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Sample records for debate subgroup analyses

  1. Debate: Subgroup analyses in clinical trials: fun to look at - but don't believe them!

    PubMed Central

    Sleight, Peter

    2000-01-01

    Analysis of subgroup results in a clinical trial is surprisingly unreliable, even in a large trial. This is the result of a combination of reduced statistical power, increased variance and the play of chance. Reliance on such analyses is likely to be more erroneous, and hence harmful, than application of the overall proportional (or relative) result in the whole trial to the estimate of absolute risk in that subgroup. Plausible explanations can usually be found for effects that are, in reality, simply due to the play of chance. When clinicians believe such subgroup analyses, there is a real danger of harm to the individual patient. PMID:11714402

  2. Controversy and debate on dengue vaccine series-paper 1: review of a licensed dengue vaccine: inappropriate subgroup analyses and selective reporting may cause harm in mass vaccination programs.

    PubMed

    Dans, Antonio L; Dans, Leonila F; Lansang, Mary Ann D; Silvestre, Maria Asuncion A; Guyatt, Gordon H

    2018-03-01

    Severe life-threatening dengue fever usually occurs when a child is infected by dengue virus a second time. This is caused by a phenomenon called antibody-dependent enhancement (ADE). Since dengue vaccines can mimic a first infection in seronegative children (those with no previous infection), a natural infection later in life could lead to severe disease. The possibility that dengue vaccines can cause severe dengue through ADE has led to serious concern regarding the safety of mass vaccination programs. A published meta-analysis addressed this safety issue for a new vaccine against dengue fever-Dengvaxia. The trials in this meta-analysis have been used to campaign for mass vaccination programs in developing countries. We discuss the results of this paper and point out problems in the analyses. Reporting the findings in an Asian trial (CYD14), the authors show a sevenfold rise in one outcome-hospitalization for dengue fever in children <5 years old. However, they fail to point out two signals of harm for another outcome-hospitalization for severe dengue fever (as confirmed by an independent data monitoring committee): 1. In children younger than 9 years, the relative risk was 8.5 (95% confidence interval [CI]: 0.5, 146.8), and 2. In the overall study group, the relative risk was 5.5 (95% CI: 0.9, 33). The authors conduct a subgroup analysis to support claims that the vaccine is probably safe among children aged 9 years or more. This subgroup analysis has limited credibility because: (1) it was a post hoc analysis; (2) it was one of a large number of subgroup analyses; (3) the test of interaction was not reported, but was insignificant (P = 0.14); and (4) there is no biological basis for a threshold age of 9 years. The more likely explanation for the higher risk in younger children is ADE, that is, more frequent seronegativity, rather than age itself. The selective reporting and inappropriate subgroup claims mask the potential harm of dengue mass vaccination

  3. A comparison of subgroup analyses in grant applications and publications.

    PubMed

    Boonacker, Chantal W B; Hoes, Arno W; van Liere-Visser, Karen; Schilder, Anne G M; Rovers, Maroeska M

    2011-07-15

    In this paper, the authors compare subgroup analyses as outlined in grant applications and their related publications. Grants awarded by the Netherlands Organization for Health Research and Development (ZonMw) from 2001 onward that were finalized before March 1, 2010, were studied. Of the 79 grant proposals, 50 (63%) were intervention studies, 18 (23%) were diagnostic studies, and 6 (8%) were prognostic studies. Subgroups were mentioned in 49 (62%) grant applications and in 53 (67%) publications. In 20 of the 79 projects (25%), the publications were completely in agreement with the grant proposal; that is, subgroups that were prespecified in the grant proposal were reported and no new subgroup analyses were introduced in the publications. Of the 149 prespecified subgroups, 46 (31%) were reported in the final report or scientific publications, and 143 of the 189 (76%) reported subgroups were based on post-hoc findings. For 77% of the subgroup analyses in the publications, there was no mention of whether these were prespecified or post hoc. Justification for subgroup analysis and methods to study subgroups were rarely reported. The authors conclude that there is a large discrepancy between grant applications and final publications regarding subgroup analyses. Both nonreporting prespecified subgroup analyses and reporting post-hoc subgroup analyses are common. More guidance is clearly needed.

  4. Valid randomization-based p-values for partially post hoc subgroup analyses.

    PubMed

    Lee, Joseph J; Rubin, Donald B

    2015-10-30

    By 'partially post-hoc' subgroup analyses, we mean analyses that compare existing data from a randomized experiment-from which a subgroup specification is derived-to new, subgroup-only experimental data. We describe a motivating example in which partially post hoc subgroup analyses instigated statistical debate about a medical device's efficacy. We clarify the source of such analyses' invalidity and then propose a randomization-based approach for generating valid posterior predictive p-values for such partially post hoc subgroups. Lastly, we investigate the approach's operating characteristics in a simple illustrative setting through a series of simulations, showing that it can have desirable properties under both null and alternative hypotheses. Copyright © 2015 John Wiley & Sons, Ltd.

  5. Performance of Stratified and Subgrouped Disproportionality Analyses in Spontaneous Databases.

    PubMed

    Seabroke, Suzie; Candore, Gianmario; Juhlin, Kristina; Quarcoo, Naashika; Wisniewski, Antoni; Arani, Ramin; Painter, Jeffery; Tregunno, Philip; Norén, G Niklas; Slattery, Jim

    2016-04-01

    Disproportionality analyses are used in many organisations to identify adverse drug reactions (ADRs) from spontaneous report data. Reporting patterns vary over time, with patient demographics, and between different geographical regions, and therefore subgroup analyses or adjustment by stratification may be beneficial. The objective of this study was to evaluate the performance of subgroup and stratified disproportionality analyses for a number of key covariates within spontaneous report databases of differing sizes and characteristics. Using a reference set of established ADRs, signal detection performance (sensitivity and precision) was compared for stratified, subgroup and crude (unadjusted) analyses within five spontaneous report databases (two company, one national and two international databases). Analyses were repeated for a range of covariates: age, sex, country/region of origin, calendar time period, event seriousness, vaccine/non-vaccine, reporter qualification and report source. Subgroup analyses consistently performed better than stratified analyses in all databases. Subgroup analyses also showed benefits in both sensitivity and precision over crude analyses for the larger international databases, whilst for the smaller databases a gain in precision tended to result in some loss of sensitivity. Additionally, stratified analyses did not increase sensitivity or precision beyond that associated with analytical artefacts of the analysis. The most promising subgroup covariates were age and region/country of origin, although this varied between databases. Subgroup analyses perform better than stratified analyses and should be considered over the latter in routine first-pass signal detection. Subgroup analyses are also clearly beneficial over crude analyses for larger databases, but further validation is required for smaller databases.

  6. Challenges and solutions to pre- and post-randomization subgroup analyses.

    PubMed

    Desai, Manisha; Pieper, Karen S; Mahaffey, Ken

    2014-01-01

    Subgroup analyses are commonly performed in the clinical trial setting with the purpose of illustrating that the treatment effect was consistent across different patient characteristics or identifying characteristics that should be targeted for treatment. There are statistical issues involved in performing subgroup analyses, however. These have been given considerable attention in the literature for analyses where subgroups are defined by a pre-randomization feature. Although subgroup analyses are often performed with subgroups defined by a post-randomization feature--including analyses that estimate the treatment effect among compliers--discussion of these analyses has been neglected in the clinical literature. Such analyses pose a high risk of presenting biased descriptions of treatment effects. We summarize the challenges of doing all types of subgroup analyses described in the literature. In particular, we emphasize issues with post-randomization subgroup analyses. Finally, we provide guidelines on how to proceed across the spectrum of subgroup analyses.

  7. Rainbow: A Framework for Analysing Computer-Mediated Pedagogical Debates

    ERIC Educational Resources Information Center

    Baker, Michael; Andriessen, Jerry; Lund, Kristine; van Amelsvoort, Marie; Quignard, Matthieu

    2007-01-01

    In this paper we present a framework for analysing when and how students engage in a specific form of interactive knowledge elaboration in CSCL environments: broadening and deepening understanding of a space of debate. The framework is termed "Rainbow," as it comprises seven principal analytical categories, to each of which a colour is assigned,…

  8. Subgroup analyses in randomised controlled trials: cohort study on trial protocols and journal publications.

    PubMed

    Kasenda, Benjamin; Schandelmaier, Stefan; Sun, Xin; von Elm, Erik; You, John; Blümle, Anette; Tomonaga, Yuki; Saccilotto, Ramon; Amstutz, Alain; Bengough, Theresa; Meerpohl, Joerg J; Stegert, Mihaela; Olu, Kelechi K; Tikkinen, Kari A O; Neumann, Ignacio; Carrasco-Labra, Alonso; Faulhaber, Markus; Mulla, Sohail M; Mertz, Dominik; Akl, Elie A; Bassler, Dirk; Busse, Jason W; Ferreira-González, Ignacio; Lamontagne, Francois; Nordmann, Alain; Gloy, Viktoria; Raatz, Heike; Moja, Lorenzo; Rosenthal, Rachel; Ebrahim, Shanil; Vandvik, Per O; Johnston, Bradley C; Walter, Martin A; Burnand, Bernard; Schwenkglenks, Matthias; Hemkens, Lars G; Bucher, Heiner C; Guyatt, Gordon H; Briel, Matthias

    2014-07-16

    To investigate the planning of subgroup analyses in protocols of randomised controlled trials and the agreement with corresponding full journal publications. Cohort of protocols of randomised controlled trial and subsequent full journal publications. Six research ethics committees in Switzerland, Germany, and Canada. 894 protocols of randomised controlled trial involving patients approved by participating research ethics committees between 2000 and 2003 and 515 subsequent full journal publications. Of 894 protocols of randomised controlled trials, 252 (28.2%) included one or more planned subgroup analyses. Of those, 17 (6.7%) provided a clear hypothesis for at least one subgroup analysis, 10 (4.0%) anticipated the direction of a subgroup effect, and 87 (34.5%) planned a statistical test for interaction. Industry sponsored trials more often planned subgroup analyses compared with investigator sponsored trials (195/551 (35.4%) v 57/343 (16.6%), P<0.001). Of 515 identified journal publications, 246 (47.8%) reported at least one subgroup analysis. In 81 (32.9%) of the 246 publications reporting subgroup analyses, authors stated that subgroup analyses were prespecified, but this was not supported by 28 (34.6%) corresponding protocols. In 86 publications, authors claimed a subgroup effect, but only 36 (41.9%) corresponding protocols reported a planned subgroup analysis. Subgroup analyses are insufficiently described in the protocols of randomised controlled trials submitted to research ethics committees, and investigators rarely specify the anticipated direction of subgroup effects. More than one third of statements in publications of randomised controlled trials about subgroup prespecification had no documentation in the corresponding protocols. Definitive judgments regarding credibility of claimed subgroup effects are not possible without access to protocols and analysis plans of randomised controlled trials. © The DISCO study group 2014.

  9. Subgroup analyses in confirmatory clinical trials: time to be specific about their purposes.

    PubMed

    Tanniou, Julien; van der Tweel, Ingeborg; Teerenstra, Steven; Roes, Kit C B

    2016-02-18

    It is well recognized that treatment effects may not be homogeneous across the study population. Subgroup analyses constitute a fundamental step in the assessment of evidence from confirmatory (Phase III) clinical trials, where conclusions for the overall study population might not hold. Subgroup analyses can have different and distinct purposes, requiring specific design and analysis solutions. It is relevant to evaluate methodological developments in subgroup analyses against these purposes to guide health care professionals and regulators as well as to identify gaps in current methodology. We defined four purposes for subgroup analyses: (1) Investigate the consistency of treatment effects across subgroups of clinical importance, (2) Explore the treatment effect across different subgroups within an overall non-significant trial, (3) Evaluate safety profiles limited to one or a few subgroup(s), (4) Establish efficacy in the targeted subgroup when included in a confirmatory testing strategy of a single trial. We reviewed the methodology in line with this "purpose-based" framework. The review covered papers published between January 2005 and April 2015 and aimed to classify them in none, one or more of the aforementioned purposes. In total 1857 potentially eligible papers were identified. Forty-eight papers were selected and 20 additional relevant papers were identified from their references, leading to 68 papers in total. Nineteen were dedicated to purpose 1, 16 to purpose 4, one to purpose 2 and none to purpose 3. Seven papers were dedicated to more than one purpose, the 25 remaining could not be classified unambiguously. Purposes of the methods were often not specifically indicated, methods for subgroup analysis for safety purposes were almost absent and a multitude of diverse methods were developed for purpose (1). It is important that researchers developing methodology for subgroup analysis explicitly clarify the objectives of their methods in terms that can be

  10. Ice age True Polar Wander: raising debates and new analyses

    NASA Astrophysics Data System (ADS)

    Sabadini, Roberto; Cambiotti, Gabriele; Ricard, Yanick

    2010-05-01

    Issues related to long time scale instability in the Earth's rotation, named True Polar Wander (TPW), have continuously been debated, after the pioneering works of the sixties. Since Maxwell Earth models with elastic or high viscosity viscoelastic lithospheres predict different ice-age TPW in the lower mantle viscosity range 1021 - 1022 Pa s, it has been recently suggested that the observed fluid Love number should be used to describe the initial equatorial bulge rather than the tidal fluid limit resulting from the viscoelastic modelling itself. We show that different ice-age TPW predictions have to be expected due to the dependence of TPW on the Earth's initial state, characterized by a larger and stress-free equatorial bulge for the viscoelastic lithosphere, compared to the elastic one, and that there is no shortcomings or errors in the traditional approach based on the use of tidal Love number from the model. The use of the observed fluid Love number represents in fact a simplified attempt to couple the effects on TPW from mantle convection and glacial forcing, by including the non-hydrostatic flattening due to mantle convection but not its driving part. This partial coupling freezes in space the non-hydrostatic contribution due to mantle convection, thus damping the present-day ice-age TPW and forcing the axis of instantaneous rotation to come back to its initial position when ice ages started. In this perspective, we discuss the implication of self-consistent convection calculations of the non-hydrostatic contribution and its impact on the long-term Earth's rotation stability during ice-age. We develop a full compressible model, based on the numerical integration in the radial variable of the momentum and Poisson equations and on the contour integration in the Laplace domain, which allows us to deal with the non-modal contribution from continuous radial rheological variations. We quantify the effects of the compressible rheology, compared to the widely used

  11. Prevention of falls in nursing homes: subgroup analyses of a randomized fall prevention trial.

    PubMed

    Rapp, Kilian; Lamb, Sarah E; Büchele, Gisela; Lall, Ranjit; Lindemann, Ulrich; Becker, Clemens

    2008-06-01

    To evaluate the effectiveness of a multifactorial fall prevention program in prespecified subgroups of nursing home residents. Secondary analysis of a cluster-randomized, controlled trial. Six nursing homes in Germany. Seven hundred twenty-five long-stay residents; median age 86; 80% female. Staff and resident education on fall prevention, advice on environmental adaptations, recommendation to wear hip protectors, and progressive balance and resistance training. Time to first fall and the number of falls. Falls were assessed during the 12-month intervention period. Univariate regression analyses were performed, including a confirmatory test of interaction. The intervention was more effective in people with cognitive impairment (hazard ratio (HR)=0.49, 95% confidence interval (CI)=0.35-0.69) than in those who were cognitively intact (HR=0.91, 95% CI=0.68-1.22), in people with a prior history of falls (HR=0.47, 95% CI=0.33-0.67) than in those with no prior fall history (HR=0.77, 95% CI=0.58-1.01), in people with urinary incontinence (HR=0.59, 95% CI=0.45-0.77) than in those with no urinary incontinence (HR=0.98, 95% CI=0.68-1.42), and in people with no mood problems (incidence rate ratio (IRR)=0.41, 95% CI=0.27-0.61) than in those with mood problems (IRR=0.74, 95% CI=0.51-1.09). The effectiveness of a multifactorial fall prevention program differed between subgroups of nursing home residents. Cognitive impairment, a history of falls, urinary incontinence, and depressed mood were important in determining response.

  12. A photometric study of the Orion OB 1 association. 3: Subgroup analyses

    NASA Technical Reports Server (NTRS)

    Warren, W. H., Jr.; Hesser, J. E.

    1977-01-01

    The four principal subgroups of the association were examined in detail using individual distances and reddening values determined for their B type members. Subgroup 1a appeared not to show a spread in age nor did it show a systematic distance increase with right ascension when fainter members were considered. An eastwardly increase in distance was found for subgroup 1b but the reddening law for the east Belt appeared normal. Small subclusterings in the vicinity of the Orion Nebula appeared not to differ in the evolutionary state but their ages were considerably greater than those of stars in the nebulae and its associated cluster.

  13. Analysing Key Debates in Education and Sustainable Development in Relation to ESD Practice in Viet Nam

    ERIC Educational Resources Information Center

    Balls, Emily

    2016-01-01

    This article is based on qualitative field research carried out in Ha Noi, Viet Nam, in 2013 for an MA dissertation in Education and International Development at the UCL Institute of Education. It analyses interpretations of education for sustainable development (ESD) in Viet Nam, relating these to key debates around instrumental and democratic…

  14. Migraine and Cardiovascular Disease in Women: the Role of Aspirin – Subgroup Analyses in the Women’s Health Study

    PubMed Central

    Kurth, Tobias; Diener, Hans-Christoph; Buring, Julie E.

    2011-01-01

    Background Migraine with aura (MA) has been associated with increased risk of cardiovascular disease (CVD). The role of aspirin on this association remains unclear. Methods Post-hoc subgroup analyses of the Women’s Health Study, a randomized trial testing 100mg aspirin on alternate days in primary prevention of CVD among 39,876 women aged ≥45. Results During 10 years, 998 major CVD events were confirmed in 39,757 women with complete migraine information. Aspirin reduced risk of ischemic stroke (RR=0.76; 95%CI=0.63–0.93) but not other CVD. Migraine or MA did not modify the effect of aspirin on CVD except for myocardial infarction (MI) (p-interaction=0.01). Women with MA on aspirin had increased risk of MI (RR=3.72, 95%CI=1.39–9.95). Further exploratory analyses indicate this is only apparent among women with MA on aspirin who ever smoked or had history of hypertension (p-interaction<0.01). Conclusion In post-hoc subgroup analyses, aspirin had similar protective effects on ischemic stroke for women with or without migraine. By contrast, our data suggest that women with MA on aspirin had increased risk of MI. The small number of outcome events in subgroups, the exploratory nature of our analyses, and lack of plausible mechanisms raise the possibility of a chance finding, which must caution the interpretation. PMID:21673005

  15. Post Hoc Analyses of ApoE Genotype-Defined Subgroups in Clinical Trials.

    PubMed

    Kennedy, Richard E; Cutter, Gary R; Wang, Guoqiao; Schneider, Lon S

    2016-01-01

    Many post hoc analyses of clinical trials in Alzheimer's disease (AD) and mild cognitive impairment (MCI) are in small Phase 2 trials. Subject heterogeneity may lead to statistically significant post hoc results that cannot be replicated in larger follow-up studies. We investigated the extent of this problem using simulation studies mimicking current trial methods with post hoc analyses based on ApoE4 carrier status. We used a meta-database of 24 studies, including 3,574 subjects with mild AD and 1,171 subjects with MCI/prodromal AD, to simulate clinical trial scenarios. Post hoc analyses examined if rates of progression on the Alzheimer's Disease Assessment Scale-cognitive (ADAS-cog) differed between ApoE4 carriers and non-carriers. Across studies, ApoE4 carriers were younger and had lower baseline scores, greater rates of progression, and greater variability on the ADAS-cog. Up to 18% of post hoc analyses for 18-month trials in AD showed greater rates of progression for ApoE4 non-carriers that were statistically significant but unlikely to be confirmed in follow-up studies. The frequency of erroneous conclusions dropped below 3% with trials of 100 subjects per arm. In MCI, rates of statistically significant differences with greater progression in ApoE4 non-carriers remained below 3% unless sample sizes were below 25 subjects per arm. Statistically significant differences for ApoE4 in post hoc analyses often reflect heterogeneity among small samples rather than true differential effect among ApoE4 subtypes. Such analyses must be viewed cautiously. ApoE genotype should be incorporated into the design stage to minimize erroneous conclusions.

  16. Gene expression analyses of the spatio-temporal relationships of human medulloblastoma subgroups during early human neurogenesis.

    PubMed

    Hooper, Cornelia M; Hawes, Susan M; Kees, Ursula R; Gottardo, Nicholas G; Dallas, Peter B

    2014-01-01

    Medulloblastoma is the most common form of malignant paediatric brain tumour and is the leading cause of childhood cancer related mortality. The four molecular subgroups of medulloblastoma that have been identified - WNT, SHH, Group 3 and Group 4 - have molecular and topographical characteristics suggestive of different cells of origin. Definitive identification of the cell(s) of origin of the medulloblastoma subgroups, particularly the poorer prognosis Group 3 and Group 4 medulloblastoma, is critical to understand the pathogenesis of the disease, and ultimately for the development of more effective treatment options. To address this issue, the gene expression profiles of normal human neural tissues and cell types representing a broad neuro-developmental continuum, were compared to those of two independent cohorts of primary human medulloblastoma specimens. Clustering, co-expression network, and gene expression analyses revealed that WNT and SHH medulloblastoma may be derived from distinct neural stem cell populations during early embryonic development, while the transcriptional profiles of Group 3 and Group 4 medulloblastoma resemble cerebellar granule neuron precursors at weeks 10-15 and 20-30 of embryogenesis, respectively. Our data indicate that Group 3 medulloblastoma may arise through abnormal neuronal differentiation, whereas deregulation of synaptic pruning-associated apoptosis may be driving Group 4 tumorigenesis. Overall, these data provide significant new insight into the spatio-temporal relationships and molecular pathogenesis of the human medulloblastoma subgroups, and provide an important framework for the development of more refined model systems, and ultimately improved therapeutic strategies.

  17. Gene Expression Analyses of the Spatio-Temporal Relationships of Human Medulloblastoma Subgroups during Early Human Neurogenesis

    PubMed Central

    Hooper, Cornelia M.; Hawes, Susan M.; Kees, Ursula R.; Gottardo, Nicholas G.; Dallas, Peter B.

    2014-01-01

    Medulloblastoma is the most common form of malignant paediatric brain tumour and is the leading cause of childhood cancer related mortality. The four molecular subgroups of medulloblastoma that have been identified – WNT, SHH, Group 3 and Group 4 - have molecular and topographical characteristics suggestive of different cells of origin. Definitive identification of the cell(s) of origin of the medulloblastoma subgroups, particularly the poorer prognosis Group 3 and Group 4 medulloblastoma, is critical to understand the pathogenesis of the disease, and ultimately for the development of more effective treatment options. To address this issue, the gene expression profiles of normal human neural tissues and cell types representing a broad neuro-developmental continuum, were compared to those of two independent cohorts of primary human medulloblastoma specimens. Clustering, co-expression network, and gene expression analyses revealed that WNT and SHH medulloblastoma may be derived from distinct neural stem cell populations during early embryonic development, while the transcriptional profiles of Group 3 and Group 4 medulloblastoma resemble cerebellar granule neuron precursors at weeks 10–15 and 20–30 of embryogenesis, respectively. Our data indicate that Group 3 medulloblastoma may arise through abnormal neuronal differentiation, whereas deregulation of synaptic pruning-associated apoptosis may be driving Group 4 tumorigenesis. Overall, these data provide significant new insight into the spatio-temporal relationships and molecular pathogenesis of the human medulloblastoma subgroups, and provide an important framework for the development of more refined model systems, and ultimately improved therapeutic strategies. PMID:25412507

  18. Adjuvant Sunitinib for High-risk Renal Cell Carcinoma After Nephrectomy: Subgroup Analyses and Updated Overall Survival Results.

    PubMed

    Motzer, Robert J; Ravaud, Alain; Patard, Jean-Jacques; Pandha, Hardev S; George, Daniel J; Patel, Anup; Chang, Yen-Hwa; Escudier, Bernard; Donskov, Frede; Magheli, Ahmed; Carteni, Giacomo; Laguerre, Brigitte; Tomczak, Piotr; Breza, Jan; Gerletti, Paola; Lechuga, Mariajose; Lin, Xun; Casey, Michelle; Serfass, Lucile; Pantuck, Allan J; Staehler, Michael

    2018-01-01

    Adjuvant sunitinib significantly improved disease-free survival (DFS) versus placebo in patients with locoregional renal cell carcinoma (RCC) at high risk of recurrence after nephrectomy (hazard ratio [HR] 0.76, 95% confidence interval [CI] 0.59-0.98; p=0.03). To report the relationship between baseline factors and DFS, pattern of recurrence, and updated overall survival (OS). Data for 615 patients randomized to sunitinib (n=309) or placebo (n=306) in the S-TRAC trial. Subgroup DFS analyses by baseline risk factors were conducted using a Cox proportional hazards model. Baseline risk factors included: modified University of California Los Angeles integrated staging system criteria, age, gender, Eastern Cooperative Oncology Group performance status (ECOG PS), weight, neutrophil-to-lymphocyte ratio (NLR), and Fuhrman grade. Of 615 patients, 97 and 122 in the sunitinib and placebo arms developed metastatic disease, with the most common sites of distant recurrence being lung (40 and 49), lymph node (21 and 26), and liver (11 and 14), respectively. A benefit of adjuvant sunitinib over placebo was observed across subgroups, including: higher risk (T3, no or undetermined nodal involvement, Fuhrman grade ≥2, ECOG PS ≥1, T4 and/or nodal involvement; hazard ratio [HR] 0.74, 95% confidence interval [CI] 0.55-0.99; p=0.04), NLR ≤3 (HR 0.72, 95% CI 0.54-0.95; p=0.02), and Fuhrman grade 3/4 (HR 0.73, 95% CI 0.55-0.98; p=0.04). All subgroup analyses were exploratory, and no adjustments for multiplicity were made. Median OS was not reached in either arm (HR 0.92, 95% CI 0.66-1.28; p=0.6); 67 and 74 patients died in the sunitinib and placebo arms, respectively. A benefit of adjuvant sunitinib over placebo was observed across subgroups. The results are consistent with the primary analysis, which showed a benefit for adjuvant sunitinib in patients at high risk of recurrent RCC after nephrectomy. Most subgroups of patients at high risk of recurrent renal cell carcinoma after

  19. The influence of industry sponsorship on the reporting of subgroup analyses within phase III randomised controlled trials in gastrointestinal oncology.

    PubMed

    Barton, Sarah; Peckitt, Clare; Sclafani, Francesco; Cunningham, David; Chau, Ian

    2015-12-01

    Correct interpretation of subgroup analyses (SGA) is important as it influences selection of therapeutic interventions for patient subsets. The primary aim of our study was to compare reporting of SGA between industry and non-industry sponsored trials. We performed a systematic literature review and extracted data from journal articles (JA) and conference abstracts (CA) published over a decade reporting SGA results of phase III randomised controlled gastrointestinal (GI) oncology trials with patient participants of ≥150. In JA, SGA was reported in 100/145 (69%) trials: 41/54 industry sponsored (76%; 95% confidence interval [CI]: 63-86%) and 59/91 non-industry sponsored (65%; 95% CI: 55-74%) trials (p = 0.16). In CA, SGA was reported in 86/204 (42%) trials: 43/83 industry sponsored (52%; 95% CI: 41-62%) and 43/121 non-industry sponsored (36%; 95% CI: 28-44%) trials (p = 0.02). Number of SGA performed per trial was significantly larger for industry compared to non-industry sponsored trials in both JA (median 6 versus 2, p = 0.003) and CA (median 1 versus 0, p = 0.023). Claims of subgroup effect were made in 52% of trials in JA and 50% in CA, with significant test of interaction evident in only 25% of JA and 16% of CA, with no difference between industry and non-industry trials. Industry sponsored trials with a significant primary end-point reported more SGA (p < 0.001 JA; p = 0.046 CA). Industry sponsored trials reported more SGA. Claimed subgroup effects were often not accompanied by significant interaction test; thus circumspection should be adopted when using SGA to deviate from standard therapeutic decision-making in GI oncology. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. Identifying patterns of adaptation in breast cancer patients with cancer-related fatigue using response shift analyses at subgroup level.

    PubMed

    Salmon, Maxime; Blanchin, Myriam; Rotonda, Christine; Guillemin, Francis; Sébille, Véronique

    2017-11-01

    Fatigue is the most prevalent symptom in breast cancer. It might be perceived differently among patients over time as a consequence of the differing patients' adaptation and psychological adjustment to their cancer experience which can be related to response shift (RS). RS analyses can provide important insights on patients' adaptation to cancer but it is usually assumed that RS occurs in the same way in all individuals which is unrealistic. This study aimed to identify patients' subgroups in which different RS effects on self-reported fatigue could occur over time using a combination of methods for manifest and latent variables. The FATSEIN study comprised 466 breast cancer patients followed over a 2-year period. Fatigue was measured with the Multidimensional Fatigue Inventory questionnaire (MFI-20) during 10 visits. A novel combination of Mixed Models, Growth Mixture Modeling, and Structural Equation Modeling was used to assess the occurrence of RS in fatigue changes to identify subgroups displaying different RS patterns over time. An increase in fatigue was evidenced over the 8-month follow-up, followed by a decrease between the 8- and 24-month. Four latent classes of patients were identified. Different RS patterns were detected in all latent classes between the inclusion and 8 months (last cycle of chemotherapy). No RS was evidenced between 8- and 24-month. Several RS effects were evidenced in different groups of patients. Women seemed to adapt differently to their treatment and breast cancer experience possibly indicating differing needs for medical/psychological support. © 2017 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  1. ROC curve analyses of eyewitness identification decisions: An analysis of the recent debate.

    PubMed

    Rotello, Caren M; Chen, Tina

    2016-01-01

    How should the accuracy of eyewitness identification decisions be measured, so that best practices for identification can be determined? This fundamental question is under intense debate. One side advocates for continued use of a traditional measure of identification accuracy, known as the diagnosticity ratio , whereas the other side argues that receiver operating characteristic curves (ROCs) should be used instead because diagnosticity is confounded with response bias. Diagnosticity proponents have offered several criticisms of ROCs, which we show are either false or irrelevant to the assessment of eyewitness accuracy. We also show that, like diagnosticity, Bayesian measures of identification accuracy confound response bias with witnesses' ability to discriminate guilty from innocent suspects. ROCs are an essential tool for distinguishing memory-based processes from decisional aspects of a response; simulations of different possible identification tasks and response strategies show that they offer important constraints on theory development.

  2. Medulloblastoma in China: Clinicopathologic Analyses of SHH, WNT, and Non-SHH/WNT Molecular Subgroups Reveal Different Therapeutic Responses to Adjuvant Chemotherapy

    PubMed Central

    Ren, Yong; Yao, Yu; Li, Kay Ka-Wai; Ng, Ho-Keung; Mao, Ying; Zhou, Liang-Fu; Zhong, Ping

    2014-01-01

    Medulloblastoma (MB) is one of the most common primary central nervous system tumors in children. Data is lacking of a large cohort of medulloblastoma patients in China. Also, our knowledge on the sensitivity of different molecular subgroups of MB to adjuvant radiation therapy (RT) or chemotherapy (CHT) is still limited. The authors performed a retrospective study of 173 medulloblastoma patients treated at two institutions from 2002 to 2011. Formalin-fixed paraffin embedded (FFPE) tissues were available in all the cases and sections were stained to classify histological and molecular subgroups. Univariate and multivariate analyses were used to investigate prognostic factors. Of 173 patients, there were 118 children and 55 adults, 112 males and 61 females. Estimated 5-year overall survival (OS) rates for all patients, children and adults were 52%, 48% and 63%, respectively. After multivariate analysis, postoperative primary radiation therapy (RT) and chemotherapy (CHT) were revealed as favorable prognostic factors influencing OS and EFS. Postoperative primary chemotherapy (CHT) was found significantly improving the survival of children (p<0.001) while it was not a significant prognostic factor for adult patients. Moreover, patients in WNT subtype had better OS (p = 0.028) than others (SHH and Non-SHH/WNT subtypes) given postoperative adjuvant therapies. Postoperative primary RT was found to be a strong prognostic factor influencing the survival in all histological and molecular subgroups (p<0.001). Postoperative primary CHT was found significantly to influence the survival of classic medulloblastoma (CMB) (OS p<0.001, EFS p<0.001), SHH subgroup (OS p = 0.020, EFS p = 0.049) and WNT subgroup (OS p = 0.003, EFS p = 0.016) but not in desmoplastic/nodular medulloblastoma (DMB) (OS p = 0.361, EFS p = 0.834) and Non-SHH/WNT subgroup (OS p = 0.127, EFS p = 0.055). Our study showed postoperative primary CHT significantly influence the

  3. Future Teachers Debate Charter Schools on Facebook: Analysing Their Political Subjectivities

    ERIC Educational Resources Information Center

    Nairn, Karen; Anderson, Vivienne; Blanch, Keely

    2018-01-01

    We argue that Garrett and Segall's concepts of "doing school" and "pushing back" are valuable tools for analysing pre-service teachers' political views of neoliberal education reforms such as the introduction of charter schools. We extend Garrett and Segall's conceptualization by hybridizing "doing school" and…

  4. Use of the radial approach in primary angioplasty: results in 1029 consecutive patients and analyses in unfavorable subgroups.

    PubMed

    Hernández-Pérez, Francisco J; Blasco-Lobo, Ana; Goicolea, Leire; Muñiz-Lozano, Ana; Fernandez-Díaz, José A; Domínguez, José R; Goicolea-Ruigómez, Javier

    2014-01-01

    The transradial approach is associated with a reduction in vascular access-related complications after primary percutaneous coronary interventions. The purpose of this study was to examine the feasibility of the routine use of transradial access in primary angioplasty and to evaluate how it affects subgroups with less favorable characteristics. We analyzed 1029 consecutive patients with an ST-segment elevation acute coronary syndrome treated with primary angioplasty. Transradial access was the primary approach in 93.1% of the patients. The success rate of primary angioplasty was 95.9%, and 87.6% of the patients were event-free 30 days after the procedure. Crossover was required in 3.0% of the patients with primary transradial access, and this rate remained stable over the years. Predictors of the need for crossover were age older than 75 years (odds ratio=2.50, 95% confidence interval, 1.09-5.71; P=.03) and a history of ischemic heart disease (odds ratio=2.65; 95% confidence interval, 1.12-6.24; P=.02). Primary transfemoral access use was higher in women older than 75 years. Use of the transradial approach in this subgroup did not affect reperfusion time or the success of angioplasty, although there was a greater need for crossover (10.9% vs 2.6%; P=.006). Among patients in cardiogenic shock, the transradial approach was used in 51.5%; reperfusion times and angioplasty success rates were similar to those obtained with transfemoral access, but there was a greater need for crossover. Transradial access can be used safely and effectively in most primary angioplasty procedures. In older women and in patients in cardiogenic shock, there is a higher crossover requirement, with no detriment to reperfusion time. Copyright © 2013 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

  5. Subgroup analyses of the effectiveness of oral glucosamine for knee and hip osteoarthritis: a systematic review and individual patient data meta-analysis from the OA trial bank.

    PubMed

    Runhaar, Jos; Rozendaal, Rianne M; van Middelkoop, Marienke; Bijlsma, Hans J W; Doherty, Michael; Dziedzic, Krysia S; Lohmander, L Stefan; McAlindon, Timothy; Zhang, Weiya; Bierma Zeinstra, Sita

    2017-11-01

    To evaluate the effectiveness of oral glucosamine in subgroups of people with hip or knee osteoarthritis (OA) based on baseline pain severity, body mass index (BMI), sex, structural abnormalities and presence of inflammation using individual patient data. After a systematic search of the literature and clinical trial registries, all randomised controlled trials (RCTs) evaluating the effect of any oral glucosamine substance in patients with clinically or radiographically defined hip or knee OA were contacted. As a minimum, pain, age, sex and BMI at baseline and pain as an outcome measure needed to be assessed. Of 21 eligible studies, six (n=1663) shared their trial data with the OA Trial Bank. Five trials (all independent of industry, n=1625) compared glucosamine with placebo, representing 55% of the total number of participants in all published placebo-controlled RCTs. Glucosamine was no better than placebo for pain or function at short (3 months) and long-term (24 months) follow-up. Glucosamine was also no better than placebo among the predefined subgroups. Stratification for knee OA and type of glucosamine did not alter these results. Although proposed and debated for several years, open trial data are not widely made available for studies of glucosamine for OA, especially those sponsored by industry. Currently, there is no good evidence to support the use of glucosamine for hip or knee OA and an absence of evidence to support specific consideration of glucosamine for any clinically relevant OA subgroup according to baseline pain severity, BMI, sex, structural abnormalities or presence of inflammation. © 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.

  6. Is Blood Eosinophil Count a Predictor of Response to Bronchodilators in Chronic Obstructive Pulmonary Disease? Results from Post Hoc Subgroup Analyses.

    PubMed

    Iqbal, Ahmar; Barnes, Neil C; Brooks, Jean

    2015-10-01

    Chronic obstructive pulmonary disease (COPD) patients with blood eosinophil (EOS) count ≥ 2% benefit from exacerbation reductions with inhaled corticosteroids (ICSs). We conducted post hoc analyses to determine if EOS count ≥ 2% is a marker for greater responsiveness to the bronchodilators umeclidinium (UMEC; long-acting muscarinic antagonist), vilanterol (VI; long-acting β2-agonist) or UMEC/VI combination. Effects of once-daily UMEC/VI 62.5/25, UMEC 62.5 and VI 25 µg versus placebo on trough forced expiratory volume in one second (FEV1), Transition Dyspnoea Index (TDI), St George's Respiratory Questionnaire (SGRQ) scores and adverse event (AE) incidences in four completed, 6-month studies were assessed by EOS subgroup. Trough FEV1 was also evaluated by ICS use and EOS subgroup. Analyses were performed using a repeated measures model. At baseline, 2437 of 4647 (52%) patients had EOS count ≥ 2%. Overall, ≈ 50% of patients used ICSs. At day 169, no notable variations were observed in trough FEV1 least squares mean differences between EOS subgroups versus placebo for UMEC/VI, UMEC and VI; results according to ICS use were similar. No differences were reported between EOS subgroups in TDI and SGRQ scores on day 168, or for incidences of AEs, serious AEs and AEs leading to withdrawal. Response to UMEC/VI, UMEC and VI in terms of trough FEV1, dyspnoea and health-related quality of life was similar for COPD patients with baseline EOS counts ≥ 2 or <2%. EOS count did not appear to predict bronchodilator response in either ICS users or non-users.

  7. Raltegravir versus Efavirenz regimens in treatment-naive HIV-1-infected patients: 96-week efficacy, durability, subgroup, safety, and metabolic analyses.

    PubMed

    Lennox, Jeffrey L; Dejesus, Edwin; Berger, Daniel S; Lazzarin, Adriano; Pollard, Richard B; Ramalho Madruga, Jose Valdez; Zhao, Jing; Wan, Hong; Gilbert, Christopher L; Teppler, Hedy; Rodgers, Anthony J; Barnard, Richard J O; Miller, Michael D; Dinubile, Mark J; Nguyen, Bach-Yen; Leavitt, Randi; Sklar, Peter

    2010-09-01

    We analyzed the 96-week results in the overall population and in prespecified subgroups from the ongoing STARTMRK study of treatment-naive HIV-infected patients. Eligible patients with HIV-1 RNA (vRNA) levels >5000 copies per milliliter and without baseline resistance to efavirenz, tenofovir, or emtricitabine were randomized in a double-blind noninferiority study to receive raltegravir or efavirenz, each combined with tenofovir/emtricitabine. At week 96 counting noncompleters as failures, 81% versus 79% achieved vRNA levels <50 copies per milliliter in the raltegravir and efavirenz groups, respectively [Delta (95% confidence interval) = 2% (-4 to 9), noninferiority P < 0.001]. Mean change in baseline CD4 count was 240 and 225 cells per cubic millimeter in the raltegravir and efavirenz groups, respectively [Delta (95% confidence interval) = 15 (-13 to 42)]. Treatment effects were consistent across prespecified baseline demographic and prognostic subgroups. Fewer drug-related clinical adverse events (47% versus 78%; P < 0.001) occurred in raltegravir than efavirenz recipients. Both regimens had modest effects on serum lipids and glucose levels and on body fat composition. When combined with tenofovir/emtricitabine in treatment-naive patients, raltegravir exhibited durable antiretroviral activity that was noninferior to the efficacy of efavirenz through 96 weeks of therapy. Subgroup analyses were generally consistent with the overall findings. Both regimens were well tolerated.

  8. 4G/5G Variant of Plasminogen Activator Inhibitor-1 Gene and Severe Pregnancy-Induced Hypertension: Subgroup Analyses of Variants of Angiotensinogen and Endothelial Nitric Oxide Synthase

    PubMed Central

    Kobashi, Gen; Ohta, Kaori; Yamada, Hideto; Hata, Akira; Minakami, Hisanori; Sakuragi, Noriaki; Tamashiro, Hiko; Fujimoto, Seiichiro

    2009-01-01

    Background Pregnancy-induced hypertension (PIH) is a common cause of perinatal mortality. It is believed to result from the interaction of several factors, including those related to the blood coagulation system. We performed genotyping and subgroup analyses to determine if the 4G/5G genotypes of the plasminogen activator inhibitor-1 gene (PAI-1) play a role in the pathogenesis of PIH, and to evaluate possible interactions of the PAI-1 polymorphisms with those of the angiotensinogen gene (AGT) and the endothelial nitric oxide synthase gene (NOS3). Methods An association study of PAI-1 polymorphism, and subgroup analyses of common variants of AGT and NOS3, among 128 patients with PIH and 376 healthy pregnant controls. Results No significant differences were found between the cases and controls in the frequencies of allele 4G or the 4G/4G genotype. In subgroup analyses, after adjustment for multiple comparison, a significant association with the AGT TT genotype was found among women with the PAI-1 4G/4G genotype, and an association with the NOS3 GA+AA genotype was found among women with the 5G/5G or 4G/5G genotypes. Conclusions Our findings suggest that there are at least 2 pathways in the pathogenesis of severe PIH. However, with respect to early prediction and prevention of severe PIH, although the PAI-1 4G/4G genotype alone was not a risk factor for severe PIH, the fact that PAI-1 genotypes are associated with varying risks for severe PIH suggests that PAI-1 genotyping of pregnant women, in combination with other tests, may be useful in the development of individualized measures that may prevent severe PIH. PMID:19838007

  9. Aflibercept versus placebo in combination with fluorouracil, leucovorin and irinotecan in the treatment of previously treated metastatic colorectal cancer: prespecified subgroup analyses from the VELOUR trial.

    PubMed

    Tabernero, Josep; Van Cutsem, Eric; Lakomý, Radek; Prausová, Jana; Ruff, Paul; van Hazel, Guy A; Moiseyenko, Vladimir M; Ferry, David R; McKendrick, Joseph J; Soussan-Lazard, Karen; Chevalier, Soazig; Allegra, Carmen J

    2014-01-01

    The antiangiogenic agent aflibercept (ziv-aflibercept in the United States) in combination with 5-fluorouracil, leucovorin and irinotecan (FOLFIRI) significantly improved survival in a phase III study of patients with metastatic colorectal cancer (mCRC) previously treated with an oxaliplatin-based regimen. In the present analysis, outcomes were evaluated in prespecified subgroups to assess the consistency of the treatment effect. Patients were randomised to receive FOLFIRI plus aflibercept or placebo every 2weeks until disease progression or unacceptable toxicity occurred. Efficacy and safety outcomes were analysed with respect to demographic and baseline characteristics, and stratification factors (prior bevacizumab treatment and Eastern Cooperative Oncology Group performance status). Median overall survival (OS, months [95.34% confidence interval (CI)]) for aflibercept versus placebo was 12.5 (10.8-15.5) versus 11.7 (9.8-13.8) in patients with prior bevacizumab treatment and 13.9 (12.7-15.6) versus 12.4 (11.2-13.5) in patients with no prior bevacizumab treatment. The p value for interaction was 0.5668, indicating there was no heterogeneity in these subgroups. For OS and progression-free survival (PFS), there was a significantly greater benefit (at the 2-sided 10% level) of treatment for patients with liver only metastases versus patients with no liver metastases/liver metastases with other organ involvement (p value for interaction: 0.0899 [OS]; 0.0076 [PFS]). There was no evidence of heterogeneity in treatment effect in any of the other subgroups examined. The benefits of aflibercept in combination with FOLFIRI in patients with mCRC previously treated with oxaliplatin were maintained across the specified patient subgroups, including in patients with or without prior bevacizumab treatment. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

  10. Palivizumab for immunoprophylaxis of respiratory syncytial virus (RSV) bronchiolitis in high-risk infants and young children: a systematic review and additional economic modelling of subgroup analyses.

    PubMed

    Wang, D; Bayliss, S; Meads, C

    2011-01-01

    find any relevant studies that may have been missed. The risk factors identified from the systematic review of included studies were analysed and synthesised using stata. The base-case decision tree model developed in the original HTA journal publication [Health Technol Assess 2008;12(36)] was used to derive the cost-effectiveness of immunoprophylaxis of RSV using palivizumab in different subgroups of pre-term infants and young children who are at high risk of serious morbidity from RSV infection. Cost-effective spectra of prophylaxis with palivizumab compared with no prophylaxis for children without CLD/CHD, children with CLD, children with acyanotic CHD and children with cyanotic CHD were derived. Thirteen studies were included in this analysis. Analysis of 16,128 subgroups showed that prophylaxis with palivizumab may be cost-effective [at a willingness-to-pay threshold of £30,000/quality-adjusted life-year (QALY)] for some subgroups. For example, for children without CLD or CHD, the cost-effective subgroups included children under 6 weeks old at the start of the RSV season who had at least two other risk factors that were considered in this report and were born at 24 weeks gestational age (GA) or less, but did not include children who were > 9 months old at the start of the RSV season or had a GA of > 32 weeks. For children with CLD, the cost-effective subgroups included children < 6 months old at the start of the RSV season who were born at 28 weeks GA or less, but did not include children who were > 21 months old at the start of the RSV season. For children with acyanotic CHD, the cost-effective subgroups included children < 6 months old at the start of the RSV season who were born at 24 weeks GA or less, but did not include children who were > 21 months old at the start of the RSV season. For children with cyanotic CHD, the cost-effective subgroups included children < 6 weeks old at the start of the RSV season who were born at 24 weeks GA or less, but did not

  11. Analysing the Present: Drawing on the Legacy of Vere Foster in Public Policy Debate on Futures of Schools

    ERIC Educational Resources Information Center

    Carr, John; Beckett, Lori

    2016-01-01

    This paper sets out a framing analysis for a public policy debate on the future of schools that resonates with practitioners in teaching and teacher education on the island of Ireland, north and south, but also in other countries. This is informed by a democratic impulse to facilitate public policy debates, particularly on the ways schools and…

  12. The Debate Debate

    ERIC Educational Resources Information Center

    Tumposky, Nancy Rennau

    2004-01-01

    Debate has been a well-known pedagogical technique since there have been written records about teaching and learning. Originally employed for learning philosophy and theology, debate was later used in the fields of history, law, literature, and the physical sciences. This author asserts, however, that, although the benefits of debate are…

  13. The Effect of IV Amino Acid Supplementation on Mortality in ICU Patients May Be Dependent on Kidney Function: Post Hoc Subgroup Analyses of a Multicenter Randomized Trial.

    PubMed

    Zhu, Ran; Allingstrup, Matilde J; Perner, Anders; Doig, Gordon S

    2018-05-15

    We investigated whether preexisting kidney function determines if ICU patients may benefit from increased (2.0 g/kg/d) protein intake. Post hoc, hypothesis-generating, subgroup analysis of a multicenter, phase 2, randomized clinical trial. All analyses were conducted by intention to treat and maintained group allocation. Ninety-day mortality was the primary outcome. ICUs of 16 hospitals throughout Australia and New Zealand. Adult critically ill patients expected to remain in the study ICU for longer than 2 days. Random allocation to receive a daily supplement of up to 100 g of IV amino acids to achieve a total protein intake of 2.0 g/kg/d or standard nutrition care. A total of 474 patients were randomized: 235 to standard care and 239 to IV amino acid supplementation. There was a statistically significant interaction between baseline kidney function and supplementation with study amino acids (p value for interaction = 0.026). Within the subgroup of patients with normal kidney function at randomization, patients who were allocated to receive the study amino acid supplement were less likely to die before study day 90 (covariate-adjusted risk difference, -7.9%; 95% CI, -15.1 to -0.7; p = 0.034). Furthermore, amino acid supplementation significantly increased estimated glomerular filtration rate in these patients (repeated-measures treatment × time interaction p = 0.009). Within the subgroup of patients with baseline kidney dysfunction and/or risk of progression of acute kidney injury, a significant effect of the study intervention on mortality was not found (covariate-adjusted risk difference, -0.6%; 95% CI, -16.2 to 15.2; p = 0.95). In this post hoc, hypothesis-generating, subgroup analysis, we observed reduced mortality and improved estimated glomerular filtration rate in ICU patients with normal kidney function who were randomly allocated to receive increased protein intake (up to 2.0 g/kg/d). We strongly recommend confirmation of these results in trials

  14. Effects of canagliflozin, an SGLT2 inhibitor, on hepatic function in Japanese patients with type 2 diabetes mellitus: pooled and subgroup analyses of clinical trials.

    PubMed

    Seko, Yuya; Sumida, Yoshio; Sasaki, Kazuyo; Itoh, Yoshito; Iijima, Hiroaki; Hashimoto, Toshio; Ishii, Shinichi; Inagaki, Nobuya

    2018-01-01

    We aimed to investigate the efficacy of canagliflozin (based on its effect on liver function and blood glucose levels) and its safety in high alanine aminotransferase (ALT) patients (ALT >30 U/L). This post hoc analysis of canagliflozin in type 2 diabetes mellitus (T2DM) patients was divided into Study 1 (pooled analysis of 12- and 24-week placebo-controlled, monotherapy studies) and Study 2 (52-week monotherapy/combination therapy study). The canagliflozin 100 mg group data were compared with placebo or baseline ALT subgroup (baseline ALT >30 or ≤30 U/L) data. The primary endpoint was change in ALT level from baseline. Secondary endpoints were changes in efficacy-related parameters. Adverse events (AEs) were evaluated. The mean ALT change at 12 weeks was -10.3 ± 11.7 and -3.2 ± 17.6 U/L in the canagliflozin vs. placebo group in the high ALT subgroup (P = 0.0206); no significant difference was shown in the low ALT subgroup (Study 1). In both ALT subgroups, glycosylated hemoglobin (HbA1c) and body weight were significantly reduced in the canagliflozin vs. placebo group (all P < 0.0001). The mean change in ALT at 52 weeks was -16.0 ± 18.8 U/L in the high ALT subgroup (P < 0.0001, Study 2). The incidence of AEs or serious AEs in the high ALT subgroup in the canagliflozin group was similar to that in the placebo group (Study 1) or low ALT subgroup (Studies 1 and 2). In T2DM patients with impaired liver function, canagliflozin may improve liver function, reduce HbA1c and body weight, and be well tolerated.

  15. The use of Quality-Adjusted Life Years in cost-effectiveness analyses in palliative care: Mapping the debate through an integrative review

    PubMed Central

    Wichmann, Anne B; Adang, Eddy MM; Stalmeier, Peep FM; Kristanti, Sinta; Van den Block, Lieve; Vernooij-Dassen, Myrra JFJ; Engels, Yvonne

    2017-01-01

    Background: In cost-effectiveness analyses in healthcare, Quality-Adjusted Life Years are often used as outcome measure of effectiveness. However, there is an ongoing debate concerning the appropriateness of its use for decision-making in palliative care. Aim: To systematically map pros and cons of using the Quality-Adjusted Life Year to inform decisions on resource allocation among palliative care interventions, as brought forward in the debate, and to discuss the Quality-Adjusted Life Year’s value for palliative care. Design: The integrative review method of Whittemore and Knafl was followed. Theoretical arguments and empirical findings were mapped. Data sources: A literature search was conducted in PubMed, EMBASE, and CINAHL, in which MeSH (Medical Subject Headings) terms were Palliative Care, Cost-Benefit Analysis, Quality of Life, and Quality-Adjusted Life Years. Findings: Three themes regarding the pros and cons were identified: (1) restrictions in life years gained, (2) conceptualization of quality of life and its measurement, including suggestions to adapt this, and (3) valuation and additivity of time, referring to changing valuation of time. The debate is recognized in empirical studies, but alternatives not yet applied. Conclusion: The Quality-Adjusted Life Year might be more valuable for palliative care if specific issues are taken into account. Despite restrictions in life years gained, Quality-Adjusted Life Years can be achieved in palliative care. However, in measuring quality of life, we recommend to—in addition to the EQ-5D— make use of quality of life or capability instruments specifically for palliative care. Also, we suggest exploring the possibility of integrating valuation of time in a non-linear way in the Quality-Adjusted Life Year. PMID:28190374

  16. The use of Quality-Adjusted Life Years in cost-effectiveness analyses in palliative care: Mapping the debate through an integrative review.

    PubMed

    Wichmann, Anne B; Adang, Eddy Mm; Stalmeier, Peep Fm; Kristanti, Sinta; Van den Block, Lieve; Vernooij-Dassen, Myrra Jfj; Engels, Yvonne

    2017-04-01

    In cost-effectiveness analyses in healthcare, Quality-Adjusted Life Years are often used as outcome measure of effectiveness. However, there is an ongoing debate concerning the appropriateness of its use for decision-making in palliative care. To systematically map pros and cons of using the Quality-Adjusted Life Year to inform decisions on resource allocation among palliative care interventions, as brought forward in the debate, and to discuss the Quality-Adjusted Life Year's value for palliative care. The integrative review method of Whittemore and Knafl was followed. Theoretical arguments and empirical findings were mapped. A literature search was conducted in PubMed, EMBASE, and CINAHL, in which MeSH (Medical Subject Headings) terms were Palliative Care, Cost-Benefit Analysis, Quality of Life, and Quality-Adjusted Life Years. Three themes regarding the pros and cons were identified: (1) restrictions in life years gained, (2) conceptualization of quality of life and its measurement, including suggestions to adapt this, and (3) valuation and additivity of time, referring to changing valuation of time. The debate is recognized in empirical studies, but alternatives not yet applied. The Quality-Adjusted Life Year might be more valuable for palliative care if specific issues are taken into account. Despite restrictions in life years gained, Quality-Adjusted Life Years can be achieved in palliative care. However, in measuring quality of life, we recommend to-in addition to the EQ-5D- make use of quality of life or capability instruments specifically for palliative care. Also, we suggest exploring the possibility of integrating valuation of time in a non-linear way in the Quality-Adjusted Life Year.

  17. Effects of internet-based cognitive behavioural therapy and physical exercise on sick leave and employment in primary care patients with depression: two subgroup analyses.

    PubMed

    Kaldo, Viktor; Lundin, Andreas; Hallgren, Mats; Kraepelien, Martin; Strid, Catharina; Ekblom, Örjan; Lavebratt, Catharina; Lindefors, Nils; Öjehagen, Agneta; Forsell, Yvonne

    2018-01-01

    Depression can negatively impact work capacity, but treatment effects on sick leave and employment are unclear. This study evaluates if internet-based cognitive behavioural therapy (ICBT) or physical exercise (PE), with already reported positive effects on clinical outcome and short-term work ability, has better effects on employment, sick leave and long-term work ability compared with treatment as usual (TAU) for depressed primary care patients (German clinical trials: DRKS00008745). After randomisation and exclusion of patients not relevant for work-related analysis, patients were divided into two subgroups: initially unemployed (total n=118) evaluated on employment, and employed (total n=703) evaluated on long-term sick leave. Secondary outcomes were self-rated work ability and average number of sick days per month evaluated for both subgroups. Assessments (self-reports) were made at baseline and follow-up at 3 and 12 months. For the initially unemployed subgroup, 52.6% were employed after 1 year (response rate 82%). Both PE (risk ratio (RR)=0.44; 95% CI 0.23 to 0.87) and ICBT (RR=0.37; 95% CI 0.16 to 0.84) showed lower rates compared with TAU after 3 months, but no difference was found after 1 year (PE: RR=0.97; 95% CI 0.69 to 1.57; ICBT: RR=1.23; 95% CI 0.72 to 2.13). For those with initial employment, long-term sick leave (response rate 75%) decreased from 7.8% to 6.5%, but neither PE (RR=1.4; 95% CI 0.52 to 3.74) nor ICBT (RR=0.99; 95% CI 0.39 to 2.46) decreased more than TAU, although a temporary positive effect for PE was found. All groups increased self-rated work ability with no differences found. No long-term effects were found for the initially unemployed on employment status or for the initially employed on sick leave. New types of interventions need to be explored. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly

  18. Bioinformatic Analyses of Subgroup-A Members of the Wheat bZIP Transcription Factor Family and Functional Identification of TabZIP174 Involved in Drought Stress Response

    PubMed Central

    Li, Xueyin; Feng, Biane; Zhang, Fengjie; Tang, Yimiao; Zhang, Liping; Ma, Lingjian; Zhao, Changping; Gao, Shiqing

    2016-01-01

    Extensive studies in Arabidopsis and rice have demonstrated that Subgroup-A members of the bZIP transcription factor family play important roles in plant responses to multiple abiotic stresses. Although common wheat (Triticum aestivum) is one of the most widely cultivated and consumed food crops in the world, there are limited investigations into Subgroup A of the bZIP family in wheat. In this study, we performed bioinformatic analyses of the 41 Subgroup-A members of the wheat bZIP family. Phylogenetic and conserved motif analyses showed that most of the Subgroup-A bZIP proteins involved in abiotic stress responses of wheat, Arabidopsis, and rice clustered in Clade A1 of the phylogenetic tree, and shared a majority of conserved motifs, suggesting the potential importance of Clade-A1 members in abiotic stress responses. Gene structure analysis showed that TabZIP genes with close phylogenetic relationships tended to possess similar exon–intron compositions, and the positions of introns in the hinge regions of the bZIP domains were highly conserved, whereas introns in the leucine zipper regions were at variable positions. Additionally, eleven groups of homologs and two groups of tandem paralogs were also identified in Subgroup A of the wheat bZIP family. Expression profiling analysis indicated that most Subgroup-A TabZIP genes were responsive to abscisic acid and various abiotic stress treatments. TabZIP27, TabZIP74, TabZIP138, and TabZIP174 proteins were localized in the nucleus of wheat protoplasts, whereas TabZIP9-GFP fusion protein was simultaneously present in the nucleus, cytoplasm, and cell membrane. Transgenic Arabidopsis overexpressing TabZIP174 displayed increased seed germination rates and primary root lengths under drought treatments. Overexpression of TabZIP174 in transgenic Arabidopsis conferred enhanced drought tolerance, and transgenic plants exhibited lower water loss rates, higher survival rates, higher proline, soluble sugar, and leaf chlorophyll

  19. Intersectionality and gender mainstreaming in international health: using a feminist participatory action research process to analyse voices and debates from the global south and north.

    PubMed

    Tolhurst, Rachel; Leach, Beryl; Price, Janet; Robinson, Jude; Ettore, Elizabeth; Scott-Samuel, Alex; Kilonzo, Nduku; Sabuni, Louis P; Robertson, Steve; Kapilashrami, Anuj; Bristow, Katie; Lang, Raymond; Romao, Francelina; Theobald, Sally

    2012-06-01

    Critiques of gender mainstreaming (GM) as the officially agreed strategy to promote gender equity in health internationally have reached a critical mass. There has been a notable lack of dialogue between gender advocates in the global north and south, from policy and practice, governments and non-governmental organisations (NGOs). This paper contributes to the debate on the shape of future action for gender equity in health, by uniquely bringing together the voices of disparate actors, first heard in a series of four seminars held during 2008 and 2009, involving almost 200 participants from 15 different country contexts. The series used (Feminist) Participatory Action Research (FPAR) methodology to create a productive dialogue on the developing theory around GM and the at times disconnected empirical experience of policy and practice. We analyse the debates and experiences shared at the seminar series using concrete, context specific examples from research, advocacy, policy and programme development perspectives, as presented by participants from southern and northern settings, including Kenya, Mozambique, India, the Democratic Republic of Congo, Canada and Australia. Focussing on key discussions around sexualities and (dis)ability and their interactions with gender, we explore issues around intersectionality across the five key themes for research and action identified by participants: (1) Addressing the disconnect between gender mainstreaming praxis and contemporary feminist theory; (2) Developing appropriate analysis methodologies; (3) Developing a coherent theory of change; (4) Seeking resolution to the dilemmas and uncertainties around the 'place' of men and boys in GM as a feminist project; and (5) Developing a politics of intersectionality. We conclude that there needs to be a coherent and inclusive strategic direction to improve policy and practice for promoting gender equity in health which requires the full and equal participation of practitioners and

  20. EFFICACY AND SAFETY OF INTRAVITREAL AFLIBERCEPT AND RANIBIZUMAB IN ASIAN PATIENTS WITH NEOVASCULAR AGE-RELATED MACULAR DEGENERATION: Subgroup Analyses From the View Trials.

    PubMed

    Wong, Tien Yin; Cheung, Chui Ming Gemmy; Lai, Timothy Y Y; Chen, Shih-Jen; Lee, Won Ki; Yoon, Young Hee; Iida, Tomohiro; Tueckmantel, Claudia; Sowade, Olaf; Ogura, Yuichiro

    2017-12-26

    To assess the treatment effect of intravitreal aflibercept and ranibizumab in Asian patients with neovascular age-related macular degeneration. We evaluated data from VIEW 1 and VIEW 2, comparing functional and morphologic outcomes at Week 96 between intravitreal aflibercept 2 mg monthly (2q4) or 2 mg bimonthly after 3 initial monthly doses (2q8) versus ranibizumab 0.5 mg monthly among Asian patients (n = 269) and between Asian and white patients (n = 2044). In Asian patients, there were no significant differences between intravitreal aflibercept 2q4 and 2q8 compared with ranibizumab in mean gain in best-corrected visual acuity (10.23 and 8.35 vs. 8.51 letters). Reduction in central retinal thickness was greater for intravitreal aflibercept 2q4 (150.43 μm, P = 0.0075) and 2q8 (148.15 μm, P = 0.0126) than ranibizumab (119.46 μm). The proportion of dry retinas was greater for intravitreal aflibercept 2q4 (65.7%, P < 0.01) than ranibizumab (41.7%). There were no differences in outcomes between Asian and white patients. Serious treatment-emergent ocular adverse events occurred in <8% of treated eyes, evenly distributed across subgroups. In Asian patients with neovascular age-related macular degeneration, functional and morphologic outcomes were largely similar between intravitreal aflibercept and ranibizumab groups, and to results seen in white patients.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

  1. The Effect of Age, Parity and Body Mass Index on the Efficacy, Safety, Placement and User Satisfaction Associated With Two Low-Dose Levonorgestrel Intrauterine Contraceptive Systems: Subgroup Analyses of Data From a Phase III Trial

    PubMed Central

    Gemzell-Danielsson, Kristina; Apter, Dan; Hauck, Brian; Schmelter, Thomas; Rybowski, Sarah; Rosen, Kimberly; Nelson, Anita

    2015-01-01

    Objective Two low-dose levonorgestrel intrauterine contraceptive systems (LNG-IUSs; total content 13.5 mg [average approx. 8 μg/24 hours over the first year; LNG-IUS 8] and total content 19.5 mg [average approx. 13 μg/24 hours over the first year; LNG-IUS 13]) have previously been shown to be highly effective (3-year Pearl Indices: 0.33 and 0.31, respectively), safe and well tolerated. The present subgroup analyses evaluated whether or not outcomes were affected by parity, age (18–25 vs 26–35 years), or body mass index (BMI, <30 vs ≥30 kg/m2). Methods Nulliparous and parous women aged 18‒35 years with regular menstrual cycles (21‒35 days) requesting contraception were randomized to 3 years of LNG-IUS 8 or LNG-IUS 13 use. Results In the LNG-IUS 8 and LNG-IUS 13 groups, 1432 and 1452 women, respectively, had a placement attempted and were included in the full analysis set; 39.2%, 39.2% and 17.1% were 18–25 years old, nulliparous and had a BMI ≥30 kg/m2, respectively. Both systems were similarly effective regardless of age, parity or BMI; the subgroup Pearl Indices had widely overlapping 95% confidence intervals. Placement of LNG-IUS 8 and LNG-IUS 13 was easier (p < 0.0001) and less painful (p < 0.0001) in women who had delivered vaginally than in women who had not. The complete/partial expulsion rate was 2.2–4.2% across all age and parity subgroups and higher in parous than in nulliparous women (p = 0.004). The incidence of pelvic inflammatory disease was 0.1–0.6% across all age and parity subgroups: nulliparous and younger women were not at higher risk than parous and older women, respectively. The ectopic pregnancy rate was 0.3–0.4% across all age and parity subgroups. Across all age and parity subgroups, the 3-year completion rate was 50.9–61.3% for LNG-IUS 8 and 57.9–61.1% for LNG-IUS 13, and was higher (p = 0.0001) among older than younger women in the LNG-IUS 8 group only. Conclusions LNG-IUS 8 and LNG-IUS 13 were highly effective

  2. Safety and efficacy of canagliflozin in Japanese patients with type 2 diabetes mellitus: post hoc subgroup analyses according to body mass index in a 52-week open-label study.

    PubMed

    Inagaki, Nobuya; Goda, Maki; Yokota, Shoko; Maruyama, Nobuko; Iijima, Hiroaki

    2015-01-01

    The safety and efficacy of sodium glucose co-transporter 2 inhibitors in non-obese compared with obese patients with type 2 diabetes mellitus is unknown. We conducted post hoc analyses of the results of a 52-week open-label study of Japanese type 2 diabetes mellitus patients treated with 100 or 200 mg canagliflozin. Patients were divided into four subgroups according to their baseline body mass index (BMI): group I, BMI < 22 kg/m(2); group II, BMI ≥ 22 to < 25 kg/m(2); group III, BMI ≥ 25 to < 30 kg/m(2) and group IV, BMI ≥ 30 kg/m(2). The overall safety was similar among the four BMI subgroups, although there were slight differences in terms of the incidences of hypoglycemia, asymptomatic hypoglycemia, female genital infections and proportions of patients with total ketone body levels exceeding 1000 μmol/l at any time for both canagliflozin doses. Hemoglobin A1c, fasting plasma glucose and body weight decreased significantly from baseline to week 52 at both canagliflozin doses. The changes in hemoglobin A1c, and fasting plasma glucose were not significantly different among the four BMI subgroups for either dose. Canagliflozin was tolerated in patients irrespective of their BMI at the start of treatment, although some caution may be needed.

  3. Subgroup analyses of the safety and efficacy of ramucirumab in Japanese and Western patients in RAINBOW: a randomized clinical trial in second-line treatment of gastric cancer.

