanning both undergraduate medical education and graduate medical education. Retrospective data from preclerkship (overall OSCE scores and EEC OSCE scores) and clerkship outcomes (internal medicine [IM] clinical points and average clerkship National Board of Medical Examiners [NBME] scores) were collected from 167 USU medical students from the class of 2011 and compared to individual scores on the CIS and ICE components of Step 2 CS, as well as to the communication skills component of the program directors' evaluation of trainees during their postgraduate year 1 (PGY-1) residency. In addition to bivariate Pearson correlation analysis, we conducted multiple linear regression analysis to examine the predictive power of the EEC score beyond the IM clerkship clinical points and the average NBME Subject Exams score on the outcome measures. The EEC score was a significant predictor of the CIS score and the PGY-1 communication skills score. Beyond the average NBME Subject Exams score and the IM clerkship clinical points, the EEC score explained an additional 13% of the variance in the Step 2 CIS score and an additional 6% of the variance in the PGY-1 communication skills score. In addition, the EEC score was more closely associated with the CIS score than the ICE score. The use of a standardized approach with a communication tool like the EEC can help explain future performance in communication skills independent of other education outcomes. In the context of a longitudinal curriculum, this information may better inform medical educators on learners' communication capabilities and more accurately direct future remediation efforts. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

The Impact of Critical Thinking on Clinical Judgment During Simulation With Senior Nursing Students.

PubMed

Cazzell, Mary; Anderson, Mindi

2016-01-01

The study examined the impact of critical thinking (CT) on clinical judgment (CJ) during a pediatric Objective Structured Clinical Evaluation (OSCE) with 160 pre-licensure nursing students. Educators are called to transform teaching strategies to develop CJ but confusion exists over definitions. A descriptive correlational design was used to examine demographics and Tower of Hanoi (TOH) and Health Science Reasoning Test (HSRT) scores. CJ was measured by scores on the Lasater Clinical Judgment Rubric (LCJR) from videotaped OSCEs. Participants were: 86 percent female, 42 percent Caucasian, median 23 years, with 49 percent having health care experience. Students averaged seven moves over minimum on the TOH. Average scores were: HSRT 25/38 and LCJR 31/44. Statistically significant predictors of CJ were gender, ethnicity, HSRT deduction, and analysis; 11 CT variables accounted for 17 percent of LCJR scores. Educators need to utilize/develop innovative teaching strategies addressing CJ predictors.

Influence of internship toward entrepreneurship interest for mechanical engineering students

NASA Astrophysics Data System (ADS)

Sunyoto, Nugroho, Agus; Ulum, Miftakhul

2017-03-01

This study was aimed to determine the influence of internship toward students' entrepreneurship interest. Mechanical Engineering Education students from 2013 Batch who had the internship from Engineering Faculty at Semarang State University are the subject of this study. Data was collected through questionnaire and analyzed by simple regression analysis method. The internship subject score and entrepreneurship are categorized in very good level in which the average is 87.08% and 85.61%. However, the influence of internship toward students' interest is categorized in low level in which the average score is 7.9%. Internship section shall encourage students to study entrepreneurship aspects during the internship for entrepreneurship interest improvement and the students' preparation once they graduated. Description scoring standard is needed for scoring the students although they conduct their internship at different locations and companies. The students are highly recommended to conduct an an internship at entrepreneurship-based companies.

Predicting scientific oral presentation scores in a high school photonics science, technology, engineering and mathematics (STEM) program

NASA Astrophysics Data System (ADS)

Gilchrist, Pamela O.; Carpenter, Eric D.; Gray-Battle, Asia

2014-07-01

A hybrid teacher professional development, student science technology mathematics and engineering pipeline enrichment program was operated by the reporting research group for the past 3 years. Overall, the program has reached 69 students from 13 counties in North Carolina and 57 teachers from 30 counties spread over a total of five states. Quantitative analysis of oral presentations given by participants at a program event is provided. Scores from multiple raters were averaged and used as a criterion in several regression analyses. Overall it was revealed that student grade point averages, most advanced science course taken, extra quality points earned in their most advanced science course taken, and posttest scores on a pilot research design survey were significant predictors of student oral presentation scores. Rationale for findings, opportunities for future research, and implications for the iterative development of the program are discussed.

Does previous healthcare experience increase success in physician assistant training?

PubMed

Hegmann, Theresa; Iverson, Katie

2016-06-01

Healthcare experience is used by many physician assistant (PA) programs to rank applicants. Despite a large healthcare literature base evaluating admissions factors, little information is available on the relationship of healthcare experience and educational outcomes. We aimed to test whether previous healthcare experience is associated with increased success during the clinical portion of the PA educational process. Hours of direct healthcare experience reported on Central Application Service for Physician Assistants applications for 124 students in the classes of 2009 through 2013 were associated with a calculated average preceptor evaluation score for each student and with average standardized-patient examination scores for a subset of students. Average student age was 28.7 years and median healthcare experience was 2,257 hours (range 390-16,400). Previous healthcare experience was not significantly correlated with preceptor evaluations or standardized-patient examination scores. This 5-year single institution pilot study did not support the hypothesis that healthcare experience is associated with improved clinical year outcomes.

Reliability and Validity of the Korean Cancer Pain Assessment Tool (KCPAT)

PubMed Central

Kim, Jeong A; Lee, Juneyoung; Park, Jeanno; Lee, Myung Ah; Yeom, Chang Hwan; Jang, Se Kwon; Yoon, Duck Mi; Kim, Jun Suk

2005-01-01

The Korean Cancer Pain Assessment Tool (KCPAT), which was developed in 2003, consists of questions concerning the location of pain, the nature of pain, the present pain intensity, the symptoms associated with the pain, and psychosocial/spiritual pain assessments. This study was carried out to evaluate the reliability and validity of the KCPAT. A stratified, proportional-quota, clustered, systematic sampling procedure was used. The study population (903 cancer patients) was 1% of the target population (90,252 cancer patients). A total of 314 (34.8%) questionnaires were collected. The results showed that the average pain score (5 point on Likert scale) according to the cancer type and the at-present average pain score (VAS, 0-10) were correlated (r=0.56, p<0.0001), and showed moderate agreement (kappa=0.364). The mean satisfaction score was 3.8 (1-5). The average time to complete the questionnaire was 8.9 min. In conclusion, the KCPAT is a reliable and valid instrument for assessing cancer pain in Koreans. PMID:16224166

RS-Forest: A Rapid Density Estimator for Streaming Anomaly Detection.

PubMed

Wu, Ke; Zhang, Kun; Fan, Wei; Edwards, Andrea; Yu, Philip S

Anomaly detection in streaming data is of high interest in numerous application domains. In this paper, we propose a novel one-class semi-supervised algorithm to detect anomalies in streaming data. Underlying the algorithm is a fast and accurate density estimator implemented by multiple fully randomized space trees (RS-Trees), named RS-Forest. The piecewise constant density estimate of each RS-tree is defined on the tree node into which an instance falls. Each incoming instance in a data stream is scored by the density estimates averaged over all trees in the forest. Two strategies, statistical attribute range estimation of high probability guarantee and dual node profiles for rapid model update, are seamlessly integrated into RS-Forest to systematically address the ever-evolving nature of data streams. We derive the theoretical upper bound for the proposed algorithm and analyze its asymptotic properties via bias-variance decomposition. Empirical comparisons to the state-of-the-art methods on multiple benchmark datasets demonstrate that the proposed method features high detection rate, fast response, and insensitivity to most of the parameter settings. Algorithm implementations and datasets are available upon request.

Improved Balance Confidence and Stability for Elderly After 6 Weeks of a Multimodal Self-Administered Balance-Enhancing Exercise Program

PubMed Central

Hafström, Anna; Malmström, Eva-Maj; Terdèn, Josefine; Fransson, Per-Anders; Magnusson, Måns

2016-01-01

Objective: To develop and assess the efficacy of a multimodal balance-enhancing exercise program (BEEP) designed to be regularly self-administered by community-dwelling elderly. The program aims to promote sensory reweighting, facilitate motor control, improve gaze stabilization, and stimulate continuous improvement by being constantly challenging. Method: Forty participants aged 60 to 80 years performed 6 weeks of BEEP training, on average for 16 min four times weekly, in a randomized one-arm crossover design. Results: One-leg standing time improved 32% with eyes open (EO), 206% with eyes closed (EC) on solid surface, and 54% EO on compliant surface (p < .001). Posturography confirmed balance improvements when perturbed on solid and compliant surfaces with EO and EC (p ≤ .033). Walking, step stool, and Timed Up and Go speeds increased (p ≤ .001), as did scores in Berg Balance and balance confidence scales (p ≤ .018). Discussion: Multimodal balance exercises offer an efficient, cost-effective way to improve balance control and confidence in elderly. PMID:28138495

Dynamic probability control limits for risk-adjusted Bernoulli CUSUM charts.

PubMed

Zhang, Xiang; Woodall, William H

2015-11-10

The risk-adjusted Bernoulli cumulative sum (CUSUM) chart developed by Steiner et al. (2000) is an increasingly popular tool for monitoring clinical and surgical performance. In practice, however, the use of a fixed control limit for the chart leads to a quite variable in-control average run length performance for patient populations with different risk score distributions. To overcome this problem, we determine simulation-based dynamic probability control limits (DPCLs) patient-by-patient for the risk-adjusted Bernoulli CUSUM charts. By maintaining the probability of a false alarm at a constant level conditional on no false alarm for previous observations, our risk-adjusted CUSUM charts with DPCLs have consistent in-control performance at the desired level with approximately geometrically distributed run lengths. Our simulation results demonstrate that our method does not rely on any information or assumptions about the patients' risk distributions. The use of DPCLs for risk-adjusted Bernoulli CUSUM charts allows each chart to be designed for the corresponding particular sequence of patients for a surgeon or hospital. Copyright © 2015 John Wiley & Sons, Ltd.

RS-Forest: A Rapid Density Estimator for Streaming Anomaly Detection

PubMed Central

Wu, Ke; Zhang, Kun; Fan, Wei; Edwards, Andrea; Yu, Philip S.

2015-01-01

Anomaly detection in streaming data is of high interest in numerous application domains. In this paper, we propose a novel one-class semi-supervised algorithm to detect anomalies in streaming data. Underlying the algorithm is a fast and accurate density estimator implemented by multiple fully randomized space trees (RS-Trees), named RS-Forest. The piecewise constant density estimate of each RS-tree is defined on the tree node into which an instance falls. Each incoming instance in a data stream is scored by the density estimates averaged over all trees in the forest. Two strategies, statistical attribute range estimation of high probability guarantee and dual node profiles for rapid model update, are seamlessly integrated into RS-Forest to systematically address the ever-evolving nature of data streams. We derive the theoretical upper bound for the proposed algorithm and analyze its asymptotic properties via bias-variance decomposition. Empirical comparisons to the state-of-the-art methods on multiple benchmark datasets demonstrate that the proposed method features high detection rate, fast response, and insensitivity to most of the parameter settings. Algorithm implementations and datasets are available upon request. PMID:25685112

Functional outcomes of conservatively treated clavicle fractures

PubMed Central

Bajuri, Mohd Yazid; Maidin, S; Rauf, A; Baharuddin, M; Harjeet, S

2011-01-01

OBJECTIVE: The main aim of the study was to analyze the outcomes of clavicle fractures in adults treated non-surgically and to evaluate the clinical effects of displacement, fracture patterns, fracture location, fracture comminution, shortening and fracture union on shoulder function. METHODS: Seventy clavicle fractures were non-surgically treated in the Orthopedics Department at the Tuanku Ja'afar General Hospital, a tertiary care hospital in Seremban, Malaysia, an average of six months after injury. The clavicle fractures were treated conservatively with an arm sling and a figure-eight splint for three weeks. No attempt was made to reduce displaced fractures, and the patients were allowed immediate free-shoulder mobilization, as tolerated. They were prospectively evaluated clinically and radiographically. Shoulder function was evaluated using the Constant scoring technique. RESULTS: There were statistically significant functional outcome impairments in non-surgically treated clavicle fractures that correlated with the fracture type (comminution), the fracture displacement (21 mm or more), shortening (15 mm or more) and the fracture union (malunion). CONCLUSION: This article reveals the need for surgical intervention to treat clavicle fractures and improve shoulder functional outcomes. PMID:21655759

School Attendance: Focusing on Engagement and Re-Engagement. Practice Notes

ERIC Educational Resources Information Center

Center for Mental Health in Schools at UCLA, 2011

2011-01-01

Every student absence jeopardizes the ability of students to succeed at school and schools to achieve their mission. School attendance is a constant concern in schools. Average daily attendance rates are a common determiner of school funding, so schools funded on the basis of average daily attendance have less resources to do the job. Students who…

Stable plume rise in a shear layer.

PubMed

Overcamp, Thomas J

2007-03-01

Solutions are given for plume rise assuming a power-law wind speed profile in a stably stratified layer for point and finite sources with initial vertical momentum and buoyancy. For a constant wind speed, these solutions simplify to the conventional plume rise equations in a stable atmosphere. In a shear layer, the point of maximum rise occurs further downwind and is slightly lower compared with the plume rise with a constant wind speed equal to the wind speed at the top of the stack. If the predictions with shear are compared with predictions for an equivalent average wind speed over the depth of the plume, the plume rise with shear is higher than plume rise with an equivalent average wind speed.

Preoperative and post-operative sleep quality evaluation in rotator cuff tear patients.

PubMed

Serbest, Sancar; Tiftikçi, Uğur; Askın, Aydogan; Yaman, Ferda; Alpua, Murat

2017-07-01

The aim of this study was to examine the potential relationship between subjective sleep quality and degree of pain in patients with rotator cuff repair. Thirty-one patients who underwent rotator cuff repair prospectively completed the Pittsburgh Sleep Quality Index, the Western Ontario Rotator Cuff Index, and the Constant and Murley shoulder scores before surgery and at 6 months after surgery. Preoperative demographic, clinical, and radiologic parameters were also evaluated. The study analysed 31 patients with a median age of 61 years. There was a significant difference preoperatively versus post-operatively in terms of all PSQI global scores and subdivisions (p < 0.001). A statistically significant improvement was determined by the Western Ontario Rotator Cuff Scale and the Constant and Murley shoulder scores (p ˂ 0.001). Sleep disorders are commonly seen in patients with rotator cuff tear, and after repair, there is an increase in the quality of sleep with a parallel improvement in shoulder functions. However, no statistically significant correlation was determined between arthroscopic procedures and the size of the tear and sleep quality. It is suggested that rotator cuff tear repair improves the quality of sleep and the quality of life. IV.

Focal Muscle Vibration and Physical Exercise in Postmastectomy Recovery: An Explorative Study

PubMed Central

Fara, Maria Antonietta; Filippi, Guido Maria; La Torre, Giuseppe; Tozzi, Roberto; Vanacore, Nicola

2017-01-01

Background. Physical activity initiation and maintenance are particular challenges in the postmastectomy recovery and in particular Dragon Boat racing seems to be a useful sport activity. The aim of this study was to evaluate the role of focal muscle vibration as a proprioceptive input to improve upper limb functioning in a group of “paddlers” patients. Methods. A group of paddlers has been evaluated before vibratory treatment (T0), immediately after therapy (T1), after one week (T2), and after one month (T3) with DASH questionnaire, Body Image Scale, McGill pain questionnaire, Constant Scale, and Short Form 36 questionnaire. Results. Fourteen patients showed a significant reduction in disability score (p = 0,001) using DASH scale, an improvement of upper limb function (p = 0,001) using the Constant scale, and a reduction of pain (p = 0,007) at the McGill pain questionnaire. The Mental Composite Score of the Short Form 36 questionnaire showed significant results (p = 0,04) while no significant results had been found regarding the physical mental score (p = 0,08). Conclusion. Focal muscle vibration may be a useful treatment in a postmastectomy recovery of upper limb functionality. PMID:28459068

Restoration of horizontal stability in complete acromioclavicular joint separations: surgical technique and preliminary results.

PubMed

Li, Haoqing; Wang, Chuanshun; Wang, Jiandong; Wu, Kai; Hang, Donghua

2013-11-13

Our purpose was to investigate the clinical efficacy of arthroscope-assisted acromioclavicular ligament reconstruction in combination with double endobutton coracoclavicular ligament reconstruction for the treatment of complete acromioclavicular joint dislocation. During the period from February 2010 to October 2012, ten patients with Rockwood types IV and V acromioclavicular joint dislocation were hospitalized and nine were treated with acromioclavicular ligament reconstruction combined with double endobutton of coracoclavicular ligament reconstruction. The improvement in shoulder functions was assessed using a Constant score and visual analog scale (VAS) system. The mean follow-up period was 33.6 ± 5.4 months. The mean Constant scores improved from 25.2 ± 6.6 preoperatively to 92.4 ± 6.5 postoperatively, while the mean VAS score decreased from 5.9 ± 1.4 to 1.2 ± 0.9; significant differences were observed. The final follow-up revealed that excellent outcomes were achieved in eight patients and good outcome in two patients. Arthroscope-assisted acromioclavicular ligament reconstruction in combination with double endobutton of coracoclavicular ligament reconstruction is an effective approach for treatment of acute complete acromioclavicular joint dislocation.

Restoration of horizontal stability in complete acromioclavicular joint separations: surgical technique and preliminary results

PubMed Central

2013-01-01

Background Our purpose was to investigate the clinical efficacy of arthroscope-assisted acromioclavicular ligament reconstruction in combination with double endobutton coracoclavicular ligament reconstruction for the treatment of complete acromioclavicular joint dislocation. Methods During the period from February 2010 to October 2012, ten patients with Rockwood types IV and V acromioclavicular joint dislocation were hospitalized and nine were treated with acromioclavicular ligament reconstruction combined with double endobutton of coracoclavicular ligament reconstruction. The improvement in shoulder functions was assessed using a Constant score and visual analog scale (VAS) system. Results The mean follow-up period was 33.6 ± 5.4 months. The mean Constant scores improved from 25.2 ± 6.6 preoperatively to 92.4 ± 6.5 postoperatively, while the mean VAS score decreased from 5.9 ± 1.4 to 1.2 ± 0.9; significant differences were observed. The final follow-up revealed that excellent outcomes were achieved in eight patients and good outcome in two patients. Conclusion Arthroscope-assisted acromioclavicular ligament reconstruction in combination with double endobutton of coracoclavicular ligament reconstruction is an effective approach for treatment of acute complete acromioclavicular joint dislocation. PMID:24225119

How often does open reduction and internal fixation of geriatric acetabular fractures lead to hip arthroplasty?

PubMed

O'Toole, Robert V; Hui, Emily; Chandra, Amit; Nascone, Jason W

2014-03-01

We hypothesized that open reduction and internal fixation (ORIF) of displaced acetabular fractures in geriatric patients result in a low rate of conversion to hip arthroplasty and satisfactory hip-specific validated outcome scores at medium-term follow-up. Retrospective review. Level I trauma center. One hundred forty-seven consecutive patients who were 60 years or older who had acetabular fractures were treated at our center from 2001 through 2006. During this time period, fractures meeting operative criteria were treated with ORIF unless medical conditions warranted nonoperative treatment. Twenty-nine patients were lost to follow-up, 46 were deceased, and 11 declined to participate, leaving 61 potential patients for inclusion, 46 of whom were treated with ORIF (average follow-up, 4.4 years; range, 1.1-8.0 years). Standardized telephone interviews included hip-specific questions and validated outcome measures. Rates of conversion to hip arthroplasty and hip-specific validated outcome scores. Among 46 patients treated with ORIF (15 others were treated nonoperatively or with percutaneous screw fixation), 28% underwent hip arthroplasty an average 2.5 years after injury (range, 0.4-5.5 years) and had an average Western Ontario and McMaster Universities Index of Osteoarthritis score of 17 (range, 0-56; n = 38). This score is similar to or better than the typical scores after elective arthroplasty for arthritis and much better than the scores for patients with established arthritis (P < 0.05). The average SF-8 Health Survey physical component score was 46.1 (range, 31-62), similar to US population norms for the geriatric age group (P > 0.20). Few data exist regarding the treatment outcomes for geriatric acetabular fractures. It is difficult for clinicians to decide among ORIF, percutaneous fixation, acute arthroplasty, and nonoperative treatment. Our protocol of mostly ORIF showed a high 1-year mortality rate of 25% and a rate of conversion to arthroplasty after ORIF of 28%. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

[Relationship between the regional cerebral blood flow and the cognitive function and anosmia in patients with Parkinson disease and Alzheimer disease].

PubMed

Imamura, Kazuhiro; Matumoto, Shinjirou; Mabuchi, Naoki; Kobayashi, Yasushi; Okayasu, Naoki; Watanabe, Kenichi

2009-06-01

We compared the relationship between regional cerebral blood flow (rCBF) of the olfactory area and the cognitive function and anosmia in patient with Parkinson disease (PD) and in those with Alzheimer disease (AD). UPDRS III, MMSE, HDS-R, CDR, Beck Depression Inventory (BDI) were employed in this study. The subjects included 56 PD patients (average age 71.4+/-9.69 years), 23 AD patients (average age 73.3+/-7.12 years), 12 patients with mild cognitive impairment (MCI) (average age 72.5+/-6.89 years), and 9 age-matched controls (NC) (average age 73.8+/-6.61 years). Next we intravenously injected 1 ampule of thiamine propyldisulphide (Alinamin) and confirmed anosmia. In addition, we performed 123I-IMP SPECT (SEE methods) and satistically determined rCBF of the olfactory area based on the basis of the Z scores of the interest area. Anosima was detected in approximately 40% of the PD and AD patients. The HDS-R and MMSE scores were significantly higher in patients with anosima than in those without anosima; the CDR scores were significantly higher in the former than in the latter. Further, the incidence of anosima in PD patients and AD patients with MCI increased with an increase in the CDR scores. In order to determine the rCBF of the olfactory area of the PD and AD patients. As to rCBF of the olfactory area, we examined left and right Z scores of hippocampus, parahippocampus, amygdala, and uncus at Talairach level 3 and the scores of the Brodmann area 28, 34, 35, and 36 at Talairach level 5. In patients with anosmia, the Z scores were significantly high in cases with anosmia in all areas except the right Brodmann area 34 in PD patients and the right Brodmann area 28 and bilateral the Brodmann area 34 of both sides in AD patients. Some parts of the olfactory area are closely related to cognitive function, and it appeares that a reduced rCBF in the olfactory areas may lead to a functional decline in these regions which may cause anosmia and cognitive decline in PD and AD patients.

Long-term follow-up after latissimus dorsi transfer for irreparable posterosuperior rotator cuff tears.

PubMed

El-Azab, Hossam Mahmoud; Rott, Olaf; Irlenbusch, Ulrich

2015-03-18

Irreparable posterosuperior rotator cuff tears are treated in several ways. Transfer of the latissimus dorsi is an alternative with acceptable mid-term results, but long-term results have rarely been published. The cases of 108 consecutive patients with 115 shoulders treated with latissimus dorsi transfer between 2000 and 2005 were reviewed clinically and radiographically. Ninety-three shoulders in eighty-six patients were included in the follow-up analysis. The mean duration of follow-up was 9.3 years (range, 6.6 to 11.7 years), and the mean age at the operation was fifty-six years (range, forty to seventy-two years). Outcome measures included the Constant-Murley score (Constant score), American Shoulder and Elbow Surgeons (ASES) index, and visual analog scale (VAS) for pain. The progress of cuff tear arthropathy was determined with radiographic evaluation according to the system described by Hamada et al. The mean relative Constant score improved from 44% preoperatively to 71% at the time of follow-up (p < 0.0001, effect size = 0.6), excluding the clinical failures. Similarly, the mean ASES index improved from 30 to 70 (p < 0.0001, effect size = 0.7), and the mean VAS score decreased from 7.8 to 2.4 (p < 0.0001, effect size = 0.8). A pain-free outcome was reported in only eighteen shoulders (19%). Active shoulder movement improved significantly (p < 0.05). The mean Hamada radiographic grade of cuff tear arthropathy increased from 1.7 (range, 0 to 2) preoperatively to 2.2 (range, 1 to 5) (p < 0.0001, effect size = 0.2). The rate of clinical failure of latissimus dorsi transfer was 10%, and the rate of shoulder prosthetic replacement after latissimus dorsi transfer was 4%. Pain relief and improvement of shoulder function were maintained a mean of 9.3 years after latissimus dorsi transfer for irreparable posterosuperior cuff defects. The younger the patient, the better the outcome. Copyright © 2015 by The Journal of Bone and Joint Surgery, Incorporated.

Effects of high- and low-energy radial shock waves therapy combined with physiotherapy in the treatment of rotator cuff tendinopathy: a retrospective study.

PubMed

Su, Xiangzheng; Li, Zhongli; Liu, Zhengsheng; Shi, Teng; Xue, Chao

2017-06-09

The aim of this study was to investigate the efficacy of high- and low-energy radial shock waves combined with physiotherapy for rotator cuff tendinopathy patients. Data from rotator cuff tendinopathy patients received high- or low-energy radial shock waves combined with physiotherapy or physiotherapy alone were collected. The Constant and Murley score and visual analog scale score were collected to assess the effectiveness of treatment in three groups at 4, 8, 12, and 24 weeks. In total, 94 patients were involved for our retrospective study. All groups showed remarkable improvement in the visual analog scale and Constant and Murley score compared to baseline at 24 weeks. The high-energy radial shock waves group had more marked improvement in the Constant and Murley score compared to the physiotherapy group at 4 and 8 weeks and at 4 weeks when compared with low-energy group. Furthermore, high-energy radial shock waves group had superior results on the visual analog scale at 4, 8, and 12 weeks compared to low-energy and physiotherapy groups. This retrospective study supported the usage of high-energy radial shock waves as a supplementary therapy over physiotherapy alone for rotator cuff tendinopathy by relieving the symptoms rapidly and maintaining symptoms at a satisfactory level for 24 weeks. Implications for Rehabilitation High-energy radial shock waves can be a supplemental therapy to physiotherapy for rotator cuff tendinopathy. We recommend the usage of high-energy radial shock waves during the first 5 weeks, at an interval of 7 days, of physiotherapy treatment. High-energy radial shock waves treatment combined with physiotherapy can benefit rotator cuff tendinopathy by relieving symptoms rapidly and maintain these improvements at a satisfactory level for quite a long time.

