In Case You Are Interested: Results of a Survey of Case Study Teachers

ERIC Educational Resources Information Center

Herreid, Clyde Freeman; Schiller, Nancy A.; Herreid, Ky F.; Wright, Carolyn

2011-01-01

Case study teaching had a long tradition in law and business before it made the jump to medical school education in the form of Problem-Based Learning (PBL) in the 1970s. Today, both the University of Delaware's Clearinghouse and the University of Buffalo's National Center for Case Study Teaching in Science (NCCSTS) have hundreds of cases and…

Alcoa Teams with DOE to Reduce Energy Consumption

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

None

2004-05-01

This is the first in a series of DOE Industrial Technologies Program case studies on corporate energy management. The case study highlights Alcoa Aluminum's successful results and activities through its corporate energy management approach and collaboration with DOE. Case studies in this series will be used to encourage other energy-intensive industrial plants to adopt a corporate strategy, and to promote the concept of replicating results with a company or industry.

Barriers to implementation of case management for patients with dementia: a systematic mixed studies review.

PubMed

Khanassov, Vladimir; Vedel, Isabelle; Pluye, Pierre

2014-01-01

Results of case management designed for patients with dementia and their caregivers in community-based primary health care (CBPHC) were inconsistent. Our objective was to identify the relationships between key outcomes of case management and barriers to implementation. We conducted a systematic mixed studies review (including quantitative and qualitative studies). Literature search was performed in MEDLINE, PsycINFO, Embase, and Cochrane Library (1995 up to August 2012). Case management intervention studies were used to assess clinical outcomes for patients, service use, caregiver outcomes, satisfaction, and cost-effectiveness. Qualitative studies were used to examine barriers to case management implementation. Patterns in the relationships between barriers to implementation and outcomes were identified using the configurational comparative method. The quality of studies was assessed using the Mixed Methods Appraisal Tool. Forty-three studies were selected (31 quantitative and 12 qualitative). Case management had a limited positive effect on behavioral symptoms of dementia and length of hospital stay for patients and on burden and depression for informal caregivers. Interventions that addressed a greater number of barriers to implementation resulted in increased number of positive outcomes. Results suggested that high-intensity case management was necessary and sufficient to produce positive clinical outcomes for patients and to optimize service use. Effective communication within the CBPHC team was necessary and sufficient for positive outcomes for caregivers. Clinicians and managers who implement case management in CBPHC should take into account high-intensity case management (small caseload, regular proactive patient follow-up, regular contact between case managers and family physicians) and effective communication between case managers and other CBPHC professionals and services. © 2014 Annals of Family Medicine, Inc.

Putting the Learning in Case Learning? The Effects of Case-Based Approaches on Student Knowledge, Attitudes, and Engagement

ERIC Educational Resources Information Center

Krain, Matthew

2016-01-01

This study revisits case learning's effects on student engagement and assesses student learning as a result of the use of case studies and problem-based learning. The author replicates a previous study that used indirect assessment techniques to get at case learning's impact, and then extends the analysis using a pre- and post-test experimental…

Implementation of case studies in undergraduate didactic nursing courses: a qualitative study

PubMed Central

2013-01-01

Background The implementation of unfolding scenario-based case studies in the didactic classroom is associated with learner-centered education. The utilization of learner-centered pedagogies, such as case studies, removes the focus from the instructor and instead places it on the student. Learner-centered pedagogies are believed to improve students’ levels of cognition. The purpose of this study was to examine how nurse educators are implementing the pedagogies of case studies in their undergraduate didactic courses. The goal was to examine, document, report, and, ultimately, implement the strategies. Methods Purposeful sampling was utilized in this qualitative, multisite-designed study. For each of the four participants, three separate site visits were completed. Observations and post-observational interviews took place at each site visit. Transcribed data from interviews, observations, and course documents were imported into the computer program Nvivo8. Repetitive comparative analysis was utilized to complete the data coding process. Results The guiding research question of this study sought to investigate the implementation strategies of case studies in didactic nursing courses. The implementation of case studies by the participants reflected two primary patterns: Formal Implementation (FI) and Informal Implementation (II) of case studies. The FI of case studies was further divided into two subcategories: Formal Implementation of case studies used Inside the Classroom setting (FIIC) and Formal Implementation of cases studies used Outside of the Classroom (FIOC). Conclusion Results of this investigation have led to an increased understanding of implementation strategies of unfolding scenario-based case studies in undergraduate nursing didactic courses. Data collected were rich in the description of specific methodologies for utilization of case studies and may serve as a resource for faculty in development of creative strategies to enhance the didactic classroom experience. PMID:23826925

A Case Study of ESD Implementation: Signs of Sustainable Leadership

ERIC Educational Resources Information Center

Iliško, Dzintra; Badyanova, Yelena

2014-01-01

This article presents a case study of two schools that were identified as a result of UNESCO associated schools survey as cases of sustainable leadership and governance. The aim of the study is to present the two cases that were crystalized in the survey carried out at end of the United Nations' "Decade of Education for Sustainable…

A comprehensive grid to evaluate case management's expected effectiveness for community-dwelling frail older people: results from a multiple, embedded case study.

PubMed

Van Durme, Thérèse; Schmitz, Olivier; Cès, Sophie; Anthierens, Sibyl; Maggi, Patrick; Delye, Sam; De Almeida Mello, Johanna; Declercq, Anja; Macq, Jean; Remmen, Roy; Aujoulat, Isabelle

2015-06-18

Case management is a type of intervention expected to improve the quality of care and therefore the quality of life of frail, community-dwelling older people while delaying institutionalisation in nursing homes. However, the heterogeneity, multidimensionality and complexity of these interventions make their evaluation by the means of classical approaches inadequate. Our objective was twofold: (i) to propose a tool allowing for the identification of the key components that explain the success of case management for this population and (ii) to propose a typology based on the results of this tool. The process started with a multiple embedded case study design in order to identify the key components of case management. Based on the results of this first step, data were collected among 22 case management interventions, in order to evaluate their expected effectiveness. Finally, multiple correspondence analyses was conducted to propose a typology of case management. The overall approach was informed by Wagner's Chronic Care Model and the theory of complexity. The study identified a total of 23 interacting key components. Based on the clustering of response patterns of the 22 case management projects included in our study, three types of case management programmes were evidenced, situated on a continuum from a more "socially-oriented" type towards a more "clinically-oriented" type of case management. The type of feedback provided to the general practitioner about both the global geriatric assessment and the result of the intervention turned out to be the most discriminant component between the types. The study design allowed to produce a tool that can be used to distinguish between different types of case management interventions and further evaluate their effect on frail older people in terms of the delaying institutionalisation, functional and cognitive status, quality of life and societal costs.

[A clinical study of PC-904 in pediatrics (author's transl)].

PubMed

Hori, M; Kono, S; Hashimoto, F

1978-07-01

A clinical study of PC-904 was performed in children. The results were as follows; 1) Serum levels of PC-904 after single administration of 20 mg/kg were studied in patients by one-shot intravenous injection or drip infusion for 1 hour or 2 hours. The results obtained in this fundamental study led to the suggestion that the proper dosage in bacterial infections would be 50 approximately 100 mg/kg intravenously in 3 approximately 4 divided doses daily. 2) A clinical study of PC-904 was performed in 16 patients including acute pharyngitis and bronchitis (3 cases), acute bronchopneumonia (3 cases), pertussis pneumonia (1 case), lymphadenitis purulenta (2 cases), acute bronchopneumonia (3 cases), pertussis pneumonia (1 case), lymphadenitis purulenta (2 cases), abscess with chronic granuloma (2 cases) and urinary tract infection (5 cases). About 50 approximately 100 mg/kg of PC-904 were administered in 3 approximately 4 divided doses daily by one-shot intravenous injection. The clinical effects of 2 cases out of 16 were impossible to be evaluated, and thses cases were excluded from the clinical evaluation. Ten cases out of 14 showed excellent or good responses (efficacy rate: 71.4%). 3) The bacteriological examinations were performed and the causative or isolated organisms were determined in 11 cases. The responses were "disappeared" in 6 cases, "decreased" in 2 cases and "not disappeared" in 3 cases. 4) No side effects were observed. Abnormalities of laboratory findings were not also noticed.

Synthesis of Single-Case Experimental Data: A Comparison of Alternative Multilevel Approaches

ERIC Educational Resources Information Center

Ferron, John; Van den Noortgate, Wim; Beretvas, Tasha; Moeyaert, Mariola; Ugille, Maaike; Petit-Bois, Merlande; Baek, Eun Kyeng

2013-01-01

Single-case or single-subject experimental designs (SSED) are used to evaluate the effect of one or more treatments on a single case. Although SSED studies are growing in popularity, the results are in theory case-specific. One systematic and statistical approach for combining single-case data within and across studies is multilevel modeling. The…

The Aggregation of Single-Case Results Using Hierarchical Linear Models

ERIC Educational Resources Information Center

Van den Noortgate, Wim; Onghena, Patrick

2007-01-01

To investigate the generalizability of the results of single-case experimental studies, evaluating the effect of one or more treatments, in applied research various simultaneous and sequential replication strategies are used. We discuss one approach for aggregating the results for single-cases: the use of hierarchical linear models. This approach…

Office of Exploration: Exploration studies technical report. Volume 2: Studies approach and results

NASA Technical Reports Server (NTRS)

Roberts, Barney B.; Bland, Dan

1988-01-01

The NASA Office of Exploration has been tasked with defining and recommending alternatives for an early 1990's national decision on a focused program of human exploration of the solar system. The Mission Analysis and System Engineering (MASE) group, which is managed by the Exploration Studies Office at the Johnson Space Center, is responsible for coordinating the technical studies necessary for accomplishing such a task. This technical report describes the process that has been developed in a case study approach. The four case studies that were developed in FY88 include: (1) human expedition to Phobos; (2) human expeditions to Mars; (3) lunar observatory; and (4) lunar outpost to early Mars evolution. The final outcome of this effort is a set of programmatic and technical conclusions and recommendations for the following year's work. Volume 2 describes the case study process, the technical results of each of the case studies, and opportunities for additional study. Included in the discussion of each case study is a description of the mission key features and profile. Mission definition and manifesting are detailed, followed by a description of the mission architecture and infrastructure. Systems concepts for the required orbital nodes, transportation systems, and planetary surface systems are discussed. Prerequisite implementation plans resulting from the synthesized case studies are described and in-depth assessments are presented.

Study on Case Teaching of Financial Management

ERIC Educational Resources Information Center

Che, Zhenghong; Che, Zhengmei

2011-01-01

Case teaching is an efficient teaching method of management. It plays an important role to enhance the students' ability to practice the theory. However, case teaching of financial management has not achieved the expected results. The paper aims to study the importance, characteristics and corresponding methods of case teaching method of financial…

University Teachers' Job Dissatisfaction: Application of Two-Factor Theory--A Case of Pakistani Education System

ERIC Educational Resources Information Center

Mir, Imran Anwar

2012-01-01

This qualitative case study presents the reasons of teachers' job dissatisfaction in the government educational institutes in Pakistan. This case study is based on the two factor theory of Herzberg. The results of this case study reveal four core factors that cause job dissatisfaction among teachers in the public sector universities in developing…

Statin-Associated Polymyalgia Rheumatica. An Analysis Using WHO Global Individual Case Safety Database: A Case/Non-Case Approach

PubMed Central

de Jong, Hilda J. I.; Saldi, Siti R. F.; Klungel, Olaf H.; Vandebriel, Rob J.; Souverein, Patrick C.; Meyboom, Ronald H. B.; Passier, J. L. M. (Anneke); van Loveren, Henk; Tervaert, Jan Willem Cohen

2012-01-01

Objective To assess whether there is an association between statin use and the occurrence of polymyalgia rheumatic (PMR) in the spontaneous reporting database of the World Health Organisation (WHO). Methods We conducted a case/non-case study based on individual case safety reports (ICSR) in the WHO global ICSR database (VigiBase). Case reports containing the adverse event term polymyalgia rheumatica (WHOART or MedDRA Preferred Term) were defined as cases. Non-cases were all case reports containing other adverse event terms. Each case was matched to five non-cases by age, gender, and time of reporting. Case reports regarding a statin as suspected or concomitant drug were identified using the Anatomical Therapeutic Chemical (ATC) classification. Multivariate logistic regression was used to calculate reporting odds ratios (RORs) with 95% confidence intervals (CI). Results We identified 327 reports of PMR as cases and 1635 reports of other ADRs as non-cases. Among cases, statins were more frequently reported as suspected agent (29.4%) compared to non-cases (2.9%). After adjustment for several covariates, statins were significantly associated with reports of PMR (ROR 14.21; 95% CI 9.89–20.85). Conclusion The results of this study lends support to previous anecdotal case reports in the literature suggesting that the use of a statin may be associated with the occurrence of PMR. Further studies are needed to study the strength of the association in more detail and to elucidate the underlying mechanism. PMID:22844450

Study designs may influence results: the problems with questionnaire-based case-control studies on the epidemiology of glioma.

PubMed

Johansen, Christoffer; Schüz, Joachim; Andreasen, Anne-Marie Serena; Dalton, Susanne Oksbjerg

2017-03-28

Glioma is a rare brain tumour with a very poor prognosis and the search for modifiable factors is intense. We reviewed the literature concerning risk factors for glioma obtained in case-control designed epidemiological studies in order to discuss the influence of this methodology on the observed results. When reviewing the association between three exposures, medical radiation, exogenous hormone use and allergy, we critically appraised the evidence from both case-control and cohort studies. For medical radiation and hormone replacement therapy (HRT), questionnaire-based case-control studies appeared to show an inverse association, whereas nested case-control and cohort studies showed no association. For allergies, the inverse association was observed irrespective of study design. We recommend that the questionnaire-based case-control design be placed lower in the hierarchy of studies for establishing cause-and-effect for diseases such as glioma. We suggest that a state-of-the-art case-control study should, as a minimum, be accompanied by extensive validation of the exposure assessment methods and the representativeness of the study sample with regard to the exposures of interest. Otherwise, such studies cannot be regarded as 'hypothesis testing' but only 'hypothesis generating'. We consider that this holds true for all questionnaire-based case-control studies on cancer and other chronic diseases, although perhaps not to the same extent for each exposure-outcome combination.

Engaging Engineering Students in Geoscience through Case Studies and Active Learning

ERIC Educational Resources Information Center

Holley, Elizabeth A.

2017-01-01

This study reports on a case study-based curricular intervention designed to help undergraduate engineering students make connections between geoscience and its applications. Teaching through case studies resulted in a measurable and significant improvement in the confidence that students had in their ability to apply geoscience concepts in an…

Using MultiMedia Content to Present Business Ethics: An Empirical Study

ERIC Educational Resources Information Center

Stanwick, Peter A.

2010-01-01

The purpose of this study is to empirically examine whether presenting a multimedia case study enhances the learning experience of students in an undergraduate management class. A questionnaire was administered before and after the presentation of the case study and the results showed that the multimedia case did indeed enhance the learning…

Case-control Studies on the Effectiveness of Breast Cancer Screening: Insights from the UK Age Trial.

PubMed

van der Waal, Daniëlle; Broeders, Mireille J M; Verbeek, André L M; Duffy, Stephen W; Moss, Sue M

2015-07-01

Ongoing breast cancer screening programs can only be evaluated using observational study designs. Most studies have observed a reduction in breast cancer mortality, but design differences appear to have resulted in different estimates. Direct comparison of case-control and trial analyses gives more insight into this variation. Here, we performed case-control analyses within the randomized UK Age Trial. The Age Trial assessed the effect of screening on breast cancer mortality in women ages 40-49 years. In our approach, case subjects were defined as breast cancer deaths between trial entry (1991-1997) and 2004. Women were ages 39-41 years at entry. For every case subject, five control subjects were selected. All case subjects were included in analyses of screening invitation (356 case subjects, 1,780 controls), whereas analyses of attendance were restricted to women invited to screening (105 case subjects, 525 age-matched controls). Odds ratios (OR) were estimated with conditional logistic regression. We used and compared two methods to correct for self-selection bias. Screening invitation resulted in a breast cancer mortality reduction of 17% (95% confidence interval [CI]: -36%, +6%), similar to trial results. Different exposure definitions and self-selection adjustments influenced the observed breast cancer mortality reduction. Depending on the method, "ever screened" appeared to be associated with a small reduction (OR: 0.86, 95% CI: 0.40, 1.89) or no reduction (OR: 1.02, 95% CI: 0.48, 2.14) using the two methods of correction. Recent attendance resulted in an adjusted mortality reduction of 36% (95% CI: -69%, +31%) or 45% (95% CI: -71%, +5%). Observational studies, and particularly case-control studies, are an important monitoring tool for breast cancer screening programs. The focus should be on diminishing bias in observational studies and gaining a better understanding of the influence of study design on estimates of mortality reduction.

Enhancing TB case detection: experience in offering upfront Xpert MTB/RIF testing to pediatric presumptive TB and DR TB cases for early rapid diagnosis of drug sensitive and drug resistant TB.

PubMed

Raizada, Neeraj; Sachdeva, Kuldeep Singh; Nair, Sreenivas Achuthan; Kulsange, Shubhangi; Gupta, Radhey Shayam; Thakur, Rahul; Parmar, Malik; Gray, Christen; Ramachandran, Ranjani; Vadera, Bhavin; Ekka, Shobha; Dhawan, Shikha; Babre, Ameet; Ghedia, Mayank; Alavadi, Umesh; Dewan, Puneet; Khetrapal, Mini; Khanna, Ashwini; Boehme, Catharina; Paramsivan, Chinnambedu Nainarappan

2014-01-01

Diagnosis of pulmonary tuberculosis (PTB) in children is challenging due to difficulties in obtaining good quality sputum specimens as well as the paucibacillary nature of disease. Globally a large proportion of pediatric tuberculosis (TB) cases are diagnosed based only on clinical findings. Xpert MTB/RIF, a highly sensitive and specific rapid tool, offers a promising solution in addressing these challenges. This study presents the results from pediatric groups taking part in a large demonstration study wherein Xpert MTB/RIF testing replaced smear microscopy for all presumptive PTB cases in public health facilities across India. The study covered a population of 8.8 million across 18 programmatic sub-district level tuberculosis units (TU), with one Xpert MTB/RIF platform established at each study TU. Pediatric presumptive PTB cases (both TB and Drug Resistant TB (DR-TB)) accessing any public health facilities in study area were prospectively enrolled and tested on Xpert MTB/RIF following a standardized diagnostic algorithm. 4,600 pediatric presumptive pulmonary TB cases were enrolled. 590 (12.8%, CI 11.8-13.8) pediatric PTB were diagnosed. Overall 10.4% (CI 9.5-11.2) of presumptive PTB cases had positive results by Xpert MTB/RIF, compared with 4.8% (CI 4.2-5.4) who had smear-positive results. Upfront Xpert MTB/RIF testing of presumptive PTB and presumptive DR-TB cases resulted in diagnosis of 79 and 12 rifampicin resistance cases, respectively. Positive predictive value (PPV) for rifampicin resistance detection was high (98%, CI 90.1-99.9), with no statistically significant variation with respect to past history of treatment. Upfront access to Xpert MTB/RIF testing in pediatric presumptive PTB cases was associated with a two-fold increase in bacteriologically-confirmed PTB, and increased detection of rifampicin-resistant TB cases under routine operational conditions across India. These results suggest that routine Xpert MTB/RIF testing is a promising solution to present-day challenges in the diagnosis of PTB in pediatric patients.

Molasses supplementation of grazing dairy cows: summary of case study, continuous culture fermenter trials, and controlled research farm study

USDA-ARS?s Scientific Manuscript database

This fact sheet summarizes the results of a three-tiered research approach (case study, two continuous culture fermenter studies, and a controlled research farm study) to evaluate molasses as an alternative supplement source for grazing dairy cows. A two-year case study of a New York organic dairy f...

The Impact of an Online Crowdsourcing Diagnostic Tool on Health Care Utilization: A Case Study Using a Novel Approach to Retrospective Claims Analysis.

PubMed

Juusola, Jessie L; Quisel, Thomas R; Foschini, Luca; Ladapo, Joseph A

2016-06-01

Patients with difficult medical cases often remain undiagnosed despite visiting multiple physicians. A new online platform, CrowdMed, uses crowdsourcing to quickly and efficiently reach an accurate diagnosis for these patients. This study sought to evaluate whether CrowdMed decreased health care utilization for patients who have used the service. Novel, electronic methods of patient recruitment and data collection were utilized. Patients who completed cases on CrowdMed's platform between July 2014 and April 2015 were recruited for the study via email and screened via an online survey. After providing eConsent, participants provided identifying information used to access their medical claims data, which was retrieved through a third-party web application program interface (API). Utilization metrics including frequency of provider visits and medical charges were compared pre- and post-case resolution to assess the impact of resolving a case on CrowdMed. Of 45 CrowdMed users who completed the study survey, comprehensive claims data was available via API for 13 participants, who made up the final enrolled sample. There were a total of 221 health care provider visits collected for the study participants, with service dates ranging from September 2013 to July 2015. Frequency of provider visits was significantly lower after resolution of a case on CrowdMed (mean of 1.07 visits per month pre-resolution vs. 0.65 visits per month post-resolution, P=.01). Medical charges were also significantly lower after case resolution (mean of US $719.70 per month pre-resolution vs. US $516.79 per month post-resolution, P=.03). There was no significant relationship between study results and disease onset date, and there was no evidence of regression to the mean influencing results. This study employed technology-enabled methods to demonstrate that patients who used CrowdMed had lower health care utilization after case resolution. However, since the final sample size was limited, results should be interpreted as a case study. Despite this limitation, the statistically significant results suggest that online crowdsourcing shows promise as an efficient method of solving difficult medical cases.

SU-E-T-511: Inter-Rater Variability in Classification of Incidents in a New Incident Reporting System

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

Pappas, D; Reis, S; Ali, A

Purpose To determine how consistent the results of different raters are when reviewing the same cases within the Radiation Oncology Incident Learning System (ROILS). Methods Three second-year medical physics graduate students filled out incident reports in spreadsheets set up to mimic ROILS. All students studied the same 33 cases and independently entered their assessments, for a total of 99 reviewed cases. The narratives for these cases were obtained from a published International Commission on Radiological Protection (ICRP) report which included shorter narratives selected from the Radiation Oncology Safety Information System (ROSIS) database. Each category of questions was reviewed to seemore » how consistent the results were by utilizing free-marginal multirater kappa analysis. The percentage of cases where all raters shared full agreement or full disagreement was recorded to show which questions were answered consistently by multiple raters for a given case. The consistency among the raters was analyzed between ICRP and ROSIS cases to see if either group led to more reliable results. Results The categories where all raters agreed 100 percent in their choices were the event type (93.94 percent of cases 0.946 kappa) and the likelihood of the event being harmful to the patient (42.42 percent of cases 0.409 kappa). The categories where all raters disagreed 100 percent in their choices were the dosimetric severity scale (39.39 percent of cases 0.139 kappa) and the potential future toxicity (48.48 percent of cases 0.205 kappa). ROSIS had more cases where all raters disagreed than ICRP (23.06 percent of cases compared to 15.58 percent, respectively). Conclusion Despite reviewing the same cases, the results among the three raters was widespread. ROSIS narratives were shorter than ICRP, which suggests that longer narratives lead to more consistent results. This study shows that the incident reporting system can be optimized to yield more consistent results.« less

Evaluation and perceived results of moral case deliberation: A mixed methods study.

PubMed

Janssens, Rien M J P A; van Zadelhoff, Ezra; van Loo, Ger; Widdershoven, Guy A M; Molewijk, Bert A C

2015-12-01

Moral case deliberation is increasingly becoming part of various Dutch healthcare organizations. Although some evaluation studies of moral case deliberation have been carried out, research into the results of moral case deliberation within aged care is scarce. How did participants evaluate moral case deliberation? What has moral case deliberation brought to them? What has moral case deliberation contributed to care practice? Should moral case deliberation be further implemented and, if so, how? Quantitative analysis of a questionnaire study among participants of moral case deliberation, both caregivers and team leaders. Qualitative analysis of written answers to open questions, interview study and focus group meetings among caregivers and team leaders. Caregivers and team leaders in a large organization for aged care in the Netherlands. A total of 61 moral case deliberation sessions, carried out on 16 care locations belonging to the organization, were evaluated and perceived results were assessed. Participants gave informed consent and anonymity was guaranteed. In the Netherlands, the law does not prescribe independent ethical review by an Institutional Review Board for this kind of research among healthcare professionals. Moral case deliberation was evaluated positively by the participants. Content and atmosphere of moral case deliberation received high scores, while organizational issues regarding the moral case deliberation sessions scored lower and merit further attention. Respondents indicated that moral case deliberation has the potential to contribute to care practice as relationships among team members improve, more openness is experienced and more understanding for different perspectives is fostered. If moral case deliberation is to be successfully implemented, top-down approaches should go hand in hand with bottom-up approaches. The relevance of moral case deliberation for care practice received wide acknowledgement from the respondents. It can contribute to the team's cohesion as mutual understanding for one another's views is fostered. If implemented well, moral case deliberation has the potential to improve care, according to the respondents. © The Author(s) 2014.

Epstein-Barr Virus and Gastric Cancer Risk: A Meta-analysis With Meta-regression of Case-control Studies.

PubMed

Bae, Jong-Myon; Kim, Eun Hee

2016-03-01

Research on how the risk of gastric cancer increases with Epstein-Barr virus (EBV) infection is lacking. In a systematic review that investigated studies published until September 2014, the authors did not calculate the summary odds ratio (SOR) due to heterogeneity across studies. Therefore, we include here additional studies published until October 2015 and conduct a meta-analysis with meta-regression that controls for the heterogeneity among studies. Using the studies selected in the previously published systematic review, we formulated lists of references, cited articles, and related articles provided by PubMed. From the lists, only case-control studies that detected EBV in tissue samples were selected. In order to control for the heterogeneity among studies, subgroup analysis and meta-regression were performed. In the 33 case-control results with adjacent non-cancer tissue, the total number of test samples in the case and control groups was 5280 and 4962, respectively. In the 14 case-control results with normal tissue, the total number of test samples in case and control groups was 1393 and 945, respectively. Upon meta-regression, the type of control tissue was found to be a statistically significant variable with regard to heterogeneity. When the control tissue was normal tissue of healthy individuals, the SOR was 3.41 (95% CI, 1.78 to 6.51; I-squared, 65.5%). The results of the present study support the argument that EBV infection increases the risk of gastric cancer. In the future, age-matched and sex-matched case-control studies should be conducted.

Automated surface quality inspection with ARGOS: a case study

NASA Astrophysics Data System (ADS)

Kiefhaber, Daniel; Etzold, Fabian; Warken, Arno F.; Asfour, Jean-Michel

2017-06-01

The commercial availability of automated inspection systems for optical surfaces specified according to ISO 10110-7 promises unsupervised and automated quality control with reproducible results. In this study, the classification results of the ARGOS inspection system are compared to the decisions by well-trained inspectors based on manual-visual inspection. Both are found to agree in 93.6% of the studied cases. Exemplary cases with differing results are studied, and shown to be partly caused by shortcomings of the ISO 10110-7 standard, which was written for the industry standard manual-visual inspection. Applying it to high resolution images of the whole surface of objective machine vision systems brings with it a few challenges which are discussed.

Impact of Community-Based DOT on Tuberculosis Treatment Outcomes: A Systematic Review and Meta-Analysis

PubMed Central

Zhang, HaiYang; Ehiri, John; Yang, Huan; Tang, Shenglan; Li, Ying

2016-01-01

Background Poor adherence to tuberculosis (TB) treatment can lead to prolonged infectivity and poor treatment outcomes. Directly observed treatment (DOT) seeks to improve adherence to TB treatment by observing patients while they take their anti-TB medication. Although community-based DOT (CB-DOT) programs have been widely studied and promoted, their effectiveness has been inconsistent. The aim of this study was to critical appraise and summarize evidence of the effects of CB-DOT on TB treatment outcomes. Methods Studies published up to the end of February 2015 were identified from three major international literature databases: Medline/PubMed, EBSCO, and EMBASE. Unpublished data from the grey literature were identified through Google and Google Scholar searches. Results Seventeen studies involving 12,839 pulmonary TB patients (PTB) in eight randomized controlled trials (RCTs) and nine cohort studies from 12 countries met the criteria for inclusion in this review and 14 studies were included in meta-analysis. Compared with clinic-based DOT, pooled results of RCTs for all PTB cases (including smear-negative or -positive, new or retreated TB cases) and smear-positive PTB cases indicated that CB-DOT promoted successful treatment [pooled RRs (95%CIs): 1.11 (1.02–1.19) for all PTB cases and 1.11 (1.02–1.19) for smear-positive PTB cases], and completed treatment [pooled RRs (95%CIs): 1.74(1.05, 2.90) for all PTB cases and 2.22(1.16, 4.23) for smear-positive PTB cases], reduced death [pooled RRs (95%CIs): 0.44 (0.26–0.72) for all PTB cases and 0.39 (0.23–0.66) for smear-positive PTB cases], and transfer out [pooled RRs (95%CIs): 0.37 (0.23–0.61) for all PTB cases and 0.42 (0.25–0.70) for smear-positive PTB cases]. Pooled results of all studies (RCTs and cohort studies) with all PTB cases demonstrated that CB-DOT promoted successful treatment [pooled RR (95%CI): 1.13 (1.03–1.24)] and curative treatment [pooled RR (95%CI): 1.24 (1.04–1.48)] compared with self-administered treatment. Conclusions CB-DOT did improved TB treatment outcomes according to the pooled results of included studies in this review. Studies on strategies for implementation of patient-centered and community-centered CB-DOT deserve further attention. PMID:26849656

International benchmarking of specialty hospitals. A series of case studies on comprehensive cancer centres

PubMed Central

2010-01-01

Background Benchmarking is one of the methods used in business that is applied to hospitals to improve the management of their operations. International comparison between hospitals can explain performance differences. As there is a trend towards specialization of hospitals, this study examines the benchmarking process and the success factors of benchmarking in international specialized cancer centres. Methods Three independent international benchmarking studies on operations management in cancer centres were conducted. The first study included three comprehensive cancer centres (CCC), three chemotherapy day units (CDU) were involved in the second study and four radiotherapy departments were included in the final study. Per multiple case study a research protocol was used to structure the benchmarking process. After reviewing the multiple case studies, the resulting description was used to study the research objectives. Results We adapted and evaluated existing benchmarking processes through formalizing stakeholder involvement and verifying the comparability of the partners. We also devised a framework to structure the indicators to produce a coherent indicator set and better improvement suggestions. Evaluating the feasibility of benchmarking as a tool to improve hospital processes led to mixed results. Case study 1 resulted in general recommendations for the organizations involved. In case study 2, the combination of benchmarking and lean management led in one CDU to a 24% increase in bed utilization and a 12% increase in productivity. Three radiotherapy departments of case study 3, were considering implementing the recommendations. Additionally, success factors, such as a well-defined and small project scope, partner selection based on clear criteria, stakeholder involvement, simple and well-structured indicators, analysis of both the process and its results and, adapt the identified better working methods to the own setting, were found. Conclusions The improved benchmarking process and the success factors can produce relevant input to improve the operations management of specialty hospitals. PMID:20807408

Alpha-fetoprotein and its value for predicting pregnancy outcomes – a re-evaluation

PubMed Central

Darouich, Ayham Alhaj; Liehr, Thomas; Weise, Anja; Schlembach, Dietmar; Schleußner, Ekkehart; Kiehntopf, Michael; Schreyer, Isolde

2015-01-01

Introduction Alpha-fetoprotein (AFP) concentrations can be determined framing others from invasively acquired amnion fluid (AF-AFP). While the biological role of AFP remains unclear it is well known that AFP-levels can be altered in connection with specific clinical and/or genetic alterations of the fetus. Materials and Method here a retrospective study based on 3,119 singleton and 56 twin pregnancies is presented. The standard levels of amnion fluid derived alpha-fetoprotein level (AF-AFP) between 12th and 36th weeks of gestation were determined. Additionally, acetylcholinesterase (AChE) test results for 63 cases, ultrasonography results for 32 cases and abnormal karyotypic findings for 100 cases were available for selected cases. Results and Discussion according to the present data the AF-AFP test is reliable and provides expected test results in terms of population studies. However, individual AF-AFP test results can be subject to high individual variations. In this study AF-AFP multiple of medians (MoM) over 1.7 were indicative for neuronal tube defects and/or omphalocele in only 6.3% of the cases, while such AF-AFP values were hints on severe sonographic signs in 62% of the cases. Also, altered AF-AFP concentrations were present in 82% of cytogenetically abnormal cases. Overall, even though predicative value of the AF-AFP-test is matter of discussion it continues to be widely applied in invasive prenatal diagnostics. This study indicates that it only can be applied reliably in combination with other tests like banding cytogenetics, ultrasonography and all embedded in well-established genetic counseling. PMID:27358693

[The IARC carcinogenicity evaluation of radio-frequency electromagnetic field: with special reference to epidemiology of mobile phone use and brain tumor risk].

PubMed

Yamaguchi, Naohito

2013-01-01

The International Agency for Research on Cancer of World Health Organization announced in May 2011 the results of evaluation of carcinogenicity of radio-frequency electromagnetic field. In the overall evaluation, the radio-frequency electromagnetic field was classified as "possibly carcinogenic to humans", on the basis of the fact that the evidence provided by epidemiological studies and animal bioassays was limited. Regarding epidemiology, the results of the Interphone Study, an international collaborative case-control study, were of special importance, together with the results of a prospective cohort study in Denmark, case-control studies in several countries, and a case-case study in Japan. The evidence obtained was considered limited, because the increased risk observed in some studies was possibly spurious, caused by selection bias or recall bias as well as residual effects of confounding factors. Further research studies, such as large-scale multinational epidemiological studies, are crucially needed to establish a sound evidence base from which a more conclusive judgment can be made for the carcinogenicity of the radio-frequency electromagnetic field.

Predictors of re-entry into the child protection system in Singapore: a cumulative ecological-transactional risk model.

PubMed

Li, Dongdong; Chu, Chi Meng; Ng, Wei Chern; Leong, Wai

2014-11-01

This study examines the risk factors of re-entry for 1,750 child protection cases in Singapore using a cumulative ecological-transactional risk model. Using administrative data, the present study found that the overall percentage of Child Protection Service (CPS) re-entry in Singapore is 10.5% based on 1,750 cases, with a range from 3.9% (within 1 year) to 16.5% (within 8 years after case closure). One quarter of the re-entry cases were observed to occur within 9 months from case closure. Seventeen risk factors, as identified from the extant literature, were tested for their utility to predict CPS re-entry in this study using a series of Cox regression analyses. A final list of seven risk factors (i.e., children's age at entry, case type, case closure result, duration of case, household income, family size, and mother's employment status) was used to create a cumulative risk score. The results supported the cumulative risk model in that higher risk score is related to higher risk of CPS re-entry. Understanding the prevalence of CPS re-entry and the risk factors associated with re-entry is the key to informing practice and policy in a culturally relevant way. The results from this study could then be used to facilitate critical case management decisions in order to enhance positive outcomes of families and children in Singapore's care system. Copyright © 2014 Elsevier Ltd. All rights reserved.

Case Study Effectiveness in a Team-Teaching and General-Education Environment

ERIC Educational Resources Information Center

Olorunnisola, Anthony A.; Ramasubramanian, Srividya; Russill, Chris; Dumas, Josephine

2003-01-01

This paper examines the effectiveness of the case study method in a team-teaching environment designed to augment a large capstone communications course that satisfies general education requirements. Results from a survey revealed that the use of case study enhanced the otherwise missing connection between the large lecture and the recitation…

Real Time Locations Systems or Outsourcing: A Case Study

ERIC Educational Resources Information Center

Lawrence, Cameron; Firth, David; Khumalo, Floyd

2013-01-01

Information Technology has transformed almost all aspects of modern healthcare and is playing a vital role in the administration of hospitals around the world. This case study examines one hospital's struggle to solve crucial operational problems related to the efficient management of medical equipment inventory. This case study is the result of…

Positivism, Postmodernism, or Critical Theory? A Case Study of Communications Students' Understandings of Criticism

ERIC Educational Resources Information Center

Fuchs, Christian; Sandoval, Marisol

2008-01-01

Neoliberalism has resulted in a large-scale economization and capitalization of society that has also permeated the academic system. The paper at hand provides the result of a case study that analyzed how students, who are today frequently confronted by the combination of studying and precarious labour and insecure job perspectives, assess the…

Interesting Practitioners in Training in Empirically Supported Treatments: Research Reviews versus Case Studies

PubMed Central

Stewart, Rebecca E.; Chambless, Dianne L.

2010-01-01

It has been repeatedly demonstrated that clinicians rely more on clinical judgment than on research findings. We hypothesized that psychologists in practice might be more open to adopting empirically supported treatments (ESTs) if outcome results were presented with a case study. Psychologists in private practice (N = 742) were randomly assigned to receive a research review of data from randomized controlled trials of cognitive-behavioral treatment (CBT) and medication for bulimia, a case study of CBT for a fictional patient with bulimia, or both. Results indicated that the inclusion of case examples renders ESTs more compelling and interests clinicians in gaining training. Despite these participants’ training in statistics, the inclusion of the statistical information had no influence on attitudes or training willingness beyond that of the anecdotal case information. PMID:19899142

Impact of selective reporting of antibiotic susceptibility test results on the appropriateness of antibiotics chosen by French general practitioners in urinary tract infections: a randomised controlled case-vignette study.

PubMed

Bourdellon, Loic; Thilly, Nathalie; Fougnot, Sébastien; Pulcini, Céline; Henard, Sandrine

2017-08-01

Selective reporting of antibiotic susceptibility test (AST) results is a potential intervention for laboratory-based antibiotic stewardship. The aim of this study was to assess the impact of AST reporting on the appropriateness of antibiotics selected by French general practitioners for urinary tract infections (UTIs). A randomised controlled case-vignette study in a region of northeast France surveyed general practitioners between July and October 2015 on treatment of four clinical cases of community-acquired Escherichia coli UTIs (two cases of complicated cystitis, one of acute pyelonephritis and one male UTI). In Group A, selective reporting of AST results was used for the first two cases and complete reporting for the other two cases; these were reversed in Group B. The overall participation rate was 131/198 (66.2%). Provision of selective AST results significantly increased the rate of adherence to national guidelines for first-line antibiotic treatment in Cases 1, 3 and 4 by 22.4% (55.2% vs. 32.8%, P = 0.01), 67.5% (75.0% vs. 7.5%, P <0.001) and 36.3% (45.3% vs. 9.0%, P <0.001), respectively. The improvement in compliance was not significant for Case 2. Prescriptions of amoxicillin-clavulanic acid, fluoroquinolones and cephalosporins decreased by 25.0% to 45.0%, depending on the clinical vignette. Most (106/131, 81.0%) participants favoured the routine use of selective reporting of AST results. In conclusion, selective reporting of AST results seems to improve antibiotic prescribing practices in primary care, and may be considered a key element of antimicrobial stewardship programmes. Copyright © 2017 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.

Improving ethical knowledge and sensemaking from cases through elaborative interrogation and outcome valence.

PubMed

Johnson, James F; Bagdasarov, Zhanna; MacDougall, Alexandra E; Steele, Logan; Connelly, Shane; Devenport, Lynn D; Mumford, Michael D

2014-01-01

The case-based approach to learning is popular among many applied fields. However, results of case-based education vary widely on case content and case presentation. This study examined two aspects of case-based education-outcome valence and case elaboration methods-in a two-day case-based Responsible Conduct of Research (RCR) ethics education program. Results suggest that outcome information is an integral part of a quality case. Furthermore, valence consistent outcomes may have certain advantages over mixed valence outcome information. Finally, students enjoy and excel working with case material, and the use of elaborative interrogation techniques can significantly improve internally-focused ethical sensemaking strategies associated with personal biases, constraints, and emotions.

Daily Report Card Intervention and Attention Deficit Hyperactivity Disorder: A Meta-Analysis of Single-Case Studies

ERIC Educational Resources Information Center

Pyle, Kellina; Fabiano, Gregory A.

2017-01-01

The daily report card (DRC) is a commonly employed behavioral intervention for treating attention deficit hyperactivity disorder (ADHD) in schools. Much of the support for the DRC comes from single-case studies, which have traditionally received less attention than group studies. This lack of attention to single-case studies results in an…

Daily Report Card Intervention and Attention Deficit Hyperactivity Disorder: A Meta-Analysis of Single-Case Studies

ERIC Educational Resources Information Center

Pyle, Kellina K.; Fabiano, Gregory A.

2017-01-01

The Daily Report Card (DRC) is a commonly employed behavioral intervention for treating Attention Deficit Hyperactivity Disorder (ADHD) in schools. Much of the support for the DRC comes from single-case studies, which have traditionally received less attention than group studies. This lack of attention to single-case studies results in an…

The Relationship between School Culture and the School Library Program: Four Case Studies

ERIC Educational Resources Information Center

Howard, Jody K.

2010-01-01

This research describes the results of a cross-case analysis of four individual case studies at schools having nationally recognized school library programs. The focus of the study is on the culture of the school as an organization and its effect on establishing an effective school library program. The purpose of the study was to identify cultural…

Global dengue death before and after the new World Health Organization 2009 case classification: A systematic review and meta-regression analysis.

PubMed

Low, Gary Kim-Kuan; Ogston, Simon A; Yong, Mun-Hin; Gan, Seng-Chiew; Chee, Hui-Yee

2018-06-01

Since the introduction of 2009 WHO dengue case classification, no literature was found regarding its effect on dengue death. This study was to evaluate the effect of 2009 WHO dengue case classification towards dengue case fatality rate. Various databases were used to search relevant articles since 1995. Studies included were cohort and cross-sectional studies, all patients with dengue infection and must report the number of death or case fatality rate. The Joanna Briggs Institute appraisal checklist was used to evaluate the risk of bias of the full-texts. The studies were grouped according to the classification adopted: WHO 1997 and WHO 2009. Meta-regression was employed using a logistic transformation (log-odds) of the case fatality rate. The result of the meta-regression was the adjusted case fatality rate and odds ratio on the explanatory variables. A total of 77 studies were included in the meta-regression analysis. The case fatality rate for all studies combined was 1.14% with 95% confidence interval (CI) of 0.82-1.58%. The combined (unadjusted) case fatality rate for 69 studies which adopted WHO 1997 dengue case classification was 1.09% with 95% CI of 0.77-1.55%; and for eight studies with WHO 2009 was 1.62% with 95% CI of 0.64-4.02%. The unadjusted and adjusted odds ratio of case fatality using WHO 2009 dengue case classification was 1.49 (95% CI: 0.52, 4.24) and 0.83 (95% CI: 0.26, 2.63) respectively, compared to WHO 1997 dengue case classification. There was an apparent increase in trend of case fatality rate from the year 1992-2016. Neither was statistically significant. The WHO 2009 dengue case classification might have no effect towards the case fatality rate although the adjusted results indicated a lower case fatality rate. Future studies are required for an update in the meta-regression analysis to confirm the findings. Copyright © 2018 Elsevier B.V. All rights reserved.

Numerical Analysis Study of Sarawak Barrage River Bed Erosion and Scouring by Using Smooth Particle Hydrodynamic (SPH)

NASA Astrophysics Data System (ADS)

Zainol, M. R. R. M. A.; Kamaruddin, M. A.; Zawawi, M. H.; Wahab, K. A.

2017-11-01

Smooth Particle Hydrodynamic is the three-dimensional (3D) model. In this research work, three cases and one validation have been simulate using DualSPHysics. Study area of this research work was at Sarawak Barrage. The cases have different water level at the downstream. This study actually to simulate riverbed erosion and scouring properties by using multi-phases cases which use sand as sediment and water. The velocity and the scouring profile have been recorded as the result and shown in the result chapter. The result of the validation is acceptable where the scouring profile and the velocity were slightly different between laboratory experiment and simulation. Hence, it can be concluded that the simulation by using SPH can be used as the alternative to simulate the real cases.

Results of neurolysis in established upper limb Volkmann's ischemic contracture

PubMed Central

Meena, Dinesh K; Thalanki, Srikiran; Patni, Poornima; Meena, Ram Khiladi; Bairawa, Dinesh; Bhatia, Chirag

2016-01-01

Background: Treatment of established cases of Volkmann's ischemic contracture (VIC) of upper limb is very tedious. Since the period of Volkmann, various experimental works are being performed for its treatment, but none are effective. Disabilities from nerve palsy and hand muscle paralysis are more problematic than any other deformity in VIC. To solve these problems, we conducted a study to see the result of neurolysis of median and ulnar nerve and their subcutaneous placement in established cases of VIC. Materials and Methods: Twelve cases of established VIC operated between July 2007 and August 2010 with complete records and followup were included in the study. VIC of lower limb and contracture of nonischemic etiology were excluded from the study. Their evaluation was done by the British Medical Research Council grading system for sensory and motor recovery. Followup was done for an average period of 24.3 months (range 15-30 months) (the average age was 8.3 years). Results: To study the results, we divided the cases into two series. One group consisted of cases which were operated within 6 months from onset of VIC. The second group consisted of cases which were operated after 6 months from onset of VIC. Our results revealed that there was no statistically significant difference between the two groups operated, though both had significant improvement in motor and sensory recovery in both median and ulnar nerve distribution. Conclusions: Neurolysis of the nerves definitely improved the outcome for motor and sensory components of median and ulnar nerves but the timing of the surgery did not play a role in the outcome contrary to the clinical assumption. This study can serve as a template and further such studies could help us find the answer to a long standing issue. PMID:27904214

Case-control vaccine effectiveness studies: Preparation, design, and enrollment of cases and controls.

PubMed

Verani, Jennifer R; Baqui, Abdullah H; Broome, Claire V; Cherian, Thomas; Cohen, Cheryl; Farrar, Jennifer L; Feikin, Daniel R; Groome, Michelle J; Hajjeh, Rana A; Johnson, Hope L; Madhi, Shabir A; Mulholland, Kim; O'Brien, Katherine L; Parashar, Umesh D; Patel, Manish M; Rodrigues, Laura C; Santosham, Mathuram; Scott, J Anthony; Smith, Peter G; Sommerfelt, Halvor; Tate, Jacqueline E; Victor, J Chris; Whitney, Cynthia G; Zaidi, Anita K; Zell, Elizabeth R

2017-06-05

Case-control studies are commonly used to evaluate effectiveness of licensed vaccines after deployment in public health programs. Such studies can provide policy-relevant data on vaccine performance under 'real world' conditions, contributing to the evidence base to support and sustain introduction of new vaccines. However, case-control studies do not measure the impact of vaccine introduction on disease at a population level, and are subject to bias and confounding, which may lead to inaccurate results that can misinform policy decisions. In 2012, a group of experts met to review recent experience with case-control studies evaluating the effectiveness of several vaccines; here we summarize the recommendations of that group regarding best practices for planning, design and enrollment of cases and controls. Rigorous planning and preparation should focus on understanding the study context including healthcare-seeking and vaccination practices. Case-control vaccine effectiveness studies are best carried out soon after vaccine introduction because high coverage creates strong potential for confounding. Endpoints specific to the vaccine target are preferable to non-specific clinical syndromes since the proportion of non-specific outcomes preventable through vaccination may vary over time and place, leading to potentially confusing results. Controls should be representative of the source population from which cases arise, and are generally recruited from the community or health facilities where cases are enrolled. Matching of controls to cases for potential confounding factors is commonly used, although should be reserved for a limited number of key variables believed to be linked to both vaccination and disease. Case-control vaccine effectiveness studies can provide information useful to guide policy decisions and vaccine development, however rigorous preparation and design is essential. Published by Elsevier Ltd.

Case definitions for chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME): a systematic review

PubMed Central

Brurberg, Kjetil Gundro; Fønhus, Marita Sporstøl; Larun, Lillebeth; Flottorp, Signe; Malterud, Kirsti

2014-01-01

Objective To identify case definitions for chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME), and explore how the validity of case definitions can be evaluated in the absence of a reference standard. Design Systematic review. Setting International. Participants A literature search, updated as of November 2013, led to the identification of 20 case definitions and inclusion of 38 validation studies. Primary and secondary outcome measure Validation studies were assessed for risk of bias and categorised according to three validation models: (1) independent application of several case definitions on the same population, (2) sequential application of different case definitions on patients diagnosed with CFS/ME with one set of diagnostic criteria or (3) comparison of prevalence estimates from different case definitions applied on different populations. Results A total of 38 studies contributed data of sufficient quality and consistency for evaluation of validity, with CDC-1994/Fukuda as the most frequently applied case definition. No study rigorously assessed the reproducibility or feasibility of case definitions. Validation studies were small with methodological weaknesses and inconsistent results. No empirical data indicated that any case definition specifically identified patients with a neuroimmunological condition. Conclusions Classification of patients according to severity and symptom patterns, aiming to predict prognosis or effectiveness of therapy, seems useful. Development of further case definitions of CFS/ME should be given a low priority. Consistency in research can be achieved by applying diagnostic criteria that have been subjected to systematic evaluation. PMID:24508851

What Case Managers Should Know About Their Roles and Functions: A National Study From the Commission for Case Manager Certification: Part 1.

PubMed

Tahan, Hussein M; Watson, Annette C; Sminkey, Patrice V

2015-01-01

The purpose of this national role and function study was to identify the essential activities and necessary knowledge areas for effective case manager practice from the perspective of those currently functioning in various care settings and across diverse professional disciplines. The national study covered all case management practices and/or work settings across the full continuum of health care. This cross-sectional descriptive study used the practice analysis method and online survey research design. It employed a purposive sample of case managers, in which 52,370 individuals received an invitation to participate. Data collection completed over a 4-week period, resulting in 7,668 useable survey responses (nearly a 15% response rate). The study identified the common activities and knowledge areas necessary for competent and effective performance of case managers, as is highlighted in this article, which is the first of a 2-part series on the role and function study. The results informed the needed update of the test specifications for the Certified Case Manager (CCM) certification examination, as will be delineated in Part 2 of the article series, to ensure that it continues to be substantiated in current practice. Of special note are the emergence of specific activity and knowledge domains in the area of case management ethical, legal, and practice standards, and an increase in the number of employers requiring certified case managers to fill vacant positions and compensating them financially for such qualifications. This study helps keep the CCM credentialing examination evidence-based and maintain its validity for evaluating competency of case managers. Specifically, the study identified essential activities and knowledge domains that define competent case management practice. Findings can be used for developing programs and curricula for the training and development of case managers. The study instrument also can be used for further research of case management practice.

Flow cytometry in the bone marrow evaluation of follicular and diffuse large B-cell lymphomas.

PubMed

Palacio, C; Acebedo, G; Navarrete, M; Ruiz-Marcellán, C; Sanchez, C; Blanco, A; López, A

2001-09-01

Bone marrow biopsies are routinely performed in the staging of patients with lymphoma. Despite the lack of evidence for its usefulness, many institutions include flow cytometry (FC) of bone-marrow aspirates in an attempt to increase sensitivity and specificity. The aim of this study is to evaluate the usefulness of FC for the assessment of bone-marrow involvement by lymphoma in follicular (FL) and diffuse large B-cell lymphomas (DLBCL). Seventy-nine bone marrow biopsies from 65 patients diagnosed with FL or DLBCL were examined to compare histology and FC for the assessment of bone-marrow involvement by lymphoma. Bone marrow histology showed involvement (BM+) in 16 cases (20.3%), lack of infiltration (BM(-)) in 52 cases (65.8%) and undetermined or undiagnosed for involvement (BMu) in 11 cases (13.9%). FC was positive for involvement in 28 cases (35.4%) and negative in 51 cases (64.6%). 65 cases (95%) showed concordance between the results of morphology and FC (BM(+)/FC(+) or BM(-)/FC(-)). No BM(+)/FC(-) cases were observed. 3 cases showed discrepant results (BM(-)/FC(+)). In these 3 cases the molecular studies (PCR) demonstrated clonal rearrangement of the heavy immunoglobulin chain (IgH) and/or bcl2-IgH in agreement with the flow results. Among the 11 cases with BMu, all but 2 were FC(+) and concordance with the PCR results was seen in 9 cases (81.9%). We conclude that FC is just as sensitive or perhaps slightly more sensitive than histology in the detection of bone marrow involvement in FL and DLBCL. FC studies may be warranted in those cases in which the morphology is not diagnosed. The clinical relevance of the small clonal B-cell population in patients without histologic bone marrow involvement (BM(-)/FC(+) cases) remains an open question.

Coffee, decaffeinated coffee, tea and cancer of the colon and rectum: a review of epidemiological studies, 1990-2003.

PubMed

Tavani, Alessandra; La Vecchia, Carlo

2004-10-01

The literature from 1990 to 2003 on the relation between coffee, decaffeinated coffee, tea and colorectal cancer risk has been reviewed. For the relation with coffee, three cohort (517 total cases) and nine case-control studies (7555 cases) analysed colon cancer; three cohort (307 cases) and four case-control studies (2704 cases) rectal cancer; six case-control studies (854 cases) colorectal cancer. For colon cancer most case-control studies found risk estimates below unity; the results are less clear for cohort studies. No relation emerged for rectal cancer. A meta-analysis, including five cohort and twelve case-control studies, reported a pooled relative risk of 0.76 (significant). Any methodological artefact is unlikely to account for the consistent inverse association in different countries and settings. Plausible biological explanations include coffee-related reductions of cholesterol, bile acids and neutral sterol secretion in the colon; antimutagenic properties of selected coffee components; increased colonic motility. Decaffeinated coffee was not related to either colon or rectal cancer in three case-control studies. No overall association between tea and either colon or rectal cancer risk emerged in seven cohort (1756 total cases of colon, 759 of rectal and 60 of colorectal cancer) and 12 case-control studies (8058 cases of colon, 4865 of rectal, 604 of colorectal cancer).

Transformational change in healthcare: an examination of four case studies.

PubMed

Charlesworth, Kate; Jamieson, Maggie; Davey, Rachel; Butler, Colin D

2016-04-01

Objectives Healthcare leaders around the world are calling for radical, transformational change of our health and care systems. This will be a difficult and complex task. In this article, we examine case studies in which transformational change has been achieved, and seek to learn from these experiences. Methods We used the case study method to investigate examples of transformational change in healthcare. The case studies were identified from preliminary doctoral research into the transition towards future sustainable health and social care systems. Evidence was collected from multiple sources, key features of each case study were displayed in a matrix and thematic analysis was conducted. The results are presented in narrative form. Results Four case studies were selected: two from the US, one from Australia and one from the UK. The notable features are discussed for each case study. There were many common factors: a well communicated vision, innovative redesign, extensive consultation and engagement with staff and patients, performance management, automated information management and high-quality leadership. Conclusions Although there were some notable differences between the case studies, overall the characteristics of success were similar and collectively provide a blueprint for transformational change in healthcare. What is known about the topic? Healthcare leaders around the world are calling for radical redesign of our systems in order to meet the challenges of modern society. What does this paper add? There are some remarkable examples of transformational change in healthcare. The key factors in success are similar across the case studies. What are the implications for practitioners? Collectively, these key factors can guide future attempts at transformational change in healthcare.

Pathology analysis for mesothelioma study in the United Kingdom: Current practice and historical development.

PubMed

Case, B W

2016-01-01

Following up on the largest case-control study of malignant mesothelioma yet performed, investigators at the London School of Hygiene and Tropical Medicine assessed 1732 male and 670 female cases as of May 2013. Epidemiological findings of a subset of these were published previously, excluding patients who died or who refused to be interviewed. Pathology reports were collected for subjects, including those both eligible and ineligible for epidemiology study based on vital status. The current investigation examined 860 cases having pathology reports available. Sixty-one cases were diagnosed using cytology only, often with equivocal diagnoses, while 799 reported at least a biopsy of the tumor. Of these, 748 had pathology sufficiently detailed for evaluation. These reports were examined for basis of diagnosis, differences between study cases and ineligible cases, pathology characteristics, and immunohistochemical and other tests used. The most prominent subtype was epithelioid (64% of study cases but only 49% of ineligible cases). Biphasic subtype was present in 10% of study cases and 16% of those ineligible. Sarcomatoid subtype was present in 7% of study cases and 19% of ineligible cases, most of whom died. Twelve percent of study cases displayed no specified subtype, versus 7% of ineligible cases. Of recorded immunohistochemical stains specific for mesothelial cell origin, calretinin (95%) and CK 5/6 or CK5 alone (84%) were by far the most common. Calretinin and CK 5/6 or CK 5 alone were also most sensitive and positive in 92% of cases presenting with surgical pathology report. Ninety percent of cases had at least one immunohistochemical marker for possible lung carcinoma applied, with BER-Ep4 and TTF-1 the most frequent at 68% and CEA at 58%. TTF-1 and CEA were positive in 1% or less of cases. Patterns of use and positive and negative results for each of these as well as other immunohistochemical stains are presented and discussed, along with a brief historical description of their development and use. Possible effects of the pathologic analysis on the results of previously published and future epidemiological studies are discussed.

[False positive result in mammography and its association with the presence of obesity: a case-control study].

PubMed

Castro-Ibarra, Marisela; Menchaca-Díaz, Rufino; Cabrales-Ruvalcaba, J Jesús; Luna-V Gómez, Rosa Alicia

2016-01-01

To analyze the association between a false positive result in mammography and obesity, inside the breast cancer early detection program in women affiliated to the Institute of Security and Social Services for Government and Municipality workers of the State of Baja California (ISSSTECALI). A case-control, retrospective study was done in women affiliated to ISSSTECALI to whom a mammography was performed between 2009 and 2012. Women with a false positive result in mammography were included as cases. Controls were women with a true negative result in mammography. Three controls were randomly selected for each case. Obesity was established with the body mass index (BMI) consigned in the woman's clinical file. Age and estrogen replacement therapy were included as co-variables. Seventy nine cases were identified and 237 controls were included. Obesity was observed in 54.4% of cases and in 41.3% of controls (odds ratio: 1.69; 95% confidence interval for odds ratio: 1.01-2.82; p value: 0.043). A logistic regression model including covariables maintained the observed association (p = 0.044). No association was found with analyzed co-variables. A false positive result in mammography was associated with the presence of obesity.

Importance of relationship context in HIV transmission: results from a qualitative case-control study in Rakai, Uganda.

PubMed

Higgins, Jenny A; Mathur, Sanyukta; Eckel, Elizabeth; Kelley, Laura; Kelly, Laura; Nakyanjo, Neema; Sekamwa, Richard; Namatovu, Josephine; Ddaaki, William; Nakubulwa, Rosette; Namakula, Sylvia; Nalugoda, Fred; Santelli, John S

2014-04-01

We present results from life history interviews with 60 young adults from southern Uganda. Using a novel qualitative case-control design, we compared newly HIV-positive cases with HIV-negative controls matched on age, gender, marital status, and place of residence. Relationship context was the most salient theme differentiating cases from controls. Compared with HIV-negative respondents, recent seroconverters described relationships marked by poorer communication, greater suspicion and mistrust, and larger and more transitory sexual networks. Results highlight the importance of dyadic approaches to HIV and possibly of couple-based interventions. Using HIV-matched pairs allowed additional understanding of the factors influencing transmission. This hybrid methodological approach holds promise for future studies of sexual health.

Importance of Relationship Context in HIV Transmission: Results From a Qualitative Case-Control Study in Rakai, Uganda

PubMed Central

Mathur, Sanyukta; Eckel, Elizabeth; Kelly, Laura; Nakyanjo, Neema; Sekamwa, Richard; Namatovu, Josephine; Ddaaki, William; Nakubulwa, Rosette; Namakula, Sylvia; Nalugoda, Fred; Santelli, John S.

2014-01-01

We present results from life history interviews with 60 young adults from southern Uganda. Using a novel qualitative case-control design, we compared newly HIV-positive cases with HIV-negative controls matched on age, gender, marital status, and place of residence. Relationship context was the most salient theme differentiating cases from controls. Compared with HIV-negative respondents, recent seroconverters described relationships marked by poorer communication, greater suspicion and mistrust, and larger and more transitory sexual networks. Results highlight the importance of dyadic approaches to HIV and possibly of couple-based interventions. Using HIV-matched pairs allowed additional understanding of the factors influencing transmission. This hybrid methodological approach holds promise for future studies of sexual health. PMID:24524490

Exchangeability in the case-crossover design

PubMed Central

Mittleman, Murray A; Mostofsky, Elizabeth

2014-01-01

In cohort and case-control studies, confounding that arises as a result of differences in the distribution of determinants of the outcome between exposure groups leading to non-exchangeability are addressed by restriction, matching or with statistical models. In case-only studies, this issue is addressed by comparing each individual with his/herself. Although case-only designs use self-matching and only include individuals who develop the outcome of interest, issues of non-exchangeability are identical to those that arise in traditional case-control and cohort studies. In this review, we describe one type of case-only design, the case-crossover design, and discuss how the concept of exchangeability can be used to understand issues of confounding, carryover effects, period effects and selection bias in case-crossover studies. PMID:24756878

Case-control studies of the efficacy of cancer screening: overcoming bias from nonrandom patterns of screening.

PubMed

Weiss, Noel S; Dhillon, Preet K; Etzioni, Ruth

2004-07-01

A case-control study of the efficacy of cancer screening, like any other case-control study, must deal with potential confounding. There are 2 categories of confounding variables that pose special problems for studies of screening: (1) age and calendar time resulting from different temporal distributions of screening between cases and controls irrespective of whether the screening test leads to a reduction in mortality; and (2) the administration of other screening tests for the cancer in question when it is not clear whether the result of the other test had a bearing on the decision to order the test under study. We describe circumstances in which confounding from these sources can be dealt with satisfactorily by means of restriction or adjustment, and other circumstances in which it cannot. Copyright 2004 Lippincott Williams and Wilkins

Evaluation of paradoxical TB–associated IRIS with the use of standardized case definitions for resource limited settings

PubMed Central

Eshun-Wilson, Ingrid; Havers, Fiona; Nachega, Jean B; Prozesky, Hans W; Taljaard, Jantjie J; Zeier, Michele D; Cotton, Mark; Simon, Gary; Soentjens, Patrick

2011-01-01

Objective Standardized case definitions have recently been proposed by the International Network for the Study of HIV-associated IRIS (INSHI) for use in resource-limited settings. We evaluated paradoxical TB-associated IRIS in a large cohort from a TB endemic setting with the use of these case definitions. Design A retrospective cohort analysis. Methods We reviewed records from 1250 South African patients who initiated anti-retroviral therapy (ART) over a five-year period. Results 333 (27%) of the patients in the cohort had prevalent TB at the initiation of ART. Of 54 possible paradoxical TB-associated IRIS cases, 35 fulfilled the INSHI case definitions (11% of TB cases). Conclusions INSHI standardised case definitions were used successfully in identifying paradoxical TB-associated IRIS in this cohort and resulted in a similar proportion of TB IRIS cases (11%) as that reported in previous studies from resource-limited settings (8-13%). This case definition should be evaluated prospectively. PMID:20160249

Case Study: A Separation of Powers Lesson.

ERIC Educational Resources Information Center

Jenkins, Steve

1986-01-01

Presents a case study involving students in the issue of separation of powers as applied to the 1952 Immigration and Nationality Act. Students examine the case of Jagdish Rai Chadha, an immigrant threatened with deportation whose problems resulted in 1983 U.S. Supreme Court decision declaring legislative veto provision of Immigration and…

Acupuncture: a first approach on pain relief using a 617 nm LED device

NASA Astrophysics Data System (ADS)

Costa, J. M.; Corral-Baqués, M. I.; Amat, A.

2007-02-01

In this study, a preliminary approach for pain relief using a novel pulsated LED device was conducted. 12 patients were treated with a Photopuncture device designed by SORISA, which consisted in a 10-channel LED system at 617 nm. 15 patients with different pain localizations were treated: cervicobrachialgia (3 cases), lumbago / sciatica (4 cases), gonalgia (3 cases), cephalalgia (2 cases), talalgia (1 case), epicondylitis (1 case) and trigeminal neuralgia (1 case). To characterize the pain level, the Categorical Pain Scale (none (0), mild (1-3), moderate (4-6) and severe (7-10)) was used. Just patients with severe pain (7-10) were treated. Patients were treated twice a week for 25 minutes; 5 to 8 sessions were given at the following treatment parameters: 10 mW per channel pulsed at 60 Hz with a 50 % duty cycle. The total dose for point was 7.5 J. To characterize the response to the treatment, the results were classified as: "no result", no changes in pain degree; "poor", pain decreased one category; "good", pain decreased two categories; "very good", complete healing (no pain). The results were: 1 case with "very good" result; 11 cases with "good" result; 3 cases with "poor" result; and 0 cases with "no result". We conclude that the Photopuncture led device may be a good alternative to classical Acupuncture in pain relief, although further experimentation is required.

Language and Communication in the Absence of Speech: A Case Study.

ERIC Educational Resources Information Center

Rogow, Sally M.

This case study reports on the language development of a child with severe speech and multiple handicaps resulting from "severe epileptic encephalopathy" who is, however, able to competently read, write, and comprehend two languages (English and Cantonese) but does not initiate conversations. Data were gathered as a result of weekly home visits…

Assigning and Combining Probabilities in Single-Case Studies

ERIC Educational Resources Information Center

Manolov, Rumen; Solanas, Antonio

2012-01-01

There is currently a considerable diversity of quantitative measures available for summarizing the results in single-case studies. Given that the interpretation of some of them is difficult due to the lack of established benchmarks, the current article proposes an approach for obtaining further numerical evidence on the importance of the results,…

[Studies of flomoxef in neonates].

PubMed

Sato, H; Narita, A; Matsumoto, K; Nakazawa, S; Suzuki, H; Nakanishi, Y; Nagao, K; Nakazawa, S; Niinou, K

1991-11-01

Studies on pharmacokinetics and clinical effects of flomoxef (FMOX), a parenteral oxacephem antibiotic, were carried out in neonates. The results obtained are summarized as follows. 1. Mean peak serum concentrations of FMOX upon single administrations at doses of 20 mg/kg and 40 mg/kg were 33.3 +/- 7.33 micrograms/ml and 68.9 micrograms/ml, respectively. 2. Mean urinary recovery rates of FMOX in the first 6 hours after administration of the above doses were 35.2% and 48.3%, respectively. 3. FMOX was administered to 4 cases including 1 prophylactic case, 1 case each with aspiration pneumonia and sepsis, hypodermic abscess of the head, and itrauterine infection, at a dose of 20-30 mg/kg 2 or 3 times a day. Clinically, excellent results were obtained in 3 cases including an methicillin-resistant Staphylococcus aureus case. 4. No side effects nor abnormal laboratory test results were observed.

