Historical Development of Learning Style Inventories from Dichotomous Cognitive Concepts of Field Dependence and Field Independence to Multi-Dimensional Assessment.

ERIC Educational Resources Information Center

Tamaoka, Katsuo

The historical development of learning style inventories is examined from the dichotomous concepts of cognitive styles to multidimensional assessment. Based on a series of experiments on vertical perception, H. A. Witkin formed the concepts of field-dependent and field-independent cognitive styles. Using the term "learning styles"…

A Bayesian Approach for Nonlinear Structural Equation Models with Dichotomous Variables Using Logit and Probit Links

ERIC Educational Resources Information Center

Lee, Sik-Yum; Song, Xin-Yuan; Cai, Jing-Heng

2010-01-01

Analysis of ordered binary and unordered binary data has received considerable attention in social and psychological research. This article introduces a Bayesian approach, which has several nice features in practical applications, for analyzing nonlinear structural equation models with dichotomous data. We demonstrate how to use the software…

Comparing Dichotomous and Trichotomous Approaches to Achievement Goal Theory: An Example Using Motivational Regulations as Outcome Variables

ERIC Educational Resources Information Center

Barkoukis, Vassilis; Ntoumanis, Nikos; Nikitaras, Nikitas

2007-01-01

Background: It is commonly assumed that there is conceptual equivalence between the task and ego achievement goals proposed by Nicholl's (1989) dichotomous achievement goal theory (Nicholls, 1989), and the mastery and performance approach goals advanced by Elliot's (1997) trichotomous hierarchical model of approach and avoidance achievement…

Heteroscedastic Latent Trait Models for Dichotomous Data.

PubMed

Molenaar, Dylan

2015-09-01

Effort has been devoted to account for heteroscedasticity with respect to observed or latent moderator variables in item or test scores. For instance, in the multi-group generalized linear latent trait model, it could be tested whether the observed (polychoric) covariance matrix differs across the levels of an observed moderator variable. In the case that heteroscedasticity arises across the latent trait itself, existing models commonly distinguish between heteroscedastic residuals and a skewed trait distribution. These models have valuable applications in intelligence, personality and psychopathology research. However, existing approaches are only limited to continuous and polytomous data, while dichotomous data are common in intelligence and psychopathology research. Therefore, in present paper, a heteroscedastic latent trait model is presented for dichotomous data. The model is studied in a simulation study, and applied to data pertaining alcohol use and cognitive ability.

Comparison of alternate scoring of variables on the performance of the frailty index

PubMed Central

2014-01-01

Background The frailty index (FI) is used to measure the health status of ageing individuals. An FI is constructed as the proportion of deficits present in an individual out of the total number of age-related health variables considered. The purpose of this study was to systematically assess whether dichotomizing deficits included in an FI affects the information value of the whole index. Methods Secondary analysis of three population-based longitudinal studies of community dwelling individuals: Nova Scotia Health Survey (NSHS, n = 3227 aged 18+), Survey of Health, Ageing and Retirement in Europe (SHARE, n = 37546 aged 50+), and Yale Precipitating Events Project (Yale-PEP, n = 754 aged 70+). For each dataset, we constructed two FIs from baseline data using the deficit accumulation approach. In each dataset, both FIs included the same variables (23 in NSHS, 70 in SHARE, 33 in Yale-PEP). One FI was constructed with only dichotomous values (marking presence or absence of a deficit); in the other FI, as many variables as possible were coded as ordinal (graded severity of a deficit). Participants in each study were followed for different durations (NSHS: 10 years, SHARE: 5 years, Yale PEP: 12 years). Results Within each dataset, the difference in mean scores between the ordinal and dichotomous-only FIs ranged from 0 to 1.5 deficits. Their ability to predict mortality was identical; their absolute difference in area under the ROC curve ranged from 0.00 to 0.02, and their absolute difference between Cox Hazard Ratios ranged from 0.001 to 0.009. Conclusions Analyses from three diverse datasets suggest that variables included in an FI can be coded either as dichotomous or ordinal, with negligible impact on the performance of the index in predicting mortality. PMID:24559204

Robustness Regions for Dichotomous Decisions.

ERIC Educational Resources Information Center

Vijn, Pieter; Molenaar, Ivo W.

1981-01-01

In the case of dichotomous decisions, the total set of all assumptions/specifications for which the decision would have been the same is the robustness region. Inspection of this (data-dependent) region is a form of sensitivity analysis which may lead to improved decision making. (Author/BW)

Determinants of violence against health workers in Portugal.

PubMed

Craveiro, Isabel; Fronteira, Inês; Candeias, Anabela

2007-01-01

The focus of this article is on the determinants of workplace violence against health workers identified in two cross-sectional analytical studies. The prevalence of victims of the several types and of any-type of workplace violence was estimated in each study, as well as the relative frequency of the associated characteristics. Each dependent variable was also analyzed, in relation to the dichotomized independent variables using a stepwise logistic regression strategy. The Ministry of Health has adopted strategies, which include guidelines on what to do to prevent and correct violence against health workers and a workplace violence observatory. Workplace violence has societal, organizational and individual determinants that can be prevented and monitored.

Measuring an Effect Size from Dichotomized Data: Contrasted Results Whether Using a Correlation or an Odds Ratio

ERIC Educational Resources Information Center

Rousson, Valentin

2014-01-01

It is well known that dichotomizing continuous data has the effect to decrease statistical power when the goal is to test for a statistical association between two variables. Modern researchers however are focusing not only on statistical significance but also on an estimation of the "effect size" (i.e., the strength of association…

The influence of base rates on correlations: An evaluation of proposed alternative effect sizes with real-world data.

PubMed

Babchishin, Kelly M; Helmus, Leslie-Maaike

2016-09-01

Correlations are the simplest and most commonly understood effect size statistic in psychology. The purpose of the current paper was to use a large sample of real-world data (109 correlations with 60,415 participants) to illustrate the base rate dependence of correlations when applied to dichotomous or ordinal data. Specifically, we examined the influence of the base rate on different effect size metrics. Correlations decreased when the dichotomous variable did not have a 50 % base rate. The higher the deviation from a 50 % base rate, the smaller the observed Pearson's point-biserial and Kendall's tau correlation coefficients. In contrast, the relationship between base rate deviations and the more commonly proposed alternatives (i.e., polychoric correlation coefficients, AUCs, Pearson/Thorndike adjusted correlations, and Cohen's d) were less remarkable, with AUCs being most robust to attenuation due to base rates. In other words, the base rate makes a marked difference in the magnitude of the correlation. As such, when using dichotomous data, the correlation may be more sensitive to base rates than is optimal for the researcher's goals. Given the magnitude of the association between the base rate and point-biserial correlations (r = -.81) and Kendall's tau (r = -.80), we recommend that AUCs, Pearson/Thorndike adjusted correlations, Cohen's d, or polychoric correlations should be considered as alternate effect size statistics in many contexts.

[Imputing missing data in public health: general concepts and application to dichotomous variables].

PubMed

Hernández, Gilma; Moriña, David; Navarro, Albert

The presence of missing data in collected variables is common in health surveys, but the subsequent imputation thereof at the time of analysis is not. Working with imputed data may have certain benefits regarding the precision of the estimators and the unbiased identification of associations between variables. The imputation process is probably still little understood by many non-statisticians, who view this process as highly complex and with an uncertain goal. To clarify these questions, this note aims to provide a straightforward, non-exhaustive overview of the imputation process to enable public health researchers ascertain its strengths. All this in the context of dichotomous variables which are commonplace in public health. To illustrate these concepts, an example in which missing data is handled by means of simple and multiple imputation is introduced. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Using Log Linear Analysis for Categorical Family Variables.

ERIC Educational Resources Information Center

Moen, Phyllis

The Goodman technique of log linear analysis is ideal for family research, because it is designed for categorical (non-quantitative) variables. Variables are dichotomized (for example, married/divorced, childless/with children) or otherwise categorized (for example, level of permissiveness, life cycle stage). Contingency tables are then…

Modelling of binary logistic regression for obesity among secondary students in a rural area of Kedah

NASA Astrophysics Data System (ADS)

Kamaruddin, Ainur Amira; Ali, Zalila; Noor, Norlida Mohd.; Baharum, Adam; Ahmad, Wan Muhamad Amir W.

2014-07-01

Logistic regression analysis examines the influence of various factors on a dichotomous outcome by estimating the probability of the event's occurrence. Logistic regression, also called a logit model, is a statistical procedure used to model dichotomous outcomes. In the logit model the log odds of the dichotomous outcome is modeled as a linear combination of the predictor variables. The log odds ratio in logistic regression provides a description of the probabilistic relationship of the variables and the outcome. In conducting logistic regression, selection procedures are used in selecting important predictor variables, diagnostics are used to check that assumptions are valid which include independence of errors, linearity in the logit for continuous variables, absence of multicollinearity, and lack of strongly influential outliers and a test statistic is calculated to determine the aptness of the model. This study used the binary logistic regression model to investigate overweight and obesity among rural secondary school students on the basis of their demographics profile, medical history, diet and lifestyle. The results indicate that overweight and obesity of students are influenced by obesity in family and the interaction between a student's ethnicity and routine meals intake. The odds of a student being overweight and obese are higher for a student having a family history of obesity and for a non-Malay student who frequently takes routine meals as compared to a Malay student.

Influence of Patient Characteristics on Success of Ambulatory Blood Pressure Monitoring

PubMed Central

Fravel, Michelle A.; Ernst, Michael E.; Weber, Cynthia A.; Dawson, Jeffrey D.; Carter, Barry L.; Bergus, George R.

2014-01-01

Study Objective To examine the influence of specific patient characteristics on the success of ambulatory blood pressure monitoring (ABPM). Design Retrospective analysis. Setting University-affiliated family care center. Patients Five hundred thirty patients (mean age 52.7 yrs, range 14–90 yrs) who were undergoing ABPM between January 1, 2001, and July 1, 2007. Measurement and Main Results Specific patient characteristics were identified through an electronic medical record review and then examined for association with ABPM session success rate. These patient characteristics included age, sex, weight, height, body mass index (BMI), occupation, clinic blood pressure, travel distance to clinic, and presence of diabetes mellitus or renal disease. The percentage of valid readings obtained during an ABPM session was analyzed continuously (0–100%), whereas overall session success was analyzed dichotomously (0–79% or 80–100%). Univariate and multivariate regression analyses were performed to examine the influence of patient characteristics on the percentage of valid readings and the overall likelihood of achieving a successful session. In the 530 patients, the average percentage of valid readings was 90%, and a successful ABPM session (≥ 80% valid readings) was obtained in 84.7% (449 patients). A diagnosis of diabetes was found to negatively predict ABPM session success (continuous variable analysis, p=0.019; dichotomous variable analysis, odds ratio [OR] 0.45, 95% confidence interval [CI] 0.23–0.87, p=0.019), as did renal disease (continuous variable analysis, p=0.006; dichotomous variable analysis, OR 0.39, 95% CI 0.17–0.90, p=0.027) and increasing BMI (continuous variable analysis, p<0.001; dichotomous variable analysis, OR 0.78, 95% CI 0.65–0.93, p=0.005). Renal disease and BMI remained significant predictors in adjusted analyses. Conclusion For most patients, ABPM was successful; however, elevated BMI and renal disease were associated with less complete ABPM session results. Adaptation and individualization of the ABPM process may be necessary to improve results in these patients. PMID:18956994

Biostatistics Series Module 10: Brief Overview of Multivariate Methods.

PubMed

Hazra, Avijit; Gogtay, Nithya

2017-01-01

Multivariate analysis refers to statistical techniques that simultaneously look at three or more variables in relation to the subjects under investigation with the aim of identifying or clarifying the relationships between them. These techniques have been broadly classified as dependence techniques, which explore the relationship between one or more dependent variables and their independent predictors, and interdependence techniques, that make no such distinction but treat all variables equally in a search for underlying relationships. Multiple linear regression models a situation where a single numerical dependent variable is to be predicted from multiple numerical independent variables. Logistic regression is used when the outcome variable is dichotomous in nature. The log-linear technique models count type of data and can be used to analyze cross-tabulations where more than two variables are included. Analysis of covariance is an extension of analysis of variance (ANOVA), in which an additional independent variable of interest, the covariate, is brought into the analysis. It tries to examine whether a difference persists after "controlling" for the effect of the covariate that can impact the numerical dependent variable of interest. Multivariate analysis of variance (MANOVA) is a multivariate extension of ANOVA used when multiple numerical dependent variables have to be incorporated in the analysis. Interdependence techniques are more commonly applied to psychometrics, social sciences and market research. Exploratory factor analysis and principal component analysis are related techniques that seek to extract from a larger number of metric variables, a smaller number of composite factors or components, which are linearly related to the original variables. Cluster analysis aims to identify, in a large number of cases, relatively homogeneous groups called clusters, without prior information about the groups. The calculation intensive nature of multivariate analysis has so far precluded most researchers from using these techniques routinely. The situation is now changing with wider availability, and increasing sophistication of statistical software and researchers should no longer shy away from exploring the applications of multivariate methods to real-life data sets.

The Robustness of LISREL Estimates in Structural Equation Models with Categorical Variables.

ERIC Educational Resources Information Center

Ethington, Corinna A.

1987-01-01

This study examined the effect of type of correlation matrix on the robustness of LISREL maximum likelihood and unweighted least squares structural parameter estimates for models with categorical variables. The analysis of mixed matrices produced estimates that closely approximated the model parameters except where dichotomous variables were…

Automated quantification of myocardial infarction from MR images by accounting for partial volume effects: animal, phantom, and human study.

PubMed

Heiberg, Einar; Ugander, Martin; Engblom, Henrik; Götberg, Matthias; Olivecrona, Göran K; Erlinge, David; Arheden, Håkan

2008-02-01

Ethics committees approved human and animal study components; informed written consent was provided (prospective human study [20 men; mean age, 62 years]) or waived (retrospective human study [16 men, four women; mean age, 59 years]). The purpose of this study was to prospectively evaluate a clinically applicable method, accounting for the partial volume effect, to automatically quantify myocardial infarction from delayed contrast material-enhanced magnetic resonance images. Pixels were weighted according to signal intensity to calculate infarct fraction for each pixel. Mean bias +/- variability (or standard deviation), expressed as percentage left ventricular myocardium (%LVM), were -0.3 +/- 1.3 (animals), -1.2 +/- 1.7 (phantoms), and 0.3 +/- 2.7 (patients), respectively. Algorithm had lower variability than dichotomous approach (2.7 vs 7.7 %LVM, P < .01) and did not differ from interobserver variability for bias (P = .31) or variability (P = .38). The weighted approach provides automatic quantification of myocardial infarction with higher accuracy and lower variability than a dichotomous algorithm. (c) RSNA, 2007.

The mediating role of dichotomous thinking and emotional eating in the relationship between depression and BMI.

PubMed

Antoniou, Evangelia E; Bongers, Peggy; Jansen, Anita

2017-08-01

Obesity and depression have important health implications. Although there is knowledge about the moderators of the depression-obesity association, our understanding of the potential behavioral and cognitive mediators that may explain the relationship between depression and obesity, is scarcely researched. The aim of this study is to investigate the mediating role of emotional eating and dichotomous thinking in the depression-obesity relationship. Data on 205 individuals from a community-based study conducted at Maastricht University, Netherlands were used. Self-reported data on depression, emotional eating and dichotomous thinking were collected and BMI scores were calculated in a cross-sectional research design. Correlations between variables were calculated. The primary analysis tested the hypothesis that depression has an effect on BMI through dichotomous thinking and emotional eating. A two-mediator model was used to predict the direct and indirect effects of emotional eating and dichotomous thinking on the depression-BMI relationship. Depression was positively correlated with BMI (r=0.21, p=0.005), emotional eating (r=0.38, p<0.001) and dichotomous thinking (r=0.49, p<0.001). Dichotomous thinking and emotional eating were positively correlated with BMI (r=0.35, p<0.001; and r=0.45, p<0.001 respectively). Both dichotomous thinking (Z=2.54, p=0.01, 95% confidence intervals=0.01-0.17) and emotional eating (Z=3.92 p<0.001, 95% confidence intervals=0.06-0.19) could explain the depression-BMI relationship. The assessment of emotional eating and dichotomous thinking might be useful in guiding assessment and treatment protocols for weight management. The present study adds to the existing literature on the role of dysfunctional cognitions and emotions on eating behavior, and particularly to the factors that may impede people's ability to control their eating. Copyright © 2017 Elsevier Ltd. All rights reserved.

A short note on the maximal point-biserial correlation under non-normality.

PubMed

Cheng, Ying; Liu, Haiyan

2016-11-01

The aim of this paper is to derive the maximal point-biserial correlation under non-normality. Several widely used non-normal distributions are considered, namely the uniform distribution, t-distribution, exponential distribution, and a mixture of two normal distributions. Results show that the maximal point-biserial correlation, depending on the non-normal continuous variable underlying the binary manifest variable, may not be a function of p (the probability that the dichotomous variable takes the value 1), can be symmetric or non-symmetric around p = .5, and may still lie in the range from -1.0 to 1.0. Therefore researchers should exercise caution when they interpret their sample point-biserial correlation coefficients based on popular beliefs that the maximal point-biserial correlation is always smaller than 1, and that the size of the correlation is always further restricted as p deviates from .5. © 2016 The British Psychological Society.

The Effect of Latent Binary Variables on the Uncertainty of the Prediction of a Dichotomous Outcome Using Logistic Regression Based Propensity Score Matching.

PubMed

Szekér, Szabolcs; Vathy-Fogarassy, Ágnes

2018-01-01

Logistic regression based propensity score matching is a widely used method in case-control studies to select the individuals of the control group. This method creates a suitable control group if all factors affecting the output variable are known. However, if relevant latent variables exist as well, which are not taken into account during the calculations, the quality of the control group is uncertain. In this paper, we present a statistics-based research in which we try to determine the relationship between the accuracy of the logistic regression model and the uncertainty of the dependent variable of the control group defined by propensity score matching. Our analyses show that there is a linear correlation between the fit of the logistic regression model and the uncertainty of the output variable. In certain cases, a latent binary explanatory variable can result in a relative error of up to 70% in the prediction of the outcome variable. The observed phenomenon calls the attention of analysts to an important point, which must be taken into account when deducting conclusions.

The Emergence of Visual Awareness: Temporal Dynamics in Relation to Task and Mask Type

PubMed Central

Kiefer, Markus; Kammer, Thomas

2017-01-01

One aspect of consciousness phenomena, the temporal emergence of visual awareness, has been subject of a controversial debate. How can visual awareness, that is the experiential quality of visual stimuli, be characterized best? Is there a sharp discontinuous or dichotomous transition between unaware and fully aware states, or does awareness emerge gradually encompassing intermediate states? Previous studies yielded conflicting results and supported both dichotomous and gradual views. It is well conceivable that these conflicting results are more than noise, but reflect the dynamic nature of the temporal emergence of visual awareness. Using a psychophysical approach, the present research tested whether the emergence of visual awareness is context-dependent with a temporal two-alternative forced choice task. During backward masking of word targets, it was assessed whether the relative temporal sequence of stimulus thresholds is modulated by the task (stimulus presence, letter case, lexical decision, and semantic category) and by mask type. Four masks with different similarity to the target features were created. Psychophysical functions were then fitted to the accuracy data in the different task conditions as a function of the stimulus mask SOA in order to determine the inflection point (conscious threshold of each feature) and slope of the psychophysical function (transition from unaware to aware within each feature). Depending on feature-mask similarity, thresholds in the different tasks were highly dispersed suggesting a graded transition from unawareness to awareness or had less differentiated thresholds indicating that clusters of features probed by the tasks quite simultaneously contribute to the percept. The latter observation, although not compatible with the notion of a sharp all-or-none transition between unaware and aware states, suggests a less gradual or more discontinuous emergence of awareness. Analyses of slopes of the fitted psychophysical functions also indicated that the emergence of awareness of single features is variable and might be influenced by the continuity of the feature dimensions. The present work thus suggests that the emergence of awareness is neither purely gradual nor dichotomous, but highly dynamic depending on the task and mask type. PMID:28316583

Comparison of Danish dichotomous and BI-RADS classifications of mammographic density.

PubMed

Hodge, Rebecca; Hellmann, Sophie Sell; von Euler-Chelpin, My; Vejborg, Ilse; Andersen, Zorana Jovanovic

2014-06-01

In the Copenhagen mammography screening program from 1991 to 2001, mammographic density was classified either as fatty or mixed/dense. This dichotomous mammographic density classification system is unique internationally, and has not been validated before. To compare the Danish dichotomous mammographic density classification system from 1991 to 2001 with the density BI-RADS classifications, in an attempt to validate the Danish classification system. The study sample consisted of 120 mammograms taken in Copenhagen in 1991-2001, which tested false positive, and which were in 2012 re-assessed and classified according to the BI-RADS classification system. We calculated inter-rater agreement between the Danish dichotomous mammographic classification as fatty or mixed/dense and the four-level BI-RADS classification by the linear weighted Kappa statistic. Of the 120 women, 32 (26.7%) were classified as having fatty and 88 (73.3%) as mixed/dense mammographic density, according to Danish dichotomous classification. According to BI-RADS density classification, 12 (10.0%) women were classified as having predominantly fatty (BI-RADS code 1), 46 (38.3%) as having scattered fibroglandular (BI-RADS code 2), 57 (47.5%) as having heterogeneously dense (BI-RADS 3), and five (4.2%) as having extremely dense (BI-RADS code 4) mammographic density. The inter-rater variability assessed by weighted kappa statistic showed a substantial agreement (0.75). The dichotomous mammographic density classification system utilized in early years of Copenhagen's mammographic screening program (1991-2001) agreed well with the BI-RADS density classification system.

The role of dichotomous thinking and rigidity in perfectionism.

PubMed

Egan, Sarah J; Piek, Jan P; Dyck, Murray J; Rees, Clare S

2007-08-01

Perfectionism is a complex psychological construct that has been defined in many different ways. Recent conceptualisations of perfectionism have involved dividing the construct into positive and negative components. Negative perfectionism is associated with high emotional distress whereas positive perfectionism is associated with positive affect and lower levels of distress. Although these distinctions have been made it remains unclear as to how distinct the two aspects of perfectionism are particularly in terms of their cognitive profiles. This study investigated two cognitive constructs that have been theoretically linked to perfectionism. Dichotomous thinking and rigidity were examined in three samples (40 clinical participants, 111 athletes, 101 students). As hypothesised, the clinical sample had the highest score on negative perfectionism, however, no differences were observed between groups on positive perfectionism. Dichotomous thinking emerged as the variable most predictive of negative perfectionism, and was less strongly related to positive perfectionism. These results highlight the importance of dichotomous thinking as a cognitive construct worthy of further research to understand negative perfectionism. Implications for the development of cognitive therapy interventions for negative perfectionism are discussed.

Measurement of psychological disorders using cognitive diagnosis models.

PubMed

Templin, Jonathan L; Henson, Robert A

2006-09-01

Cognitive diagnosis models are constrained (multiple classification) latent class models that characterize the relationship of questionnaire responses to a set of dichotomous latent variables. Having emanated from educational measurement, several aspects of such models seem well suited to use in psychological assessment and diagnosis. This article presents the development of a new cognitive diagnosis model for use in psychological assessment--the DINO (deterministic input; noisy "or" gate) model--which, as an illustrative example, is applied to evaluate and diagnose pathological gamblers. As part of this example, a demonstration of the estimates obtained by cognitive diagnosis models is provided. Such estimates include the probability an individual meets each of a set of dichotomous Diagnostic and Statistical Manual of Mental Disorders (text revision [DSM-IV-TR]; American Psychiatric Association, 2000) criteria, resulting in an estimate of the probability an individual meets the DSM-IV-TR definition for being a pathological gambler. Furthermore, a demonstration of how the hypothesized underlying factors contributing to pathological gambling can be measured with the DINO model is presented, through use of a covariance structure model for the tetrachoric correlation matrix of the dichotomous latent variables representing DSM-IV-TR criteria. Copyright 2006 APA

Moment stability for a predator-prey model with parametric dichotomous noises

NASA Astrophysics Data System (ADS)

Jin, Yan-Fei

2015-06-01

In this paper, we investigate the solution moment stability for a Harrison-type predator-prey model with parametric dichotomous noises. Using the Shapiro-Loginov formula, the equations for the first-order and second-order moments are obtained and the corresponding stable conditions are given. It is found that the solution moment stability depends on the noise intensity and correlation time of noise. The first-order and second-order moments become unstable with the decrease of correlation time. That is, the dichotomous noise can improve the solution moment stability with respect to Gaussian white noise. Finally, some numerical results are presented to verify the theoretical analyses. Project supported by the National Natural Science Foundation of China (Grant No. 11272051).

Mismeasurement and the resonance of strong confounders: uncorrelated errors.

PubMed

Marshall, J R; Hastrup, J L

1996-05-15

Greenland first documented (Am J Epidemiol 1980; 112:564-9) that error in the measurement of a confounder could resonate--that it could bias estimates of other study variables, and that the bias could persist even with statistical adjustment for the confounder as measured. An important question is raised by this finding: can such bias be more than trivial within the bounds of realistic data configurations? The authors examine several situations involving dichotomous and continuous data in which a confounder and a null variable are measured with error, and they assess the extent of resultant bias in estimates of the effect of the null variable. They show that, with continuous variables, measurement error amounting to 40% of observed variance in the confounder could cause the observed impact of the null study variable to appear to alter risk by as much as 30%. Similarly, they show, with dichotomous independent variables, that 15% measurement error in the form of misclassification could lead the null study variable to appear to alter risk by as much as 50%. Such bias would result only from strong confounding. Measurement error would obscure the evidence that strong confounding is a likely problem. These results support the need for every epidemiologic inquiry to include evaluations of measurement error in each variable considered.

Static and dynamic protein impact on electronic properties of light-harvesting complex LH2.

PubMed

Zerlauskiene, O; Trinkunas, G; Gall, A; Robert, B; Urboniene, V; Valkunas, L

2008-12-11

A comparative analysis of the temperature dependence of the absorption spectra of the LH2 complexes from different species of photosynthetic bacteria, i.e., Rhodobacter sphaeroides, Rhodoblastus acidophilus, and Phaeospirillum molischianum, was performed in the temperature range from 4 to 300 K. Qualitatively, the temperature dependence is similar for all of the species studied. The spectral bandwidths of both B800 and B850 bands increases with temperature while the band positions shift in opposite directions: the B800 band shifts slightly to the red while the B850 band to the blue. These results were analyzed using the modified Redfield theory based on the exciton model. The main conclusion drawn from the analysis was that the spectral density function (SDF) is the main factor underlying the strength of the temperature dependence of the bandwidths for the B800 and B850 electronic transitions, while the bandwidths themselves are defined by the corresponding inhomogeneous distribution function (IDF). Slight variation of the slope of the temperature dependence of the bandwidths between species can be attributed to the changes of the values of the reorganization energies and characteristic frequencies determining the SDF. To explain the shift of the B850 band position with temperature, which is unusual for the conventional exciton model, a temperature dependence of the IDF must be postulated. This dependence can be achieved within the framework of the modified (dichotomous) exciton model. The slope of the temperature dependence of the B850 bandwidth is then defined by the value of the reorganization energy and by the difference between the transition energies of the dichotomous states of the pigment molecules. The equilibration factor between these dichotomous states mainly determines the temperature dependence of the peak shift.

Discriminatory value of alanine aminotransferase for diabetes prediction: the Insulin Resistance Atherosclerosis Study.

PubMed

Lorenzo, C; Hanley, A J; Rewers, M J; Haffner, S M

2016-03-01

To examine the incremental usefulness of adding alanine aminotransferase to established risk factors for predicting future diabetes. The study population of the Insulin Resistance Atherosclerosis Study included 724 people aged 40-69 years. We excluded people who had excessive alcohol intake or were treated with lipid-lowering agents. Incident diabetes was assessed after a mean follow-up period of 5.2 years. Alanine aminotransferase had a non-linear relationship with incident diabetes (Wald chi-squared test, P < 0.001; P for linearity = 0.005) independent of demographic variables, family history of diabetes, BMI and fasting glucose; therefore, we used Youden's J statistic to dichotomize alanine aminotransferase [threshold ≥ 0.43 μkat/L ( ≥ 26 IU/l)]. Dichotomized alanine aminotransferase increased the area under the receiver-operating characteristic curve (0.805 vs. 0.823; P = 0.007) of a model that included demographic variables, family history of diabetes, BMI and fasting glucose as independent variables. The net reclassification improvement was 9.6% (95% CI 1.8-17.4; P = 0.016), and the integrated discrimination improvement was 0.031 (95% CI 0.011-0.050; P = 0.002). Dichotomized alanine aminotransferase reclassified a net of 9.6% of individuals more appropriately. Alanine aminotransferase may be useful for classifying individuals who are at risk of future diabetes after accounting for the effect of other risk factors, including family history, adiposity and plasma glucose. © 2015 The Authors. Diabetic Medicine © 2015 Diabetes UK.

Probability estimation with machine learning methods for dichotomous and multicategory outcome: theory.

PubMed

Kruppa, Jochen; Liu, Yufeng; Biau, Gérard; Kohler, Michael; König, Inke R; Malley, James D; Ziegler, Andreas

2014-07-01

Probability estimation for binary and multicategory outcome using logistic and multinomial logistic regression has a long-standing tradition in biostatistics. However, biases may occur if the model is misspecified. In contrast, outcome probabilities for individuals can be estimated consistently with machine learning approaches, including k-nearest neighbors (k-NN), bagged nearest neighbors (b-NN), random forests (RF), and support vector machines (SVM). Because machine learning methods are rarely used by applied biostatisticians, the primary goal of this paper is to explain the concept of probability estimation with these methods and to summarize recent theoretical findings. Probability estimation in k-NN, b-NN, and RF can be embedded into the class of nonparametric regression learning machines; therefore, we start with the construction of nonparametric regression estimates and review results on consistency and rates of convergence. In SVMs, outcome probabilities for individuals are estimated consistently by repeatedly solving classification problems. For SVMs we review classification problem and then dichotomous probability estimation. Next we extend the algorithms for estimating probabilities using k-NN, b-NN, and RF to multicategory outcomes and discuss approaches for the multicategory probability estimation problem using SVM. In simulation studies for dichotomous and multicategory dependent variables we demonstrate the general validity of the machine learning methods and compare it with logistic regression. However, each method fails in at least one simulation scenario. We conclude with a discussion of the failures and give recommendations for selecting and tuning the methods. Applications to real data and example code are provided in a companion article (doi:10.1002/bimj.201300077). © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Multiple Measures of Outcome in Assessing a Prison-Based Drug Treatment Program

ERIC Educational Resources Information Center

Prendergast, Michael L.; Hall, Elizabeth A.; Wexler, Harry K.

2003-01-01

Evaluations of prison-based drug treatment programs typically focus on one or two dichotomous outcome variables related to recidivism. In contrast, this paper uses multiple measures of outcomes related to crime and drug use to examine the impact of prison treatment. Crime variables included self-report data of time to first illegal activity,…

Effects of categorization method, regression type, and variable distribution on the inflation of Type-I error rate when categorizing a confounding variable.

PubMed

Barnwell-Ménard, Jean-Louis; Li, Qing; Cohen, Alan A

2015-03-15

The loss of signal associated with categorizing a continuous variable is well known, and previous studies have demonstrated that this can lead to an inflation of Type-I error when the categorized variable is a confounder in a regression analysis estimating the effect of an exposure on an outcome. However, it is not known how the Type-I error may vary under different circumstances, including logistic versus linear regression, different distributions of the confounder, and different categorization methods. Here, we analytically quantified the effect of categorization and then performed a series of 9600 Monte Carlo simulations to estimate the Type-I error inflation associated with categorization of a confounder under different regression scenarios. We show that Type-I error is unacceptably high (>10% in most scenarios and often 100%). The only exception was when the variable categorized was a continuous mixture proxy for a genuinely dichotomous latent variable, where both the continuous proxy and the categorized variable are error-ridden proxies for the dichotomous latent variable. As expected, error inflation was also higher with larger sample size, fewer categories, and stronger associations between the confounder and the exposure or outcome. We provide online tools that can help researchers estimate the potential error inflation and understand how serious a problem this is. Copyright © 2014 John Wiley & Sons, Ltd.

Major motor-functional determinants associated with poor self-reported health-related quality of life in myasthenia gravis patients.

PubMed

Cioncoloni, David; Casali, Stefania; Ginanneschi, Federica; Carone, Marisa; Veronica, Boni; Rossi, Alessandro; Giannini, Fabio

2016-05-01

Myasthenia gravis (MG) is an autoimmune neuromuscular disorder in which disabling muscle weakness may affect health-related quality of life (HRQoL). The aim of this study was to investigate which common motor-functional deficits and corresponding severity are most determinant of poor HRQoL in these patients. In 41 patients, the dichotomized first item of the Italian Myasthenia Gravis Questionnaire (IMGQ), categorizing patients who report "good" and "poor" HRQoL, was chosen as dependent-outcome variable. All items composing the myasthenia gravis-specific scale (MG-ADL), i.e. talking, chewing, swallowing, breathing, impairment of ability to brush teeth or comb hair, impairment of ability to rise from chair, double vision, and eyelid droop were acquired as independent variables and dichotomized. Stepwise backward LR multivariable logistic regression analysis was performed. In addition, the main characteristics of patients were compared. MG-ADL items "chewing" ≥1, i.e. "fatigue chewing solid food", and "breathing" ≥2, i.e. "shortness of breath at rest" proved to be significant determinants. Higher dose of corticosteroid therapy was significantly (p = 0.027; r s  = -0.35), correlated with poor HRQoL. At diagnosis, a decremental response to repetitive nerve stimulation (RNS) from the abductor pollicis brevis was significantly more frequent in patients with poor HRQoL. In conclusion, impaired "chewing" and "breathing" functions indicate the need for careful planning of rehabilitation, re-education and patient management. Moreover, decremental response to RNS at diagnosis may identify patients at risk for poor HRQoL.

Supervisor behaviour and its associations with employees' health in Europe.

PubMed

Montano, Diego

2016-02-01

To estimate the magnitude of the associations between different facets of supervisor behaviour and several health-related outcomes, and to assess whether these associations are mediated by known occupational health factors. Cross-sectional data from the European Working Conditions Survey were analysed by generalised linear mixed models (n = 32,770). Six regression models were estimated. Dependent variables include musculoskeletal (upper body, lower limbs, backache) and psychosomatic symptoms (stress and self-assessed general health). Independent variables correspond to several facets of supervisor behaviours such as supervisor support, feedback on work, ability to solve conflicts, encouragement to participate in decisions, and known occupational risk and protective factors. Even though supervisor behaviour is mediated by several known occupational risk factors, it still accounts for a substantial proportion of explained variance. The order of magnitude of associations was comparable to the strength of associations of known occupational risk factors. Odds ratios vary from 0.79 95% CI [0.73-0.86] to 1.12 95% CI [0.97-1.29] for dichotomous dependent variables. Regression coefficients vary from -0.22 95% CI [-0.28 to -0.17] to 0.07 95% CI [0.04-0.10] for metric dependent variables. Results suggest that good conflict solving skills, supervisor's work-planning ability, and a participative leadership style have the strongest predictive power regarding all health-related outcomes considered. Supervisor behaviour seems to play a non-negligible role from an occupational health perspective concerning the prevalence of musculoskeletal and psychosomatic symptoms. Results suggest that supervisor behaviour should be routinely assessed and monitored, especially among occupational groups reporting a lower quality of supervisor behaviours.

The intermediate endpoint effect in logistic and probit regression

PubMed Central

MacKinnon, DP; Lockwood, CM; Brown, CH; Wang, W; Hoffman, JM

2010-01-01

Background An intermediate endpoint is hypothesized to be in the middle of the causal sequence relating an independent variable to a dependent variable. The intermediate variable is also called a surrogate or mediating variable and the corresponding effect is called the mediated, surrogate endpoint, or intermediate endpoint effect. Clinical studies are often designed to change an intermediate or surrogate endpoint and through this intermediate change influence the ultimate endpoint. In many intermediate endpoint clinical studies the dependent variable is binary, and logistic or probit regression is used. Purpose The purpose of this study is to describe a limitation of a widely used approach to assessing intermediate endpoint effects and to propose an alternative method, based on products of coefficients, that yields more accurate results. Methods The intermediate endpoint model for a binary outcome is described for a true binary outcome and for a dichotomization of a latent continuous outcome. Plots of true values and a simulation study are used to evaluate the different methods. Results Distorted estimates of the intermediate endpoint effect and incorrect conclusions can result from the application of widely used methods to assess the intermediate endpoint effect. The same problem occurs for the proportion of an effect explained by an intermediate endpoint, which has been suggested as a useful measure for identifying intermediate endpoints. A solution to this problem is given based on the relationship between latent variable modeling and logistic or probit regression. Limitations More complicated intermediate variable models are not addressed in the study, although the methods described in the article can be extended to these more complicated models. Conclusions Researchers are encouraged to use an intermediate endpoint method based on the product of regression coefficients. A common method based on difference in coefficient methods can lead to distorted conclusions regarding the intermediate effect. PMID:17942466

Fundamentals of Research Data and Variables: The Devil Is in the Details.

PubMed

Vetter, Thomas R

2017-10-01

Designing, conducting, analyzing, reporting, and interpreting the findings of a research study require an understanding of the types and characteristics of data and variables. Descriptive statistics are typically used simply to calculate, describe, and summarize the collected research data in a logical, meaningful, and efficient way. Inferential statistics allow researchers to make a valid estimate of the association between an intervention and the treatment effect in a specific population, based upon their randomly collected, representative sample data. Categorical data can be either dichotomous or polytomous. Dichotomous data have only 2 categories, and thus are considered binary. Polytomous data have more than 2 categories. Unlike dichotomous and polytomous data, ordinal data are rank ordered, typically based on a numerical scale that is comprised of a small set of discrete classes or integers. Continuous data are measured on a continuum and can have any numeric value over this continuous range. Continuous data can be meaningfully divided into smaller and smaller or finer and finer increments, depending upon the precision of the measurement instrument. Interval data are a form of continuous data in which equal intervals represent equal differences in the property being measured. Ratio data are another form of continuous data, which have the same properties as interval data, plus a true definition of an absolute zero point, and the ratios of the values on the measurement scale make sense. The normal (Gaussian) distribution ("bell-shaped curve") is of the most common statistical distributions. Many applied inferential statistical tests are predicated on the assumption that the analyzed data follow a normal distribution. The histogram and the Q-Q plot are 2 graphical methods to assess if a set of data have a normal distribution (display "normality"). The Shapiro-Wilk test and the Kolmogorov-Smirnov test are 2 well-known and historically widely applied quantitative methods to assess for data normality. Parametric statistical tests make certain assumptions about the characteristics and/or parameters of the underlying population distribution upon which the test is based, whereas nonparametric tests make fewer or less rigorous assumptions. If the normality test concludes that the study data deviate significantly from a Gaussian distribution, rather than applying a less robust nonparametric test, the problem can potentially be remedied by judiciously and openly: (1) performing a data transformation of all the data values; or (2) eliminating any obvious data outlier(s).

Logistic regression for dichotomized counts.

PubMed

Preisser, John S; Das, Kalyan; Benecha, Habtamu; Stamm, John W

2016-12-01

Sometimes there is interest in a dichotomized outcome indicating whether a count variable is positive or zero. Under this scenario, the application of ordinary logistic regression may result in efficiency loss, which is quantifiable under an assumed model for the counts. In such situations, a shared-parameter hurdle model is investigated for more efficient estimation of regression parameters relating to overall effects of covariates on the dichotomous outcome, while handling count data with many zeroes. One model part provides a logistic regression containing marginal log odds ratio effects of primary interest, while an ancillary model part describes the mean count of a Poisson or negative binomial process in terms of nuisance regression parameters. Asymptotic efficiency of the logistic model parameter estimators of the two-part models is evaluated with respect to ordinary logistic regression. Simulations are used to assess the properties of the models with respect to power and Type I error, the latter investigated under both misspecified and correctly specified models. The methods are applied to data from a randomized clinical trial of three toothpaste formulations to prevent incident dental caries in a large population of Scottish schoolchildren. © The Author(s) 2014.

Measurement of Psychological Disorders Using Cognitive Diagnosis Models

ERIC Educational Resources Information Center

Templin, Jonathan L.; Henson, Robert A.

2006-01-01

Cognitive diagnosis models are constrained (multiple classification) latent class models that characterize the relationship of questionnaire responses to a set of dichotomous latent variables. Having emanated from educational measurement, several aspects of such models seem well suited to use in psychological assessment and diagnosis. This article…

Short-term quality of life after subthalamic stimulation depends on non-motor symptoms in Parkinson's disease.

PubMed

Dafsari, Haidar Salimi; Weiß, Luisa; Silverdale, Monty; Rizos, Alexandra; Reddy, Prashanth; Ashkan, Keyoumars; Evans, Julian; Reker, Paul; Petry-Schmelzer, Jan Niklas; Samuel, Michael; Visser-Vandewalle, Veerle; Antonini, Angelo; Martinez-Martin, Pablo; Ray-Chaudhuri, K; Timmermann, Lars

2018-02-24

Subthalamic nucleus (STN) deep brain stimulation (DBS) improves quality of life (QoL), motor, and non-motor symptoms (NMS) in advanced Parkinson's disease (PD). However, considerable inter-individual variability has been observed for QoL outcome. We hypothesized that demographic and preoperative NMS characteristics can predict postoperative QoL outcome. In this ongoing, prospective, multicenter study (Cologne, Manchester, London) including 88 patients, we collected the following scales preoperatively and on follow-up 6 months postoperatively: PDQuestionnaire-8 (PDQ-8), NMSScale (NMSS), NMSQuestionnaire (NMSQ), Scales for Outcomes in PD (SCOPA)-motor examination, -complications, and -activities of daily living, levodopa equivalent daily dose. We dichotomized patients into "QoL responders"/"non-responders" and screened for factors associated with QoL improvement with (1) Spearman-correlations between baseline test scores and QoL improvement, (2) step-wise linear regressions with baseline test scores as independent and QoL improvement as dependent variables, (3) logistic regressions using aforementioned "responders/non-responders" as dependent variable. All outcomes improved significantly on follow-up. However, approximately 44% of patients were categorized as "QoL non-responders". Spearman-correlations, linear and logistic regression analyses were significant for NMSS and NMSQ but not for SCOPA-motor examination. Post-hoc, we identified specific NMS (flat moods, difficulties experiencing pleasure, pain, bladder voiding) as significant contributors to QoL outcome. Our results provide evidence that QoL improvement after STN-DBS depends on preoperative NMS characteristics. These findings are important in the advising and selection of individuals for DBS therapy. Future studies investigating motor and non-motor PD clusters may enable stratifying QoL outcomes and help predict patients' individual prospects of benefiting from DBS. Copyright © 2018. Published by Elsevier Inc.

Immunization Attitudes and Beliefs Among Parents: Beyond a Dichotomous Perspective

ERIC Educational Resources Information Center

Gust, Deborah; Brown, Cedric; Sheedy, Kristine; Hibbs, Beth; Weaver, Donna; Nowak, Glen

2005-01-01

Objective: To better understand differences among parents in their attitudes, beliefs, and behaviors regarding childhood immunizations and health-related issues. Methods: Forty-four survey variables assessing attitudes and beliefs about immunizations and health were analyzed. The K-means clusters technique was used to identify homogeneous groups…

Three Cs in measurement models: causal indicators, composite indicators, and covariates.

PubMed

Bollen, Kenneth A; Bauldry, Shawn

2011-09-01

In the last 2 decades attention to causal (and formative) indicators has grown. Accompanying this growth has been the belief that one can classify indicators into 2 categories: effect (reflective) indicators and causal (formative) indicators. We argue that the dichotomous view is too simple. Instead, there are effect indicators and 3 types of variables on which a latent variable depends: causal indicators, composite (formative) indicators, and covariates (the "Three Cs"). Causal indicators have conceptual unity, and their effects on latent variables are structural. Covariates are not concept measures, but are variables to control to avoid bias in estimating the relations between measures and latent variables. Composite (formative) indicators form exact linear combinations of variables that need not share a concept. Their coefficients are weights rather than structural effects, and composites are a matter of convenience. The failure to distinguish the Three Cs has led to confusion and questions, such as, Are causal and formative indicators different names for the same indicator type? Should an equation with causal or formative indicators have an error term? Are the coefficients of causal indicators less stable than effect indicators? Distinguishing between causal and composite indicators and covariates goes a long way toward eliminating this confusion. We emphasize the key role that subject matter expertise plays in making these distinctions. We provide new guidelines for working with these variable types, including identification of models, scaling latent variables, parameter estimation, and validity assessment. A running empirical example on self-perceived health illustrates our major points.

Factoring vs linear modeling in rate estimation: a simulation study of relative accuracy.

PubMed

Maldonado, G; Greenland, S

1998-07-01

A common strategy for modeling dose-response in epidemiology is to transform ordered exposures and covariates into sets of dichotomous indicator variables (that is, to factor the variables). Factoring tends to increase estimation variance, but it also tends to decrease bias and thus may increase or decrease total accuracy. We conducted a simulation study to examine the impact of factoring on the accuracy of rate estimation. Factored and unfactored Poisson regression models were fit to follow-up study datasets that were randomly generated from 37,500 population model forms that ranged from subadditive to supramultiplicative. In the situations we examined, factoring sometimes substantially improved accuracy relative to fitting the corresponding unfactored model, sometimes substantially decreased accuracy, and sometimes made little difference. The difference in accuracy between factored and unfactored models depended in a complicated fashion on the difference between the true and fitted model forms, the strength of exposure and covariate effects in the population, and the study size. It may be difficult in practice to predict when factoring is increasing or decreasing accuracy. We recommend, therefore, that the strategy of factoring variables be supplemented with other strategies for modeling dose-response.

Population-Based Questionnaire Survey on Health Effects of Aircraft Noise on Residents Living around U.S. Airfields in the RYUKYUS—PART i: AN Analysis of 12 Scale Scores

NASA Astrophysics Data System (ADS)

MIYAKITA, T.; MATSUI, T.; ITO, A.; TOKUYAMA, T.; HIRAMATSU, K.; OSADA, Y.; YAMAMOTO, T.

2002-02-01

A questionnaire survey was made of health effects of aircraft noise on residents living around Kadena and Futenma airfields using the Todai Health Index. Aircraft noise exposure expressed by Ldnranged from under 55 to over 70 in the surveyed area. The number of valid answers was 7095, including 848 among the control group. Twelve scale scores were converted to dichotomous variables based on scale scores of the 90 percentile value or the 10 percentile value in the control group. Multiple logistic regression analysis was done taking 12 scale scores converted into the dependent variable andLdn , age (six levels), sex, occupation (four categories) and the interaction of age and sex as the independent variables. Significant dose-response relationships were found in the scale scores for vague complaints, respiratory, digestive, mental instability, depression and nervousness. The results suggest that the residents living around Kadena and Futenma airfields may suffer both physical and mental effects as a result of exposure to military aircraft noise and that such responses increase with the level of noise exposure (Ldn).

A comparison of independent depression and substance-induced depression in cannabis-, cocaine-, and opioid-dependent treatment seekers.

PubMed

Dakwar, Elias; Nunes, Edward V; Bisaga, Adam; Carpenter, Kenneth C; Mariani, John P; Sullivan, Maria A; Raby, Wilfrid N; Levin, Frances R

2011-01-01

Depressive symptoms often coexist with substance use disorders (SUDs). The DSM-IV has identified two distinct categories for depression coexisting with SUDs-independent depression and substance-induced depression. While this distinction has important therapeutic and prognostic implications, it remains difficult to make in clinical practice; the differentiation is often guided by chronological and symptom severity criteria that patients may be unable to precisely provide. Furthermore, it is unclear whether the various substances commonly abused-cannabis, cocaine, and opioids-are equally associated with the two types of depression. Predictors, associations, and other markers may be helpful in guiding the diagnostic process. We, therefore, examined the differences between cannabis-, cocaine-, and opioid-dependent individuals contending with independent depression and those contending with substance-induced depression in regard to several variables, hypothesizing that independent depression is more commonly found in females, and that it is associated with higher symptom severity and psychiatric comorbidity. Cocaine-, cannabis-, and/or opioid-dependent, treatment-seeking individuals underwent a structured clinical interview for DSM-IV-TR disorders after providing consent at our clinical research site; those with co-existing primary depression or substance-induced depression diagnoses were provided with further questionnaires and were entered into this analysis (n= 242). Pair-wise comparisons were conducted between the groups classified as independent versus substance-induced depression with 2-by-2 tables and chi-square tests for dichotomous independent variables, and t-tests for continuous variables. Binomial logistic regression was performed in order to ascertain which of the variables were significant predictors. Women were more likely than men to have independent depression (p< .005). Cannabis dependence was highly associated with independent depression (p< .001), while cocaine dependence was highly associated with substance-induced depression (p< .05). Independent depression was associated with higher Hamilton depression scale scores (16 vs. 10, p< .005), and was more highly associated with the comorbid diagnosis of posttraumatic stress disorder (p< .05). Cannabis dependence (p< .001) and female gender (p< .05) were highly significant predictors of major depression specifically. Gender, cannabis dependence, psychiatric severity, and psychiatric comorbidity have variable, statistically significant associations with independent and substance-induced depression, and may be helpful in guiding the diagnostic process. © American Academy of Addiction Psychiatry.

The Effect of Sequential Dependence on the Sampling Distributions of KR-20, KR-21, and Split-Halves Reliabilities.

ERIC Educational Resources Information Center

Sullins, Walter L.

Five-hundred dichotomously scored response patterns were generated with sequentially independent (SI) items and 500 with dependent (SD) items for each of thirty-six combinations of sampling parameters (i.e., three test lengths, three sample sizes, and four item difficulty distributions). KR-20, KR-21, and Split-Half (S-H) reliabilities were…

Testing Manifest Monotonicity Using Order-Constrained Statistical Inference

ERIC Educational Resources Information Center

Tijmstra, Jesper; Hessen, David J.; van der Heijden, Peter G. M.; Sijtsma, Klaas

2013-01-01

Most dichotomous item response models share the assumption of latent monotonicity, which states that the probability of a positive response to an item is a nondecreasing function of a latent variable intended to be measured. Latent monotonicity cannot be evaluated directly, but it implies manifest monotonicity across a variety of observed scores,…

Real and Artificial Differential Item Functioning in Polytomous Items

ERIC Educational Resources Information Center

Andrich, David; Hagquist, Curt

2015-01-01

Differential item functioning (DIF) for an item between two groups is present if, for the same person location on a variable, persons from different groups have different expected values for their responses. Applying only to dichotomously scored items in the popular Mantel-Haenszel (MH) method for detecting DIF in which persons are classified by…

Cause and Event: Supporting Causal Claims through Logistic Models

ERIC Educational Resources Information Center

O'Connell, Ann A.; Gray, DeLeon L.

2011-01-01

Efforts to identify and support credible causal claims have received intense interest in the research community, particularly over the past few decades. In this paper, we focus on the use of statistical procedures designed to support causal claims for a treatment or intervention when the response variable of interest is dichotomous. We identify…

Dichotomous-noise-induced pattern formation in a reaction-diffusion system

NASA Astrophysics Data System (ADS)

Das, Debojyoti; Ray, Deb Shankar

2013-06-01

We consider a generic reaction-diffusion system in which one of the parameters is subjected to dichotomous noise by controlling the flow of one of the reacting species in a continuous-flow-stirred-tank reactor (CSTR) -membrane reactor. The linear stability analysis in an extended phase space is carried out by invoking Furutzu-Novikov procedure for exponentially correlated multiplicative noise to derive the instability condition in the plane of the noise parameters (correlation time and strength of the noise). We demonstrate that depending on the correlation time an optimal strength of noise governs the self-organization. Our theoretical analysis is corroborated by numerical simulations on pattern formation in a chlorine-dioxide-iodine-malonic acid reaction-diffusion system.

Job Loss and Unmet Health Care Needs in the Economic Recession: Different Associations by Family Income

PubMed Central

Birkenmaier, Julie; Kim, Youngmi

2014-01-01

Objectives. We examined heterogeneous associations between job loss and unmet health care needs by family income level in the recent economic recession. Methods. We conducted logistic regression analyses with the sample from the 2008 Survey of Income and Program Participation (n = 12 658). Dependent variables were 2 dichotomous measures of unmet health care needs in medical and dental services. The primary independent variables were a dummy indicator of job loss during a 2-year period and the family income-to-needs ratio. We used an interaction term between job loss and the family income-to-needs ratio to test the proposed research question. Results. Job loss was significantly associated with the increased risk of unmet health care needs. The proportion with unmet needs was highest for the lowest-income unemployed, but the association between job loss and health hardship was stronger for the middle- and higher-income unemployed. Conclusions. The unemployed experience health hardship differently by income level. A comprehensive coordination of applications for unemployment and health insurance should be considered to protect the unemployed from health hardship. PMID:25211745

Mock juror sampling issues in jury simulation research: A meta-analysis.

PubMed

Bornstein, Brian H; Golding, Jonathan M; Neuschatz, Jeffrey; Kimbrough, Christopher; Reed, Krystia; Magyarics, Casey; Luecht, Katherine

2017-02-01

The advantages and disadvantages of jury simulation research have often been debated in the literature. Critics chiefly argue that jury simulations lack verisimilitude, particularly through their use of student mock jurors, and that this limits the generalizabilty of the findings. In the present article, the question of sample differences (student v. nonstudent) in jury research was meta-analyzed for 6 dependent variables: 3 criminal (guilty verdicts, culpability, and sentencing) and 3 civil (liability verdicts, continuous liability, and damages). In total, 53 studies (N = 17,716) were included in the analysis (40 criminal and 13 civil). The results revealed that guilty verdicts, culpability ratings, and damage awards did not vary with sample. Furthermore, the variables that revealed significant or marginally significant differences, sentencing and liability judgments, had small or contradictory effect sizes (e.g., effects on dichotomous and continuous liability judgments were in opposite directions). In addition, with the exception of trial presentation medium, moderator effects were small and inconsistent. These results may help to alleviate concerns regarding the use of student samples in jury simulation research. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Job loss and unmet health care needs in the economic recession: different associations by family income.

PubMed

Huang, Jin; Birkenmaier, Julie; Kim, Youngmi

2014-11-01

We examined heterogeneous associations between job loss and unmet health care needs by family income level in the recent economic recession. We conducted logistic regression analyses with the sample from the 2008 Survey of Income and Program Participation (n = 12,658). Dependent variables were 2 dichotomous measures of unmet health care needs in medical and dental services. The primary independent variables were a dummy indicator of job loss during a 2-year period and the family income-to-needs ratio. We used an interaction term between job loss and the family income-to-needs ratio to test the proposed research question. Job loss was significantly associated with the increased risk of unmet health care needs. The proportion with unmet needs was highest for the lowest-income unemployed, but the association between job loss and health hardship was stronger for the middle- and higher-income unemployed. The unemployed experience health hardship differently by income level. A comprehensive coordination of applications for unemployment and health insurance should be considered to protect the unemployed from health hardship.

Three Cs in Measurement Models: Causal Indicators, Composite Indicators, and Covariates

PubMed Central

Bollen, Kenneth A.; Bauldry, Shawn

2013-01-01

In the last two decades attention to causal (and formative) indicators has grown. Accompanying this growth has been the belief that we can classify indicators into two categories, effect (reflective) indicators and causal (formative) indicators. This paper argues that the dichotomous view is too simple. Instead, there are effect indicators and three types of variables on which a latent variable depends: causal indicators, composite (formative) indicators, and covariates (the “three Cs”). Causal indicators have conceptual unity and their effects on latent variables are structural. Covariates are not concept measures, but are variables to control to avoid bias in estimating the relations between measures and latent variable(s). Composite (formative) indicators form exact linear combinations of variables that need not share a concept. Their coefficients are weights rather than structural effects and composites are a matter of convenience. The failure to distinguish the “three Cs” has led to confusion and questions such as: are causal and formative indicators different names for the same indicator type? Should an equation with causal or formative indicators have an error term? Are the coefficients of causal indicators less stable than effect indicators? Distinguishing between causal and composite indicators and covariates goes a long way toward eliminating this confusion. We emphasize the key role that subject matter expertise plays in making these distinctions. We provide new guidelines for working with these variable types, including identification of models, scaling latent variables, parameter estimation, and validity assessment. A running empirical example on self-perceived health illustrates our major points. PMID:21767021

Quantification of errors in ordinal outcome scales using shannon entropy: effect on sample size calculations.

PubMed

Mandava, Pitchaiah; Krumpelman, Chase S; Shah, Jharna N; White, Donna L; Kent, Thomas A

2013-01-01

Clinical trial outcomes often involve an ordinal scale of subjective functional assessments but the optimal way to quantify results is not clear. In stroke, the most commonly used scale, the modified Rankin Score (mRS), a range of scores ("Shift") is proposed as superior to dichotomization because of greater information transfer. The influence of known uncertainties in mRS assessment has not been quantified. We hypothesized that errors caused by uncertainties could be quantified by applying information theory. Using Shannon's model, we quantified errors of the "Shift" compared to dichotomized outcomes using published distributions of mRS uncertainties and applied this model to clinical trials. We identified 35 randomized stroke trials that met inclusion criteria. Each trial's mRS distribution was multiplied with the noise distribution from published mRS inter-rater variability to generate an error percentage for "shift" and dichotomized cut-points. For the SAINT I neuroprotectant trial, considered positive by "shift" mRS while the larger follow-up SAINT II trial was negative, we recalculated sample size required if classification uncertainty was taken into account. Considering the full mRS range, error rate was 26.1%±5.31 (Mean±SD). Error rates were lower for all dichotomizations tested using cut-points (e.g. mRS 1; 6.8%±2.89; overall p<0.001). Taking errors into account, SAINT I would have required 24% more subjects than were randomized. We show when uncertainty in assessments is considered, the lowest error rates are with dichotomization. While using the full range of mRS is conceptually appealing, a gain of information is counter-balanced by a decrease in reliability. The resultant errors need to be considered since sample size may otherwise be underestimated. In principle, we have outlined an approach to error estimation for any condition in which there are uncertainties in outcome assessment. We provide the user with programs to calculate and incorporate errors into sample size estimation.

Nursing Homes Appeals of Deficiency Citations: The Informal Dispute Resolution Process

PubMed Central

Mukamel, Dana B.; Weimer, David L.; Li, Yue; Bailey, Lauren; Spector, William D.; Harrington, Charlene

2012-01-01

Objective Nursing homes found to be not meeting quality standards are cited for deficiencies. Before 1995, their only recourse was a formal appeal process, which is lengthy and costly. In 1995, the Centers for Medicare & Medicaid Services (CMS) instituted the Informal Dispute Resolution (IDR) process. This study presents for the first time national statistics about the IDR process and an analysis of the factors that influence nursing homes’ decisions to request an IDR. Design Retrospective study including descriptive statistics and multivariate logistic hierarchical models. Setting U.S. nursing homes in 2005 to 2008. Participant 15,916 Medicaid and Medicare certified nursing homes nationally, with 94,188 surveys and 9,388 IDRs. Measures The unit of observation was an annual survey or a complaint survey that generated at least one deficiency. The dependent variable was dichotomous and indicated whether the annual or a complaint survey triggered an IDR request. Independent variables included characteristics of the nursing home, the deficiency, the market, and the state regulatory environment. Results Ten percent of all annual surveys and complaint surveys resulted in IDRs. There was substantial variation across states, which persisted over time. Multivariate results suggest that nursing homes’ decisions to request an IDR depend on their assessment of the probability of success and assessment of the benefits of the submission. Conclusions Nursing homes avail themselves of the IDR process. Their propensity to do so depends on a number of factors, including the state regulatory system and the market environment in which they operate. PMID:22402171

A Maximum Likelihood Approach for Multisample Nonlinear Structural Equation Models with Missing Continuous and Dichotomous Data

ERIC Educational Resources Information Center

Song, Xin-Yuan; Lee, Sik-Yum

2006-01-01

Structural equation models are widely appreciated in social-psychological research and other behavioral research to model relations between latent constructs and manifest variables and to control for measurement error. Most applications of SEMs are based on fully observed continuous normal data and models with a linear structural equation.…

Assessment of Differential Item Functioning in Testlet-Based Items Using the Rasch Testlet Model

ERIC Educational Resources Information Center

Wang, Wen-Chung; Wilson, Mark

2005-01-01

This study presents a procedure for detecting differential item functioning (DIF) for dichotomous and polytomous items in testlet-based tests, whereby DIF is taken into account by adding DIF parameters into the Rasch testlet model. Simulations were conducted to assess recovery of the DIF and other parameters. Two independent variables, test type…

Mothers Who Kill Their Offspring: Testing Evolutionary Hypothesis in a 110-Case Italian Sample

ERIC Educational Resources Information Center

Camperio Ciani, Andrea S.; Fontanesi, Lilybeth

2012-01-01

Objectives: This research aimed to identify incidents of mothers in Italy killing their own children and to test an adaptive evolutionary hypothesis to explain their occurrence. Methods: 110 cases of mothers killing 123 of their own offspring from 1976 to 2010 were analyzed. Each case was classified using 13 dichotomic variables. Descriptive…

What Are the Odds of that? A Primer on Understanding Logistic Regression

ERIC Educational Resources Information Center

Huang, Francis L.; Moon, Tonya R.

2013-01-01

The purpose of this Methodological Brief is to present a brief primer on logistic regression, a commonly used technique when modeling dichotomous outcomes. Using data from the National Education Longitudinal Study of 1988 (NELS:88), logistic regression techniques were used to investigate student-level variables in eighth grade (i.e., enrolled in a…

Photoinduced diffusion molecular transport

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

Rozenbaum, Viktor M., E-mail: vik-roz@mail.ru, E-mail: litrakh@gmail.com; Dekhtyar, Marina L.; Lin, Sheng Hsien

2016-08-14

We consider a Brownian photomotor, namely, the directed motion of a nanoparticle in an asymmetric periodic potential under the action of periodic rectangular resonant laser pulses which cause charge redistribution in the particle. Based on the kinetics for the photoinduced electron redistribution between two or three energy levels of the particle, the time dependence of its potential energy is derived and the average directed velocity is calculated in the high-temperature approximation (when the spatial amplitude of potential energy fluctuations is small relative to the thermal energy). The thus developed theory of photoinduced molecular transport appears applicable not only to conventionalmore » dichotomous Brownian motors (with only two possible potential profiles) but also to a much wider variety of molecular nanomachines. The distinction between the realistic time dependence of the potential energy and that for a dichotomous process (a step function) is represented in terms of relaxation times (they can differ on the time intervals of the dichotomous process). As shown, a Brownian photomotor has the maximum average directed velocity at (i) large laser pulse intensities (resulting in short relaxation times on laser-on intervals) and (ii) excited state lifetimes long enough to permit efficient photoexcitation but still much shorter than laser-off intervals. A Brownian photomotor with optimized parameters is exemplified by a cylindrically shaped semiconductor nanocluster which moves directly along a polar substrate due to periodically photoinduced dipole moment (caused by the repetitive excited electron transitions to a non-resonant level of the nanocylinder surface impurity).« less

Kappa statistic for the clustered dichotomous responses from physicians and patients

PubMed Central

Kang, Chaeryon; Qaqish, Bahjat; Monaco, Jane; Sheridan, Stacey L.; Cai, Jianwen

2013-01-01

The bootstrap method for estimating the standard error of the kappa statistic in the presence of clustered data is evaluated. Such data arise, for example, in assessing agreement between physicians and their patients regarding their understanding of the physician-patient interaction and discussions. We propose a computationally efficient procedure for generating correlated dichotomous responses for physicians and assigned patients for simulation studies. The simulation result demonstrates that the proposed bootstrap method produces better estimate of the standard error and better coverage performance compared to the asymptotic standard error estimate that ignores dependence among patients within physicians with at least a moderately large number of clusters. An example of an application to a coronary heart disease prevention study is presented. PMID:23533082

A note on the kappa statistic for clustered dichotomous data.

PubMed

Zhou, Ming; Yang, Zhao

2014-06-30

The kappa statistic is widely used to assess the agreement between two raters. Motivated by a simulation-based cluster bootstrap method to calculate the variance of the kappa statistic for clustered physician-patients dichotomous data, we investigate its special correlation structure and develop a new simple and efficient data generation algorithm. For the clustered physician-patients dichotomous data, based on the delta method and its special covariance structure, we propose a semi-parametric variance estimator for the kappa statistic. An extensive Monte Carlo simulation study is performed to evaluate the performance of the new proposal and five existing methods with respect to the empirical coverage probability, root-mean-square error, and average width of the 95% confidence interval for the kappa statistic. The variance estimator ignoring the dependence within a cluster is generally inappropriate, and the variance estimators from the new proposal, bootstrap-based methods, and the sampling-based delta method perform reasonably well for at least a moderately large number of clusters (e.g., the number of clusters K ⩾50). The new proposal and sampling-based delta method provide convenient tools for efficient computations and non-simulation-based alternatives to the existing bootstrap-based methods. Moreover, the new proposal has acceptable performance even when the number of clusters is as small as K = 25. To illustrate the practical application of all the methods, one psychiatric research data and two simulated clustered physician-patients dichotomous data are analyzed. Copyright © 2014 John Wiley & Sons, Ltd.

Dichotomous Thinking Leads to Entity Theories of Human Ability

ERIC Educational Resources Information Center

Oshio, Atsushi

2012-01-01

Previous research has indicated that dichotomous thinkers have stereotypic and rigid views of others. This study focuses on the world-view of dichotomous thinkers from the perspective of entity vs. incremental theory. Study 1 explored the relationship between dichotomous thinking and the IPTM (implicit person theory measure) (Dweck, Chiu, &…

Correction of the significance level when attempting multiple transformations of an explanatory variable in generalized linear models

PubMed Central

2013-01-01

Background In statistical modeling, finding the most favorable coding for an exploratory quantitative variable involves many tests. This process involves multiple testing problems and requires the correction of the significance level. Methods For each coding, a test on the nullity of the coefficient associated with the new coded variable is computed. The selected coding corresponds to that associated with the largest statistical test (or equivalently the smallest pvalue). In the context of the Generalized Linear Model, Liquet and Commenges (Stat Probability Lett,71:33–38,2005) proposed an asymptotic correction of the significance level. This procedure, based on the score test, has been developed for dichotomous and Box-Cox transformations. In this paper, we suggest the use of resampling methods to estimate the significance level for categorical transformations with more than two levels and, by definition those that involve more than one parameter in the model. The categorical transformation is a more flexible way to explore the unknown shape of the effect between an explanatory and a dependent variable. Results The simulations we ran in this study showed good performances of the proposed methods. These methods were illustrated using the data from a study of the relationship between cholesterol and dementia. Conclusion The algorithms were implemented using R, and the associated CPMCGLM R package is available on the CRAN. PMID:23758852

Multivariate outcome prediction in traumatic brain injury with focus on laboratory values.

PubMed

Nelson, David W; Rudehill, Anders; MacCallum, Robert M; Holst, Anders; Wanecek, Michael; Weitzberg, Eddie; Bellander, Bo-Michael

2012-11-20

Traumatic brain injury (TBI) is a major cause of morbidity and mortality. Identifying factors relevant to outcome can provide a better understanding of TBI pathophysiology, in addition to aiding prognostication. Many common laboratory variables have been related to outcome but may not be independent predictors in a multivariate setting. In this study, 757 patients were identified in the Karolinska TBI database who had retrievable early laboratory variables. These were analyzed towards a dichotomized Glasgow Outcome Scale (GOS) with logistic regression and relevance vector machines, a non-linear machine learning method, univariately and controlled for the known important predictors in TBI outcome: age, Glasgow Coma Score (GCS), pupil response, and computed tomography (CT) score. Accuracy was assessed with Nagelkerke's pseudo R². Of the 18 investigated laboratory variables, 15 were found significant (p<0.05) towards outcome in univariate analyses. In contrast, when adjusting for other predictors, few remained significant. Creatinine was found an independent predictor of TBI outcome. Glucose, albumin, and osmolarity levels were also identified as predictors, depending on analysis method. A worse outcome related to increasing osmolarity may warrant further study. Importantly, hemoglobin was not found significant when adjusted for post-resuscitation GCS as opposed to an admission GCS, and timing of GCS can thus have a major impact on conclusions. In total, laboratory variables added an additional 1.3-4.4% to pseudo R².

Partner violence victimization and unintended pregnancy in Latina and Asian American women: Analysis using structural equation modeling.

PubMed

Cha, Susan; Masho, Saba W; Heh, Victor

2017-04-01

Intimate partner violence (IPV) is a pervasive public health problem in the U.S., affecting nearly one in every three women over their lifetimes. Using structural equation modeling, we evaluated the association between IPV and unintended pregnancy, mediated by condom use and perceived spousal/partner support among Latina and Asian women. Data came from the 2002-2003 National Latino and Asian American Study (NLAAS). The analysis was restricted to married or cohabiting female respondents aged 18+ years (n = 1,595). Dependent variables included unintended pregnancy, condom use, and perceived partner support. Independent variables included physical abuse or threats by current partner and primary decision-maker. Weighted least squares was used to fit path models to data comprising dichotomous and ordinal variables. More than 13% of women reported IPV during their relationship with their partner/spouse. Abused women were twice as likely as non-abused women to have had an unintended pregnancy. This association was partially mediated by perceived partner support. Condom use had a positive, but non-significant association with unintended pregnancy, and IPV had a negative, but non-significant association with condom use. Results highlight the importance of IPV screening for minority women. Efforts to combine family planning and violence prevention services may help reduce unintended pregnancy.

[Frequency and variables associated with perceived devaluation-discrimination in victims of the armed conflict in Colombia].

PubMed

Campo-Arias, Adalberto; Ospino, Anyelly C; Sanabria, Adriana R; Guerra, Valeria M; Caamaño, Beatriz H; Herazo, Edwin

2017-11-21

There is no information on frequency of perceived devaluation-discrimination in victims of the armed conflict in Colombia. The aim of this study was thus to determine the frequency of perceived devaluation-discrimination and associated variables among victims of the armed conflict in municipalities in the Department of Magdalena, Colombia. A cross-sectional study was conducted among victims enrolled in the Program for Psychosocial Care and Comprehensive Healthcare for Victims. Depressive symptoms were quantified with four dichotomous items (three or more were classified as high level of depressive symptoms), and perceived devaluation-discrimination was quantified with six dichotomous items (two or more were classified as high perceived devaluation-discrimination). A total of 943 adults participated (M = 47.9; SD = 14.2); 67.4%, women; 109 (11.6%) reported high level of depressive symptoms and 217 (23%) showed high perceived devaluation-discrimination. High perceived devaluation-discrimination was associated with high level of depressive symptoms (OR = 6.47; 95%CI: 4.23-9.88). In conclusion, one-fourth of the victims of the armed conflict in Magdalena reported high perceived devaluation-discrimination, which was significantly associated with high level of depressive symptoms.

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

Williamson, Mark S.; Son Wonmin; Heaney, Libby

Recently, it was demonstrated by Son et al., Phys. Rev. Lett. 102, 110404 (2009), that a separable bipartite continuous-variable quantum system can violate the Clauser-Horne-Shimony-Holt (CHSH) inequality via operationally local transformations. Operationally local transformations are parametrized only by local variables; however, in order to allow violation of the CHSH inequality, a maximally entangled ancilla was necessary. The use of the entangled ancilla in this scheme caused the state under test to become dependent on the measurement choice one uses to calculate the CHSH inequality, thus violating one of the assumptions used in deriving a Bell inequality, namely, the free willmore » or statistical independence assumption. The novelty in this scheme however is that the measurement settings can be external free parameters. In this paper, we generalize these operationally local transformations for multipartite Bell inequalities (with dichotomic observables) and provide necessary and sufficient conditions for violation within this scheme. Namely, a violation of a multipartite Bell inequality in this setting is contingent on whether an ancillary system admits any realistic local hidden variable model (i.e., whether the ancilla violates the given Bell inequality). These results indicate that violation of a Bell inequality performed on a system does not necessarily imply that the system is nonlocal. In fact, the system under test may be completely classical. However, nonlocality must have resided somewhere, this may have been in the environment, the physical variables used to manipulate the system or the detectors themselves provided the measurement settings are external free variables.« less

Singapore's Anatomical Future: Quo Vadis?

ERIC Educational Resources Information Center

Ang, Eng-Tat; Sugand, Kapil; Hartman, Mikael; Seow, Choon-Sheong; Bay, Boon-Huat; Abrahams, Peter

2012-01-01

The disciplines of anatomy and surgery are not dichotomous since one is dependent on the other. Traditionally, surgeons predominantly taught gross and clinical anatomy. In this review, we examine the context of how human anatomy is taught nowadays. In essence, we discovered that there are certain discernable trends consistently observable between…

The chi-square test of independence.

PubMed

McHugh, Mary L

2013-01-01

The Chi-square statistic is a non-parametric (distribution free) tool designed to analyze group differences when the dependent variable is measured at a nominal level. Like all non-parametric statistics, the Chi-square is robust with respect to the distribution of the data. Specifically, it does not require equality of variances among the study groups or homoscedasticity in the data. It permits evaluation of both dichotomous independent variables, and of multiple group studies. Unlike many other non-parametric and some parametric statistics, the calculations needed to compute the Chi-square provide considerable information about how each of the groups performed in the study. This richness of detail allows the researcher to understand the results and thus to derive more detailed information from this statistic than from many others. The Chi-square is a significance statistic, and should be followed with a strength statistic. The Cramer's V is the most common strength test used to test the data when a significant Chi-square result has been obtained. Advantages of the Chi-square include its robustness with respect to distribution of the data, its ease of computation, the detailed information that can be derived from the test, its use in studies for which parametric assumptions cannot be met, and its flexibility in handling data from both two group and multiple group studies. Limitations include its sample size requirements, difficulty of interpretation when there are large numbers of categories (20 or more) in the independent or dependent variables, and tendency of the Cramer's V to produce relative low correlation measures, even for highly significant results.

Evaluation of methodology for the analysis of 'time-to-event' data in pharmacogenomic genome-wide association studies.

PubMed

Syed, Hamzah; Jorgensen, Andrea L; Morris, Andrew P

2016-06-01

To evaluate the power to detect associations between SNPs and time-to-event outcomes across a range of pharmacogenomic study designs while comparing alternative regression approaches. Simulations were conducted to compare Cox proportional hazards modeling accounting for censoring and logistic regression modeling of a dichotomized outcome at the end of the study. The Cox proportional hazards model was demonstrated to be more powerful than the logistic regression analysis. The difference in power between the approaches was highly dependent on the rate of censoring. Initial evaluation of single-nucleotide polymorphism association signals using computationally efficient software with dichotomized outcomes provides an effective screening tool for some design scenarios, and thus has important implications for the development of analytical protocols in pharmacogenomic studies.

Kappa statistic for clustered dichotomous responses from physicians and patients.

PubMed

Kang, Chaeryon; Qaqish, Bahjat; Monaco, Jane; Sheridan, Stacey L; Cai, Jianwen

2013-09-20

The bootstrap method for estimating the standard error of the kappa statistic in the presence of clustered data is evaluated. Such data arise, for example, in assessing agreement between physicians and their patients regarding their understanding of the physician-patient interaction and discussions. We propose a computationally efficient procedure for generating correlated dichotomous responses for physicians and assigned patients for simulation studies. The simulation result demonstrates that the proposed bootstrap method produces better estimate of the standard error and better coverage performance compared with the asymptotic standard error estimate that ignores dependence among patients within physicians with at least a moderately large number of clusters. We present an example of an application to a coronary heart disease prevention study. Copyright © 2013 John Wiley & Sons, Ltd.

Acting without Regarding: Daoist Self-Cultivation as Education for Non-Dichotomous Thinking

ERIC Educational Resources Information Center

Sta. Maria, Joseph Emmanuel D.

2017-01-01

In this article, I show how resources for an education for non-dichotomous thinking can be drawn from the two Daoist texts, the Daodejing and the Zhuangzi. Dichotomous thinking can be defined as thinking that considers things in terms of strict and even irreconcilable dichotomous oppositions. The authors of the Daodejing and the Zhuangzi are known…

Differences in medication adherence are associated with beliefs about medicines in asthma and COPD.

PubMed

Brandstetter, Susanne; Finger, Tamara; Fischer, Wiebke; Brandl, Magdalena; Böhmer, Merle; Pfeifer, Michael; Apfelbacher, Christian

2017-01-01

Adherence to medication is crucial for achieving treatment control in chronic obstructive lung diseases. This study refers to the "necessity-concerns framework" and examines the associations between beliefs about medicines and self-reported medication adherence in people with chronic obstructive lung disease. 402 patients (196 with asthma, 206 with COPD) participated in the study and completed a questionnaire comprising the "Beliefs about Medicines-Questionnaire" (BMQ) and the "Medication Adherence Report Scale" (MARS). Multivariable logistic regression analyses with the BMQ-subscales as explanatory and the dichotomized MARS-score as dependent variable were computed for the asthma and the COPD sample, respectively, and adjusted for potentially confounding variables. 19% of asthma patients and 34% of COPD patients were completely adherent to their prescribed medication. While specific beliefs about the necessity of medicines were positively associated with medication adherence both in patients with asthma and with COPD, general beliefs about harm and overuse of medicines by doctors were negatively associated with medication adherence only among patients with asthma. The findings of this study suggest that patients' specific beliefs about the necessity of medicines represent an important modifiable target for improving patient-doctor consultations when prescribing medicines.

A Method for Calculating the Probability of Successfully Completing a Rocket Propulsion Ground Test

NASA Technical Reports Server (NTRS)

Messer, Bradley

2007-01-01

Propulsion ground test facilities face the daily challenge of scheduling multiple customers into limited facility space and successfully completing their propulsion test projects. Over the last decade NASA s propulsion test facilities have performed hundreds of tests, collected thousands of seconds of test data, and exceeded the capabilities of numerous test facility and test article components. A logistic regression mathematical modeling technique has been developed to predict the probability of successfully completing a rocket propulsion test. A logistic regression model is a mathematical modeling approach that can be used to describe the relationship of several independent predictor variables X(sub 1), X(sub 2),.., X(sub k) to a binary or dichotomous dependent variable Y, where Y can only be one of two possible outcomes, in this case Success or Failure of accomplishing a full duration test. The use of logistic regression modeling is not new; however, modeling propulsion ground test facilities using logistic regression is both a new and unique application of the statistical technique. Results from this type of model provide project managers with insight and confidence into the effectiveness of rocket propulsion ground testing.

A Bayesian prediction model between a biomarker and the clinical endpoint for dichotomous variables.

PubMed

Jiang, Zhiwei; Song, Yang; Shou, Qiong; Xia, Jielai; Wang, William

2014-12-20

Early biomarkers are helpful for predicting clinical endpoints and for evaluating efficacy in clinical trials even if the biomarker cannot replace clinical outcome as a surrogate. The building and evaluation of an association model between biomarkers and clinical outcomes are two equally important concerns regarding the prediction of clinical outcome. This paper is to address both issues in a Bayesian framework. A Bayesian meta-analytic approach is proposed to build a prediction model between the biomarker and clinical endpoint for dichotomous variables. Compared with other Bayesian methods, the proposed model only requires trial-level summary data of historical trials in model building. By using extensive simulations, we evaluate the link function and the application condition of the proposed Bayesian model under scenario (i) equal positive predictive value (PPV) and negative predictive value (NPV) and (ii) higher NPV and lower PPV. In the simulations, the patient-level data is generated to evaluate the meta-analytic model. PPV and NPV are employed to describe the patient-level relationship between the biomarker and the clinical outcome. The minimum number of historical trials to be included in building the model is also considered. It is seen from the simulations that the logit link function performs better than the odds and cloglog functions under both scenarios. PPV/NPV ≥0.5 for equal PPV and NPV, and PPV + NPV ≥1 for higher NPV and lower PPV are proposed in order to predict clinical outcome accurately and precisely when the proposed model is considered. Twenty historical trials are required to be included in model building when PPV and NPV are equal. For unequal PPV and NPV, the minimum number of historical trials for model building is proposed to be five. A hypothetical example shows an application of the proposed model in global drug development. The proposed Bayesian model is able to predict well the clinical endpoint from the observed biomarker data for dichotomous variables as long as the conditions are satisfied. It could be applied in drug development. But the practical problems in applications have to be studied in further research.

An Extension of IRT-Based Equating to the Dichotomous Testlet Response Theory Model

ERIC Educational Resources Information Center

Tao, Wei; Cao, Yi

2016-01-01

Current procedures for equating number-correct scores using traditional item response theory (IRT) methods assume local independence. However, when tests are constructed using testlets, one concern is the violation of the local item independence assumption. The testlet response theory (TRT) model is one way to accommodate local item dependence.…

IRT Model Selection Methods for Dichotomous Items

ERIC Educational Resources Information Center

Kang, Taehoon; Cohen, Allan S.

2007-01-01

Fit of the model to the data is important if the benefits of item response theory (IRT) are to be obtained. In this study, the authors compared model selection results using the likelihood ratio test, two information-based criteria, and two Bayesian methods. An example illustrated the potential for inconsistency in model selection depending on…

Old and New Ideas for Data Screening and Assumption Testing for Exploratory and Confirmatory Factor Analysis

PubMed Central

Flora, David B.; LaBrish, Cathy; Chalmers, R. Philip

2011-01-01

We provide a basic review of the data screening and assumption testing issues relevant to exploratory and confirmatory factor analysis along with practical advice for conducting analyses that are sensitive to these concerns. Historically, factor analysis was developed for explaining the relationships among many continuous test scores, which led to the expression of the common factor model as a multivariate linear regression model with observed, continuous variables serving as dependent variables, and unobserved factors as the independent, explanatory variables. Thus, we begin our paper with a review of the assumptions for the common factor model and data screening issues as they pertain to the factor analysis of continuous observed variables. In particular, we describe how principles from regression diagnostics also apply to factor analysis. Next, because modern applications of factor analysis frequently involve the analysis of the individual items from a single test or questionnaire, an important focus of this paper is the factor analysis of items. Although the traditional linear factor model is well-suited to the analysis of continuously distributed variables, commonly used item types, including Likert-type items, almost always produce dichotomous or ordered categorical variables. We describe how relationships among such items are often not well described by product-moment correlations, which has clear ramifications for the traditional linear factor analysis. An alternative, non-linear factor analysis using polychoric correlations has become more readily available to applied researchers and thus more popular. Consequently, we also review the assumptions and data-screening issues involved in this method. Throughout the paper, we demonstrate these procedures using an historic data set of nine cognitive ability variables. PMID:22403561

Learning: from association to cognition.

PubMed

Shanks, David R

2010-01-01

Since the very earliest experimental investigations of learning, tension has existed between association-based and cognitive theories. Associationism accounts for the phenomena of both conditioning and "higher" forms of learning via concepts such as excitation, inhibition, and reinforcement, whereas cognitive theories assume that learning depends on hypothesis testing, cognitive models, and propositional reasoning. Cognitive theories have received considerable impetus in regard to both human and animal learning from recent research suggesting that the key illustration of cue selection in learning, blocking, often arises from inferential reasoning. At the same time, a dichotomous view that separates noncognitive, unconscious (implicit) learning from cognitive, conscious (explicit) learning has gained favor. This review selectively describes key findings from this research, evaluates evidence for and against associative and cognitive explanatory constructs, and critically examines both the dichotomous view of learning as well as the claim that learning can occur unconsciously.

Organizational and environmental factors associated with nursing home participation in managed care.

PubMed Central

Zinn, J S; Mor, V; Castle, N; Intrator, O; Brannon, D

1999-01-01

OBJECTIVE: To develop and test a model, based on resource dependence theory, that identifies the organizational and environmental characteristics associated with nursing home participation in managed care. DATA SOURCES AND STUDY SETTING: Data for statistical analysis derived from a survey of Directors of Nursing in a sample of nursing homes in eight states (n = 308). These data were merged with data from the On-line Survey Certification and Reporting System, the Medicare Managed Care State/County Data File, and the 1995 Area Resource File. STUDY DESIGN: Since the dependent variable is dichotomous, the logistic procedure was used to fit the regression. The analysis was weighted using SUDAAN. FINDINGS: Participation in a provider network, higher proportions of resident care covered by Medicare, providing IV therapy, greater availability of RNs and physical therapists, and Medicare HMO market penetration are associated with a greater likelihood of having a managed care contract. CONCLUSION: As more Medicare recipients enroll in HMOs, nursing home involvement in managed care is likely to increase. Interorganizational linkages enhance the likelihood of managed care participation. Nursing homes interested in managed care should consider upgrading staffing and providing at least some subacute services. PMID:10029508

An Analysis of Factor Extraction Strategies: A Comparison of the Relative Strengths of Principal Axis, Ordinary Least Squares, and Maximum Likelihood in Research Contexts That Include Both Categorical and Continuous Variables

ERIC Educational Resources Information Center

Coughlin, Kevin B.

2013-01-01

This study is intended to provide researchers with empirically derived guidelines for conducting factor analytic studies in research contexts that include dichotomous and continuous levels of measurement. This study is based on the hypotheses that ordinary least squares (OLS) factor analysis will yield more accurate parameter estimates than…

A general diagnostic model applied to language testing data.

PubMed

von Davier, Matthias

2008-11-01

Probabilistic models with one or more latent variables are designed to report on a corresponding number of skills or cognitive attributes. Multidimensional skill profiles offer additional information beyond what a single test score can provide, if the reported skills can be identified and distinguished reliably. Many recent approaches to skill profile models are limited to dichotomous data and have made use of computationally intensive estimation methods such as Markov chain Monte Carlo, since standard maximum likelihood (ML) estimation techniques were deemed infeasible. This paper presents a general diagnostic model (GDM) that can be estimated with standard ML techniques and applies to polytomous response variables as well as to skills with two or more proficiency levels. The paper uses one member of a larger class of diagnostic models, a compensatory diagnostic model for dichotomous and partial credit data. Many well-known models, such as univariate and multivariate versions of the Rasch model and the two-parameter logistic item response theory model, the generalized partial credit model, as well as a variety of skill profile models, are special cases of this GDM. In addition to an introduction to this model, the paper presents a parameter recovery study using simulated data and an application to real data from the field test for TOEFL Internet-based testing.

Quantifying Local, Response Dependence between Two Polytomous Items Using the Rasch Model

ERIC Educational Resources Information Center

Andrich, David; Humphry, Stephen M.; Marais, Ida

2012-01-01

Models of modern test theory imply statistical independence among responses, generally referred to as "local independence." One violation of local independence occurs when the response to one item governs the response to a subsequent item. Expanding on a formulation of this kind of violation as a process in the dichotomous Rasch model,…

Family communication in a population at risk for hypertrophic cardiomyopathy.

PubMed

Batte, Brittany; Sheldon, Jane P; Arscott, Patricia; Huismann, Darcy J; Salberg, Lisa; Day, Sharlene M; Yashar, Beverly M

2015-04-01

Encouraging family communication is an integral component of genetic counseling; therefore, we sought to identify factors impacting communication to family members at risk for Hypertrophic Cardiomyopathy (HCM). Participants (N = 383) completed an online survey assessing: 1) demographics (gender, genetic test results, HCM family history, and disease severity); 2) illness representations; 3) family functioning and cohesiveness; 4) coping styles; 5) comprehension of HCM autosomal dominant inheritance; and 6) communication of HCM risk information to at-risk relatives. Participants were a national sample of individuals with HCM, recruited through the Hypertrophic Cardiomyopathy Association. Data from 183 participants were analyzed using a logistic regression analysis, with family communication as a dichotomous dependent variable. We found that female gender and higher comprehension of autosomal dominant inheritance were significant predictors of participants' communication of HCM risk information to all their siblings and children. Our results suggest that utilizing interventions that promote patient comprehension (e.g., a teaching-focused model of genetic counseling) are important and may positively impact family communication within families with HCM.

Addition of 24-Hour Heart Rate Variability Parameters to the Cardiovascular Health Study Stroke Risk Score and Prediction of Incident Stroke: The Cardiovascular Health Study.

PubMed

Bodapati, Rohan K; Kizer, Jorge R; Kop, Willem J; Kamel, Hooman; Stein, Phyllis K

2017-07-21

Heart rate variability (HRV) characterizes cardiac autonomic functioning. The association of HRV with stroke is uncertain. We examined whether 24-hour HRV added predictive value to the Cardiovascular Health Study clinical stroke risk score (CHS-SCORE), previously developed at the baseline examination. N=884 stroke-free CHS participants (age 75.3±4.6), with 24-hour Holters adequate for HRV analysis at the 1994-1995 examination, had 68 strokes over ≤8 year follow-up (median 7.3 [interquartile range 7.1-7.6] years). The value of adding HRV to the CHS-SCORE was assessed with stepwise Cox regression analysis. The CHS-SCORE predicted incident stroke (HR=1.06 per unit increment, P =0.005). Two HRV parameters, decreased coefficient of variance of NN intervals (CV%, P =0.031) and decreased power law slope (SLOPE, P =0.033) also entered the model, but these did not significantly improve the c-statistic ( P =0.47). In a secondary analysis, dichotomization of CV% (LOWCV% ≤12.8%) was found to maximally stratify higher-risk participants after adjustment for CHS-SCORE. Similarly, dichotomizing SLOPE (LOWSLOPE <-1.4) maximally stratified higher-risk participants. When these HRV categories were combined (eg, HIGHCV% with HIGHSLOPE), the c-statistic for the model with the CHS-SCORE and combined HRV categories was 0.68, significantly higher than 0.61 for the CHS-SCORE alone ( P =0.02). In this sample of older adults, 2 HRV parameters, CV% and power law slope, emerged as significantly associated with incident stroke when added to a validated clinical risk score. After each parameter was dichotomized based on its optimal cut point in this sample, their composite significantly improved prediction of incident stroke during ≤8-year follow-up. These findings will require validation in separate, larger cohorts. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

US Medical Student Performance on the NBME Subject Examination in Internal Medicine: Do Clerkship Sequence and Clerkship Length Matter?

PubMed

Ouyang, Wenli; Cuddy, Monica M; Swanson, David B

2015-09-01

Prior to graduation, US medical students are required to complete clinical clerkship rotations, most commonly in the specialty areas of family medicine, internal medicine, obstetrics and gynecology (ob/gyn), pediatrics, psychiatry, and surgery. Within a school, the sequence in which students complete these clerkships varies. In addition, the length of these rotations varies, both within a school for different clerkships and between schools for the same clerkship. The present study investigated the effects of clerkship sequence and length on performance on the National Board of Medical Examiner's subject examination in internal medicine. The study sample included 16,091 students from 67 US Liaison Committee on Medical Education (LCME)-accredited medical schools who graduated in 2012 or 2013. Student-level measures included first-attempt internal medicine subject examination scores, first-attempt USMLE Step 1 scores, and five dichotomous variables capturing whether or not students completed rotations in family medicine, ob/gyn, pediatrics, psychiatry, and surgery prior to taking the internal medicine rotation. School-level measures included clerkship length and average Step 1 score. Multilevel models with students nested in schools were estimated with internal medicine subject examination scores as the dependent measure. Step 1 scores and the five dichotomous variables were treated as student-level predictors. Internal medicine clerkship length and average Step 1 score were used to predict school-to-school variation in average internal medicine subject examination scores. Completion of rotations in surgery, pediatrics and family medicine prior to taking the internal medicine examination significantly improved scores, with the largest benefit observed for surgery (coefficient = 1.58 points; p value < 0.01); completion of rotations in ob/gyn and psychiatry were unrelated to internal medicine subject examination performance. At the school level, longer internal medicine clerkships were associated with higher scores on the internal medicine examination (coefficient = 0.23 points/week; p value < 0.01). The order in which students complete clinical clerkships and the length of the internal medicine clerkship are associated with their internal medicine subject examination scores. Findings may have implications for curriculum re-design.

Optimal clinical trial design based on a dichotomous Markov-chain mixed-effect sleep model.

PubMed

Steven Ernest, C; Nyberg, Joakim; Karlsson, Mats O; Hooker, Andrew C

2014-12-01

D-optimal designs for discrete-type responses have been derived using generalized linear mixed models, simulation based methods and analytical approximations for computing the fisher information matrix (FIM) of non-linear mixed effect models with homogeneous probabilities over time. In this work, D-optimal designs using an analytical approximation of the FIM for a dichotomous, non-homogeneous, Markov-chain phase advanced sleep non-linear mixed effect model was investigated. The non-linear mixed effect model consisted of transition probabilities of dichotomous sleep data estimated as logistic functions using piecewise linear functions. Theoretical linear and nonlinear dose effects were added to the transition probabilities to modify the probability of being in either sleep stage. D-optimal designs were computed by determining an analytical approximation the FIM for each Markov component (one where the previous state was awake and another where the previous state was asleep). Each Markov component FIM was weighted either equally or by the average probability of response being awake or asleep over the night and summed to derive the total FIM (FIM(total)). The reference designs were placebo, 0.1, 1-, 6-, 10- and 20-mg dosing for a 2- to 6-way crossover study in six dosing groups. Optimized design variables were dose and number of subjects in each dose group. The designs were validated using stochastic simulation/re-estimation (SSE). Contrary to expectations, the predicted parameter uncertainty obtained via FIM(total) was larger than the uncertainty in parameter estimates computed by SSE. Nevertheless, the D-optimal designs decreased the uncertainty of parameter estimates relative to the reference designs. Additionally, the improvement for the D-optimal designs were more pronounced using SSE than predicted via FIM(total). Through the use of an approximate analytic solution and weighting schemes, the FIM(total) for a non-homogeneous, dichotomous Markov-chain phase advanced sleep model was computed and provided more efficient trial designs and increased nonlinear mixed-effects modeling parameter precision.

A Conceptual and Empirical Examination of Justifications for Dichotomization

ERIC Educational Resources Information Center

DeCoster, Jamie; Iselin, Anne-Marie R.; Gallucci, Marcello

2009-01-01

Despite many articles reporting the problems of dichotomizing continuous measures, researchers still commonly use this practice. The authors' purpose in this article was to understand the reasons that people still dichotomize and to determine whether any of these reasons are valid. They contacted 66 researchers who had published articles using…

Another Strategy for Teaching Histology to A&P Students: Classification versus Memorization.

ERIC Educational Resources Information Center

Bavis, Ryan W.; Seveyka, Jerred; Shigeoka, Cassie A.

2000-01-01

Defines dichotomous keys as common learning tools based on identification rather than memorization. Provides an example of a dichotomous key developed for introducing histology in human anatomy and physiology (A&P) courses and explains how students can use the dichotomous key. Discusses the goals of the exercises and the process of…

The Nursing Home Pneumonia Risk Index: A Simple, Valid MDS-Based Method of Identifying 6-Month Risk for Pneumonia and Mortality.

PubMed

Sloane, Philip D; Zimmerman, Sheryl; Ward, Kimberly; Reed, David; Preisser, John S; Weber, David J

2017-09-01

Pneumonia is the leading infectious cause of hospitalization and death for nursing home (NH) residents; however, diagnosis is often delayed because classic signs of infection are not present. We sought to identify NH residents at high risk for pneumonia, to identify persons to target for more intensive surveillance and preventive measures. Based on a literature review, we identified key risk factors for pneumonia and compiled them for use as prediction tool, limiting risk factors to those available on the Minimum Data Set (MDS). Next, we tested the tool's ability to predict 6-month pneumonia incidence and mortality rates in a sample of 674 residents from 7 NHs, evaluating it both as a continuous and a dichotomous variable, and applying both logistic regression and survival analysis to calculate estimates. NH Pneumonia Risk Index scores ranged from -1 to 6, with a mean of 2.1, a median of 2, and a mode of 2. For the outcome of pneumonia, a 1-point increase in the index was associated with a risk odds ratio of 1.26 (P = .038) or a hazard ratio of 1.24 (P = .037); using it as a dichotomous variable (≤2 vs ≥3), the corresponding figures were a risk odds ratio of 1.78 (P = .045) and a hazard ratio of 1.82 (P = .025). For the outcome of mortality, a 1-point increase in the NH Pneumonia Risk Index was associated with a risk odds ratio of 1.58 (P = .002) and a hazard ratio of 1.45 (P = .013); using the index as a dichotomous variable, the corresponding figures were a risk odds ratio of 3.71 (P < .001) and a hazard ratio of 3.29 (P = .001). The NH Pneumonia Risk Index can be used by NH staff to identify residents for whom to apply especially intensive preventive measures and surveillance. Because of its strong association with mortality, the index may also be valuable in care planning and discussion of advance directives. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Oral Health-Related Quality of Life and Traumatic Dental Injuries in Young Permanent Incisors in Brazilian Schoolchildren: A Multilevel Approach.

PubMed

Freire-Maia, Fernanda Bartolomeo; Auad, Sheyla Márcia; Abreu, Mauro Henrique Nogueira Guimarães de; Sardenberg, Fernanda; Martins, Milene Torres; Paiva, Saul Martins; Pordeus, Isabela Almeida; Vale, Míriam Pimenta

2015-01-01

Traumatic dental injury (TDI) during childhood may negatively impact the quality of life of children. To describe the association of oral health-related quality of life (OHRQoL) and domains (oral symptons, functional limitation, emotional- and social-well-being) of children with individual and contextual variables. A cross-sectional study was performed using a representative sample of 1,201 schoolchildren, 8-10 years-old, from public and private schools of Belo Horizonte, Brazil. The CPQ8-10 was used to assess OHRQoL, dichotomized in low and high impact. Sociodemographic information was collected through questionnaires to parents. Children were examined at schools, using the Andreasen criteria. Individual variables were gender, age, number of residents in home, parents/caregivers' level of education, family income, and TDI (dichotomized into without trauma/mild trauma and severe trauma). Dental caries and malocclusion were considered co-variables. Contextual variables were the Social Vulnerability Index and type of school. Ethical approval and consent forms were obtained. Data were analyzed using SPSS for Windows 19.0 and HLM 6.06, including frequency distribution, chi-squared test and multilevel approach (p < 0.05). The prevalence of a negative impact on OHRQoL in children with severe trauma was 55.9%. The TDI negatively impacted emotional and social domains of OHRQoL. A multilevel analysis revealed a significant difference in OHRQoL according to the type of school and showed that 16% of the total variance was due to contextual characteristics (p < 0.001; ICC = 0.16). The negative impact on OHRQoL was higher in girls (p = 0.009), younger children (p = 0.023), with severe TDI (p = 0.014), those from public schools (p = 0.017) and whose parents had a lower education level (p = 0.001). Severe trauma impacts OHRQoL on emotional and social domains. Contextual dimensions add information to individual variability to explain higher impact, emphasizing socioeconomic inequalities.

Weighted Maximum-a-Posteriori Estimation in Tests Composed of Dichotomous and Polytomous Items

ERIC Educational Resources Information Center

Sun, Shan-Shan; Tao, Jian; Chang, Hua-Hua; Shi, Ning-Zhong

2012-01-01

For mixed-type tests composed of dichotomous and polytomous items, polytomous items often yield more information than dichotomous items. To reflect the difference between the two types of items and to improve the precision of ability estimation, an adaptive weighted maximum-a-posteriori (WMAP) estimation is proposed. To evaluate the performance of…

On an Extension of the Rasch Model to the Case of Polychotomously Scored Items.

ERIC Educational Resources Information Center

Vogt, Dorothee K.

The Rasch model for the probability of a person's response to an item is extended to the case where this response depends on a set of scoring or category weights, in addition to person and item parameters. The maximum likelihood approach introduced by Wright for the dichotomous case is applicable here also, and it is shown to yield a unique…

Intraurban Differences in the Use of Ambulatory Health Services in a Large Brazilian City

PubMed Central

Lima-Costa, Maria Fernanda; Proietti, Fernando Augusto; Cesar, Cibele C.; Macinko, James

2010-01-01

A major goal of health systems is to reduce inequities in access to services, that is, to ensure that health care is provided based on health needs rather than social or economic factors. This study aims to identify the determinants of health services utilization among adults in a large Brazilian city and intraurban disparities in health care use. We combine household survey data with census-derived classification of social vulnerability of each household’s census tract. The dependent variable was utilization of physician services in the prior 12 months, and the independent variables included predisposing factors, health needs, enabling factors, and context. Prevalence ratios and 95% confidence intervals were estimated by the Hurdle regression model, which combined Poisson regression analysis of factors associated with any doctor visits (dichotomous variable) and zero-truncated negative binomial regression for the analysis of factors associated with the number of visits among those who had at least one. Results indicate that the use of health services was greater among women and increased with age, and was determined primarily by health needs and whether the individual had a regular doctor, even among those living in areas of the city with the worst socio-environmental indicators. The experience of Belo Horizonte may have implications for other world cities, particularly in the development and use of a comprehensive index to identify populations at risk and in order to guide expansion of primary health care services as a means of enhancing equity in health. PMID:21104332

[Socioeconomic inequalities in oral health: factors associated with tooth brushing frequency among Nicaraguan schoolchildren].

PubMed

Herrera, Miriam del Socorro; Lucas-Rincón, Salvador Eduardo; Medina-Solís, Carlo Eduardo; Maupomé, Gerardo; Márquez-Corona, María de Lourdes; Islas-Granillo, Horacio; Islas-Márquez, Arturo José; Atitlán-Gil, Alfonso

2009-01-01

To identify the association between tooth brushing frequency and variables of socioeconomic position in Nicaraguan schoolchildren. A cross sectional study was undertaken in 1353 schoolchildren ages 6 to 12 randomly selected from 25 elementary schools in Leon, Nicaragua. Using a questionnaire addressed to mothers, sociodemographic, socioeconomic and behavioral variables were collected. The dependent variable was tooth brushing frequency, which was dichotomized in 0 "at least one 7 times/week" and 1 "7 or more times/week". A multivariate analysis was carried out with logistic regression in STATA 9. The average age of child participants was 8.99 +/- 2.00 years and 49.7% were women. In the final model, older age (OR = 2.04), female sex (OR = 1.39) and having a mother with positive attitudes toward oral health (OR = 2.5) were positively associated with the tooth brushing frequency (p < 0.05). Larger family size (OR = 0.89) and having low socioeconomic status (1st quartile; OR = 0.54, 2nd quartile; OR = 0.62, 3rd quartile; OR = 0.67) showed a negative relationship with the tooth brushing frequency. To have had at least one preventive dental visit in the previous year was positively associated (p < 0.10) with tooth brushing frequency. This study suggested that existence of indicators of socioeconomic inequalities exist even within less developed countries, and thus emphasize the need to target health promotion programs to vulnerable socioeconomic groups.

Comparing continuous and dichotomous scoring of the balanced inventory of desirable responding.

PubMed

Stöber, Joachim; Dette, Dorothea E; Musch, Jochen

2002-04-01

The Balanced Inventory of Desirable Responding (BIDR; Paulhus, 1994) is a widely used instrument to measure the 2 components of social desirability: self-deceptive enhancement and impression management. With respect to scoring of the BIDR, Paulhus (1994) authorized 2 methods, namely continuous scoring (all answers on the continuous answer scale are counted) and dichotomous scoring (only extreme answers are counted). In this article, we report 3 studies with student samples, and continuous and dichotomous scoring of BIDR subscales are compared with respect to reliability, convergent validity, sensitivity to instructional variations, and correlations with personality. Across studies, the scores from continuous scoring (continuous scores) showed higher Cronbach's alphas than those from dichotomous scoring (dichotomous scores). Moreover, continuous scores showed higher convergent correlations with other measures of social desirability and more consistent effects with self-presentation instructions (fake-good vs. fake-bad instructions). Finally, continuous self-deceptive enhancement scores showed higher correlations with those traits of the Five-factor model for which substantial correlations were expected (i.e., Neuroticism, Extraversion, and Conscientiousness). Consequently, these findings indicate that continuous scoring may be preferable to dichotomous scoring when assessing socially desirable responding with the BIDR.

Psychometric properties for the Balanced Inventory of Desirable Responding: dichotomous versus polytomous conventional and IRT scoring.

PubMed

Vispoel, Walter P; Kim, Han Yi

2014-09-01

[Correction Notice: An Erratum for this article was reported in Vol 26(3) of Psychological Assessment (see record 2014-16017-001). The mean, standard deviation and alpha coefficient originally reported in Table 1 should be 74.317, 10.214 and .802, respectively. The validity coefficients in the last column of Table 4 are affected as well. Correcting this error did not change the substantive interpretations of the results, but did increase the mean, standard deviation, alpha coefficient, and validity coefficients reported for the Honesty subscale in the text and in Tables 1 and 4. The corrected versions of Tables 1 and Table 4 are shown in the erratum.] Item response theory (IRT) models were applied to dichotomous and polytomous scoring of the Self-Deceptive Enhancement and Impression Management subscales of the Balanced Inventory of Desirable Responding (Paulhus, 1991, 1999). Two dichotomous scoring methods reflecting exaggerated endorsement and exaggerated denial of socially desirable behaviors were examined. The 1- and 2-parameter logistic models (1PLM, 2PLM, respectively) were applied to dichotomous responses, and the partial credit model (PCM) and graded response model (GRM) were applied to polytomous responses. For both subscales, the 2PLM fit dichotomous responses better than did the 1PLM, and the GRM fit polytomous responses better than did the PCM. Polytomous GRM and raw scores for both subscales yielded higher test-retest and convergent validity coefficients than did PCM, 1PLM, 2PLM, and dichotomous raw scores. Information plots showed that the GRM provided consistently high measurement precision that was superior to that of all other IRT models over the full range of both construct continuums. Dichotomous scores reflecting exaggerated endorsement of socially desirable behaviors provided noticeably weak precision at low levels of the construct continuums, calling into question the use of such scores for detecting instances of "faking bad." Dichotomous models reflecting exaggerated denial of the same behaviors yielded much better precision at low levels of the constructs, but it was still less precision than that of the GRM. These results support polytomous over dichotomous scoring in general, alternative dichotomous scoring for detecting faking bad, and extension of GRM scoring to situations in which IRT offers additional practical advantages over classical test theory (adaptive testing, equating, linking, scaling, detecting differential item functioning, and so forth). PsycINFO Database Record (c) 2014 APA, all rights reserved.

You Only Get One Chance to Make a First Impression: A Quantitative Analysis of Division Officer Fleet Experiences on Surface Warfare Officer Retention

DTIC Science & Technology

2007-03-01

They conclude that the most important contributors to turnover in human services fields are stress, burnout , and lack of job satisfaction...as it relates to performance, satisfaction, and turnover. Lucas (1999) conducted a controlled experiment with college students in an attempt to... dental benefits of service in the military. 6. Prior-Enlisted Status The prior-enlisted status variable is dichotomous, where non-prior=0 and prior=1

Using a Mobile Dichotomous Key iPad Application as a Scaffolding Tool in a Museum Setting

ERIC Educational Resources Information Center

Knight, Kathryn; Davies, Randall S.

2016-01-01

This study tested an iPad application using a dichotomous key as a scaffolding tool to help students make more detailed observations as they identified various species of birds on display in a museum of natural science. The Mobile Dichotomous Key (MDK) iPad application was used by groups of fifth- and seventh-grade students. Analysis of the…

Effect of age at onset on cortical thickness and cognition in posterior cortical atrophy

PubMed Central

Suárez-González, Aida; Lehmann, Manja; Shakespeare, Timothy J.; Yong, Keir X.X.; Paterson, Ross W.; Slattery, Catherine F.; Foulkes, Alexander J.M.; Rabinovici, Gil D.; Gil-Néciga, Eulogio; Roldán-Lora, Florinda; Schott, Jonathan M.; Fox, Nick C.; Crutch, Sebastian J.

2016-01-01

Age at onset (AAO) has been shown to influence the phenotype of Alzheimer’s disease (AD), but how it affects atypical presentations of AD remains unknown. Posterior cortical atrophy (PCA) is the most common form of atypical AD. In this study, we aimed to investigate the effect of AAO on cortical thickness and cognitive function in 98 PCA patients. We used Freesurfer (v5.3.0) to compare cortical thickness with AAO both as a continuous variable, and by dichotomizing the groups based on median age (58 years). In both the continuous and dichotomized analyses, we found a pattern suggestive of thinner cortex in precuneus and parietal areas in earlier-onset PCA, and lower cortical thickness in anterior cingulate and prefrontal cortex in later-onset PCA. These cortical thickness differences between PCA subgroups were consistent with earlier-onset PCA patients performing worse on cognitive tests involving parietal functions. Our results provide a suggestion that AAO may not only affect the clinico-anatomical characteristics in AD but may also affect atrophy patterns and cognition within atypical AD phenotypes. PMID:27318138

Organic solvent exposure and depressive symptoms among licensed pesticide applicators in the Agricultural Health Study

PubMed Central

Siegel, Miriam; Starks, Sarah E.; Sanderson, Wayne T.; Kamel, Freya; Hoppin, Jane A.; Gerr, Fred

2017-01-01

Purpose Although organic solvents are often used in agricultural operations, neurotoxic effects of solvent exposure have not been extensively studied among famers. The current analysis examined associations between questionnaire-based metrics of organic solvent exposure and depressive symptoms among farmers. Methods Results from 692 male Agricultural Health Study participants were analyzed. Solvent type and exposure duration were assessed by questionnaire. An “ever-use” variable and years of use categories were constructed for exposure to gasoline, paint/lacquer thinner, petroleum distillates, and any solvent. Depressive symptoms were ascertained with the Center for Epidemiologic Studies Depression Scale (CES-D); scores were analyzed separately as continuous (0-60) and dichotomous (<16 versus ≥16) variables. Multivariate linear and logistic regression models were used to estimate crude and adjusted associations between measures of solvent exposure and CES-D score. Results Forty-one percent of the sample reported some solvent exposure. The mean CES-D score was 6.5 (SD=6.4; median=5; range=0 – 44); 92% of the sample had a score below 16. After adjusting for covariates, statistically significant associations were observed between ever-use of any solvent, long duration of any solvent exposure, ever-use of gasoline, ever-use of petroleum distillates, and short duration of petroleum distillate exposure and continuous CES-D score (p<0.05). Although nearly all associations were positive, fewer statistically significant associations were observed between metrics of solvent exposure and the dichotomized CES-D variable. Conclusions Solvent exposures were associated with depressive symptoms among farmers. Efforts to limit exposure to organic solvents may reduce the risk of depressive symptoms among farmers. PMID:28702848

Doppler indices of gas phase formation in hypobaric environments: Time-intensity analysis

NASA Technical Reports Server (NTRS)

Powell, Michael R.

1991-01-01

A semi-quantitative method to analyze decompression data is described. It possesses the advantage that it allows a graded response to decompression rather than the dichotomous response generally employed. A generalized critical volume (C-V), or stoichiometric time-dependent equilibrium model is examined that relates the constant of the equation P sub i equals m P sub f plus b to variable tissue supersaturation and gas washout terms. The effects of the tissue ratio on gas phase formation indicate that a decreased ratio yields fewer individuals with Doppler detectable gas bubbles, but those individuals still present with Spencer Grade 3 or 4. This might indicate a local collapse of tissue saturation. The individuals with Grade 3 or 4 could be at risk for type 2 decompression sickness by transpulmonic arterialization. The primary regulator of the problems of decompression sickness is the reduction of local supersaturation, presumably governed by the presence and number of gas micronuclei. It is postulated that a reduction in these nuclei will favor a low incidence of decompression sickness in microgravity secondary to hypokinesia and adynamia.

Is agritourism eco-friendly? A comparison between agritourisms and other farms in Italy using farm accountancy data network dataset.

PubMed

Mastronardi, Luigi; Giaccio, Vincenzo; Giannelli, Agostino; Scardera, Alfonso

2015-01-01

This paper presents the results of research regarding the environmental performances of Italian farms with agritourism compared with farms without agritourism. In Italy, agritourism is considered an agricultural activity and can only be performed by a farmer. Moreover, Italian national legislation forces the farmer to dedicate himself mainly to traditional farming, rather than to tourism activities. For this reason, environmental performances have been highlighted by analyzing only features and production systems of the farms. By utilizing the most frequent indicators used in studies regarding sustainability, the authors show how Italian agritourisms tend to develop more environmentally friendly agricultural methods, which have a positive impact on biodiversity, landscape and natural resources. The empirical analysis is based on the Italian FADN (Farm Accountancy Data Network) dataset. The European FADN was created to represent farms' technical and economic operation in the European Union and on which it drafts the agricultural and rural policies. The dichotomous structure of the dependent variable (presence or absence of agritourism at the farm) has a propensity for an assessment method based on Binary Response Model Regression.

Contextuality in canonical systems of random variables

NASA Astrophysics Data System (ADS)

Dzhafarov, Ehtibar N.; Cervantes, Víctor H.; Kujala, Janne V.

2017-10-01

Random variables representing measurements, broadly understood to include any responses to any inputs, form a system in which each of them is uniquely identified by its content (that which it measures) and its context (the conditions under which it is recorded). Two random variables are jointly distributed if and only if they share a context. In a canonical representation of a system, all random variables are binary, and every content-sharing pair of random variables has a unique maximal coupling (the joint distribution imposed on them so that they coincide with maximal possible probability). The system is contextual if these maximal couplings are incompatible with the joint distributions of the context-sharing random variables. We propose to represent any system of measurements in a canonical form and to consider the system contextual if and only if its canonical representation is contextual. As an illustration, we establish a criterion for contextuality of the canonical system consisting of all dichotomizations of a single pair of content-sharing categorical random variables. This article is part of the themed issue `Second quantum revolution: foundational questions'.

Temperament types are associated with weak self-construct, elevated distress and emotion-oriented coping in schizophrenia: evidence for a complex vulnerability marker?

PubMed

Ritsner, Michael; Susser, Ehud

2004-10-30

Knowledge concerning temperament factors involved in vulnerability to schizophrenia is limited. We hypothesized that temperament and self-variables (emotional distress, coping styles, self-efficacy and self-esteem) might present a complex trait marker for underlying vulnerability to schizophrenia. We sought to (1) assess temperament dimensions and types in schizophrenia patients and healthy controls using the Tridimensional Personality Questionnaire (TPQ), and (2) explore their association with symptom dimensions, emotional distress, coping styles, self-constructs, demographic and background variables. We evaluated 90 consecutively recruited DSM-IV schizophrenia patients and 136 healthy controls matched for gender and age. We found that the harm avoidance (HA) factor was higher, while reward dependence (RD) was lower in schizophrenia patients than in healthy controls. Relationships of negative symptoms to novelty seeking (NS) and general psychopathology with both NS and HA show a confounding relation to self-variables. TPQ temperament types were defined by dichotomization into high and low according to medians of the three TPQ temperament dimensions. The odds ratios for the HA and HA/NS temperament types were significantly higher, while the NS/RD type was lower in schizophrenia patients than in healthy controls. HA/NS, HA/RD and high-HA/NS/RD types revealed higher scores for emotional distress, emotion-oriented coping and lower scores on self-constructs. No links were found between temperament types and schizophrenia symptom dimensions, task and avoidance oriented coping, or demographic and background variables. Thus, our findings strengthen the hypothesis that temperament types, when associated with elevated emotional distress, emotion-oriented coping and weak self-constructs, might represent a complex trait marker for underlying vulnerability to schizophrenia.

A variant of sparse partial least squares for variable selection and data exploration.

PubMed

Olson Hunt, Megan J; Weissfeld, Lisa; Boudreau, Robert M; Aizenstein, Howard; Newman, Anne B; Simonsick, Eleanor M; Van Domelen, Dane R; Thomas, Fridtjof; Yaffe, Kristine; Rosano, Caterina

2014-01-01

When data are sparse and/or predictors multicollinear, current implementation of sparse partial least squares (SPLS) does not give estimates for non-selected predictors nor provide a measure of inference. In response, an approach termed "all-possible" SPLS is proposed, which fits a SPLS model for all tuning parameter values across a set grid. Noted is the percentage of time a given predictor is chosen, as well as the average non-zero parameter estimate. Using a "large" number of multicollinear predictors, simulation confirmed variables not associated with the outcome were least likely to be chosen as sparsity increased across the grid of tuning parameters, while the opposite was true for those strongly associated. Lastly, variables with a weak association were chosen more often than those with no association, but less often than those with a strong relationship to the outcome. Similarly, predictors most strongly related to the outcome had the largest average parameter estimate magnitude, followed by those with a weak relationship, followed by those with no relationship. Across two independent studies regarding the relationship between volumetric MRI measures and a cognitive test score, this method confirmed a priori hypotheses about which brain regions would be selected most often and have the largest average parameter estimates. In conclusion, the percentage of time a predictor is chosen is a useful measure for ordering the strength of the relationship between the independent and dependent variables, serving as a form of inference. The average parameter estimates give further insight regarding the direction and strength of association. As a result, all-possible SPLS gives more information than the dichotomous output of traditional SPLS, making it useful when undertaking data exploration and hypothesis generation for a large number of potential predictors.

Generating intrinsically disordered protein conformational ensembles from a Markov chain

NASA Astrophysics Data System (ADS)

Cukier, Robert I.

2018-03-01

Intrinsically disordered proteins (IDPs) sample a diverse conformational space. They are important to signaling and regulatory pathways in cells. An entropy penalty must be payed when an IDP becomes ordered upon interaction with another protein or a ligand. Thus, the degree of conformational disorder of an IDP is of interest. We create a dichotomic Markov model that can explore entropic features of an IDP. The Markov condition introduces local (neighbor residues in a protein sequence) rotamer dependences that arise from van der Waals and other chemical constraints. A protein sequence of length N is characterized by its (information) entropy and mutual information, MIMC, the latter providing a measure of the dependence among the random variables describing the rotamer probabilities of the residues that comprise the sequence. For a Markov chain, the MIMC is proportional to the pair mutual information MI which depends on the singlet and pair probabilities of neighbor residue rotamer sampling. All 2N sequence states are generated, along with their probabilities, and contrasted with the probabilities under the assumption of independent residues. An efficient method to generate realizations of the chain is also provided. The chain entropy, MIMC, and state probabilities provide the ingredients to distinguish different scenarios using the terminologies: MoRF (molecular recognition feature), not-MoRF, and not-IDP. A MoRF corresponds to large entropy and large MIMC (strong dependence among the residues' rotamer sampling), a not-MoRF corresponds to large entropy but small MIMC, and not-IDP corresponds to low entropy irrespective of the MIMC. We show that MorFs are most appropriate as descriptors of IDPs. They provide a reasonable number of high-population states that reflect the dependences between neighbor residues, thus classifying them as IDPs, yet without very large entropy that might lead to a too high entropy penalty.

The Relationships Among Socio-Demographics, Perceived Health, and Happiness

PubMed Central

Weech-Maldonado, Robert; Miller, Michael J.; Lord, Justin C.

2017-01-01

This article explores explore the relationships among socio-demographics, perceived health, and happiness in a patient population of 221 adults recruited from 39 primary care practices in Alabama. We also explored whether the relationship between socio-demographics and happiness is mediated by perceived health. The dependent variable, happiness, was dichotomized as happy versus unhappy. Independent variables or correlates of happiness included race (Black or White), age (< 65 vs. 65 and older), gender (male vs. female), perceived income (sufficient vs. insufficient to meet basic needs), health literacy (adequate vs. inadequate), and self-rated health (excellent/very good/good vs. poor/fair). Data were analyzed using generalized linear latent and mixed models to examine the relationship between happiness and its correlates. Our findings suggest that adequate health literacy and better perceived health are associated with an increase in the likelihood of happiness. In addition, the relationship between perceived sufficient income and happiness is mediated by perceived health; whereas, individuals with sufficient income are more likely to have better perceived health, and as a result more likely to be happy. Other individual factors, such as gender, age, and race were not significantly associated with being happy or having higher perceived health in any of the models. Results suggest that policies aimed at increasing health literacy, promoting health, and reducing income disparities may be associated with greater happiness. PMID:28757904

Food Insecurity and Perceived Diet Quality Among Low-Income Older Americans with Functional Limitations.

PubMed

Chang, Yunhee; Hickman, Haley

2018-05-01

To evaluate how functional limitations are associated with food insecurity and perceived diet quality in low-income older Americans. Nationwide repeated cross-sectional surveys regarding health and nutritional status. The National Health and Nutrition Examination Surveys, 2007-2008, 2009-2010, and 2011-2012. Individuals aged ≥65 years with household incomes ≤130% of the federal poverty level (n = 1,323). Dependent variables included dichotomous indicators of food insecurity and poor-quality diet, measured with the household food security survey module and respondents' own ratings, respectively. Independent variable was presence of limitations in physical functioning. Weighted logistic regressions with nested controls and interaction terms. Functional limitations in low-income older adults were associated with 1.69 times higher odds of food insecurity (P < .01) and 1.65 times higher odds of poor-quality diet (P < .01) after accounting for individuals' health care needs and socioeconomic conditions. These associations were greatest among those living alone (odds ratio = 3.38 for food insecurity; 3.07 for poor-quality diet; P < .05) and smallest among those living with a partner. Low-income older adults who live alone with functional limitations are exposed to significant nutritional risk. Resources should be directed to facilitating their physical access to healthful foods. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Colorectal cancer stage at diagnosis in migrants versus non-migrants (KoMigra): study protocol of a cross-sectional study in Germany

PubMed Central

2014-01-01

Background In Germany, about 20% of the total population have a migration background. Differences exist between migrants and non-migrants in terms of health care access and utilisation. Colorectal cancer is the second most common malignant tumour in Germany, and incidence, staging and survival chances depend, amongst other things, on ethnicity and lifestyle. The current study investigates whether stage at diagnosis differs between migrants and non-migrants with colorectal cancer in an area of high migration and attempts to identify factors that can explain any differences. Methods/Design Data on tumour and migration status will be collected for 1,200 consecutive patients that have received a new, histologically verified diagnosis of colorectal cancer in a high migration area in Germany in the previous three months. The recruitment process is expected to take 16 months and will include gastroenterological private practices and certified centres for intestinal diseases. Descriptive and analytical analysis will be performed: the distribution of variables for migrants versus non-migrants and participants versus non-participants will be analysed using appropriate χ2-, t-, F- or Wilcoxon tests. Multivariable, logistic regression models will be performed, with the dependent variable being the dichotomized stage of the tumour (UICC stage I versus more advanced than UICC stage I). Odds ratios and associated 95%-confidence intervals will be calculated. Furthermore, ordered logistic regression models will be estimated, with the exact stage of the tumour at diagnosis as the dependent variable. Predictors used in the ordered logistic regression will be patient characteristics that are specific to migrants as well as patient characteristics that are not. Interaction models will be estimated in order to investigate whether the effects of patient characteristics on stage of tumour at the time of the initial diagnosis is different in migrants, compared to non-migrants. Discussion An association of migration status or other socioeconomic variables with stage at diagnosis of colorectal cancer would be an important finding with respect to equal health care access among migrants. It would point to access barriers or different symptom appraisal and, in the long term, could contribute to the development of new health care concepts for migrants. Trial registration German Clinical Trials Register DRKS00005056. PMID:24559172

The status of parametric studies in radar agriculture

NASA Technical Reports Server (NTRS)

Morain, S. A.

1972-01-01

Outlined is an information system based on the use of remote sensor data and the design, testing, and implementation of interpretation keys for agriculture. The task of crop identification from radar imagery emphasizes dichotomous keys and the effects of frequency, angular and other microwave dependencies of crops for use in discrimination. A mosaic is formulated from imagery and used to study acres in wheat for spread of circular irrigation, spread of crops, and other phenomena.

Social cognition in borderline personality disorder: evidence for dichotomous thinking but no evidence for less complex attributions.

PubMed

Arntz, Arnoud; ten Haaf, José

2012-11-01

This experiment investigated social cognition in borderline personality disorder (BPD). We tested whether BPD-patients' evaluations of others were characterized by splitting, dichotomous thinking, or negativity; and whether they showed less complex understanding of others. Participants discussed a problem with three alleged mental health worker trainees, performing three interpersonal roles (rejecting, accepting and neutral). Participants evaluated trainees in a structured response format and in a semi-structured interview. BPD-patients (n = 18) were compared to Cluster-C personality disorder patients (n = 18) and nonpatients (n = 18). From visual analog scales with opposite trait descriptions (structured response format) negativity, dichotomous thinking, and splitting scores were derived. The interviews were scored by an independent rater on affect tone, differentiation, and complexity of attributions. BPD-patients showed, in all conditions, and in both response formats, more dichotomous thinking than control groups. Evidence for splitting as specific BPD-characteristic was not convincing, and more negativity in BPD was only found with the rejecting role and structured responses. The interview-based evaluations by BPD-patients could not be discriminated from nonpatients in cognitive complexity. Results indicate that dichotomous thinking, and not so much splitting, negativity, or less complexity, is central in the interpretation of others by BPD-patients. Treatment might address dichotomous thinking to reduce BPD-patients' interpersonal problems. Copyright © 2012 Elsevier Ltd. All rights reserved.

Worker safety and injury severity analysis of earthmoving equipment accidents.

PubMed

Kazan, Emrah; Usmen, Mumtaz A

2018-06-01

Research on construction worker safety associated with construction equipment has mostly focused on accident type rather than injury severity and the embedded factor relationships. Significant variables and their effects on the degree of injury are examined for earthmoving equipment using data from OSHA. Four types of equipment, backhoe, bulldozer, excavator, and scraper are included in the study. Accidents involving on-foot workers and equipment operators are investigated collectively, as well as separately. Cross tabulation analysis was conducted to establish the associations between selected categorical variables, using degree of injury as a dichotomous dependent variable (fatal vs. nonfatal) and a number of independent variables having different values. Odds ratios were calculated to determine how much a certain variable/factor increases the odds of fatality in an accident, and the odds ratios were ranked to determine the relative impact of a given factor. It was found that twelve variables were significantly associated with injury severity. Rankings based on odds ratios showed that inadequate safety training (2.54), missing equipment protective system (2.38), being a non-union worker (2.26), being an equipment operator (1.93), and being on or around inadequately maintained equipment (1.58) produced higher odds for fatality. A majority of the earthmoving equipment accidents resulted in fatality. Backhoes were the most common equipment involved in accidents and fatalities. Struck-by accidents were the most prevalent and most fatal. Non-OSHA compliant safety training, missing seatbelt, operator not using seatbelt, malfunctioning back-up alarms, and poorly maintained equipment were factors contributing to accidents and fatalities. On-foot workers experienced a higher number of accidents than operators, while fatality odds were higher for the operators. Practical applications: Safety professionals should benefit from our findings in planning and delivering training and providing oversight to workers in earthmoving equipment operations. Copyright © 2018 National Safety Council and Elsevier Ltd. All rights reserved.

[User violence towards nursing staff in public hospitals: Murcia, Spain].

PubMed

Galián Muñoz, Inmaculada; Llor Esteban, Bartolomé; Ruiz Hernández, José Antonio

2012-01-01

The workplace violence has special relevance for the health care workers. Nursing staff is one of the professions most affected by this risk. Our objective is to determine the prevalence during the past year of diverse hostile manifestations by users towards professional hospital nursing staff who depend on the "Servicio Murciano de Salud" [Health Service of Murcia] (SMS), as well as to detect the sociodemographic and occupational workers characteristics associated with higher exposure. A cross-sectional study carried out during the year 2010 of a random sample of nursing personnel from all the hospitals of SMS, through a self-administered and anonymous survey (Ecoh-U scale). The sample was stratified by hospitals and services (30% of the workers) and finally we got a sample of 1.489 workers (confidence level 99%; sampling error 1,75%). We compared the punctuation average obtained in the scale according to variables sociodemographics and laborables. We used the test t of student in variables dichotomous and ANOVA and Tukey in variables multi-response. The 21,8% of the surveyed people reported that they suffered from "anger due to assistential delay" at least once a month. The workers who obtained punctuations significantly larger were psychiatric hospital workers (19,7), emergency workers (20,60), temporary (16,38) and with old 6-10 years in the profession (17,20). Although nursing staff is one of the professions most exposed to violence, the risk distribution is not homogeneous. Significant differences were found according to marital status, age, hospital, service, profession, contract type, shift and seniority in the profession.

Country, School and Students Factors Associated with Extreme Levels of Science Literacy Across 25 Countries

NASA Astrophysics Data System (ADS)

Alivernini, F.; Manganelli, S.

2015-08-01

A huge gap in science literacy is between students who do not show the competencies that are necessary to participate effectively in life situations related to science and technology and students who have the skills which would give them the potential to create new technology. The objective of this paper is to identify, for 25 countries, distinct subgroups of students with characteristics that appear to be associated with this proficiency gap. Data were based on the answers of 46,131 PISA 2006 students with scores classified below level 2 or above level 4, as well as the answers of their principals to school questionnaire and the OECD indicators of the financial and human resources invested in education at the national level for secondary school. The dependent variable of the analysis was a dichotomous variable the values of which represent the two different groups of students. The independent variables were the OECD indicators, and the items and indices derived from the student and school questionnaires. The analysis was based on classification trees and the findings were replicated and extended by the means of a multilevel logistic regression model. The results show that very specific levels of teachers' salaries, parental pressure on schools, school size, awareness of environmental issues, science self-efficacy and socio-economic status have a very important role in predicting whether 15 year olds in OECD countries will belong to the lower or the highest proficiency groups as regards their aptitude in the context of life situations involving problems of a scientific nature.

Matching on the Disease Risk Score in Comparative Effectiveness Research of New Treatments

PubMed Central

Wyss, Richard; Ellis, Alan R.; Brookhart, M. Alan; Funk, Michele Jonsson; Girman, Cynthia J.; Simpson, Ross J.; Stürmer, Til

2016-01-01

Purpose We use simulations and an empirical example to evaluate the performance of disease risk score (DRS) matching compared with propensity score (PS) matching when controlling large numbers of covariates in settings involving newly introduced treatments. Methods We simulated a dichotomous treatment, a dichotomous outcome, and 100 baseline covariates that included both continuous and dichotomous random variables. For the empirical example, we evaluated the comparative effectiveness of dabigatran versus warfarin in preventing combined ischemic stroke and all-cause mortality. We matched treatment groups on a historically estimated DRS and again on the PS. We controlled for a high-dimensional set of covariates using 20% and 1% samples of Medicare claims data from October 2010 through December 2012. Results In simulations, matching on the DRS versus the PS generally yielded matches for more treated individuals and improved precision of the effect estimate. For the empirical example, PS and DRS matching in the 20% sample resulted in similar hazard ratios (0.88 and 0.87) and standard errors (0.04 for both methods). In the 1% sample, PS matching resulted in matches for only 92.0% of the treated population and a hazard ratio and standard error of 0.89 and 0.19, respectively, while DRS matching resulted in matches for 98.5% and a hazard ratio and standard error of 0.85 and 0.16, respectively. Conclusions When PS distributions are separated, DRS matching can improve the precision of effect estimates and allow researchers to evaluate the treatment effect in a larger proportion of the treated population. However, accurately modeling the DRS can be challenging compared with the PS. PMID:26112690

Matching on the disease risk score in comparative effectiveness research of new treatments.

PubMed

Wyss, Richard; Ellis, Alan R; Brookhart, M Alan; Jonsson Funk, Michele; Girman, Cynthia J; Simpson, Ross J; Stürmer, Til

2015-09-01

We use simulations and an empirical example to evaluate the performance of disease risk score (DRS) matching compared with propensity score (PS) matching when controlling large numbers of covariates in settings involving newly introduced treatments. We simulated a dichotomous treatment, a dichotomous outcome, and 100 baseline covariates that included both continuous and dichotomous random variables. For the empirical example, we evaluated the comparative effectiveness of dabigatran versus warfarin in preventing combined ischemic stroke and all-cause mortality. We matched treatment groups on a historically estimated DRS and again on the PS. We controlled for a high-dimensional set of covariates using 20% and 1% samples of Medicare claims data from October 2010 through December 2012. In simulations, matching on the DRS versus the PS generally yielded matches for more treated individuals and improved precision of the effect estimate. For the empirical example, PS and DRS matching in the 20% sample resulted in similar hazard ratios (0.88 and 0.87) and standard errors (0.04 for both methods). In the 1% sample, PS matching resulted in matches for only 92.0% of the treated population and a hazard ratio and standard error of 0.89 and 0.19, respectively, while DRS matching resulted in matches for 98.5% and a hazard ratio and standard error of 0.85 and 0.16, respectively. When PS distributions are separated, DRS matching can improve the precision of effect estimates and allow researchers to evaluate the treatment effect in a larger proportion of the treated population. However, accurately modeling the DRS can be challenging compared with the PS. Copyright © 2015 John Wiley & Sons, Ltd.

Population Fisher information matrix and optimal design of discrete data responses in population pharmacodynamic experiments.

PubMed

Ogungbenro, Kayode; Aarons, Leon

2011-08-01

In the recent years, interest in the application of experimental design theory to population pharmacokinetic (PK) and pharmacodynamic (PD) experiments has increased. The aim is to improve the efficiency and the precision with which parameters are estimated during data analysis and sometimes to increase the power and reduce the sample size required for hypothesis testing. The population Fisher information matrix (PFIM) has been described for uniresponse and multiresponse population PK experiments for design evaluation and optimisation. Despite these developments and availability of tools for optimal design of population PK and PD experiments much of the effort has been focused on repeated continuous variable measurements with less work being done on repeated discrete type measurements. Discrete data arise mainly in PDs e.g. ordinal, nominal, dichotomous or count measurements. This paper implements expressions for the PFIM for repeated ordinal, dichotomous and count measurements based on analysis by a mixed-effects modelling technique. Three simulation studies were used to investigate the performance of the expressions. Example 1 is based on repeated dichotomous measurements, Example 2 is based on repeated count measurements and Example 3 is based on repeated ordinal measurements. Data simulated in MATLAB were analysed using NONMEM (Laplace method) and the glmmML package in R (Laplace and adaptive Gauss-Hermite quadrature methods). The results obtained for Examples 1 and 2 showed good agreement between the relative standard errors obtained using the PFIM and simulations. The results obtained for Example 3 showed the importance of sampling at the most informative time points. Implementation of these expressions will provide the opportunity for efficient design of population PD experiments that involve discrete type data through design evaluation and optimisation.

[WTP guidance technology: a comparison of payment card, single-bounded and double-bounded dichotomous formats for evaluating non-use values of Sanjiang Plain ecotourism water resources].

PubMed

Chen, Hong-Guang; Wang, Qiu-Dan; Li, Chen-Yang

2014-09-01

Contingent valuation method (CVM) is the most widespread method to assess resources and value of environmental goods and services. The guidance technology of willingness to pay (WTP) is an important means of CVM. Therefore, the study on the WTP guidance technology is an important approach to improve the reliability and validity of CVM. This article conducted comprehensive evaluation on non-use value of eco-tourism water resources in Sanjiang Plain by using payment card, single-bound dichotomous choice and double-bound dichotomous choice. Results showed that the socio-economic attributes were consistent with the willingness to pay in the three formats, and the tender value, age, educational level, annual income and the concern level had significant effect on the willingness to pay, while gender and job did not have significant influence. The WTP value was 112.46 yuan per capita with the payment card, 136.15 with the single-bound dichotomous choice, and 168.74 with the double-bound dichotomous choice. Comprehensive consideration of the nature of the investigation, investigation costs and statistical techniques, the result of double-bound dichotomous choice (47.86 x 10(8) yuan · a(-1)) was best in accordance with the reality, and could be used as non-use value of eco-tourism water resources in Sanjiang Plain. The format of questionnaire was very important to improve its validity, and made a great influence on the WTP.

A Lower Bound to the Probability of Choosing the Optimal Passing Score for a Mastery Test When There is an External Criterion [and] Estimating the Parameters of the Beta-Binomial Distribution.

ERIC Educational Resources Information Center

Wilcox, Rand R.

A mastery test is frequently described as follows: an examinee responds to n dichotomously scored test items. Depending upon the examinee's observed (number correct) score, a mastery decision is made and the examinee is advanced to the next level of instruction. Otherwise, a nonmastery decision is made and the examinee is given remedial work. This…

Prevalence of Imaging Biomarkers to Guide the Planning of Acute Stroke Reperfusion Trials.

PubMed

Jiang, Bin; Ball, Robyn L; Michel, Patrik; Jovin, Tudor; Desai, Manisha; Eskandari, Ashraf; Naqvi, Zack; Wintermark, Max

2017-06-01

Imaging biomarkers are increasingly used as selection criteria for stroke clinical trials. The goal of our study was to determine the prevalence of commonly studied imaging biomarkers in different time windows after acute ischemic stroke onset to better facilitate the design of stroke clinical trials using such biomarkers for patient selection. This retrospective study included 612 patients admitted with a clinical suspicion of acute ischemic stroke with symptom onset no more than 24 hours before completing baseline imaging. Patients with subacute/chronic/remote infarcts and hemorrhage were excluded from this study. Imaging biomarkers were extracted from baseline imaging, which included a noncontrast head computed tomography (CT), perfusion CT, and CT angiography. The prevalence of dichotomized versions of each of the imaging biomarkers in several time windows (time since symptom onset) was assessed and statistically modeled to assess time dependence (not lack thereof). We created tables showing the prevalence of the imaging biomarkers pertaining to the core, the penumbra and the arterial occlusion for different time windows. All continuous imaging features vary over time. The dichotomized imaging features that vary significantly over time include: noncontrast head computed tomography Alberta Stroke Program Early CT (ASPECT) score and dense artery sign, perfusion CT infarct volume, and CT angiography collateral score and visible clot. The dichotomized imaging features that did not vary significantly over time include the thresholded perfusion CT penumbra volumes. As part of the feasibility analysis in stroke clinical trials, this analysis and the resulting tables can help investigators determine sample size and the number needed to screen. © 2017 American Heart Association, Inc.

Dichotomous scoring of Trails B in patients referred for a dementia evaluation.

PubMed

Schmitt, Andrew L; Livingston, Ronald B; Smernoff, Eric N; Waits, Bethany L; Harris, James B; Davis, Kent M

2010-04-01

The Trail Making Test is a popular neuropsychological test and its interpretation has traditionally used time-based scores. This study examined an alternative approach to scoring that is simply based on the examinees' ability to complete the test. If an examinee is able to complete Trails B successfully, they are coded as "completers"; if not, they are coded as "noncompleters." To assess this approach to scoring Trails B, the performance of 97 diagnostically heterogeneous individuals referred for a dementia evaluation was examined. In this sample, 55 individuals successfully completed Trails B and 42 individuals were unable to complete it. Point-biserial correlations indicated a moderate-to-strong association (r(pb)=.73) between the Trails B completion variable and the Total Scale score of the Repeatable Battery for the Assessment of Neurological Status (RBANS), which was larger than the correlation between the Trails B time-based score and the RBANS Total Scale score (r(pb)=.60). As a screen for dementia status, Trails B completion showed a sensitivity of 69% and a specificity of 100% in this sample. These results suggest that dichotomous scoring of Trails B might provide a brief and clinically useful measure of dementia status.

Effect of age at onset on cortical thickness and cognition in posterior cortical atrophy.

PubMed

Suárez-González, Aida; Lehmann, Manja; Shakespeare, Timothy J; Yong, Keir X X; Paterson, Ross W; Slattery, Catherine F; Foulkes, Alexander J M; Rabinovici, Gil D; Gil-Néciga, Eulogio; Roldán-Lora, Florinda; Schott, Jonathan M; Fox, Nick C; Crutch, Sebastian J

2016-08-01

Age at onset (AAO) has been shown to influence the phenotype of Alzheimer's disease (AD), but how it affects atypical presentations of AD remains unknown. Posterior cortical atrophy (PCA) is the most common form of atypical AD. In this study, we aimed to investigate the effect of AAO on cortical thickness and cognitive function in 98 PCA patients. We used Freesurfer (v5.3.0) to compare cortical thickness with AAO both as a continuous variable, and by dichotomizing the groups based on median age (58 years). In both the continuous and dichotomized analyses, we found a pattern suggestive of thinner cortex in precuneus and parietal areas in earlier-onset PCA, and lower cortical thickness in anterior cingulate and prefrontal cortex in later-onset PCA. These cortical thickness differences between PCA subgroups were consistent with earlier-onset PCA patients performing worse on cognitive tests involving parietal functions. Our results provide a suggestion that AAO may not only affect the clinico-anatomical characteristics in AD but may also affect atrophy patterns and cognition within atypical AD phenotypes. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Parental perceived built environment measures and active play in Washington DC metropolitan children.

PubMed

Roberts, Jennifer D; Knight, Brandon; Ray, Rashawn; Saelens, Brian E

2016-06-01

Previous research identified associations between perceived built environment and adult physical activity; however, fewer studies have explored associations in children. The Built Environment and Active Play (BEAP) Study examined relationships between children's active play and parental perceptions of home neighborhood built environments within the Washington, DC metropolitan area (DMV). With this cross-sectional study, a questionnaire was administered in 2014 to parents of children (7-12 years old) residing in the DMV. Data were collected on children's active play, home built environment parental perceptions, and demographics. Active play response data were dichotomized by whether the child did or did not meet the 60-min/day Physical Activity Guidelines for Americans (PAGAs) recommendation. Perceived home neighborhood built environment data were also dichotomized. Chi-square tests determined differences in parental perceived built environment measures between active and non-active child groups. Logistic regression assessed the association of parental perceived built environment variables with active play while adjusting for demographic variables. The BEAP Study population (n = 144) included a uniquely diverse population of children with 23.7% African Americans and 10.4% Asian Americans. A statistically significant greater proportion of active children's parents agreed with the importance of neighborhood esthetics, active play areas, walkability and safety as compared to the parents of non-active children. Fully adjusted logistic regression models demonstrated that some parental perceived built environment measures (e.g. access to play equipment) were predictors of their children meeting the 60-min/day PAGA recommendation. Our findings support the important role of home neighborhood built environment perceptions on childhood active play.

Coarse particulate matter concentrations from residential outdoor sites associated with the North Carolina Asthma and Children's Environment Studies (NC-ACES)

NASA Astrophysics Data System (ADS)

Chen, Fu-Lin; Williams, Ronald; Svendsen, Erik; Yeatts, Karin; Creason, John; Scott, James; Terrell, Dock; Case, Martin

Coarse particulate matter (PM 10) concentration data from residential outdoor sites were collected using portable samplers as part of an exposure assessment for the North Carolina Asthma and Children's Environment Studies (NC-ACES). PM 10 values were estimated using the differential between independent PM 10 and PM 2.5 collocated MiniVol measurements. Repeated daily 24-h integrated PM 10 and PM 2.5 residential outdoor monitoring was performed at a total of 26 homes during September 2003-June 2004 in the Research Triangle Park, NC area. This effort resulted in the collection of 73 total daily measurements. This assessment was conducted to provide data needed to investigate the association of exposures to coarse particle PM mass concentrations with observed human health effects. Potential instrument bias between the differential MiniVol methodology and a dichotomous sampler were investigated. Results indicated that minimal bias of PM 10 mass concentration estimates (slope = 0.8, intercept =0.36μg m -3) existed between the dichotomous and differential MiniVol procedures. Residential outdoor PM 10 mass concentrations were observed to be highly variable across measurement days and ranged from 1.1 to 12.6μg m -3 (mean of 5.4μg m -3). An average correlation coefficient of r=0.75 existed between residential outdoor PM 10 mass concentrations and those obtained from the central ambient monitoring site. Temporal and spatial variability of PM 10 mass concentrations during the study were observed and are described in this report.

The image of health status and quality of life in a Caribbean society

PubMed Central

Bourne, Paul A.; McGrowder, Donovan A.; Charles, Christopher A.D.; Francis, Cynthia G.

2010-01-01

Background: Health is defined as the presence or absence of illness. This conceptualization of health status is dominant in health treatment and in fashioning the health care system. However, very little research has been done on how Jamaicans view health status and quality of life (QoL). Aims: This article seeks to understand how Jamaicans conceptualize health status and QoL because definitional content has implications for their health. Material and Methods: The current study utilized two national cross-sectional probability surveys from the Centre for Leadership and Governance (CLG) which looked at QoL among other variables and the Jamaican Survey of Living Conditions (JSLC) which measured living standards including health status. The sample in both surveys was 8,120 participants. Results: The majority of the respondents in the CLG (54%) and the JSLC (82.2%) surveys reported good health status. There was a strong statistical relationship between area of residence and health status (P < 0.0001) unlike the relationship between area of residence and quality of life (P < 0.137). The respondents dichotomized health status and QoL and a significant relationship was found between both variables (P < 0.0001). The respondents’ dichotomization of health status and QoL is explained by the significant relationship between health status and self reported illness (P < 0.0001) where respondents view health status as the absence or presence of illness, excluding QoL. Conclusion: Health status means the presence or absence of illness and excludes QoL which is not in keeping with previous findings. This distinction is culturally determined. PMID:22624140

Factors influencing the impact of oral health on the daily activities of adolescents, adults and older adults

PubMed Central

Bulgareli, Jaqueline Vilela; de Faria, Eduardo Tanajura; Cortellazzi, Karine Laura; Guerra, Luciane Miranda; Meneghim, Marcelo de Castro; Ambrosano, Glaucia Maria Bovi; Frias, Antonio Carlos; Pereira, Antonio Carlos

2018-01-01

ABSTRACT OBJECTIVE: Analyze if clinical, sociodemographic and access to dental services variables influence the impact of oral health on the daily activities of adolescents, adults and older adults. METHODS: A cross-sectional study with secondary data from the State Oral Health Survey (SB São Paulo 2015) conducted in 163 cities of São Paulo. A total of 17,560 individuals from three age groups: 15–19-year-old (n = 5,558), 35–44-year-old (n = 6,051), and older people of 65 years or more (n = 5,951) participated in the survey. The selection was made by probabilistic sample by conglomerates in two stages. The endpoint variable was the impact of oral health on daily activities, evaluated by the Oral Impacts on Daily Performances questionnaire, containing questions about eating, talking, oral hygiene, relaxation, sports practice, smile, study or work, social contact, and sleep. Oral Impacts on Daily Performances was dichotomized with and without impact. The independent variables were sociodemographic, clinical and access variables, divided into three blocks. A hierarchical multiple logistic regression analysis was performed considering the complex sampling plan of clusters. Each observation received a specific weight, depending on the location that resulted in weighted frequencies and adjusted for the design effect. RESULTS: The presence of oral health impact was observed in 27.9% of the individuals. In block 1, female gender and black/brown ethnic group had a greater chance of impact of oral health on quality of life, as well as the adults and the older adults in relation to adolescents. In block 2, family income up to R$1,500 was associated with the presence of impact. In block 3, individuals who reported toothache, used the public service and sought dental treatment had a greater chance of impact. CONCLUSIONS: Sociodemographic, clinical and access to health services variables influence the impact of oral health on the daily activities of adolescents, adults and older adults. PMID:29668813

The Association Between Commonly Investigated User Factors and Various Types of eHealth Use for Self-Care of Type 2 Diabetes: Case of First-Generation Immigrants From Pakistan in the Oslo Area, Norway

PubMed Central

Hammer, Hugo Lewi; Andreassen, Hege Kristin; Mirkovic, Jelena; Kjøllesdal, Marte Karoline Råberg

2017-01-01

Background Sociodemographic and health-related factors are often investigated for their association with the active use of electronic health (eHealth). The importance of such factors has been found to vary, depending on the purpose or means of eHealth and the target user groups. Pakistanis are one of the biggest immigrant groups in the Oslo area, Norway. Due to an especially high risk of developing type 2 diabetes (T2D) among this population, knowledge about their use of eHealth for T2D self-management and prevention (self-care) will be valuable for both understanding this vulnerable group and for developing effective eHealth services. Objective The aim of this study was to examine how commonly were the nine types of eHealth for T2D self-care being used among our target group, the first-generation Pakistani immigrants living in the Oslo area. The nine types of eHealth use are divided into three broad categories based on their purpose: information seeking, communication, and active self-care. We also aimed to investigate how sociodemographic factors, as well as self-assessment of health status and digital skills are associated with the use of eHealth in this group. Methods A survey was carried out in the form of individual structured interviews from September 2015 to January 2016 (N=176). For this study, dichotomous data about whether or not an informant had used each of the nine types of eHealth in the last 12 months and the total number of positive answers were used as dependent variables in a regression analysis. The independent variables were age, gender, total years of education, digital skills (represented by frequency of asking for help when using information and communication technology [ICT]), and self-assessment of health status. Principal component analyses were applied to make categories of independent variables to avoid multicollinearity. Results Principal component analysis yielded three components: knowledge, comprising total years of education and digital skills; health, comprising age and self-assessment of health status; and gender, as being a female. With the exception of closed conversation with a few specific acquaintances about self-care of T2D (negatively associated, P=.02) and the use of ICT for relevant information-seeking by using search engines (not associated, P=.18), the knowledge component was positively associated with all the other dependent variables. The health component was negatively associated with the use of ICT for closed conversation with a few specific acquaintances about self-care of T2D (P=.01) but not associated with the other dependent variables. Gender component showed no association with any of the dependent variables. Conclusions In our sample, knowledge, as a composite measure of education and digital skills, was found to be the main factor associated with eHealth use regarding T2D self-care. Enhancing digital skills would encourage and support more active use of eHealth for T2D self-care. PMID:28982646

Modern modelling techniques are data hungry: a simulation study for predicting dichotomous endpoints.

PubMed

van der Ploeg, Tjeerd; Austin, Peter C; Steyerberg, Ewout W

2014-12-22

Modern modelling techniques may potentially provide more accurate predictions of binary outcomes than classical techniques. We aimed to study the predictive performance of different modelling techniques in relation to the effective sample size ("data hungriness"). We performed simulation studies based on three clinical cohorts: 1282 patients with head and neck cancer (with 46.9% 5 year survival), 1731 patients with traumatic brain injury (22.3% 6 month mortality) and 3181 patients with minor head injury (7.6% with CT scan abnormalities). We compared three relatively modern modelling techniques: support vector machines (SVM), neural nets (NN), and random forests (RF) and two classical techniques: logistic regression (LR) and classification and regression trees (CART). We created three large artificial databases with 20 fold, 10 fold and 6 fold replication of subjects, where we generated dichotomous outcomes according to different underlying models. We applied each modelling technique to increasingly larger development parts (100 repetitions). The area under the ROC-curve (AUC) indicated the performance of each model in the development part and in an independent validation part. Data hungriness was defined by plateauing of AUC and small optimism (difference between the mean apparent AUC and the mean validated AUC <0.01). We found that a stable AUC was reached by LR at approximately 20 to 50 events per variable, followed by CART, SVM, NN and RF models. Optimism decreased with increasing sample sizes and the same ranking of techniques. The RF, SVM and NN models showed instability and a high optimism even with >200 events per variable. Modern modelling techniques such as SVM, NN and RF may need over 10 times as many events per variable to achieve a stable AUC and a small optimism than classical modelling techniques such as LR. This implies that such modern techniques should only be used in medical prediction problems if very large data sets are available.

Association of Indoxyl Sulfate with Heart Failure among Patients on Hemodialysis

PubMed Central

Cao, Xue-Sen; Chen, Jun; Zou, Jian-Zhou; Zhong, Yi-Hong; Teng, Jie; Ji, Jun; Chen, Zhang-Wei; Liu, Zhong-Hua; Shen, Bo; Nie, Yu-Xin; Lv, Wen-Lv; Xiang, Fang-Fang; Tan, Xiao

2015-01-01

Background and objectives Indoxyl sulfate, a protein-bound uremic toxin, may be associated with cardiovascular events and mortality in patients with CKD. This study aimed to investigate the relationship between indoxyl sulfate and heart failure in patients on hemodialysis. Design, setting, participants, & measurements Patients on hemodialysis for >6 months were enrolled within 6 months. Patients with congestive heart failure, angina pectoris, acute myocardial infarction, cerebral infarction, or cerebral hemorrhage within 3 months before the study or those <18 years old were excluded. The primary end point was first heart failure event during follow-up. Results In total, 258 patients (145 men) with a mean age of 57.0±14.6 years old were enrolled. Median plasma indoxyl sulfate level was used to categorize patients into two groups: the low-indoxyl sulfate group (indoxyl sulfate ≤32.35 μg/ml) and the high-indoxyl sulfate group (indoxyl sulfate >32.35 μg/ml). Then, patients were prospectively followed up for a median of 48.0 (interquartile range: 33.5–48.0) months. During follow-up, 68 patients experienced episodes of first heart failure. Kaplan–Meier analysis revealed the incidence of first heart failure event in the high–indoxyl sulfate group was significantly higher than in the low-indoxyl sulfate group (log rank P<0.001). Cox regression analysis showed indoxyl sulfate was significantly associated with first heart failure event (indoxyl sulfate as the continuous variable: hazard ratio, 1.02; 95% confidence interval [95% CI], 1.01 to 1.03; P=0.001; indoxyl sulfate as the dichotomous variable: hazard ratio, 3.49; 95% CI, 1.97 to 6.20; P<0.001). After adjustment for other confounding factors, the results remained significant (indoxyl sulfate as the continuous variable: hazard ratio, 1.04; 95% CI, 1.02 to 1.06; P<0.001; indoxyl sulfate as the dichotomous variable: hazard ratio, 5.31; 95% CI, 2.43 to 11.58; P<0.001). Conclusions Plasma indoxyl sulfate was associated with first heart failure event in patients on hemodialysis. Whether indoxyl sulfate is only a biomarker or involved in the pathogenesis of heart failure in hemodialysis warrants additional study. PMID:25332316

Strategic Orientation and Nursing Home Response to Public Reporting of Quality Measures: An Application of the Miles and Snow Typology

PubMed Central

Zinn, Jacqueline S; Spector, William D; Weimer, David L; Mukamel, Dana B

2008-01-01

Objective To assess whether differences in strategic orientation of nursing homes as identified by the Miles and Snow typology are associated with differences in their response to the publication of quality measures on the Nursing Home Compare website. Data Sources Administrator survey of a national 10 percent random sample (1,502 nursing homes) of all facilities included in the first publication of the Nursing Home Compare report conducted in May–June 2004; 724 responded, yielding a response rate of 48.2 percent. Study Design The dependent variables are dichotomous, indicating whether or not action was taken and the type of action taken. Four indicator variables were created for each of the four strategic types: Defender, Analyzer, Prospector, and Reactor. Other variables were included in the seven logistic regression models to control for factors other than strategic type that could influence nursing home response to public disclosure of their quality of care. Data Collection/Extraction Methods Survey data were merged with data on quality measures and organizational characteristics from the first report (November 2002). Principal Findings About 43 percent of surveyed administrators self-typed as Defenders, followed by Analyzers (33 percent), and Prospectors (19 percent). The least self-selected strategic type was the Reactor (6.6 percent). In general, results of the regression models indicate differences in response to quality measure publication by strategic type, with Prospectors and Analyzers more likely, and Reactors less likely, to respond than Defenders. Conclusions While almost a third of administrators took no action at all, our results indicate that whether, when, and how nursing homes reacted to publication of federally reported quality measures is associated with strategic orientation. PMID:18370969

Factors Affecting Adolescents' Involvement in Cyberbullying: What Divides the 20% from the 80%?

PubMed

Shin, Namin; Ahn, Hwasil

2015-07-01

Despite some variations among cyberbullying studies, about 20% of the youth population surveyed appears to be involved in cyberbullying. Coincidentally, the current study found that exactly 20% of the students surveyed were involved in cyberbullying as bullies (7.8%), victims (7.5%), and bully/victims (4.7%). What divides those 20% from the 80% of noninvolved students? This study aimed to produce a parsimonious and accurate model that can predict the occurrence of involvement in cyberbullying among youth. Data were collected from a questionnaire survey administered to 1,036 students enrolled in secondary schools in South Korea. Stepwise logistic regression (SLR) was carried out to predict the dichotomous dependent variable (involved/noninvolved) with 10 independent variables grouped into three categories: (a) demographic, (b) media-related, and (c) school and psychology factors. The result of the SLR analysis yielded a four-step model including the variables of cyber-confidence, weekday game time, mobile activities, and age as being significant in explaining the 20/80 division (model χ(2)=34.306, df=4, p<0.001, Nagelkerke R(2)=0.071). This finding suggests that younger students who spend more time playing games on weekdays while being more confident in cyberspace and active in using mobile phones are more likely to be involved in cyberbullying than other students. In particular, the construct of cyber-confidence calls for further elaboration and research, given its controversial function with respect to adolescents' involvement in cyberbullying. Also, this study may bring about insights into practical considerations needed for concerned researchers, teachers, and parents to identify who is inside the group involved in cyberbullying so as to help the participating adolescents escape from the circle of cyberbullying.

DICHOTOMOUS SAMPLER - A PRACTICAL APPROACH TO AEROSOL FRACTIONATION AND COLLECTION

EPA Science Inventory

Procedures to size fractionate, collect, and analyze ambient concentrations of particulate matter are described. Emphasis is placed on the design and characteristics of the single-stage dichotomous sampler. A new inlet is described that samples aerosol independent of wind speed a...

Fatigue and crashes: the case of freight transport in Colombia.

PubMed

Torregroza-Vargas, Nathaly M; Bocarejo, Juan Pablo; Ramos-Bonilla, Juan P

2014-11-01

Truck drivers have been involved in a significant number of road fatalities in Colombia. To identify variables that could be associated with crashes in which truck drivers are involved, a logistic regression model was constructed. The model had as the response variable a dichotomous variable that included the presence or absence of a crash during a specific trip. As independent variables the model included information regarding a driver's work shift, with variables that could be associated with driver's fatigue. The model also included potential confounders related with road conditions. With the model, it was possible to determine the odds ratio of a crash in relation to several variables, adjusting for confounding. To collect the information about the trips included in the model, a survey among truck drivers was conducted. The results suggest strong associations between crashes (i.e., some of them statistically significant) with the number of stops made during the trip, and the average time of each stop. Survey analysis allowed us to identify the practices that contribute to generating fatigue and unhealthy conditions on the road among professional drivers. A review of national regulations confirmed the lack of legislation on this topic. Copyright © 2014 Elsevier Ltd. All rights reserved.

Calibrating the Medical Council of Canada's Qualifying Examination Part I using an integrated item response theory framework: a comparison of models and designs.

PubMed

De Champlain, Andre F; Boulais, Andre-Philippe; Dallas, Andrew

2016-01-01

The aim of this research was to compare different methods of calibrating multiple choice question (MCQ) and clinical decision making (CDM) components for the Medical Council of Canada's Qualifying Examination Part I (MCCQEI) based on item response theory. Our data consisted of test results from 8,213 first time applicants to MCCQEI in spring and fall 2010 and 2011 test administrations. The data set contained several thousand multiple choice items and several hundred CDM cases. Four dichotomous calibrations were run using BILOG-MG 3.0. All 3 mixed item format (dichotomous MCQ responses and polytomous CDM case scores) calibrations were conducted using PARSCALE 4. The 2-PL model had identical numbers of items with chi-square values at or below a Type I error rate of 0.01 (83/3,499 or 0.02). In all 3 polytomous models, whether the MCQs were either anchored or concurrently run with the CDM cases, results suggest very poor fit. All IRT abilities estimated from dichotomous calibration designs correlated very highly with each other. IRT-based pass-fail rates were extremely similar, not only across calibration designs and methods, but also with regard to the actual reported decision to candidates. The largest difference noted in pass rates was 4.78%, which occurred between the mixed format concurrent 2-PL graded response model (pass rate= 80.43%) and the dichotomous anchored 1-PL calibrations (pass rate= 85.21%). Simpler calibration designs with dichotomized items should be implemented. The dichotomous calibrations provided better fit of the item response matrix than more complex, polytomous calibrations.

CORTISOL CORRELATES WITH SEVERITY OF ILLNESS AND POORLY REFLECTS ADRENAL FUNCTION IN PEDIATRIC ACUTE RESPIRATORY DISTRESS SYNDROME

PubMed Central

Yehya, Nadir; Vogiatzi, Maria G.; Thomas, Neal J.; Srinivasan, Vijay

2016-01-01

Objective To test the association between random cortisol and severity of illness in a “real-world” application of current guidelines. Study design We performed a secondary analysis of a prospective observational cohort of acute respiratory distress syndrome (ARDS). Children with ARDS and vasopressor-dependent shock were identified and random cortisol levels prior to potential hydrocortisone initiation recorded. The cohort was dichotomized to cortisol < 18 μg/dL and ≥ 18 μg/dL, and hydrocortisone use and outcomes compared. Results Of 357 children with ARDS, 155 (15 non-survivors, 10%) had vasopressors initiated with cortisol drawn prior to possible hydrocortisone use. Patients with cortisol < 18 μg/dL had lower severity of illness scores, fewer organ failures, and lower vasopressor scores (all rank-sum p < 0.05). No benefit was seen with hydrocortisone in either the entire cohort, or when dichotomized by a cortisol cutoff of 18 μg/dL. In patients with cortisol ≥ 18 μg/dL, hydrocortisone was associated with increased mortality after adjustment for either organ dysfunction or vasopressor score. Conclusions In children with ARDS with vasopressor-dependent shock, low cortisol correlated with lower severity of illness. Random cortisol was a poor method of diagnosing adrenal insufficiency, and a strategy of hydrocortisone replacement for cortisol < 18 μg/dL did not target a population likely to benefit from hydrocortisone. Future guidelines should reconsider using random cortisol levels alone for assessing adrenal function. PMID:27283464

Cortisol Correlates with Severity of Illness and Poorly Reflects Adrenal Function in Pediatric Acute Respiratory Distress Syndrome.

PubMed

Yehya, Nadir; Vogiatzi, Maria G; Thomas, Neal J; Srinivasan, Vijay

2016-10-01

To test the association between random cortisol and severity of illness in a "real-world" application of current guidelines. We performed a secondary analysis of a prospective observational cohort of acute respiratory distress syndrome (ARDS). Children with ARDS and vasopressor-dependent shock were identified and random cortisol levels before potential hydrocortisone initiation recorded. The cohort was dichotomized to cortisol < 18 and ≥ 18 μg/dL, and hydrocortisone use and outcomes compared. Of 357 children with ARDS, 155 (15 nonsurvivors; 10%) had vasopressors initiated with cortisol drawn before possible hydrocortisone use. Patients with cortisol < 18 μg/dL had lower severity of illness scores, fewer organ failures, and lower vasopressor scores (all rank-sum P < .05). No benefit was seen with hydrocortisone in either the entire cohort, or when dichotomized by a cortisol cutoff of 18 μg/dL. In patients with cortisol ≥ 18 μg/dL, hydrocortisone was associated with increased mortality after adjustment for either organ dysfunction or vasopressor score. In children with ARDS with vasopressor-dependent shock, low cortisol correlated with lower severity of illness. Random cortisol was a poor method of diagnosing adrenal insufficiency, and a strategy of hydrocortisone replacement for cortisol < 18 μg/dL did not target a population likely to benefit from hydrocortisone. Future guidelines should reconsider using random cortisol levels alone for assessing adrenal function. Copyright © 2016 Elsevier Inc. All rights reserved.

Model Selection Methods for Mixture Dichotomous IRT Models

ERIC Educational Resources Information Center

Li, Feiming; Cohen, Allan S.; Kim, Seock-Ho; Cho, Sun-Joo

2009-01-01

This study examines model selection indices for use with dichotomous mixture item response theory (IRT) models. Five indices are considered: Akaike's information coefficient (AIC), Bayesian information coefficient (BIC), deviance information coefficient (DIC), pseudo-Bayes factor (PsBF), and posterior predictive model checks (PPMC). The five…

Artworks as dichotomous objects: implications for the scientific study of aesthetic experience

PubMed Central

Pepperell, Robert

2015-01-01

This paper addresses an issue that has been studied from both scientific and art theoretical perspectives, namely the dichotomous nature of representational artworks. Representational artworks are dichotomous in that they present us with two distinct aspects at once. In one aspect we are aware of what is represented while in the other we are aware of the material from which the representation is composed. The dichotomy arises due the incompatibility, indeed contradiction, between these aspects of awareness, both of which must be present if we are to fully appreciate the artwork. Examples from art history are given to show how artists have exploited this dichotomy in a way that conditions our response to their work. I hypothesize that the degree of manifest dichotomy in a work determines the strength of its aesthetic effect, and propose this could be experimentally tested. I conclude that scientific studies of aesthetic experience should take the dichotomous nature of artworks into account. PMID:26106312

Context-dependent female mate choice maintains variation in male sexual activity

PubMed Central

Plath, Martin; Gismann, Jakob; Helfrich, Claudia; Bierbach, David

2017-01-01

The existence of individual variation in males' motivation to mate remains a conundrum as directional selection should favour high mating frequencies. Balancing selection resulting from (context-dependent) female mate choice could contribute to the maintenance of this behavioural polymorphism. In dichotomous choice tests, mosquitofish (Gambusia holbrooki) females preferred virtual males showing intermediate mating frequencies, reflecting females' tendencies to avoid harassment by highly sexually active males. When tested in the presence of a female shoal—which protects females from male harassment—focal females showed significantly stronger preferences for high sexual activity. A trade-off between (indirect) benefits and (direct) costs of mating with sexually active males probably explains context-dependent female mate choice, as costs depend on the social environment in which females choose their mates. No preference was observed when we tested virgin females, suggesting that the behavioural pattern described here is part of the learned behavioural repertoire of G. holbrooki females. PMID:28791157

Accounting for Local Dependence with the Rasch Model: The Paradox of Information Increase.

PubMed

Andrich, David

Test theories imply statistical, local independence. Where local independence is violated, models of modern test theory that account for it have been proposed. One violation of local independence occurs when the response to one item governs the response to a subsequent item. Expanding on a formulation of this kind of violation between two items in the dichotomous Rasch model, this paper derives three related implications. First, it formalises how the polytomous Rasch model for an item constituted by summing the scores of the dependent items absorbs the dependence in its threshold structure. Second, it shows that as a consequence the unit when the dependence is accounted for is not the same as if the items had no response dependence. Third, it explains the paradox, known, but not explained in the literature, that the greater the dependence of the constituent items the greater the apparent information in the constituted polytomous item when it should provide less information.

Dissolution of bovine pulp tissue in solutions consisting of varying NaOCl concentrations and combined with EDTA.

PubMed

Irala, Luis Eduardo Duarte; Grazziotin-Soares, Renata; Salles, Alexandre Azevedo; Munari, Aline Zen; Pereira, Joseani Santos

2010-01-01

This in vitro study evaluated (1) the dissolution of bovine pulp tissue in solutions consisting of varying NaOCl concentrations and combined with EDTA; and (2) the pH of these solutions before and after the experiment. The independent variables were the concentration and the volume of the solution. Thirty bovine pulps were divided in equal fragments, resulting in 90 fragments of pulp tissue. Each fragment was immersed in one of the following solutions: 1% NaOCl (4 ml), 2.5% NaOCl (4 ml), 1% NaOCl + 17% EDTA (2 ml : 2 ml), 1% NaOCl + 17% EDTA (1 ml : 3 ml), 2.5% NaOCl + 17% EDTA (2 ml : 2 ml), and 2.5% NaOCl + 17% EDTA (1 ml : 3 ml). The test solutions were dichotomized as either able or not able to dissolve the tissue, the latter being attributed when the dissolution of the pulp tissue was not complete within 48 hours. When the samples were able to dissolve the tissue, the time required for complete tissue dissolution was submitted to statistical analysis. The pH of the solutions was measured before and after the experiment. The pH variable was dichotomized as either changed or unchanged. The results demonstrated that the NaOCl solutions combined with 17% EDTA were not able to dissolve the tissue. The t-test revealed that the 2.5% NaOCl solution presented a lower mean dissolution time than the 1% NaOCl solution (p < 0.001). The pH of the solutions with equal volumes of NaOCl and EDTA decreased in 48 hours.

Association of Serum Vitamin D with the Risk of Incident Dementia and Subclinical Indices of Brain Aging: The Framingham Heart Study.

PubMed

Karakis, Ioannis; Pase, Matthew P; Beiser, Alexa; Booth, Sarah L; Jacques, Paul F; Rogers, Gail; DeCarli, Charles; Vasan, Ramachandran S; Wang, Thomas J; Himali, Jayandra J; Annweiler, Cedric; Seshadri, Sudha

2016-01-01

Identifying nutrition- and lifestyle-based risk factors for cognitive impairment and dementia may aid future primary prevention efforts. We aimed to examine the association of serum vitamin D levels with incident all-cause dementia, clinically characterized Alzheimer's disease (AD), MRI markers of brain aging, and neuropsychological function. Framingham Heart Study participants had baseline serum 25-hydroxyvitamin D (25(OH)D) concentrations measured between 1986 and 2001. Vitamin D status was considered both as a continuous variable and dichotomized as deficient (<10 ng/mL), or at the cohort-specific 20th and 80th percentiles. Vitamin D was related to the 9-year risk of incident dementia (n = 1663), multiple neuropsychological tests (n = 1291) and MRI markers of brain volume, white matter hyperintensities and silent cerebral infarcts (n = 1139). In adjusted models, participants with vitamin D deficiency (n = 104, 8% of the cognitive sample) displayed poorer performance on Trail Making B-A (β= -0.03 to -0.05±0.02) and the Hooper Visual Organization Test (β= -0.09 to -0.12±0.05), indicating poorer executive function, processing speed, and visuo-perceptual skills. These associations remained when vitamin D was examined as a continuous variable or dichotomized at the cohort specific 20th percentile. Vitamin D deficiency was also associated with lower hippocampal volumes (β= -0.01±0.01) but not total brain volume, white matter hyperintensities, or silent brain infarcts. No association was found between vitamin D deficiency and incident all-cause dementia or clinically characterized AD. In this large community-based sample, low 25(OH)D concentrations were associated with smaller hippocampal volume and poorer neuropsychological function.

Using Multidimensional Scaling To Assess the Dimensionality of Dichotomous Item Data.

ERIC Educational Resources Information Center

Meara, Kevin; Robin, Frederic; Sireci, Stephen G.

2000-01-01

Investigated the usefulness of multidimensional scaling (MDS) for assessing the dimensionality of dichotomous test data. Focused on two MDS proximity measures, one based on the PC statistic (T. Chen and M. Davidson, 1996) and other, on interitem Euclidean distances. Simulation results show that both MDS procedures correctly identify…

Recycled Insect Models

ERIC Educational Resources Information Center

Rule, Audrey C.; Meyer, Mary Ann

2007-01-01

This article presents an engaging activity in which high school students use a dichotomous key to guide the creation and classification of model insects from recycled plastic lids and containers. Besides teaching the use of a dichotomous key and the effect of evolutionary descent upon groupings of organisms, this activity focuses on an…

An Interactive Multimedia Dichotomous Key for Teaching Plant Identification

ERIC Educational Resources Information Center

Jacquemart, Anne-Laure; Lhoir, Pierre; Binard, Fabian; Descamps, Charlotte

2016-01-01

Teaching plant identification includes demonstrating how to use dichotomous keys; this requires knowledge of numerous botanical terms and can be challenging, confusing and frustrating for students. Here, we developed a multimedia tool to help students (1) learn botanical terms, (2) practice, train and test their knowledge of plant identification…

Order-Constrained Bayes Inference for Dichotomous Models of Unidimensional Nonparametric IRT

ERIC Educational Resources Information Center

Karabatsos, George; Sheu, Ching-Fan

2004-01-01

This study introduces an order-constrained Bayes inference framework useful for analyzing data containing dichotomous scored item responses, under the assumptions of either the monotone homogeneity model or the double monotonicity model of nonparametric item response theory (NIRT). The framework involves the implementation of Gibbs sampling to…

Predictors of student success in entry-level science courses

NASA Astrophysics Data System (ADS)

Singh, Mamta K.

Although the educational evaluation process is useful and valuable and is supported by the Higher Education Act, a strong research base for program evaluation of college entry-level science courses is still lacking. Studies in science disciplines such as, biology, chemistry, and physics have addressed various affective and demographic factors and their relationships to student achievement. However, the literature contains little information that specifically addresses student biology content knowledge skills (basics and higher order thinking skills) and identifies factors that affect students' success in entry-level college science courses. These gate-keeping courses require detailed evaluation if the goal of an institution is to increase students' performance and success in these courses. These factors are, in fact, a stepping stone for increasing the number of graduates in Science, Technology, Engineering, and Mathematics (STEM) majors. The present study measured students' biology content knowledge and investigated students' performance and success in college biology, chemistry, and physics entry-level courses. Seven variables---gender, ethnicity, high school Grade Point Average (GPA), high school science, college major, school financial aid support, and work hours were used as independent variables and course final performance as a dichotomous dependent variable. The sample comprised voluntary student participants in entry-level science courses. The study attempted to explore eight research questions. Content knowledge assessments, demographic information analysis, multiple regression analysis, and binary logistic regression analysis were used to address research questions. The results suggested that high school GPA was a consistently good predictor of students' performance and success in entry-level science courses. Additionally, high school chemistry was a significant predictor variable for student success in entry-level biology and chemistry courses. Similarly, students' performance and success in entry-level physics courses were influenced by high school physics. Finally, the study developed student success equation with high school GAP and high school chemistry as good predictors of students' success in entry-level science courses.

Design of a universal two-layered neural network derived from the PLI theory

NASA Astrophysics Data System (ADS)

Hu, Chia-Lun J.

2004-05-01

The if-and-only-if (IFF) condition that a set of M analog-to-digital vector-mapping relations can be learned by a one-layered-feed-forward neural network (OLNN) is that all the input analog vectors dichotomized by the i-th output bit must be positively, linearly independent, or PLI. If they are not PLI, then the OLNN just cannot learn no matter what learning rules is employed because the solution of the connection matrix does not exist mathematically. However, in this case, one can still design a parallel-cascaded, two-layered, perceptron (PCTLP) to acheive this general mapping goal. The design principle of this "universal" neural network is derived from the major mathematical properties of the PLI theory - changing the output bits of the dependent relations existing among the dichotomized input vectors to make the PLD relations PLI. Then with a vector concatenation technique, the required mapping can still be learned by this PCTLP system with very high efficiency. This paper will report in detail the mathematical derivation of the general design principle and the design procedures of the PCTLP neural network system. It then will be verified in general by a practical numerical example.

The Dichotomy in Degree Correlation of Biological Networks

PubMed Central

Hao, Dapeng; Li, Chuanxing

2011-01-01

Most complex networks from different areas such as biology, sociology or technology, show a correlation on node degree where the possibility of a link between two nodes depends on their connectivity. It is widely believed that complex networks are either disassortative (links between hubs are systematically suppressed) or assortative (links between hubs are enhanced). In this paper, we analyze a variety of biological networks and find that they generally show a dichotomous degree correlation. We find that many properties of biological networks can be explained by this dichotomy in degree correlation, including the neighborhood connectivity, the sickle-shaped clustering coefficient distribution and the modularity structure. This dichotomy distinguishes biological networks from real disassortative networks or assortative networks such as the Internet and social networks. We suggest that the modular structure of networks accounts for the dichotomy in degree correlation and vice versa, shedding light on the source of modularity in biological networks. We further show that a robust and well connected network necessitates the dichotomy of degree correlation, suggestive of an evolutionary motivation for its existence. Finally, we suggest that a dichotomous degree correlation favors a centrally connected modular network, by which the integrity of network and specificity of modules might be reconciled. PMID:22164269

[Clinical research IV. Relevancy of the statistical test chosen].

PubMed

Talavera, Juan O; Rivas-Ruiz, Rodolfo

2011-01-01

When we look at the difference between two therapies or the association of a risk factor or prognostic indicator with its outcome, we need to evaluate the accuracy of the result. This assessment is based on a judgment that uses information about the study design and statistical management of the information. This paper specifically mentions the relevance of the statistical test selected. Statistical tests are chosen mainly from two characteristics: the objective of the study and type of variables. The objective can be divided into three test groups: a) those in which you want to show differences between groups or inside a group before and after a maneuver, b) those that seek to show the relationship (correlation) between variables, and c) those that aim to predict an outcome. The types of variables are divided in two: quantitative (continuous and discontinuous) and qualitative (ordinal and dichotomous). For example, if we seek to demonstrate differences in age (quantitative variable) among patients with systemic lupus erythematosus (SLE) with and without neurological disease (two groups), the appropriate test is the "Student t test for independent samples." But if the comparison is about the frequency of females (binomial variable), then the appropriate statistical test is the χ(2).

Dimensionality Assessment for Dichotomously Scored Items Using Multidimensional Scaling.

ERIC Educational Resources Information Center

Jones, Patricia B.; And Others

In order to determine the effectiveness of multidimensional scaling (MDS) in recovering the dimensionality of a set of dichotomously-scored items, data were simulated in one, two, and three dimensions for a variety of correlations with the underlying latent trait. Similarity matrices were constructed from these data using three margin-sensitive…

The Asymptotic Distribution of Ability Estimates: Beyond Dichotomous Items and Unidimensional IRT Models

ERIC Educational Resources Information Center

Sinharay, Sandip

2015-01-01

The maximum likelihood estimate (MLE) of the ability parameter of an item response theory model with known item parameters was proved to be asymptotically normally distributed under a set of regularity conditions for tests involving dichotomous items and a unidimensional ability parameter (Klauer, 1990; Lord, 1983). This article first considers…

Firestar-"D": Computerized Adaptive Testing Simulation Program for Dichotomous Item Response Theory Models

ERIC Educational Resources Information Center

Choi, Seung W.; Podrabsky, Tracy; McKinney, Natalie

2012-01-01

Computerized adaptive testing (CAT) enables efficient and flexible measurement of latent constructs. The majority of educational and cognitive measurement constructs are based on dichotomous item response theory (IRT) models. An integral part of developing various components of a CAT system is conducting simulations using both known and empirical…

FIELD EVALUATION OF A HIGH-VOLUME DICHOTOMOUS SAMPLER

EPA Science Inventory

This study presents the field evaluation of a high-volume dichotomous sampler that collects coarse (PM10-2.5) and fine (PM2.5) particulate matter. The key feature of this device is the utilization of a round-nozzle virtual impactor with a 50% cutpoint at 2.5 5m to split PM10 into...

"If you have the flu symptoms, your asymptomatic spouse may better answer the willingness-to-pay question". Evidence from a double-bounded dichotomous choice model with heterogeneous anchoring.

PubMed

Schwarzinger, Michaël; Carrat, Fabrice; Luchini, Stéphane

2009-07-01

The small sample size of contingent valuation (CV) surveys conducted in patients may have limited the use of the single-bounded (SB) dichotomous choice format which is recommended in environmental economics. In this paper, we explore two ways to increase the statistical efficiency of the SB format: (1) by the inclusion of proxies in addition to patients; (2) by the addition of a follow-up dichotomous question, i.e. the double-bounded (DB) dichotomous choice format. We found that patients (n=223) and spouses (n=64) answering on behalf of the patient had on average a similar willingness-to-pay for earlier alleviation of flu symptoms. However, a patient was significantly more likely to anchor his/her answer on the first bid as compared to a spouse. Finally, our original DB model with shift effect and heterogeneous anchoring reconciled the discrepancies found in willingness-to-pay statistics between SB and DB models in keeping with increased statistical efficiency.

The Association Between Commonly Investigated User Factors and Various Types of eHealth Use for Self-Care of Type 2 Diabetes: Case of First-Generation Immigrants From Pakistan in the Oslo Area, Norway.

PubMed

Tatara, Naoe; Hammer, Hugo Lewi; Andreassen, Hege Kristin; Mirkovic, Jelena; Kjøllesdal, Marte Karoline Råberg

2017-10-05

Sociodemographic and health-related factors are often investigated for their association with the active use of electronic health (eHealth). The importance of such factors has been found to vary, depending on the purpose or means of eHealth and the target user groups. Pakistanis are one of the biggest immigrant groups in the Oslo area, Norway. Due to an especially high risk of developing type 2 diabetes (T2D) among this population, knowledge about their use of eHealth for T2D self-management and prevention (self-care) will be valuable for both understanding this vulnerable group and for developing effective eHealth services. The aim of this study was to examine how commonly were the nine types of eHealth for T2D self-care being used among our target group, the first-generation Pakistani immigrants living in the Oslo area. The nine types of eHealth use are divided into three broad categories based on their purpose: information seeking, communication, and active self-care. We also aimed to investigate how sociodemographic factors, as well as self-assessment of health status and digital skills are associated with the use of eHealth in this group. A survey was carried out in the form of individual structured interviews from September 2015 to January 2016 (N=176). For this study, dichotomous data about whether or not an informant had used each of the nine types of eHealth in the last 12 months and the total number of positive answers were used as dependent variables in a regression analysis. The independent variables were age, gender, total years of education, digital skills (represented by frequency of asking for help when using information and communication technology [ICT]), and self-assessment of health status. Principal component analyses were applied to make categories of independent variables to avoid multicollinearity. Principal component analysis yielded three components: knowledge, comprising total years of education and digital skills; health, comprising age and self-assessment of health status; and gender, as being a female. With the exception of closed conversation with a few specific acquaintances about self-care of T2D (negatively associated, P=.02) and the use of ICT for relevant information-seeking by using search engines (not associated, P=.18), the knowledge component was positively associated with all the other dependent variables. The health component was negatively associated with the use of ICT for closed conversation with a few specific acquaintances about self-care of T2D (P=.01) but not associated with the other dependent variables. Gender component showed no association with any of the dependent variables. In our sample, knowledge, as a composite measure of education and digital skills, was found to be the main factor associated with eHealth use regarding T2D self-care. Enhancing digital skills would encourage and support more active use of eHealth for T2D self-care. ©Naoe Tatara, Hugo Lewi Hammer, Hege Kristin Andreassen, Jelena Mirkovic, Marte Karoline Råberg Kjøllesdal. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 05.10.2017.

[Assessment of stress in childhood: Children's Daily Stress Inventory (Inventario Infantil de Estresores Cotidiano, IIEC)].

PubMed

Trianes Torres, María Victoria; Blanca Mena, María José; Fernández Baena, Francisco J; Escobar Espejo, Milagros; Maldonado Montero, Enrique F; Muñoz Sánchez, Angela María

2009-11-01

The present study introduces the Children's Daily Stress Inventory (Inventario Infantil de Estresores Cotidianos, IIEC) as a measure that assesses daily stress in primary school children. The inventory was applied to a sample of 1094 primary school students. The final version includes 25 dichotomic items covering the areas of health, school/peers, and family. The score is obtained by adding the total of positive answers. Analyses of items, reliability and several external pieces of evidence of validity based on relations with other variables are presented. The results show adequate psychometric properties for the assessment of daily stress in children.

The Association between Insurance Status and Acceptance of Chlamydia Screening By Teenagers Who Present for Preventive Care Visits.

PubMed

Playforth, Krupa B; Coughlan, Alexandria; Upadhya, Krishna K

2016-02-01

The purpose of this study was to evaluate whether providers offer chlamydia screening to teenagers and/or whether screening is accepted at different rates depending on insurance type. Retrospective chart review. Academic center serving urban and suburban patients between April 2009 and October 2011. Nine hundred eighty-three health maintenance visits for asymptomatic, insured female adolescents aged 15-19 years. None. Dichotomous dependent variables of interest indicated whether chlamydia screening was: (1) offered; and (2) accepted. The key independent variable insurance type was coded as 'public' if Medicaid or Medicaid Managed Care and 'private' if a commercial plan. χ(2) and logistic regression analyses were used to assess the significance of differences in screening rates according to insurance type. Of asymptomatic health-maintenance visits 933 (95%) had a documented sexual history and 339 (34%) had a documented history of sexual activity. After excluding those who had a documented chlamydia screen in the 12 months before the visit (n = 79; 23%), 260 visits met eligibility for chlamydia screening. Only 169 (65%) of eligible visits had chlamydia screening offered and there was no difference in offer of screening according to insurance type. Significantly more visits covered by public insurance had chlamydia screening accepted (98%) than those covered by private insurance (82%). Controlling for demographic factors, the odds of accepted chlamydia screening was 8 times higher in visits covered by public insurance than those with private insurance. Although publically and privately insured teens were equally likely to be offered chlamydia screening, publically insured teens were significantly more likely to accept screening. Future research should investigate reasons for this difference in screening acceptance. These findings have implications for interventions to improve chlamydia screening because more adolescents are covered by parental insurance under the Affordable Care Act. Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Source apportionment of speciated PM2.5 and non-parametric regressions of PM2.5 and PM(coarse) mass concentrations from Denver and Greeley, Colorado, and construction and evaluation of dichotomous filter samplers

NASA Astrophysics Data System (ADS)

Piedrahita, Ricardo A.

The Denver Aerosol Sources and Health study (DASH) was a long-term study of the relationship between the variability in fine particulate mass and chemical constituents (PM2.5, particulate matter less than 2.5mum) and adverse health effects such as cardio-respiratory illnesses and mortality. Daily filter samples were chemically analyzed for multiple species. We present findings based on 2.8 years of DASH data, from 2003 to 2005. Multilinear Engine 2 (ME-2), a receptor-based source apportionment model was applied to the data to estimate source contributions to PM2.5 mass concentrations. This study relied on two different ME-2 models: (1) a 2-way model that closely reflects PMF-2; and (2) an enhanced model with meteorological data that used additional temporal and meteorological factors. The Coarse Rural Urban Sources and Health study (CRUSH) is a long-term study of the relationship between the variability in coarse particulate mass (PMcoarse, particulate matter between 2.5 and 10mum) and adverse health effects such as cardio-respiratory illnesses, pre-term births, and mortality. Hourly mass concentrations of PMcoarse and fine particulate matter (PM2.5) are measured using tapered element oscillating microbalances (TEOMs) with Filter Dynamics Measurement Systems (FDMS), at two rural and two urban sites. We present findings based on nine months of mass concentration data, including temporal trends, and non-parametric regressions (NPR) results, which were used to characterize the wind speed and wind direction relationships that might point to sources. As part of CRUSH, 1-year coarse and fine mode particulate matter filter sampling network, will allow us to characterize the chemical composition of the particulate matter collected and perform spatial comparisons. This work describes the construction and validation testing of four dichotomous filter samplers for this purpose. The use of dichotomous splitters with an approximate 2.5mum cut point, coupled with a 10mum cut diameter inlet head allows us to collect the separated size fractions that the collocated TEOMs collect continuously. Chemical analysis of the filters will include inorganic ions, organic compounds, EC, OC, and biological analyses. Side by side testing showed the cut diameters were in agreement with each other, and with a well characterized virtual impactor lent to the group by the University of Southern California. Error propagation was performed and uncertainty results were similar to the observed standard deviations.

Psychosocial job strain and sleep quality interaction leading to insufficient recovery.

PubMed

Rydstedt, Leif W; Devereux, Jason J

2013-11-05

The purpose of the study was to assess the impact of job strain and sleep quality on the diurnal pattern of cortisol reactivity, measured by awakening and evening (10 PM) saliva cortisol. The sample consisted of 76 British white-collar workers (24 women, 52 men; mean age 45.8 years). Sleep quality and job strain were assessed in a survey distributed just before the cortisol sampling. Both input variables were dichotomized about the median and factorial ANOVA was used for the statistical analysis. Low sleep quality was significantly associated with lower morning cortisol secretion. While job strain had no main effects on the cortisol reactivity there was a significant interaction effect between the input variables on morning cortisol secretion. These findings tentatively support the hypothesis that lack of sleep for workers with high job strain may result in a flattened diurnal cortisol reactivity.

Psychosocial Job Strain and Sleep Quality Interaction Leading to Insufficient Recovery

PubMed Central

Rydstedt, Leif W.; Devereux, Jason J.

2013-01-01

The purpose of the study was to assess the impact of job strain and sleep quality on the diurnal pattern of cortisol reactivity, measured by awakening and evening (10 PM) saliva cortisol. The sample consisted of 76 British white-collar workers (24 women, 52 men; mean age 45.8 years). Sleep quality and job strain were assessed in a survey distributed just before the cortisol sampling. Both input variables were dichotomized about the median and factorial ANOVA was used for the statistical analysis. Low sleep quality was significantly associated with lower morning cortisol secretion. While job strain had no main effects on the cortisol reactivity there was a significant interaction effect between the input variables on morning cortisol secretion. These findings tentatively support the hypothesis that lack of sleep for workers with high job strain may result in a flattened diurnal cortisol reactivity. PMID:24196305

Dichotomous Identification Keys: A Ladder to Higher Order Knowledge about the Human Body

ERIC Educational Resources Information Center

Sorgo, Andrej

2006-01-01

We tried to enrich teaching human anatomy in high school biology lessons. Students construct dichotomous identification keys to the cells, tissues, organs, or body parts. By doing this, students have achieved higher-order cognitive levels of knowledge because construction of such keys is based on analysis, synthesis, and evaluation. Students found…

Elucidating Article 45.6 of the International Code of Zoological Nomenclature: A dichotomous key for the determination of subspecific or infrasubspecific rank

USDA-ARS?s Scientific Manuscript database

We present an overview of the difficulties sometimes encountered when determining whether a published name following a binomen is available or infrasubspecific and unavailable, following Article 45.6 of the International Code of Zoological Nomenclature (ICZN, 1999). We propose a dichotomous key that...

Use of dichotomous choice nonmarket methods to value the whooping crane resource

Treesearch

J. Michael Bowker; John R. Stoll

1985-01-01

A dichotomous choice form of contingent valuation is applied to quantify individuals' economic surplus associated with preservation of the whooping crane resource. Specific issues and limitations of the empirical approach are discussed. The results of this case study reveal that models with similar statistical fits can lead to very disparate measures of economic...

Comparing and Combining Dichotomous and Polytomous Items with SPRT Procedure in Computerized Classification Testing.

ERIC Educational Resources Information Center

Lau, C. Allen; Wang, Tianyou

The purposes of this study were to: (1) extend the sequential probability ratio testing (SPRT) procedure to polytomous item response theory (IRT) models in computerized classification testing (CCT); (2) compare polytomous items with dichotomous items using the SPRT procedure for their accuracy and efficiency; (3) study a direct approach in…

Harry Potter and the Dichotomous Key

ERIC Educational Resources Information Center

Crowther, David T.

2003-01-01

In this lesson, students use Bertie Bott's Every Flavor Beans--a "wild" candy written about in the Harry Potter books and now available in stores--to learn about classification and dichotomous keys. In these activities, students sort jelly beans according to a key and then construct a key for a "new" flavor of beans. Students then build on their…

It's My Way or the Highway: Academic Success and Social Mobility in Dangerous Minds and Boston Public

ERIC Educational Resources Information Center

Freedman, Debra; Easley, Ii, Jacob

2004-01-01

In this paper we explore dichotomies that exist between/within/through the (re)presentations of students and teachers found in the television shows Dangerous Minds and Boston Public . These dichotomized relationships engender a school culture organized by and through either/or conditions. More specifically, these dichotomized relationships force…

DEVELOPMENT AND EVALUATION OF A HIGH-VOLUME DICHOTOMOUS SAMPLER FOR CHEMICAL SPECIATION OF COARSE AND FINE PARTICLES

EPA Science Inventory

This paper describes the development and field evaluation of a compact high-volume dichotomous sampler (HVDS) that collects coarse (PM_10-2.5) and fine (PM_2.5) particulate matter. In its primary configuration as tested, the sampler size-fractionates PM10 into...

MIXOR: a computer program for mixed-effects ordinal regression analysis.

PubMed

Hedeker, D; Gibbons, R D

1996-03-01

MIXOR provides maximum marginal likelihood estimates for mixed-effects ordinal probit, logistic, and complementary log-log regression models. These models can be used for analysis of dichotomous and ordinal outcomes from either a clustered or longitudinal design. For clustered data, the mixed-effects model assumes that data within clusters are dependent. The degree of dependency is jointly estimated with the usual model parameters, thus adjusting for dependence resulting from clustering of the data. Similarly, for longitudinal data, the mixed-effects approach can allow for individual-varying intercepts and slopes across time, and can estimate the degree to which these time-related effects vary in the population of individuals. MIXOR uses marginal maximum likelihood estimation, utilizing a Fisher-scoring solution. For the scoring solution, the Cholesky factor of the random-effects variance-covariance matrix is estimated, along with the effects of model covariates. Examples illustrating usage and features of MIXOR are provided.

Trends in ADL and IADL Disability in Community-Dwelling Older Adults in Shanghai, China, 1998–2008

PubMed Central

2013-01-01

Objectives. We investigated trends in activities of daily living (ADL) and instrumental activities of daily living (IADL) disability from 1998 to 2008 among elder adults in Shanghai, China. Method. Our data came from 4 waves of the Shanghai Longitudinal Survey of Elderly Life and Opinion (1998, 2003, 2005, and 2008). ADL and IADL disabilities were recorded dichotomously (difficulty vs. no difficulty). The major independent variable was survey year. Covariates included demographics, socioeconomic conditions, family and social support, and other health conditions. Nested random-effect models were applied to estimate trends over time, referenced to 1998. Results. In comparison with the baseline year (1998), older adults in 2008 had lower odds of being ADL disabled, though the effect was no longer statistically significant when other health conditions were taken into account. Elders in 2003, 2005, and 2008 were 20%–26%, 17%–38%, and 53%–64% less likely to be IADL disabled than those in 1998, respectively, depending on the set of covariates included in the model. Discussion. Shanghai elders experienced substantial improvements in both ADL and IADL disability prevalence over the past decade. The trend toward improvement in IADL function is more consistent and substantial than that of ADL function. PMID:23525547

The Association Between Residential Care Facility Manager's Educational Attainment and the Presence of Structural and Service Innovations.

PubMed

Davis, Jullet A

For many service-oriented firms, knowledge is a key commodity, and the process by which knowledge is codified is critical for firm survival. The administrator or top manager acts as the repository and disseminator of organizational knowledge. The purpose of this project is to examine the association between the administrator's educational attainment and innovation in residential care facilities. The study hypothesized that administrator academic education and certification or licensure would be positively associated with facility innovation. Data for this project comes from the 2010 National Survey of Residential Care Facilities. There were 2277 facilities included in the sample (weighted 30 811). Innovation, the dependent variable, was operationalized using 5 dichotomized measures: clinical information systems, pharmaceutical information systems, electronic health records, providing adult day care, and providing respite care. The data were analyzed using logistic regression. Overall, the results reveal that college education or certification/licensure increased the likelihood of technology use. In addition, those with a high school diploma and certification/licensure were more likely to use technology than were individuals who had, at a minimum, some college. The services models were not significant. It may be that the resources necessary to implement information systems vary substantially from the resources necessary to provide services.

Predictors of the Perception of Smoking Health Risks in Smokers With or Without Schizophrenia.

PubMed

Kowalczyk, William J; Wehring, Heidi J; Burton, George; Raley, Heather; Feldman, Stephanie; Heishman, Stephen J; Kelly, Deanna L

2017-01-01

This study sought to examine the predictors of health risk perception in smokers with or without schizophrenia. The health risk subscale from the Smoking Consequences Questionnaire was dichotomized and used to measure health risk perception in smokers with (n = 67) and without schizophrenia (n = 100). A backward stepwise logistic regression was conducted using variables associated at the bivariate level to determine multivariate predictors. Overall, 62.5% of smokers without schizophrenia and 40.3% of smokers with schizophrenia completely recognize the health risks of smoking (p ≤ .01). Multivariate predictors for smokers without schizophrenia included: sex (Exp (B) = .3; p < .05), Smoking Consequences Questionnaire state enhancement (Exp (B) = .69; p < .01), and craving relief (Exp (B) = 1.8; p < .01). Among smokers with schizophrenia, predictors were education (Exp (B) = .7; p < .05), nicotine dependence (Exp (B) = .5; p < .01), motivation to quit (Exp (B) = 1.8; p < .01), and Smoking Consequences Questionnaire craving relief (Exp (B) = 1.8; p < .01). There was overlap and differences between predictors in smokers with and without schizophrenia. Commonly used techniques for education on the health consequences of cigarettes may work in smokers with schizophrenia, but intervention efforts specifically tailored to smokers with schizophrenia might be more efficacious.

Predictors of the Perception of Smoking Health Risks in Smokers With or Without Schizophrenia

PubMed Central

Kowalczyk, William J.; Wehring, Heidi J.; Burton, George; Raley, Heather; Feldman, Stephanie; Heishman, Stephen J.; Kelly, Deanna L.

2017-01-01

Objective This study sought to examine the predictors of health risk perception in smokers with or without schizophrenia. Methods The health risk subscale from the Smoking Consequences Questionnaire was dichotomized and used to measure health risk perception in smokers with (n = 67) and without schizophrenia (n = 100). A backward stepwise logistic regression was conducted using variables associated at the bivariate level to determine multivariate predictors. Results Overall, 62.5% of smokers without schizophrenia and 40.3% of smokers with schizophrenia completely recognize the health risks of smoking (p ≤ .01). Multivariate predictors for smokers without schizophrenia included: sex (Exp (B) = .3; p < .05), Smoking Consequences Questionnaire state enhancement (Exp (B) = .69; p < .01), and craving relief (Exp (B) = 1.8; p < .01). Among smokers with schizophrenia, predictors were education (Exp (B) = .7; p < .05), nicotine dependence (Exp (B) = .5; p < .01), motivation to quit (Exp (B) = 1.8; p < .01), and Smoking Consequences Questionnaire craving relief (Exp (B) = 1.8; p < .01). Conclusions There was overlap and differences between predictors in smokers with and without schizophrenia. Commonly used techniques for education on the health consequences of cigarettes may work in smokers with schizophrenia, but intervention efforts specifically tailored to smokers with schizophrenia might be more efficacious. PMID:27858591

The Mantel-Haenszel procedure revisited: models and generalizations.

PubMed

Fidler, Vaclav; Nagelkerke, Nico

2013-01-01

Several statistical methods have been developed for adjusting the Odds Ratio of the relation between two dichotomous variables X and Y for some confounders Z. With the exception of the Mantel-Haenszel method, commonly used methods, notably binary logistic regression, are not symmetrical in X and Y. The classical Mantel-Haenszel method however only works for confounders with a limited number of discrete strata, which limits its utility, and appears to have no basis in statistical models. Here we revisit the Mantel-Haenszel method and propose an extension to continuous and vector valued Z. The idea is to replace the observed cell entries in strata of the Mantel-Haenszel procedure by subject specific classification probabilities for the four possible values of (X,Y) predicted by a suitable statistical model. For situations where X and Y can be treated symmetrically we propose and explore the multinomial logistic model. Under the homogeneity hypothesis, which states that the odds ratio does not depend on Z, the logarithm of the odds ratio estimator can be expressed as a simple linear combination of three parameters of this model. Methods for testing the homogeneity hypothesis are proposed. The relationship between this method and binary logistic regression is explored. A numerical example using survey data is presented.

The Mantel-Haenszel Procedure Revisited: Models and Generalizations

PubMed Central

Fidler, Vaclav; Nagelkerke, Nico

2013-01-01

Several statistical methods have been developed for adjusting the Odds Ratio of the relation between two dichotomous variables X and Y for some confounders Z. With the exception of the Mantel-Haenszel method, commonly used methods, notably binary logistic regression, are not symmetrical in X and Y. The classical Mantel-Haenszel method however only works for confounders with a limited number of discrete strata, which limits its utility, and appears to have no basis in statistical models. Here we revisit the Mantel-Haenszel method and propose an extension to continuous and vector valued Z. The idea is to replace the observed cell entries in strata of the Mantel-Haenszel procedure by subject specific classification probabilities for the four possible values of (X,Y) predicted by a suitable statistical model. For situations where X and Y can be treated symmetrically we propose and explore the multinomial logistic model. Under the homogeneity hypothesis, which states that the odds ratio does not depend on Z, the logarithm of the odds ratio estimator can be expressed as a simple linear combination of three parameters of this model. Methods for testing the homogeneity hypothesis are proposed. The relationship between this method and binary logistic regression is explored. A numerical example using survey data is presented. PMID:23516463

Effectiveness of the Epley’s maneuver performed in primary care to treat posterior canal benign paroxysmal positional vertigo: study protocol for a randomized controlled trial

PubMed Central

2014-01-01

Background Vertigo is a common medical condition with a broad spectrum of diagnoses which requires an integrated approach to patients through a structured clinical interview and physical examination. The main cause of vertigo in primary care is benign paroxysmal positional vertigo (BPPV), which should be confirmed by a positive D-H positional test and treated with repositioning maneuvers. The objective of this study is to evaluate the effectiveness of Epley’s maneuver performed by general practitioners (GPs) in the treatment of BPPV. Methods/Design This study is a randomized clinical trial conducted in the primary care setting. The study’s scope will include two urban primary care centers which provide care for approximately 49,400 patients. All patients attending these two primary care centers, who are newly diagnosed with benign paroxysmal positional vertigo, will be invited to participate in the study and will be randomly assigned either to the treatment group (Epley’s maneuver) or to the control group (a sham maneuver). Both groups will receive betahistine. Outcome variables will be: response to the D-H test, patients’ report on presence or absence of vertigo during the previous week (dichotomous variable: yes/no), intensity of vertigo symptoms on a Likert-type scale in the previous week, total score on the Dizziness Handicap Inventory (DHI) and quantity of betahistine taken. We will use descriptive statistics of all variables collected. Groups will be compared using the intent-to-treat approach and either parametric or nonparametric tests, depending on the nature and distribution of the variables. Chi-square test or Fisher’s exact test will be conducted to compare categorical measures and Student’s t-test or Mann–Whitney U-test will be used for intergroup comparison variables. Discussion Positive results from our study will highlight that treatment of benign paroxysmal positional vertigo can be performed by trained general practitioners (GPs) and, therefore, its widespread practice may contribute to improve the quality of life of BPPV patients. Trial registration ClinicalTrials.gov Identifier: NCT01969513. PMID:24886338

Development of a severity score for CRPS.

PubMed

Harden, R Norman; Bruehl, Stephen; Perez, Roberto S G M; Birklein, Frank; Marinus, Johan; Maihofner, Christian; Lubenow, Timothy; Buvanendran, Asokumar; Mackey, Sean; Graciosa, Joseph; Mogilevski, Mila; Ramsden, Christopher; Schlereth, Tanja; Chont, Melissa; Vatine, Jean-Jacques

2010-12-01

The clinical diagnosis of Complex Regional Pain Syndrome (CRPS) is a dichotomous (yes/no) categorization necessary for clinical decision-making. However, such dichotomous diagnostic categories do not convey an individual's subtle and temporal gradations in severity of the condition, and have poor statistical power when used as an outcome measure in research. This study evaluated the validity and potential utility of a continuous type score to index severity of CRPS. Psychometric and medical evaluations were conducted in 114 CRPS patients and 41 non-CRPS neuropathic pain patients. Based on the presence/absence of 17 clinically-assessed signs and symptoms of CRPS, an overall CRPS Severity Score (CSS) was derived. The CSS discriminated well between CRPS and non-CRPS patients (p<.001), and displayed strong associations with dichotomous CRPS diagnoses using both IASP diagnostic criteria (Eta=0.69) and proposed revised criteria (Eta=0.77-0.88). Higher CSS was associated with significantly higher clinical pain intensity, distress, and functional impairments, as well as greater bilateral temperature asymmetry and thermal perception abnormalities (p's<.05). In an archival prospective dataset, increases in anxiety and depression from pre-surgical baseline to 4 weeks post-knee arthroplasty were found to predict significantly higher CSS at 6- and 12-month follow-up (p's<.05). Results indicate the CSS corresponds with and complements currently accepted dichotomous diagnostic criteria for CRPS, and support its validity as an index of CRPS severity. Its utility as an outcome measure in research studies is also suggested, with potential statistical advantages over dichotomous diagnostic criteria. Copyright © 2010. Published by Elsevier B.V.

The Role of Personal Best (PB) and Dichotomous Achievement Goals in Students' Academic Motivation and Engagement: A Longitudinal Investigation

ERIC Educational Resources Information Center

Martin, Andrew J.; Elliot, Andrew J.

2016-01-01

This study assessed the role of prior personal best goals in predicting subsequent academic motivation and engagement. A total of 1160 high school students participated in a longitudinal survey study exploring the extent to which personal best and mastery and performance (dichotomous) achievement goals predict students' academic motivation and…

Measuring the difference in mean willingness to pay when dichotomous choice contingent valuation responses are not independent

Treesearch

Gregory L. Poe; Michael P. Welsh; Patricia A. Champ

1997-01-01

Dichotomous choice contingent valuation surveys frequently elicit multiple values in a single questionnaire. If individual responses are correlated across scenarios, the standard approach of estimating willingness to pay (WTP) functions independently for each scenario may result in biased estimates of the significance of the difference in mean WTP values. This paper...

Bryophytes for Beginners: The Usability of a Printed Dichotomous Key versus a Multi-Access Computer-Based Key for Bryophyte Identification

ERIC Educational Resources Information Center

Stagg, Bethan C.; Donkin, Maria E.; Smith, Alison M.

2015-01-01

Bryophytes are a rewarding study group in field biology and the UK bryophyte flora has international importance to biodiversity conservation. We designed an identification key to common woodland moss species and compared the usability of two formats, web-based multi-access and printed dichotomous key, with undergraduate students. The rate of…

A Dichotomous Key for the Identification of Common British Wild Flower Families

ERIC Educational Resources Information Center

Wood, Piers

2004-01-01

This article argues the need for, and provides, a dichotomous single access key for the identification of common British wild flower families. A minimum of technical vocabulary is used while at the same time retaining most of the recent botanical names of families. The key provides a user-friendly opportunity for school pupils to become familiar…

Multi-Population Invariance with Dichotomous Measures: Combining Multi-Group and MIMIC Methodologies in Evaluating the General Aptitude Test in the Arabic Language

ERIC Educational Resources Information Center

Sideridis, Georgios D.; Tsaousis, Ioannis; Al-harbi, Khaleel A.

2015-01-01

The purpose of the present study was to extend the model of measurement invariance by simultaneously estimating invariance across multiple populations in the dichotomous instrument case using multi-group confirmatory factor analytic and multiple indicator multiple causes (MIMIC) methodologies. Using the Arabic version of the General Aptitude Test…

The Assessment of Reliability Under Range Restriction: A Comparison of [Alpha], [Omega], and Test-Retest Reliability for Dichotomous Data

ERIC Educational Resources Information Center

Fife, Dustin A.; Mendoza, Jorge L.; Terry, Robert

2012-01-01

Though much research and attention has been directed at assessing the correlation coefficient under range restriction, the assessment of reliability under range restriction has been largely ignored. This article uses item response theory to simulate dichotomous item-level data to assess the robustness of KR-20 ([alpha]), [omega], and test-retest…

Comparing Vertical Scales Derived from Dichotomous and Polytomous IRT Models for a Test Composed of Testlets.

ERIC Educational Resources Information Center

Bishop, N. Scott; Omar, Md Hafidz

Previous research has shown that testlet structures often violate important assumptions of dichotomous item response theory (D-IRT) models, applied to item-level scores, that can in turn affect the results of many measurement applications. In this situation, polytomous IRT (P-IRT) models, applied to testlet-level scores, have been used as an…

A Dichotomous Key to Tree Cones and Fruits of the Eastern United States.

ERIC Educational Resources Information Center

Collins, Linda T.

1991-01-01

The author presents a dichotomous key to 29 tree cones, fruits, and nuts of eastern United States. Students can use the key to identify at least 10 species in a 1-hour laboratory assignment. This key uses reproductive structures that are significantly different from others. These structures are durable enough to be used in the laboratory for many…

Graded Response Model Based on the Logistic Positive Exponent Family of Models for Dichotomous Responses

ERIC Educational Resources Information Center

Samejima, Fumiko

2008-01-01

Samejima ("Psychometrika "65:319--335, 2000) proposed the logistic positive exponent family of models (LPEF) for dichotomous responses in the unidimensional latent space. The objective of the present paper is to propose and discuss a graded response model that is expanded from the LPEF, in the context of item response theory (IRT). This…

Sociodemographic, lifestyle, and psychosocial determinants of hair cortisol in a South London community sample.

PubMed

Fischer, Susanne; Duncko, Roman; Hatch, Stephani L; Papadopoulos, Andrew; Goodwin, Laura; Frissa, Souci; Hotopf, Matthew; Cleare, Anthony J

2017-02-01

Hypothalamic-pituitary-adrenal (HPA) measures are crucial for research into stress and stress-related disorders. Most HPA measures fluctuate depending on diurnal rhythms and state confounders. Hair cortisol concentrations (HCC) are less susceptible to such fluctuations, but less is known about trait-like confounders. Using a community sample, we tested the relationship between HCC and a range of variables including demographic variables, hair treatment, and medication, as well as psychosocial variables, namely childhood trauma, critical life events, and depressive symptoms. Hair samples were collected from 144 individuals from the South East London Community Health (SELCoH) study. Childhood trauma, life events, and depressive symptoms were measured, together with age, sex, ethnicity, relationship status, educational attainment, employment status, occupational social class, hair washing frequency, hair treatments, season reflected in the hair sample, hazardous drinking, smoking, medication intake, and body mass index. Hair samples reflecting the past 3 months were collected and analysed using immunoassays. First, correlations (continuous variables) and simple linear regressions (dichotomous variables) were conducted to identify sociodemographic, hair-related, and lifestyle determinants of HCC. Next, multiple linear regressions were conducted to test the relationship between psychosocial variables and HCC when controlling for the identified confounders. Age (r=-0.17, p=0.050), White British ethnicity (β=-0.19, p=0.023), heat-based treatments (β=-0.22, p=0.010), and winter season (β=-0.18, p=0.024) were associated with lower HCC, whereas summer season (β=0.24, p=0.024), painkillers (β=0.25, p=0.003), anxiolytics/antidepressants (β=0.21, p=0.014), and hormonal contraceptives (β=0.27, p=0.006) were associated with higher HCC. Controlling for these confounders, physical neglect during childhood (β=-0.17, p=0.057), war-related experiences (β=0.20, p=0.027), separation (β=0.18, p=0.054), and being the victim of a serious crime (β=-0.17, p=0.062) were linked with altered HCC. Our findings suggest that variation in HCC occurs according to sociodemographic, hair-related, and lifestyle variables, and that certain associations between stress and altered HCC can only be revealed when accounting for these confounders. Copyright © 2016 Elsevier Ltd. All rights reserved.

Estimating interaction on an additive scale between continuous determinants in a logistic regression model.

PubMed

Knol, Mirjam J; van der Tweel, Ingeborg; Grobbee, Diederick E; Numans, Mattijs E; Geerlings, Mirjam I

2007-10-01

To determine the presence of interaction in epidemiologic research, typically a product term is added to the regression model. In linear regression, the regression coefficient of the product term reflects interaction as departure from additivity. However, in logistic regression it refers to interaction as departure from multiplicativity. Rothman has argued that interaction estimated as departure from additivity better reflects biologic interaction. So far, literature on estimating interaction on an additive scale using logistic regression only focused on dichotomous determinants. The objective of the present study was to provide the methods to estimate interaction between continuous determinants and to illustrate these methods with a clinical example. and results From the existing literature we derived the formulas to quantify interaction as departure from additivity between one continuous and one dichotomous determinant and between two continuous determinants using logistic regression. Bootstrapping was used to calculate the corresponding confidence intervals. To illustrate the theory with an empirical example, data from the Utrecht Health Project were used, with age and body mass index as risk factors for elevated diastolic blood pressure. The methods and formulas presented in this article are intended to assist epidemiologists to calculate interaction on an additive scale between two variables on a certain outcome. The proposed methods are included in a spreadsheet which is freely available at: http://www.juliuscenter.nl/additive-interaction.xls.

Prevalence and risk factors for tinea pedis in Israeli soldiers.

PubMed

Cohen, A D; Wolak, A; Alkan, M; Shalev, R; Vardy, D A

2005-12-01

Tinea pedis is a common infection in soldiers. However, prevalence and risk factors for tinea pedis in soldiers were investigated in only a few studies. To investigate the prevalence and risk factors for tinea pedis in Israeli soldiers. A cross-sectional study including interviews, clinical skin examination and mycological tests was performed in Israeli soldiers. The presence of tinea pedis was assessed using the Athlete's Foot Severity Index (AFSI), a scoring system that was developed in order to evaluate the presence and severity of tinea pedis. In soldiers with clinical evidence of tinea pedis (AFSI > 1), scrapings were taken for direct microscopic examination (20% KOH preparation) and fungal culture. Statistical analyses were performed using chi-square or Fisher's exact test for dichotomous variables (as needed), or t-tests for continuous variables. Logistic regression was used for multivariate analyses of dichotomous variables. Two hundred and twenty-three soldiers were included in the study: 205 men (91.9%) and 18 women (8.1%). Mean age was 19.6 years (SD 1.0 year). Clinical point prevalence was 60.1%. Mycological point prevalence was 27.3%. Further analyses were performed using the clinical point prevalence. Univariate analyses demonstrated that the prevalence of tinea pedis varied with the setting of military training (basic training: 70.3%, advanced infantry training: 81.5%, armor commander training: 56.4% and armor officer training: 34.8%) and was associated with male gender, frequency of sock changes and the length of military service. A multivariate analysis demonstrated that tinea pedis was associated with the setting of the military training (OR 1.6, 95% CI 1.2-2.1) and male gender (OR 4.3, 95% CI 1.4-13.8); however, there was no association with hygiene measures (e.g. frequency of changing socks or sleeping with socks) or the length of military service. Tinea pedis is highly prevalent in Israeli soldiers. Association of tinea pedis with the setting of military training suggests that contagious spread may be an important risk factor. We suggest that environmental interventions should be planned to in order to decrease the morbidity of tinea pedis among soldiers.

Variation between seated and standing/walking postures among male and female call centre operators.

PubMed

Toomingas, Allan; Forsman, Mikael; Mathiassen, Svend Erik; Heiden, Marina; Nilsson, Tohr

2012-03-02

The dose and time-pattern of sitting has been suggested in public health research to be an important determinant of risk for developing a number of diseases, including cardiovascular disorders and diabetes. The aim of the present study was to assess the time-pattern of seated and standing/walking postures amongst male and female call centre operators, on the basis of whole-shift posture recordings, analysed and described by a number of novel variables describing posture variation. Seated vs. standing/walking was recorded using dichotomous inclinometers throughout an entire work shift for 43 male and 97 female call centre operators at 16 call centres. Data were analysed using an extensive set of variables describing occurrence of and switches between seated and standing/walking, posture similarity across the day, and compliance with standard recommendations for computer work. The majority of the operators, both male and female, spent more than 80% of the shift in a seated posture with an average of 10.4 switches/hour between seated and standing/walking or vice versa. Females spent, on average, 11% of the day in periods of sustained sitting longer than 1 hour; males 4.6% (p = 0.013). Only 38% and 11% of the operators complied with standard recommendations of getting an uninterrupted break from seated posture of at least 5 or 10 minutes, respectively, within each hour of work. Two thirds of all investigated variables showed coefficients of variation between subjects above 0.5. Since work tasks and contractual break schedules were observed to be essentially similar across operators and across days, this indicates that sedentary behaviours differed substantially between individuals. The extensive occurrence of uninterrupted seated work indicates that efforts should be made at call centres - and probably in other settings in the office sector - to introduce more physical variation in terms of standing/walking periods during the work day. We suggest the metrics used in this study for quantifying variation in sedentary behaviour to be of interest even for other dichotomous exposures relevant to occupational and public health, for instance physical activity/inactivity.

SAS and SPSS macros to calculate standardized Cronbach's alpha using the upper bound of the phi coefficient for dichotomous items.

PubMed

Sun, Wei; Chou, Chih-Ping; Stacy, Alan W; Ma, Huiyan; Unger, Jennifer; Gallaher, Peggy

2007-02-01

Cronbach's a is widely used in social science research to estimate the internal consistency of reliability of a measurement scale. However, when items are not strictly parallel, the Cronbach's a coefficient provides a lower-bound estimate of true reliability, and this estimate may be further biased downward when items are dichotomous. The estimation of standardized Cronbach's a for a scale with dichotomous items can be improved by using the upper bound of coefficient phi. SAS and SPSS macros have been developed in this article to obtain standardized Cronbach's a via this method. The simulation analysis showed that Cronbach's a from upper-bound phi might be appropriate for estimating the real reliability when standardized Cronbach's a is problematic.

Invited Commentary: The Need for Cognitive Science in Methodology.

PubMed

Greenland, Sander

2017-09-15

There is no complete solution for the problem of abuse of statistics, but methodological training needs to cover cognitive biases and other psychosocial factors affecting inferences. The present paper discusses 3 common cognitive distortions: 1) dichotomania, the compulsion to perceive quantities as dichotomous even when dichotomization is unnecessary and misleading, as in inferences based on whether a P value is "statistically significant"; 2) nullism, the tendency to privilege the hypothesis of no difference or no effect when there is no scientific basis for doing so, as when testing only the null hypothesis; and 3) statistical reification, treating hypothetical data distributions and statistical models as if they reflect known physical laws rather than speculative assumptions for thought experiments. As commonly misused, null-hypothesis significance testing combines these cognitive problems to produce highly distorted interpretation and reporting of study results. Interval estimation has so far proven to be an inadequate solution because it involves dichotomization, an avenue for nullism. Sensitivity and bias analyses have been proposed to address reproducibility problems (Am J Epidemiol. 2017;186(6):646-647); these methods can indeed address reification, but they can also introduce new distortions via misleading specifications for bias parameters. P values can be reframed to lessen distortions by presenting them without reference to a cutoff, providing them for relevant alternatives to the null, and recognizing their dependence on all assumptions used in their computation; they nonetheless require rescaling for measuring evidence. I conclude that methodological development and training should go beyond coverage of mechanistic biases (e.g., confounding, selection bias, measurement error) to cover distortions of conclusions produced by statistical methods and psychosocial forces. © The Author(s) 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Social connections and happiness among the elder population of Taiwan.

PubMed

Hsu, H-C; Chang, W-C

2015-01-01

The purpose of this study was to examine the association between social connections and happiness among members of the elder population of Taiwan. Longitudinal panel data collected in three waves from 1999 to 2007 that are selected from national samples of Taiwanese older people were used for the analysis (n = 4731 persons). Happiness was defined as a dichotomous variable. Social connection variables included living arrangements, contacts with children/grandchildren/parents/relatives/friends, telephone contacts, providing instrumental and informational support, receiving instrumental and emotional support, and social participation. We controlled for the variables demographics, physical and mental health, economic satisfaction, and lifestyle. A generalized linear model (GLM) was applied in the analysis. Happiness remained stable over time. Receiving more emotional support and participating in social events were related to happiness at the beginning, while the effect of social participation was offset over time. Living arrangements, telephone contacts, providing social support, and receiving instrumental support were not significant. The quality of social relationships experienced is possibly more important than the quantity of social interaction for older people, and having social relationships outside the informal social network may increase happiness.

Testing concordance of instrumental variable effects in generalized linear models with application to Mendelian randomization

PubMed Central

Dai, James Y.; Chan, Kwun Chuen Gary; Hsu, Li

2014-01-01

Instrumental variable regression is one way to overcome unmeasured confounding and estimate causal effect in observational studies. Built on structural mean models, there has been considerale work recently developed for consistent estimation of causal relative risk and causal odds ratio. Such models can sometimes suffer from identification issues for weak instruments. This hampered the applicability of Mendelian randomization analysis in genetic epidemiology. When there are multiple genetic variants available as instrumental variables, and causal effect is defined in a generalized linear model in the presence of unmeasured confounders, we propose to test concordance between instrumental variable effects on the intermediate exposure and instrumental variable effects on the disease outcome, as a means to test the causal effect. We show that a class of generalized least squares estimators provide valid and consistent tests of causality. For causal effect of a continuous exposure on a dichotomous outcome in logistic models, the proposed estimators are shown to be asymptotically conservative. When the disease outcome is rare, such estimators are consistent due to the log-linear approximation of the logistic function. Optimality of such estimators relative to the well-known two-stage least squares estimator and the double-logistic structural mean model is further discussed. PMID:24863158

Campaign contributions, lobbying and post-Katrina contracts.

PubMed

Hogan, Michael J; Long, Michael A; Stretesky, Paul B

2010-07-01

This research explores the relationship between political campaign contributions, lobbying and post-Hurricane Katrina cleanup and reconstruction contracts. Specifically, a case-control study design is used to determine whether campaign contributions to national candidates in the 2000-04 election cycles and/or the employment of lobbyists and lobbying firms increased a company's probability of receiving a post-hurricane contract. Results indicate that both a campaign contribution dichotomous variable and the dollar amount of contributions are significantly related to whether a company received a contract, but that lobbying activity was not. These findings are discussed in the context of previous research on the politics of natural disasters, government contracting and governmental and corporate deviance.

Fitting IRT Models to Dichotomous and Polytomous Data: Assessing the Relative Model-Data Fit of Ideal Point and Dominance Models

ERIC Educational Resources Information Center

Tay, Louis; Ali, Usama S.; Drasgow, Fritz; Williams, Bruce

2011-01-01

This study investigated the relative model-data fit of an ideal point item response theory (IRT) model (the generalized graded unfolding model [GGUM]) and dominance IRT models (e.g., the two-parameter logistic model [2PLM] and Samejima's graded response model [GRM]) to simulated dichotomous and polytomous data generated from each of these models.…

The added value of ordinal analysis in clinical trials: an example in traumatic brain injury.

PubMed

Roozenbeek, Bob; Lingsma, Hester F; Perel, Pablo; Edwards, Phil; Roberts, Ian; Murray, Gordon D; Maas, Andrew Ir; Steyerberg, Ewout W

2011-01-01

In clinical trials, ordinal outcome measures are often dichotomized into two categories. In traumatic brain injury (TBI) the 5-point Glasgow outcome scale (GOS) is collapsed into unfavourable versus favourable outcome. Simulation studies have shown that exploiting the ordinal nature of the GOS increases chances of detecting treatment effects. The objective of this study is to quantify the benefits of ordinal analysis in the real-life situation of a large TBI trial. We used data from the CRASH trial that investigated the efficacy of corticosteroids in TBI patients (n = 9,554). We applied two techniques for ordinal analysis: proportional odds analysis and the sliding dichotomy approach, where the GOS is dichotomized at different cut-offs according to baseline prognostic risk. These approaches were compared to dichotomous analysis. The information density in each analysis was indicated by a Wald statistic. All analyses were adjusted for baseline characteristics. Dichotomous analysis of the six-month GOS showed a non-significant treatment effect (OR = 1.09, 95% CI 0.98 to 1.21, P = 0.096). Ordinal analysis with proportional odds regression or sliding dichotomy showed highly statistically significant treatment effects (OR 1.15, 95% CI 1.06 to 1.25, P = 0.0007 and 1.19, 95% CI 1.08 to 1.30, P = 0.0002), with 2.05-fold and 2.56-fold higher information density compared to the dichotomous approach respectively. Analysis of the CRASH trial data confirmed that ordinal analysis of outcome substantially increases statistical power. We expect these results to hold for other fields of critical care medicine that use ordinal outcome measures and recommend that future trials adopt ordinal analyses. This will permit detection of smaller treatment effects.

Adopting a Patient-Centered Approach to Primary Outcome Analysis of Acute Stroke Trials by Use of a Utility-Weighted Modified Rankin Scale

PubMed Central

Chaisinanunkul, Napasri; Adeoye, Opeolu; Lewis, Roger J.; Grotta, James C.; Broderick, Joseph; Jovin, Tudor G.; Nogueira, Raul G.; Elm, Jordan; Graves, Todd; Berry, Scott; Lees, Kennedy R.; Barreto, Andrew D.; Saver, Jeffrey L.

2015-01-01

Background and Purpose Although the modified Rankin Scale (mRS) is the most commonly employed primary endpoint in acute stroke trials, its power is limited when analyzed in dichotomized fashion and its indication of effect size challenging to interpret when analyzed ordinally. Weighting the seven Rankin levels by utilities may improve scale interpretability while preserving statistical power. Methods A utility weighted mRS (UW-mRS) was derived by averaging values from time-tradeoff (patient centered) and person-tradeoff (clinician centered) studies. The UW-mRS, standard ordinal mRS, and dichotomized mRS were applied to 11 trials or meta-analyses of acute stroke treatments, including lytic, endovascular reperfusion, blood pressure moderation, and hemicraniectomy interventions. Results Utility values were: mRS 0–1.0; mRS 1 - 0.91; mRS 2 - 0.76; mRS 3 - 0.65; mRS 4 - 0.33; mRS 5 & 6 - 0. For trials with unidirectional treatment effects, the UW-mRS paralleled the ordinal mRS and outperformed dichotomous mRS analyses. Both the UW-mRS and the ordinal mRS were statistically significant in six of eight unidirectional effect trials, while dichotomous analyses were statistically significant in two to four of eight. In bidirectional effect trials, both the UW-mRS and ordinal tests captured the divergent treatment effects by showing neutral results whereas some dichotomized analyses showed positive results. Mean utility differences in trials with statistically significant positive results ranged from 0.026 to 0.249. Conclusion A utility-weighted mRS performs similarly to the standard ordinal mRS in detecting treatment effects in actual stroke trials and ensures the quantitative outcome is a valid reflection of patient-centered benefits. PMID:26138130

The role of perfectionism, dichotomous thinking, shape and weight overvaluation, and conditional goal setting in eating disorders.

PubMed

Lethbridge, Jessica; Watson, Hunna J; Egan, Sarah J; Street, Helen; Nathan, Paula R

2011-08-01

This study examined the role of perfectionism (self-oriented and socially prescribed), shape and weight overvaluation, dichotomous thinking, and conditional goal setting in eating disorder psychopathology. Perfectionism and shape and weight overvaluation have had longstanding implication in the development and maintenance of eating disorders. A leading evidence-based theory of eating disorders (Fairburn, Cooper & Shafran, 2003) outlines perfectionism as a maintaining mechanism of eating disorder psychopathology and as a proximal risk factor for the development of shape and weight overvaluation. These constructs have been linked to other cognitive processes relevant to eating disorders, specifically, dichotomous thinking and conditional goal setting. Women with DSM-IV eating disorders (N=238) were compared to women in the general community (N=248) and, as hypothesised, scores on measures of these constructs were pronounced in the clinical sample. Hierarchical regression analyses predicting eating disorder psychopathology showed that for both groups, dichotomous thinking and conditional goal setting significantly improved model fit beyond perfectionism and shape and weight overvaluation alone. Self-oriented perfectionism, but not socially prescribed perfectionism, was relevant to eating disorder psychopathology. We discuss the implications for current treatment protocols and early intervention. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.

Attitudes towards informed consent, confidentiality, and substitute treatment decisions in southern African medical students: a case study from Zimbabwe.

PubMed

Hipshman, L

1999-08-01

This study explored the attitudes of biomedical science students (medical students) in a non-Western setting towards three medical ethics concepts that are based on fundamental Western culture ethical principles. A dichotomous (agree/disagree) response questionnaire was constructed using Western ethnocentric culture (WEC) based perspectives of informed consent, confidentiality, and substitute decision-making. Hypothesized WEC-Biased responses were assigned to the questionnaire's questions or propositions. A number of useful responses (169) were obtained from a large, cross-sectional, convenience sample of the MBChB students at the University of Zimbabwe Medical School. Statistical analysis described the differences in response patterns between the student's responses compared to the hypothesized WEC-Biased response. The effect of the nine independent variables on selected dependent variables (responses to certain questionnaire questions) was analyzed by stepwise logistic regression. Students concurred with the hypothesized WEC-Biased responses for two-thirds of the questionnaire items. This agreement included support for the role of legal advocacy in the substitute decision-making process. The students disagreed with the hypothesized WEC-Biased responses in several important medical ethics aspects. Most notably, the students indicated that persons with mental dysfunctions, as a class, were properly considered incompetent to make treatment decisions. None of the studied independent variables was often associated with students' responses, but training year was more frequently implicated than either ethnicity or gender. In order to develop internationally and culturally relevant medical ethics standards, non-Western perspectives ought to be acknowledged and incorporated. Two main areas for further efforts include: curriculum development in ethics reasoning and related clinical (medico-legal) decision-making processes that would be relevant to medical students from various cultures, and; the testing of models that could increase legal system input in the clinical process in societies with limited jurisprudence resources.

Association between non-fatal opioid overdose and encounters with healthcare and criminal justice systems: Identifying opportunities for intervention.

PubMed

Wagner, Karla D; Liu, Lin; Davidson, Peter J; Cuevas-Mota, Jazmine; Armenta, Richard F; Garfein, Richard S

2015-08-01

Accidental overdose, driven largely by opioids, is a leading cause of death among people who inject drugs (PWIDs). We conducted secondary analysis of data from a cohort of PWIDs to identify venues where high-risk PWID could be targeted by overdose education/naloxone distribution (OEND) programs. 573 PWIDs completed a quantitative survey between June, 2012 and January, 2014, which was analyzed using multivariable logistic regression. The dependent variable was a dichotomous indicator of experiencing a heroin/opioid-related overdose in the past six months. Independent variables included: demographics, drug use behavior, and encounters with two venues - the health care and criminal justice systems - that could serve as potential venues for OEND programs. Almost half (41.5%) reported ever experiencing a heroin/opioid overdose, and 45 (7.9%) reported experiencing at least one heroin/opioid overdose in the past six months. In the final multivariable model, receiving care in a hospital in the past six months (Adjusted Odds Ratio [AdjOR] 4.08, 95% Confidence Interval [C.I.] 2.07, 8.04, p<0.001) and being arrested for drug possession in the past six months (AdjOR 5.17, 95% C.I. 2.37, 11.24, p<0.001) were associated with experiencing an opioid overdose in the past six months. Identifying venues outside of those that traditionally target services to PWIDs (i.e., syringe exchange programs) will be critical to implementing OEND interventions at a scale sufficient to address the growing epidemic of heroin/opioid related deaths. Clinical settings, such as hospitals, and drug-related encounters with law enforcement officers are promising venues for the expansion of OEND programs. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Prevalence and sociodemographic characteristics of women with induced abortion in a population sample of São Paulo, Brazil.

PubMed

Souza, Milena Goulart; Fusco, Carmen L B; Andreoni, Solange A; de Souza e Silva, Rebeca

2014-01-01

This study aims at estimating the prevalence of women with induced abortion among women of childbearing age (15-49 years) who had any previous pregnancy, in the city of Sao Paulo, Brazil, in the last quarter of 2008, and identifying the Sociodemographic Characteristics (SC) associated with it. A cross-sectional survey was carried out. The dependent variable was dichotomized as: no abortion and induced abortion. The independent variables were: age, paid work/activity, familial monthly income, schooling, marital status, contraceptive use and number of live births. Statistical analysis was performed using log-binomial regression models with approximation of Poisson to estimate the Prevalance Ratios (PR). Of all women with any previous pregnancy (n = 683), 4.5% (n = 31) reported induced abortion. The final multivariate model showed that having now between 40 and 44 years (PR = 2.76, p = 0.0043), being single (PR = 2.79, p = 0.0159), having 5 or more live births (PR = 3.97, p = 0.0013), current oral contraception or IUD use (PR = 2.70, p = 0.454) and using a "non effective" (or of low efficacy) contraceptive method (PR = 4.18, p = 0.0009) were sociodemographic characteristics associated with induced abortion in this population. Induced abortion seems to be used to limit fertility, more precisely after having reached the desired number of children. The inadequate use or non-use of effective contraceptive methods, and / or the use of contraceptives " non effective", exposed also the women to the risk of unintended pregnancies and, therefore, induced abortions. In addition, when faced with a pregnancy, single women were more likely to have an abortion than married women.

Sexual orientation differences in the relationship between victimization and hazardous drinking among women in the National Alcohol Survey

PubMed Central

Drabble, Laurie; Trocki, Karen F.; Hughes, Tonda L.; Korcha, Rachael A.; Lown, Anne E.

2013-01-01

This study examined relationships between past experiences of victimization (sexual abuse and physical abuse in childhood, sexual abuse and physical abuse in adulthood, and lifetime victimization) and hazardous drinking among sexual minority women compared to exclusively heterosexual women. Data were from 11,169 women responding to sexual identity and sexual behavior questions from three National Alcohol Survey waves: 2000 (n=3,880), 2005 (n=3,464) and 2010 (n=3,825). A hazardous drinking index was constructed from five dichotomous variables (5+ drinking in the past year, drinking two or more drinks daily, drinking to intoxication in the past year, two or more lifetime dependence symptoms and two or more lifetime drinking-related negative consequences). Exclusively heterosexual women were compared to three groups of sexual minority women: lesbian, bisexual, and women who identified as heterosexual but reported same-sex partners. Each of the sexual minority groups reported significantly higher rates of lifetime victimization (59.1% lesbians, 76% bisexuals, and 64.4% heterosexual women reporting same-sex partners) than exclusively heterosexual women (42.3 %). Odds for hazardous drinking among sexual minority women were attenuated when measures of victimization were included in the regression models. Sexual minority groups had significantly higher odds of hazardous drinking, even after controlling for demographic and victimization variables: lesbian (ORadj=2.0, CI=1.1–3.9, p<.01; bisexual (ORadj=1.8, CI=1.0–3.3, p<.05; heterosexual with same-sex partners (ORadj=2.7; CI=1.7–4.3, p<.001). Higher rates of victimization likely contribute to, but do not fully explain, higher rates of hazardous drinking among sexual minority women. PMID:23438246

Socioeconomic Status and Self-Rated Oral Health; Diminished Return among Hispanic Whites.

PubMed

Assari, Shervin

2018-04-24

Background. An extensive body of knowledge has documented weaker health effects of socio-economic status (SES) for Blacks compared to Whites, a phenomenon also known as Blacks’ diminished return. It is, however, unknown whether the same diminished return also holds for other ethnic minorities such as Hispanics or not. Aim. Using a nationally representative sample, the current study aimed to compare Non-Hispanic and Hispanic Whites for the effects of SES on self-rated oral health. Methods. For the current cross-sectional study, we used data from the Collaborative Psychiatric Epidemiology Surveys (CPES), 2001⁻2003. With a nationally representative sampling, CPES included 11,207 adults who were either non-Hispanic Whites ( n = 7587) or Hispanic Whites ( n = 3620. The dependent variable was self-rated oral health, treated as dichotomous measure. Independent variables were education, income, employment, and marital status. Ethnicity was the focal moderator. Age and gender were covariates. Logistic regressions were used for data analysis. Results. Education, income, employment, and marital status were associated with oral health in the pooled sample. Although education, income, employment, and marital status were associated with oral health in non-Hispanic Whites, none of these associations were found for Hispanic Whites. Conclusion. In a similar pattern to Blacks’ diminished return, differential gain of SES indicators exists between Hispanic and non-Hispanic Whites, with a disadvantage for Hispanic Whites. Diminished return of SES should be regarded as a systemically neglected contributing mechanism behind ethnic oral health disparities in the United States. Replication of Blacks’ diminished return for Hispanics suggests that these processes are not specific to ethnic minority groups, and non-White groups gain less because they are not enjoying the privilege and advantage of Whites.

Intractable epilepsy and structural lesions of the brain: mapping, resection strategies, and seizure outcome.

PubMed

Awad, I A; Rosenfeld, J; Ahl, J; Hahn, J F; Lüders, H

1991-01-01

Forty-seven patients with structural brain lesions on neuroimaging studies and partial epilepsy intractable to medical therapy were studied. Prolonged noninvasive interictal and ictal EEG recording was performed, followed by more focused mapping using chronically implanted subdural electrode plates. Surgical procedures included lesion biopsy, maximal lesion excision, and/or resection of zones of epileptogenesis depending on accessibility and involvement of speech or other functional areas. The epileptogenic zone involved exclusively the region adjacent to the structural lesion in 11 patients. It extended beyond the lesion in 18 patients. Eighteen other patients had remote noncontiguous zones of epileptogenesis. Postoperative control of epilepsy was accomplished in 17 of 18 patients (94%) with complete lesion excision regardless of extent of seizure focus excision. Postoperative control of epilepsy was accomplished in 5 of 6 patients (83%) with incomplete lesion excision but complete seizure focus excision and in 12 of 23 patients (52%) with incomplete lesion excision and incomplete focus excision. The extent of lesion resection was strongly associated with surgical outcome either in itself (p less than 0.003), or in combination with focus excision. Focus resection was marginally associated with surgical outcome as a dichotomous variable (p = 0.048) and showed a trend toward significance (p = 0.07) only as a three-level outcome variable. We conclude that structural lesions are associated with zones of epileptogenesis in neighboring and remote areas of the brain. Maximum resection of the lesion offers the best chance at controlling intractable epilepsy; however, seizure control is achieved in many patients by carefully planned subtotal resection of lesions or foci.(ABSTRACT TRUNCATED AT 250 WORDS)

Paternal incarceration and trajectories of marijuana and other illegal drug use from adolescence into young adulthood: evidence from longitudinal panels of males and females in the United States.

PubMed

Roettger, Michael E; Swisher, Raymond R; Kuhl, Danielle C; Chavez, Jorge

2011-01-01

One-eighth of young adults in the United States report that their biological father has ever been incarcerated (FEI). This study is the first to examine associations between FEI and trajectories of substance use during the transition from adolescence into young adulthood for the US population. Using multi-level modeling techniques, trajectories of marijuana and other illegal drug use are examined, with FEI as the primary independent variable. Data are from the first three waves of the National Longitudinal Study of Adolescent Health, a nationally representative sample of US adolescents beginning in 1995. Panels of 7157 males and 7997 females followed from adolescence (7th-12th grades) into early adulthood (ages 18-27 years). Dependent variables included an ordinal measure of marijuana frequency of use in last thirty days, and a dichotomous measure for whether respondent had any use in the last thirty days of illegal drugs such crystal meth, cocaine, heroin, hallucinogens, PCP, LSD, speed, and ecstasy. Among males and females, respectively, FEI is associated with an increased frequency of marijuana use, and increased odds of any other illegal drug use. Interactions between FEI and age further reveal that FEI is associated with an accentuated trajectory (i.e. a steeper slope) of marijuana use, and an elevated risk (i.e. higher mean level) of other illegal drug use. Analysis provides some of the first evidence that paternal incarceration is significantly associated with drug use among U.S. males and females, even after controlling for a number of family background, parental, and individual characteristics. © 2010 The Authors, Addiction © 2010 Society for the Study of Addiction.

Medication safety knowledge, attitudes and practices among community pharmacists in Lebanon.

PubMed

Hajj, Aline; Hallit, Souheil; Ramia, Elsy; Salameh, Pascale

2018-01-01

The effectiveness of a national post-marketing surveillance program depends directly on the active participation of all health professionals. There is no current comprehensive and active pharmacovigilance program available in Lebanon. To assess the knowledge, attitudes, and practices (KAP) among community pharmacists in Lebanon with respect to potential pharmacovigilance and adverse-drug-reaction reporting in Lebanon. A cross-sectional descriptive study, using a self-administered KAP questionnaire and conducted between March and July 2016, included 1857 pharmacists practicing in community settings. Statistical analysis included χ 2 test for dichotomous or multinomial qualitative variables, and Wilcoxon test for quantitative variables with non-homogeneous variances or non-normal distribution. The majority of responders had good knowledge concerning the concept and purpose of pharmacovigilance as well as adverse drug reactions (how to report these/the importance of reporting adverse events/the definition of an adverse event and pharmacovigilance). Concerning community pharmacists' attitudes and practice towards pharmacovigilance, the majority described having a positive attitude towards their role in adverse drug reaction reporting and this activity was even seen as one of their core duties. The questionnaire revealed a lack of practice and training regarding pharmacovigilance. Nonetheless, the pharmacists agreed on the Order of Pharmacists in Lebanon and the Ministry of Health's role in promoting this practice and helping them be more involved in reporting adverse drug reactions (ADRs). The pharmacists thought that they are well positioned regarding patient-safety practice in their pharmacies and the results were not statistically different between pharmacy employers and employees. Lebanese pharmacists have the required knowledge and positive attitude to start reporting ADRs, were aware of ADRs occurring with various medicines post-marketing, yet were currently not able to disseminate this information widely or to record it centrally, emphasizing the importance of establishing a national ADR reporting system.

Influence of radical prostatectomy for prostate cancer on work status and working life 3 years after surgery.

PubMed

Dahl, Sigrun; Loge, Jon Håvard; Berge, Viktor; Dahl, Alv Andreas; Cvancarova, Milada; Fosså, Sophie Dorothea

2015-06-01

The purpose of this study is to study the influence of radical prostatectomy (RP) for prostate cancer on work status and working life in men 3 years after surgery. In a prospective, questionnaire-based study on adverse effects after RP, 330 prostate cancer (PCa) patients who had been active in the workforce before RP described their work status 3 years after having surgery. We dichotomized their postoperative work status into "unchanged or increased" versus "reduced." The participants also reported whether their working life was influenced by the PCa trajectory to no, some, or a great extent. Univariate and multiple logistic regression models were established with sociodemographic and clinical characteristics as independent variables and "work status" or "influence of PCa trajectory on working life" as dependent variables. Twenty-five percent of the participants had retired. Of the remaining participants, approximately 20 % had a reduced work status, which in the multivariate analyses was significantly associated with increasing age. One third of the men still active in the workforce considered the PCa to negatively influence their working life. This was independently associated with bother related to urinary leakage, fatigue, and having undergone additional oncological therapy (pelvic radiotherapy and/or hormone treatment). Though RP does not affect work status in most men, approximately one third of them experience problems in their working life due to adverse effects related to RP and/or additional post-RP anti-cancer therapy. Most PCa survivors can expect to remain in the workforce for at least 3 years after RP, but for some, persistent adverse effects after RP and /or additional anti-cancer treatment negatively affect their working life. Pre-RP counseling of men within the workforce should cover possible post-RP changes concerning work status and working life.

Sensitivity analysis for missing dichotomous outcome data in multi-visit randomized clinical trial with randomization-based covariance adjustment.

PubMed

Li, Siying; Koch, Gary G; Preisser, John S; Lam, Diana; Sanchez-Kam, Matilde

2017-01-01

Dichotomous endpoints in clinical trials have only two possible outcomes, either directly or via categorization of an ordinal or continuous observation. It is common to have missing data for one or more visits during a multi-visit study. This paper presents a closed form method for sensitivity analysis of a randomized multi-visit clinical trial that possibly has missing not at random (MNAR) dichotomous data. Counts of missing data are redistributed to the favorable and unfavorable outcomes mathematically to address possibly informative missing data. Adjusted proportion estimates and their closed form covariance matrix estimates are provided. Treatment comparisons over time are addressed with Mantel-Haenszel adjustment for a stratification factor and/or randomization-based adjustment for baseline covariables. The application of such sensitivity analyses is illustrated with an example. An appendix outlines an extension of the methodology to ordinal endpoints.

Aerosols concentration in the Candiota area applying different gravimetric methods of sampling and numeric modelling.

PubMed

Braga, C F; Alves, R C M; Teixeira, E C; Pire, M

2002-12-01

The main purpose of the present work is to study the concentration of atmospheric particles in the Candiota region, in the state of Rio Grande do Sul, where the Presidente Médici coal power plant is located. Aerosol samples were collected at the studied locations between December 2000 and December 2001 during 24 h periods at 15 day intervals using HV PM10 and dichotomous samplers. Then, the values obtained with the ISCST (Industrial Source Complex Term) model, with the HV PM10 sampler at all studied stations, and with the dichotomous sampler at the 8 de Agosto station were compared with each other. The results show that the values for the model had been underestimated in relation to the HV PM10 data for the studied stations, but agreed with the values obtained with the dichotomous sampler.

Factors associated with the success of first-time African American freshmen taking introductory science lecture courses at a private HBCU

NASA Astrophysics Data System (ADS)

Smith, Kendra Leigh

This study had four purposes: (1) to investigate the relationship between performance in introductory biology or introductory chemistry lecture courses and their accompanying laboratory courses, (2) to investigate the relationship between performance in introductory biology or introductory chemistry lecture courses and a student's gender, (3) to investigate the relationship between performance in introductory biology or introductory chemistry lecture courses and a student's major, and (4) to investigate the relationship between performance in introductory biology or introductory chemistry lecture courses and a student's ACT scores. The sample consisted of 195 first--time freshmen who enrolled in and completed an introductory biology or an introductory chemistry lecture and laboratory courses during the fall semesters of 2007-2012. Of the 195 students, 61 were enrolled in introductory chemistry and 134 were enrolled in introductory biology courses. Logistic regression, via the Statistical Package for the Social Sciences (SPSS), was utilized to analyze several variables as they related to success in the lecture courses. Data were extracted from the university's student information system (BANNER), and analyses were conducted on biology and chemistry separately. The dependent variable for this study was a dichotomous variable for success and nonsuccess in introductory biology or introductory chemistry lecture course. The independent variables analyzed were student's gender, major, final grade in an accompanying biology or chemistry laboratory course, and ACT test scores (composite, mathematics, and science). Results indicate that concurrent enrollment in a biology laboratory course increased the likelihood of success by 15.64 times in the lecture course. Gender was found to not be a significant predictor of success for either introductory biology or introductory chemistry lecture courses. STEM majors were 9.6 times more likely to be successful than non-STEM majors in introductory chemistry lecture course. It was also found that the higher the given ACT score (composite, science, mathematics), the higher the rate of success (between a 1.19-1.44 odds increase for every one point increase in ACT score) in both introductory biology and introductory chemistry lecture courses.

A phenomenological view of language shift.

PubMed

Tsitsipis, Lukas D

2004-01-01

Sociolinguistic studies of language shift have in their majority framed their research object in a horizon of theoretically received variables such as class, ethnicity, locality, attitudes etc. In spite of a limited usefulness of such conceptual variables, and of a recently emerging focus on agency, negotiation, and praxis the best results we obtain have not questioned in a coherent and theoretically sound manner the continuing hegemony of mechanistic-metaphorical models (language death, language suicide). In this paper I propose to examine language shift as a multifaceted phenomenon, joining in this respect work by other linguistic anthropologists researching similar areas. I specifically argue that by replacing vertical concepts such as age and generation, and dichotomous logics such as center and periphery with phenomenologically inspired concepts such as typifications, consociateship, contemporariness, and stream of consciousness we are in a better position to generalize about language shift dynamics. Data for this work is derived primarily from the Albanian speech communities of modern Greece, but also from other communities for comparative purposes.

Evaluating effects of developmental education for college students using a regression discontinuity design.

PubMed

Moss, Brian G; Yeaton, William H

2013-10-01

Annually, American colleges and universities provide developmental education (DE) to millions of underprepared students; however, evaluation estimates of DE benefits have been mixed. Using a prototypic exemplar of DE, our primary objective was to investigate the utility of a replicative evaluative framework for assessing program effectiveness. Within the context of the regression discontinuity (RD) design, this research examined the effectiveness of a DE program for five, sequential cohorts of first-time college students. Discontinuity estimates were generated for individual terms and cumulatively, across terms. Participants were 3,589 first-time community college students. DE program effects were measured by contrasting both college-level English grades and a dichotomous measure of pass/fail, for DE and non-DE students. Parametric and nonparametric estimates of overall effect were positive for continuous and dichotomous measures of achievement (grade and pass/fail). The variability of program effects over time was determined by tracking results within individual terms and cumulatively, across terms. Applying this replication strategy, DE's overall impact was modest (an effect size of approximately .20) but quite consistent, based on parametric and nonparametric estimation approaches. A meta-analysis of five RD results yielded virtually the same estimate as the overall, parametric findings. Subset analysis, though tentative, suggested that males benefited more than females, while academic gains were comparable for different ethnicities. The cumulative, within-study comparison, replication approach offers considerable potential for the evaluation of new and existing policies, particularly when effects are relatively small, as is often the case in applied settings.

How much does "how much" matter? Assessing the relationship between children's lifetime exposure to violence and trauma symptoms, behavior problems, and parenting stress.

PubMed

Hickman, Laura J; Jaycox, Lisa H; Setodji, Claude M; Kofner, Aaron; Schultz, Dana; Barnes-Proby, Dionne; Harris, Racine

2013-04-01

The study explores whether and how lifetime violence exposure is related to a set of negative symptoms: child internalizing and externalizing behavior problems, child trauma symptoms, and parenting stress. Using a large sample of violence-exposed children recruited to participate in intervention research, the study employs different methods of measuring that exposure. These include total frequency of all lifetime exposure, total frequency of lifetime exposure by broad category (i.e., assault, maltreatment, sexual abuse, and witnessing violence), and polyvictimization defined as exposure to multiple violence categories. The results indicate that only polyvictimization, constructed as a dichotomous variable indicating two or more categories of lifetime exposure, emerged as a consistent predictor of negative symptoms. The total lifetime frequency of all violence exposure was not associated with negative symptoms, after controlling for the influence of polyvictimization. Likewise, in the presence of a dichotomous polyvictimization indicator the total lifetime frequency of exposure to a particular violence category was unrelated to symptoms overall, with the exception of trauma symptoms and experiences of sexual abuse. Taken together, these findings suggest that total lifetime exposure is not particularly important to negative symptoms, nor is any particular category of exposure after controlling for polyvictimization, with the single exception of sexual abuse and trauma symptoms. Instead, it is the mix of exposure experiences that predict negative impacts on children in this sample. Further research is needed to continue to explore and test these issues.

Perioperative fever and outcome in surgical patients with aneurysmal subarachnoid hemorrhage.

PubMed

Todd, Michael M; Hindman, Bradley J; Clarke, William R; Torner, James C; Weeks, Julie B; Bayman, Emine O; Shi, Qian; Spofford, Christina M

2009-05-01

We examined the incidence of perioperative fever and its relationship to outcome among patients enrolled in the Intraoperative Hypothermia for Aneurysm Surgery Trial. One thousand patients with initial World Federation of Neurological Surgeons grades of I to III undergoing clipping of intracranial aneurysms after subarachnoid hemorrhage were randomized to intraoperative normothermia (36 degrees C-37 degrees C) or hypothermia (32.5 degrees C-33.5 degrees C). Fever (> or =38.5 degrees C) and other complications (including infections) occurring between admission and discharge (or death) were recorded. Functional and neuropsychologic outcomes were assessed 3 months postoperatively. The primary outcome variable for the trial was dichotomized Glasgow Outcome Scale (good outcome versus all others). Fever was reported in 41% of patients. In 97% of these, fever occurred in the postoperative period. The median time from surgery to first fever was 3 days. All measures of outcome were worse in patients who developed fever, even in those without infections or who were World Federation of Neurological Surgeons grade I. Logistic regression analyses were performed to adjust for differences in preoperative factors (e.g., age, Fisher grade, initial neurological status). This demonstrated that fever continued to be significantly associated with most outcome measures, even when infection was added to the model. An alternative stepwise model selection process including all fever-related measures from the preoperative and intraoperative period (e.g., hydrocephalus, duration of surgery, intraoperative blood loss) resulted in the loss of significance for dichotomized Glasgow Outcome Scale, but significant associations between fever and several other outcome measures remained. After adding postoperative delayed ischemic neurological deficits to the model, only worsened National Institutes of Health Stroke Scale score, Barthel Activities of Daily Living index, and discharge destination (home versus other) remained independently associated with fever. These findings suggest that fever is associated with worsened outcome in surgical subarachnoid hemorrhage patients, although, because the association between fever and the primary outcome measure for the trial is dependent on the covariates used in the analysis (particularly operative events and delayed ischemic neurological deficits), we cannot rule out the possibility that fever is a marker for other events. Only a formal trial of fever treatment or prevention can address this issue.

Using the Rasch analysis for the psychometric validation of the Irregular Word Reading Test (TeLPI): A Portuguese test for the assessment of premorbid intelligence.

PubMed

Freitas, Sandra; Prieto, Gerardo; Simões, Mário R; Nogueira, Joana; Santana, Isabel; Martins, Cristina; Alves, Lara

2018-05-03

The present study aims to analyze the psychometric characteristics of the TeLPI (Irregular Words Reading Test), a Portuguese premorbid intelligence test, using the Rasch model for dichotomous items. The results reveal an overall adequacy and a good fit of values regarding both items and persons. A high variability of cognitive performance level and a good quality of the measurements were also found. The TeLPI has proved to be a unidimensional measure with reduced DIF effects. The present findings contribute to overcome an important gap in the psychometric validity of this instrument and provide good evidence of the overall psychometric validity of TeLPI results.

The borderline range of toxicological methods: Quantification and implications for evaluating precision.

PubMed

Leontaridou, Maria; Urbisch, Daniel; Kolle, Susanne N; Ott, Katharina; Mulliner, Denis S; Gabbert, Silke; Landsiedel, Robert

2017-01-01

Test methods to assess the skin sensitization potential of a substance usually use threshold criteria to dichotomize continuous experimental read-outs into yes/no conclusions. The threshold criteria are prescribed in the respective OECD test guidelines and the conclusion is used for regulatory hazard assessment, i.e., classification and labelling of the substance. We can identify a borderline range (BR) around the classification threshold within which test results are inconclusive due to a test method's biological and technical variability. We quantified BRs in the prediction models of the non-animal test methods DPRA, LuSens and h-CLAT, and of the animal test LLNA, respectively. Depending on the size of the BR, we found that between 6% and 28% of the substances in the sets tested with these methods were considered borderline. When the results of individual non-animal test methods were combined into integrated testing strategies (ITS), borderline test results of individual tests also affected the overall assessment of the skin sensitization potential of the testing strategy. This was analyzed for the 2-out-of-3 ITS: Four out of 40 substances (10%) were considered borderline. Based on our findings we propose expanding the standard binary classification of substances into "positive"/"negative" or "hazardous"/"non-hazardous" by adding a "borderline" or "inconclusive" alert for cases where test results fall within the borderline range.

Delay of smoking gratification as a laboratory model of relapse: effects of incentives for not smoking, and relationship with measures of executive function.

PubMed

Mueller, Eldon T; Landes, Reid D; Kowal, Benjamin P; Yi, Richard; Stitzer, Maxine L; Burnett, Cody A; Bickel, Warren K

2009-09-01

Nineteen nicotine-deprived cigarette smokers received monetary rewards for each minute they chose not to initiate smoking in 2-h laboratory sessions followed by a 30-min period of enforced abstinence from smoking. Reinforcer amounts were delivered according to one of three schedules: increasing, decreasing, and constant. Relapse time (time until first cigarette) was shortest in the decreasing condition, longest in the increasing condition, and intermediate in the constant condition. All differences were significant except in the constant-decreasing comparison. The relationships between a battery of baseline assessments and relapse times were examined. Relapse times were predicted by delay-discounting coefficients (k) for $10 and $1000 in money and for $1000 of cigarettes. Relapse times were also predicted by the number of cigarettes smoked daily and a Wisconsin Card Sorting Test score. Performance on the Stroop Task and the Fagerström Test for Nicotine Dependence differentiated participants dichotomized into those who relapsed 'earlier' in sessions versus those who first smoked 'later'. The variability in some scores from smoking-urges and affect questionnaires administered after smoking-room sessions was explained by measures related to in-session nicotine intake. Results are discussed as they relate to contingency-management procedures, predictors of relapse, and the competing neurobehavioral decision systems theory of addiction.

Aneurysmal subarachnoid hemorrhage prognostic decision-making algorithm using classification and regression tree analysis.

PubMed

Lo, Benjamin W Y; Fukuda, Hitoshi; Angle, Mark; Teitelbaum, Jeanne; Macdonald, R Loch; Farrokhyar, Forough; Thabane, Lehana; Levine, Mitchell A H

2016-01-01

Classification and regression tree analysis involves the creation of a decision tree by recursive partitioning of a dataset into more homogeneous subgroups. Thus far, there is scarce literature on using this technique to create clinical prediction tools for aneurysmal subarachnoid hemorrhage (SAH). The classification and regression tree analysis technique was applied to the multicenter Tirilazad database (3551 patients) in order to create the decision-making algorithm. In order to elucidate prognostic subgroups in aneurysmal SAH, neurologic, systemic, and demographic factors were taken into account. The dependent variable used for analysis was the dichotomized Glasgow Outcome Score at 3 months. Classification and regression tree analysis revealed seven prognostic subgroups. Neurological grade, occurrence of post-admission stroke, occurrence of post-admission fever, and age represented the explanatory nodes of this decision tree. Split sample validation revealed classification accuracy of 79% for the training dataset and 77% for the testing dataset. In addition, the occurrence of fever at 1-week post-aneurysmal SAH is associated with increased odds of post-admission stroke (odds ratio: 1.83, 95% confidence interval: 1.56-2.45, P < 0.01). A clinically useful classification tree was generated, which serves as a prediction tool to guide bedside prognostication and clinical treatment decision making. This prognostic decision-making algorithm also shed light on the complex interactions between a number of risk factors in determining outcome after aneurysmal SAH.

Breakfast and Other Meal Consumption in Adolescents from Southern Poland

PubMed Central

Ostachowska-Gasior, Agnieszka; Piwowar, Monika; Kwiatkowski, Jacek; Kasperczyk, Janusz; Skop-Lewandowska, Agata

2016-01-01

The aim of the study was to evaluate the frequency of breakfast and other meal consumption by adolescents and to assess the relationship between the first and the last meal consumption and sex, body mass index (BMI), and middle school and high school students’ education level. The study was conducted in 2013–2014 among 3009 students (1658 girls and 1351 boys) from middle s and high schools in Krakow and Silesia (Poland). The data was obtained from questionnaires that were analyzed with a logistic regression model for measurable and dichotomous variables. Breakfast consumers were seen to eat other meals (second breakfast, lunch, dessert, supper) significantly more often than breakfast skippers. The main meal consumption habits depend on sex and change as adolescents age. Being a girl and a high school student predisposed participants to skip breakfast and supper more often. The BMI of breakfast consumers does not differ significantly from the BMI of breakfast skippers, so BMI might thus not be a sufficient marker of breakfast consumption regularity and dietary habits in an adolescent group. The importance of regularly eaten meals, especially breakfast, together with adequate daily dietary energy intake are beneficial for physical and psychological development and cannot be overestimated in nutritional education and it is necessary to promote healthy eating behavior for well-being in later adult life. PMID:27136572

Delay of Smoking Gratification as a Laboratory Model of Relapse: Effects of Incentives for Not Smoking, and Relationship to Measures of Executive Function

PubMed Central

Mueller, E. Terry; Landes, Reid D.; Kowal, Benjamin P.; Yi, Richard; Stitzer, Maxine L.; Burnett, Cody A.; Bickel, Warren K.

2010-01-01

Nineteen nicotine-deprived cigarette smokers received monetary rewards for each minute they choose not to initiate smoking in 2-hour laboratory sessions followed by a 30-min period of enforced abstinence from smoking. Reinforcer amounts were delivered according to one of three schedules: increasing, decreasing, and constant. Relapse time (time until first smoke) was shortest in the decreasing condition, longest in the increasing condition, and intermediate in the constant condition. All differences were significant except in the constant-decreasing comparison. The relationships between a battery of baseline assessments and relapse times were examined. Relapse times were predicted by delay-discounting coefficients (k) for $10 and $1000 in money, and for $1000 of cigarettes. Relapse times were also predicted by the number of cigarettes smoked daily and a Wisconsin Card Sorting Test score. Performance on the Stroop Task and the Fagerström Test for Nicotine Dependence differentiated participants dichotomized into those who relapsed “earlier” in sessions versus those who first smoked “later.” Variability on some scores from smoking-urges and affect questionnaires administered after smoking-room sessions was explained by measures related to in-session nicotine intake. Results are discussed as they relate to contingency-management procedures, predictors of relapse, and the competing neuro-behavioral decision systems theory of addiction. PMID:19741301

ADL ability characteristics of partially dependent older people: Gender and age differences in ADL ability.

PubMed

Sato, S; Demura, S; Tanaka, K; Kasuga, K; Kobayashi, H

2001-07-01

Age and gender differences in ADL ability were investigated using 568 Japanese partially dependent older people (PD, Mean age=82.2±7.76 years) living in welfare institutions. The subjects were asked about 17 ADL items representing 7 ADL domains by the professional staff working at subjects' institutions. Each item was assessed by a dichotomous scale of "possible" or "impossible". Item proportions of "possible" response were calculated for gender and age groups (60s, 70s, 80s and 90s). Two-way analysis of variance (ANOVA) using the arcsine transformation method indicated no gender differences. Significant decreases in ADL ability with aging were found in 13 of the 17 items. The dependency of ADL in the PD significantly increases with aging, and there is no significant difference in this trend between men and women. The dependency of more difficult activities using lower limb increase from the 70s, and independency of low-difficult activities such as manual activities, feeding and changing posture while lying is maintained until the 80s and over.

Healthcare Cost and Impact of Persistent Orofacial Pain: The DEEP Study Cohort.

PubMed

Durham, J; Shen, J; Breckons, M; Steele, J G; Araujo-Soares, V; Exley, C; Vale, L

2016-09-01

Few data are available on the healthcare costs of those suffering from persistent orofacial pain (POFP). This cohort and cost analysis study examined the direct costs of POFP from the perspective of the healthcare provider (specifically, the UK National Health Service) in 2012 pounds sterling and sought to identify whether dichotomized (high, IIb to IV; low, 0 to IIa) graded chronic pain scale (GCPS) status is predictive of the total cost of healthcare over the last 6 mo. The healthcare utilization data of 198 patients with POFP were collected using a structured interview and a validated "use of services and productivity" questionnaire. Unit costs were used with these utilization data to calculate direct healthcare costs in 3 categories: consultation, medication, and appliances and interventions. Consultation costs were a significant proportion of cumulative healthcare cost (P < 0.001). Dichotomized GCPS status was predictive of increased healthcare cost over the last 6 mo, accounting for an average increase of £366 (95% confidence interval, 135 to 598; P < 0.01) when moving from a low GCPS status to a high GCPS status. Given the predictive capability of dichotomized GCPS status and the success of stratified models of care for other persistent pain conditions, dichotomized GCPS status may offer an opportunity to help determine stratification of care for patients with POFP. © International & American Associations for Dental Research 2016.

Physiotherapist agreement when visually rating movement quality during lower extremity functional screening tests.

PubMed

Whatman, Chris; Hing, Wayne; Hume, Patria

2012-05-01

To investigate physiotherapist agreement in rating movement quality during lower extremity functional tests using two visual rating methods and physiotherapists with differing clinical experience. Clinical measurement. Six healthy individuals were rated by 44 physiotherapists. These raters were in three groups (inexperienced, novice, experienced). Video recordings of all six individuals performing four lower extremity functional tests were visually rated (dichotomous or ordinal scale) using two rating methods (overall or segment) on two occasions separated by 3-4 weeks. Intra and inter-rater agreement for physiotherapists was determined using overall percentage agreement (OPA) and the first order agreement coefficient (AC1). Intra-rater agreement for overall and segment methods ranged from slight to almost perfect (OPA: 29-96%, AC1: 0.01 to 0.96). AC1 agreement was better in the experienced group (84-99% likelihood) and for dichotomous rating (97-100% likelihood). Inter-rater agreement ranged from fair to good (OPA: 45-79%; AC1: 0.22-0.71). AC1 agreement was not influenced by clinical experience but was again better using dichotomous rating. Physiotherapists' visual rating of movement quality during lower extremity functional tests resulted in slight to almost perfect intra-rater agreement and fair to good inter-rater agreement. Agreement improved with increased level of clinical experience and use of dichotomous rating. Copyright © 2011 Elsevier Ltd. All rights reserved.

Nonequilibrium transitions driven by external dichotomous noise

NASA Astrophysics Data System (ADS)

Behn, U.; Schiele, K.; Teubel, A.; Kühnel, A.

1987-06-01

The stationary probability density P s for a class of nonlinear one-dimensional models driven by a dichotomous Markovian process (DMP) I t , can be calculated explicitly. For the specific case of the Stratonovich model, x=ax - -x 3 +I t x, the qualitative shape of P s and its support is discussed in the whole parameter region. The location of the maxima of P s shows a behavior similar to order parameters in continuous phase transitions. The possibility of a noiseinduced change from continuous to a discontinuous transition in an extended model, in which the DMP couples also to the cubic term, is discussed. The time-dependent moments can be represented as an infinite series of terms, which are determined by a recursion formula. For negative even moments the series terminates and the long-time behavior can be obtained analytically. As a function of the physical parameters, qualitative changes of this behavior may occur which can be partially related to the behavior of P s . All results reproduce those for Gaussian white noise in the corresponding limit. The influence of the finite correlation time and the discreteness of the space of states of the DMP are discussed. An extensive list of references is contained in U. Behn, K. Schiele, and A. Teubel, Wiss. Z. Karl-Marx-Univ. Leipzig, Mathem.-Naturwiss. R. 34:602 (1985).

The Stress-responsive Gene ATF3 Mediates Dichotomous UV Responses by Regulating the Tip60 and p53 Proteins*

PubMed Central

Cui, Hongmei; Li, Xingyao; Han, Chunhua; Wang, Qi-En; Wang, Hongbo; Ding, Han-Fei; Zhang, Junran; Yan, Chunhong

2016-01-01

The response to UV irradiation is important for a cell to maintain its genetic integrity when challenged by environmental genotoxins. An immediate early response to UV irradiation is the rapid induction of activating transcription factor 3 (ATF3) expression. Although emerging evidence has linked ATF3 to stress pathways regulated by the tumor suppressor p53 and the histone acetyltransferase Tip60, the role of ATF3 in the UV response remains largely unclear. Here, we report that ATF3 mediated dichotomous UV responses. Although UV irradiation enhanced the binding of ATF3 to Tip60, knockdown of ATF3 expression decreased Tip60 stability, thereby impairing Tip60 induction by UV irradiation. In line with the role of Tip60 in mediating UV-induced apoptosis, ATF3 promoted the death of p53-defective cells in response to UV irradiation. However, ATF3 could also activate p53 and promote p53-mediated DNA repair, mainly through altering histone modifications that could facilitate recruitment of DNA repair proteins (such as DDB2) to damaged DNA sites. As a result, ATF3 rather protected the p53 wild-type cells from UV-induced apoptosis. Our results thus indicate that ATF3 regulates cell fates upon UV irradiation in a p53-dependent manner. PMID:26994140

Adopting a Patient-Centered Approach to Primary Outcome Analysis of Acute Stroke Trials Using a Utility-Weighted Modified Rankin Scale.

PubMed

Chaisinanunkul, Napasri; Adeoye, Opeolu; Lewis, Roger J; Grotta, James C; Broderick, Joseph; Jovin, Tudor G; Nogueira, Raul G; Elm, Jordan J; Graves, Todd; Berry, Scott; Lees, Kennedy R; Barreto, Andrew D; Saver, Jeffrey L

2015-08-01

Although the modified Rankin Scale (mRS) is the most commonly used primary end point in acute stroke trials, its power is limited when analyzed in dichotomized fashion and its indication of effect size challenging to interpret when analyzed ordinally. Weighting the 7 Rankin levels by utilities may improve scale interpretability while preserving statistical power. A utility-weighted mRS (UW-mRS) was derived by averaging values from time-tradeoff (patient centered) and person-tradeoff (clinician centered) studies. The UW-mRS, standard ordinal mRS, and dichotomized mRS were applied to 11 trials or meta-analyses of acute stroke treatments, including lytic, endovascular reperfusion, blood pressure moderation, and hemicraniectomy interventions. Utility values were 1.0 for mRS level 0; 0.91 for mRS level 1; 0.76 for mRS level 2; 0.65 for mRS level 3; 0.33 for mRS level 4; 0 for mRS level 5; and 0 for mRS level 6. For trials with unidirectional treatment effects, the UW-mRS paralleled the ordinal mRS and outperformed dichotomous mRS analyses. Both the UW-mRS and the ordinal mRS were statistically significant in 6 of 8 unidirectional effect trials, whereas dichotomous analyses were statistically significant in 2 to 4 of 8. In bidirectional effect trials, both the UW-mRS and ordinal tests captured the divergent treatment effects by showing neutral results, whereas some dichotomized analyses showed positive results. Mean utility differences in trials with statistically significant positive results ranged from 0.026 to 0.249. A UW-mRS performs similar to the standard ordinal mRS in detecting treatment effects in actual stroke trials and ensures the quantitative outcome is a valid reflection of patient-centered benefits. © 2015 American Heart Association, Inc.

Cutoff Finder: A Comprehensive and Straightforward Web Application Enabling Rapid Biomarker Cutoff Optimization

PubMed Central

Budczies, Jan; Klauschen, Frederick; Sinn, Bruno V.; Győrffy, Balázs; Schmitt, Wolfgang D.; Darb-Esfahani, Silvia; Denkert, Carsten

2012-01-01

Gene or protein expression data are usually represented by metric or at least ordinal variables. In order to translate a continuous variable into a clinical decision, it is necessary to determine a cutoff point and to stratify patients into two groups each requiring a different kind of treatment. Currently, there is no standard method or standard software for biomarker cutoff determination. Therefore, we developed Cutoff Finder, a bundle of optimization and visualization methods for cutoff determination that is accessible online. While one of the methods for cutoff optimization is based solely on the distribution of the marker under investigation, other methods optimize the correlation of the dichotomization with respect to an outcome or survival variable. We illustrate the functionality of Cutoff Finder by the analysis of the gene expression of estrogen receptor (ER) and progesterone receptor (PgR) in breast cancer tissues. This distribution of these important markers is analyzed and correlated with immunohistologically determined ER status and distant metastasis free survival. Cutoff Finder is expected to fill a relevant gap in the available biometric software repertoire and will enable faster optimization of new diagnostic biomarkers. The tool can be accessed at http://molpath.charite.de/cutoff. PMID:23251644

Estimation of the biserial correlation and its sampling variance for use in meta-analysis.

PubMed

Jacobs, Perke; Viechtbauer, Wolfgang

2017-06-01

Meta-analyses are often used to synthesize the findings of studies examining the correlational relationship between two continuous variables. When only dichotomous measurements are available for one of the two variables, the biserial correlation coefficient can be used to estimate the product-moment correlation between the two underlying continuous variables. Unlike the point-biserial correlation coefficient, biserial correlation coefficients can therefore be integrated with product-moment correlation coefficients in the same meta-analysis. The present article describes the estimation of the biserial correlation coefficient for meta-analytic purposes and reports simulation results comparing different methods for estimating the coefficient's sampling variance. The findings indicate that commonly employed methods yield inconsistent estimates of the sampling variance across a broad range of research situations. In contrast, consistent estimates can be obtained using two methods that appear to be unknown in the meta-analytic literature. A variance-stabilizing transformation for the biserial correlation coefficient is described that allows for the construction of confidence intervals for individual coefficients with close to nominal coverage probabilities in most of the examined conditions. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Factors that distinguish college students with depressive symptoms with and without suicidal thoughts

PubMed Central

Nyer, Maren; Holt, Daphne J.; Pedrelli, Paola; Fava, Maurizio; Ameral, Victoria; Cassiello, Clair F.; Nock, Matthew K.; Ross, Margaret; Hutchinson, Dori; Farabaugh, Amy

2013-01-01

BACKGROUND Suicide among college students is a significant public health concern. Although suicidality is linked to depression, not all depressed college students experience suicidal ideation (SI). The primary aim of this study was to determine potential factors that may distinguish college students with depressive symptoms with and without SI. METHODS A total of 287 undergraduate college students with substantial depressive symptoms (Beck Depression Inventory [BDI] total score >13) with and without SI were compared across psychiatric and functional outcome variables. Independent sample t tests were conducted for each outcome variable using the suicide item of the BDI as a dichotomous (ie, zero vs nonzero score) grouping variable. RESULTS Relative to students with substantial depressive symptoms without SI, those with SI were more symptomatic overall, having significantly higher levels of depressive symptoms, hopelessness, and anxiety. However, contrary to our expectations, nonsuicidal and suicidal students did not differ on measures of everyday functioning (ie, cognitive and physical functioning and grade point average). CONCLUSIONS Our findings suggest that SI among college students is associated with increased subjective distress but may not adversely impact physical or cognitive functioning or academic performance. PMID:23376869

Measuring the willingness to pay user fees for interpretive services at a national forest

NASA Astrophysics Data System (ADS)

Goldhor-Wilcock, Barbara Ashley

An understanding of willingness to pay (WTP) for nonmarket environmental goods is useful for planning and policy, but difficult to determine. WTP for interpretive services was investigated using interviews with 361 participants in guided nature tours. Immediately after the tour, participants were asked to state their WIT for the tour. Responses were predominantly 5 (42%), 2 (14%) and 10 (13%). A predetermined amount was added to the open-ended (OE) WTP offer and respondents were asked if they were willing to pay a larger amount. Acceptance of the larger amount depended strongly on the relative increase over the initial WTP. If the increase was smaller than the initial offer, most respondents agreed, whereas if the increment was larger, most did not agree, suggesting that the initial offer was approximately half of the true WTP. The two WTP questions were used to define lower and upper bounds for each respondent's true WTP. A censored interval regression was used to estimate a WTP distribution with mean 11.30 and median $10.00. The median is twice that of the OE WTP, further suggesting that the OE response understated value by 50 percent. The estimated true WTP distribution and the OE WTP distribution have a weak, but statistically significant, dependence on some demographic, travel, and benefit variables, although these relations have negligible practical significance over the observed range of the variables. To evaluate whether the WTP amounts were based on a true economic tradeoff, respondents were asked to explain their WTP responses. For the initial OE question, 38% gave explanations that could be interpreted as an economic tradeoff, whereas 33% gave reasons that were clearly irrelevant. For the second, dichotomous choice (DC), question, 59% gave reasons suggesting a relevant economic judgement. A DC question may provoke apparently relevant answers, regardless of the underlying reasoning (a majority simply said "it was (not) worth it"). The DC reasoning may also be influenced by the preceding OE question, which provides a comparative base. Combining OE and DC questions in a single survey may encourage relevant reasoning, while also helping to identify the true WTP and consumer surplus.

Unbiased split variable selection for random survival forests using maximally selected rank statistics.

PubMed

Wright, Marvin N; Dankowski, Theresa; Ziegler, Andreas

2017-04-15

The most popular approach for analyzing survival data is the Cox regression model. The Cox model may, however, be misspecified, and its proportionality assumption may not always be fulfilled. An alternative approach for survival prediction is random forests for survival outcomes. The standard split criterion for random survival forests is the log-rank test statistic, which favors splitting variables with many possible split points. Conditional inference forests avoid this split variable selection bias. However, linear rank statistics are utilized by default in conditional inference forests to select the optimal splitting variable, which cannot detect non-linear effects in the independent variables. An alternative is to use maximally selected rank statistics for the split point selection. As in conditional inference forests, splitting variables are compared on the p-value scale. However, instead of the conditional Monte-Carlo approach used in conditional inference forests, p-value approximations are employed. We describe several p-value approximations and the implementation of the proposed random forest approach. A simulation study demonstrates that unbiased split variable selection is possible. However, there is a trade-off between unbiased split variable selection and runtime. In benchmark studies of prediction performance on simulated and real datasets, the new method performs better than random survival forests if informative dichotomous variables are combined with uninformative variables with more categories and better than conditional inference forests if non-linear covariate effects are included. In a runtime comparison, the method proves to be computationally faster than both alternatives, if a simple p-value approximation is used. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

Assessing the comprehensive restoration of an urban river: an integrated application of contingent valuation in Shanghai, China.

PubMed

Zhao, Jun; Liu, Qiuxia; Lin, Liqing; Lv, Huafang; Wang, Yao

2013-08-01

Around 2000, China began to address the comprehensive restoration of its urban rivers and attempt to restore river ecosystem services. This paper reports an integrated contingent valuation of the ecosystem services of Zhangjiabang Creek in Shanghai, which is in the most developed region of China. A total of 1440 questionnaires were delivered, and 1153 were returned as usable in August 2008. The willingness to pay for the restoration of the urban river is 20.22 RMB (2.91 USD) per month per household under the payment card and 110.64 RMB (15.92 USD) under the dichotomous format. Several important methodological issues of the contingent valuation method (CVM) are observed, including the disparity between willingness to pay and willingness to accept, the difference between payment card and dichotomous choice question formats, and the comparison of different models in welfare estimation using dichotomous choice data. Several new findings are disclosed for these three issues of CVM. Copyright © 2013 Elsevier B.V. All rights reserved.

Interval estimation and optimal design for the within-subject coefficient of variation for continuous and binary variables

PubMed Central

Shoukri, Mohamed M; Elkum, Nasser; Walter, Stephen D

2006-01-01

Background In this paper we propose the use of the within-subject coefficient of variation as an index of a measurement's reliability. For continuous variables and based on its maximum likelihood estimation we derive a variance-stabilizing transformation and discuss confidence interval construction within the framework of a one-way random effects model. We investigate sample size requirements for the within-subject coefficient of variation for continuous and binary variables. Methods We investigate the validity of the approximate normal confidence interval by Monte Carlo simulations. In designing a reliability study, a crucial issue is the balance between the number of subjects to be recruited and the number of repeated measurements per subject. We discuss efficiency of estimation and cost considerations for the optimal allocation of the sample resources. The approach is illustrated by an example on Magnetic Resonance Imaging (MRI). We also discuss the issue of sample size estimation for dichotomous responses with two examples. Results For the continuous variable we found that the variance stabilizing transformation improves the asymptotic coverage probabilities on the within-subject coefficient of variation for the continuous variable. The maximum like estimation and sample size estimation based on pre-specified width of confidence interval are novel contribution to the literature for the binary variable. Conclusion Using the sample size formulas, we hope to help clinical epidemiologists and practicing statisticians to efficiently design reliability studies using the within-subject coefficient of variation, whether the variable of interest is continuous or binary. PMID:16686943

NEUROPSYCHOLOGICAL PERFORMANCE WITHIN-PERSON VARIABILITY IS ASSOCIATED WITH REDUCED TREATMENT CONSENT CAPACITY

PubMed Central

Gurrera, Ronald J.; Karel, Michele J.; Azar, Armin R.; Moye, Jennifer

2013-01-01

OBJECTIVES The capacity of older adults to make health care decisions is often impaired in dementia and has been linked to performance on specific neuropsychological tasks. Within-person across-test neuropsychological performance variability has been shown to predict future dementia. This study examined the relationship of within-person across-test neuropsychological performance variability to a current construct of treatment decision (consent) capacity. DESIGN Participants completed a neuropsychological test battery and a standardized capacity assessment. Standard scores were used to compute mean neuropsychological performance and within-person across-test variability. SETTING Assessments were performed in the participant’s preferred location (e.g., outpatient clinic office, senior center, or home). PARTICIPANTS Participants were recruited from the community with fliers and advertisements, and consisted of men (N=79) and women (N=80) with (N=83) or without (N=76) significant cognitive impairment. MEASUREMENTS Participants completed the MacArthur Competence Assessment Tool - Treatment (MacCAT-T) and 11 neuropsychological tests commonly used in the cognitive assessment of older individuals. RESULTS Neuropsychological performance and within-person variability were independently associated with continuous and dichotomous measures of capacity, and within-person neuropsychological variability was significantly associated with within-person decisional ability variability. Prevalence of incapacity was greater than expected in participants with and without significant cognitive impairment when decisional abilities were considered separately. CONCLUSIONS These findings are consistent with an emerging construct of consent capacity in which discrete decisional abilities are differentially associated with cognitive processes, and indicate that the sensitivity and accuracy of consent capacity assessments can be improved by evaluating decisional abilities separately. PMID:23831178

Circuit analysis method for thin-film solar cell modules

NASA Technical Reports Server (NTRS)

Burger, D. R.

1985-01-01

The design of a thin-film solar cell module is dependent on the probability of occurrence of pinhole shunt defects. Using known or assumed defect density data, dichotomous population statistics can be used to calculate the number of defects expected in a module. Probability theory is then used to assign the defective cells to individual strings in a selected series-parallel circuit design. Iterative numerical calculation is used to calcuate I-V curves using cell test values or assumed defective cell values as inputs. Good and shunted cell I-V curves are added to determine the module output power and I-V curve. Different levels of shunt resistance can be selected to model different defect levels.

Rising relative fluctuation as a warning indicator of discontinuous transitions in symbiotic metapopulations

NASA Astrophysics Data System (ADS)

Lumi, Neeme; Laas, Katrin; Mankin, Romi

2015-11-01

The long-time limit behavior of the stochastic Lotka-Volterra model of a symbiotic metapopulation subjected to generalized Verhulst self-regulation is considered. The influence of a time-variable environment on the carrying capacities of subpopulations is modeled as a periodic deterministic part and a symmetric dichotomous noise. Relying on the mean-field approach it is established that at certain parameter regimes the mean field (average subpopulations size) exhibits hysteresis in respect to the noise correlation time, manifested in the appearance of colored-noise-induced discontinuous transitions. Especially, it is shown that the relative fluctuation of the subpopulation sizes exhibits accelerated increase prior to abrupt transitions of the metapopulation state. Moreover, in certain cases the autocorrelation function of the population sizes demonstrates anticorrelation at some values of the lag time.

Influences on choice of surgery as a career: a study of consecutive cohorts in a medical school.

PubMed

Sobral, Dejano T

2006-06-01

To examine the differential impact of person-based and programme-related features on graduates' dichotomous choice between surgical or non-surgical field specialties for first-year residency. A 10-year cohort study was conducted, following 578 students (55.4% male) who graduated from a university medical school during 1994-2003. Data were collected as follows: at the beginning of medical studies, on career preference and learning frame; during medical studies, on academic achievement, cross-year peer tutoring and selective clinical traineeship, and at graduation, on the first-year residency selected. Contingency and logistic regression analyses were performed, with graduates grouped by the dichotomous choice of surgery or not. Overall, 23% of graduates selected a first-year residency in surgery. Seven time-steady features related to this choice: male sex, high self-confidence, option of surgery at admission, active learning style, preference for surgery after Year 1, peer tutoring on clinical surgery, and selective training in clinical surgery. Logistic regression analysis, including all features, predicted 87.1% of the graduates' choices. Male sex, updated preference, peer tutoring and selective training were the most significant predictors in the pathway to choice. The relative roles of person-based and programme-related factors in the choice process are discussed. The findings suggest that for most students the choice of surgery derives from a temporal summation of influences that encompass entry and post-entry factors blended in variable patterns. It is likely that sex-unbiased peer tutoring and selective training supported the students' search process for personal compatibility with specialty-related domains of content and process.

Prototypic and Arkypallidal Neurons in the Dopamine-Intact External Globus Pallidus

PubMed Central

Abdi, Azzedine; Mallet, Nicolas; Mohamed, Foad Y.; Sharott, Andrew; Dodson, Paul D.; Nakamura, Kouichi C.; Suri, Sana; Avery, Sophie V.; Larvin, Joseph T.; Garas, Farid N.; Garas, Shady N.; Vinciati, Federica; Morin, Stéphanie; Bezard, Erwan

2015-01-01

Studies in dopamine-depleted rats indicate that the external globus pallidus (GPe) contains two main types of GABAergic projection cell; so-called “prototypic” and “arkypallidal” neurons. Here, we used correlative anatomical and electrophysiological approaches in rats to determine whether and how this dichotomous organization applies to the dopamine-intact GPe. Prototypic neurons coexpressed the transcription factors Nkx2-1 and Lhx6, comprised approximately two-thirds of all GPe neurons, and were the major GPe cell type innervating the subthalamic nucleus (STN). In contrast, arkypallidal neurons expressed the transcription factor FoxP2, constituted just over one-fourth of GPe neurons, and innervated the striatum but not STN. In anesthetized dopamine-intact rats, molecularly identified prototypic neurons fired at relatively high rates and with high regularity, regardless of brain state (slow-wave activity or spontaneous activation). On average, arkypallidal neurons fired at lower rates and regularities than prototypic neurons, and the two cell types could be further distinguished by the temporal coupling of their firing to ongoing cortical oscillations. Complementing the activity differences observed in vivo, the autonomous firing of identified arkypallidal neurons in vitro was slower and more variable than that of prototypic neurons, which tallied with arkypallidal neurons displaying lower amplitudes of a “persistent” sodium current important for such pacemaking. Arkypallidal neurons also exhibited weaker driven and rebound firing compared with prototypic neurons. In conclusion, our data support the concept that a dichotomous functional organization, as actioned by arkypallidal and prototypic neurons with specialized molecular, structural, and physiological properties, is fundamental to the operations of the dopamine-intact GPe. PMID:25926446

What subject matter questions motivate the use of machine learning approaches compared to statistical models for probability prediction?

PubMed

Binder, Harald

2014-07-01

This is a discussion of the following papers: "Probability estimation with machine learning methods for dichotomous and multicategory outcome: Theory" by Jochen Kruppa, Yufeng Liu, Gérard Biau, Michael Kohler, Inke R. König, James D. Malley, and Andreas Ziegler; and "Probability estimation with machine learning methods for dichotomous and multicategory outcome: Applications" by Jochen Kruppa, Yufeng Liu, Hans-Christian Diener, Theresa Holste, Christian Weimar, Inke R. König, and Andreas Ziegler. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

University of North Carolina Caries Risk Assessment Study: comparisons of high risk prediction, any risk prediction, and any risk etiologic models.

PubMed

Beck, J D; Weintraub, J A; Disney, J A; Graves, R C; Stamm, J W; Kaste, L M; Bohannan, H M

1992-12-01

The purpose of this analysis is to compare three different statistical models for predicting children likely to be at risk of developing dental caries over a 3-yr period. Data are based on 4117 children who participated in the University of North Carolina Caries Risk Assessment Study, a longitudinal study conducted in the Aiken, South Carolina, and Portland, Maine areas. The three models differed with respect to either the types of variables included or the definition of disease outcome. The two "Prediction" models included both risk factor variables thought to cause dental caries and indicator variables that are associated with dental caries, but are not thought to be causal for the disease. The "Etiologic" model included only etiologic factors as variables. A dichotomous outcome measure--none or any 3-yr increment, was used in the "Any Risk Etiologic model" and the "Any Risk Prediction Model". Another outcome, based on a gradient measure of disease, was used in the "High Risk Prediction Model". The variables that are significant in these models vary across grades and sites, but are more consistent among the Etiologic model than the Predictor models. However, among the three sets of models, the Any Risk Prediction Models have the highest sensitivity and positive predictive values, whereas the High Risk Prediction Models have the highest specificity and negative predictive values. Considerations in determining model preference are discussed.

Multi-way multi-group segregation and diversity indices.

PubMed

Gorelick, Root; Bertram, Susan M

2010-06-01

How can we compute a segregation or diversity index from a three-way or multi-way contingency table, where each variable can take on an arbitrary finite number of values and where the index takes values between zero and one? Previous methods only exist for two-way contingency tables or dichotomous variables. A prototypical three-way case is the segregation index of a set of industries or departments given multiple explanatory variables of both sex and race. This can be further extended to other variables, such as disability, number of years of education, and former military service. We extend existing segregation indices based on Euclidean distance (square of coefficient of variation) and Boltzmann/Shannon/Theil index from two-way to multi-way contingency tables by including multiple summations. We provide several biological applications, such as indices for age polyethism and linkage disequilibrium. We also provide a new heuristic conceptualization of entropy-based indices. Higher order association measures are often independent of lower order ones, hence an overall segregation or diversity index should be the arithmetic mean of the normalized association measures at all orders. These methods are applicable when individuals self-identify as multiple races or even multiple sexes and when individuals work part-time in multiple industries. The policy implications of this work are enormous, allowing people to rigorously test whether employment or biological diversity has changed.

Induced abortion: risk factors for adolescent female students, a Brazilian study.

PubMed

Correia, Divanise S; Cavalcante, Jairo C; Maia, Eulália M C

2009-12-16

The purpose of this study was to analyze risk factors for abortion among female teenagers from 12 to 19 years of age in the city of Maceió, Brazil. This is a cross-sectional study, conducted in ten schools. The sample was calculated by considering the number of admissions for postabortion curettage, obtained from the Information System of Hospitalization. Data were obtained through a semi-structured questionnaire divided into three basic blocks of data: sociodemographic, sexual life, and pregnancy/abortion. To analyze the data, the logistic regression model was used. The Forward Method was chosen to set the final model that minimizes the number of variables and maximizes the accuracy of the model. The significant analysis between the dichotomous variables provided eight significant variables. Two of them are protective for abortion: the ages 12-14 years and talking with parents about sex. After the logistic regression, the receipt of support for abortion was the most significant variable of all. The adolescent with an active sexual life, a previous pregnancy, who is married, and has received support for an abortion has a 99.74% probability for an abortion. The results of this study, demonstrating the importance of the group in adolescence, and the statistical significance of having a partner to support and approve the pregnancy appears as a preventive factor for abortion. It shows the importance of support and companionship for adolescent women.

Tumoral Versus Flat Intraepithelial Neoplasia of Pancreatobiliary Tract, Gallbladder, and Ampulla of Vater.

PubMed

Jang, Kee-Taek; Ahn, Sangjeong

2016-05-01

-The identification of a precursor lesion is important to understanding the histopathologic and genetic alterations in carcinogenesis. There are a plethora of terminologies that describe precursor lesions of the pancreatobiliary tract, ampulla of Vater, and gallbladder. The current terminologies for precursor lesions may make it difficult to understand the tumor biology. Here, we propose the concept of tumoral and flat intraepithelial neoplasia to improve our understanding of precursor lesions of many epithelial organs, including the pancreatobiliary tract, ampulla of Vater, and gallbladder. -To understand the dichotomous pattern of tumoral and flat intraepithelial neoplasia in carcinogenesis of pancreatobiliary tract, ampulla of Vater, and gallbladder. -Review of relevant literatures indexed in PubMed. -Tumoral intraepithelial neoplasia presents as an intraluminal or intraductal, mass-forming, polypoid lesion or a macroscopic, visible, cystic lesion without intracystic papillae. Microscopically, tumoral intraepithelial neoplasia shows various proportions of papillary and tubular architecture, often with a mixed pattern, such as papillary, tubular, and papillary-tubular. The malignant potential depends on the degree of dysplasia and the cell phenotype of the epithelium. Flat intraepithelial neoplasia presents as a flat or superficial, spreading, mucosal lesion that is frequently accompanied by an invasive carcinoma. Tumoral and flat intraepithelial neoplasias are not homogeneous entities and may exhibit histopathologic spectrum changes and different genetic profiles. Although intraepithelial neoplasia showed a dichotomous pattern in the tumoral versus flat types, they can coexist. Tumoral and flat intraepithelial neoplasia can be interpreted as part of a spectrum of changes in the carcinogenesis pathway of each organ.

Emotion recognition based on physiological changes in music listening.

PubMed

Kim, Jonghwa; André, Elisabeth

2008-12-01

Little attention has been paid so far to physiological signals for emotion recognition compared to audiovisual emotion channels such as facial expression or speech. This paper investigates the potential of physiological signals as reliable channels for emotion recognition. All essential stages of an automatic recognition system are discussed, from the recording of a physiological dataset to a feature-based multiclass classification. In order to collect a physiological dataset from multiple subjects over many weeks, we used a musical induction method which spontaneously leads subjects to real emotional states, without any deliberate lab setting. Four-channel biosensors were used to measure electromyogram, electrocardiogram, skin conductivity and respiration changes. A wide range of physiological features from various analysis domains, including time/frequency, entropy, geometric analysis, subband spectra, multiscale entropy, etc., is proposed in order to find the best emotion-relevant features and to correlate them with emotional states. The best features extracted are specified in detail and their effectiveness is proven by classification results. Classification of four musical emotions (positive/high arousal, negative/high arousal, negative/low arousal, positive/low arousal) is performed by using an extended linear discriminant analysis (pLDA). Furthermore, by exploiting a dichotomic property of the 2D emotion model, we develop a novel scheme of emotion-specific multilevel dichotomous classification (EMDC) and compare its performance with direct multiclass classification using the pLDA. Improved recognition accuracy of 95\\% and 70\\% for subject-dependent and subject-independent classification, respectively, is achieved by using the EMDC scheme.

Generalized Full-Information Item Bifactor Analysis

PubMed Central

Cai, Li; Yang, Ji Seung; Hansen, Mark

2011-01-01

Full-information item bifactor analysis is an important statistical method in psychological and educational measurement. Current methods are limited to single group analysis and inflexible in the types of item response models supported. We propose a flexible multiple-group item bifactor analysis framework that supports a variety of multidimensional item response theory models for an arbitrary mixing of dichotomous, ordinal, and nominal items. The extended item bifactor model also enables the estimation of latent variable means and variances when data from more than one group are present. Generalized user-defined parameter restrictions are permitted within or across groups. We derive an efficient full-information maximum marginal likelihood estimator. Our estimation method achieves substantial computational savings by extending Gibbons and Hedeker’s (1992) bifactor dimension reduction method so that the optimization of the marginal log-likelihood only requires two-dimensional integration regardless of the dimensionality of the latent variables. We use simulation studies to demonstrate the flexibility and accuracy of the proposed methods. We apply the model to study cross-country differences, including differential item functioning, using data from a large international education survey on mathematics literacy. PMID:21534682

Perceptions of primary health care service users regarding dental team practices in Brazil.

PubMed

Baumgarten, Alexandre; Veiga, Rochelle Santos Da; Bulgarelli, Patricia Tavora; Diesel, Vitor Motta; Bulgarelli, Alexandre Favero

2018-05-01

The Unified Health System (SUS) is the Brazilian set of public health services that offers global access to health care and disease treatments for all citizens. These services have been evaluated by means of a national survey assessing the users' perceptions.AimTo explore and characterize the SUS users' perceptions regarding primary dental team practices in the five Brazilian geographical regions. Descriptive study. The sample consisted of 37 262 subjects. Data were collected by means of the Ministry of Health survey, conducted between 2012 and 2014. Variables used in the present study are associated with SUS users' perspectives of satisfaction, access, and use of services. The study utilized bivariate data analysis, and dichotomous variables were derived for analysis following 95% reliability.FindingsThis study observed similarities and proportionality of perceptions in the Brazilian territory. In most macro-regions, dental teams did not develop an active search for dental treatment absentees. However, the SUS users reported very good and good perceptions, which were homogeneously distributed across five Brazilian regions, thereby showing an overall positive perception of primary dental treatment.

[Simplified indicator of socioeconomic status in short surveys: a proposal based on assets and services].

PubMed

Díaz-Acosta, Rodrigo; Shiba-Matsumoto, Andrey Ryo; Gutiérrez, Juan Pablo

2015-01-01

To develop a socioeconomic index for brief surveys that allows a classification in relation to a reference population with a parsimonious approach. A socioeconomic index was created using assets and use of services indicators to predict income level within a national representative survey of income (ENIGH, National Survey of Households Income and Expenditures) and then tested with data from a survey among key populations (men who have sex with men/transvestite, transgender, transsexual/female sex workers) and compared to an already published indicator. The concordance for quintiles 1, 2, 3, 4, and 5 between the two indexes were 94, 94, 82, 83, and 89%, respectively. The Spearman's rank correlation coefficient was 0.85. The proposed parsimonious index captures the socioeconomic level heterogeneity in the MSM/TTT/FSW survey. The use of this index is suggested for short surveys because of the next advantages: a) it uses dichotomic variables; b) the variables used do not imply the fulfillment of any statistical assumption; c) it is easily calculated; d) it can be used for comparing groups.

Vitamin D levels and their associations with survival and major disease outcomes in a large cohort of patients with chronic graft-vs-host disease

PubMed Central

Katić, Mašenjka; Pirsl, Filip; Steinberg, Seth M.; Dobbin, Marnie; Curtis, Lauren M.; Pulanić, Dražen; Desnica, Lana; Titarenko, Irina; Pavletic, Steven Z.

2016-01-01

Aim To identify the factors associated with vitamin D status in patients with chronic graft-vs-host disease (cGVHD) and evaluate the association between serum vitamin D (25(OH)D) levels and cGVHD characteristics and clinical outcomes defined by the National Institutes of Health (NIH) criteria. Methods 310 cGVHD patients enrolled in the NIH cGVHD natural history study (clinicaltrials.gov: NCT00092235) were analyzed. Univariate analysis and multiple logistic regression were used to determine the associations between various parameters and 25(OH)D levels, dichotomized into categorical variables: ≤20 and >20 ng/mL, and as a continuous parameter. Multiple logistic regression was used to develop a predictive model for low vitamin D. Survival analysis and association between cGVHD outcomes and 25(OH)D as a continuous as well as categorical variable: ≤20 and >20 ng/mL; <50 and ≥50 ng/mL, and among three ordered categories: ≤20, 20-50, and ≥50 ng/mL, was performed. PMID:27374829

Prediction of Mental Health Services Use One Year After Regular Referral to Specialized Care Versus Referral to Stepped Collaborative Care.

PubMed

van Orden, Mirjam; Leone, Stephanie; Haffmans, Judith; Spinhoven, Philip; Hoencamp, Erik

2017-04-01

Referral to collaborative mental health care within the primary care setting is a service concept that has shown to be as effective as direct referral to specialized mental health care for patients with common mental disorders. Additionally it is more efficient in terms of lower mental health services use. This post-hoc analysis examines if treatment intensity during 1-year of follow-up can be predicted prospectively by baseline characteristics. With multilevel multivariate regression analyses baseline characteristics were examined as potential predictors of visit counts. Results showed that only the enabling factors service concept and referral delay for treatment had a significant association with mental health visit counts, when outcome was dichotomized in five or more visits. Inclusion of the outcome variable as a count variable confirmed the predictive value of service concept and referral delay, but added marital status as a significant predictor. Overall, enabling factors (service concept and referral delay) seem to be important and dominant predictors of mental health services use.

Association of airborne moisture-indicating microorganisms withbuilding-related symptoms and water damage in 100 U.S. office buildings:Analyses of the U.S. EPA BASE data

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

Mendell, Mark J.; Lei, Quanhong; Cozen, Myrna O.

2003-10-01

Metrics of culturable airborne microorganisms for either total organisms or suspected harmful subgroups have generally not been associated with symptoms among building occupants. However, the visible presence of moisture damage or mold in residences and other buildings has consistently been associated with respiratory symptoms and other health effects. This relationship is presumably caused by adverse but uncharacterized exposures to moisture-related microbiological growth. In order to assess this hypothesis, we studied relationships in U.S. office buildings between the prevalence of respiratory and irritant symptoms, the concentrations of airborne microorganisms that require moist surfaces on which to grow, and the presence ofmore » visible water damage. For these analyses we used data on buildings, indoor environments, and occupants collected from a representative sample of 100 U.S. office buildings in the U.S. Environmental Protection Agency's Building Assessment Survey and Evaluation (EPA BASE) study. We created 19 alternate metrics, using scales ranging from 3-10 units, that summarized the concentrations of airborne moisture-indicating microorganisms (AMIMOs) as indicators of moisture in buildings. Two were constructed to resemble a metric previously reported to be associated with lung function changes in building occupants; the others were based on another metric from the same group of Finnish researchers, concentration cutpoints from other studies, and professional judgment. We assessed three types of associations: between AMIMO metrics and symptoms in office workers, between evidence of water damage and symptoms, and between water damage and AMIMO metrics. We estimated (as odds ratios (ORs) with 95% confidence intervals) the unadjusted and adjusted associations between the 19 metrics and two types of weekly, work-related symptoms--lower respiratory and mucous membrane--using logistic regression models. Analyses used the original AMIMO metrics and were repeated with simplified dichotomized metrics. The multivariate models adjusted for other potential confounding variables associated with respondents, occupied spaces, buildings, or ventilation systems. Models excluded covariates for moisture-related risks hypothesized to increase AMIMO levels. We also estimated the association of water damage (using variables for specific locations in the study space or building, or summary variables) with the two symptom outcomes. Finally, using selected AMIMO metrics as outcomes, we constructed logistic regression models with observations at the building level to estimate unadjusted and adjusted associations of evident water damage with AMIMO metrics. All original AMIMO metrics showed little overall pattern of unadjusted or adjusted association with either symptom outcome. The 3-category metric resembling that previously used by others, which of all constructed metrics had the largest number of buildings in its top category, was not associated with symptoms in these buildings. However, most metrics with few buildings in their highest category showed increased risk for both symptoms in that category, especially metrics using cutpoints of >100 but <500 colony-forming units (CFU)/m{sup 3} for concentration of total culturable fungi. With AMIMO metrics dichotomized to compare the highest category with all lower categories combined, four metrics had unadjusted ORs between 1.4 and 1.6 for both symptom outcomes. The same four metrics had adjusted ORs of 1.7-2.1 for both symptom outcomes. In models of water damage and symptoms, several specific locations of past water damage had significant associations with outcomes, with ORs ranging from 1.4-1.6. In bivariate models of water damage and selected AMIMO metrics, a number of specific types of water damage and several summary variables for water damage were very strongly associated with AMIMO metrics (significant ORs ranging above 15). Multivariate modeling with the dichotomous AMIMO metrics was not possible due to limited numbers of observations.« less

The Internet Gaming Disorder Scale.

PubMed

Lemmens, Jeroen S; Valkenburg, Patti M; Gentile, Douglas A

2015-06-01

Recently, the American Psychiatric Association included Internet gaming disorder (IGD) in the appendix of the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The main aim of the current study was to test the reliability and validity of 4 survey instruments to measure IGD on the basis of the 9 criteria from the DSM-5: a long (27-item) and short (9-item) polytomous scale and a long (27-item) and short (9-item) dichotomous scale. The psychometric properties of these scales were tested among a representative sample of 2,444 Dutch adolescents and adults, ages 13-40 years. Confirmatory factor analyses demonstrated that the structural validity (i.e., the dimensional structure) of all scales was satisfactory. Both types of assessment (polytomous and dichotomous) were also reliable (i.e., internally consistent) and showed good criterion-related validity, as indicated by positive correlations with time spent playing games, loneliness, and aggression and negative correlations with self-esteem, prosocial behavior, and life satisfaction. The dichotomous 9-item IGD scale showed solid psychometric properties and was the most practical scale for diagnostic purposes. Latent class analysis of this dichotomous scale indicated that 3 groups could be discerned: normal gamers, risky gamers, and disordered gamers. On the basis of the number of people in this last group, the prevalence of IGD among 13- through 40-year-olds in the Netherlands is approximately 4%. If the DSM-5 threshold for diagnosis (experiencing 5 or more criteria) is applied, the prevalence of disordered gamers is more than 5%. (c) 2015 APA, all rights reserved).

On models of the genetic code generated by binary dichotomic algorithms.

PubMed

Gumbel, Markus; Fimmel, Elena; Danielli, Alberto; Strüngmann, Lutz

2015-02-01

In this paper we introduce the concept of a BDA-generated model of the genetic code which is based on binary dichotomic algorithms (BDAs). A BDA-generated model is based on binary dichotomic algorithms (BDAs). Such a BDA partitions the set of 64 codons into two disjoint classes of size 32 each and provides a generalization of known partitions like the Rumer dichotomy. We investigate what partitions can be generated when a set of different BDAs is applied sequentially to the set of codons. The search revealed that these models are able to generate code tables with very different numbers of classes ranging from 2 to 64. We have analyzed whether there are models that map the codons to their amino acids. A perfect matching is not possible. However, we present models that describe the standard genetic code with only few errors. There are also models that map all 64 codons uniquely to 64 classes showing that BDAs can be used to identify codons precisely. This could serve as a basis for further mathematical analysis using coding theory, for example. The hypothesis that BDAs might reflect a molecular mechanism taking place in the decoding center of the ribosome is discussed. The scan demonstrated that binary dichotomic partitions are able to model different aspects of the genetic code very well. The search was performed with our tool Beady-A. This software is freely available at http://mi.informatik.hs-mannheim.de/beady-a. It requires a JVM version 6 or higher. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Analysis of the Influence of microRNAs in Lithium Response in Bipolar Disorder.

PubMed

Reinbold, Céline S; Forstner, Andreas J; Hecker, Julian; Fullerton, Janice M; Hoffmann, Per; Hou, Liping; Heilbronner, Urs; Degenhardt, Franziska; Adli, Mazda; Akiyama, Kazufumi; Akula, Nirmala; Ardau, Raffaella; Arias, Bárbara; Backlund, Lena; Benabarre, Antonio; Bengesser, Susanne; Bhattacharjee, Abesh K; Biernacka, Joanna M; Birner, Armin; Marie-Claire, Cynthia; Cervantes, Pablo; Chen, Guo-Bo; Chen, Hsi-Chung; Chillotti, Caterina; Clark, Scott R; Colom, Francesc; Cousins, David A; Cruceanu, Cristiana; Czerski, Piotr M; Dayer, Alexandre; Étain, Bruno; Falkai, Peter; Frisén, Louise; Gard, Sébastien; Garnham, Julie S; Goes, Fernando S; Grof, Paul; Gruber, Oliver; Hashimoto, Ryota; Hauser, Joanna; Herms, Stefan; Jamain, Stéphane; Jiménez, Esther; Kahn, Jean-Pierre; Kassem, Layla; Kittel-Schneider, Sarah; Kliwicki, Sebastian; König, Barbara; Kusumi, Ichiro; Lackner, Nina; Laje, Gonzalo; Landén, Mikael; Lavebratt, Catharina; Leboyer, Marion; Leckband, Susan G; López Jaramillo, Carlos A; MacQueen, Glenda; Manchia, Mirko; Martinsson, Lina; Mattheisen, Manuel; McCarthy, Michael J; McElroy, Susan L; Mitjans, Marina; Mondimore, Francis M; Monteleone, Palmiero; Nievergelt, Caroline M; Ösby, Urban; Ozaki, Norio; Perlis, Roy H; Pfennig, Andrea; Reich-Erkelenz, Daniela; Rouleau, Guy A; Schofield, Peter R; Schubert, K Oliver; Schweizer, Barbara W; Seemüller, Florian; Severino, Giovanni; Shekhtman, Tatyana; Shilling, Paul D; Shimoda, Kazutaka; Simhandl, Christian; Slaney, Claire M; Smoller, Jordan W; