Sample records for concorde olympus engine

  1. 78 FR 28634 - Notice of Determinations Regarding Eligibility To Apply for Worker Adjustment Assistance

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-15

    ...)(1); or (C) An affirmative final determination of material injury or threat thereof under section 705... and 76, Owens- Brockway Packaging, Inc. 82,619 Connextions Olympus Program, A Concord, NC... investigations were issued because the petitioning groups of workers are covered by active certifications...

  2. Improvements to the Ontology-based Metadata Portal for Unified Semantics (OlyMPUS)

    NASA Astrophysics Data System (ADS)

    Linsinbigler, M. A.; Gleason, J. L.; Huffer, E.

    2016-12-01

    The Ontology-based Metadata Portal for Unified Semantics (OlyMPUS), funded by the NASA Earth Science Technology Office Advanced Information Systems Technology program, is an end-to-end system designed to support Earth Science data consumers and data providers, enabling the latter to register data sets and provision them with the semantically rich metadata that drives the Ontology-Driven Interactive Search Environment for Earth Sciences (ODISEES). OlyMPUS complements the ODISEES' data discovery system with an intelligent tool to enable data producers to auto-generate semantically enhanced metadata and upload it to the metadata repository that drives ODISEES. Like ODISEES, the OlyMPUS metadata provisioning tool leverages robust semantics, a NoSQL database and query engine, an automated reasoning engine that performs first- and second-order deductive inferencing, and uses a controlled vocabulary to support data interoperability and automated analytics. The ODISEES data discovery portal leverages this metadata to provide a seamless data discovery and access experience for data consumers who are interested in comparing and contrasting the multiple Earth science data products available across NASA data centers. Olympus will support scientists' services and tools for performing complex analyses and identifying correlations and non-obvious relationships across all types of Earth System phenomena using the full spectrum of NASA Earth Science data available. By providing an intelligent discovery portal that supplies users - both human users and machines - with detailed information about data products, their contents and their structure, ODISEES will reduce the level of effort required to identify and prepare large volumes of data for analysis. This poster will explain how OlyMPUS leverages deductive reasoning and other technologies to create an integrated environment for generating and exploiting semantically rich metadata.

  3. Validation of a hospital-laboratory workstation for immunohematologic methods.

    PubMed

    Schoenfeld, Helge; Pretzel, Karin J; von Heymann, Christian; Neuner, Bruno; Kalus, Ulrich; Kiesewetter, Holger; Pruss, Axel

    2010-01-01

    The FREELYS Nano system (Diagast) is a manual workstation for ABO/D grouping, Rh phenotyping, K typing, and antibody screening (ABS) for immunoglobulin G (IgG) antibodies only and works with the erythrocyte-magnetized technology (EMT). The principle of EMT is based on magnetization of red blood cells and avoids centrifugation and washing steps. A total of 304 samples were tested with our routine blood bank methods, 100 samples for ABO/D grouping, 196 samples (100 at first evaluation, 96 at second evaluation) for Rh phenotyping and K typing (PK7200, Olympus), and 108 samples for ABS (DiaMed). All samples were tested in parallel with the FREELYS Nano. We found a 100% concordance between the observed (FREELYS Nano) and the expected (Olympus PK7200) results for ABO/D grouping in all 100 samples. For Rh phenotyping and K tests, in 24 of 100 samples false-positive reactions were observed in the first evaluation by the FREELYS Nano. After changing the test kit batch for Rh phenotyping by the manufacturer, a complete concordance in Rh phenotyping and K tests was observed in a second evaluation. For ABS, the FREELYS Nano showed in 4 of 108 samples (3.7%) false-negative reactions for IgG antibodies (two anti-K, one anti-E, one anti-C(w)), and one (0.9%) false-positive reaction. The FREELYS Nano is reliably suited to ABO/D grouping, Rh phenotyping, and K testing. The rate of false-negative reactions for IgG antibodies should be reduced.

  4. THEMIS analysis of Olympus Mons' mineralogical makeup

    NASA Astrophysics Data System (ADS)

    Chase, N. D.

    2016-12-01

    Olympus Mons is the largest shield volcano in our known solar system. In previous studies, the composition of the basaltic lava flows on Olympus Mons was shown to be similar to the composition of those lava flows of Earth's shield volcanoes. It has been suggested that basalt located near volcanoes contained bacteria living below the surface of the Earth. In this pilot study, the effect of Olympus Mons' aspect (i.e. north- vs. south-facing slope) on its mineral composition was examined. Imagery from Thermal Emission Imaging System (THEMIS), onboard the 2001 Mars Odyssey spacecraft, were used because Olympus Mons' size and surface roughness hinder rover exploration. After removing transmission errors and performing an atmospheric correction, the THEMIS images were ready to be analyzed via a mineral spectral library. Using Arizona State University's Thermal Emission Spectrometer (TES) derived mineral spectral library, the images were classified in ENVI. These classifications were verified using ASU's GIS tool, Java Mission-planning and Analysis for Remote Sensing (JMARS) and TES. Results show a significant amount of silicates located throughout the sampled areas of Olympus Mons. The results also show differences in the mineral composition and in the geological features on Olympus Mons' surface. The minerals vanadinite and halloysite were shown to be prevalent on the sampled southern portions of Olympus Mons, but were sparse on the sampled northern portions. Previous studies suggested that the mineral ilmenite, which this study found in high concentrations on the sampled northern portions of Olympus Mons, might serve as a food source for iron-oxidizing and iron-scavenging bacteria. Future research should focus on better understanding these concentrations on Olympus Mons to see if these minerals play a role in the potential bacterial presence on Olympus Mons.

  5. Using THEMIS and TES to conduct a mineral analysis on Olympus Mons

    NASA Astrophysics Data System (ADS)

    Chase, Nicole Danielle

    2016-10-01

    Olympus Mons is the largest shield volcano in our known solar system. In previous studies, the composition of the basaltic lava flows on Olympus Mons was shown to be similar to the composition of those lava flows of Earth's shield volcanoes. It has been suggested that basalt located near volcanoes contained bacteria living below the surface of the Earth. In this pilot study, the effect of Olympus Mons' aspect (i.e. north- vs. south-facing slope) on its mineral composition was examined. Imagery from Thermal Emission Imaging System (THEMIS), onboard the Mars Odyssey spacecraft, were used because Olympus Mons' size and surface roughness hinder rover exploration. After removing transmission errors and performing an atmospheric correction, the THEMIS images were ready to be analyzed via a mineral spectral library. Using Arizona State University's Thermal Emission Spectrometer (TES) derived mineral spectral library, the images were classified in ENVI. These classifications were verified using ASU's GIS tool, Java Mission-planning and Analysis for Remote Sensing (JMARS) and TES. Results show differences in the mineral composition and in the geological features on Olympus Mons' surface. The mineral vanadinite was shown to be prevalent on the sampled southern portions of Olympus Mons, but was sparse on the sampled northern portions. Previous studies suggested that the mineral ilmenite, which this study found in high concentrations on the sampled northern portions of Olympus Mons, might serve as a food source for iron-oxidizing and iron-scavenging bacteria. Future research should focus on better understanding the concentrations of vanadinite and ilmenite on Olympus Mons to see if these minerals have a role in the potential presence of bacteria on Olympus Mons.

  6. The Ascent of Olympus - An Everest Anniversary Perspective

    NASA Astrophysics Data System (ADS)

    Cockell, C. S.

    Olympus Mons, at 21,183 m above the Mars gravitational equipotential, stands just under 2.5 times the height of Mount Everest. Symbolically, as the highest construct in the Solar System, it is the most important feature to be climbed. Despite its powerful symbolism, the mountain presents one of the most tedious long distance expeditions on Mars - a ~300 km journey up a near constant 5 degree slope. Only at the beginning and the end of the expedition do the scarp and caldera cliffs present impressive climbs. In almost all respects Olympus presents environmental challenges much worse than Everest, apart from the lack of fatal storms, perhaps the only environmental factor in which Olympus is an improvement. Similarly to Everest, Olympus presents scien- tific questions of immense interest. In this mini-review I compare Olympus and Everest as exploratory and scientific challenges.

  7. Product Plan of New Generation System Camera "OLYMPUS PEN E-P1"

    NASA Astrophysics Data System (ADS)

    Ogawa, Haruo

    "OLYMPUS PEN E-P1", which is new generation system camera, is the first product of Olympus which is new standard "Micro Four-thirds System" for high-resolution mirror-less cameras. It continues good sales by the concept of "small and stylish design, easy operation and SLR image quality" since release on July 3, 2009. On the other hand, the half-size film camera "OLYMPUS PEN" was popular by the concept "small and stylish design and original mechanism" since the first product in 1959 and recorded sale number more than 17 million with 17 models. By the 50th anniversary topic and emotional value of the Olympus pen, Olympus pen E-P1 became big sales. I would like to explain the way of thinking of the product plan that included not only the simple functional value but also emotional value on planning the first product of "Micro Four-thirds System".

  8. Hypersonic Technology Developments with EU Co-Funded Projects

    DTIC Science & Technology

    2010-09-01

    metal or even high performance alloys . The hollow sphere technology allows high degrees of porosities, reproducible properties and fair process control...sandwich structure configuration will be investigated. Titanium alloys and Ti-aluminides exhibit excellent mechanical properties for applications where...cooling techniques, new alloys , improved thermodynamic cycles by increased pressure ratios and TIT, etc… As the Olympus 593 engine was based on the

  9. The Olympus satellite and satellite direct broadcasting in Italy

    NASA Astrophysics Data System (ADS)

    Castelli, E.; Tirro, S.

    Plans for the development of DBS-TV technology in Italy are discussed from the perspective of the Italian electronics industry, with an emphasis on experimental broadcasts using the Olympus satellite channel assigned to Italy by ESA. Consideration is given to the operating characteristics of PAL, MAC-C, MAC-D2, extended-MAC, and MUSE color-TV systems and their compatibility with DBS; the planned availability of TV channels on Olympus-type and Italsat-type satellites; individual, community, and CATV reception of DBS signals; the projected growth of the DBS audience in Italy, the UK, and the FRG by 1999; and the potential Italian market for satellite receivers and antennas. The need for prompt completion and evaluation of the Olympus experiments and antennas. The need for prompt completion and evaluation of the Olympus experiments (beginning in 1987) and selection of the systems to be implemented, so that the industry can supply the home equipment required on time, is stressed. Tables of numerical data and maps of the Olympus coverage areas are provided.

  10. Through Life Management of Naval Gas Turbines for Extended Service Lives and Reduced Lifetime Costs

    DTIC Science & Technology

    2003-02-01

    The following component part numbers comprise the compilation report: ADP014092 thru ADP014141 UNCLASSIFIED (SYB) 4- 1 Through Life Management of...fleet for repair or overhaul. In addition, and in (CODLAG) mode of operation (Figure 1 ) or in a Combined terms of the economy of scale advantages that the...O IVý ,tV44tI. 1Engine 1 *fl Spare Total ..- ......... h...t ....... Variant l Engines 0 RN RNLN BN FN fI~T~ Olympus 43 12 3 14 17 89 Figure 1 - Type

  11. [Study of Image Quality Comparison Based on the MTF Method Between Different Medical Rigid Endoscopes in an In Vitro Model].

    PubMed

    Wang, Yunlong; Ji, Jun; Jiang, Changsong; Huang, Zengyue

    2015-04-01

    This study was aimed to use the method of modulation transfer function (MTF) to compare image quality among three different Olympus medical rigid cystoscopes in an in vitro model. During the experimental processes, we firstly used three different types of cystoscopes (i. e. OLYMPUS cystourethroscopy with FOV of 12 degrees, OLYMPUS Germany A22003A and OLYMPUS A2013A) to collect raster images at different brightness with industrial camera and computer from the resolution target which is with different spatial frequency, and then we processed the collected images using MALAB software with the optical transfer function MTF to obtain the values of MTF at different brightness and different spatial frequency. We then did data mathematical statistics and compared imaging quality. The statistical data showed that all three MTF values were smaller than 1. MTF values with the spatial frequency gradually increasing would decrease approaching 0 at the same brightness. When the brightness enhanced in the same process at the same spatial frequency, MTF values showed a slowly increasing trend. The three endoscopes' MTF values were completely different. In some cases the MTF values had a large difference, and the maximum difference could reach 0.7. Conclusion can be derived from analysis of experimental data that three Olympus medical rigid cystoscopes have completely different imaging quality abilities. The No. 3 endoscope OLYMPUS A2013A has low resolution but high contrast. The No. 1 endoscope OLYMPUS cystourethroscopy with FOV of 12 degrees, on the contrary, had high resolution and lower contrast. The No. 2 endoscope OLYMPUS Germany A22003A had high contrast and high resolution, and its image quality was the best.

  12. Olympus Mons

    NASA Astrophysics Data System (ADS)

    Murdin, P.

    2000-11-01

    The largest volcano on Mars, and the largest in the solar system, centered at 18.4 °N, 133.1 °W. It coincides with the albedo feature visible from Earth known as Nix Olympica, the `Snows of Olympus', after the mountain in Greece which in legend was the home of the gods. Olympus Mons rises to a height of 27 km above Mars's mean surface level, and in its greatest horizontal dimension measures 624 k...

  13. OPEX: (Olympus Propagation EXperiment)

    NASA Technical Reports Server (NTRS)

    Brussaard, Gert

    1988-01-01

    The Olympus-1 satellite carries four distinct payloads for experimental utilization and research in the field of satellite communications: (1) the Direct Broadcasting Service (DBS) payload; (2) the Specialized Services Payload; (3) the 20/30 GHz Advanced Communications Payload; and (4) the Propagation Payload. Experimental utilization of the first three payloads involves ground transmissions to the satellite and hence sharing of available satellite time among experimenters. This is coordinated through the Olympus Utilization Program.

  14. Earth Observations taken by the Expedition 10 crew

    NASA Image and Video Library

    2004-11-22

    ISS010-E-08224 (22 November 2004) --- Mount Olympus, Greece is featured in this image photographed by an Expedition 10 crewmember on the International Space Station (ISS). Mount Olympus is the highest peak (2917 meters) in Greece, as well as the mountain chain that runs north into Bulgaria and south, via the Cyclades Islands, into Turkey. In this winter view, Olympus is the only peak with a dusting of snow—perhaps for this reason its name in classical Greek means “the luminous one.” In Greek mythology the peak was inhabited by the Twelve Olympians, the most famous gods of the ancient Greeks. North of Mount Olympus lies Macedonia, the homeland of Alexander the Great. Climbing the mountain is a favorite tourist activity today. The slopes of the peaks of Olympus and its neighboring peaks drop sheer into the Thermaikos Gulf, a northern arm of the Aegean Sea. White cirrus clouds obscure the shoreline near the city of Thessaloniki. This major port is spread along the shores of a small and well protected bay at the north end of the gulf. On the plains inland of the Olympus chain lie a lake, on the Aliakmon River, and the town of Larisa, at the focus point of a series of transport routes.

  15. Flank vents and graben as indicators of Late Amazonian volcanotectonic activity on Olympus Mons

    NASA Astrophysics Data System (ADS)

    Peters, S. I.; Christensen, P. R.

    2017-03-01

    Previous studies have focused on large-scale features on Olympus Mons, such as its flank terraces, the summit caldera complex, and the basal escarpment and aureole deposits. Here we identify and characterize previously unrecognized and unmapped small scale features to help further understand the volcanotectonic evolution of this enormous volcano. Using Context Camera, High Resolution Imaging Science Experiment, Thermal Emission Imaging System, High Resolution Stereo Camera Digital Terrain Model, and Mars Orbiter Laser Altimeter data, we identified and characterized the morphology and distribution of 60 flank vents and 84 grabens on Olympus Mons. We find that effusive eruptions have dominated volcanic activity on Olympus Mons in the Late Amazonian. Explosive eruptions were rare, implying volatile-poor magmas and/or a lack of magma-water interactions during the Late Amazonian. The distribution of flank vents suggests dike propagation of hundreds of kilometers and shallow magma storage. Small grabens, not previously observed in lower-resolution data, occur primarily on the lower flanks of Olympus Mons and indicate late-stage extensional tectonism. Based on superposition relationships, we have concluded two stages of development for Olympus Mons during the Late Amazonian: (1) primarily effusive resurfacing and formation of flank vents followed by (2) waning effusive volcanism and graben formation and/or reactivation. This developmental sequence resembles that proposed for Ascraeus Mons and other large Martian shields, suggesting a similar geologic evolution for these volcanoes.

  16. Hard two-photon contribution to elastic lepton-proton scattering determined by the OLYMPUS experiment

    NASA Astrophysics Data System (ADS)

    Hasell, D. K.; OLYMPUS Collaboration

    2018-02-01

    The OLYMPUS collaboration has recently made a precise measurement of the positron-proton to electron-proton elastic scattering cross section ratio, R 2γ, over a wide range of the virtual photon polarization, 0.456 < ɛ < 0.978. This provides a direct measure of hard two-photon exchange in elastic lepton-proton scattering widely thought to explain the discrepancy observed between unpolarized and polarized measurements of the proton form factor ratio, {μ }p{G}Ep/{G}Mp. The OLYMPUS results are small, within 1% on unity, over the range of momentum transfers measured and significantly lower than theoretical calculations that can explain part of the observed discrepancy in terms of two-photon exchange at higher momentum transfers. However, the results are in reasonable agreement with predictions based on phenomenological fits to the available form factor data. The motivation for measuring R 2γ will be presented followed by a description of the OLYMPUS experiment. The importance of radiative corrections in the analysis will be shown also. Then we will present the OLYMPUS results and compare with results from two similar experiments and theoretical calculations.

  17. A proposed origin of the Olympus Mons escarpment. [Martian volcanic feature

    NASA Technical Reports Server (NTRS)

    King, J. S.; Riehle, J. R.

    1974-01-01

    Olympus Mons (Nix Olympica) on Mars is delimited by a unique steep, nearly circular scarp. A pyroclastic model is proposed for the construct's origin. It is postulated that the Olympus Mons plateau is constructed predominantly of numerous ash-flow tuffs which were erupted from central sources over an extended period of time. Lava flows may be intercalated with the tuffs. A schematic radial profile incorporating the inferred compaction zones for an ash sheet is proposed. Following emplacement, eolian (and possibly fluvial) erosion and abrasion during dust storms would act on the ash sheets. Interior portions of the sheets would spall and slump following eolian erosion, generating steep, relatively smooth boundary scarps. The scarp would be circular due to symmetrical distribution of compaction zones. The model implies further that the Olympus Mons plateau rests on a more resistant rock substrate.

  18. Refinement of ERCP by using the Olympus V-scope system with a 0.025 in. compatible and complete fixable Visiglide(®) guidewire.

    PubMed

    Raithel, Martin; Naegel, Andreas; Seidel, Sebastian; Raithel, Sandra; Diebel, Hiwot; Neurath, Markus F; Maiss, Juergen

    2011-10-01

    Prospective evaluation of the new 0.025 in. Visiglide(®) guidewire to facilitate endoscopic retrograde cholangiopancreaticography using the Olympus V-scope. Interventional endoscopic retrograde cholangiopancreaticography was performed in 9 patients with the Olympus V-scope and the 0.025 in. Visiglide(®) guidewire (VS group), whilst 9 other patients underwent endoscopic retrograde cholangiopancreaticography with a conventional Olympus duodenoscope using 0.035 in. conventional guidewires (controls). Exchange time of accessories, X-ray time, dose and endoscopic retrograde cholangiopancreaticography examination time were investigated. The VS group showed a significantly lower exchange time of endoscopic retrograde cholangiopancreaticography accessories (9; 4-10s, p<0.0001) than controls (29; 19-44s). The Visiglide(®) guidewire was complete fixable by the elevator in 35/36 instrument exchanges (97%) compared to 16/31 exchanges (52%) using conventional guidewires. Single-centre study, small patient numbers, two investigators. Endoscopic retrograde cholangiopancreaticography using the Olympus V-scope with the new 0.025 in. Visiglide(®) guidewire enables a 3-fold faster exchange of accessories due to a nearly complete fixation of the guidewire. Copyright © 2011 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  19. Modeling Olympus Mons from the Earth.

    ERIC Educational Resources Information Center

    Lebofsky, Nancy R.; Lebofsky, Larry A.

    2002-01-01

    Presents a science activity using cubes for constructing the "Olympus Mons" model, the largest known volcano in the solar system. Uses the Catalina Mountains as a real-life comparison and builds a scale-proportionate model. (YDS)

  20. Preliminary Volcanic Feature Analysis of Olympus Mons and Ascraeus Mons, Mars

    NASA Astrophysics Data System (ADS)

    Mohr, K. J.; Williams, D. A.; Garry, W. B.; Bleacher, J. E.

    2018-06-01

    Geologic mapping has shown similar volcanic features observed on Olympus and Ascraeus Mons. These features are found on the same flanks, suggesting a similar evolutionary process for formation of the edifices.

  1. Comparison of Flexible Ureterorenoscope Quality of Vision: An In Vitro Study.

    PubMed

    Talso, Michele; Proietti, Silvia; Emiliani, Esteban; Gallioli, Andrea; Dragos, Laurian; Orosa, Andrea; Servian, Pol; Barreiro, Aaron; Giusti, Guido; Montanari, Emanuele; Somani, Bhaskar; Traxer, Olivier

    2018-06-01

    Flexible ureterorenoscopy (fURS) is one of the best solutions for treatment of renal calculi <2 cm and for upper urinary tract urothelial carcinoma conservative treatment. An adequate quality of vision is mandatory to help surgeon get better outcomes. No studies have been done, to our knowledge, about what fURS in the market has the best quality of vision. Seven different fURS were used to compare the image quality (Lithovue, Olympus V, Olympus V2, Storz Flex XC-in White Light and in Clara+Chroma mode-Wolf Cobra Vision, Olympus P6, and Storx Flex X2). Two standardized grids to evaluate contrast and image definition and three stones of different composition were filmed in four standardized different scenarios. These videos were shown to 103 subjects (51 urologists and 52 nonurologists) who had to evaluate them with a rating scale from 1 (very bad) to 5 (very good). No difference in terms of scores was observed for sex of the participants. Digital (D) ureterorenoscopes were rated better than fiber optics (FOs) ureterorenoscopes. Overall, Flex XC White Light and XC Clara+Chroma image quality resulted steadily better than other fURS (p < 0.0001). Olympus V generally provided a vision better than Lithovue. Cobra Vision and Olympus V2 had superimposable values that were significantly lower than Lithovue's ones. Olympus P6 and Storz X2 offered a low quality of vision compared to the others. In the medium simulating bleeding, Olympus V and V2 significantly improved their scores of 12% and 8.1%, contrary to rest of the ureterorenoscopes. D ureterorenoscopes have a better image quality than FO ones. The only disposable ureterorenoscope tested was comparable to the majority of other D ureterorenoscopes. The best image quality was provided by Storz D ureterorenoscopes, being Clara Chroma the favorite Spies Mode, according to literature.

  2. Topography of the shield volcano, Olympus Mons on Mars

    USGS Publications Warehouse

    Wu, S.S.C.; Garcia, P.A.; Jordan, R.; Schafer, F.J.; Skiff, B.A.

    1984-01-01

    Olympus Mons, one of the largest known shield volcanoes in the Solar System, covers an area of >3.2 ?? 105 km2and has a diameter of >600 km, excluding its vast aureole deposits. The structure is five times larger than the largest shield volcano on the Earth. It is situated on the north-west flank of the Tharsis volcanic region, a broad topographic rise on the martian surface. The volcano has three physical subdivisions: the summit caldera, the terraced upper flanks, and the lower flanks, which terminate in a scarp 2-10 km high that nearly surrounds the structure. A large block of images of the Tharsis region, including Olympus Mons, was obtained by the Viking mission1. Here we present a topographic map of Olympus Mons, compiled using various combinations of stereo pairs of these images, together with stereoscopic perspective views generated by image processing techniques. ?? 1984 Nature Publishing Group.

  3. Olympus Mons - False Color

    NASA Image and Video Library

    2015-01-05

    The THEMIS VIS camera contains 5 filters. The data from different filters can be combined to create a false color image. This false color image from NASA 2001 Mars Odyssey spacecraft shows part of the caldera at the summit of Olympus Mons.

  4. Anaglyph of the Basal Scarp of Olympus Mons Volcano

    NASA Image and Video Library

    2007-01-17

    This anaglyph from NASA Mars Reconnaissance Orbiter spacecraft, shows Olympus Mons, the largest volcano in the Solar System. Constructed of lava flows, many aspects of this titanic volcano remain puzzling. 3D glasses are necessary to view this image.

  5. Caldera subsidence and magma chamber depth of the Olympus Mons volcano, Mars

    NASA Technical Reports Server (NTRS)

    Zuber, M. T.; Mouginis-Mark, P. J.

    1992-01-01

    An axisymmetric finite element model is constructed to calculate elastic stresses in a volcanic edifice to examine the relationship between surface tectonism, caldera subsidence, and the physical characteristics of Olympus Mons' magmatic reservoir. Model results indicate that the surface stress state is not strongly sensitive to the aspect ratio or pressure distribution of the magma chamber, or to the contrast in stiffness between the magma chamber and surroundings, but is strongly dependent on the depth and width of the chamber. A gross similarity is suggested between the configurations of the magmatic plumbing systems of Olympus Mons and several well-studied terrestrial volcanoes such as the Hawaiian shields.

  6. The pristine shape of Olympus Mons on Mars and the subaqueous origin of its aureole deposits

    NASA Astrophysics Data System (ADS)

    De Blasio, Fabio Vittorio

    2018-03-01

    The tallest volcano in the solar system, Olympus Mons on Mars, is bordered by at least ten enormous sub-circular hummocky deposits forming a welded halo, termed the aureole. The aureole units (or simply aureoles), which are the deposits of landslides from Olympus Mons, have dramatically transformed the pristine size and shape of the volcanic edifice. Topographic data are used to determine the amount of collapsed material, and so reconstruct the original outline of Olympus Mons before the landslides took place, under the assumption that the edifice did not start failing until it had reached this maximum size. Due to post-aureole deposition on the eastern and southern flanks and to the uncertainty of the slippage level on the northern side, the reconstruction is sufficiently precise along the western and north-western Olympus Mons flank, it is more uncertain for the northern flank, while it is not feasible around the rest of the volcano. It appears that the radius along the western and north-western Olympus Mons before the collapse of the aureole landslides was approximately 200 km longer or more. The results show that the volume of the aureoles, even if enormous, is insufficient to fill the ideal conical edifice which would be obtained prolonging the Olympus Mons flanks with present slope angles. Thus, an overhang remains in the pre-aureole reconstructed Olympus Mons, which would also explain the onset of instability that led to the aureole collapse. Further, a drape deposit blanketing the southern Acheron Fossae ridge just at the front of the western (W) aureole landslide deposit and a fan-channel system carved on the same W aureole are investigated, and it is suggested that these morphologies have been emplaced in subaqueous setting. While the drape may indicate a landslide-thrust water splash akin to a tsunami deposit caused by the fast travelling W aureole landslide, the fan-channel system is similar to certain morphologies in the terrestrial oceans. A numerical model of the collapse of the western aureole unit in water shows final runouts on both Acheron ridge and Amazonis Planitia compatible with observations provided that the friction angle is extremely small, of the order of a tenth of degree. Simulations indicate that the W aureole could have reached Acheron Fossae ridge with velocities in excess of 100 m/s, which would explain the several tens of km long distance reached by the landslide-thrust tsunami deposit. In short, morphological and numerical lines of evidence would indicate a subaqueous origin for the largest, W aureole landslide.

  7. Olympus Mons, Mars: Constraints on Lava Flow Silica Composition

    NASA Astrophysics Data System (ADS)

    Kirshner, M.; Jurdy, D. M.

    2016-12-01

    Olympus Mons, Mars, the largest known volcano in our solar system, contains numerous enigmatic lava flow features. Lava tubes have received attention as their final morphologies may offer habitable zones for both native life and human exploration. Such tubes were formed through mechanisms involving several volatile species with significant silica content. Olympus Mons, a shield volcano, might be expected to have flows with silica content similar to that of terrestrial basaltic flows. However, past investigations have estimated a slightly more andesitic composition. Data pertaining to lava tubes such as flow width and slope are collected from the Mars Reconnaissance Orbiter's Context Camera, Mars Odyssey's THEMIS instrument, and Mars Express' HRSC instrument. Compiling this data in GIS software allows for extensive mapping and analysis of Olympus Mons' seemingly inactive flow features. A rheological analysis performed on 62 mapped lava tubes utilizes geometric parameters inferred from mapping. Lava was modeled as a Bingham fluid on an inclined plane, allowing for the derivation of lava yield stress. Percent silica content was calculated for each of the 62 mapped flows using a relationship derived from observations of terrestrial lava yield strengths and corresponding silica composition. Results indicate that lava tube flows across Olympus Mons were on average basaltic in nature, occasionally reaching into the andesitic classification: percent silica content is 51% on average and ranges between roughly 40% and 57%.

  8. Olympus Imaging Fraud Scandal: A Case Study

    ERIC Educational Resources Information Center

    Elam, Dennis; Madrigal, Marion; Jackson, Maura

    2014-01-01

    This case examines the two decade long tobashi scheme by Olympus Imaging Executives to hide $1.7 billion in losses. In the 1980s, a soaring yen and falling dollar caused bottom line income problems for many Japanese companies. Some companies sought to offset the declining revenue with zaiteku, a form of speculative investment. While early…

  9. Design of a hybrid receiver for the OLYMPUS spacecraft beacons

    NASA Technical Reports Server (NTRS)

    Sweeney, D. G.; Mckeeman, J. C.

    1990-01-01

    The theory and design of a hybrid analogue/digital receiver which acquires and monitors the OLYMPUS satellite beacons is presented. The analogue portion of this receiver uses a frequency locked loop for signal tracking. A digital sampling detector operating at IF is used to obtain the I and Q outputs.

  10. Status of the Olympus experiment at CRC

    NASA Technical Reports Server (NTRS)

    Rogers, David V.

    1992-01-01

    The status of the Olympus Propagation Experiment of the Communications Research Centre in Ottawa, Canada, is briefly summarized. Path attenuation measurements at multiple frequencies correlated with concurrent dual polarized radar data provide a unique method to investigate propagation effects. An experiment of this type is being implemented by the Communications Research Centre (CRC) on the grounds of the National Research Council of Canada in Ottawa. Beacon receivers monitor signals from the Olympus satellite at 12.5, 19.77, and 29.66 GHz at a path elevation angle of 14.2 deg. Sky noise radiometers operating near the same frequencies and pointed along the same path provide additional propagation information. A colocated dual-polarized 9.6-GHz radar probes the precipitation state on the path, permitting identification of precipitation regimes that cause the observed impairments. The Olympus experiment configuration is displayed pictorially. Information on path propagation phenomena can be deduced by correlating the radar, beacon, and sky noise data. Melting layer effects and propagation losses for higher time percentages are prime interests. Data collected by Diversitel Communications during equipment verification tests are presented.

  11. Evaluation of immunohematologic routine methods using the new erythrocyte-magnetized technology on the QWALYS 2 system.

    PubMed

    Schoenfeld, Helge; Bulling, Katia; von Heymann, Christian; Neuner, Bruno; Kalus, Ulrich; Kiesewetter, Holger; Pruss, Axel

    2009-07-01

    QWALYS 2 is a fully automated system for ABO/D grouping, Rh phenotyping, K typing, and antibody screening (ABS). Its new erythrocyte-magnetized technology (EMT) is based on the use of magnetic nanoparticles and avoids centrifugation and washing steps. Overall 499 blood samples were tested with our routine blood bank methods for ABO/D grouping, 313 samples for Rh phenotyping and K typing (microtiter plates; Olympus PK 7200), and 478 samples for ABS (gel centrifugation technique, DiaMed). All samples were tested in parallel with the EMT. In 496 of 499 samples (99.4%), a complete concordance between the observed (QWALYS 2) and the expected results for ABO/D grouping was found. One sample with a weak A in an AB blood group and 2 samples with a weak D were not detected by the QWALYS system. Rh phenotyping and K tests revealed a 100% concordance. In the two ABS techniques, 427 samples were negative in both and 15 samples showed the same antibody specificity in both. Three immunoglobulin M antibodies were as expected negative in EMT and positive by DiaMed. In 32 cases (6.7%), false-positive reactions were observed by EMT due to 22 unspecific reactions (4.6%) and 10 lipemic or fibrinic plasmas (2.1%). One autoantibody was found by EMT only. The EMT is reliably suited to ABO/D grouping, Rh phenotyping, and K testing and is suitable to detect immunoglobulin G red blood cell alloantibodies as well. The rate of false-positive reactions in ABS due to lipemic and fibrinic samples needs to be reduced.

  12. Olympus propagation studies in the US: Propagation terminal hardware and experiments

    NASA Technical Reports Server (NTRS)

    Stutzmzn, Warren L.

    1990-01-01

    Virginia Tech is performing a comprehensive set of propagation measurements using the Olympus satellite beacons at 12.5, 20, and 30 GHz. These data will be used to characterize propagation conditions on small earth terminal (VSAT)-type networks for next generation small aperture Ka-band systems. The European Space Agency (ESA) satellite Olympus was launched July 12, 1989. The spacecraft contains a sophisticated package of propagation beacons operating at 12.5, 19.77, and 29.66 GHz (referred to as 12.5, 20, and 30 beacons). These beacons cover the east coast of the United States with sufficient power for attenuation measurements. The Virginia Satellite Communications Group is completing the hardware construction phase and will begin formal data collection in June.

  13. What now, Asclepius? Lessons from Olympus.

    PubMed

    Moore, M R

    1996-10-01

    Asclepius, the Greek and Roman god of healing, is called before a council of gods on Mount Olympus to account for the shortcomings of his mortal descendants, the present day physicians. Accusations by the gods and Asclepius' defense and explanation bring the gods an understanding of human history and what physicians must become if humanity is to triumph over disease. Asclepius hopes the modern medical profession will understand also.

  14. Major Martian Volcanoes from MOLA - Olympus Mons

    NASA Technical Reports Server (NTRS)

    2000-01-01

    Two views of Olympus Mons, shown as topography draped over a Viking image mosaic. MOLA's regional topography has shown that this volcano sits off to the west of the main Tharsis rise rather than on its western flank. The topography also clearly shows the relationship between the volcano's scarp and massive aureole deposit that was produced by flank collapse. The vertical exaggeration is 10:1.

  15. Global Citizenship Education within a Context of Accountability and 21st Century Skills: The Case of Olympus High School

    ERIC Educational Resources Information Center

    DiCicco, Marzia Cozzolino

    2016-01-01

    This article addresses the present gap in empirical research on the possibilities and challenges of global citizenship education in U.S. public schools by presenting findings from a five-year, ethnographic case study. The setting for this study is Olympus High School, a small, suburban public high school in Pennsylvania. Beginning in the 2009-2010…

  16. Latin, the Key to English Vocabulary. A Gamebook on English Derivatives and Cognates to Accompany "Voces de Olympo" (Echoes from Mt. Olympus).

    ERIC Educational Resources Information Center

    Masciantonio, Rudolph

    This gamebook is intended to assist the grade school (FLES) Latin teacher to introduce the reading and writing of English derivatives and cognates after these have been mastered audiolingually in Philadelphia's Latin course "Voces de Olympo (Echoes from Mt. Olympus): A Humanistic Approach to Latin for Children in the Sixth Grade." Games are…

  17. Effort to recover SOHO spacecraft continue as investigation board focuses on most likely causes

    NASA Astrophysics Data System (ADS)

    1998-07-01

    Meanwhile, the ESA/NASA investigation board concentrates its inquiry on three errors that appear to have led to the interruption of communications with SOHO on June 25. Officials remain hopeful that, based on ESA's successful recovery of the Olympus spacecraft after four weeks under similar conditions in 1991, recovery of SOHO may be possible. The SOHO Mission Interruption Joint ESA/NASA Investigation Board has determined that the first two errors were contained in preprogrammed command sequences executed on ground system computers, while the last error was a decision to send a command to the spacecraft in response to unexpected telemetry readings. The spacecraft is controlled by the Flight Operations Team, based at NASA's Goddard Space Flight Center, Greenbelt, MD. The first error was in a preprogrammed command sequence that lacked a command to enable an on-board software function designed to activate a gyro needed for control in Emergency Sun Reacquisition (ESR) mode. ESR mode is entered by the spacecraft in the event of anomalies. The second error, which was in a different preprogrammed command sequence, resulted in incorrect readings from one of the spacecraft's three gyroscopes, which in turn triggered an ESR. At the current stage of the investigation, the board believes that the two anomalous command sequences, in combination with a decision to send a command to SOHO to turn off a gyro in response to unexpected telemetry values, caused the spacecraft to enter a series of ESRs, and ultimately led to the loss of control. The efforts of the investigation board are now directed at identifying the circumstances that led to the errors, and at developing a recovery plan should efforts to regain contact with the spacecraft succeed. ESA and NASA engineers believe the spacecraft is currently spinning with its solar panels nearly edge-on towards the Sun, and thus not generating any power. Since the spacecraft is spinning around a fixed axis, as the spacecraft progresses in its orbit around the Sun, the orientation of the panels with respect to the Sun should gradually change. The orbit of the spacecraft and the seasonal change in the spacecraft-Sun alignment should result in the increased solar illumination of the spacecraft solar arrays over the next few months. The engineers predict that in late September 1998, illumination of the solar arrays and, consequently, power supplied to the spacecraft, should approach a maximum. The probability of successfully establishing contact reaches a maximum at this point. After this time, illumination of the solar arrays gradually diminishes as the spacecraft-Sun alignment continues to change. In an attempt to recover SOHO as soon as possible, the Flight Operations Team is uplinking commands to the spacecraft via NASA's Deep Space Network, managed by NASA's Jet Propulsion Laboratory, Pasadena, CA, approximately 12 hours per day with no success to date. A recovery plan is under development by ESA and NASA to provide for orderly restart of the spacecraft and to mitigate risks involved. The recovery of the Olympus spacecraft by ESA in 1991 under similar conditions leads to optimism that the SOHO spacecraft may be recoverable once contact is re-established. In May 1991, ESA's Olympus telecommunications satellite experienced a similar major anomaly which resulted in the loss of attitude, leading to intermittent power availability. As a consequence, there was inadequate communication, and the batteries and fuel froze. From analysis of the data available prior to the loss, there was confidence that the power situation would improve over the coming months. A recovery plan was prepared, supported by laboratory tests, to assess the characteristics of thawing batteries and propellants. Telecommand access of Olympus was regained four weeks later, and batteries and propellant tanks were thawed out progressively over the next four weeks. The attitude was then fully recovered and the payload switched back on three months after the incident. Equipment damage was sustained as a result of the low temperatures, but nothing significant enough to prevent the successful resumption of the mission. The experience of Olympus is being applied, where possible, to SOHO and increases the hope of also recovering this mission. Estimating the probability of recovery is made difficult by a number of unknown spacecraft conditions. Like Olympus, the hydrazine fuel and batteries may be frozen. Thermal stress may have damaged some of the scientific instruments as well. If the rate of spin is excessive, there may have been structural damage. SOHO engineers can reliably predict the spacecraft's orbit through November 1998. After that time, the long-term orbital behavior becomes dependent on the initial velocity conditions of the spacecraft at the time of the telemetry loss. These are not known precisely, due to spacecraft thruster activity that continued after loss of telemetry, so orbital prediction becomes very difficult.

  18. OLYMPUS: an automated hybrid clustering method in time series gene expression. Case study: host response after Influenza A (H1N1) infection.

    PubMed

    Dimitrakopoulou, Konstantina; Vrahatis, Aristidis G; Wilk, Esther; Tsakalidis, Athanasios K; Bezerianos, Anastasios

    2013-09-01

    The increasing flow of short time series microarray experiments for the study of dynamic cellular processes poses the need for efficient clustering tools. These tools must deal with three primary issues: first, to consider the multi-functionality of genes; second, to evaluate the similarity of the relative change of amplitude in the time domain rather than the absolute values; third, to cope with the constraints of conventional clustering algorithms such as the assignment of the appropriate cluster number. To address these, we propose OLYMPUS, a novel unsupervised clustering algorithm that integrates Differential Evolution (DE) method into Fuzzy Short Time Series (FSTS) algorithm with the scope to utilize efficiently the information of population of the first and enhance the performance of the latter. Our hybrid approach provides sets of genes that enable the deciphering of distinct phases in dynamic cellular processes. We proved the efficiency of OLYMPUS on synthetic as well as on experimental data. The discriminative power of OLYMPUS provided clusters, which refined the so far perspective of the dynamics of host response mechanisms to Influenza A (H1N1). Our kinetic model sets a timeline for several pathways and cell populations, implicated to participate in host response; yet no timeline was assigned to them (e.g. cell cycle, homeostasis). Regarding the activity of B cells, our approach revealed that some antibody-related mechanisms remain activated until day 60 post infection. The Matlab codes for implementing OLYMPUS, as well as example datasets, are freely accessible via the Web (http://biosignal.med.upatras.gr/wordpress/biosignal/). Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  19. Comparison of OLYMPUS beacon and radiometric attenuation measurements at Blacksburg, Virginia

    NASA Technical Reports Server (NTRS)

    Snider, J. B.; Jacobson, M. D.; Beeler, R. H.; Hazen, D. A.

    1991-01-01

    Measurements of attenuation of the 20 and 30 GHz beacons onboard the OLYMPUS satellite are compared to simultaneous observations of atmospheric attenuation by a multichannel microwave radiometer along the same path. Departures from high correlation between the two measurements are believed to be related to differences in antenna beamwidths. Mean equivalent zenith attenuations derived from the slant path data are compared to zenith observations made at previous locations.

  20. Ridges and Flows

    NASA Image and Video Library

    2015-11-16

    Located southwest of Olympus Mons, this image captured by NASA 2001 Mars Odyssey spacecraft shows part of a complex region that has undergone several geologic processes. The hills have been modified by wind, creating narrow ridges, and then the entire region has been covered with volcanic flows from Olympus Mons. Orbit Number: 60744 Latitude: 13.4267 Longitude: 220.554 Instrument: VIS Captured: 2015-08-24 10:00 http://photojournal.jpl.nasa.gov/catalog/PIA20093

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

    Thomas, P.J.; Squyres, S.W.; Carr, M.H.

    On the flanks of Olympus Mons is a series of terraces, concentrically distributed around the caldera. Their morphology and location suggest that they could be thrust faults caused by compressional failure of the cone. In an attempt to understand the mechanism of faulting and the possible influences of the interior structure of Olympus Mons, the authors have constructed a numerical model for elastic stresses within a Martian volcano. In the absence of internal pressurization, the middle slopes of the cone are subjected to compressional stress, appropriate to the formation of thrust faults. These stresses for Olympus Mons are {approximately}250 MPa.more » If a vacant magma chamber is contained within the cone, the region of maximum compressional stress is extended toward the base of the cone. If the magma chamber is pressurized, extensional stresses occur at the summit and on the upper slopes of the cone. For a filled but unpressurized magma chamber, the observed positions of the faults agree well with the calculated region of high compressional stress. Three other volcanoes on Mars, Ascraeus Mons, Arsia Mons, and Pavonis Mons, possess similar terraces. Extending the analysis to other Martian volcanoes, they find that only these three and Olympus Mons have flank stresses that exceed the compressional failure strength of basalt, lending support to the view that the terraces on all four are thrust faults.« less

  2. Mars gravity: high-resolution results from viking orbiter 2.

    PubMed

    Sjogren, W L

    1979-03-09

    Doppler radio-tracking data have provided detailed measurements for a martian gravity map extending from 30 degrees S to 65 degrees N in latitude and through 360 degrees of longitude. The feature resolution is approximately 500 kilometers, revealing a huge anomaly associated with Olympus Mons, a mascon in Isidis Planitia, and other anomalies correlated with volcanic structure. Olympus Mons has been modeled with a 600-kilometer surface disk having a mass of 8.7 x 1021grams.

  3. New studies of Martian volcanoes

    NASA Technical Reports Server (NTRS)

    Mouginis-Mark, P. J.; Robinson, M. S.; Zisk, S. H.

    1991-01-01

    To investigate the morphology, topography, and evolution of volcanic constructs on Mars, researchers have been studying the volcanoes Olympus Mons, Tyrrhena Patera, and Apollinaris Patera. These studies relied upon the analysis of digital Viking orbiter images to measure the depth and slopes of the summit area of Olympus Mons, upon new Earth-based radar measurements for the analysis of the slopes of Tyrrhena Patera, and upon the color characteristics of the flanks of Apollinaris Patera for information regarding surface properties.

  4. Aircraft Jet Engine Exhaust Blast Effects on Par-56 Runway Threshold Lamp Fixtures

    DTIC Science & Technology

    1989-06-01

    Engine Type(s): SPEY 511-14 British Aerospace, BAe-125-700/ -700 Engine Type(s): Garret TFE731 -3 British Aerospace, Concorde Engine Type(s): Not Given... TFE731 -3B Falcon Jet, Falcon 50 Engine Type(s): Garrett TFE-731-3C (See data for Citation) Gates Learjet, Models 23/24, 35/36, 35A/36A, 55/55B Engine Type

  5. Mechanism of Ice Crystal Growth Habit and Shape Instability Development Below Water Saturation.

    DTIC Science & Technology

    1981-08-01

    The temperature dependence of the mass growth rate of ice crystals at water saturation had been intepreted in terms of the varia- tions with temperature...copy film and recorded by use of a camera for subsequent analysis. 3.3.4.3 Wedge-shaped chamber. A new geometry was introduced to thermal diffusion...camera, equippped with an Olympus Winder 2, a motor driven film advancer, an Olympus Varimagni 3600 rotating eyepiece attachment, and a Dot Line

  6. Mars - Stratigraphy and gravimetry of Olympus Mons and its aureole

    NASA Technical Reports Server (NTRS)

    Hiller, K. H.; Neukum, G. P. O.; Janle, P.; Guest, J. E.; Lopes, R. M. C.

    1982-01-01

    The relative ages of the major geologic units on and around Olympus Mons are considered, together with an interpretation of the gravity anomaly found for this area. The crater data for this investigation have been acquired and interpreted according to the method outlined by Neukum and Hiller (1981). After careful geological mapping, craters clearly identified as impacts are measured and counted. Crater frequency values per sq km for craters greater than or equal to 1 km ('crater retention ages') are read from the individual counts by fitting the Martian cumulative crater production size-frequency distribution to the individual counts. In addition to age dating, the problem of the origin and nature of the aureole materials using gravity data is addressed. This is done by determining whether the line-of-sight gravity extending from Olympus Mons to the northwestern part of the aureole can be explained by the aureole masses alone or whether additional high-density intrusive masses must be assumed in the aureola area.

  7. Modeling Recent Subsidence of Mars' Olympus Mons Using Lava Flows as Paleo-Slope Indicators

    NASA Astrophysics Data System (ADS)

    Simpson, M.; Reeves, A.; Chadwick, J.; McGovern, P. J.

    2013-12-01

    Olympus Mons is an enormous volcanic edifice on Mars with a basal diameter over 600 km and a height of 23 km. In spite of this size, no indications of subsidence, such as an obvious topographic moat, have previously been detected around the volcano. In this study, we mapped the orientations of long, thin lava flows on the plains to the south and southeast of Olympus Mons using 100m-resolution imagery from the Thermal Emission Imaging System (THEMIS) on Mars Odyssey, and topography using Mars Orbiter Laser Altimeter (MOLA) data from Mars Global Surveyor. The results show that the flows are no longer oriented in a downhill direction, consistently deviating from modern slope vectors in a counterclockwise direction by 21.4 × 10.8 degrees (n = 65). The configuration of this misalignment between modern and paleo-topography is consistent with subsidence centered on the volcano in the time since the flows were emplaced. Our preliminary geophysical modeling used a range of load volumes, load radii, and lithospheric thicknesses to identify the scenario required to best restore modern topography to match the paleo-topography present when the lava flows were emplaced (i.e. 'uplift' Olympus Mons until the lava flows on the surrounding plains are restored to a downhill direction). The results show that lithospheric subsidence of about 1.2 km due to the magmatic addition of 3.8x10^5 km^3 best fits the observed topographic changes. Load center heights of 1 to 8 km were considered, with best fits generally in the 3-5 km range. Best-fit elastic lithosphere thickness (Te) values were generally 100 km or greater, consistent with estimates for Te from loading models [1,2] and gravity-topography relationships [3,4,5]. Our new crater size-density measurements of the plains in the study area show that the observed subsidence occurred within the past 229 × 26 my. Previous crater counts for Olympus Mons calderas and lower flank flows [6] reveal volcanic activity clustered around 100-200 Myr ago and as young as 2.5 Myr ago, and young faulting of the Olympus Mons edifice suggests recent flank spreading [7]. These young features are consistent with the evidence for recent magmatic loading and subsidence found in this study. REFERENCES: [1] Thurber and Toksoz, 1978; [2] Comer et al., 1985; [3] McGovern et al., 2002, [4] McGovern et al., 2004; [5] Belleguic et al., 2005; [6] Neukum et al 2004; [7] Basilevsky et al., 2006.

  8. Engine non-containment: UK risk assessment methods

    NASA Technical Reports Server (NTRS)

    Wallin, J. C.

    1977-01-01

    More realistic guideline data must be developed for use in aircraft design in order to comply with recent changes in British civil airworthiness requirements. Unrealistically pessimistic results were obtained when the methodology developed during the Concorde SST certification program was extended to assess catastrophic risks resulting from uncontained engine rotors.

  9. Use of High-Throughput Cell-Based and Model Organism Assays for Understanding the Potential Toxicity of Engineered Nanomaterials

    EPA Science Inventory

    The rapidly expanding field of nanotechnology is introducing a large number and diversity of engineered nanomaterials into research and commerce with concordant uncertainty regarding the potential adverse health and ecological effects. With costs and time of traditional animal to...

  10. A new Agraecina spider species from the Balkan Peninsula (FYR Macedonia) (Araneae: Liocranidae).

    PubMed

    Deltshev, Christo; Wang, Chunxia

    2016-05-30

            Specimens were collected using pitfall traps. Coloration is described from alcohol-preserved specimens. Specimens were examined and measured using a Wild M5A stereomicroscope. Further details were studied and measured under an Olympus BX41 compound microscope. All drawings were made using a drawing apparatus attached to a Leica stereomicroscope. Male palps and female genitalia were examined and illustrated after they were dissected from the spiders' bodies. Photos were taken with an Olympus C7070 wide zoom digital camera mounted on an Olympus SZX12 stereomicroscope. The images were montaged using Helicon Focus image stacking software. Measurements of the legs are taken from the dorsal side. Total length of the body includes the chelicerae. All measurements were taken in mm. Abbreviations used in text include: AME, anterior median eyes; ALE, anterior lateral eyes; EM, embolus; MA, median apophysis; CD, copulatory duct; ST, spermatheca; fe, femur; pa, patella; ti, tibia; mt, metatarsus; p, prolateral; d, dorsal; r, retrolateral; v, ventral. Type specimens are deposited in the National Museum of Natural History (NMNHS), Sofia, Bulgaria.

  11. Recent and episodic volcanic and glacial activity on Mars revealed by the High Resolution Stereo Camera.

    PubMed

    Neukum, G; Jaumann, R; Hoffmann, H; Hauber, E; Head, J W; Basilevsky, A T; Ivanov, B A; Werner, S C; van Gasselt, S; Murray, J B; McCord, T

    2004-12-23

    The large-area coverage at a resolution of 10-20 metres per pixel in colour and three dimensions with the High Resolution Stereo Camera Experiment on the European Space Agency Mars Express Mission has made it possible to study the time-stratigraphic relationships of volcanic and glacial structures in unprecedented detail and give insight into the geological evolution of Mars. Here we show that calderas on five major volcanoes on Mars have undergone repeated activation and resurfacing during the last 20 per cent of martian history, with phases of activity as young as two million years, suggesting that the volcanoes are potentially still active today. Glacial deposits at the base of the Olympus Mons escarpment show evidence for repeated phases of activity as recently as about four million years ago. Morphological evidence is found that snow and ice deposition on the Olympus construct at elevations of more than 7,000 metres led to episodes of glacial activity at this height. Even now, water ice protected by an insulating layer of dust may be present at high altitudes on Olympus Mons.

  12. MOLA Global roughness map of Mars

    NASA Technical Reports Server (NTRS)

    2000-01-01

    The median of slopes in 35-km windows indicate the typical roughness on 300-meter baselines. The rougher nature of the heavily cratered terrain in the Southern Hemisphere is apparent, as well as that of Valles Marineris (12S, 289E) canyon walls and the Olympus Mons (18N, 227E) aureole deposits. The Northern Lowlands are smooth, especially Amazonis Planitia (16N, 202E), a region to the west of Olympus Mons, were typical median slopes on these baselines are often smaller than 0.1 degree. A shaded relief map of the topography is overlaid is monochrome.

  13. Evolution of the Olympus Mons Caldera, Mars

    NASA Technical Reports Server (NTRS)

    Mouginis-Mark, Peter J.; Robinson, Mark S.; Zuber, Maria T.

    1990-01-01

    Extensive high-resolution (15 to 20 m/pixel) coverage of Olympus Mons volcano permits the investigation of the sequence of events associated with the evolution of the nested summit caldera. The sequence of the intra-caldera events is well illustrated by image data collected on orbits 473S and 474S of Viking Orbiter 1. These data cover both the oldest and youngest portions of the caldera floor. The chronology inferred from the observations is presented which in turn can be interpreted in terms of the internal structure of the volcano (i.e., magma chamber depth and the existence of dikes).

  14. Olympus propagation studies in the US: Receiver development and the data acquisition system

    NASA Technical Reports Server (NTRS)

    Mckeeman, John C.

    1990-01-01

    Virginia Tech has developed two types of receivers to monitor the Olympus beacons, as well as a custom data acquisition system to store and display propagation data. Each of the receiver designs uses new hybrid analog/digital techniques. The data acquisition system uses a stand alone processor to collect and format the data for display and subsequent processing. The launch of the Olympus satellite with its coherent beacons offers new opportunities to study propagation effects at 12.5, 20, and 30 GHz. At Virginia Tech, the satellite is at 14 degrees in elevation, which allows us to measure low elevation angle effects. However, to make these measurements, a very accurate and stable measurement system is required. Virginia Tech has constructed a complex receiving system which monitors the Olympus beacons and all parameters associated with propagation research. In the current configuration, researchers have developed a receiver which frequency locks to the less fade susceptible 12.5 GHz beacon. Since all beacons on the satellite are driven from a single master oscillator, drift in the 12.5 GHz beacon implies corresponding drifts in the 20, and 30 GHz beacons. The receivers for the 20 and 30 GHz systems derive their frequency locking information from the 12.5 GHz system. This widens the dynamic range of the receivers and allows the receivers to maintain lock in severe fade conditions. In addition to monitoring the beacons, the sky noise is monitored with radiometers at each frequency. The radiometer output is used to set the clear air level for each beacon measurement. Researchers also measure the rain rate with several tipping bucket rain gauges placed along the propagation path.

  15. Yardangs near Olympus Mons

    NASA Image and Video Library

    2002-12-16

    In this region of the Olympus Mons aureole, located to the SW of the volcano, the surface has been eroded by the wind into linear landforms called yardangs. These ridges generally point in direction of the prevailing winds that carved them, in this case winds from the southeast. Yardangs typically occur on surfaces that are easily erodable, such as wind-blown dust or volcanic ash. The northeast - southwest trending ridges and valleys in the northwest corner of the image are typical of the Olympus Mons aureole. The varying concentration and shape of the yardangs in this area may be controlled by the motion of winds around these topographic features. Some crater outlines are visible near the top of this image. The rims of these craters appear to have been stripped away - indicating that the wind erosion is younger than these craters. There are two round knobs in the image, one on the bottom on the right side of the image and another about midway down on the left. These may be inverted craters, formed because the impacts caused materials underneath the crater to become harder to erode than the surrounding materials. http://photojournal.jpl.nasa.gov/catalog/PIA04036

  16. Lava Flow Near the Base of Olympus Mons

    NASA Image and Video Library

    2015-02-18

    This image from NASA Mars Reconnaissance Orbiter shows a lava channel, which lies just to the east of the largest volcano in the solar system: Olympus Mons. The channel appears to be discontinuous, meaning it disappears several times throughout its length, but in fact, it is likely that the channel continues underground as a lava tube. These are relatively common features at terrestrial volcanic centers, such as the Big Island of Hawai'i. The channel appears to have been infilled with dust and sand, so that the entrance to a lava tube cave is no longer visible at this particular location; fortunately this has been observed elsewhere on Mars. http://photojournal.jpl.nasa.gov/catalog/PIA19299

  17. Western Portion of Acheron Fossae

    NASA Image and Video Library

    2002-12-16

    Located north of Olympus Mons and west of Alba Patera, Acheron Fossae provides a record of early tectonic activity in the Tharsis region. Acheron Fossae is a relatively high standing region characterized by multiple subparallel graben. As seen in the image, the graben trend generally to the northwest. The entire area predates the Alba Patera flows (which embay the eastern most Acheron grabens) and the Olympus Mons volcano (one of the youngest Tharsis features). The subdued nature of the highstanding hills, the erosion the graben walls, the eroded rims of all the visible craters, and the wind etching of the flat surfaces all help indicate the great age of Acheron Fossae. http://photojournal.jpl.nasa.gov/catalog/PIA04034

  18. Dark Materials on Olympus Mons

    NASA Image and Video Library

    2018-01-23

    This image from NASA's Mars Reconnaissance Orbiter (MRO) shows blocks of layered terrain within the Olympus Mons aureole. The aureole is a giant apron of chaotic material around the volcano, perhaps formed by enormous landslides off the flanks of the giant volcano. These blocks of layered material have been eroded by the wind into the scenic landscape we see here. The map is projected here at a scale of 25 centimeters (9.8 inches) per pixel. [The original image scale is 28.3 centimeters (11.1 inches) per pixel (with 1 x 1 binning); objects on the order of 85 centimeters (33.5 inches) across are resolved.] North is up. https://photojournal.jpl.nasa.gov/catalog/PIA22181

  19. Eruption history of the Tharsis shield volcanoes, Mars

    NASA Technical Reports Server (NTRS)

    Plescia, J. B.

    1993-01-01

    The Tharsis Montes volcanoes and Olympus Mons are giant shield volcanoes. Although estimates of their average surface age have been made using crater counts, the length of time required to build the shields has not been considered. Crater counts for the volcanoes indicate the constructs are young; average ages are Amazonian to Hesperian. In relative terms; Arsia Mons is the oldest, Pavonis Mons intermediate, and Ascreaus Mons the youngest of the Tharsis Montes shield; Olympus Mons is the youngest of the group. Depending upon the calibration, absolute ages range from 730 Ma to 3100 Ma for Arsia Mons and 25 Ma to 100 Ma for Olympus Mons. These absolute chronologies are highly model dependent, and indicate only the time surficial volcanism ceased, not the time over which the volcano was built. The problem of estimating the time necessary to build the volcanoes can be attacked in two ways. First, eruption rates from terrestrial and extraterrestrial examples can be used to calculate the required period of time to build the shields. Second, some relation of eruptive activity between the volcanoes can be assumed, such as they all began at a speficic time or they were active sequentially, and calculate the eruptive rate. Volumes of the shield volcanoes were derived from topographic/volume data.

  20. OPEX propagation measurements and studies

    NASA Technical Reports Server (NTRS)

    Arbesser-Rastburg, Bertram

    1990-01-01

    With the launch of the telecommunications Olympus satellite a new area began for the Olympus Propagation Experiments (OPEX) group. The years of preparations are now paying off - the experiments are underway and the co-operative effort is now turning its attention to the processing and analysis of data and to the interpretation of results. The aim here is to give a short review of the accomplishments made since NAPEX 13 and the work planned for the future. When ESA's Olympus was launched in summer of 1989 it carried a payload producing three unmodulated beacons at 12.5, 19.8, and 29.7 GHz. The main purpose of these beacons is to enable scientists to carry out long term slant path propagation experiments at these frequencies. The OPEX group, which was set up under ESA auspices in 1980, had been preparing for this event very carefully. The specifications for the equipment to be used and the elaboration of standard procedures for data processing and analysis have been worked out jointly. Today the OPEX community includes approximately 30 groups of experimenters. Immediately after achieving platform stability at the orbital location at 341 degrees east, ESA performed the In-Orbit Tests. Most measurements were carried out in Belgium using terminals specially developed for this purpose. A summary of the test results is given.

  1. OlyMPUS - The Ontology-based Metadata Portal for Unified Semantics

    NASA Astrophysics Data System (ADS)

    Huffer, E.; Gleason, J. L.

    2015-12-01

    The Ontology-based Metadata Portal for Unified Semantics (OlyMPUS), funded by the NASA Earth Science Technology Office Advanced Information Systems Technology program, is an end-to-end system designed to support data consumers and data providers, enabling the latter to register their data sets and provision them with the semantically rich metadata that drives the Ontology-Driven Interactive Search Environment for Earth Sciences (ODISEES). OlyMPUS leverages the semantics and reasoning capabilities of ODISEES to provide data producers with a semi-automated interface for producing the semantically rich metadata needed to support ODISEES' data discovery and access services. It integrates the ODISEES metadata search system with multiple NASA data delivery tools to enable data consumers to create customized data sets for download to their computers, or for NASA Advanced Supercomputing (NAS) facility registered users, directly to NAS storage resources for access by applications running on NAS supercomputers. A core function of NASA's Earth Science Division is research and analysis that uses the full spectrum of data products available in NASA archives. Scientists need to perform complex analyses that identify correlations and non-obvious relationships across all types of Earth System phenomena. Comprehensive analytics are hindered, however, by the fact that many Earth science data products are disparate and hard to synthesize. Variations in how data are collected, processed, gridded, and stored, create challenges for data interoperability and synthesis, which are exacerbated by the sheer volume of available data. Robust, semantically rich metadata can support tools for data discovery and facilitate machine-to-machine transactions with services such as data subsetting, regridding, and reformatting. Such capabilities are critical to enabling the research activities integral to NASA's strategic plans. However, as metadata requirements increase and competing standards emerge, metadata provisioning becomes increasingly burdensome to data producers. The OlyMPUS system helps data providers produce semantically rich metadata, making their data more accessible to data consumers, and helps data consumers quickly discover and download the right data for their research.

  2. Discrete Element Simulations of Density-Driven Volcanic Deformation: Applications to Martian and Terrestrial Volcanoes

    NASA Astrophysics Data System (ADS)

    Farrell, L. L.; McGovern, P. J.; Morgan, J. K.

    2008-12-01

    We have carried out 2-D numerical simulations using the discrete element method (DEM) to investigate density-driven deformation in volcanic edifices on Earth (e.g., Hawaii) and Mars (e.g., Olympus Mons and Arsia Mons). Located within volcanoes are series of magma chambers, reservoirs, and conduits where magma travels and collects. As magma differentiates, dense minerals settle out, building thick accumulations referred to as cumulates that can flow ductilely due to stresses imparted by gravity. To simulate this process, we construct granular piles subject to Coulomb frictional rheology, incrementally capture internal rectangular regions to which higher densities and lower interparticle friction values are assigned (analogs for denser, weaker cumulates), and then bond the granular edifice. Thus, following each growth increment, the edifice is allowed to relax gravitationally with a reconfigured weak cumulate core. The presence and outward spreading of the cumulate causes the development of distinctive structural and stratigraphic patterns. We obtained a range of volcanic shapes that vary from broad, shallowly dipping flanks reminiscent of those of Olympus Mons, to short, steep surface slopes more similar to Arsia Mons. Edifices lacking internal cumulate exhibit relatively horizontal strata compared to the high-angle, inward dipping strata that develops within the cumulate-bearing edifices. Our simulated volcanoes also illustrate a variety of gravity driven deformation features, including regions of thrust faulting within the flanks and large-scale flank collapses, as observed in Hawaii and inferred on Olympus Mons. We also see significant summit subsidence, and of particular interest, distinct summit calderas. The broad, flat caldera and convex upward profile of Arsia Mons appears to be well-simulated by cumulate-driven volcanic spreading. In contrast, the concave upward slopes of Olympus Mons are more challenging to reproduce, and instead are attributed to volcanic spreading along a pore-fluid- pressurized decollement with low basal friction.

  3. Correlations between topography and intraflow width behavior in Martian and terrestrial lava flows

    NASA Astrophysics Data System (ADS)

    Peitersen, Matthew N.; Crown, David A.

    2000-02-01

    Local correlations between topography and width behavior within lava flows at Puu Oo, Mount Etna, Glass Mountain, Cerro Bayo, Alba Patera, Tyrrhena Patera, Elysium Mons, and Olympus Mons were investigated. For each flow, width and slope data were both referenced via downflow distance as a sequence of points; the data were then divided into collections of adjacent three-point features and two-point segments. Four discrete types of analyses were conducted: (1) Three-point analysis examined positional correlations between width and slope features, (2) two-point analysis did the same for flow segments, (3) mean slope analysis included segment slope comparisons, and (4) sudden width behavior analysis measured abruptness of width changes. The distribution of types of correlations compared to random combinations of features and segments does not suggest a significant correlation between flow widths and local underlying slopes and indicates that for these flows at least, other factors have more influence on changes in width than changes in underlying topography. Mean slopes underlying narrowing, widening, and constant flow width segments were calculated. An inverse correlation between slope and width was found only at Mount Etna, where slopes underlying narrowing segments were greater than those underlying widening in 62% of the examined flows. For the majority of flows at Mount Etna, Puu Oo, and Olympus Mons, slopes were actually greatest under constant width segments; this may imply a topographically dependent resistance to width changes. The rate of change of width was also examined. Sudden width changes are relatively common at Puu Oo, Mount Etna, Elysium Mons, and Tyrrhena Patera and relatively rare at Glass Mountain, Cerro Bayo, Olympus Mons, and Alba Patera. After correction for mapping scale, Puu Oo, Mount Etna, Olympus Mons, and Alba Patera appear to fall on the same trend; Glass Mount exhibits unusually small amounts of sudden width behavior, and Tyrrhena Patera exhibits a relatively large number of sudden width behavior occurrences.

  4. The TURis System for Transurethral Resection of the Prostate: A NICE Medical Technology Guidance.

    PubMed

    Cleves, Andrew; Dimmock, Paul; Hewitt, Neil; Carolan-Rees, Grace

    2016-06-01

    The transurethral resection in saline (TURis) system was notified by the company Olympus Medical to the National Institute of Health and Care Excellence's (NICE's) Medical Technologies Evaluation Programme. Following selection for medical technologies guidance, the company developed a submission of clinical and economic evidence for evaluation. TURis is a bipolar surgical system for treating men with lower urinary tract symptoms due to benign prostatic enlargement. The comparator is any monopolar transurethral resection of the prostate (mTURP) system. Cedar, a collaboration between Cardiff and Vale University Health Board, Cardiff University and Swansea University in the UK, acted as an External Assessment Centre (EAC) for NICE to independently critique the company's submission of evidence. Eight randomised trials provided evidence for TURis, demonstrating efficacy equivalent to that of mTURP for improvement of symptoms. The company presented meta-analyses of key outcome measures, and the EAC made methodological modifications in response to the heterogeneity of the trial data. The EAC analysis found that TURis substantially reduced the relative risks of transurethral resection syndrome (relative risk 0.18 [95 % confidence interval 0.05-0.62]) and blood transfusion (relative risk 0.35 [95 % confidence interval 0.19-0.65]). The company provided a de novo economic model comparing TURis with mTURP. The EAC critiqued the model methodology and made modifications. This found TURis to be cost saving at £70.55 per case for existing Olympus customers and cost incurring at £19.80 per case for non-Olympus customers. When an additional scenario based on the only available data on readmission (due to any cause) from a single trial was modelled, the estimated cost saving per case was £375.02 for existing users of Olympus electrosurgery equipment and £284.66 per case when new Olympus equipment would need to be purchased. Meta-analysis of eight randomised trials showed that TURis is associated with a statistically significantly reduced risk of transurethral resection syndrome and a reduced need for blood transfusion-two factors that may drive cost saving for the National Health Service. The clinical data are equivocal as to whether TURis shortens the hospital stay. Limited data from a single study suggest that TURis may reduce the rate of readmission after surgery. The NICE guidance supports adoption of the TURis technology for performing transurethral resection of the prostate in men with lower urinary tract symptoms due to benign prostatic enlargement.

  5. The Learning Portal

    ERIC Educational Resources Information Center

    Staudt, Carolyn; Hanzlick-Burton, Camden; Williamson, Carol; McIntyre, Cynthia

    2015-01-01

    The Innovative Technology in Science Inquiry (ITSI) project is a learning portal with hundreds of free, customizable science, math, and engineering activities funded by the National Science Foundation at the Concord Consortium, a nonprofit research and development organization dedicated to transforming education through technology. The project…

  6. Evaluation of the infrared test method for the olympus thermal balance tests

    NASA Technical Reports Server (NTRS)

    Donato, M.; Stpierre, D.; Green, J.; Reeves, M.

    1986-01-01

    The performance of the infrared (IR) rig used for the thermal balance testing of the Olympus S/C thermal model is discussed. Included in this evaluation are the rig effects themselves, the IRFLUX computer code used to predict the radiation inputs, the Monitored Background Radiometers (MBR's) developed to measure the absorbed radiation flux intensity, the Uniform Temperature Reference (UTR) based temperature measurement system and the data acquisition system. A preliminary set of verification tests were performed on a 1 m x 1 m zone to assess the performance of the IR lamps, calrods, MBR's and aluminized baffles. The results were used, in part, to obtain some empirical data required for the IRFLUX code. This data included lamp and calrod characteristics, the absorptance function for various surface types, and the baffle reflectivities.

  7. Constraints on the depth and geometry of the magma chamber of the Olympus Mons Volcano, Mars

    NASA Technical Reports Server (NTRS)

    Zuber, Maria T.; Mouginis-Mark, Peter J.

    1990-01-01

    The summit caldera of the Olympus Mons volcano exhibits one of the clearest examples of tectonic processes associated with shield volcanism on Mars. The radial distance from the center of the transition from concentric ridges to concentric graben within the oldest crater provides a constraint on the geometry and depth of the subsurface magmatic reservoir at the time of subsidence. Here, researchers use this constraint to investigate the size, shape, and depth of the reservoir. Their approach consists of calculating radial surface stresses corresponding to the range of subsurface pressure distributions representing an evacuating magma chamber. They then compare stress patterns to the observed radial positions of concentric ridges and graben. The problem is solved by employing the finite element approach using the program TECTON.

  8. Future mobile satellite communication concepts at 20/30 GHz

    NASA Technical Reports Server (NTRS)

    Barton, S. K.; Norbury, J. R.

    1990-01-01

    The outline of a design of a system using ultra small earth stations (picoterminals) for data traffic at 20/30 GHz is discussed. The picoterminals would be battery powered, have an RF transmitter power of 0.5 W, use a 10 cm square patch antenna, and have a receiver G/T of about -8 dB/K. Spread spectrum modulation would be required (due to interference consideration) to allow a telex type data link (less than 200 bit/s data rate) from the picoterminal to the hub station of the network and about 40 kbit/s on the outbound patch. An Olympus type transponder at 20/30 GHz could maintain several thousand simultaneous picoterminal circuits. The possibility of demonstrating a picoterminal network with voice traffic using Olympus is discussed together with fully mobile systems based on this concept.

  9. Hard Two-Photon Contribution to Elastic Lepton-Proton Scattering Determined by the OLYMPUS Experiment.

    PubMed

    Henderson, B S; Ice, L D; Khaneft, D; O'Connor, C; Russell, R; Schmidt, A; Bernauer, J C; Kohl, M; Akopov, N; Alarcon, R; Ates, O; Avetisyan, A; Beck, R; Belostotski, S; Bessuille, J; Brinker, F; Calarco, J R; Carassiti, V; Cisbani, E; Ciullo, G; Contalbrigo, M; De Leo, R; Diefenbach, J; Donnelly, T W; Dow, K; Elbakian, G; Eversheim, P D; Frullani, S; Funke, Ch; Gavrilov, G; Gläser, B; Görrissen, N; Hasell, D K; Hauschildt, J; Hoffmeister, Ph; Holler, Y; Ihloff, E; Izotov, A; Kaiser, R; Karyan, G; Kelsey, J; Kiselev, A; Klassen, P; Krivshich, A; Lehmann, I; Lenisa, P; Lenz, D; Lumsden, S; Ma, Y; Maas, F; Marukyan, H; Miklukho, O; Milner, R G; Movsisyan, A; Murray, M; Naryshkin, Y; Perez Benito, R; Perrino, R; Redwine, R P; Rodríguez Piñeiro, D; Rosner, G; Schneekloth, U; Seitz, B; Statera, M; Thiel, A; Vardanyan, H; Veretennikov, D; Vidal, C; Winnebeck, A; Yeganov, V

    2017-03-03

    The OLYMPUS Collaboration reports on a precision measurement of the positron-proton to electron-proton elastic cross section ratio, R_{2γ}, a direct measure of the contribution of hard two-photon exchange to the elastic cross section. In the OLYMPUS measurement, 2.01 GeV electron and positron beams were directed through a hydrogen gas target internal to the DORIS storage ring at DESY. A toroidal magnetic spectrometer instrumented with drift chambers and time-of-flight scintillators detected elastically scattered leptons in coincidence with recoiling protons over a scattering angle range of ≈20° to 80°. The relative luminosity between the two beam species was monitored using tracking telescopes of interleaved gas electron multiplier and multiwire proportional chamber detectors at 12°, as well as symmetric Møller or Bhabha calorimeters at 1.29°. A total integrated luminosity of 4.5  fb^{-1} was collected. In the extraction of R_{2γ}, radiative effects were taken into account using a Monte Carlo generator to simulate the convolutions of internal bremsstrahlung with experiment-specific conditions such as detector acceptance and reconstruction efficiency. The resulting values of R_{2γ}, presented here for a wide range of virtual photon polarization 0.456<ε<0.978, are smaller than some hadronic two-photon exchange calculations predict, but are in reasonable agreement with a subtracted dispersion model and a phenomenological fit to the form factor data.

  10. Reducing sickness absence from work due to low back pain: how well do intervention strategies match modifiable risk factors?

    PubMed

    Shaw, William S; Linton, Steven J; Pransky, Glenn

    2006-12-01

    To assess, from the review literature, the extent to which effective strategies for reducing work absence after acute low back pain (LBP) match empirical risk factors. From 17 recent review articles (2000-2005), disability risk factors and interventions were cross-tabulated to assess levels of relative concordance. Potentially modifiable risk factors included 23 variables describing 3 workplace and 3 personal domains. Effective interventions included 25 strategies that were personal (physical or behavioral), engineering, or administrative in nature. There was a strong risk factor concordance for workplace technical and organizational interventions, graded activity exposure, and cognitive restructuring of pain beliefs. There was less risk factor concordance for exercise, back education, and RTW coordination. Few interventions focused on relieving emotional distress or improving job dissatisfaction, two well-supported risk factors. Gaps between the epidemiological and intervention research of back disability prevention could be reduced by testing mediators of intervention effects or by stratifying outcomes according to pre-intervention risk factors.

  11. Lycus Sulci

    NASA Image and Video Library

    2003-03-14

    This NASA Mars Odyssey image shows Lycus Sulci, a region of ridges and hills located north-northwest of the volcano Olympus Mons. Several dust avalanches on the flanks of the roughly textured surfaces suggest a thick coating of fine-grained materials.

  12. Comparison of low-frequency noise levels of the Concorde supersonic transport with other commercial service airplanes

    NASA Technical Reports Server (NTRS)

    Powell, C. A.; Mccurdy, D. A.

    1978-01-01

    Fifty-two airplane noise recordings, made at several locations around Dulles International Airport, were analyzed to compare the low-frequency noise levels of the Concorde supersonic transport with those of other commercial jet airplanes. Comparisons of the relative low-frequency noise levels which were produced at close and distant locations for departures and arrivals were made for three noise measures: the sound pressure level in the 1/3 octave band centered at 20 Hz, the total sound pressure level in the 1/3 octave bands with center frequencies less than or equal to 125 Hz, and the total sound pressure level in the 1/3 octave bands with center frequencies less than or equal to 500 Hz. Although the absolute noise levels for Concorde were found, in general, to be higher than those for the other airplane types, the level of low-frequency noise of the Concorde relative to the perceived noise level (PNL), effective perceived noise level (EPNL), and overall sound pressure level (OASPL) was within the range established by the other airplane types, except for the arrival operations of four-engine, narrow-body airplanes. The measure OASPL was found to be a significantly better predictor of low-frequency noise level than PNL or EPNL.

  13. The continuum slope of Mars - Bidirectional reflectance investigations and applications to Olympus Mons

    NASA Astrophysics Data System (ADS)

    Fischer, E. M.; Pieters, C. M.

    1993-04-01

    Two primary causes of near-IR continuum slope variations have been observed in an investigation of the bidirectional reflectance characteristics of ferric coatings on the continuum slope of Mars. First, the presence of a thin ferric coating on a dark substrate produces a negative continuum slope due to the wavelength-dependent transparency of the ferric coating. Second, wavelength-dependent directional reflectance occurs when the surface particles are tightly packed, particle sizes are on the order of or smaller than the wavelength of light, or the surface is otherwise smooth on the order of the wavelength of light. Based on these results, the annuli on the flanks of Olympus Mons which are defined by reflectance and continuum slope are consistent with spatial variations in surface texture and possibly with spatial variations in the thickness of a ferric dust coating or rind.

  14. Mars Express HRSC View of Western Olympus Mons: Evidence for Ice-bearing Deposit and High-Altitude Glaciation

    NASA Technical Reports Server (NTRS)

    Basilevsky, A. T.; Neukam, G.; Ivanov, B. A.; Werner, S. C.; vanGesselt, S.; Head, J. W.; Hauber, E.

    2005-01-01

    This study is based on the geological analysis of the HRSC images taken on the orbit 0143 (12 m/px in nadir channel). The study area includes the western segment of Olympus Mons and the adjacent lowland plains (Fig. 1). Part of the volcano above the scarp is rather flat and is called "summit plateau" below. What is often called the volcano scarp is a slope classified into three morphologic types: Type 1 (S1 in Fig.1) is the steepest and dominated by ravines in its upper part and by talus beneath; Type 2 (S2) is intermediate in steepness and dominated by downslope trending linear depressions, part of which have channel-like morphology; and Type 3 (S3), is the most gentle and covered by lava flows, continuing from the summit plateau down to the lowland plains.

  15. Olympus receiver evaluation and phase noise measurements

    NASA Technical Reports Server (NTRS)

    Campbell, Richard L.; Wang, Huailiang; Sweeney, Dennis

    1990-01-01

    A set of measurements performed by the Michigan Tech Sensing and Signal Processing Group on the analog receiver built by the Virginia Polytechnic Institute (VPI) and the Jet Propulsion Laboratory (JPL) for propagation measurements using the Olympus Satellite is described. Measurements of local oscillator (LO) phase noise were performed for all of the LOs supplied by JPL. In order to obtain the most useful set of measurements, LO phase noise measurements were made using the complete VPI receiver front end. This set of measurements demonstrates the performance of the receiver from the Radio Frequency (RF) input through the high Intermediate Frequency (IF) output. Three different measurements were made: LO phase noise with DC on the voltage controlled crystal oscillator (VCXO) port; LO phase noise with the 11.381 GHz LO locked to the reference signal generator; and a reference measurement with the JPL LOs out of the system.

  16. Sulci Gordii - False Color

    NASA Image and Video Library

    2014-12-29

    The THEMIS VIS camera contains 5 filters. The data from different filters can be combined in multiple ways to create a false color image. This false color image from NASA 2001 Mars Odyssey spacecraft shows part of Sulci Gordii east of Olympus Mons.

  17. Ice-lubricated gravity spreading of the Olympus Mons aureole deposits

    USGS Publications Warehouse

    Tanaka, K.L.

    1985-01-01

    Gravity sliding and spreading at low strain rates can account for the general morphology and structure of the aureoles and basal scarp of Olympus Mons. Detachment sliding could have occurred around the volcano if either pore-fluid pressures were exceptionally high (greater than 90%) or the rocks had very low resistance to shear (about 1 ?? 105 Pa or 1 bar). Because of the vast areal extent and probable shallow depth of the detachment zone, development of ubiquitous, high pore-fluid pressures beneath aureole-forming material was unlikely. However, a zone of sufficiently weak material consisting of about 10% interstitial or interbedded ice could have been present. If so, a simple rheologic model for the aureole deposits can be applied that consists of a thin ductile layer overlain by a thicker brittle layer. According to this model, extensional deformation would have occurred near the shield and compressional deformation in its distal parts. Proximal grabens and distal corrugations on aureole surfaces support this model. A submarine slide at Kitimat Arm, British Columbia, is a valid qualitative analogy for the observed features and inferred emplacement style of the aureole deposits. Ground-ice processes have been considered the cause of many geologic features on Mars; a 3% average concentration of ground ice in the regolith is predicted by theoretical models for the ice budget and cryosphere. Ice may have been deposited in higher concentrations below the aureole-forming material; the source of the ice could have been juvenile water circulated hydrothermally by Olympus Mons volcanism. The basal scarp of Olympus Mons apparently demarcates the transition between the upper, stable part of the shield and its lower part that decoupled and formed the aureole deposits. This transition may reflect a change in the bulk shear strength of the shield, caused either by a radial dependence in the abundance of ice or fluid in the shield materials or by the concentration of intrusive dikes within the volcano. Other Martian volcanoes exhibit virtually no evidence of similar large-scale gravity spreading and basal scarps. Perhaps such evidence, if it existed, has been buried by lava flows, or perhaps the smaller size of other volcanoes did not permit the development of these features. ?? 1985.

  18. Discrete Element Simulations of Density-Driven Volcanic Deformation: Applications to Martian Caldera Complexes

    NASA Astrophysics Data System (ADS)

    Zivney, L. L.; Morgan, J. K.; McGovern, P. J.

    2009-12-01

    We have carried out 2-D numerical simulations using the discrete element method (DEM) to investigate density-driven deformation in Martian volcanic edifices. Our initial simulations demonstrated that gravitationally-driven settling of a dense, ductile cumulate body within a volcano causes enhanced lateral spreading of the edifice flanks, influencing the overall volcano morphology and generating pronounced summit subsidence. Here, we explore the effects of cumulate bodies and their geometries on the generation of summit calderas, to gain insight into the origin of Martian caldera complexes, in particular the Olympus Mons and Arsia Mons calderas. The Olympus Mons caldera, roughly 80 km in diameter, is composed of several small over-lapping craters with steep walls, thought to be produced by episodic collapse events of multiple shallow magma chambers. The Arsia Mons caldera spans ~130 km across and displays one prominent crater with gently sloping margins, possibly reflecting the collapse of a single magma chamber. Although the depth of the magma chamber is debated, its lateral width is thought to approximate the diameter of the caldera. Our models indicate that cumulate bodies located at shallow depths of <10 km below the edifice surface produce caldera complexes on the order of 80-100 km in width, with increasing cumulate widths producing widening calderas. Narrow cumulate bodies with densities near 4000 kg/m3 produce the deepest calderas (up to ~8 km deep). We conclude that the generation of large Arsia-type calderas may be adequately modeled by the presence of a wide cumulate body found at shallow depths beneath the summit. Although we do not model the multiple magma chamber systems thought to exist beneath the Olympus Mons summit, the closely spaced craters and the small size of the caldera relative to the size of the volcano (~13% of the edifice) suggests that the cumulate body would be narrow; our simulations of a single narrow cumulate body are capable of generating summit subsidence that is similar in dimension to the Olympus Mons caldera. Our findings suggest that cumulate spreading may play a primary role in the long-term development of caldera geometry, although the collapse of magma reservoirs (not modeled here) may cause important short-term changes in caldera structure.

  19. Antibacterial and antioxidant activity of different types of honey derived from Mount Olympus in Greece.

    PubMed

    Stagos, Dimitrios; Soulitsiotis, Nikolaos; Tsadila, Christina; Papaeconomou, Stamatina; Arvanitis, Charalampos; Ntontos, Alexandros; Karkanta, Fani; Adamou-Androulaki, Soultana; Petrotos, Konstantinos; Spandidos, Demetrios A; Kouretas, Demetrios; Mossialos, Dimitris

    2018-05-04

    The aim of the present study was to examine the antioxidant and antibacterial activity of 21 types of honey derived from Mount Olympus (Mt. Olympus), a region with great plant biodiversity. The antibacterial activity was examined against the growth of Staphylococcus aureus (S. aureus) and Pseudomonas aeruginosa (P. aeruginosa) by the agar well diffusion assay and the determination of the minimum inhibitory concentration (MIC). The antioxidant activity was assessed by using the 2,2‑diphenyl‑1‑picrylhydrazyl (DPPH) and 2,2'‑azino‑bis(3‑ethylbenzothiazoline‑6‑sulphonic acid (ABTS•+) free radical scavenging assays. These activities were compared to Manuka honey which is used as an alternative medicine. The results revealed that all tested honey types exhibited antibacterial activity against S. aureus and P. aeruginosa. The MIC of the tested honey types against S. aureus ranged from 3.125 to 12.5% (v/v), while MIC of Manuka honey was determined to be 6.25% (v/v). The MIC values of the tested honey types against P. aeruginosa ranged from 6.25 to 12.5% (v/v) and the MIC of Manuka honey was determined at 12.5% (v/v). Moreover, the results suggested that the presence of hydrogen peroxide and proteinaceous compounds in the honey types accounted, at least in part, for the antibacterial activity. In addition, the total polyphenolic content (TPC) of the honey types seemed to contribute to the antibacterial activity against P. aeruginosa. Furthermore, some of the tested honey types exhibited potent free radical scavenging activity against DPPH and ABTS•+ radicals, which was greater than that of Manuka honey. The results indicated that not only the quantity, but also the quality of the polyphenols were responsible for the antioxidant activity. Moreover, four honey types exhibiting great antioxidant activity were converted to powder using a freeze drying method. The results indicated that following conversion to powder all honey types, apart from one, retained their antioxidant activity, although their TPC was reduced. On the whole, and at least to the best of our knowledge, the present study is the first that extensively examined the bioactivities of different types of honey derived from Mt. Olympus.

  20. Validation of the second-generation Olympus colonoscopy simulator for skills assessment.

    PubMed

    Haycock, A V; Bassett, P; Bladen, J; Thomas-Gibson, S

    2009-11-01

    Simulators have potential value in providing objective evidence of technical skill for procedures within medicine. The aim of this study was to determine face and construct validity for the Olympus colonoscopy simulator and to establish which assessment measures map to clinical benchmarks of expertise. Thirty-four participants were recruited: 10 novices with no prior colonoscopy experience, 13 intermediate (trainee) endoscopists with fewer than 1000 previous colonoscopies, and 11 experienced endoscopists with more than 1000 previous colonoscopies. All participants completed three standardized cases on the simulator and experts gave feedback regarding the realism of the simulator. Forty metrics recorded automatically by the simulator were analyzed for their ability to distinguish between the groups. The simulator discriminated participants by experience level for 22 different parameters. Completion rates were lower for novices than for trainees and experts (37 % vs. 79 % and 88 % respectively, P < 0.001) and both novices and trainees took significantly longer to reach all major landmarks than the experts. Several technical aspects of competency were discriminatory; pushing with an embedded tip ( P = 0.03), correct use of the variable stiffness function ( P = 0.004), number of sigmoid N-loops ( P = 0.02); size of sigmoid N-loops ( P = 0.01), and time to remove alpha loops ( P = 0.004). Out of 10, experts rated the realism of movement at 6.4, force feedback at 6.6, looping at 6.6, and loop resolution at 6.8. The Olympus colonoscopy simulator has good face validity and excellent construct validity. It provides an objective assessment of colonoscopic skill on multiple measures and benchmarks have been set to allow its use as both a formative and a summative assessment tool. Georg Thieme Verlag KG Stuttgart. New York.

  1. Contrast-enhanced harmonic endoscopic ultrasound in solid lesions of the pancreas: results of a pilot study.

    PubMed

    Napoleon, B; Alvarez-Sanchez, M V; Gincoul, R; Pujol, B; Lefort, C; Lepilliez, V; Labadie, M; Souquet, J C; Queneau, P E; Scoazec, J Y; Chayvialle, J A; Ponchon, T

    2010-07-01

    Distinguishing pancreatic adenocarcinoma from other pancreatic masses remains challenging with current imaging techniques. This prospective study aimed to evaluate the accuracy of a new procedure, imaging the microcirculation pattern of the pancreas by contrast-enhanced harmonic endoscopic ultrasound (CEH-EUS) with a new Olympus prototype echo endoscope. 35 patients presenting with solid pancreatic lesions were prospectively enrolled. All patients had conventional B mode and power Doppler EUS. After an intravenous bolus injection of 2.4 ml of a second-generation ultrasound contrast agent (SonoVue) CEH-EUS was then performed with a new Olympus prototype echo endoscope (xGF-UCT 180). The microvascular pattern was compared with the final diagnosis based on the pathological examination of specimens from surgery or EUS-guided fine-needle aspiration (EUS-FNA) or on follow-up for at least 12 months. The final diagnoses were: 18 adenocarcinomas, 9 neuroendocrine tumors, 7 chronic pancreatitis, and 1 stromal tumor. Power Doppler failed to display microcirculation, whereas harmonic imaging demonstrated it in all cases. Out of 18 lesions with a hypointense signal on CEH-EUS, 16 were adenocarcinomas. The sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), and accuracy of hypointensity for diagnosing pancreatic adenocarcinoma were 89 %, 88 %, 88 %, 89 %, and 88.5 %, compared with corresponding values of 72 %, 100 %, 77 %, 100 %, and 86 % for EUS-FNA. Of five adenocarcinomas with false-negative results at EUS-FNA, four had a hypointense echo signal at CEH-EUS. CEH-EUS with the new Olympus prototype device successfully visualizes the microvascular pattern in pancreatic solid lesions, and may be useful for distinguishing adenocarcinomas from other pancreatic masses.

  2. New-Generation High-Definition Colonoscopes Increase Adenoma Detection when Screening a Moderate-Risk Population for Colorectal Cancer.

    PubMed

    Bond, Ashley; O'Toole, Paul; Fisher, Gareth; Subramanian, Sreedhar; Haslam, Neil; Probert, Chris; Cox, Trevor; Sarkar, Sanchoy

    2017-03-01

    Adenoma detection rate (ADR) is the most important quality indicator for screening colonoscopy, due to its association with colorectal cancer outcomes. As a result, a number of techniques and technologies have been proposed that have the potential to improve ADR. The aim of this study was to assess the potential impact of new-generation high-definition (HD) colonoscopy on ADR within the Bowel Cancer Screening Programme (BCSP). This was a retrospective single-center observational study in patients undergoing an index screening colonoscopy. The examination was performed with either standard-definition colonoscopes (Olympus Q240/Q260 series) or HD colonoscopes (Olympus HQ290 EVIS LUCERA ELITE system) with the primary outcome measures of ADR and mean adenoma per procedure (MAP) between the 2 groups. A total of 395 patients (60.5% male, mean age 66.8 years) underwent screening colonoscopy with 45% performed with HD colonoscopes. The cecal intubation rate was 97.5% on an intention-to-treat basis and ADR was 68.6%. ADR with standard-definition was 63.13%, compared with 75.71% with HD (P = .007). The MAP in the HD group was 2.1 (± 2.0), whereas in the standard-definition group it was 1.6 (± 1.8) (P = .01). There was no significant difference in withdrawal time between the 2 groups. In the multivariate regression model, only HD scopes (P = .03) and male sex (P = .04) independently influenced ADR. Olympus H290 LUCERA ELITE HD colonoscopes improved adenoma detection within the moderate-risk population. A 12% improvement in ADR might be expected to increase significantly the protection afforded by colonoscopy against subsequent colorectal cancer mortality. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. OLYMPUS DISS - A Readily Implemented Geographic Data and Information Sharing System

    NASA Astrophysics Data System (ADS)

    Necsoiu, D. M.; Winfrey, B.; Murphy, K.; McKague, H. L.

    2002-12-01

    Electronic information technology has become a crucial component of business, government, and scientific organizations. In this technology era, many enterprises are moving away from the perception that information repositories are only a tool for decision-making. Instead, many organizations are learning that information systems, which are capable of organizing and following the interrelations between information and both the short-term and strategic organizational goals, are assets themselves, with inherent value. Olympus Data and Information Sharing System (DISS) is a system developed at the Center for Nuclear Waste Regulatory Analyses (CNWRA) to solve several difficult tasks associated with the management of geographical, geological and geophysical data. Three of the tasks were to (1) gather the large amount of heterogeneous information that has accumulated over the operational lifespan of CNWRA, (2) store the data in a central, knowledge-based, searchable database and (3) create quick, easy, convenient, and reliable access to that information. Faced with these difficult tasks CNWRA identified the requirements for designing such a system. Key design criteria were: (a) ability to ingest different data formats (i.e., raster, vector, and tabular data); (b) minimal expense using open-source and commercial off-the-shelf software; (c) seamless management of geospatial data, freeing up time for researchers to focus on analyses or algorithm development, rather than on time consuming format conversions; (d) controlled access; and (e) scalable architecture to meet new and continuing demands. Olympus DISS is a solution that can be easily adapted to small and mid-size enterprises dealing with heterogeneous geographic data. It uses established data standards, provides a flexible mechanism to build applications upon and output geographic data in multiple and clear ways. This abstract is an independent product of the CNWRA and does not necessarily reflect the views or regulatory position of the Nuclear Regulatory Commission.

  4. A NEW TRACER METHOD FOR ASSESSING HAND-TO-MOUTH TRANSFERS OF PESTICIDES

    EPA Science Inventory

    A common food chemical with high fluorescence intensity is being used in an evaluation of dermal transfer efficiencies as a surrogate for indoor pesticides chlorpyrifos and synthetic pyrethroids. The fluorescence monitoring system is based on an Olympus digital camera and the ...

  5. Digital Cameras for Student Use.

    ERIC Educational Resources Information Center

    Simpson, Carol

    1997-01-01

    Describes the features, equipment and operations of digital cameras and compares three different digital cameras for use in education. Price, technology requirements, features, transfer software, and accessories for the Kodak DC25, Olympus D-200L and Casio QV-100 are presented in a comparison table. (AEF)

  6. Statistical results from the Virginia Tech propagation experiment using the Olympus 12, 20, and 30 GHz satellite beacons

    NASA Technical Reports Server (NTRS)

    Stutzman, Warren L.; Safaai-Jazi, A.; Pratt, Timothy; Nelson, B.; Laster, J.; Ajaz, H.

    1993-01-01

    Virginia Tech has performed a comprehensive propagation experiment using the Olympus satellite beacons at 12.5, 19.77, and 29.66 GHz (which we refer to as 12, 20, and 30 GHz). Four receive terminals were designed and constructed, one terminal at each frequency plus a portable one with 20 and 30 GHz receivers for microscale and scintillation studies. Total power radiometers were included in each terminal in order to set the clear air reference level for each beacon and also to predict path attenuation. More details on the equipment and the experiment design are found elsewhere. Statistical results for one year of data collection were analyzed. In addition, the following studies were performed: a microdiversity experiment in which two closely spaced 20 GHz receivers were used; a comparison of total power and Dicke switched radiometer measurements, frequency scaling of scintillations, and adaptive power control algorithm development. Statistical results are reported.

  7. Olympus beacon receiver

    NASA Technical Reports Server (NTRS)

    Ostergaard, Jens

    1988-01-01

    A medium-size Beacon Receiving System for reception and processing of the B1 (20 GHz) and B2 (30 GHz) beacons from Olympus has been developed. Integration of B1 and B2 receiving equipment into one system using one antenna and a common computer for control and data processing provides the advantages of a compact configuration and synchronization of the two receiver chains. Range for co-polar signal attenuation meaurement is about 30 dB for both beacons, increasing to 40 dB for B2 if the receivers are synchronized to B1. The accuracy is better than 0.5 dB. Cross-polarization discriminations of the order of 10 to 30 dB may be determined with an accuracy of 1 to 2 dB. A number of radiometers for complementary measurements of atmospheric attenuation of 13 to 30 GHz has also been constructed. A small multi-frequency system for operation around 22 GHz and 31 GHz is presently under development.

  8. L- and K-band LMSS propagation measurements using MARECS-B, OLYMPUS, and ACTS

    NASA Technical Reports Server (NTRS)

    Vogel, W. J.; Torrence, G. W.; Goldhirsh, J.; Rowland, J. R.

    1992-01-01

    L-band measurements of land mobile satellite systems (LMSS) propagation effects were last made at the end of 1988, but some voids were left in the database, making modeling of low elevation roadside tree shadowing and multipath reflections difficult for some path geometries. Transmission of a pilot tone from MARECS-B at 55 deg West during Sep. and Dec. 1991 gave an opportunity to fill the gaps in the experimental results. Two campaigns during which fade data were obtained at elevation angles from 7 deg to 40 deg are described. Below 15 deg, specular terrain reflections in a non-shadowing, hilly environment were observed to introduce significant fading. Although the reflecting surface was at a distance of up to several km, it is shown that the reflected signals are delayed by less than 1 microsec. Mobile measurements were also attempted receiving the 20 GHz Olympus beacon, but antenna pointing problems restricted first results to straight-line driving.

  9. Permafrost features on Earth and Mars: Similarities, differences

    NASA Technical Reports Server (NTRS)

    Joens, H. P.

    1985-01-01

    Typical permafrost features on Earth are polygonal structures, pingos and soli-/gelifluxion features. In areas around the poles and in mountain ranges the precipitation accumulates to inland ice or ice streams. On Mars the same features were identified: polygonal features cover the larger part of the northern lowlands indicating probably an ice wedge-/sand wedge system or desiccation cracks. These features indicate the extend of large mud accumulations which seem to be related to large outflow events of the chaotic terrains. The shore line of this mud accumulation is indicated by a special set of relief types. In some areas large pingo-like hills were identified. In the vicinity of the largest martian volcano, Olympus Mons, the melting of underlying permafrost and/or ground ice led to the downslope sliding of large parts of the primary shield which formed the aureole around Olympus Mons. Glacier-like features are identified along the escarpment which separates the Southern Uplands from the Northern Lowlands.

  10. Young flood lavas in the Elysium Region, Mars

    NASA Technical Reports Server (NTRS)

    Plescia, J. B.

    1990-01-01

    The nature and origin of a smooth plains unit (the Cerberus Plains) in southeastern Elysium and western Amazonis are reported. The interpretation that the Cerberus Plains resulted from flood plains style volcanism late in martian history is presented which carries implications for martian thermal history and volcanic evolution of a global scale. Although central construct volcanism (e.g., Olympus Mons) has long been recognized as occurring late in time, flood volcanism has not. Flood volcanism has been suggested as the origin of the ridged plains units (e.g., Lunae Planum, Solis, and Sinai Planum). This type of volcanic activity generally occurred early, and in Tharsis, the style of volcanism evolved from flood eruptions into centralized eruptions which built the large Tharsis Montes and Olympus Mons shields. Volcanism in the Elysium region seems to have followed a similar trend from flood eruptions to central construct building. But, the Cerberus Plains indicate that the volcanic style returned to flood eruption again after central constructional volcanism had ended.

  11. [Attachment to a fibergastroscope for cinematography].

    PubMed

    Ignat'ev, A I

    1979-01-01

    The diagnostic horizon of endoscopy is being extended due to the record of endoscopic pictures on the cinema film. The accessories offered by the author allow successful application of the "Kiev-16" movie-camera jointly with the fibrogastroscopes produced by Olympus Co without camera, for cinema and photodocumentation.

  12. Evolution from a hinge actuator mechanism to an antenna deployment mechanism for use on the European large communications satellite (L-SAT/OLYMPUS)

    NASA Technical Reports Server (NTRS)

    Death, M. D.

    1984-01-01

    The evolution of an Antenna Deployment Mechanism (ADM) from a Hinge Actuator Mechanism (HAM) is described as it pertains to the deployment of large satellite antennas. Design analysis and mechanical tests are examined in detail.

  13. Closeout Report - Search for Time Reversal Symmetry Violation with TREK at J-PARC

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

    Kohl, Michael

    2015-04-15

    This DOE Early Career Award has enabled Dr. Michael Kohl to take on and expand his leadership roles in several projects such as TREK@J-PARC, OLYMPUS@DESY, MUSE@PSI, and in the experimental program in Hall C at Jefferson Lab. Dr. Kohl has successfully accomplished several items: (i) Preliminary results from SANE (E08-003) at Jefferson Lab: Former HU graduate student Anusha Liyanage has pursued her PhD research on SANE. Her analysis of the elastic ep scattering data has resulted in the extraction of the proton electric-to-magnetic form factor ratio from double spin asymmetries at the highest momentum transfer to date. The results aremore » almost final and a publication is in preparation. (ii) Approval of TREK/E36 for running, preparation of simulation and analysis: the TREK experiment has been stage-II approved in fall 2013, has been mounted on the hall floor from November 2014 to April 2015, has been commissioned in April-June 2015 and is scheduled to run in fall 2015. The group has contributed significantly with simulations and magnetic field map calculations, has investigated the sensitivity of TREK to new light neutral particles, and contributed substantially to the mounting and commissioning of the experiment. (iii) Running of OLYMPUS and analysis: Under Dr. Kohl's leadership as spokesman, the OLYMPUS experiment has completed data taking beginning of 2013; calibrations and analysis have been well underway, with results to be expected in the course of 2015. (iv) Operation of GEM detectors at OLYMPUS and MUSE: The GEM telescopes built for OLYMPUS luminosity monitoring with forward-angle ep elastic scattering have been operated successfully, have meanwhile been relocated to PSI, and have been re-commissioned as beam particle trackers for the PSI secondary beams for MUSE. (v) Trained and prepared postdocs and graduate students for their future careers. Two postdocs from Dr. Kohl's group (Dr. Juergen Diefenbach and Dr. Peter Monaghan) have found permanent academic positions. Two former graduate students of the group have graduated and received their PhD degrees in nuclear physics (Dr. Anusha Liyanage and Dr. Ozgur Ates). In particular, this award has enabled Dr. Kohl to pursue the TREK project (Time Reversal Experiment with Kaons) at J-PARC, which he has been leading and advancing as International Spokesperson. Originally proposed as a search for time reversal symmetry violation [6], the project has evolved into a precision test of lepton flavor universality in the Standard Model along with sensitive searches for physics beyond the Standard Model through a possible discovery of new particles such as a sterile neutrino or a neutral gauge boson from the hidden sector in the mass region up to 300 MeV/c2 [7]. Experiment TREK/E36, first proposed in 2010, has been mounted between November 2014 and April 2015, and commissioning with beam has been started in April 2015, with production running anticipated in early summer and late fall 2015. It uses the apparatus from the previous KEK/E-246 experiment with partial upgrades to measure the ratio of decay widths of leptonic two-body decays of the charged kaon to µν and eν, respectively, which is highly sensitive to the ratio of electromagnetic charged lepton couplings and possible new physics processes that could differentiate between μ and e, hence breaking lepton flavor universality of the Standard Model. Through the searches for neutral massive particles, TREK/E36 can severely constrain any new physics scenarios designed to explain the proton radius puzzle [12, 13].« less

  14. Mars: Chronological Studies of the Large Volcanoes in Tharsis

    NASA Technical Reports Server (NTRS)

    Grier, Jennifer; Bottke, William; Berman, Daniel C.; Hartmann, William K.

    2001-01-01

    We are beginning a study of age and morphology relations among Tharsis volcanics, with crater counts using new age calibrations. On Olympus Mons, averages over large areas give characteristic ages of a few hundred My, but youngest flows have ages in range 5-50 My. Additional information is contained in the original extended abstract.

  15. The RAI DBS experiment with Olympus

    NASA Astrophysics Data System (ADS)

    Castelli, Enzo

    The Italian broadcasting network (RAI) has studied the development of a national DBS service in an effort to outline a proposal for a space segment configuration compatible with development of new services, including HDTV. Proposals so far considered feature the integration of RAI's channel on Olympus in a future operational system and after extensive experimental use. Contents of the experimental program are discussed, and need for a broadcasting standard which considers projected introduction of HDTV is noted. The debate between RAI and consumer electronic industries on the use of broadcasting standards is outlined. The position of RAI in the context of HDTV and DBS is defined and the issue of determining the most effective transmission standard during the experimental stage is raised. It is pointed out that, in the absence of new production facilities for HDTV, the maximum quality which MAC will yield will be that of PAL since programs must be produced in PAL and then converted into MAC. Two alternatives for strategy on the use of broadcasting standards for DBS are offered. Finally, technical experiments and a market survey are discussed.

  16. Propagation characteristics of 20/30 GHz links with a 40 deg masking angle

    NASA Technical Reports Server (NTRS)

    Davarian, Faramaz; Kantak, Anil V.; Le, Choung

    1994-01-01

    An effective means of reducing Ka-band propagation loss is the use of high elevation angle paths, i.e., a large masking angle, between earth stations and the space platform. Experimental data have shown that the signal loss associated with most atmospheric effects is inversely proportional to sin(theta), where theta denotes the path elevation angle. A large masking angle and a generous link margin are the primary tools used in the Teledesic Corporation network to minimize atmospheric-related signal outages. This report documents the results of a study sponsored by Teledesic Corporation to characterize the effect of radiowave propagation on Teledesic's links. The recent Olympus campaign in Europe and the U.S. has provided new information that is not included. Therefore, CCIR recommendations and NASA Propagation Handbook models constitute the base of this study, and, when applicable, data from other sources have been used to improve the predictions. Furthermore, attention has been given to data from the Olympus campaign. The effects investigated during this study include gas, rain, fog, sand, and cloud attenuation; diversity gain; scintillation; and depolarization.

  17. Tharsis

    NASA Image and Video Library

    1998-06-08

    A color image of the Tharsis region of Mars; north toward top. The scene shows the Tharsis bulge, a huge ridge covered by the 3 large aligned Tharsis Montes shield volcanoes (from lower left to right): Arsia, Pavonis, and Ascraeus Mons. To the left of the Tharsis Montes lies the huge Olympus Mons shield volcano, followed clockwise by Alba Patera (north center), several smaller volcanoes, and the linear depressions of Mareotis and Tempe Fossae (upper right). This image is a composite of Viking medium-resolution images in black and white and low-resolution images in color. The image extends from latitude 50 degrees N. to 20 degrees S. and from longitude 85 degrees to 150 degrees. Mercator projection is used between latitudes 20 degrees S. and 30 degrees N.; Lambert projection is used above latitude 30 degrees N. The Tharsis bulge encompasses the most intensely and most recently active volcanic region of the planet. Each Tharsis Montes volcano is 350-400 km in diameter and about 17 km above the surrounding plain. The volcanoes are about 700 km apart and appear to be above a major northeast-trending fracture zone along the bulge, now buried by volcanic deposits. Olympus Mons (left center) is the largest known volcano in the Solar System. It is 27 km high, over 600 km at the base, and is surrounded by a well-defined scarp that is up to 6 km high. The summit calderas (central depressions) of all four volcanoes probably formed from recurrent collapse following drainage of magma resulting from flank eruptions. 1,600-km-diameter Alba Patera (north center) far exceeds any other known volcano in areal extent; it covers eight times the area of Olympus Mons but reaches only about 6 km in height. Fossae (linear depressions) of the Tharsis area are fault-bound graben formed by upwarping of the Tharsis bulge. http://photojournal.jpl.nasa.gov/catalog/PIA00408

  18. Tharsis

    NASA Technical Reports Server (NTRS)

    1997-01-01

    A color image of the Tharsis region of Mars; north toward top. The scene shows the Tharsis bulge, a huge ridge covered by the 3 large aligned Tharsis Montes shield volcanoes (from lower left to right): Arsia, Pavonis, and Ascraeus Mons. To the left of the Tharsis Montes lies the huge Olympus Mons shield volcano, followed clockwise by Alba Patera (north center), several smaller volcanoes, and the linear depressions of Mareotis and Tempe Fossae (upper right).

    This image is a composite of Viking medium-resolution images in black and white and low-resolution images in color. The image extends from latitude 50 degrees N. to 20 degrees S. and from longitude 85 degrees to 150 degrees. Mercator projection is used between latitudes 20 degrees S. and 30 degrees N.; Lambert projection is used above latitude 30 degrees N.

    The Tharsis bulge encompasses the most intensely and most recently active volcanic region of the planet. Each Tharsis Montes volcano is 350-400 km in diameter and about 17 km above the surrounding plain. The volcanoes are about 700 km apart and appear to be above a major northeast-trending fracture zone along the bulge, now buried by volcanic deposits. Olympus Mons (left center) is the largest known volcano in the Solar System. It is 27 km high, over 600 km at the base, and is surrounded by a well-defined scarp that is up to 6 km high. The summit calderas (central depressions) of all four volcanoes probably formed from recurrent collapse following drainage of magma resulting from flank eruptions. 1,600-km-diameter Alba Patera (north center) far exceeds any other known volcano in areal extent; it covers eight times the area of Olympus Mons but reaches only about 6 km in height. Fossae (linear depressions) of the Tharsis area are fault-bound graben formed by upwarping of the Tharsis bulge.

  19. Comparison of different biopsy forceps models for tissue sampling in eosinophilic esophagitis.

    PubMed

    Bussmann, Christian; Schoepfer, Alain M; Safroneeva, Ekaterina; Haas, Nadine; Godat, Sébastien; Sempoux, Christine; Simon, Hans-Uwe; Straumann, Alex

    2016-12-01

    Background and aims: Eosinophilic esophagitis (EoE) is a mixed inflammatory and fibrostenotic disease. Unlike superficial inflammatory changes, subepithelial fibrosis is not routinely sampled in esophageal biopsies. This study aimed to evaluate the efficacy and safety of deep esophageal sampling with four different types of biopsy forceps. Patients and methods: In this cross-sectional study, esophageal biopsies were taken in 30 adult patients by one expert endoscopist. Biopsies sampled from distal esophagus using a static jaw forceps (Olympus, FB-11K-1) were compared with proximal biopsies sampled with static jaw (Olympus, FB-45Q-1), alligator jaw (Olympus, FB-210K), and large-capacity forceps (Boston Scientific, Radial Jaw 4). One pathologist calculated the surface area of epithelial and subepithelial layers in hematoxylin and eosin (H&E)-stained biopsies. Results: Subepithelial tissue was acquired in 97 % (static jaw FB-11K-1), 93 % (static jaw FB-45Q-1), 80 % (alligator jaw), and 55 % (large-capacity) of samples. Median (interquartile [IQR]) ratios of surface area of epithelial to subepithelial tissue were: static jaw FB-45Q-1, 1.07 (0.65 - 4.465); static jaw FB-11K-1, 1.184 (0.608 - 2.545); alligator jaw, 2.353 (1.312 - 4.465); and large-capacity, 2.71 (1.611 - 4.858). The static jaw models obtained a larger surface area of subepithelial tissue compared with the alligator jaw ( P  < 0.001 and P  = 0.037, for FB-11K-1 and FB-45Q-1, respectively) and the large-capacity forceps ( P  < 0.001, for both static jaw models). No esophageal perforations occurred. Conclusions: The static jaw forceps models allowed sampling of subepithelial tissue in > 90 % of biopsies and appear to be superior to alligator or large-capacity forceps in sampling larger amounts of subepithelial tissue. © Georg Thieme Verlag KG Stuttgart · New York.

  20. A technical review of flexible endoscopic multitasking platforms.

    PubMed

    Yeung, Baldwin Po Man; Gourlay, Terence

    2012-01-01

    Further development of advanced therapeutic endoscopic techniques and natural orifice translumenal endoscopic surgery (NOTES) requires a powerful flexible endoscopic multitasking platform. Medline search was performed to identify literature relating to flexible endoscopic multitasking platform from year 2004-2011 using keywords: Flexible endoscopic multitasking platform, NOTES, Instrumentation, Endoscopic robotic surgery, and specific names of various endoscopic multitasking platforms. Key articles from articles references were reviewed. Flexible multitasking platforms can be classified as either mechanical or robotic. Purely mechanical systems include the dual channel endoscope (DCE) (Olympus), R-Scope (Olympus), the EndoSamurai (Olympus), the ANUBIScope (Karl-Storz), Incisionless Operating Platform (IOP) (USGI), and DDES system (Boston Scientific). Robotic systems include the MASTER system (Nanyang University, Singapore) and the Viacath (Hansen Medical). The DCE, the R-Scope, the EndoSamurai and the ANUBIScope have integrated visual function and instrument manipulation function. The IOP and DDES systems rely on the conventional flexible endoscope for visualization, and instrument manipulation is integrated through the use of a flexible, often lockable, multichannel access device. The advantage of the access device concept is that it allows optics and instrument dissociation. Due to the anatomical constrains of the pharynx, systems are designed to have a diameter of less than 20 mm. All systems are controlled by traction cable system actuated either by hand or by robotic machinery. In a flexible system, this method of actuation inevitably leads to significant hysteresis. This problem will be accentuated with a long endoscope such as that required in performing colonic procedures. Systems often require multiple operators. To date, the DCE, the R-Scope, the IOP, and the Viacath system have data published relating to their application in human. Alternative forms of instrument actuation, camera control and master console ergonomics should be explored to improve instrument precision, sphere of action, size and minimize assistance required. Copyright © 2012 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  1. The Soviet Road to Olympus. Theory and Practice of Soviet Physical Culture and Sport. Occasional Papers/19.

    ERIC Educational Resources Information Center

    Shneidman, N. Norman

    Serving as an introduction to Soviet physical education which endeavors to give a concise outline of the organizational structure and the theoretical foundatons of Soviet sport, this book attempts to discuss Soviet physical education in relation to Soviet education and culture generally and to examine critically the practical applications of the…

  2. The Moon and Mars in August

    NASA Astrophysics Data System (ADS)

    Paice, P.

    2003-10-01

    The naked-eye view of the full Moon and Mars together was captured by Peter Paice, Belfast, on 2003 August 12/13 at midnight UT using an Olympus 730 Ultra Zoom digital camera, with no additional processing applied. In a partly cloudy sky, the secret was to wait until clouds partly occluded the power of the Moon, and Mars was in a clear patch.

  3. Influence of laser-welding and electroerosion on passive fit of implant-supported prosthesis.

    PubMed

    Silva, Tatiana Bernardon; De Arruda Nobilo, Mauro Antonio; Pessanha Henriques, Guilherme Elias; Mesquita, Marcelo Ferraz; Guimaraes, Magali Beck

    2008-01-01

    This study investigated the influence of laser welding and electroerosion procedure on the passive fit of interim fixed implant-supported titanium frameworks. Twenty frameworks were made from a master model, with five parallel placed implants in the inter foramen region, and cast in commercially pure titanium. The frameworks were divided into 4 groups: 10 samples were tested before (G1) and after (G2) electroerosion application; and another 10 were sectioned into five pieces and laser welded before (G3) and after (G4) electroerosion application. The passive fit between the UCLA abutment of the framework and the implant was evaluated using an optical microscope Olympus STM (Olympus Optical Co., Tokyo, Japan) with 0.0005mm of accuracy. Statistical analyses showed significant differences between G1 and G2, G1 and G3, G1 and G4, G2 and G4. However, no statistical difference was observed when comparing G2 and G3. These results indicate that frameworks may show a more precise adaptation if they are sectioned and laser welded. In the same way, electroerosion improves the precision in the framework adaptation.

  4. Water ice clouds observations with PFS on Mars Express

    NASA Astrophysics Data System (ADS)

    Moroz, V. I.; Zasova, L. V.; Formisano, V.; Grassi, D.; Ignatiev, N. I.; Giuranna, M.; Maturilli, A.; Pfs Team

    The water ice cloud observation is one of the scientific goals of PFS. Presence and properties of the ice particles are identified from absorption features, observed in both spectral ranges of PFS. Being in the near perihelion condition, the temperature of the Martian atmosphere is pretty high and ice clouds exist only in some places, for example, related to topography or at north high latitudes et etc. The ice clouds are observed often above the tops of the volcanoes. We have found the ice clouds above Olympus (orbit 37) and Ascraeus Mons (orbit 68). Effective radius of particles according to the thermal IR is preliminary estimated of 1 μ m, which leads to the visual opacity of 0.2 -0.3 above Olympus and of maximum of 0.6 above Ascraeus Mons. In the case of Ascraeus Mons the ice clouds are observed on the south slope near the top of the volcano. The maximum surface temperature, observed there, results in the upward flux of warm air, which, cooling, provides the condensation of H2O. We will present a detailed analysis of the ice clouds, observed over the planet in the IR spectral range.

  5. High resolution 3D confocal microscope imaging of volcanic ash particles.

    PubMed

    Wertheim, David; Gillmore, Gavin; Gill, Ian; Petford, Nick

    2017-07-15

    We present initial results from a novel high resolution confocal microscopy study of the 3D surface structure of volcanic ash particles from two recent explosive basaltic eruptions, Eyjafjallajökull (2010) and Grimsvötn (2011), in Iceland. The majority of particles imaged are less than 100μm in size and include PM 10 s, known to be harmful to humans if inhaled. Previous studies have mainly used 2D microscopy to examine volcanic particles. The aim of this study was to test the potential of 3D laser scanning confocal microscopy as a reliable analysis tool for these materials and if so to what degree high resolution surface and volume data could be obtained that would further aid in their classification. First results obtained using an Olympus LEXT scanning confocal microscope with a ×50 and ×100 objective lens are highly encouraging. They reveal a range of discrete particle types characterised by sharp or concave edges consistent with explosive formation and sudden rupture of magma. Initial surface area/volume ratios are given that may prove useful in subsequent modelling of damage to aircraft engines and human tissue where inhalation has occurred. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. 78 FR 42902 - Safety Zone; Olympus Tension Leg Platform, Mississippi Canyon Block 807, Outer Continental Shelf...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-18

    ..., an email address, or a telephone number in the body of your document so that we can contact you if we... Federal Register (73 FR 3316). 4. Public Meeting We do not now plan to hold a public meeting. But you may... the purpose of protecting life, property and the marine environment (33 CFR 147.1). Placing a safety...

  7. Variations in Crustal Structure, Lithospheric Flexural Strength, and Isostatic Compensation Mechanisms of Mars

    NASA Astrophysics Data System (ADS)

    Ding, M.; Lin, J.; Zuber, M. T.

    2014-12-01

    We analyze gravity and topography of Mars to investigate the spatial variations in crustal thickness, lithospheric strength, and mechanisms of support of prominent topographic features on Mars. The latest gravity model JGMRO110c (released in 2012) from the Mars Reconnaissance Orbiter mission has a spatial block size resolution of ~97 km (corresponding to degree-110), enabling us to resolve crustal structures at higher spatial resolution than those determined from previous degree-80 and 85 gravity models [Zuber et al., 2000; McGovern et al., 2002, 2004; Neumann et al., 2004; Belleguic et al., 2005]. Using the latest gravity data, we first inverted for a new version of crustal thickness model of Mars assuming homogeneous crust and mantle densities of 2.9 and 3.5 g/cm3. We calculated "isostatic" topography for the Airy local isostatic compensation mechanism, and "non-isostatic" topography after removing the isostatic part. We find that about 92% of the Martian surface is in relatively isostatic state, indicating either relatively small lithospheric strength and/or small vertical loading. Relatively isostatic regions include the hemispheric dichotomy, Hellas and Argyre Planitia, Noachis and Arabia Terra, and Terra Cimmeria. In contrast, regions with significant amount of non-isostatic topography include the Olympus, Ascraeus, Arsia, Pavonis, Alba, and Elysium Mons, Isidis Planitia and Valles Marineris. Their relatively large "non-isostatc topography" implies relatively strong lithospheric strength and large vertical loading. Spectral analysis of the admittance and correlation relationship between gravity and topography were conducted for the non-isostatic regions using the localized spectra method [Wieczorek and Simons, 2005, 2007] and thin-shell lithospheric flexural approximation [Forsyth, 1985; McGovern et al., 2002, 2004]. The best-fitting models reveal significant variations in the effective lithospheric thickness with the greatest values for the Olympus Mon, Valles Marineris, and Isidis Planitia; reduced values for the Ascraeus, Arsis, and Pavonis Mons; and smallest values for the Alba and Elysium Mons. Our models also suggest that there could be significant sub-surface loading underneath the Olympus, Ascraeus, Arsia, and Pavonis Mons, and Isidis Planitia.

  8. Assessing the Relationship Between Sexual Concordance, Sexual Attractions, and Sexual Identity in Women.

    PubMed

    Suschinsky, Kelly D; Dawson, Samantha J; Chivers, Meredith L

    2017-01-01

    On average, there is a gender difference in sexual concordance, with men exhibiting greater agreement between genital and self-reported sexual arousal, relative to women. Much less is known about the substantial variation in women's sexual concordance; women's genital and self-reported sexual responses may correlate strongly and positively, not at all, or even strongly negatively. The within-gender variation in sexual concordance suggests that individual differences may be related to sexual concordance. We examined whether sexual concordance varies as a function of sexual orientation (based on self-reported sexual attractions and sexual identity labels) in a sample (N = 76) that included exclusively androphilic, predominantly androphilic, ambiphilic, and predominantly/exclusively gynephilic women. Participants viewed sexual and nonsexual stimuli that varied by actor gender while their vaginal vasocongestion and subjective sexual responses were measured. Women's sexual concordance varied as a function of their sexual attractions; women with any degree of gynephilia exhibited higher sexual concordance than exclusively androphilic women across a variety of sexual concordance measures, and these effects were demonstrated using correlation and multi-level modeling analyses. Only sexual concordance based on overall feelings of arousal varied by sexual identity, with heterosexual women exhibiting the lowest sexual concordance. Stimulus gender significantly influenced sexual concordance for most groups of women: Ambiphilic and predominantly/exclusively gynephilic women exhibited greater sexual concordance to female stimuli and exclusively androphilic women exhibited greater sexual concordance to male stimuli. These findings suggest that sexual orientation (particularly one's degree of gynephilia) may explain some of the within-gender variation seen in women's sexual concordance.

  9. 27. Photocopy of a photograph (original print in the collection ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    27. Photocopy of a photograph (original print in the collection of the New Hampshire Water Resources Board, Concord, New Hampshire) 1927, photographer unknown 2 3/8 X 4 inch negative VIEW OF THE POND OF DAM NO. 5, WITH PORTIONS OF THE COVERED FOOTBRIDGE (ca 1929) AND DAM No.4 (1887-1927) VISIBLE IN BACKGROUND. THE SULLIVAN MACHINERY COMPANY BOILER ROOM AND ENGINE AND COMPRESSION ROOM (1919) ARE VISIBLE IN THE LEFT FOREGROUND. - Claremont Village Industrial District, Between B, Claremont, Sullivan County, NH

  10. Maximizing the sensitivity and reliability of peptide identification in large-scale proteomic experiments by harnessing multiple search engines.

    PubMed

    Yu, Wen; Taylor, J Alex; Davis, Michael T; Bonilla, Leo E; Lee, Kimberly A; Auger, Paul L; Farnsworth, Chris C; Welcher, Andrew A; Patterson, Scott D

    2010-03-01

    Despite recent advances in qualitative proteomics, the automatic identification of peptides with optimal sensitivity and accuracy remains a difficult goal. To address this deficiency, a novel algorithm, Multiple Search Engines, Normalization and Consensus is described. The method employs six search engines and a re-scoring engine to search MS/MS spectra against protein and decoy sequences. After the peptide hits from each engine are normalized to error rates estimated from the decoy hits, peptide assignments are then deduced using a minimum consensus model. These assignments are produced in a series of progressively relaxed false-discovery rates, thus enabling a comprehensive interpretation of the data set. Additionally, the estimated false-discovery rate was found to have good concordance with the observed false-positive rate calculated from known identities. Benchmarking against standard proteins data sets (ISBv1, sPRG2006) and their published analysis, demonstrated that the Multiple Search Engines, Normalization and Consensus algorithm consistently achieved significantly higher sensitivity in peptide identifications, which led to increased or more robust protein identifications in all data sets compared with prior methods. The sensitivity and the false-positive rate of peptide identification exhibit an inverse-proportional and linear relationship with the number of participating search engines.

  11. Feasibility of Prostate Cancer Diagnosis by Transrectal Photoacoustic Imaging

    DTIC Science & Technology

    2012-03-01

    cancer detection; needle biopsy is the current practice for diagnosis of the disease, aiming randomly in the prostate. Transrectal ultrasound has...been used as a guiding tool to direct tissue needle biopsy for prostate cancer diagnosis; it cannot be utilized for detecting prostate cancer due to...Research Systems, CA) and used as a reference signal. The sample and the ultrasound transducer (UST, Olympus NDT, one inch in focal length) are

  12. Voces de Olympo (Echoes from Mount Olympus). A Humanistic Approach to Latin for Children in the Sixth Grade: Teachers' Guide.

    ERIC Educational Resources Information Center

    Masciantonio, Rudolph; And Others

    This curriculum guide, developed for use in a sixth-grade FLES (foreign language in elementary school) program, embraces a visual-audiolingual approach to the teaching of Latin while providing a source of materials for the teaching of the culture of ancient Rome. The course is organized around eight major units on: (1) Jupiter and His Siblings,…

  13. Olympus Mons Landslide

    NASA Technical Reports Server (NTRS)

    2005-01-01

    [figure removed for brevity, see original site]

    The landslide in this VIS image originated from the steep escarpment which surrounds the Olympus Mons volcano on Mars. This landslide is located on the northern side of the volcano.

    Image information: VIS instrument. Latitude 23.2, Longitude 223.9 East (136.1 West). 100 meter/pixel resolution.

    Note: this THEMIS visual image has not been radiometrically nor geometrically calibrated for this preliminary release. An empirical correction has been performed to remove instrumental effects. A linear shift has been applied in the cross-track and down-track direction to approximate spacecraft and planetary motion. Fully calibrated and geometrically projected images will be released through the Planetary Data System in accordance with Project policies at a later time.

    NASA's Jet Propulsion Laboratory manages the 2001 Mars Odyssey mission for NASA's Office of Space Science, Washington, D.C. The Thermal Emission Imaging System (THEMIS) was developed by Arizona State University, Tempe, in collaboration with Raytheon Santa Barbara Remote Sensing. The THEMIS investigation is led by Dr. Philip Christensen at Arizona State University. Lockheed Martin Astronautics, Denver, is the prime contractor for the Odyssey project, and developed and built the orbiter. Mission operations are conducted jointly from Lockheed Martin and from JPL, a division of the California Institute of Technology in Pasadena.

  14. Measurement and tricubic interpolation of the magnetic field for the OLYMPUS experiment

    NASA Astrophysics Data System (ADS)

    Bernauer, J. C.; Diefenbach, J.; Elbakian, G.; Gavrilov, G.; Goerrissen, N.; Hasell, D. K.; Henderson, B. S.; Holler, Y.; Karyan, G.; Ludwig, J.; Marukyan, H.; Naryshkin, Y.; O'Connor, C.; Russell, R. L.; Schmidt, A.; Schneekloth, U.; Suvorov, K.; Veretennikov, D.

    2016-07-01

    The OLYMPUS experiment used a 0.3 T toroidal magnetic spectrometer to measure the momenta of outgoing charged particles. In order to accurately determine particle trajectories, knowledge of the magnetic field was needed throughout the spectrometer volume. For that purpose, the magnetic field was measured at over 36,000 positions using a three-dimensional Hall probe actuated by a system of translation tables. We used these field data to fit a numerical magnetic field model, which could be employed to calculate the magnetic field at any point in the spectrometer volume. Calculations with this model were computationally intensive; for analysis applications where speed was crucial, we pre-computed the magnetic field and its derivatives on an evenly spaced grid so that the field could be interpolated between grid points. We developed a spline-based interpolation scheme suitable for SIMD implementations, with a memory layout chosen to minimize space and optimize the cache behavior to quickly calculate field values. This scheme requires only one-eighth of the memory needed to store necessary coefficients compared with a previous scheme (Lekien and Marsden, 2005 [1]). This method was accurate for the vast majority of the spectrometer volume, though special fits and representations were needed to improve the accuracy close to the magnet coils and along the toroidal axis.

  15. 33 CFR 165.1199 - Security Zones; Military Ocean Terminal Concord (MOTCO), Concord, California.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Security Zones; Military Ocean... Coast Guard District § 165.1199 Security Zones; Military Ocean Terminal Concord (MOTCO), Concord..., extending from the surface to the sea floor, within 500 yards of the three Military Ocean Terminal Concord...

  16. 33 CFR 165.1199 - Security Zones; Military Ocean Terminal Concord (MOTCO), Concord, California.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Security Zones; Military Ocean... Coast Guard District § 165.1199 Security Zones; Military Ocean Terminal Concord (MOTCO), Concord..., extending from the surface to the sea floor, within 500 yards of the three Military Ocean Terminal Concord...

  17. 33 CFR 165.1199 - Security Zones; Military Ocean Terminal Concord (MOTCO), Concord, California.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false Security Zones; Military Ocean... Coast Guard District § 165.1199 Security Zones; Military Ocean Terminal Concord (MOTCO), Concord..., extending from the surface to the sea floor, within 500 yards of the three Military Ocean Terminal Concord...

  18. 33 CFR 165.1199 - Security Zones; Military Ocean Terminal Concord (MOTCO), Concord, California.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false Security Zones; Military Ocean... Coast Guard District § 165.1199 Security Zones; Military Ocean Terminal Concord (MOTCO), Concord..., extending from the surface to the sea floor, within 500 yards of the three Military Ocean Terminal Concord...

  19. 33 CFR 165.1199 - Security Zones; Military Ocean Terminal Concord (MOTCO), Concord, California.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 2 2013-07-01 2013-07-01 false Security Zones; Military Ocean... Coast Guard District § 165.1199 Security Zones; Military Ocean Terminal Concord (MOTCO), Concord..., extending from the surface to the sea floor, within 500 yards of the three Military Ocean Terminal Concord...

  20. The role of British Aerospace in satellite TV broadcasting

    NASA Astrophysics Data System (ADS)

    Blonstein, J. L.

    DBS spacecraft development (completed, underway, and planned) at British Aerospace is surveyed and illustrated with diagrams, graphs, drawings, maps, and tables. The satellites briefly characterized include OTS, ECS, Olympus, Eurostar, and Unisat. The growth in the number and power of DBS channels available is described, and the design concept of a 15-kW platform combining sun-pointing solar panels and outer structure with a slowly rotating earth-pointing inner antenna structure is presented.

  1. Proceedings of the Thirteenth NASA Propagation Experimenters Meeting (NAPEX 13)

    NASA Technical Reports Server (NTRS)

    Davarian, Faramaz (Editor)

    1989-01-01

    The NASA Propagation Experimenters Meeting (NAPEX), supported by the NASA Propagation Program, is convened annually to discuss studies made on radio wave propagation by investigators from domestic and international organizations. The meeting was organized into three technical sessions: the first focused on mobile satellite propagation; the second examined the propagation effects for frequencies above 10 GHz; and the third addressed studies devoted exclusively to the Olympus/Advanced Communications Technology Satellite (ACTS) Program.

  2. Concordance of Beta-papillomavirus across anogenital and oral anatomic sites of men: The HIM Study.

    PubMed

    Nunes, Emily M; López, Rossana V M; Sudenga, Staci L; Gheit, Tarik; Tommasino, Massimo; Baggio, Maria L; Ferreira, Silvaneide; Galan, Lenice; Silva, Roberto C; Lazcano-Ponce, Eduardo; Giuliano, Anna R; Villa, Luisa L; Sichero, Laura

    2017-10-01

    We evaluated the concordance between β-HPVs detected in external genital skin, anal canal, and oral cavity specimens collected simultaneously from 717 men that were participating in the multinational HIM Study. Viral genotyping was performed using the Luminex technology. Species- and type-specific concordance was measured using kappa statistics for agreement. Overall, concordance of β-HPVs across sites was low and mainly observed among paired genital/anal canal samples. When grouped by species, solely β-4 HPVs showed moderate concordance in genital/anal pairs (κ = 0.457), which could be attributed to the substantial concordance of HPV-92 in men from Brazil and Mexico (κ > 0.610). β-HPV type concordance was higher in Mexico, where HPV-19 was consistently concordant in all anatomic site combinations. Our analysis indicates that type-specific concordance across sites is limited to few viral types; however, these infections seem to occur more often than would be expected by chance, suggesting that although rare, there is agreement among sites. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Does Repeated Testing Impact Concordance Between Genital and Self-Reported Sexual Arousal in Women?

    PubMed

    Velten, Julia; Chivers, Meredith L; Brotto, Lori A

    2018-04-01

    Women show a substantial variability in their genital and subjective responses to sexual stimuli. The level of agreement between these two aspects of response is termed sexual concordance and has been increasingly investigated because of its implications for understanding models of sexual response and as a potential endpoint in clinical trials of treatments to improve women's sexual dysfunction. However, interpreting changes in sexual concordance may be problematic because, to date, it still is unclear how repeated testing itself influences sexual concordance in women. We are aware of only one study that evaluated temporal stability of concordance in women, and it found no evidence of stability. However, time stability would be necessary for arguing that concordance is a stable individual difference. The main goal of this study was to investigate the test-retest reliability of sexual concordance in a sample of 30 women with sexual difficulties. Using hierarchical linear modeling, we found that sexual concordance was not influenced by repeated testing 12 weeks later, but showed test-retest reliability suggesting temporal stability. Our findings support the hypothesis that sexual concordance is a relatively stable individual difference and that changes in sexual concordance after treatment or experimental conditions could, therefore, be attributed to effects of those conditions.

  4. Efficient femtosecond driven SOX 17 delivery into mouse embryonic stem cells: differentiation studies

    NASA Astrophysics Data System (ADS)

    Thobakgale, Lebogang; Manoto, Sello Lebohang; Lemboumba, Satuurnin Ombinda; Maaza, Malik; Mthunzi-Kufa, Patience

    2017-02-01

    Embryonic stem cells have great promise in regenerative medicine because of their ability to self-renew and differentiate into various cell types. Delivery of therapeutic genes into cells has already been achieved using of chemical agents and viral vectors with high transfection efficiencies. However, these methods have also been documented as toxic and in the latter case they can cause latent cell infections. In this study we use femtosecond laser pulses to optically deliver genetic material in mouse embryonic stem cells. Femtosecond laser pulses in contrast to the conventional approach, minimises the risk of unwanted side effects because photons are used to create transient pores on the membrane which allow free entry of molecules with no need for delivery agents. Using an Olympus microscope, fluorescence imaging of the samples post irradiation was performed and decreased expression of stage specific embryonic antigen one (SSEA-1) consistent with on-going cellular differentiation was observed. Our results also show that femtosecond laser pulses were effective in delivering SOX 17 plasmid DNA (pSOX17) which resulted in the differentiation of mouse embryonic stem cells into endoderm cells. We thus concluded that laser transfection of stem cells for the purpose of differentiation, holds potential for applications in tissue engineering as a method of generating new cell lines.

  5. Accessibility, nature and quality of health information on the Internet: a survey on osteoarthritis.

    PubMed

    Maloney, S; Ilic, D; Green, S

    2005-03-01

    This study aims to determine the quality and validity of information available on the Internet about osteoarthritis and to investigate the best way of sourcing this information. Keywords relevant to osteoarthritis were searched across 15 search engines representing medical, general and meta-search engines. Search engine efficiency was defined as the percentage of unique and relevant websites from all websites returned by each search engine. The quality of relevant information was appraised using the DISCERN tool and the concordance of the information offered by the website with the available evidence about osteoarthritis determined. A total of 3443 websites were retrieved, of which 344 were identified as unique and providing information relevant to osteoarthritis. The overall quality of website information was poor. There was no significant difference between types of search engine in sourcing relevant information; however, the information retrieved from medical search engines was of a higher quality. Fewer than a third of the websites identified as offering relevant information cited evidence to support their recommendations. Although the overall quality of website information about osteoarthritis was poor, medical search engines may provide consumers with the opportunity to source high-quality health information on the Internet. In the era of evidence-based medicine, one of the main obstacles to the Internet reaching its potential as a medical resource is the failure of websites to incorporate and attribute evidence-based information.

  6. Overseas Internship Education in Engineering Graduate Courses and Evaluation of the Educational Effect

    NASA Astrophysics Data System (ADS)

    Noguchi, Toru; Yoshikawa, Kozo; Nakamura, Masato

    Center for Engineering Education Development, CEED, Hokkaido University was established to provide new graduate course programs more practical and concordant with the needs of industry and global society. The major program is the overseas internship, where students join some project as experiment, design, analysis, production, software making, etc, in the companies or research organizations in the foreign countries. For these three years, CEED sent over 65 students to 24 countries in the world. In this report, the CEED implementation of the internship program is described and examples of students‧ activities in the overseas internship are introduced. The educational effect is also stated based on the questionnaire survey. From the data, students‧ abilities such as, international understanding, challenging spirit, attitude to learn new things, as well as language proficiency are markedly improved.

  7. Modulation of Memory T Cells to Control Acquired Bone Marrow Failure

    DTIC Science & Technology

    2016-01-01

    Representative images show the tissues from one of 6 recipients in each group at day 7 after transplantation. Images were obtained with an OlympusBX41...alloreactive effector T cells capable of mediating host tissue injury and could be beneficial targets for improving the efficacy of allogeneic HSCT...leukemia (GVL) effect, but showed impaired expansion in local tissues .69-72 This nTEM pool might have less diverse T cell receptor (TCR) repertoire

  8. Evaluation of the Olympus AU-510 analyser.

    PubMed

    Farré, C; Velasco, J; Ramón, F

    1991-01-01

    The selective multitest Olympus AU-510 analyser was evaluated according to the recommendations of the Comision de Instrumentacion de la Sociedad Española de Quimica Clinica and the European Committee for Clinical Laboratory Standards. The evaluation was carried out in two stages: an examination of the analytical units and then an evaluation in routine work conditions. The operational characteristics of the system were also studied.THE FIRST STAGE INCLUDED A PHOTOMETRIC STUDY: dependent on the absorbance, the inaccuracy varies between +0.5% to -0.6% at 405 nm and from -5.6% to 10.6% at 340 nm; the imprecision ranges between -0.22% and 0.56% at 405 nm and between 0.09% and 2.74% at 340 nm. Linearity was acceptable, apart from a very low absorbance for NADH at 340 nm; and the imprecision of the serum sample pipetter was satisfactory.TWELVE SERUM ANALYTES WERE STUDIED UNDER ROUTINE CONDITIONS: glucose, urea urate, cholesterol, triglycerides, total bilirubin, creatinine, phosphate, iron, aspartate aminotransferase, alanine aminotransferase and gamma-glutamyl transferase.The within-run imprecision (CV%) ranged from 0.67% for phosphate to 2.89% for iron and the between-run imprecision from 0.97% for total bilirubin to 7.06% for iron. There was no carryover in a study of the serum sample pipetter. Carry-over studies with the reagent and sample pipetters shows some cross contamination in the iron assay.

  9. Evaluation of photoshop based image analysis in cytologic diagnosis of pleural fluid in comparison with conventional modalities.

    PubMed

    Jafarian, Amir Hossein; Tasbandi, Aida; Mohamadian Roshan, Nema

    2018-04-19

    The aim of this study is to investigate and compare the results of digital image analysis in pleural effusion cytology samples with conventional modalities. In this cross-sectional study, 53 pleural fluid cytology smears from Qaem hospital pathology department, located in Mashhad, Iran were investigated. Prior to digital analysis, all specimens were evaluated by two pathologists and categorized into three groups as: benign, suspicious, and malignant. Using an Olympus microscope and Olympus DP3 digital camera, digital images from cytology slides were captured. Appropriate images (n = 130) were separately imported to Adobe Photoshop CS5 and parameters including area and perimeter, circularity, Gray Value mean, integrated density, and nucleus to cytoplasm area ratio were analyzed. Gray Value mean, nucleus to cytoplasm area ratio, and circularity showed the best sensitivity and specificity rates as well as significant differences between all groups. Also, nucleus area and perimeter showed a significant relation between suspicious and malignant groups with benign group. Whereas, there was no such difference between suspicious and malignant groups. We concluded that digital image analysis is welcomed in the field of research on pleural fluid smears as it can provide quantitative data to apply various comparisons and reduce interobserver variation which could assist pathologists to achieve a more accurate diagnosis. © 2018 Wiley Periodicals, Inc.

  10. Endoscopic management of congenital esophageal stenosis.

    PubMed

    Romeo, Erminia; Foschia, Francesca; de Angelis, Paola; Caldaro, Tamara; Federici di Abriola, Giovanni; Gambitta, Rosaalba; Buoni, Simona; Torroni, Filippo; Pardi, Valerio; Dall'oglio, Luigi

    2011-05-01

    Congenital esophageal stenosis (CES) is a rare malformation. Endoscopic dilations represent a therapeutic option. This study retrospectively evaluated the efficacy and safety of a conservative treatment of CES. Patients diagnosed with CES since 1980 by a barium study or endoscopy were reviewed. Endoscopic ultrasonography (Olympus UM-3R-20-MHz radial miniprobe, Olympus Corporation, Tokyo, Japan), available from 2001, allowed for the differential diagnosis of tracheobronchial remnants (TBR) and fibromuscular hypertrophy (FMH) CES. All children underwent conservative treatment by endoscopic dilations (hydrostatic and Savary). Forty-seven patients (20 men) had CES. Fifteen were associated with esophageal atresia; and 8, with Down syndrome. Mean age at the diagnosis was 28.3 months (range, 1 day to 146 months). Symptoms were solid food refusal, regurgitation, vomiting, and dysphagia. Congenital esophageal stenosis was located in the distal esophagus. Endoscopic ultrasonography demonstrated TBR and FMH in 6 patients. One hundred forty-eight dilations in 47 patients were performed. The stenosis healed in 45 (95.7%). Complications were 5 (10.6%) esophageal perforations, hydrostatic (3/32, or 9.3%), and Savary (2/116, or 1.7%). At follow-up, 1 patient with FMH CES and 1 patient with TBR CES required operation for persistent dysphagia. The conservative treatment yielded positive outcomes in CES. Endoscopic ultrasonography allows for a correct diagnosis of TBR/FMH CES. A surgical approach should be reserved for CES not responsive to dilations. Copyright © 2011 Elsevier Inc. All rights reserved.

  11. 76 FR 59167 - Siemens Medical Solutions USA, Inc., Oncology Care Systems Division, Concord, CA; Siemens Medical...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-23

    ... Medical Solutions USA, Inc., Oncology Care Systems Division, Concord, CA; Siemens Medical Solutions USA... Solutions USA, Inc. (Siemens), Oncology Care Systems Division, Concord, California (subject firm). The...., Oncology Care Systems Division, Concord, California (TA-W-73,158) and Siemens Medical Solutions USA, Inc...

  12. Are Physicians and Patients in Agreement? Exploring Dyadic Concordance

    ERIC Educational Resources Information Center

    Coran, Justin J.; Koropeckyj-Cox, Tanya; Arnold, Christa L.

    2013-01-01

    Dyadic concordance in physician-patient interactions can be defined as the extent of agreement between physicians and patients in their perceptions of the clinical encounter. The current research specifically examined two types of concordance: informational concordance--the extent of agreement in physician and patient responses regarding patient…

  13. Estimating the concordance probability in a survival analysis with a discrete number of risk groups.

    PubMed

    Heller, Glenn; Mo, Qianxing

    2016-04-01

    A clinical risk classification system is an important component of a treatment decision algorithm. A measure used to assess the strength of a risk classification system is discrimination, and when the outcome is survival time, the most commonly applied global measure of discrimination is the concordance probability. The concordance probability represents the pairwise probability of lower patient risk given longer survival time. The c-index and the concordance probability estimate have been used to estimate the concordance probability when patient-specific risk scores are continuous. In the current paper, the concordance probability estimate and an inverse probability censoring weighted c-index are modified to account for discrete risk scores. Simulations are generated to assess the finite sample properties of the concordance probability estimate and the weighted c-index. An application of these measures of discriminatory power to a metastatic prostate cancer risk classification system is examined.

  14. Testing the effects of suppression and reappraisal on emotional concordance using a multivariate multilevel model.

    PubMed

    Butler, Emily A; Gross, James J; Barnard, Kobus

    2014-04-01

    In theory, the essence of emotion is coordination across experiential, behavioral, and physiological systems in the service of functional responding to environmental demands. However, people often regulate emotions, which could either reduce or enhance cross-system concordance. The present study tested the effects of two forms of emotion regulation (expressive suppression, positive reappraisal) on concordance of subjective experience (positive-negative valence), expressive behavior (positive and negative), and physiology (inter-beat interval, skin conductance, blood pressure) during conversations between unacquainted young women. As predicted, participants asked to suppress showed reduced concordance for both positive and negative emotions. Reappraisal instructions also reduced concordance for negative emotions, but increased concordance for positive ones. Both regulation strategies had contagious interpersonal effects on average levels of responding. Suppression reduced overall expression for both regulating and uninstructed partners, while reappraisal reduced negative experience. Neither strategy influenced the uninstructed partners' concordance. These results suggest that emotion regulation impacts concordance by altering the temporal coupling of phasic subsystem responses, rather than by having divergent effects on subsystem tonic levels. Copyright © 2013 Elsevier B.V. All rights reserved.

  15. Concordance Between Clinical Practice and Published Evidence: Findings From Virginia Commonwealth University School of Dentistry.

    PubMed

    Chiang, Harmeet K; Best, Al M; Sarrett, David C

    2017-09-01

    To evaluate the concordance between clinical practice and published evidence by dental faculty and graduating students of the Virginia Commonwealth University School of Dentistry. A questionnaire previously developed by the National Dental Practice-Based Research Network with 12 clinical scenarios was administered to VCU faculty and graduating students. Responses were scored as either consistent or inconsistent with published evidence and then analyzed for differences between dental faculty, graduating students, and the national results. There were 43 dental faculty members with at least half-time student contact who responded to the survey. Faculty concordance ranged from 33% to 100%, and general practice faculty had the highest concordance (82%). Eighty-five of the graduating class of 98 responded to the survey, and student concordance ranged from 18% to 92% and averaged 67%. General practice faculty had higher concordance with published evidence than recently graduated dental students. Graduating students and dental faculty demonstrated higher concordance with evidence-based practice than practitioners in the National Dental Practice-Based Research Network. General practice dental faculty demonstrated adequate concordance, but students demonstrated only a medium-level concordance. Practitioners involved in teaching dental students are better able to keep up with evolving evidence and are better able to demonstrate evidence-based practice. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. A quality control study on cytotechnologist-cytopathologist concordance and its relationship to the number of dots on the slide.

    PubMed

    Bongiovanni, Massimo; De Saussure, Barbara; Kumar, Neeta; Pache, Jean-Claude; Cibas, Edmund S

    2009-01-01

    To study cytotechnologist (CT)-cytopathologist (CP) concordance for evaluating individual CTs' performance and for quality assurance and educational feedback. The interpretations of individual CTs were compared with the final interpretations (according to the 2001 Bethesda System) of the CP. Concordance percentages and kappa values were calculated for each CT and correlated with the numbers of dots on each slide, years of experience and percentage of work hours devoted to cytology. A total of 10,453 Pap tests were screened by 9 CTs during one year, out of which 993 (9.5%) were referred to one CP for a final interpretation. Mean concordance between the aggregate CT interpretations and those of the CP was 65.5%. Five CTs had good concordance, 3 had moderately good concordance, and one had surprisingly poor concordance that contrasted with good subjective impressions. No correlation was found between concordance and the average number of dots per slide, screening experience in cervicovaginal cytology or percentage of work hours devoted to cytology. Monitoring CT-CP concordance rates can unveil performance issues not detected by subjective impressions. An excessive number of dots per slide may not reflect poor diagnostic precision so much as a lack of confidence in interpretation.

  17. Walking to Olympus: An EVA Chronology

    NASA Technical Reports Server (NTRS)

    Portree, David S. F.; Trevino, Robert C.

    1997-01-01

    Spacewalkers enjoy a view of Earth once reserved for Apollo, Zeus, and other denizens of Mt. Olympus. During humanity's first extravehicular activity (EVA), Alexei Leonov floated above Gibraltar, the rock ancient seafarers saw as the gateway to the great unknown Atlantic. The symbolism was clear, Leonov stepped past a new Gibraltar when he stepped into space. More than 32 years and 154 EVAs later, Jerry Linenger conducted an EVA with Vladimir Tsibliyev as part of International Space Station Phase 1. They floated together above Gibraltar. Today the symbolism has new meaning: humanity is starting to think of stepping out of Earth orbit, space travel's new Gibraltar, and perhaps obtaining a new olympian view, a close-up look at Olympus Mons on Mars. Walking to Olympus: An EVA Chronology chronicles the 154 EVAs conducted from March 1965 to April 1997. It is intended to make clear the crucial role played by EVA in the history of spaceflight, as well as to chronicle the large body of EVA "lessons learned." Russia and the U.S. define EVA differently. Russian cosmonauts are said to perform EVA any time they are in vacuum in a space suit. A U.S. astronaut must have at least his head outside his spacecraft before he is said to perform an EVA. The difference is based in differing spacecraft design philoso- phies. Russian and Soviet spacecraft have always had a specialized airlock through which the EVA cosmonaut egressed, leaving the main habitable volume of the spacecraft pressurized. The U.S. Gemini and Apollo vehicles, on the other hand, depressurized their entire habitable volume for egress. In this document, we apply the Russian definition to Russian EVAS, and the U.S. definition to U.S. EVAS. Thus, for example, Gemini 4 Command Pilot James McDivitt does not share the honor of being first American spacewalker with Ed White, even though he was suited and in vacuum when White stepped out into space. Non-EVA spaceflights are listed in the chronology to provide context and to display the large num- ber of flights in which EVA played a role. This approach also makes apparent significant EVA gaps, for example, the U.S. gap between 1985 and 1991 following the Challenger accident. This NASA History Monograph is an edited extract from an extensive EVA Chronology and Reference Book being produced by the EVA Project Office, NASA Johnson Space Center, Houston, Texas. The larger work will be published as part of the NASA Formal Series in 1998. The authors gratefully acknowledge the assistance rendered by Max Ary, Ashot Bakunts, Gert-Jan Bartelds, Frank Cepollina, Andrew Chaikin, Phillip Clark, Richard Fullerton, Steven Glenn, Linda Godwin, Jennifer Green, Greg Harris, Clifford Hess, Jeffrey Hoffman, David Homan, Steven Hopkins, Nicholas Johnson, Eric Jones, Neville Kidger, Joseph Kosmo, Alexei Lebedev, Mark Lee, James LeBlanc, Dmitri Leshchenskii, Jerry Linenger, Igor Lissov, James McBarron, Clay McCullough, Joseph McMann, Story Musgrave, Dennis Newkirk, James Oberg, Joel Powell, Lee Saegesser, Andy Salmon, Glen Swanson, Joseph Tatarewicz, Kathy Thornton, Chris Vandenberg, Charles Vick, Bert Vis, David Woods, Mike Wright, John Young, and Keith Zimmerman. Special thanks to Laurie Buchanan, John Charles, Janet Kovacevich, Joseph Loftus, Sue McDonald, Martha Munies, Colleen Rapp, and Jerry Ross. Any errors remain the responsibility of the authors.

  18. Genotype-Specific Concordance of Chlamydia trachomatis Genital Infection Within Heterosexual Partnerships.

    PubMed

    Schillinger, Julia A; Katz, Barry P; Markowitz, Lauri E; Braslins, Phillip G; Shrier, Lydia A; Madico, Guillermo; Van Der Pol, Barbara; Orr, Donald P; Rice, Peter A; Batteiger, Byron E

    2016-12-01

    Sexual transmission rates of Chlamydia trachomatis (Ct) cannot be measured directly; however, the study of concordance of Ct infection in sexual partnerships (dyads) can help to illuminate factors influencing Ct transmission. Heterosexual men and women with Ct infection and their sex partners were enrolled and partner-specific coital and behavioral data collected for the prior 30 days. Microbiological data included Ct culture, and nucleic acid amplification testing (NAAT), quantitative Ct polymerase chain reaction, and ompA genotyping. We measured Ct concordance in dyads and factors (correlates) associated with concordance. One hundred twenty-one women and 125 men formed 128 dyads. Overall, 72.9% of male partners of NAAT-positive women and 68.6% of female partners of NAAT-positive men were Ct-infected. Concordance was more common in dyads with culture-positive members (78.6% of male partners, 77% of female partners). Partners of women and men who were NAAT-positive only had lower concordance (33.3%, 46.4%, respectively). Women in concordant dyads had significantly higher median endocervical quantitative Ct polymerase chain reaction values (3,032) compared with CT-infected women in discordant dyads (1013 inclusion forming units DNA equivalents per mL; P < 0.01). Among 54 Ct-concordant dyads with ompA genotype data for both members, 96.2% had identical genotypes. Higher organism load appears associated with concordance among women. Same-genotype chlamydial concordance was high in sexual partnerships. No behavioral factors were sufficiently discriminating to guide partner services activities. Findings may help model coitus-specific transmission probabilities.

  19. No decision about me without me: concordance operationalised.

    PubMed

    Snowden, Austyn; Marland, Glenn

    2013-05-01

    To demonstrate that concordance can be operationalised to the benefit of patients. Concordance can be understood as a composite of knowledge, health beliefs and collaboration. In discussing any clinical decision, it would be ideal if different views could be incorporated to reach the most coherent decision. This is a definition of concordance, a widely agreed ideal in nursing. There are limits, however, that make the practice of concordance problematic. Sometimes there is little time or willingness to discuss issues in depth. Some views of the world are considered more worthy than others. As a consequence, clinical guidelines currently prioritise easier to measure outcomes of negotiation, such as adherence. This discursive article argues that prioritising adherence is a fundamental error, incoherent with current strategic rhetoric such as the Department of Health's 'no decision about me without me'. The impact of prioritising concordance is contrasted with adherence-based interventions. Where adherence is a goal of treatment, non-adherence is considered problematic. This value judgment is not useful and does not occur in a consultation that prioritises concordance. However, concordance is difficult to translate into clinical practice. This article shows that concordance can be operationalised by considering it a composite of health beliefs, knowledge and collaboration. The main thesis is that different behaviours can always be incorporated into a concordance framework. This negates the necessity for adherence as an endpoint in itself. Fifty per cent of people do not take medicines as prescribed. Interventions focused towards improving adherence are only ever partially successful. This is because it presupposes the clinician is right. Concordance by contrast is more coherent with person centred care and thus more likely to generate clinically meaningful outcomes for patients. © 2012 Blackwell Publishing Ltd.

  20. Prediction future asset price which is non-concordant with the historical distribution

    NASA Astrophysics Data System (ADS)

    Seong, Ng Yew; Hin, Pooi Ah

    2015-12-01

    This paper attempts to predict the major characteristics of the future asset price which is non-concordant with the distribution estimated from the price today and the prices on a large number of previous days. The three major characteristics of the i-th non-concordant asset price are the length of the interval between the occurrence time of the previous non-concordant asset price and that of the present non-concordant asset price, the indicator which denotes that the non-concordant price is extremely small or large by its values -1 and 1 respectively, and the degree of non-concordance given by the negative logarithm of the probability of the left tail or right tail of which one of the end points is given by the observed future price. The vector of three major characteristics of the next non-concordant price is modelled to be dependent on the vectors corresponding to the present and l - 1 previous non-concordant prices via a 3-dimensional conditional distribution which is derived from a 3(l + 1)-dimensional power-normal mixture distribution. The marginal distribution for each of the three major characteristics can then be derived from the conditional distribution. The mean of the j-th marginal distribution is an estimate of the value of the j-th characteristics of the next non-concordant price. Meanwhile, the 100(α/2) % and 100(1 - α/2) % points of the j-th marginal distribution can be used to form a prediction interval for the j-th characteristic of the next non-concordant price. The performance measures of the above estimates and prediction intervals indicate that the fitted conditional distribution is satisfactory. Thus the incorporation of the distribution of the characteristics of the next non-concordant price in the model for asset price has a good potential of yielding a more realistic model.

  1. 33 CFR 165.1198 - Safety zone; Military Ocean Terminal Concord Safety Zone, Suisun Bay, Military Ocean Terminal...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false Safety zone; Military Ocean Terminal Concord Safety Zone, Suisun Bay, Military Ocean Terminal Concord, CA. 165.1198 Section 165.1198... Limited Access Areas Eleventh Coast Guard District § 165.1198 Safety zone; Military Ocean Terminal Concord...

  2. 33 CFR 165.1198 - Safety zone; Military Ocean Terminal Concord Safety Zone, Suisun Bay, Military Ocean Terminal...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 2 2013-07-01 2013-07-01 false Safety zone; Military Ocean Terminal Concord Safety Zone, Suisun Bay, Military Ocean Terminal Concord, CA. 165.1198 Section 165.1198... Limited Access Areas Eleventh Coast Guard District § 165.1198 Safety zone; Military Ocean Terminal Concord...

  3. Tharsis Flood Features

    NASA Technical Reports Server (NTRS)

    2005-01-01

    17 July 2005 This Mars Global Surveyor (MGS) Mars Orbiter Camera (MOC) image shows channels carved by catastrophic floods in the Tharsis region of Mars. This area is located northwest of the volcano, Jovis Tholus, and east of the large martian volcano, Olympus Mons. The terrain is presently mantled with fine dust.

    Location near: 20.8oN, 118.8oW Image width: width: 3 km (1.9 mi) Illumination from: lower left Season: Northern Autumn

  4. Two-Photon Fluorescence Correlation Spectroscopy

    NASA Technical Reports Server (NTRS)

    Zimmerli, Gregory A.; Fischer, David G.

    2002-01-01

    We will describe a two-photon microscope currently under development at the NASA Glenn Research Center. It is composed of a Coherent Mira 900 tunable, pulsed Titanium:Sapphire laser system, an Olympus Fluoview 300 confocal scanning head, and a Leica DM IRE inverted microscope. It will be used in conjunction with a technique known as fluorescence correlation spectroscopy (FCS) to study intracellular protein dynamics. We will briefly explain the advantages of the two-photon system over a conventional confocal microscope, and provide some preliminary experimental results.

  5. ARTES: the future of satellite telecommunication

    NASA Astrophysics Data System (ADS)

    González-Blázquez, Angel; Detain, Dominique

    2005-08-01

    Throughout its 30-year existence, ESA has played a key role by providing telecommunications infrastructures that have allowed the in-orbit validation, qualification and demonstration of equipment, technology and services. In the past, this has been achieved through the provision of dedicated satellites like OTS, Marecs, Olympus and Artemis, as well as by the implementation of piggy-back payloads on other ESA or commercial satellites. Today, due to the importance of satellite telecommunications, ESA continues to support this sector mainly through its ARTES - Advanced Research in Telecommunications - Programme.

  6. Individual characteristics, area social participation, and primary non-concordance with medication: a multilevel analysis.

    PubMed

    Johnell, Kristina; Lindström, Martin; Sundquist, Jan; Eriksson, Charli; Merlo, Juan

    2006-03-02

    Non-concordance with medication remains a major public health problem that imposes a considerable financial burden on the health care system, and there is still a need for studies on correlates of non-concordance. Our first aim is to analyse whether any of the individual characteristics age, educational level, financial strain, self-rated health, social participation, and trust in the health care system are associated with primary non-concordance with medication. Our second aim is to investigate whether people living in the same area have similar probability of primary non-concordance with medication, that relates to area social participation. We analysed cross sectional data from 9,070 women and 6,795 men aged 18 to 79 years, living in 78 areas in central Sweden, who participated in the Life & Health year 2000 survey, with multilevel logistic regression (individuals at the first level and areas at the second level). Younger age, financial strain, low self-rated health, and low trust in the health care system were associated with primary non-concordance with medication. However, area social participation was not related to primary non-concordance, and the variation in primary non-concordance between the areas was small. Our results indicate that people in central Sweden with younger age, financial difficulties, low self-rated health, and low trust in the health care system may have a higher probability of primary non-concordance with medication. However, the area of residence--as defined by administrative boundaries--seems to play a minor role for primary non-concordance.

  7. Individual characteristics, area social participation, and primary non-concordance with medication: a multilevel analysis

    PubMed Central

    Johnell, Kristina; Lindström, Martin; Sundquist, Jan; Eriksson, Charli; Merlo, Juan

    2006-01-01

    Background Non-concordance with medication remains a major public health problem that imposes a considerable financial burden on the health care system, and there is still a need for studies on correlates of non-concordance. Our first aim is to analyse whether any of the individual characteristics age, educational level, financial strain, self-rated health, social participation, and trust in the health care system are associated with primary non-concordance with medication. Our second aim is to investigate whether people living in the same area have similar probability of primary non-concordance with medication, that relates to area social participation. Methods We analysed cross sectional data from 9 070 women and 6 795 men aged 18 to 79 years, living in 78 areas in central Sweden, who participated in the Life & Health year 2000 survey, with multilevel logistic regression (individuals at the first level and areas at the second level). Results Younger age, financial strain, low self-rated health, and low trust in the health care system were associated with primary non-concordance with medication. However, area social participation was not related to primary non-concordance, and the variation in primary non-concordance between the areas was small. Conclusion Our results indicate that people in central Sweden with younger age, financial difficulties, low self-rated health, and low trust in the health care system may have a higher probability of primary non-concordance with medication. However, the area of residence – as defined by administrative boundaries – seems to play a minor role for primary non-concordance. PMID:16512907

  8. Spousal concordance in attitudes toward violence and reported physical abuse in African couples.

    PubMed

    Alio, Amina P; Clayton, Heather B; Garba, Madeleine; Mbah, Alfred K; Daley, Ellen; Salihu, Hamisu M

    2011-09-01

    We examined the potential association between African couples' concordance on attitudes toward violence (ATV) and risk for intimate partner violence (IPV). Analyses included 13,837 couples from Demographic and Health Surveys conducted between 2003 and 2007, from six African countries. Concordance on ATV was defined as both spouses justifying physical abuse, and IPV was defined as incidence of a physically violent act against the wife. We constructed a concordance measure from the surveys to assess overall and country-level differences in couple's ATV concordance rates and assessed the association between concordance in ATV and IPV using hierarchical regression modeling that adjusted for multilevel influences on risk estimates. Negative concordance (perfect agreement in negative ATV) was used as referent category in all analyses. Overall, spousal ATV concordance was associated with higher likelihood for IPV (adjusted odds ratio [AOR] = 2.27, 95% confidence interval [CI] = [2.01, 2.56]). The level of wealth, educational attainment, rural/urban residence, presence of a cowife, religion, maternal age, and parity were characteristics that predicted the occurrence of IPV within couples. Spousal ATV concordance was significantly associated with violence in every African nation included in the analysis except Rwanda. African couples with high rates of ATV concor- dance experience higher risks for IPV, with some variation in magnitude of risk across countries. In African settings, ATV positive concordance could serve as a supplemental screening tool to detect spousal violence. Understanding ATV could potentially enhance our ability to formulate public health intervention to detect and prevent spousal abuse.

  9. The Influence of Respondent Characteristics on the Validity of Self-Reported Survey Responses.

    PubMed

    Guerard, Barbara; Omachonu, Vincent; Harvey, Raymond A; Hernandez, S Robert; Sen, Bisakha

    2016-06-01

    To examine concordance between member self-reports and the organization's administrative claims data for two key health factors: number of chronic conditions, and number of prescription drugs. Medicare Advantage plan claims data and member survey data from 2011 to 2012. Mailed surveys to 15,000 members, enrolled minimum 6 months, drawn from a random sample of primary care physician practices with at least 200 members. Descriptive statistics were generated for extent of concordance. Multivariable logistic regressions were used to analyze the association of selected respondent characteristics with likelihood of concordance. Concordance for number of chronic conditions was 58.4 percent, with 27.3 percent under-reporting, 14.2 percent over-reporting. Concordance for number of prescription drugs was 56.6 percent with 38.9 percent under-reporting, 4.5 percent over-reporting. Number of prescriptions and assistance in survey completion were associated with higher likelihood of concordance for chronic conditions. Assistance in survey completion and number of chronic conditions were associated with higher concordance, and age and number of prescriptions were associated with lower concordance, for prescription drugs. Self-reported number of chronic conditions and prescription medications are not in high concordance with claims data. Health care researchers and policy makers using patient self-reported data should be aware of these potential biases. © Health Research and Educational Trust.

  10. Work happiness among teachers: a day reconstruction study on the role of self-concordance.

    PubMed

    Tadić, Maja; Bakker, Arnold B; Oerlemans, Wido G M

    2013-12-01

    Self-concordant work motivation arises from one's authentic choices, personal values, and interests. In the present study, we investigated whether self-concordant motivation may fluctuate from one work-related task to the next. On the basis of self-determination theory, we hypothesized that momentary self-concordance buffers the negative impact of momentary work demands on momentary happiness. We developed a modified version of the day reconstruction method to investigate self-concordance, work demands, and happiness during specific work-related tasks on a within-person and within-day level. In total, 132 teachers completed a daily diary on three consecutive work days as well as a background questionnaire. The daily diary resulted in 792 reported work activities and activity-related work demands, self-concordance, and happiness scores. Multilevel analysis showed that-for most work activities-state self-concordant motivation buffered the negative association of work demands with happiness. These findings add to the literature on motivation and well-being by showing that the levels of self-concordance and happiness experienced by employees vary significantly on a within-day level and show a predictable pattern. We discuss theoretical and practical implications of the findings to increase employees' well-being. © 2013.

  11. Behavioral and neural concordance in parent-child dyadic sleep patterns.

    PubMed

    Lee, Tae-Ho; Miernicki, Michelle E; Telzer, Eva H

    2017-08-01

    Sleep habits developed in adolescence shape long-term trajectories of psychological, educational, and physiological well-being. Adolescents' sleep behaviors are shaped by their parents' sleep at both the behavioral and biological levels. In the current study, we sought to examine how neural concordance in resting-state functional connectivity between parent-child dyads is associated with dyadic concordance in sleep duration and adolescents' sleep quality. To this end, we scanned both parents and their child (N=28 parent-child dyads; parent M age =42.8years; adolescent M age =14.9years; 14.3% father; 46.4% female adolescent) as they each underwent a resting-state scan. Using daily diaries, we also assessed dyadic concordance in sleep duration across two weeks. Our results show that greater daily concordance in sleep behavior is associated with greater neural concordance in default-mode network connectivity between parents and children. Moreover, greater neural and behavioral concordances in sleep is associated with more optimal sleep quality in adolescents. The current findings expand our understanding of dyadic concordance by providing a neurobiological mechanism by which parents and children share daily sleep behaviors. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  12. A sibling adoption study of adult attachment: The influence of shared environment on attachment states of mind

    PubMed Central

    Caspers, Kristin; Yucuis, Rebecca; Troutman, Beth; Arndt, Stephan; Langbehn, Douglas

    2009-01-01

    This study extends existing research investigating sibling concordance on attachment by examining concordance for adult attachment in a sample of 126 genetically unrelated sibling pairs. The Adult Attachment Interview (George, Kaplan, & Main, 1985; Main, Goldwyn, & Hesse, 2003) was used to assess states of mind with regard to attachment. The average age of the participants was 39 years old. The distribution of attachment classifications was independent of adoptive status. Attachment concordance rates were unassociated with gender concordance and sibling age difference. Concordance for autonomous/non-autonomous classifications was significant at 61% as was concordance for primary classifications at 53%. The concordance rate for not-unresolved/unresolved was non-significant at 67%. Our findings demonstrate similarity of working models of attachment between siblings independent of genetic relatedness between siblings and generations (i.e., parent and child). These findings extend previous research by further implicating shared environment as a major influence on sibling similarities on organized patterns of attachment in adulthood. The non-significant concordance for the unresolved classification suggests that unresolved loss or trauma may be less influenced by shared environment and more likely to be influenced by post-childhood experiences or genetic factors. PMID:18049934

  13. Parent and Teacher Concordance of Child Outcomes for Youth with Autism Spectrum Disorder

    PubMed Central

    Suhrheinrich, Jessica; Rieth, Sarah R.; Stahmer, Aubyn C.

    2017-01-01

    Cross-informant ratings of are considered gold standard for child behavioral assessment. To date, little work has examined informant ratings of adaptive functioning for youth with autism spectrum disorder (ASD). In a large, diverse sample of youth with ASD, this study evaluated parent–teacher concordance of ratings of adaptive functioning and ASD-specific symptomatology across time. The impact of child clinical characteristics on concordance was also examined. Participants included 246 children, their caregivers and teachers. Parent–teacher concordance was variable but generally consistent across time. Concordance was significantly impacted by autism severity and child cognitive abilities. Findings inform the broader concordance literature and support the need to consider child clinical factors when assessing child functioning in samples of children with ASD. PMID:29164440

  14. Structural health monitoring (vibration) as a tool for identifying structural alterations of the lumbar spine: a twin control study.

    PubMed

    Kawchuk, Gregory N; Hartvigsen, Jan; Edgecombe, Tiffany; Prasad, Narasimha; van Dieen, Jaap H

    2016-03-11

    Structural health monitoring (SHM) is an engineering technique used to identify mechanical abnormalities not readily apparent through other means. Recently, SHM has been adapted for use in biological systems, but its invasive nature limits its clinical application. As such, the purpose of this project was to determine if a non-invasive form of SHM could identify structural alterations in the spines of living human subjects. Lumbar spines of 10 twin pairs were visualized by magnetic resonance imaging then assessed by a blinded radiologist to determine whether twin pairs were structurally concordant or discordant. Vibration was then applied to each subject's spine and the resulting response recorded from sensors overlying lumbar spinous processes. The peak frequency, area under the curve and the root mean square were computed from the frequency response function of each sensor. Statistical analysis demonstrated that in twins whose structural appearance was discordant, peak frequency was significantly different between twin pairs while in concordant twins, no outcomes were significantly different. From these results, we conclude that structural changes within the spine can alter its vibration response. As such, further investigation of SHM to identify spinal abnormalities in larger human populations is warranted.

  15. [Abdominal ultrasound and magnetic resonance imaging: a comparative study on the non-alcoholic fatty liver disease diagnosis in morbidly obese patients].

    PubMed

    Chaves, Gabriela Villaça; Pereira, Sílvia Elaine; Saboya, Carlos José; Cortes, Caroline; Ramalho, Rejane

    2009-01-01

    To evaluate the concordance between abdominal ultrasound and an MRI (Magnetic Resonance Imaging) in the diagnosis of non-alcoholic fatty liver disease (NAFLD), and concordance of these two methods with the histopathological exam. The population studied was comprised of 145 patients with morbid obesity (BMI > or = 40 Kg/m(2)), of both genders. NAFLD diagnosis was performed by MRI and Ultrasound. Liver biopsy was performed in a sub-sample (n=40). To evaluate the concordance of these two methods, the kappa coefficient was used. Concordance between both methods (MRI and Ultrasound) was poor and not significant (Kappa adjusted= 0.27; CI 95%= 0.07-0.39.) Nevertheless a slight concordance was found between diagnosis of NAFLD by ultrasound and the hepatic biopsy, with 83.,3% of concordant results and Kappa adjusted= 0.67.Results of an MRI and the histopathological exam were compared and results showed 53.6% of concordant results and kappa adjusted= 0.07. The concordance found in the diagnosis performed using the ultrasound method and the hepatic biopsy, shows a need to implement and perform more research on the use of ultrasound to validate and reconsider these methods. This would minimize the need to perform biopsies to detect and diagnose such disease.

  16. Degree of concordance with DASH diet guidelines and incidence of hypertension and fatal cardiovascular disease.

    PubMed

    Folsom, Aaron R; Parker, Emily D; Harnack, Lisa J

    2007-03-01

    Guidelines to prevent and treat hypertension advocate the Dietary Approaches to Stop Hypertension (DASH) diet. We studied whether a greater concordance with the DASH diet is associated with reduced incidence of hypertension (self-reported) and mortality from cardiovascular disease in 20,993 women initially aged 55 to 69 years. We created a DASH diet concordance score using food frequency data in 1986 and followed the women for events through 2002. No woman had perfect concordance with the DASH diet. Adjusted for age and energy intake, incidence of hypertension was inversely associated with the degree of concordance with the DASH diet, with hazard ratios across quintiles of 1.0, 0.91, 0.95, 0.99, and 0.87 (P trend = .02). There also were inverse, but not monotonic, associations between better DASH diet concordance and mortality from coronary heart disease, stroke, and all cardiovascular disease (CVD). However, after adjustment for other risk factors, there was little evidence that any end point was associated with the DASH diet score. Our results suggest that greater concordance with DASH guidelines did not have an independent long-term association with hypertension or cardiovascular mortality in this cohort. This implies that very high concordance, as achieved in the DASH trials, may be necessary to achieve any benefits of the DASH diet.

  17. Planned LMSS propagation experiment using ACTS: Preliminary antenna pointing results during mobile operations

    NASA Technical Reports Server (NTRS)

    Rowland, John R.; Goldhirsh, Julius; Vogel, Wolfhard J.; Torrence, Geoffrey W.

    1991-01-01

    An overview and a status description of the planned LMSS mobile K band experiment with ACTS is presented. As a precursor to the ACTS mobile measurements at 20.185 GHz, measurements at 19.77 GHz employing the Olympus satellite were originally planned. However, because of the demise of Olympus in June of 1991, the efforts described here are focused towards the ACTS measurements. In particular, we describe the design and testing results of a gyro controlled mobile-antenna pointing system. Preliminary pointing measurements during mobile operations indicate that the present system is suitable for measurements employing a 15 cm aperture (beamwidth at approximately 7 deg) receiving antenna operating with ACTS in the high gain transponder mode. This should enable measurements with pattern losses smaller than plus or minus 1 dB over more than 95 percent of the driving distance. Measurements with the present mount system employing a 60 cm aperture (beamwidth at approximately 1.7 deg) results in pattern losses smaller than plus or minus 3 dB for 70 percent of the driving distance. Acceptable propagation measurements may still be made with this system by employing developed software to flag out bad data points due to extreme pointing errors. The receiver system including associated computer control software has been designed and assembled. Plans are underway to integrate the antenna mount with the receiver on the University of Texas mobile receiving van and repeat the pointing tests on highways employing a recently designed radome system.

  18. Data filtering with support vector machines in geometric camera calibration.

    PubMed

    Ergun, B; Kavzoglu, T; Colkesen, I; Sahin, C

    2010-02-01

    The use of non-metric digital cameras in close-range photogrammetric applications and machine vision has become a popular research agenda. Being an essential component of photogrammetric evaluation, camera calibration is a crucial stage for non-metric cameras. Therefore, accurate camera calibration and orientation procedures have become prerequisites for the extraction of precise and reliable 3D metric information from images. The lack of accurate inner orientation parameters can lead to unreliable results in the photogrammetric process. A camera can be well defined with its principal distance, principal point offset and lens distortion parameters. Different camera models have been formulated and used in close-range photogrammetry, but generally sensor orientation and calibration is performed with a perspective geometrical model by means of the bundle adjustment. In this study, support vector machines (SVMs) using radial basis function kernel is employed to model the distortions measured for Olympus Aspherical Zoom lens Olympus E10 camera system that are later used in the geometric calibration process. It is intended to introduce an alternative approach for the on-the-job photogrammetric calibration stage. Experimental results for DSLR camera with three focal length settings (9, 18 and 36 mm) were estimated using bundle adjustment with additional parameters, and analyses were conducted based on object point discrepancies and standard errors. Results show the robustness of the SVMs approach on the correction of image coordinates by modelling total distortions on-the-job calibration process using limited number of images.

  19. The Diversity of Martian Volcanic Features as Seen in MOC Images and MOLA Topographic Data

    NASA Technical Reports Server (NTRS)

    Mouginis-Mark, Peter J.

    2004-01-01

    This project focused on the evolution of the summit areas of Martian volcanoes. By using data collected from the Mars Orbiter Camera (MOC) and Mars Laser Altimeter (MOLA) instruments, we tried to better understand the diversity of constructional volcanism on Mars, and hence further understand eruption processes. We investigated the styles of volcanism on the major volcanic constructs (Olympus, Arsia, Pavonis, and Ascraeus Montes), and also studied the role of magma-volatile interactions within the shallow subsurface of these volcanoes and the surrounding areas. Theoretical models for internal processes within volcanoes, including the thermal influences of dike intrusions on pre-existing volatiles, were developed based on our identification of landform distributions. Our work provided new insights into the diversity of volcanism on Mars, and the distribution of Martian volatiles in space and time. Highlights of our results include: 1) The identification of large ash deposits at the summit of Arsia Mons; 2) The study of a large flank eruption on Elysium Mons and the estimation of the effusion rate needed to produce the observed lava channel; 3) The quantitative description of dike intrusion into volatile-rich terrain to explain the origin of Hrad Vallis; 4) The identification of constructional ridges on top of very young lava flows from Olympus Mons, with the interpretation that these ridges were formed by very recent phreatomagmatic eruptions; and 5) The characterization of the dimensions and slope distributions on 18 volcanic edifices on Mars.

  20. Comparison of 10 digital SLR cameras for orthodontic photography.

    PubMed

    Bister, D; Mordarai, F; Aveling, R M

    2006-09-01

    Digital photography is now widely used to document orthodontic patients. High quality intra-oral photography depends on a satisfactory 'depth of field' focus and good illumination. Automatic 'through the lens' (TTL) metering is ideal to achieve both the above aims. Ten current digital single lens reflex (SLR) cameras were tested for use in intra- and extra-oral photography as used in orthodontics. The manufacturers' recommended macro-lens and macro-flash were used with each camera. Handling characteristics, colour-reproducibility, quality of the viewfinder and flash recharge time were investigated. No camera took acceptable images in factory default setting or 'automatic' mode: this mode was not present for some cameras (Nikon, Fujifilm); led to overexposure (Olympus) or poor depth of field (Canon, Konica-Minolta, Pentax), particularly for intra-oral views. Once adjusted, only Olympus cameras were able to take intra- and extra-oral photographs without the need to change settings, and were therefore the easiest to use. All other cameras needed adjustments of aperture (Canon, Konica-Minolta, Pentax), or aperture and flash (Fujifilm, Nikon), making the latter the most complex to use. However, all cameras produced high quality intra- and extra-oral images, once appropriately adjusted. The resolution of the images is more than satisfactory for all cameras. There were significant differences relating to the quality of colour reproduction, size and brightness of the viewfinders. The Nikon D100 and Fujifilm S 3 Pro consistently scored best for colour fidelity. Pentax and Konica-Minolta had the largest and brightest viewfinders.

  1. Choline-Deficient-Diet-Induced Fatty Liver Is a Metastasis-Resistant Microenvironment.

    PubMed

    Nakamura, Miki; Suetsugu, Atsushi; Hasegawa, Kosuke; Matsumoto, Takuro; Aoki, Hitomi; Kunisada, Takahiro; Shimizu, Masahito; Saji, Shigetoyo; Moriwaki, Hisataka; Hoffman, Robert M

    2017-07-01

    Fatty liver disease is increasing in the developed and developing world. Liver metastasis from malignant lymphoma in the fatty liver is poorly understood. In a previous report, we developed color-coded imaging of the tumor microenvironment (TME) of the murine EL4-RFP malignant lymphoma during metastasis, including the lung. In the present report, we investigated the potential and microenvironment of the fatty liver induced by a choline-deficient diet as a metastatic site in this mouse lymphoma model. C57BL/6-GFP transgenic mice were fed with a choline-deficient diet in order to establish a fatty liver model. EL4-RFP cells were injected in the spleen of normal mice and fatty-liver mice. Metastases in mice with fatty liver or normal liver were imaged with the Olympus SZX7 microscope and the Olympus FV1000 confocal microscope. Metastases of EL4-RFP were observed in the liver, ascites and bone marrow. Primary tumors were imaged in the spleen at the injection site. The fewest metastases were observed in the fatty liver. In addition, the fewest cancer-associated fibroblasts (CAFs) were observed in the fatty liver. The relative metastatic resistance of the fatty liver may be due to the reduced number of CAFs in the fatty livers. The mechanism of the effect of the choline-deficient diet is discussed. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  2. Geologic Mapping of the Olympus Mons Volcano, Mars

    NASA Technical Reports Server (NTRS)

    Bleacher, J. E.; Williams, D. A.; Shean, D.; Greeley, R.

    2012-01-01

    We are in the third year of a three-year Mars Data Analysis Program project to map the morphology of the Olympus Mons volcano, Mars, using ArcGIS by ESRI. The final product of this project is to be a 1:1,000,000-scale geologic map. The scientific questions upon which this mapping project is based include understanding the volcanic development and modification by structural, aeolian, and possibly glacial processes. The project s scientific objectives are based upon preliminary mapping by Bleacher et al. [1] along a approx.80-km-wide north-south swath of the volcano corresponding to High Resolution Stereo Camera (HRSC) image h0037. The preliminary project, which covered approx.20% of the volcano s surface, resulted in several significant findings, including: 1) channel-fed lava flow surfaces are areally more abundant than tube-fed surfaces by a ratio of 5:1, 2) channel-fed flows consistently embay tube-fed flows, 3) lava fans appear to be linked to tube-fed flows, 4) no volcanic vents were identified within the map region, and 5) a Hummocky unit surrounds the summit and is likely a combination of non-channelized flows, dust, ash, and/or frozen volatiles. These results led to the suggestion that the volcano had experienced a transition from long-lived tube-forming eruptions to more sporadic and shorter-lived, channel-forming eruptions, as seen at Hawaiian volcanoes between the tholeiitic shield building phase (Kilauea to Mauna Loa) and alkalic capping phase (Hualalai and Mauna Kea).

  3. Image-enhanced endoscopy for diagnosis of colorectal tumors in view of endoscopic treatment

    PubMed Central

    Yoshida, Naohisa; Yagi, Nobuaki; Yanagisawa, Akio; Naito, Yuji

    2012-01-01

    Recently, image-enhanced endoscopy (IEE) has been used to diagnose gastrointestinal tumors. This method is a change from conventional white-light (WL) endoscopy without dyeing solution, requiring only the push of a button. In IEE, there are many advantages in diagnosis of neoplastic tumors, evaluation of invasion depth for cancerous lesions, and detection of neoplastic lesions. In narrow band imaging (NBI) systems (Olympus Medical Co., Tokyo, Japan), optical filters that allow narrow-band light to pass at wavelengths of 415 and 540 nm are used. Mucosal surface blood vessels are seen most clearly at 415 nm, which is the wavelength that corresponds to the hemoglobin absorption band, while vessels in the deep layer of the mucosa can be detected at 540 nm. Thus, NBI also can detect pit-like structures named surface pattern. The flexible spectral imaging color enhancement (FICE) system (Fujifilm Medical Co., Tokyo, Japan) is also an IEE but different to NBI. FICE depends on the use of spectral-estimation technology to reconstruct images at different wavelengths based on WL images. FICE can enhance vascular and surface patterns. The autofluorescence imaging (AFI) video endoscope system (Olympus Medical Co., Tokyo, Japan) is a new illumination method that uses the difference in intensity of autofluorescence between the normal area and neoplastic lesions. AFI light comprises a blue light for emitting and a green light for hemoglobin absorption. The aim of this review is to highlight the efficacy of IEE for diagnosis of colorectal tumors for endoscopic treatment. PMID:23293724

  4. [Bacteriological evaluation of a procedure for disinfecting the Olympus GIF-D2 panendoscope].

    PubMed

    Ramírez Ramos, A; Domínguez, N; Makino, R; Barrera, C

    1980-01-01

    We have performed a total of 107 cultures from three critical areas of an Olympus Panendoscope Model GIF-D2 in order to evaluate bacteriologically cur system of desinfection of this endoscope. Samples were taken from the distal end, external surface and biopsy canal before and after an endoscopic examination was performed. The procedure of desinfection employed was as follows: washing of the distal end, external surface and biopsy canal with Hexaclorophel (Phisohex) diluted 50% with water and a second washing with tap water. In the middle of the study, we added a second washing of the biopsy canal with ten ml. of ether alcohol to allow for better drying. As a result of the present study we observed that in the distal end in 50% of the samples we encountered bacteria. Cultures of the external surface were positive in 20% of samples. The biopsy canal should be washed with ether alcohol to allow for complete drying, because when we did not use this method, Pseudomonas Aeruginosa was isolated. After this modification we did not isolate bacteria. The most frequent types of isolated bacteria were from the normal oropharyngeal flora. From the present study we can conclude that desinfection of the Panendespe with Hexaclorophen gives satisfactory results on the external surface of the endoscope. Biopsy canal requires additional washing with ether alcohol. However, both procedures do not assure a satisfactory desinfection of the distal end.

  5. Direct peroral cholangioscopy using an ultrathin endoscope: making technique easier.

    PubMed

    Sola-Vera, Javier; Uceda, Francisco; Cuesta, Rubén; Vázquez, Narcís

    2014-01-01

    Cholangioscopy is a useful tool for the study and treatment of biliary pathology. Ultrathin upper endoscopes allow direct peroral cholangioscopy (DPC) but have some drawbacks. The aim of the study was to evaluate the success rate of DPC with an ultrathin endoscope using a balloon catheter to reach the biliary confluence. Prospective observational study. An ultrathin endoscope (Olympus XP180N, outer diameter 5.5 mm, working channel 2 mm) was used. To access the biliary tree, free-hand technique was used. To reach the biliary confluence an intraductal balloon catheter (Olympus B5-2Q diameter 1.9 mm) and a 0.025 inch guide wire was used. In all cases sphincterotomy and/or sphincteroplasty was performed. The success rate was defined as the percentage of cases in which the biliary confluence could be reached with the ultrathin endoscope. Fifteen patients (8 men/7 women) were included. Mean age was 77.7 + or - 10.8 years (range 45-91). The indications for cholangioscopy were suspected bile duct stones (n = 9), electrohydraulic lithotripsy for the treatment of difficult choledocholithiasis (n = 5) and evaluation of biliary stricture (n = 1). Access to the bile duct was achieved in 14/15 cases (93.3%). Biliary confluence was reached in 13/15 cases (86.7%). One complication was observed in one patient (oxigen desaturation). DPC with an ultrathin endoscope can be done with the free-hand technique. Intraductal balloon-guided DPC allows full examination of the common bile duct in most cases.

  6. Brief report: parent-adolescent child concordance in social norms related to gender equity in marriage - findings from rural India.

    PubMed

    Raj, Anita; Ghule, Mohan; Battala, Madhusudana; Dasgupta, Anindita; Ritter, Julie; Nair, Saritha; Saggurti, Niranjan; Silverman, Jay G; Balaiah, Donta

    2014-10-01

    The purpose of this exploratory study was to assess parent-adolescent child concordance on social norms related to gender equity in marriage in rural Maharashtra, India. Survey data on marital norms related to girl's marital age and choice, contraception, and marital violence (MV) were collected from unmarried adolescents (n = 113 girls, 116 boys) and their parents (n = 227 mothers, 203 fathers). Concordance was assessed using a Cohen's unweighted Kappa statistic, with analyses stratified by sex of parent and child. Analyses revealed fair (K = .25-.27) mother-daughter concordance on girls' right to choose when to marry, contraception use, and acceptability of MV. Father-son concordance was seen on girls' right to choose when (K = .22, slight) and who (K = .20, fair) to marry and MV acceptability (K = .53, moderate). No opposite sex parent-child concordance was revealed. Results indicate same but not opposite sex parent-child concordance on gender equity social norms related to marriage, suggesting same sex transfer of these norms. Copyright © 2014 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  7. Daily Concordance between Parent and Adolescent Sleep Habits

    PubMed Central

    Fuligni, Andrew J.; Tsai, Kim M.; Krull, Jennifer L.; Gonzales, Nancy A.

    2014-01-01

    Purpose To assess the daily concordance between parent and adolescent daily sleep habits, how that concordance compares to other predictors of sleep, and whether the degree of concordance varies across families. Methods A total of 421 adolescents (Mage = 15.03 years) and their primary caregivers (Mage = 41.93 years) reported their sleep, bed, and wake times on a daily basis for a two-week period. Approximately 80% of the sample repeated the same protocol one year later. Results Multi-level modeling indicated a significant concordance between parent and adolescent sleep, bed, and wake times on a daily basis. Concordance existed independent of other predictors of sleep such as day of the week and adolescent study time. Larger families and those with higher levels of parent-adolescent support exhibited greater concordance. Conclusions Adolescent sleep is connected to the sleep habits of their parents, above and beyond commonly-known structural and experiential factors that can shape teenage sleep. Efforts to improve teenage sleep should pay greater attention to the sleep patterns of parents and potentially other family members. PMID:25620309

  8. Daily concordance between parent and adolescent sleep habits.

    PubMed

    Fuligni, Andrew J; Tsai, Kim M; Krull, Jennifer L; Gonzales, Nancy A

    2015-02-01

    To assess the daily concordance between parent and adolescent daily sleep habits, how that concordance compares to other predictors of sleep, and whether the degree of concordance varies across families. A total of 421 adolescents (Mage = 15.03 years) and their primary caregivers (Mage = 41.93 years) reported their sleep, bed, and wake times on a daily basis for a 2-week period. Approximately 80% of the sample repeated the same protocol 1 year later. Multilevel modeling indicated a significant concordance between parent and adolescent sleep, bed, and wake times on a daily basis. Concordance existed independent of other predictors of sleep such as day of the week and adolescent study time. Larger families and those with higher levels of parent-adolescent support exhibited greater concordance. Adolescent sleep is connected to the sleep habits of their parents, above and beyond commonly known structural and experiential factors that can shape teenage sleep. Efforts to improve teenage sleep should pay greater attention to the sleep patterns of parents and potentially other family members. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  9. Water clouds and dust aerosols observations with PFS MEX at Mars

    NASA Astrophysics Data System (ADS)

    Zasova, L.; Formisano, V.; Moroz, V.; Grassi, D.; Ignatiev, N.; Giuranna, M.; Hansen, G.; Blecka, M.; Ekonomov, A.; Lellouch, E.; Fonti, S.; Grigoriev, A.; Hirsch, H.; Khatuntsev, I.; Mattana, A.; Maturilli, A.; Moshkin, B.; Patsaev, D.; Piccioni, G.; Rataj, M.; Saggin, B.

    2005-08-01

    Observations of water ice clouds and dust are among the main scientific goals of the Planetary Fourier Spectrometer (PFS), a payload instrument of the European Mars Express mission. We report some results, obtained in three orbits: 37, 41 and 68. The temperature profile, and dust and water ice cloud opacities are retrieved from the thermal infrared (long-wavelength channel of PFS) in a self-consistent way using the same spectrum. Orographic ice clouds are identified above Olympus (orbit 37) and Ascraeus Mons (orbit 68). Both volcanoes were observed near noon at Ls=337° and 342°, respectively. The effective radius of ice particles is preliminary estimated as 1-3 μm, changing along the flanks. The corresponding visual opacity changes in the interval 0.2-0.4 above Olympus and 0.1-0.6 above Ascraeus Mons. In the case of Ascraeus Mons, the ice clouds were observed mainly above the Southern flank of the volcano with maximum opacity near the summit. In the case of Olympus, the clouds were found above both sides of the top. A different type of ice cloud is observed at latitudes above 50°N (orbit 68) in the polar hood: the effective particle radius is estimated to be 4 μm. Below the 1 mb level an inversion in the temperature profiles is found with maximum temperature at around 0.6 mb. Along orbit 68 it appears above Alba Patera, then it increases to the north and decreases above the CO 2 polar cap. Beginning from latitude 20°S above Tharsis (orbit 68), the ice clouds and dust contribute equally to the spectral shape. Further on, the ice clouds are found everywhere along orbit 68 up to the Northern polar cap, except the areas between the Northern flank of Ascraeus Mons (below 10 km) and the edge of Alba Patera. Orbit 41 is shifted from the orbit 68 by roughly 180° longitude and passes through Hellas. Ice clouds are not visible in this orbit at latitudes below 80°S. The dust opacity is anticorrelated with the surface altitude. From 70°S to 25°N latitude the vertical dust distribution follows an exponential law with a scale height of 11.5±0.5 km, which corresponds to the gaseous scale height near noon and indicates a well-mixed condition. The 9 μm dust opacity, reduced to zero surface altitude, is found to be 0.25±0.05, which corresponds to a visual opacity of 0.5-0.7 (depending on the particle size).

  10. Investigating spousal concordance of diabetes through statistical analysis and data mining.

    PubMed

    Wang, Jong-Yi; Liu, Chiu-Shong; Lung, Chi-Hsuan; Yang, Ya-Tun; Lin, Ming-Hung

    2017-01-01

    Spousal clustering of diabetes merits attention. Whether old-age vulnerability or a shared family environment determines the concordance of diabetes is also uncertain. This study investigated the spousal concordance of diabetes and compared the risk of diabetes concordance between couples and noncouples by using nationally representative data. A total of 22,572 individuals identified from the 2002-2013 National Health Insurance Research Database of Taiwan constituted 5,643 couples and 5,643 noncouples through 1:1 dual propensity score matching (PSM). Factors associated with concordance in both spouses with diabetes were analyzed at the individual level. The risk of diabetes concordance between couples and noncouples was compared at the couple level. Logistic regression was the main statistical method. Statistical data were analyzed using SAS 9.4. C&RT and Apriori of data mining conducted in IBM SPSS Modeler 13 served as a supplement to statistics. High odds of the spousal concordance of diabetes were associated with old age, middle levels of urbanization, and high comorbidities (all P < 0.05). The dual PSM analysis revealed that the risk of diabetes concordance was significantly higher in couples (5.19%) than in noncouples (0.09%; OR = 61.743, P < 0.0001). A high concordance rate of diabetes in couples may indicate the influences of assortative mating and shared environment. Diabetes in a spouse implicates its risk in the partner. Family-based diabetes care that emphasizes the screening of couples at risk of diabetes by using the identified risk factors is suggested in prospective clinical practice interventions.

  11. Investigating spousal concordance of diabetes through statistical analysis and data mining

    PubMed Central

    Liu, Chiu-Shong; Lung, Chi-Hsuan; Yang, Ya-Tun; Lin, Ming-Hung

    2017-01-01

    Objective Spousal clustering of diabetes merits attention. Whether old-age vulnerability or a shared family environment determines the concordance of diabetes is also uncertain. This study investigated the spousal concordance of diabetes and compared the risk of diabetes concordance between couples and noncouples by using nationally representative data. Methods A total of 22,572 individuals identified from the 2002–2013 National Health Insurance Research Database of Taiwan constituted 5,643 couples and 5,643 noncouples through 1:1 dual propensity score matching (PSM). Factors associated with concordance in both spouses with diabetes were analyzed at the individual level. The risk of diabetes concordance between couples and noncouples was compared at the couple level. Logistic regression was the main statistical method. Statistical data were analyzed using SAS 9.4. C&RT and Apriori of data mining conducted in IBM SPSS Modeler 13 served as a supplement to statistics. Results High odds of the spousal concordance of diabetes were associated with old age, middle levels of urbanization, and high comorbidities (all P < 0.05). The dual PSM analysis revealed that the risk of diabetes concordance was significantly higher in couples (5.19%) than in noncouples (0.09%; OR = 61.743, P < 0.0001). Conclusions A high concordance rate of diabetes in couples may indicate the influences of assortative mating and shared environment. Diabetes in a spouse implicates its risk in the partner. Family-based diabetes care that emphasizes the screening of couples at risk of diabetes by using the identified risk factors is suggested in prospective clinical practice interventions. PMID:28817654

  12. Phenotypic concordance in familial inflammatory bowel disease (IBD). Results of a nationwide IBD Spanish database.

    PubMed

    Cabré, Eduard; Mañosa, Míriam; García-Sánchez, Valle; Gutiérrez, Ana; Ricart, Elena; Esteve, Maria; Guardiola, Jordi; Aguas, Mariam; Merino, Olga; Ponferrada, Angel; Gisbert, Javier P; Garcia-Planella, Esther; Ceña, Gloria; Cabriada, José L; Montoro, Miguel; Domènech, Eugeni

    2014-07-01

    Disease outcome has been found to be poorer in familial inflammatory bowel disease (IBD) than in sporadic forms, but assessment of phenotypic concordance in familial IBD provided controversial results. We assessed the concordance for disease type and phenotypic features in IBD families. Patients with familial IBD were identified from the IBD Spanish database ENEIDA. Families in whom at least two members were in the database were selected for concordance analysis (κ index). Concordance for type of IBD [Crohn's disease (CD) vs. ulcerative colitis (UC)], as well as for disease extent, localization and behaviour, perianal disease, extraintestinal manifestations, and indicators of severe disease (i.e., need for immunosuppressors, biological agents, and surgery) for those pairs concordant for IBD type, were analyzed. 798 out of 11,905 IBD patients (7%) in ENEIDA had familial history of IBD. Complete data of 107 families (231 patients and 144 consanguineous pairs) were available for concordance analyses. The youngest members of the pairs were diagnosed with IBD at a significantly younger age (p<0.001) than the oldest ones. Seventy-six percent of pairs matched up for the IBD type (κ=0.58; 95%CI: 0.42-0.73, moderate concordance). There was no relevant concordance for any of the phenotypic items assessed in both diseases. Familial IBD is associated with diagnostic anticipation in younger individuals. Familial history does not allow predicting any phenotypic feature other than IBD type. Copyright © 2013 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.

  13. Achieving Goal-Concordant Care: A Conceptual Model and Approach to Measuring Serious Illness Communication and Its Impact.

    PubMed

    Sanders, Justin J; Curtis, J Randall; Tulsky, James A

    2018-03-01

    High-quality care for seriously ill patients aligns treatment with their goals and values. Failure to achieve "goal-concordant" care is a medical error that can harm patients and families. Because communication between clinicians and patients enables goal concordance and also affects the illness experience in its own right, healthcare systems should endeavor to measure communication and its outcomes as a quality assessment. Yet, little consensus exists on what should be measured and by which methods. To propose measurement priorities for serious illness communication and its anticipated outcomes, including goal-concordant care. We completed a narrative review of the literature to identify links between serious illness communication, goal-concordant care, and other outcomes. We used this review to identify gaps and opportunities for quality measurement in serious illness communication. Our conceptual model describes the relationship between communication, goal-concordant care, and other relevant outcomes. Implementation-ready measures to assess the quality of serious illness communication and care include (1) the timing and setting of serious illness communication, (2) patient experience of communication and care, and (3) caregiver bereavement surveys that include assessment of perceived goal concordance of care. Future measurement priorities include direct assessment of communication quality, prospective patient or family assessment of care concordance with goals, and assessment of the bereaved caregiver experience. Improving serious illness care necessitates ensuring that high-quality communication has occurred and measuring its impact. Measuring patient experience and receipt of goal-concordant care should be our highest priority. We have the tools to measure both.

  14. Comparison of glass slides and various digital-slide modalities for cytopathology screening and interpretation.

    PubMed

    Hanna, Matthew G; Monaco, Sara E; Cuda, Jacqueline; Xing, Juan; Ahmed, Ishtiaque; Pantanowitz, Liron

    2017-09-01

    Whole-slide imaging in cytology is limited when glass slides are digitized without z-stacks for focusing. Different vendors have started to provide z-stacking solutions to overcome this limitation. The Panoptiq imaging system allows users to create digital files combining low-magnification panoramic images with regions of interest (ROIs) that are imaged with high-magnification z-stacks. The aim of this study was to compare such panoramic images with conventional whole-slide images and glass slides for the tasks of screening and interpretation in cytopathology. Thirty glass slides, including 10 ThinPrep Papanicolaou tests and 20 nongynecologic cytology cases, were digitized with an Olympus BX45 integrated microscope with an attached Prosilica GT camera. ViewsIQ software was used for image acquisition and viewing. These glass slides were also scanned on an Aperio ScanScope XT at ×40 (0.25 μm/pixel) with 1 z-plane and were viewed with ImageScope software. Digital and glass sides were screened and dotted/annotated by a cytotechnologist and were subsequently reviewed by 3 cytopathologists. For panoramic images, the cytotechnologist manually created digital maps and selected representative ROIs to generate z-stacks at a higher magnification. After 3-week washout periods, panoramic images were compared with Aperio digital slides and glass slides. The Panoptiq system permitted fine focusing of thick smears and cell clusters. In comparison with glass slides, the average screening times were 5.5 and 1.8 times longer with Panoptiq and Aperio images, respectively, but this improved with user experience. There was no statistical difference in diagnostic concordance between all 3 modalities. Users' diagnostic confidence was also similar for all modalities. The Aperio whole-slide scanner with 1 z-plane scanning and the Panoptiq imaging system with z-stacking are both suitable for cytopathology screening and interpretation. However, ROI z-stacks do offer a superior mechanism for overcoming focusing problems commonly encountered with digital cytology slides. Unlike whole-slide imaging, the acquisition of representative z-stack images with the Panoptiq system requires a trained cytologist to create digital files. Cancer Cytopathol 2017;125:701-9. © 2017 American Cancer Society. © 2017 American Cancer Society.

  15. Reproducibility of the NEPTUNE descriptor-based scoring system on whole-slide images and histologic and ultrastructural digital images.

    PubMed

    Barisoni, Laura; Troost, Jonathan P; Nast, Cynthia; Bagnasco, Serena; Avila-Casado, Carmen; Hodgin, Jeffrey; Palmer, Matthew; Rosenberg, Avi; Gasim, Adil; Liensziewski, Chrysta; Merlino, Lino; Chien, Hui-Ping; Chang, Anthony; Meehan, Shane M; Gaut, Joseph; Song, Peter; Holzman, Lawrence; Gibson, Debbie; Kretzler, Matthias; Gillespie, Brenda W; Hewitt, Stephen M

    2016-07-01

    The multicenter Nephrotic Syndrome Study Network (NEPTUNE) digital pathology scoring system employs a novel and comprehensive methodology to document pathologic features from whole-slide images, immunofluorescence and ultrastructural digital images. To estimate inter- and intra-reader concordance of this descriptor-based approach, data from 12 pathologists (eight NEPTUNE and four non-NEPTUNE) with experience from training to 30 years were collected. A descriptor reference manual was generated and a webinar-based protocol for consensus/cross-training implemented. Intra-reader concordance for 51 glomerular descriptors was evaluated on jpeg images by seven NEPTUNE pathologists scoring 131 glomeruli three times (Tests I, II, and III), each test following a consensus webinar review. Inter-reader concordance of glomerular descriptors was evaluated in 315 glomeruli by all pathologists; interstitial fibrosis and tubular atrophy (244 cases, whole-slide images) and four ultrastructural podocyte descriptors (178 cases, jpeg images) were evaluated once by six and five pathologists, respectively. Cohen's kappa for inter-reader concordance for 48/51 glomerular descriptors with sufficient observations was moderate (0.40

  16. Sleep-Wake Concordance in Couples Is Inversely Associated With Cardiovascular Disease Risk Markers.

    PubMed

    Gunn, Heather E; Buysse, Daniel J; Matthews, Karen A; Kline, Christopher E; Cribbet, Matthew R; Troxel, Wendy M

    2017-01-01

    To determine whether interdependence in couples' sleep (sleep-wake concordance i.e., whether couples are awake or asleep at the same time throughout the night) is associated with two markers of cardiovascular disease (CVD) risk, ambulatory blood pressure (BP) and systemic inflammation. This community-based study is a cross-sectional analysis of 46 adult couples, aged 18-45 years, without known sleep disorders. Percent sleep-wake concordance, the independent variable, was calculated for each individual using actigraphy. Ambulatory BP monitors measured BP across 48 h. Dependent variables included mean sleep systolic BP (SBP) and diastolic BP (DBP), mean wake SBP and DBP, sleep-wake SBP and DBP ratios, and C-reactive protein (CRP). Mixed models were used and were adjusted for age, sex, education, race, and body mass index. Higher sleep-wake concordance was associated with lower sleep SBP (b = -.35, SE = .01) and DBP (b = -.22, SE = .10) and lower wake SBP (b = -.26, SE = .12; all p values < .05). Results were moderated by sex; for women, high concordance was associated with lower BP. Men and women with higher sleep-wake concordance also had lower CRP values (b = -.15, SE = .03, p < .05). Sleep-wake concordance was not associated with wake DBP or sleep/wake BP ratios. Significant findings remained after controlling for individual sleep quality, duration, and wake after sleep onset. Sleep-wake concordance was associated with sleep BP, and this association was stronger for women. Higher sleep-wake concordance was associated with lower systemic inflammation for men and women. Sleep-wake concordance may be a novel mechanism by which marital relationships are associated with long-term CVD outcomes. © Sleep Research Society 2016. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

  17. Assessing clinical reasoning in optometry using the script concordance test.

    PubMed

    Faucher, Caroline; Dufour-Guindon, Marie-Pier; Lapointe, Gabrielle; Gagnon, Robert; Charlin, Bernard

    2016-05-01

    Clinical reasoning is central to any health profession but its development among learners is difficult to assess. Over the last few decades, the script concordance test (SCT) has been developed to solve this dilemma and has been used in many health professions; however, no study has been published on the use of the script concordance test in optometry. The purpose of this study was to develop and validate a script concordance test for the field of optometry. A 101-question script concordance test (27 short clinical scenarios) was developed and administered online to a convenience sample of 23 second-year and 19 fourth-year students of optometry. It was also administered to a reference panel of 12 experienced optometrists to develop the scoring key. An item-total correlation was calculated for each question. Cronbach's alpha coefficient was used to evaluate the script concordance test reliability and a t-test compared the two groups. A final 77-question script concordance test was created by eliminating questions with low item-total correlation. Cronbach's alpha for this optimised 77-question script concordance test was 0.80. A group comparison revealed that the second-year students' scores (n = 23; mean score = 66.4 ± 7.87 per cent) were statistically lower (t = -4.141; p < 0.001) than those of the fourth-year students (n = 19; mean score = 75.5 ± 5.97 per cent). The online script concordance test developed for this study was found to be both reliable and capable of discriminating between second- and fourth-year optometric students. These results demonstrate that the script concordance test may be considered as a new tool in the optometric educators' assessment arsenal. Further studies will be needed to cover additional levels of professional development. © 2016 The Authors. Clinical and Experimental Optometry © 2016 Optometry Australia.

  18. Is physician-patient concordance associated with greater trust for women of low socioeconomic status?

    PubMed

    Scheid, Teresa L; Smith, Galen H

    2017-07-01

    The authors examined the association between physician-patient concordance and patient trust for low socio-economic status women who were enrolled in Medicaid case management. The data were collected from October 2006 through March 2007 from a stratified random sample of 2,815 adult beneficiaries enrolled in North Carolina Medicaid's primary care case management delivery system. We limited our analyses to women enrolled in primary care, hence controlling for gender and social class as well as access to care. We were also able to control for the availability of minority providers. The findings revealed that the enrollee's race, education, and experiences seeking help with their health providers were significantly related to patient's trust of their physicians. Neither race concordance nor gender concordance improved trust. This may be because relatively few minority providers were included in the sample. These results extend research on physician-patient concordance by examining the relationship of both racial and gender concordance with patient trust while controlling for access and social class. Research on physician-patient concordance needs to account for multiple measures of social status, as well as differences in culture and communication styles between physicians and their patients.

  19. Morphometric variations in gametocytes of Hepatozoon canis from naturally infected dogs.

    PubMed

    Eljadar, Mohamed S M; Singla, L D; Mustafa, Radya A A; Uppal, S K

    2013-04-01

    This study presents the morphometric characteristic of canine haemoprotozoan, Hepatozoon canis, using software DP2-BSW (OLYMPUS). The gametocytes of H. canis found inside the neutrophils were characteristic in shape and size and varied from 9.50 to 11.80 μm × 5.10-6.00 μm. Parasitaemia ranged from 1.00 to 39.00 %. Few gametocytes without nuclei and of abnormal shapes were also observed. The results were compared with the measurements done by using ocular micrometer.

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

    Blunden, P. G.; Melnitchouk, W.

    We examine the two-photon exchange corrections to elastic electron-nucleon scattering within a dispersive approach, including contributions from both nucleon and Δ intermediate states. The dispersive analysis avoids off-shell uncertainties inherent in traditional approaches based on direct evaluation of loop diagrams, and guarantees the correct unitary behavior in the high energy limit. Using empirical information on the electromagnetic nucleon elastic and NΔ transition form factors, we compute the two-photon exchange corrections both algebraically and numerically. Finally, results are compared with recent measurements of e + p to e - p cross section ratios from the CLAS, VEPP-3 and OLYMPUS experiments.

  1. Concord Grape Juice Supplementation Improves Memory Function In Older Adults with Mild Cognitive Impairment

    USDA-ARS?s Scientific Manuscript database

    Concord grape juice contains flavonoid polyphenol compounds, which have antioxidant and anti-inflammatory properties and influence neuronal signaling. Concord grape juice supplementation has been shown to reduce inflammation, blood pressure, and vascular pathology in individuals with cardiovascular...

  2. Patient-provider language concordance and colorectal cancer screening.

    PubMed

    Linsky, Amy; McIntosh, Nathalie; Cabral, Howard; Kazis, Lewis E

    2011-02-01

    Patient-provider language barriers may play a role in health-care disparities, including obtaining colorectal cancer (CRC) screening. Professional interpreters and language-concordant providers may mitigate these disparities. DESIGN, SUBJECTS, AND MAIN MEASURES: We performed a retrospective cohort study of individuals age 50 years and older who were categorized as English-Concordant (spoke English at home, n = 21,594); Other Language-Concordant (did not speak English at home but someone at their provider's office spoke their language, n = 1,463); or Other Language-Discordant (did not speak English at home and no one at their provider's spoke their language, n = 240). Multivariate logistic regression assessed the association of language concordance with colorectal cancer screening. Compared to English speakers, non-English speakers had lower use of colorectal cancer screening (30.7% vs 50.8%; OR, 0.63; 95% CI, 0.51-0.76). Compared to the English-Concordant group, the Language-Discordant group had similar screening (adjusted OR, 0.84; 95% CI, 0.58-1.21), while the Language-Concordant group had lower screening (adjusted OR, 0.57; 95% CI, 0.46-0.71). Rates of CRC screening are lower in individuals who do not speak English at home compared to those who do. However, the Language-Discordant cohort had similar rates to those with English concordance, while the Language-Concordant cohort had lower rates of CRC screening. This may be due to unmeasured differences among the cohorts in patient, provider, and health care system characteristics. These results suggest that providers should especially promote the importance of CRC screening to non-English speaking patients, but that language barriers do not fully account for CRC screening rate disparities in these populations.

  3. Concordance of HPV-DNA in cervical dysplasia or genital warts in women and their monogamous long-term male partners.

    PubMed

    Rob, Filip; Tachezy, Ruth; Pichlík, Tomáš; Škapa, Petr; Rob, Lukáš; Hamšíková, Eva; Šmahelová, Jana; Hercogová, Jana

    2017-09-01

    Transmission of human papillomavirus (HPV) is a premise for development of cervical dysplasia and genital warts (GWs). This cross-sectional study assesses concordance of HPV types present in GWs or cervical dysplasia in women and genital infection of their monogamous male partners in conjunction with seroprevalence of HPV-6, -11, -16, and -18 antibodies. Blood was taken from both women and men, as well a smear of the urogenital area of men. HPV DNA detection in women was done in fixed paraffin embedded tissues under histological control. Of 143 couples who agreed to participate in the study, 68 met inclusion criteria. Type-specific concordance was observed in 32.5% (13/40) of couples in which women had genital warts and in 32.1% (9/28) of couples in which women had cervical dysplasia. In multivariate analysis only smoking in women was associated with concordance (P < 0.05). Prevalence of HPV-specific antibodies was high in male partners, but was not associated with presence of the same HPV type on their genitals. The same type-specific HPV antibodies were detected in 81.8% of men in couples with HPV-6 concordant genital warts, but only in 14.3% of men in couples with HPV-16 concordant cervical dysplasia (P < 0.01). These results suggest that type-specific HPV concordance in genital warts and cervical dysplasia lesions of women and genital infection of their male partners is common and similar. Higher seroconversion in couples with HPV-6 concordant genital warts compared with couples with HPV-16 concordant cervical dysplasia may be explained by viral load exposure. © 2017 Wiley Periodicals, Inc.

  4. Where Do Self-Concordant Goals Come From? The Role of Domain-Specific Psychological Need Satisfaction.

    PubMed

    Milyavskaya, Marina; Nadolny, Daniel; Koestner, Richard

    2014-06-01

    Previous research has shown that self-concordant goals are more likely to be attained. But what leads someone to adopt a self-concordant goal in the first place? The present research addresses this question by looking at the domains in which goals are set, focusing on the amount of psychological need satisfaction experienced in these domains. Across three experimental studies, we demonstrate that domain-related need satisfaction predicts the extent to which people adopt self-concordant goals in a given domain, laying the foundation for successful goal pursuit. In addition, we show that need satisfaction influences goal self-concordance because in need-satisfying domains people are both more likely to choose the most self-concordant goal (among a set of comparable choices), and are more likely to internalize the possible goals. The implications of this research for goal setting and pursuit as well as for the importance of examining goals within their broader motivational framework are discussed. © 2014 by the Society for Personality and Social Psychology, Inc.

  5. Concordant Chemical Reaction Networks and the Species-Reaction Graph

    PubMed Central

    Shinar, Guy; Feinberg, Martin

    2015-01-01

    In a recent paper it was shown that, for chemical reaction networks possessing a subtle structural property called concordance, dynamical behavior of a very circumscribed (and largely stable) kind is enforced, so long as the kinetics lies within the very broad and natural weakly monotonic class. In particular, multiple equilibria are precluded, as are degenerate positive equilibria. Moreover, under certain circumstances, also related to concordance, all real eigenvalues associated with a positive equilibrium are negative. Although concordance of a reaction network can be decided by readily available computational means, we show here that, when a nondegenerate network’s Species-Reaction Graph satisfies certain mild conditions, concordance and its dynamical consequences are ensured. These conditions are weaker than earlier ones invoked to establish kinetic system injectivity, which, in turn, is just one ramification of network concordance. Because the Species-Reaction Graph resembles pathway depictions often drawn by biochemists, results here expand the possibility of inferring significant dynamical information directly from standard biochemical reaction diagrams. PMID:22940368

  6. Concordance between clinical and histopathologic diagnoses of oral mucosal lesions.

    PubMed

    Patel, Kush J; De Silva, Harsha L; Tong, Darryl C; Love, Robert M

    2011-01-01

    To study the epidemiology of oral soft tissue lesions in New Zealand from 2002 to 2006 and to determine the concordance between the clinical diagnosis and the definitive histopathologic diagnosis achieved by general dental practitioners and by specialists. The details from biopsy referrals and the corresponding histopathologic reports of oral soft tissue lesions were recorded into a statistical software package, and the concordance between the clinical diagnosis and histopathologic diagnosis was determined for all the lesions. Most biopsies were benign lesions, and both clinician groups achieved a high diagnostic concordance for these lesions. However, when considering all lesion types, the overall concordance for both groups was a moderate 50.6%, with little difference between specialists and general dental practitioners, although specialists were more accurate in diagnosing a malignant or premalignant lesion. The clinical and histopathologic concordance achieved by oral health practitioners in New Zealand appears to be moderate. Copyright © 2011 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  7. The effect of emotional distance on psychophysiologic concordance and perceived empathy between patient and interviewer.

    PubMed

    Marci, Carl D; Orr, Scott P

    2006-06-01

    This preliminary study investigated the effect of emotional distance on psychophysiologic concordance and perceived empathy in a clinical population. Participants included 20 adult outpatients from a mental health clinic that underwent a brief semi-structured interview with a trained psychiatrist in either an emotionally neutral or an emotionally distant condition. Simultaneous skin conductance (SC) levels of the patient and interviewer were recorded and used to calculate a measure of psychophysiologic concordance. Interviewer gaze was rated by an independent observer and used as a proxy indicator of emotional distance. Observer ratings of interviewer gaze, SC concordance, and patient ratings of perceived interviewer empathy were significantly lower in the emotionally distant condition compared with the emotionally neutral condition (p < 0.05). Results suggest that increased emotional distance is associated with decreased psychophysiologic concordance and reduced subjective ratings of perceived empathy. The observed differences in psychophysiologic concordance support the use of this measure as a potential marker of empathy in a clinical population in an interview setting.

  8. Concordant Chemical Reaction Networks

    PubMed Central

    Shinar, Guy; Feinberg, Martin

    2015-01-01

    We describe a large class of chemical reaction networks, those endowed with a subtle structural property called concordance. We show that the class of concordant networks coincides precisely with the class of networks which, when taken with any weakly monotonic kinetics, invariably give rise to kinetic systems that are injective — a quality that, among other things, precludes the possibility of switch-like transitions between distinct positive steady states. We also provide persistence characteristics of concordant networks, instability implications of discordance, and consequences of stronger variants of concordance. Some of our results are in the spirit of recent ones by Banaji and Craciun, but here we do not require that every species suffer a degradation reaction. This is especially important in studying biochemical networks, for which it is rare to have all species degrade. PMID:22659063

  9. A concordance-based study to assess doctors’ and nurses’ mental models in Internal Medicine

    PubMed Central

    Chan, K. C. Gary; Muller-Juge, Virginie; Cullati, Stéphane; Hudelson, Patricia; Maître, Fabienne; Vu, Nu V.; Savoldelli, Georges L.; Nendaz, Mathieu R.

    2017-01-01

    Interprofessional collaboration between doctors and nurses is based on team mental models, in particular for each professional’s roles. Our objective was to identify factors influencing concordance on the expectations of doctors’ and nurses’ roles and responsibilities in an Internal Medicine ward. Using a dataset of 196 doctor-nurse pairs (14x14 = 196), we analyzed choices and prioritized management actions of 14 doctors and 14 nurses in six clinical nurse role scenarios, and in five doctor role scenarios (6 options per scenario). In logistic regression models with a non-nested correlation structure, we evaluated concordance among doctors and nurses, and adjusted for potential confounders (including prior experience in Internal Medicine, acuteness of case and gender). Concordance was associated with number of female professionals (adjusted OR 1.32, 95% CI 1.02 to 1.73), for acute situations (adjusted OR 2.02, 95% CI 1.13 to 3.62), and in doctor role scenarios (adjusted OR 2.19, 95% CI 1.32 to 3.65). Prior experience and country of training were not significant predictors of concordance. In conclusion, our concordance-based approach helped us identify areas of lower concordance in expected doctor-nurse roles and responsibilities, particularly in non-acute situations, which can be targeted by future interprofessional, educational interventions. PMID:28792524

  10. Concordance and Transmission of Human Papillomavirus Within Heterosexual Couples Observed Over Short Intervals

    PubMed Central

    Widdice, Lea; Ma, Yifei; Jonte, Janet; Farhat, Sepideh; Breland, David; Shiboski, Stephen; Moscicki, Anna-Barbara

    2013-01-01

    Background. Because many human papillomavirus (HPV) infections are transient, rates of transmission may be miscalculated if the interval between testing spans several months. We examined rates of concordance and transmission in heterosexual couples over short intervals. Methods. Twenty-five adult couples were enrolled and sampled for HPV DNA from the genitals, hand, and mouth 5 times over a 6-week period, including 24 hours after sexual intercourse and after 48 hours of abstinence. Concordance and transmission patterns were described. Results. Concordance between the couple's genital sites ranged from 64% to 95% for at least 1 HPV type. The highest rates of concordance were observed 24 hours after sexual intercourse. A similar peak in concordance was not seen between genital and nongenital anatomic sites. Transmission rates for female genital to male genital ranged from 26.8 to 187.5 per 100 person-months and for male genital to female genital from 14.5 to 100 per 100 person-months. Conclusions. High rates of concordance shortly after intercourse suggest that some DNA detections in the genital area are contaminants from a partner and not established HPV infections. Female-to-male transmission appeared more common than male-to-female transmission. PMID:23319742

  11. Concordance with dietary and lifestyle population goals for cancer prevention in Dutch, Scottish, Mexican, and Guatemalan population samples.

    PubMed

    Vossenaar, Marieke; Solomons, Noel W; Valdés-Ramos, Roxana; Anderson, Annie S

    2010-01-01

    We assessed concordance with selected population goal components of the 1997 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) diet and lifestyle recommendations to decrease cancer risk across four population samples. This was a prospectively designed survey examining concordance with the population goals of the WCRF/AICR recommendations using target criteria across sites. Population samples were from the Netherlands, Scotland, Mexico, and Guatemala. A total of 3564 men and women aged 18 to 70 y were recruited in equal proportions by site and gender. None of the four pooled samples met the target population average criteria for body mass index or refined sugar intake. The Guatemalan sample had concordance with the largest number of recommended cancer-prevention goals (10 of 12 selected WCRF/AICR components). Successively, Mexican, Scottish, and Dutch samples were concordant with seven, four, and three selected components, respectively. A prospectively designed research instrument and exhaustive prior examination of operative criteria allow for the assessment of group-level concordance with cancer-prevention goals. To the extent that the study samples reflect the respective national situations, geographic variance in concordance exists, with conditions and behaviors in Guatemala bringing that nation into more general compliance with the 1997 WCRF/AICR goals.

  12. Receipt of Guideline-Concordant Treatment in Elderly Prostate Cancer Patients

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

    Chen, Ronald C., E-mail: Ronald_chen@med.unc.edu; Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina

    2014-02-01

    Purpose: To examine the proportion of elderly prostate cancer patients receiving guideline-concordant treatment, using the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database. Methods and Materials: A total of 29,001 men diagnosed in 2004-2007 with localized prostate cancer, aged 66 to 79 years, were included. We characterized the proportion of men who received treatment concordant with the National Comprehensive Cancer Network guidelines, stratified by risk group and age. Logistic regression was used to examine covariates associated with receipt of guideline-concordant management. Results: Guideline concordance was 79%-89% for patients with low- or intermediate-risk disease. Among high-risk patients, 66.6% of those agedmore » 66-69 years received guideline-concordant management, compared with 51.9% of those aged 75-79 years. Discordance was mainly due to conservative management—no treatment or hormone therapy alone. Among the subgroup of patients aged ≤76 years with no measured comorbidity, findings were similar. On multivariable analysis, older age (75-79 vs 66-69 years, odds ratio 0.51, 95% confidence interval 0.50-0.57) was associated with a lower likelihood of guideline concordance for high-risk prostate cancer, but comorbidity was not. Conclusions: There is undertreatment of elderly but healthy patients with high-risk prostate cancer, the most aggressive form of this disease.« less

  13. Automated Microscopy: Macro Language Controlling a Confocal Microscope and its External Illumination: Adaptation for Photosynthetic Organisms.

    PubMed

    Steinbach, Gábor; Kaňa, Radek

    2016-04-01

    Photosynthesis research employs several biophysical methods, including the detection of fluorescence. Even though fluorescence is a key method to detect photosynthetic efficiency, it has not been applied/adapted to single-cell confocal microscopy measurements to examine photosynthetic microorganisms. Experiments with photosynthetic cells may require automation to perform a large number of measurements with different parameters, especially concerning light conditions. However, commercial microscopes support custom protocols (through Time Controller offered by Olympus or Experiment Designer offered by Zeiss) that are often unable to provide special set-ups and connection to external devices (e.g., for irradiation). Our new system combining an Arduino microcontroller with the Cell⊕Finder software was developed for controlling Olympus FV1000 and FV1200 confocal microscopes and the attached hardware modules. Our software/hardware solution offers (1) a text file-based macro language to control the imaging functions of the microscope; (2) programmable control of several external hardware devices (light sources, thermal controllers, actuators) during imaging via the Arduino microcontroller; (3) the Cell⊕Finder software with ergonomic user environment, a fast selection method for the biologically important cells and precise positioning feature that reduces unwanted bleaching of the cells by the scanning laser. Cell⊕Finder can be downloaded from http://www.alga.cz/cellfinder. The system was applied to study changes in fluorescence intensity in Synechocystis sp. PCC6803 cells under long-term illumination. Thus, we were able to describe the kinetics of phycobilisome decoupling. Microscopy data showed that phycobilisome decoupling appears slowly after long-term (>1 h) exposure to high light.

  14. Do neural tube defects lead to structural alterations in the human bladder?

    PubMed

    Pazos, Helena M F; Lobo, Márcio Luiz de P; Costa, Waldemar S; Sampaio, Francisco J B; Cardoso, Luis Eduardo M; Favorito, Luciano Alves

    2011-05-01

    Anencephaly is the most severe neural tube defect in human fetuses. The objective of this paper is to analyze the structure of the bladder in anencephalic human fetuses. We studied 40 bladders of normal human fetuses (20 male and 20 female, aged 14 to 23 WPC) and 12 bladders of anencephalic fetuses (5 male and 7 female, aged 18 to 22 WPC). The bladders were removed and processed by routine histological techniques. Stereological analysis of collagen, elastic system fibers and smooth muscle was performed in sections. Data were expressed as volumetric density (Vv-%). The images were captured with Olympus BX51 microscopy and Olympus DP70 camera. The stereological analysis was done using the software Image Pro and Image J. For biochemical analysis, samples were fixed in acetone, and collagen concentrations were expressed as micrograms of hydroxyproline per mg of dry tissue. Means were statistically compared using the unpaired t-test (p<0.05). We observed a significant increase (p<0.0001) in the Vv of collagen in the bladders of anencephalic fetuses (69.71%) when compared to normal fetuses (52.74%), and a significant decrease (p<0.0001) in the Vv of smooth muscle cells in the bladders of anencephalic fetuses (23.96%) when compared to normal fetuses (38.35%). The biochemical analyses showed a higher concentration of total collagen in the bladders of anencephalic fetuses (37354 µg/mg) when compared to normal fetuses (48117 µg/mg, p<0.02). The structural alterations of the bladder found in this study may suggest the existence of functional alterations in the bladder of anencephalic human fetuses.

  15. Characterization of aeroallergen of Texas panhandle using scanning and fluorescence microscopy

    NASA Astrophysics Data System (ADS)

    Ghosh, Nabarun; Whiteside, Mandy; Ridner, Chris; Celik, Yasemin; Saadeh, C.; Bennert, Jeff

    2010-06-01

    Aeroallergens cause serious allergic and asthmatic reactions. Characterizing the aeroallergen provides information regarding the onset, duration, and severity of the pollen season that clinicians use to guide allergen selection for skin testing and treatment. Fluorescence Microscopy has useful approaches to understand the structure and function of the microscopic objects. Prepared slides from the pollen were observed under an Olympus BX40 microscope equipped with FITC and TRITC fluorescent filters, a mercury lamp source, an Olympus DP-70 digital camera connected to the computer with Image Pro 6.0 software. Aeroallergens were viewed, recorded and analyzed with DP Manager using the Image Pro 6.0 software. Photographs were taken at bright field, the fluorescein-isothiocyanate (FITC) filter, and the tetramethylrhodamine (TRITC) filter settings at 40X. A high pressure mercury lamp or UV source was used to excite the storage molecules or proteins which exhibited autofluorescence. The FITC filter reveals the green fluorescent proteins (GFP and EGFP), and the TRITC filter for red fluorescent proteins (DsRed). SEM proved to be useful for observing ultra-structural details like pores, colpi, sulci and ornamentations on the pollen surface. Samples were examined with an SEM (TM-1000) after gold coating and Critical Point Drying. Pollen grains were measured using the TM-1000 imaging software that revealed the specific information on the size of colpi or sulci and the distance between the micro-structures. This information can be used for classification and circumscription in Angiosperm taxonomy. Data were correlated clinical studies established at Allergy A.R.T.S. Clinical Research Laboratory.

  16. Olympus Mons at Night

    NASA Technical Reports Server (NTRS)

    2004-01-01

    [figure removed for brevity, see original site]

    This nighttime IR image is of a portion of the flank of Olympus Mons. In last week's Arsia Mons flow images, it was easy to delineate lava flows. While this image is also of a region of extensive flows, it is nearly impossible to identify any flows. This illustrates one of the problems imaging high altitudes in nighttime IR, the surface is almost as cold as the atmosphere and is emitting very little signal back to the IR camera.

    Image information: IR instrument. Latitude 16.4, Longitude 230.6 East (129.4 West). 100 meter/pixel resolution.

    Note: this THEMIS visual image has not been radiometrically nor geometrically calibrated for this preliminary release. An empirical correction has been performed to remove instrumental effects. A linear shift has been applied in the cross-track and down-track direction to approximate spacecraft and planetary motion. Fully calibrated and geometrically projected images will be released through the Planetary Data System in accordance with Project policies at a later time.

    NASA's Jet Propulsion Laboratory manages the 2001 Mars Odyssey mission for NASA's Office of Space Science, Washington, D.C. The Thermal Emission Imaging System (THEMIS) was developed by Arizona State University, Tempe, in collaboration with Raytheon Santa Barbara Remote Sensing. The THEMIS investigation is led by Dr. Philip Christensen at Arizona State University. Lockheed Martin Astronautics, Denver, is the prime contractor for the Odyssey project, and developed and built the orbiter. Mission operations are conducted jointly from Lockheed Martin and from JPL, a division of the California Institute of Technology in Pasadena.

  17. Discrete element simulations of gravitational volcanic deformation. 1; Deformation structures and geometries

    NASA Technical Reports Server (NTRS)

    Morgan, Julia K.; McGovern, Patrick J.

    2005-01-01

    We have carried out two-dimensional particle dynamics simulations of granular piles subject to frictional Coulomb failure criteria to gain a first-order understanding of different modes of gravitational deformation within volcanoes. Under uniform basal and internal strength conditions, granular piles grow self-similarly, developing distinctive stratigraphies, morphologies, and structures. Piles constructed upon cohesive substrates exhibit particle avalanching, forming outward dipping strata and angle of repose slopes. Systematic decreases in basal strength lead to progressively deeper and steeper internal detachment faults and slip along a basal decollement; landslide forms grade from shallow slumps to deep-seated landslide and, finally, to axial subsidence and outward flank displacements, or volcanic spreading. Surface slopes decrease and develop concave up morphologies with decreasing decollement strength; depositional layers tilt progressively inward. Spatial variations in basal strength cause lateral transitions in pile structure, stratigraphy, and morphology. This approximation of volcanoes as Coulomb granular piles reproduces the richness of deformational structures and surface morphologies in many volcanic settings. The gentle slopes of Hawaiian volcanoes and Olympus Mons on Mars suggest weak basal decollements that enable volcanic spreading. High-angle normal faults, favored above weak decollements, are interpreted in both settings and may explain catastrophic sector collapse in Hawaii and broad aureole deposits surrounding Olympus Mons. In contrast, steeper slopes and shallow detachment faults predominate in the Canary Islands, thought to lack a weak decollement, favoring smaller, more frequent slope failures than predicted for Hawaii. The numerical results provide a useful predictive tool for interpreting dynamic behavior and associated geologic hazards of active volcanoes.

  18. Gigas Meets Ulysses

    NASA Technical Reports Server (NTRS)

    2003-01-01

    [figure removed for brevity, see original site]

    Released 9 July 2003

    Roughly halfway between the great volcanoes of Olympus Mons and Pavonis Mons, the graben (troughs) of Ulysses Fossae intersect with the furrows of Gigas (gigantic) Sulci. A clear time sequence is evident: first came the formation of the sulci terrain (to the left), which then was fractured by graben radial to Olympus Mons, followed by flooding of lava. All but the deepest graben are filled by lava in the topographic low between the two volcanic rises.

    Image information: VIS instrument. Latitude 11.8, Longitude 234.3 East (125.7 West). 19 meter/pixel resolution.

    Note: this THEMIS visual image has not been radiometrically nor geometrically calibrated for this preliminary release. An empirical correction has been performed to remove instrumental effects. A linear shift has been applied in the cross-track and down-track direction to approximate spacecraft and planetary motion. Fully calibrated and geometrically projected images will be released through the Planetary Data System in accordance with Project policies at a later time.

    NASA's Jet Propulsion Laboratory manages the 2001 Mars Odyssey mission for NASA's Office of Space Science, Washington, D.C. The Thermal Emission Imaging System (THEMIS) was developed by Arizona State University, Tempe, in collaboration with Raytheon Santa Barbara Remote Sensing. The THEMIS investigation is led by Dr. Philip Christensen at Arizona State University. Lockheed Martin Astronautics, Denver, is the prime contractor for the Odyssey project, and developed and built the orbiter. Mission operations are conducted jointly from Lockheed Martin and from JPL, a division of the California Institute of Technology in Pasadena.

  19. He Said, She Said: Examining Parental Concordance on Home Environment Factors and Adolescent Health Behaviors and Weight Status.

    PubMed

    Berge, Jerica M; MacLehose, Richard F; Meyer, Craig; Didericksen, Katharine; Loth, Katie A; Neumark-Sztainer, Dianne

    2016-01-01

    Few studies have examined concordance/discordance between caregivers to identify whether caregivers see familial and parental factors in the home environment similarly or differently and whether the agreement or disagreement is related to adolescent obesity risk. Answers to these questions are important and may inform whether family-based childhood obesity interventions need to target both parents. The main objective of the study was to examine whether and how parental concordance/discordance on factors in the home environment (eg, importance of family meals, parent feeding practices, encouraging child physical activity, and limit setting on child screen time) are associated with adolescent health behaviors and weight status. Data from two linked population-based studies were used in cross-sectional analyses. Linear regression models examined associations between parental concordance/discordance on home environment factors and adolescents' health behaviors and weight status. Racially/ethnically and socioeconomically diverse adolescents (n=1,052; 54% girls; mean age=14.3 years) and their parents (n=2,104; 52% women; mean age=41.0 years) from Minneapolis and St Paul, MN, participated in the study. Anthropometric assessments and surveys were completed at school by adolescents and surveys were completed at home by parents. Parental concordance on home environment factors was high for some factors (eg, 68% concordance on not pressuring adolescent to eat) and low for other factors (eg, 2% concordance on parent engaging in physically activity with child 4+ hours per week). Parental concordance on positive home environment factors (eg, frequency of family meals) was associated with more adolescent healthful eating patterns and hours of physical activity (P<0.05), but not consistently. When parents were discordant, adolescents had higher consumption of fast food and more unhealthy weight control behaviors (P<0.05), but not consistently. Results suggest there is some degree of parental concordance on home environment factors; however, the results were inconsistent and approximately one-third of parents were discordant on these factors. Future research is needed to further examine the role of parental concordance/discordance on adolescent health behaviors and weight status. Copyright © 2016 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  20. Do patients and health care providers have discordant preferences about which aspects of treatments matter most? Evidence from a systematic review of discrete choice experiments.

    PubMed

    Harrison, Mark; Milbers, Katherine; Hudson, Marie; Bansback, Nick

    2017-05-17

    To review studies eliciting patient and healthcare provider preferences for healthcare interventions using discrete choice experiments (DCEs) to (1) review the methodology to evaluate similarities, differences, rigour of designs and whether comparisons are made at the aggregate level or account for individual heterogeneity; and (2) quantify the extent to which they demonstrate concordance of patient and healthcare provider preferences. A systematic review searching Medline, EMBASE, Econlit, PsycINFO and Web of Science for DCEs using patient and healthcare providers. peer-reviewed; complete empiric text in English from 1995 to 31July 2015; discussing a healthcare-related topic; DCE methodology; comparing patients and healthcare providers. Systematic review. We identified 38 papers exploring 16 interventions in 26 diseases/indications. Methods to analyse results, determine concordance between patient and physician values, and explore heterogeneity varied considerably between studies. The majority of studies we reviewed found more evidence of mixed concordance and discordance (n=28) or discordance of patient and healthcare provider preferences (n=12) than of concordant preferences (n=4). A synthesis of concordance suggested that healthcare providers rank structure and outcome attributes more highly than patients, while patients rank process attributes more highly than healthcare providers. Discordant patient and healthcare provider preferences for different attributes of healthcare interventions are common. Concordance varies according to whether attributes are processes, structures or outcomes, and therefore determining preference concordance should consider all aspects jointly and not a binary outcome. DCE studies provide excellent opportunities to assess value concordance between patients and providers, but assessment of concordance was limited by a lack of consistency in the approaches used and consideration of heterogeneity of preferences. Future DCEs assessing concordance should fully report the framing of the questions and investigate the heterogeneity of preferences within groups and how these compare. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  1. He Said, She Said: Examining Parental Concordance on Home Environment Factors and Adolescent Health Behaviors and Weight Status

    PubMed Central

    Berge, Jerica M.; MacLehose, Richard F; Meyer, Craig; Didericksen, Katharine; Loth, Katie A.; Neumark-Sztainer, Dianne

    2015-01-01

    Introduction Few studies have examined concordance/discordance between caregivers to identify whether caregivers see familial and parental factors in the home environment similarly or differently and whether the agreement or disagreement is related to adolescent obesity risk. Answers to these questions are important and may inform whether family-based childhood obesity interventions need to target both parents. Objective The main objective of the study is to examine whether and how parental concordance/discordance on factors in the home environment (e.g., importance of family meals, parent feeding practices, encouraging child physical activity, limit setting on child screen time) are associated with adolescent health behaviors and weight status. Design Data from two linked population-based studies were used in cross-sectional analyses. Linear regression models examined associations between parental concordance/discordance on home environment factors and adolescents’ health behaviors and weight status. Participant/Settings Racially/ethnically and socioeconomically diverse adolescents (n=1,052; 54% girls; mean age = 14.3 years) and their parents (n=2,104; 52% female; mean age = 41.0 years) from Minneapolis and St. Paul, Minnesota participated in the study. Anthropometric assessments and surveys were completed at school by adolescents and surveys were completed at home by parents. Results Parental concordance on home environment factors was high for some factors (e.g., 68% concordance on not pressuring adolescent to eat) and low for other factors (e.g., 2% concordance on parent engaging in physically activity with child 4+ hours/week). Parental concordance on positive home environment factors (e.g., frequency of family meals) was associated with more adolescent healthful eating patterns and hours of physical activity (p < 0.05), but not consistently. When parents were discordant, adolescents had higher consumption of fast food and more unhealthy weight control behaviors (p < 0.05), but not consistently. Conclusions Results suggest there is some degree of parental concordance on home environment factors, however the results were inconsistent and approximately one third of parents were discordant on these factors. Future research is needed to further examine the role of parental concordance/discordance on adolescent health behaviors and weight status. PMID:26163351

  2. Disease-Concordant Twins Empower Genetic Association Studies.

    PubMed

    Tan, Qihua; Li, Weilong; Vandin, Fabio

    2017-01-01

    Genome-wide association studies with moderate sample sizes are underpowered, especially when testing SNP alleles with low allele counts, a situation that may lead to high frequency of false-positive results and lack of replication in independent studies. Related individuals, such as twin pairs concordant for a disease, should confer increased power in genetic association analysis because of their genetic relatedness. We conducted a computer simulation study to explore the power advantage of the disease-concordant twin design, which uses singletons from disease-concordant twin pairs as cases and ordinary healthy samples as controls. We examined the power gain of the twin-based design for various scenarios (i.e., cases from monozygotic and dizygotic twin pairs concordant for a disease) and compared the power with the ordinary case-control design with cases collected from the unrelated patient population. Simulation was done by assigning various allele frequencies and allelic relative risks for different mode of genetic inheritance. In general, for achieving a power estimate of 80%, the sample sizes needed for dizygotic and monozygotic twin cases were one half and one fourth of the sample size of an ordinary case-control design, with variations depending on genetic mode. Importantly, the enriched power for dizygotic twins also applies to disease-concordant sibling pairs, which largely extends the application of the concordant twin design. Overall, our simulation revealed a high value of disease-concordant twins in genetic association studies and encourages the use of genetically related individuals for highly efficiently identifying both common and rare genetic variants underlying human complex diseases without increasing laboratory cost. © 2016 John Wiley & Sons Ltd/University College London.

  3. Achieving Goal-Concordant Care: A Conceptual Model and Approach to Measuring Serious Illness Communication and Its Impact

    PubMed Central

    Curtis, J. Randall; Tulsky, James A.

    2018-01-01

    Abstract Background: High-quality care for seriously ill patients aligns treatment with their goals and values. Failure to achieve “goal-concordant” care is a medical error that can harm patients and families. Because communication between clinicians and patients enables goal concordance and also affects the illness experience in its own right, healthcare systems should endeavor to measure communication and its outcomes as a quality assessment. Yet, little consensus exists on what should be measured and by which methods. Objectives: To propose measurement priorities for serious illness communication and its anticipated outcomes, including goal-concordant care. Methods: We completed a narrative review of the literature to identify links between serious illness communication, goal-concordant care, and other outcomes. We used this review to identify gaps and opportunities for quality measurement in serious illness communication. Results: Our conceptual model describes the relationship between communication, goal-concordant care, and other relevant outcomes. Implementation-ready measures to assess the quality of serious illness communication and care include (1) the timing and setting of serious illness communication, (2) patient experience of communication and care, and (3) caregiver bereavement surveys that include assessment of perceived goal concordance of care. Future measurement priorities include direct assessment of communication quality, prospective patient or family assessment of care concordance with goals, and assessment of the bereaved caregiver experience. Conclusion: Improving serious illness care necessitates ensuring that high-quality communication has occurred and measuring its impact. Measuring patient experience and receipt of goal-concordant care should be our highest priority. We have the tools to measure both. PMID:29091522

  4. Patient comprehension of emergency department care and instructions: are patients aware of when they do not understand?

    PubMed

    Engel, Kirsten G; Heisler, Michele; Smith, Dylan M; Robinson, Claire H; Forman, Jane H; Ubel, Peter A

    2009-04-01

    To be able to adhere to discharge instructions after a visit to the emergency department (ED), patients should understand both the care that they received and their discharge instructions. The objective of this study is to assess, at discharge, patients' comprehension of their ED care and instructions and their awareness of deficiencies in their comprehension. We conducted structured interviews of 140 adult English-speaking patients or their primary caregivers after ED discharge in 2 health systems. Participants rated their subjective understanding of 4 domains: (1) diagnosis and cause; (2) ED care; (3) post-ED care, and (4) return instructions. We assessed patient comprehension as the degree of agreement (concordance) between patients' recall of each of these domains and information obtained from chart review. Two authors scored each case independently and discussed discrepancies before providing a final concordance rating (no concordance, minimal concordance, partial concordance, near concordance, complete concordance). Seventy-eight percent of patients demonstrated deficient comprehension (less than complete concordance) in at least 1 domain; 51% of patients, in 2 or more domains. Greater than a third of these deficiencies (34%) involved patients' understanding of post-ED care, whereas only 15% were for diagnosis and cause. The majority of patients with comprehension deficits failed to perceive them. Patients perceived difficulty with comprehension only 20% of the time when they demonstrated deficient comprehension. Many patients do not understand their ED care or their discharge instructions. Moreover, most patients appear to be unaware of their lack of understanding and report inappropriate confidence in their comprehension and recall.

  5. Spousal Concordance in Attitudes toward Violence and Reported Physical Abuse in African Couples

    ERIC Educational Resources Information Center

    Alio, Amina P.; Clayton, Heather B.; Garba, Madeleine; Mbah, Alfred K.; Daley, Ellen; Salihu, Hamisu M.

    2011-01-01

    Purpose: We examined the potential association between African couples' concordance on attitudes toward violence (ATV) and risk for intimate partner violence (IPV). Method: Analyses included 13,837 couples from Demographic and Health Surveys conducted between 2003 and 2007, from six African countries. Concordance on ATV was defined as both spouses…

  6. KWICgrouper--Designing a Tool for Corpus-Driven Concordance Analysis

    ERIC Educational Resources Information Center

    O'Donnell, Matthew Brook

    2008-01-01

    The corpus-driven analysis of concordance data often results in the identification of groups of lines in which repeated patterns around the node item establish membership in a particular function meaning group (Mahlberg, 2005). This paper explains the KWICgrouper, a concept designed to support this kind of concordance analysis. Groups are defined…

  7. Influence knowledge and behavior of TB medical personnels’ concordance principle based communications skill at primary healthcare, Medan, Indonesia

    NASA Astrophysics Data System (ADS)

    Wahyuni, A. S.; Soeroso, N. N.; Alona, I.; Yunanda, Y.; Siregar, I.

    2018-03-01

    Concordance behavior of TB management is a form of collaboration among doctors, personnel, and patients in treating TB. Approvalamong them could be achieved if credibility and policy occur. This study is aimed to analyze the influence of TB medical personnel’s concordance behaviour principle to patient obedience at primary health care in Medan.The design of this study was quasi experimental, focusing on interventional primary health care, which is those who applied concordance behaviour principle to non-interventionalprimary health care. The population is TB patients, starting from 18 years old, TB category I with positive Acid Fast Bacilli Smear Test (AFBST), and taking TB regimens at Medan. Seventy- four patients were selected to be samples. They had undergone interview based on validated concordance principle, knowledge, behavior, and treatment. Data were analyzed using chi- square. The percentage of knowledge, behavior of TB patient to the treatment is higher on interventional primary health care than noninterventional ones. Treatment awareness based on concordance principle is expected to planish DOTS-based TB programs.

  8. Decision-Making in Pediatric Transport Team Dispatch Using Script Concordance Testing.

    PubMed

    Rajapreyar, Prakadeshwari; Marcdante, Karen; Zhang, Liyun; Simpson, Pippa; Meyer, Michael T

    2017-11-01

    Our objective was to compare decision-making in dispatching pediatric transport teams by Medical Directors of pediatric transport teams (serving as experts) to that of Pediatric Intensivists and Critical Care fellows who often serve as Medical Control physicians. Understanding decision-making around team composition and dispatch could impact clinical management, cost effectiveness, and educational needs. Survey was developed using Script Concordance Testing guidelines. The survey contained 15 transport case vignettes covering 20 scenarios (45 questions). Eleven scenarios assessed impact of intrinsic patient factors (e.g., procedural needs), whereas nine assessed extrinsic factors (e.g., weather). Pediatric Critical Care programs accredited by the Accreditation Council for Graduate Medical Education (the United States). Pediatric Intensivists and senior Critical Care fellows at Pediatric Critical Care programs were the target population with Transport Medical Directors serving as the expert panel. None. Survey results were scored per Script Concordance Testing guidelines. Concordance within groups was assessed using simple percentage agreement. There was little concordance in decision-making by Transport Medical Directors (median Script Concordance Testing percentage score [interquartile range] of 33.9 [30.4-37.3]). In addition, there was no statistically significant difference between the median Script Concordance Testing scores among the senior fellows and Pediatric Intensivists (31.1 [29.6-33.2] vs 29.7 [28.3-32.3], respectively; p = 0.12). Transport Medical Directors were more concordant on reasoning involving intrinsic patient factors rather than extrinsic factors (10/21 vs 4/24). Our study demonstrates pediatric transport team dispatch decision-making discordance by pediatric critical care physicians of varying levels of expertise and experience. Script Concordance Testing at a local level may better elucidate standards in medical decision-making within pediatric critical care physicians. The development of a curriculum, which provides education and trains our workforce on the logistics of pediatric transport team dispatch, would help standardize practice and evaluate outcomes based on decision-making.

  9. Impact of Patient-Provider Race, Ethnicity, and Gender Concordance on Cancer Screening: Findings from Medical Expenditure Panel Survey.

    PubMed

    Malhotra, Jyoti; Rotter, David; Tsui, Jennifer; Llanos, Adana A M; Balasubramanian, Bijal A; Demissie, Kitaw

    2017-12-01

    Background: Racial and ethnic minorities experience lower rates of cancer screening compared with non-Hispanic whites (NHWs). Previous studies evaluating the role of patient-provider race, ethnicity, or gender concordance in cancer screening have been inconclusive. Methods: In a cross-sectional analysis using the Medical Expenditure Panel Survey (MEPS), data from 2003 to 2010 were assessed for associations between patient-provider race, ethnicity, and/or gender concordance and, screening (American Cancer Society guidelines) for breast, cervical, and colorectal cancer. Multivariable logistic analyses were conducted to examine associations of interest. Results: Of the 32,041 patient-provider pairs in our analysis, more than 60% of the patients were NHW, 15% were non-Hispanic black (NHB), and 15% were Hispanic. Overall, patients adherent to cancer screening were more likely to be non-Hispanic, better educated, married, wealthier, and privately insured. Patient-provider gender discordance was associated with lower rates of breast [OR, 0.83; 95% confidence interval (CI), 0.76-0.90], cervical (OR, 0.83; 95% CI, 0.76-0.91), and colorectal cancer (OR, 0.84; 95% CI, 0.79-0.90) screening in all patients. This association was also significant after adjusting for racial and/or ethnic concordance. Conversely, among NHWs and NHBs, patient-provider racial and/or ethnic concordance was not associated with screening. Among Hispanics, patient-provider ethnic discordant pairs had higher breast (58% vs. 52%) and colorectal cancer (45% vs. 39%) screening rates compared with concordant pairs. Conclusions: Patient-provider gender concordance positively affected cancer screening. Patient-provider ethnic concordance was inversely associated with receipt of cancer screening among Hispanics. This counter-intuitive finding requires further study. Impact: Our findings highlight the importance of gender concordance in improving cancer screening rates. Cancer Epidemiol Biomarkers Prev; 26(12); 1804-11. ©2017 AACR . ©2017 American Association for Cancer Research.

  10. Concordance with prescribing information dosage recommendations for dipeptidyl-peptidase-4 inhibitors among type 2 diabetes mellitus patients with moderate to severe chronic kidney disease.

    PubMed

    Huang, Huan; Shetty, Sharash; Bauer, Elise; Lang, Kathleen

    2018-06-01

    To estimate the proportion of patients with moderate to severe chronic kidney disease (CKD) whose initial dipeptidyl-peptidase-4 inhibitor (DPP4-i) dosage was concordant with prescribing information (label) recommendations in the United States. Adult patients with type 2 diabetes mellitus (T2DM) who initiated a DPP4-i (linagliptin, sitagliptin, saxagliptin) between 1 January 2011 and 30 June 2014 were identified using electronic medical records and administrative claims, with index date being the date of first observed DPP4-i treatment. Patients were required to have chronic kidney disease (CKD) stage 3b, 4 or 5 (estimated Glomerular Filtration Rate [eGFR] value <45 ml/min/1.73 m 2 ) during the 12 month pre-index period. Patients were classified as concordant or not concordant based on whether the first prescribed dose was consistent with label recommendations. Demographics, clinical characteristics, resource use and costs during pre-index were evaluated by DPP4-i concordance status. Of the 492 patients (323 sitagliptin, 57 saxagliptin, 112 linagliptin), 36.2% were prescribed doses that were not concordant with label recommendations (44.9% for sitagliptin, 57.9% for saxagliptin and 0% for linagliptin [which does not require dosage adjustment]). Concordant patients were slightly older (mean age 71 years vs. 68, p = .01) but had similar gender distribution (55% vs. 60% female, p = .31) compared to those who were not concordant. They had lower general health status (Charlson Comorbidity Score 2.6 vs. 2.2, p = .03), and had similar pre-index all-cause total costs ($25,245 vs. $21,972, p = .68) and lower pre-index T2DM-related costs ($1618 vs. $1922, p = .05). More than a third of DPP4-i patients with CKD stage 3b or higher were prescribed doses not concordant with DPP4-i label dosage recommendations.

  11. Attitudes toward concordance and self-efficacy in decision making: a cross-sectional study on pharmacist-patient consultations.

    PubMed

    Ng, Yew Keong; Shah, Noraida Mohamed; Loong, Ly Sia; Pee, Lay Ting; Hidzir, Sarina Anim M; Chong, Wei Wen

    2018-01-01

    This study investigated patients' and pharmacists' attitudes toward concordance in a pharmacist-patient consultation and how patients' attitudes toward concordance relate to their involvement and self-efficacy in decision making associated with medication use. A cross-sectional study was conducted among patients with chronic diseases and pharmacists from three public hospitals in Malaysia. The Revised United States Leeds Attitudes toward Concordance (RUS-LATCon) was used to measure attitudes toward concordance in both patients and pharmacists. Patients also rated their perceived level of involvement in decision making and completed the Decision Self-Efficacy scale. One-way analysis of variance (ANOVA) and independent t -test were used to determine significant differences between different subgroups on attitudes toward concordance, and multiple linear regression was performed to find the predictors of patients' self-efficacy in decision making. A total of 389 patients and 93 pharmacists participated in the study. Pharmacists and patients scored M=3.92 (SD=0.37) and M=3.84 (SD=0.46) on the RUS-LATCon scale, respectively. Seven items were found to be significantly different between pharmacists and patients on the subscale level. Patients who felt fully involved in decision making (M=3.94, SD=0.462) scored significantly higher on attitudes toward concordance than those who felt partially involved (M=3.82, SD=0.478) and not involved at all (M=3.68, SD=0.471; p <0.001). Patients had an average score of 76.7% (SD=14.73%) on the Decision Self-Efficacy scale. In multiple linear regression analysis, ethnicity, number of medications taken by patients, patients' perceived level of involvement, and attitudes toward concordance are significant predictors of patients' self-efficacy in decision making ( p <0.05). Patients who felt involved in their consultations had more positive attitudes toward concordance and higher confidence in making an informed decision. Further study is recommended on interventions involving pharmacists in supporting patients' involvement in medication-related decision making.

  12. Is sexual concordance related to awareness of physiological states?

    PubMed

    Suschinsky, Kelly D; Lalumière, Martin L

    2012-02-01

    Sexual concordance refers to the degree to which two aspects of human sexual arousal (genital response and self-reported sexual arousal) correspond with each other. Researchers have consistently reported a sex difference in sexual concordance: The relationship between genital responses and reported feelings of sexual arousal in men is positive and large, whereas the relationship in women is positive but much smaller than that seen in men. The study of interoception--people's awareness of their physiological states--reveals a similar sex difference: Men are more aware of a variety of (non-genital) responses (e.g., heart rate) than women in the laboratory. The purpose of the current study was to investigate whether the sex difference in sexual concordance was related to a broader sex difference in interoception. Twenty men and 20 women were presented with twelve 90 s sexual and non-sexual film clips while their genital responses, heart rate, and respiration rate were measured. Participants also estimated their physiological responses. As expected, men were significantly more sexually concordant than women. Men were also significantly more aware of their heart rate, but there was no significant sex difference in respiration rate awareness. Sexual concordance was not significantly correlated with either heart rate or respiration rate awareness. The results suggest that the sex difference in sexual concordance may be a unique phenomenon, separate from general awareness of physiological states.

  13. Parent-Youth Rating Concordance for Hair Pulling Variables, Functional Impairment, and Anxiety Scale Scores in Trichotillomania

    ERIC Educational Resources Information Center

    Keuthen, Nancy J.; Flessner, Christopher A.; Woods, Douglas W.; Franklin, Martin E.; Piacentini, John A.; Khanna, Muniya; Moore, Phoebe; Cashin, Susan

    2008-01-01

    Knowledge of cross-informant rating concordance is critical for the assessment of child and adolescent problems in clinical and research settings. We explored parent-youth rating concordance for hair pulling variables, functional impairment, and anxiety symptoms in a sample of child and adolescent hair pullers (n = 133) satisfying conservative…

  14. Is There Concordance in Attitudes and Beliefs between Parents and Scientists about Autism Spectrum Disorder?

    ERIC Educational Resources Information Center

    Fischbach, Ruth L.; Harris, Mark J.; Ballan, Michelle S.; Fischbach, Gerald D.; Link, Bruce G.

    2016-01-01

    There is no reported investigation comparing concordance in attitudes and beliefs about autism spectrum disorder between parents of children with autism spectrum disorder and scientists who research autism spectrum disorder. To investigate the level of concordance between these groups on causes of autism, priorities of research, perceived stigma,…

  15. 78 FR 5717 - Safety Zone; Military Ocean Terminal Concord Safety Zone, Suisun Bay, Military Ocean Terminal...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-28

    ...-AA00 Safety Zone; Military Ocean Terminal Concord Safety Zone, Suisun Bay, Military Ocean Terminal... Guard is establishing a safety zone in the navigable waters of Suisun Bay near Military Ocean Terminal Concord, CA in support of military onload and offload operations. This safety zone is established to...

  16. Intimate Partner Aggression Reporting Concordance and Correlates of Agreement among Men with Alcohol Use Disorders and Their Female Partners

    ERIC Educational Resources Information Center

    Panuzio, Jillian; O'Farrell, Timothy J.; Marshall, Amy D.; Murphy, Christopher M.; Murphy, Marie; Taft, Casey T.

    2006-01-01

    This study examined relationship aggression reporting concordance among 303 men with alcohol use disorders and their female partners enrolled in couples-based alcohol abuse treatment. Agreement for physical and psychological aggression was generally consistent with, or higher than, concordance rates reported among other populations. Men's…

  17. Personal, Family, and Social Functioning among Older Couples Concordant and Discordant for High-Risk Alcohol Consumption

    PubMed Central

    Moos, Rudolf H.; Schutte, Kathleen K.; Brennan, Penny L.; Moos, Bernice S.

    2010-01-01

    Aims This study compares the personal, family, and social functioning of older husbands and wives concordant or discordant for high-risk alcohol consumption and identifies predictors of changes in concordance and high-risk consumption. Design, Participants, Measurements Three groups of couples were identified at baseline and followed 10 years later: (1) concordant couples in which husbands and wives engaged in low-risk alcohol consumption (N = 54), (2) concordant couples in which husbands and wives engaged in high-risk alcohol consumption (N = 38), and (3) discordant couples in which one partner engaged in high-risk alcohol consumption and the other partner did not (N = 75). At each follow-up, husbands and wives completed an inventory that assessed their personal, family, and social functioning. Findings Compared to the low-risk concordant group, husbands and wives in the high-risk concordant group were more likely to rely on tension-reduction coping, reported more friend approval of drinking, and were less involved in religious activities; however, they did not differ in the quality of the spousal relationship. The frequency of alcohol consumption declined among husbands in discordant couples, but not among husbands in concordant couples. Predictors of high-risk drinking included tension-reduction coping, friend approval of drinking, and, for husbands, their wives’ level of drinking. Conclusions High-risk and discordant alcohol consumption do not seem to be linked to decrements in family functioning among older couples in long-term stable marriages. The predictors of heavy alcohol consumption among older husbands and wives identify points of intervention that may help to reduce their high-risk drinking. PMID:20883458

  18. The role of SISCOM in preoperative evaluation for patients with epilepsy surgery: A meta-analysis.

    PubMed

    Chen, Tong; Guo, Liang

    2016-10-01

    To assess the specific value of subtraction ictal and inter-ictal SPECT co-registered to MRI (SISCOM) in identifying the epileptogenic zone (EZ) and predicting postoperative outcomes in epileptic surgical patients. A meta-analysis of studies published from January 1995 to June 2015 was conducted through a comprehensive literature search, and 11 studies were included. R software was first used to calculate a pooled positive rate, concordant rate and positive predictive value (PPV) for good outcomes. Stata software was then used to explore the relationship between SISCOM localization and surgical outcomes, including a subgroup analysis for extra-temporal lobe epilepsy. The unweighted positive and concordant rates of SISCOM were 85.9% and 65.3%, respectively. In 142 MRI-negative patients, the SISCOM positive rate was 83.8%. The pooled PPV of 178 surgical patients with concordant SISCOM was 56%. In the meta-analysis of 275 surgical patients, the seizure-free odds ratio was 3.28-times higher in concordant than in non-concordant SISCOM patients [95%CI (1.90, 5.67)]. For extra-temporal lobe epilepsy, the seizure-free odds ratio was 2.44-times higher in concordant than in non-concordant SISCOM patients [95%CI (1.34, 4.43)]. Our data indicate that SISCOM has moderate sensitivity in localizing the epileptogenic zone and can provide complementary information when MRI is negative. Furthermore, SISCOM localization concordant with the gold standard demonstrates slightly higher predictive value for good surgical outcomes. Further research is required to explore the influence of SISCOM localization results in temporal lobe versus extra-temporal lobe epilepsy. Copyright © 2016 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  19. Personal, family and social functioning among older couples concordant and discordant for high-risk alcohol consumption.

    PubMed

    Moos, Rudolf H; Schutte, Kathleen K; Brennan, Penny L; Moos, Bernice S

    2011-02-01

    This study compares the personal, family and social functioning of older husbands and wives concordant or discordant for high-risk alcohol consumption and identifies predictors of changes in concordance and high-risk consumption. Three groups of couples were identified at baseline and followed 10 years later: (i) concordant couples in which husbands and wives engaged in low-risk alcohol consumption (n = 54); (ii) concordant couples in which husbands and wives engaged in high-risk alcohol consumption (n = 38); and (iii) discordant couples in which one partner engaged in high-risk alcohol consumption and the other partner did not (n = 75). At each follow-up, husbands and wives completed an inventory that assessed their personal, family and social functioning. Compared to the low-risk concordant group, husbands and wives in the high-risk concordant group were more likely to rely on tension-reduction coping, reported more friend approval of drinking, and were less involved in religious activities; however, they did not differ in the quality of the spousal relationship. The frequency of alcohol consumption declined among husbands in discordant couples, but not among husbands in concordant couples. Predictors of high-risk drinking included tension-reduction coping, friend approval of drinking and, for husbands, their wives' level of drinking. High-risk and discordant alcohol consumption do not seem to be linked to decrements in family functioning among older couples in long-term stable marriages. The predictors of heavy alcohol consumption among older husbands and wives identify points of intervention that may help to reduce their high-risk drinking. © 2010 Society for the Study of Addiction. No claim to US government works.

  20. A structural MRI study in monozygotic twins concordant or discordant for attention/hyperactivity problems: Evidence for genetic and environmental heterogeneity in the developing brain

    PubMed Central

    van ’t Ent, D.; Lehn, H.; Derks, E.M.; Hudziak, J.J.; Van Strien, N.M.; Veltman, D.J.; De Geus, E.J.C.; Todd, R.D.; Boomsma, D.I.

    2007-01-01

    Several structural brain abnormalities have been reported in patients with Attention Deficit Hyperactivity Disorder (ADHD). However, the aetiology of these brain changes is still unclear. To investigate genetic and environmental influences on ADHD related neurobiological changes we performed Voxel Based Morphometry on MRI scans from monozygotic (MZ) twins selected from a large longitudinal population database to be highly concordant or highly discordant for ratings on the Child Behavior Checklist Attention Problem scale (CBCL-AP). Children scoring low on the CBCL-AP are at low risk for ADHD, whereas children scoring high on this scale are at high risk for ADHD. Brain differences between concordant high risk twin pairs and concordant low risk twin pairs likely reflect the genetic risk for ADHD; brain differences between the low risk and high risk twins from discordant MZ twin pairs reflect the environmental risk for ADHD. A major difference between comparisons of high and low risk twins from concordant pairs and high/low twins from discordant pairs was found for the prefrontal lobes. The concordant high risk pairs showed volume loss in orbitofrontal subdivisions. High risk members from the discordant twin pairs exhibited volume reduction in the right inferior dorsolateral prefontal cortex. In addition, the posterior corpus callosum was compromised in concordant high risk pairs, only. Our findings indicate that inattention and hyperactivity symptoms are associated with anatomical abnormalities of a distributed action-attentional network. Different brain areas of this network appear to be affected in inattention/hyperactivity caused by genetic (i.e., high concordant MZ pairs) versus environmental (i.e., high-low discordant MZ pairs) risk factors. These results provide clues that further our understanding of brain alterations in ADHD. PMID:17346990

  1. Concordance between partners in desired waiting time to birth for newlyweds in India

    PubMed Central

    Singh, Abhishek; Becker, Stan

    2014-01-01

    Examining waiting time to birth among newlywed couples is likely to provide insights into the desire for spacing births among newlywed husbands and wives. Data from the Indian National Family Health Survey of 2005-06 is used to examine the desired waiting time (DWT) to birth among newlywed couples. The dependent variable is spousal concordance on desired times. Overall 65 % of couples have concordant DWTs. Among discordant couples, wives were more likely to want to wait longer than their husbands. Couples from richer wealth quintiles were more likely than couples from poorest quintile to have a concordant DWTs. Muslims were less likely than Hindus to have concordant desires. There is a need for spacing methods among newlyweds. This may have implications for the Indian Family Planning Programme which to date has largely focused on sterilization. Programmes need to include newlywed husbands to promote use of spacing methods. PMID:21933466

  2. Moderators of Implicit-Explicit Exercise Cognition Concordance.

    PubMed

    Berry, Tanya R; Rodgers, Wendy M; Markland, David; Hall, Craig R

    2016-12-01

    Investigating implicit-explicit concordance can aid in understanding underlying mechanisms and possible intervention effects. This research examined the concordance between implicit associations of exercise with health or appearance and related explicit motives. Variables considered as possible moderators were behavioral regulations, explicit attitudes, and social desirability. Participants (N = 454) completed measures of implicit associations of exercise with health and appearance and questionnaire measures of health and appearance motives, attitudes, social desirability, and behavioral regulations. Attitudes significantly moderated the relationship between implicit associations of exercise with health and health motives. Identified regulations significantly moderated implicit-explicit concordance with respect to associations with appearance. These results suggest that implicit and explicit exercise-related cognitions are not necessarily independent and their relationship to each other may be moderated by attitudes or some forms of behavioral regulation. Future research that takes a dual-processing approach to exercise behavior should consider potential theoretical moderators of concordance.

  3. Estimation of melanin content in iris of human eye: prognosis for glaucoma diagnostics

    NASA Astrophysics Data System (ADS)

    Bashkatov, Alexey N.; Koblova, Ekaterina V.; Genina, Elina A.; Kamenskikh, Tatyana G.; Dolotov, Leonid E.; Sinichkin, Yury P.; Tuchin, Valery V.

    2007-02-01

    Based on the experimental data obtained in vivo from digital analysis of color images of human irises, the mean melanin content in human eye irises has been estimated. For registration of the color images a digital camera Olympus C-5060 has been used. The images have been obtained from irises of healthy volunteers as well as from irises of patients with open-angle glaucoma. The computer program has been developed for digital analysis of the images. The result has been useful for development of novel and optimization of already existing methods of non-invasive glaucoma diagnostics.

  4. Memnonia Sulci

    NASA Image and Video Library

    2017-01-09

    Today's VIS image shows some of the extensive wind etched terrain in Memnonia Sulci, located south west of Olympus Mons. The linear ridges are called yardangs and form by wind removal of semi-cemented material. The ridges are parallel to wind direction, so the predominate winds that created the yardangs in this image blew NW/SE. At the bottom of the image several of the ridges have been eroded into smaller ridges aligned perpendicular to the large yardangs, indicating winds at a different angle. Orbit Number: 66197 Latitude: -5.91796 Longitude: 183.886 Instrument: VIS Captured: 2016-11-15 13:08 http://photojournal.jpl.nasa.gov/catalog/PIA21283

  5. A Volcanic Fissure

    NASA Image and Video Library

    2017-04-26

    Although Mars is known for having the largest volcano in our solar system, Olympus Mons, we also find small-scale volcanic features on its surface, as shown in this image from HiRISE onboard NASA's Mars Reconnaissance Orbiter (MRO). This fissure, less than 500 meters across at its widest point, lies in the Tharsis region and is believed to be a vent from which lava flowed in ancient eruptions. The total volume of lava released from this fissure is much less than what would erupt from nearby volcanoes, but the mark left on the landscape is dramatic nonetheless. https://photojournal.jpl.nasa.gov/catalog/PIA21601

  6. Endomicroscopy imaging of epithelial structures using tissue autofluorescence

    NASA Astrophysics Data System (ADS)

    Lin, Bevin; Urayama, Shiro; Saroufeem, Ramez M. G.; Matthews, Dennis L.; Demos, Stavros G.

    2011-04-01

    We explore autofluorescence endomicroscopy as a potential tool for real-time visualization of epithelial tissue microstructure and organization in a clinical setting. The design parameters are explored using two experimental systems--an Olympus Medical Systems Corp. stand-alone clinical prototype probe, and a custom built bench-top rigid fiber conduit prototype. Both systems entail ultraviolet excitation at 266 nm and/or 325 nm using compact laser sources. Preliminary results using ex vivo animal and human tissue specimens suggest that this technology can be translated toward in vivo application to address the need for real-time histology.

  7. A Place Called Home: Educational Reform in a Concord, Massachusetts School, 1897-1914

    ERIC Educational Resources Information Center

    Morice, Linda C.

    2012-01-01

    This paper examines the role of place in the reform efforts of two teachers who established Miss White's Home School in Concord, Massachusetts (USA). Flora and Mary White rebelled against the prevailing industrial model of instruction in tax-supported schools where they taught. As a solution, they moved to Concord--a nonconformist town with a…

  8. Exact and efficient simulation of concordant computation

    NASA Astrophysics Data System (ADS)

    Cable, Hugo; Browne, Daniel E.

    2015-11-01

    Concordant computation is a circuit-based model of quantum computation for mixed states, that assumes that all correlations within the register are discord-free (i.e. the correlations are essentially classical) at every step of the computation. The question of whether concordant computation always admits efficient simulation by a classical computer was first considered by Eastin in arXiv:quant-ph/1006.4402v1, where an answer in the affirmative was given for circuits consisting only of one- and two-qubit gates. Building on this work, we develop the theory of classical simulation of concordant computation. We present a new framework for understanding such computations, argue that a larger class of concordant computations admit efficient simulation, and provide alternative proofs for the main results of arXiv:quant-ph/1006.4402v1 with an emphasis on the exactness of simulation which is crucial for this model. We include detailed analysis of the arithmetic complexity for solving equations in the simulation, as well as extensions to larger gates and qudits. We explore the limitations of our approach, and discuss the challenges faced in developing efficient classical simulation algorithms for all concordant computations.

  9. The evaluation of an intervention based on the application of patient self-completion concordance forms in Dutch community pharmacies and the effect on adherence to chronic medication.

    PubMed

    Geurts, Marlies M E; Pot, Johan L W; Schepers, Emiel H; Tromp, Chris; Colijn, Corine G; Dijkstra, Arie; de Gier, Johan J

    2010-01-01

    To evaluate the use of patient self-completion concordance forms and to determine the effect of patient counselling by using concordance forms on adherence to chronic medication. Patients with a prescription for new chronic treatment were randomised in an intervention or control group. The intervention group received a concordance form to fill in at home and to discuss during a consultation 2 weeks later in the pharmacy. The control group received the usual information and instruction on how to use the medicine. Afterwards, all patients were asked to fill in a questionnaire about their use of medicines and contact with the pharmacy employees. Adherence to the medicine was determined using rates of prescription refills after 6 months of use. The questionnaires showed that patients were satisfied about the concordance model. After 6 months of use, 79% of the patients from both intervention and control group were defined as adherent. There was no significant difference found in adherence between intervention and control group. Use five selected questions from the concordance form which provided most answers. Focus on one drug group and have more consultation moments.

  10. Occupation and industry on death certificates of long-term chemical workers: concordance with work history records.

    PubMed

    Olsen, G W; Brondum, J; Bodner, K M; Kravat, B A; Mandel, J S; Mandel, J H; Bond, G G

    1990-01-01

    This study evaluated the concordance between occupation and industry listed on death certificates with actual work history information for a group (n = 5,882) of long-term (10 years or more) workers at a chemical company. Match rates were calculated as the percent of death certificate occupation and company entries that were confirmed by work history data using 3-digit 1980 U.S. Census Bureau group codes. The concordance rate for industry differed by employment status at death: employed, 94.9%; inactive, 30.8%; and retired, 91.1%. Concordance on occupation was analyzed for employed (n = 467) and retired (n = 932) subjects who had computerized work histories (randomly done prior to the study) and who had matched on the company on the death certificate. Concordance ranged from 0 to 50% for the first job, to 50 to 70% for the last job, longest job, and longest job in the last 10 years of company employment. The most consistent predictor of concordance was job duration. Misclassification was reviewed by occupational category. Results from this and other investigations lead to the inevitable conclusion that usual occupation data from death certificates are grossly inadequate for studies of occupational risks.

  11. Effects of Genital Response Measurement Device and Stimulus Characteristics on Sexual Concordance in Women.

    PubMed

    Bouchard, Katrina N; Chivers, Meredith L; Pukall, Caroline F

    2017-01-01

    Investigations of sexual concordance suggest that, on average, women exhibit a low, positive correlation between their subjective sexual arousal and genital response. However, this relationship appears to be stronger, on average, when genital response is measured via the external tissues of the vulva than within the vagina walls. Given the methodological variations, such as stimulus content and duration, in studies of vulvar and vaginal concordance, direct comparisons between individual studies are limited. In the current study, sexual concordance was examined using concurrent measures of vulvar blood flow (using laser Doppler imaging) and vaginal vasocongestion (using vaginal photoplethysmography) to investigate potential differences in vulvar and vaginal concordance. Twenty-five women viewed two erotic films that differed in sexual activity content (foreplay and intercourse) while their subjective sexual arousal and genital response was measured. In support of previous meta-analytic findings, results suggest that subjective sexual arousal is more strongly correlated with vulvar blood flow than with vaginal vasocongestion. Likewise, perceived genital response and actual vulvar blood flow are more strongly related than are vaginal vasocongestion and self-reported genital sensations. Practical implications for the study of women's sexual concordance as well as broader implications for the understanding of female sexuality are considered.

  12. Retrospective study

    PubMed Central

    Lu, Chao; Lv, Xueyou; Lin, Yiming; Li, Dejian; Chen, Lihua; Ji, Feng; Li, Youming; Yu, Chaohui

    2016-01-01

    Abstract Conventional forceps biopsy (CFB) is the most popular way to screen for gastric epithelial neoplasia (GEN) and adenocarcinoma of gastric epithelium. The aim of this study was to compare the diagnostic accuracy between conventional forceps biopsy and endoscopic submucosal dissection (ESD). Four hundred forty-four patients who finally undertook ESD in our hospital were enrolled from Jan 1, 2009 to Sep 1, 2015. We retrospectively assessed the characteristics of pathological results of CFB and ESD. The concordance rate between CFB and ESD specimens was 68.92% (306/444). Men showed a lower concordance rate (63.61% vs 79.33%; P = 0.001) and concordance patients were younger (P = 0.048). In multivariate analysis, men significantly had a lower concordance rate (coefficient −0.730, P = 0.002) and a higher rate of pathological upgrade (coefficient −0.648, P = 0.015). Locations of CFB did not influence the concordance rate statistically. The concordance rate was relatively high in our hospital. According to our analysis, old men plus gastric fundus or antrum of CFB were strongly suggested to perform ESD if precancerous lesions were found. And young women with low-grade intraepithelial neoplasia could select regular follow-up. PMID:27472723

  13. Development And Use Of Advanced Microfabricated Traction Force Sensing Substrates To Study The Effect of Nanosilver On Human Macrophages

    NASA Astrophysics Data System (ADS)

    Stark, Daniel Thomas

    While nanoparticles are a natural byproduct of combustion and a number of natural processes, engineered nanoparticles have only recently entered the consumer market. This motivates the development of methods for studying their effects on human cells, thereby indicating how larger models such as animals and humans might react to them. This research develops a method to mechanically characterize cellular traction forces as a measure of exposure to nanoparticles. To do this, 1microm micropillar molds were fabricated in silicon wafers using smooth sidewall reactive ion plasma etching technologies. Polydimethylsiloxane (PDMS), was cured inside the silicon molds, subsequently treated for cell culture and used to measure cellular traction forces over time in live cell time-lapse experiments. For the first time, transmitted light was used to visualize the PDMS micropillars; a force resolution of 5.6 +/-2.1nN was achieved across all experiments using a standard Olympus IX81 confocal microscope affixed with a 60x NA2.1 objective. To initiate cellular movement, monocyte chemoattractant protein (MCP-1) was conjugated to 1microm latex beads. The effects of 40nm silver nanoparticle exposures were quantified using the micropillar array. Changes in cellular behavior between the control group and cells exposed to nanosilver were not significant, although a comparison between the 5microg/ml and 10microg/ml nanosilver concentrations yielded strong significance using a 2 sided Students t test.

  14. Are physicians and patients in agreement? Exploring dyadic concordance.

    PubMed

    Coran, Justin J; Koropeckyj-Cox, Tanya; Arnold, Christa L

    2013-10-01

    Dyadic concordance in physician-patient interactions can be defined as the extent of agreement between physicians and patients in their perceptions of the clinical encounter. The current research specifically examined two types of concordance: informational concordance-the extent of agreement in physician and patient responses regarding patient information (education, self-rated health, pain); and interactional concordance-the extent of physician-patient agreement regarding the patient's level of confidence and trust in the physician and the perceived quality of explanations concerning diagnosis and treatment. Using a convenience sample of physicians and patients (N = 50 dyads), a paired survey method was tested, which measured and compared physician and patient reports to identify informational and interactional concordances. Factors potentially related to dyadic concordance were also measured, including demographic characteristics (patient race, gender, age, and education) and clinical factors (whether this was a first visit and physician specialty in family medicine or oncology). The paired survey showed informational discordances, as physicians tended to underestimate patients' pain and overestimate patient education. Interactional discordances included overestimating patients' understanding of diagnosis and treatment explanations and patients' level of confidence and trust. Discordances were linked to patient dissatisfaction with physician listening, having unanswered questions, and feeling the physician had not spent enough time. The paired survey method effectively identified physician-patient discordances that may interfere with effective medical practice; this method may be used in various settings to identify potential areas of improvement in health communication and education.

  15. Transitions from hospital to community care: the role of patient-provider language concordance.

    PubMed

    Rayan, Nosaiba; Admi, Hanna; Shadmi, Efrat

    2014-01-01

    Cultural and language discordance between patients and providers constitutes a significant challenge to provision of quality healthcare. This study aims to evaluate minority patients' discharge from hospital to community care, specifically examining the relationship between patient-provider language concordance and the quality of transitional care. This was a multi-method prospective study of care transitions of 92 patients: native Hebrew, Russian or Arabic speakers, with a pre-discharge questionnaire and structured observations examining discharge preparation from a large Israeli teaching hospital. Two weeks post-discharge patients were surveyed by phone, on the transition from hospital to community care (the Care Transition Measure (CTM-15, 0-100 scale)) and on the primary-care post-discharge visit. Overall, ratings on the CTM indicated fair quality of the transition process (scores of 51.8 to 58.8). Patient-provider language concordance was present in 49% of minority patients' discharge briefings. Language concordance was associated with higher CTM scores among minority groups (64.1 in language-concordant versus 49.8 in non-language-concordant discharges, P <0.001). Other aspects significantly associated with CTM scores: extent of discharge explanations (P <0.05), quality of discharge briefing (P <0.001), and post-discharge explanations by the primary care physician (P <0.01). Language-concordant care, coupled with extensive discharge briefings and post-discharge explanations for ongoing care, are important contributors to the quality of care transitions of ethnic minority patients.

  16. Transitions from hospital to community care: the role of patient–provider language concordance

    PubMed Central

    2014-01-01

    Background Cultural and language discordance between patients and providers constitutes a significant challenge to provision of quality healthcare. This study aims to evaluate minority patients’ discharge from hospital to community care, specifically examining the relationship between patient–provider language concordance and the quality of transitional care. Methods This was a multi-method prospective study of care transitions of 92 patients: native Hebrew, Russian or Arabic speakers, with a pre-discharge questionnaire and structured observations examining discharge preparation from a large Israeli teaching hospital. Two weeks post-discharge patients were surveyed by phone, on the transition from hospital to community care (the Care Transition Measure (CTM-15, 0–100 scale)) and on the primary-care post-discharge visit. Results Overall, ratings on the CTM indicated fair quality of the transition process (scores of 51.8 to 58.8). Patient–provider language concordance was present in 49% of minority patients’ discharge briefings. Language concordance was associated with higher CTM scores among minority groups (64.1 in language-concordant versus 49.8 in non-language-concordant discharges, P <0.001). Other aspects significantly associated with CTM scores: extent of discharge explanations (P <0.05), quality of discharge briefing (P <0.001), and post-discharge explanations by the primary care physician (P <0.01). Conclusion Language-concordant care, coupled with extensive discharge briefings and post-discharge explanations for ongoing care, are important contributors to the quality of care transitions of ethnic minority patients. PMID:25075273

  17. Parent-child coregulation of parasympathetic processes varies by social context and risk for psychopathology.

    PubMed

    Lunkenheimer, Erika; Tiberio, Stacey S; Skoranski, Amanda M; Buss, Kristin A; Cole, Pamela M

    2018-02-01

    The parasympathetic nervous system supports social interaction and varies in relation to psychopathology. However, we know little about parasympathetic processes from a dyadic framework, nor in early childhood when parent-child social interactions become more complex and child psychopathology first emerges. We hypothesized that higher risk for psychopathology (maternal psychopathology symptoms and child problem behavior) would be related to weaker concordance of respiratory sinus arrhythmia (RSA) between mothers and children (M = 3½ years old; N = 47) and that these relations could vary by social contextual demands, comparing unstructured free play, semistructured cleanup, and structured teaching tasks. Multilevel coupled autoregressive models of RSA during parent-child interactions showed overall dynamic, positive concordance in mother-child RSA over time, but this concordance was weaker during the more structured teaching task. In contrast, higher maternal psychological aggression and child externalizing and internalizing problems were associated with weaker dyadic RSA concordance, which was weakest during unstructured free play. Higher maternal depressive symptoms were related to disrupted individual mother and child RSA but not to RSA concordance. Thus, risk for psychopathology was generally related to weaker dyadic mother-child RSA concordance in contexts with less complex structure or demands (free play, cleanup), as compared to the structured teaching task that showed weaker RSA concordance for all dyads. Implications for the meaning and utility of the construct of parent-child physiological coregulation are discussed. © 2017 Society for Psychophysiological Research.

  18. Estimating HPV DNA Deposition Between Sexual Partners Using HPV Concordance, Y Chromosome DNA Detection, and Self-reported Sexual Behaviors.

    PubMed

    Malagón, Talía; Burchell, Ann N; El-Zein, Mariam; Guénoun, Julie; Tellier, Pierre-Paul; Coutlée, François; Franco, Eduardo L

    2017-12-05

    Detection of human papillomavirus (HPV) DNA in genital samples may not always represent true infections but may be depositions from infected sexual partners. We examined whether sexual risk factors and a biomarker (Y chromosome DNA) were associated with genital HPV partner concordance and estimated the fraction of HPV detections potentially attributable to partner deposition. The HITCH study enrolled young women attending a university or college in Montréal, Canada, and their male partners, from 2005 to 2010. We tested baseline genital samples for Y chromosome DNA and HPV DNA using polymerase chain reaction. Type-specific HPV concordance was 42.4% in partnerships where at least one partner was HPV DNA positive. Y chromosome DNA predicted type-specific HPV concordance in univariate analyses, but in multivariable models the independent predictors of concordance were days since last vaginal sex (26.5% higher concordance 0-1 vs 8-14 days after last vaginal sex) and condom use (22.6% higher concordance in never vs always users). We estimated that 14.1% (95% confidence interval [CI], 6.3-21.9%) of HPV DNA detections in genital samples were attributable to vaginal sex in the past week. A substantial proportion of HPV DNA detections may be depositions due to recent unprotected vaginal sex. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

  19. Watson for Oncology and breast cancer treatment recommendations: agreement with an expert multidisciplinary tumor board.

    PubMed

    Somashekhar, S P; Sepúlveda, M-J; Puglielli, S; Norden, A D; Shortliffe, E H; Rohit Kumar, C; Rauthan, A; Arun Kumar, N; Patil, P; Rhee, K; Ramya, Y

    2018-02-01

    Breast cancer oncologists are challenged to personalize care with rapidly changing scientific evidence, drug approvals, and treatment guidelines. Artificial intelligence (AI) clinical decision-support systems (CDSSs) have the potential to help address this challenge. We report here the results of examining the level of agreement (concordance) between treatment recommendations made by the AI CDSS Watson for Oncology (WFO) and a multidisciplinary tumor board for breast cancer. Treatment recommendations were provided for 638 breast cancers between 2014 and 2016 at the Manipal Comprehensive Cancer Center, Bengaluru, India. WFO provided treatment recommendations for the identical cases in 2016. A blinded second review was carried out by the center's tumor board in 2016 for all cases in which there was not agreement, to account for treatments and guidelines not available before 2016. Treatment recommendations were considered concordant if the tumor board recommendations were designated 'recommended' or 'for consideration' by WFO. Treatment concordance between WFO and the multidisciplinary tumor board occurred in 93% of breast cancer cases. Subgroup analysis found that patients with stage I or IV disease were less likely to be concordant than patients with stage II or III disease. Increasing age was found to have a major impact on concordance. Concordance declined significantly (P ≤ 0.02; P < 0.001) in all age groups compared with patients <45 years of age, except for the age group 55-64 years. Receptor status was not found to affect concordance. Treatment recommendations made by WFO and the tumor board were highly concordant for breast cancer cases examined. Breast cancer stage and patient age had significant influence on concordance, while receptor status alone did not. This study demonstrates that the AI clinical decision-support system WFO may be a helpful tool for breast cancer treatment decision making, especially at centers where expert breast cancer resources are limited. © The Author(s) 2018. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  20. Attitudes toward concordance and self-efficacy in decision making: a cross-sectional study on pharmacist–patient consultations

    PubMed Central

    Ng, Yew Keong; Shah, Noraida Mohamed; Loong, Ly Sia; Pee, Lay Ting; Hidzir, Sarina Anim M; Chong, Wei Wen

    2018-01-01

    Purpose This study investigated patients’ and pharmacists’ attitudes toward concordance in a pharmacist–patient consultation and how patients’ attitudes toward concordance relate to their involvement and self-efficacy in decision making associated with medication use. Subjects and methods A cross-sectional study was conducted among patients with chronic diseases and pharmacists from three public hospitals in Malaysia. The Revised United States Leeds Attitudes toward Concordance (RUS-LATCon) was used to measure attitudes toward concordance in both patients and pharmacists. Patients also rated their perceived level of involvement in decision making and completed the Decision Self-Efficacy scale. One-way analysis of variance (ANOVA) and independent t-test were used to determine significant differences between different subgroups on attitudes toward concordance, and multiple linear regression was performed to find the predictors of patients’ self-efficacy in decision making. Results A total of 389 patients and 93 pharmacists participated in the study. Pharmacists and patients scored M=3.92 (SD=0.37) and M=3.84 (SD=0.46) on the RUS-LATCon scale, respectively. Seven items were found to be significantly different between pharmacists and patients on the subscale level. Patients who felt fully involved in decision making (M=3.94, SD=0.462) scored significantly higher on attitudes toward concordance than those who felt partially involved (M=3.82, SD=0.478) and not involved at all (M=3.68, SD=0.471; p<0.001). Patients had an average score of 76.7% (SD=14.73%) on the Decision Self-Efficacy scale. In multiple linear regression analysis, ethnicity, number of medications taken by patients, patients’ perceived level of involvement, and attitudes toward concordance are significant predictors of patients’ self-efficacy in decision making (p<0.05). Conclusion Patients who felt involved in their consultations had more positive attitudes toward concordance and higher confidence in making an informed decision. Further study is recommended on interventions involving pharmacists in supporting patients’ involvement in medication-related decision making. PMID:29731609

  1. Single use disposable digital flexible ureteroscopes: an ex-vivo assessment and cost analysis.

    PubMed

    Hennessey, D B; Fojecki, G; Papa, N; Lawrentschuk, N; Bolton, D

    2018-04-15

    The single use flexible ureteroscope (fURS), the LithoVue is an important recent development. We aim to measure the capability of this instrument and to assess if there is a benefit to switching to single use instruments. The LithoVue was compared to Olympus URF-V and Stortz Flex Xc ex-vivo. An analysis of reusable fURS usage was performed to evaluate damage, durability and maintenance costs. This was then compared to the projected costs of using single use instruments. Flexion, deflection and irrigation flow of the LithoVue was equivalent, if not better than reusable instruments. An analysis of 234 procedures with 7 new Olympus URF-V scopes, revealed 15 scope damages. Staghorn stones and lower pole/midzone stones were significant risk factors for damage, p=0.014. Once damage occurred, it was likely to occur again. Total repair costs were $162,628 (£92,411), the mean cost per case is $695 (£395). Factoring in the purchase cost, cleaning and repair costs, and the cumulative cost of 28 reusable fURS cases is approximately $50,000 (£28,412). If the LithoVue was priced at $1200 AUD, switching to a single use scope would cost approximately $35,000 (£19,888). The LithoVue is analogous to reusable fURS scopes in regard to standard technical metrics. Depending on its purchase cost it may also represent a cost saving for hospitals when compared to the cumulative costs of maintaining reusable fURS. Additionally, urologist may consider to use the scope in cases in which reusable scope damage is anticipated. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  2. Stereomicroscopic evaluation of the joint cartilage and bone tissue in osteoporosis

    NASA Astrophysics Data System (ADS)

    Vasile, Liliana; Torok, Rodica; Deleanu, Bogdan; Marchese, Cristian; Valeanu, Adina; Bodea, Rodica

    2012-06-01

    Aim of the study. Assessment by stereomicroscopy of the severity of lesions in osteoporotic bone at both sexes and to correlate micro-and macro-bone fracture due to low bone density values with the disease evolution. Material and method: The study material consists of fragments of bone from the femoral head, vertebral bone, costal and iliac crest biopsy obtained from patients aged over 70 years, female and male, treated in the County Hospital of Timisoara, Department of Orthopedics. For the purpose of studying the samples in stereomicroscopy and trough polarized light it has been used the Olympus Microscope SZ ×7 and an Olympus camera with 2,5 × digital zoom and a 3× optical zoom in the Vest Politechnic Univesity. Results and discussions: Subchondral bone presents osteolysis associated with a osteoporotic bone transformation. Pseudocystic chondrolisis was noted in the osteoarticular cartilage, in addition with areas of hemorrhagic postfractural necrosis. The osteoporotic bone exhibits ischemic necrosis and focal hemorrhagic necrosis adjacent fracture. Microporosity pattern of the bone observed by stereomicroscopy correspond to the spongy bone osteoporosis images. Morphometry of the bone spiculi reveals length of 154.88 and 498.32 μ. In men we found a greater thickness of bone trabeculi compared with bone texture porosity in women. The subchondral bone supports and fulfills an important role in transmitting forces from the overlying articular cartilage inducing the bone resorbtion. The femoral head fracture may be the final event of many accumulated bone microcracks. Conclusions: Bone fragility depends not only of the spongy bone but also of the cortical bone properties. Osteolysis produced by loss of balance in the process of remodeling in favor of bone resorption leads to the thinning of the subchondral bone at both sexes.

  3. Peristomal skin disorders in patients with intestinal and urinary ostomies: influence of adhesive forces of various hydrocolloid wafer skin barriers.

    PubMed

    Omura, Yuko; Yamabe, Motoko; Anazawa, Sadao

    2010-01-01

    This study examines the adhesiveness of hydrocolloid wafers and its relationship to physical damage of the underlying skin. Observational study. All subjects received ostomy care at the Tokyo Ostomy Center and outpatient departments of 4 hospitals in Tokyo, Japan. One hundred ninety-four of 917 patients receiving care over a 23-year span agreed to participate in the research. Subjects met 2 inclusion criteria: (1) ostomy management was performed using a combination of skin barriers and an adhesive ostomy pouch; and (2) the patient's medical file and color photographs were available, allowing analysis of the peristomal skin over time. Photographs were taken with an Olympus (OM2) camera equipped with an Olympus macro lens and a ring flash. We analyzed the impact of the adhesive force of various hydrocolloid wafers on the underlying skin. Photographs were digitized and systematically examined the peristomal skin exposed to regular use of skin barriers. The observation period varied among individual patients, ranging from 1 week to 30 years after surgery. The incidence of dermatologic changes (active, inactive, and area cutanea changes) was lower in patients who used skin barriers with adhesive force of not more than 2 Newtons(N) than among those using higher forces (>2 N). Specifically, there was a significant difference in change of the area cutanea. The incidence of papules and erosion was unrelated to the adhesive force of skin barriers. These results suggest that the peristomal skin is irritated by repeated peeling, resulting in physical damage to the horny layer of the skin. The presence of papules and erosion was not associated with the adhesive force of skin barriers. This finding suggests that these changes are associated with an inflammatory process, possibly caused by chemical substances within the skin barrier.

  4. Occupational noise exposure during endourologic procedures.

    PubMed

    Soucy, Frédéric; Ko, Raymond; Denstedt, John D; Razvi, Hassan

    2008-08-01

    Long-term noise exposure in the workplace is a known cause of hearing loss. There has been limited study on the potential harm related to shock wave lithotripsy (SWL) or intracorporeal devices on patients and operating room personnel. We used a digital sound meter to measure decibel levels in the operating room during several endourologic procedures. The decibel levels were recorded during SWL (Storz SLX-F2), percutaneous nephrolithotomy using single- and dual-probe ultrasonic lithotripters (Olympus LUS-2, CyberWand), and during ureteroscopy using the Versa Pulse Holmium:YAG laser. Findings were compared with the U.S. Department of Labor Occupational Health and Safety Administration and Canadian Centre for Occupational Health recommendations on permissible noise levels in the workplace. The background sound level in the operating room prior to endourologic procedures ranged between 58 and 60 dB. In the SWL control room, 5 m from the source, the mean sound level was 68 dB (range 64-75) during treatment. The mean corresponding decibel level recorded at the patient's head during SWL was 77 dB (range 73-83). Noises produced by intracorporeal lithotripters were recorded at the surgeon's head, 2 m from the source. Measurements of the CyberWand (dual-probe) device revealed a higher mean decibel reading of 93 dB (range 85-102). Noise levels recorded for the Olympus LUS-2 (single-probe) ultrasound and the holmium laser were 65 dB (62 -68) and 60 dB (58-62), respectively. Although we noted that patients and urologists maybe exposed to significant noise levels during endourologic procedures, the duration of exposure is short. This risk appears to be minimal, based on current occupational guidelines, for most operating personnel.

  5. Accuracy and precision evaluation of seven self-monitoring blood glucose systems.

    PubMed

    Kuo, Chih-Yi; Hsu, Cheng-Teng; Ho, Cheng-Shiao; Su, Ting-En; Wu, Ming-Hsun; Wang, Chau-Jong

    2011-05-01

    Self-monitoring blood glucose (SMBG) systems play a critical role in management of diabetes. SMBG systems should at least meet the minimal requirement of the World Health Organization's ISO 15197:2003. For tight glycemic control, a tighter accuracy requirement is needed. Seven SMBG systems were evaluated for accuracy and precision: Bionime Rightest(™) GM550 (Bionime Corp., Dali City, Taiwan), Accu-Chek(®) Performa (Roche Diagnostics, Indianapolis, IN), OneTouch(®) Ultra(®)2 (LifeScan Inc., Milpitas, CA), MediSense(®) Optium(™) Xceed (Abbott Diabetes Care Inc., Alameda, CA), Medisafe (TERUMO Corp., Tokyo, Japan), Fora(®) TD4227 (Taidac Technology Corp., Wugu Township, Taiwan), and Ascensia Contour(®) (Bayer HealthCare LLC, Mishawaka, IN). The 107 participants (44 men and 63 women) were between 23 and 91 years old. The analytical results of seven SMBG systems were compared with those of plasma analyzed with the hexokinase method (Olympus AU640, Olympus America Inc., Center Valley, PA). The imprecision of the seven blood glucose meters ranged from 1.1% to 4.7%. Three of the seven blood glucose meters (42.9%) fulfilled the minimum accuracy criteria of ISO 15197:2003. The mean absolute relative error value for each blood glucose meter was calculated and ranged from 6.5% to 12.0%. More than 40% of evaluated SMBG systems meet the minimal accuracy criteria requirement of ISO 15197:2003. However, considering tighter criteria for accuracy of ±15%, only the Bionime Rightest GM550 meets this requirement. Because SMBG systems play a critical role in management of diabetes, manufacturers have to strive to improve accuracy and precision and to ensure the good quality of blood glucose meters and test strips.

  6. Outcomes of flexible ureterorenoscopy and laser fragmentation for renal stones: comparison between digital and conventional ureteroscope.

    PubMed

    Somani, Bhaskar K; Al-Qahtani, Saeed M; de Medina, Sixtina Diez Gil; Traxer, Olivier

    2013-11-01

    To compare the outcomes of flexible ureterorenoscopy and lasertripsy (FURS) using digital and conventional FURS for kidney stones. From September 2007 to April 2011, 118 patients underwent FURS (by the same surgeon). The outcomes were compared between equal numbers of procedures (59 each) using a conventional flexible ureterorenoscope (C-FURS; Olympus URF-P5) and a digital flexible ureterorenoscope (D-FURS; Olympus URF-V). Although the deflection, working channel, and field view are similar in both, the initial and terminal diameter is 8.4F and 9.9F and 6.9F and 8.4F for the D-FURS and C-FURS, respectively. The mean stone fragmentation time was calculated by the size per operative time. The preoperative, operative, and postoperative data were retrospectively analyzed and compared. The patient demographics were comparable. The mean stone size was 12.8 and 12 mm in the C-FURS and D-FURS groups, respectively. The initial assessment of the entire pyelocaliceal system was possible in 58 of 59 cases (98%) in the C-FURS group and 56 of 59 cases (94%) in the D-FURS group. The mean operative time was significantly longer in the C-FURS group (53.8 ± 15.2 minutes vs 44.5 ± 14.9 minutes). The overall stone-free rate 1 month after the procedure was 86% in the C-FURS group and 88% in the D-FURS group. Although on comparison, the D-FURS had slightly limited maneuverability, comparable success rates can be achieved with both conventional and digital ureteroscopes. D-FURSs significantly reduced the operative time compared with C-FURSs. Copyright © 2013 Elsevier Inc. All rights reserved.

  7. Evaluating Random Error in Clinician-Administered Surveys: Theoretical Considerations and Clinical Applications of Interobserver Reliability and Agreement.

    PubMed

    Bennett, Rebecca J; Taljaard, Dunay S; Olaithe, Michelle; Brennan-Jones, Chris; Eikelboom, Robert H

    2017-09-18

    The purpose of this study is to raise awareness of interobserver concordance and the differences between interobserver reliability and agreement when evaluating the responsiveness of a clinician-administered survey and, specifically, to demonstrate the clinical implications of data types (nominal/categorical, ordinal, interval, or ratio) and statistical index selection (for example, Cohen's kappa, Krippendorff's alpha, or interclass correlation). In this prospective cohort study, 3 clinical audiologists, who were masked to each other's scores, administered the Practical Hearing Aid Skills Test-Revised to 18 adult owners of hearing aids. Interobserver concordance was examined using a range of reliability and agreement statistical indices. The importance of selecting statistical measures of concordance was demonstrated with a worked example, wherein the level of interobserver concordance achieved varied from "no agreement" to "almost perfect agreement" depending on data types and statistical index selected. This study demonstrates that the methodology used to evaluate survey score concordance can influence the statistical results obtained and thus affect clinical interpretations.

  8. Concordance of Mother-Daughter Diurnal Cortisol Production: Understanding the Intergenerational Transmission of Risk for Depression

    PubMed Central

    LeMoult, Joelle; Chen, Michael C.; Foland-Ross, Lara C.; Burley, Hannah W.; Gotlib, Ian H.

    2015-01-01

    A growing body of research is demonstrating concordance between mother and child diurnal cortisol production. In the context of maternal history of depression, intergenerational concordance of cortisol production could contribute to hypercortisolemia in children of depressed mothers, which has been shown to increase risk for MDD. The current study is the first to examine concordance in diurnal cortisol production between mothers with a history of depression and their never-depressed, but high-risk, children. We collected salivary cortisol across two days from mothers with (remitted; RMD) and without (CTL) a history of recurrent episodes of depression and their never-depressed daughters. As expected, RMD mothers and their daughters both exhibited higher cortisol production than did their CTL counterparts. Moreover, both across and within groups, mothers’ and daughters’ cortisol production was directly coupled. These findings suggest that there is an intergenerational concordance in cortisol dysregulation that may contribute to hypercortisolemia in girls at familial risk for depression. PMID:25862380

  9. Concordance of mother-daughter diurnal cortisol production: Understanding the intergenerational transmission of risk for depression.

    PubMed

    LeMoult, Joelle; Chen, Michael C; Foland-Ross, Lara C; Burley, Hannah W; Gotlib, Ian H

    2015-05-01

    A growing body of research is demonstrating concordance between mother and child diurnal cortisol production. In the context of maternal history of depression, intergenerational concordance of cortisol production could contribute to hypercortisolemia in children of depressed mothers, which has been shown to increase risk for MDD. The current study is the first to examine concordance in diurnal cortisol production between mothers with a history of depression and their never-depressed, but high-risk, children. We collected salivary cortisol across 2 days from mothers with (remitted; RMD) and without (CTL) a history of recurrent episodes of depression and their never-depressed daughters. As expected, RMD mothers and their daughters both exhibited higher cortisol production than did their CTL counterparts. Moreover, both across and within groups, mothers' and daughters' cortisol production were directly coupled. These findings suggest that there is an intergenerational concordance in cortisol dysregulation that may contribute to hypercortisolemia in girls at familial risk for depression. Copyright © 2015 Elsevier B.V. All rights reserved.

  10. Concordance of Parent- and Child-Reported Physical Abuse Following Child Protective Services Investigation.

    PubMed

    Kobulsky, Julia M; Kepple, Nancy Jo; Holmes, Megan R; Hussey, David L

    2017-02-01

    Knowledge about the concordance of parent- and child-reported child physical abuse is scarce, leaving researchers and practitioners with little guidance on the implications of selecting either informant. Drawing from a 2008-2009 sample of 11- to 17-year-olds ( N = 636) from Wave 1 of the second National Survey of Child and Adolescent Well-Being, this study first examined parent-child concordance in physical abuse reporting (Parent-Child Conflict Tactic Scale). Second, it applied multivariate regression analysis to relate parent-child agreement in physical abuse to parent-reported (Child Behavior Checklist) and child-reported (Youth Self Report) child behavioral problems. Results indicate low parent-child concordance of physical abuse (κ = .145). Coreporting of physical abuse was related to clinical-level parent-reported externalizing problems ([Formula: see text] = 64.57), whereas child-only reports of physical abuse were the only agreement category related to child-reported internalizing problems ( B = 4.17, p < .001). Attribution bias theory may further understanding of reporting concordance and its implications.

  11. Concorde noise-induced building vibrations John F. Kennedy International Airport

    NASA Technical Reports Server (NTRS)

    Mayes, W. H.; Deloach, R.; Stephens, D. G.; Cawthorn, J. M.; Holmes, H. K.; Lewis, R. B.; Holliday, B. G.; Ward, D. W.

    1978-01-01

    The outdoor and indoor noise levels resulting from aircraft flyovers and certain nonaircraft events were recorded at six home sites along with the associated vibration levels in the walls, windows, and floors of these test homes. Limited subjective tests conducted to examine the human detection and annoyance thresholds for building vibration and rattle caused by aircraft noise showed that both vibration and rattle were detected subjectively in several houses for some operations of both the Concorde and subsonic aircraft. Preliminary results indicate that the relationship between window vibration and aircraft noise is: (1) linear, with vibration levels being accurately predicted from OASPL levels measured near the window; (2) consistent from flyover to flyover for a given aircraft type under approach conditions; (3) no different for Concorde than for other conventional jet transports (in the case of window vibrations induced under approach power conditions); and (4) relatively high levels of window vibration measured during Concorde operations are due more to higher OASPL levels than to unique Concorde source characteristics.

  12. Effects of Macroposthonia xenoplax on the growth of Concord grape.

    PubMed

    Santo, G S; Bolander, W J

    1977-07-01

    Concord grape (Vitis labrusca) plants were inoculated with Macroposthonia xenoplax at levels of 100, 1,000, and 10,000 nematodes. After 4 months, plants inoculated with 10,000 M. xenoplax were stunted, and root systems were darker and had fewer feeder roots than those in other treatments. The lower nematode inoculation levels suppressed top growth but did not affect root growth. M. xenoplax reproduced well on Concord grapes.

  13. Interoception and sexual response in women with low sexual desire

    PubMed Central

    Velten, Julia

    2017-01-01

    Sexual concordance is defined as the association between genital response and self-reported sexual arousal. Though one might predict a strong association between sexual concordance and awareness of other internal physiological sensations (termed interoception), past research on sexually healthy women has not found these different domains to be related. The aim of the present study was to test the association between interoception and sexual concordance in a clinical sample of women with Sexual Interest/Arousal Disorder (SIAD). Fifty-two women with SIAD completed the Multidimensional Assessment of Interoceptive Awareness (MAIA), a validated self-report measure of interoception, and completed a heart-beat accuracy test, an objective measure of interoception. They also participated in a laboratory-based assessment of physiological sexual arousal and self-reported sexual arousal while viewing an erotic film. Mental and physiological arousal were correlated at r = 0.27 (range -0.80 to 0.95). There was no significant association between sexual concordance and women’s heartrate awareness. However, five aspects of interoceptive awareness (noticing, emotional awareness, self-regulation, body-listening, and trusting), were predictive of lower, and one aspect (not-distracting) was predictive of higher sexual concordance. We discuss the findings in relation to the role of emotions and arousal states in the interoception-sexual concordance relationship. PMID:29020067

  14. Interoception and sexual response in women with low sexual desire.

    PubMed

    Velten, Julia; Brotto, Lori A

    2017-01-01

    Sexual concordance is defined as the association between genital response and self-reported sexual arousal. Though one might predict a strong association between sexual concordance and awareness of other internal physiological sensations (termed interoception), past research on sexually healthy women has not found these different domains to be related. The aim of the present study was to test the association between interoception and sexual concordance in a clinical sample of women with Sexual Interest/Arousal Disorder (SIAD). Fifty-two women with SIAD completed the Multidimensional Assessment of Interoceptive Awareness (MAIA), a validated self-report measure of interoception, and completed a heart-beat accuracy test, an objective measure of interoception. They also participated in a laboratory-based assessment of physiological sexual arousal and self-reported sexual arousal while viewing an erotic film. Mental and physiological arousal were correlated at r = 0.27 (range -0.80 to 0.95). There was no significant association between sexual concordance and women's heartrate awareness. However, five aspects of interoceptive awareness (noticing, emotional awareness, self-regulation, body-listening, and trusting), were predictive of lower, and one aspect (not-distracting) was predictive of higher sexual concordance. We discuss the findings in relation to the role of emotions and arousal states in the interoception-sexual concordance relationship.

  15. Correlates of and Couples’ Concordance in Reports of Recent Sexual Behavior and Contraceptive Use

    PubMed Central

    Koffi, Alain K.; Adjiwanou, Visseho D.; Becker, Stan; Olaolorun, Funmilola; Tsui, Amy O.

    2014-01-01

    This study uses couple-level data to measure couples’ concordance of self-reported time since last coitus and of condom and other contraceptive use at last sexual intercourse among monogamous couples in Liberia (N = 1,673), Madagascar (N = 4,138), and Namibia (N = 588). The study also examines the characteristics associated with sexual behavior and contraceptive use occurring in the 28 days prior to the interviews among couples whose reports are concordant. Overall, our study finds less than 75 percent concordance in reporting of time since last coitus. Use of condoms and other contraceptives yielded fair (0.27) to substantial (0.67) agreement on the kappa index. Factors predicting a shorter time since last coitus among concordant couples in at least two of the countries included wealth, spousal age difference, education, and both partners wanting another child. The discordant reports of recent sexual behavior and contraceptive use suggest that caution should be exercised when inferring couples’ behavior from the report of one spouse, that concordant reports should be examined when possible, that methodological changes to improve the validity of spousal reports should be pursued, and that family planning and HIV-prevention programs should target those groups found to be using condoms and other contraceptives less frequently, particularly poorer couples. PMID:23185870

  16. Correlates of and couples' concordance in reports of recent sexual behavior and contraceptive use.

    PubMed

    Koffi, Alain K; Adjiwanou, Visseho D; Becker, Stan; Olaolorun, Funmilola; Tsui, Amy O

    2012-03-01

    This study uses couple-level data to measure couples' concordance of self-reported time since last coitus and of condom and other contraceptive use at last sexual intercourse among monogamous couples in Liberia (N = 1,673), Madagascar (N = 4,138), and Namibia (N = 588). The study also examines the characteristics associated with sexual behavior and contraceptive use occurring in the 28 days prior to the interviews among couples whose reports are concordant. Overall, our study finds less than 75 percent concordance in reporting of time since last coitus. Use of condoms and other contraceptives yielded fair (0.27) to substantial (0.67) agreement on the kappa index. Factors predicting a shorter time since last coitus among concordant couples in at least two of the countries included wealth, spousal age difference, education, and both partners wanting another child. The discordant reports of recent sexual behavior and contraceptive use suggest that caution should be exercised when inferring couples' behavior from the report of one spouse, that concordant reports should be examined when possible, that methodological changes to improve the validity of spousal reports should be pursued, and that family planning and HIV-prevention programs should target those groups found to be using condoms and other contraceptives less frequently, particularly poorer couples.

  17. Retrospective study: The diagnostic accuracy of conventional forceps biopsy of gastric epithelial compared to endoscopic submucosal dissection (STROBE compliant).

    PubMed

    Lu, Chao; Lv, Xueyou; Lin, Yiming; Li, Dejian; Chen, Lihua; Ji, Feng; Li, Youming; Yu, Chaohui

    2016-07-01

    Conventional forceps biopsy (CFB) is the most popular way to screen for gastric epithelial neoplasia (GEN) and adenocarcinoma of gastric epithelium. The aim of this study was to compare the diagnostic accuracy between conventional forceps biopsy and endoscopic submucosal dissection (ESD).Four hundred forty-four patients who finally undertook ESD in our hospital were enrolled from Jan 1, 2009 to Sep 1, 2015. We retrospectively assessed the characteristics of pathological results of CFB and ESD.The concordance rate between CFB and ESD specimens was 68.92% (306/444). Men showed a lower concordance rate (63.61% vs 79.33%; P = 0.001) and concordance patients were younger (P = 0.048). In multivariate analysis, men significantly had a lower concordance rate (coefficient -0.730, P = 0.002) and a higher rate of pathological upgrade (coefficient -0.648, P = 0.015). Locations of CFB did not influence the concordance rate statistically.The concordance rate was relatively high in our hospital. According to our analysis, old men plus gastric fundus or antrum of CFB were strongly suggested to perform ESD if precancerous lesions were found. And young women with low-grade intraepithelial neoplasia could select regular follow-up.

  18. Predictors of health literacy and numeracy concordance among adolescent with special health care needs and their parents

    PubMed Central

    Chisolm, Deena J; Sarkar, Madhurima; Kelleher, Kelly J.; Sanders, Lee M.

    2015-01-01

    Background Parent and teen health literacies (HL) are employed as teens with chronic illnesses transition to health self-management and the adult health system. This study explores the relationships between parent and teen HL. Methods Teens ages 12-18 with chronic conditions and their parents, sampled from a pediatric Medicaid ACO, completed an interview assessing HL and self-reported competence with written and numeric health information. Rates of teen and parent HL, degree of concordance, and relationship between concordance and teen-reported competence with health materials were measured. Results Half (52%) of teens had adequate HL. 62% of teens reported competence with written health materials and 69% with numeric information. Correlation between parent and teen HL was modest but significant (phi=0.13; p=0.03). 47% of parent-teen dyads were concordant for adequate HL while 10% were concordant inadequate. Adequate teen HL was associated with parental adequate HL and parental education. Discordance was associated with self-reported competence with written material and numeric material. Conclusion Over half of parent-teen dyads had at least one member with less than adequate health literacy and parent-teen HL concordance were associated with teen perception of health literacy. These findings support the consideration of both independent and dyad HL levels in adolescent care. PMID:26513030

  19. The relationship between sexual concordance and interoception in anxious and nonanxious women.

    PubMed

    Suschinsky, Kelly D; Lalumière, Martin L

    2014-04-01

    Sexual concordance refers to the association between physiological and self-reported sexual arousal. Women typically exhibit lower sexual concordance scores than men. There is also a sex difference in interoception--awareness of (nonsexual) physiological states or responses--such that women, compared with men, tend to be less aware of and less accurate at detecting changes in their physiological responses. Women with anxiety problems tend to have better interoceptive abilities than nonanxious women. To investigate whether women's lower sexual concordance is associated with interoception using a sample likely to show high variation in interoceptive abilities. Sixteen anxious and 15 nonanxious women were presented with twelve 90 seconds sexual and nonsexual film clips while their genital response, heart rate, and respiration rate were measured. A heartbeat mental tracking task was also employed. Genital response was measured with a vaginal photoplethysmograph. Heart rate was measured with an electrocardiogram and respiration rate with a thermistor. Participants estimated their physiological responses after each film. A mental tracking task was also used to assess participants' awareness of heart rate. Within-subject correlations were computed for each physiological/self-reported response combination. Overall, sexual concordance (i.e., the correlation between genital responses and perceptions of genital response) was not significantly associated with heart rate awareness or respiration rate awareness. Anxious women did not exhibit significantly higher sexual concordance or heart rate awareness than nonanxious women; the nonanxious women actually exhibited higher respiration rate awareness. The results suggest that sexual concordance may be a distinct phenomenon from interoception and in need of its own explanation. © 2013 International Society for Sexual Medicine.

  20. Genders of patients and clinicians and their effect on shared decision making: a participant-level meta-analysis.

    PubMed

    Wyatt, Kirk D; Branda, Megan E; Inselman, Jonathan W; Ting, Henry H; Hess, Erik P; Montori, Victor M; LeBlanc, Annie

    2014-09-02

    Gender differences in communication styles between clinicians and patients have been postulated to impact patient care, but the extent to which the gender dyad structure impacts outcomes in shared decision making remains unclear. Participant-level meta-analysis of 775 clinical encounters within 7 randomized trials where decision aids, shared decision making tools, were used at the point of care. Outcomes analysed include decisional conflict scale scores, satisfaction with the clinical encounter, concordance between stated decision and action taken, and degree of patient engagement by the clinician using the OPTION scale. An estimated minimal important difference was used to determine if nonsignificant results could be explained by low power. We did not find a statistically significant interaction between clinician/patient gender mix and arm for decisional conflict, satisfaction with the clinical encounter or patient engagement. A borderline significant interaction (p = 0.05) was observed for one outcome: concordance between stated decision and action taken, where encounters with female clinician/male patient showed increased concordance in the decision aid arm compared to control (8% more concordant encounters). All other gender dyads showed decreased concordance with decision aid use (6% fewer concordant encounters for same-gender, 16% fewer concordant encounters for male clinician/female patient). In this participant-level meta-analysis of 7 randomized trials, decision aids used at the point of care demonstrated comparable efficacy across gender dyads. Purported barriers to shared decision making based on gender were not detected when tested for a minimum detected difference. ClinicalTrials.gov NCT00888537, NCT01077037, NCT01029288, NCT00388050, NCT00578981, NCT00949611, NCT00217061.

  1. Patient preference for a racially or gender-concordant student dentist.

    PubMed

    Bender, Daniel J

    2007-06-01

    Disparities in health and health care due to race and ethnicity are a national problem. One commonly proposed method to address disparities is to increase the number of underrepresented minorities in the health professions to serve the needs of growing minority populations. This position is based in part on the racial concordance hypothesis, an untested assumption that minority patients prefer to be treated by providers of the same race as themselves. The purpose of this study was to test the racial concordance hypothesis. Gender preference of dental patients was also investigated. One hundred twenty male and female Caucasian, African American, Hispanic, and Asian dental patients over eighteen were recruited from the reception area of a private dental school clinic in Northern California. Participants were randomly assigned to a treatment condition that gave them a choice between two equally qualified fictitious dental students that varied on race and gender. Participants were initially blinded to the study's purpose to preserve the authenticity of the choice decision. Results showed that 58 percent of the participants had no preference for the race or gender of their student dentist, but that some black and Hispanic patients preferred a racially concordant student dentist and some female patients preferred a gender-concordant student dentist. Hispanic females were especially likely to prefer racial and gender concordance. The findings suggest that the racial concordance hypothesis may not apply to choosing a dentist and thus may not be as strong an argument to justify efforts to increase diversity in dental schools as previously thought.

  2. Patient-centered communication, ratings of care, and concordance of patient and physician race.

    PubMed

    Cooper, Lisa A; Roter, Debra L; Johnson, Rachel L; Ford, Daniel E; Steinwachs, Donald M; Powe, Neil R

    2003-12-02

    African-American patients who visit physicians of the same race rate their medical visits as more satisfying and participatory than do those who see physicians of other races. Little research has investigated the communication process in race-concordant and race-discordant medical visits. To compare patient-physician communication in race-concordant and race-discordant visits and examine whether communication behaviors explain differences in patient ratings of satisfaction and participatory decision making. Cohort study with follow-up using previsit and postvisit surveys and audiotape analysis. 16 urban primary care practices. 252 adults (142 African-American patients and 110 white patients) receiving care from 31 physicians (of whom 18 were African-American and 13 were white). Audiotape measures of patient-centeredness, patient ratings of physicians' participatory decision-making styles, and overall satisfaction. Race-concordant visits were longer (2.15 minutes [95% CI, 0.60 to 3.71]) and had higher ratings of patient positive affect (0.55 point, [95% CI, 0.04 to 1.05]) compared with race-discordant visits. Patients in race-concordant visits were more satisfied and rated their physicians as more participatory (8.42 points [95% CI, 3.23 to 13.60]). Audiotape measures of patient-centered communication behaviors did not explain differences in participatory decision making or satisfaction between race-concordant and race-discordant visits. Race-concordant visits are longer and characterized by more patient positive affect. Previous studies link similar communication findings to continuity of care. The association between race concordance and higher patient ratings of care is independent of patient-centered communication, suggesting that other factors, such as patient and physician attitudes, may mediate the relationship. Until more evidence is available regarding the mechanisms of this relationship and the effectiveness of intercultural communication skills programs, increasing ethnic diversity among physicians may be the most direct strategy to improve health care experiences for members of ethnic minority groups.

  3. What gross weight and range for an advanced HSCT?

    NASA Technical Reports Server (NTRS)

    Driver, Cornelius

    1992-01-01

    A review of studies conducted in 1986 indicates that a 300 passenger, 5500 nautical mile range aircraft should weigh less than 400,000 pounds. Some data from a British Aerospace Society of Automotive Engineers (SAE) paper will be shown that purport to be an advanced Concorde that meets the range payload specifications at a gross weight of 360,000 pounds. Previous studies by Peter Coen of Langley Research Center support these results. The weight of a supersonic transport is important from the point of view of how much effort should be expended in developing lower sonic boom technologies. It is obvious that a 360,000 pound aircraft can be modified to a more acceptable boom level than a 700,000 pound one.

  4. Language, Literacy, and Communication Regarding Medication in an Anticoagulation Clinic: Are Pictures Better Than Words?

    DTIC Science & Technology

    2005-05-01

    visual concordance rates varied with the patient’s language and level of health literacy . Fifty percent of patients achieved verbal concordance and...and having inadequate health literacy were associated with a lower odds ratio for verbal concordance compared to being an English speaker and having...adequate health literacy . Neither language nor health literacy was associated with visual discordance. The authors conclude that clinician-patient

  5. Tharsis Grooved Channel

    NASA Image and Video Library

    2002-12-04

    The Tharsis Montes region on Mars is a major center of volcanic and tectonic activity. The channel in this image from NASA Mars Odyssey is west of the relatively small volcano called Biblis Patera although it shows no obvious relationship to that volcano. Instead, it may be related to the more distant, but more massive volcano Olympus Mons to the north. The channel may have hosted flowing lava at one time but now contains a material that has eroded into an impressive ridge-and-groove pattern. These features may be yardangs, landforms produced from the erosion by wind of sedimentary material. http://photojournal.jpl.nasa.gov/catalog/PIA04020

  6. Analysis of direct punch velocity in professional defence

    NASA Astrophysics Data System (ADS)

    Lapkova, Dora; Adamek, Milan

    2016-06-01

    This paper is focused on analysis of a direct punch. Nowadays, professional defence is basic part of effective protection of people and property. There are many striking techniques and the goal of this research was to analyze the direct punch. The analysis is aimed to measure the velocity with help of high speed camera Olympus i-Speed 2 and then find the dependences of this velocity on input parameters. For data analysis two pieces of software were used - i-Speed Control Software and MINITAB. 111 participants took part in this experiment. The results are presented in this paper - especially dependence of mean velocity on time and difference in velocity between genders.

  7. Dispersive approach to two-photon exchange in elastic electron-proton scattering

    DOE PAGES

    Blunden, P. G.; Melnitchouk, W.

    2017-06-14

    We examine the two-photon exchange corrections to elastic electron-nucleon scattering within a dispersive approach, including contributions from both nucleon and Δ intermediate states. The dispersive analysis avoids off-shell uncertainties inherent in traditional approaches based on direct evaluation of loop diagrams, and guarantees the correct unitary behavior in the high energy limit. Using empirical information on the electromagnetic nucleon elastic and NΔ transition form factors, we compute the two-photon exchange corrections both algebraically and numerically. Finally, results are compared with recent measurements of e + p to e - p cross section ratios from the CLAS, VEPP-3 and OLYMPUS experiments.

  8. Cannulation method for intra-diverticular papilla with long oral protrusion using biopsy forceps for axis alignment.

    PubMed

    Takenaka, Mamoru; Minaga, Kosuke; Kudo, Masatoshi

    2018-06-22

    Intra-diverticular papilla is considered as a difficult anatomical orientation for biliary cannulation. 1 2 3 To our knowledge, this is the first report to show the usefulness of biopsy forceps for cannulation not only to expose the ampulla in the case of an intra-diverticular papilla but also for axis alignment.An 85-year-old woman underwent endoscopic retrograde cholangiopancreatography for a common bile duct (CBD) stone. A duodenoscope (TJF TYPE 260V; Olympus Medical Systems, Tokyo, Japan) was inserted into Vater's papilla. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  9. Fault propagation folds induced by gravitational failure and slumping of the Central Costa Rica volcanic range - Implications for large terrestrial and Martian volcanic edifices

    NASA Technical Reports Server (NTRS)

    Borgia, Andrea; Burr, Jeremiah; Montero, Walter; Morales, Luis Diego; Alvarado, Guillermo E.

    1990-01-01

    Maps are presented that describe the compressional tectonic structures found at the base of the Central Costa Rica volcanic range (CCRVR), which comprise thrust faults and related fault propagation folds, only partly covered by syntectonic and posttectonic volcanoclastic deposits. Evidence is presented that these structures formed by gravitational failure and lumping of the flanks of the volcanic range. It is suggested that similar structures may be found at the toe of the southern flank of Kilauea volcano, Hawaii, and along the perimeter scarp of the Olympus Mons volcano on Mars.

  10. Examination of Spatial Polygamy among Young Gay, Bisexual, and Other Men Who Have Sex with Men in New York City: The P18 Cohort Study

    PubMed Central

    Duncan, Dustin T.; Kapadia, Farzana; Halkitis, Perry N.

    2014-01-01

    The few previous studies examining the influence of the neighborhood context on health and health behavior among young gay, bisexual, and other men who have sex with men (YMSM) have predominantly focused on residential neighborhoods. No studies have examined multiple neighborhood contexts among YMSM or the relationships between sociodemographic characteristics, psychosocial factors, social support network characteristics, health behaviors, and neighborhood concordance. In this study, we assessed spatial polygamy by determining the amount of concordance between residential, social, and sex neighborhoods (defined as boroughs) in addition to examining individual-level characteristics that may be associated with neighborhood concordance. These data come from the baseline assessment of Project 18, a cohort of racially and ethnically diverse YMSM residing in the New York City metropolitan area. Participants (N = 598) provided information on their residential, social, and sex boroughs as well as information on their sociodemographic characteristics, psychosocial factors, social support network characteristics, and health behaviors (e.g., substance use and condomless sex). Descriptive analyses were conducted to examine the distribution of boroughs reported across all three contexts, i.e., residential, social, and sex boroughs. Next, concordance between: (1) residential and social boroughs; (2) residential and sex boroughs; (3) social and sex boroughs; and (4) residential, social, and sex boroughs was assessed. Finally, bivariable analyses were conducted to examine the relationships between sociodemographic characteristics, psychosocial factors, social support network characteristics, and health behaviors in relation to borough concordance. Approximately two-thirds of participants reported concordance between residential/socializing, residential/sex, and sex/socializing boroughs, whereas 25% reported concordance between all three residential/socializing/sex boroughs. Borough concordance varied by some individual-level characteristics. For example, White YMSM and YMSM reporting lower perceived socioeconomic status were significantly more likely to report residential/socializing/sex borough concordance (p < 0.001). With regard to psychosocial factors, YMSM who reported experiencing gay-related stigma in public forums were more likely to report discordant socializing/sex and residential/socializing/sex boroughs (p < 0.001). Greater frequency of communication with network members (≥weekly) was associated with less residential/social borough concordance (p < 0.05). YMSM who reported residential/socializing/sex borough concordance were more likely to report recent (last 30 days) alcohol use, recent marijuana use, and recently engaging in condomless oral sex (all p < 0.05). These findings suggest that spatial polygamy, or an individual moving across and experiencing multiple neighborhood contexts, is prevalent among urban YMSM and that spatial polygamy varies by multiple individual-level characteristics. Future research among YMSM populations should consider multiple neighborhood contexts in order to provide a more nuanced understanding of how and which neighborhood contexts influence the health and well-being of YMSM. This further examination of spatial polygamy (and individual-level characteristics associated with it) may increase understanding of the most appropriate locations for targeted disease prevention and health promotion interventions (e.g., HIV prevention interventions). PMID:25170685

  11. Examination of spatial polygamy among young gay, bisexual, and other men who have sex with men in New York City: the P18 cohort study.

    PubMed

    Duncan, Dustin T; Kapadia, Farzana; Halkitis, Perry N

    2014-08-28

    The few previous studies examining the influence of the neighborhood context on health and health behavior among young gay, bisexual, and other men who have sex with men (YMSM) have predominantly focused on residential neighborhoods. No studies have examined multiple neighborhood contexts among YMSM or the relationships between sociodemographic characteristics, psychosocial factors, social support network characteristics, health behaviors, and neighborhood concordance. In this study, we assessed spatial polygamy by determining the amount of concordance between residential, social, and sex neighborhoods (defined as boroughs) in addition to examining individual-level characteristics that may be associated with neighborhood concordance. These data come from the baseline assessment of Project 18, a cohort of racially and ethnically diverse YMSM residing in the New York City metropolitan area. Participants (N = 598) provided information on their residential, social, and sex boroughs as well as information on their sociodemographic characteristics, psychosocial factors, social support network characteristics, and health behaviors (e.g., substance use and condomless sex). Descriptive analyses were conducted to examine the distribution of boroughs reported across all three contexts, i.e., residential, social, and sex boroughs. Next, concordance between: (1) residential and social boroughs; (2) residential and sex boroughs; (3) social and sex boroughs; and (4) residential, social, and sex boroughs was assessed. Finally, bivariable analyses were conducted to examine the relationships between sociodemographic characteristics, psychosocial factors, social support network characteristics, and health behaviors in relation to borough concordance. Approximately two-thirds of participants reported concordance between residential/socializing, residential/sex, and sex/socializing boroughs, whereas 25% reported concordance between all three residential/socializing/sex boroughs. Borough concordance varied by some individual-level characteristics. For example, White YMSM and YMSM reporting lower perceived socioeconomic status were significantly more likely to report residential/socializing/sex borough concordance (p < 0.001). With regard to psychosocial factors, YMSM who reported experiencing gay-related stigma in public forums were more likely to report discordant socializing/sex and residential/socializing/sex boroughs (p < 0.001). Greater frequency of communication with network members (>weekly) was associated with less residential/social borough concordance (p < 0.05). YMSM who reported residential/socializing/sex borough concordance were more likely to report recent (last 30 days) alcohol use, recent marijuana use, and recently engaging in condomless oral sex (all p < 0.05). These findings suggest that spatial polygamy, or an individual moving across and experiencing multiple neighborhood contexts, is prevalent among urban YMSM and that spatial polygamy varies by multiple individual-level characteristics. Future research among YMSM populations should consider multiple neighborhood contexts in order to provide a more nuanced understanding of how and which neighborhood contexts influence the health and well-being of YMSM. This further examination of spatial polygamy (and individual-level characteristics associated with it) may increase understanding of the most appropriate locations for targeted disease prevention and health promotion interventions (e.g., HIV prevention interventions).

  12. Comparison of Content on the American Board of Internal Medicine Maintenance of Certification Examination With Conditions Seen in Practice by General Internists.

    PubMed

    Gray, Bradley; Vandergrift, Jonathan; Lipner, Rebecca S; Green, Marianne M

    2017-06-13

    Success on the internal medicine (IM) examination is a central requirement of the American Board of Internal Medicine's (ABIM's) Maintenance of Certification program (MOC). Therefore, it is important to understand the degree to which this examination reflects conditions seen in practice, one dimension of content validity, which focuses on the match between content in the discipline and the topics on the examination questions. To assess whether the frequency of questions on IM-MOC examinations were concordant with the frequency of conditions seen in practice. The 2010-2013 IM-MOC examinations were used to calculate the percentage of questions for 186 medical condition categories from the examination blueprint, which balances examination content by considering importance and frequency of conditions seen in practice. Nationally representative estimates of conditions seen in practice by general internists were estimated from the primary diagnosis for 13 832 office visits (2010-2013 National Ambulatory Medical Care Surveys) and 108 472 hospital stays (2010 National Hospital Discharge Survey). Prevalence of conditions included on the IM-MOC examination questions. The outcome measure was the concordance between the percentages of IM-MOC examination questions and the percentages of conditions seen in practice during either office visits or hospital stays for each of 186 condition categories (eg, diabetes mellitus, ischemic heart disease, liver disease). The concordance thresholds were 0.5 SD of the weighted mean percentages of the applicable 186 conditions seen in practice (0.74% for office visits; 0.51% for hospital stays). If the absolute differences between the percentages of examination questions and the percentages of office visit conditions or hospital stay conditions seen were less than the applicable concordance threshold, then the condition category was judged to be concordant. During the 2010-2013 IM-MOC examination periods, 3600 questions (180 questions per examination form) were administered and 3461 questions (96.1%) were mapped into the 186 study conditions (mean, 18.6 questions per condition). Comparison of the percentages of 186 categories of medical conditions seen in 13 832 office visits and 108 472 hospital stays with the percentages of 3461 questions on IM-MOC examinations revealed that 2389 examination questions (69.0%; 95% CI, 67.5%-70.6% involving 158 conditions) were categorized as concordant. For concordance between questions and office visits only, 2010 questions (58.08%; 95% CI, 56.43%-59.72% of all examination questions) involving 145 conditions were categorized as concordant. For concordance between questions and hospital stays only, 1456 questions (42.07%; 95% CI, 40.42%-43.71% of all examination questions) involving 122 conditions were categorized as concordant. Among questions on IM-MOC examinations from 2010-2013, 69% were concordant with conditions seen in general internal medicine practices, although some areas of discordance were identified.

  13. Concordance between European and US case definitions of healthcare-associated infections

    PubMed Central

    2012-01-01

    Background Surveillance of healthcare-associated infections (HAI) is a valuable measure to decrease infection rates. Across Europe, inter-country comparisons of HAI rates seem limited because some countries use US definitions from the US Centers for Disease Control and Prevention (CDC/NHSN) while other countries use European definitions from the Hospitals in Europe Link for Infection Control through Surveillance (HELICS/IPSE) project. In this study, we analyzed the concordance between US and European definitions of HAI. Methods An international working group of experts from seven European countries was set up to identify differences between US and European definitions and then conduct surveillance using both sets of definitions during a three-month period (March 1st -May 31st, 2010). Concordance between case definitions was estimated with Cohen’s kappa statistic (κ). Results Differences in HAI definitions were found for bloodstream infection (BSI), pneumonia (PN), urinary tract infection (UTI) and the two key terms “intensive care unit (ICU)-acquired infection” and “mechanical ventilation”. Concordance was analyzed for these definitions and key terms with the exception of UTI. Surveillance was performed in 47 ICUs and 6,506 patients were assessed. One hundred and eighty PN and 123 BSI cases were identified. When all PN cases were considered, concordance for PN was κ = 0.99 [CI 95%: 0.98-1.00]. When PN cases were divided into subgroups, concordance was κ = 0.90 (CI 95%: 0.86-0.94) for clinically defined PN and κ = 0.72 (CI 95%: 0.63-0.82) for microbiologically defined PN. Concordance for BSI was κ = 0.73 [CI 95%: 0.66-0.80]. However, BSI cases secondary to another infection site (42% of all BSI cases) are excluded when using US definitions and concordance for BSI was κ = 1.00 when only primary BSI cases, i.e. Europe-defined BSI with ”catheter” or “unknown” origin and US-defined laboratory-confirmed BSI (LCBI), were considered. Conclusions Our study showed an excellent concordance between US and European definitions of PN and primary BSI. PN and primary BSI rates of countries using either US or European definitions can be compared if the points highlighted in this study are taken into account. PMID:22958646

  14. CFHTLenS revisited: assessing concordance with Planck including astrophysical systematics

    NASA Astrophysics Data System (ADS)

    Joudaki, Shahab; Blake, Chris; Heymans, Catherine; Choi, Ami; Harnois-Deraps, Joachim; Hildebrandt, Hendrik; Joachimi, Benjamin; Johnson, Andrew; Mead, Alexander; Parkinson, David; Viola, Massimo; van Waerbeke, Ludovic

    2017-02-01

    We investigate the impact of astrophysical systematics on cosmic shear cosmological parameter constraints from the Canada-France-Hawaii Telescope Lensing Survey (CFHTLenS) and the concordance with cosmic microwave background measurements by Planck. We present updated CFHTLenS cosmic shear tomography measurements extended to degree scales using a covariance calibrated by a new suite of N-body simulations. We analyse these measurements with a new model fitting pipeline, accounting for key systematic uncertainties arising from intrinsic galaxy alignments, baryonic effects in the non-linear matter power spectrum, and photometric redshift uncertainties. We examine the impact of the systematic degrees of freedom on the cosmological parameter constraints, both independently and jointly. When the systematic uncertainties are considered independently, the intrinsic alignment amplitude is the only degree of freedom that is substantially preferred by the data. When the systematic uncertainties are considered jointly, there is no consistently strong preference in favour of the more complex models. We quantify the level of concordance between the CFHTLenS and Planck data sets by employing two distinct data concordance tests, grounded in Bayesian evidence and information theory. We find that the two data concordance tests largely agree with one another and that the level of concordance between the CFHTLenS and Planck data sets is sensitive to the exact details of the systematic uncertainties included in our analysis, ranging from decisive discordance to substantial concordance as the treatment of the systematic uncertainties becomes more conservative. The least conservative scenario is the one most favoured by the cosmic shear data, but it is also the one that shows the greatest degree of discordance with Planck. The data and analysis code are publicly available at https://github.com/sjoudaki/cfhtlens_revisited.

  15. Polyethylene glycol and contrast-enhanced MRI of Crohn's disease in children: preliminary experience.

    PubMed

    Magnano, Gianmichele; Granata, Claudio; Barabino, Arrigo; Magnaguagno, Francesca; Rossi, Umberto; Calevo, Maria Grazia; Toma, Paolo

    2003-06-01

    To assess the ability of MRI to detect bowel abnormalities in children affected by Crohn's disease (CD). We studied 22 children (age range 8-18 years) referred to us with a known history of CD. MRI was carried out using a 1.5-T unit with a maximum gradient field strength of 16 mT and a phased-array body coil. The sequences performed were breath-hold coronal and axial T2-weighted, express fat saturation, followed by T1-weighted, spoiled gradient, fast fat saturation after IV injection of gadolinium chelate (0.3 mmol/kg) for contrast enhancement of the bowel wall. Bowel distension was achieved using oral administration of isosmotic polyethylene glycol solution. Ileo-colonoscopy was considered the gold standard for evaluation of superficial abnormalities and stenoses of the colon and terminal ileum. MRI findings of bowel-wall thickening, increased vascularisation and extramural involvement were compared with the findings using B-mode and Doppler US. Concordance between MRI and endoscopy, B-mode US and Doppler US findings was determined by the Kappa statistical method. Superficial lesions were not shown by MRI. MR enteroclysis easily detected stenoses, thickening and hyperaemia of bowel wall. Concordance of findings between MRI and endoscopy was 90% (K=0.79, substantial concordance). Concordance of findings between MRI and US concerning bowel-wall thickening and increased vascularisation was 95% (K=0.875, excellent concordance) and 80% (K=0.6, fairly good concordance), respectively. Our initial results show that MRI can detect intra- and extra-mural lesions of CD. The high concordance observed between MRI, endoscopy, US and Doppler US findings suggests that MRI is at least comparable for diagnostic capability with these techniques offering, thanks to multiplanar projections, an improved visualisation of the bowel without ionising radiation.

  16. A Lateral Flow Rapid Test for Human Toxocariasis Developed Using Three Toxocara canis Recombinant Antigens.

    PubMed

    Yunus, Muhammad Hafiznur; Tan Farrizam, Siti Naqiuyah; Abdul Karim, Izzati Zahidah; Noordin, Rahmah

    2018-01-01

    Laboratory diagnosis of toxocariasis is still a challenge especially in developing endemic countries with polyparasitism. In this study, three Toxocara canis recombinant antigens, rTES-26, rTES-30, and rTES-120, were expressed and used to prepare lateral flow immunoglobulin G4 (IgG4) dipsticks. The concordance of the results of the rapid test (comprising three dipsticks) with a commercial IgG-enzyme-linked immunosorbent assay (ELISA) (Cypress Diagnostics, Belgium) was compared against the concordance of two other commercial IgG-ELISA kits (Bordier, Switzerland and NovaTec, Germany) with the Cypress kit. Using Toxocara- positive samples, the concordance of the dipstick dotted with rTES-26, rTES-30, and rTES-120 was 41.4% (12/29), 51.7% (15/29), and 72.4% (21/29), respectively. When positivity with any dipstick was considered as an overall positive rapid test result, the concordance with the Cypress kit was 93% (27/29). Meanwhile, when compared with the results of the Cypress kit, the concordance of IgG-ELISA from NovaTec and Bordier was 100% (29/29) and 89.7% (26/29), respectively. Specific IgG4 has been recognized as a marker of active infection for several helminthic diseases; therefore, the two non-concordant results of the rapid test when compared with the NovaTec IgG-ELISA kit may be from samples of people with non-active infection. All the three dipsticks showed 100% (50/50) concordance with the Cypress kit when tested with serum from individuals who were healthy and with other infections. In conclusion, the lateral flow rapid test is potentially a good, fast, and easy test for toxocariasis. Next, further validation studies and development of a test with the three antigens in one dipstick will be performed.

  17. The accuracy of parent-reported height and weight for 6-12 year old U.S. children.

    PubMed

    Wright, Davene R; Glanz, Karen; Colburn, Trina; Robson, Shannon M; Saelens, Brian E

    2018-02-12

    Previous studies have examined correlations between BMI calculated using parent-reported and directly-measured child height and weight. The objective of this study was to validate correction factors for parent-reported child measurements. Concordance between parent-reported and investigator measured child height, weight, and BMI (kg/m 2 ) among participants in the Neighborhood Impact on Kids Study (n = 616) was examined using the Lin coefficient, where a value of ±1.0 indicates perfect concordance and a value of zero denotes non-concordance. A correction model for parent-reported height, weight, and BMI based on commonly collected demographic information was developed using 75% of the sample. This model was used to estimate corrected measures for the remaining 25% of the sample and measured concordance between correct parent-reported and investigator-measured values. Accuracy of corrected values in classifying children as overweight/obese was assessed by sensitivity and specificity. Concordance between parent-reported and measured height, weight and BMI was low (0.007, - 0.039, and - 0.005 respectively). Concordance in the corrected test samples improved to 0.752 for height, 0.616 for weight, and 0.227 for BMI. Sensitivity of corrected parent-reported measures for predicting overweight and obesity among children in the test sample decreased from 42.8 to 25.6% while specificity improved from 79.5 to 88.6%. Correction factors improved concordance for height and weight but did not improve the sensitivity of parent-reported measures for measuring child overweight and obesity. Future research should be conducted using larger and more nationally-representative samples that allow researchers to fully explore demographic variance in correction coefficients.

  18. Measuring colorectal cancer care quality for the publicly insured in New York State

    PubMed Central

    Sinclair, Amber H; Schymura, Maria J; Boscoe, Francis P; Yung, Rachel L; Chen, Kun; Roohan, Patrick; Tai, Eric; Schrag, Deborah

    2012-01-01

    The extent to which concordance with colorectal cancer treatment quality metrics varies by patient characteristics in the publicly insured is not well understood. Our objective was to evaluate the quality of colorectal cancer care for publicly insured residents of New York State (NYS). NYS cancer registry data were linked to Medicaid and Medicare claims and hospital discharge data. We identified colorectal cancer cases diagnosed from 2004 through 2006 and evaluated three treatment quality measures: adjuvant chemotherapy within 4 months of diagnosis for American Joint Cancer Committee (AJCC) stage III colon cancer, adjuvant radiation within 6 months of diagnosis for AJCC stage IIB or III rectal cancer, and adjuvant chemotherapy within 9 months of diagnosis for AJCC stage II–III rectal cancer. Concordance with guidelines was evaluated separately for Medicaid-enrollees under age 65 years and Medicare-enrollees aged 65–79 years. For adjuvant chemotherapy for colon cancer, 79.4% (274/345) of the Medicaid cohort and 71.8% (585/815) of the Medicare cohort were guideline concordant. For adjuvant radiation for rectal cancer, 72.3% (125/173) of the Medicaid cohort and 66.9% (206/308) of the Medicare cohort were concordant. For adjuvant chemotherapy for rectal cancer, 89.5% (238/266) of the Medicaid cohort and 76.0% (392/516) of the Medicare cohort were concordant. Younger age was associated with higher adjusted odds of concordance for all three measures in the Medicare cohort. Racial differences were not evident in either cohort. There is room for improvement in concordance with accepted metrics of cancer care quality. Feedback about performance may assist in targeting efforts to improve care. PMID:23342286

  19. Language, literacy, and communication regarding medication in an anticoagulation clinic: a comparison of verbal vs. visual assessment.

    PubMed

    Schillinger, Dean; Machtinger, Edward L; Wang, Frances; Palacios, Jorge; Rodriguez, Maytrella; Bindman, Andrew

    2006-01-01

    Despite the importance of clinician-patient communication, little is known about rates and predictors of medication miscommunication. Measuring rates of miscommunication, as well as differences between verbal and visual modes of assessment, can inform efforts to more effectively communicate about medications. We studied 220 diverse patients in an anticoagulation clinic to assess concordance between patient and clinician reports of warfarin regimens. Bilingual research assistants asked patients to (1) verbalize their prescribed weekly warfarin regimen and (2) identify this regimen from a digitized color menu of warfarin pills. We obtained clinician reports of patient regimens from chart review. Patients were categorized as having regimen concordance if there were no patient-clinician discrepancies in total weekly dosage. We then examined whether verbal and visual concordance rates varied with patient's language and health literacy. Fifty percent of patients achieved verbal concordance and 66% achieved visual concordance with clinicians regarding the weekly warfarin regimen (P < .001). Being a Cantonese speaker and having inadequate health literacy were associated with a lower odds of verbal concordance compared with English speakers and subjects with adequate health literacy (AOR 0.44, 0.21-0.93, AOR 0.50, 0.26-0.99, respectively). Neither language nor health literacy was associated with visual discordance. Shifting from verbal to visual modes was associated with greater patient-provider concordance across all patient subgroups, but especially for those with communication barriers.Clinician-patient discordance regarding patients' warfarin regimen was common but occurred less frequently when patients used a visual aid. Visual aids may improve the accuracy of medication assessment, especially for patients with communication barriers.

  20. Accuracy of manual QRS duration assessment: its importance in patient selection for cardiac resynchronization and implantable cardioverter defibrillator therapy.

    PubMed

    Tomlinson, David R; Bashir, Yaver; Betts, Timothy R; Rajappan, Kim

    2009-05-01

    Patients with left ventricular systolic dysfunction and electrocardiographic QRS duration (QRSd) >or=120 ms may obtain symptomatic and prognostic benefits from cardiac resynchronization therapy (CRT). However, clinical trials do not describe the methods used to measure QRSd. We investigated the effect of electrocardiogram (ECG) display format and paper speed on the accuracy of manual QRSd assessment and concordance of manual QRSd with computer-calculated mean and maximal QRSd. Six cardiologists undertook QRSd measurements on ECGs, with computer-calculated mean QRSd close to 120 ms. Display formats were 12-lead, 6-limb, and 6-precordial leads, each at 25 and 50 mm/s. When the computer-calculated mean was used to define QRSd, manual assessment demonstrated 97 and 83% concordance at categorizing QRSd as < and >or=120 ms, respectively. Using the computer-calculated maximal QRSd, manual assessment demonstrated 83% concordance when QRSd was <120 ms and 19% concordance when QRSd was >or=120 ms. The six-precordial lead format demonstrated significantly less intra and inter-observer variabilities than the 12-lead, but this did not improve concordance rates. Manual QRSd assessments demonstrate significant variability, and concordance with computer-calculated measurement depends on whether QRSd is defined as the mean or maximal value. Consensus is required both on the most appropriate definition of QRSd and its measurement.

  1. Concorde noise-induced building vibrations, Sully Plantation - Report no. 2, Chantilly, Virginia

    NASA Technical Reports Server (NTRS)

    1976-01-01

    Noise-induced building vibrations associated with Concorde operations were studied. The approach is to record the levels of induced vibrations and associated indoor/outdoor noise levels in selected homes, historic and other buildings near Dulles International Airport. Representative data are presented which were recorded at Sully Plantation, Chantilly, Virginia during the periods of May 20 through May 28, 1976, and June 14 through June 17, 1976. Recorded data provide relationships between the vibration levels of windows, walls, floors, and the noise associated with Concorde operations, other aircraft, and nonaircraft events. The results presented are drawn from the combined May-June data base which is considerably larger than the May data base covered. The levels of window, wall and floor vibratory response resulting from Concorde operations are higher than the vibratory levels associated with conventional aircraft. Furthermore, the vibratory responses of the windows are considerably higher than those of the walls and floors. The window response is higher for aircraft than recorded nonaircraft events and exhibits a linear response relationship with the overall sound pressure level. For a given sound pressure level, the Concorde may cause more vibration than a conventional aircraft due to spectral or other differences. However, the responses associated with Concorde appear to be much more dependent upon sound pressure level than spectral or other characteristics of the noise.

  2. Dominant intraprostatic cancer confirmed by direct MRI-guided biopsy: Concordance with histopathological findings.

    PubMed

    Meermeier, Nicholas P; Turner, Kevin R; Foster, Bryan R; Várallyay, Csanád; Liu, Jen-Jane; Coakley, Fergus V

    2018-06-09

    To investigate the concordance between dominant intraprostatic cancer seen on endorectal multiparametric MRI and confirmed by MRI-targeted biopsy with histopathological findings at radical prostatectomy, since existing literature has emphasized the miss rather than the concordance rate of MRI. We retrospectively identified 20 patients who underwent radical prostatectomy after a dominant intraprostatic cancer focus was identified at endorectal multiparametric MRI and confirmed by MRI-targeted biopsy. Concordance was determined by comparing the location and Gleason grade group of dominant tumor at MRI with the location and Gleason grade group determined at histopathological review. Mean patient age was 65 years (range, 48 to 76) and median serum prostatic specific antigen level was 9.4 ng/mL (range, 4.6 to 58.0). In all 20 patients, the location of dominant tumor based on MRI and targeted biopsy corresponded with the dominant tumor location at histopathology. In 9 patients, Gleason grade group was the same at targeted biopsy and final histopathology. In 9 patients, final Gleason grade group was higher and in two patients it was lower. Our preliminary results suggest dominant tumor as determined by endorectal multiparametric MRI and confirmed by a positive MRI-targeted biopsy has high concordance with histopathological findings at radical prostatectomy for location, and reasonable concordance for Gleason grade group. Copyright © 2018 Elsevier Inc. All rights reserved.

  3. Reasons for referral and diagnostic concordance between physicians/surgeons and the consultation-liaison psychiatry team: An exploratory study from a tertiary care hospital in India

    PubMed Central

    Grover, Sandeep; Sahoo, Swapnajeet; Aggarwal, Shivali; Dhiman, Shallu; Chakrabarti, Subho; Avasthi, Ajit

    2017-01-01

    Background: Very few studies have evaluated the reasons for referral to consultation-liaison (CL) psychiatry teams. Aim: This study aimed to evaluate the psychiatric morbidity pattern, reasons for referral and diagnostic concordance between physicians/surgeons and the CL psychiatry team. Materials and Methods: Two hundred and nineteen psychiatric referrals made to the CL psychiatry team were assessed for reason for referral and diagnostic concordance in terms of reason of referral and psychiatric diagnosis made by the CL psychiatry team. Results: In 57% of cases, a specific psychiatric diagnosis was mentioned by the physician/surgeon. The most common specific psychiatric diagnoses considered by the physician/surgeon included depression, substance abuse, and delirium. Most common psychiatric diagnosis made by the CL psychiatric services was delirium followed by depressive disorders. Diagnostic concordance between physician/surgeon and psychiatrist was low (κ < 0.3) for depressive disorders and delirium and better for the diagnosis of substance dependence (κ = 0.678) and suicidality (κ = 0.655). Conclusions: The present study suggests that delirium is the most common diagnosis in referrals made to CL psychiatry team, and there is poor concordance between the psychiatric diagnosis considered by the physician/surgeon and the psychiatrist for delirium and depression; however, the concordance rates for substance dependence and suicidal behavior are acceptable. PMID:28827863

  4. Consanguinity and spousal concordance in Kuwait.

    PubMed

    al-Kandari, Y; Crews, D E; Poirier, F E

    2002-12-01

    Consanguineous marriage is favored in Kuwait. This research focuses on the relationship of physical and cultural traits to marriage types in Kuwait and examines concordance as a function of consanguinity and marriage duration. In a nonrandom opportunistic sample of 242 couples anthropometric and blood pressure data have been collected as well as data on acculturation, religiosity, Farsi proficiency, level of education, occupation, and attitudes regarding fertility. Significant concordances occur in cultural characteristics among couples in all three types of marriages with respect to the degree of religiosity, acculturation, language similarity, education, and occupation. Non-consanguineous spouses have the highest concordance in educational level, occupation, and degree of acculturation, but the lowest for religiosity and Farsi proficiency. Nonkin marriages seem to be based on personal preferences. In the wider potential nonkin marriage pool spouses show more concordance in stature and education indicating the positive assortative mating for those traits. Non-consanguineous spouses show a significant association for triceps and subscapular skinfold thicknesses hip and waist circumferences, and body fat distribution. Unrelated spouses exhibit more concordance for physical traits than do related spouses. There is a significant correlation between spouses in first and double cousin marriages as well as in spouses in second and less than second cousin unions for systolic and diastolic blood pressure, while non-consanguineous spouses show a significant association in diastolic blood pressure only.

  5. Radiology Reports With Hyperlinks Improve Target Lesion Selection and Measurement Concordance in Cancer Trials.

    PubMed

    Machado, Laura B; Apolo, Andrea B; Steinberg, Seth M; Folio, Les R

    2017-02-01

    Radiology reports often lack the measurements of target lesions that are needed for oncology clinical trials. When available, the measurements in the radiology reports often do not match those in the records used to calculate therapeutic response. This study assessed the clinical value of hyperlinked tumor measurements in multimedia-enhanced radiology reports in the PACS and the inclusion of a radiologist assistant in the process of assessing tumor burden. We assessed 489 target lesions in 232 CT examinations of 71 patients with metastatic genitourinary cancer enrolled in two therapeutic trials. We analyzed target lesion selection and measurement concordance between oncology records (used to calculate therapeutic response) and two types of radiology reports in the PACS: multimedia-enhanced radiology reports and text-only reports. For statistical tests, we used the Wilcoxon signed rank, Wilcoxon rank sum test, and Fisher method to combine p values from the paired and unpaired results. The Fisher exact test was used to compare overall measurement concordance. Concordance on target lesion selection was greater for multimedia-enhanced radiology reports (78%) than the text-only reports (52%) (p = 0.0050). There was also improved overall measurement concordance with the multimedia-enhanced radiology reports (68%) compared with the text-only reports (38%) (p < 0.0001). Compared with text-only reports, hyperlinked multimedia-enhanced radiology reports improved concordance of target lesion selection and measurement with the measurements used to calculate therapeutic response.

  6. [Inter-rater concordance of the "Nursing Activities Score" in intensive care].

    PubMed

    Valls-Matarín, Josefa; Salamero-Amorós, Maria; Roldán-Gil, Carmen; Quintana-Riera, Salvador

    2015-01-01

    To evaluate inter-rater concordance in the valuation of the "Nursing Activities Score". Cross-sectional descriptive study conducted from December 2012 until June 2013 in a general intensive care unit with twelve beds. Three evaluator nurses, simultaneously and independently, through the patient daily charts, scored the nursing workload using Nursing Activities Score scale in all patients admitted over 18 years old. Three hundreds and thirty-nine records were collected. The intra-class correlation coefficient (ICC) between evaluators was 0.92 (0.89-0.94). A perfect concordance was obtained in 39.1% of the items, with 52.2% having a high, and 8.7% having lower concordance, corresponding to two of the items with multiple scoring options. Significant differences between two of the evaluators (P=.049) were found. Although the inter-rater concordance was high, more accurate records are needed to reduce the variability of the items with multiple options and to allow more accuracy in the interpretation and measurement of the data regarding nursing workload. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  7. Emotion dysregulation and dyadic conflict in depressed and typical adolescents: Evaluating concordance across psychophysiological and observational measures

    PubMed Central

    Crowell, Sheila E.; Baucom, Brian R.; Yaptangco, Mona; Bride, Daniel; Hsiao, Ray; McCauley, Elizabeth; Beauchaine, Theodore P.

    2014-01-01

    Many depressed adolescents experience difficulty regulating their emotions. These emotion regulation difficulties appear to emerge in part from socialization processes within families and then generalize to other contexts. However, emotion dysregulation is typically assessed within the individual, rather than in the social relationships that shape and maintain dysregulation. In this study, we evaluated concordance of physiological and observational measures of emotion dysregulation during interpersonal conflict, using a multilevel actor-partner interdependence model (APIM). Participants were 75 mother-daughter dyads, including 50 depressed adolescents with or without a history of self-injury, and 25 typically developing controls. Behavior dysregulation was operationalized as observed aversiveness during a conflict discussion, and physiological dysregulation was indexed by respiratory sinus arrhythmia (RSA). Results revealed different patterns of concordance for control versus depressed participants. Controls evidenced a concordant partner (between-person) effect, and showed increased physiological regulation during minutes when their partner was more aversive. In contrast, clinical dyad members displayed a concordant actor (within-person) effect, becoming simultaneously physiologically and behaviorally dysregulated. Results inform current understanding of emotion dysregulation across multiple levels of analysis. PMID:24607894

  8. Caregiver-Teacher Concordance of Challenging Behaviors in Children with Autism Spectrum Disorder Served in Community Mental Health Settings

    PubMed Central

    Chlebowski, Colby; Brookman-Frazee, Lauren

    2018-01-01

    Children with autism spectrum disorder (ASD) exhibit high rates of challenging behaviors that impair functioning and represent the primary presenting problem in mental health (MH) services. Obtaining symptom reports from multiple informants is critical for treatment planning. This study evaluated caregiver-teacher concordance of ratings of the intensity of challenging behaviors in children with ASD receiving MH services, and identified child clinical factors associated with concordance. This sample included 141 children (M = 9.07 years), their caregivers, and teachers. Caregiver-teacher concordance of challenging behaviors was low and impacted by the degree and type of child psychiatric comorbidity. Findings support need for increased attention to the range of psychiatric problems children with ASD present to tailor treatment recommendations and service delivery. PMID:28343342

  9. Diagnostic concordance among pathologists interpreting breast biopsy specimens.

    PubMed

    Elmore, Joann G; Longton, Gary M; Carney, Patricia A; Geller, Berta M; Onega, Tracy; Tosteson, Anna N A; Nelson, Heidi D; Pepe, Margaret S; Allison, Kimberly H; Schnitt, Stuart J; O'Malley, Frances P; Weaver, Donald L

    2015-03-17

    A breast pathology diagnosis provides the basis for clinical treatment and management decisions; however, its accuracy is inadequately understood. To quantify the magnitude of diagnostic disagreement among pathologists compared with a consensus panel reference diagnosis and to evaluate associated patient and pathologist characteristics. Study of pathologists who interpret breast biopsies in clinical practices in 8 US states. Participants independently interpreted slides between November 2011 and May 2014 from test sets of 60 breast biopsies (240 total cases, 1 slide per case), including 23 cases of invasive breast cancer, 73 ductal carcinoma in situ (DCIS), 72 with atypical hyperplasia (atypia), and 72 benign cases without atypia. Participants were blinded to the interpretations of other study pathologists and consensus panel members. Among the 3 consensus panel members, unanimous agreement of their independent diagnoses was 75%, and concordance with the consensus-derived reference diagnoses was 90.3%. The proportions of diagnoses overinterpreted and underinterpreted relative to the consensus-derived reference diagnoses were assessed. Sixty-five percent of invited, responding pathologists were eligible and consented to participate. Of these, 91% (N = 115) completed the study, providing 6900 individual case diagnoses. Compared with the consensus-derived reference diagnosis, the overall concordance rate of diagnostic interpretations of participating pathologists was 75.3% (95% CI, 73.4%-77.0%; 5194 of 6900 interpretations). Among invasive carcinoma cases (663 interpretations), 96% (95% CI, 94%-97%) were concordant, and 4% (95% CI, 3%-6%) were underinterpreted; among DCIS cases (2097 interpretations), 84% (95% CI, 82%-86%) were concordant, 3% (95% CI, 2%-4%) were overinterpreted, and 13% (95% CI, 12%-15%) were underinterpreted; among atypia cases (2070 interpretations), 48% (95% CI, 44%-52%) were concordant, 17% (95% CI, 15%-21%) were overinterpreted, and 35% (95% CI, 31%-39%) were underinterpreted; and among benign cases without atypia (2070 interpretations), 87% (95% CI, 85%-89%) were concordant and 13% (95% CI, 11%-15%) were overinterpreted. Disagreement with the reference diagnosis was statistically significantly higher among biopsies from women with higher (n = 122) vs lower (n = 118) breast density on prior mammograms (overall concordance rate, 73% [95% CI, 71%-75%] for higher vs 77% [95% CI, 75%-80%] for lower, P < .001), and among pathologists who interpreted lower weekly case volumes (P < .001) or worked in smaller practices (P = .034) or nonacademic settings (P = .007). In this study of pathologists, in which diagnostic interpretation was based on a single breast biopsy slide, overall agreement between the individual pathologists' interpretations and the expert consensus-derived reference diagnoses was 75.3%, with the highest level of concordance for invasive carcinoma and lower levels of concordance for DCIS and atypia. Further research is needed to understand the relationship of these findings with patient management.

  10. Patient factors associated with guideline-concordant treatment of anxiety and depression in primary care.

    PubMed

    Prins, Marijn A; Verhaak, Peter F M; Smolders, Mirrian; Laurant, Miranda G H; van der Meer, Klaas; Spreeuwenberg, Peter; van Marwijk, Harm W J; Penninx, Brenda W J H; Bensing, Jozien M

    2010-07-01

    To identify associations of patient characteristics (predisposing, enabling and need factors) with guideline-concordant care for anxiety and depression in primary care. Analysis of data from the Netherlands Study of Depression and Anxiety (NESDA). Seven hundred and twenty-one patients with a current anxiety or depressive disorder, recruited from 67 general practitioners (GPs), were included. Diagnoses according to the Diagnostic and Statistic Manual of Mental Disorders, fourth edition (DSM-IV) were made using a structured and widely validated assessment. Socio-demographic and enabling characteristics, severity of symptoms, disability, (under treatment for) chronic somatic conditions, perceived need for care, beliefs and evaluations of care were measured by questionnaires. Actual care data were derived from electronic medical records. Criteria for guideline-concordant care were based on general practice guidelines, issued by the Dutch College of General Practitioners. Two hundred and eighty-one (39%) patients received guideline-concordant care. High education level, accessibility of care, comorbidity of anxiety and depression, and severity and disability scores were positively associated with receiving guideline-concordant care in univariate analyses. In multivariate multi-level logistic regression models, significant associations with the clinical need factors disappeared. Positive evaluations of accessibility of care increased the chance (OR = 1.31; 95%-CI = 1.05-1.65; p = 0.02) of receiving guideline-concordant care, as well as perceiving any need for medication (OR = 2.99; 95%-CI = 1.84-4.85; p < 0.001), counseling (OR = 2.25; 95%-CI = 1.29-3.95; p = 0.005) or a referral (OR = 1.83; 95%-CI = 1.09-3.09; p = 0.02). A low educational level decreased the odds (OR = 0.33; 95%-CI = 0.11-0.98; p = 0.04) of receiving guideline-concordant care. This study shows that education level, accessibility of care and patients' perceived needs for care are more strongly associated with the delivery of guideline-concordant care for anxiety or depression than clinical need factors. Initiatives to improve GPs' communication skills around mental health issues, and to improve recognition of people suffering from anxiety disorders, could increase the number of patients receiving treatment for depression and anxiety in primary care.

  11. Concordance of Results from Randomized and Observational Analyses within the Same Study: A Re-Analysis of the Women's Health Initiative Limited-Access Dataset.

    PubMed

    Bolland, Mark J; Grey, Andrew; Gamble, Greg D; Reid, Ian R

    2015-01-01

    Observational studies (OS) and randomized controlled trials (RCTs) often report discordant results. In the Women's Health Initiative Calcium and Vitamin D (WHI CaD) RCT, women were randomly assigned to CaD or placebo, but were permitted to use personal calcium and vitamin D supplements, creating a unique opportunity to compare results from randomized and observational analyses within the same study. WHI CaD was a 7-year RCT of 1g calcium/400IU vitamin D daily in 36,282 post-menopausal women. We assessed the effects of CaD on cardiovascular events, death, cancer and fracture in a randomized design- comparing CaD with placebo in 43% of women not using personal calcium or vitamin D supplements- and in a observational design- comparing women in the placebo group (44%) using personal calcium and vitamin D supplements with non-users. Incidence was assessed using Cox proportional hazards models, and results from the two study designs deemed concordant if the absolute difference in hazard ratios was ≤0.15. We also compared results from WHI CaD to those from the WHI Observational Study(WHI OS), which used similar methodology for analyses and recruited from the same population. In WHI CaD, for myocardial infarction and stroke, results of unadjusted and 6/8 covariate-controlled observational analyses (age-adjusted, multivariate-adjusted, propensity-adjusted, propensity-matched) were not concordant with the randomized design results. For death, hip and total fracture, colorectal and total cancer, unadjusted and covariate-controlled observational results were concordant with randomized results. For breast cancer, unadjusted and age-adjusted observational results were concordant with randomized results, but only 1/3 other covariate-controlled observational results were concordant with randomized results. Multivariate-adjusted results from WHI OS were concordant with randomized WHI CaD results for only 4/8 endpoints. Results of randomized analyses in WHI CaD were concordant with observational analyses for 5/8 endpoints in WHI CaD and 4/8 endpoints in WHI OS.

  12. Concordance of Results from Randomized and Observational Analyses within the Same Study: A Re-Analysis of the Women’s Health Initiative Limited-Access Dataset

    PubMed Central

    Bolland, Mark J.; Grey, Andrew; Gamble, Greg D.; Reid, Ian R.

    2015-01-01

    Background Observational studies (OS) and randomized controlled trials (RCTs) often report discordant results. In the Women’s Health Initiative Calcium and Vitamin D (WHI CaD) RCT, women were randomly assigned to CaD or placebo, but were permitted to use personal calcium and vitamin D supplements, creating a unique opportunity to compare results from randomized and observational analyses within the same study. Methods WHI CaD was a 7-year RCT of 1g calcium/400IU vitamin D daily in 36,282 post-menopausal women. We assessed the effects of CaD on cardiovascular events, death, cancer and fracture in a randomized design- comparing CaD with placebo in 43% of women not using personal calcium or vitamin D supplements- and in a observational design- comparing women in the placebo group (44%) using personal calcium and vitamin D supplements with non-users. Incidence was assessed using Cox proportional hazards models, and results from the two study designs deemed concordant if the absolute difference in hazard ratios was ≤0.15. We also compared results from WHI CaD to those from the WHI Observational Study(WHI OS), which used similar methodology for analyses and recruited from the same population. Results In WHI CaD, for myocardial infarction and stroke, results of unadjusted and 6/8 covariate-controlled observational analyses (age-adjusted, multivariate-adjusted, propensity-adjusted, propensity-matched) were not concordant with the randomized design results. For death, hip and total fracture, colorectal and total cancer, unadjusted and covariate-controlled observational results were concordant with randomized results. For breast cancer, unadjusted and age-adjusted observational results were concordant with randomized results, but only 1/3 other covariate-controlled observational results were concordant with randomized results. Multivariate-adjusted results from WHI OS were concordant with randomized WHI CaD results for only 4/8 endpoints. Conclusions Results of randomized analyses in WHI CaD were concordant with observational analyses for 5/8 endpoints in WHI CaD and 4/8 endpoints in WHI OS. PMID:26440516

  13. Concordance between administrative health data and medical records for diabetes status in coronary heart disease patients: a retrospective linked data study

    PubMed Central

    2013-01-01

    Background Administrative data are a valuable source of estimates of diabetes prevalence for groups such as coronary heart disease (CHD) patients. The primary aim of this study was to measure concordance between medical records and linked administrative health data for recording diabetes in CHD patients, and to assess temporal differences in concordance. Secondary aims were to determine the optimal lookback period for identifying diabetes in this patient group, whether concordance differed for Indigenous people, and to identify predictors of false positives and negatives in administrative data. Methods A population representative sample of 3943 CHD patients hospitalized in Western Australia in 1998 and 2002–04 were selected, and designated according to the International Classification of Diseases (ICD) version in use at the time (ICD-9 and ICD-10 respectively). Crude prevalence and concordance were compared for the two samples. Concordance measures were estimated from administrative data comparing diabetes status recorded on the selected CHD admission (‘index admission’) and on any hospitalization in the previous 1, 2, 5, 10 or 15 years, against hospital medical records. Potential modifiers of agreement were determined using chi-square tests and multivariable logistic regression models. Results Identification of diabetes on the index CHD admission was underestimated more in the ICD-10 than ICD-9 sample (sensitivity 81.5% versus 91.1%, underestimation 15.1% versus 4.4% respectively). Sensitivity increased to 89.6% in the ICD-10 period using at least 10 years of hospitalization history. Sensitivity was higher and specificity lower in Indigenous patients, and followed a similar pattern of improving concordance with increasing lookback period. Characteristics associated with false negatives for diabetes on the index CHD hospital admission were elective admission, in-hospital death, principal diagnosis, and in the ICD-10 period only, fewer recorded comorbidities. Conclusions The accuracy of identifying diabetes status in CHD patients is improved in linked administrative health data by using at least 10 years of hospitalization history. Use of this method would reduce bias when measuring temporal trends in diabetes prevalence in this patient group. Concordance measures are as reliable in Indigenous as non-Indigenous patients. PMID:24079345

  14. Concordance between administrative health data and medical records for diabetes status in coronary heart disease patients: a retrospective linked data study.

    PubMed

    Nedkoff, Lee; Knuiman, Matthew; Hung, Joseph; Sanfilippo, Frank M; Katzenellenbogen, Judith M; Briffa, Tom G

    2013-10-01

    Administrative data are a valuable source of estimates of diabetes prevalence for groups such as coronary heart disease (CHD) patients. The primary aim of this study was to measure concordance between medical records and linked administrative health data for recording diabetes in CHD patients, and to assess temporal differences in concordance. Secondary aims were to determine the optimal lookback period for identifying diabetes in this patient group, whether concordance differed for Indigenous people, and to identify predictors of false positives and negatives in administrative data. A population representative sample of 3943 CHD patients hospitalized in Western Australia in 1998 and 2002-04 were selected, and designated according to the International Classification of Diseases (ICD) version in use at the time (ICD-9 and ICD-10 respectively). Crude prevalence and concordance were compared for the two samples. Concordance measures were estimated from administrative data comparing diabetes status recorded on the selected CHD admission ('index admission') and on any hospitalization in the previous 1, 2, 5, 10 or 15 years, against hospital medical records. Potential modifiers of agreement were determined using chi-square tests and multivariable logistic regression models. Identification of diabetes on the index CHD admission was underestimated more in the ICD-10 than ICD-9 sample (sensitivity 81.5% versus 91.1%, underestimation 15.1% versus 4.4% respectively). Sensitivity increased to 89.6% in the ICD-10 period using at least 10 years of hospitalization history. Sensitivity was higher and specificity lower in Indigenous patients, and followed a similar pattern of improving concordance with increasing lookback period. Characteristics associated with false negatives for diabetes on the index CHD hospital admission were elective admission, in-hospital death, principal diagnosis, and in the ICD-10 period only, fewer recorded comorbidities. The accuracy of identifying diabetes status in CHD patients is improved in linked administrative health data by using at least 10 years of hospitalization history. Use of this method would reduce bias when measuring temporal trends in diabetes prevalence in this patient group. Concordance measures are as reliable in Indigenous as non-Indigenous patients.

  15. Concordance between fine-needle aspiration and core biopsies for osseous lesions by lesion imaging appearance and CT attenuation.

    PubMed

    Li, John; Weissberg, Zoe; Bevilacqua, Thomas A; Yu, Gordon; Weber, Kristy; Sebro, Ronnie

    2018-04-01

    To compare the concordance between fine-needle aspiration and core biopsies for osseous lesions by lesion imaging appearance and CT attenuation. Retrospective review of 215 FNAs of osseous lesions performed in conjunction with core biopsy at our institution over a 6-year period (2011-2016). FNAs were interpreted independently of core biopsies. We assessed if FNA in conjunction with core biopsy increased diagnostic accuracy compared to core biopsy alone. We also calculated the concordance between FNA and core biopsy by lesion appearance, lesion CT attenuation, lesion histology, lesion location and FNA needle gauge size. Core biopsy alone provided the diagnosis in 207/215 cases (96.3%), however, the FNA provided the diagnosis in the remaining 8/215 cases (3.7%) where the core biopsy was non-diagnostic. There were 154 (71.6%) lytic lesions, 21 (9.8%) blastic lesions, 25 (11.6%) mixed lytic and blastic lesions and 15 (7.0%) lesions that were neither lytic nor blastic. The concordance between FNA and core biopsy for lytic osseous lesions (136/154 cases, 88.3%) was statistically significantly higher than that for blastic osseous lesions (13/21 cases, 61.9%) [P = 4.2 × 10 -3 ; 95% CI (0.02, 0.50)]. The concordance between FNA and core biopsy was higher for low-attenuation- (110/126) than high-attenuation (58/77) lesions (P = 0.028). The concordance between FNA and core biopsy was also higher for metastases (102/119 cases, 85.7%) than non-metastases (78/96, 81.3%) [P = 0.487; 95% CI (- 0.15, 0.065)]. There was no difference in the rate of concordance between FNA and core biopsy by lesion location or FNA needle gauge size (P > 0.05). FNA with core biopsy increases diagnostic rate compared to core biopsy alone or FNA alone. The concordance between FNA and core biopsy is higher for lytic lesions than for blastic lesions; and higher for low-attenuation lesions than for high-attenuation lesions.

  16. 2. View of Liquified Propane Air Plant (New), former Exhaust ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    2. View of Liquified Propane Air Plant (New), former Exhaust and Compressor Building and former Purifying Plant in background. - Concord Gas Light Company, South Main Street, Concord, Merrimack County, NH

  17. The Kaiser Permanente Clinician Cultural and Linguistic Assessment Initiative: Research and Development in Patient–Provider Language Concordance

    PubMed Central

    MSN, Gayle Tang; Lanza, Oscar; Rodriguez, Fátima Marinely; Chang, Annie

    2011-01-01

    Patient–clinician language concordance is a critical component of the language access equation and is considered the gold standard for communication. As a result of lack of validated testing standards, measures, and tools, Kaiser Permanente developed the Clinician Cultural and Linguistic Assessment Initiative to ensure verifiable linguistic proficiency in clinical encounters and has established a standard level whereby the clinician is deemed to have a qualifying level of proficiency in communicating directly with patients independent of an interpreter. Our benchmarking efforts in language concordance have been rooted with the key aim to identify talented bilingual and bicultural clinician workforce and to establish the systems foundation to coordinate appropriate language services. We share accomplishments, lessons learned, and promising practices to inform future efforts in language concordance. PMID:21228282

  18. Core self-evaluations and job and life satisfaction: the role of self-concordance and goal attainment.

    PubMed

    Judge, Timothy A; Bono, Joyce E; Erez, Amir; Locke, Edwin A

    2005-03-01

    The present study tested a model explaining how the core self-evaluations (i.e., positive self-regard) concept is linked to job and life satisfaction. The self-concordance model, which focuses on motives underlying goal pursuit, was used as an explanatory framework. Data were collected from 2 samples: (a) 183 university students (longitudinal measures of goal attainment and life satisfaction were used) and (b) 251 employees (longitudinal measures of goal attainment and job satisfaction were utilized). In both studies, the core self-evaluations concept was positively related to goal self-concordance, meaning that individuals with positive self-regard were more likely to pursue goals for intrinsic and identified (value-congruent) reasons. Furthermore, in both studies, goal self-concordance was related to satisfaction (job satisfaction in Study 1 and life satisfaction in Study 2).

  19. Comparison of administrative/billing data to expected protocol-mandated chemotherapy exposure in children with acute myeloid leukemia: A report from the Children's Oncology Group.

    PubMed

    Miller, Tamara P; Troxel, Andrea B; Li, Yimei; Huang, Yuan-Shung; Alonzo, Todd A; Gerbing, Robert B; Hall, Matt; Torp, Kari; Fisher, Brian T; Bagatell, Rochelle; Seif, Alix E; Sung, Lillian; Gamis, Alan; Rubin, David; Luger, Selina; Aplenc, Richard

    2015-07-01

    Recently investigators have used analysis of administrative/billing datasets to answer clinical and pharmacoepidemiology questions in pediatric oncology. However, the accuracy of pharmacy data from administrative/billing datasets have not yet been evaluated. The primary objective of this study was to determine the concordance of Pediatric Health Information System (PHIS) administrative/billing chemotherapy data with Children's Oncology Group (COG) protocol-mandated chemotherapy and to assess the implications of this level of concordance for further PHIS research. Data from 384 pediatric patients (1,060 courses of chemotherapy) with acute myeloid leukemia treated on COG clinical trial AAML0531 were previously merged with PHIS data. PHIS chemotherapy administrative/billing data were reviewed for the first three courses of chemotherapy. Accuracy was assessed using three metrics: recognizability of chemotherapy pattern by course, chemotherapy administration pattern by individual medication, and concordance with the number of days of protocol-defined chemotherapy. The chemotherapy pattern was recognizable in 87.3% of courses when course-wide accuracy was assessed. Chemotherapy administration pattern varied by medication. Cytarabine had perfect concordance 70.9% of the time, daunorubicin had perfect concordance 77.4% of the time, and etoposide had perfect concordance 67.8% of the time. The accuracy of chemotherapy administrative/billing data supports the continued use of PHIS data for epidemiology studies as long as investigators perform data quality control checks and evaluate each specific medication prior to undertaking definitive analyses. © 2015 Wiley Periodicals, Inc.

  20. John M. Eisenberg Patient Safety Awards. System innovation: Concord Hospital.

    PubMed

    Uhlig, Paul N; Brown, Jeffrey; Nason, Anne K; Camelio, Addie; Kendall, Elise

    2002-12-01

    The Cardiac Surgery Program at Concord Hospital (Concord, NH) restructured clinical teamwork for improved safety and effectiveness on the basis of theory and practice from human factors science, aviation safety, and high-reliability organization theory. A team-based, collaborative rounds process--the Concord Collaborative Care Model--that involved use of a structured communications protocol was conducted daily at each patient's bedside. The entire care team agreed to meet at the same time each day (8:45 AM to 9:30 AM) to share information and develop a plan of care for each patient, with patient and family members as active participants. The cardiac surgery team developed a structured communications protocol adapted from human factors science. To provide a forum for discussion of team goals and progress and to address system-level concerns, a biweekly system rounds process was established. Following implementation of collaborative rounds, mortality of Concord Hospital's cardiac surgery patients declined significantly from expected rates. Satisfaction rates of open heart patients scores were consistently in the 97th-99th percentile nationally. A quality of work life survey indicated that in every category, providers expressed greater satisfaction with the collaborative care process than with the traditional rounds process. Practice patterns in the Cardiac Surgery Program at Concord Hospital have changed to a much more collaborative and participatory process, with improved outcomes, happier patients, and more satisfied practitioners. A culture of continuous program improvement has been implemented that continues to evolve and produce benefits.

  1. The use of whole food animal studies in the safety assessment of genetically modified crops: limitations and recommendations.

    PubMed

    Bartholomaeus, Andrew; Parrott, Wayne; Bondy, Genevieve; Walker, Kate

    2013-11-01

    There is disagreement internationally across major regulatory jurisdictions on the relevance and utility of whole food (WF) toxicity studies on GM crops, with no harmonization of data or regulatory requirements. The scientific value, and therefore animal ethics, of WF studies on GM crops is a matter addressable from the wealth of data available on commercialized GM crops and WF studies on irradiated foods. We reviewed available GM crop WF studies and considered the extent to which they add to the information from agronomic and compositional analyses. No WF toxicity study was identified that convincingly demonstrated toxicological concern or that called into question the adequacy, sufficiency, and reliability of safety assessments based on crop molecular characterization, transgene source, agronomic characteristics, and/or compositional analysis of the GM crop and its near-isogenic line. Predictions of safety based on crop genetics and compositional analyses have provided complete concordance with the results of well-conducted animal testing. However, this concordance is primarily due to the improbability of de novo generation of toxic substances in crop plants using genetic engineering practices and due to the weakness of WF toxicity studies in general. Thus, based on the comparative robustness and reliability of compositional and agronomic considerations and on the absence of any scientific basis for a significant potential for de novo generation of toxicologically significant compositional alterations as a sole result of transgene insertion, the conclusion of this review is that WF animal toxicity studies are unnecessary and scientifically unjustifiable.

  2. [Concordance and usefulness of a stratification system for clinical decision making].

    PubMed

    González González, Ana Isabel; Miquel Gómez, Ana María; Rodríguez Morales, David; Hernández Pascual, Montserrat; Sánchez Perruca, Luis; Mediavilla Herrera, Inmaculada

    2017-04-01

    1) To analyse concordance between the level of risk classification using the Adjusted Groups Morbidity (GMA) tool and the assigned level of intervention by general practitioners (GP). 2) To study the usefulness of the GMA tool as an aid in electronic medical records (EMR) for decision making. Cross-sectional observational study of concordance. Primary Care. Madrid Health Service. Twenty eight GPs. A sample of 840 patients assigned to participating GPs was selected by disproportionate stratified random sampling (0.65 kappa, 0.125 precision, 5% positive rate, 95% confidence level). Weighted Cohen Kappa index for the degree of concordance between the GMA tool and the GPs. The usefulness of the tool was assessed using an ad hoc developed questionnaire. Kappa weighted index obtained was 0.60 (95%CI: 0.55-0.65). In 3% of cases the disagreement was maximum. The GPs found that the grouping tool had been useful in 76% of cases. Moderate strength/good concordance; incorporating a grouping tool in the EMR helps as a reminder for taking more proactive/integrated decisions based on social and health needs of people with chronic diseases. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  3. Morbidities, concordance, and predictors of preterm premature rupture of membranes among pregnant women at the University of Nigeria Teaching Hospital (UNTH), Enugu, Nigeria.

    PubMed

    Okeke, T C; Enwereji, J O; Adiri, C O; Onwuka, C I; Iferikigwe, E S

    2016-01-01

    Preterm premature rupture of membranes (PPROM) is a challenging complication of pregnancies and an important cause of perinatal morbidity and mortality. Management of morbidities associated with PPROM is fraught with controversy. However, women should be informed of these complications. This article aimed to review the morbidities, concordance, and predictors of PPROM over a 10-year period. This was a retrospective review of morbidities, concordance, and predictors of PPROM among pregnant women at the University of Nigeria Teaching Hospital, Enugu, Nigeria between January 1, 1999, and December 31, 2008. The morbidities, concordance, and predictors of PPROM were expressed by regression analysis output for PPROM. Primigravidae had the highest occurrence of PPROM. Increasing parity does not significantly influence the incidence of PPROM. The concordance and predictors of PPROM are maternal age (P < 0.000), gestational age at PROM (P < 0.000), latency period (P < 0.000), and birth weight (P < 0.001). PPROM is a major complication of pregnancies and an important cause of perinatal morbidity and mortality. Management of these morbidities associated with PPROM poses a great challenge. However, women should be informed of these complications.

  4. Concordance between VDU-users' ratings of comfort and perceived exertion with experts' observations of workplace layout and working postures.

    PubMed

    Lindegård, A; Karlberg, C; Wigaeus Tornqvist, E; Toomingas, A; Hagberg, M

    2005-05-01

    The aim of the present study was to evaluate the concordance (agreement) between VDU-users' ratings of comfort and ergonomists' observations of workplace layout, and the concordance between VDU-users' ratings of perceived exertion and ergonomists' observations of working postures during VDU-work. The study population consisted of 853 symptom free subjects. Data on perceived comfort in different dimensions and data regarding perceived exertion in different body locations were collected by means of a questionnaire. Data concerning workplace layout and working postures were collected with an observation protocol, by an ergonomist. Concordance between ratings of comfort and observations of workplace layout was reasonably good for the chair and the keyboard (0.60, 0.58) and good regarding the screen and the input device (0.72, 0.61). Concordance between ratings of perceived exertion and observations of working postures indicated good agreement (0.63-0.77) for all measured body locations (neck, shoulder, wrist and trunk). In conclusion ratings of comfort and perceived exertion could be used as cost-efficient and user-friendly methods for practitioners to identify high exposure to poor workplace layout and poor working postures.

  5. Patient-Clinician Ethnic Concordance and Communication in Mental Health Intake Visits

    PubMed Central

    Alegría, Margarita; Roter, Debra L.; Valentine, Anne; Chen, Chih-nan; Li, Xinliang; Lin, Julia; Rosen, Daniel; Lapatin, Sheri; Normand, Sharon-Lise; Larson, Susan; Shrout, Patrick E.

    2013-01-01

    Objective This study examines how communication patterns vary across racial and ethnic patient-clinician dyads in mental health intake sessions and its relation to continuance in treatment, defined as attending the next scheduled appointment. Methods Observational study of communication patterns among ethnically/racially concordant and discordant patient-clinician dyads. Primary analysis included 93 patients with 38 clinicians in race/ethnic concordant and discordant dyads. Communication was coded using the Roter Interaction Analysis System (RIAS) and the Working Alliance Inventory Observer (WAI-O) bond scale; continuance in care was derived from chart reviews. Results Latino concordant dyad patients were more verbally dominant (p<.05), engaged in more patient-centered communication (p<.05) and scored higher on the (WAI-O) bond scale (all p<.05) than other groups. Latino patients had higher continuance rates than other patients in models that adjusted for non-communication variables. When communication, global affect, and therapeutic process variables were adjusted for, differences were reversed and white dyad patients had higher continuance in care rates than other dyad patients. Conclusion Communication patterns seem to explain the role of ethnic concordance for continuance in care. Practice Implications Improve intercultural communication in cross cultural encounters appears significant for retaining minorities in care. PMID:23896127

  6. Diagnostic electrocardiography in epidemiological studies of Chagas' disease: multicenter evaluation of a standardized method.

    PubMed

    Lázzari, J O; Pereira, M; Antunes, C M; Guimarães, A; Moncayo, A; Chávez Domínguez, R; Hernández Pieretti, O; Macedo, V; Rassi, A; Maguire, J; Romero, A

    1998-11-01

    An electrocardiographic recording method with an associated reading guide, designed for epidemiological studies on Chagas' disease, was tested to assess its diagnostic reproducibility. Six cardiologists from five countries each read 100 electrocardiographic (ECG) tracings, including 30 from chronic chagasic patients, then reread them after an interval of 6 months. The readings were blind, with the tracings numbered randomly for the first reading and renumbered randomly for the second reading. The physicians, all experienced in interpreting ECGs from chagasic patients, followed printed instructions for reading the tracings. Reproducibility of the readings was evaluated using the kappa (kappa) index for concordance. The results showed a high degree of interobserver concordance with respect to the diagnosis of normal vs. abnormal tracings (kappa = 0.66; SE 0.02). While the interpretations of some categories of ECG abnormalities were highly reproducible, others, especially those having a low prevalence, showed lower levels of concordance. Intraobserver concordance was uniformly higher than interobserver concordance. The findings of this study justify the use by specialists of the recording of readings method proposed for epidemiological studies on Chagas' disease, but warrant caution in the interpretation of some categories of electrocardiographic alterations.

  7. Detection of Pathogenic Protozoa in the Diagnostic Laboratory: Result Reproducibility, Specimen Pooling, and Competency Assessment▿

    PubMed Central

    Libman, M. D.; Gyorkos, T. W.; Kokoskin, E.; MacLean, J. D.

    2008-01-01

    Stool microscopy as performed in clinical parasitology laboratories is a complex procedure with subjective interpretation. Quality assurance (QA) programs often emphasize proficiency testing as an assessment tool. We describe a result reproducibility assessment tool, which can form part of a broader QA program, and which is based on the blinded resubmission of selected clinical samples, using concordance between the reports of the initial and resubmitted specimen as an indicator. Specimens preserved in sodium acetate-acetic acid-formalin can be stored for several months for use in such a program. The presence of multiple protozoa in one specimen does not affect concordance. Some dilution of specimens occurs in this process, and this may explain poor concordance when specimens with low protozoal concentrations are resubmitted. Evaluation of this tool in a large parasitology laboratory revealed concordance rates for pathogenic protozoa (Entamoeba histolytica/Entamoeba dispar, Giardia lamblia, and Dientamoeba fragilis) of about 80%, which may be considered for use as a benchmark value. We also used this tool to demonstrate that when pairs of specimens from one patient are pooled to create a single specimen, concordance between the results of the individual and pooled specimens is high. PMID:18448690

  8. Emotion dysregulation and dyadic conflict in depressed and typical adolescents: evaluating concordance across psychophysiological and observational measures.

    PubMed

    Crowell, Sheila E; Baucom, Brian R; Yaptangco, Mona; Bride, Daniel; Hsiao, Ray; McCauley, Elizabeth; Beauchaine, Theodore P

    2014-04-01

    Many depressed adolescents experience difficulty in regulating their emotions. These emotion regulation difficulties appear to emerge in part from socialization processes within families and then generalize to other contexts. However, emotion dysregulation is typically assessed within the individual, rather than in the social relationships that shape and maintain dysregulation. In this study, we evaluated concordance of physiological and observational measures of emotion dysregulation during interpersonal conflict, using a multilevel actor-partner interdependence model (APIM). Participants were 75 mother-daughter dyads, including 50 depressed adolescents with or without a history of self-injury, and 25 typically developing controls. Behavior dysregulation was operationalized as observed aversiveness during a conflict discussion, and physiological dysregulation was indexed by respiratory sinus arrhythmia (RSA). Results revealed different patterns of concordance for control versus depressed participants. Controls evidenced a concordant partner (between-person) effect, and showed increased physiological regulation during minutes when their partner was more aversive. In contrast, clinical dyad members displayed a concordant actor (within-person) effect, becoming simultaneously physiologically and behaviorally dysregulated. Results inform current understanding of emotion dysregulation across multiple levels of analysis. Copyright © 2014 Elsevier B.V. All rights reserved.

  9. A Horizontal Take-off and Landing satellite launcher or aerospace plane (HOTOL)

    NASA Astrophysics Data System (ADS)

    Conchie, P. J.

    1985-09-01

    An assessment is made of the technology readiness and typical mission profile of a Horizontal Takeoof and Landing (HOTOL) single-stage satellite launch vehicle for 1990s deployment. HOTOL would employ H2-fueled air-breathing propulsion for the first stage of its ascent to low earth orbit through the lower portions of the atmosphere; it would then switch to H2-fueled rocket engines using liquid oxygen from internal tanks for exoatmospheric flight and orbit insertion. Mission cost comparisons are made with alternative launch vehicle design options. HOTOL is approximately the same size as the Concorde SST, and will weigh so much less than the current Space Shuttle as to significantly reduce reentry speeds and temperatures, obviating ceramic insulation systems for the primary structure.

  10. Critical assessment of pediatric neurosurgery patient/parent educational information obtained via the Internet.

    PubMed

    Garcia, Michael; Daugherty, Christopher; Ben Khallouq, Bertha; Maugans, Todd

    2018-05-01

    OBJECTIVE The Internet is used frequently by patients and family members to acquire information about pediatric neurosurgical conditions. The sources, nature, accuracy, and usefulness of this information have not been examined recently. The authors analyzed the results from searches of 10 common pediatric neurosurgical terms using a novel scoring test to assess the value of the educational information obtained. METHODS Google and Bing searches were performed for 10 common pediatric neurosurgical topics (concussion, craniosynostosis, hydrocephalus, pediatric brain tumor, pediatric Chiari malformation, pediatric epilepsy surgery, pediatric neurosurgery, plagiocephaly, spina bifida, and tethered spinal cord). The first 10 "hits" obtained with each search engine were analyzed using the Currency, Relevance, Authority, Accuracy, and Purpose (CRAAP) test, which assigns a numerical score in each of 5 domains. Agreement between results was assessed for 1) concurrent searches with Google and Bing; 2) Google searches over time (6 months apart); 3) Google searches using mobile and PC platforms concurrently; and 4) searches using privacy settings. Readability was assessed with an online analytical tool. RESULTS Google and Bing searches yielded information with similar CRAAP scores (mean 72% and 75%, respectively), but with frequently differing results (58% concordance/matching results). There was a high level of agreement (72% concordance) over time for Google searches and also between searches using general and privacy settings (92% concordance). Government sources scored the best in both CRAAP score and readability. Hospitals and universities were the most prevalent sources, but these sources had the lowest CRAAP scores, due in part to an abundance of self-marketing. The CRAAP scores for mobile and desktop platforms did not differ significantly (p = 0.49). CONCLUSIONS Google and Bing searches yielded useful educational information, using either mobile or PC platforms. Most information was relevant and accurate; however, the depth and breadth of information was variable. Search results over a 6-month period were moderately stable. Pediatric neurosurgery practices and neurosurgical professional organization websites were inferior (less current, less accurate, less authoritative, and less purposeful) to governmental and encyclopedia-type resources such as Wikipedia. This presents an opportunity for pediatric neurosurgeons to participate in the creation of better online patient/parent educational material.

  11. 'Testing Together Challenges the Relationship': Consequences of HIV Testing as a Couple in a High HIV Prevalence Setting in Rural South Africa.

    PubMed

    Tabana, Hanani; Doherty, Tanya; Rubenson, Birgitta; Jackson, Debra; Ekström, Anna Mia; Thorson, Anna

    2013-01-01

    We conducted qualitative individual and combined interviews with couples to explore their experiences since the time of taking an HIV test and receiving the test result together, as part of a home-based HIV counselling and testing intervention. This study was conducted in October 2011 in rural KwaZulu-Natal, South Africa, about 2 years after couples tested and received results together. Fourteen couples were purposively sampled: discordant, concordant negative and concordant positive couples. Learning about each other's status together challenged relationships of the couples in different ways depending on HIV status and gender. The mutual information confirmed suspected infidelity that had not been discussed before. Negative women in discordant partnerships remained with their positive partner due to social pressure and struggled to maintain their HIV negative status. Most of the couple relationships were characterized by silence and mistrust. Knowledge of sero-status also led to loss of sexual intimacy in some couples especially the discordant. For most men in concordant negative couples, knowledge of status was an awakening of the importance of fidelity and an opportunity for behaviour change, while for concordant positive and discordant couples, it was seen as proof of infidelity. Although positive HIV status was perceived as confirmation of infidelity, couples continued their relationship and offered some support for each other, living and managing life together. Sexual life in these couples was characterized by conflict and sometimes violence. In the concordant negative couples, trust was enhanced and behaviour change was promised. Findings suggest that testing together as couples challenged relationships in both negative and positive ways. Further, knowledge of HIV status indicated potential to influence behaviour change especially among concordant negatives. In the discordant and concordant positive couples, traditional gender roles exposed women's vulnerability and their lack of decision-making power.

  12. Statin prescription rates and their facility-level variation in patients with peripheral artery disease and ischemic cerebrovascular disease: Insights from the Department of Veterans Affairs.

    PubMed

    McBride, Cameron L; Akeroyd, Julia M; Ramsey, David J; Nambi, Vijay; Nasir, Khurram; Michos, Erin D; Bush, Ruth L; Jneid, Hani; Morris, Pamela B; Bittner, Vera A; Ballantyne, Christie M; Petersen, Laura A; Virani, Salim S

    2018-06-01

    The 2013 American College of Cardiology/American Heart Association cholesterol guideline recommends moderate to high-intensity statin therapy in patients with peripheral artery disease (PAD) and ischemic cerebrovascular disease (ICVD). We examined frequency and facility-level variation in any statin prescription and in guideline-concordant statin prescriptions in patients with PAD and ICVD receiving primary care in 130 facilities across the Veterans Affairs (VA) health care system between October 2013 and September 2014. Guideline-concordant statin intensity was defined as the prescription of high-intensity statins in patients with PAD or ICVD ≤75 years and at least moderate-intensity statins in those >75 years. We calculated median rate ratios (MRR) after adjusting for patient demographic factors to assess the magnitude of facility-level variation in statin prescribing patterns independent of patient characteristics. Among 194,151 PAD patients, 153,438 patients (79.0%) were prescribed any statin and 79,435 (40.9%) were prescribed a guideline-concordant intensity of statin. PAD patients without ischemic heart disease were prescribed any statin and a guideline-concordant intensity of statin therapy less frequently (69.1% and 28.9%, respectively). Among 339,771 ICVD patients, 265,491 (78.1%) were prescribed any statin and 136,430 (40.2%) were prescribed a guideline-concordant intensity of statin. ICVD patients without ischemic heart disease were prescribed any statin and a guideline-concordant intensity of statin less frequently (70.9% and 30.5%, respectively). MRRs for both PAD and ICVD patients demonstrated a 20% and 28% variation among two facilities in treating two identical patients with statin therapy and guideline-concordant intensity of statin therapy, respectively. The prescription of statins, especially guideline-recommended intensity of statin therapy, is suboptimal in PAD and ICVD patients, with significant facility-level variation not explained by patient-level factors.

  13. RadNet Air Data From Concord, NH

    EPA Pesticide Factsheets

    This page presents radiation air monitoring and air filter analysis data for Concord, NH from EPA's RadNet system. RadNet is a nationwide network of monitoring stations that measure radiation in air, drinking water and precipitation.

  14. 6. Photocopy of etching (from collection of New Hampshire Historical ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    6. Photocopy of etching (from collection of New Hampshire Historical Society, Concord, New Hampshire), post 1870 VIEW SOUTHEAST SHOWING WEST FRONT (ELEVATION) - Merchants' Exchange Block, 94-102 North Main Street, Concord, Merrimack County, NH

  15. Paul Hill d/b/a Alternative Energy Windows and Siding

    EPA Pesticide Factsheets

    Paul Hill d/b/a Alternative Energy Windows and Siding (the Company) is located in Concord, New Hampshire. The settlement involves renovation activities conducted at property constructed prior to 1978, located in Concord, New Hampshire.

  16. An on-board processing satellite payload for European mobile communications

    NASA Astrophysics Data System (ADS)

    Evans, B. G.; Casewell, I. E.; Craig, A. D.

    1987-06-01

    An examination of the use of satellite on-board processing (OBP) for land mobile applications shows the feasibility of designing an OBP payload to satisfy the functional requirements of the land mobile system projected for the 1990s. Following a discussion of the proposed land mobile system, advantages of OBP over conventional transport payloads are considered. The use of digital signal processing techniques is shown to provide a solution for the merging of the routing and transmultiplexing functions into a single element, and such techniques are ideally suited to space applications. It is suggested that the projected power, mass, and size estimates are compatible with the payload capacity of one of the large Olympus satellites.

  17. Goal striving, need satisfaction, and longitudinal well-being: the self-concordance model.

    PubMed

    Sheldon, K M; Elliot, A J

    1999-03-01

    An integrative model of the conative process, which has important ramifications for psychological need satisfaction and hence for individuals' well-being, is presented. The self-concordance of goals (i.e., their consistency with the person's developing interests and core values) plays a dual role in the model. First, those pursuing self-concordant goals put more sustained effort into achieving those goals and thus are more likely to attain them. Second, those who attain self-concordant goals reap greater well-being benefits from their attainment. Attainment-to-well-being effects are mediated by need satisfaction, i.e., daily activity-based experiences of autonomy, competence, and relatedness that accumulate during the period of striving. The model is shown to provide a satisfactory fit to 3 longitudinal data sets and to be independent of the effects of self-efficacy, implementation intentions, avoidance framing, and life skills.

  18. Genetic and teratological considerations in the analysis of concordant and discordant abnormalities in twins.

    PubMed

    Gericke, G S

    1986-01-18

    Results from monozygotic (MZ) and dizygotic (DZ) twin research are often used in an attempt to gain a clearer understanding of the 'nature v. nurture' dilemma. Discordance between MZ twins has been considered to be environmental, and greater concordance in MZ compared with DZ pairs to be genetic. Current genetic and teratological theories considerably complicate the interpretation of concordance and discordance of abnormalities. The high rate of discordant intra-uterine death recently demonstrated in twins may profoundly influence the value of epidemiological studies usually performed in later life. Furthermore, indirect zygosity estimations based on sex ratios in DZ twins may be flawed because it is now recognized that increasing numbers of conditions are genetically heterogeneous. Emphasis is laid on problems of interpretation of discordance and concordance for developmental abnormalities in twins, and some possible mechanisms for their induction are discussed. Basic genetic concepts relevant to the expression of abnormalities in twins are outlined.

  19. Internet stream synchronization using Concord

    NASA Astrophysics Data System (ADS)

    Sreenan, Cormac J.; Narendran, B.; Agrawal, Prathima; Shivakumar, Narayanan

    1996-03-01

    Using packet networks to transport multimedia introduces delay variations within and across streams, necessitating synchronization at the receiver. This requires stream data to be buffered prior to presentation, which also increases its total end to end delay. Concord recognizes that applications may wish to influence the underlying synchronization policy in terms of its effect on quality of service. It provides a single framework for synchronization within and across streams and employs an application specific tradeoff between packet losses, delay and inter- stream skew. We present a new predictive approach for synchronization and a selection of results from an extensive evaluation of Concord for use in the Internet. A trace driven simulator is used, allowing a direct comparison with alternative approaches. We demonstrate that Concord can operate with lower maximum delay and less variation in total end to end delay, which in turn can allow receiver buffer requirements to be reduced.

  20. Models and methods of emotional concordance.

    PubMed

    Hollenstein, Tom; Lanteigne, Dianna

    2014-04-01

    Theories of emotion generally posit the synchronized, coordinated, and/or emergent combination of psychophysiological, cognitive, and behavioral components of the emotion system--emotional concordance--as a functional definition of emotion. However, the empirical support for this claim has been weak or inconsistent. As an introduction to this special issue on emotional concordance, we consider three domains of explanations as to why this theory-data gap might exist. First, theory may need to be revised to more accurately reflect past research. Second, there may be moderating factors such as emotion regulation, context, or individual differences that have obscured concordance. Finally, the methods typically used to test theory may be inadequate. In particular, we review a variety of potential issues: intensity of emotions elicited in the laboratory, nonlinearity, between- versus within-subject associations, the relative timing of components, bivariate versus multivariate approaches, and diversity of physiological processes. Copyright © 2013 Elsevier B.V. All rights reserved.

  1. Birth attendants as perinatal verbal autopsy respondents in low- and middle-income countries: a viable alternative?

    PubMed Central

    Garces, A; Jehan, I; Ditekemena, J; Phiri, M; Thorsten, V; Mazariegos, M; Chomba, E; Pasha, O; Tshefu, A; Wallace, D; McClure, EM; Goldenberg, RL; Carlo, WA; Wright, LL; Bose, C

    2012-01-01

    Abstract Objective To assess the feasibility of using birth attendants instead of bereaved mothers as perinatal verbal autopsy respondents. Methods Verbal autopsy interviews for early neonatal deaths and stillbirths were conducted separately among mothers (reference standard) and birth attendants in 38 communities in four developing countries. Concordance between maternal and attendant responses was calculated for all questions, for categories of questions and for individual questions. The sensitivity and specificity of individual questions with the birth attendant as respondent were assessed. Findings For early neonatal deaths, concordance across all questions was 94%. Concordance was at least 95% for more than half the questions on maternal medical history, birth attendance and neonate characteristics. Concordance on any given question was never less than 80%. Sensitivity and specificity varied across individual questions, more than 80% of which had a sensitivity of at least 80% and a specificity of at least 90%. For stillbirths, concordance across all questions was 93%. Concordance was 95% or greater more than half the time for questions on birth attendance, site of delivery and stillborn characteristics. Sensitivity and specificity varied across individual questions. Over 60% of the questions had a sensitivity of at least 80% and over 80% of them had a specificity of at least 90%. Overall, the causes of death established through verbal autopsy were similar, regardless of respondent. Conclusion Birth attendants can substitute for bereaved mothers as verbal autopsy respondents. The questions in existing harmonized verbal autopsy questionnaires need further refinement, as their sensitivity and specificity differ widely. PMID:22461715

  2. CKD-EPI equation: A suitable Glomerular Filtration Rate estimate for drug dosing in HIV-infected patients.

    PubMed

    Gagneux-Brunon, A; Botelho-Nevers, E; Delanaye, P; Lucht, F; Frésard, A; Cazorla, C; Guglielminotti, C; Fafin, C; Mariat, C; Moranne, O

    2017-06-01

    To evaluate concordance between glomerular filtration rate (GFR) estimates (Cockcroft and Gault, modification of diet in renal diseases, chronic kidney disease epidemiology study group equations) for drug dosing in HIV-infected patients. We performed a monocentric study. GFR was measured using the gold standard method (plasma clearance of iohexol) in 230 HIV-infected patients. Concordance rate was evaluated between measured GFR (mGFR) and estimated GFR (eGFR) for different GFR categories (GFR>90 mL/min, GFR<90 mL/min, GFR>70 mL/min, and GFR<70 mL/min). MDRD and CKD-EPI were used with and without indexation to body surface area (BSA). Mean age was 48±10 years, mean mGFR was 101±26 mL/min. Concordance between mGFR and eGFR estimated with CG, CKD-EPI (indexed and not indexed to BSA), or MDRD equations (not indexed to BSA) was similar (73%, 73%, 74%, and 73% respectively) for a breakpoint value of 90 mL/min for GFR. At this value, the concordance rate between mGFR and MDRD indexed to BSA was significantly lower (65%, P<0.05). Using 70 mL/min of GFR as the breakpoint value, all equations had similar concordance rates with mGFR (with or without indexation to BSA). CKD-EPI equation has the same concordance with GFR and with CG when used for drug dosing. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  3. CDX2 expression is concordant between primary colorectal cancer lesions and corresponding liver metastases independent of chemotherapy: a single-center retrospective study in Japan.

    PubMed

    Shigematsu, Yasuyuki; Inamura, Kentaro; Mise, Yoshihiro; Saiura, Akio; Rehnberg, Emil; Yamamoto, Noriko; Ishikawa, Yuichi; Takahashi, Shunji; Kanda, Hiroaki

    2018-03-30

    Loss of caudal-type homeobox transcription factor 2 (CDX2) expression in colorectal cancers (CRCs) has recently been proposed as a promising predictive biomarker for not only prognosis but also response to chemotherapy. However, the relationship between alterations in CDX2 expression during cancer progression and response to chemotherapy remains unclear. We herein aimed to determine the concordance of CDX2 expression between primary CRCs and corresponding liver metastases, in association with chemotherapy. Primary CRCs exhibited heterogeneous CDX2 expression. Seven of the 144 CRCs in the cohort (4.9%, 95% confidential interval, 2.0%-9.8%) were CDX2-negative. The concordance rate of the CDX2 expression status in patients who did not receive chemotherapy was 100% ( P = 0.041), whereas the concordance rate among patients who received chemotherapy only after primary resection was 96.3% ( P = 0.005). Moreover, the concordance rate in patients who received chemotherapy before both primary resection and liver metastasectomy was 100% ( P < 0.001). CDX2 expression status was highly concordant between primary CRCs and corresponding liver metastases, independent of chemotherapy, suggesting that the CDX2 expression status in CRCs was not affected by metastasis or chemotherapy. A total of 144 consecutive patients with CRC who were treated at a single center in Japan between 2006 and 2014 were included. Formalin-fixed paraffin-embedded whole sections of surgically resected primary CRCs and corresponding liver metastases were assessed for CDX2 expression by immunohistochemistry.

  4. Evaluation of concordance among three cardiac output measurement techniques in adult patients during cardiovascular surgery postoperative care.

    PubMed

    Muñoz, L; Velandia, A; Reyes, L E; Arevalo-Rodríguez, I; Mejía, C; Asprilla, D; Uribe, D V; Arevalo, J J

    2017-12-01

    The standard method for cardiac output measuring is thermodilution although it is an invasive technique. Transesophageal Echocardiography (TEE) offers a dynamic and functional alternative to thermodilution. Analyze concordance between two TEE methods and thermodilution for cardiac output assessment. Observational concordance study in cardiovascular surgery patients that required pulmonary artery catheter. TEE cardiac output measurement at both mitral annulus (MA) and left ventricle outflow tract (LVOT) were performed. Results were compared with thermodilution. Correlation was evaluated by Lin's concordance correlation coefficient and Bland-Altman analysis. Statistical analysis was undertaken in STATA 13.0. Twenty-five patients were enrolled. Fifty two percent of patients were male, median age and ejection fraction was 63 years and 35% respectively. Median thermodilution, LVOT and MA -measured cardiac output was 3.25 L/min, 3.46 L/min and 8.4 L/min respectively. Different values between thermodilution and MA measurements were found (Lin concordance=0.071; Confidence Interval 95%=-0.009 to 0.151; Spearman's correlation=0.22) as values between thermodilution and LVOT (Lin concordance=0.232; Confidence Interval 95%=-0.12 a 0.537; Spearman's correlation 0.28). Bland-Altman analysis showed greater difference between MA measurements and thermodilution (DM=-0.408; Bland-Altman Limits=-0.809 to -0.007), than the other echocardiographic findings (DM=0.007; Bland-Altman Limits=-0.441 to 0.428). Results from cardiac output measurement by doppler and 2D-TEE on both MA and LVOT do not correlate with those obtained by thermodilution. Copyright © 2017 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  5. Evaluation of language concordant, patient-centered drug label instructions.

    PubMed

    Bailey, Stacy Cooper; Sarkar, Urmimala; Chen, Alice Hm; Schillinger, Dean; Wolf, Michael S

    2012-12-01

    Despite federal laws requiring language access in healthcare settings, most US pharmacies are unable to provide prescription (Rx) medication instructions to limited English proficient (LEP) patients in their native language. To evaluate the efficacy of health literacy-informed, multilingual Rx instructions (the ConcordantRx instructions) to improve Rx understanding, regimen dosing and regimen consolidation in comparison to standard, language-concordant Rx instructions. Randomized, experimental evaluation. Two hundred and two LEP adults speaking five non-English languages (Chinese, Korean, Russian, Spanish, Vietnamese), recruited from nine clinics and community organizations in San Francisco and Chicago. Subjects were randomized to review Rx bottles with either ConcordantRx or standard instructions. Proper demonstration of common prescription label instructions for single and multi-drug medication regimens. Regimen consolidation was assessed by determining how many times per day subjects would take medicine for a multi-drug regimen. Subjects receiving the ConcordantRx instructions demonstrated significantly greater Rx understanding, regimen dosing and regimen consolidation in comparison to those receiving standard instructions (incidence rate ratio [IRR]: 1.25, 95 % confidence interval [CI]: 1.06-1.48; P= 0.007 for Rx understanding, IRR: 1.19, 95 % CI: 1.03-1.39; P= 0.02 for regimen dosing and IRR: 0.76, 95 % CI: 0.64-0.90; P= 0.001 for regimen consolidation). In most cases, instruction type was the sole, independent predictor of outcomes in multivariate models controlling for relevant covariates. There is a need for standardized, multilingual Rx instructions that can be implemented in pharmacy practices to promote safe medication use among LEP patients. The ConcordantRx instructions represent an important step towards achieving this goal.

  6. Concordant and discordant alcohol, tobacco, and marijuana use as predictors of marital dissolution

    PubMed Central

    Leonard, Kenneth E.; Smith, Philip H.; Homish, Gregory G.

    2014-01-01

    Objective This study examined concordant and discrepant alcohol, tobacco, and marijuana use among couples to determine whether they predicted marital separation/divorce over nine years. Method The study recruited 634 couples as they applied for their marriage license and assessed them at that time, and re-assessed them with mailed questionnaires at their 1st, 2nd, 4th, 7th, and 9th anniversaries. Approximately 60% of the men and women were European-American, and approximately 1/3 were African-American. The frequency of drinking to intoxication and binge drinking (more than 5 drinks in an occasion) were assessed, as were the use of cigarettes and marijuana. At each assessment, each member of the couple was asked about the occurrence of marital separations and divorce. Results Bivariate analyses indicated that tobacco and marijuana use, whether discrepant or concordant, were associated with marital disruptions. However, discrepant heavy drinking was associated with disruptions but concordant heavy drinking was not. Concordant and discordant marijuana use were not associated with divorce when analyses controlled for alcohol and tobacco use. Concordant and discordant tobacco use was not associated with divorce when analyses controlled for sociodemographic and personality factors. However, discrepant alcohol use was related to divorce after controlling for the other substances in one analysis and after controlling for the sociodemographic factors in a separate analysis. Conclusions Tobacco and marijuana use were related to divorce through their associations with other variables. However, results suggested that discrepant alcohol use may lead to marital disruptions and should be addressed with couples seeking marital treatment. PMID:24128287

  7. The CpG island methylator phenotype is concordant between primary colorectal carcinoma and matched distant metastases.

    PubMed

    Cohen, Stacey A; Yu, Ming; Baker, Kelsey; Redman, Mary; Wu, Chen; Heinzerling, Tai J; Wirtz, Ralph M; Charalambous, Elpida; Pentheroudakis, George; Kotoula, Vassiliki; Kalogeras, Konstantine T; Fountzilas, George; Grady, William M

    2017-01-01

    The CpG island methylator phenotype (CIMP) in stage III colon cancer (CRC) has been associated with improved survival after treatment with adjuvant irinotecan-based chemotherapy. In this analysis, we determine whether CIMP status in the primary CRC is concordant with the CIMP status of matched metastases in order to determine if assessment of CIMP status in the primary tumor can be used to predict CIMP status of metastatic disease, which is relevant for patient management as well as for understanding the biology of CIMP CRCs. We assessed the CIMP status of 70 pairs of primary CRC and matched metastases using a CRC-specific panel of five markers ( CACNA1G , IGF2 , NEUROG1 , RUNX3 , and SOCS1 ) where CIMP positive was defined as 3/5 positive markers at a percent methylated reference threshold of ≥10%. Concordance was compared using the Fisher's exact test and P  < 0.05 was considered significant. Sixty-nine of the pairs (98.6%) showed concordant CIMP status in the primary tumor and matched metastasis; five (7.0%) of the pairs were concordantly CIMP positive. Only one pair (1.4%) had divergent CIMP status, demonstrating CIMP positivity (4/5 markers positive) in the primary tumor, while the matched metastasis was CIMP negative (0 markers positive). CIMP status is generally concordant between primary CRCs and matched metastases. Thus, CIMP status in the primary tumor is maintained in matched metastases and can be used to inform CIMP-based therapy options for the metastases.

  8. Perceptions of Patient-Provider Communication in Breast and Cervical Cancer-Related Care: A Qualitative Study of Low-Income English- and Spanish-Speaking Women

    PubMed Central

    Simon, Melissa A.; Ragas, Daiva M.; Nonzee, Narissa J.; Phisuthikul, Ava M.; Luu, Thanh Ha; Dong, XinQi

    2013-01-01

    To explore patient perceptions of patient-provider communication in breast and cervical cancer-related care among low-income English- and Spanish- speaking women, we examined communication barriers and facilitators reported by patients receiving care at safety net clinics. Participants were interviewed in English or Spanish after receiving an abnormal breast or cervical cancer screening test or cancer diagnosis. Following an inductive approach, interviews were coded and analyzed by the language spoken with providers and patient-provider language concordance status. Of 78 participants, 53% (n = 41) were English-speakers and 47% (n = 37) were Spanish-speakers. All English-speakers were language-concordant with providers. Of Spanish-speakers, 27% (n = 10) were Spanish-concordant; 38% (n = 14) were Spanish-discordant, requiring an interpreter; and 35% (n = 13) were Spanish mixed-concordant, experiencing both types of communication throughout the care continuum. English-speakers focused on communication barriers, and difficulty understanding jargon arose as a theme. Spanish-speakers emphasized communication facilitators related to Spanish language use. Themes among all Spanish-speaking sub-groups included appreciation for language support resources and preference for Spanish-speaking providers. Mixed-concordant participants accounted for the majority of Spanish-speakers who reported communication barriers. Our data suggest that, although perception of patient-provider communication may depend on the language spoken throughout the care continuum, jargon is lost when health information is communicated in Spanish. Further, the respective consistency of language concordance or interpretation may play a role in patient perception of patient-provider communication. PMID:23553683

  9. Spousal Concordance of Diabetes Mellitus among Women in Ajman, United Arab Emirates

    PubMed Central

    Al-Sharbatti, Shatha S.; Abed, Yasmeen I.; Al-Heety, Lujain M.; Basha, Shaikh A.

    2016-01-01

    Objectives: Spousal concordance is defined as similar behaviours and associated health statuses between spouses. This study aimed to identify the concordance of diabetes mellitus (DM) and related variables among genetically unrelated couples in Ajman, United Arab Emirates (UAE). Methods: This cross-sectional study included 270 married women attending either the Mushairef Health Center or the Gulf Medical College Hospital in Ajman between May and November 2012. A validated questionnaire was designed to determine sociodemographic characteristics and a history or family history of DM, hypertension, coronary artery disease or dyslipidaemia among the women and their husbands. The weight, height, body mass index, waist circumference, fasting blood sugar and glycated haemoglobin (HbA1c) levels of all women were measured. Results: Of the women, 39.3% of those with diabetic husbands and 39.9% of those with non-diabetic husbands were diabetic themselves (P >0.050). The prevalence of DM spousal concordance was 17.8%. A history of hypertension, coronary artery disease and dyslipidaemia was significantly more frequent among women whose husbands had a history of the same conditions (P = 0.001, 0.040 and 0.002, respectively). Spousal concordance of abnormal glycaemia among non-diabetic women with diabetic husbands was significant (P = 0.001). Having a diabetic husband (P = 0.006) and being obese (P = 0.009) were the only significant predictors of hyperglycaemia among non-diabetic women after controlling for confounding factors. Conclusion: There was significant concordance of abnormal glycaemia among non-diabetic women with diabetic husbands. The spouses of diabetic patients may therefore be a target population for regular hyperglycaemia and DM screening. PMID:27226911

  10. Spousal Concordance of Diabetes Mellitus among Women in Ajman, United Arab Emirates.

    PubMed

    Al-Sharbatti, Shatha S; Abed, Yasmeen I; Al-Heety, Lujain M; Basha, Shaikh A

    2016-05-01

    Spousal concordance is defined as similar behaviours and associated health statuses between spouses. This study aimed to identify the concordance of diabetes mellitus (DM) and related variables among genetically unrelated couples in Ajman, United Arab Emirates (UAE). This cross-sectional study included 270 married women attending either the Mushairef Health Center or the Gulf Medical College Hospital in Ajman between May and November 2012. A validated questionnaire was designed to determine sociodemographic characteristics and a history or family history of DM, hypertension, coronary artery disease or dyslipidaemia among the women and their husbands. The weight, height, body mass index, waist circumference, fasting blood sugar and glycated haemoglobin (HbA1c) levels of all women were measured. Of the women, 39.3% of those with diabetic husbands and 39.9% of those with non-diabetic husbands were diabetic themselves (P >0.050). The prevalence of DM spousal concordance was 17.8%. A history of hypertension, coronary artery disease and dyslipidaemia was significantly more frequent among women whose husbands had a history of the same conditions (P = 0.001, 0.040 and 0.002, respectively). Spousal concordance of abnormal glycaemia among non-diabetic women with diabetic husbands was significant (P = 0.001). Having a diabetic husband (P = 0.006) and being obese (P = 0.009) were the only significant predictors of hyperglycaemia among non-diabetic women after controlling for confounding factors. There was significant concordance of abnormal glycaemia among non-diabetic women with diabetic husbands. The spouses of diabetic patients may therefore be a target population for regular hyperglycaemia and DM screening.

  11. [Diagnostic concordance between seven definitions of metabolic syndrome in overweight and obese adults].

    PubMed

    Cabrera-Rode, Eduardo; Stusser, Beatriz; Cálix, Wenny; Orlandi, Neraldo; Rodríguez, Janet; Cubas-Dueñas, Ileana; Echevarría, Ragmila; Álvarez, Aimee

    2017-01-01

    The aim of this study was to determine the level of diagnostic concordance between seven definitions of metabolic syndrome (MS) in a group of overweight and obese adults. 350 subjects aged from 19 to 70 years were recruited for study from a clinic for overweight and obese subjects. The definitions of MS used were those given by the WHO (World Health Organization), EGIR (European Group for the Study of Insulin Resistance), NCEP- ATPIII (Adult Treatment Panel), AHA/NHLBI (American Heart Association), IDF (International Diabetes Federation), and JIS (Joint Interim Statement) as well as the Szabo criteria. Concordance between the definitions was calculated with the Kappa coefficient. Insulin resistance (IR) was assessed using the HOMA-IR index. According to the Szabo, WHO, EGIR, NCEP-ATPIII, AHA/NHLBI, IDF, and JIS criteria, MS frequency was 74.3%, 42.0%, 46.8%, 56.0%, 52.9%, 58.6%, and 58.6%, respectively. The concordance between the Szabo and AHA/NHLBI criteria was 0.559, while the Kappa coefficient between the Szabo criteria and the rest of the guides (NCEP-ATPIII, IDF, and JIS) was from 0.612 to 0.657, respectively. The concordance of the WHO with the EGIR was 0.602, but it was between 0.358 and 0.422 with the other guidelines. IR was distributed similarly in all guidelines. There is a considerable concordance between the NCEP-ATPIII, IDF, and JIS guidelines and the Szabo criteria. The Szabo criteria could be an option for the active surveillance of MS in populations.

  12. Concordance With Prevention Guidelines and Subsequent Cancer, Cardiovascular Disease, and Mortality: A Longitudinal Study of Older Adults.

    PubMed

    Greenlee, Heather; Strizich, Garrett; Lovasi, Gina S; Kaplan, Robert C; Biggs, Mary L; Li, Christopher I; Richardson, John; Burke, Gregory L; Fitzpatrick, Annette L; Fretts, Amanda M; Psaty, Bruce M; Fried, Linda P

    2017-11-15

    Reports on the associations between multiple clinical and behavioral health indicators and major health outcomes among older adults are scarce. We prospectively examined concordance with guidelines from the American Cancer Society and American Heart Association for disease prevention in relation to cancer, cardiovascular disease (CVD), and mortality among Cardiovascular Health Study enrollees aged 65-98 years who, at baseline assessment in 1989-1996 (n = 3,491), were free of CVD and cancer. Total and cause-specific mortality, as well as incidence of cancer and CVD, were lower with higher guideline concordance. Independent of body mass index, blood pressure, total cholesterol, and fasting plasma glucose, better health behaviors (diet, physical activity, and alcohol consumption) were associated with lower mortality (2-sided P < 0.0001). Among individuals with ideal levels for 3-4 of these 4 cardiometabolic biomarkers, those with poor concordance with health behavior recommendations had higher mortality compared with those who had the highest concordance with these behavioral recommendations (adjusted mortality hazard ratio = 1.82, 95% confidence interval: 1.25, 2.67). Older adults who are concordant with recommendations for cancer and CVD prevention have reduced rates of chronic disease and mortality. Interventions to achieve and maintain healthy lifestyle behaviors may offer benefits both in the presence and absence of adverse traditional clinical risk factors. © The Author(s) 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  13. Epilepsy in twins: insights from unique historical data of William Lennox.

    PubMed

    Vadlamudi, L; Andermann, E; Lombroso, C T; Schachter, S C; Milne, R L; Hopper, J L; Andermann, F; Berkovic, S F

    2004-04-13

    To classify the Lennox twin pairs according to modern epilepsy classifications, use the classic twin model to identify which epilepsy syndromes have an inherited component, search for evidence of syndrome-specific genes, and compare concordances from Lennox's series with a contemporary Australian series. Following review of Lennox's original files describing twins with seizures from 1934 through 1958, the International League Against Epilepsy classifications of seizures and epileptic syndromes were applied to 169 pairs. Monozygous (MZ) and dizygous (DZ) pairs were subdivided into epilepsy syndromes and casewise concordances estimated. The authors excluded 26 pairs, with 71 MZ and 72 DZ pairs remaining. Seizure analysis demonstrated strong parallels between contemporary seizure classification and Lennox's terminology. Epilepsy syndrome diagnoses were made in 75%. The MZ and DZ casewise concordance estimates gave strong evidence for a major genetic influence in idiopathic generalized epilepsies (0.80 versus 0.00; n = 23). High MZ casewise concordances also supported a genetic etiology in symptomatic generalized epilepsies and febrile seizures. The pairs who were concordant for seizures usually had the same syndromic diagnoses in both twins (86% in MZ, 60% in DZ), suggesting syndrome-specific genes. Apart from partial epilepsies, the MZ casewise concordances were similar to those derived from Australian twin data. The authors were able to apply contemporary classifications to Lennox's twins. The data confirm genetic bases for common generalized epilepsies as well as febrile seizures and provide further support for syndrome-specific genes. Finally, comparable results to our Australian series were obtained, verifying the value of twin studies.

  14. Concord grape juice reverses the age-related impairment in latent learning in rats.

    PubMed

    Smith, Jessica M; Stouffer, Eric M

    2014-02-01

    Two experiments were conducted to determine if dietary supplementation with Concord grape juice could reverse the latent learning impairment normally observed in middle-aged male rats. Both experiments utilized the latent cue preference (LCP) task, in which water-replete rats sample water in one compartment of a three-compartment box, and are subsequently given a compartment preference test when water-deprived to determine if they remember the compartment cue previously associated with water. In the first experiment, 40 male Sprague-Dawley rats (9, 10, 11, or 12 months old) were used to determine the age of onset of the impairment. In the second experiment, 24 male Sprague-Dawley rats (11 months old) were given daily access (10 ml/day) to 50% Concord grape juice, 50% white grape juice, or a calorically-equivalent sugar solution daily for 5 weeks prior to training. The first experiment revealed that the latent learning impairment begins to manifest at 10 months of age in the male rats and is fully present at 11 months. The second experiment showed that rats that consumed the 50% Concord grape juice for 5 weeks beginning at 11 months of age showed intact latent learning in the LCP task, while rats that consumed the other two supplements showed the normal impairment on the LCP task. These results indicate that daily supplementation with Concord grape juice was able to reverse the latent learning impairment normally seen in middle-aged male rats. This reversal is most likely due to the presence of flavonoids in Concord grape juice.

  15. 14. Photocopy of a drawing (original in the Collection of ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    14. Photocopy of a drawing (original in the Collection of the PL&C, Shelf 118, Drawing 236) MIDDLESEX COMPANY DAM ACROSS THE CONCORD RIVER, JULY 8, 1871 - Lowell Canal System, Merrimack & Concord Rivers, Lowell, Middlesex County, MA

  16. 15. Photocopy of a drawing (original in the Collection of ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    15. Photocopy of a drawing (original in the Collection of the PL&C, Shelf 118, Drawing 340) SECTION OF THE CONCORD RIVER DAM, AUGUST 11, 1841 - Lowell Canal System, Merrimack & Concord Rivers, Lowell, Middlesex County, MA

  17. 5. Photocopy of woodcut (from collection of New HampshireHistorical Society, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    5. Photocopy of woodcut (from collection of New HampshireHistorical Society, Concord, New Hampshire), pre 1870 VIEW SOUTHEAST SHOWING NORTH AND WEST (FRONT) ELEVATIONS - Merchants' Exchange Block, 94-102 North Main Street, Concord, Merrimack County, NH

  18. A test of concordance between patient and psychiatrist valuations of multiple treatment goals for schizophrenia

    PubMed Central

    Bridges, John F. P.; Slawik, Lara; Schmeding, Annette; Reimer, Jens; Naber, Dieter; Kuhnigk, Olaf

    2011-01-01

    Abstract Background  While much discussion has been placed on the problem of poor compliance in the treatment of schizophrenia, there has been little discussion on the concordance between patients and psychiatrists, an important contributing factor to patient‐centred care. Objective  To estimate the concordance between patients’ and psychiatrists’ (ordinal and cardinal) valuations of multiple goals for schizophrenia treatment and to illustrate the utility of the self‐explicated method in valuing a large number of treatment goals. Design  Twenty treatment goals were identified during focus groups and literature review and were presented to patients and psychiatrists during structured interviews. Respondents were asked to rank the multiple treatment goals and rate them on a 5‐point Likert scale. Three scores were calculated based on the ranking (1–20), rating (Likert scale) (1–5) and a self‐explicated method estimated as the product of rating and ranking score (1–100). Concordance was tested using Spearman’s rho for overall ordinal rankings and via anova and F‐test for the cardinal values assigned to a specific treatment goal. Participants  A total of 105 outpatients diagnosed with schizophrenia and 160 psychiatrists in Germany. Results  Patient and psychiatrist values were concordant when the ordinal properties of their valuations were assessed by rating (ρ = 0.63; P = 0.002), ranking (ρ = 0.51; P = 0.02) and self‐explicated methods (ρ = 0.54; P = 0.01). Significant discordances were found when comparing the cardinal value placed on any given treatment goal using all three approaches, but the self‐explicated method produced a more discerning statistic. Relative to patients, psychiatrists significantly (P < 0.05) overvalued reduced lack of emotion, improved sexual pleasure and improved communication while undervaluing reuptake of activities of daily living, improved satisfaction and recovered capacity for work. Conclusions  While there is an overall concordance between patients’ and psychiatrists’ valuation, significantly different valuations on specific goals can be identified. Here, psychiatrists tend to focus on ‘textbook’ outcomes, while patients are more concerned with functioning and living a normal life. This study also demonstrates the importance of comparing the concordance in treatment goals and the importance of preference‐based methods, such as the self‐explicated method, in the study of concordance. PMID:21668795

  19. Concordance of Gleason grading with three-dimensional ultrasound systematic biopsy and biopsy core pre-embedding.

    PubMed

    van der Aa, Anouk A M A; Mannaerts, Christophe K; van der Linden, Hans; Gayet, Maudy; Schrier, Bart Ph; Mischi, Massimo; Beerlage, Harrie P; Wijkstra, Hessel

    2018-02-01

    To determine the value of a three-dimensional (3D) greyscale transrectal ultrasound (TRUS)-guided prostate biopsy system and biopsy core pre-embedding method on concordance between Gleason scores of needle biopsies and radical prostatectomy (RP) specimens. Retrospective analysis of prostate biopsies and subsequent RP for PCa in the Jeroen Bosch Hospital, the Netherlands, from 2007 to 2016. Two cohorts were analysed: conventional 2D TRUS-guided biopsies and RP (2007-2013, n = 266) versus 3D TRUS-guided biopsies with pre-embedding (2013-2016, n = 129). The impact of 3D TRUS-guidance with pre-embedding on Gleason score (GS) concordance between biopsy and RP was evaluated using the κ-coefficient. Predictors of biopsy GS 6 upgrading were assessed using logistic regression models. Gleason concordance was comparable between the two cohorts with a κ = 0.44 for the 3D cohort, compared to κ = 0.42 for the 2D cohort. 3D TRUS-guidance with pre-embedding, did not significantly affect the risk of biopsy GS 6 upgrading in univariate and multivariate analysis. 3D TRUS-guidance with biopsy core pre-embedding did not improve Gleason concordance. Improved detection techniques are needed for recognition of low-grade disease upgrading.

  20. Patient-clinician ethnic concordance and communication in mental health intake visits.

    PubMed

    Alegría, Margarita; Roter, Debra L; Valentine, Anne; Chen, Chih-nan; Li, Xinliang; Lin, Julia; Rosen, Daniel; Lapatin, Sheri; Normand, Sharon-Lise; Larson, Susan; Shrout, Patrick E

    2013-11-01

    This study examines how communication patterns vary across racial and ethnic patient-clinician dyads in mental health intake sessions and its relation to continuance in treatment, defined as attending the next scheduled appointment. Observational study of communication patterns among ethnically/racially concordant and discordant patient-clinician dyads. Primary analysis included 93 patients with 38 clinicians in race/ethnic concordant and discordant dyads. Communication was coded using the Roter Interaction Analysis System (RIAS) and the Working Alliance Inventory Observer (WAI-O) bond scale; continuance in care was derived from chart reviews. Latino concordant dyad patients were more verbally dominant (p<.05), engaged in more patient-centered communication (p<.05) and scored higher on the (WAI-O) bond scale (all p<.05) than other groups. Latino patients had higher continuance rates than other patients in models that adjusted for non-communication variables. When communication, global affect, and therapeutic process variables were adjusted for, differences were reversed and white dyad patients had higher continuance in care rates than other dyad patients. Communication patterns seem to explain the role of ethnic concordance for continuance in care. Improve intercultural communication in cross cultural encounters appears significant for retaining minorities in care. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  1. Binge drinking, marijuana use, and friendships: the relationship between similar and dissimilar usage and friendship quality.

    PubMed

    Boman, John H; Stogner, John; Miller, Bryan Lee

    2013-01-01

    While it is commonly understood that the substance use of peers influences an individual's substance use, much less is understood about the interplay between substance use and friendship quality. Using a sample of 2,148 emerging adults nested within 1,074 dyadic friendships, this study separately investigates how concordance and discordance in binge drinking and marijuana use between friends is related to each friend's perceptions of friendship quality. Because "friendship quality" is a complex construct, we employ a measure containing five sub-elements--companionship, a lack of conflict, willingness to help a friend, relationship security, and closeness. Results for both binge drinking and marijuana use reveal that individuals in friendship pairs who are concordant in their substance use perceive significantly higher perceptions of friendship quality than individuals in dyads who are dissimilar in substance use. Specifically, concordant binge drinkers estimate significantly higher levels of companionship, relationship security, and willingness to help their friend than concordant non-users, discordant users, and discordant non-users. However, the highest amount of conflict in friendships is found when both friends engage in binge drinking and marijuana use. Several interpretations of these findings are discussed. Overall, concordance between friends' binge drinking and marijuana use appears to help some elements of friendship quality and harm others.

  2. Concordance Between Administrator and Clinician Ratings of Organizational Culture and Climate.

    PubMed

    Beidas, Rinad S; Williams, Nathaniel J; Green, Philip D; Aarons, Gregory A; Becker-Haimes, Emily M; Evans, Arthur C; Rubin, Ronnie; Adams, Danielle R; Marcus, Steven C

    2018-01-01

    Organizational culture and climate are important determinants of behavioral health service delivery for youth. The Organizational Social Context measure is a well validated assessment of organizational culture and climate that has been developed and extensively used in public sector behavioral health service settings. The degree of concordance between administrators and clinicians in their reports of organizational culture and climate may have implications for research design, inferences, and organizational intervention. However, the extent to which administrators' and clinicians' reports demonstrate concordance is just beginning to garner attention in public behavioral health settings in the United States. We investigated the concordance between 73 administrators (i.e., supervisors, clinical directors, and executive directors) and 247 clinicians in 28 child-serving programs in a public behavioral health system. Findings suggest that administrators, compared to clinicians, reported more positive cultures and climates. Organizational size moderated this relationship such that administrators in small programs (<466 youth clients served annually) provided more congruent reports of culture and climate in contrast to administrators in large programs (≥466 youth clients served annually) who reported more positive cultures and climates than clinicians. We propose a research agenda that examines the effect of concordance between administrators and clinicians on organizational outcomes in public behavioral health service settings.

  3. Environmental and Genetic Contributions to Indicators of Oral Malodor in Twins

    PubMed Central

    Bretz, Walter A.; Biesbrock, A.; Corby, P. M; Corby, A. L.; Bretz, W. G.; Wessel, J.; Schork, N. J.

    2011-01-01

    This study aimed to: (1) determine concordance rates of self-reported and subjectively determined indicators of oral malodor in twins; (2) determine the relative contributions of genetic and environmental factors to levels of volatile sulfur compounds (VSCs) in intraoral and exhaled breath. Fifty-one twin pairs participated in the study. Measurements of VSCs were obtained by a halimeter. The presence of tongue coatings was determined and twins filled out a 32-item questionnaire on oral malodor indicators independently of one another. Estimates of heritability (h2) for halimeter measurements were computed by SOLAR. The concordance rates for the presence of tongue coating among identical and fraternal twins were 67% and 11%, respectively. In the 10 most informative items, 70% exhibited higher concordance rates for identical than for fraternal twins. Of particular interest were the differences in concordance rates for dry mouth, sinus infection and unusual sweating. The h2 for intraoral breath was 0.28 ± 0.17 (NS), whereas the h2 for exhaled breath was 0.50 ± 0.20 (p = .0207). The concordance rates of tongue coatings and malodor indicators were higher in identical twins than in fraternal twins. Intraoral breath VSC values were primarily attributable to environmental factors, whereas exhaled breath VSC values were partially explained by genetic factors. PMID:22506313

  4. Diagnostic concordance between mobile interfaces and conventional workstations for emergency imaging assessment.

    PubMed

    Venson, José Eduardo; Bevilacqua, Fernando; Berni, Jean; Onuki, Fabio; Maciel, Anderson

    2018-05-01

    Mobile devices and software are now available with sufficient computing power, speed and complexity to allow for real-time interpretation of radiology exams. In this paper, we perform a multivariable user study that investigates concordance of image-based diagnoses provided using mobile devices on the one hand and conventional workstations on the other hand. We performed a between-subjects task-analysis using CT, MRI and radiography datasets. Moreover, we investigated the adequacy of the screen size, image quality, usability and the availability of the tools necessary for the analysis. Radiologists, members of several teams, participated in the experiment under real work conditions. A total of 64 studies with 93 main diagnoses were analyzed. Our results showed that 56 cases were classified with complete concordance (87.69%), 5 cases with almost complete concordance (7.69%) and 1 case (1.56%) with partial concordance. Only 2 studies presented discordance between the reports (3.07%). The main reason to explain the cause of those disagreements was the lack of multiplanar reconstruction tool in the mobile viewer. Screen size and image quality had no direct impact on the mobile diagnosis process. We concluded that for images from emergency modalities, a mobile interface provides accurate interpretation and swift response, which could benefit patients' healthcare. Copyright © 2018 Elsevier B.V. All rights reserved.

  5. Interlaboratory comparison of autoradiographic DNA profiling measurements: precision and concordance.

    PubMed

    Duewer, D L; Lalonde, S A; Aubin, R A; Fourney, R M; Reeder, D J

    1998-05-01

    Knowledge of the expected uncertainty in restriction fragment length polymorphism (RFLP) measurements is required for confident exchange of such data among different laboratories. The total measurement uncertainty among all Technical Working Group for DNA Analysis Methods laboratories has previously been characterized and found to be acceptably small. Casework cell line control measurements provided by six Royal Canadian Mounted Police (RCMP) and 30 U.S. commercial, local, state, and Federal forensic laboratories enable quantitative determination of the within-laboratory precision and among-laboratory concordance components of measurement uncertainty typical of both sets of laboratories. Measurement precision is the same in the two countries for DNA fragments of size 1000 base pairs (bp) to 10,000 bp. However, the measurement concordance among the RCMP laboratories is clearly superior to that within the U.S. forensic community. This result is attributable to the use of a single analytical protocol in all RCMP laboratories. Concordance among U.S. laboratories cannot be improved through simple mathematical adjustments. Community-wide efforts focused on improved concordance may be the most efficient mechanism for further reduction of among-laboratory RFLP measurement uncertainty, should the resources required to fully evaluate potential cross-jurisdictional matches become burdensome as the number of RFLP profiles on record increases.

  6. Endobronchial ultrasound elastography: a new method in endobronchial ultrasound-guided transbronchial needle aspiration.

    PubMed

    Jiang, Jun-Hong; Turner, J Francis; Huang, Jian-An

    2015-12-01

    TBNA through the flexible bronchoscope is a 37-year-old technology that utilizes a TBNA needle to puncture the bronchial wall and obtain specimens of peribronchial and mediastinal lesions through the flexible bronchoscope for the diagnosis of benign and malignant diseases in the mediastinum and lung. Since 2002, the Olympus Company developed the first generation ultrasound equipment for use in the airway, initially utilizing an ultrasound probe introduced through the working channel followed by incoroporation of a fixed linear ultrasound array at the distal tip of the bronchoscope. This new bronchoscope equipped with a convex type ultrasound probe on the tip was subsequently introduced into clinical practice. The convex probe (CP)-EBUS allows real-time endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) of mediastinal and hilar lymph nodes. EBUS-TBNA is a minimally invasive procedure performed under local anesthesia that has been shown to have a high sensitivity and diagnostic yield for lymph node staging of lung cancer. In 10 years of EBUS development, the Olympus Company developed the second generation EBUS bronchoscope (BF-UC260FW) with the ultrasound image processor (EU-M1), and in 2013 introduced a new ultrasound image processor (EU-M2) into clinical practice. FUJI company has also developed a curvilinear array endobronchial ultrasound bronchoscope (EB-530 US) that makes it easier for the operator to master the operation of the ultrasonic bronchoscope. Also, the new thin convex probe endobronchial ultrasound bronchoscope (TCP-EBUS) is able to visualize one to three bifurcations distal to the current CP-EBUS. The emergence of EBUS-TBNA has also been accompanied by innovation in EBUS instruments. EBUS elastography is, then, a new technique for describing the compliance of structures during EBUS, which may be of use in the determination of metastasis to the mediastinal and hilar lymph nodes. This article describes these new EBUS techniques and reviews the relevant literature.

  7. Evaluation of four commercial biuret reagent kits of serum total protein by the American Association for Clinical Chemistry reference measurement procedure.

    PubMed

    He, Meilin; Zhang, Jie

    2011-06-01

    In China, the traceability of clinical chemistry methods is still immature. Therefore, it is necessary to establish a reference measurement procedure and evaluate commercial reagent kits using such established procedures. We reproduced the reference measurement procedure for serum total protein, as recommended by the American Association for Clinical Chemistry (AACC). We evaluated the performance by Clinical Laboratory Standard Institute (CLSI) guidelines EP15-A and EP6-A. Subsequently, four commercial reagent kits were evaluated by the reproduced reference procedure following CLSI guideline EP9-A2. The performance of the reproduced reference procedure was as follows: CVs ranged from 0.47% to 0.85% at medical decision levels (X(c)) of 45 g/L, 60 g/L and 80 g/L. Linearity was Y=1.0022X-0.2121 (r=0.9999), and recovery ranged from 100.2% to 102.4%. The External Quality Assessment Scheme for Reference Laboratories in Laboratory Medicine (RELA) was applied, and the result was within the limit of equivalence. The linear relationships of four commercial reagent kits, Merit Choice, KHB, Leadman, and Olympus, were, respectively: Y=0.9922X+0.5776 (r=0.9961); Y=0.9936X+0.4316 (r=0.9992); Y=0.9949X+0.9129 (r=0.9987) and Y=0.9923X+0.8876 (r=0.9989). KHB showed slight negative bias, and the mean±SD was -0.03±0.60 g/L. Merit Choice, Leadman, and Olympus all showed positive bias, and the mean±SDs were 0.02±0.63 g/L, 0.55±0.77 g/L and 0.34±0.71 g/L, respectively. The correlation and bias of four commercial reagent kits for serum total protein were found to be acceptable. Thus, these reagent kits can be used reliably in China.

  8. Subcellular real-time in vivo imaging of intralymphatic and intravascular cancer-cell trafficking

    NASA Astrophysics Data System (ADS)

    McElroy, M.; Hayashi, K.; Kaushal, S.; Bouvet, M.; Hoffman, Robert M.

    2008-02-01

    With the use of fluorescent cells labeled with green fluorescent protein (GFP) in the nucleus and red fluorescent protein (RFP) in the cytoplasm and a highly sensitive small animal imaging system with both macro-optics and micro-optics, we have developed subcellular real-time imaging of cancer cell trafficking in live mice. Dual-color cancer cells were injected by a vascular route in an abdominal skin flap in nude mice. The mice were imaged with an Olympus OV100 small animal imaging system with a sensitive CCD camera and four objective lenses, parcentered and parfocal, enabling imaging from macrocellular to subcellular. We observed the nuclear and cytoplasmic behavior of cancer cells in real time in blood vessels as they moved by various means or adhered to the vessel surface in the abdominal skin flap. During extravasation, real-time dual-color imaging showed that cytoplasmic processes of the cancer cells exited the vessels first, with nuclei following along the cytoplasmic projections. Both cytoplasm and nuclei underwent deformation during extravasation. Different cancer cell lines seemed to strongly vary in their ability to extravasate. We have also developed real-time imaging of cancer cell trafficking in lymphatic vessels. Cancer cells labeled with GFP and/or RFP were injected into the inguinal lymph node of nude mice. The labeled cancer cells trafficked through lymphatic vessels where they were imaged via a skin flap in real-time at the cellular level until they entered the axillary lymph node. The bright dual-color fluorescence of the cancer cells and the real-time microscopic imaging capability of the Olympus OV100 enabled imaging the trafficking cancer cells in both blood vessels and lymphatics. With the dual-color cancer cells and the highly sensitive imaging system described here, the subcellular dynamics of cancer metastasis can now be observed in live mice in real time.

  9. Three-Dimensional Endoanal Ultrasound Features of the Anal Sphincter in Asian Primigravidae.

    PubMed

    Wickramasinghe, Dakshitha Praneeth; Senaratne, Supun; Senanayake, Hemantha; Samarasekera, Dharmabandu Nandadeva

    2018-04-17

    The normal parameters of 3-dimensional endoanal ultrasound (3DEAUS) of the anal sphincter have not been reported for primigravidae or pregnant women at present. 3DEAUS parameters in Asian primigravidae were assessed in this study. We analyzed 3DEAUS data of 101 consecutives Asian primigravidae, assessed in the early third trimester. The assessment was performed with a rigid ultrasonic probe (Olympus ® RU 12M-R1 probe and EU-ME1 ultrasound system (Olympus Corp., Shinjuku, Japan). The Wilcoxon signed-rank test was used to detect the differences in pressure in different quadrants. The participants had a mean age of 24.7 (standard deviation [SD], 5.1) years. The Cleveland Clinic Incontinence Score was normal in all participants. The anal sphincter complex had 3 characteristic segments that were identifiable: upper, middle and lower. The puborectalis muscle was identified as a striated "V"-shaped sling, and its mean thickness was 7.44 (SD, 1.41) mm. The mean thickness of internal (IAS) and external (EAS) sphincters at the mid-sphincter level were 1.78 (SD, 0.59) and 5.49 (SD, 1.21) mm, respectively. The EAS measured 6.02 (SD, 1.07) mm at the lower sphincter level. The statistically significant differences seen in the in quadrants were: the IAS was thicker anteriorly (Z = -2.642; P = .008), the EAS at both midsphincter level (Z = -3.70; P < .001) and lower sphincter level (Z = -7.712; P < .001) was thicker posteriorly, and the IAS was thicker at the 9 o'clock position (Z = -2.081; P = .037). Good symmetry at all 3 levels was seen in the EAS (including the puborectalis muscle). Normal values of 3DEAUS for primigravidae have been identified and may serve as reference values for other laboratories. © 2018 by the American Institute of Ultrasound in Medicine.

  10. Fault propagation folds induced by gravitational failure and slumping of the Central Costa Rica volcanic range: Implications for large terrestrial and Martian volcanic edifices

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

    Borgia, A.; Burr, J.; Montero, W.

    1990-08-30

    Long sublinear ridges and related scarps located at the base of large volcanic structures are frequently interpreted as normal faults associated with extensional regional stress. In contrast, the ridges bordering the Central Costa Rica volcanic range (CCRVR) are the topographic expression of hanging wall asymmetric angular anticlines overlying low-angle thrust faults at the base of the range. These faults formed by gravitational failure and slumping of the flanks of the range due to the weight of the volcanic edifices and were perhaps triggered by the intrusion of magma over the past 20,000 years. These anticlines are hypothesized to occur alongmore » the base of the volcano, where the thrust faults ramp up toward the sea bottom. Ridges and scarps between 2,000 and 5,000 m below sea level are interpreted as the topographic expression of these folds. The authors further suggest that the scarps of the CCRVR and valid scaled terrestrial analogs of the perimeter scarp of the Martian volcano Olympus Mons. They suggest that the crust below Olympus Mons has failed under the load of the volcano, triggering the radial slumping of the flanks of the volcano on basal thrusts. The thrusting would have, in turn, formed the anticlinal ridges and scarps that surround the edifice. The thrust faults may extend all the way to the base of the Martian crust (about 40 km), and they may have been active until almost the end of the volcanic activity. They suggest that gravitational failure and slumping of the flanks of volcanoes is a process common to most large volcanic edifices. In the CCRVR this slumping of the flanks is a slow intermittent process, but it could evolve to rapid massive avalanching leading to catastrophic eruptions. Thus monitoring of uplift and displacement of the folds related to the slump tectonics could become an additional effective method for mitigating volcanic hazards.« less

  11. 14 CFR 36.301 - Noise limits: Concorde.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Noise limits: Concorde. 36.301 Section 36.301 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT NOISE STANDARDS: AIRCRAFT TYPE AND AIRWORTHINESS CERTIFICATION Noise Limits for Supersonic Transport Category...

  12. 14 CFR 36.301 - Noise limits: Concorde.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Noise limits: Concorde. 36.301 Section 36.301 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT NOISE STANDARDS: AIRCRAFT TYPE AND AIRWORTHINESS CERTIFICATION Noise Limits for Supersonic Transport Category...

  13. The Concord Pavilion: A City Succeeds at Promoting the Performing Arts.

    ERIC Educational Resources Information Center

    Toffoli, John, Jr.

    1983-01-01

    The author attributes the success of the Concord Pavilion (California) to two things, marketing and experience. Experience has taught administrators to make better, more selective programing choices, and marketing has helped them to sell those programs and events. (JMK)

  14. Noise emissions and building structural vibration levels from the Supersonic Concorde and subsconic turbojet aircraft

    DOT National Transportation Integrated Search

    1975-03-01

    Noise emissions and building structural vibration levels were measured during landing and take off operations of the Anglo/French supersonic aircraft (Concorde) and from some conventional subsonic turbojet aircraft. Measurements were made at both the...

  15. CONCORDANCE OF TAXONOMIC RICHNESS PATTERNS ACROSS MULTIPLE ASSEMBLAGES IN LAKES OF THE NORTHEASTERN UNITED STATES

    EPA Science Inventory

    We investigated the concordance of taxonomic richness patterns and their environmental correlates for assemblages of benthic macroinvertebrates, riparian birds, sedimentary diatoms, fish, planktonic crustaceans, and planktonic rotifers in 186 northeastern U.S. lakes. Taxon counts...

  16. Localizing value of electrical source imaging: Frontal lobe, malformations of cortical development and negative MRI related epilepsies are the best candidates.

    PubMed

    Abdallah, Chifaou; Maillard, Louis G; Rikir, Estelle; Jonas, Jacques; Thiriaux, Anne; Gavaret, Martine; Bartolomei, Fabrice; Colnat-Coulbois, Sophie; Vignal, Jean-Pierre; Koessler, Laurent

    2017-01-01

    We aimed to prospectively assess the anatomical concordance of electric source localizations of interictal discharges with the epileptogenic zone (EZ) estimated by stereo-electroencephalography (SEEG) according to different subgroups: the type of epilepsy, the presence of a structural MRI lesion, the aetiology and the depth of the EZ. In a prospective multicentric observational study, we enrolled 85 consecutive patients undergoing pre-surgical SEEG investigation for focal drug-resistant epilepsy. Electric source imaging (ESI) was performed before SEEG. Source localizations were obtained from dipolar and distributed source methods. Anatomical concordance between ESI and EZ was defined according to 36 predefined sublobar regions. ESI was interpreted blinded to- and subsequently compared with SEEG estimated EZ. 74 patients were finally analyzed. 38 patients had temporal and 36 extra-temporal lobe epilepsy. MRI was positive in 52. 41 patients had malformation of cortical development (MCD), 33 had another or an unknown aetiology. EZ was medial in 27, lateral in 13, and medio-lateral in 34. In the overall cohort, ESI completely or partly localized the EZ in 85%: full concordance in 13 cases and partial concordance in 50 cases. The rate of ESI full concordance with EZ was significantly higher in (i) frontal lobe epilepsy (46%; p  = 0.05), (ii) cases of negative MRI (36%; p  = 0.01) and (iii) MCD (27%; p  = 0.03). The rate of ESI full concordance with EZ was not statistically different according to the depth of the EZ. We prospectively demonstrated that ESI more accurately estimated the EZ in subgroups of patients who are often the most difficult cases in epilepsy surgery: frontal lobe epilepsy, negative MRI and the presence of MCD.

  17. Procedural validity of the AUDADIS-5 depression, anxiety and post-traumatic stress disorder modules: substance abusers and others in the general population*

    PubMed Central

    Hasin, Deborah S.; Shmulewitz, Dvora; Stohl, Malka; Greenstein, Eliana; Aivadyan, Christina; Morita, Kara; Saha, Tulshi; Aharonovich, Efrat; Jung, Jeesun; Zhang, Haitao; Nunes, Edward V.; Grant, Bridget F.

    2016-01-01

    Background Little is known about the procedural validity of lay-administered, fully-structured assessments of depressive, anxiety and post-traumatic stress (PTSD) disorders in the general population as determined by comparison to clinical re-appraisal, and whether this differs between current regular substance abusers and others. We evaluated the procedural validity of the Alcohol Use Disorder and Associated Disabilities Interview Schedule, DSM-5 Version (AUDADIS-5) assessment of these disorders through clinician re-interviews. Methods Test-retest design among respondents from the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III): (264 current regular substance abusers, 447 others). Clinicians blinded to AUDADIS-5 results administered the semi-structured Psychiatric Research Interview for Substance and Mental Disorders, DSM-5 version (PRISM-5). AUDADIS-5/PRISM-5 concordance was indicated by kappa (κ) for diagnoses and intraclass correlation coefficients (ICC) for dimensional measures (DSM-5 symptom or criterion counts). Results were compared between current regular substance abusers and others. Results AUDADIS-5 and PRISM-5 concordance for DSM-5 depressive disorders, anxiety disorders and PTSD was generally fair to moderate (κ =0.24–0.59), with concordance on dimensional scales much better (ICC=0.53–0.81). Concordance differed little between regular substance abusers and others. Conclusions AUDADIS-5/PRISM-5 concordance indicated procedural validity for the AUDADIS-5 among substance abusers and others, suggesting that AUDADIS-5 diagnoses of DSM-5 depressive, anxiety and PTSD diagnoses are informative measures in both groups in epidemiologic studies. The stronger concordance on dimensional measures supports the current movement towards dimensional psychopathology measures, suggesting that such measures provide important information for research in the NESARC-III and other datasets, and possibly for clinical purposes as well. PMID:25939727

  18. Pathological diagnostic criterion of blood and lymphatic vessel invasion in colorectal cancer: a framework for developing an objective pathological diagnostic system using the Delphi method, from the Pathology Working Group of the Japanese Society for Cancer of the Colon and Rectum.

    PubMed

    Kojima, Motohiro; Shimazaki, Hideyuki; Iwaya, Keiichi; Kage, Masayoshi; Akiba, Jun; Ohkura, Yasuo; Horiguchi, Shinichiro; Shomori, Kohei; Kushima, Ryoji; Ajioka, Yoichi; Nomura, Shogo; Ochiai, Atsushi

    2013-07-01

    The goal of this study is to create an objective pathological diagnostic system for blood and lymphatic vessel invasion (BLI). 1450 surgically resected colorectal cancer specimens from eight hospitals were reviewed. Our first step was to compare the current practice of pathology assessment among eight hospitals. Then, H&E stained slides with or without histochemical/immunohistochemical staining were assessed by eight pathologists and concordance of BLI diagnosis was checked. In addition, histological findings associated with BLI having good concordance were reviewed. Based on these results, framework for developing diagnostic criterion was developed, using the Delphi method. The new criterion was evaluated using 40 colorectal cancer specimens. Frequency of BLI diagnoses, number of blocks obtained and stained for assessment of BLI varied among eight hospitals. Concordance was low for BLI diagnosis and was not any better when histochemical/immunohistochemical staining was provided. All histological findings associated with BLI from H&E staining were poor in agreement. However, observation of elastica-stained internal elastic membrane covering more than half of the circumference surrounding the tumour cluster as well as the presence of D2-40-stained endothelial cells covering more than half of the circumference surrounding the tumour cluster showed high concordance. Based on this observation, we developed a framework for pathological diagnostic criterion, using the Delphi method. This criterion was found to be useful in improving concordance of BLI diagnosis. A framework for pathological diagnostic criterion was developed by reviewing concordance and using the Delphi method. The criterion developed may serve as the basis for creating a standardised procedure for pathological diagnosis.

  19. Quality of Antiepileptic Treatment Among Older Medicare Beneficiaries With Epilepsy: A Retrospective Claims Data Analysis.

    PubMed

    Pisu, Maria; Richman, Joshua; Piper, Kendra; Martin, Roy; Funkhouser, Ellen; Dai, Chen; Juarez, Lucia; Szaflarski, Jerzy P; Faught, Edward

    2017-07-01

    Enzyme-inducing antiepileptic drugs (EI-AEDs) are not recommended for older adults with epilepsy. Quality Indicator for Epilepsy Treatment 9 (QUIET-9) states that new patients should not receive EI-AEDs as first line of treatment. In light of reported racial/ethnic disparities in epilepsy care, we investigated EI-AED use and QUIET-9 concordance across major racial/ethnic groups of Medicare beneficiaries. Retrospective analyses of 2008-2010 Medicare claims for a 5% random sample of beneficiaries 67 years old and above in 2009 augmented for minority representation. Logistic regressions examined QUIET-9 concordance differences by race/ethnicity adjusting for individual, socioeconomic, and geography factors. Epilepsy prevalent (≥1 International Classification of Disease-version 9 code 345.x or ≥2 International Classification of Disease-version 9 code 780.3x, ≥1 AED), and new (same as prevalent+no seizure/epilepsy events nor AEDs in 365 d before index event) cases. Use of EI-AEDs and QUIET-9 concordance (no EI-AEDs for the first 2 AEDs). Cases were 21% white, 58% African American, 12% Hispanic, 6% Asian, 2% American Indian/Alaskan Native. About 65% of prevalent, 43.6% of new cases, used EI-AEDs. QUIET-9 concordance was found for 71% Asian, 65% white, 61% Hispanic, 57% African American, 55% American Indian/Alaskan new cases: racial/ethnic differences were not significant in adjusted model. Beneficiaries without neurology care, in deductible drug benefit phase, or in high poverty areas were less likely to have QUIET-9 concordant care. EI-AED use is high, and concordance with recommendations low, among all racial/ethnic groups of older adults with epilepsy. Potential socioeconomic disparities and drug coverage plans may affect treatment quality and opportunities to live well with epilepsy.

  20. Pathological diagnostic criterion of blood and lymphatic vessel invasion in colorectal cancer: a framework for developing an objective pathological diagnostic system using the Delphi method, from the Pathology Working Group of the Japanese Society for Cancer of the Colon and Rectum

    PubMed Central

    Kojima, Motohiro; Shimazaki, Hideyuki; Iwaya, Keiichi; Kage, Masayoshi; Akiba, Jun; Ohkura, Yasuo; Horiguchi, Shinichiro; Shomori, Kohei; Kushima, Ryoji; Ajioka, Yoichi; Nomura, Shogo; Ochiai, Atsushi

    2013-01-01

    Aims The goal of this study is to create an objective pathological diagnostic system for blood and lymphatic vessel invasion (BLI). Methods 1450 surgically resected colorectal cancer specimens from eight hospitals were reviewed. Our first step was to compare the current practice of pathology assessment among eight hospitals. Then, H&E stained slides with or without histochemical/immunohistochemical staining were assessed by eight pathologists and concordance of BLI diagnosis was checked. In addition, histological findings associated with BLI having good concordance were reviewed. Based on these results, framework for developing diagnostic criterion was developed, using the Delphi method. The new criterion was evaluated using 40 colorectal cancer specimens. Results Frequency of BLI diagnoses, number of blocks obtained and stained for assessment of BLI varied among eight hospitals. Concordance was low for BLI diagnosis and was not any better when histochemical/immunohistochemical staining was provided. All histological findings associated with BLI from H&E staining were poor in agreement. However, observation of elastica-stained internal elastic membrane covering more than half of the circumference surrounding the tumour cluster as well as the presence of D2-40-stained endothelial cells covering more than half of the circumference surrounding the tumour cluster showed high concordance. Based on this observation, we developed a framework for pathological diagnostic criterion, using the Delphi method. This criterion was found to be useful in improving concordance of BLI diagnosis. Conclusions A framework for pathological diagnostic criterion was developed by reviewing concordance and using the Delphi method. The criterion developed may serve as the basis for creating a standardised procedure for pathological diagnosis. PMID:23592799

  1. Concordance analysis of paired cancer antigen (CA) 15-3 and 27.29 testing.

    PubMed

    Lin, David C; Genzen, Jonathan R

    2018-01-01

    Cancer antigens (CA) 15-3 and 27.29 are used in the clinical management of many breast cancer patients. Given that immunoassays for CA 15-3 and CA 27.29 target epitopes on the same glycoprotein-Mucin 1 (MUC1)-the present analysis was conducted to evaluate the potential concordance of tumor marker results when both tests were ordered by providers on the same specimens. A retrospective limited dataset of paired CA 15-3 (Roche Diagnostics) and CA 27.29 (Siemens Diagnostics) test results was obtained from a national clinical reference laboratory. Concordance according to reference interval (RI) status and percent (%) change between consecutive test results was analyzed. 37,652 paired results from 12,470 distinct patients were obtained. The correlation between CA 15-3 and CA 27.29 results was high (correlation coefficient: Pearson, 0.967), although across the dataset a significant difference between CA 15-3 and CA 27.29 results was observed (P < 0.05). RI concordance between CA 15-3 and CA 27.29 results was observed in 93.7% of pairs (35,280 of 37,652). Correlation was also observed in the % change of CA 15-3 and CA 27.29 results between consecutive specimens for individual patients. Using doubling or halving thresholds (i.e., 100% increase or 50% decrease), concordance in % change was observed between CA 15-3 and CA 27.29 in approximately 90% of cases. Individual patient results trended similarly across both markers over time. While generally concordant, CA 15-3 and CA 27.29 results should not be used interchangeably. The present report provides no evidence for added value in performing both tests routinely for individual patients.

  2. Surgical site infections among high-risk patients in clean-contaminated head and neck reconstructive surgery: concordance with preoperative oral flora.

    PubMed

    Yang, Ching-Hsiang; Chew, Khong-Yik; Solomkin, Joseph S; Lin, Pao-Yuan; Chiang, Yuan-Cheng; Kuo, Yur-Ren

    2013-12-01

    Salivary contamination of surgical wounds in clean-contaminated head and neck surgery with free flap reconstruction remains a major cause of infection and leads to significant morbidity. This study investigates the correlation between intraoral flora and surgical site infections (SSIs) among high-risk head and neck cancer patients undergoing resection and free flap reconstruction. One hundred twenty-nine patients were identified as being at high risk for infective complications based on cancer stage, tumor size, comorbid factors, and extent of reconstruction. All patients had intraoral swab cultures before surgery. Patients with culture-confirmed SSI after surgery were chosen for analysis, using the κ index and its 95% confidence interval for concordance analysis. All patients received clindamycin and gentamicin for antibiotic prophylaxis for 5 days. Antibiotic susceptibility testing of all isolates was obtained and analyzed. Thirty-seven patients experienced SSI, or an infection rate of 28.3%, occurring at a mean of 9.3 postoperative days. The overall concordance between oral flora and SSI was fair to moderate (κ index of 0.25), but detailed analysis shows a higher concordance for known and opportunistic pathogens, such as Pseudomonas aeruginosa and Enterococcus faecalis, compared to typical oral commensals. Antibiotic susceptibility tests show rapid and significant increases in resistance to clindamycin, indicating a need for a more effective alternative. Predicting pathogens in SSI using preoperative oral swabs did not demonstrate a good concordance in general for patients undergoing clean-contaminated head and neck surgery, although concordance for certain pathogenic species seem to be higher than for typical intraoral commensals. The rapid development of resistance to clindamycin precludes its use as a prophylactic agent.

  3. Fasting plasma total ghrelin concentrations in monozygotic twins discordant for obesity.

    PubMed

    Leskelä, Piia; Ukkola, Olavi; Vartiainen, Johanna; Rönnemaa, Tapani; Kaprio, Jaakko; Bouchard, Claude; Kesäniemi, Y Antero

    2009-02-01

    Ghrelin is a hormone that is involved in the regulation of food intake. Neuronal, endocrine, and genetic factors have been shown to regulate plasma ghrelin levels; but the determinants of fasting ghrelin concentrations are not yet fully understood. The main aim was to explore the roles of adiposity and genetic differences in determining fasting plasma total ghrelin levels. We measured total ghrelin levels in a population of 23 monozygotic twin pairs discordant for obesity. In addition, 2 variants of ghrelin gene, namely, Arg51Gln and Leu72Met, were genotyped in 3 populations of monozygotic twin pairs: 23 obesity-discordant, 43 lean-concordant, and 46 obesity-concordant twin pairs. In discordant twins, lean co-twins had higher fasting plasma total ghrelin levels (950 pg/mL, SD = 328 pg/mL) than obese twins (720 pg/mL, SD = 143 pg/mL; P = .003). Arg51Gln-polymorphism of the ghrelin gene was equally distributed between the twin groups. However, there were significant differences in genotype frequencies at the Leu72Met polymorphism between the discordant and obese-concordant groups (P = .003) and between the discordant and lean-concordant groups (P = .011), but not between the 2 concordant groups. In the discordant group, there were fewer Met carriers (4%) than among the obese (17%) or the lean-concordant groups (15%). Plasma total ghrelin levels are affected by acquired obesity independent of genetic background. The Leu72 allele is particularly common among monozygotic twins discordant for obesity, suggesting that this ghrelin allele is more permissive in the regulation of energy balance. The ghrelin gene may thus play a role in the regulation of variability of body weight, such that Leu72 allele carriers are more prone to weight variability in response to environmental factors.

  4. Health and Nutrition Literacy and Adherence to Treatment in Children, Adolescents, and Young Adults With Chronic Kidney Disease and Hypertension, North Carolina, 2015

    PubMed Central

    Ferris, Maria; Rak, Eniko

    2016-01-01

    Introduction Adherence to treatment and dietary restrictions is important for health outcomes of patients with chronic/end-stage kidney disease and hypertension. The relationship of adherence with nutritional and health literacy in children, adolescents, and young adults is not well understood. The current study examined the relationship of health literacy, nutrition knowledge, nutrition knowledge–behavior concordance, and medication adherence in a sample of children and young people with chronic/end-stage kidney disease and hypertension. Methods We enrolled 74 patients (aged 7–29 y) with a diagnosis of chronic/end-stage kidney disease and hypertension from the University of North Carolina Kidney Center. Participants completed instruments of nutrition literacy (Disease-Specific Nutrition Knowledge Test), health literacy (Newest Vital Sign), nutrition behavior (Nutrition Knowledge–Behavior Concordance Scale), and medication adherence (Morisky Medication Adherence Scale). Linear and binary logistic regressions were used to test the associations. Results In univariate comparisons, nutrition knowledge was significantly higher in people with adequate health literacy. Medication adherence was related to nutrition knowledge and nutrition knowledge–behavior concordance. Multivariate regression models demonstrated that knowledge of disease-specific nutrition restrictions did not significantly predict nutrition knowledge–behavior concordance scores. In logistic regression, knowledge of nutrition restrictions did not significantly predict medication adherence. Lastly, health literacy and nutrition knowledge–behavior concordance were significant predictors of medication adherence. Conclusion Nutrition knowledge and health literacy skills are positively associated. Nutrition knowledge, health literacy, and nutrition knowledge–behavior concordance are positively related to medication adherence. Future research should focus on additional factors that may predict disease-specific nutrition behavior (adherence to dietary restrictions) in children and young people with chronic conditions. PMID:27490366

  5. Discordant changes in plasma ACTH and beta-lipotropin/beta-endorphin levels in Cushing's disease patients with depression.

    PubMed

    Starkman, M N; Schteingart, D E; Schork, M A

    1992-11-01

    Cushing's Disease is often associated with a depressive syndrome, with mood, vegetative, and cognitive abnormalities of variable severity. In 11 patients with (pituitary ACTH-dependent) Cushing's disease (10 women, 1 man), we studied the relationship between severity of the depressive syndrome and concordance of changes in ACTH and beta-lipotropin/beta-endorphin (beta-LPH/beta-E) levels at baseline and in response to metyrapone and dexamethasone. For each condition, blood samples were drawn at 0800h, 1200h, 1600h, and 2200h. Six patients were categorized as mildly depressed (mean [+/- SD] depressed mood score = 0.17 +/- 0.4; modified Hamilton Depression scale score = 7.6 +/- 4.5) and five as severely depressed (mean depressed mood score = 2.4 +/- 0.5; modified Hamilton Depression scale score = 15 +/- 5.6) (p < 0.05). ACTH and beta-LPH/beta-E were measured by radioimmunoassay. For each experimental condition, changes in levels were scored as concordant if the two peptides moved in parallel between sampling points. There was a relationship between greater severity of depression and more frequent discordant changes in ACTH and beta-LPH/beta-E levels: The six patients with mild depression exhibited 23 concordant and 3 discordant change patterns, while the five patients with severe depression showed 8 concordant and 15 discordant patterns. The mean percentage of concordant patterns per patient differed significantly between the two groups (mildly depressed = 90.0 +/- 16.7; severely depressed = 34.6 +/- 8.7 (p < 0.001). When each study condition was examined separately, differences in the frequency of concordance between the groups reached significance during the post-metyrapone phase and with 8.0 mg dexamethasone administration.(ABSTRACT TRUNCATED AT 250 WORDS)

  6. Attitudes toward concordance in psychiatry: a comparative, cross-sectional study of psychiatric patients and mental health professionals

    PubMed Central

    2012-01-01

    Background Concordance and Shared Decision-Making (SDM) are considered measures of the quality of care that improves communication, promotes patient participation, creates a positive relationship with the healthcare professional, and results in greater adherence with the treatment plan. Methods This study compares the attitudes of 225 mental health professionals (125 psychiatrists and 100 psychiatry registrars) and 449 psychiatric outpatients towards SDM and concordance in medicine taking by using the "Leeds Attitude toward Concordance Scale" (LATCon). Results The internal consistency of the scale was good in all three samples (Cronbach's α: patients = 0.82, psychiatrists = 0.76, and registrars = 0.82). Patients scored significantly lower (1.96 ± 0.48) than professionals (P < .001 in both cases), while no statistically significant differences between psychiatrists (2.32 ± 0.32) and registrars (2.23 ± 0.35) were registered; the three groups showed a positive attitude towards concordance in most indicators. Patients are clearly in favor of being informed and that their views and preferences be taken into account during the decision-making process, although they widely consider that the final decision must be the doctor's responsibility. Among mental health professionals, the broader experience provides a greater conviction of the importance of the patient's decision about treatment. Conclusions We observed a positive attitude towards concordance in the field of psychotropic drugs prescription both in professionals and among patients, but further studies are needed to address the extent to which this apparently accepted model is reflected in the daily practice of mental health professionals. PMID:22646974

  7. Guidelines-concordant empiric antimicrobial therapy and mortality in patients with severe community-acquired pneumonia requiring mechanical ventilation.

    PubMed

    Sakamoto, Yukiyo; Yamauchi, Yasuhiro; Yasunaga, Hideo; Takeshima, Hideyuki; Hasegawa, Wakae; Jo, Taisuke; Matsui, Hiroki; Fushimi, Kiyohide; Nagase, Takahide

    2017-01-01

    Community-acquired pneumonia (CAP) has high morbidity and mortality among adults. Several clinical guidelines recommend prompt administration of combined antimicrobial therapy. However, the association between guidelines concordance and mortality in patients with severe pneumonia remains unclear. The present study aimed to examine the impact of guidelines-concordant empiric antimicrobial therapy on 7-day mortality in patients with extremely severe pneumonia who required mechanical ventilation at admission, using a nationwide inpatient database in Japan. Data of CAP patients aged over 20 years who required mechanical ventilation at admission between April 2012 and March 2014 were retrospectively analyzed. Multivariable logistic regression analysis was performed to examine the association between guidelines-concordant empiric antimicrobial therapy and all-cause 7-day mortality, with adjustment for patient backgrounds and pneumonia severity. There were a total of 3719 eligible patients, 836 (22.5%) of whom received guidelines-concordant combination therapy. Overall, 7-day mortality was 29.5%. Higher 7-day mortality was associated with advanced age, confusion, lower systolic blood pressure, malignant tumor or immunocompromised state, and C-reactive protein ≥20mg/dl or infiltration occupying two-thirds of one lung on chest radiography. After adjustment for these variables, guidelines-concordant combined antimicrobial therapy was associated with significantly lower 7-day mortality (odds ratio: 0.78; 95% confidence interval: 0.65-0.95; P=0.013). Adherence to initial empiric treatment as recommended by the guidelines was associated with better short-term prognosis in patients with extremely severe pneumonia who required mechanical ventilation on hospital admission. Copyright © 2016 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved.

  8. Familial intracranial aneurysms: is anatomic vulnerability heritable?

    PubMed

    Mackey, Jason; Brown, Robert D; Moomaw, Charles J; Hornung, Richard; Sauerbeck, Laura; Woo, Daniel; Foroud, Tatiana; Gandhi, Dheeraj; Kleindorfer, Dawn; Flaherty, Matthew L; Meissner, Irene; Anderson, Craig; Rouleau, Guy; Connolly, E Sander; Deka, Ranjan; Koller, Daniel L; Abruzzo, Todd; Huston, John; Broderick, Joseph P

    2013-01-01

    Previous studies have suggested that family members with intracranial aneurysms (IAs) often harbor IAs in similar anatomic locations. IA location is important because of its association with rupture. We tested the hypothesis that anatomic susceptibility to IA location exists using a family-based IA study. We identified all affected probands and first-degree relatives (FDRs) with a definite or probable phenotype in each family. We stratified each IA of the probands by major arterial territory and calculated each family's proband-FDR territory concordance and overall contribution to the concordance analysis. We then matched each family unit to an unrelated family unit selected randomly with replacement and performed 1001 simulations. The median concordance proportions, odds ratios (ORs), and P values from the 1001 logistic regression analyses were used to represent the final results of the analysis. There were 323 family units available for analysis, including 323 probands and 448 FDRs, with a total of 1176 IAs. IA territorial concordance was higher in the internal carotid artery (55.4% versus 45.6%; OR, 1.54 [1.04-2.27]; P=0.032), middle cerebral artery (45.8% versus 30.5%; OR, 1.99 [1.22-3.22]; P=0.006), and vertebrobasilar system (26.6% versus 11.3%; OR, 2.90 [1.05-8.24], P=0.04) distributions in the true family compared with the comparison family. Concordance was also higher when any location was considered (53.0% versus 40.7%; OR, 1.82 [1.34-2.46]; P<0.001). In a highly enriched sample with familial predisposition to IA development, we found that IA territorial concordance was higher when probands were compared with their own affected FDRs than with comparison FDRs, which suggests that anatomic vulnerability to IA formation exists. Future studies of IA genetics should consider stratifying cases by IA location.

  9. Concordance and discordance between measured and perceived balance and the effect on gait speed and falls following stroke

    PubMed Central

    Liphart, Jodi; Gallichio, Joann; Tilson, Julie K; Pei, Qinglin; Wu, Samuel S; Duncan, Pamela W

    2016-01-01

    Objective To ascertain the existence of discordance between perceived and measured balance in persons with stroke and to examine the impact on walking speed and falls. Design A secondary analysis of a phase three, multicentered randomized controlled trial examining walking recovery following stroke. Subjects A total of 352 participants from the Locomotor Experience Applied Post-Stroke (LEAPS) trial. Methods Participants were categorized into four groups: two concordant and two discordant groups in relation to measured and perceived balance. Number and percentage of individuals with concordance and discordance were evaluated at two and 12 months. Walking speed and fall incidence between groups were examined. Main measures Perceived balance was measured by the Activity-specific Balance Confidence scale, measured balance was determined by the Berg Balance Scale and gait speed was measured by the 10-meter walk test. Results Discordance was present for 35.8% of participants at two months post-stroke with no statistically significant change in proportion at 12 months. Discordant participants with high perceived balance and low measured balance walked 0.09 m/s faster at two months than participants with concordant low perceived and measured balance (p < 0.05). Discordant participants with low perceived balance and high measured balance walked 0.15 m/s slower than those that were concordant with high perceived and measured balance (p ⩽ 0.0001) at 12 months. Concordant participants with high perceived and measured balance walked fastest and had fewer falls. Conclusions Discordance existed between perceived and measured balance in one-third of individuals at two and 12 months post-stroke. Perceived balance impacted gait speed but not fall incidence. PMID:25810426

  10. The concordance between self-reported medication use and pharmacy records in pregnant women.

    PubMed

    Cheung, K; El Marroun, H; Elfrink, M E; Jaddoe, V W V; Visser, L E; Stricker, B H Ch

    2017-09-01

    Several studies have been conducted to assess determinants affecting the performance or accuracy of self-reports. These studies are often not focused on pregnant women, or medical records were used as a data source where it is unclear if medications have been dispensed. Therefore, our objective was to evaluate the concordance between self-reported medication data and pharmacy records among pregnant women and its determinants. We conducted a population-based cohort study within the Generation R study, in 2637 pregnant women. The concordance between self-reported medication data and pharmacy records was calculated for different therapeutic classes using Yule's Y. We evaluated a number of variables as determinant of discordance between both sources through univariate and multivariate logistic regression analysis. The concordance between self-reports and pharmacy records was moderate to good for medications used for chronic conditions, such as selective serotonin reuptake inhibitors or anti-asthmatic medications (0.88 and 0.68, respectively). Medications that are used occasionally, such as antibiotics, had a lower concordance (0.51). Women with a Turkish or other non-Western background were more likely to demonstrate discordance between pharmacy records and self-reported data compared with women with a Dutch background (Turkish: odds ratio, 1.63; 95% confidence interval, 1.16-2.29; other non-Western: odds ratio, 1.33; 95% confidence interval, 1.03-1.71). Further research is needed to assess how the cultural or ethnic differences may affect the concordance or discordance between both medication sources. The results of this study showed that the use of multiple sources is needed to have a good estimation of the medication use during pregnancy. Copyright © 2017 John Wiley & Sons, Ltd.

  11. Can multidetector CT detect the site of gastrointestinal tract injury in trauma? – A retrospective study

    PubMed Central

    Panda, Ananya; Kumar, Atin; Gamanagatti, Shivanand; Das, Ranjita; Paliwal, Swati; Gupta, Amit; Kumar, Subodh

    2017-01-01

    PURPOSE We aimed to assess the performance of computed tomography (CT) in localizing site of traumatic gastrointestinal tract (GIT) injury and determine the diagnostic value of CT signs in site localization. METHODS CT scans of 97 patients with surgically proven GIT or mesenteric injuries were retrospectively reviewed by radiologists blinded to surgical findings. Diagnosis of either GIT or mesenteric injuries was made. In patients with GIT injuries, site of injury and presence of CT signs such as focal bowel wall hyperenhancement, hypoenhancement, wall discontinuity, wall thickening, extramural air, intramural air, perivisceral infiltration, and active vascular contrast leak were evaluated. RESULTS Out of 97 patients, 90 had GIT injuries (70 single site injuries and 20 multiple site injuries) and seven had isolated mesenteric injury. The overall concordance between CT and operative findings for exact site localization was 67.8% (61/90), partial concordance rate was 11.1% (10/90), and discordance rate was 21.1% (19/90). For single site localization, concordance rate was 77.1% (54/70), discordance rate was 21.4% (15/70), and partial concordance rate was 1.4% (1/70). In multiple site injury, concordance rate for all sites of injury was 35% (7/20), partial concordance rate was 45% (9/20), and discordance rate was 20% (4/20). For upper GIT injuries, wall discontinuity was the most accurate sign for localization. For small bowel injury, intramural air and hyperenhancement were the most specific signs for site localization, while for large bowel injury, wall discontinuity and hypoenhancement were the most specific signs. CONCLUSION CT performs better in diagnosing small bowel injury compared with large bowel injury. CT can well predict the presence of multiple site injury but has limited performance in exact localization of all injury sites. PMID:27924777

  12. 47 CFR 73.622 - Digital television table of allotments.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 44c Coalinga *22 Concord 63c Corona 39 Cotati *23c El Centro 22, 48 Eureka *11, 16, 17, 28 Fort Bragg..., 43 Clovis 43 Concord 14 Corona 39 Cotati *23 El Centro 9, 22 Eureka 3, *11, 17, 28 Fort Bragg 8...

  13. 47 CFR 73.622 - Digital television table of allotments.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 44c Coalinga *22 Concord 63c Corona 39 Cotati *23c El Centro 22, 48 Eureka *11, 16, 17, 28 Fort Bragg..., 43 Clovis 43 Concord 14 Corona 39 Cotati *23 El Centro 9, 22 Eureka 3, *11, 17, 28 Fort Bragg 8...

  14. Calibration of the Concorde radiation detection instrument and measurements at SST altitude.

    DOT National Transportation Integrated Search

    1971-06-01

    Performance tests were carried out on a solar cosmic radiation detection instrument developed for the Concorde SST. The instrument calibration curve (log dose-rate vs instrument reading) was reasonably linear from 0.004 to 1 rem/hr for both gamma rad...

  15. Concordance between Preservice Teachers' Personal Responsibilities and Intended Instructional Practices

    ERIC Educational Resources Information Center

    Daniels, Lia M.; Radil, Amanda; Wagner, Amanda K.

    2016-01-01

    During their education, preservice teachers begin to assume professional responsibilities and gain pedagogical knowledge. However, the question remains whether preservice teachers intend to use instructional practices that are effective in meeting their assumed responsibilities. Thus, we examined the concordance between preservice teachers'…

  16. Concordance Between Patient and Family Reports of Family Functioning in Bipolar I Disorder and Major Depressive Disorder

    PubMed Central

    Weinstock, Lauren M.; Wenze, Susan J.; Munroe, Mary K.; Miller, Ivan W.

    2013-01-01

    Despite the extensive literature on family functioning and mood disorders, less is known about concordance between patient- and family-reported family functioning. To address this question, adults with bipolar I disorder (BD; n = 92), major depressive disorder (MDD; n = 121), and their family members (ns = 135 and 201, respectively) were recruited from hospital sources. All patients and their family members completed the Family Assessment Device (Epstein et al., 1983). Intraclass correlation coefficients revealed that, in contrast to the moderate degree of concordance in the MDD sample, degree of concordance between patient- and family-reported family functioning was significantly weaker in BD. Subsequent analysis revealed that this discordance was driven by the reports of the child and young adolescent family members of the patients with BD. Results highlight the importance of collateral reports in the assessment of family functioning, especially among families of patients with BD, in research and treatment. PMID:23588224

  17. Concordance and acceptability of electric stimulation therapy: a randomised controlled trial.

    PubMed

    Miller, C; McGuiness, W; Wilson, S; Cooper, K; Swanson, T; Rooney, D; Piller, N; Woodward, M

    2017-08-02

    A pilot single-blinded randomised controlled trial (RCT) was conducted to examine concordance with and acceptability of electric stimulation therapy (EST) in patients with venous leg ulcers (VLUs) who had not tolerated moderate to high compression. Participants were randomised to the intervention group (n=15) or a placebo control group (n=8) in which EST was used four times daily for 20 minutes per session. Participants were monitored for eight weeks during which time concordance with the treatment and perceptions of the treatment were assessed. Concordance with the total recommended treatment time was 71.4% for the intervention group and 82.9% for the control group; a difference that was not statistically significant. Participants rated EST as acceptable (84.6% intervention; 83.3% control), only two participants, both from the placebo control group, would not be willing to use EST again. The majority considered EST easier to use than compression (68.4%). EST was a practical and acceptable treatment among people who have been unable to tolerate moderate to high compression therapy.

  18. Comparison of sequencing-based methods to profile DNA methylation and identification of monoallelic epigenetic modifications

    PubMed Central

    Harris, R. Alan; Wang, Ting; Coarfa, Cristian; Nagarajan, Raman P.; Hong, Chibo; Downey, Sara L.; Johnson, Brett E.; Fouse, Shaun D.; Delaney, Allen; Zhao, Yongjun; Olshen, Adam; Ballinger, Tracy; Zhou, Xin; Forsberg, Kevin J.; Gu, Junchen; Echipare, Lorigail; O’Geen, Henriette; Lister, Ryan; Pelizzola, Mattia; Xi, Yuanxin; Epstein, Charles B.; Bernstein, Bradley E.; Hawkins, R. David; Ren, Bing; Chung, Wen-Yu; Gu, Hongcang; Bock, Christoph; Gnirke, Andreas; Zhang, Michael Q.; Haussler, David; Ecker, Joseph; Li, Wei; Farnham, Peggy J.; Waterland, Robert A.; Meissner, Alexander; Marra, Marco A.; Hirst, Martin; Milosavljevic, Aleksandar; Costello, Joseph F.

    2010-01-01

    Sequencing-based DNA methylation profiling methods are comprehensive and, as accuracy and affordability improve, will increasingly supplant microarrays for genome-scale analyses. Here, four sequencing-based methodologies were applied to biological replicates of human embryonic stem cells to compare their CpG coverage genome-wide and in transposons, resolution, cost, concordance and its relationship with CpG density and genomic context. The two bisulfite methods reached concordance of 82% for CpG methylation levels and 99% for non-CpG cytosine methylation levels. Using binary methylation calls, two enrichment methods were 99% concordant, while regions assessed by all four methods were 97% concordant. To achieve comprehensive methylome coverage while reducing cost, an approach integrating two complementary methods was examined. The integrative methylome profile along with histone methylation, RNA, and SNP profiles derived from the sequence reads allowed genome-wide assessment of allele-specific epigenetic states, identifying most known imprinted regions and new loci with monoallelic epigenetic marks and monoallelic expression. PMID:20852635

  19. Concordance between patient and family reports of family functioning in bipolar I disorder and major depressive disorder.

    PubMed

    Weinstock, Lauren M; Wenze, Susan J; Munroe, Mary K; Miller, Ivan W

    2013-05-01

    Despite the extensive literature on family functioning and mood disorders, less is known about concordance between patient- and family-reported family functioning. To address this question, adults with bipolar I disorder (BD; n = 92) or major depressive disorder (MDD; n = 121) and their family members (n = 135 and 201, respectively) were recruited from hospital sources. All patients and their family members completed the Family Assessment Device (Epstein, Baldwin, Bishop. J Marital Fam Ther. 9:171-180, 1983). Intraclass correlation coefficients revealed that, in contrast to the moderate degree of concordance in the MDD sample, degree of concordance between patient- and family-reported family functioning was significantly weaker in BD. Subsequent analysis revealed that this discordance was driven by the reports of the child and young adolescent family members of the patients with BD. Results highlight the importance of collateral reports in the assessment of family functioning, especially among families of patients with BD, in research and treatment.

  20. Embodied simulation as part of affective evaluation processes: task dependence of valence concordant EMG activity.

    PubMed

    Weinreich, André; Funcke, Jakob Maria

    2014-01-01

    Drawing on recent findings, this study examines whether valence concordant electromyography (EMG) responses can be explained as an unconditional effect of mere stimulus processing or as somatosensory simulation driven by task-dependent processing strategies. While facial EMG over the Corrugator supercilii and the Zygomaticus major was measured, each participant performed two tasks with pictures of album covers. One task was an affective evaluation task and the other was to attribute the album covers to one of five decades. The Embodied Emotion Account predicts that valence concordant EMG is more likely to occur if the task necessitates a somatosensory simulation of the evaluative meaning of stimuli. Results support this prediction with regard to Corrugator supercilii in that valence concordant EMG activity was only present in the affective evaluation task but not in the non-evaluative task. Results for the Zygomaticus major were ambiguous. Our findings are in line with the view that EMG activity is an embodied part of the evaluation process and not a mere physical outcome.

  1. [Evaluation of Gastric Atrophy. Comparison between Sidney and OLGA Systems].

    PubMed

    Ramírez-Mendoza, Pablo; González-Angulo, Jorge; Angeles-Garay, Ulises; Segovia-Cueva, Gustavo Adolfo

    2008-01-01

    histopathologic identification of atrophy and metaplasia is decisive to stop the way of gastritis?carcinoma in patients with chronic gastritis. to compare diagnostic concordance between Sidney system and the operative Link on Gastritis Assessment (OLGA) system. 120 consecutive biopsies were analyzed by general pathologists according to the Sidney system. All of them were evaluated by a second pathologist who used OLGA System. We employed kappa index to evaluate diagnostic concordance between the classifications. the clinical picture includes dyspepsia (94 %), abdominal pain (50 %), gastroesophageal reflux (30 %), bleed of the upper digestive system (24 %), and presence of Helicobacter pylori (47.5 %). Four were diagnosed as atrophy by Sidney system and 26 cases with atrophy by OLGA system. The concordance between two classifications systems was too low (p = 0.05). the atrophy diagnosis, between systems, had low concordance. The description of metaplastic atrophy in the OLGA system represents the only one difference. The non-metaplastic atrophy is the same for both classifications. Therefore, the general pathologist should include this evaluation more consistently using OLGA system.

  2. [Low concordance between primary care and hospital clinical information].

    PubMed

    Revilla-López, Concha; Calderón-Larrañaga, Amaia; Enríquez-Martín, Natalia; Prados-Torres, Alexandra

    2016-04-01

    To measure the diagnostic agreement between Primary Care (PC) and hospital information systems, in order to assess the usefulness of health care records for research purposes. Cross-sectional retrospective study integrating PC and hospital diagnostic information for the Aragon population admitted to hospital in 2010. 75.176 patients were analysed. Similarities, differences and the kappa index were calculated for each of the diagnoses recorded in both information systems. The studied diseases included COPD, diabetes, hypertension, cerebrovascular disease, ischaemic heart disease, asthma, epilepsy, and heart failure. Diagnostic concordance was higher in men and between 45 and 64 years. Diabetes was the condition showing the highest concordance (kappa index: 0.75), while asthma had the lowest values (kappa index: 0.34). The low concordance between the diagnostic information recorded in PC and in the hospital setting calls for urgent measures to ensure that healthcare professionals have a comprehensive picture of patient's health problems. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  3. Concordance between macrophytes and macroinvertebrates in a Mediterranean river of central Apennine region.

    PubMed

    Traversetti, Lorenzo; Scalici, Massimiliano; Ginepri, Valeria; Manfrin, Alessandro; Ceschin, Simona

    2014-05-01

    The main aim of this study was to improve the knowledge about the concordance among macrophytes and macroinvertebrates to provide complementary information and facilitate the procedures for quality assessment of river ecosystems. Macrophytes and macroinvertebrates were collected in 11 sampling sites along a central Apennine calcareous river in October 2008 and June 2009. The concordance between the two biomonitoring groups was tested according to several environmental parameters. The comparison of data matrix similarities by Mantel test showed differences in the assemblage of macrophytes and macroinvertebrates along the river since correlation values were 0.04, p > 0.05 in October 2008 and 0.39, p > 0.05 in June 2009. The study revealed lack of concordance between the two groups, emphasizing that the information provided by macrophytes and macroinvertebrates does not overlap in terms of response to environmental parameters. Indeed, the two different biological groups resulted useful descriptors of different parameters. Together, they could represent a complementary tool to reflect the river environmental quality.

  4. Strengths and Weaknesses of Global Positioning System (GPS) Data-Loggers and Semi-structured Interviews for Capturing Fine-scale Human Mobility: Findings from Iquitos, Peru

    PubMed Central

    Paz-Soldan, Valerie A.; Reiner, Robert C.; Morrison, Amy C.; Stoddard, Steven T.; Kitron, Uriel; Scott, Thomas W.; Elder, John P.; Halsey, Eric S.; Kochel, Tadeusz J.; Astete, Helvio; Vazquez-Prokopec, Gonzalo M.

    2014-01-01

    Quantifying human mobility has significant consequences for studying physical activity, exposure to pathogens, and generating more realistic infectious disease models. Location-aware technologies such as Global Positioning System (GPS)-enabled devices are used increasingly as a gold standard for mobility research. The main goal of this observational study was to compare and contrast the information obtained through GPS and semi-structured interviews (SSI) to assess issues affecting data quality and, ultimately, our ability to measure fine-scale human mobility. A total of 160 individuals, ages 7 to 74, from Iquitos, Peru, were tracked using GPS data-loggers for 14 days and later interviewed using the SSI about places they visited while tracked. A total of 2,047 and 886 places were reported in the SSI and identified by GPS, respectively. Differences in the concordance between methods occurred by location type, distance threshold (within a given radius to be considered a match) selected, GPS data collection frequency (i.e., 30, 90 or 150 seconds) and number of GPS points near the SSI place considered to define a match. Both methods had perfect concordance identifying each participant's house, followed by 80–100% concordance for identifying schools and lodgings, and 50–80% concordance for residences and commercial and religious locations. As the distance threshold selected increased, the concordance between SSI and raw GPS data increased (beyond 20 meters most locations reached their maximum concordance). Processing raw GPS data using a signal-clustering algorithm decreased overall concordance to 14.3%. The most common causes of discordance as described by a sub-sample (n = 101) with whom we followed-up were GPS units being accidentally off (30%), forgetting or purposely not taking the units when leaving home (24.8%), possible barriers to the signal (4.7%) and leaving units home to recharge (4.6%). We provide a quantitative assessment of the strengths and weaknesses of both methods for capturing fine-scale human mobility. PMID:24922530

  5. Decision support during electronic prescription to stem antibiotic overuse for acute respiratory infections: a long-term, quasi-experimental study.

    PubMed

    Gifford, Jeneen; Vaeth, Elisabeth; Richards, Katherine; Siddiqui, Tariq; Gill, Christine; Wilson, Lucy; DeLisle, Sylvain

    2017-07-31

    Interventions to support decision-making can reduce inappropriate antibiotic use for acute respiratory infections (ARI), but they may not be sustainable. The objective of the study is to evaluate the long-term effectiveness of a clinical decision-support system (CDSS) interposed at the time of electronic (e-) prescriptions for selected antibiotics. This is a retrospective, observational intervention study, conducted within a large, statewide Veterans Affairs health system. Participants are outpatients with an initial visit for ARI. A CDSS was deployed upon e-prescription of selected antibiotics during the study period. From 01/2004 to 05/2006 (pre-withdrawal period), the CDSS targeted azithromycin and the fluoroquinolone gatifloxacin. From 05/2006 to 12/2011 (post-withdrawal period), the CDSS was retained for azithromycin but withdrawn for the fluoroquinolone. A manual record review was conducted to determine concordance of antibiotic prescription with ARI treatment guidelines. Of 1131 included ARI visits, 380 (33.6%) were guideline-concordant. For azithromycin, concordance did not change between the pre- and post-withdrawal periods, and adjusted odds of concordance was 8.8 for the full study period, compared to unrestricted antibiotics. For fluoroquinolones, guideline concordance decreased from 88.6% (39 of 44 visits) to 51.3% (59 of 115 visits), pre- vs. post-withdrawal periods (p < 0.005). The adjusted odds of concordance compared to "All Other Antibiotics" visits decreased from 24.4 (95% CI 9.0-66.3) pre-withdrawal to 5.5 (95% CI 3.5-8.8) post-withdrawal (p = .008). Concordance did not change between those same time periods for antibiotics that were never subjected to the intervention ("All Other Antibiotics"). A CDSS interposed at the time of e-prescription of selected antibiotics can shift their use toward ARI treatment guidelines, and this effect can be maintained over the long term as long as the CDSS remains in place. Removal of the CDSS after 3.5 years of implementation resulted in a rise in guideline-discordant antibiotic use.

  6. Effects of a health information system data quality intervention on concordance in Mozambique: time-series analyses from 2009-2012.

    PubMed

    Wagenaar, Bradley H; Gimbel, Sarah; Hoek, Roxanne; Pfeiffer, James; Michel, Cathy; Manuel, João Luis; Cuembelo, Fatima; Quembo, Titos; Afonso, Pires; Porthé, Victoria; Gloyd, Stephen; Sherr, Kenneth

    2015-01-01

    We assessed the effects of a three-year national-level, ministry-led health information system (HIS) data quality intervention and identified associated health facility factors. Monthly summary HIS data concordance between a gold standard data quality audit and routine HIS data was assessed in 26 health facilities in Sofala Province, Mozambique across four indicators (outpatient consults, institutional births, first antenatal care visits, and third dose of diphtheria, pertussis, and tetanus vaccination) and five levels of health system data aggregation (daily facility paper registers, monthly paper facility reports, monthly paper district reports, monthly electronic district reports, and monthly electronic provincial reports) through retrospective yearly audits conducted July-August 2010-2013. We used mixed-effects linear models to quantify changes in data quality over time and associated health system determinants. Median concordance increased from 56.3% during the baseline period (2009-2010) to 87.5% during 2012-2013. Concordance improved by 1.0% (confidence interval [CI]: 0.60, 1.5) per month during the intervention period of 2010-2011 and 1.6% (CI: 0.89, 2.2) per month from 2011-2012. No significant improvements were observed from 2009-2010 (during baseline period) or 2012-2013. Facilities with more technical staff (aβ: 0.71; CI: 0.14, 1.3), more first antenatal care visits (aβ: 3.3; CI: 0.43, 6.2), and fewer clinic beds (aβ: -0.94; CI: -1.7, -0.20) showed more improvements. Compared to facilities with no stock-outs, facilities with five essential drugs stocked out had 51.7% (CI: -64.8 -38.6) lower data concordance. A data quality intervention was associated with significant improvements in health information system data concordance across public-sector health facilities in rural and urban Mozambique. Concordance was higher at those facilities with more human resources for health and was associated with fewer clinic-level stock-outs of essential medicines. Increased investments should be made in data audit and feedback activities alongside targeted efforts to improve HIS data in low- and middle-income countries.

  7. Lack of concordance amongst measurements of individual anaerobic threshold and maximal lactate steady state on a cycle ergometer.

    PubMed

    Arratibel-Imaz, Iñaki; Calleja-González, Julio; Emparanza, Jose Ignacio; Terrados, Nicolas; Mjaanes, Jeffrey M; Ostojic, Sergej M

    2016-01-01

    The calculation of exertion intensity, in which a change is produced in the metabolic processes which provide the energy to maintain physical work, has been defined as the anaerobic threshold (AT). The direct calculation of maximal lactate steady state (MLSS) would require exertion intensities over a long period of time and with sufficient rest periods which would prove significantly difficult for daily practice. Many protocols have been used for the indirect calculation of MLSS. The aim of this study is to determine if the results of measurements with 12 different AT calculation methods and calculation software [Keul, Simon, Stegmann, Bunc, Dickhuth (TKM and WLa), Dmax, Freiburg, Geiger-Hille, Log-Log, Lactate Minimum] can be used interchangeably, including the method of the fixed threshold of Mader/OBLA's 4 mmol/l and then to compare them with the direct measurement of MLSS. There were two parts to this research. Phase 1: results from 162 exertion tests chosen at random from the 1560 tests. Phase 2: sixteen athletes (n = 16) carried out different tests on five consecutive days. There was very high concordance among all the methods [intraclass correlation coefficient (ICC) > 0.90], except Log-Log in relation to the Stegamnn, Dmax, Dickhuth-WLa and Geiger-Hille. The Dickhuth-TKM showed a high tendency towards concordance, with Dmax (2.2 W) and Dickhuth-WLa (0.1 W). The Dickhuth-TKM method presented a high tendency to concordance with Dickhuth-WLa (0.5 W), Freiburg (7.4 W), MLSS (2.0 W), Bunc (8.9 W), Dmax (0.1 W). The calculation of MLSS power showed a high tendency to concordance, with Dickhuth-TKM (2 W), Dmax (2.1 W), Dickhuth-WLa (1.5 W). The fixed threshold of 4 mmol/l or OBLA produces slightly different and higher results than those obtained with all the methods analyzed, including MLSS, meaning an overestimation of power in the individual anaerobic threshold. The Dickhuth-TKM, Dmax and Dickhuth-WLa methods defined a high concordance on a cycle ergometer. Dickhuth-TKM, Dmax, Dickhuth-WLa described a high concordance with the power calculated to know the MLSS.

  8. The c-index is not proper for the evaluation of $t$-year predicted risks.

    PubMed

    Blanche, Paul; Kattan, Michael W; Gerds, Thomas A

    2018-02-16

    We show that the widely used concordance index for time to event outcome is not proper when interest is in predicting a $t$-year risk of an event, for example 10-year mortality. In the situation with a fixed prediction horizon, the concordance index can be higher for a misspecified model than for a correctly specified model. Impropriety happens because the concordance index assesses the order of the event times and not the order of the event status at the prediction horizon. The time-dependent area under the receiver operating characteristic curve does not have this problem and is proper in this context.

  9. 47 CFR 73.622 - Digital television table of allotments.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 44c Coalinga *22 Concord 63c Corona 39 Cotati *23c El Centro 22, 48 Eureka *11, 16, 17, 28 Fort Bragg... Clovis 43 Concord 14 Corona 39 Cotati *23 El Centro 9, 22 Eureka 3, *11, 17, 28 Fort Bragg 8 Fresno 7, 30...

  10. 47 CFR 73.622 - Digital television table of allotments.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 44c Coalinga *22 Concord 63c Corona 39 Cotati *23c El Centro 22, 48 Eureka *11, 16, 17, 28 Fort Bragg... Clovis 43 Concord 14 Corona 39 Cotati *23 El Centro 9, 22 Eureka 3, *11, 17, 28 Fort Bragg 8 Fresno 7, 30...

  11. Concordance correlation for model performance assessment: An example with reference evapotranspiration

    USDA-ARS?s Scientific Manuscript database

    Procedures for assessing model performance in agronomy are often arbitrary and not always helpful. An omnibus analysis statistic, concordance correlation, is widely known and used in many other sciences. An illustrative example is presented here. The analysis assumes the exact relationship “observat...

  12. CONCORDANCE OF TAXONOMIC COMPOSITION PATTERNS ACROSS MULTIPLE LAKE ASSEMBLAGES: EFFECTS OF SCALE, BODY SIZE, AND LAND USE

    EPA Science Inventory

    We assessed environmental gradients and the extent to which they induced concordant patterns of taxonomic composition among benthic macroinvertebrate, riparian bird, sedimentary diatom, fish, and pelagic zooplankton assemblages in 186 northeastern U.S.A. lakes. Human population ...

  13. Modeling Concordance Correlation Coefficient for Longitudinal Study Data

    ERIC Educational Resources Information Center

    Ma, Yan; Tang, Wan; Yu, Qin; Tu, X. M.

    2010-01-01

    Measures of agreement are used in a wide range of behavioral, biomedical, psychosocial, and health-care related research to assess reliability of diagnostic test, psychometric properties of instrument, fidelity of psychosocial intervention, and accuracy of proxy outcome. The concordance correlation coefficient (CCC) is a popular measure of…

  14. The use of whole food animal studies in the safety assessment of genetically modified crops: Limitations and recommendations

    PubMed Central

    Bartholomaeus, Andrew; Parrott, Wayne; Bondy, Genevieve

    2013-01-01

    There is disagreement internationally across major regulatory jurisdictions on the relevance and utility of whole food (WF) toxicity studies on GM crops, with no harmonization of data or regulatory requirements. The scientific value, and therefore animal ethics, of WF studies on GM crops is a matter addressable from the wealth of data available on commercialized GM crops and WF studies on irradiated foods. We reviewed available GM crop WF studies and considered the extent to which they add to the information from agronomic and compositional analyses. No WF toxicity study was identified that convincingly demonstrated toxicological concern or that called into question the adequacy, sufficiency, and reliability of safety assessments based on crop molecular characterization, transgene source, agronomic characteristics, and/or compositional analysis of the GM crop and its near-isogenic line. Predictions of safety based on crop genetics and compositional analyses have provided complete concordance with the results of well-conducted animal testing. However, this concordance is primarily due to the improbability of de novo generation of toxic substances in crop plants using genetic engineering practices and due to the weakness of WF toxicity studies in general. Thus, based on the comparative robustness and reliability of compositional and agronomic considerations and on the absence of any scientific basis for a significant potential for de novo generation of toxicologically significant compositional alterations as a sole result of transgene insertion, the conclusion of this review is that WF animal toxicity studies are unnecessary and scientifically unjustifiable. PMID:24164514

  15. The impact of health coaching on medication adherence in patients with poorly controlled diabetes, hypertension, and/or hyperlipidemia: a randomized controlled trial.

    PubMed

    Thom, David H; Willard-Grace, Rachel; Hessler, Danielle; DeVore, Denise; Prado, Camille; Bodenheimer, Thomas; Chen, Ellen

    2015-01-01

    Lack of concordance between medications listed in the medical record and taken by the patient contributes to poor outcomes. We sought to determine whether patients who received health coaching by medical assistants improved their medication concordance and adherence. This was a nonblinded, randomized, controlled, pragmatic intervention trial. English- or Spanish-speaking patients, age 18 to 75 years, with poorly controlled type 2 diabetes, hypertension, and/or hyperlipidemia were enrolled from 2 urban safety net clinics and randomized to receive 12 months of health coaching versus usual care. Outcomes included concordance between medications documented in the medical record and those reported by the patient and adherence based on the patient-reported number of days (of the last 7) on which patient took all prescribed medications. The proportion of medications completely concordant increased in the coached group versus the usual care group (difference in change, 10%; P = .05). The proportion of medications listed in the chart but not taken significantly decreased in the coached group compared with the usual care group (difference in change, 17%; P = .013). The mean number of adherent days increased in the coached but not in the usual care group (difference in change, 1.08; P < .001). Health coaching by medical assistants significantly increases medication concordance and adherence. © Copyright 2015 by the American Board of Family Medicine.

  16. Public health surveillance of cancer survival in the United States and worldwide: The contribution of the CONCORD programme.

    PubMed

    Allemani, Claudia; Coleman, Michel P

    2017-12-15

    CONCORD is a programme for the global surveillance of cancer survival. In 2015, the second cycle of the program (CONCORD-2) established long-term surveillance of cancer survival worldwide, for the first time, in the largest cancer survival study published to date. CONCORD-2 provided cancer survival trends for 25,676,887 patients diagnosed during the 15-year period between 1995 and 2009 with 1 of 10 common cancers that collectively represented 63% of the global cancer burden in 2009. Herein, the authors summarize the past, describe the present, and outline the future of the CONCORD programme. They discuss the difference between population-based studies and clinical trials, and review the importance of international comparisons of population-based cancer survival. This study will focus on the United States. The authors explain why population-based survival estimates are crucial for driving effective cancer control strategies to reduce the wide and persistent disparities in cancer survival between white and black patients, which are likely to be attributable to differences in access to early diagnosis and optimal treatment. Cancer 2017;123:4977-81. Published 2017. This article is a U.S. Government work and is in the public domain in the USA. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

  17. Mindfulness-Based Sex Therapy Improves Genital-Subjective Arousal Concordance in Women With Sexual Desire/Arousal Difficulties.

    PubMed

    Brotto, Lori A; Chivers, Meredith L; Millman, Roanne D; Albert, Arianne

    2016-11-01

    There is emerging evidence for the efficacy of mindfulness-based interventions for improving women's sexual functioning. To date, this literature has been limited to self-reports of sexual response and distress. Sexual arousal concordance-the degree of agreement between self-reported sexual arousal and psychophysiological sexual response-has been of interest due to the speculation that it may be a key component to healthy sexual functioning in women. We examined the effects of mindfulness-based sex therapy on sexual arousal concordance in a sample of women with sexual desire/arousal difficulties (n = 79, M age 40.8 years) who participated in an in-laboratory assessment of sexual arousal using a vaginal photoplethysmograph before and after four sessions of group mindfulness-based sex therapy. Genital-subjective sexual arousal concordance significantly increased from pre-treatment levels, with changes in subjective sexual arousal predicting contemporaneous genital sexual arousal (but not the reverse). These findings have implications for our understanding of the mechanisms by which mindfulness-based sex therapy improves sexual functioning in women, and suggest that such treatment may lead to an integration of physical and subjective arousal processes. Moreover, our findings suggest that future research might consider the adoption of sexual arousal concordance as a relevant endpoint in treatment outcome research of women with sexual desire/arousal concerns.

  18. Dyadic Concordance in Mother and Preschooler Resting Cardiovascular Function Varies by Risk Status

    PubMed Central

    Skowron, Elizabeth A.; Hughes, Brian M.; Howard, Siobhán; Loken, Eric

    2014-01-01

    This study examined concordance in heart rate (HR) and respiratory sinus arrhythmia (RSA) in a sample of 104 child-maltreating (CM) and nonCM mother–preschooler dyads (208 individuals). In a laboratory setting, mother and child cardiac physiology was simultaneously monitored via ECG in a 5-min resting period. Mothers ranged in age from 20 to 49 years; children ranged in age from 3 to 5 years. Significant within-dyad (WD) and between-dyad (BD) associations were observed for mother HR and both child HR and RSA, and the associations were moderated by CM status. Only CM dyads exhibited BD associations: Higher average maternal HR was associated with higher child HR and lower child RSA. By contrast, when the time interval was divided into 30 s epochs, nonCM dyads exhibited positive WD (dynamic) associations in mother and child HR, and both CM and nonCM dyads showed negative WD associations in mother HR and child RSA. Further, mothers’ mean HR levels moderated the extent of epoch-by-epoch WD concordance observed in mother and child, such that elevated average maternal HR was associated with lower levels of WD (dynamic) concordance. No BD or WD concordance in maternal and child RSA was observed. The findings suggest that measures of intraindividual variation provide useful, alternate perspectives in the study of dyadic processes in at-risk families. PMID:24022469

  19. Availability of Care Concordant With Patient-centered Medical Home Principles Among Those With Chronic Conditions: Measuring Care Outcomes.

    PubMed

    Pourat, Nadereh; Charles, Shana A; Snyder, Sophie

    2016-03-01

    Care delivery redesign in the form of patient-centered medical home (PCMH) is considered as a potential solution to improve patient outcomes and reduce costs, particularly for patients with chronic conditions. But studies of prevalence or impact at the population level are rare. We aimed to assess whether desired outcomes indicating better care delivery and patient-centeredness were associated with receipt of care according to 3 important PCMH principles. We analyzed data from a representative population survey in California in 2009, focusing on a population with chronic condition who had a usual source of care. We used bivariate, logistic, and negative-binomial regressions. The indicators of PCMH concordant care included continuity of care (personal doctor), care coordination, and care management (individual treatment plan). Outcomes included flu shots, count of outpatient visits, any emergency department visit, timely provider communication, and confidence in self-care. We found that patients whose care was concordant with all 3 PCMH principles were more likely to receive flu shots, more outpatient care, and timely response from providers. Concordance with 2 principles led to some desired outcomes. Concordance with only 1 principle was not associated with desired outcomes. Patients who received care that met 3 key aspects of PCMH: coordination, continuity, and management, had better quality of care and more efficient use of the health care system.

  20. Comparison between Measurements Obtained with three Different Perineometers

    PubMed Central

    Barbosa, Patrícia Brentegani; Franco, Maíra Menezes; de Oliveira Souza, Flaviane; Antônio, Flávia Ignácio; Montezuma, Thaís; Ferreira, Cristine Homsi Jorge

    2009-01-01

    OBJECTIVE: To analyze the results obtained in the evaluation of intra-vaginal pressure using three different brands of perineometers in nulliparous volunteers. MATERIALS AND METHODS: Twenty nulliparous women with no anatomical alterations and/or dysfunction of the pelvic floor were enrolled in our study. All the women had the ability to voluntarily contract their PFM (Pelvic Floor Muscles), as assessed by digital palpation. The intra-vaginal pressure was assessed using three different brands of perineometer (Neurodyn Evolution™, SensuPower™ and Peritron™). Each volunteer was evaluated on three alternate days by a single examiner using a single brand of perineometer on each day. In the assessment, the volunteers were required to pull (contract) their PFM in and up as strongly as possible 3 times and to sustain the contraction for 5 seconds, with an interval of 30 seconds between each pull. For the statistical analysis, a concordance correlation coefficient was used to compare the values that were obtained with each brand of perineometer. RESULTS: A moderate concordance (0.51) was found between the results from the Peritron™ and Neurodyn™ perineometers, a fair concordance (0.21) between the Peritron™ and SensuPower™ brands and a poor concordance (0.19) between the Neurodyn™ and SensuPower™ brands. CONCLUSION: The concordance of the measurements of the intra-vaginal pressure ranged from poor to moderate, suggesting that perineometers of different brands generate different results. PMID:19578656

  1. The comparison of automated urine analyzers with manual microscopic examination for urinalysis automated urine analyzers and manual urinalysis.

    PubMed

    İnce, Fatma Demet; Ellidağ, Hamit Yaşar; Koseoğlu, Mehmet; Şimşek, Neşe; Yalçın, Hülya; Zengin, Mustafa Osman

    2016-08-01

    Urinalysis is one of the most commonly performed tests in the clinical laboratory. However, manual microscopic sediment examination is labor-intensive, time-consuming, and lacks standardization in high-volume laboratories. In this study, the concordance of analyses between manual microscopic examination and two different automatic urine sediment analyzers has been evaluated. 209 urine samples were analyzed by the Iris iQ200 ELITE (İris Diagnostics, USA), Dirui FUS-200 (DIRUI Industrial Co., China) automatic urine sediment analyzers and by manual microscopic examination. The degree of concordance (Kappa coefficient) and the rates within the same grading were evaluated. For erythrocytes, leukocytes, epithelial cells, bacteria, crystals and yeasts, the degree of concordance between the two instruments was better than the degree of concordance between the manual microscopic method and the individual devices. There was no concordance between all methods for casts. The results from the automated analyzers for erythrocytes, leukocytes and epithelial cells were similar to the result of microscopic examination. However, in order to avoid any error or uncertainty, some images (particularly: dysmorphic cells, bacteria, yeasts, casts and crystals) have to be analyzed by manual microscopic examination by trained staff. Therefore, the software programs which are used in automatic urine sediment analysers need further development to recognize urinary shaped elements more accurately. Automated systems are important in terms of time saving and standardization.

  2. Investigating Female Sexual Concordance: Do Sexual Excitation and Sexual Inhibition Moderate the Agreement of Genital and Subjective Sexual Arousal in Women?

    PubMed

    Velten, Julia; Scholten, Saskia; Graham, Cynthia A; Adolph, Dirk; Margraf, Jürgen

    2016-11-01

    The agreement of subjective and genital sexual response, also referred to as sexual concordance, shows substantial variability between women. Identifying predictors of sexual arousal and sexual concordance is important to improve our understanding of female sexual response and its relationship to sexual function or dysfunction. The aim of this study was to assess the relevance of sexual excitation and sexual inhibition as predictors of subjective sexual arousal, genital arousal, and sexual concordance. In a laboratory setting, sexual arousal was induced by erotic video stimuli. Subjective sexual arousal was assessed continuously during stimulus presentation and genital arousal was measured with vaginal photoplethysmography. Data of 58 women (M age = 24.95, SD = 4.65) were analyzed using multilevel analyses (HLM). This data analytic technique estimates the within-subject associations of subjective and genital arousal, by controlling for between-subject differences. An interaction term of sexual excitation and sexual inhibition significantly predicted genital sexual arousal. In exploratory analyses, two lower order factors of sexual inhibition (Concerns about Sexual Function and Arousal Contingency) were predictive of sexual concordance. Further examination of these associations might increase our knowledge of female sexual function and deepen our understanding of how sexual excitation and sexual inhibition affect sexual arousal and consequently, impact sexual behaviors, in women.

  3. Sizing up the planets

    NASA Technical Reports Server (NTRS)

    Meszaros, S. P.

    1985-01-01

    Visual, scaled comparisons are made among prominent volcanic, tectonic, crater and impact basin features photographed on various planets and moons in the solar system. The volcanic formation Olympus Mons, on Mars, is 27 km tall, while Io volcanic plumes reach 200-300 km altitude. Valles Marineris, a tectonic fault on Mars, is several thousand kilometers long, and the Ithasa Chasma on the Saturnian moon Tethys extends two-thirds the circumference of the moon. Craters on the Saturnian moons Tethys and Mimas are large enough to suggest a collision by objects which almost shattered the planetoids. Large meteorite impacts may leave large impact basins or merely ripples, such as found on Callisto, whose icy surface could not support high mountains formed by giant body impacts.

  4. [Video recording system of endoscopic procedures for digital forensics].

    PubMed

    Endo, Chiaki; Sakurada, A; Kondo, T

    2009-07-01

    Recently, endoscopic procedures including surgery, intervention, and examination have been widely performed. Medical practitioners are required to record the procedures precisely in order to check the procedures retrospectively and to get the legally reliable record. Medical Forensic System made by KS Olympus Japan offers 2 kinds of movie and patient's data, such as heart rate, blood pressure, and Spo, which are simultaneously recorded. We installed this system into the bronchoscopy room and have experienced its benefit. Under this system, we can get bronchoscopic image, bronchoscopy room view, and patient's data simultaneously. We can check the quality of the bronchoscopic procedures retrospectively, which is useful for bronchoscopy staff training. Medical Forensic System should be installed in any kind of endoscopic procedures.

  5. Proceedings of the 16th NASA Propagation Experimenters Meeting (NAPEX 16) and the Advanced Communications Technology Satellite (ACTS) Propagation Studies Miniworkshop

    NASA Technical Reports Server (NTRS)

    Davarian, Faramaz (Editor)

    1992-01-01

    The NASA Propagation Experimenters Meeting (NAPEX), supported by the NASA Propagation Program, is convened annually to discuss studies made on radio wave propagation by investigators from domestic and international organizations. NAPEX 16 was held on May 29, 1992 in Houston, Texas. The meeting was organized into two technical sessions. The first session was dedicated to slant path propagation studies and measurements. The second session focused on Olympus propagation measurements and results. Following NAPEX 16, the Advanced Communications Technology Satellite (ACTS) Miniworkshop was held to review ACTS propagation activities with emphasis on ACTS hardware development and experiment planning. Eight technical papers were presented by contributors from government agencies, private industry, and university research establishments.

  6. Relative crater production rates on planets

    NASA Technical Reports Server (NTRS)

    Hartmann, W. K.

    1977-01-01

    The relative numbers of impacts on different planets, estimated from the dynamical histories of planetesimals in specified orbits (Wetherill, 1975), are converted by a described procedure to crater production rates. Conversions are dependent on impact velocity and surface gravity. Crater retention ages can then be derived from the ratio of the crater density to the crater production rate. The data indicate that the terrestrial planets have crater production rates within a factor ten of each other. As an example, for the case of Mars, least-squares fits to crater-count data suggest an average age of 0.3 to 3 billion years for two types of channels. The age of Olympus Mons is discussed, and the effect of Tharsis volcanism on channel formation is considered.

  7. Size-velocity distribution of large ejecta fragments

    NASA Technical Reports Server (NTRS)

    Vickery, A. M.

    1986-01-01

    The characteristics of three primary extraterrestrial craters and the associated craters were examined to generate a size-velocity distribution for large ejecta fragments. The lunar craters Copernicus and Aristillus and the Martian crater Dv on Olympus Mons were used. Attention was focused on the radial distances between the primary and secondary crater centers and the diameters of the secondaries. The primary craters selected are all relatively young, which avoided contamination of the data from secondaries from other primaries. Attempts were made to account for the speed of the hypervelocity impacts and the elemental compositions of the impactors. An apparent velocity cutoff of about 1 km/sec was observed for the secondaries, which implies that no meteoroid impacts can accelerate ejecta to escape velocities from the moon or Mars.

  8. The Effects of Concordance-Based Electronic Glosses on L2 Vocabulary Learning

    ERIC Educational Resources Information Center

    Lee, Hansol; Warschauer, Mark; Lee, Jang Ho

    2017-01-01

    The present study investigates the effects of two different vocabulary learning conditions in digital reading environments equipped with electronic textual glossing. The first condition presents the concordance lines of a target lexical item, thereby making learners infer its meaning by reading the referenced sentences. The second condition…

  9. Linking the ACT ASPIRE Assessments to NWEA MAP Assessments

    ERIC Educational Resources Information Center

    Northwest Evaluation Association, 2016

    2016-01-01

    Northwest Evaluation Association™ (NWEA™) is committed to providing partners with useful tools to help make inferences from Measures of Academic Progress® (MAP®) interim assessment scores. One important tool is the concordance table between MAP and state summative assessments. Concordance tables have been used for decades to relate scores on…

  10. Divergence in Siblings' Adult Attachment Security: Potential Contributors and Consequences

    ERIC Educational Resources Information Center

    Fortuna, Keren

    2009-01-01

    Previous research has revealed only modest concordance in attachment security between siblings during childhood and adolescence. The first goal of this dissertation was to estimate sibling concordance in adult attachment security and identify factors contributing to divergence. The Adult Attachment Interview (AAI) was administered to young adult…

  11. 78 FR 55216 - Safety Zone: Suisun Bay Electromagnetic Scan and Ordnance Recovery, Suisun Bay, Concord, CA

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-10

    ...-AA00 Safety Zone: Suisun Bay Electromagnetic Scan and Ordnance Recovery, Suisun Bay, Concord, CA AGENCY... (MOTCO) electromagnetic scan and ordnance recovery operations. These safety zones are established to... 10, 2013 that they intend to conduct an intrusive electromagnetic scan and ordnance recovery...

  12. Script Concordance Testing in Continuing Professional Development: Local or International Reference Panels?

    ERIC Educational Resources Information Center

    Pleguezuelos, E. M.; Hornos, E.; Dory, V.; Gagnon, R.; Malagrino, P.; Brailovsky, C. A.; Charlin, B.

    2013-01-01

    Context: The PRACTICUM Institute has developed large-scale international programs of on-line continuing professional development (CPD) based on self-testing and feedback using the Practicum Script Concordance Test© (PSCT). Aims: To examine the psychometric consequences of pooling the responses of panelists from different countries (composite…

  13. Parent/Child Concordance about Bullying Involvement and Family Characteristics Related to Bullying and Peer Victimization

    ERIC Educational Resources Information Center

    Holt, Melissa K.; Kaufman Kantor, Glenda; Finkelhor, David

    2009-01-01

    This study examined parent perspectives on bullying, parent/child concordance about bullying involvement, and family characteristics associated with bullying perpetration and peer victimization. Participants were 205 fifth-grade students and their parents. Students attended an urban, ethnically diverse school district in the Northeast. Youth…

  14. Some Formulas and Methods for the Effective Teaching of Verbal Concord (in Non-Native English Settings)

    ERIC Educational Resources Information Center

    Ekundayo, Steve Bode

    2013-01-01

    This paper examines the incidence of verbal concord rule violation in educated Nigeria ESL against the conceptual framework of interference and "intraference". Intraference is a coinage for the "overgeneralization of linguistic material and semantic features" or "intralingual interference". The paper is basically…

  15. Automatic sorting of toxicological information into the IUCLID (International Uniform Chemical Information Database) endpoint-categories making use of the semantic search engine Go3R.

    PubMed

    Sauer, Ursula G; Wächter, Thomas; Hareng, Lars; Wareing, Britta; Langsch, Angelika; Zschunke, Matthias; Alvers, Michael R; Landsiedel, Robert

    2014-06-01

    The knowledge-based search engine Go3R, www.Go3R.org, has been developed to assist scientists from industry and regulatory authorities in collecting comprehensive toxicological information with a special focus on identifying available alternatives to animal testing. The semantic search paradigm of Go3R makes use of expert knowledge on 3Rs methods and regulatory toxicology, laid down in the ontology, a network of concepts, terms, and synonyms, to recognize the contents of documents. Search results are automatically sorted into a dynamic table of contents presented alongside the list of documents retrieved. This table of contents allows the user to quickly filter the set of documents by topics of interest. Documents containing hazard information are automatically assigned to a user interface following the endpoint-specific IUCLID5 categorization scheme required, e.g. for REACH registration dossiers. For this purpose, complex endpoint-specific search queries were compiled and integrated into the search engine (based upon a gold standard of 310 references that had been assigned manually to the different endpoint categories). Go3R sorts 87% of the references concordantly into the respective IUCLID5 categories. Currently, Go3R searches in the 22 million documents available in the PubMed and TOXNET databases. However, it can be customized to search in other databases including in-house databanks. Copyright © 2013 Elsevier Ltd. All rights reserved.

  16. Concordance Between Laboratory Diagnosed Sexually Transmitted Infections and Self-Reported Measures of Risky Sex by Partner Type Among Rural Ugandan Outpatients.

    PubMed

    Kiene, Susan M; Lule, Haruna; Hughes, Peter; Wanyenze, Rhoda K

    2017-07-01

    Numerous HIV risk reduction interventions which show effects on sexual risk behaviors fail to find effects on STIs. We examined the concordance between laboratory diagnosed STIs and sexual risk behavior among Ugandan outpatients (n = 328). We screened for STIs and assessed sexual behavior at baseline and 6 month follow-up. Less risk was associated with an STI at baseline. At follow-up more unprotected sex with casual partners was associated with incident Syphilis, more unprotected sex with primary and secondary regular partners was associated with incident Chlamydia or Gonorrhea. Our results suggest ways to improve concordance between behavioral measures and STIs.

  17. Linking the Kentucky K-PREP Assessments to NWEA MAP Tests

    ERIC Educational Resources Information Center

    Northwest Evaluation Association, 2016

    2016-01-01

    Northwest Evaluation Association™ (NWEA™) is committed to providing partners with useful tools to help make inferences from the Measures of Academic Progress® (MAP®) interim assessment scores. One important tool is the concordance table between MAP and state summative assessments. Concordance tables have been used for decades to relate scores on…

  18. Linking the Kansas KAP Assessments to NWEA MAP Tests

    ERIC Educational Resources Information Center

    Northwest Evaluation Association, 2016

    2016-01-01

    Northwest Evaluation Association™ (NWEA™) is committed to providing partners with useful tools to help make inferences from the Measures of Academic Progress® (MAP®) interim assessment scores. One important tool is the concordance table between MAP and state summative assessments. Concordance tables have been used for decades to relate scores on…

  19. Linking the PARCC Assessments to NWEA MAP Tests for Illinois

    ERIC Educational Resources Information Center

    Northwest Evaluation Association, 2016

    2016-01-01

    Northwest Evaluation Association™ (NWEA™) is committed to providing partners with useful tools to help make inferences from the Measures of Academic Progress® (MAP®) interim assessment scores. One important tool is the concordance table between MAP and state summative assessments. Concordance tables have been used for decades to relate scores on…

  20. Linking the Texas STAAR Assessments to NWEA MAP Tests

    ERIC Educational Resources Information Center

    Northwest Evaluation Association, 2016

    2016-01-01

    Northwest Evaluation Association™ (NWEA™) is committed to providing partners with useful tools to help make inferences from the Measures of Academic Progress® (MAP®) interim assessment scores. One important tool is the concordance table between MAP and state summative assessments. Concordance tables have been used for decades to relate scores on…

  1. Linking the Nebraska NeSA Assessments to NWEA MAP Tests

    ERIC Educational Resources Information Center

    Northwest Evaluation Association, 2016

    2016-01-01

    Northwest Evaluation Association™ (NWEA™) is committed to providing partners with useful tools to help make inferences from the Measures of Academic Progress® (MAP®) interim assessment scores. One important tool is the concordance table between MAP and state summative assessments. Concordance tables have been used for decades to relate scores on…

  2. Linking the Alaska AMP Assessments to NWEA MAP Tests

    ERIC Educational Resources Information Center

    Northwest Evaluation Association, 2016

    2016-01-01

    Northwest Evaluation Association™ (NWEA™) is committed to providing partners with useful tools to help make inferences from the Measures of Academic Progress® (MAP®) interim assessment scores. One important tool is the concordance table between MAP and state summative assessments. Concordance tables have been used for decades to relate scores on…

  3. Linking the PARCC Assessments to NWEA MAP Tests for New Mexico

    ERIC Educational Resources Information Center

    Northwest Evaluation Association, 2016

    2016-01-01

    Northwest Evaluation Association™ (NWEA™) is committed to providing partners with useful tools to help make inferences from the Measures of Academic Progress® (MAP®) interim assessment scores. One important tool is the concordance table between MAP and state summative assessments. Concordance tables have been used for decades to relate scores on…

  4. Linking the Arizona AZMERIT Assessments to NWEA MAP Tests

    ERIC Educational Resources Information Center

    Northwest Evaluation Association, 2016

    2016-01-01

    Northwest Evaluation Association™ (NWEA™) is committed to providing partners with useful tools to help make inferences from the Measures of Academic Progress® (MAP®) interim assessment scores. One important tool is the concordance table between MAP and state summative assessments. Concordance tables have been used for decades to relate scores on…

  5. Concordance among Physical Educators', Teachers', and Parents' Perceptions of Attention Problems in Children

    ERIC Educational Resources Information Center

    Efstratopoulou, Maria; Simons, Johan; Janssen, Rianne

    2013-01-01

    Objective: The study examined the concordance among rating sources on attention problems of elementary school-aged children. Method: A randomly selected sample ("N" = 841) of children was rated by the physical educators, the teachers, and the parents, using the Attention Scales of the Motor Behavior Checklist (MBC), the Teacher Report…

  6. Motor Impairment in Sibling Pairs Concordant and Discordant for Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Hilton, Claudia List; Zhang, Yi; Whilte, Megan R.; Klohr, Cheryl L.; Constantino, John

    2012-01-01

    Aim: Although motor impairment is frequently observed in children with autism spectrum disorders (ASD), the manner in which these impairments aggregate in families affected by autism is unknown. We used a standardized measure of motor proficiency to objectively examine quantitative variation in motor proficiency in sibling pairs concordant and…

  7. [Genetic and environmental contribution to rheumatoid arthritis: a family study].

    PubMed

    Iebba, Filippo; Di Sora, Fiorella; Leti, Wilma; Montella, Tatiana; Montella, Francesco

    2012-01-01

    We report on the HLA typing of three brothers (A, B, C) with rheumatoid arthritis (RA) and their six sons. This family is interesting for the full concordance for RA between parents. The aim of this study was the discovery of genetic and/or enviromental cofactors determining this absolute concordance.

  8. Determination of quantitative trait variants by concordance via application of the a posteriori granddaughter design to the U.S. Holstein population

    USDA-ARS?s Scientific Manuscript database

    Experimental designs that exploit family information can provide substantial predictive power in quantitative trait variant discovery projects. Concordance between quantitative trait locus genotype as determined by the a posteriori granddaughter design and marker genotype was determined for 29 trai...

  9. English Collocation Learning through Corpus Data: On-Line Concordance and Statistical Information

    ERIC Educational Resources Information Center

    Ohtake, Hiroshi; Fujita, Nobuyuki; Kawamoto, Takeshi; Morren, Brian; Ugawa, Yoshihiro; Kaneko, Shuji

    2012-01-01

    We developed an English Collocations On Demand system offering on-line corpus and concordance information to help Japanese researchers acquire a better command of English collocation patterns. The Life Science Dictionary Corpus consists of approximately 90,000,000 words collected from life science related research papers published in academic…

  10. Brief Report: On the Concordance Percentages for Autistic Spectrum Disorder of Twins

    ERIC Educational Resources Information Center

    Bohm, Henry V.; Stewart, Melbourne G.

    2009-01-01

    In the development of genetic theories of Autistic Spectrum Disorder (ASD) various characteristics of monozygotic (MZ) and dizygotic (DZ) twins are often considered. This paper sets forth a possible refinement in the interpretation of the MZ twin concordance percentages for ASD underlying such genetic theories, and, drawing the consequences from…

  11. NAVO MSRC Navigator. Fall 2004

    DTIC Science & Technology

    2004-01-01

    conjunction with Concord eHealth Enterprise Management Suite. Together these enterprise management packages provide real-time network and host performance...Right. A Concord eHealth -generated trend report from the NAVO MSRC 10-Gb Ethernet backbone. B an dw id th U ti liz at io n 23AU G04 0:00 30 AUG 04

  12. Understanding Adolescent Delinquency: The Role of Older Siblings' Delinquency and Popularity with Peers

    ERIC Educational Resources Information Center

    Craine, Jessica L.; Tanaka,Teri A.; Nishina, Adrienne; Conger, Katherine J.

    2009-01-01

    The present study examined delinquency concordance and the moderating effects of younger sibling perceptions of older sibling popularity in a sample of 587 adolescent sibling pairs. Using a social learning framework and taking dyad composition into account, perceptions of popularity were hypothesized to strengthen siblings' concordance for…

  13. Exploring the Effects and Use of a Chinese-English Parallel Concordancer

    ERIC Educational Resources Information Center

    Gao, Zhao-Ming

    2011-01-01

    Previous studies on self-correction using corpora involve monolingual concordances and intervention from instructors such as marking of errors, the use of modified concordances, and other simplifications of the task. Can L2 learners independently refine their previous outputs by simply using a parallel concordancer without any hints about their…

  14. A Descriptive Enquiry into Subject-Verb Concord in English Existential Constructions

    ERIC Educational Resources Information Center

    Tsuchida, Takehiro

    2011-01-01

    Subject-verb concord in English existential constructions is often viewed as problematic from both prescriptive and descriptive approaches to grammar and causes considerable confusion among teachers and learners of English as a second language (ESL). This paper aims to disentangle debates over the curious usage of the "there" + plural noun phrase…

  15. Konkordanz zu Schillers aesthetischen und philosophischen Schriften (Concordance of Schiller's Aesthetic and Philosophical Writings).

    ERIC Educational Resources Information Center

    Sanford, Gerlinde Ulm

    This document provides a computer-based concordance of the vocabulary used in Friedrich von Schiller's "Aesthetic and Philosophical Writings" as they appear in Volumes 20 and 21 of Schiller's "Werke," 1967 edition, edited by Benno von Wiese. The first section includes the entire text, each sentence numbered for research…

  16. Young Learners and Lexical Awareness: Children's Engagement with Wordlists and Concordances

    ERIC Educational Resources Information Center

    MacGregor, Alex

    2014-01-01

    Sinclair (1991) found that lexical analysis can be overcomplicated, yet Johns (1994) called for investigation into whether corpus analysis can motivate beginners and near-beginners. The findings of this research suggest that young EFL learners can enjoy using corpus analysis tools (wordlists and concordances) to identify, classify, and generalize…

  17. Attachment for Infants in Foster Care: The Role of Caregiver State of Mind.

    ERIC Educational Resources Information Center

    Dozier, Mary; Stovall, K. Chase; Albus, Kathleen E.; Bates, Brady

    2001-01-01

    Examined concordance between foster mothers' attachment state of mind and infants' attachment quality. Found that two-way correspondence between maternal state of mind and infant attachment quality was similar to that of biological mother-infant dyads. Age at placement was not related to attachment quality. Concordance between maternal state of…

  18. Dietary quality varies according to data collection instrument: a comparison between a food frequency questionnaire and 24-hour recall.

    PubMed

    Rodrigues, Paulo Rogério Melo; de Souza, Rita Adriana Gomes; De Cnop, Mara Lima; Monteiro, Luana Silva; Coura, Camila Pinheiro; Brito, Alessandra Page; Pereira, Rosangela Alves

    2016-02-01

    The objective of this study was to assess the agreement between the Brazilian Healthy Eating Index - Revised (BHEI-R), estimated by a food frequency questionnaire (FFQ) and multiple 24-hour recalls (24h-R). The Wilcoxon paired test, partial correlations (PC), intraclass correlation coefficient (ICC), and Bland-Altman method were used. The total BHEI-R scores and its components ("total fruits", "whole fruits", "total vegetables", "integral cereals", "saturated fat", "sodium", and "energy intake derived from solid fat, added sugar, and alcoholic beverages") were statistically different, with the ICC and PC indicating poor concordance and correlation. The mean concordance estimated for the total BHEI-R and its components varied from 68% for "integral cereals" to 147% for "whole fruits". The suitable concordance limits were violated for most of the components of the BHEI-R. Poor concordance was observed between the BHEI-R estimated by the FFQ and by multiple 24h-R, which indicated a strong reliability of the BHEI-R on the instrument used to collect information on food consumption.

  19. A risk-based classification scheme for genetically modified foods. III: Evaluation using a panel of reference foods.

    PubMed

    Chao, Eunice; Krewski, Daniel

    2008-12-01

    This paper presents an exploratory evaluation of four functional components of a proposed risk-based classification scheme (RBCS) for crop-derived genetically modified (GM) foods in a concordance study. Two independent raters assigned concern levels to 20 reference GM foods using a rating form based on the proposed RBCS. The four components of evaluation were: (1) degree of concordance, (2) distribution across concern levels, (3) discriminating ability of the scheme, and (4) ease of use. At least one of the 20 reference foods was assigned to each of the possible concern levels, demonstrating the ability of the scheme to identify GM foods of different concern with respect to potential health risk. There was reasonably good concordance between the two raters for the three separate parts of the RBCS. The raters agreed that the criteria in the scheme were sufficiently clear in discriminating reference foods into different concern levels, and that with some experience, the scheme was reasonably easy to use. Specific issues and suggestions for improvements identified in the concordance study are discussed.

  20. Concordance between the quality of maternal and paternal parenting behavior within couples.

    PubMed

    Deschênes, Marie; Bernier, Annie; Jarry-Boileau, Véronique; St-Laurent, Diane

    2014-01-01

    There is compelling evidence that the quality of maternal and paternal parenting behavior bears critical importance for child development. Yet, less is known of the degree of similarity between maternal and paternal parenting behavior in families, and especially little is known about the factors that may explain variation in degrees of similarity. This article aims to examine (a) the concordance (similarity) between the quality of mothers' and fathers' interactive behavior with their child and (b) the sociodemographic determinants of this concordance. The sample included 74 families (mother, father, and their child). The quality of maternal and paternal interactive behavior was assessed independently, and rated with the Maternal Behavior Q-Sort (mother-infant, 12 months; D. R. Pederson et al., 1990) or the Mutually Responsive Orientation scale (father-toddler, 18 months; N. Aksan et al., 2006). The results indicated that the overall correlation between the quality of mothers' and fathers' behavior was moderate. The concordance was greater among higher socioeconomic status families or when interacting with a boy, but did not differ according to the presence or absence of siblings in the family.

  1. Concorde noise-induced building vibrations for Sully Plantation, Chantilly, Virginia

    NASA Technical Reports Server (NTRS)

    Mayes, W. H.; Scholl, H. F.; Stephens, D. G.; Holliday, B. G.; Deloach, R.; Holmes, H. K.; Lewis, R. B.; Lynch, J. W.

    1976-01-01

    A study to assess the noise-induced building vibrations associated with Concorde operations is presented. The approach is to record the levels of induced vibrations and associated indoor/outdoor noise levels in selected homes, historic and other buildings near Dulles and Kennedy International Airports. Presented is a small, representative sample of data recorded at Sully Plantation, Chantilly, Virginia during the period of May 20 through May 28, 1976. Recorded data provide relationships between the vibration levels of walls, floors, windows, and the noise associated with Concorde operations (2 landings and 3 takeoffs), other aircraft, nonaircraft sources, and normal household activities. Results suggest that building vibrations resulting from aircraft operations were proportional to the overall sound pressure levels and relatively insensitive to spectral differences associated with the different types of aircraft. Furthermore, the maximum levels of vibratory response resulting from Concorde operations were higher than those associated with conventional aircraft. The vibrations of nonaircraft events were observed in some cases to exceed the levels resulting from aircraft operations. These nonaircraft events are currently being analyzed in greater detail.

  2. Utility of an Algorithm to Increase the Accuracy of Medication History in an Obstetrical Setting.

    PubMed

    Corbel, Aline; Baud, David; Chaouch, Aziz; Beney, Johnny; Csajka, Chantal; Panchaud, Alice

    2016-01-01

    In an obstetrical setting, inaccurate medication histories at hospital admission may result in failure to identify potentially harmful treatments for patients and/or their fetus(es). This prospective study was conducted to assess average concordance rates between (1) a medication list obtained with a one-page structured medication history algorithm developed for the obstetrical setting and (2) the medication list reported in medical records and obtained by open-ended questions based on standard procedures. Both lists were converted into concordance rate using a best possible medication history approach as the reference (information obtained by patients, prescribers and community pharmacists' interviews). The algorithm-based method obtained a higher average concordance rate than the standard method, with respectively 90.2% [CI95% 85.8-94.3] versus 24.6% [CI95%15.3-34.4] concordance rates (p<0.01). Our algorithm-based method strongly enhanced the accuracy of the medication history in our obstetric population, without using substantial resources. Its implementation is an effective first step to the medication reconciliation process, which has been recognized as a very important component of patients' drug safety.

  3. Fulminant clostridium difficile colitis: comparing computed tomography with histopathology: are they concordant?

    PubMed

    Felder, Seth I; Larson, Brent; Balzer, Bonnie; Wachsman, Ashley; Haker, Katherine; Fleshner, Phillip; Annamalai, Alagappan; Margulies, Daniel R

    2014-10-01

    A Total abdominal colectomy (TAC) is recommended for fulminant Clostridium difficile colitis (FCDC) because intraoperative assessment of diseased segments is inaccurate. To determine whether computerized tomography (CT) provides an accurate assessment of disease, we examined the concordance between CT and histopathologic colitis distribution in patients undergoing TAC for FCDC. The ileocolon was divided into seven distinct segments. Of 20 patients meeting criteria, the median interval between preoperative CT and TAC was 1.5 days (range, 0 to 23 days), and mortality was 65 per cent. The CT distribution of colitis was pancolitis in 12 patients and segmental in eight. Nine of the 12 patients with CT pancolitis had histologic pancolitis (75% concordance). Four of the eight patients with CT-diagnosed segmental disease had histologic segmental disease (50% concordance). For patients with FCDC, the distribution of colitis on CT agrees with the histopathologic extent of disease in the majority of patients. However, discordance between CT and histologic extent of disease was present in 25 to 50 per cent of patients. Therefore, the recommendation for TAC rather than segmental resection for FCDC remains justified.

  4. Concorde noise-induced building vibrations: John F. Kennedy International Airport

    NASA Technical Reports Server (NTRS)

    Mayes, W. H.; Stephens, D. G.; Deloach, R.; Cawthorn, J. M.; Holmes, H. K.; Lewis, R. B.; Holliday, B. G.; Ward, D. W.; Miller, W. T.

    1978-01-01

    Outdoor and indoor noise levels resulting from aircraft flyovers and certain nonaircraft events were recorded at eight homesites and a school along with the associated vibration levels in the walls, windows, and floors at these test sites. Limited subjective tests were conducted to examine the human detection and annoyance thresholds for building vibration and rattle caused by aircraft noise. Both vibration and rattle were detected subjectively in several houses for some operations of both the Concorde and subsonic aircraft. Seated subjects more readily detected floor vibrations than wall or window vibrations. Aircraft noise generally caused more window vibrations than common nonaircraft events such as walking and closing doors. Nonaircraft events and aircraft flyovers resulted in comparable wall vibration levels, while floor vibrations were generally greater for nonaircraft events than for aircraft flyovers. The relationship between structural vibration and aircraft noise is linear, with vibration levels being accurately predicted from overall sound pressure levels (OASPL) measured near the structure. Relatively high levels of structural vibration measured during Concorde operations are due more to higher OASPL levels than to unique Concorde-source characteristics.

  5. Scalable whole-exome sequencing of cell-free DNA reveals high concordance with metastatic tumors.

    PubMed

    Adalsteinsson, Viktor A; Ha, Gavin; Freeman, Samuel S; Choudhury, Atish D; Stover, Daniel G; Parsons, Heather A; Gydush, Gregory; Reed, Sarah C; Rotem, Denisse; Rhoades, Justin; Loginov, Denis; Livitz, Dimitri; Rosebrock, Daniel; Leshchiner, Ignaty; Kim, Jaegil; Stewart, Chip; Rosenberg, Mara; Francis, Joshua M; Zhang, Cheng-Zhong; Cohen, Ofir; Oh, Coyin; Ding, Huiming; Polak, Paz; Lloyd, Max; Mahmud, Sairah; Helvie, Karla; Merrill, Margaret S; Santiago, Rebecca A; O'Connor, Edward P; Jeong, Seong H; Leeson, Rachel; Barry, Rachel M; Kramkowski, Joseph F; Zhang, Zhenwei; Polacek, Laura; Lohr, Jens G; Schleicher, Molly; Lipscomb, Emily; Saltzman, Andrea; Oliver, Nelly M; Marini, Lori; Waks, Adrienne G; Harshman, Lauren C; Tolaney, Sara M; Van Allen, Eliezer M; Winer, Eric P; Lin, Nancy U; Nakabayashi, Mari; Taplin, Mary-Ellen; Johannessen, Cory M; Garraway, Levi A; Golub, Todd R; Boehm, Jesse S; Wagle, Nikhil; Getz, Gad; Love, J Christopher; Meyerson, Matthew

    2017-11-06

    Whole-exome sequencing of cell-free DNA (cfDNA) could enable comprehensive profiling of tumors from blood but the genome-wide concordance between cfDNA and tumor biopsies is uncertain. Here we report ichorCNA, software that quantifies tumor content in cfDNA from 0.1× coverage whole-genome sequencing data without prior knowledge of tumor mutations. We apply ichorCNA to 1439 blood samples from 520 patients with metastatic prostate or breast cancers. In the earliest tested sample for each patient, 34% of patients have ≥10% tumor-derived cfDNA, sufficient for standard coverage whole-exome sequencing. Using whole-exome sequencing, we validate the concordance of clonal somatic mutations (88%), copy number alterations (80%), mutational signatures, and neoantigens between cfDNA and matched tumor biopsies from 41 patients with ≥10% cfDNA tumor content. In summary, we provide methods to identify patients eligible for comprehensive cfDNA profiling, revealing its applicability to many patients, and demonstrate high concordance of cfDNA and metastatic tumor whole-exome sequencing.

  6. Comparison of diagnostic quality of motion picture experts group-2 digital video with super VHS videotape for echocardiographic imaging.

    PubMed

    Harris, Kevin M; Schum, Kevin R; Knickelbine, Thomas; Hurrell, David G; Koehler, Jodi L; Longe, Terrence F

    2003-08-01

    Motion Picture Experts Group-2 (MPEG2) is a broadcast industry standard that allows high-level compression of echocardiographic data. Validation of MPEG2 digital images compared with super VHS videotape has not been previously reported. Simultaneous super VHS videotape and MPEG2 digital images were acquired. In all, 4 experienced echocardiographers completed detailed reporting forms evaluating chamber size, ventricular function, regional wall-motion abnormalities, and measures of valvular regurgitation and stenosis in a blinded fashion. Comparisons between the 2 interpretations were then performed and intraobserver concordance was calculated for the various categories. A total of 80 paired comparisons were made. The overall concordance rate was 93.6% with most of the discrepancies being minor (4.1%). Concordance was 92.4% for left ventricle, 93.2% for right ventricle, 95.2% for regional wall-motion abnormalities, and 97.8% for valve stenosis. The mean grade of valvular regurgitation was similar for the 2 techniques. MPEG2 digital imaging offers excellent concordance compared with super VHS videotape.

  7. Reliability and validity of the self-report version of the apathy evaluation scale in first-episode Psychosis: Concordance with the clinical version at baseline and 12 months follow-up.

    PubMed

    Faerden, Ann; Lyngstad, Siv Hege; Simonsen, Carmen; Ringen, Petter Andreas; Papsuev, Oleg; Dieset, Ingrid; Andreassen, Ole A; Agartz, Ingrid; Marder, Stephen R; Melle, Ingrid

    2018-05-31

    Negative symptoms have traditionally been assessed based on clinicians' observations. The subjective experience of negative symptoms in people with psychosis may bring new insight. The Apathy Evaluation Scale (AES) is commonly used to study apathy in psychosis and has corresponding self-rated (AES-S) and clinician-rated (AES-C) versions. The aim of the present study was to determine the validity and reliability of the AES-S by investigating its concordance with the AES-C. Eighty-four first-episode (FEP) patients completed the shortened 12-item AES-S and AES-C at baseline (T1) and 12 months (T2). Concordance was studied by degree of correlation, comparison of mean scores, and change and difference between diagnostic groups. The Positive and Negative Symptom Scale (PANSS) was used to study convergent and discriminative properties. High concordance was found between AES-S and AES-C at both T1 and T2 regarding mean values, change from T1 to T2, and the proportion with high levels of apathy. Both versions indicated high levels of apathy in FEP, while associations with PANSS negative symptoms were weaker for AES-S than AES-C. Controlling for depression did not significantly alter results. We concluded that self-rated apathy in FEP patients is in concordance with clinician ratings, but in need of further study. Copyright © 2018. Published by Elsevier B.V.

  8. Correlates of unmet need for contraception in Bangladesh: does couples' concordance in household decision making matter?

    PubMed

    Uddin, Jalal; Pulok, Mohammad Habibullah; Sabah, Md Nasim-Us

    2016-07-01

    A large body of literature has highlighted that women's household decision-making power is associated with better reproductive health outcomes, while most of the studies tend to measure such power from only women's point of view. Using both husband's and wife's matched responses to decision-making questions, this study examined the association between couples' concordant and discordant decision makings, and wife's unmet need for contraception in Bangladesh. This study used couple's data set (n=3336) from Bangladesh Demographic and Health Survey of 2007. Multivariate logistic regression was used to examine the likelihood of unmet need for contraception among married women of reproductive age. Study results suggested that couples who support the equalitarian power structure seemed to be more powerful in meeting the unmet demand for contraception. Logistic regression analysis revealed that compared to couple's concordant joint decision making, concordance in husband-only or other's involvement in decision making was associated with higher odds of unmet need for contraception. Wives exposed to family planning information discussed family planning more often with husbands, and those from richest households were less likely to have unmet need for contraception. Couple's concordant joint decision making, reflecting the concept of equalitarian power structure, appeared to be a significant analytic category. Policy makers in the field of family planning may promote community-based outreach programs and communication campaigns for family planning focusing on egalitarian gender roles in the household. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Concordance of adolescent human papillomavirus vaccination parental report with provider report in the National Immunization Survey-Teen (2008-2013).

    PubMed

    Hirth, Jacqueline; Kuo, Yong-Fang; Laz, Tabassum Haque; Starkey, Jonathan M; Rupp, Richard E; Rahman, Mahbubur; Berenson, Abbey B

    2016-08-17

    To examine the accuracy of parental report of HPV vaccination through examination of concordance, with healthcare provider vaccination report as the comparison. The 2008-2013 National Immunization Survey (NIS)-Teen was used to examine accuracy of parent reports of HPV vaccination for their female daughters aged 13-17years, as compared with provider report of initiation and number of doses. Multivariable logistic regression models were used to examine associations related to concordance of parent and provider report. Of 51,746 adolescents, 84% concordance for HPV vaccine initiation and 70% concordance for number of doses was observed. Accuracy varied by race/ethnicity, region, time, and income. The parent report of number of doses was more likely to be accurate among parents of 13 and 14year old females than 17year olds. Accuracy of initiation and number of doses were lower among Hispanic and black adolescents compared to white parents. The odds of over-report was higher among minorities compared to whites, but the odds of underreport was also markedly higher in these groups compared to parents of white teens. Accuracy of parental vaccine report decreased across time. These findings are important for healthcare providers who need to ascertain the vaccination status of young adults. Strengthening existing immunization registries to improve data sharing capabilities and record completeness could improve vaccination rates, while avoiding costs associated with over-vaccination. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Comparison of Combined Endoscopic Ultrasonography and Endoscopic Secretin Testing With the Traditional Secretin Pancreatic Function Test in Patients With Suspected Chronic Pancreatitis: A Prospective Crossover Study.

    PubMed

    Kothari, Darshan; Ketwaroo, Gyanprakash; Sawhney, Mandeep S; Freedman, Steven D; Sheth, Sunil G

    2017-07-01

    We aimed to determine the feasibility and accuracy of a combined endoscopic ultrasonography (EUS) with a shortened pancreatic function testing (sEUS) for structural and functional assessment using a single instrument in patients with suspected chronic pancreatitis (CP). We completed a prospective crossover study, enrolling patients with suspected CP. Patients who underwent both traditional 1-hour secretin pancreatic function test (sPFT) and sEUS were included in the analysis. We compared study results for test concordance and for correlation of peak bicarbonate concentrations. Eleven (64.7%) of 17 patients had concordant sPFT and sEUS findings when the cutoff for peak bicarbonate was 80 mEq/L. Six patients had discordant findings with a negative sPFT and positive sEUS. This poor concordance suggests that sEUS is an unreliable functional test. Lowering the sEUS cutoff to 70 mEq/L resulted in improved concordance (64.7% vs 70.6%). Finally, there was no significant correlation between peak bicarbonate concentrations (r = 0.47; 95% confidence interval, -0.02 to 0.79) in these 2 functional tests. We demonstrate poor concordance between sPFT and sEUS suggesting that a combined shortened functional and structural test using a single instrument may not be a feasible test for diagnosis of suspected CP when a cutoff of 80 mEq/L is used.

  11. Mohs Micrographic Surgery Dermatopathology Concordance in Canada: A Single-Institution Experience.

    PubMed

    Chia, Justin C; Abi Daoud, Marie S; Williamson, Tyler S; Kurwa, Habib A

    2018-06-01

    Mohs micrographic surgery (MMS) is a surgical modality that achieves high cure rates of nonmelanoma skin cancers but is dependent on accurate histologic examination of surgical margins. Therefore, quality assurance is essential to ongoing assessment of histological margins. To prospectively determine the concordance rate between a Mohs surgeon (MS) and dermatopathologist (DP) with respect to tumour status (ie, present or absent) and tumour type. Secondary end points were to determine the relationship between discordant interpretations and slide quality and to assess the feasibility of using an electronic webform for data collection. Ten percent (10%) of the planned MMS cases between January 2015 and March 2016 were randomly selected by a histotechnologist at the start of each month. The MS and DP were blinded to the chosen cases, and slides were reviewed independently at the beginning of the following month. Data were collected using an online webform. A blinded third party determined if there were discrepancies in interpretation, and any discordant slides were reviewed together and a consensus was reached. A total of 270 slides from 54 total cases were reviewed. The overall tumour status concordance rate was 93.6%. Cohen's κ was 0.86. Tumour type concordance was 98.9%. No discrepancy required a change in patient care. All discrepant slides were from cases that required multiple stages. This is the first study looking at MS-DP concordance in Canada, and our findings support the MS acting as his or her own pathologist.

  12. Differences in Parent-Provider Concordance Regarding Prognosis and Goals of Care Among Children With Advanced Cancer

    PubMed Central

    Rosenberg, Abby R.; Orellana, Liliana; Kang, Tammy I.; Geyer, J. Russell; Feudtner, Chris; Dussel, Veronica; Wolfe, Joanne

    2014-01-01

    Purpose Concordance between parents of children with advanced cancer and health care providers has not been described. We aimed to describe parent-provider concordance regarding prognosis and goals of care, including differences by cancer type. Patients and Methods A total of 104 pediatric patients with recurrent or refractory cancer were enrolled at three large children's hospitals. On enrollment, their parents and providers were invited to complete a survey assessing perceived prognosis and goals of care. Patients' survival status was retrospectively abstracted from medical records. Concordance was assessed via discrepancies in perceived prognosis, κ statistics, and McNemar's test. Distribution of categorical variables and survival rates across cancer type were compared with Fisher's exact and log-rank tests, respectively. Results Data were available from 77 dyads (74% of enrolled). Parent-provider agreement regarding prognosis and goals of care was poor (κ, 0.12 to 0.30). Parents were more likely to report cure was likely (P < .001). The frequency of perceived likelihood of cure and the goal of cure varied by cancer type for both parents and providers (P < .001 to .004). Relatively optimistic responses were more common among parents and providers of patients with hematologic malignancies, although there were no differences in survival. Conclusion Parent-provider concordance regarding prognosis and goals in advanced pediatric cancer is generally poor. Perceptions of prognosis and goals of care vary by cancer type. Understanding these differences may inform parent-provider communication and decision making. PMID:25024073

  13. The Influence of Physical Body Traits and Masculinity on Anal Sex Roles in Gay and Bisexual Men

    PubMed Central

    Moskowitz, David A.; Hart, Trevor A.

    2016-01-01

    Sociological, psychological, and public health studies document that many gay and bisexual men may self-label by their anal penetrative role (i.e., bottom or exclusively receptive; top or exclusively insertive; or versatile, both receptive and insertive during anal intercourse). Yet, what orients men to think of themselves as tops, bottoms or versatiles is poorly understood. We surveyed 429 men engaging in same-sex anal intercourse to investigate the degree to which anal penetrative self-identity was concordant with actual penetrative behavior. Additionally, the roles of masculinity and physical body traits (e.g., penis size, muscularity, height, hairiness, and weight) were tested as correlates of anal penetrative identity and identity-behavior concordance. Tops and bottoms showed a high degree of concordance between identity and enacted behavior; however, only half of versatiles reported concordant identity and behavior (i.e., wanting to be versatile and actually reporting versatile behavior). Generally, tops reported larger penises than bottoms. They also reported being comparatively more masculine than bottoms. Versatiles fell somewhat between the tops and bottoms on these traits. Of the six independent variables, penis size and masculinity were the only two factors to influence concordance or discordance between identity and penetrative behavior. Our study suggests that the correlates of gay men’s sexual self-labels may depend on objective traits in addition to the subjective pleasure associated with receptive or insertive anal intercourse. PMID:21465269

  14. Concordance in the Assessment of Effectiveness of Palliative Care between Patients and Palliative Care Nurses in Malaysia: A Study with the Palliative Care Outcome Scale

    PubMed Central

    Koh, Kwee Choy; Gupta, Esha Das; Poovaneswaran, Sangeetha; Then, Siaw Ling; Teo, Michelle Jia Jui; Gan, Teik Yiap; Thing, Joanne Hwei Yean

    2017-01-01

    Context: The Palliative Care Outcome Scale (POS) is an easy-to-use assessment tool to evaluate the effectiveness of palliative care. There is no published literature on the use of POS as an assessment tool in Malaysia. Aim: To define the concordance in the assessment of quality of life between patients with advanced cancers and their palliative care nurses using a Malay version of the POS. Settings and Design: This study was conducted in the palliative care unit of the Hospital Tuanku Ja'afar Seremban, Malaysia, from February 2014 to June 2014. Subjects and Methods: We adapted and validated the English version of the 3-day recall POS into Malay and used it to define the concordance in the assessment of quality of life between patients and palliative care nurses. Forty patients with advanced stage cancers and forty palliative care nurses completed the Malay POS questionnaire. Statistical Analysis Used: The kappa statistical test was used to assess the agreement between patients and their palliative care nurses. Results: Slight to fair concordance was found in all items, except for one item (family anxiety) where there was no agreement. Conclusions: The Malay version of the POS was well accepted and reliable as an assessment tool for evaluation of the effectiveness of palliative care in Malaysia. Slight to fair concordance was shown between the patients and their palliative care nurses, suggesting the needs for more training of the nurses. PMID:28216862

  15. Validation of microscopic observation drug susceptibility testing for rapid, direct rifampicin and isoniazid drug susceptibility testing in patients receiving tuberculosis treatment

    PubMed Central

    Coronel, J; Roper, M H; Herrera, C; Bonilla, C; Jave, O; Gianella, C; Sabogal, I; Huancaré, V; Leo, E; Tyas, A; Mendoza-Ticona, A; Caviedes, L; Moore, D A J; Drancourt, M

    2014-01-01

    Drug susceptibility testing (DST) is often needed in patients clinically failing tuberculosis (TB) therapy. Most studies of phenotypic direct drug susceptibility tests, such as microscopic observation drug susceptibility (MODS) tests, have been performed in patients not receiving TB treatment. The effect of ongoing TB treatment on the performance of MODS direct DST has not been previously explored, but patients failing such therapy constitute an important target group. The aim of this study was to determine the performance of MODS direct rifampicin and isoniazid DST in patients clinically failing first-line TB treatment, and to compare MODS direct DST with indirect proportion method DST. Sputa from 264 TB patients were cultured in parallel in Lowenstein–Jensen (LJ) and MODS assays; strains were tested for rifampicin and isoniazid susceptibility by the proportion method at the national reference laboratory. Ninety-three samples were culture-positive by LJ and MODS (concordance of 96%; kappa 0.92). With conventional MODS plate DST reading (performed on the same day as the sample is classified as culture-positive), the isoniazid DST concordance was 96.8% (kappa 0.89), and the concordance for rifampicin susceptibility testing was 92.6% (kappa 0.80). Reading of MODS DST plates 1 week after cultures had been determined to be culture-positive improved overall performance marginally—the isoniazid DST concordance was 95.7% (kappa 0.85); and the rifampicin DST concordance was 96.8% (kappa 0.91). Sensitivity for detection of multidrug-resistant TB was 95.8%. MODS testing provided reliable rifampicin and isoniazid DST results for samples obtained from patients receiving TB therapy. A modified DST reading schedule for such samples, with a final reading 1 week after a MODS culture turns positive, marginally improves the concordance with reference DST. PMID:24107197

  16. Nosologic Comparisons of DSM-IV and DSM-5 Alcohol and Drug Use Disorders: Results From the National Epidemiologic Survey on Alcohol and Related Conditions–III

    PubMed Central

    Goldstein, Risë B.; Chou, S. Patricia; Smith, Sharon M.; Jung, Jeesun; Zhang, Haitao; Saha, Tulshi D.; Pickering, Roger P.; June Ruan, W.; Huang, Boji; Grant, Bridget F.

    2015-01-01

    Objective: The purpose of this study was to examine prevalences and concordances between Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), and Fifth Edition (DSM-5) substance use disorders (SUDs) in a newly completed U.S. epidemiologic survey. Method: The National Epidemiologic Survey on Alcohol and Related Conditions–III surveyed 36,309 civilian, noninstitutionalized adults. SUDs were assessed using the Alcohol Use Disorder and Associated Disabilities Interview Schedule–5. Concordances between DSM-IV and DSM-5 disorders were assessed using kappa statistics. Results: Prevalences of past-year substance-specific DSM-5 disorders (2+ criteria) were modestly higher than those of DSM-IV dependence and abuse combined for alcohol, sedatives/tranquilizers, opioids, and heroin, but lower for cannabis, cocaine, and stimulants. Lifetime prevalences were lower under DSM-5. Prevalences were similar between moderate to severe (4+ criteria) DSM-5 disorders and dependence, whereas prevalences of DSM-5 disorders at 3+ criteria (DSM-5 [3+]) were higher, particularly for cannabis. Past-year concordances were excellent for DSM-IV dependence and abuse combined versus any DSM-5 and DSM-IV dependence versus DSM-5 moderate to severe disorders; lifetime concordances were fair to excellent. Past-year concordances between DSM-IV and DSM-5 (3+) were generally similar to or modestly higher than those with any DSM-5 disorder; lifetime concordances were mostly lower. Conclusions: Findings are consistent with those informing the development of DSM-5. Future research should examine differences in patterns between past-year and lifetime disorders, particularly for cannabis. Other questions warranting investigation include whether different combinations of the same numbers of criteria carry different clinical or nosologic implications, whether changes innosology yield changes in treatment demand, and whether changes in characteristics of individuals with DSM-5 SUDs dictate modifications to screening and intervention. PMID:25978823

  17. Liver fibrosis diagnosis by blood test and elastography in chronic hepatitis C: agreement or combination?

    PubMed

    Calès, P; Boursier, J; Lebigot, J; de Ledinghen, V; Aubé, C; Hubert, I; Oberti, F

    2017-04-01

    In chronic hepatitis C, the European Association for the Study of the Liver and the Asociacion Latinoamericana para el Estudio del Higado recommend performing transient elastography plus a blood test to diagnose significant fibrosis; test concordance confirms the diagnosis. To validate this rule and improve it by combining a blood test, FibroMeter (virus second generation, Echosens, Paris, France) and transient elastography (constitutive tests) into a single combined test, as suggested by the American Association for the Study of Liver Diseases and the Infectious Diseases Society of America. A total of 1199 patients were included in an exploratory set (HCV, n = 679) or in two validation sets (HCV ± HIV, HBV, n = 520). Accuracy was mainly evaluated by correct diagnosis rate for severe fibrosis (pathological Metavir F ≥ 3, primary outcome) by classical test scores or a fibrosis classification, reflecting Metavir staging, as a function of test concordance. Score accuracy: there were no significant differences between the blood test (75.7%), elastography (79.1%) and the combined test (79.4%) (P = 0.066); the score accuracy of each test was significantly (P < 0.001) decreased in discordant vs. concordant tests. Classification accuracy: combined test accuracy (91.7%) was significantly (P < 0.001) increased vs. the blood test (84.1%) and elastography (88.2%); accuracy of each constitutive test was significantly (P < 0.001) decreased in discordant vs. concordant tests but not with combined test: 89.0 vs. 92.7% (P = 0.118). Multivariate analysis for accuracy showed an interaction between concordance and fibrosis level: in the 1% of patients with full classification discordance and severe fibrosis, non-invasive tests were unreliable. The advantage of combined test classification was confirmed in the validation sets. The concordance recommendation is validated. A combined test, expressed in classification instead of score, improves this rule and validates the recommendation of a combined test, avoiding 99% of biopsies, and offering precise staging. © 2017 John Wiley & Sons Ltd.

  18. Nosologic Comparisons of DSM-IV and DSM-5 Alcohol and Drug Use Disorders: Results From the National Epidemiologic Survey on Alcohol and Related Conditions-III.

    PubMed

    Goldstein, Risë B; Chou, S Patricia; Smith, Sharon M; Jung, Jeesun; Zhang, Haitao; Saha, Tulshi D; Pickering, Roger P; Ruan, W June; Huang, Boji; Grant, Bridget F

    2015-05-01

    The purpose of this study was to examine prevalences and concordances between Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), and Fifth Edition (DSM-5) substance use disorders (SUDs) in a newly completed U.S. epidemiologic survey. The National Epidemiologic Survey on Alcohol and Related Conditions-III surveyed 36,309 civilian, noninstitutionalized adults. SUDs were assessed using the Alcohol Use Disorder and Associated Disabilities Interview Schedule-5. Concordances between DSM-IV and DSM-5 disorders were assessed using kappa statistics. Prevalences of past-year substance-specific DSM-5 disorders (2+ criteria) were modestly higher than those of DSM-IV dependence and abuse combined for alcohol, sedatives/tranquilizers, opioids, and heroin, but lower for cannabis, cocaine, and stimulants. Lifetime prevalences were lower under DSM-5. Prevalences were similar between moderate to severe (4+ criteria) DSM-5 disorders and dependence, whereas prevalences of DSM-5 disorders at 3+ criteria (DSM-5 [3+]) were higher, particularly for cannabis. Past-year concordances were excellent for DSM-IV dependence and abuse combined versus any DSM-5 and DSM-IV dependence versus DSM-5 moderate to severe disorders; lifetime concordances were fair to excellent. Past-year concordances between DSM-IV and DSM-5 (3+) were generally similar to or modestly higher than those with any DSM-5 disorder; lifetime concordances were mostly lower. Findings are consistent with those informing the development of DSM-5. Future research should examine differences in patterns between past-year and lifetime disorders, particularly for cannabis. Other questions warranting investigation include whether different combinations of the same numbers of criteria carry different clinical or nosologic implications, whether changes innosology yield changes in treatment demand, and whether changes in characteristics of individuals with DSM-5 SUDs dictate modifications to screening and intervention.

  19. The Parenting to Reduce Adolescent Depression and Anxiety Scale: Assessing parental concordance with parenting guidelines for the prevention of adolescent depression and anxiety disorders

    PubMed Central

    Cardamone-Breen, Mairead C.; Jorm, Anthony F.; Lawrence, Katherine A.; Mackinnon, Andrew J.

    2017-01-01

    Background Despite substantial evidence demonstrating numerous parental risk and protective factors for the development of adolescent depression and anxiety disorders, there is currently no single measure that assesses these parenting factors. To address this gap, we developed the Parenting to Reduce Adolescent Depression and Anxiety Scale (PRADAS) as a criterion-referenced measure of parental concordance with a set of evidence-based parenting guidelines for the prevention of adolescent depression and anxiety disorders. In this paper, we used a sample of Australian parents of adolescents to: (1) validate the PRADAS as a criterion-referenced measure; (2) examine parental concordance with the guidelines in the sample; and (3) examine correlates of parental concordance with the guidelines. Methods Seven hundred eleven parents completed the PRADAS, as well as two established parenting measures, and parent-report measures of adolescent depression and anxiety symptoms. Six hundred sixty adolescent participants (aged 12–15) also completed the symptom measures. Concordance with the guidelines was assessed via nine subscale scores and a total score. Reliability of the scores was assessed with an estimate of the agreement coefficient, as well as 1-month test-retest reliability. Convergent validity was examined via correlations between the scale and two established parenting measures. Results One proposed subscale was removed from the final version of the scale, resulting in a total of eight subscales. Reliability was high for the total score, and acceptable to high for seven of the eight subscales. One-month test-retest reliability was acceptable to high for the total score. Convergent validity was supported by moderate to high correlations with two established measures of parenting. Overall, rates of parental concordance with the guidelines were low in our sample. Higher scores were associated with being female and higher levels of parental education. Greater parental concordance with the guidelines was associated with fewer symptoms of depression and anxiety in adolescent participants. Discussion This initial validation study provides preliminary support for the reliability and validity of the PRADAS. The scale has potential for use in both clinical and research settings. It may be used to identify parents’ strengths and potential targets for intervention, and as an outcome measure in studies of preventive parenting interventions. PMID:28951815

  20. Implications of American College of Cardiology/American Heart Association (ACC/AHA) Cholesterol Guidelines on Statin Underutilization for Prevention of Cardiovascular Disease in Diabetes Mellitus Among Several US Networks of Community Health Centers.

    PubMed

    Akhabue, Ehimare; Rittner, Sarah S; Carroll, Joseph E; Crawford, Phillip M; Dant, Lydia; Laws, Reesa; Leo, Michael C; Puro, Jon; Persell, Stephen D

    2017-07-03

    Little is known about statin underutilization among diabetes mellitus patients cared for in community health centers, which tend to serve socioeconomically disadvantaged populations. Implications of the American College of Cardiology/American Heart Association (ACC/AHA) guidelines on preexisting gaps in statin treatment in this population are unclear. We included 32 440 adults (45% male, 63% nonwhite, 29% uninsured/Medicaid) aged 40 to 75 years with diabetes mellitus who received care within 16 community health center groups in 11 states in the Community Health Applied Research Network during 2013. Statin prescribing was analyzed as a function of concordance with the National Cholesterol Education Program Adult Treatment Panel 2001 and ACC/AHA 2013 guidelines. More patients' treatments were concordant with the ACC/AHA (52.8%) versus the National Cholesterol Education Program Adult Treatment Panel (36.2%) guideline. Female sex was associated with lower concordance for both (odds ratio [OR] 0.90, CI 0.85-0.94; and OR 0.84, CI 0.80-0.88, respectively). Being insured, an Asian/Pacific Islander, or primarily Spanish speaking were associated with greater concordance for both guidelines: 35.5% (11 526/32 440) were concordant with neither guideline, the majority (79.7%) having no statin prescribed; 28.2% (9168/32 440) were concordant with ACC/AHA but not the National Cholesterol Education Program Adult Treatment Panel. 8.7% of these patients had a low-density lipoprotein cholesterol >160 mg/dL despite having a moderate- or high-intensity statin prescribed. And 11.6% (3772/32 440) were concordant with the National Cholesterol Education Program Adult Treatment Panel but not with ACC/AHA. Most of these patients had a low-density lipoprotein cholesterol between 70 and 99 mg/dL with no or a low-intensity statin prescribed. Opportunities exist to improve cholesterol management in diabetes mellitus patients in community health centers. Addressing care gaps could improve cardiovascular disease prevention in this high-risk population. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

  1. Discordance between patient and physician assessments of global disease activity in rheumatoid arthritis and association with work productivity.

    PubMed

    Smolen, Josef S; Strand, Vibeke; Koenig, Andrew S; Szumski, Annette; Kotak, Sameer; Jones, Thomas V

    2016-05-21

    Discordance between patient and physician ratings of rheumatoid arthritis (RA) severity occurs in clinical practice and correlates with pain scores and measurements of joint disease. However, information is lacking on whether discordance impacts patients' ability to work. We evaluated the discordance between patient and physician ratings of RA disease activity before and after treatment with etanercept and investigated the associations between discordance, clinical outcomes, and work productivity. In the PRESERVE clinical trial, patients with moderate RA received open-label etanercept 50 mg once weekly plus methotrexate for 36 weeks. Baseline and week-36 disease characteristics and clinical and work productivity outcomes were categorized according to week-36 concordance category, defined as positive discordance (patient global assessment - physician global assessment ≥2), negative discordance (patient global assessment - physician global assessment ≤ -2), and concordance (absolute difference between the two disease activity assessments = 0 or 1). Correlations between discordance, clinical outcomes, and predictors of discordance were determined. At baseline, 520/762 (68.2 %) patient and physician global assessment scores were concordant, 194 (25.5 %) were positively discordant, and 48 (6.3 %) were negatively discordant. After 36 weeks of therapy, 556/763 (72.9 %) scores were concordant, 189 (24.8 %) were positively discordant, and 18 (2.4 %) were negatively discordant. Patients with week-36 concordance had the best 36-week clinical and patient-reported outcomes, and overall, the greatest improvement between baseline and week 36. Baseline pain, swollen joint count, duration of morning stiffness, fatigue, and patient general health significantly correlated with week-36 discordance, p < 0.0001 to p < 0.05. Additionally, baseline pain, patient general health, and C-reactive protein were predictors of week-36 discordance (odds ratios 1.22, 1.02, and 0.98, respectively). For the employed patients, percent impairment while working and percent overall work impairment were highest (greatest impairment) at baseline and 36 weeks in the group with positive discordance. The percentage of patients with concordance increased after 36 weeks of treatment with etanercept, with concordant patients demonstrating the greatest improvement in clinical and patient-reported outcomes. Discordance correlated with several measures of disease activity and was associated with decreased work productivity. ClinicalTrials.gov identifier: NCT00565409 . Registered 28/11/2007.

  2. Research University STEM Faculty Members' Motivation to Engage in Teaching Professional Development: Building the Choir Through an Appeal to Extrinsic Motivation and Ego

    NASA Astrophysics Data System (ADS)

    Bouwma-Gearhart, Jana

    2012-10-01

    This paper reports on a qualitative, grounded-theory-based study that explored the motivations of science and engineering faculty to engage in teaching professional development at a major research university. Faculty members were motivated to engage in teaching professional development due to extrinsic motivations, mainly a weakened professional ego, and sought to bring their teaching identities in better concordance with their researcher identities. The results pose a challenge to a body of research that has concluded that faculty must be intrinsically motivated to participate in teaching professional development. Results confirmed a pre-espoused theory of motivation, self-determination theory; a discussion of research literature consideration during grounded theory research is offered. A framework for motivating more faculty members at research universities to engage in teaching professional development is provided.

  3. Light trapping structures in wing scales of butterfly Trogonoptera brookiana.

    PubMed

    Han, Zhiwu; Niu, Shichao; Shang, Chunhui; Liu, Zhenning; Ren, Luquan

    2012-04-28

    The fine optical structures in wing scales of Trogonoptera brookiana, a tropical butterfly exhibiting efficient light trapping effect, were carefully examined and the reflectivity was measured using reflectance spectrometry. The optimized 3D configuration of the coupling structure was determined using SEM and TEM data, and the light trapping mechanism of butterfly scales was studied. It is found that the front and back sides of butterfly wings possess different light trapping structures, but both can significantly increase the optical path and thus result in almost total absorption of all incident light. An optical model was created to check the properties of this light trapping structure. The simulated reflectance spectra are in concordance with the experimental ones. The results reliably confirm that these structures induce efficient light trapping effect. This functional "biomimetic structure" would have a potential value in wide engineering and optical applications. This journal is © The Royal Society of Chemistry 2012

  4. Multiple microscopic approaches demonstrate linkage between chromoplast architecture and carotenoid composition in diverse Capsicum annuum fruit.

    PubMed

    Kilcrease, James; Collins, Aaron M; Richins, Richard D; Timlin, Jerilyn A; O'Connell, Mary A

    2013-12-01

    Increased accumulation of specific carotenoids in plastids through plant breeding or genetic engineering requires an understanding of the limitations that storage sites for these compounds may impose on that accumulation. Here, using Capsicum annuum L. fruit, we demonstrate directly the unique sub-organellar accumulation sites of specific carotenoids using live cell hyperspectral confocal Raman microscopy. Further, we show that chromoplasts from specific cultivars vary in shape and size, and these structural variations are associated with carotenoid compositional differences. Live-cell imaging utilizing laser scanning confocal (LSCM) and confocal Raman microscopy, as well as fixed tissue imaging by scanning and transmission electron microscopy (SEM and TEM), all demonstrated morphological differences with high concordance for the measurements across the multiple imaging modalities. These results reveal additional opportunities for genetic controls on fruit color and carotenoid-based phenotypes. © 2013 The Authors The Plant Journal © 2013 John Wiley & Sons Ltd.

  5. Locked on course: Hydro-Quebec`s commitment to mega-projects

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

    Maxwell, J.; Briscoe, F.; Suzuki, Tatsujiro

    1997-01-01

    Large organizations often escalate their commitments to mega-project development, even after evidence becomes available of adverse environmental consequences or lack of economic feasibility. This escalation of commitment transcends both sectorial and national boundaries. Preeminent examples include controversial nuclear projects in the US, hydroelectric projects like the Three Gorges Dam in China, and transport projects like the Chunnel and the Concorde. In this article, the authors examine the experience of Hydro-Quebec with the Great Whale Project. They argue that Hydro-Quebec escalated its commitment even after serious questions emerged about its environmental impacts and economic feasibility, because of (1) its earlier successmore » with large projects, (2) its engineering culture`s norms for consistency, and (3) its role in the government`s desire for economic and cultural autonomy. Finally, they discuss the changes that are necessary to break commitments to such projects.« less

  6. Concord, Convergence and Accommodation in Bilingual Children

    ERIC Educational Resources Information Center

    Radford, Andrew; Kupisch, Tanja; Koppe, Regina; Azzaro, Gabriele

    2007-01-01

    This paper examines the syntax of "GENDER CONCORD" in mixed utterances where bilingual children switch between a modifier in one language and a noun in another. Particular attention is paid to how children deal with potential gender mismatches between modifier and noun, i.e., if one of the languages has grammatical gender but the other does not,…

  7. Effects of concord grape juice on appetite, diet, body weight, lipid profile, and antioxidant status of adults

    USDA-ARS?s Scientific Manuscript database

    Concord grape juice (CGJ) is a rich source of phenolic antioxidants with a range of putative health benefits. However, high beverage energy and fructose intake may lead to weight gain and insulin resistance, respectively. This study assessed the effects of CGJ consumption for 12-wk on appetite, di...

  8. Concordance between Measures of Anxiety and Physiological Arousal Following Treatment of Panic Disorder in Adolescence

    ERIC Educational Resources Information Center

    Bacow, Terri Landon; May, Jill Ehrenreich; Choate-Summers, Molly; Pincus, Donna B.; Mattis, Sara G.

    2010-01-01

    This study examined the concordance (or synchrony/desynchrony) between adolescents' self-reports of anxiety and physiological measures of arousal (heart rate) both prior to and after treatment for panic disorder. Results indicated a decline in reported subjective units of distress (SUDS) for the treatment group only at the post-treatment…

  9. 33 CFR 334.1110 - Suisun Bay at Naval Weapons Station, Concord; restricted area.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 3 2014-07-01 2014-07-01 false Suisun Bay at Naval Weapons....1110 Suisun Bay at Naval Weapons Station, Concord; restricted area. (a) The area. Beginning at a point... his control from this area upon the request of the Commanding Officer of the Naval Weapons Station...

  10. 33 CFR 334.1110 - Suisun Bay at Naval Weapons Station, Concord; restricted area.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 3 2012-07-01 2012-07-01 false Suisun Bay at Naval Weapons....1110 Suisun Bay at Naval Weapons Station, Concord; restricted area. (a) The area. Beginning at a point... his control from this area upon the request of the Commanding Officer of the Naval Weapons Station...

  11. 33 CFR 334.1110 - Suisun Bay at Naval Weapons Station, Concord; restricted area.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 3 2013-07-01 2013-07-01 false Suisun Bay at Naval Weapons....1110 Suisun Bay at Naval Weapons Station, Concord; restricted area. (a) The area. Beginning at a point... his control from this area upon the request of the Commanding Officer of the Naval Weapons Station...

  12. Brief Report: Identical Male Twins Concordant for Asperger's Disorder

    ERIC Educational Resources Information Center

    Ishijima, Michiko; Kurita, Hiroshi

    2007-01-01

    The first case study of identical male twins concordant for DSM-IV Asperger's disorder (ASD) was presented. Their monozygocity was confirmed by short tandem repeat analyses with a probability of 99.999963%. Despite sharing the same DNA and environment, the twins are different in comorbidity (i.e., major depressive disorder in the elder and absence…

  13. The Concordance of Multilingual Legal Texts at the WTO

    ERIC Educational Resources Information Center

    Condon, Bradly J.

    2012-01-01

    Multilingualism is a sensitive and complex subject in a global organisation such as the World Trade Organization (WTO). In the WTO legal texts, there is a need for full concordance, not simply translation. This article begins with an overview of the issues raised by multilingual processes at the WTO in the negotiation, drafting, translation,…

  14. The Practicum Script Concordance Test: An Online Continuing Professional Development Format to Foster Reflection on Clinical Practice

    ERIC Educational Resources Information Center

    Hornos, Eduardo H.; Pleguezuelos, Eduardo M.; Brailovsky, Carlos A.; Harillo, Leandro D.; Dory, Valerie; Charlin, Bernard

    2013-01-01

    Introduction: Judgment in the face of uncertainty is an important dimension of expertise and clinical competence. However, it is challenging to conceive continuing professional development (CPD) initiatives aimed at helping physicians enhance their clinical judgment skills in ill-defined situations. We present an online script concordance-based…

  15. Use and Understanding of Adverbial Conjuncts: A Developmental Study of Adolescents and Young Adults.

    ERIC Educational Resources Information Center

    Nippold, Marilyn A.; And Others

    1992-01-01

    Adolescents and young adults (n=120) were assessed on their use and understanding of concordant and discordant adverbial conjuncts. Results demonstrated an increasing ability with age to use and understand these words in the written mode, with mastery in usage trailing understanding. Concordant and discordant conjuncts were equally difficult.…

  16. Concordance of Interests in Dynamic Models of Social Partnership in the System of Continuing Professional Education

    ERIC Educational Resources Information Center

    Tarasenko, Larissa V.; Ougolnitsky, Guennady A.; Usov, Anatoly B.; Vaskov, Maksim A.; Kirik, Vladimir A.; Astoyanz, Margarita S.; Angel, Olga Y.

    2016-01-01

    A dynamic game theoretic model of concordance of interests in the process of social partnership in the system of continuing professional education is proposed. Non-cooperative, cooperative, and hierarchical setups are examined. Analytical solution for a linear state version of the model is provided. Nash equilibrium algorithms (for non-cooperative…

  17. Parent and Teacher Concordance of Child Outcomes for Youth with Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Dickson, Kelsey S.; Suhrheinrich, Jessica; Rieth, Sarah R.; Stahmer, Aubyn C.

    2017-01-01

    Cross-informant ratings of are considered gold standard for child behavioral assessment. To date, little work has examined informant ratings of adaptive functioning for youth with autism spectrum disorder (ASD). In a large, diverse sample of youth with ASD, this study evaluated parent-teacher concordance of ratings of adaptive functioning and…

  18. National Comorbidity Survey Replication Adolescent Supplement (NCS-A): III. Concordance of DSM-IV/CIDI Diagnoses with Clinical Reassessments

    ERIC Educational Resources Information Center

    Kessler, Ronald C.; Avenevoli, Shelli; Green, Jennifer; Gruber, Michael J.; Guyer, Margaret; He, Yulei; Jin, Robert; Kaufman, Joan; Sampson, Nancy A.; Zaslavsky, Alan M.; Merikangas, Kathleen R.

    2009-01-01

    The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) diagnoses that was based on the World Health Organization's Composite International Diagnostic Interview (CIDI) and implemented in the National comorbidity survey replication adolescent supplement is found to have good individual-level concordance with diagnosis based on blinded…

  19. Validation of the Seating and Mobility Script Concordance Test

    ERIC Educational Resources Information Center

    Cohen, Laura J.; Fitzgerald, Shirley G.; Lane, Suzanne; Boninger, Michael L.; Minkel, Jean; McCue, Michael

    2009-01-01

    The purpose of this study was to develop the scoring system for the Seating and Mobility Script Concordance Test (SMSCT), obtain and appraise internal and external structure evidence, and assess the validity of the SMSCT. The SMSCT purpose is to provide a method for testing knowledge of seating and mobility prescription. A sample of 106 therapists…

  20. Caregiver-Teacher Concordance of Challenging Behaviors in Children with Autism Spectrum Disorder Served in Community Mental Health Settings

    ERIC Educational Resources Information Center

    Stadnick, Nicole; Chlebowski, Colby; Brookman-Frazee, Lauren

    2017-01-01

    Children with autism spectrum disorder (ASD) exhibit high rates of challenging behaviors that impair functioning and represent the primary presenting problem in mental health (MH) services. Obtaining symptom reports from multiple informants is critical for treatment planning. This study evaluated caregiver-teacher concordance of ratings of the…

  1. 33 CFR 334.1110 - Suisun Bay at Naval Weapons Station, Concord; restricted area.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 3 2011-07-01 2011-07-01 false Suisun Bay at Naval Weapons....1110 Suisun Bay at Naval Weapons Station, Concord; restricted area. (a) The area. Beginning at a point... his control from this area upon the request of the Commanding Officer of the Naval Weapons Station...

  2. 33 CFR 334.1110 - Suisun Bay at Naval Weapons Station, Concord; restricted area.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Suisun Bay at Naval Weapons....1110 Suisun Bay at Naval Weapons Station, Concord; restricted area. (a) The area. Beginning at a point... his control from this area upon the request of the Commanding Officer of the Naval Weapons Station...

  3. Attention Problems and Attention-Deficit/Hyperactivity Disorder in Discordant and Concordant Monozygotic Twins: Evidence of Environmental Mediators

    ERIC Educational Resources Information Center

    Lehn, Hanne; Derks, Eske M.; Hudziak, James J.; Heutink, Peter; van Beijsterveldt, Toos; Boomsma, Dorret I.

    2007-01-01

    Objective: To study familial and nonfamilial environmental influences on attention problems and attention-deficit/hyperactivity disorder (ADHD) in monozygotic twins discordant and concordant-high and low for these traits. Method: Ninety-five twin pairs from The Netherlands Twin Register were selected. Longitudinal survey data were collected at 1,…

  4. Parent and Teacher Concordance of Child Outcomes for Youth with Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Dickson, Kelsey S.; Suhrheinrich, Jessica; Rieth, Sarah R.; Stahmer, Aubyn C.

    2018-01-01

    Cross-informant ratings of are considered gold standard for child behavioral assessment. To date, little work has examined informant ratings of adaptive functioning for youth with autism spectrum disorder (ASD). In a large, diverse sample of youth with ASD, this study evaluated parent-teacher concordance of ratings of adaptive functioning and…

  5. Identical twins concordant for pulmonary sequestration communicating with the esophagus and discordant for the VACTERL association.

    PubMed

    Becker, Julie; Hernandez, Ambrosio; Dipietro, Michael; Coran, Arnold G

    2005-07-01

    Communicating bronchopulmonary foregut malformations (CBPFMs) are unusual congenital structures composed of a segment of lung tissue connected to the foregut. We present what we believe is the first reported case of identical twins concordant for CBPFM who are discordant for the VACTERL association. Their nonfunctional lung tissue was successfully removed and the fistulae were corrected, and they are expected to live normal life spans. We review the literature concerning these malformations and the proposed theories of their etiology. This case report of concordance in identical twins suggests that a possible genetic component to CBPFMs cannot be ruled out. The discordance for the VACTERL association implies that the etiology is most likely multifactorial.

  6. Gender identity disorder in twins: a review of the case report literature.

    PubMed

    Heylens, Gunter; De Cuypere, Griet; Zucker, Kenneth J; Schelfaut, Cleo; Elaut, Els; Vanden Bossche, Heidi; De Baere, Elfride; T'Sjoen, Guy

    2012-03-01

    The etiology of gender identity disorder (GID) remains largely unknown. In recent literature, increased attention has been attributed to possible biological factors in addition to psychological variables. To review the current literature on case studies of twins concordant or discordant for GID. A systematic, comprehensive literature review. Of 23 monozygotic female and male twins, nine (39.1%) were concordant for GID; in contrast, none of the 21 same-sex dizygotic female and male twins were concordant for GID, a statistically significant difference (P=0.005). Of the seven opposite-sex twins, all were discordant for GID. These findings suggest a role for genetic factors in the development of GID. © 2011 International Society for Sexual Medicine.

  7. Digital image transformation and rectification of spacecraft and radar images

    USGS Publications Warehouse

    Wu, S.S.C.

    1985-01-01

    Digital image transformation and rectification can be described in three categories: (1) digital rectification of spacecraft pictures on workable stereoplotters; (2) digital correction of radar image geometry; and (3) digital reconstruction of shaded relief maps and perspective views including stereograms. Digital rectification can make high-oblique pictures workable on stereoplotters that would otherwise not accommodate such extreme tilt angles. It also enables panoramic line-scan geometry to be used to compile contour maps with photogrammetric plotters. Rectifications were digitally processed on both Viking Orbiter and Lander pictures of Mars as well as radar images taken by various radar systems. By merging digital terrain data with image data, perspective and three-dimensional views of Olympus Mons and Tithonium Chasma, also of Mars, are reconstructed through digital image processing. ?? 1985.

  8. The gravity field of Mars: results from Mars Global Surveyor.

    PubMed

    Smith, D E; Sjogren, W L; Tyler, G L; Balmino, G; Lemoine, F G; Konopliv, A S

    1999-10-01

    Observations of the gravity field of Mars reveal a planet that has responded differently in its northern and southern hemispheres to major impacts and volcanic processes. The rough, elevated southern hemisphere has a relatively featureless gravitational signature indicating a state of near-isostatic compensation, whereas the smooth, low northern plains display a wider range of gravitational anomalies that indicates a thinner but stronger surface layer than in the south. The northern hemisphere shows evidence for buried impact basins, although none large enough to explain the hemispheric elevation difference. The gravitational potential signature of Tharsis is approximately axisymmetric and contains the Tharsis Montes but not the Olympus Mons or Alba Patera volcanoes. The gravity signature of Valles Marineris extends into Chryse and provides an estimate of material removed by early fluvial activity.

  9. Proceedings of the Fifteenth NASA Propagation Experimenters Meeting (NAPEX 15) and the Advanced Communications Technology Satellite (ACTS) Propagation Studies Miniworkshop

    NASA Technical Reports Server (NTRS)

    Davarian, Faramaz (Editor)

    1991-01-01

    The NASA Propagation Experimenters Meeting (NAPEX), supported by the NASA Propagation Program, is convened annually to discuss studies made on radio wave propagation by investigators from domestic and international organizations. The meeting was organized into three technical sessions. The first session was dedicated to Olympus and ACTS studies and experiments, the second session was focused on the propagation studies and measurements, and the third session covered computer-based propagation model development. In total, sixteen technical papers and some informal contributions were presented. Following NAPEX 15, the Advanced Communications Technology Satellite (ACTS) miniworkshop was held on 29 Jun. 1991, to review ACTS propagation activities, with emphasis on ACTS hardware development and experiment planning. Five papers were presented.

  10. Maximizing fluorescence collection efficiency in multiphoton microscopy

    PubMed Central

    Zinter, Joseph P.; Levene, Michael J.

    2011-01-01

    Understanding fluorescence propagation through a multiphoton microscope is of critical importance in designing high performance systems capable of deep tissue imaging. Optical models of a scattering tissue sample and the Olympus 20X 0.95NA microscope objective were used to simulate fluorescence propagation as a function of imaging depth for physiologically relevant scattering parameters. The spatio-angular distribution of fluorescence at the objective back aperture derived from these simulations was used to design a simple, maximally efficient post-objective fluorescence collection system. Monte Carlo simulations corroborated by data from experimental tissue phantoms demonstrate collection efficiency improvements of 50% – 90% over conventional, non-optimized fluorescence collection geometries at large imaging depths. Imaging performance was verified by imaging layer V neurons in mouse cortex to a depth of 850 μm. PMID:21934897

  11. Proceedings of the Fourteenth NASA Propagation Experimenters Meeting (NAPEX 14) and the Advanced Communications Technology Satellite (ACTS) Propagation Studies Miniworkshop

    NASA Technical Reports Server (NTRS)

    Davarian, Faramaz (Editor)

    1990-01-01

    The NASA Propagation Experimenters Meeting (NAPEX), supported by the NASA Propagation Program, is convened annually to discuss studies made on radio wave propagation by investigators from domestic and international organizations. NAPEX XIV was held on May 11, 1990, at the Balcones Research Centers, University of Texas, Austin, Texas. The meeting was organized into two technical sessions: Satellite (ACTS) and the Olympus Spacecraft, while the second focused on the fixed and mobile satellite propagation studies and experiments. Following NAPEX XIV, the ACTS Miniworkshop was held at the Hotel Driskill, Austin, Texas, on May 12, 1990, to review ACTS propagation activities since the First ACTS Propagation Studies Workshop was held in Santa Monica, California, on November 28 and 29, 1989.

  12. Impact of communication on preventive services among deaf American Sign Language users.

    PubMed

    McKee, Michael M; Barnett, Steve L; Block, Robert C; Pearson, Thomas A

    2011-07-01

    Deaf American Sign Language (ASL) users face communication and language barriers that limit healthcare communication with their providers. Prior research has not examined preventive services with ASL-skilled clinicians. The goal of this study was to determine whether provider language concordance is associated with improved receipt of preventive services among deaf respondents. This cross-sectional study included 89 deaf respondents aged 50-75 years from the Deaf Health Survey (2008), a Behavioral Risk Factor Surveillance System survey adapted for use with deaf ASL users. Association between the respondent's communication method with the provider (i.e., categorized as either concordant-doctor signs or discordant-other) and preventive services use was assessed using logistic regression adjusting for race, gender, income, health status, health insurance, and education. Analyses were conducted in 2010. Deaf respondents who reported having a concordant provider were more likely to report a greater number of preventive services (OR=3.42, 95% CI=1.31, 8.93, p=0.0122) when compared to deaf respondents who reported having a discordant provider even after adjusting for race, gender, income, health status, health insurance, and education. In unadjusted analyses, deaf respondents who reported having a concordant provider were more likely to receive an influenza vaccination in the past year (OR=4.55, p=0.016) when compared to respondents who had a discordant provider. Language-concordant patient-provider communication is associated with higher appropriate use of preventive services by deaf ASL users. Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  13. Problems and hopes perceived by mothers, fathers and physicians of children receiving palliative care.

    PubMed

    Hill, Douglas L; Miller, Victoria A; Hexem, Kari R; Carroll, Karen W; Faerber, Jennifer A; Kang, Tammy; Feudtner, Chris

    2015-10-01

    The quality of shared decision making for children with serious illness may depend on whether parents and physicians share similar perceptions of problems and hopes for the child. (i) Describe the problems and hopes reported by mothers, fathers and physicians of children receiving palliative care; (ii) examine the observed concordance between participants; (iii) examine parental perceived agreement; and (iv) examine whether parents who identified specific problems also specified corresponding hopes, or whether the problems were left 'hopeless'. Seventy-one parents and 43 physicians were asked to report problems and hopes and perceived agreement for 50 children receiving palliative care. Problems and hopes were classified into eight domains. Observed concordance was calculated between parents and between each parent and the physicians. The most common problem domains were physical body (88%), quality of life (74%) and medical knowledge (48%). The most common hope domains were quality of life (88%), suffering (76%) and physical body (39%). Overall parental dyads demonstrated a high percentage of concordance (82%) regarding reported problem domains and a lower percentage of concordance on hopes (65%). Concordance between parents and physicians regarding specific children was lower on problem (65-66%) and hope domains (59-63%). Respondents who identified problems regarding a child's quality of life or suffering were likely to also report corresponding hopes in these domains (93 and 82%, respectively). Asking parents and physicians to talk about problems and hopes may provide a straightforward means to improve the quality of shared decision making for critically ill children. © 2013 John Wiley & Sons Ltd.

  14. The Effect of Draft DSM-5 Criteria on Posttraumatic Stress Disorder Prevalence

    PubMed Central

    Calhoun, Patrick S.; Hertzberg, Jeffrey S.; Kirby, Angela C.; Dennis, Michelle F.; Hair, Lauren P.; Dedert, Eric A.; Beckham, Jean C.

    2012-01-01

    Background This study was designed to examine the concordance of proposed DSM-5 posttraumatic stress disorder (PTSD) criteria with DSM-IV classification rules and examine the impact of the proposed DSM-5 PTSD criteria on prevalence. Method The sample (N=185) included participants who were recruited for studies focused on trauma and health conducted at an academic medical center and VA medical center in the southeastern United States. The prevalence and concordance between DSM-IV and the proposed DSM-5 classifications were calculated based on results from structured clinical interviews. Prevalence rates and diagnostic efficiency indices including sensitivity, specificity, area under the curve (AUC), and Kappa were calculated for each of the possible ways to define DSM-5 PTSD. Results Ninety-five percent of the sample reported an event that met both DSM-IV PTSD Criterion A1 and A2, but only 89% reported a trauma that met Criterion A on DSM-5. Results examining concordance between DSM-IV and DSM-5 algorithms indicated that several of the algorithms had AUCs above .90. The requirement of two symptoms from both Clusters D and E provided strong concordance to DSM-IV (AUC = .93; Kappa = .86) and a greater balance between sensitivity and specificity than requiring three symptoms in both Clusters D and E. Conclusions Despite several significant changes to the diagnostic criteria for PTSD for DSM-5, several possible classification rules provided good concordance with DSM-IV. The magnitude of the impact of DSM-5 decision rules on prevalence will be largely affected by the DSM-IV PTSD base rate in the population of interest. PMID:23109002

  15. Use of whole-genome sequencing for Campylobacter surveillance from NARMS retail poultry in the United States in 2015.

    PubMed

    Whitehouse, Chris A; Young, Shenia; Li, Cong; Hsu, Chih-Hao; Martin, Gordon; Zhao, Shaohua

    2018-08-01

    Whole genome sequencing (WGS) has become a rapid and affordable tool for public health surveillance and outbreak detection. In this study, we used the Illuminia MiSeq ® to sequence 589 Campylobacter isolates obtained in 2015 from retail poultry meats as part of the National Antimicrobial Resistance Monitoring System (NARMS). WGS data were used to identify the Campylobacter species and to compare the concordance between resistance genotypes and phenotypes. WGS accurately identified 386 C. jejuni and 203 C. coli using gyrA sequence information. Ten resistance genes, including tetO, bla OXA-61 , aph(2″)-Ic, aph(2″)-If, aph(2″)-Ig, aph(3')-III, ant(6)-1a, aadE, aph(3")-VIIa, and Inu(C), plus mutations in housekeeping genes (gyrA at position 86, 23S rRNA at position 2074 and 2075), were identified by WGS analysis. Overall, there was a high concordance between phenotypic resistance to a given drug and the presence of known resistance genes. Concordance between both resistance and susceptible phenotypes and genotype was 100% for ciprofloxacin, nalidixic acid, gentamicin, azithromycin, and florfenicol. A few discrepancies were observed for tetracycline, clindamycin, and telithromycin. The concordance between resistance phenotype and genotype ranged from 67.9% to 100%; whereas, the concordance between susceptible phenotype and genotype ranged from 98.0% to 99.6%. Our study demonstrates that WGS can correctly identify Campylobacter species and predict antimicrobial resistance with a high degree of accuracy. Published by Elsevier Ltd.

  16. Lack of concordance between a rapid bedside and conventional laboratory method of cardiac troponin testing: impact on risk stratification of patients suspected of acute coronary syndrome.

    PubMed

    Cramer, G Etienne; Kievit, Peter C; Brouwer, Marc A; de Keijzer, Marinus H; Luijten, Hans E; Verheugt, Freek W A

    2007-06-01

    This study was designed to test the usefulness of a bedside assay as compared to a laboratory method of troponin testing to predict adverse cardiac outcome of chest pain patients. We studied 358 ER visits of patients suspected of a non ST-elevation acute coronary syndrome. cTnI (Immulite, DPC) on a lab analyser and cTnT (Cardiac Reader, Roche) at bedside were measured at baseline. The between-assay level of concordance, reporting turnaround times and clinical outcomes during 180 days of follow-up were assessed. Death and myocardial infarction were then evaluated according to troponin result, either concordant negative, discordant or concordant positive. Discordance occurred in 11.4% (41/358) of cases. The proportion of patients with a positive cTnI and negative cTnT result (8.9%) versus the reverse (2.5%) differed significantly (p<0.001). The median time gained using the rapid test was 72 min. The rate of death and/or MI was 25% (10/40) among patients with discordant results as compared to 7.5% (17/228) with a concordant negative result (p<0.001). All patients from the discordant group with an event had a positive cTnI result, while cTnT was negative. Patients with a discordant reading were at high risk of adverse cardiac outcome, which was only identified by the laboratory cTnI assay. Markedly, the use of the rapid assay saved time at the expense of clinical sensitivity.

  17. Concordance between Self-Reports and Medicare Claims among Participants in a National Study of Chronic Disease Self-Management Program.

    PubMed

    Jiang, Luohua; Zhang, Ben; Smith, Matthew Lee; Lorden, Andrea L; Radcliff, Tiffany A; Lorig, Kate; Howell, Benjamin L; Whitelaw, Nancy; Ory, Marcia G

    2015-01-01

    To evaluate the concordance between self-reported data and variables obtained from Medicare administrative data in terms of chronic conditions and health care utilization. Retrospective observational study. We analyzed data from a sample of Medicare beneficiaries who were part of the National Study of Chronic Disease Self-Management Program (CDSMP) and were eligible for the Centers for Medicare and Medicaid Services (CMS) pilot evaluation of CDSMP (n = 119). Self-reported and Medicare claims-based chronic conditions and health care utilization were examined. Percent of consistent numbers, kappa statistic (κ), and Pearson's correlation coefficient were used to evaluate concordance. The two data sources had substantial agreement for diabetes and chronic obstructive pulmonary disease (COPD) (κ = 0.75 and κ = 0.60, respectively), moderate agreement for cancer and heart disease (κ = 0.50 and κ = 0.47, respectively), and fair agreement for depression (κ = 0.26). With respect to health care utilization, the two data sources had almost perfect or substantial concordance for number of hospitalizations (κ = 0.69-0.79), moderate concordance for ED care utilization (κ = 0.45-0.61), and generally low agreement for number of physician visits (κ ≤ 0.31). Either self-reports or claim-based administrative data for diabetes, COPD, and hospitalizations can be used to analyze Medicare beneficiaries in the US. Yet, caution must be taken when only one data source is available for other types of chronic conditions and health care utilization.

  18. Examining Convergence of Retrospective and Ecological Momentary Assessment Measures of Negative Affect and Eating Disorder Behaviors

    PubMed Central

    Wonderlich, Joseph A.; Lavender, Jason M.; Wonderlich, Stephen A.; Peterson, Carol B.; Crow, Scott J.; Engel, Scott G.; Le Grange, Daniel; Mitchell, James E.; Crosby, Ross D.

    2017-01-01

    Objective Data gathered via retrospective forms of assessment are subject to various recall biases. Ecological momentary assessment (EMA) is an alternative approach involving repeated momentary assessments within a participant's natural environment, thus reducing recall biases and improving ecological validity. EMA has been used in numerous prior studies examining various constructs of theoretical relevance to eating disorders. Method This investigation includes data from three previously published studies with distinct clinical samples: (a) women with anorexia nervosa (N=118), (b) women with bulimia nervosa (N=133), and (c) obese men and women (N=50; 9 with current binge eating disorder). Each study assessed negative affective states and eating disorder behaviors using traditional retrospective assessments and EMA. Spearman rho correlations were used to evaluate the concordance of retrospective versus EMA measures of affective and/or behavioral constructs in each sample. Bland-Altman plots were also used to further evaluate concordance in the assessment of eating disorder behaviors. Results There was moderate to strong concordance for the measures of negative affective states across all three studies. Moderate to strong concordance was also found for the measures of binge eating and exercise frequency. The strongest evidence of concordance across measurement approaches was found for purging behaviors. Discussion Overall, these preliminary findings support the convergence of retrospective and EMA assessments of both negative affective states and various eating disorder behaviors. Given the advantages and disadvantages associated with each of these assessment approaches, the specific questions being studied in future empirical studies should inform decisions regarding selection of the most appropriate method. PMID:25195932

  19. Usefulness of in-house PCR methods for hepatitis B virus DNA detection.

    PubMed

    Portilho, Moyra Machado; Baptista, Marcia Leite; da Silva, Messias; de Sousa, Paulo Sérgio Fonseca; Lewis-Ximenez, Lia Laura; Lampe, Elisabeth; Villar, Livia Melo

    2015-10-01

    The aim of the present study was to evaluate the performance of three in-house PCR techniques for HBV DNA detection and compare it with commercial quantitative methods to evaluate the usefulness of in-house methods for HBV diagnosis. Three panels of HBsAg reactive sera samples were evaluated: (i) 50 samples were examined using three methods for in-house qualitative PCR and the Cobas Amplicor HBV Monitor Assay; (ii) 87 samples were assayed using in-house semi-nested PCR and the Cobas TaqMan HBV test; (iii) 11 serial samples obtained from 2 HBV-infected individuals were assayed using the Cobas Amplicor HBV test and semi-nested PCR. In panel I, HBV DNA was detected in 44 samples using the Cobas Amplicor HBV test, 42 samples using semi-nested PCR (90% concordance with Cobas Amplicor), 22 samples using PCR for the core gene (63.6% concordance) and 29 samples using single-round PCR for the pre-S/S gene (75% concordance). In panel II, HBV DNA was quantified in 78 of the 87 HBsAg reactive samples using Cobas TaqMan but 52 samples using semi-nested PCR (67.8% concordance). HBV DNA was detected in serial samples until the 17th and 26th week after first donation using in-house semi-nested PCR and the Cobas Amplicor HBV test, respectively. In-house semi-nested PCR presented adequate concordance with commercial methods as an alternative method for HBV molecular diagnosis in low-resource settings. Copyright © 2015 Elsevier B.V. All rights reserved.

  20. Advanced Practitioners Are Peers in Trauma Performance Improvement Peer Review.

    PubMed

    Collins, Tara Ann; Sicoutris, Corinna P; McNicholas, Amanda; Krumrie, Nicole; Eddinger, Abby; Fernandez, Forrest B; Schwab, C William; Reilly, Patrick M; Kim, Patrick K

    2016-01-01

    Advanced practitioners (APs) have been successfully integrated into the clinical care of injured patients. Given the expanding role of APs in trauma care, we hypothesized that APs can perform Performance Improvement and Patient Safety (PIPS) peer review at a level comparable with trauma surgeons. For Phase 1, cases previously reviewed by a trauma surgeon were randomly selected by the PIPS coordinator and peer reviewed by an AP. The trauma surgeons' and APs' reviews were compared. For Phase 2, cases requiring concurrent review were peer reviewed by both an AP and an MD, who were blinded to each other's review. Both the APs' and trauma surgeons' reviews of the same medical record were presented at a bimonthly performance improvement (PI) meeting. In Phase 1, 46 PI cases were reviewed including 22 deaths. Trauma surgeons and APs had high concordance (96.0%) regarding appropriateness or inappropriateness of care (κ = 0.774). Among disagreements, APs were 3 times more likely than trauma surgeons to determine care to be inappropriate. Trauma surgeons and APs had similarly high concordance (95.5%) regarding preventability of mortality (κ = 0.861). In Phase 2, 38 PI cases were reviewed, including 31 deaths. Trauma surgeons and APs had high concordance (89.0%) regarding appropriateness or inappropriateness of care (κ = 0.585). Among disagreements, trauma surgeons and APs had similarly high concordance (86.2%) regarding preventability of mortality (κ = 0.266). We found that APs had high concordance with trauma surgeons regarding medical record reviews and are thus able to effectively review medical records for the purposes of PIPS.

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