    PubMed

    Shitara, Kohei; Muro, Kei; Shimada, Yasuhiro; Hironaka, Shuichi; Sugimoto, Naotoshi; Komatsu, Yoshito; Nishina, Tomohiro; Yamaguchi, Kensei; Segawa, Yoshihiko; Omuro, Yasushi; Tamura, Takao; Doi, Toshihiko; Yukisawa, Seigo; Yasui, Hirofumi; Nagashima, Fumio; Gotoh, Masahiro; Esaki, Taito; Emig, Michael; Chandrawansa, Kumari; Liepa, Astra M; Wilke, Hansjochen; Ichimiya, Yukako; Ohtsu, Atsushi

    2016-07-01

    We evaluated the safety and efficacy of ramucirumab plus paclitaxel versus placebo plus paclitaxel in patients previously treated for advanced gastric or gastroesophageal junction adenocarcinoma in Japanese and Western subgroups from the RAINBOW trial. Patients received ramucirumab at 8 mg/kg or placebo (days 1 and 15) plus paclitaxel at 80 mg/m(2) (days 1, 8, and 15 of a 28-day cycle). End points were compared between treatment arms within Japanese (N = 140) and Western (N = 398) populations. The incidence of adverse events of grade 3 or higher was higher for ramucirumab plus paclitaxel in both populations (Japanese population, 83.8 % vs 52.1 %; Western population, 79.1 % vs 61.9 %). Neutropenia was the commonest adverse event of grade 3 or higher, with a higher incidence for ramucirumab plus paclitaxel (Japanese population, 66.2 % vs 25.4 %; Western population, 32.1 % vs 14.7 %). The incidence of febrile neutropenia was low and was similar between treatment arms in both populations. The overall survival hazard ratio was 0.88 (95 % confidence interval, 0.60-1.28) in the Japanese population and 0.73 (95 % confidence interval, 0.58-0.91) in the Western population. The progression-free survival hazard ratio was 0.50 (95 % confidence interval, 0.35-0.73) in the Japanese population and 0.63 (95 % confidence interval, 0.51-0.79) in the Western population. The objective response rate was higher for ramucirumab plus paclitaxel in both populations (Japanese population, 41.2 % vs 19.4 %; Western population, 26.8 % vs 13.0 %), as was the 6-month survival rate (Japanese population, 94.1 % vs 71.4 %; Western population, 66.0 % vs 49.0 %). Safety profiles of the ramucirumab plus paclitaxel arm were similar between populations, though there was a higher incidence of neutropenia in Japanese patients. Progression-free survival and objective response rate improvements were observed for ramucirumab plus paclitaxel in both populations. CLINICALTRIALS. NCT

  4. Efficacy of aripiprazole augmentation in Japanese patients with major depressive disorder: a subgroup analysis and Montgomery-Åsberg Depression Rating Scale and Hamilton Rating Scale for Depression item analyses of the Aripiprazole Depression Multicenter Efficacy study.

    PubMed

    Ozaki, Norio; Otsubo, Tempei; Kato, Masaki; Higuchi, Teruhiko; Ono, Hiroaki; Kamijima, Kunitoshi

    2015-01-01

    Results from this randomized, placebo-controlled study of aripiprazole augmentation to antidepressant therapy (ADT) in Japanese patients with major depressive disorder (MDD) (the Aripiprazole Depression Multicenter Efficacy [ADMIRE] study) revealed that aripiprazole augmentation was superior to ADT alone and was well tolerated. In subgroup analyses, we investigated the influence of demographic- and disease-related factors on the observed responses. We also examined how individual symptom improvement was related to overall improvement in MDD. Data from the ADMIRE study were analyzed. Subgroup analyses were performed on the primary outcome measures: the mean change in the Montgomery-Åsberg Depression Rating Scale (MADRS) total score from the end of selective serotonin reuptake inhibitor (SSRI)/serotonin norepinephrine reuptake inhibitor (SNRI) treatment to the end of the randomized treatment. Changes in the MADRS total scores were consistently greater with aripiprazole than placebo in each of the subgroups. Efficacy was not related to sex, age, number of adequate ADT trials in the current episode, MDD diagnosis, number of depressive episodes, duration of the current episode, age at first depressive episode, time since the first depressive episode, type of SSRI/SNRI, or severity at the end of SSRI/SNRI treatment phase. Compared to placebo, aripiprazole resulted in significant and rapid improvement on seven of the 10 MADRS items, including sadness. These post-hoc analyses indicated that aripiprazole was effective for a variety of Japanese patients with MDD who had exhibited inadequate responses to ADT. Additionally, we suggest that aripiprazole significantly and rapidly improved the core depressive symptoms. © 2014 The Authors. Psychiatry and Clinical Neurosciences © 2014 Japanese Society of Psychiatry and Neurology.

  5. Factors impacting the efficacy of venlafaxine extended release 75-225 mg/day in patients with major depressive disorder: exploratory post hoc subgroup analyses of a randomized, double-blind, placebo-controlled study in Japan.

    PubMed

    Watanabe, Yoshinori; Asami, Yuko; Hirano, Yoko; Kuribayashi, Kazuhiko; Itamura, Rio; Imaeda, Takayuki

    2018-01-01

    To explore the potential factors impacting the efficacy of venlafaxine extended release (ER) and treatment differences between 75 mg/day and 75-225 mg/day dose in patients with major depressive disorder (MDD). We performed exploratory post hoc subgroup analyses of a randomized, double-blind, placebo-controlled study conducted in Japan. A total of 538 outpatients aged 20 years or older with a primary diagnosis of MDD who experienced single or recurrent episodes were randomized into three groups: fixed-dose, flexible-dose, or placebo. Venlafaxine ER was initiated at 37.5 mg/day and titrated to 75 mg/day for both fixed-dose and flexible-dose group, and to 225 mg/day for flexible-dose group (if well tolerated). Efficacy endpoints were changes from baseline at Week 8 using the Hamilton Rating Scale for Depression-17 items (HAM-D 17 ) total score, Hamilton Rating Scale for Depression-6 items score, and Montgomery-Asberg Depression Rating Scale total score. The following factors were considered in the subgroup analyses: sex, age, HAM-D 17 total score at baseline, duration of MDD, duration of current depressive episode, history of previous depressive episodes, history of previous medications for MDD, and CYP2D6 phenotype. For each subgroup, an analysis of covariance model was fitted and the adjusted mean of the treatment effect and corresponding 95% CI were computed. Due to the exploratory nature of the investigation, no statistical hypothesis testing was used. Venlafaxine ER improved symptoms of MDD compared with placebo in most subgroups. The subgroup with a long duration of MDD (>22 months) consistently showed greater treatment benefits in the flexible-dose group than in the fixed-dose group. These results suggest that a greater treatment response to venlafaxine ER (up to 225 mg/day) can be seen in patients with a longer duration of MDD. Further investigations are needed to identify additional factors impacting the efficacy of venlafaxine ER.

  6. Factors impacting the efficacy of venlafaxine extended release 75–225 mg/day in patients with major depressive disorder: exploratory post hoc subgroup analyses of a randomized, double-blind, placebo-controlled study in Japan

    PubMed Central

    Watanabe, Yoshinori; Asami, Yuko; Hirano, Yoko; Kuribayashi, Kazuhiko; Itamura, Rio; Imaeda, Takayuki

    2018-01-01

    Purpose To explore the potential factors impacting the efficacy of venlafaxine extended release (ER) and treatment differences between 75 mg/day and 75–225 mg/day dose in patients with major depressive disorder (MDD). Methods We performed exploratory post hoc subgroup analyses of a randomized, double-blind, placebo-controlled study conducted in Japan. A total of 538 outpatients aged 20 years or older with a primary diagnosis of MDD who experienced single or recurrent episodes were randomized into three groups: fixed-dose, flexible-dose, or placebo. Venlafaxine ER was initiated at 37.5 mg/day and titrated to 75 mg/day for both fixed-dose and flexible-dose group, and to 225 mg/day for flexible-dose group (if well tolerated). Efficacy endpoints were changes from baseline at Week 8 using the Hamilton Rating Scale for Depression–17 items (HAM-D17) total score, Hamilton Rating Scale for Depression–6 items score, and Montgomery–Asberg Depression Rating Scale total score. The following factors were considered in the subgroup analyses: sex, age, HAM-D17 total score at baseline, duration of MDD, duration of current depressive episode, history of previous depressive episodes, history of previous medications for MDD, and CYP2D6 phenotype. For each subgroup, an analysis of covariance model was fitted and the adjusted mean of the treatment effect and corresponding 95% CI were computed. Due to the exploratory nature of the investigation, no statistical hypothesis testing was used. Results Venlafaxine ER improved symptoms of MDD compared with placebo in most subgroups. The subgroup with a long duration of MDD (>22 months) consistently showed greater treatment benefits in the flexible-dose group than in the fixed-dose group. Conclusion These results suggest that a greater treatment response to venlafaxine ER (up to 225 mg/day) can be seen in patients with a longer duration of MDD. Further investigations are needed to identify additional factors impacting the efficacy of

  7. Sensitivity subgroup analysis based on single-center vs. multi-center trial status when interpreting meta-analyses pooled estimates: the logical way forward.

    PubMed

    Alexander, Paul E; Bonner, Ashley J; Agarwal, Arnav; Li, Shelly-Anne; Hariharan, Abishek; Izhar, Zain; Bhatnagar, Neera; Alba, Carolina; Akl, Elie A; Fei, Yutong; Guyatt, Gordon H; Beyene, Joseph

    2016-06-01

    Prior studies regarding whether single-center trial estimates are larger than multi-center are equivocal. We examined the extent to which single-center trials yield systematically larger effects than multi-center trials. We searched the 119 core clinical journals and the Cochrane Database of Systematic Reviews for meta-analyses (MAs) of randomized controlled trials (RCTs) published during 2012. In this meta-epidemiologic study, for binary variables, we computed the pooled ratio of ORs (RORs), and for continuous outcomes mean difference in standardized mean differences (SMDs), we conducted weighted random-effects meta-regression and random-effects MA modeling. Our primary analyses were restricted to MAs that included at least five RCTs and in which at least 25% of the studies used each of single trial center (SC) and more trial center (MC) designs. We identified 81 MAs for the odds ratio (OR) and 43 for the SMD outcome measures. Based on our analytic plan, our primary analysis (core) is based on 25 MAs/241 RCTs (binary outcome) and 18 MAs/173 RCTs (continuous outcome). Based on the core analysis, we found no difference in magnitude of effect between SC and MC for binary outcomes [RORs: 1.02; 95% confidence interval (CI): 0.83, 1.24; I(2) 20.2%]. Effect sizes were systematically larger for SC than MC for the continuous outcome measure (mean difference in SMDs: -0.13; 95% CI: -0.21, -0.05; I(2) 0%). Our results do not support prior findings of larger effects in SC than MC trials addressing binary outcomes but show a very similar small increase in effect in SC than MC trials addressing continuous outcomes. Authors of systematic reviews would be wise to include all trials irrespective of SC vs. MC design and address SC vs. MC status as a possible explanation of heterogeneity (and consider sensitivity analyses). Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Cost-effectiveness of insulin aspart versus human soluble insulin in type 2 diabetes in four European countries: subgroup analyses from the PREDICTIVE study.

    PubMed

    Palmer, James L; Goodall, Gordon; Nielsen, Steffen; Kotchie, Robert W; Valentine, William J; Palmer, Andrew J; Roze, Stéphane

    2008-05-01

    To evaluate the long-term health economic outcomes associated with insulin aspart (IAsp) compared to human soluble insulin (HI) in type 2 diabetes patients on basal-bolus therapy in Sweden, Spain, Italy and Poland. A published computer simulation model of diabetes was used to predict life expectancy, quality-adjusted life expectancy and incidence of diabetes-related complications. Baseline cohort characteristics (age 61.6 years, duration of diabetes 13.2 years, 45.1% male, HbA(1c) 8.2%, BMI 29.8 kg/m(2)) and treatment effects were derived from the PREDICTIVE observational study. Country-specific complication costs were derived from published sources. The analyses were run over 35-year time horizons from third-party payer perspectives in Spain, Italy and Poland and from a societal perspective in Sweden. Future costs and clinical benefits were discounted at country-specific discount rates. Sensitivity analyses were performed. IAsp was associated with improvements in discounted life expectancy and quality-adjusted life expectancy, and a reduced incidence of most diabetes-related complications versus HI in all four settings. IAsp was associated with societal cost-savings in Sweden (SEK 2470), direct medical cost-savings in Sweden and Spain (SEK 8248 and euro 1382, respectively), but increased direct costs in Italy (euro 2235) and Poland (euro 743). IAsp was associated with improved quality-adjusted life expectancy in Sweden (0.077 QALYs), Spain (0.080 QALYs), Italy (0.120 QALYs) and Poland (0.003 QALYs). IAsp was dominant versus HI in both Sweden and Spain, would be considered cost-effective in Italy with an incremental cost-effectiveness ratio of euro 18,597 per QALY gained, but would not be considered cost-effective in Poland.

  9. Efficacy and safety of palbociclib in combination with letrozole as first-line treatment of ER-positive, HER2-negative, advanced breast cancer: expanded analyses of subgroups from the randomized pivotal trial PALOMA-1/TRIO-18.

    PubMed

    Finn, Richard S; Crown, John P; Ettl, Johannes; Schmidt, Marcus; Bondarenko, Igor M; Lang, Istvan; Pinter, Tamas; Boer, Katalin; Patel, Ravindranath; Randolph, Sophia; Kim, Sindy T; Huang, Xin; Schnell, Patrick; Nadanaciva, Sashi; Bartlett, Cynthia Huang; Slamon, Dennis J

    2016-06-28

    Palbociclib is an oral small-molecule inhibitor of cyclin-dependent kinases 4 and 6. In the randomized, open-label, phase II PALOMA-1/TRIO-18 trial, palbociclib in combination with letrozole improved progression-free survival (PFS) compared with letrozole alone as first-line treatment of estrogen receptor (ER)-positive, human epidermal growth factor receptor 2 (HER2)-negative, advanced breast cancer (20.2 months versus 10.2 months; hazard ratio (HR) = 0.488, 95 % confidence interval (CI) 0.319-0.748; one-sided p = 0.0004). Grade 3-4 neutropenia was the most common adverse event (AE) in the palbociclib + letrozole arm. We now present efficacy and safety analyses based on several specific patient and tumor characteristics, and present in detail the clinical patterns of neutropenia observed in the palbociclib + letrozole arm of the overall safety population. Postmenopausal women (n = 165) with ER+, HER2-negative, advanced breast cancer who had not received any systemic treatment for their advanced disease were randomized 1:1 to receive either palbociclib in combination with letrozole or letrozole alone. Treatment continued until disease progression, unacceptable toxicity, consent withdrawal, or death. The primary endpoint was PFS. We now analyze the difference in PFS for the treatment populations by subgroups, including age, histological type, history of prior neoadjuvant/adjuvant systemic treatment, and sites of distant metastasis, using the Kaplan-Meier method. HR and 95 % CI are derived from a Cox proportional hazards regression model. A clinically meaningful improvement in median PFS and clinical benefit response (CBR) rate was seen with palbociclib + letrozole in every subgroup evaluated. Grade 3-4 neutropenia was the most common AE with palbociclib + letrozole in all subgroups. Analysis of the frequency of neutropenia by grade during the first six cycles of treatment showed that there was a downward trend in Grade 3-4 neutropenia

  10. London Education and Inclusion Project (LEIP): Exploring Negative and Null Effects of a Cluster-Randomised School-Intervention to Reduce School Exclusion—Findings from Protocol-Based Subgroup Analyses

    PubMed Central

    Obsuth, Ingrid; Cope, Aiden; Sutherland, Alex; Pilbeam, Liv; Murray, Aja Louise; Eisner, Manuel

    2016-01-01

    This paper presents subgroup analyses from the London Education and Inclusion Project (LEIP). LEIP was a cluster-randomised controlled trial of an intervention called Engage in Education-London (EiE-L) which aimed to reduce school exclusions in those at greatest risk of exclusion. Pupils in the control schools attended an hour-long employability seminar. Minimisation was used to randomly assign schools to treatment and control following baseline data collection. The study involved 36 schools (17 in treatment—373 pupils; 19 in control—369 pupils) with >28% free school meal eligibility across London and utilised on pupil self-reports, teacher reports as well as official records to assess the effectiveness of EiE-L. Due to multiple data sources, sample sizes varied according to analysis. Analyses of pre-specified subgroups revealed null and negative effects on school exclusion following the intervention. Our findings suggest that the design and implementation of EiE-L may have contributed to the negative outcomes for pupils in the treatment schools when compared to those in the control schools. These findings call into question the effectiveness of bolt-on short-term interventions with pupils, particularly those at the highest risk of school exclusion and when they are faced with multiple problems. This is especially pertinent given the possibility of negative outcomes. Trial Registration: Controlled Trials: ISRCTN23244695 PMID:27045953

  11. Tofacitinib for the treatment of moderate to severe chronic plaque psoriasis in Japanese patients: Subgroup analyses from a randomized, placebo-controlled phase 3 trial.

    PubMed

    Abe, Masatoshi; Nishigori, Chikako; Torii, Hideshi; Ihn, Hironobu; Ito, Kei; Nagaoka, Makoto; Isogawa, Naoki; Kawaguchi, Isao; Tomochika, Yukiko; Kobayashi, Mihoko; Tallman, Anna M; Papp, Kim A

    2017-11-01

    Tofacitinib is an oral Janus kinase inhibitor. These post-hoc analyses assessed tofacitinib efficacy and safety in Japanese patients with psoriasis enrolled in a 52-week global phase 3 study. Patients received tofacitinib 5 mg, tofacitinib 10 mg or placebo twice daily (b.i.d.); placebo-treated patients advanced to tofacitinib at week 16. Primary efficacy end-points were the proportions of patients with 75% or more reduction from baseline Psoriasis Area and Severity Index (PASI-75) and Physician's Global Assessment (PGA) of "clear" or "almost clear" (PGA response) at week 16. Other end-points included: Itch Severity Item (ISI), Dermatology Life Quality Index (DLQI) score and Nail Psoriasis Severity Index (NAPSI). Adverse events (AEs) were recorded throughout the study. Overall, 58 Japanese patients were included in this analysis (tofacitinib 5 mg b.i.d., n = 22; 10 mg b.i.d., n = 24; placebo, n = 12); 29 completed the study. At week 16, significantly more patients receiving tofacitinib 5 and 10 mg b.i.d. versus placebo achieved PASI-75 (50% and 75% vs 0%, P < 0.01) and PGA response (59% and 75% vs 0%, P < 0.001). Substantial improvements in ISI, DLQI and NAPSI score were observed with both tofacitinib doses. Over 52 weeks, similar rates of AEs were reported across treatment groups; one serious AE occurred with tofacitinib 10 mg b.i.d. Herpes zoster occurred in three patients receiving tofacitinib 10 mg b.i.d. No deaths, serious infections, malignancies or gastrointestinal perforations were reported. Results were generally consistent with global analysis, suggesting sustained efficacy and a manageable safety profile, with increased herpes zoster incidence, of tofacitinib in Japanese patients with psoriasis. © 2017 The Authors. The Journal of Dermatology published by John Wiley & Sons Australia, Ltd on behalf of Japanese Dermatological Association.

  12. Tofacitinib induction and maintenance therapy in East Asian patients with active ulcerative colitis: subgroup analyses from three phase 3 multinational studies.

    PubMed

    Motoya, Satoshi; Watanabe, Mamoru; Kim, Hyo Jong; Kim, Young Ho; Han, Dong Soo; Yuasa, Hirotoshi; Tabira, Junichi; Isogawa, Naoki; Arai, Shoko; Kawaguchi, Isao; Hibi, Toshifumi

    2018-04-01

    Tofacitinib is an oral, small-molecule Janus kinase inhibitor being investigated for ulcerative colitis (UC). In OCTAVE Induction 1 and 2, patients with moderately to severely active UC received placebo or tofacitinib 10 mg twice daily (BID) for 8 weeks. Clinical responders in OCTAVE Induction were re-randomized to 52 weeks' therapy with placebo, tofacitinib 5 mg BID, or tofacitinib 10 mg BID. We conducted post-hoc efficacy and safety analyses of East Asian patients in OCTAVE Induction 1 and 2 and OCTAVE Sustain. A total of 121 East Asian (Japan, Korea, and Taiwan) patients were randomized in OCTAVE Induction 1 and 2 (placebo, n=26; tofacitinib 10 mg BID, n=95), and 63 in OCTAVE Sustain (placebo, n=20; tofacitinib 5 mg BID, n=22; tofacitinib 10 mg BID, n=21). At week 8 of OCTAVE Induction 1 and 2, 18.9% of patients (18/95) achieved remission with tofacitinib 10 mg BID versus 3.8% (1/26) with placebo. In OCTAVE Sustain, the week 52 remission rates were 45.5% (10/22), 47.6% (10/21), and 15.0% (3/20) with 5 mg BID, 10 mg BID, and placebo, respectively. Adverse event rates were similar between groups in OCTAVE Induction and numerically higher with tofacitinib in OCTAVE Sustain. Serious adverse event rates were similar across groups in all studies. Infections were numerically more frequent with tofacitinib than placebo. Increases in serum lipid levels were observed with tofacitinib. In East Asian patients with UC, tofacitinib demonstrated numerically greater efficacy versus placebo as induction and maintenance therapy, with a safety profile consistent with the global study population. ClinicalTrials.gov: NCT01465763; NCT01458951; NCT01458574.

  13. Cytogenetic prognostication within medulloblastoma subgroups.

    PubMed

    Shih, David J H; Northcott, Paul A; Remke, Marc; Korshunov, Andrey; Ramaswamy, Vijay; Kool, Marcel; Luu, Betty; Yao, Yuan; Wang, Xin; Dubuc, Adrian M; Garzia, Livia; Peacock, John; Mack, Stephen C; Wu, Xiaochong; Rolider, Adi; Morrissy, A Sorana; Cavalli, Florence M G; Jones, David T W; Zitterbart, Karel; Faria, Claudia C; Schüller, Ulrich; Kren, Leos; Kumabe, Toshihiro; Tominaga, Teiji; Shin Ra, Young; Garami, Miklós; Hauser, Peter; Chan, Jennifer A; Robinson, Shenandoah; Bognár, László; Klekner, Almos; Saad, Ali G; Liau, Linda M; Albrecht, Steffen; Fontebasso, Adam; Cinalli, Giuseppe; De Antonellis, Pasqualino; Zollo, Massimo; Cooper, Michael K; Thompson, Reid C; Bailey, Simon; Lindsey, Janet C; Di Rocco, Concezio; Massimi, Luca; Michiels, Erna M C; Scherer, Stephen W; Phillips, Joanna J; Gupta, Nalin; Fan, Xing; Muraszko, Karin M; Vibhakar, Rajeev; Eberhart, Charles G; Fouladi, Maryam; Lach, Boleslaw; Jung, Shin; Wechsler-Reya, Robert J; Fèvre-Montange, Michelle; Jouvet, Anne; Jabado, Nada; Pollack, Ian F; Weiss, William A; Lee, Ji-Yeoun; Cho, Byung-Kyu; Kim, Seung-Ki; Wang, Kyu-Chang; Leonard, Jeffrey R; Rubin, Joshua B; de Torres, Carmen; Lavarino, Cinzia; Mora, Jaume; Cho, Yoon-Jae; Tabori, Uri; Olson, James M; Gajjar, Amar; Packer, Roger J; Rutkowski, Stefan; Pomeroy, Scott L; French, Pim J; Kloosterhof, Nanne K; Kros, Johan M; Van Meir, Erwin G; Clifford, Steven C; Bourdeaut, Franck; Delattre, Olivier; Doz, François F; Hawkins, Cynthia E; Malkin, David; Grajkowska, Wieslawa A; Perek-Polnik, Marta; Bouffet, Eric; Rutka, James T; Pfister, Stefan M; Taylor, Michael D

    2014-03-20

    Medulloblastoma comprises four distinct molecular subgroups: WNT, SHH, Group 3, and Group 4. Current medulloblastoma protocols stratify patients based on clinical features: patient age, metastatic stage, extent of resection, and histologic variant. Stark prognostic and genetic differences among the four subgroups suggest that subgroup-specific molecular biomarkers could improve patient prognostication. Molecular biomarkers were identified from a discovery set of 673 medulloblastomas from 43 cities around the world. Combined risk stratification models were designed based on clinical and cytogenetic biomarkers identified by multivariable Cox proportional hazards analyses. Identified biomarkers were tested using fluorescent in situ hybridization (FISH) on a nonoverlapping medulloblastoma tissue microarray (n = 453), with subsequent validation of the risk stratification models. Subgroup information improves the predictive accuracy of a multivariable survival model compared with clinical biomarkers alone. Most previously published cytogenetic biomarkers are only prognostic within a single medulloblastoma subgroup. Profiling six FISH biomarkers (GLI2, MYC, chromosome 11 [chr11], chr14, 17p, and 17q) on formalin-fixed paraffin-embedded tissues, we can reliably and reproducibly identify very low-risk and very high-risk patients within SHH, Group 3, and Group 4 medulloblastomas. Combining subgroup and cytogenetic biomarkers with established clinical biomarkers substantially improves patient prognostication, even in the context of heterogeneous clinical therapies. The prognostic significance of most molecular biomarkers is restricted to a specific subgroup. We have identified a small panel of cytogenetic biomarkers that reliably identifies very high-risk and very low-risk groups of patients, making it an excellent tool for selecting patients for therapy intensification and therapy de-escalation in future clinical trials.

  14. Cytogenetic Prognostication Within Medulloblastoma Subgroups

    PubMed Central

    Shih, David J.H.; Northcott, Paul A.; Remke, Marc; Korshunov, Andrey; Ramaswamy, Vijay; Kool, Marcel; Luu, Betty; Yao, Yuan; Wang, Xin; Dubuc, Adrian M.; Garzia, Livia; Peacock, John; Mack, Stephen C.; Wu, Xiaochong; Rolider, Adi; Morrissy, A. Sorana; Cavalli, Florence M.G.; Jones, David T.W.; Zitterbart, Karel; Faria, Claudia C.; Schüller, Ulrich; Kren, Leos; Kumabe, Toshihiro; Tominaga, Teiji; Shin Ra, Young; Garami, Miklós; Hauser, Peter; Chan, Jennifer A.; Robinson, Shenandoah; Bognár, László; Klekner, Almos; Saad, Ali G.; Liau, Linda M.; Albrecht, Steffen; Fontebasso, Adam; Cinalli, Giuseppe; De Antonellis, Pasqualino; Zollo, Massimo; Cooper, Michael K.; Thompson, Reid C.; Bailey, Simon; Lindsey, Janet C.; Di Rocco, Concezio; Massimi, Luca; Michiels, Erna M.C.; Scherer, Stephen W.; Phillips, Joanna J.; Gupta, Nalin; Fan, Xing; Muraszko, Karin M.; Vibhakar, Rajeev; Eberhart, Charles G.; Fouladi, Maryam; Lach, Boleslaw; Jung, Shin; Wechsler-Reya, Robert J.; Fèvre-Montange, Michelle; Jouvet, Anne; Jabado, Nada; Pollack, Ian F.; Weiss, William A.; Lee, Ji-Yeoun; Cho, Byung-Kyu; Kim, Seung-Ki; Wang, Kyu-Chang; Leonard, Jeffrey R.; Rubin, Joshua B.; de Torres, Carmen; Lavarino, Cinzia; Mora, Jaume; Cho, Yoon-Jae; Tabori, Uri; Olson, James M.; Gajjar, Amar; Packer, Roger J.; Rutkowski, Stefan; Pomeroy, Scott L.; French, Pim J.; Kloosterhof, Nanne K.; Kros, Johan M.; Van Meir, Erwin G.; Clifford, Steven C.; Bourdeaut, Franck; Delattre, Olivier; Doz, François F.; Hawkins, Cynthia E.; Malkin, David; Grajkowska, Wieslawa A.; Perek-Polnik, Marta; Bouffet, Eric; Rutka, James T.; Pfister, Stefan M.; Taylor, Michael D.

    2014-01-01

    Purpose Medulloblastoma comprises four distinct molecular subgroups: WNT, SHH, Group 3, and Group 4. Current medulloblastoma protocols stratify patients based on clinical features: patient age, metastatic stage, extent of resection, and histologic variant. Stark prognostic and genetic differences among the four subgroups suggest that subgroup-specific molecular biomarkers could improve patient prognostication. Patients and Methods Molecular biomarkers were identified from a discovery set of 673 medulloblastomas from 43 cities around the world. Combined risk stratification models were designed based on clinical and cytogenetic biomarkers identified by multivariable Cox proportional hazards analyses. Identified biomarkers were tested using fluorescent in situ hybridization (FISH) on a nonoverlapping medulloblastoma tissue microarray (n = 453), with subsequent validation of the risk stratification models. Results Subgroup information improves the predictive accuracy of a multivariable survival model compared with clinical biomarkers alone. Most previously published cytogenetic biomarkers are only prognostic within a single medulloblastoma subgroup. Profiling six FISH biomarkers (GLI2, MYC, chromosome 11 [chr11], chr14, 17p, and 17q) on formalin-fixed paraffin-embedded tissues, we can reliably and reproducibly identify very low-risk and very high-risk patients within SHH, Group 3, and Group 4 medulloblastomas. Conclusion Combining subgroup and cytogenetic biomarkers with established clinical biomarkers substantially improves patient prognostication, even in the context of heterogeneous clinical therapies. The prognostic significance of most molecular biomarkers is restricted to a specific subgroup. We have identified a small panel of cytogenetic biomarkers that reliably identifies very high-risk and very low-risk groups of patients, making it an excellent tool for selecting patients for therapy intensification and therapy de-escalation in future clinical trials. PMID

  15. The Debate.

    ERIC Educational Resources Information Center

    Current Issues in Language and Society, 1997

    1997-01-01

    The transcript of a debate within a group of specialists in translation is presented. The discussion addresses: translator "visibility" in translations and reader reception; the relationship of functionalism in translation, comparative linguistics, and intercultural communication; the client's power; literary translation; the…

  16. Debating Paul

    ERIC Educational Resources Information Center

    Torbett, David

    2007-01-01

    This classroom note describes the lessons I learned from the use of formal debates during the two semesters I taught "Paul and Early Christianity" to undergraduates at a liberal arts college in Ohio. The purpose of the course was primarily to give students the exegetical skills to understand Paul in his own context. The secondary purpose…

  17. Sub-group Analyses from a Trial of a Fixed Combination of Clindamycin Phosphate 1.2% and Benzoyl Peroxide 3.75% Gel for the Treatment of Moderate-to-severe Acne Vulgaris

    PubMed Central

    Korotzer, Andrew

    2015-01-01

    Background: Acne vulgaris is commonplace and can be difficult to manage. Providing an effective and well-tolerated treatment may lead to improved adherence, increased patient satisfaction, and improved clinical outcomes. Methods: A review of efficacy, safety, and cutaneous tolerability of clindamycin phosphate 1.2%-benzoyl peroxide 3.75% gel in 498 patients with moderate-to-severe acne vulgaris enrolled in a multicenter Phase III study randomized to receive active or vehicle once daily for 12 weeks, including the most recent post-hoc analyses. Results: Significantly superior reductions in lesion counts were observed with clindamycin phosphate 1.2%-benzoyl peroxide 3.75% gel from Week 4, with median percent reductions in inflammatory and noninflammatory lesions from baseline of 68.4 and 57.9 percent, respectively (bothp<0.001 versus vehicle). More than half (55.1%) of the severe acne vulgaris patients treated with clindamycin phosphate 1.2%-benzoyl peroxide 3.75% gel achieved ≥2-grade improvement from baseline in their Evaluator’s Global Severity Score, and almost a third of the adolescent acne vulgaris patients (32.4%) achieved at least a marked improvement in their acne vulgaris as early as Week 2. In adult female acne overall treatments success was achieved in 52.7 percent of patients treated with clindamycin phosphate 1.2%-benzoyl peroxide 3.75% gel. Overall, and in the specific subpopulations, clindamycin phosphate 1.2%-benzoyl peroxide 3.75% gel was well-tolerated with a similar adverse event profile to vehicle. Limitations: Post-hoc analyses from a single clinical trial with demographic imbalances that could potentially confound the results. Conclusion: Clindamycin phosphate 1.2%-benzoyl peroxide 3.75% gel appears to be effective in treating acne across various clinically relevant sub-groups. PMID:26705445

  18. Intertumoral Heterogeneity within Medulloblastoma Subgroups.

    PubMed

    Cavalli, Florence M G; Remke, Marc; Rampasek, Ladislav; Peacock, John; Shih, David J H; Luu, Betty; Garzia, Livia; Torchia, Jonathon; Nor, Carolina; Morrissy, A Sorana; Agnihotri, Sameer; Thompson, Yuan Yao; Kuzan-Fischer, Claudia M; Farooq, Hamza; Isaev, Keren; Daniels, Craig; Cho, Byung-Kyu; Kim, Seung-Ki; Wang, Kyu-Chang; Lee, Ji Yeoun; Grajkowska, Wieslawa A; Perek-Polnik, Marta; Vasiljevic, Alexandre; Faure-Conter, Cecile; Jouvet, Anne; Giannini, Caterina; Nageswara Rao, Amulya A; Li, Kay Ka Wai; Ng, Ho-Keung; Eberhart, Charles G; Pollack, Ian F; Hamilton, Ronald L; Gillespie, G Yancey; Olson, James M; Leary, Sarah; Weiss, William A; Lach, Boleslaw; Chambless, Lola B; Thompson, Reid C; Cooper, Michael K; Vibhakar, Rajeev; Hauser, Peter; van Veelen, Marie-Lise C; Kros, Johan M; French, Pim J; Ra, Young Shin; Kumabe, Toshihiro; López-Aguilar, Enrique; Zitterbart, Karel; Sterba, Jaroslav; Finocchiaro, Gaetano; Massimino, Maura; Van Meir, Erwin G; Osuka, Satoru; Shofuda, Tomoko; Klekner, Almos; Zollo, Massimo; Leonard, Jeffrey R; Rubin, Joshua B; Jabado, Nada; Albrecht, Steffen; Mora, Jaume; Van Meter, Timothy E; Jung, Shin; Moore, Andrew S; Hallahan, Andrew R; Chan, Jennifer A; Tirapelli, Daniela P C; Carlotti, Carlos G; Fouladi, Maryam; Pimentel, José; Faria, Claudia C; Saad, Ali G; Massimi, Luca; Liau, Linda M; Wheeler, Helen; Nakamura, Hideo; Elbabaa, Samer K; Perezpeña-Diazconti, Mario; Chico Ponce de León, Fernando; Robinson, Shenandoah; Zapotocky, Michal; Lassaletta, Alvaro; Huang, Annie; Hawkins, Cynthia E; Tabori, Uri; Bouffet, Eric; Bartels, Ute; Dirks, Peter B; Rutka, James T; Bader, Gary D; Reimand, Jüri; Goldenberg, Anna; Ramaswamy, Vijay; Taylor, Michael D

    2017-06-12

    While molecular subgrouping has revolutionized medulloblastoma classification, the extent of heterogeneity within subgroups is unknown. Similarity network fusion (SNF) applied to genome-wide DNA methylation and gene expression data across 763 primary samples identifies very homogeneous clusters of patients, supporting the presence of medulloblastoma subtypes. After integration of somatic copy-number alterations, and clinical features specific to each cluster, we identify 12 different subtypes of medulloblastoma. Integrative analysis using SNF further delineates group 3 from group 4 medulloblastoma, which is not as readily apparent through analyses of individual data types. Two clear subtypes of infants with Sonic Hedgehog medulloblastoma with disparate outcomes and biology are identified. Medulloblastoma subtypes identified through integrative clustering have important implications for stratification of future clinical trials. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Molecular subgroups of medulloblastoma

    PubMed Central

    Northcott, Paul A; Dubuc, Adrian M; Pfister, Stefan; Taylor, Michael D

    2014-01-01

    Recent efforts at stratifying medulloblastomas based on their molecular features have revolutionized our understanding of this morbidity. Collective efforts by multiple independent groups have subdivided medulloblastoma from a single disease into four distinct molecular subgroups characterized by disparate transcriptional signatures, mutational spectra, copy number profiles and, most importantly, clinical features. We present a summary of recent studies that have contributed to our understanding of the core medulloblastoma subgroups, focusing largely on clinically relevant discoveries that have already, and will continue to, shape research. PMID:22853794

  20. Subgroups Among Opiate Addicts

    ERIC Educational Resources Information Center

    Berzins, Juris I.; And Others

    1974-01-01

    The principal objective of the present investigation was to delineate homogeneous MMPI profile subgroups (types) through multivariate clustering procedures and to compare the derived (replicable) types on measures of the components of "sociopathy" as well as on other psychometric devices. (Author)

  1. Health care expenditures among Asian American subgroups.

    PubMed

    Chen, Jie; Vargas-Bustamante, Arturo; Ortega, Alexander N

    2013-06-01

    Using two nationally representative data sets, this study examined health care expenditure disparities between Caucasians and different Asian American subgroups. Multivariate analyses demonstrate that Asian Americans, as a group, have significantly lower total expenditures compared with Caucasians. Results also point to considerable heterogeneities in health care spending within Asian American subgroups. Findings suggest that language assistance programs would be effective in reducing disparities among Caucasians and Asian American subgroups with the exception of Indians and Filipinos, who tend to be more proficient in English. Results also indicate that citizenship and nativity were major factors associated with expenditure disparities. Socioeconomic status, however, could not explain expenditure disparities. Results also show that Asian Americans have lower physician and pharmaceutical costs but not emergency department or hospital expenditures. These findings suggest the need for culturally competent policies specific to Asian American subgroups and the necessity to encourage cost-effective treatments among Asian Americans.

  2. Health Care Expenditures Among Asian American Subgroups

    PubMed Central

    Chen, Jie; Vargas-Bustamante, Arturo; Ortega, Alexander N.

    2014-01-01

    Using two nationally representative data sets, this study examined health care expenditure disparities between Caucasians and different Asian American subgroups. Multivariate analyses demonstrate that Asian Americans, as a group, have significantly lower total expenditures compared with Caucasians. Results also point to considerable heterogeneities in health care spending within Asian American subgroups. Findings suggest that language assistance programs would be effective in reducing disparities among Caucasians and Asian American subgroups with the exception of Indians and Filipinos, who tend to be more proficient in English. Results also indicate that citizenship and nativity were major factors associated with expenditure disparities. Socioeconomic status, however, could not explain expenditure disparities. Results also show that Asian Americans have lower physician and pharmaceutical costs but not emergency department or hospital expenditures. These findings suggest the need for culturally competent policies specific to Asian American subgroups and the necessity to encourage cost-effective treatments among Asian Americans. PMID:23223329

  3. 1977 National Debate Tournament Final Debate

    ERIC Educational Resources Information Center

    Rives, Stanley G., ed.; Boaz, John K., ed.

    1977-01-01

    Presents a transcript of the final debate of the Thirty-First National Debate Tournament sponsored by the American Forensic Association in 1977. Focuses on the necessity and desirability of requiring airbags to promote automobile safety. (MH)

  4. Subgrouping Automata: automatic sequence subgrouping using phylogenetic tree-based optimum subgrouping algorithm.

    PubMed

    Seo, Joo-Hyun; Park, Jihyang; Kim, Eun-Mi; Kim, Juhan; Joo, Keehyoung; Lee, Jooyoung; Kim, Byung-Gee

    2014-02-01

    Sequence subgrouping for a given sequence set can enable various informative tasks such as the functional discrimination of sequence subsets and the functional inference of unknown sequences. Because an identity threshold for sequence subgrouping may vary according to the given sequence set, it is highly desirable to construct a robust subgrouping algorithm which automatically identifies an optimal identity threshold and generates subgroups for a given sequence set. To meet this end, an automatic sequence subgrouping method, named 'Subgrouping Automata' was constructed. Firstly, tree analysis module analyzes the structure of tree and calculates the all possible subgroups in each node. Sequence similarity analysis module calculates average sequence similarity for all subgroups in each node. Representative sequence generation module finds a representative sequence using profile analysis and self-scoring for each subgroup. For all nodes, average sequence similarities are calculated and 'Subgrouping Automata' searches a node showing statistically maximum sequence similarity increase using Student's t-value. A node showing the maximum t-value, which gives the most significant differences in average sequence similarity between two adjacent nodes, is determined as an optimum subgrouping node in the phylogenetic tree. Further analysis showed that the optimum subgrouping node from SA prevents under-subgrouping and over-subgrouping. Copyright © 2013. Published by Elsevier Ltd.

  5. Safety and efficacy of first-line bevacizumab combination therapy in Chinese population with advanced non-squamous NSCLC: data of subgroup analyses from MO19390 (SAiL) study.

    PubMed

    Zhou, C C; Bai, C X; Guan, Z Z; Jiang, G L; Shi, Y K; Wang, M Z; Wu, Y L; Zhang, Y P; Zhu, Y Z

    2014-05-01

    Bevacizumab is a monoclonal antibody with high antitumor activity against malignant diseases. Previous studies have demonstrated the efficacy of first-line bevacizumab combination therapy in advanced, non-squamous non-small cell lung cancer (NS-NSCLC). SAiL (MO19390), an open-label, multicenter, single-arm study, evaluated the safety and efficacy of first-line bevacizumab-based treatment in clinical practice. This report presents the results of a subgroup analysis of Chinese patients enrolled in SAiL. Chemo-naive Chinese patients with locally advanced, metastatic or recurrent NSCLC were randomized to receive Bev 15 mg/kg every 3 weeks plus carboplatin + paclitaxel for maximum of six cycles, followed by single-agent bevacizumab until disease progression. The primary endpoint was safety. Secondary endpoints included time to progression and overall survival. The Chinese intent-to-treat (ITT) population consists of 198 Chinese patients, among whom 107 (54 %) were non-smokers and 90 (45.5 %) were female. The median cycle of bevacizumab administration was 10 and median duration of bevacizumab treatment was 29.5 weeks. Only eight cases of severe adverse events were observed in the study, which were deemed to be related to bevacizumab. The incidence of AEs over grade 3 in Chinese ITT patients was generally low (<9 %). No new safety signals were reported. Objective response rate in 195 evaluable Chinese patients was 68.8 %, including four complete responses (2.1 %). Time to disease progression (TTP) and overall survival were 8.8 and 18.5 months, respectively. The safety and efficacy of first-line bevacizumab-based treatment in Chinese population with advanced NS-NSCLC are consistent with those in previous studies as well as in Asian subgroup population from SAiL study. No new safety signals were reported.

  6. Impact of prior treatment status and reasons for discontinuation on the efficacy and safety of fingolimod: Subgroup analyses of the Fingolimod Research Evaluating Effects of Daily Oral Therapy in Multiple Sclerosis (FREEDOMS) study.

    PubMed

    Kremenchutzky, Marcelo; O'Connor, Paul; Hohlfeld, Reinhard; Zhang-Auberson, Lixin; von Rosenstiel, Philipp; Meng, Xiangyi; Grinspan, Augusto; Hashmonay, Ron; Kappos, Ludwig

    2014-05-01

    Fingolimod is a once-daily, oral sphingosine 1-phosphate receptor modulator approved for the treatment of relapsing multiple sclerosis. This post-hoc analysis of phase 3 FREEDOMS data assessed whether the effects of fingolimod are consistent among subgroups of patients defined by prior treatment history. Annualized relapse rate and safety profile of treatment with fingolimod 0.5mg, 1.25mg, or placebo once-daily for 24 months were analyzed in 1272 relapsing multiple sclerosis patients, by subgroups based on disease-modifying therapy history (treatment-naive; prior interferon-β or glatiramer acetate), reason for discontinuation of prior disease-modifying therapy (unsatisfactory therapeutic response or adverse events), and prior disease-modifying therapy duration. Both fingolimod doses significantly reduced annualized relapse rate in patients that received prior interferon-β or glatiramer acetate, discontinued prior disease-modifying therapy owing to unsatisfactory therapeutic effect, were treatment-naive, or had prior disease-modifying therapy duration of >1-3 years (P≤0.0301 for all comparisons vs placebo). Fingolimod 1.25mg resulted in greater reductions in annualized relapse rate in patients that discontinued prior disease-modifying therapy for adverse events or had prior disease-modifying therapy duration of ≤1 year or >3 years (P≤0.0194 vs placebo). Fingolimod demonstrated similar efficacy in relapsing multiple sclerosis patients regardless of prior treatment history. Clinicaltrials.gov identifier: NCT00289978. © 2013 The Authors. Published by Elsevier B.V. All rights reserved.

  7. Let's Put "Debate" into "Presidential Debates."

    ERIC Educational Resources Information Center

    Benoit, William L.

    Presidential debates come in all shapes and sizes. The presence and length of opening statements and closing remarks, the opportunity and length of rebuttal, the nature of the questioner, and other factors have created a bewildering variety of formats. However, most scholars agree that these confrontations are not "really" debates but merely…

  8. It's no debate, debates are great.

    PubMed

    Dy-Boarman, Eliza A; Nisly, Sarah A; Costello, Tracy J

    A debate can be a pedagogical method used to instill essential functions in pharmacy students. This non-traditional teaching method may help to further develop a number of skills that are highlighted in the current Accreditation Council for Pharmacy Education Standards 2016 and Center for the Advancement of Pharmacy Education Educational Outcomes 2013. Debates have also been used as an educational tool in other health disciplines. Current pharmacy literature does illustrate the use of debates in various areas within the pharmacy curriculum in both required and elective courses; however, the current body of literature would suggest that debates are an underutilized teaching tool in pharmacy experiential education. With all potential benefits of debates as a teaching tool, pharmacy experiential preceptors should further explore their use in the experiential setting. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Subgroup Analysis of Trials Is Rarely Easy (SATIRE): a study protocol for a systematic review to characterize the analysis, reporting, and claim of subgroup effects in randomized trials.

    PubMed

    Sun, Xin; Briel, Matthias; Busse, Jason W; Akl, Elie A; You, John J; Mejza, Filip; Bala, Malgorzata; Diaz-Granados, Natalia; Bassler, Dirk; Mertz, Dominik; Srinathan, Sadeesh K; Vandvik, Per Olav; Malaga, German; Alshurafa, Mohamed; Dahm, Philipp; Alonso-Coello, Pablo; Heels-Ansdell, Diane M; Bhatnagar, Neera; Johnston, Bradley C; Wang, Li; Walter, Stephen D; Altman, Douglas G; Guyatt, Gordon H

    2009-11-09

    Subgroup analyses in randomized trials examine whether effects of interventions differ between subgroups of study populations according to characteristics of patients or interventions. However, findings from subgroup analyses may be misleading, potentially resulting in suboptimal clinical and health decision making. Few studies have investigated the reporting and conduct of subgroup analyses and a number of important questions remain unanswered. The objectives of this study are: 1) to describe the reporting of subgroup analyses and claims of subgroup effects in randomized controlled trials, 2) to assess study characteristics associated with reporting of subgroup analyses and with claims of subgroup effects, and 3) to examine the analysis, and interpretation of subgroup effects for each study's primary outcome. We will conduct a systematic review of 464 randomized controlled human trials published in 2007 in the 118 Core Clinical Journals defined by the National Library of Medicine. We will randomly select journal articles, stratified in a 1:1 ratio by higher impact versus lower impact journals. According to 2007 ISI total citations, we consider the New England Journal of Medicine, JAMA, Lancet, Annals of Internal Medicine, and BMJ as higher impact journals. Teams of two reviewers will independently screen full texts of reports for eligibility, and abstract data, using standardized, pilot-tested extraction forms. We will conduct univariable and multivariable logistic regression analyses to examine the association of pre-specified study characteristics with reporting of subgroup analyses and with claims of subgroup effects for the primary and any other outcomes. A clear understanding of subgroup analyses, as currently conducted and reported in published randomized controlled trials, will reveal both strengths and weaknesses of this practice. Our findings will contribute to a set of recommendations to optimize the conduct and reporting of subgroup analyses, and claim

  10. Subgroup Analysis of Trials Is Rarely Easy (SATIRE): a study protocol for a systematic review to characterize the analysis, reporting, and claim of subgroup effects in randomized trials

    PubMed Central

    Sun, Xin; Briel, Matthias; Busse, Jason W; Akl, Elie A; You, John J; Mejza, Filip; Bala, Malgorzata; Diaz-Granados, Natalia; Bassler, Dirk; Mertz, Dominik; Srinathan, Sadeesh K; Vandvik, Per Olav; Malaga, German; Alshurafa, Mohamed; Dahm, Philipp; Alonso-Coello, Pablo; Heels-Ansdell, Diane M; Bhatnagar, Neera; Johnston, Bradley C; Wang, Li; Walter, Stephen D; Altman, Douglas G; Guyatt, Gordon H

    2009-01-01

    Background Subgroup analyses in randomized trials examine whether effects of interventions differ between subgroups of study populations according to characteristics of patients or interventions. However, findings from subgroup analyses may be misleading, potentially resulting in suboptimal clinical and health decision making. Few studies have investigated the reporting and conduct of subgroup analyses and a number of important questions remain unanswered. The objectives of this study are: 1) to describe the reporting of subgroup analyses and claims of subgroup effects in randomized controlled trials, 2) to assess study characteristics associated with reporting of subgroup analyses and with claims of subgroup effects, and 3) to examine the analysis, and interpretation of subgroup effects for each study's primary outcome. Methods We will conduct a systematic review of 464 randomized controlled human trials published in 2007 in the 118 Core Clinical Journals defined by the National Library of Medicine. We will randomly select journal articles, stratified in a 1:1 ratio by higher impact versus lower impact journals. According to 2007 ISI total citations, we consider the New England Journal of Medicine, JAMA, Lancet, Annals of Internal Medicine, and BMJ as higher impact journals. Teams of two reviewers will independently screen full texts of reports for eligibility, and abstract data, using standardized, pilot-tested extraction forms. We will conduct univariable and multivariable logistic regression analyses to examine the association of pre-specified study characteristics with reporting of subgroup analyses and with claims of subgroup effects for the primary and any other outcomes. Discussion A clear understanding of subgroup analyses, as currently conducted and reported in published randomized controlled trials, will reveal both strengths and weaknesses of this practice. Our findings will contribute to a set of recommendations to optimize the conduct and reporting of

  11. Histopathological subgroups in knee osteoarthritis.

    PubMed

    Wyatt, L A; Moreton, B J; Mapp, P I; Wilson, D; Hill, R; Ferguson, E; Scammell, B E; Walsh, D A

    2017-01-01

    Osteoarthritis (OA) is a heterogeneous, multi-tissue disease. We hypothesised that different histopathological features characterise different stages during knee OA progression, and that discrete subgroups can be defined based on validated measures of OA histopathological features. Medial tibial plateaux and synovium were from 343 post-mortem (PM) and 143 OA arthroplasty donations. A 'chondropathy/osteophyte' group (n = 217) was classified as PM cases with osteophytes or macroscopic medial tibiofemoral chondropathy lesions ≥grade 3 to represent pre-surgical (early) OA. 'Non-arthritic' controls (n = 48) were identified from the remaining PM cases. Mankin histopathological scores were subjected to Rasch analysis and supplemented with histopathological scores for subchondral bone marrow replacement and synovitis. Item weightings were derived by principle components analysis (PCA). Histopathological subgroups were sought using latent class analysis (LCA). Chondropathy, synovitis and osteochondral pathology were each associated with OA at arthroplasty, but each was also identified in some 'non-arthritic' controls. Tidemark breaching in the chondropathy/osteophyte group was greater than in non-arthritic controls. Three histopathological subgroups were identified, characterised as 'mild OA', or 'severe OA' with mild or moderate/severe synovitis. Presence and severity of synovitis helps define distinct histopathological OA subgroups. The absence of a discrete 'normal' subgroup indicates a pathological continuum between normality and OA status. Identifying specific pathological processes and their clinical correlates in OA subgroups has potential to accelerate the development of more effective therapies. Copyright © 2016 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  12. The Acid Rain Debate.

    ERIC Educational Resources Information Center

    Oates-Bockenstedt, Catherine

    1997-01-01

    Details an activity designed to motivate students by incorporating science-related issues into a classroom debate. Includes "The Acid Rain Bill" and "Position Guides" for student roles as committee members, consumers, governors, industry owners, tourism professionals, senators, and debate directors. (DKM)

  13. Debating Historical Propositions: Toward a Unique Genre of NEDA Debate.

    ERIC Educational Resources Information Center

    Scott, David K.

    The best way to develop a unique identity for the National Education Debate Association (NEDA) is to debate propositions distinct from National Debate Tournament (NDT) and the Cross Examination Debate Association (CEDA). A neglected area of debate includes propositions temporally framed in the past. Yet, the present propositional categories of…

  14. Subgroup Analysis in Burnout: Relations Between Fatigue, Anxiety, and Depression

    PubMed Central

    van Dam, Arno

    2016-01-01

    Several authors have suggested that burned out patients do not form a homogeneous group and that subgroups should be considered. The identification of these subgroups may contribute to a better understanding of the burnout construct and lead to more specific therapeutic interventions. Subgroup analysis may also help clarify whether burnout is a distinct entity and whether subgroups of burnout overlap with other disorders such as depression and chronic fatigue syndrome. In a group of 113 clinically diagnosed burned out patients, levels of fatigue, depression, and anxiety were assessed. In order to identify possible subgroups, we performed a two-step cluster analysis. The analysis revealed two clusters that differed from one another in terms of symptom severity on the three aforementioned measures. Depression appeared to be the strongest predictor of group membership. These results are considered in the light of the scientific debate on whether burnout can be distinguished from depression and whether burnout subtyping is useful. Finally, implications for clinical practice and future research are discussed. PMID:26869983

  15. Judging the Kitchen Debate.

    ERIC Educational Resources Information Center

    Larner, John W.

    1986-01-01

    Presents passages from the memoirs of Richard Nixon and Nikita Khrushchev which reveal their recollections regarding the famous "Kitchen Debate." Provides activity suggestions which help students analyze the contrasting points of view presented. (JDH)

  16. Identifying Changes in Youth's Subgroup Membership over Time Based on Their Targeted Communication about Substance Use with Parents and Friends

    ERIC Educational Resources Information Center

    Kam, Jennifer A.

    2011-01-01

    Using latent class/transition analyses, this study: (a) identified subgroups of youth based on their targeted communication about substance use with parents and friends, (b) examined subgroup differences in substance use, and (c) considered changes in subgroup membership over four years. Among 5,874 youth, five subgroups emerged, with parents-only…

  17. Debating Real-World Issues.

    ERIC Educational Resources Information Center

    Koenig, Maureen

    2001-01-01

    Presents three different scientific issues to students and uses debate as a way of gaining information. Involves information collection on the topic, team preparation, and debate between teams. Includes debate format and presentation guidelines, suggestions for debate questions, information on areas to explore when preparing to debate the question…

  18. The "Ad Circulorum" Fallacy and Comparative Advantage Debating or: Why Don't Debate Cases Make Sense to Outside Listeners?

    ERIC Educational Resources Information Center

    Richardson, Larry S.

    Circular reasoning is often employed in comparative advantage debate cases when only a plan and advantages are articulated without adequate reference to the resolution which inspired the proposal. The advancing of such subtopical analyses as debate cases is deleterious to the long-range interests of educational debate because the practice…

  19. The Artilect Debate

    NASA Astrophysics Data System (ADS)

    de Garis, Hugo; Halioris, Sam

    Twenty-first-century technologies will allow the creation of massively intelligent machines, many trillions of times as smart, fast, and durable as humans. Issues concerning industrial, consumer, and military applications of mobile autonomous robots, cyborgs, and computer-based AI systems could divisively split humanity into ideological camps regarding whether "artilects" (artificial intellects) should be built or not. The artilect debate, unlike any before it, could dominate the 21st-century political landscape, and has the potential to cause conflict on a global scale. Research is needed to inform policy and individual decisions; and healthy debate should be initiated now to prepare institutions and individuals alike for the impact of AI.

  20. Policy Developments: Debate.

    ERIC Educational Resources Information Center

    Ottersten, Eugenia Kazamaki; Steedman, Hilary; Schneeberger, Arthur; Carneiro, Roberto

    2000-01-01

    Three articles debate the findings of a study: "Low-Skilled People on the European Labor Market: Towards a Minimum Learning Platform?" (Ottersen, Steedman); "The Concept of a Minimum Learning Platform Educational Contents and Methods for Improving the Low-Skilled" (Schneeberger); and "Achieving a Minimum Learning Platform…

  1. The Class Size Debate.

    ERIC Educational Resources Information Center

    Mishel, Lawrence, Ed.; Rothstein, Richard, Ed.

    This collection of papers debates the merits of smaller class sizes and research methods used to evaluate the efficacy of this education reform measure. Four chapters focus on (1) "Understanding the Magnitude and Effect of Class Size on Student Achievement" (Alan B. Krueger), which discusses expenditures per student and economic criterion; (2)…

  2. The Mainstreaming Debate.

    ERIC Educational Resources Information Center

    Harvard Education Letter, 1989

    1989-01-01

    The question of responsibility for the education of disabled students has become a controversial issue. This article explores the debate between proponents of special education and of mainstreaming for academically handicapped children. Under Public Law 94-142, disabled children are guaranteed an appropriate public education in the least…

  3. Reading the Reparations Debate

    ERIC Educational Resources Information Center

    Bacon, Jacqueline

    2003-01-01

    This essay examines the ways in which the rhetoric of the reparations debate elucidates the varying accounts of history favored by Americans of different backgrounds, the political and ideological foundations underlying different perspectives on the nature and uses of history, and the norms guiding public deliberation in the contemporary U.S.…

  4. Debates in Teaching Bioethics

    ERIC Educational Resources Information Center

    Kedraka, Katerina; Kourkoutas, Yiannis

    2018-01-01

    In this small scale study in higher education, a good educational practice on the teaching of Bioethics based on transformative learning and accomplished by debates is presented. The research was carried out in June 2016 at the Department of Molecular Biology and Genetics, Democritus University of Thrace, Greece and it includes the assessment of…

  5. Vitalism and the Darwin Debate

    ERIC Educational Resources Information Center

    Henderson, James

    2012-01-01

    There are currently both scientific and public debates surrounding Darwinism. In the scientific debate, the details of evolution are in dispute, but not the central thesis of Darwin's theory; in the public debate, Darwinism itself is questioned. I concentrate on the public debate because of its direct impact on education in the United States. Some…

  6. The impact of subgroup type and subgroup configurational properties on work team performance.

    PubMed

    Carton, Andrew M; Cummings, Jonathon N

    2013-09-01

    Scholars have invoked subgroups in a number of theories related to teams, yet certain tensions in the literature remain unresolved. In this article, we address 2 of these tensions, both relating to how subgroups are configured in work teams: (a) whether teams perform better with a greater number of subgroups and (b) whether teams perform better when they have imbalanced subgroups (majorities and minorities are present) or balanced subgroups (subgroups are of equal size). We predict that the impact of the number and balance of subgroups depends on the type of subgroup-whether subgroups are formed according to social identity (i.e., identity-based subgroups) or information processing (i.e., knowledge-based subgroups). We first propose that teams are more adversely affected by 2 identity-based subgroups than by any other number, yet the uniquely negative impact of a 2-subgroup configuration is not apparent for knowledge-based subgroups. Instead, a larger number of knowledge-based subgroups is beneficial for performance, such that 2 subgroups is worse for performance when compared with 3 or more subgroups but better for performance when compared with no subgroups or 1 subgroup. Second, we argue that teams perform better when identity-based subgroups are imbalanced yet knowledge-based subgroups are balanced. We also suggest that there are interactive effects between the number and balance of subgroups-however, the nature of this interaction depends on the type of subgroup. To test these predictions, we developed and validated an algorithm that measures the configurational properties of subgroups in organizational work teams. Results of a field study of 326 work teams from a multinational organization support our predictions. PsycINFO Database Record (c) 2013 APA, all rights reserved

  7. Subgroup Achievement and Gap Trends: Wyoming, 2010

    ERIC Educational Resources Information Center

    Center on Education Policy, 2010

    2010-01-01

    This paper profiles the student subgroup achievement and gap trends in Wyoming for 2010. Wyoming's demographic profile is such that achievement trends could only be determined for white, Latino, male and female, and low-income student subgroups. In grade 8 (the only grade in which subgroup trends were analyzed by achievement level), the white,…

  8. 'Homeopathy': untangling the debate.

    PubMed

    Relton, Clare; O'Cathain, Alicia; Thomas, Kate J

    2008-07-01

    There are active public campaigns both for and against homeopathy, and its continuing availability in the NHS is debated in the medical, scientific and popular press. However, there is a lack of clarity in key terms used in the debate, and in how the evidence base of homeopathy is described and interpreted. The term 'homeopathy' is used with several different meanings including: the therapeutic system, homeopathic medicine, treatment by a homeopath, and the principles of 'homeopathy'. Conclusions drawn from one of these aspects are often inappropriately applied to another aspect. In interpreting the homeopathy evidence it is important to understand that the existing clinical experimental (randomised controlled trial) evidence base provides evidence as to the efficacy of homeopathic medicines, but not the effectiveness of treatment by a homeopath. The observational evidence base provides evidence as to the effectiveness of treatment by a homeopath. We make four recommendations to promote clarity in the reporting, design and interpretation of homeopathy research.

  9. Psychopathic Traits of Dutch Adolescents in Residential Care: Identifying Subgroups

    ERIC Educational Resources Information Center

    Nijhof, Karin S.; Vermulst, Ad; Scholte, Ron H. J.; van Dam, Coleta; Veerman, Jan Willem; Engels, Rutger C. M. E.

    2011-01-01

    The present study examined whether a sample of 214 (52.8% male, M age = 15.76, SD = 1.29) institutionalized adolescents could be classified into subgroups based on psychopathic traits. Confirmatory Factor Analyses revealed a relationship between the subscales of the Youth Psychopathic traits Inventory (YPI) and the three latent constructs of the…

  10. Adult Developmental Dyslexia in a Shallow Orthography: Are There Subgroups?

    ERIC Educational Resources Information Center

    Laasonen, Marja; Service, Elisabet; Lipsanen, Jari; Virsu, Veijo

    2012-01-01

    The existence and stability of subgroups among adult dyslexic readers of a shallow orthography was explored by comparing three different cluster analyses based on previously suggested combinations of two variables. These were oral reading speed versus accuracy, word versus pseudoword reading speed, and phonological awareness versus rapid naming.…

  11. When Is the Story in the Subgroups? Strategies for Interpreting and Reporting Intervention Effects on Subgroups. MDRC Working Papers on Research Methodology

    ERIC Educational Resources Information Center

    Bloom, Howard S.; Michalopoulos, Charles

    2010-01-01

    This paper examines strategies for interpreting and reporting estimates of intervention effects for subgroups of a study sample. Specifically, the paper considers: why and how subgroup findings are important for applied research, the importance of pre-specifying sub- groups before analyses are conducted, the importance of using existing theory and…

  12. Debating personal health budgets

    PubMed Central

    Alakeson, Vidhya; Boardman, Jed; Boland, Billy; Crimlisk, Helen; Harrison, Charlotte; Iliffe, Steve; Khan, Masood; O'Shea, Rory; Patterson, Janet

    2016-01-01

    Personal health budgets (PHBs) were piloted in the National Health Service (NHS) in England between 2009 and 2012 and were found to have greater positive effects on quality of life and psychological well-being for those with mental health problems than commissioned service, as well as reducing their use of unplanned care. The government intends to extend PHBs in England for long-term conditions, including mental health, from April 2015. Given the importance of engaging clinicians in the next phase of PHB development, we provide an overview of the approach, synthesise the evidence from the national pilot and debate some of the opportunities and challenges. Balancing individual choice and recovery with concerns for risk, equity and the sustainability of existing community services is the central tension underpinning this innovation in mental health service delivery. PMID:26958358

  13. Subgroup Specific Alternative Splicing in Medulloblastoma

    PubMed Central

    Kloosterhof, Nanne K; Northcott, Paul A; Yu, Emily PY; Shih, David; Peacock, John; Grajkowska, Wieslawa; van Meter, Timothy; Eberhart, Charles G; Pfister, Stefan; Marra, Marco A; Weiss, William A; Scherer, Stephen W; Rutka, James T; French, Pim J; Taylor, Michael D

    2014-01-01

    Medulloblastoma is comprised of four distinct molecular variants: WNT, SHH, Group 3, and Group 4. We analyzed alternative splicing usage in 14 normal cerebellar samples and 103 medulloblastomas of known subgroup. Medulloblastoma samples have a statistically significant increase in alternative splicing as compared to normal fetal cerebella (2.3-times; P<6.47E-8). Splicing patterns are distinct and specific between molecular subgroups. Unsupervised hierarchical clustering of alternative splicing events accurately assigns medulloblastomas to their correct subgroup. Subgroup-specific splicing and alternative promoter usage was most prevalent in Group 3 (19.4%) and SHH (16.2%) medulloblastomas, while observed less frequently in WNT (3.2%), and Group 4 (9.3%) tumors. Functional annotation of alternatively spliced genes reveals over-representation of genes important for neuronal development. Alternative splicing events in medulloblastoma may be regulated in part by the correlative expression of antisense transcripts, suggesting a possible mechanism affecting subgroup specific alternative splicing. Our results identify additional candidate markers for medulloblastoma subgroup affiliation, further support the existence of distinct subgroups of the disease, and demonstrate an additional level of transcriptional heterogeneity between medulloblastoma subgroups. PMID:22358458

  14. Urinary infection caused by Micrococcus subgroup 3

    PubMed Central

    Kerr, Helen

    1973-01-01

    The laboratory findings and clinical presentations in urinary infections in 23 nurses, 10 caused by Micrococcus subgroup 3 and 13 by Escherichia coli, were studied, and the symptoms and possible predisposing factors compared. There were no important differences between the two groups. The infections caused by Micrococcus subgroup 3 were symptomatically severe, as were those caused by Escherichia coli. PMID:4593863

  15. Tracing the French Policy PISA Debate: A Policy Configuration Approach

    ERIC Educational Resources Information Center

    Pons, Xavier

    2016-01-01

    This article traces the evolution of the French policy PISA debate from 2001 to 2014 by analysing the results of two original qualitative researches. Theoretically, this debate is the outcome of specific policy configurations, which predetermine its scope, content and effectiveness. These configurations are themselves described through their…

  16. A debate about the merits of debate in nurse education.

    PubMed

    Hartin, Peter; Birks, Melanie; Bodak, Marie; Woods, Cindy; Hitchins, Marnie

    2017-09-01

    In this 'Issues for Debate' paper, the issue is debate. Today's nurses must be able to advocate, lead, and grow 'big ideas', as well as knowing their way around a patient's body and mind. This paper reports, partly, on a research study into the use of debate to develop clinical reasoning and thinking skills in nursing students. The study was conducted with first and third-year nursing students enrolled at an Australian regional university. Students were asked to comment on the effectiveness of debate as an educational strategy. We combine the results of this research study with literature and discussion into the educational uses of debate to put the argument that using debate in nursing education can be an effective way to foster the type of creative, intelligent, thoughtful and forward-thinking nurses needed in the modern healthcare system. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Hierarchical Bayes approach for subgroup analysis.