Retrospective study of sonographic findings in bone involvement associated with rotator cuff calcific tendinopathy: preliminary results of a case series*

PubMed Central

Nogueira-Barbosa, Marcello H.; Gregio-Junior, Everaldo; Lorenzato, Mario Muller

2015-01-01

Objective The present study was aimed at investigating bone involvement secondary to rotator cuff calcific tendonitis at ultrasonography. Materials and Methods Retrospective study of a case series. The authors reviewed shoulder ultrasonography reports of 141 patients diagnosed with rotator cuff calcific tendonitis, collected from the computer-based data records of their institution over a four-year period. Imaging findings were retrospectively and consensually analyzed by two experienced musculoskeletal radiologists looking for bone involvement associated with calcific tendonitis. Only the cases confirmed by computed tomography were considered for descriptive analysis. Results Sonographic findings of calcific tendinopathy with bone involvement were observed in 7/141 (~ 5%) patients (mean age, 50.9 years; age range, 42-58 years; 42% female). Cortical bone erosion adjacent to tendon calcification was the most common finding, observed in 7/7 cases. Signs of intraosseous migration were found in 3/7 cases, and subcortical cysts in 2/7 cases. The findings were confirmed by computed tomography. Calcifications associated with bone abnormalities showed no acoustic shadowing at ultrasonography, favoring the hypothesis of resorption phase of the disease. Conclusion Preliminary results of the present study suggest that ultrasonography can identify bone abnormalities secondary to rotator cuff calcific tendinopathy, particularly the presence of cortical bone erosion. PMID:26811551

Case Studies Comparing System Advisor Model (SAM) Results to Real Performance Data: Preprint

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

Blair, N.; Dobos, A.; Sather, N.

2012-06-01

NREL has completed a series of detailed case studies comparing the simulations of the System Advisor Model (SAM) and measured performance data or published performance expectations. These case studies compare PV measured performance data with simulated performance data using appropriate weather data. The measured data sets were primarily taken from NREL onsite PV systems and weather monitoring stations.

Big Data Science Education: A Case Study of a Project-Focused Introductory Course

ERIC Educational Resources Information Center

Saltz, Jeffrey; Heckman, Robert

2015-01-01

This paper reports on a case study of a project-focused introduction to big data science course. The pedagogy of the course leveraged boundary theory, where students were positioned to be at the boundary between a client's desire to understand their data and the academic class. The results of the case study demonstrate that using live clients…

A stochastic approach for automatic generation of urban drainage systems.

PubMed

Möderl, M; Butler, D; Rauch, W

2009-01-01

Typically, performance evaluation of new developed methodologies is based on one or more case studies. The investigation of multiple real world case studies is tedious and time consuming. Moreover extrapolating conclusions from individual investigations to a general basis is arguable and sometimes even wrong. In this article a stochastic approach is presented to evaluate new developed methodologies on a broader basis. For the approach the Matlab-tool "Case Study Generator" is developed which generates a variety of different virtual urban drainage systems automatically using boundary conditions e.g. length of urban drainage system, slope of catchment surface, etc. as input. The layout of the sewer system is based on an adapted Galton-Watson branching process. The sub catchments are allocated considering a digital terrain model. Sewer system components are designed according to standard values. In total, 10,000 different virtual case studies of urban drainage system are generated and simulated. Consequently, simulation results are evaluated using a performance indicator for surface flooding. Comparison between results of the virtual and two real world case studies indicates the promise of the method. The novelty of the approach is that it is possible to get more general conclusions in contrast to traditional evaluations with few case studies.

International benchmarking of specialty hospitals. A series of case studies on comprehensive cancer centres.

PubMed

van Lent, Wineke A M; de Beer, Relinde D; van Harten, Wim H

2010-08-31

Benchmarking is one of the methods used in business that is applied to hospitals to improve the management of their operations. International comparison between hospitals can explain performance differences. As there is a trend towards specialization of hospitals, this study examines the benchmarking process and the success factors of benchmarking in international specialized cancer centres. Three independent international benchmarking studies on operations management in cancer centres were conducted. The first study included three comprehensive cancer centres (CCC), three chemotherapy day units (CDU) were involved in the second study and four radiotherapy departments were included in the final study. Per multiple case study a research protocol was used to structure the benchmarking process. After reviewing the multiple case studies, the resulting description was used to study the research objectives. We adapted and evaluated existing benchmarking processes through formalizing stakeholder involvement and verifying the comparability of the partners. We also devised a framework to structure the indicators to produce a coherent indicator set and better improvement suggestions. Evaluating the feasibility of benchmarking as a tool to improve hospital processes led to mixed results. Case study 1 resulted in general recommendations for the organizations involved. In case study 2, the combination of benchmarking and lean management led in one CDU to a 24% increase in bed utilization and a 12% increase in productivity. Three radiotherapy departments of case study 3, were considering implementing the recommendations.Additionally, success factors, such as a well-defined and small project scope, partner selection based on clear criteria, stakeholder involvement, simple and well-structured indicators, analysis of both the process and its results and, adapt the identified better working methods to the own setting, were found. The improved benchmarking process and the success factors can produce relevant input to improve the operations management of specialty hospitals.

Query Optimization in Distributed Databases.

DTIC Science & Technology

1982-10-01

general, the strategy a31 a11 a 3 is more time comsuming than the strategy a, a, and sually we do not use it. Since the semijoin of R.XJ> RS requires...analytic behavior of those heuristic algorithms. Although some analytic results of worst case and average case analysis are difficult to obtain, some...is the study of the analytic behavior of those heuristic algorithms. Although some analytic results of worst case and average case analysis are

Deflection and Supporting Force Analysis of a Slender Beam under Combined Transverse and Tensile Axial Loads

DTIC Science & Technology

2016-05-01

force T > 0 case (this study) ............................................. 3 3.3 Nonlinear FEA solution for tension force T ≥ 0 case...6 3.4 Computed analytical and nonlinear FEA results...4.1 Analytical modal solution for tension force T = 0 case (textbook) ................................... 8 4.2 Computed nonlinear FEA results for

Parent-child incest that extends into adulthood: a survey of international press reports, 2007-2011.

PubMed

Middleton, Warwick

2013-01-01

Although the subject of ongoing incestuous abuse during adulthood has never been addressed in a systematic way in the professional literature, accounts of such cases have been appearing for many years. The Josef Fritzl case added a new impetus to reporting such abuses in the popular press. The current study presents 44 such cases from 24 countries that appeared in English-language press accounts over 5 years commencing January 2007. These cases are discussed in light of the minimal coverage of such issues in the professional literature. The results of this study suggest that cases of enduring incest are not rare and typically incorporate decades of sexual abuse, frequently result in pregnancies, and commonly incorporate ongoing violence and death threats.

Laboratory study of sonic booms and their scaling laws. [ballistic range simulation

NASA Technical Reports Server (NTRS)

Toong, T. Y.

1974-01-01

This program undertook to seek a basic understanding of non-linear effects associated with caustics, through laboratory simulation experiments of sonic booms in a ballistic range and a coordinated theoretical study of scaling laws. Two cases of superbooms or enhanced sonic booms at caustics have been studied. The first case, referred to as acceleration superbooms, is related to the enhanced sonic booms generated during the acceleration maneuvers of supersonic aircrafts. The second case, referred to as refraction superbooms, involves the superbooms that are generated as a result of atmospheric refraction. Important theoretical and experimental results are briefly reported.

The use of indium-111 labeled platelet scanning for the detection of asymptomatic deep venous thrombosis in a high risk population

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

Siegel, R.S.; Rae, J.L.; Ryan, N.L.

Five hundred indium-111 labeled platelet imaging studies (387 donor and 113 autologous) were performed postoperatively in 473 patients who had undergone total hip replacement, total knee replacement, or internal fixation of a hip fracture to detect occult deep venous thrombosis. All patients had been anticoagulated prophylactically with aspirin, warfarin sodium (Coumadin), or dextran. Thirty-four possible cases of proximal deep venous thrombosis were identified in 28 asymptomatic patients. To verify the scan results, 31 venograms were performed in 25 patients (three refused). In 21 of 31 cases, totally occlusive thrombi were detected; in 5 cases, partially occlusive thrombi were detected; inmore » 5 cases, no thrombus was seen. No patient who had a negative scan nor any patient who had a verified positive scan (and received appropriate heparin therapy) subsequently developed symptoms or signs of pulmonary embolism. One hundred forty-one indium study patients also underwent Doppler ultrasonography/impedance plethysmography (Doppler/IPG) as a comparative non-invasive technique. In 137 cases, the results of the indium study and Doppler/IPG studies were congruent. The indium study had no false negative results that were detected by Doppler/IPG. No patient had any clinically evident toxicity. These results suggest that indium-111 labeled platelet scanning is a safe, noninvasive means for identifying DVT in high risk patients.« less

Incorporating ITS into corridor planning : Seattle case study

DOT National Transportation Integrated Search

1999-08-01

The goals of this study were to develop a methodology for incorporating Intelligent Transportation Systems (ITS) into the transportation planning process and apply the methodology to estimate ITS costs and benefits for one case study. A major result ...

Incorporating ITS into corridor planning : Seattle case study

DOT National Transportation Integrated Search

1999-06-01

The goals of this study were to develop a methodology for incorporating Intelligent Transportation Systems (ITS) into the transportation planning process and apply the methodology to estimate ITS costs and benefits for one case study. A major result ...

Hip fracture risk in relation to vitamin D supplementation and serum 25-hydroxyvitamin D levels: a systematic review and meta-analysis of randomised controlled trials and observational studies

PubMed Central

2010-01-01

Background Vitamin D supplementation for fracture prevention is widespread despite conflicting interpretation of relevant randomised controlled trial (RCT) evidence. This study summarises quantitatively the current evidence from RCTs and observational studies regarding vitamin D, parathyroid hormone (PTH) and hip fracture risk. Methods We undertook separate meta-analyses of RCTs examining vitamin D supplementation and hip fracture, and observational studies of serum vitamin D status (25-hydroxyvitamin D (25(OH)D) level), PTH and hip fracture. Results from RCTs were combined using the reported hazard ratios/relative risks (RR). Results from case-control studies were combined using the ratio of 25(OH)D and PTH measurements of hip fracture cases compared with controls. Original published studies of vitamin D, PTH and hip fracture were identified through PubMed and Web of Science databases, searches of reference lists and forward citations of key papers. Results The seven eligible RCTs identified showed no significant difference in hip fracture risk in those randomised to cholecalciferol or ergocalciferol supplementation versus placebo/control (RR = 1.13[95%CI 0.98-1.29]; 801 cases), with no significant difference between trials of <800 IU/day and ≥800 IU/day. The 17 identified case-control studies found 33% lower serum 25(OH)D levels in cases compared to controls, based on 1903 cases. This difference was significantly greater in studies with population-based compared to hospital-based controls (χ21 (heterogeneity) = 51.02, p < 0.001) and significant heterogeneity was present overall (χ216 (heterogeneity) = 137.9, p < 0.001). Serum PTH levels in hip fracture cases did not differ significantly from controls, based on ten case-control studies with 905 cases (χ29 (heterogeneity) = 149.68, p < 0.001). Conclusions Neither higher nor lower dose vitamin D supplementation prevented hip fracture. Randomised and observational data on vitamin D and hip fracture appear to differ. The reason for this is unclear; one possible explanation is uncontrolled confounding in observational studies. Post-fracture PTH levels are unrelated to hip fracture risk. PMID:20540727

Clinical Case Definitions for Classification of Intrathoracic Tuberculosis in Children: An Update

PubMed Central

Graham, Stephen M.; Cuevas, Luis E.; Jean-Philippe, Patrick; Browning, Renee; Casenghi, Martina; Detjen, Anne K.; Gnanashanmugam, Devasena; Hesseling, Anneke C.; Kampmann, Beate; Mandalakas, Anna; Marais, Ben J.; Schito, Marco; Spiegel, Hans M. L.; Starke, Jeffrey R.; Worrell, Carol; Zar, Heather J.

2015-01-01

Consensus case definitions for childhood tuberculosis have been proposed by an international expert panel, aiming to standardize the reporting of cases in research focusing on the diagnosis of intrathoracic tuberculosis in children. These definitions are intended for tuberculosis diagnostic evaluation studies of symptomatic children with clinical suspicion of intrathoracic tuberculosis, and were not intended to predefine inclusion criteria into such studies. Feedback from researchers suggested that further clarification was required and that these case definitions could be further improved. Particular concerns were the perceived complexity and overlap of some case definitions, as well as the potential exclusion of children with acute onset of symptoms or less severe disease. The updated case definitions proposed here incorporate a number of key changes that aim to reduce complexity and improve research performance, while maintaining the original focus on symptomatic children suspected of having intrathoracic tuberculosis. The changes proposed should enhance harmonized classification for intrathoracic tuberculosis disease in children across studies, resulting in greater comparability and the much-needed ability to pool study results. PMID:26409281

Study of dose calculation on breast brachytherapy using prism TPS

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

Fendriani, Yoza; Haryanto, Freddy

2015-09-30

PRISM is one of non-commercial Treatment Planning System (TPS) and is developed at the University of Washington. In Indonesia, many cancer hospitals use expensive commercial TPS. This study aims to investigate Prism TPS which been applied to the dose distribution of brachytherapy by taking into account the effect of source position and inhomogeneities. The results will be applicable for clinical Treatment Planning System. Dose calculation has been implemented for water phantom and CT scan images of breast cancer using point source and line source. This study used point source and line source and divided into two cases. On the firstmore » case, Ir-192 seed source is located at the center of treatment volume. On the second case, the source position is gradually changed. The dose calculation of every case performed on a homogeneous and inhomogeneous phantom with dimension 20 × 20 × 20 cm{sup 3}. The inhomogeneous phantom has inhomogeneities volume 2 × 2 × 2 cm{sup 3}. The results of dose calculations using PRISM TPS were compared to literature data. From the calculation of PRISM TPS, dose rates show good agreement with Plato TPS and other study as published by Ramdhani. No deviations greater than ±4% for all case. Dose calculation in inhomogeneous and homogenous cases show similar result. This results indicate that Prism TPS is good in dose calculation of brachytherapy but not sensitive for inhomogeneities. Thus, the dose calculation parameters developed in this study were found to be applicable for clinical treatment planning of brachytherapy.« less

Clinical case in digital technology for nursing students' learning: An integrative review.

PubMed

Hara, Cristina Yuri Nakata; Aredes, Natália Del Angelo; Fonseca, Luciana Mara Monti; Silveira, Renata Cristina de Campos Pereira; Camargo, Rosangela Andrade Aukar; de Goes, Fernanda Santos Nogueira

2016-03-01

This review aimed to analyze the available evidences in literature about clinical case studies inserted in digital technologies for nursing education, characterizing the technology resources and cognitive, procedural and attitudinal learnings. Integrative review of literature with the following steps: development of the research problem, data collection, data extraction and critic evaluation, data analysis and interpretation and presentation of results. The research question was: how does the clinical case study inserted in educational digital technology collaborate for cognitive, attitudinal and procedural learning of nursing students? data bases LILACS, PUBMED, CINAHL and Scopus. the search resulted in 437 studies: 136 from LILACS, 122 from PUBMED, 104 from Scopus and 75 from CINAHL. Of these, 143 did not meet the including criteria, 93 were duplicated and four studies were unavailable. After analyzing all abstracts based on inclusion and exclusion criteria, there were selected 197 studies and after full text analysis the final sample resulted in 21 primary studies. Case study use in educational digital technologies allowed the students to build different types of learning: cognitive learning (n 16 studies), attitudinal learning (n=12 studies) and procedural learning (n=8 studies). It is possible to conclude that case studies can collaborate with the students to develop different learnings which can be built integrate, continuous, informative and formative, aiming integral formation and aligned to policies of formation in nursing, both national and international. Copyright © 2015 Elsevier Ltd. All rights reserved.

Working smarter on cold cases: identifying factors associated with successful cold case investigations.

PubMed

Davis, Robert C; Jensen, Carl J; Burgette, Lane; Burnett, Kathryn

2014-03-01

Cold case squads have garnered much attention; however, they have yet to undergo significant empirical scrutiny. In the present study, the authors interviewed investigators and reviewed 189 solved and unsolved cold cases in Washington, D.C., to determine whether there are factors that can predict cold case solvability. In the interviews, new information from witnesses or information from new witnesses was cited as the most prevalent reason for case clearance. The case reviews determined that there were factors in each of the following domains that predicted whether cases would be solved during cold case investigations: Crime Context, Initial Investigation Results, Basis for Opening Cold Case, and Cold Case Investigator Actions. The results suggest that it is possible to prioritize cold case work based on the likelihood of investigations leading to clearances. © 2014 American Academy of Forensic Sciences.

Grey literature in systematic reviews: a cross-sectional study of the contribution of non-English reports, unpublished studies and dissertations to the results of meta-analyses in child-relevant reviews.

PubMed

Hartling, Lisa; Featherstone, Robin; Nuspl, Megan; Shave, Kassi; Dryden, Donna M; Vandermeer, Ben

2017-04-19

Systematic reviews (SRs) are an important source of information about healthcare interventions. A key component of a well-conducted SR is a comprehensive literature search. There is limited evidence on the contribution of non-English reports, unpublished studies, and dissertations and their impact on results of meta-analyses. Our sample included SRs from three Cochrane Review Groups: Acute Respiratory Infections (ARI), Infectious Diseases (ID), Developmental Psychosocial and Learning Problems (DPLP) (n = 129). Outcomes included: 1) proportion of reviews that searched for and included each study type; 2) proportion of relevant studies represented by each study type; and 3) impact on results and conclusions of the primary meta-analysis for each study type. Most SRs searched for non-English studies; however, these were included in only 12% of reviews and represented less than 5% of included studies. There was a change in results in only four reviews (total sample = 129); in two cases the change did not have an impact on the statistical or clinical significance of results. Most SRs searched for unpublished studies but the majority did not include these (only 6%) and they represented 2% of included studies. In most cases the impact of including unpublished studies was small; a substantial impact was observed in one case that relied solely on unpublished data. Few reviews in ARI (9%) and ID (3%) searched for dissertations compared to 65% in DPLP. Overall, dissertations were included in only nine SRs and represented less than 2% of included studies. In the majority of cases the change in results was negligible or small; in the case where a large change was noted, the estimate was more conservative without dissertations. The majority of SRs searched for non-English and unpublished studies; however, these represented a small proportion of included studies and rarely impacted the results and conclusions of the review. Inclusion of these study types may have an impact in situations where there are few relevant studies, or where there are questionable vested interests in the published literature. We found substantial variation in whether SRs searched for dissertations; in most reviews that included dissertations, these had little impact on results.

Clinical profile, predisposing factors, and associated co-morbidities of children with cerebral palsy in South India

PubMed Central

Gowda, Vykuntaraju K.; Kumar, Anil; Shivappa, Sanjay K.; Srikanteswara, Praveen Kumar; Shivananda; Mahadeviah, M. S.; Govindraj, M.; Ramaswamy, Premalatha

2015-01-01

Introduction: Cerebral palsy (CP) is the most common physical disorder of children. Causes like jaundice and birth injury though are decreasing; complications resulting from the survival of low birth weight babies are replacing some of the older etiologies. Hence, this study was planned. Objectives: The objective was to study the clinical patterns, predisposing factors, and co-morbidities in children with CP. Materials and Methods: The present study is a hospital based prospective study conducted from January 2012 to January 2013 in children presenting to neurodevelopmental clinic at a tertiary care teaching hospital in India. Hundred cases with clinical features suggestive of CP were included in the study. Cases were evaluated by history, clinical examination, and necessary investigations. Results: Results of the study showed 81% of spastic, 12% of hypotonic, 5% of dystonic, and 2% of mixed CP cases. The mean age of presentation was 2 year, 2 month, and male to female ratio of 1:2. Pregnancy-induced hypertension (PIH) was the most common antenatal complication observed in 6%. Four percent had neonatal sepsis and 19% were born premature. Associated co-morbidities were mental retardation (55%), seizure disorder (46%), visual problems (26%), hearing problems (19%), and failure to thrive (47%). Discussion: Sex distribution observed in our study was male to female ratio of 1.2, which was comparable with a multicenter study in Europe. PIH was observed in 6% of cases, which was comparable with prior studies. Birth asphyxia was observed in 43% of cases. Eighty-one percent of the cases constituted a spastic variety of CP which was comparable to other studies. Conclusion: Perinatal asphyxia was the important etiological factor. We found preventable intranatal causes (60%) and antenatal causes (20%) forming a significant proportion. Co-morbidities were significantly observed in our study. PMID:26167210

The Misconception of Case-Control Studies in the Plastic Surgery Literature: A Literature Audit.

PubMed

Hatchell, Alexandra C; Farrokhyar, Forough; Choi, Matthew

2017-06-01

Case-control study designs are commonly used. However, many published case-control studies are not true case-controls and are in fact mislabeled. The purpose of this study was to identify all case-control studies published in the top three plastic surgery journals over the past 10 years, assess which were truly case-control studies, clarify the actual design of the articles, and address common misconceptions. MEDLINE, Embase, and Web of Science databases were searched for case-control studies in the three highest-impact factor plastic surgery journals (2005 to 2015). Two independent reviewers screened the resulting titles, abstracts, and methods, if applicable, to identify articles labeled as case-control studies. These articles were appraised and classified as true case-control studies or non-case-control studies. The authors found 28 articles labeled as case-control studies. However, only six of these articles (21 percent) were truly case-control designs. Of the 22 incorrectly labeled studies, one (5 percent) was a randomized controlled trial, three (14 percent) were nonrandomized trials, two (9 percent) were prospective comparative cohort designs, 14 (64 percent) were retrospective comparative cohort designs, and two (9 percent) were cross-sectional designs. The mislabeling was worse in recent years, despite increases in evidence-based medicine awareness. The majority of published case-control studies are not in fact case-control studies. This misunderstanding is worsening with time. Most of these studies are actually comparative cohort designs. However, some studies are truly clinical trials and thus a higher level of evidence than originally proposed.

Characteristics of Teachers' Support on Learning: A Case Study

ERIC Educational Resources Information Center

Sardà, Anna; Márquez, Conxita; Sanmartí, Neus

2014-01-01

One of the problems in science education research is obtaining evidence that particular teacher support of learning helps achieve better academic results for students. Classroom ecology involves many variables that are difficult to control and, moreover, many results can only be seen in the medium term. The purpose of this case study on an expert…

A Case Study: Testing in the Albuquerque Public Schools.

ERIC Educational Resources Information Center

Robinson, Carol

1983-01-01

This case study of testing in the Albuquerque public schools highlights improvement of test results dissemination and use through cooperative planning, integrated database development, and a partnership with public media. (Author)

A Case Study of Engineering Ethics

NASA Astrophysics Data System (ADS)

Shimizu, Kazuo

In Engineering Ethics Class at Shizuoka University, the Code of Ethics and Cases for Electrical Engineers by IEEJ Ethics committee is used to promote for high education effect to correspond large number of students (140students). In this paper, a case study in the class, and survey results for ethics value of students are presented. In addition, some comments for role playing act on the case of virtual experiences by students are described.

[Surrogacy, yes or no? Case report].

PubMed

Pektorová, M; Ventruba, P

2015-08-01

Case study of surrogacy which did not come up to client-couple´s expectation. Case report. Department of Gynaecology and Obstetrics, Uherske Hradiste Hospital a. s., Uherske Hradiste. Description of the case, case study. In the Czech Republic, missing legislation when subject matter is surrogacy does not allow to make a complex legal contract. This fact causes legal uncertainty to all participants. Irresponsible approach of doctors, surrogate mother, client-couple, and in the upshot care of disabled child at government expense can be results.

The Impact of Facilitated Communication on the Educational Lives of Students with Autism Spectrum Disorders: Four Case Studies

ERIC Educational Resources Information Center

Knox, Michael

2013-01-01

This action qualitative study with a case research design investigated the impact of facilitated communication (FC) on the educational lives of high school students with autism spectrum disorders (ASD). The effect of FC on nonverbal students and schools' reactions to FC were also examined. The results from the four case studies indicate that FC…

WIND Validation Cases: Computational Study of Thermally-perfect Gases

NASA Technical Reports Server (NTRS)

DalBello, Teryn; Georgiadis, Nick (Technical Monitor)

2002-01-01

The ability of the WIND Navier-Stokes code to predict the physics of multi-species gases is investigated in support of future high-speed, high-temperature propulsion applications relevant to NASA's Space Transportation efforts. Three benchmark cases are investigated to evaluate the capability of the WIND chemistry model to accurately predict the aerodynamics of multi-species chemically non-reacting (frozen) gases. Case 1 represents turbulent mixing of sonic hydrogen and supersonic vitiated air. Case 2 consists of heated and unheated round supersonic jet exiting to ambient. Case 3 represents 2-D flow through a converging-diverging Mach 2 nozzle. For Case 1, the WIND results agree fairly well with experimental results and that significant mixing occurs downstream of the hydrogen injection point. For Case 2, the results show that the Wilke and Sutherland viscosity laws gave similar results, and the available SST turbulence model does not predict round supersonic nozzle flows accurately. For Case 3, results show that experimental, frozen, and 1-D gas results agree fairly well, and that frozen, homogeneous, multi-species gas calculations can be approximated by running in perfect gas mode while specifying the mixture gas constant and Ratio of Specific Heats.

Analysis of components of variance in multiple-reader studies of computer-aided diagnosis with different tasks

NASA Astrophysics Data System (ADS)

Beiden, Sergey V.; Wagner, Robert F.; Campbell, Gregory; Metz, Charles E.; Chan, Heang-Ping; Nishikawa, Robert M.; Schnall, Mitchell D.; Jiang, Yulei

2001-06-01

In recent years, the multiple-reader, multiple-case (MRMC) study paradigm has become widespread for receiver operating characteristic (ROC) assessment of systems for diagnostic imaging and computer-aided diagnosis. We review how MRMC data can be analyzed in terms of the multiple components of the variance (case, reader, interactions) observed in those studies. Such information is useful for the design of pivotal studies from results of a pilot study and also for studying the effects of reader training. Recently, several of the present authors have demonstrated methods to generalize the analysis of multiple variance components to the case where unaided readers of diagnostic images are compared with readers who receive the benefit of a computer assist (CAD). For this case it is necessary to model the possibility that several of the components of variance might be reduced when readers incorporate the computer assist, compared to the unaided reading condition. We review results of this kind of analysis on three previously published MRMC studies, two of which were applications of CAD to diagnostic mammography and one was an application of CAD to screening mammography. The results for the three cases are seen to differ, depending on the reader population sampled and the task of interest. Thus, it is not possible to generalize a particular analysis of variance components beyond the tasks and populations actually investigated.

Simulation study of the ROMPS robot control system

NASA Technical Reports Server (NTRS)

Nguyen, Charles C.; Liu, HUI-I.

1994-01-01

This is a report presenting the progress of a research grant funded by NASA for work performed from June 1, 1993 to August 1, 1993. The report deals with the Robot Operated Material Processing System (ROMPS). It presents results of a computer simulation study conducted to investigate the performance of the control systems controlling the azimuth, elevation, and radial axes of the ROMPS and its gripper. Four study cases are conducted. The first case investigates the control of free motion of the three areas. In the second case, the compliant motion in the elevation axis with the wrist compliant device is studied in terms of position accuracy and impact forces. The third case focuses on the behavior of the control system in controlling the robot motion along the radial axis when pulling the pallet out of the rack. In the fourth case, the compliant motion of the gripper grasping a solid object under the effect of the gripper passive compliance is studied in terms of position accuracy and contact forces. For each of the above cases, a set of PIR gains will be selected to optimize the controller performance and computer simulation results will be presented and discussed.

Summary of Data from the Sixth AIAA CFD Drag Prediction Workshop: CRM Cases 2 to 5

NASA Technical Reports Server (NTRS)

Tinoco, Edward N.; Brodersen, Olaf P.; Keye, Stefan; Laflin, Kelly R.; Feltrop, Edward; Vassberg, John C.; Mani, Mori; Rider, Ben; Wahls, Richard A.; Morrison, Joseph H.;

Molasses versus grain: what the research says

USDA-ARS?s Scientific Manuscript database

This article summarizes the results of a three-tiered research approach (case study, two continuous culture fermenter studies, and two controlled research farm studies) to evaluate molasses as an alternative supplement source for grazing dairy cows. A two-year case study of a New York organic dairy ...

A sham case-control study of effectiveness of DTP-Hib-hepatitis B vaccine against rotavirus acute gastroenteritis in Kenya

PubMed Central

2014-01-01

Background In many GAVI-eligible countries, effectiveness of new vaccines will be evaluated by case-control methodology. To inform the design and assess selection bias of a future case-control study of rotavirus vaccine effectiveness (VE) in western Kenya, we performed a sham case-control study evaluating VE of pentavalent vaccine (DTP-Hib-HepB) against rotavirus acute gastroenteritis (AGE). Methods From ongoing rotavirus surveillance, we defined cases as children 12 weeks to 23 months old with EIA-confirmed rotavirus AGE. We enrolled one community-based and two hospital-based control groups. We collected vaccination status from cards at enrollment, or later in homes, and evaluated VE by logistic regression. Results We enrolled 91 cases (64 inpatient, 27 outpatient), 252 non-rotavirus AGE facility-based controls (unmatched), 203 non-AGE facility-based controls (age-matched) and 271 community controls (age-matched). Documented receipt of 3 pentavalent doses was 77% among cases and ranged from 81-86% among controls. One percent of cases and 0-2% of controls had no pentavalent doses. The adjusted odds ratio of three versus zero doses for being a case was 3.27 (95% CI 0.01-1010) for community controls and 0.69 (95% CI 0.06-7.75) for non-rotavirus hospital-based AGE controls, translating to VE of -227% and 31%, respectively, with wide confidence intervals. (No facility-based non-AGE controls were unvaccinated.) Similar results were found for ≥2 pentavalent doses and for severe rotavirus AGE. Conclusions The study showed that it is feasible to carry out a real case control in the study area, but this needs to be done as soon as the vaccine is introduced to capture the real impact. Sham case-control or pilot studies before vaccine introduction can be useful in designing case-control VE studies. PMID:24517198

21 CFR 312.68 - Inspection of investigator's records and reports.

Code of Federal Regulations, 2010 CFR

2010-04-01

... particular individuals require a more detailed study of the cases, or unless there is reason to believe that the records do not represent actual case studies, or do not represent actual results obtained. ...

Commuter choice program case study development and analysis

DOT National Transportation Integrated Search

2004-08-01

This paper presents the results of a study in which the case study method was used to sort out the internal and external conditions that might affect the success of a work site trip reduction program. Investigators attempted to disprove a null hypoth...

Relevance of the 1-year dog study in assessing human health risks for registration of pesticides. An update to include pesticides registered in Japan.

PubMed

Kobel, Werner; Fegert, Ivana; Billington, Richard; Lewis, Richard; Bentley, Karin; Langrand-Lerche, Carole; Botham, Phil; Sato, Masako; Debruyne, Eric; Strupp, Christian; van Ravenzwaay, Bennard

2014-11-01

Over 400 active pesticides are registered in Japan (FAMIC 2013). The results of dog toxicity studies (usually, the 1-year study) were used by the Japanese regulatory authorities to establish the acceptable daily intake (ADI) for 45 pesticide active ingredients (about 9%). A retrospective review of ADIs established in Japan with dog studies as pivotal data for their derivation was performed: the ADIs were reassessed under the assumption that the 1-year dog study would not be available and an alternate ADI was derived based on the remaining toxicology database. In 35 of the 45 cases (77.8%) the ADI resulting from the absence of the 1-year dog study was no greater than twice the Japanese ADI, a difference considered not to be of biological significance. In 6 cases (13%) the resulting ADI was 2-5 times higher, which is considered of questionable biological relevance. On further evaluation of the database, three of these six cases were assessed as to clarify that there is no clear difference and for the other three additional studies to clarify that uncertain findings would have been required. In 3 of the 45 cases (7%) there may be a real difference within the ADI ratio of 2-5. Only in 1 case (2.2%) ADI was five times higher than that has been set. Accordingly, the absence of a 1-year dog study does not appear to influence the ADI derivation in a relevant manner in more than 98% of cases. For the four compounds with a real difference in ADI, consumer exposure would still be well below the alternative ADI. Therefore, a strong case can be made that the standard mandatory requirement to conduct a 1-year dog study, in addition to the 3-month study, is not justified and of no additional value in protecting human health. In addition, a substantial reduction in test animals could be achieved.

Making intelligent systems team players: Additional case studies

NASA Technical Reports Server (NTRS)

Malin, Jane T.; Schreckenghost, Debra L.; Rhoads, Ron W.

1993-01-01

Observations from a case study of intelligent systems are reported as part of a multi-year interdisciplinary effort to provide guidance and assistance for designers of intelligent systems and their user interfaces. A series of studies were conducted to investigate issues in designing intelligent fault management systems in aerospace applications for effective human-computer interaction. The results of the initial study are documented in two NASA technical memoranda: TM 104738 Making Intelligent Systems Team Players: Case Studies and Design Issues, Volumes 1 and 2; and TM 104751, Making Intelligent Systems Team Players: Overview for Designers. The objective of this additional study was to broaden the investigation of human-computer interaction design issues beyond the focus on monitoring and fault detection in the initial study. The results of this second study are documented which is intended as a supplement to the original design guidance documents. These results should be of interest to designers of intelligent systems for use in real-time operations, and to researchers in the areas of human-computer interaction and artificial intelligence.

Risk of lung cancer associated with six types of chlorinated solvents: results from two case-control studies in Montreal, Canada

EPA Science Inventory

Methods: Two case-control studies of occupation and lung cancer were conducted in Montreal, including 2,016 cases and 2,001 population controls. Occupational exposure to a host of agents was evaluated using a combination of subject-reported job history and expert assessment. We e...

Contemporary Instructor-Librarian Collaboration: A Case Study of an Online Embedded Librarian Implementation

ERIC Educational Resources Information Center

Edwards, Mary E.; Black, Erik W.

2012-01-01

This paper reports the results of a case study evaluation of an embedded librarian project at a large, land-grant, research institution. The case is comprised of learners who are full-time academic health care professionals enrolled in an online graduate educational technology program. The mixed methods methodology focused on assessing the…

The Use of Interrupted Case Studies to Enhance Critical Thinking Skills in Biology

PubMed Central

White, Tracy K.; Whitaker, Paul; Gonya, Terri; Hein, Richard; Kroening, Dubear; Lee, Kevin; Lee, Laura; Lukowiak, Andrea; Hayes, Elizabeth

2009-01-01

There has been a dramatic increase in the availability of case studies for use in the biology classroom, and perceptions of the effectiveness of case-study-based learning are overwhelmingly positive. Here we report the results of a study in which we evaluated the ability of interrupted case studies to improve critical thinking in the context of experimental design and the conventions of data interpretation. Students were assessed using further case studies designed to evaluate their ability to recognize and articulate problematic approaches to these elements of experimentation. Our work reveals that case studies have broad utility in the classroom. In addition to demonstrating a small but statistically significant increase in the number of students capable of critically evaluating selected aspects of experimental design, we also observed increased student engagement and documented widespread misconceptions regarding the conventions of data acquisition and analysis. PMID:23653687

Case-based ethics instruction: the influence of contextual and individual factors in case content on ethical decision-making.

PubMed

Bagdasarov, Zhanna; Thiel, Chase E; Johnson, James F; Connelly, Shane; Harkrider, Lauren N; Devenport, Lynn D; Mumford, Michael D

2013-09-01

Cases have been employed across multiple disciplines, including ethics education, as effective pedagogical tools. However, the benefit of case-based learning in the ethics domain varies across cases, suggesting that not all cases are equal in terms of pedagogical value. Indeed, case content appears to influence the extent to which cases promote learning and transfer. Consistent with this argument, the current study explored the influences of contextual and personal factors embedded in case content on ethical decision-making. Cases were manipulated to include a clear description of the social context and the goals of the characters involved. Results indicated that social context, specifically the description of an autonomy-supportive environment, facilitated execution of sense making processes and resulted in greater decision ethicality. Implications for designing optimal cases and case-based training programs are discussed.

RESULTS OF NATIONAL SURVEILLANCE OF CHILDHOOD TUBERCULOSIS: 2013–2016

PubMed Central

Giroux, R; Montgomery-Song, A; Consunji-Araneta, R; Kitai, I; Morris, S

2017-01-01

Abstract BACKGROUND: There is little detailed epidemiologic and clinical data about tuberculosis (TB) disease in children in Canada. OBJECTIVES: This study characterizes the epidemiologic, clinical, and treatment data for all cases of TB in children under age 15 in Canada surveyed through the Canadian Pediatric Surveillance Program’s (CPSP) Childhood Tuberculosis Study. Preliminary results from the study from October 2013 to September 2016 are presented here, as data collection from reported cases is still ongoing. DESIGN/METHODS: New active TB cases were identified through a monthly form sent by the CPSP to approximately 2500 active pediatricians, pediatric subspecialists, and select non-pediatricians who manage childhood TB. For cases meeting inclusion criteria, a detailed questionnaire was sent to the treating physician to collect clinical, epidemiological, and treatment data, followed by 6-month follow-up surveys until 6 months after treatment completion. RESULTS: Of 248 unique incident cases reported, 142 cases both met inclusion criteria and returned a detailed questionnaire. Selected demographic data are shown here: Intrathoracic TB was reported in 129/142 (91%) of cases of which 111 had pulmonary disease. Of 104 patients who underwent investigations for pulmonary disease (sputum in 60, brochoalveolar lavage in 6, and gastric aspirates in 56), one or more positive cultures were obtained in 42 (40%). Within age groups, the proportion of cases who underwent investigation for pulmonary disease and were culture positive was: 3/11 (27%) under 1 year of age, 14/40 (35%) 1-4 years old, 8/23 (35%) 5-9 years old, and 17/30 (57%) 10 years or older. Extrathoracic TB was reported in 35 (25%), including 16 (42%) patients 10+ years old. There was one case of multi-drug resistant TB. CONCLUSION: Preliminary results from this study suggests a high incidence of TB in Inuit and First Nations children, as well as a higher proportion of extrathoracic TB and greater success in culture positivity in children aged 10+. At completion, this study will provide the most complete picture of childhood TB in Canada and will serve to refine practice in monitoring, detecting, and treating this infection.

Chair Report Consultancy Meeting on Nuclear Security Assessment Methodologies (NUSAM) Transport Case Study Working Group

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

Shull, Doug

The purpose of the consultancy assignment was to (i) apply the NUSAM assessment methods to hypothetical transport security table top exercise (TTX) analyses and (ii) document its results to working materials of NUSAM case study on transport. A number of working group observations, using the results of TTX methodologies, are noted in the report.

The Use of Case Studies in Teaching Undergraduate Neuroscience

PubMed Central

Meil, William M.

2007-01-01

Case studies have been the cornerstone of many discoveries in neurology and continue to be an indispensable source of knowledge. Attaching a name, face, and story to the study of neurological disorders makes them more “real” and memorable. This article describes the value of the case study methodology and its advantages as a pedagogical approach. It also illustrates how the seminal case of H.M. can be used to highlight the advantages and disadvantages of the case study methodology. Three exercises are described for incorporating case studies into neuroscience courses. The first exercise requires students to conduct a literature review regarding their assigned case and then design an experiment to address a lingering question regarding that neurological disorder. Survey results of 90 students provide quantitative and qualitative support for this approach. The vast majority of students indicated this exercise was a valuable learning experience; sparked interest in the topic and in biopsychology; increased their knowledge and stimulated critical thinking. The second exercise discusses how students might conduct their own case studies. The third exercise emphasizes the use of case studies as a platform to examine competing hypotheses regarding neurological conditions and their treatment. A table listing case studies appropriate for undergraduate neuroscience courses is included. Cases are categorized by the type of neurological disorder and notes regarding the nature of and content of each case are provided. PMID:23493154

Case-control studies in neurosurgery.

PubMed

Nesvick, Cody L; Thompson, Clinton J; Boop, Frederick A; Klimo, Paul

2014-08-01

Observational studies, such as cohort and case-control studies, are valuable instruments in evidence-based medicine. Case-control studies, in particular, are becoming increasingly popular in the neurosurgical literature due to their low cost and relative ease of execution; however, no one has yet systematically assessed these types of studies for quality in methodology and reporting. The authors performed a literature search using PubMed/MEDLINE to identify all studies that explicitly identified themselves as "case-control" and were published in the JNS Publishing Group journals (Journal of Neurosurgery, Journal of Neurosurgery: Pediatrics, Journal of Neurosurgery: Spine, and Neurosurgical Focus) or Neurosurgery. Each paper was evaluated for 22 descriptive variables and then categorized as having either met or missed the basic definition of a case-control study. All studies that evaluated risk factors for a well-defined outcome were considered true case-control studies. The authors sought to identify key features or phrases that were or were not predictive of a true case-control study. Those papers that satisfied the definition were further evaluated using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist. The search detected 67 papers that met the inclusion criteria, of which 32 (48%) represented true case-control studies. The frequency of true case-control studies has not changed with time. Use of odds ratios (ORs) and logistic regression (LR) analysis were strong positive predictors of true case-control studies (for odds ratios, OR 15.33 and 95% CI 4.52-51.97; for logistic regression analysis, OR 8.77 and 95% CI 2.69-28.56). Conversely, negative predictors included focus on a procedure/intervention (OR 0.35, 95% CI 0.13-0.998) and use of the word "outcome" in the Results section (OR 0.23, 95% CI 0.082-0.65). After exclusion of nested case-control studies, the negative correlation between focus on a procedure/intervention and true case-control studies was strengthened (OR 0.053, 95% CI 0.0064-0.44). There was a trend toward a negative association between the use of survival analysis or Kaplan-Meier curves and true case-control studies (OR 0.13, 95% CI 0.015-1.12). True case-control studies were no more likely than their counterparts to use a potential study design "expert" (OR 1.50, 95% CI 0.57-3.95). The overall average STROBE score was 72% (range 50-86%). Examples of reporting deficiencies were reporting of bias (28%), missing data (55%), and funding (44%). The results of this analysis show that the majority of studies in the neurosurgical literature that identify themselves as "case-control" studies are, in fact, labeled incorrectly. Positive and negative predictors were identified. The authors provide several recommendations that may reverse the incorrect and inappropriate use of the term "case-control" and improve the quality of design and reporting of true case-control studies in neurosurgery.

Comparison of three problem-based learning conditions (real patients, digital and paper) with lecture-based learning in a dermatology course: a prospective randomized study from China.

PubMed

Li, Jie; Li, Qing Ling; Li, Ji; Chen, Ming Liang; Xie, Hong Fu; Li, Ya Ping; Chen, Xiang

2013-01-01

The precise effect and the quality of different cases used in dermatology problem-based learning (PBL) curricula are yet unclear. To prospectively compare the impact of real patients, digital, paper PBL (PPBL) and traditional lecture-based learning (LBL) on academic results and student perceptions. A total of 120 students were randomly allocated into either real-patients PBL (RPBL) group studied via real-patient cases, digital PBL (DPBL) group studied via digital-form cases, PPBL group studied via paper-form cases, or conventional group who received didactic lectures. Academic results were assessed through review of written examination, objective structured clinical examination and student performance scores. A five-point Likert scale questionnaire was used to evaluate student perceptions. Compared to those receiving lectures only, all PBL participants had better results for written examination, clinical examination and overall performance. Students in RPBL group exhibited better overall performance than those in the other two PBL groups. Real-patient cases were more effective in helping develop students' self-directed learning skills, improving their confidence in future patient encounters and encouraging them to learn more about the discussed condition, compared to digital and paper cases. Both real patient and digital triggers are helpful in improving students' clinical problem-handling skills. However, real patients provide greater benefits to students.

Economic Analysis of Energy-Efficiency Measures: Tribal Case Studies with the Yurok Tribe, the Confederated Salish and Kootenai Tribes of the Flathead Reservation, and the Pascua Yaqui Tribe

ERIC Educational Resources Information Center

Acker, Thomas L.; Auberle, William M.; Eastwood, John D.; Laroche, David R.; Slack, Robert P.; Smith, Dean H.; Ormond, Amanda S.

2005-01-01

The results of three energy-efficiency case studies conducted with three different Native American tribes in the western United States is presented. The case studies demonstrate that energy-efficiency is economically feasible and has the potential to reduce air pollution, and can potentially help tribes meet other important tribal objectives.

The case-control design in veterinary sciences: A survey.

PubMed

Cullen, Jonah N; Sargeant, Jan M; Makielski, Kelly M; O'Connor, Annette M

2016-11-01

The case-control study design is deceptively simple. However, many design considerations influence the estimated effect measure. An investigation of case-control studies in the human health literature suggested that some of these considerations are not described in reports of case-control studies. Our hypothesis was that the majority of veterinary studies labeled as case-controls would be incident density designs, and many would not interpret the effect measure obtained from those studies as the rate ratio rather than the odds ratio. Reference databases were searched for author-designated case-control studies. A survey of 100 randomly selected studies was conducted to examine the different design options described and estimated effect measures. Of the 100 author-identified case-control studies, 83 assessed an exposure-outcome association and, of those, only 54 (65.1%) sampled the study population based on an outcome and would thus be considered case-control designs. Twelve studies were incidence density designs but none used this terminology. Of the studies that reported an odds ratio as the effect measure, none reported on additional considerations that would have enabled a more interpretable result. This survey indicated many case-control-labeled studies were not case-control designs and among case-control studies, key design aspects were not often described. The absence of information about study design elements and underlying assumptions in case-control studies limits the ability to establish the effect measured by the study and the evidentiary value of the study might be underestimated. Copyright © 2016 Elsevier B.V. All rights reserved.

Determining legal responsibility in otolaryngology: a review of 44 trials since 2008.

PubMed

Svider, Peter F; Husain, Qasim; Kovalerchik, Olga; Mauro, Andrew C; Setzen, Michael; Baredes, Soly; Eloy, Jean Anderson

2013-01-01

Medicolegal factors contribute to increasing healthcare costs through the direct costs of malpractice litigation, malpractice insurance premiums, and defensive medicine. Malpractice litigation trends are constantly changing as a result of technological innovations and changes in laws. In this study, we examine the most recent legal decisions related to Otolaryngology and characterize the factors responsible for determining legal responsibility. The Westlaw legal database (Thomson Reuters, New York, NY) was used to search for jury verdicts since 2008 in Otolaryngology malpractice cases. The 44 cases included in this analysis were studied to determine the procedures most commonly litigated and progressing to trial, as well as the year, location, alleged cause of malpractice, specialty of co-defendants, and case outcomes. Out of the 44 cases included in this analysis, physicians were not found liable in 36 (81.8%) cases. Rhinologic procedures comprised 38.6% of cases litigated, and rulings were in physicians' favor in 66.7% of endoscopic sinus surgery (ESS) cases and all non-ESS rhinologic cases. A perceived lack of informed consent was noted in 34.1% of cases. The 8 jury awards averaged $940,000 (range, $148,000-$3,600,000). Otolaryngologists were not found liable in the majority of cases reviewed. Rhinologic surgeries were the most common procedures resulting in litigation. Adenotonsillectomies, thyroidectomies, and airway management are also well-represented. Perceived deficits in informed consent and misdiagnosis were noted in a considerable proportion of otolaryngologic malpractice cases resulting in jury decisions. Copyright © 2013 Elsevier Inc. All rights reserved.

Electronic Freight Management Case Studies : a Summary of Results

DOT National Transportation Integrated Search

2012-04-01

The Electronic Freight Management (EFM) initiative is a USDOT-sponsored project that applies Web technologies that improve data and message transmissions between supply chain partners. The EFM implementation case studies contained in this document ex...

Seasat-A ASVT: Commercial demonstration experiments. Results analysis methodology for the Seasat-A case studies

NASA Technical Reports Server (NTRS)

1979-01-01

The SEASAT-A commercial demonstration program ASVT is described. The program consists of a set of experiments involving the evaluation of a real time data distributions system, the SEASAT-A user data distribution system, that provides the capability for near real time dissemination of ocean conditions and weather data products from the U.S. Navy Fleet Numerical Weather Central to a selected set of commercial and industrial users and case studies, performed by commercial and industrial users, using the data gathered by SEASAT-A during its operational life. The impact of the SEASAT-A data on business operations is evaluated by the commercial and industrial users. The approach followed in the performance of the case studies, and the methodology used in the analysis and integration of the case study results to estimate the actual and potential economic benefits of improved ocean condition and weather forecast data are described.

The Welfare of Bears in Zoos: A Case Study of Poland.

PubMed

Maślak, Robert; Sergiel, Agnieszka; Bowles, David; Paśko, Łukasz

2016-01-01

The welfare of captive bears became a big issue of concern in Poland when a case of a bear being ill-treated became a high-profile case in the media. This case created a challenge to verify, study, and understand the main problems associated with bear keeping so that zoos could significantly improve the conditions in which they keep bears or ensure they keep bears at the minimum required standards. The results presented here are from 1 of the few countrywide studies of captive bear conditions conducted in all the captive institutions in Poland that keep bears. Thirteen institutions kept bears at the time of the study (2007-2009), including 54 individuals of 5 species. Major welfare problems were identified, and the results have been used to challenge zoos to address the changes required and focus the government's attention on areas that require legislative improvement.

Facilitating Case Studies in Massage Therapy Clinical Education

PubMed Central

Baskwill, Amanda

2013-01-01

The integration of evidence into reflective health care practice has been on the rise in recent years and is a phenomenon that has affected all health care professions, including massage therapy. Clinical case studies are a research design that follows one patient or subject, making the studies ideal for use in clinical practice. They are valuable for communicating information from clinical practice to the broader community. Case studies have face validity that may be more valuable to individual practitioners than homogeneous randomized controlled trials, as the practitioner may recognize a complex patient in the case report. At Humber College, Student Massage Therapists (SMTs) create, conduct, and communicate results of a clinical case study prior to graduation. This article describes the process and experience. PMID:23730397

OPTIMIZED REAL-TIME CONTROL OF COMBINED SEWERAGE SYSTEMS: TWO CASE STUDIES

EPA Science Inventory

The paper presents results of two case studies of Real-Time Control (RTC) alternatives evaluations that were conducted on portions of sewerage systems near Paris, France and in Quebec City, Canada, respectively. The studies were performed at real-scale demonstration sites. RTC ...

Meta-Analysis of Incremental Rehearsal Using Phi Coefficients to Compare Single-Case and Group Designs

ERIC Educational Resources Information Center

Burns, Matthew K.; Zaslofsky, Anne F.; Kanive, Rebecca; Parker, David C.

2012-01-01

The current study meta-analyzed single-case design (SCD) and group research regarding incremental rehearsal (IR). We used phi to meta-analyze data from 19 IR studies. Data from the SCD studies resulted in a nonoverlap of all pairs (NAP) score of 98.9% (95% CI = 97.6-100%), which resulted in a weighted phi of 0.77 (95% CI = 0.69-0.83). The group…

Theoretical pluralism in psychoanalytic case studies.

PubMed

Willemsen, Jochem; Cornelis, Shana; Geerardyn, Filip M; Desmet, Mattias; Meganck, Reitske; Inslegers, Ruth; Cauwe, Joachim M B D

2015-01-01

The aim of this study is to provide an overview of the scientific activity of different psychoanalytic schools of thought in terms of the content and production of case studies published on ISI Web of Knowledge. Between March 2013 and November 2013, we contacted all case study authors included in the online archive of psychoanalytic and psychodynamic case studies (www.singlecasearchive.com) to inquire about their psychoanalytic orientation during their work with the patient. The response rate for this study was 45%. It appears that the two oldest psychoanalytic schools, Object-relations psychoanalysis and Ego psychology or "Classical psychoanalysis" dominate the literature of published case studies. However, most authors stated that they feel attached to two or more psychoanalytic schools of thought. This confirms that the theoretical pluralism in psychoanalysis stretches to the field of single case studies. The single case studies of each psychoanalytic school are described separately in terms of methodology, patient, therapist, or treatment features. We conclude that published case studies features are fairly similar across different psychoanalytic schools. The results of this study are not representative of all psychoanalytic schools, as some do not publish their work in ISI ranked journals.

Theoretical pluralism in psychoanalytic case studies

PubMed Central

Willemsen, Jochem; Cornelis, Shana; Geerardyn, Filip M.; Desmet, Mattias; Meganck, Reitske; Inslegers, Ruth; Cauwe, Joachim M. B. D.

2015-01-01

The aim of this study is to provide an overview of the scientific activity of different psychoanalytic schools of thought in terms of the content and production of case studies published on ISI Web of Knowledge. Between March 2013 and November 2013, we contacted all case study authors included in the online archive of psychoanalytic and psychodynamic case studies (www.singlecasearchive.com) to inquire about their psychoanalytic orientation during their work with the patient. The response rate for this study was 45%. It appears that the two oldest psychoanalytic schools, Object-relations psychoanalysis and Ego psychology or “Classical psychoanalysis” dominate the literature of published case studies. However, most authors stated that they feel attached to two or more psychoanalytic schools of thought. This confirms that the theoretical pluralism in psychoanalysis stretches to the field of single case studies. The single case studies of each psychoanalytic school are described separately in terms of methodology, patient, therapist, or treatment features. We conclude that published case studies features are fairly similar across different psychoanalytic schools. The results of this study are not representative of all psychoanalytic schools, as some do not publish their work in ISI ranked journals. PMID:26483725

Case-study experiments in the introductory physics curriculum

NASA Astrophysics Data System (ADS)

Arion, D. N.; Crosby, K. M.; Murphy, E. A.

2000-09-01

Carthage College added inquiry-based case study activities to the traditional introductory physics laboratory. Student teams designed, constructed, and executed their own experiments to study real-world phenomena, through which they gained understanding both of physic principles and methods of physics research. Assessment results and student feedback through teacher evaluations indicate that these activities improved student attitudes about physics as well as their ability to solve physics problems relative to previous course offerings that did not include case study.

The effect of class imbalance on case selection for case-based classifiers: An empirical study in the context of medical decision support

PubMed Central

Malof, Jordan M.; Mazurowski, Maciej A.; Tourassi, Georgia D.

2013-01-01

Case selection is a useful approach for increasing the efficiency and performance of case-based classifiers. Multiple techniques have been designed to perform case selection. This paper empirically investigates how class imbalance in the available set of training cases can impact the performance of the resulting classifier as well as properties of the selected set. In this study, the experiments are performed using a dataset for the problem of detecting breast masses in screening mammograms. The classification problem was binary and we used a k-nearest neighbor classifier. The classifier’s performance was evaluated using the Receiver Operating Characteristic (ROC) area under the curve (AUC) measure. The experimental results indicate that although class imbalance reduces the performance of the derived classifier and the effectiveness of selection at improving overall classifier performance, case selection can still be beneficial, regardless of the level of class imbalance. PMID:21820273

A case-control study: occupational cooking and the risk of uveal melanoma

PubMed Central

2010-01-01

Background A European-wide population based case-control study (European rare cancer study) undertaken in nine European countries examined risk factors for uveal melanoma. They found a positive association between cooks and the risk of uveal melanoma. In our study we examine whether cooks or people who worked in cook related jobs have an increased uveal melanoma risk. Methods We conducted a case-control study during 2002 and 2005. Overall, 1653 eligible subjects (age range: 20-74 years, living in Germany) participated. Interviews were conducted with 459 incident uveal melanoma cases, 827 population controls, 180 ophthalmologist controls and 187 sibling controls. Data on occupational exposure were obtained from a self-administered postal questionnaire and a computer-assisted telephone interview. We used conditional logistic regression to estimate odds ratios adjusting for the matching factors. Results Overall, we did not observe an increased risk of uveal melanoma among people who worked as cooks or who worked in cook related jobs. When we restricted the source population of our study to the population of the Federal State of Northrhine-Westphalia, we observed an increased risk among subjects who were categorized as cooks in the cases-control analysis. Conclusion Our results are in conflict with former results of the European rare cancer study. Considering the rarity of the disease laboratory in vitro studies of human uveal melanoma cell lines should be done to analyze potential exposure risk factors like radiation from microwaves, strong light from incandescent ovens, or infrared radiation. PMID:20969762

Homeopathy for Depression: A Randomized, Partially Double-Blind, Placebo-Controlled, Four-Armed Study (DEP-HOM)

PubMed Central

Adler, Ubiratan C.; Krüger, Stephanie; Teut, Michael; Lüdtke, Rainer; Schützler, Lena; Martins, Friederike; Willich, Stefan N.; Linde, Klaus; Witt, Claudia M.

2013-01-01

Background The specific clinical benefit of the homeopathic consultation and of homeopathic remedies in patients with depression has not yet been investigated. Aims To investigate the 1) specific effect of individualized homeopathic Q-potencies compared to placebo and 2) the effect of an extensive homeopathic case taking (case history I) compared to a shorter, rather conventional one (case history II) in the treatment of acute major depression (moderate episode) after six weeks. Methods A randomized, partially double-blind, placebo-controlled, four-armed trial using a 2×2 factorial design with a six-week study duration per patient was performed. Results A total of 44 from 228 planned patients were randomized (2∶1∶2∶1 randomization: 16 homeopathic Q-potencies/case history I, 7 placebo/case history I, 14 homeopathic Q-potencies/case history II, 7 placebo/case history II). Because of recruitment problems, the study was terminated prior to full recruitment, and was underpowered for the preplanned confirmatory hypothesis testing. Exploratory data analyses showed heterogeneous and inconclusive results with large variance in the sample. The mean difference for the Hamilton-D after 6 weeks was 2.0 (95%CI −1.2;5.2) for Q-potencies vs. placebo and −3.1 (−5.9;−0.2) for case history I vs. case history II. Overall, no consistent or clinically relevant results across all outcomes between homeopathic Q-potencies versus placebo and homeopathic versus conventional case taking were observed. The frequency of adverse events was comparable for all groups. Conclusions Although our results are inconclusive, given that recruitment into this trial was very difficult and we had to terminate early, we cannot recommend undertaking a further trial addressing this question in a similar setting. Prof. Dr. Claudia Witt had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Trial registration clinicaltrials.gov identifier NCT01178255. Protocol publication: http://www.trialsjournal.com/content/12/1/43 PMID:24086352

Nitrosamine and related food intake and gastric and oesophageal cancer risk: A systematic review of the epidemiological evidence

PubMed Central

Jakszyn, Paula; González, Carlos Alberto

2006-01-01

AIM: To study the association between nitrite and nitrosamine intake and gastric cancer (GC), between meat and processed meat intake, GC and oesophageal cancer (OC), and between preserved fish, vegetable and smoked food intake and GC. METHODS: In this article we reviewed all the published cohort and case-control studies from 1985-2005, and analyzed the relationship between nitrosamine and nitrite intake and the most important related food intake (meat and processed meat, preserved vegetables and fish, smoked foods and beer drinking) and GC or OC risk. Sixty-one studies, 11 cohorts and 50 case-control studies were included. RESULTS: Evidence from case-control studies supported an association between nitrite and nitrosamine intake with GC but evidence was insufficient in relation to OC. A high proportion of case-control studies found a positive association with meat intake for both tumours (11 of 16 studies on GC and 11 of 18 studies on OC). A relatively large number of case-control studies showed quite consistent results supporting a positive association between processed meat intake and GC and OC risk (10 of 14 studies on GC and 8 of 9 studies on OC). Almost all the case-control studies found a positive and significant association between preserved fish, vegetable and smoked food intake and GC. The evidence regarding OC was more limited. Overall the evidence from cohort studies was insufficient or more inconsistent than that from case-control studies. CONCLUSION: The available evidence supports a positive association between nitrite and nitrosamine intake and GC, between meat and processed meat intake and GC and OC, and between preserved fish, vegetable and smoked food intake and GC, but is not conclusive. PMID:16865769

[Quality assurance in coding expertise of hospital cases in the German DRG system. Evaluation of inter-rater reliability in MDK expertise].

PubMed

Huber, H; Brambrink, M; Funk, R; Rieger, M

2012-10-01

The purpose of this study was to evaluate differences in the D-DRG results of a hospital case by 2 independently coding MKD raters. Calculation of the 2-inter-rater reliability was performed by examination of the coding of individual hospital cases. The reasons for the non-agreement of the expert evaluations and suggestions to improve the process are discussed. From the expert evaluation pool of the MDK-WL a random sample of 0.7% of the 57,375 expertises was taken. Distribution equality with the basic total was tested by the χ² test or, respectively, Fisher's exact test. For the total of 402 individual hospital cases, the G-DRG case sums of 2 experts of the MDK were determined independently and the results checked for each individual case for agreement or non-agreement. The corresponding confidence intervals with standard errors were analysed to test if certain major diagnosis categories (MDC) were statistically significantly more affected by differing expertise results than others. In 280 of the total 402 tested hospital cases, the 2 MDK raters independently reached the same G-DRG results; in 122 cases the G-DRG case sums determined by the 2 raters differed (agreement 70%; CI 65.2-74.1). Different DRG results between the 2 experts occurred regularly in the entire MDC spectrum. No MDC chapter in which significant differences between the 2 raters arose could be identified. The results of our study demonstrate an almost 70% agreement in the evaluation of hospital cost accounts by 2 independently operating MDK. This result leaves room for improvement. Optimisation potentials can be recognised on the basis of the results. Potential for improvement was established in combination with regular further training and the expansion of binding internal code recommendations as well as exchange of code-relevant information among experts in internal forums. The presented model is in principle suitable for cross-border examinations within the MDK system with the advantage that further trends could be uncovered by more variety and larger numbers of the randomly selected cases. © Georg Thieme Verlag KG Stuttgart · New York.

Histologic Features associated with Diagnostic Agreement in Atypical Ductal Hyperplasia of the Breast: Illustrative Cases from the B-Path Study

PubMed Central

Allison, Kimberly H.; Rendi, Mara H.; Peacock, Sue; Morgan, Tom; Elmore, Joann G.; Weaver, Donald L.

2016-01-01

Background Case specific characteristics associated with interobserver diagnostic agreement in atypical ductal hyperplasia (ADH) of the breast are poorly understood. Methods Seventy-two test set cases with a consensus diagnosis of ADH from the B-Path study were evaluated. Cases were scored for 17 histologic features which were then correlated with the participant agreement with the consensus ADH diagnosis. Participating pathologists’ perceptions of case difficulty, borderline features, or if they would obtain a second opinion were also examined for associations with agreement. Results Of the 2,070 participant interpretations on the 72 consensus ADH cases, 48% were scored by participants as difficult and 45% as borderline between two diagnoses; the presence of both of these features was significantly associated with increased agreement (p < 0.001). A second opinion would have been obtained in 80% of interpretations, and this was associated with increased agreement (p < 0.001). Diagnostic agreement ranged from 10–89% on a case-by-case basis. Cases with papillary lesions, cribriform architecture and obvious cytologic monotony were associated with higher agreement. Lower agreement rates were associated with solid or micro-papillary architecture, borderline cytologic monotony or cases without a diagnostic area that was obvious on low power. Conclusions The results of this study suggest that pathologists frequently recognize the challenge of ADH cases with some cases more prone to diagnostic variability. In addition, there are specific histologic features associated with diagnostic agreement on ADH cases. Multiple example images from cases in this test set are provided to serve as educational illustrations of these challenges. PMID:27398812

Origin of nondisjunction in trisomy 8 and trisomy 8 mosaicism.

PubMed

Karadima, G; Bugge, M; Nicolaidis, P; Vassilopoulos, D; Avramopoulos, D; Grigoriadou, M; Albrecht, B; Passarge, E; Annerén, G; Blennow, E; Clausen, N; Galla-Voumvouraki, A; Tsezou, A; Kitsiou-Tzeli, S; Hahnemann, J M; Hertz, J M; Houge, G; Kuklík, M; Macek, M; Lacombe, D; Miller, K; Moncla, A; López Pajares, I; Patsalis, P C; Petersen, M B

1998-01-01

Causes of chromosomal nondisjunction is one of the remaining unanswered questions in human genetics. In order to increase our understanding of the mechanisms underlying nondisjunction we have performed a molecular study on trisomy 8 and trisomy 8 mosaicism. We report the results on analyses of 26 probands (and parents) using 19 microsatellite DNA markers mapping along the length of chromosome 8. The 26 cases represented 20 live births, four spontaneous abortions, and two prenatal diagnoses (CVS). The results of the nondisjunction studies show that 20 cases (13 maternal, 7 paternal) were probably due to mitotic (postzygotic) duplication as reduction to homozygosity of all informative markers was observed and as no third allele was ever detected. Only two cases from spontaneous abortions were due to maternal meiotic nondisjunction. In four cases we were not able to detect the extra chromosome due to a low level of mosaicism. These results are in contrast to the common autosomal trisomies (including mosaics), where the majority of cases are due to errors in maternal meiosis.

Case Studies.

ERIC Educational Resources Information Center

Emerson, Allen; And Others

1994-01-01

Three cases of use of collaborative learning techniques in the college classroom are described: a developmental mathematics course, a graduate-level writing project, and college science instruction. Each case includes description of specific class activities and assignments, results, and teacher concerns and comments. (MSE)

Retrospective Analysis of Opioid Medication Incidents Requiring Administration of Naloxone

PubMed Central

Neil, Katherine; Marcil, Allison; Kosar, Lynette; Dumont, Zack; Ruda, Lisa; McMillan, Kaitlyn

2013-01-01

Background: Opioid analgesics are high-alert medications known to cause adverse drug events. Objectives: The purpose of this study was to determine the cause of opioid incidents requiring administration of naloxone, an opioid reversal agent. The specific objectives were to determine the number of opioid incidents and the proportion of incidents documented through occurrence reporting and to characterize the incidents by phase in the medication-use process, by type of incident, and by drug responsible for toxic effects. Methods: A retrospective chart analysis was conducted using records from 2 acute care centres in the Regina Qu’Appelle Health Region. The study included inpatients who received naloxone for reversal of opioid toxicity resulting from licit, in-hospital opioid use. Cases were classified as preventable or nonpreventable. Preventable cases were analyzed to determine the phase of the medication-use process during which the incident occurred. These cases were also grouped thematically by the type of incident. The drug most likely responsible for opioid toxicity was determined for each case. The proportion of cases documented by occurrence reporting was also noted. Results: Thirty-six cases involving administration of naloxone were identified, of which 29 (81%) were deemed preventable. Of these 29 preventable cases, the primary medication incident occurred most frequently in the prescribing phase (23 [79%]), but multiple phases were often involved. The cases were grouped into 6 themes according to the type of incident. Morphine was the drug that most frequently resulted in toxic effects (18 cases [50%]). Only two of the cases (5.6%) were documented by occurrence reports. Conclusion: Preventable opioid incidents occurred in the acute care centres under study. A combination of medication safety initiatives involving multiple disciplines may be required to decrease the incidence of these events and to better document their occurrence. PMID:24159230

Analysis of gunshot residue test results in 112 suicides.

PubMed

Reed, G E; McGuire, P J; Boehm, A

1990-01-01

The results of gunshot residue (GSR) tests in 112 suicide cases investigated by the U.S. Army Criminal Investigation Command over a ten-year period are described. Only suicide cases in which there was certainty that the victim fired a weapon were examined in an effort to reduce ambiguous results. Previous case work research by Rudzitis indicated that positive GSR test results were encountered in suicides 62% of the time using various combinations of neutron activation analysis (NAA) and atomic absorption spectrophotometry (AAS). Threshold values of 0.2-micrograms antimony and 0.3-micrograms barium (0.2-micrograms antimony and 0.5-micrograms barium after 1985) used by the U.S. Army Criminal Investigation Laboratory resulted in positive GSR results in suicide cases 38% of the time. The effects of time, location of body, handling of the body, weapon type, caliber, and condition of the hands on GSR results are examined. Case studies involving suicides by unit armorers are discussed.

Agreement between the results of meta-analyses from case reports and from clinical studies regarding the efficacy of laronidase therapy in patients with mucopolysaccharidosis type I who initiated enzyme replacement therapy in adult age: An example of case reports meta-analyses as an useful tool for evidence-based medicine in rare diseases.

PubMed

Sampayo-Cordero, Miguel; Miguel-Huguet, Bernat; Pardo-Mateos, Almudena; Moltó-Abad, Marc; Muñoz-Delgado, Cecilia; Pérez-López, Jordi

2018-02-01

Case reports might have a prominent role in the rare diseases field, due to the small number of patients affected by one such disease. A previous systematic review regarding the efficacy of laronidase therapy in patients with mucopolysaccharidosis type I (MPS-I) who initiated enzyme replacement therapy (ERT) in adult age has been published. The review included a meta-analysis of 19 clinical studies and the description of eleven case reports. It was of interest to perform a meta-analysis of those case reports to explore the role of such meta-analyses as a tool for evidence-based medicine in rare diseases. The study included all case reports with standard treatment regimen. Primary analysis was the percentage of case reports showing an improvement in a specific outcome. Only when that percentage was statistically higher than 5%, the improvement was confirmed as such. The outcomes that accomplished this criterion were ranked and compared to the GRADE criteria obtained by those same outcomes in the previous meta-analysis of clinical studies. There were three outcomes that had a significant improvement: Urine glycosaminoglycans, liver volume and 6-minute walking test. Positive and negative predictive values, sensitivity and specificity for the results of the meta-analysis of case reports as compared to that of clinical studies were 100%, 88.9%, 75% and 100%, respectively. Accordingly, absolute (Rho=0.82, 95%CI: 0.47 to 0.95) and relative agreement (Kappa=0.79, 95%CI: 0.593 to 0.99) between the number of case reports with improvement in a specific outcome and the GRADE evidence score for that outcome were good. Sensitivity analysis showed that agreement between the meta-analysis of case reports and that of the clinical studies were good only when using a strong confirmatory strategy for outcome improvement in case reports. We found an agreement between the results of meta-analyses from case reports and from clinical studies in the efficacy of laronidase therapy in patients with MPS-I who initiated ERT in adult age. This agreement suggests that combining case reports quantitatively, rather than analyzing them separately or qualitatively, may improve conclusions in the field of rare diseases. Copyright © 2018 Elsevier Inc. All rights reserved.

Effect of Impact Location on the Response of Shuttle Wing Leading Edge Panel 9

NASA Technical Reports Server (NTRS)

Lyle, Karen H.; Spellman, Regina L.; Hardy, Robin C.; Fasanella, Edwin L.; Jackson, Karen E.

2005-01-01

The objective of this paper is to compare the results of several simulations performed to determine the worst-case location for a foam impact on the Space Shuttle wing leading edge. The simulations were performed using the commercial non-linear transient dynamic finite element code, LS-DYNA. These simulations represent the first in a series of parametric studies performed to support the selection of the worst-case impact scenario. Panel 9 was selected for this study to enable comparisons with previous simulations performed during the Columbia Accident Investigation. The projectile for this study is a 5.5-in cube of typical external tank foam weighing 0.23 lb. Seven locations spanning the panel surface were impacted with the foam cube. For each of these cases, the foam was traveling at 1000 ft/s directly aft, along the orbiter X-axis. Results compared from the parametric studies included strains, contact forces, and material energies for various simulations. The results show that the worst case impact location was on the top surface, near the apex.

A Case Study of Principal Leadership in an Effective Inclusive School

ERIC Educational Resources Information Center

Hoppey, David; McLeskey, James

2013-01-01

This investigation examined the role of the principal in school change during the current era of high-stakes accountability. Qualitative methods were used to conduct a case study of one principal who had a record of success in leading school change efforts and developing a model inclusive program in his school. The results of the case study…

A comparison of results from two mycology laboratories for the diagnosis of onychomycosis: a study of 85 cases in a geriatric population.

PubMed

Scherer, William P; Scherer, Michael D

2004-01-01

An investigative study was performed to compare the results from two mycology laboratories for the diagnosis of onychomycosis in a geriatric population and to determine the possible pharmacologic treatments based on the two laboratories' results. In this study, 85 cases of suspected onychomycosis involving men and women 65 years and older from a nursing home setting in South Florida were used. Samples were taken from the hallux toenail and sent to two different mycology laboratories for fluorescent potassium hydroxide preparation and microscopic examination of a fungal culture. Of the 85 cases studied, the two mycology laboratories reported similar potassium hydroxide preparation results for 58.8% of the patients and similar fungal culture results for genus and species identification for 37.6% of the patients. When the potassium hydroxide preparation and fungal culture results were combined, the two mycology laboratories reported similar results for only 27.1% of the patients. As a result of the two mycology laboratories' findings, the possible US Food and Drug Administration-approved pharmacologic treatments may differ for 43.5% of the patients studied. The discrepancy between the two independent laboratories leaves physicians to question the reproducibility of fluorescent potassium hydroxide preparation and fungal culture analysis in a geriatric patient population for the diagnosis of onychomycosis.

Lyme Disease Surveillance in New York State: an Assessment of Case Underreporting.

PubMed

White, J; Noonan-Toly, C; Lukacik, G; Thomas, N; Hinckley, A; Hook, S; Backenson, P B

2018-03-01

Despite the mandatory nature of Lyme disease (LD) reporting in New York State (NYS), it is believed that only a fraction of the LD cases diagnosed annually are reported to public health authorities. Lack of complete LD case reporting generally stems from (i) lack of report of provider-diagnosed cases where supportive laboratory testing is not ordered or results are negative (i.e. provider underreporting) and (ii) incomplete case information (clinical laboratory reporting only with no accompanying clinical information) such that cases are considered 'suspect' and not included in national and statewide case counts (i.e. case misclassification). In an attempt to better understand LD underreporting in NYS, a two-part study was conducted in 2011 using surveillance data from three counties. Case misclassification was assessed by obtaining medical records on suspect cases and reclassifying according to the surveillance case definition. To assess provider underreporting, lists of patients for whom ICD-9-CM code 088.81 (LD) had been used were reported to NYS Department of Health (NYSDOH). These lists were matched to the NYSDOH case reporting system, and medical records were requested on patients not previously reported; cases were then classified according to the case definition. When including both provider underreporting and case misclassification, approximately 20% (range 18.4-24.6%) more LD cases were identified in the three-county study area than were originally reported through standard surveillance. The additional cases represent a minimum percentage of unreported cases; the true percentage of unreported cases is likely higher. Unreported cases were more likely to have a history of erythema migrans (EM) rash and were more likely to be young paediatric cases. Results of the study support the assertion that LD cases are underreported in NYS. Initiatives to increase reporting should highlight the importance of reporting clinically diagnosed EM and be targeted to those providers most likely to diagnose LD, specifically providers treating paediatric patients. © 2016 Blackwell Verlag GmbH.

The generic danger and the idiosyncratic support

NASA Astrophysics Data System (ADS)

Temme, Arnaud; Nijp, Jelmer; van der Meij, Marijn; Samia, Jalal; Masselink, Rens

2016-04-01

This contribution argues two main points. First, that generic landscapes used in some modelling studies sometimes have properties or cause simulation results that are unrealistic. Such initially flat or straight-sloped landscapes, sometimes with minor random perturbations, e.g. form the backdrop for ecological simulations of vegetation growth and competition that predict catastrophic shifts. Exploratory results for semi-arid systems suggest that the results based on these generic landscapes are end-members from a distribution of results, rather than an unbiased, typical outcome. Apparently, the desire to avoid idiosyncrasy has unintended consequences. Second, we argue and illustrate that in fact new insights often come from close inspection of idiosyncratic case studies. Our examples from landslide systems, connectivity and soil formation show how a central role for the case study - either in empirical work or to provide model targets - has advanced our understanding. Both points contribute to the conclusion that it is dangerous to forget about annoying, small-scale, idiosyncratic and, indeed, perhaps bad-ass case studies in Earth Sciences.

Numerical and Experimental Case Study of Blasting Works Effect

NASA Astrophysics Data System (ADS)

Papán, Daniel; Valašková, Veronika; Drusa, Marian

2016-10-01

This article introduces the theoretical and experimental case study of dynamic monitoring of the geological environment above constructed highway tunnel. The monitored structure is in this case a very important water supply pipeline, which crosses the tunnel and was made from steel tubes with a diameter of 800 mm. The basic dynamic parameters had been monitored during blasting works, and were compared with the FEM (Finite Element Method) calculations and checked by the Slovak standard limits. A calibrated FEM model based on the experimental measurement data results was created and used in order to receive more realistic results in further predictions, time and space extrapolations. This case study was required and demanded by the general contractor company and also by the owner of water pipeline, and it was an answer of public safety evaluation of risks during tunnel construction.

Case-Control Study of Breast Cancer in India: Role of PERIOD3 Clock Gene Length Polymorphism and Chronotype

PubMed Central

Wirth, Michael D.; Burch, James B.; Hébert, James R.; Kowtal, Pradnya; Kapoor, Aparna; Steck, Susan E.; Hurley, Thomas G.; Gupta, Prakash C.; Pednekar, Mangesh S.; Youngstedt, Shawn D.; Zhang, Hongmei; Sarin, Rajiv

2014-01-01

Background This study examined a PERIOD3 (PER3) gene variable number tandem repeat polymorphism and chronotype as potential BrCA risk factors among Indian women. Methods This case-control study included sporadic, histologically confirmed BrCA cases (n=255) and controls (n=249) from India with data collection from 2010–2012. Results Women with the 4/5 or 5/5 PER3 genotype had a non-statistically significant 33% increased odds of BrCA. BrCA cases were more likely to have a morning (OR=2.43, 95% CI=1.23–4.81) or evening (OR=2.55, 95% CI=1.19–5.47) chronotype. Conclusions Findings are consistent with the possibility that extremes in chronotype may elicit circadian desynchronization, resulting in adverse health outcomes. PMID:24903750

Extending the boundaries of the Declaration of Helsinki: a case study of an unethical experiment in a non-medical setting

PubMed Central

Richter, E.; Barach, P.; Berman, T.; Ben-David, G; Weinberger, Z.

2001-01-01

To examine the ethical issues involved in governmental decisions with potential health risks, we review the history of the decision to raise the interurban speed limit in Israel in light of its impact on road death and injury. In 1993, the Israeli Ministry of Transportation initiated an "experiment" to raise the interurban speed limit from 90 to 100 kph. The "experiment" did not include a protocol and did not specify cut-off points for early termination in the case of adverse results. After the raise in the speed limit, the death toll on interurban roads rose as a result of a sudden increase in speeds and case fatality rates. The committee's decision is a case study in unfettered human experimentation and public health risks when the setting is non-medical and lacks a defined ethical framework. The case study states the case for extending Helsinki type safeguards to experimentation in non-medical settings. Key Words: Declaration of Helsinki • human experimentation • speed limit PMID:11314157

Allergies and Risk of Head and Neck Cancer: An Original Study plus Meta-Analysis

PubMed Central

Lo, Hung-I; Huang, Cheng-Chih; Lee, Wei-Ting; Huang, Jehn-Shyun; Chen, Ken-Chung; Wong, Tung-Yiu; Tsai, Sen-Tien; Yen, Chia-Jui; Wu, Yuan-Hua; Hsueh, Wei-Ting; Yang, Ming-Wei; Wu, Shang-Yin; Chang, Jang-Yang; Chang, Kwang-Yu; Lin, Chen-Lin; Wang, Fang-Ting; Wang, Yi-Hui; Weng, Ya-Ling; Yang, Han-Chien; Chang, Jeffrey S.

2013-01-01

Background Although the relationship between allergy and cancer has been investigated extensively, the role of allergy in head and neck cancer (HNC) appears less consistent. It is not clear whether allergies can independently influence the risk of HNC in the presence of known strong environmental risk factors, including consumption of alcohol, betel quid, and cigarette. Methods The current paper reports results from: 1) an original hospital-based case-control study, which included 252 incident cases of HNC and 236 controls frequency-matched to cases on sex and age; and 2) a meta-analysis combining the results of the current case-control study and 13 previously published studies (9 cohort studies with 727,569 subjects and 550 HNC outcomes and 5 case-control studies with 4,017 HNC cases and 10,928 controls). Results In the original case-control study, we observed a strong inverse association between allergies and HNC [odds ratio = 0.41, 95% confidence interval (CI): 0.27–0.62]. The meta-analysis also indicated a statistically significant inverse association between HNC and allergies [meta-relative risk (RR) = 0.76, 95% CI: 0.63–0.91], particularly strong for allergic rhinitis (meta-RR = 0.55, 95% CI: 0.40–0.76). In addition, the inverse association between allergies and HNC was observed only among men (meta-RR = 0.67, 95% CI: 0.54–0.84) but not among women (meta-RR = 0.98, 95% CI: 0.81–1.18). Conclusions These findings suggest that immunity plays an influential role in the risk of HNC. Future studies investigating immune biomarkers, including cytokine profiles and genetic polymorphisms, are warranted to further delineate the relationship between allergies and HNC. Understanding the relationship between allergies and HNC may help devise effective strategies to reduce and treat HNC. PMID:23383309

Frequency, probability, and prediction: easy solutions to cognitive illusions?

PubMed

Griffin, D; Buehler, R

1999-02-01

Many errors in probabilistic judgment have been attributed to people's inability to think in statistical terms when faced with information about a single case. Prior theoretical analyses and empirical results imply that the errors associated with case-specific reasoning may be reduced when people make frequentistic predictions about a set of cases. In studies of three previously identified cognitive biases, we find that frequency-based predictions are different from-but no better than-case-specific judgments of probability. First, in studies of the "planning fallacy, " we compare the accuracy of aggregate frequency and case-specific probability judgments in predictions of students' real-life projects. When aggregate and single-case predictions are collected from different respondents, there is little difference between the two: Both are overly optimistic and show little predictive validity. However, in within-subject comparisons, the aggregate judgments are significantly more conservative than the single-case predictions, though still optimistically biased. Results from studies of overconfidence in general knowledge and base rate neglect in categorical prediction underline a general conclusion. Frequentistic predictions made for sets of events are no more statistically sophisticated, nor more accurate, than predictions made for individual events using subjective probability. Copyright 1999 Academic Press.

A Model of Human Orientation and Self Motion Perception during Body Acceleration: The Orientation Modeling System

DTIC Science & Technology

2016-09-28

previous research and modeling results. The OMS and Perception Toolbox were used to perform a case study of an F18 mishap. Model results imply that...request documents from DTIC. Change of Address Organizations receiving reports from the U.S. Army Aeromedical Research Laboratory on automatic...54  Coriolis head movement during a coordinated turn. .............................................55  Case Study

Cognitive and Learning Strategies for Longstanding Temporal Lobe Lesions in a Child Who Suffered from "Herpes Simplex" Virus Encephalitis: A Case Study over 10 Years

ERIC Educational Resources Information Center

van Schoor, A. N.; Naude, H.; van Rensburg, M.; Pretorius, E.; Boon, J. M.

2005-01-01

This article presents a case study indicating that "Herpes simplex" virus (HSV) encephalitis may cause permanent learning disabilities due to damage to the temporal lobes as it discusses the results of a case study extending over 10 years to determine the long-term effects on both the anatomy of the brain and the intellectual functioning of the…

The Role of Re-Appropriation in Open Design: A Case Study on How Openness in Higher Education for Industrial Design Engineering Can Trigger Global Discussions on the Theme of Urban Gardening

ERIC Educational Resources Information Center

Ostuzzi, Francesca; Conradie, Peter; De Couvreur, Lieven; Detand, Jan; Saldien, Jelle

2016-01-01

This case study explores the opportunities for students of Industrial Design Engineering to engage with direct and indirect stakeholders by making their design process and results into open-ended designed solutions. The reported case study involved 47 students during a two-weeks intensive course on the topic of urban gardening. Observations were…

Cognitive and Learning Strategies for Longstanding Temporal Lobe Lesions in a Child Who Suffered from "Herpes Simplex" Virus Encephalitis: A Case Study over 10 Years

ERIC Educational Resources Information Center

van Schoor, A. N.; Naude, H.; van Rensburg, M.; Pretorius, E.; Boon, J. M.

2004-01-01

This article presents a case study indicating that "Herpes simplex" virus (HSV) encephalitis may cause permanent learning disabilities due to damage to the temporal lobes, as it discusses the results of a case study extending over 10 years to determine the long-term effects on both the anatomy of the brain and the intellectual functioning of the…

Evaluation of School Uniform Policy in Turkey: A Case Study

ERIC Educational Resources Information Center

Cinoglu, Mustafa

2014-01-01

The purpose of this study is to evaluate the results of current school uniform policies according to views of stakeholders. Descriptive case study method was used for this study to understand the concerns of the stakeholders about school uniforms. Data was collected through interviews with stakeholders and also reviewing the documents in TOKI…

Effective Teaching Strategies: Case Studies from the Alphabetic Braille and Contracted Braille Study

ERIC Educational Resources Information Center

Barclay, Lizbeth; Herlich, Stephanie A.; Sacks, Sharon Zell

2010-01-01

This article discusses some of the qualitative data that were documented during the Alphabetic Braille and Contracted Braille Study. Two case studies of students are described, highlighting many effective teaching strategies used by their teachers of students with visual impairments that resulted in the students' successful academic progress.…

Predicting Students Drop Out: A Case Study

ERIC Educational Resources Information Center

Dekker, Gerben W.; Pechenizkiy, Mykola; Vleeshouwers, Jan M.

2009-01-01

The monitoring and support of university freshmen is considered very important at many educational institutions. In this paper we describe the results of the educational data mining case study aimed at predicting the Electrical Engineering (EE) students drop out after the first semester of their studies or even before they enter the study program…

[Rapid diagnosis of the most common fetal aneuploidies with the QF-PCR method--a study of 100 cases].

PubMed

Łaczmańska, Izabela; Gil, Justyna; Stembalska, Agnieszka; Makowska, Izabela; Kozłowska, Joanna; Skiba, Paweł; Czemarmazowicz, Halina; Pesz, Karolina; Slęzak, Ryszard; Smigiel, Robert; Jakubiak, Aleksandra; Doraczyńska-Kowalik, Anna; Sąsiadek, Maria M

2015-09-01

The aim of the study was to assess whether commercial kit QF-PCR can be used as the only method for rapic prenatal dia gnosis of chromosomes 13, 18, 21, X and Y aneuploidies, omitting cell culture and complete cyt6genetik analysis of fetal chromosomes. DNA from amniocytes (94 cases) and trophoblast cells (6 cases) was analyzed witt QF-PCR according to the manufacturer's protocol. The obtained products were separated using ABI 310 Genetic Analyzer and the resulting data were analyzed using GeneMarker software. The results of QF-PCR were obtained in 95 out of 100 cases (95%). Abnormalities were found in 28 casea (29.5%). All these results were confirmed in subsequent cytogenetic analysis. Normal results were obtained in 62 patients (70.5%). However in that group, we found three chromosomal aberrations other than those analyzed b3 QF-PCR. Additionally two abnormal and three normal karyotypes were found in patients with inconclusive QF-POF results. QF-PCR is a fast and reliable tool for chromosomal aneuploidy analysis and can be used as the only method without a full analysis of the karyotype, but only in cases of suspected fetal 13, 18, 21 trisomy or numerica aberrations of X chromosome. In other cases, fetal karyotype analysis from cells obtained after cell culture should be offered to the patient.

Clinical and immunological studies of 49 cases of various types of intercellular IgA dermatosis and 13 cases of classical subcorneal pustular dermatosis examined at Kurume University.

PubMed

Hashimoto, T; Teye, K; Ishii, N

2017-01-01

Intercellular IgA dermatosis (IAD) is a subset of autoimmune bullous disease exclusively with IgA antikeratinocyte cell-surface antibodies. The classification and pathogenesis of this condition are still obscure. To classify IAD and study its pathogenesis. From our cohort of 5402 cases of autoimmune bullous disease, we selected 49 cases of various types of intercellular IgA dermatosis (IAD) and 13 cases of classical subcorneal pustular dermatosis (SPD), for which sera and information were available. We studied these cases clinically and immunologically. There were 17 SPD-type IAD, 12 intraepidermal neutrophilic IgA dermatosis (IEN)-type IAD, two IgA-pemphigus vegetans, four IgA-pemphigus foliaceus, six IgA-pemphigus vulgaris and eight unclassified IAD cases. There was no sex predominance, and the average age at disease onset was 45·9 years. Clinically, bullous and pustular skin lesions developed on various sites, particularly intertriginous areas. Histopathology showed intraepidermal blisters or pustules at the upper epidermis in the SPD-type and at the midepidermis in the IEN-type. Immunological studies revealed that direct immunofluorescence, indirect immunofluorescence of normal human skin and enzyme-linked immunosorbent assays (ELISAs) of recombinant proteins of desmogleins and desmocollins frequently showed positive results, although no antigens were detected in many cases. All cases of classical SPD, which showed no positive immunological results, were indistinguishable clinically and histopathologically from SPD-type IAD. The present study of the largest cohort of cases of IAD showed that the major subtypes are SPD and IEN, and that the combination of indirect immunofluorescence and ELISAs of desmogleins and desmocollins, in addition to direct immunofluorescence, was useful for the diagnosis of IAD and its subtypes. © 2016 British Association of Dermatologists.

Histopathological study of the outer membrane of the dura mater in chronic sub dural hematoma: Its clinical and radiological correlation

PubMed Central

Bokka, Sriharsha; Trivedi, Adarsh

2016-01-01

Background: A chronic subdural hematoma is an old clot of blood on the surface of the brain between dura and arachnoid membranes. These liquefied clots most often occur in patients aged 60 and older with brain atrophy. When the brain shrinks inside the skull over time, minor head trauma can cause tearing of blood vessels over the brain surface, resulting in a slow accumulation of blood over several days to weeks. Aim of the Study: To evaluate the role of membrane in hematoma evaluation and to correlate its histopathology with clinic-radiological aspects of the condition and overall prognosis of patients. Material and Methods: The study incorporated all cases of chronic SDH admitted to the Neurosurgery department of JLN Hospital and Research Centre, Bhilai, between November 2011 and November 2013. All such cases were analyzed clinically, radiologically like site, size, thickness in computed tomography, the attenuation value, midline shift and histopathological features were recorded. Criteria for Inclusion: All cases of chronic subdural haematoma irrespective of age and sex were incorporated into the study. Criteria for Exclusion: All cases of acute subdural haematoma and cases of chronic sub dural hematoma which were managed conservatively irrespective of age and sex were excluded from the study Results: In our series of cases, the most common histopathological type of membrane was the inflammatory membrane (Type II) seen in 42.30% of cases followed by hemorrhagic inflammatory membrane (Type III) seen in 34.62% of cases while scar inflammatory type of membrane (Type IV) was seen in 23.08% of cases. No case with noninflammatory type (Type I) was encountered. PMID:26889276

A Novel Classification System for Injuries After Electronic Cigarette Explosions.

PubMed

Patterson, Scott B; Beckett, Allison R; Lintner, Alicia; Leahey, Carly; Greer, Ashley; Brevard, Sidney B; Simmons, Jon D; Kahn, Steven A

Electronic cigarettes (e-cigarettes) contain lithium batteries that have been known to explode and/or cause fires that have resulted in burn injury. The purpose of this article is to present a case study, review injuries caused by e-cigarettes, and present a novel classification system from the newly emerging patterns of burns. A case study was presented and online media reports for e-cigarette burns were queried with search terms "e-cigarette burns" and "electronic cigarette burns." The reports and injury patterns were tabulated. Analysis was then performed to create a novel classification system based on the distinct injury patterns seen in the study. Two patients were seen at our regional burn center after e-cigarette burns. One had an injury to his thigh and penis that required operative intervention after ignition of this device in his pocket. The second had a facial burn and corneal abrasions when the device exploded while he was inhaling vapor. The Internet search and case studies resulted in 26 cases for evaluation. The burn patterns were divided in direct injury from the device igniting and indirect injury when the device caused a house or car fire. A numerical classification was created: direct injury: type 1 (hand injury) 7 cases, type 2 (face injury) 8 cases, type 3 (waist/groin injury) 11 cases, and type 5a (inhalation injury from using device) 2 cases; indirect injury: type 4 (house fire injury) 7 cases and type 5b (inhalation injury from fire started by the device) 4 cases. Multiple e-cigarette injuries are occurring in the United States and distinct patterns of burns are emerging. The classification system developed in this article will aid in further study and future regulation of these dangerous devices.

Feasibility study for remote assessment of cognitive function in multiple sclerosis

PubMed Central

George, Michaela F.; Holingue, Calliope B.; Briggs, Farren B.S.; Shao, Xiaorong; Bellesis, Kalliope H.; Whitmer, Rachel A.; Schaefer, Catherine; Benedict, Ralph HB; Barcellos, Lisa F.

2017-01-01

Background Cognitive impairment is common in multiple sclerosis (MS), and affects employment and quality of life. Large studies are needed to identify risk factors for cognitive decline. Currently, a MS-validated remote assessment for cognitive function does not exist. Studies to determine feasibility of large remote cognitive function investigations in MS have not been published. Objective To determine whether MS patients would participate in remote cognitive studies. We utilized the Modified Telephone Interview for Cognitive Status (TICS-M), a previously validated phone assessment for cognitive function in healthy elderly populations to detect mild cognitive impairment. We identified factors that influenced participation rates. We investigated the relationship between MS risk factors and TICS-M score in cases, and score differences between cases and control individuals. Methods The TICS-M was administered to MS cases and controls. Linear and logistic regression models were utilized. Results 11.5% of eligible study participants did not participate in cognitive testing. MS cases, females and individuals with lower educational status were more likely to refuse (p<0.001). Cases who did complete testing did not differ in terms of perceived cognitive deficit compared to cases that did participate. More severe disease, smoking, and being male were associated with a lower TICS-M score among cases (p<0.001). The TICS-M score was significantly lower in cases compared to controls (p=0.007). Conclusions Our results demonstrate convincingly that a remotely administered cognitive assessment is quite feasible for conducting large epidemiologic studies in MS, and lay the much needed foundation for future work that will utilize MS-validated cognitive measures. PMID:28255581

Deep venous thrombophlebitis: detection with 4-hour versus 24-hour platelet scintigraphy

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

Seabold, J.E.; Conrad, G.R.; Ponto, J.A.

Thirty-one nonheparinized patients with suspected deep venous thrombophlebitis (DVT) underwent contrast venography and indium-111 platelet scintigraphy (In-111 PS). Venography permitted identification of acute DVT in 12 of 31 cases (39%). One additional patient was considered to have acute DVT despite nonconclusive venography results. In-111 PS results were positive at 4 hours in nine of 13 cases (69%) and at 24 hours in 12 of 13 cases (92%). Two of four patients with false-negative 4-hour In-111 PS studies had received warfarin. Thus, the sensitivity of 4-hour In-111 PS in patients not receiving anticoagulants was 82%. Venography results were negative for acutemore » DVT in 18 cases, and 4-hour In-111 PS studies were negative or equivocal in each. In-111 PS is an alternative to contrast venography for detecting acute DVT. If 4-hour In-111 PS results are positive, anticoagulation can be initiated. Delayed images are necessary if the 4-hour images are negative or equivocal.« less

Effect of digital problem-based learning cases on student learning outcomes in ophthalmology courses.

PubMed

Kong, Jun; Li, Xiaoyan; Wang, Youdong; Sun, Wei; Zhang, Jinsong

2009-09-01

To assess the impact of digital problem-based learning (PBL) cases on student learning in ophthalmology courses. Ninety students were randomly divided into 3 classes (30 students per class). The first class studied under a didactic model. The other 2 classes were divided into 6 groups (10 students per group) and received PBL teaching; 3 groups studied via cases presented in digital form and the others studied via paper-form cases. The results of theoretical and case analysis examinations were analyzed using the chi(2) test. Student performance on the interval practice was analyzed using the Kruskal-Wallis test. Questionnaires were used to evaluate student and facilitator perceptions. Students in the digital groups exhibited better performance in the practice procedures according to tutorial evaluations compared with the other groups (P < .05). The 2 PBL classes had significantly higher mean results of theoretical and case analysis examinations (P < .001), but there was no significant difference between the 2 PBL classes. Ninety-three percent of students in the digital groups (vs 73% in the paper groups) noted that the cases greatly stimulated their interest. Introducing PBL into ophthalmology could improve educational quality and effectiveness. Digital PBL cases stimulate interest and motivate students to further improve diagnosis and problem-handling skills.

Using Case-Based Pedagogy in the Philippines: A Narrative Inquiry

NASA Astrophysics Data System (ADS)

Arellano, Elvira L.; Barcenal, Tessie L.; Bilbao, Purita P.; Castellano, Merilin A.; Nichols, Sharon E.; Tippins, Deborah J.

2001-04-01

This study features use of case-based pedagogy as a context for exploring science teacher education reform. A central premise of the study is that science teacher education reform is a complex process characterised by the individual and collective narrative histories of teachers. The study was conducted at West Visayas State University in the Philippines as a collaborative research endeavour involving two US and four Filipino science teacher educators. The centrepiece of this study was a case experience prompted by reflection on prospective and practicing elementary teachers' written cases. Results of the study are presented here as a layered narrative. An initial layer explores how a case, written by a prospective teacher, was interwoven with her past and future life history. A second layer looks at sociocultural and professional tensions that mediated the participants' case experience. A third layer represents how the case experience provided a community that supported critical reflection among the research team members. Implications from the study emphasise that case-based pedagogy can serve as a basis for critical reflection to inform community-based approaches to science teacher education pedagogical and research reform.

Technologies in Literacy Learning: A Case Study

ERIC Educational Resources Information Center

Cloonan, Anne

2010-01-01

This article draws on outcomes of a study which explored changes in teachers' literacy pedagogies as a result of their participation in a collaborative teacher professional learning project. The educational usability of schemas drawn from multiliteracies and Learning by Design theory is illustrated through a case study of a teacher's work on…

Optimized Real-Time Control of Combined Sewerage Systems: Two Case Studies (Proceedings Paper)

EPA Science Inventory

The paper presents results of two case studies of Real-Time Control (RTC) alternatives evaluations that were conducted on portions of sewerage systems near Paris, France and in Quebec City, Canada, respectively. The studies were performed at real-scale demonstration sites. RTC al...

Academic Capitalism and Academic Culture: A Case Study

ERIC Educational Resources Information Center

Mendoza, Pilar; Berger, Joseph B.

2008-01-01

This case study investigated the impact of academic capitalism on academic culture by examining the perspectives of faculty members in an American academic department with significant industrial funding. The results of this study indicate that faculty members believe that the broad integrity of the academic culture remains unaffected in this…

Risk Factors Profile of Shoulder Dystocia in Oman: A Case Control Study

PubMed Central

Al-Khaduri, Maha M.; Abudraz, Rania Mohammed; Al-Farsi, Yahya M.

2014-01-01

Objective This study aimed to assess the risk factor profile of shoulder dystocia and associated neonatal complications in Oman, a developing Arab country. Methods A retrospective case-control study was conducted among 111 cases with dystocia and 111 controls, identified during 1994-2006 period in a tertiary care hospital in Oman. Controls were randomly selected among women who did not have dystocia, and were matched to cases on the day of delivery. Data related to potential risk factors, delivery, and obstetric complications were collected. Results Dystocia was significantly associated with older maternal age, higher parity, larger BMI, diabetes, and previous record of dystocia. In addition, dystocia was associated more with vacuum and forceps deliveries. Routine traction (51%) was the most used manoeuvre. Among dystocia cases, 13% were associated with fetal complications of which Erb’s Palsy was the most prevalent (79%). Conclusion Our finding of significant associations with risk factors lays out the ground to develop a predictability index for shoulder dystocia, which would help in making it preventable. Further p rospective studies are required to confirm the obtained results. PMID:25337307

IVHS Institutional Issues And Case Studies: Help/Cresent Case Study

DOT National Transportation Integrated Search

1997-04-01

This report presents the results of research on procurement-related legal and non-technical issues which may be viewed as constraints to the deployment of Intelligent Transportation Systems (ITS). It focuses on state and local practices when federal ...

A case study of the Maintenance Decision Support System (MDSS) in Maine.

DOT National Transportation Integrated Search

2007-09-10

This report presents the results of a case study evaluation of a Maintenance Decision Support System (MDSS) project under a program funded by the U.S. Department of Transportations (USDOT) Intelligent Transportation Systems (ITS) Joint Program Off...

Access Management Awareness Program. Phase II Report

DOT National Transportation Integrated Search

1997-01-01

This report presents the results of a number of detailed Iowa access management case studies. Case studies were selected to provide a cross-section of locations and community sizes in Iowa as well as a variety of project types. Projects were analyzed...

Retrocochlear impairments in systemic sclerosis: a case report study.

PubMed

Valente, Julia de Souza Pinto; Corona, Ana Paula

2017-12-07

To report three cases of patients with Systemic Sclerosis (SSc) and retrocochlear impairments. This is a case report of three individuals with SSc and retrocochlear impairments assisted at a rheumatology outpatient clinic. All individuals underwent Brainstem Auditory Evoked Potential (BAEP) and, when necessary, audiometry. All three individuals presented sensorineural hearing loss. Although no retrocochlear impairment was identified in the basic audiologic evaluation, the BAEP results were altered. Retrocochlear impairments were present in the individuals under study, both in the absolute latencies and interpeak interval, thereby demanding the attention of rheumatologists and speech-language pathologists to such changes during the monitoring of SSc patients. The results also show a need for epidemiological studies on the theme.

[Clinical decision making: Fostering critical thinking in the nursing diagnostic process through case studies].

PubMed

Müller-Staub, Maria; Stuker-Studer, Ursula

2006-10-01

Case studies, based on actual patients' situations, provide a method of clinical decision making to foster critical thinking in nurses. This paper describes the method and process of group case studies applied in continuous education settings. This method bases on Balints' case supervision and was further developed and combined with the nursing diagnostic process. A case study contains different phases: Pre-phase, selection phase, case delineation and case work. The case provider narratively tells the situation of a patient. This allows the group to analyze and cluster signs and symptoms, to state nursing diagnoses and to derive nursing interventions. Results of the case study are validated by applying the theoretical background and critical appraisal of the case provider. Learning effects of the case studies were evaluated by means of qualitative questionnaires and analyzed according to Mayring. Findings revealed the following categories: a) Patients' problems are perceived in a patient centred way, accurate nursing diagnoses are stated and effective nursing interventions implemented. b) Professional nursing tasks are more purposefully perceived and named more precise. c) Professional nursing relationship, communication and respectful behaviour with patients were perceived in differentiated ways. The theoretical framework is described in the paper "Clinical decision making and critical thinking in the nursing diagnostic process". (Müller-Staub, 2006).

Implementation of case studies in undergraduate didactic nursing courses: a qualitative study.

PubMed

Dutra, Danette K

2013-07-04

The implementation of unfolding scenario-based case studies in the didactic classroom is associated with learner-centered education. The utilization of learner-centered pedagogies, such as case studies, removes the focus from the instructor and instead places it on the student. Learner-centered pedagogies are believed to improve students' levels of cognition. The purpose of this study was to examine how nurse educators are implementing the pedagogies of case studies in their undergraduate didactic courses. The goal was to examine, document, report, and, ultimately, implement the strategies. Purposeful sampling was utilized in this qualitative, multisite-designed study. For each of the four participants, three separate site visits were completed. Observations and post-observational interviews took place at each site visit. Transcribed data from interviews, observations, and course documents were imported into the computer program Nvivo8. Repetitive comparative analysis was utilized to complete the data coding process. The guiding research question of this study sought to investigate the implementation strategies of case studies in didactic nursing courses. The implementation of case studies by the participants reflected two primary patterns: Formal Implementation (FI) and Informal Implementation (II) of case studies. The FI of case studies was further divided into two subcategories: Formal Implementation of case studies used Inside the Classroom setting (FIIC) and Formal Implementation of cases studies used Outside of the Classroom (FIOC). Results of this investigation have led to an increased understanding of implementation strategies of unfolding scenario-based case studies in undergraduate nursing didactic courses. Data collected were rich in the description of specific methodologies for utilization of case studies and may serve as a resource for faculty in development of creative strategies to enhance the didactic classroom experience.

Simulations of the vortex in the Dellenback abrupt expansion, resembling a hydro turbine draft tube operating at part-load

NASA Astrophysics Data System (ADS)

Nilsson, H.

2012-11-01

This work presents an OpenFOAM case-study, based on the experimental studies of the swirling flow in the abrupt expansion by Dellenback et al.[1]. The case yields similar flow conditions as those of a helical vortex rope in a hydro turbine draft tube working at part-load. The case-study is set up similar to the ERCOFTAC Conical Diffuser and Centrifugal Pump OpenFOAM case-studies [2,3], making all the files available and the results fully reproducable using OpenSource software. The mesh generation is done using m4 scripting and the OpenFOAM built-in blockMesh mesh generator. The swirling inlet boundary condition is specified as an axi-symmetric profile. The outlet boundary condition uses the zeroGradient condition for all variables except for the pressure, which uses the fixed mean value boundary condition. The wall static pressure is probed at a number of locations during the simulations, and post-processing of the time-averaged solution is done using the OpenFOAM sample utility. Gnuplot scripts are provided for plotting the results. The computational results are compared to one of the operating conditions studied by Dellenback, and measurements for all the experimentally studied operating conditions are available in the case-study. Results from five cases are here presented, based on the kEpsilon model, the kOmegaSST model, and a filtered version of the same kOmegaSST model, named kOmegaSSTF [4,5]. Two different inlet boundary conditions are evaluated. It is shown that kEpsilon and kOmegaSST give steady solutions, while kOmegaSSTF gives a highly unsteady solution. The time-averaged solution of the kOmegaSSTF model is much more accurate than the other models. The kEpsilon and kOmegaSST models are thus unable to accurately model the effect of the large-scale unsteadiness, while kOmegaSSTF resolves those scales and models only the smaller scales. The use of two different boundary conditions shows that the boundary conditions are more important than the choice between kEpsilon and kOmegaSST, for the results just after the abrupt expansion.

Evaluation, Supervision, and Staff Development under Mandated Reform: The Perceptions and Practices of Rural Middle School Principals

ERIC Educational Resources Information Center

Eady, Charlotte King; Zepeda, Sally J.

2007-01-01

The perspectives of three rural middle school principals as they implement Georgia's A Plus Education Reform Act of 2000 were investigated in this study. A case study approach was used, employing both within case and cross case analyses. Three interviews were conducted with each of the three participants, resulting in a total of nine interviews.…

Enhancement of Entrepreneurial Leadership: A Case Focusing on a Model of Successful Conflict Management Skills

ERIC Educational Resources Information Center

Leffel, Anita; Hallam, Cory; Darling, John

2012-01-01

The purpose of this paper is to present a case study focusing on a new technology start-up firm, founded by two graduate students, an engineer and a business major, who met during their university studies. The case is timely, in that only ten percent of new product introductions result in a profitable business. The causes of failure are numerous…

Automated and Autonomous Systems for Combat Service Support: Scoping Study and Technology Prioritisation

DTIC Science & Technology

2016-10-01

workshop, and use case development for automated and autonomous systems for CSS. The scoping study covers key concepts and trends, a technology scan, and...requirements and delimiters for the selected technologies. The report goes on to present detailed use cases for two technologies of interest: semi...selected use cases . As a result of the workshop, the large list of technologies and applications from the scoping study was narrowed down to the top

Intussusception following rotavirus vaccination in the Valencia Region, Spain.

PubMed

Pérez-Vilar, Silvia; Díez-Domingo, Javier; Puig-Barberà, Joan; Gil-Prieto, Ruth; Romio, Silvana

2015-01-01

Studies have shown high intussusception rates in Spain. We performed a hospital-based retrospective observational study of the intussusception risk following rotavirus vaccinations among infants in Valencia, a region of Spain with an annual birth cohort of approximately 48,000 children, during 2007-2011, using a self-controlled case series design. We performed medical record review of all cases using Brighton Collaboration's case definition and assessed the positive predictive value (PPV) of the intussusception diagnosis code. Among 151 hospitalized cases discharged as intussusception, we confirmed 136 as Brighton Collaboration's Levels 1 or 2, resulting in a PPV of 93% (95% CI: 87%-96%). Three confirmed cases occurred within days 1-7 following the first rotavirus vaccination. The incidence rate ratio was 9.0 (95% CI: 0.9-86.5) (crude) and 4.7 (95% CI:0.3-74.1)(age adjusted). In this first study in Europe, the intussusception risk point estimate was comparable to other studies, although results were not statistically significant, maybe due to limited power. The high PPV found will facilitate implementation of a larger study without requiring medical record review. Our finding of very few vaccinated cases despite a thorough 5-year investigation in a country that, according to previous studies, may have a large background rate of intussusception is reassuring and should contribute to deliberations about the need to include rotavirus vaccines in the official Spanish calendars.

Behavioral Case Consultation with Parents and Teachers: An Example Using Differential Reinforcement to Treat Psychogenic Cough.

ERIC Educational Resources Information Center

Watson, T. Steuart; Heindl, Betsy

1996-01-01

Presents a demonstration of successful behavioral case consultation combined with case study methodology in the treatment of a 13-year-old female afflicted with a psychogenic cough. Results suggest that psychogenic cough can be successfully treated by using behavioral case consultation as a framework for applying intervention. Limitations are also…

GST Theta null genotype is associated with an increased risk for ulcerative colitis: a case-control study and meta-analysis of GST Mu and GST Theta polymorphisms in inflammatory bowel disease.

PubMed

Broekman, Mark M T J; Bos, Caro; Te Morsche, René H M; Hoentjen, Frank; Roelofs, Hennie M J; Peters, Wilbert H M; Wanten, Geert J A; de Jong, Dirk J

2014-10-01

Glutathione S-transferases (GSTs) are important in the detoxification of many compounds, including reactive oxygen species. Polymorphisms in GSTs resulting in a decreased enzyme activity might enhance the risk for inflammatory bowel disease by eliciting a state of oxidative stress. Previous case-control studies showed divergent results and were frequently limited in sample size; therefore we conducted a meta-analysis including results from our case-control study. For the case-control study, we genotyped 552 patients with Crohn's disease (CD), 223 patients with ulcerative colitis (UC) and 972 healthy controls by PCR for functional deletions in GST Mu and GST Theta. Both were not analyzed in recent genome-wide association studies. For the meta-analysis, PubMed, EMBASE and Web of Science were searched. In this meta-analysis, we show an enhanced susceptibility for UC in individuals with the GSTT1null genotype (odds ratio (OR) 2.27, 95% confidence interval (CI) 1.31-3.92). In our case-control study, a reduced risk for CD was seen with the GSTT1null genotype (OR 0.58, 95% CI 0.43-0.77); however, pooled analysis showed an OR of 1.67, 95% CI 0.81-3.45. In this meta-analysis, we showed an increased risk for UC in individuals with the GSTT1null genotype.

Maternal and paternal occupational exposures and hepatoblastoma: results from the HOPE study through the Children’s Oncology Group (COG)

PubMed Central

Janitz, Amanda E.; Ramachandran, Gurumurthy; Tomlinson, Gail E.; Krailo, Mark; Richardson, Michaela; Spector, Logan

2017-01-01

Introduction Little is known about the etiology of hepatoblastoma. We aimed to confirm the results of a previous study evaluating the association between parental occupational exposures and hepatoblastoma. Methods In our case-control study, we identified cases (n=383) from the Children’s Oncology Group and controls from birth certificates (n=387), which were frequency matched to cases on year and region of birth, sex, and birth weight. Occupational exposure in the year prior to and during the index pregnancy was collected through maternal interview and analyzed using unconditional logistic regression. Results The odds of both paternal and maternal “Likely” exposure to paints was elevated among cases compared to controls (Paternal Odds Ratio [OR]: 1.71, 95% Confidence Interval [CI]: 1.04, 2.81; Maternal OR: 3.29, 95% CI: 0.32, 33.78) after adjustment for matching factors and the confounding factors of maternal race (maternal only) and household income. In addition, paternal exposure to other chemicals was also elevated when adjusting for matching factors only (OR: 1.53, 95% CI: 1.02, 2.30). Discussion The results of our study provide further evidence of an association between parental occupation and hepatoblastoma. These results warrant further investigation of the etiologically relevant timing of occupational exposure to fumes and chemicals related to hepatoblastoma. PMID:28272399

Characteristics and management of presumptive tuberculosis in public health facilities in Malawi, 2014-2016.

PubMed

Ng'ambi, W; Gugsa, S; Tweya, H; Girma, B; Kanyerere, H; Dambe, I; Babaye, Y; Mpunga, J; Phiri, S

2017-12-21

Setting: Public health facilities providing tuberculosis (TB) and human immunodeficiency virus (HIV) services in Malawi. Objectives: Using routinely collected health service delivery data to describe trends in HIV ascertainment and use of the Xpert ® MTB/RIF assay to diagnose TB among HIV-positive presumptive TB cases. Design: This was an implementation study of presumptive TB cases who sought care from 21 facilities between April 2014 and June 2016. Descriptive statistics were used to summarise patient, facility and service level characteristics. Results: Of 28 567 presumptive TB cases analysed, 23 198 (81%) had known HIV status. The proportion of ascertained HIV status in presumptive TB cases increased over the study period. HIV prevalence was 49%, with 73% of HIV-positive presumptive TB cases on antiretroviral therapy. Access to Xpert ranged between 37% and 63% per quarter among HIV-positive presumptive TB patients with smear-negative sputum results. Of 7829 patients with documented Xpert results, 68% were HIV-positive. Conclusion: After the introduction of registers with HIV-related variables, HIV ascertainment among presumptive TB cases increased over time. Access to Xpert was suboptimal among HIV-positive presumptive TB cases. Further collaboration between national TB and HIV programmes may facilitate increased use of Xpert for HIV-positive patients with presumptive TB who seek care in public health facilities.

Atmospheric Pressure and Abdominal Aortic Aneurysm Rupture: Results From a Time Series Analysis and Case-Crossover Study.

PubMed

Penning de Vries, Bas B L; Kolkert, Joé L P; Meerwaldt, Robbert; Groenwold, Rolf H H

2017-10-01

Associations between atmospheric pressure and abdominal aortic aneurysm (AAA) rupture risk have been reported, but empirical evidence is inconclusive and largely derived from studies that did not account for possible nonlinearity, seasonality, and confounding by temperature. Associations between atmospheric pressure and AAA rupture risk were investigated using local meteorological data and a case series of 358 patients admitted to hospital for ruptured AAA during the study period, January 2002 to December 2012. Two analyses were performed-a time series analysis and a case-crossover study. Results from the 2 analyses were similar; neither the time series analysis nor the case-crossover study showed a significant association between atmospheric pressure ( P = .627 and P = .625, respectively, for mean daily atmospheric pressure) or atmospheric pressure variation ( P = .464 and P = .816, respectively, for 24-hour change in mean daily atmospheric pressure) and AAA rupture risk. This study failed to support claims that atmospheric pressure causally affects AAA rupture risk. In interpreting our results, one should be aware that the range of atmospheric pressure observed in this study is not representative of the atmospheric pressure to which patients with AAA may be exposed, for example, during air travel or travel to high altitudes in the mountains. Making firm claims regarding these conditions in relation to AAA rupture risk is difficult at best. Furthermore, despite the fact that we used one of the largest case series to date to investigate the effect of atmospheric pressure on AAA rupture risk, it is possible that this study is simply too small to demonstrate a causal link.

Acoustical case studies of three green buildings

NASA Astrophysics Data System (ADS)

Siebein, Gary; Lilkendey, Robert; Skorski, Stephen

2005-04-01

Case studies of 3 green buildings with LEED certifications that required extensive acoustical retrofit work to become satisfactory work environments for their intended user groups will be used to define areas where green building design concepts and acoustical design concepts require reconciliation. Case study 1 is an office and conference center for a city environmental education agency. Large open spaces intended to collect daylight through clerestory windows provided large, reverberant volumes with few acoustic finishes that rendered them unsuitable as open office space and a conference room/auditorium. Case Study 2 describes one of the first gold LEED buildings in the southeast whose primary design concepts were so narrowly focused on thermal and lighting issues that they often worked directly against basic acoustical requirements resulting in sound levels of NC 50-55 in classrooms and faculty offices, crosstalk between classrooms and poor room acoustics. Case study 3 is an environmental education and conference center with open public areas, very high ceilings, and all reflective surfaces made from wood and other environmentally friendly materials that result in excessive loudness when the building is used by the numbers of people which it was intended to serve.

Maternal and paternal occupational exposures and hepatoblastoma: results from the HOPE study through the Children's Oncology Group.

PubMed

Janitz, Amanda E; Ramachandran, Gurumurthy; Tomlinson, Gail E; Krailo, Mark; Richardson, Michaela; Spector, Logan

2017-07-01

Little is known about the etiology of hepatoblastoma. We aimed to confirm the results of a previous study evaluating the association between parental occupational exposures and hepatoblastoma. In our case-control study, we identified cases (n=383) from the Children's Oncology Group and controls from birth certificates (n=387), which were frequency matched to cases on year and region of birth, sex, and birth weight. Occupational exposure in the year before and during the index pregnancy was collected through maternal interview and analyzed using unconditional logistic regression. The odds of both paternal and maternal "Likely" exposure to paints was elevated among cases compared with controls (paternal odds ratio (OR): 1.71, 95% confidence interval (CI): 1.04, 2.81; maternal OR: 3.29, 95% CI: 0.32, 33.78) after adjustment for matching factors and the confounding factors of maternal race (maternal only) and household income. In addition, paternal exposure to other chemicals was also elevated when adjusting for matching factors only (OR: 1.53, 95% CI: 1.02, 2.30). The results of our study provide further evidence of an association between parental occupation and hepatoblastoma. These results warrant further investigation of the etiologically relevant timing of occupational exposure to fumes and chemicals related to hepatoblastoma.

An Exploratory Case-Study Research Report Incorporating Service Learning

ERIC Educational Resources Information Center

Mcloughlin, Caven S.

2010-01-01

Background: Traditional approaches to reducing adolescents' socially inappropriate behaviour typically target individuals rather than groups. This case study investigates whether positive outcomes might accrue in social behaviours among a group of extraordinarily behaviourally-challenging youth resulting from a peer-mediated service-learning…

WMOST v2 Case Study: Monponsett Ponds

EPA Science Inventory

This webinar presents an overview of the preliminary results of a case study application of EPA's Watershed Management Optimization Support Tool v2 (WMOST) for stakeholders in the Monponsett Ponds Watershed Workgroup. Monponsett Ponds is a large water system consisting of two ba...

Design of Stripping Columns Applied to Drinking Water to Minimize Carcinogenic Risk from Trihalomethanes (THMs)

PubMed Central

Canosa, Joel

2018-01-01

The aim of this study is the application of a software tool to the design of stripping columns to calculate the removal of trihalomethanes (THMs) from drinking water. The tool also allows calculating the rough capital cost of the column and the decrease in carcinogenic risk indeces associated with the elimination of THMs and, thus, the investment to save a human life. The design of stripping columns includes the determination, among other factors, of the height (HOG), the theoretical number of plates (NOG), and the section (S) of the columns based on the study of pressure drop. These results have been compared with THM stripping literature values, showing that simulation is sufficiently conservative. Three case studies were chosen to apply the developed software. The first case study was representative of small-scale application to a community in Córdoba (Spain) where chloroform is predominant and has a low concentration. The second case study was of an intermediate scale in a region in Venezuela, and the third case study was representative of large-scale treatment of water in the Barcelona metropolitan region (Spain). Results showed that case studies with larger scale and higher initial risk offer the best capital investment to decrease the risk. PMID:29562670

Studying the Longitudinal Study. I. Introduction: Do Impromptu Essays Show Changes in Critical Thinking over the Span of College? Cautions and Insights from a Pilot Case Study.

ERIC Educational Resources Information Center

Clark, Francelia

The problematic results of longitudinal studies on college writing indicate the need for multidimensional studies to be able to explore perceptible changes in students' writing. Accordingly a small pilot case study, to explore the promise and the limitations of doing a longitudinal multidimensional study, investigated whether impromptu essays…

Case studies in pathophysiology: The development and evaluation of an interactive online learning environment to develop higher order thinking and argumentation

NASA Astrophysics Data System (ADS)

Titterington, Lynda C.

2007-12-01

This study presents a framework for examining the effects of higher order thinking on the achievement of allied health students enrolled in a pathophysiology course. A series of clinical case studies was developed and published in an enriched online environment that guided students through the process of developing a solution and supporting it through data analysis and interpretation. The series of case study modules scaffolded argumentation through question prompts. The modules began with a simple, direct problem and they became progressively more complex throughout the quarter. A control group was assigned a pencil-and-paper case study based upon recall. The case studies were scored for content accuracy and evidence of higher order thinking skills. Higher order thinking was measured using a rubric based upon the Toulmin argumentation pattern. The results indicated implementing a case study of either online or traditional format was associated with significant gains in achievement. The Web-enhanced case studies were associated with modest gains in knowledge acquisition. The argumentation scores across the series followed two trends: directed case studies were associated with higher levels of argumentation than ill-structured case studies, and there appeared to be an inverse relationship between the students' argumentation and content scores. The protocols developed for this study can serve as a template for a larger, extended investigation into student learning in the online environment.

TH-A-19A-11: Validation of GPU-Based Monte Carlo Code (gPMC) Versus Fully Implemented Monte Carlo Code (TOPAS) for Proton Radiation Therapy: Clinical Cases Study

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

Giantsoudi, D; Schuemann, J; Dowdell, S

Purpose: For proton radiation therapy, Monte Carlo simulation (MCS) methods are recognized as the gold-standard dose calculation approach. Although previously unrealistic due to limitations in available computing power, GPU-based applications allow MCS of proton treatment fields to be performed in routine clinical use, on time scales comparable to that of conventional pencil-beam algorithms. This study focuses on validating the results of our GPU-based code (gPMC) versus fully implemented proton therapy based MCS code (TOPAS) for clinical patient cases. Methods: Two treatment sites were selected to provide clinical cases for this study: head-and-neck cases due to anatomical geometrical complexity (air cavitiesmore » and density heterogeneities), making dose calculation very challenging, and prostate cases due to higher proton energies used and close proximity of the treatment target to sensitive organs at risk. Both gPMC and TOPAS methods were used to calculate 3-dimensional dose distributions for all patients in this study. Comparisons were performed based on target coverage indices (mean dose, V90 and D90) and gamma index distributions for 2% of the prescription dose and 2mm. Results: For seven out of eight studied cases, mean target dose, V90 and D90 differed less than 2% between TOPAS and gPMC dose distributions. Gamma index analysis for all prostate patients resulted in passing rate of more than 99% of voxels in the target. Four out of five head-neck-cases showed passing rate of gamma index for the target of more than 99%, the fifth having a gamma index passing rate of 93%. Conclusion: Our current work showed excellent agreement between our GPU-based MCS code and fully implemented proton therapy based MC code for a group of dosimetrically challenging patient cases.« less

Plasma carotenoids, retinol, and tocopherols and postmenopausal breast cancer risk in the Multiethnic Cohort Study: a nested case-control study

PubMed Central

Epplein, Meira; Shvetsov, Yurii B; Wilkens, Lynne R; Franke, Adrian A; Cooney, Robert V; Le Marchand, Loïc; Henderson, Brian E; Kolonel, Laurence N; Goodman, Marc T

2009-01-01

Introduction Assessments by the handful of prospective studies of the association of serum antioxidants and breast cancer risk have yielded inconsistent results. This multiethnic nested case-control study sought to examine the association of plasma carotenoids, retinol, and tocopherols with postmenopausal breast cancer risk. Methods From the biospecimen subcohort of the Multiethnic Cohort Study, 286 incident postmenopausal breast cancer cases were matched to 535 controls on age, sex, ethnicity, study location (Hawaii or California), smoking status, date/time of collection and hours of fasting. We measured prediagnostic circulating levels of individual carotenoids, retinol, and tocopherols. Conditional logistic regression was used to compute odds ratios and 95% confidence intervals. Results Women with breast cancer tended to have lower levels of plasma carotenoids and tocopherols than matched controls, but the differences were not large or statistically significant and the trends were not monotonic. No association was seen with retinol. A sensitivity analysis excluding cases diagnosed within 1 year after blood draw did not alter the findings. Conclusions The lack of significant associations in this multiethnic population is consistent with previously observed results from less racially-diverse cohorts and serves as further evidence against a causal link between plasma micronutrient concentrations and postmenopausal breast cancer risk. PMID:19619335

Does case misclassification threaten the validity of studies investigating the relationship between neck manipulation and vertebral artery dissection stroke? No.

PubMed

Murphy, Donald R; Schneider, Michael J; Perle, Stephen M; Bise, Christopher G; Timko, Michael; Haas, Mitchell

2016-01-01

The purported relationship between cervical manipulative therapy (CMT) and stroke related to vertebral artery dissection (VAD) has been debated for several decades. A large number of publications, from case reports to case-control studies, have investigated this relationship. A recent article suggested that case misclassification in the case-control studies on this topic resulted in biased odds ratios in those studies. Given its rarity, the best epidemiologic research design for investigating the relationship between CMT and VAD is the case-control study. The addition of a case-crossover aspect further strengthens the scientific rigor of such studies by reducing bias. The most recent studies investigating the relationship between CMT and VAD indicate that the relationship is not causal. In fact, a comparable relationship between vertebral artery-related stroke and visits to a primary care physician has been observed. The statistical association between visits to chiropractors and VAD can best be explained as resulting from a patient with early manifestation of VAD (neck pain with or without headache) seeking the services of a chiropractor for relief of this pain. Sometime after the visit the patient experiences VAD-related stroke that would have occurred regardless of the care received. This explanation has been challenged by a recent article putting forth the argument that case misclassification is likely to have biased the odds ratios of the case-control studies that have investigated the association between CMT and vertebral artery related stroke. The challenge particularly focused on one of the case-control studies, which had concluded that the association between CMT and vertebral artery related stroke was not causal. It was suggested by the authors of the recent article that misclassification led to an underestimation of risk. We argue that the information presented in that article does not support the authors' claim for a variety of reasons, including the fact that the assumptions upon which their analysis is based lack substantiation and the fact that any possible misclassification would not have changed the conclusion of the study in question. Current evidence does not support the notion that misclassification threatens the validity of recent case-control studies investigating the relationship between CMT and VAD. Hence, the recent re-analysis cannot refute the conclusion from previous studies that CMT is not a cause of VAD.

Probing of congenital nasolacrimal duct obstruction with dacryoendoscope

PubMed Central

Kato, Kumiko; Matsunaga, Koichi; Takashima, Yuko; Kondo, Mineo

2014-01-01

Background A congenital nasolacrimal duct obstruction (CNLDO) is a relatively common disease in infants. We evaluated the results of probing three patients with CNLDO, under direct view, with a dacryoendoscope. Methods Three cases of CNLDO were examined and treated by probing with a dacryoendoscope, under intravenous anesthesia. The diameter of the dacryoendoscope probe was 0.7 mm, and we were able to observe the inner walls of the lacrimal duct and able to guide the probe through the duct. Results In all cases, the site of obstruction was detected, and the probe was used to remove the obstruction. At 2 weeks after the removal of the obstruction, there was no epiphora or mucopurulent discharge in any of the cases. No complications were detected intra- and postoperatively. Conclusion Although only three cases were studied, we believe that probing with a dacryoendoscope is a safe and effective method of treating a CNLDO. More cases need to be studied. PMID:24876765

An alternative approach for socio-hydrology: case study research

NASA Astrophysics Data System (ADS)

Mostert, Erik

2018-01-01

Currently the most popular approach in socio hydrology is to develop coupled human-water models. This article proposes an alternative approach, qualitative case study research, involving a systematic review of (1) the human activities affecting the hydrology in the case, (2) the main human actors, and (3) the main factors influencing the actors and their activities. Moreover, this article presents a case study of the Dommel Basin in Belgium and the Netherlands, and compares this with a coupled model of the Kissimmee Basin in Florida. In both basins a pendulum swing from water resources development and control to protection and restoration can be observed. The Dommel case study moreover points to the importance of institutional and financial arrangements, community values, and broader social, economic, and technical developments. These factors are missing from the Kissimmee model. Generally, case studies can result in a more complete understanding of individual cases than coupled models, and if the cases are selected carefully and compared with previous studies, it is possible to generalize on the basis of them. Case studies also offer more levers for management and facilitate interdisciplinary cooperation. Coupled models, on the other hand, can be used to generate possible explanations of past developments and quantitative scenarios for future developments. The article concludes that, given the limited attention they currently get and their potential benefits, case studies deserve more attention in socio-hydrology.

Recall bias in melanoma risk factors and measurement error effects: a nested case-control study within the Norwegian Women and Cancer Study.

PubMed

Parr, Christine L; Hjartåker, Anette; Laake, Petter; Lund, Eiliv; Veierød, Marit B

2009-02-01

Case-control studies of melanoma have the potential for recall bias after much public information about the relation with ultraviolet radiation. Recall bias has been investigated in few studies and only for some risk factors. A nested case-control study of recall bias was conducted in 2004 within the Norwegian Women and Cancer Study: 208 melanoma cases and 2,080 matched controls were invited. Data were analyzed for 162 cases (response, 78%) and 1,242 controls (response, 77%). Questionnaire responses to several host factors and ultraviolet exposures collected at enrollment in 1991-1997 and in 2004 were compared stratified on case-control status. Shifts in responses were observed among both cases and controls, but a shift in cases was observed only for skin color after chronic sun exposure, and a larger shift in cases was observed for nevi. Weighted kappa was lower for cases than for controls for most age intervals of sunburn, sunbathing vacations, and solarium use. Differences in odds ratio estimates of melanoma based on prospective and retrospective measurements indicate measurement error that is difficult to characterize. The authors conclude that indications of recall bias were found in this sample of Norwegian women, but that the results were inconsistent for the different exposures.

Test-Enhanced Learning in Competence-Based Predoctoral Orthodontics: A Four-Year Study.

PubMed

Freda, Nicolas M; Lipp, Mitchell J

2016-03-01

Dental educators intend to promote integration of knowledge, skills, and values toward professional competence. Studies report that retrieval, in the form of testing, results in better learning with retention than traditional studying. The aim of this study was to evaluate test-enhanced experiences on demonstrations of competence in diagnosis and management of malocclusion and skeletal problems. The study participants were all third-year dental students (2011 N=88, 2012 N=74, 2013 N=91, 2014 N=85) at New York University College of Dentistry. The 2013 and 2014 groups received the test-enhanced method emphasizing formative assessments with written and dialogic delayed feedback, while the 2011 and 2012 groups received the traditional approach emphasizing lectures and classroom exercises. The students received six two-hour sessions, spaced one week apart. At the final session, a summative assessment consisting of the same four cases was administered. Students constructed a problem list, treatment objectives, and a treatment plan for each case, scored according to the same criteria. Grades were based on the number of cases without critical errors: A=0 critical errors on four cases, A-=0 critical errors on three cases, B+=0 critical errors on two cases, B=0 critical errors on one case, F=critical errors on four cases. Performance grades were categorized as high quality (B+, A-, A) and low quality (F, B). The results showed that the test-enhanced groups demonstrated statistically significant benefits at 95% confidence intervals compared to the traditional groups when comparing low- and high-quality grades. These performance trends support the continued use of the test-enhanced approach.

Case Manager Perspectives on the Role of Treatment in Supportive Housing for People with Severe Mental Illness

PubMed Central

Stanhope, Victoria; Choy-Brown, Mimi; Tiderington, Emmy; Henwood, Benjamin F.; Padgett, Deborah K.

2016-01-01

Objective Growing recognition exists of housing as a social determinant of health, and thus, health care reform initiatives are expanding the reach of health care beyond traditional settings. One result of this expansion is increased Medicaid funds for supportive-housing programs for people with severe mental illnesses. This qualitative study explores the ways in which case managers working in a supportive housing program approach treatment and how their approach is influenced by both program requirements and their beliefs about mental illness. Method The study is part of a longitudinal qualitative study on recovery for people with severe mental illnesses living in supportive housing. Multiple interviews (n = 55) with 24 case managers from a residential-continuum supportive-housing program were conducted over 18 months. To provide an in-depth view of case manager perspectives, the study uses thematic analysis with multiple coders. Results Overall, case managers understand supportive housing as being a treatment program but predominantly characterize treatment as medication management. The following themes emerged: believing medication to be the key to success in the program, persuading residents to take medication, and questioning the utility of the program for residents who were not medication adherent. Conclusions Case managers understand supportive housing to be a treatment program; however, given the external constraints and their own beliefs about mental illness, case managers often equate treatment with taking medication. Study findings demonstrate the need to train case managers about mental health recovery and integrated health care. The findings also have implications for policies that tie housing to services. PMID:28163830

A case-control study of Nocardia mastitis in Nova Scotia dairy herds

PubMed Central

Ferns, Lyn; Dohoo, Ian; Donald, Alan

1991-01-01

A case-control study was conducted to identify herd production, housing, and hygienic and therapeutic factors associated with a diagnosis of Nocardia mastitis in dairy herds in Nova Scotia. The data were collected by on-farm interviews with owners of 54 case and 54 control herds. Logistic regression was used to study risk factors. The use of dry cow products containing neomycin, including two specific dry cow products, was strongly associated with a diagnosis of Nocardia mastitis in a herd. Other factors which increased the risk of Nocardia mastitis were higher levels of production, larger herd size, and a large percentage of cows treated with dry cow products. These results are compared to results from a similar study carried out in Ontario. PMID:17423896

Human exploration mission studies

NASA Technical Reports Server (NTRS)

Cataldo, Robert L.

1989-01-01

The Office of Exploration has established a process whereby all NASA field centers and other NASA Headquarters offices participate in the formulation and analysis of a wide range of mission strategies. These strategies were manifested into specific scenarios or candidate case studies. The case studies provided a systematic approach into analyzing each mission element. First, each case study must address several major themes and rationale including: national pride and international prestige, advancement of scientific knowledge, a catalyst for technology, economic benefits, space enterprise, international cooperation, and education and excellence. Second, the set of candidate case studies are formulated to encompass the technology requirement limits in the life sciences, launch capabilities, space transfer, automation, and robotics in space operations, power, and propulsion. The first set of reference case studies identify three major strategies: human expeditions, science outposts, and evolutionary expansion. During the past year, four case studies were examined to explore these strategies. The expeditionary missions include the Human Expedition to Phobos and Human Expedition to Mars case studies. The Lunar Observatory and Lunar Outpost to Early Mars Evolution case studies examined the later two strategies. This set of case studies established the framework to perform detailed mission analysis and system engineering to define a host of concepts and requirements for various space systems and advanced technologies. The details of each mission are described and, specifically, the results affecting the advanced technologies required to accomplish each mission scenario are presented.

Audio Feedback -- Better Feedback?

ERIC Educational Resources Information Center

Voelkel, Susanne; Mello, Luciane V.

2014-01-01

National Student Survey (NSS) results show that many students are dissatisfied with the amount and quality of feedback they get for their work. This study reports on two case studies in which we tried to address these issues by introducing audio feedback to one undergraduate (UG) and one postgraduate (PG) class, respectively. In case study one…

Technology Utilisation in Elementary Schools in Turkey's Capital: A Case Study

ERIC Educational Resources Information Center

Karaca, Feride; Can, Gulfidan; Yildirim, Soner

2013-01-01

A case study was conducted to explore teachers' current technology use in elementary schools in Ankara, the capital of Turkey. The data were collected through a survey, and participants included 1030 classroom teachers across eight districts. The present study results revealed that significant challenges remain with regard to technology use in the…

Word Processing in Elementary Schools: Seven Case Studies. Education and Technology Series.

ERIC Educational Resources Information Center

Murray, Jack; And Others

As a result of preliminary observations of word processing in elementary level language the seven case studies presented in this report reveal the effectiveness of current word processing (WP) activities within their respective instructional contexts. Each study is presented separately, detailing the classroom context, tasks and outcomes, program…

Factors influencing voting results of local transportation funding initiatives with a substantial rail transit component : case studies of ballot measures in eleven communities

DOT National Transportation Integrated Search

2001-10-01

This publication is a follow-up study to MTI publication 00-01, Why Campaigns for Local Transportation Funding Initiatives Succeed or Fail: An Analysis of Four Communities and National Data.The earlier publication was case studies of four local ballo...

Office development, parking management, and travel behavior : the case of midtown Atlanta

DOT National Transportation Integrated Search

1999-05-01

The effects of special parking provision in zoning ordinances are assessed based on a case study of midtown Atlanta. The study results indicate that it is somewhat easier to promote increased office development around rail transit stations than it is...

Police shootings against civilians in Portugal: Contextual, forensic medical and judicial characterization.

PubMed

Rodrigues, Ezequiel; Faria, Paula; Santos, Agostinho; Fraga, Sílvia

2015-07-01

The aim of this study was to analyse the circumstances, the forensic assessment and the legal assessment of police shootings of civilians, according to the severity of the victim's injuries. Sixty-nine cases tried in Portuguese criminal courts were analysed. Of the 32 cases that resulted in death, 16 were on the public thoroughfare and 13 were in the victim's vehicle or in third-party vehicles. The majority of the lethal cases occurred when the region of the body hit was the thorax/abdomen. The firearm most frequently used was a semi-automatic 9 mm pistol. In cases resulting in death police officers involved were convicted whilst those involved in non-lethal cases were acquitted. The results of this study can be taken into account by Portuguese authorities for the implementation of policies that will allow the restriction of firearms use by police officers to situations of imminent danger of death or serious injury and that will make it possible to avoid shooting at fleeing civilians. Copyright © 2015 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Characterizing dense suspensions: two case studies from the pharmaceutical industry

NASA Astrophysics Data System (ADS)

Goldfarb, David J.; Khawaja, Nazia; Kazakevich, Irina; Bhattacharjee, Himanshu; Heslinga, Michael; Dalton, Chad

2015-11-01

Liquid suspensions of Active Pharmaceutical Ingredient powders are present as pharmaceutical dosage forms in the form of oral suspensions and injectables. We present two case studies, both dense (~ 30-40%) suspensions, in which the physical characterization of the product, specifically, particle size & shape and rheology were key to understanding the key product attributes as pertaining to the manufacturing process and to patient administration. For the one case study, an oral suspension, identifying variations in particle morphology during the wet milling of the product was key to the product understanding necessary to modify the milling process. Rheological measurements were applied as well. For the second case study, an injectable, results from different particle size measurement techniques and rheological measurements indicated the possibility of flocculation in a formulation. Additionally, measurements were obtained to assess the ``injectability'' of the product via rheometer and texture analyzer measurements and Poiseuille flow modeling. As a result, the relevant shear rate regime for this drug product administration was identified.

Discrimination between active and inactive neurocysticercosis by metacestode excretory/secretory antigens of Taenia solium in an enzyme-linked immunosorbent assay.

PubMed

Molinari, José L; García-Mendoza, Esperanza; de la Garza, Yazmin; Ramírez, José A; Sotelo, Julio; Tato, Patricia

2002-06-01

To detect IgG antibodies to Taenia solium, a controlled double-blind study was conducted using 91 coded cerebrospinal fluid samples from patients with neurocysticercosis (NCC) and other neurologic disorders. Samples were tested in an enzyme-linked immunosorbent assay (ELISA) using metacestode excretion/secretion antigens. The results were correlated with data from medical records on the diagnosis of NCC (based on computed tomography and magnetic resonance imaging criteria) and other neurologic disorders. The ELISA results were positive in 22 of the 24 cases with active NCC. In contrast, six cases with calcified cysts (inactive NCC), as well as one case in a transitional stage, were negative. One case with a calcified granuloma and another with a granuloma plus calcifications (classified as inactive NCC) had positive results. The remaining negative results corresponded to other neurologic disorders (58 cases). The results of the ELISA showed a significant difference between active and inactive NCC (P = 0.0034).

Development and evaluation of a case group concept for inpatients with mental disorders in Germany: using self-report and expert-rated instruments.

PubMed

Andreas, Sylke; Dirmaier, Jörg; Harfst, Timo; Kawski, Stephan; Koch, Uwe; Schulz, Holger

2009-03-01

The aim of this study was to evaluate a case-mix system to classify inpatients with mental disorders in Germany by means of self-report and expert-rated instruments. The use of case-mix systems enhances the transparency of performance and cost structure and can thus improve the quality of mental health care. We analysed a consecutive sample of 1677 inpatients with mental disorders from 11 hospitals using regression tree analysis. The model assigns patients to 17 groups, accounting for 17% of the variance for duration of stay. Patients with eating disorders had a longer duration of stay than patients with anxiety disorder, duration of mental illness of less than 3-5 years, lower levels of interpersonal problems and higher occupational position. The results showed that besides diagnosis, variables such as duration of illness and interpersonal problems are important for classifying inpatients with mental disorders. The results of the study should be critically reviewed regarding the empirical results of other studies and the appropriateness of case group concepts for inpatients with mental disorders.

How should an incident case of atopic dermatitis be defined? A systematic review of primary prevention studies

PubMed Central

Simpson, Eric L.; Keck, Laura E.; Chalmers, Joanne R.; Williams, Hywel C.

2012-01-01

Background Eczema prevention is now an active area of dermatologic and allergic research. Defining an incident case is therefore a prerequisite for such as study. Objective We sought to examine how an incident case of atopic dermatitis was defined in previous atopic dermatitis prevention studies in order to make recommendations on a standard definition of new atopic dermatitis cases for use in future prevention trials. Methods We conducted a systematic review of controlled interventional atopic dermatitis prevention studies using searches of Medline and Cochrane databases from 1980 to the end of January 2011. Studies that included atopic dermatitis as a secondary outcome, such as asthma prevention trials, were included. Results One hundred and two (102) studies were included in the final analysis, of which 27 (26.5%) did not describe any criteria for defining an incident case of atopic dermatitis. Of the remaining 75 studies with reported disease criteria, the Hanifin-Rajka criteria were the most commonly used (28 studies). A disease definition unique to that particular study (21 studies) was the second most commonly used disease definition, although the sources for such novel definitions were not cited. Conclusions The results from this systematic review highlight the need for improved reporting and standardization of the definition used for an incident case in atopic dermatitis prevention studies. Most prevention studies have used disease definitions such as the Hanifin-Rajka criteria that include disease chronicity. While acceptable for cumulative incidence outcomes, inclusion of disease chronicity precludes the precise measurement of disease onset. We propose a definition based on existing scientific studies that could be used in future prospective studies. PMID:22424882

Religion and motion pictures' effects on reversing suicidal intentions: two case studies.

PubMed

Khouzam, Hani Raoul; Williams, Leonard; Manzano, Nestor

2003-02-01

Case studies of two veterans contemplating suicide are described. Their suicidal intentions subsided as a result of a rekindling of their Christian faith. Although their Christian beliefs were awakened following their attendance at a motion picture, they both attributed the remission of their suicidal intentions to the practices of their Christian faith in their lives. Despite the favorable outcome, these findings are not generalizable to other cases.

Response rates in case-control studies of cancer by era of fieldwork and by characteristics of study design.

PubMed

Xu, Mengting; Richardson, Lesley; Campbell, Sally; Pintos, Javier; Siemiatycki, Jack

2018-04-09

The purpose of this study was to describe time trends in response rates in case-control studies of cancer and identify study design factors that influence response rate. We reviewed 370 case-control studies of cancer published in 12 journals during indicator years in each of the last four decades. We estimated time trends of response rates and reasons for nonresponse in each of the following types of study subjects: cases, medical source controls, and population controls. We also estimated response rates according to characteristics of study context. Median response rates among cases and population controls were between 75% and 80% in the 1970s. Between 1971 and 2010, study response rates declined by 0.31% per year for cases and 0.78% for population controls. Only a minority of studies reported reasons for nonparticipation; subject refusal was the most common reported reason. Studies conducted in North America had lower median response rates than studies conducted in Europe. In-person and telephone interviews elicited higher response rates than mail questionnaires. Response rates from case-control studies of cancer have declined, and this could threaten the validity of results derived from these studies. Copyright © 2018 Elsevier Inc. All rights reserved.

Promoting student case creation to enhance instruction of clinical reasoning skills: a pilot feasibility study

PubMed Central

Chandrasekar, Hamsika; Gesundheit, Neil; Nevins, Andrew B; Pompei, Peter; Bruce, Janine; Merrell, Sylvia Bereknyei

2018-01-01

Background It is a common educational practice for medical students to engage in case-based learning (CBL) exercises by working through clinical cases that have been developed by faculty. While such faculty-developed exercises have educational strengths, there are at least two major drawbacks to learning by this method: the number and diversity of cases is often limited; and students decrease their engagement with CBL cases as they grow accustomed to the teaching method. We sought to explore whether student case creation can address both of these limitations. We also compared student case creation to traditional clinical reasoning sessions in regard to tutorial group effectiveness, perceived gains in clinical reasoning, and quality of student–faculty interaction. Methods Ten first-year medical students participated in a feasibility study wherein they worked in small groups to develop their own patient case around a preassigned diagnosis. Faculty provided feedback on case quality afterwards. Students completed pre- and post-self-assessment surveys. Students and faculty also participated in separate focus groups to compare their case creation experience to traditional CBL sessions. Results Students reported high levels of team engagement and peer learning, as well as increased ownership over case content and understanding of clinical reasoning nuances. However, students also reported decreases in student–faculty interaction and the use of visual aids (P < 0.05). Conclusion The results of our feasibility study suggest that student-generated cases can be a valuable adjunct to traditional clinical reasoning instruction by increasing content ownership, encouraging student-directed learning, and providing opportunities to explore clinical nuances. However, these gains may reduce student–faculty interaction. Future studies may be able to identify an improved model of faculty participation, the ideal timing for incorporation of this method in a medical curriculum, and a more rigorous assessment of the impact of student case creation on the development of clinical reasoning skills. PMID:29692641

Thromboembolism Following Shoulder Arthroscopy

PubMed Central

Schick, Cameron W.; Westermann, Robert W.; Gao, Yubo; Abboud, Joseph A.; Wolf, Brian R.

2014-01-01

Background: Thromboembolism following shoulder arthroscopy is considered an uncommon complication, with fewer than 50 cases reported in the literature. Arthroscopy of the shoulder is one of the most commonly performed orthopaedic procedures, with low associated risks. Purpose: To identify potential risk factors for the development of venous thromboembolism (VTE) following shoulder arthroscopy and to determine the overall incidence of this complication. Study Design: Case-control study; Level of evidence, 3. Methods: A retrospective case-control review was performed of patients who developed symptomatic deep venous thrombosis (DVT) or pulmonary embolism (PE) following shoulder arthroscopy. Multiple surgeons from across North America were queried. For every case of DVT or PE identified, 2 control cases of shoulder arthroscopy were analyzed. The incidence of DVT/PE following shoulder arthroscopy was determined. A univariate analysis and a multivariate logistic regression model were conducted to identify any potential risk factors for the development of VTE following shoulder arthroscopy. Results: A total of 17 surgeons participated in this study and had performed a total of 15,033 cases of shoulder arthroscopy from September 2002 through August 2011. Eleven of the 17 participating surgeons had had a patient with a VTE complication during this time frame. The incidence of VTE in the 15,033 cases was 0.15%; 22 patients of the 15,033 patients had a DVT (n = 15) and/or PE (n = 8). Forty-four control cases were also analyzed. Univariate and multivariate analyses were performed. No significant risk factors were identified other than patient positioning. All cases and controls were positioned in the beach-chair position for surgery. Conclusion: The results of this study show that although rare, VTE occurs following shoulder arthroscopy at a rate of 0.15%. The variables analyzed in the cases of VTE compared with the control cases did not show any significant risk factors. All cases were positioned in the beach-chair position. Further analysis of future cases is warranted. PMID:26535285

Retrospective study of sonographic findings in bone involvement associated with rotator cuff calcific tendinopathy: preliminary results of a case series.

PubMed

Nogueira-Barbosa, Marcello H; Gregio-Junior, Everaldo; Lorenzato, Mario Muller

2015-01-01

The present study was aimed at investigating bone involvement secondary to rotator cuff calcific tendonitis at ultrasonography. Retrospective study of a case series. The authors reviewed shoulder ultrasonography reports of 141 patients diagnosed with rotator cuff calcific tendonitis, collected from the computer-based data records of their institution over a four-year period. Imaging findings were retrospectively and consensually analyzed by two experienced musculoskeletal radiologists looking for bone involvement associated with calcific tendonitis. Only the cases confirmed by computed tomography were considered for descriptive analysis. Sonographic findings of calcific tendinopathy with bone involvement were observed in 7/141 (~ 5%) patients (mean age, 50.9 years; age range, 42-58 years; 42% female). Cortical bone erosion adjacent to tendon calcification was the most common finding, observed in 7/7 cases. Signs of intraosseous migration were found in 3/7 cases, and subcortical cysts in 2/7 cases. The findings were confirmed by computed tomography. Calcifications associated with bone abnormalities showed no acoustic shadowing at ultrasonography, favoring the hypothesis of resorption phase of the disease. Preliminary results of the present study suggest that ultrasonography can identify bone abnormalities secondary to rotator cuff calcific tendinopathy, particularly the presence of cortical bone erosion.

Can a limited double reading/second opinion of initially recalled breast ultrasound screening examinations improve radiologists' performances?

NASA Astrophysics Data System (ADS)

Gur, David; Harnist, Kimberly; Gizienski, Terri-Ann; Zuley, Margarita; Hakim, Christiane; Lu, Amy; Sumkin, Jules; Abrams, Gordon; Ganott, Marie A.; Kelly, Amy E.; Tyma, Cathy S.; Chang, Thomas; BÓ§hm-Vélez, Marcella; Sobolewski, Robin

2018-03-01

Interpretations of breast ultrasound screening examinations result in high recall rates and large inter-radiologist variability, frequently leading to "conservative" recommendations. Double reading of all breast ultrasound screening examinations is cost prohibitive, but double reading of only "initially recalled" cases may prove efficacious. We assessed changes in recommendations, if any, by providing a consensus second opinion in a limited subset of examinations initially recommended for recall. We performed a retrospective reader study with 197 ultrasound examinations (97 not recalled and 100 recalled clinically). First, we generated a consensus "second opinion" consisting of the majority vote of three independent readings of each case by experienced ultrasound interpreters. During the reader study that followed, if the reader recommended a "recall" and the "consensus second opinion" did not, a message to that effect was displayed and the reader was asked to re-review the exam and re-assess if, knowing the second opinion, a re-rating of the case was warranted. We compared performance levels pre- and post- the second opinion. The second opinion resulted in "no recall" recommendations of 141 cases in the entire set, including four cancer cases missed by all three readers. On average, radiologists received "warning" messages in 30 cases (range 15-50), or in 15% of cases. Rating changes (downgrades to no recall) occurred in 36 of these cases. These changes resulted in a possible recall rate reduction of 28% in prompted cases or 14% overall recall reduction, while increasing the false negative rate by only one case missed by 2 readers ( 1%).

Cost-Benefit Analysis on Countermeasures for Health Risk by Exposure to Asbestos in Japan

NASA Astrophysics Data System (ADS)

Fujinaga, Aiichiro; Hihara, Hidemi; Tatsuno, Makoto

This study examines asbestos mitigation countermeasures by predicting air concentrations of asbestos, and then cost-benefit analyses is performed. A comparative study was conducted on three cases as follows; case one, demolition by machine & landfill, case two, demolition by hand & landfill, and case three demolition by hand & vitrification treatment. The results showed that if demolition by machine is continued, the risk is greater than 10-4 of upper acceptable risk for 2020. However, if demolition is conducted by hand, the risk is under 10-4 for 2010. And also, the risk will be less than 10-5 of the safety level for environmental standards until 2030. The results show that vitrification deletes the risk on future management at a landfill site, however at a higher cost.

Prospects of poisoning - a multi facet study.

PubMed

Mishra, Pradeep K; Kulkarni, Rashmi; Sane, Mandar R; Deshpande, Ajit; Kushwah, Manish

2016-01-01

Aim of the study is to find out demographic profile, clinical characteristics and analysis of poison in clinical set up. The study carried out in Sri Aurobindo Medical College and PG Institute Indore, Madhya Pradesh. Total 75 cases of poisoning were studied for demographic profile, vitals (BP, pulse, heart rate, pupils, etc.), clinical features (such as vomiting, salivation, consciousness, etc.), type of poison and its analysis. Results: Poisoning was more common in cases between 15 and 25 years of age, in males than in females and in Hindu religion. Poisoning cases were predominantly from rural areas and in married people. Majority of cases were discharged after proper treatment and counseling. Altered vitals and clinical features were found in most of the cases. Organophosphate and aluminum phosphide compound were evaluated in most of the cases. Conclusions: Preventive measures should be applied through educating people, proper counseling, promoting poison information centers, and introducing separate toxicological units in hospitals.

The use of administrative health care databases to identify patients with rheumatoid arthritis

PubMed Central

Hanly, John G; Thompson, Kara; Skedgel, Chris

2015-01-01

Objective To validate and compare the decision rules to identify rheumatoid arthritis (RA) in administrative databases. Methods A study was performed using administrative health care data from a population of 1 million people who had access to universal health care. Information was available on hospital discharge abstracts and physician billings. RA cases in health administrative databases were matched 1:4 by age and sex to randomly selected controls without inflammatory arthritis. Seven case definitions were applied to identify RA cases in the health administrative data, and their performance was compared with the diagnosis by a rheumatologist. The validation study was conducted on a sample of individuals with administrative data who received a rheumatologist consultation at the Arthritis Center of Nova Scotia. Results We identified 535 RA cases and 2,140 non-RA, noninflammatory arthritis controls. Using the rheumatologist’s diagnosis as the gold standard, the overall accuracy of the case definitions for RA cases varied between 68.9% and 82.9% with a kappa statistic between 0.26 and 0.53. The sensitivity and specificity varied from 20.7% to 94.8% and 62.5% to 98.5%, respectively. In a reference population of 1 million, the estimated annual number of incident cases of RA was between 176 and 1,610 and the annual number of prevalent cases was between 1,384 and 5,722. Conclusion The accuracy of case definitions for the identification of RA cases from rheumatology clinics using administrative health care databases is variable when compared to a rheumatologist’s assessment. This should be considered when comparing results across studies. This variability may also be used as an advantage in different study designs, depending on the relative importance of sensitivity and specificity for identifying the population of interest to the research question. PMID:27790047

Face and Construct Validation of a Next Generation Virtual Reality (Gen2-VR©) Surgical Simulator

PubMed Central

Sankaranarayanan, Ganesh; Li, Baichun; Manser, Kelly; Jones, Stephanie B.; Jones, Daniel B.; Schwaitzberg, Steven; Cao, Caroline G. L.; De, Suvranu

2015-01-01

Introduction Surgical performance is affected by distractors and interruptions to surgical workflow that exist in the operating room. However, traditional surgical simulators are used to train surgeons in a skills lab that does not recreate these conditions. To overcome this limitation, we have developed a novel, immersive virtual reality (Gen2-VR©) system to train surgeons in these environments. This study was to establish face and construct validity of our system. Methods and Procedures The study was a within-subjects design, with subjects repeating a virtual peg transfer task under three different conditions: CASE I: traditional VR; CASE II: Gen2-VR© with no distractions and CASE III: Gen2-VR© with distractions and interruptions.. In Case III, to simulate the effects of distractions and interruptions, music was played intermittently, the camera lens was fogged for 10 seconds and tools malfunctioned for 15 seconds at random points in time during the simulation. At the completion of the study subjects filled in a 5-point Likert scale feedback questionnaire. A total of sixteen subjects participated in this study. Results Friedman test showed significant difference in scores between the three conditions (p < 0.0001). Post hoc analysis using Wilcoxon Signed Rank tests with Bonferroni correction further showed that all the three conditions were significantly different from each other (Case I, Case II, p < 0.001), (Case I, Case III, p < 0.001) and (Case II, Case III, p = 0.009). Subjects rated that fog (mean= 4.18) and tool malfunction (median = 4.56) significantly hindered their performance. Conclusion The results showed that Gen2-VR© simulator has both face and construct validity and it can accurately and realistically present distractions and interruptions in a simulated OR, in spite of limitations of the current HMD hardware technology. PMID:26092010

Role of survivor bias in pancreatic cancer case-control studies.

PubMed

Hu, Zhen-Huan; Connett, John E; Yuan, Jian-Min; Anderson, Kristin E

2016-01-01

The purpose of this study was to evaluate the impact of survivor bias on pancreatic cancer case-control studies. The authors constructed five case-loss scenarios based on the Iowa Women's Health Study cohort to reflect how case recruitment in population-based studies varies by case survival time. Risk factors for disease incidence included smoking, body mass index (BMI), waist circumference, diabetes, and alcohol consumption. Odds ratios (ORs) were estimated by conditional logistic regression and quantitatively compared by the interactions between risk factors and 3-month survival time. Additionally, Kaplan-Meier estimates for overall survival were compared within the subset cohort of pancreatic cancer cases. BMI and waist circumference showed a significant inverse relationship with survival time. Decreasing trends in ORs for BMI and waist circumference were observed with increasing case survival time. The interaction between BMI and survival time based on a cutpoint of 3 months was significant (P < .01) as was the interaction between waist circumference and survival time (P < .01). The findings suggested that case losses could result in survivor bias causing underestimated odds ratios for both BMI and waist circumference, whereas other risk factors were not significantly affected by case losses. Copyright © 2016 Elsevier Inc. All rights reserved.

Allergies and risk of head and neck cancer: an original study plus meta-analysis.

PubMed

Hsiao, Jenn-Ren; Ou, Chun-Yen; Lo, Hung-I; Huang, Cheng-Chih; Lee, Wei-Ting; Huang, Jehn-Shyun; Chen, Ken-Chung; Wong, Tung-Yiu; Tsai, Sen-Tien; Yen, Chia-Jui; Wu, Yuan-Hua; Hsueh, Wei-Ting; Yang, Ming-Wei; Wu, Shang-Yin; Chang, Jang-Yang; Chang, Kwang-Yu; Lin, Chen-Lin; Wang, Fang-Ting; Wang, Yi-Hui; Weng, Ya-Ling; Yang, Han-Chien; Chang, Jeffrey S

2013-01-01

Although the relationship between allergy and cancer has been investigated extensively, the role of allergy in head and neck cancer (HNC) appears less consistent. It is not clear whether allergies can independently influence the risk of HNC in the presence of known strong environmental risk factors, including consumption of alcohol, betel quid, and cigarette. THE CURRENT PAPER REPORTS RESULTS FROM: 1) an original hospital-based case-control study, which included 252 incident cases of HNC and 236 controls frequency-matched to cases on sex and age; and 2) a meta-analysis combining the results of the current case-control study and 13 previously published studies (9 cohort studies with 727,569 subjects and 550 HNC outcomes and 5 case-control studies with 4,017 HNC cases and 10,928 controls). In the original case-control study, we observed a strong inverse association between allergies and HNC [odds ratio = 0.41, 95% confidence interval (CI): 0.27-0.62]. The meta-analysis also indicated a statistically significant inverse association between HNC and allergies [meta-relative risk (RR) = 0.76, 95% CI: 0.63-0.91], particularly strong for allergic rhinitis (meta-RR = 0.55, 95% CI: 0.40-0.76). In addition, the inverse association between allergies and HNC was observed only among men (meta-RR = 0.67, 95% CI: 0.54-0.84) but not among women (meta-RR = 0.98, 95% CI: 0.81-1.18). These findings suggest that immunity plays an influential role in the risk of HNC. Future studies investigating immune biomarkers, including cytokine profiles and genetic polymorphisms, are warranted to further delineate the relationship between allergies and HNC. Understanding the relationship between allergies and HNC may help devise effective strategies to reduce and treat HNC.

Gunshot residue testing in suicides: Part II: Analysis by inductive coupled plasma-atomic emission spectrometry.

PubMed

Molina, D Kimberley; Castorena, Joe L; Martinez, Michael; Garcia, James; DiMaio, Vincent J M

2007-09-01

Several different methods can be employed to test for gunshot residue (GSR) on a decedent's hands, including scanning electron microscopy with energy dispersive x-ray (SEM/EDX) and inductive coupled plasma-atomic emission spectrometry (ICP-AES). In part I of this 2-part series, GSR results performed by SEM/EDX in undisputed cases of suicidal handgun wounds were studied. In part II, the same population was studied, deceased persons with undisputed suicidal handgun wounds, but GSR testing was performed using ICP-AES. A total of 102 cases were studied and analyzed for caliber of weapon, proximity of wound, and the results of the GSR testing. This study found that 50% of cases where the deceased was known to have fired a handgun immediately prior to death had positive GSR results by ICP/AES, which did not differ from the results of GSR testing by SEM/EDX. Since only 50% of cases where the person is known to have fired a weapon were positive for GSR by either method, this test should not be relied upon to determine whether someone has discharged a firearm and is not useful as a determining factor of whether or not a wound is self-inflicted or non-self-inflicted. While a positive GSR result may be of use, a negative result is not helpful in the medical examiner setting as a negative result indicates that either a person fired a weapon prior to death or a person did not fire a weapon prior to death.

Studying health information from a distance: refining an e-learning case study in the crucible of student evaluation.

PubMed

Booth, Andrew; Levy, Philippa; Bath, Peter A; Lacey, Terence; Sanderson, Mark; Diercks-O'Brien, Gabi

2005-12-01

To present a formative evaluation of the impact of a multimedia case study as a component of a masters course in health informatics delivered by distance learning. First and second year health informatics students undertaking four core modules of a masters programme at the University of Sheffield. Individual qualitative user surveys and interviews. Formative evaluation has played a significant role in refining the case study through its text-based, intermediate and CD-ROM based stages. Feedback from students has resulted in clarification of case study tasks, clearer definition of teaching roles and a revised approach to assessment. At the same time it has highlighted the importance of ongoing revision and maintenance in keeping the scenarios realistic and current. The multimedia case study has met many of its original aims in providing greater cohesion for core modules and encouraging greater levels of interaction and multidisciplinary collaboration.

Breastfeeding, infant formula supplementation, and Autistic Disorder: the results of a parent survey

PubMed Central

Schultz, Stephen T; Klonoff-Cohen, Hillary S; Wingard, Deborah L; Akshoomoff, Natacha A; Macera, Caroline A; Ji, Ming; Bacher, Christopher

2006-01-01

Background Although Autistic Disorder is associated with several congenital conditions, the cause for most cases is unknown. The present study was undertaken to determine whether breastfeeding or the use of infant formula supplemented with docosahexaenoic acid and arachidonic acid is associated with Autistic Disorder. The hypothesis is that breastfeeding and use of infant formula supplemented with docosahexaenoic acid/arachidonic acid are protective for Autistic Disorder. Methods This is a case-control study using data from the Autism Internet Research Survey, an online parental survey conducted from February to April 2005 with results for 861 children with Autistic Disorder and 123 control children. The analyses were performed using logistic regression. Results Absence of breastfeeding when compared to breastfeeding for more than six months was significantly associated with an increase in the odds of having autistic disorder when all cases were considered (OR 2.48, 95% CI 1.42, 4.35) and after limiting cases to children with regression in development (OR 1.95, 95% CI 1.01, 3.78). Use of infant formula without docosahexaenoic acid and arachidonic acid supplementation versus exclusive breastfeeding was associated with a significant increase in the odds of autistic disorder when all cases were considered (OR 4.41, 95% CI 1.24, 15.7) and after limiting cases to children with regression in development (OR 12.96, 95% CI 1.27, 132). Conclusion The results of this preliminary study indicate that children who were not breastfed or were fed infant formula without docosahexaenoic acid/arachidonic acid supplementation were significantly more likely to have autistic disorder. PMID:16978397

[10 cases of psychosis in Mapuche indians].

PubMed

Biedermann, N; Barria, C; Maass, J; Steil, W

1983-12-01

Ten Mapuche indians have been studied with the purpose of observing the particularities of mental disorders in this ethnic group, composed of rural migrants. In each case a syndromatic and an etiological diagnosis has been made. Our cases correspond to six women and four men with an average age of 24.5 years. All are single with a low educational level. Our results show a great frequency of the acute oniroid psychotic syndrome. These results agree with a retrospective study made by Muñoz et al (1966) who found the same syndrome in 66.6% of their Mapuche patients against only 16.3% in non Mapuche chilean patients.

Fine needle aspiration cytology of granulomatous mastitis with special emphasis on microbiologic correlation.

PubMed

Nemenqani, Dalal; Yaqoob, Nausheen; Hafiz, Momein

2009-01-01

To describe the cytomorphology of granulomatous mastitis (GM) and to evaluate the causative agents involved, proven on the basis of microbiologic culture results and polymerase chain reaction (PCR) studies. We retrospectively reviewed the inflammatory breast aspirates reported at King Abdul Aziz Specialist Hospital and Al Hada Armed Forces Hospital, Taif, Kingdom of Saudi Arabia, from January 2000 until March 2008. The pathology reports, clinical information, slides, microbiologic culture results and tuberculosis (TB)/PCR were reviewed. Cases of inflammatory carcinoma or duct ectasia were excluded. A total of 49 cases of inflammatory breast aspirates were identified, of which 15 cases were GM. The microbiologic cultures of all 15 cases were available. Six of 15 cases had positive culture for Brucella melitenses, and 2 cases were positive for TB, which was further confirmed by TB/PCR. The fungal cultures were negative in all the cases. Seven of 15 cases were classified as idiopathic GM. Fine needle aspiration cytology was found to be a useful tool in the early diagnosis of GM and its classification if performed by a pathologist as the material can be submitted for culture. The definitive diagnosis can be established by a combination of the cytomorphologic features and microbiologic studies.

Auditory processing disorders, verbal disfluency, and learning difficulties: a case study.

PubMed

Jutras, Benoît; Lagacé, Josée; Lavigne, Annik; Boissonneault, Andrée; Lavoie, Charlen

2007-01-01

This case study reports the findings of auditory behavioral and electrophysiological measures performed on a graduate student (identified as LN) presenting verbal disfluency and learning difficulties. Results of behavioral audiological testing documented the presence of auditory processing disorders, particularly temporal processing and binaural integration. Electrophysiological test results, including middle latency, late latency and cognitive potentials, revealed that LN's central auditory system processes acoustic stimuli differently to a reference group with normal hearing.

Suspected survivor bias in case-control studies: stratify on survival time and use a negative control.

PubMed

van Rein, Nienke; Cannegieter, Suzanne C; Rosendaal, Frits R; Reitsma, Pieter H; Lijfering, Willem M

2014-02-01

Selection bias in case-control studies occurs when control selection is inappropriate. However, selection bias due to improper case sampling is less well recognized. We describe how to recognize survivor bias (i.e., selection on exposed cases) and illustrate this with an example study. A case-control study was used to analyze the effect of statins on major bleedings during treatment with vitamin K antagonists. A total of 110 patients who experienced such bleedings were included 18-1,018 days after the bleeding complication and matched to 220 controls. A protective association of major bleeding for exposure to statins (odds ratio [OR]: 0.56; 95% confidence interval: 0.29-1.08) was found, which did not become stronger after adjustment for confounding factors. These observations lead us to suspect survivor bias. To identify this bias, results were stratified on time between bleeding event and inclusion, and repeated for a negative control (an exposure not related to survival): blood group non-O. The ORs for exposure to statins increased gradually to 1.37 with shorter time between outcome and inclusion, whereas ORs for the negative control remained constant, confirming our hypothesis. We recommend the presented method to check for overoptimistic results, that is, survivor bias in case-control studies. Copyright © 2014 Elsevier Inc. All rights reserved.

Development, Characterization, and Resultant Properties of a Carbon, Boron, and Chromium Ternary Diffusion System

NASA Astrophysics Data System (ADS)

Domec, Brennan S.

In today's industry, engineering materials are continuously pushed to the limits. Often, the application only demands high-specification properties in a narrowly-defined region of the material, such as the outermost surface. This, in combination with the economic benefits, makes case hardening an attractive solution to meet industry demands. While case hardening has been in use for decades, applications demanding high hardness, deep case depth, and high corrosion resistance are often under-served by this process. Instead, new solutions are required. The goal of this study is to develop and characterize a new borochromizing process applied to a pre-carburized AISI 8620 alloy steel. The process was successfully developed using a combination of computational simulations, calculations, and experimental testing. Process kinetics were studied by fitting case depth measurement data to Fick's Second Law of Diffusion and an Arrhenius equation. Results indicate that the kinetics of the co-diffusion method are unaffected by the addition of chromium to the powder pack. The results also show that significant structural degradation of the case occurs when chromizing is applied sequentially to an existing boronized case. The amount of degradation is proportional to the chromizing parameters. Microstructural evolution was studied using metallographic methods, simulation and computational calculations, and analytical techniques. While the co-diffusion process failed to enrich the substrate with chromium, significant enrichment is obtained with the sequential diffusion process. The amount of enrichment is directly proportional to the chromizing parameters with higher parameters resulting in more enrichment. The case consists of M7C3 and M23C6 carbides nearest the surface, minor amounts of CrB, and a balance of M2B. Corrosion resistance was measured with salt spray and electrochemical methods. These methods confirm the benefit of surface enrichment by chromium in the sequential diffusion method with corrosion resistance increasing directly with chromium concentration. The results also confirm the deleterious effect of surface-breaking case defects and the need to reduce or eliminate them. The best combination of microstructural integrity, mean surface hardness, effective case depth, and corrosion resistance is obtained in samples sequentially boronized and chromized at 870°C for 6hrs. Additional work is required to further optimize process parameters and case properties.

Lung and stomach cancer associations with groundwater radon in North Carolina, USA

PubMed Central

Messier, Kyle P; Serre, Marc L

2017-01-01

Abstract Background: The risk of indoor air radon for lung cancer is well studied, but the risks of groundwater radon for both lung and stomach cancer are much less studied, and with mixed results. Methods: Geomasked and geocoded stomach and lung cancer cases in North Carolina from 1999 to 2009 were obtained from the North Carolina Central Cancer Registry. Models for the association with groundwater radon and multiple confounders were implemented at two scales: (i) an ecological model estimating cancer incidence rates at the census tract level; and (ii) a case-only logistic model estimating the odds that individual cancer cases are members of local cancer clusters. Results: For the lung cancer incidence rate model, groundwater radon is associated with an incidence rate ratio of 1.03 [95% confidence interval (CI) = 1.01, 1.06] for every 100 Bq/l increase in census tract averaged concentration. For the cluster membership models, groundwater radon exposure results in an odds ratio for lung cancer of 1.13 (95% CI = 1.04, 1.23) and for stomach cancer of 1.24 (95% CI = 1.03, 1.49), which means groundwater radon, after controlling for multiple confounders and spatial auto-correlation, increases the odds that lung and stomach cancer cases are members of their respective cancer clusters. Conclusion: Our study provides epidemiological evidence of a positive association between groundwater radon exposure and lung cancer incidence rates. The cluster membership model results find groundwater radon increases the odds that both lung and stomach cancer cases occur within their respective cancer clusters. The results corroborate previous biokinetic and mortality studies that groundwater radon is associated with increased risk for lung and stomach cancer. PMID:27639278

Validation of asthma recording in electronic health records: a systematic review

PubMed Central

Nissen, Francis; Quint, Jennifer K; Wilkinson, Samantha; Mullerova, Hana; Smeeth, Liam; Douglas, Ian J

2017-01-01

Objective To describe the methods used to validate asthma diagnoses in electronic health records and summarize the results of the validation studies. Background Electronic health records are increasingly being used for research on asthma to inform health services and health policy. Validation of the recording of asthma diagnoses in electronic health records is essential to use these databases for credible epidemiological asthma research. Methods We searched EMBASE and MEDLINE databases for studies that validated asthma diagnoses detected in electronic health records up to October 2016. Two reviewers independently assessed the full text against the predetermined inclusion criteria. Key data including author, year, data source, case definitions, reference standard, and validation statistics (including sensitivity, specificity, positive predictive value [PPV], and negative predictive value [NPV]) were summarized in two tables. Results Thirteen studies met the inclusion criteria. Most studies demonstrated a high validity using at least one case definition (PPV >80%). Ten studies used a manual validation as the reference standard; each had at least one case definition with a PPV of at least 63%, up to 100%. We also found two studies using a second independent database to validate asthma diagnoses. The PPVs of the best performing case definitions ranged from 46% to 58%. We found one study which used a questionnaire as the reference standard to validate a database case definition; the PPV of the case definition algorithm in this study was 89%. Conclusion Attaining high PPVs (>80%) is possible using each of the discussed validation methods. Identifying asthma cases in electronic health records is possible with high sensitivity, specificity or PPV, by combining multiple data sources, or by focusing on specific test measures. Studies testing a range of case definitions show wide variation in the validity of each definition, suggesting this may be important for obtaining asthma definitions with optimal validity. PMID:29238227

Creating a Learning Organization: A Case Study of Outcomes and Lessons Learned.

ERIC Educational Resources Information Center

Bierema, Laura L.; Berdish, David M.

1999-01-01

Discusses how organizations are gaining a competitive edge in a global business environment through learning and highlights a learning organization implementation case study of a division of Ford Motor Company. Examines the strategic initiative; performance improvement results; individual learning, including interpersonal development and…

Numerical investigation of rotating stall in centrifugal compressor with vaned and vaneless diffuser

NASA Astrophysics Data System (ADS)

Halawa, Taher; Alqaradawi, Mohamed; Gadala, Mohamed S.; Shahin, Ibrahim; Badr, Osama

2015-06-01

This study presents a numerical simulation of the stall and surge in a centrifugal compressor and presents a descriptionof the stall development in two different cases. The first case is for a compressor with vaneless diffuser and the second is for a compressor with vaned diffuser of the vane island shape. The main aim of this study is to compare the flow characteristics and behavior for the two compressors near the surge operating condition and provide further understanding of the diffuser role when back flow occurs at surge. Results showed that for a locationnear the diffuser entrance, the amplitude of the static pressure fluctuations for the vaneless diffuser case is higher than that for the vaned diffuser case near surge condition. These pressure fluctuations in the case of the vaneless diffuser appear with a gradual decrease of the mean pressure value as a part of the surge cycle. While for the case of the vaned diffuser, the pressure drop during surge occurs faster than the case of the vaneless diffuser. Also, results indicated that during surge in the case of vaneless diffuser, there is a region with low velocity and back flow that appears as a layer connecting all impeller passages near shroud surface and this layer develops in size with time. On the other hand, for the case of vaned diffuser during surge, the low velocity regions appear in random locations in some passages and these regions expand with time towards the shroud surface. Results showed that during stall, the impeller passages are exposed to identical impact from stall cells in the case of vaneless diffuser while the stall effect varies from passage to another in the case of the vaned diffuser.

Noise peaks influence communication in the operating room. An observational study.

PubMed

Keller, Sandra; Tschan, Franziska; Beldi, Guido; Kurmann, Anita; Candinas, Daniel; Semmer, Norbert K

2016-12-01

Noise peaks are powerful distractors. This study focuses on the impact of noise peaks on surgical teams' communication during 109 long abdominal surgeries. We related measured noise peaks during 5-min intervals to the amount of observed communication during the same interval. Results show that noise peaks are associated with less case-relevant communication; this effect is moderated by the level of surgical experience; case-relevant communications decrease under high noise peak conditions among junior, but not among senior surgeons. However, case-irrelevant communication did not decrease under high noise level conditions, rather there was a trend to more case-irrelevant communication under high noise peaks. The results support the hypothesis that noise peaks impair communication because they draw on attentional resources rather than impairing understanding of communication. As case-relevant communication is important for surgical performance, exposure to high noise peaks in the OR should be minimised especially for less experienced surgeons. Practitioner Summary: This study investigated whether noise during surgeries influenced the communication within surgical teams. During abdominal surgeries, noise levels were measured and communication was observed. Results showed that high noise peaks reduced the frequency of patient-related communication, but did not reduce patient-irrelevant communication. Noise may negatively affect team coordination in surgeries.

InSAR detection of aquifer recovery: Case studies of Koehn Lake (central California) and Lone Tree Gold Mine (Basin and Range)

NASA Astrophysics Data System (ADS)

Wdowinski, S.; Greene, F.; Amelung, F.

2013-12-01

Anthropogenic intervention in groundwater flow and aquifer storage often results in vertical movements of Earth's surface, which are well detected by InSAR observations. Most anthropogenic intervention occurs due to groundwater extraction for both agriculture and human consumption and results in land subsidence. However in some cases, ending anthropogenic intervention can lead to aquifer recovery and, consequently, surface uplift. In this study we present two such cases of aquifer recovery. The first case is the aquifer beneath Koehn Lake in Central California, which was overused to meet agricultural demands until the 1990's. The second case is the Lone Tree Gold Mine in Nevada that during active mining in the 1991-2006 groundwater pumping disrupted the aquifer and cause subsidence. But after mining ceased, groundwater flow was recovered and resulted in uplift. In both cases we studied the surface uplift using InSAR time series observations. We conduct an ERS and Envisat InSAR survey over Koehn Lake in California and Lone Tree Gold Mine in Nevada between 1992 and 2010. We followed the SBAS algorithm to generate a time-series of ground displacements and average velocities of pixels, which remain coherent through time in the SAR dataset. A total of 100 and 80 combined ERS and Envisat SAR dates are inverted for Koehn Lake and Lone Tree Gold Mine respectively. Results for the Koehn Lake area indicate a rapid uplift of about 3.5 mm/yr between 1992-2000 and a slower uplift rate of 1.6 mm/yr between 2000-2004, suggesting a decrease in the recovery process. The observed uplift correlates well with groundwater level increase in the Koehn Lake area. Results for the Lone Tree Gold Mine show a constant subsidence (~ 1 cm/yr) due to groundwater extraction between 1992-2006, but uplift of ~1 cm/yr since the beginning of 2007. In both case studies, InSAR observations reveal that the aquifer recovery is accompanied by surface uplift. We plan to use the InSAR observations and the groundwater level records to model and better understand aquifer recovery processes.

Surrogacy: outcomes for surrogate mothers, children and the resulting families-a systematic review.

PubMed

Söderström-Anttila, Viveca; Wennerholm, Ulla-Britt; Loft, Anne; Pinborg, Anja; Aittomäki, Kristiina; Romundstad, Liv Bente; Bergh, Christina

2016-01-01

Surrogacy is a highly debated method mainly used for treating women with infertility caused by uterine factors. This systematic review summarizes current levels of knowledge of the obstetric, medical and psychological outcomes for the surrogate mothers, the intended parents and children born as a result of surrogacy. PubMed, Cochrane and Embase databases up to February 2015 were searched. Cohort studies and case series were included. Original studies published in English and the Scandinavian languages were included. In case of double publications, the latest study was included. Abstracts only and case reports were excluded. Studies with a control group and case series (more than three cases) were included. Cohort studies, but not case series, were assessed for methodological quality, in terms of risk of bias. We examined a variety of main outcomes for the surrogate mothers, children and intended mothers, including obstetric outcome, relationship between surrogate mother and intended couple, surrogate's experiences after relinquishing the child, preterm birth, low birthweight, birth defects, perinatal mortality, child psychological development, parent-child relationship, and disclosure to the child. The search returned 1795 articles of which 55 met the inclusion criteria. The medical outcome for the children was satisfactory and comparable to previous results for children conceived after fresh IVF and oocyte donation. The rate of multiple pregnancies was 2.6-75.0%. Preterm birth rate in singletons varied between 0 and 11.5% and low birthweight occurred in between 0 and 11.1% of cases. At the age of 10 years there were no major psychological differences between children born after surrogacy and children born after other types of assisted reproductive technology (ART) or after natural conception. The obstetric outcomes for the surrogate mothers were mainly reported from case series. Hypertensive disorders in pregnancy were reported in between 3.2 and 10% of cases and placenta praevia/placental abruption in 4.9%. Cases with hysterectomies have also been reported. Most surrogate mothers scored within the normal range on personality tests. Most psychosocial variables were satisfactory, although difficulties related to handing over the child did occur. The psychological well-being of children whose mother had been a surrogate mother between 5 and 15 years earlier was found to be good. No major differences in psychological state were found between intended mothers, mothers who conceived after other types of ART and mothers whose pregnancies were the result of natural conception. Most studies reporting on surrogacy have serious methodological limitations. According to these studies, most surrogacy arrangements are successfully implemented and most surrogate mothers are well-motivated and have little difficulty separating from the children born as a result of the arrangement. The perinatal outcome of the children is comparable to standard IVF and oocyte donation and there is no evidence of harm to the children born as a result of surrogacy. However, these conclusions should be interpreted with caution. To date, there are no studies on children born after cross-border surrogacy or growing up with gay fathers. © The Author 2015. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Indoor radon and childhood leukaemia.

PubMed

Raaschou-Nielsen, Ole

2008-01-01

This paper summarises the epidemiological literature on domestic exposure to radon and risk for childhood leukaemia. The results of 12 ecological studies show a consistent pattern of higher incidence and mortality rates for childhood leukaemia in areas with higher average indoor radon concentrations. Although the results of such studies are useful to generate hypotheses, they must be interpreted with caution, as the data were aggregated and analysed for geographical areas and not for individuals. The seven available case-control studies of childhood leukaemia with measurement of radon concentrations in the residences of cases and controls gave mixed results, however, with some indication of a weak (relative risk < 2) association with acute lymphoblastic leukaemia. The epidemiological evidence to date suggests that an association between indoor exposure to radon and childhood leukaemia might exist, but is weak. More case-control studies are needed, with sufficient statistical power to detect weak associations and based on designs and methods that minimise misclassification of exposure and provide a high participation rate and low potential selection bias.

No evidence that protein truncating variants in BRIP1 are associated with breast cancer risk: implications for gene panel testing

PubMed Central

Easton, Douglas F; Lesueur, Fabienne; Decker, Brennan; Michailidou, Kyriaki; Li, Jun; Allen, Jamie; Luccarini, Craig; Pooley, Karen A; Shah, Mitul; Bolla, Manjeet K; Wang, Qin; Dennis, Joe; Ahmad, Jamil; Thompson, Ella R; Damiola, Francesca; Pertesi, Maroulio; Voegele, Catherine; Mebirouk, Noura; Robinot, Nivonirina; Durand, Geoffroy; Forey, Nathalie; Luben, Robert N; Ahmed, Shahana; Aittomäki, Kristiina; Anton-Culver, Hoda; Arndt, Volker; Baynes, Caroline; Beckman, Matthias W; Benitez, Javier; Van Den Berg, David; Blot, William J; Bogdanova, Natalia V; Bojesen, Stig E; Brenner, Hermann; Chang-Claude, Jenny; Chia, Kee Seng; Choi, Ji-Yeob; Conroy, Don M; Cox, Angela; Cross, Simon S; Czene, Kamila; Darabi, Hatef; Devilee, Peter; Eriksson, Mikael; Fasching, Peter A; Figueroa, Jonine; Flyger, Henrik; Fostira, Florentia; García-Closas, Montserrat; Giles, Graham G; Glendon, Gord; González-Neira, Anna; Guénel, Pascal; Haiman, Christopher A; Hall, Per; Hart, Steven N; Hartman, Mikael; Hooning, Maartje J; Hsiung, Chia-Ni; Ito, Hidemi; Jakubowska, Anna; James, Paul A; John, Esther M; Johnson, Nichola; Jones, Michael; Kabisch, Maria; Kang, Daehee; Kosma, Veli-Matti; Kristensen, Vessela; Lambrechts, Diether; Li, Na; Lindblom, Annika; Long, Jirong; Lophatananon, Artitaya; Lubinski, Jan; Mannermaa, Arto; Manoukian, Siranoush; Margolin, Sara; Matsuo, Keitaro; Meindl, Alfons; Mitchell, Gillian; Muir, Kenneth; Nevelsteen, Ines; van den Ouweland, Ans; Peterlongo, Paolo; Phuah, Sze Yee; Pylkäs, Katri; Rowley, Simone M; Sangrajrang, Suleeporn; Schmutzler, Rita K; Shen, Chen-Yang; Shu, Xiao-Ou; Southey, Melissa C; Surowy, Harald; Swerdlow, Anthony; Teo, Soo H; Tollenaar, Rob A E M; Tomlinson, Ian; Torres, Diana; Truong, Thérèse; Vachon, Celine; Verhoef, Senno; Wong-Brown, Michelle; Zheng, Wei; Zheng, Ying; Nevanlinna, Heli; Scott, Rodney J; Andrulis, Irene L; Wu, Anna H; Hopper, John L; Couch, Fergus J; Winqvist, Robert; Burwinkel, Barbara; Sawyer, Elinor J; Schmidt, Marjanka K; Rudolph, Anja; Dörk, Thilo; Brauch, Hiltrud; Hamann, Ute; Neuhausen, Susan L; Milne, Roger L; Fletcher, Olivia; Pharoah, Paul D P; Campbell, Ian G; Dunning, Alison M; Le Calvez-Kelm, Florence; Goldgar, David E; Tavtigian, Sean V; Chenevix-Trench, Georgia

2016-01-01

Background BRCA1 interacting protein C-terminal helicase 1 (BRIP1) is one of the Fanconi Anaemia Complementation (FANC) group family of DNA repair proteins. Biallelic mutations in BRIP1 are responsible for FANC group J, and previous studies have also suggested that rare protein truncating variants in BRIP1 are associated with an increased risk of breast cancer. These studies have led to inclusion of BRIP1 on targeted sequencing panels for breast cancer risk prediction. Methods We evaluated a truncating variant, p.Arg798Ter (rs137852986), and 10 missense variants of BRIP1, in 48 144 cases and 43 607 controls of European origin, drawn from 41 studies participating in the Breast Cancer Association Consortium (BCAC). Additionally, we sequenced the coding regions of BRIP1 in 13 213 cases and 5242 controls from the UK, 1313 cases and 1123 controls from three population-based studies as part of the Breast Cancer Family Registry, and 1853 familial cases and 2001 controls from Australia. Results The rare truncating allele of rs137852986 was observed in 23 cases and 18 controls in Europeans in BCAC (OR 1.09, 95% CI 0.58 to 2.03, p=0.79). Truncating variants were found in the sequencing studies in 34 cases (0.21%) and 19 controls (0.23%) (combined OR 0.90, 95% CI 0.48 to 1.70, p=0.75). Conclusions These results suggest that truncating variants in BRIP1, and in particular p.Arg798Ter, are not associated with a substantial increase in breast cancer risk. Such observations have important implications for the reporting of results from breast cancer screening panels. PMID:26921362

Using the reference framework for good measles management in practice--a case study from North Rhine-Westphalia.

PubMed

Schröter, Matthias; Schröder-Bäck, Peter; Brand, Helmut

2009-12-01

In 2005, WHO Europe reconfirmed the objective of eradicating measles and fixed a strategy plan for the years 2005 up to 2010. While a downward trend of measles infections in Germany between 2001 and 2004 could be observed, as many as 780 cases of measles were reported in 2005 and in 2006 even 2.281 cases. These high figures in 2006 were almost exclusively caused by an outbreak in the German region of North Rhine-Westphalia. This case study describes how a reference framework for good health management of measles prevention was applied for this region. As a result, various recommendations for action could be given, among them the recommendation to implement individual vaccination reminder systems for parents and bonus systems for parents. Based on these results, a comprehensive policy concept has been drawn up and has become the subject of a political agreement process in this region. Thus this case study shows a paradigm how reference frameworks for good health management can be utilised in practice.

Music therapy in the treatment of multiple sclerosis: a comprehensive literature review.

PubMed

Ostermann, Thomas; Schmid, Wolfgang

2006-04-01

Coping with multiple sclerosis symptoms still remains a challenge for each patient suffering from this chronic inflammatory disease. Therefore, patients often turn to using complementary and alternative medicine (CAM). In this review, the authors aimed to investigate the current state of literature of music therapy in the treatment of multiple sclerosis (MS). Medline, PubMed, Embase, AMED, CAMbase and the Music Therapy World Journal Index were searched for the terms MS and 'music therapy'. In addition, an internet search using Google Scholar was performed. The authors found seven case-reports/series and seven studies on music therapy for MS-patients. Both the case reports and studies presented here are pioneer work. Most of the studies are naturally predominated by the use of qualitative and uncontrolled research designs. Nevertheless, the results of the studies as well as the case reports demonstrate patients' improvement in the domains of self-acceptance, anxiety and depression. The results of the studies as well as the case reports define a sufficient basis for further music therapeutical work as they show a variety of psychosocial and emotional benefits for MS patients.

Case Study of K-12 Public School Superintendents Having Business Background and No Teaching Experience

ERIC Educational Resources Information Center

Novak, James

2012-01-01

The purpose of this study was to describe the experiences of superintendents with business backgrounds and who lack teaching experience. There is a shortage of qualified superintendent candidates in K-12 school districts. As a result, some school boards are hiring nontraditional superintendents. This qualitative case study is important because it…

The "UIC German" Game App for the Enhancement of Foreign Language Learning--Case Study

ERIC Educational Resources Information Center

Ryder, Robert; Machajewski, Szymon

2017-01-01

This qualitative case study reports the adoption of gamification in a college level foreign language courses. An exploratory approach allows the authors to describe how gamification was applied and what results were documented. A custom mobile app was adopted to increase engagement and interest of students in the specific field of study. External…

Mecca Hills: Visitor research case study

Treesearch

Deborah Chavez; John Baas; Patricia Winter

1993-01-01

This "Case Study" represents the first in a series of reports which provide insight into specific management environments and the factors significant to an understanding of the expectations and demands of public land visitors in the West. The study describes the methods and results of a two year inventory of visitors in a wildland area in the desert...

Higher Education and Social Change. Promising Experiments in Developing Countries. Volume 2: Case Studies.

ERIC Educational Resources Information Center

Thompson, Kenneth W., Ed.; And Others

Presented are the results of a study made by developing country educators for twelve national and international agencies, directed and coordinated by the International Council for Educational Development. Volume 2 contains the reports of 25 case studies of higher education institutions and systems in Africa, Asia, and Latin America: University of…

Demographic and spatio-temporal distribution of cutaneous leishmaniasis in the Souf oasis (Eastern South of Algeria): Results of 13 years.

PubMed

Khezzani, Bachir; Bouchemal, Salah

2017-02-01

Cutaneous leishmaniasis is one of many dangerous parasitic diseases. It remains a serious public health problem not only in Souf oasis, but also in Algeria and all developing countries. The results of our thirteen-year study shows a recording of 4813 confirmed cases of cutaneous leishmaniasis and the details shows that this disease affects all municipalities and all age groups, from infants to elderly, but the most affected ones are teenagers aging (10-19) years with 1512 cases (31.41%) and infants less than 9 years old with 1237 cases (25.70%). In addition, males are more prone to this disease than females (65% and 35% respectively). Among the 18 municipalities in the Souf, the most affected were El-Oued with 1171 cases (24.33%) followed by Guemar with 997 cases (20.71%). Furthermore, more than 40.03% of all cases (1927 cases), were record just in one year in 2010. A parallel, this study shows that the original factors of the studied area, such as climatological, agricultural and environmental factors, was the reason do not apparition this epidemic for a long time, but the changes in these conditions, resulting from various human activities create new environmental conditions, which help with the emergence and spread of leishmaniasis disease. The effective fight against this disease should be based on the elimination of the vectors and reservoirs populations, by the overall improvement of sanitary conditions and hygiene, extensive research in epidemiology of leishmaniasis could also reduce the incidence of cutaneous leishmaniasis. Copyright © 2016 Elsevier B.V. All rights reserved.

Detection of susceptibility genes as modifiers due to subgroup differences in complex disease.

PubMed

Bergen, Sarah E; Maher, Brion S; Fanous, Ayman H; Kendler, Kenneth S

2010-08-01

Complex diseases invariably involve multiple genes and often exhibit variable symptom profiles. The extent to which disease symptoms, course, and severity differ between affected individuals may result from underlying genetic heterogeneity. Genes with modifier effects may or may not also influence disease susceptibility. In this study, we have simulated data in which a subset of cases differ by some effect size (ES) on a quantitative trait and are also enriched for a risk allele. Power to detect this 'pseudo-modifier' gene in case-only and case-control designs was explored blind to case substructure. Simulations involved 1000 iterations and calculations for 80% power at P<0.01 while varying the risk allele frequency (RAF), sample size (SS), ES, odds ratio (OR), and proportions of the case subgroups. With realistic values for the RAF (0.20), SS (3000) and ES (1), an OR of 1.7 is necessary to detect a pseudo-modifier gene. Unequal numbers of subjects in the case groups result in little decrement in power until the group enriched for the risk allele is <30% or >70% of the total case population. In practice, greater numbers of subjects and selection of a quantitative trait with a large range will provide researchers with greater power to detect a pseudo-modifier gene. However, even under ideal conditions, studies involving alleles with low frequencies or low ORs are usually underpowered for detection of a modifier or susceptibility gene. This may explain some of the inconsistent association results for many candidate gene studies of complex diseases.

Case-control analysis in highway safety: Accounting for sites with multiple crashes.

PubMed

Gross, Frank

2013-12-01

There is an increased interest in the use of epidemiological methods in highway safety analysis. The case-control and cohort methods are commonly used in the epidemiological field to identify risk factors and quantify the risk or odds of disease given certain characteristics and factors related to an individual. This same concept can be applied to highway safety where the entity of interest is a roadway segment or intersection (rather than a person) and the risk factors of interest are the operational and geometric characteristics of a given roadway. One criticism of the use of these methods in highway safety is that they have not accounted for the difference between sites with single and multiple crashes. In the medical field, a disease either occurs or it does not; multiple occurrences are generally not an issue. In the highway safety field, it is necessary to evaluate the safety of a given site while accounting for multiple crashes. Otherwise, the analysis may underestimate the safety effects of a given factor. This paper explores the use of the case-control method in highway safety and two variations to account for sites with multiple crashes. Specifically, the paper presents two alternative methods for defining cases in a case-control study and compares the results in a case study. The first alternative defines a separate case for each crash in a given study period, thereby increasing the weight of the associated roadway characteristics in the analysis. The second alternative defines entire crash categories as cases (sites with one crash, sites with two crashes, etc.) and analyzes each group separately in comparison to sites with no crashes. The results are also compared to a "typical" case-control application, where the cases are simply defined as any entity that experiences at least one crash and controls are those entities without a crash in a given period. In a "typical" case-control design, the attributes associated with single-crash segments are weighted the same as the attributes of segments with multiple crashes. The results support the hypothesis that the "typical" case-control design may underestimate the safety effects of a given factor compared to methods that account for sites with multiple crashes. Compared to the first alternative case definition (where multiple crash segments represent multiple cases) the results from the "typical" case-control design are less pronounced (i.e., closer to unity). The second alternative (where case definitions are constructed for various crash categories and analyzed separately) provides further evidence that sites with single and multiple crashes should not be grouped together in a case-control analysis. This paper indicates a clear need to differentiate sites with single and multiple crashes in a case-control analysis. While the results suggest that sites with multiple crashes can be accounted for using a case-control design, further research is needed to determine the optimal method for addressing this issue. This paper provides a starting point for that research. Copyright © 2012 Elsevier Ltd. All rights reserved.

Characteristics of the Traumatic Forensic Cases Admitted To Emergency Department and Errors in the Forensic Report Writing.

PubMed

Aktas, Nurettin; Gulacti, Umut; Lok, Ugur; Aydin, İrfan; Borta, Tayfun; Celik, Murat

2018-01-01

To identify errors in forensic reports and to describe the characteristics of traumatic medico-legal cases presenting to the emergency department (ED) at a tertiary care hospital. This study is a retrospective cross-sectional study. The study includes cases resulting in a forensic report among all traumatic patients presenting to the ED of Adiyaman University Training and Research Hospital, Adiyaman, Turkey during a 1-year period. We recorded the demographic characteristics of all the cases, time of presentation to the ED, traumatic characteristics of medico-legal cases, forms of suicide attempt, suspected poisonous substance exposure, the result of follow-up and the type of forensic report. A total of 4300 traumatic medico-legal cases were included in the study and 72% of these cases were male. Traumatic medico-legal cases occurred at the greatest frequency in July (10.1%) and 28.9% of all cases occurred in summer. The most frequent causes of traumatic medico-legal cases in the ED were traffic accidents (43.4%), violent crime (30.5%), and suicide attempt (7.2%). The most common method of attempted suicide was drug intake (86.4%). 12.3% of traumatic medico-legal cases were hospitalized and 24.2% of those hospitalized were admitted to the orthopedics service. The most common error in forensic reports was the incomplete recording of the patient's "cooperation" status (82.7%). Additionally, external traumatic lesions were not defined in 62.4% of forensic reports. The majority of traumatic medico-legal cases were male age 18-44 years, the most common source of trauma was traffic accidents and in the summer months. When writing a forensic report, emergency physicians made mistakes in noting physical examination findings and identifying external traumatic lesions. Physicians should make sure that the traumatic medico-legal patients they treat have adequate documentation for reference during legal proceedings. The legal duties and responsibilities of physicians should be emphasized with in-service training.

Non-Malignant Respiratory Disease Among Workers in Industries Using Styrene—A Review of the Evidence

PubMed Central

Nett, Randall J.; Cox-Ganser, Jean M.; Hubbs, Ann F.; Ruder, Avima M.; Cummings, Kristin J.; Huang, Yuh-Chin T.; Kreiss, Kathleen

2017-01-01

Background Asthma and obliterative bronchiolitis (OB) cases have occurred among styrene-exposed workers. We aimed to investigate styrene as a risk factor for non-malignant respiratory disease (NMRD). Methods From a literature review, we identified case reports and assessed cross-sectional and mortality studies for strength of evidence of positive association (i.e., strong, intermediate, suggestive, none) between styrene exposure and NMRD-related morbidity and mortality. Results We analyzed 55 articles and two unpublished case reports. Ten OB cases and eight asthma cases were identified. Six (75%) asthma cases had abnormal styrene inhalation challenges. Thirteen (87%) of 15 cross-sectional studies and 12 (50%) of 24 mortality studies provided at least suggestive evidence that styrene was associated with NMRD-related morbidity or mortality. Six (66%) of nine mortality studies assessing chronic obstructive pulmonary disease-related mortality indicated excess mortality. Conclusions Available evidence suggests styrene exposure is a potential risk factor for NMRD. Additional studies of styrene-exposed workers are warranted. PMID:28079275

Case conceptualization research in cognitive behavior therapy: A state of the science review.

PubMed

Easden, Michael H; Kazantzis, Nikolaos

2018-03-01

Prominent models of cognitive behavior therapy (CBT) assert that case conceptualization is crucial for tailoring interventions to adequately address the needs of the individual client. We aimed to review the research on case conceptualization in CBT. We conducted a systematic search of PsychINFO, MEDLINE, Psychology and Behavioral Science Collection, and CINAHL databases to February 2016. A total of 24 studies that met inclusion criteria were identified. It was notable that studies (a) focused on the assessment function of case conceptualization, (b) employed diverse methodologies, and, overall, (c) there remains a paucity of studies examining the in-session process of using case conceptualization or examining relations with outcome. Results from the existing studies suggest that experienced therapists can reliably construct some elements of case conceptualizations, but importance for the efficacy of case conceptualization in CBT has yet to be demonstrated. Research that involves direct observation of therapist competence in case conceptualization as a predictor of CBT outcomes is recommended as a focus for future hypothesis testing. © 2017 Wiley Periodicals, Inc.

Case management.

PubMed

Woodward, Judy; Rice, Eve

2015-03-01

Health care in the United States is changing rapidly under pressure from both political and professional stakeholders, and one area on the front line of required change is the discipline of case management. Historically, case management has worked to defragment the health care delivery system for clients and increase access to health care. Case management will have an expanded role resulting from Affordable Care Act initiatives to improve health care. This article includes definitions of case management, current issues related to case management, case management standards of practice, and a case study of the management of pediatric chronic disease. Copyright © 2015 Elsevier Inc. All rights reserved.

Implementation Processes, Structures, and Barriers to High School Restructuring: A Case Study.

ERIC Educational Resources Information Center

Whitaker, Kathryn S.

1998-01-01

Presents results of a school-restructuring case study involving a high school participating in the Coalition of Essential Schools and RE: Learning Project. Nine common coalition principles were implemented, primarily within the school-within-a-school program. Barriers included staff jealousy, political controversy, decreased staff development…

Compressed Air System Redesign Results in Increased Production at a Fuel System Plant (Caterpillar Fuel Systems Pontiac Plant)

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

None

2001-06-01

This case study is one in a series on industrial firms who are implementing energy efficient technologies and system improvements into their manufacturing processes. This case study documents the activities, savings, and lessons learned on the Caterpillar's Pontiac Plant project.

SetonWorldWide: A Case Study of Student Success

ERIC Educational Resources Information Center

DiSalvio, Philip

2009-01-01

This case study offers a strategic model of methods and services resulting in relatively high student success rates as defined by course completion of introductory first and second semester online courses. This strategic model is presented in the context of Sloan-C's "Five Pillars of Quality Online Education."

Relegation and Reversion: Longitudinal Analysis of School Turnaround and Decline

ERIC Educational Resources Information Center

Hochbein, Craig

2012-01-01

School turnaround has become a popular strategy for improvement of chronically low-performing schools. Research related to school turnaround has relied substantially upon case studies. These case studies often focus on successful turnarounds and report immediate outcomes, failing to provide information about the sustainability of the results. In…

Behavioral Treatment of Hysterical Coughing and Mutism: A Case Study

ERIC Educational Resources Information Center

Munford, Paul R.; And Others

1976-01-01

This case study demonstrates the value of conceptualizing functional somatic disorders as operants. The subject, an adolescent girl, diagnosed as having a "hysterical neurosis," manifested the symptoms of incessant coughing and mutism. The cough and mutism were treated by extinction and shaping, respectively. Positive results were obtained.…

Learning Machine Learning: A Case Study

ERIC Educational Resources Information Center

Lavesson, N.

2010-01-01

This correspondence reports on a case study conducted in the Master's-level Machine Learning (ML) course at Blekinge Institute of Technology, Sweden. The students participated in a self-assessment test and a diagnostic test of prerequisite subjects, and their results on these tests are correlated with their achievement of the course's learning…

Cultural Competence and School Counselor Training: A Collective Case Study

ERIC Educational Resources Information Center

Nelson, Judith A.; Bustamante, Rebecca; Sawyer, Cheryl; Sloan, Eva D.

2015-01-01

This collective case study investigated the experiences of bilingual counselors-in-training who assessed school-wide cultural competence in public schools. Analysis and interpretation of data resulted in the identification of 5 themes: eye-opening experiences, recognition of strengths, the role of school leaders, road maps for change, and…

Strategies for Research Development in Hospital Social Work: A Case Study

ERIC Educational Resources Information Center

McNeill, Ted; Nicholas, David Bruce

2012-01-01

Objectives: This article identifies salient components in the advancement of social work research leadership within health care. Method: Using tenets of a modified retrospective case study approach, processes and outcomes of social work research progression at a pediatric hospital are reviewed. Results: Capacity-building processes were…

Collaborative Textbook Selection: A Case Study Leading to Practical and Theoretical Considerations

ERIC Educational Resources Information Center

Czerwionka, Lori; Gorokhovsky, Bridget

2015-01-01

This case study developed a collaborative approach to the selection of a Spanish language textbook. The collaborative process consisted of six steps, detailed in this article: team building, generating evaluation criteria, formulating a meaningful rubric, selecting prospective textbooks, calculating rubric results, and reflectively reviewing…

Faculty Perceptions of Teaching Nontraditional College Students: A Qualitative Single Descriptive Case Study

ERIC Educational Resources Information Center

Spedding, Lindsey

2016-01-01

Nontraditional students bring to the classroom diversity in age, culture, experience, knowledge, and preparedness. The risk factors that circumstantially define nontraditional students outside the classroom result in transferrable challenges within the classroom. The purpose of this single descriptive case study was to explore and understand…

A Case Study Using Child-Centered Play Therapy Approach to Treat Enuresis and Encopresis.

ERIC Educational Resources Information Center

Cuddy-Casey, Maria

1997-01-01

Demonstrates an alternative method (nondirective child-centered therapy) in treating enuresis and encopresis resulting from emotional disturbances. Examines various etiologies and approaches to treating these conditions. Provides a case study example. Claims that professionals must differentiate between primary and secondary occurrences of these…

Catching a Wave: An Australian Case Study on Building Competence in Search of Competitive Advantage.

ERIC Educational Resources Information Center

Kellie, Deborah

1998-01-01

A case study of an Australian road construction company's skill development project is an example of an attempt to increase competitive advantage through competency acquisition. It remains to be seen whether reconstruction of the company will result in improved productivity and financial performance. (SK)

Diagnosis of post-partum ovarian vein thrombophlebitis by color Doppler ultrasonography: about 10 cases.

PubMed

Giraud, J R; Poulain, P; Renaud-Giono, A; Darnault, J P; Proudhon, J F; Grall, J Y; Mocquet, P Y

1997-09-01

Post-partum ovarian vein thrombosis is often overlooked or mistaken for other complications such as endometritis. Color Doppler ultrasonography is a very good diagnostic method when properly indicated and correctly interpreted according to clinical data. This study reports ten cases that were retrospectively studied, during which color Doppler ultrasonography was used. The clinical signs and the results are reviewed. The lesions were clearly visualized in eight of the ten cases; one of the two failures resulted from a methodological fault (uninterpretable result); the other one was due to the lack of experience of the operator and nonrecognition of the clinical signs. Thrombosis appears as a hypoechogenic and tubular image. This type of examination is particularly indicated in the presence of certain clinical signs that were observed in our cases: fever and iliac pain are the main precursor signs, often associated with abdominal meteorism and slow digestive transit; provoked cul-de-sac pain during vaginal probing was the only constant sign, sometimes associated with painful swelling.

Characteristics and management of presumptive tuberculosis in public health facilities in Malawi, 2014–2016

PubMed Central

Gugsa, S.; Tweya, H.; Girma, B.; Kanyerere, H.; Dambe, I.; Babaye, Y.; Mpunga, J.; Phiri, S.

2017-01-01

Setting: Public health facilities providing tuberculosis (TB) and human immunodeficiency virus (HIV) services in Malawi. Objectives: Using routinely collected health service delivery data to describe trends in HIV ascertainment and use of the Xpert® MTB/RIF assay to diagnose TB among HIV-positive presumptive TB cases. Design: This was an implementation study of presumptive TB cases who sought care from 21 facilities between April 2014 and June 2016. Descriptive statistics were used to summarise patient, facility and service level characteristics. Results: Of 28 567 presumptive TB cases analysed, 23 198 (81%) had known HIV status. The proportion of ascertained HIV status in presumptive TB cases increased over the study period. HIV prevalence was 49%, with 73% of HIV-positive presumptive TB cases on antiretroviral therapy. Access to Xpert ranged between 37% and 63% per quarter among HIV-positive presumptive TB patients with smear-negative sputum results. Of 7829 patients with documented Xpert results, 68% were HIV-positive. Conclusion: After the introduction of registers with HIV-related variables, HIV ascertainment among presumptive TB cases increased over time. Access to Xpert was suboptimal among HIV-positive presumptive TB cases. Further collaboration between national TB and HIV programmes may facilitate increased use of Xpert for HIV-positive patients with presumptive TB who seek care in public health facilities. PMID:29584793

Case Studies in Modelling, Control in Food Processes.

PubMed

Glassey, J; Barone, A; Montague, G A; Sabou, V

This chapter discusses the importance of modelling and control in increasing food process efficiency and ensuring product quality. Various approaches to both modelling and control in food processing are set in the context of the specific challenges in this industrial sector and latest developments in each area are discussed. Three industrial case studies are used to demonstrate the benefits of advanced measurement, modelling and control in food processes. The first case study illustrates the use of knowledge elicitation from expert operators in the process for the manufacture of potato chips (French fries) and the consequent improvements in process control to increase the consistency of the resulting product. The second case study highlights the economic benefits of tighter control of an important process parameter, moisture content, in potato crisp (chips) manufacture. The final case study describes the use of NIR spectroscopy in ensuring effective mixing of dry multicomponent mixtures and pastes. Practical implementation tips and infrastructure requirements are also discussed.

The life cycles of intense cyclonic and anticyclonic circulation systems observed over oceans

NASA Technical Reports Server (NTRS)

Smith, Phillip J.

1994-01-01

The work over the past six months has focused on the October/November 1985 blocking case study noted in the last progress report. A summary of the results of this effort is contained in the attached preprint papers for the Symposium on the Life Cycles of Extratropical Cyclones. Using this case study as a model, Ph.D. student Anthony Lupo is now initiating the multiple-case diagnosis by first examining two more fall 1985 blocking episodes. In addition, two secondary efforts have been completed, as summarized in the attached M.S. thesis abstracts. Both studies, which were primarily funded by a fellowship and a teaching assistantship, complement the objectives of this study by providing diagnoses of additional cyclone cases to serve as a comparative base for the pre-blocking cyclones to be studied in the multiple-case blocking diagnosis.

Exploring the Replicability of a Study's Results: Bootstrap Statistics for the Multivariate Case.

ERIC Educational Resources Information Center

Thompson, Bruce

1995-01-01

Use of the bootstrap method in a canonical correlation analysis to evaluate the replicability of a study's results is illustrated. More confidence may be vested in research results that replicate. (SLD)

[Clinical study of PC-904 in pediatrics (author's transl)].

PubMed

Minamitani, M; Hachimori, K

1978-07-01

Clinical study of PC-904 was performed in 8 children with infectious diseases and the following results were obtained. 1) The patients treated with PC-904 were each one case of acute pharyngitis, lacunar tonsillitis, scarlet fever, phlegmone, acute bronchitis and lung abscess, and 2 cases of bronchopneumonia. 2) The administration methods were drip infusion, one-shot intravenous injection and the combined use of these administrations. The daily dosage varied from 30 to 49 mg/kg in 3 cases and from 50 to 70 mg/kg in 3 cases, and was 227 mg/kg in 1 case. 3) Clinical evaluation was examined in 7 cases and 57.1% of effectiveness was obtained. Out of 2 cases of pneumonia, one case with the causative organism of My. pneumoniae was excluded from the clinical evaluation. 4) No side effects were observed in all 8 cases treated with PC-904.

Occupational exposure to pesticides and lymphoid neoplasms among men: results of a French case-control study

PubMed Central

Orsi, Laurent; Delabre, Laurene; Monnereau, Alain; Delval, Philippe; Berthou, Christian; Fenaux, Pierre; Marit, Gerald; Soubeyran, Pierre; Huguet, Francoise; Milpied, Noel; Leporrier, Michel; Hemon, Denis; Troussard, Xavier; Clavel, Jacqueline

2009-01-01

Objectives Investigating the relationship between occupational exposure to pesticides and the risk of lymphoid neoplasms (LN) in men. Methods A hospital-based case-control study was conducted in six centres in France between 2000 and 2004. The cases were incident cases with a diagnosis of lymphoid neoplasm aged 18 to 75 years. During the same period, controls of the same age and gender as the cases were recruited in the same hospital, mainly in the orthopaedic and rheumatological departments. Exposures to pesticides were evaluated through specific interviews and case-by-case expert reviews. Four hundred and ninety-one cases (244 cases of non-Hodgkin’s lymphoma (NHL), 87 of Hodgkin’s lymphoma (HL), 104 of lymphoproliferative syndromes (LPS) and 56 of multiple myeloma (MM) cases) and 456 controls were included in the analyses. The odds ratios (OR) and 95% confidence intervals (95% CI) were estimated using unconditional logistic regressions. Results Positive associations between HL and occupational exposure to triazole fungicides and urea herbicides were observed (OR=8.4 [2.2–32.4], 10.8 [2.4–48.1] respectively). Exposure to insecticides, fungicides and herbicides were linked to a three-fold increases in MM risk (OR=2.8 [1.2–6.5], 3.2 [1.4–7.2], 2.9 [1.3–6.5]). For LPS subtypes, associations restricted to hairy-cell leukaemia (HCL) were evidenced for exposure to organochlorine insecticides, phenoxy herbicides and triazine herbicides (OR=4.9 [1.1–21.2], 4.1 [1.1–15.5], 5.1 [1.4–19.3]), although based on small numbers. Lastly, despite the increased odds ratios for organochlorine and organophosphate insecticides, carbamate fungicides and triazine herbicides, no significant associations were evidenced for NHL. Conclusions The results, based on case-by-case expert review of occupation-specific questionnaires, support the hypothesis that occupational pesticide exposures may be involved in HL, MM and HCL and do not rule out a role in NHL. The analyses identified specific pesticides that deserve further investigation and the findings were consistent with those of previous studies. PMID:19017688

Effects of alternative outcome scenarios and structured outcome evaluation on case-based ethics instruction.

PubMed

Peacock, Juandre; Harkrider, Lauren N; Bagdasarov, Zhanna; Connelly, Shane; Johnson, James F; Thiel, Chase E; Macdougall, Alexandra E; Mumford, Michael D; Devenport, Lynn D

2013-09-01

Case-based instruction has been regarded by many as a viable alternative to traditional lecture-based education and training. However, little is known about how case-based training techniques impact training effectiveness. This study examined the effects of two such techniques: (a) presentation of alternative outcome scenarios to a case, and (b) conducting a structured outcome evaluation. Consistent with the hypotheses, results indicate that presentation of alternative outcome scenarios reduced knowledge acquisition, reduced sensemaking and ethical decision-making strategy use, and reduced decision ethicality. Conducting a structured outcome evaluation had no impact on these outcomes. Results indicate that those who use case-based instruction should take care to use clear, less complex cases with only a singular outcome if they are seeking these types of outcomes.

Benefits of Integration of Aerojet Rocketdyne and RTI Advanced Gasification Technologies for Hydrogen-Rich Syngas Production

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

Gupta, Vijay; Denton, David; SHarma, Pradeep

The key objective for this project was to evaluate the potential to achieve substantial reductions in the production cost of H 2-rich syngas via coal gasification with near-zero emissions due to the cumulative and synergistic benefits realized when multiple advanced technologies are integrated into the overall conversion process. In this project, Aerojet Rocketdyne’s (AR’s) advanced gasification technology (currently being offered as R-GAS™) and RTI International’s (RTI’s) advanced warm syngas cleanup technologies were evaluated via a number of comparative techno-economic case studies. AR’s advanced gasification technology consists of a dry solids pump and a compact gasifier system. Based on the uniquemore » design of this gasifier, it has been shown to reduce the capital cost of the gasification block by between 40 and 50%. At the start of this project, actual experimental work had been demonstrated through pilot plant systems for both the gasifier and dry solids pump. RTI’s advanced warm syngas cleanup technologies consist primarily of RTI’s Warm Gas Desulfurization Process (WDP) technology, which effectively allows decoupling of the sulfur and CO 2 removal allowing for more flexibility in the selection of the CO 2 removal technology, plus associated advanced technologies for direct sulfur recovery and water gas shift (WGS). WDP has been demonstrated at pre-commercial scale using an activated amine carbon dioxide recovery process which would not have been possible if a majority of the sulfur had not been removed from the syngas by WDP. This pre-commercial demonstration of RTI’s advanced warm syngas cleanup system was conducted in parallel to the activities on this project. The technical data and cost information from this pre-commercial demonstration were extensively used in this project during the techno-economic analysis. With this project, both of RTI’s advanced WGS technologies were investigated. Because RT’s advanced fixed-bed WGS (AFWGS) process was successfully implemented in the WDP pre-commercial demonstration test mentioned above, this technology was used as part of RTI’s advanced warm syngas technology package for the techno-economic analyses for this project. RTI’s advanced transport-reactor-based WGS (ATWGS) process was still conceptual at the start of this project, but one of the tasks for this project was to evaluate the technical feasibility of this technology. In each of the three application-based comparison studies conducted as part of this project, the reference case was based on an existing Department of Energy National Energy Technology Laboratory (DOE/NETL) system study. Each of these references cases used existing commercial technology and the system resulted in > 90% carbon capture. In the comparison studies for the use of the hydrogen-rich syngas generated in either an Integrated Gasification Combined Cycle (IGCC) or a Coal-to-Methanol (CTM) plant, the comparison cases consisted of the reference case, a case with the integration of each individual advanced technology (either AR or RTI), and finally a case with the integration of all the advanced technologies (AR and RTI combined). In the Coal-to-Liquids (CTL) comparison study, the comparison study consisted of only three cases, which included a reference case, a case with just RTI’s advanced syngas cleaning technology, and a case with AR’s and RTI’s advanced technologies. The results from these comparison studies showed that the integration of the advanced technologies did result in substantial benefits, and by far the greatest benefits were achieved for cases integrating all the advanced technologies. For the IGCC study, the fully integrated case resulted in a 1.4% net efficiency improvement, an 18% reduction in capital cost per kW of capacity, a 12% reduction in the operating cost per kWh, and a 75–79% reduction in sulfur emissions. For the CTM case, the fully integrated plant resulted in a 22% reduction in capital cost, a 13% reduction in operating costs, a > 99% net reduction in sulfur emissions, and a reduction of 13–15% in CO 2 emissions. Because the capital cost represents over 60% of the methanol Required Selling Price (RSP), the significant reduction in the capital cost for the advanced technology case resulted in an 18% reduction in methanol RSP. For the CTL case, the fully integrated plant resulted in a 16% reduction in capital cost, which represented a 13% reduction in diesel RSP. Finally, the technical feasibility analysis of RTI’s ATWGS process demonstrated that a fluid-bed catalyst with sufficient attrition resistance and WGS activity could be made and that the process achieved about a 24% reduction in capital cost compared to a conventional fixed-bed commercial process.« less

Performance of Disease Risk Score Matching in Nested Case-Control Studies: A Simulation Study.

PubMed

Desai, Rishi J; Glynn, Robert J; Wang, Shirley; Gagne, Joshua J

2016-05-15

In a case-control study, matching on a disease risk score (DRS), which includes many confounders, should theoretically result in greater precision than matching on only a few confounders; however, this has not been investigated. We simulated 1,000 hypothetical cohorts with a binary exposure, a time-to-event outcome, and 13 covariates. Each cohort comprised 2 subcohorts of 10,000 patients each: a historical subcohort and a concurrent subcohort. DRS were estimated in the historical subcohorts and applied to the concurrent subcohorts. Nested case-control studies were conducted in the concurrent subcohorts using incidence density sampling with 2 strategies-matching on age and sex, with adjustment for additional confounders, and matching on DRS-followed by conditional logistic regression for 9 outcome-exposure incidence scenarios. In all scenarios, DRS matching yielded lower average standard errors and mean squared errors than did matching on age and sex. In 6 scenarios, DRS matching also resulted in greater empirical power. DRS matching resulted in less relative bias than did matching on age and sex at lower outcome incidences but more relative bias at higher incidences. Post-hoc analysis revealed that the effect of DRS model misspecification might be more pronounced at higher outcome incidences, resulting in higher relative bias. These results suggest that DRS matching might increase the statistical efficiency of case-control studies, particularly when the outcome is rare. © The Author 2016. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

A Two-Step Bayesian Approach for Propensity Score Analysis: Simulations and Case Study.

PubMed

Kaplan, David; Chen, Jianshen

2012-07-01

A two-step Bayesian propensity score approach is introduced that incorporates prior information in the propensity score equation and outcome equation without the problems associated with simultaneous Bayesian propensity score approaches. The corresponding variance estimators are also provided. The two-step Bayesian propensity score is provided for three methods of implementation: propensity score stratification, weighting, and optimal full matching. Three simulation studies and one case study are presented to elaborate the proposed two-step Bayesian propensity score approach. Results of the simulation studies reveal that greater precision in the propensity score equation yields better recovery of the frequentist-based treatment effect. A slight advantage is shown for the Bayesian approach in small samples. Results also reveal that greater precision around the wrong treatment effect can lead to seriously distorted results. However, greater precision around the correct treatment effect parameter yields quite good results, with slight improvement seen with greater precision in the propensity score equation. A comparison of coverage rates for the conventional frequentist approach and proposed Bayesian approach is also provided. The case study reveals that credible intervals are wider than frequentist confidence intervals when priors are non-informative.

[Prevalence of altered mismatch repair protein nuclear expression detected by immunohistochemistry on adenomas with high-grade dysplasia and features associated with this risk in a population-based study].

PubMed

Basterra, Marta; Gomez, Marta; Mercado, María Del Rosario; Irisarri, Rebeca; Amorena, Edurne; Arrospide, Arantzazu; Montes, Marta; Aisa, Gregorio; Cambra, Koldo Iñaki; Urman, Jesús

2016-10-01

Alteration of mismatch repair system protein expression detected by immunohistochemistry (IHQ) in tumoural tissue is a useful technique for Lynch Syndrome (LS) screening. A recent review proposes LS screening through immunohistochemical study not only in all diagnosed cases of colorectal cancer (CRC) but also in advanced adenomas, especially in young patients. To assess the prevalence of altered IHQ carried out in all adenomas with high-grade dysplasia (HGD) diagnosed in our community in 2011, as well as the variables associated with this alteration. We included all the cases of adenomatous polyps with HGD diagnosed in the three public pathology laboratories of Navarre during 2011 and performed a statistical study to assess the association between different patient and lesion characteristics and altered IHQ results. A total of 213 colonic adenomas with HGD were diagnosed, and 26 (12.2%) cases were excluded from the final analysis (2 known LS, 22 without IHQ study and 2 with inconclusive IHQ studies). The final number of adenomas included was 187. Pathologic results were found in 10 cases (5.35%)-6 cases in MLH1 and PMS2, 2 cases in PMS2, 1 case in MSH6 and 1 case in MSH2 and MSH6. The factors showing a statistically significant association with the presence of abnormal proteins were the synchronous presence of CRC, the presence of only one advanced adenoma, proximal location of HGD and age <50 years. The percentage of pathologic nuclear expression found in IHQ is high. Consequently, screening of all diagnosed HGD could be indicated, especially in young patients, with a single AA and proximal HGD. Copyright © 2015 Elsevier España, S.L.U. y AEEH y AEG. All rights reserved.

Extracting information from the text of electronic medical records to improve case detection: a systematic review

PubMed Central

Carroll, John A; Smith, Helen E; Scott, Donia; Cassell, Jackie A

2016-01-01

Background Electronic medical records (EMRs) are revolutionizing health-related research. One key issue for study quality is the accurate identification of patients with the condition of interest. Information in EMRs can be entered as structured codes or unstructured free text. The majority of research studies have used only coded parts of EMRs for case-detection, which may bias findings, miss cases, and reduce study quality. This review examines whether incorporating information from text into case-detection algorithms can improve research quality. Methods A systematic search returned 9659 papers, 67 of which reported on the extraction of information from free text of EMRs with the stated purpose of detecting cases of a named clinical condition. Methods for extracting information from text and the technical accuracy of case-detection algorithms were reviewed. Results Studies mainly used US hospital-based EMRs, and extracted information from text for 41 conditions using keyword searches, rule-based algorithms, and machine learning methods. There was no clear difference in case-detection algorithm accuracy between rule-based and machine learning methods of extraction. Inclusion of information from text resulted in a significant improvement in algorithm sensitivity and area under the receiver operating characteristic in comparison to codes alone (median sensitivity 78% (codes + text) vs 62% (codes), P = .03; median area under the receiver operating characteristic 95% (codes + text) vs 88% (codes), P = .025). Conclusions Text in EMRs is accessible, especially with open source information extraction algorithms, and significantly improves case detection when combined with codes. More harmonization of reporting within EMR studies is needed, particularly standardized reporting of algorithm accuracy metrics like positive predictive value (precision) and sensitivity (recall). PMID:26911811

Lack of association between migraine headache and patent foramen ovale: results of a case-control study.

PubMed

Garg, Pallav; Servoss, Stephen J; Wu, Justina C; Bajwa, Zahid H; Selim, Magdy H; Dineen, Alexis; Kuntz, Richard E; Cook, E Francis; Mauri, Laura

2010-03-30

Clinical observations of migraine headache symptoms in patients with a patent foramen ovale (PFO), both of which conditions are highly prevalent, have raised the question of a possible pathophysiological relationship. We sought to evaluate the assumption of an association between migraine headaches and the presence of PFO by use of a large case-control study. We conducted a case-control study to assess the prevalence of PFO in subjects with and without migraine. Case subjects were those with a history of migraine (diagnosed by neurologists at a specialty academic headache clinic). Control subjects were healthy volunteers without migraine 1:1 matched on the basis of age and sex with case subjects. Presence of PFO was determined by transthoracic echocardiogram with second harmonic imaging and transcranial Doppler ultrasonography during a standardized procedure of infused agitated saline contrast with or without Valsalva maneuver and a review of the results by experts blinded to case-control status. PFO was considered present if both studies were positive. Odds ratios were calculated with conditional logistic regression in the matched cohort (n=288). In the matched analysis, the prevalence of PFO was similar in case and control subjects (26.4% versus 25.7%; odds ratio 1.04, 95% confidence interval 0.62 to 1.74, P=0.90). There was no difference in PFO prevalence in those with migraine with aura and those without (26.8% versus 26.1%; odds ratio 1.03, 95% confidence interval 0.48 to 2.21, P=0.93). We found no association between migraine headaches and the presence of PFO in this large case-control study.

Lung cancer, pulmonary emphysema and pleural effusion: An autopsy study.

PubMed

Marel, Miloslav; Koubkova, Leona; Kovarikova, Zuzana; Grandcourtova, Alzbeta; Petrik, Frantisek; Hroudova, Hana; Capkova, Linda; Kodet, Roman; Fila, Libor

2015-12-01

To determine the exact incidence of lung cancer, pulmonary emphysema and pleural effusion we decided to carry out an autopsy study. In this autopsy study carried out over two years, we compared the results of autopsy findings with the clinical data in accompanying records of the deceased. Among the 708 deceased subjects, there were 398 males and 310 females with a median age of 71 years. At autopsy, 55 cases of lung carcinoma (BCA) were found, of which 24 have not been identified during life (44%). Among the deceased with BCA, emphysema was also observed at autopsy in 40% of the cases. Pulmonary emphysema was described macroscopically in 28% of the full set of 708 deceased, whereas the accompanying records of the deceased described this condition in only 12% of the cases. Microscopic changes compatible with emphysema were identified in 54% of the examined lungs. Pleural effusions were described in the accompanying records of 13% of the deceased, while the autopsies showed this condition in 33% of the deceased. BCA was accompanied by effusion in 25% of the cases. The obtained results show that the studied conditions are present in more cases than are reported by clinicians. The study confirms the commonly accepted association between lung cancer and emphysema.

JPL Thermal Design Modeling Philosophy and NASA-STD-7009 Standard for Models and Simulations - A Case Study

NASA Technical Reports Server (NTRS)

Avila, Arturo

2011-01-01

The Standard JPL thermal engineering practice prescribes worst-case methodologies for design. In this process, environmental and key uncertain thermal parameters (e.g., thermal blanket performance, interface conductance, optical properties) are stacked in a worst case fashion to yield the most hot- or cold-biased temperature. Thus, these simulations would represent the upper and lower bounds. This, effectively, represents JPL thermal design margin philosophy. Uncertainty in the margins and the absolute temperatures is usually estimated by sensitivity analyses and/or by comparing the worst-case results with "expected" results. Applicability of the analytical model for specific design purposes along with any temperature requirement violations are documented in peer and project design review material. In 2008, NASA released NASA-STD-7009, Standard for Models and Simulations. The scope of this standard covers the development and maintenance of models, the operation of simulations, the analysis of the results, training, recommended practices, the assessment of the Modeling and Simulation (M&S) credibility, and the reporting of the M&S results. The Mars Exploration Rover (MER) project thermal control system M&S activity was chosen as a case study determining whether JPL practice is in line with the standard and to identify areas of non-compliance. This paper summarizes the results and makes recommendations regarding the application of this standard to JPL thermal M&S practices.

Results of routine restaurant inspections can predict outbreaks of foodborne illness: the Seattle-King County experience.

PubMed Central

Irwin, K; Ballard, J; Grendon, J; Kobayashi, J

1989-01-01

To analyze the association between the results of routine inspections and foodborne outbreaks in restaurants, we conducted a matched case-control study using available data from Seattle-King County, Washington. Case restaurants were facilities with a reported foodborne outbreak between January 1, 1986 and March 31, 1987 (N = 28). Two control restaurants with no reported outbreaks during this period were matched to each case restaurant on county health district and date of routine inspection (N = 56). Data from the routine inspection that preceded the outbreak (for case restaurants) or the date-matched routine inspection (for control restaurants) were abstracted from computerized inspection records. Case restaurants had a significantly lower mean inspection score (83.8 on a 0 to 100 point scale) than control restaurants (90.9). Restaurants with poor inspection scores and violations of proper temperature controls of potentially hazardous foods were, respectively, five and ten times more likely to have outbreaks than restaurants with better results. Although this study demonstrates that Seattle-King County's routine inspection form can successfully identify restaurants at increased risk of foodborne outbreaks, it also illustrates that more emphasis on regulation and education is needed to prevent outbreaks in restaurants with poor inspection results. PMID:2705592

PERIAPICAL LESIONS OF THE JAWS: A REVIEW OF 104 CASES IN IBADAN

PubMed Central

Akinyamoju, AO; Gbadebo, SO; Adeyemi, BF

2014-01-01

Background: Periapical lesions (PLs) occur as a result of pulpal inflammation and may rarely be seen in the absence of pulpal diseases. They are the most common pathological lesions affecting the alveolar bone. Objective: This study aims to describe the clinicopathological features of PLs of the jaws with emphasis on the two most common types. Methods: Histopathology records of PLs diagnosed from January 1990 to December 2012 at the Department of Oral Pathology, University College Hospital Ibadan, were examined and categorized into periapical cysts (PCs); periapical granuloma (PGs) and others. Clinical data and histopathological features of these PLs were reviewed and analyzed. Results: One hundred and four lesions met the criteria for this study and consisted of PGs with 71 (68.3%) cases and PCs with 31 (29.8%) cases and one case each of apical scar and pleomorphic adenoma. Age range of cases was 9 to 80 years (mean=35.6 ± 15.8years) with a peak at age group of 20-29 years. Females were more frequently affected with 51.9% of cases. PLs were most frequently diagnosed in the anterior maxillary region with 58 (56.9%) cases, while the most frequently involved tooth was the left maxillary central incisor with 23 (22.1%) cases. Conclusion: Findings in this study are consistent with those of previous studies. It is important for all periapical pathological specimens to be submitted for histological examination to establish an accurate diagnosis and aid in the identification of sinister lesions that may present in the Periradicular region of teeth. PMID:25960702

A numerical comparison of discrete Kalman filtering algorithms: An orbit determination case study

NASA Technical Reports Server (NTRS)

Thornton, C. L.; Bierman, G. J.

1976-01-01

The numerical stability and accuracy of various Kalman filter algorithms are thoroughly studied. Numerical results and conclusions are based on a realistic planetary approach orbit determination study. The case study results of this report highlight the numerical instability of the conventional and stabilized Kalman algorithms. Numerical errors associated with these algorithms can be so large as to obscure important mismodeling effects and thus give misleading estimates of filter accuracy. The positive result of this study is that the Bierman-Thornton U-D covariance factorization algorithm is computationally efficient, with CPU costs that differ negligibly from the conventional Kalman costs. In addition, accuracy of the U-D filter using single-precision arithmetic consistently matches the double-precision reference results. Numerical stability of the U-D filter is further demonstrated by its insensitivity of variations in the a priori statistics.

Urban Environment Development based on Universal Design Principles

NASA Astrophysics Data System (ADS)

Harsritanto, Bangun Ir

2018-02-01

Universal Design is a design which facilitated full range of human diversity. By applying Universal design principles, urban environment can be more functional and more user-friendly for everyone. This study examined five urban streets of South Korea as a country experienced on developing various urban street designs based on universal design. This study aimed to examine and compare the South Korea cases using seven principles of universal design. The research methods of this study are literature study, case study, and site observation. The results of this study are: South Korea cases are good practices, urgency of implementing the direction into local regulations; and change of urban development paradigm.

Focal therapy in prostate cancer: the current situation

PubMed Central

Jácome-Pita, FX; Sánchez-Salas, R; Barret, E; Amaruch, N; Gonzalez-Enguita, C; Cathelineau, X

2014-01-01

Prostate cancer is one of the most significant pathologies in the field of urology. The adoption of screening strategies and improvements in biopsies have resulted in an increase in early-stage tumour detection. Radical global therapies provide very good oncological results in localised prostate cancer. However, excess treatment in low- and, in some cases, intermediate-risk groups affects the quality of life of these patients. In the case of localised prostate cancer, focal therapies offer a minimally invasive option with good results with respect to established treatments. Although this is currently not a standard treatment, it represents the therapeutic approach with the greatest potential. This literature review has the following objectives: to define selection criteria for patients who are candidates for focal therapy, to assess the current situation and results of the different therapeutic options, and to define procedures in cases of recurrence and for follow-ups. We concluded that focal therapy is a viable therapeutic alternative for localised prostate cancer, specifically cryosurgery and high-intensity targeted ultrasound, which have acceptable oncologic results and a lower comorbidity compared with global treatments. Studies with a high level of scientific evidence are still needed to validate these results. Acquisition of evidence A search was carried out on the Medline (PubMed), EMBASE, Web of Science and Cochrane databases of all papers published before 31 July 2013. We included clinical studies and literature reviews that evaluated primary focal therapy for prostate cancer confirmed by biopsy and excluded focal rescue therapy studies. The keywords used were focal therapy and prostate cancer. Initially, we found 42 articles; 15 studies were excluded because they did not meet the minimum criteria for inclusion. A total of 1350 cases were treated throughout 27 studies. PMID:24944577

Using full-cohort data in nested case-control and case-cohort studies by multiple imputation.

PubMed

Keogh, Ruth H; White, Ian R

2013-10-15

In many large prospective cohorts, expensive exposure measurements cannot be obtained for all individuals. Exposure-disease association studies are therefore often based on nested case-control or case-cohort studies in which complete information is obtained only for sampled individuals. However, in the full cohort, there may be a large amount of information on cheaply available covariates and possibly a surrogate of the main exposure(s), which typically goes unused. We view the nested case-control or case-cohort study plus the remainder of the cohort as a full-cohort study with missing data. Hence, we propose using multiple imputation (MI) to utilise information in the full cohort when data from the sub-studies are analysed. We use the fully observed data to fit the imputation models. We consider using approximate imputation models and also using rejection sampling to draw imputed values from the true distribution of the missing values given the observed data. Simulation studies show that using MI to utilise full-cohort information in the analysis of nested case-control and case-cohort studies can result in important gains in efficiency, particularly when a surrogate of the main exposure is available in the full cohort. In simulations, this method outperforms counter-matching in nested case-control studies and a weighted analysis for case-cohort studies, both of which use some full-cohort information. Approximate imputation models perform well except when there are interactions or non-linear terms in the outcome model, where imputation using rejection sampling works well. Copyright © 2013 John Wiley & Sons, Ltd.

Clinical characteristics of patients with tinnitus evaluated with the Tinnitus Sample Case History Questionnaire in Japan: A case series

PubMed Central

Kojima, Takashi; Kanzaki, Sho; Oishi, Naoki; Ogawa, Kaoru

2017-01-01

Background The Tinnitus Sample Case History Questionnaire was determined as a standardized questionnaire for obtaining patient case histories and for characterizing patients into subgroups at the Tinnitus Research Initiative in 2006. In this study, we developed a Japanese version of this questionnaire for evaluating the clinical characteristics of patients with tinnitus. The Japanese version of the questionnaire will be available for evaluating treatments for tinnitus and for comparing data on tinnitus in research centers. Aims/Objectives To evaluate the clinical characteristics of patients with tinnitus in Japan using a newly developed Japanese version of Tinnitus Sample Case History Questionnaire. Study design This was a prospective study based on patient records. Setting University hospitals, general hospitals, and clinics. Subjects and methods We collected patient data using a Japanese translated version of the Tinnitus Sample Case History Questionnaire. In total, 584 patients who visited our institutions in Japan between August 2012 and March 2014 were included (280 males and 304 females; age 13–92 years; mean age, 60.8). We examined patients after dividing them into two groups according to the presence or absence of hyperacusis. The collected results were compared with those from the Tinnitus Research Initiative database. Results Compared with the TRI database, there were significantly more elderly female patients and fewer patients with trauma-associated tinnitus. There was a statistically lower ratio of patients with hyperacusis. We found that patients with tinnitus in addition to hyperacusis had greater tinnitus severity and exhibited higher rates of various complications. Conclusion The Japanese version of the Tinnitus Sample Case History Questionnaire developed in this study can be a useful tool for evaluating patients with tinnitus in Japan. The results of this multicenter study reflect the characteristics of patients with tinnitus who require medical care in Japan. Our data provides a preliminary basis for an international comparison of tinnitus epidemiology. PMID:28841656

Implementation and value of using a split-plot reader design in a study of digital breast tomosynthesis in a breast cancer assessment clinic

NASA Astrophysics Data System (ADS)

Mall, Suneeta; Brennan, Patrick C.; Mello-Thoms, Claudia

2015-03-01

The rapid evolution in medical imaging has led to an increased number of recurrent trials, primarily to ensure that the efficacy of new imaging techniques is known. The cost associated with time and resources in conducting such trials is usually high. The recruitment of participants, in a medium to large reader study, is often very challenging as the demanding number of cases discourages involvement with the trial. We aim to evaluate the efficacy of Digital Breast Tomosynthesis (DBT) in a recall assessment clinic in Australia in a prospective multi-reader-multi-case (MRMC) trial. Conducting such a study with the more commonly used fully crossed MRMC study design would require more cases and more cases read per reader, which was not viable in our setting. With an aim to perform a cost effective yet statistically efficient clinical trial, we evaluated alternative study designs, particularly the alternative split-plot MRMC study design and compared and contrasted it with more commonly used fully crossed MRMC study design. Our results suggest that `split-plot', an alternative MRMC study design, could be very beneficial for medium to large clinical trials and the cost associated with conducting such trials can be greatly reduced without adversely effecting the variance of the study. We have also noted an inverse dependency between number of required readers and cases to achieve a target variance. This suggests that split-plot could also be very beneficial for studies that focus on cases that are hard to procure or readers that are hard to recruit. We believe that our results may be relevant to other researchers seeking to design a medium to large clinical trials.

[Total reverse shoulder replacement. Evaluation of the clinical results and complications in a series of 52 cases].

PubMed

Cáceres-Sánchez, L; Mesa-Mateo, A; Barrionuevo-Sánchez, F J; García-Benítez, B; Expósito-Triano, S

2015-01-01

To evaluate the clinical results and analyse the complications of total reverse shoulder replacement performed in our centre over an 8 year period. A retrospective study was conducted on 50 patients (52 shoulders), with a mean age of 70.15 years (range 51 to 84 years) between December 2004 and December 2012, who received a total reverse shoulder replacement, all performed by the same surgeon. The results have been evaluated according to clinical data, radiography study, a satisfaction scale, and the Constant scale, with a minimum follow-up of 16 months. Five of the cases (9.62%) had been intervened due to fractures of the proximal end of the humerus, 6 cases (11.53%) as surgical consequence of a prosthesis revision, 10 cases (19.23%) due to fracture sequelae, and 30 cases (59.62%) were patients with arthropathy due to a massive fracture of the rotator cuff. After a mean follow up of 35.78 months (range, 16-82), satisfactory clinical results were obtained in 80% of cases, with a mean preoperative Constant of 27.7 points, and reaching 67.1 points 12 months after the operation. On the visual analogue scale, 8.25 points were obtained before the surgery, which decreased to 2.25 points 12 months later. The complications rate was 15.38%, which were due to an intra-operative fracture (1.92%), deep infection (3.84%), instability (3.84%), and early mechanical loosening (3.84%). Scapular notching was observed in the radiographic study in 9 (17.3%) cases. After the results obtained, it could be said that total reverse shoulder replacement achieved encouraging results in the short term for the treatment of glenohumeral arthrosis and massive tears of the rotary cuff. On analysing our series, it can be seen that the complications rate is much higher when it is used to treat fracture sequelae in which there is a loss of proximal humerus bone stock. Copyright © 2014 SECOT. Published by Elsevier Espana. All rights reserved.

Performance Analysis of Science Education Undergraduates: A Case Study of Biology Education Students

ERIC Educational Resources Information Center

Ochonogor, Chukunoye Enunuwe

2011-01-01

The problem of the study was to analyze the results of university biology education students as a case study against gender and performance and empirically determine the implications of the findings to countries, such as Nigeria, South Africa and the rest of the world. The study made use of all the 344 students in the levels from 100 to 400 of…

Glycemic index, glycemic load and endometrial cancer risk: results from the Australian National Endometrial Cancer study and an updated systematic review and meta-analysis.

PubMed

Nagle, Christina M; Olsen, Catherine M; Ibiebele, Torukiri I; Spurdle, Amanda B; Webb, Penelope M

2013-03-01

The relationship between habitual consumption of foods with a high glycemic index (GI) and/or a diet with a high glycemic load (GL) and risk of endometrial cancer is uncertain, and relatively few studies have investigated these associations. The objectives of this study were to examine the association between GI/GL and risk of endometrial cancer using data from an Australian population-based case-control study and systematically review all the available evidence to quantify the magnitude of the association using meta-analysis. The case-control study included 1,290 women aged 18-79 years with newly diagnosed, histologically confirmed endometrial cancer and 1,436 population controls. Controls were selected to match the expected Australian state of residence and age distribution (in 5-year bands) of cases. For the systematic review, relevant studies were identified by searching PubMed and Embase databases through to July 2011. Random-effects models were used to calculate the summary risk estimates, overall and dose-response. In our case-control study, we observed a modest positive association between high dietary GI (OR 1.43, 95 % CI 1.11-1.83) and risk of endometrial cancer, but no association with high dietary GL (OR 1.15, 95 % CI 0.90-1.48). For the meta-analysis, we collated information from six cohort and two case-control studies, involving a total of 5,569 cases. The pooled OR for the highest versus the lowest intake category of GI was 1.15 (0.95-1.40); however, there was significant heterogeneity (p 0.004) by study design (RR 1.00 [95 % CI 0.87-1.14] for cohort studies and 1.56 [95 % CI 1.21-2.02] for case-control studies). There was no association in the dose-response meta-analysis of GI (RR per 5 unit/day increment of GI 1.00, 95 % CI 0.97-1.03). GL was positively associated with endometrial cancer. The pooled RR for the highest versus the lowest GL intake was 1.21 (95 % CI 1.09-1.33) and 1.06 (95 % CI 1.01-1.11) per 50 unit/day increment of GL in the dose-response meta-analysis. The pooled results from observational studies, including our case-control results, provide evidence of a modest positive association between high GL, but not GI, and endometrial cancer risk.

A Clinicopathological Study of Pemphigus in Eastern India with Special Reference to Direct Immunofluorescence

PubMed Central

Chowdhury, Joyeeta; Datta, Pijush Kanti; Chowdhury, Satyendra Nath; Das, Nilay Kanti

2016-01-01

Background: Pemphigus is a group of chronic autoimmune vesico-bullous disorders in which the epidermis and the basement membrane zone are the focus of attack resulting in cutaneous and mucosal blister formation. Direct immunofluorescence (DIF) test is a very sensitive test for the diagnosis Aim: To study the clinico histopathological patterns of pemphigus in eastern India. The study also aims to correlate DIF with clinical and histologic findings as well as severity of skin involvement [scoring systems]. Materials and Methods: Total 41 patients were studied over a period of 1 year in the Post-graduate centre of Dermatology in Eastern India. DIF, histopathology and clinical data were correlated. Results: In our study Pemphigus vulgaris (PV) was the predominant type with 32 cases followed by 8 cases of pemphigus foliaceus (PF) and a single case of IgA pemphigus. Mean age at presentation was late middle age. Majority of the patients, 26 (63.41%) initially had cutaneous involvement followed by mucosal involvement. In this study group 36 (87.80%) patients showed acantholytic cells on histopathological examination. Most patients of PV showed suprabasal blister 20 (62.50%) followed by intraspinous 5 (15.62%) and subcorneal 5 (15.62%) blister. In majority 28 (87.50%) of the PV patients IgG and C3 antibodies were deposited throughout the epidermis. The strength of antibody positivity was strong in most of the patients (71.87%). In cases of PF mostly IgG 6 (75%) antibodies were deposited in the upper epidermis. DIF intensity had poor correlation with disease activity/severity except in PF. Conclusion: Almost 85.36% cases of pemphigus were diagnosed clinicopathologically. But 6 cases couldn’t be diagnosed accurately on clinicopathological basis and in them DIF was confirmatory. Two cases of pure mucosal PV and 1 case of IgA pemphigus was confirmed by DIF. Two cases of bullous pemphigoid clinico-histologically mimicking PV were also excluded by DIF. So it appears from our study that DIF is confirmatory for diagnosis of pemphigus in all cases. PMID:27293249

Tonsillectomy remains a questionable option for pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS).

PubMed

Windfuhr, Jochen P

2016-01-01

Background: Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) is a disease attributed to children with obsessive compulsive disorders (OCD) or tic disorders associated with streptococcal infections. Because otolaryngologists examine a large number of pediatric patients with recurrent streptococcal infections, tonsillectomy (TE) is a common option of therapy. This study was conducted to evaluate the efficacy of TE in patients presenting with verified PANDAS. Material and methods: A PubMed review was performed using search terms "tonsillectomy" and "PANDAS", "OCD", "compulsive" "pediatric autoimmune", "chorea" and "tic" limited by publication date of January 1, 1995, to July 31, 2015. Reviews without patients were not included in the review. Results: Nine papers matched our search criteria, including 6 case reports with 8 patients and 3 case series. Most case reports were in favor of TE, but this was by far not supported by the findings in the case series. The follow-up ranged from 2 to 36 months in case reports and from 24 to 36 in case series. Conclusion: Establishing the diagnosis of PANDAS is complicated because of underlying comorbidities in the field of neurology-psychiatry and the lack of a reliable biomarker. The positive outcome after TE as reported in case studies may be influenced by the postoperative medication and is not supported by the results of large-scale studies. In the light of the considerable postoperative morbidity rate, it appears wise to indicate TE for PANDAS only in supervised clinical studies.

Examining DNA fingerprinting as an epidemiology tool in the tuberculosis program in the Northwest Territories, Canada

PubMed Central

Case, Cheryl; Kandola, Kami; Chui, Linda; Li, Vincent; Nix, Nancy; Johnson, Rhonda

2013-01-01

Background Tuberculosis (TB) is an important public health problem in the Northwest Territories (NWT), particularly among Canadian Aboriginal people. Objective To analyse the transmission patterns of tuberculosis among the population living in the NWT, a territorial jurisdiction located within Northern Canada. Methods This population-based retrospective study examined the DNA fingerprints of all laboratory confirmed cases of TB in the NWT, Canada, between 1990 and 2009. An isolate of each lab-confirmed case had genotyping done using IS6110 Restriction Fragment Length Polymorphism. DNA patterns were assigned to each DNA fingerprint, and indistinguishable fingerprints patterns were assigned a cluster. Social network analysis (SNA) was used to examine direct linkages among cases determined through conventional contact tracing (CCT), their DNA fingerprint and home community. Results Of the 225 lab-confirmed cases identified, the study was limited to 195 subjects due to DNA fingerprinting data availability. The mean age of the cases was 43.8 years (±22.6) and 120 (61.5%) males. The Dene (First Nations) encompassed 120 of the cases (87.7%), 8 cases (4.1%) were Inuit, 2 cases (1.0%) were Metis, 7 cases (3.6%) were Immigrants and 1 case had unknown ethnicity. One hundred and eighty six (95.4%) subjects were clustered, resulting in 8 clusters. Trend analysis showed significant relationships between with risk factors for unemployment (p=0.020), geographic location (p≤0.001) and homelessness (p≤0.001). Other significant risk factors included excessive alcohol consumption, prior infection with Mycobacterium tuberculosis and prior contact with a case of TB. Conclusions This study demonstrates how DNA fingerprinting and SNA can be additional epidemiological tools, along with CCT method, to determine transmission patterns of TB. PMID:23671837

Epidemiology of measles in vaccinated people, Spain 2003-2014.

PubMed

Risco-Risco, Carlos; Masa-Calles, Josefa; López-Perea, Noemí; Echevarría, Juan Emilio; Rodríguez-Caravaca, Gil

2017-11-01

During the final phase of measles elimination rigorous investigation of each individual case becomes fundamental to confirm or discard cases, particularly among vaccinated people, since they experience a milder disease, and laboratory diagnosis is more complex. Our study focused in the epidemiology of measles in vaccinated people. Longitudinal study on measles cases in two dose vaccinated people in Spain from 2003 to 2014. We confirmed 138 measles cases (90 of them, laboratory confirmed) in people with two doses of vaccine. The median of time from last vaccination to rash onset showed a lineal trend (P<.001), in parallel with the number of doses of vaccine received (0, 1, 2 doses). Among confirmed cases, the hospitalization risk decreased inversely proportional to the number of administered vaccine doses (linear trend, P<.001). Only in 23.9% of confirmed cases and 50% of discarded cases the guidelines about sample taking were fulfilled. 50% of samples in two dose vaccinated people were taken without fulfilling time delay criteria. 16.7% (36/215) of discarded cases with a negative IgM result did correspond to samples taken early (first 72h after rash) and could represent false negatives. Our results highlight the importance of fulfilling properly the guidelines for laboratory diagnosis in order to confirm or discard every measles case, especially in two dose vaccinated people. When a negative IgM result is obtained in early samples a new IgM test should be practiced, as well as a PCR test, in order to avoid infra-detection of cases. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Impact of Communication Errors in Radiology on Patient Care, Customer Satisfaction, and Work-Flow Efficiency.

PubMed

Siewert, Bettina; Brook, Olga R; Hochman, Mary; Eisenberg, Ronald L

2016-03-01

The purpose of this study is to analyze the impact of communication errors on patient care, customer satisfaction, and work-flow efficiency and to identify opportunities for quality improvement. We performed a search of our quality assurance database for communication errors submitted from August 1, 2004, through December 31, 2014. Cases were analyzed regarding the step in the imaging process at which the error occurred (i.e., ordering, scheduling, performance of examination, study interpretation, or result communication). The impact on patient care was graded on a 5-point scale from none (0) to catastrophic (4). The severity of impact between errors in result communication and those that occurred at all other steps was compared. Error evaluation was performed independently by two board-certified radiologists. Statistical analysis was performed using the chi-square test and kappa statistics. Three hundred eighty of 422 cases were included in the study. One hundred ninety-nine of the 380 communication errors (52.4%) occurred at steps other than result communication, including ordering (13.9%; n = 53), scheduling (4.7%; n = 18), performance of examination (30.0%; n = 114), and study interpretation (3.7%; n = 14). Result communication was the single most common step, accounting for 47.6% (181/380) of errors. There was no statistically significant difference in impact severity between errors that occurred during result communication and those that occurred at other times (p = 0.29). In 37.9% of cases (144/380), there was an impact on patient care, including 21 minor impacts (5.5%; result communication, n = 13; all other steps, n = 8), 34 moderate impacts (8.9%; result communication, n = 12; all other steps, n = 22), and 89 major impacts (23.4%; result communication, n = 45; all other steps, n = 44). In 62.1% (236/380) of cases, no impact was noted, but 52.6% (200/380) of cases had the potential for an impact. Among 380 communication errors in a radiology department, 37.9% had a direct impact on patient care, with an additional 52.6% having a potential impact. Most communication errors (52.4%) occurred at steps other than result communication, with similar severity of impact.

Coffee Consumption and the Risk of Thyroid Cancer: A Systematic Review and Meta-Analysis.

PubMed

Han, Mi Ah; Kim, Jin Hwa

2017-01-27

An inverse association has been reported between coffee consumption and the risk of several cancers. However, the association between coffee and thyroid cancer is controversial. Thus, this study aimed to evaluate the association between coffee consumption and the risk of thyroid cancer through a systematic review and meta-analysis. Published studies were examined from PubMed, Embase, Cochrane Central, and the reference lists of the retrieved articles. The summary odds ratio (OR) for the association between coffee consumption was categorized as highest versus lowest consumption, and thyroid cancer risk was calculated using a fixed effects model. Subgroup analyses by study design, geographic location, source of controls, and adjusted variables were performed. A total of 1039 thyroid cancer cases and 220,816 controls were identified from five case-control studies and two cohort studies. The summary OR for the association between coffee consumption and thyroid cancer risk was 0.88 (95% confidence interval (CI) = 0.71-1.07). There was no significant heterogeneity among the study results (I² = 0%, p = 0.79). However, the beneficial effect of coffee consumption on thyroid cancer was found only in hospital-based case-control studies (OR= 0.59, 95% CI= 0.37-0.93). There was no significant association between coffee consumption and thyroid cancer risk according to our meta-analysis results. These findings should be interpreted with caution because of potential biases and confounding variables. Further prospective studies with a larger number of cases are encouraged to confirm these results.

Neuroimaging findings in pediatric sports-related concussion.

PubMed

Ellis, Michael J; Leiter, Jeff; Hall, Thomas; McDonald, Patrick J; Sawyer, Scott; Silver, Norm; Bunge, Martin; Essig, Marco

2015-09-01

The goal in this review was to summarize the results of clinical neuroimaging studies performed in patients with sports-related concussion (SRC) who were referred to a multidisciplinar ypediatric concussion program. The authors conducted a retrospective review of medical records and neuroimaging findings for all patients referred to a multidisciplinary pediatric concussion program between September 2013 and July 2014. Inclusion criteria were as follows: 1) age ≤ 19 years; and 2) physician-diagnosed SRC. All patients underwent evaluation and follow-up by the same neurosurgeon. The 2 outcomes examined in this review were the frequency of neuroimaging studies performed in this population (including CT and MRI) and the findings of those studies. Clinical indications for neuroimaging and the impact of neuroimaging findings on clinical decision making were summarized where available. This investigation was approved by the local institutional ethics review board. A total of 151 patients (mean age 14 years, 59% female) were included this study. Overall, 36 patients (24%) underwent neuroimaging studies, the results of which were normal in 78% of cases. Sixteen percent of patients underwent CT imaging; results were normal in 79% of cases. Abnormal CT findings included the following: arachnoid cyst (1 patient), skull fracture (2 patients), suspected intracranial hemorrhage (1 patient), and suspected hemorrhage into an arachnoid cyst (1 patient). Eleven percent of patients underwent MRI; results were normal in 75% of cases. Abnormal MRI findings included the following: intraparenchymal hemorrhage and sylvian fissure arachnoid cyst (1 patient); nonhemorrhagic contusion (1 patient); demyelinating disease (1 patient); and posterior fossa arachnoid cyst, cerebellar volume loss, and nonspecific white matter changes (1 patient). Results of clinical neuroimaging studies are normal in the majority of pediatric patients with SRC. However, in selected cases neuroimaging can provide information that impacts decision making about return to play and retirement from the sport.

Inter-observer variability in the classification of ovarian cancer cell type using microscopy: a pilot study

NASA Astrophysics Data System (ADS)

Gavrielides, Marios A.; Ronnett, Brigitte M.; Vang, Russell; Seidman, Jeffrey D.

2015-03-01

Studies have shown that different cell types of ovarian carcinoma have different molecular profiles, exhibit different behavior, and that patients could benefit from typespecific treatment. Different cell types display different histopathology features, and different criteria are used for each cell type classification. Inter-observer variability for the task of classifying ovarian cancer cell types is an under-examined area of research. This study served as a pilot study to quantify observer variability related to the classification of ovarian cancer cell types and to extract valuable data for designing a validation study of digital pathology (DP) for this task. Three observers with expertise in gynecologic pathology reviewed 114 cases of ovarian cancer with optical microscopy, with specific guidelines for classifications into distinct cell types. For 93 cases all 3 pathologists agreed on the same cell type, for 18 cases 2 out of 3 agreed, and for 3 cases there was no agreement. Across cell types with a minimum sample size of 10 cases, agreement between all three observers was {91.1%, 80.0%, 90.0%, 78.6%, 100.0%, 61.5%} for the high grade serous carcinoma, low grade serous carcinoma, endometrioid, mucinous, clear cell, and carcinosarcoma cell types respectively. These results indicate that unanimous agreement varied over a fairly wide range. However, additional research is needed to determine the importance of these differences in comparison studies. These results will be used to aid in the design and sizing of such a study comparing optical and digital pathology. In addition, the results will help in understanding the potential role computer-aided diagnosis has in helping to improve the agreement of pathologists for this task.

Meta-analysis of thirty-two case-control and two ecological radon studies of lung cancer.

PubMed

Dobrzynski, Ludwik; Fornalski, Krzysztof W; Reszczynska, Joanna

2018-03-01

A re-analysis has been carried out of thirty-two case-control and two ecological studies concerning the influence of radon, a radioactive gas, on the risk of lung cancer. Three mathematically simplest dose-response relationships (models) were tested: constant (zero health effect), linear, and parabolic (linear-quadratic). Health effect end-points reported in the analysed studies are odds ratios or relative risk ratios, related either to morbidity or mortality. In our preliminary analysis, we show that the results of dose-response fitting are qualitatively (within uncertainties, given as error bars) the same, whichever of these health effect end-points are applied. Therefore, we deemed it reasonable to aggregate all response data into the so-called Relative Health Factor and jointly analysed such mixed data, to obtain better statistical power. In the second part of our analysis, robust Bayesian and classical methods of analysis were applied to this combined dataset. In this part of our analysis, we selected different subranges of radon concentrations. In view of substantial differences between the methodology used by the authors of case-control and ecological studies, the mathematical relationships (models) were applied mainly to the thirty-two case-control studies. The degree to which the two ecological studies, analysed separately, affect the overall results when combined with the thirty-two case-control studies, has also been evaluated. In all, as a result of our meta-analysis of the combined cohort, we conclude that the analysed data concerning radon concentrations below ~1000 Bq/m3 (~20 mSv/year of effective dose to the whole body) do not support the thesis that radon may be a cause of any statistically significant increase in lung cancer incidence.

Comparative study of control selection in a national population-based case-control study: Estimating risk of smoking on cancer deaths in Chinese men.

PubMed

Jiang, Jingmei; Liu, Boqi; Nasca, Philip C; Han, Wei; Zou, Xiaonong; Zeng, Xianjia; Tian, Xiaobing; Wu, Yanping; Zhao, Ping; Li, Junyao

2009-10-28

To assess the validation of a novel control selection design by comparing the consistency between the new design and a routine design in a large case-control study that was incorporated into a nationwide mortality survey in China. A nationwide mortality study was conducted during 1989-1991. Surviving spouses or other relatives of all adults who died during 1986-1988 provided detailed information about their own as well as the deceased person's smoking history. In this study, 130,079 males who died of various smoking-related cancers at age 35 or over were taken as cases, while 103,248 male surviving spouses (same age range with cases) of women who died during the same period and 49,331 males who died from causes other than those related to smoking were used as control group 1 and control group 2, respectively. Consistency in the results when comparing cases with each of the control groups was assessed. Consistency in the results was observed in the analyses using different control groups although cancer deaths varied with region and age. Equivalence could be ascertained using a 15% criterion in most cancer deaths which had high death rates in urban areas, but they were uncertain for most cancers in rural areas irrespective of whether the hypothesis testing showed significant differences or not. Sex-matched living spouse control design as an alternative control selection for a case-control study is valid and feasible, and the basic principles of the equivalence study are also supported by epidemiological survey data.

5D Super Yang-Mills on Y p, q Sasaki-Einstein Manifolds

NASA Astrophysics Data System (ADS)

Qiu, Jian; Zabzine, Maxim

2015-01-01

On any simply connected Sasaki-Einstein five dimensional manifold one can construct a super Yang-Mills theory which preserves at least two supersymmetries. We study the special case of toric Sasaki-Einstein manifolds known as Y p, q manifolds. We use the localisation technique to compute the full perturbative part of the partition function. The full equivariant result is expressed in terms of a certain special function which appears to be a curious generalisation of the triple sine function. As an application of our general result we study the large N behaviour for the case of single hypermultiplet in adjoint representation and we derive the N 3-behaviour in this case.

Global Lakes Sentinel Services: Monitoring Water Quality Trends in Deep, Clear Lakes to Detect Causes and Effects of Changes in Trophic Status

NASA Astrophysics Data System (ADS)

Poser, Kathrin; Peters, Steef; Hommersom, Annelies; Giardino, Claudia; Bresciani, Mariano; Cazzaniga, Ilaria; Schenk, Karin; Heege, Thomas; Philipson, Petra; Ruescas, Ana; Bottcher, Martin; Stelzer, Kerstin

2015-12-01

The GLaSS project develops a prototype infrastructure to ingest and process large amounts of Sentinel-2 and Sentinel-3 data for lakes and reservoirs. To demonstrate the value of satellite observations for the management of aquatic ecosystems, global case studies are performed addressing different types of lakes with their respective problems and management questions. One of these case studies is concentrating on deep clear lakes worldwide. The aim of this case study is to evaluate trends of chlorophyll-a concentrations (Chl-a) as a proxy of the trophic status based on the MERIS full resolution data archive. Some preliminary results of this case study are presented here.

Use of Fine Needle Aspirate from Peripheral Nerves of Pure-neural Leprosy for Cytology and Polymerase Chain Reaction to Confirm the Diagnosis: A Follow-up Study of 4 Years

PubMed Central

De, Abhishek; Hasanoor Reja, Abu Hena; Aggarwal, Ishad; Sen, Sumit; Sil, Amrita; Bhattacharya, Basudev; Sharma, Nidhi; Ansari, Asad; Sarda, Aarti; Chatterjee, Gobinda; Das, Sudip

2017-01-01

Background: Pure neural leprosy (PNL) still remains a diagnostic challenge because of the absence of sine qua non skin lesions of leprosy and a confirmatory diagnostic method. The authors had earlier described a simple yet objective technique of combining fine needle aspiration cytology (FNAC) coupled with a multiplex polymerase chain reaction (PCR) in a pilot study, wherein the technique showed promise of a reliable diagnostic tool. In the pursuit of further evidence, the authors carried out a 4-year study with PNL cases to find the efficacy and reliability of the said method in a larger sample size. Aim: This study was conducted to find the efficacy, reliability, and reproducibility of FNAC coupled with multiplex PCR and Ziehl-Neelsen (ZN) staining in identifying the cases of PNL. Materials and Methods: All cases that were suspected to be suffering from PNL, following evaluation by two independent observers were included in the study and were subjected to FNAC from the affected nerve, and the aspirates were evaluated for cytology, ZN staining, and multiplex PCR for Mycobacterium leprae genome. In addition, serum anti-PGL1 levels were also performed in all the study subjects. Fifteen non-PNL cases were also included in the control arm. Results: A total of 47 cases were included in the test arm and subjected to FNAC. Conventional ZN staining could demonstrate acid-fast bacilli (AFB) in only 15 out of 47 cases (31.91%) while M. leprae DNA could be elicited in 37 (78.72%) cases by the multiplex PCR. Only 13 (27.65%) out of 47 cases showed anti-PGLI-1 antibody positivity. On cytological examination of the nerve aspirates, only 11 (23.40%) cases showed epithelioid cells whereas nonspecific inflammation was seen in 26 (75.60%) cases. Conclusion: The results of this study conducted over a larger sample size corroborate with the findings of our pilot study. In a resource poor set up, FNAC in combination with ZN staining and multiplex PCR is a rapid, simple, and easily performed test, which can give a reproducible and objective diagnosis in cases of PNL. PMID:29263539

Evolving the ECSS Standards and their Use: Experience Based on Industrial Case Studies

NASA Astrophysics Data System (ADS)

Feldt, R.; Ahmad, E.; Raza, B.; Hult, E.; Nordebäck, T.

2009-05-01

This paper introduces two case studies conducted at two Swedish companies developing software for the space industry. The overall goal of the project is to evaluate if current use of ECSS is cost efficient and if there are ways to make the process leaner while maintaining quality. The case studies reported on here focused on how the ECSS standard was used by the companies and how that affected software development processes and software quality. This paper describes the results and recommendations based on identified challenges.

Candidemia in neonatal intensive care units: Barcelona, Spain.

PubMed

Rodriguez, Dolors; Almirante, Benito; Park, Benjamin J; Cuenca-Estrella, Manuel; Planes, Ana M; Sanchez, Ferran; Gene, Amadeu; Xercavins, Mariona; Fontanals, Dionisia; Rodriguez-Tudela, Juan L; Warnock, David W; Pahissa, Albert

2006-03-01

Candida spp. are increasingly important hospital-acquired pathogens in neonatal intensive care units (NICU) and cause considerable mortality in preterm infants. Most studies have been limited to a single institution. The aim of this study was to determine the epidemiology of candidemia in all Barcelona NICUs. We conducted prospective population-based surveillance for candidemia in Barcelona, Spain, during 2002-2003. This report focuses on the results from 5 participating hospitals with NICUs. We detected 24 cases, resulting in an annual incidence of 32.6 cases per 100,000 live births and 1.1 cases per 100 NICU discharges. Median gestational age was 27.5 weeks (range, 24-40.5), and there were 21 cases among very low birth weight infants. Among the 20 (83%) cases evaluated for the presence of end organ infection, endophthalmitis occurred in 2 cases, and endocarditis, meningitis and peritonitis occurred in 1 case each. Candida parapsilosis was the most frequent species isolated (67%). All isolates were fluconazole-susceptible. Crude mortality was 21%. The preponderance of C. parapsilosis candidemias observed in Barcelona NICUs is similar to reports from the literature. Morbidity and mortality associated with neonatal candidemia remain high.

Influencing factors of functional result and bone union in tibiotalocalcaneal arthrodesis with intramedullary locking nail: a retrospective series of 30 cases.

PubMed

Gross, Jean-Baptiste; Belleville, Rémi; Nespola, Arnaud; Poircuitte, Jean-Manuel; Coudane, Henry; Mainard, Didier; Galois, Laurent

2014-05-01

Initially considered as an established salvage procedure for tibiotalocalcaneal arthrodesis (TTCA), intramedullary nailing indications have expanded as evidenced in recent literature. We have tried to identify factors influencing functional result and bone union. In a retrospective study, 30 patients were treated by a TTCA between January 2006 and November 2011. Indications, operative technique, bone fusion, X-rays and functional result [American Foot and Ankle Society (AOFAS) and short-form health survey (SF-36) scores] before and after surgery were registered and analyzed. Thirty cases of TTCA were included. The patient's average age was 52 (range 24-90). Union rate was 86% for the tibiotalar joint and 74% for the subtalar joint with an average follow-up of 25.4 months (8-67). The mean AOFAS' score significantly improved (from 37 to 59) as the SF-36' score. Global complication rate was about 56%. It has not been possible to identify factors significantly influencing bone fusion or functional results. All septic cases achieved fusion without any septic resurgence. Retrograde intramedullary nailing in TTCA is an effective technique, which allows good clinical results even in case of septic history of the patient. Fusion rate and functional results were not significantly influenced by any of the factors examined in this study.

Evaluation of coexistence of cancer and active tuberculosis; 16 case series.

PubMed

Çakar, Beyhan; Çiledağ, Aydın

2018-01-01

Tuberculosis is an important risk factor for cancer. Pulmonary TB and lung cancer(LC) may mimic each other especially in the aspect of the clinical and radiological features. The aim of the study was to evaluate the features and risk factors of cases with coexistence cancer and active TB. We retrospectively reviewed the medical records of patients with coexisting TB and cancer a period from 2009 to 2014. We evaluated demographic data, the ways diagnosis of TB cases, the location of TB and cancer, TB treatment results of the cases. We recorded 374 TB cases in our dyspensary at this study period. In 16 (4%) of these cases, a coexistence of cancer and TB was detected. The male/female ratio was 12/4. The mean age was 62,12 ± 15,13 years. There were TST results except three cases. There were ten pulmonary TB and six extra-pulmonary TB (four peripheral lymphadenopathy TB, one abdominal TB lymphadenopathy and one salivary gland TB). Cancer types were as follows; eight lung cancer, two breast cancer, one base of tongue, one endometrium cancer, one hypopharyngeal cancer, one stomach cancer, one bladder cancer and one maxillary cancer. Diagnosis of all cases was confirmed by bacteriologic and/or histopathological examination. Squamous cell carcinoma was the most common type of cancers. This rate was 9/16. All TB cases were new. There were risk factors out of two case in the cases. Five cases were died during TB treatment. Others completed TB treatment without any complication. In our study, the coexistence of LC and pulmonary TB was more common. The local immunity is deteriorated in cancer cases. If there is pulmonary infiltrates in lung or peripheral lymphadenopathy, we must search tuberculosis too out of metastatic lesion and other infectious diseases. We should not make delay in the diagnosis of active TB in cancer cases.

Evaluating psychiatric case-control studies using the STROBE (STrengthening the Reporting of OBservational Studies in Epidemiology) statement.

PubMed

Goi, Pedro Domingues; Goi, Julia Domingues; Cordini, Kariny Larissa; Ceresér, Keila Mendes; Rocha, Neusa Sica da

2014-01-01

Case-control studies are important in developing clinical and public health knowledge. The STROBE statement (STrengthening the Reporting of OBservational Studies in Epidemiology) was developed to establish a checklist of items that should be included in articles reporting observational studies. Our aim was to analyze whether the psychiatric case-control articles published in Brazilian journals with CAPES Qualis rating B1/B2 in 2009 conformed with the STROBE statement. Descriptive study on psychiatric papers published in Brazilian journals, within the Postgraduate Medical Program on Psychiatry, at Universidade Federal do Rio Grande do Sul. All psychiatric case-control studies from Brazilian Qualis B1/B2 journals of psychiatry, neurology and public health in 2009 were analyzed. The four most specific items of the STROBE statement were used to evaluate whether these studies fitted within the case-control parameters: 1) selection of cases and controls; 2) controlling for bias; 3) statistical analysis; and 4) presentation of results. Sixteen case-control studies were identified, of which eleven (68.75%) were in psychiatry-focused journals. From analysis using the STROBE statement, all of the articles conformed with item 1; two (12.5%) completely conformed with item 2; none completely conformed with item 3; and only three (18.8%) conformed with item 4. The case-control studies analyzed here did not completely conform with the four STROBE statement items for case-control design. In view of the inadequate methodology of the published studies, these findings justify focusing on research and methodology and expanding the investigations on adherence of studies to their designs.

The influence of flexible management practices on the sharing of experiential knowledge in the workplace: a case study of food service helpers.

PubMed

Ledoux, Elise; Cloutier, Esther; Fournier, Pierre-Sébastien

2012-01-01

Previous studies have shown that the job knowledge and prudent knowledge of experienced workers constitute a wealth that needs to be shared in workplaces to promote worker integration, job retention and occupational health and safety. It appears, however, that certain management practices undermine this knowledge sharing process. This case study of food service helpers in institutional food service departments is part of a research project aimed at comparing the impact of different work organization methods on knowledge sharing in the workplace on the basis of case studies carried out in several organizations. The results of this case study reveal that by destabilizing and weakening the work teams, flexible management practices create an environment that is not conducive to experiential knowledge sharing.

Bayesian approach to the assessment of the population-specific risk of inhibitors in hemophilia A patients: a case study

PubMed Central

Cheng, Ji; Iorio, Alfonso; Marcucci, Maura; Romanov, Vadim; Pullenayegum, Eleanor M; Marshall, John K; Thabane, Lehana

2016-01-01

Background Developing inhibitors is a rare event during the treatment of hemophilia A. The multifacets and uncertainty surrounding the development of inhibitors further complicate the process of estimating inhibitor rate from the limited data. Bayesian statistical modeling provides a useful tool in generating, enhancing, and exploring the evidence through incorporating all the available information. Methods We built our Bayesian analysis using three study cases to estimate the inhibitor rates of patients with hemophilia A in three different scenarios: Case 1, a single cohort of previously treated patients (PTPs) or previously untreated patients; Case 2, a meta-analysis of PTP cohorts; and Case 3, a previously unexplored patient population – patients with baseline low-titer inhibitor or history of inhibitor development. The data used in this study were extracted from three published ADVATE (antihemophilic factor [recombinant] is a product of Baxter for treating hemophilia A) post-authorization surveillance studies. Noninformative and informative priors were applied to Bayesian standard (Case 1) or random-effects (Case 2 and Case 3) logistic models. Bayesian probabilities of satisfying three meaningful thresholds of the risk of developing a clinical significant inhibitor (10/100, 5/100 [high rates], and 1/86 [the Food and Drug Administration mandated cutoff rate in PTPs]) were calculated. The effect of discounting prior information or scaling up the study data was evaluated. Results Results based on noninformative priors were similar to the classical approach. Using priors from PTPs lowered the point estimate and narrowed the 95% credible intervals (Case 1: from 1.3 [0.5, 2.7] to 0.8 [0.5, 1.1]; Case 2: from 1.9 [0.6, 6.0] to 0.8 [0.5, 1.1]; Case 3: 2.3 [0.5, 6.8] to 0.7 [0.5, 1.1]). All probabilities of satisfying a threshold of 1/86 were above 0.65. Increasing the number of patients by two and ten times substantially narrowed the credible intervals for the single cohort study (1.4 [0.7, 2.3] and 1.4 [1.1, 1.8], respectively). Increasing the number of studies by two and ten times for the multiple study scenarios (Case 2: 1.9 [0.6, 4.0] and 1.9 [1.5, 2.6]; Case 3: 2.4 [0.9, 5.0] and 2.6 [1.9, 3.5], respectively) had a similar effect. Conclusion Bayesian approach as a robust, transparent, and reproducible analytic method can be efficiently used to estimate the inhibitor rate of hemophilia A in complex clinical settings. PMID:27822129

Exploring the Factors That Influence Female Students' Decision to (Not) Enrol in Elective Physical Education: A Private School Case Study

ERIC Educational Resources Information Center

Kiley, Jill; Robinson, Daniel Bruce

2016-01-01

This article presents the results from a qualitative case study that examined the influencers upon a somewhat unique group of female students who opted out of elective physical education (PE). More specifically, this study focused upon female students attending an affluent private school, investigating why--when they transitioned from middle…

Academic English Teaching for Postgraduates Based on Self-Regulated Learning Environment: A Case Study of Academic Reading Course

ERIC Educational Resources Information Center

Zhao, Wei

2016-01-01

This study selects postgraduate students in the first grade as the participants, based on their needs analysis, classroom presentations and performance of assignments completion, through the methodology of case study, the results show that students at the university level even the graduate levels still struggle with academic English. Thus, this…

Fostering Interdisciplinary Research in Universities: A Case Study of Leadership, Alignment and Support

ERIC Educational Resources Information Center

Townsend, Tony; Pisapia, John; Razzaq, Jamila

2015-01-01

The aim of this paper is to describe actions designed to foster interdisciplinary research efforts at a major university in the UK. The study employed a descriptive mixed method case study approach to collecting and analysing the data used to draw its conclusions. One hundred and twenty-seven academic staff responded to the survey. The results of…

A Case Study of the Implementation of Conflict Resolution in a Second Grade Classroom.

ERIC Educational Resources Information Center

LeBlanc, Patrice R.; Lacey, Candace; Adler, Alison

This case study evaluated a second grade teacher and her students and the implementation of a conflict resolution program in the classroom; the goals of the evaluation were to provide descriptive data on the success or failure of the program and why those results occurred, and to make recommendations for program improvement. The study used…

Identifying the Local Impacts of National ATE Centers on Their Host Institutions: An Exploratory Study

ERIC Educational Resources Information Center

Henderson, Charles; Fynewever, Herb; Petcovic, Heather; Bierema, Andrea

2012-01-01

The purpose of this study is to identify the local impacts of national advanced technological education (ATE) centers on their host institutions. A sample of three mature, national ATE centers are chosen, with each center serving as a case for a mixed-methods, collective case study research design. Results, drawn from interviews and surveys,…

Environmental Comfort in School Buildings: A Case Study of Awareness and Participation of Users

ERIC Educational Resources Information Center

Bernardi, Nubia; Kowaltowski, Doris C. C. K.

2006-01-01

This article describes the results of a study on user behavior in relation to environmental comfort conditions. A case study was conducted in school buildings in the region of the city of Campinas, So Paulo, Brazil. The methodology adopted was based on field observations of technical aspects of the school environment and of types of user behavior…

Nutrition and Its Effects on the Hyperkinetic Child's Behavior and Learning: A Case Study.

ERIC Educational Resources Information Center

Noonan, Roberta L.

This case study reviews the literature related to diet, behavior and learning and describes procedures and results of a change in the diet of an adolescent girl who had an extensive history of problems at home and at school. Studies of nutritional deficiency, nutritional imbalance, allergies, and synthetic food additives are briefly overviewed.…

Culturally and Linguistically Responsive Teaching in Practice: A Case Study of a Fourth-Grade Mainstream Classroom Teacher

ERIC Educational Resources Information Center

Zhang-Wu, Qianqian

2017-01-01

As a result of increases in immigration, more students from culturally and linguistically diverse backgrounds are entering K-12 classrooms in the United States. Thus, the need to study the education of diverse learners is intensified. Drawing upon semi-structured interviews, observations, and informal conversations, this case study examined how a…

External Evaluation of Education and Teacher Work: The Brazilian Case

ERIC Educational Resources Information Center

Rothen, José Carlos; da Cunha Malheiros Santana, Andréia

2015-01-01

This article aims to discuss whether external evaluations are instruments to ensure increased quality of public school education. It is part of a research that investigated how evaluation results and the resulting indices were used in two schools in the state of São Paulo (Brazil). The methodology adopted was the case study, using different…

Analysis of Forensic Autopsy in 120 Cases of Medical Disputes Among Different Levels of Institutional Settings.

PubMed

Yu, Lin-Sheng; Ye, Guang-Hua; Fan, Yan-Yan; Li, Xing-Biao; Feng, Xiang-Ping; Han, Jun-Ge; Lin, Ke-Zhi; Deng, Miao-Wu; Li, Feng

2015-09-01

Despite advances in medical science, the causes of death can sometimes only be determined by pathologists after a complete autopsy. Few studies have investigated the importance of forensic autopsy in medically disputed cases among different levels of institutional settings. Our study aimed to analyze forensic autopsy in 120 cases of medical disputes among five levels of institutional settings between 2001 and 2012 in Wenzhou, China. The results showed an overall concordance rate of 55%. Of the 39% of clinically missed diagnosis, cardiovascular pathology comprises 55.32%, while respiratory pathology accounts for the remaining 44. 68%. Factors that increase the likelihood of missed diagnoses were private clinics, community settings, and county hospitals. These results support that autopsy remains an important tool in establishing causes of death in medically disputed case, which may directly determine or exclude the fault of medical care and therefore in helping in resolving these cases. © 2015 American Academy of Forensic Sciences.

Performance factors of mobile rich media job aids for community health workers

PubMed Central

Florez-Arango, Jose F; Dunn, Kim; Zhang, Jiajie

2011-01-01

Objective To study and analyze the possible benefits on performance of community health workers using point-of-care clinical guidelines implemented as interactive rich media job aids on small-format mobile platforms. Design A crossover study with one intervention (rich media job aids) and one control (traditional job aids), two periods, with 50 community health workers, each subject solving a total 15 standardized cases per period per period (30 cases in total per subject). Measurements Error rate per case and task, protocol compliance. Results A total of 1394 cases were evaluated. Intervention reduces errors by an average of 33.15% (p=0.001) and increases protocol compliance 30.18% (p<0.001). Limitations Medical cases were presented on human patient simulators in a laboratory setting, not on real patients. Conclusion These results indicate encouraging prospects for mHealth technologies in general, and the use of rich media clinical guidelines on cell phones in particular, for the improvement of community health worker performance in developing countries. PMID:21292702

The comparison of pyrosequencing molecular Gram stain, culture, and conventional Gram stain for diagnosing orthopaedic infections.

PubMed

Kobayashi, Naomi; Bauer, Thomas W; Tuohy, Marion J; Lieberman, Isador H; Krebs, Viktor; Togawa, Daisuke; Fujishiro, Takaaki; Procop, Gary W

2006-08-01

We have developed a combined real-time PCR and pyrosequencing assay that successfully differentiated the vast majority of gram-positive and gram-negative bacteria when bacterial isolates were tested. The purpose of this study was to evaluate this assay on clinical specimens obtained from orthopedic surgeries, and to prospectively compare the results of "molecular Gram stain" with culture and conventional direct Gram stain. Forty-five surgical specimens were obtained from patients who underwent orthopedic surgery procedures. The DNA was extracted and a set of broad-range PCR primers that targeted a part of the 16S rDNA gene was used for pan-bacterial PCR. The amplicons were submitted for pyrosequencing and the resulting molecular Gram stain characteristics were recorded. Culture and direct Gram staining were performed using standard methods for all cases. Surgical specimens were reviewed histologically for all cases that had a discrepancy between culture and molecular results. There was an 86.7% (39/45) agreement between the traditional and molecular methods. In 12/14 (85.7%) culture-proven cases of bacterial infection, molecular Gram stain characteristics were in agreement with the culture results, while the conventional Gram stain result was in agreement only for five cases (35.7%). In the 31 culture negative cases, 27 cases were also PCR negative, whereas 4 were PCR positive. Three of these were characterized as gram negative and one as gram positive by this molecular method. Molecular determination of the Gram stain characteristics of bacteria that cause orthopedic infections may be achieved, in most instances, by this method. Further studies are necessary to understand the clinical importance of PCR-positive/culture-negative results.

The struggle for schizophrenia treatment: A case study.

PubMed

Kozlowski-Gibson, Maria

Individual of legal age with schizophrenia presenting anosognosia was abandoned, as a result of a court decision. Close family members were not allowed to provide medical follow-up, treatment, protection regarding his vulnerability, and preserve the dignity of their loved one. The issue was the court's prioritization of the autonomy of the individual over his mental health status. The purpose of this case study was to identify the pitfalls of a court case seeking medical follow-up and treatment for a family member with schizophrenia and anosognosia. The method was qualitative and the design was descriptive and instrumental, linking the law to the life experience resulting from the procedures for its implementation. This study examined the difference between clinical and medical-legal evaluation of the examinee. The application of the Therapeutic Jurisprudence principles to the high number of schizophrenia cases with anosognosia, the abandonment of the mentally ill, and family crisis call healthcare providers and the Judiciary for an improvement action of the process of guardianship. Copyright © 2016 Elsevier Ltd. All rights reserved.

Association between subthalamic nucleus deep brain stimulation and weight gain: Results of a case-control study.

PubMed

Strowd, Roy E; Herco, Maja; Passmore-Griffin, Leah; Avery, Bradley; Haq, Ihtsham; Tatter, Stephen B; Tate, Jessica; Siddiqui, Mustafa S

2016-01-01

To evaluate whether weight change in patients with Parkinson's disease (PD) is different in those undergoing deep brain stimulation (DBS) of the subthalamic nucleus (STN) compared to those not undergoing DBS. A retrospective case-control study was performed in PD patients who had undergone STN DBS (cases) compared to matched PD patients without DBS (controls). Demographic and clinical data including Unified Parkinson's Disease Rating Scale (UPDRS) motor scores were collected. Repeated measures mixed model regression was used to identify variables associated with weight gain. Thirty-five cases and 34 controls were identified. Baseline age, gender, diagnosis and weight were similar. Duration of diagnosis was longer in cases (6.3 vs 4.9 years, p=0.0015). At 21.3 months, cases gained 2.9 kg (+4.65%) while controls lost 1.8 kg (-3.05%, p<0.02). Postoperative UPDRS motor scores improved by 49% indicating surgical efficacy. Only younger age (p=0.0002) and DBS (p=0.008) were significantly associated with weight gain. In this case-control study, PD patients undergoing STN DBS experienced post-operative weight gain that was significantly different from the weight loss observed in non-DBS PD controls. Patients, especially overweight individuals, should be informed that STN DBS can result in weight gain. Copyright © 2015 Elsevier B.V. All rights reserved.

Adjusting for outcome misclassification: the importance of accounting for case-control sampling and other forms of outcome-related selection.

PubMed

Jurek, Anne M; Maldonado, George; Greenland, Sander

2013-03-01

Special care must be taken when adjusting for outcome misclassification in case-control data. Basic adjustment formulas using either sensitivity and specificity or predictive values (as with external validation data) do not account for the fact that controls are sampled from a much larger pool of potential controls. A parallel problem arises in surveys and cohort studies in which participation or loss is outcome related. We review this problem and provide simple methods to adjust for outcome misclassification in case-control studies, and illustrate the methods in a case-control birth certificate study of cleft lip/palate and maternal cigarette smoking during pregnancy. Adjustment formulas for outcome misclassification that ignore case-control sampling can yield severely biased results. In the data we examined, the magnitude of error caused by not accounting for sampling is small when population sensitivity and specificity are high, but increases as (1) population sensitivity decreases, (2) population specificity decreases, and (3) the magnitude of the differentiality increases. Failing to account for case-control sampling can result in an odds ratio adjusted for outcome misclassification that is either too high or too low. One needs to account for outcome-related selection (such as case-control sampling) when adjusting for outcome misclassification using external information. Copyright © 2013 Elsevier Inc. All rights reserved.

Clinical significance of atypical glandular cells in Pap tests: An analysis of more than 3000 cases at a large academic women's center.

PubMed

Pradhan, Dinesh; Li, Zaibo; Ocque, Rebecca; Patadji, Stell; Zhao, Chengquan

2016-08-01

The interpretation of atypical glandular cells (AGC) in Papanicolaou (Pap) tests and screening for glandular neoplasia remain challenging. Pap tests with an AGC interpretation from January 2008 to December 2013 were retrieved from a pathology database, and cases with histologic follow-up within 1 year were included in the study. There were 589,830 Pap tests during the study period, and 3709 cases (0.6%) were reported as AGC, which included the following: AGC, not otherwise specified (52.0%); atypical endocervical cells (28.0%); and other categories. There were 3007 cases (81.1%) with histologic follow-up results within 1 year. Cervical intraepithelial neoplasia 2/3 (CIN2/3), cervical adenocarcinoma in situ (AIS)/adenocarcinoma, and endometrial carcinoma were identified in 5.6%, 1.9%, and 5.5% of cases, respectively. Glandular neoplasia was more likely to be identified in cases with pure AGC subcategories than cases with AGC and squamous abnormalities. Endometrial neoplasia was more likely to be identified in cases with atypical endometrial cells than other categories. Overall, the most common severe abnormality on histologic follow-up was CIN2/3. Although CIN2/3 was the most common severe lesion in patients younger than 30 years (10.0%) and in patients aged 30 to 49 years (6.4%), endometrial carcinoma was the most common lesion in women who were 50 years old or older (13.7%). Endocervical glandular lesions (AIS and adenocarcinoma) occurred in only 1.9% of women. AGC subtypes and ages significantly affect histological follow-up results; 90.5% of cases with carcinoma on histologic follow-up were either endometrial or metastatic carcinoma. This study supports the recommendation that women with AGC Pap test results should be followed up with both endocervical and endometrial sampling. Cancer Cytopathol 2016;124:589-95. © 2016 American Cancer Society. © 2016 American Cancer Society.

The association of extreme temperatures and the incidence of tuberculosis in Japan

NASA Astrophysics Data System (ADS)

Onozuka, Daisuke; Hagihara, Akihito

2015-08-01

Seasonal variation in the incidence of tuberculosis (TB) has been widely assumed. However, few studies have investigated the association between extreme temperatures and the incidence of TB. We collected data on cases of TB and mean temperature in Fukuoka, Japan for 2008-2012 and used time-series analyses to assess the possible relationship of extreme temperatures with TB incident cases, adjusting for seasonal and interannual variation. Our analysis revealed that the occurrence of extreme heat temperature events resulted in a significant increase in the number of TB cases (relative risk (RR) 1.20, 95 % confidence interval (CI) 1.01-1.43). We also found that the occurrence of extreme cold temperature events resulted in a significant increase in the number of TB cases (RR 1.23, 95 % CI 1.05-1.45). Sex and age did not modify the effect of either heat or cold extremes. Our study provides quantitative evidence that the number of TB cases increased significantly with extreme heat and cold temperatures. The results may help public health officials predict extreme temperature-related TB incidence and prepare for the implementation of preventive public health interventions.

An evaluation of clinical, radiological and three-dimensional dental tomography findings in ectodermal dysplasia cases

PubMed Central

Doğan, Mehmet-Sinan; Callea, Michele; Aksoy, Orhan; Clarich, Gabriella; Günay, Ayşe; Günay, Ahmet; Güven, Sedat; Maglione, Michele; Akkuş, Zeki

2015-01-01

Background This study aimed to review the results related to head and jaw disorders in cases of ectodermal dysplasia. The evaluation of ectodermal dysplasia cases was made by clincal examination and examination of the jaw and facial areas radiologically and on cone-beam 3-dimensional dental tomography (CBCT) images. Material and Methods In the 36 cases evaluated in the study, typical clinical findings of pure hypohidrotic ectodermal displasia (HED) were seen, such as missing teeth, dry skin, hair and nail disorders. CBCT images were obtained from 12 of the 36 cases, aged 1.5- 45 years, and orthodontic analyses were made on these images. Results The clinical and radiological evaluations determined, hypodontia or oligodontia, breathing problems, sweating problems, a history of fever, sparse hair, saddle nose, skin peeling, hypopigmentation, hyperpigmentation, finger and nail deformities, conical teeth anomalies, abnormal tooth root formation, tooth resorption in the root, gingivitis, history of epilepsy, absent lachrymal canals and vision problems in the cases which included to the study. Conclusions Ectodermal dysplasia cases have a particular place in dentistry and require a professional, multi-disciplinary approach in respect of the chewing function, orthognathic problems, growth, oral and dental health. It has been understood that with data obtained from modern technologies such as three-dimensional dental tomography and the treatments applied, the quality of life of these cases can be improved. Key words: Ectodermal dysplasia, three-dimensional dental tomography. PMID:25662550

Alveolar ridge keratosis - a retrospective clinicopathological study

PubMed Central

2013-01-01

Background Alveolar ridge keratosis (ARK) is a distinct, benign clinicopathological entity, characterized by a hyperkeratotic plaque or patch that occurs on the alveolar edentulous ridge or on the retromolar trigone, considered to be caused by chronic frictional trauma. The aim of this retrospective study is to present the clinicopathological features of 23 consecutive cases of ARK. Material and methods The 23 biopsy samples of ARK were selected and pathological features were revised (keratosis, acanthosis, surface architecture, and inflammation). Factors such as the patient’s gender, age, anatomical location, tobacco and alcohol use were analyzed. Results Sixteen out of the 23 cases studied were men and 7 women with a mean age of 55.05 (age ranged from 17 to 88 years). Thirteen cases had a history of tobacco habit, amongst whom, 4 also presented alcohol consumption. All the cases presented only unilateral lesions. Nineteen cases involved the retromolar trigone while 4 cases involved edentulous alveolar ridges. When observed microscopically, the lesions were mainly characterized by moderate to important hyperorthokeratosis. Inflammation was scanty or absent. In four of the cases, the presence of melanin pigment in the superficial corium or in the cytoplasm of macrophages was detected. None of the cases showed any features of dysplasia. Conclusion Our results reveal that ARK is a benign lesion. However, the high prevalence of smokers amongst the patients might suggest that some potentially malignant disorders such as tobacco associated leukoplakia may clinically mimic ARK. PMID:23587097

Immunohistochemical study of p21 and Bcl-2 in leukoplakia, oral submucous fibrosis and oral squamous cell carcinoma.

PubMed

Sutariya, Rakesh V; Manjunatha, Bhari Sharanesha

2016-11-01

Oral Squamous cell carcinoma (OSCC) results from genetic damage, leading to uncontrolled cell proliferation of damaged cells and the cell death. In the course of its progression, visible changes are taking place at the cellular level (atypical) and the resultant at the tissue level (epithelial dysplasia). The Aim of the present study was to evaluate and compare the expressions of intensity of p21 and Bcl-2 in Leukoplakia, oralsubmucous fibrosis (OSMF) and oral squamous cell carcinoma. Total 60 cases, 30 cases of oral squamous cell carcinoma, 15 cases of oral submucous fibrosis and 15 cases of Leukoplakia were evaluated immunohistochemically for p21 and Bcl-2 expression. p21 showed positive expression in 13 (86.67%) cases out of 15 cases of OSMF, 12 (80%) cases of leukoplakia out of 15 cases and 24 (80%) cases out of 30 cases of OSCC. The Bcl-2 expression was positive in 13 (86.67%) cases of OSMF, all cases of Leukoplakia and 25 (83.33%) cases of OSCC. No statistical significance was noted in the expression of p21 and Bcl-2 positive expression between OSMF, Leukoplakia and OSCC. Statistical analysis for comparison of intensity of p21 expression in different grades of OSCC showed no significance. Statistical significance difference was found between the expressions of Bcl-2 in moderately and poorly differentiated SCC. The intensity of p21 and Bcl-2 expressions in different grades of OSCC indicates a key role in progression of oral neoplasia.

Vehicle exhaust exposure in an incident case-control study of adult asthma.

PubMed

Modig, L; Järvholm, B; Rönnmark, E; Nyström, L; Lundbäck, B; Andersson, C; Forsberg, B

2006-07-01

The objective of this case-control study was to evaluate whether traffic-related air pollution exposure at home increases the risk of asthma in adults and to compare two commonly used exposure variables and differences between urban and rural living. Incident cases of asthma and matched controls of subjects aged 20-60 yrs were recruited in Luleå, Sweden. In total 203 cases and 203 controls were enrolled in the study. Exposure was estimated by traffic flow and measured levels of outdoor nitrogen dioxide (NO2) in the surrounding environment of each home, respectively. The relationship between measured levels of NO2 and traffic flow was studied using linear regression. The results indicated a nonsignificant tendency between living in a home close to a high traffic flow and an increased risk of asthma. The association between asthma and measured NO2 was weak and not significant, but the skin-prick test result acted as an effect modifier with a borderline significant association among positives. The correlation between traffic flow and outdoor NO2 was low. The results suggest that living close to high traffic flows might increase the asthma incidence in adults, while the tendency for nitrogen dioxide was only seen among atopics. Traffic flow and nitrogen dioxide had a lower than expected correlation.

Comparison of the Delay in Processing Time and Protective Plastic Cases in Two Phosphor Plate Systems

PubMed Central

Aktan, Ali Murat; Çiftçi, Mehmet Ertuğrul; Akgünlü, Faruk

2012-01-01

Objective. The purpose of this study was to analyze two phosphor plate systems (PSPs) (Dürr Dental, Digora Optime) according to their scanning delay and protective plastic case performances. Methods. Two PSPs using an aluminum step wedge were exposed. These plates were placed in three different protective plastic cases (manufacturers' original cases, black case, and white case) before obtaining the radiographs and were then processed immediately and 1, 5, 10, 30, 60, 120, 240, and 480 min after exposure. Mean gray values (MGVs) of the 3rd, 5th, 7th, and 9th steps of the wedges were compared using ANOVA. Results. Statistically significant differences were found between the two PSPs (P < 0.001). ANOVA revealed that the MGVs of four steps of the wedges were significantly different from each other for all scan delays (P < 0.001). MGVs increased with increasing scanning delay, except the group with Dürr plates in their original cases. Reduction in image quality began 5 min after exposure in the other Dürr plate groups. Conclusions. Within the limitations of the current study, it can be concluded that scanning delay causes a reduction in image quality, and using the manufacturer's original protective case will result in better performance of PSPs. PMID:23213301

Household transmission of SARS, 2003

PubMed Central

Wilson-Clark, Samantha D.; Deeks, Shelley L.; Gournis, Effie; Hay, Karen; Bondy, Susan; Kennedy, Erin; Johnson, Ian; Rea, Elizabeth; Kuschak, Theodore; Green, Diane; Abbas, Zahid; Guarda, Brenda

2006-01-01

Background In the 2003 outbreak in Toronto (in Ontario, Canada) of severe acute respiratory syndrome (SARS), about 20% of cases resulted from household transmission. The purpose of our study was to determine characteristics associated with the transmission of SARS within households. Methods A retrospective cohort of SARS-affected households was studied to determine risk factors for household transmission. Questionnaires addressed characteristics of the index case, the household and behaviours among household members. Potential risk factors for secondary transmission of infection were assessed in regression models appropriate to the outcome (secondary cases) and nonindependence of household members. Results The 74 households that participated included 18 secondary cases and 158 uninfected household members in addition to the 74 index cases. The household secondary attack rate was 10.2% (95% confidence interval [CI] 6.7%–23.5%). There was a linear association between the time the index patient spent at home after symptom onset and the secondary attack rate. Infected health care workers who were index cases had lower rates of household transmission. Interpretation SARS transmission in households is complex and increases with the length of time an ill person spends at home. Risk of transmission was lower when the index case was a health care worker. Rapid case identification is the public health measure most useful in minimizing exposure in the home. PMID:17098951

Neural differences in processing of case particles in Japanese: an fMRI study

PubMed Central

Hashimoto, Yosuke; Yokoyama, Satoru; Kawashima, Ryuta

2014-01-01

Introduction In subject–object–verb (SOV) languages, such as Japanese, sentence processing proceeds incrementally to the late presentation of the head (verb). Japanese case particles play a crucial role in sentence processing; however, little is known about how these particles are processed. In particular, it is still unclear how the functional difference between case particles is represented in the human brain. Methods In this study, we conducted an fMRI experiment using an event-related design to directly compare brain activity during Japanese case particle processing among the nominative case ga, accusative case o, and dative case ni. Twenty five native Japanese speakers were asked to judge whether the presented character was a particle in a particle judgment task and whether the character ended with a specific vowel in a phonological judgment task, which was used as a control condition. Results A particle comparison demonstrated that the processing of ni was associated with significantly weaker brain activity than that of ga and o in the left middle frontal gyrus (MFG) and the inferior frontal gyrus (IFG). Significantly greater brain activity associated with ni relative to ga in the right IFG was also observed. Conclusion These results suggest that the Japanese case particles ga, ni, and o are represented differently in the brain. PMID:24683511

Comments on: blood product transfusion in emergency department patients: a case control study of practice patterns and impact on outcome.

PubMed

Karami, Manoochehr; Khazaei, Salman

2017-12-06

Clinical decision makings according studies result require the valid and correct data collection, andanalysis. However, there are some common methodological and statistical issues which may ignore by authors. In individual matched case- control design bias arising from the unconditional analysis instead of conditional analysis. Using an unconditional logistic for matched data causes the imposition of a large number of nuisance parameters which may result in seriously biased estimates.

A Case Study of Computer Gaming for Math: Engaged Learning from Gameplay?

ERIC Educational Resources Information Center

Ke, Fengfeng

2008-01-01

Employing mixed-method approach, this case study examined the in situ use of educational computer games in a summer math program to facilitate 4th and 5th graders' cognitive math achievement, metacognitive awareness, and positive attitudes toward math learning. The results indicated that students developed more positive attitudes toward math…

Migration and Multilingualism in Western Europe: A Case Study of the Netherlands.

ERIC Educational Resources Information Center

Extra, Guus; Vallen, Ton

1997-01-01

Reviews demographic and linguistic consequences of recent processes of migration and minority group influx in Western Europe and describes the case of the Netherlands to illustrate these effects. Highlights first- and second-language studies of immigrant and ethnic minority groups and notes resulting major demographic trends in Dutch society and…

A POPULATION EXPOSURE MODEL FOR PARTICULATE MATTER: CASE STUDY RESULTS FOR PM 2.5 IN PHILADELPHIA, PA

EPA Science Inventory

A population exposure model for particulate matter (PM), called the Stochastic Human Exposure and Dose Simulation (SHEDS-PM) model, has been developed and applied in a case study of daily PM2.5 exposures for the population living in Philadelphia, PA. SHEDS-PM is a probabilisti...

Cause and Prevention of Playground Injuries and Litigation; Case Studies.

ERIC Educational Resources Information Center

Frost, Joe L.; Sweeney, Theodora B.

This study examined 187 playground injuries and 13 fatalities that resulted in lawsuits between 1981 and 1995, taken from the files of two expert witnesses on playground safety who testified in the cases. The data are presented by geographic location, nature of injuries, cause of injuries/fatalities, playground equipment implicated, location of…

A Case Study of Middle Grades Leadership in a Conversion Charter School

ERIC Educational Resources Information Center

Bickmore, Dana L.; Dowell, Margaret-Mary Sulentic

2015-01-01

This 3-year case study examined middle grades principal leadership in a takeover charter school. The researcher analyzed principal and teacher interviews, field notes, and documents in relationship to a middle grades model of principal leadership. Results suggest the principals' limited experience, organizational factors unique to takeover charter…

The Significance of Motivation in Student-Centred Learning: A Reflective Case Study

ERIC Educational Resources Information Center

Maclellan, Effie

2008-01-01

The theoretical underpinnings of student-centred learning suggest motivation to be an integral component. However, lack of clarification of what is involved in motivation in education often results in unchallenged assumptions that fail to recognise that what motivates some students may alienate others. This case study, using socio-cognitive…

Trial and Error: Negotiating Manhood and Struggling to Discover True Self

ERIC Educational Resources Information Center

Foste, Zak; Edwards, Keith; Davis, Tracy

2012-01-01

Using a case study approach , this article explores how men become restricted in experiencing a full range of emotions and human potential. After reviewing current literature describing the pressures men face to conform to traditional ideologies of masculinity, the case study methodology is described, results presented, and implications for…

DBT-Enhanced Cognitive Behavioral Therapy for Adolescent Trichotillomania: An Adolescent Case Study

ERIC Educational Resources Information Center

Welch, Stacy Shaw; Kim, Junny

2012-01-01

Results and a case study for a DBT-enhanced habit reversal treatment (HRT) for adult trichotillomania (TTM) (Keuthen & Sprich, 2012) is adapted for use with adolescents. Trichotillomania in adolescence is a very important but understudied problem. Onset often occurs in adolescence, and yet very little treatment research exists. DBT-enhanced habit…

Comparing the Lifetimes of Two Brands of Batteries

ERIC Educational Resources Information Center

Dunn, Peter K.

2013-01-01

In this paper, we report a case study that illustrates the importance in interpreting the results from statistical tests, and shows the difference between practical importance and statistical significance. This case study presents three sets of data concerning the performance of two brands of batteries. The data are easy to describe and…

Collaboration, Collegiality, and Collective Reflection: A Case Study of Professional Development for Teachers

ERIC Educational Resources Information Center

Kelly, Jennifer; Cherkowski, Sabre

2015-01-01

This case study documents and interprets teachers' experiences in a professional development initiative called Changing Results for Young Readers in British Columbia. The reflections and discussions of a group of teachers in a rural school district were examined in order to understand how the participants constructed their realities relative to…

Pushing the Employment Agenda: Case Study Research of High Performing States in Integrated Employment

ERIC Educational Resources Information Center

Hall, Allison Cohen; Butterworth, John; Winsor, Jean; Gilmore, Dana; Metzel, Deborah

2007-01-01

Organizational variables, including policies, practices, collaborations, and funding mechanisms resulting in high performance in integrated employment, were described through case study research in 3 states. Findings address how contextual factors, system-level strategies, and goals of the system are related as well as how they sustain systems…

French-Algonquian Interaction in Canada: A Michif Case Study

ERIC Educational Resources Information Center

Rosen, Nicole

2008-01-01

This paper discusses the language contact situation between Algonquian languages and French in Canada. Michif, a French-Plains Cree mixed language, is used as a case study for linguistic results of language contact. The paper describes the phonological, morphological, and syntactic conflict sites between the grammars of Plains Cree and French, as…

Improving In Vitro to In Vivo Extrapolation by Incorporating Toxicokinetic Measurements: A Case Study of Lindane-Induced Neurotoxicity

EPA Science Inventory

Approaches for extrapolating in vitro toxicity testing results for prediction of human in vivo outcomes are needed. The purpose of this case study was to employ in vitro toxicokinetics and PBPK modeling to perform in vitro to in vivo extrapolation (IVIVE) of lindane neurotoxicit...

Using exposure prediction tools to link exposure and dosimetry for risk based decisions: a case study with phthalates

EPA Science Inventory

The Population Life-course Exposure to Health Effects Modeling (PLETHEM) platform being developed provides a tool that links results from emerging toxicity testing tools to exposure estimates for humans as defined by the USEPA. A reverse dosimetry case study using phthalates was ...

Primary Prevention: Reducing Institutional Racism/Sexism Through Consultation. Case Study.

ERIC Educational Resources Information Center

O'Neil, James M.; Conyne, Robert

This paper presents a two-year primary prevention intervention aimed at reducing institutional racism and sexism at a large midwestern university. A case study format is used to describe the history, process, and outcomes of the consultation that resulted in proactive change in the institution. Definitions of primary prevention are given and the…

Benchmarking Investments in Advancement: Results of the Inaugural CASE Advancement Investment Metrics Study (AIMS). CASE White Paper

ERIC Educational Resources Information Center

Kroll, Juidith A.

2012-01-01

The inaugural Advancement Investment Metrics Study, or AIMS, benchmarked investments and staffing in each of the advancement disciplines (advancement services, alumni relations, communications and marketing, fundraising and advancement management) as well as the return on the investment in fundraising specifically. This white paper reports on the…

Organizational Structure and Strategy. Symposium 30. [Concurrent Symposium Session at AHRD Annual Conference, 2000.

ERIC Educational Resources Information Center

2000

This packet contains four papers on organizational structure and strategy from a symposium on human resource development (HRD). The first paper, "Exploring Alignment: A Comparative Case Study of Alignment in Two Organizations" (Steven W. Semler), reports on a case study that compared the results of an alignment measurement instrument…

Follow-Up Study on Parenting with Intellectual Disability in Germany.

ERIC Educational Resources Information Center

Pixa-Kettner, Ursula

1999-01-01

Five cases of parenthood of persons with intellectual disability were reinvestigated about two years after a previous German study. Problem-centered interviews were conducted with mothers or fathers with an intellectual disability and with the caretakers. Results show developmental disability in two of six children and, in some cases,…

The Effects of a High-School Poetry Competition: A Case-Study

ERIC Educational Resources Information Center

Locke, Terry

2013-01-01

This case-study explores the effects of a school-wide writing competition and the implementation of a poetry-writing unit across all junior English classes in a rural New Zealand school. Teacher interview data were thematically analysed using a social constructionist lens. Results highlight the varied strategies adopted by teachers, while…

Culture Clash in the Multicultural Classroom: A Case Study from A Newcomer School

ERIC Educational Resources Information Center

Hansen-Thomas, Holly; Chennapragada, SriPadmini

2018-01-01

This ethnographic case study of a multicultural/multilingual classroom in a newcomer school describes an incident that occurred among new immigrant English Language Learners from widely diverse backgrounds in a secondary classroom in Texas. Increased numbers of immigrant students in U.S. schools have resulted in classrooms with tremendous…

Managers and Information Technology: A Case Study of Organizational Change in County Government.

ERIC Educational Resources Information Center

Rosenbaum, Howard

1992-01-01

Discussion of the interrelationship of information technology, managers, and users, and the structure of public sector organizations focuses on a case study that examined the organizational changes in the information services department of a large, urban county government as a result of the use of sophisticated information technologies. (11…

Employment after Vision Loss: Results of a Collective Case Study.

ERIC Educational Resources Information Center

Crudden, Adele

2002-01-01

A collective case study approach was used to examine factors that influence the job retention of persons with vision loss. Computer technology was found to be a major positive influence and print access and technology were a source of stress for most participants (n=10). (Contains 7 references.) (Author/CR)

Genome-wide association analysis of secondary imaging phenotypes from the Alzheimer's disease neuroimaging initiative study.

PubMed

Zhu, Wensheng; Yuan, Ying; Zhang, Jingwen; Zhou, Fan; Knickmeyer, Rebecca C; Zhu, Hongtu

2017-02-01

The aim of this paper is to systematically evaluate a biased sampling issue associated with genome-wide association analysis (GWAS) of imaging phenotypes for most imaging genetic studies, including the Alzheimer's Disease Neuroimaging Initiative (ADNI). Specifically, the original sampling scheme of these imaging genetic studies is primarily the retrospective case-control design, whereas most existing statistical analyses of these studies ignore such sampling scheme by directly correlating imaging phenotypes (called the secondary traits) with genotype. Although it has been well documented in genetic epidemiology that ignoring the case-control sampling scheme can produce highly biased estimates, and subsequently lead to misleading results and suspicious associations, such findings are not well documented in imaging genetics. We use extensive simulations and a large-scale imaging genetic data analysis of the Alzheimer's Disease Neuroimaging Initiative (ADNI) data to evaluate the effects of the case-control sampling scheme on GWAS results based on some standard statistical methods, such as linear regression methods, while comparing it with several advanced statistical methods that appropriately adjust for the case-control sampling scheme. Copyright © 2016 Elsevier Inc. All rights reserved.

Lung Cancer Risk from Occupational and Environmental Radon and Role of Smoking in Two Czech Nested Case-Control Studies

PubMed Central

Tomasek, Ladislav

2013-01-01

The aim of the present study was to evaluate the risk of lung cancer from combined exposure to radon and smoking. Methodologically, it is based on case-control studies nested within two Czech cohort studies of nearly 11,000 miners followed-up for mortality in 1952–2010 and nearly 12,000 inhabitants exposed to high levels of radon in homes, with mortality follow-up in 1960–2010. In addition to recorded radon exposure, these studies use information on smoking collected from the subjects or their relatives. A total of 1,029 and 370 cases with smoking information have been observed in the occupational and environmental (residential) studies, respectively. Three or four control subjects have been individually matched to cases according to sex, year of birth, and age. The combined effect from radon and smoking is analyzed in terms of geometric mixture models of which the additive and multiplicative models are special cases. The resulting models are relatively close to the additive interaction (mixing parameter 0.2 and 0.3 in the occupational and residential studies, respectively). The impact of the resulting model in the residential radon study is illustrated by estimates of lifetime risk in hypothetical populations of smokers and non-smokers. In comparison to the multiplicative risk model, the lifetime risk from the best geometric mixture model is considerably higher, particularly in the non-smoking population. PMID:23470882

Catching the Missing Million: Experiences in Enhancing TB & DR-TB Detection by Providing Upfront Xpert MTB/RIF Testing for People Living with HIV in India

PubMed Central

Raizada, Neeraj; Sachdeva, Kuldeep Singh; Sreenivas, Achuthan; Kulsange, Shubhangi; Gupta, Radhey Shyam; Thakur, Rahul; Dewan, Puneet; Boehme, Catharina; Paramsivan, Chinnambedu Nainarappan

2015-01-01

Background A critical challenge in providing TB care to People Living with HIV (PLHIV) is establishing an accurate bacteriological diagnosis. Xpert MTB/RIF, a highly sensitive and specific rapid tool, offers a promising solution in addressing these challenges. This study presents results from PLHIV taking part in a large demonstration study across India wherein upfront Xpert MTB/RIF testing was offered to all presumptive PTB cases in public health facilities. Method The study covered a population of 8.8 million across 18 sub-district level tuberculosis units (TU), with one Xpert MTB/RIF platform established at each TU. All HIV-infected patients suspected of TB (both TB and Drug Resistant TB (DR-TB)) accessing public health facilities in study area were prospectively enrolled and provided upfront Xpert MTB/RIF testing. Result 2,787 HIV-infected presumptive pulmonary TB cases were enrolled and 867 (31.1%, 95% Confidence Interval (CI) 29.4‒32.8) HIV-infected TB cases were diagnosed under the study. Overall 27.6% (CI 25.9–29.3) of HIV-infected presumptive PTB cases were positive by Xpert MTB/RIF, compared with 12.9% (CI 11.6–14.1) who had positive sputum smears. Upfront Xpert MTB/RIF testing of presumptive PTB and DR-TB cases resulted in diagnosis of 73 (9.5%, CI 7.6‒11.8) and 16 (11.2%, CI 6.7‒17.1) rifampicin resistance cases, respectively. Positive predictive value (PPV) for rifampicin resistance detection was high 97.7% (CI 89.3‒99.8), with no significant difference with or without prior history of TB treatment. Conclusion The study results strongly demonstrate limitations of using smear microscopy for TB diagnosis in PLHIV, leading to low TB and DR-TB detection which can potentially lead to either delayed or sub-optimal TB treatment. Our findings demonstrate the usefulness and feasibility of addressing this diagnostic gap with upfront of Xpert MTB/RIF testing, leading to overall strengthening of care and support package for PLHIV. PMID:25658091

[DIAGNOSTIC AND TREATMENT STRATEGY IN FOLLICULAR TUMOR OF THYROID GLAND].

PubMed

Mikhaĭlova, M V; Zubarovskiĭ, I N; Osipenko, S K

2015-01-01

The article is based on the treatment results of 44 patients with follicular tunor of thyroid gland. A staged morphological assessment of thyroid nodes was performed for all patients: in case of preoperative fine-needle biopsy, urgent intraoperative study and according to results of final histological research. The urgent histological study of surgical material was conducted for 44 patients with diagnosis "follicular tumor" according to fine-needle biopsy. The data of final histological study were matched with findings of intraoperative research. A micro-follicular adenoma was detected in 22 patients (50%) and 6 (13,6%) patients had this diagnosis combined with autoimmune thyroiditis. The general part of patients didn't changed in final study, but the rate of diagnosis "micro-follicular adenoma against the background of autoimmune thyroiditis" increased. Papillary carcinoma was revealed in 5 (11,4%) patients and follicular cancer had 4 (9,1%) patients detected in intraoperative study and 3 (6,8%) more patients according to data of final research. The histopathologic feature of colloid goiter was observed in 7 (15,9%) cases and a part of such patients reduced to 6,8% during final study. One of the patients (2,3%) had final diagnosis "oncocytoma". In case of thyroid nodules detection the needle biopsy should be carried out regardless to the size of nodule. The authors recommended performing the surgery with the urgent histological study in case of undetermined histological report. The following surgical strategy was specified by the results of the urgent histological report.

Association between Zika virus infection and microcephaly in Brazil, January to May, 2016: preliminary report of a case-control study.

PubMed

de Araújo, Thalia Velho Barreto; Rodrigues, Laura Cunha; de Alencar Ximenes, Ricardo Arraes; de Barros Miranda-Filho, Demócrito; Montarroyos, Ulisses Ramos; de Melo, Ana Paula Lopes; Valongueiro, Sandra; de Albuquerque, Maria de Fátima Pessoa Militão; Souza, Wayner Vieira; Braga, Cynthia; Filho, Sinval Pinto Brandão; Cordeiro, Marli Tenório; Vazquez, Enrique; Di Cavalcanti Souza Cruz, Danielle; Henriques, Cláudio Maierovitch Pessanha; Bezerra, Luciana Caroline Albuquerque; da Silva Castanha, Priscila Mayrelle; Dhalia, Rafael; Marques-Júnior, Ernesto Torres Azevedo; Martelli, Celina Maria Turchi

2016-12-01

The microcephaly epidemic, which started in Brazil in 2015, was declared a Public Health Emergency of International Concern by WHO in 2016. We report the preliminary results of a case-control study investigating the association between microcephaly and Zika virus infection during pregnancy. We did this case-control study in eight public hospitals in Recife, Brazil. Cases were neonates with microcephaly. Two controls (neonates without microcephaly), matched by expected date of delivery and area of residence, were selected for each case. Serum samples of cases and controls and cerebrospinal fluid samples of cases were tested for Zika virus-specific IgM and by quantitative RT-PCR. Laboratory-confirmed Zika virus infection during pregnancy was defined as detection of Zika virus-specific IgM or a positive RT-PCR result in neonates. Maternal serum samples were tested by plaque reduction neutralisation assay for Zika virus and dengue virus. We estimated crude odds ratios (ORs) and 95% CIs using a median unbiased estimator for binary data in an unconditional logistic regression model. We estimated ORs separately for cases with and without radiological evidence of brain abnormalities. Between Jan 15, 2016, and May 2, 2016, we prospectively recruited 32 cases and 62 controls. 24 (80%) of 30 mothers of cases had Zika virus infection compared with 39 (64%) of 61 mothers of controls (p=0·12). 13 (41%) of 32 cases and none of 62 controls had laboratory-confirmed Zika virus infection; crude overall OR 55·5 (95% CI 8·6-∞); OR 113·3 (95% CI 14·5-∞) for seven cases with brain abnormalities; and OR 24·7 (95% CI 2·9-∞) for four cases without brain abnormalities. Our data suggest that the microcephaly epidemic is a result of congenital Zika virus infection. We await further data from this ongoing study to assess other potential risk factors and to confirm the strength of association in a larger sample size. Brazilian Ministry of Health, Pan American Health Organization, and Enhancing Research Activity in Epidemic Situations. Copyright This is an Open Access article published under the CC BY 3.0 IGO license, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. In any use of this article, there should be no suggestion that WHO endorses any specific organisation, products or services. The use of the WHO logo is not permitted. This notice should be preserved along with the article's original URL.

Revision Knee Arthroplasty in Patients with Inherited Bleeding Disorders: A Single-Center Experience

PubMed Central

Kotela, Andrzej; Wilk-Frańczuk, Magdalena; Żbikowski, Piotr; Łęgosz, Paweł; Ambroziak, Paweł; Kotela, Ireneusz

2017-01-01

Background The results of total knee arthroplasty (TKA) in patients with inherited bleeding disorders (IBDs) are poorer when compared with those in the general population, with a notably higher risk of complications and higher revision rates. Thus, revision procedures are becoming a growing concern in this group of patients. The aim of this study was to evaluate the results of revision TKA in patients with IBD. Material/Methods A retrospective cohort study with longitudinal assessment of hemophilia patients scheduled for revision TKA between January 2010 and September 2015 was performed. The clinical status of the patients was assessed based on the Knee Society Score, and the Numeric Rating Scale was used to assess knee pain severity and patient satisfaction with the surgery. Radiological examination, post-operative complications, and reinterventions were recorded and analyzed. Results Very good results were obtained in all patients treated for aseptic loosening of the implant. However, inferior results were found in cases with infection. All patients operated on for aseptic loosening required only single-stage TKA, whereas patients with infection underwent multiple interventions. Complications were observed only in cases with infection. Conclusions Our study clearly outlined the differences in results based on failure mode, with far inferior results obtained in cases with infection. Given the lack of data in this area as well as the high specificity of this population, further high-quality studies are needed. PMID:28068306

Effect of wear on the burst strength of l-80 steel casing

NASA Astrophysics Data System (ADS)

Irawan, S.; Bharadwaj, A. M.; Temesgen, B.; Karuppanan, S.; Abdullah, M. Z. B.

2015-12-01

Casing wear has recently become one of the areas of research interest in the oil and gas industry especially in extended reach well drilling. The burst strength of a worn out casing is one of the significantly affected mechanical properties and is yet an area where less research is done The most commonly used equations to calculate the resulting burst strength after wear are Barlow, the initial yield burst, the full yield burst and the rupture burst equations. The objective of this study was to estimate casing burst strength after wear through Finite Element Analysis (FEA). It included calculation and comparison of the different theoretical bursts pressures with the simulation results along with effect of different wear shapes on L-80 casing material. The von Misses stress was used in the estimation of the burst pressure. The result obtained shows that the casing burst strength decreases as the wear percentage increases. Moreover, the burst strength value of the casing obtained from the FEA has a higher value compared to the theoretical burst strength values. Casing with crescent shaped wear give the highest burst strength value when simulated under nonlinear analysis.

Case-control studies in cancer patients as a surveillance system of occupational exposure in the European Community. European Community Working Party.

PubMed Central

Rona, R J; Taub, N A; Rasmussen, S

1993-01-01

STUDY OBJECTIVE--The main aim was to detect known relationships between lung and blood cancers and various occupational exposures (using job titles as proxies) using a case-control design. The suitability of this system for routine surveillance could then be assessed. DESIGN--A case-control study was carried out in 1989. SETTING--Hospitals in eight European Community countries. SUBJECTS--Men aged 25 to 75 years with incident and prevalent cancer of the lung (190 cases), haematopoietic system (210 cases), or gastrointestinal tract (245 controls) were studied. MEASUREMENTS AND MAIN RESULTS--The crude estimate of the overall odds ratio exposure (OR) for relevant occupational exposure of lung cancer relative to gastrointestinal cancer was 1.20 (95% confidence interval (CI) 0.82, 1.77). In a logistic regression analysis adjusting for country, age at diagnosis, smoking, and alcohol consumption, the overall OR was not greatly changed. A significant interaction of occupational exposure and age at diagnosis showed that lung cancer patients diagnosed at a younger age had a higher OR than patients diagnosed at an older age. Thus, the overall, insignificant result may have been due to a low reliability of occupational history in older age or to a selective mechanism related to age. The overall OR for occupational exposure of cancer of the blood relative to gastrointestinal cancer was 0.88 (95% CI 0.60, 1.31). The logistic regression analysis did not alter these results. CONCLUSION--A surveillance based on a case-control design using job titles would not be sensitive enough to detect possible occupational risks. PMID:8228771

Long-term in vivo left ventricular assist device study for 284 days with Gyro PI pump.

PubMed

Ohtsuka, G; Nakata, K; Yoshikawa, M; Takano, T; Glueck, J; Sankai, Y; Takami, Y; Mueller, J; Sueoka, A; Letsou, G; Schima, H; Schmallegger, H; Wolner, E; Koyanagi, H; Fujisawa, A; Baldwin, J C; Nosé, Y

1999-06-01

A totally implantable centrifugal artificial heart has been developed. The plastic prototype, the Gyro PI 601, passed 2 day hemodynamic tests as a functional total artificial heart (TAH), 2 week screening tests for anti-thrombogenecity, and a 1 month system feasibility study. Based upon these results, a metallic prototype, the Gyro PI 700 series, was subjected to long-term in vivo left ventricular assist device (LVAD) studies of over 1 month. The Gyro PI 700 series has the same inner dimension and same characteristics of the Gyro PI 601 such as an eccentric inlet port, a double pivot bearing system, and a magnet coupling system. The PI metallic pump is also driven with the Vienna DC brushless motor actuator like the PI 601. The pump-actuator package was implanted in 3 calves in the preperitoneal space, bypassing from the left ventricular (LV) apex to the descending aorta. Case 1 achieved a 284 day survival. Case 2 was euthanized early at 72 postoperative days as a result of the functional obstruction of the inlet port due to the excessive growth of the calf. There was no blood clot inside the pumps of either case. Case 3 is on-going (22 days on July 24, 1998). During these periods, all cases showed no physiological abnormalities. In conclusion, the PI 700 series pump has excellent results as a long-term implantable LVAD.

Occupational brain cancer risks in Umbria (Italy), with a particular focus on steel foundry workers.

PubMed

Oddone, Enrico; Scaburri, Alessandra; Bai, Edoardo; Modonesi, Carlo; Stracci, Fabrizio; Marchionna, Giuliano; Crosignani, Paolo; Imbriani, Marcello

2014-01-01

As a part of the Occupational Cancer Monitoring (OCCAM) project, a routine analysis based on Umbria region cancer registry (RTUP) database in 2002-2008 was performed. Among other results, the incidental finding of brain cancer increased risk in steel foundry workers in Terni province (Italy), lead us to deepen the analysis, focusing on this specific industrial sector. A monitoring study, based on Umbria Regional Cancer Registry data, was recently carried out. Brain cancer cases and controls identified within this preliminary study were selected. Therefore, we considered all incident cases (in Umbria region 2002-2008) of brain cancer occurred among workers occupied for at least one year in private companies since 1974 and controls randomly sampled from the same population. Afterwards, taking in to account results from steel foundry in Terni province, we further deepened our analysis, focusing on this productive sector. Odds ratios (ORs) and corresponding 90% confidence intervals (CIs) were calculated using multiple logistic regression models, adjusted by age at diagnosis or sampling, sex and province of residence, when appropriate. Statistical analyses were carried out on 14913 subjects, 56 cases and 14857 controls. Significantly increased ORs were observed for garment, mechanical manufacturing and chemical industries. Moreover, the risk estimates were strongly correlated with exposures in iron and steel foundries and a cluster of 14 cases in the same foundry in Terni was observed (OR 9.59, 90% CI 2.76-33.34). Results of this explorative study showed increased ORs of brain cancer in some productive branches, involving possible exposures to chemical compounds and/or solvents. Moreover, our results pointed out a significantly increased risk in Terni foundry workers, determining an interesting brain cancer cluster (14 cases). Further studies on this industrial sector are needed with improved definitions of tasks and exposures.

Lung and stomach cancer associations with groundwater radon in North Carolina, USA.

PubMed

Messier, Kyle P; Serre, Marc L

2017-04-01

The risk of indoor air radon for lung cancer is well studied, but the risks of groundwater radon for both lung and stomach cancer are much less studied, and with mixed results. Geomasked and geocoded stomach and lung cancer cases in North Carolina from 1999 to 2009 were obtained from the North Carolina Central Cancer Registry. Models for the association with groundwater radon and multiple confounders were implemented at two scales: (i) an ecological model estimating cancer incidence rates at the census tract level; and (ii) a case-only logistic model estimating the odds that individual cancer cases are members of local cancer clusters. For the lung cancer incidence rate model, groundwater radon is associated with an incidence rate ratio of 1.03 [95% confidence interval (CI) = 1.01, 1.06] for every 100 Bq/l increase in census tract averaged concentration. For the cluster membership models, groundwater radon exposure results in an odds ratio for lung cancer of 1.13 (95% CI = 1.04, 1.23) and for stomach cancer of 1.24 (95% CI = 1.03, 1.49), which means groundwater radon, after controlling for multiple confounders and spatial auto-correlation, increases the odds that lung and stomach cancer cases are members of their respective cancer clusters. Our study provides epidemiological evidence of a positive association between groundwater radon exposure and lung cancer incidence rates. The cluster membership model results find groundwater radon increases the odds that both lung and stomach cancer cases occur within their respective cancer clusters. The results corroborate previous biokinetic and mortality studies that groundwater radon is associated with increased risk for lung and stomach cancer. © The Author 2016; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association

Effect of Active Case Finding on Prevalence and Transmission of Pulmonary Tuberculosis in Dhaka Central Jail, Bangladesh

PubMed Central

Banu, Sayera; Rahman, Md. Toufiq; Uddin, Mohammad Khaja Mafij; Khatun, Razia; Khan, Md. Siddiqur Rahman; Rahman, Md. Mojibur; Uddin, Syed Iftekhar; Ahmed, Tahmeed; Heffelfinger, James D.

2015-01-01

Background Understanding tuberculosis (TB) transmission dynamics is essential for establishing effective TB control strategies in settings where the burden and risk of transmission are high. The objectives of this study were to evaluate the effect of active screening on controlling TB transmission and also to characterize Mycobacterium tuberculosis strains for investigating transmission dynamics in a correctional setting. Methods The study was carried out in Dhaka Central Jail (DCJ), from October 2005 to February 2010. An active case finding strategy for pulmonary TB was established both at the entry point to the prison and inside the prison. Three sputum specimens were collected from all pulmonary TB suspects and subjected to smear microscopy, culture, and drug susceptibility testing as well as genotyping which included deletion analysis, spoligotyping and analysis of mycobacterial interspersed repetitive units (MIRU). Results A total of 60,585 inmates were screened during the study period. We found 466 inmates with pulmonary TB of whom 357 (77%) had positive smear microscopy results and 109 (23%) had negative smear microscopy results but had positive results on culture. The number of pulmonary TB cases declined significantly, from 49 cases during the first quarter to 8 cases in the final quarter of the study period (p=0.001). Deletion analysis identified all isolates as M. tuberculosis and further identified 229 (70%) strains as ‘modern’ and 100 (30%) strains as ‘ancestral’. Analysis of MIRU showed that 347 strains (85%) exhibited unique patterns, whereas 61 strains (15%) clustered into 22 groups. The largest cluster comprised eight strains of the Beijing M. tuberculosis type. The rate of recent transmission was estimated to be 9.6%. Conclusions Implementation of active screening for TB was associated with a decline in TB cases in DCJ. Implementation of active screening in prison settings might substantially reduce the national burden of TB in Bangladesh. PMID:25933377

[Fundamental and clinical studies on aspoxicillin in the field of pediatrics].

PubMed

Nobori, T; Katoh, Y; Ochiai, H; Ochiai, H; Kawai, K; Kamiya, H; Sakurai, M

1985-07-01

Fundamental and clinical studies were performed with aspoxicillin (ASPC), a new developed injectable broad penicillin, in pediatric infectious diseases, and the following results were obtained. Pharmacokinetics ASPC was administered to 2 cases at a dose of 20 mg/kg by one shot intravenous injection. The mean half-life (T 1/2) was 1.17 hours. The mean urinary excretion rate was 58.4% during 6 hours after ASPC treatment. In 3 cases of intravenous drip infusion with a period of 1 hour at a dose of 10 mg/kg (2 cases) and 20 mg/kg (1 case), the half-lives (T 1/2) were 1.7 hours, 3.5 hours and 1.0 hour, respectively. The urinary recovery rate during 6 hours after administration was 57.7%, 32.6% and 42.7%, respectively. At only one case treated with 10 mg/kg intravenous drip infusion, the half-life was prolonged and urinary excretion rate was lower than other 2 cases. Clinical study ASPC was administered 50-80 mg/kg/day for 4-8 days to 22 children comprising 6 tonsillitis, 2 bronchitis, 6 pneumonia and 8 urinary tract infections. Clinical efficacy was excellent in 13 cases, good in 8 cases and fair in 1 case, the total cure rate was 95%. As for the clinical response classified by diagnosis, the each efficacy rate of tonsillitis, bronchitis and pneumonia was 100%, and that of urinary tract infection was 87.5%. Clinical side effect and abnormal laboratory findings were not observed in any cases. From the above results, it was concluded that ASPC was one of the useful secure drug for treatment of infections in pediatric field.

Place of laparoscopy in pelvic inflammatory disease.

PubMed

Krishna, U R; Sheth, S S; Motashaw, N D

1979-06-01

577 laparoscopic examinations were performed in women presenting with sterility, chronic abdominal pain, primary or secondary amenorrhea, and irregular menstrual periods. 125 cases of chronic pelvic inflammatory disease (PID) of both the tuberculous and nonspecific varieties were detected through this procedure. 59 of the 125 cases were diagnosed as tuberculous. Investigations prior to laparoscopy had yielded significant results in only 12 cases. 87 of the 125 cases had no abnormal clinical findings, and only 18 of the 37 tubo-ovarian masses were diagnosed by bimanual examination. These results indicate that laparoscopy is an invaluable tool for the diagnosis of PID. It can reveal peritubal adhesions, tubercles on the tubes, small tubo-ovarian masses, and hydrosalpinx cases that cannot be detected clinically. It is considered a more suitable tool than culdoscopy, which less frequently notes adhesions to the fallopian tubes and pathological conditions in the upper pelvis. Laparoscopy can play an especially valuable role in India as a prelude to tuboplasty, given the high incidence of pelvic tuberculosis. Of the 316 cases of primary sterility examined in this study, 51 had genital tuberculosis and 39 had nonspecific PID. Laparoscopy can also be useful in disproving cases wrongly labelled as chronic pelvic disease. 15 women in this study who reported chronic lower abdominal pain had normal findings, and only 13 cases of PID were confirmed among the 33 cases preoperatively diagnosed as PID. A significant number of PID cases are attributed to operative procedures such as hysterosalpingography and ventrisuspension that are repeated unnecessarily and without proper sepsis. Thus, the possibility of a flare-up of infection during laparoscopy, especially due to hydroperturbation, should be considered. Women in this study who were found to have PID were given postoperative antibiotics. No significant postoperative complications were observed.

Tibial lengthening over intramedullary nails

PubMed Central

Burghardt, R. D.; Manzotti, A.; Bhave, A.; Paley, D.

2016-01-01

Objectives The purpose of this study was to compare the results and complications of tibial lengthening over an intramedullary nail with treatment using the traditional Ilizarov method. Methods In this matched case study, 16 adult patients underwent 19 tibial lengthening over nails (LON) procedures. For the matched case group, 17 patients who underwent 19 Ilizarov tibial lengthenings were retrospectively matched to the LON group. Results The mean external fixation time for the LON group was 2.6 months and for the matched case group was 7.6 months. The mean lengthening amounts for the LON and the matched case groups were 5.2 cm and 4.9 cm, respectively. The radiographic consolidation time in the LON group was 6.6 months and in the matched case group 7.6 months. Using a clinical and radiographic outcome score that was designed for this study, the outcome was determined to be excellent in 17 and good in two patients for the LON group. The outcome was excellent in 14 and good in five patients in the matched case group. The LON group had increased blood loss and increased cost. The LON group had four deep infections; the matched case group did not have any deep infections. Conclusions The outcomes in the LON group were comparable with the outcomes in the matched case group. The LON group had a shorter external fixation time but experienced increased blood loss, increased cost, and four cases of deep infection. The advantage of reducing external fixation treatment time may outweigh these disadvantages in patients who have a healthy soft-tissue envelope. Cite this article: J. E. Herzenberg. Tibial lengthening over intramedullary nails: A matched case comparison with Ilizarov tibial lengthening. Bone Joint Res 2016;5:1–10. doi: 10.1302/2046-3758.51.2000577 PMID:26764351

Gonorrhoea and Syphilis Epidemiology in Flemish General Practice 2009–2013: Results from a Registry-based Retrospective Cohort Study Compared with Mandatory Notification

PubMed Central

Schweikardt, Christoph; Goderis, Geert; Elli, Steven; Coppieters, Yves

2016-01-01

Background The number of newly diagnosed gonorrhoea and syphilis cases has increased in Flanders in recent years. Our aim was to investigate, to which extent these diagnoses were registered by general practitioners (GPs), and to examine opportunities and limits of the Intego database in this regard. Methods Data from a retrospective cohort study based on the Flemish Intego general practice database was analyzed for the years 2009–2013. Case definitions were applied. Due to small case numbers obtained, cases were pooled and averaged over the observation period. Frequencies were compared with those calculated from figures of mandatory notification. Results A total of 91 gonorrhoea and 23 syphilis cases were registered. The average Intego annual frequency of gonorrhoea cases obtained was 11.9 (95% Poisson confidence interval (CI) 9.6; 14.7) per 100,000 population, and for syphilis 3.0 (CI 1.9; 4.5), respectively, while mandatory notification was calculated at 14.0 (CI: 13.6, 14.4) and 7.0 (CI: 6.7, 7.3), respectively. Conclusion In spite of limitations such as small numbers and different case definitions, comparison with mandatory notification suggests that the GP was involved in the large majority of gonorrhoea cases, while the majority of new syphilis cases did not come to the knowledge of the GP. PMID:29546196

The role of transnational mobility in the local spread of mosquito-borne disease: Measuring the determinants of spatial-temporal lags of imported dengue cases initiating indigenous epidemics in Taiwan

NASA Astrophysics Data System (ADS)

Wen, Tzai-Hung

2014-05-01

Dengue fever is one of the world's most widely spread mosquito-borne diseases. International travelers who acquire dengue infection are important routes for virus transmission from one country to another one. Previous studies have shown that imported dengue cases are able to initiate indigenous epidemics when appropriate weather conditions are present. However, the spatial-temporal associations between imported cases and indigenous epidemics in areas with different social-economic conditions are still unclear. This study investigated determinants of spatial-temporal lags of imported dengue cases who initiated indigenous epidemics from 2003 to 2012 in Taiwan. The quantile regression is used to explore the associations between spatial-temporal lags of imported cases and social-economic indicators with geographic heterogeneity. Our results indicated that imported cases in April and May have statistically significant contribution to initiate indigenous epidemics. Areas with high population density and low average income have significant risk of being imported virus from other areas. However, the areas with imported cases are not significant transmission risk. The results imply that imported cases reported in early summer may be an early-warning indicator of indigenous epidemics. Local demographic and economic conditions, rather than imported cases, may determine the areas with the risk of indigenous epidemics.

[Surgical procedures in 156 cases of pleural effusion. Immediate results].

PubMed

Cicero-Sabido, Raúl; Páramo-Arroyo, Rafael F; Navarro-Reynoso, Francisco Pascual; Pimentel-Ugarte, Lorenzo

2006-01-01

Pleural effusion is a common clinical entity. Proper diagnosis and management are important for successful treatment. We undertook this study to evaluate immediate results of the procedures used in a group of cases with pleural effusion. Of 2589 patients at first consultation, 787 were hospitalized and 156 had pleural effusion. Diagnostic and therapeutic procedures used were evaluated. With thoracentesis and evacuation of liquid, 23 nonneoplastic cases had resolution. Chest tube drainage with water seal was performed in 133 patients. This procedure suppressed the effusion in 109 patients, but in 24 patients another approach was necessary. In this group there were 35 neoplastic and 96 nonmalignant cases, the latter 36 were provoked by iatrogenic management. Twenty two cases of pneumothorax considered as gaseous effusion and 10 cases of chronic empyema sequelae of pleural effusions were also studied. Proportion comparison demonstrated significant differences between neoplastic and nonneoplastic effusions (p =0.001) and in cases managed with minimally invasive procedures and chest tube drainage (p =0.001). The performance of pleurodesis and thoracoscopy is discussed. In chronic cases, indications of open window thoracostomy and myoplasty are elucidated. In pleural effusion, opportune diagnosis and proper management are essential. Drainage tube can solve the majority of cases. Pneumothorax must be treated in the same way. In chronic empyema, open window thoracostomy and myoplasty are indicated. Careless patient management and poor treatment lead to iatrogenic complications.

Survival bias and drug interaction can attenuate cross-sectional case-control comparisons of genes with health outcomes. An example of the kinesin-like protein 6 (KIF6) Trp719Arg polymorphism and coronary heart disease.

PubMed

Williams, Paul; Pendyala, Lakshmana; Superko, Robert

2011-03-24

Case-control studies typically exclude fatal endpoints from the case set, which we hypothesize will substantially underestimate risk if survival is genotype-dependent. The loss of fatal cases is particularly nontrivial for studies of coronary heart disease (CHD) because of significantly reduced survival (34% one-year fatality following a coronary attack). A case in point is the KIF6 Trp719Arg polymorphism (rs20455). Whereas six prospective studies have shown that carriers of the KIF6 Trp719Arg risk allele have 20% to 50% greater CHD risk than non-carriers, several cross-sectional case-control studies failed to show that carrier status is related to CHD. Computer simulations were therefore employed to assess the impact of the loss of fatal events on gene associations in cross-sectional case-control studies, using KIF6 Trp719Arg as an example. Ten replicates of 1,000,000 observations each were generated reflecting Canadian demographics. Cardiovascular disease (CVD) risks were assigned by the Framingham equation and events distributed among KIF6 Trp719Arg genotypes according to published prospective studies. Logistic regression analysis was used to estimate odds ratios between KIF6 genotypes. Results were examined for 33%, 41.5%, and 50% fatality rates for incident CVD.In the absence of any difference in percent fatalities between genotypes, the odds ratios (carriers vs. noncarriers) were unaffected by survival bias, otherwise the odds ratios were increasingly attenuated as the disparity between fatality rates increased between genotypes. Additional simulations demonstrated that statin usage, shown in four clinical trials to substantially reduce the excess CHD risk in the KIF6 719Arg variant, should also attenuate the KIF6 719Arg odds ratio in case-control studies. These computer simulations show that exclusions of prior CHD fatalities attenuate odds ratios of case-control studies in proportion to the difference in the percent fatalities between genotypes. Disproportionate CHD survival for KIF6 Trip719Arg carriers is suggested by their 50% greater risk for recurrent myocardial infarction. This, and the attenuation of KIF6 719Arg carrier risk with statin use, may explain the genotype's weak association with CHD in cross-sectional case-control studies. The results may be relevant to the underestimation of risk in cross-sectional case-control studies of other genetic CHD-risk factors affecting survival.

Six consecutive false positive cases from cell-free fetal DNA testing in a single referring centre

PubMed Central

Dugo, Nella; Padula, Francesco; Mobili, Luisa; Brizzi, Cristiana; D’Emidio, Laura; Cignini, Pietro; Mesoraca, Alvaro; Bizzoco, Domenico; Cima, Antonella; Giorlandino, Claudio

2014-01-01

Introduction recent studies have proposed the introduction of cell-free fetal DNA testing (NIPT-Non Invasive Prenatal Testing) in routine clinical practice emphasizing its high sensibility and specificity. In any case, false positive and false negative findings may result from placental mosaicism, because cell-free fetal DNA originates mainly from placenta. Case we report six cases of women who underwent chorionic villus sampling (CVS) or amniocentesis to confirm the results from NIPT: two Turner syndromes, two Triple X, one Patau syndrome, one Edward syndrome. Results using classic cytogenetic analysis and, also, Array - Comparative Genomic Hybridization (Array CGH) the karyotype of all 5 fetuses was found to be normal. Conclusion results from NIPT must always be confirmed by invasive prenatal diagnosis. It is mandatory to inform the patient that the CVS and amniocentesis still represent the only form of prenatal diagnostic test available. PMID:25332757

[Reduced number of fatal and life-threatening reactions to food. Reporting by the medical profession has resulted in effective measures].

PubMed

Foucard, Tony; Yman, Ingrid Malmheden; Nordvall, Lennart

The results from the Swedish system for reporting severe and fatal reactions caused by food for the period 1993-96 were published in Lakartidningen in 1997. We now report the results for the period 1997-2003. The number of fatal cases has decreased from 1.75 to 0.86 per year and the number of life-threatening cases from 3 to I per year. The most gratifying result was the large decrease in severe reactions caused by soy, from 3 deaths and 6 life-threatening cases during the first 4-year period to just one life-threatening case during the following 7-year period. This reduction is probably largely due to an increased awareness of identified risk persons, but also to a reduced use of soy protein. The ongoing study illustrates the usefulness of a national system for reporting severe and fatal reactions caused by food.

Arthroscopic assessment for intra-articular disorders in residual ankle disability after sprain.

PubMed

Takao, Masato; Uchio, Yuji; Naito, Kohei; Fukazawa, Ikuo; Ochi, Mitsuo

2005-05-01

After ankle sprain, there can be many causes of disability, the origins of which cannot be determined using standard diagnostic tools. Ankle arthroscopy is a useful tool in identifying intra-articular disorders of the talocrural joint in cases of residual ankle disability after sprain. Cohort study (diagnosis); Level of evidence, 2. The authors gathered the independent diagnostic results of physical examination, standard mortise and lateral radiography, stress radiography of the talocrural joint, and magnetic resonance imaging for 72 patients with residual ankle disability lasting more than 2 months after injury (mean, 7 months after injury). They performed arthroscopic procedures and compared the double-blind results. In all cases, the arthroscopic results matched those of other means of diagnosis. In 14 cases, the arthroscopic approach exceeded the capabilities of the other methods. Including duplications, 39 patients (54.2%) had anterior talofibular ligament injuries, 17 patients (23.6%) had distal tibiofibular ligament injuries, 29 patients (40.3%) had osteochondral lesions, 13 patients (18%) had symptomatic os subfibulare, 3 patients (4.2%) had anterior impingement exostosis, and 3 patients (4.2%) had impingement due to abnormally fibrous bands. There were only 2 cases in which the cause of symptoms could not be detected by ankle arthroscopy, compared with 16 cases in which the cause of disability could not be detected using standard methods. In 3 cases (17.6%) of distal tibiofibular ligament injuries, 8 cases (27.6%) of osteochondral lesions, and all 3 cases (100%) of impingement of an abnormal fibrous band, ankle arthroscopy was the only method capable of diagnosing the cause of residual ankle pain after a sprain. The present results suggest that arthroscopy can be used to diagnose the cause of residual pain after an ankle sprain in most cases that are otherwise undiagnosable by clinical examination and imaging study.

Effects of Interspersed versus Summary Feedback on the Quality of Students' Case Report Revisions

ERIC Educational Resources Information Center

Phillips, Fred; Wolcott, Susan

2014-01-01

This study examines whether students show greater improvement in written case analyses when given feedback that is either interspersed throughout their written case analyses or presented only as a summary, and whether the benefits of these placements vary across differing levels of student performance in the course. Results from an exploratory…

Do Undergraduate Paramedic Students Embrace Case Based Learning Using a Blended Teaching Approach? A 3-Year Review

ERIC Educational Resources Information Center

Williams, Brett

2009-01-01

This paper presents the results of a descriptive longitudinal study which aimed to identify student paramedic perceptions of case based learning used in the clinical curriculum of the Bachelor of Emergency Health (BEH) degree at Monash University, Victoria, Australia. Case based learning and its integration within clinical curriculum is an…

Leadership Effectiveness and Instructional Supervision: The Case of the Failing Twin

ERIC Educational Resources Information Center

Bloom, Collette Madeleine

2011-01-01

This case study examines the leadership practices of an effective versus an ineffective elementary school principal. The background of this case involves two fourth grade teachers, each teaching one of a set of identical twins. Discrepancies in teaching and grading practices result in one twin failing. The decision-making choices of the principal…

Teaching Case: Security Breach at Target

ERIC Educational Resources Information Center

Plachkinova, Miloslava; Maurer, Chris

2018-01-01

This case study follows the security breach that affected Target at the end of 2013 and resulted in the loss of financial data for over 70 million customers. The case provides an overview of the company and describes the reasons that led to one of the biggest security breaches in history. It offers a discussion on Target's vendor management…

The Ethnic/Racial Variations of Intracerebral Hemorrhage (ERICH) Study Protocol

PubMed Central

Woo, Daniel; Rosand, Jonathan; Kidwell, Chelsea; McCauley, Jacob L.; Osborne, Jennifer; Brown, Mark W.; West, Sandra E.; Rademacher, Eric W.; Waddy, Salina; Roberts, Jamie N.; Koch, Sebastian; Gonzales, Nicole R.; Sung, Gene; Kittner, Steven J.; Birnbaum, Lee; Frankel, Michael; Daniel Testai, Fernando; Hall, Christiana E.; Elkind, Mitchell S. V.; Flaherty, Matthew; Coull, Bruce; Chong, Ji Y.; Warwick, Tanya; Malkoff, Marc; James, Michael L.; Ali, Latisha K.; Worrall, Bradford B.; Jones, Floyd; Watson, Tiffany; Leonard, Anne; Martinez, Rebecca; Sacco, Ralph I; Langefeld, Carl D.

2013-01-01

Background and Purpose Epidemiologic studies of intracerebral hemorrhage (ICH) have consistently demonstrated variation in incidence, location, age at presentation, and outcomes among non-Hispanic white, black, and Hispanic populations. We report here the design and methods for this large, prospective, multi-center case-control study of ICH. Methods The ERICH study is a multi-center, prospective case-control study of ICH. Cases are identified by hot-pursuit and enrolled using standard phenotype and risk factor information and include neuroimaging and blood sample collection. Controls are centrally identified by random digit dialing to match cases by age (+/−5 years), race, ethnicity, gender and metropolitan region. Results As of March 22, 2013, 1,655 cases of ICH had been recruited into the study which is 101.5% of the target for that date and 851 controls had been recruited which is 67.2% of the target for that date (1,267 controls) for a total of 2,506 subjects which is 86.5% of the target for that date (2,897 subjects). Of the 1,655 cases enrolled, 1,640 cases had the case interview entered into the database of which 628 (38%) were non-Hispanic black, 458 (28%) were non-Hispanic white and 554 (34%) were Hispanic. Of the 1,197 cases with imaging submitted, 876 (73.2%) had a 24 hour follow-up CT available In addition to CT imaging, 607 cases have had MRI evaluation. Conclusion The ERICH study is a large, case-control study of ICH with particular emphasis on recruitment of minority populations for the identification of genetic and epidemiologic risk factors for ICH and outcomes after ICH. PMID:24021679

Clinicopathological study of 13 cases of squamous cell carcinoma complicating hidradenitis suppurativa.

PubMed

Lavogiez, C; Delaporte, E; Darras-Vercambre, S; Martin De Lassalle, E; Castillo, C; Mirabel, X; Laurent, F; Patenotre, P; Gheit, T; Talmant, J C; Beylot-Barry, M; Martinot, V; Piette, F; Aubin, F; Mortier, L

2010-01-01

To the best of our knowledge, only 52 cases of squamous cell carcinoma (SCC) complicating hidradenitis suppurativa (HS) have been reported since 1958. We describe 13 new cases. We propose a clinical and histological analysis of our cases. We include these results in a review of previously reported cases to analyze a total of 65 patients. In our series of 13 cases, we also investigate the presence of human papillomavirus (HPV) in tumor samples, by polymerase chain reaction (PCR) on paraffin-embedded material. Malignant transformation affects mainly men with a long-term history of genitoanal HS. Although our cases were 7 well-differentiated carcinomas and 6 verrucous carcinomas, lymphatic and visceral metastasis occurred in 2 and 3 cases, respectively. With PCR, we demonstrated presence of HPV in genitoanal tumoral lesions, principally HPV-16. SCC complicating HS evolves poorly, despite a good histological prognosis. Our results sustain the implication of HPV in the malignant transformation of HS.

Look Local: The Value of Cancer Surveillance and Reporting by American Indian Clinics

PubMed Central

Creswell, Paul D.; Stephenson, Laura; Pierce-Hudson, Kimmine; Matloub, Jacqueline; Waukau, Jerry; Adams, Alexandra; Kaur, Judith; Remington, Patrick L.

2013-01-01

Introduction Cancer incidence and mortality rates for American Indians in the Northern Plains region of the United States are among the highest in the nation. Reliable cancer surveillance data are essential to help reduce this burden; however, racial data in state cancer registries are often misclassified, and cases are often underreported. Methods We used a community-based participatory research approach to conduct a retrospective ascertainment of cancer cases in clinic medical records over a 9-year period (1995–2003) and compared the results with the state cancer registry to evaluate missing or racially misclassified cases. Six tribal and/or urban Indian clinics participated in the study. The project team consisted of participating clinics, a state cancer registry, a comprehensive cancer center, an American Indian/Alaska Native Leadership Initiative on Cancer, and a set of diverse organizational partners. Clinic personnel were trained by project staff to accurately identify cancer cases in clinic records. These records were then matched with the state cancer registry to assess misclassification and underreporting. Results Forty American Indian cases were identified that were either missing or misclassified in the state registry. Adding these cases to the registry increased the number of American Indian cases by 21.3% during the study period (P = .05). Conclusions Our results indicate that direct reporting of cancer cases by tribal and urban Indian health clinics to a state cancer registry improved the quality of the data available for cancer surveillance. Higher-quality data can advance the efforts of cancer prevention and control stakeholders to address disparities in Native communities. PMID:24286271

Acute recreational drug toxicity

PubMed Central

Liakoni, Evangelia; Yates, Christopher; Dines, Alison M.; Dargan, Paul I.; Heyerdahl, Fridtjof; Hovda, Knut Erik; Wood, David M.; Eyer, Florian; Liechti, Matthias E.

2018-01-01

Abstract The aim of the study was to compare self-reported and analytically confirmed substance use in cases of acute recreational drug toxicity. We performed a retrospective analysis of emergency department presentations of acute recreational drug toxicity over 2 years (October 2013 to September 2015) within the European Drug Emergencies Network Plus project. Among the 10,956 cases of acute recreational drug toxicity during the study period, 831 could be included. Between the self-reported substance use and the toxicological results, the highest agreement was found for heroin (86.1%) and cocaine (74.1%), whereas inhalants, poppers, and magic mushrooms were self-reported but not analytically detected. Cathinones and other new psychoactive substances (NPS) could be detected using additional analytical methods. Among cases with both immunoassay (IA) and confirmation with mass spectrometry (MS), the results were consistent for methadone (100%) and cocaine (95.5%) and less consistent for amphetamines (81.8%). In cases with a positive IA for amphetamines (n = 54), MS confirmed the presence of 3,4-methylenedioxymethamphetamine (MDMA), amphetamine, methamphetamine, and NPS in 37, 20, 10, and 6 cases, respectively, also revealing use of more than 1 substance in some cases. MS yielded positive results in 21 cases with a negative IA for amphetamines, including amphetamine, MDMA, methamphetamine, and NPS, in 14, 7, 2, and 2 cases, respectively. In conclusion, the highest agreement was found between self-reports and analytical findings for heroin and cocaine. The diagnosis of NPS use was mainly based on self-report. The IAs accurately identified methadone and cocaine, and MS had advantages for the detection of NPS and amphetamine derivatives. PMID:29384873

Toxoplasma Seroconversion with Negative or Transient Immunoglobulin M in Pregnant Women: Myth or Reality? A French Multicenter Retrospective Study

PubMed Central

Cimon, B.; Chemla, C.; Darde, M. L.; Delhaes, L.; L'Ollivier, C.; Godineau, N.; Houze, S.; Paris, L.; Quinio, D.; Robert-Gangneux, F.; Villard, O.; Villena, I.; Candolfi, E.; Pelloux, H.

2013-01-01

Classically, Toxoplasma infection is associated with high levels of specific IgM antibody and a rise in specific IgG levels 1 to 3 weeks later. Atypical IgG seroconversion, without IgM detection or with transient IgM levels, has been described during serologic follow-up of seronegative pregnant women and raises difficulties in interpreting the results. To evaluate the frequency and the characteristics of these atypical cases of seroconversion, an investigation was conducted within the French National Reference Center for Toxoplasmosis, from which 26 cases collected from 12 laboratories belonging to the network were identified. The aim of this work was to retrospectively analyze the results of serologic testing, the treatments administered, and the results of prenatal and postnatal follow-up for these women. In each case, IgG antibodies were detected using both screening and confirmatory tests. IgM antibodies were not detected in 15 cases, and the levels were equivocal or low-positive in 11 cases. The IgG avidity results were low in 16 cases and high in one case. Most of the pregnant women (22/26) were treated with spiramycin from the time that IgG antibodies appeared until delivery. Amniotic fluid was analyzed for Toxoplasma gondii DNA by PCR in 11/26 cases, and the results were negative in all cases. Congenital toxoplasmosis was ruled out in 12/26 newborns. There was no abnormality observed at birth for 10 newborns and no information available for 4 newborns. In conclusion, when the interpretation of serological results is so difficult, it seems cautious to initiate treatment by spiramycin and to follow the pregnant women and their newborns. PMID:23616461

Short-term effects of floods on Japanese encephalitis in Nanchong, China, 2007-2012: A time-stratified case-crossover study.

PubMed

Zhang, Feifei; Liu, Zhidong; Zhang, Caixia; Jiang, Baofa

2016-09-01

This time-stratified case-crossover study aimed to quantify the impact of floods on daily Japanese encephalitis (JE) cases from 2007 to 2012 in Nanchong city of Sichuan Province, China. Using conditional logistic regression analysis, we calculated the odds ratios (ORs) and 95% confidence intervals (CIs) at different lagged days, adjusting for daily average temperature (AT) and daily average relative humidity (ARH). A total of 370 JE cases were notified during the study period, with the median patient age being 4.2years. The seasonal pattern of JE cases clustered in July and August during the study period. Floods were significantly associated with an increased number of JE cases from lag 23 to lag 24, with the strongest lag effect at lag 23 (OR=2.00, 95% CI: 1.14-3.52). Similarly, AT and ARH were positively associated with daily JE cases from lag 0 to lag 8 and from lag 0 to lag 9, respectively. Floods, with AT and ARH, can be used to forecast JE outbreaks in the study area. Based on the results of this study, recommendations include undertaking control measures before the number of cases increases, especially for regions with similar geographic, climatic, and socio-economic conditions as those in the study area. Copyright © 2016 Elsevier B.V. All rights reserved.

The Use of Music Therapy During the Treatment of Cancer Patients: A Collection of Evidence

PubMed Central

Boyde, Constance; Linden, Ulrike; Boehm, Katja

2012-01-01

Background: Music therapy is one of the oldest forms of creative art therapy and has been shown to have effects in different clinical and therapeutic settings, such as schizophrenia, pain, cardiovascular parameters, and dementia. This article provides an overview of some of the recent findings in this field and also reports two single case vignettes that offer insight into day-to-day applications of clinical music therapy. Material and Methods: For the collection of clinical studies of music therapy in oncology, the databases AMED, CAIRSS, EMBASE, MEDLINE, PsychINFO, and PSYNDEX were searched with the terms “Study OR Trial” AND “Music Therapy” AND “Cancer OR Oncolog$.” Studies were analyzed with respect to their design, setting and interventions, indications, patients, and outcomes. In addition, two case vignettes present the application of music therapy for a child with leukemia and an adult patient with breast cancer. Results: We found a total of 12 clinical studies conducted between 2001 and 2011 comprised of a total of 922 patients. Eight studies had a randomized controlled design, and four studies were conducted in the field of pediatric oncology. Studies reported heterogeneous results on short-term improvements in patients' mood and relaxation and reduced exhaustion and anxiety as well as in coping with the disease and cancer-related pain. Case descriptions showed similar effects in expressing emotions, opening up new goals, and turning the mind toward a healthy process and away form a disease-centered focus. Conclusion: The use of music therapy in the integrative treatment of cancer patients is a therapeutic option whose salutogenetic potential is shown in many case studies such as those presented here. Study results, however, did not draw a conclusive picture of the overall effect of music therapy. In addition to further clinical trials, the evidence mosaic should be complemented with qualitative studies, single case descriptions, and basic research. PMID:27257528

MO-F-16A-04: Case Study: Estimation of Peak Skin Dose Following a Physician Reported “High Dose” Case and Sentinel Event Considerations

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

Supanich, M; Chu, J; Wehmeyer, A

2014-06-15

Purpose: This work offers as a teaching example a reported high dose fluoroscopy case and the workflow the institution followed to self-report a radiation overdose sentinel event to the Joint Commission. Methods: Following the completion of a clinical case in a hybrid OR room with a reported air kerma of >18 Gy at the Interventional Reference Point (IRP) the physicians involved in the case referred study to the institution's Radiation Safety Committee (RSC) for review. The RSC assigned a Diagnostic Medical Physicist (DMP) to estimate the patient's Peak Skin Dose (PSD) and analyze the case. Following the DMP's analysis andmore » estimate of a PSD of >15 Gy the institution's adverse event committee was convened to discuss the case and to self-report the case as a radiation overdose sentinel event to the Joint Commission. The committee assigned a subgroup to perform the root cause analysis and develop institutional responses to the event. Results: The self-reporting of the sentinel event and the associated root cause analysis resulted in several institutional action items that are designed to improve process and safety. A formal reporting and analysis mechanism was adopted to review fluoroscopy cases with air kerma greater than 6 Gy at the IRP. An improved and formalized radiation safety training program for physicians using fluoroscopy equipment was implemented. Additionally efforts already under way to monitor radiation exposure in the Radiology department were expanded to include all fluoroscopy equipment capable of automated dose reporting. Conclusion: The adverse event review process and the root cause analysis following the self-reporting of the sentinel event resulted in policies and procedures that are expected to improve the quality and safe usage of fluoroscopy throughout the institution.« less

Exploring the relation between online case-based discussions and learning outcomes in dental education.

PubMed

Koole, Sebastiaan; Vervaeke, Stijn; Cosyn, Jan; De Bruyn, Hugo

2014-11-01

Online case-based discussions, parallel to theoretical dental education, have been highly valued by students and supervisors. This study investigated the relation between variables of online group discussions and learning outcomes. At Ghent University in Belgium, undergraduate dental students (years two and three) are required to participate in online case-based discussion groups (five students/group) in conjunction with two theoretical courses on basic periodontics and related therapy. Each week, a patient case is discussed under supervision of a periodontist, who authored the case and performed the treatment. Each case includes treatment history and demand, intra- and extraoral images, and full diagnostic information with periodontal and radiographic status. For this retrospective study, data were obtained for all 252 students in forty-three discussion groups between 2009 and 2012. Spearman's rank correlations were calculated to investigate the relation among group dynamics (number of group posts and views), individual student contributions (number of individual posts, newly introduced elements, questions, and reactions to other posts), supervisors' interventions (number of posts and posed questions), and learning outcomes (examination result). The results showed that learning outcomes were significantly related to the number of student posts (Spearman's rho (ρ)=0.19), newly introduced elements (ρ=0.21), reactions to other posts (ρ=0.14), number of supervisors' interventions (ρ=0.12), and supervisors' questions (ρ=0.20). These results suggest that individual student contributions during online case-based discussions and the provided supervision were related to learning outcomes.

Molecular testing in lung cancer: fine-needle aspiration specimen adequacy and test prioritization prior to the CAP/IASLC/AMP Molecular Testing Guideline publication.

PubMed

Rafael, Oana C; Aziz, Mohamed; Raftopoulos, Harry; Vele, Oana E; Xu, Weisheng; Sugrue, Chiara

2014-06-01

Subtyping of lung carcinoma with immunohistochemistry is essential for diagnosis, whereas molecular testing (MT) is required for therapy guidance. In the current study, the authors report on MT performed on fine-needle aspiration specimens at the study institution over a 2-year period preceding the April 2013 College of American Pathologists (CAP)/International Association for the Study of Lung Cancer (IASLC)/Association for Molecular Pathology (AMP) Molecular Testing Guideline (MTG) publication. The database of the study institution was retrospectively queried for cases of lung and thoracic/lower cervical lymph node fine-needle aspiration specimens for 2011 through 2012. Of 246 selected cases, 26 featured a limited amount of material in cell blocks. MT increased significantly between 2011 and 2012 and was requested in 39.4% of cases (97 of 246 cases): 86 of those cases had at least 1 MT result and 11 had insufficient material for any MT. Anaplastic lymphoma kinase (ALK) testing was performed in 9 cases in which DNA was insufficient for epidermal growth factor receptor (EGFR) testing. In addition, 13 cases of adenocarcinoma/non-small cell lung carcinoma had at least 1 MT canceled because of insufficient DNA, but at the same time had an average of 3.46 immunohistochemical stains performed. Of all the cytology specimens, 10.6% featured limited material; however, no universally accepted testing sequence priority was available at the time the study was performed. As per the MTG, MT should take precedence over immunohistochemistry in cases of adenocarcinoma/non-small cell lung carcinoma. Approximately 5.3% of the specimens in the current study had insufficient material for MT while having multiple stains performed instead. The MTG also recommend performing EGFR before ALK testing; the authors found 9 cases with insufficient material for EGFR testing that had ALK testing performed. The results of the current study underscore the need for a testing prioritization algorithm in view of the MTG publication to serve as reference for both clinicians and pathologists. © 2014 American Cancer Society.

How Educators Define Their Role: Building 'Professional' Relationships with Children and Parents during Transition to Childcare: A Case Study

ERIC Educational Resources Information Center

Hostettler Schärer, Janine

2018-01-01

Using case study methodology including weekly focus group meetings and individual interviews, this article reports results of a study in a Canadian childcare centre in which four educators shared their attitudes and experiences on their role as educators and on building relationships with the children transitioning into their care and their…

Vision and Action

DTIC Science & Technology

1994-06-01

Recent results from Cognitive Neurophysiology-the discipline which is concerned, among other topics, with the study of visual agnosia (a condition...and A. Newell. GPS: A Case Study in Generality and Problem Solving. Academic Press, New York, 1969. [13] M. Farah. Visual Agnosia : Diesorders of Object...A Case Study of Visual Agnosia . Lawrence Erlbaum, Hillsdale, New Jersey, 1992. [31] D. Jacobs. Space efficient 3d model indexing. In Proc. IEEE

Why Children Join and Stay in Sports Clubs: Case Studies in Australian, French and German Swimming Clubs

ERIC Educational Resources Information Center

Light, Richard L.; Harvey, Stephen; Memmert, Daniel

2013-01-01

This article builds upon research on youth sport clubs conducted from a socio-cultural perspective by reporting on a study that inquired into the reasons why children aged 9-12 joined swimming clubs in France, Germany and Australia. Comprising three case studies it employed a mixed method approach with results considered within the framework of…

Reducing selection bias in case-control studies from rare disease registries.

PubMed

Cole, J Alexander; Taylor, John S; Hangartner, Thomas N; Weinreb, Neal J; Mistry, Pramod K; Khan, Aneal

2011-09-12

In clinical research of rare diseases, where small patient numbers and disease heterogeneity limit study design options, registries are a valuable resource for demographic and outcome information. However, in contrast to prospective, randomized clinical trials, the observational design of registries is prone to introduce selection bias and negatively impact the validity of data analyses. The objective of the study was to demonstrate the utility of case-control matching and the risk-set method in order to control bias in data from a rare disease registry. Data from the International Collaborative Gaucher Group (ICGG) Gaucher Registry were used as an example. A case-control matching analysis using the risk-set method was conducted to identify two groups of patients with type 1 Gaucher disease in the ICGG Gaucher Registry: patients with avascular osteonecrosis (AVN) and those without AVN. The frequency distributions of gender, decade of birth, treatment status, and splenectomy status were presented for cases and controls before and after matching. Odds ratios (and 95% confidence intervals) were calculated for each variable before and after matching. The application of case-control matching methodology results in cohorts of cases (i.e., patients with AVN) and controls (i.e., patients without AVN) who have comparable distributions for four common parameters used in subject selection: gender, year of birth (age), treatment status, and splenectomy status. Matching resulted in odds ratios of approximately 1.00, indicating no bias. We demonstrated bias in case-control selection in subjects from a prototype rare disease registry and used case-control matching to minimize this bias. Therefore, this approach appears useful to study cohorts of heterogeneous patients in rare disease registries.

Evaluating the effect of intraoperative peritoneal lavage on bacterial culture in dogs with suspected septic peritonitis.

PubMed

Swayne, Seanna L; Brisson, Brigitte; Weese, J Scott; Sears, William

2012-09-01

This pilot study describes the effect of intraoperative peritoneal lavage (IOPL) on bacterial counts and outcome in clinical cases of septic peritonitis. Intraoperative samples were cultured before and after IOPL. Thirty-three dogs with presumed septic peritonitis on the basis of cytology were managed surgically during the study period. Positive pre-lavage bacterial cultures were found in 14 cases, 13 of which were a result of intestinal leakage. The post-lavage cultures showed fewer isolates in 9 cases and in 1 case became negative. The number of dogs with a decrease in the concentration of bacteria cultured from pre-lavage to post-lavage samples was not statistically significant. There was no significant effect of the change in pre- to post-lavage culture, single versus multiple types of bacteria, selection of an appropriate empiric antimicrobial on survival or the need for subsequent surgery. This pilot study describes the effect of intraoperative peritoneal lavage (IOPL) on bacterial counts and outcome in clinical cases of septic peritonitis. Intraoperative samples were cultured before and after IOPL. Thirty-three dogs with presumed septic peritonitis on the basis of cytology were managed surgically during the study period. Positive pre-lavage bacterial cultures were found in 14 cases, 13 of which were a result of intestinal leakage. The post-lavage cultures showed fewer isolates in 9 cases and in 1 case became negative. The number of dogs with a decrease in the concentration of bacteria cultured from pre-lavage to post-lavage samples was not statistically significant. There was no significant effect of the change in pre- to post-lavage culture, single versus multiple types of bacteria, selection of an appropriate empiric antimicrobial on survival or the need for subsequent surgery.

Toxoplasma gondii Infection and Headache: A Matched Case-Control Study in a Public Hospital in Durango City, Mexico

PubMed Central

Alvarado-Esquivel, Cosme; Rico-Almochantaf, Yazmin del Rosario; Sanchez-Anguiano, Luis Francisco; Quinones-Canales, Gerardo; Hernandez-Tinoco, Jesus; Torres-Gonzalez, Jorge; Gonzalez-Silva, Maria Felix; Ramirez-Valles, Eda Guadalupe

2018-01-01

Background Toxoplasma gondii (T. gondii) can disseminate to brain in infected hosts. Little is known about the magnitude of the association between this infection and headache. Therefore, we sought to determine the association of T. gondii seropositivity and headache in patients attending neurological consultations in a public hospital in Durango City, Mexico. Methods Through an age- and gender-matched case-control study, 105 patients suffering from headache and 105 subjects without headache were examined for anti-T. gondii IgG and IgM antibodies using commercially available enzyme-linked immunoassays. Seropositive cases were analyzed for detection of T. gondii DNA by polymerase chain reaction. Results Anti-T. gondii IgG antibodies were found in five (4.8%) of the 105 cases and in seven (6.7%) of the 105 controls (odds ratio (OR) = 0.70; 95% confidence interval (CI): 0.21 - 2.28; P = 0.76). The frequency of high (> 150 IU/mL) levels of anti-T. gondii IgG antibodies among anti-T. gondii IgG positive individuals was significantly (P = 0.01) higher in cases (5/5) than in controls (1/7). Anti-T. gondii IgM antibodies were found in one (20.0%) of the five IgG seropositive cases, and in three (42.9%) of the seven IgG seropositive controls (P = 0.60). T. gondii DNA was not detected in any of the five anti-T. gondii IgG positive cases. No association between T. gondii infection and specific headache types was found. Conclusions This is the first matched case-control study on the association between T. gondii infection and headache. Results suggest that high anti-T. gondii IgG antibody levels, but not T. gondii seropositivity, were associated with headache in the population studied. PMID:29238431

[Diagnosis of lung embolism. Prospective study].

PubMed

Melcher, G A; Frauchiger, B; Brunner, W; Nager, F

1987-01-31

In a prospective study over the years 1983-1985, 300 cases of acute pulmonary embolism were analyzed in relation to predisposing factors, clinical signs, arterial blood gas analysis and isotope perfusion scanning. Comparison of this prospective study with an earlier retrospective one showed similar results, with the exception of isotope scanning, an investigation which has gained increasing diagnostic reliability (highly suggestive results in 94% of patients with massive pulmonary embolism and in 64% with submassive pulmonary embolism). In two thirds of the cases the diagnosis was established during the first day after hospitalisation. In 10% of the patients pulmonary embolism occurred despite anticoagulant therapy.

Wind Tunnel Data Fusion and Immersive Visualization: A Case Study

NASA Technical Reports Server (NTRS)

Severance, Kurt; Brewster, Paul; Lazos, Barry; Keefe, Daniel

2001-01-01

This case study describes the process of fusing the data from several wind tunnel experiments into a single coherent visualization. Each experiment was conducted independently and was designed to explore different flow features around airplane landing gear. In the past, it would have been very difficult to correlate results from the different experiments. However, with a single 3-D visualization representing the fusion of the three experiments, significant insight into the composite flowfield was observed that would have been extremely difficult to obtain by studying its component parts. The results are even more compelling when viewed in an immersive environment.

Positive Bacteriological Analyses in Individuals With Diabetes Mellitus: Preliminary Results From a Forensic Study.

PubMed

Palmiere, Cristian; Tettamanti, Camilla

2018-06-01

Increased infection susceptibility in the diabetic population is a controversial issue in the clinical field. The greater frequency of infections in diabetic patients has been speculated as caused by the hyperglycemic environment that favors immune dysfunction. The aim of this study was to investigate the proportion of positive bacterial cultures in a series of diabetic individuals who underwent forensic investigations and assess the frequency of hyperglycemia at the time of death in these cases as well as the percentage of diabetics with cause of death due to bacterial infection. Forensic autopsy cases characterized by positive bacterial cultures and pre-existing diagnosis of diabetes mellitus were included in the study. Initial findings revealed that 12% (7/58 cases) of positive bacterial cultures concerned individuals with a pre-existing diagnosis of diabetes mellitus. Bacterial infection was considered to be the cause of death in 22% (7/31 cases) of diabetics with positive bacterial cultures. Hyperglycemia could be identified in 1 case only at the time of death. These preliminary results highlight the usefulness of systematically performing postmortem bacteriology in the forensic setting to more precisely characterize infectious risk factors in diabetics.

Analysis of risk factors for schizophrenia with two different case definitions: a nationwide register-based external validation study.

PubMed

Sørensen, Holger J; Larsen, Janne T; Mors, Ole; Nordentoft, Merete; Mortensen, Preben B; Petersen, Liselotte

2015-03-01

Different case definitions of schizophrenia have been used in register based research. However, no previous study has externally validated two different case definitions of schizophrenia against a wide range of risk factors for schizophrenia. We investigated hazard ratios (HRs) for a wide range of risk factors for ICD-10 DCR schizophrenia using a nationwide Danish sample of 2,772,144 residents born in 1955-1997. We compared one contact only (OCO) (the case definition of schizophrenia used in Danish register based studies) with two or more contacts (TMC) (a case definition of at least 2 inpatient contacts with schizophrenia). During the follow-up, the OCO definition included 15,074 and the TMC 7562 cases; i.e. half as many. The TMC case definition appeared to select for a worse illness course. A wide range of risk factors were uniformly associated with both case definitions and only slightly higher risk estimates were found for the TMC definition. Choosing at least 2 inpatient contacts with schizophrenia (TMC) instead of the currently used case definition would result in almost similar risk estimates for many well-established risk factors. However, this would also introduce selection and include considerably fewer cases and reduce power of e.g. genetic studies based on register-diagnosed cases only. Copyright © 2015 Elsevier B.V. All rights reserved.

Case-control studies in diabetes. Do they really use a case-control design?

PubMed

Ramos, Analía; Mendoza, Lilian Cristina; Rabasa, Fernanda; Bolíbar, Ignasi; Puig, Teresa; Corcoy, Rosa

2017-07-01

Studies defined as case-control do not always use this design. We aimed to estimate the frequency of mislabelled case-control studies in published articles in the area of diabetes and to identify the predictors of incorrect labelling. We searched Medline and Web of Science for articles with "diabetes" and "case control" in title and filtered for language (English/Romance) and period (January 2010-December 2014). Inclusion criteria were: (1) statement to use a case-control design in title, (2) to be a final full-length publication and (3) to have original data in the area of diabetes. Three independent reviewers went through titles, looked for full texts and reviewed them. Discrepancies were settled with a fourth reviewer. Expert epidemiologist advice was requested in case of doubt. case-control mislabelling; addressed predictors: publication year, journal impact factor and journal subject. proportion of mislabelled CC articles and assessment of predictors by multivariate logistic regression analysis. We retrieved 362 articles, 251 of them fulfilling inclusion criteria. The proportion of mislabelled CC studies was 43.8% (confidence interval 95% 37.7-50.0%). Most mislabelled studies had a cross-sectional design (82.7%). Predictors of mislabelling were publication year, journal impact factor and journal area. A relevant subset of studies defined as case-control in the area of diabetes correspond to mislabelled cross-sectional studies. Incorrect labelling misleads readers regarding the interpretation of results and the cause-effect hypothesis. Researchers, reviewers and editors should be aware of and commit to settle this issue.

Methods to control for unmeasured confounding in pharmacoepidemiology: an overview.

PubMed

Uddin, Md Jamal; Groenwold, Rolf H H; Ali, Mohammed Sanni; de Boer, Anthonius; Roes, Kit C B; Chowdhury, Muhammad A B; Klungel, Olaf H

2016-06-01

Background Unmeasured confounding is one of the principal problems in pharmacoepidemiologic studies. Several methods have been proposed to detect or control for unmeasured confounding either at the study design phase or the data analysis phase. Aim of the Review To provide an overview of commonly used methods to detect or control for unmeasured confounding and to provide recommendations for proper application in pharmacoepidemiology. Methods/Results Methods to control for unmeasured confounding in the design phase of a study are case only designs (e.g., case-crossover, case-time control, self-controlled case series) and the prior event rate ratio adjustment method. Methods that can be applied in the data analysis phase include, negative control method, perturbation variable method, instrumental variable methods, sensitivity analysis, and ecological analysis. A separate group of methods are those in which additional information on confounders is collected from a substudy. The latter group includes external adjustment, propensity score calibration, two-stage sampling, and multiple imputation. Conclusion As the performance and application of the methods to handle unmeasured confounding may differ across studies and across databases, we stress the importance of using both statistical evidence and substantial clinical knowledge for interpretation of the study results.

A probability model for evaluating the bias and precision of influenza vaccine effectiveness estimates from case-control studies.

PubMed

Haber, M; An, Q; Foppa, I M; Shay, D K; Ferdinands, J M; Orenstein, W A

2015-05-01

As influenza vaccination is now widely recommended, randomized clinical trials are no longer ethical in many populations. Therefore, observational studies on patients seeking medical care for acute respiratory illnesses (ARIs) are a popular option for estimating influenza vaccine effectiveness (VE). We developed a probability model for evaluating and comparing bias and precision of estimates of VE against symptomatic influenza from two commonly used case-control study designs: the test-negative design and the traditional case-control design. We show that when vaccination does not affect the probability of developing non-influenza ARI then VE estimates from test-negative design studies are unbiased even if vaccinees and non-vaccinees have different probabilities of seeking medical care against ARI, as long as the ratio of these probabilities is the same for illnesses resulting from influenza and non-influenza infections. Our numerical results suggest that in general, estimates from the test-negative design have smaller bias compared to estimates from the traditional case-control design as long as the probability of non-influenza ARI is similar among vaccinated and unvaccinated individuals. We did not find consistent differences between the standard errors of the estimates from the two study designs.

The value of ultrasonography alone in screening surveys of cystic echinococcosis in children in Turkey.

PubMed

Kilimcioğlu, Ali A; Ozkol, Mine; Bayindir, Petek; Girginkardeşler, Nogay; Ostan, Ipek; Ok, Ulgen Z

2006-12-01

A total of 1,205 primary school children were examined for cystic echinococcosis in five villages of Manisa, Turkey, to evaluate the efficacy of diagnostic methods of this infection in community-based screening surveys. Six hundred and thirty children from three villages, examined by a portable ultrasound scanner, chest microfilm and serological methods (ELISA, indirect hemagglutination) in our previous study, were designated as Study Group 1; and 575 children, from two adjacent villages, examined by ultrasonography alone in the present study, were designated as Study Group 2. In Study Group 1, hepatic cystic echinococcosis was detected in two cases (0.3%) by ultrasonography, while 43 (8.9%) and 49 (10.1%) cases were found to be positive for cystic echinococcosis by ELISA and indirect hemagglutination, respectively. Three of 575 children (0.5%) were diagnosed with cystic echinococcosis (two hepatic and one renal involvement) by ultrasonography alone in Study Group 2; and lung lesions were later detected in both cases with liver involvement by chest radiography. Our results suggested that serological tests may be beneficial in suspected cases for confirmation and differential diagnosis, but have some drawbacks, such as discrepancy in results and high false seropositivity rates. Chest microfilm is not easy in field studies and exposure to X-ray is undesirable. As a reliable, simple, inexpensive and rapid technique, ultrasonography alone is recommended to be used in community-based screening surveys for cystic echinococcosis with confirmatory tests for suspected cases found during the screening program.

Effect Size for Token Economy Use in Contemporary Classroom Settings: A Meta-Analysis of Single-Case Research

ERIC Educational Resources Information Center

Soares, Denise A.; Harrison, Judith R.; Vannest, Kimberly J.; McClelland, Susan S.

2016-01-01

Recent meta-analyses of the effectiveness of token economies (TEs) report insufficient quality in the research or mixed effects in the results. This study examines the contemporary (post-Public Law 94-142) peer-reviewed published single-case research evaluating the effectiveness of TEs. The results are stratified across quality of demonstrated…

Department of Defense Ecosystem Management Policy Evaluation

DTIC Science & Technology

2002-08-01

HQ Naval Facilities Engineering Command, DC • Tom Hillard, Fort Stewart, GA • Manual Joia , MCLB Barstow, CA • John Krupovage, Tinker AFB, OK...studies can follow single or multiple-case designs . Multiple cases strengthen the results and increase confidence in those results (Tellis 1997...groups having responsibility for maintaining their designated data layers (range, fish and wildlife, threatened and endangered species, forestry

Linking Resources to Results: The Chicago Public Education Fund's Master Teacher Initiative. Principles for Effective Education Grantmaking. Case in Brief Number 1

ERIC Educational Resources Information Center

Grantmakers for Education, 2012

2012-01-01

"Linking Resources to Results" explores the deliberate approach--including specific goals, a clearly articulated grantmaking strategy and benchmarks for measuring progress--the Chicago Public Education Fund used to help the Chicago Public Schools recognize, reward and deploy high-quality teachers. The case study is intended to help…

The role of phthalate esters in autism development: A systematic review.

PubMed

Jeddi, Maryam Zare; Janani, Leila; Memari, Amir Hossein; Akhondzadeh, Shahin; Yunesian, Masud

2016-11-01

Available evidence implicates environmental factors in the pathogenesis of autism spectrum disorders (ASD). However, the role of specific environmental chemicals such as phthalate esters that influence ASD risk remains elusive. This paper systematically reviews published evidences on association between prenatal and/or childhood exposure to phthalate and ASD. Studies pertaining to systematic literature search from Scopus, PubMed, PsycInfo and Web of Science prior to December 2015 were identified. The authors included studies which assessed the effect of exposure to phthalates on occurrence of ASD. This comprehensive bibliographic search identified five independent studies. Each eligible paper was summarized with respect to its methods and results with particular attention to study design and exposure assessment. Because of the heterogeneity in the type of included studies, different methods of assessing exposure to phthalates and the use of different statistics for summarizing the results, meta-analysis could not be used to combine the results of included studies. The results of this systematic review have revealed the limited number of studies conducted and assessed phthalate exposure. Seven studies were regarded as relevant to the objectives of this review. Two of them did not measure phthalate exposure directly and did not result in quantitative results. Out of the five studies in which phthalate exposure was mainly measured by the examining biomarkers in biological samples, two were cohort studies (one with positive results and another one with not clear association). Among the three case control studies, two of them showed a significant relation between exposure to phthalate and ASD and the last case control study had negative results. Indeed, this case control studies showed a compromised phthalate metabolite glucuronidation pathway, as a probable explanation of mechanism of the relation between phthalate exposure and ASD. This review reveals evidence showing a connection between exposure to phthalates and ASD. Nevertheless, further research is needed with appropriate attention to exposure assessment and relevant pre and post-natal cofounders. Copyright © 2016 Elsevier Inc. All rights reserved.

A new atraumatic method of removing fractured palatal root using endodontic H-files luted with resin modified glass ionomercement: A pilot study

PubMed Central

Kannan, V. Sadesh; Narayanan, G. R. Sathya; Ahamed, A. Saneem; Velavan, K.; Elavarasi, E.; Danavel, C.

2014-01-01

Purpose: The purpose of this study is to evaluate the efficacy of using endodontic H-files luted with Resin modified glass ionomer cement (RMGIC) in removing fractured palatal root. Materials and Methods: This study consists of 30 patients, of which 16 were males and 14 were females with a mean age of 36 years. In which, 19 were maxillary first molar and 11 were maxillary second molar. In that, 18 were fractured at the level of apical 1/3rd and 12 were at the level of apical 2/3rd. All cases were first tried with endodontic H-files, within few attempts, it was wedged tightly in the remaining pulp chamber with one or two clockwise direction and using sudden jerk with a downward pull the remnant part was removed. The cases, which fail to deliver after several attempts were taken up for study. After sufficient isolation with a rubber dam and the socket was dried using sterile gauze, under good lighting and vision again the same file was introduced, which was now luted with RMGIC, after 5 min of setting time, the same attempt using sudden jerk with a downward pull was given. Results: In those 30 cases, 20 cases were removed in the first few attempts using endodontic H-files. The 10 cases (7 cases were apical 2/3rd and 3 cases were of apical 1/3rd), which fails to come out were tried using endodontic H-files luted with RMGIC, in which 9 cases were successfully removed (90%) and 1 case of apical 1/3rd was again failed to come out. Conclusion: Even though, the number of cases were too small to come to a definitive conclusion, the encouraging result (90%) and technically easy, this is a novel method of removing fractured palatal root atraumatically and devoid of any complication. PMID:25210360

Life cycle design metrics for energy generation technologies: Method, data, and case study

NASA Astrophysics Data System (ADS)

Cooper, Joyce; Lee, Seung-Jin; Elter, John; Boussu, Jeff; Boman, Sarah

A method to assist in the rapid preparation of Life Cycle Assessments of emerging energy generation technologies is presented and applied to distributed proton exchange membrane fuel cell systems. The method develops life cycle environmental design metrics and allows variations in hardware materials, transportation scenarios, assembly energy use, operating performance and consumables, and fuels and fuel production scenarios to be modeled and comparisons to competing systems to be made. Data and results are based on publicly available U.S. Life Cycle Assessment data sources and are formulated to allow the environmental impact weighting scheme to be specified. A case study evaluates improvements in efficiency and in materials recycling and compares distributed proton exchange membrane fuel cell systems to other distributed generation options. The results reveal the importance of sensitivity analysis and system efficiency in interpreting case studies.

Pediatric Exposures to Topical Benzocaine Preparations Reported to a Statewide Poison Control System

PubMed Central

Vohra, Rais; Huntington, Serena; Koike, Jennifer; Le, Kevin; Geller, Richard J.

2017-01-01

Introduction Topical benzocaine is a local anesthetic commonly used to relieve pain caused by teething, periodontal irritation, burns, wounds, and insect bites. Oral preparations may contain benzocaine concentrations ranging from 7.5% to 20%. Pediatric exposure to such large concentrations may result in methemoglobinemia and secondarily cause anemia, cyanosis, and hypoxia. Methods This is a retrospective study of exposures reported to a statewide poison control system. The electronic health records were queried for pediatric exposures to topical benzocaine treated at a healthcare facility from 2004 to 2014. Cases of benzocaine exposure were reviewed for demographic and clinical information, and descriptive statistical analysis was performed. Results The query resulted in 157 cases; 58 were excluded due to co-ingestants, or miscoding of non-benzocaine exposures. Children four years of age and younger represented the majority of cases (93%) with a median age of 1 year. There were 88 cases of accidental/ exploratory exposure, while 6 cases resulted from therapeutic application or error, 4 cases from adverse reactions, and 1 case from an unknown cause. Asymptomatic children accounted for 75.5% of cases, but major clinical effects were observed in 5 patients. Those with serious effects were exposed to a range of benzocaine concentrations (7.5–20%), with 4 cases reporting methemoglobin levels between 20.2%–55%. Methylene blue was administered in 4 of the cases exhibiting major effects. Conclusion The majority of exposures were accidental ingestions by young children. Most exposures resulted in minor to no effects. However, some patients required treatment with methylene blue and admission to a critical care unit. Therapeutic application by parents or caregivers may lead to adverse effects from these commonly available products. PMID:28874945

Interleukin-10-1082G/A polymorphism and acute liver graft rejection: A meta-analysis

PubMed Central

Liu, Fei; Li, Bo; Wang, Wen-Tao; Wei, Yong-Gang; Yan, Lv-Nan; Wen, Tian-Fu; Xu, Ming-Qing; Yang, Jia-Yin

2012-01-01

AIM: To investigate the association between interleukin (IL)-10-1082 (G/A) promoter polymorphism and acute rejection (AR) in liver transplant (LT) recipients. METHODS: Two investigators independently searched the Medline, Embase, China National Knowledge Infrastructure, and Chinese Biomedicine Databases. Summary odds ratios (ORs) and 95% CIs for IL-10-1082 G/A polymorphism and AR were calculated in a fixed- and a random-effects model as appropriate. RESULTS: This meta-analysis included seven case-control studies, which comprised 652 cases of LT recipients in which 241 cases developed AR and 411 cases did not develop AR. Overall, the variant A allele was not associated with AR risk when compared with the wild-type G allele (OR = 0.94, 95% CI: 0.64-1.39). Moreover, similar results were observed when the AA genotype was compared with the AG/GG genotype (OR = 1.05, 95% CI: 0.55-2.02). When stratifying for ethnicity, no significant association was observed among either Caucasians or Asians. Because only one study was performed in Asian patients, the result of subgroup analysis by ethnicity would not be reliable for Asians. Limiting the analysis to the studies with controls in the Hardy-Weinberg equilibrium, the results were persistent and robust. No publication bias was found in the present study. CONCLUSION: This meta-analysis suggests that IL-10-1082 G/A polymorphism may be not associated with AR risk in LT recipients among Caucasians. PMID:22371646

Positive predictive value of a case definition for diabetes mellitus using automated administrative health data in children and youth exposed to antipsychotic drugs or control medications: a Tennessee Medicaid study

PubMed Central

2012-01-01

Background We developed and validated an automated database case definition for diabetes in children and youth to facilitate pharmacoepidemiologic investigations of medications and the risk of diabetes. Methods The present study was part of an in-progress retrospective cohort study of antipsychotics and diabetes in Tennessee Medicaid enrollees aged 6–24 years. Diabetes was identified from diabetes-related medical care encounters: hospitalizations, outpatient visits, and filled prescriptions. The definition required either a primary inpatient diagnosis or at least two other encounters of different types, most commonly an outpatient diagnosis with a prescription. Type 1 diabetes was defined by insulin prescriptions with at most one oral hypoglycemic prescription; other cases were considered type 2 diabetes. The definition was validated for cohort members in the 15 county region geographically proximate to the investigators. Medical records were reviewed and adjudicated for cases that met the automated database definition as well as for a sample of persons with other diabetes-related medical care encounters. Results The study included 64 cases that met the automated database definition. Records were adjudicated for 46 (71.9%), of which 41 (89.1%) met clinical criteria for newly diagnosed diabetes. The positive predictive value for type 1 diabetes was 80.0%. For type 2 and unspecified diabetes combined, the positive predictive value was 83.9%. The estimated sensitivity of the definition, based on adjudication for a sample of 30 cases not meeting the automated database definition, was 64.8%. Conclusion These results suggest that the automated database case definition for diabetes may be useful for pharmacoepidemiologic studies of medications and diabetes. PMID:22920280

Quantitative risk management in gas injection project: a case study from Oman oil and gas industry

NASA Astrophysics Data System (ADS)

Khadem, Mohammad Miftaur Rahman Khan; Piya, Sujan; Shamsuzzoha, Ahm

2017-09-01

The purpose of this research was to study the recognition, application and quantification of the risks associated in managing projects. In this research, the management of risks in an oil and gas project is studied and implemented within a case company in Oman. In this study, at first, the qualitative data related to risks in the project were identified through field visits and extensive interviews. These data were then translated into numerical values based on the expert's opinion. Further, the numerical data were used as an input to Monte Carlo simulation. RiskyProject Professional™ software was used to simulate the system based on the identified risks. The simulation result predicted a delay of about 2 years as a worse case with no chance of meeting the project's on stream date. Also, it has predicted 8% chance of exceeding the total estimated budget. The result of numerical analysis from the proposed model is validated by comparing it with the result of qualitative analysis, which was obtained through discussion with various project managers of company.

Analyzing self-controlled case series data when case confirmation rates are estimated from an internal validation sample.

PubMed

Xu, Stanley; Clarke, Christina L; Newcomer, Sophia R; Daley, Matthew F; Glanz, Jason M

2018-05-16

Vaccine safety studies are often electronic health record (EHR)-based observational studies. These studies often face significant methodological challenges, including confounding and misclassification of adverse event. Vaccine safety researchers use self-controlled case series (SCCS) study design to handle confounding effect and employ medical chart review to ascertain cases that are identified using EHR data. However, for common adverse events, limited resources often make it impossible to adjudicate all adverse events observed in electronic data. In this paper, we considered four approaches for analyzing SCCS data with confirmation rates estimated from an internal validation sample: (1) observed cases, (2) confirmed cases only, (3) known confirmation rate, and (4) multiple imputation (MI). We conducted a simulation study to evaluate these four approaches using type I error rates, percent bias, and empirical power. Our simulation results suggest that when misclassification of adverse events is present, approaches such as observed cases, confirmed case only, and known confirmation rate may inflate the type I error, yield biased point estimates, and affect statistical power. The multiple imputation approach considers the uncertainty of estimated confirmation rates from an internal validation sample, yields a proper type I error rate, largely unbiased point estimate, proper variance estimate, and statistical power. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Greater Polar Moment of Inertia at the Tibia in Athletes Who Develop Stress Fractures

PubMed Central

Weidauer, Lee A.; Binkley, Teresa; Vukovich, Matt; Specker, Bonny

2014-01-01

Background: Several previous investigations have determined potential risk factors for stress fractures in athletes and military personnel. Purpose: To determine factors associated with the development of stress fractures in female athletes. Study Design: Case-control study; Level of evidence, 3. Methods: A total of 88 female athletes (cross-country, n = 29; soccer, n = 15; swimming, n = 9; track and field, n = 14; volleyball, n = 12; and basketball, n = 9) aged 18 to 24 years were recruited to participate in a longitudinal bone study and had their left distal tibia at the 4%, 20%, and 66% sites scanned by peripheral quantitative computed tomography (pQCT). Patients included 23 athletes who developed stress fractures during the following year (cases). Whole body, hip, and spine scans were obtained using dual-energy x-ray absorptiometry (DXA). Analysis of covariance was used to determine differences in bone parameters between cases and controls after adjusting for height, lower leg length, lean mass, fat mass, and sport. Results: No differences were observed between cases and controls in any of the DXA measurements. Cases had significantly greater unadjusted trabecular bone mineral content (BMC), greater polar moment of inertia (PMI) at the 20% site, and greater cortical BMC at the 66% site; however, after adjusting for covariates, the differences became nonsignificant. When analyses were repeated using all individuals who had ever had a stress fracture as cases (n = 31) and after controlling for covariates, periosteal circumference was greater in the cases than the controls (71.1 ± 0.7 vs 69.4 ± 0.5 mm, respectively; P = .04). Conclusion: A history of stress fractures is associated with larger bones. These findings are important because larger bones were previously reported to be protective against fractures and stress fractures, but study findings indicate that may not always be true. One explanation could be that individuals who sustain stress fractures have greater loading that results in greater periosteal circumference but also results in the development of stress fractures. PMID:26535343

Comparative study between quantitative digital image analysis and fluorescence in situ hybridization of breast cancer equivocal human epidermal growth factor receptors 2 score 2(+) cases.

PubMed

Ayad, Essam; Mansy, Mina; Elwi, Dalal; Salem, Mostafa; Salama, Mohamed; Kayser, Klaus

2015-01-01

Optimization of workflow for breast cancer samples with equivocal human epidermal growth factor receptors 2 (HER2)/neu score 2(+) results in routine practice, remains to be a central focus of the on-going efforts to assess HER2 status. According to the College of American Pathologists/American Society of Clinical Oncology guidelines equivocal HER2/neu score 2(+) cases are subject for further testing, usually by fluorescence in situ hybridization (FISH) investigations. It still remains on open question, whether quantitative digital image analysis of HER2 immunohistochemistry (IHC) stained slides can assist in further refining the HER2 score 2(+). To assess utility of quantitative digital analysis of IHC stained slides and compare its performance to FISH in cases of breast cancer with equivocal HER2 score 2(+). Fifteen specimens (previously diagnosed as breast cancer and was evaluated as HER 2(-) score 2(+)) represented the study population. Contemporary new cuts were prepared for re-evaluation of HER2 immunohistochemical studies and FISH examination. All the cases were digitally scanned by iScan (Produced by BioImagene [Now Roche-Ventana]). The IHC signals of HER2 were measured using an automated image analyzing system (MECES, www.Diagnomx.eu/meces). Finally, a comparative study was done between the results of the FISH and the quantitative analysis of the virtual slides. Three out of the 15 cases with equivocal HER2 score 2(+), turned out to be positive (3(+)) by quantitative digital analysis, and 12 were found to be negative in FISH too. Two of these three positive cases proved to be positive with FISH, and only one was negative. Quantitative digital analysis is highly sensitive and relatively specific when compared to FISH in detecting HER2/neu overexpression. Therefore, it represents a potential reliable substitute for FISH in breast cancer cases, which desire further refinement of equivocal IHC results.

Tonsillectomy remains a questionable option for pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS)

PubMed Central

Windfuhr, Jochen P.

2016-01-01

Background: Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) is a disease attributed to children with obsessive compulsive disorders (OCD) or tic disorders associated with streptococcal infections. Because otolaryngologists examine a large number of pediatric patients with recurrent streptococcal infections, tonsillectomy (TE) is a common option of therapy. This study was conducted to evaluate the efficacy of TE in patients presenting with verified PANDAS. Material and methods: A PubMed review was performed using search terms “tonsillectomy” and “PANDAS”, “OCD”, “compulsive” “pediatric autoimmune”, “chorea” and “tic” limited by publication date of January 1, 1995, to July 31, 2015. Reviews without patients were not included in the review. Results: Nine papers matched our search criteria, including 6 case reports with 8 patients and 3 case series. Most case reports were in favor of TE, but this was by far not supported by the findings in the case series. The follow-up ranged from 2 to 36 months in case reports and from 24 to 36 in case series. Conclusion: Establishing the diagnosis of PANDAS is complicated because of underlying comorbidities in the field of neurology-psychiatry and the lack of a reliable biomarker. The positive outcome after TE as reported in case studies may be influenced by the postoperative medication and is not supported by the results of large-scale studies. In the light of the considerable postoperative morbidity rate, it appears wise to indicate TE for PANDAS only in supervised clinical studies. PMID:28025607

Performance of Momguard, a new non-invasive prenatal testing protocol developed in Korea.

PubMed

Lee, Mi-Young; Cho, Dae-Yeon; Won, Hye-Sung; Hwang, Ah Reum; Jeong, Bada; Kim, Jihun; Oh, Mijin

2015-09-01

To evaluate the performance of Momguard, non-invasive prenatal test (NIPT) for detecting trisomy (T) 21, T18, T13, and sex-chromosome abnormalities recently developed in Korea. This preliminary study formed part of a large prospective cohort study conducted at Asan Medical Center, Seoul, Korea. Only pregnant women who underwent both NIPT and confirmatory karyotyping were included in this study. NIPT results were compared with those of karyotype analyses. Among 93 eligible cases, NIPT results could not be obtained in one case due to a low fetal cell-free DNA fraction. Based on NIPT, eight cases of fetal aneuploidies, including T21 (n=5), T18 (n=2), and T13 (n=1), were identified. For T21 and T18, the sensitivity and specificity of NIPT were both 100%, with a false-positive and false-negative rate of 0% and a positive-predictive value of 100%. One patient classified as having intermediate risk for T13 by NIPT was confirmed to have T13 by karyotyping, and there were no false-negative cases. No cases of sex-chromosome anomalies were detected by NIPT or karyotyping during the study period. Momguard is a reliable screening tool for detecting T21 and T18. For T13 and sex-chromosome anomalies, further prospective studies are necessary to confirm its utility.

[Shigellosis outbreak with 146 cases related to a fair].

PubMed

Castell Monsalve, Juan; Gutiérrez Avila, Gonzalo; Rodolfo Saavedra, Remedios; Santos Azorín, Antonia

2008-01-01

On September 3, 2005, the Ciudad Real Public Health Service (Spain) received a report of 20 cases of gastroenteritis in the municipality of Daimiel. We conducted an investigation to determine the cause or causes of the outbreak and to implement control measures. Most of the cases involved young people who visited the municipality's fair. We carried out a descriptive study and an analytic case-control study. In the descriptive study, all variables of interest available in the medical records were included. In the case-control study, each case was matched with a control by age (plus or minus 5 years), gender, and attendance at the fair. Sixty-five cases and 65 controls were finally included in the study. Samples of foods and stools from food handlers were taken. We found 196 cases, 146 of which were confirmed. The epidemic curve suggested a common source of infection with a short period of activity. The case-control study showed an association between infection and eating potatoes with a sauce at any of the fair's five food stalls (OR = 20.56; 95%CI, 6.15-75.93; p < 0.0001). Logistic regression analysis showed an association with eating potatoes in food stall number 2 (OR = 6.38; 95%CI, 1.70-23.90; p < 0.0059). Neither samples of foods nor stools from food handlers yielded any positive results. However, Shigella sonnei was isolated from stool samples from 20 cases. The epidemiological study suggested that the most probable cause of the outbreak was a sauce, handmade with garlic, milk, and oil and served with the potatoes.

[The role of arthroscopy in subacromial pathology. Retrospective study of a series of arthroscopic acromioplasties].

PubMed

Schiepers, P; Pauwels, P; Penders, W; Brandelet, B; Putz, P

2000-12-01

The authors report the results of a retrospective study of 59 arthroscopic acromioplasties. Objective shoulder assessment was made following the relative Constant score and UCLA rating scale. Subjective satisfaction of the patient was assessed on an analogic scale. The patients were divided into 3 groups, according to the subacromial pathology treated. The first group (27 shoulders in 23 patients) included patients with subacromial impingement without a complete rotator cuff tear. The objective result, between 80 and 90%, was close to results in others series reported. Distinction between patients with no tear or partial tear of the cuff showed better results for patients with partial tears. This surprising finding may be at least partially explained by the fact that these patients were older than those without a cuff tear. The results of this study, and the review of the literature, confirmed the value of subacromial decompression as a treatment for impingement without complete cuff tear resistant to at least 6 months of conservative treatment; comparison between surgical and arthroscopic series showed similar results. The second group (19 shoulders in 19 patients) included patients with impingement and complete cuff tear. The objective results and the literature review led us to specify indications. Subacromial decompression with debridment of the tear has given excellent results in older patients--over 60 for most authors--when the tear was limited. In our study, the function of the shoulder at revision was good when the tear was limited to the supraspinatus and part of the infraspinatus. The third group (13 shoulders in 10 patients) included patients with calcifying tendinitis. Arthroscopic acromioplasty was performed in every case; excision of the calcification was performed in less than half of the cases and did not influence the final result. The calcifications had disappeared at revision in all cases. This may suggest that the treatment of the associated impingement was the most important procedure in these cases.

A Framework for Testing Scientific Software: A Case Study of Testing Amsterdam Discrete Dipole Approximation Software

NASA Astrophysics Data System (ADS)

Shao, Hongbing

Software testing with scientific software systems often suffers from test oracle problem, i.e., lack of test oracles. Amsterdam discrete dipole approximation code (ADDA) is a scientific software system that can be used to simulate light scattering of scatterers of various types. Testing of ADDA suffers from "test oracle problem". In this thesis work, I established a testing framework to test scientific software systems and evaluated this framework using ADDA as a case study. To test ADDA, I first used CMMIE code as the pseudo oracle to test ADDA in simulating light scattering of a homogeneous sphere scatterer. Comparable results were obtained between ADDA and CMMIE code. This validated ADDA for use with homogeneous sphere scatterers. Then I used experimental result obtained for light scattering of a homogeneous sphere to validate use of ADDA with sphere scatterers. ADDA produced light scattering simulation comparable to the experimentally measured result. This further validated the use of ADDA for simulating light scattering of sphere scatterers. Then I used metamorphic testing to generate test cases covering scatterers of various geometries, orientations, homogeneity or non-homogeneity. ADDA was tested under each of these test cases and all tests passed. The use of statistical analysis together with metamorphic testing is discussed as a future direction. In short, using ADDA as a case study, I established a testing framework, including use of pseudo oracles, experimental results and the metamorphic testing techniques to test scientific software systems that suffer from test oracle problems. Each of these techniques is necessary and contributes to the testing of the software under test.

Mobile phone use and risk for intracranial tumors and salivary gland tumors - A meta-analysis.

PubMed

Bortkiewicz, Alicja; Gadzicka, Elżbieta; Szymczak, Wiesław

2017-02-21

Results of epidemiological studies on the association between use of mobile phone and brain cancer are ambiguous, as well as the results of 5 meta-analysis studies published to date. Since the last meta-analysis (2009), new case-control studies have been published, which theoretically could affect the conclusions on this relationship. Therefore, we decided to perform a new meta-analysis. We conducted a systematic review of multiple electronic data bases for relevant publications. The inclusion criteria were: original papers, case-control studies, published till the end of March 2014, measures of association (point estimates as odds ratio and confidence interval of the effect measured), data on individual exposure. Twenty four studies (26 846 cases, 50 013 controls) were included into the meta-analysis. A significantly higher risk of an intracranial tumor (all types) was noted for the period of mobile phone use over 10 years (odds ratio (OR) = 1.324, 95% confidence interval (CI): 1.028-1.704), and for the ipsilateral location (OR = 1.249, 95% CI: 1.022-1.526). The results support the hypothesis that long-term use of mobile phone increases risk of intracranial tumors, especially in the case of ipsilateral exposure. Further studies are needed to confirm this relationship. Int J Occup Med Environ Health 2017;30(1)27-43. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

The rare TREM2 R47H variant exerts only a modest effect on Alzheimer disease risk

PubMed Central

Hooli, Basavaraj V.; Parrado, Antonio R.; Mullin, Kristina; Yip, Wai-Ki; Liu, Tian; Roehr, Johannes T.; Qiao, Dandi; Jessen, Frank; Peters, Oliver; Becker, Tim; Ramirez, Alfredo; Lange, Christoph; Bertram, Lars

2014-01-01

Objectives: Recently, 2 independent studies reported that a rare missense variant, rs75932628 (R47H), in exon 2 of the gene encoding the “triggering receptor expressed on myeloid cells 2” (TREM2) significantly increases the risk of Alzheimer disease (AD) with an effect size comparable to that of the APOE ε4 allele. Methods: In this study, we attempted to replicate the association between rs75932628 and AD risk by directly genotyping rs75932628 in 2 independent Caucasian family cohorts consisting of 927 families (with 1,777 affected and 1,235 unaffected) and in 2 Caucasian case-control cohorts composed of 1,314 cases and 1,609 controls. In addition, we imputed genotypes in 3 independent Caucasian case-control cohorts containing 1,906 cases and 1,503 controls. Results: Meta-analysis of the 2 family-based and the 5 case-control cohorts yielded a p value of 0.0029, while the overall summary estimate (using case-control data only) resulted in an odds ratio of 1.67 (95% confidence interval 0.95–2.92) for the association between the TREM2 R47H and increased AD risk. Conclusions: While our results serve to confirm the association between R47H and risk of AD, the observed effect on risk was substantially smaller than that previously reported. PMID:25186855

Working with a fixed operating room team on consecutive similar cases and the effect on case duration and turnover time.

PubMed

Stepaniak, Pieter S; Vrijland, Wietske W; de Quelerij, Marcel; de Vries, Guus; Heij, Christiaan

2010-12-01

If variation in procedure times could be controlled or better predicted, the cost of surgeries could be reduced through improved scheduling of surgical resources. This study on the impact of similar consecutive cases on the turnover, surgical, and procedure times tests the perception that repeating the same manual tasks reduces the duration of these tasks. We hypothesize that when a fixed team works on similar consecutive cases the result will be shorter turnover and procedure duration as well as less variation as compared with the situation without a fixed team. Case-control study. St Franciscus Hospital, a large general teaching hospital in Rotterdam, the Netherlands. Two procedures, inguinal hernia repair and laparoscopic cholecystectomy, were selected and divided across a control group and a study group. Patients were randomly assigned to the study or control group. Preparation time, surgical time, procedure time, and turnover time. For inguinal hernia repair, we found a significantly lower preparation time and 10 minutes less procedure time in the study group, as compared with the control group. Variation in the study group was lower, as compared with the control group. For laparoscopic cholecystectomy, preparation time was significantly lower in the study group, as compared with the control group. For both procedures, there was a significant decrease in turnover time. Scheduling similar consecutive cases and performing with a fixed team results in lower turnover times and preparation times. The procedure time of the inguinal hernia repair decreased significantly and has practical scheduling implications. For more complex surgery, like laparoscopic cholecystectomy, there is no effect on procedure time.

Field-based random sampling without a sampling frame: control selection for a case-control study in rural Africa.

PubMed

Crampin, A C; Mwinuka, V; Malema, S S; Glynn, J R; Fine, P E

2001-01-01

Selection bias, particularly of controls, is common in case-control studies and may materially affect the results. Methods of control selection should be tailored both for the risk factors and disease under investigation and for the population being studied. We present here a control selection method devised for a case-control study of tuberculosis in rural Africa (Karonga, northern Malawi) that selects an age/sex frequency-matched random sample of the population, with a geographical distribution in proportion to the population density. We also present an audit of the selection process, and discuss the potential of this method in other settings.

Age-Related Decline and Diagnostic Performance of More and Less Prevalent Clinical Cases

ERIC Educational Resources Information Center

St-Onge, Christina; Landry, Marjolaine; Xhignesse, Marianne; Voyer, Gilles; Tremblay-Lavoie, Stéphanie; Mamede, Sílvia; Schmidt, Henk; Rikers, Remy

2016-01-01

Since cognitive abilities have been shown to decrease with age, it is expected that older physicians would not perform as well as their younger counterparts on clinical cases unless their expertise can counteract the cognitive effects of aging. However, studies on the topic have shown contradictory results. This study aimed to further investigate…

Suitability of a Virtual Learning Environment for Higher Education

ERIC Educational Resources Information Center

Koskela, Marileena; Kiltti, Piia; Vilpola, Inka; Tervonen, Janne

2005-01-01

The number of virtual learning environments (VLEs) is increasing. Already a few case studies claim that VLEs are more effective as a learning method than traditional lecturing. Many of these case studies are in the area of information and communication technology (ICT). Therefore, the good learning results are not surprising. The aim of this paper…

The Business of Internationalisation: Emerging Issues for the Entrepreneurial University. AIR 1999 Annual Forum Paper.

ERIC Educational Resources Information Center

Poole, David; Pratt, Graham

This paper analyzes various strategic management models for international programs from an Australian perspective. It presents the results of a qualitative case study of one Australian university faculty of business in the context of the relevance of chaos and complexity theories to strategic management. The case study is organized around the…

Task-Based Interaction and Incidental Vocabulary Learning: A Case Study.

ERIC Educational Resources Information Center

Newton, Jonathan

1995-01-01

This case study examined the vocabulary gains made by an adult learner of English as a Second Language as a result of performing four communication tasks. It found that explicit negotiation of word meaning appeared less deterministic of posttest improvements than use of words in the process of completing the task. (13 references) (MDM)

The Causes for Stresses to Families with Deaf-Blind Children.

ERIC Educational Resources Information Center

Yu, Muriel

Described in 13 case studies of deaf blind (as a result of rubella) children are medical, economical, emotional, and professional factors that add to stresses of parents. Medical factors are examined in relation to frequent hospitalization of the rubella children before 18 months of age. One of the case studies shows how young adult parents were…

The Early Start Denver Model: A Case Study of an Innovative Practice

ERIC Educational Resources Information Center

Vismara, Laurie A.; Rogers, Sally J.

2008-01-01

Intervention was implemented with an infant identified at 9 months of age with a behavioral profile consistent with autistic spectrum disorder. The intervention approach, the Early Start Denver model, consisted of a 12-week, 1.5-hr-per-week individualized parent-child education program. Results of this case study demonstrated that the parent…

The Delivery of Business Courses via the African Virtual University: A Case Study

ERIC Educational Resources Information Center

Graber, Mark; Bolt, Susan

2011-01-01

In this case study the delivery of business courses as a result of the partnership between the African Virtual University (AVU) and Curtin University in Western Australia is described. From 2004 to 2008, degree and diploma business courses were delivered using WebCT in the four AVU partner locations: Addis Ababa University (Ethiopia), Kigali…

Cultivate Mindfulness: A Case Study of Mindful Learning in an English as a Foreign Language Classroom

ERIC Educational Resources Information Center

Wang, Yang; Liu, Chao

2016-01-01

This case study investigated how the use of mindfulness affected college English as a foreign language (EFL) students' learning and how mindful learning strategies supported their learning of English. Mindful learning considers the students' abilities to be aware, perceive and conceive. Mindfulness results in an increase in competence, memory,…

Ukraine and the Bologna Process: A Case Study of the Impact of the Bologna Process on Ukrainian State Institutions

ERIC Educational Resources Information Center

Kovtun, Olena; Stick, Sheldon

2009-01-01

This paper discusses the results of a case study exploring perceptions of selected administrators and instructors at a Ukrainian state institution regarding the effectiveness of the Bologna Process at their institution. Data were collected from focus group interviews with five volunteer instructors involved in the implementation process. The…

Sign-Supported Dutch in Children with Severe Speech and Language Impairments: A Multiple Case Study

ERIC Educational Resources Information Center

Wijkamp, Inge; Gerritsen, Betsy; Bonder, Freke; Haisma, Hinke; van der Schans, Cees

2010-01-01

In the Netherlands, many educators and care providers working at special schools for children with severe speech and language impairments (SSLI) use sign-supported Dutch (SSD) to facilitate communication. Anecdotal experiences suggest positive results, but empirical evidence is lacking. In this multiple case study the changes that occur in the way…

The Social-Sexual Voice of Adults with Mild Intellectual Disabilities: A Qualitative Case Study

ERIC Educational Resources Information Center

Turner, George W.

2012-01-01

The purpose of this qualitative case study was to explore how adults with mild intellectual disabilities live out their social-sexual lives. Adults with intellectual disabilities (ID) are often assumed to be asexual or incapable of having sexual lives, resulting in a paucity of research-based knowledge. Research and educational efforts with this…

Evaluating the Impact of Open Educational Resources: A Case Study

ERIC Educational Resources Information Center

Choi, Young Mi; Carpenter, Cathy

2017-01-01

This paper presents a case study of the replacement of a textbook with free to use materials in a class on Human Factors and Ergonomics. Data on exam grades, course grades, and student opinions over a total of five semesters are reported, before and after the implementation. The results show that class performance remained similar before and…

Repairing Discordant Student--Teacher Relationships: A Case Study Using Emotion-Focused Therapy

ERIC Educational Resources Information Center

Lander, Itzhak

2009-01-01

This article describes the use of emotion-focused therapy (EFT) to reduce conflict in the student-teacher relationship. A case study of a homeroom teacher and a sixth-grade student is presented. This innovative family treatment model is demonstrated to be a useful tool for improving the student-teacher relational system, resulting in amelioration…

Control systems on Lie groups.

NASA Technical Reports Server (NTRS)

Jurdjevic, V.; Sussmann, H. J.

1972-01-01

The controllability properties of systems which are described by an evolution equation in a Lie group are studied. The revelant Lie algebras induced by a right invariant system are singled out, and the basic properties of attainable sets are derived. The homogeneous case and the general case are studied, and results are interpreted in terms of controllability. Five examples are given.

Educational Innovation from Distributed Leadership: Case Study Spanish Public School

ERIC Educational Resources Information Center

García, Ingrid

2017-01-01

The purpose of the communication is to present a case study of distributed leadership practices and the performances of the Principal of a public school in Madrid. Educational leadership can be considered one of the most important elements of the education system to be effective, achieve quality results, and develop processes of change and…

Publishing Single-Case Research Design Studies That Do Not Demonstrate Experimental Control

ERIC Educational Resources Information Center

Tincani, Matt; Travers, Jason

2018-01-01

Demonstration of experimental control is considered a hallmark of high-quality single-case research design (SCRD). Studies that fail to demonstrate experimental control may not be published because researchers are unwilling to submit these papers for publication and journals are unlikely to publish negative results (i.e., the file drawer effect).…

Exploring Gender through Education Abroad Programs: A Graduate Student Case Study

ERIC Educational Resources Information Center

Squire, Dian D.; Williams, Terry E.; Cartwright, Matthew; Jourian, T. J.; Monter, Marie; Weatherford, Amy

2015-01-01

This case study explores how graduate students who attended a short-term education abroad program understood gender as a result of participation in the trip. Findings reveal that students' understandings of gender are influenced by in and out of class contexts. Implications for faculty and education abroad practitioners are shared to deepen and…

Teachers' Perceptions about their Own and their Schools' Readiness for Computer Implementation: A South African Case Study

ERIC Educational Resources Information Center

du Plessis, Andre; Webb, Paul

2012-01-01

This case study, involving 30 participating teachers from six previously disadvantaged South African schools, provides data on teacher perceptions of the challenges related to implementing Information and Communication Technology (ICT). The schools had minimal resources as a residual result of the South African apartheid policy prior to 1994 and…

Improved Attitude and Achievement: A Case Study of an Elementary School Academic Advisement Intervention

ERIC Educational Resources Information Center

Kamrath, Barry; Brooker, Teresa

2018-01-01

School counselors are often called upon to develop and implement academic interventions. In this case study of one urban elementary school, a school counselor conducted a small group academic advisement intervention. The results suggest that integrating the activities into the elementary school counseling program can be an effective Response to…

Factors Influencing Error Recovery in Collections Databases: A Museum Case Study

ERIC Educational Resources Information Center

Marty, Paul F.

2005-01-01

This article offers an analysis of the process of error recovery as observed in the development and use of collections databases in a university museum. It presents results from a longitudinal case study of the development of collaborative systems and practices designed to reduce the number of errors found in the museum's databases as museum…

Bitter Strawberries: The Construction of Differences in a Multicultural School: A Case Study

ERIC Educational Resources Information Center

González-Faraco, Juan Carlos; Jiménez-Vicioso, Juan Ramón; Pérez-Moreno, Heliodoro Manuel

2013-01-01

This paper presents the results of a case study looking at the views of teachers and other educational professionals pertaining to the academic progress and general integration of immigrant schoolchildren in multicultural schools in the province of Huelva (Andalusia, Spain). It is organised into three sections: first, the geographical and social…

Academic Integrity, Remix Culture, Globalization: A Canadian Case Study of Student and Faculty Perceptions of Plagiarism

ERIC Educational Resources Information Center

Evans-Tokaryk, Tyler

2014-01-01

This article presents the results of a case study at a Canadian university that used a combination of surveys and focus groups to explore faculty members' and students' perceptions of plagiarism. The research suggests that the globalization of education and remix culture have contributed to competing and contradictory understandings of plagiarism…

On Becoming a Good English Language Learner: An Exploratory Case Study

ERIC Educational Resources Information Center

Panzachi Heredia, Damaris Ana Ruth; Luchini, Pedro Luis

2015-01-01

This paper reports a case study that explores the cognitive process and the language learning strategies and styles that one Spanish trainee used to become a good English language learner. The participant held an in-depth, semi-structured interview and completed a learning style survey. Results show that the conscious use of multiple…

The Learning Outcomes of Mentoring Library Science Students in Virtual World Reference: A Case Study

ERIC Educational Resources Information Center

Purpur, Geraldine; Morris, Jon Levi

2015-01-01

This article reports on the cognitive and affective development of students being mentored in virtual reference interview skills by professional librarians. The authors present a case study which examines the impact on student learning resulting from librarian mentor participation and collaboration with students on a course assignment. This study…

Advances in malaria elimination in Botswana: a dramatic shift to parasitological diagnosis, 2008–2014

PubMed Central

Edwards, J. K.; Motlaleng, M.; Namboze, J.; Butt, W.; Obopile, M.; Mosweunyane, T.; Manzi, M.; Takarinda, K. C.; Owiti, P.

2018-01-01

Background: Malaria elimination requires infection detection using quality assured diagnostics and appropriate treatment regimens. Although Botswana is moving towards malaria elimination, reports of unconfirmed cases may jeopardise this effort. This study aimed to determine the proportion of cases treated for malaria that were confirmed by rapid diagnostic testing (RDT) and/or microscopy. Methods: This was a retrospective descriptive study using routine national data from the integrated disease surveillance and case-based surveillance systems from 2008 to 2014. The data were categorised into clinical and confirmed cases each year. An analysis of the data on cases registered in three districts that reported approximately 70% of all malaria cases was performed, stratified by year, type of reporting health facilities and diagnostic method. Results: During 2008–2014, 50 487 cases of malaria were reported in Botswana, and the proportion of RDT and/or blood microscopy confirmed cases improved from 6% in 2008 to 89% in 2013. The total number of malaria cases decreased by 97% in the same period, then increased by 41% in 2013. Conclusion: This study shows that malaria diagnostic tests dramatically improved malaria diagnosis and consequently reduced the malaria burden in Botswana. The study identified a need to build capacity on microscopy for species identification, parasite quantification and guiding treatment choices. PMID:29713592

Advances in malaria elimination in Botswana: a dramatic shift to parasitological diagnosis, 2008-2014.

PubMed

Moakofhi, K; Edwards, J K; Motlaleng, M; Namboze, J; Butt, W; Obopile, M; Mosweunyane, T; Manzi, M; Takarinda, K C; Owiti, P

2018-04-25

Background: Malaria elimination requires infection detection using quality assured diagnostics and appropriate treatment regimens. Although Botswana is moving towards malaria elimination, reports of unconfirmed cases may jeopardise this effort. This study aimed to determine the proportion of cases treated for malaria that were confirmed by rapid diagnostic testing (RDT) and/or microscopy. Methods: This was a retrospective descriptive study using routine national data from the integrated disease surveillance and case-based surveillance systems from 2008 to 2014. The data were categorised into clinical and confirmed cases each year. An analysis of the data on cases registered in three districts that reported approximately 70% of all malaria cases was performed, stratified by year, type of reporting health facilities and diagnostic method. Results: During 2008-2014, 50 487 cases of malaria were reported in Botswana, and the proportion of RDT and/or blood microscopy confirmed cases improved from 6% in 2008 to 89% in 2013. The total number of malaria cases decreased by 97% in the same period, then increased by 41% in 2013. Conclusion: This study shows that malaria diagnostic tests dramatically improved malaria diagnosis and consequently reduced the malaria burden in Botswana. The study identified a need to build capacity on microscopy for species identification, parasite quantification and guiding treatment choices.

Emergency management of traumatic collateral palmar digital nerve defect inferior to 30 mm by venous grafting. Report of 12 clinical cases.

PubMed

Laveaux, C; Pauchot, J; Obert, L; Choserot, V; Tropet, Y

2011-02-01

When traumatic collateral palmar digital nerve defect occurs, emergency venous grafting is an alternative to the two-step nervous grafting procedure. During the course of a monocentric retrospective study, 12 cases of emergency venous grafting were reviewed by a single independent examiner 11 months, at least, post-intervention. Clinical and functional evaluation was carried out, together with a self-assessment of the results by the patient. Data were compacted using a filtering method and the final result was considered in terms of "good" or "bad". Good result was observed in ten cases out of 12. Bad results were associated with poor sensory recovery in the two other cases. In one of these, the bad result was also related to severe symptoms in cold conditions and a troublesome hyperesthesia. Through a review of the literature, we justify the emergency treatment of nerve defects of the collateral palmar digital nerves with venous grafting. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

Coffee Consumption and the Risk of Thyroid Cancer: A Systematic Review and Meta-Analysis

PubMed Central

Han, Mi Ah; Kim, Jin Hwa

2017-01-01

An inverse association has been reported between coffee consumption and the risk of several cancers. However, the association between coffee and thyroid cancer is controversial. Thus, this study aimed to evaluate the association between coffee consumption and the risk of thyroid cancer through a systematic review and meta-analysis. Published studies were examined from PubMed, Embase, Cochrane Central, and the reference lists of the retrieved articles. The summary odds ratio (OR) for the association between coffee consumption was categorized as highest versus lowest consumption, and thyroid cancer risk was calculated using a fixed effects model. Subgroup analyses by study design, geographic location, source of controls, and adjusted variables were performed. A total of 1039 thyroid cancer cases and 220,816 controls were identified from five case-control studies and two cohort studies. The summary OR for the association between coffee consumption and thyroid cancer risk was 0.88 (95% confidence interval (CI) = 0.71–1.07). There was no significant heterogeneity among the study results (I² = 0%, p = 0.79). However, the beneficial effect of coffee consumption on thyroid cancer was found only in hospital-based case-control studies (OR= 0.59, 95% CI= 0.37–0.93). There was no significant association between coffee consumption and thyroid cancer risk according to our meta-analysis results. These findings should be interpreted with caution because of potential biases and confounding variables. Further prospective studies with a larger number of cases are encouraged to confirm these results. PMID:28134794

Commotio Cordis

PubMed Central

Palacio, Luis E.; Link, Mark S.

2009-01-01

Content: Commotio cordis is blunt, nonpenetrating trauma to the chest resulting in irregular heart rhythm and often leading to sudden death. This article presents the epidemiology, variables leading to commotio cordis, theories on predisposing factors, diagnosis, treatment, treatment outcomes, and return-to-play recommendations. Evidence Acquisition: A PubMed (MEDLINE) search for commotio cordis was conducted on July 1, 2008, and it yielded 106 results, of which 26 were used for this review, including experimental models, simulation studies, case analysis studies, case reports, general recommendation, review articles, and editorials. Results: There are more than 190 reported cases of commotio cordis in the United States. Forty-seven percent of reported cases occurred during athletic participation. Commotio cordis is the second-most common cause of sudden cardiac death in athletes. Occurrence of commotio cordis is related to time of impact during the cardiac cycle, direct impact over the heart, the hardness and speed of the projectile, and the ineffectiveness of chest barriers. As a result, the US Consumer Product Safety Commission recommends that softer “safety” baseballs be used for youth baseball. Resuscitation using defibrillation was effective in only 15% of cases. Resuscitation within 3 minutes resulted in a survival rate of 25% (17 of 68 cases). Survival drops to 3% when resuscitation is delayed beyond 3 minutes. Survival of commotio cordis has risen from 10% to 15% since 2001. Reduced ventricular ejection fraction has been identified in some commotio cordis survivors. Conclusion: Preventive measures, such as using soft “safety” balls and making automated external defibrillators available at sporting venues, can reduce commotio cordis morbidity and mortality. Chest protector designs can be improved to enhance protection. Return to play is best left to clinical judgment given that data are lacking with regard to susceptibility for reoccurrence. PMID:23015869

Personal hair dyes use and risk of glioma: a meta-analysis

PubMed Central

Shao, Chuan; Qi, Zhen-Yu; Hui, Guo-Zhen; Wang, Zhong

2013-01-01

Background and Objective: Use of hair dyes for glioma risk has been investigated in numerous epidemiological studies, but the evidence is inconsistent. Therefore, a meta-analysis was performed to estimate the association between hair dyes use and glioma risk. Methods: We searched PubMed and EMBASE databases without any limitations, covering all papers published by the end of March 8, 2013. Cohort and case-control studies reporting relative risk estimates (RRs) with corresponding 95% confidence intervals (CIs) (or data to calculate them) on this issue were included. Random effects models were used to calculate the pooled RRs and corresponding 95% CIs. Results: Four case-control and two cohort studies were included in this meta-analysis. The summary RRs and 95 % CIs for ever users of any hair dyes were 1.132 (0.887-1.446) for all studies, 1.291 (0.938-1.777) for case-control studies, and 0.903 (0.774-1.054) for cohort studies. In the subgroup analysis by geographic regions and sex, the similar results were detected. No significant associations were also observed among the studies which reported data involving permanent hair dye use and duration of any hair dye use. Conclusion: In summary, the results of our study demonstrated that hair dyes use is not associated with risk of glioma. PMID:24179568

Usefullness of IGH/TCR PCR studies in lymphoproliferative disorders with inconclusive clonality by flow cytometry.

PubMed

Ribera, Jordi; Zamora, Lurdes; Juncà, Jordi; Rodríguez, Inés; Marcé, Silvia; Cabezón, Marta; Millá, Fuensanta

2013-07-25

In up to 5-15% of studies of lymphoproliferative disorders (LPD) flow cytometry (FCM) or immunomorphologic methods cannot discriminate malignant from reactive processes. The aim of this work was to determine the usefulness of PCR for solving these diagnostic uncertainties. We analyzed IGH and TCRγ genes by PCR in 106 samples with inconclusive FCM results. A clonal result was registered in 36/106 studies, with a LPD being confirmed in 27 (75%) of these cases. Specifically, 9/9 IGH clonal and 16/25 TCRγ clonal results were finally diagnosed with LPD. Additionally, 2 clonal TCRγ samples with suspicion of undefined LPD were finally diagnosed with T LPD. Although polyclonal results were obtained in 47 of the cases studied (38 IGH and 9 TCRγ), hematologic neoplasms were diagnosed in 4/38 IGH polyclonal and in 1/9 TCRγ polyclonal studies. There were also 14 PCR polyclonal results (4 IGH, 10 TCRγ), albeit non-conclusive. Of these, 2/4 were eventually diagnosed with B-cell lymphoma and 3/10 with T-cell LPD. In 8 IGH samples the results of PCR techniques were non-informative but in 3/8 cases a B lymphoma was finally confirmed. We concluded that PCR is a useful technique to identify LPD when FCM is inconclusive. A PCR clonal B result is indicative of malignancy but IGH polyclonal and non-conclusive results do not exclude lymphoid neoplasms. Interpretation of T-cell clonality should be based on all the available clinical and analytical data. © 2013 Clinical Cytometry Society. Copyright © 2013 Clinical Cytometry Society.

Creating advantages through franchising in healthcare: a qualitative, multiple embedded case study on the role of the business format.

PubMed

Nijmeijer, Karlijn J; Huijsman, Robbert; Fabbricotti, Isabelle N

2014-11-02

Business format franchising is an organizational form that originates from the business sector. It is increasingly used in healthcare, being a promising organizational form for improving the competitiveness and efficiency of organizations, the quality of care, and the professional work environment. However, evidence is lacking concerning how these healthcare franchises should be designed to actually deliver the promised benefits. This study explores how the design of the central element in franchising, the business format (i.e., brand name, support systems, specification of the products and services), helps or hinders the achievement of positive results. A qualitative comparative embedded case study was conducted. The cases focused on three Dutch healthcare franchises providing mental healthcare, hospital care and care for the intellectually disabled. The data were collected through document analyses, observations, and 96 in-depth, semi-structured interviews with franchisors and unit actors (franchisees, unit managers, professionals). The interviews were recorded and transcribed verbatim. A conceptual model based on a systematic review of studies in other industries was used as an initial method for coding the data. New inductive codes were used to enrich and extend the analysis. The data were subjected to within-case and cross-case comparative thematic analyses. Different business format designs have different effects on results, as perceived by franchisors and unit actors. The analysis revealed how this variation in perceived effects can be explained by different dynamics with regard to system-wide adaptation, local adaptation, professionals' resistance to change, ease of knowledge sharing, bureaucracy, overhead, uniform brand presentation, accelerating effects and reliable performance levels. The analysis resulted in a new typology of four types of business formats, showing how combinations of business format elements facilitate or hinder the achievement of different types of results. Practitioners using healthcare franchising as a model to improve client-related, strategic, organizational and professional results should carefully consider how to design their business format in order to facilitate the achievement of desired results. The developed typology can be used as a starting point for these practitioners and as a basis for future scholarly research. Further quantitative research is recommended to confirm the results.

Experiences Using Formal Methods for Requirements Modeling

NASA Technical Reports Server (NTRS)

Easterbrook, Steve; Lutz, Robyn; Covington, Rick; Kelly, John; Ampo, Yoko; Hamilton, David

1996-01-01

This paper describes three cases studies in the lightweight application of formal methods to requirements modeling for spacecraft fault protection systems. The case studies differ from previously reported applications of formal methods in that formal methods were applied very early in the requirements engineering process, to validate the evolving requirements. The results were fed back into the projects, to improve the informal specifications. For each case study, we describe what methods were applied, how they were applied, how much effort was involved, and what the findings were. In all three cases, the formal modeling provided a cost effective enhancement of the existing verification and validation processes. We conclude that the benefits gained from early modeling of unstable requirements more than outweigh the effort needed to maintain multiple representations.

Implementing augmentative and alternative communication in inclusive educational settings: a case study.

PubMed

Stoner, Julia B; Angell, Maureen E; Bailey, Rita L

2010-06-01

The purpose of this study was to describe a single case of augmentative and alternative communication (AAC) implementation. Case study methodology was used to describe the perspectives of educational team members regarding AAC implementation for Joey, a high school junior with athetoid cerebral palsy. Benefits included greater intelligibility for Joey and subsequent comfort of the staff. Facilitators of Joey's AAC system use included the team's student-focused disposition and willingness to implement use of the device, Joey's increased intelligibility, peers' acceptance of the technology, and the resulting increase in Joey's socialization. Limited team cohesiveness, problem solving, and communication were the true barriers in this case. Implications of these facilitators and barriers are discussed and recommendations for school-based AAC implementation are made.

Psoriasis superimposed on vitiligo: the tricolored vulva.

PubMed

Tin, Kyi Saw; Scurry, James; Dyall-Smith, Delwyn

2014-01-01

This study aimed to describe 2 cases of vulvar psoriasis and vitiligo resulting in a striking clinical appearance. Case 1 was of a 41-year-old woman concerned about a dark pigmentation around the introitus. Case 2 was of an 80-year-old woman with vulvar itch and red, white, and brown areas. The vulva in each case showed a tricolored appearance of well-demarcated red, white, and brown colors. Biopsies showed psoriasis superimposed on vitiligo in the red, vitiligo in the white, and normal skin in the brown areas. When psoriasis and vitiligo are colocalized, the redness of the psoriasis may mask the vitiligo resulting in a striking red, white, and brown tricolored appearance.

Identification of cranial nerves around trigeminal schwannomas using diffusion tensor tractography: a technical note and report of 3 cases.

PubMed

Wei, Peng-Hu; Qi, Zhi-Gang; Chen, Ge; Li, Ming-Chu; Liang, Jian-Tao; Guo, Hong-Chuan; Bao, Yu-Hai; Hao, Qiang

2016-03-01

There are no large series studies identifying the locations of cranial nerves (CNs) around trigeminal schwannomas (TSs); however, surgically induced cranial neuropathies are commonly observed after surgeries to remove TSs. In this study, we preoperatively identified the location of CNs near TSs using diffusion tensor tractography (DTT). An observational study of the DTT results and intraoperative findings was performed. We preoperatively completed tractography from images of patients with TSs who received surgical therapy. The result was later validated during tumorectomy. A total of three consecutive patients were involved in this study. The locations of CNs V-VIII in relation to the tumor was clearly revealed in all cases, except for CN VI in case 3.The predicted fiber tracts were in agreement with intraoperative observations. In this study, preoperative DTT accurately predicted the location of the majority of the nerves of interest. This technique can be applied by surgeons to preoperatively visualize nerve arrangements.

Endoscopic carpal tunnel release: a prospective analysis of factors associated with unsatisfactory results.

PubMed

Straub, T A

1999-04-01

The first 100 consecutive cases of endoscopic carpal tunnel release (ECTR) performed by the author were studied prospectively during 6 to 24 months follow-up. Various preoperative and postoperative factors were subjected to statistical analysis to determine possible associations with unsatisfactory results. Overall, 92% of hands had a satisfactory result from ECTR, although not all were rendered symptom-free. There were no significant complications. Preoperative factors associated with an increased likelihood of unsatisfactory results included hands with preoperative weakness, widened two-point discrimination, myofascial pain syndrome or fibromyalgia, involvement in litigation, multiple compressive neuropathies, or the presence of abnormal psychological factors. A trend to less satisfactory results was present in Workers' Compensation cases and patients with normal motor latencies on nerve conduction studies. Multiple postoperative factors correlated with unsatisfactory results.

Rotational Flap to Enhance Buccal Gingival Thickness and Implant Emergence Profile in the Esthetic Zone: Two Cases Reports

PubMed Central

AL-Juboori, Mohammed Jasim

2017-01-01

Objective: Many techniques have been developed to enhance the gingival thickness, gingival level and emergence profile around the implant in the esthetic zone. Introduction: In this study, a buccal rotational flap was used to improve the implant site in the esthetic zone and increase gingival tissue thickness. Methods: Two cases involved the use of a rotational flap during second-stage implant surgery, one case involved the use of a temporary crown with a healing abutment, and another case involved the use of a healing abutment. Result: The cases were followed up until the final crown was placed. The implant site was improved in 2 cases; the gingival thickness increased, the gingival level was enhanced and the emergence profile was developed. Conclusion: Many factors affect the results of a rotational flap; some factors are surgical, while others are prosthetic, biological and anatomical. PMID:28839477

Management of Sacral Tumors Requiring Spino-Pelvic Reconstruction with Different Histopathologic Diagnosis: Evaluation with Four Cases

PubMed Central

Togral, Guray; Hasturk, Askin Esen; Kekec, Fevzi; Parpucu, Murat; Gungor, Safak

2015-01-01

In this retrospective study, surgical results of four patients with sacral tumors having disparate pathologic diagnoses, who were treated with partial or total sacrectomy and lumbopelvic stabilization were abstracted. Two patients were treated with partial sacral resection and two patients were treated with total sacrectomy and spinopelvic fixation. Fixation methods included spinopelvic fixation with rods and screws in two cases, reconstruction plate in one case, and fresh frozen allografts in two cases. Fibular allografts used for reconstruction accelerated bony union and enhanced the stability in two cases. Addition of polymethyl methacrylate in the cavity in the case of a giant cell tumor had a positive stabilizing effect on fixation. As a result, we can conclude that mechanical instability after sacral resection can be stabilized securely with lumbopelvic fixation and polymethyl methacrylate application or addition of fresh frozen allografts between the rods can augment the stability of the reconstruction. PMID:26713133

Management of Sacral Tumors Requiring Spino-Pelvic Reconstruction with Different Histopathologic Diagnosis: Evaluation with Four Cases.

PubMed

Arıkan, Murat; Togral, Guray; Hasturk, Askin Esen; Kekec, Fevzi; Parpucu, Murat; Gungor, Safak

2015-12-01

In this retrospective study, surgical results of four patients with sacral tumors having disparate pathologic diagnoses, who were treated with partial or total sacrectomy and lumbopelvic stabilization were abstracted. Two patients were treated with partial sacral resection and two patients were treated with total sacrectomy and spinopelvic fixation. Fixation methods included spinopelvic fixation with rods and screws in two cases, reconstruction plate in one case, and fresh frozen allografts in two cases. Fibular allografts used for reconstruction accelerated bony union and enhanced the stability in two cases. Addition of polymethyl methacrylate in the cavity in the case of a giant cell tumor had a positive stabilizing effect on fixation. As a result, we can conclude that mechanical instability after sacral resection can be stabilized securely with lumbopelvic fixation and polymethyl methacrylate application or addition of fresh frozen allografts between the rods can augment the stability of the reconstruction.

Depressive symptoms among survivors of Ebola virus disease in Conakry (Guinea): preliminary results of the PostEboGui cohort.

PubMed

Keita, Mamady Mory; Taverne, Bernard; Sy Savané, Sékou; March, Laura; Doukoure, Morifodé; Sow, Mamadou Saliou; Touré, Abdoulaye; Etard, Jean François; Barry, Moumié; Delaporte, Eric

2017-04-04

The 2013-2016 West African Ebola outbreak infected 28,616 people and caused 11,310 deaths by 11 May 2016, across six countries. The outbreak has also resulted in the largest number of EVD survivors in history-over 17,000. Guinea was declared Ebola-free on 1 June 2016. Reports from the outbreak documented 3814 cases resulting in 2544 deaths and 1270 survivors. EVD survivors face various neuropsychological and psycho-affective alterations that have not been fully identified yet. This study aims to document the depressive symptoms among adult survivors in Guinea. Depressive symptoms were investigated using the French version of the Center for Epidemiologic Studies-Depression Scale (CES-D) administered to all adult survivors (≥ 20 years) participating in the PostEboGui study and receiving care in Conakry. The study was combined with a clinical consultation by a psychiatrist at the Donka National Hospital in Conakry that ensured adapted care was provided when needed. Overall, 256 adult participants receiving care in Conakry participated in this study: 55% were women, median age 31 years [IQR: 26-40]. The median time since the Ebola Treatment Center (ETC) discharge was 8.1 months [IQR: 4.1-11.7]. 15% had a score above the threshold values indicating psychological suffering (15% for men and 14% for women). 33 people (16 women and 17 men) met with the psychiatrist, which resulted in the diagnosis of 3 cases of post-traumatic stress disorder (PTSD), 3 cases of mild depression, 13 cases of moderate depression, and 11 cases of severe depression, including 1 with kinesthetic hallucinations and another with visual hallucinations, and 1 with suicidal ideation and 3 with attempted suicide. Severe depression was diagnosed between 1 and 19 months after ETC discharge. The various identified forms of depression responded favorably to conventional drug therapies and cognitive behavioral therapy. Long-term follow-up for EVD survivors will be necessary to understand the evolution of these pathologies. In the current post-epidemic context, these cases underscore the need to strengthen mental health diagnostic systems and treatment on a national scale.

Histological features associated with diagnostic agreement in atypical ductal hyperplasia of the breast: illustrative cases from the B-Path study.

PubMed

Allison, Kimberly H; Rendi, Mara H; Peacock, Sue; Morgan, Tom; Elmore, Joann G; Weaver, Donald L

2016-12-01

This study examined the case-specific characteristics associated with interobserver diagnostic agreement in atypical ductal hyperplasia (ADH) of the breast. Seventy-two test set cases with a consensus diagnosis of ADH from the B-Path study were evaluated. Cases were scored for 17 histological features, which were then correlated with the participant agreement with the consensus ADH diagnosis. Participating pathologists' perceptions of case difficulty, borderline features or whether they would obtain a second opinion were also examined for associations with agreement. Of the 2070 participant interpretations of the 72 consensus ADH cases, 48% were scored by participants as difficult and 45% as borderline between two diagnoses; the presence of both of these features was significantly associated with increased agreement (P < 0.001). A second opinion would have been obtained in 80% of interpretations, and this was associated with increased agreement (P < 0.001). Diagnostic agreement ranged from 10% to 89% on a case-by-case basis. Cases with papillary lesions, cribriform architecture and obvious cytological monotony were associated with higher agreement. Lower agreement rates were associated with solid or micropapillary architecture, borderline cytological monotony, or cases without a diagnostic area that was obvious on low power. The results of this study suggest that pathologists frequently recognize the challenge of ADH cases, with some cases being more prone to diagnostic variability. In addition, there are specific histological features associated with diagnostic agreement on ADH cases. Multiple example images from cases in this test set are provided to serve as educational illustrations of these challenges. © 2016 John Wiley & Sons Ltd.

Epidemiologic analysis of respiratory viral infections among Singapore military servicemen in 2016.

PubMed

Lau, Yuk-Fai; Koh, Wee-Hong Victor; Kan, Clement; Dua, Poh-Choo Alethea; Lim, Ai-Sim Elizabeth; Liaw, Chin-Wen Jasper; Gao, Qiu-Han; Chng, Jeremiah; Lee, Vernon J; Tan, Boon-Huan; Loh, Jin-Phang

2018-03-12

Respiratory illnesses have been identified as a significant factor leading to lost training time and morbidity among Singapore military recruits. A surveillance programme has been put in place to determine etiological agents responsible for febrile, as well as afebrile respiratory illnesses in a military camp. The goal of the study is to better understand the epidemiology of these diseases and identify potential countermeasures to protect military recruits against them. From Jan 2016 - Jan 2017, a total of 2647 respiratory cases were enrolled into the surveillance programme. The cases were further stratified into Febrile Respiratory Illness (FRI, with body temperature > 37.5 °C) or Acute Respiratory Illness (ARI, with body temperature < 37.5 °C). Nasal washes were collected and tested by multiplex PCR to detect 26 different pathogens. One thousand ninety five cases (41% of total cases) met the criteria of FRI in which 932 cases (85% of FRI cases) were screened positive for at least one virus. The most common etiological agents for FRI mono-infection cases were Adenovirus E and Rhinovirus. Recruits infected with H3N2 influenza, Influenza B and Adenovirus E viruses were most likely presented as FRI cases. Notably, H3N2 influenza resulted in the greatest rise in body temperature. The remaining 1552 cases (59% of total cases) met the criteria of ARI in which 1198 cases (77% of ARI cases) were screened positive for at least one virus. The most common etiological agent for ARI mono-infection was Rhinovirus. The distribution pattern for dual infections was different for ARI and FRI cases. Maximum number of pathogens detected in a sample was five for both groups. Previous studies on respiratory diseases in military focused largely on FRI cases. With the expanded surveillance to ARI cases, this study allows unbiased evaluation of the impact of respiratory disease pathogens among recruits in a military environment. The results show that several pathogens have a much bigger role in causing respiratory diseases in this cohort.

Complications of intra-articular injections of triamcinolone hexacetonide in chronic arthritis in children.

PubMed

Job-Deslandre, C; Menkes, C J

1990-01-01

Intra-articular injections of triamcinolone hexacetonide (THA) are a useful therapy in JRA and HLA B 27 related arthritis (B 27 RA). Published data have indicated good results and few side effects. We evaluate here the frequency of occurrence of local side effects in 35 children with JRA (115 joints treated) and 13 children with B 27 RA (29 joints treated). With a mean follow up of 25 months in JRA and 18 months in B 27 RA, we observed 12 cases (8.3%) of subcutaneous tissue atrophy with local depigmentation (knees 5 cases, wrists 2 cases, ankles 3 cases, metatarsophalangeal joints 2 cases) and 7 cases (4.9%) of intra-articular calcifications all in the JRA group (wrists 3 cases, knees 2 cases, ankles 2 cases). Youth and joint size are possible predisposing factors for subcutaneous tissue atrophy and intra-articular calcification. Spontaneous improvement previously reported for these local side effects was not observed in our study. These results underline the necessity of discussing on a case by case basis whether intra-articular, non long-acting corticosteroid or THA are indicated. THA must be injected with a rigorous technique and with a dosage adapted to the articular volume.

A comparison of breath- and blood-alcohol test results from real-life policing situations: a one-year study of data from the Central Hessian police district in Germany.

PubMed

Roiu, Immanuel; Birngruber, Christoph G; Spencer, Victoria C; Wollersen, Heike; Dettmeyer, Reinhard; Verhoff, Marcel A

2013-10-10

So far, studies investigating the comparability of breath alcohol concentration (BrAC) with blood alcohol concentration (BAC) have focused on the accuracy of BrAC testing instruments. The presented study, conducted with cases from the district of the Middle Hessian Police Headquarters, is to the best of our knowledge the first to compare both methods under real-life conditions in normal policing situations. For a 1-year period, alcohol-impaired drunk-driving suspects, who were by criminal procedure required to give a blood sample, were offered a voluntary, additional BrAC test with a "Dräger Alcotest 7110 Evidential". The BrAC test was to be administered as soon as possible after the suspect had been apprehended, without, however, delaying the collection of the blood sample. Ninety-two cases could be included in our study. In 30 cases, a blood sample was not taken; in 11 cases, a BrAC test could not be performed. In the remaining 51 cases, we found the following pairings of BrAC and BAC results: BrAC≥0.55 mg/l and BAC≥1.1‰ (n=39); 0.25 mg/l≤BrAC<0.55 mg/l and 0.5‰≤BAC<1.1‰ (n=5); BrAC≥0.55 mg/l and BAC<1.1‰ (n=4); BrAC<0.55 mg/l and BAC≥1.1‰ (n=3). The mean value for the conversion factor, Q, was 2.12‰l/mg. In accord with numerous other studies, our study results would suggest a value of 2.1‰ l/mg to German legislature as a new statutory value for Q. In borderline cases, of which there were already 7 in our study with 51 cases, suspects could benefit both from a BrAC test or a BAC test, with the benefit lastly depending more on early testing time than on the test method used. Our results support the call for the earliest possible measurement of alcohol concentration values after a drunk driving offense was committed. In some situations, this can probably only be accomplished with BrAC testing. A supplementary blood sample and BAC testing could compensate for the known weaknesses of BrAC testing. Thus, the complementary use of both methods might be a viable option. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Doctors disciplined for professional misconduct in Australia and New Zealand, 2000-2009.

PubMed

Elkin, Katie J; Spittal, Matthew J; Elkin, David J; Studdert, David M

2011-05-02

To describe professional discipline cases in Australia and New Zealand in which doctors were found guilty of professional misconduct, and to develop a typology for describing the misconduct. A retrospective analysis of disciplinary cases adjudicated in five jurisdictions (New South Wales, Victoria, Queensland, Western Australia and New Zealand) in 2000-2009. Characteristics of the cases (setting, misconduct type, patient outcomes, disciplinary measure imposed), characteristics of the doctors involved (sex, specialty, years since qualification) and population-level case rates (by doctor characteristics). The tribunals studied disciplined 485 doctors. Male doctors were disciplined for misconduct at four times the rate of their female colleagues (91 versus 22 cases per 100 000 doctor-years). Obstetrics and gynaecology and psychiatry were the specialties with the highest rates (224 and 178 cases per 100 000 doctor-years). The mean age of disciplined doctors did not differ from that of the general doctor population. The most common types of offences considered as the primary issue were sexual misconduct (24% of cases), illegal or unethical prescribing (21%) and inappropriate medical care (20%). In 78% of cases, the tribunal made no mention of any patient having experienced physical or mental harm as a result of the misconduct. Penalties were severe, with 43% of cases resulting in removal from practice and 37% in restrictions on practice. Disciplinary cases in Australia and New Zealand have features distinct from those studied internationally. The recent nationalisation of Australia's medical boards offers new possibilities for tracking and analysing disciplinary cases to improve the safety and quality of health care.

Coffee Drinking and the Risk of Endometrial Cancer: An Updated Meta-Analysis of Observational Studies.

PubMed

Lukic, Marko; Guha, Neela; Licaj, Idlir; van den Brandt, Piet A; Stayner, Leslie Thomas; Tavani, Alessandra; Weiderpass, Elisabete

2018-01-01

Several compounds contained in coffee have been found to suppress carcinogenesis in experimental studies. We conducted a dose-response meta-analysis to assess the impact of coffee consumption on the risk of endometrial cancer. We searched MEDLINE and EMBASE databases for studies published up to August 2016. Using random effects models, we estimated summary relative risks (RR) for cohort studies and odds ratios (OR) for case-control studies with 95% confidence intervals (CI). Dose-response analyses were conducted by using generalized least square trend estimation. We identified 12 cohort studies and 8 case-control studies eligible for inclusion, contributing with 11,663 and 2,746 endometrial cancer cases, respectively. The summary RR for highest compared with lowest coffee intake was 0.74 (95% CI: 0.68-0.81; p heterogeneity = 0.09, I 2 = 32%). The corresponding summary RR among cohort studies was 0.78 (95% CI: 0.71-0.85; p heterogeneity = 0.14, I 2 = 31.9%) and 0.63 (95% CI: 0.53-0.76; p heterogeneity = 0.57, I 2 = 0%) for case-control studies. One-cup increment per day was associated with 3% risk reduction (95% CI: 2-4%) in cohort studies and 12% (95% CI: 5-18%) in case-control studies. After pooling the results from 5 cohort studies, the association remained significant only in women with body mass index over 30 (RR = 0.71, 95% CI: 0.61-0.81). The results from our meta-analysis strengthen the evidence of a protective effect of coffee consumption on the risk of EC and further suggest that increased coffee intake might be particularly beneficial for women with obesity.

Chronic idiopathic anal pain. Results of a diagnostic-therapeutic protocol in a colorectal referral unit.

PubMed

Armañanzas, Laura; Arroyo, Antonio; Ruiz-Tovar, Jaime; López, Alberto; Santos, Jair; Moya, Pedro; Gómez, María Amparo; Candela, Fernando; Calpena, Rafael

2015-01-01

Chronic idiopathic anal pain (CIAP) remains a diagnosis of exclusion. Its study and management still lack a standardized protocol. The aim of this study is to evaluate the results obtained with the diagnostic-therapeutic protocol established in our service. We performed a retrospective study of patients diagnosed with CIAP at the Colorectal Unit of the General University Hospital of Elche, between 2005 and 2011. We evaluated 57 patients with a diagnosis of chronic anal pain for functional anorectal disease (FAD). After the application of our diagnostic protocol, final diagnosis of chronic anal pain (CAP) was achieved in 43 cases (75%), including 22 cases of descending perineum syndrome, 12 of proctalgia fugax, 2 of pudendal neuritis and 7 of coccydynia. In 14 patients exclusion diagnosis of CIAP was established. Among the therapies used on patients with CIAP, biofeedback combined with conservative measures improved symptoms in 43% of the cases. Sacral nerve stimulation was assessed in patients who did not respond to other treatments. Through proper anamnesis, physical examination and complementary tests, a specific diagnosis of the cause of CAP by FAD can be achieved, reducing exclusion diagnosis of CIAP to 25% of cases. Conservative measures combined with biofeedback achieved an improvement in pain in more than 40% of the cases of CIAP in our study. Sacral nerve stimulation can be considered as a treatment option in refractory cases. Copyright © 2013 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

MECP2 duplications in six patients with complex sex chromosome rearrangements

PubMed Central

Breman, Amy M; Ramocki, Melissa B; Kang, Sung-Hae L; Williams, Misti; Freedenberg, Debra; Patel, Ankita; Bader, Patricia I; Cheung, Sau Wai

2011-01-01

Duplications of the Xq28 chromosome region resulting in functional disomy are associated with a distinct clinical phenotype characterized by infantile hypotonia, severe developmental delay, progressive neurological impairment, absent speech, and proneness to infections. Increased expression of the dosage-sensitive MECP2 gene is considered responsible for the severe neurological impairments observed in affected individuals. Although cytogenetically visible duplications of Xq28 are well documented in the published literature, recent advances using array comparative genomic hybridization (CGH) led to the detection of an increasing number of microduplications spanning MECP2. In rare cases, duplication results from intrachromosomal rearrangement between the X and Y chromosomes. We report six cases with sex chromosome rearrangements involving duplication of MECP2. Cases 1–4 are unbalanced rearrangements between X and Y, resulting in MECP2 duplication. The additional Xq material was translocated to Yp in three cases (cases 1–3), and to the heterochromatic region of Yq12 in one case (case 4). Cases 5 and 6 were identified by array CGH to have a loss in copy number at Xp and a gain in copy number at Xq28 involving the MECP2 gene. In both cases, fluorescent in situ hybridization (FISH) analysis revealed a recombinant X chromosome containing the duplicated material from Xq28 on Xp, resulting from a maternal pericentric inversion. These cases add to a growing number of MECP2 duplications that have been detected by array CGH, while demonstrating the value of confirmatory chromosome and FISH studies for the localization of the duplicated material and the identification of complex rearrangements. PMID:21119712

Crystal-Storing Histiocytosis: A Clinicopathologic Study of 13 Cases

PubMed Central

Kanagal-Shamanna, Rashmi; Xu-Monette, Zijun Y.; Miranda, Roberto N.; Dogan, Ahmet; Zou, Dehui; Luthra, Rajyalakshmi; Weber, Donna; O’Malley, Dennis P.; Jorgensen, Jeffrey L.; Khoury, Joseph D.; Bueso-Ramos, Carlos E.; Orlowski, Robert Z.; Medeiros, L. Jeffrey; Young, Ken H.

2015-01-01

Aims Crystal-storing histiocytosis (CSH) is a rare lesion composed of histiocytes with abnormal intra-lysosomal accumulation of immunoglobulin (Ig) as crystals, reported in patients with plasmacytic/ lymphoplasmacytic neoplasms. We report the clinicopathologic features of 13 patients with CSH and describe the proteomic composition of the crystals in 3 cases analyzed by mass spectrometry (MS). Methods and results There were 7 men and 6 women with a median age of 60 years (range, 33-79). CSH was generalized in 1 (8%) and localized in 12 (92%) patients involving various sites. CSH was associated with a low-grade B-cell lymphoma with plasmacytoid differentiation or a plasma cell neoplasm in all cases. In 10 (77%) cases, CSH represented more than 50% of the neoplastic infiltrate. By immunohistochemical studies, histiocytes were positive for monotypic kappa in 5 (50%), lambda in 4 (40%) cases; in 1 (10%) case, results were equivocal. MS analysis of the histiocyte contents in all 3 tested cases showed predominance of variable-region fragments of Ig light and/or heavy chains. Conclusions CSH is frequently associated with an underlying lymphoplasmacytic neoplasm. MS findings suggest that Ig alterations and/ or possibly defects in the ability of histiocytes to process Ig play a role in pathogenesis. PMID:26118455

A case-control study of chronic neuropsychiatric disease and organic solvent exposure in automobile assembly plant workers.

PubMed Central

Nelson, N A; Robins, T G; White, R F; Garrison, R P

1994-01-01

A case-control study of chronic neurological and psychiatric disease and occupational exposure to solvents was carried out in eight automobile assembly plants. Cases included 299 subjects who were granted medical disability retirement in 1980-8. Two control groups were selected, the first from those granted retirement in the same period because of medical disability from causes unrelated to solvent exposure. The second included hourly employees from the plant population. In these facilities, solvent exposures tended to be short term and low level, although common: the average duration of exposure was 2.3 years; about 41% experienced at least one day of exposure. Of those exposed, 46% had less than one year of exposure. Results for all psychiatric disease combined (273 cases) suggested that cases had lower exposures than either control group, regardless of how exposure was expressed. Results could not be explained by conventional confounding exposures or characteristics or by usual manifestations of the healthy worker effect. By contrast, chronic neurological disease, and multiple sclerosis in particular, seemed to be associated with exposure, although few cases were identified and observed increases in risk were not statistically significant. PMID:8199679

Durability of aneurysm treatments in patients with active Behcet's disease.

PubMed

Elsharawy, Mohamed A; Elsaid, Aymen; Al-Dhafery, Bander; Alghnimi, Ibrahim; Almabyouq, Fatimah

2016-10-01

Aneurysms in Behcet's disease are rare, serious, and recurrent. To achieve durable treatment, patients should receive immunosuppressive therapy before intervention to induce remission. We present early and long-term results of emergency cases of active Behcet's disease, which did not permit waiting for suppressive treatment. The study was undertaken on all cases admitted to the vascular unit, King Fahd Hospital of University for aneurysm treatment in patients with active Behcet's disease over about 10 years. All patients had exclusion of the aneurysm either by open surgery or endovascular intervention. Morbidities and mortality were recorded within the hospital admission and on the follow-up. During the study period, three cases were included. All interventions were successful and lifesaving. However, two cases, treated with surgical interposition grafts, were blocked in the intermediate term follow-up (2-12 months) and one case, treated with endovascular treatment, complicated with pseudoaneurysm at femoral puncture site after six months. Although early results were good, intermediate ones were not satisfactory because of progressive graft thrombosis and formation of new aneurysms. Awareness of these rare cases help for early identification and proper immunosuppressive before emergency vascular intervention is warranted. © The Author(s) 2015.

Pesticide poisoning in Zhejiang, China: a retrospective analysis of adult cases registration by occupational disease surveillance and reporting systems from 2006 to 2010

PubMed Central

Zhang, Meibian; Fang, Xinglin; Zhou, Lifang; Su, Liling; Zheng, Jiajia; Jin, Minjuan; Zou, Hua; Chen, Guangdi

2013-01-01

Objective Despite the rapid industrialisation and urbanisation over the past 30 years, agriculture is one of the largest economic sectors in China and the unregulated use of pesticides result in extensive pesticide poisoning. The objective of this study was to analyse pesticide poisoning cases registration received by Zhejiang Provincial Center for Disease Control and Prevention, China. Design Register-based study. Setting Cases registered regarding pesticide poisoning. Data were obtained from the Occupational Disease Surveillance and Reporting Systems in Zhejiang province from 2006 to 2010, which contains anonymous records representing general population of Zhejiang province, China. Participants All cases registered as pesticide poisoning were identified. Primary outcome Monthly and age-group pesticide poisoning death rates were calculated. Results A total of 20 097 pesticide poisoning cases with 1413 deaths were recorded during the study period. There were 10 513 male pesticide poisoning cases with 782 deaths, and 9584 females with 631 deaths. Pesticide poisoning occurred mostly in non-occupational exposure (79.86%), in which the majority (85.77%) of the cases was of intentional pesticide poisoning. The occupational exposure was most common in men during the farming season. The death rate increased stepwise with age, and the pesticide suicide rate was higher in the older age group. Conclusions Pesticide poisoning remains a major health problem in China, and further recommendations to reduce the pesticide poisoning are required. PMID:24270833

A prospective cohort study to evaluate peridomestic infection as a determinant of dengue transmission: Protocol

PubMed Central

2012-01-01

Background Vector control programs, which have focused mainly on the patient house and peridomestic areas around dengue cases, have not produced the expected impact on transmission. This project will evaluate the assumption that the endemic/epidemic transmission of dengue begins around peridomestic vicinities of the primary cases. Its objective is to assess the relationship between symptomatic dengue case exposure and peridomestic infection incidence. Methods/Design A prospective cohort study will be conducted (in Tepalcingo and Axochiapan, in the state of Morelos, Mexico), using the state surveillance system for the detection of incident cases. Paired blood specimens will be collected from both the individuals who live with the incident cases and a sample of subjects residing within a 25-meter radius of such cases (exposed cohort), in order to measure dengue-specific antibodies. Other subjects will be selected from areas which have not presented any incident cases within 200 meters, during the two months preceding the sampling (non-exposed cohort). Symptomatic/asymptomatic incident infection will be considered as the dependent variable, exposure to confirmed dengue cases, as the principal variable, and the socio-demographic, environmental and socio-cultural conditions of the subjects, as additional explanatory variables. Discussion Results indicating a high infection rate among the exposed subjects would justify the application of peridomestic control measures and call for an evaluation of alternate causes for insufficient program impact. On the other hand, a low incidence of peridomestic-infected subjects would support the hypothesis that infection occurs outside the domicile, and would thus explain why the vector control measures applied in the past have exerted such a limited impact on cases incidence rates. The results of the present study may therefore serve to reassess site selection for interventions of this type. PMID:22471857

Molecular Profiling of Malignant Pleural Effusion in Metastatic Non-Small-Cell Lung Carcinoma. The Effect of Preanalytical Factors.

PubMed

Carter, Jamal; Miller, James Adam; Feller-Kopman, David; Ettinger, David; Sidransky, David; Maleki, Zahra

2017-07-01

Non-small-cell lung cancer (NSCLC)-associated malignant pleural effusions (MPEs) are sometimes the only available specimens for molecular analysis. This study evaluates diagnostic yield of NSCLC-associated MPE, its adequacy for molecular profiling and the potential influence of MPE volume/cellularity on the analytic sensitivity of our assays. Molecular results of 50 NSCLC-associated MPE cases during a 5-year period were evaluated. Molecular profiling was performed on cell blocks and consisted of fluorescent in situ hybridization (FISH) for ALK gene rearrangements and the following sequencing platforms: Sanger sequencing (for EGFR) and high-throughput pyrosequencing (for KRAS and BRAF) during the first 4 years of the study period, and targeted next-generation sequencing performed thereafter. A total of 50 NSCLC-associated MPE cases were identified where molecular testing was requested. Of these, 17 cases were excluded: 14 cases (28%) due to inadequate tumor cellularity and 3 cases due to unavailability of the slides to review. A total of 27 out of 50 MPE cases (54%) underwent at least EGFR and KRAS sequencing and FISH for ALK rearrangement. Of the 27 cases with molecular testing results available, a genetic abnormality was detected in 16 cases (59%). The most common genetic aberrations identified involved EGFR ( 9 ) and KRAS ( 7 ). Six cases had ALK FISH only, of which one showed rearrangement. MPE volume was not associated with overall cellularity or tumor cellularity (P = 0.360). Molecular profiling of MPE is a viable alternative to testing solid tissue in NSCLC. This study shows successful detection of genetic aberrations in 59% of samples with minimal risk of false negative.

Pedestrian Injuries By Source: Serious and Disabling Injuries in US and European Cases

PubMed Central

Mallory, Ann; Fredriksson, Rikard; Rosén, Erik; Donnelly, Bruce

2012-01-01

US and European pedestrian crash cases were analyzed to determine frequency of injury by body region and by the vehicle component identified as the injury source. US pedestrian data was drawn from the Pedestrian Crash Data Study (PCDS). European pedestrian data was drawn from the German In-Depth Accident Study (GIDAS). Results were analyzed in terms of both serious injury (AIS 3+) and disabling injury estimated with the Functional Capacity Index (FCI). The results are presented in parallel for a more complete international perspective on injuries and injury sources. Lower extremity injury from bumper impact and head&face injury from windshield impact were the most frequent combinations for both serious and disabling injuries. Serious lower extremity injuries from bumper contact occurred in 43% of seriously injured pedestrian cases in US PCDS data and 35% of European GIDAS cases. Lower-extremity bumper injuries also account for more than 20% of disability in both datasets. Serious head &face injuries from windshield contact occur in 27% of PCDS and 15% of GIDAS serious injury cases. While bumper impacts primarily result in lower extremity injury and windshield impacts are most often associated with head & face injuries, the hood and hood leading edge are responsible for serious and disabling injuries to a number of different body regions. Therefore, while it is appropriate to focus on lower extremity injury when studying bumper performance and on head injury risk when studying windshield impact, pedestrian performance of other components may require better understanding of injury risk for multiple body regions. PMID:23169112

Immunohistochemical Study of ER, PR, Ki67 and p53 in Endometrial Hyperplasias and Endometrial Carcinomas

PubMed Central

Masjeed, Nayar Musfera Abdul; Joshi, Avinash R; Kulkarni, Maithili Mandar; Pandya, Nidhi

2017-01-01

Introduction Endometrial carcinoma is the second most common gynecologic malignancy in the developing countries. Endometrial Hyperplasia (EH) is a precursor to Endometrioid Adenocarcinoma (EMAC). A 23% of Atypical Hyperplasias (AEH) progress to EMAC. Aim This study was undertaken to analyse ER, PR, p53 and Ki67 in EH and endometrial carcinomas and attempt correlation with clinical and histopathological findings. Materials and Methods The present study was conducted over a period of seven years. A manual tissue array technique was employed for cases subjected to IHC. Analysis of the expression of IHC markers (ER, PR, p53, Ki67) in EH and endometrial carcinoma was attempted. Results were subjected to statistical analysis. The results were considered to be significant when the p-value <0.05. Results A total of 85 cases of EH and 28 cases of endometrial carcinoma were included in the study. EH (75.22%) was more common than endometrial carcinoma (24.78%). Among 28 cases of endometrial carcinomas, EMAC was most common (78.57%) followed by Clear Cell Carcinoma (CCC) (14.28%), and Uterine Serous Carcinoma (USC) (7.14%). ER and PR expression decreased as lesion progressed from EH to EMAC. ER and PR expression was negative in USC and CCC. The p53 expression and mean Ki67 labelling index increased as the severity of lesion increased from EH to endometrial carcinoma. Conclusion The ER, PR, p53, Ki67 IHC markers may be included in every case of endometrial carcinoma to understand the tumour biological behavior which in turn could help individual treatment strategies. PMID:28969139

The role of professional knowledge in case-based reasoning in practical ethics.

PubMed

Pinkus, Rosa Lynn; Gloeckner, Claire; Fortunato, Angela

2015-06-01

The use of case-based reasoning in teaching professional ethics has come of age. The fields of medicine, engineering, and business all have incorporated ethics case studies into leading textbooks and journal articles, as well as undergraduate and graduate professional ethics courses. The most recent guidelines from the National Institutes of Health recognize case studies and face-to-face discussion as best practices to be included in training programs for the Responsible Conduct of Research. While there is a general consensus that case studies play a central role in the teaching of professional ethics, there is still much to be learned regarding how professionals learn ethics using case-based reasoning. Cases take many forms, and there are a variety of ways to write them and use them in teaching. This paper reports the results of a study designed to investigate one of the issues in teaching case-based ethics: the role of one's professional knowledge in learning methods of moral reasoning. Using a novel assessment instrument, we compared case studies written and analyzed by three groups of students whom we classified as: (1) Experts in a research domain in bioengineering. (2) Novices in a research domain in bioengineering. (3) The non-research group--students using an engineering domain in which they were interested but had no in-depth knowledge. This study demonstrates that a student's level of understanding of a professional knowledge domain plays a significant role in learning moral reasoning skills.

Occurrence of Multiple Sclerosis After Drug Exposure: Insights From Evidence Mapping.

PubMed

Antonazzo, Ippazio Cosimo; Raschi, Emanuel; Vignatelli, Luca; Baldin, Elisa; Riise, Trond; D'Alessandro, Roberto; De Ponti, Fabrizio; Poluzzi, Elisabetta

2017-09-01

The role of drugs in the occurrence of multiple sclerosis (MS) is perceived to be insufficiently investigated. The aim of this study was to map and assess the evidence on MS occurrence after drug exposure, in order to identify possible signals of causal association. A search strategy was performed in MEDLINE and Embase as of July 2016; references consistent with the aim of the study were analysed to extract relevant measures of causal association between drugs and MS. The Newcastle-Ottawa Scale and appropriate guidelines from the International Society for Pharmacoepidemiology (ISPE) and the International Society of Pharmacovigilance (ISoP) were used to assess the quality of included studies. After screening 832 articles, 58 were selected (of which 14 were found by checking the reference lists of reviews): 30 case reports and case series, 24 longitudinal studies and four randomized controlled trials. Seven longitudinal studies had good (at least 7 out of 9) quality scores, whereas case reports/case series presented several limitations. Half of included articles focused on immunomodulatory drugs (etanercept, infliximab and adalimumab), especially in case reports/series, suggesting an association with MS occurrence. Contraceptives and antibacterials were investigated in some population-based studies, without definite results. A heterogeneous pharmacological profile of identified classes emerged. Low strength of evidence and conflicting results highlighted the difficulties in addressing the possible contribution of drugs in MS occurrence. Methodological advances are needed, especially to control the confounding role of underlying disease for specific drug classes.

An epidemiologic study to screen for chronic myelocytic leukemia in war victims exposed to mustard gas.

PubMed Central

Ghanei, Mostafa; Vosoghi, Ali Akbar

2002-01-01

Chemical agents such as mustard gas (or sulfur mustard), which has alkylating characteristics, were used against Iranian combatants in the Iraq-Iran war. Previous studies have not shown a strong link between these chemical agents and the development of chronic myelocytic leukemia (CML). The purpose of this study was to evaluate the increased risk of CML development in Iranian soldiers exposed to mustard gas during the war. Based on a descriptive study of 2,500 cases with documented exposure to various chemical warfare agents, 665 patients had documented exposure to mustard gas. We screened the latter using the leukocyte alkaline phosphatase (LAP) test and performed further cytochemical studies on cases with positive results. From among the 665 cases with documented exposure to mustard gas, 9 cases had LAP scores < 20; 2 of these 9 cases had CML and a score of zero (0.3%). We detected cytogenetic abnormalities in 7 patients with low LAP scores and atypical lymphocytes of 5-11% in 40 patients. The risk ratio of CML developing in victims exposed to mustard gas (cutaneous or respiratory) may be higher in comparison with the normal population, although confounding factors (e.g., the possibility of exposure to combined chemical agents, excluding patients who did not manifest blisters) limited our results. Because the increased development of CML in young patients with a documented history of exposure to mustard gas cannot be disregarded, further studies are needed. PMID:12003756

Beta-2 adrenergic receptor (ADRB2) gene polymorphisms and the risk of asthma: a meta-analysis of case-control studies.

PubMed

Liang, Si-Qiao; Chen, Xiao-Li; Deng, Jing-Min; Wei, Xuan; Gong, Chen; Chen, Zhang-Rong; Wang, Zhi-Bo

2014-01-01

A number of studies have assessed the relationship between beta-2 adrenergic receptor (ADRB2) gene polymorphisms and asthma risk. However, the results are inconsistent. A meta-analysis that focused on the association between asthma and all ADRB2 polymorphisms with at least three case-control studies was thus performed. A literature search of the PubMed, Embase, Web of Science, CNKI, and Wangfang databases was conducted. Odds ratios with 95% confidence intervals were used to assess the strength of associations. Arg16Gly, Gln27Glu, Thr164Ile, and Arg19Cys single nucleotide polymorphisms (SNPs) were identified in 46 case-control studies. The results showed that not all of the SNPs were associated with asthma in the overall population. Significant associations were found for the Arg16Gly polymorphism in the South American population via dominant model comparison (OR = 1.754, 95% CI = 1.179-2.609, I2 = 16.9%, studies  = 2, case  = 314, control  = 237) in an analysis stratified by ethnicity. For the Gln27Glu polymorphism, a protective association was found in children via recessive model comparison (OR = 0.566, 95% CI = 0.417-0.769, I2 = 0.0%, studies  = 11, case  = 1693, control  =  502) and homozygote genotype comparison (OR = 0.610, 95% CI = 0.434-0.856, I2 = 0.0%, studies  = 11, case  = 1693, control  = 1502), and in adults via dominant model comparison (OR = 0.864, 95% CI = 0.768-0.971, I2 = 46.9%, n = 18, case  = 3160, control  = 3433). None of the ADRB2 gene polymorphisms were reproducibly associated with a risk of asthma across ethnic groups in the general population.