Regulatory Disruption and Arbitrage in Health-Care Data Protection.

PubMed

Terry, Nicolas P

This article explains how the structure of U.S. health-care data protection (specifically its sectoral and downstream properties) has led to a chronically uneven policy environment for different types of health-care data. It examines claims for health-care data protection exceptionalism and competing demands such as data liquidity. In conclusion, the article takes the position that healthcare- data exceptionalism remains a valid imperative and that even current concerns about data liquidity can be accommodated in an exceptional protective model. However, re-calibrating our protection of health-care data residing outside of the traditional health-care domain is challenging, currently even politically impossible. Notwithstanding, a hybrid model is envisioned with downstream HIPAA model remaining the dominant force within the health-care domain, but being supplemented by targeted upstream and point-of-use protections applying to health-care data in disrupted spaces.

8 CFR 1212.4 - Applications for the exercise of discretion under section 212(d)(1) and 212(d)(3).

Code of Federal Regulations, 2014 CFR

2014-01-01

... the official record of each conviction, and any other documents relating to commutation of sentence... valid for a period not to exceed the validity of the biometric BCC for applications for admission at U.S... may remain valid. Although the waiver may remain valid, the non-biometric border crossing card portion...

8 CFR 1212.4 - Applications for the exercise of discretion under section 212(d)(1) and 212(d)(3).

Code of Federal Regulations, 2012 CFR

2012-01-01

... the official record of each conviction, and any other documents relating to commutation of sentence... valid for a period not to exceed the validity of the biometric BCC for applications for admission at U.S... may remain valid. Although the waiver may remain valid, the non-biometric border crossing card portion...

8 CFR 1212.4 - Applications for the exercise of discretion under section 212(d)(1) and 212(d)(3).

Code of Federal Regulations, 2013 CFR

2013-01-01

... the official record of each conviction, and any other documents relating to commutation of sentence... valid for a period not to exceed the validity of the biometric BCC for applications for admission at U.S... may remain valid. Although the waiver may remain valid, the non-biometric border crossing card portion...

8 CFR 1212.4 - Applications for the exercise of discretion under section 212(d)(1) and 212(d)(3).

Code of Federal Regulations, 2010 CFR

2010-01-01

... the official record of each conviction, and any other documents relating to commutation of sentence... valid for a period not to exceed the validity of the biometric BCC for applications for admission at U.S... may remain valid. Although the waiver may remain valid, the non-biometric border crossing card portion...

Towards a model-based patient selection strategy for proton therapy: External validation of photon-derived Normal Tissue Complication Probability models in a head and neck proton therapy cohort

PubMed Central

Blanchard, P; Wong, AJ; Gunn, GB; Garden, AS; Mohamed, ASR; Rosenthal, DI; Crutison, J; Wu, R; Zhang, X; Zhu, XR; Mohan, R; Amin, MV; Fuller, CD; Frank, SJ

2017-01-01

Objective To externally validate head and neck cancer (HNC) photon-derived normal tissue complication probability (NTCP) models in patients treated with proton beam therapy (PBT). Methods This prospective cohort consisted of HNC patients treated with PBT at a single institution. NTCP models were selected based on the availability of data for validation and evaluated using the leave-one-out cross-validated area under the curve (AUC) for the receiver operating characteristics curve. Results 192 patients were included. The most prevalent tumor site was oropharynx (n=86, 45%), followed by sinonasal (n=28), nasopharyngeal (n=27) or parotid (n=27) tumors. Apart from the prediction of acute mucositis (reduction of AUC of 0.17), the models overall performed well. The validation (PBT) AUC and the published AUC were respectively 0.90 versus 0.88 for feeding tube 6 months post-PBT; 0.70 versus 0.80 for physician rated dysphagia 6 months post-PBT; 0.70 versus 0.80 for dry mouth 6 months post-PBT; and 0.73 versus 0.85 for hypothyroidism 12 months post-PBT. Conclusion While the drop in NTCP model performance was expected in PBT patients, the models showed robustness and remained valid. Further work is warranted, but these results support the validity of the model-based approach for treatment selection for HNC patients. PMID:27641784

Development and initial validation of a content taxonomy for patient records in general dentistry

PubMed Central

Acharya, Amit; Hernandez, Pedro; Thyvalikakath, Thankam; Ye, Harold; Song, Mei; Schleyer, Titus

2013-01-01

Objective Develop and validate an initial content taxonomy for patient records in general dentistry. Methods Phase 1–Obtain 95 de-identified patient records from 11 general dentists in the United States. Phase 2–Extract individual data fields (information items), both explicit (labeled) and implicit (unlabeled), from records, and organize into categories mirroring original field context. Phase 3–Refine raw list of information items by eliminating duplicates/redundancies and focusing on general dentistry. Phase 4–Validate all items regarding inclusion and importance using a two-round Delphi study with a panel of 22 general dentists active in clinical practice, education, and research. Results Analysis of 76 patient records from 9 dentists, combined with previous work, yielded a raw list of 1,509 information items. Refinement reduced this list to 1,107 items, subsequently rated by the Delphi panel. The final model contained 870 items, with 761 (88%) rated as mandatory. In Round 1, 95% (825) of the final items were accepted, in Round 2 the remaining 5% (45). Only 45 items on the initial list were rejected and 192 (or 17%) remained equivocal. Conclusion Grounded in the reality of clinical practice, our proposed content taxonomy represents a significant advance over existing guidelines and standards by providing a granular and comprehensive information representation for general dental patient records. It offers a significant foundational asset for implementing an interoperable health information technology infrastructure for general dentistry. PMID:23838618

Validation Study of a Predictive Algorithm to Evaluate Opioid Use Disorder in a Primary Care Setting

PubMed Central

Sharma, Maneesh; Lee, Chee; Kantorovich, Svetlana; Tedtaotao, Maria; Smith, Gregory A.

2017-01-01

Background: Opioid abuse in chronic pain patients is a major public health issue. Primary care providers are frequently the first to prescribe opioids to patients suffering from pain, yet do not always have the time or resources to adequately evaluate the risk of opioid use disorder (OUD). Purpose: This study seeks to determine the predictability of aberrant behavior to opioids using a comprehensive scoring algorithm (“profile”) incorporating phenotypic and, more uniquely, genotypic risk factors. Methods and Results: In a validation study with 452 participants diagnosed with OUD and 1237 controls, the algorithm successfully categorized patients at high and moderate risk of OUD with 91.8% sensitivity. Regardless of changes in the prevalence of OUD, sensitivity of the algorithm remained >90%. Conclusion: The algorithm correctly stratifies primary care patients into low-, moderate-, and high-risk categories to appropriately identify patients in need for additional guidance, monitoring, or treatment changes. PMID:28890908

Routine development of objectively derived search strategies.

PubMed

Hausner, Elke; Waffenschmidt, Siw; Kaiser, Thomas; Simon, Michael

2012-02-29

Over the past few years, information retrieval has become more and more professionalized, and information specialists are considered full members of a research team conducting systematic reviews. Research groups preparing systematic reviews and clinical practice guidelines have been the driving force in the development of search strategies, but open questions remain regarding the transparency of the development process and the available resources. An empirically guided approach to the development of a search strategy provides a way to increase transparency and efficiency. Our aim in this paper is to describe the empirically guided development process for search strategies as applied by the German Institute for Quality and Efficiency in Health Care (Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen, or "IQWiG"). This strategy consists of the following steps: generation of a test set, as well as the development, validation and standardized documentation of the search strategy. We illustrate our approach by means of an example, that is, a search for literature on brachytherapy in patients with prostate cancer. For this purpose, a test set was generated, including a total of 38 references from 3 systematic reviews. The development set for the generation of the strategy included 25 references. After application of textual analytic procedures, a strategy was developed that included all references in the development set. To test the search strategy on an independent set of references, the remaining 13 references in the test set (the validation set) were used. The validation set was also completely identified. Our conclusion is that an objectively derived approach similar to that used in search filter development is a feasible way to develop and validate reliable search strategies. Besides creating high-quality strategies, the widespread application of this approach will result in a substantial increase in the transparency of the development process of search strategies.

If We Don’t, Who Will? The Employment of the United States Army to Combat Potential Pandemic Outbreaks in West Africa

DTIC Science & Technology

2015-06-12

27 viii Threats to Validity and Biases ...draw conclusions and make recommendations for future research. Threats to Validity and Biases There are a several issues that pose a threat to...validity and bias to the research. Threats to validity affect the accuracy of the research and soundness of the conclusion. Threats to external validity

8 CFR 212.4 - Applications for the exercise of discretion under section 212(d)(1) and 212(d)(3).

Code of Federal Regulations, 2014 CFR

2014-01-01

... supplemented by the official record of each conviction, and any other documents relating to commutation of... Card, issued by the DOS shall be valid for a period not to exceed the validity of the biometric BCC for... is noted on the card may remain valid. Although the waiver may remain valid, the non-biometric border...

8 CFR 212.4 - Applications for the exercise of discretion under section 212(d)(1) and 212(d)(3).

Code of Federal Regulations, 2012 CFR

2012-01-01

... supplemented by the official record of each conviction, and any other documents relating to commutation of... Card, issued by the DOS shall be valid for a period not to exceed the validity of the biometric BCC for... is noted on the card may remain valid. Although the waiver may remain valid, the non-biometric border...

The construct validity of HPAT-Ireland for the selection of medical students: unresolved issues and future research implications.

PubMed

Kelly, Maureen E; O'Flynn, Siun

2017-05-01

Aptitude tests are widely used in selection. However, despite certain advantages their use remains controversial. This paper aims to critically appraise five sources of evidence for the construct validity of the Health Professions Admission Test (HPAT)-Ireland, an aptitude test used for selecting undergraduate medical students. The objectives are to identify gaps in the evidence, draw comparisons with other aptitude tests and outline future research directions. Our appraisal of the literature found that stakeholder feedback indicates that there is reasonable evidence for test content validity for two of the three sections of HPAT-Ireland. By contrast the Non-Verbal Reasoning section is widely criticised as having limited relevance to medical school performance and future clinical practice. In terms of concurrent validity there is a significant small to medium, negative correlation with school exit examinations, but not consistently so across all studies (r = -0.18, -0.28, 0.017). Likewise predictive validity studies vary, from negative to moderate strength correlations with examination performance during early years at medical school. Five studies indicate that HPAT-Ireland is supported in principle by the majority of stakeholders. While one consequence of its introduction is that successful applicants are now coming from more diverse academic backgrounds, there is no evidence that the socio-economic background of medical school entrants has been altered significantly. Negative perceptions of unfairness relating to gender, coaching and socio-economics remain. The evidence to date suggests that while there are slight gender differences, initially favouring males, these vary year on year. In conclusion, the attitudes towards, and performance of, HPAT-Ireland is not unlike that of other aptitude tests widely used internationally. The main justifications for its introduction have been achieved, in that Ireland no longer relies exclusively on a single measure of academic record for selection to medical school. However a number of areas require further research and exploration.

OCO-2 advances photosynthesis observation from space via solar-induced chlorophyll fluorescence

DOE PAGES

Sun, Ying; Frankenberg, C.; Wood, Jeff D.; ...

2017-10-12

Quantifying gross primary production (GPP) remains a major challenge in global carbon cycle research. Spaceborne monitoring of solar-induced chlorophyll fluorescence (SIF), an integrative photosynthetic signal of molecular origin, can assist in terrestrial GPP monitoring. However, the extent to which SIF tracks spatiotemporal variations in GPP remains unresolved. Orbiting Carbon Observatory-2 (OCO-2)’s SIF data acquisition and fine spatial resolution permit direct validation against ground and airborne observations. Empirical orthogonal function analysis shows consistent spatiotemporal correspondence between OCO-2 SIF and GPP globally. A linear SIF-GPP relationship is also obtained at eddy-flux sites covering diverse biomes, setting the stage for future investigations ofmore » the robustness of such a relationship across more biomes. In conclusion, our findings support the central importance of high-quality satellite SIF for studying terrestrial carbon cycle dynamics.« less

Task Validation for the AN/TPQ-36 Radar System

DTIC Science & Technology

1978-09-01

report presents the method and results of a study to validate personnel task descriptions for the new AN/TyP-Jb radar...TP.J-Sb KAPAK SVSTKM CONTENTS i ■ l.t |i- INTRODUCTION t METHOD 2 RESULTS, CONCLUSIONS, AND RECOMMENDATIONS b Task Validation 5 26B MOS... method , results, conclusions, and recommendations of the validation study. The appendixes contain the following: 1. Appendix A contains

When fast logic meets slow belief: Evidence for a parallel-processing model of belief bias.

PubMed

Trippas, Dries; Thompson, Valerie A; Handley, Simon J

2017-05-01

Two experiments pitted the default-interventionist account of belief bias against a parallel-processing model. According to the former, belief bias occurs because a fast, belief-based evaluation of the conclusion pre-empts a working-memory demanding logical analysis. In contrast, according to the latter both belief-based and logic-based responding occur in parallel. Participants were given deductive reasoning problems of variable complexity and instructed to decide whether the conclusion was valid on half the trials or to decide whether the conclusion was believable on the other half. When belief and logic conflict, the default-interventionist view predicts that it should take less time to respond on the basis of belief than logic, and that the believability of a conclusion should interfere with judgments of validity, but not the reverse. The parallel-processing view predicts that beliefs should interfere with logic judgments only if the processing required to evaluate the logical structure exceeds that required to evaluate the knowledge necessary to make a belief-based judgment, and vice versa otherwise. Consistent with this latter view, for the simplest reasoning problems (modus ponens), judgments of belief resulted in lower accuracy than judgments of validity, and believability interfered more with judgments of validity than the converse. For problems of moderate complexity (modus tollens and single-model syllogisms), the interference was symmetrical, in that validity interfered with belief judgments to the same degree that believability interfered with validity judgments. For the most complex (three-term multiple-model syllogisms), conclusion believability interfered more with judgments of validity than vice versa, in spite of the significant interference from conclusion validity on judgments of belief.

An evidence-based framework for predicting the impact of differing autotroph-heterotroph thermal sensitivities on consumer–prey dynamics

PubMed Central

Yang, Zhou; Zhang, Lu; Zhu, Xuexia; Wang, Jun; Montagnes, David J S

2016-01-01

Increased temperature accelerates vital rates, influencing microbial population and wider ecosystem dynamics, for example, the predicted increases in cyanobacterial blooms associated with global warming. However, heterotrophic and mixotrophic protists, which are dominant grazers of microalgae, may be more thermally sensitive than autotrophs, and thus prey could be suppressed as temperature rises. Theoretical and meta-analyses have begun to address this issue, but an appropriate framework linking experimental data with theory is lacking. Using ecophysiological data to develop a novel model structure, we provide the first validation of this thermal sensitivity hypothesis: increased temperature improves the consumer's ability to control the autotrophic prey. Specifically, the model accounts for temperature effects on auto- and mixotrophs and ingestion, growth and mortality rates, using an ecologically and economically important system (cyanobacteria grazed by a mixotrophic flagellate). Once established, we show the model to be a good predictor of temperature impacts on consumer–prey dynamics by comparing simulations with microcosm observations. Then, through simulations, we indicate our conclusions remain valid, even with large changes in bottom-up factors (prey growth and carrying capacity). In conclusion, we show that rising temperature could, counterintuitively, reduce the propensity for microalgal blooms to occur and, critically, provide a novel model framework for needed, continued assessment. PMID:26684731

Reviews of the Comprehensive Nuclear-Test-Ban Treaty and U.S. security

NASA Astrophysics Data System (ADS)

Jeanloz, Raymond

2017-11-01

Reviews of the Comprehensive Nuclear-Test-Ban Treaty (CTBT) by the National Academy of Sciences concluded that the United States has the technical expertise and physical means to i) maintain a safe, secure and reliable nuclear-weapons stockpile without nuclear-explosion testing, and ii) effectively monitor global compliance once the Treaty enters into force. Moreover, the CTBT is judged to help constrain proliferation of nuclear-weapons technology, so it is considered favorable to U.S. security. Review of developments since the studies were published, in 2002 and 2012, show that the study conclusions remain valid and that technical capabilities are better than anticipated.

Emotion modelling towards affective pathogenesis.

PubMed

Bas, James Le

2009-12-01

Objective: There is a need in psychiatry for models that integrate pathological states with normal systems. The interaction of arousal and emotion is the focus of an exploration of affective pathogenesis. Method: Given that the explicit causes of affective disorder remain nascent, methods of linking emotion and disorder are evaluated. Results: A network model of emotional families is presented, in which emotions exist as quantal gradients. Morbid emotional states are seen as the activation of distal emotion sites. The phenomenology of affective disorders is described with reference to this model. Recourse is made to non-linear dynamic theory. Conclusions: Metaphoric emotion models have face validity and may prove a useful heuristic.

Development and Validation Study of the Internet Overuse Screening Questionnaire

PubMed Central

Lee, Han-Kyeong; Lee, Hae-Woo; Han, Joo Hyun; Park, Subin; Ju, Seok-Jin; Choi, Kwanwoo; Lee, Ji Hyeon; Jeon, Hong Jin

2018-01-01

Objective Concerns over behavioral and emotional problems caused by excessive internet usage have been developed. This study intended to develop and a standardize questionnaire that can efficiently identify at-risk internet users through their internet usage habits. Methods Participants (n=158) were recruited at six I-will-centers located in Seoul, South Korea. From the initial 36 questionnaire item pool, 28 preliminary items were selected through expert evaluation and panel discussions. The construct validity, internal consistency, and concurrent validity were examined. We also conducted Receiver Operating Curve (ROC) analysis to assess diagnostic ability of the Internet Overuse Screening-Questionnaire (IOS-Q). Results The exploratory factor analysis yielded a five factor structure. Four factors with 17 items remained after items that had unclear factor loading were removed. The Cronbach’s alpha for the IOS-Q total score was 0.91, and test-retest reliability was 0.72. The correlation between Young’s internet addiction scale and K-scale supported concurrent validity. ROC analysis showed that the IOS-Q has superior diagnostic ability with the Area Under the Curve of 0.87. At the cut-off point of 25.5, the sensitivity was 0.93 and specificity was 0.86. Conclusion Overall, this study supports the use of IOS-Q for internet addiction research and for screening high-risk individuals. PMID:29669406

Decontamination and Management of Human Remains Following Incidents of Hazardous Chemical Release

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

Hauschild, Veronique; Watson, Annetta Paule; Bock, Robert Eldon

2012-01-01

Abstract Objective: To provide specific procedural guidance and resources for identification, assessment, control, and mitigation of compounds that may contaminate human remains resulting from chemical attack or release. Design: A detailed technical, policy, and regulatory review is summarized. Setting: Guidance is suitable for civilian or military settings where human remains potentially contaminated with hazardous chemicals may be present. Settings would include sites of transportation accidents, natural disasters, terrorist or military operations, mortuary affairs or medical examiner processing and decontamination points, and similar. Patients, Participants: While recommended procedures have not been validated with actual human remains, guidance has been developed frommore » data characterizing controlled experiments with fabrics, materiel, and laboratory animals. Main Outcome Measure(s): Presentation of logic and specific procedures for remains management, protection and decontamination of mortuary affairs personnel, as well as decision criteria for determining when remains are sufficiently decontaminated so as to pose no chemical health hazard. Results: Established procedures and existing equipment/materiel available for decontamination and verification provide appropriate and reasonable means to mitigate chemical hazards from remains. Extensive characterization of issues related to remains decontamination indicates that supra-lethal concentrations of liquid chemical warfare agent VX may prove difficult to decontaminate and verify in a timely fashion. Specialized personnel can and should be called upon to assist with monitoring necessary to clear decontaminated remains for transport and processing. Conclusions: Once appropriate decontamination and verification have been accomplished, normal procedures for remains processing and transport to the decedent s family and the continental United States can be followed.« less

PCA as a practical indicator of OPLS-DA model reliability.

PubMed

Worley, Bradley; Powers, Robert

Principal Component Analysis (PCA) and Orthogonal Projections to Latent Structures Discriminant Analysis (OPLS-DA) are powerful statistical modeling tools that provide insights into separations between experimental groups based on high-dimensional spectral measurements from NMR, MS or other analytical instrumentation. However, when used without validation, these tools may lead investigators to statistically unreliable conclusions. This danger is especially real for Partial Least Squares (PLS) and OPLS, which aggressively force separations between experimental groups. As a result, OPLS-DA is often used as an alternative method when PCA fails to expose group separation, but this practice is highly dangerous. Without rigorous validation, OPLS-DA can easily yield statistically unreliable group separation. A Monte Carlo analysis of PCA group separations and OPLS-DA cross-validation metrics was performed on NMR datasets with statistically significant separations in scores-space. A linearly increasing amount of Gaussian noise was added to each data matrix followed by the construction and validation of PCA and OPLS-DA models. With increasing added noise, the PCA scores-space distance between groups rapidly decreased and the OPLS-DA cross-validation statistics simultaneously deteriorated. A decrease in correlation between the estimated loadings (added noise) and the true (original) loadings was also observed. While the validity of the OPLS-DA model diminished with increasing added noise, the group separation in scores-space remained basically unaffected. Supported by the results of Monte Carlo analyses of PCA group separations and OPLS-DA cross-validation metrics, we provide practical guidelines and cross-validatory recommendations for reliable inference from PCA and OPLS-DA models.

Person mobility in the design and analysis of cluster-randomized cohort prevention trials.

PubMed

Vuchinich, Sam; Flay, Brian R; Aber, Lawrence; Bickman, Leonard

2012-06-01

Person mobility is an inescapable fact of life for most cluster-randomized (e.g., schools, hospitals, clinic, cities, state) cohort prevention trials. Mobility rates are an important substantive consideration in estimating the effects of an intervention. In cluster-randomized trials, mobility rates are often correlated with ethnicity, poverty and other variables associated with disparity. This raises the possibility that estimated intervention effects may generalize to only the least mobile segments of a population and, thus, create a threat to external validity. Such mobility can also create threats to the internal validity of conclusions from randomized trials. Researchers must decide how to deal with persons who leave study clusters during a trial (dropouts), persons and clusters that do not comply with an assigned intervention, and persons who enter clusters during a trial (late entrants), in addition to the persons who remain for the duration of a trial (stayers). Statistical techniques alone cannot solve the key issues of internal and external validity raised by the phenomenon of person mobility. This commentary presents a systematic, Campbellian-type analysis of person mobility in cluster-randomized cohort prevention trials. It describes four approaches for dealing with dropouts, late entrants and stayers with respect to data collection, analysis and generalizability. The questions at issue are: 1) From whom should data be collected at each wave of data collection? 2) Which cases should be included in the analyses of an intervention effect? and 3) To what populations can trial results be generalized? The conclusions lead to recommendations for the design and analysis of future cluster-randomized cohort prevention trials.

Methodologies for Pre-Validation of Biofilters and Wetlands for Stormwater Treatment

PubMed Central

Zhang, Kefeng; Randelovic, Anja; Aguiar, Larissa M.; Page, Declan; McCarthy, David T.; Deletic, Ana

2015-01-01

Background Water Sensitive Urban Design (WSUD) systems are frequently used as part of a stormwater harvesting treatment trains (e.g. biofilters (bio-retentions and rain-gardens) and wetlands). However, validation frameworks for such systems do not exist, limiting their adoption for end-uses such as drinking water. The first stage in the validation framework is pre-validation, which prepares information for further validation monitoring. Objectives A pre-validation roadmap, consisting of five steps, is suggested in this paper. Detailed methods for investigating target micropollutants in stormwater, and determining challenge conditions for biofilters and wetlands, are provided. Methods A literature review was undertaken to identify and quantify micropollutants in stormwater. MUSIC V5.1 was utilized to simulate the behaviour of the systems based on 30-year rainfall data in three distinct climate zones; outputs were evaluated to identify the threshold of operational variables, including length of dry periods (LDPs) and volume of water treated per event. Results The paper highlights that a number of micropollutants were found in stormwater at levels above various worldwide drinking water guidelines (eight pesticides, benzene, benzo(a)pyrene, pentachlorophenol, di-(2-ethylhexyl)-phthalate and a total of polychlorinated biphenyls). The 95th percentile LDPs was exponentially related to system design area while the 5th percentile length of dry periods remained within short durations (i.e. 2–8 hours). 95th percentile volume of water treated per event was exponentially related to system design area as a percentage of an impervious catchment area. Conclusions The out-comings of this study show that pre-validation could be completed through a roadmap consisting of a series of steps; this will help in the validation of stormwater treatment systems. PMID:25955688

[Validation of SHI Claims Data Exemplified by Gender-specific Diagnoses].

PubMed

Hartmann, J; Weidmann, C; Biehle, R

2016-10-01

Aim: Use of statutory health insurance (SHI) data in health services research is increasing steadily and questions of validity are gaining importance. Using gender-specific diagnosis as an example, the aim of this study was to estimate the prevalence of implausible diagnosis and demonstrate an internal validation strategy. Method: The analysis is based on the SHI data from Baden-Württemberg for 2012. Subject of validation are gender-specific outpatient diagnoses that mismatch with the gender of the insured. To uncover this implausibility, it is necessary to clarify whether the diagnosis or the gender is wrong. The validation criteria used were the presence of further gender-specific diagnoses, the presence of gender-specific settlement items, the specialization of the physician in charge and the gender assignment of the first name of the insured. To review the quality of the validation, it was verified if the gender was changed during the following year. Results: Around 5.1% of all diagnoses were gender-specific and there was a mismatch between diagnosis and gender in 0.04% of these cases. All validation criteria were useful to sort out implausibility, whereas the last one was the most effective. Only 14% remained unsolved. From the total of 1 145 insured with implausible gender-specific diagnoses, one year later 128 had a new gender (in the data). 119 of these cases were rightly classified as insured with wrong gender and 9 cases were in the unsolved group. This confirms that the validation works well. Conclusion: Implausibility in SHI data is relatively small and can be solved with appropriate validation criteria. When validating SHI data, it is advisable to question all data used critically, to use multiple validation criteria instead of just one and to abandon the idea that reality and the associated data conform to standardized norms. Keeping these aspects in mind, analysis of SHI data is a good starting point for research in health services. © Georg Thieme Verlag KG Stuttgart · New York.

Measuring Physical Activity in Pregnancy Using Questionnaires: A Meta-Analysis

PubMed

Schuster, Snježana; Šklempe Kokić, Iva; Sindik, Joško

2016-09-01

Physical activity (PA) during normal pregnancy has various positive effects on pregnant women’s health. Determination of the relationship between PA and health outcomes requires accurate measurement of PA in pregnant women. The purpose of this review is to provide a summary of valid and reliable PA questionnaires for pregnant women. During 2013, Pubmed, OvidSP and Web of Science databases were searched for trials on measurement properties of PA questionnaires for pregnant population. Six studies and four questionnaires met the inclusion criteria: Pregnancy Physical Activity Questionnaire, Modified Kaiser Physical Activity Survey, Short Pregnancy Leisure Time Physical Activity Questionnaire and Third Pregnancy Infection and Nutrition Study Physical Activity Questionnaire. Assessment of validity and reliability was performed using correlations of the scores in these questionnaires with objective measures and subjective measures (self-report) of PA, as well as test-retest reliability coefficients. Sample sizes included in analysis varied from 45 to 177 subjects. The best validity and reliability characteristics (together with effect sizes) were identified for the Modified Kaiser Physical Activity Survey and Pregnancy Physical Activity Questionnaire (French, Vietnamese, standard). In conclusion, assessment of PA during pregnancy remains a challenging and complex task. Questionnaires are a simple and effective, yet limited tool for assessing PA.

Assessing Measurement Error in Medicare Coverage From the National Health Interview Survey

PubMed Central

Gindi, Renee; Cohen, Robin A.

2012-01-01

Objectives Using linked administrative data, to validate Medicare coverage estimates among adults aged 65 or older from the National Health Interview Survey (NHIS), and to assess the impact of a recently added Medicare probe question on the validity of these estimates. Data sources Linked 2005 NHIS and Master Beneficiary Record and Payment History Update System files from the Social Security Administration (SSA). Study design We compared Medicare coverage reported on NHIS with “benchmark” benefit records from SSA. Principal findings With the addition of the probe question, more reports of coverage were captured, and the agreement between the NHIS-reported coverage and SSA records increased from 88% to 95%. Few additional overreports were observed. Conclusions Increased accuracy of the Medicare coverage status of NHIS participants was achieved with the Medicare probe question. Though some misclassification remains, data users interested in Medicare coverage as an outcome or correlate can use this survey measure with confidence. PMID:24800138

Validation of an instrument to evaluate health promotion at schools

PubMed Central

Pinto, Raquel Oliveira; Pattussi, Marcos Pascoal; Fontoura, Larissa do Prado; Poletto, Simone; Grapiglia, Valenca Lemes; Balbinot, Alexandre Didó; Teixeira, Vanessa Andina; Horta, Rogério Lessa

2016-01-01

ABSTRACT OBJECTIVE To validate an instrument designed to assess health promotion in the school environment. METHODS A questionnaire, based on guidelines from the World Health Organization and in line with the Brazilian school health context, was developed to validate the research instrument. There were 60 items in the instrument that included 40 questions for the school manager and 20 items with direct observations made by the interviewer. The items’ content validation was performed using the Delphi technique, with the instrument being applied in 53 schools from two medium-sized cities in the South region of Brazil. Reliability (Cronbach’s alpha and split-half) and validity (principal component analysis) analyses were performed. RESULTS The final instrument remained composed of 28 items, distributed into three dimensions: pedagogical, structural and relational. The resulting components showed good factorial loads (> 0.4) and acceptable reliability (> 0.6) for most items. The pedagogical dimension identifies educational activities regarding drugs and sexuality, violence and prejudice, auto care and peace and quality of life. The structural dimension is comprised of access, sanitary structure, and conservation and equipment. The relational dimension includes relationships within the school and with the community. CONCLUSIONS The proposed instrument presents satisfactory validity and reliability values, which include aspects relevant to promote health in schools. Its use allows the description of the health promotion conditions to which students from each educational institution are exposed. Because this instrument includes items directly observed by the investigator, it should only be used during periods when there are full and regular activities at the school in question. PMID:26982958

[The adaptation and validation to Spanish of the questionnaire Aid to Capacity Evaluation (ACE), for the assessment of the ability of patients in medical decision-making].

PubMed

Moraleda Barba, Sandra; Ballesta Rodríguez, M Isabel; Delgado Quero, Antonio Luis; Lietor Villajos, Norberto; Moreno Corredor, Andrés; Delgado Rodríguez, Miguel

2015-03-01

To adapt and validate the Spanish version of the Aid to Capacity Evaluation scale, designed to assess the capacity of the adult in medical decision-making, both in diagnosis and treatment processes. Observational study of prospective validation. Primary and hospital care of the basic health area of Jaen. One hundred twenty-nine patients. Questionnaire which included sociodemographic variables, concerning the decision (scope, type of decision, the need for written informed consent), assessment of the capacity to the Aid to Capacity Evaluation scale and other related comorbidity (hearing loss, alcoholism, cognitive level variables with the Mini-Mental State Examination and depression by Goldberg or Yesavage test). The tool is considered viable. The conclusions of the expert panel were favorable. The result of the criteria' validity, comparing the results with the assessment of the experts (forensic and psychiatrist) was very satisfying (P<.001). The intra-observer reliability was low (kappa=0,135). Interobserver reliability remained high (kappa=0.74). The internal consistency was awarded an alpha of Cronbach's 0,645 for the reduced model of 6 items. The Aid to Capacity Evaluation scale was adapted to Spanish, demonstrating adequate internal consistency and construct validity. Its use in clinical practice could contribute to the identification of patients unable to make a particular medical decision and/or to give an informed consent. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

Development and validation of a registry-based definition of eosinophilic esophagitis in Denmark

PubMed Central

Dellon, Evan S; Erichsen, Rune; Pedersen, Lars; Shaheen, Nicholas J; Baron, John A; Sørensen, Henrik T; Vyberg, Mogens

2013-01-01

AIM: To develop and validate a case definition of eosinophilic esophagitis (EoE) in the linked Danish health registries. METHODS: For case definition development, we queried the Danish medical registries from 2006-2007 to identify candidate cases of EoE in Northern Denmark. All International Classification of Diseases-10 (ICD-10) and prescription codes were obtained, and archived pathology slides were obtained and re-reviewed to determine case status. We used an iterative process to select inclusion/exclusion codes, refine the case definition, and optimize sensitivity and specificity. We then re-queried the registries from 2008-2009 to yield a validation set. The case definition algorithm was applied, and sensitivity and specificity were calculated. RESULTS: Of the 51 and 49 candidate cases identified in both the development and validation sets, 21 and 24 had EoE, respectively. Characteristics of EoE cases in the development set [mean age 35 years; 76% male; 86% dysphagia; 103 eosinophils per high-power field (eos/hpf)] were similar to those in the validation set (mean age 42 years; 83% male; 67% dysphagia; 77 eos/hpf). Re-review of archived slides confirmed that the pathology coding for esophageal eosinophilia was correct in greater than 90% of cases. Two registry-based case algorithms based on pathology, ICD-10, and pharmacy codes were successfully generated in the development set, one that was sensitive (90%) and one that was specific (97%). When these algorithms were applied to the validation set, they remained sensitive (88%) and specific (96%). CONCLUSION: Two registry-based definitions, one highly sensitive and one highly specific, were developed and validated for the linked Danish national health databases, making future population-based studies feasible. PMID:23382628

Comment on ‘Monogamy of multi-qubit entanglement using Rényi entropy’

NASA Astrophysics Data System (ADS)

Yu, Long-Bao; Zhang, Li-Hua; Zhao, Jun-Long; Tang, Yong-Sheng

2018-02-01

In an article in 2010, Kim et al introduced the definition of Rényi-α entanglement for bipartite quantum states and established an analytic formula of Rényi-α entanglement for arbitrary two-qubit states with α≥slant 1 . They also derived a monogamy of entanglement in multi-qubit systems in terms of Rényi-α entanglement for α≥slant 2 Kim et al (2010 J. Phys. A: Math. Theor. 43 445305). We find the proofs of theorems 2 and 3 contain some errors and we also present an improved derivation to overcome this flaw. The alternative derivation shows that the main conclusions remain valid despite the invalidity of the proofs.

Chiari malformation Type I surgery in pediatric patients. Part 1: validation of an ICD-9-CM code search algorithm.

PubMed

Ladner, Travis R; Greenberg, Jacob K; Guerrero, Nicole; Olsen, Margaret A; Shannon, Chevis N; Yarbrough, Chester K; Piccirillo, Jay F; Anderson, Richard C E; Feldstein, Neil A; Wellons, John C; Smyth, Matthew D; Park, Tae Sung; Limbrick, David D

2016-05-01

OBJECTIVE Administrative billing data may facilitate large-scale assessments of treatment outcomes for pediatric Chiari malformation Type I (CM-I). Validated International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code algorithms for identifying CM-I surgery are critical prerequisites for such studies but are currently only available for adults. The objective of this study was to validate two ICD-9-CM code algorithms using hospital billing data to identify pediatric patients undergoing CM-I decompression surgery. METHODS The authors retrospectively analyzed the validity of two ICD-9-CM code algorithms for identifying pediatric CM-I decompression surgery performed at 3 academic medical centers between 2001 and 2013. Algorithm 1 included any discharge diagnosis code of 348.4 (CM-I), as well as a procedure code of 01.24 (cranial decompression) or 03.09 (spinal decompression or laminectomy). Algorithm 2 restricted this group to the subset of patients with a primary discharge diagnosis of 348.4. The positive predictive value (PPV) and sensitivity of each algorithm were calculated. RESULTS Among 625 first-time admissions identified by Algorithm 1, the overall PPV for CM-I decompression was 92%. Among the 581 admissions identified by Algorithm 2, the PPV was 97%. The PPV for Algorithm 1 was lower in one center (84%) compared with the other centers (93%-94%), whereas the PPV of Algorithm 2 remained high (96%-98%) across all subgroups. The sensitivity of Algorithms 1 (91%) and 2 (89%) was very good and remained so across subgroups (82%-97%). CONCLUSIONS An ICD-9-CM algorithm requiring a primary diagnosis of CM-I has excellent PPV and very good sensitivity for identifying CM-I decompression surgery in pediatric patients. These results establish a basis for utilizing administrative billing data to assess pediatric CM-I treatment outcomes.

Measures of frailty in population-based studies: an overview

PubMed Central

2013-01-01

Background Although research productivity in the field of frailty has risen exponentially in recent years, there remains a lack of consensus regarding the measurement of this syndrome. This overview offers three services: first, we provide a comprehensive catalogue of current frailty measures; second, we evaluate their reliability and validity; third, we report on their popularity of use. Methods In order to identify relevant publications, we searched MEDLINE (from its inception in 1948 to May 2011); scrutinized the reference sections of the retrieved articles; and consulted our own files. An indicator of the frequency of use of each frailty instrument was based on the number of times it had been utilized by investigators other than the originators. Results Of the initially retrieved 2,166 papers, 27 original articles described separate frailty scales. The number (range: 1 to 38) and type of items (range of domains: physical functioning, disability, disease, sensory impairment, cognition, nutrition, mood, and social support) included in the frailty instruments varied widely. Reliability and validity had been examined in only 26% (7/27) of the instruments. The predictive validity of these scales for mortality varied: for instance, hazard ratios/odds ratios (95% confidence interval) for mortality risk for frail relative to non-frail people ranged from 1.21 (0.78; 1.87) to 6.03 (3.00; 12.08) for the Phenotype of Frailty and 1.57 (1.41; 1.74) to 10.53 (7.06; 15.70) for the Frailty Index. Among the 150 papers which we found to have used at least one of the 27 frailty instruments, 69% (n = 104) reported on the Phenotype of Frailty, 12% (n = 18) on the Frailty Index, and 19% (n = 28) on one of the remaining 25 instruments. Conclusions Although there are numerous frailty scales currently in use, reliability and validity have rarely been examined. The most evaluated and frequently used measure is the Phenotype of Frailty. PMID:23786540

The Effect of Physical Exercise on Frail Older Persons: A Systematic Review.

PubMed

Silva, R B; Aldoradin-Cabeza, H; Eslick, G D; Phu, S; Duque, G

2017-01-01

Physical exercise is one of the most effective non-pharmacological interventions aimed to improve mobility and independence in older persons. The effect of physical exercise and the most effective type of exercise in frail older persons remain undefined. This systematic review examines the effectiveness of physical exercise on frail older persons. Seven databases were search for randomized control trials which assessed the effect of exercise on participants who were identified as being frail using specific and validated criteria. Nine articles were reviewed from eight studies, from which seven used a validated definition of frailty. Based on the articles analyzed in our systematic review, the evidence suggests that exercise has a positive effect on various measures used to determine frailty including cognition, physical functioning, and psychological wellbeing. Some studies revealed that exercise may prevent or delay the onset of frailty which can enhance quality of life in older adults. Despite the evidence for exercise interventions in frail older adults, it appears that there is no clear guidance regarding the most effective program variables. The reviewed studies were generally long in duration (≥6 months) with sessions lasting around 60 minutes performed three or more times per week, including multicomponent exercises. In conclusion, although exercise interventions appear to be effective in managing the various components of frailty and preventing/delaying the onset of frailty, the most effective exercise program in this population remains unidentified.

Social networking addiction, attachment style, and validation of the Italian version of the Bergen Social Media Addiction Scale

PubMed Central

Monacis, Lucia; de Palo, Valeria; Griffiths, Mark D.; Sinatra, Maria

2017-01-01

Aim Research into social networking addiction has greatly increased over the last decade. However, the number of validated instruments assessing addiction to social networking sites (SNSs) remains few, and none have been validated in the Italian language. Consequently, this study tested the psychometric properties of the Italian version of the Bergen Social Media Addiction Scale (BSMAS), as well as providing empirical data concerning the relationship between attachment styles and SNS addiction. Methods A total of 769 participants were recruited to this study. Confirmatory factor analysis (CFA) and multigroup analyses were applied to assess construct validity of the Italian version of the BSMAS. Reliability analyses comprised the average variance extracted, the standard error of measurement, and the factor determinacy coefficient. Results Indices obtained from the CFA showed the Italian version of the BSMAS to have an excellent fit of the model to the data, thus confirming the single-factor structure of the instrument. Measurement invariance was established at configural, metric, and strict invariances across age groups, and at configural and metric levels across gender groups. Internal consistency was supported by several indicators. In addition, the theoretical associations between SNS addiction and attachment styles were generally supported. Conclusion This study provides evidence that the Italian version of the BSMAS is a psychometrically robust tool that can be used in future Italian research into social networking addiction. PMID:28494648

Incremental Validity of Useful Field of View Subtests for the Prediction of Instrumental Activities of Daily Living

PubMed Central

Aust, Frederik; Edwards, Jerri D.

2015-01-01

Introduction The Useful Field of View Test (UFOV®) is a cognitive measure that predicts older adults’ ability to perform a range of everyday activities. However, little is known about the individual contribution of each subtest to these predictions and the underlying constructs of UFOV performance remain a topic of debate. Method We investigated the incremental validity of UFOV subtests for the prediction of Instrumental Activities of Daily Living (IADL) performance in two independent datasets, the SKILL (n = 828) and ACTIVE (n = 2426) studies. We, then, explored the cognitive and visual abilities assessed by UFOV using a range of neuropsychological and vision tests administered in the SKILL study. Results In the four subtest variant of UFOV, only subtests 2 and 3 consistently made independent contributions to the prediction of IADL performance across three different behavioral measures. In all cases, the incremental validity of UFOV subtests 1 and 4 was negligible. Furthermore, we found that UFOV was related to processing speed, general non-speeded cognition, and visual function; the omission of subtests 1 and 4 from the test score did not affect these associations. Conclusions UFOV subtests 1 and 4 appear to be of limited use to predict IADL and possibly other everyday activities. Future experimental research should investigate if shortening the UFOV by omitting these subtests is a reliable and valid assessment approach. PMID:26782018

Social networking addiction, attachment style, and validation of the Italian version of the Bergen Social Media Addiction Scale.

PubMed

Monacis, Lucia; de Palo, Valeria; Griffiths, Mark D; Sinatra, Maria

2017-06-01

Aim Research into social networking addiction has greatly increased over the last decade. However, the number of validated instruments assessing addiction to social networking sites (SNSs) remains few, and none have been validated in the Italian language. Consequently, this study tested the psychometric properties of the Italian version of the Bergen Social Media Addiction Scale (BSMAS), as well as providing empirical data concerning the relationship between attachment styles and SNS addiction. Methods A total of 769 participants were recruited to this study. Confirmatory factor analysis (CFA) and multigroup analyses were applied to assess construct validity of the Italian version of the BSMAS. Reliability analyses comprised the average variance extracted, the standard error of measurement, and the factor determinacy coefficient. Results Indices obtained from the CFA showed the Italian version of the BSMAS to have an excellent fit of the model to the data, thus confirming the single-factor structure of the instrument. Measurement invariance was established at configural, metric, and strict invariances across age groups, and at configural and metric levels across gender groups. Internal consistency was supported by several indicators. In addition, the theoretical associations between SNS addiction and attachment styles were generally supported. Conclusion This study provides evidence that the Italian version of the BSMAS is a psychometrically robust tool that can be used in future Italian research into social networking addiction.

42 CFR 137.342 - What happens to funds remaining at the conclusion of a cost reimbursement construction project?

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false What happens to funds remaining at the conclusion of a cost reimbursement construction project? 137.342 Section 137.342 Public Health PUBLIC HEALTH... remaining at the conclusion of a cost reimbursement construction project? All funds, including contingency...

Short health scale: A valid measure of health-related quality of life in Korean-speaking patients with inflammatory bowel disease

PubMed Central

Park, Soo-Kyung; Ko, Bong Min; Goong, Hyeon Jeong; Seo, Jeong Yeon; Lee, Sang Hyuk; Baek, Hae Lim; Lee, Moon Sung; Park, Dong Il

2017-01-01

AIM To evaluate the short health scale (SHS), a new, simple, four-part visual analogue scale questionnaire that is designed to assess the impact of inflammatory bowel disease (IBD) on health-related quality of life (HRQOL), in Korean-speaking patients with IBD. METHODS The SHS was completed by 256 patients with Crohn’s disease (CD) and ulcerative colitis (UC). Individual SHS items were correlated with inflammatory bowel disease questionnaire (IBDQ) dimensions and with disease activity to assess validity. Test-retest reliability, responsiveness and patient or disease characteristics with probable association with high SHS scores were analyzed. RESULTS Of 256 patients with IBD, 139 (54.3%) had UC and 117 (45.7%) had CD. The correlation coefficients between SHS questions about “symptom burden”, “activities of daily living”, and “disease-related worry” and their corresponding dimensions in the IBDQ ranged from 0.62 to 0.71, compared with correlation coefficients ranging from -0.45 to -0.61 for their non-corresponding dimensions. There was a stepwise increase in SHS scores, with increasing disease activity in both CD and UC (all P values < 0.001). Reliability was confirmed with test-retest correlations ranging from 0.68 to 0.90 (all P values < 0.001). Responsiveness was confirmed with the patients who remained in remission. Their SHS scores remained unchanged, except for the SHS dimension “disease-related worry”. In the multivariate analysis, female sex was associated with worse “general well-being” (OR = 2.28, 95%CI: 1.02-5.08) along with worse disease activity. CONCLUSION The SHS is a valid and reliable measure of HRQOL in Korean-speaking patients with IBD. PMID:28596689

A pilot study: the development of a culturally tailored Malaysian Diabetes Education Module (MY-DEMO) based on the Health Belief Model

PubMed Central

2014-01-01

Background Diabetes education and self-care remains the cornerstone of diabetes management. There are many structured diabetes modules available in the United Kingdom, Europe and United States of America. Contrastingly, few structured and validated diabetes modules are available in Malaysia. This pilot study aims to develop and validate diabetes education material suitable and tailored for a multicultural society like Malaysia. Methods The theoretical framework of this module was founded from the Health Belief Model (HBM). The participants were assessed using 6-item pre- and post-test questionnaires that measured some of the known HBM constructs namely cues to action, perceived severity and perceived benefit. Data was analysed using PASW Statistics 18.0. Results The pre- and post-test questionnaires were administered to 88 participants (31 males). In general, there was a significant increase in the total score in post-test (97.34 ± 6.13%) compared to pre-test (92.80 ± 12.83%) (p < 0.05) and a significant increase in excellent score (>85%) at post-test (84.1%) compared to pre-test (70.5%) (p < 0.05). There was an improvement in post-test score in 4 of 6 items tested. The remaining 2 items which measured the perceived severity and cues to action had poorer post-test score. Conclusions The preliminary results from this pilot study suggest contextualised content material embedded within MY DEMO maybe suitable for integration with the existing diabetes education programmes. This was the first known validated diabetes education programme available in the Malay language. PMID:24708715

Nonsingular bouncing cosmology: Consistency of the effective description

NASA Astrophysics Data System (ADS)

Koehn, Michael; Lehners, Jean-Luc; Ovrut, Burt

2016-05-01

We explicitly confirm that spatially flat nonsingular bouncing cosmologies make sense as effective theories. The presence of a nonsingular bounce in a spatially flat universe implies a temporary violation of the null energy condition, which can be achieved through a phase of ghost condensation. We calculate the scale of strong coupling and demonstrate that the ghost-condensate bounce remains trustworthy throughout, and that all perturbation modes within the regime of validity of the effective description remain under control. For this purpose we require the perturbed action up to third order in perturbations, which we calculate in both flat and co-moving gauge—since these two gauges allow us to highlight different physical aspects. Our conclusion is that there exist healthy descriptions of nonsingular bouncing cosmologies providing a viable resolution of the big-bang singularities in cosmological models. Our results also suggest a variant of ekpyrotic cosmology, in which entropy perturbations are generated during the contracting phase, but are only converted into curvature perturbations after the bounce.

Validity and reliability of a self-report instrument to assess social support and physical environmental correlates of physical activity in adolescents

PubMed Central

2012-01-01

Background The purpose of this study was to examine the internal consistency, test-retest reliability, construct validity and predictive validity of a new German self-report instrument to assess the influence of social support and the physical environment on physical activity in adolescents. Methods Based on theoretical consideration, the short scales on social support and physical environment were developed and cross-validated in two independent study samples of 9 to 17 year-old girls and boys. The longitudinal sample of Study I (n = 196) was recruited from a German comprehensive school, and subjects in this study completed the questionnaire twice with a between-test interval of seven days. Cronbach’s alphas were computed to determine the internal consistency of the factors. Test-retest reliability of the latent factors was assessed using intra-class coefficients. Factorial validity of the scales was assessed using principle components analysis. Construct validity was determined using a cross-validation technique by performing confirmatory factor analysis with the independent nationwide cross-sectional sample of Study II (n = 430). Correlations between factors and three measures of physical activity (objectively measured moderate-to-vigorous physical activity (MVPA), self-reported habitual MVPA and self-reported recent MVPA) were calculated to determine the predictive validity of the instrument. Results Construct validity of the social support scale (two factors: parental support and peer support) and the physical environment scale (four factors: convenience, public recreation facilities, safety and private sport providers) was shown. Both scales had moderate test-retest reliability. The factors of the social support scale also had good internal consistency and predictive validity. Internal consistency and predictive validity of the physical environment scale were low to acceptable. Conclusions The results of this study indicate moderate to good reliability and construct validity of the social support scale and physical environment scale. Predictive validity was only confirmed for the social support scale but not for the physical environment scale. Hence, it remains unclear if a person’s physical environment has a direct or an indirect effect on physical activity behavior or a moderation function. PMID:22928865

Basic processes in reading aloud and colour naming: towards a better understanding of the role of spatial attention.

PubMed

Robidoux, Serje; Rauwerda, Derek; Besner, Derek

2014-05-01

Whether or not lexical access from print requires spatial attention has been debated intensively for the last 30 years. Studies involving colour naming generally find evidence that "unattended" words are processed. In contrast, reading-based experiments do not find evidence of distractor processing. One theory ascribes the discrepancy to weaker attentional demands for colour identification. If colour naming does not capture all of a subject's attention, the remaining attentional resources can be deployed to process the distractor word. The present study combined exogenous spatial cueing with colour naming and reading aloud separately and found that colour naming is less sensitive to the validity of a spatial cue than is reading words aloud. Based on these results, we argue that colour naming studies do not effectively control attention so that no conclusions about unattended distractor processing can be drawn from them. Thus we reiterate the consistent conclusion drawn from reading aloud and lexical decision studies: There is no word identification without (spatial) attention.

Agnotology: learning from mistakes

NASA Astrophysics Data System (ADS)

Benestad, R. E.; Hygen, H. O.; van Dorland, R.; Cook, J.; Nuccitelli, D.

2013-05-01

Replication is an important part of science, and by repeating past analyses, we show that a number of papers in the scientific literature contain severe methodological flaws which can easily be identified through simple tests and demonstrations. In many cases, shortcomings are related to a lack of robustness, leading to results that are not universally valid but rather an artifact of a particular experimental set-up. Some examples presented here have ignored data that do not fit the conclusions, and in several other cases, inappropriate statistical methods have been adopted or conclusions have been based on misconceived physics. These papers may serve as educational case studies for why certain analytical approaches sometimes are unsuitable in providing reliable answers. They also highlight the merit of replication. A lack of common replication has repercussions for the quality of the scientific literature, and may be a reason why some controversial questions remain unanswered even when ignorance could be reduced. Agnotology is the study of such ignorance. A free and open-source software is provided for demonstration purposes.

Harmonization of strategies for the validation of quantitative analytical procedures. A SFSTP proposal--Part I.

PubMed

Hubert, Ph; Nguyen-Huu, J-J; Boulanger, B; Chapuzet, E; Chiap, P; Cohen, N; Compagnon, P-A; Dewé, W; Feinberg, M; Lallier, M; Laurentie, M; Mercier, N; Muzard, G; Nivet, C; Valat, L

2004-11-15

This paper is the first part of a summary report of a new commission of the Société Française des Sciences et Techniques Pharmaceutiques (SFSTP). The main objective of this commission was the harmonization of approaches for the validation of quantitative analytical procedures. Indeed, the principle of the validation of theses procedures is today widely spread in all the domains of activities where measurements are made. Nevertheless, this simple question of acceptability or not of an analytical procedure for a given application, remains incompletely determined in several cases despite the various regulations relating to the good practices (GLP, GMP, ...) and other documents of normative character (ISO, ICH, FDA, ...). There are many official documents describing the criteria of validation to be tested, but they do not propose any experimental protocol and limit themselves most often to the general concepts. For those reasons, two previous SFSTP commissions elaborated validation guides to concretely help the industrial scientists in charge of drug development to apply those regulatory recommendations. If these two first guides widely contributed to the use and progress of analytical validations, they present, nevertheless, weaknesses regarding the conclusions of the performed statistical tests and the decisions to be made with respect to the acceptance limits defined by the use of an analytical procedure. The present paper proposes to review even the bases of the analytical validation for developing harmonized approach, by distinguishing notably the diagnosis rules and the decision rules. This latter rule is based on the use of the accuracy profile, uses the notion of total error and allows to simplify the approach of the validation of an analytical procedure while checking the associated risk to its usage. Thanks to this novel validation approach, it is possible to unambiguously demonstrate the fitness for purpose of a new method as stated in all regulatory documents.

Extracellular Neural Microstimulation May Activate Much Larger Regions than Expected by Simulations: A Combined Experimental and Modeling Study

PubMed Central

Joucla, Sébastien; Branchereau, Pascal; Cattaert, Daniel; Yvert, Blaise

2012-01-01

Electrical stimulation of the central nervous system has been widely used for decades for either fundamental research purposes or clinical treatment applications. Yet, very little is known regarding the spatial extent of an electrical stimulation. If pioneering experimental studies reported that activation threshold currents (TCs) increase with the square of the neuron-to-electrode distance over a few hundreds of microns, there is no evidence that this quadratic law remains valid for larger distances. Moreover, nowadays, numerical simulation approaches have supplanted experimental studies for estimating TCs. However, model predictions have not yet been validated directly with experiments within a common paradigm. Here, we present a direct comparison between experimental determination and modeling prediction of TCs up to distances of several millimeters. First, we combined patch-clamp recording and microelectrode array stimulation in whole embryonic mouse spinal cords to determine TCs. Experimental thresholds did not follow a quadratic law beyond 1 millimeter, but rather tended to remain constant for distances larger than 1 millimeter. We next built a combined finite element – compartment model of the same experimental paradigm to predict TCs. While theoretical TCs closely matched experimental TCs for distances <250 microns, they were highly overestimated for larger distances. This discrepancy remained even after modifications of the finite element model of the potential field, taking into account anisotropic, heterogeneous or dielectric properties of the tissue. In conclusion, these results show that quadratic evolution of TCs does not always hold for large distances between the electrode and the neuron and that classical models may underestimate volumes of tissue activated by electrical stimulation. PMID:22879886

A model of the evaporation of binary-fuel clusters of drops

NASA Technical Reports Server (NTRS)

Harstad, K.; Bellan, J.

1991-01-01

A formulation has been developed to describe the evaporation of dense or dilute clusters of binary-fuel drops. The binary fuel is assumed to be made of a solute and a solvent whose volatility is much lower than that of the solute. Convective flow effects, inducing a circulatory motion inside the drops, are taken into account, as well as turbulence external to the cluster volume. Results obtained with this model show that, similar to the conclusions for single isolated drops, the evaporation of the volatile is controlled by liquid mass diffusion when the cluster is dilute. In contrast, when the cluster is dense, the evaporation of the volatile is controlled by surface layer stripping, that is, by the regression rate of the drop, which is in fact controlled by the evaporation rate of the solvent. These conclusions are in agreement with existing experimental observations. Parametric studies show that these conclusions remain valid with changes in ambient temperature, initial slip velocity between drops and gas, initial drop size, initial cluster size, initial liquid mass fraction of the solute, and various combinations of solvent and solute. The implications of these results for computationally intensive combustor calculations are discussed.

A biomarker-based risk score to predict death in patients with atrial fibrillation: the ABC (age, biomarkers, clinical history) death risk score

PubMed Central

Hijazi, Ziad; Oldgren, Jonas; Lindbäck, Johan; Alexander, John H; Connolly, Stuart J; Eikelboom, John W; Ezekowitz, Michael D; Held, Claes; Hylek, Elaine M; Lopes, Renato D; Yusuf, Salim; Granger, Christopher B; Siegbahn, Agneta; Wallentin, Lars

2018-01-01

Abstract Aims In atrial fibrillation (AF), mortality remains high despite effective anticoagulation. A model predicting the risk of death in these patients is currently not available. We developed and validated a risk score for death in anticoagulated patients with AF including both clinical information and biomarkers. Methods and results The new risk score was developed and internally validated in 14 611 patients with AF randomized to apixaban vs. warfarin for a median of 1.9 years. External validation was performed in 8548 patients with AF randomized to dabigatran vs. warfarin for 2.0 years. Biomarker samples were obtained at study entry. Variables significantly contributing to the prediction of all-cause mortality were assessed by Cox-regression. Each variable obtained a weight proportional to the model coefficients. There were 1047 all-cause deaths in the derivation and 594 in the validation cohort. The most important predictors of death were N-terminal pro B-type natriuretic peptide, troponin-T, growth differentiation factor-15, age, and heart failure, and these were included in the ABC (Age, Biomarkers, Clinical history)-death risk score. The score was well-calibrated and yielded higher c-indices than a model based on all clinical variables in both the derivation (0.74 vs. 0.68) and validation cohorts (0.74 vs. 0.67). The reduction in mortality with apixaban was most pronounced in patients with a high ABC-death score. Conclusion A new biomarker-based score for predicting risk of death in anticoagulated AF patients was developed, internally and externally validated, and well-calibrated in two large cohorts. The ABC-death risk score performed well and may contribute to overall risk assessment in AF. ClinicalTrials.gov identifier NCT00412984 and NCT00262600 PMID:29069359

Unbiased and automated identification of a circulating tumour cell definition that associates with overall survival.

PubMed

Ligthart, Sjoerd T; Coumans, Frank A W; Attard, Gerhardt; Cassidy, Amy Mulick; de Bono, Johann S; Terstappen, Leon W M M

2011-01-01

Circulating tumour cells (CTC) in patients with metastatic carcinomas are associated with poor survival and can be used to guide therapy. Classification of CTC however remains subjective, as they are morphologically heterogeneous. We acquired digital images, using the CellSearch™ system, from blood of 185 castration resistant prostate cancer (CRPC) patients and 68 healthy subjects to define CTC by computer algorithms. Patient survival data was used as the training parameter for the computer to define CTC. The computer-generated CTC definition was validated on a separate CRPC dataset comprising 100 patients. The optimal definition of the computer defined CTC (aCTC) was stricter as compared to the manual CellSearch CTC (mCTC) definition and as a consequence aCTC were less frequent. The computer-generated CTC definition resulted in hazard ratios (HRs) of 2.8 for baseline and 3.9 for follow-up samples, which is comparable to the mCTC definition (baseline HR 2.9, follow-up HR 4.5). Validation resulted in HRs at baseline/follow-up of 3.9/5.4 for computer and 4.8/5.8 for manual definitions. In conclusion, we have defined and validated CTC by clinical outcome using a perfectly reproducing automated algorithm.

Assessment of the structural validity of the domestic violence healthcare providers’ survey questionnaire using a Nigerian sample

PubMed Central

John, Ime A; Lawoko, Stephen

2010-01-01

Abstract: Background: There has been increased advocacy to involve healthcare providers in the prevention of intimate partner violence (IPV) through screening for it in healthcare. Yet, only one in ten providers screen for IPV, suggesting barriers. Understanding the readiness of healthcare providers to screen for IPV is therefore paramount. The Domestic Violence Healthcare Provider Survey Scales (DVHPSS) is a previously validated, comprehensive scale to study readiness of healthcare providers to screen for IPV. However, an understanding of its usefulness in the Sub-Saharan African context remains elusive. The current study undertook to examine the structural validity of the DVHPSS in Nigeria. Methods: Exploratory factor analysis and Cronbach's Alpha were run to reveal the factorial structure and reliability of the instrument/subscales respectively. Established thresholds were used to determine significant factor loadings and alphas coefficient. Results: A six factor model emerged, with 2 factors similar to the original scale, another two differing slightly and a further two factors resulting from a splitting up of the original combination of victim/provider safety to having distinct victim and provider safety subscales. Conclusions: With slight modifications, the DVHPSS can be use to study IPV screening among Nigerian healthcare professionals. Introducing screening protocols could promote better understanding of crucial questions that were lost in the analysis. PMID:21483202

Development of an anaerobic threshold (HRLT, HRVT) estimation equation using the heart rate threshold (HRT) during the treadmill incremental exercise test

PubMed Central

Ham, Joo-ho; Park, Hun-Young; Kim, Youn-ho; Bae, Sang-kon; Ko, Byung-hoon

2017-01-01

[Purpose] The purpose of this study was to develop a regression model to estimate the heart rate at the lactate threshold (HRLT) and the heart rate at the ventilatory threshold (HRVT) using the heart rate threshold (HRT), and to test the validity of the regression model. [Methods] We performed a graded exercise test with a treadmill in 220 normal individuals (men: 112, women: 108) aged 20–59 years. HRT, HRLT, and HRVT were measured in all subjects. A regression model was developed to estimate HRLT and HRVT using HRT with 70% of the data (men: 79, women: 76) through randomization (7:3), with the Bernoulli trial. The validity of the regression model developed with the remaining 30% of the data (men: 33, women: 32) was also examined. [Results] Based on the regression coefficient, we found that the independent variable HRT was a significant variable in all regression models. The adjusted R2 of the developed regression models averaged about 70%, and the standard error of estimation of the validity test results was 11 bpm, which is similar to that of the developed model. [Conclusion] These results suggest that HRT is a useful parameter for predicting HRLT and HRVT. PMID:29036765

Examining the ecological validity of the Talent Development Environment Questionnaire.

PubMed

Martindale, Russell J J; Collins, Dave; Douglas, Carl; Whike, Ally

2013-01-01

It is clear that high class expertise and effective practice exists within many talent development environments across the world. However, there is also a general consensus that widespread evidence-based policy and practice is lacking. As such, it is crucial to develop solutions which can facilitate effective dissemination of knowledge and promotion of evidence-based talent development systems. While the Talent Development Environment Questionnaire (Martindale et al., 2010 ) provides a method through which this could be facilitated, its ecological validity has remained untested. As such, this study aimed to investigate the real world applicability of the questionnaire through discriminant function analysis. Athletes across ten distinct regional squads and academies were identified and separated into two broad levels, 'higher quality' (n = 48) and 'lower quality' (n = 51) environments, based on their process quality and productivity. Results revealed that the Talent Development Environment Questionnaire was able to discriminate with 77.8% accuracy. Furthermore, in addition to the questionnaire as a whole, two individual features, 'quality preparation' (P < 0.01) and 'understanding the athlete' (P < 0.01), were found to be significant discriminators. In conclusion, the results indicate robust structural properties and sound ecological validity, allowing the questionnaire to be used with more confidence in applied and research settings.

Validation of a Spanish version of the Revised Fibromyalgia Impact Questionnaire (FIQR)

PubMed Central

2013-01-01

Background The Revised version of the Fibromyalgia Impact Questionnaire (FIQR) was published in 2009. The aim of this study was to prepare a Spanish version, and to assess its psychometric properties in a sample of patients with fibromyalgia. Methods The FIQR was translated into Spanish and administered, along with the FIQ, the Hospital Anxiety Depression Scale (HADS), the 36-Item Short-Form Health Survey (SF-36), and the Brief Pain Inventory (BPI), to 113 Spanish fibromyalgia patients. The administration of the Spanish FIQR was repeated a week later. Results The Spanish FIQR had high internal consistency (Cronbach’s α was 0.91 and 0.95 at visits 1 and 2 respectively). The test-retest reliability was good for the FIQR total score and its function and symptoms domains (intraclass correlation coefficient (ICC > 0.70), but modest for the overall impact domain (ICC = 0.51). Statistically significant correlations (p < 0.05) were also found between the FIQR and the FIQ scores, as well as between the FIQR scores and the remaining scales’ scores. Conclusions The Spanish version of the FIQR has a good internal consistency and our findings support its validity for assessing fibromyalgia patients. It might be a valid instrument to apply in clinical and investigational grounds. PMID:23915386

Functionalized Buckyballs for Visualizing Microbial Species in Different States and Environments

DOE PAGES

Cheng, Qingsu; Aravind, Ashwin; Buckley, Matthew; ...

2015-09-08

To date, in situ visualization of microbial density has remained an open problem. Here, functionalized buckyballs (e.g., C60-pyrrolidine tris acid) are shown to be a versatile platform that allows internalization within a microorganism without either adhering to the cell wall and cell membrane or binding to a matrix substrate such as soil. These molecular probes are validated via multi-scale imaging, to show association with microorganisms via fluorescence microscopy, positive cellular uptake via electron microscopy, and non-specific binding to the substrates through a combination of fluorescence and autoradiography imaging. In conclusion, we also demonstrate that cysteine-functionalized C60- pyrrolidine tris acid canmore » differentiate live and dead microorganisms.« less

Antiquity of man in America indicated by radiometric dates on the Yuha burial site

USGS Publications Warehouse

Bischoff, J.L.; Merriam, R.; Childers, W.M.; Protsch, R.

1976-01-01

MUCH evidence suggests that man was present in the Western Hemisphere before 12,000 yr ago, but the case has remained less than conclusive 1. In some situations, the geological age of the site is reasonably well established but the association or nature of the artefacts is questionable2,3. In other cases, museum specimens of human bones dated by radiocarbon analysis of collagen lack desirable information concerning site location, geology, and stratigraphy even though the accuracy of their absolute ages seems valid4-6. We report here the results of radiometric dates of the Yuha burial site from Imperial County, California, for which the geology and stratigraphy have been documented and reported in detail7. ?? 1976 Nature Publishing Group.

Comment on 'Semitransparency effects in the moving mirror model for Hawking radiation'

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

Elizalde, Emilio; Haro, Jaume

2010-06-15

Particle production by a semitransparent mirror accelerating on trajectories which simulate the Hawking effect was recently discussed in 3. This author points out that some results in 1 are incorrect. We show here that, contrary to statements therein, the main results and conclusions of the last paper remain valid, only Eq. (41) there and some particular implication are not. The misunderstanding actually comes from comparing two very different parameter regions, and from the fact that, in our work, the word statistics was used in an unusual way related to the sign of the {beta}-Bogoliubov coefficient, and not with its ordinarymore » meaning, connected with the number of particles emitted per mode.« less

Predicting non-isometric fatigue induced by electrical stimulation pulse trains as a function of pulse duration

PubMed Central

2013-01-01

Background Our previous model of the non-isometric muscle fatigue that occurs during repetitive functional electrical stimulation included models of force, motion, and fatigue and accounted for applied load but not stimulation pulse duration. Our objectives were to: 1) further develop, 2) validate, and 3) present outcome measures for a non-isometric fatigue model that can predict the effect of a range of pulse durations on muscle fatigue. Methods A computer-controlled stimulator sent electrical pulses to electrodes on the thighs of 25 able-bodied human subjects. Isometric and non-isometric non-fatiguing and fatiguing knee torques and/or angles were measured. Pulse duration (170–600 μs) was the independent variable. Measurements were divided into parameter identification and model validation subsets. Results The fatigue model was simplified by removing two of three non-isometric parameters. The third remained a function of other model parameters. Between 66% and 77% of the variability in the angle measurements was explained by the new model. Conclusion Muscle fatigue in response to different stimulation pulse durations can be predicted during non-isometric repetitive contractions. PMID:23374142

Observational study to calculate addictive risk to opioids: a validation study of a predictive algorithm to evaluate opioid use disorder

PubMed Central

Brenton, Ashley; Richeimer, Steven; Sharma, Maneesh; Lee, Chee; Kantorovich, Svetlana; Blanchard, John; Meshkin, Brian

2017-01-01

Background Opioid abuse in chronic pain patients is a major public health issue, with rapidly increasing addiction rates and deaths from unintentional overdose more than quadrupling since 1999. Purpose This study seeks to determine the predictability of aberrant behavior to opioids using a comprehensive scoring algorithm incorporating phenotypic risk factors and neuroscience-associated single-nucleotide polymorphisms (SNPs). Patients and methods The Proove Opioid Risk (POR) algorithm determines the predictability of aberrant behavior to opioids using a comprehensive scoring algorithm incorporating phenotypic risk factors and neuroscience-associated SNPs. In a validation study with 258 subjects with diagnosed opioid use disorder (OUD) and 650 controls who reported using opioids, the POR successfully categorized patients at high and moderate risks of opioid misuse or abuse with 95.7% sensitivity. Regardless of changes in the prevalence of opioid misuse or abuse, the sensitivity of POR remained >95%. Conclusion The POR correctly stratifies patients into low-, moderate-, and high-risk categories to appropriately identify patients at need for additional guidance, monitoring, or treatment changes. PMID:28572737

Translated Versions of Voice Handicap Index (VHI)-30 across Languages: A Systematic Review

PubMed Central

SEIFPANAHI, Sadegh; JALAIE, Shohreh; NIKOO, Mohammad Reza; SOBHANI-RAD, Davood

2015-01-01

Background: In this systematic review, the aim is to investigate different VHI-30 versions between languages regarding their validity, reliability and their translation process. Methods: Articles were extracted systematically from some of the prime databases including Cochrane, googlescholar, MEDLINE (via PubMed gate), Sciencedirect, Web of science, and their reference lists by Voice Handicap Index keyword with only title limitation and time of publication (from 1997 to 2014). However the other limitations (e.g. excluding non-English, other versions of VHI ones, and so on) applied manually after studying the papers. In order to appraise the methodology of the papers, three authors did it by 12-item diagnostic test checklist in “Critical Appraisal Skills Programme” or (CASP) site. After applying all of the screenings, the papers that had the study eligibility criteria such as; translation, validity, and reliability processes, included in this review. Results: The remained non-repeated articles were 12 from different languages. All of them reported validity, reliability and translation method, which presented in details in this review. Conclusion: Mainly the preferred method for translation in the gathered papers was “Brislin’s classic back-translation model (1970), although the procedure was not performed completely but it was more prominent than other translation procedures. High test-retest reliability, internal consistency and moderate construct validity between different languages in regards to all 3 VHI-30 domains confirm the applicability of translated VHI-30 version across languages. PMID:26056664

Cross-Cultural Psychometric Assessment of the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) Pain Scale in the Portuguese Population.

PubMed

Barbosa, Margarida; Bennett, Michael I; Verissimo, Ramiro; Carvalho, Davide

2014-09-01

Chronic pain is a well-known phenomenon. The differential diagnosis between neuropathic and nociceptive pain syndromes is a challenge. Consequently, assessment instruments that can distinguish between these conditions in a standardized way are of the utmost importance. The Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) is a screening tool developed to identify chronic neuropathic pain. The aim of this study was the Portuguese language translation, linguistic adaptation of the LANSS pain scale, its semantic validation, internal consistency, temporal stability, as well its validity and discriminative power. LANSS Portuguese version scale was applied to 165 consecutive patients attending the pain clinic: 103 fulfilled the clinical criteria for the diagnosis of pain of neuropathic origin and the remaining 62 fulfilled the criteria for nociceptive pain. The scale proved to be an internally consistent (Cronbach's alpha = 0.78) and reliable instrument with good test-retest stability (r = 0.7; P < 0.001). However, its validity and specificity with a cutoff point of ≥ 12, for differentiating patients with neuropathic pain from those with non-neuropathic pain, had 89% sensitivity, 74% specificity, positive predictive value of 85%, and negative predictive value of 81%. The Portuguese LANSS version pain scale properties lead us to the conclusion that such a cross-cultural version is a reliable and valid instrument for the differentiation of this type of pain. Its usage is recommended. © 2013 World Institute of Pain.

State of the art in the validation of screening methods for the control of antibiotic residues: is there a need for further development?

PubMed

Gaudin, Valérie

2017-09-01

Screening methods are used as a first-line approach to detect the presence of antibiotic residues in food of animal origin. The validation process guarantees that the method is fit-for-purpose, suited to regulatory requirements, and provides evidence of its performance. This article is focused on intra-laboratory validation. The first step in validation is characterisation of performance, and the second step is the validation itself with regard to pre-established criteria. The validation approaches can be absolute (a single method) or relative (comparison of methods), overall (combination of several characteristics in one) or criterion-by-criterion. Various approaches to validation, in the form of regulations, guidelines or standards, are presented and discussed to draw conclusions on their potential application for different residue screening methods, and to determine whether or not they reach the same conclusions. The approach by comparison of methods is not suitable for screening methods for antibiotic residues. The overall approaches, such as probability of detection (POD) and accuracy profile, are increasingly used in other fields of application. They may be of interest for screening methods for antibiotic residues. Finally, the criterion-by-criterion approach (Decision 2002/657/EC and of European guideline for the validation of screening methods), usually applied to the screening methods for antibiotic residues, introduced a major characteristic and an improvement in the validation, i.e. the detection capability (CCβ). In conclusion, screening methods are constantly evolving, thanks to the development of new biosensors or liquid chromatography coupled to tandem-mass spectrometry (LC-MS/MS) methods. There have been clear changes in validation approaches these last 20 years. Continued progress is required and perspectives for future development of guidelines, regulations and standards for validation are presented here.

Quality appraisal of generic self-reported instruments measuring health-related productivity changes: a systematic review

PubMed Central

2014-01-01

Background Health impairments can result in disability and changed work productivity imposing considerable costs for the employee, employer and society as a whole. A large number of instruments exist to measure health-related productivity changes; however their methodological quality remains unclear. This systematic review critically appraised the measurement properties in generic self-reported instruments that measure health-related productivity changes to recommend appropriate instruments for use in occupational and economic health practice. Methods PubMed, PsycINFO, Econlit and Embase were systematically searched for studies whereof: (i) instruments measured health-related productivity changes; (ii) the aim was to evaluate instrument measurement properties; (iii) instruments were generic; (iv) ratings were self-reported; (v) full-texts were available. Next, methodological quality appraisal was based on COSMIN elements: (i) internal consistency; (ii) reliability; (iii) measurement error; (iv) content validity; (v) structural validity; (vi) hypotheses testing; (vii) cross-cultural validity; (viii) criterion validity; and (ix) responsiveness. Recommendations are based on evidence syntheses. Results This review included 25 articles assessing the reliability, validity and responsiveness of 15 different generic self-reported instruments measuring health-related productivity changes. Most studies evaluated criterion validity, none evaluated cross-cultural validity and information on measurement error is lacking. The Work Limitation Questionnaire (WLQ) was most frequently evaluated with moderate respectively strong positive evidence for content and structural validity and negative evidence for reliability, hypothesis testing and responsiveness. Less frequently evaluated, the Stanford Presenteeism Scale (SPS) showed strong positive evidence for internal consistency and structural validity, and moderate positive evidence for hypotheses testing and criterion validity. The Productivity and Disease Questionnaire (PRODISQ) yielded strong positive evidence for content validity, evidence for other properties is lacking. The other instruments resulted in mostly fair-to-poor quality ratings with limited evidence. Conclusions Decisions based on the content of the instrument, usage purpose, target country and population, and available evidence are recommended. Until high-quality studies are in place to accurately assess the measurement properties of the currently available instruments, the WLQ and, in a Dutch context, the PRODISQ are cautiously preferred based on its strong positive evidence for content validity. Based on its strong positive evidence for internal consistency and structural validity, the SPS is cautiously recommended. PMID:24495301

Discovery and Validation of Novel Expression Signature for Postcystectomy Recurrence in High-Risk Bladder Cancer

PubMed Central

Lam, Lucia L.; Ghadessi, Mercedeh; Erho, Nicholas; Vergara, Ismael A.; Alshalalfa, Mohammed; Buerki, Christine; Haddad, Zaid; Sierocinski, Thomas; Triche, Timothy J.; Skinner, Eila C.; Davicioni, Elai; Daneshmand, Siamak; Black, Peter C.

2014-01-01

Background Nearly half of muscle-invasive bladder cancer patients succumb to their disease following cystectomy. Selecting candidates for adjuvant therapy is currently based on clinical parameters with limited predictive power. This study aimed to develop and validate genomic-based signatures that can better identify patients at risk for recurrence than clinical models alone. Methods Transcriptome-wide expression profiles were generated using 1.4 million feature-arrays on archival tumors from 225 patients who underwent radical cystectomy and had muscle-invasive and/or node-positive bladder cancer. Genomic (GC) and clinical (CC) classifiers for predicting recurrence were developed on a discovery set (n = 133). Performances of GC, CC, an independent clinical nomogram (IBCNC), and genomic-clinicopathologic classifiers (G-CC, G-IBCNC) were assessed in the discovery and independent validation (n = 66) sets. GC was further validated on four external datasets (n = 341). Discrimination and prognostic abilities of classifiers were compared using area under receiver-operating characteristic curves (AUCs). All statistical tests were two-sided. Results A 15-feature GC was developed on the discovery set with area under curve (AUC) of 0.77 in the validation set. This was higher than individual clinical variables, IBCNC (AUC = 0.73), and comparable to CC (AUC = 0.78). Performance was improved upon combining GC with clinical nomograms (G-IBCNC, AUC = 0.82; G-CC, AUC = 0.86). G-CC high-risk patients had elevated recurrence probabilities (P < .001), with GC being the best predictor by multivariable analysis (P = .005). Genomic-clinicopathologic classifiers outperformed clinical nomograms by decision curve and reclassification analyses. GC performed the best in validation compared with seven prior signatures. GC markers remained prognostic across four independent datasets. Conclusions The validated genomic-based classifiers outperform clinical models for predicting postcystectomy bladder cancer recurrence. This may be used to better identify patients who need more aggressive management. PMID:25344601

28 CFR 25.5 - Validation and data integrity of records in the system.

Code of Federal Regulations, 2010 CFR

2010-07-01

... INFORMATION SYSTEMS The National Instant Criminal Background Check System § 25.5 Validation and data integrity... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Validation and data integrity of records... verify that the information provided to the NICS Index remains valid and correct. (b) Each data source...

SU-E-T-131: Artificial Neural Networks Applied to Overall Survival Prediction for Patients with Periampullary Carcinoma

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

Gong, Y; Yu, J; Yeung, V

Purpose: Artificial neural networks (ANN) can be used to discover complex relations within datasets to help with medical decision making. This study aimed to develop an ANN method to predict two-year overall survival of patients with peri-ampullary cancer (PAC) following resection. Methods: Data were collected from 334 patients with PAC following resection treated in our institutional pancreatic tumor registry between 2006 and 2012. The dataset contains 14 variables including age, gender, T-stage, tumor differentiation, positive-lymph-node ratio, positive resection margins, chemotherapy, radiation therapy, and tumor histology.After censoring for two-year survival analysis, 309 patients were left, of which 44 patients (∼15%) weremore » randomly selected to form testing set. The remaining 265 cases were randomly divided into training set (211 cases, ∼80% of 265) and validation set (54 cases, ∼20% of 265) for 20 times to build 20 ANN models. Each ANN has one hidden layer with 5 units. The 20 ANN models were ranked according to their concordance index (c-index) of prediction on validation sets. To further improve prediction, the top 10% of ANN models were selected, and their outputs averaged for prediction on testing set. Results: By random division, 44 cases in testing set and the remaining 265 cases have approximately equal two-year survival rates, 36.4% and 35.5% respectively. The 20 ANN models, which were trained and validated on the 265 cases, yielded mean c-indexes as 0.59 and 0.63 on validation sets and the testing set, respectively. C-index was 0.72 when the two best ANN models (top 10%) were used in prediction on testing set. The c-index of Cox regression analysis was 0.63. Conclusion: ANN improved survival prediction for patients with PAC. More patient data and further analysis of additional factors may be needed for a more robust model, which will help guide physicians in providing optimal post-operative care. This project was supported by PA CURE Grant.« less

The role of postural control in the association between aerobic capacity and walking capacity in chronic stroke: a cross-sectional analysis.

PubMed

Outermans, Jacqueline C; van de Port, Ingrid; Kwakkel, Gert; Visser-Meily, Johanna M; Wittink, Harriet

2018-03-12

Reports on the association between aerobic capacity and walking capacity in people after stroke show disparate results. To determine (1) if the predictive validity of peak oxygen uptake (VO2peak) for walking capacity post stroke is different from that of maximal oxygen uptake (VO2max) and (2) if postural control, hemiplegic lower extremity muscle strength, age and gender distort the association between aerobic capacity and walking capacity. Cross-sectional study. General community in Utrecht, the Netherlands. Community-dwelling people more than three months after stroke. Measurement of aerobic capacity were performed with cardiopulmonary exercise testing (CPET) and differentiated between the achievement of VO2peak or VO2max. Measurement of walking capacity with the Six Minute Walk Test (6MWT), postural control with the Performance Oriented Mobility Assessment (POMA) and hemiplegic lower extremity muscle strength with the Motricity Index (MI-LE). Fifty-one out of 62 eligible participants, aged 64.7 (±12.5) years were included. Analysis of covariance (ANCOVA) showed a nonsignificant difference between the predictive validities of VO2max (N = 22, β = 0.56; 95%CI 0.12 - 0.97) and VO2peak (N = 29, β = 0.72; 95%CI 0.38 - 0.92). Multiple regression analysis of the pooled sample showed a significant decrease in the β value of VO2peak (21.6%) for the 6MWT when adding the POMA as a covariate in the association model. VO2peak remained significantly related to 6MWT after correcting for the POMA (β = 0.56 (95%CI 0.39 - 0.75)) CONCLUSIONS: The results suggest similar predictive validity of aerobic capacity for walking capacity in participants achieving VO2max compared to those only achieving VO2peak. Postural control confounds the association between aerobic capacity and walking capacity. Aerobic capacity remains a valid predictor of walking capacity. Aerobic capacity is an important factor associated with walking capacity after stroke. However, to understand this relationship, postural control needs to be measured. Both aerobic capacity and postural control may need to be addressed during interventions aiming to improve walking capacity after stroke.

Validation of a Radiosensitivity Molecular Signature in Breast Cancer

PubMed Central

Eschrich, Steven A.; Fulp, William J.; Pawitan, Yudi; Foekens, John A.; Smid, Marcel; Martens, John W. M.; Echevarria, Michelle; Kamath, Vidya; Lee, Ji-Hyun; Harris, Eleanor E.; Bergh, Jonas; Torres-Roca, Javier F.

2014-01-01

Purpose Previously, we developed a radiosensitivity molecular signature (RSI) that was clinically-validated in three independent datasets (rectal, esophageal, head and neck) in 118 patients. Here, we test RSI in radiotherapy (RT) treated breast cancer patients. Experimental Design RSI was tested in two previously published breast cancer datasets. Patients were treated at the Karolinska University Hospital (n=159) and Erasmus Medical Center (n=344). RSI was applied as previously described. Results We tested RSI in RT-treated patients (Karolinska). Patients predicted to be radiosensitive (RS) had an improved 5 yr relapse-free survival when compared with radioresistant (RR) patients (95% vs. 75%, p=0.0212) but there was no difference between RS/RR patients treated without RT (71% vs. 77%, p=0.6744), consistent with RSI being RT-specific (interaction term RSIxRT, p=0.05). Similarly, in the Erasmus dataset RT-treated RS patients had an improved 5-year distant-metastasis-free survival over RR patients (77% vs. 64%, p=0.0409) but no difference was observed in patients treated without RT (RS vs. RR, 80% vs. 81%, p=0.9425). Multivariable analysis showed RSI is the strongest variable in RT-treated patients (Karolinska, HR=5.53, p=0.0987, Erasmus, HR=1.64, p=0.0758) and in backward selection (removal alpha of 0.10) RSI was the only variable remaining in the final model. Finally, RSI is an independent predictor of outcome in RT-treated ER+ patients (Erasmus, multivariable analysis, HR=2.64, p=0.0085). Conclusions RSI is validated in two independent breast cancer datasets totaling 503 patients. Including prior data, RSI is validated in five independent cohorts (621 patients) and represents, to our knowledge, the most extensively validated molecular signature in radiation oncology. PMID:22832933

Automatic Detection of Whole Night Snoring Events Using Non-Contact Microphone

PubMed Central

Dafna, Eliran; Tarasiuk, Ariel; Zigel, Yaniv

2013-01-01

Objective Although awareness of sleep disorders is increasing, limited information is available on whole night detection of snoring. Our study aimed to develop and validate a robust, high performance, and sensitive whole-night snore detector based on non-contact technology. Design Sounds during polysomnography (PSG) were recorded using a directional condenser microphone placed 1 m above the bed. An AdaBoost classifier was trained and validated on manually labeled snoring and non-snoring acoustic events. Patients Sixty-seven subjects (age 52.5±13.5 years, BMI 30.8±4.7 kg/m2, m/f 40/27) referred for PSG for obstructive sleep apnea diagnoses were prospectively and consecutively recruited. Twenty-five subjects were used for the design study; the validation study was blindly performed on the remaining forty-two subjects. Measurements and Results To train the proposed sound detector, >76,600 acoustic episodes collected in the design study were manually classified by three scorers into snore and non-snore episodes (e.g., bedding noise, coughing, environmental). A feature selection process was applied to select the most discriminative features extracted from time and spectral domains. The average snore/non-snore detection rate (accuracy) for the design group was 98.4% based on a ten-fold cross-validation technique. When tested on the validation group, the average detection rate was 98.2% with sensitivity of 98.0% (snore as a snore) and specificity of 98.3% (noise as noise). Conclusions Audio-based features extracted from time and spectral domains can accurately discriminate between snore and non-snore acoustic events. This audio analysis approach enables detection and analysis of snoring sounds from a full night in order to produce quantified measures for objective follow-up of patients. PMID:24391903

Mathematical multi-scale model of the cardiovascular system including mitral valve dynamics. Application to ischemic mitral insufficiency

PubMed Central

2011-01-01

Background Valve dysfunction is a common cardiovascular pathology. Despite significant clinical research, there is little formal study of how valve dysfunction affects overall circulatory dynamics. Validated models would offer the ability to better understand these dynamics and thus optimize diagnosis, as well as surgical and other interventions. Methods A cardiovascular and circulatory system (CVS) model has already been validated in silico, and in several animal model studies. It accounts for valve dynamics using Heaviside functions to simulate a physiologically accurate "open on pressure, close on flow" law. However, it does not consider real-time valve opening dynamics and therefore does not fully capture valve dysfunction, particularly where the dysfunction involves partial closure. This research describes an updated version of this previous closed-loop CVS model that includes the progressive opening of the mitral valve, and is defined over the full cardiac cycle. Results Simulations of the cardiovascular system with healthy mitral valve are performed, and, the global hemodynamic behaviour is studied compared with previously validated results. The error between resulting pressure-volume (PV) loops of already validated CVS model and the new CVS model that includes the progressive opening of the mitral valve is assessed and remains within typical measurement error and variability. Simulations of ischemic mitral insufficiency are also performed. Pressure-Volume loops, transmitral flow evolution and mitral valve aperture area evolution follow reported measurements in shape, amplitude and trends. Conclusions The resulting cardiovascular system model including mitral valve dynamics provides a foundation for clinical validation and the study of valvular dysfunction in vivo. The overall models and results could readily be generalised to other cardiac valves. PMID:21942971

External validation of a risk assessment model for venous thromboembolism in the hospitalised acutely-ill medical patient (VTE-VALOURR).

PubMed

Mahan, Charles E; Liu, Yang; Turpie, A Graham; Vu, Jennifer T; Heddle, Nancy; Cook, Richard J; Dairkee, Undaleeb; Spyropoulos, Alex C

2014-10-01

Venous thromboembolic (VTE) risk assessment remains an important issue in hospitalised, acutely-ill medical patients, and several VTE risk assessment models (RAM) have been proposed. The purpose of this large retrospective cohort study was to externally validate the IMPROVE RAM using a large database of three acute care hospitals. We studied 41,486 hospitalisations (28,744 unique patients) with 1,240 VTE hospitalisations (1,135 unique patients) in the VTE cohort and 40,246 VTE-free hospitalisations (27,609 unique patients) in the control cohort. After chart review, 139 unique VTE patients were identified and 278 randomly-selected matched patients in the control cohort. Seven independent VTE risk factors as part of the RAM in the derivation cohort were identified. In the validation cohort, the incidence of VTE was 0.20%; 95% confidence interval (CI) 0.18-0.22, 1.04%; 95%CI 0.88-1.25, and 4.15%; 95%CI 2.79-8.12 in the low, moderate, and high VTE risk groups, respectively, which compared to rates of 0.45%, 1.3%, and 4.74% in the three risk categories of the derivation cohort. For the derivation and validation cohorts, the total percentage of patients in low, moderate and high VTE risk occurred in 68.6% vs 63.3%, 24.8% vs 31.1%, and 6.5% vs 5.5%, respectively. Overall, the area under the receiver-operator characteristics curve for the validation cohort was 0.7731. In conclusion, the IMPROVE RAM can accurately identify medical patients at low, moderate, and high VTE risk. This will tailor future thromboprophylactic strategies in this population as well as identify particularly high VTE risk patients in whom multimodal or more intensive prophylaxis may be beneficial.

MR Imaging Anatomy in Neurodegeneration: A Robust Volumetric Parcellation Method of the Frontal Lobe Gyri with Quantitative Validation in Patients with Dementia

PubMed Central

Iordanova, B.; Rosenbaum, D.; Norman, D.; Weiner, M.; Studholme, C.

2007-01-01

BACKGROUND AND PURPOSE Brain volumetry is widely used for evaluating tissue degeneration; however, the parcellation methods are rarely validated and use arbitrary planes to mark boundaries of brain regions. The goal of this study was to develop, validate, and apply an MR imaging tracing method for the parcellation of 3 major gyri of the frontal lobe, which uses only local landmarks intrinsic to the structures of interest, without the need for global reorientation or the use of dividing planes or lines. METHODS Studies were performed on 25 subjects—healthy controls and subjects diagnosed with Lewy body dementia and Alzheimer disease—with significant variation in the underlying gyral anatomy and state of atrophy. The protocol was evaluated by using multiple observers tracing scans of subjects diagnosed with neurodegenerative disease and those aging normally, and the results were compared by spatial overlap agreement. To confirm the results, observers marked the same locations in different brains. We illustrated the variabilities of the key boundaries that pose the greatest challenge to defining consistent parcellations across subjects. RESULTS The resulting gyral volumes were evaluated, and their consistency across raters was used as an additional assessment of the validity of our marking method. The agreement on a scale of 0–1 was found to be 0.83 spatial and 0.90 volumetric for the same rater and 0.85 spatial and 0.90 volumetric for 2 different raters. The results revealed that the protocol remained consistent across different neurodegenerative conditions. CONCLUSION Our method provides a simple and reliable way for the volumetric evaluation of frontal lobe neurodegeneration and can be used as a resource for larger comparative studies as well as a validation procedure of automated algorithms. PMID:16971629

Development and initial validation of the Bedside Paediatric Early Warning System score

PubMed Central

2009-01-01

Introduction Adverse outcomes following clinical deterioration in children admitted to hospital wards is frequently preventable. Identification of children for referral to critical care experts remains problematic. Our objective was to develop and validate a simple bedside score to quantify severity of illness in hospitalized children. Methods A case-control design was used to evaluate 11 candidate items and identify a pragmatic score for routine bedside use. Case-patients were urgently admitted to the intensive care unit (ICU). Control-patients had no 'code blue', ICU admission or care restrictions. Validation was performed using two prospectively collected datasets. Results Data from 60 case and 120 control-patients was obtained. Four out of eleven candidate-items were removed. The seven-item Bedside Paediatric Early Warning System (PEWS) score ranges from 0–26. The mean maximum scores were 10.1 in case-patients and 3.4 in control-patients. The area under the receiver operating characteristics curve was 0.91, compared with 0.84 for the retrospective nurse-rating of patient risk for near or actual cardiopulmonary arrest. At a score of 8 the sensitivity and specificity were 82% and 93%, respectively. The score increased over 24 hours preceding urgent paediatric intensive care unit (PICU) admission (P < 0.0001). In 436 urgent consultations, the Bedside PEWS score was higher in patients admitted to the ICU than patients who were not admitted (P < 0.0001). Conclusions We developed and performed the initial validation of the Bedside PEWS score. This 7-item score can quantify severity of illness in hospitalized children and identify critically ill children with at least one hours notice. Prospective validation in other populations is required before clinical application. PMID:19678924

The development and validation of different decision-making tools to predict urine culture growth out of urine flow cytometry parameter

PubMed Central

Seidenberg, Ruth; Schuh, Sabine K.; Exadaktylos, Aristomenis K.; Schechter, Clyde B.; Leichtle, Alexander B.; Hautz, Wolf E.

2018-01-01

Objective Patients presenting with suspected urinary tract infection are common in every day emergency practice. Urine flow cytometry has replaced microscopic urine evaluation in many emergency departments, but interpretation of the results remains challenging. The aim of this study was to develop and validate tools that predict urine culture growth out of urine flow cytometry parameter. Methods This retrospective study included all adult patients that presented in a large emergency department between January and July 2017 with a suspected urinary tract infection and had a urine flow cytometry as well as a urine culture obtained. The objective was to identify urine flow cytometry parameters that reliably predict urine culture growth and mixed flora growth. The data set was split into a training (70%) and a validation set (30%) and different decision-making approaches were developed and validated. Results Relevant urine culture growth (respectively mixed flora growth) was found in 40.2% (7.2% respectively) of the 613 patients included. The number of leukocytes and bacteria in flow cytometry were highly associated with urine culture growth, but mixed flora growth could not be sufficiently predicted from the urine flow cytometry parameters. A decision tree, predictive value figures, a nomogram, and a cut-off table to predict urine culture growth from bacteria and leukocyte count were developed, validated and compared. Conclusions Urine flow cytometry parameters are insufficient to predict mixed flora growth. However, the prediction of urine culture growth based on bacteria and leukocyte count is highly accurate and the developed tools should be used as part of the decision-making process of ordering a urine culture or starting an antibiotic therapy if a urogenital infection is suspected. PMID:29474463

Diagnostic Value of Combining Tumor and Inflammatory Markers in Lung Cancer

PubMed Central

Yoon, Ho Il; Kwon, Oh-Ran; Kang, Kyung Nam; Shin, Yong Sung; Shin, Ho Sang; Yeon, Eun Hee; Kwon, Keon Young; Hwang, Ilseon; Jeon, Yoon Kyung; Kim, Yongdai; Kim, Chul Woo

2016-01-01

Background Despite major advances in lung cancer treatment, early detection remains the most promising way of improving outcomes. To detect lung cancer in earlier stages, many serum biomarkers have been tested. Unfortunately, no single biomarker can reliably detect lung cancer. We combined a set of 2 tumor markers and 4 inflammatory or metabolic markers and tried to validate the diagnostic performance in lung cancer. Methods We collected serum samples from 355 lung cancer patients and 590 control subjects and divided them into training and validation datasets. After measuring serum levels of 6 biomarkers (human epididymis secretory protein 4 [HE4], carcinoembryonic antigen [CEA], regulated on activation, normal T cell expressed and secreted [RANTES], apolipoprotein A2 [ApoA2], transthyretin [TTR], and secretory vascular cell adhesion molecule-1 [sVCAM-1]), we tested various sets of biomarkers for their diagnostic performance in lung cancer. Results In a training dataset, the area under the curve (AUC) values were 0.821 for HE4, 0.753 for CEA, 0.858 for RANTES, 0.867 for ApoA2, 0.830 for TTR, and 0.552 for sVCAM-1. A model using all 6 biomarkers and age yielded an AUC value of 0.986 and sensitivity of 93.2% (cutoff at specificity 94%). Applying this model to the validation dataset showed similar results. The AUC value of the model was 0.988, with sensitivity of 93.33% and specificity of 92.00% at the same cutoff point used in the validation dataset. Analyses by stages and histologic subtypes all yielded similar results. Conclusions Combining multiple tumor and systemic inflammatory markers proved to be a valid strategy in the diagnosis of lung cancer. PMID:27722145

The return of the bow shock

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

Scherer, K.; Fichtner, H., E-mail: kls@tp4.rub.de, E-mail: hf@tp4.rub.de

2014-02-10

Recently, whether a bow shock ahead of the heliospheric stagnation region exists or not has been a topic of discussion. This was triggered by measurements indicating that the Alfvén speed and the speed of fast magnetosonic waves are higher than the flow speed of the local interstellar medium (LISM) relative to the heliosphere and resulted in the conclusion that either a bow wave or a slow magnetosonic shock might exist. We demonstrate here that including the He{sup +} component of the LISM yields both an Alfvén and fast magnetosonic wave speed lower than the LISM flow speed. Consequently, the scenariomore » of a bow shock in front of the heliosphere, as modeled in numerous simulations of the interaction of the solar wind with the LISM, remains valid.« less

Integrability of spinning particle motion in higher-dimensional rotating black hole spacetimes.

PubMed

Kubizňák, David; Cariglia, Marco

2012-02-03

We study the motion of a classical spinning particle (with spin degrees of freedom described by a vector of Grassmann variables) in higher-dimensional general rotating black hole spacetimes with a cosmological constant. In all dimensions n we exhibit n bosonic functionally independent integrals of spinning particle motion, corresponding to explicit and hidden symmetries generated from the principal conformal Killing-Yano tensor. Moreover, we demonstrate that in 4-, 5-, 6-, and 7-dimensional black hole spacetimes such integrals are in involution, proving the bosonic part of the motion integrable. We conjecture that the same conclusion remains valid in all higher dimensions. Our result generalizes the result of Page et al. [Phys. Rev. Lett. 98, 061102 (2007)] on complete integrability of geodesic motion in these spacetimes.

ACOG Committee Opinion No. 646: Ethical Considerations for Including Women as Research Participants.

PubMed

2015-11-01

Inclusion of women in research studies is necessary for valid inferences about health and disease in women. The generalization of results from trials conducted in men may yield erroneous conclusions that fail to account for the biologic differences between men and women. Although significant changes in research design and practice have led to an increase in the proportion of women included in research trials, knowledge gaps remain because of a continued lack of inclusion of women, especially those who are pregnant, in premarketing research trials. This document provides a historical overview of issues surrounding women as participants in research trials, followed by an ethical framework and discussion of the issues of informed consent, contraception requirements, intimate partner consent, and the appropriate inclusion of pregnant women in research studies.

The predictive validity of three versions of the MCAT in relation to performance in medical school, residency, and licensing examinations: a longitudinal study of 36 classes of Jefferson Medical College.

PubMed

Callahan, Clara A; Hojat, Mohammadreza; Veloski, Jon; Erdmann, James B; Gonnella, Joseph S

2010-06-01

The Medical College Admission Test (MCAT) has undergone several revisions for content and validity since its inception. With another comprehensive review pending, this study examines changes in the predictive validity of the MCAT's three recent versions. Study participants were 7,859 matriculants in 36 classes entering Jefferson Medical College between 1970 and 2005; 1,728 took the pre-1978 version of the MCAT; 3,032 took the 1978-1991 version, and 3,099 took the post-1991 version. MCAT subtest scores were the predictors, and performance in medical school, attrition, scores on the medical licensing examinations, and ratings of clinical competence in the first year of residency were the criterion measures. No significant improvement in validity coefficients was observed for performance in medical school or residency. Validity coefficients for all three versions of the MCAT in predicting Part I/Step 1 remained stable (in the mid-0.40s, P < .01). A systematic decline was observed in the validity coefficients of the MCAT versions in predicting Part II/Step 2. It started at 0.47 for the pre-1978 version, decreased to between 0.42 and 0.40 for the 1978-1991 versions, and to 0.37 for the post-1991 version. Validity coefficients for the MCAT versions in predicting Part III/Step 3 remained near 0.30. These were generally larger for women than men. Although the findings support the short- and long-term predictive validity of the MCAT, opportunities to strengthen it remain. Subsequent revisions should increase the test's ability to predict performance on United States Medical Licensing Examination Step 2 and must minimize the differential validity for gender.

Instruments Measuring Integrated Care: A Systematic Review of Measurement Properties

PubMed Central

BAUTISTA, MARY ANN C.; NURJONO, MILAWATY; DESSERS, EZRA; VRIJHOEF, HUBERTUS JM

2016-01-01

Policy Points: Investigations on systematic methodologies for measuring integrated care should coincide with the growing interest in this field of research.A systematic review of instruments provides insights into integrated care measurement, including setting the research agenda for validating available instruments and informing the decision to develop new ones.This study is the first systematic review of instruments measuring integrated care with an evidence synthesis of the measurement properties.We found 209 index instruments measuring different constructs related to integrated care; the strength of evidence on the adequacy of the majority of their measurement properties remained largely unassessed. Context Integrated care is an important strategy for increasing health system performance. Despite its growing significance, detailed evidence on the measurement properties of integrated care instruments remains vague and limited. Our systematic review aims to provide evidence on the state of the art in measuring integrated care. Methods Our comprehensive systematic review framework builds on the Rainbow Model for Integrated Care (RMIC). We searched MEDLINE/PubMed for published articles on the measurement properties of instruments measuring integrated care and identified eligible articles using a standard set of selection criteria. We assessed the methodological quality of every validation study reported using the COSMIN checklist and extracted data on study and instrument characteristics. We also evaluated the measurement properties of each examined instrument per validation study and provided a best evidence synthesis on the adequacy of measurement properties of the index instruments. Findings From the 300 eligible articles, we assessed the methodological quality of 379 validation studies from which we identified 209 index instruments measuring integrated care constructs. The majority of studies reported on instruments measuring constructs related to care integration (33%) and patient‐centered care (49%); fewer studies measured care continuity/comprehensive care (15%) and care coordination/case management (3%). We mapped 84% of the measured constructs to the clinical integration domain of the RMIC, with fewer constructs related to the domains of professional (3.7%), organizational (3.4%), and functional (0.5%) integration. Only 8% of the instruments were mapped to a combination of domains; none were mapped exclusively to the system or normative integration domains. The majority of instruments were administered to either patients (60%) or health care providers (20%). Of the measurement properties, responsiveness (4%), measurement error (7%), and criterion (12%) and cross‐cultural validity (14%) were less commonly reported. We found <50% of the validation studies to be of good or excellent quality for any of the measurement properties. Only a minority of index instruments showed strong evidence of positive findings for internal consistency (15%), content validity (19%), and structural validity (7%); with moderate evidence of positive findings for internal consistency (14%) and construct validity (14%). Conclusions Our results suggest that the quality of measurement properties of instruments measuring integrated care is in need of improvement with the less‐studied constructs and domains to become part of newly developed instruments. PMID:27995711

Swedish Acceptance and Action Questionnaire (SAAQ): a psychometric evaluation.

PubMed

Lundgren, Tobias; Parling, Thomas

2017-06-01

Psychological inflexibility and experiential avoidance are equivalent (with somewhat different connotations) concepts and refer to an unwillingness to remain in contact with particular private events. This concept is most often measured by the Acceptance and Action Questionnaire (AAQ-II) and is strongly related to psychopathology and behavioral effectiveness. In this study, the preliminary psychometric properties of the Swedish version of the AAQ-II (Swedish Acceptance and Action Questionnaire-SAAQ) are presented. The study is done in two steps. In the first step, the 10-item version of the AAQ-II is investigated through principal component analysis (n = 147). Secondly, due to problems with the component structure, the instrument is reduced to a six-item version and its validity and internal consistency are investigated (n = 154). The six-item version shows good concurrent and convergent validity as well as satisfying internal consistency (α = .85). Furthermore, the Swedish six-item version of the AAQ-II showed one strong component. Test-retest reliability was satisfactory (r = .80; n = 228). In future research, predictive and external validity would be important to investigate in order to further ensure that the SAAQ is a useful measure for clinical research. In conclusion, the SAAQ has satisfactory psychometric properties, but more data need to be gathered to further explore the possibilities for the instruments in Swedish contexts.

Early Prognostication Markers in Cardiac Arrest Patients Treated with Hypothermia

PubMed Central

Karapetkova, Maria; Koenig, Matthew A.; Jia, Xiaofeng

2015-01-01

Background and purpose Established prognostication markers, such as clinical findings, electroencephalography (EEG), and biochemical markers, used by clinicians to predict neurologic outcome after cardiac arrest (CA) are altered under therapeutic hypothermia (TH) conditions and their validity remains uncertain. Methods MEDLINE and EMBASE were searched for evidence on the current standards for neurologic outcome prediction for out-of-hospital CA patients treated with TH and the validity of a wide range of prognostication markers. Relevant studies that suggested one or several established biomarkers, and multimodal approaches for prognostication were included and reviewed. Results While the prognostic accuracy of various tests has been questioned after TH, pupillary light reflexes and somatosensory evoked potentials (SSEP) are still strongly associated with negative outcome for early prognostication. Increasingly, EEG background activity has also been identified as a valid predictor for outcome after 72 hours after CA and a preferred prognostic method in clinical settings. Neuroimaging techniques, such as MRI and CT, can identify functional and structural brain injury, but are not readily available at the patient’s bedside because of limited availability and high costs. Conclusions A multimodal algorithm composed of neurological examination, EEG-based quantitative testing, and SSEP, in conjunction with newer MRI sequences, if available, holds promise for accurate prognostication in CA patients treated with TH. In order to avoid premature withdrawal of care, prognostication should be performed later than 72 hours after CA. PMID:26228521

Development and validation of stability indicating method for the quantitative determination of venlafaxine hydrochloride in extended release formulation using high performance liquid chromatography

PubMed Central

Kaur, Jaspreet; Srinivasan, K. K.; Joseph, Alex; Gupta, Abhishek; Singh, Yogendra; Srinivas, Kona S.; Jain, Garima

2010-01-01

Objective: Venlafaxine,hydrochloride is a structurally novel phenethyl bicyclic antidepressant, and is usually categorized as a serotonin–norepinephrine reuptake inhibitor (SNRI) but it has been referred to as a serotonin–norepinephrine–dopamine reuptake inhibitor. It inhibits the reuptake of dopamine. Venlafaxine HCL is widely prescribed in the form of sustained release formulations. In the current article we are reporting the development and validation of a fast and simple stability indicating, isocratic high performance liquid chromatographic (HPLC) method for the determination of venlafaxine hydrochloride in sustained release formulations. Materials and Methods: The quantitative determination of venlafaxine hydrochloride was performed on a Kromasil C18 analytical column (250 × 4.6 mm i.d., 5 μm particle size) with 0.01 M phosphate buffer (pH 4.5): methanol (40: 60) as a mobile phase, at a flow rate of 1.0 ml/min. For HPLC methods, UV detection was made at 225 nm. Results: During method validation, parameters such as precision, linearity, accuracy, stability, limit of quantification and detection and specificity were evaluated, which remained within acceptable limits. Conclusions: The method has been successfully applied for the quantification and dissolution profiling of Venlafaxine HCL in sustained release formulation. The method presents a simple and reliable solution for the routine quantitative analysis of Venlafaxine HCL. PMID:21814426

Development and validation of a professionalism assessment scale for medical students

PubMed Central

Klemenc-Ketis, Zalika; Vrecko, Helena

2014-01-01

Objectives To develop and validate a scale for the assess-ment of professionalism in medical students based on students' perceptions of and attitudes towards professional-ism in medicine. Methods This was a mixed methods study with under-graduate medical students. Two focus groups were carried out with 12 students, followed by a transcript analysis (grounded theory method with open coding). Then, a 3-round Delphi with 20 family medicine experts was carried out. A psychometric assessment of the scale was performed with a group of 449 students. The items of the Professional-ism Assessment Scale could be answered on a five-point Likert scale. Results After the focus groups, the first version of the PAS consisted of 56 items and after the Delphi study, 30 items remained. The final sample for quantitative study consisted of 122 students (27.2% response rate). There were 95 (77.9%) female students in the sample. The mean age of the sample was 22.1 ± 2.1 years. After the principal component analysis, we removed 8 items and produced the final version of the PAS (22 items). The Cronbach's alpha of the scale was 0.88. Factor analysis revealed three factors: empathy and humanism, professional relationships and development and responsibility. Conclusions The new Professionalism Assessment Scale proved to be valid and reliable. It can be used for the assessment of professionalism in undergraduate medical students. PMID:25382090

A Systematic Review of Athletes’ and Coaches’ Nutrition Knowledge and Reflections on the Quality of Current Nutrition Knowledge Measures

PubMed Central

Trakman, Gina L.; Forsyth, Adrienne; Devlin, Brooke L.; Belski, Regina

2016-01-01

Context: Nutrition knowledge can influence dietary choices and impact on athletic performance. Valid and reliable measures are needed to assess the nutrition knowledge of athletes and coaches. Objectives: (1) To systematically review the published literature on nutrition knowledge of adult athletes and coaches and (2) to assess the quality of measures used to assess nutrition knowledge. Data Sources: MEDLINE, CINAHL, SPORTDiscuss, Web of Science, and SCOPUS. Study Selection: 36 studies that provided a quantitative measure of nutrition knowledge and described the measurement tool that was used were included. Data extraction: Participant description, questionnaire description, results (mean correct and responses to individual items), study quality, and questionnaire quality. Data synthesis: All studies were of neutral quality. Tools used to measure knowledge did not consider health literacy, were outdated with regards to consensus recommendations, and lacked appropriate and adequate validation. The current status of nutrition knowledge in athletes and coaches is difficult to ascertain. Gaps in knowledge also remain unclear, but it is likely that energy density, the need for supplementation, and the role of protein are frequently misunderstood. Conclusions: Previous reports of nutrition knowledge need to be interpreted with caution. A new, universal, up-to-date, validated measure of general and sports nutrition knowledge is required to allow for assessment of nutrition knowledge. PMID:27649242

Application and Validation of Remaining Service Interval Framework for Pavements

DOT National Transportation Integrated Search

2016-10-01

The pavement remaining service interval (RSI) terminology was developed to remove confusion caused by the multitude of meanings assigned to the various forms of pavement remaining service life (RSL). The RSI concept considers the complete maintenance...

WE-DE-201-04: Cross Validation of Knowledge-Based Treatment Planning for Prostate LDR Brachytherapy Using Principle Component Analysis

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

Roper, J; Ghavidel, B; Godette, K

Purpose: To validate a knowledge-based algorithm for prostate LDR brachytherapy treatment planning. Methods: A dataset of 100 cases was compiled from an active prostate seed implant service. Cases were randomized into 10 subsets. For each subset, the 90 remaining library cases were registered to a common reference frame and then characterized on a point by point basis using principle component analysis (PCA). Each test case was converted to PCA vectors using the same process and compared with each library case using a Mahalanobis distance to evaluate similarity. Rank order PCA scores were used to select the best-matched library case. Themore » seed arrangement was extracted from the best-matched case and used as a starting point for planning the test case. Any subsequent modifications were recorded that required input from a treatment planner to achieve V100>95%, V150<60%, V200<20%. To simulate operating-room planning constraints, seed activity was held constant, and the seed count could not increase. Results: The computational time required to register test-case contours and evaluate PCA similarity across the library was 10s. Preliminary analysis of 2 subsets shows that 9 of 20 test cases did not require any seed modifications to obtain an acceptable plan. Five test cases required fewer than 10 seed modifications or a grid shift. Another 5 test cases required approximately 20 seed modifications. An acceptable plan was not achieved for 1 outlier, which was substantially larger than its best match. Modifications took between 5s and 6min. Conclusion: A knowledge-based treatment planning algorithm for prostate LDR brachytherapy is being cross validated using 100 prior cases. Preliminary results suggest that for this size library, acceptable plans can be achieved without planner input in about half of the cases while varying amounts of planner input are needed in remaining cases. Computational time and planning time are compatible with clinical practice.« less

Is there any evidence for the validity of diagnostic criteria used for accommodative and nonstrabismic binocular dysfunctions?

PubMed Central

Cacho-Martínez, Pilar; García-Muñoz, Ángel; Ruiz-Cantero, María Teresa

2013-01-01

Purpose To analyze the diagnostic criteria used in the scientific literature published in the past 25 years for accommodative and nonstrabismic binocular dysfunctions and to explore if the epidemiological analysis of diagnostic validity has been used to propose which clinical criteria should be used for diagnostic purposes. Methods We carried out a systematic review of papers on accommodative and non-strabic binocular disorders published from 1986 to 2012 analysing the MEDLINE, CINAHL, PsycINFO and FRANCIS databases. We admitted original articles about diagnosis of these anomalies in any population. We identified 839 articles and 12 studies were included. The quality of included articles was assessed using the QUADAS-2 tool. Results The review shows a wide range of clinical signs and cut-off points between authors. Only 3 studies (regarding accommodative anomalies) assessed diagnostic accuracy of clinical signs. Their results suggest using the accommodative amplitude and monocular accommodative facility for diagnosing accommodative insufficiency and a high positive relative accommodation for accommodative excess. The remaining 9 articles did not analyze diagnostic accuracy, assessing a diagnosis with the criteria the authors considered. We also found differences between studies in the way of considering patients’ symptomatology. 3 studies of 12 analyzed, performed a validation of a symptom survey used for convergence insufficiency. Conclusions Scientific literature reveals differences between authors according to diagnostic criteria for accommodative and nonstrabismic binocular dysfunctions. Diagnostic accuracy studies show that there is only certain evidence for accommodative conditions. For binocular anomalies there is only evidence about a validated questionnaire for convergence insufficiency with no data of diagnostic accuracy. PMID:24646897

Discovery and Validation of Biomarkers to Guide Clinical Management of Pneumonia in African Children

PubMed Central

Huang, Honglei; Ideh, Readon C.; Gitau, Evelyn; Thézénas, Marie L.; Jallow, Muminatou; Ebruke, Bernard; Chimah, Osaretin; Oluwalana, Claire; Karanja, Henri; Mackenzie, Grant; Adegbola, Richard A.; Kwiatkowski, Dominic; Kessler, Benedikt M.; Berkley, James A.; Howie, Stephen R. C.; Casals-Pascual, Climent

2014-01-01

Background. Pneumonia is the leading cause of death in children globally. Clinical algorithms remain suboptimal for distinguishing severe pneumonia from other causes of respiratory distress such as malaria or distinguishing bacterial pneumonia and pneumonia from others causes, such as viruses. Molecular tools could improve diagnosis and management. Methods. We conducted a mass spectrometry–based proteomic study to identify and validate markers of severity in 390 Gambian children with pneumonia (n = 204) and age-, sex-, and neighborhood-matched controls (n = 186). Independent validation was conducted in 293 Kenyan children with respiratory distress (238 with pneumonia, 41 with Plasmodium falciparum malaria, and 14 with both). Predictive value was estimated by the area under the receiver operating characteristic curve (AUC). Results. Lipocalin 2 (Lpc-2) was the best protein biomarker of severe pneumonia (AUC, 0.71 [95% confidence interval, .64–.79]) and highly predictive of bacteremia (78% [64%–92%]), pneumococcal bacteremia (84% [71%–98%]), and “probable bacterial etiology” (91% [84%–98%]). These results were validated in Kenyan children with severe malaria and respiratory distress who also met the World Health Organization definition of pneumonia. The combination of Lpc-2 and haptoglobin distinguished bacterial versus malaria origin of respiratory distress with high sensitivity and specificity in Gambian children (AUC, 99% [95% confidence interval, 99%–100%]) and Kenyan children (82% [74%–91%]). Conclusions. Lpc-2 and haptoglobin can help discriminate the etiology of clinically defined pneumonia and could be used to improve clinical management. These biomarkers should be further evaluated in prospective clinical studies. PMID:24696240

Development and validation of a headspace gas chromatographic method for the determination of residual solvents in arterolane (RBx11160) maleate bulk drug

PubMed Central

Gupta, Abhishek; Singh, Yogendra; Srinivas, Kona S.; Jain, Garima; Sreekumar, V. B.; Semwal, Vinod Prasad

2010-01-01

Objective: Arterolane maleate is an antimalarial drug currently under Phase III clinical evaluation, and presents a simple, economical and scalable synthesis, and does not suffer from safety problems. Arterolane maleate is more active than artemisinin; and is cheap to produce. It has a longer lifetime in the plasma, so it stays active longer in the body. To provide quality control over the manufacture of any API, it is essential to develop highly selective analytical methods. In the current article we are reporting the development and validation of a rapid and specific Head space gas chromatographic (HSGC) method for the determination of organic volatile impurities (residual solvents) in Arterolane Maleate bulk drug. Materials and Methods: The method development and its validation were performed on Perkin Elmer's gas chromatographic system equipped with Flame Ionization detector and head space analyzer. The method involved a thermal gradient elution of ten residual solvents present in arterolane maleate salt in RTx-624, 30 m × 0.32 mm, 1.8 μ column using nitrogen gas as a carrier. The flow rate was 0.5 ml/min and flame ionization detector (FID) was used. Results: During method validation, parameters such as precision, linearity, accuracy, limit of quantification and detection and specificity were evaluated, which remained within acceptable limits. Conclusions: The method has been successfully applied for the quantification of the amount of residual solvents present in arterolane maleate bulk drug.The method presents a simple and reliable solution for the routine quantitative analysis of residual solvents in Arterolane maleate bulk drug. PMID:21814428

Validity of self-reported family history of cancer: A systematic literature review on selected cancers.

PubMed

Fiederling, Jonas; Shams, Ahmad Zia; Haug, Ulrike

2016-10-01

Evidence regarding validity of self-reported family history of cancer (FHC) has been reviewed only for breast, colorectal, prostate, ovarian, endometrial and uterine cancer. We aimed to systematically review studies assessing validity of self-reported family history for the remaining cancer sites. We searched the Medline database for relevant studies published by January 2016. We extracted information on the study design and the positive predictive value (PPV) of self-reported FHC, defined as the proportion of reported cancer diagnoses among relatives that was confirmed by a reference standard (as a measure of over-reporting). We also extracted information on sensitivity of self-reported FHC (as a measure of underreporting). Overall, 21 studies were included that provided information on the PPV of self-reported FHC for relevant cancers and four studies also provided information on sensitivity. The PPV was highest (mostly >70%) for pancreatic, lung, thyroid and urinary system cancers and for leukemia and lymphoma, while it was lowest for stomach and liver cancer. Sensitivity was highest (>70%) for pancreatic cancer, lung cancer, brain cancer, melanoma, leukemia and lymphoma. For several cancers, sample sizes were low and the number of studies limited, particularly regarding sensitivity of self-reported FHC. In conclusion, for some cancers (e.g., pancreatic cancer, lung cancer, leukemia, lymphoma) self-reported FHC can be considered sufficiently valid to be useful, for example, in preventive counseling. For several cancers, it is not sufficiently studied or the pattern is inconsistent. This needs to be taken into account when using self-reported information about FHC in clinical practice or epidemiological research. © 2016 UICC.

Updated Systematic Review and Meta-Analysis of the Performance of Risk Prediction Rules in Children and Young People with Febrile Neutropenia

PubMed Central

Phillips, Robert S.; Lehrnbecher, Thomas; Alexander, Sarah; Sung, Lillian

2012-01-01

Introduction Febrile neutropenia is a common and potentially life-threatening complication of treatment for childhood cancer, which has increasingly been subject to targeted treatment based on clinical risk stratification. Our previous meta-analysis demonstrated 16 rules had been described and 2 of them subject to validation in more than one study. We aimed to advance our knowledge of evidence on the discriminatory ability and predictive accuracy of such risk stratification clinical decision rules (CDR) for children and young people with cancer by updating our systematic review. Methods The review was conducted in accordance with Centre for Reviews and Dissemination methods, searching multiple electronic databases, using two independent reviewers, formal critical appraisal with QUADAS and meta-analysis with random effects models where appropriate. It was registered with PROSPERO: CRD42011001685. Results We found 9 new publications describing a further 7 new CDR, and validations of 7 rules. Six CDR have now been subject to testing across more than two data sets. Most validations demonstrated the rule to be less efficient than when initially proposed; geographical differences appeared to be one explanation for this. Conclusion The use of clinical decision rules will require local validation before widespread use. Considerable uncertainty remains over the most effective rule to use in each population, and an ongoing individual-patient-data meta-analysis should develop and test a more reliable CDR to improve stratification and optimise therapy. Despite current challenges, we believe it will be possible to define an internationally effective CDR to harmonise the treatment of children with febrile neutropenia. PMID:22693615

Angular Distribution of Gamma-Ray Bursts: An Observational Probe of Cosmological Principle

NASA Astrophysics Data System (ADS)

Mészáros, A.; Balázs, L. G.; Vavrek, R.; Horváth, I.; Bagoly, Z.

The test of the isotropy in the angular distribution of the gamma-ray bursts collected in BATSE Catalog (Meegan C. A. et al., http://www.batse.msfc.nasa.gov/data, 2000) is a test of cosmological principle itself, because the gamma-ray bursts are at cosmological distances. Several articles of the authors study this question (Balázs L. G., Mészáros A., & Horváth I., Astron. Astrophys., 339, 1, 1998; Balázs L. G., Mészáros A., Horváth I., & Vavrek R., Astron. Astrophys. Suppl., 138, 417, 1999; Mészáros A., Bagoly Z., & Vavrek R. Astron. Astrophys., in press, 2000). The final conclusion concerning the validity of isotropy is complicated both by instrumental effects and by the fact that there are three subgroups of gamma-ray bursts ("short", "intermediate", "long"; separation is done with respect to the duration of bursts). The long bursts are surely up to z ≃ 4 (z is the redshift); for the remaining two subclasses the redshifts are unknown. The done tests of isotropy suggest (after the elimination of instrumental effects) the existence of anisotropy for the intermediate subclass on the confidence level > 95%. On the other hand, for the remaining two subclasses the situation is unclear; there is no unambiguous rejection of isotropy for them yet on the higher than 95% confidence level. If the bursts of intermediate subclass are at high z-s (say, at, z > 0.1), then the validity of cosmological principle would be at a serious doubt.

Microsurgical principles and postoperative adhesions: lessons from the past.

PubMed

Gomel, Victor; Koninckx, Philippe R

2016-10-01

"Microsurgery" is a set of principles developed to improve fertility surgery outcomes. These principles were developed progressively based on common sense and available evidence, under control of clinical feedback obtained with the use of second-look laparoscopy. Fertility outcome was the end point; significant improvement in fertility rates validated the concept clinically. Postoperative adhesion formation being a major cause of failure in fertility surgery, the concept of microsurgery predominantly addresses prevention of postoperative adhesions. In this concept, magnification with a microscope or laparoscope plays a minor role as technical facilitator. Not surprisingly, the principles to prevent adhesion formation are strikingly similar to our actual understanding: gentle tissue handling, avoiding desiccation, irrigation at room temperature, shielding abdominal contents from ambient air, meticulous hemostasis and lavage, avoiding foreign body contamination and infection, administration of dexamethasone postoperatively, and even the concept of keeping denuded areas separated by temporary adnexal or ovarian suspension. The actual concepts of peritoneal conditioning during surgery and use of dexamethasone and a barrier at the end of surgery thus confirm without exception the tenets of microsurgery. Although recent research helped to clarify the pathophysiology of adhesion formation, refined its prevention and the relative importance of each factor, the clinical end point of improvement of fertility rates remains demonstrated for only the microsurgical tenets as a whole. In conclusion, the principles of microsurgery remain fully valid as the cornerstones of reproductive microsurgery, whether performed by means of open access or laparoscopy. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

A Multilevel Analysis of Gatekeeper Characteristics and Consistent Condom Use Among Establishment-Based Female Sex Workers in Guangxi, China

PubMed Central

Li, Qing; Li, Xiaoming; Stanton, Bonita; Fang, Xiaoyi; Zhao, Ran

2010-01-01

Background Multilevel analytical techniques are being applied in condom use research to ensure the validity of investigation on environmental/structural influences and clustered data from venue-based sampling. The literature contains reports of consistent associations between perceived gatekeeper support and condom use among entertainments establishment-based female sex workers (FSWs) in Guangxi, China. However, the clustering inherent in the data (FSWs being clustered within establishment) has not been accounted in most of the analyses. We used multilevel analyses to examine perceived features of gatekeepers and individual correlates of consistent condom use among FSWs and to validate the findings in the existing literature. Methods We analyzed cross-sectional data from 318 FSWs from 29 entertainment establishments in Guangxi, China in 2004, with a minimum of 5 FSWs per establishment. The Hierarchical Linear Models program with Laplace estimation was used to estimate the parameters in models containing random effects and binary outcomes. Results About 11.6% of women reported consistent condom use with clients. The intraclass correlation coefficient indicated 18.5% of the variance in condom use could be attributed to their similarity between FSWs within the same establishments. Women’s perceived gatekeeper support and education remained positively associated with condom use (P < 0.05), after controlling for other individual characteristics and clustering. Conclusions After adjusting for data clustering, perceived gatekeeper support remains associated with consistent condom use with clients among FSWs in China. The results imply that combined interventions to intervene both gatekeepers and individual FSW may effectively promote consistent condom use. PMID:20539262

THE PEDIATRIC RHEUMATOLOGY INTERNATIONAL TRIALS ORGANIZATION PROVISIONAL CRITERIA FOR THE EVALUATION OF RESPONSE TO THERAPY IN JUVENILE DERMATOMYOSITIS

PubMed Central

Ruperto, Nicolino; Pistorio, Angela; Ravelli, Angelo; Rider, Lisa G.; Pilkington, Clarissa; Oliveira, Sheila; Wulffraat, Nico; Espada, Graciela; Garay, Stella; Cuttica, Ruben; Hofer, Michael; Quartier, Pierre; Melo-Gomes, Jose; Reed, Ann M.; Wierzbowska, Malgorzata; Feldman, Brian M.; Harjacek, Miroslav; Huppertz, Hans-Iko; Nielsen, Susan; Flato, Berit; Lahdenne, Pekka; Michels, Harmut; Murray, Kevin J.; Punaro, Lynn; Rennebohm, Robert; Russo, Ricardo; Balogh, Zsolt; Rooney, Madeleine; Pachman, Lauren M.; Wallace, Carol; Hashkes, Philip; Lovell, Daniel J.; Giannini, Edward H.; Martini, Alberto

2010-01-01

Objective To develop a provisional definition for the evaluation of response to therapy in juvenile dermatomyositis (JDM) based on the PRINTO JDM core set of variables. Methods Thirty-seven experienced pediatric rheumatologists from 27 countries, achieved consensus on 128 difficult patient profiles as clinically improved or not improved using a stepwise approach (patients rating, statistical analysis, definition selection). Using the physicians’ consensus ratings as the “gold-standard measure”, chi-square, sensitivity, specificity, false positive and negative rate, area under the ROC, and kappa agreement for candidate definitions of improvement were calculated. Definitions with kappa >0.8 were multiplied with the face validity score to select the top definitions. Results The top definition of improvement was: at least 20% improvement from baseline in 3/6 core set variables with no more than 1 of the remaining worsening by more than 30%, which cannot be muscle strength. The second highest scoring definition was at least 20% improvement from baseline in 3/6 core set variables with no more than 2 of the remaining worsening by more than 25%, which cannot be muscle strength which is definition P1 selected by the IMACS group. The third is similar to the second with the maximum amount of worsening set to 30%. This indicates convergent validity of the process. Conclusion we proposes a provisional data driven definition of improvement that reflects well the consensus rating of experienced clinicians, which incorporates clinically meaningful change in core set variables in a composite endpoint for the evaluation of global response to therapy in JDM. PMID:20583105

"Presumed fair: Ironic effects of organizational diversity structures": Correction to Kaiser et al. (2013).

PubMed

2016-06-01

Reports an error in "Presumed fair: Ironic effects of organizational diversity structures" by Cheryl R. Kaiser, Brenda Major, Ines Jurcevic, Tessa L. Dover, Laura M. Brady and Jenessa R. Shapiro (Journal of Personality and Social Psychology, 2013[Mar], Vol 104[3], 504-519). In the article, a raw data merging error in one racial discrimination claim condition from Experiment 6 inadvertently resulted in data analyses on an inaccurate data set. When the error was discovered by the authors and corrected, all analyses reported in Experiment 6 for claim validity, seriousness of the claim, and support for the claimant were inaccurate and none were statistically significant. The conclusions should be altered to indicate that participants with management experience who reflected on their own workplace diversity policies did not show the predicted effects. The literature review, remaining five studies, and remaining conclusions in the article are unaffected by this error. Experiment 6 should also report that 26.4% (not 26.4.7%) of participants had a graduate degree and eight participants (not 8%) did not provide educational data. Experiment 5 should have referred to the claim validity measure as a six-item measure ( .92) rather than a five-item measure; analyses on claim validity are accurate in text. Table 2's note should have said standard errors, not standard deviations. (The following abstract of the original article appeared in record 2012-31077-001.) This research tests the hypothesis that the presence (vs. absence) of organizational diversity structures causes high-status group members (Whites, men) to perceive organizations with diversity structures as procedurally fairer environments for underrepresented groups (racial minorities, women), even when it is clear that underrepresented groups have been unfairly disadvantaged within these organizations. Furthermore, this illusory sense of fairness derived from the mere presence of diversity structures causes high-status group members to legitimize the status quo by becoming less sensitive to discrimination targeted at underrepresented groups and reacting more harshly toward underrepresented group members who claim discrimination. Six experiments support these hypotheses in designs using 4 types of diversity structures (diversity policies, diversity training, diversity awards, idiosyncratically generated diversity structures from participants' own organizations) among 2 high-status groups in tests involving several types of discrimination (discriminatory promotion practices, adverse impact in hiring, wage discrimination). Implications of these experiments for organizational diversity and employment discrimination law are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

[A Screening-Tool for Three Dimensions of Work-Related Behavior and Experience Patterns in the Psychosomatic Rehabilitation - A Proposal for a Short-Form of the Occupational Stress and Coping Inventory (AVEM-3D)].

PubMed

Beierlein, V; Köllner, V; Neu, R; Schulz, H

2016-12-01

Objectives: The assessment of work pressures is of particular importance in psychosomatic rehabilitation. An established questionnaire is the Occupational Stress and Coping Inventory (German abbr. AVEM), but it is quite long and with regard to scoring time-consuming in routine clinical care. It should therefore be tested, whether a shortened version of the AVEM can be developed, which is able to assess the formerly described three second-order factors of the AVEM, namely Working Commitment, Resilience, and Emotions, sufficiently reliable and valid, and which also may be used for screening of patients with prominent work-related behavior and experience patterns. Methods: Data were collected at admission from consecutive samples of three hospitals of psychosomatic rehabilitation ( N  = 10,635 patients). The sample was randomly divided in two subsamples (design and validation sample). Using exploratory principal component analyses in the design sample, items with the highest factor loadings for the three new scales were selected and evaluated psychometrically using the validation sample. Possible Cut-off values ought to be derived from distribution patterns of scores in the scales. Relationships with sociodemographic, occupational and diagnosis-related characteristics, as well as with patterns of work-related experiences and behaviors are examined. Results: The three performed principal component analyses explained in the design sample on the respective first factor between 31 % and 34 % of the variance. The selected 20 items were assigned to the 3-factor structure in the validation sample as expected. The three new scales are sufficiently reliable with values of Cronbach's α between 0,84 and 0,88. The naming of the three new scales is based on the names of the secondary factors. Cut-off values for the identification of distinctive patient-reported data are proposed. Conclusion: Main advantages of the proposed shortened version AVEM-3D are that with a considerable smaller number of items the three main dimensions of relevant work-related behavior and experience patterns can be reliably measured. The proposed measure is simple and economic to use and interpret. Based on the present sample we provide means and standard deviations as reference at admission of psychosomatic rehabilitation. As a limitation it should be mentioned that further evaluation of reliability, validity and sensitivity to change restricted to the items of the shortened version is necessary. The practicability and validity of the proposed cut-off values cannot yet be conclusively assessed. Finally, the validity of the AVEM-3D in groups of indications other than psychosomatic patients and in healthy persons remains to be examined. © Georg Thieme Verlag KG Stuttgart · New York.

49 CFR 236.905 - Railroad Safety Program Plan (RSPP).

Code of Federal Regulations, 2010 CFR

2010-10-01

... validation. The RSPP must require the identification of verification and validation methods for the... to be used in the verification and validation process, consistent with appendix C to this part. The... information. (3) If no action is taken on the petition within 180 days, the petition remains pending for...

What Counts as Validity Evidence? Examples and Prevalence in a Systematic Review of Simulation-Based Assessment

ERIC Educational Resources Information Center

Cook, David A.; Zendejas, Benjamin; Hamstra, Stanley J.; Hatala, Rose; Brydges, Ryan

2014-01-01

Ongoing transformations in health professions education underscore the need for valid and reliable assessment. The current standard for assessment validation requires evidence from five sources: content, response process, internal structure, relations with other variables, and consequences. However, researchers remain uncertain regarding the types…

Interlaboratory validation of the modified murine local lymph node assay based on adenosine triphosphate measurement.

PubMed

Omori, Takashi; Idehara, Kenji; Kojima, Hajime; Sozu, Takashi; Arima, Kazunori; Goto, Hirohiko; Hanada, Tomohiko; Ikarashi, Yoshiaki; Inoda, Taketo; Kanazawa, Yukiko; Kosaka, Tadashi; Maki, Eiji; Morimoto, Takashi; Shinoda, Shinsuke; Shinoda, Naoki; Takeyoshi, Masahiro; Tanaka, Masashi; Uratani, Mamoru; Usami, Masahito; Yamanaka, Atsushi; Yoneda, Tomofumi; Yoshimura, Isao; Yuasa, Atsuko

2008-01-01

The murine local lymph node assay (LLNA) is a well-established alternative to the guinea pig maximization test (GPMT) or Buehler test (BT) for the assessment of the skin sensitizing ability of drugs and chemicals. Daicel Chemical Industries Ltd. has developed a modified LLNA based on the adenosine triphosphate (ATP) content (LLNA-DA). We conducted 2 interlaboratory validation studies to evaluate the reliability and relevance of LLNA-DA. The experiment involved 17 laboratories, wherein 14 chemicals were examined under blinded conditions. In the first study, 3 chemicals were examined in 10 laboratories and the remaining 9 were examined in 3 laboratories. In the second study, 1 chemical was examined in 7 laboratories and the remaining 4 chemicals were examined in 4 laboratories. The data were expressed as the ATP content for each chemical-treated group, and the stimulation index (SI) for each chemical-treated group was determined as the increase in the ATP content relative to the concurrent vehicle control group. An SI of 3 was set as the cut-off value for exhibiting skin sensitization activity. The results of the first study obtained in the experiments conducted for the 3 chemicals that were examined in all the 10 laboratories and for 5 of the remaining 9 chemicals were sufficiently consistent with small variations in their SI values. The sensitivity, specificity, and accuracy of LLNA-DA against those of GPMT/BT were 7/8 (87.5%), 3/3 (100%), and 10/11 (90.9%), respectively. In the second study, all the 5 chemicals studied demonstrated acceptably small interlaboratory variations. In the first study, a large variation was observed for 2 chemicals; in the second study, this variation was small. It was attributed to the application of dimethylsulfoxide as the solvent for the metallic salts. In conclusion, these 2 studies provide good evidence for the reliability of the LLNA-DA.

National Administrative Databases in Adult Spinal Deformity Surgery: A Cautionary Tale.

PubMed

Buckland, Aaron J; Poorman, Gregory; Freitag, Robert; Jalai, Cyrus; Klineberg, Eric O; Kelly, Michael; Passias, Peter G

2017-08-15

Comparison between national administrative databases and a prospective multicenter physician managed database. This study aims to assess the applicability of National Administrative Databases (NADs) in adult spinal deformity (ASD). Our hypothesis is that NADs do not include comparable patients as in a physician-managed database (PMD) for surgical outcomes in adult spinal deformity. NADs such as National Inpatient Sample (NIS) and National Surgical Quality Improvement Program (NSQIP) provide large numbers of publications owing to ease of data access and lack of IRB approval requirement. These databases utilize billing codes, not clinical inclusion criteria, and have not been validated against PMDs in ASD surgery. The NIS was searched for years 2002 to 2012 and NSQIP for years 2006 to 2013 using validated spinal deformity diagnostic codes. Procedural codes (ICD-9 and CPT) were then applied to each database. A multicenter PMD including years 2008 to 2015 was used for comparison. Databases were assessed for levels fused, osteotomies, decompressed levels, and invasiveness. Database comparisons for surgical details were made in all patients, and also for patients with ≥ 5 level spinal fusions. Approximately, 37,368 NIS, 1291 NSQIP, and 737 PMD patients were identified. NADs showed an increased use of deformity billing codes over the study period (NIS doubled, 68x NSQIP, P < 0.001), but ASD remained stable in the PMD.Surgical invasiveness, levels fused and use of 3-column osteotomy (3-CO) were significantly lower for all patients in the NIS (11.4-13.7) and NSQIP databases (6.4-12.7) compared with PMD (27.5-32.3). When limited to patients with ≥5 levels, invasiveness, levels fused, and use of 3-CO remained significantly higher in the PMD compared with NADs (P < 0.001). National databases NIS and NSQIP do not capture the same patient population as is captured in PMDs in ASD. Physicians should remain cautious in interpreting conclusions drawn from these databases. 4.

A risk-model for hospital mortality among patients with severe sepsis or septic shock based on German national administrative claims data

PubMed Central

Fleischmann-Struzek, Carolin; Rüddel, Hendrik; Reinhart, Konrad; Thomas-Rüddel, Daniel O.

2018-01-01

Background Sepsis is a major cause of preventable deaths in hospitals. Feasible and valid methods for comparing quality of sepsis care between hospitals are needed. The aim of this study was to develop a risk-adjustment model suitable for comparing sepsis-related mortality between German hospitals. Methods We developed a risk-model using national German claims data. Since these data are available with a time-lag of 1.5 years only, the stability of the model across time was investigated. The model was derived from inpatient cases with severe sepsis or septic shock treated in 2013 using logistic regression with backward selection and generalized estimating equations to correct for clustering. It was validated among cases treated in 2015. Finally, the model development was repeated in 2015. To investigate secular changes, the risk-adjusted trajectory of mortality across the years 2010–2015 was analyzed. Results The 2013 deviation sample consisted of 113,750 cases; the 2015 validation sample consisted of 134,851 cases. The model developed in 2013 showed good validity regarding discrimination (AUC = 0.74), calibration (observed mortality in 1st and 10th risk-decile: 11%-78%), and fit (R2 = 0.16). Validity remained stable when the model was applied to 2015 (AUC = 0.74, 1st and 10th risk-decile: 10%-77%, R2 = 0.17). There was no indication of overfitting of the model. The final model developed in year 2015 contained 40 risk-factors. Between 2010 and 2015 hospital mortality in sepsis decreased from 48% to 42%. Adjusted for risk-factors the trajectory of decrease was still significant. Conclusions The risk-model shows good predictive validity and stability across time. The model is suitable to be used as an external algorithm for comparing risk-adjusted sepsis mortality among German hospitals or regions based on administrative claims data, but secular changes need to be taken into account when interpreting risk-adjusted mortality. PMID:29558486

Validation of the Chronic Pain Acceptance Questionnaire (CPAQ) in Cantonese-speaking Chinese patients.

PubMed

Cheung, Michelle N; Ning, Michelle Cheung; Wong, Tony C M; Ming, Tony Wong Chi; Yap, Jacqueline C M; Mae, Jacqueline Yap Chooi; Chen, Phoon P; Ping, Chen Phoon

2008-09-01

Acceptance of chronic pain has become an important concept in understanding and predicting that chronic pain sufferers can remain engaged with meaningful aspects of life. Assessment of acceptance has been facilitated by the development of Chronic Pain Acceptance Questionnaire (CPAQ). In this study, we aimed to test the reliability and validity of translated Chinese version of CPAQ to use this important tool in the future management of Hong Kong Chinese patients with chronic nonmalignant pain. Content validity was established by consensus formed among a panel of 5 experts in clinical psychology and pain specialty during the process of forward and backward translations. Test-retest reliability was examined by completing the Chinese CPAQ twice, 2 weeks apart, by 54 patients. A total of 224 Chinese patients with chronic nonmalignant pain attending our cluster multidisciplinary pain clinic were asked to complete a battery of psychometric instruments in Chinese, including an intake form for demographic data, Hospital Anxiety and Depression Score (HADS), Medical Outcome Study Short Form 36 (SF-36), Pain Catastrophizing Scale (PCS), and Pain Self-Efficacy Questionnaire (PSEQ). Analysis results showed that Chinese CPAQ had good test-retest reliability (intraclass correlation coefficient, 0.79) and internal consistency reliability (Cronbach alpha = 0.79). The Chinese CPAQ score was significantly correlated to anxiety, depression, pain catastrophizing, pain self-efficacy, and physical and psychosocial disability. Scree plot and Principal Components Factor analysis confirmed the same 2-factor construct as the original English CPAQ. Construct validity of the Chinese CPAQ can therefore be supported. In conclusion, the Chinese CPAQ is a reliable clinical assessment tool with valid construct for acceptance measurement in our heterogeneous Chinese patients sample with chronic nonmalignant pain. This article confirms the reliability and validity of a Chinese version of the CPAQ. The Chinese CPAQ can then be used by pain clinicians caring for Chinese chronic pain patients worldwide for acceptance-based psychometric assessment as well as therapies.

Validity and reliability of a video questionnaire to assess physical function in older adults.

PubMed

Balachandran, Anoop; N Verduin, Chelsea; Potiaumpai, Melanie; Ni, Meng; Signorile, Joseph F

2016-08-01

Self-report questionnaires are widely used to assess physical function in older adults. However, they often lack a clear frame of reference and hence interpreting and rating task difficulty levels can be problematic for the responder. Consequently, the usefulness of traditional self-report questionnaires for assessing higher-level functioning is limited. Video-based questionnaires can overcome some of these limitations by offering a clear and objective visual reference for the performance level against which the subject is to compare his or her perceived capacity. Hence the purpose of the study was to develop and validate a novel, video-based questionnaire to assess physical function in older adults independently living in the community. A total of 61 community-living adults, 60years or older, were recruited. To examine validity, 35 of the subjects completed the video questionnaire, two types of physical performance tests: a test of instrumental activity of daily living (IADL) included in the Short Physical Functional Performance battery (PFP-10), and a composite of 3 performance tests (30s chair stand, single-leg balance and usual gait speed). To ascertain reliability, two-week test-retest reliability was assessed in the remaining 26 subjects who did not participate in validity testing. The video questionnaire showed a moderate correlation with the IADLs (Spearman rho=0.64, p<0.001; 95% CI (0.4, 0.8)), and a lower correlation with the composite score of physical performance tests (Spearman rho=0.49, p<0.01; 95% CI (0.18, 0.7)). The test-retest assessment yielded an intra-class correlation (ICC) of 0.87 (p<0.001; 95% CI (0.70, 0.94)) and a Cronbach's alpha of 0.89 demonstrating good reliability and internal consistency. Our results show that the video questionnaire developed to evaluate physical function in community-living older adults is a valid and reliable assessment tool; however, further validation is needed for definitive conclusions. Copyright © 2016 Elsevier Inc. All rights reserved.

Recent Status Scores for Version 6 of the Addiction Severity Index (ASI-6)

PubMed Central

Cacciola, John S.; Alterman, Arthur I; Habing, Brian; McLellan, A. Thomas

2012-01-01

Aims To describe the derivation of Recent Status Scores (RSSs) for Version 6 of the Addiction Severity Index (ASI-6). Design 118 ASI-6 recent status items were subjected to nonparametric item response theory (NIRT) analyses followed by confirmatory factor analysis (CFA). Generalizability and concurrent validity of the derived scores were determined. Setting and Participants 607 recent admissions to variety of substance abuse treatment programs constituted the derivation sample; a subset (N = 254) comprised the validity sample. Measurements The ASI-6 interview and a validity battery of primarily self-report questionnaires that included at least one measure corresponding to each of the seven ASI domains were administered. Findings Nine summary scales describing recent status that achieved or approached both high scalability and reliability were derived; one scale for each of six areas (medical, employment/finances, alcohol, drug, legal, psychiatric), and three scales for the family/social area. Intercorrelations among the RSSs also supported the multidimensionality of the ASI-6. Concurrent validity analyses yielded strong evidence supporting the validity of the six of the RSSs (Medical, Alcohol, Drug, Employment, Family/Social Problems, Psychiatric). Evidence was weaker for the Legal, Family/Social Support and Child Problems RSSs. Generalizability analyses of the scales to males versus females and whites versus blacks supported the comparability of the findings with slight exceptions. Conclusions The psychometric analyses to derive Addiction Severity Index-6 Recent Status Scores (RSSs) support the multidimensionality of the ASI-6 (i.e., the relative independence of different life functioning areas), consistent with research on earlier editions of the instrument. In general, the ASI-6 scales demonstrate acceptable scalability, reliability and concurrent validity. While questions remain about the generalizability of some scales to population subgroups, the overall findings coupled with updated and more extensive content in the ASI-6 support its use in clinical practice and research. PMID:21545666

Discriminative Prediction of A-To-I RNA Editing Events from DNA Sequence

PubMed Central

Sun, Jiangming; Singh, Pratibha; Bagge, Annika; Valtat, Bérengère; Vikman, Petter; Spégel, Peter; Mulder, Hindrik

2016-01-01

RNA editing is a post-transcriptional alteration of RNA sequences that, via insertions, deletions or base substitutions, can affect protein structure as well as RNA and protein expression. Recently, it has been suggested that RNA editing may be more frequent than previously thought. A great impediment, however, to a deeper understanding of this process is the paramount sequencing effort that needs to be undertaken to identify RNA editing events. Here, we describe an in silico approach, based on machine learning, that ameliorates this problem. Using 41 nucleotide long DNA sequences, we show that novel A-to-I RNA editing events can be predicted from known A-to-I RNA editing events intra- and interspecies. The validity of the proposed method was verified in an independent experimental dataset. Using our approach, 203 202 putative A-to-I RNA editing events were predicted in the whole human genome. Out of these, 9% were previously reported. The remaining sites require further validation, e.g., by targeted deep sequencing. In conclusion, the approach described here is a useful tool to identify potential A-to-I RNA editing events without the requirement of extensive RNA sequencing. PMID:27764195

TAP score: torsion angle propensity normalization applied to local protein structure evaluation

PubMed Central

Tosatto, Silvio CE; Battistutta, Roberto

2007-01-01

Background Experimentally determined protein structures may contain errors and require validation. Conformational criteria based on the Ramachandran plot are mainly used to distinguish between distorted and adequately refined models. While the readily available criteria are sufficient to detect totally wrong structures, establishing the more subtle differences between plausible structures remains more challenging. Results A new criterion, called TAP score, measuring local sequence to structure fitness based on torsion angle propensities normalized against the global minimum and maximum is introduced. It is shown to be more accurate than previous methods at estimating the validity of a protein model in terms of commonly used experimental quality parameters on two test sets representing the full PDB database and a subset of obsolete PDB structures. Highly selective TAP thresholds are derived to recognize over 90% of the top experimental structures in the absence of experimental information. Both a web server and an executable version of the TAP score are available at . Conclusion A novel procedure for energy normalization (TAP) has significantly improved the possibility to recognize the best experimental structures. It will allow the user to more reliably isolate problematic structures in the context of automated experimental structure determination. PMID:17504537

42 CFR 476.85 - Conclusive effect of QIO initial denial determinations and changes as a result of DRG validations.

Code of Federal Regulations, 2013 CFR

2013-10-01

... determinations and changes as a result of DRG validations. 476.85 Section 476.85 Public Health CENTERS FOR... denial determinations and changes as a result of DRG validations. A QIO initial denial determination or change as a result of DRG validation is final and binding unless, in accordance with the procedures in...

42 CFR 476.85 - Conclusive effect of QIO initial denial determinations and changes as a result of DRG validations.

Code of Federal Regulations, 2011 CFR

2011-10-01

... determinations and changes as a result of DRG validations. 476.85 Section 476.85 Public Health CENTERS FOR... denial determinations and changes as a result of DRG validations. A QIO initial denial determination or change as a result of DRG validation is final and binding unless, in accordance with the procedures in...

42 CFR 476.85 - Conclusive effect of QIO initial denial determinations and changes as a result of DRG validations.

Code of Federal Regulations, 2012 CFR

2012-10-01

... determinations and changes as a result of DRG validations. 476.85 Section 476.85 Public Health CENTERS FOR... denial determinations and changes as a result of DRG validations. A QIO initial denial determination or change as a result of DRG validation is final and binding unless, in accordance with the procedures in...

Integrability of Spinning Particle Motion in Higher-Dimensional Rotating Black Hole Spacetimes

NASA Astrophysics Data System (ADS)

Kubizňák, David; Cariglia, Marco

2012-02-01

We study the motion of a classical spinning particle (with spin degrees of freedom described by a vector of Grassmann variables) in higher-dimensional general rotating black hole spacetimes with a cosmological constant. In all dimensions n we exhibit n bosonic functionally independent integrals of spinning particle motion, corresponding to explicit and hidden symmetries generated from the principal conformal Killing-Yano tensor. Moreover, we demonstrate that in 4-, 5-, 6-, and 7-dimensional black hole spacetimes such integrals are in involution, proving the bosonic part of the motion integrable. We conjecture that the same conclusion remains valid in all higher dimensions. Our result generalizes the result of Page et al. [Phys. Rev. Lett. 98, 061102 (2007)PRLTAO0031-900710.1103/PhysRevLett.98.061102] on complete integrability of geodesic motion in these spacetimes.

Genesis and Evolution of the Skyrme Model from 1954 TO the Present

NASA Astrophysics Data System (ADS)

Sanyuk, Valery I.

Not widely known facts on the genesis of the Skyrme model are presented in a historical survey, based on Skyrme's earliest papers and on his own published remembrance. We consider the evolution of Skyrme's model description of nuclear matter from the "Mesonic Fluid" model up to its final version, known as the baryon model. We pay special tribute to some well-known ideas in contemporary particle physics which one can find in Skyrme's earlier papers, such as: Nuclear Democracy, the Solitonic Mechanism, the Nonlinear Realization of Chiral Symmetry, Topological Charges, Fermi-Bose Transmutations, etc. It is curious to note in the final version of the Skyrme model gleams of Kelvin's "Vortex Atoms" theory. In conclusion we make a brief analysis of the validity of Skyrme's conjectures in view of recent results and pinpoint some questions which still remain.

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

San Yuk, V.I.

Not widely known facts on the genesis of the Skyrme model are presented in a historical survey, based on Skyrme's earliest papers and on his own published remembrance. This paper considers the evolution of Skyrme's model description of nuclear matter from the Mesonic Fluid model up to its final version, known as the baryon model. We pay special tribute to some well-known ideas in contemporary particle physics which one can find in Skyrme's earlier papers, such as: Nuclear Democracy, the Solitonic Mechanism, the Nonlinear Realization of Chiral Symmetry, Topological Charges, Fermi-Bose Transmutations, etc. It is curious to note in themore » final version of the Skyrme model gleams of Kelvin's Vortex Atoms theory. In conclusion we make a brief analysis of the validity of Skyrme's conjectures in view of recent results and pinpoint some questions which still remain.« less

Borderline Personality Disorder: Ontogeny of a Diagnosis

PubMed Central

Gunderson, John G.

2011-01-01

Objective The purpose of this article is to describe the development of the borderline personality disorder diagnosis, highlighting both the obstacles encountered and the associated achievements. Method On the basis of a review of the literature, the author provides a chronological account of the borderline construct in psychiatry, summarizing progress in decade-long intervals. Results Borderline personality disorder has moved from being a psychoanalytic colloquialism for untreatable neurotics to becoming a valid diagnosis with significant heritability and with specific and effective psychotherapeutic treatments. Nonetheless, patients with this disorder pose a major public health problem while they themselves remain highly stigmatized and largely neglected. Conclusions Despite remarkable changes in our knowledge about borderline personality disorder, increased awareness involving much more education and research is still needed. Psychiatric institutions, professional organizations, public policies, and reimbursement agencies need to prioritize this need. PMID:19411380

Current Status of Simulation-based Training Tools in Orthopedic Surgery: A Systematic Review.

PubMed

Morgan, Michael; Aydin, Abdullatif; Salih, Alan; Robati, Shibby; Ahmed, Kamran

To conduct a systematic review of orthopedic training and assessment simulators with reference to their level of evidence (LoE) and level of recommendation. Medline and EMBASE library databases were searched for English language articles published between 1980 and 2016, describing orthopedic simulators or validation studies of these models. All studies were assessed for LoE, and each model was subsequently awarded a level of recommendation using a modified Oxford Centre for Evidence-Based Medicine classification, adapted for education. A total of 76 articles describing orthopedic simulators met the inclusion criteria, 47 of which described at least 1 validation study. The most commonly identified models (n = 34) and validation studies (n = 26) were for knee arthroscopy. Construct validation was the most frequent validation study attempted by authors. In all, 62% (47 of 76) of the simulator studies described arthroscopy simulators, which also contained validation studies with the highest LoE. Orthopedic simulators are increasingly being subjected to validation studies, although the LoE of such studies generally remain low. There remains a lack of focus on nontechnical skills and on cost analyses of orthopedic simulators. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

A systematic review of the reliability and validity of discrete choice experiments in valuing non-market environmental goods.

PubMed

Rakotonarivo, O Sarobidy; Schaafsma, Marije; Hockley, Neal

2016-12-01

While discrete choice experiments (DCEs) are increasingly used in the field of environmental valuation, they remain controversial because of their hypothetical nature and the contested reliability and validity of their results. We systematically reviewed evidence on the validity and reliability of environmental DCEs from the past thirteen years (Jan 2003-February 2016). 107 articles met our inclusion criteria. These studies provide limited and mixed evidence of the reliability and validity of DCE. Valuation results were susceptible to small changes in survey design in 45% of outcomes reporting reliability measures. DCE results were generally consistent with those of other stated preference techniques (convergent validity), but hypothetical bias was common. Evidence supporting theoretical validity (consistency with assumptions of rational choice theory) was limited. In content validity tests, 2-90% of respondents protested against a feature of the survey, and a considerable proportion found DCEs to be incomprehensible or inconsequential (17-40% and 10-62% respectively). DCE remains useful for non-market valuation, but its results should be used with caution. Given the sparse and inconclusive evidence base, we recommend that tests of reliability and validity are more routinely integrated into DCE studies and suggest how this might be achieved. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

42 CFR 476.85 - Conclusive effect of QIO initial denial determinations and changes as a result of DRG validations.

Code of Federal Regulations, 2014 CFR

2014-10-01

... determinations and changes as a result of DRG validations. 476.85 Section 476.85 Public Health CENTERS FOR... changes as a result of DRG validations. A QIO initial denial determination or change as a result of DRG validation is final and binding unless, in accordance with the procedures in part 473— (a) The initial denial...

Validation of urban freeway models.

DOT National Transportation Integrated Search

2015-01-01

This report describes the methodology, data, conclusions, and enhanced models regarding the validation of two sets of models developed in the Strategic Highway Research Program 2 (SHRP 2) Reliability Project L03, Analytical Procedures for Determining...

School Age Populations Research Needs - NCS Dietary Assessment Literature Review

Cancer.gov

Drawing conclusions about the validity of available dietary assessment instruments in school age children is hampered by the differences in instruments, research design, reference methods, and populations in the validation literature.

Validity and reliability of a structured interview for early detection and risk assessment of parenting and developmental problems in young children: a cross-sectional study

PubMed Central

2012-01-01

Background Preventive child health care is well suited for the early detection of parenting and developmental problems. However, as far as the younger age group is concerned, there are no validated early detection instruments which cover both the child and its environment. Therefore, we have developed a broad-scope structured interview which assesses parents’ concerns and their need for support, using both the parental perspective and the experience of the child health care nurse: the Structured Problem Analysis of Raising Kids (SPARK). This study reports the psychometric characteristics of the SPARK. Method A cross-sectional study of 2012 18-month-old children, living in Zeeland, a province of the Netherlands. Inter-rater reliability was assessed in 67 children. Convergent validity was assessed by comparing SPARK-domains with domains in self-report questionnaires on child development and parenting stress. Discriminative validity was assessed by comparing different outcomes of the SPARK between groups with different levels of socio-economic status and by performing an extreme-groups comparison. The user experience of both parents and nurses was assessed with the aid of an online survey. Results The response rate was 92.1% for the SPARK. Self-report questionnaires were returned in the case of 66.9% of the remaining 1721 children. There was selective non-reporting: 33.1% of the questionnaires were not returned, covering 65.2% of the children with a high-risk label according to the SPARK (p < 0.001). Inter-rater reliability was good to excellent with intraclass correlations between 0.85 and 1.0 for physical topics; between 0.61 and 0.8 for social-emotional topics and 0.92 for the overall risk assessment. Convergent validity was unexpectedly low (all correlations ≤0.3) although the pattern was as expected. Discriminative validity was good. Users were satisfied with the SPARK and identified some topics for improvement. Conclusion The SPARK discriminates between children with a high, increased and low risk of parenting and developmental problems. It does so in a reliable way, but more research is needed on aspects of validity and in other populations. PMID:22697218

The benefit of lithium carbonate adjunct in refractory depression--fact or fiction?

PubMed

Kantor, D; McNevin, S; Leichner, P; Harper, D; Krenn, M

1986-06-01

Our group attempted to validate previous claims of rapid success with lithium carbonate adjunct therapy in antidepressant-resistant depression. Seven depressed patients volunteered for a study of placebo controlled, double-blind design. During their treatment on general hospital psychiatric wards, these patients received antidepressant medication for a period of at least 21 days. While continuing to receive antidepressant medication after the 21 day period, four of the patients then received lithium carbonate, and three received placebo. This combination pharmacological therapy continued for a 48 hour period. After this time, six of the seven patients showed no significant improvement. The remaining patient, who had received lithium carbonate, improved markedly over the 48 hour period. However, this patient relapsed within one week. A review of the two most extensive studies claiming significant results with the lithium carbonate adjunct therapy was performed. We feel that they, as presented, leave serious doubt as to the validity of their conclusions. We conclude that on the basis of our work up to this point in time and the analysis of previous reports claiming otherwise, no valid evidence exists for a consistent therapeutic effect of lithium carbonate adjunct in antidepressant-resistant depression. It was also found that methodologic contamination necessitated the exclusion of an additional six patients from the double-blind trial. We conclude that in order to objectively examine the rapidly expanding field of biological psychiatry, teaching of clinical staff in basic research procedure should be stressed as a part of routine ward orientation.

Validity and Reliability of the Brazilian Version of the Rapid Estimate of Adult Literacy in Dentistry – BREALD-30

PubMed Central

Junkes, Monica C.; Fraiz, Fabian C.; Sardenberg, Fernanda; Lee, Jessica Y.; Paiva, Saul M.; Ferreira, Fernanda M.

2015-01-01

Objective The aim of the present study was to translate, perform the cross-cultural adaptation of the Rapid Estimate of Adult Literacy in Dentistry to Brazilian-Portuguese language and test the reliability and validity of this version. Methods After translation and cross-cultural adaptation, interviews were conducted with 258 parents/caregivers of children in treatment at the pediatric dentistry clinics and health units in Curitiba, Brazil. To test the instrument's validity, the scores of Brazilian Rapid Estimate of Adult Literacy in Dentistry (BREALD-30) were compared based on occupation, monthly household income, educational attainment, general literacy, use of dental services and three dental outcomes. Results The BREALD-30 demonstrated good internal reliability. Cronbach’s alpha ranged from 0.88 to 0.89 when words were deleted individually. The analysis of test-retest reliability revealed excellent reproducibility (intraclass correlation coefficient = 0.983 and Kappa coefficient ranging from moderate to nearly perfect). In the bivariate analysis, BREALD-30 scores were significantly correlated with the level of general literacy (rs = 0.593) and income (rs = 0.327) and significantly associated with occupation, educational attainment, use of dental services, self-rated oral health and the respondent’s perception regarding his/her child's oral health. However, only the association between the BREALD-30 score and the respondent’s perception regarding his/her child's oral health remained significant in the multivariate analysis. Conclusion The BREALD-30 demonstrated satisfactory psychometric properties and is therefore applicable to adults in Brazil. PMID:26158724

Reexamining epilepsy-associated stigma: validation of the Stigma Scale of Epilepsy in Zambia

PubMed Central

Bowles, Ryan P.; Atadzhanov, Masharip; Mbewe, Edward; Haworth, Alan; Chomba, Elwyn; Birbeck, Gretchen L.

2017-01-01

Purpose Epilepsy-associated stigma is an important patient-centered outcome, yet quantification remains challenging. Jacoby’s 3-item Stigma Scale is commonly used to assess felt stigma among people with epilepsy (PWE) yet has ceiling effects. The Stigma Scale of Epilepsy (SSE) is a 24-item instrument that measures felt stigma among PWE and stigmatizing attitudes among others. If cross-culturally valid, the SSE may elucidate stigma determinants and provide an outcome measure for interventions. Methods We assessed the properties of the SSE in 102 Zambian PWE using exploratory and confirmatory item response theories and compared the latent traits assessed by the SSE to those assessed by Jacoby’s Stigma Scale. Differential item functioning based on forced disclosure of epilepsy was examined. Results The SSE yielded two latent traits—the first reflected difficulties faced by PWE; the second reflected emotions associated with epilepsy. Jacoby’s Stigma Scale was associated only with the first latent trait. Forced disclosure was associated with “worry” and “pity” that were associated with the second latent trait. Conclusions In Zambian PWE, the SSE captured two latent traits. One trait represents feelings associated with epilepsy, which is theorized as a substantial yet unmeasured part of stigma. The SSE performs well across cultures and may more comprehensively assess felt stigma than other instruments. Further validation is required to determine whether the SSE adequately assesses stigmatizing attitudes among people without epilepsy. PMID:25416086

Methods of Measurement in epidemiology: Sedentary Behaviour

PubMed Central

Atkin, Andrew J; Gorely, Trish; Clemes, Stacy A; Yates, Thomas; Edwardson, Charlotte; Brage, Soren; Salmon, Jo; Marshall, Simon J; Biddle, Stuart JH

2012-01-01

Background Research examining sedentary behaviour as a potentially independent risk factor for chronic disease morbidity and mortality has expanded rapidly in recent years. Methods We present a narrative overview of the sedentary behaviour measurement literature. Subjective and objective methods of measuring sedentary behaviour suitable for use in population-based research with children and adults are examined. The validity and reliability of each method is considered, gaps in the literature specific to each method identified and potential future directions discussed. Results To date, subjective approaches to sedentary behaviour measurement, e.g. questionnaires, have focused predominantly on TV viewing or other screen-based behaviours. Typically, such measures demonstrate moderate reliability but slight to moderate validity. Accelerometry is increasingly being used for sedentary behaviour assessments; this approach overcomes some of the limitations of subjective methods, but detection of specific postures and postural changes by this method is somewhat limited. Instruments developed specifically for the assessment of body posture have demonstrated good reliability and validity in the limited research conducted to date. Miniaturization of monitoring devices, interoperability between measurement and communication technologies and advanced analytical approaches are potential avenues for future developments in this field. Conclusions High-quality measurement is essential in all elements of sedentary behaviour epidemiology, from determining associations with health outcomes to the development and evaluation of behaviour change interventions. Sedentary behaviour measurement remains relatively under-developed, although new instruments, both objective and subjective, show considerable promise and warrant further testing. PMID:23045206

Political homogeneity can nurture threats to research validity.

PubMed

Chambers, John R; Schlenker, Barry R

2015-01-01

Political homogeneity within a scientific field nurtures threats to the validity of many research conclusions by allowing ideologically compatible values to influence interpretations, by minimizing skepticism, and by creating premature consensus. Although validity threats can crop in any research, the usual corrective activities in science are more likely to be minimized and delayed.

Aristotle Meets Zeno: Psychophysiological Evidence

PubMed Central

Papageorgiou, Charalabos; Stachtea, Xanthi; Papageorgiou, Panos; Alexandridis, Antonio T.

2016-01-01

This study, a tribute to Aristotle's 2400 years, used a juxtaposition of valid Aristotelian arguments to the paradoxes formulated by Zeno the Eleatic, in order to investigate the electrophysiological correlates of attentional and /or memory processing effects in the course of deductive reasoning. Participants undertook reasoning tasks based on visually presented arguments which were either (a) valid (Aristotelian) statements or (b) paradoxes. We compared brain activation patterns while participants maintained the premises / conclusions of either the valid statements or the paradoxes in working memory (WM). Event-related brain potentials (ERPs), specifically the P300 component of ERPs, were recorded during the WM phase, during which participants were required to draw a logical conclusion regarding the correctness of the valid syllogisms or the paradoxes. During the processing of paradoxes, results demonstrated a more positive event-related potential deflection (P300) across frontal regions, whereas processing of valid statements was associated with noticeable P300 amplitudes across parieto-occipital regions. These findings suggest that paradoxes mobilize frontal attention mechanisms, while valid deduction promotes parieto-occipital activity associated with attention and/or subsequent memory processing. PMID:28033333

Aristotle Meets Zeno: Psychophysiological Evidence.

PubMed

Papageorgiou, Charalabos; Stachtea, Xanthi; Papageorgiou, Panos; Alexandridis, Antonio T; Tsaltas, Eleftheria; Angelopoulos, Elias

2016-01-01

This study, a tribute to Aristotle's 2400 years, used a juxtaposition of valid Aristotelian arguments to the paradoxes formulated by Zeno the Eleatic, in order to investigate the electrophysiological correlates of attentional and /or memory processing effects in the course of deductive reasoning. Participants undertook reasoning tasks based on visually presented arguments which were either (a) valid (Aristotelian) statements or (b) paradoxes. We compared brain activation patterns while participants maintained the premises / conclusions of either the valid statements or the paradoxes in working memory (WM). Event-related brain potentials (ERPs), specifically the P300 component of ERPs, were recorded during the WM phase, during which participants were required to draw a logical conclusion regarding the correctness of the valid syllogisms or the paradoxes. During the processing of paradoxes, results demonstrated a more positive event-related potential deflection (P300) across frontal regions, whereas processing of valid statements was associated with noticeable P300 amplitudes across parieto-occipital regions. These findings suggest that paradoxes mobilize frontal attention mechanisms, while valid deduction promotes parieto-occipital activity associated with attention and/or subsequent memory processing.

Development of the Career Anchors Scale among Occupational Health Nurses in Japan

PubMed Central

Kubo, Yoshiko; Hatono, Yoko; Kubo, Tomohide; Shimamoto, Satoko; Nakatani, Junko; Burgel, Barbara J.

2016-01-01

Objectives: This study aimed to develop the Career Anchors Scale among Occupational Health Nurses (CASOHN) and evaluate its reliability and validity. Methods: Scale items were developed through a qualitative inductive analysis of interview data, and items were revised following an examination of content validity by experts and occupational health nurses (OHNs), resulting in a provisional scale of 41 items. A total of 745 OHNs (response rate 45.2%) affiliated with the Japan Society for Occupational Health participated in the self-administered questionnaire survey. Results: Two items were deleted based on item-total correlations. Factor analysis was then conducted on the remaining 39 items to examine construct validity. An exploratory factor analysis with a main factor method and promax rotation resulted in the extraction of six factors. The variance contribution ratios of the six factors were 37.45, 7.01, 5.86, 4.95, 4.16, and 3.19%. The cumulative contribution ratio was 62.62%. The factors were named as follows: Demonstrating expertise and considering position in work (Factor 1); Management skills for effective work (Factor 2); Supporting health improvement in groups and organizations (Factor 3); Providing employee-focused support (Factor 4); Collaborating with occupational health team members and personnel (Factor 5); and Compatibility of work and private life (Factor 6). The confidence coefficient determined by the split-half method was 0.85. Cronbach's alpha coefficient for the overall scale was 0.95, whereas those of the six subscales were 0.88, 0.90, 0.91, 0.80, 0.85, and 0.79, respectively. Conclusions: CASOHN was found to be valid and reliable for measuring career anchors among OHNs in Japan. PMID:27725484

Are the available apathy measures reliable and valid? A review of the psychometric evidence

PubMed Central

Clarke, Diana E.; Ko, Jean Y.; Kuhl, Emily A.; van Reekum, Robert; Salvador, Rocio; Marin, Robert S.

2014-01-01

Objective Apathy is highly prevalent among neuropsychiatric populations and is associated with greater morbidity and worse functional outcomes. Despite this, it remains understudied and poorly understood, primarily due to lack of consensus definition and clear diagnostic criteria for apathy. Without a gold standard for defining and measuring apathy, the availability of empirically sound measures is imperative. This paper provides a psychometric review of the most commonly used apathy measures and provides recommendations for use and further research. Methods Pertinent literature databases were searched to identify all available assessment tools for apathy in adults aged 18 and older. Evidence of the reliability and validity of the scales were examined. Alternate variations of scales (e.g., non-English versions) were also evaluated if the validating articles were written in English. Results Fifteen apathy scales or subscales were examined. The most psychometrically robust measures for assessing apathy across any disease population appear to be the Apathy Evaluation Scale and the apathy subscale of the Neuropsychiatric Inventory based on the criteria set in this review. For assessment in specific populations, the Dementia Apathy Interview and Rating for patients with Alzheimer’s dementia, the Positive and Negative Symptom Scale for schizophrenia populations, and the Frontal System Behavior Scale for patients with fronto-temporal deficits are reliable and valid measures. Conclusion Clinicians and researchers have numerous apathy scales for use in broad and disease-specific neuropsychiatric populations. Our understanding of apathy would be advanced by research that helps build a consensus as to the definition and diagnosis of apathy, and further refine the psychometric properties of all apathy assessment tools. PMID:21193104

Development of the Return-to-Work Obstacles and Self-Efficacy Scale (ROSES) and Validation with Workers Suffering from a Common Mental Disorder or Musculoskeletal Disorder.

PubMed

Corbière, Marc; Negrini, Alessia; Durand, Marie-José; St-Arnaud, Louise; Briand, Catherine; Fassier, Jean-Baptiste; Loisel, Patrick; Lachance, Jean-Philippe

2017-09-01

Introduction Common mental disorders (CMDs) and musculoskeletal disorders (MSDs) lead the list of causes for work absence in several countries. Current research is starting to look at workers on sick leave as a single population, regardless of the nature of the disease or accident. The purpose of this study is to report the validation of the Return to Work Obstacles and Self-Efficacy Scale (ROSES) for people with MSDs and CMDs, based on the disability paradigm. Methods From a prospective design, the ROSES' reliability and validity were investigated in a Canadian sample of workers on sick leave due to MSDs (n = 206) and CMDs (n = 157). Results Exploratory and confirmatory factor analyses revealed that 46 items spread out on 10 conceptual dimensions (e.g., Fears of a relapse, Job demands, Difficult relation with the immediate supervisor), with satisfactory alpha coefficients and test-retest reliability for all subscales. Finally, several dimensions of ROSES also predict the participant's RTW within 6 months for MSDs (e.g., job demands), and CMDs (e.g., difficult relation with the immediate supervisor), even when adjusted by several variables (e.g., age, severity of symptoms). Apart from the job demands dimension, when the ROSES dimension is more external to the individual, only the perception of obstacles remains significant to predict RTW whereas it is the opposite result when the dimension is more internal (e.g., fears of a relapse). Conclusion The ROSES demonstrated satisfactory results regarding its validity and reliability with people having MSDs or CMDs, at the time of the return-to-work process.

Is questionnaire-based sitting time inaccurate and can it be improved? A cross-sectional investigation using accelerometer-based sitting time

PubMed Central

Gupta, Nidhi; Christiansen, Caroline Stordal; Hanisch, Christiana; Bay, Hans; Burr, Hermann; Holtermann, Andreas

2017-01-01

Objectives To investigate the differences between a questionnaire-based and accelerometer-based sitting time, and develop a model for improving the accuracy of questionnaire-based sitting time for predicting accelerometer-based sitting time. Methods 183 workers in a cross-sectional study reported sitting time per day using a single question during the measurement period, and wore 2 Actigraph GT3X+ accelerometers on the thigh and trunk for 1–4 working days to determine their actual sitting time per day using the validated Acti4 software. Least squares regression models were fitted with questionnaire-based siting time and other self-reported predictors to predict accelerometer-based sitting time. Results Questionnaire-based and accelerometer-based average sitting times were ≈272 and ≈476 min/day, respectively. A low Pearson correlation (r=0.32), high mean bias (204.1 min) and wide limits of agreement (549.8 to −139.7 min) between questionnaire-based and accelerometer-based sitting time were found. The prediction model based on questionnaire-based sitting explained 10% of the variance in accelerometer-based sitting time. Inclusion of 9 self-reported predictors in the model increased the explained variance to 41%, with 10% optimism using a resampling bootstrap validation. Based on a split validation analysis, the developed prediction model on ≈75% of the workers (n=132) reduced the mean and the SD of the difference between questionnaire-based and accelerometer-based sitting time by 64% and 42%, respectively, in the remaining 25% of the workers. Conclusions This study indicates that questionnaire-based sitting time has low validity and that a prediction model can be one solution to materially improve the precision of questionnaire-based sitting time. PMID:28093433

Prognostic nomogram and score to predict overall survival in locally advanced untreated pancreatic cancer (PROLAP)

PubMed Central

Vernerey, Dewi; Huguet, Florence; Vienot, Angélique; Goldstein, David; Paget-Bailly, Sophie; Van Laethem, Jean-Luc; Glimelius, Bengt; Artru, Pascal; Moore, Malcolm J; André, Thierry; Mineur, Laurent; Chibaudel, Benoist; Benetkiewicz, Magdalena; Louvet, Christophe; Hammel, Pascal; Bonnetain, Franck

2016-01-01

Background: The management of locally advanced pancreatic cancer (LAPC) patients remains controversial. Better discrimination for overall survival (OS) at diagnosis is needed. We address this issue by developing and validating a prognostic nomogram and a score for OS in LAPC (PROLAP). Methods: Analyses were derived from 442 LAPC patients enrolled in the LAP07 trial. The prognostic ability of 30 baseline parameters was evaluated using univariate and multivariate Cox regression analyses. Performance assessment and internal validation of the final model were done with Harrell's C-index, calibration plot and bootstrap sample procedures. On the basis of the final model, a prognostic nomogram and a score were developed, and externally validated in 106 consecutive LAPC patients treated in Besançon Hospital, France. Results: Age, pain, tumour size, albumin and CA 19-9 were independent prognostic factors for OS. The final model had good calibration, acceptable discrimination (C-index=0.60) and robust internal validity. The PROLAP score has the potential to delineate three different prognosis groups with median OS of 15.4, 11.7 and 8.5 months (log-rank P<0.0001). The score ability to discriminate OS was externally confirmed in 63 (59%) patients with complete clinical data derived from a data set of 106 consecutive LAPC patients; median OS of 18.3, 14.1 and 7.6 months for the three groups (log-rank P<0.0001). Conclusions: The PROLAP nomogram and score can accurately predict OS before initiation of induction chemotherapy in LAPC-untreated patients. They may help to optimise clinical trials design and might offer the opportunity to define risk-adapted strategies for LAPC management in the future. PMID:27404456

PROGNOSTIC SIGNIFICANCE OF CLINICAL, HISTOPATHOLOGICAL, AND MOLECULAR CHARACTERISTICS OF MEDULLOBLASTOMAS IN THE PROSPECTIVE HIT2000 MULTICENTER CLINICAL TRIAL COHORT

PubMed Central

Pietsch, Torsten; Schmidt, Rene; Remke, Marc; Korshunov, Andrey; Hovestadt, Volker; Jones, David TW; Felsberg, Jörg; Kaulich, Kerstin; Goschzik, Tobias; Kool, Marcel; Northcott, Paul A.; von Hoff, Katja; von Bueren, André O.; Friedrich, Carsten; Skladny, Heyko; Fleischhack, Gudrun; Taylor, Michael D.; Cremer, Friedrich; Lichter, Peter; Faldum, Andreas; Reifenberger, Guido; Rutkowski, Stefan; Pfister, Stefan M.

2014-01-01

BACKGROUND: This study aimed to prospectively evaluate clinical, histopathological and molecular variables for outcome prediction in medulloblastoma patients. METHODS: Patients from the HIT2000 cooperative clinical trial were prospectively enrolled based on the availability of sufficient tumor material and complete clinical information. This revealed a cohort of 184 patients (median age 7.6 years), which was randomly split at a 2:1 ratio into a training (n = 127), and a validation (n = 57) dataset. All samples were subjected to thorough histopathological investigation, CTNNB1 mutation analysis, quantitative PCR, MLPA and FISH analyses for cytogenetic variables, and methylome analysis. RESULTS: By univariable analysis, clinical factors (M-stage), histopathological variables (large cell component, endothelial proliferation, synaptophysin pattern), and molecular features (chromosome 6q status, MYC amplification, TOP2A copy-number, subgrouping) were found to be prognostic. Molecular consensus subgrouping (WNT, SHH, Group 3, Group 4) was validated as an independent feature to stratify patients into different risk groups. When comparing methods for the identification of WNT-driven medulloblastoma, this study identified CTNNB1 sequencing and methylation profiling to most reliably identify these patients. After removing patients with particularly favorable (CTNNB1 mutation, extensive nodularity) or unfavorable (MYC amplification) markers, a risk score for the remaining “intermediate molecular risk” population dependent on age, M-stage, pattern of synaptophysin expression, and MYCN copy-number status was identified and validated, with speckled synaptophysin expression indicating worse outcome. CONCLUSIONS: Methylation subgrouping and CTNNB1 mutation status represent robust tools for the risk-stratification of medulloblastoma. A simple clinico-pathological risk score for “intermediate molecular risk” patients was identified, which deserves further validation. SECONDARY CATEGORY: Pediatrics.

Preparing Electronic Clinical Data for Quality Improvement and Comparative Effectiveness Research: The SCOAP CERTAIN Automation and Validation Project

PubMed Central

Devine, Emily Beth; Capurro, Daniel; van Eaton, Erik; Alfonso-Cristancho, Rafael; Devlin, Allison; Yanez, N. David; Yetisgen-Yildiz, Meliha; Flum, David R.; Tarczy-Hornoch, Peter

2013-01-01

Background: The field of clinical research informatics includes creation of clinical data repositories (CDRs) used to conduct quality improvement (QI) activities and comparative effectiveness research (CER). Ideally, CDR data are accurately and directly abstracted from disparate electronic health records (EHRs), across diverse health-systems. Objective: Investigators from Washington State’s Surgical Care Outcomes and Assessment Program (SCOAP) Comparative Effectiveness Research Translation Network (CERTAIN) are creating such a CDR. This manuscript describes the automation and validation methods used to create this digital infrastructure. Methods: SCOAP is a QI benchmarking initiative. Data are manually abstracted from EHRs and entered into a data management system. CERTAIN investigators are now deploying Caradigm’s Amalga™ tool to facilitate automated abstraction of data from multiple, disparate EHRs. Concordance is calculated to compare data automatically to manually abstracted. Performance measures are calculated between Amalga and each parent EHR. Validation takes place in repeated loops, with improvements made over time. When automated abstraction reaches the current benchmark for abstraction accuracy - 95% - itwill ‘go-live’ at each site. Progress to Date: A technical analysis was completed at 14 sites. Five sites are contributing; the remaining sites prioritized meeting Meaningful Use criteria. Participating sites are contributing 15–18 unique data feeds, totaling 13 surgical registry use cases. Common feeds are registration, laboratory, transcription/dictation, radiology, and medications. Approximately 50% of 1,320 designated data elements are being automatically abstracted—25% from structured data; 25% from text mining. Conclusion: In semi-automating data abstraction and conducting a rigorous validation, CERTAIN investigators will semi-automate data collection to conduct QI and CER, while advancing the Learning Healthcare System. PMID:25848565

Measuring Food Brand Awareness in Australian Children: Development and Validation of a New Instrument

PubMed Central

Boyland, Emma; Bauman, Adrian E.

2015-01-01

Background Children’s exposure to food marketing is one environmental determinant of childhood obesity. Measuring the extent to which children are aware of food brands may be one way to estimate relative prior exposures to food marketing. This study aimed to develop and validate an Australian Brand Awareness Instrument (ABAI) to estimate children’s food brand awareness. Methods The ABAI incorporated 30 flashcards depicting food/drink logos and their corresponding products. An abbreviated version was also created using 12 flashcards (ABAI-a). The ABAI was presented to 60 primary school aged children (7-11yrs) attending two Australian after-school centres. A week later, the full-version was repeated on approximately half the sample (n=27) and the abbreviated-version was presented to the remaining half (n=30). The test-retest reliability of the ABAI was analysed using Intra-class correlation coefficients. The concordance of the ABAI-a and full-version was assessed using Bland-Altman plots. The ‘nomological’ validity of the full tool was investigated by comparing children’s brand awareness with food marketing-related variables (e.g. television habits, intake of heavily promoted foods). Results Brand awareness increased with age (p<0.01) but was not significantly correlated with other variables. Bland-Altman analyses showed good agreement between the ABAI and ABAI-a. Reliability analyses revealed excellent agreement between the two administrations of the full-ABAI. Conclusions The ABAI was able to differentiate children’s varying levels of brand awareness. It was shown to be a valid and reliable tool and may allow quantification of brand awareness as a proxy measure for children’s prior food marketing exposure. PMID:26222624

Three-Gene Immunohistochemical Panel Adds to Clinical Staging Algorithms to Predict Prognosis for Patients With Esophageal Adenocarcinoma

PubMed Central

Ong, Chin-Ann J.; Shapiro, Joel; Nason, Katie S.; Davison, Jon M.; Liu, Xinxue; Ross-Innes, Caryn; O'Donovan, Maria; Dinjens, Winand N.M.; Biermann, Katharina; Shannon, Nicholas; Worster, Susannah; Schulz, Laura K.E.; Luketich, James D.; Wijnhoven, Bas P.L.; Hardwick, Richard H.; Fitzgerald, Rebecca C.

2013-01-01

Purpose Esophageal adenocarcinoma (EAC) is a highly aggressive disease with poor long-term survival. Despite growing knowledge of its biology, no molecular biomarkers are currently used in routine clinical practice to determine prognosis or aid clinical decision making. Hence, this study set out to identify and validate a small, clinically applicable immunohistochemistry (IHC) panel for prognostication in patients with EAC. Patients and Methods We recently identified eight molecular prognostic biomarkers using two different genomic platforms. IHC scores of these biomarkers from a UK multicenter cohort (N = 374) were used in univariate Cox regression analysis to determine the smallest biomarker panel with the greatest prognostic power with potential therapeutic relevance. This new panel was validated in two independent cohorts of patients with EAC who had undergone curative esophagectomy from the United States and Europe (N = 666). Results Three of the eight previously identified prognostic molecular biomarkers (epidermal growth factor receptor [EGFR], tripartite motif-containing 44 [TRIM44], and sirtuin 2 [SIRT2]) had the strongest correlation with long-term survival in patients with EAC. Applying these three biomarkers as an IHC panel to the validation cohort segregated patients into two different prognostic groups (P < .01). Adjusting for known survival covariates, including clinical staging criteria, the IHC panel remained an independent predictor, with incremental adverse overall survival (OS) for each positive biomarker (hazard ratio, 1.20; 95% CI, 1.03 to 1.40 per biomarker; P = .02). Conclusion We identified and validated a clinically applicable IHC biomarker panel, consisting of EGFR, TRIM44, and SIRT2, that is independently associated with OS and provides additional prognostic information to current survival predictors such as stage. PMID:23509313

Validation of the Dutch version of the Swallowing Quality-of-Life Questionnaire (DSWAL-QoL) and the adjusted DSWAL-QoL (aDSWAL-QoL) using item analysis with the Rasch model: a pilot study.

PubMed

Simpelaere, Ingeborg S; Van Nuffelen, Gwen; De Bodt, Marc; Vanderwegen, Jan; Hansen, Tina

2017-04-07

The Swallowing Quality-of-Life Questionnaire (SWAL-QoL) is considered the gold standard for assessing health-related QoL in oropharyngeal dysphagia. The Dutch translation (DSWAL-QoL) and its adjusted version (aDSWAL-QoL) have been validated using classical test theory (CTT). However, these scales have not been tested against the Rasch measurement model, which is required to establish the structural validity and objectivity of the total scale and subscale scores. Thus, the purpose of this study was to examine the psychometric properties of these scales using item analysis according to the Rasch model. Item analysis with the Rasch model was performed using RUMM2030 software with previously collected data from a validation study of 108 patients. The assessment included evaluations of overall model fit, reliability, unidimensionality, threshold ordering, individual item and person fits, differential item functioning (DIF), local item dependency (LID) and targeting. The analysis could not establish the psychometric properties of either of the scales or their subscales because they did not fit the Rasch model, and multidimensionality, disordered thresholds, DIF, and/or LID were found. The reliability and power of fit were high for the total scales (PSI = 0.93) but low for most of the subscales (PSI < 0.70). The targeting of persons and items was suboptimal. The main source of misfit was disordered thresholds for both the total scales and subscales. Based on the results of the analysis, adjustments to improve the scales were implemented as follows: disordered thresholds were rescaled, misfit items were removed and items were split for DIF. However, the multidimensionality and LID could not be resolved. The reliability and power of fit remained low for most of the subscales. This study represents the first analyses of the DSWAL-QoL and aDSWAL-QoL with the Rasch model. Relying on the DSWAL-QoL and aDSWAL-QoL total and subscale scores to make conclusions regarding dysphagia-related HRQoL should be treated with caution before the structural validity and objectivity of both scales have been established. A larger and well-targeted sample is recommended to derive definitive conclusions about the items and scales. Solutions for the psychometric weaknesses suggested by the model and practical implications are discussed.

Outcomes after Deep Vein Thrombosis and Pulmonary Embolism in the Community: The Worcester Venous Thromboembolism Study

PubMed Central

Spencer, Frederick A.; Gore, Joel M.; Lessard, Darleen; Douketis, James D.; Emery, Cathy; Goldberg, Robert J.

2009-01-01

Background Despite advances in the management of deep vein thrombosis (DVT) and pulmonary embolism (PE), there are relatively few contemporary data describing and comparing outcomes in patients with these common conditions from a more generalizable community-based perspective. The purpose of this study was to measure and compare clinical characteristics and outcomes of patients with validated symptomatic PE and isolated DVT in a New England community. Methods The medical records of residents from the Worcester (MA) area with ICD-9 codes consistent with possible venous thromboembolism (VTE) during 1999, 2001, and 2003 were independently validated and reviewed by trained abstractors. Results Patients presenting with PE or isolated DVT experienced similar rates of subsequent PE, overall venous thromboembolism (VTE), and major bleeding during 3-year follow-up (5.9% vs. 5.1%, 15% vs. 17.9%, 15.6% vs. 12.4%, respectively). Mortality was significantly increased at 1-month follow-up in patients initially presenting with PE (13.0% vs. 5.4%) - this difference persisted at 3 years (35.3% vs. 29.6%). Patients whose course was complicated by major bleeding were more likely to suffer recurrent VTE or to die at 3 years than those without these complications. Conclusions Patients presenting with PE had similar rates of subsequent PE or recurrent VTE as patients with isolated DVT. However, rates of recurrent VTE and major bleeding following DVT and PE remain unacceptably high in the community setting. Efforts remain needed to identify patients most at risk for VTE-associated complications and development of better anticoagulation strategies conducive to long-term use in the community setting. PMID:18299499

EUROmediCAT signal detection: an evaluation of selected congenital anomaly‐medication associations

PubMed Central

Given, Joanne E.; Loane, Maria; Luteijn, Johannes M.; Morris, Joan K.; de Jong van den Berg, Lolkje T.W.; Garne, Ester; Addor, Marie‐Claude; Barisic, Ingeborg; de Walle, Hermien; Gatt, Miriam; Klungsoyr, Kari; Khoshnood, Babak; Latos‐Bielenska, Anna; Nelen, Vera; Neville, Amanda J.; O'Mahony, Mary; Pierini, Anna; Tucker, David; Wiesel, Awi

2016-01-01

Aims To evaluate congenital anomaly (CA)‐medication exposure associations produced by the new EUROmediCAT signal detection system and determine which require further investigation. Methods Data from 15 EUROCAT registries (1995–2011) with medication exposures at the chemical substance (5th level of Anatomic Therapeutic Chemical classification) and chemical subgroup (4th level) were analysed using a 50% false detection rate. After excluding antiepileptics, antidiabetics, antiasthmatics and SSRIs/psycholeptics already under investigation, 27 associations were evaluated. If evidence for a signal persisted after data validation, a literature review was conducted for prior evidence of human teratogenicity. Results Thirteen out of 27 CA‐medication exposure signals, based on 389 exposed cases, passed data validation. There was some prior evidence in the literature to support six signals (gastroschisis and levonorgestrel/ethinylestradiol (OR 4.10, 95% CI 1.70–8.53; congenital heart disease/pulmonary valve stenosis and nucleoside/tide reverse transcriptase inhibitors (OR 5.01, 95% CI 1.99–14.20/OR 28.20, 95% CI 4.63–122.24); complete absence of a limb and pregnen (4) derivatives (OR 6.60, 95% CI 1.70–22.93); hypospadias and pregnadien derivatives (OR 1.40, 95% CI 1.10–1.76); hypospadias and synthetic ovulation stimulants (OR 1.89, 95% CI 1.28–2.70). Antipropulsives produced a signal for syndactyly while the literature revealed a signal for hypospadias. There was no prior evidence to support the remaining six signals involving the ordinary salt combinations, propulsives, bulk‐forming laxatives, hydrazinophthalazine derivatives, gonadotropin releasing hormone analogues and selective serotonin agonists. Conclusion Signals which strengthened prior evidence should be prioritized for further investigation, and independent evidence sought to confirm the remaining signals. Some chance associations are expected and confounding by indication is possible. PMID:27028286

Hormone replacement therapy is associated with gastro-oesophageal reflux disease: a retrospective cohort study

PubMed Central

2012-01-01

Background Oestrogen and progestogen have the potential to influence gastro-intestinal motility; both are key components of hormone replacement therapy (HRT). Results of observational studies in women taking HRT rely on self-reporting of gastro-oesophageal symptoms and the aetiology of gastro-oesophageal reflux disease (GORD) remains unclear. This study investigated the association between HRT and GORD in menopausal women using validated general practice records. Methods 51,182 menopausal women were identified using the UK General Practice Research Database between 1995–2004. Of these, 8,831 were matched with and without hormone use. Odds ratios (ORs) were calculated for GORD and proton-pump inhibitor (PPI) use in hormone and non-hormone users, adjusting for age, co-morbidities, and co-pharmacy. Results In unadjusted analysis, all forms of hormone use (oestrogen-only, tibolone, combined HRT and progestogen) were statistically significantly associated with GORD. In adjusted models, this association remained statistically significant for oestrogen-only treatment (OR 1.49; 1.18–1.89). Unadjusted analysis showed a statistically significant association between PPI use and oestrogen-only and combined HRT treatment. When adjusted for covariates, oestrogen-only treatment was significant (OR 1.34; 95% CI 1.03–1.74). Findings from the adjusted model demonstrated the greater use of PPI by progestogen users (OR 1.50; 1.01–2.22). Conclusions This first large cohort study of the association between GORD and HRT found a statistically significant association between oestrogen-only hormone and GORD and PPI use. This should be further investigated using prospective follow-up to validate the strength of association and describe its clinical significance. PMID:22642788

The Cord Blood Apgar: a novel scoring system to optimize selection of banked cord blood grafts for transplantation

PubMed Central

Page, Kristin M.; Zhang, Lijun; Mendizabal, Adam; Wease, Stephen; Carter, Shelly; Shoulars, Kevin; Gentry, Tracy; Balber, Andrew E.; Kurtzberg, Joanne

2012-01-01

BACKGROUND Engraftment failure and delays, likely due to diminished cord blood unit (CBU) potency, remain major barriers to the overall success of unrelated umbilical cord blood transplantation (UCBT). To address this problem, we developed and retrospectively validated a novel scoring system, the Cord Blood Apgar (CBA), which is predictive of engraftment after UCBT. STUDY DESIGN AND METHODS In a single-center retrospective study, utilizing a database of 435 consecutive single cord myeloablative UCBTs performed between January 1, 2000, to December 31, 2008, precryopreservation and postthaw graft variables (total nucleated cell, CD34+, colony-forming units, mononuclear cell content, and volume) were initially correlated with neutrophil engraftment. Subsequently, based on the magnitude of hazard ratios (HRs) in univariate analysis, a weighted scoring system to predict CBU potency was developed using a randomly selected training data set and internally validated on the remaining data set. RESULTS The CBA assigns transplanted CBUs three scores: a precryopreservation score (PCS), a postthaw score (PTS), and a composite score (CS), which incorporates the PCS and PTS values. CBA-PCS scores, which could be used for initial unit selection, were predictive of neutrophil (CBA-PCS ≥ 7.75 vs. <7.75, HR 3.5; p < 0.0001) engraftment. Likewise, CBA-PTS and CS scores were strongly predictive of Day 42 neutrophil engraftment (CBA-PTS ≥ 9.5 vs. <9.5, HR 3.16, p < 0.0001; CBA-CS ≥ 17.75 vs. <17.75, HR 4.01, p < 0.0001). CONCLUSION The CBA is strongly predictive of engraftment after UCBT and shows promise for optimizing screening of CBU donors for transplantation. In the future, a segment could be assayed for the PTS score providing data to apply the CS for final CBU selection. PMID:21810098

Identification of Four Novel Loci in Asthma in European American and African American Populations

PubMed Central

Almoguera, Berta; Vazquez, Lyam; Mentch, Frank; Connolly, John; Pacheco, Jennifer A.; Sundaresan, Agnes S.; Peissig, Peggy L.; Linneman, James G.; McCarty, Catherine A.; Crosslin, David; Carrell, David S.; Lingren, Todd; Namjou-Khales, Bahram; Harley, John B.; Larson, Eric; Jarvik, Gail P.; Brilliant, Murray; Williams, Marc S.; Kullo, Iftikhar J.; Hysinger, Erik B.; Hakonarson, Hakon

2017-01-01

Rationale: Despite significant advances in knowledge of the genetic architecture of asthma, specific contributors to the variability in the burden between populations remain uncovered. Objectives: To identify additional genetic susceptibility factors of asthma in European American and African American populations. Methods: A phenotyping algorithm mining electronic medical records was developed and validated to recruit cases with asthma and control subjects from the Electronic Medical Records and Genomics network. Genome-wide association analyses were performed in pediatric and adult asthma cases and control subjects with European American and African American ancestry followed by metaanalysis. Nominally significant results were reanalyzed conditioning on allergy status. Measurements and Main Results: The validation of the algorithm yielded an average of 95.8% positive predictive values for both cases and control subjects. The algorithm accrued 21,644 subjects (65.83% European American and 34.17% African American). We identified four novel population-specific associations with asthma after metaanalyses: loci 6p21.31, 9p21.2, and 10q21.3 in the European American population, and the PTGES gene in African Americans. TEK at 9p21.2, which encodes TIE2, has been shown to be involved in remodeling the airway wall in asthma, and the association remained significant after conditioning by allergy. PTGES, which encodes the prostaglandin E synthase, has also been linked to asthma, where deficient prostaglandin E2 synthesis has been associated with airway remodeling. Conclusions: This study adds to understanding of the genetic architecture of asthma in European Americans and African Americans and reinforces the need to study populations of diverse ethnic backgrounds to identify shared and unique genetic predictors of asthma. PMID:27611488

Gleason grade remains an important prognostic predictor in men diagnosed with prostate cancer while on finasteride therapy

PubMed Central

CARVER, BRETT S.; KATTAN, MICHAEL W.; SCARDINO, PETER T.; EASTHAM, JAMES A.

2007-01-01

OBJECTIVE To evaluate men treated with finasteride for lower urinary tract symptoms, who subsequently were diagnosed with prostate cancer and had a radical prostatectomy (RP) at our institution, to determine if finasteride therapy prevented accurate Gleason grade assignment and prediction of biochemical recurrence. PATIENTS AND METHODS Between May 1996 and July 2003, 45 men were identified who had RP and had previously been treated with finasteride for ≥6 months before the diagnosis of prostate cancer. Clinical and pathological information was gathered from a RP database. Serum prostate-specific antigen (PSA) level, duration of finasteride therapy, biopsy Gleason grade, clinical stage, RP Gleason grade and pathological stage were reviewed. Freedom from recurrence was predicted using validated nomograms before and after RP, and compared against actuarial 5-year freedom from recurrence using the Kaplan-Meier method. RESULTS The mean duration of finasteride therapy before diagnosis was 23.6 months, the mean serum PSA (doubled to account for finasteride use) 11.02 ng/mL and mean biopsy Gleason score 6. When comparing the biopsy and RP specimen Gleason score, it was downgraded by 1 point in six men, upgraded by 1 point in eight, and upgraded by 2 points in one. The Gleason score was constant in 30 patients. The nomograms predicted freedom from recurrence in 83% and 85%, respectively; the 5-year actuarial freedom from recurrence was 86%. CONCLUSION Finasteride does not appear to compromise the assignment of Gleason grade for use in prediction tools before or after RP in men undergoing prostate biopsy or RP. The actuarial 5-year freedom from recurrence was similar to that predicted by the validated nomograms. Gleason grade remains an important prognostic predictor in men treated with finasteride and undergoing RP for clinically localized prostate cancer. PMID:15705069

Identifying Social Learning in Animal Populations: A New ‘Option-Bias’ Method

PubMed Central

Kendal, Rachel L.; Kendal, Jeremy R.; Hoppitt, Will; Laland, Kevin N.

2009-01-01

Background Studies of natural animal populations reveal widespread evidence for the diffusion of novel behaviour patterns, and for intra- and inter-population variation in behaviour. However, claims that these are manifestations of animal ‘culture’ remain controversial because alternative explanations to social learning remain difficult to refute. This inability to identify social learning in social settings has also contributed to the failure to test evolutionary hypotheses concerning the social learning strategies that animals deploy. Methodology/Principal Findings We present a solution to this problem, in the form of a new means of identifying social learning in animal populations. The method is based on the well-established premise of social learning research, that - when ecological and genetic differences are accounted for - social learning will generate greater homogeneity in behaviour between animals than expected in its absence. Our procedure compares the observed level of homogeneity to a sampling distribution generated utilizing randomization and other procedures, allowing claims of social learning to be evaluated according to consensual standards. We illustrate the method on data from groups of monkeys provided with novel two-option extractive foraging tasks, demonstrating that social learning can indeed be distinguished from unlearned processes and asocial learning, and revealing that the monkeys only employed social learning for the more difficult tasks. The method is further validated against published datasets and through simulation, and exhibits higher statistical power than conventional inferential statistics. Conclusions/Significance The method is potentially a significant technological development, which could prove of considerable value in assessing the validity of claims for culturally transmitted behaviour in animal groups. It will also be of value in enabling investigation of the social learning strategies deployed in captive and natural animal populations. PMID:19657389

Implementation of remaining service interval concept.

DOT National Transportation Integrated Search

2016-10-01

This document is a technical summary of the Federal Highway Administration (FHWA) report, "Application and Validation of RSI Framework to Pavements" (FHWA-HRT-16-053). The goal of this project was to demonstrate and to validate the application of the...

A Critical Evaluation of the Validity and the Reliability of Global Competency Constructs for Supervisor Assessment of Junior Medical Trainees

ERIC Educational Resources Information Center

McGill, D. A.; van der Vleuten, C. P. M.; Clarke, M. J.

2013-01-01

Supervisor assessments are critical for both formative and summative assessment in the workplace. Supervisor ratings remain an important source of such assessment in many educational jurisdictions even though there is ambiguity about their validity and reliability. The aims of this evaluation is to explore the: (1) construct validity of ward-based…

Validity of an Exercise Test Based on Habitual Gait Speed in Mobility-Limited Older Adults

PubMed Central

Li, Xin; Forman, Daniel E.; Kiely, Dan K.; LaRose, Sharon; Hirschberg, Ronald; Frontera, Walter R.; Bean, Jonathan F.

2013-01-01

Objective To evaluate whether a customized exercise tolerance testing (ETT) protocol based on an individual’s habitual gait speed (HGS) on level ground would be a valid mode of exercise testing older adults. Although ETT provides a useful means to risk-stratify adults, age-related declines in gait speed paradoxically limit the utility of standard ETT protocols for evaluating older adults. A customized ETT protocol may be a useful alternative to these standard methods, and this study hypothesized that this alternative approach would be valid. Design We performed a cross-sectional analysis of baseline data from a randomized controlled trial of older adults with observed mobility problems. Screening was performed using a treadmill-based ETT protocol customized for each individual’s HGS. We determined the content validity by assessing the results of the ETTs, and we evaluated the construct validity of treadmill time in relation to the Physical Activity Scale for the Elderly (PASE) and the Late Life Function and Disability Instrument (LLFDI). Setting Outpatient rehabilitation center. Participants Community-dwelling, mobility-limited older adults (N = 141). Interventions Not applicable. Main Outcome Measures Cardiac instability, ETT duration, peak heart rate, peak systolic blood pressure, PASE, and LLFDI. Results Acute cardiac instability was identified in 4 of the participants who underwent ETT. The remaining participants (n = 137, 68% female; mean age, 75.3y) were included in the subsequent analyses. Mean exercise duration was 9.39 minutes, with no significant differences in durations being observed after evaluating among tertiles by HGS status. Mean peak heart rate and mean peak systolic blood pressure were 126.6 beats/ min and 175.0mmHg, respectively. Within separate multivariate models, ETT duration in each of the 3 gait speed groups was significantly associated (P<.05) with PASE and LLFDI. Conclusions Mobility-limited older adults can complete this customized ETT protocol, allowing for the identification of acute cardiac instability and the achievement of optimal exercise parameters. PMID:22289248

Validation of a Telephone-administered Geriatric Depression Scale in a Hispanic Elderly Population

PubMed Central

Carrete, Paula; Augustovski, Federico; Gimpel, Nora; Fernandez, Sebastian; Di Paolo, Rodolfo; Schaffer, Irene; Rubinstein, Fernando

2001-01-01

OBJECTIVE To develop and validate a Spanish version of the Geriatric Depression Scale (GDS) for telephone administration. DESIGN, SETTING, AND PATIENTS The original version of the GDS was translated into Spanish. A random sample of 282 ambulatory elderly individuals was contacted by phone. Those completing the phone GDS (GDS-T) were asked to schedule an appointment within two weeks in which we collected data on demographics, physical exam, functional and mental status, and a face-to-face version of the GDS (GDS-P). We estimated question-to-question κ statistics and the Pearson correlation coefficient between the GDS-T and GDS-P scores. We evaluated reliability of the GDS-T and GDS-P using the Cronbach's α coefficient. We estimated the sensitivity, specificity, and criterion validity of the GDS using the DSM IV criteria for depression as our gold standard. RESULTS Thirty patients (11%) refused to participate. Of the remaining 252 patients, 169 (67%) attended the personal interview. The Cronbach's α coefficient was 0.85 for GSD-P and 0.88 for GDS-T. Sensitivity and specificity were 88% and 82% for GDS-P and 84% and 79% for GDS-T. The prevalence of depression in the group completing both scales was 12.8% using the GDS-P and 14.9% using the GDS-T (P >.05). Among those who only completed the GDS-T, the prevalence was 22.7% (P <.05) suggesting that depressed patients kept their appointments less frequently. CONCLUSIONS The telephone GDS had high internal consistency and was highly correlated with the validated personal administration of the scale, suggesting that it could be a valid instrument for screening of depression among elderly ambulatory Spanish-speaking patients. Because the depression rate was significantly higher among those not presenting to the personal evaluation, the adoption of GDS-T may help detect and plan early interventions in patients who otherwise would not be identified. PMID:11520381

A conceptual model for generating and validating in-session clinical judgments

PubMed Central

Jacinto, Sofia B.; Lewis, Cara C.; Braga, João N.; Scott, Kelli

2016-01-01

Objective Little attention has been paid to the nuanced and complex decisions made in the clinical session context and how these decisions influence therapy effectiveness. Despite decades of research on the dual-processing systems, it remains unclear when and how intuitive and analytical reasoning influence the direction of the clinical session. Method This paper puts forth a testable conceptual model, guided by an interdisciplinary integration of the literature, that posits that the clinical session context moderates the use of intuitive versus analytical reasoning. Results A synthesis of studies examining professional best practices in clinical decision-making, empirical evidence from clinical judgment research, and the application of decision science theories indicate that intuitive and analytical reasoning may have profoundly different impacts on clinical practice and outcomes. Conclusions The proposed model is discussed with respect to its implications for clinical practice and future research. PMID:27088962

Context Matters: Volunteer Bias, Small Sample Size, and the Value of Comparison Groups in the Assessment of Research-Based Undergraduate Introductory Biology Lab Courses

PubMed Central

Brownell, Sara E.; Kloser, Matthew J.; Fukami, Tadashi; Shavelson, Richard J.

2013-01-01

The shift from cookbook to authentic research-based lab courses in undergraduate biology necessitates the need for evaluation and assessment of these novel courses. Although the biology education community has made progress in this area, it is important that we interpret the effectiveness of these courses with caution and remain mindful of inherent limitations to our study designs that may impact internal and external validity. The specific context of a research study can have a dramatic impact on the conclusions. We present a case study of our own three-year investigation of the impact of a research-based introductory lab course, highlighting how volunteer students, a lack of a comparison group, and small sample sizes can be limitations of a study design that can affect the interpretation of the effectiveness of a course. PMID:24358380

A state-of-the-art review on segmentation algorithms in intravascular ultrasound (IVUS) images.

PubMed

Katouzian, Amin; Angelini, Elsa D; Carlier, Stéphane G; Suri, Jasjit S; Navab, Nassir; Laine, Andrew F

2012-09-01

Over the past two decades, intravascular ultrasound (IVUS) image segmentation has remained a challenge for researchers while the use of this imaging modality is rapidly growing in catheterization procedures and in research studies. IVUS provides cross-sectional grayscale images of the arterial wall and the extent of atherosclerotic plaques with high spatial resolution in real time. In this paper, we review recently developed image processing methods for the detection of media-adventitia and luminal borders in IVUS images acquired with different transducers operating at frequencies ranging from 20 to 45 MHz. We discuss methodological challenges, lack of diversity in reported datasets, and weaknesses of quantification metrics that make IVUS segmentation still an open problem despite all efforts. In conclusion, we call for a common reference database, validation metrics, and ground-truth definition with which new and existing algorithms could be benchmarked.

Context matters: volunteer bias, small sample size, and the value of comparison groups in the assessment of research-based undergraduate introductory biology lab courses.

PubMed

Brownell, Sara E; Kloser, Matthew J; Fukami, Tadashi; Shavelson, Richard J

2013-01-01

The shift from cookbook to authentic research-based lab courses in undergraduate biology necessitates the need for evaluation and assessment of these novel courses. Although the biology education community has made progress in this area, it is important that we interpret the effectiveness of these courses with caution and remain mindful of inherent limitations to our study designs that may impact internal and external validity. The specific context of a research study can have a dramatic impact on the conclusions. We present a case study of our own three-year investigation of the impact of a research-based introductory lab course, highlighting how volunteer students, a lack of a comparison group, and small sample sizes can be limitations of a study design that can affect the interpretation of the effectiveness of a course.

Cybercrimes vs. Cyberliberties

NASA Astrophysics Data System (ADS)

Strossen, Nadine

This new Introduction explains how all of the themes and conclusions of the original chapter remain valid despite intervening developments, including the 2001 terrorist attacks. It shows that the major points that the 1999 chapter made about one particular medium, at one particular historical point, concerning particular safety and security issues that were then at the forefront of public concern, apply more universally to other media, during other historical periods, and regarding other safety and security concerns. The Introduction supports this generalization by analyzing two sets of subsequent developments. First, it shows that post-911 surveillance measures that target communications, including Internet communications, violate freedom of speech and privacy without sufficient countervailing security benefits. Second, it shows that the government’s continuing efforts to suppress online sexual expression, in order to protect children from seeing it, continue appropriately to be struck down by the courts as violating free speech rights without sufficient countervailing benefits.

Emission of fermions in little string theory

NASA Astrophysics Data System (ADS)

Lorente-Espín, Oscar

2013-03-01

It is well known that little string theory (LST) black holes radiate a purely thermal spectrum of scalar particles. This theory lives in a Hagedorn phase with a fixed Hagedorn temperature that does not depend on its mass. Therefore, the theory keeps a thermal profile even taking into account self-gravitating effects and the backreaction of the metric. This has implications concerning the information loss paradox; one would not be able to recover any information from the LST black hole since the emission of scalar particles is totally uncorrelated. Several studies of the emission spectrum in LST concern scalar fields; it is our aim in this work to extend the study to the emission of fermions in order to verify that the most relevant conclusion for the scalar field remains valid for the fermion fields. Thus, we have calculated the emission probability, the flux, and also the greybody factor corresponding to a fermion field in LST background.

Relationship between Student Pharmacist Decision Making Preferences and Experiential Learning.

PubMed

Williams, Charlene R; McLaughlin, Jacqueline E; Cox, Wendy C; Shepherd, Greene

2016-09-25

Objective. To determine if student pharmacists' preferences towards experiential and rational thinking are associated with performance on advanced pharmacy practice experiences (APPEs) and whether thinking style preference changes following APPEs. Methods. The Rational Experiential Inventory (REI), a validated survey of thinking style, was administered to student pharmacists before starting APPEs and re-administered after completing APPEs. APPE grades were compared to initial REI scores. Results. Rational Experiential Inventory scores remained consistent before and after APPEs. Overall, APPE grades were independent of REI scores. In a regression model, the REI experiential score was a significant negative predictor of hospital APPE grades. Conclusion. These findings suggest that overall APPE performance is independent of decision-making preference, and decision-making style does not change following immersion into APPEs. Instead of targeting teaching strategies towards a specific decision-making style, preceptors may use pedagogical approaches that promote sound clinical decision-making skills through critical thinking and reflection.

Relationship between Student Pharmacist Decision Making Preferences and Experiential Learning

PubMed Central

McLaughlin, Jacqueline E.; Cox, Wendy C.; Shepherd, Greene

2016-01-01

Objective. To determine if student pharmacists’ preferences towards experiential and rational thinking are associated with performance on advanced pharmacy practice experiences (APPEs) and whether thinking style preference changes following APPEs. Methods. The Rational Experiential Inventory (REI), a validated survey of thinking style, was administered to student pharmacists before starting APPEs and re-administered after completing APPEs. APPE grades were compared to initial REI scores. Results. Rational Experiential Inventory scores remained consistent before and after APPEs. Overall, APPE grades were independent of REI scores. In a regression model, the REI experiential score was a significant negative predictor of hospital APPE grades. Conclusion. These findings suggest that overall APPE performance is independent of decision-making preference, and decision-making style does not change following immersion into APPEs. Instead of targeting teaching strategies towards a specific decision-making style, preceptors may use pedagogical approaches that promote sound clinical decision-making skills through critical thinking and reflection. PMID:27756927

24 CFR 597.402 - Validation of designation.

Code of Federal Regulations, 2010 CFR

2010-04-01

... URBAN DEVELOPMENT COMMUNITY FACILITIES URBAN EMPOWERMENT ZONES AND ENTERPRISE COMMUNITIES: ROUND ONE... eligibility for and the validity of the designation of any Empowerment Zone or Enterprise Community. Determinations of whether any designated Empowerment Zone or Enterprise Community remains in good standing shall...

Content Validity and Psychometric Characteristics of the "Knowledge about Older Patients Quiz" for Nurses Using Item Response Theory.

PubMed

Dikken, Jeroen; Hoogerduijn, Jita G; Kruitwagen, Cas; Schuurmans, Marieke J

2016-11-01

To assess the content validity and psychometric characteristics of the Knowledge about Older Patients Quiz (KOP-Q), which measures nurses' knowledge regarding older hospitalized adults and their certainty regarding this knowledge. Cross-sectional. Content validity: general hospitals. Psychometric characteristics: nursing school and general hospitals in the Netherlands. Content validity: 12 nurse specialists in geriatrics. Psychometric characteristics: 107 first-year and 78 final-year bachelor of nursing students, 148 registered nurses, and 20 nurse specialists in geriatrics. Content validity: The nurse specialists rated each item of the initial KOP-Q (52 items) on relevance. Ratings were used to calculate Item-Content Validity Index and average Scale-Content Validity Index (S-CVI/ave) scores. Items with insufficient content validity were removed. Psychometric characteristics: Ratings of students, nurses, and nurse specialists were used to test for different item functioning (DIF) and unidimensionality before item characteristics (discrimination and difficulty) were examined using Item Response Theory. Finally, norm references were calculated and nomological validity was assessed. Content validity: Forty-three items remained after assessing content validity (S-CVI/ave = 0.90). Psychometric characteristics: Of the 43 items, two demonstrating ceiling effects and 11 distorting ability estimates (DIF) were subsequently excluded. Item characteristics were assessed for the remaining 30 items, all of which demonstrated good discrimination and difficulty parameters. Knowledge was positively correlated with certainty about this knowledge. The final 30-item KOP-Q is a valid, psychometrically sound, comprehensive instrument that can be used to assess the knowledge of nursing students, hospital nurses, and nurse specialists in geriatrics regarding older hospitalized adults. It can identify knowledge and certainty deficits for research purposes or serve as a tool in educational or quality improvement programs. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

Diverse convergent evidence in the genetic analysis of complex disease: coordinating omic, informatic, and experimental evidence to better identify and validate risk factors

PubMed Central

2014-01-01

In omic research, such as genome wide association studies, researchers seek to repeat their results in other datasets to reduce false positive findings and thus provide evidence for the existence of true associations. Unfortunately this standard validation approach cannot completely eliminate false positive conclusions, and it can also mask many true associations that might otherwise advance our understanding of pathology. These issues beg the question: How can we increase the amount of knowledge gained from high throughput genetic data? To address this challenge, we present an approach that complements standard statistical validation methods by drawing attention to both potential false negative and false positive conclusions, as well as providing broad information for directing future research. The Diverse Convergent Evidence approach (DiCE) we propose integrates information from multiple sources (omics, informatics, and laboratory experiments) to estimate the strength of the available corroborating evidence supporting a given association. This process is designed to yield an evidence metric that has utility when etiologic heterogeneity, variable risk factor frequencies, and a variety of observational data imperfections might lead to false conclusions. We provide proof of principle examples in which DiCE identified strong evidence for associations that have established biological importance, when standard validation methods alone did not provide support. If used as an adjunct to standard validation methods this approach can leverage multiple distinct data types to improve genetic risk factor discovery/validation, promote effective science communication, and guide future research directions. PMID:25071867

Adolescent Populations Research Needs - NCS Dietary Assessment Literature Review

Cancer.gov

As with school age children, it is difficult to make conclusions about the validity of available dietary assessment instruments for adolescents because of the differences in instruments, research designs, reference methods, and populations in the validation literature.

The Impact of Environment and Occupation on the Health and Safety of Active Duty Air Force Members: Database Development and De-Identification.

PubMed

Erich, Roger; Eaton, Melinda; Mayes, Ryan; Pierce, Lamar; Knight, Andrew; Genovesi, Paul; Escobar, James; Mychalczuk, George; Selent, Monica

2016-08-01

Preparing data for medical research can be challenging, detail oriented, and time consuming. Transcription errors, missing or nonsensical data, and records not applicable to the study population may hamper progress and, if unaddressed, can lead to erroneous conclusions. In addition, study data may be housed in multiple disparate databases and complex formats. Merging methods may be incomplete to obtain temporally synchronized data elements. We created a comprehensive database to explore the general hypothesis that environmental and occupational factors influence health outcomes and risk-taking behavior among active duty Air Force personnel. Several databases containing demographics, medical records, health survey responses, and safety incident reports were cleaned, validated, and linked to form a comprehensive, relational database. The final step involved removing and transforming personally identifiable information to form a Health Insurance Portability and Accountability Act compliant limited database. Initial data consisted of over 62.8 million records containing 221 variables. When completed, approximately 23.9 million clean and valid records with 214 variables remained. With a clean, robust database, future analysis aims to identify high-risk career fields for targeted interventions or uncover potential protective factors in low-risk career fields. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

Gender differences in the association between the incidence of cutaneous melanoma and geographic UV exposure

PubMed Central

Liu-Smith, Feng; Farhat, Ahmed Majid; Arce, Anthony; Ziogas, Argyrios; Taylor, Thomas; Wang, Zi; Yourk, Vandy; Liu, Jing; Wu, Jun; McEligot, Archana J.; Anton-Culver, Hoda; Meyskens, Frank L.

2016-01-01

Background Cutaneous melanoma (CM) incidence rates continue to increase, and the reasons are unknown. Previously, we reported a unique age-specific gender difference in melanoma that suggested additional causes other than solar UV radiation. Objective This study attempted to understand whether and how UV radiation differentially impacts the CM incidence in men and women. Methods CM data and daily UV index (UVI) from 31 cancer registries were collected for association analysis. A second dataset from 42 states of the U.S.A. was used for validation. Results There was no association between log-transformed female CM rates and levels of UVI but there was a significant association between male rates and UVI and a significant association between overall rates and UVI. The 5 year age-specific rate-UVI association levels (represented by Pearson’s coefficient ρ) increased with age in men, but age-specific ρ levels remained low and unchanged in women. The significant rate-UVI association in men and non-association in women was validated in the US white population. Limitations Confounders including temperature and latitude are difficult to separate from UVI Conclusions: Ambient UVI appears to be associated with melanoma incidence in males but not in females. PMID:28413057

Cross-cultural psychometric assessment of the VAGUS insight into psychosis scale - Spanish version.

PubMed

de León, Patricia Ponce; Gerretsen, Philip; Shah, Parita; Saracco-Alvarez, Ricardo; Graff-Guerrero, Ariel; Fresán, Ana

2018-01-01

Impaired insight into illness, a core feature of schizophrenia with negative clinical implications, is a multidimensional phenomenon existing on a continuum. However, the degree to which illness perception in distinct cultures influences the appraisal of insight into illness in schizophrenia remains unclear. As such, we aimed to determine if the psychometric properties of the VAGUS insight into psychosis scale (www.vagusonline.com), which was originally assessed in English speaking Canadians, were similar in a sample of Latino Mexican Spanish speaking patients with schizophrenia. To accomplish this, the VAGUS - Self-Report (SR) version was translated from English to Spanish and psychometrically evaluated in 95 participants. The Spanish version of the VAGUS-SR was internally consistent (ᾳ = 0.713), and demonstrated good convergent and discriminant validity with the subscales of the Positive and Negative Syndrome Scale. Factor analysis identified two components of insight, congruent with two of the components of the English version of the VAGUS-SR. In conclusion, the VAGUS-SR is a brief, novel, and valid measure of insight into illness in schizophrenia, which demonstrated similar psychometric properties in two culturally and linguistically distinct samples with schizophrenia. Future studies should assess whether the VAGUS demonstrates similar psychometric properties in non-Western cultures. Copyright © 2017 Elsevier B.V. All rights reserved.

Pancreatitis Quality of Life Instrument: Development of a new instrument

PubMed Central

Bova, Carol; Barton, Bruce; Hartigan, Celia

2014-01-01

Objectives: The goal of this project was to develop the first disease-specific instrument for the evaluation of quality of life in chronic pancreatitis. Methods: Focus groups and interview sessions were conducted, with chronic pancreatitis patients, to identify items felt to impact quality of life which were subsequently formatted into a paper-and-pencil instrument. This instrument was used to conduct an online survey by an expert panel of pancreatologists to evaluate its content validity. Finally, the modified instrument was presented to patients during precognitive testing interviews to evaluate its clarity and appropriateness. Results: In total, 10 patients were enrolled in the focus groups and interview sessions where they identified 50 items. Once redundant items were removed, the 40 remaining items were made into a paper-and-pencil instrument referred to as the Pancreatitis Quality of Life Instrument. Through the processes of content validation and precognitive testing, the number of items in the instrument was reduced to 24. Conclusions: This marks the development of the first disease-specific instrument to evaluate quality of life in chronic pancreatitis. It includes unique features not found in generic instruments (economic factors, stigma, and spiritual factors). Although this marks a giant step forward, psychometric evaluation is still needed prior to its clinical use. PMID:26770703

Validity of Factors of the Psychopathy Checklist-Revised in Female Prisoners: Discriminant Relations with Antisocial Behavior, Substance Abuse, and Personality

ERIC Educational Resources Information Center

Kennealy, Patrick J.; Hicks, Brian M.; Patrick, Christopher J.

2007-01-01

The validity of the Psychopathy Checklist-Revised (PCL-R) has been examined extensively in men, but its validity for women remains understudied. Specifically, the correlates of the general construct of psychopathy and its components as assessed by PCL-R total, factor, and facet scores have yet to be examined in depth. Based on previous research…

Ada (Tradename) Compiler Validation Summary Report. Harris Corporation. HARRIS Ada Compiler, Version 1.0. Harris H1200 and H800.

DTIC Science & Technology

This Validations Summary Report (VSR) summarizes the results and conclusions of validation testing performed on the HARRIS Ada Compiler, Version 1.0...at compile time, at link time, or during execution. On-site testing was performed 28 APR 1986 through 30 APR 1986 at Harris Corporation, Ft. Lauderdale

Triglycerides as a biological marker of repeated re-hospitalization resulting from deliberate self-harm in acute psychiatry patients: a prospective observational study

PubMed Central

2014-01-01

Background Biological factors have been associated with deliberate self-harm (DSH) but have not been integrated with clinical factors in routine risk assessments. This study aimed to examine the incremental validity of lipid levels and platelet serotonin when combined with psychosocial factors in risk assessments for repeated admissions due to DSH. Methods In this prospective observational study of 196 acutely admitted patients, results of blood tests performed upon admission and the MINI Suicidal Scale and psychosocial DSH risk factor assessments performed at discharge were compared with the incidence of DSH recorded during the first 3 and 12 months after discharge. Results High triglyceride levels were found to be a significant marker for patients admitted 3 or more times due to DSH (repeated DSH, DSH-R) when tested against other significant risk factors. When all (9) significant univariate factors associated with 12-month post-discharge DSH-R were analyzed in a multivariate logistic regression, the MINI Suicidal Scale (p = 0.043), a lack of insight (p = 0.040), and triglyceride level (p = 0.020) remained significant. The estimated 12-month area under the curve of the receiver operator characteristic (ROC-AUC) for DSH-R was 0.74 for triglycerides, 0.81 for the MINI, 0.89 for the MINI + psychosocial factors, and 0.91 for the MINI + psychosocial factors + triglycerides. The applied multifaceted approach also significantly discriminated between 12-month post-discharge DSH-R patients and other DSH patients, and a lack of insight (p = 0.047) and triglycerides (p = 0.046) remained significant for DSH-R patients in a multivariate analysis in which other DSH patients served as the reference group (rather than non-DSH patients). Conclusion The triglyceride values provided incremental validity to the MINI Suicidal Scale and psychosocial risk factors in the assessment of the risk of repeated DSH. Therefore, a bio-psychosocial approach appears promising, but further research is necessary to refine and validate this method. PMID:24568671

Lessons Learned From Methodological Validation Research in E-Epidemiology

PubMed Central

Assmann, Karen; Andreeva, Valentina; Castetbon, Katia; Méjean, Caroline; Touvier, Mathilde; Salanave, Benoît; Deschamps, Valérie; Péneau, Sandrine; Fezeu, Léopold; Julia, Chantal; Allès, Benjamin; Galan, Pilar; Hercberg, Serge

2016-01-01

Background Traditional epidemiological research methods exhibit limitations leading to high logistics, human, and financial burden. The continued development of innovative digital tools has the potential to overcome many of the existing methodological issues. Nonetheless, Web-based studies remain relatively uncommon, partly due to persistent concerns about validity and generalizability. Objective The objective of this viewpoint is to summarize findings from methodological studies carried out in the NutriNet-Santé study, a French Web-based cohort study. Methods On the basis of the previous findings from the NutriNet-Santé e-cohort (>150,000 participants are currently included), we synthesized e-epidemiological knowledge on sample representativeness, advantageous recruitment strategies, and data quality. Results Overall, the reported findings support the usefulness of Web-based studies in overcoming common methodological deficiencies in epidemiological research, in particular with regard to data quality (eg, the concordance for body mass index [BMI] classification was 93%), reduced social desirability bias, and access to a wide range of participant profiles, including the hard-to-reach subgroups such as young (12.30% [15,118/122,912], <25 years) and old people (6.60% [8112/122,912], ≥65 years), unemployed or homemaker (12.60% [15,487/122,912]), and low educated (38.50% [47,312/122,912]) people. However, some selection bias remained (78.00% (95,871/122,912) of the participants were women, and 61.50% (75,590/122,912) had postsecondary education), which is an inherent aspect of cohort study inclusion; other specific types of bias may also have occurred. Conclusions Given the rapidly growing access to the Internet across social strata, the recruitment of participants with diverse socioeconomic profiles and health risk exposures was highly feasible. Continued efforts concerning the identification of specific biases in e-cohorts and the collection of comprehensive and valid data are still needed. This summary of methodological findings from the NutriNet-Santé cohort may help researchers in the development of the next generation of high-quality Web-based epidemiological studies. PMID:27756715

Design and validation of diffusion MRI models of white matter

NASA Astrophysics Data System (ADS)

Jelescu, Ileana O.; Budde, Matthew D.

2017-11-01

Diffusion MRI is arguably the method of choice for characterizing white matter microstructure in vivo. Over the typical duration of diffusion encoding, the displacement of water molecules is conveniently on a length scale similar to that of the underlying cellular structures. Moreover, water molecules in white matter are largely compartmentalized which enables biologically-inspired compartmental diffusion models to characterize and quantify the true biological microstructure. A plethora of white matter models have been proposed. However, overparameterization and mathematical fitting complications encourage the introduction of simplifying assumptions that vary between different approaches. These choices impact the quantitative estimation of model parameters with potential detriments to their biological accuracy and promised specificity. First, we review biophysical white matter models in use and recapitulate their underlying assumptions and realms of applicability. Second, we present up-to-date efforts to validate parameters estimated from biophysical models. Simulations and dedicated phantoms are useful in assessing the performance of models when the ground truth is known. However, the biggest challenge remains the validation of the “biological accuracy” of estimated parameters. Complementary techniques such as microscopy of fixed tissue specimens have facilitated direct comparisons of estimates of white matter fiber orientation and densities. However, validation of compartmental diffusivities remains challenging, and complementary MRI-based techniques such as alternative diffusion encodings, compartment-specific contrast agents and metabolites have been used to validate diffusion models. Finally, white matter injury and disease pose additional challenges to modeling, which are also discussed. This review aims to provide an overview of the current state of models and their validation and to stimulate further research in the field to solve the remaining open questions and converge towards consensus.

Design and validation of diffusion MRI models of white matter

PubMed Central

Jelescu, Ileana O.; Budde, Matthew D.

2018-01-01

Diffusion MRI is arguably the method of choice for characterizing white matter microstructure in vivo. Over the typical duration of diffusion encoding, the displacement of water molecules is conveniently on a length scale similar to that of the underlying cellular structures. Moreover, water molecules in white matter are largely compartmentalized which enables biologically-inspired compartmental diffusion models to characterize and quantify the true biological microstructure. A plethora of white matter models have been proposed. However, overparameterization and mathematical fitting complications encourage the introduction of simplifying assumptions that vary between different approaches. These choices impact the quantitative estimation of model parameters with potential detriments to their biological accuracy and promised specificity. First, we review biophysical white matter models in use and recapitulate their underlying assumptions and realms of applicability. Second, we present up-to-date efforts to validate parameters estimated from biophysical models. Simulations and dedicated phantoms are useful in assessing the performance of models when the ground truth is known. However, the biggest challenge remains the validation of the “biological accuracy” of estimated parameters. Complementary techniques such as microscopy of fixed tissue specimens have facilitated direct comparisons of estimates of white matter fiber orientation and densities. However, validation of compartmental diffusivities remains challenging, and complementary MRI-based techniques such as alternative diffusion encodings, compartment-specific contrast agents and metabolites have been used to validate diffusion models. Finally, white matter injury and disease pose additional challenges to modeling, which are also discussed. This review aims to provide an overview of the current state of models and their validation and to stimulate further research in the field to solve the remaining open questions and converge towards consensus. PMID:29755979

A systematic review of the psychometric properties of self-report research utilization measures used in healthcare

PubMed Central

2011-01-01

Background In healthcare, a gap exists between what is known from research and what is practiced. Understanding this gap depends upon our ability to robustly measure research utilization. Objectives The objectives of this systematic review were: to identify self-report measures of research utilization used in healthcare, and to assess the psychometric properties (acceptability, reliability, and validity) of these measures. Methods We conducted a systematic review of literature reporting use or development of self-report research utilization measures. Our search included: multiple databases, ancestry searches, and a hand search. Acceptability was assessed by examining time to complete the measure and missing data rates. Our approach to reliability and validity assessment followed that outlined in the Standards for Educational and Psychological Testing. Results Of 42,770 titles screened, 97 original studies (108 articles) were included in this review. The 97 studies reported on the use or development of 60 unique self-report research utilization measures. Seven of the measures were assessed in more than one study. Study samples consisted of healthcare providers (92 studies) and healthcare decision makers (5 studies). No studies reported data on acceptability of the measures. Reliability was reported in 32 (33%) of the studies, representing 13 of the 60 measures. Internal consistency (Cronbach's Alpha) reliability was reported in 31 studies; values exceeded 0.70 in 29 studies. Test-retest reliability was reported in 3 studies with Pearson's r coefficients > 0.80. No validity information was reported for 12 of the 60 measures. The remaining 48 measures were classified into a three-level validity hierarchy according to the number of validity sources reported in 50% or more of the studies using the measure. Level one measures (n = 6) reported evidence from any three (out of four possible) Standards validity sources (which, in the case of single item measures, was all applicable validity sources). Level two measures (n = 16) had evidence from any two validity sources, and level three measures (n = 26) from only one validity source. Conclusions This review reveals significant underdevelopment in the measurement of research utilization. Substantial methodological advances with respect to construct clarity, use of research utilization and related theory, use of measurement theory, and psychometric assessment are required. Also needed are improved reporting practices and the adoption of a more contemporary view of validity (i.e., the Standards) in future research utilization measurement studies. PMID:21794144

Induction Chemotherapy plus Concurrent Chemoradiotherapy in Endemic Nasopharyngeal Carcinoma: Individual Patient Data Pooled Analysis of Four Randomized Trials.

PubMed

Chen, Yu-Pei; Tang, Ling-Long; Yang, Qi; Poh, Sharon-Shuxian; Hui, Edwin P; Chan, Anthony T C; Ong, Whee-Sze; Tan, Terence; Wee, Joseph; Li, Wen-Fei; Chen, Lei; Ma, Brigette B Y; Tong, Macy; Tan, Sze-Huey; Cheah, Shie-Lee; Fong, Kam-Weng; Sommat, Kiattisa; Soong, Yoke Lim; Guo, Ying; Lin, Ai-Hua; Sun, Ying; Hong, Ming-Huang; Cao, Su-Mei; Chen, Ming-Yuan; Ma, Jun

2018-04-15

Purpose: Because of the uneven geographic distribution and small number of randomized trials available, the value of additional induction chemotherapy (IC) to concurrent chemoradiotherapy (CCRT) in nasopharyngeal carcinoma (NPC) remains controversial. This study performed an individual patient data (IPD) pooled analysis to better assess the precise role of IC + CCRT in locoregionally advanced NPC. Experimental Design: Four randomized trials in endemic areas were identified, representing 1,193 patients; updated IPD were obtained. Progression-free survival (PFS) and overall survival (OS) were the primary and secondary endpoints, respectively. Results: Median follow-up was 5.0 years. The HR for PFS was 0.70 [95% confidence interval (CI), 0.56-0.86; P = 0.0009; 9.3% absolute benefit at 5 years] in favor of IC + CCRT versus CCRT alone. IC + CCRT also improved OS (HR = 0.75; 95% CI, 0.57-0.99; P = 0.04) and reduced distant failure (HR = 0.68; 95% CI, 0.51-0.90; P = 0.008). IC + CCRT had a tendency to improve locoregional control compared with CCRT alone (HR = 0.70; 95% CI, 0.48-1.01; P = 0.06). There was no heterogeneity between trials in any analysis. No interactions between patient characteristics and treatment effects on PFS or OS were found. After adding two supplementary trials to provide a more comprehensive overview, the conclusions remained valid and were strengthened. In a supplementary Bayesian network analysis, no statistically significant differences in survival between different IC regimens were detected. Conclusions: This IPD pooled analysis demonstrates the superiority of additional IC over CCRT alone in locoregionally advanced NPC, with the survival benefit mainly associated with improved distant control. Clin Cancer Res; 24(8); 1824-33. ©2018 AACR . ©2018 American Association for Cancer Research.

Development of the SaFETy Score: A Clinical Screening Tool for Predicting Future Firearm Violence Risk

PubMed Central

Goldstick, Jason E.; Carter, Patrick M.; Walton, Maureen A.; Dahlberg, Linda L.; Sumner, Steven A.; Zimmerman, Marc A.; Cunningham, Rebecca M.

2017-01-01

Background Interpersonal firearm violence among youth is a substantial public health problem, and emergency department (ED) physicians require a clinical screening tool to identify high-risk youth. Objective To derive a clinically feasible risk index for firearm violence. Design 24-month prospective cohort study. Setting Urban, level 1 ED. Participants Substance-using youths, aged 14 to 24 years, seeking ED care for an assault-related injury and a proportionately sampled group of non–assault-injured youth enrolled from September 2009 through December 2011. Measurements Firearm violence (victimization/perpetration) and validated questionnaire items. Results A total of 599 youths were enrolled, and presence/absence of future firearm violence during follow-up could be ascertained in 483 (52.2% were positive). The sample was randomly split into training (75%) and post–score-construction validation (25%) sets. Using elastic-net penalized logistic regression, 118 baseline predictors were jointly analyzed; the most predictive variables fell predominantly into 4 domains: violence victimization, community exposure, peer influences, and fighting. By selection of 1 item from each domain, the 10-point SaFETy (Serious fighting, Friend weapon carrying, community Environment, and firearm Threats) score was derived. SaFETy was associated with firearm violence in the validation set (odds ratio [OR], 1.47 [95% CI, 1.23 to 1.79]); this association remained (OR, 1.44 [CI, 1.20 to 1.76]) after adjustment for reason for ED visit. In 5 risk strata observed in the training data, firearm violence rates in the validation set were 18.2% (2 of 11), 40.0% (18 of 45), 55.8% (24 of 43), 81.3% (13 of 16), and 100.0% (6 of 6), respectively. Limitations The study was conducted in a single ED and involved substance-using youths. SaFETy was not externally validated. Conclusion The SaFETy score is a 4-item score based on clinically feasible questionnaire items and is associated with firearm violence. Although broader validation is required, SaFETy shows potential to guide resource allocation for prevention of firearm violence. Primary Funding Source National Institute on Drug Abuse R01024646. PMID:28395357

An observational examination of the literature in diagnostic anatomic pathology.

PubMed

Foucar, Elliott; Wick, Mark R

2005-05-01

Original research published in the medical literature confronts the reader with three very basic and closely linked questions--are the authors' conclusions true in the contextual setting in which the work was performed (internally valid); if so, are the conclusions also applicable in other practice settings (externally valid); and, if the conclusions of the study are bona fide, do they represent an important contribution to medical practice or are they true-but-insignificant? Most publications attempt to convince readers that the researchers' conclusions are both internally valid and important, and occasionally papers also directly address external validity. Developing standardized methods to facilitate the prospective determination of research importance would be useful to both journals and their readers, but has proven difficult. In contrast, the evidence-based medicine (EBM) movement has had more success with understanding and codifying factors thought to promote research validity. Of the many variables that can influence research validity, research design is the one that has received the most attention. The present paper reviews the contributions of EBM to understanding research validity, looking for areas where EBM's body of knowledge is applicable to the anatomic pathology (AP) literature. As part of this project, the authors performed a pilot observational analysis of a representative sample of the current pertinent literature on diagnostic tissue pathology. The results of that review showed that most of the latter publications employ one of the four categories of "observational" research design that have been delineated by the EBM movement, and that the most common of these observational designs is a "cross-sectional" comparison. Pathologists do not presently use the "experimental" research designs so admired by advocates of EBM. Slightly > 50% of AP observational studies employed statistical evaluations to support their final conclusions. Comparison of the current AP literature with a selected group of papers published in 1977 shows a discernible change over that period that has affected not just technological procedures, but also research design and use of statistics. Although we feel that advocates of EBM deserve credit for bringing attention to the close link between research design and research validity, much of the EBM effort has centered on refining "experimental" methodology, and the complexities of observational research have often been treated in an inappropriately dismissive manner. For advocates of EBM, an observational study is what you are relegated to as a second choice when you are unable to do an experimental study. The latter viewpoint may be true for evaluating new chemotherapeutic agents, but is unacceptable to pathologists, whose research advances are currently completely dependent on well-conducted observational research. Rather than succumb to randomization envy and accept EBM's assertion that observational research is second best, the challenge to AP is to develop and adhere to standards for observational research that will allow our patients to benefit from the full potential of this time tested approach to developing valid insights into disease.

Logic, probability, and human reasoning.

PubMed

Johnson-Laird, P N; Khemlani, Sangeet S; Goodwin, Geoffrey P

2015-04-01

This review addresses the long-standing puzzle of how logic and probability fit together in human reasoning. Many cognitive scientists argue that conventional logic cannot underlie deductions, because it never requires valid conclusions to be withdrawn - not even if they are false; it treats conditional assertions implausibly; and it yields many vapid, although valid, conclusions. A new paradigm of probability logic allows conclusions to be withdrawn and treats conditionals more plausibly, although it does not address the problem of vapidity. The theory of mental models solves all of these problems. It explains how people reason about probabilities and postulates that the machinery for reasoning is itself probabilistic. Recent investigations accordingly suggest a way to integrate probability and deduction. Copyright © 2015 Elsevier Ltd. All rights reserved.

Association of mGFR of the Remaining Kidney Divided by Its Volume before Donation with Functional Gain in mGFR among Living Kidney Donors

PubMed Central

Gaillard, François; Tissier, Anne-Marie; Fournier, Catherine; Le Nestour, Alexis; Corréas, Jean-Michel; Slimani-Thevenet, Hind; Martinez, Frank; Léon, Carine; Eladari, Dominique; Timsit, Marc-Olivier; Otal, Philippe; Hignette, Chantal; Friedlander, Gérard; Méjean, Arnaud; Houillier, Pascal; Kamar, Nassim; Legendre, Christophe

2016-01-01

Background and objectives The predictors of long–term renal function in living kidney donors are currently discussed. Our objectives were to describe the predictors of functional gain of the remaining kidney after kidney donation. We hypothesized that GFR of the remaining kidney divided by volume of this kidney (rk-GFR/vol) would reflect the density of functional nephrons and be inversely associated with functional gain of the remaining kidney. Design, setting, participants, & measurements We conducted a prospective monocentric study including 63 living donors (26 men; 50.3±11.8 years old) who had been evaluated for 51Cr-EDTA and measured GFR, split renal function by scintigraphy before donation (between 2004 and 2009), and measured GFR at 5.7±0.5 years after donation. For 52 donors, volume of the remaining kidney (measured and estimated with the ellipsoid formula using renal computed tomography scannography) was determined before donation. We tested our hypothesis in an external validation cohort of 39 living donors (13 men; 51.0±9.4 years old) from another single center during the same time period. Results For the main cohort, the mean measured GFR was 97.6±13.0 ml/min per 1.73 m2 before donation and 63.8±9.4 ml/min per 1.73 m2 at 5 years. Functional gain averaged 16.2±7.2 ml/min per 1.73 m2 (+35.3%±16.7%). Multivariate analysis showed that age, body mass index, and rk-GFR/vol at donation were negatively correlated with functional gain and had strong predictive power of the 5-year functional gain (adjusted 5-year functional gain for age: −0.4 [95% confidence interval (95% CI), −0.5 to −0.1]; body mass index: −0.3 [95% CI, −0.6 to −0.1]; rk-GFR/vol: −55.1 [95% CI, −92.3 to −17.9]). We tested this model in the external validation cohort (adjusted 5-year functional gain for age: −0.1 [95% CI, −0.5 to 0.3]; body mass index: −0.9 [95% CI, −1.8 to −0.1]; rk-GFR/vol: −97.6 [95% CI, −137.5 to −57.6]) and confirmed that rk-GFR/vol was inversely associated with 5-year functional gain. Conclusions For given age and body mass index, the long–term functional gain of the remaining kidney is inversely associated with the new variable rk-GFR/vol at donation. PMID:27189317

The Validity of Conscientiousness Is Overestimated in the Prediction of Job Performance.

PubMed

Kepes, Sven; McDaniel, Michael A

2015-01-01

Sensitivity analyses refer to investigations of the degree to which the results of a meta-analysis remain stable when conditions of the data or the analysis change. To the extent that results remain stable, one can refer to them as robust. Sensitivity analyses are rarely conducted in the organizational science literature. Despite conscientiousness being a valued predictor in employment selection, sensitivity analyses have not been conducted with respect to meta-analytic estimates of the correlation (i.e., validity) between conscientiousness and job performance. To address this deficiency, we reanalyzed the largest collection of conscientiousness validity data in the personnel selection literature and conducted a variety of sensitivity analyses. Publication bias analyses demonstrated that the validity of conscientiousness is moderately overestimated (by around 30%; a correlation difference of about .06). The misestimation of the validity appears to be due primarily to suppression of small effects sizes in the journal literature. These inflated validity estimates result in an overestimate of the dollar utility of personnel selection by millions of dollars and should be of considerable concern for organizations. The fields of management and applied psychology seldom conduct sensitivity analyses. Through the use of sensitivity analyses, this paper documents that the existing literature overestimates the validity of conscientiousness in the prediction of job performance. Our data show that effect sizes from journal articles are largely responsible for this overestimation.

Recommendations of the VAC2VAC workshop on the design of multi-centre validation studies.

PubMed

Halder, Marlies; Depraetere, Hilde; Delannois, Frédérique; Akkermans, Arnoud; Behr-Gross, Marie-Emmanuelle; Bruysters, Martijn; Dierick, Jean-François; Jungbäck, Carmen; Kross, Imke; Metz, Bernard; Pennings, Jeroen; Rigsby, Peter; Riou, Patrice; Balks, Elisabeth; Dobly, Alexandre; Leroy, Odile; Stirling, Catrina

2018-03-01

Within the Innovative Medicines Initiative 2 (IMI 2) project VAC2VAC (Vaccine batch to vaccine batch comparison by consistency testing), a workshop has been organised to discuss ways of improving the design of multi-centre validation studies and use the data generated for product-specific validation purposes. Moreover, aspects of validation within the consistency approach context were addressed. This report summarises the discussions and outlines the conclusions and recommendations agreed on by the workshop participants. Copyright © 2018.

Alzheimer's Disease Diagnosis in Individual Subjects using Structural MR Images: Validation Studies

PubMed Central

Vemuri, Prashanthi; Gunter, Jeffrey L.; Senjem, Matthew L.; Whitwell, Jennifer L.; Kantarci, Kejal; Knopman, David S.; Boeve, Bradley F.; Petersen, Ronald C.; Jack, Clifford R.

2008-01-01

OBJECTIVE To develop and validate a tool for Alzheimer's disease (AD) diagnosis in individual subjects using support vector machine (SVM) based classification of structural MR (sMR) images. BACKGROUND Libraries of sMR scans of clinically well characterized subjects can be harnessed for the purpose of diagnosing new incoming subjects. METHODS 190 patients with probable AD were age- and gender-matched with 190 cognitively normal (CN) subjects. Three different classification models were implemented: Model I uses tissue densities obtained from sMR scans to give STructural Abnormality iNDex (STAND)-score; and Models II and III use tissue densities as well as covariates (demographics and Apolipoprotein E genotype) to give adjusted-STAND (aSTAND)-score. Data from 140 AD and 140 CN were used for training. The SVM parameter optimization and training was done by four-fold cross validation. The remaining independent sample of 50 AD and 50 CN were used to obtain a minimally biased estimate of the generalization error of the algorithm. RESULTS The CV accuracy of Model II and Model III aSTAND-scores was 88.5% and 89.3% respectively and the developed models generalized well on the independent test datasets. Anatomic patterns best differentiating the groups were consistent with the known distribution of neurofibrillary AD pathology. CONCLUSIONS This paper presents preliminary evidence that application of SVM-based classification of an individual sMR scan relative to a library of scans can provide useful information in individual subjects for diagnosis of AD. Including demographic and genetic information in the classification algorithm slightly improves diagnostic accuracy. PMID:18054253

Validation of Essential Acoustic Parameters for Highly Urgent In-Vehicle Collision Warnings.

PubMed

Lewis, Bridget A; Eisert, Jesse L; Baldwin, Carryl L

2018-03-01

Objective The aim of this study was to validate the importance of key acoustic criteria for use as in-vehicle forward collision warning (FCW) systems. Background Despite recent advances in vehicle safety, automobile crashes remain one of the leading causes of death. As automation allows for more control of noncritical functions by the vehicle, the potential for disengagement and distraction from the driving task also increases. It is, therefore, as important as ever that in-vehicle safety-critical interfaces are intuitive and unambiguous, promoting effective collision avoidance responses upon first exposure even under divided-attention conditions. Method The current study used a driving simulator to assess the effectiveness of two warnings, one that met all essential acoustic parameters, one that met only some essential parameters, and a no-warning control in the context of a lead vehicle-following task in conjunction with a cognitive distractor task and collision event. Results Participants receiving an FCW comprising five essential acoustic components had improved collision avoidance responses relative to a no-warning condition and an FCW missing essential elements on their first exposure. Responses to a consistently good warning (GMU Prime) improved with subsequent exposures, whereas continued exposure to the less optimal FCW (GMU Sub-Prime) resulted in poorer performance even relative to receiving no warning at all. Conclusions This study provides support for previous warning design studies and for the validity of five key acoustic parameters essential for the design of effective in-vehicle FCWs. Application Results from this study have implications for the design of auditory FCWs and in-vehicle display design.

Validity of a Manual Soft Tissue Profile Prediction Method Following Mandibular Setback Osteotomy

PubMed Central

Kolokitha, Olga-Elpis

2007-01-01

Objectives The aim of this study was to determine the validity of a manual cephalometric method used for predicting the post-operative soft tissue profiles of patients who underwent mandibular setback surgery and compare it to a computerized cephalometric prediction method (Dentofacial Planner). Lateral cephalograms of 18 adults with mandibular prognathism taken at the end of pre-surgical orthodontics and approximately one year after surgery were used. Methods To test the validity of the manual method the prediction tracings were compared to the actual post-operative tracings. The Dentofacial Planner software was used to develop the computerized post-surgical prediction tracings. Both manual and computerized prediction printouts were analyzed by using the cephalometric system PORDIOS. Statistical analysis was performed by means of t-test. Results Comparison between manual prediction tracings and the actual post-operative profile showed that the manual method results in more convex soft tissue profiles; the upper lip was found in a more prominent position, upper lip thickness was increased and, the mandible and lower lip were found in a less posterior position than that of the actual profiles. Comparison between computerized and manual prediction methods showed that in the manual method upper lip thickness was increased, the upper lip was found in a more anterior position and the lower anterior facial height was increased as compared to the computerized prediction method. Conclusions Cephalometric simulation of post-operative soft tissue profile following orthodontic-surgical management of mandibular prognathism imposes certain limitations related to the methods implied. However, both manual and computerized prediction methods remain a useful tool for patient communication. PMID:19212468

Bridging the gap between computation and clinical biology: validation of cable theory in humans

PubMed Central

Finlay, Malcolm C.; Xu, Lei; Taggart, Peter; Hanson, Ben; Lambiase, Pier D.

2013-01-01

Introduction: Computerized simulations of cardiac activity have significantly contributed to our understanding of cardiac electrophysiology, but techniques of simulations based on patient-acquired data remain in their infancy. We sought to integrate data acquired from human electrophysiological studies into patient-specific models, and validated this approach by testing whether electrophysiological responses to sequential premature stimuli could be predicted in a quantitatively accurate manner. Methods: Eleven patients with structurally normal hearts underwent electrophysiological studies. Semi-automated analysis was used to reconstruct activation and repolarization dynamics for each electrode. This S2 extrastimuli data was used to inform individualized models of cardiac conduction, including a novel derivation of conduction velocity restitution. Activation dynamics of multiple premature extrastimuli were then predicted from this model and compared against measured patient data as well as data derived from the ten-Tusscher cell-ionic model. Results: Activation dynamics following a premature S3 were significantly different from those after an S2. Patient specific models demonstrated accurate prediction of the S3 activation wave, (Pearson's R2 = 0.90, median error 4%). Examination of the modeled conduction dynamics allowed inferences into the spatial dispersion of activation delay. Further validation was performed against data from the ten-Tusscher cell-ionic model, with our model accurately recapitulating predictions of repolarization times (R2 = 0.99). Conclusions: Simulations based on clinically acquired data can be used to successfully predict complex activation patterns following sequential extrastimuli. Such modeling techniques may be useful as a method of incorporation of clinical data into predictive models. PMID:24027527

Substance Use Stigma: Reliability and validity of a theory-based scale for substance-using populations*

PubMed Central

Smith, Laramie R.; Earnshaw, Valerie A.; Copenhaver, Michael M.; Cunningham, Chinazo O.

2016-01-01

Background Substance use disorders consistently rank among the most stigmatized conditions worldwide. Thus, substance use stigma fosters health inequities among persons with substance use disorders and remains a key barrier to successful screening and treatment efforts. Current efforts to measure substance use stigma are limited. This study aims to advance measurement efforts by drawing on stigma theory to develop and evaluate the Substance Use Stigma Mechanisms Scale (SU-SMS). The SU-SMS was designed to capture enacted, anticipated, and internalized substance use stigma mechanisms among persons with current and past substance use disorders, and distinguish between key stigma sources most likely to impact this target population. Methods This study was a cross-sectional evaluation of the validity, reliability, and generalizability of the SU-SMS across two independent samples with diverse substance use and treatment histories. Results Findings support the structural and construct validity of the SU-SMS, suggesting the scale was able to capture enacted, anticipated, and internalized stigma as distinct stigma experiences. It also further differentiated between two distinct stigma sources (family and healthcare providers). Analysis of these mechanisms and psychosocial metrics suggests that the scale is also associated with other health-related outcomes. Furthermore, the SU-SMS demonstrated high levels of internal reliability and generalizability across two independent samples of persons with diverse substance use disorders and treatment histories. Conclusion The SU-SMS may serve as a valuable tool for better understanding the processes through which substance use stigma serves to undermine key health behaviors and outcomes among persons with substance use disorders. PMID:26972790

Assessment of published models and prognostic variables in epithelial ovarian cancer at Mayo Clinic

PubMed Central

Hendrickson, Andrea Wahner; Hawthorne, Kieran M.; Goode, Ellen L.; Kalli, Kimberly R.; Goergen, Krista M.; Bakkum-Gamez, Jamie N.; Cliby, William A.; Keeney, Gary L.; Visscher, Dan W.; Tarabishy, Yaman; Oberg, Ann L.; Hartmann, Lynn C.; Maurer, Matthew J.

2015-01-01

Objectives Epithelial ovarian cancer (EOC) is an aggressive disease in which first line therapy consists of a surgical staging/debulking procedure and platinum based chemotherapy. There is significant interest in clinically applicable, easy to use prognostic tools to estimate risk of recurrence and overall survival. In this study we used a large prospectively collected cohort of women with EOC to validate currently published models and assess prognostic variables. Methods Women with invasive ovarian, peritoneal, or fallopian tube cancer diagnosed between 2000-2011 and prospectively enrolled into the Mayo Clinic Ovarian Cancer registry were identified. Demographics and known prognostic markers as well as epidemiologic exposure variables were abstracted from the medical record and collected via questionnaire. Six previously published models of overall and recurrence-free survival were assessed for external validity. In addition, predictors of outcome were assessed in our dataset. Results Previously published models validated with a range of c-statistics (0.587-0.827), though application of models containing variables not part of routine practice were somewhat limited by missing data; utilization of all applicable models and comparison of results is suggested. Examination of prognostic variables identified only the presence of ascites and ASA score to be independent predictors of prognosis in our dataset, albeit with marginal gain in prognostic information, after accounting for stage and debulking. Conclusions Existing prognostic models for newly diagnosed EOC showed acceptable calibration in our cohort for clinical application. However, modeling of prospective variables in our dataset reiterates that stage and debulking remain the most important predictors of prognosis in this setting. PMID:25620544

Application of Koopmans' theorem for density functional theory to full valence-band photoemission spectroscopy modeling.

PubMed

Li, Tsung-Lung; Lu, Wen-Cai

2015-10-05

In this work, Koopmans' theorem for Kohn-Sham density functional theory (KS-DFT) is applied to the photoemission spectra (PES) modeling over the entire valence-band. To examine the validity of this application, a PES modeling scheme is developed to facilitate a full valence-band comparison of theoretical PES spectra with experiments. The PES model incorporates the variations of electron ionization cross-sections over atomic orbitals and a linear dispersion of spectral broadening widths. KS-DFT simulations of pristine rubrene (5,6,11,12-tetraphenyltetracene) and potassium-rubrene complex are performed, and the simulation results are used as the input to the PES models. Two conclusions are reached. First, decompositions of the theoretical total spectra show that the dissociated electron of the potassium mainly remains on the backbone and has little effect on the electronic structures of phenyl side groups. This and other electronic-structure results deduced from the spectral decompositions have been qualitatively obtained with the anionic approximation to potassium-rubrene complexes. The qualitative validity of the anionic approximation is thus verified. Second, comparison of the theoretical PES with the experiments shows that the full-scale simulations combined with the PES modeling methods greatly enhance the agreement on spectral shapes over the anionic approximation. This agreement of the theoretical PES spectra with the experiments over the full valence-band can be regarded, to some extent, as a collective validation of the application of Koopmans' theorem for KS-DFT to valence-band PES, at least, for this hydrocarbon and its alkali-adsorbed complex. Copyright © 2015 Elsevier B.V. All rights reserved.

Measuring Patient Mobility in the ICU Using a Novel Noninvasive Sensor

PubMed Central

Ma, Andy J.; Rawat, Nishi; Reiter, Austin; Shrock, Christine; Zhan, Andong; Stone, Alex; Rabiee, Anahita; Griffin, Stephanie; Needham, Dale M.; Saria, Suchi

2017-01-01

Objectives To develop and validate a noninvasive mobility sensor to automatically and continuously detect and measure patient mobility in the ICU. Design Prospective, observational study. Setting Surgical ICU at an academic hospital. Patients Three hundred sixty-two hours of sensor color and depth image data were recorded and curated into 109 segments, each containing 1,000 images, from eight patients. Interventions None. Measurements and Main Results Three Microsoft Kinect sensors (Microsoft, Beijing, China) were deployed in one ICU room to collect continuous patient mobility data. We developed software that automatically analyzes the sensor data to measure mobility and assign the highest level within a time period. To characterize the highest mobility level, a validated 11-point mobility scale was collapsed into four categories: nothing in bed, in-bed activity, out-of-bed activity, and walking. Of the 109 sensor segments, the noninvasive mobility sensor was developed using 26 of these from three ICU patients and validated on 83 remaining segments from five different patients. Three physicians annotated each segment for the highest mobility level. The weighted Kappa (κ) statistic for agreement between automated noninvasive mobility sensor output versus manual physician annotation was 0.86 (95% CI, 0.72–1.00). Disagreement primarily occurred in the “nothing in bed” versus “in-bed activity” categories because “the sensor assessed movement continuously,” which was significantly more sensitive to motion than physician annotations using a discrete manual scale. Conclusions Noninvasive mobility sensor is a novel and feasible method for automating evaluation of ICU patient mobility. PMID:28291092

Patient-Reported Measures of Narcolepsy: The Need for Better Assessment

PubMed Central

Kallweit, Ulf; Schmidt, Markus; Bassetti, Claudio L.

2017-01-01

Study Objectives: Narcolepsy, a chronic disorder of the central nervous system, is clinically characterized by a symptom pentad that includes excessive daytime sleepiness, cataplexy, sleep paralysis, hypnopompic/hypnagogic hallucinations, and disrupted nighttime sleep. Ideally, screening and diagnosis instruments that assist physicians in evaluating a patient for type 1 or type 2 narcolepsy would be brief, easy for patients to understand and physicians to score, and would identify or rule out the need for electrophysiological testing. Methods: A search of the literature was conducted to review patient-reported measures used for the assessment of narcolepsy, mainly in clinical trials, with the goal of summarizing existing scales and identifying areas that may require additional screening questions and clinical practice scales. Results: Of the seven scales reviewed, the Epworth Sleepiness Scale continues to be an important outcome measure to screen adults for excessive daytime sleepiness, which may be associated with narcolepsy. Several narcolepsy-specific scales have demonstrated utility, such as the Ullanlinna Narcolepsy Scale, Swiss Narcolepsy Scale, and Narcolepsy Symptom Assessment Questionnaire, but further validation is required. Conclusions: Although the narcolepsy-specific scales currently in use may identify type 1 narcolepsy, there are no validated questionnaires to identify type 2 narcolepsy. Thus, there remains a need for short, easily understood, and well-validated instruments that can be readily used in clinical practice to distinguish narcolepsy subtypes, as well as other hypersomnias, and for assessing symptoms of these conditions during treatment. Citation: Kallweit U, Schmidt M, Bassetti CL. Patient-reported measures of narcolepsy: the need for better assessment. J Clin Sleep Med. 2017;13(5):737–744. PMID:28162143

A Validation Study of the "School Leader Dispositions Inventory"[C

ERIC Educational Resources Information Center

Melton, Teri Denlea; Tysinger, Dawn; Mallory, Barbara; Green, James

2011-01-01

Although university-based school administrator preparation programs are required by accreditation agencies to assess the dispositions of candidates, valid and reliable methods for doing so remain scarce. "The School Leaders Disposition Inventory"[C] (SDLI) is proposed as an instrument that has promise for identifying leadership…

Anxiety measures validated in perinatal populations: a systematic review.

PubMed

Meades, Rose; Ayers, Susan

2011-09-01

Research and screening of anxiety in the perinatal period is hampered by a lack of psychometric data on self-report anxiety measures used in perinatal populations. This paper aimed to review self-report measures that have been validated with perinatal women. A systematic search was carried out of four electronic databases. Additional papers were obtained through searching identified articles. Thirty studies were identified that reported validation of an anxiety measure with perinatal women. Most commonly validated self-report measures were the General Health Questionnaire (GHQ), State-Trait Anxiety Inventory (STAI), and Hospital Anxiety and Depression Scales (HADS). Of the 30 studies included, 11 used a clinical interview to provide criterion validity. Remaining studies reported one or more other forms of validity (factorial, discriminant, concurrent and predictive) or reliability. The STAI shows criterion, discriminant and predictive validity and may be most useful for research purposes as a specific measure of anxiety. The Kessler 10 (K-10) may be the best short screening measure due to its ability to differentiate anxiety disorders. The Depression Anxiety Stress Scales 21 (DASS-21) measures multiple types of distress, shows appropriate content, and remains to be validated against clinical interview in perinatal populations. Nineteen studies did not report sensitivity or specificity data. The early stages of research into perinatal anxiety, the multitude of measures in use, and methodological differences restrict comparison of measures across studies. There is a need for further validation of self-report measures of anxiety in the perinatal period to enable accurate screening and detection of anxiety symptoms and disorders. Copyright © 2010 Elsevier B.V. All rights reserved.

Use of Canonical Analysis in Cropley's "A Five-Year Longitudinal Study of the Validity of Creativity Tests"

ERIC Educational Resources Information Center

Jordan, Lawrence A.

1975-01-01

Calls attention to several errors in a recent application of canonical correlation analysis. The reanalysis contradicts Cropley's conclusion that "creativity tests can be said to possess reasonable and encouraging long-range predictive validity." (Author/SDH)

Are BTK and PLCG2 mutations necessary and sufficient for ibrutinib resistance in chronic lymphocytic leukemia?

PubMed

Lampson, Benjamin L; Brown, Jennifer R

2018-03-01

Ibrutinib is the first BTK inhibitor to show efficacy in chronic lymphocytic leukemia (CLL) and is also the first BTK inhibitor to which patients have developed resistance. Mutations in BTK and PLCG2 are found in ≈80% of CLL patients with acquired resistance to ibrutinib, but it remains unclear if these mutations are merely associated with disease relapse or directly cause it. Areas covered: Unique properties of both CLL and ibrutinib that complicate attempts to definitively conclude whether BTK/PLCG2 mutations are passengers or drivers of ibrutinib-resistant disease are reviewed. Characteristics of mutations that drive drug resistance are summarized and whether BTK/PLCG2 mutations possess these is discussed. These characteristics include (1) identification in multiple patients with acquired resistance, (2) in vitro validation of drug-resistant properties, (3) mutual exclusivity with one another, (4) increasing frequency over time on drug, and (5) high frequency at the time and site of clinical relapse. Expert commentary: While BTK/PLCG2 mutations have characteristics suggesting that they can drive ibrutinib resistance, this conclusion remains formally unproven until specific inhibition of such mutations is shown to cause regression of ibrutinib-resistant CLL. Data suggest that alternative mechanisms of resistance do exist in some patients.

Canine osteosarcoma cell lines contain stem-like cancer cells: biological and pharmacological characterization.

PubMed

Gatti, Monica; Wurth, Roberto; Vito, Guendalina; Pattarozzi, Alessandra; Campanella, Chiara; Thellung, Stefano; Maniscalco, Lorella; De Maria, Raffaella; Villa, Valentina; Corsaro, Alessandro; Nizzari, Mario; Bajetto, Adriana; Ratto, Alessandra; Ferrari, Angelo; Barbieri, Federica; Florio, Tullio

2016-05-01

Cancer stem cells (CSCs) represent a small subpopulation of cells responsible for tumor formation and progression, drug resistance, tumor recurrence and metastasization. CSCs have been identified in many human tumors including osteosarcoma (OSA). CSC distinctive properties are the expression of stem cell markers, sustained growth, self-renewal and tumorigenicity. Here we report the isolation of stem-like cells from two canine OSA cultures, characterized by self-renewal, evaluated by sphere formation ability, differential marker expression, and in vitro proliferation when cultured in a medium containing EGF and bFGF. Current therapies for OSA increased survival time, but prognosis remains poor, due to the development of drug resistance and metastases. Chemotherapy shrinks the tumor mass but CSCs remain unaffected, leading to tumor recurrence. Metformin, a drug for type 2 diabetes, has been shown to possess antitumor properties affecting CSC survival in different human and animal cancers. Here we show that metformin has a significant antiproliferative effect on canine OSA stem-like cells, validating this in vitro model for further pre-clinical drug evaluations. In conclusion, our results demonstrate the feasibility of obtaining CSC-enriched cultures from primary canine OSA cells as a promising model for biological and pharmacological studies of canine and human OSAs.

Review of the Reported Measures of Clinical Validity and Clinical Utility as Arguments for the Implementation of Pharmacogenetic Testing: A Case Study of Statin-Induced Muscle Toxicity.

PubMed

Jansen, Marleen E; Rigter, T; Rodenburg, W; Fleur, T M C; Houwink, E J F; Weda, M; Cornel, Martina C

2017-01-01

Advances from pharmacogenetics (PGx) have not been implemented into health care to the expected extent. One gap that will be addressed in this study is a lack of reporting on clinical validity and clinical utility of PGx-tests. A systematic review of current reporting in scientific literature was conducted on publications addressing PGx in the context of statins and muscle toxicity. Eighty-nine publications were included and information was selected on reported measures of effect, arguments, and accompanying conclusions. Most authors report associations to quantify the relationship between a genetic variation an outcome, such as adverse drug responses. Conclusions on the implementation of a PGx-test are generally based on these associations, without explicit mention of other measures relevant to evaluate the test's clinical validity and clinical utility. To gain insight in the clinical impact and select useful tests, additional outcomes are needed to estimate the clinical validity and utility, such as cost-effectiveness.

Validation of Statistical Sampling Algorithms in Visual Sample Plan (VSP): Summary Report

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

Nuffer, Lisa L; Sego, Landon H.; Wilson, John E.

2009-02-18

The U.S. Department of Homeland Security, Office of Technology Development (OTD) contracted with a set of U.S. Department of Energy national laboratories, including the Pacific Northwest National Laboratory (PNNL), to write a Remediation Guidance for Major Airports After a Chemical Attack. The report identifies key activities and issues that should be considered by a typical major airport following an incident involving release of a toxic chemical agent. Four experimental tasks were identified that would require further research in order to supplement the Remediation Guidance. One of the tasks, Task 4, OTD Chemical Remediation Statistical Sampling Design Validation, dealt with statisticalmore » sampling algorithm validation. This report documents the results of the sampling design validation conducted for Task 4. In 2005, the Government Accountability Office (GAO) performed a review of the past U.S. responses to Anthrax terrorist cases. Part of the motivation for this PNNL report was a major GAO finding that there was a lack of validated sampling strategies in the U.S. response to Anthrax cases. The report (GAO 2005) recommended that probability-based methods be used for sampling design in order to address confidence in the results, particularly when all sample results showed no remaining contamination. The GAO also expressed a desire that the methods be validated, which is the main purpose of this PNNL report. The objective of this study was to validate probability-based statistical sampling designs and the algorithms pertinent to within-building sampling that allow the user to prescribe or evaluate confidence levels of conclusions based on data collected as guided by the statistical sampling designs. Specifically, the designs found in the Visual Sample Plan (VSP) software were evaluated. VSP was used to calculate the number of samples and the sample location for a variety of sampling plans applied to an actual release site. Most of the sampling designs validated are probability based, meaning samples are located randomly (or on a randomly placed grid) so no bias enters into the placement of samples, and the number of samples is calculated such that IF the amount and spatial extent of contamination exceeds levels of concern, at least one of the samples would be taken from a contaminated area, at least X% of the time. Hence, "validation" of the statistical sampling algorithms is defined herein to mean ensuring that the "X%" (confidence) is actually met.« less

The Measurement of Negative Creativity: Metrics and Relationships

ERIC Educational Resources Information Center

Kapoor, Hansika; Khan, Azizuddin

2016-01-01

Although the dark side of creativity and negative creativity are shaping into legitimate subconstructs, measures to assess the same remain to be validated. To meet this goal, two studies assessed the convergent, predictive, and criterion-related validities of two valence-inclusive creativity measures. One measure assessed the self-report…

Empirical Refinements of a Molecular Genetics Learning Progression: The Molecular Constructs

ERIC Educational Resources Information Center

Todd, Amber; Kenyon, Lisa

2016-01-01

This article describes revisions to four of the eight constructs of the Duncan molecular genetics learning progression [Duncan, Rogat, & Yarden, (2009)]. As learning progressions remain hypothetical models until validated by multiple rounds of empirical studies, these revisions are an important step toward validating the progression. Our…

Predicting Intent to Get a College Degree.

ERIC Educational Resources Information Center

Staats, Sara; Partlo, Christie

1990-01-01

Examined reliability and validity of Perceived Quality of Academic Life (PQAL) instrument with data collected from 218 midwestern commuter college students. Extended existing research by studying PQAL scores as predictors of intent to remain in college. Findings showed that the PQAL was reliable, valid, and predictive of future intent to obtain a…

The Predictive Validity of Dynamic Assessment: A Review

ERIC Educational Resources Information Center

Caffrey, Erin; Fuchs, Douglas; Fuchs, Lynn S.

2008-01-01

The authors report on a mixed-methods review of 24 studies that explores the predictive validity of dynamic assessment (DA). For 15 of the studies, they conducted quantitative analyses using Pearson's correlation coefficients. They descriptively examined the remaining studies to determine if their results were consistent with findings from the…

Systematic review and meta-analyses of randomized controlled trials examining tinnitus management

PubMed Central

Hoare, Derek J; Kowalkowski, Victoria L; Kang, Sujin; Hall, Deborah A

2011-01-01

Objectives/Hypothesis To evaluate the existing level of evidence for tinnitus management strategies identified in the UK Department of Health's Good Practice Guideline. Study Design Systematic review of peer-reviewed literature and meta-analyses. Methods Searches were conducted in PubMed, Cambridge Scientific Abstracts, Web of Science, and EMBASE (earliest to August 2010), supplemented by hand searches in October 2010. Only randomized controlled trials that used validated questionnaire measures of symptoms (i.e., measures of tinnitus distress, anxiety, depression) were included. Results Twenty-eight randomized controlled trials met our inclusion criteria, most of which provide moderate levels of evidence for the effects they reported. Levels of evidence were generally limited by the lack of blinding, lack of power calculations, and incomplete data reporting in these studies. Only studies examining cognitive behavioral therapy were numerous and similar enough to perform meta-analysis, from which the efficacy of cognitive behavioral therapy (moderate effect size) appears to be reasonably established. Antidepressants were the only drug class to show any evidence of potential benefit. Conclusions The efficacy of most interventions for tinnitus benefit remains to be demonstrated conclusively. In particular, high-level assessment of the benefit derived from those interventions most commonly used in practice, namely hearing aids, maskers, and tinnitus retraining therapy needs to be performed. PMID:21671234

Discovery and validation of cell cycle arrest biomarkers in human acute kidney injury

PubMed Central

2013-01-01

Introduction Acute kidney injury (AKI) can evolve quickly and clinical measures of function often fail to detect AKI at a time when interventions are likely to provide benefit. Identifying early markers of kidney damage has been difficult due to the complex nature of human AKI, in which multiple etiologies exist. The objective of this study was to identify and validate novel biomarkers of AKI. Methods We performed two multicenter observational studies in critically ill patients at risk for AKI - discovery and validation. The top two markers from discovery were validated in a second study (Sapphire) and compared to a number of previously described biomarkers. In the discovery phase, we enrolled 522 adults in three distinct cohorts including patients with sepsis, shock, major surgery, and trauma and examined over 300 markers. In the Sapphire validation study, we enrolled 744 adult subjects with critical illness and without evidence of AKI at enrollment; the final analysis cohort was a heterogeneous sample of 728 critically ill patients. The primary endpoint was moderate to severe AKI (KDIGO stage 2 to 3) within 12 hours of sample collection. Results Moderate to severe AKI occurred in 14% of Sapphire subjects. The two top biomarkers from discovery were validated. Urine insulin-like growth factor-binding protein 7 (IGFBP7) and tissue inhibitor of metalloproteinases-2 (TIMP-2), both inducers of G1 cell cycle arrest, a key mechanism implicated in AKI, together demonstrated an AUC of 0.80 (0.76 and 0.79 alone). Urine [TIMP-2]·[IGFBP7] was significantly superior to all previously described markers of AKI (P <0.002), none of which achieved an AUC >0.72. Furthermore, [TIMP-2]·[IGFBP7] significantly improved risk stratification when added to a nine-variable clinical model when analyzed using Cox proportional hazards model, generalized estimating equation, integrated discrimination improvement or net reclassification improvement. Finally, in sensitivity analyses [TIMP-2]·[IGFBP7] remained significant and superior to all other markers regardless of changes in reference creatinine method. Conclusions Two novel markers for AKI have been identified and validated in independent multicenter cohorts. Both markers are superior to existing markers, provide additional information over clinical variables and add mechanistic insight into AKI. Trial registration ClinicalTrials.gov number NCT01209169. PMID:23388612

Validation of learning assessments: A primer.

PubMed

Peeters, Michael J; Martin, Beth A

2017-09-01

The Accreditation Council for Pharmacy Education's Standards 2016 has placed greater emphasis on validating educational assessments. In this paper, we describe validity, reliability, and validation principles, drawing attention to the conceptual change that highlights one validity with multiple evidence sources; to this end, we recommend abandoning historical (confusing) terminology associated with the term validity. Further, we describe and apply Kane's framework (scoring, generalization, extrapolation, and implications) for the process of validation, with its inferences and conclusions from varied uses of assessment instruments by different colleges and schools of pharmacy. We then offer five practical recommendations that can improve reporting of validation evidence in pharmacy education literature. We describe application of these recommendations, including examples of validation evidence in the context of pharmacy education. After reading this article, the reader should be able to understand the current concept of validation, and use a framework as they validate and communicate their own institution's learning assessments. Copyright © 2017 Elsevier Inc. All rights reserved.

Bibliometrics for Social Validation.

PubMed

Hicks, Daniel J

2016-01-01

This paper introduces a bibliometric, citation network-based method for assessing the social validation of novel research, and applies this method to the development of high-throughput toxicology research at the US Environmental Protection Agency. Social validation refers to the acceptance of novel research methods by a relevant scientific community; it is formally independent of the technical validation of methods, and is frequently studied in history, philosophy, and social studies of science using qualitative methods. The quantitative methods introduced here find that high-throughput toxicology methods are spread throughout a large and well-connected research community, which suggests high social validation. Further assessment of social validation involving mixed qualitative and quantitative methods are discussed in the conclusion.

Bibliometrics for Social Validation

PubMed Central

2016-01-01

This paper introduces a bibliometric, citation network-based method for assessing the social validation of novel research, and applies this method to the development of high-throughput toxicology research at the US Environmental Protection Agency. Social validation refers to the acceptance of novel research methods by a relevant scientific community; it is formally independent of the technical validation of methods, and is frequently studied in history, philosophy, and social studies of science using qualitative methods. The quantitative methods introduced here find that high-throughput toxicology methods are spread throughout a large and well-connected research community, which suggests high social validation. Further assessment of social validation involving mixed qualitative and quantitative methods are discussed in the conclusion. PMID:28005974

Differential roles of polar orbital prefrontal cortex and parietal lobes in logical reasoning with neutral and negative emotional content.

PubMed

Eimontaite, Iveta; Goel, Vinod; Raymont, Vanessa; Krueger, Frank; Schindler, Igor; Grafman, Jordan

2018-05-14

To answer the question of how brain pathology affects reasoning about negative emotional content, we administered a disjunctive logical reasoning task involving arguments with neutral content (e.g. Either there are tigers or women in NYC, but not both; There are no tigers in NYC; There are women in NYC) and emotionally laden content (e.g. Either there are pedophiles or politicians in Texas, but not both; There are politicians in Texas; There are no pedophiles in Texas) to 92 neurological patients with focal lesions to various parts of the brain. A Voxel Lesion Symptom Mapping (VLSM) analysis identified 16 patients, all with lesions to the orbital polar prefrontal cortex (BA 10 & 11), as being selectively impaired in the emotional reasoning condition. Another 17 patients, all with lesions to the parietal cortex, were identified as being impaired in the neutral content condition. The reasoning scores of these two patient groups, along with 23 matched normal controls, underwent additional analysis to explore the effect of belief bias. This analysis revealed that the differences identified above were largely driven by trials where there was an incongruency between the believability of the conclusion and the validity of the argument (i.e. valid argument /false conclusion or invalid argument /true conclusion). Patients with lesions to polar orbital prefrontal cortex underperformed in incongruent emotional content trials and over performed in incongruent neutral content trials (compared to both normal controls and patients with parietal lobe lesions). Patients with lesions to parietal lobes underperformed normal controls (at a trend level) in neutral trials where there was a congruency between the believability of the conclusion and the validity of the argument (i.e. valid argument/true conclusion or invalid argument/false conclusion). We conclude that lesions to the polar orbital prefrontal cortex (i) prevent these patients from enjoying any emotionally induced cognitive boost, and (ii) block the belief bias processing route in the neutral condition. Lesions to parietal lobes result in a generalized impairment in logical reasoning with neutral content. Copyright © 2018. Published by Elsevier Ltd.

Co-Occurrence of ADHD and High IQ: A Case Series Empirical Study

ERIC Educational Resources Information Center

Cordeiro, Mara L.; Farias, Antonio C.; Cunha, Alexandre; Benko, Cassia R.; Farias, Lucilene G.; Costa, Maria T.; Martins, Leandra F.; McCracken, James T.

2011-01-01

Objective: The validity of a diagnosis of ADHD in children with a high intelligence quotient (IQ) remains controversial. Using a multidisciplinary approach, rigorous diagnostic criteria, and worldwide-validated psychometric instruments, we identified a group of children attending public schools in southern Brazil for co-occurrence of high IQ and…

Validating a Model of Effective Teaching Behaviour of Pre-Service Teachers

ERIC Educational Resources Information Center

Maulana, Ridwan; Helms-Lorenz, Michelle; Van de Grift, Wim

2017-01-01

Although effective teaching behaviour is central for pupil outcomes, the extent to which pre-service teachers behave effectively in the classroom and how their behaviour relates to pupils' engagement remain unanswered. The present study aims to validate a theoretical model linking effective pre-service teaching behaviour and pupil's engagement,…

A Study of Developing an Environmental Attitude Scale for Primary School Students

ERIC Educational Resources Information Center

Artvinli, Eyup; Demir, Zulfiye Melis

2018-01-01

The aim of this research is to develop an instrument that measures environmental attitudes of third grade students. The study was completed in six stages: creating scale items, content validity study, item total and remaining item correlation study, determining item discrimination, determining construct validity study and examining the internal…

Using Social Network Methods to Study School Leadership

ERIC Educational Resources Information Center

Pitts, Virginia M.; Spillane, James P.

2009-01-01

Social network analysis is increasingly used in the study of policy implementation and school leadership. A key question that remains is that of instrument validity--that is, the question of whether these social network survey instruments measure what they purport to measure. In this paper, we describe our work to examine the validity of the…

Evaluating the Complementary Roles of an SJT and Academic Assessment for Entry into Clinical Practice

ERIC Educational Resources Information Center

Cousans, Fran; Patterson, Fiona; Edwards, Helena; Walker, Kim; McLachlan, John C.; Good, David

2017-01-01

Although there is extensive evidence confirming the predictive validity of situational judgement tests (SJTs) in medical education, there remains a shortage of evidence for their predictive validity for performance of postgraduate trainees in their first role in clinical practice. Moreover, to date few researchers have empirically examined the…

Exploring the Validity of a Second Language Intercultural Pragmatics Assessment Tool

ERIC Educational Resources Information Center

Timpe-Laughlin, Veronika; Choi, Ikkyu

2017-01-01

Pragmatics has been a key component of language competence frameworks. While the majority of second/foreign language (L2) pragmatics tests have targeted productive skills, the assessment of receptive pragmatic skills remains a developing field. This study explores validation evidence for a test of receptive L2 pragmatic ability called the American…

Validity of the Working Alliance Inventory within Child Protection Services

ERIC Educational Resources Information Center

Killian, Michael; Forrester, Donald; Westlake, David; Antonopoulou, Paraskevi

2017-01-01

The Working Alliance Inventory remains a widely studied measure of quality of therapeutic relationships between the practitioner and client. No prior study has examined the psychometrics and validity of the Working Alliance Inventory-Short (WAI-S) in a sample of families, social workers, and trained observers within child protection services.…

Validity of a Scale to Measure Teachers' Attitudes towards Sex Education

ERIC Educational Resources Information Center

de Almeida Reis, Maria Helena; Vilar, Duarte Goncalo Rei

2006-01-01

Despite the current legislation requiring sex education as part of the school curriculum in Portugal, great obstacles to its implementation remain. Furthermore, sex education is far from being systematically administered. Thus, the main interest in our project was to validate a scale that measures teachers' attitudes towards sex education. There…

Iranian Effective Clinical Nurse Instructor evaluation tool: Development and psychometric testing

PubMed Central

Shahsavari, Hooman; Yekta, Zohreh Parsa; Zare, Zahra; Sigaroodi, Abdolhossain Emami

2014-01-01

Background: Clinical education is the heart of the nursing education program. Effective nursing clinical instructors are needed for graduating the future qualified nurses. There is a well-developed body of knowledge about the effectiveness of clinical teaching and the instructors. However, translating this knowledge into a context-based evaluation tool for measuring the effectiveness of Iranian clinical nursing instructors remains a deficiency. The purpose of this study is to describe the development and psychometric testing process of an instrument to evaluate the characteristics of Iranian effective clinical nurse instructor. Materials and Methods: Following a precise review of Iranian literatures and expert consultation, 83 statements about the characteristics that make clinical nurse instructors effective were extracted. In the next phase, the psychometric properties of the instrument were established by looking at the content validity, face validity, and internal consistency. Content validity of the instrument was assessed based on the comments of an expert panel including 10 nursing faculty members. During this phase, 30 items of the instrument were omitted or merged. Face validity of the instrument was assured based on the advices of 10 nursing students and 10 nursing faculty members. Finally, in the pilot test, the data of 168 filled questionnaires were gathered and analyzed by an exploratory factor analysis to reduce the items and identify the factor structure of the instrument. Results: Through subsequent analyses, of the 83 items, 31 items were merged or omitted. At last, 52 retained items were divided into four subscales including student-centric behaviors, clinical performances, planning ability, and personality traits. The Cronbach's alpha level of the inventory was 0.96, with the value for each domain ranging from 0.87 to 0.94. Conclusions: Iranian Effective Clinical Nurse Instructor evaluation tool has acceptable psychometric properties and can be used in evaluating the effectiveness of clinical nursing instructors. PMID:24834081

Development and preliminary psychometric properties of a well-being index for medical students

PubMed Central

2010-01-01

Background Psychological distress is common among medical students but manifests in a variety of forms. Currently, no brief, practical tool exists to simultaneously evaluate these domains of distress among medical students. The authors describe the development of a subject-reported assessment (Medical Student Well-Being Index, MSWBI) intended to screen for medical student distress across a variety of domains and examine its preliminary psychometric properties. Methods Relevant domains of distress were identified, items generated, and a screening instrument formed using a process of literature review, nominal group technique, input from deans and medical students, and correlation analysis from previously administered assessments. Eleven experts judged the clarity, relevance, and representativeness of the items. A Content Validity Index (CVI) was calculated. Interrater agreement was assessed using pair-wise percent agreement adjusted for chance agreement. Data from 2248 medical students who completed the MSWBI along with validated full-length instruments assessing domains of interest was used to calculate reliability and explore internal structure validity. Results Burnout (emotional exhaustion and depersonalization), depression, mental quality of life (QOL), physical QOL, stress, and fatigue were domains identified for inclusion in the MSWBI. Six of 7 items received item CVI-relevance and CVI-representativeness of ≥0.82. Overall scale CVI-relevance and CVI-representativeness was 0.94 and 0.91. Overall pair-wise percent agreement between raters was ≥85% for clarity, relevance, and representativeness. Cronbach's alpha was 0.68. Item by item percent pair-wise agreements and Phi were low, suggesting little overlap between items. The majority of MSWBI items had a ≥74% sensitivity and specificity for detecting distress within the intended domain. Conclusions The results of this study provide evidence of reliability and content-related validity of the MSWBI. Further research is needed to assess remaining psychometric properties and establish scores for which intervention is warranted. PMID:20105312

Development and Validation of the Bicultural Youth Acculturation Questionnaire

PubMed Central

Kukaswadia, Atif; Janssen, Ian; Pickett, William; Bajwa, Jasmine; Georgiades, Katholiki; Lalonde, Richard N.; Quon, Elizabeth C.; Safdar, Saba; Pike, Ian

2016-01-01

Objectives Acculturation is a multidimensional process involving changes in behaviour and beliefs. Questionnaires developed to measure acculturation are typically designed for specific ethnic populations and adult experiences. This study developed a questionnaire that measures acculturation among ethnically diverse populations of youth that can be included as a module in population surveys. Methods Questionnaires measuring acculturation in youth were identified in the literature. The importance of items from the existing questionnaires was determined using a Delphi process and this informed the development of our questionnaire. The questionnaire was then pilot tested using a sample of 248 Canadians aged 18–25 via an online system. Participants identified as East and South East Asian (27.8%), South Asian (17.7%) and Black (13.7%). The majority were 1st (33.5%) or 2nd generation immigrants (52.0%). After redundant items were eliminated, exploratory factor analysis grouped items into domains, and, for each domain, internal consistency, and convergent validity with immigrant generation then age at immigration estimated. A subset of participants re-completed the questionnaire for reliability estimation. Results The literature review yielded 117 articles that used 13 questionnaires with a total of 440 questions. The Delphi process reduced these to 32 questions. Pilot testing occurred in 248 Canadians aged 18–25. Following item reduction, 16 questions in three domains remained: dominant culture, heritage language, and heritage culture. All had good internal consistency (Cronbach’s alphas > .75). The mean dominant domain score increased with immigrant generation (1st generation: 3.69 (95% CI: 3.49–3.89), 2nd: 4.13 (4.00–4.26), 3rd: 4.40 (4.19–4.61)), and mean heritage language score was higher among those who immigrated after age 12 than before (p = .0001), indicative of convergent validity. Conclusions This Bicultural Youth Acculturation Questionnaire has demonstrated validity. It can be incorporated into population health surveys to elucidate the impact of acculturation on health outcomes among bicultural youth. PMID:27557080

Quantitative measurement of hypertrophic scar: interrater reliability and concurrent validity.

PubMed

Nedelec, Bernadette; Correa, José A; Rachelska, Grazyna; Armour, Alexis; LaSalle, Léo

2008-01-01

Research into the pathophysiology and treatment of hypertrophic scar (HSc) remains limited by the heterogeneity of scar and the imprecision with which its severity is measured. The objective of this study was to test the interrater reliability and concurrent validity of the Cutometer measurement of elasticity, the Mexameter measurement of erythema and pigmentation, and total thickness measure of the DermaScan C relative to the modified Vancouver Scar Scale (mVSS) in patient-matched normal skin, normal scar, and HSc. Three independent investigators evaluated 128 sites (severe HSc, moderate or mild HSc, donor site, and normal skin) on 32 burn survivors using all of the above measurement tools. The intraclass correlation coefficient, which was used to measure interrater reliability, reflects the inherent amount of error in the measure and is considered acceptable when it is >0.75. Interrater reliability of the totals of the height, pliability, and vascularity subscales of the mVSS fell below the acceptable limit ( congruent with0.50). The individual subscales of the mVSS fell well below the acceptable level (< or =0.3). The Cutometer reading of elasticity provided acceptable reliability (>0.89) for each study site with the exception of severe scar. Mexameter and DermaScan C reliability measurements were acceptable for all sites (>0.82). Concurrent validity correlations with the mVSS were significant except for the comparison of the mVSS pliability subscale and the Cutometer maximum deformation measure comparison in severe scar. In conclusion, the Mexameter and DermaScan C measurements of scar color and thickness of all sites, as well as the Cutometer measurement of elasticity in all but the most severe scars shows high interrater reliability. Their significant concurrent validity with the mVSS confirms that these tools are measuring the same traits as the mVSS, and in a more objective way.

3D-CAM: Derivation and Validation of a 3-Minute Diagnostic Interview for CAM-defined Delirium

PubMed Central

Marcantonio, Edward R.; Ngo, Long H.; O’Connor, Margaret; Jones, Richard N.; Crane, Paul K.; Metzger, Eran D.; Inouye, Sharon K.

2015-01-01

Background Delirium is common, morbid, and costly, yet remains often unrecognized in most clinical settings. The Confusion Assessment Method (CAM) is the most widely used diagnostic algorithm, and operationalizing its features would represent a substantial advance for clinical care. Objective To derive the 3D-CAM, a new 3-minute diagnostic assessment for CAM-defined delirium, and to validate it against a clinical reference standard. Design Diagnostic test study Setting 4 general medicine units in an academic medical center Participants 201 inpatients aged ≥ 75 years old Measurements We identified 20 items that best operationalized the 4 CAM diagnostic features to create the 3D-CAM. For prospective validation, 3D-CAM assessments were administered by trained research assistants. Independently, clinicians performed an extensive assessment that included patient interviews, family interviews, and review of the medical record. These data were considered by an expert panel to determine the presence or absence of delirium and dementia (reference standard). We compared the 3D-CAM delirium determination to the reference standard in all patients and in subgroups with and without dementia. Results The 201 participants in the prospective validation study had mean age (SD) of 84 (5.5) years, and 27% had dementia. The expert panel identified delirium in 21%. Median administration time for 3D-CAM was 3 minutes (inter-quartile range: 2–5 minutes). The sensitivity [95% CI] of 3D-CAM was 95% [84%, 99%] and the specificity was 94% [90%, 97%]. The 3D-CAM performed well in patients both with dementia (sensitivity=96% [82%, 100%], specificity=86% [67%, 96%]) and without dementia (sensitivity=93% [66%, 100%], specificity=96% [91%,99%]). Limitations Limited to single center, cross-sectional, and medicine patients only Conclusion The 3D-CAM operationalizes the CAM algorithm using a 3-minute structured assessment with high sensitivity and specificity relative to a reference standard and could be an important tool for improving recognition of delirium. PMID:25329203

Injury Rehabilitation Overadherence: Preliminary Scale Validation and Relationships With Athletic Identity and Self-Presentation Concerns

PubMed Central

Podlog, Leslie; Gao, Zan; Kenow, Laura; Kleinert, Jens; Granquist, Megan; Newton, Maria; Hannon, James

2013-01-01

Context: Evidence suggests that nonadherence to rehabilitation protocols may be associated with worse clinical and functional rehabilitation outcomes. Recently, it has been recognized that nonadherence may not only reflect a lack of rehabilitation engagement but that some athletes may “overadhere” to their injury-rehabilitation regimen or risk a premature return to sport. Presently, no measure of overadherence exists, and correlates of overadherence and risking a premature return to sport remain uncertain. Objective: To provide initial validation of a novel injury-rehabilitation overadherence measure (study 1) and to examine correlates of overadherence and risking a premature return to sport (study 2). Design: Cross-sectional study. Setting: High school athletes (study 1) and collegiate athletes (study 2). Patients or Other Participants: In study 1, 118 currently injured US adolescent athletes competing in a range of high school sports participated. In study 2, 105 currently injured collegiate athletes (National Collegiate Athletic Association Divisions I–III) volunteered. Main Outcome Measure(s): The Rehabilitation Overadherence Questionnaire was a novel instrument developed to assess injured athletes' tendency toward overadherence behaviors and beliefs. We used an adapted version of the Injury Psychological Readiness to Return to Sport Scale to assess the tendency to risk a premature return to sport. Results: In study 1, the construct validity of the overadherence measure was supported using principal axis factoring. Moreover, bivariate correlation and regression analyses indicated that self-presentation concerns and athletic identity were positive predictors of adolescent rehabilitation overadherence and a premature return to sport. Study 2 provided support for the 2-factor structure of the overadherence measure found in study 1 via confirmatory factor analysis. Further support for the relationship among self-presentation concerns, athletic identity, and rehabilitation overadherence was also noted. Conclusions: The Rehabilitation Overadherence Questionnaire is a valid and reliable measure of overadherence. PMID:23675797

Validating a Local Failure Risk Stratification for Use in Prospective Studies of Adjuvant Radiation Therapy for Bladder Cancer

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

Baumann, Brian C.; He, Jiwei; Hwang, Wei-Ting

Purpose: To inform prospective trials of adjuvant radiation therapy (adj-RT) for bladder cancer after radical cystectomy, a locoregional failure (LF) risk stratification was proposed. This stratification was developed and validated using surgical databases that may not reflect the outcomes expected in prospective trials. Our purpose was to assess sources of bias that may affect the stratification model's validity or alter the LF risk estimates for each subgroup: time bias due to evolving surgical techniques; trial accrual bias due to inclusion of patients who would be ineligible for adj-RT trials because of early disease progression, death, or loss to follow-up shortlymore » after cystectomy; bias due to different statistical methods to estimate LF; and subgrouping bias due to different definitions of the LF subgroups. Methods and Materials: The LF risk stratification was developed using a single-institution cohort (n=442, 1990-2008) and the multi-institutional SWOG 8710 cohort (n=264, 1987-1998) treated with radical cystectomy with or without chemotherapy. We evaluated the sensitivity of the stratification to sources of bias using Fine-Gray regression and Kaplan-Meier analyses. Results: Year of radical cystectomy was not associated with LF risk on univariate or multivariate analysis after controlling for risk group. By use of more stringent inclusion criteria, 26 SWOG patients (10%) and 60 patients from the single-institution cohort (14%) were excluded. Analysis of the remaining patients confirmed 3 subgroups with significantly different LF risks with 3-year rates of 7%, 17%, and 36%, respectively (P<.01), nearly identical to the rates without correcting for trial accrual bias. Kaplan-Meier techniques estimated higher subgroup LF rates than competing risk analysis. The subgroup definitions used in the NRG-GU001 adj-RT trial were validated. Conclusions: These sources of bias did not invalidate the LF risk stratification or substantially change the model's LF estimates.« less

Jung's views on causes and treatments of schizophrenia in light of current trends in cognitive neuroscience and psychotherapy research I. Aetiology and phenomenology.

PubMed

Silverstein, Steven M

2014-02-01

Jung's writings on schizophrenia are almost completely ignored or forgotten today. The purpose of this paper, along with a follow-up article, is to review the primary themes found in Jung's writings on schizophrenia, and to assess the validity of his theories about the disorder in light of our current knowledge base in the fields of psychopathology, cognitive neuroscience and psychotherapy research. In this article, five themes related to the aetiology and phenomenology of schizophrenia from Jung's writings are discussed:1) abaissement du niveau mental; 2) the complex; 3) mandala imagery; 4) constellation of archetypes and 5) psychological versus toxic aetiology. Reviews of the above areas suggest three conclusions. First, in many ways, Jung's ideas on schizophrenia anticipated much current thinking and data about the disorder. Second, with the recent (re)convergence of psychological and biological approaches to understanding and treating schizophrenia, the pioneering ideas of Jung regarding the importance of both factors and their interaction remain a useful and rich, but still underutilized resource. Finally, a more concerted effort to understand and evaluate the validity of Jung's concepts in terms of evidence from neuroscience could lead both to important advances in analytical psychology and to developments in therapeutic approaches that would extend beyond the treatment of schizophrenia. © 2014, The Society of Analytical Psychology.

Mining, Validation, and Clinical Significance of Colorectal Cancer (CRC)-Associated lncRNAs.

PubMed

Sun, Xiangwei; Hu, Yingying; Zhang, Liang; Hu, Changyuan; Guo, Gangqiang; Mao, Chenchen; Xu, Jianfeng; Ye, Sisi; Huang, Guanli; Xue, Xiangyang; Guo, Aizhen; Shen, Xian

2016-01-01

Colorectal cancer (CRC) is one of the deadliest tumours, but its pathogenesis remains unclear. The involvement of differentially expressed long non-coding RNAs (lncRNAs) in CRC tumorigenesis makes them suitable tumour biomarkers. Here, we screened 150 cases of CRC and 85 cases of paracancerous tissues in the GEO database for differentially expressed lncRNAs. The levels of lncRNA candidates in 84 CRC and paracancerous tissue samples were validated by qRT-PCR and their clinical significance was analyzed. We identified 15 lncRNAs with differential expression in CRC tumours; among them, AK098081 was significantly up-regulated, whereas AK025209, BC040303, BC037331, AK026659, and CR749831 were down-regulated in CRC. In a receiver operating characteristic curve analysis, the area under the curve for the six lncRNAs was 0.914. High expression of AK098081 and low expression of BC040303, CR749831, and BC037331 indicated poor CRC differentiation. CRC patients with lymph node metastasis had lower expression of BC037331. In addition, the group with high AK098081 expression presented significantly lower overall survival and disease-free survival rates than the low-expression group, confirming AK098081 as an independent risk factor for CRC patients. In conclusion, we have identified multiple CRC-associated lncRNAs from microarray expression profiles that can serve as novel biomarkers for the diagnosis and prognosis of CRC.

An 8-gene qRT-PCR-based gene expression score that has prognostic value in early breast cancer

PubMed Central

2010-01-01

Background Gene expression profiling may improve prognostic accuracy in patients with early breast cancer. Our objective was to demonstrate that it is possible to develop a simple molecular signature to predict distant relapse. Methods We included 153 patients with stage I-II hormonal receptor-positive breast cancer. RNA was isolated from formalin-fixed paraffin-embedded samples and qRT-PCR amplification of 83 genes was performed with gene expression assays. The genes we analyzed were those included in the 70-Gene Signature, the Recurrence Score and the Two-Gene Index. The association among gene expression, clinical variables and distant metastasis-free survival was analyzed using Cox regression models. Results An 8-gene prognostic score was defined. Distant metastasis-free survival at 5 years was 97% for patients defined as low-risk by the prognostic score versus 60% for patients defined as high-risk. The 8-gene score remained a significant factor in multivariate analysis and its performance was similar to that of two validated gene profiles: the 70-Gene Signature and the Recurrence Score. The validity of the signature was verified in independent cohorts obtained from the GEO database. Conclusions This study identifies a simple gene expression score that complements histopathological prognostic factors in breast cancer, and can be determined in paraffin-embedded samples. PMID:20584321

Increased circulating cell signalling phosphoproteins in sera are useful for the detection of pancreatic cancer

PubMed Central

Takano, S; Sogawa, K; Yoshitomi, H; Shida, T; Mogushi, K; Kimura, F; Shimizu, H; Yoshidome, H; Ohtsuka, M; Kato, A; Ishihara, T; Tanaka, H; Yokosuka, O; Nomura, F; Miyazaki, M

2010-01-01

Background: Intracellular phosphoprotein activation significantly regulates cancer progression. However, the significance of circulating phosphoproteins in the blood remains unknown. We investigated the serum phosphoprotein profile involved in pancreatic cancer (PaCa) by a novel approach that comprehensively measured serum phosphoproteins levels, and clinically applied this method to the detection of PaCa. Methods: We analysed the serum phosphoproteins that comprised cancer cellular signal pathways by comparing sera from PaCa patients and benign controls including healthy volunteers (HVs) and pancreatitis patients. Results: Hierarchical clustering analysis between PaCa patients and HVs revealed differential pathway-specific profiles. In particular, the components of the extracellular signal-regulated kinase (ERK) signalling pathway were significantly increased in the sera of PaCa patients compared with HVs. The positive rate of p-ERK1/2 (82%) was found to be superior to that of CA19-9 (53%) for early stage PaCa. For the combination of these serum levels, the area under the receiver-operator characteristics curves was showing significant ability to distinguish between the two populations in independent validation set, and between cancer and non-cancer populations in another validation set. Conclusion: The comprehensive measurement of serum cell signal phosphoproteins is useful for the detection of PaCa. Further investigations will lead to the implementation of tailor-made molecular-targeted therapeutics. PMID:20551957

Feasibility and acceptability of using jumping mechanography to detect early components of sarcopenia in community-dwelling older women

PubMed Central

Hannam, K.; Hartley, A.; Clark, E.M.; Sayer, A. Aihie; Tobias, J.H.; Gregson, C.L.

2017-01-01

Objective: To determine the feasibility and acceptability of using peak power and force, measured by jumping mechanography (JM), to detect early age-related features of sarcopenia in older women. Methods: Community-dwelling women aged 71-87 years were recruited into this cross-sectional study. Physical function tests comprised the short physical performance battery (SPPB), grip strength and, if SPPB score≥6, JM. JM measured peak weight-adjusted power and force from two-footed jumps and one-legged hops respectively. Questionnaires assessed acceptability. Results: 463 women were recruited; 37(8%) with SPPB<6 were ineligible for JM. Of 426 remaining, 359(84%) were able to perform ≥1 valid two-footed jump, 300(70%) completed ≥1 valid one-legged hop. No adverse events occurred. Only 14% reported discomfort. Discomfort related to JM performance, with inverse associations with both power and force (p<0.01). Peak power and force respectively explained 8% and 10% of variance in SPPB score (13% combined); only peak power explained additional variance in grip strength (17%). Conclusions: Peak power and force explained a significant, but limited, proportion of variance in SPPB and grip strength. JM represents a safe and acceptable clinical tool for evaluating lower-limb muscle power and force in older women, detecting distinct components of muscle function, and possibly sarcopenia, compared to those evaluated by more established measures. PMID:28860427

Identification of PPARgamma Partial Agonists of Natural Origin (I): Development of a Virtual Screening Procedure and In Vitro Validation

PubMed Central

Guasch, Laura; Sala, Esther; Castell-Auví, Anna; Cedó, Lidia; Liedl, Klaus R.; Wolber, Gerhard; Muehlbacher, Markus; Mulero, Miquel; Pinent, Montserrat; Ardévol, Anna; Valls, Cristina; Pujadas, Gerard; Garcia-Vallvé, Santiago

2012-01-01

Background Although there are successful examples of the discovery of new PPARγ agonists, it has recently been of great interest to identify new PPARγ partial agonists that do not present the adverse side effects caused by PPARγ full agonists. Consequently, the goal of this work was to design, apply and validate a virtual screening workflow to identify novel PPARγ partial agonists among natural products. Methodology/Principal Findings We have developed a virtual screening procedure based on structure-based pharmacophore construction, protein-ligand docking and electrostatic/shape similarity to discover novel scaffolds of PPARγ partial agonists. From an initial set of 89,165 natural products and natural product derivatives, 135 compounds were identified as potential PPARγ partial agonists with good ADME properties. Ten compounds that represent ten new chemical scaffolds for PPARγ partial agonists were selected for in vitro biological testing, but two of them were not assayed due to solubility problems. Five out of the remaining eight compounds were confirmed as PPARγ partial agonists: they bind to PPARγ, do not or only moderately stimulate the transactivation activity of PPARγ, do not induce adipogenesis of preadipocyte cells and stimulate the insulin-induced glucose uptake of adipocytes. Conclusions/Significance We have demonstrated that our virtual screening protocol was successful in identifying novel scaffolds for PPARγ partial agonists. PMID:23226391

Pyrosequencing-based validation of a simple cell-suspension polymerase chain reaction assay for Campylobacter with application of high-processivity polymerase and novel internal amplification controls for rapid and specific detection.

PubMed

Oakley, Brian B; Line, J Eric; Berrang, Mark E; Johnson, Jessica M; Buhr, R Jeff; Cox, Nelson A; Hiett, Kelli L; Seal, Bruce S

2012-02-01

Although Campylobacter is an important food-borne human pathogen, there remains a lack of molecular diagnostic assays that are simple to use, cost-effective, and provide rapid results in research, clinical, or regulatory laboratories. Of the numerous Campylobacter assays that do exist, to our knowledge none has been empirically tested for specificity using high-throughput sequencing. Here we demonstrate the power of next-generation sequencing to determine the specificity of a widely cited Campylobacter-specific polymerase chain reaction (PCR) assay and describe a rapid method for direct cell suspension PCR to quickly and easily screen samples for Campylobacter. We present a specific protocol which eliminates the need for time-consuming and expensive genomic DNA extractions and, using a high-processivity polymerase, demonstrate conclusive screening of samples in <1 h. Pyrosequencing results show the assay to be extremely (>99%) sensitive, and spike-back experiments demonstrated a detection threshold of <10(2) CFU mL(-1). Additionally, we present 2 newly designed broad-range bacterial primer sets targeting the 23S rRNA gene that have wide applicability as internal amplification controls. Empirical testing of putative taxon-specific assays using high-throughput sequencing is an important validation step that is now financially feasible for research, regulatory, or clinical applications. Published by Elsevier Inc.

Towards Personalized Cardiology: Multi-Scale Modeling of the Failing Heart

PubMed Central

Amr, Ali; Neumann, Dominik; Georgescu, Bogdan; Seegerer, Philipp; Kamen, Ali; Haas, Jan; Frese, Karen S.; Irawati, Maria; Wirsz, Emil; King, Vanessa; Buss, Sebastian; Mereles, Derliz; Zitron, Edgar; Keller, Andreas; Katus, Hugo A.; Comaniciu, Dorin; Meder, Benjamin

2015-01-01

Background Despite modern pharmacotherapy and advanced implantable cardiac devices, overall prognosis and quality of life of HF patients remain poor. This is in part due to insufficient patient stratification and lack of individualized therapy planning, resulting in less effective treatments and a significant number of non-responders. Methods and Results State-of-the-art clinical phenotyping was acquired, including magnetic resonance imaging (MRI) and biomarker assessment. An individualized, multi-scale model of heart function covering cardiac anatomy, electrophysiology, biomechanics and hemodynamics was estimated using a robust framework. The model was computed on n=46 HF patients, showing for the first time that advanced multi-scale models can be fitted consistently on large cohorts. Novel multi-scale parameters derived from the model of all cases were analyzed and compared against clinical parameters, cardiac imaging, lab tests and survival scores to evaluate the explicative power of the model and its potential for better patient stratification. Model validation was pursued by comparing clinical parameters that were not used in the fitting process against model parameters. Conclusion This paper illustrates how advanced multi-scale models can complement cardiovascular imaging and how they could be applied in patient care. Based on obtained results, it becomes conceivable that, after thorough validation, such heart failure models could be applied for patient management and therapy planning in the future, as we illustrate in one patient of our cohort who received CRT-D implantation. PMID:26230546

PDCD1 (PD-1) promoter methylation predicts outcome in head and neck squamous cell carcinoma patients

PubMed Central

Dietrich, Joern; Schroeck, Friederike; de Vos, Luka; Droege, Freya; Kristiansen, Glen; Schroeck, Andreas; Landsberg, Jennifer; Bootz, Friedrich; Dietrich, Dimo

2017-01-01

Background Biomarkers that facilitate the prediction of disease recurrence in head and neck squamous cell carcinoma (HNSCC) may enable physicians to personalize treatment. In the current study, DNA promoter methylation of programmed cell death 1 (PDCD1, PD-1) was evaluated as a prognostic biomarker in HNSCC patients. Results High PDCD1 methylation (mPDCD1) was associated with a significantly shorter overall survival after surgical resection in both the discovery (HR = 2.24 [95%CI: 1.08–4.64], p = 0.029) and the validation cohort (HR = 1.54 [95%CI: 1.08–2.21], p = 0.017). In multivariate Cox proportional hazards analysis, PDCD1 methylation remained a significant prognostic factor for HNSCC (HR = 2.14 [95%CI: 1.19–3.84], p = 0.011). Further, mPDCD1 was strongly associated with the human papilloma virus (HPV) status. Materials and Methods mPDCD1 was assessed retrospectively in a discovery cohort of 120 HNSCC patients treated at the University Hospital of Bonn and a validation cohort of 527 HNSCC cases analyzed by The Cancer Genome Atlas Research Network. Conclusions PDCD1 methylation might aid the identification of HNSCC patients potentially benefitting from a radical or alternative treatment, particularly in the context of immunotherapies targeting PD-1/PD-L1. PMID:28487502

A comparison of pre ICU admission SIRS, EWS and q SOFA scores for predicting mortality and length of stay in ICU.

PubMed

Siddiqui, Shahla; Chua, Maureen; Kumaresh, Venkatesan; Choo, Robin

2017-10-01

The 2015 sepsis definitions suggest using the quick SOFA score for risk stratification of sepsis patients among other changes in sepsis definition. Our aim was to validate the q sofa score for diagnosing sepsis and comparing it to traditional scores of pre ICU admission sepsis outcome prediction such as EWS and SIRS in our setting in order to predict mortality and length of stay. This was a retrospective cohort study. We retrospectively calculated the q sofa, SIRS and EWS scores of all ICU patients admitted with the diagnosis of sepsis at our center in 2015. This was analysed using STATA 12. Logistic regression and ROC curves were used for analysis in addition to descriptive analysis. 58 patients were included in the study. Based on our one year results we have shown that although q SOFA is more sensitive in predicting LOS in ICU of sepsis patients, the EWS score is more sensitive and specific in predicting mortality in the ICU of such patients when compared to q SOFA and SIRS scores. In conclusion, we find that in our setting, EWS is better than SIRS and q SOFA for predicting mortality and perhaps length of stay as well. The q Sofa score remains validated for diagnosis of sepsis. Copyright © 2017 Elsevier Inc. All rights reserved.

Validation of an administrative claims-based diagnostic code for pneumonia in a US-based commercially insured COPD population

PubMed Central

Kern, David M; Davis, Jill; Williams, Setareh A; Tunceli, Ozgur; Wu, Bingcao; Hollis, Sally; Strange, Charlie; Trudo, Frank

2015-01-01

Objective To estimate the accuracy of claims-based pneumonia diagnoses in COPD patients using clinical information in medical records as the reference standard. Methods Selecting from a repository containing members’ data from 14 regional United States health plans, this validation study identified pneumonia diagnoses within a group of patients initiating treatment for COPD between March 1, 2009 and March 31, 2012. Patients with ≥1 claim for pneumonia (International Classification of Diseases Version 9-CM code 480.xx–486.xx) were identified during the 12 months following treatment initiation. A subset of 800 patients was randomly selected to abstract medical record data (paper based and electronic) for a target sample of 400 patients, to estimate validity within 5% margin of error. Positive predictive value (PPV) was calculated for the claims diagnosis of pneumonia relative to the reference standard, defined as a documented diagnosis in the medical record. Results A total of 388 records were reviewed; 311 included a documented pneumonia diagnosis, indicating 80.2% (95% confidence interval [CI]: 75.8% to 84.0%) of claims-identified pneumonia diagnoses were validated by the medical charts. Claims-based diagnoses in inpatient or emergency departments (n=185) had greater PPV versus outpatient settings (n=203), 87.6% (95% CI: 81.9%–92.0%) versus 73.4% (95% CI: 66.8%–79.3%), respectively. Claims-diagnoses verified with paper-based charts had similar PPV as the overall study sample, 80.2% (95% CI: 71.1%–87.5%), and higher PPV than those linked to electronic medical records, 73.3% (95% CI: 65.5%–80.2%). Combined paper-based and electronic records had a higher PPV, 87.6% (95% CI: 80.9%–92.6%). Conclusion Administrative claims data indicating a diagnosis of pneumonia in COPD patients are supported by medical records. The accuracy of a medical record diagnosis of pneumonia remains unknown. With increased use of claims data in medical research, COPD researchers can study pneumonia with confidence that claims data are a valid tool when studying the safety of COPD therapies that could potentially lead to increased pneumonia susceptibility or severity. PMID:26229461

Development and Validation of the Chinese Attitudes to Starting Insulin Questionnaire (Ch-ASIQ) for Primary Care Patients with Type 2 Diabetes

PubMed Central

Fu, Sau Nga; Chin, Weng Yee; Wong, Carlos King Ho; Yeung, Vincent Tok Fai; Yiu, Ming Pong; Tsui, Hoi Yee; Chan, Ka Hung

2013-01-01

Objectives To develop and evaluate the psychometric properties of a Chinese questionnaire which assesses the barriers and enablers to commencing insulin in primary care patients with poorly controlled Type 2 diabetes. Research Design and Method Questionnaire items were identified using literature review. Content validation was performed and items were further refined using an expert panel. Following translation, back translation and cognitive debriefing, the translated Chinese questionnaire was piloted on target patients. Exploratory factor analysis and item-scale correlations were performed to test the construct validity of the subscales and items. Internal reliability was tested by Cronbach’s alpha. Results Twenty-seven identified items underwent content validation, translation and cognitive debriefing. The translated questionnaire was piloted on 303 insulin naïve (never taken insulin) Type 2 diabetes patients recruited from 10 government-funded primary care clinics across Hong Kong. Sufficient variability in the dataset for factor analysis was confirmed by Bartlett’s Test of Sphericity (P<0.001). Using exploratory factor analysis with varimax rotation, 10 factors were generated onto which 26 items loaded with loading scores > 0.4 and Eigenvalues >1. Total variance for the 10 factors was 66.22%. Kaiser-Meyer-Olkin measure was 0.725. Cronbach’s alpha coefficients for the first four factors were ≥0.6 identifying four sub-scales to which 13 items correlated. Remaining sub-scales and items with poor internal reliability were deleted. The final 13-item instrument had a four scale structure addressing: ‘Self-image and stigmatization’; ‘Factors promoting self-efficacy; ‘Fear of pain or needles’; and ‘Time and family support’. Conclusion The Chinese Attitudes to Starting Insulin Questionnaire (Ch-ASIQ) appears to be a reliable and valid measure for assessing barriers to starting insulin. This short instrument is easy to administer and may be used by healthcare providers and researchers as an assessment tool for Chinese diabetic primary care patients, including the elderly, who are unwilling to start insulin. PMID:24236071

The Johns Hopkins Fall Risk Assessment Tool: A Study of Reliability and Validity.

PubMed

Poe, Stephanie S; Dawson, Patricia B; Cvach, Maria; Burnett, Margaret; Kumble, Sowmya; Lewis, Maureen; Thompson, Carol B; Hill, Elizabeth E

Patient falls and fall-related injury remain a safety concern. The Johns Hopkins Fall Risk Assessment Tool (JHFRAT) was developed to facilitate early detection of risk for anticipated physiologic falls in adult inpatients. Psychometric properties in acute care settings have not yet been fully established; this study sought to fill that gap. Results indicate that the JHFRAT is reliable, with high sensitivity and negative predictive validity. Specificity and positive predictive validity were lower than expected.

Heuristic and analytic processes in reasoning: an event-related potential study of belief bias.

PubMed

Banks, Adrian P; Hope, Christopher

2014-03-01

Human reasoning involves both heuristic and analytic processes. This study of belief bias in relational reasoning investigated whether the two processes occur serially or in parallel. Participants evaluated the validity of problems in which the conclusions were either logically valid or invalid and either believable or unbelievable. Problems in which the conclusions presented a conflict between the logically valid response and the believable response elicited a more positive P3 than problems in which there was no conflict. This shows that P3 is influenced by the interaction of belief and logic rather than either of these factors on its own. These findings indicate that belief and logic influence reasoning at the same time, supporting models in which belief-based and logical evaluations occur in parallel but not theories in which belief-based heuristic evaluations precede logical analysis.

Neurosyphilis in Anglo-American Composers and Jazz Musicians.

PubMed

Breitenfeld, Darko; Kust, Davor; Breitenfeld, Tomislav; Prpić, Marin; Lucijanić, Marko; Zibar, Davor; Hostić, Vedran; Franceschi, Maja; Bolanča, Ante

2017-09-01

Syphilis is a sexually transmitted, systemic disease caused by the spirochete bacterium Treponema pallidum. The most common mechanism of transmission is sexual intercourse. Although there are several hypotheses, the exact origin of the disease remains unknown. Newly published evidence suggests that the hypothesis supporting the theory of the American origin of the disease is the valid one. Among 1500 analyzed pathographies of composers and musicians, data on ten Anglo-American composers and jazz musicians having suffered from neurosyphilis (tertiary stage of the disease) were extracted for this report. In this group of Anglo-American composers and musicians, most of them died from progressive paralysis while still in the creative phase of life. Additionally, diagnoses of eleven other famous neurosyphilitic composers, as well as basic biographic data on ten less known composers that died from neurosyphilis-progressive paralysis are also briefly mentioned. In conclusion, neurosyphilis can cause serious neurological damage, as well as permanent disability or death, preventing further work and skill improvement.

Complete Insecurity of Quantum Protocols for Classical Two-Party Computation

NASA Astrophysics Data System (ADS)

Buhrman, Harry; Christandl, Matthias; Schaffner, Christian

2012-10-01

A fundamental task in modern cryptography is the joint computation of a function which has two inputs, one from Alice and one from Bob, such that neither of the two can learn more about the other’s input than what is implied by the value of the function. In this Letter, we show that any quantum protocol for the computation of a classical deterministic function that outputs the result to both parties (two-sided computation) and that is secure against a cheating Bob can be completely broken by a cheating Alice. Whereas it is known that quantum protocols for this task cannot be completely secure, our result implies that security for one party implies complete insecurity for the other. Our findings stand in stark contrast to recent protocols for weak coin tossing and highlight the limits of cryptography within quantum mechanics. We remark that our conclusions remain valid, even if security is only required to be approximate and if the function that is computed for Bob is different from that of Alice.

Complete insecurity of quantum protocols for classical two-party computation.

PubMed

Buhrman, Harry; Christandl, Matthias; Schaffner, Christian

2012-10-19

A fundamental task in modern cryptography is the joint computation of a function which has two inputs, one from Alice and one from Bob, such that neither of the two can learn more about the other's input than what is implied by the value of the function. In this Letter, we show that any quantum protocol for the computation of a classical deterministic function that outputs the result to both parties (two-sided computation) and that is secure against a cheating Bob can be completely broken by a cheating Alice. Whereas it is known that quantum protocols for this task cannot be completely secure, our result implies that security for one party implies complete insecurity for the other. Our findings stand in stark contrast to recent protocols for weak coin tossing and highlight the limits of cryptography within quantum mechanics. We remark that our conclusions remain valid, even if security is only required to be approximate and if the function that is computed for Bob is different from that of Alice.

Diabetes mellitus associated with processed and unprocessed red meat: an overview.

PubMed

Kouvari, M; Notara, V; Kalogeropoulos, N; Panagiotakos, D B

2016-11-01

According to American Diabetes Association "as many as 1 in 3 American adults will have diabetes by 2050" imposing a serious burden on healthcare services and highlighting a substantial need to reduce "new-cases" incidence. Diabetes is inextricably linked to diet, in the prevention-spectrum. Red-meat-intake has been positively associated with reduced glycemic control. However, divergence exists among meat subtypes (i.e. fresh and processed) and the magnitude of their impact on diabetes development. The present overview attempted to summarize the latest data regarding red-meat subtypes on the examined association. Four meta-analysis and 10 prospective studies, focusing on the role of fresh and processed red meat in diabetes prevention, were selected. All of studies highlighted the aggravating role of processed meat-products in diabetes incidence, while fresh meat reached significance in only half of them. Therefore, the contribution of fresh red meat on diabetes remains inconclusive. Valid conclusions seem more robust concerning processed-meat-consumption.

Food insecurity is longitudinally associated with depressive symptoms among homeless and marginally-housed individuals living with HIV

PubMed Central

Palar, Kartika; Kushel, Margot; Frongillo, Edward A.; Riley, Elise D.; Grede, Nils; Bangsberg, David; Weiser, Sheri D.

2014-01-01

Introduction Depression and food insecurity are prevalent among people with HIV (PLHIV) and contribute to poor HIV outcomes. Longitudinal data can help clarify the effect of food insecurity on depression among PLHIV in the United States. Methods We assessed the longitudinal association of food insecurity with symptoms of depression using validated measures among participants living with HIV from the Research on Access to Care in the Homeless cohort in San Francisco. Results We followed 346 participants for a median of 28 months. Over half of participants (55.0%) were food insecure and 35.8% had symptoms of depression. In adjusted models, severe food insecurity in the previous period was associated with increased depressive symptom severity (b=1.22; p<0.001). The association remained statistically significant in models including participant fixed effects. Conclusions Severe food insecurity was longitudinally associated with symptoms of depression. Efforts to increase access to and participation in food security safety net programs for PLHIV could improve depression. PMID:25351185

Acoustic Analysis of a Sandwich Non Metallic Panel for Roofs by FEM and Experimental Validation

NASA Astrophysics Data System (ADS)

Nieto, P. J. García; del Coz Díaz, J. J.; Vilán, J. A. Vilán; Rabanal, F. P. Alvarez

2007-12-01

In this paper we have studied the acoustic behavior of a sandwich non metallic panel for roofs by the finite element method (FEM). This new field of analysis is the fully coupled solution of fluid flows with structural interactions, commonly referred to as fluid-structure interaction (FSI). It is the natural next step to take in the simulation of mechanical systems. The finite element analysis of acoustic-fluid/structure interactions using potential-based or displacement-based Lagrangian formulations is now well established. The non-linearity is due to the `fluid-structure interaction' (FSI) that governs the problem. In a very considerable range of problems the fluid displacement remains small while interaction is substantial. In this category falls our problem, in which the structural motion influence and react with the generation of pressures in two reverberation rooms. The characteristic of acoustic insulation of the panel is calculated basing on the pressures for different frequencies and points in the transmission rooms. Finally the conclusions reached are shown.

Transient enhanced diffusion in preamorphized silicon: the role of the surface

NASA Astrophysics Data System (ADS)

Cowern, N. E. B.; Alquier, D.; Omri, M.; Claverie, A.; Nejim, A.

1999-01-01

Experiments on the depth dependence of transient enhanced diffusion (TED) of boron during rapid thermal annealing of Ge-preamorphized layers reveal a linear decrease in the diffusion enhancement between the end-of-range (EOR) defect band and the surface. This behavior, which indicates a quasi-steady-state distribution of excess interstitials, emitted from the EOR band and absorbed at the surface, is observed for annealing times as short as 1 s at 900°C. Using an etching procedure we vary the distance xEOR from the EOR band to the surface in the range 80-175 nm, and observe how this influences the interstitial supersaturation, s( x). The supersaturations at the EOR band and the surface remain unchanged, while the gradient d s/d x, and thus the flux to the surface, varies inversely with xEOR. This confirms the validity of earlier modelling of EOR defect evolution in terms of Ostwald ripening, and provides conclusive evidence that the surface is the dominant sink for interstitials during TED.

Can the Air Pollution Index be used to communicate the health risks of air pollution?

PubMed

Li, Li; Lin, Guo-Zhen; Liu, Hua-Zhang; Guo, Yuming; Ou, Chun-Quan; Chen, Ping-Yan

2015-10-01

The validity of using the Air Pollution Index (API) to assess health impacts of air pollution and potential modification by individual characteristics on air pollution effects remain uncertain. We applied distributed lag non-linear models (DLNMs) to assess associations of daily API, specific pollution indices for PM10, SO2, NO2 and the weighted combined API (APIw) with mortality during 2003-2011 in Guangzhou, China. An increase of 10 in API was associated with a 0.88% (95% confidence interval (CI): 0.50, 1.27%) increase of non-accidental mortality at lag 0-2 days. Harvesting effects appeared after 2 days' exposure. The effect estimate of API over lag 0-15 days was statistically significant and similar with those of pollutant-specific indices and APIw. Stronger associations between API and mortality were observed in the elderly, females and residents with low educational attainment. In conclusion, the API can be used to communicate health risks of air pollution. Copyright © 2015 Elsevier Ltd. All rights reserved.

Meta-review of protein network regulating obesity between validated obesity candidate genes in the white adipose tissue of high-fat diet-induced obese C57BL/6J mice.

PubMed

Kim, Eunjung; Kim, Eun Jung; Seo, Seung-Won; Hur, Cheol-Goo; McGregor, Robin A; Choi, Myung-Sook

2014-01-01

Worldwide obesity and related comorbidities are increasing, but identifying new therapeutic targets remains a challenge. A plethora of microarray studies in diet-induced obesity models has provided large datasets of obesity associated genes. In this review, we describe an approach to examine the underlying molecular network regulating obesity, and we discuss interactions between obesity candidate genes. We conducted network analysis on functional protein-protein interactions associated with 25 obesity candidate genes identified in a literature-driven approach based on published microarray studies of diet-induced obesity. The obesity candidate genes were closely associated with lipid metabolism and inflammation. Peroxisome proliferator activated receptor gamma (Pparg) appeared to be a core obesity gene, and obesity candidate genes were highly interconnected, suggesting a coordinately regulated molecular network in adipose tissue. In conclusion, the current network analysis approach may help elucidate the underlying molecular network regulating obesity and identify anti-obesity targets for therapeutic intervention.

What is in a name? Is food addiction a misnomer?

PubMed

Vella, Shae-Leigh; Pai, Nagesh

2017-02-01

Recently interest in the phenomenon of food addiction has increased substantially since the inclusion of gambling disorder in the DSM-5. However the phenomenon of food addiction remains controversial and the designation continues to lack clear consideration. Few researchers have offered an explicit theoretical definition of the phenomenon which is fundamental; as it not only pertains to the aetiology it also directs research and management of the phenomenon. Therefore this review explores 'what is in a name'? Specifically possible aetiologies of food addiction, eating addiction and food addiction as an eating disorder are reviewed and the potential DSM-5 classification espoused. It is evident that the phenomenon requires further research and evaluation in order to delineate whether the phenomenon constitutes a disorder and if the phenomenon is found to be a valid entity the most appropriate designation. As it is too early to draw definitive conclusions regarding the concept all plausible designations and the associated aetiologies require further investigation. Copyright © 2016 Elsevier B.V. All rights reserved.

A DIGE proteomic analysis for high-intensity exercise-trained rat skeletal muscle.

PubMed

Yamaguchi, Wataru; Fujimoto, Eri; Higuchi, Mitsuru; Tabata, Izumi

2010-09-01

Exercise training induces various adaptations in skeletal muscles. However, the mechanisms remain unclear. In this study, we conducted 2D-DIGE proteomic analysis, which has not yet been used for elucidating adaptations of skeletal muscle after high-intensity exercise training (HIT). For 5 days, rats performed HIT, which consisted of 14 20-s swimming exercise bouts carrying a weight (14% of the body weight), and 10-s pause between bouts. The 2D-DIGE analysis was conducted on epitrochlearis muscles excised 18 h after the final training exercise. Proteomic profiling revealed that out of 800 detected and matched spots, 13 proteins exhibited changed expression by HIT compared with sedentary rats. All proteins were identified by MALDI-TOF/MS. Furthermore, using western immunoblot analyses, significantly changed expressions of NDUFS1 and parvalbumin (PV) were validated in relation to HIT. In conclusion, the proteomic 2D-DIGE analysis following HIT-identified expressions of NDUFS1 and PV, previously unknown to have functions related to exercise-training adaptations.

Development and validation of instrument for ergonomic evaluation of tablet arm chairs

PubMed Central

Tirloni, Adriana Seára; dos Reis, Diogo Cunha; Bornia, Antonio Cezar; de Andrade, Dalton Francisco; Borgatto, Adriano Ferreti; Moro, Antônio Renato Pereira

2016-01-01

The purpose of this study was to develop and validate an evaluation instrument for tablet arm chairs based on ergonomic requirements, focused on user perceptions and using Item Response Theory (IRT). This exploratory study involved 1,633 participants (university students and professors) in four steps: a pilot study (n=26), semantic validation (n=430), content validation (n=11) and construct validation (n=1,166). Samejima's graded response model was applied to validate the instrument. The results showed that all the steps (theoretical and practical) of the instrument's development and validation processes were successful and that the group of remaining items (n=45) had a high consistency (0.95). This instrument can be used in the furniture industry by engineers and product designers and in the purchasing process of tablet arm chairs for schools, universities and auditoriums. PMID:28337099

Modality, probability, and mental models.

PubMed

Hinterecker, Thomas; Knauff, Markus; Johnson-Laird, P N

2016-10-01

We report 3 experiments investigating novel sorts of inference, such as: A or B or both. Therefore, possibly (A and B). Where the contents were sensible assertions, for example, Space tourism will achieve widespread popularity in the next 50 years or advances in material science will lead to the development of antigravity materials in the next 50 years, or both . Most participants accepted the inferences as valid, though they are invalid in modal logic and in probabilistic logic too. But, the theory of mental models predicts that individuals should accept them. In contrast, inferences of this sort—A or B but not both. Therefore, A or B or both—are both logically valid and probabilistically valid. Yet, as the model theory also predicts, most reasoners rejected them. The participants’ estimates of probabilities showed that their inferences tended not to be based on probabilistic validity, but that they did rate acceptable conclusions as more probable than unacceptable conclusions. We discuss the implications of the results for current theories of reasoning. PsycINFO Database Record (c) 2016 APA, all rights reserved

A network model of genomic hormone interactions underlying dementia and its translational validation through serendipitous off-target effect

PubMed Central

2013-01-01

Background While the majority of studies have focused on the association between sex hormones and dementia, emerging evidence supports the role of other hormone signals in increasing dementia risk. However, due to the lack of an integrated view on mechanistic interactions of hormone signaling pathways associated with dementia, molecular mechanisms through which hormones contribute to the increased risk of dementia has remained unclear and capacity of translating hormone signals to potential therapeutic and diagnostic applications in relation to dementia has been undervalued. Methods Using an integrative knowledge- and data-driven approach, a global hormone interaction network in the context of dementia was constructed, which was further filtered down to a model of convergent hormone signaling pathways. This model was evaluated for its biological and clinical relevance through pathway recovery test, evidence-based analysis, and biomarker-guided analysis. Translational validation of the model was performed using the proposed novel mechanism discovery approach based on ‘serendipitous off-target effects’. Results Our results reveal the existence of a well-connected hormone interaction network underlying dementia. Seven hormone signaling pathways converge at the core of the hormone interaction network, which are shown to be mechanistically linked to the risk of dementia. Amongst these pathways, estrogen signaling pathway takes the major part in the model and insulin signaling pathway is analyzed for its association to learning and memory functions. Validation of the model through serendipitous off-target effects suggests that hormone signaling pathways substantially contribute to the pathogenesis of dementia. Conclusions The integrated network model of hormone interactions underlying dementia may serve as an initial translational platform for identifying potential therapeutic targets and candidate biomarkers for dementia-spectrum disorders such as Alzheimer’s disease. PMID:23885764

Factor analysis of the contextual fine motor questionnaire in children.

PubMed

Lin, Chin-Kai; Meng, Ling-Fu; Yu, Ya-Wen; Chen, Che-Kuo; Li, Kuan-Hua

2014-02-01

Most studies treat fine motor as one subscale in a developmental test, hence, further factor analysis of fine motor has not been conducted. In fact, fine motor has been treated as a multi-dimensional domain from both clinical and theoretical perspectives, and therefore to know its factors would be valuable. The aim of this study is to analyze the internal consistency and factor validity of the Contextual Fine Motor Questionnaire (CFMQ). Based on the ecological observation and literature, the Contextual Fine Motor Questionnaire (CFMQ) was developed and includes 5 subscales: Pen Control, Tool Use During Handicraft Activities, the Use of Dining Utensils, Connecting and Separating during Dressing and Undressing, and Opening Containers. The main purpose of this study is to establish the factorial validity of the CFMQ through conducting this factor analysis study. Among 1208 questionnaires, 904 were successfully completed. Data from the children's CFMQ submitted by primary care providers was analyzed, including 485 females (53.6%) and 419 males (46.4%) from grades 1 to 5, ranging in age from 82 to 167 months (M=113.9, SD=16.3). Cronbach's alpha was used to measure internal consistency and explorative factor analysis was applied to test the five factor structures within the CFMQ. Results showed that Cronbach's alpha coefficient of the CFMQ for 5 subscales ranged from .77 to .92 and all item-total correlations with corresponding subscales were larger than .4 except one item. The factor loading of almost all items classified to their factor was larger than .5 except 3 items. There were five factors, explaining a total of 62.59% variance for the CFMQ. In conclusion, the remaining 24 items in the 5 subscales of the CFMQ had appropriate internal consistency, test-retest reliability and construct validity. Copyright © 2013 Elsevier Ltd. All rights reserved.

Predictive Validation of an Influenza Spread Model

PubMed Central

Hyder, Ayaz; Buckeridge, David L.; Leung, Brian

2013-01-01

Background Modeling plays a critical role in mitigating impacts of seasonal influenza epidemics. Complex simulation models are currently at the forefront of evaluating optimal mitigation strategies at multiple scales and levels of organization. Given their evaluative role, these models remain limited in their ability to predict and forecast future epidemics leading some researchers and public-health practitioners to question their usefulness. The objective of this study is to evaluate the predictive ability of an existing complex simulation model of influenza spread. Methods and Findings We used extensive data on past epidemics to demonstrate the process of predictive validation. This involved generalizing an individual-based model for influenza spread and fitting it to laboratory-confirmed influenza infection data from a single observed epidemic (1998–1999). Next, we used the fitted model and modified two of its parameters based on data on real-world perturbations (vaccination coverage by age group and strain type). Simulating epidemics under these changes allowed us to estimate the deviation/error between the expected epidemic curve under perturbation and observed epidemics taking place from 1999 to 2006. Our model was able to forecast absolute intensity and epidemic peak week several weeks earlier with reasonable reliability and depended on the method of forecasting-static or dynamic. Conclusions Good predictive ability of influenza epidemics is critical for implementing mitigation strategies in an effective and timely manner. Through the process of predictive validation applied to a current complex simulation model of influenza spread, we provided users of the model (e.g. public-health officials and policy-makers) with quantitative metrics and practical recommendations on mitigating impacts of seasonal influenza epidemics. This methodology may be applied to other models of communicable infectious diseases to test and potentially improve their predictive ability. PMID:23755236

SU-F-R-24: Identifying Prognostic Imaging Biomarkers in Early Stage Lung Cancer Using Radiomics

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

Zeng, X; Wu, J; Cui, Y

2016-06-15

Purpose: Patients diagnosed with early stage lung cancer have favorable outcomes when treated with surgery or stereotactic radiotherapy. However, a significant proportion (∼20%) of patients will develop metastatic disease and eventually die of the disease. The purpose of this work is to identify quantitative imaging biomarkers from CT for predicting overall survival in early stage lung cancer. Methods: In this institutional review board-approved HIPPA-compliant retrospective study, we retrospectively analyzed the diagnostic CT scans of 110 patients with early stage lung cancer. Data from 70 patients were used for training/discovery purposes, while those of remaining 40 patients were used for independentmore » validation. We extracted 191 radiomic features, including statistical, histogram, morphological, and texture features. Cox proportional hazard regression model, coupled with the least absolute shrinkage and selection operator (LASSO), was used to predict overall survival based on the radiomic features. Results: The optimal prognostic model included three image features from the Law’s feature and wavelet texture. In the discovery cohort, this model achieved a concordance index or CI=0.67, and it separated the low-risk from high-risk groups in predicting overall survival (hazard ratio=2.72, log-rank p=0.007). In the independent validation cohort, this radiomic signature achieved a CI=0.62, and significantly stratified the low-risk and high-risk groups in terms of overall survival (hazard ratio=2.20, log-rank p=0.042). Conclusion: We identified CT imaging characteristics associated with overall survival in early stage lung cancer. If prospectively validated, this could potentially help identify high-risk patients who might benefit from adjuvant systemic therapy.« less

Self-reported sunscreen use and urinary benzophenone-3 concentrations in the United States: NHANES 2003-2006 and 2009-2012

PubMed Central

Zamoiski, Rachel D.; Cahoon, Elizabeth K.; Freedman, D. Michal; Linet, Martha S.

2015-01-01

Background Sunscreens protect against skin cancer and other harmful effects of solar ultraviolet radiation (UVR). Epidemiologic and public health surveys often rely on self-reported sunscreen use to estimate sun exposure and avoidance, but questions remain about the validity of self-reports. Benzophenone-3 (BP-3), a common sunscreen ingredient, can be detected in the urine. Prior studies suggest that BP-3 concentrations increase after application of sunscreen. Objectives The goal of this study was to assess the validity of self-reported frequency of sunscreen use in relation to urinary BP-3 concentrations in a representative sample of the general US population, including in sub-groups defined by age, sex and race/ethnicity. Methods To assess the relationship between categorical self-reported sunscreen use and creatinine-corrected urinary BP-3 concentrations, we conducted a linear regression adjusted for age, sex, race/ethnicity, six-month time period, body mass index, education, and sun avoidance behaviors. We tested for effect modification by age, sex, ethnicity and time period of measurement using multiplicative interaction terms and a F test. Results BP-3 was positively associated with self-reported frequency of sunscreen use across all ages, sexes, race/ethnicities, and time periods. Crude and multivariate adjusted models were all statistically significant. R-square was relatively low for all models, ranging from 0.15-0.43. Conclusions Urinary BP-3 is positively associated with self-reported frequency of sunscreen use in the general US population, even in groups with overall low sunscreen use. These results suggest that self-report is a valid, although weak, way of assessing relative frequencies of sunscreen usage in a population-based study. PMID:26298557

Validation and application of a death proxy in adult cancer patients.

PubMed

Mealing, Nicole M; Dobbins, Timothy A; Pearson, Sallie-Anne

2012-07-01

PURPOSE: Fact of death is not always available on data sets used for pharmacoepidemiological research. Proxies may be an appropriate substitute in the absence of death data. The purposes of this study were to validate a proxy for death in adult cancer patients and to assess its performance when estimating survival in two cohorts of cancer patients. METHODS: We evaluated 30-, 60-, 90- and 180-day proxies overall and by cancer type using data from 12 394 Australian veterans with lung, colorectal, breast or prostate cancer. The proxy indicated death if the difference between the last dispensing record and the end of the observational period exceeded the proxy cutoff. We then compared actual survival to 90-day proxy estimates in a subset of 4090 veterans with 'full entitlements' for pharmaceutical items and in 3704 Australian women receiving trastuzumab for HER2+ metastatic breast cancer. RESULTS: The 90-day proxy was optimal with an overall sensitivity of 99.3% (95%CI: 98.4-99.7) and a specificity of 97.6% (95%CI: 91.8-99.4). These measures remained high when evaluated by cancer type and spread of disease. The application of the proxy using the most conservative date of death estimate (date of last dispensing) generally underestimated survival, with estimates up to 3 months shorter than survival based on fact of death. CONCLUSIONS: A 90-day death proxy is a robust substitute to identify death in a chronic population when fact of death is not available. The proxy is likely to be valid across a range of chronic diseases as it relies on the presence of 'regular' dispensing records for individual patients. Copyright © 2011 John Wiley & Sons, Ltd. Copyright © 2011 John Wiley & Sons, Ltd.

Validation of psoriatic arthritis diagnoses in electronic medical records using natural language processing

PubMed Central

Cai, Tianxi; Karlson, Elizabeth W.

2013-01-01

Objectives To test whether data extracted from full text patient visit notes from an electronic medical record (EMR) would improve the classification of PsA compared to an algorithm based on codified data. Methods From the > 1,350,000 adults in a large academic EMR, all 2318 patients with a billing code for PsA were extracted and 550 were randomly selected for chart review and algorithm training. Using codified data and phrases extracted from narrative data using natural language processing, 31 predictors were extracted and three random forest algorithms trained using coded, narrative, and combined predictors. The receiver operator curve (ROC) was used to identify the optimal algorithm and a cut point was chosen to achieve the maximum sensitivity possible at a 90% positive predictive value (PPV). The algorithm was then used to classify the remaining 1768 charts and finally validated in a random sample of 300 cases predicted to have PsA. Results The PPV of a single PsA code was 57% (95%CI 55%–58%). Using a combination of coded data and NLP the random forest algorithm reached a PPV of 90% (95%CI 86%–93%) at sensitivity of 87% (95% CI 83% – 91%) in the training data. The PPV was 93% (95%CI 89%–96%) in the validation set. Adding NLP predictors to codified data increased the area under the ROC (p < 0.001). Conclusions Using NLP with text notes from electronic medical records improved the performance of the prediction algorithm significantly. Random forests were a useful tool to accurately classify psoriatic arthritis cases to enable epidemiological research. PMID:20701955

Improved sexual and urinary function in women with sacral nerve stimulation.

PubMed

Gill, Bradley C; Swartz, Mia A; Firoozi, Farzeen; Rackley, Raymond R; Moore, Courtenay K; Goldman, Howard B; Vasavada, Sandip P

2011-01-01

  Urinary and sexual function improve following sacral nerve stimulation (SNS) for refractory overactive bladder. No significant associations between these changes have been found. Whether improvements in sexual function are independent of or secondary to improvements in urinary function remains unclear. The aim of this study was to analyze changes in urinary and sexual function in a homogeneous sample of patients undergoing SNS for urge urinary incontinence and subsequently identify associations between the two.   A prospective database was created. Enrollees underwent a full history and physical examination at the first office visit. Multiple-day voiding diaries with validated and investigator-designed questionnaires were administered at baseline and follow-up as standard implantation procedures and to assess changes in urinary and sexual function, respectively. Analyses were completed using data from patients who were sexually active at baseline and follow-up.   Statistically significant improvements in urinary and sexual function occurred according to multiple metrics. Patient global impression scales categorized all patients' urinary conditions as improved, with most being less severe. Validated urinary symptom and quality of life scores improved significantly. After treatment, most patients were incontinent less often with sexual activity and felt less restricted from sexual activity by fear of incontinence. Validated quantification of sexual function demonstrated significant improvements in overall sexual function, arousal, and satisfaction. No significant associations between changes in urinary and sexual function were noted; however, trends appeared to exist between the two.   Improved sexual function was not significantly associated with improved urinary function after SNS despite apparent trends between the two. Larger samples are required to definitively demonstrate this conclusion. © 2011 International Neuromodulation Society.

Validation of a Low-Cost Paper-Based Screening Test for Sickle Cell Anemia

PubMed Central

Piety, Nathaniel Z.; Yang, Xiaoxi; Kanter, Julie; Vignes, Seth M.; George, Alex; Shevkoplyas, Sergey S.

2016-01-01

Background The high childhood mortality and life-long complications associated with sickle cell anemia (SCA) in developing countries could be significantly reduced with effective prophylaxis and education if SCA is diagnosed early in life. However, conventional laboratory methods used for diagnosing SCA remain prohibitively expensive and impractical in this setting. This study describes the clinical validation of a low-cost paper-based test for SCA that can accurately identify sickle trait carriers (HbAS) and individuals with SCA (HbSS) among adults and children over 1 year of age. Methods and Findings In a population of healthy volunteers and SCA patients in the United States (n = 55) the test identified individuals whose blood contained any HbS (HbAS and HbSS) with 100% sensitivity and 100% specificity for both visual evaluation and automated analysis, and detected SCA (HbSS) with 93% sensitivity and 94% specificity for visual evaluation and 100% sensitivity and 97% specificity for automated analysis. In a population of post-partum women (with a previously unknown SCA status) at a primary obstetric hospital in Cabinda, Angola (n = 226) the test identified sickle cell trait carriers with 94% sensitivity and 97% specificity using visual evaluation (none of the women had SCA). Notably, our test permits instrument- and electricity-free visual diagnostics, requires minimal training to be performed, can be completed within 30 minutes, and costs about $0.07 in test-specific consumable materials. Conclusions Our results validate the paper-based SCA test as a useful low-cost tool for screening adults and children for sickle trait and disease and demonstrate its practicality in resource-limited clinical settings. PMID:26735691

Increased Frequency of De Novo Copy Number Variations in Congenital Heart Disease by Integrative Analysis of SNP Array and Exome Sequence Data

PubMed Central

Rodriguez-Murillo, Laura; Fromer, Menachem; Mazaika, Erica; Vardarajan, Badri; Italia, Michael; Leipzig, Jeremy; DePalma, Steven R.; Golhar, Ryan; Sanders, Stephan J.; Yamrom, Boris; Ronemus, Michael; Iossifov, Ivan; Willsey, A. Jeremy; State, Matthew W.; Kaltman, Jonathan R.; White, Peter S.; Shen, Yufeng; Warburton, Dorothy; Brueckner, Martina; Seidman, Christine; Goldmuntz, Elizabeth; Gelb, Bruce D.; Lifton, Richard; Seidman, Jonathan; Hakonarson, Hakon; Chung, Wendy K.

2014-01-01

Rationale Congenital heart disease (CHD) is among the most common birth defects. Most cases are of unknown etiology. Objective To determine the contribution of de novo copy number variants (CNVs) in the etiology of sporadic CHD. Methods and Results We studied 538 CHD trios using genome-wide dense single nucleotide polymorphism (SNP) arrays and/or whole exome sequencing (WES). Results were experimentally validated using digital droplet PCR. We compared validated CNVs in CHD cases to CNVs in 1,301 healthy control trios. The two complementary high-resolution technologies identified 63 validated de novo CNVs in 51 CHD cases. A significant increase in CNV burden was observed when comparing CHD trios with healthy trios, using either SNP array (p=7x10−5, Odds Ratio (OR)=4.6) or WES data (p=6x10−4, OR=3.5) and remained after removing 16% of de novo CNV loci previously reported as pathogenic (p=0.02, OR=2.7). We observed recurrent de novo CNVs on 15q11.2 encompassing CYFIP1, NIPA1, and NIPA2 and single de novo CNVs encompassing DUSP1, JUN, JUP, MED15, MED9, PTPRE SREBF1, TOP2A, and ZEB2, genes that interact with established CHD proteins NKX2-5 and GATA4. Integrating de novo variants in WES and CNV data suggests that ETS1 is the pathogenic gene altered by 11q24.2-q25 deletions in Jacobsen syndrome and that CTBP2 is the pathogenic gene in 10q sub-telomeric deletions. Conclusions We demonstrate a significantly increased frequency of rare de novo CNVs in CHD patients compared with healthy controls and suggest several novel genetic loci for CHD. PMID:25205790

Development and Preliminary Validation of Chinese Preschoolers’ Eating Behavior Questionnaire

PubMed Central

Zhang, Yuhai; Wang, Baoxi; Sun, Lijun; Shang, Lei

2014-01-01

Background The objective of this study was to develop a questionnaire for caregivers to assess the eating behavior of Chinese preschoolers. Methods To assess children’s eating behaviors, 152 items were derived from a broad review of the literature related to epidemiology surveys and the assessment of children’s eating behaviors. All of these items were reviewed by 50 caregivers of preschoolers and 10 experienced pediatricians. Seventy-seven items were selected for use in a primary questionnaire. After conducting an exploratory factor analysis and a variability analysis on the data from 313 preschoolers used to evaluate this primary questionnaire, we deleted 39 of these 77 items. A Chinese Preschoolers’ Eating Behavior Questionnaire (CPEBQ) was finally established from the remaining 38 items. The structure of this questionnaire was explored by factor analysis, and its reliability, validity and discriminative ability were evaluated with data collected from caregivers of 603 preschoolers. Results The CPEBQ consisted of 7 dimensions and 38 items. The 7 dimensions were food fussiness, food responsiveness, eating habit, satiety responsiveness, exogenous eating, emotional eating and initiative eating. The Cronbach’s α coefficient for the questionnaire was 0.92, and the test-retest reliability was 0.72. There were significant differences between the scores of normal-weight, overweight and obese preschoolers when it was referred to food fussiness, food responsiveness, eating habits, satiety responsiveness and emotional eating (p<0.05). Differences in caregiver’s education levels also had significant effects on scores for food fussiness, eating habits and exogenous eating (p<0.05). Conclusions The CPEBQ satisfies the conditions of reliability and validity, in accordance with psychometric demands. The questionnaire can be employed to evaluate the characteristics of Chinese preschoolers’ eating behaviors; therefore, it can be used in child health care practice and research. PMID:24520359

The COPD Helplessness Index

PubMed Central

Katz, Patricia P.; Yelin, Edward H.; Iribarren, Carlos; Knight, Sara J.; Blanc, Paul D.; Eisner, Mark D.

2010-01-01

Background: Psychologic factors affect how patients with COPD respond to attempts to improve their self-management skills. Learned helplessness may be one such factor, but there is no validated measure of helplessness in COPD. Methods: We administered a new COPD Helplessness Index (CHI) to 1,202 patients with COPD. Concurrent validity was assessed through association of the CHI with established psychosocial measures and COPD severity. The association of helplessness with incident COPD exacerbations was then examined by following subjects over a median 2.1 years, defining COPD exacerbations as COPD-related hospitalizations or ED visits. Results: The CHI demonstrated internal consistency (Cronbach α = 0.75); factor analysis was consistent with the CHI representing a single construct. Greater CHI-measured helplessness correlated with greater COPD severity assessed by the BODE (Body-mass, Obstruction, Dyspnea, Exercise) Index (r = 0.34; P < .001). Higher CHI scores were associated with worse generic (Short Form-12, Physical Component Summary Score) and respiratory-specific (Airways Questionnaire 20) health-related quality of life, greater depressive symptoms, and higher anxiety (all P < .001). Controlling for sociodemographics and smoking status, helplessness was prospectively associated with incident COPD exacerbations (hazard ratio = 1.31; P < .001). After also controlling for the BODE Index, helplessness remained predictive of COPD exacerbations among subjects with BODE Index ≤ median (hazard ratio = 1.35; P = .01), but not among subjects with higher BODE Index values (hazard ratio = 0.93; P = .34). Conclusions: The CHI is an internally consistent and valid measure, concurrently associated with health status and predictively associated with COPD exacerbations. The CHI may prove a useful tool in analyzing differential clinical responses mediated by patient-centered attributes. PMID:19837823

Development and evaluation of a brief self-completed family history screening tool for common chronic disease prevention in primary care

PubMed Central

Walter, Fiona M; Prevost, A Toby; Birt, Linda; Grehan, Nicola; Restarick, Kathy; Morris, Helen C; Sutton, Stephen; Rose, Peter; Downing, Sarah; Emery, Jon D

2013-01-01

Background Family history is an important risk factor for many common chronic diseases, but it remains underutilised for diagnostic assessment and disease prevention in routine primary care. Aim To develop and validate a brief self-completed family history questionnaire (FHQ) for systematic primary care assessment for family history of diabetes, ischaemic heart disease, breast cancer, and colorectal cancer. Design and setting Two-stage diagnostic validation study in 10 general practices in eastern England. Method Participants aged 18–50 years were identified via random sampling from electronic searches of general practice records. Participants completed a FHQ then had a three-generational ‘gold standard’ pedigree taken, to determine disease risk category. In stage 1, the FHQ comprised 12 items; in stage 2 the shorter 6-item FHQ was validated against the same ‘gold standard’. Results There were 1147 participants (stage 1: 618; stage 2: 529). Overall, 32% were at increased risk of one or more marker conditions (diabetes 18.9%, ischaemic heart disease 13.3%, breast cancer 6.2%, colorectal cancer 2.2%). The shorter 6-item FHQ performed very well for all four conditions: pooled data from both stages show diabetes, sensitivity = 98%, specificity = 94%; ischaemic heart disease, sensitivity = 93%, specificity = 81%; breast cancer, sensitivity = 81%, specificity = 83%; colorectal cancer, sensitivity = 96%, specificity = 88%, with an area under the receiver operating characteristic curve of 0.90 for males and 0.89 for females. Conclusion This brief self-completed FHQ shows good diagnostic accuracy for identifying people at higher risk of four common chronic diseases. It could be used in routine primary care to identify patients who would be most likely to benefit from a more detailed pedigree and risk assessment, and consequent management strategies. PMID:23735410

Cytokeratin 8 in Association with sdLDL and ELISA Development

PubMed Central

Ashmaig, Mohmed

2015-01-01

Background: Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality worldwide. Cytokeratins (CKs) which may also be expressed in vascular smooth muscle cells (SMCs) are generally considered to be markers for the differentiation of epithelial cells. Small, dense, low-density lipoprotein (sdLDL) particles, also termed LDL-IV, independently predict risk of CVD. Aims: The aims of this study were to develop an analytical method, apart from ultracentrifugation capable of isolating sdLDL in order to study any associated proteins. Materials and Methods: Using modified gradient gel electrophoresis (GGE), de-identified sdLDL-enriched plasma was used to physically elute and isolate sdLDL particles. To validate the finding, additional plasma from 77 normal and 48 higher risk subjects were used to measure sdLDL particles and CK8. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and immunoblotting method were used to identify the characteristics of proteins associated with sdLDL. An enzyme-linked immunosorbent assay (ELISA) method was developed and validated for the measurement of CK8 in plasma. Results: The validation of the CK8 ELISA method showed good analytical performance. The isolated sdLDL particles were verified with nondenaturing GGE with the apolipoprotein B component confirmed by Western immunoblotting. Confirmed by SDS-PAGE and Western immunoblotting, CK8 was associated with sdLDL. Two-tailed statistical analysis showed that CK8 and sdLDL particles were significantly higher in the high-risk CVD group compared to control group (P < 0.01 and P < 0.01, respectively). Conclusion: This study reports a novel association between CK8 and sdLDL in individuals with CVD who have a predominance of sdLDL. PMID:26713292

The Immune System as a Model for Pattern Recognition and Classification

PubMed Central

Carter, Jerome H.

2000-01-01

Objective: To design a pattern recognition engine based on concepts derived from mammalian immune systems. Design: A supervised learning system (Immunos-81) was created using software abstractions of T cells, B cells, antibodies, and their interactions. Artificial T cells control the creation of B-cell populations (clones), which compete for recognition of “unknowns.” The B-cell clone with the “simple highest avidity” (SHA) or “relative highest avidity” (RHA) is considered to have successfully classified the unknown. Measurement: Two standard machine learning data sets, consisting of eight nominal and six continuous variables, were used to test the recognition capabilities of Immunos-81. The first set (Cleveland), consisting of 303 cases of patients with suspected coronary artery disease, was used to perform a ten-way cross-validation. After completing the validation runs, the Cleveland data set was used as a training set prior to presentation of the second data set, consisting of 200 unknown cases. Results: For cross-validation runs, correct recognition using SHA ranged from a high of 96 percent to a low of 63.2 percent. The average correct classification for all runs was 83.2 percent. Using the RHA metric, 11.2 percent were labeled “too close to determine” and no further attempt was made to classify them. Of the remaining cases, 85.5 percent were correctly classified. When the second data set was presented, correct classification occurred in 73.5 percent of cases when SHA was used and in 80.3 percent of cases when RHA was used. Conclusions: The immune system offers a viable paradigm for the design of pattern recognition systems. Additional research is required to fully exploit the nuances of immune computation. PMID:10641961

Maintaining Peace - The Threat, the Force, and the Nation

DTIC Science & Technology

1992-04-03

that properly managed, the central theme enunciated variously by Hobbes and Locke, Rousseau and the Federalists remains valid today, namely: "As...combat, in all its forms, is a secondary by-product of the defense effort. The real product of defense is, and must remain , the production of peace...reshape the American military represents a threat to peace. 5. Global Hostilities: The threat of U.S. involvement in an armed conflict remains a distinct

The Development and Validation of the School-Based Counseling Self-Efficacy Scale

ERIC Educational Resources Information Center

Boughfman, Erica M.

2010-01-01

The purpose of this study was to develop and validate the School-Based Counseling Self-Efficacy Scale (SB-SES). Two hundred sixty-five (N = 265) licensed mental health professionals participated in this study. Fifty-eight percent of the participants reported experience working as a school-based counselor with the remaining 42% reporting no…

The Construct Validity of HPAT-Ireland for the Selection of Medical Students: Unresolved Issues and Future Research Implications

ERIC Educational Resources Information Center

Kelly, Maureen E.; O'Flynn, Siun

2017-01-01

Aptitude tests are widely used in selection. However, despite certain advantages their use remains controversial. This paper aims to critically appraise five sources of evidence for the construct validity of the Health Professions Admission Test (HPAT)-Ireland, an aptitude test used for selecting undergraduate medical students. The objectives are…

Puzzling Findings in Studying the Outcome of “Real World” Adolescent Mental Health Services: The TRAILS Study

PubMed Central

Jörg, Frederike; Ormel, Johan; Reijneveld, Sijmen A.; Jansen, Daniëlle E. M. C.; Verhulst, Frank C.; Oldehinkel, Albertine J.

2012-01-01

Background The increased use and costs of specialist child and adolescent mental health services (MHS) urge us to assess the effectiveness of these services. The aim of this paper is to compare the course of emotional and behavioural problems in adolescents with and without MHS use in a naturalistic setting. Method and Findings Participants are 2230 (pre)adolescents that enrolled in a prospective cohort study, the TRacking Adolescents' Individual Lives Survey (TRAILS). Response rate was 76%, mean age at baseline 11.09 (SD 0.56), 50.8% girls. We used data from the first three assessment waves, covering a six year period. Multiple linear regression analysis, propensity score matching, and data validation were used to compare the course of emotional and behavioural problems of adolescents with and without MHS use. The association between MHS and follow-up problem score (β 0.20, SE 0.03, p-value<0.001) was not confounded by baseline severity, markers of adolescent vulnerability or resilience nor stressful life events. The propensity score matching strategy revealed that follow-up problem scores of non-MHS-users decreased while the problem scores of MHS users remained high. When taking into account future MHS (non)use, it appeared that problem scores decreased with limited MHS use, albeit not as much as without any MHS use, and that problem scores with continuous MHS use remained high. Data validation showed that using a different outcome measure, multiple assessment waves and multiple imputation of missing values did not alter the results. A limitation of the study is that, although we know what type of MHS participants used, and during which period, we lack information on the duration of the treatment. Conclusions The benefits of MHS are questionable. Replication studies should reveal whether a critical examination of everyday care is necessary or an artefact is responsible for these results. PMID:23028584

An ultrahigh-resolution mass spectrometry index to estimate natural organic matter lability

PubMed Central

D'Andrilli, Juliana; Cooper, William T; Foreman, Christine M; Marshall, Alan G

2015-01-01

Rationale Determining the chemical constituents of natural organic matter (NOM) by Fourier Transform Ion Cyclotron Resonance Mass Spectrometry (FTICRMS) remains the ultimate measure for probing its source material, evolution, and transport; however, lability and the fate of organic matter (OM) in the environment remain controversial. FTICRMS-derived elemental compositions are presented in this study to validate a new interpretative method to determine the extent of NOM lability from various environments. Methods FTICRMS data collected over the last decade from the same 9.4 tesla instrument using negative electrospray ionization at the National High Magnetic Field Laboratory in Tallahassee, Florida, was used to validate the application of a NOM lability index. Solid-phase extraction cartridges were used to isolate the NOM prior to FTICRMS; mass spectral peaks were calibrated internally by commonly identified NOM homologous series, and molecular formulae were determined for NOM composition and lability analysis. Results A molecular lability boundary (MLB) was developed from the FTICRMS molecular data, visualized from van Krevelen diagrams, dividing the data into more and less labile constituents. NOM constituents above the MLB at H/C ≥1.5 correspond to more labile material, whereas NOM constituents below the MLB, H/C <1.5, exhibit less labile, more recalcitrant character. Of all marine, freshwater, and glacial environments considered for this study, glacial ecosystems were calculated to contain the most labile OM. Conclusions The MLB extends our interpretation of FTICRMS NOM molecular data to include a metric of lability, and generally ranked the OM environments from most to least labile as glacial > marine > freshwater. Applying the MLB is useful not only for individual NOM FTICRMS studies, but also provides a lability threshold to compare and contrast molecular data with other FTICRMS instruments that survey NOM from around the world. Copyright © 2015 The Authors. Rapid Communications in Mass Spectrometry published by John Wiley & Sons Ltd. PMID:26563709

Incongruence in Doping Related Attitudes, Beliefs and Opinions in the Context of Discordant Behavioural Data: In Which Measure Do We Trust?

PubMed Central

Petróczi, Andrea; Uvacsek, Martina; Nepusz, Tamás; Deshmukh, Nawed; Shah, Iltaf; Aidman, Eugene V.; Barker, James; Tóth, Miklós; Naughton, Declan P.

2011-01-01

Background Social psychology research on doping and outcome based evaluation of primary anti-doping prevention and intervention programmes have been dominated by self-reports. Having confidence in the validity and reliability of such data is vital. Methodology/Principal Findings The sample of 82 athletes from 30 sports (52.4% female, mean age: 21.48±2.86 years) was split into quasi-experimental groups based on i) self-admitted previous experience with prohibited performance enhancing drugs (PED) and ii) the presence of at least one prohibited PED in hair covering up to 6 months prior to data collection. Participants responded to questionnaires assessing a range of social cognitive determinants of doping via self-reports; and completed a modified version of the Brief Implicit Association Test (BIAT) assessing implicit attitudes to doping relative to the acceptable nutritional supplements (NS). Social projection regarding NS was used as control. PEDs were detected in hair samples from 10 athletes (12% prevalence), none of whom admitted doping use. This group of ‘deniers’ was characterised by a dissociation between explicit (verbal declarations) and implicit (BIAT) responding, while convergence was observed in the ‘clean’ athlete group. This dissociation, if replicated, may act as a cognitive marker of the denier group, with promising applications of the combined explicit-implicit cognitive protocol as a proxy in lieu of biochemical detection methods in social science research. Overall, discrepancies in the relationship between declared doping-related opinion and implicit doping attitudes were observed between the groups, with control measures remaining unaffected. Questionnaire responses showed a pattern consistent with self-reported doping use. Conclusions/Significance Following our preliminary work, this study provides further evidence that both self-reports on behaviour and social cognitive measures could be affected by some form of response bias. This can question the validity of self-reports, with reliability remaining unaffected. Triangulation of various assessment methods is recommended. PMID:21541317

42 CFR 476.85 - Conclusive effect of QIO initial denial determinations and changes as a result of DRG validations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs) Qio Review Functions § 476.85 Conclusive effect of QIO initial...

Sampling for pharmaceuticals and personal care products (PPCPs) and illicit drugs in wastewater systems: are your conclusions valid? A critical review.

PubMed

Ort, Christoph; Lawrence, Michael G; Rieckermann, Jörg; Joss, Adriano

2010-08-15

The analysis of 87 peer-reviewed journal articles reveals that sampling for pharmaceuticals and personal care products (PPCPs) and illicit drugs in sewers and sewage treatment plant influents is mostly carried out according to existing tradition or standard laboratory protocols. Less than 5% of all studies explicitly consider internationally acknowledged guidelines or methods for the experimental design of monitoring campaigns. In the absence of a proper analysis of the system under investigation, the importance of short-term pollutant variations was typically not addressed. Therefore, due to relatively long sampling intervals, potentially inadequate sampling modes, or insufficient documentation, it remains unclear for the majority of reviewed studies whether observed variations can be attributed to "real" variations or if they simply reflect sampling artifacts. Based on results from previous and current work, the present paper demonstrates that sampling errors can lead to overinterpretation of measured data and ultimately, wrong conclusions. Depending on catchment size, sewer type, sampling setup, substance of interest, and accuracy of analytical method, avoidable sampling artifacts can range from "not significant" to "100% or more" for different compounds even within the same study. However, in most situations sampling errors can be reduced greatly, and sampling biases can be eliminated completely, by choosing an appropriate sampling mode and frequency. This is crucial, because proper sampling will help to maximize the value of measured data for the experimental assessment of the fate of PPCPs as well as for the formulation and validation of mathematical models. The trend from reporting presence or absence of a compound in "clean" water samples toward the quantification of PPCPs in raw wastewater requires not only sophisticated analytical methods but also adapted sampling methods. With increasing accuracy of chemical analyses, inappropriate sampling increasingly represents the major source of inaccuracy. A condensed step-by-step Sampling Guide is proposed as a starting point for future studies.

The Psychometric Properties of the Center for Epidemiologic Studies Depression Scale in Chinese Primary Care Patients: Factor Structure, Construct Validity, Reliability, Sensitivity and Responsiveness

PubMed Central

2015-01-01

Background The Center for Epidemiologic Studies Depression Scale (CES-D) is a commonly used instrument to measure depressive symptomatology. Despite this, the evidence for its psychometric properties remains poorly established in Chinese populations. The aim of this study was to validate the use of the CES-D in Chinese primary care patients by examining factor structure, construct validity, reliability, sensitivity and responsiveness. Methods and Results The psychometric properties were assessed amongst a sample of 3686 Chinese adult primary care patients in Hong Kong. Three competing factor structure models were examined using confirmatory factor analysis. The original CES-D four-structure model had adequate fit, however the data was better fit into a bi-factor model. For the internal construct validity, corrected item-total correlations were 0.4 for most items. The convergent validity was assessed by examining the correlations between the CES-D, the Patient Health Questionnaire 9 (PHQ-9) and the Short Form-12 Health Survey (version 2) Mental Component Summary (SF-12 v2 MCS). The CES-D had a strong correlation with the PHQ-9 (coefficient: 0.78) and SF-12 v2 MCS (coefficient: -0.75). Internal consistency was assessed by McDonald’s omega hierarchical (ωH). The ωH value for the general depression factor was 0.855. The ωH values for “somatic”, “depressed affect”, “positive affect” and “interpersonal problems” were 0.434, 0.038, 0.738 and 0.730, respectively. For the two-week test-retest reliability, the intraclass correlation coefficient was 0.91. The CES-D was sensitive in detecting differences between known groups, with the AUC >0.7. Internal responsiveness of the CES-D to detect positive and negative changes was satisfactory (with p value <0.01 and all effect size statistics >0.2). The CES-D was externally responsive, with the AUC>0.7. Conclusions The CES-D appears to be a valid, reliable, sensitive and responsive instrument for screening and monitoring depressive symptoms in adult Chinese primary care patients. In its original four-factor and bi-factor structure, the CES-D is supported for cross-cultural comparisons of depression in multi-center studies. PMID:26252739

The Validation of a Case-Based, Cumulative Assessment and Progressions Examination

PubMed Central

Coker, Adeola O.; Copeland, Jeffrey T.; Gottlieb, Helmut B.; Horlen, Cheryl; Smith, Helen E.; Urteaga, Elizabeth M.; Ramsinghani, Sushma; Zertuche, Alejandra; Maize, David

2016-01-01

Objective. To assess content and criterion validity, as well as reliability of an internally developed, case-based, cumulative, high-stakes third-year Annual Student Assessment and Progression Examination (P3 ASAP Exam). Methods. Content validity was assessed through the writing-reviewing process. Criterion validity was assessed by comparing student scores on the P3 ASAP Exam with the nationally validated Pharmacy Curriculum Outcomes Assessment (PCOA). Reliability was assessed with psychometric analysis comparing student performance over four years. Results. The P3 ASAP Exam showed content validity through representation of didactic courses and professional outcomes. Similar scores on the P3 ASAP Exam and PCOA with Pearson correlation coefficient established criterion validity. Consistent student performance using Kuder-Richardson coefficient (KR-20) since 2012 reflected reliability of the examination. Conclusion. Pharmacy schools can implement internally developed, high-stakes, cumulative progression examinations that are valid and reliable using a robust writing-reviewing process and psychometric analyses. PMID:26941435

Making and Executing Decisions for Safe and Independent Living (MED-SAIL): development and validation of a brief screening tool.

PubMed

Mills, Whitney L; Regev, Tziona; Kunik, Mark E; Wilson, Nancy L; Moye, Jennifer; McCullough, Laurence B; Naik, Aanand D

2014-03-01

Older adults prefer to remain in their own homes for as long as possible. The purpose of this article is to describe the development and preliminary validation of Making and Executing Decisions for Safe and Independent Living (MED-SAIL), a brief screening tool for capacity to live safely and independently in the community. Prospective preliminary validation study. Outpatient geriatrics clinic located in a community-based hospital. Forty-nine community-dwelling older adults referred to the clinic for a comprehensive capacity assessment. We examined internal consistency, criterion-based validity, concurrent validity, and accuracy of classification for MED-SAIL. The items included in MED-SAIL demonstrated internal consistency (5 items; α = 0.85). MED-SAIL was significantly correlated with the Independent Living Scales (r = 0.573, p ≤0.001) and instrumental activities of daily living (r = 0.440, p ≤0.01). The Mann-Whitney U test revealed significant differences between the no capacity and partial/full capacity classifications on MED-SAIL (U(48) = 60.5, Z = -0.38, p <0.0001). The area under the curve was 0.864 (95% confidence interval: 0.84-0.99). This study demonstrated the validity of MED-SAIL as a brief screening tool to identify older adults with impaired capacity for remaining safe and independent in their current living environment. MED-SAIL is useful tool for health and social service providers in the community for the purpose of referral for definitive capacity evaluation. Published by Elsevier Inc.

A methodology for assessing the professional development needs of nurses and midwives in Indonesia: paper 1 of 3

PubMed Central

Hennessy, Deborah; Hicks, Carolyn; Hilan, Aflah; Kawonal, Yoanna

2006-01-01

Background Despite recent developments, health care provision in Indonesia remains suboptimal. Difficult terrain, economic crises, endemic diseases and high population numbers, coupled with limited availability of qualified health care professionals, all contribute to poor health status. In a country with a population of 220 million, there are currently an estimated 50 nurses and 26 midwives per 100 000 people. In line with government initiatives, this series of studies was undertaken to establish the training and development needs of nurses and midwives working within a variety of contexts in Indonesia, with the ultimate aim of enhancing care provision within these domains. Methods An established, psychometrically valid and reliable training needs instrument was modified for use within the Indonesian context. While this technique has had widespread international use in the developed world, its application for developing countries has not yet been established. The standard form consists of a biographical cover sheet and a core set of 30 items (all health-related tasks), which have to be rated along two seven-point scales. The first of these scales asks respondents to assess how important the task is to their job and the second scale is a self-assessment of respondents' current performance level of the task. By comparing the importance rating with the performance rating, an index of training need can be obtained (high importance and low performance indicating a significant training need). The modifications incorporated for use in this series of studies were a further 10 items, which were constructed following expert group and focus group discussions and a review of the relevant literature. Pilot trials with 109 respondents confirmed its feasibility and acceptability. The instrument was then administered to 524 nurses and 332 midwives across Indonesia. Results The data were subjected to a retrospective factor analysis, using a Varimax rotation and Cronbach's α to check the instrument's validity and reliability following modification. The results yielded six factors, which accounted for >53% of the variance, each of which had a Cronbach's α score of between 0.8644 and 0.7068. Conclusion The results suggest that the modified instrument remained valid and reliable for use in the Indonesian nursing and midwifery context. PMID:16623935

Experimental Design and Some Threats to Experimental Validity: A Primer

ERIC Educational Resources Information Center

Skidmore, Susan

2008-01-01

Experimental designs are distinguished as the best method to respond to questions involving causality. The purpose of the present paper is to explicate the logic of experimental design and why it is so vital to questions that demand causal conclusions. In addition, types of internal and external validity threats are discussed. To emphasize the…

The Impact of Model Parameterization and Estimation Methods on Tests of Measurement Invariance with Ordered Polytomous Data

ERIC Educational Resources Information Center

Koziol, Natalie A.; Bovaird, James A.

2018-01-01

Evaluations of measurement invariance provide essential construct validity evidence--a prerequisite for seeking meaning in psychological and educational research and ensuring fair testing procedures in high-stakes settings. However, the quality of such evidence is partly dependent on the validity of the resulting statistical conclusions. Type I or…

Design and stability study of an oral solution of amlodipine besylate for pediatric patients.

PubMed

van der Vossen, A C; van der Velde, I; Smeets, O S N M; Postma, D J; Vermes, A; Koch, B C P; Vulto, A G; Hanff, L M

2016-09-20

Amlodipine is an antihypertensive agent recommended for the management of hypertension in children and adolescents. The commercially available tablets of 5 and 10mg do not provide the necessary flexibility in dosing needed for treating children. Our goal was to develop a pediatric oral solution of amlodipine, using a robust manufacturing process suitable for ex-tempora and larger scale production. The parameters API and preservative content, related substances, appearance and pH were studied under four different storage conditions. Samples were analyzed up to 12months. Microbiological quality was studied in an 18-week in-use test based on a two-times daily dosing schedule. The stability of the formulation was influenced by storage conditions and composition. A formulation containing amlodipine besylate, sucrose syrup and methyl paraben remained physically stable for 12months at 4°C with no loss of amlodipine content. Related substances increased during the study but remained below 0.5%. In-use stability was proven up to 18weeks. Storage under refrigerated conditions was necessary to prevent precipitation and to obtain an acceptable shelf-life. In conclusion, we have developed and validated an amlodipine oral solution, suitable for the pediatric population. This liquid formulation is preferred over manipulated commercial dosage forms or non-standardized extemporaneously compounded formulations. Copyright © 2016 Elsevier B.V. All rights reserved.

Declining incidence of chickenpox in the absence of universal childhood immunisation

PubMed Central

Lowe, G; Salmon, R; Thomas, D; Evans, M

2004-01-01

Objective: To examine the epidemiology of chickenpox in Wales from 1986 to 2001. Design: Descriptive analysis of chickenpox consultations reported by the Welsh general practice sentinel surveillance scheme for infectious diseases, compared with annual shingles consultation rates from the same scheme to exclude reporting fatigue and data from a general practice morbidity database to validate results. Setting: A total of 226 884 patients registered with one of 30 volunteer general practices participating in the sentinel surveillance scheme. Main outcome measures: Age standardised and age specific incidence of chickenpox. Results: Crude and age standardised consultation rates for chickenpox declined from 1986 to 2001, with loss of epidemic cycling. Rates remained stable in 0–4 year olds but declined in all older age groups, particularly those aged 5–14 years. Shingles consultation rates remained constant over the same period. Data from the morbidity database displayed similar trends. Conclusion: General practitioner consultation rates for chickenpox are declining in Wales except in pre-school children. These findings are unlikely to be a reporting artefact but may be explained either by an overall decline in transmission or increased social mixing in those under 5 years old, through formal child care and earlier school entry, and associated increasing rates of mild or subclinical infection in this age group. Further investigation, particularly by serological surveillance, is necessary before universal varicella immunisation can be considered in the UK. PMID:15383443

The Onset of Magnetic Reconnection in Tail-Like Equilibria

NASA Technical Reports Server (NTRS)

Hesse, Michael; Birn, Joachim; Kuznetsova, Masha

1999-01-01

Magnetic reconnection is a fundamental mode of dynamics in the magnetotail, and is recognized as the basic mechanisms converting stored magnetic energy into kinetic energy of plasma particles. The effects of the reconnection process are well documented by spacecraft observations of plasmoids in the distant magnetotail, or bursty bulk flows, and magnetic field dipolarizations in the near Earth region. Theoretical and numerical analyses have, in recent years, shed new light on the way reconnection operates, and, in particular, which microscopic mechanism supports the dissipative electric field in the associated diffusion region. Despite this progress, however. the question of how magnetic reconnection initiates in a tail-like magnetic field with finite flux threading the current i.sheet remains unanswered. Instead, theoretical studies supported by numerical simulations support the point-of-view that such plasma and current sheets are stable with respect to collisionless tearing mode. In this paper, we will further investigate this conclusion, with emphasis on the question whether it remains valid in plasma sheets with embedded thin current sheets. For this purpose, we perform particle-in-cell simulations of the driven formation of thin current sheets, and their subsequent evolution either to equilibrium or to instability of a tearing-type mode. In the latter case we will pay particular attention to the nature of the electric field contribution which unmagnetizes the electrons.

Diversity of endophytic fungi and screening of fungal paclitaxel producer from Anglojap yew, Taxus x media

PubMed Central

2013-01-01

Background Endophytic fungi represent underexplored resource of novel lead compounds and have a capacity to produce diverse class of plant secondary metabolites. Here we investigated endophytic fungi diversity and screening of paclitaxel-producing fungi from Taxus x media. Results Eighty-one endophytic fungi isolated from T. media were grouped into 8 genera based on the morphological and molecular identification. Guignardia and Colletotrichum were the dominant genera, whereas the remaining genera were infrequent groups. The genera Glomerella and Gibberella were first reported in Taxus. Three representative species of the distinct genera gave positive hits by molecular marker screening and were capable of producing taxol which were validated by HPLC-MS. Among these 3 taxol-producing fungi, the highest yield of taxol was 720 ng/l by Guignardia mangiferae HAA11 compared with those of Fusarium proliferatum HBA29 (240 ng/l) and Colletotrichum gloeosporioides TA67 (120 ng/l). This is the first report of taxol producer from Guignardia. Moreover, the lower similarities of ts and bapt between microbial and plant origin suggested that fungal taxol biosynthetic cluster might be repeatedly invented during evolution, nor horizontal gene transfer from Taxus species. Conclusions Taxol-producing endophytic fungi could be a fascinating reservoir to generate taxol-related drug lead and to elucidate the remained 5 unknown genes or the potential regulation mechanism in the taxol biosynthesis pathway. PMID:23537181

A statistically robust EEG re-referencing procedure to mitigate reference effect

PubMed Central

Lepage, Kyle Q.; Kramer, Mark A.; Chu, Catherine J.

2014-01-01

Background The electroencephalogram (EEG) remains the primary tool for diagnosis of abnormal brain activity in clinical neurology and for in vivo recordings of human neurophysiology in neuroscience research. In EEG data acquisition, voltage is measured at positions on the scalp with respect to a reference electrode. When this reference electrode responds to electrical activity or artifact all electrodes are affected. Successful analysis of EEG data often involves re-referencing procedures that modify the recorded traces and seek to minimize the impact of reference electrode activity upon functions of the original EEG recordings. New method We provide a novel, statistically robust procedure that adapts a robust maximum-likelihood type estimator to the problem of reference estimation, reduces the influence of neural activity from the re-referencing operation, and maintains good performance in a wide variety of empirical scenarios. Results The performance of the proposed and existing re-referencing procedures are validated in simulation and with examples of EEG recordings. To facilitate this comparison, channel-to-channel correlations are investigated theoretically and in simulation. Comparison with existing methods The proposed procedure avoids using data contaminated by neural signal and remains unbiased in recording scenarios where physical references, the common average reference (CAR) and the reference estimation standardization technique (REST) are not optimal. Conclusion The proposed procedure is simple, fast, and avoids the potential for substantial bias when analyzing low-density EEG data. PMID:24975291

Life in ice: implications to astrobiology

NASA Astrophysics Data System (ADS)

Hoover, Richard B.; Pikuta, Elena V.

2009-08-01

During previous research expeditions to Siberia, Alaska and Antarctica, it was observed that glaciers and ice wedges contained bacterial cells that became motile as soon as the ice melted. This phenomenon of live bacteria in ice was first documented for microbes in ancient ice cores from Vostok, Antarctica. The first validly published species of Pleistocene bacteria alive on Earth today was Carnobacterium pleistocenium. This extremophile had remained for 32,000 years, encased in ice recently exposed in the Fox Tunnel of Alaska. These frozen bacteria began to swim as soon as the ice was thawed. Dark field microscopy studies revealed that large numbers of bacteria exhibited motility as soon as glacial ice was melted during our recent Expeditions to Alaska and Antarctica led to the conclusion that microbial life in ice was not a rare phenomenon. The ability of bacteria to remain alive while frozen in ice for long periods of time is of great significance to Astrobiology. In this paper, we describe the recent observations and advance the hypothesis that life in ice provides valuable clues to how we can more easily search for evidence of life on the Polar Caps of Mars, comets and other icy bodies of our Solar System. It is suggested that cryopanspermia may have played a far more important role in Origin of Life on Earth and the distribution of Life throughout the Cosmos and than previously thought possible.

A germline missense mutation in COQ6 is associated with susceptibility to familial schwannomatosis

PubMed Central

Zhang, Keqiang; Lin, Jia-Wei; Wang, Jinhui; Wu, Xiwei; Gao, Hanlin; Hsieh, Yi-Chen; Hwu, Peter; Liu, Yun-Ru; Su, Leila; Chiou, Hung-Yi; Wang, Daidong; Yuan, Yate-Ching; Whang-Peng, Jacqueline; Chiu, Wen-Ta; Yen, Yun

2014-01-01

Purpose: Schwannomatosis, a subtype of neurofibromatosis, is characterized by multiple benign, nonvestibular, nonintradermal schwannomas. Although the tumor suppressor SMARCB1 gene has been frequently identified as the underlying genetic cause of half of familial and ~10% of sporadic schwannomatosis, for most other cases, further causative genes remain to be discovered. Herein, we characterize the genome of a schwannomatosis family without constitutional inactivation of the SMARCB1 gene to explore novel genomic alterations predisposing individuals to the familial disease. Methods: We performed whole-genome/exome sequencing on genomic DNA of both schwannomatosis-affected and normal members of the family. Results: We identified a novel missense mutation (p.Asp208His; c.622G>C) in the coenzyme Q10 (CoQ10) biosynthesis monooxygenase 6 gene (COQ6) in schwannomatosis-affected members. The deleterious effects of the COQ6 mutations were validated by their lack of complementation in a coq6-deficient yeast mutant. Our study further indicated that the resultant haploinsufficiency of COQ6 might lead to CoQ10 deficiency and chronic overproduction of reactive oxygen species in Schwann cells. Conclusion: Although the exact oncogenetic mechanisms in this schwannomatosis family remain to be elucidated, our data strongly indicate a probable role of COQ6 mutation and CoQ10 deficiency in the development of familial schwannomatosis. PMID:24763291

Bioprosthetic heart valve heterograft biomaterials: structure, mechanical behavior and computational simulation.

PubMed

Sacks, Michael S; Mirnajafi, Ali; Sun, Wei; Schmidt, Paul

2006-11-01

The present review surveys significant developments in the biomechanical characterization and computational simulation of biologically derived chemically cross-linked soft tissues, or 'heterograft' biomaterials, used in replacement bioprosthetic heart valve (BHV). A survey of mechanical characterization techniques, relevant mechanical properties and computational simulation approaches is presented for both the source tissues and cross-linked biomaterials. Since durability remains the critical problem with current bioprostheses, changes with the mechanical behavior with fatigue are also presented. Moreover, given the complex nature of the mechanical properties of heterograft biomaterials it is not surprising that most constitutive (stress-strain) models, historically used to characterize their behavior, were oversimplified. Simulations of BHV function utilizing these models have inevitably been inaccurate. Thus, more recent finite element simulations utilizing nonlinear constitutive models, which achieve greater model fidelity, are reviewed. An important conclusion of this review is the need for accurate constitutive models, rigorously validated with appropriate experimental data, in order that the design benefits of computational models can be realized. Finally, for at least the coming 20 years, BHVs fabricated from heterograft biomaterials will continue to be extensively used, and will probably remain as the dominant valve design. We should thus recognize that rational, scientifically based approaches to BHV biomaterial development and design can lead to significantly improved BHV, over the coming decades, which can potentially impact millions of patients worldwide with heart valve disease.

An Empirical Investigation of Student Evaluations of Instruction--The Relative Importance of Factors

ERIC Educational Resources Information Center

Nargundkar, Satish; Shrikhande, Milind

2012-01-01

We analyzed over 100,000 student evaluations of instruction over 4 years in the college of business at a major public university. We found that the original instrument that was validated about 20 years ago is still valid, with factor analysis showing that the six underlying dimensions used in the instrument remained relatively intact. Also, we…

Content Validity of Game-Based Assessment: Case Study of a Serious Game for ICT Managers in Training

ERIC Educational Resources Information Center

Hummel, Hans G. K.; Joosten-ten Brinke, Desirée; Nadolski, Rob J.; Baartman, Liesbeth K. J.

2017-01-01

Serious games foster the acquisition of complex problem-solving skills. Assessment of such skills should be in line with instruction, and within a serious game environment its content validity should equal face-to-face assessment. Research on assessment in serious gaming has remained rather scarce. This article shows how assessment can be…

Emerging Technologies for the Diagnosis of Perihilar Cholangiocarcinoma.

PubMed

Rizvi, Sumera; Eaton, John; Yang, Ju Dong; Chandrasekhara, Vinay; Gores, Gregory J

2018-05-01

The diagnosis of malignant biliary strictures remains problematic, especially in the perihilar region and in primary sclerosing cholangitis (PSC). Conventional cytology obtained during endoscopic retrograde cholangiography (ERC)-guided brushings of biliary strictures is suboptimal due to limited sensitivity, albeit it remains the gold standard with a high specificity. Emerging technologies are being developed and validated to address this pressing unmet patient need. Such technologies include enhanced visualization of the biliary tree by cholangioscopy, intraductal ultrasound, and confocal laser endomicroscopy. Conventional cytology can be aided by employing complementary and advanced cytologic techniques such as fluorescent in situ hybridization (FISH), and this technique should be widely adapted. Interrogation of bile and serum by examining extracellular vesicle number and cargo, and exploiting next-generation sequencing and proteomic technologies, is also being explored. Examination of circulating cell-free deoxyribonucleic acid (cfDNA) for differentially methylated regions is a promising test which is being rigorously validated. The special expertise required for these analyses has to date hampered their validation and adaptation. Herein, we will review these emerging technologies to inform the reader of the progress made and encourage further studies, as well as adaptation of validated approaches. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The revised EEMCO guidance for the in vivo measurement of water in the skin.

PubMed

Berardesca, Enzo; Loden, Marie; Serup, Jorgen; Masson, Philippe; Rodrigues, Luis Monteiro

2018-06-20

Noninvasive quantification of stratum corneum water content is widely used in skin research and topical product development. The original EEMCO guidelines on measurements of skin hydration by electrical methods and transepidermal water loss (TEWL) by evaporimeter published in 1997 and 2001 have been revisited and updated with the incorporation of recently available technologies. Electrical methods and open-chamber evaporimeters for measurement of TEWL are still the preferred techniques to measure the water balance in the stratum corneum. The background technology and biophysics of these instruments remain relevant and valid. However, new methods that can image surface hydration and measure depth profiles of dermal water content now available. Open-chamber measurement of TEWL has been supplemented with semiopen and closed chamber probes, which are more robust to environmental influence and therefore convenient to use and more applicable to field studies. However, closed chamber methods interfere with the evaporation of water, and the methods cannot be used for continuous monitoring. Validation of methods with respect to intra- and inter-instrument variation remains challenging. No validation standard or test phantom is available. The established methods for measurement of epidermal water content and TEWL have been supplemented with important new technologies including methods that allow imaging of epidermal water distribution and water depth profiles. A much more complete and sophisticated characterization of the various aspects of the dermal water barrier has been accomplished by means of today's noninvasive techniques; however, instrument standardization and validation remain a challenge. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The Effects of Acute Cannabis Use on Nontraffic Injury Risk: Reviewing the Available Literature and Identifying Ways Forward

PubMed Central

Andreuccetti, Gabriel; Ye, Yu; Kang, Jaewook; Korcha, Rachael; Witbrodt, Jane A.; Carvalho, Heraclito B.; Cherpitel, Cheryl J.

2018-01-01

Recent evidence has indicated that cannabis use before driving is associated with a modest but increased risk for traffic-related injuries. However, the question of whether recent cannabis use is associated with a greater risk for other types of injuries remains unanswered. Aiming to understand better how acute cannabis use might affect the risk for all causes of injury, we have summarized the limited data available in the literature on the risk of non-traffic injuries associated with recent cannabis use. Very few studies were able to provide estimate risks for all injuries or injuries other than those related to road traffic injuries, with the limited evidence available showing mixed findings. The only significant risk found (in only one study) suggests an inverse association between all injuries and cannabis use. Study designs are limited, and the majority of studies have neither data on acute cannabis use among injured individuals nor a valid control group for estimating injury risk attributable to cannabis. In conclusion, studies of the association between cannabis and non-traffic injuries present several limitations, particularly regarding sampling strategies, injury risk assessment for different causes of injury, and a dose-response risk relationship with injury. Further studies, incorporating better design for different causes of injury and drug testing, are required to reach firmer conclusions on the association between cannabis use and non-traffic injury risk. PMID:29456273

Women with spontaneous 46,XX primary ovarian insufficiency (hypergonadotropic hypogonadism) have lower perceived social support than control women

PubMed Central

Orshan, Susan A.; Ventura, June L.; Covington, Sharon N.; Vanderhoof, Vien H.; Troendle, James F.; Nelson, Lawrence M.

2009-01-01

Objective To test the hypothesis that women with spontaneous primary ovarian insufficiency differ from control women with regard to perceived social support and to investigate the relationship between perceived social support and self-esteem. Design Cross-sectional Setting Mark O. Hatfield Clinical Research Center, National Institutes of Health. Patient(s) Women diagnosed with spontaneous primary ovarian insufficiency (N=154) at a mean age of 27 years and healthy control women (N=63). Intervention(s) Administration of validated self-reporting instruments. Main Outcome Measure(s) Personal Resource Questionnaire-85 (PRQ85), Rosenberg Self-Esteem Scale Result(s) Women with primary ovarian insufficiency had significantly lower scores than controls on the perceived social support scale and the self-esteem scale. The findings remained significant after modeling with multivariate regression for differences in age, marital status, and having children. In patients there was a significant positive correlation between self-esteem scores and perceived social support. We found no significant differences in perceived social support or self-esteem related to marital status, whether or not they had children, or time since diagnosis. Conclusion(s) This evidence supports the need for prospective controlled studies. Strategies to improve social support and self-esteem might provide a therapeutic approach to reduce the emotional suffering that accompanies the life-altering diagnosis of spontaneous primary ovarian insufficiency. PMID:18829005

Development and evaluation of the Korean Health Literacy Instrument.

PubMed

Kang, Soo Jin; Lee, Tae Wha; Paasche-Orlow, Michael K; Kim, Gwang Suk; Won, Hee Kwan

2014-01-01

The purpose of this study is to develop and validate the Korean Health Literacy Instrument, which measures the capacity to understand and use health-related information and make informed health decisions in Korean adults. In Phase 1, 33 initial items were generated to measure functional, interactive, and critical health literacy with prose, document, and numeracy tasks. These items included content from health promotion, disease management, and health navigation contexts. Content validity assessment was conducted by an expert panel, and 11 items were excluded. In Phase 2, the 22 remaining items were administered to a convenience sample of 292 adults from community and clinical settings. Exploratory factor and item difficulty and discrimination analyses were conducted and four items with low discrimination were deleted. In Phase 3, the remaining 18 items were administered to a convenience sample of 315 adults 40-64 years of age from community and clinical settings. A confirmatory factor analysis was performed to test the construct validity of the instrument. The Korean Health Literacy Instrument has a range of 0 to 18. The mean score in our validation study was 11.98. The instrument exhibited an internal consistency reliability coefficient of 0.82, and a test-retest reliability of 0.89. The instrument is suitable for screening individuals who have limited health literacy skills. Future studies are needed to further define the psychometric properties and predictive validity of the Korean Health Literacy Instrument.

Concurrent validity of the College Adjustment scales using comparison with the MMPI College Maladjustment Scale.

PubMed

Campbell, Michael H; Palmieri, Michael; Lasch, Brandi

2006-12-01

The concurrent validity of the College Adjustment Scales was assessed using comparison to the College Maladjustment Scale of the Minnesota Multiphasic Inventory-2. Undergraduate students (N=56, 40 women, M age = 21.3 yr., 87.5% white, non-Hispanic) completed both tests. Analysis indicated scores on 8 of 9 College Adjustment Scales correlated significantly in the predicted direction with those on the College Maladjustment Scale, thereby providing some additional support for convergent validity. While the conclusions are limited significantly by the small sample, this report provides an incremental contribution to the validity of the College Adjustment Scales.

Measuring quality of life in cleft lip and palate patients: currently available patient-reported outcomes measures.

PubMed

Eckstein, Donna A; Wu, Rebecca L; Akinbiyi, Takintope; Silver, Lester; Taub, Peter J

2011-11-01

Patient-reported outcomes in cleft lip and palate treatment are critical for patient care. Traditional surgical outcomes focused on objective measures, such as photographs, anatomic measurements, morbidity, and mortality. Although these remain important, they leave many questions unanswered. Surveys that include aesthetics, speech, functionality, self-image, and quality of life provide more thorough outcomes assessment. It is vital that reliable, valid, and comprehensive questionnaires are available to craniofacial surgeons. The authors performed a literature review to identify questionnaires validated in cleft lip and palate patients. Qualifying instruments were assessed for adherence to guidelines for development and validation by the scientific advisory committee and for content. The authors identified 44 measures used in cleft lip and palate studies. After 15 ad hoc questionnaires, eight generic instruments, 11 psychiatric instruments, and one non-English language questionnaire were excluded, nine measures remained. Of these, four were never validated in the cleft population. Analysis revealed one craniofacial-specific measure (Youth Quality of Life-Facial Differences), two voice-related measures (Patient Voice-Related Quality of Life and Cleft Audit Protocol for Speech-Augmented), and two oral health-related measures (Child Oral Health Impact Profile and Child Oral Health Quality of Life). The Youth Quality of Life-Facial Differences, Child Oral Health Impact Profile, and Child Oral Health Quality of Life questionnaires were sufficiently validated. None was created specifically for clefts, resulting in content limitations. There is a lack of comprehensive, valid, and reliable questionnaires for cleft lip and palate surgery. For thorough assessment of satisfaction, further research to develop and validate cleft lip and palate surgery-specific instruments is needed.

Early Identification of Children at Risk for Academic Difficulties Using Standardized Assessment: Stability and Predictive Validity of Preschool Math and Language Scores

ERIC Educational Resources Information Center

Frans, Niek; Post, Wendy J.; Huisman, Mark; Oenema-Mostert, Ineke C. E.; Keegstra, Anne L.; Minnaert, Alexander E. M. G.

2017-01-01

Despite the claim by several researchers that variability in performance may complicate the identification of "at-risk" children, variability in the academic performance of young children remains an undervalued area of research. The goal of this study is to examine the predictive validity for future scores and the score stability of two…

Teachers' Self-Efficacy and Knowledge of Healthy Nutrition and Physical Activity Practices for Preschoolers: Instrument Development and Validation

ERIC Educational Resources Information Center

Derscheid, Linda E.; Kim, So-Yeun; Zittel, Lauriece L.; Umoren, Josephine; Henry, Beverly W.

2014-01-01

Childhood obesity remains a problem in the United States. Preschool teachers can help to attenuate it but need to have the confidence or self-efficacy to provide healthy practices. Therefore, the purpose of this study was to (a) develop and validate a preschool teacher self-efficacy tool to examine teachers' confidence in addressing the nutrition…

Content validity of critical success factors for e-Government implementation in Indonesia

NASA Astrophysics Data System (ADS)

Napitupulu, D.; Syafrullah, M.; Rahim, R.; Amar, A.; Sucahyo, YG

2018-05-01

The purpose of this research is to validate the Critical Success Factors (CSFs) of e-Government implementation in Indonesia. The e-Government initiative conducted only to obey the regulation but ignoring the quality. Defining CSFs will help government agencies to avoid failure of e-Government projects. A survey with the questionnaire was used to validate the item of CSF based on expert judgment through two round of Delphi. The result showed from 67 subjects in instrument tested; there are 11 invalid items deleted and remain only 56 items that had good content validity and internal reliability. Therefore, all 56 CSFs should be adopted by government agencies in Indonesia to support e-Government implementation.

Validating a mouse model of ovarian cancer for early detection through imaging | Division of Cancer Prevention

Cancer.gov

Despite advances in treatment strategies, ovarian cancer remains the deadliest gynecological malignancy and the 5th largest cancer killer in women. Located deep in the body, with few early symptoms and no effective screening technique, ovarian cancer has remained stubbornly difficult to understand, much less effectively combat. Ovarian cancer is almost always discovered at an

Validation of Computational Models in Biomechanics

PubMed Central

Henninger, Heath B.; Reese, Shawn P.; Anderson, Andrew E.; Weiss, Jeffrey A.

2010-01-01

The topics of verification and validation (V&V) have increasingly been discussed in the field of computational biomechanics, and many recent articles have applied these concepts in an attempt to build credibility for models of complex biological systems. V&V are evolving techniques that, if used improperly, can lead to false conclusions about a system under study. In basic science these erroneous conclusions may lead to failure of a subsequent hypothesis, but they can have more profound effects if the model is designed to predict patient outcomes. While several authors have reviewed V&V as they pertain to traditional solid and fluid mechanics, it is the intent of this manuscript to present them in the context of computational biomechanics. Specifically, the task of model validation will be discussed with a focus on current techniques. It is hoped that this review will encourage investigators to engage and adopt the V&V process in an effort to increase peer acceptance of computational biomechanics models. PMID:20839648

Is Implicit Theory of Mind a Real and Robust Phenomenon? Results From a Systematic Replication Study.

PubMed

Kulke, Louisa; von Duhn, Britta; Schneider, Dana; Rakoczy, Hannes

2018-06-01

Recently, theory-of-mind research has been revolutionized by findings from novel implicit tasks suggesting that at least some aspects of false-belief reasoning develop earlier in ontogeny than previously assumed and operate automatically throughout adulthood. Although these findings are the empirical basis for far-reaching theories, systematic replications are still missing. This article reports a preregistered large-scale attempt to replicate four influential anticipatory-looking implicit theory-of-mind tasks using original stimuli and procedures. Results showed that only one of the four paradigms was reliably replicated. A second set of studies revealed, further, that this one paradigm was no longer replicated once confounds were removed, which calls its validity into question. There were also no correlations between paradigms, and thus, no evidence for their convergent validity. In conclusion, findings from anticipatory-looking false-belief paradigms seem less reliable and valid than previously assumed, thus limiting the conclusions that can be drawn from them.

The influence of sagittal profile alteration and final lordosis on the clinical outcome of cervical spondylotic myelopathy. A Delta-Omega-analysis

PubMed Central

Koeppen, Daniel; Piepenbrock, Claudia; Kroppenstedt, Stefan; Čabraja, Mario

2017-01-01

Purpose Decompression and maintaining or restoring a cervical lordosis are major goals in the surgical treatment of cervical spondylotic myelopathy (CSM). Numerous studies support the assumption that cervical lordosis is a key factor for neurological recovery and pain reduction. However, even kyphotic patients can be asymptomatic. The balance of the spine is subject of an increasing number of publications. The main purpose of the study was to evaluate the validity of lordotic alignment on the course of CSM and to set this parameter in context with well-validated tools, namely the modified Japanese Orthopaedic Association scoring system (mJOAS) and the visual analogue scale (VAS), to predict and measure the clinical outcome after surgery. Methods This is a retrospective study with prospectively collected data of a heterogeneous cohort. The authors analyzed the records of 102 patients suffering from CSM that underwent decompressive surgery and instrumentation. Clinical outcome was assessed by using the mJOAS, VAS and Odom’s criteria. The radiological analysis involved comparison of pre- and postoperative radiographs. The patients were divided into subgroups to be able to compare the influence of various amounts of correction (3 Delta-groups: <0°, 1–7° and ≥8°) and final lordosis (4 Omega-groups: 0–7°, 8–14°, 15–21°, ≥22°). Results 219 levels were fused in 102 patients. Surgery improved the clinical outcome of all groups significantly. A lordotic profile was achieved in all analyzed groups. Patients that showed small lordosis after surgery (<8°) did not have an inferior clinical outcome compared to patients with larger cervical lordosis (>14°). The comparison of Odom’s criteria showed that preoperatively kyphotic patients benefitted more from surgery than lordotic patients (p = 0.029), but no differences could be seen comparing neck pain and neurological improvement. The improvement of pain and neurological impairment measured by VAS and mJOAS supports the statistical impact and validity of the data despite comparatively small numbers of patients. The lack of postoperative kyphosis is a major limitation of the study to encompass the impact of sagittal alignment on clinical outcome. Conclusions Decompression and stabilization appear to be key elements of surgical treatment of CSM. While the achievement of cervical lordosis remains a major goal of surgery, clinical improvement is not hindered in patients who show small lordosis. However, kyphosis should be eliminated in symptomatic patients. The terms “balance” and “physiologic lordosis” remain complex entities without clear definition. To check the results of our study controlled randomized trials to validate and determine the exact role of cervical balance on the course of CSM would be helpful. PMID:28430792

Development and validation of an educational booklet for healthy eating during pregnancy1

PubMed Central

de Oliveira, Sheyla Costa; Lopes, Marcos Venícios de Oliveira; Fernandes, Ana Fátima Carvalho

2014-01-01

OBJECTIVE: to describe the validation process of an educational booklet for healthy eating in pregnancy using local and regional food. METHODS: methodological study, developed in three steps: construction of the educational booklet, validation of the educational material by judges, and by pregnant women. The validation process was conducted by 22 judges and 20 pregnant women, by convenience selection. We considered a p-value<0.85 to validate the booklet compliance and relevance, according to the six items of the instrument. As for content validation, the item-level Content Validity Index (I-CVI) was considered when a minimum score of at least 0.80 was obtained. RESULTS: five items were considered relevant by the judges. The mean I-CVI was 0.91. The pregnant women evaluated positively the booklet. The suggestions were accepted and included in the final version of the material. CONCLUSION: the booklet was validated in terms of content and relevance, and should be used by nurses for advice on healthy eating during pregnancy. PMID:25296145

Item Development and Validity Testing for a Self- and Proxy Report: The Safe Driving Behavior Measure

PubMed Central

Classen, Sherrilene; Winter, Sandra M.; Velozo, Craig A.; Bédard, Michel; Lanford, Desiree N.; Brumback, Babette; Lutz, Barbara J.

2010-01-01

OBJECTIVE We report on item development and validity testing of a self-report older adult safe driving behaviors measure (SDBM). METHOD On the basis of theoretical frameworks (Precede–Proceed Model of Health Promotion, Haddon’s matrix, and Michon’s model), existing driving measures, and previous research and guided by measurement theory, we developed items capturing safe driving behavior. Item development was further informed by focus groups. We established face validity using peer reviewers and content validity using expert raters. RESULTS Peer review indicated acceptable face validity. Initial expert rater review yielded a scale content validity index (CVI) rating of 0.78, with 44 of 60 items rated ≥0.75. Sixteen unacceptable items (≤0.5) required major revision or deletion. The next CVI scale average was 0.84, indicating acceptable content validity. CONCLUSION The SDBM has relevance as a self-report to rate older drivers. Future pilot testing of the SDBM comparing results with on-road testing will define criterion validity. PMID:20437917

Use of Bayesian Networks to Probabilistically Model and Improve the Likelihood of Validation of Microarray Findings by RT-PCR

PubMed Central

English, Sangeeta B.; Shih, Shou-Ching; Ramoni, Marco F.; Smith, Lois E.; Butte, Atul J.

2014-01-01

Though genome-wide technologies, such as microarrays, are widely used, data from these methods are considered noisy; there is still varied success in downstream biological validation. We report a method that increases the likelihood of successfully validating microarray findings using real time RT-PCR, including genes at low expression levels and with small differences. We use a Bayesian network to identify the most relevant sources of noise based on the successes and failures in validation for an initial set of selected genes, and then improve our subsequent selection of genes for validation based on eliminating these sources of noise. The network displays the significant sources of noise in an experiment, and scores the likelihood of validation for every gene. We show how the method can significantly increase validation success rates. In conclusion, in this study, we have successfully added a new automated step to determine the contributory sources of noise that determine successful or unsuccessful downstream biological validation. PMID:18790084

Competency-Based Training and Simulation: Making a "Valid" Argument.

PubMed

Noureldin, Yasser A; Lee, Jason Y; McDougall, Elspeth M; Sweet, Robert M

2018-02-01

The use of simulation as an assessment tool is much more controversial than is its utility as an educational tool. However, without valid simulation-based assessment tools, the ability to objectively assess technical skill competencies in a competency-based medical education framework will remain challenging. The current literature in urologic simulation-based training and assessment uses a definition and framework of validity that is now outdated. This is probably due to the absence of awareness rather than an absence of comprehension. The following review article provides the urologic community an updated taxonomy on validity theory as it relates to simulation-based training and assessments and translates our simulation literature to date into this framework. While the old taxonomy considered validity as distinct subcategories and focused on the simulator itself, the modern taxonomy, for which we translate the literature evidence, considers validity as a unitary construct with a focus on interpretation of simulator data/scores.

Restraint and the question of validity.

PubMed

Paterson, Brodie; Duxbury, Joy

2007-07-01

Restraint as an intervention in the management of acute mental distress has a long history that predates the existence of psychiatry. However, it remains a source of controversy with an ongoing debate as to its role. This article critically explores what to date has seemingly been only implicit in the debate surrounding the role of restraint: how should the concept of validity be interpreted when applied to restraint as an intervention? The practice of restraint in mental health is critically examined using two post-positivist constructions of validity, the pragmatic and the psychopolitical, by means of a critical examination of the literature. The current literature provides only weak support for the pragmatic validity of restraint as an intervention and no support to date for its psychopolitical validity. Judgements regarding the validity of any intervention that is coercive must include reference to the psychopolitical dimensions of both practice and policy.

7 CFR 12.30 - NRCS responsibilities regarding wetlands.

Code of Federal Regulations, 2010 CFR

2010-01-01

... approve wetland determinations, delineations and certifications, functional assessments, mitigation plans... production of food, fiber, or horticultural crops, a certification made under this section will remain valid...

Use of Latent Class Analysis to define groups based on validity, cognition, and emotional functioning.

PubMed

Morin, Ruth T; Axelrod, Bradley N

Latent Class Analysis (LCA) was used to classify a heterogeneous sample of neuropsychology data. In particular, we used measures of performance validity, symptom validity, cognition, and emotional functioning to assess and describe latent groups of functioning in these areas. A data-set of 680 neuropsychological evaluation protocols was analyzed using a LCA. Data were collected from evaluations performed for clinical purposes at an urban medical center. A four-class model emerged as the best fitting model of latent classes. The resulting classes were distinct based on measures of performance validity and symptom validity. Class A performed poorly on both performance and symptom validity measures. Class B had intact performance validity and heightened symptom reporting. The remaining two Classes performed adequately on both performance and symptom validity measures, differing only in cognitive and emotional functioning. In general, performance invalidity was associated with worse cognitive performance, while symptom invalidity was associated with elevated emotional distress. LCA appears useful in identifying groups within a heterogeneous sample with distinct performance patterns. Further, the orthogonal nature of performance and symptom validities is supported.

A preliminary study on postmortem interval estimation of suffocated rats by GC-MS/MS-based plasma metabolic profiling.

PubMed

Sato, Takako; Zaitsu, Kei; Tsuboi, Kento; Nomura, Masakatsu; Kusano, Maiko; Shima, Noriaki; Abe, Shuntaro; Ishii, Akira; Tsuchihashi, Hitoshi; Suzuki, Koichi

2015-05-01

Estimation of postmortem interval (PMI) is an important goal in judicial autopsy. Although many approaches can estimate PMI through physical findings and biochemical tests, accurate PMI calculation by these conventional methods remains difficult because PMI is readily affected by surrounding conditions, such as ambient temperature and humidity. In this study, Sprague-Dawley (SD) rats (10 weeks) were sacrificed by suffocation, and blood was collected by dissection at various time intervals (0, 3, 6, 12, 24, and 48 h; n = 6) after death. A total of 70 endogenous metabolites were detected in plasma by gas chromatography-tandem mass spectrometry (GC-MS/MS). Each time group was separated from each other on the principal component analysis (PCA) score plot, suggesting that the various endogenous metabolites changed with time after death. To prepare a prediction model of a PMI, a partial least squares (or projection to latent structure, PLS) regression model was constructed using the levels of significantly different metabolites determined by variable importance in the projection (VIP) score and the Kruskal-Wallis test (P < 0.05). Because the constructed PLS regression model could successfully predict each PMI, this model was validated with another validation set (n = 3). In conclusion, plasma metabolic profiling demonstrated its ability to successfully estimate PMI under a certain condition. This result can be considered to be the first step for using the metabolomics method in future forensic casework.

Validation of a T1 and T2* leakage correction method based on multi-echo DSC-MRI using MION as a reference standard

PubMed Central

Stokes, Ashley M.; Semmineh, Natenael; Quarles, C. Chad

2015-01-01

Purpose A combined biophysical- and pharmacokinetic-based method is proposed to separate, quantify, and correct for both T1 and T2* leakage effects using dual-echo DSC acquisitions to provide more accurate hemodynamic measures, as validated by a reference intravascular contrast agent (CA). Methods Dual-echo DSC-MRI data were acquired in two rodent glioma models. The T1 leakage effects were removed and also quantified in order to subsequently correct for the remaining T2* leakage effects. Pharmacokinetic, biophysical, and combined biophysical and pharmacokinetic models were used to obtain corrected cerebral blood volume (CBV) and cerebral blood flow (CBF), and these were compared with CBV and CBF from an intravascular CA. Results T1-corrected CBV was significantly overestimated compared to MION CBV, while T1+T2*-correction yielded CBV values closer to the reference values. The pharmacokinetic and simplified biophysical methods showed similar results and underestimated CBV in tumors exhibiting strong T2* leakage effects. The combined method was effective for correcting T1 and T2* leakage effects across tumor types. Conclusions Correcting for both T1 and T2* leakage effects yielded more accurate measures of CBV. The combined correction method yields more reliable CBV measures than either correction method alone, but for certain brain tumor types (e.g., gliomas) the simplified biophysical method may provide a robust and computationally efficient alternative. PMID:26362714

Injury Source and Correlation Analysis of Riders in Car-Electric Bicycle Accidents.

PubMed

Zou, Tiefang; Yi, Liang; Cai, Ming; Hu, Lin; Li, Yuelin

2018-01-01

The knowledge about the injury source and correlation of riders in car-electric bicycle accident will be helpful in the cross validation of traces and vehicle safety design. In order to know more information about such kind of knowledge, 57 true car-electric bicycle accidents were reconstructed by PC-Crash and then data on injury information of riders were collected directly from the reconstructed cases. These collected data were validated by some existing research results firstly, and then 4 abnormal cases were deleted according to the statistical method. Finally, conclusions can be obtained according to the data obtained from the remaining 53 cases. Direct injuries of the head and right leg are from the road pavement upon low speed; the source laws of indirect head injuries are not obvious. Upon intermediate and high speed, the injuries of the above parts are from automobiles. Injuries of the left leg, femur, and right knee are from automobiles; left knee injuries are from automobiles, the road pavement and automobiles, respectively, upon low, intermediate, and high speed. The source laws of indirect torso injuries are not obvious upon intermediate and low speed, which are from automobiles upon high speed, while direct torso injuries are from the road pavement. And there is no high correlation between all parts of the injury of riders. The largest correlation coefficient was the head-left femur and left femur-right femur, which was 0.647, followed by the head-right femur (0.638) and head-torso which was 0.617.

Mean Normalized Gain: A New Method for the Assessment of the Aerobic System Temporal Dynamics during Randomly Varying Exercise in Humans.

PubMed

Beltrame, Thomas; Hughson, Richard L

2017-01-01

The temporal dynamics of the oxygen uptake ([Formula: see text]) during moderate exercise has classically been related to physical fitness and a slower [Formula: see text] dynamics was associated with deterioration of physical health. However, methods that better characterize the aerobic system temporal dynamics remain challenging. The purpose of this study was to develop a new method (named mean normalized gain, MNG ) to systematically characterize the [Formula: see text] temporal dynamics. Eight healthy, young adults (28 ± 6 years old, 175 ± 7 cm and 79 ± 13 kg) performed multiple pseudorandom binary sequence cycling protocols on different days and time of the day. The MNG was calculated as the normalized amplitude of the [Formula: see text] signal in frequency-domain. The MNG was validated considering the time constant τ obtained from time-domain analysis as reference. The intra-subject consistency of the MNG was checked by testing the same participant on different days and times of the day. The MNG and τ were strongly negatively correlated ( r = -0.86 and p = 0.005). The MNG measured on different days and periods of the day was similar between conditions. Calculations for the MNG have inherent filtering characteristics enhancing reliability for the evaluation of the aerobic system temporal dynamics. In conclusion, the present study successfully validated the use of the MNG for aerobic system analysis and as a potential complementary tool to assess changes in physical fitness.

Validation of specific inhalation challenge for the diagnosis of occupational asthma due to persulphate salts

PubMed Central

Munoz, X; Cruz, M; Orriols, R; Torres, F; Espuga, M; Morell, F

2004-01-01

Background: The significant value of tests used to certify the diagnosis of occupational asthma due to persulphate salts remains uncertain. Aims: To validate the specific inhalation challenge (SIC) test for the diagnosis of occupational asthma. Methods: Eight patients with occupational asthma due to persulphate salts, eight patients with bronchial asthma who were never exposed to persulphate salts, and ten healthy subjects were studied. Clinical history taking, spirometry, bronchial challenge with methacholine, skin prick testing to common inhalant allergens and persulphate salts, total IgE levels, and SIC to potassium persulphate were carried out in all subjects. The SIC used increasing concentrations of potassium persulphate (5, 10, 15, and 30 g) mixed with 150 g of lactose. Patients tipped the mixture from one tray to another at a distance of 30 cm from the face for 10 minutes in a challenge booth. Results: The SIC was positive in all subjects with persulphate induced asthma and in one patient with bronchial asthma who had never been exposed to persulphate salts. Sensitivity was 100% (95% CI 67.6 to 100) and specificity was 87.5% (95% CI 52.9–97.8) when patients with occupational asthma due to persulphate salts were compared with those with bronchial asthma never exposed to persulphate salts. Conclusions: SIC to persulphate salts performed according to the protocol described appears to be useful for the diagnosis of occupational asthma secondary to inhalation of this substance. PMID:15377773

Does partial Granger causality really eliminate the influence of exogenous inputs and latent variables?

PubMed

Roelstraete, Bjorn; Rosseel, Yves

2012-04-30

Partial Granger causality was introduced by Guo et al. (2008) who showed that it could better eliminate the influence of latent variables and exogenous inputs than conditional G-causality. In the recent literature we can find some reviews and applications of this type of Granger causality (e.g. Smith et al., 2011; Bressler and Seth, 2010; Barrett et al., 2010). These articles apparently do not take into account a serious flaw in the original work on partial G-causality, being the negative F values that were reported and even proven to be plausible. In our opinion, this undermines the credibility of the obtained results and thus the validity of the approach. Our study is aimed to further validate partial G-causality and to find an answer why negative partial Granger causality estimates were reported. Time series were simulated from the same toy model as used in the original paper and partial and conditional causal measures were compared in the presence of confounding variables. Inference was done parametrically and using non-parametric block bootstrapping. We counter the proof that partial Granger F values can be negative, but the main conclusion of the original article remains. In the presence of unknown latent and exogenous influences, it appears that partial G-causality will better eliminate their influence than conditional G-causality, at least when non-parametric inference is used. Copyright © 2012 Elsevier B.V. All rights reserved.

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

Titt, U; Suzuki, K

Purpose: The PTCH is preparing the ocular proton beam nozzle for clinical use. Currently commissioning measurements are being performed using films, diodes and ionization chambers. In parallel, a Monte Carlo model of the beam line was created for integration into the automated Monte Carlo treatment plan computation system, MC{sup 2}. This work aims to compare Monte Carlo predictions to measured proton doses in order to validate the Monte Carlo model. Methods: A complete model of the double scattering ocular beam line has been created and is capable of simulating proton beams with a comprehensive set of beam modifying devices, includingmore » eleven different range modulator wheels. Simulations of doses in water were scored and compare to ion chamber measurements of depth doses, lateral dose profiles extracted from half beam block exposures of films, and diode measurements of lateral penumbrae at various depths. Results: All comparison resulted in an average relative entrance dose difference of less than 3% and peak dose difference of less than 2%. All range differences were smaller than 0.2 mm. The differences in the lateral beam profiles were smaller than 0.2 mm, and the differences in the penumbrae were all smaller than 0.4%. Conclusion: All available data shows excellent agreement of simulations and measurements. More measurements will have to be performed in order to completely and systematically validate the model. Besides simulating and measuring PDDs and lateral profiles of all remaining range modulator wheels, the absolute dosimetry factors in terms of number of source protons per monitor unit have to be determined.« less

A novel, microscope based, non invasive Laser Doppler flowmeter for choroidal blood flow assessment

PubMed Central

Strohmaier, C; Werkmeister, RM; Bogner, B; Runge, C; Schroedl, F; Brandtner, H; Radner, W; Schmetterer, L; Kiel, JW; Grabnerand, G; Reitsamer, HA

2015-01-01

Impaired ocular blood flow is involved in the pathogenesis of numerous ocular diseases like glaucoma or AMD. The purpose of the present study was to introduce and validate a novel, microscope based, non invasive laser Doppler flowmeter (NILDF) for measurement of blood flow in the choroid. The custom made NI-LDF was compared with a commercial fiber optic based laser Doppler flowmeter (Perimed PF4000). Linearity and stability of the NI-LDF were assessed in a silastic tubing model (i.d. 0.3 mm) at different flow rates (range 0.4 – 3 ml/h). In a rabbit model continuous choroidal blood flow measurements were performed with both instruments simultaneously. During blood flow measurements ocular perfusion pressure was changed by manipulations of intraocular pressure via intravitreal saline infusions. The NILDF measurement correlated linearly to intraluminal flow rates in the perfused tubing model (r = 0.99, p<0.05) and remained stable during a 1 hour measurement at a constant flow rate. Rabbit choroidal blood flow measured by the PF4000 and the NI-LDF linearly correlated with each other over the entire measurement range (r = 0.99, y = x* 1,01 – 12,35 P.U., p < 0,001). In conclusion, the NI-LDF provides valid, semi quantitative measurements of capillary blood flow in comparison to an established LDF instrument and is suitable for measurements at the posterior pole of the eye. PMID:21443871

Epigenomic Elements Analyses for Promoters Identify ESRRG as a New Susceptibility Gene for Obesity-related Traits

PubMed Central

Dong, Shan-Shan; Guo, Yan; Zhu, Dong-Li; Chen, Xiao-Feng; Wu, Xiao-Ming; Shen, Hui; Chen, Xiang-Ding; Tan, Li-Jun; Tian, Qing; Deng, Hong-Wen; Yang, Tie-Lin

2016-01-01

OBJECTIVES With ENCODE epigenomic data and results from published genome-wide association studies (GWASs), we aimed to find regulatory signatures of obesity genes and discover novel susceptibility genes. METHODS Obesity genes were obtained from public GWASs databases and their promoters were annotated based on the regulatory elements information. Significantly enriched or depleted epigenomic elements in the promoters of obesity genes were evaluated and all human genes were then prioritized according to the existence of the selected elements to predict new candidate genes. Top ranked genes were subsequently applied to validate their associations with obesity-related traits in three independent in-house GWASs samples. RESULTS We identified RAD21 and EZH2 as over-represented, STAT2 and IRF3 as depleted transcription factors. Histone modification of H3K9me3 and chromatin state segmentation of “poised promoter” and “repressed” were overrepresented. All genes were prioritized and we selected the top five genes for validation at population level. Combined results from the three GWASs samples, rs7522101 in ESRRG remained significantly associated with BMI after multiple testing corrections (P = 7.25 × 10−5). It was also associated with β-cell function (P = 1.99 × 10−3) and fasting glucose level (P < 0.05) in the meta-analyses of glucose and insulin-related traits consortium (MAGIC) dataset. CONCLUSIONS In summary, we identified epigenomic characteristics for obesity genes and suggested ESRRG as a novel obesity susceptibility gene. PMID:27113491

Validation of Version 3.0 of the Breast Cancer Genetics Referral Screening Tool (B-RST™).

PubMed

Bellcross, Cecelia; Hermstad, April; Tallo, Christine; Stanislaw, Christine

2018-05-08

Despite increased awareness of hereditary breast and ovarian cancer among clinicians and the public, many BRCA1/2 mutation carriers remain unaware of their risk status. The Breast Cancer Genetics Referral Screening Tool (B-RST™) was created and validated to easily identify individuals at increased risk for hereditary breast and ovarian cancer for referral to cancer genetics services. The purpose of this study was to revise B-RST™ to maximize sensitivity against BRCA1/2 mutation status. We analyzed pedigrees of 277 individuals who had undergone BRCA1/2 testing to determine modifications to the B-RST™ 2.0 algorithm that would maximize sensitivity for mutations, while maintaining simplicity. We used McNemar's chi-square test to compare validation measures between the revised version (3.0) and the 2.0 version. Algorithmic changes made to B-RST™ 2.0 increased the sensitivity against BRCA1/2 mutation analysis from 71.1 to 94.0% (P < 0.0001). While specificity decreased, all screen-positive individuals were appropriate for cancer genetics referral, the primary purpose of the tool. Despite calls for BRCA1/2 population screening, there remains a critical need to identify those most at risk who should receive cancer genetics services. B-RST™ version 3.0 demonstrates high sensitivity for BRCA1/2 mutations, yet remains a simple and quick screening tool for at-risk individuals.

Inhibitory mechanism of the matching heuristic in syllogistic reasoning.

PubMed

Tse, Ping Ping; Moreno Ríos, Sergio; García-Madruga, Juan Antonio; Bajo Molina, María Teresa

2014-11-01

A number of heuristic-based hypotheses have been proposed to explain how people solve syllogisms with automatic processes. In particular, the matching heuristic employs the congruency of the quantifiers in a syllogism—by matching the quantifier of the conclusion with those of the two premises. When the heuristic leads to an invalid conclusion, successful solving of these conflict problems requires the inhibition of automatic heuristic processing. Accordingly, if the automatic processing were based on processing the set of quantifiers, no semantic contents would be inhibited. The mental model theory, however, suggests that people reason using mental models, which always involves semantic processing. Therefore, whatever inhibition occurs in the processing implies the inhibition of the semantic contents. We manipulated the validity of the syllogism and the congruency of the quantifier of its conclusion with those of the two premises according to the matching heuristic. A subsequent lexical decision task (LDT) with related words in the conclusion was used to test any inhibition of the semantic contents after each syllogistic evaluation trial. In the LDT, the facilitation effect of semantic priming diminished after correctly solved conflict syllogisms (match-invalid or mismatch-valid), but was intact after no-conflict syllogisms. The results suggest the involvement of an inhibitory mechanism of semantic contents in syllogistic reasoning when there is a conflict between the output of the syntactic heuristic and actual validity. Our results do not support a uniquely syntactic process of syllogistic reasoning but fit with the predictions based on mental model theory. Copyright © 2014 Elsevier B.V. All rights reserved.

Psychological testing and psychological assessment. A review of evidence and issues.

PubMed

Meyer, G J; Finn, S E; Eyde, L D; Kay, G G; Moreland, K L; Dies, R R; Eisman, E J; Kubiszyn, T W; Reed, G M

2001-02-01

This article summarizes evidence and issues associated with psychological assessment. Data from more than 125 meta-analyses on test validity and 800 samples examining multimethod assessment suggest 4 general conclusions: (a) Psychological test validity is strong and compelling, (b) psychological test validity is comparable to medical test validity, (c) distinct assessment methods provide unique sources of information, and (d) clinicians who rely exclusively on interviews are prone to incomplete understandings. Following principles for optimal nomothetic research, the authors suggest that a multimethod assessment battery provides a structured means for skilled clinicians to maximize the validity of individualized assessments. Future investigations should move beyond an examination of test scales to focus more on the role of psychologists who use tests as helpful tools to furnish patients and referral sources with professional consultation.

Development and Validation of a Nutritional Education Pamphlet for Low-Literacy Pediatric Oncology Caregivers in Central America

PubMed Central

Garcia, Melissa; Chismark, Elisabeth A.; Mosby, Terezie; Day, Sara

2013-01-01

Background A culturally appropriate nutrition education pamphlet was developed and validated for low-literacy caregivers in Honduras, El Salvador, and Guatemala. Methods The pamphlet was developed after a preliminary survey of pediatric oncology nurses in the 3 countries to assess the need for education materials, caregiver literacy levels, and local eating habits. Experts in nutrition and low-literacy patient education and nurses validated the pamphlet’s content and design. Results and Conclusions Nurses expressed the need for nutrition-related pamphlets in developing countries. The pamphlet was validated positively by experts and nurses and has been circulated to pediatric oncology caregivers in Central America. PMID:20300913

Theoretical Issues of Validity in the Measurement of Aided Speech Reception Threshold in Noise for Comparing Nonlinear Hearing Aid Systems.

PubMed

Naylor, Graham

2016-07-01

Adaptive Speech Reception Threshold in noise (SRTn) measurements are often used to make comparisons between alternative hearing aid (HA) systems. Such measurements usually do not constrain the signal-to-noise ratio (SNR) at which testing takes place. Meanwhile, HA systems increasingly include nonlinear features that operate differently in different SNRs, and listeners differ in their inherent SNR requirements. To show that SRTn measurements, as commonly used in comparisons of alternative HA systems, suffer from threats to their validity, to illustrate these threats with examples of potentially invalid conclusions in the research literature, and to propose ways to tackle these threats. An examination of the nature of SRTn measurements in the context of test theory, modern nonlinear HAs, and listener diversity. Examples from the audiological research literature were used to estimate typical interparticipant variation in SRTn and to illustrate cases where validity may have been compromised. There can be no doubt that SRTn measurements, when used to compare nonlinear HA systems, in principle, suffer from threats to their internal and external/ecological validity. Interactions between HA nonlinearities and SNR, and interparticipant differences in inherent SNR requirements, can act to generate misleading results. In addition, SRTn may lie at an SNR outside the range for which the HA system is designed or expected to operate in. Although the extent of invalid conclusions in the literature is difficult to evaluate, examples of studies were nevertheless identified where the risk of each form of invalidity is significant. Reliable data on ecological SNRs is becoming available, so that ecological validity can be assessed. Methodological developments that can reduce the risk of invalid conclusions include variations on the SRTn measurement procedure itself, manipulations of stimulus or scoring conditions to place SRTn in an ecologically relevant range, and design and analysis approaches that take account of interparticipant differences. American Academy of Audiology.

The Bidimensional Impression Management Index (BIMI): measuring agentic and communal forms of impression management.

PubMed

Blasberg, Sabrina A; Rogers, Katherine H; Paulhus, Delroy L

2014-01-01

Measures of impression management have yet to incorporate two-factor models of person perception. The 2 primary factors are often labeled agency and communion. In Study 1, we assembled a new measure of impression management—the Bidimensional Impression Management Index (BIMI): It comprises 2 subscales designed specifically to tap agentic and communal content. Both subscales showed adequate alpha reliabilities under both honest and faking conditions. In Study 2, the BIMI was cross-validated in a new sample: The subscales remained relatively independent, and their reliabilities remained solid. A coherent pattern of personality correlates also supported the validities of both subscales. In Study 3, the differential sensitivity of the 2 subscales was demonstrated by manipulating the job type in simulated job applications. Implications and applications of the BIMI are discussed.

Weighing the Evidence in Peters' Rule: Does Neuronal Morphology Predict Connectivity?

PubMed

Rees, Christopher L; Moradi, Keivan; Ascoli, Giorgio A

2017-02-01

Although the importance of network connectivity is increasingly recognized, identifying synapses remains challenging relative to the routine characterization of neuronal morphology. Thus, researchers frequently employ axon-dendrite colocations as proxies of potential connections. This putative equivalence, commonly referred to as Peters' rule, has been recently studied at multiple levels and scales, fueling passionate debates regarding its validity. Our critical literature review identifies three conceptually distinct but often confused applications: inferring neuron type circuitry, predicting synaptic contacts among individual cells, and estimating synapse numbers within neuron pairs. Paradoxically, at the originally proposed cell-type level, Peters' rule remains largely untested. Leveraging Hippocampome.org, we validate and refine the relationship between axonal-dendritic colocations and synaptic circuits, clarifying the interpretation of existing and forthcoming data. Copyright © 2016 Elsevier Ltd. All rights reserved.

75 FR 1437 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Order Approving a...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-11

... ratio at the conclusion of COA, the order, or any remaining balance, will route to the CBOE's Complex... basis, to route the remaining balance of the option leg(s) of such an order to CBOE's Hybrid System for... remaining balance of the stock leg of such an order to the CBOE Stock Exchange (``CBSX''), CBOE's stock...

The predictive validity of quality of evidence grades for the stability of effect estimates was low: a meta-epidemiological study.

PubMed

Gartlehner, Gerald; Dobrescu, Andreea; Evans, Tammeka Swinson; Bann, Carla; Robinson, Karen A; Reston, James; Thaler, Kylie; Skelly, Andrea; Glechner, Anna; Peterson, Kimberly; Kien, Christina; Lohr, Kathleen N

2016-02-01

To determine the predictive validity of the U.S. Evidence-based Practice Center (EPC) approach to GRADE (Grading of Recommendations Assessment, Development and Evaluation). Based on Cochrane reports with outcomes graded as high quality of evidence (QOE), we prepared 160 documents which represented different levels of QOE. Professional systematic reviewers dually graded the QOE. For each document, we determined whether estimates were concordant with high QOE estimates of the Cochrane reports. We compared the observed proportion of concordant estimates with the expected proportion from an international survey. To determine the predictive validity, we used the Hosmer-Lemeshow test to assess calibration and the C (concordance) index to assess discrimination. The predictive validity of the EPC approach to GRADE was limited. Estimates graded as high QOE were less likely, estimates graded as low or insufficient QOE more likely to remain stable than expected. The EPC approach to GRADE could not reliably predict the likelihood that individual bodies of evidence remain stable as new evidence becomes available. C-indices ranged between 0.56 (95% CI, 0.47 to 0.66) and 0.58 (95% CI, 0.50 to 0.67) indicating a low discriminatory ability. The limited predictive validity of the EPC approach to GRADE seems to reflect a mismatch between expected and observed changes in treatment effects as bodies of evidence advance from insufficient to high QOE. Copyright © 2016 Elsevier Inc. All rights reserved.

Evaluating statistical validity of research reports: a guide for managers, planners, and researchers

Treesearch

Amanda L. Golbeck

1986-01-01

Inappropriate statistical methods, as well as appropriate methods inappropriately used, can lead to incorrect conclusions in any research report. Incorrect conclusions may also be due to the fact that the research problem is just hard to quantify in a satisfactory way. Publication of a research report does not guarantee that appropriate statistical methods have been...

Interpretations of quantum mechanics, joint measurement of incompatible observables, and counterfactual definiteness

NASA Astrophysics Data System (ADS)

de Muynck, W. M.; de Baere, W.; Martens, H.

1994-12-01

The validity of the conclusion to the nonlocality of quantum mechanics, accepted widely today as the only reasonable solution to the EPR and Bell issues, is questioned and criticized. Arguments are presented which remove the compelling character of this conclusion and make clear that it is not the most obvious solution. Alternative solutions are developed which are free of the contradictions related with the nonlocality conclusion. Firstly, the dependence on the adopted interpretation is shown, with the conclusion that the alleged nonlocality property of the quantum formalism may have been reached on the basis of an interpretation that is unnecessarily restrictive. Secondly, by extending the conventional quantum formalism along the lines of Ludwig and Davies it is shown that the Bell problem may be related to complementarity rather than to nonlocality. Finally, the dependence on counterfactual reasoning is critically examined. It appears that locality on the quantum level may still be retained provided one accepts a newly proposed principle of nonreproducibility at the individual quantum level as an alternative of quantum nonlocality. It is concluded that the locality principle can retain its general validity, in full conformity with all experimental data.

Interpretations of quantum mechanics, joint measurement of incompatible observables, and counterfactual definiteness

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

Muynck, W.M. de; Martens, H.; De Baere, W.

1994-12-01

The validity of the conclusion to the nonlocality of quantum mechanics, accepted widely today as the only reasonable solution to the EPR and Bell issues, is questioned and criticized. Arguments are presented which remove the compelling character of this conclusion and make clear that it is not the most obvious solution. Alternative solutions are developed which are free of the contradictions related with the nonlocality conclusion. Firstly, the dependence on the adopted interpretation is shown, with the conclusion that the alleged nonlocality property of the quantum formalism may have been reached on the basis of an interpretation that is unnecessarilymore » restrictive. Secondly, by extending the conventional quantum formalism along the lines of Ludwig and Davies it is shown that the Bell problem may be related to complementarity rather than to nonlocality. Finally, the dependence on counterfactual reasoning is critically examined. It appears that locality on the quantum level may still be retained provided one accepts a newly proposed principle of nonreproducibility at the individual quantum level as an alternative of quantum nonlocality. It is concluded that the locality principle can retain its general validity, in full conformity with all experimental data.« less

Introducing student inquiry in large introductory genetics classes.

PubMed Central

Pukkila, Patricia J

2004-01-01

An appreciation of genetic principles depends upon understanding the individual curiosity that sparked particular investigations, the creativity involved in imagining alternative outcomes and designing experiments to eliminate these outcomes, and the clarity of thought necessary to convince one's scientific peers of the validity of the conclusions. At large research universities, students usually begin their study of genetics in large lecture classes. It is widely assumed that the lecture format, coupled with the pressures to be certain that students become familiar with the principal conclusions of genetics investigations, constrains most if not all departures from the formats textbooks used to explain these conclusions. Here I present several examples of mechanisms to introduce meaningful student inquiry in an introductory genetics course and to evaluate student creative effort. Most of the examples involve altered student preparation prior to class and additional in-class activities, while a few depend upon a smaller recitation section, which accompanies the course from which the examples have been drawn. I conclude that large introductory classes are suitable venues to teach students how to identify scientific claims, determine the evidence that is essential to eliminate alternative conclusions, and convince their peers of the validity of their arguments. PMID:15020401

The Ability of Students’ Mathematical Proof in Determining the Validity of Argument Reviewed from Gender Differences

NASA Astrophysics Data System (ADS)

Feriyanto

2018-01-01

This research aims to describe the ability of students’ mathematical proof in determining the validity of argument reviewed from gender differences. The subjects of this research were one male and one female student of the fifth semester of Mathematic Education study program. The subjects were selected based on the highest mathematics ability which was assesed from their previous assignments and tests. In addition, the communication ability of the subjects was also considered in order to facilitate the researcher in conducting interviews. Based on the result of the test with direct and indirect proof, it could be concluded that the subjects were able to: 1) mention all facts/premises and write about what should be shown (conclusion) in direct proof and write additional premise in indirect proof; 2) connect facts/premises to concepts which must be mastered; 3) use equivalent concept to manipulate and organize the proof; 4) use the concept of syllogism and tollens mode to obtain the desired conclusion; 5) construct mathematical evidence systematically, and logically; 6) complement the reason for each step appropriately. The difference was that the male subject wrote the final conclusion, while the female subject did not write the final conclusion on the proof.

[Computerized system validation of clinical researches].

PubMed

Yan, Charles; Chen, Feng; Xia, Jia-lai; Zheng, Qing-shan; Liu, Daniel

2015-11-01

Validation is a documented process that provides a high degree of assurance. The computer system does exactly and consistently what it is designed to do in a controlled manner throughout the life. The validation process begins with the system proposal/requirements definition, and continues application and maintenance until system retirement and retention of the e-records based on regulatory rules. The objective to do so is to clearly specify that each application of information technology fulfills its purpose. The computer system validation (CSV) is essential in clinical studies according to the GCP standard, meeting product's pre-determined attributes of the specifications, quality, safety and traceability. This paper describes how to perform the validation process and determine relevant stakeholders within an organization in the light of validation SOPs. Although a specific accountability in the implementation of the validation process might be outsourced, the ultimate responsibility of the CSV remains on the shoulder of the business process owner-sponsor. In order to show that the compliance of the system validation has been properly attained, it is essential to set up comprehensive validation procedures and maintain adequate documentations as well as training records. Quality of the system validation should be controlled using both QC and QA means.

Design and validation of a comprehensive fecal incontinence questionnaire.

PubMed

Macmillan, Alexandra K; Merrie, Arend E H; Marshall, Roger J; Parry, Bryan R

2008-10-01

Fecal incontinence can have a profound effect on quality of life. Its prevalence remains uncertain because of stigma, lack of consistent definition, and dearth of validated measures. This study was designed to develop a valid clinical and epidemiologic questionnaire, building on current literature and expertise. Patients and experts undertook face validity testing. Construct validity, criterion validity, and test-retest reliability was undertaken. Construct validity comprised factor analysis and internal consistency of the quality of life scale. The validity of known groups was tested against 77 control subjects by using regression models. Questionnaire results were compared with a stool diary for criterion validity. Test-retest reliability was calculated from repeated questionnaire completion. The questionnaire achieved good face validity. It was completed by 104 patients. The quality of life scale had four underlying traits (factor analysis) and high internal consistency (overall Cronbach alpha = 0.97). Patients and control subjects answered the questionnaire significantly differently (P < 0.01) in known-groups validity testing. Criterion validity assessment found mean differences close to zero. Median reliability for the whole questionnaire was 0.79 (range, 0.35-1). This questionnaire compares favorably with other available instruments, although the interpretation of stool consistency requires further research. Its sensitivity to treatment still needs to be investigated.

Finding Furfural Hydrogenation Catalysts via Predictive Modelling

PubMed Central

Strassberger, Zea; Mooijman, Maurice; Ruijter, Eelco; Alberts, Albert H; Maldonado, Ana G; Orru, Romano V A; Rothenberg, Gadi

2010-01-01

Abstract We combine multicomponent reactions, catalytic performance studies and predictive modelling to find transfer hydrogenation catalysts. An initial set of 18 ruthenium-carbene complexes were synthesized and screened in the transfer hydrogenation of furfural to furfurol with isopropyl alcohol complexes gave varied yields, from 62% up to >99.9%, with no obvious structure/activity correlations. Control experiments proved that the carbene ligand remains coordinated to the ruthenium centre throughout the reaction. Deuterium-labelling studies showed a secondary isotope effect (kH:kD=1.5). Further mechanistic studies showed that this transfer hydrogenation follows the so-called monohydride pathway. Using these data, we built a predictive model for 13 of the catalysts, based on 2D and 3D molecular descriptors. We tested and validated the model using the remaining five catalysts (cross-validation, R2=0.913). Then, with this model, the conversion and selectivity were predicted for four completely new ruthenium-carbene complexes. These four catalysts were then synthesized and tested. The results were within 3% of the model’s predictions, demonstrating the validity and value of predictive modelling in catalyst optimization. PMID:23193388

Parametric vs. non-parametric statistics of low resolution electromagnetic tomography (LORETA).

PubMed

Thatcher, R W; North, D; Biver, C

2005-01-01

This study compared the relative statistical sensitivity of non-parametric and parametric statistics of 3-dimensional current sources as estimated by the EEG inverse solution Low Resolution Electromagnetic Tomography (LORETA). One would expect approximately 5% false positives (classification of a normal as abnormal) at the P < .025 level of probability (two tailed test) and approximately 1% false positives at the P < .005 level. EEG digital samples (2 second intervals sampled 128 Hz, 1 to 2 minutes eyes closed) from 43 normal adult subjects were imported into the Key Institute's LORETA program. We then used the Key Institute's cross-spectrum and the Key Institute's LORETA output files (*.lor) as the 2,394 gray matter pixel representation of 3-dimensional currents at different frequencies. The mean and standard deviation *.lor files were computed for each of the 2,394 gray matter pixels for each of the 43 subjects. Tests of Gaussianity and different transforms were computed in order to best approximate a normal distribution for each frequency and gray matter pixel. The relative sensitivity of parametric vs. non-parametric statistics were compared using a "leave-one-out" cross validation method in which individual normal subjects were withdrawn and then statistically classified as being either normal or abnormal based on the remaining subjects. Log10 transforms approximated Gaussian distribution in the range of 95% to 99% accuracy. Parametric Z score tests at P < .05 cross-validation demonstrated an average misclassification rate of approximately 4.25%, and range over the 2,394 gray matter pixels was 27.66% to 0.11%. At P < .01 parametric Z score cross-validation false positives were 0.26% and ranged from 6.65% to 0% false positives. The non-parametric Key Institute's t-max statistic at P < .05 had an average misclassification error rate of 7.64% and ranged from 43.37% to 0.04% false positives. The nonparametric t-max at P < .01 had an average misclassification rate of 6.67% and ranged from 41.34% to 0% false positives of the 2,394 gray matter pixels for any cross-validated normal subject. In conclusion, adequate approximation to Gaussian distribution and high cross-validation can be achieved by the Key Institute's LORETA programs by using a log10 transform and parametric statistics, and parametric normative comparisons had lower false positive rates than the non-parametric tests.

Unresectable Hepatocellular Carcinoma: MR Imaging after Intraarterial Therapy. Part I. Identification and Validation of Volumetric Functional Response Criteria

PubMed Central

Bonekamp, Susanne; Li, Zhen; Geschwind, Jean-François H.; Halappa, Vivek Gowdra; Corona-Villalobos, Celia Pamela; Reyes, Diane; Pawlik, Timothy M.; Bonekamp, David; Eng, John

2013-01-01

Purpose: To identify and validate the optimal thresholds for volumetric functional MR imaging response criteria to predict overall survival after intraarterial treatment (IAT) in patients with unresectable hepatocellular carcinoma (HCC). Materials and Methods: Institutional review board approval and waiver of informed consent were obtained. A total of 143 patients who had undergone MR imaging before and 3–4 weeks after the first cycle of IAT were included. MR imaging analysis of one representative HCC index lesion was performed with proprietary software after initial treatment. Subjects were randomly divided into training (n = 114 [79.7%]) and validation (n = 29 [20.3%]) data sets. Uni- and multivariate Cox models were used to determine the best cutoffs, as well as survival differences, between response groups in the validation data set. Results: Optimal cutoffs in the training data set were 23% increase in apparent diffusion coefficient (ADC) and 65% decrease in volumetric enhancement in the portal venous phase (VE). Subsequently, 25% increase in ADC and 65% decrease in VE were used to stratify patients in the validation data set. Comparison of ADC responders (n = 12 [58.6%]) with nonresponders (n = 17 [34.5%]) showed significant differences in survival (25th percentile survival, 11.2 vs 4.9 months, respectively; P = .008), as did VE responders (n = 9 [31.0%]) compared with nonresponders (n = 20 [69.0%]; 25th percentile survival, 11.5 vs 5.1 months, respectively; P = .01). Stratification of patients with a combination of the criteria resulted in significant differences in survival between patients with lesions that fulfilled both criteria (n = 6 [20.7%]; too few cases to determine 25th percentile), one criterion (n = 9 [31.0%]; 25th percentile survival, 6.0 months), and neither criterion (n = 14 [48.3%]; 25th percentile survival, 5.1 months; P = .01). The association between the two criteria and overall survival remained significant in a multivariate analysis that included age, sex, Barcelona Clinic for Liver Cancer stage, and number of follow-up treatments. Conclusion: After IAT for unresectable HCC, patients can be stratified into significantly different survival categories based on responder versus nonresponder status according to MR imaging ADC and VE cutoffs. © RSNA, 2013 PMID:23616631

Empirically Derived Dehydration Scoring and Decision Tree Models for Children With Diarrhea: Assessment and Internal Validation in a Prospective Cohort Study in Dhaka, Bangladesh

PubMed Central

Glavis-Bloom, Justin; Modi, Payal; Nasrin, Sabiha; Rege, Soham; Chu, Chieh; Schmid, Christopher H; Alam, Nur H

2015-01-01

Introduction: Diarrhea remains one of the most common and most deadly conditions affecting children worldwide. Accurately assessing dehydration status is critical to determining treatment course, yet no clinical diagnostic models for dehydration have been empirically derived and validated for use in resource-limited settings. Methods: In the Dehydration: Assessing Kids Accurately (DHAKA) prospective cohort study, a random sample of children under 5 with acute diarrhea was enrolled between February and June 2014 in Bangladesh. Local nurses assessed children for clinical signs of dehydration on arrival, and then serial weights were obtained as subjects were rehydrated. For each child, the percent weight change with rehydration was used to classify subjects with severe dehydration (>9% weight change), some dehydration (3–9%), or no dehydration (<3%). Clinical variables were then entered into logistic regression and recursive partitioning models to develop the DHAKA Dehydration Score and DHAKA Dehydration Tree, respectively. Models were assessed for their accuracy using the area under their receiver operating characteristic curve (AUC) and for their reliability through repeat clinical exams. Bootstrapping was used to internally validate the models. Results: A total of 850 children were enrolled, with 771 included in the final analysis. Of the 771 children included in the analysis, 11% were classified with severe dehydration, 45% with some dehydration, and 44% with no dehydration. Both the DHAKA Dehydration Score and DHAKA Dehydration Tree had significant AUCs of 0.79 (95% CI = 0.74, 0.84) and 0.76 (95% CI = 0.71, 0.80), respectively, for the diagnosis of severe dehydration. Additionally, the DHAKA Dehydration Score and DHAKA Dehydration Tree had significant positive likelihood ratios of 2.0 (95% CI = 1.8, 2.3) and 2.5 (95% CI = 2.1, 2.8), respectively, and significant negative likelihood ratios of 0.23 (95% CI = 0.13, 0.40) and 0.28 (95% CI = 0.18, 0.44), respectively, for the diagnosis of severe dehydration. Both models demonstrated 90% agreement between independent raters and good reproducibility using bootstrapping. Conclusion: This study is the first to empirically derive and internally validate accurate and reliable clinical diagnostic models for dehydration in a resource-limited setting. After external validation, frontline providers may use these new tools to better manage acute diarrhea in children. PMID:26374802

[A valid quality system for mental health care: from accountability and control in institutionalised settings to co-creation in small areas and a focus on community vital signs].

PubMed

van Os, J; Delespaul, P H

In a given year, around 25% of the Dutch population may experience significant mental health problems, much more than the mental health service can attend to, given a maximum capacity of 6% of the population per year. Due to the lack of a public mental health system, there is fierce competition over who gets to receive care from mental health services and little control over how the level of needs can be matched with the appropriate intensity of care. As a result, resources are being wasted and both overtreatment and undertreatment are prevalent.
AIM: To propose a valid quality system that benefits the mental health of the entire population and does not simply attend to the symptoms of a strategically selected group.
METHOD: Literature review from an epidemiological and public mental health perspective.
RESULTS: In our view, a valid quality system for mental health care needs to focus on two distinct areas. The first area involves the analysis of about 20 quantitative population parameters or 'Community Vital Signs' (care consumption, pharmaco-epidemiological indicators, mortality, somatic morbidity, social care, housing, work, benefits, involuntary admissions). This analysis will reveal regional variation in the mental health of the entire population rather than in the relatively small, selected group receiving mental health care. The second area to which attention needs to be directed comprises a system of simple qualitative visits to mental health care institutions based on 10 quality parameters that currently remain invisible; these parameters will measure the impact at local community level. The focus of these will be on a transition from accountability and control in large institutions to provision of care in small areas that was co-designed with users and other stakeholders.
CONCLUSION: A valid quality system for mental health care is within reach, provided it is combined with a novel system of public mental health and transition of care to a system of co-design with users in small areas.

Self-reported sunscreen use and urinary benzophenone-3 concentrations in the United States: NHANES 2003–2006 and 2009–2012

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

Zamoiski, Rachel D., E-mail: rachel.zamoiski@nih.gov; Cahoon, Elizabeth K.; Michal Freedman, D.

Background: Sunscreens protect against skin cancer and other harmful effects of solar ultraviolet radiation (UVR). Epidemiologic and public health surveys often rely on self-reported sunscreen use to estimate sun exposure and avoidance, but questions remain about the validity of self-reports. Benzophenone-3 (BP-3), a common sunscreen ingredient, can be detected in the urine. Prior studies suggest that BP-3 concentrations increase after application of sunscreen. Objectives: The goal of this study was to assess the validity of self-reported frequency of sunscreen use in relation to urinary BP-3 concentrations in a representative sample of the general US population, including in sub-groups defined bymore » age, sex and race/ethnicity. Methods: To assess the relationship between categorical self-reported sunscreen use and creatinine-corrected urinary BP-3 concentrations, we conducted a linear regression adjusted for age, sex, race/ethnicity, six-month time period, body mass index, education, and sun avoidance behaviors. We tested for effect modification by age, sex, ethnicity and time period of measurement using multiplicative interaction terms and a F test. Results: BP-3 was positively associated with self-reported frequency of sunscreen use across all ages, sexes, race/ethnicities, and time periods. Crude and multivariate adjusted models were all statistically significant. R-square was relatively low for all models, ranging from 0.15 to 0.43. Conclusions: Urinary BP-3 is positively associated with self-reported frequency of sunscreen use in the general US population, even in groups with overall low sunscreen use. These results suggest that self-report is a valid, although weak, way of assessing relative frequencies of sunscreen usage in a population-based study. - Highlights: • Urinary benzophenone-3 (BP-3) is a metabolite of a common sunscreen ingredient. • We modeled urinary BP-3 against self-reported sunscreen usage. • We observed a positive association between sunscreen use and urinary BP-3. • R{sup 2} was low, suggesting self-report is a valid but weak way to assess sunscreen use.« less

Influence of Patient Characteristics on Success of Ambulatory Blood Pressure Monitoring

PubMed Central

Fravel, Michelle A.; Ernst, Michael E.; Weber, Cynthia A.; Dawson, Jeffrey D.; Carter, Barry L.; Bergus, George R.

2014-01-01

Study Objective To examine the influence of specific patient characteristics on the success of ambulatory blood pressure monitoring (ABPM). Design Retrospective analysis. Setting University-affiliated family care center. Patients Five hundred thirty patients (mean age 52.7 yrs, range 14–90 yrs) who were undergoing ABPM between January 1, 2001, and July 1, 2007. Measurement and Main Results Specific patient characteristics were identified through an electronic medical record review and then examined for association with ABPM session success rate. These patient characteristics included age, sex, weight, height, body mass index (BMI), occupation, clinic blood pressure, travel distance to clinic, and presence of diabetes mellitus or renal disease. The percentage of valid readings obtained during an ABPM session was analyzed continuously (0–100%), whereas overall session success was analyzed dichotomously (0–79% or 80–100%). Univariate and multivariate regression analyses were performed to examine the influence of patient characteristics on the percentage of valid readings and the overall likelihood of achieving a successful session. In the 530 patients, the average percentage of valid readings was 90%, and a successful ABPM session (≥ 80% valid readings) was obtained in 84.7% (449 patients). A diagnosis of diabetes was found to negatively predict ABPM session success (continuous variable analysis, p=0.019; dichotomous variable analysis, odds ratio [OR] 0.45, 95% confidence interval [CI] 0.23–0.87, p=0.019), as did renal disease (continuous variable analysis, p=0.006; dichotomous variable analysis, OR 0.39, 95% CI 0.17–0.90, p=0.027) and increasing BMI (continuous variable analysis, p<0.001; dichotomous variable analysis, OR 0.78, 95% CI 0.65–0.93, p=0.005). Renal disease and BMI remained significant predictors in adjusted analyses. Conclusion For most patients, ABPM was successful; however, elevated BMI and renal disease were associated with less complete ABPM session results. Adaptation and individualization of the ABPM process may be necessary to improve results in these patients. PMID:18956994

Validating the weight gain of preterm infants between the reference growth curve of the fetus and the term infant

PubMed Central

2013-01-01

Background Current fetal-infant growth references have an obvious growth disjuncture around 40 week gestation overlapping where the fetal and infant growth references are combined. Graphical smoothening of the disjuncture to connect the matching percentile curves has never been validated. This study was designed to compare weight gain patterns of contemporary preterm infants with a fetal-infant growth reference (derived from a meta-analysis) to validate the previous smoothening assumptions and inform the revision of the Fenton chart. Methods Growth and descriptive data of preterm infants (23 to 31 weeks) from birth through 10 weeks post term age were collected in three cities in Canada and the USA between 2001 and 2010 (n = 977). Preterm infants were grouped by gestational age into 23–25, 26–28, and 29–31 weeks. Comparisons were made between the weight data of the preterm cohort and the fetal-infant growth reference. Results Median weight gain curves of the three preterm gestational age groups were almost identical and remained between the 3rd and the 50th percentiles of the fetal-infant-growth-reference from birth through 10 weeks post term. The growth velocity of the preterm infants decreased in a pattern similar to the decreased velocity of the fetus and term infant estimates, from a high of 17–18 g/kg/day between 31–34 weeks to rates of 4–5 g/kg/day by 50 weeks in each gestational age group. The greatest discrepancy in weight gain velocity between the preterm infants and the fetal estimate was between 37 and 40 weeks; preterm infants grew more rapidly than the fetus. The infants in this study regained their birthweight earlier compared to those in the 1999 National Institute of Child Health and Human Development report. Conclusion The weight gain velocity of preterm infants through the period of growth data disjuncture between 37 and 50 weeks gestation is consistent with and thus validates the smoothening assumptions made between preterm and post-term growth references. PMID:23758808

Development and validation of MIX: comprehensive free software for meta-analysis of causal research data

PubMed Central

Bax, Leon; Yu, Ly-Mee; Ikeda, Noriaki; Tsuruta, Harukazu; Moons, Karel GM

2006-01-01

Background Meta-analysis has become a well-known method for synthesis of quantitative data from previously conducted research in applied health sciences. So far, meta-analysis has been particularly useful in evaluating and comparing therapies and in assessing causes of disease. Consequently, the number of software packages that can perform meta-analysis has increased over the years. Unfortunately, it can take a substantial amount of time to get acquainted with some of these programs and most contain little or no interactive educational material. We set out to create and validate an easy-to-use and comprehensive meta-analysis package that would be simple enough programming-wise to remain available as a free download. We specifically aimed at students and researchers who are new to meta-analysis, with important parts of the development oriented towards creating internal interactive tutoring tools and designing features that would facilitate usage of the software as a companion to existing books on meta-analysis. Results We took an unconventional approach and created a program that uses Excel as a calculation and programming platform. The main programming language was Visual Basic, as implemented in Visual Basic 6 and Visual Basic for Applications in Excel 2000 and higher. The development took approximately two years and resulted in the 'MIX' program, which can be downloaded from the program's website free of charge. Next, we set out to validate the MIX output with two major software packages as reference standards, namely STATA (metan, metabias, and metatrim) and Comprehensive Meta-Analysis Version 2. Eight meta-analyses that had been published in major journals were used as data sources. All numerical and graphical results from analyses with MIX were identical to their counterparts in STATA and CMA. The MIX program distinguishes itself from most other programs by the extensive graphical output, the click-and-go (Excel) interface, and the educational features. Conclusion The MIX program is a valid tool for performing meta-analysis and may be particularly useful in educational environments. It can be downloaded free of charge via or . PMID:17038197

Artificial neural networks predict the incidence of portosplenomesenteric venous thrombosis in patients with acute pancreatitis.

PubMed

Fei, Y; Hu, J; Li, W-Q; Wang, W; Zong, G-Q

2017-03-01

Essentials Predicting the occurrence of portosplenomesenteric vein thrombosis (PSMVT) is difficult. We studied 72 patients with acute pancreatitis. Artificial neural networks modeling was more accurate than logistic regression in predicting PSMVT. Additional predictive factors may be incorporated into artificial neural networks. Objective To construct and validate artificial neural networks (ANNs) for predicting the occurrence of portosplenomesenteric venous thrombosis (PSMVT) and compare the predictive ability of the ANNs with that of logistic regression. Methods The ANNs and logistic regression modeling were constructed using simple clinical and laboratory data of 72 acute pancreatitis (AP) patients. The ANNs and logistic modeling were first trained on 48 randomly chosen patients and validated on the remaining 24 patients. The accuracy and the performance characteristics were compared between these two approaches by SPSS17.0 software. Results The training set and validation set did not differ on any of the 11 variables. After training, the back propagation network training error converged to 1 × 10 -20 , and it retained excellent pattern recognition ability. When the ANNs model was applied to the validation set, it revealed a sensitivity of 80%, specificity of 85.7%, a positive predictive value of 77.6% and negative predictive value of 90.7%. The accuracy was 83.3%. Differences could be found between ANNs modeling and logistic regression modeling in these parameters (10.0% [95% CI, -14.3 to 34.3%], 14.3% [95% CI, -8.6 to 37.2%], 15.7% [95% CI, -9.9 to 41.3%], 11.8% [95% CI, -8.2 to 31.8%], 22.6% [95% CI, -1.9 to 47.1%], respectively). When ANNs modeling was used to identify PSMVT, the area under receiver operating characteristic curve was 0.849 (95% CI, 0.807-0.901), which demonstrated better overall properties than logistic regression modeling (AUC = 0.716) (95% CI, 0.679-0.761). Conclusions ANNs modeling was a more accurate tool than logistic regression in predicting the occurrence of PSMVT following AP. More clinical factors or biomarkers may be incorporated into ANNs modeling to improve its predictive ability. © 2016 International Society on Thrombosis and Haemostasis.

Linguistic validation of the Alberta Context Tool and two measures of research use, for German residential long term care

PubMed Central

2014-01-01

Background To study the association between organizational context and research utilization in German residential long term care (LTC), we translated three Canadian assessment instruments: the Alberta Context Tool (ACT), Estabrooks’ Kinds of Research Utilization (RU) items and the Conceptual Research Utilization Scale. Target groups for the tools were health care aides (HCAs), registered nurses (RNs), allied health professionals (AHPs), clinical specialists and care managers. Through a cognitive debriefing process, we assessed response processes validity–an initial stage of validity, necessary before more advanced validity assessment. Methods We included 39 participants (16 HCAs, 5 RNs, 7 AHPs, 5 specialists and 6 managers) from five residential LTC facilities. We created lists of questionnaire items containing problematic items plus items randomly selected from the pool of remaining items. After participants completed the questionnaires, we conducted individual semi-structured cognitive interviews using verbal probing. We asked participants to reflect on their answers for list items in detail. Participants’ answers were compared to concept maps defining the instrument concepts in detail. If at least two participants gave answers not matching concept map definitions, items were revised and re-tested with new target group participants. Results Cognitive debriefings started with HCAs. Based on the first round, we modified 4 of 58 ACT items, 1 ACT item stem and all 8 items of the RU tools. All items were understood by participants after another two rounds. We included revised HCA ACT items in the questionnaires for the other provider groups. In the RU tools for the other provider groups, we used different wording than the HCA version, as was done in the original English instruments. Only one cognitive debriefing round was needed with each of the other provider groups. Conclusion Cognitive debriefing is essential to detect and respond to problematic instrument items, particularly when translating instruments for heterogeneous, less well educated provider groups such as HCAs. Cognitive debriefing is an important step in research tool development and a vital component of establishing response process validity evidence. Publishing cognitive debriefing results helps researchers to determine potentially critical elements of the translated tools and assists with interpreting scores. PMID:24479645

Reliability and validity of the Microsoft Kinect for evaluating static foot posture

PubMed Central

2013-01-01

Background The evaluation of foot posture in a clinical setting is useful to screen for potential injury, however disagreement remains as to which method has the greatest clinical utility. An inexpensive and widely available imaging system, the Microsoft Kinect™, may possess the characteristics to objectively evaluate static foot posture in a clinical setting with high accuracy. The aim of this study was to assess the intra-rater reliability and validity of this system for assessing static foot posture. Methods Three measures were used to assess static foot posture; traditional visual observation using the Foot Posture Index (FPI), a 3D motion analysis (3DMA) system and software designed to collect and analyse image and depth data from the Kinect. Spearman’s rho was used to assess intra-rater reliability and concurrent validity of the Kinect to evaluate foot posture, and a linear regression was used to examine the ability of the Kinect to predict total visual FPI score. Results The Kinect demonstrated moderate to good intra-rater reliability for four FPI items of foot posture (ρ = 0.62 to 0.78) and moderate to good correlations with the 3DMA system for four items of foot posture (ρ = 0.51 to 0.85). In contrast, intra-rater reliability of visual FPI items was poor to moderate (ρ = 0.17 to 0.63), and correlations with the Kinect and 3DMA systems were poor (absolute ρ = 0.01 to 0.44). Kinect FPI items with moderate to good reliability predicted 61% of the variance in total visual FPI score. Conclusions The majority of the foot posture items derived using the Kinect were more reliable than the traditional visual assessment of FPI, and were valid when compared to a 3DMA system. Individual foot posture items recorded using the Kinect were also shown to predict a moderate degree of variance in the total visual FPI score. Combined, these results support the future potential of the Kinect to accurately evaluate static foot posture in a clinical setting. PMID:23566934

Psychometrics of the Home Safety Self-Assessment Tool (HSSAT) to prevent falls in community-dwelling older adults.

PubMed

Tomita, Machiko R; Saharan, Sumandeep; Rajendran, Sheela; Nochajski, Susan M; Schweitzer, Jo A

2014-01-01

OBJECTIVE. To identify psychometric properties of the Home Safety Self-Assessment Tool (HSSAT) to prevent falls in community-dwelling older adults. METHOD. We tested content validity, test-retest reliability, interrater reliability, construct validity, convergent and discriminant validity, and responsiveness to change. RESULTS. The content validity index was .98, the intraclass correlation coefficient for test-retest reliability was .97, and the interrater reliability was .89. The difference on identified risk factors between the use and nonuse of the HSSAT was significant (p = .005). Convergent validity with the Centers for Disease Control and Prevention Home Safety Checklist was high (r = .65), and discriminant validity with fear of falling was very low (r = .10). The responsiveness to change was moderate (standardized response mean = 0.57). CONCLUSION. The HSSAT is a reliable and valid instrument to identify fall risks in a home environment, and the HSSAT booklet is effective as educational material leading to improvement in home safety. Copyright © 2014 by the American Occupational Therapy Association, Inc.

A New Generation of Crystallographic Validation Tools for the Protein Data Bank

PubMed Central

Read, Randy J.; Adams, Paul D.; Arendall, W. Bryan; Brunger, Axel T.; Emsley, Paul; Joosten, Robbie P.; Kleywegt, Gerard J.; Krissinel, Eugene B.; Lütteke, Thomas; Otwinowski, Zbyszek; Perrakis, Anastassis; Richardson, Jane S.; Sheffler, William H.; Smith, Janet L.; Tickle, Ian J.; Vriend, Gert; Zwart, Peter H.

2011-01-01

Summary This report presents the conclusions of the X-ray Validation Task Force of the worldwide Protein Data Bank (PDB). The PDB has expanded massively since current criteria for validation of deposited structures were adopted, allowing a much more sophisticated understanding of all the components of macromolecular crystals. The size of the PDB creates new opportunities to validate structures by comparison with the existing database, and the now-mandatory deposition of structure factors creates new opportunities to validate the underlying diffraction data. These developments highlighted the need for a new assessment of validation criteria. The Task Force recommends that a small set of validation data be presented in an easily understood format, relative to both the full PDB and the applicable resolution class, with greater detail available to interested users. Most importantly, we recommend that referees and editors judging the quality of structural experiments have access to a concise summary of well-established quality indicators. PMID:22000512

A new generation of crystallographic validation tools for the protein data bank.

PubMed

Read, Randy J; Adams, Paul D; Arendall, W Bryan; Brunger, Axel T; Emsley, Paul; Joosten, Robbie P; Kleywegt, Gerard J; Krissinel, Eugene B; Lütteke, Thomas; Otwinowski, Zbyszek; Perrakis, Anastassis; Richardson, Jane S; Sheffler, William H; Smith, Janet L; Tickle, Ian J; Vriend, Gert; Zwart, Peter H

2011-10-12

This report presents the conclusions of the X-ray Validation Task Force of the worldwide Protein Data Bank (PDB). The PDB has expanded massively since current criteria for validation of deposited structures were adopted, allowing a much more sophisticated understanding of all the components of macromolecular crystals. The size of the PDB creates new opportunities to validate structures by comparison with the existing database, and the now-mandatory deposition of structure factors creates new opportunities to validate the underlying diffraction data. These developments highlighted the need for a new assessment of validation criteria. The Task Force recommends that a small set of validation data be presented in an easily understood format, relative to both the full PDB and the applicable resolution class, with greater detail available to interested users. Most importantly, we recommend that referees and editors judging the quality of structural experiments have access to a concise summary of well-established quality indicators. Copyright © 2011 Elsevier Ltd. All rights reserved.

Release adiabat measurements on minerals: The effect of viscosity

NASA Technical Reports Server (NTRS)

Jeanloz, R.; Ahrens, T. J.

1979-01-01

The current inversion of pressure-particle velocity data for release from a high pressure shock state to a pressure-density path is analyzed. It is assumed that the release process is isentropic. It was shown that for geological materials below stresses of 150 GPa, the effective viscosity must be 1000 kg/m/s in order that the viscous (irreversible) work carried out on the material in the shock state remains small compared to the mechanical work recovered upon adiabatic rarefaction. The available data pertaining to the offset of the Rayleigh line from the Hugoniot for minerals, the magnitude of the shear stress in the high pressure shock state for minerals, and the direct measurements of the viscosities of several engineering materials shocked to pressures below 150 GPa yield effective viscosities of 1000 kg/m/s or less. An inferance that this indicates that the conditions for isentropic release of minerals from shock states are achieved, and a conclusion that the application of the Riemann integral to obtain pressure-density states along the release adiabats of minerals in shock experiments is valid are made.

Identifying Stress Transcription Factors Using Gene Expression and TF-Gene Association Data

PubMed Central

Wu, Wei-Sheng; Chen, Bor-Sen

2007-01-01

Unicellular organisms such as yeasts have evolved to survive environmental stresses by rapidly reorganizing the genomic expression program to meet the challenges of harsh environments. The complex adaptation mechanisms to stress remain to be elucidated. In this study, we developed Stress Transcription Factor Identification Algorithm (STFIA), which integrates gene expression and TF-gene association data to identify the stress transcription factors (TFs) of six kinds of stresses. We identified some general stress TFs that are in response to various stresses, and some specific stress TFs that are in response to one specific stress. The biological significance of our findings is validated by the literature. We found that a small number of TFs may be sufficient to control a wide variety of expression patterns in yeast under different stresses. Two implications can be inferred from this observation. First, the adaptation mechanisms to different stresses may have a bow-tie structure. Second, there may exist extensive regulatory cross-talk among different stress responses. In conclusion, this study proposes a network of the regulators of stress responses and their mechanism of action. PMID:20066130

Circulating microparticles: square the circle

PubMed Central

2013-01-01

Background The present review summarizes current knowledge about microparticles (MPs) and provides a systematic overview of last 20 years of research on circulating MPs, with particular focus on their clinical relevance. Results MPs are a heterogeneous population of cell-derived vesicles, with sizes ranging between 50 and 1000 nm. MPs are capable of transferring peptides, proteins, lipid components, microRNA, mRNA, and DNA from one cell to another without direct cell-to-cell contact. Growing evidence suggests that MPs present in peripheral blood and body fluids contribute to the development and progression of cancer, and are of pathophysiological relevance for autoimmune, inflammatory, infectious, cardiovascular, hematological, and other diseases. MPs have large diagnostic potential as biomarkers; however, due to current technological limitations in purification of MPs and an absence of standardized methods of MP detection, challenges remain in validating the potential of MPs as a non-invasive and early diagnostic platform. Conclusions Improvements in the effective deciphering of MP molecular signatures will be critical not only for diagnostics, but also for the evaluation of treatment regimens and predicting disease outcomes. PMID:23607880

Can a Resident's Publication Record Predict Fellowship Publications?

PubMed Central

Prasad, Vinay; Rho, Jason; Selvaraj, Senthil; Cheung, Mike; Vandross, Andrae; Ho, Nancy

2014-01-01

Background Internal medicine fellowship programs have an incentive to select fellows who will ultimately publish. Whether an applicant's publication record predicts long term publishing remains unknown. Methods Using records of fellowship bound internal medicine residents, we analyzed whether publications at time of fellowship application predict publications more than 3 years (2 years into fellowship) and up to 7 years after fellowship match. We calculate the sensitivity, specificity, positive and negative predictive values and likelihood ratios for every cutoff number of application publications, and plot a receiver operator characteristic curve of this test. Results Of 307 fellowship bound residents, 126 (41%) published at least one article 3 to 7 years after matching, and 181 (59%) of residents do not publish in this time period. The area under the receiver operator characteristic curve is 0.59. No cutoff value for application publications possessed adequate test characteristics. Conclusion The number of publications an applicant has at time of fellowship application is a poor predictor of who publishes in the long term. These findings do not validate the practice of using application publications as a tool for selecting fellows. PMID:24658088

A Case for the Standardized Assessment of Testamentary Capacity

PubMed Central

Brenkel, Megan; Whaley, Kimberley; Herrmann, Nathan; Crawford, Kerri; Hazan, Elias; Cardiff, Laura; Owen, Adrian M.

2018-01-01

Background With an increasingly aged, frail population that holds a disproportionate amount of wealth, clinicians (especially those with expertise in older adults) may be asked with more frequency to offer a clinical opinion on testamentary capacity (TC), the mental capacity to make a will. Method This paper reviews the legal criteria as well as the empirical research on assessment tools for determining testamentary capacity (TC). We also review the relevance of instruments used for the assessment of other decisional capacities in order to evince the potential value of developing a standardized assessment of TC for clinician experts. Results The legal criteria, often referred to as a “test”, for determining requisite TC (Banks v. Goodfellow) have remained much the same since 1870 with minimal clinical input and, as such, there has been little development in TC assessment instruments. Decisional instruments designed to assess Consent to Treatment may have relevance for TC. Conclusion We make the case for a semi-structured interview that includes standardized criteria for the legal test for TC, supplemented by a validated brief neuropsychological assessment, which together comprise a Contemporaneous Assessment Instrument (CAI) for TC. PMID:29581818

Effect of increasing CO2 on the terrestrial carbon cycle

PubMed Central

Schimel, David; Fisher, Joshua B.

2015-01-01

Feedbacks from the terrestrial carbon cycle significantly affect future climate change. The CO2 concentration dependence of global terrestrial carbon storage is one of the largest and most uncertain feedbacks. Theory predicts the CO2 effect should have a tropical maximum, but a large terrestrial sink has been contradicted by analyses of atmospheric CO2 that do not show large tropical uptake. Our results, however, show significant tropical uptake and, combining tropical and extratropical fluxes, suggest that up to 60% of the present-day terrestrial sink is caused by increasing atmospheric CO2. This conclusion is consistent with a validated subset of atmospheric analyses, but uncertainty remains. Improved model diagnostics and new space-based observations can reduce the uncertainty of tropical and temperate zone carbon flux estimates. This analysis supports a significant feedback to future atmospheric CO2 concentrations from carbon uptake in terrestrial ecosystems caused by rising atmospheric CO2 concentrations. This feedback will have substantial tropical contributions, but the magnitude of future carbon uptake by tropical forests also depends on how they respond to climate change and requires their protection from deforestation. PMID:25548156

Lack of prion transmission by sexual or parental routes in experimentally infected hamsters.

PubMed

Morales, Rodrigo; Pritzkow, Sandra; Hu, Ping Ping; Duran-Aniotz, Claudia; Soto, Claudio

2013-01-01

Prion diseases are a group of neurodegenerative disorders affecting humans as well as captive and wild animals. The mechanisms and routes governing the natural spread of prions are not completely understood and several hypotheses have been proposed. In this study, we analyzed the effect of gender in prion incubation period, as well as the possibility of prion transmission by sexual and parental contact using 263K infected hamsters as a model. Our results show that males have significantly longer incubation periods compared with females when exposed to the same quantity of infectious material. Importantly, no evidence of sexual or parental prion transmission was found, even 500 d after sexual contact or birth, respectively. Western blotting and PMCA were unable to detect sub-clinical levels of PrP(Sc) in experimental subjects, suggesting a complete absence of prion transmission by these routes. Our results show that sexual and parental transmission of prions does not occur in this model. It remains to be studied whether this conclusion is valid also for other prion strains and species.

Coping Flexibility and Complicated Grief: A Comparison of American and Chinese Samples

PubMed Central

Burton, Charles L.; Yan, Oscar H.; Pat-Horenczyk, Ruth; Chan, Ide S. F.; Ho, Samuel; Bonanno, George A.

2011-01-01

Background The ability to process a death, and the ability to remain optimistic and look beyond the loss, are both thought to be effective means of coping with loss and other aversive events. Recently, these seemingly contrary dimensions have been integrated into the idea of coping flexibility. Method In this study we assessed the ability of married and bereaved individuals in the US and Hong Kong to use both coping approaches as operationalized by the trauma-focused and forward-focused coping scales of a previously validated questionnaire. We also calculated a single flexibility score. Results Bereaved participants reported greater trauma-focused coping ability than did married participants. However, bereaved participants meeting criteria for complicated grief (CG) reported less forward-focused coping than both asymptomatic bereaved and married participants. The CG group also showed less overall coping flexibility than the asymptomatic bereaved and married groups. Country was not a factor. Conclusions Findings suggest that deficits in coping flexibility are indicative of pathology in bereaved individuals, and that this relationship extends across cultures. Limitations of the study and directions for future research are discussed. PMID:21898713

Design, development, and clinical validation of therapeutic toys for autistic children

PubMed Central

Tseng, Kevin C.; Tseng, Sung-Hui; Cheng, Hsin-Yi Kathy

2016-01-01

[Purpose] One of the characteristics of autistic children is social interaction difficulties. Although therapeutic toys can promote social interaction, however its related research remains insufficient. The aim of the present study was to build a set of cooperative play toys that are suitable for autistic children. [Subjects and Methods] This study used an innovative product design and development approach as the basis for the creation of cooperative play toys. [Results] The present study has successfully developed cooperative play toys. Compared to the traditional game therapy for autism, cooperative play toy therapy can significantly improve the interactions between autistic children and their peers. [Conclusion] The most critical design theme of cooperative play toys focuses on captivating the interest of autistic children. Based on the needs of the individual cases, the design of the therapeutic toy set was specifically tailored, i.e., by reinforcing the sound and light effects to improve the attractiveness of the toys. In the future, different play modes can be combined with this toy set to further enhance the degree of interaction of autistic children and improve their quality of life and social skills. PMID:27512246

The Reliability of Neurons

PubMed Central

Bullock, Theodore Holmes

1970-01-01

The prevalent probabilistic view is virtually untestable; it remains a plausible belief. The cases usually cited can not be taken as evidence for it. Several grounds for this conclusion are developed. Three issues are distinguished in an attempt to clarify a murky debate: (a) the utility of probabilistic methods in data reduction, (b) the value of models that assume indeterminacy, and (c) the validity of the inference that the nervous system is largely indeterministic at the neuronal level. No exception is taken to the first two; the second is a private heuristic question. The third is the issue to which the assertion in the first two sentences is addressed. Of the two kinds of uncertainty, statistical mechanical (= practical unpredictability) as in a gas, and Heisenbergian indeterminancy, the first certainly exists, the second is moot at the neuronal level. It would contribute to discussion to recognize that neurons perform with a degree of reliability. Although unreliability is difficult to establish, to say nothing of measure, evidence that some neurons have a high degree of reliability, in both connections and activity is increasing greatly. An example is given from sternarchine electric fish. PMID:5462670

Evaluating a Speech-Language Pathology Technology

PubMed Central

Spinardi-Panes, Ana Carulina; Lopes-Herrera, Simone Aparecida; Maximino, Luciana Paula

2014-01-01

Abstract Background: The creation of new educational strategies based on technology is the essence of telehealth. This innovative learning is an alternative to promote integration and improve the professional practices in speech-language pathology (SLP). The objective of this study was to evaluate an SLP technology designed for distance learning. Materials and Methods: The survey selected fourth-year SLP students (n=60) from three public universities in the state of São Paulo, Brazil. The experimental group (EG) contained 10 students from each university (n=30), and the remaining students formed the control group (CG). Initially, both groups answered a preprotocol questionnaire, and the EG students received the technology, the recommendations, and the deadline to explore the material. In the second stage all students answered the postprotocol questionnaire in order to evaluate the validity and the learning of the technology contents. Results: The comparison between the CG students showed that their performance worsened in the majority in comparison with the EG students, who showed an improved performance. Conclusions: Therefore, this study concluded that the technology instrument actually responded to the population studied and is recommended to complement traditional teaching. PMID:24404815

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

Zadora, A. S., E-mail: as.zadora@physics.msu.ru

The objective of the present study is to consider in more detail the exotic color-charge-glow effect discovered recently and to analyze its possible physical manifestations associated with the treatment of ensembles of color-charged particles at a classical level. The ways in which this effect may appear in arbitrary systems consisting of pointlike massive particles and admitting the partition into elementary configurations like color charges and color dipoles are studied. The possible influence of this effect on particle dynamics (in particular, on gluon distributions) is also examined. Particle collisions at a given impact parameters are considered for a natural regularization ofmore » emerging expressions. It is shown that, in the case of reasonable impact-parameter values, collisions may proceed in the electrodynamic mode, in which case the charge-glow contribution to field strengths is suppressed in relation to what we have in the electrodynamic picture. From an analysis of the color-echo situation, it follows that the above conclusion remains valid for more complicated particle configurations as well, since hard gluon fields may arise only owing to a direct collision rather than owing to any echo-like effects.« less

A Proposed Method to Predict Preterm Birth Using Clinical Data, Standard Maternal Serum Screening, and Cholesterol

PubMed Central

ALLEMAN, Brandon W.; SMITH, Amanda R.; BYERS, Heather M.; BEDELL, Bruce; RYCKMAN, Kelli K.; MURRAY, Jeffrey C.; BOROWSKI, Kristi S.

2013-01-01

Objective To create a predictive model for preterm birth (PTB) from available clinical data and serum analytes. Study Design Serum analytes, routine pregnancy screening plus cholesterol and corresponding health information were linked to birth certificate data for a cohort of 2699 Iowa women with serum sampled in the first and second trimester. Stepwise logistic regression was used to select the best predictive model for PTB. Results Serum screening markers remained significant predictors of PTB even after controlling for maternal characteristics. The best predictive model included maternal characteristics, first trimester total cholesterol (TC), TC change between trimesters and second trimester alpha-fetoprotein and inhibin A. The model showed better discriminatory ability than PTB history alone and performed similarly in subgroups of women without past PTB. Conclusions Using clinical and serum screening data a potentially useful predictor of PTB was constructed. Validation and replication in other populations, and incorporation of other measures that identify PTB risk, like cervical length, can be a step towards identifying additional women who may benefit from new or currently available interventions. PMID:23500456

Design, development, and clinical validation of therapeutic toys for autistic children.

PubMed

Tseng, Kevin C; Tseng, Sung-Hui; Cheng, Hsin-Yi Kathy

2016-07-01

[Purpose] One of the characteristics of autistic children is social interaction difficulties. Although therapeutic toys can promote social interaction, however its related research remains insufficient. The aim of the present study was to build a set of cooperative play toys that are suitable for autistic children. [Subjects and Methods] This study used an innovative product design and development approach as the basis for the creation of cooperative play toys. [Results] The present study has successfully developed cooperative play toys. Compared to the traditional game therapy for autism, cooperative play toy therapy can significantly improve the interactions between autistic children and their peers. [Conclusion] The most critical design theme of cooperative play toys focuses on captivating the interest of autistic children. Based on the needs of the individual cases, the design of the therapeutic toy set was specifically tailored, i.e., by reinforcing the sound and light effects to improve the attractiveness of the toys. In the future, different play modes can be combined with this toy set to further enhance the degree of interaction of autistic children and improve their quality of life and social skills.

Development and validation of a predictive model for excessive postpartum blood loss: A retrospective, cohort study.

PubMed

Rubio-Álvarez, Ana; Molina-Alarcón, Milagros; Arias-Arias, Ángel; Hernández-Martínez, Antonio

2018-03-01

postpartum haemorrhage is one of the leading causes of maternal morbidity and mortality worldwide. Despite the use of uterotonics agents as preventive measure, it remains a challenge to identify those women who are at increased risk of postpartum bleeding. to develop and to validate a predictive model to assess the risk of excessive bleeding in women with vaginal birth. retrospective cohorts study. "Mancha-Centro Hospital" (Spain). the elaboration of the predictive model was based on a derivation cohort consisting of 2336 women between 2009 and 2011. For validation purposes, a prospective cohort of 953 women between 2013 and 2014 were employed. Women with antenatal fetal demise, multiple pregnancies and gestations under 35 weeks were excluded METHODS: we used a multivariate analysis with binary logistic regression, Ridge Regression and areas under the Receiver Operating Characteristic curves to determine the predictive ability of the proposed model. there was 197 (8.43%) women with excessive bleeding in the derivation cohort and 63 (6.61%) women in the validation cohort. Predictive factors in the final model were: maternal age, primiparity, duration of the first and second stages of labour, neonatal birth weight and antepartum haemoglobin levels. Accordingly, the predictive ability of this model in the derivation cohort was 0.90 (95% CI: 0.85-0.93), while it remained 0.83 (95% CI: 0.74-0.92) in the validation cohort. this predictive model is proved to have an excellent predictive ability in the derivation cohort, and its validation in a latter population equally shows a good ability for prediction. This model can be employed to identify women with a higher risk of postpartum haemorrhage. Copyright © 2017 Elsevier Ltd. All rights reserved.

Validity of the SAT for Predicting First-Year Grades: 2008 SAT Validity Sample. Statistical Report No. 2011-5

ERIC Educational Resources Information Center

Patterson, Brian F.; Mattern, Krista D.

2011-01-01

The findings for the 2008 sample are largely consistent with the previous reports. SAT scores were found to be correlated with FYGPA (r = 0.54), with a magnitude similar to HSGPA (r = 0.56). The best set of predictors of FYGPA remains SAT scores and HSGPA (r = 0.63), as the addition of the SAT sections to the correlation of HSGPA alone with FYGPA…

The development and evaluation of a five-language multi-perspective standardised measure: clinical decision-making involvement and satisfaction (CDIS)

PubMed Central

2014-01-01

Background The aim of this study was to develop and evaluate a brief quantitative five-language measure of involvement and satisfaction in clinical decision-making (CDIS) – with versions for patients (CDIS-P) and staff (CDIS-S) – for use in mental health services. Methods An English CDIS was developed by reviewing existing measures, focus groups, semistructured interviews and piloting. Translations into Danish, German, Hungarian and Italian followed the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Task Force principles of good practice for translation and cultural adaptation. Psychometricevaluation involved testing the measure in secondary mental health services in Aalborg, Debrecen, London, Naples, Ulm and Zurich. Results After appraising 14 measures, the Control Preference Scale and Satisfaction With Decision-making English-language scales were modified and evaluated in interviews (n = 9), focus groups (n = 22) and piloting (n = 16). Translations were validated through focus groups (n = 38) and piloting (n = 61). A total of 443 service users and 403 paired staff completed CDIS. The Satisfaction sub-scale had internal consistency of 0.89 (0.86-0.89 after item-level deletion) for staff and 0.90 (0.87-0.90) for service users, both continuous and categorical (utility) versions were associated with symptomatology and both staff-rated and service userrated therapeutic alliance (showing convergent validity), and not with social disability (showing divergent validity), and satisfaction predicted staff-rated (OR 2.43, 95%CI 1.54- 3.83 continuous, OR 5.77, 95%CI 1.90-17.53 utility) and service user-rated (OR 2.21, 95%CI 1.51-3.23 continuous, OR 3.13, 95%CI 1.10-8.94 utility) decision implementation two months later. The Involvement sub-scale had appropriate distribution and no floor or ceiling effects, was associated with stage of recovery, functioning and quality of life (staff only) (showing convergent validity), and not with symptomatology or social disability (showing divergent validity), and staff-rated passive involvement by the service user predicted implementation (OR 3.55, 95%CI 1.53-8.24). Relationships remained after adjusting for clustering by staff. Conclusions CDIS demonstrates adequate internal consistency, no evidence of item redundancy, appropriate distribution, and face, content, convergent, divergent and predictive validity. It can be recommended for research and clinical use. CDIS-P and CDIS-S in all 3 five languages can be downloaded at http://www.cedar-net.eu/instruments. Trial registration ISRCTN75841675. PMID:25066212

Molecular paleontology and complexity in the last eukaryotic common ancestor

PubMed Central

Koumandou, V. Lila; Wickstead, Bill; Ginger, Michael L.; van der Giezen, Mark; Dacks, Joel B.

2013-01-01

Eukaryogenesis, the origin of the eukaryotic cell, represents one of the fundamental evolutionary transitions in the history of life on earth. This event, which is estimated to have occurred over one billion years ago, remains rather poorly understood. While some well-validated examples of fossil microbial eukaryotes for this time frame have been described, these can provide only basic morphology and the molecular machinery present in these organisms has remained unknown. Complete and partial genomic information has begun to fill this gap, and is being used to trace proteins and cellular traits to their roots and to provide unprecedented levels of resolution of structures, metabolic pathways and capabilities of organisms at these earliest points within the eukaryotic lineage. This is essentially allowing a molecular paleontology. What has emerged from these studies is spectacular cellular complexity prior to expansion of the eukaryotic lineages. Multiple reconstructed cellular systems indicate a very sophisticated biology, which by implication arose following the initial eukaryogenesis event but prior to eukaryotic radiation and provides a challenge in terms of explaining how these early eukaryotes arose and in understanding how they lived. Here, we provide brief overviews of several cellular systems and the major emerging conclusions, together with predictions for subsequent directions in evolution leading to extant taxa. We also consider what these reconstructions suggest about the life styles and capabilities of these earliest eukaryotes and the period of evolution between the radiation of eukaryotes and the eukaryogenesis event itself. PMID:23895660

Screening of Active Lyssavirus Infection in Wild Bat Populations by Viral RNA Detection on Oropharyngeal Swabs

PubMed Central

Echevarría, Juan E.; Avellón, Ana; Juste, Javier; Vera, Manuel; Ibáñez, Carlos

2001-01-01

Brain analysis cannot be used for the investigation of active lyssavirus infection in healthy bats because most bat species are protected by conservation directives. Consequently, serology remains the only tool for performing virological studies on natural bat populations; however, the presence of antibodies merely reflects past exposure to the virus and is not a valid marker of active infection. This work describes a new nested reverse transcription (RT)-PCR technique specifically designed for the detection of the European bat virus 1 on oropharyngeal swabs obtained from bats but also able to amplify RNA from the remaining rabies-related lyssaviruses in brain samples. The technique was successfully used for surveillance of a serotine bat (Eptesicus serotinus) colony involved in a case of human exposure, in which 15 out of 71 oropharyngeal swabs were positive. Lyssavirus infection was detected on 13 oropharyngeal swabs but in only 5 brains out of the 34 animals from which simultaneous brain and oropharyngeal samples had been taken. The lyssavirus involved could be rapidly identified by automatic sequencing of the RT-PCR products obtained from 14 brains and three bat oropharyngeal swabs. In conclusion, RT-PCR using oropharyngeal swabs will permit screening of wild bat populations for active lyssavirus infection, for research or epidemiological purposes, in line not only with conservation policies but also in a more efficient manner than classical detection techniques used on the brain. PMID:11574590

A Network Biology Approach to Decipher Stress Response in Bacteria Using Escherichia coli As a Model.

PubMed

Nagar, Shashwat Deepali; Aggarwal, Bhavye; Joon, Shikha; Bhatnagar, Rakesh; Bhatnagar, Sonika

2016-05-01

The development of drug-resistant pathogenic bacteria poses challenges to global health for their treatment and control. In this context, stress response enables bacterial populations to survive extreme perturbations in the environment but remains poorly understood. Specific modules are activated for unique stressors with few recognized global regulators. The phenomenon of cross-stress protection strongly suggests the presence of central proteins that control the diverse stress responses. In this work, Escherichia coli was used to model the bacterial stress response. A Protein-Protein Interaction Network was generated by integrating differentially expressed genes in eight stress conditions of pH, temperature, and antibiotics with relevant gene ontology terms. Topological analysis identified 24 central proteins. The well-documented role of 16 central proteins in stress indicates central control of the response, while the remaining eight proteins may have a novel role in stress response. Cluster analysis of the generated network implicated RNA binding, flagellar assembly, ABC transporters, and DNA repair as important processes during response to stress. Pathway analysis showed crosstalk of Two Component Systems with metabolic processes, oxidative phosphorylation, and ABC transporters. The results were further validated by analysis of an independent cross-stress protection dataset. This study also reports on the ways in which bacterial stress response can progress to biofilm formation. In conclusion, we suggest that drug targets or pathways disrupting bacterial stress responses can potentially be exploited to combat antibiotic tolerance and multidrug resistance in the future.

A Review of Numerical Simulation and Analytical Modeling for Medical Devices Safety in MRI

PubMed Central

Kabil, J.; Belguerras, L.; Trattnig, S.; Pasquier, C.; Missoffe, A.

2016-01-01

Summary Objectives To review past and present challenges and ongoing trends in numerical simulation for MRI (Magnetic Resonance Imaging) safety evaluation of medical devices. Methods A wide literature review on numerical and analytical simulation on simple or complex medical devices in MRI electromagnetic fields shows the evolutions through time and a growing concern for MRI safety over the years. Major issues and achievements are described, as well as current trends and perspectives in this research field. Results Numerical simulation of medical devices is constantly evolving, supported by calculation methods now well-established. Implants with simple geometry can often be simulated in a computational human model, but one issue remaining today is the experimental validation of these human models. A great concern is to assess RF heating on implants too complex to be traditionally simulated, like pacemaker leads. Thus, ongoing researches focus on alternative hybrids methods, both numerical and experimental, with for example a transfer function method. For the static field and gradient fields, analytical models can be used for dimensioning simple implants shapes, but limited for complex geometries that cannot be studied with simplifying assumptions. Conclusions Numerical simulation is an essential tool for MRI safety testing of medical devices. The main issues remain the accuracy of simulations compared to real life and the studies of complex devices; but as the research field is constantly evolving, some promising ideas are now under investigation to take up the challenges. PMID:27830244

Human papilloma virus vaccination in Nepal: an initial experience in Nepal.

PubMed

Singh, Yogendra; Shah, Aarti; Singh, Meeta; Verma, Sheela; Shrestha, Bhakta Man; Vaidya, Prabhu; Nakarmi, Radha Pyari; Shrestha, Surendra Bb

2010-01-01

Cervical cancer is the most common cancer among women in Nepal. Human papilloma virus (HPV) infection, a recognized cause of cervical cancer, is very common in sexually active women and HPV vaccination has been recommended as a prophylactic therapy. If HPV infection is prevented by the HPV vaccination to the adolescent girls, cervical cancer is also prevented. We received 3,300 vials of quadrivalent human papilloma virus (types 6, 11, 16, 18) recombinant vaccine (Gardasil; Merck and Co.) as a gift from the Australian Cervical Cancer Foundation (ACCF) which has a mission to provide life-saving HPV cervical cancer vaccines for women in developing countries, who cannot otherwise afford vaccination. HPV vaccine was offered to 1,096 of 10 to 26 year aged girls attending 17 secondary schools. In total, 1,091 (99.5%) received the second dose and 1,089 (99.3%) received the third dose of the vaccine. The remaining 5 girls at second dose and 2 girls at third dose remained unvaccinated. No serious vaccine related adverse events were reported except mild pain at the injection site in 7.8% of the vaccine recipients. High cost and low public awareness are the key barriers for successful implementation of the vaccination program in resource limited developing countries. In conclusion, HPV vaccine is safe with high acceptability in Nepalese school girls. However a large population study for longer follow up is warranted to validate the findings of this vaccination program.

Reconstitution of the ERG Gene Expression Network Reveals New Biomarkers and Therapeutic Targets in ERG Positive Prostate Tumors

PubMed Central

Dubovenko, Alexey; Serebryiskaya, Tatiana; Nikolsky, Yuri; Nikolskaya, Tatiana; Perlina, Ally; JeBailey, Lellean; Bureeva, Svetlana; Katta, Shilpa; Srivastava, Shiv; Dobi, Albert; Khasanova, Tatiana

2015-01-01

Background: Despite a growing number of studies evaluating cancer of prostate (CaP) specific gene alterations, oncogenic activation of the ETS Related Gene (ERG) by gene fusions remains the most validated cancer gene alteration in CaP. Prevalent gene fusions have been described between the ERG gene and promoter upstream sequences of androgen-inducible genes, predominantly TMPRSS2 (transmembrane protease serine 2). Despite the extensive evaluations of ERG genomic rearrangements, fusion transcripts and the ERG oncoprotein, the prognostic value of ERG remains to be better understood. Using gene expression dataset from matched prostate tumor and normal epithelial cells from an 80 GeneChip experiment examining 40 tumors and their matching normal pairs in 40 patients with known ERG status, we conducted a cancer signaling-focused functional analysis of prostatic carcinoma representing moderate and aggressive cancers stratified by ERG expression. Results: In the present study of matched pairs of laser capture microdissected normal epithelial cells and well-to-moderately differentiated tumor epithelial cells with known ERG gene expression status from 20 patients with localized prostate cancer, we have discovered novel ERG associated biochemical networks. Conclusions: Using causal network reconstruction methods, we have identified three major signaling pathways related to MAPK/PI3K cascade that may indeed contribute synergistically to the ERG dependent tumor development. Moreover, the key components of these pathways have potential as biomarkers and therapeutic target for ERG positive prostate tumors. PMID:26000039

Validation of the Functional Assessment of Chronic Illness Therapy-Spiritual Well-being (FACIT-Sp12) on French Old People.

PubMed

Agli, Océane; Bailly, Nathalie; Ferrand, Claude

2017-04-01

The study aimed to develop a French version of the Functional Assessment of Chronic Illness Therapy-Spiritual Well-being short version (FACIT-Sp12), in order to provide a self-reported measure for French people in the field of gerontology. The study involving 63 nursing home residents was conducted to evaluate the construct validity, reliability, and convergence validity of the FACIT-Sp12. A confirmatory factor analysis corroborated a three-factor model (Meaning, Peace and Faith) with modifications for two items, also valid among people with cognitive impairment. Subscales showed good internal consistency and are correlated with quality of life and depression. In conclusion, the validated French version is an suitable instrument to study the maintenance and promotion of quality of life in the elderly.

Effect of individual shades on reliability and validity of observers in colour matching.

PubMed

Lagouvardos, P E; Diamanti, H; Polyzois, G

2004-06-01

The effect of individual shades in shade guides, on the reliability and validity of measurements in a colour matching process is very important. Observer's agreement on shades and sensitivity/specificity of shades, can give us an estimate of shade's effect on observer's reliability and validity. In the present study, a group of 16 students, matched 15 shades of a Kulzer's guide and 10 human incisors to Kulzer's and/or Vita's shade tabs, in 4 different tests. The results showed shades I, B10, C40, A35 and A10 were those with the highest reliability and validity values. In conclusion, a) the matching process with shades of different materials was not accurate enough, b) some shades produce a more reliable and valid match than others and c) teeth are matched with relative difficulty.

Development and Validation of a Safety Climate Scale for Manufacturing Industry

PubMed Central

Ghahramani, Abolfazl; Khalkhali, Hamid R.

2015-01-01

Background This paper describes the development of a scale for measuring safety climate. Methods This study was conducted in six manufacturing companies in Iran. The scale developed through conducting a literature review about the safety climate and constructing a question pool. The number of items was reduced to 71 after performing a screening process. Results The result of content validity analysis showed that 59 items had excellent item content validity index (≥ 0.78) and content validity ratio (> 0.38). The exploratory factor analysis resulted in eight safety climate dimensions. The reliability value for the final 45-item scale was 0.96. The result of confirmatory factor analysis showed that the safety climate model is satisfactory. Conclusion This study produced a valid and reliable scale for measuring safety climate in manufacturing companies. PMID:26106508

Therapy for pneumococcal infection at the millennium: doubts and certainties.

PubMed

Ball, P

1999-07-26

Rapidly burgeoning worldwide multiple drug-resistant pneumococcal serotypes pose an urgent demand for new management approaches. Perhaps modern intensive care methods may have alternatives to offer. Indeed, standard assessments such as the admission APACHE II score may overestimate individual risk of death in severe CAP, and mortality can be reduced. However, among those at highest risk for mortality in the early phase of invasive disease, the conclusions reached 2-3 decades ago, that it is questionable whether a more effective drug than penicillin can be developed, and that a reduction in the number of deaths consequent to this infection can be accomplished only by widespread immunoprophylactic measures, remain inescapable. Clearly, as discussed elsewhere in this supplement, the continuing validity of these 20-year-old conclusions and the global prevalence of DRSP demand the development and marketing of new conjugate vaccines, although more widespread use of the existing 23-valent polysaccharide vaccine among high-risk populations is essential in the interim. With respect to resistance selection pressures, antibiotic prescription control may provide the answer. However, patient expectations of antibiotic therapy for trivial respiratory infection is high and, in the United Kingdom, 75% of previously healthy adults will receive it; those who do not will usually consult another physician in an effort to secure such therapy. Thus, without the intervention of government or managed care organizations, self-regulation in prescribing is unlikely. The evidence for beta-lactam treatment failure in meningitis has led to alternative approaches, with vancomycin as the primary agent. Penicillins may remain effective for otitis media, but oral cephalosporins are suspect. Data on pediatric pneumococcal pneumonia continue to suggest use of beta-lactams, at least for disease caused by strains with intermediate penicillin sensitivity. Pallares et al concluded that penicillins and cephalosporins remain the drugs of choice for severe pneumococcal pneumonia in adults. Others who share this conclusion often cite that study as evidence. However, in the case of penicillins, the mortality rate was 6% higher in a subgroup selected for monomicrobial infection and reduced risk factors for mortality when penicillin-resistant infection was present, and the overall mortality was 14% higher with penicillin-resistant strains (taking into account "all comers"). Those who depend on the findings of evidence-based medicine may accept the premise that penicillins and cephalosporins remain the drugs of choice, and agree with Goldstein and Garau that it would indeed be a mistake to adopt alternative therapies. Others may consider the deaths of 6 of 100 patients who were not in the highest-risk group too high a price to pay for statistical significance and may be skeptical of the continued use of beta-lactam therapy on higher-risk patients. In addition, the persistent selection pressure applied by continued use of beta-lactams offers a powerful population-based argument for alternatives. As DRSP continues to spread and resistant strains with penicillin MIC >2 mg/L become more prevalent, new agents such as the azabicyclo-methoxyquinolone, moxifloxacin, and perhaps grepafloxacin, but not the more toxic sparfloxacin and trovafloxacin, will undoubtedly flourish as treatments for CAP. By that time, the results of clinical studies on ketolides and oxazolidinones could offer further choices.

Addressing Participant Validity in a Small Internet Health Survey (The Restore Study): Protocol and Recommendations for Survey Response Validation

PubMed Central

Dewitt, James; Capistrant, Benjamin; Kohli, Nidhi; Mitteldorf, Darryl; Merengwa, Enyinnaya; West, William

2018-01-01

Background While deduplication and cross-validation protocols have been recommended for large Web-based studies, protocols for survey response validation of smaller studies have not been published. Objective This paper reports the challenges of survey validation inherent in a small Web-based health survey research. Methods The subject population was North American, gay and bisexual, prostate cancer survivors, who represent an under-researched, hidden, difficult-to-recruit, minority-within-a-minority population. In 2015-2016, advertising on a large Web-based cancer survivor support network, using email and social media, yielded 478 completed surveys. Results Our manual deduplication and cross-validation protocol identified 289 survey submissions (289/478, 60.4%) as likely spam, most stemming from advertising on social media. The basic components of this deduplication and validation protocol are detailed. An unexpected challenge encountered was invalid survey responses evolving across the study period. This necessitated the static detection protocol be augmented with a dynamic one. Conclusions Five recommendations for validation of Web-based samples, especially with smaller difficult-to-recruit populations, are detailed. PMID:29691203

Development and validation of a yoga module for Parkinson disease.

PubMed

Kakde, Noopur; Metri, Kashinath G; Varambally, Shivarama; Nagaratna, Raghuram; Nagendra, H R

2017-03-25

Background Parkinson's disease (PD), a progressive neurodegenerative disease, affects motor and nonmotor functions, leading to severe debility and poor quality of life. Studies have reported the beneficial role of yoga in alleviating the symptoms of PD; however, a validated yoga module for PD is unavailable. This study developed and validated an integrated yoga module(IYM) for PD. Methods The IYM was prepared after a thorough review of classical yoga texts and previous findings. Twenty experienced yoga experts, who fulfilled the inclusion criteria, were selected validating the content of the IYM. A total of 28 practices were included in the IYM, and each practice was discussed and rated as (i) not essential, (ii) useful but not essential, and (iii) essential; the content validity ratio (CVR) was calculated using Lawshe's formula. Results Data analysis revealed that of the 28 IYM practices, 21 exhibited significant content validity (cut-off value: 0.42, as calculated by applying Lawshe's formula for the CVR). Conclusions The IYM is valid for PD, with good content validity. However, future studies must determine the feasibility and efficacy of the developed module.

Discriminant Validity Assessment: Use of Fornell & Larcker criterion versus HTMT Criterion

NASA Astrophysics Data System (ADS)

Hamid, M. R. Ab; Sami, W.; Mohmad Sidek, M. H.

2017-09-01

Assessment of discriminant validity is a must in any research that involves latent variables for the prevention of multicollinearity issues. Fornell and Larcker criterion is the most widely used method for this purpose. However, a new method has emerged for establishing the discriminant validity assessment through heterotrait-monotrait (HTMT) ratio of correlations method. Therefore, this article presents the results of discriminant validity assessment using these methods. Data from previous study was used that involved 429 respondents for empirical validation of value-based excellence model in higher education institutions (HEI) in Malaysia. From the analysis, the convergent, divergent and discriminant validity were established and admissible using Fornell and Larcker criterion. However, the discriminant validity is an issue when employing the HTMT criterion. This shows that the latent variables under study faced the issue of multicollinearity and should be looked into for further details. This also implied that the HTMT criterion is a stringent measure that could detect the possible indiscriminant among the latent variables. In conclusion, the instrument which consisted of six latent variables was still lacking in terms of discriminant validity and should be explored further.

[Reliability and validity of the Chinese version on Comprehensive Scores for Financial Toxicity based on the patient-reported outcome measures].

PubMed

Yu, H H; Bi, X; Liu, Y Y

2017-08-10

Objective: To evaluate the reliability and validity of the Chinese version on comprehensive scores for financial toxicity (COST), based on the patient-reported outcome measures. Methods: A total of 118 cancer patients were face-to-face interviewed by well-trained investigators. Cronbach's α and Pearson correlation coefficient were used to evaluate reliability. Content validity index (CVI) and exploratory factor analysis (EFA) were used to evaluate the content validity and construct validity, respectively. Results: The Cronbach's α coefficient appeared as 0.889 for the whole questionnaire, with the results of test-retest were between 0.77 and 0.98. Scale-content validity index (S-CVI) appeared as 0.82, with item-content validity index (I-CVI) between 0.83 and 1.00. Two components were extracted from the Exploratory factor analysis, with cumulative rate as 68.04% and loading>0.60 on every item. Conclusion: The Chinese version of COST scale showed high reliability and good validity, thus can be applied to assess the financial situation in cancer patients.

Validity of the MMPI Personality Disorder scales (MMPI-PD).

PubMed

Schuler, C E; Snibbe, J R; Buckwalter, J G

1994-03-01

The MMPI Personality Disorder scales, developed by Morey, Waugh, and Blashfield (1985), were validated on an inpatient population by comparing 104 patients' MMPI-PD scores with the MCMI and with DSM-III-R diagnosis. Conservative significance levels were used to ensure more valid conclusions. Schizoid, Avoidant, Dependent, Histrionic, and Narcissistic scales were correlated significantly. Passive-Aggressive, Schizotypal, and Borderline scales did not correlate with corresponding MCMI scales. The MMPI-PD nonoverlapping scales were most effective in predicting diagnosis, specifically the Personality Disorder NOS, Eccentric and Borderline groups. The overlapping scales were not as effective in predicting diagnosis, but best predicted the Eccentric and Borderline groups. This study provides support for the validity of specific scales and circumscribed diagnostic utility for both measures.

The validity and clinical utility of purging disorder.

PubMed

Keel, Pamela K; Striegel-Moore, Ruth H

2009-12-01

To review evidence of the validity and clinical utility of Purging Disorder and examine options for the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-V). Articles were identified by computerized and manual searches and reviewed to address five questions about Purging Disorder: Is there "ample" literature? Is the syndrome clearly defined? Can it be measured and diagnosed reliably? Can it be differentiated from other eating disorders? Is there evidence of syndrome validity? Although empirical classification and concurrent validity studies provide emerging support for the distinctiveness of Purging Disorder, questions remain about definition, diagnostic reliability in clinical settings, and clinical utility (i.e., prognostic validity). We discuss strengths and weaknesses associated with various options for the status of Purging Disorder in the DSM-V ranging from making no changes from DSM-IV to designating Purging Disorder a diagnosis on equal footing with Anorexia Nervosa and Bulimia Nervosa.

A Look at Infinite Series

ERIC Educational Resources Information Center

Basor, Estelle

1978-01-01

Sums for divergent series that were seriously considered by eighteenth century mathematicians are shown to have reappeared as result of new interpretations for divergent series that make these previous conclusions valid. (MN)

The NTE and Teacher Certification

ERIC Educational Resources Information Center

McDaniel, Thomas R.

1977-01-01

Although in U.S. v. State of South Carolina the Court has established important guidelines legitimating the use of validated National Teacher Examination scores in the certification of teachers, some problems and questions remain. (Author/IRT)

49 CFR 1540.203 - Security threat assessment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... prevent completion of the threat assessment). (5) Gender. (6) Country of citizenship. (7) If the applicant... subpart remains valid for five years from the date that TSA issues a Determination of No Security Threat...

KENNEDY SPACE CENTER, FLA. -- Endeavour backs out of the Orbiter Processing Facility for temporary transfer to the Vehicle Assembly Building. The move allows work to be performed in the OPF that can only be accomplished while the bay is empty. Work scheduled in the OPF includes annual validation of the bay’s cranes, work platforms, lifting mechanisms and jack stands. Endeavour will remain in the VAB for approximately 12 days, then return to the OPF.

NASA Image and Video Library

2004-01-09

KENNEDY SPACE CENTER, FLA. -- Endeavour backs out of the Orbiter Processing Facility for temporary transfer to the Vehicle Assembly Building. The move allows work to be performed in the OPF that can only be accomplished while the bay is empty. Work scheduled in the OPF includes annual validation of the bay’s cranes, work platforms, lifting mechanisms and jack stands. Endeavour will remain in the VAB for approximately 12 days, then return to the OPF.

Are we puppets on a string? Comparing the impact of contingency and validity on implicit and explicit evaluations.

PubMed

Peters, Kurt R; Gawronski, Bertram

2011-04-01

Research has demonstrated that implicit and explicit evaluations of the same object can diverge. Explanations of such dissociations frequently appeal to dual-process theories, such that implicit evaluations are assumed to reflect object-valence contingencies independent of their perceived validity, whereas explicit evaluations reflect the perceived validity of object-valence contingencies. Although there is evidence supporting these assumptions, it remains unclear if dissociations can arise in situations in which object-valence contingencies are judged to be true or false during the learning of these contingencies. Challenging dual-process accounts that propose a simultaneous operation of two parallel learning mechanisms, results from three experiments showed that the perceived validity of evaluative information about social targets qualified both explicit and implicit evaluations when validity information was available immediately after the encoding of the valence information; however, delaying the presentation of validity information reduced its qualifying impact for implicit, but not explicit, evaluations.

Prior Study of Cross-Cultural Validation of McGill Quality-of-Life Questionnaire in Mainland Mandarin Chinese Patients With Cancer.

PubMed

Hu, Liya; Li, Jingwen; Wang, Xu; Payne, Sheila; Chen, Yuan; Mei, Qi

2015-11-01

The validation of McGill quality-of-life questionnaire (MQOLQ) in mainland China, which had already been used in multicultural palliative care background including Hong Kong and Taiwan, remained unknown. Eligible patients completed the translated Chinese version of McGill questionnaires (MQOL-C), which had been examined before the study. Construct validity was preliminarily assessed through exploratory factor analysis extracting 4 factors that construct a new hypothesis model and then the original model was proved to be better confirmed by confirmatory factor analysis. Internal consistency of all the subscales was within 0.582 to 0.917. Furthermore, test-retest reliability ranged from 0.509 to 0.859, which was determined by Spearman rank correlation coefficient. Face validation and feasibility also confirm the good validity of MQOL-C. The MQOL-C has satisfied validation in mainland Chinese patients with cancer, although cultural difference should be considered while using it. © The Author(s) 2014.

Ada Compiler Validation Summary Report. Certificate Number: 920918S1. 11272, U.S. Navy Ada/M, Version 4.5 (/OPTIMIZE) VAX 8550/8600/8650 (Cluster) Enhanced Processor (EP) AN/UYK-44 (Bare Board)

DTIC Science & Technology

1992-09-01

and Technology Gaithersburg, MD DI USA ELECTE _993_ _ _ _ 7 . PERFORMING ORGANIZATION NAME(S) AND ADDRESS(E JUN 3 1993 8. PERFORMING ORGANIZATION...current Ada Compiler Validation Capability (ACVC). This Validation Summary Report ( VSR ) gives an account of the testing of this Ada implementation. For...34 $MAXLENREALBASEDLITERAL ൘:" & (1..V- 7 => 𔃺’) & "F.E:" SMAXSTRINGLITERAL "’ & (1..V-2 => ’A’) & ’ A-1 The following table contains the values for the remaining macro

Ada Compiler Validation Summary Report: Certificate Number: 910626S1. 11174 U.S. Navy, Ada/M, Version 4.0 (/Optimize), VAX 8550, Running VAX/VMS version 5.3 (Host) to AN/UYK-44 (EMR) (Bare Board) (Target).

DTIC Science & Technology

1991-07-30

Gaithersburg, MD USA 7 PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) 8. PERFORMING ORGANIZATION National Institute of Standards and Technology REPORT...Ada Compiler Validation Capability (ACVC). This Validation Summary Report ( VSR ) gives an account of the testing of this Ada implementation. For any... 7 => 𔃺’) & "F.E:" $MAXSTRINGLITERAL ’"’ & (1..V-2 => ’A’) & ’"’ A-i The fo~te1-wing table contains the values for the remaining macro parameters

Validation of the new diagnosis grouping system for pediatric emergency department visits using the International Classification of Diseases, 10th Revision.

PubMed

Lee, Jin Hee; Hong, Ki Jeong; Kim, Do Kyun; Kwak, Young Ho; Jang, Hye Young; Kim, Hahn Bom; Noh, Hyun; Park, Jungho; Song, Bongkyu; Jung, Jae Yun

2013-12-01

A clinically sensible diagnosis grouping system (DGS) is needed for describing pediatric emergency diagnoses for research, medical resource preparedness, and making national policy for pediatric emergency medical care. The Pediatric Emergency Care Applied Research Network (PECARN) developed the DGS successfully. We developed the modified PECARN DGS based on the different pediatric population of South Korea and validated the system to obtain the accurate and comparable epidemiologic data of pediatric emergent conditions of the selected population. The data source used to develop and validate the modified PECARN DGS was the National Emergency Department Information System of South Korea, which was coded by the International Classification of Diseases, 10th Revision (ICD-10) code system. To develop the modified DGS based on ICD-10 code, we matched the selected ICD-10 codes with those of the PECARN DGS by the General Equivalence Mappings (GEMs). After converting ICD-10 codes to ICD-9 codes by GEMs, we matched ICD-9 codes into PECARN DGS categories using the matrix developed by PECARN group. Lastly, we conducted the expert panel survey using Delphi method for the remaining diagnosis codes that were not matched. A total of 1879 ICD-10 codes were used in development of the modified DGS. After 1078 (57.4%) of 1879 ICD-10 codes were assigned to the modified DGS by GEM and PECARN conversion tools, investigators assigned each of the remaining 801 codes (42.6%) to DGS subgroups by 2 rounds of electronic Delphi surveys. And we assigned the remaining 29 codes (4%) into the modified DGS at the second expert consensus meeting. The modified DGS accounts for 98.7% and 95.2% of diagnoses of the 2008 and 2009 National Emergency Department Information System data set. This modified DGS also exhibited strong construct validity using the concepts of age, sex, site of care, and seasons. This also reflected the 2009 outbreak of H1N1 influenza in Korea. We developed and validated clinically feasible and sensible DGS system for describing pediatric emergent conditions in Korea. The modified PECARN DGS showed good comprehensiveness and demonstrated reliable construct validity. This modified DGS based on PECARN DGS framework may be effectively implemented for research, reporting, and resource planning in pediatric emergency system of South Korea.

Validation of the Inverted Pendulum Model in standing for transtibial prosthesis users.

PubMed

Rusaw, David F; Ramstrand, Simon

2016-01-01

Often in balance assessment variables associated with the center of pressure are used to draw conclusions about an individual's balance. Validity of these conclusions rests upon assumptions that movement of the center of pressure is inter-dependent on movement of the center of mass. This dependency is mechanical and is referred to as the Inverted Pendulum Model. The following study aimed to validate this model both kinematically and kinetically, in transtibial prosthesis users and a control group. Prosthesis users (n=6) and matched control participants (n=6) stood quietly while force and motion data were collected under three conditions (eyes-open, eyes-closed, and weight-bearing feedback). Correlation coefficients were used to investigate the relationships between height and excursion of markers and center of masses in mediolateral/anteroposterior-directions, difference between center of pressure and center of mass and the center of mass acceleration in mediolateral/anteroposterior directions, magnitude of mediolateral/anteroposterior-component forces and center of mass acceleration, angular position of ankle and excursion in mediolateral/anteroposterior-directions, and integrated force signals. Results indicate kinematic validity of similar magnitudes (mean (SD) marker-displacement) between prosthesis users and control group for mediolateral- (r=0.77 (0.17); 0.74 (0.19)) and anteroposterior-directions (r=0.88 (0.18); 0.88 (0.19)). Correlation between difference of center of pressure and center of mass and the center of mass acceleration was negligible on the prosthetic side (r = 0.08 (0.06)) vs. control group (r=-0.51(0.13)). Results indicate kinematic validity of the Inverted Pendulum Model in transtibial prosthesis users but kinetic validity is questionable, particularly on the side with a prosthesis. Copyright © 2015 Elsevier Ltd. All rights reserved.

A systematic review of the quality of homeopathic clinical trials

PubMed Central

Jonas, Wayne B; Anderson, Rachel L; Crawford, Cindy C; Lyons, John S

2001-01-01

Background While a number of reviews of homeopathic clinical trials have been done, all have used methods dependent on allopathic diagnostic classifications foreign to homeopathic practice. In addition, no review has used established and validated quality criteria allowing direct comparison of the allopathic and homeopathic literature. Methods In a systematic review, we compared the quality of clinical-trial research in homeopathy to a sample of research on conventional therapies using a validated and system-neutral approach. All clinical trials on homeopathic treatments with parallel treatment groups published between 1945–1995 in English were selected. All were evaluated with an established set of 33 validity criteria previously validated on a broad range of health interventions across differing medical systems. Criteria covered statistical conclusion, internal, construct and external validity. Reliability of criteria application is greater than 0.95. Results 59 studies met the inclusion criteria. Of these, 79% were from peer-reviewed journals, 29% used a placebo control, 51% used random assignment, and 86% failed to consider potentially confounding variables. The main validity problems were in measurement where 96% did not report the proportion of subjects screened, and 64% did not report attrition rate. 17% of subjects dropped out in studies where this was reported. There was practically no replication of or overlap in the conditions studied and most studies were relatively small and done at a single-site. Compared to research on conventional therapies the overall quality of studies in homeopathy was worse and only slightly improved in more recent years. Conclusions Clinical homeopathic research is clearly in its infancy with most studies using poor sampling and measurement techniques, few subjects, single sites and no replication. Many of these problems are correctable even within a "holistic" paradigm given sufficient research expertise, support and methods. PMID:11801202

Validation of reference genes for normalization of qPCR gene expression data from Coffea spp. hypocotyls inoculated with Colletotrichum kahawae

PubMed Central

2013-01-01

Background Coffee production in Africa represents a significant share of the total export revenues and influences the lives of millions of people, yet severe socio-economic repercussions are annually felt in result of the overall losses caused by the coffee berry disease (CBD). This quarantine disease is caused by the fungus Colletotrichum kahawae Waller and Bridge, which remains one of the most devastating threats to Coffea arabica production in Africa at high altitude, and its dispersal to Latin America and Asia represents a serious concern. Understanding the molecular genetic basis of coffee resistance to this disease is of high priority to support breeding strategies. Selection and validation of suitable reference genes presenting stable expression in the system studied is the first step to engage studies of gene expression profiling. Results In this study, a set of ten genes (S24, 14-3-3, RPL7, GAPDH, UBQ9, VATP16, SAND, UQCC, IDE and β-Tub9) was evaluated to identify reference genes during the first hours of interaction (12, 48 and 72 hpi) between resistant and susceptible coffee genotypes and C. kahawae. Three analyses were done for the selection of these genes considering the entire dataset and the two genotypes (resistant and susceptible), separately. The three statistical methods applied GeNorm, NormFinder, and BestKeeper, allowed identifying IDE as one of the most stable genes for all datasets analysed, and in contrast GADPH and UBQ9 as the least stable ones. In addition, the expression of two defense-related transcripts, encoding for a receptor like kinase and a pathogenesis related protein 10, were used to validate the reference genes selected. Conclusion Taken together, our results provide guidelines for reference gene(s) selection towards a more accurate and widespread use of qPCR to study the interaction between Coffea spp. and C. kahawae. PMID:24073624

Validity of consumer-grade activity monitor to identify manual wheelchair propulsion in standardized activities of daily living

PubMed Central

Horemans, Henricus L. D.; Vegter, Riemer J. K.; de Groot, Sonja; Bussmann, Johannes B. J.; van der Woude, Lucas H. V.

2018-01-01

Background Hypoactive lifestyle contributes to the development of secondary complications and lower quality of life in wheelchair users. There is a need for objective and user-friendly physical activity monitors for wheelchair-dependent individuals in order to increase physical activity through self-monitoring, goal setting, and feedback provision. Objective To determine the validity of Activ8 Activity Monitors to 1) distinguish two classes of activities: independent wheelchair propulsion from other non-propulsive wheelchair-related activities 2) distinguish five wheelchair-related classes of activities differing by the movement intensity level: sitting in a wheelchair (hands may be moving but wheelchair remains stationary), maneuvering, and normal, high speed or assisted wheelchair propulsion. Methods Sixteen able-bodied individuals performed sixteen various standardized 60s-activities of daily living. Each participant was equipped with a set of two Activ8 Professional Activity Monitors, one at the right forearm and one at the right wheel. Task classification by the Active8 Monitors was validated using video recordings. For the overall agreement, sensitivity and positive predictive value, outcomes above 90% are considered excellent, between 70 and 90% good, and below 70% unsatisfactory. Results Division in two classes resulted in overall agreement of 82.1%, sensitivity of 77.7% and positive predictive value of 78.2%. 84.5% of total duration of all tasks was classified identically by Activ8 and based on the video material. Division in five classes resulted in overall agreement of 56.6%, sensitivity of 52.8% and positive predictive value of 51.9%. 59.8% of total duration of all tasks was classified identically by Activ8 and based on the video material. Conclusions Activ8 system proved to be suitable for distinguishing between active wheelchair propulsion and other non-propulsive wheelchair-related activities. The ability of the current system and algorithms to distinguish five various wheelchair-related activities is unsatisfactory. PMID:29641582

High-Sensitivity C-Reactive Protein Complements Plasma Epstein-Barr Virus Deoxyribonucleic Acid Prognostication in Nasopharyngeal Carcinoma: A Large-Scale Retrospective and Prospective Cohort Study

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

Tang, Lin-Quan; Department of Nasopharyngeal Carcinoma, Sun Yat-sen University, Guangzhou; Li, Chao-Feng

Purpose: To evaluate the effects of combining the assessment of circulating high-sensitivity C-reactive protein (hs-CRP) with that of Epstein-Barr virus DNA (EBV DNA) in the pretherapy prognostication of nasopharyngeal carcinoma (NPC). Patients and Methods: Three independent cohorts of NPC patients (training set of n=3113, internal validation set of n=1556, and prospective validation set of n=1668) were studied. Determinants of disease-free survival, distant metastasis–free survival, and overall survival were assessed by multivariate analysis. Hazard ratios and survival probabilities of the patient groups, segregated by clinical stage (T1-2N0-1M0, T3-4N0-1M0, T1-2N2-3M0, and T3-4N2-3M0) and EBV DNA load (low or high) alone, and alsomore » according to hs-CRP level (low or high), were compared. Results: Elevated hs-CRP and EBV DNA levels were significantly correlated with poor disease-free survival, distant metastasis–free survival, and overall survival in both the training and validation sets. Associations were similar and remained significant after excluding patients with cardiovascular disease, diabetes, and chronic hepatitis B. Patients with advanced-stage disease were segregated by high EBV DNA levels and high hs-CRP level into a poorest-risk group, and participants with either high EBV DNA but low hs-CRP level or high hs-CRP but low EBV DNA values had poorer survival compared with the bottom values for both biomarkers. These findings demonstrate a significant improvement in the prognostic ability of conventional advanced NPC staging. Conclusion: Baseline plasma EBV DNA and serum hs-CRP levels were significantly correlated with survival in NPC patients. The combined interpretation of EBV DNA with hs-CRP levels led to refinement of the risks for the patient subsets, with improved risk discrimination in patients with advanced-stage disease.« less

Quality of health literacy instruments used in children and adolescents: a systematic review.

PubMed

Guo, Shuaijun; Armstrong, Rebecca; Waters, Elizabeth; Sathish, Thirunavukkarasu; Alif, Sheikh M; Browne, Geoffrey R; Yu, Xiaoming

2018-06-14

Improving health literacy at an early age is crucial to personal health and development. Although health literacy in children and adolescents has gained momentum in the past decade, it remains an under-researched area, particularly health literacy measurement. This study aimed to examine the quality of health literacy instruments used in children and adolescents and to identify the best instrument for field use. Systematic review. A wide range of settings including schools, clinics and communities. Children and/or adolescents aged 6-24 years. Measurement properties (reliability, validity and responsiveness) and other important characteristics (eg, health topics, components or scoring systems) of health literacy instruments. There were 29 health literacy instruments identified from the screening process. When measuring health literacy in children and adolescents, researchers mainly focus on the functional domain (basic skills in reading and writing) and consider participant characteristics of developmental change (of cognitive ability), dependency (on parents) and demographic patterns (eg, racial/ethnic backgrounds), less on differential epidemiology (of health and illness). The methodological quality of included studies as assessed via measurement properties varied from poor to excellent. More than half (62.9%) of measurement properties were unknown, due to either poor methodological quality of included studies or a lack of reporting or assessment. The 8-item Health Literacy Assessment Tool (HLAT-8) showed best evidence on construct validity, and the Health Literacy Measure for Adolescents showed best evidence on reliability. More rigorous and high-quality studies are needed to fill the knowledge gap in measurement properties of health literacy instruments. Although it is challenging to draw a robust conclusion about which instrument is the most reliable and the most valid, this review provides important evidence that supports the use of the HLAT-8 to measure childhood and adolescent health literacy in future school-based research. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Ability of Lactobacillus fermentum to overcome host α-galactosidase deficiency, as evidenced by reduction of hydrogen excretion in rats consuming soya α-galacto-oligosaccharides

PubMed Central

LeBlanc, Jean Guy; Ledue-Clier, Florence; Bensaada, Martine; de Giori, Graciela Savoy; Guerekobaya, Theodora; Sesma, Fernando; Juillard, Vincent; Rabot, Sylvie; Piard, Jean-Christophe

2008-01-01

Background Soya and its derivatives represent nutritionally high quality food products whose major drawback is their high content of α-galacto-oligosaccharides. These are not digested in the small intestine due to the natural absence of tissular α-galactosidase in mammals. The passage of these carbohydrates to the large intestine makes them available for fermentation by gas-producing bacteria leading to intestinal flatulence. The aim of the work reported here was to assess the ability of α-galactosidase-producing lactobacilli to improve the digestibility of α-galacto-oligosaccharides in situ. Results Gnotobiotic rats were orally fed with soy milk and placed in respiratory chambers designed to monitor fermentative gas excretion. The validity of the animal model was first checked using gnotobiotic rats monoassociated with a Clostridium butyricum hydrogen (H2)-producing strain. Ingestion of native soy milk by these rats caused significant H2 emission while ingestion of α-galacto-oligosaccharide-free soy milk did not, thus validating the experimental system. When native soy milk was fermented using the α-galactosidase-producing Lactobacillus fermentum CRL722 strain, the resulting product failed to induce H2 emission in rats thus validating the bacterial model. When L. fermentum CRL722 was coadministered with native soy milk, a significant reduction (50 %, P = 0.019) in H2 emission was observed, showing that α-galactosidase from L. fermentum CRL722 remained active in situ, in the gastrointestinal tract of rats monoassociated with C. butyricum. In human-microbiota associated rats, L. fermentum CRL722 also induced a significant reduction of H2 emission (70 %, P = 0.004). Conclusion These results strongly suggest that L. fermentum α-galactosidase is able to partially alleviate α-galactosidase deficiency in rats. This offers interesting perspectives in various applications in which lactic acid bacteria could be used as a vector for delivery of digestive enzymes in man and animals. PMID:18230145

Development of Risk Score for Predicting 3-Year Incidence of Type 2 Diabetes: Japan Epidemiology Collaboration on Occupational Health Study

PubMed Central

Nanri, Akiko; Nakagawa, Tohru; Kuwahara, Keisuke; Yamamoto, Shuichiro; Honda, Toru; Okazaki, Hiroko; Uehara, Akihiko; Yamamoto, Makoto; Miyamoto, Toshiaki; Kochi, Takeshi; Eguchi, Masafumi; Murakami, Taizo; Shimizu, Chii; Shimizu, Makiko; Tomita, Kentaro; Nagahama, Satsue; Imai, Teppei; Nishihara, Akiko; Sasaki, Naoko; Hori, Ai; Sakamoto, Nobuaki; Nishiura, Chihiro; Totsuzaki, Takafumi; Kato, Noritada; Fukasawa, Kenji; Huanhuan, Hu; Akter, Shamima; Kurotani, Kayo; Kabe, Isamu; Mizoue, Tetsuya; Sone, Tomofumi; Dohi, Seitaro

2015-01-01

Objective Risk models and scores have been developed to predict incidence of type 2 diabetes in Western populations, but their performance may differ when applied to non-Western populations. We developed and validated a risk score for predicting 3-year incidence of type 2 diabetes in a Japanese population. Methods Participants were 37,416 men and women, aged 30 or older, who received periodic health checkup in 2008–2009 in eight companies. Diabetes was defined as fasting plasma glucose (FPG) ≥126 mg/dl, random plasma glucose ≥200 mg/dl, glycated hemoglobin (HbA1c) ≥6.5%, or receiving medical treatment for diabetes. Risk scores on non-invasive and invasive models including FPG and HbA1c were developed using logistic regression in a derivation cohort and validated in the remaining cohort. Results The area under the curve (AUC) for the non-invasive model including age, sex, body mass index, waist circumference, hypertension, and smoking status was 0.717 (95% CI, 0.703–0.731). In the invasive model in which both FPG and HbA1c were added to the non-invasive model, AUC was increased to 0.893 (95% CI, 0.883–0.902). When the risk scores were applied to the validation cohort, AUCs (95% CI) for the non-invasive and invasive model were 0.734 (0.715–0.753) and 0.882 (0.868–0.895), respectively. Participants with a non-invasive score of ≥15 and invasive score of ≥19 were projected to have >20% and >50% risk, respectively, of developing type 2 diabetes within 3 years. Conclusions The simple risk score of the non-invasive model might be useful for predicting incident type 2 diabetes, and its predictive performance may be markedly improved by incorporating FPG and HbA1c. PMID:26558900

Gaia Data Release 1. Astrometry: one billion positions, two million proper motions and parallaxes

NASA Astrophysics Data System (ADS)

Lindegren, L.; Lammers, U.; Bastian, U.; Hernández, J.; Klioner, S.; Hobbs, D.; Bombrun, A.; Michalik, D.; Ramos-Lerate, M.; Butkevich, A.; Comoretto, G.; Joliet, E.; Holl, B.; Hutton, A.; Parsons, P.; Steidelmüller, H.; Abbas, U.; Altmann, M.; Andrei, A.; Anton, S.; Bach, N.; Barache, C.; Becciani, U.; Berthier, J.; Bianchi, L.; Biermann, M.; Bouquillon, S.; Bourda, G.; Brüsemeister, T.; Bucciarelli, B.; Busonero, D.; Carlucci, T.; Castañeda, J.; Charlot, P.; Clotet, M.; Crosta, M.; Davidson, M.; de Felice, F.; Drimmel, R.; Fabricius, C.; Fienga, A.; Figueras, F.; Fraile, E.; Gai, M.; Garralda, N.; Geyer, R.; González-Vidal, J. J.; Guerra, R.; Hambly, N. C.; Hauser, M.; Jordan, S.; Lattanzi, M. G.; Lenhardt, H.; Liao, S.; Löffler, W.; McMillan, P. J.; Mignard, F.; Mora, A.; Morbidelli, R.; Portell, J.; Riva, A.; Sarasso, M.; Serraller, I.; Siddiqui, H.; Smart, R.; Spagna, A.; Stampa, U.; Steele, I.; Taris, F.; Torra, J.; van Reeven, W.; Vecchiato, A.; Zschocke, S.; de Bruijne, J.; Gracia, G.; Raison, F.; Lister, T.; Marchant, J.; Messineo, R.; Soffel, M.; Osorio, J.; de Torres, A.; O'Mullane, W.

2016-11-01

Context. Gaia Data Release 1 (DR1) contains astrometric results for more than 1 billion stars brighter than magnitude 20.7 based on observations collected by the Gaia satellite during the first 14 months of its operational phase. Aims: We give a brief overview of the astrometric content of the data release and of the model assumptions, data processing, and validation of the results. Methods: For stars in common with the Hipparcos and Tycho-2 catalogues, complete astrometric single-star solutions are obtained by incorporating positional information from the earlier catalogues. For other stars only their positions are obtained, essentially by neglecting their proper motions and parallaxes. The results are validated by an analysis of the residuals, through special validation runs, and by comparison with external data. Results: For about two million of the brighter stars (down to magnitude 11.5) we obtain positions, parallaxes, and proper motions to Hipparcos-type precision or better. For these stars, systematic errors depending for example on position and colour are at a level of ± 0.3 milliarcsecond (mas). For the remaining stars we obtain positions at epoch J2015.0 accurate to 10 mas. Positions and proper motions are given in a reference frame that is aligned with the International Celestial Reference Frame (ICRF) to better than 0.1 mas at epoch J2015.0, and non-rotating with respect to ICRF to within 0.03 mas yr-1. The Hipparcos reference frame is found to rotate with respect to the Gaia DR1 frame at a rate of 0.24 mas yr-1. Conclusions: Based on less than a quarter of the nominal mission length and on very provisional and incomplete calibrations, the quality and completeness of the astrometric data in Gaia DR1 are far from what is expected for the final mission products. The present results nevertheless represent a huge improvement in the available fundamental stellar data and practical definition of the optical reference frame.

Virtue or Pretense? Looking behind Self-Declared Innocence in Doping

PubMed Central

Petróczi, Andrea; Aidman, Eugene V.; Hussain, Iltaf; Deshmukh, Nawed; Nepusz, Tamás; Uvacsek, Martina; Tóth, Miklós; Barker, James; Naughton, Declan P.

2010-01-01

Background Social science studies of doping practices in sport rely predominantly on self-reports. Studies of psychoactive drug use indicate that self-reporting is characterised by under-reporting. Likewise doping practice is likely to be equally under-reported, if not more so. This calls for more sophisticated methods for such reporting and for independent, objective validation of its results. The aims of this study were: i) to contrast self-reported doping use with objective results from chemical hair analysis and ii) to investigate the influence of the discrepancy on doping attitudes, social projection, descriptive norms and perceived pressure to use doping. Methodology/Principal Findings A doping attitudes questionnaire was developed and combined with a response latency-based implicit association test and hair sample analysis for key doping substances in 14 athletes selected from a larger sample (N = 82) to form contrast comparison groups. Results indicate that patterns of group differences in social projection, explicit attitude about and perceived pressure to use doping, vary depending on whether the user and non-user groups are defined by self-report or objectively verified through hair analysis. Thus, self-confessed users scored higher on social projection, explicit attitude to doping and perceived pressure. However, when a doping substance was detected in the hair of an athlete who denied doping use, their self-report evidenced extreme social desirability (negative attitude, low projection and low perceived pressure) and contrasted sharply with a more positive estimate of their implicit doping attitude. Conclusions/Significance Hair analysis for performance enhancing substances has shown considerable potential in validating athletes' doping attitude estimations and admissions of use. Results not only confirm the need for improved self-report methodology for future research in socially-sensitive domains but also indicate where the improvements are likely to come from: as chemical validation remains expensive, a more realistic promise for large scale studies and online data collection efforts is held by measures of implicit social cognition. PMID:20463978

Developing a dengue forecast model using machine learning: A case study in China

PubMed Central

Zhang, Qin; Wang, Li; Xiao, Jianpeng; Zhang, Qingying; Luo, Ganfeng; Li, Zhihao; He, Jianfeng; Zhang, Yonghui; Ma, Wenjun

2017-01-01

Background In China, dengue remains an important public health issue with expanded areas and increased incidence recently. Accurate and timely forecasts of dengue incidence in China are still lacking. We aimed to use the state-of-the-art machine learning algorithms to develop an accurate predictive model of dengue. Methodology/Principal findings Weekly dengue cases, Baidu search queries and climate factors (mean temperature, relative humidity and rainfall) during 2011–2014 in Guangdong were gathered. A dengue search index was constructed for developing the predictive models in combination with climate factors. The observed year and week were also included in the models to control for the long-term trend and seasonality. Several machine learning algorithms, including the support vector regression (SVR) algorithm, step-down linear regression model, gradient boosted regression tree algorithm (GBM), negative binomial regression model (NBM), least absolute shrinkage and selection operator (LASSO) linear regression model and generalized additive model (GAM), were used as candidate models to predict dengue incidence. Performance and goodness of fit of the models were assessed using the root-mean-square error (RMSE) and R-squared measures. The residuals of the models were examined using the autocorrelation and partial autocorrelation function analyses to check the validity of the models. The models were further validated using dengue surveillance data from five other provinces. The epidemics during the last 12 weeks and the peak of the 2014 large outbreak were accurately forecasted by the SVR model selected by a cross-validation technique. Moreover, the SVR model had the consistently smallest prediction error rates for tracking the dynamics of dengue and forecasting the outbreaks in other areas in China. Conclusion and significance The proposed SVR model achieved a superior performance in comparison with other forecasting techniques assessed in this study. The findings can help the government and community respond early to dengue epidemics. PMID:29036169

Validity of ICD-9-CM Coding for Identifying Incident Methicillin-Resistant Staphylococcus aureus (MRSA) Infections: Is MRSA Infection Coded as a Chronic Disease?

PubMed Central

Schweizer, Marin L.; Eber, Michael R.; Laxminarayan, Ramanan; Furuno, Jon P.; Popovich, Kyle J.; Hota, Bala; Rubin, Michael A.; Perencevich, Eli N.

2013-01-01

BACKGROUND AND OBJECTIVE Investigators and medical decision makers frequently rely on administrative databases to assess methicillin-resistant Staphylococcus aureus (MRSA) infection rates and outcomes. The validity of this approach remains unclear. We sought to assess the validity of the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) code for infection with drug-resistant microorganisms (V09) for identifying culture-proven MRSA infection. DESIGN Retrospective cohort study. METHODS All adults admitted to 3 geographically distinct hospitals between January 1, 2001, and December 31, 2007, were assessed for presence of incident MRSA infection, defined as an MRSA-positive clinical culture obtained during the index hospitalization, and presence of the V09 ICD-9-CM code. The k statistic was calculated to measure the agreement between presence of MRSA infection and assignment of the V09 code. Sensitivities, specificities, positive predictive values, and negative predictive values were calculated. RESULTS There were 466,819 patients discharged during the study period. Of the 4,506 discharged patients (1.0%) who had the V09 code assigned, 31% had an incident MRSA infection, 20% had prior history of MRSA colonization or infection but did not have an incident MRSA infection, and 49% had no record of MRSA infection during the index hospitalization or the previous hospitalization. The V09 code identified MRSA infection with a sensitivity of 24% (range, 21%–34%) and positive predictive value of 31% (range, 22%–53%). The agreement between assignment of the V09 code and presence of MRSA infection had a κ coefficient of 0.26 (95% confidence interval, 0.25–0.27). CONCLUSIONS In its current state, the ICD-9-CM code V09 is not an accurate predictor of MRSA infection and should not be used to measure rates of MRSA infection. PMID:21460469

Pneumatic Distension of Ventricular Mural Architecture Validated Histologically.

PubMed

Burg, M C; Lunkenheimer, P; Niederer, P; Brune, C; Redmann, K; Smerup, M; Spiegel, U; Becker, F; Maintz, D; Heindel, W; Anderson, R H

2016-11-01

Purpose: There are ongoing arguments as to how cardiomyocytes are aggregated together within the ventricular walls. We used pneumatic distension through the coronary arteries to exaggerate the gaps between the aggregated cardiomyocytes, analyzing the pattern revealed using computed tomography, and validating our findings by histology. Methods: We distended 10 porcine hearts, arresting 4 in diastole by infusion of cardioplegic solutions, and 4 in systole by injection of barium chloride. Mural architecture was revealed by computed tomography, measuring also the angulations of the long chains of cardiomyocytes. We prepared the remaining 2 hearts for histology by perfusion with formaldehyde. Results: Increasing pressures of pneumatic distension elongated the ventricular walls, but produced insignificant changes in mural thickness. The distension exaggerated the spaces between the aggregated cardiomyocytes, compartmenting the walls into epicardial, central, and endocardial regions, with a feathered arrangement of transitions between them. Marked variation was noted in the thicknesses of the parts in the different ventricular segments, with no visible anatomical boundaries between them. Measurements of angulations revealed intruding and extruding populations of cardiomyocytes that deviated from a surface-parallel alignment. Scrolling through the stacks of tomographic images revealed marked spiraling of the aggregated cardiomyocytes when traced from base to apex. Conclusion: Our findings call into question the current assumption that cardiomyocytes are uniformly aggregated together in a tangential fashion. There is marked heterogeneity in the architecture of the different ventricular segments, with the aggregated units never extending in a fully transmural fashion. Key Points: • Pneumographic computed tomography reveals an organized structure of the ventricular walls.• Aggregated cardiomyocytes form a structured continuum, with marked regional heterogeneity.• Global ventricular function results from antagonistic forces generated by aggregated cardiomyocytes. Citation Format: • Burg MC, Lunkenheimer P, Niederer P et al. Pneumatic Distension of Ventricular Mural Architecture Validated Histologically. Fortschr Röntgenstr 2016; 188: 1045 - 1053. © Georg Thieme Verlag KG Stuttgart · New York.

Multicenter Validation Study of Pathologic Response and Tumor Thickness at the Tumor–Normal Liver Interface as Independent Predictors of Disease-Free Survival after Preoperative Chemotherapy and Surgery for Colorectal Liver Metastases

PubMed Central

Brouquet, Antoine; Zimmitti, Giuseppe; Kopetz, Scott; Stift, Judith; Julié, Catherine; Lemaistre, Anne-Isabelle; Agarwal, Atin; Patel, Viren; Benoist, Stephane; Nordlinger, Bernard; Gandini, Alessandro; Rivoire, Michel; Stremitzer, Stefan; Gruenberger, Thomas; Vauthey, Jean-Nicolas; Maru, Dipen M.

2014-01-01

Purpose To validate pathologic markers of response to preoperative chemotherapy as predictors of disease-free survival (DFS) after resection of colorectal liver metastases (CLM). Patients and Methods One hundred seventy one patients who underwent resection of CLM after preoperative chemotherapy at 4 centers were studied. Pathologic response defined as proportion of tumor cells remaining (categorized complete (0%), major (<50%) or minor (≥50%)) and tumor thickness at tumor–normal liver interface (TNI) (categorized <0.5 mm, 0.5 mm-<5 mm and ≥5 mm)—were assessed by a central pathology reviewer and local pathologists. Results Pathologic response was complete in 8%, major in 49% and minor in 43%. Tumor thickness at the TNI was <0.5 mm in 21%, 0.5 mm-<5 mm in 56% and ≥5 mm in 23%.In multivariate analyses, using either pathologic response or tumor thickness at TNI, pathologic response (P=.002,.009), tumor thickness at TNI (P=0.015, <.001), duration of preoperative chemotherapy(P=.028,.043), number of CLM (P=.038,.037) and margin (P=.011,.016) were associated with DFS. In a multivariate analysis using both parameters, tumor thickness at TNI (P=.004,.015), duration of preoperative chemotherapy(P=.025), number of nodules(P=.027) and margin(P=.014) were associated with DFS. Tumor size by pathology examination was the predictor of pathologic response. Predictors of tumor thickness at the TNI were tumor size and chemotherapy regimen. There was near perfect agreement for pathologic response (κ=.82) and substantial agreement (κ=.76) for tumor thickness between central reviewer and local pathologists. Conclusion Pathologic response and tumor thickness at the TNI are valid predictors of DFS after preoperative chemotherapy and surgery for CLM. PMID:23868456

Cognitive Testing in People at Increased Risk of Dementia Using a Smartphone App: The iVitality Proof-of-Principle Study

PubMed Central

Wijsman, Liselotte Willemijn; Cachucho, Ricardo; Hoevenaar-Blom, Marieke Peternella; Mooijaart, Simon Pieter; Richard, Edo

2017-01-01

Background Smartphone-assisted technologies potentially provide the opportunity for large-scale, long-term, repeated monitoring of cognitive functioning at home. Objective The aim of this proof-of-principle study was to evaluate the feasibility and validity of performing cognitive tests in people at increased risk of dementia using smartphone-based technology during a 6 months follow-up period. Methods We used the smartphone-based app iVitality to evaluate five cognitive tests based on conventional neuropsychological tests (Memory-Word, Trail Making, Stroop, Reaction Time, and Letter-N-Back) in healthy adults. Feasibility was tested by studying adherence of all participants to perform smartphone-based cognitive tests. Validity was studied by assessing the correlation between conventional neuropsychological tests and smartphone-based cognitive tests and by studying the effect of repeated testing. Results We included 151 participants (mean age in years=57.3, standard deviation=5.3). Mean adherence to assigned smartphone tests during 6 months was 60% (SD 24.7). There was moderate correlation between the firstly made smartphone-based test and the conventional test for the Stroop test and the Trail Making test with Spearman ρ=.3-.5 (P<.001). Correlation increased for both tests when comparing the conventional test with the mean score of all attempts a participant had made, with the highest correlation for Stroop panel 3 (ρ=.62, P<.001). Performance on the Stroop and the Trail Making tests improved over time suggesting a learning effect, but the scores on the Letter-N-back, the Memory-Word, and the Reaction Time tests remained stable. Conclusions Repeated smartphone-assisted cognitive testing is feasible with reasonable adherence and moderate relative validity for the Stroop and the Trail Making tests compared with conventional neuropsychological tests. Smartphone-based cognitive testing seems promising for large-scale data-collection in population studies. PMID:28546139

Temporal regularization of ultrasound-based liver motion estimation for image-guided radiation therapy

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

O’Shea, Tuathan P., E-mail: tuathan.oshea@icr.ac.uk; Bamber, Jeffrey C.; Harris, Emma J.

Purpose: Ultrasound-based motion estimation is an expanding subfield of image-guided radiation therapy. Although ultrasound can detect tissue motion that is a fraction of a millimeter, its accuracy is variable. For controlling linear accelerator tracking and gating, ultrasound motion estimates must remain highly accurate throughout the imaging sequence. This study presents a temporal regularization method for correlation-based template matching which aims to improve the accuracy of motion estimates. Methods: Liver ultrasound sequences (15–23 Hz imaging rate, 2.5–5.5 min length) from ten healthy volunteers under free breathing were used. Anatomical features (blood vessels) in each sequence were manually annotated for comparison withmore » normalized cross-correlation based template matching. Five sequences from a Siemens Acuson™ scanner were used for algorithm development (training set). Results from incremental tracking (IT) were compared with a temporal regularization method, which included a highly specific similarity metric and state observer, known as the α–β filter/similarity threshold (ABST). A further five sequences from an Elekta Clarity™ system were used for validation, without alteration of the tracking algorithm (validation set). Results: Overall, the ABST method produced marked improvements in vessel tracking accuracy. For the training set, the mean and 95th percentile (95%) errors (defined as the difference from manual annotations) were 1.6 and 1.4 mm, respectively (compared to 6.2 and 9.1 mm, respectively, for IT). For each sequence, the use of the state observer leads to improvement in the 95% error. For the validation set, the mean and 95% errors for the ABST method were 0.8 and 1.5 mm, respectively. Conclusions: Ultrasound-based motion estimation has potential to monitor liver translation over long time periods with high accuracy. Nonrigid motion (strain) and the quality of the ultrasound data are likely to have an impact on tracking performance. A future study will investigate spatial uniformity of motion and its effect on the motion estimation errors.« less

High microvessel density determines a poor outcome in patients with diffuse large B-cell lymphoma treated with rituximab plus chemotherapy

PubMed Central

Cardesa-Salzmann, Teresa M.; Colomo, Luis; Gutierrez, Gonzalo; Chan, Wing C.; Weisenburger, Dennis; Climent, Fina; González-Barca, Eva; Mercadal, Santiago; Arenillas, Leonor; Serrano, Sergio; Tubbs, Ray; Delabie, Jan; Gascoyne, Randy D.; Connors, Joseph M; Mate, Jose L.; Rimsza, Lisa; Braziel, Rita; Rosenwald, Andreas; Lenz, Georg; Wright, George; Jaffe, Elaine S.; Staudt, Louis; Jares, Pedro; López-Guillermo, Armando; Campo, Elias

2011-01-01

Background Diffuse large B-cell lymphoma is a clinically and molecularly heterogeneous disease. Gene expression profiling studies have shown that the tumor microenvironment affects survival and that the angiogenesis-related signature is prognostically unfavorable. The contribution of histopathological microvessel density to survival in diffuse large B-cell lymphomas treated with immunochemotherapy remains unknown. The purpose of this study is to assess the prognostic impact of histopathological microvessel density in two independent series of patients with diffuse large B-cell lymphoma treated with immunochemotherapy. Design and Methods One hundred and forty-seven patients from the Leukemia Lymphoma Molecular Profiling Project (training series) and 118 patients from the Catalan Lymphoma-Study group-GELCAB (validation cohort) were included in the study. Microvessels were immunostained with CD31 and quantified with a computerized image analysis system. The stromal scores previously defined in 110 Leukemia Lymphoma Molecular Profiling Project cases were used to analyze correlations with microvessel density data. Results Microvessel density significantly correlated with the stromal score (r=0.3209; P<0.001). Patients with high microvessel density showed significantly poorer overall survival than those with low microvessel density both in the training series (4-year OS 54% vs. 78%; P=0.004) and in the validation cohort (57% vs. 81%; P=0.006). In multivariate analysis, in both groups high microvessel density was a statistically significant unfavorable prognostic factor independent of international prognostic index [training series: international prognostic index (relative risk 2.7; P=0.003); microvessel density (relative risk 1.96; P=0.002); validation cohort: international prognostic index (relative risk 4.74; P<0.001); microvessel density (relative risk 2.4; P=0.016)]. Conclusions These findings highlight the impact of angiogenesis in the outcome of patients with diffuse large B-cell lymphoma and the interest of evaluating antiangiogenic drugs in clinical trials. PMID:21546504

A Case-Matched Gender Comparison Transcriptomic Screen Identifies eIF4E and eIF5 as Potential Prognostic Markers in Male Breast Cancer.

PubMed

Humphries, Matthew P; Sundara Rajan, Sreekumar; Droop, Alastair; Suleman, Charlotte A B; Carbone, Carmine; Nilsson, Cecilia; Honarpisheh, Hedieh; Cserni, Gabor; Dent, Jo; Fulford, Laura; Jordan, Lee B; Jones, J Louise; Kanthan, Rani; Litwiniuk, Maria; Di Benedetto, Anna; Mottolese, Marcella; Provenzano, Elena; Shousha, Sami; Stephens, Mark; Walker, Rosemary A; Kulka, Janina; Ellis, Ian O; Jeffery, Margaret; Thygesen, Helene H; Cappelletti, Vera; Daidone, Maria G; Hedenfalk, Ingrid A; Fjällskog, Marie-Louise; Melisi, Davide; Stead, Lucy F; Shaaban, Abeer M; Speirs, Valerie

2017-05-15

Purpose: Breast cancer affects both genders, but is understudied in men. Although still rare, male breast cancer (MBC) is being diagnosed more frequently. Treatments are wholly informed by clinical studies conducted in women, based on assumptions that underlying biology is similar. Experimental Design: A transcriptomic investigation of male and female breast cancer was performed, confirming transcriptomic data in silico Biomarkers were immunohistochemically assessed in 697 MBCs ( n = 477, training; n = 220, validation set) and quantified in pre- and posttreatment samples from an MBC patient receiving everolimus and PI3K/mTOR inhibitor. Results: Gender-specific gene expression patterns were identified. eIF transcripts were upregulated in MBC. eIF4E and eIF5 were negatively prognostic for overall survival alone (log-rank P = 0.013; HR = 1.77, 1.12-2.8 and P = 0.035; HR = 1.68, 1.03-2.74, respectively), or when coexpressed ( P = 0.01; HR = 2.66, 1.26-5.63), confirmed in the validation set. This remained upon multivariate Cox regression analysis [eIF4E P = 0.016; HR = 2.38 (1.18-4.8), eIF5 P = 0.022; HR = 2.55 (1.14-5.7); coexpression P = 0.001; HR = 7.04 (2.22-22.26)]. Marked reduction in eIF4E and eIF5 expression was seen post BEZ235/everolimus, with extended survival. Conclusions: Translational initiation pathway inhibition could be of clinical utility in MBC patients overexpressing eIF4E and eIF5. With mTOR inhibitors that target this pathway now in the clinic, these biomarkers may represent new targets for therapeutic intervention, although further independent validation is required. Clin Cancer Res; 23(10); 2575-83. ©2016 AACR . ©2016 American Association for Cancer Research.

Heparin-Binding Protein Measurement Improves the Prediction of Severe Infection With Organ Dysfunction in the Emergency Department

PubMed Central

Arnold, Ryan; Boyd, John H.; Zindovic, Marko; Zindovic, Igor; Lange, Anna; Paulsson, Magnus; Nyberg, Patrik; Russell, James A.; Pritchard, David; Christensson, Bertil; Åkesson, Per

2015-01-01

Objectives: Early identification of patients with infection and at risk of developing severe disease with organ dysfunction remains a difficult challenge. We aimed to evaluate and validate the heparin-binding protein, a neutrophil-derived mediator of vascular leakage, as a prognostic biomarker for risk of progression to severe sepsis with circulatory failure in a multicenter setting. Design: A prospective international multicenter cohort study. Setting: Seven different emergency departments in Sweden, Canada, and the United States. Patients: Adult patients with a suspected infection and at least one of three clinical systemic inflammatory response syndrome criteria (excluding leukocyte count). Intervention: None. Measurements and Main Results: Plasma levels of heparin-binding protein, procalcitonin, C-reactive protein, lactate, and leukocyte count were determined at admission and 12–24 hours after admission in 759 emergency department patients with suspected infection. Patients were defined depending on the presence of infection and organ dysfunction. Plasma samples from 104 emergency department patients with suspected sepsis collected at an independent center were used to validate the results. Of the 674 patients diagnosed with an infection, 487 did not have organ dysfunction at enrollment. Of these 487 patients, 141 (29%) developed organ dysfunction within the 72-hour study period; 78.0% of the latter patients had an elevated plasma heparin-binding protein level (> 30 ng/mL) prior to development of organ dysfunction (median, 10.5 hr). Compared with other biomarkers, heparin-binding protein was the best predictor of progression to organ dysfunction (area under the receiver operating characteristic curve = 0.80). The performance of heparin-binding protein was confirmed in the validation cohort. Conclusion: In patients presenting at the emergency department, heparin-binding protein is an early indicator of infection-related organ dysfunction and a strong predictor of disease progression to severe sepsis within 72 hours. PMID:26468696

The Use of a Bayesian Hierarchy to Develop and Validate a Co-Morbidity Score to Predict Mortality for Linked Primary and Secondary Care Data from the NHS in England

PubMed Central

Card, Tim R.; West, Joe

2016-01-01

Background We have assessed whether the linkage between routine primary and secondary care records provided an opportunity to develop an improved population based co-morbidity score with the combined information on co-morbidities from both health care settings. Methods We extracted all people older than 20 years at the start of 2005 within the linkage between the Hospital Episodes Statistics, Clinical Practice Research Datalink, and Office for National Statistics death register in England. A random 50% sample was used to identify relevant diagnostic codes using a Bayesian hierarchy to share information between similar Read and ICD 10 code groupings. Internal validation of the score was performed in the remaining 50% and discrimination was assessed using Harrell’s C statistic. Comparisons were made over time, age, and consultation rate with the Charlson and Elixhauser indexes. Results 657,264 people were followed up from the 1st January 2005. 98 groupings of codes were derived from the Bayesian hierarchy, and 37 had an adjusted weighting of greater than zero in the Cox proportional hazards model. 11 of these groupings had a different weighting dependent on whether they were coded from hospital or primary care. The C statistic reduced from 0.88 (95% confidence interval 0.88–0.88) in the first year of follow up, to 0.85 (0.85–0.85) including all 5 years. When we stratified the linked score by consultation rate the association with mortality remained consistent, but there was a significant interaction with age, with improved discrimination and fit in those under 50 years old (C = 0.85, 0.83–0.87) compared to the Charlson (C = 0.79, 0.77–0.82) or Elixhauser index (C = 0.81, 0.79–0.83). Conclusions The use of linked population based primary and secondary care data developed a co-morbidity score that had improved discrimination, particularly in younger age groups, and had a greater effect when adjusting for co-morbidity than existing scores. PMID:27788230

VESPA: software to facilitate genomic annotation of prokaryotic organisms through integration of proteomic and transcriptomic data

PubMed Central

2012-01-01

Background The procedural aspects of genome sequencing and assembly have become relatively inexpensive, yet the full, accurate structural annotation of these genomes remains a challenge. Next-generation sequencing transcriptomics (RNA-Seq), global microarrays, and tandem mass spectrometry (MS/MS)-based proteomics have demonstrated immense value to genome curators as individual sources of information, however, integrating these data types to validate and improve structural annotation remains a major challenge. Current visual and statistical analytic tools are focused on a single data type, or existing software tools are retrofitted to analyze new data forms. We present Visual Exploration and Statistics to Promote Annotation (VESPA) is a new interactive visual analysis software tool focused on assisting scientists with the annotation of prokaryotic genomes though the integration of proteomics and transcriptomics data with current genome location coordinates. Results VESPA is a desktop Java™ application that integrates high-throughput proteomics data (peptide-centric) and transcriptomics (probe or RNA-Seq) data into a genomic context, all of which can be visualized at three levels of genomic resolution. Data is interrogated via searches linked to the genome visualizations to find regions with high likelihood of mis-annotation. Search results are linked to exports for further validation outside of VESPA or potential coding-regions can be analyzed concurrently with the software through interaction with BLAST. VESPA is demonstrated on two use cases (Yersinia pestis Pestoides F and Synechococcus sp. PCC 7002) to demonstrate the rapid manner in which mis-annotations can be found and explored in VESPA using either proteomics data alone, or in combination with transcriptomic data. Conclusions VESPA is an interactive visual analytics tool that integrates high-throughput data into a genomic context to facilitate the discovery of structural mis-annotations in prokaryotic genomes. Data is evaluated via visual analysis across multiple levels of genomic resolution, linked searches and interaction with existing bioinformatics tools. We highlight the novel functionality of VESPA and core programming requirements for visualization of these large heterogeneous datasets for a client-side application. The software is freely available at https://www.biopilot.org/docs/Software/Vespa.php. PMID:22480257

Reliable Multi-Label Learning via Conformal Predictor and Random Forest for Syndrome Differentiation of Chronic Fatigue in Traditional Chinese Medicine

PubMed Central

Wang, Huazhen; Liu, Xin; Lv, Bing; Yang, Fan; Hong, Yanzhu

2014-01-01

Objective Chronic Fatigue (CF) still remains unclear about its etiology, pathophysiology, nomenclature and diagnostic criteria in the medical community. Traditional Chinese medicine (TCM) adopts a unique diagnostic method, namely ‘bian zheng lun zhi’ or syndrome differentiation, to diagnose the CF with a set of syndrome factors, which can be regarded as the Multi-Label Learning (MLL) problem in the machine learning literature. To obtain an effective and reliable diagnostic tool, we use Conformal Predictor (CP), Random Forest (RF) and Problem Transformation method (PT) for the syndrome differentiation of CF. Methods and Materials In this work, using PT method, CP-RF is extended to handle MLL problem. CP-RF applies RF to measure the confidence level (p-value) of each label being the true label, and then selects multiple labels whose p-values are larger than the pre-defined significance level as the region prediction. In this paper, we compare the proposed CP-RF with typical CP-NBC(Naïve Bayes Classifier), CP-KNN(K-Nearest Neighbors) and ML-KNN on CF dataset, which consists of 736 cases. Specifically, 95 symptoms are used to identify CF, and four syndrome factors are employed in the syndrome differentiation, including ‘spleen deficiency’, ‘heart deficiency’, ‘liver stagnation’ and ‘qi deficiency’. The Results CP-RF demonstrates an outstanding performance beyond CP-NBC, CP-KNN and ML-KNN under the general metrics of subset accuracy, hamming loss, one-error, coverage, ranking loss and average precision. Furthermore, the performance of CP-RF remains steady at the large scale of confidence levels from 80% to 100%, which indicates its robustness to the threshold determination. In addition, the confidence evaluation provided by CP is valid and well-calibrated. Conclusion CP-RF not only offers outstanding performance but also provides valid confidence evaluation for the CF syndrome differentiation. It would be well applicable to TCM practitioners and facilitate the utilities of objective, effective and reliable computer-based diagnosis tool. PMID:24918430

Validating the Inactivation Effectiveness of Chemicals on Ebola Virus.

PubMed

Haddock, Elaine; Feldmann, Friederike

2017-01-01

While viruses such as Ebola virus must be handled in high-containment laboratories, there remains the need to process virus-infected samples for downstream research testing. This processing often includes removal to lower containment areas and therefore requires assurance of complete viral inactivation within the sample before removal from high-containment. Here we describe methods for the removal of chemical reagents used in inactivation procedures, allowing for validation of the effectiveness of various inactivation protocols.

Validation of a new classification system for interprosthetic femoral fractures.

PubMed

Pires, Robinson Esteves Santos; Silveira, Marcelo Peixoto Sena; Resende, Alessandra Regina da Silva; Junior, Egidio Oliveira Santana; Campos, Tulio Vinicius Oliveira; Santos, Leandro Emilio Nascimento; Balbachevsky, Daniel; Andrade, Marco Antônio Percope de

2017-07-01

Interprosthetic femoral fracture (IFF) incidence is gradually increasing as the population is progressively ageing. However, treatment remains challenging due to several contributing factors, such as poor bone quality, patient comorbidities, small interprosthetic fragment, and prostheses instability. An effective and specific classification system is essential to optimize treatment management, therefore diminishing complication rates. This study aims to validate a previously described classification system for interprosthetic femoral fractures. Copyright © 2017 Elsevier Ltd. All rights reserved.

Evaluation of a Computational Model of Situational Awareness

NASA Technical Reports Server (NTRS)

Burdick, Mark D.; Shively, R. Jay; Rutkewski, Michael (Technical Monitor)

2000-01-01

Although the use of the psychological construct of situational awareness (SA) assists researchers in creating a flight environment that is safer and more predictable, its true potential remains untapped until a valid means of predicting SA a priori becomes available. Previous work proposed a computational model of SA (CSA) that sought to Fill that void. The current line of research is aimed at validating that model. The results show that the model accurately predicted SA in a piloted simulation.

Developing a Self-Scoring Comprehensive Instrument to Measure Rest's Four-Component Model of Moral Behavior: The Moral Skills Inventory.

PubMed

Chambers, David W

2011-01-01

One of the most extensively studied constructs in dental education is the four-component model of moral behavior proposed by James Rest and the set of instruments for measuring it developed by Rest, Muriel Bebeau, and others. Although significant associations have been identified between the four components Rest proposed (called here Moral Sensitivity, Moral Reasoning, Moral Integrity, and Moral Courage) and dental ethics courses and practitioners with disciplined licenses, there is no single instrument that measures all four components, and existing single component instruments require professional scoring. This article describes the development and validation of a short, self-scoring instrument, the Moral Skills Inventory, that measures all four components. Evidence of face validity, test/retest reliability, and concurrent convergent and divergent predictive validity are demonstrated in three populations: dental students, clinical dental faculty members, and regents and officers of the American College of Dentists. Significant issues remain in developing the Rest four-component model for use in dental education and practice. Specifically, further construct validation research is needed to understand the nature of the components. In particular, it remains undetermined whether moral constructs are characteristics of individuals that drive behavior in specific situations or whether particular patterns of moral behavior learned and used in response to individual circumstances are summarized by researchers and then imputed to practitioners.

Comparing the nine-item Shared Decision-Making Questionnaire to the OPTION Scale - an attempt to establish convergent validity.

PubMed

Scholl, Isabelle; Kriston, Levente; Dirmaier, Jörg; Härter, Martin

2015-02-01

While there has been a clear move towards shared decision-making (SDM) in the last few years, the measurement of SDM-related constructs remains challenging. There has been a call for further psychometric testing of known scales, especially regarding validity aspects. To test convergent validity of the nine-item Shared Decision-Making Questionnaire (SDM-Q-9) by comparing it to the OPTION Scale. Cross-sectional study. Data were collected in outpatient care practices. Patients suffering from chronic diseases and facing a medical decision were included in the study. Consultations were evaluated using the OPTION Scale. Patients completed the SDM-Q-9 after the consultation. First, the internal consistency of both scales and the inter-rater reliability of the OPTION Scale were calculated. To analyse the convergent validity of the SDM-Q-9, correlation between the patient (SDM-Q-9) and expert ratings (OPTION Scale) was calculated. A total of 21 physicians provided analysable data of consultations with 63 patients. Analyses revealed good internal consistency of the SDM-Q-9 and limited internal consistency of the OPTION Scale. Inter-rater reliability of the latter was less than optimal. Association between the total scores of both instruments was weak with a Spearman correlation of r = 0.19 and did not reach statistical significance. By the use of the OPTION Scale convergent validity of the SDM-Q-9 could not be established. Several possible explanations for this result are discussed. This study shows that the measurement of SDM remains challenging. © 2012 John Wiley & Sons Ltd.

Specification Reformulation During Specification Validation

NASA Technical Reports Server (NTRS)

Benner, Kevin M.

1992-01-01

The goal of the ARIES Simulation Component (ASC) is to uncover behavioral errors by 'running' a specification at the earliest possible points during the specification development process. The problems to be overcome are the obvious ones the specification may be large, incomplete, underconstrained, and/or uncompilable. This paper describes how specification reformulation is used to mitigate these problems. ASC begins by decomposing validation into specific validation questions. Next, the specification is reformulated to abstract out all those features unrelated to the identified validation question thus creating a new specialized specification. ASC relies on a precise statement of the validation question and a careful application of transformations so as to preserve the essential specification semantics in the resulting specialized specification. This technique is a win if the resulting specialized specification is small enough so the user my easily handle any remaining obstacles to execution. This paper will: (1) describe what a validation question is; (2) outline analysis techniques for identifying what concepts are and are not relevant to a validation question; and (3) identify and apply transformations which remove these less relevant concepts while preserving those which are relevant.

Validity of Rorschach Inkblot scores for discriminating psychopaths from non-psychopaths in forensic populations: a meta-analysis.

PubMed

Wood, James M; Lilienfeld, Scott O; Nezworski, M Teresa; Garb, Howard N; Allen, Keli Holloway; Wildermuth, Jessica L

2010-06-01

Gacono and Meloy (2009) have concluded that the Rorschach Inkblot Test is a sensitive instrument with which to discriminate psychopaths from nonpsychopaths. We examined the association of psychopathy with 37 Rorschach variables in a meta-analytic review of 173 validity coefficients derived from 22 studies comprising 780 forensic participants. All studies included the Hare Psychopathy Checklist or one of its versions (Hare, 1980, 1991, 2003) and Exner's (2003) Comprehensive System for the Rorschach. Mean validity coefficients of Rorschach variables in the meta-analysis ranged from -.113 to .239, with a median validity of .070 and a mean validity of .062. Psychopathy displayed a significant and medium-sized association with the number of Aggressive Potential responses (weighted mean validity coefficient = .232) and small but significant associations with the Sum of Texture responses, Cooperative Movement = 0, the number of Personal responses, and the Egocentricity Index (weighted mean validity coefficients = .097 to .159). The remaining 32 Rorschach variables were not significantly related to psychopathy. The present findings contradict the view that the Rorschach is a clinically sensitive instrument for discriminating psychopaths from nonpsychopaths.

Integrating Validity Theory with Use of Measurement Instruments in Clinical Settings

PubMed Central

Kelly, P Adam; O'Malley, Kimberly J; Kallen, Michael A; Ford, Marvella E

2005-01-01

Objective To present validity concepts in a conceptual framework useful for research in clinical settings. Principal Findings We present a three-level decision rubric for validating measurement instruments, to guide health services researchers step-by-step in gathering and evaluating validity evidence within their specific situation. We address construct precision, the capacity of an instrument to measure constructs it purports to measure and differentiate from other, unrelated constructs; quantification precision, the reliability of the instrument; and translation precision, the ability to generalize scores from an instrument across subjects from the same or similar populations. We illustrate with specific examples, such as an approach to validating a measurement instrument for veterans when prior evidence of instrument validity for this population does not exist. Conclusions Validity should be viewed as a property of the interpretations and uses of scores from an instrument, not of the instrument itself: how scores are used and the consequences of this use are integral to validity. Our advice is to liken validation to building a court case, including discovering evidence, weighing the evidence, and recognizing when the evidence is weak and more evidence is needed. PMID:16178998

Performance of the Volumetric Diffusive Respirator at Altitude

DTIC Science & Technology

2014-08-18

information if it does not display a currently valid OMB control number. PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS. 1. REPORT DATE (DD-MM...increased by 30-40%. Tidal volume remained within 15% of sea level values. Respiratory rate fell, while inspiratory time increased and high frequency...altitude, positive end expiratory pressure and peak inspiratory pressure were increased by 30-40%. Tidal volume remained within 15% of sea level

Transtheoretical Model Constructs for Physical Activity Behavior are Invariant across Time among Ethnically Diverse Adults in Hawaii

PubMed Central

Nigg, Claudio R; Motl, Robert W; Horwath, Caroline; Dishman, Rod K

2012-01-01

Objectives Physical activity (PA) research applying the Transtheoretical Model (TTM) to examine group differences and/or change over time requires preliminary evidence of factorial validity and invariance. The current study examined the factorial validity and longitudinal invariance of TTM constructs recently revised for PA. Method Participants from an ethnically diverse sample in Hawaii (N=700) completed questionnaires capturing each TTM construct. Results Factorial validity was confirmed for each construct using confirmatory factor analysis with full-information maximum likelihood. Longitudinal invariance was evidenced across a shorter (3-month) and longer (6-month) time period via nested model comparisons. Conclusions The questionnaires for each validated TTM construct are provided, and can now be generalized across similar subgroups and time points. Further validation of the provided measures is suggested in additional populations and across extended time points. PMID:22778669

Measuring psychosocial exposures: validation of the Persian of the copenhagen psychosocial questionnaire (COPSOQ)

PubMed Central

Pournik, Omid; Ghalichi, Leila; TehraniYazdi, Alireza; Tabatabaee, Seyed Mohammad; Ghaffari, Mostafa; Vingard, Eva

2015-01-01

Background: The effect of psychosocial work environment on personal and organizational aspects of employees is well-known; and it is of fundamental importance to have valid tools to evaluate them. This study aims to evaluate the reliability and validity of the Persian version of Copenhagen Psychosocial Questionnaire (COPSOQ). Methods: The questionnaire was translated into Persian and then back translated into English by two translators separately. The wording of the final Persian version was established by comparing the translated versions with the original questionnaire. One hundred three health care workers completed the questionnaire. Chronbach’s alpha was calculated, and factor analysis was performed. Results: Factor analysis revealed acceptable validity for the five contexts of the questionnaire. Cronbach’s alpha ranged from 0.73 to 0.82 in different contexts. Conclusion: This study revealed that the Persian version of COPSOQ is a reliable and valid instrument for measuring psychosocial factors at work. PMID:26478879

Cognitive assessment: A challenge for occupational therapists in Brazil

PubMed Central

Conti, Juliana

2017-01-01

Cognitive impairment is a common dysfunction after neurological injury. Cognitive assessment tools can help the therapist understand how impairments are affecting functional status and quality of life. Objective The aim of the study was to identify instruments for cognitive assessment that Occupational Therapists (OT) can use in clinical practice. Methods The instruments published in English and Portuguese between 1999 and 2016 were systematically reviewed. Results The search identified 17 specific instruments for OT not validated in Brazilian Portuguese, 10 non-specific instruments for OT not validated in Brazilian Portuguese, and 25 instruments validated for Portuguese, only one of which was specific for OT (Lowenstein Occupational Therapy Cognitive Assessment). Conclusion There are few assessment cognitive tools validated for use in the Brazilian culture and language. The majority of the instruments appear not to be validated for use by OT in clinical practice. PMID:29213503

A validation of the construct and reliability of an emotional intelligence scale applied to nursing students1

PubMed Central

Espinoza-Venegas, Maritza; Sanhueza-Alvarado, Olivia; Ramírez-Elizondo, Noé; Sáez-Carrillo, Katia

2015-01-01

OBJECTIVE: The current study aimed to validate the construct and reliability of an emotional intelligence scale. METHOD: The Trait Meta-Mood Scale-24 was applied to 349 nursing students. The process included content validation, which involved expert reviews, pilot testing, measurements of reliability using Cronbach's alpha, and factor analysis to corroborate the validity of the theoretical model's construct. RESULTS: Adequate Cronbach coefficients were obtained for all three dimensions, and factor analysis confirmed the scale's dimensions (perception, comprehension, and regulation). CONCLUSION: The Trait Meta-Mood Scale is a reliable and valid tool to measure the emotional intelligence of nursing students. Its use allows for accurate determinations of individuals' abilities to interpret and manage emotions. At the same time, this new construct is of potential importance for measurements in nursing leadership; educational, organizational, and personal improvements; and the establishment of effective relationships with patients. PMID:25806642

Validation of an Empathy Scale in Pharmacy and Nursing Students

PubMed Central

Chen, Aleda M. H.; Yehle, Karen S.; Plake, Kimberly S.

2013-01-01

Objective. To validate an empathy scale to measure empathy in pharmacy and nursing students. Methods. A 15-item instrument comprised of the cognitive and affective empathy domains, was created. Each item was rated using a 7-point Likert scale, ranging from strongly disagree to strongly agree. Concurrent validity was demonstrated with the Jefferson Scale of Empathy – Health Professional Students (JSE-HPS). Results. Reliability analysis of data from 216 students (pharmacy, N=158; nursing, N=58) showed that scores on the empathy scale were positively associated with JSE-HPS scores (p<0.001). Factor analysis confirmed that 14 of the 15 items were significantly associated with their respective domain, but the overall instrument had limited goodness of fit. Conclusions. Results of this study demonstrate the reliability and validity of a new scale for evaluating student empathy. Further testing of the scale at other universities is needed to establish validity. PMID:23788805

Elaboration and Validation of the Medication Prescription Safety Checklist 1

PubMed Central

Pires, Aline de Oliveira Meireles; Ferreira, Maria Beatriz Guimarães; do Nascimento, Kleiton Gonçalves; Felix, Márcia Marques dos Santos; Pires, Patrícia da Silva; Barbosa, Maria Helena

2017-01-01

ABSTRACT Objective: to elaborate and validate a checklist to identify compliance with the recommendations for the structure of medication prescriptions, based on the Protocol of the Ministry of Health and the Brazilian Health Surveillance Agency. Method: methodological research, conducted through the validation and reliability analysis process, using a sample of 27 electronic prescriptions. Results: the analyses confirmed the content validity and reliability of the tool. The content validity, obtained by expert assessment, was considered satisfactory as it covered items that represent the compliance with the recommendations regarding the structure of the medication prescriptions. The reliability, assessed through interrater agreement, was excellent (ICC=1.00) and showed perfect agreement (K=1.00). Conclusion: the Medication Prescription Safety Checklist showed to be a valid and reliable tool for the group studied. We hope that this study can contribute to the prevention of adverse events, as well as to the improvement of care quality and safety in medication use. PMID:28793128

Further development of the talent development environment questionnaire for sport.

PubMed

Li, Chunxiao; Wang, Chee Keng John; Pyun, Do Young; Martindale, Russell

2015-01-01

Given the significance of monitoring the critical environmental factors that facilitate athlete performance, this two-phase research aimed to validate and refine the revised talent development environment questionnaire (TDEQ). The TDEQ is a multidimensional self-report scale that assesses talented athletes' environmental experiences. Study 1 (the first phase) involved the examination of the revised TDEQ through an exploratory factor analysis (n = 363). This exploratory investigation identified a 28-item five-factor structure (i.e., TDEQ-5) with adequate internal consistency. Study 2 (the second phase) examined the factorial structure of the TDEQ-5, including convergent validity, discriminant validity, and group invariance (i.e., gender and sports type). The second phase was carried out with 496 talented athletes through the application of confirmatory factor analyses and multigroup invariance tests. The results supported the convergent validity, discriminant validity, and group invariance of the TDEQ-5. In conclusion, the TDEQ-5 with 25 items appears to be a reliable and valid scale for use in talent development environments.

Social validity in single-case research: A systematic literature review of prevalence and application.

PubMed

Snodgrass, Melinda R; Chung, Moon Y; Meadan, Hedda; Halle, James W

2018-03-01

Single-case research (SCR) has been a valuable methodology in special education research. Montrose Wolf (1978), an early pioneer in single-case methodology, coined the term "social validity" to refer to the social importance of the goals selected, the acceptability of procedures employed, and the effectiveness of the outcomes produced in applied investigations. Since 1978, many contributors to SCR have included social validity as a feature of their articles and several authors have examined the prevalence and role of social validity in SCR. We systematically reviewed all SCR published in six highly-ranked special education journals from 2005 to 2016 to establish the prevalence of social validity assessments and to evaluate their scientific rigor. We found relatively low, but stable prevalence with only 28 publications addressing all three factors of the social validity construct (i.e., goals, procedures, outcomes). We conducted an in-depth analysis of the scientific rigor of these 28 publications. Social validity remains an understudied construct in SCR, and the scientific rigor of social validity assessments is often lacking. Implications and future directions are discussed. Copyright © 2018 Elsevier Ltd. All rights reserved.

Validation in Support of Internationally Harmonised OECD Test Guidelines for Assessing the Safety of Chemicals.

PubMed

Gourmelon, Anne; Delrue, Nathalie

Ten years elapsed since the OECD published the Guidance document on the validation and international regulatory acceptance of test methods for hazard assessment. Much experience has been gained since then in validation centres, in countries and at the OECD on a variety of test methods that were subjected to validation studies. This chapter reviews validation principles and highlights common features that appear to be important for further regulatory acceptance across studies. Existing OECD-agreed validation principles will most likely generally remain relevant and applicable to address challenges associated with the validation of future test methods. Some adaptations may be needed to take into account the level of technique introduced in test systems, but demonstration of relevance and reliability will continue to play a central role as pre-requisite for the regulatory acceptance. Demonstration of relevance will become more challenging for test methods that form part of a set of predictive tools and methods, and that do not stand alone. OECD is keen on ensuring that while these concepts evolve, countries can continue to rely on valid methods and harmonised approaches for an efficient testing and assessment of chemicals.

Comparison of Actigraphy Immobility Rules with Polysomnographic Sleep Onset Latency in Children and Adolescents

PubMed Central

Meltzer, Lisa J.; Walsh, Colleen M.; Peightal, Ashley A.

2015-01-01

Purpose While actigraphy has gained popularity in pediatric sleep research, questions remain about the validity of actigraphy as an estimate of sleep-wake patterns. In particular, there is little consistency in the field in terms of scoring rules used to determine sleep onset latency. The purpose of this study was to evaluate different criteria of immobility as a measure of sleep onset latency in children and adolescents. Methods Ninety-five youth (ages 3-17 years, 46% male) wore both the Ambulatory-Monitoring Inc. Motionlogger Sleep Watch (AMI) and the Philips Respironics Mini-Mitter Actiwatch-2 (PRMM) during overnight polysomnography in a pediatric sleep lab. We examined different sleep onset latency scoring rules (3, 5, 10, 15, and 20 minutes of immobility) using different algorithms (Sadeh and Cole-Kripke) and sensitivity settings (Low, Medium, High) for the devices. Comparisons were also made across age groups (preschoolers, school-aged, adolescents) and sleep disordered breathing status (no obstructive sleep apnea [OSA], mild OSA, clinically significant OSA). Results For the AMI device, shorter scoring rules performed best for children and longer scoring rules were better for adolescents, with shorter scoring rules best across sleep disordered breathing groups. For the PRMM device, medium to longer scoring rules performed best across age and sleep disordered breathing groups. Conclusions Researchers are encouraged to determine the scoring rule that best fits their population of interest. Future studies are needed with larger samples of children and adolescents to further validate actigraphic immobility as a proxy for sleep onset latency. PMID:25687438

External validation of the modified Glasgow prognostic score for renal cancer

PubMed Central

Tai, Caroline G.; Johnson, Timothy V.; Abbasi, Ammara; Herrell, Lindsey; Harris, Wayne B.; Kucuk, Omer; Canter, Daniel J.; Ogan, Kenneth; Pattaras, John G.; Nieh, Peter T.; Master, Viraj A.

2014-01-01

Purpose: The modified Glasgow prognostic Score (mGPS) incorporates C-reactive protein and albumin as a clinically useful marker of tumor behavior. The ability of the mGPS to predict metastasis in localized renal cell carcinoma (RCC) remains unknown in an external validation cohort. Patients and Methods: Patients with clinically localized clear cell RCC were followed for 1 year post-operatively. Metastases were identified radiologically. Patients were categorized by mGPS score as low-risk (mGPS = 0 points), intermediate-risk (mGPS = 1 point) and high-risk (mGPS = 2 points). Univariate, Kaplan-Meier and multivariate Cox regression analyses examined Recurrence -free survival (RFS) across patient and disease characteristics. Results: Of the 129 patients in this study, 23.3% developed metastases. Of low, intermediate and high risk patients, 10.1%, 38.9% and 89.9% recurred during the study. After accounting for various patient and tumor characteristics in multivariate analysis including stage and grade, only mGPS was significantly associated with RFS. Compared with low-risk patients, intermediate- and high-risk patients experienced a 4-fold (hazard ratios [HR]: 4.035, 95% confidence interval [CI]: 1.312-12.415, P = 0.015) and 7-fold (HR: 7.012, 95% CI: 2.126-23.123 P < 0.001) risk of metastasis, respectively. Conclusions: mGPS is a robust predictor of metastasis following potentially curative nephrectomy for localized RCC. Clinicians may consider mGPS as an adjunct to identify high-risk patients for possible enrollment into clinical trials or for patient counseling PMID:24497679

Validity and clinical impact of glucose transporter 1 expression in colorectal cancer

PubMed Central

GabAllah, Ghada M. K.; El-din Habib, Mona Salah; Soliman, Shimaa El-Shafey; Kasemy, Zienab A.; Gohar, Suzy F.

2017-01-01

Background/Aim: There is no doubt that colorectal cancer (CRC) poses a major threat to public health worldwide, and despite improvement in managements, prognosis still remains an irritating question with no definite answer. Being a fundamental player in cancer metabolism, glucose transporter 1 (GLUT1) could be utilized as a prognostic biomarker that could fuel development of new treatment strategies. The aim of this study was to assess the validity of GLUT1 expression as a prognostic biomarker and to elucidate to what extent it is immersed in poor clinical outcome among CRC patients. Patients and Methods: GLUT1 expression in peripheral blood specimens was analyzed by quantitative real-time polymerase chain reaction in 47 CRC patients and 20 healthy controls. Results: There was significantly elevated GLUT1 expression in peripheral blood of CRC patients than in controls (P < 0.001). The cutoff value of 0.605 provided 98% sensitivity and 100% specificity. There were significantly higher values of GLUT1 expression in patients under 50 years (P = 0.003), performance status 2 (P = 0.009), stage IV (P < 0.001), and presence of metastasis (P < 0.001). GLUT1 expression showed nonsignificant association with overall survival (P = 0.068), while tumor stage (P = 0.01) and metastasis (P = 0.009) were significantly associated with lower overall survival. Conclusion: GLUT1 is sensitive and specific marker for CRC. It is overexpressed in young age patients, poor performance status, and stage IV patients. Although this was not statistically significant, GLUT 1 showed higher expression level in patients with lesser survival. PMID:29205188

Injury Source and Correlation Analysis of Riders in Car-Electric Bicycle Accidents

PubMed Central

Yi, Liang; Hu, Lin; Li, Yuelin

2018-01-01

The knowledge about the injury source and correlation of riders in car-electric bicycle accident will be helpful in the cross validation of traces and vehicle safety design. In order to know more information about such kind of knowledge, 57 true car-electric bicycle accidents were reconstructed by PC-Crash and then data on injury information of riders were collected directly from the reconstructed cases. These collected data were validated by some existing research results firstly, and then 4 abnormal cases were deleted according to the statistical method. Finally, conclusions can be obtained according to the data obtained from the remaining 53 cases. Direct injuries of the head and right leg are from the road pavement upon low speed; the source laws of indirect head injuries are not obvious. Upon intermediate and high speed, the injuries of the above parts are from automobiles. Injuries of the left leg, femur, and right knee are from automobiles; left knee injuries are from automobiles, the road pavement and automobiles, respectively, upon low, intermediate, and high speed. The source laws of indirect torso injuries are not obvious upon intermediate and low speed, which are from automobiles upon high speed, while direct torso injuries are from the road pavement. And there is no high correlation between all parts of the injury of riders. The largest correlation coefficient was the head-left femur and left femur-right femur, which was 0.647, followed by the head-right femur (0.638) and head-torso which was 0.617. PMID:29849757

Development and Validation of a Novel Platform-Independent Metastasis Signature in Human Breast Cancer

PubMed Central

Speers, Corey; Liu, Meilan; Wilder-Romans, Kari; Lawrence, Theodore S.; Pierce, Lori J.; Feng, Felix Y.

2015-01-01

Purpose The molecular drivers of metastasis in breast cancer are not well understood. Therefore, we sought to identify the biological processes underlying distant progression and define a prognostic signature for metastatic potential in breast cancer. Experimental design In vivo screening for metastases was performed using Chick Chorioallantoic Membrane assays in 21 preclinical breast cancer models. Expressed genes associated with metastatic potential were identified using high-throughput analysis. Correlations with biological function were determined using the Database for Annotation, Visualization and Integrated Discovery. Results We identified a broad range of metastatic potential that was independent of intrinsic breast cancer subtypes. 146 genes were significantly associated with metastasis progression and were linked to cancer-related biological functions, including cell migration/adhesion, Jak-STAT, TGF-beta, and Wnt signaling. These genes were used to develop a platform-independent gene expression signature (M-Sig), which was trained and subsequently validated on 5 independent cohorts totaling nearly 1800 breast cancer patients with all p-values < 0.005 and hazard ratios ranging from approximately 2.5 to 3. On multivariate analysis accounting for standard clinicopathologic prognostic variables, M-Sig remained the strongest prognostic factor for metastatic progression, with p-values < 0.001 and hazard ratios > 2 in three different cohorts. Conclusion M-Sig is strongly prognostic for metastatic progression, and may provide clinical utility in combination with treatment prediction tools to better guide patient care. In addition, the platform-independent nature of the signature makes it an excellent research tool as it can be directly applied onto existing, and future, datasets. PMID:25974184

Bacterial infections in childhood: A risk factor for gastrointestinal and other diseases?

PubMed Central

Unverdorben, Alexandra; Weimer, Katja; Schlarb, Angelika Anita; Gulewitsch, Marco Daniel; Ellert, Ute; Enck, Paul

2015-01-01

Background There is evidence for post-infectious irritable bowel syndrome (PI-IBS) in adults, but little is known about PI-IBS in children. The nationwide representative German Health Interview and Examination Survey for Children and Adolescents (KiGGS) assessed children’s health. Objective and methods We identified 643 children (50.1% males) in the KiGGS cohort (N = 15,878, 51% males) with a history of Salmonella infection. The number was validated comparing this group with the known infection statistics from the Robert Koch-Institute registry. We compared this group to the remaining KiGGS cohort (n = 12,951) with respect to sociodemographic characteristics, pain and quality of life. To check for specificity, we repeated the comparisons with a group with a history of scarlet fever. Results Infection statistics predicted 504 cases of Salmonella infection in the KiGGS cohort, indicating high validity of the data. In children between 3 and 10 years with a history of Salmonella infection, significantly more abdominal pain (31.7% versus 21.9%, p < 0.001) and headache (27.2% versus 15.1%, p < 0.001) were reported. This group showed lower quality of life (p < 0.001). Comparison to a group of scarlet fever-infected children revealed poor specificity of the data. Conclusion Differences found between children with and without Salmonella infection reveal the role of gastrointestinal infection in the development of post-infectious abdominal problems, but poor specificity may point toward a psychosocial (“somatization”) rather than a Salmonella-specific mechanism. PMID:25653857

Modeling the role of environmental variables on the population dynamics of the malaria vector Anopheles gambiae sensu stricto

PubMed Central

2012-01-01

Background The impact of weather and climate on malaria transmission has attracted considerable attention in recent years, yet uncertainties around future disease trends under climate change remain. Mathematical models provide powerful tools for addressing such questions and understanding the implications for interventions and eradication strategies, but these require realistic modeling of the vector population dynamics and its response to environmental variables. Methods Published and unpublished field and experimental data are used to develop new formulations for modeling the relationships between key aspects of vector ecology and environmental variables. These relationships are integrated within a validated deterministic model of Anopheles gambiae s.s. population dynamics to provide a valuable tool for understanding vector response to biotic and abiotic variables. Results A novel, parsimonious framework for assessing the effects of rainfall, cloudiness, wind speed, desiccation, temperature, relative humidity and density-dependence on vector abundance is developed, allowing ease of construction, analysis, and integration into malaria transmission models. Model validation shows good agreement with longitudinal vector abundance data from Tanzania, suggesting that recent malaria reductions in certain areas of Africa could be due to changing environmental conditions affecting vector populations. Conclusions Mathematical models provide a powerful, explanatory means of understanding the role of environmental variables on mosquito populations and hence for predicting future malaria transmission under global change. The framework developed provides a valuable advance in this respect, but also highlights key research gaps that need to be resolved if we are to better understand future malaria risk in vulnerable communities. PMID:22877154

Identification of Distinct Psychosis Biotypes Using Brain-Based Biomarkers

PubMed Central

Clementz, Brett A.; Sweeney, John A.; Hamm, Jordan P.; Ivleva, Elena I.; Ethridge, Lauren E.; Pearlson, Godfrey D.; Keshavan, Matcheri S.; Tamminga, Carol A.

2017-01-01

Objective Clinical phenomenology remains the primary means for classifying psychoses despite considerable evidence that this method incompletely captures biologically meaningful differentiations. Rather than relying on clinical diagnoses as the gold standard, this project drew on neurobiological heterogeneity among psychosis cases to delineate subgroups independent of their phenomenological manifestations. Method A large biomarker panel (neuropsychological, stop signal, saccadic control, and auditory stimulation paradigms) characterizing diverse aspects of brain function was collected on individuals with schizophrenia, schizoaffective disorder, and bipolar disorder with psychosis (N=711), their first-degree relatives (N=883), and demographically comparable healthy subjects (N=278). Biomarker variance across paradigms was exploited to create nine integrated variables that were used to capture neurobiological variance among the psychosis cases. Data on external validating measures (social functioning, structural magnetic resonance imaging, family biomarkers, and clinical information) were collected. Results Multivariate taxometric analyses identified three neurobiologically distinct psychosis biotypes that did not respect clinical diagnosis boundaries. The same analysis procedure using clinical DSM diagnoses as the criteria was best described by a single severity continuum (schizophrenia worse than schizoaffective disorder worse than bipolar psychosis); this was not the case for biotypes. The external validating measures supported the distinctiveness of these subgroups compared with clinical diagnosis, highlighting a possible advantage of neurobiological versus clinical categorization schemes for differentiating psychotic disorders. Conclusions These data illustrate how multiple pathways may lead to clinically similar psychosis manifestations, and they provide explanations for the marked heterogeneity observed across laboratories on the same biomarker variables when DSM diagnoses are used as the gold standard. PMID:26651391

Diagnostic methods for insect sting allergy.

PubMed

Hamilton, Robert G

2004-08-01

This review overviews advances from mid-2002 to the present in the validation and performance methods used in the diagnosis of Hymenoptera venom-induced immediate-type hypersensitivity. The general diagnostic algorithm for insect sting allergy is initially discussed with an examination of the AAAAI's 2003 revised practice parameter guidelines. Changes as a result of a greater recognition of skin test negative systemic reactors include repeat analysis of all testing and acceptance of serology as a complementary diagnostic test to the skin test. Original data examining concordance of venom-specific IgE results produced by the second-generation Pharmacia CAP System with the Johns Hopkins University radioallergosorbent test are presented. Diagnostic performance of honeybee venom-specific IgE assays used in clinical laboratories in North America is discussed using data from the Diagnostic Allergy Proficiency Survey conducted by the College of American Pathologists. Validity of venom-specific IgE antibody in postmortem blood specimens is demonstrated. The utility of alternative in-vivo (provocation) and in-vitro (basophil-based) diagnostic testing methods is critiqued. This overview supports the following conclusions. Improved practice parameter guidelines include serology and skin test as complementary in supporting a positive clinical history during the diagnostic process. Data are provided which support the analytical performance of commercially available venom-specific IgE antibody serology-based assays. Intentional sting challenge in-vivo provocation, in-vitro basophil flow cytometry (CD63, CD203c) based assays, and in-vitro basophil histamine and sulfidoleukotriene release assays have their utility in the study of difficult diagnostic cases, but their use will remain as supplementary, secondary diagnostic tests.

Molecular and clinical characterization of IDH associated immune signature in lower-grade gliomas.

PubMed

Qian, Zenghui; Li, Yiming; Fan, Xing; Zhang, Chuanbao; Wang, Yinyan; Jiang, Tao; Liu, Xing

2018-01-01

Background : Mutations in isocitrate dehydrogenase (IDH) affect the development and prognosis of gliomas. We investigated the role of IDH mutations in the regulation of immune phenotype in lower-grade gliomas (LGGs). Method and patients : A total of 1,008 cases with clinical and IDH mutation data from five cohorts were enrolled. Samples with RNA sequencing data from the Chinese Glioma Genome Atlas (CGGA) were used as training set, whereas RNA data from the Cancer Genome Atlas, Repository for Molecular Brain Neoplasia, GSE16011, and CGGA microarray databases were used for validation. R language tools and bioinformatics analysis were used for gene signature construction and biological function annotation. Results : We found that IDH mutations caused down-regulation of local immune response as among 332 immune system-related genes, 196(59.0%) were differentially expressed according to IDH mutation status. Nearly 70% of those differentially expressed genes exhibited prognostic value in LGGs. An immune response-based gene signature was constructed that distinguished cases with high- or low-risk of unfavorable prognosis and remained an independent prognostic factor in multivariate analyses in both training and validation cohorts. Samples from high-risk cases exhibited elevated expression of genes involved in immune response and NF-κB pathway activation. Furthermore, we found a strong correlation between the risk score and T cells, macrophage-related immune response, and expression of several prominent immune checkpoints. Conclusion : Our results indicated that mutant IDH is highly associated with the regulation of the immune microenvironment in LGGs. The observed immune system gene signature, which was sensitive to IDH mutation status, efficiently predicted patient survival.

Miniature circulatory systems: A new exposure system for ecotoxicological effect assessments in riverine organisms.

PubMed

Feiner, Mona; Beggel, Sebastian; Geist, Juergen

2016-11-01

Long-term effect assessments in ecotoxicological investigations are important, yet there is a lack of suitable exposure systems for these experiments that can be used for riverine species. A cost-efficient miniature circulatory system was developed that was evaluated for its applicability in long-term exposures in 2 stream-dwelling species: brown trout (Salmo trutta) and an amphipod (Gammarus roeseli). In an egg-to-fry exposure of S. trutta, the toxicity of 2 reverse osmosis concentrates was investigated as examples. Control hatching rate of yolk sac fry was 75 ± 7% and thus complies with the Organisation for Economic Co-operation and Development validity criterion (≥66%). The reverse osmosis concentrates did not impair the hatching rate in any tested concentration. In G. roeseli, mortality rates remained below 20% during a 21-d cultivation, fulfilling the common validity criterion in ecotoxicological testing. Mortality was significantly lower when the species was fed with conditioned alder leaves instead of an artificial shrimp food. Finally, a toxicity test on G. roeseli using copper as the test substance revealed median lethal concentration (LC50) values of 156 μg/L after 96 h and 99 μg/L after 264 h, which is in line with literature findings using other accepted exposure units. In conclusion, the miniature circulatory system provides a novel and cost-efficient exposure system for long-term investigations on riverine species that may also be applicable for other species of fishes and macroinvertebrates. Environ Toxicol Chem 2016;35:2827-2833. © 2016 SETAC. © 2016 SETAC.

A Neuropsychological Investigation of Multitasking in HIV Infection: Implications for Everyday Functioning

PubMed Central

Scott, J. Cobb; Woods, Steven Paul; Vigil, Ofilio; Heaton, Robert K.; Schweinsburg, Brian C.; Ellis, Ronald J.; Grant, Igor; Marcotte, Thomas D.

2010-01-01

Objective A subset of individuals with HIV-associated neurocognitive impairment experience related deficits in “real world” functioning (i.e., independently performing instrumental activities of daily living [IADL]). While performance-based tests of everyday functioning are reasonably sensitive to HIV-associated IADL declines, questions remain regarding the extent to which these tests’ highly structured nature fully captures the inherent complexities of daily life. The aim of this study was to assess the predictive and ecological validity of a novel multitasking measure in HIV infection. Method Participants included 60 individuals with HIV infection (HIV+) and 25 demographically comparable seronegative adults (HIV−). Participants were administered a comprehensive neuropsychological battery, questionnaires assessing mood and everyday functioning, and a novel standardized test of multitasking, which involved balancing the demands of four interconnected performance-based functional tasks (i.e., financial management, cooking, medication management, and telephone communication). Results HIV+ individuals demonstrated significantly worse overall performance, fewer simultaneous task attempts, and increased errors on the multitasking test as compared to the HIV− sample. Within the HIV+ sample, multitasking impairments were modestly associated with deficits on standard neuropsychological measures of executive functions, episodic memory, attention/working memory, and information processing speed, providing preliminary evidence for convergent validity. More importantly, multivariate prediction models revealed that multitasking deficits were uniquely predictive of IADL dependence beyond the effects of depression and global neurocognitive impairment, with excellent sensitivity (86%), but modest specificity (57%). Conclusions Taken together, these data indicate that multitasking ability may play an important role in successful everyday functioning in HIV+ individuals. PMID:21401259

Methods and dimensions of electronic health record data quality assessment: enabling reuse for clinical research

PubMed Central

Weng, Chunhua

2013-01-01

Objective To review the methods and dimensions of data quality assessment in the context of electronic health record (EHR) data reuse for research. Materials and methods A review of the clinical research literature discussing data quality assessment methodology for EHR data was performed. Using an iterative process, the aspects of data quality being measured were abstracted and categorized, as well as the methods of assessment used. Results Five dimensions of data quality were identified, which are completeness, correctness, concordance, plausibility, and currency, and seven broad categories of data quality assessment methods: comparison with gold standards, data element agreement, data source agreement, distribution comparison, validity checks, log review, and element presence. Discussion Examination of the methods by which clinical researchers have investigated the quality and suitability of EHR data for research shows that there are fundamental features of data quality, which may be difficult to measure, as well as proxy dimensions. Researchers interested in the reuse of EHR data for clinical research are recommended to consider the adoption of a consistent taxonomy of EHR data quality, to remain aware of the task-dependence of data quality, to integrate work on data quality assessment from other fields, and to adopt systematic, empirically driven, statistically based methods of data quality assessment. Conclusion There is currently little consistency or potential generalizability in the methods used to assess EHR data quality. If the reuse of EHR data for clinical research is to become accepted, researchers should adopt validated, systematic methods of EHR data quality assessment. PMID:22733976

A novel, microscope based, non-invasive laser Doppler flowmeter for choroidal blood flow assessment.

PubMed

Strohmaier, C; Werkmeister, R M; Bogner, B; Runge, C; Schroedl, F; Brandtner, H; Radner, W; Schmetterer, L; Kiel, J W; Grabner, G; Reitsamer, H A

2011-06-01

Impaired ocular blood flow is involved in the pathogenesis of numerous ocular diseases like glaucoma or AMD. The purpose of the present study was to introduce and validate a novel, microscope based, non-invasive Laser Doppler Flowmeter (NI-LDF) for measurement of blood flow in the choroid. The custom made NI-LDF was compared with a commercial fiber optic based laser Doppler flowmeter (Perimed PF4000). Linearity and stability of the NI-LDF were assessed in a silastic tubing model (i.d. 0.3 mm) at different flow rates (range 0.4-3 ml/h). In a rabbit model continuous choroidal blood flow measurements were performed with both instruments simultaneously. During blood flow measurements ocular perfusion pressure was changed by manipulations of intraocular pressure via intravitreal saline infusions. The NI-LDF measurement correlated linearly to intraluminal flow rates in the perfused tubing model (r = 0.99, p < 0.05) and remained stable during a 1 h measurement at a constant flow rate. Rabbit choroidal blood flow measured by the PF4000 and the NI-LDF linearly correlated with each other over the entire measurement range (r = 0.99, y = x∗1.01-12.35 P.U., p < 0.001). In conclusion, the NI-LDF provides valid, semi quantitative measurements of capillary blood flow in comparison to an established LDF instrument and is suitable for measurements at the posterior pole of the eye. Copyright © 2011 Elsevier Ltd. All rights reserved.

[Can Psychometric Tests Predict Success in the Selection Interview for Medical School? A Cross-Sectional Study at One German Medical School].

PubMed

Kötter, T; Obst, K U; Brüheim, L; Eisemann, N; Voltmer, E; Katalinic, A

2017-07-01

Background The final exam grade is the main selection criterion for medical school application in Germany. For academic success, it seems to be a reliable predictor. Its use as the only selection criterion is, however, criticised. At some universities, personal interviews are part of the selection process. However, these are very time consuming and are of doubtful validity. The (additional) use of appropriate psychometric instruments could reduce the cost and increase the validity. This study investigates the extent to which psychometric instruments can predict the outcome of a personal selection interview. Methods This is a cross-sectional study on the correlation of the results of psychometric instruments with those of the personal selection interview as part of the application process. As the outcome, the score of the selection interview was used. The NEO - Five Factor Inventory, the Hospital Anxiety and Depression Scale (HADS) and the questionnaire to identify work-related behaviour and experience patterns (AVEM) were used as psychometric interviews. Results There was a statistically significant correlation with the results of the personal selection interview for the sum score of the depression scale from the HADS and the sum score for the dimension of life satisfaction of the AVEM. In addition, those participants who did not previously complete an application training achieved a better result in the selection interview. Conclusion The instruments used measure different aspects than the interviews and cannot replace them. It remains to be seen whether the selected parameters are able to predict academic success. © Georg Thieme Verlag KG Stuttgart · New York.

Design, assembly, and validation of a nose-only inhalation exposure system for studies of aerosolized viable influenza H5N1 virus in ferrets

PubMed Central

2010-01-01

Background The routes by which humans acquire influenza H5N1 infections have not been fully elucidated. Based on the known biology of influenza viruses, four modes of transmission are most likely in humans: aerosol transmission, ingestion of undercooked contaminated infected poultry, transmission by large droplets and self-inoculation of the nasal mucosa by contaminated hands. In preparation of a study to resolve whether H5N1 viruses are transmissible by aerosol in an animal model that is a surrogate for humans, an inhalation exposure system for studies of aerosolized H5N1 viruses in ferrets was designed, assembled, and validated. Particular attention was paid towards system safety, efficacy of dissemination, the viability of aerosolized virus, and sampling methodology. Results An aerosol generation and delivery system, referred to as a Nose-Only Bioaerosol Exposure System (NBIES), was assembled and function tested. The NBIES passed all safety tests, met expected engineering parameters, required relatively small quantities of material to obtain the desired aerosol concentrations of influenza virus, and delivered doses with high-efficacy. Ferrets withstood a mock exposure trial without signs of stress. Conclusions The NBIES delivers doses of aerosolized influenza viruses with high efficacy, and uses less starting material than other similar designs. Influenza H5N1 and H3N2 viruses remain stable under the conditions used for aerosol generation and sample collection. The NBIES is qualified for studies of aerosolized H5N1 virus. PMID:20573226

Automatic segmentation and co-registration of gated CT angiography datasets: measuring abdominal aortic pulsatility

NASA Astrophysics Data System (ADS)

Wentz, Robert; Manduca, Armando; Fletcher, J. G.; Siddiki, Hassan; Shields, Raymond C.; Vrtiska, Terri; Spencer, Garrett; Primak, Andrew N.; Zhang, Jie; Nielson, Theresa; McCollough, Cynthia; Yu, Lifeng

2007-03-01

Purpose: To develop robust, novel segmentation and co-registration software to analyze temporally overlapping CT angiography datasets, with an aim to permit automated measurement of regional aortic pulsatility in patients with abdominal aortic aneurysms. Methods: We perform retrospective gated CT angiography in patients with abdominal aortic aneurysms. Multiple, temporally overlapping, time-resolved CT angiography datasets are reconstructed over the cardiac cycle, with aortic segmentation performed using a priori anatomic assumptions for the aorta and heart. Visual quality assessment is performed following automatic segmentation with manual editing. Following subsequent centerline generation, centerlines are cross-registered across phases, with internal validation of co-registration performed by examining registration at the regions of greatest diameter change (i.e. when the second derivative is maximal). Results: We have performed gated CT angiography in 60 patients. Automatic seed placement is successful in 79% of datasets, requiring either no editing (70%) or minimal editing (less than 1 minute; 12%). Causes of error include segmentation into adjacent, high-attenuating, nonvascular tissues; small segmentation errors associated with calcified plaque; and segmentation of non-renal, small paralumbar arteries. Internal validation of cross-registration demonstrates appropriate registration in our patient population. In general, we observed that aortic pulsatility can vary along the course of the abdominal aorta. Pulsation can also vary within an aneurysm as well as between aneurysms, but the clinical significance of these findings remain unknown. Conclusions: Visualization of large vessel pulsatility is possible using ECG-gated CT angiography, partial scan reconstruction, automatic segmentation, centerline generation, and coregistration of temporally resolved datasets.

Simulation verification techniques study. Subsystem simulation validation techniques

NASA Technical Reports Server (NTRS)

Duncan, L. M.; Reddell, J. P.; Schoonmaker, P. B.

1974-01-01

Techniques for validation of software modules which simulate spacecraft onboard systems are discussed. An overview of the simulation software hierarchy for a shuttle mission simulator is provided. A set of guidelines for the identification of subsystem/module performance parameters and critical performance parameters are presented. Various sources of reference data to serve as standards of performance for simulation validation are identified. Environment, crew station, vehicle configuration, and vehicle dynamics simulation software are briefly discussed from the point of view of their interfaces with subsystem simulation modules. A detailed presentation of results in the area of vehicle subsystems simulation modules is included. A list of references, conclusions and recommendations are also given.

Validation of the content of the prevention protocol for early sepsis caused by Streptococcus agalactiaein newborns

PubMed Central

da Silva, Fabiana Alves; Vidal, Cláudia Fernanda de Lacerda; de Araújo, Ednaldo Cavalcante

2015-01-01

Abstract Objective: to validate the content of the prevention protocol for early sepsis caused by Streptococcus agalactiaein newborns. Method: a transversal, descriptive and methodological study, with a quantitative approach. The sample was composed of 15 judges, 8 obstetricians and 7 pediatricians. The validation occurred through the assessment of the content of the protocol by the judges that received the instrument for data collection - checklist - which contained 7 items that represent the requisites to be met by the protocol. The validation of the content was achieved by applying the Content Validity Index. Result: in the judging process, all the items that represented requirements considered by the protocol obtained concordance within the established level (Content Validity Index > 0.75). Of 7 items, 6 have obtained full concordance (Content Validity Index 1.0) and the feasibility item obtained a Content Validity Index of 0.93. The global assessment of the instruments obtained a Content Validity Index of 0.99. Conclusion: the validation of content that was done was an efficient tool for the adjustment of the protocol, according to the judgment of experienced professionals, which demonstrates the importance of conducting a previous validation of the instruments. It is expected that this study will serve as an incentive for the adoption of universal tracking by other institutions through validated protocols. PMID:26444165

In-Flight Validation of Mid and Thermal Infrared Remotely Sensed Data Using the Lake Tahoe and Salton Sea Automated Validation Sites

NASA Technical Reports Server (NTRS)

Hook, Simon J.

2008-01-01

The presentation includes an introduction, Lake Tahoe site layout and measurements, Salton Sea site layout and measurements, field instrument calibration and cross-calculations, data reduction methodology and error budgets, and example results for MODIS. Summary and conclusions are: 1) Lake Tahoe CA/NV automated validation site was established in 1999 to assess radiometric accuracy of satellite and airborne mid and thermal infrared data and products. Water surface temperatures range from 4-25C.2) Salton Sea CA automated validation site was established in 2008 to broaden range of available water surface temperatures and atmospheric water vapor test cases. Water surface temperatures range from 15-35C. 3) Sites provide all information necessary for validation every 2 mins (bulk temperature, skin temperature, air temperature, wind speed, wind direction, net radiation, relative humidity). 4) Sites have been used to validate mid and thermal infrared data and products from: ASTER, AATSR, ATSR2, MODIS-Terra, MODIS-Aqua, Landsat 5, Landsat 7, MTI, TES, MASTER, MAS. 5) Approximately 10 years of data available to help validate AVHRR.

Testing multiple statistical hypotheses resulted in spurious associations: a study of astrological signs and health.

PubMed

Austin, Peter C; Mamdani, Muhammad M; Juurlink, David N; Hux, Janet E

2006-09-01

To illustrate how multiple hypotheses testing can produce associations with no clinical plausibility. We conducted a study of all 10,674,945 residents of Ontario aged between 18 and 100 years in 2000. Residents were randomly assigned to equally sized derivation and validation cohorts and classified according to their astrological sign. Using the derivation cohort, we searched through 223 of the most common diagnoses for hospitalization until we identified two for which subjects born under one astrological sign had a significantly higher probability of hospitalization compared to subjects born under the remaining signs combined (P<0.05). We tested these 24 associations in the independent validation cohort. Residents born under Leo had a higher probability of gastrointestinal hemorrhage (P=0.0447), while Sagittarians had a higher probability of humerus fracture (P=0.0123) compared to all other signs combined. After adjusting the significance level to account for multiple comparisons, none of the identified associations remained significant in either the derivation or validation cohort. Our analyses illustrate how the testing of multiple, non-prespecified hypotheses increases the likelihood of detecting implausible associations. Our findings have important implications for the analysis and interpretation of clinical studies.

Reliability, factor structure, and validity of the German version of the Trauma Symptom Checklist for Children in a sample of adolescents

PubMed Central

Matulis, Simone; Loos, Laura; Langguth, Nadine; Schreiber, Franziska; Gutermann, Jana; Gawrilow, Caterina; Steil, Regina

2015-01-01

Background The Trauma Symptom Checklist for Children (TSC-C) is the most widely used self-report scale to assess trauma-related symptoms in children and adolescents on six clinical scales. The purpose of the present study was to develop a German version of the TSC-C and to investigate its psychometric properties, such as factor structure, reliability, and validity, in a sample of German adolescents. Method A normative sample of N=583 and a clinical sample of N=41 adolescents with a history of physical or sexual abuse aged between 13 and 21 years participated in the study. Results The Confirmatory Factor Analysis on the six-factor model (anger, anxiety, depression, dissociation, posttraumatic stress, and sexual concerns with the subdimensions preoccupation and distress) revealed acceptable to good fit statistics in the normative sample. One item had to be excluded from the German version of the TSC-C because the factor loading was too low. All clinical scales presented acceptable to good reliability, with Cronbach's α's ranging from .80 to .86 in the normative sample and from .72 to .87 in the clinical sample. Concurrent validity was also demonstrated by the high correlations between the TSC-C scales and instruments measuring similar psychopathology. TSC-C scores reliably differentiated between adolescents with trauma history and those without trauma history, indicating discriminative validity. Conclusions In conclusion, the German version of the TSC-C is a reliable and valid instrument for assessing trauma-related symptoms on six different scales in adolescents aged between 13 and 21 years. PMID:26498182

Copenhagen Psychosocial Questionnaire - A validation study using the Job Demand-Resources model

PubMed Central

Hakanen, Jari J.; Westerlund, Hugo

2018-01-01

Aim This study aims at investigating the nomological validity of the Copenhagen Psychosocial Questionnaire (COPSOQ II) by using an extension of the Job Demands-Resources (JD-R) model with aspects of work ability as outcome. Material and methods The study design is cross-sectional. All staff working at public dental organizations in four regions of Sweden were invited to complete an electronic questionnaire (75% response rate, n = 1345). The questionnaire was based on COPSOQ II scales, the Utrecht Work Engagement scale, and the one-item Work Ability Score in combination with a proprietary item. The data was analysed by Structural Equation Modelling. Results This study contributed to the literature by showing that: A) The scale characteristics were satisfactory and the construct validity of COPSOQ instrument could be integrated in the JD-R framework; B) Job resources arising from leadership may be a driver of the two processes included in the JD-R model; and C) Both the health impairment and motivational processes were associated with WA, and the results suggested that leadership may impact WA, in particularly by securing task resources. Conclusion In conclusion, the nomological validity of COPSOQ was supported as the JD-R model-can be operationalized by the instrument. This may be helpful for transferral of complex survey results and work life theories to practitioners in the field. PMID:29708998

The Dimensionality of Reasoning: Inductive and Deductive Inference can be Explained by a Single Process.

PubMed

Hayes, Brett K; Stephens, Rachel G; Ngo, Jeremy; Dunn, John C

2018-02-01

Three-experiments examined the number of qualitatively different processing dimensions needed to account for inductive and deductive reasoning. In each study, participants were presented with arguments that varied in logical validity and consistency with background knowledge (believability), and evaluated them according to deductive criteria (whether the conclusion was necessarily true given the premises) or inductive criteria (whether the conclusion was plausible given the premises). We examined factors including working memory load (Experiments 1 and 2), individual working memory capacity (Experiments 1 and 2), and decision time (Experiment 3), which according to dual-processing theories, modulate the contribution of heuristic and analytic processes to reasoning. A number of empirical dissociations were found. Argument validity affected deduction more than induction. Argument believability affected induction more than deduction. Lower working memory capacity reduced sensitivity to argument validity and increased sensitivity to argument believability, especially under induction instructions. Reduced decision time led to decreased sensitivity to argument validity. State-trace analyses of each experiment, however, found that only a single underlying dimension was required to explain patterns of inductive and deductive judgments. These results show that the dissociations, which have traditionally been seen as supporting dual-processing models of reasoning, are consistent with a single-process model that assumes a common evidentiary scale for induction and deduction. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Domain of validity of the perturbative approach to femtosecond optical spectroscopy

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

Gelin, Maxim F.; Rao, B. Jayachander; Nest, Mathias

2013-12-14

We have performed numerical nonperturbative simulations of transient absorption pump-probe responses for a series of molecular model systems. The resulting signals as a function of the laser field strength and the pump-probe delay time are compared with those obtained in the perturbative response function formalism. The simulations and their theoretical analysis indicate that the perturbative description remains valid up to moderately strong laser pulses, corresponding to a rather substantial depopulation (population) of the initial (final) electronic states.

KENNEDY SPACE CENTER, FLA. -- Endeavour settles into place inside the Vehicle Assembly Building (VAB) where it has been moved for temporary storage. It left the Orbiter Processing Facility (OPF) to allow work to be performed in the OPF that can only be accomplished while the bay is empty. Work scheduled in the OPF includes annual validation of the bay’s cranes, work platforms, lifting mechanisms and jack stands. Endeavour will remain in the VAB for approximately 12 days, then return to the OPF.

NASA Image and Video Library

2004-01-09

KENNEDY SPACE CENTER, FLA. -- Endeavour settles into place inside the Vehicle Assembly Building (VAB) where it has been moved for temporary storage. It left the Orbiter Processing Facility (OPF) to allow work to be performed in the OPF that can only be accomplished while the bay is empty. Work scheduled in the OPF includes annual validation of the bay’s cranes, work platforms, lifting mechanisms and jack stands. Endeavour will remain in the VAB for approximately 12 days, then return to the OPF.

KENNEDY SPACE CENTER, FLA. -- Endeavour begins rolling out of the Orbiter Processing Facility for temporary transfer to the Vehicle Assembly Building. The move allows work to be performed in the OPF that can only be accomplished while the bay is empty. Work scheduled in the OPF includes annual validation of the bay’s cranes, work platforms, lifting mechanisms and jack stands. Endeavour will remain in the VAB for approximately 12 days, then return to the OPF.

NASA Image and Video Library

2004-01-09

KENNEDY SPACE CENTER, FLA. -- Endeavour begins rolling out of the Orbiter Processing Facility for temporary transfer to the Vehicle Assembly Building. The move allows work to be performed in the OPF that can only be accomplished while the bay is empty. Work scheduled in the OPF includes annual validation of the bay’s cranes, work platforms, lifting mechanisms and jack stands. Endeavour will remain in the VAB for approximately 12 days, then return to the OPF.

KENNEDY SPACE CENTER, FLA. -- Endeavour rolls into the Vehicle Assembly Building (VAB) for temporary storage. The orbiter has been moved from the Orbiter Processing Facility (OPF) to allow work to be performed in the OPF that can only be accomplished while the bay is empty. Work scheduled in the OPF includes annual validation of the bay’s cranes, work platforms, lifting mechanisms and jack stands. Endeavour will remain in the VAB for approximately 12 days, then return to the OPF.

NASA Image and Video Library

2004-01-09

KENNEDY SPACE CENTER, FLA. -- Endeavour rolls into the Vehicle Assembly Building (VAB) for temporary storage. The orbiter has been moved from the Orbiter Processing Facility (OPF) to allow work to be performed in the OPF that can only be accomplished while the bay is empty. Work scheduled in the OPF includes annual validation of the bay’s cranes, work platforms, lifting mechanisms and jack stands. Endeavour will remain in the VAB for approximately 12 days, then return to the OPF.

KENNEDY SPACE CENTER, FLA. -- Endeavour is towed toward the Vehicle Assembly Building for temporary storage. The orbiter has been moved from the Orbiter Processing Facility (OPF) to allow work to be performed in the OPF that can only be accomplished while the bay is empty. Work scheduled in the OPF includes annual validation of the bay’s cranes, work platforms, lifting mechanisms and jack stands. Endeavour will remain in the VAB for approximately 12 days, then return to the OPF.

NASA Image and Video Library

2004-01-09

KENNEDY SPACE CENTER, FLA. -- Endeavour is towed toward the Vehicle Assembly Building for temporary storage. The orbiter has been moved from the Orbiter Processing Facility (OPF) to allow work to be performed in the OPF that can only be accomplished while the bay is empty. Work scheduled in the OPF includes annual validation of the bay’s cranes, work platforms, lifting mechanisms and jack stands. Endeavour will remain in the VAB for approximately 12 days, then return to the OPF.

KENNEDY SPACE CENTER, FLA. -- Endeavour is ready to be rolled out of the Orbiter Processing Facility for temporary transfer to the Vehicle Assembly Building. The move allows work to be performed in the OPF that can only be accomplished while the bay is empty. Work scheduled in the OPF includes annual validation of the bay’s cranes, work platforms, lifting mechanisms and jack stands. Endeavour will remain in the VAB for approximately 12 days, then return to the OPF.

NASA Image and Video Library

2004-01-09

KENNEDY SPACE CENTER, FLA. -- Endeavour is ready to be rolled out of the Orbiter Processing Facility for temporary transfer to the Vehicle Assembly Building. The move allows work to be performed in the OPF that can only be accomplished while the bay is empty. Work scheduled in the OPF includes annual validation of the bay’s cranes, work platforms, lifting mechanisms and jack stands. Endeavour will remain in the VAB for approximately 12 days, then return to the OPF.

Serial album validation for promotion of infant body weight control

PubMed Central

Saraiva, Nathalia Costa Gonzaga; Medeiros, Carla Campos Muniz; de Araujo, Thelma Leite

2018-01-01

ABSTRACT Objective: to validate the content and appearance of a serial album for children aged from 7 to 10 years addressing the topic of prevention and control of body weight. Method: methodological study with descriptive nature. The validation process was attended by 33 specialists in educational technologies and/or in excess of infantile weight. The agreement index of 80% was the minimum considered to guarantee the validation of the material. Results: most of the specialists had a doctoral degree and a graduate degree in nursing. Regarding content, illustrations, layout and relevance, all items were validated and 69.7% of the experts considered the album as great. The overall agreement validation index for the educational technology was 0.88. Only the script-sheet 3 did not reach the cutoff point of the content validation index. Changes were made to the material, such as title change, inclusion of the school context and insertion of nutritionist and physical educator in the story narrated in the album. Conclusion: the proposed serial album was considered valid by experts regarding content and appearance, suggesting that this technology has the potential to contribute in health education by promoting healthy weight in the age group of 7 to 10 years. PMID:29791665

Translation, cultural adaptation and validation of the Diabetes Attitudes Scale - third version into Brazilian Portuguese 1

PubMed Central

Vieira, Gisele de Lacerda Chaves; Pagano, Adriana Silvino; Reis, Ilka Afonso; Rodrigues, Júlia Santos Nunes; Torres, Heloísa de Carvalho

2018-01-01

ABSTRACT Objective: to perform the translation, adaptation and validation of the Diabetes Attitudes Scale - third version instrument into Brazilian Portuguese. Methods: methodological study carried out in six stages: initial translation, synthesis of the initial translation, back-translation, evaluation of the translated version by the Committee of Judges (27 Linguists and 29 health professionals), pre-test and validation. The pre-test and validation (test-retest) steps included 22 and 120 health professionals, respectively. The Content Validity Index, the analyses of internal consistency and reproducibility were performed using the R statistical program. Results: in the content validation, the instrument presented good acceptance among the Judges with a mean Content Validity Index of 0.94. The scale presented acceptable internal consistency (Cronbach’s alpha = 0.60), while the correlation of the total score at the test and retest moments was considered high (Polychoric Correlation Coefficient = 0.86). The Intra-class Correlation Coefficient, for the total score, presented a value of 0.65. Conclusion: the Brazilian version of the instrument (Escala de Atitudes dos Profissionais em relação ao Diabetes Mellitus) was considered valid and reliable for application by health professionals in Brazil. PMID:29319739

Surrogates for numerical simulations; optimization of eddy-promoter heat exchangers

NASA Technical Reports Server (NTRS)

Patera, Anthony T.; Patera, Anthony

1993-01-01

Although the advent of fast and inexpensive parallel computers has rendered numerous previously intractable calculations feasible, many numerical simulations remain too resource-intensive to be directly inserted in engineering optimization efforts. An attractive alternative to direct insertion considers models for computational systems: the expensive simulation is evoked only to construct and validate a simplified, input-output model; this simplified input-output model then serves as a simulation surrogate in subsequent engineering optimization studies. A simple 'Bayesian-validated' statistical framework for the construction, validation, and purposive application of static computer simulation surrogates is presented. As an example, dissipation-transport optimization of laminar-flow eddy-promoter heat exchangers are considered: parallel spectral element Navier-Stokes calculations serve to construct and validate surrogates for the flowrate and Nusselt number; these surrogates then represent the originating Navier-Stokes equations in the ensuing design process.

Healthcare Databases for Drug Safety Research: Data Validity Assessment Remains Crucial.

PubMed

Rawson, Nigel S B; D'Arcy, Carl

2018-04-30

Administrative healthcare utilization databases are frequently used either individually or as a component of aggregated data for evaluating drug safety issues without taking into account their known deficiencies. All too often insufficient evidence is provided about their validity for the purposes for which they are used. The assessment of data validity is a key constituent that should be included in drug safety research studies and should take a broad multifaceted approach that encompasses both diagnostic and drug exposure data. Drug safety researchers need to continue advancing their knowledge of the data resources they use and to ensure that they and the users of their research understand the limitations of the data that are the foundation on which their research is built. Fundamental issues regarding data validity should be addressed in each use of administrative data for drug safety research.

Thread Migration in the Presence of Pointers

NASA Technical Reports Server (NTRS)

Cronk, David; Haines, Matthew; Mehrotra, Piyush

1996-01-01

Dynamic migration of lightweight threads supports both data locality and load balancing. However, migrating threads that contain pointers referencing data in both the stack and heap remains an open problem. In this paper we describe a technique by which threads with pointers referencing both stack and non-shared heap data can be migrated such that the pointers remain valid after migration. As a result, threads containing pointers can now be migrated between processors in a homogeneous distributed memory environment.

Investigation of Content and Face Validity and Reliability of Sociocultural Attitude towards Appearance Questionnaire-3 (SATAQ-3) among Female Adolescents

PubMed Central

Mousazadeh, Somayeh; Rakhshan, Mahnaz; Mohammadi, Fateme

2017-01-01

Objective: This study aimed to determine the psychometric properties of sociocultural attitude towards appearance questionnaire in female adolescents. Method: This was a methodological study. The English version of the questionnaire was translated into Persian, using forward-backward method. Then the face validity, content validity and reliability were checked. To ensure face validity, the questionnaire was given to 25 female adolescents, a psychologist and three nurses, who were required to evaluate the items with respect to problems, ambiguity, relativity, proper terms and grammar, and understandability. For content validity, 15 experts in psychology and nursing, who met the inclusion criteria, were required. They were asked to assess the qualitative of content validity. To determine the quantitative content validity, content validity index and content validity ratio were calculated. At the end, internal consistency of the items was assessed, using Cronbach’s alpha method. Results: According to the expert judgments, content validity ratio was 0.81 and content validity index was 0.91. Besides, the reliability of the questionnaire was confirmed with Cronbach’s alpha = 0.91, and physical and developmental areas showed the highest reliability indices. Conclusion: The aforementioned questionnaire could be used in researches to assess female adolescents’ self-concept. This can be a stepping-stone towards identification of problems and improvement of adolescents’ body image. PMID:28496497

Drug Target Validation Methods in Malaria - Protein Interference Assay (PIA) as a Tool for Highly Specific Drug Target Validation.

PubMed

Meissner, Kamila A; Lunev, Sergey; Wang, Yuan-Ze; Linzke, Marleen; de Assis Batista, Fernando; Wrenger, Carsten; Groves, Matthew R

2017-01-01

The validation of drug targets in malaria and other human diseases remains a highly difficult and laborious process. In the vast majority of cases, highly specific small molecule tools to inhibit a proteins function in vivo are simply not available. Additionally, the use of genetic tools in the analysis of malarial pathways is challenging. These issues result in difficulties in specifically modulating a hypothetical drug target's function in vivo. The current "toolbox" of various methods and techniques to identify a protein's function in vivo remains very limited and there is a pressing need for expansion. New approaches are urgently required to support target validation in the drug discovery process. Oligomerisation is the natural assembly of multiple copies of a single protein into one object and this self-assembly is present in more than half of all protein structures. Thus, oligomerisation plays a central role in the generation of functional biomolecules. A key feature of oligomerisation is that the oligomeric interfaces between the individual parts of the final assembly are highly specific. However, these interfaces have not yet been systematically explored or exploited to dissect biochemical pathways in vivo. This mini review will describe the current state of the antimalarial toolset as well as the potentially druggable malarial pathways. A specific focus is drawn to the initial efforts to exploit oligomerisation surfaces in drug target validation. As alternative to the conventional methods, Protein Interference Assay (PIA) can be used for specific distortion of the target protein function and pathway assessment in vivo. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Cross-cultural adaptation, reliability and validity of the Spanish version of the Quality of Life in Adult Cancer Survivors (QLACS) questionnaire: application in a sample of short-term survivors.

PubMed

Escobar, Antonio; Trujillo-Martín, Maria del Mar; Rueda, Antonio; Pérez-Ruiz, Elisabeth; Avis, Nancy E; Bilbao, Amaia

2015-11-16

The aim of this study was to validate the Quality of Life in Adult Cancer Survivors (QLACS) in short-term Spanish cancer survivor's patients. Patients with breast, colorectal or prostate cancer that had finished their initial cancer treatment 3 years before the beginning of this study completed QLACS, WHOQOL, Short Form-36, Hospital Anxiety and Depression Scale, EORTC-QLQ-BR23 and EQ-5D. Cultural adaptation was made based on established guidelines. Reliability was evaluated using internal consistency and test-retest. Convergent validity was studied by mean of Pearson's correlation coefficient. Structural validity was determined by a second-order confirmatory factor analysis (CFA) and Rasch analysis was used to assess the unidimensionality of the Generic and Cancer-specific scales. Cronbach's alpha were above 0.7 in all domains and summary scales. Test-retest coefficients were 0.88 for Generic and 0.82 for Cancer-specific summary scales. QLACS generic summary scale was correlated with other generic criterion measures, SF-36 MCS (r = - 0.74) and EQ-VAS (r = - 0.63). QLACS cancer-specific scale had lower values with the same constructs. CFA provided satisfactory fit indices in all cases. The RMSEA value was 0.061 and CFI and TLI values were 0.929 and 0.925, respectively. All factor loadings were higher than 0.40 and statistically significant (P < 0.001). Generic summary scale had eight misfitting items. In the remaining 20 items, the unidimensionality was supported. Cancer Specific summary scale showed four misfitting items, the remaining showed unidimensionality. The findings support the validity and reliability of QLACS questionnaire to be used in short-term cancer survivors.

Guideline for translation and national validation of the Quality of Life in Hand Eczema Questionnaire (QOLHEQ).

PubMed

Oosterhaven, Jart A F; Schuttelaar, Marie L A; Apfelbacher, Christian; Diepgen, Thomas L; Ofenloch, Robert F

2017-08-01

There is a need for well-developed and validated questionnaires to measure patient reported outcomes. The Quality of Life in Hand Eczema Questionnaire (QOLHEQ) is such a validated instrument measuring disease-specific health-related quality of life in hand eczema patients. A re-validation of measurement properties is required before an instrument is used in a new population. With the objective of arriving at a guideline for translation and national validation of the QOLHEQ, we have developed the design of a reference study on how to adequately assess measurement properties of the QOLHEQ based on interdisciplinary discussions and current standards. We present a step-by-step guideline to assess translation (including cross-cultural adaptation), scale structure, validity, reproducibility, responsiveness, and interpretability. We describe which outcomes should be reported for each measurement property, and give advice on how to calculate these. It is also specified which sample size is needed, how to deal with missing data, and which cutoff values should be applied for the measurement properties assessed during the validation process. In conclusion, this guideline, presenting a reference validation study for the QOLHEQ, creates the possibility to harmonize the national validation of the various language versions of the QOLHEQ. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

A Retrospective Performance Assessment of the Developmental Neurotoxicity Study in Support of OECD Test Guideline 426

PubMed Central

Makris, Susan L.; Raffaele, Kathleen; Allen, Sandra; Bowers, Wayne J.; Hass, Ulla; Alleva, Enrico; Calamandrei, Gemma; Sheets, Larry; Amcoff, Patric; Delrue, Nathalie; Crofton, Kevin M.

2009-01-01

Objective We conducted a review of the history and performance of developmental neurotoxicity (DNT) testing in support of the finalization and implementation of Organisation of Economic Co-operation and Development (OECD) DNT test guideline 426 (TG 426). Information sources and analysis In this review we summarize extensive scientific efforts that form the foundation for this testing paradigm, including basic neurotoxicology research, interlaboratory collaborative studies, expert workshops, and validation studies, and we address the relevance, applicability, and use of the DNT study in risk assessment. Conclusions The OECD DNT guideline represents the best available science for assessing the potential for DNT in human health risk assessment, and data generated with this protocol are relevant and reliable for the assessment of these end points. The test methods used have been subjected to an extensive history of international validation, peer review, and evaluation, which is contained in the public record. The reproducibility, reliability, and sensitivity of these methods have been demonstrated, using a wide variety of test substances, in accordance with OECD guidance on the validation and international acceptance of new or updated test methods for hazard characterization. Multiple independent, expert scientific peer reviews affirm these conclusions. PMID:19165382

Psychological Autopsy Studies as Diagnostic Tools: Are they Methodologically Flawed?

PubMed Central

Hjelmeland, Heidi; Dieserud, Gudrun; Dyregrov, Kari; Knizek, Birthe L.; Leenaars, Antoon A.

2012-01-01

One of the most established “truths” in suicidology is that almost all (90 % or more) of those who kill themselves suffer from one or more mental disorders, and a causal link between the two is implied. Psychological autopsy (PA) studies constitute one main evidence base for this conclusion. However, there has been little reflection on the reliability and validity of this method. For example, psychiatric diagnoses are assigned to people who have died by suicide by interviewing a few of the relatives and/or friends, often many years after the suicide. In this article, we scrutinize PA studies with particular focus on the diagnostic process and demonstrate that they cannot constitute a valid evidence base for a strong relationship between mental disorders and suicide. We show that most questions asked to assign a diagnosis are impossible to answer reliably by proxies, and thus, one cannot validly make conclusions. Thus, as a diagnostic tool psychological autopsies should now be abandoned. Instead, we recommend qualitative approaches focusing on the understanding of suicide beyond mental disorders, where narratives from a relatively high number of informants around each suicide are systematically analyzed in terms of the informants’ relationships with the deceased. PMID:24563941

Fatigue Failure of Space Shuttle Main Engine Turbine Blades

NASA Technical Reports Server (NTRS)

Swanson, Gregrory R.; Arakere, Nagaraj K.

2000-01-01

Experimental validation of finite element modeling of single crystal turbine blades is presented. Experimental results from uniaxial high cycle fatigue (HCF) test specimens and full scale Space Shuttle Main Engine test firings with the High Pressure Fuel Turbopump Alternate Turbopump (HPFTP/AT) provide the data used for the validation. The conclusions show the significant contribution of the crystal orientation within the blade on the resulting life of the component, that the analysis can predict this variation, and that experimental testing demonstrates it.

Scattering From the Finite-Length, Dielectric Circular Cylinder. Part 2 - On the Validity of an Analytical Solution for Characterizing Backscattering from Tree Trunks at P-Band

DTIC Science & Technology

2015-09-01

accuracy of an analytical solution for characterizing the backscattering responses of circular cylindrical tree trunks located above a dielectric ground...Figures iv 1. Introduction 1 2. Analytical Solution 2 3. Validation with Full-Wave Solution 4 3.1 Untapered Circular Cylindrical Trunk 5 3.2...Linearly Tapered Circular Cylindrical Trunk 13 3.3 Nonlinearly Tapered Circular Cylindrical Trunk 18 4. Conclusions 22 5. References 23 Appendix

Results of an Internet survey determining the most frequently used ankle scores by AOFAS members.

PubMed

Lau, Johnny T C; Mahomed, Nizar M; Schon, Lew C

2005-06-01

With technological advances in ankle arthroplasty, there has been parallel development in the outcome instruments used to assess the results of surgery. The literature recommends the use of valid, reliable, and responsive ankle scores, but the ankle scores commonly used in clinical practice remain undefined. An internet survey of members of the American Orthopaedic Foot and Ankle Society (AOFAS) was conducted to determine which three ankle scores they perceived as most commonly used in the literature, which ones they believe are validated, which ones they prefer, and which they use in practice. According to respondents, the three most commonly used scores were the AOFAS Ankle score, the Foot Function Index (FFI), and the Musculoskeletal Outcomes Data Evaluation and Management System (MODEMS). The respondents believed that the AOFAS Ankle score, FFI, and MODEMS were validated. The FFI and MODEMS are validated, but the AOFAS ankle score is not validated. Most respondents preferred using the AOFAS Ankle score. The use of the empirical AOFAS Ankle score continues among AOFAS members.

Scale indicators of social exchange relationships: a comparison of relative content validity.

PubMed

Colquitt, Jason A; Baer, Michael D; Long, David M; Halvorsen-Ganepola, Marie D K

2014-07-01

Although social exchange theory has become one of the most oft-evoked theories in industrial and organizational psychology, there remains no consensus about how to measure its key mechanism: social exchange relationships (Blau, 1964). Drawing on Cropanzano and Byrne's (2000) review of contemporary social exchange theorizing, we examined the content validity of perceived support, exchange quality, affective commitment, trust, and psychological contract fulfillment as indicators of social exchange relationships. We used Hinkin and Tracey's (1999) quantitative approach to content validation, which asks participants to rate the correspondence between scale items and definitions of intended (and unintended) constructs. Our results revealed that some of the most frequently utilized indicators of social exchange relationships--perceived support and exchange quality--were significantly less content valid than rarely used options like affect-based trust. Our results also revealed that 2 direct measures--Bernerth, Armenakis, Feild, Giles, and Walker's (2007) scale and a scale created for this study--were content valid. We discuss the implications of these results for future applications of social exchange theory.

Development and validation of a new tool to measure Iranian pregnant women's empowerment.

PubMed

Borghei, N S; Taghipour, A; Roudsari, R Latifnejad; Keramat, A

2016-03-15

Empowering pregnant women improves their health and reduces maternal mortality, but there is a lack of suitable tools to measure women's empowerment in some cultures. This study aimed to design and validate a questionnaire for measuring the dimensions of empowerment among Iranian pregnant women. After a literature review, and face and content validity testing, a 38-item questionnaire was developed and tested on a sample of 161 pregnant women. Factor analysis grouped the items into 3 subscales: educational empowerment (e.g. prenatal training), autonomy (e.g. financial independency and mental ability) and sociopolitical empowerment (e.g. involvement in social and political activities). Criterion validity testing showed a strong positive correlation of the total scale and subscales scores with the Kameda and the Spritzer empowerment scales. Cronbach alpha was 0.92 for total empowerment. A total of 32 items remained in the Self-Structured Pregnancy Empowerment Questionnaire, which is a valid new tool to measure the dimensions of pregnant women's empowerment.

Development of self and peer performance assessment on iodometric titration experiment

NASA Astrophysics Data System (ADS)

Nahadi; Siswaningsih, W.; Kusumaningtyas, H.

2018-05-01

This study aims to describe the process in developing of reliable and valid assessment to measure students’ performance on iodometric titration and the effect of the self and peer assessment on students’ performance. The self and peer-instrument provides valuable feedback for the student performance improvement. The developed assessment contains rubric and task for facilitating self and peer assessment. The participants are 24 students at the second-grade student in certain vocational high school in Bandung. The participants divided into two groups. The first 12 students involved in the validity test of the developed assessment, while the remain 12 students participated for the reliability test. The content validity was evaluated based on the judgment experts. Test result of content validity based on judgment expert show that the developed performance assessment instrument categorized as valid on each task with the realibity classified as very good. Analysis of the impact of the self and peer assessment implementation showed that the peer instrument supported the self assessment.

External validation of Medicare claims codes for digital mammography and computer-aided detection.

PubMed

Fenton, Joshua J; Zhu, Weiwei; Balch, Steven; Smith-Bindman, Rebecca; Lindfors, Karen K; Hubbard, Rebecca A

2012-08-01

While Medicare claims are a potential resource for clinical mammography research or quality monitoring, the validity of key data elements remains uncertain. Claims codes for digital mammography and computer-aided detection (CAD), for example, have not been validated against a credible external reference standard. We matched Medicare mammography claims for women who received bilateral mammograms from 2003 to 2006 to corresponding mammography data from the Breast Cancer Surveillance Consortium (BCSC) registries in four U.S. states (N = 253,727 mammograms received by 120,709 women). We assessed the accuracy of the claims-based classifications of bilateral mammograms as either digital versus film and CAD versus non-CAD relative to a reference standard derived from BCSC data. Claims data correctly classified the large majority of film and digital mammograms (97.2% and 97.3%, respectively), yielding excellent agreement beyond chance (κ = 0.90). Claims data correctly classified the large majority of CAD mammograms (96.6%) but a lower percentage of non-CAD mammograms (86.7%). Agreement beyond chance remained high for CAD classification (κ = 0.83). From 2003 to 2006, the predictive values of claims-based digital and CAD classifications increased as the sample prevalences of each technology increased. Medicare claims data can accurately distinguish film and digital bilateral mammograms and mammograms conducted with and without CAD. The validity of Medicare claims data regarding film versus digital mammography and CAD suggests that these data elements can be useful in research and quality improvement. ©2012 AACR.

[Inter-rater reliability and validity of the OPD-CA axes structure and conflict].

PubMed

Benecke, Cord; Bock, Astrid; Wieser, Elke; Tschiesner, Reinhard; Lochmann, Martha; Küspert, Felicia; Schorn, Robert; Viertler, Bernhard; Steinmayr-Gensluckner, Maria

2011-01-01

The manual of the Operationalized Psychodynamic Diagnostics in childhood and adolescence (OPD-CA) is an instrument meanwhile widespread in the clinical practice to assess psychodynamic dimensions. Publications of inter-rater agreement and validity are still outstanding. This study assessed the interrater-reliability and validity for the axis structure and the axis conflict. 60 adolescents between 14 and 17 years, with and without psychic disorders, were diagnosed with the Operationalized Psychodynamic Diagnostics in childhood and adolescence (Arbeitskreis OPD-KJ, 2007) and SCID-II-interviews and questionnaires. A partial sample of 36 OPD-CA-interviews was the data basis for the assessment of inter-rater agreement. Calculations of validity for axis structure and axis conflict were made with the whole sample. Inter-rater agreement for the axis structure and the axis conflict showed good to very good weighted Kappa coefficients among the trained raters. Validity of the axis structure showed good results. The Operationalized Psychodynamic Diagnostics in childhood and adolescence (OPD-CA) allows a reliable diagnostic of axis structure and axis conflict, if the ratings are done on the basis of semistructured videotaped interviews by trained raters. The axis structure shows validity, while the results concerning the validity of the axis conflict remain unclear.

Using plot experiments to test the validity of mass balance models employed to estimate soil redistribution rates from 137Cs and 210Pb(ex) measurements.

PubMed

Porto, Paolo; Walling, Des E

2012-10-01

Information on rates of soil loss from agricultural land is a key requirement for assessing both on-site soil degradation and potential off-site sediment problems. Many models and prediction procedures have been developed to estimate rates of soil loss and soil redistribution as a function of the local topography, hydrometeorology, soil type and land management, but empirical data remain essential for validating and calibrating such models and prediction procedures. Direct measurements using erosion plots are, however, costly and the results obtained relate to a small enclosed area, which may not be representative of the wider landscape. In recent years, the use of fallout radionuclides and more particularly caesium-137 ((137)Cs) and excess lead-210 ((210)Pb(ex)) has been shown to provide a very effective means of documenting rates of soil loss and soil and sediment redistribution in the landscape. Several of the assumptions associated with the theoretical conversion models used with such measurements remain essentially unvalidated. This contribution describes the results of a measurement programme involving five experimental plots located in southern Italy, aimed at validating several of the basic assumptions commonly associated with the use of mass balance models for estimating rates of soil redistribution on cultivated land from (137)Cs and (210)Pb(ex) measurements. Overall, the results confirm the general validity of these assumptions and the importance of taking account of the fate of fresh fallout. However, further work is required to validate the conversion models employed in using fallout radionuclide measurements to document soil redistribution in the landscape and this could usefully direct attention to different environments and to the validation of the final estimates of soil redistribution rate as well as the assumptions of the models employed. Copyright © 2012 Elsevier Ltd. All rights reserved.

Development and validation of a questionnaire to evaluate the factors influencing training transfer among nursing professionals.

PubMed

Bai, Yangjing; Li, Jiping; Bai, Yangjuan; Ma, Weiguang; Yang, Xiangyu; Ma, Fang

2018-02-13

Most organizations invest in people for training to improve human capital and maximize profitability. Yet it is reported in industry and nursing as well that training effectiveness is constrained because of inadequate transfer of training and the underlying reasons for the transfer problem remain unknown. And there is lack of tool to measure transfer problem. The purpose of this study was to develop and validate a questionnaire to evaluate the scores of factors influencing training transfer (FITT) among nursing professionals. The questionnaire was developed by item generation through interview with nurses and literature review. The FITT was validated in terms of content validity through expert reviews. Psychometric properties of the final instrument were assessed in a sample of 960 nurses with training experiences. The content validity of the instrument were as follows: the IR was 0.8095. 51 items on the 63-item scale had I-CVIs of 1.0 and the remaining 12 items had I-CVIs of 0.88. The S-CVI/UA was 0.976 and the S-CVI/Ave was 0.977. For the exploratory step, principal axis factoring (PAF) was selected for this study. Parallel analysis was used to decide the number of factors to extract and oblimin rotation method was used. Exploratory factor analysis identified a five-factor solution including 53 items, accounting for 68.23% of the total variance. The confirmatory factor analysis showed some support for this five-factor model. The findings demonstrate high internal consistency (Cronbach's alpha = .965). This study indicates that the FITT is a valid and reliable instrument for assessing the factors influencing training transfer among nursing professionals. The FITT can be used to assess individual perceptions of catalysts and barriers to the transfer of training among nursing professionals, which can help promote training transfer and training effectiveness in the workplace.

An analytical Micro CT methodology for quantifying inorganic dentine debris following internal tooth preparation.

PubMed

Robinson, Jonathan P; Lumley, Philip J; Claridge, Ela; Cooper, Paul R; Grover, Liam M; Williams, Richard L; Walmsley, A Damien

2012-11-01

MicroCT allows the complex canal network of teeth to be mapped but does not readily distinguish between structural tissue (dentine) and the debris generated during cleaning. The aim was to introduce a validated approach for identifying debris following routine instrumentation and disinfection. The mesial canals of 12 mandibular molars were instrumented, and irrigated with EDTA and NaOCl. MicroCT images before and after instrumentation and images were assessed qualitatively and quantitatively. Debris in the canal space was identified through morphological image analysis and superimposition of the images before and after instrumentation. This revealed that the removal of debris is prohibited by protrusions and micro-canals within the tooth creating areas which are inaccessible to the irrigant. Although the results arising from the analytical methodology did provide measurements of debris produced, biological differences in the canals resulted in variances. Both irrigants reduced debris compared to the control which decreased with EDTA and further with NaOCl. However, anatomical variation did not allow definitive conclusions on which irrigant was best to use although both reduced debris build up. This work presents a new approach for distinguishing between debris and structural inorganic tissue in root canals of teeth. The application may prove useful in other calcified tissue shape determination. Remaining debris may contain bacteria and obstruct the flow of irrigating solutions into lateral canal anatomy. This new approach for detecting the amount of remaining debris in canal systems following instrumentation provides a clearer methodology of the identification of such debris. Copyright © 2012 Elsevier Ltd. All rights reserved.