    PubMed

    Hsu, Yu-Yi; Zalkikar, Jyoti; Tiwari, Ram C

    2017-01-01

    In clinical data analysis, both treatment effect estimation and consistency assessment are important for a better understanding of the drug efficacy for the benefit of subjects in individual subgroups. The linear mixed-effects model has been used for subgroup analysis to describe treatment differences among subgroups with great flexibility. The hierarchical Bayes approach has been applied to linear mixed-effects model to derive the posterior distributions of overall and subgroup treatment effects. In this article, we discuss the prior selection for variance components in hierarchical Bayes, estimation and decision making of the overall treatment effect, as well as consistency assessment of the treatment effects across the subgroups based on the posterior predictive p-value. Decision procedures are suggested using either the posterior probability or the Bayes factor. These decision procedures and their properties are illustrated using a simulated example with normally distributed response and repeated measurements.

  18. [Bioethics and abortion. Debate].

    PubMed

    Diniz, D; Gonzalez Velez, A C

    1998-06-01

    Although abortion has been the most debated of all issues analyzed in bioethics, no moral consensus has been achieved. The problem of abortion exemplifies the difficulty of establishing social dialogue in the face of distinct moral positions, and of creating an independent academic discussion based on writings that are passionately argumentative. The greatest difficulty posed by the abortion literature is to identify consistent philosophical and scientific arguments amid the rhetorical manipulation. A few illustrative texts were selected to characterize the contemporary debate. The terms used to describe abortion are full of moral meaning and must be analyzed for their underlying assumptions. Of the four main types of abortion, only 'eugenic abortion', as exemplified by the Nazis, does not consider the wishes of the woman or couple--a fundamental difference for most bioethicists. The terms 'selective abortion' and 'therapeutic abortion' are often confused, and selective abortion is often called eugenic abortion by opponents. The terms used to describe abortion practitioners, abortion opponents, and the 'product' are also of interest in determining the style of the article. The video entitled "The Silent Scream" was a classic example of violent and seductive rhetoric. Its type of discourse, freely mixing scientific arguments and moral beliefs, hinders analysis. Within writings about abortion three extreme positions may be identified: heteronomy (the belief that life is a gift that does not belong to one) versus reproductive autonomy; sanctity of life versus tangibility of life; and abortion as a crime versus abortion as morally neutral. Most individuals show an inconsistent array of beliefs, and few groups or individuals identify with the extreme positions. The principal argument of proponents of legalization is respect for the reproductive autonomy of the woman or couple based on the principle of individual liberty, while heteronomy is the main principle of

  19. The debate over eponyms.

    PubMed

    Fargen, Kyle M; Hoh, Brian L

    2014-11-01

    Traditionally, important clinical or anatomic discoveries were labeled with the discoverer's name, to serve as both a means to recognize and reward the discoverer's contribution to the field but also because scientific names were often harder to remember and more difficult to communicate. Eponyms have been pervasive throughout anatomy and medicine over the last few centuries. Recently, some experts have argued that eponyms harbor significant limitations and have become antiquated. For instance, some eponyms fail to convey the characteristic findings associated with the disease or structure for which they are associated and eponyms are often times variable based on country and journal and in the grammatical form that is used. In fact, some individuals are going so far as to call for the removal of eponyms from published medical literature and medical textbooks going forward. In this article, we explore the arguments for and against the continued use of eponyms within medical education and practice, so that readers may understand both sides of the debate. © 2014 Wiley Periodicals, Inc.

  20. Evaluation of Evidence of Statistical Support and Corroboration of Subgroup Claims in Randomized Clinical Trials.

    PubMed

    Wallach, Joshua D; Sullivan, Patrick G; Trepanowski, John F; Sainani, Kristin L; Steyerberg, Ewout W; Ioannidis, John P A

    2017-04-01

    Many published randomized clinical trials (RCTs) make claims for subgroup differences. To evaluate how often subgroup claims reported in the abstracts of RCTs are actually supported by statistical evidence (P < .05 from an interaction test) and corroborated by subsequent RCTs and meta-analyses. This meta-epidemiological survey examines data sets of trials with at least 1 subgroup claim, including Subgroup Analysis of Trials Is Rarely Easy (SATIRE) articles and Discontinuation of Randomized Trials (DISCO) articles. We used Scopus (updated July 2016) to search for English-language articles citing each of the eligible index articles with at least 1 subgroup finding in the abstract. Articles with a subgroup claim in the abstract with or without evidence of statistical heterogeneity (P < .05 from an interaction test) in the text and articles attempting to corroborate the subgroup findings. Study characteristics of trials with at least 1 subgroup claim in the abstract were recorded. Two reviewers extracted the data necessary to calculate subgroup-level effect sizes, standard errors, and the P values for interaction. For individual RCTs and meta-analyses that attempted to corroborate the subgroup findings from the index articles, trial characteristics were extracted. Cochran Q test was used to reevaluate heterogeneity with the data from all available trials. The number of subgroup claims in the abstracts of RCTs, the number of subgroup claims in the abstracts of RCTs with statistical support (subgroup findings), and the number of subgroup findings corroborated by subsequent RCTs and meta-analyses. Sixty-four eligible RCTs made a total of 117 subgroup claims in their abstracts. Of these 117 claims, only 46 (39.3%) in 33 articles had evidence of statistically significant heterogeneity from a test for interaction. In addition, out of these 46 subgroup findings, only 16 (34.8%) ensured balance between randomization groups within the subgroups (eg, through stratified

  1. Identification of subgroups among fibromyalgia patients.

    PubMed

    Auvinet, B; Chaleil, D

    2012-09-28

    This paper presents some hypotheses concerning the identification of homogeneous subgroups among fibromyalgia (FM) patients in order to improve the management of the disease. It also reviews the available literature about this subject. Three methods for subgrouping are discussed according to clinical features, biomarkers, and gait analysis. Clinical subgrouping based on cluster analysis has been used for the identification of homogeneous subgroups of patients and, more recently, homogeneous clinical features. So far, longitudinal studies using clinical subgroups to direct treatment and predict outcome are still required. Biomarkers in FM, which is a neurobiological disease, are of promising interest, nevertheless currently, none of them can be used to subgroup FM patients. Due to the fact that cortical and subcortical mechanisms of gait control share some cognitive functions which are involved in FM, gait markers have been proposed to evaluate and to subgroup FM patients, in clinical settings. Three out of 4 core FM symptoms are linked to gait markers. Kinesia measured by means of cranio-caudal power is correlated to pain, and could be proposed to assess pain behavior (kinesiophobia). Stride frequency, which is linked to physical component, allows the identification of a hyperkinetic subgroup. Moreover, SF has been correlated to fatigue during the 6 minute walking test. Stride regularity, which expresses the unsteadiness of gait, is correlated to cognitive dysfunction in FM. Decreased stride regularity allows the recognition of a homogeneous subgroup characterized by an increased anxiety and depression, and decreased cognitive functions. These results need further studies to be validated and so used in the daily clinical practice.

  2. Treatment effect heterogeneity for univariate subgroups in clinical trials: Shrinkage, standardization, or else

    PubMed Central

    Varadhan, Ravi; Wang, Sue-Jane

    2016-01-01

    Treatment effect heterogeneity is a well-recognized phenomenon in randomized controlled clinical trials. In this paper, we discuss subgroup analyses with prespecified subgroups of clinical or biological importance. We explore various alternatives to the naive (the traditional univariate) subgroup analyses to address the issues of multiplicity and confounding. Specifically, we consider a model-based Bayesian shrinkage (Bayes-DS) and a nonparametric, empirical Bayes shrinkage approach (Emp-Bayes) to temper the optimism of traditional univariate subgroup analyses; a standardization approach (standardization) that accounts for correlation between baseline covariates; and a model-based maximum likelihood estimation (MLE) approach. The Bayes-DS and Emp-Bayes methods model the variation in subgroup-specific treatment effect rather than testing the null hypothesis of no difference between subgroups. The standardization approach addresses the issue of confounding in subgroup analyses. The MLE approach is considered only for comparison in simulation studies as the “truth” since the data were generated from the same model. Using the characteristics of a hypothetical large outcome trial, we perform simulation studies and articulate the utilities and potential limitations of these estimators. Simulation results indicate that Bayes-DS and Emp-Bayes can protect against optimism present in the naïve approach. Due to its simplicity, the naïve approach should be the reference for reporting univariate subgroup-specific treatment effect estimates from exploratory subgroup analyses. Standardization, although it tends to have a larger variance, is suggested when it is important to address the confounding of univariate subgroup effects due to correlation between baseline covariates. The Bayes-DS approach is available as an R package (DSBayes). PMID:26485117

  3. Debates in English Teaching. The Debates in Subject Teaching Series

    ERIC Educational Resources Information Center

    Davison, Jon, Ed.; Daly, Caroline, Ed.; Moss, John, Ed.

    2012-01-01

    "Debates in English Teaching" explores the major issues all English teachers encounter in their daily professional lives. It engages with established and contemporary debates, promotes and supports critical reflection and aims to stimulate both novice and experienced teachers to reach informed judgements and argue their point of view with deeper…

  4. Debates in Religious Education. The Debates in Subject Teaching Series

    ERIC Educational Resources Information Center

    Barnes, L. Philip, Ed.

    2011-01-01

    What are the key debates in Religious Education teaching today? "Debates in Religious Education" explores the major issues all RE teachers encounter in their daily professional lives. It encourages critical reflection and aims to stimulate both novice and experienced teachers to think more deeply about their practice, and link research…

  5. Debates in Citizenship Education. The Debates in Subject Teaching Series

    ERIC Educational Resources Information Center

    Arthur, James, Ed.; Cremin, Hilary, Ed.

    2011-01-01

    What are the key issues in Citizenship Education today? "Debates in Citizenship Education" encourages student and practising teachers to engage with and reflect on some of the key topics, concepts and debates that they will have to address throughout their career. It places the specialist field of Citizenship Education in a wider context…

  6. Score Trends, SAT Validity and Subgroup Differences

    ERIC Educational Resources Information Center

    Camara, Wayne

    2008-01-01

    Presented at the Summer Institute on College Admissions at Harvard in June 2008. The presentation explores whether the SAT validity has changed with the test changes and if those changes affect specific subgroups.

  7. Student Pressure Subject of Debate

    ERIC Educational Resources Information Center

    Gewertz, Catherine

    2006-01-01

    This article discusses student pressure as a subject of debate. The latest debate about schoolwork is being fueled by three recent books: "The Homework Myth" by Alfie Kohn, "The Case Against Homework" by Sara Bennett and Nancy Kalish, and "The Overachievers", by Alexandra Robbins, which depicts overextended high…

  8. The Great Mini-Debate

    ERIC Educational Resources Information Center

    Benucci, Heather

    2017-01-01

    Debates remain popular in English language courses, and this activity gives students a low-stress opportunity to develop their speaking debating skills. This lesson plan is appropriate for upper intermediate or advanced students. Goals of the activity are to present an oral argument using evidence and use functional language related to agreeing,…

  9. The Japanese Domestic Labor Debate.

    ERIC Educational Resources Information Center

    Ueno, Chizuko

    The changing role of Japanese women can be seen in the stages of a domestic labor debate which occurred at three different times in the past 30 years. The first debate began with Ayako Ishigaki's (1955) insistence that women should have a job outside the home. Wartime production helped break down traditional divisions of labor by encouraging women…

  10. Clash! The World of Debate

    ERIC Educational Resources Information Center

    Azzam, Amy M.

    2008-01-01

    Debating has been around for a long time, with some pretty spectacular results. Look at Socrates, who was put to death in 399 BCE for corrupting the youth of Athens; his accusers could not forgive him for incessantly questioning their beliefs and making "the worse appear the better cause." More recently, debating has morphed into a sport for the…

  11. The Two Cultures Debate Today.

    ERIC Educational Resources Information Center

    Smith, Ralph A.

    1978-01-01

    Discusses the "two cultures debate," initiated in 1959, which emphasized the moral obligation of rich countries to help poor ones, and the need to reform education in order to provide people with a common culture that included scientific literacy. Article examines reactions to the theory in 1959, directions the debate took, and status of the…

  12. Curriculum Debate and Policy Change

    ERIC Educational Resources Information Center

    Elgstrom, Ole; Hellstenius, Mats

    2011-01-01

    This article investigates the underlying themes and principles that inform curriculum debate and how they are articulated in current school policy discussions. This topic is approached with the help of a case study covering the debate on which subjects should be mandatory for students at the upper secondary school curriculum in Sweden. The focus…

  13. Novel mutations target distinct subgroups of medulloblastoma

    PubMed Central

    Robinson, Giles; Parker, Matthew; Kranenburg, Tanya A.; Lu, Charles; Chen, Xiang; Ding, Li; Phoenix, Timothy N.; Hedlund, Erin; Wei, Lei; Zhu, Xiaoyan; Chalhoub, Nader; Baker, Suzanne J.; Huether, Robert; Kriwacki, Richard; Curley, Natasha; Thiruvenkatam, Radhika; Wang, Jianmin; Wu, Gang; Rusch, Michael; Hong, Xin; Beckford, Jared; Gupta, Pankaj; Ma, Jing; Easton, John; Vadodaria, Bhavin; Onar-Thomas, Arzu; Lin, Tong; Li, Shaoyi; Pounds, Stanley; Paugh, Steven; Zhao, David; Kawauchi, Daisuke; Roussel, Martine F.; Finkelstein, David; Ellison, David W.; Lau, Ching C.; Bouffet, Eric; Hassall, Tim; Gururangan, Sridharan; Cohn, Richard; Fulton, Robert S.; Fulton, Lucinda L.; Dooling, David J.; Ochoa, Kerri; Gajjar, Amar; Mardis, Elaine R.; Wilson, Richard K.; Downing, James R.; Zhang, Jinghui; Gilbertson, Richard J.

    2012-01-01

    Summary Medulloblastoma is a malignant childhood brain tumour comprising four discrete subgroups. To identify mutations that drive medulloblastoma we sequenced the entire genomes of 37 tumours and matched normal blood. One hundred and thirty-six genes harbouring somatic mutations in this discovery set were sequenced in an additional 56 medulloblastomas. Recurrent mutations were detected in 41 genes not yet implicated in medulloblastoma: several target distinct components of the epigenetic machinery in different disease subgroups, e.g., regulators of H3K27 and H3K4 trimethylation in subgroup-3 and 4 (e.g., KDM6A and ZMYM3), and CTNNB1-associated chromatin remodellers in WNT-subgroup tumours (e.g., SMARCA4 and CREBBP). Modelling of mutations in mouse lower rhombic lip progenitors that generate WNT-subgroup tumours, identified genes that maintain this cell lineage (DDX3X) as well as mutated genes that initiate (CDH1) or cooperate (PIK3CA) in tumourigenesis. These data provide important new insights into the pathogenesis of medulloblastoma subgroups and highlight targets for therapeutic development. PMID:22722829

  14. Outcome of 24 years national surveillance in different hereditary colorectal cancer subgroups leading to more individualised surveillance.

    PubMed

    Lindberg, Lars Joachim; Ladelund, Steen; Frederiksen, Birgitte Lidegaard; Smith-Hansen, Lars; Bernstein, Inge

    2017-05-01

    Individuals with hereditary non-polyposis colorectal cancer (HNPCC) have a high risk of colorectal cancer (CRC). The benefits of colonic surveillance in Lynch syndrome and Amsterdam-positive (familial CRC type X familial colorectal cancer type X (FCCTX)) families are clear; only the interval between colonoscopies is debated. The potential benefits for families not fulfilling the Amsterdam criteria are uncertain. The aim of this study was to compare the outcome of colonic surveillance in different hereditary subgroups and to evaluate the surveillance programmes. A prospective, observational study on the outcome of colonic surveillance in different hereditary subgroups based on 24 years of surveillance data from the national Danish HNPCC register. We analysed 13 444 surveillance sessions, including 8768 incidence sessions and 20 450 years of follow-up. CRC was more incident in the Lynch subgroup (2.0%) than in any other subgroup (0.0-0.4%, p<0.0001), but the incidence of advanced adenoma did not differ between the Lynch (3.6%) and non-Lynch (2.3-3.9%, p=0.28) subgroups. Non-Lynch Amsterdam-positive and Amsterdam-negative families were similar in their CRC (0.1-0.4%, p=0.072), advanced adenoma (2.3-3.3%, p=0.32) and simple adenoma (8.4-9.9%, p=0.43) incidence. In moderate-risk families, no CRC and only one advanced adenoma was found. The risk of CRC in Lynch families is considerable, despite biannual surveillance. We suggest less frequent and more individualised surveillance in non-Lynch families. Individuals from families with a strong history of CRC could be offered 5-year surveillance colonoscopies (unless findings at the preceding surveillance session indicate shorter interval) and individuals from moderate-risk families could be handled with the population-based screening programme for CRC after an initial surveillance colonoscopy. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  15. No improvement in the reporting of clinical trial subgroup effects in high-impact general medical journals.

    PubMed

    Gabler, Nicole B; Duan, Naihua; Raneses, Eli; Suttner, Leah; Ciarametaro, Michael; Cooney, Elizabeth; Dubois, Robert W; Halpern, Scott D; Kravitz, Richard L

    2016-07-16

    When subgroup analyses are not correctly analyzed and reported, incorrect conclusions may be drawn, and inappropriate treatments provided. Despite the increased recognition of the importance of subgroup analysis, little information exists regarding the prevalence, appropriateness, and study characteristics that influence subgroup analysis. The objective of this study is to determine (1) if the use of subgroup analyses and multivariable risk indices has increased, (2) whether statistical methodology has improved over time, and (3) which study characteristics predict subgroup analysis. We randomly selected randomized controlled trials (RCTs) from five high-impact general medical journals during three time periods. Data from these articles were abstracted in duplicate using standard forms and a standard protocol. Subgroup analysis was defined as reporting any subgroup effect. Appropriate methods for subgroup analysis included a formal test for heterogeneity or interaction across treatment-by-covariate groups. We used logistic regression to determine the variables significantly associated with any subgroup analysis or, among RCTs reporting subgroup analyses, using appropriate methodology. The final sample of 416 articles reported 437 RCTs, of which 270 (62 %) reported subgroup analysis. Among these, 185 (69 %) used appropriate methods to conduct such analyses. Subgroup analysis was reported in 62, 55, and 67 % of the articles from 2007, 2010, and 2013, respectively. The percentage using appropriate methods decreased over the three time points from 77 % in 2007 to 63 % in 2013 (p < 0.05). Significant predictors of reporting subgroup analysis included industry funding (OR 1.94 (95 % CI 1.17, 3.21)), sample size (OR 1.98 per quintile (1.64, 2.40), and a significant primary outcome (OR 0.55 (0.33, 0.92)). The use of appropriate methods to conduct subgroup analysis decreased by year (OR 0.88 (0.76, 1.00)) and was less common with industry funding (OR 0.35 (0.18, 0

  16. Genetic and molecular alterations across medulloblastoma subgroups.

    PubMed

    Skowron, Patryk; Ramaswamy, Vijay; Taylor, Michael D

    2015-10-01

    Medulloblastoma is the most common malignant brain tumour diagnosed in children. Over the last few decades, advances in radiation and chemotherapy have significantly improved the odds of survival. Nevertheless, one third of all patients still succumb to their disease, and many long-term survivors are afflicted with neurocognitive sequelae. Large-scale multi-institutional efforts have provided insight into the transcriptional and genetic landscape of medulloblastoma. Four distinct subgroups of medulloblastoma have been identified, defined by distinct transcriptomes, genetics, demographics and outcomes. Integrated genomic profiling of each of these subgroups has revealed distinct genetic alterations, driving pathways and in some instances cells of origin. In this review, we highlight, in a subgroup-specific manner, our current knowledge of the genetic and molecular alterations in medulloblastoma and underscore the possible avenues for future therapeutic intervention.

  17. Exploring the compassion deficit debate.

    PubMed

    Stenhouse, Rosie; Ion, Robin; Roxburgh, Michelle; Devitt, Patric Ffrench; Smith, Stephen D M

    2016-04-01

    Several recent high profile failures in the UK health care system have promoted strong debate on compassion and care in nursing. A number of papers articulating a range of positions within this debate have been published in this journal over the past two and a half years. These articulate a diverse range of theoretical perspectives and have been drawn together here in an attempt to bring some coherence to the debate and provide an overview of the key arguments and positions taken by those involved. In doing this we invite the reader to consider their own position in relation to the issues raised and to consider the impact of this for their own practice. Finally the paper offers some sense of how individual practitioners might use their understanding of the debates to ensure delivery of good nursing care. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. Debate: A Neglected Teaching Tool

    ERIC Educational Resources Information Center

    Jackson, Michael

    1973-01-01

    The classroom teacher, regardless of the teaching area, can utilize debate as a device to help the student achieve objectives such as critical thinking, problem solving, the enhancing of self-concept and the art of communicating. (Author/CB)

  19. Clustering of self-organizing map identifies five distinct medulloblastoma subgroups.

    PubMed

    Cao, Changjun; Wang, Wei; Jiang, Pucha

    2016-01-01

    Medulloblastoma is one the most malignant paediatric brain tumours. Molecular subgrouping these medulloblastomas will not only help identify specific cohorts for certain treatment but also improve confidence in prognostic prediction. Currently, there is a consensus of the existences of four distinct subtypes of medulloblastoma. We proposed a novel bioinformatics method, clustering of self-organizing map, to determine the subgroups and their molecular diversity. Microarray expression profiles of 46 medulloblastoma samples were analysed and five clusters with distinct demographics, clinical outcome and transcriptional profiles were identified. The previously reported Wnt subgroup was identified as expected. Three other novel subgroups were proposed for later investigation. Our findings underscore the value of SOM clustering for discovering the medulloblastoma subgroups. When the suggested subdivision has been confirmed in large cohorts, this method should serve as a part of routine classification of clinical samples.

  20. SUBGR: A Program to Generate Subgroup Data for the Subgroup Resonance Self-Shielding Calculation

    SciTech Connect

    Kim, Kang Seog

    2016-06-06

    The Subgroup Data Generation (SUBGR) program generates subgroup data, including levels and weights from the resonance self-shielded cross section table as a function of background cross section. Depending on the nuclide and the energy range, these subgroup data can be generated by (a) narrow resonance approximation, (b) pointwise flux calculations for homogeneous media; and (c) pointwise flux calculations for heterogeneous lattice cells. The latter two options are performed by the AMPX module IRFFACTOR. These subgroup data are to be used in the Consortium for Advanced Simulation of Light Water Reactors (CASL) neutronic simulator MPACT, for which the primary resonance self-shieldingmore » method is the subgroup method.« less

  1. Subgroup Achievement and Gap Trends: Idaho, 2010

    ERIC Educational Resources Information Center

    Center on Education Policy, 2010

    2010-01-01

    This paper profiles the student subgroup achievement and gap trends in Idaho for 2010. Idaho showed improvement in reading and math in grade 8 at the basic, proficient, and advanced levels for Latino and white students, low income students, and boys and girls. The state has also made progress in narrowing achievement gaps between Latino and white…

  2. Heterogeneity in chronic fatigue syndrome - empirically defined subgroups from the PACE trial.

    PubMed

    Williams, T E; Chalder, T; Sharpe, M; White, P D

    2017-06-01

    Chronic fatigue syndrome is likely to be a heterogeneous condition. Previous studies have empirically defined subgroups using combinations of clinical and biological variables. We aimed to explore the heterogeneity of chronic fatigue syndrome. We used baseline data from the PACE trial, which included 640 participants with chronic fatigue syndrome. Variable reduction, using a combination of clinical knowledge and principal component analyses, produced a final dataset of 26 variables for 541 patients. Latent class analysis was then used to empirically define subgroups. The most statistically significant and clinically recognizable model comprised five subgroups. The largest, 'core' subgroup (33% of participants), had relatively low scores across all domains and good self-efficacy. A further three subgroups were defined by: the presence of mood disorders (21%); the presence of features of other functional somatic syndromes (such as fibromyalgia or irritable bowel syndrome) (21%); or by many symptoms - a group which combined features of both of the above (14%). The smallest 'avoidant-inactive' subgroup was characterized by physical inactivity, belief that symptoms were entirely physical in nature, and fear that they indicated harm (11%). Differences in the severity of fatigue and disability provided some discriminative validation of the subgroups. In addition to providing further evidence for the heterogeneity of chronic fatigue syndrome, the subgroups identified may aid future research into the important aetiological factors of specific subtypes of chronic fatigue syndrome and the development of more personalized treatment approaches.

  3. Cluster Analysis to Identify Possible Subgroups in Tinnitus Patients.

    PubMed

    van den Berge, Minke J C; Free, Rolien H; Arnold, Rosemarie; de Kleine, Emile; Hofman, Rutger; van Dijk, J Marc C; van Dijk, Pim

    2017-01-01

    In tinnitus treatment, there is a tendency to shift from a "one size fits all" to a more individual, patient-tailored approach. Insight in the heterogeneity of the tinnitus spectrum might improve the management of tinnitus patients in terms of choice of treatment and identification of patients with severe mental distress. The goal of this study was to identify subgroups in a large group of tinnitus patients. Data were collected from patients with severe tinnitus complaints visiting our tertiary referral tinnitus care group at the University Medical Center Groningen. Patient-reported and physician-reported variables were collected during their visit to our clinic. Cluster analyses were used to characterize subgroups. For the selection of the right variables to enter in the cluster analysis, two approaches were used: (1) variable reduction with principle component analysis and (2) variable selection based on expert opinion. Various variables of 1,783 tinnitus patients were included in the analyses. Cluster analysis (1) included 976 patients and resulted in a four-cluster solution. The effect of external influences was the most discriminative between the groups, or clusters, of patients. The "silhouette measure" of the cluster outcome was low (0.2), indicating a "no substantial" cluster structure. Cluster analysis (2) included 761 patients and resulted in a three-cluster solution, comparable to the first analysis. Again, a "no substantial" cluster structure was found (0.2). Two cluster analyses on a large database of tinnitus patients revealed that clusters of patients are mostly formed by a different response of external influences on their disease. However, both cluster outcomes based on this dataset showed a poor stability, suggesting that our tinnitus population comprises a continuum rather than a number of clearly defined subgroups.

  4. Molecular Subgroup of Primary Prostate Cancer Presenting with Metastatic Biology.

    PubMed

    Walker, Steven M; Knight, Laura A; McCavigan, Andrena M; Logan, Gemma E; Berge, Viktor; Sherif, Amir; Pandha, Hardev; Warren, Anne Y; Davidson, Catherine; Uprichard, Adam; Blayney, Jaine K; Price, Bethanie; Jellema, Gera L; Steele, Christopher J; Svindland, Aud; McDade, Simon S; Eden, Christopher G; Foster, Chris; Mills, Ian G; Neal, David E; Mason, Malcolm D; Kay, Elaine W; Waugh, David J; Harkin, D Paul; Watson, R William; Clarke, Noel W; Kennedy, Richard D

    2017-10-01

    Approximately 4-25% of patients with early prostate cancer develop disease recurrence following radical prostatectomy. To identify a molecular subgroup of prostate cancers with metastatic potential at presentation resulting in a high risk of recurrence following radical prostatectomy. Unsupervised hierarchical clustering was performed using gene expression data from 70 primary resections, 31 metastatic lymph nodes, and 25 normal prostate samples. Independent assay validation was performed using 322 radical prostatectomy samples from four sites with a mean follow-up of 50.3 months. Molecular subgroups were identified using unsupervised hierarchical clustering. A partial least squares approach was used to generate a gene expression assay. Relationships with outcome (time to biochemical and metastatic recurrence) were analysed using multivariable Cox regression and log-rank analysis. A molecular subgroup of primary prostate cancer with biology similar to metastatic disease was identified. A 70-transcript signature (metastatic assay) was developed and independently validated in the radical prostatectomy samples. Metastatic assay positive patients had increased risk of biochemical recurrence (multivariable hazard ratio [HR] 1.62 [1.13-2.33]; p=0.0092) and metastatic recurrence (multivariable HR=3.20 [1.76-5.80]; p=0.0001). A combined model with Cancer of the Prostate Risk Assessment post surgical (CAPRA-S) identified patients at an increased risk of biochemical and metastatic recurrence superior to either model alone (HR=2.67 [1.90-3.75]; p<0.0001 and HR=7.53 [4.13-13.73]; p<0.0001, respectively). The retrospective nature of the study is acknowledged as a potential limitation. The metastatic assay may identify a molecular subgroup of primary prostate cancers with metastatic potential. The metastatic assay may improve the ability to detect patients at risk of metastatic recurrence following radical prostatectomy. The impact of adjuvant therapies should be assessed in

  5. Identifying Subgroups among Hardcore Smokers: a Latent Profile Approach

    PubMed Central

    Bommelé, Jeroen; Kleinjan, Marloes; Schoenmakers, Tim M.; Burk, William J.; van den Eijnden, Regina; van de Mheen, Dike

    2015-01-01

    Introduction Hardcore smokers are smokers who have little to no intention to quit. Previous research suggests that there are distinct subgroups among hardcore smokers and that these subgroups vary in the perceived pros and cons of smoking and quitting. Identifying these subgroups could help to develop individualized messages for the group of hardcore smokers. In this study we therefore used the perceived pros and cons of smoking and quitting to identify profiles among hardcore smokers. Methods A sample of 510 hardcore smokers completed an online survey on the perceived pros and cons of smoking and quitting. We used these perceived pros and cons in a latent profile analysis to identify possible subgroups among hardcore smokers. To validate the profiles identified among hardcore smokers, we analysed data from a sample of 338 non-hardcore smokers in a similar way. Results We found three profiles among hardcore smokers. ‘Receptive’ hardcore smokers (36%) perceived many cons of smoking and many pros of quitting. ‘Ambivalent’ hardcore smokers (59%) were rather undecided towards quitting. ‘Resistant’ hardcore smokers (5%) saw few cons of smoking and few pros of quitting. Among non-hardcore smokers, we found similar groups of ‘receptive’ smokers (30%) and ‘ambivalent’ smokers (54%). However, a third group consisted of ‘disengaged’ smokers (16%), who saw few pros and cons of both smoking and quitting. Discussion Among hardcore smokers, we found three distinct profiles based on perceived pros and cons of smoking. This indicates that hardcore smokers are not a homogenous group. Each profile might require a different tobacco control approach. Our findings may help to develop individualized tobacco control messages for the particularly hard-to-reach group of hardcore smokers. PMID:26207829

  6. European regulatory use and impact of subgroup evaluation in marketing authorisation applications.

    PubMed

    Tanniou, Julien; Teerenstra, Steven; Hassan, Sagal; Elferink, Andre; van der Tweel, Ingeborg; Gispen-de Wied, Christine; Roes, Kit C B

    2017-12-01

    Marketing authorisation application dossiers relating to medicinal products containing new active substances and evaluated by the European Medicines Agency (EMA) over the period 2012-2015 were examined. Major objections and other concerns relating to efficacy and safety of the day 80 assessment reports were reviewed. Overall, approved products have more subgroup concerns than nonapproved products, which seems to be a consistent pattern. Subgroup analyses are mainly assessed to have the insurance that subgroups of patients that might lack a positive benefit: risk ratio will not be wrongly included in the approved treatment indication. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  7. Unpacking the great transmission debate

    NASA Astrophysics Data System (ADS)

    Denning, Kathryn

    2010-12-01

    The debate about the wisdom of sending interstellar transmissions is well-known to those involved in SETI, and frustrating for many. Its tendency towards intractability is a result of multiple factors, including: different models of the scientist's role as citizen and/or leader; disparate ideas about society's readiness to cope with frontier science; variable political substrates, particularly ideas concerning individual freedom and state control; competing ideologies of globalization; and the perceived relative risks and benefits of contact. (Variations in the latter, i.e. assessments of the risks and benefits of contact, derive partly from different thinking styles, including tolerance for risk, and partly from inferences based upon episodes of biological and cultural contact on Earth.) Unpacking the debate into its components may be of use to those debating policy about SETI transmissions, or at the very least, help keep in focus what, precisely, the perennial arguments are really about.

  8. Consciousness operationalized, a debate realigned.

    PubMed

    Carruthers, Peter; Veillet, Bénédicte

    2017-10-01

    This paper revisits the debate about cognitive phenomenology. It elaborates, defends, and improves on our earlier proposal for resolving that debate, according to which the test for irreducible phenomenology is the presence of explanatory gaps. After showing how proposals like ours have been misunderstood or misused by others, we deploy our operationalization to argue that the correct way to align the debate over cognitive phenomenology is not between sensory and (alleged) cognitive phenomenology, but rather between non-conceptual and (alleged) conceptual or propositional phenomenology. In doing so we defend three varieties of non-sensory (amodal) 1 non-conceptual phenomenology: valence, a sense of approximate number, and a sense of elapsed time. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Debates in History Teaching. The Debates in Subject Teaching Series

    ERIC Educational Resources Information Center

    Davies, Ian, Ed.

    2010-01-01

    "Debates in History Teaching" explores the major issues all history teachers encounter in their daily professional lives. It encourages critical reflection and aims to stimulate both novice and experienced teachers to think more deeply about their practice, and link research and evidence to what they have observed in schools. Written by a range of…

  10. Debates in Music Teaching. The Debates in Subject Teaching Series

    ERIC Educational Resources Information Center

    Philpott, Chris, Ed.; Spruce, Gary, Ed.

    2012-01-01

    "Debates in Music Teaching" encourages student and practising teachers to engage with contemporary issues and developments in music education. It aims to introduce a critical approach to the central concepts and practices that have influenced major interventions and initiatives in music teaching, and supports the development of new ways of looking…

  11. Distinguishing between respiratory syncytial virus subgroups by protein profile analysis.

    PubMed Central

    Walpita, P; Mufson, M A; Stanek, R J; Pfeifer, D; Connor, J D

    1992-01-01

    We subgrouped 75 strains of respiratory syncytial virus by a protein profile method (PPM) which relies on different mobilities of the phosphoprotein in one-dimensional polyacrylamide gel electrophoresis and does not require monoclonal antibodies. When compared with enzyme immunoassay, PPM correctly subgrouped 54 of 56 subgroup A and all 19 subgroup B strains. Images PMID:1572961

  12. Intergroup Leadership Across Distinct Subgroups and Identities.

    PubMed

    Rast, David E; Hogg, Michael A; van Knippenberg, Daan

    2018-03-01

    Resolving intergroup conflict is a significant and often arduous leadership challenge, yet existing theory and research rarely, if ever, discuss or examine this situation. Leaders confront a significant challenge when they provide leadership across deep divisions between distinct subgroups defined by self-contained identities-The challenge is to avoid provoking subgroup identity distinctiveness threat. Drawing on intergroup leadership theory, three studies were conducted to test the core hypothesis that, where identity threat exists, leaders promoting an intergroup relational identity will be better evaluated and are more effective than leaders promoting a collective identity; in the absence of threat, leaders promoting a collective identity will prevail. Studies 1 and 2 ( N = 170; N = 120) supported this general proposition. Study 3 ( N = 136) extended these findings, showing that leaders promoting an intergroup relational identity, but not a collective identity, improved intergroup attitudes when participants experienced an identity distinctiveness threat.

  13. Tallying Differences between Demographic Subgroups from Multiple Institutions: The Practical Utility of Nonparametric Analysis

    ERIC Educational Resources Information Center

    Yorke, Mantz

    2017-01-01

    When analysing course-level data by subgroups based upon some demographic characteristics, the numbers in analytical cells are often too small to allow inferences to be drawn that might help in the enhancement of practices. However, relatively simple analyses can provide useful pointers. This article draws upon a study involving a partnership with…

  14. Framing the policy debate over spirits excise tax in Poland.

    PubMed

    Zatonski, Mateusz; Hawkins, Benjamin; McKee, Martin

    2018-06-01

    Industry lobbying remains an obstacle to effective health-oriented alcohol policy. In 2013, an increase in excise tax on spirits was announced by the Polish government. This article presents a qualitative analysis of the public debate that ensued on the potential economic, health and social effects of the policy. It focuses on how competing groups, including industry actors, framed their position and sought to dominate the debate. Online archives of five Polish national newspapers, two spirits trade associations, and parliamentary and ministerial archives were searched. A thematic content analysis of the identified sources was conducted. The overall findings were compared with existing research on the framing of the Minimum Unit Pricing (MUP) debate in the UK. A total of 155 sources were analysed. Two main frames were identified: health, and economic. The spirits industry successfully promoted the economic frame in their own publications and in the media. The debate was dominated by arguments about potential growth of the grey market and losses in tax revenue that might result from the excise tax increase. The framing of the debate in Poland differed from the framing of the MUP debate in the United Kingdom. The Polish public health community was unsuccessful in making health considerations a significant element of the alcohol policy debate. The strategies pursued by UK health advocates offer lessons for how to make a more substantial impact on media coverage and promote health-oriented legislation.

  15. Eliminating Borders through Debate Education.

    ERIC Educational Resources Information Center

    Peterson, Keith; Clower, Ramona

    As the world moves into the millennium, students will need certain skills to be successful in a global environment. This paper argues that competitive international exposure through debate can provide these skills. The paper consists of three sections. The first section briefly reviews current literature identifying the academic and intercultural…

  16. The Great Neurolinguistics Methodology Debate.

    ERIC Educational Resources Information Center

    Obler, L. K.

    A major debate exists in the neuropsychology community concerning whether case study is preferable to group study of brain-damaged patients. So far, the discussion has been limited to the advantages and disadvantages of both methods, with the assumption that neurolinguists pursue a single goal attainable by one or the other method. Practical…

  17. Using Debate in EFL Classes

    ERIC Educational Resources Information Center

    Alasmari, Ali; Ahmed, Sayed Salahuddin

    2013-01-01

    The countries that use English as a foreign language need effective activities which propel students to practice skills of the language properly inside as well as outside classrooms. Debating is a practice that inspires learners to open their mouth, get into discussion, defend their own positions, place counter arguments and also conduct research…

  18. Cooling Signs in Wake Debate

    ERIC Educational Resources Information Center

    Samuels, Christina A.

    2011-01-01

    More than a year after dismantling a student-assignment policy based on socioeconomic diversity and setting off a wave of reaction that drew national attention, the Wake County, North Carolina, school board took a step that may turn down the temperature of the intense debate. The board, which has been deeply split on an assignment plan for the…

  19. A debate on open inflation

    NASA Astrophysics Data System (ADS)

    Hawking, S. W.

    1999-07-01

    This is a reproduction of Professor Stephen Hawking's part in a debate, which took place at the COSMO 98 Coference, in Monterey, California. Two other physicists, Andrei Linde and Alexander Villenkin, also took part. Professor Hawking is the Lucasian Professor of Mathematics at the University of Cambridge, in England.

  20. Bicentennial Youth Debates: Issue Analysis.

    ERIC Educational Resources Information Center

    Huseman, Richard C., Ed.; Luck, James I., Ed.

    This document includes introductory essays, excerpted documents, and selected bibliographies to promote a national dialogue concerning America for its Bicentennial. Bicentennial Youth Debates (BYD) is a national program developed by the Speech Communication Association and supported by a grant from the National Endowment for the Humanities. The…

  1. "Parent Unions" Join Policy Debates

    ERIC Educational Resources Information Center

    Cavanagh, Sean

    2012-01-01

    Whether they're organizing events, buttonholing legislators, or simply trading ideas and information, a growing number of "parent unions" are attempting to stake out a place in policy debates over education in states and districts, amid a crowded field of actors and advocates. As the term implies, some of these organizations see…

  2. Championship Debates and Speeches 1986. Vol. 1.

    ERIC Educational Resources Information Center

    Boaz, John K., Ed.; Brey, James R., Ed.

    Including speech transcripts and judges' critiques, this book presents the results of the 1986 (1) National Debate Tournament Final Debate, sponsored by the American Forensic Association, including the affirmative and negative presentations; (2) National CEDA Tournament Final Debate, sponsored by the Cross-Examination Debate Association, including…

  3. Intimate Debate Technique: Medicinal Use of Marijuana

    ERIC Educational Resources Information Center

    Herreid, Clyde Freeman; DeRei, Kristie

    2007-01-01

    Classroom debates used to be familiar exercises to students schooled in past generations. In this article, the authors describe the technique called "intimate debate". To cooperative learning specialists, the technique is known as "structured debate" or "constructive debate". It is a powerful method for dealing with case topics that involve…

  4. Mining Health App Data to Find More and Less Successful Weight Loss Subgroups

    PubMed Central

    2016-01-01

    Background More than half of all smartphone app downloads involve weight, diet, and exercise. If successful, these lifestyle apps may have far-reaching effects for disease prevention and health cost-savings, but few researchers have analyzed data from these apps. Objective The purposes of this study were to analyze data from a commercial health app (Lose It!) in order to identify successful weight loss subgroups via exploratory analyses and to verify the stability of the results. Methods Cross-sectional, de-identified data from Lose It! were analyzed. This dataset (n=12,427,196) was randomly split into 24 subsamples, and this study used 3 subsamples (combined n=972,687). Classification and regression tree methods were used to explore groupings of weight loss with one subsample, with descriptive analyses to examine other group characteristics. Data mining validation methods were conducted with 2 additional subsamples. Results In subsample 1, 14.96% of users lost 5% or more of their starting body weight. Classification and regression tree analysis identified 3 distinct subgroups: “the occasional users” had the lowest proportion (4.87%) of individuals who successfully lost weight; “the basic users” had 37.61% weight loss success; and “the power users” achieved the highest percentage of weight loss success at 72.70%. Behavioral factors delineated the subgroups, though app-related behavioral characteristics further distinguished them. Results were replicated in further analyses with separate subsamples. Conclusions This study demonstrates that distinct subgroups can be identified in “messy” commercial app data and the identified subgroups can be replicated in independent samples. Behavioral factors and use of custom app features characterized the subgroups. Targeting and tailoring information to particular subgroups could enhance weight loss success. Future studies should replicate data mining analyses to increase methodology rigor. PMID:27301853

  5. MPACT Subgroup Self-Shielding Efficiency Improvements

    SciTech Connect

    Stimpson, Shane; Liu, Yuxuan; Collins, Benjamin S.

    Recent developments to improve the efficiency of the MOC solvers in MPACT have yielded effective kernels that loop over several energy groups at once, rather that looping over one group at a time. These kernels have produced roughly a 2x speedup on the MOC sweeping time during eigenvalue calculation. However, the self-shielding subgroup calculation had not been reevaluated to take advantage of these new kernels, which typically requires substantial solve time. The improvements covered in this report start by integrating the multigroup kernel concepts into the subgroup calculation, which are then used as the basis for further extensions. The nextmore » improvement that is covered is what is currently being termed as “Lumped Parameter MOC”. Because the subgroup calculation is a purely fixed source problem and multiple sweeps are performed only to update the boundary angular fluxes, the sweep procedure can be condensed to allow for the instantaneous propagation of the flux across a spatial domain, without the need to sweep along all segments in a ray. Once the boundary angular fluxes are considered to be converged, an additional sweep that will tally the scalar flux is completed. The last improvement that is investigated is the possible reduction of the number of azimuthal angles per octant in the shielding sweep. Typically 16 azimuthal angles per octant are used for self-shielding and eigenvalue calculations, but it is possible that the self-shielding sweeps are less sensitive to the number of angles than the full eigenvalue calculation.« less

  6. Vitalism and the Darwin Debate

    NASA Astrophysics Data System (ADS)

    Henderson, James

    2012-08-01

    There are currently both scientific and public debates surrounding Darwinism. In the scientific debate, the details of evolution are in dispute, but not the central thesis of Darwin's theory; in the public debate, Darwinism itself is questioned. I concentrate on the public debate because of its direct impact on education in the United States. Some critics of Darwin advocate the teaching of intelligent design theory along with Darwin's theory, and others seek to eliminate even the mention of evolution from science classes altogether. Many of these critics base their objections on the claim that non-living matter cannot give rise to living matter. After considering some of the various meanings assigned to `vitalism' over the years, I argue that a considerable portion of Darwin deniers support a literal version of vitalism that is not scientifically respectable. Their position seems to be that since life cannot arise naturally, Darwin's theory accomplishes nothing: If it can only account for life forms changing from one to another (even this is disputed by some) but not how life arose in the first place, what's the point? I argue that there is every reason to believe that living and non-living matter differ only in degree, not in kind, and that all conversation about Darwinism should start with the assumption that abiogenesis is possible unless or until compelling evidence of its impossibility is presented. That is, I advocate a position that the burden of proof lies with those who claim "Life only comes from life." Until that case is made, little weight should be given to their position.

  7. Tapping into the Wiretap Debate

    DTIC Science & Technology

    2012-02-03

    Shamrock (1945 – 1975). During World War II the U.S. Army had the authority to read and censor all telegram traffic going into and out of the United...with foreigners, organizations, and American citizens who were active in the 9 anti- war and civil rights movements. Names of U.S. persons were...Tapping into the Wiretap Debate by Lieutenant Colonel David W. May United States Army United States Army War College

  8. Abortion 1980: the debate continues.

    PubMed

    Healey, J M

    1980-09-01

    Although recent Supreme Court rulings clarified the constitutional issues concerning induced abortion in the U.S., the abortion debate is not over. The debate has simply moved out of the courtroom and into the country's state and federal legislative bodies. The 1973 Supreme Court rulings recognized that women have the constitutional right to decide whether to abort or continue a pregnancy while the 1980 Supreme Court ruling declared that state and federal governments are not obligated by the constitution to provide funds to insure that women can exercise their abortion rights. The court ruled that neither the due process nor the equal protection clauses applied to abortion funding. The court did, nowever, leave the way open for the battle to continue in legislative bodies. The legislative bodies were clearly assigned the task of deciding for themselves whether or not to fund abortions. Since the public has a variety of views on the subject, debate on the issue in legislatures throughout the country will be intense.

  9. Subgroup Economic Evaluation of Radiotherapy for Breast Cancer After Mastectomy.

    PubMed

    Wan, Xiaomin; Peng, Liubao; Ma, Jinan; Chen, Gannong; Li, Yuanjian

    2015-11-01

    A recent meta-analysis by the Early Breast Cancer Trialists' Collaborative Group found significant improvements achieved by postmastectomy radiotherapy (PMRT) for patients with breast cancer with 1 to 3 positive nodes (pN1-3). It is unclear whether PMRT is cost-effective for subgroups of patients with positive nodes. To determine the cost-effectiveness of PMRT for subgroups of patients with breast cancer with positive nodes. A semi-Markov model was constructed to estimate the expected lifetime costs, life expectancy, and quality-adjusted life-years for patients receiving or not receiving radiation therapy. Clinical and health utilities data were from meta-analyses by the Early Breast Cancer Trialists' Collaborative Group or randomized clinical trials. Costs were estimated from the perspective of the Chinese society. One-way and probabilistic sensitivity analyses were performed. The incremental cost-effective ratio was estimated as $7984, $4043, $3572, and $19,021 per quality-adjusted life-year for patients with positive nodes (pN+), patients with pN1-3, patients with pN1-3 who received systemic therapy, and patients with >4 positive nodes (pN4+), respectively. According to World Health Organization recommendations, these incremental cost-effective ratios were judged as cost-effective. However, the results of one-way sensitivity analyses suggested that the results were highly sensitive to the relative effectiveness of PMRT (rate ratio). We determined that the results were highly sensitive to the rate ratio. However, the addition of PMRT for patients with pN1-3 in China has a reasonable chance to be cost-effective and may be judged as an efficient deployment of limited health resource, and the risk and uncertainty of PMRT are relatively greater for patients with pN4+. Copyright © 2015 Elsevier HS Journals, Inc. All rights reserved.

  10. Myasthenia gravis: subgroup classification and therapeutic strategies.

    PubMed

    Gilhus, Nils Erik; Verschuuren, Jan J

    2015-10-01

    Myasthenia gravis is an autoimmune disease that is characterised by muscle weakness and fatigue, is B-cell mediated, and is associated with antibodies directed against the acetylcholine receptor, muscle-specific kinase (MUSK), lipoprotein-related protein 4 (LRP4), or agrin in the postsynaptic membrane at the neuromuscular junction. Patients with myasthenia gravis should be classified into subgroups to help with therapeutic decisions and prognosis. Subgroups based on serum antibodies and clinical features include early-onset, late-onset, thymoma, MUSK, LRP4, antibody-negative, and ocular forms of myasthenia gravis. Agrin-associated myasthenia gravis might emerge as a new entity. The prognosis is good with optimum symptomatic, immunosuppressive, and supportive treatment. Pyridostigmine is the preferred symptomatic treatment, and for patients who do not adequately respond to symptomatic therapy, corticosteroids, azathioprine, and thymectomy are first-line immunosuppressive treatments. Additional immunomodulatory drugs are emerging, but therapeutic decisions are hampered by the scarcity of controlled studies. Long-term drug treatment is essential for most patients and must be tailored to the particular form of myasthenia gravis. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Teaching the Mantle Plumes Debate

    NASA Astrophysics Data System (ADS)

    Foulger, G. R.

    2010-12-01

    There is an ongoing debate regarding whether or not mantle plumes exist. This debate has highlighted a number of issues regarding how Earth science is currently practised, and how this feeds into approaches toward teaching students. The plume model is an hypothesis, not a proven fact. And yet many researchers assume a priori that plumes exist. This assumption feeds into teaching. That the plume model is unproven, and that many practising researchers are skeptical, may be at best only mentioned in passing to students, with most teachers assuming that plumes are proven to exist. There is typically little emphasis, in particular in undergraduate teaching, that the origin of melting anomalies is currently uncertain and that scientists do not know all the answers. Little encouragement is given to students to become involved in the debate and to consider the pros and cons for themselves. Typically teachers take the approach that “an answer” (or even “the answer”) must be taught to students. Such a pedagogic approach misses an excellent opportunity to allow students to participate in an important ongoing debate in Earth sciences. It also misses the opportunity to illustrate to students several critical aspects regarding correct application of the scientific method. The scientific method involves attempting to disprove hypotheses, not to prove them. A priori assumptions should be kept uppermost in mind and reconsidered at all stages. Multiple working hypotheses should be entertained. The predictions of a hypothesis should be tested, and unpredicted observations taken as weakening the original hypothesis. Hypotheses should not be endlessly adapted to fit unexpected observations. The difficulty with pedagogic treatment of the mantle plumes debate highlights a general uncertainty about how to teach issues in Earth science that are not yet resolved with certainty. It also represents a missed opportunity to let students experience how scientific theories evolve, warts

  12. Citizenship Education and the Dutch National Identity Debate

    ERIC Educational Resources Information Center

    Doppen, Frans H.

    2010-01-01

    As a result of dramatic demographic changes during the last half century as well as a series of recent events surrounding prominent personas, the Dutch have been engaged in an intense debate about their national identity and how citizenship education can contribute to the integration of Muslim immigrants in particular. This article analyses the…

  13. Language Policy, In-Migration and Discursive Debates in Wales

    ERIC Educational Resources Information Center

    Edwards, Catrin Wyn

    2017-01-01

    Drawing on theory from critical language policy literature, this article explores the impact of discourses on in-migration on Welsh language policy. By focussing on discursive debates surrounding the subject of in-migration, the article analyses how a range of actors produce and reproduce discourses on in-migration in Wales and how these…

  14. Novel molecular subgroups for clinical classification and outcome prediction in childhood medulloblastoma: a cohort study.

    PubMed

    Schwalbe, Edward C; Lindsey, Janet C; Nakjang, Sirintra; Crosier, Stephen; Smith, Amanda J; Hicks, Debbie; Rafiee, Gholamreza; Hill, Rebecca M; Iliasova, Alice; Stone, Thomas; Pizer, Barry; Michalski, Antony; Joshi, Abhijit; Wharton, Stephen B; Jacques, Thomas S; Bailey, Simon; Williamson, Daniel; Clifford, Steven C

    2017-07-01

    International consensus recognises four medulloblastoma molecular subgroups: WNT (MB WNT ), SHH (MB SHH ), group 3 (MB Grp3 ), and group 4 (MB Grp4 ), each defined by their characteristic genome-wide transcriptomic and DNA methylomic profiles. These subgroups have distinct clinicopathological and molecular features, and underpin current disease subclassification and initial subgroup-directed therapies that are underway in clinical trials. However, substantial biological heterogeneity and differences in survival are apparent within each subgroup, which remain to be resolved. We aimed to investigate whether additional molecular subgroups exist within childhood medulloblastoma and whether these could be used to improve disease subclassification and prognosis predictions. In this retrospective cohort study, we assessed 428 primary medulloblastoma samples collected from UK Children's Cancer and Leukaemia Group (CCLG) treatment centres (UK), collaborating European institutions, and the UKCCSG-SIOP-PNET3 European clinical trial. An independent validation cohort (n=276) of archival tumour samples was also analysed. We analysed samples from patients with childhood medulloblastoma who were aged 0-16 years at diagnosis, and had central review of pathology and comprehensive clinical data. We did comprehensive molecular profiling, including DNA methylation microarray analysis, and did unsupervised class discovery of test and validation cohorts to identify consensus primary molecular subgroups and characterise their clinical and biological significance. We modelled survival of patients aged 3-16 years in patients (n=215) who had craniospinal irradiation and had been treated with a curative intent. Seven robust and reproducible primary molecular subgroups of childhood medulloblastoma were identified. MB WNT remained unchanged and each remaining consensus subgroup was split in two. MB SHH was split into age-dependent subgroups corresponding to infant (<4·3 years; MB SHH

  15. Debate continues on northwest's merits

    SciTech Connect

    Stremel, K.

    1984-07-01

    Estimates of northwest Montana's petroleum reserves range from barren Precambrian rock to reserves exceeding those of Alaska's Prudhoe Bay. Geological debates concerning the merits of the vast areas continues. Seismic data and geological studies indicate that the area holds considerable promise. Several large structures have been identified, and oil and gas seeps have been reported. The area's true potential, however, will be revealed only by drilling, which is both risky and expensive. Several wildcat drilling operations are underway but the area's hydrocarbon potential may not be released for several years.

  16. Cholesterol: the debate should be terminated.

    PubMed

    Nathan, David G

    2017-07-01

    Here, I offer personal perspectives on cholesterol homeostasis that reflect my belief that certain aspects of the debate have been overstated.-Nathan, D. G. Cholesterol: the debate should be terminated. © FASEB.

  17. Speech and Debate as Civic Education

    ERIC Educational Resources Information Center

    Hogan, J. Michael; Kurr, Jeffrey A.; Johnson, Jeremy D.; Bergmaier, Michael J.

    2016-01-01

    In light of the U.S. Senate's designation of March 15, 2016 as "National Speech and Debate Education Day" (S. Res. 398, 2016), it only seems fitting that "Communication Education" devote a special section to the role of speech and debate in civic education. Speech and debate have been at the heart of the communication…

  18. Affective Learning and the Classroom Debate

    ERIC Educational Resources Information Center

    Jagger, Suzy

    2013-01-01

    A commonly used teaching method to promote student engagement is the classroom debate. This study evaluates how affective characteristics, as defined in Bloom's taxonomy, were stimulated during debates that took place on a professional ethics module for first year computing undergraduates. The debates led to lively interactive group discussions…

  19. The Power of In-Class Debates

    ERIC Educational Resources Information Center

    Kennedy, Ruth R.

    2009-01-01

    The students in three sections of a class rated their knowledge and identified their view before and after each of five in-class debates. The degree of self-reported knowledge was significantly different after four of the five debates. Between 31% and 58% of participants changed their views after participating in or observing each debate. Some…

  20. 11 CFR 100.92 - Candidate debates.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 11 Federal Elections 1 2011-01-01 2011-01-01 false Candidate debates. 100.92 Section 100.92 Federal Elections FEDERAL ELECTION COMMISSION GENERAL SCOPE AND DEFINITIONS (2 U.S.C. 431) Exceptions to Contributions § 100.92 Candidate debates. Funds provided to defray costs incurred in staging candidate debates...

  1. 11 CFR 100.154 - Candidate debates.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 11 Federal Elections 1 2010-01-01 2010-01-01 false Candidate debates. 100.154 Section 100.154 Federal Elections FEDERAL ELECTION COMMISSION GENERAL SCOPE AND DEFINITIONS (2 U.S.C. 431) Exceptions to Expenditures § 100.154 Candidate debates. Funds used to defray costs incurred in staging candidate debates in...

  2. 11 CFR 110.13 - Candidate debates.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 11 Federal Elections 1 2010-01-01 2010-01-01 false Candidate debates. 110.13 Section 110.13... PROHIBITIONS § 110.13 Candidate debates. (a) Staging organizations. (1) Nonprofit organizations described in 26... political parties may stage candidate debates in accordance with this section and 11 CFR 114.4(f). (2...

  3. 11 CFR 110.13 - Candidate debates.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 11 Federal Elections 1 2011-01-01 2011-01-01 false Candidate debates. 110.13 Section 110.13... PROHIBITIONS § 110.13 Candidate debates. (a) Staging organizations. (1) Nonprofit organizations described in 26... political parties may stage candidate debates in accordance with this section and 11 CFR 114.4(f). (2...

  4. Literacy as Social Action in City Debate

    ERIC Educational Resources Information Center

    Cridland-Hughes, Susan

    2012-01-01

    This study examines critical literacy and the intersections of oral, aural, written, and performative literate practices in City Debate, an afterschool program dedicated to providing debate instruction to students in a major Southeastern city. Previous research into definitions and beliefs about literacy in an urban debate program over its twenty…

  5. 11 CFR 100.92 - Candidate debates.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 11 Federal Elections 1 2010-01-01 2010-01-01 false Candidate debates. 100.92 Section 100.92 Federal Elections FEDERAL ELECTION COMMISSION GENERAL SCOPE AND DEFINITIONS (2 U.S.C. 431) Exceptions to Contributions § 100.92 Candidate debates. Funds provided to defray costs incurred in staging candidate debates...

  6. 11 CFR 100.154 - Candidate debates.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 11 Federal Elections 1 2011-01-01 2011-01-01 false Candidate debates. 100.154 Section 100.154 Federal Elections FEDERAL ELECTION COMMISSION GENERAL SCOPE AND DEFINITIONS (2 U.S.C. 431) Exceptions to Expenditures § 100.154 Candidate debates. Funds used to defray costs incurred in staging candidate debates in...

  7. Technological Imperatives: Using Computers in Academic Debate.

    ERIC Educational Resources Information Center

    Ticku, Ravinder; Phelps, Greg

    Intended for forensic educators and debate teams, this document details how one university debate team, at the University of Iowa, makes use of computer resources on campus to facilitate storage and retrieval of information useful to debaters. The introduction notes the problem of storing and retrieving the amount of information required by debate…

  8. High School Graduation Rates across English Learner Student Subgroups in Arizona. REL 2017-205

    ERIC Educational Resources Information Center

    Huang, Min; Haas, Eric; Zhu, Niufeng; Tran, Loan

    2016-01-01

    Recent studies have documented differences in academic achievement between current and former English learner students. These differences validate calls for more focused analyses of achievement across English learner student subgroups. Specifically, there is interest in examining variation in academic success based on the amount of time a student…

  9. Detecting Subgroups in Children Diagnosed with Pervasive Developmental Disorder--Not Otherwise Specified

    ERIC Educational Resources Information Center

    Brennan, Laura; Barton, Marianne; Chen, Chi-Ming; Green, James; Fein, Deborah

    2015-01-01

    Hierarchical cluster analyses were used to detect three subgroups in a sample of children with pervasive developmental disorder--not otherwise specified (PDD-NOS) evaluated at ages 2 and 4. At age 2, Cluster 1 demonstrated few autism symptoms and high cognitive scores; 60% no longer met criteria for PDD at 4. Cluster 2 exhibited more autism…

  10. Commognitive Analysis of Undergraduate Mathematics Students' First Encounter with the Subgroup Test

    ERIC Educational Resources Information Center

    Ioannou, Marios

    2018-01-01

    This study analyses learning aspects of undergraduate mathematics students' first encounter with the subgroup test, using the commognitive theoretical framework. It focuses on students' difficulties as these are related to the object-level and metalevel mathematical learning in group theory, and, when possible, highlights any commognitive…

  11. Commognitive Analysis of Undergraduate Mathematics Students' Responses in Proving Subgroup's Non-Emptiness

    ERIC Educational Resources Information Center

    Ioannou, Marios

    2016-01-01

    Proving that a given set is indeed a subgroup, one needs to show that it is non-empty, and closed under operation and inverses. This study focuses on the first condition, analysing students' responses to this task. Results suggest that there are three distinct problematic responses: the total absence of proving this condition, the problematic…

  12. [The climate debate: the facts].

    PubMed

    van den Broeke, Michiel R

    2009-01-01

    The first report by the Intergovernmental Panel on Climate Change (IPCC) appeared almost 20 years ago. Environmental contamination has a negative effect on the environment in which we live. However, the public at large is confused about the ins and outs of climate change. Managers, politicians, various kinds of advisors, scientists, so-called experts, sceptics and journalists have all taken it upon themselves to lead the debate. Whose task is it to ensure a sound discussion? Surely it is the IPCC's task. However, most politicians and many journalists, and even many scientists, do not take the trouble to read the entire IPCC report or parts of it. As a consequence, much nonsense is published and broadcast. An effective procedure to deal with the climate problem starts with a fair discussion of the scientific evidence. My advice is: just read the free IPCC report: http://www.ipcc.ch/ and click on 'WG I The Physical Science Basis'.

  13. Diversity among mandarin varieties and natural sub-groups in aroma volatiles compositions.

    PubMed

    Goldenberg, Livnat; Yaniv, Yossi; Doron-Faigenboim, Adi; Carmi, Nir; Porat, Ron

    2016-01-15

    Mandarins constitute a large, diverse and important group within the Citrus family. Here, we analysed the aroma volatiles compositions of 13 mandarin varieties belonging to seven genetically different natural sub-groups that included common mandarin (C. reticulata Blanco), clementine (C. clementina Hort. ex. Tan), satsuma (C. unshiu Marcovitch), Mediterranean mandarin (C. deliciosa Tenore), King mandarin (C. nobilis Loureiro), and mandarin hybrids, such as tangor (C. reticulata × C. sinensis) and tangelo (C. reticulata × C. paradisi). We found that mandarin varieties among tangors ('Temple', 'Ortanique'), tangelos ('Orlando', 'Minneola') and King ('King') had more volatiles, at higher levels, and were richer in sesquiterpene and ester volatiles, than other varieties belonging to the sub-groups common mandarin ('Ora', 'Ponkan'), clementine ('Oroval', 'Caffin'), satsuma ('Okitsu', 'Owari') and Mediterranean mandarin ('Avana', 'Yusuf Efendi'). Hierarchical clustering and principal component analysis accurately differentiated between mandarin varieties and natural sub-groups according to their aroma-volatile profiles. Although we found wide differences in aroma-volatiles compositions among varieties belonging to different natural sub-groups, we detected only minor differences among varieties within any natural sub-group. These findings suggest that selecting appropriate parents would enable manipulation of aroma-volatile compositions in future mandarin breeding programmes. © 2015 Society of Chemical Industry.

  14. Global epigenetic profiling identifies methylation subgroups associated with recurrence-free survival in meningioma

    PubMed Central

    Olar, Adriana; Wani, Khalida M; Wilson, Charmaine D; Zadeh, Gelareh; DeMonte, Franco; Jones, David TW; Pfister, Stefan M; Sulman, Erik P; Aldape, Kenneth D

    2017-01-01

    Meningioma is the most common primary brain tumor and carries a substantial risk of local recurrence. Methylation profiles of meningioma and their clinical implications are not well understood. We hypothesized that aggressive meningiomas have unique DNA methylation patterns that could be used to better stratify patient management. Samples (n=140) were profiled using the Illumina HumanMethylation450 BeadChip. Unsupervised modeling on a training set (n=89) identified 2 molecular methylation subgroups of meningioma (MM) with significantly different recurrence free survival (RFS) times between the groups: a prognostically unfavorable subgroup (MM-UNFAV) and a prognostically favorable subgroup (MM-FAV). This finding was validated in the remaining 51 samples and led to a baseline meningioma methylation classifier (bMMC) defined by 283 CpG loci (283-bMMC). To further optimize a recurrence predictor, probes subsumed within the baseline classifier were subject to additional modeling using a similar training/validation approach, leading to a 64-CpG loci meningioma methylation predictor (64-MMP). After adjustment for relevant clinical variables [WHO grade, mitotic index, Simpson grade, sex, location, and copy number aberrations (CNA)] multivariable analyses for RFS showed that the baseline methylation classifier was not significant (p=0.0793). The methylation predictor however was significantly associated with tumor recurrence (p<0.0001). CNA were extracted from the 450k intensity profiles. Tumor samples in the MM-UNFAV subgroup showed an overall higher proportion of CNAs compared to the MM-FAV subgroup tumors and the CNAs were complex in nature. CNAs in the MM-UNFAV subgroup included recurrent losses of 1p, 6q, 14q and 18q, and gain of 1q, all of which were previously identified as indicators of poor outcome. In conclusion, our analyses demonstrate robust DNA methylation signatures in meningioma that correlate with CNAs and stratify patients by recurrence risk. PMID:28130639

  15. Biomedical ontologies: toward scientific debate.

    PubMed

    Maojo, V; Crespo, J; García-Remesal, M; de la Iglesia, D; Perez-Rey, D; Kulikowski, C

    2011-01-01

    Biomedical ontologies have been very successful in structuring knowledge for many different applications, receiving widespread praise for their utility and potential. Yet, the role of computational ontologies in scientific research, as opposed to knowledge management applications, has not been extensively discussed. We aim to stimulate further discussion on the advantages and challenges presented by biomedical ontologies from a scientific perspective. We review various aspects of biomedical ontologies going beyond their practical successes, and focus on some key scientific questions in two ways. First, we analyze and discuss current approaches to improve biomedical ontologies that are based largely on classical, Aristotelian ontological models of reality. Second, we raise various open questions about biomedical ontologies that require further research, analyzing in more detail those related to visual reasoning and spatial ontologies. We outline significant scientific issues that biomedical ontologies should consider, beyond current efforts of building practical consensus between them. For spatial ontologies, we suggest an approach for building "morphospatial" taxonomies, as an example that could stimulate research on fundamental open issues for biomedical ontologies. Analysis of a large number of problems with biomedical ontologies suggests that the field is very much open to alternative interpretations of current work, and in need of scientific debate and discussion that can lead to new ideas and research directions.

  16. Debating the Controlled Substances Act.

    PubMed

    Spillane, Joseph F

    2004-10-05

    In the United States, the basis of modern drug regulation is the Controlled Substances Act (CSA) of 1970. The CSA laid out the authority of the federal government and provided a framework within which all existing and new substances could be regulated on their abuse potential, safety, and medical utility. The debates over the CSA centered on several critical issues: where to place the authority to make scheduling designations, the impact of scheduling on drug research, and defining what constituted drug "abuse" for purposes of scheduling. Passage of the CSA was aided by broad language that provided a kind of "big tent" which could accommodate diverse points of view. A retrospective assessment of the CSA shows it to have greatly expanded federal administrative authority over the nation's drug supply, much as its authors intended. Other impacts of the CSA, however, are much less certain. This article concludes by highlighting the issues and questions that should guide future retrospective research on the efficacy of drug control regimes.

  17. The interest of gait markers in the identification of subgroups among fibromyalgia patients.

    PubMed

    Auvinet, Bernard; Chaleil, Denis; Cabane, Jean; Dumolard, Anne; Hatron, Pierre; Juvin, Robert; Lanteri-Minet, Michel; Mainguy, Yves; Negre-Pages, Laurence; Pillard, Fabien; Riviere, Daniel; Maugars, Yves-Michel

    2011-11-11

    Fibromyalgia (FM) is a heterogeneous syndrome and its classification into subgroups calls for broad-based discussion. FM subgrouping, which aims to adapt treatment according to different subgroups, relies in part, on psychological and cognitive dysfunctions. Since motor control of gait is closely related to cognitive function, we hypothesized that gait markers could be of interest in the identification of FM patients' subgroups. This controlled study aimed at characterizing gait disorders in FM, and subgrouping FM patients according to gait markers such as stride frequency (SF), stride regularity (SR), and cranio-caudal power (CCP) which measures kinesia. A multicentre, observational open trial enrolled patients with primary FM (44.1 ± 8.1 y), and matched controls (44.1 ± 7.3 y). Outcome measurements and gait analyses were available for 52 pairs. A 3-step statistical analysis was carried out. A preliminary single blind analysis using k-means cluster was performed as an initial validation of gait markers. Then in order to quantify FM patients according to psychometric and gait variables an open descriptive analysis comparing patients and controls were made, and correlations between gait variables and main outcomes were calculated. Finally using cluster analysis, we described subgroups for each gait variable and looked for significant differences in self-reported assessments. SF was the most discriminating gait variable (73% of patients and controls). SF, SR, and CCP were different between patients and controls. There was a non-significant association between SF, FIQ and physical components from Short-Form 36 (p = 0.06). SR was correlated to FIQ (p = 0.01) and catastrophizing (p = 0.05) while CCP was correlated to pain (p = 0.01). The SF cluster identified 3 subgroups with a particular one characterized by normal SF, low pain, high activity and hyperkinesia. The SR cluster identified 2 distinct subgroups: the one with a reduced SR was distinguished by high FIQ

  18. The interest of gait markers in the identification of subgroups among fibromyalgia patients

    PubMed Central

    2011-01-01

    Background Fibromyalgia (FM) is a heterogeneous syndrome and its classification into subgroups calls for broad-based discussion. FM subgrouping, which aims to adapt treatment according to different subgroups, relies in part, on psychological and cognitive dysfunctions. Since motor control of gait is closely related to cognitive function, we hypothesized that gait markers could be of interest in the identification of FM patients' subgroups. This controlled study aimed at characterizing gait disorders in FM, and subgrouping FM patients according to gait markers such as stride frequency (SF), stride regularity (SR), and cranio-caudal power (CCP) which measures kinesia. Methods A multicentre, observational open trial enrolled patients with primary FM (44.1 ± 8.1 y), and matched controls (44.1 ± 7.3 y). Outcome measurements and gait analyses were available for 52 pairs. A 3-step statistical analysis was carried out. A preliminary single blind analysis using k-means cluster was performed as an initial validation of gait markers. Then in order to quantify FM patients according to psychometric and gait variables an open descriptive analysis comparing patients and controls were made, and correlations between gait variables and main outcomes were calculated. Finally using cluster analysis, we described subgroups for each gait variable and looked for significant differences in self-reported assessments. Results SF was the most discriminating gait variable (73% of patients and controls). SF, SR, and CCP were different between patients and controls. There was a non-significant association between SF, FIQ and physical components from Short-Form 36 (p = 0.06). SR was correlated to FIQ (p = 0.01) and catastrophizing (p = 0.05) while CCP was correlated to pain (p = 0.01). The SF cluster identified 3 subgroups with a particular one characterized by normal SF, low pain, high activity and hyperkinesia. The SR cluster identified 2 distinct subgroups: the one with a reduced SR was

  19. Online Catalog Documentation Task Force: Onscreen Documentation Subgroup. Final Report.

    ERIC Educational Resources Information Center

    Campbell, John; And Others

    This report describes the work of the Onscreen Documentation Subgroup in revising screens for GALIN, the University of Georgia (UGA) Libraries new online system. The responsibilities of the Subgroup were to revise screens from the previous online catalog and to create basic help screens, primarily for the command searching mode. Responsibilities…

  20. Subgroup Achievement and Gap Trends: New Hampshire, 2010

    ERIC Educational Resources Information Center

    Center on Education Policy, 2010

    2010-01-01

    This paper profiles the student subgroup achievement and gap trends in New Hampshire for 2010. New Hampshire's demographic profile is such that, with the exception of Latino students at the elementary level, there are fewer than 500 students in the racial/ethnic subgroups at the various grade levels, and therefore these groups are too small to…

  1. A Systematic Approach to Subgroup Classification in Intellectual Disability

    ERIC Educational Resources Information Center

    Schalock, Robert L.; Luckasson, Ruth

    2015-01-01

    This article describes a systematic approach to subgroup classification based on a classification framework and sequential steps involved in the subgrouping process. The sequential steps are stating the purpose of the classification, identifying the classification elements, using relevant information, and using clearly stated and purposeful…

  2. A Stock Approach to Value Debate.

    ERIC Educational Resources Information Center

    Colbert, Kent R.

    Existing theories of value debating (resolutions dealing with values rather than policy) may be more effectively applied and developed when viewed as stock issues paradigms for debating values in competitive situations. Issues are vital to an advocate's cause because they are essential to the meaning of a proposition and can also provide an…

  3. Debate Revives Old Arguments on HPV Vaccine

    ERIC Educational Resources Information Center

    Shah, Nirvi

    2011-01-01

    The author reports on a Republican presidential debate which revives the contention over requiring middle school girls to be vaccinated against the virus that causes cervical cancer. At the September 12 debate, U.S. Representative Michele Bachmann, of Minnesota, and Rick Santorum, a former U.S. senator from Pennsylvania, attacked Texas Governor…

  4. A Taxonomy of CEDA Debate Critics.

    ERIC Educational Resources Information Center

    Dudczak, Craig A.; Day, Donald L.

    To develop a taxonomy of Cross Examination Debate Association (CEDA) critics, a study associated professed judging philosophy and responses to survey questions with ballot behavior and elaborated judging profiles. Subjects were debate critics who judged rounds at CEDA tournaments in the Northeast during the Spring 1989 season. In all, 13 critics…

  5. The 1980 Presidential Debates. Special Issue.

    ERIC Educational Resources Information Center

    Ritter, Kurt W., Ed.

    1981-01-01

    Prepared by educators and researchers involved in argumentation and debate, the articles in this special journal issue are based upon the assumptions that presidential debates are important, are likely to continue, and are of unique interest to students, scholars, and practitioners of argument. The first two articles in the issue provide overviews…

  6. Thinking About the Greenfield-Griffiths Debate.

    ERIC Educational Resources Information Center

    Kendell, Richard; Byrne, David R.

    1977-01-01

    The continuing debate between Daniel Griffiths and T. Barr Greenfield over the respective merits of the "theory-based movement" or "positivist" view of educational administration and the "phenomenological" view that organizational theories should properly consist of "multifaceted images of organizations" has become more a political debate than an…

  7. Leagues Revive Debate in City Schools

    ERIC Educational Resources Information Center

    Keller, Bess

    2008-01-01

    This article describes how the National Association for Urban Debate Leagues is reviving debate competitions among high school students in city schools. Starting in Atlanta in 1985 and boosted by seed money from the billionaire George Soros' Open Society Institute, urban educators and their supporters in 2002 formed the National Association for…

  8. Debating Our Way toward Stronger Thinking

    ERIC Educational Resources Information Center

    Field, Kathryn

    2017-01-01

    Teachers often find it challenging to incorporate higher order thinking skills in ways that both inspire student interest and allow for meaningful differentiation. Structured debate is an activity that can facilitate all of these goals. This article explains, in detail, how debates can be structured to promote a variety of critical thinking skills…

  9. Using Debates to Teach Information Ethics

    ERIC Educational Resources Information Center

    Peace, A. Graham

    2011-01-01

    This experience report details the use of debates in a course on Information Ethics. Formal debates have been used in academia for centuries and create an environment in which students must think critically, communicate well and, above all, synthesize and evaluate the relevant classroom material. They also provide a break from the standard…

  10. The Debate Judge as Educator [and] Responses.

    ERIC Educational Resources Information Center

    Phillips, Leslie; And Others

    The purpose of the three papers that make up this document is to explore and redefine the role of debate judges. The first paper, by Leslie Phillips, begins with the assertion that the debate judge is first and foremost an educator, notes that judging is one of the forces that shape and direct competitive forensics, and goes on to consider…

  11. School Boundary Debate Divides Minnesota Suburb

    ERIC Educational Resources Information Center

    Samuels, Christina A.

    2011-01-01

    The author discusses how an assignment plan intended to keep schools socioeconomically balanced spurs a bitter debate in suburban Eden Prairie. The boundary debate in the 9,700-student Eden Prairie, Minnesota, district has been bruising. Eden Prairie adopted new school attendance boundaries this year based on socioeconomic balance, ensuring for…

  12. The Affirmative Action Debate: A Critical Reflection

    ERIC Educational Resources Information Center

    van Wyk, Berte

    2010-01-01

    In this article I contend that we cannot divorce affirmative action from issues about race and racism. Further, debates on affirmative action have to acknowledge the power of words/concepts/definitions and how they can be constructed and used for the purposes of domination or liberation. I argue that, in debating affirmative action, we have to…

  13. The United States: A Persistent Debate

    ERIC Educational Resources Information Center

    van Scotter, Richard; Hartoonian, H. Michael; White, William E.; Davis, James E.

    2007-01-01

    American democratic society is sustained through debate among its citizens. Four sets of value tensions--(1) law versus ethics, (2) private wealth versus common wealth, (3) freedom versus equality, and (4) unity versus diversity--are central in allowing citizens to address matters of public interest through debate. These value pairs are the…

  14. Industry Interests in the HDTV Debate.

    ERIC Educational Resources Information Center

    Neil, Suzanne Chambliss

    This analysis of the pattern of industrial interests in the current debate over high definition television systems argues that the debate involves more than just television; rather, it is an expression of a shift in the conceptualization of the nature of standards, one which conceives of standards as guidelines for the development of specific…

  15. Network Approach to Autistic Traits: Group and Subgroup Analyses of ADOS Item Scores

    ERIC Educational Resources Information Center

    Anderson, George M.; Montazeri, Farhad; de Bildt, Annelies

    2015-01-01

    A network conceptualization might contribute to understanding the occurrence and interacting nature of behavioral traits in the autism realm. Networks were constructed based on correlations of item scores of the Autism Diagnostic Observation Schedule for Modules 1, 2 and 3 obtained for a group of 477 Dutch individuals with developmental disorders.…

  16. Evidence of separate subgroups of juvenile southern bluefin tuna.

    PubMed

    Chambers, Mark S; Sidhu, Leesa A; O'Neill, Ben; Sibanda, Nokuthaba

    2017-11-01

    Archival tagging studies of southern bluefin tuna (SBT , Thunnus maccoyii ) have revealed that juveniles residing in the Great Australian Bight (GAB) over the austral summer undertake seasonal cyclic migrations to the southeast Indian Ocean and the Tasman Sea during winter. However, there remains disagreement about the extent of mixing between juvenile SBT regularly caught by longline fleets south of Africa and those observed in the GAB. Some researchers have argued that archival tag recoveries indicate most juveniles reside in the GAB over the austral summer. Others have suggested that recoveries of conventional and archival tags are better explained by a juvenile population consisting of separate groups on the eastern and western sides of the Indian Ocean with limited intermixing. We present analyses of catch and tag recovery data and re-examine archival tagging studies. The evidence provided strongly favors the hypothesis of separate juvenile subgroups, or contingents, with limited intermixing. We draw some tentative conclusions about the nature of the putative contingents and discuss some implications of these findings for the interpretation of existing datasets and future research priorities. We also provide the first evidence that the migration choices of juveniles that summer in the GAB are influenced by fidelity to winter feeding grounds and suggest this helps explain the collapse of the surface fishery off New South Wales in the 1980s.

  17. Matching mice to malignancy: molecular subgroups and models of medulloblastoma

    PubMed Central

    Lau, Jasmine; Schmidt, Christin; Markant, Shirley L.; Taylor, Michael D.; Wechsler-Reya, Robert J.

    2012-01-01

    Introduction Medulloblastoma, the largest group of embryonal brain tumors, has historically been classified into five variants based on histopathology. More recently, epigenetic and transcriptional analyses of primary tumors have sub-classified medulloblastoma into four to six subgroups, most of which are incongruous with histopathological classification. Discussion Improved stratification is required for prognosis and development of targeted treatment strategies, to maximize cure and minimize adverse effects. Several mouse models of medulloblastoma have contributed both to an improved understanding of progression and to developmental therapeutics. In this review, we summarize the classification of human medulloblastoma subtypes based on histopathology and molecular features. We describe existing genetically engineered mouse models, compare these to human disease, and discuss the utility of mouse models for developmental therapeutics. Just as accurate knowledge of the correct molecular subtype of medulloblastoma is critical to the development of targeted therapy in patients, we propose that accurate modeling of each subtype of medulloblastoma in mice will be necessary for preclinical evaluation and optimization of those targeted therapies. PMID:22315164

  18. Molecular subgroups of medulloblastoma identification using noninvasive magnetic resonance spectroscopy.

    PubMed

    Blüml, Stefan; Margol, Ashley S; Sposto, Richard; Kennedy, Rebekah J; Robison, Nathan J; Vali, Marzieh; Hung, Long T; Muthugounder, Sakunthala; Finlay, Jonathan L; Erdreich-Epstein, Anat; Gilles, Floyd H; Judkins, Alexander R; Krieger, Mark D; Dhall, Girish; Nelson, Marvin D; Asgharzadeh, Shahab

    2016-01-01

    Medulloblastomas in children can be categorized into 4 molecular subgroups with differing clinical characteristics, such that subgroup determination aids in prognostication and risk-adaptive treatment strategies. Magnetic resonance spectroscopy (MRS) is a widely available, noninvasive tool that is used to determine the metabolic characteristics of tumors and provide diagnostic information without the need for tumor tissue. In this study, we investigated the hypothesis that metabolite concentrations measured by MRS would differ between molecular subgroups of medulloblastoma and allow accurate subgroup determination. MRS was used to measure metabolites in medulloblastomas across molecular subgroups (SHH = 12, Groups 3/4 = 17, WNT = 1). Levels of 14 metabolites were analyzed to determine those that were the most discriminant for medulloblastoma subgroups in order to construct a multivariable classifier for distinguishing between combined Group 3/4 and SHH tumors. Medulloblastomas across molecular subgroups revealed distinct spectral features. Group 3 and Group 4 tumors demonstrated metabolic profiles with readily detectable taurine, lower levels of lipids, and high levels of creatine. SHH tumors showed prominent choline and lipid with low levels of creatine and little or no evidence of taurine. A 5-metabolite subgroup classifier inclusive of creatine, myo-inositol, taurine, aspartate, and lipid 13a was developed that could discriminate between Group 3/4 and SHH medulloblastomas with excellent accuracy (cross-validated area under the curve [AUC] = 0.88). The data show that medulloblastomas of Group 3/4 differ metabolically as measured using MRS when compared with SHH molecular subgroups. MRS is a useful and accurate tool to determine medulloblastoma molecular subgroups. © The Author(s) 2015. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  19. Cluster analysis and subgrouping to investigate inter-individual variability to non-invasive brain stimulation: a systematic review.

    PubMed

    Pellegrini, Michael; Zoghi, Maryam; Jaberzadeh, Shapour

    2018-01-12

    Cluster analysis and other subgrouping techniques have risen in popularity in recent years in non-invasive brain stimulation research in the attempt to investigate the issue of inter-individual variability - the issue of why some individuals respond, as traditionally expected, to non-invasive brain stimulation protocols and others do not. Cluster analysis and subgrouping techniques have been used to categorise individuals, based on their response patterns, as responder or non-responders. There is, however, a lack of consensus and consistency on the most appropriate technique to use. This systematic review aimed to provide a systematic summary of the cluster analysis and subgrouping techniques used to date and suggest recommendations moving forward. Twenty studies were included that utilised subgrouping techniques, while seven of these additionally utilised cluster analysis techniques. The results of this systematic review appear to indicate that statistical cluster analysis techniques are effective in identifying subgroups of individuals based on response patterns to non-invasive brain stimulation. This systematic review also reports a lack of consensus amongst researchers on the most effective subgrouping technique and the criteria used to determine whether an individual is categorised as a responder or a non-responder. This systematic review provides a step-by-step guide to carrying out statistical cluster analyses and subgrouping techniques to provide a framework for analysis when developing further insights into the contributing factors of inter-individual variability in response to non-invasive brain stimulation.

  20. Astronomers debate diamonds in space

    NASA Astrophysics Data System (ADS)

    1999-04-01

    This is not the first time the intriguing carbonaceous compound has been detected in space. A peculiar elite of twelve stars are known to produce it. The star now added by ISO to this elite is one of the best representatives of this exclusive family, since it emits a very strong signal of the compound. Additionally ISO found a second new member of the group with weaker emission, and also observed with a spectral resolution never achieved before other already known stars in this class. Astronomers think these ISO results will help solve the mystery of the true nature of the compound. Their publication by two different groups, from Spain and Canada, has triggered a debate on the topic, both in astronomy institutes and in chemistry laboratories. At present, mixed teams of astrophysicists and chemists are investigating in the lab compounds whose chemical signature or "fingerprint" matches that detected by ISO. Neither diamonds nor fullerenes have ever been detected in space, but their presence has been predicted. Tiny diamonds of pre-solar origin --older than the Solar System-- have been found in meteorites, which supports the as yet unconfirmed theory of their presence in interstellar space. The fullerene molecule, made of 60 carbon atoms linked to form a sphere (hence the name "buckyball"), has also been extensively searched for in space but never found. If the carbonaceous compound detected by ISO is a fullerene or a diamond, there will be new data on the production of these industrially interesting materials. Fullerenes are being investigated as "capsules" to deliver new pharmaceuticals to the body. Diamonds are commonly used in the electronics industry and for the development of new materials; if they are formed in the dust surrounding some stars, at relatively low temperatures and conditions of low pressure, companies could learn more about the ideal physical conditions to produce them. A textbook case The latest star in which the compound has been found is

  1. Identifying and predicting subgroups of information needs among cancer patients: an initial study using latent class analysis.

    PubMed

    Neumann, Melanie; Wirtz, Markus; Ernstmann, Nicole; Ommen, Oliver; Längler, Alfred; Edelhäuser, Friedrich; Scheffer, Christian; Tauschel, Diethard; Pfaff, Holger

    2011-08-01

    clinically significant subgroups of CaPts. Moreover, regression analyses indicate the following association: Nurses and physicians seem to be able to reduce CaPts' unmet information needs by establishing a relationship with the patient, which is trusting, caring and empathic.

  2. The medical genetics workforce: an analysis of clinical geneticist subgroups.

    PubMed

    Cooksey, Judith A; Forte, Gaetano; Flanagan, Patricia A; Benkendorf, Judith; Blitzer, Miriam G

    2006-10-01

    Clinical geneticists with a Doctor of Medicine degree face challenges to meet the growing population demand for genetic services. This study was designed to assist the profession with workforce planning by identifying clinically relevant subgroups of geneticists and describing their professional characteristics and clinical practices. Geneticists' patient care productivity is compared across subgroups and other medical specialists. Part of a comprehensive national study of genetic services and the health workforce, this study uses data from a 2003 survey of geneticists certified by the American Board of Medical Genetics. This study includes 610 clinical geneticists who spend at least 5% of their time in direct patient-care services. An iterative approach was used to identify five subgroups based on the types of new patients seen. We conducted a descriptive analysis of subgroups by demographic, training, professional, and practice characteristics. The subgroups include general (36%), pediatric (28%), reproductive (15%), metabolic (14%), and adult (7%) geneticists. Clinically relevant variations across subgroups were noted in training, professional, and practice parameters. Subgroups vary across patient care hours (median, 15-33 hours/week) and total weekly work hours (52-60 hours). New patient visits (mean, 222-900/year) are higher than follow-up patient visits (mean, 155-405) for all subgroups except metabolic geneticists. Although many geneticists practice as generalist geneticists, this study provides an evidence base for distinguishing clinically relevant subgroups of geneticists. Geneticists provide similar numbers of new patient visits and far fewer follow-up visits than other medical specialists. These findings are relevant to geneticist workforce planning.

  3. Subgroup differences in psychosocial factors relating to coronary heart disease in the UK South Asian population.

    PubMed

    Williams, Emily D; Nazroo, James Y; Kooner, Jaspal S; Steptoe, Andrew

    2010-10-01

    To explore the differences in psychosocial risk factors related to coronary heart disease (CHD) between South Asian subgroups in the UK. South Asian people suffer significantly higher rates of CHD than other ethnic groups, but vulnerability varies between South Asian subgroups, in terms of both CHD rates and risk profiles. Psychosocial factors may contribute to the excess CHD propensity that is observed; however, subgroup heterogeneity in psychosocial disadvantage has not previously been systematically explored. With a cross-sectional design, 1065 healthy South Asian and 818 white men and women from West London, UK, completed psychosocial questionnaires. Psychosocial profiles were compared between South Asian religious groups and the white sample, using analyses of covariance and post hoc tests. Of the South Asian sample, 50.5% was Sikh, 28.0% was Hindu, and 15.8% was Muslim. Muslim participants were more socioeconomically deprived and experienced higher levels of chronic stress, including financial strain, low social cohesion, and racial discrimination, compared with other South Asian religious groups. In terms of health behaviors, Muslim men smoked more than Sikhs and Hindus, and Muslims also reported lower alcohol consumption and were less physically active than other groups. This study found that Muslims were exposed to more psychosocial and behavioral adversity than Sikhs and Hindus, and highlights the importance of investigating subgroup heterogeneity in South Asian CHD risk. Crown Copyright © 2010. Published by Elsevier Inc. All rights reserved.

  4. Patterns of Alcohol Use and Consequences Among Empirically Derived Sexual Minority Subgroups

    PubMed Central

    Talley, Amelia E.; Sher, Kenneth J.; Steinley, Douglas; Wood, Phillip K.; Littlefield, Andrew K.

    2012-01-01

    Objective: The current study develops an empirically determined classification of sexual orientation developmental patterns based on participants’ annual reports of self-identifications, sexual attractions, and sexual behaviors during the first 4 years of college. A secondary aim of the current work was to examine trajectories of alcohol involvement among identified subgroups. Method: Data were drawn from a subsample of a longitudinal study of incoming first-time college students at a large, public university (n = 2,068). Longitudinal latent class analysis was used to classify sexual minority participants into empirically derived subgroups based on three self-reported facets of sexual orientation. Multivariate repeated-measures analyses were conducted to examine how trajectories of alcohol involvement varied by sexual orientation class membership. Results: Four unique subclasses of sexual orientation developmental patterns were identified for males and females: one consistently exclusively heterosexual group and three sexual minority groups. Despite generally similar alcohol use patterns among subclasses, certain sexual minority subgroups reported elevated levels of alcohol-related negative consequences and maladaptive motivations for use throughout college compared with their exclusively heterosexual counterparts. Conclusions: Elevations in coping and conformity motivations for alcohol use were seen among those subgroups that also evidenced heightened negative alcohol-related consequences. Implications and limitations of the current work are discussed. PMID:22333337

  5. Subgroup differences in psychosocial factors relating to coronary heart disease in the UK South Asian population☆

    PubMed Central

    Williams, Emily D.; Nazroo, James Y.; Kooner, Jaspal S.; Steptoe, Andrew

    2010-01-01

    Objectives To explore the differences in psychosocial risk factors related to coronary heart disease (CHD) between South Asian subgroups in the UK. South Asian people suffer significantly higher rates of CHD than other ethnic groups, but vulnerability varies between South Asian subgroups, in terms of both CHD rates and risk profiles. Psychosocial factors may contribute to the excess CHD propensity that is observed; however, subgroup heterogeneity in psychosocial disadvantage has not previously been systematically explored. Methods With a cross-sectional design, 1065 healthy South Asian and 818 white men and women from West London, UK, completed psychosocial questionnaires. Psychosocial profiles were compared between South Asian religious groups and the white sample, using analyses of covariance and post hoc tests. Results Of the South Asian sample, 50.5% was Sikh, 28.0% was Hindu, and 15.8% was Muslim. Muslim participants were more socioeconomically deprived and experienced higher levels of chronic stress, including financial strain, low social cohesion, and racial discrimination, compared with other South Asian religious groups. In terms of health behaviors, Muslim men smoked more than Sikhs and Hindus, and Muslims also reported lower alcohol consumption and were less physically active than other groups. Conclusion This study found that Muslims were exposed to more psychosocial and behavioral adversity than Sikhs and Hindus, and highlights the importance of investigating subgroup heterogeneity in South Asian CHD risk. PMID:20846539

  6. Seven Democratic Presidential Candidates Debate Educational Issues.

    ERIC Educational Resources Information Center

    Equity and Excellence, 1988

    1988-01-01

    Provides the transcript of a debate on educational issues among Democratic presidential candidates Paul Simon, Albert Gore, Joseph Biden, Jesse Jackson, Bruce Babbitt, Richard Gephart, and Michael Dukakis. (BJV)

  7. Ground Rules for the Power Debate.

    ERIC Educational Resources Information Center

    Fainberg, Anthony

    1980-01-01

    A physicist argues for the establishment of ground rules in the current nuclear power debate so that vital policy decisions and discussions stay within the realm of rationality permitting useful and meaningful exchanges of information and data. (BT)

  8. G-protein coupled receptor expression patterns delineate medulloblastoma subgroups

    PubMed Central

    2013-01-01

    Background Medulloblastoma is the most common malignant brain tumor in children. Genetic profiling has identified four principle tumor subgroups; each subgroup is characterized by different initiating mutations, genetic and clinical profiles, and prognoses. The two most well-defined subgroups are caused by overactive signaling in the WNT and SHH mitogenic pathways; less is understood about Groups 3 and 4 medulloblastoma. Identification of tumor subgroup using molecular classification is set to become an important component of medulloblastoma diagnosis and staging, and will likely guide therapeutic options. However, thus far, few druggable targets have emerged. G-protein coupled receptors (GPCRs) possess characteristics that make them ideal targets for molecular imaging and therapeutics; drugs targeting GPCRs account for 30-40% of all current pharmaceuticals. While expression patterns of many proteins in human medulloblastoma subgroups have been discerned, the expression pattern of GPCRs in medulloblastoma has not been investigated. We hypothesized that analysis of GPCR expression would identify clear subsets of medulloblastoma and suggest distinct GPCRs that might serve as molecular targets for both imaging and therapy. Results Our study found that medulloblastoma tumors fall into distinct clusters based solely on GPCR expression patterns. Normal cerebellum clustered separately from the tumor samples. Further, two of the tumor clusters correspond with high fidelity to the WNT and SHH subgroups of medulloblastoma. Distinct over-expressed GPCRs emerge; for example, LGR5 and GPR64 are significantly and uniquely over-expressed in the WNT subgroup of tumors, while PTGER4 is over-expressed in the SHH subgroup. Uniquely under-expressed GPCRs were also observed. Our key findings were independently validated using a large international dataset. Conclusions Our results identify GPCRs with potential to act as imaging and therapeutic targets. Elucidating tumorigenic pathways

  9. The Value of Heterogeneity for Cost-Effectiveness Subgroup Analysis

    PubMed Central

    Manca, Andrea; Claxton, Karl; Sculpher, Mark J.

    2014-01-01

    This article develops a general framework to guide the use of subgroup cost-effectiveness analysis for decision making in a collectively funded health system. In doing so, it addresses 2 key policy questions, namely, the identification and selection of subgroups, while distinguishing 2 sources of potential value associated with heterogeneity. These are 1) the value of revealing the factors associated with heterogeneity in costs and outcomes using existing evidence (static value) and 2) the value of acquiring further subgroup-related evidence to resolve the uncertainty given the current understanding of heterogeneity (dynamic value). Consideration of these 2 sources of value can guide subgroup-specific treatment decisions and inform whether further research should be conducted to resolve uncertainty to explain variability in costs and outcomes. We apply the proposed methods to a cost-effectiveness analysis for the management of patients with acute coronary syndrome. This study presents the expected net benefits under current and perfect information when subgroups are defined based on the use and combination of 6 binary covariates. The results of the case study confirm the theoretical expectations. As more subgroups are considered, the marginal net benefit gains obtained under the current information show diminishing marginal returns, and the expected value of perfect information shows a decreasing trend. We present a suggested algorithm that synthesizes the results to guide policy. PMID:24944196

  10. Debating science policy in the physics classroom.

    NASA Astrophysics Data System (ADS)

    Mayer, Shannon

    2010-03-01

    It is critically important that national and international science policy be scientifically grounded. To this end, the next generation of scientists and engineers will need to be technically competent, effective communicators of science, and engaged advisors in the debate and formulation of science policy. We describe three science policy debates developed for the physics classroom aimed at encouraging students to draw connections between their developing technical expertise and important science policy issues. The first debate considers the proposal for a 450-megawatt wind farm on public lands in Nantucket Sound and fits naturally into the curriculum related to alternative forms of energy production. The second debate considers national fuel-economy standards for sport-utility vehicles and can be incorporated into the curriculum related to heat engines. The third debate, suitable for the curriculum in optics, considers solid state lighting and implications of recent United States legislation that places stringent new energy-efficiency and reliability requirements on conventional lighting. The technical foundation for each of these debates fits naturally into the undergraduate physics curriculum and the material is suitable for a wide range of physics courses, including general science courses for non-majors.

  11. Are the mentally ill homeless a distinct homeless subgroup?

    PubMed

    North, C S; Smith, E M; Pollio, D E; Spitznagel, E L

    1996-09-01

    The question has been raised whether it is useful or meaningful to dichotomize the homeless population by mental illness - i.e., to consider the mentally ill homeless as distinct from other homeless people. The current article presents evidence from a single data set to address this question empirically. Data from a randomly sampled population of 900 homeless men and women systemically interviewed using the Diagnostic Interview Schedule were examined to determine associations of mental illness with the problems of homelessness, controlling for the presence of substance abuse in the analyses. Although a few clinically meaningful associations with mental illness were found that might suggest directions for appropriate interventions, mental illness did not differentiate individuals in many important demographic and biographic respects. Individual diagnoses did not perform much better in differentiating the homeless by mental illness. Schizophrenia and bipolar mania showed a few significant associations not identified by the "major mental illness" construct. Major depression, constituting the majority of nonsubstance Axis I disorder in the homeless, provided no association beyond that obtained with the "major mental illness" category. The data provide little support for conceptualizing homeless subgroups or homelessness in general on the basis of mental illness alone. To do so also risks neglecting the emotional distress of the majority without major mental illness and the other problems that homeless persons share regardless of psychiatric illness. While serious mental illness is overrepresented among the homeless, it represents just one of many important vulnerability factors for homelessness. Substance abuse is far more prevalent than other Axis I disorders. Media images equating homelessness with major mental illness unnecessarily stigmatize homeless people and encourage oversimplified and narrowly conceived psychiatric interventions. While continuing attention is

  12. The Participation and Success of Women in CEDA Debate.

    ERIC Educational Resources Information Center

    Medcalf, Lawrence D.

    A study was conducted to investigate the success of women contestants in Cross Examination Debate Association (CEDA) debate. The study sought to determine whether (1) CEDA is a more attractive debate activity for women, (2) men are more successful in CEDA debate than women, (3) the gender mix of debate teams favors all-male teams over all-female…

  13. A person-centered approach to examining heterogeneity and subgroups among survivors of sexual assault.

    PubMed

    Masters, N Tatiana; Stappenbeck, Cynthia A; Kaysen, Debra; Kajumulo, Kelly F; Davis, Kelly Cue; George, William H; Norris, Jeanette; Heiman, Julia R

    2015-08-01

    This study identified subgroups of female sexual assault survivors based on characteristics of their victimization experiences, validated the subgroup structure in a second cohort of women recruited identically to the first, and examined subgroups' differential associations with sexual risk/safety behavior, heavy episodic drinking (HED), psychological distress symptomatology, incarceration, transactional sex, and experiences with controlling and violent partners. The community sample consisted of 667 female survivors of adolescent or adult sexual assault who were 21 to 30 years old (M = 24.78, SD = 2.66). Eligibility criteria included having unprotected sex within the past year, other HIV/STI risk factors, and some experience with HED, but without alcohol problems or dependence. Latent class analyses (LCA) were used to identify subgroups of women with similar victimization experiences. Three groups were identified and validated across 2 cohorts of women using multiple-group LCA: contact or attempted assault (17% of the sample), incapacitated assault (52%), and forceful severe assault (31%). Groups did not differ in their sexual risk/safety behavior. Women in the forceful severe category had higher levels of anxiety, depression, and trauma symptoms; higher proportions of incarceration and transactional sex; and more experiences with controlling and violent partners than did women in the other 2 groups. Women in the forceful severe category also reported a higher frequency of HED than women in the incapacitated category. Different types of assault experiences appear to be differentially associated with negative outcomes. Understanding heterogeneity and subgroups among sexual assault survivors has implications for improving clinical care and contributing to recovery. (c) 2015 APA, all rights reserved).

  14. A Person-Centered Approach to Examining Heterogeneity and Subgroups Among Survivors of Sexual Assault

    PubMed Central

    Masters, N. Tatiana; Stappenbeck, Cynthia A.; Kaysen, Debra; Kajumulo, Kelly F.; Davis, Kelly Cue; George, William H.; Norris, Jeanette; Heiman, Julia R.

    2015-01-01

    This study identified subgroups of female sexual assault survivors based on characteristics of their victimization experiences, validated the subgroup structure in a second cohort of women recruited identically to the first, and examined subgroups' differential associations with sexual risk/safety behavior, heavy episodic drinking (HED), psychological distress symptomatology, incarceration, transactional sex, and experiences with controlling and violent partners. The community sample consisted of 667 female survivors of adolescent or adult sexual assault who were 21 to 30 years old (M=24.78, SD=2.66). Eligibility criteria included having unprotected sex within the past year, other HIV/STI risk factors, and some experience with HED, but without alcohol problems or dependence. Latent class analyses (LCA) were used to identify subgroups of women with similar victimization experiences. Three groups were identified and validated across two cohorts of women using multiple-group LCA: Contact or Attempted assault (17% of the sample), Incapacitated assault (52%), and Forceful Severe assault (31%). Groups did not differ in their sexual risk/safety behavior. Women in the Forceful Severe category had higher levels of anxiety, depression, and trauma symptoms, higher proportions of incarceration and transactional sex, and more experiences with controlling and violent partners than did women in the other two groups. Women in the Forceful Severe category also reported a higher frequency of HED than women in the Incapacitated category. Different types of assault experiences appear to be differentially associated with negative outcomes. Understanding heterogeneity and subgroups among sexual assault survivors has implications for improving clinical care and contributing to recovery. PMID:26052619

  15. Thinking and Caring about Indigenous Peoples' Human Rights: Swedish Students Writing History beyond Scholarly Debate

    ERIC Educational Resources Information Center

    Nygren, Thomas

    2016-01-01

    According to national and international guidelines, schools should promote historical thinking and foster moral values. Scholars have debated, but not analysed in depth in practice, whether history education can and should hold a normative dimension. This study analyses current human rights education in two Swedish senior high school groups, in…

  16. Rhinology Future Debates, an EUFOREA Report.

    PubMed

    Fokkens, W J; Bachert, C; Bernal-Sprekelsen, M; Bousquet, J; Djandji, M; Dorenbaum, A; Hakimi-Mehr, D; Hendry, S; Hopkins, C; Leunig, A; Mannent, L; Mucha, D; Onerci, M; Pugin, B; Toppila-Salmi, S; Rowe, P; Seys, S F; Stimson, S; Strzembosz, A; Hellings, P W

    2017-12-01

    The first Rhinology Future Debates was held in Brussels in December 2016, organized by EUFOREA (European Forum for Research and Education in Allergy and Airways diseases). The purpose of these debates is to bring novel developments in the field of Rhinology to the attention of the medical, paramedical and patient community, in a highly credible and balanced context. For the first time in Rhinology, a peer to peer scientific exchange with key experts in the field of rhinology and key medical colleagues from leading industries let to a brainstorming and discussion event on a number of hot issues in Rhinology. Novel developments are presented by key experts from industry and/or key thought leaders in Rhinology, and then followed by a lively debate on the potential positioning of new developments in care pathways, the strengths and weaknesses of the novel development(s), and comparisons with existing and/or competing products, devices, and/or molecules. As all debates are recorded and distributed on-line with limited editing (www.rhinology-future.com), EUFOREA aims at maximizing the education of the target groups on novel developments, allowing a critical appraisal of the future and a more rapid implementation of promising novel tools, techniques and/or molecules in clinical practise in Europe. The next Rhinology Future debate will be held in Brussels in December 2017.

  17. Beyond the mammography debate: a moderate perspective.

    PubMed

    Kaniklidis, C

    2015-06-01

    After some decades of contention, one can almost despair and conclude that (paraphrasing) "the mammography debate you will have with you always." Against that sentiment, in this review I argue, after reflecting on some of the major themes of this long-standing debate, that we must begin to move beyond the narrow borders of claim and counterclaim to seek consensus on what the balance of methodologically sound and critically appraised evidence demonstrates, and also to find overlooked underlying convergences; after acknowledging the reality of some residual and non-trivial harms from mammography, to promote effective strategies for harm mitigation; and to encourage deployment of new screening modalities that will render many of the issues and concerns in the debate obsolete. To these ends, I provide a sketch of what this looking forward and beyond the current debate might look like, leveraging advantages from abbreviated breast magnetic resonance imaging technologies (such as the ultrafast and twist protocols) and from digital breast tomosynthesis-also known as three-dimensional mammography. I also locate the debate within the broader context of mammography in the real world as it plays out not for the disputants, but for the stakeholders themselves: the screening-eligible patients and the physicians in the front lines who are charged with enabling both the acts of screening and the facts of screening at their maximally objective and patient-accessible levels to facilitate informed decisions.

  18. Beyond the mammography debate: a moderate perspective

    PubMed Central

    Kaniklidis, C

    2015-01-01

    After some decades of contention, one can almost despair and conclude that (paraphrasing) “the mammography debate you will have with you always.” Against that sentiment, in this review I argue, after reflecting on some of the major themes of this long-standing debate, that we must begin to move beyond the narrow borders of claim and counterclaim to seek consensus on what the balance of methodologically sound and critically appraised evidence demonstrates, and also to find overlooked underlying convergences; after acknowledging the reality of some residual and non-trivial harms from mammography, to promote effective strategies for harm mitigation; and to encourage deployment of new screening modalities that will render many of the issues and concerns in the debate obsolete. To these ends, I provide a sketch of what this looking forward and beyond the current debate might look like, leveraging advantages from abbreviated breast magnetic resonance imaging technologies (such as the ultrafast and twist protocols) and from digital breast tomosynthesis—also known as three-dimensional mammography. I also locate the debate within the broader context of mammography in the real world as it plays out not for the disputants, but for the stakeholders themselves: the screening-eligible patients and the physicians in the front lines who are charged with enabling both the acts of screening and the facts of screening at their maximally objective and patient-accessible levels to facilitate informed decisions. PMID:26089721

  19. Attacking Heterogeneity in Schizophrenia by Deriving Clinical Subgroups From Widely Available Symptom Data.

    PubMed

    Dickinson, Dwight; Pratt, Danielle N; Giangrande, Evan J; Grunnagle, MeiLin; Orel, Jennifer; Weinberger, Daniel R; Callicott, Joseph H; Berman, Karen F

    2018-01-13

    Previous research has identified (1) a "deficit" subtype of schizophrenia characterized by enduring negative symptoms and diminished emotionality and (2) a "distress" subtype associated with high emotionality-including anxiety, depression, and stress sensitivity. Individuals in deficit and distress categories differ sharply in development, clinical course and behavior, and show distinct biological markers, perhaps signaling different etiologies. We tested whether deficit and distress subtypes would emerge from a simple but novel data-driven subgrouping analysis, based on Positive and Negative Syndrome Scale (PANSS) negative and distress symptom dimensions, and whether subgrouping was informative regarding other facets of behavior and brain function. PANSS data, and other assessments, were available for 549 people with schizophrenia diagnoses. Negative and distress symptom composite scores were used as indicators in 2-step cluster analyses, which divided the sample into low symptom (n = 301), distress (n = 121), and deficit (n = 127) subgroups. Relative to the low-symptom group, the deficit and distress subgroups had comparably higher total PANSS symptoms (Ps < .001) and were similarly functionally impaired (eg, global functioning [GAF] Ps < .001), but showed markedly different patterns on symptom, cognitive and personality variables, among others. Initial analyses of functional magnetic resonance imaging (fMRI) data from a 182-participant subset of the full sample also suggested distinct patterns of neural recruitment during working memory. The field seeks more neuroscience-based systems for classifying psychiatric conditions, but these are inescapably behavioral disorders. More effective parsing of clinical and behavioral traits could identify homogeneous target groups for further neural system and molecular studies, helping to integrate clinical and neuroscience approaches. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center

  20. Subgroup analysis of Asian patients in the INPULSIS® trials of nintedanib in idiopathic pulmonary fibrosis.

    PubMed

    Taniguchi, Hiroyuki; Xu, Zuojun; Azuma, Arata; Inoue, Yoshikazu; Li, Huiping; Fujimoto, Tsuyoshi; Bailes, Zelie; Schlenker-Herceg, Rozsa; Kim, Dong S

    2016-11-01

    In the two-replicate randomized Phase III INPULSIS® trials in patients with idiopathic pulmonary fibrosis (IPF), nintedanib 150 mg bd significantly reduced the annual rate of decline in forced vital capacity (FVC) compared with placebo. The key secondary endpoints were time to first investigator-reported acute exacerbation and change from baseline in St George's Respiratory Questionnaire total score, both over 52 weeks. Here, we assessed the effect of nintedanib in Asian patients. Pre-specified subgroup analyses of the effect of nintedanib on the primary and key secondary endpoints in Asian versus White patients were undertaken based on pooled data from the two INPULSIS® trials. Safety data were analyzed descriptively. Of the treated patients, 322 were Asian (nintedanib n = 194; placebo n = 128) and 608 were White (nintedanib n = 360; placebo n = 248). In Asian patients, the nintedanib versus placebo difference in the adjusted annual rate of decline in FVC was 94.1 mL/year (95% CI: 33.7, 154.6). The treatment effect of nintedanib on the annual rate of decline in FVC in Asian and White patients was similar (treatment-by-subgroup interaction P = 0.72) and consistent with the overall population. No significant treatment-by-subgroup interaction was observed for the key secondary endpoints between Asian and White patients. In Asian patients, the most common adverse event in the nintedanib group was diarrhoea (56.2% of patients vs 15.6% for placebo). In pre-specified subgroup analyses of Asian versus White patients with IPF in the INPULSIS® trials, race did not influence the effect of nintedanib on disease progression. © 2016 Asian Pacific Society of Respirology.

  1. Promoting Student Metacognition through the Analysis of Their Own Debates. Is It Better with Text or with Graphics?

    ERIC Educational Resources Information Center

    Martínez, Marc Lafuente; Valdivia, Ibis M. Álvarez

    2016-01-01

    This paper presents a higher education experience aimed at explicitly promoting metacognitive processes in a social and collaborative context. Students carried out a debate on an e-forum, and were later asked to collaboratively analyse their own debates. The control group conducted this analysis using text-based tools; the experimental group…

  2. Understanding Definitions of Minimally Verbal across Instruments: Evidence for Subgroups within Minimally Verbal Children and Adolescents with Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Bal, Vanessa Hus; Katz, Terry; Bishop, Somer L.; Krasileva, Kate

    2016-01-01

    Background: Minimally verbal (MV) children with autism spectrum disorder (ASD) are often assumed to be profoundly cognitively impaired and excluded from analyses due to challenges completing standardized testing protocols. A literature aimed at increasing understanding of this subgroup is emerging; however, the many methods used to define MV…

  3. Clebsch-Gordan coefficients of discrete groups in subgroup bases

    NASA Astrophysics Data System (ADS)

    Chen, Gaoli

    2018-04-01

    We express each Clebsch-Gordan (CG) coefficient of a discrete group as a product of a CG coefficient of its subgroup and a factor, which we call an embedding factor. With an appropriate definition, such factors are fixed up to phase ambiguities. Particularly, they are invariant under basis transformations of irreducible representations of both the group and its subgroup. We then impose on the embedding factors constraints, which relate them to their counterparts under complex conjugate and therefore restrict the phases of embedding factors. In some cases, the phase ambiguities are reduced to sign ambiguities. We describe the procedure of obtaining embedding factors and then calculate CG coefficients of the group 𝒫𝒮ℒ2(7) in terms of embedding factors of its subgroups S4 and 𝒯7.

  4. Tracking cohesive subgroups over time in inferred social networks

    NASA Astrophysics Data System (ADS)

    Chin, Alvin; Chignell, Mark; Wang, Hao

    2010-04-01

    As a first step in the development of community trackers for large-scale online interaction, this paper shows how cohesive subgroup analysis using the Social Cohesion Analysis of Networks (SCAN; Chin and Chignell 2008) and Data-Intensive Socially Similar Evolving Community Tracker (DISSECT; Chin and Chignell 2010) methods can be applied to the problem of identifying cohesive subgroups and tracking them over time. Three case studies are reported, and the findings are used to evaluate how well the SCAN and DISSECT methods work for different types of data. In the largest of the case studies, variations in temporal cohesiveness are identified across a set of subgroups extracted from the inferred social network. Further modifications to the DISSECT methodology are suggested based on the results obtained. The paper concludes with recommendations concerning further research that would be beneficial in addressing the community tracking problem for online data.

  5. Book review: The Wilderness Debate Rages On: Continuing the Great New Wilderness Debate

    Treesearch

    Peter Landres

    2009-01-01

    The Wilderness Debate Rages On is a collection of mostly previously published papers about the meaning, value, and role of wilderness and continues the discussion that was propelled by the editors' previous book The Great New Wilderness Debate (also a collection of papers) published in 1998. The editors state that this sequel to their previous book is mandated...

  6. Issue ads and the health reform debate.

    PubMed

    Bergan, Daniel; Risner, Genevieve

    2012-06-01

    The public debate over health care reform in 2009 was carried out partly through issue advertisements aired online and on television. Did these advertisements alter the course of the debate over health care reform? While millions of dollars are spent each year on issue ads, little is known about their effects. Results from a naturalistic online experiment on the effects of issue ads suggest that they can influence the perceived importance of an issue and perceptions of politicians associated with the featured policy while influencing policy support only among those low in political awareness.

  7. Medicinal cannabis: moving the debate forward.

    PubMed

    Newton-Howes, Giles; McBride, Sam

    2016-11-18

    There has been increased interest in cannabis as a medicine both nationally and internationally. Internationally, cannabis is accepted as a medication for a variety of purposes in a variety of legal guises and this, associated with anecdotes of the utility of cannabis as medication has led for calls for it to be 'medicalised' in New Zealand. This viewpoint discusses the issues associated with this approach to accessing cannabis and some of the difficulties that may be associated with it. It is important doctors are at the forefront of the debate surrounding medicalised cannabis. Recommendations as to the ongoing debate are offered.

  8. Differential Distributions of Synechococcus Subgroups Across the California Current System

    PubMed Central

    Paerl, Ryan W.; Johnson, Kenneth S.; Welsh, Rory M.; Worden, Alexandra Z.; Chavez, Francisco P.; Zehr, Jonathan P.

    2011-01-01

    Synechococcus is an abundant marine cyanobacterial genus composed of different populations that vary physiologically. Synechococcus narB gene sequences (encoding for nitrate reductase in cyanobacteria) obtained previously from isolates and the environment (e.g., North Pacific Gyre Station ALOHA, Hawaii or Monterey Bay, CA, USA) were used to develop quantitative PCR (qPCR) assays. These qPCR assays were used to quantify populations from specific narB phylogenetic clades across the California Current System (CCS), a region composed of dynamic zones between a coastal-upwelling zone and the oligotrophic Pacific Ocean. Targeted populations (narB subgroups) had different biogeographic patterns across the CCS, which appear to be driven by environmental conditions. Subgroups C_C1, D_C1, and D_C2 were abundant in coastal-upwelling to coastal-transition zone waters with relatively high to intermediate ammonium, nitrate, and chl. a concentrations. Subgroups A_C1 and F_C1 were most abundant in coastal-transition zone waters with intermediate nutrient concentrations. E_O1 and G_O1 were most abundant at different depths of oligotrophic open-ocean waters (either in the upper mixed layer or just below). E_O1, A_C1, and F_C1 distributions differed from other narB subgroups and likely possess unique ecologies enabling them to be most abundant in waters between coastal and open-ocean waters. Different CCS zones possessed distinct Synechococcus communities. Core California current water possessed low numbers of narB subgroups relative to counted Synechococcus cells, and coastal-transition waters contained high abundances of Synechococcus cells and total number of narB subgroups. The presented biogeographic data provides insight on the distributions and ecologies of Synechococcus present in an eastern boundary current system. PMID:21833315

  9. PRIM versus CART in subgroup discovery: when patience is harmful.

    PubMed

    Abu-Hanna, Ameen; Nannings, Barry; Dongelmans, Dave; Hasman, Arie

    2010-10-01

    We systematically compare the established algorithms CART (Classification and Regression Trees) and PRIM (Patient Rule Induction Method) in a subgroup discovery task on a large real-world high-dimensional clinical database. Contrary to current conjectures, PRIM's performance was generally inferior to CART's. PRIM often considered "peeling of" a large chunk of data at a value of a relevant discrete ordinal variable unattractive, ultimately missing an important subgroup. This finding has considerable significance in clinical medicine where ordinal scores are ubiquitous. PRIM's utility in clinical databases would increase when global information about (ordinal) variables is better put to use and when the search algorithm keeps track of alternative solutions.

  10. United States: Exploring the Marriage Debate

    ERIC Educational Resources Information Center

    Carter, Julie H.

    2004-01-01

    As citizens of the United States respond to legislative and judicial actions that have challenged the prohibition against same-sex couples receiving marriage licenses, schools have a timely opportunity to engage students on this most important debate. Educators can help their students understand the full significance of this issue by encouraging…

  11. Evolution: Don't Debate, Educate.

    ERIC Educational Resources Information Center

    Bybee, Rodger W.

    2000-01-01

    Discusses controversy over the teaching of biological evolution and other scientific ideas such as Big Bang theory. Recommends that teachers avoid debating creationists, help students develop a greater understanding and appreciation for science as a way of explaining the natural world, and emphasize inquiry and the nature of science. (Contains 19…

  12. Debates over School Shutdowns Heating Up

    ERIC Educational Resources Information Center

    Zubrzycki, Jaclyn

    2012-01-01

    As school closures are increasingly used as a remedy to budget woes and a solution to failing schools in many cities, debates are intensifying about their effect on student performance and well-being, on district finances, and on communities and the processes districts use to choose which schools will be shuttered. Student and parent groups in…

  13. Multiple "Curriculum" Meanings Heighten Debate over Standards

    ERIC Educational Resources Information Center

    Gewertz, Catherine

    2011-01-01

    Calls for shared curricula for the common standards have triggered renewed debates about who decides what students learn, and even about varied meanings of the word "curriculum," adding layers of complexity to the job of translating the broad learning goals into classroom teaching. The most recent calls for common curricula came from the American…

  14. Teaching Group Work with "The Great Debaters"

    ERIC Educational Resources Information Center

    Moe, Jeffry; Autry, Linda; Olson, Joann S.; Johnson, Kaprea F.

    2014-01-01

    An experiential learning activity, based on the film "The Great Debaters" (Washington, D., 2007), was used during a group work class. Description and preliminary evaluation of the activity is provided, including analysis of participant scores on the group leader self-efficacy instrument at multiple points. Implications and future…

  15. Beyond the Virtues-Principles Debate.

    ERIC Educational Resources Information Center

    Keat, Marilyn S.

    1992-01-01

    Indicates basic ontological assumptions in the virtues-principles debate in moral philosophy, noting Aristotle's and Kant's fundamental ideas about morality and considering a hermeneutic synthesis of theories. The article discusses what acceptance of the synthesis might mean in the theory and practice of moral pedagogy, offering examples of…

  16. The Net Neutrality Debate: The Basics

    ERIC Educational Resources Information Center

    Greenfield, Rich

    2006-01-01

    Rich Greenfield examines the basics of today's net neutrality debate that is likely to be an ongoing issue for society. Greenfield states the problems inherent in the definition of "net neutrality" used by Common Cause: "Network neutrality is the principle that Internet users should be able to access any web content they choose and…

  17. Market Rhetoric and the Ebonics Debate

    ERIC Educational Resources Information Center

    Longaker, Mark Garrett

    2005-01-01

    Using a method of topical rhetorical analysis, inspired by K. Burke, to discuss the Ebonics debate, this article demonstrates that conversations about education, particularly writing instruction, have adopted a market rhetoric that limits teachers' agency. However, reappropriation of this market rhetoric can help writing teachers to imagine and…

  18. Making Sense of the MOOCs Debate

    ERIC Educational Resources Information Center

    Sharrock, Geoff

    2015-01-01

    This article considers recent public debates about massive open online courses (MOOCs) and their potential to transform higher education. Drawing on reports and media commentary, it probes the claims and counterclaims of MOOC proponents and MOOC sceptics. It considers the implications for students, governments, institutions and scholars…

  19. Debate: Should Abortion Be Available on Request?

    ERIC Educational Resources Information Center

    Nathanson, Bernard; Lawrence, George

    1971-01-01

    Two physicians debate whether abortions should be available on request regardless of medical indications. The crux of the issue is whether the fetus should be considered body tissue over which the woman has complete control or whether society has an interest in the embryo and should protect it. (Author/BY)

  20. National Debate Tournament Booklet of Judges, 1987.

    ERIC Educational Resources Information Center

    Ulrich, Walter, Ed.

    A compilation of statements of the judging philosophies of the judges for the 1987 National Debate Tournament, this booklet presents the views of 132 college level coaches from institutions all across the country. The areas examined in the standard judge philosophy form include (1) personal preferences in regard to a decision making paradigm; (2)…

  1. Bioethics and the Stem Cell Research Debate

    ERIC Educational Resources Information Center

    Shapiro, Robyn S.

    2006-01-01

    Bioethics--the study of ethical issues in science and medicine--has grown to become a significant academic and service-oriented discipline with its own research centers, conferences, journals, and degree programs. As these issues have moved to the center of public debate, the law has assumed an increasingly important place in the discipline of…

  2. Debating Globalization and Education after September 11

    ERIC Educational Resources Information Center

    Rizvi, Fazal

    2004-01-01

    This article examines some of the ways in which debates about globalization and education have changed since the tragic events of September 11, 2001 and their aftermath. From a postcolonial perspective, I argue that while some of the claims about the world "changing for ever" are clearly simplistic and grossly exaggerated, there are at least three…

  3. Debate, Research on E-Cigarettes Continues

    Cancer.gov

    Since they first began to be sold in North America in the mid-2000s, electronic cigarettes have been the subject of intense debate. NCI's Dr. Michele Bloch recently presented an update on some of the issues surrounding e-cigarettes.

  4. Anonymity in Classroom Voting and Debating

    ERIC Educational Resources Information Center

    Ainsworth, Shaaron; Gelmini-Hornsby, Giulia; Threapleton, Kate; Crook, Charles; O'Malley, Claire; Buda, Marie

    2011-01-01

    The advent of networked environments into the classroom is changing classroom debates in many ways. This article addresses one key attribute of these environments, namely anonymity, to explore its consequences for co-present adolescents anonymous, by virtue of the computer system, to peers not to teachers. Three studies with 16-17 year-olds used a…

  5. Debating Diversity: Ethics and Controversial Public Issues

    ERIC Educational Resources Information Center

    Darr, Christopher R.

    2016-01-01

    Courses: Ethics, Organizational Communication, Political Communication. Objectives: After completing this unit activity, students should be able to (1) apply multiple ethical perspectives to real-world diversity issues in a debate format, and (2) explain the role of informational and social category diversity in current controversies.

  6. Reframing the English Grammar Schools Debate

    ERIC Educational Resources Information Center

    Morris, Rebecca; Perry, Thomas

    2017-01-01

    In October 2015 the Department for Education (DfE) permitted a grammar school in Tonbridge, Kent, to open up an annexe in Sevenoaks, 10 miles away. Amidst claims that the annexe was essentially a new grammar school, the decision reignited an old debate about the value of academically-selective "grammar" schools in England. The intensity…

  7. Using Role Play to Debate Animal Testing

    ERIC Educational Resources Information Center

    Agell, Laia; Soria, Vanessa; Carrió, Mar

    2015-01-01

    The use of animals in biomedical research is a socio-scientific issue in which decision-making is complicated. In this article, we describe an experience involving a role play activity performed during school visits to the Barcelona Biomedical Research Park (PRBB) to debate animal testing. Role playing games require students to defend different…

  8. Gun Control: The Debate and Public Policy.

    ERIC Educational Resources Information Center

    Watkins, Christine

    1997-01-01

    Provides an overview and background information on the debate over gun control, as well as several teaching ideas. Handouts include a list of related topics drawn from various disciplines (economics, U.S. history), seven arguments for and against gun control, and a set of policy evaluation guidelines. (MJP)

  9. The Great Graduation-Rate Debate

    ERIC Educational Resources Information Center

    Wolfe, Christine O.

    2009-01-01

    The purpose of this paper is to promote clearer understanding of the graduation-rate debate by distilling the policy developments and controversy surrounding the measurement of these rates over the last decade. The paper concludes with a discussion of the move toward a federally mandated common metric for graduation rates. The No Child Left Behind…

  10. China's Succession Battle Stirs Higher Education Debate

    ERIC Educational Resources Information Center

    Cleverley, John

    1976-01-01

    Describes the current debate going on in Chinese political and educational circles regarding the quality of university education since the Cultural Revolution. Those being singled out for their bourgeois line are critical of such practices as nonacademic selection criteria and the weight given to practical experience in the shortened courses. (JT)

  11. Contemporary Debates in Childhood Education and Development

    ERIC Educational Resources Information Center

    Suggate, Sebastian, Ed.; Reese, Elaine, Ed.

    2012-01-01

    "Contemporary Debates in Childhood Education and Development" is a unique resource and reference work that brings together leading international researchers and thinkers, with divergent points of view, to discuss contemporary problems and questions in childhood education and developmental psychology. Through an innovative format whereby leading…

  12. Applications of Computer Technology in Intercollegiate Debate.

    ERIC Educational Resources Information Center

    Kay, Jack, Ed.

    1986-01-01

    Focusing on how computers can and should be used in intercollegiate forensics, this journal issue offers the perspectives of a number of forensics instructors. The lead article, "Applications of Computer Technology in Intercollegiate Debate" by Theodore F. Sheckels, Jr., discusses five areas in which forensics educators might use computer…

  13. Twitter Gets Favorited in the Education Debate

    ERIC Educational Resources Information Center

    Supovitz, Jonathan

    2015-01-01

    The author describes how the interactive study of social media's effect on the Common Core debate was designed and executed. Important findings from the study were: 1) We live in an increasingly interconnected social world. 2) Media has evolved over the last half century from a passive system dominated by a few central opinion makers to the…

  14. Nebraska Speech, Debate, and Drama Manuals.

    ERIC Educational Resources Information Center

    Nebraska School Activities Association, Lincoln.

    Prepared and designed to provide general information in the administration of speech activities in the Nebraska schools, this manual offers rules and regulations for speech events, high school debate, and one act plays. The section on speech events includes information about general regulations, the scope of competition, district contests, the…

  15. "Scientific" Label in Law Stirs Debate

    ERIC Educational Resources Information Center

    Viadero, Debra

    2007-01-01

    This article reports that a quiet debate is unfolding over proposals to tinker with No Child Left Behind Act's (NCLB) definition of what constitutes "scientifically based research" in education while other ideas for revamping it are taking center stage. Sprinkled through the federal education statute more than 100 times, the references…

  16. Voices on Choice: The Education Reform Debate.

    ERIC Educational Resources Information Center

    Billingsley, K. L., Ed.

    This collection presents a sampling of opinions of both proponents and opponents in the school choice debate from a variety of professional perspectives, including academics, bureaucrats, politicians, union leaders, economists, lawyers, parents, and activists. The following essays are included: (1) "School Choice Promotes Educational…

  17. Knowledge of the Debate Critic-Judge.

    ERIC Educational Resources Information Center

    Phillips, Neil

    Arguing that any discussion of debate theory is incomplete without at least some analysis or review of paradigm theory, this paper begins by analogizing the arguments over paradigms to a battle ground over control of the activity. The analysis then shifts to an examination of Thomas Kuhn's sociological theory as a basis for the argument that the…

  18. Latino Male Ethnic Subgroups: Patterns in College Enrollment and Degree Completion

    ERIC Educational Resources Information Center

    Ponjuan, Luis; Palomin, Leticia; Calise, Angela

    2015-01-01

    This chapter examines Latino male ethnic subgroups and their college enrollment and degree completion patterns. The chapter also offers recommendations to improve Latino male ethnic subgroups' educational achievement.

  19. Patterns and Risk Factors of Soil-Transmitted Helminthiasis among Orang Asli Subgroups in Peninsular Malaysia

    PubMed Central

    Ngui, Romano; Aziz, Shafie; Chua, Kek Heng; Aidil, Roslan Muhammad; Lee, Soo Ching; Tan, Tiong Kai; Sani, Mistam Mohd; Arine, Ahmad Fadzlun; Rohela, Mahmud; Lim, Yvonne A. L.

    2015-01-01

    A cross-sectional study was conducted to provide comprehensive data on the patterns and associated risk factors of soil-transmitted helminth (STH) infections among five Orang Asli subgroups in Peninsular Malaysia. The overall prevalence of STH infections was 59.9% (95% confidence interval [CI] = 56.1–63.7%). Trichuris trichiura (54.3%; 95% CI = 50.4–58.2%) was the predominant species followed by Ascaris lumbricoides (26.7%; 95% CI = 23.3–30.1%) and hookworm (9.1%; 95% CI = 6.9–11.3%). This study showed diversity for STH infections by subgroup with poverty and personal sanitary behavior as important risk factors for infection. Risk profile analyses indicating that Orang Kuala subgroup who has a generally well-developed infrastructure and better quality of life had a low rate of infection. There is a need for poverty reduction and promotion of deworming programs along with mass scale campaigns to create awareness about health and hygiene to reduce STH infections. PMID:26055746

  20. Patterns and Risk Factors of Soil-Transmitted Helminthiasis Among Orang Asli Subgroups in Peninsular Malaysia.

    PubMed

    Ngui, Romano; Aziz, Shafie; Chua, Kek Heng; Aidil, Roslan Muhammad; Lee, Soo Ching; Tan, Tiong Kai; Sani, Mistam Mohd; Arine, Ahmad Fadzlun; Rohela, Mahmud; Lim, Yvonne A L

    2015-08-01

    A cross-sectional study was conducted to provide comprehensive data on the patterns and associated risk factors of soil-transmitted helminth (STH) infections among five Orang Asli subgroups in Peninsular Malaysia. The overall prevalence of STH infections was 59.9% (95% confidence interval [CI] = 56.1-63.7%). Trichuris trichiura (54.3%; 95% CI = 50.4-58.2%) was the predominant species followed by Ascaris lumbricoides (26.7%; 95% CI = 23.3-30.1%) and hookworm (9.1%; 95% CI = 6.9-11.3%). This study showed diversity for STH infections by subgroup with poverty and personal sanitary behavior as important risk factors for infection. Risk profile analyses indicating that Orang Kuala subgroup who has a generally well-developed infrastructure and better quality of life had a low rate of infection. There is a need for poverty reduction and promotion of deworming programs along with mass scale campaigns to create awareness about health and hygiene to reduce STH infections. © The American Society of Tropical Medicine and Hygiene.

  1. Controlled human infection models for vaccine development: Zika virus debate.

    PubMed

    Gopichandran, Vijayaprasad

    2018-01-01

    An ethics panel, convened by the National Institute of Health and other research bodies in the USA, disallowed researchers from the Johns Hopkins University and University of Vermont from performing controlled human infection of healthy volunteers to develop a vaccine against Zika virus infection. The members published their ethical analysis and recommendations in February 2017. They have elaborated on the risks posed by human challenge with Zika virus to the volunteers and other uninvolved third parties and have systematically analysed the social value of such a human challenge experiment. They have also posited some mandatory ethical requirements which should be met before allowing the infection of healthy volunteers with the Zika virus. This commentary elaborates on the debate on the ethics of the human challenge model for the development of a Zika virus vaccine and the role of systematic ethical analysis in protecting the interests of research participants. It further analyses the importance of this debate to the development of a Zika vaccine in India.

  2. The Impact of Growth Models on AYP Subgroup Accountability

    ERIC Educational Resources Information Center

    Radmer, Elaine Marie

    2012-01-01

    The No Child Left Behind Act (2001) increased the federal presence in the test-based accountability movement with its goal of all children meeting standard by 2014. To measure progress toward this goal, each state created a series of intermediate goals. Schools or districts that attained the goal for a given year in 9 different subgroups made…

  3. Avian Metapneumovirus Subgroup C Infection in Chickens, China

    PubMed Central

    Wei, Li; Zhu, Shanshan; Yan, Xv; Wang, Jing; Zhang, Chunyan; She, Ruiping; Hu, Fengjiao; Quan, Rong

    2013-01-01

    Avian metapneumovirus causes acute respiratory tract infection and reductions in egg production in various avian species. We isolated and characterized an increasingly prevalent avian metapneumovirus subgroup C strain from meat-type commercial chickens with severe respiratory signs in China. Culling of infected flocks could lead to economic consequences. PMID:23763901

  4. An Improved Qualitative Analysis Procedure for Aluminum Subgroup Cations.

    ERIC Educational Resources Information Center

    Kistner, C. R.; Robinson, Patricia J.

    1983-01-01

    Describes a procedure for the qualitative analysis of aluminum subgroup cations designed to avoid failure to obtain lead or barium chromate precipitates or failure to report aluminum hydroxide when present (due to staining). Provides a flow chart and step-by-step explanation for the new procedure, indicating significantly improved student results.…

  5. Single-Phase Mail Survey Design for Rare Population Subgroups

    ERIC Educational Resources Information Center

    Brick, J. Michael; Andrews, William R.; Mathiowetz, Nancy A.

    2016-01-01

    Although using random digit dialing (RDD) telephone samples was the preferred method for conducting surveys of households for many years, declining response and coverage rates have led researchers to explore alternative approaches. The use of address-based sampling (ABS) has been examined for sampling the general population and subgroups, most…

  6. Subgroup conflicts? Try the psychodramatic "double triad method".

    PubMed

    Verhofstadt-Denève, Leni M F

    2012-04-01

    The present article suggests the application of a psychodramatic action method for tackling subgroup conflicts in which the direct dialogue between representatives of two opposing subgroups is prepared step by step through an indirect dialogue strategy within two triads, a strategy known as the Double Triad Method (DTM). In order to achieve integration in the group as a whole, it is important that all the members of both subgroups participate actively during the entire process. The first part of the article briefly explores the theoretical background, with a special emphasis on the Phenomenological-Dialectical Personality Model (Phe-Di PModel). In the second part, the DTM procedure is systematically described through its five action stages, each accompanied with 1) a spatial representation of the consecutive actions, 2) some illustrative statements for each stage, and 3) a theoretical interpretation of the dialectically involved personality dimensions in both protagonists. The article concludes with a discussion and suggestions for more extensive applications of the DTM method, including the question of its relationships to Agazarian's functional subgrouping, psychodrama, and sociodrama.

  7. Metabolite profiling in retinoblastoma identifies novel clinicopathological subgroups

    PubMed Central

    Kohe, Sarah; Brundler, Marie-Anne; Jenkinson, Helen; Parulekar, Manoj; Wilson, Martin; Peet, Andrew C; McConville, Carmel M

    2015-01-01

    Background: Tumour classification, based on histopathology or molecular pathology, is of value to predict tumour behaviour and to select appropriate treatment. In retinoblastoma, pathology information is not available at diagnosis and only exists for enucleated tumours. Alternative methods of tumour classification, using noninvasive techniques such as magnetic resonance spectroscopy, are urgently required to guide treatment decisions at the time of diagnosis. Methods: High-resolution magic-angle spinning magnetic resonance spectroscopy (HR-MAS MRS) was undertaken on enucleated retinoblastomas. Principal component analysis and cluster analysis of the HR-MAS MRS data was used to identify tumour subgroups. Individual metabolite concentrations were determined and were correlated with histopathological risk factors for each group. Results: Multivariate analysis identified three metabolic subgroups of retinoblastoma, with the most discriminatory metabolites being taurine, hypotaurine, total-choline and creatine. Metabolite concentrations correlated with specific histopathological features: taurine was correlated with differentiation, total-choline and phosphocholine with retrolaminar optic nerve invasion, and total lipids with necrosis. Conclusions: We have demonstrated that a metabolite-based classification of retinoblastoma can be obtained using ex vivo magnetic resonance spectroscopy, and that the subgroups identified correlate with histopathological features. This result justifies future studies to validate the clinical relevance of these subgroups and highlights the potential of in vivo MRS as a noninvasive diagnostic tool for retinoblastoma patient stratification. PMID:26348444

  8. Detection of Problem Gambler Subgroups Using Recursive Partitioning

    ERIC Educational Resources Information Center

    Markham, Francis; Young, Martin; Doran, Bruce

    2013-01-01

    The multivariate socio-demographic risk factors for problem gambling have been well documented. While this body of research is valuable in determining risk factors aggregated across various populations, the majority of studies tend not to specifically identify particular subgroups of problem gamblers based on the interaction between variables. The…

  9. 29 CFR 1912a.13 - Subcommittees and subgroups.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 7 2013-07-01 2013-07-01 false Subcommittees and subgroups. 1912a.13 Section 1912a.13 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) NATIONAL ADVISORY COMMITTEE ON OCCUPATIONAL SAFETY AND HEALTH § 1912a.13...

  10. Active medulloblastoma enhancers reveal subgroup-specific cellular origins

    PubMed Central

    Lin, Charles Y.; Erkek, Serap; Tong, Yiai; Yin, Linlin; Federation, Alexander J.; Zapatka, Marc; Haldipur, Parthiv; Kawauchi, Daisuke; Risch, Thomas; Warnatz, Hans-Jörg; Worst, Barbara C.; Ju, Bensheng; Orr, Brent A.; Zeid, Rhamy; Polaski, Donald R.; Segura-Wang, Maia; Waszak, Sebastian M.; Jones, David T.W.; Kool, Marcel; Hovestadt, Volker; Buchhalter, Ivo; Sieber, Laura; Johann, Pascal; Chavez, Lukas; Gröschel, Stefan; Ryzhova, Marina; Korshunov, Andrey; Chen, Wenbiao; Chizhikov, Victor V.; Millen, Kathleen J.; Amstislavskiy, Vyacheslav; Lehrach, Hans; Yaspo, Marie-Laure; Eils, Roland; Lichter, Peter; Korbel, Jan O.; Pfister, Stefan M.; Bradner, James E.; Northcott, Paul A.

    2016-01-01

    Summary Medulloblastoma is a highly malignant paediatric brain tumour, often inflicting devastating consequences on the developing child. Genomic studies have revealed four distinct molecular subgroups with divergent biology and clinical behaviour. An understanding of the regulatory circuitry governing the transcriptional landscapes of medulloblastoma subgroups, and how this relates to their respective developmental origins, is lacking. Using H3K27ac and BRD4 ChIP-Seq, coupled with tissue-matched DNA methylation and transcriptome data, we describe the active cis-regulatory landscape across 28 primary medulloblastoma specimens. Analysis of differentially regulated enhancers and super-enhancers reinforced inter-subgroup heterogeneity and revealed novel, clinically relevant insights into medulloblastoma biology. Computational reconstruction of core regulatory circuitry identified a master set of transcription factors, validated by ChIP-Seq, that are responsible for subgroup divergence and implicate candidate cells-of-origin for Group 4. Our integrated analysis of enhancer elements in a large series of primary tumour samples reveals insights into cis-regulatory architecture, unrecognized dependencies, and cellular origins. PMID:26814967

  11. 29 CFR 1912a.13 - Subcommittees and subgroups.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 7 2010-07-01 2010-07-01 false Subcommittees and subgroups. 1912a.13 Section 1912a.13 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) NATIONAL ADVISORY COMMITTEE ON OCCUPATIONAL SAFETY AND HEALTH § 1912a.13...

  12. Debating Values: Key Issues in Formatting an Argumentative Case.

    ERIC Educational Resources Information Center

    Scott, David K.

    This paper analyzes the components of an "ideal" debate using a non-policy proposition. It is argued that debates using non-policy propositions are currently plagued by a variety of problems. Value propositions on the college level are dissimilar to the value propositions used in high school Lincoln-Douglas debate. Many debaters are…

  13. Is Dance a Sport?: A Twenty-First-Century Debate

    ERIC Educational Resources Information Center

    Guarino, Lindsay

    2015-01-01

    This article discusses a new debate which has emerged for dancers. For many years dancers debated dance as art versus entertainment. This age-old debate still exists without a consensus, yet there is suddenly a new generation of dancers with a fresh debate. Legions of young performers are fervently proclaiming that their dance is actually a sport.…

  14. Reaching Out: Extending the Argument about Debate Outreach.

    ERIC Educational Resources Information Center

    Grassmick, David; Clinton, Pamela A.

    A. C. Snider has suggested that CEDA (Cross Examination Debate Association) should create an outreach program to connect CEDA debate programs with the high school policy debate community. Most debate educators would laud programs that promise to train more students in argumentation, but a pilot program shows that an outreach program does not…

  15. Prevalence of Psychiatric Comorbidity in Symptomatic Gastroesophageal Reflux Subgroups.

    PubMed

    Bilgi, Mustafa Melih; Vardar, Rukiye; Yıldırım, Esra; Veznedaroğlu, Baybars; Bor, Serhat

    2017-04-01

    Limited data exist regarding the psychosocial aspects of gastroesophageal reflux disease (GERD). Some GERD subgroups, such as functional heartburn and hypersensitive esophagus, might show different psychiatric comorbidities than others. We aimed to evaluate the psychiatric comorbidities of GERD subgroups using a cross-sectional design. A group of GERD patients at a tertiary outpatient clinic were evaluated via upper GIS (gastrointestinal system) endoscopy, esophageal manometry, and 24-h impedance-pH monitoring. Thirty-nine patients diagnosed with erosive reflux disease, 44 with non-erosive reflux disease, 20 with functional heartburn, 11 with hypersensitive esophagus, and 44 healthy controls participated. Psychiatric diagnoses were made using the Structured Clinical Interview for Diagnostics and Statistical Manual of Mental Disorders IV. Psychometric measurements of the patients were performed using the Somatosensory Amplification Scale, Beck Depression Inventory, State-Trait Anxiety Inventory, and Short-Form 36. Healthy controls were evaluated with the same psychometric scales except for the Short-Form 36. All of the GERD subgroups were significantly more depressed than the control group. Depressive disorders were significantly more prevalent in the functional heartburn group than in the non-erosive reflux disease and erosive reflux disease groups. The trait anxiety level of the functional heartburn group was significantly higher than those of the control and non-erosive reflux disease groups. The quality of life scores of the GERD subgroups were significantly lower than the population standards. Depressive disorders were frequently comorbid in the GERD subgroups studied (30-65 %). It is essential to consider the high prevalence rates of comorbid depression when managing GERD.

  16. Cluster Analysis of Clinical Data Identifies Fibromyalgia Subgroups

    PubMed Central

    Docampo, Elisa; Collado, Antonio; Escaramís, Geòrgia; Carbonell, Jordi; Rivera, Javier; Vidal, Javier; Alegre, José

    2013-01-01

    Introduction Fibromyalgia (FM) is mainly characterized by widespread pain and multiple accompanying symptoms, which hinder FM assessment and management. In order to reduce FM heterogeneity we classified clinical data into simplified dimensions that were used to define FM subgroups. Material and Methods 48 variables were evaluated in 1,446 Spanish FM cases fulfilling 1990 ACR FM criteria. A partitioning analysis was performed to find groups of variables similar to each other. Similarities between variables were identified and the variables were grouped into dimensions. This was performed in a subset of 559 patients, and cross-validated in the remaining 887 patients. For each sample and dimension, a composite index was obtained based on the weights of the variables included in the dimension. Finally, a clustering procedure was applied to the indexes, resulting in FM subgroups. Results Variables clustered into three independent dimensions: “symptomatology”, “comorbidities” and “clinical scales”. Only the two first dimensions were considered for the construction of FM subgroups. Resulting scores classified FM samples into three subgroups: low symptomatology and comorbidities (Cluster 1), high symptomatology and comorbidities (Cluster 2), and high symptomatology but low comorbidities (Cluster 3), showing differences in measures of disease severity. Conclusions We have identified three subgroups of FM samples in a large cohort of FM by clustering clinical data. Our analysis stresses the importance of family and personal history of FM comorbidities. Also, the resulting patient clusters could indicate different forms of the disease, relevant to future research, and might have an impact on clinical assessment. PMID:24098674

  17. Differences in Psychosocial Predictors of Obesity Among LGBT Subgroups.

    PubMed

    Warren, Jacob C; Smalley, K Bryant; Barefoot, K Nikki

    2016-08-01

    The purpose of the current study was to examine the overall presence of and differences in rates of overweight/obesity among a large, nationally diverse sample of lesbian, gay, bisexual, transgender (LGBT)-identified individuals (i.e., cisgender lesbians, cisgender gay men, cisgender bisexual women, cisgender bisexual men, transgender women, and transgender men) and to identify specific psychosocial predictors of obesity within each of the six LGBT subgroups. A total of 2702 LGBT-identified participants participated in the online study. Participants completed a series of demographic questions (including weight and height) and the Depression Anxiety Stress Scale 21. The percentage of participants who were overweight/obese did not differ significantly across LGBT subgroups, with 61.1% of the total sample being overweight/obese. However, the percentage of participants who self-reported body mass indexes in the obese range differed significantly across the six LGBT subgroups, with the highest prevalence in transgender men (46.0%). In addition, the predictors of obesity varied by subgroup, with age a significant predictor for cisgender lesbians, cisgender gay men, and cisgender bisexual women, relationship status for cisgender bisexual women, employment status for both cisgender gay men and cisgender bisexual women, education level for cisgender lesbians, and depression, anxiety, and stress for cisgender gay men. None of the examined psychosocial factors emerged as predictors of obesity for cisgender bisexual men, transgender women, or transgender men. These findings suggest that there are substantial variations in the presence and predictors of obesity across LGBT subgroups that support the need for culturally tailored healthy weight promotion efforts within the LGBT community.

  18. Going flat: examining heterogeneity in the soda-obesity relationship by subgroup and place of birth among Asian Americans.

    PubMed

    Alcalá, Héctor E; Sharif, Mienah Z

    2017-06-01

    To determine if the association between soda consumption and obesity is uniform among Asian-American population subgroups. We conducted multivariate logistic regression analyses on odds of being obese among seven Asian subgroups and by place of birth using data from the 2009 California Health Interview Survey. An omnibus population-based health survey. Non-institutionalized adults, aged 18 years or over, residing in California (n 36 271). Despite low levels of soda consumption in several Asian-American ethnic groups, soda consumption increased the odds of being obese among Chinese, Koreans and Other Asians but not for Whites. Obesity risk varied across Asian subgroups and by place of birth within these subgroups. More public health efforts addressing soda consumption in Asian-American communities are needed as a strategy for not only preventing chronic diseases but also disparities, considering the varying levels of soda intake across subgroups. Results support the growing body of literature critiquing acculturation theory in immigrant health research by documenting inconsistent findings by place of birth. Future research should take into account the heterogeneity among Asian Americans to advance our understanding of health outcomes and disparities.

  19. Going flat: examining heterogeneity in the soda–obesity relationship by subgroup and place of birth among Asian Americans

    PubMed Central

    Alcalá, Héctor E; Sharif, Mienah Z

    2018-01-01

    Objective To determine if the association between soda consumption and obesity is uniform among Asian-American population subgroups. Design We conducted multivariate logistic regression analyses on odds of being obese among seven Asian subgroups and by place of birth using data from the 2009 California Health Interview Survey. Setting An omnibus population-based health survey. Subjects Non-institutionalized adults, aged 18 years or over, residing in California (n 36 271). Results Despite low levels of soda consumption in several Asian-American ethnic groups, soda consumption increased the odds of being obese among Chinese, Koreans and Other Asians but not for Whites. Obesity risk varied across Asian subgroups and by place of birth within these subgroups. Conclusions More public health efforts addressing soda consumption in Asian-American communities are needed as a strategy for not only preventing chronic diseases but also disparities, considering the varying levels of soda intake across subgroups. Results support the growing body of literature critiquing acculturation theory in immigrant health research by documenting inconsistent findings by place of birth. Future research should take into account the heterogeneity among Asian Americans to advance our understanding of health outcomes and disparities. PMID:28233506

  20. The effect of active video games by ethnicity, sex and fitness: subgroup analysis from a randomised controlled trial.

    PubMed

    Foley, Louise; Jiang, Yannan; Ni Mhurchu, Cliona; Jull, Andrew; Prapavessis, Harry; Rodgers, Anthony; Maddison, Ralph

    2014-04-03

    The prevention and treatment of childhood obesity is a key public health challenge. However, certain groups within populations have markedly different risk profiles for obesity and related health behaviours. Well-designed subgroup analysis can identify potential differential effects of obesity interventions, which may be important for reducing health inequalities. The study aim was to evaluate the consistency of the effects of active video games across important subgroups in a randomised controlled trial (RCT). A two-arm, parallel RCT was conducted in overweight or obese children (n=322; aged 10-14 years) to determine the effect of active video games on body composition. Statistically significant overall treatment effects favouring the intervention group were found for body mass index, body mass index z-score and percentage body fat at 24 weeks. For these outcomes, pre-specified subgroup analyses were conducted among important baseline demographic (ethnicity, sex) and prognostic (cardiovascular fitness) groups. No statistically significant interaction effects were found between the treatment and subgroup terms in the main regression model (p=0.36 to 0.93), indicating a consistent treatment effect across these groups. Preliminary evidence suggests an active video games intervention had a consistent positive effect on body composition among important subgroups. This may support the use of these games as a pragmatic public health intervention to displace sedentary behaviour with physical activity in young people.

  1. Psychopathy and Personality: Advances and Debates.

    PubMed

    Miller, Joshua D; Lynam, Donald R

    2015-12-01

    Nine original articles comprise this special issue of the Journal of Personality addressing personality-based perspectives of psychopathy. In this introduction to the special issue, we review five advances and areas of agreement that are highlighted across the articles, including the utility of trait perspectives to psychopathy, the emergence of a prototypical trait profile of psychopathy, the importance of recognizing earlier developmental manifestations of psychopathy, the ongoing study and revelation of the basic neural underpinnings of psychopathy, and the important theoretical and empirical association between psychopathy and antisocial behavior. At the same time, several important debates remain, which are also highlighted in the special issue's articles. These debates center around the necessity and sufficiency of certain psychopathy traits, the role of traits alternatively labeled stable Extraversion, fearless dominance, or boldness, and the validity and utility of separating psychopathy from Machiavellianism as is done in research on the Dark Triad. © 2014 Wiley Periodicals, Inc.

  2. NORMAL HUMAN VARIATION: REFOCUSSING THE ENHANCEMENT DEBATE

    PubMed Central

    Kahane, Guy; Savulescu, Julian

    2015-01-01

    This article draws attention to several common mistakes in thinking about biomedical enhancement, mistakes that are made even by some supporters of enhancement. We illustrate these mistakes by examining objections that John Harris has recently raised against the use of pharmacological interventions to directly modulate moral decision-making. We then apply these lessons to other influential figures in the debate about enhancement. One upshot of our argument is that many considerations presented as powerful objections to enhancement are really strong considerations in favour of biomedical enhancement, just in a different direction. Another upshot is that it is unfortunate that much of the current debate focuses on interventions that will radically transform normal human capacities. Such interventions are unlikely to be available in the near future, and may not even be feasible. But our argument shows that the enhancement project can still have a radical impact on human life even if biomedical enhancement operated entirely within the normal human range. PMID:23906367

  3. Moving research beyond the spanking debate.

    PubMed

    MacMillan, Harriet L; Mikton, Christopher R

    2017-09-01

    Despite numerous studies identifying a broad range of harms associated with the use of spanking and other types of physical punishment, debate continues about its use as a form of discipline. In this commentary, we recommend four strategies to move the field forward and beyond the spanking debate including: 1) use of methodological approaches that allow for stronger causal inference; 2) consideration of human rights issues; 3) a focus on understanding the causes of spanking and reasons for its decline in certain countries; and 4) more emphasis on evidence-based approaches to changing social norms to reject spanking as a form of discipline. Physical punishment needs to be recognized as an important public health problem. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. Using guided debates to teach current issues.

    PubMed

    Hanna, Debra R

    2014-06-01

    A guided-debate strategy was developed for a graduate-level core course in current issues based on the Jesuit method of discernment (group decision making). The strategy encourages students to use up-to-date Internet sources to determine the range of opinions on current controversies in the discipline. In addition to providing a structured process to engage in persuasive discussion of difficult issues, the strategy facilitates critical thinking about the quality of the debate itself. Thus, students learn to avoid the pitfalls associated with consensus, such as failing to express reservations or negative opinions that might be important, while learning how to express concerns that might not be easily received by others in a group. Copyright 2014, SLACK Incorporated.

  5. Patenting human genetic material: refocusing the debate

    PubMed Central

    Caulfield, Timothy; Gold, E. Richard; Cho, Mildred K.

    2008-01-01

    The biotechnology industry has become firmly established over the past twenty years and gene patents have played an important part in this phenomenon. However, concerns have been raised over the patentability of human genetic material, through public protests and international statements, but to little effect. Here we discuss some of these concerns, the patent authorities’ response to them, and ways in which to address these issues and to move the debate forward using current legal structures. PMID:11252752

  6. The New U.S. Strategic Debate

    DTIC Science & Technology

    1994-01-01

    place a burgeoning debate is emerging about the nature of the post-Cold War world and the de- sired American role in it. Against this background...be read as a contribution to a better understanding of these factors. This study was produced as part of the "Beyond Containment: U.S. National...Chapter Two RETHINKING STRATEGY: THE NATURE OF THE GAME AND U.S. INTERESTS ............................ 5 Chapter Three THE NEW POLITICAL

  7. Distinctive ribonucleic acid patterns of human rotavirus subgroups 1 and 2.

    PubMed Central

    Kalica, A R; Greenberg, H B; Espejo, R T; Flores, J; Wyatt, R G; Kapikian, A Z; Chanock, R M

    1981-01-01

    The ribonucleic acid migration patterns of 7 subgroup 1 and 16 subgroup 2 human rotaviruses recovered from four geographic areas were compared. The subgroup 1 ribonucleic acid patterns had strikingly slower-moving segments 10 and 11, suggesting a correlation between the ribonucleic acid pattern and the subgroup specificity. Images PMID:6270002

  8. Combined group ECC protection and subgroup parity protection

    SciTech Connect

    Gara, Alan; Cheng, Dong; Heidelberger, Philip

    A method and system are disclosed for providing combined error code protection and subgroup parity protection for a given group of n bits. The method comprises the steps of identifying a number, m, of redundant bits for said error protection; and constructing a matrix P, wherein multiplying said given group of n bits with P produces m redundant error correction code (ECC) protection bits, and two columns of P provide parity protection for subgroups of said given group of n bits. In the preferred embodiment of the invention, the matrix P is constructed by generating permutations of m bit widemore » vectors with three or more, but an odd number of, elements with value one and the other elements with value zero; and assigning said vectors to rows of the matrix P.« less

  9. Combined group ECC protection and subgroup parity protection

    DOEpatents

    Gara, Alan G.; Chen, Dong; Heidelberger, Philip; Ohmacht, Martin

    2013-06-18

    A method and system are disclosed for providing combined error code protection and subgroup parity protection for a given group of n bits. The method comprises the steps of identifying a number, m, of redundant bits for said error protection; and constructing a matrix P, wherein multiplying said given group of n bits with P produces m redundant error correction code (ECC) protection bits, and two columns of P provide parity protection for subgroups of said given group of n bits. In the preferred embodiment of the invention, the matrix P is constructed by generating permutations of m bit wide vectors with three or more, but an odd number of, elements with value one and the other elements with value zero; and assigning said vectors to rows of the matrix P.

  10. Fast determination of structurally cohesive subgroups in large networks

    PubMed Central

    Sinkovits, Robert S.; Moody, James; Oztan, B. Tolga; White, Douglas R.

    2016-01-01

    Structurally cohesive subgroups are a powerful and mathematically rigorous way to characterize network robustness. Their strength lies in the ability to detect strong connections among vertices that not only have no neighbors in common, but that may be distantly separated in the graph. Unfortunately, identifying cohesive subgroups is a computationally intensive problem, which has limited empirical assessments of cohesion to relatively small graphs of at most a few thousand vertices. We describe here an approach that exploits the properties of cliques, k-cores and vertex separators to iteratively reduce the complexity of the graph to the point where standard algorithms can be used to complete the analysis. As a proof of principle, we apply our method to the cohesion analysis of a 29,462-vertex biconnected component extracted from a 128,151-vertex co-authorship data set. PMID:28503215

  11. Pathophysiology and immunological profile of myasthenia gravis and its subgroups.

    PubMed

    Romi, Fredrik; Hong, Yu; Gilhus, Nils Erik

    2017-12-01

    Myasthenia gravis (MG) is an autoimmune antibody-mediated disease characterized by muscle weakness and fatigability. It is believed that the initial steps triggering humoral immunity in MG take place inside thymic tissue and thymoma. The immune response against one or several epitopes expressed on thymic tissue cells spills over to neuromuscular junction components sharing the same epitope causing humoral autoimmunity and antibody production. The main cause of MG is acetylcholine receptor antibodies. However, many other neuromuscular junction membrane protein targets, intracellular and extracellular proteins are suggested to participate in MG pathophysiology. MG should be divided into subgroups based on clinical presentation and immunology. This includes onset age, clinical characteristics, thymic pathology and antibody profile. The immunological profile of these subgroups is determined by the antibodies present. Copyright © 2017. Published by Elsevier Ltd.

  12. Distinguishing between Subgroups of Adolescents Who Self-Harm

    ERIC Educational Resources Information Center

    Hargus, Emily; Hawton, Keith; Rodham, Karen

    2009-01-01

    The differences in factors associated with subgroups of adolescents in the continuum of deliberate self-harm (DSH) phenomena were investigated. In an anonymous self-report survey of 6,020 adolescents aged 15 and 16 years, 3.2% of adolescents (5.3% females, 1.3% males) reported DSH with intent to die, 2.8% (4.3% females; 1.5% males) reported DSH…

  13. Measuring the Speed of Aging across Population Subgroups

    PubMed Central

    2014-01-01

    People in different subgroups age at different rates. Surveys containing biomarkers can be used to assess these subgroup differences. We illustrate this using hand-grip strength to produce an easily interpretable, physical-based measure that allows us to compare characteristic-based ages across educational subgroups in the United States. Hand-grip strength has been shown to be a good predictor of future mortality and morbidity, and therefore a useful indicator of population aging. Data from the Health and Retirement Survey (HRS) were used. Two education subgroups were distinguished, those with less than a high school diploma and those with more education. Regressions on hand-grip strength were run for each sex and race using age and education, their interactions and other covariates as independent variables. Ages of identical mean hand-grip strength across education groups were compared for people in the age range 60 to 80. The hand-grip strength of 65 year old white males with less education was the equivalent to that of 69.6 (68.2, 70.9) year old white men with more education, indicating that the more educated men had aged more slowly. This is a constant characteristic age, as defined in the Sanderson and Scherbov article “The characteristics approach to the measurement of population aging” published 2013 in Population and Development Review. Sixty-five year old white females with less education had the same average hand-grip strength as 69.4 (68.2, 70.7) year old white women with more education. African-American women at ages 60 and 65 with more education also aged more slowly than their less educated counterparts. African American men with more education aged at about the same rate as those with less education. This paper expands the toolkit of those interested in population aging by showing how survey data can be used to measure the differential extent of aging across subpopulations. PMID:24806337

  14. Differences in pain, function and coping in Multidimensional Pain Inventory subgroups of chronic back pain: a one-group pretest-posttest study.

    PubMed

    Verra, Martin L; Angst, Felix; Staal, J Bart; Brioschi, Roberto; Lehmann, Susanne; Aeschlimann, André; de Bie, Rob A

    2011-06-30

    Patients with non-specific back pain are not a homogeneous group but heterogeneous with regard to their bio-psycho-social impairments. This study examined a sample of 173 highly disabled patients with chronic back pain to find out how the three subgroups based on the Multidimensional Pain Inventory (MPI) differed in their response to an inpatient pain management program. Subgroup classification was conducted by cluster analysis using MPI subscale scores at entry into the program. At program entry and at discharge after four weeks, participants completed the MPI, the MOS Short Form-36 (SF-36), the Hospital Anxiety and Depression Scale (HADS), and the Coping Strategies Questionnaire (CSQ). Pairwise analyses of the score changes of the mentioned outcomes of the three MPI subgroups were performed using the Mann-Whitney-U-test for significance. Cluster analysis identified three MPI subgroups in this highly disabled sample: a dysfunctional, interpersonally distressed and an adaptive copers subgroup. The dysfunctional subgroup (29% of the sample) showed the highest level of depression in SF-36 mental health (33.4 ± 13.9), the interpersonally distressed subgroup (35% of the sample) a modest level of depression (46.8 ± 20.4), and the adaptive copers subgroup (32% of the sample) the lowest level of depression (57.8 ± 19.1). Significant differences in pain reduction and improvement of mental health and coping were observed across the three MPI subgroups, i.e. the effect sizes for MPI pain reduction were: 0.84 (0.44-1.24) for the dysfunctional subgroup, 1.22 (0.86-1.58) for the adaptive copers subgroup, and 0.53 (0.24-0.81) for the interpersonally distressed subgroup (p = 0.006 for pairwise comparison). Significant score changes between subgroups concerning activities and physical functioning could not be identified. MPI subgroup classification showed significant differences in score changes for pain, mental health and coping. These findings underscore the importance of

  15. Polarization of the vaccination debate on Facebook.

    PubMed

    Schmidt, Ana Lucía; Zollo, Fabiana; Scala, Antonio; Betsch, Cornelia; Quattrociocchi, Walter

    2018-06-14

    Vaccine hesitancy has been recognized as a major global health threat. Having access to any type of information in social media has been suggested as a potential influence on the growth of anti-vaccination groups. Recent studies w.r.t. other topics than vaccination show that access to a wide amount of content through the Internet without intermediaries resolved into major segregation of the users in polarized groups. Users select information adhering to theirs system of beliefs and tend to ignore dissenting information. The goal was to assess whether users' attitudes are polarized on the topic of vaccination on Facebook and how this polarization develops over time. We perform a thorough quantitative analysis by studying the interaction of 2.6 M users with 298,018 Facebook posts over a time span of seven years and 5 months. We applied community detection algorithms to automatically detect the emergence of communities accounting for the users' activity on the pages. Also, we quantified the cohesiveness of these communities over time. Our findings show that the consumption of content about vaccines is dominated by the echo chamber effect and that polarization increased over the years. Well-segregated communities emerge from the users' consumption habits i.e., the majority of users consume information in favor or against vaccines, not both. The existence of echo chambers may explain why social-media campaigns that provide accurate information have limited reach and be effective only in sub-groups, even fomenting further opinion polarization. The introduction of dissenting information into a sub-group is disregarded and can produce a backfire effect, thus reinforcing the pre-existing opinions within the sub-group. Public health professionals should try to understand the contents of these echo chambers, for example by getting passively involved in such groups. Only then it will be possible to find effective ways of countering anti-vaccination thinking. Copyright

  16. Association between Obesity and Cardiometabolic Health Risk in Asian-Canadian Sub-Groups

    PubMed Central

    Nie, Jason X.; Ardern, Chris I.

    2014-01-01

    Objectives To quantify and compare the association between the World Health Organizations’ Asian-specific trigger points for public health action [‘increased risk’: body mass index (BMI) ≥23 kg/m2, and; ‘high risk’: BMI ≥27.5 kg/m2] with self-reported cardiovascular-related conditions in Asian-Canadian sub-groups. Methods Six cycles of the Canadian Community Health Survey (2001–2009) were pooled to examine BMI and health in Asian sub-groups (South Asians, Chinese, Filipino, Southeast Asians, Arabs, West Asians, Japanese and Korean; N = 18 794 participants, ages 18–64 y). Multivariable logistic regression, adjusting for demographic, lifestyle characteristics and acculturation measures, was used to estimate the odds of cardiovascular-related health (high blood pressure, heart disease, diabetes, ‘at least one cardiometabolic condition’) outcomes across all eight Asian sub-groups. Results Compared to South Asians (OR = 1.00), Filipinos had higher odds of having ‘at least one cardiometabolic condition’ (OR = 1.29, 95% CI: 1.04–1.62), whereas Chinese (0.63, 0.474–0.9) and Arab-Canadians had lower odds (0.38, 0.28–0.51). In ethnic-specific analyses (with ‘acceptable’ risk weight as the referent), ‘increased’ and ‘high’ risk weight categories were the most highly associated with ‘at least one cardiometabolic condition’ in Chinese (‘increased’: 3.6, 2.34–5.63; ‘high’: 8.9, 3.6–22.01). Compared to normal weight South Asians, being in the ‘high’ risk weight category in all but the Southeast Asian, Arab, and Japanese ethnic groups was associated with approximately 3-times the likelihood of having ‘at least one cardiometabolic condition’. Conclusion Differences in the association between obesity and cardiometabolic health risks were seen among Asian sub-groups in Canada. The use of WHO’s lowered Asian-specific BMI cut-offs identified obesity-related risks in South Asian, Filipino and Chinese sub-groups

  17. Association between obesity and cardiometabolic health risk in Asian-Canadian sub-groups.

    PubMed

    Nie, Jason X; Ardern, Chris I

    2014-01-01

    To quantify and compare the association between the World Health Organizations' Asian-specific trigger points for public health action ['increased risk': body mass index (BMI) ≥23 kg/m2, and; 'high risk': BMI ≥27.5 kg/m2] with self-reported cardiovascular-related conditions in Asian-Canadian sub-groups. Six cycles of the Canadian Community Health Survey (2001-2009) were pooled to examine BMI and health in Asian sub-groups (South Asians, Chinese, Filipino, Southeast Asians, Arabs, West Asians, Japanese and Korean; N = 18 794 participants, ages 18-64 y). Multivariable logistic regression, adjusting for demographic, lifestyle characteristics and acculturation measures, was used to estimate the odds of cardiovascular-related health (high blood pressure, heart disease, diabetes, 'at least one cardiometabolic condition') outcomes across all eight Asian sub-groups. Compared to South Asians (OR = 1.00), Filipinos had higher odds of having 'at least one cardiometabolic condition' (OR = 1.29, 95% CI: 1.04-1.62), whereas Chinese (0.63, 0.474-0.9) and Arab-Canadians had lower odds (0.38, 0.28-0.51). In ethnic-specific analyses (with 'acceptable' risk weight as the referent), 'increased' and 'high' risk weight categories were the most highly associated with 'at least one cardiometabolic condition' in Chinese ('increased': 3.6, 2.34-5.63; 'high': 8.9, 3.6-22.01). Compared to normal weight South Asians, being in the 'high' risk weight category in all but the Southeast Asian, Arab, and Japanese ethnic groups was associated with approximately 3-times the likelihood of having 'at least one cardiometabolic condition'. Differences in the association between obesity and cardiometabolic health risks were seen among Asian sub-groups in Canada. The use of WHO's lowered Asian-specific BMI cut-offs identified obesity-related risks in South Asian, Filipino and Chinese sub-groups that would have been masked by traditional BMI categories. These findings have implications for

  18. Informant discrepancy defines discrete, clinically useful autism spectrum disorder subgroups.

    PubMed

    Lerner, Matthew D; De Los Reyes, Andres; Drabick, Deborah A G; Gerber, Alan H; Gadow, Kenneth D

    2017-07-01

    Discrepancy between informants (parents and teachers) in severity ratings of core symptoms commonly arise when assessing autism spectrum disorder (ASD). Whether such discrepancy yields unique information about the ASD phenotype and its clinical correlates has not been examined. We examined whether degree of discrepancy between parent and teacher ASD symptom ratings defines discrete, clinically meaningful subgroups of youth with ASD using an efficient, cost-effective procedure. Children with ASD (N = 283; 82% boys; M age  = 10.5 years) were drawn from a specialty ASD clinic. Parents and teachers provided ratings of the three core DSM-IV-TR domains of ASD symptoms (communication, social, and perseverative behavior) with the Child and Adolescent Symptom Inventory-4R (CASI-4R). External validators included child psychotropic medication status, frequency of ASD-relevant school-based services, and the Autism Diagnostic Observation Schedule (ADOS-2). Four distinct subgroups emerged that ranged from large between-informant discrepancy (informant-specific) to relative lack of discrepancy (i.e. informant agreement; cross-situational): Moderate Parent/Low Teacher or Low Parent/Moderate Teacher Severity (Discrepancy), and Moderate or High Symptom Severity (Agreement). Subgroups were highly distinct (mean probability of group assignment = 94%). Relative to Discrepancy subgroups, Agreement subgroups were more likely to receive psychotropic medication, school-based special education services, and an ADOS-2 diagnosis. These differential associations would not have been identified based solely on CASI-4R scores from one informant. The degree of parent-teacher discrepancy about ASD symptom severity appears to provide more clinically useful information than reliance on a specific symptom domain or informant, and thus yields an innovative, cost-effective approach to assessing functional impairment. This conclusion stands in contrast to existing symptom clustering approaches in

  19. HTLV-1 subgroups associated with the risk of HAM/TSP are related to viral and host gene expression in peripheral blood mononuclear cells, independent of the transactivation functions of the viral factors.

    PubMed

    Yasuma, Keiko; Matsuzaki, Toshio; Yamano, Yoshihisa; Takashima, Hiroshi; Matsuoka, Masao; Saito, Mineki

    2016-08-01

    Among human T cell leukemia virus type 1 (HTLV-1)-infected individuals, the risk of developing HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) across lifetime differs between ethnic groups. There is an association between HTLV-1 tax gene subgroups (subgroup-A or subgroup-B) and the risk of HAM/TSP in the Japanese population. In this study, we investigated the full-length proviral genome sequences of various HTLV-1-infected cell lines and patient samples. The functional differences in the viral transcriptional regulators Tax and HTLV-1 bZIP factor (HBZ) between each subgroup and the relationships between subgroups and the clinical and laboratory characteristics of HAM/TSP patients were evaluated. The results of these analyses indicated the following: (1) distinct nucleotide substitutions corresponding to each subgroup were associated with nucleotide substitutions in viral structural, regulatory, and accessory genes; (2) the HBZ messenger RNA (mRNA) expression in HTLV-1-infected cells was significantly higher in HAM/TSP patients with subgroup-B than in those with subgroup-A; (3) a positive correlation was observed between the expression of HBZ mRNA and its target Foxp3 mRNA in HAM/TSP patients with subgroup-B, but not in patients with subgroup-A; (4) no clear differences were noted in clinical and laboratory characteristics between HAM/TSP patients with subgroup-A and subgroup-B; and (5) no functional differences were observed in Tax and HBZ between each subgroup based on reporter gene assays. Our results indicate that although different HTLV-1 subgroups are characterized by different patterns of viral and host gene expression in HAM/TSP patients via independent mechanisms of direct transcriptional regulation, these differences do not significantly affect the clinical and laboratory characteristics of HAM/TSP patients.

  20. The Language of the Right: Sex Education Debates in South Australia

    ERIC Educational Resources Information Center

    Gibson, Sally

    2007-01-01

    In 2003 a campaign took place against a new model of sex education in South Australia. This campaign, organized primarily by Christian Right groups, included community forums, a letter-writing campaign, extensive media coverage and a parliamentary debate. This paper analyses the language, arguments and strategies used by those who opposed the…

  1. Fecal metagenomic profiles in subgroups of patients with myalgic encephalomyelitis/chronic fatigue syndrome.

    PubMed

    Nagy-Szakal, Dorottya; Williams, Brent L; Mishra, Nischay; Che, Xiaoyu; Lee, Bohyun; Bateman, Lucinda; Klimas, Nancy G; Komaroff, Anthony L; Levine, Susan; Montoya, Jose G; Peterson, Daniel L; Ramanan, Devi; Jain, Komal; Eddy, Meredith L; Hornig, Mady; Lipkin, W Ian

    2017-04-26

    Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is characterized by unexplained persistent fatigue, commonly accompanied by cognitive dysfunction, sleeping disturbances, orthostatic intolerance, fever, lymphadenopathy, and irritable bowel syndrome (IBS). The extent to which the gastrointestinal microbiome and peripheral inflammation are associated with ME/CFS remains unclear. We pursued rigorous clinical characterization, fecal bacterial metagenomics, and plasma immune molecule analyses in 50 ME/CFS patients and 50 healthy controls frequency-matched for age, sex, race/ethnicity, geographic site, and season of sampling. Topological analysis revealed associations between IBS co-morbidity, body mass index, fecal bacterial composition, and bacterial metabolic pathways but not plasma immune molecules. IBS co-morbidity was the strongest driving factor in the separation of topological networks based on bacterial profiles and metabolic pathways. Predictive selection models based on bacterial profiles supported findings from topological analyses indicating that ME/CFS subgroups, defined by IBS status, could be distinguished from control subjects with high predictive accuracy. Bacterial taxa predictive of ME/CFS patients with IBS were distinct from taxa associated with ME/CFS patients without IBS. Increased abundance of unclassified Alistipes and decreased Faecalibacterium emerged as the top biomarkers of ME/CFS with IBS; while increased unclassified Bacteroides abundance and decreased Bacteroides vulgatus were the top biomarkers of ME/CFS without IBS. Despite findings of differences in bacterial taxa and metabolic pathways defining ME/CFS subgroups, decreased metabolic pathways associated with unsaturated fatty acid biosynthesis and increased atrazine degradation pathways were independent of IBS co-morbidity. Increased vitamin B6 biosynthesis/salvage and pyrimidine ribonucleoside degradation were the top metabolic pathways in ME/CFS without IBS as well as in the

  2. The debate over diagnosis related groups.

    PubMed

    Spiegel, A D; Kavaler, F

    1985-01-01

    With the advent of the Prospective Payment System (PPS) using Diagnosis Related Groups (DRGs) as a classification method, the pros and cons of that mechanism have been sharply debated. Grouping the comments into categories related to administration/management, DRG system and quality of care, a review of relevant literature highlights the pertinent attitudes and views of professionals and organizations. Points constantly argued include data utilization, meaningful medical classifications, resource use, gaming, profit centers, patient homogeneity, severity of illness, length of stay, technology limitations and the erosion of standards.

  3. Great debate probes Pluto's planetary credentials

    NASA Astrophysics Data System (ADS)

    Gwynne, Peter

    2008-09-01

    It had all the trappings of an Olympic boxing final: two fiery competitors, a partisan crowd and the attention of the global press. But no individual gold medalist emerged from the Great Planet Debate held last month in Baltimore to discuss what type of astronomical object Pluto really is. Rather, the contest between Neil de-Grasse Tyson, director of New York's Hayden Planetarium, and Mark Sykes of the University of Arizona's Planetary Science Institute provided a view of how science deals with controversial issues of definition.

  4. Debating Organ Procurement Policy Without Illusions.

    PubMed

    Hippen, Benjamin

    2015-10-01

    In this perspective, I review and critique claims that the transplant waiting list overstates the demand for kidneys and correct a few mischaracterizations of some structural barriers to increasing rates of transplantation. The solutions to the shortage of organs proffered by opponents of financial incentives fail to account for a panoply of clinical, regulatory, and financial realities of transplantation centers in the United States in ways that undermine the thesis that a trial of financial incentives for organ procurement is not warranted at this time. I conclude with some personal pessimistic reflections on the progress of this debate. Copyright © 2015 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  5. The HIV self-testing debate: where do we stand?

    PubMed

    Gagnon, Marilou; French, Martin; Hébert, Yamilee

    2018-01-18

    Emphasis on HIV testing as a gateway to prevention, treatment and care has grown tremendously over the past decade. In turn, this emphasis on testing has created a demand for new policies, programs, and technologies that can potentially increase access to and uptake of HIV testing. HIV self-testing (HST) technologies have gained important momentum following the approval of the over-the-counter self-tests in the United States, the UK, and France. While the renewed interest in HST has given rise to a number of high quality reviews of empirical studies conducted on this topic, we have yet to find an article that captures the extent of the debate on HST. A critical review of the literature on HST was conducted and organized into three categories based on the focus of the article: 1) Empirical research, 2) Arguments, and 3) Context. We focused exclusively on the second category which included ethical analyses, policy analyses, editorials, opinion pieces, commentaries, letters to the editor and so forth. 10 lines of argument on HST were identified in the literature: 1) Individual - Public Health, 2) Strengths - Limits, 3) Benefits - Harms, 4) Screening - Testing, 5) Target - Market, 6) Health Care - Industry, 7) Regulation - Restriction, 8) Resource-Rich Settings - Resource-Limited Settings, 9) Ethical - Unethical, and 10) Exceptionalism - Normalization. Each line of argument is presented and discussed in the paper. We conclude by providing examples of critical questions that should be raised in order to take the debate to another level and generate new ways of thinking about HST.

  6. The Debate on the Moral Responsibilities of Online Service Providers.

    PubMed

    Taddeo, Mariarosaria; Floridi, Luciano

    2016-12-01

    Online service providers (OSPs)-such as AOL, Facebook, Google, Microsoft, and Twitter-significantly shape the informational environment (infosphere) and influence users' experiences and interactions within it. There is a general agreement on the centrality of OSPs in information societies, but little consensus about what principles should shape their moral responsibilities and practices. In this article, we analyse the main contributions to the debate on the moral responsibilities of OSPs. By endorsing the method of the levels of abstract (LoAs), we first analyse the moral responsibilities of OSPs in the web (LoA IN ). These concern the management of online information, which includes information filtering, Internet censorship, the circulation of harmful content, and the implementation and fostering of human rights (including privacy). We then consider the moral responsibilities ascribed to OSPs on the web (LoA ON ) and focus on the existing legal regulation of access to users' data. The overall analysis provides an overview of the current state of the debate and highlights two main results. First, topics related to OSPs' public role-especially their gatekeeping function, their corporate social responsibilities, and their role in implementing and fostering human rights-have acquired increasing relevance in the specialised literature. Second, there is a lack of an ethical framework that can (a) define OSPs' responsibilities, and (b) provide the fundamental sharable principles necessary to guide OSPs' conduct within the multicultural and international context in which they operate. This article contributes to the ethical framework necessary to deal with (a) and (b) by endorsing a LoA enabling the definition of the responsibilities of OSPs with respect to the well-being of the infosphere and of the entities inhabiting it (LoA For ).

  7. A 6-gene signature identifies four molecular subgroups of neuroblastoma

    PubMed Central

    2011-01-01

    Background There are currently three postulated genomic subtypes of the childhood tumour neuroblastoma (NB); Type 1, Type 2A, and Type 2B. The most aggressive forms of NB are characterized by amplification of the oncogene MYCN (MNA) and low expression of the favourable marker NTRK1. Recently, mutations or high expression of the familial predisposition gene Anaplastic Lymphoma Kinase (ALK) was associated to unfavourable biology of sporadic NB. Also, various other genes have been linked to NB pathogenesis. Results The present study explores subgroup discrimination by gene expression profiling using three published microarray studies on NB (47 samples). Four distinct clusters were identified by Principal Components Analysis (PCA) in two separate data sets, which could be verified by an unsupervised hierarchical clustering in a third independent data set (101 NB samples) using a set of 74 discriminative genes. The expression signature of six NB-associated genes ALK, BIRC5, CCND1, MYCN, NTRK1, and PHOX2B, significantly discriminated the four clusters (p < 0.05, one-way ANOVA test). PCA clusters p1, p2, and p3 were found to correspond well to the postulated subtypes 1, 2A, and 2B, respectively. Remarkably, a fourth novel cluster was detected in all three independent data sets. This cluster comprised mainly 11q-deleted MNA-negative tumours with low expression of ALK, BIRC5, and PHOX2B, and was significantly associated with higher tumour stage, poor outcome and poor survival compared to the Type 1-corresponding favourable group (INSS stage 4 and/or dead of disease, p < 0.05, Fisher's exact test). Conclusions Based on expression profiling we have identified four molecular subgroups of neuroblastoma, which can be distinguished by a 6-gene signature. The fourth subgroup has not been described elsewhere, and efforts are currently made to further investigate this group's specific characteristics. PMID:21492432

  8. Socialized sub-groups in a temporary stable Raven flock?

    PubMed Central

    Braun, Anna; Walsdorff, Thomas; Fraser, Orlaith N.; Bugnyar, Thomas

    2015-01-01

    A complex social life serves as one of the main driving forces behind the evolution of higher cognitive abilities in vertebrates. In birds, however, data are primarily derived from captive animals, which strongly contrast with free-flying birds in terms of the number of interaction partners as well as available space. In captivity, Common Raven Corvus corax, nonbreeder groups show strong social bonds and complex tactical manoeuvring, whereas wild non-breeders are thought to resemble anonymous aggregations. Over 2 years, we observed a free-flying population of Ravens that visits a game park in the northern Alps. We here focus on the daily fission–fusion dynamics, individual spacing, and the influence of spacing on the birds’ agonistic and affiliative behaviour. The composition of marked Ravens in the local population changed slowly but constantly, although often remaining stable for several weeks. Birds only flocked for feeding, mobbing and roosting, and spent the rest of the day in loose aggregations, characterised by temporary small subgroups of 2–5 individuals. Aggression was high during crowd foraging but low outside of a feeding context. Affiliative behaviours, such as sitting within reaching distance, allo-preening and social play, were observed particularly in the small subgroups. These findings suggest that Raven aggregations are not as unstructured as previously thought. Birds may spend time and/or interact affilliatively with multiple individuals during the day. This, along with temporary stability in group composition, provides the opportunity for social relationships to develop, and enables the existence of socialised subgroups within free-flying Raven aggregations. PMID:25892747

  9. Electroencephalographic characterization of subgroups of children with learning disorders

    PubMed Central

    Roca-Stappung, Milene; Bosch-Bayard, Jorge; Harmony, Thalía; Ricardo-Garcell, Josefina

    2017-01-01

    Electroencephalographic alterations have been reported in subjects with learning disorders, but there is no consensus on what characterizes their electroencephalogram findings. Our objective was to determine if there were subgroups within a group of scholars with not otherwise specified learning disorders and if they had specific electroencephalographic patterns. Eighty-five subjects (31 female, 8–11 years) who scored low in at least two subscales -reading, writing and arithmetic- of the Infant Neuropsychological Evaluation were included. Electroencephalograms were recorded in 19 leads during rest with eyes closed; absolute power was obtained every 0.39 Hz. Three subgroups were formed according to children’s performance: Group 1 (G1, higher scores than Group 2 in reading speed and reading and writing accuracy), Group 2 (G2, better performance than G1 in composition) and Group 3 (G3, lower scores than Groups 1 and 2 in the three subscales). G3 had higher absolute power in frequencies in the delta and theta range at left frontotemporal sites than G1 and G2. G2 had higher absolute power within alpha frequencies than G3 and G1 at the left occipital site. G3 had higher absolute power in frequencies in the beta range than G1 in parietotemporal areas and than G2 in left frontopolar and temporal sites. G1 had higher absolute power within beta frequencies than G2 in the left frontopolar site. G3 had lower gamma absolute power values than the other groups in the left hemisphere, and gamma activity was higher in G1 than in G2 in frontopolar and temporal areas. This group of children with learning disorders is very heterogeneous. Three subgroups were found with different cognitive profiles, as well as a different electroencephalographic pattern. It is important to consider these differences when planning interventions for children with learning disorders. PMID:28708890

  10. Heterogeneity in 14-year Dementia Incidence Between Asian American Subgroups.

    PubMed

    Mayeda, Elizabeth R; Glymour, M Maria; Quesenberry, Charles P; Whitmer, Rachel A

    2017-01-01

    Asian Americans are a rapidly growing and diverse population. Prior research on dementia among Asian Americans focused on Japanese Americans or Asian Americans overall, although marked differences in cardiometabolic conditions between subgroups have been documented. We compared dementia incidence among 4 Asian American subgroups (n=8384 Chinese; n=4478 Japanese; n=6210 Filipino; n=197 South Asian) and whites (n=206,490) who were Kaiser Permanente Northern California members aged 64 years and above with no dementia diagnoses as of January 1, 2000. Dementia diagnoses were collected from medical records January 1, 2000 to December 31, 2013. Baseline medical utilization and comorbidities (diabetes, depression, hypertension, stroke, cardiovascular disease) were abstracted from medical records January 1, 1996 to December 31, 1999. We calculated age-standardized dementia incidence rates and Cox models adjusted for age, sex, medical utilization, and comorbidities. Mean baseline age was 71.7 years; mean follow-up was 9.6 years. Age-standardized dementia incidence rates were higher among whites than "All Asian-Americans" or any subgroup. Compared with Chinese (13.7/1000 person-years), dementia incidence was slightly higher among Japanese [14.8/1000 person-years; covariate-adjusted hazard ratio (adjusted-HR)=1.08; 95% confidence interval (CI), 0.99-1.18] and Filipinos (17.3/1000 person-years; adjusted-HR=1.20; 95% CI, 1.11-1.31), and lower among South Asians (12.1/1000 person-years; adjusted-HR=0.81; 95% CI, 0.53-1.25). Future studies are needed to understand how immigration history, social, environmental, and genetic factors contribute to dementia risk in the growing and diverse Asian American population.

  11. Debates about assisted suicide in Switzerland.

    PubMed

    Burkhardt, Sandra; La Harpe, Romano

    2012-12-01

    Assisted suicide is allowed in 3 states of the United States (Oregon, Washington, Montana) but only if performed by a physician.On the opposite, in Switzerland, at the beginning of the 20th century, the Swiss Penal Code referred to assisted suicide in the context of honor or an unhappy love affair. It was only in 1985 that Exit Deutsche Schweiz (Exit for German-speaking Switzerland) "medically" assisted the first patient to end his life.Even if authorized by the Swiss law upon certain conditions, assisted suicide is subject to debates for ethical reasons. The Swiss Academy of Medical Sciences described directives to guide physicians on this difficult subject.Different studies showed an increase in the number of medical-assisted suicide in Switzerland since the 1990s. Now, this number seems to be quite stable. Assisted suicide is authorized in a few hospitals under strict conditions (especially when returning home is impossible).Thus, according to the Swiss law, any person could perform assisted suicide; this is essentially performed by 3 main associations, using pentobarbital on medical prescription as lethal substance.Generally speaking, the Swiss population is rather in favor of assisted suicide. Among politics, the debate has been tough until 2010, when the Federal Council decided not to modify the Swiss Penal Code concerning assisted suicide.

  12. The Negative Effects of Using Apocalyptism on Debate.

    ERIC Educational Resources Information Center

    Hubbard, Bryan

    People involved in debate often encounter apocalyptic appeals but seldom look at how these arguments affect debate beyond their ability to influence winning. Debaters use nuclear war apocalyptism, for example, by capitalizing on the human desire to sustain its own story, by appealing to the universal drive for control and power inside all humans,…

  13. The Dewey-Hutchins Debate: A Dispute over Moral Teleology

    ERIC Educational Resources Information Center

    Johnston, James Scott

    2011-01-01

    In this essay, James Scott Johnston claims that a dispute over moral teleology lies at the basis of the debate between John Dewey and Robert M. Hutchins. This debate has very often been cast in terms of perennialism, classicism, or realism versus progressivism, experimentalism, or pragmatism. Unfortunately, casting the debate in these terms…

  14. A Debate and Decision-Making Tool for Enhanced Learning

    ERIC Educational Resources Information Center

    López Garcia, Diego A.; Mateo Sanguino, Tomás de J.; Cortés Ancos, Estefania; Fernández de Viana González, Iñaki

    2016-01-01

    Debates have been used to develop critical thinking within teaching environments. Many learning activities are configured as working groups, which use debates to make decisions. Nevertheless, in a classroom debate, only a few students can participate; large work groups are similarly limited. Whilst the use of web tools would appear to offer a…

  15. Assigned Positions for In-Class Debates Influence Student Opinions

    ERIC Educational Resources Information Center

    Lilly, Emily

    2012-01-01

    In-class debates are frequently used to encourage student engagement. Ideally, after researching both sides of the debate, students will form their own opinions based on what they have learned. However, in a large course of Environmental Science, opinions of students, when surveyed after the debate, were remarkably consistent with the position…

  16. A Judicial Paradigm for the Evaluation of Debates.

    ERIC Educational Resources Information Center

    Ulrich, Walter

    Because legal argument shares many of the characteristics of academic debate, it can serve as a paradigm for evaluating debates. Like debate, legal argument is bilateral, the judge is external to the deliberation and excluded from raising his or her own arguments, and reasons have been developed for assigning presumption, determining the wording…

  17. Argument, Ideology, and Databases: On the Corporatization of Academic Debate.

    ERIC Educational Resources Information Center

    Tucker, Robert E.

    1995-01-01

    Argues that a deleterious effect of increased use of online databases in academic debate is the change in the nature of information available to debaters and corresponding changes in ideological assumptions in argumentation. Examines the link between debate training and argumentative proficiency in a democracy. Foresees the likely consequences of…

  18. Is It Too Late To Save Policy Debate?

    ERIC Educational Resources Information Center

    Herbeck, Dale A.

    National Debate Tournament (NDT) policy debate is in a state of crisis, suffering a steady and precipitous drop in participation. This decline is due not to external factors, but rather to problems and abuses unique to NDT policy debate. Its demise reflects a much broader problem, the abrogation of intellectual leadership in the activity. Coaches…

  19. The Past and Future of Presidential Primary Debates.

    ERIC Educational Resources Information Center

    Ritter, Kurt; Hellweg, Susan A.

    Studies focusing on televised presidential primary debates include four prespectives. From a historical perspective, televised presidential primary debates have increased slowly from 1956 through 1980. With the 1975 Federal Communications Commission ruling that independently sponsored campaign debates were news events exempt from "equal…

  20. The Thrill Is Gone: Rediscovering Pathos and Style in Debate.

    ERIC Educational Resources Information Center

    Tallmon, James M.

    This is a polemic on the need to rehumanize collegiate debate. Viewed as a reform movement insofar as its primary concern is to revitalize public debate, the National Education Debate Association (NEDA) ought to be mindful of the ethical implications of its aims in the same way that a repairman fixes what is broken: by concentrating, not on the…

  1. "Association or causation?" The debate on the scientific status of risk factor epidemiology, 1947-c. 1965.

    PubMed

    Berlivet, Luc

    2005-01-01

    In the second half of the twentieth century, epidemiology came to shape public health discourses and practices to an unprecedented extent. The chapter explores the transformation of the discipline after World War Two and analyses the crucial debate on the notion of "causation" that sprung from the growing interest in non-transmissible, chronic diseases. A landmark in this history was the controversy over the interpretation of the statistical relationship between smoking and lung cancer prompted by American and British publications in 1950. This sometimes heated debate also provided Austin Bradford Hill with the opportunity to set out his "pragmatics" of risk factor epidemiology.

  2. Gender by Preferred Gambling Activity in Treatment Seeking Problem Gamblers: A Comparison of Subgroup Characteristics and Treatment Outcomes.

    PubMed

    Khanbhai, Yasmin; Smith, David; Battersby, Malcolm

    2017-03-01

    Problem gambling is a growing public health concern and treatment incompletion levels remain high. The study aims to support and extend previous studies in relation to the heterogeneity of the gambling population based on gender and gambling type, and the implications of subgroup differences on treatment outcomes. Additionally, the concept of drop-out is addressed in terms of categorical treatment measures. The empirical findings are examined in the context of the theoretical framework of the pathways model. Participants were recruited from the Statewide Gambling Therapy Service and stratified into subgroups based on gender and gambling mode preference [Electronic Gambling Machines (EGM) or track race betters]. Baseline predictors collected and analysed using multinomial logistical regression included demographic information as well as gambling variables, while treatment outcomes consisted of three therapist rated measures. Significant differences between the subgroups were found for age, marital and employment status, gambling duration, alcohol use and the Kessler 10 measure of psychological distress. Specifically, male track race gamblers were younger, married, employed, had a longer duration of gambling, higher alcohol use and lower psychological distress relative to EGM users. No difference was found in any of the treatment outcomes, however, consistent with previous studies, all subgroups had high treatment incompletion levels. The findings demonstrate the importance of screening, assessing and treating problem gamblers as a heterogeneous group with different underlying demographics and psychopathologies. It is also hoped future studies will continue to address treatment incompletion with a re-conceptualisation of the term drop-out.

  3. Suicide Risk across Latent Class Subgroups: A Test of the Generalizability of the Interpersonal Psychological Theory of Suicide.

    PubMed

    Ma, Jennifer S; Batterham, Philip J; Calear, Alison L; Han, Jin

    2018-01-06

    It remains unclear whether the Interpersonal Psychological Theory of Suicide (IPTS; Joiner, ) is generalizable to the population or holds more explanatory power for certain subgroups compared to others. The aim of this study was to (1) identify subgroups of individuals who endorsed suicide ideation in the past month based on a range of mental health and demographic variables, (2) compare levels of the IPTS constructs within these subgroups, and (3) test the IPTS predictions for suicide ideation and suicide attempt for each group. Latent class, negative binomial, linear, and logistic regression analyses were conducted on population-based data obtained from 1,321 adults recruited from Facebook. Among participants reporting suicide ideation, four distinct patterns of risk factors emerged based on age and severity of mental health symptoms. Groups with highly elevated mental health symptoms reported the highest levels of thwarted belongingness and perceived burdensomeness. Tests of the IPTS interactions provided partial support for the theory, primarily in young adults with elevated mental health symptoms. Lack of support found for the IPTS predictions across the subgroups and full sample in this study raise some questions around the broad applicability of the theory. © 2018 The American Association of Suicidology.

  4. Symptom dimensions and subgroups in childhood-onset schizophrenia.

    PubMed

    Craddock, Kirsten E S; Zhou, Xueping; Liu, Siyuan; Gochman, Peter; Dickinson, Dwight; Rapoport, Judith L

    2017-11-13

    This study investigated symptom dimensions and subgroups in the National Institute of Mental Health (NIMH) childhood-onset schizophrenia (COS) cohort and their similarities to adult-onset schizophrenia (AOS) literature. Scores from the Scales for the Assessment of Positive and Negative Symptoms (SAPS & SANS) from 125 COS patients were assessed for fit with previously established symptom dimensions from AOS literature using confirmatory factor analysis (CFA). K-means cluster analysis of each individual's scores on the best fitting set of dimensions was used to form patient clusters, which were then compared using demographic and clinical data. CFA showed the SAPS & SANS data was well suited to a 2-dimension solution, including positive and negative dimensions, out of five well established models. Cluster analysis identified three patient groups characterized by different dimension scores: (1) low scores on both dimensions, (2) high negative, low positive scores, and (3) high scores on both dimensions. These groups had different Full scale IQ, Children's Global Assessment Scale (CGAS) scores, ages of onset, and prevalence of some co-morbid behavior disorders (all p<3.57E-03). Our analysis found distinct symptom-based subgroups within the NIMH COS cohort using an established AOS symptom structure. These findings confirm the heterogeneity of COS and were generally consistent with AOS literature. Published by Elsevier B.V.

  5. Executive and Attention Functioning Among Children in the Pandas Subgroup

    PubMed Central

    Hirschtritt, Matthew E.; Hammond, Christopher J.; Luckenbaugh, David; Buhle, Jason; Thurm, Audrey E.; Casey, B. J.; Swedo, Susan E.

    2009-01-01

    Evidence from past studies indicates that adults and children with Obsessive-Compulsive Disorder (OCD) and Tourette syndrome (TS) experience subtle neuropsychological deficits. Less is known about neuropsychological functioning of children and adolescents with a symptom course consistent with the PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infection) subgroup of OCD and tics. To provide such information, we administered three tests of attention control and two of executive function to 67 children and adolescents (ages 5–16) diagnosed with OCD and/or tics and a symptom course consistent with the PANDAS subgroup and 98 healthy volunteers (HV) matched by age, sex, and IQ. In a paired comparison of the two groups, the PANDAS subjects were less accurate than HV in a test of response suppression. Further, in a two-step linear regression analysis of the PANDAS group in which clinical variables were added stepwise into the model and in the second step matching variables (age, sex, and IQ) were added, IQ emerged as a predictor of performance on this task. In the same analysis, ADHD diagnosis and age emerged as predictors of response time in a continuous performance task. Subdividing the PANDAS group by primary psychiatric diagnosis revealed that subjects with TS or OCD with tics exhibited a longer response time compared to controls than subjects with OCD only, replicating previous findings within TS and OCD. This study demonstrates that children with PANDAS exhibit neuropsychological profiles similar to those of their primary psychiatric diagnosis. PMID:18622810

  6. Executive and attention functioning among children in the PANDAS subgroup.

    PubMed

    Hirschtritt, Matthew E; Hammond, Christopher J; Luckenbaugh, David; Buhle, Jason; Thurm, Audrey E; Casey, B J; Swedo, Susan E

    2009-03-01

    Evidence from past studies indicates that adults and children with Obsessive-Compulsive Disorder (OCD) and Tourette syndrome (TS) experience subtle neuropsychological deficits. Less is known about neuropsychological functioning of children and adolescents with a symptom course consistent with the PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infection) subgroup of OCD and tics. To provide such information, we administered three tests of attention control and two of executive function to 67 children and adolescents (ages 5-16) diagnosed with OCD and/or tics and a symptom course consistent with the PANDAS subgroup and 98 healthy volunteers (HV) matched by age, sex, and IQ. In a paired comparison of the two groups, the PANDAS subjects were less accurate than HV in a test of response suppression. Further, in a two-step linear regression analysis of the PANDAS group in which clinical variables were added stepwise into the model and in the second step matching variables (age, sex, and IQ) were added, IQ emerged as a predictor of performance on this task. In the same analysis, ADHD diagnosis and age emerged as predictors of response time in a continuous performance task. Subdividing the PANDAS group by primary psychiatric diagnosis revealed that subjects with TS or OCD with tics exhibited a longer response time compared to controls than subjects with OCD only, replicating previous findings within TS and OCD. This study demonstrates that children with PANDAS exhibit neuropsychological profiles similar to those of their primary psychiatric diagnosis.

  7. Comparative Genomics of the Listeria monocytogenes ST204 Subgroup

    PubMed Central

    Fox, Edward M.; Allnutt, Theodore; Bradbury, Mark I.; Fanning, Séamus; Chandry, P. Scott

    2016-01-01

    The ST204 subgroup of Listeria monocytogenes is among the most frequently isolated in Australia from a range of environmental niches. In this study we provide a comparative genomics analysis of food and food environment isolates from geographically diverse sources. Analysis of the ST204 genomes showed a highly conserved core genome with the majority of variation seen in mobile genetic elements such as plasmids, transposons and phage insertions. Most strains (13/15) harbored plasmids, which although varying in size contained highly conserved sequences. Interestingly 4 isolates contained a conserved plasmid of 91,396 bp. The strains examined were isolated over a period of 12 years and from different geographic locations suggesting plasmids are an important component of the genetic repertoire of this subgroup and may provide a range of stress tolerance mechanisms. In addition to this 4 phage insertion sites and 2 transposons were identified among isolates, including a novel transposon. These genetic elements were highly conserved across isolates that harbored them, and also contained a range of genetic markers linked to stress tolerance and virulence. The maintenance of conserved mobile genetic elements in the ST204 population suggests these elements may contribute to the diverse range of niches colonized by ST204 isolates. Environmental stress selection may contribute to maintaining these genetic features, which in turn may be co-selecting for virulence markers relevant to clinical infection with ST204 isolates. PMID:28066377

  8. Comparative Genomics of the Listeria monocytogenes ST204 Subgroup.

    PubMed

    Fox, Edward M; Allnutt, Theodore; Bradbury, Mark I; Fanning, Séamus; Chandry, P Scott

    2016-01-01

    The ST204 subgroup of Listeria monocytogenes is among the most frequently isolated in Australia from a range of environmental niches. In this study we provide a comparative genomics analysis of food and food environment isolates from geographically diverse sources. Analysis of the ST204 genomes showed a highly conserved core genome with the majority of variation seen in mobile genetic elements such as plasmids, transposons and phage insertions. Most strains (13/15) harbored plasmids, which although varying in size contained highly conserved sequences. Interestingly 4 isolates contained a conserved plasmid of 91,396 bp. The strains examined were isolated over a period of 12 years and from different geographic locations suggesting plasmids are an important component of the genetic repertoire of this subgroup and may provide a range of stress tolerance mechanisms. In addition to this 4 phage insertion sites and 2 transposons were identified among isolates, including a novel transposon. These genetic elements were highly conserved across isolates that harbored them, and also contained a range of genetic markers linked to stress tolerance and virulence. The maintenance of conserved mobile genetic elements in the ST204 population suggests these elements may contribute to the diverse range of niches colonized by ST204 isolates. Environmental stress selection may contribute to maintaining these genetic features, which in turn may be co-selecting for virulence markers relevant to clinical infection with ST204 isolates.