Use of scoring systems for assessing and reporting the outcome results from shoulder surgery and arthroplasty

PubMed Central

Booker, Simon; Alfahad, Nawaf; Scott, Martin; Gooding, Ben; Wallace, W Angus

2015-01-01

To investigate shoulder scoring systems used in Europe and North America and how outcomes might be classified after shoulder joint replacement. All research papers published in four major journals in 2012 and 2013 were reviewed for the shoulder scoring systems used in their published papers. A method of identifying how outcomes after shoulder arthroplasty might be used to categorize patients into fair, good, very good and excellent outcomes was explored using the outcome evaluations from patients treated in our own unit. A total of 174 research articles that were published in the four journals used some form of shoulder scoring system. The outcome from shoulder arthroplasty in our unit has been evaluated using the constant score (CS) and the oxford shoulder score and these scores have been used to evaluate individual patient outcomes. CSs of < 30 = unsatisfactory; 30-39 = fair; 40-59 = good; 60-69 = very good; and 70 and over = excellent. The most popular shoulder scoring systems in North America were Simple Shoulder Test and American shoulder and elbow surgeons standard shoulder assessment form score and in Europe CS, Oxford Shoulder Score and DASH score. PMID:25793164

On the use of hydroxyl radical kinetics to assess the number-average molecular weight of dissolved organic matter.

PubMed

Appiani, Elena; Page, Sarah E; McNeill, Kristopher

2014-10-21

Dissolved organic matter (DOM) is involved in numerous environmental processes, and its molecular size is important in many of these processes, such as DOM bioavailability, DOM sorptive capacity, and the formation of disinfection byproducts during water treatment. The size and size distribution of the molecules composing DOM remains an open question. In this contribution, an indirect method to assess the average size of DOM is described, which is based on the reaction of hydroxyl radical (HO(•)) quenching by DOM. HO(•) is often assumed to be relatively unselective, reacting with nearly all organic molecules with similar rate constants. Literature values for HO(•) reaction with organic molecules were surveyed to assess the unselectivity of DOM and to determine a representative quenching rate constant (k(rep) = 5.6 × 10(9) M(-1) s(-1)). This value was used to assess the average molecular weight of various humic and fulvic acid isolates as model DOM, using literature HO(•) quenching constants, kC,DOM. The results obtained by this method were compared with previous estimates of average molecular weight. The average molecular weight (Mn) values obtained with this approach are lower than the Mn measured by other techniques such as size exclusion chromatography (SEC), vapor pressure osmometry (VPO), and flow field fractionation (FFF). This suggests that DOM is an especially good quencher for HO(•), reacting at rates close to the diffusion-control limit. It was further observed that humic acids generally react faster than fulvic acids. The high reactivity of humic acids toward HO(•) is in line with the antioxidant properties of DOM. The benefit of this method is that it provides a firm upper bound on the average molecular weight of DOM, based on the kinetic limits of the HO(•) reaction. The results indicate low average molecular weight values, which is most consistent with the recent understanding of DOM. A possible DOM size distribution is discussed to reconcile the small nature of DOM with the large-molecule behavior observed in other studies.

Theoretical analysis of nonnuniform skin effects on drawdown variation

NASA Astrophysics Data System (ADS)

Chen, C.-S.; Chang, C. C.; Lee, M. S.

2003-04-01

Under field conditions, the skin zone surrounding the well screen is rarely uniformly distributed in the vertical direction. To understand such non-uniform skin effects on drawdown variation, we assume the skin factor to be an arbitrary, continuous or piece-wise continuous function S_k(z), and incorporate it into a well hydraulics model for constant rate pumping in a homogeneous, vertically anisotropic, confined aquifer. Solutions of depth-specific drawdown and vertical average drawdown are determined by using the Gram-Schmidt method. The non-uniform effects of S_k(z) in vertical average drawdown are averaged out, and can be represented by a constant skin factor S_k. As a result, drawdown of fully penetrating observation wells can be analyzed by appropriate well hydraulics theories assuming a constant skin factor. The S_k is the vertical average value of S_k(z) weighted by the well bore flux q_w(z). In depth-specific drawdown, however, the non-uniform effects of S_k(z) vary with radial and vertical distances, which are under the influence of the vertical profile of S_k(z) and the vertical anisotropy ratio, K_r/K_z. Therefore, drawdown of partially penetrating observation wells may reflect the vertical anisotropy as well as the non-uniformity of the skin zone. The method of determining S_k(z) developed herein involves the use of q_w(z) as can be measured with the borehole flowmeter, and K_r/K_z and S_k as can be determined by the conventional pumping test.

Clinical and Radiographic Mid-Term Outcomes After Total Shoulder Replacement: A Retrospective Study Protocol Including 400 Anatomical and Reverse Prosthetic Implants

PubMed Central

Merolla, Giovanni; Tartarone, Antonio; Porcellini, Giuseppe

2016-01-01

Objectives: To obtain outcomes data on anatomical and reverse total shoulder arthroplasty by analysis of clinical scores and standard radiographs. Subject selection and enrollment: 400 consecutive series of patients replaced with anatomical and reverse total shoulder arthroplasty (minimum 3 years follow-up). Study Design: retrospective monocenter. Preoperative assessment: Demographics, clinical scores (Constant-Murley) as available, shoulder X-ray (AP, outlet and axillary views) . Last follow-up: Postoperative radiographhs and clinical scores. Adverse events and complications to be reported as occurred since implantation. Statistical analysis: Data collected will be summarized and analyzed for statistical significance. PMID:27326389

Short-term outcomes of arthroscopic TightRope® fixation are better than hook plate fixation in acute unstable acromioclavicular joint dislocations.

PubMed

Bin Abd Razak, Hamid Rahmatullah; Yeo, Eng-Meng Nicholas; Yeo, William; Lie, Tijauw-Tjoen Denny

2018-07-01

The aim of this study was to compare the short-term outcomes of arthroscopic TightRope ® fixation with that of hook plate fixation in patients with acute unstable acromioclavicular joint dislocations. We conducted a prospective case-control study of twenty-six patients with an acute ACJ dislocation who underwent surgical repair with either an arthroscopic TightRope ® fixation or a hook plate from 2013 to 2016. Clinical and radiological data were collected prospectively. Clinical outcomes were evaluated using the Constant Score, the University of California at Los Angeles (UCLA) Shoulder Score, Oxford Shoulder Score as well as the visual analogue scale. Radiological outcomes were assessed with the coracoclavicular distance (CCD). Sixteen patients underwent arthroscopic TightRope ® fixation, while 10 patients underwent hook plate fixation. There were no significant differences in the preoperative variables except for the mean UCLA 4b infraspinatus score (TightRope ® 2.8 vs. hook plate 3.8; p = 0.030). Duration of surgery was significantly longer in the TightRope ® group. At 1 year post-operatively, the TightRope ® group had a significantly better Constant Score and CCD with no complications. All patients with hook plate fixation had to undergo a second procedure for removal of implant, and 3 patients had complications. Arthroscopic TightRope ® fixation is a good option for the treatment of acute unstable ACJ dislocations. It has better short-term clinical and radiological outcomes as well as lesser complications when compared to hook plate fixation. Therapeutic, Level III.

No difference in outcome for open versus arthroscopic rotator cuff repair: a prospective comparative trial.

PubMed

Bayle, Xavier; Pham, Thuy-Trang; Faruch, Marie; Gobet, Aurelie; Mansat, Pierre; Bonnevialle, Nicolas

2017-12-01

Arthroscopic techniques tend to become the gold standard in rotator cuff repair. However, little data are reported in the literature regarding the improvement of postoperative outcomes and re-tear rate relative to conventional open surgery. The aim of this study was to compare clinical outcomes and cuff integrity after arthroscopic versus open cuff repair. We prospectively assessed clinical outcomes and cuff integrity after an arthroscopic or open rotator cuff repair with a minimum follow-up of 12 months. Clinical evaluation was based on Constant score, Simple Shoulder Value (SSV) and American Shoulder and Elbow Score (ASES). Rotator cuff healing was explored with ultrasound. 44 patients in arthroscopic group A (mean age 56-year-old) and 43 in open group O (mean age 61-year-old) fulfilled the inclusion criteria. Tendons were repaired with a single row technique associated with biceps tenodesis and subacromial decompression. All objective clinical scores significantly improved postoperatively in both groups. No statistical difference was identified between group A and O regarding, respectively, Constant score (72 vs 75 points; p = 0.3), ASES score (88 vs 91 points; p = 0.3), and SSV (81 vs 85%). The overall rate of re-tear (Sugaya type IV or V) reached 7 and 9%, respectively, in group A and O (p = 0.8). This study did not prove any difference of arthroscopic over open surgery in case of rotator cuff repair regarding clinical outcome and cuff integrity at 1-year follow-up. Prospective comparative study.

Arthroscopic Removal and Rotator Cuff Repair Without Acromioplasty for the Treatment of Symptomatic Calcifying Tendinitis of the Supraspinatus Tendon.

PubMed

Ranalletta, Maximiliano; Rossi, Luciano Andrés; Bongiovanni, Santiago Luis; Tanoira, Ignacio; Piuzzi, Nicolas; Maignon, Gastón

2015-04-01

Calcified rotator cuff tendinitis is a common cause of chronic shoulder pain that leads to significant pain and functional limitations. Although most patients respond well to conservative treatment, some eventually require surgical treatment. To evaluate the clinical outcome with arthroscopic removal of calcific deposit and rotator cuff repair without acromioplasty for the treatment of calcific tendinitis of the supraspinatus tendon. Case series; Level of evidence, 4. This study retrospectively evaluated 30 consecutive patients with a mean age of 49.2 years. The mean follow-up was 35 months (range, 24-88 months). Pre- and postoperative functional assessment was performed using the Constant score, University of California Los Angeles (UCLA) score, and Quick Disabilities of the Arm, Shoulder, and Hand (DASH). Pain was assessed by visual analog scale (VAS). Radiographs and magnetic resonance imaging (MRI) were performed to evaluate the recurrence of calcifications and the indemnity of the supraspinatus tendon repair. Significant improvement was obtained for pain (mean VAS, 8.7 before surgery to 0.8 after; P < .001). The mean Constant score increased from 23.9 preoperatively to 85.3 postoperatively (P < .001), the mean Quick DASH score decreased from 47.3 preoperatively to 8.97 postoperatively (P < .001), and the UCLA score increased from 15.8 preoperatively to 32.2 postoperatively (P < .001). MRI examination at last follow-up (70% of patients) showed no tendon tears, and 96.2% of patients were satisfied with their results. Arthroscopic removal and rotator cuff repair without acromioplasty can lead to good results in patients with symptomatic calcifying tendonitis of the supraspinatus tendon.

Evaluation of a haptics-based virtual reality temporal bone simulator for anatomy and surgery training.

PubMed

Fang, Te-Yung; Wang, Pa-Chun; Liu, Chih-Hsien; Su, Mu-Chun; Yeh, Shih-Ching

2014-02-01

Virtual reality simulation training may improve knowledge of anatomy and surgical skills. We evaluated a 3-dimensional, haptic, virtual reality temporal bone simulator for dissection training. The subjects were 7 otolaryngology residents (3 training sessions each) and 7 medical students (1 training session each). The virtual reality temporal bone simulation station included a computer with software that was linked to a force-feedback hand stylus, and the system recorded performance and collisions with vital anatomic structures. Subjects performed virtual reality dissections and completed questionnaires after the training sessions. Residents and students had favorable responses to most questions of the technology acceptance model (TAM) questionnaire. The average TAM scores were above neutral for residents and medical students in all domains, and the average TAM score for residents was significantly higher for the usefulness domain and lower for the playful domain than students. The average satisfaction questionnaire for residents showed that residents had greater overall satisfaction with cadaver temporal bone dissection training than training with the virtual reality simulator or plastic temporal bone. For medical students, the average comprehension score was significantly increased from before to after training for all anatomic structures. Medical students had significantly more collisions with the dura than residents. The residents had similar mean performance scores after the first and third training sessions for all dissection procedures. The virtual reality temporal bone simulator provided satisfactory training for otolaryngology residents and medical students. Copyright © 2013. Published by Elsevier Ireland Ltd.

Two-year quality of life after free flap reconstruction in tumor-site discrepancy among Taiwanese with moderately advanced oral squamous cell carcinoma.

PubMed

Chang, Kao-Ping; Lai, Chung-Sheng; Hsieh, Tung-Ying; Wu, Yi-Chia; Chang, Chih-Hau

2012-07-13

This study describes 2-year impact on quality of life (QOL) in relation to the anatomical discrepancy among T4a oral cancer patients after free flap reconstruction in Taiwan. Thirty-two patients who underwent tumor ablation with simultaneous microvascular free flap transfer at 2-year follow-up were recruited. They were divided into six subgroups, according to the resected area, consisting of: (1) buccal/retromolar trigone; (2) cheek; (3) commissure; (4) lip; (5) mandible; and (6) tongue. Functional disturbances and daily activity were analyzed using the Version-1 UW QOL Questionnaire with one more specific category: 'Drooling'. Kruskal-Wallis rank sums analysis was used to test differences in average QOL scores between these subgroups. Post-hoc analysis was applied to assess influence of dominant categories between subgroups. The category 'Pain' revealed the highest average score and reached significant statistical difference (P = 0.019) among all the categories, however, the category 'Employment' averaged the lowest score. Regarding 'Pain', there existed a statistical significance (P = 0.0032) between the commissure- and cheek-involved groups, which described the former showed poorer pain quality of life. The commissure-involved group had the lowest average score, which might imply the worst QOL in our study, especially for the categories 'Pain' and 'Drooling'. This present study of T4a patients was the first carried out in Taiwan implementing the QOL questionnaire, and its results may serve for future reference.

Outcomes of single-row and double-row arthroscopic rotator cuff repair: a systematic review.

PubMed

Saridakis, Paul; Jones, Grant

2010-03-01

Arthroscopic rotator cuff repair is a common procedure that is gaining wide acceptance among orthopaedic surgeons because it is less invasive than open repair techniques. However, there is little consensus on whether to employ single-row or double-row fixation. The purpose of the present study was to systematically review the English-language literature to see if there is a difference between single-row and double-row fixation techniques in terms of clinical outcomes and radiographic healing. PubMed, the Cochrane Central Register of Controlled Trials, and EMBASE were reviewed with the terms "arthroscopic rotator cuff," "single row repair," and "double row repair." The inclusion criteria were a level of evidence of III (or better), an in vivo human clinical study on arthroscopic rotator cuff repair, and direct comparison of single-row and double-row fixation. Excluded were technique reports, review articles, biomechanical studies, and studies with no direct comparison of arthroscopic rotator cuff repair techniques. On the basis of these criteria, ten articles were found, and a review of the full-text articles identified six articles for final review. Data regarding demographic characteristics, rotator cuff pathology, surgical techniques, biases, sample sizes, postoperative rehabilitation regimens, American Shoulder and Elbow Surgeons scores, University of California at Los Angeles scores, Constant scores, and the prevalence of recurrent defects noted on radiographic studies were extracted. Confidence intervals were then calculated for the American Shoulder and Elbow Surgeons, University of California at Los Angeles, and Constant scores. Quality appraisal was performed by the two authors to identify biases. There was no significant difference between the single-row and double-row groups within each study in terms of postoperative clinical outcomes. However, one study divided each of the groups into patients with small-to-medium tears (< 3 cm in length) and those with large-to-massive tears (> or = 3 cm in length), and the authors noted that patients with large to massive tears who had double-row fixation performed better in terms of the American Shoulder and Elbow Surgeons scores and Constant scores in comparison with those who had single-row fixation. Two studies demonstrated a significant difference in terms of structural healing of the rotator cuff tendons after surgery, with the double-row method having superior results. There was an overlap in the confidence intervals between the single-row and double-row groups for all of the studies and the American Shoulder and Elbow Surgeons, Constant, and University of California at Los Angeles scoring systems utilized in the studies, indicating that there was no difference in these scores between single-row and double-row fixation. Potential biases included selection, performance, detection, and attrition biases; each study had at least one bias. Two studies had potentially inadequate power to detect differences between the two techniques. There appears to be a benefit of structural healing when an arthroscopic rotator cuff repair is performed with double-row fixation as opposed to single-row fixation. However, there is little evidence to support any functional differences between the two techniques, except, possibly, for patients with large or massive rotator cuff tears (> or = 3 cm). A risk-reward analysis of a patient's age, functional demands, and other quality-of-life issues should be considered before deciding which surgical method to employ. Double-row fixation may result in improved structural healing at the site of rotator cuff repair in some patients, depending on the size of the tear.