  9. Identifying and Assessing Interesting Subgroups in a Heterogeneous Population.

    PubMed

    Lee, Woojoo; Alexeyenko, Andrey; Pernemalm, Maria; Guegan, Justine; Dessen, Philippe; Lazar, Vladimir; Lehtiö, Janne; Pawitan, Yudi

    2015-01-01

    Biological heterogeneity is common in many diseases and it is often the reason for therapeutic failures. Thus, there is great interest in classifying a disease into subtypes that have clinical significance in terms of prognosis or therapy response. One of the most popular methods to uncover unrecognized subtypes is cluster analysis. However, classical clustering methods such as k-means clustering or hierarchical clustering are not guaranteed to produce clinically interesting subtypes. This could be because the main statistical variability--the basis of cluster generation--is dominated by genes not associated with the clinical phenotype of interest. Furthermore, a strong prognostic factor might be relevant for a certain subgroup but not for the whole population; thus an analysis of the whole sample may not reveal this prognostic factor. To address these problems we investigate methods to identify and assess clinically interesting subgroups in a heterogeneous population. The identification step uses a clustering algorithm and to assess significance we use a false discovery rate- (FDR-) based measure. Under the heterogeneity condition the standard FDR estimate is shown to overestimate the true FDR value, but this is remedied by an improved FDR estimation procedure. As illustrations, two real data examples from gene expression studies of lung cancer are provided.

  10. The science achievement of various subgroups on alternative assessment formats

    NASA Astrophysics Data System (ADS)

    Lawrenz, Frances; Huffman, Douglas; Welch, Wayne

    2001-05-01

    The purpose of this study was to examine the science achievement outcomes for different subgroups of students using different assessment formats. A nationally representative sample of approximately 3,500 ninth grade science students from 13 high schools throughout the United States completed a series of science assessments designed to measure their level of achievement on the national science education standards. All of the schools were using a curriculum designed to meet the standards. The assessments included a multiple-choice test, a written open-ended test, a hands-on lab skills test, and a hands-on full investigation. The results show that the student outcomes on the different assessment formats are more highly correlated for higher achieving students than for lower achieving students. Patterns for different cultural groups also vary by assessment format. There were no differences found for sex. The results support the notion that different assessment formats assess different competencies and that the achievement of students from different subgroups varies by assessment format.

  11. Identifying and Assessing Interesting Subgroups in a Heterogeneous Population

    PubMed Central

    Lee, Woojoo; Alexeyenko, Andrey; Pernemalm, Maria; Guegan, Justine; Dessen, Philippe; Lazar, Vladimir; Lehtiö, Janne; Pawitan, Yudi

    2015-01-01

    Biological heterogeneity is common in many diseases and it is often the reason for therapeutic failures. Thus, there is great interest in classifying a disease into subtypes that have clinical significance in terms of prognosis or therapy response. One of the most popular methods to uncover unrecognized subtypes is cluster analysis. However, classical clustering methods such as k-means clustering or hierarchical clustering are not guaranteed to produce clinically interesting subtypes. This could be because the main statistical variability—the basis of cluster generation—is dominated by genes not associated with the clinical phenotype of interest. Furthermore, a strong prognostic factor might be relevant for a certain subgroup but not for the whole population; thus an analysis of the whole sample may not reveal this prognostic factor. To address these problems we investigate methods to identify and assess clinically interesting subgroups in a heterogeneous population. The identification step uses a clustering algorithm and to assess significance we use a false discovery rate- (FDR-) based measure. Under the heterogeneity condition the standard FDR estimate is shown to overestimate the true FDR value, but this is remedied by an improved FDR estimation procedure. As illustrations, two real data examples from gene expression studies of lung cancer are provided. PMID:26339613

  12. Broadening the Debate: Comments on Michael J. Feuer's "Moderating the Debate"

    ERIC Educational Resources Information Center

    Robertson, Emily

    2009-01-01

    In "Moderating the Debate: Rationality and the Promise of American Education", Michael Feuer argues that insights from cognitive science and the theory of bounded rationality can help us understand why educational policy makers overreach in seeking optimal solutions to educational problems. In this essay, Emily Robertson argues that cognitive…

  13. Commognitive analysis of undergraduate mathematics students' first encounter with the subgroup test

    NASA Astrophysics Data System (ADS)

    Ioannou, Marios

    2018-06-01

    This study analyses learning aspects of undergraduate mathematics students' first encounter with the subgroup test, using the commognitive theoretical framework. It focuses on students' difficulties as these are related to the object-level and metalevel mathematical learning in group theory, and, when possible, highlights any commognitive conflicts. In the data analysis, one can identify three types of difficulties, relevant to object-level learning: namely regarding the frequently observed confusion between groups and sets, the object-level rules of visual mediators, and the object-level rules of contextual notions, such as permutations, exponentials, sets and matrices. In addition, data analysis suggests two types of difficulties, relevant to metalevel learning. The first refers to the actual proof that the three conditions of subgroup test hold, and the second is related to syntactic inaccuracies, incomplete argumentation and problematic use of visual mediators. Finally, this study suggests that there are clear links between object-level and metalevel learning, mainly due to the fact that objectification of the various relevant mathematical notions influences the endorsement of the governing metarules.

  14. Analysis of the complete genome of subgroup A' hepatitis B virus isolates from South Africa.

    PubMed

    Kramvis, Anna; Weitzmann, Louise; Owiredu, William K B A; Kew, Michael C

    2002-04-01

    A phylogenetic analysis is presented of six complete and seven pre-S1/S2/S gene sequences of hepatitis B virus (HBV) isolates from South Africa. Five of the full-length sequences and all of the pre-S2/S sequences have been previously reported. Four of the six complete genomes and three of the five incomplete sequences clustered with subgroup A', a unique segment of genotype A of HBV previously identified in 60% of South African isolates using analysis of the pre-S2/S region alone. This separation was also evident when the polymerase open reading frame was analysed, but not on analysis of either the X or pre-core/core genes. Amino acids were identified in the pre-S1 and polymerase regions specific to subgroup A'. In common with genotype D, 10 of 11 genotype A South African isolates had an 11 amino acid deletion in the amino end of the pre-S1 region. This deletion is also found in hepadnaviruses from non-human primates.

  15. Analysis of chronic lymphotic leukemia transcriptomic profile: differences between molecular subgroups.

    PubMed

    Jantus Lewintre, Eloisa; Reinoso Martín, Cristina; Montaner, David; Marín, Miguel; José Terol, María; Farrás, Rosa; Benet, Isabel; Calvete, Juan J; Dopazo, Joaquín; García-Conde, Javier

    2009-01-01

    B cell chronic lymphocytic leukemia (CLL) is a lymphoproliferative disorder with a variable clinical course. Patients with unmutated IgV(H) gene show a shorter progression-free and overall survival than patients with immunoglobulin heavy chain variable regions (IgV(H)) gene mutated. In addition, BCL6 mutations identify a subgroup of patients with high risk of progression. Gene expression was analysed in 36 early-stage patients using high-density microarrays. Around 150 genes differentially expressed were found according to IgV(H) mutations, whereas no difference was found according to BCL6 mutations. Functional profiling methods allowed us to distinguish KEGG and gene ontology terms showing coordinated gene expression changes across subgroups of CLL. We validated a set of differentially expressed genes according to IgV(H) status, scoring them as putative prognostic markers in CLL. Among them, CRY1, LPL, CD82 and DUSP22 are the ones with at least equal or superior performance to ZAP70 which is actually the most used surrogate marker of IgV(H) status.

  16. Phenotypic subgroups of polycystic ovary syndrome have different intra-renal resistance symptoms.

    PubMed

    Ciftci, Ceylan F; Uckuyu, Ayla; Karadeli, Elif; Turhan, Erdem; Toprak, Erzat; Ozcimen, Emel E

    2012-12-01

    The polycystic ovary syndrome (PCOS) is known to be related with increased metabolic and cardiovascular risks. Various phenotypic subgroups of PCOS have been proven to have metabolic and endocrine disorders with varying degrees of severity However, intra-renal vascular resistance, which is an indirect indication of atherosclerosis, remains unknown in PCOS subgroups. In this study we examined whether PCOS subgroups have different intra-renal resistance symptoms. 98 PCOS patients (diagnosed according to the Rotterdam criteria) 30 controls were included in the study The diagnosis of PCOS was established in the presence of at least two of the following criteria: 1-oligo and/or amenorrhea (OM); 2-clinic and/or biochemical signs of hyperandrogenism (HA); 3-polycystic ovarian morphology (PCO) detected by transvaginal ultrasonography 37 patients (Group 1) met all three criteria (HA+OM+PCO), 29 patients (Group 2) met two of the criteria including hyperandrogenism (HA+OM or HA+PCO) and the remaining 32 patients (Group 3) had no hyperandrogenism but fulfilled the other two criteria; PCO+OM. Renal Doppler ultrasonography and hormonal/biochemical analyses were carried out. The first outcome measure was designated as the differences in the renal resistive index (RRI) values of the groups, and the second outcome measure was designated as the relation of RRI with the insulin resistance and lipid profile. In Group 1, the RRI and the homeostasis model assessment of insulin resistance (HOMA-IR) values were significantly higher than in Group 3 and controls (P < 0.031, P < 0.001, respectively after adjusting for age and BMI). The RRI and HOMA-IR values in Group 3 were similar to those of the control group. It was determined that RRI has a positive correlation with HOMA-IR (r = 0.784, P < .0001) and BMI (r = 0.645, P < .0001). In this study we demonstrated that PCOS subgroups have metabolic and endocrine disorders and cardiovascular risks of varying degrees of severity Moreover, we

  17. Debate preparation/participation: an active, effective learning tool.

    PubMed

    Koklanaris, Nikki; MacKenzie, Andrew P; Fino, M Elizabeth; Arslan, Alan A; Seubert, David E

    2008-01-01

    Passive educational techniques (such as lectures) are thought to be less productive than active learning. We examined whether preparing for and participating in a debate would be an effective, active way to learn about a controversial topic. We compared quiz performance in residents who attended a lecture to residents who prepared for/participated in a debate. Twelve residents each participated in one lecture session and one debate session. Learning was evaluated via a quiz. Quizzes were given twice: before the debate/lecture and 1 week after the debate/lecture. Quiz scores were compared using repeated measures analysis of variance, with a p value of < .05 considered significant. A survey evaluating the usefulness of debating was given to all participants. There was a statistically significant difference in the pretest mean quiz score between the debate and lecture groups: 78.3% and 52.5%, respectively (p = .02). Similarly, on posttest quizzes, the average debater scored 85.8%, versus 61.7% for the lecture group (p = .003). Although no one in the debate group scored lower on a follow-up quiz, 3 residents in the lecture group did worse on follow-up. When learning about a controversial topic, residents who prepared for/participated in a debate achieved higher quiz scores and were better at retaining information than those who attended a lecture. When faced with teaching a controversial topic, organizing a debate may be more effective than giving a lecture.

  18. A comparison of three clustering methods for finding subgroups in MRI, SMS or clinical data: SPSS TwoStep Cluster analysis, Latent Gold and SNOB.

    PubMed

    Kent, Peter; Jensen, Rikke K; Kongsted, Alice

    2014-10-02

    There are various methodological approaches to identifying clinically important subgroups and one method is to identify clusters of characteristics that differentiate people in cross-sectional and/or longitudinal data using Cluster Analysis (CA) or Latent Class Analysis (LCA). There is a scarcity of head-to-head comparisons that can inform the choice of which clustering method might be suitable for particular clinical datasets and research questions. Therefore, the aim of this study was to perform a head-to-head comparison of three commonly available methods (SPSS TwoStep CA, Latent Gold LCA and SNOB LCA). The performance of these three methods was compared: (i) quantitatively using the number of subgroups detected, the classification probability of individuals into subgroups, the reproducibility of results, and (ii) qualitatively using subjective judgments about each program's ease of use and interpretability of the presentation of results.We analysed five real datasets of varying complexity in a secondary analysis of data from other research projects. Three datasets contained only MRI findings (n = 2,060 to 20,810 vertebral disc levels), one dataset contained only pain intensity data collected for 52 weeks by text (SMS) messaging (n = 1,121 people), and the last dataset contained a range of clinical variables measured in low back pain patients (n = 543 people). Four artificial datasets (n = 1,000 each) containing subgroups of varying complexity were also analysed testing the ability of these clustering methods to detect subgroups and correctly classify individuals when subgroup membership was known. The results from the real clinical datasets indicated that the number of subgroups detected varied, the certainty of classifying individuals into those subgroups varied, the findings had perfect reproducibility, some programs were easier to use and the interpretability of the presentation of their findings also varied. The results from the artificial datasets

  19. [The Danish debate on priority setting in medicine - characteristics and results].

    PubMed

    Pornak, S; Meyer, T; Raspe, H

    2011-10-01

    Priority setting in medicine helps to achieve a fair and transparent distribution of health-care resources. The German discussion about priority setting is still in its infancy and may benefit from other countries' experiences. This paper aims to analyse the Danish priority setting debate in order to stimulate the German discussion. The methods used are a literature analysis and a document analysis as well as expert interviews. The Danish debate about priority setting in medicine began in the 1970s, when a government committee was constituted to evaluate health-care priorities at the national level. In the 1980s a broader debate arose in politics, ethics, medicine and health economy. The discussions reached a climax in the 1990s, when many local activities - always involving the public - were initiated. Some Danish counties tried to implement priority setting in the daily routine of health care. The Council of Ethics was a major player in the debate of the 1990s and published a detailed statement on priority setting in 1996. With the new century the debate about priority setting seemed to have come to an end, but in 2006 the Technology Council and the Danish Regions resumed the discussion. In 2009 the Medical Association called for a broad debate in order to achieve equity among all patients. The long lasting Danish debate on priority setting has entailed only very little practical consequences on health care. The main problems seem to have been the missing effort to bundle the various local initiatives on a national level and the lack of powerful players to put results of the discussion into practice. Nevertheless, today the attitude towards priority setting is predominantly positive and even politicians talk freely about it. © Georg Thieme Verlag KG Stuttgart · New York.

  20. Debating restrictions on embryonic stem cell research.

    PubMed

    McClain, Colleen

    2009-09-01

    This study investigates the emotional and behavioral effects of interpersonal online communication, focusing on the controversy surrounding the loosening of restrictions on human embryonic stem cell research. The issue, central to national and statewide elections in 2008, generated heated debate among candidates and voters and evoked strong emotional sentiments among partisans. Using the theory of affective intelligence, this study proposes a predictive model connecting levels of enthusiasm and anxiety with behavioral and information-seeking outcomes. Cognitive appraisal theory is also employed to provide a role for political emotion in accounting for interactive media effects. To investigate the ways that online deliberation may influence discussions surrounding stem cell research, a between-subjects experimental study was conducted that systematically varied the tone of feedback received (reinforcing or challenging) and type of interaction (synchronous or asynchronous) experienced by users. Results indicate that emotional responses play a significant role in predicting behavioral intentions arising from the user-to-user interactive experience.

  1. [The gender debate from the pedagogic perspective].

    PubMed

    Forster, Johanna

    2004-09-01

    The question of form and extent of biological and/or cultural influences on female and male behaviour and performance is marking a major focus in present scientific research. Accordingly, a broad spectrum of approaches in research and interpretations of results is available. The recent debate on sex and gender is offering two basic objectives for research in education science: First, the critical review of the data and results on sex specifics presented in respect to the articulation of educational aims, topics and methods. Second, the intensified research focus on the developmental consequences of gender and gender roles for boys and girls, women and men. The pedagogical focus is discussed regarding the following three objectives: 1. developmental conditions in early ontogeny, 2. the question of sex specific differences in cognitive abilities in respect to school performance of adolescents, and 3. teaching knowledge on "sex" and "gender" in schools.

  2. The debate over robotics in benign gynecology.

    PubMed

    Rardin, Charles R

    2014-05-01

    The debate over the role of the da Vinci surgical robotic platform in benign gynecology is raging with increasing fervor and, as product liability issues arise, greater financial stakes. Although the best currently available science suggests that, in the hands of experts, robotics offers little in surgical advantage over laparoscopy, at increased expense, the observed decrease in laparotomy for hysterectomy is almost certainly, at least in part, attributable to the availability of the robot. In this author's opinion, the issue is not whether the robot has any role but rather to define the role in an institutional environment that also supports the safe use of vaginal and laparoscopic approaches in an integrated minimally invasive surgery program. Programs engaging robotic surgery should have a clear and self-determined regulatory process and should resist pressures in place that may preferentially support robotics over other forms of minimally invasive surgery. Copyright © 2014 Mosby, Inc. All rights reserved.

  3. [A Parliament debate regarding a scientific study].

    PubMed

    Cervino, Marco; Mangia, Cristina; Gianicolo, Emilio Antonio Luca

    2015-01-01

    Publishing studies on the relationship between health and pollution provokes reactions and interest in the public opinion involved, the highest national institutions included. This commentary, aroused by a parliamentary debate, which also concerned one of our recent scientific papers published on Environmental Research about the association between congenital anomalies and maternal exposure to atmospheric pollutants in Brindisi (Apulia Region, Southern Italy), aims at contributing to reply the following questions: the type and quality of the data used in the estimates of exposure must be certified by institutional bodies? Adverse health effects in people exposed to pollutants at levels below the law limits can be excluded? Finally, we draw some remarks on measures to protect public health and on the relationship between the work of the researchers of public institutes and administrations.

  4. Online debates to enhance critical thinking in pharmacotherapy.

    PubMed

    Charrois, Theresa L; Appleton, Michelle

    2013-10-14

    To assess the impact of teaching strategies on the complexity and structure of students' arguments and type of informal reasoning used in arguments. Students were given an introduction to argumentation followed by 2 formal debates, with feedback provided in between. Four debate groups were randomly selected for evaluation. In debate 1, all groups posted 1 argument, and all 4 arguments were rationalistic and ranked as high-level arguments. In debate 2, members of the 4 groups posted a total of 33 arguments, which were evaluated and received an overall median ranking lower than that for debate 1. All debates were categorized as rationalistic. Students were able to formulate rationalistic arguments to therapeutic controversies; however, their level of argumentation decreased over the course of the study. Changes planned for the future include conducting the debates in the context of patient scenarios to increase practical applicability.

  5. Online Debates to Enhance Critical Thinking in Pharmacotherapy

    PubMed Central

    Appleton, Michelle

    2013-01-01

    Objectives. To assess the impact of teaching strategies on the complexity and structure of students’ arguments and type of informal reasoning used in arguments. Design. Students were given an introduction to argumentation followed by 2 formal debates, with feedback provided in between. Assessment. Four debate groups were randomly selected for evaluation. In debate 1, all groups posted 1 argument, and all 4 arguments were rationalistic and ranked as high-level arguments. In debate 2, members of the 4 groups posted a total of 33 arguments, which were evaluated and received an overall median ranking lower than that for debate 1. All debates were categorized as rationalistic. Conclusion. Students were able to formulate rationalistic arguments to therapeutic controversies; however, their level of argumentation decreased over the course of the study. Changes planned for the future include conducting the debates in the context of patient scenarios to increase practical applicability. PMID:24159211

  6. Debating Race, Race-ing Debate: An Extended Ethnographic Case Study of Black Intellectual Insurgency in U.S. Intercollegiate Debate

    ERIC Educational Resources Information Center

    Peterson, David Kent

    2014-01-01

    The following study is an extended ethnographic case study of a "black intellectual insurgency" within the predominantly white space of the U.S. intercollegiate policy debate activity. A growing number of black students are entering the debate activity and insisting that "whiteness" be confronted and interrogated and that…

  7. Equal, global, local: discourses in Taiwan's international medical graduate debate.

    PubMed

    Ho, Ming-Jung; Shaw, Kevin; Liu, Tzu-Hung; Norris, Jessie; Chiu, Yu-Ting

    2015-01-01

    With the globalisation of medicine, the role of international medical graduates (IMGs) has expanded. Nonetheless, the experiences of native-born IMGs remain under-researched. In Taiwan, public controversy has unfolded around IMGs educated in Poland, calling into question the meaning(s) of equality in policy and medicine. In focusing on the return of IMGs to their countries of origin, this study adds to the growing literature concerning equality and globalisation in medical education. The primary research aim was to analyse how stakeholders in the IMG debate use equality in their arguments. The authors set out to frame the dispute within the recent history of Taiwanese medical governance. An overarching objective was to contribute a critical, historical view of how discourses of globalisation and equality construct different policy approaches to international medical education. The authors performed a critical discourse analysis of a public policy dispute in Taiwan, assembling an archive from online interactions, government reports and news articles. Coding focused on stakeholders' uses of equality to generate broader discourses. International and domestic Taiwanese students conceived of equality differently, referencing both 'equality of opportunity' and 'equality of outcome' within localisation and globalisation frameworks, respectively. The dominance of localisation discourse is reflected in hostile online rhetoric towards Poland-educated IMGs. Rhetorical disagreements over equality in medical education trace shifting state policies, from earlier attempts to remove barriers for IMGs to the present-day push to regulate IMGs for acculturation and quality assurance. The global Internet had a double-sided influence, facilitating both democratic political mobilization and the spread of hate speech. The policy debate in Taiwan mirrors discourses in Canada, where IMGs are likewise conceived either as globally competent physicians or as lacking in merit and technical

  8. No evidence of subgroups found in amphetamine consumers in Iran.

    PubMed

    Bananej, Atireza; Völkl-Kernstock, Sabine; Lesch, Otto; Walter, Henriette; Skala, Katrin

    2018-06-01

    Amphetamine type substances are the second most commonly consumed illicit drug type and their use is an important contributor to the global burden of disease. This investigation set out to determine whether, similar to alcohol or nicotine addiction, subgroups of consumers can also be found in amphetamine addicts. 204 consumers of methamphetamine only (n = 50) or both methamphetamine and heroin (n = 154) have been investigated in Mashhad, Iran by means of "Lesch Alcoholism Typology". No significant differences in consumption pattern or age of onset have been found between the different types. Many subjects, however, reported symptoms of anxiety (n=78) or depression (n = 129) prior to drug use. These findings highlight the need for high quality epidemiological studies further addressing this issue.

  9. Dysexecutive versus amnestic Alzheimer disease subgroups: analysis of demographic, genetic, and vascular factors.

    PubMed

    Mez, Jesse; Cosentino, Stephanie; Brickman, Adam M; Huey, Edward D; Manly, Jennifer J; Mayeux, Richard

    2013-01-01

    The objective of this study was to compare the demographic and vascular characteristics and APOE genotypes of a dysexecutive subgroup of Alzheimer disease (AD) with an amnestic subgroup of AD early in the disease course. A total of 2224 participants from the National Alzheimer's Coordinating Center database who carried a diagnosis of mild cognitive impairment (n=1188) or mild AD (clinical dementia rating ≤1) (n=1036) were included in this study. A subset of the mild cognitive impairment (n=61) and mild AD (n=79) participants underwent an autopsy. A dysexecutive subgroup (n=587) was defined as having executive performance >1 SD worse than memory performance, and an amnestic subgroup (n=549) was defined conversely. Among the autopsy subset, the odds of an AD pathologic diagnosis were compared in the 2 subgroups. The demographics, APOE[Latin Small Letter Open E]4 status, and vascular risk factors were compared in the 2 subgroups. Among the autopsy subset, the odds of having an AD pathologic diagnosis did not differ between the dysexecutive and amnestic subgroups. Under an additive model, participants in the dysexecutive subgroup possessed the APOE[Latin Small Letter Open E]4 allele less frequently compared with those in the amnestic subgroup. The dysexecutive subgroup had a history of hypertension less frequently compared with the amnestic subgroup. These distinct characteristics add to accumulating evidence that a dysexecutive subgroup of AD may have a unique underlying pathophysiology.

  10. Active Learning Increases Children's Physical Activity across Demographic Subgroups.

    PubMed

    Bartholomew, John B; Jowers, Esbelle M; Roberts, Gregory; Fall, Anna-Mária; Errisuriz, Vanessa L; Vaughn, Sharon

    2018-01-01

    Given the need to find more opportunities for physical activity within the elementary school day, this study was designed to asses the impact of I-CAN!, active lessons on: 1) student physical activity (PA) outcomes via accelerometry; and 2) socioeconomic status (SES), race, sex, body mass index (BMI), or fitness as moderators of this impact. Participants were 2,493 fourth grade students (45.9% male, 45.8% white, 21.7% low SES) from 28 central Texas elementary schools randomly assigned to intervention (n=19) or control (n=9). Multilevel regression models evaluated the effect of I-CAN! on PA and effect sizes were calculated. The moderating effects of SES, race, sex, BMI, and fitness were examined in separate models. Students in treatment schools took significantly more steps than those in control schools (β = 125.267, SE = 41.327, p = .002, d = .44). I-CAN! had a significant effect on MVPA with treatment schools realizing 80% (β = 0.796, SE =0.251, p = .001; d = .38) more MVPA than the control schools. There were no significant school-level differences on sedentary behavior (β = -0.177, SE = 0.824, p = .83). SES, race, sex, BMI, and fitness level did not moderate the impact of active learning on step count and MVPA. Active learning increases PA within elementary students, and does so consistently across demographic sub-groups. This is important as these sub-groups represent harder to reach populations for PA interventions. While these lessons may not be enough to help children reach daily recommendations of PA, they can supplement other opportunities for PA. This speaks to the potential of schools to adopt policy change to require active learning.

  11. The relationship between post traumatic stress disorder and post traumatic growth: gender differences in PTG and PTSD subgroups.

    PubMed

    Jin, Yuchang; Xu, Jiuping; Liu, Dongyue

    2014-12-01

    This study investigated the post traumatic stress disorder (PTSD) and post traumatic growth (PTG) in 2,300 earthquake survivors 1 year after the 2008 Wenchuan earthquake. This study aimed to investigate the relationship between PTSD and PTG and also tested for the gender differences in PTSD and PTG subgroups. A stratification random sampling strategy and questionnaires were used to collect the data. The PTSD was assessed using the PTSD Check list-Civilian and the PTG was assessed using the Post traumatic growth inventory. 2,300 individuals were involved in the initial survey with 2,080 completing the final questionnaire, a response rate of 90.4%. One-way ANOVA analyses were performed to investigate the gender differences in the PTSD and PTG subgroups. One year following the earthquake, 40.1 and 51.1% of survivors reported PTSD and PTG, respectively. A bivariate correlation analysis indicated that there was a positive association between PTG and PTSD. The PTG and PTSD variance analysis conducted on female and male subgroups suggested that women were more affected than men. Given the relatively high PTG prevalence, it was concluded that researchers need to pay more attention to the positive outcomes of an earthquake rather than just focusing on the negative effects. The surveys and analyses indicated that psychological intervention and care for the earthquake disaster survivors should focus more on females and older people, who tend to be more adversely affected.

  12. A new "American" subgroup of African-lineage Chikungunya virus detected in and isolated from mosquitoes collected in Haiti, 2016.

    PubMed

    White, Sarah Keller; Mavian, Carla; Salemi, Marco; Morris, John Glenn; Elbadry, Maha A; Okech, Bernard A; Lednicky, John A; Dunford, James C

    2018-01-01

    As part of on-going arboviral surveillance activity in a semi-rural region in Haiti, Chikungunya virus (CHIKV)-positive mosquito pools were identified in 2014 (the peak of the Caribbean Asian-clade epidemic), and again in 2016 by RT-PCR. In 2014, CHIKV was only identified in Aedes aegypti (11 positive pools/124 screened). In contrast, in sampling in 2016, CHIKV was not identified in Ae. aegypti, but, rather, in (a) a female Aedes albopictus pool, and (b) a female Culex quinquefasciatus pool. Genomic sequence analyses indicated that the CHIKV viruses in the 2016 mosquito pools were from the East-Central-South African (ECSA) lineage, rather than the Asian lineage. In phylogenetic studies, these ECSA lineage strains form a new ECSA subgroup (subgroup IIa) together with Brazilian ECSA lineage strains from an isolated human outbreak in 2014, and a mosquito pool in 2016. Additional analyses date the most recent common ancestor of the ECSA IIa subgroup around May 2007, and the 2016 Haitian CHIKV genomes around December 2015. Known CHIKV mutations associated with improved Ae. albopictus vector competence were not identified. Isolation of this newly identified lineage from Ae. albopictus is of concern, as this vector has a broader geographic range than Ae. aegypti, especially in temperate areas of North America, and stresses the importance for continued vector surveillance.

  13. The Role of Anger in Psychosocial Subgrouping for Patients with Low Back Pain

    PubMed Central

    Nisenzon, Anne N.; George, Steven Z.; Beneciuk, Jason M.; Wandner, Laura D.; Torres, Calia; Robinson, Michael E.

    2014-01-01

    Low back pain (LBP) is a common and costly condition that often becomes chronic if not properly addressed. Recent research has shown that psychosocial symptoms can complicate LBP, necessitating more comprehensive screening measures. The present study investigated the role of psychosocial factors, including anger regulation, in pain and disability using a screening measure designed for LBP treated with physical therapy. One-hundred and three LBP patients initiating physical therapy completed an established screening measure to assess risk for developing chronic pain, as well as psychosocial measures assessing anger, depression, anxiety, fear-avoidance, and pain-catastrophizing before and after four weeks of treatment. Dependent variables were pain intensity, physical impairment, and patient-reported disability. Risk subgrouping based on anger and other psychosocial measures was examined using established screening methods and through employing an empirical statistical approach. Analyses revealed that risk subgroups differed according to corresponding levels of negative affect, as opposed to anger alone. General psychosocial distress also predicted disability post-treatment, but, interestingly, did not have a strong relationship to pain. Subsequent hierarchical agglomerative clustering procedures divided patients into overall High and Low Distress groups, with follow-up analyses revealing that the High Distress group had higher baseline measures of pain, disability, and impairment. Findings suggest that anger may be part of generalized negative affect rather than a unique predictor when assessing risk for pain and disability in LBP treatment. Continued research in the area of screening for psychosocial prognostic indicators in LBP may ultimately guide treatment protocols in physical therapy for more comprehensive patient care. PMID:24281272

  14. Comparative sequence analyses of sixteen reptilian paramyxoviruses

    USGS Publications Warehouse

    Ahne, W.; Batts, W.N.; Kurath, G.; Winton, J.R.

    1999-01-01

    Viral genomic RNA of Fer-de-Lance virus (FDLV), a paramyxovirus highly pathogenic for reptiles, was reverse transcribed and cloned. Plasmids with significant sequence similarities to the hemagglutinin-neuraminidase (HN) and polymerase (L) genes of mammalian paramyxoviruses were identified by BLAST search. Partial sequences of the FDLV genes were used to design primers for amplification by nested polymerase chain reaction (PCR) and sequencing of 518-bp L gene and 352-bp HN gene fragments from a collection of 15 previously uncharacterized reptilian paramyxoviruses. Phylogenetic analyses of the partial L and HN sequences produced similar trees in which there were two distinct subgroups of isolates that were supported with maximum bootstrap values, and several intermediate isolates. Within each subgroup the nucleotide divergence values were less than 2.5%, while the divergence between the two subgroups was 20-22%. This indicated that the two subgroups represent distinct virus species containing multiple virus strains. The five intermediate isolates had nucleotide divergence values of 11-20% and may represent additional distinct species. In addition to establishing diversity among reptilian paramyxoviruses, the phylogenetic groupings showed some correlation with geographic location, and clearly demonstrated a low level of host species-specificity within these viruses. Copyright (C) 1999 Elsevier Science B.V.

  15. Debating space security: Capabilities and vulnerabilities

    NASA Astrophysics Data System (ADS)

    Sankaran, Jaganath

    The U.S. position in the debate on space security has been that (1) space-based systems could be developed and used to obtain decisive warfighting superiority over an adversary, and (2) these space-based systems, because they might give such an inordinate advantage over any adversary, will be attacked. The Russians and Chinese, in contrast, claim to be threatened by U.S. aspirations in space but deny that they pose a serious threat to U.S. space-based systems. They view the development of advanced military space systems by the United States as evidence of a growing gap of military capabilities limited only by technological—not political—constraints. They argue that U.S. missile defense systems operating in coordination with advanced satellite sensors would weaken their nuclear retaliatory potential. This dissertation argues that the positions held by both of these parties are more extreme than warranted. An analytical evaluation quickly narrows the touted capabilities and assumed vulnerabilities of space systems to a much smaller set of concerns that can be addressed by collaboration. Chapter 2: Operationally Responsive Space (ORS): Is 24/7 Warfighter Support Feasible? demonstrates the infeasibility of dramatically increasing U.S. warfighting superiority by using satellites. Chapter 3: What Can be Achieved by Attacking Satellites? makes the case that although U.S. armed forces rely extensively on its satellite infrastructure, that does not immediately make them desirable targets. The functions performed by military satellites are diffused among large constellations with redundancies. Also, some of the functions performed by these satellites can be substituted for by other terrestrial and aerial systems. Chapter 4: The Limits of Chinese Anti-Satellite Missiles demonstrates that anti-satellite (ASAT) intercepts are very complex under realistic conditions and that a potential adversary with space capabilities comparable to China's has very limited capability to

  16. Accounting for Subgroup Structure in Line-Transect Abundance Estimates of False Killer Whales (Pseudorca crassidens) in Hawaiian Waters

    PubMed Central

    Bradford, Amanda L.; Forney, Karin A.; Oleson, Erin M.; Barlow, Jay

    2014-01-01

    For biological populations that form aggregations (or clusters) of individuals, cluster size is an important parameter in line-transect abundance estimation and should be accurately measured. Cluster size in cetaceans has traditionally been represented as the total number of individuals in a group, but group size may be underestimated if group members are spatially diffuse. Groups of false killer whales (Pseudorca crassidens) can comprise numerous subgroups that are dispersed over tens of kilometers, leading to a spatial mismatch between a detected group and the theoretical framework of line-transect analysis. Three stocks of false killer whales are found within the U.S. Exclusive Economic Zone of the Hawaiian Islands (Hawaiian EEZ): an insular main Hawaiian Islands stock, a pelagic stock, and a Northwestern Hawaiian Islands (NWHI) stock. A ship-based line-transect survey of the Hawaiian EEZ was conducted in the summer and fall of 2010, resulting in six systematic-effort visual sightings of pelagic (n = 5) and NWHI (n = 1) false killer whale groups. The maximum number and spatial extent of subgroups per sighting was 18 subgroups and 35 km, respectively. These sightings were combined with data from similar previous surveys and analyzed within the conventional line-transect estimation framework. The detection function, mean cluster size, and encounter rate were estimated separately to appropriately incorporate data collected using different methods. Unlike previous line-transect analyses of cetaceans, subgroups were treated as the analytical cluster instead of groups because subgroups better conform to the specifications of line-transect theory. Bootstrap values (n = 5,000) of the line-transect parameters were randomly combined to estimate the variance of stock-specific abundance estimates. Hawai’i pelagic and NWHI false killer whales were estimated to number 1,552 (CV = 0.66; 95% CI = 479–5,030) and 552 (CV = 1.09; 95% CI = 97–3

  17. Accounting for subgroup structure in line-transect abundance estimates of false killer whales (Pseudorca crassidens) in Hawaiian waters.

    PubMed

    Bradford, Amanda L; Forney, Karin A; Oleson, Erin M; Barlow, Jay

    2014-01-01

    For biological populations that form aggregations (or clusters) of individuals, cluster size is an important parameter in line-transect abundance estimation and should be accurately measured. Cluster size in cetaceans has traditionally been represented as the total number of individuals in a group, but group size may be underestimated if group members are spatially diffuse. Groups of false killer whales (Pseudorca crassidens) can comprise numerous subgroups that are dispersed over tens of kilometers, leading to a spatial mismatch between a detected group and the theoretical framework of line-transect analysis. Three stocks of false killer whales are found within the U.S. Exclusive Economic Zone of the Hawaiian Islands (Hawaiian EEZ): an insular main Hawaiian Islands stock, a pelagic stock, and a Northwestern Hawaiian Islands (NWHI) stock. A ship-based line-transect survey of the Hawaiian EEZ was conducted in the summer and fall of 2010, resulting in six systematic-effort visual sightings of pelagic (n = 5) and NWHI (n = 1) false killer whale groups. The maximum number and spatial extent of subgroups per sighting was 18 subgroups and 35 km, respectively. These sightings were combined with data from similar previous surveys and analyzed within the conventional line-transect estimation framework. The detection function, mean cluster size, and encounter rate were estimated separately to appropriately incorporate data collected using different methods. Unlike previous line-transect analyses of cetaceans, subgroups were treated as the analytical cluster instead of groups because subgroups better conform to the specifications of line-transect theory. Bootstrap values (n = 5,000) of the line-transect parameters were randomly combined to estimate the variance of stock-specific abundance estimates. Hawai'i pelagic and NWHI false killer whales were estimated to number 1,552 (CV = 0.66; 95% CI = 479-5,030) and 552 (CV = 1.09; 95% CI = 97

  18. Criteria for phytoplasma 16Sr group/subgroup delineation and the need of a platform for proper registration of new groups and subgroups

    USDA-ARS?s Scientific Manuscript database

    As more phytoplasmas are discovered in emerging and re-emerging plant diseases worldwide, the scheme for classification of phytoplasmas into 16S rRNA gene RFLP (16Sr) groups and subgroups is experiencing an ongoing rapid expansion. Improper delineation or designation of new groups and subgroups can...

  19. Tobacco price increase and smoking behaviour changes in various subgroups: a nationwide longitudinal 7-year follow-up study among a middle-aged Japanese population

    PubMed Central

    Fujiwara, Takeo; Shinozaki, Tomohiro

    2017-01-01

    Objective Few longitudinal studies have examined the effect of tobacco price increase on both cessation among smokers and relapse among quitters. Our objective was to investigate the differential impact of the tobacco price increase on the changes in smoking status in the total population and various subgroups. Methods We analysed data from a Japanese nationally representative longitudinal study of 30 773 individuals aged 50–59 years (weighted sum of discrete-time number = 215 411) with smoking information, using inverse probability weighting to account for non-response at follow-up. Generalised estimating equation models were used to calculate the odds ratios (ORs) for smoking behavioural changes (cessation among smokers and relapse among quitters), using discrete-time design. Stratified analyses were conducted according to demographic, socioeconomic and health behavioural characteristics. Results From 2005 to 2012, current smoker prevalence among the middle-aged Japanese population decreased from 30.5% to 24.3%. Of all the factors surveyed, only the tobacco price increase in 2010 (up by 37%, the highest increase during the period) was significantly associated with both cessation among smokers (OR 2.14, 95% confidence interval 1.90 to 2.41) and prevention of relapse among quitters (0.60, 0.46 to 0.77). Regarding the subgroup analysis, the tobacco price increase was associated with a significant reduction in relapse in the lowest income, recent quitters and very poor health subgroups. However, different associations were observed for cessation; a significant association between price increase and cessation was observed among all subgroups except for the heavy smoker and recently unemployed subgroups. Conclusions We confirmed that the tobacco price rise was associated with increasing cessation and decreasing relapse concurrently. Furthermore, this price rise was associated with favourable smoking changes in nearly all population subgroups; a large

  20. Serological analysis of the subgroup protein of rotavirus, using monoclonal antibodies.

    PubMed Central

    Greenberg, H; McAuliffe, V; Valdesuso, J; Wyatt, R; Flores, J; Kalica, A; Hoshino, Y; Singh, N

    1983-01-01

    Ten monoclones directed to the 42,000-dalton inner structural protein of rotavirus were analyzed. Eight monoclones reacted broadly with antigenic domains common to virtually all mammalian rotaviruses. Two monoclones had specificities similar or identical to previously characterized subgroup specificities. These subgroup monoclones were more efficient in detecting subgroup antigen than either hyperimmune or postinfection antisera. Using the subgroup monoclones, we determined that some animal as well as human rotavirus strains carry subgroup 2 specificity and that epizootic diarrhea of infant mice virus and turkey rotavirus are antigenically distinct from other mammalian rotavirus strains. Images PMID:6185436

  1. Using Debate to Teach Pharmacy Students About Ethical Issues

    PubMed Central

    Hanna, Lezley-Anne; Barry, Johanne; Donnelly, Ryan; Hughes, Fiona; Jones, David; Laverty, Garry; Parsons, Carole; Ryan, Cristin

    2014-01-01

    Objective. To create, implement, and evaluate debate as a method of teaching pharmacy undergraduate students about ethical issues. Design. Debate workshops with 5 hours of contact with student peers and facilitators and 5 hours of self-study were developed for second-year pharmacy students. Student development of various skills and understanding of the topic were assessed by staff members and student peers. Assessment. One hundred fifty students completed the workshops. The mean score for debating was 25.9 out of 30, with scores ranging from 23.2 to 28.7. Seventy percent of students agreed that the debates were a useful teaching method in the degree program. Conclusion. A series of workshops using debates effectively delivered course content on ethical issues and resulted in pharmacy students developing skills such as teamwork, peer assessment, communication, and critical evaluation. These findings suggest that pharmacy students respond favorably to a program using debates as a teaching tool. PMID:24761018

  2. Using debate to teach pharmacy students about ethical issues.

    PubMed

    Hanna, Lezley-Anne; Barry, Johanne; Donnelly, Ryan; Hughes, Fiona; Jones, David; Laverty, Garry; Parsons, Carole; Ryan, Cristin

    2014-04-17

    To create, implement, and evaluate debate as a method of teaching pharmacy undergraduate students about ethical issues. Debate workshops with 5 hours of contact with student peers and facilitators and 5 hours of self-study were developed for second-year pharmacy students. Student development of various skills and understanding of the topic were assessed by staff members and student peers. One hundred fifty students completed the workshops. The mean score for debating was 25.9 out of 30, with scores ranging from 23.2 to 28.7. Seventy percent of students agreed that the debates were a useful teaching method in the degree program. A series of workshops using debates effectively delivered course content on ethical issues and resulted in pharmacy students developing skills such as teamwork, peer assessment, communication, and critical evaluation. These findings suggest that pharmacy students respond favorably to a program using debates as a teaching tool.

  3. Reconsolidation of memory: a decade of debate.

    PubMed

    Besnard, Antoine; Caboche, Jocelyne; Laroche, Serge

    2012-10-01

    Memory consolidation refers to a slow process that stabilises a memory trace after initial acquisition of novel events. The consolidation theory posits that once a memory is stored in the brain, it remains fixed for the lifetime of the memory. However, compelling evidence has suggested that upon recall, memories can re-enter a state of transient instability, requiring further stabilisation to be available once again for recall. Since its rehabilitation in the past ten years, this process of reconsolidation of memory after recall stimulated intense debates in the field of cognitive neuroscience. In this review we compile this plentiful literature with a particular emphasis on some of the key questions that have emerged from the reconsolidation theory. We focus on tracing the characterisation of the boundary conditions that constrain the occurrence of memory reconsolidation. We also discuss accumulating evidence supporting the idea that reconsolidation, as implied by its definition, is not a mere repetition of consolidation. We review seminal studies that uncovered specific mechanisms recruited during reconsolidation that are not always crucially involved in consolidation. We next address the physiological significance of reconsolidation since several lines of evidence support the idea that reconsolidation, as opposed to consolidation, may offer a unique opportunity to update memories. We finally discuss recent evidence for or against the potential that the process of memory reconsolidation offers for ongoing efforts to develop novel strategies to combat pathogenic memories. Copyright © 2012 Elsevier Ltd. All rights reserved.

  4. The conscientious objection: debate on emergency contraception.

    PubMed

    Montanari Vergallo, G; Zaami, S; Di Luca, N M; Marinelli, E

    2017-01-01

    The authors discuss the emergency contraception (EC) topic, assessing scientific and ethical aspects. The almost totality of the studies carried out tends to report on the use of drugs as an emergency measure to prevent pregnancy. However, it is not yet completely excluded that emergency contraceptives can induce medical abortion. The debate on side effects of EC continues to be a highly emotional and controversial issue both for advocates who believe they will lower considerably the number of unintended pregnancies and abortions, and for opponents who believe that using emergency contraception amounts to an abortion. This latter hypothesis highlights the conflicting aspect of the conscientious objection to abortion of physicians and pharmacists. This research work is aimed at investigating the emergency contraception issue, paying particular attention to the medico-legal and regulatory aspects of this subject. Particularly, the authors focus on the conscientious objection in order to assess, if any, legal protection for physicians and pharmacists who claim a right to conscientious objection. Inappropriate use of EC could be resolved through a registry of user. This registry, of course, would not have the intention of persecution, but would only serve to detect possible cases of subjugation, exploitation and harassment.

  5. Debating Water Fluoridation Before Dr. Strangelove

    PubMed Central

    2015-01-01

    In the 1930s, scientists learned that small amounts of fluoride naturally occurring in water could protect teeth from decay, and the idea of artificially adding fluoride to public water supplies to achieve the same effect arose. In the 1940s and early 1950s, a number of studies were completed to determine whether fluoride could have harmful effects. The research suggested that the possibility of harm was small. In the early 1950s, Canadian and US medical, dental, and public health bodies all endorsed water fluoridation. I argue in this article that some early concerns about the toxicity of fluoride were put aside as evidence regarding the effectiveness and safety of water fluoridation mounted and as the opposition was taken over by people with little standing in the scientific, medical, and dental communities. The sense of optimism that infused postwar science and the desire of dentists to have a magic bullet that could wipe out tooth decay also affected the scientific debate. PMID:26066938

  6. Emphasizing history in communicating scientific debates

    NASA Astrophysics Data System (ADS)

    Sherwood, S. C.

    2010-12-01

    Communication to the public of the reality of anthropogenic climate change has been less successful than many expect. The scientists themselves, the media, special interest groups, or the complexity of modern society are often blamed. However a look at past scientific paradigm shifts, in particular the Copernican revolution and the discovery of relativity, shows close parallels with the modern situation. Common aspects include the gradual formation of a scientific consensus in advance of the public; a politically partisan backlash against the new theory that, paradoxically, occurs after the arrival of conclusive supporting evidence; the prevalence of convincing but invalid pseudo-scientific counterarguments; the general failure of "debates" to increase public acceptance of the scientists' position; and, in the case of the heliocentric solar system, a very long time scale to final public acceptance (> 100 years). Greater emphasis on the lessons from such historical parallels, and on the success so far of consensus predictions of global warming made up to and including the first IPCC report in 1990, might be one useful way of enhancing the public's trust in science and scientists and thereby accelerate acceptance of uncomfortable scientific findings.

  7. Nuclear power, energy, and the national debate

    SciTech Connect

    McCormack, R.A.

    1976-01-01

    The U.S. power industry is engaged in a national debate. On the outside, it appears to be a nuclear issue, but basically it is energy, growth, capitalism, institutions, and the way of life itself. It is a new experience for the engineers in the power industry, who, in the past handled their responsibilities in a ''low-key way, the way of the specialist.'' All this has changed. The author reviews the concerns the power industry now faces--the lack of an energy policy, state referenda, power plant delays, lobbying for financial support, energy shortages, and fragmentation of the energy industry. The authormore » urges ''that we of the third estate establish a permanent national energy forum bringing together every major sector of the energy industry--coal, oil, uranium, the electric utilities, suppliers and users of high technology, those on the forefront of research for using new fuels, and the major financial institutions who must obtain for all the rest of us in the private sector the money we need from the investor marketplace. The founding purpose and initial task would be to assemble a panel of statesmen from the private sector, following the pattern employed by the National Petroleum Council, to undertake and direct in the next year a fundamental reassessment of the role of the private sector in energy supply and in the research, development, and full commercialization of advanced energy production technology.'' (MCW)« less

  8. Geneticization and bioethics: advancing debate and research.

    PubMed

    Arnason, Vilhjálmur; Hjörleifsson, Stefán

    2007-12-01

    In the present paper, we focus on the role that the concept of geneticization has played in the discussion about health care, bioethics and society. The concept is discussed and examples from the evolving discourse about geneticization are critically analyzed. The relationship between geneticization, medicalization and biomedicalization is described, emphasizing how debates about the latter concepts can inspire future research on geneticization. It is shown how recurrent themes from the media coverage of genetics portray typical traits of geneticization and thus contribute to the process. We look at examples of small-scale studies from the literature where geneticization of medical practice has been demonstrated. Methodological disputes about the relevance of empirical evidence for the geneticization thesis and the normative status of the concept are discussed. We consider arguments to the effect that ideas from mainstream bioethics have facilitated geneticization by emphasizing individualistic notions of autonomy and responsibility while ignoring the role of genetics in the wider social context. It is shown how a concept like geneticization, which can be used to draw the attention of philosophers, social scientists and others to challenges that tend to be neglected by mainstream bioethics, also has the potential to move people's attention away from other pertinent issues. This may happen if researchers become preoccupied with the transformative effects of genetics, and we argue that a wider reading of geneticization should inspire critical analysis of the sociocultural preconditions under which genetics is currently evolving.

  9. [Professional debate on shortage of physicians].

    PubMed

    Gérvas, Juan; Bonis, Julio

    2008-01-01

    We do not know the best answer to problems due to shortage of physicians (absolute number and by specialities) but perhaps what is important is the lack of a professional debate about what means 'to be' a physician. In this paper we address four key professional questions: 1/ the over-training of physicians when health demand now includes minor problems, 2/ predominance of physician-patient direct encounters in a world of telecommunications and indirect encounters, 3/ the need to delegate power and responsibilities to other health professionals as a consequence of new technology developments and changes in role-design, and 4/ too much emphasis in diagnosis with the danger to initiate cascades with its side-effects. Practical answers to these questions require changes in pre and postgraduate education, improvement in health services organization to profit the use of telecommunications and analysis and re-design of the limits in between professions, levels of care, institutions and health and social sectors.

  10. The preprint debate: What are the issues?

    PubMed

    da Silva, Jaime A Teixeira

    2018-04-01

    The debate surrounding preprints is increasing. Preprint proponents claim that preprints are a way to shore up trust in academic publishing, that they provide an additional 'quality' screen prior to traditional peer review, that they can assist with the replication crisis plaguing science in part by making negative or contradictory results public, and that they speed up the publishing process because fundamental results can be presented early, serving as timely reports for the purposes of tenure or grant funding. Preprint skeptics and critics claim that preprints may represent a risk and a danger to quality-based academic publishing because they are documents that have not been carefully and thoroughly vetted prior to their release into the public domain. Thus, academics who cite invalid, poorly vetted, or false facts could cause harm, not unlike the unscholarly 'predatory' open access movement. Feedback on work from lesser-known groups, or on less glamorous topics, may be null or worse than from traditional peer review, annulling an initial key objective of preprints. Although there is no widespread empirical evidence or data yet regarding some of these issues, academics should be aware of the ideological, financial, and political tug-of-war taking place before deciding if they wish to publish their important findings as a preprint prior or simultaneous to submitting to a regular journal for peer review.

  11. Discriminative and predictive validity of the scoliosis research society-22 questionnaire in management and curve-severity subgroups of adolescents with idiopathic scoliosis.

    PubMed

    Parent, Eric C; Hill, Doug; Mahood, Jim; Moreau, Marc; Raso, Jim; Lou, Edmond

    2009-10-15

    Prospective cross-sectional measurement study. To determine the ability of the Scoliosis Research Society (SRS)-22 questionnaire to discriminate among management and scoliosis severity subgroups and to correlate with internal and external measures of curve severity. In earlier studies of the SRS-22 discriminative ability, age was not a controlled factor. The ability of the SRS-22 to predict curve severity has not been thoroughly examined. The SRS-22 was completed by 227 females with adolescent idiopathic scoliosis. Using Analysis of covariance analyses controlling for age, the SRS-22 scores were compared among management subgroups (observation, brace, presurgery, and postsurgery) and curve-severity subgroups (in nonoperated subjects: Cobb angles of <30 degrees, 30 degrees -50 degrees, and >50 degrees). A stepwise discriminant analysis was used to identify the SRS-22 domains most discriminative for curve-severity categories. Correlation between SRS-22 scores and radiographic or surface topography measurements was used to determine the predictive ability of the questionnaire. Pain was better for subjects treated with braces than for those planning surgery. Self-image was better for subjects under observation or postsurgery than for those planning surgery. Satisfaction was better for the brace and postsurgery subgroups than for the observation or presurgery subgroups. Statistically significant mean differences between subgroups were all larger than 0.5, which is within the range of minimal clinically important differences recommended for each of the 5-point SRS-22 domain scoring scales. Pain and mental health were worse for those with Cobb angles of >50 degrees than with Cobb angles of 30 degrees to 50 degrees. Self-image and total scores were worse for those with Cobb angles of >50 degrees than both other subgroups. Using discriminant analysis, self-image was the only SRS-22 domain score selected to classify subjects within curve severity subgroups. The percentage of

  12. Anatomic and Physiologic Heterogeneity of Subgroup-A Auditory Sensory Neurons in Fruit Flies.

    PubMed

    Ishikawa, Yuki; Okamoto, Natsuki; Nakamura, Mizuki; Kim, Hyunsoo; Kamikouchi, Azusa

    2017-01-01

    The antennal ear of the fruit fly detects acoustic signals in intraspecific communication, such as the courtship song and agonistic sounds. Among the five subgroups of mechanosensory neurons in the fly ear, subgroup-A neurons respond maximally to vibrations over a wide frequency range between 100 and 1,200 Hz. The functional organization of the neural circuit comprised of subgroup-A neurons, however, remains largely unknown. In the present study, we used 11 GAL4 strains that selectively label subgroup-A neurons and explored the diversity of subgroup-A neurons by combining single-cell anatomic analysis and Ca 2+ imaging. Our findings indicate that the subgroup-A neurons that project into various combinations of subareas in the brain are more anatomically diverse than previously described. Subgroup-A neurons were also physiologically diverse, and some types were tuned to a narrow frequency range, suggesting that the response of subgroup-A neurons to sounds of a wide frequency range is due to the existence of several types of subgroup-A neurons. Further, we found that an auditory behavioral response to the courtship song of flies was attenuated when most subgroup-A neurons were silenced. Together, these findings characterize the heterogeneous functional organization of subgroup-A neurons, which might facilitate species-specific acoustic signal detection.

  13. Anatomic and Physiologic Heterogeneity of Subgroup-A Auditory Sensory Neurons in Fruit Flies

    PubMed Central

    Ishikawa, Yuki; Okamoto, Natsuki; Nakamura, Mizuki; Kim, Hyunsoo; Kamikouchi, Azusa

    2017-01-01

    The antennal ear of the fruit fly detects acoustic signals in intraspecific communication, such as the courtship song and agonistic sounds. Among the five subgroups of mechanosensory neurons in the fly ear, subgroup-A neurons respond maximally to vibrations over a wide frequency range between 100 and 1,200 Hz. The functional organization of the neural circuit comprised of subgroup-A neurons, however, remains largely unknown. In the present study, we used 11 GAL4 strains that selectively label subgroup-A neurons and explored the diversity of subgroup-A neurons by combining single-cell anatomic analysis and Ca2+ imaging. Our findings indicate that the subgroup-A neurons that project into various combinations of subareas in the brain are more anatomically diverse than previously described. Subgroup-A neurons were also physiologically diverse, and some types were tuned to a narrow frequency range, suggesting that the response of subgroup-A neurons to sounds of a wide frequency range is due to the existence of several types of subgroup-A neurons. Further, we found that an auditory behavioral response to the courtship song of flies was attenuated when most subgroup-A neurons were silenced. Together, these findings characterize the heterogeneous functional organization of subgroup-A neurons, which might facilitate species-specific acoustic signal detection. PMID:28701929

  14. Linus Pauling and the scientific debate over fallout hazards.

    PubMed

    Jolly, J Christopher

    2002-12-01

    From 1954 to 1963, numerous scientists engaged in a public debate over the possible hazards from radioactive fallout from nuclear weapons testing. Nobel laureate Linus Pauling, a California Institute of Technology chemist, was one of the most prominent. His scientific papers relating to the fallout debate reveal many of the scientific, social and political issues involved in the controversy. Although the public controversy ended after the signing of the 1963 Limited Test Ban Treaty, many of the scientific questions about the possible hazards of low-level radiation remain under debate within the scientific community. Moreover, the fallout debate was a prototype of current controversies over environmental and public-health hazards.

  15. Authoritative regulation and the stem cell debate.

    PubMed

    Capps, Benjamin

    2008-01-01

    In this paper I argue that liberal democratic communities are justified in regulating the activities of their members because of the inevitable existence of conflicting conceptions of what is considered as morally right. This will often lead to tension and disputes, and in such circumstances, reliance on peaceful or orderly co-existence will not normally suffice. In such pluralistic societies, the boundary between permissible and impermissible activities will be unclear; and this becomes a particular concern in controversial issues which raise specific anxieties and uncertainty. One context that has repeatedly raised issues in this regard is that of biotechnology and, in particular, the recent stem cell debate, on which this paper concentrates. While such developments have the potential to make significant improvements to therapeutic progress, we should also be sceptical because predicting the impact of these developments remains uncertain and complex. For the sake of socio-political stability, it will therefore be necessary to enact and enforce rules which limit these competing claims in public policy but which may not be compatible with what individual moral commitments ideally permit. One way to achieve this is to establish procedural frameworks to resolve potential disputes in the public sphere about what is right, wrong, or permissible conduct. I argue that for one to commit to authoritative regulation, an idea of harm prevention through state intervention is necessary; and that this requires optimum mechanisms of procedure which allow the individual the opportunity to compromise and yet to continue to oppose or fight for changes as demanded by his or her moral position.

  16. Hispanic Subgroups, Acculturation, and Substance Abuse Treatment Outcomes

    PubMed Central

    Chartier, Karen G.; Carmody, Tom; Akhtar, Maleeha; Stebbins, Mary B.; Walters, Scott T.; Warden, Diane

    2015-01-01

    This study explored Hispanic subgroup differences in substance use treatment outcomes, and the relationship of acculturation characteristics to these outcomes. Data were from a multisite randomized clinical trial of motivational enhancement therapy versus treatment as usual in a sample of Spanish-speaking substance abusers. Participants were Cuban American (n=34), Mexican American (n=209), Puerto Rican (n=78), and other Hispanic American (n=54). Results suggested that Cuban Americans and individuals with more connection to Hispanic culture had lower treatment retention. Hispanics born in the U.S and those who spoke English at home had a lower percentage of days abstinent during weeks 5-16, although Puerto Ricans born in the U.S. and Cuban Americans living more years in the U.S. had a higher percentage of days abstinent in weeks 1-4 and 5-16, respectively. Results may inform future hypothesis-driven studies in larger Hispanic treatment seeking samples of the relationship between acculturation and treatment outcome. PMID:26362001

  17. ctsGE-clustering subgroups of expression data.

    PubMed

    Sharabi-Schwager, Michal; Or, Etti; Ophir, Ron

    2017-07-01

    A pre-requisite to clustering noisy data, such as gene-expression data, is the filtering step. As an alternative to this step, the ctsGE R-package applies a sorting step in which all of the data are divided into small groups. The groups are divided according to how the time points are related to the time-series median. Then clustering is performed separately on each group. Thus, the clustering is done in two steps. First, an expression index (i.e. a sequence of 1, -1 and 0) is defined and genes with the same index are grouped together, and then each group of genes is clustered by k-means to create subgroups. The ctsGE package also provides an interactive tool to visualize and explore the gene-expression patterns and their subclusters. ctsGE proposes a way of organizing and exploring expression data without eliminating valuable information. Freely available as part of the Bioconductor project at https://bioconductor.org/packages/ctsGE/ . ron@agri.gov.il. Supplementary data are available at Bioinformatics online. © The Author (2017). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  18. Distinct tumor protein p53 mutants in breast cancer subgroups.

    PubMed

    Dumay, Anne; Feugeas, Jean-Paul; Wittmer, Evelyne; Lehmann-Che, Jacqueline; Bertheau, Philippe; Espié, Marc; Plassa, Louis-François; Cottu, Paul; Marty, Michel; André, Fabrice; Sotiriou, Christos; Pusztai, Lajos; de Thé, Hugues

    2013-03-01

    Tumor protein p53 (TP53) is mutated in approximately 30% of breast cancers, but this frequency fluctuates widely between subclasses. We investigated the p53 mutation status in 572 breast tumors, classified into luminal, basal and molecular apocrine subgroups. As expected, the lowest mutation frequency was observed in luminal (26%), and the highest in basal (88%) tumors. Luminal tumors showed significantly higher frequency of substitutions (82 vs. 65%), notably A/T to G/C transitions (31 vs. 15%), whereas molecular apocrine and basal tumors presented much higher frequencies of complex mutations (deletions/insertions) (36 and 33%, respectively, vs. 18%). Accordingly, missense mutations were significantly more frequent in luminal tumors (75 vs. 54%), whereas basal tumors displayed significantly increased rates of TP53 truncations (43 vs. 25%), resulting in loss of function and/or expression. Interestingly, as basal tumors, molecular apocrine tumors presented with a high rate of complex mutations, but paradoxically, these were not associated with increased frequency of p53 truncation. As in luminal tumors, this could reflect a selective pressure for p53 gain of function, possibly through P63/P73 inactivation. Collectively, these observations point not only to different mechanisms of TP53 alterations, but also to different functional consequences in the different breast cancer subtypes. Copyright © 2012 UICC.

  19. Detection of Patient Subgroups with Differential Expression in Omics Data: A Comprehensive Comparison of Univariate Measures

    PubMed Central

    Ahrens, Maike; Turewicz, Michael; Casjens, Swaantje; May, Caroline; Pesch, Beate; Stephan, Christian; Woitalla, Dirk; Gold, Ralf; Brüning, Thomas; Meyer, Helmut E.

    2013-01-01

    Detection of yet unknown subgroups showing differential gene or protein expression is a frequent goal in the analysis of modern molecular data. Applications range from cancer biology over developmental biology to toxicology. Often a control and an experimental group are compared, and subgroups can be characterized by differential expression for only a subgroup-specific set of genes or proteins. Finding such genes and corresponding patient subgroups can help in understanding pathological pathways, diagnosis and defining drug targets. The size of the subgroup and the type of differential expression determine the optimal strategy for subgroup identification. To date, commonly used software packages hardly provide statistical tests and methods for the detection of such subgroups. Different univariate methods for subgroup detection are characterized and compared, both on simulated and on real data. We present an advanced design for simulation studies: Data is simulated under different distributional assumptions for the expression of the subgroup, and performance results are compared against theoretical upper bounds. For each distribution, different degrees of deviation from the majority of observations are considered for the subgroup. We evaluate classical approaches as well as various new suggestions in the context of omics data, including outlier sum, PADGE, and kurtosis. We also propose the new FisherSum score. ROC curve analysis and AUC values are used to quantify the ability of the methods to distinguish between genes or proteins with and without certain subgroup patterns. In general, FisherSum for small subgroups and -test for large subgroups achieve best results. We apply each method to a case-control study on Parkinson's disease and underline the biological benefit of the new method. PMID:24278130

  20. Molecular subgroups of adult medulloblastoma: a long-term single-institution study.

    PubMed

    Zhao, Fu; Ohgaki, Hiroko; Xu, Lei; Giangaspero, Felice; Li, Chunde; Li, Peng; Yang, Zhijun; Wang, Bo; Wang, Xingchao; Wang, Zhenmin; Ai, Lin; Zhang, Jing; Luo, Lin; Liu, Pinan

    2016-07-01

    Recent transcriptomic approaches have demonstrated that there are at least 4 distinct subgroups in medulloblastoma (MB); however, survival studies of molecular subgroups in adult MB have been inconclusive because of small sample sizes. The aim of this study is to investigate the molecular subgroups in adult MB and identify their clinical and prognostic implications in a large, single-institution cohort. We determined gene expression profiles for 13 primary adult MBs. Bioinformatics tools were used to establish distinct molecular subgroups based on the most informative genes in the dataset. Immunohistochemistry with subgroup-specific antibodies was then used for validation within an independent cohort of 201 formalin-fixed MB tumors, in conjunction with a systematic analysis of clinical and histological characteristics. Three distinct molecular variants of adult MB were identified: the SHH, WNT, and group 4 subgroups. Validation of these subgroups in the 201-tumor cohort by immunohistochemistry identified significant differences in subgroup-specific demographics, histology, and metastatic status. The SHH subgroup accounted for the majority of the tumors (62%), followed by the group 4 subgroup (28%) and the WNT subgroup (10%). Group 4 tumors had significantly worse progression-free and overall survival compared with tumors of the other molecular subtypes. We have identified 3 subgroups of adult MB, characterized by distinct expression profiles, clinical features, pathological features, and prognosis. Clinical variables incorporated with molecular subgroup are more significantly informative for predicting adult patient outcome. © The Author(s) 2016. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  1. Low Back Pain Subgroups using Fear-Avoidance Model Measures: Results of a Cluster Analysis

    PubMed Central

    Beneciuk, Jason M.; Robinson, Michael E.; George, Steven Z.

    2012-01-01

    Objectives The purpose of this secondary analysis was to test the hypothesis that an empirically derived psychological subgrouping scheme based on multiple Fear-Avoidance Model (FAM) constructs would provide additional capabilities for clinical outcomes in comparison to a single FAM construct. Methods Patients (n = 108) with acute or sub-acute low back pain (LBP) enrolled in a clinical trial comparing behavioral physical therapy interventions to classification based physical therapy completed baseline questionnaires for pain catastrophizing (PCS), fear-avoidance beliefs (FABQ-PA, FABQ-W), and patient-specific fear (FDAQ). Clinical outcomes were pain intensity and disability measured at baseline, 4-weeks, and 6-months. A hierarchical agglomerative cluster analysis was used to create distinct cluster profiles among FAM measures and discriminant analysis was used to interpret clusters. Changes in clinical outcomes were investigated with repeated measures ANOVA and differences in results based on cluster membership were compared to FABQ-PA subgrouping used in the original trial. Results Three distinct FAM subgroups (Low Risk, High Specific Fear, and High Fear & Catastrophizing) emerged from cluster analysis. Subgroups differed on baseline pain and disability (p’s<.01) with the High Fear & Catastrophizing subgroup associated with greater pain than the Low Risk subgroup (p<.01) and the greatest disability (p’s<.05). Subgroup × time interactions were detected for both pain and disability (p’s<.05) with the High Fear & Catastrophizing subgroup reporting greater changes in pain and disability than other subgroups (p’s<.05). In contrast, FABQ-PA subgroups used in the original trial were not associated with interactions for clinical outcomes. Discussion These data suggest that subgrouping based on multiple FAM measures may provide additional information on clinical outcomes in comparison to determining subgroup status by FABQ-PA alone. Subgrouping methods for

  2. Prognostic subgroups for remission and response in the Coordinated Anxiety Learning and Management (CALM) trial.

    PubMed

    Kelly, J MacLaren; Jakubovski, Ewgeni; Bloch, Michael H

    2015-03-01

    Most patients with anxiety disorders receive treatment in primary care settings. Limited moderator data are available to inform clinicians of likely prognostic outcomes for individual patients. We identify baseline characteristics associated with outcome in adults seeking treatment for anxiety disorders. We conducted an exploratory moderator analysis from the Coordinated Anxiety Learning and Management (CALM) trial. In the CALM trial, 1,004 adults who met DSM-IV criteria for generalized anxiety disorder (GAD), panic disorder, social anxiety disorder, and/or posttraumatic stress disorder (PTSD) were randomized to usual care (UC) or a collaborative care intervention (ITV) of cognitive-behavioral therapy and/or pharmacotherapy between June 2006 and April 2008. Logistic regression was used to examine baseline characteristics associated with remission and response overall and by treatment condition. Receiver operating curve (ROC) analyses identified subgroups associated with similar likelihood of response and remission of global anxiety symptoms. Remission was defined as score < 6 on the 12-item Brief Symptom Inventory (BSI-12) anxiety and somatization subscales. Response was defined as at least 50% reduction on BSI-12, or meeting remission criteria. Randomization to ITV over UC was often the strongest predictor of outcome. Several baseline patient characteristics were associated with poor treatment outcome including comorbid depression, increased severity of underlying anxiety disorder(s) (P < .001), low socioeconomic status (perceived [P < .001] and actual [P < .05]), and limited social support (P < .001). Patient characteristics associated with particular benefit from ITV were being female (P < .05), increased depression (P < .01)/GAD severity (P < .05), and low socioeconomic status (P < .05). ROC analysis demonstrated prognostic subgroups with large differences in response likelihood. Further research should focus on the effectiveness of implementing the ITV

  3. Farmer-suicide in India: debating the role of biotechnology.

    PubMed

    Thomas, Gigesh; De Tavernier, Johan

    2017-12-01

    Indian Biotech opponents have attributed the increase of suicides to the monopolization of GM seeds, centering on patent control, application of terminator technology, marketing strategy, and increased production costs. The contentions of the biotech opponents, however, have been criticized for a lack of transparency in their modus operandi i.e. the use of methodology in their argumentation. The fact is, however, that with the intention of getting the attention of those capable of determining the future of GM cotton in India, opponents resorted to generating controversies. Therefore, this article will review and evaluate the multifaceted contentions of both opponents and defenders. Although the association between seed monopolization and farmer-suicide is debatable, we will show that there is a link between the economic factors associated with Bt. cultivation and farmer suicide. The underlying thesis of biotech opponents becomes all the more significant when analysed vis-à-vis the contention of the globalization critics that there has been a political and economic marginalization of the Indian farmers. Their accusation assumes significance in the context of a fragile democracy like India where market forces are accorded precedence over farmers' needs until election time.

  4. Forensics and mitochondrial DNA: applications, debates, and foundations.

    PubMed

    Budowle, Bruce; Allard, Marc W; Wilson, Mark R; Chakraborty, Ranajit

    2003-01-01

    Debate on the validity and reliability of scientific methods often arises in the courtroom. When the government (i.e., the prosecution) is the proponent of evidence, the defense is obliged to challenge its admissibility. Regardless, those who seek to use DNA typing methodologies to analyze forensic biological evidence have a responsibility to understand the technology and its applications so a proper foundation(s) for its use can be laid. Mitochondrial DNA (mtDNA), an extranuclear genome, has certain features that make it desirable for forensics, namely, high copy number, lack of recombination, and matrilineal inheritance. mtDNA typing has become routine in forensic biology and is used to analyze old bones, teeth, hair shafts, and other biological samples where nuclear DNA content is low. To evaluate results obtained by sequencing the two hypervariable regions of the control region of the human mtDNA genome, one must consider the genetically related issues of nomenclature, reference population databases, heteroplasmy, paternal leakage, recombination, and, of course, interpretation of results. We describe the approaches, the impact some issues may have on interpretation of mtDNA analyses, and some issues raised in the courtroom.

  5. Deconstructing the Skills Training Debate in Doctoral Education

    ERIC Educational Resources Information Center

    Craswell, Gail

    2007-01-01

    The pressure being placed on universities to deliver skills training for the workplace has generated considerable debate. This paper deconstructs the broader employability discourse in which the debate is embedded in order to draw out its formative implications for skills training during candidature. The paper argues against erection of a…

  6. Rhetorical Legitimacy, and the Presidential Debates.

    ERIC Educational Resources Information Center

    Lucaites, John Louis

    1989-01-01

    Explores the negative popular reaction to the 1988 Presidential Debates. Examines how these events function as ritualistic enactments of the , thus providing a rhetorical legitimacy for the electoral process in a system dedicated to . Suggests how the 1988 debates failed to satisfy that function. (MM)

  7. Debate as an alternative method for medical literature evaluation.

    PubMed

    Toor, Rebecca; Samai, Kathryn; Wargo, Ryan

    2017-05-01

    To determine the student impression of utilizing a debate style journal club as an alternative approach for preceptors to teach medical literature evaluation skills to pharmacy students undergoing Advance Pharmacy Practice Experiences (APPE) in both acute care and ambulatory care. Students were asked to debate on a controversial topic or two drugs with similar indications. Each side had to research supporting evidence based medicine and use literature appraisal skills to incorporate the information logically into an oral debate style format. Approximately fifteen minutes were allotted for each debate, allowing five minutes for each opening argument, three minutes for each rebuttal, and two minutes for each closing argument. Students were then asked to complete a post-debate survey using a Likert Scale to evaluate their perception of the debate style journal club. Following implementation of the debate style journal club, students reported being more confident with their ability to find, compare, and retain information from primary literature with a mean of 4.1, 4.2, and 4.4 respectively on a Likert Scale. Students also reported overall enjoyment and satisfaction with a mean of 4.0. Debate style journal clubs have the capability to teach pharmacy students vital literature appraisal skills, and are a well-liked alternative to the traditional style journal club. Incorporating this method improved student interest as well as increased their ability to find, compare, and retain the information gathered from primary literature. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Stimulating Critical Thinking in the Undergrad Classroom: The Spanking Debate

    ERIC Educational Resources Information Center

    Walker, Susan K.; Benson, Lisa J.

    2010-01-01

    To encourage critical thinking and expression of viewpoints by undergraduate students, an in-class debate on the issue of spanking as a disciplinary practice and its impact on children's development is presented as a class activity. Specific details on how the debate is conducted are provided. Evaluation results suggest that the activity is…

  9. Petition may trigger parliamentary debate on regulator's fee.

    PubMed

    2014-06-01

    THE NURSING and Midwifery Council's (NMC) proposed registration fee increase to £120 is likely to be debated in parliament after a petition against the rise reached 100,000 signatures. The petition, started by mental health liaison nurse Steve Iwasyk, gained the necessary number of signatures to spark a debate.

  10. Preparing Students in Online Debates with Worked Examples

    ERIC Educational Resources Information Center

    Tollison, Scott; Xie, Kui

    2012-01-01

    The current study investigates the effects of preparing students for an online debate through a worked example in terms of student perception, participation, and level of cognitive skills. The study found that students prepared for online debate through a worked example participated more frequently, wrote more words or phrases that encouraged the…

  11. Students as Customers in Higher Education: Reframing the Debate

    ERIC Educational Resources Information Center

    Guilbault, Melodi

    2016-01-01

    Even though marketing in higher education (HE) is well established, there is a continued debate about who the customer is, with many still not accepting that students should be viewed as customers in HE. The student as customer model has its opponents and proponents. This paper reframes the debate using the framework of market orientation,…

  12. Overlooked Issues of Religious Identity in the School Dinners Debate

    ERIC Educational Resources Information Center

    Twiner, Alison; Cook, Guy; Gillen, Julia

    2009-01-01

    The TV broadcast of "Jamie's school dinners" in 2005 prompted action throughout the UK to improve the standards of school meals. A public debate continues across the media around changes, resistance to them and consequences. This article draws upon the findings of a one-year ESRC-funded project on the English school dinners debate, which…

  13. Credentials, Curriculum, and Access: The Debate Over Nurse Preparation.

    ERIC Educational Resources Information Center

    Karp, Melinda Mechur; Jacobs, James; Hughes, Katherine L.

    The question of how to best prepare nurses for practice continues to be debated extensively. The crux of the debate is whether a bachelor of science in nursing (BSN) should be required of all registered nurses in the United States or whether an associate degree in nursing (ADN) and diploma programs adequately prepare novice nurses for practice.…

  14. The College Access Debate: Class Considerations and College Preparation

    ERIC Educational Resources Information Center

    Hodgman, Matthew R.

    2013-01-01

    The college access debate in America remains an important one. Affirmative action policies and practices continue to occupy a significant sub-component of the overall college access discussion. Recent legal debates and policy changes pertaining to affirmative action have encouraged analysis surrounding the overall viability and fairness of these…

  15. The Use and Abuse of Risk Analysis in Policy Debate.

    ERIC Educational Resources Information Center

    Herbeck, Dale A.; Katsulas, John P.

    The best check on the preposterous claims of crisis rhetoric is an appreciation of the nature of risk analysis and how it functions in argumentation. The use of risk analysis is common in policy debate. While the stock issues paradigm focused the debate exclusively on the affirmative case, the advent of policy systems analysis has transformed…

  16. The Pre-K Debates: Current Controversies and Issues

    ERIC Educational Resources Information Center

    Zigler, Edward, Ed.; Gilliam, Walter S., Ed.; Barnett, W. Steven, Ed.

    2011-01-01

    Targeted or universal pre-K? Direct instruction or learning through play? These and other debates are heating up as more and more young children across the country gain access to pre-K programs. Now there's a single volume that spotlights today's most urgent pre-K debates, explores each one from all sides, and paves the way for sound, educated…

  17. Presidential Debate Watching, Issue Knowledge, Character Evaluation, and Vote Choice

    ERIC Educational Resources Information Center

    Benoit, William L.; Hansen, Glenn J.

    2004-01-01

    This study employs NES (National Election Survey) data from several presidential elections to investigate the effects of presidential debate watching on voters' issue knowledge, character evaluation, and vote choice. Debates can instill issue knowledge; however, voters are less likely to learn about incumbent presidents seeking re-election after a…

  18. Debates Contribute to the Development of the Journalistic Science.

    ERIC Educational Resources Information Center

    Gan, Xifen

    1994-01-01

    Discusses seven major debates on journalism that typify the Chinese journalism reform's ideological and operational dilemmas. Maintains that these debates have opened up Chinese journalists to alternatives and contributed to the development of journalism in China since reform was launched in 1979. (SR)

  19. A Problem-Solving Analysis of Women in Debate.

    ERIC Educational Resources Information Center

    Haffey, Deborah Bush

    The number of women participating in intercollegiate debate is proportionately lower than their representation on campuses. Furthermore, women's rate of success at the highest level of the Cross Examination Debate Association national competition is far lower than their representation in the organization. However, as women enter fields such as…

  20. The Parameters of the Liberal-Communitarian Debate.

    ERIC Educational Resources Information Center

    Theobald, Paul; Dinkelman, Todd

    This essay presents components of the debate between liberals and communitarians, discusses how this debate centers around policies affecting market economies and the role of government, and points out implications for school reform. The chief criticism communitarians aim at liberalism is that it promotes obsessive individualism, and in this…

  1. A "Fair Play" Perspective of Ethics for Intercollegiate Debate.

    ERIC Educational Resources Information Center

    Gallagher, Jeanne

    The philosophy behind competitive debate is to teach students the art of rational discourse with emphasis on correct use of evidence, analysis of argument, logical thinking and persuasive delivery. Although ethics help define the goals of the activity, the extreme competitiveness of intercollegiate debate threatens to undermine the principles of…

  2. Using Debate to Maximize Learning Potential: A Case Study

    ERIC Educational Resources Information Center

    Firmin, Michael W.; Vaughn, Aaron; Dye, Amanda

    2007-01-01

    Following a review of the literature, an educational case study is provided for the benefit of faculty preparing college courses. In particular, we provide a transcribed debate utilized in a General Psychology course as a best practice example of how to craft a debate which maximizes student learning. The work is presented as a model for the…

  3. Motivating a Productive Discussion of Normative Issues through Debates

    ERIC Educational Resources Information Center

    Hennessey, Jessica

    2014-01-01

    In this article, the author presents a way of using in-class debates to discuss contentious issues and help students develop critical thinking skills. Three elements were incorporated into an undergraduate public finance course: a presentation of ethical approaches in order to formally discuss normative issues, class debates which required…

  4. Subgroup differences in having a usual source of health care among working-age adults with and without disabilities.

    PubMed

    Dobbertin, Konrad; Horner-Johnson, Willi; Lee, Jae Chul; Andresen, Elena M

    2015-04-01

    Having a usual source of health care is positively associated with regular health maintenance visits and receipt of preventive services. People with disabilities are, overall, more likely than those without disabilities to have a usual source of care (USC). However, the population of people with disabilities is quite heterogenous, and some segments of the population may have less access to a USC than others. To determine whether there are significant subgroup differences in having a USC within the U.S. population of working-age adults with disabilities, and to compare adults with and without disabilities while controlling for other subgroup differences. We analyzed Medical Expenditure Panel Survey annual data files from 2002 to 2008. We performed both bivariate and multivariate logistic regression analyses to examine the relationship of sociodemographic and disability subgroup variables with having a USC. Within the disability population, individuals who were younger; male; Black, Hispanic, or other (non-White) race; less educated; of lower income; or uninsured for part or all of the year were significantly less likely to have a USC. These differences mirrored those among adults without disabilities. When controlling for these differences, people with physical, hearing, or multiple disabilities had greater odds of having a USC than people without disabilities, but those with vision or cognitive limitations did not differ significantly from the non-disabled referent group. Disparities among people with and without disabilities are similar, underscoring the need for attention to disparities within the disability population. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Physician wages across specialties: informing the physician reimbursement debate.

    PubMed

    Leigh, J Paul; Tancredi, Daniel; Jerant, Anthony; Kravitz, Richard L

    2010-10-25

    Disparities in remuneration between primary care and other physician specialties may impede health care reform by undermining the sustainability of a primary care workforce. Previous studies have compared annual incomes across specialties unadjusted for work hours. Wage (earnings-per-hour) comparisons could better inform the physician payment debate. In a cross-sectional analysis of data from 6381 physicians providing patient care in the 2004-2005 Community Tracking Study (adjusted response rate, 53%), we compared wages across broad and narrow categories of physician specialties. Tobit and linear regressions were run. Four broad specialty categories (primary care, surgery, internal medicine and pediatric subspecialties, and other) and 41 specific specialties were analyzed together with demographic, geographic, and market variables. In adjusted analyses on broad categories, wages for surgery, internal medicine and pediatric subspecialties, and other specialties were 48%, 36%, and 45% higher, respectively, than for primary care specialties. In adjusted analyses for 41 specific specialties, wages were significantly lower for the following than for the reference group of general surgery (wage near median, $85.98): internal medicine and pediatrics combined (-$24.36), internal medicine (-$24.27), family medicine (-$23.70), and other pediatric subspecialties (-$23.44). Wage rankings were largely impervious to adjustment for control variables, including age, race, sex, and region. Wages varied substantially across physician specialties and were lowest for primary care specialties. The primary care wage gap was likely conservative owing to exclusion of radiologists, anesthesiologists, and pathologists. In light of low and declining medical student interest in primary care, these findings suggest the need for payment reform aimed at increasing incomes or reducing work hours for primary care physicians.

  6. Evaluation of a multinational, multilingual vaccine debate on Twitter.

    PubMed

    Becker, Benedikt F H; Larson, Heidi J; Bonhoeffer, Jan; van Mulligen, Erik M; Kors, Jan A; Sturkenboom, Miriam C J M

    2016-12-07

    Public confidence in an immunization programme is a pivotal determinant of the programme's success. The mining of social media is increasingly employed to provide insight into the public's sentiment. This research further explores the value of monitoring social media to understand public sentiment about an international vaccination programme. To gain insight into international public discussion on the paediatric pentavalent vaccine (DTP-HepB-Hib) programme by analysing Twitter messages. Using a multilingual search, we retrospectively collected all public Twitter messages mentioning the DTP-HepB-Hib vaccine from July 2006 until May 2015. We analysed message characteristics by frequency of referencing other websites, type of websites, and geographic focus of the discussion. In addition, a sample of messages was manually annotated for positive or negative message tone. We retrieved 5771 messages. Only 3.1% of the messages were reactions to other messages, and 86.6% referred to websites, mostly news sites (70.7%), other social media (9.8%), and health-information sites (9.5%). Country mentions were identified in 70.4% of the messages, of which India (35.4%), Indonesia (18.3%), and Vietnam (13.9%) were the most prevalent. In the annotated sample, 63% of the messages showed a positive or neutral sentiment about DTP-HepB-Hib. Peaks in negative and positive messages could be related to country-specific programme events. Public messages about DTP-HepB-Hib were characterized by little interaction between tweeters, and by frequent referencing of websites and other information links. Twitter messages can indirectly reflect the public's opinion about major events in the debates about the DTP-HepB-Hib vaccine. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. Chromosome sizes of phytoplasmas composing major phylogenetic groups and subgroups.

    PubMed

    Marcone, C; Neimark, H; Ragozzino, A; Lauer, U; Seemüller, E

    1999-09-01

    ABSTRACT Chromosome sizes of 71 phytoplasmas belonging to 12 major phylogenetic groups including several of the aster yellows subgroups were estimated from electrophoretic mobilities of full-length chromosomes in pulsed-field gels. Considerable variation in genome size, from 660 to 1,130 kilobases (kb), was observed among aster yellows phytoplasmas. Chromosome size heterogeneity was also observed in the stolbur phytoplasma group (range 860 to 1,350 kb); in this group, isolate STOLF contains the largest chromosome found in a phytoplasma to date. A wide range of chromosome sizes, from 670 to 1,075 kb, was also identified in the X-disease group. The other phytoplasmas examined, which included members of the apple proliferation, Italian alfalfa witches' broom, faba bean phyllody, pigeon pea witches' broom, sugarcane white leaf, Bermuda grass white leaf, ash yellows, clover proliferation, and elm yellows groups, all have chromosomes smaller than 1 megabase, and the size ranges within each of these groups is narrower than in the aster yellows, stolbur, and X-disease groups. The smallest chromosome, approximately 530 kb, was found in two Bermuda grass white leaf phytoplasma isolates. This not only is the smallest mollicute chromosome found to date, but also is the smallest chromosome known for any cell. More than one large DNA band was observed in several phytoplasma preparations. Possible explanations for the occurrence of more than one band may be infection of the host plant by different phytoplasmas, the presence of more than one chromosome in the same organism, or the presence of large extrachromosomal DNA elements.

  8. The prevalence of chromosomal abnormalities in subgroups of infertile men.

    PubMed

    Dul, E C; Groen, H; van Ravenswaaij-Arts, C M A; Dijkhuizen, T; van Echten-Arends, J; Land, J A

    2012-01-01

    The prevalence of chromosomal abnormalities is assumed to be higher in infertile men and inversely correlated with sperm concentration. Although guidelines advise karyotyping infertile men, karyotyping is costly, therefore it would be of benefit to identify men with the highest risk of chromosomal abnormalities, possibly by using parameters other than sperm concentration. The aim of this study was to evaluate several clinical parameters in azoospermic and non-azoospermic men, in order to assess the prevalence of chromosomal abnormalities in different subgroups of infertile men. In a retrospective cohort of 1223 azoospermic men and men eligible for ICSI treatment, we studied sperm parameters, hormone levels and medical history for an association with chromosomal abnormalities. The prevalence of chromosomal abnormalities in the cohort was 3.1%. No association was found between chromosomal abnormalities and sperm volume, concentration, progressive motility or total motile sperm count. Azoospermia was significantly associated with the presence of a chromosomal abnormality [15.2%, odds ratio (OR) 7.70, P < 0.001]. High gonadotrophin levels were also associated with an increased prevalence of chromosomal abnormalities (OR 2.96, P = 0.013). Azoospermic men with a positive andrologic history had a lower prevalence of chromosomal abnormalities than azoospermic men with an uneventful history (OR 0.28, P = 0.047). In non-azoospermic men, we found that none of the studied variables were associated with the prevalence of chromosomal abnormalities. We show that the highest prevalence of chromosomal abnormalities is found in hypergonadotrophic azoospermic men with an uneventful andrologic history.

  9. Account for Clinical Heterogeneity in Assessment of Catheter-based Renal Denervation among Resistant Hypertension Patients: Subgroup Meta-analysis

    PubMed Central

    Chen, Xiao-Han; Kim, Sehee; Zeng, Xiao-Xi; Chen, Zhi-Bing; Cui, Tian-Lei; Hu, Zhang-Xue; Li, Yi; Fu, Ping

    2017-01-01

    Background: Catheter-based renal denervation (RDN) is a novel treatment for resistant hypertension (RH). A recent meta-analysis reported that RDN did not significantly reduce blood pressure (BP) based on the pooled effects with mild to severe heterogeneity. The aim of the present study was to identify and reduce clinical sources of heterogeneity and reassess the safety and efficacy of RDN within the identified homogeneous subpopulations. Methods: This was a meta-analysis of 9 randomized clinical trials (RCTs) among patients with RH up to June 2016. Sensitivity analyses and subgroup analyses were extensively conducted by baseline systolic blood pressure (SBP) level, antihypertensive medication change rates, and coronary heart disease (CHD). Results: In all patients with RH, no statistical differences were found in mortality, severe cardiovascular events rate, and changes in 24-h SBP and office SBP at 6 and 12 months. However, subgroup analyses showed significant differences between the RDN and control groups. In the subpopulations with baseline 24-h SBP ≥155 mmHg (1 mmHg = 0.133 kPa) and the infrequently changed medication, the use of RDN resulted in a significant reduction in 24-h SBP level at 6 months (P = 0.100 and P = 0.009, respectively). Subgrouping RCTs with a higher prevalent CHD in control showed that the control treatment was significantly better than RDN in office SBP reduction at 6 months (P < 0.001). Conclusions: In all patients with RH, the catheter-based RDN is not more effective in lowering ambulatory or office BP than an optimized antihypertensive drug treatment at 6 and 12 months. However, among RH patients with higher baseline SBP, RDN might be more effective in reducing SBP. PMID:28639575

  10. Account for Clinical Heterogeneity in Assessment of Catheter-based Renal Denervation among Resistant Hypertension Patients: Subgroup Meta-analysis.

    PubMed

    Chen, Xiao-Han; Kim, Sehee; Zeng, Xiao-Xi; Chen, Zhi-Bing; Cui, Tian-Lei; Hu, Zhang-Xue; Li, Yi; Fu, Ping

    2017-07-05

    Catheter-based renal denervation (RDN) is a novel treatment for resistant hypertension (RH). A recent meta-analysis reported that RDN did not significantly reduce blood pressure (BP) based on the pooled effects with mild to severe heterogeneity. The aim of the present study was to identify and reduce clinical sources of heterogeneity and reassess the safety and efficacy of RDN within the identified homogeneous subpopulations. This was a meta-analysis of 9 randomized clinical trials (RCTs) among patients with RH up to June 2016. Sensitivity analyses and subgroup analyses were extensively conducted by baseline systolic blood pressure (SBP) level, antihypertensive medication change rates, and coronary heart disease (CHD). In all patients with RH, no statistical differences were found in mortality, severe cardiovascular events rate, and changes in 24-h SBP and office SBP at 6 and 12 months. However, subgroup analyses showed significant differences between the RDN and control groups. In the subpopulations with baseline 24-h SBP ≥155 mmHg (1 mmHg = 0.133 kPa) and the infrequently changed medication, the use of RDN resulted in a significant reduction in 24-h SBP level at 6 months (P = 0.100 and P= 0.009, respectively). Subgrouping RCTs with a higher prevalent CHD in control showed that the control treatment was significantly better than RDN in office SBP reduction at 6 months (P < 0.001). In all patients with RH, the catheter-based RDN is not more effective in lowering ambulatory or office BP than an optimized antihypertensive drug treatment at 6 and 12 months. However, among RH patients with higher baseline SBP, RDN might be more effective in reducing SBP.

  11. The origins of species: the debate between August Weismann and Moritz Wagner.

    PubMed

    Weissman, Charlotte

    2010-01-01

    Weismann's ideas on species transmutation were first expressed in his famous debate with Moritz Wagner on the mechanism of speciation. Wagner suggested that the isolation of a colony from its original source is a preliminary and necessary factor for speciation. Weismann accepted a secondary, facilitating role for isolation, but argued that natural and sexual selection are the primary driving forces of species transmutation, and are always necessary and often sufficient causes for its occurrence. The debate with Wagner, which occurred between 1868 and 1872 within the framework of Darwin's discussions of geographical distribution, was Weismann's first public battle over the mechanism of evolution. This paper, which offers the first comprehensive analysis of this debate, extends previous analyses and throws light on the underlying beliefs and motivations of these early evolutionists, focusing mainly on Weismann's views and showing his commitment to what he later called "the all sufficiency of Natural Selection." It led to the crystallization of his ideas on the central and essential role of selection, both natural and sexual, in all processes of evolution, and, already at this early stage in his theoretical thinking, was coupled with sophisticated and nuanced approach to biological organization. The paper also discusses Ernst Mayr's analysis of the debate and highlights aspects of Weismann's views that were overlooked by Mayr and were peripheral to the discussions of other historians of biology.

  12. Uniformity under in vitro conditions: Changes in the phenotype of cancer cell lines derived from different medulloblastoma subgroups.

    PubMed

    Chlapek, Petr; Zitterbart, Karel; Kren, Leos; Filipova, Lenka; Sterba, Jaroslav; Veselska, Renata

    2017-01-01

    Medulloblastoma comprises four main subgroups (WNT, SHH, Group 3 and Group 4) originally defined by transcriptional profiling. In primary medulloblastoma tissues, these groups are thought to be distinguishable using the immunohistochemical detection of β-catenin, filamin A, GAB1 and YAP1 protein markers. To investigate the utility of these markers for in vitro studies using medulloblastoma cell lines, immunoblotting and indirect immunofluorescence were employed for the detection of β-catenin, filamin A, GAB1 and YAP1 in both DAOY and D283 Med reference cell lines and the panel of six medulloblastoma cell lines derived in our laboratory from the primary tumor tissues of known molecular subgroups. Immunohistochemical detection of these markers was performed on formalin-fixed paraffin-embedded tissue of the matching primary tumors. The results revealed substantial divergences between the primary tumor tissues and matching cell lines in the immunoreactivity pattern of medulloblastoma-subgroup-specific protein markers. Regardless of the molecular subgroup of the primary tumor, all six patient-derived medulloblastoma cell lines exhibited a uniform phenotype: immunofluorescence showed the nuclear localization of YAP1, accompanied by strong cytoplasmic positivity for β-catenin and filamin A, as well as weak positivity for GAB1. The same immunoreactivity pattern was also found in both DAOY and D283 Med reference medulloblastoma cell lines. Therefore, we can conclude that various medulloblastoma cell lines tend to exhibit the same characteristics of protein marker expression under standard in vitro conditions. Such a finding emphasizes the importance of the analyses of primary tumors in clinically oriented medulloblastoma research and the urgent need to develop in vitro models of improved clinical relevance, such as 3D cultures and organotypic slice cultures.

  13. The Panelists as Pseudo-Debaters: An Evaluation of the Questions and the Questioners in the Major Debates of 1980.

    ERIC Educational Resources Information Center

    McCall, Jeffrey M.

    Journalists play a central role in U.S. presidential debates, but their exact role is unclear. Unlike the news conference or interview, the situation of a debate does not favor an adversarial role because journalists who assume this role tend to shift attention away from the main issues and reduce exchanges between the candidates. To insure true…

  14. Different demographic, genetic, and longitudinal traits in language versus memory Alzheimer's subgroups.

    PubMed

    Mez, Jesse; Cosentino, Stephanie; Brickman, Adam M; Huey, Edward D; Mayeux, Richard

    2013-01-01

    The study's objective was to compare demographics, APOE genotypes, and rate of rise over time in functional impairment in neuropsychologically defined language, typical, and memory subgroups of clinical Alzheimer's disease (AD). 1,368 participants from the National Alzheimer's Coordinating Center database with a diagnosis of probable AD (CDR 0.5-1.0) were included. A language subgroup (n = 229) was defined as having language performance >1 SD worse than memory performance. A memory subgroup (n = 213) was defined as having memory performance >1 SD worse than language performance. A typical subgroup (n = 926) was defined as having a difference in language and memory performance of <1 SD. Compared with the memory subgroup, the language subgroup was 3.7 years older and more frequently self-identified as African American (OR = 3.69). Under a dominant genetic model, the language subgroup had smaller odds of carrying at least one APOEε4 allele relative to the memory subgroup. While this difference was present for all ages, it was more striking at a younger age (OR = 0.19 for youngest tertile; OR = 0.52 for oldest tertile). Compared with the memory subgroup, the language subgroup rose 35% faster on the Functional Assessment Questionnaire and 44% faster on CDR sum of boxes over time. Among a subset of participants who underwent autopsy (n = 98), the language, memory, and typical subgroups were equally likely to have an AD pathologic diagnosis, suggesting that variation in non-AD pathologies across subtypes did not lead to the observed differences. The study demonstrates that a language subgroup of AD has different demographics, genetic profile, and disease course in addition to cognitive phenotype.

  15. The impact of body mass index and height on the risk for glioblastoma and other glioma subgroups: a large prospective cohort study.

    PubMed

    Wiedmann, Markus K H; Brunborg, Cathrine; Di Ieva, Antonio; Lindemann, Kristina; Johannesen, Tom B; Vatten, Lars; Helseth, Eirik; Zwart, John A

    2017-07-01

    Glioma comprises a heterogeneous group of mostly malignant brain tumors, whereof glioblastoma (GBM) represents the largest and most lethal subgroup. Body height and body mass index (BMI) are risk factors for other cancers, but no previous study has examined anthropometric data in relation to different glioma subgroups. This prospective cohort study includes 1.8 million Norwegian women and men between ages 14 and 80 years at baseline. Body weight and height were measured, and incident cases of glioma were identified by linkage to the National Cancer Registry. Cox regression analyses were performed to evaluate risk for different glioma subgroups in relation to anthropometric measures. During 54 million person-years of follow-up, 4,382 gliomas were identified. Overweight and obesity were not associated with risk for any glioma subgroup. Height was positively associated with risk for GBM and all other gliomas (hazard ratio [HR] per 10 cm increase: 1.24; 95% confidence interval [CI], 1.17-1.31 and 1.18; 95% CI, 1.09-1.29) but not with the proxy for isocitrate dehydrogenase (IDH)-mutant glioma (HR, 1.09; 95% CI, 0.98-1.21). In further subgroup analyses, the effect of height on glioma risk varied significantly with positive associations for oligoastrocytoma (HR, 1.74; 95% CI, 1.20-2.53) and malignant glioma not otherwise specified (NOS) (HR, 1.42; 95% CI, 1.16-1.76, but not with diffuse astrocytoma (WHO grades II and III) or oligodendroglioma. This epidemiologic study consolidates height as a risk factor for GBM and other gliomas. It further indicates that this association is not universal for gliomas but may differ between different glioma subgroups. © The Author(s) 2016. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  16. High proportion of subgroup A' (genotype A) among Brazilian isolates of Hepatitis B virus.

    PubMed

    Araujo, N M; Mello, F C A; Yoshida, C F T; Niel, C; Gomes, S A

    2004-07-01

    Hepatitis B virus (HBV) genotype A has been divided recently into two subgroups, designated A-A' (genotype A excluding A') and A'. Isolates belonging to subgroup A' have been identified in Africa. A new genotyping method, based on PCR amplification of the pre-S/S genome region and subsequent restriction fragment length polymorphism (RFLP) analysis, was developed, that established a correlation between RFLP subtypes and subgroups within genotype A. To investigate the occurrence of subgroup A' in South America, 119 Brazilian HBV isolates were analyzed. Ninety-three (78%) of them belonged to genotype A, with three predominating RFLP subtypes: 44 (37%) isolates were classified as AI, 30 (25%) were AII, and 18 (15%) were AIII. Pre-S/S nucleotide sequences of 15 genotype A isolates were determined. Phylogenetic analysis performed with these 15 and an additional 41 sequences revealed that isolates AI and AII clustered in subgroup A', whereas isolates AIII were classified into subgroup A-A'. The correlation RFLP subtypes-subgroups was confirmed by the presence of amino acid residues specific for subgroup A' in the surface antigens and polymerase of isolates AI and AII. The high proportion (63%) of isolates from subgroup A' suggested an African origin for a large number of Brazilian HBVs.

  17. OMERACT-based fibromyalgia symptom subgroups: an exploratory cluster analysis.

    PubMed

    Vincent, Ann; Hoskin, Tanya L; Whipple, Mary O; Clauw, Daniel J; Barton, Debra L; Benzo, Roberto P; Williams, David A

    2014-10-16

    The aim of this study was to identify subsets of patients with fibromyalgia with similar symptom profiles using the Outcome Measures in Rheumatology (OMERACT) core symptom domains. Female patients with a diagnosis of fibromyalgia and currently meeting fibromyalgia research survey criteria completed the Brief Pain Inventory, the 30-item Profile of Mood States, the Medical Outcomes Sleep Scale, the Multidimensional Fatigue Inventory, the Multiple Ability Self-Report Questionnaire, the Fibromyalgia Impact Questionnaire-Revised (FIQ-R) and the Short Form-36 between 1 June 2011 and 31 October 2011. Hierarchical agglomerative clustering was used to identify subgroups of patients with similar symptom profiles. To validate the results from this sample, hierarchical agglomerative clustering was repeated in an external sample of female patients with fibromyalgia with similar inclusion criteria. A total of 581 females with a mean age of 55.1 (range, 20.1 to 90.2) years were included. A four-cluster solution best fit the data, and each clustering variable differed significantly (P <0.0001) among the four clusters. The four clusters divided the sample into severity levels: Cluster 1 reflects the lowest average levels across all symptoms, and cluster 4 reflects the highest average levels. Clusters 2 and 3 capture moderate symptoms levels. Clusters 2 and 3 differed mainly in profiles of anxiety and depression, with Cluster 2 having lower levels of depression and anxiety than Cluster 3, despite higher levels of pain. The results of the cluster analysis of the external sample (n = 478) looked very similar to those found in the original cluster analysis, except for a slight difference in sleep problems. This was despite having patients in the validation sample who were significantly younger (P <0.0001) and had more severe symptoms (higher FIQ-R total scores (P = 0.0004)). In our study, we incorporated core OMERACT symptom domains, which allowed for clustering based on a

  18. The American abortion debate: culture war or normal discourse?

    PubMed

    Dillon, M

    1995-01-01

    This paper investigates whether James Hunter's culture war thesis is an apt characterization of the American abortion debate. The author focuses on three arguments central to Hunter's analysis: 1) that the abortion debate involves two paradigmatically opposed world views; 2) that debate about abortion, since it involves moral discourse, is structurally different than other political debates; and 3) that the new alignments in abortion politics are culturally significant. Examining existing research in each of these three domains, the author finds that the debate over abortion is more complex than suggested by Hunter. World views of pro-life and pro-choice activists, for example, share a commitment to some overlapping values; the argumentative structure of abortion discourse has a pattern rather similar to that of political debate more generally, and new alignments on abortion, such as that between the Catholic Church and the Southern Baptist Convention, do not displace historically embedded differences in symbolic resources and cultural orientation. As suggested by the author, it may be more helpful, therefore, to think of the abortion debate as an ongoing public conversation about America's cultural tradition and how it should be variously expressed in contemporary laws and practices.

  19. How does unemployment affect self-assessed health? A systematic review focusing on subgroup effects.

    PubMed

    Norström, Fredrik; Virtanen, Pekka; Hammarström, Anne; Gustafsson, Per E; Janlert, Urban

    2014-12-22

    Almost all studies on the effect on health from unemployment have concluded that unemployment is bad for your health. However, only a few review articles have dealt with this relation in recent years, and none of them have focused on the analysis of subgroups such as age, gender, and marital status. The objective of our article is to review how unemployment relates to self-assessed health with a focus on its effect on subgroups. A search was performed in Web of Science to find articles that measured the effect on health from unemployment. The selection of articles was limited to those written in English, consisting of original data, and published in 2003 or later. Our definition of health was restricted to self-assessed health. Mortality- and morbidity-related measurements were therefore not included in our analysis. For the 41 articles included, information about health measurements, employment status definitions, other factors included in the statistical analysis, study design (including study population), and statistical method were collected with the aim of analysing the results on both the population and factor level. Most of the studies in our review showed a negative effect on health from unemployment on a population basis. Results at the factor levels were most common for gender (25 articles), age (11 articles), geographic location (8 articles), and education level (5 articles). The analysis showed that there was a health effect for gender, age, education level, household income, and geographic location. However, this effect differed between studies and no clear pattern on who benefits or suffers more among these groups could be determined. The result instead seemed to depend on the study context. The only clear patterns of association found were for socioeconomic status (manual workers suffer more), reason for unemployment (being unemployed due to health reasons is worse), and social network (a strong network is beneficial). Unemployment affects groups of

  20. The infiltration, and prognostic importance, of Th1 lymphocytes vary in molecular subgroups of colorectal cancer

    PubMed Central

    Ling, Agnes; Lundberg, Ida V; Eklöf, Vincy; Wikberg, Maria L; Öberg, Åke; Palmqvist, Richard

    2015-01-01

    Abstract Giving strong prognostic information, T‐cell infiltration is on the verge of becoming an additional component in the routine clinical setting for classification of colorectal cancer (CRC). With a view to further improving the tools for prognostic evaluation, we have studied how Th1 lymphocyte infiltration correlates with prognosis not only by quantity, but also by subsite, within CRCs with different molecular characteristics (microsatellite instability, CpG island methylator phenotype status, and BRAF and KRAS mutational status). We evaluated the Th1 marker T‐bet by immunohistochemistry in 418 archival tumour tissue samples from patients who underwent surgical resection for CRC. We found that a high number of infiltrating Th1 lymphocytes is strongly associated with an improved prognosis in patients with CRC, irrespective of intratumoural subsite, and that both extent of infiltration and patient outcome differ according to molecular subgroup. In brief, microsatellite instability, CpG island methylator phenotype‐high and BRAF mutated tumours showed increased infiltration of Th1 lymphocytes, and the most pronounced prognostic effect of Th1 infiltration was found in these tumours. Interestingly, BRAF mutated tumours were found to be more highly infiltrated by Th1 lymphocytes than BRAF wild‐type tumours whereas the opposite was seen for KRAS mutated tumours. These differences could be explained at least partly by our finding that BRAF mutated, in contrast to KRAS mutated, CRC cell lines and tumour specimens expressed higher levels of the Th1‐attracting chemokine CXCL10, and reduced levels of CCL22 and TGFB1, stimulating Th2/Treg recruitment and polarisation. In conclusion, the strong prognostic importance of Th1 lymphocyte infiltration in CRC was found at all subsites evaluated, and it remained significant in multivariable analyses, indicating that T‐bet may be a valuable marker in the clinical setting. Our results also indicate that T‐bet is of

  1. A Historical Materialist Analysis of the Debate in Swedish Print Media on Mobile Phones in School Settings

    ERIC Educational Resources Information Center

    Ott, Torbjörn

    2014-01-01

    The use of mobile phones for teaching and learning in schools has been a controversial matter. In this paper the debate in two Swedish newspapers on the use of mobile phones in schools is analysed using a historical materialist framework. The results are discussed in relation to contemporary research on mobile learning. The analysis reveals that…

  2. Debate: Open radical prostatectomy vs. laparoscopic vs. robotic.

    PubMed

    Nelson, Joel B

    2007-01-01

    Surgical removal of clinically localized prostate cancer remains the most definitive treatment for the disease. The emergence of laparoscopic and robotic radical prostatectomy (RP) as alternatives to open RP has generated considerable discussion about the real and relative merits of each approach. Such was the topic of a debate that took place during the 2006 Society of Urologic Oncology meeting. The participants were Dr. William Catalona, Northwestern University, advocating for open RP, Dr. Betrand Guillonneau, Memorial Sloan Kettering Cancer Center advocating for laparoscopic RP, and Dr. Mani Menon, Henry Ford Hospital, advocating for robotic RP. The debate was moderated by Dr. Joel Nelson, University of Pittsburgh. This paper summarizes that debate.

  3. Is undifferentiated spondyloarthritis a discrete entity? A debate.

    PubMed

    Deodhar, Atul; Miossec, Pierre; Baraliakos, Xenofon

    2018-01-01

    The concept of undifferentiated spondyloarthritis has been introduced recently to describe a clinical setting where the classical features of spondyloarthritis (SpA) are not fully present. Whether this is a discrete entity was the basis of a debate during the 4th International Congress on Controversies in Rheumatology & Autoimmunity held in Bologna, Italy 9-11 March 2017. The pro and con aspects of the debate are presented. The implications of the debate are important ranging from diagnostic aspects to consequences for the society and the payers. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. The enteral vs parenteral nutrition debate revisited.

    PubMed

    Thomson, Andrew

    2008-01-01

    Many trials and several meta-analyses have been devoted to comparing enteral with parenteral nutrition support. In this review, these studies are subjected to critical analysis with particular emphasis on their methodology and clinical relevance. Evidence is produced to suggest that the heterogeneous patient populations of the studies and the rigid approach taken to comparing different nutrition therapies inter alia render their conclusions highly questionable and of very doubtful clinical significance. An alternative approach to nutrition research is suggested in which strategies of nutrition support rather than fixed menus are compared. It is suggested that objective measures of intestinal function be evaluated more fully in patients requiring nonvolitional nutrition support, and these are briefly reviewed. In addition, a more scientific approach to evaluating the physiological effects of nutrition support, including chemical tagging and evaluation of muscle function, is recommended.

  5. Etiological Subgroups of Small-for-Gestational-Age: Differential Neurodevelopmental Outcomes

    PubMed Central

    Li, Xiuhong; Eiden, Rina D.; Epstein, Leonard H.; Shenassa, Edmond D.; Xie, Chuanbo; Wen, Xiaozhong

    2016-01-01

    Objectives It remains unclear why substantial variations in neurodevelopmental outcomes exist within small-for-gestational-age (SGA) children. We prospectively compared 5-y neurodevelopmental outcomes across SGA etiological subgroups. Methods Children born SGA (N = 1050) from U.S. Early Childhood Longitudinal Study-Birth Cohort (2001–2007) was divided into etiological subgroups by each of 7 well-established prenatal risk factors. We fit linear regression models to compare 5-y reading, math, gross motor and fine motor scores across SGA subgroups, adjusting for socio-demographic confounders. Results Compared to singleton SGA subgroup, multiple-birth SGA subgroup had lower mean reading (adjusted mean difference, -4.08 [95% confidence interval, -6.10, -2.06]) and math (-2.22 [-3.61, -0.84]) scores. These disadvantages in reading and math existed only among multiple-birth SGA subgroup without ovulation stimulation (reading, -4.50 [-6.64, -2.36]; math, -2.91 [-4.37, -1.44]), but not among those with ovulation stimulation (reading, -2.33 [-6.24, 1.57]; math 0.63 [-1.86, 3.12]). Compared to singleton SGA subgroup without maternal smoking and inadequate gestational weight gain, singleton SGA subgroup with co-occurrence of maternal smoking and inadequate gestational weight gain (GWG) had lower mean reading (-4.81 [-8.50, -1.12]) and math (-2.95 [-5.51, -0.38]) scores. These differences were not mediated by Apgar score. Conclusions Multiple-birth SGA subgroups (vs. singleton SGA) or singleton SGA subgroup with co-occurrence of smoking and inadequate GWG (vs. singleton SGA subgroup without maternal smoking and inadequate gestational weight gain) have poorer cognitive development up to 5 y. PMID:27501456

  6. Carboplatin in BRCA1/2-mutated and triple-negative breast cancer BRCAness subgroups: the TNT Trial.

    PubMed

    Tutt, Andrew; Tovey, Holly; Cheang, Maggie Chon U; Kernaghan, Sarah; Kilburn, Lucy; Gazinska, Patrycja; Owen, Julie; Abraham, Jacinta; Barrett, Sophie; Barrett-Lee, Peter; Brown, Robert; Chan, Stephen; Dowsett, Mitchell; Flanagan, James M; Fox, Lisa; Grigoriadis, Anita; Gutin, Alexander; Harper-Wynne, Catherine; Hatton, Matthew Q; Hoadley, Katherine A; Parikh, Jyoti; Parker, Peter; Perou, Charles M; Roylance, Rebecca; Shah, Vandna; Shaw, Adam; Smith, Ian E; Timms, Kirsten M; Wardley, Andrew M; Wilson, Gregory; Gillett, Cheryl; Lanchbury, Jerry S; Ashworth, Alan; Rahman, Nazneen; Harries, Mark; Ellis, Paul; Pinder, Sarah E; Bliss, Judith M

    2018-05-01

    Germline mutations in BRCA1/2 predispose individuals to breast cancer (termed germline-mutated BRCA1/2 breast cancer, gBRCA-BC) by impairing homologous recombination (HR) and causing genomic instability. HR also repairs DNA lesions caused by platinum agents and PARP inhibitors. Triple-negative breast cancers (TNBCs) harbor subpopulations with BRCA1/2 mutations, hypothesized to be especially platinum-sensitive. Cancers in putative 'BRCAness' subgroups-tumors with BRCA1 methylation; low levels of BRCA1 mRNA (BRCA1 mRNA-low); or mutational signatures for HR deficiency and those with basal phenotypes-may also be sensitive to platinum. We assessed the efficacy of carboplatin and another mechanistically distinct therapy, docetaxel, in a phase 3 trial in subjects with unselected advanced TNBC. A prespecified protocol enabled biomarker-treatment interaction analyses in gBRCA-BC and BRCAness subgroups. The primary endpoint was objective response rate (ORR). In the unselected population (376 subjects; 188 carboplatin, 188 docetaxel), carboplatin was not more active than docetaxel (ORR, 31.4% versus 34.0%, respectively; P = 0.66). In contrast, in subjects with gBRCA-BC, carboplatin had double the ORR of docetaxel (68% versus 33%, respectively; biomarker, treatment interaction P = 0.01). Such benefit was not observed for subjects with BRCA1 methylation, BRCA1 mRNA-low tumors or a high score in a Myriad HRD assay. Significant interaction between treatment and the basal-like subtype was driven by high docetaxel response in the nonbasal subgroup. We conclude that patients with advanced TNBC benefit from characterization of BRCA1/2 mutations, but not BRCA1 methylation or Myriad HRD analyses, to inform choices on platinum-based chemotherapy. Additionally, gene expression analysis of basal-like cancers may also influence treatment selection.

  7. Fracking in the UK press: threat dynamics in an unfolding debate.

    PubMed

    Jaspal, Rusi; Nerlich, Brigitte

    2014-04-01

    Shale gas is a novel source of fossil fuel which is extracted by induced hydraulic fracturing, or "fracking". This article examines the socio-political dimension of fracking as manifested in the UK press at three key temporal points in the debate on the practice. Three newspaper corpora were analysed qualitatively using Thematic Analysis and Social Representations Theory. Three overarching themes are discussed: "April-May 2011: from Optimism to Scepticism"; "November 2011: (De-) Constructing and Re-Constructing Risk and Danger"; "April 2012: consolidating Social Representations of Fracking". In this article, we examine the emergence of and inter-relations between competing social representations, discuss the dynamics of threat positioning and show how threat can be re-construed in order to serve particular socio-political ends in the debate on fracking.

  8. More frequent moments in the climate change debate as emissions continue

    NASA Astrophysics Data System (ADS)

    Huntingford, Chris; Friedlingstein, Pierre

    2015-12-01

    Recent years have witnessed unprecedented interest in how the burning of fossil fuels may impact on the global climate system. Such visibility of this issue is in part due to the increasing frequency of key international summits to debate emissions levels, including the 2015 21st Conference of Parties meeting in Paris. In this perspective we plot a timeline of significant climate meetings and reports, and against metrics of atmospheric greenhouse gas changes and global temperature. One powerful metric is cumulative CO2 emissions that can be related to past and future warming levels. That quantity is analysed in detail through a set of papers in this ERL focus issue. We suggest it is an open question as to whether our timeline implies a lack of progress in constraining climate change despite multiple recent keynote meetings—or alternatively—that the increasing level of debate is encouragement that solutions will be found to prevent any dangerous warming levels?

  9. A Longitudinal Comparison of Systems Used to Identify Subgroups of Learning Disabled Children.

    ERIC Educational Resources Information Center

    Goldstein, David; Dundon, William D.

    This paper addresses the problem of heterogeneity of samples of learning disabled (LD) children by comparing five different systems for identifying homogeneous subgroups in terms of their ability to predict longitudinal reading and mathematics scores. One hundred and sixty LD children served as subjects. Three of the five subgrouping systems were…

  10. A single test for rejecting the null hypothesis in subgroups and in the overall sample.

    PubMed

    Lin, Yunzhi; Zhou, Kefei; Ganju, Jitendra

    2017-01-01

    In clinical trials, some patient subgroups are likely to demonstrate larger effect sizes than other subgroups. For example, the effect size, or informally the benefit with treatment, is often greater in patients with a moderate condition of a disease than in those with a mild condition. A limitation of the usual method of analysis is that it does not incorporate this ordering of effect size by patient subgroup. We propose a test statistic which supplements the conventional test by including this information and simultaneously tests the null hypothesis in pre-specified subgroups and in the overall sample. It results in more power than the conventional test when the differences in effect sizes across subgroups are at least moderately large; otherwise it loses power. The method involves combining p-values from models fit to pre-specified subgroups and the overall sample in a manner that assigns greater weight to subgroups in which a larger effect size is expected. Results are presented for randomized trials with two and three subgroups.

  11. Pain Behavior in Rheumatoid Arthritis Patients: Identification of Pain Behavior Subgroups

    PubMed Central

    Waters, Sandra J.; Riordan, Paul A.; Keefe, Francis J.; Lefebvre, John C.

    2008-01-01

    This study used Ward’s minimum variance hierarchical cluster analysis to identify homogeneous subgroups of rheumatoid arthritis patients suffering from chronic pain who exhibited similar pain behavior patterns during a videotaped behavior sample. Ninety-two rheumatoid arthritis patients were divided into two samples. Six motor pain behaviors were examined: guarding, bracing, active rubbing, rigidity, grimacing, and sighing. The cluster analysis procedure identified four similar subgroups in Sample 1 and Sample 2. The first subgroup exhibited low levels of all pain behaviors. The second subgroup exhibited a high level of guarding and low levels of other pain behaviors. The third subgroup exhibited high levels of guarding and rigidity and low levels of other pain behaviors. The fourth subgroup exhibited high levels of guarding and active rubbing and low levels of other pain behaviors. Sample 1 contained a fifth subgroup that exhibited a high level of active rubbing and low levels of other pain measures. The results of this study suggest that there are homogeneous subgroups within rheumatoid arthritis patient populations who differ in the motor pain behaviors they exhibit. PMID:18358682

  12. Conditions for Effective Application of Analysis of Symmetrically-Predicted Endogenous Subgroups

    ERIC Educational Resources Information Center

    Peck, Laura R.

    2015-01-01

    Several analytic strategies exist for opening up the "black box" to reveal more about what drives policy and program impacts. This article focuses on one of these strategies: the Analysis of Symmetrically-Predicted Endogenous Subgroups (ASPES). ASPES uses exogenous baseline data to identify endogenously-defined subgroups, keeping the…

  13. Life of Pizza Pie: The Implications of Sub-Group Comparisons in Education

    ERIC Educational Resources Information Center

    Thomas, Tara N.

    2013-01-01

    Current educational statistics have pitted subgroups against one another without consideration of the actual population sizes of each group. This paper is intended to provided a clearer understanding of the current usage of sub-group comparisons in American education. (Contains 4 figures.)

  14. A Simulation Study of Methods for Selecting Subgroup-Specific Doses in Phase I Trials

    PubMed Central

    Morita, Satoshi; Thall, Peter F.; Takeda, Kentaro

    2016-01-01

    Summary Patient heterogeneity may complicate dose-finding in phase I clinical trials if the dose-toxicity curves differ between subgroups. Conducting separate trials within subgroups may lead to infeasibly small sample sizes in subgroups having low prevalence. Alternatively, it is not obvious how to conduct a single trial while accounting for heterogeneity. To address this problem, we consider a generalization of the continual reassessment method (O’Quigley, et al., 1990) based on a hierarchical Bayesian dose-toxicity model that borrows strength between subgroups under the assumption that the subgroups are exchangeable. We evaluate a design using this model that includes subgroup-specific dose selection and safety rules. A simulation study is presented that includes comparison of this method to three alternative approaches, based on non-hierarchical models, that make different types of assumptions about within-subgroup dose-toxicity curves. The simulations show that the hierarchical model-based method is recommended in settings where the dose-toxicity curves are exchangeable between subgroups. We present practical guidelines for application, and provide computer programs for trial simulation and conduct. PMID:28111916

  15. Orienting Schools toward Equity: Subgroup Accountability Pressure and School-Level Responses

    ERIC Educational Resources Information Center

    Garver, Rachel

    2017-01-01

    This article examines school-level responses to subgroup accountability pressure through an ethnographic case study of a school cited for failing to make adequate yearly progress for student subgroups. Concerns about the calculations and measures used to derive the citation and reservations about acting on accountability data delegitimized the…

  16. Using Demographic Subgroup and Dummy Variable Equations to Predict College Freshman Grade Average.

    ERIC Educational Resources Information Center

    Sawyer, Richard

    1986-01-01

    This study was designed to determine whether adjustments for the differential prediction observed among sex, racial/ethnic, or age subgroups in one freshman class at a college could be used to improve prediction accuracy for these subgroups in future freshman classes. (Author/LMO)

  17. Facial Structure Analysis Separates Autism Spectrum Disorders into Meaningful Clinical Subgroups

    ERIC Educational Resources Information Center

    Obafemi-Ajayi, Tayo; Miles, Judith H.; Takahashi, T. Nicole; Qi, Wenchuan; Aldridge, Kristina; Zhang, Minqi; Xin, Shi-Qing; He, Ying; Duan, Ye

    2015-01-01

    Varied cluster analysis were applied to facial surface measurements from 62 prepubertal boys with essential autism to determine whether facial morphology constitutes viable biomarker for delineation of discrete Autism Spectrum Disorders (ASD) subgroups. Earlier study indicated utility of facial morphology for autism subgrouping (Aldridge et al. in…

  18. Selected Linguistic and Perceptual Abilities of Empirically Derived Subgroups of Learning Disabled Readers.

    ERIC Educational Resources Information Center

    Lyon, Reid; And Others

    1981-01-01

    Linguistic and perceptual tests were administered to learning disabled readers (LDR) and normal readers (NR). Results found six LDR subgroups all significantly different. Differences were found among the six LDR subgroups on measures of oral reading, reading comprehension, and spelling skills, but not on family history and developmental…

  19. Measuring English Language Workplace Proficiency across Subgroups: Using CFA Models to Validate Test Score Interpretation

    ERIC Educational Resources Information Center

    Yoo, Hanwook; Manna, Venessa F.

    2017-01-01

    This study assessed the factor structure of the Test of English for International Communication (TOEIC®) Listening and Reading test, and its invariance across subgroups of test-takers. The subgroups were defined by (a) gender, (b) age, (c) employment status, (d) time spent studying English, and (e) having lived in a country where English is the…

  20. Using Debate Skills to Engage Students in Astronomy

    NASA Astrophysics Data System (ADS)

    Karsten, Anna

    2016-04-01

    To increase the excitement for the astronomy unit and to expose the subject in all of its weird glory, students debate each other in a bracket style tournament defending their idea of the coolest object in the universe. At the start of May, causing the name of this event to be called May Madness, students choose an object or concept in the universe to research and construct an opening argument on how it is the coolest object in the universe. Every student in the eighth grade selects an object and proceeds to debate its attributes in a head-to-head competition leading to a class winner. The class winners then debate in front of the grade with celebrity guest judges. In the four minute debate, two students defend, cross examine, and construct a rebuttal for their chosen object.

  1. The Necessity of Debate: A Comment on Commentaries.

    ERIC Educational Resources Information Center

    Deegan, Dorothy H.

    1995-01-01

    Raises issues related to the relationship between literacy practices and literacy philosophies and theories. Addresses the question of whether the "great debate" regarding literacy education can and should be resolved. (SR)

  2. Current Debates in the Study of the Industrial Revolution.

    ERIC Educational Resources Information Center

    Beaudoin, Steven M.

    2000-01-01

    Provides an overview of the literature on the debates surrounding the industrial revolution using four categories: (1) definition and characteristics; (2) context and causation; (3) impacts and scope; and (4) industrialization as a worldwide phenomenon. (CMK)

  3. Outcomes of modified formal online debating in graduate nursing education.

    PubMed

    Vandall-Walker, Virginia; Park, Caroline L; Munich, Kim

    2012-06-29

    Formal debating is a process for argumentation with a long history of use in classroom settings to promote students' development of skills associated with influencing others. In an online, 14-week, MN nursing course, modified formal debate procedures and rules were used to address contemporary issues in nursing. A qualitative descriptive study of student's reflections about engaging in the debate process was conducted involving 24 of 48 students representing three sections of this course taught by three professors during the 2009-2010 academic year. On analysis, the data revealed five categories of outcomes: 1) Risk Taking; 2) Defence of a Position; 3) Coverage of all Aspects; 4) Skill and Knowledge Transfer; and 5) Critical Thinking. Additionally, factors that influenced each of these outcomes are described. Study findings support the compelling benefits of debating in online learning environments using a format modified for use online.

  4. The Great Nuclear Power Debate (1)--A Summary

    ERIC Educational Resources Information Center

    Douglas, John H.

    1976-01-01

    Five issues concerning nuclear power--economics, danger from accidents, environmental effects, terrorism, and alternatives are debated, with one paragraph statements from opponents and advocates on each of the topics. (CP)

  5. Low birthweight among US Hispanic/Latino subgroups: the effect of maternal foreign-born status and education.

    PubMed

    Acevedo-Garcia, Dolores; Soobader, Mah-J; Berkman, Lisa F

    2007-12-01

    We investigated whether maternal foreign-born status confers a protective effect against low birthweight (LBW) across US Hispanic/Latino subgroups (i.e., Mexicans, Puerto Ricans, Cubans and Central/South Americans) in the USA, and whether the association between maternal education and LBW varies by Hispanic/Latino subgroup and by foreign-born status. We conducted logistic regression analyses of the 2002 US Natality Detail Data (n=634,797). Overall, foreign-born Latino women are less likely to have LBW infants than US-born Latino women. The protective effect of foreign-born status is stronger among Latino women with less than high school education. The maternal education gradient is significantly flatter among foreign-born Latino women than among their US-born counterparts (p<0.001). Patterns among Mexican-origin women account for the overall trends among all Latinos.Foreign-born status (main effect) reduces the risk of LBW among Mexicans by about 21% but does not protect against LBW among other Latino subgroups (i.e., Puerto Ricans, Cubans and Central/South Americans). Among Mexicans and Central South Americans, the protective effect of foreign-born status is stronger among women with low education (i.e., 0-11 and 12 years) than among women with more education (i.e., 13-15 and 16+ years). The educational gradient in LBW is less pronounced among foreign-born Mexicans and Central/South Americans than among their US-born counterparts. As such, maternal foreign-born status and education are associated with LBW, though the direction and strength of these associations vary across Latino subgroups. A "health paradox" is apparent for foreign-born Mexican and Central/South American women among whom there is a weak maternal educational gradient in LBW. Future research may test hypotheses regarding the mechanisms underlying these variations in LBW among Latino subgroups, i.e., different gradients in sending countries, health selection of immigrants, cultural factors, and

  6. The Impact of Low-Level Lead Toxicity on School Performance among Hispanic Subgroups in the Chicago Public Schools.

    PubMed

    Blackowicz, Michael J; Hryhorczuk, Daniel O; Rankin, Kristin M; Lewis, Dan A; Haider, Danish; Lanphear, Bruce P; Evens, Anne

    2016-08-01

    Environmental lead exposure detrimentally affects children's educational performance, even at very low blood lead levels (BLLs). Among children in Chicago Public Schools (CPS), the severity of the effects of BLL on reading and math vary by racial subgroup (White vs. Hispanic vs. non-Hispanic Black). We investigated the impact of BLL on standardized test performance by Hispanic subgroup (Mexican, Puerto Rican, and Other Hispanic). We examined 12,319 Hispanic children born in Chicago between 1994 and 1998 who were tested for BLL between birth and 2006 and enrolled in the 3rd grade at a CPS school between 2003 and 2006. We linked the Chicago birth registry, the Chicago Blood Lead Registry, and 3rd grade Illinois Standard Achievement Test (ISAT) scores to examine associations between BLL and school performance. Primary analyses were restricted to children with BLL below 10 µg/dL (0.483 µmol/L). BLLs below 10 µg/dL (0.483 µmol/L) were inversely associated with reading and math scores in all Hispanic subgroups. Adjusted Relative Risks (RRadj) and 95% confidence intervals (CI) for reading and math failure were 1.34 (95% CI = 1.25, 1.63) and 1.53 (95% CI = 1.32, 1.78), respectively, per each additional 5 µg/dL of lead exposure for Hispanic children; RRadj did not differ across subgroups. We estimate that 7.0% (95% CI = 1.8, 11.9) of reading and 13.6% (95% CI = 7.7, 19.2) of math failure among Hispanic children can be attributed to exposure to BLLs of 5-9 µg/dL (0.242 to 0.435 µmol/L) vs. 0-4 µg/dL (0-0.193 µmol/L). The RRadj of math failure for each 5 µg/dL (0.242 µmol/L) increase in BLL was notably (p = 0.074) stronger among black Puerto Rican children (RRadj = 5.14; 95% CI = 1.65-15.94) compared to white Puerto Rican children (RRadj = 1.50; 95% CI = 1.12-2.02). Early childhood lead exposure is associated with poorer achievement on standardized reading and math tests in the 3rd grade for Mexican, Puerto Rican, and Other Hispanic children enrolled in Chicago

  7. Misleading "New Insights into the Chrysotile Debate".

    PubMed

    Woitowitz, H-J; Baur, X

    2018-05-18

    Although there is no dispute among independent scientists about the carcinogenic and fibrogenic effects of chrysotile, the asbestos industry has been continuously and successfully acting to cast doubts on its harm. Another approach including asbestos insurance entities is to refuse compensation by raising the bar and fight criminal prosecution for asbestos-related diseases by the help of paid scientists. A recent publication on asbestos fibre burden in human lungs fits well in this context. The claim that chrysotile fibres are biopersistent in human lung is not based on the data provided by these authors, and, additionally, exhibits serious inconsistencies and obvious mismeasurements and significant methodological problems. The conclusion of the authors that fibre analysis of workers' lungs "is of high significance for differential diagnosis, risk assessment and occupational compensation" is unfounded and reprehensible. Also the available literature, the statements of the WHO, IARC, other decisive independent international organizations, and all our experience provide abundant evidence to the contrary. Note, the method is generally restricted to research only and is not recognized for diagnostic purpose and compensation in any other country. In conclusion, fibre counting in lung tissues should not be used to estimate former exposure to chrysotile comprising c. 94 % of applied asbestos in Germany. The authors claim that the analyses can improve the compensation rates in Germany. However, the opposite has been the case; it significantly worsens the non-justified denial of well-substantiated compensation claims. © Georg Thieme Verlag KG Stuttgart · New York.

  8. Latent class analysis derived subgroups of low back pain patients - do they have prognostic capacity?

    PubMed

    Molgaard Nielsen, Anne; Hestbaek, Lise; Vach, Werner; Kent, Peter; Kongsted, Alice

    2017-08-09

    Heterogeneity in patients with low back pain is well recognised and different approaches to subgrouping have been proposed. One statistical technique that is increasingly being used is Latent Class Analysis as it performs subgrouping based on pattern recognition with high accuracy. Previously, we developed two novel suggestions for subgrouping patients with low back pain based on Latent Class Analysis of patient baseline characteristics (patient history and physical examination), which resulted in 7 subgroups when using a single-stage analysis, and 9 subgroups when using a two-stage approach. However, their prognostic capacity was unexplored. This study (i) determined whether the subgrouping approaches were associated with the future outcomes of pain intensity, pain frequency and disability, (ii) assessed whether one of these two approaches was more strongly or more consistently associated with these outcomes, and (iii) assessed the performance of the novel subgroupings as compared to the following variables: two existing subgrouping tools (STarT Back Tool and Quebec Task Force classification), four baseline characteristics and a group of previously identified domain-specific patient categorisations (collectively, the 'comparator variables'). This was a longitudinal cohort study of 928 patients consulting for low back pain in primary care. The associations between each subgroup approach and outcomes at 2 weeks, 3 and 12 months, and with weekly SMS responses were tested in linear regression models, and their prognostic capacity (variance explained) was compared to that of the comparator variables listed above. The two previously identified subgroupings were similarly associated with all outcomes. The prognostic capacity of both subgroupings was better than that of the comparator variables, except for participants' recovery beliefs and the domain-specific categorisations, but was still limited. The explained variance ranged from 4.3%-6.9% for pain intensity and

  9. Differential diagnosis of feline leukemia virus subgroups using pseudotype viruses expressing green fluorescent protein.

    PubMed

    Nakamura, Megumi; Sato, Eiji; Miura, Tomoyuki; Baba, Kenji; Shimoda, Tetsuya; Miyazawa, Takayuki

    2010-06-01

    Feline leukemia virus (FeLV) is classified into three receptor interference subgroups, A, B and C. In this study, to differentiate FeLV subgroups, we developed a simple assay system using pseudotype viruses expressing green fluorescent protein (GFP). We prepared gfp pseudotype viruses, named gfp(FeLV-A), gfp(FeLV-B) and gfp(FeLV-C) harboring envelopes of FeLV-A, B and C, respectively. The gfp pseudotype viruses completely interfered with the same subgroups of FeLV reference strains on FEA cells (a feline embryonic fibroblast cell line). We also confirmed that the pseudotype viruses could differentiate FeLV subgroups in field isolates. The assay will be useful for differential diagnosis of FeLV subgroups in veterinary diagnostic laboratories in the future.

  10. The State of College Debate According to a Survey of Its Coaches: Data to Ground the Discussion of Debate and Civic Engagement

    ERIC Educational Resources Information Center

    Hlavacik, Mark; Lain, Brian; Ivanovic, Matea; Ontiveros-Kersch, Brian

    2016-01-01

    In 2015, prominent figures from the debate community gathered at Penn State for a Conference on Speech and Debate as Civic Education. Convened in response to a perceived decline in debate's contributions to civic education, the conference also aimed to start a conversation about the future of debate education. Although a great deal can be learned…

  11. Structure and content of Native American stereotypic subgroups: Not just (ig)noble.

    PubMed

    Burkley, Edward; Durante, Federica; Fiske, Susan T; Burkley, Melissa; Andrade, Angela

    2017-04-01

    Prejudice against Native Americans as an overall group generally polarizes into positive and negative stereotypic extremes, but distinct subgroups may explain this variability. Using college student samples (Study 1), a preliminary study identified common Native American subgroups and then a main study (N = 153, 74% women, 73% White, mean age = 19 years) had participants rate these subgroups on basic dimensions of stereotype content (i.e., warmth and competence), elicited emotions (e.g., admiration, contempt), and elicited behaviors (e.g., facilitation, harm). In Study 2, these preliminary study and main study procedures were replicated using nationwide samples (main study: N = 139, 51% women, 78% White, mean age = 35 years). For the most part, similar Native American subgroups emerged in both samples. Using the stereotype content model (SCM; Fiske, Cuddy, Glick, & Xu, 2002), the subgroups were found to vary along a competence-by-warmth space. The majority of subgroups (e.g., alcoholics, lazy) were judged low in both competence and warmth. Additional subgroups (e.g., casino operators, warriors) were ambivalently judged as high on competence but low on warmth. Subgroups perceived as high in both competence and warmth elicited more admiration, those low in both competence and warmth elicited more contempt, those high in competence elicited more passive facilitation and less passive harm, and those high in warmth elicited more active facilitation and less active harm. Native American stereotypes are apparently characterized by both noble and ignoble subgroups, highlighting the importance of studying stereotypes at the subgroup level. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  12. Prophylactic antibiotics in acute pancreatitis: endless debate.

    PubMed

    Mourad, M M; Evans, Rpt; Kalidindi, V; Navaratnam, R; Dvorkin, L; Bramhall, S R

    2017-02-01

    INTRODUCTION The development of pancreatic infection is associated with the development of a deteriorating disease with subsequent high morbidity and mortality. There is agreement that in mild pancreatitis there is no need to use antibiotics; in severe pancreatitis it would appear to be a logical choice to use antibiotics to prevent secondary pancreatic infection and decrease associated mortality. MATERIALS AND METHODS A non-systematic review of current evidence, meta-analyses and randomized controlled trials was conducted to assess the role of prophylactic antibiotics in acute pancreatitis and whether it might improve morbidity and mortality in pancreatitis. RESULTS Mixed evidence was found to support and refute the role of prophylactic antibiotics in acute pancreatitis. Most studies have failed to demonstrate much benefit from its routine use. Data from our unit suggested little benefit of their routine use, and showed that the mortality of those treated with antibiotics was significantly higher compared with those not treated with antibiotics (9% vs 0%, respectively, P = 0.043). In addition, the antibiotic group had significantly higher morbidity (36% vs 5%, respectively, P = 0.002). CONCLUSIONS Antibiotics should be used in patients who develop sepsis, infected necrosis-related systemic inflammatory response syndrome, multiple organ dysfunction syndrome or pancreatic and extra-pancreatic infection. Despite the many other factors that should be considered, prompt antibiotic therapy is recommended once inflammatory markers are raised, to prevent secondary pancreatic infection. Unfortunately, there remain many unanswered questions regarding the indications for antibiotic administration and the patients who benefit from antibiotic treatment in acute pancreatitis.

  13. Qualitative Treatment-Subgroup Interactions in a Randomized Clinical Trial of Treatments for Adolescents with ADHD: Exploring What Cognitive-Behavioral Treatment Works for Whom

    PubMed Central

    Geurts, Hilde M.; Prins, Pier J. M.; Van Mechelen, Iven; Van der Oord, Saskia

    2016-01-01

    Objective This study explored qualitative treatment-subgroup interactions within data of a RCT with two cognitive behavioral treatments (CBT) for adolescents with ADHD: a planning-focused (PML) and a solution-focused CBT (SFT). Qualitative interactions imply that which treatment is best differs across subgroups of patients, and are therefore most relevant for personalized medicine. Methods Adolescents with ADHD (N = 159) received either PML or SFT. Pre-, post- and three-month follow-up data were gathered on parent-rated ADHD symptoms and planning problems. Pretreatment characteristics were explored as potential qualitative moderators of pretest to follow-up treatment effects, using an innovative analyses technique (QUINT; Dusseldorp & Van Mechelen, 2014). In addition, qualitative treatment-subgroup interactions for the therapeutic changes from pre- to posttest and from post- to follow-up test were investigated. Results For the entire time span from pretest to follow-up only a quantitative interaction was found, while from posttest to follow-up qualitative interactions were found: Adolescents with less depressive symptoms but more anxiety symptoms showed more improvement when receiving PML than SFT, while for other adolescents the effects of PML and SFT were comparable. Discussion Whereas subgroups in both treatments followed different trajectories, no subgroup was found for which SFT outperformed PML in terms of the global change in symptoms from pretest to three months after treatment. This implies that, based on this exploratory study, there is no need for personalized treatment allocation with regard to the CBTs under study for adolescents with ADHD. However, for a subgroup with comorbid anxiety symptoms but low depression PML clearly appears the treatment of preference. Trial Registration Nederlands Trial Register NTR2142 PMID:26977602

  14. Qualitative Treatment-Subgroup Interactions in a Randomized Clinical Trial of Treatments for Adolescents with ADHD: Exploring What Cognitive-Behavioral Treatment Works for Whom.

    PubMed

    Boyer, Bianca E; Doove, Lisa L; Geurts, Hilde M; Prins, Pier J M; Van Mechelen, Iven; Van der Oord, Saskia

    2016-01-01

    This study explored qualitative treatment-subgroup interactions within data of a RCT with two cognitive behavioral treatments (CBT) for adolescents with ADHD: a planning-focused (PML) and a solution-focused CBT (SFT). Qualitative interactions imply that which treatment is best differs across subgroups of patients, and are therefore most relevant for personalized medicine. Adolescents with ADHD (N = 159) received either PML or SFT. Pre-, post- and three-month follow-up data were gathered on parent-rated ADHD symptoms and planning problems. Pretreatment characteristics were explored as potential qualitative moderators of pretest to follow-up treatment effects, using an innovative analyses technique (QUINT; Dusseldorp & Van Mechelen, 2014). In addition, qualitative treatment-subgroup interactions for the therapeutic changes from pre- to posttest and from post- to follow-up test were investigated. For the entire time span from pretest to follow-up only a quantitative interaction was found, while from posttest to follow-up qualitative interactions were found: Adolescents with less depressive symptoms but more anxiety symptoms showed more improvement when receiving PML than SFT, while for other adolescents the effects of PML and SFT were comparable. Whereas subgroups in both treatments followed different trajectories, no subgroup was found for which SFT outperformed PML in terms of the global change in symptoms from pretest to three months after treatment. This implies that, based on this exploratory study, there is no need for personalized treatment allocation with regard to the CBTs under study for adolescents with ADHD. However, for a subgroup with comorbid anxiety symptoms but low depression PML clearly appears the treatment of preference. Nederlands Trial Register NTR2142.

  15. To Watch or to Read? The Respective Influence of Televised Political Debates and Media Debate Coverage on Citizen Learning

    ERIC Educational Resources Information Center

    Kunde, Meg

    2017-01-01

    Courses: Media and Politics, Political Communication, Political Rhetoric, Media Effects. Objective: By taking part in a classroom activity, students will explore how cognitive frames and media frames play a role in learning from political debates.

  16. Subgroup analysis of telehealthcare for patients with chronic obstructive pulmonary disease: the cluster-randomized Danish Telecare North Trial

    PubMed Central

    Witt Udsen, Flemming; Lilholt, Pernille H; Hejlesen, Ole K; Ehlers, Lars H

    2017-01-01

    Purpose Results from the Danish cluster-randomized trial of telehealthcare to 1,225 patients with chronic obstructive pulmonary disease (COPD), the Danish Telecare North Trial, concluded that the telehealthcare solution was unlikely to be cost-effective, by applying international willingness-to-pay threshold values. The purpose of this article was to assess potential sources of variation across subgroups, which could explain overall cost-effectiveness results or be utilized in future economic studies in telehealthcare research. Methods First, the cost-structures and cost-effectiveness across COPD severities were analyzed. Second, five additional subgroup analyses were conducted, focusing on differences in cost-effectiveness across a set of comorbidities, age-groups, genders, resource patterns (resource use in the social care sector prior to randomization), and delivery sites. All subgroups were investigated post hoc. In analyzing cost-effectiveness, two separate linear mixed-effects models with treatment-by-covariate interactions were applied: one for quality-adjusted life-year (QALY) gain and one for total healthcare and social sector costs. Probabilistic sensitivity analysis was used for each subgroup result in order to quantify the uncertainty around the cost-effectiveness results. Results The study concludes that, across the COPD severities, patients with severe COPD (GOLD 3 classification) are likely to be the most cost-effective group. This is primarily due to lower hospital-admission and primary-care costs. Telehealthcare for patients younger than 60 years is also more likely to be cost-effective than for older COPD patients. Overall, results indicate that existing resource patterns of patients and variations in delivery-site practices might have a strong influence on cost-effectiveness, possibly stronger than the included health or sociodemographic sources of heterogeneity. Conclusion Future research should focus more on sources of heterogeneity found in

  17. Phylogenomic analysis of proteins that are distinctive of Archaea and its main subgroups and the origin of methanogenesis

    PubMed Central

    Gao, Beile; Gupta, Radhey S

    2007-01-01

    Background The Archaea are highly diverse in terms of their physiology, metabolism and ecology. Presently, very few molecular characteristics are known that are uniquely shared by either all archaea or the different main groups within archaea. The evolutionary relationships among different groups within the Euryarchaeota branch are also not clearly understood. Results We have carried out comprehensive analyses on each open reading frame (ORFs) in the genomes of 11 archaea (3 Crenarchaeota – Aeropyrum pernix, Pyrobaculum aerophilum and Sulfolobus acidocaldarius; 8 Euryarchaeota – Pyrococcus abyssi, Methanococcus maripaludis, Methanopyrus kandleri, Methanococcoides burtonii, Halobacterium sp. NCR-1, Haloquadratum walsbyi, Thermoplasma acidophilum and Picrophilus torridus) to search for proteins that are unique to either all Archaea or for its main subgroups. These studies have identified 1448 proteins or ORFs that are distinctive characteristics of Archaea and its various subgroups and whose homologues are not found in other organisms. Six of these proteins are unique to all Archaea, 10 others are only missing in Nanoarchaeum equitans and a large number of other proteins are specific for various main groups within the Archaea (e.g. Crenarchaeota, Euryarchaeota, Sulfolobales and Desulfurococcales, Halobacteriales, Thermococci, Thermoplasmata, all methanogenic archaea or particular groups of methanogens). Of particular importance is the observation that 31 proteins are uniquely present in virtually all methanogens (including M. kandleri) and 10 additional proteins are only found in different methanogens as well as A. fulgidus. In contrast, no protein was exclusively shared by various methanogen and any of the Halobacteriales or Thermoplasmatales. These results strongly indicate that all methanogenic archaea form a monophyletic group exclusive of other archaea and that this lineage likely evolved from Archaeoglobus. In addition, 15 proteins that are uniquely shared

  18. Endarterectomy for symptomatic carotid stenosis in relation to clinical subgroups and timing of surgery.

    PubMed

    Rothwell, P M; Eliasziw, M; Gutnikov, S A; Warlow, C P; Barnett, H J M

    2004-03-20

    Carotid endarterectomy reduces the risk of stroke in patients with recently symptomatic stenosis. Benefit depends on the degree of stenosis, and we aimed to see whether it might also depend on other clinical and angiographic characteristics, and on the timing of surgery. We analysed pooled data from the European Carotid Surgery Trial and North American Symptomatic Carotid Endarterectomy Trial. The risk of ipsilateral ischaemic stroke for patients on medical treatment, the perioperative risk of stroke and death, and the overall benefit from surgery were determined in relation to seven predefined and seven post hoc subgroups. 5893 patients with 33000 patient-years of follow-up were analysed. Sex (p=0.003), age (p=0.03), and time from the last symptomatic event to randomisation (p=0.009) modified the effectiveness of surgery. Benefit from surgery was greatest in men, patients aged 75 years or older, and those randomised within 2 weeks after their last ischaemic event, and fell rapidly with increasing delay. For patients with 50% or higher stenosis, the number of patients needed to undergo surgery (ie, number needed to treat) to prevent one ipsilateral stroke in 5 years was nine for men versus 36 for women, five for age 75 years or older versus 18 for younger than 65 years, and five for those randomised within 2 weeks after their last ischaemic event, versus 125 for patients randomised after more than 12 weeks. These results were consistent across the individual trials. Benefit from endarterectomy depends not only on the degree of carotid stenosis, but also on several other clinical characteristics such as delay to surgery after the presenting event. Ideally, the procedure should be done within 2 weeks of the patient's last symptoms.

  19. Paternal age related schizophrenia (PARS): Latent subgroups detected by k-means clustering analysis.

    PubMed

    Lee, Hyejoo; Malaspina, Dolores; Ahn, Hongshik; Perrin, Mary; Opler, Mark G; Kleinhaus, Karine; Harlap, Susan; Goetz, Raymond; Antonius, Daniel

    2011-05-01

    Paternal age related schizophrenia (PARS) has been proposed as a subgroup of schizophrenia with distinct etiology, pathophysiology and symptoms. This study uses a k-means clustering analysis approach to generate hypotheses about differences between PARS and other cases of schizophrenia. We studied PARS (operationally defined as not having any family history of schizophrenia among first and second-degree relatives and fathers' age at birth ≥ 35 years) in a series of schizophrenia cases recruited from a research unit. Data were available on demographic variables, symptoms (Positive and Negative Syndrome Scale; PANSS), cognitive tests (Wechsler Adult Intelligence Scale-Revised; WAIS-R) and olfaction (University of Pennsylvania Smell Identification Test; UPSIT). We conducted a series of k-means clustering analyses to identify clusters of cases containing high concentrations of PARS. Two analyses generated clusters with high concentrations of PARS cases. The first analysis (N=136; PARS=34) revealed a cluster containing 83% PARS cases, in which the patients showed a significant discrepancy between verbal and performance intelligence. The mean paternal and maternal ages were 41 and 33, respectively. The second analysis (N=123; PARS=30) revealed a cluster containing 71% PARS cases, of which 93% were females; the mean age of onset of psychosis, at 17.2, was significantly early. These results strengthen the evidence that PARS cases differ from other patients with schizophrenia. Hypothesis-generating findings suggest that features of PARS may include a discrepancy between verbal and performance intelligence, and in females, an early age of onset. These findings provide a rationale for separating these phenotypes from others in future clinical, genetic and pathophysiologic studies of schizophrenia and in considering responses to treatment. Copyright © 2011 Elsevier B.V. All rights reserved.

  20. Molecularly defined diffuse leptomeningeal glioneuronal tumor (DLGNT) comprises two subgroups with distinct clinical and genetic features.

    PubMed

    Deng, Maximilian Y; Sill, Martin; Chiang, Jason; Schittenhelm, Jens; Ebinger, Martin; Schuhmann, Martin U; Monoranu, Camelia-Maria; Milde, Till; Wittmann, Andrea; Hartmann, Christian; Sommer, Clemens; Paulus, Werner; Gärtner, Jutta; Brück, Wolfgang; Rüdiger, Thomas; Leipold, Alfred; Jaunmuktane, Zane; Brandner, Sebastian; Giangaspero, Felice; Nozza, Paolo; Mora, Jaume; Morales la Madrid, Andres; Cruz Martinez, Ofelia; Hansford, Jordan R; Pietsch, Torsten; Tietze, Anna; Hernáiz-Driever, Pablo; Stoler, Iris; Capper, David; Korshunov, Andrey; Ellison, David W; von Deimling, Andreas; Pfister, Stefan M; Sahm, Felix; Jones, David T W

    2018-05-15

    Diffuse leptomeningeal glioneuronal tumors (DLGNT) represent rare CNS neoplasms which have been included in the 2016 update of the WHO classification. The wide spectrum of histopathological and radiological features can make this enigmatic tumor entity difficult to diagnose. In recent years, large-scale genomic and epigenomic analyses have afforded insight into key genetic alterations occurring in multiple types of brain tumors and provide unbiased, complementary tools to improve diagnostic accuracy. Through genome-wide DNA methylation screening of > 25,000 tumors, we discovered a molecularly distinct class comprising 30 tumors, mostly diagnosed histologically as DLGNTs. Copy-number profiles derived from the methylation arrays revealed unifying characteristics, including loss of chromosomal arm 1p in all cases. Furthermore, this molecular DLGNT class can be subdivided into two subgroups [DLGNT methylation class (MC)-1 and DLGNT methylation class (MC)-2], with all DLGNT-MC-2 additionally displaying a gain of chromosomal arm 1q. Co-deletion of 1p/19q, commonly seen in IDH-mutant oligodendroglioma, was frequently observed in DLGNT, especially in DLGNT-MC-1 cases. Both subgroups also had recurrent genetic alterations leading to an aberrant MAPK/ERK pathway, with KIAA1549:BRAF fusion being the most frequent event. Other alterations included fusions of NTRK1/2/3 and TRIM33:RAF1, adding up to an MAPK/ERK pathway activation identified in 80% of cases. In the DLGNT-MC-1 group, age at diagnosis was significantly lower (median 5 vs 14 years, p < 0.01) and clinical course less aggressive (5-year OS 100, vs 43% in DLGNT-MC-2). Our study proposes an additional molecular layer to the current histopathological classification of DLGNT, of particular use for cases without typical morphological or radiological characteristics, such as diffuse growth and radiologic leptomeningeal dissemination. Recurrent 1p deletion and MAPK/ERK pathway activation represent diagnostic

  1. Understanding the debate on medical education research: a sociological perspective.

    PubMed

    Albert, Mathieu

    2004-10-01

    Since the mid-1990s, a debate has taken place among medical education scholars regarding the forms that research should take and the roles it should play. Editors of major journals in medical education and prominent researchers in the domain have repeatedly addressed the issue and have attempted to define what medical education research should be. The goal of this article is to look at the debate from a sociological perspective and to outline the social factors shaping it. An analysis of the texts published since 1990 addressing the issue shows that the debates can be deconstructed in four topics: epistemology, methodology, the primary purpose of medical education research, and the "quality" of the projects carried out in the domain. However, the debates can also be amalgamated and synthesized using the concept of "field" as developed by sociologist Pierre Bourdieu. A "field" refers to the configuration of power relations among individuals, social groups, or institutions within a domain of activities. Scientific fields are typically structured around a "bipolar" opposition pattern. At one pole stand those individuals who promote greater collaboration with nonscientists as well as research aimed at responding to practical needs. At the opposite pole stand those individuals who aspire to achieve independence of the field from such external constraints. The use of the concept of "field" allows us to understand the debate from a larger perspective and to establish parallels with similar debates in other scientific fields. In doing so, we will have the opportunity to learn from the experience of these other fields and be more reflective about the debate in which we engage.

  2. Adenoma Prevalence and Distribution Among US Latino Subgroups Undergoing Screening Colonoscopy.

    PubMed

    Chablani, Sumedha V; Jandorf, Lina; DuHamel, Katherine; Lee, Kristen K; Sriphanlop, Pathu; Villagra, Cristina; Itzkowitz, Steven H

    2017-06-01

    Colorectal cancer (CRC) is the second leading malignancy diagnosed among US Latinos. Latinos in the USA represent a heterogeneous amalgam of subgroups varying in genetic background, culture, and socioeconomic status. Little is known about the frequency of CRC precursor lesions found at screening colonoscopy among Latino subgroups. The aim was to determine the prevalence and distribution of histologically confirmed adenomas found at screening colonoscopy among average-risk, asymptomatic US Latinos according to their subgroup and socio-demographic background. Cross-sectional analysis of pathological findings resulting from screening colonoscopy among average-risk, asymptomatic US Latinos aged ≥50 in two prospective randomized controlled trials at an academic medical center. Among the 561 Latinos who completed screening colonoscopy, the two largest subgroups were Puerto Ricans and Dominicans. The findings among both subgroups were: adenomas 30.6%, proximal adenomas 23.5%, advanced adenomas 12.0%, and proximal advanced adenomas 8.9%. These rates are at least as high as those found at screening colonoscopy among US whites. While Puerto Ricans were more likely than Dominicans to be born in the USA, speak English, be acculturated, have a smoking history, and be obese, there were no significant differences in adenoma rates between these subgroups. The prevalence of adenomas, advanced adenomas, and proximal neoplasia was high among both subgroups. These findings have implications for CRC screening and surveillance among the increasingly growing Latino population in the USA.

  3. Type 2 Diabetes: Identifying High Risk Asian American Subgroups in a Clinical Population

    PubMed Central

    Wang, Elsie J.; Wong, Eric C.; Dixit, Anjali A.; Fortmann, Stephen P.; Linde, Randolph B.; Palaniappan, Latha P.

    2011-01-01

    Aims We compared the prevalence and treatment of type 2 diabetes across Asian American subgroups (Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese) and Non-Hispanic Whites (NHWs) in a Northern California healthcare system. Methods A three-year, cross-sectional sample of patient electronic health records was accessed to compare diabetes prevalence in 21,816 Asian and 73,728 NHWs aged 35+ years. Diabetes was classified through ICD-9 codes, abnormal laboratory values, or use of oral anti-diabetic medication. Multivariate adjusted prevalence rates for each Asian subgroup, and adjusted odds ratios (OR) relative to NHWs, were compared. Results Age-adjusted prevalence ranged from 5.8%-18.2% (women) and 8.1%-25.3% (men). Age-adjusted ORs of Asian subgroups ranged 1.11-3.94 (women) and 1.14-4.56 (men). The odds of diabetes were significantly higher in Asian Indians (women OR 3.44, men OR 3.54) and Filipinos (women OR 3.94, men OR 4.56), compared to NHWs. Results for Asian Indians and Filipinos were similar with age-and-BMI adjustment. Treatment rates across subgroups were 59.7-82.0% (women) and 62.9-79.4% (men). Conclusions Heterogeneity exists in the prevalence of diabetes across Asian subgroups, independent of obesity prevalence. Asian Indian and Filipino subgroups had particularly high prevalence of diabetes when compared to NHWs. Future studies should explore these clinically important differences among Asian subgroups. PMID:21665315

  4. Genetically modified food in the news: media representations of the GM debate in the UK.

    PubMed

    Augoustinos, Martha; Crabb, Shona; Shepherd, Richard

    2010-01-01

    This paper analyses a corpus of articles on GM crops and food which appeared in six UK newspapers in the first three months of 2004, the year following the GM Nation? debate (2003). Using the methods of critical discourse analysis we focus on how specific and pervasive representations of the major stakeholders in the national debate on GM--the British public, the British government, the science of GM, and biotechnology companies--served significant rhetorical functions in the controversy. Of particular significance was the pervasive representation of the British public as uniformly opposed to GM crops and food which served rhetorically to position the British government as undemocratic and as being beholden to powerful political and economic interests. Of significance also in our analysis, is how the science of GM farming itself became a highly contested arena. In short, our analysis demonstrates how the GM debate was represented in the newsprint media as a "battleground" of competing interests. We conclude by considering the possible implications of this representation given the increasing emphasis placed on the importance of deliberative and inclusive forms of science policy decision-making.

  5. [Debate and challenges on the topic of free medical care in Africa: "Back to the Future"?].

    PubMed

    Ridde, Valéry; Blanchet, Karl

    2009-01-01

    In its 2008 annual report, WHO affirmed the importance of resisting the temptation to depend on direct payment for primary health care. Members of the WHO committee on the social determinants of health as well as of those at the conference on primary health care in Ouagadougou in 2008 reaffirmed the need to make access to health care systems more equitable. Several decades after imposition of direct payment began, convincing data clearly demonstrate its harmful effects on the basic fairness of access to care. Accordingly, the current debate in the field of financial support for health involves the elimination of payments. More precisely, we can finally say that this is a debate about a return to the free care that existed before the widespread implementation of "cost recovery" systems. Here we want to review these discussions and prepare the ground for a debate on possible effective strategies for making health care systems more equitable from the perspective of universal coverage. We will thus note that analyses today must certainly focus more on how to eliminate direct payments than on the reasons to do so, already amply demonstrated. The international community must now undertake to support governments that want to move in this direction and ensure that the process is thoroughly documented so that it can also produce useful knowledge for the formulation of fair public policies.

  6. Debate on GMOs health risks after statistical findings in regulatory tests.

    PubMed

    de Vendômois, Joël Spiroux; Cellier, Dominique; Vélot, Christian; Clair, Emilie; Mesnage, Robin; Séralini, Gilles-Eric

    2010-10-05

    We summarize the major points of international debate on health risk studies for the main commercialized edible GMOs. These GMOs are soy, maize and oilseed rape designed to contain new pesticide residues since they have been modified to be herbicide-tolerant (mostly to Roundup) or to produce mutated Bt toxins. The debated alimentary chronic risks may come from unpredictable insertional mutagenesis effects, metabolic effects, or from the new pesticide residues. The most detailed regulatory tests on the GMOs are three-month long feeding trials of laboratory rats, which are biochemically assessed. The tests are not compulsory, and are not independently conducted. The test data and the corresponding results are kept in secret by the companies. Our previous analyses of regulatory raw data at these levels, taking the representative examples of three GM maize NK 603, MON 810, and MON 863 led us to conclude that hepatorenal toxicities were possible, and that longer testing was necessary. Our study was criticized by the company developing the GMOs in question and the regulatory bodies, mainly on the divergent biological interpretations of statistically significant biochemical and physiological effects. We present the scientific reasons for the crucially different biological interpretations and also highlight the shortcomings in the experimental protocols designed by the company. The debate implies an enormous responsibility towards public health and is essential due to nonexistent traceability or epidemiological studies in the GMO-producing countries.

  7. Debate on GMOs Health Risks after Statistical Findings in Regulatory Tests

    PubMed Central

    de Vendômois, Joël Spiroux; Cellier, Dominique; Vélot, Christian; Clair, Emilie; Mesnage, Robin; Séralini, Gilles-Eric

    2010-01-01

    We summarize the major points of international debate on health risk studies for the main commercialized edible GMOs. These GMOs are soy, maize and oilseed rape designed to contain new pesticide residues since they have been modified to be herbicide-tolerant (mostly to Roundup) or to produce mutated Bt toxins. The debated alimentary chronic risks may come from unpredictable insertional mutagenesis effects, metabolic effects, or from the new pesticide residues. The most detailed regulatory tests on the GMOs are three-month long feeding trials of laboratory rats, which are biochemically assessed. The tests are not compulsory, and are not independently conducted. The test data and the corresponding results are kept in secret by the companies. Our previous analyses of regulatory raw data at these levels, taking the representative examples of three GM maize NK 603, MON 810, and MON 863 led us to conclude that hepatorenal toxicities were possible, and that longer testing was necessary. Our study was criticized by the company developing the GMOs in question and the regulatory bodies, mainly on the divergent biological interpretations of statistically significant biochemical and physiological effects. We present the scientific reasons for the crucially different biological interpretations and also highlight the shortcomings in the experimental protocols designed by the company. The debate implies an enormous responsibility towards public health and is essential due to nonexistent traceability or epidemiological studies in the GMO-producing countries. PMID:20941377

  8. Prognostic factors associated with the success rates of posterior orthodontic miniscrew implants: A subgroup meta-analysis.

    PubMed

    Hong, Sung-Bin; Kusnoto, Budi; Kim, Eun-Jeong; BeGole, Ellen A; Hwang, Hyeon-Shik; Lim, Hoi-Jeong

    2016-03-01

    To systematically review previous studies and to assess, via a subgroup meta-analysis, the combined odds ratio (OR) of prognostic factors affecting the success of miniscrew implants (MIs) inserted into the buccal posterior region. Three electronic searches that were limited to articles on clinical human studies using MIs that were published in English prior to March 2015 were conducted. The outcome measure was the success of MIs. Patient factors included age, sex, and jaw of insertion (maxilla vs. mandible), while the MI factors included length and diameter. A meta-analysis was performed on 17 individual studies. The quality of each study was assessed for non-randomized studies and quantified using the Newcastle-Ottawa Scale. The meta-analysis outcome was a combined OR. Subgroup and sensitivity analyses based on the study design, study quality, and sample size of miniscrews implanted were performed. Significantly higher success rates were revealed for MIs inserted in the maxilla, for patients ≥ 20 years of age, and for long MIs (≥ 8 mm) and MIs with a large diameter (> 1.4 mm). All subgroups acquired homogeneity, and the combined OR of the prospective studies (OR, 3.67; 95% confidence interval [CI], 2.10-6.44) was significantly higher in the maxilla than that in the retrospective studies (OR, 2.10; 95% CI, 1.60-2.74). When a treatment plan is made, these risk factors, i.e. jaw of insertion, age, MI length, and MI diameter, should be taken into account, while sex is not critical to the success of MIs.

  9. Visualising abortion: emotion discourse and fetal imagery in a contemporary abortion debate.

    PubMed

    Hopkins, Nick; Zeedyk, Suzanne; Raitt, Fiona

    2005-07-01

    This paper presents an analysis of a recent UK anti-abortion campaign in which the use of fetal imagery--especially images of fetal remains--was a prominent issue. A striking feature of the texts produced by the group behind the campaign was the emphasis given to the emotions of those viewing such imagery. Traditionally, social scientific analyses of mass communication have problematised references to emotion and viewed them as being of significance because of their power to subvert the rational appraisal of message content. However, we argue that emotion discourse may be analysed from a different perspective. As the categorisation of the fetus is a social choice and contested, it follows that all protagonists in the abortion debate (whether pro- or anti-abortion) are faced with the task of constructing the fetus as a particular entity rather than another, and that they must seek to portray their preferred categorisation as objective and driven by an 'out-there' reality. Following this logic, we show how the emotional experience of viewing fetal imagery was represented so as to ground an anti-abortion construction of the fetus as objective. We also show how the arguments of the (pro-abortion) opposition were construed as totally discrepant with such emotions and so were invalidated as deceitful distortions of reality. The wider significance of this analysis for social scientific analyses of the abortion debate is discussed.

  10. Consumer-mediated health information exchanges: the 2012 ACMI debate.

    PubMed

    Cimino, James J; Frisse, Mark E; Halamka, John; Sweeney, Latanya; Yasnoff, William

    2014-04-01

    The American College of Medical Informatics (ACMI) sponsors periodic debates during the American Medical Informatics Fall Symposium to highlight important informatics issues of broad interest. In 2012, a panel debated the following topic: "Resolved: Health Information Exchange Organizations Should Shift Their Principal Focus to Consumer-Mediated Exchange in Order to Facilitate the Rapid Development of Effective, Scalable, and Sustainable Health Information Infrastructure." Those supporting the proposition emphasized the need for consumer-controlled community repositories of electronic health records (health record banks) to address privacy, stakeholder cooperation, scalability, and sustainability. Those opposing the proposition emphasized that the current healthcare environment is so complex that development of consumer control will take time and that even then, consumers may not be able to mediate their information effectively. While privately each discussant recognizes that there are many sides to this complex issue, each followed the debater's tradition of taking an extreme position in order emphasize some of the polarizing aspects in the short time allotted them. In preparing this summary, we sought to convey the substance and spirit of the debate in printed form. Transcripts of the actual debate were edited for clarity, and appropriate supporting citations were added for the further edification of the reader. Published by Elsevier Inc.

  11. Beyond the realism debate: The metaphysics of 'racial' distinctions.

    PubMed

    Lemeire, Olivier

    2016-10-01

    The current metaphysical race debate is very much focused on the realism question whether races exist. In this paper I argue against the importance of this question. Philosophers, biologists and anthropologists expect that answering this question will tell them something substantive about the metaphysics of racial classifications, and will help them to decide whether it is justified to use racial categories in scientific research and public policy. I argue that there are two reasons why these expectations are not fulfilled. First of all, the realism question about race leads to a very broad philosophical debate about the semantics of general terms and the criteria for real kinds, rather than to a debate about the metaphysics of racial categories specifically. Secondly, there is a type of race realism that is so toothless that it is almost completely uninformative about the metaphysics of race. In response to these worries, I argue that the metaphysical race debate should rather be focused on the question in what way and to what extent 'racial' distinctions can ground the epistemic practices of various scientific disciplines. I spell out what I mean by this, and go on to demonstrate that trying to answer this question leads to a more fruitful metaphysical debate. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Tobacco price increase and smoking behaviour changes in various subgroups: a nationwide longitudinal 7-year follow-up study among a middle-aged Japanese population.

    PubMed

    Tabuchi, Takahiro; Fujiwara, Takeo; Shinozaki, Tomohiro

    2017-01-01

    Few longitudinal studies have examined the effect of tobacco price increase on both cessation among smokers and relapse among quitters. Our objective was to investigate the differential impact of the tobacco price increase on the changes in smoking status in the total population and various subgroups. We analysed data from a Japanese nationally representative longitudinal study of 30 773 individuals aged 50-59 years (weighted sum of discrete-time number = 215 411) with smoking information, using inverse probability weighting to account for non-response at follow-up. Generalised estimating equation models were used to calculate the odds ratios (ORs) for smoking behavioural changes (cessation among smokers and relapse among quitters), using discrete-time design. Stratified analyses were conducted according to demographic, socioeconomic and health behavioural characteristics. From 2005 to 2012, current smoker prevalence among the middle-aged Japanese population decreased from 30.5% to 24.3%. Of all the factors surveyed, only the tobacco price increase in 2010 (up by 37%, the highest increase during the period) was significantly associated with both cessation among smokers (OR 2.14, 95% confidence interval 1.90 to 2.41) and prevention of relapse among quitters (0.60, 0.46 to 0.77). Regarding the subgroup analysis, the tobacco price increase was associated with a significant reduction in relapse in the lowest income, recent quitters and very poor health subgroups. However, different associations were observed for cessation; a significant association between price increase and cessation was observed among all subgroups except for the heavy smoker and recently unemployed subgroups. We confirmed that the tobacco price rise was associated with increasing cessation and decreasing relapse concurrently. Furthermore, this price rise was associated with favourable smoking changes in nearly all population subgroups; a large differential impact was not observed across the

  13. Identification of Patient Benefit From Proton Therapy for Advanced Head and Neck Cancer Patients Based on Individual and Subgroup Normal Tissue Complication Probability Analysis

    SciTech Connect

    Jakobi, Annika, E-mail: Annika.Jakobi@OncoRay.de; Bandurska-Luque, Anna; Department of Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden

    Purpose: The purpose of this study was to determine, by treatment plan comparison along with normal tissue complication probability (NTCP) modeling, whether a subpopulation of patients with head and neck squamous cell carcinoma (HNSCC) could be identified that would gain substantial benefit from proton therapy in terms of NTCP. Methods and Materials: For 45 HNSCC patients, intensity modulated radiation therapy (IMRT) was compared to intensity modulated proton therapy (IMPT). Physical dose distributions were evaluated as well as the resulting NTCP values, using modern models for acute mucositis, xerostomia, aspiration, dysphagia, laryngeal edema, and trismus. Patient subgroups were defined based onmore » primary tumor location. Results: Generally, IMPT reduced the NTCP values while keeping similar target coverage for all patients. Subgroup analyses revealed a higher individual reduction of swallowing-related side effects by IMPT for patients with tumors in the upper head and neck area, whereas the risk reduction of acute mucositis was more pronounced in patients with tumors in the larynx region. More patients with tumors in the upper head and neck area had a reduction in NTCP of more than 10%. Conclusions: Subgrouping can help to identify patients who may benefit more than others from the use of IMPT and, thus, can be a useful tool for a preselection of patients in the clinic where there are limited PT resources. Because the individual benefit differs within a subgroup, the relative merits should additionally be evaluated by individual treatment plan comparisons.« less

  14. Current debates on end-of-life sedation: an international expert elicitation study.

    PubMed

    Papavasiliou, Evangelia Evie; Payne, Sheila; Brearley, Sarah

    2014-08-01

    End-of-life sedation, though increasingly prevalent and widespread internationally, remains one of the most highly debated medical practices in the context of palliative medicine. This qualitative study aims to elicit and record the perspectives of leading international palliative care experts on current debates. Twenty-one professionals from diverse backgrounds, sharing field-specific knowledge/expertise defined by significant scholarly contribution on end-of-life sedation, were recruited. Open-ended, semi-structured interviews, following a topic-oriented structure reflecting on current debates, were conducted. Results were analysed using thematic content analysis. Three main aspects of sedation were identified and discussed as potentially problematic: (a) continuous deep sedation as an extreme facet of end-of-life sedation, (b) psycho-existential suffering as an ambivalent indication for sedation and (c) withdrawal or withholding of artificial nutrition and hydration as potentially life-shortening. On these grounds, concerns were reported over end-of-life sedation being morally equivalent to euthanasia. Considerable emphasis was placed on intentions as the distinguishing factor between end-of-life acts, and protective safeguards were introduced to distance sedation from euthanasia. This study shows that, despite the safeguards introduced, certain aspects of sedation, including the intentions associated with the practice, are still under question, parallels being drawn between end-of-life sedation and euthanasia. This reaffirms the existence of a grey area surrounding the two practices, already evidenced in countries where euthanasia is legalized. More clarity over the issues that generate this grey area, with their causes being uncovered and eliminated, is imperative to resolve current debates and effectively inform research, policy and practice of end-of-life sedation.

  15. Debating the Effectiveness and Necessity of Tenure in Pharmacy Education.

    PubMed

    Asbill, Scott; Moultry, Aisha Morris; Policastri, Anne; Sincak, Carrie A; Smith, Lisa S; Ulbrich, Timothy R

    2016-08-25

    Academic tenure is a controversial and highly debated topic. Is tenure truly outdated or does it simply need to be reformed? On one hand, the tenure system has shortcomings including deincentivizing productive faculty members, inconsistent application of tenure policies and procedures, and the potential for discrimination during tenure decisions. On the other hand, the tenure system is a long held tradition in the academy, essential in higher education to ensure academic standards and values are upheld in the best interest of students. It provides faculty members with the academic freedom to try innovative teaching strategies and conduct research and assists with faculty retention and recruitment. Regardless of one's opinion, the tenure debate is not going away and warrants further discussion. This paper represents the work of a group of academic leaders participating in the 2014-2015 AACP Academic Leadership Fellowship Program. This work was presented as a debate at the 2015 AACP Interim Meeting in Austin, TX in February 2015.

  16. [The first Dutch debate on anaesthesia in obstetrics].

    PubMed

    Bijker, Liselotte E

    2015-01-01

    After the publication of the Dutch medical guideline on pharmacological analgesia during childbirth in 2008, the question of whether pharmacological pain relief should be permissible during labour was hotly debated. This discussion has been going on since the second half of the 19th century when the introduction of ether and chloroform was extensively studied and described in Great Britain. This article looks back on the same debate in the Netherlands when inhalational anaesthetics were introduced into obstetrics. Study of historical journals and textbooks, originating in the Netherlands and elsewhere, and of historical medical literature on anaesthesia and obstetrics shows that the Dutch protagonists adopted more nuanced ideas on this issue than many of their foreign colleagues. This description of the first Dutch debate on anaesthesia in obstetrics shows that in fact the issues and arguments are timeless.

  17. Transcultural ADHD and Bioethics: Reformulating a Doubly Dichotomized Debate.

    PubMed

    Pickering, Neil; Nie, Jing-Bao

    A double dichotomization, of biology and culture, and of cultures (the difference presumption), is to be found in debates about Attention Deficit Hyperactivity Disorder (ADHD) in cross-cultural psychiatric and bioethics literature. The double dichotomy takes biology to explain cross-cultural similarities and culture to explain inter-cultural differences. In this paper, the double dichotomy is explored in debates on the significance of the worldwide prevalence of ADHD, and on the cogency of cross-cultural diagnosis of ADHD in the central character of Chinese classic novel The Dream of the Red Chamber. Contrary to the difference presumption, cultures are not homogenous unities that contrast in toto with one another. The Dream reveals parallels to contemporary US debates-the medicalization of human life and normative disputes about childhood behaviors. To overcome the empirical and theoretical shortcomings of the difference presumption and its underlying characterization of cultural differences, a transcultural approach is proposed and its potential advantages illustrated.

  18. E-cigarettes: a need to broaden the debate.

    PubMed

    Latif, E; Nair, M

    2016-11-01

    The unregulated market for e-cigarettes continues to grow, with debates on their efficacy and impact on global public health. E-cigarettes, or electronic nicotine delivery systems (ENDs), are marketed as a 'safe' alternative to tobacco products and a tool for 'harm reduction'. Some public health experts are calling it a 'game changer' and favour the 'harm reduction' strategy, while others dispute this claim. In our opinion, the debate needs to be broadened to encompass other related concerns and effects on non-users and affected stakeholders. As with tobacco control, a holistic approach is needed to build a raft of policies that effectively address the issue from all angles and look beyond the direct health implications of e-cigarette use to explore the social, economic, political and environmental aspects of this debate, putting 'harm reduction' in context.

  19. Team negotiation: social, epistemic, economic, and psychological consequences of subgroup conflict.

    PubMed

    Halevy, Nir

    2008-12-01

    Large collectives (e.g., organizations, political parties, nations) are seldom unitary players. Rather, they consist of different subgroups that often have conflicting interests. Nonetheless, negotiation research consistently regards negotiating teams, who represent these collectives, as monolithic parties with uniform interests. This article integrates concepts from social psychology, management, political science, and behavioral game theory to explore the effects of subgroup conflict on team negotiation. Specifically, the present research introduced a conflict of interests within negotiating teams and investigated how this internal conflict affects the outcome of the negotiation between teams. An experiment with 80 four-person teams found that conflict between subgroups had a detrimental effect on the performance of negotiating teams. This research also employed a recent model of motivated information processing in groups to investigate possible processes underlying the effect of subgroup conflict on team negotiation.

  20. Caregiving Subgroups Differences in the Associations Between the Resilience Resources and Life Satisfaction

    PubMed Central

    Kim, Seungyoun; Knight, Bob G.

    2016-01-01

    Using a model of resilience, this study compared the direct and indirect associations between resilience resources (sense of mastery, openness to experience, emotion regulation, and social support) and life satisfaction among caregiving subgroups (spouses, adult-children, and parents). Participants were included from the survey of Midlife in the United States (MIDUS II). Estimates of direct and indirect relationships between the resources and life satisfaction were calculated for each subgroup, and differences in the relationships between subgroups were tested. The direct positive relationships between sense of mastery and life satisfaction were significant and stronger for spouses and parents than for adult-children. In contrast, an indirect relationship through social support between the two variables was stronger for adult-children than for spouses. Openness to experience had a direct positive link to life satisfaction among spouses, and emotion regulation was directly related to life satisfaction among parents. We suggested targeted interventions for caregiving subgroups. PMID:27655236

  1. Discrete subgroups of adolescents diagnosed with borderline personality disorder: a latent class analysis of personality features.

    PubMed

    Ramos, Vera; Canta, Guilherme; de Castro, Filipa; Leal, Isabel

    2014-08-01

    Research suggests that borderline personality disorder (BPD) can be diagnosed in adolescents and is marked by considerable heterogeneity. This study aimed to identify personality features characterizing adolescents with BPD and possible meaningful patterns of heterogeneity that could lead to personality subgroups. The authors analyzed data on 60 adolescents, ages 15 to 18 years, who met DSM criteria for a BPD diagnosis. The authors used latent class analysis (LCA) to identify subgroups based on the personality pattern scales from the Millon Adolescent Clinical Inventory (MACI). LCA indicated that the best-fitting solution was a two-class model, identifying two discrete subgroups of BPD adolescents that were described as internalizing and externalizing. The subgroups were then compared on clinical and sociodemographic variables, measures of personality dimensions, DSM BPD criteria, and perception of attachment styles. Adolescents with a BPD diagnosis constitute a heterogeneous group and vary meaningfully on personality features that can have clinical implications for treatment.

  2. [Generalization of the results of clinical studies through the analysis of subgroups].

    PubMed

    Costa, João; Fareleira, Filipa; Ascensão, Raquel; Vaz Carneiro, António

    2012-01-01

    Subgroup analysis in clinical trials are usually performed to define the potential heterogeneity of treatment effect in relation with the baseline risk, physiopathology, practical application of therapy or the under-utilization in clinical practice of effective interventions due to uncertainties of its benefit/risk ratio. When appropriately planned, subgroup analysis are a valid methodology the define benefits in subgroups of patients, thus providing good quality evidence to support clinical decision making. However, in order to be correct, subgroup analysis should be defined a priori, done in small numbers, should be fully reported and, most important, must endure statistical tests for interaction. In this paper we present an example of the treatment of post-menopausal osteoporosis, in which the benefits of an intervention (the higher the fracture risk is, the better the benefit is) with a specific agent (bazedoxifene) was only disclosed after a post-hoc analysis of the initial global trial sample.

  3. IDENTIFYING A SUSCEPTIBLE SUBGROUP: EFFECTS OF THE PITTSBURGH AIR POLLUTION EPISODE UPON SCHOOL CHILDREN

    EPA Science Inventory

    Pulmonary function test results on 224 parochial schoolchildren collected during and after the Pittsburgh air pollution episode of November 1975 were reanalyzed to determine whether a small subgroup of susceptible children could be defined. Individual regressions of three-quarter...

  4. Twelve-year trends in health insurance coverage among Latinos, by subgroup and immigration status.

    PubMed

    Shah, N Sarita; Carrasquillo, Olveen

    2006-01-01

    We examine twelve-year trends in the Latino uninsured population by ethnic subgroup and immigration status. From 1993 to 1999, most Latino subgroups, particularly Puerto Ricans, had large decreases in Medicaid coverage. For some subgroups these were offset by increases in employer coverage, but not for Mexicans, resulting in a four-percentage-point increase in their uninsured population. During 2000-2004, Medicaid/SCHIP expansions benefited most subgroups and mitigated smaller losses in employer coverage. However, during 1993-2004, the percentage of noncitizen Latinos lacking coverage increased by several percentage points. This was attributable to Medicaid losses during 1993-1999 and losses in employer coverage during 2000-2004.

  5. Individual, Cultural and Structural Predictors of Vaccine Safety Confidence and Influenza Vaccination Among Hispanic Female Subgroups.

    PubMed

    Moran, Meghan Bridgid; Chatterjee, Joyee S; Frank, Lauren B; Murphy, Sheila T; Zhao, Nan; Chen, Nancy; Ball-Rokeach, Sandra

    2017-08-01

    Rates of influenza vaccination among US Hispanics are lower than for non-Hispanic whites, yet little is known about factors affecting vaccination in this population. Additionally, although Hispanics are a diverse population with culturally distinct subgroups, they are often treated as a homogenous population. This study (1) examines how confidence in vaccine safety and influenza vaccine use vary by Hispanic subgroup and (2) identifies individual, cultural and structural correlates of these outcomes. This study analyzed survey data from 1565 Hispanic women who were recruited at clinic- and community-based sites in Los Angeles. Education, healthcare coverage, acculturation, fatalism, and religiosity were predictors of influenza vaccination behavior and predictors varied by subgroup. These findings provide guidance for how influenza vaccine promotion efforts can be developed for Hispanic subgroups. Confidence in the safety of a vaccine is a major predictor of flu vaccination and an important modifiable target for intervention.

  6. Identification of a novel subgroup 16SrII-U phytoplasma associated with papaya little leaf disease.

    PubMed

    Yang, Yi; Jiang, Lei; Che, Haiyan; Cao, Xueren; Luo, Daquan

    2016-09-01

    Papaya is an important fruit crop cultivated in tropical and subtropical regions. Papaya little leaf (PLL) disease was observed in China. The phytoplasma 16S rRNA gene was detected from symptomatic papaya trees via PCR using phytoplasma universal primers P1/P7 followed by R16F2n/R16R2. No amplification products were obtained from templates of asymptomatic papaya trees. These results indicated a direct association between phytoplasma infection and PLL disease. Comparative and phylogenetic analyses of 16S rRNA gene sequences indicated that the papaya-infecting phytoplasmas under study belonged to the peanut witches' broom phytoplasma group (16SrII). Genotyping through use of computer-simulated RFLP analysis of 16S rRNA genes and coefficients of RFLP pattern similarities (0.97) reveal that the PLL phytoplasma was placed in a new subgroup. In this article, we describe the molecular characterization of a new phytoplasma associated with PLL disease and propose that the PLL phytoplasma be considered as a novel subgroup, 16SrII-U.

  7. Ethnic differences in BMI and body/self-dissatisfaction among Whites, Asian subgroups, Pacific Islanders, and African-Americans.

    PubMed

    Yates, Alayne; Edman, Jeanne; Aruguete, Mara

    2004-04-01

    To distinguish body mass index (BMI) and body/self-dissatisfaction among Asian subgroups. 211 white, 155 Japanese, 112 African-American, 79 Filipino, 70 Chinese, 70 Hawaiian, and 124 multiethnic college students in Hawaii completed: Figure Drawings (index of body-dissatisfaction), self-loathing subscale (SLSS, exercise-based measure of self-dissatisfaction), Eating Disorder Inventory-2 (EDI), and symptom self-report. Pearson correlation analyses were performed to determine whether BMI scores were related to self- and body-dissatisfaction and the relationship between self- and body-dissatisfaction. BMI was highly correlated with body and self-dissatisfaction for males and females. Males appeared more satisfied than females with the body and more diverse in choice of larger or smaller ideal body type. Highly significant BMI/ethnic group differences emerged. White males were large (high BMI) but very satisfied with body and self. Filipino males were the largest of all male groups but followed a female pattern of strong body/self-dislike and preference for smaller body. Chinese females were small and highly satisfied with body/self whereas Japanese females were small but highly dissatisfied with body/self. Combining various ethnic groups under a single "Asian" category obscures important group differences. Study clearly demonstrates Asian ethnic subgroup differences in BMI and body/self dissatisfaction.

  8. Bioethics and health disparity: Adding diversity to the debate.

    PubMed

    Chilton, Janice Allen; Hajek, Richard A

    2006-01-01

    Advances in biomedical science and technology have raised profound challenges to the way we think, feel, and act regarding human practices and ideals. Ethicists are needed from diverse populations who can enhance moral debate by offering cultural insight as choices are made as to how society should approach the expanding medical and biological possibilities. In this text, we review comments from bioethicists who are focusing on the moral issues surrounding health disparity. The purpose of the report is to ask the reader to begin to understand how to be an informed partner in this ethical debate.

  9. Identifying Subgroups of Tinnitus Using Novel Resting State fMRI Biomarkers and Cluster Analysis

    DTIC Science & Technology

    2016-10-01

    AWARD NUMBER: W81XWH-15-2-0032 TITLE: Identifying Subgroups of Tinnitus Using Novel Resting State fMRI Biomarkers and Cluster Analysis PRINCIPAL...4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Identifying Subgroups of Tinnitus Using Novel Resting State fMRI Biomarkers and Cluster Analysis 5b...Public Release; Distribution Unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT The subject of the project is FY14 PRMRP Topic Area – Tinnitus . The broad

  10. Identifying Subgroups of Tinnitus Using Novel Resting State fMRI Biomarkers and Cluster Analysis

    DTIC Science & Technology

    2017-10-13

    AWARD NUMBER: W81XWH-15-2-0032 TITLE: Identifying Subgroups of Tinnitus Using Novel Resting State fMRI Biomarkers and Cluster Analysis...TITLE AND SUBTITLE 5a. CONTRACT NUMBER W81XWH-15-2-0032 5b. GRANT NUMBER Identifying Subgroups of Tinnitus Using Novel Resting State fMRI...Release; Distribution Unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT The subject of the project is FY14 PRMRP Topic Area – Tinnitus . The broad goal is

  11. The value of maximum jaw motion measurements for distinguishing between common temporomandibular disorder subgroups.

    PubMed

    Masumi, S; Kim, Y J; Clark, G T

    2002-05-01

    The purpose of this study was to determine if mandibular motion measurements could be used to distinguish between common temporomandibular disorder (TMD) subgroups that were established on the basis of only clinical signs and symptoms. Patients were 41 consecutive TMD clinic patients (31 women and 10 men). These patients were divided into 6 typical TMD subgroups. The subgroups were patients with (1) arthromyalgia, (2) arthromyalgia with disk condyle incoordination, (3) disk condyle incoordination only, (4) osteoarthritis, (5) suspected disk displacement without reduction, or (6) other diagnoses. There were no subjects in the other-diagnosis subgroup and only 1 subject with suspected disk displacement without reduction who was dropped without further consideration. The data for mean age showed that the osteoarthritis subgroup (n = 12) was statistically older (17 years) than the disk-condyle-incoordination-only subgroup (n = 11). The mean age of the other 2 groups, arthromyalgia (n = 11) and arthromyalgia with disk condyle incoordination (n = 6), was between the osteoarthritis and the disk-condyle-incoordination-only subgroups. For the 4 TMD subgroups whose data were analyzed, the mean differences between similar jaw opening measurements ranged from 6 to 8 mm with a standard deviation of approximately 8 to 10 mm. The mean left lateral motions were 0.5 to 1.3 mm larger than observed on the right. The widest mean jaw opening (56 mm) occurred in the disk-condyle-incoordination-only group. These differences were not found to be statistically significant. Analysis of opening, lateral and protrusive jaw motion data showed these measurements could not reliably differentiate between patients with osteoarthritis, arthromyalgia, arthromyalgia with disk condyle incoordination and disk condyle incoordination only.

  12. The Rings with Identity Whose Additive Subgroups Are One-Sided Ideals

    ERIC Educational Resources Information Center

    Dobbs, David E.

    2017-01-01

    Let R be a ring with identity. Then {0} and R are the only additive subgroups of R if and only if R is isomorphic (as a ring with identity) to (exactly) one of {0}, Z/pZ for a prime number p. Also, each additive subgroup of R is a one-sided ideal of R if and only if R is isomorphic to (exactly) one of {0}, Z, Z/nZ for an integer n = 2. This note…

  13. [Max Planck--an adversary of Christianity? The debate about Planck's attitude towards religion after World War II].

    PubMed

    Löhr, Gebhard

    2012-03-01

    The article discusses a debate which unfolded in the early 1950s and 1960s between East German Marxist philosophers and historians of science and West German theologians and scientists. The subject treated was the attitude towards religion of famous physicist Max Planck who had died a few years earlier, in 1947. The article analyses the different positions of the contributors, mainly with a view to developing a categorial framework usable in descriptions and analyses of the religious attitudes of natural scientists. Moreover the different stages of the debate are outlined in order to exhibit their connections to the larger historical context, i.e. the unfolding of the cold war. In the light of this the debate can be regarded as a religious or ideological war, albeit a cold one, on German soil, which fortunately did not escalate into a hot conflict. It ended, as can be illustrated in a late contribution to the debate, with the collapse of the GDR in 1989 or shortly thereafter.

  14. Genome-Wide Association Study Reveals Four Loci for Lipid Ratios in the Korean Population and the Constitutional Subgroup.

    PubMed

    Kim, Taehyeung; Park, Ah Yeon; Baek, Younghwa; Cha, Seongwon

    2017-01-01

    Circulating lipid ratios are considered predictors of cardiovascular risks and metabolic syndrome, which cause coronary heart diseases. One constitutional type of Korean medicine prone to weight accumulation, the Tae-Eum type, predisposes the consumers to metabolic syndrome, hypertension, diabetes mellitus, etc. Here, we aimed to identify genetic variants for lipid ratios using a genome-wide association study (GWAS) and followed replication analysis in Koreans and constitutional subgroups. GWASs in 5,292 individuals of the Korean Genome and Epidemiology Study and replication analyses in 2,567 subjects of the Korea medicine Data Center were performed to identify genetic variants associated with triglyceride (TG) to HDL cholesterol (HDLC), LDL cholesterol (LDLC) to HDLC, and non-HDLC to HDLC ratios. For subgroup analysis, a computer-based constitution analysis tool was used to categorize the constitutional types of the subjects. In the discovery stage, seven variants in four loci, three variants in three loci, and two variants in one locus were associated with the ratios of log-transformed TG:HDLC (log[TG]:HDLC), LDLC:HDLC, and non-HDLC:HDLC, respectively. The associations of the GWAS variants with lipid ratios were replicated in the validation stage: for the log[TG]:HDLC ratio, rs6589566 near APOA5 and rs4244457 and rs6586891 near LPL; for the LDLC:HDLC ratio, rs4420638 near APOC1 and rs17445774 near C2orf47; and for the non-HDLC:HDLC ratio, rs6589566 near APOA5. Five of these six variants are known to be associated with TG, LDLC, and/or HDLC, but rs17445774 was newly identified to be involved in lipid level changes in this study. Constitutional subgroup analysis revealed effects of variants associated with log[TG]:HDLC and non-HDLC:HDLC ratios in both the Tae-Eum and non-Tae-Eum types, whereas the effect of the LDLC:HDLC ratio-associated variants remained only in the Tae-Eum type. In conclusion, we identified three log[TG]:HDLC ratio-associated variants, two LDLC

  15. Genome-Wide Association Study Reveals Four Loci for Lipid Ratios in the Korean Population and the Constitutional Subgroup

    PubMed Central

    Kim, Taehyeung; Park, Ah Yeon; Baek, Younghwa

    2017-01-01

    Circulating lipid ratios are considered predictors of cardiovascular risks and metabolic syndrome, which cause coronary heart diseases. One constitutional type of Korean medicine prone to weight accumulation, the Tae-Eum type, predisposes the consumers to metabolic syndrome, hypertension, diabetes mellitus, etc. Here, we aimed to identify genetic variants for lipid ratios using a genome-wide association study (GWAS) and followed replication analysis in Koreans and constitutional subgroups. GWASs in 5,292 individuals of the Korean Genome and Epidemiology Study and replication analyses in 2,567 subjects of the Korea medicine Data Center were performed to identify genetic variants associated with triglyceride (TG) to HDL cholesterol (HDLC), LDL cholesterol (LDLC) to HDLC, and non-HDLC to HDLC ratios. For subgroup analysis, a computer-based constitution analysis tool was used to categorize the constitutional types of the subjects. In the discovery stage, seven variants in four loci, three variants in three loci, and two variants in one locus were associated with the ratios of log-transformed TG:HDLC (log[TG]:HDLC), LDLC:HDLC, and non-HDLC:HDLC, respectively. The associations of the GWAS variants with lipid ratios were replicated in the validation stage: for the log[TG]:HDLC ratio, rs6589566 near APOA5 and rs4244457 and rs6586891 near LPL; for the LDLC:HDLC ratio, rs4420638 near APOC1 and rs17445774 near C2orf47; and for the non-HDLC:HDLC ratio, rs6589566 near APOA5. Five of these six variants are known to be associated with TG, LDLC, and/or HDLC, but rs17445774 was newly identified to be involved in lipid level changes in this study. Constitutional subgroup analysis revealed effects of variants associated with log[TG]:HDLC and non-HDLC:HDLC ratios in both the Tae-Eum and non-Tae-Eum types, whereas the effect of the LDLC:HDLC ratio-associated variants remained only in the Tae-Eum type. In conclusion, we identified three log[TG]:HDLC ratio-associated variants, two LDLC

  16. Amoxicillin for acute lower respiratory tract infection in primary care: subgroup analysis of potential high-risk groups

    PubMed Central

    Moore, Michael; Stuart, Beth; Coenen, Samuel; Butler, Chris C; Goossens, Herman; Verheij, Theo JM; Little, Paul

    2014-01-01

    Background Antibiotics are of limited overall clinical benefit for uncomplicated lower respiratory tract infection (LRTI) but there is uncertainty about their effectiveness for patients with features associated with higher levels of antibiotic prescribing. Aim To estimate the benefits and harms of antibiotics for acute LRTI among those producing coloured sputum, smokers, those with fever or prior comorbidities, and longer duration of prior illness. Design and setting Secondary analysis of a randomised controlled trial of antibiotic placebo for acute LRTI in primary care. Method Two thousand and sixty-one adults with acute LRTI, where pneumonia was not suspected clinically, were given amoxicillin or matching placebo. The duration of symptoms, rated moderately bad or worse (primary outcome), symptom severity on days 2–4 (0–6 scale), and the development of new or worsening symptoms were analysed in pre-specified subgroups of interest. Evidence of differential treatment effectiveness was assessed in prespecified subgroups by interaction terms. Results No subgroups were identified that were significantly more likely to benefit from antibiotics in terms of symptom duration or the development of new or worsening symptoms. Those with a history of significant comorbidities experienced a significantly greater reduction in symptom severity between days 2 and 4 (interaction term −0.28, P = 0.003; estimated effect of antibiotics among those with a past history −0.28 [95% confidence interval = −0.44 to −0.11], P = 0.001), equivalent to three people in 10 rating symptoms as a slight rather than a moderately bad problem. For subgroups not specified in advance antibiotics provided a modest reduction in symptom severity for non-smokers and for those with short prior illness duration (<7 days), and a modest reduction in symptom duration for those with short prior illness duration. Conclusion There is no clear evidence of clinically meaningful benefit from antibiotics in

  17. Subgroup effects of occupational therapy-based intervention for people with advanced cancer.

    PubMed

    Sampedro Pilegaard, Marc; Oestergaard, Lisa Gregersen; la Cour, Karen; Thit Johnsen, Anna; Brandt, Åse

    2018-03-23

    Many people with advanced cancer have decreased ability to perform activities of daily living (ADL). We recently performed a randomized, controlled trial (RCT) assessing the efficacy of an occupational therapy-based program, the 'Cancer Home-Life Intervention' in people with advanced cancer (N = 242) and found no overall effects on ADL ability. However, heterogeneity of treatment effect may disguise subgroup differences. To investigate whether subgroups of people with advanced cancer gain positive effects from the 'Cancer Home-Life Intervention' on ADL ability. An exploratory subgroup analysis including 191 participants from a RCT. The outcome was ADL motor ability measured by the Assessment of Motor and Process Skills (AMPS). Subgroups were defined by age, gender, years of education, type of primary tumor, functional level, and activity problems. The 'Cancer Home-Life Intervention' had no statistically significant effect in the six subgroups. Modifying effects of age (0.30 [95% CI: -0.05 to 0.64]) and gender (0.23 [95% CI: -0.11 to 0.57]) were not found. There were no subgroup effects of the 'Cancer Home-Life Intervention'on ADL motor ability. Some indications suggest greater effects for those aged below 69 years; however, this result should be interpreted with caution.

  18. A utility-based design for randomized comparative trials with ordinal outcomes and prognostic subgroups.

    PubMed

    Murray, Thomas A; Yuan, Ying; Thall, Peter F; Elizondo, Joan H; Hofstetter, Wayne L

    2018-01-22

    A design is proposed for randomized comparative trials with ordinal outcomes and prognostic subgroups. The design accounts for patient heterogeneity by allowing possibly different comparative conclusions within subgroups. The comparative testing criterion is based on utilities for the levels of the ordinal outcome and a Bayesian probability model. Designs based on two alternative models that include treatment-subgroup interactions are considered, the proportional odds model and a non-proportional odds model with a hierarchical prior that shrinks toward the proportional odds model. A third design that assumes homogeneity and ignores possible treatment-subgroup interactions also is considered. The three approaches are applied to construct group sequential designs for a trial of nutritional prehabilitation versus standard of care for esophageal cancer patients undergoing chemoradiation and surgery, including both untreated patients and salvage patients whose disease has recurred following previous therapy. A simulation study is presented that compares the three designs, including evaluation of within-subgroup type I and II error probabilities under a variety of scenarios including different combinations of treatment-subgroup interactions. © 2018, The International Biometric Society.

  19. The value of heterogeneity for cost-effectiveness subgroup analysis: conceptual framework and application.

    PubMed

    Espinoza, Manuel A; Manca, Andrea; Claxton, Karl; Sculpher, Mark J

    2014-11-01

    This article develops a general framework to guide the use of subgroup cost-effectiveness analysis for decision making in a collectively funded health system. In doing so, it addresses 2 key policy questions, namely, the identification and selection of subgroups, while distinguishing 2 sources of potential value associated with heterogeneity. These are 1) the value of revealing the factors associated with heterogeneity in costs and outcomes using existing evidence (static value) and 2) the value of acquiring further subgroup-related evidence to resolve the uncertainty given the current understanding of heterogeneity (dynamic value). Consideration of these 2 sources of value can guide subgroup-specific treatment decisions and inform whether further research should be conducted to resolve uncertainty to explain variability in costs and outcomes. We apply the proposed methods to a cost-effectiveness analysis for the management of patients with acute coronary syndrome. This study presents the expected net benefits under current and perfect information when subgroups are defined based on the use and combination of 6 binary covariates. The results of the case study confirm the theoretical expectations. As more subgroups are considered, the marginal net benefit gains obtained under the current information show diminishing marginal returns, and the expected value of perfect information shows a decreasing trend. We present a suggested algorithm that synthesizes the results to guide policy. © The Author(s) 2014.

  20. The genomic and transcriptomic architecture of 2,000 breast tumours reveals novel subgroups.

    PubMed

    Curtis, Christina; Shah, Sohrab P; Chin, Suet-Feung; Turashvili, Gulisa; Rueda, Oscar M; Dunning, Mark J; Speed, Doug; Lynch, Andy G; Samarajiwa, Shamith; Yuan, Yinyin; Gräf, Stefan; Ha, Gavin; Haffari, Gholamreza; Bashashati, Ali; Russell, Roslin; McKinney, Steven; Langerød, Anita; Green, Andrew; Provenzano, Elena; Wishart, Gordon; Pinder, Sarah; Watson, Peter; Markowetz, Florian; Murphy, Leigh; Ellis, Ian; Purushotham, Arnie; Børresen-Dale, Anne-Lise; Brenton, James D; Tavaré, Simon; Caldas, Carlos; Aparicio, Samuel

    2012-04-18

    The elucidation of breast cancer subgroups and their molecular drivers requires integrated views of the genome and transcriptome from representative numbers of patients. We present an integrated analysis of copy number and gene expression in a discovery and validation set of 997 and 995 primary breast tumours, respectively, with long-term clinical follow-up. Inherited variants (copy number variants and single nucleotide polymorphisms) and acquired somatic copy number aberrations (CNAs) were associated with expression in ~40% of genes, with the landscape dominated by cis- and trans-acting CNAs. By delineating expression outlier genes driven in cis by CNAs, we identified putative cancer genes, including deletions in PPP2R2A, MTAP and MAP2K4. Unsupervised analysis of paired DNA–RNA profiles revealed novel subgroups with distinct clinical outcomes, which reproduced in the validation cohort. These include a high-risk, oestrogen-receptor-positive 11q13/14 cis-acting subgroup and a favourable prognosis subgroup devoid of CNAs. Trans-acting aberration hotspots were found to modulate subgroup-specific gene networks, including a TCR deletion-mediated adaptive immune response in the ‘CNA-devoid’ subgroup and a basal-specific chromosome 5 deletion-associated mitotic network. Our results provide a novel molecular stratification of the breast cancer population, derived from the impact of somatic CNAs on the transcriptome.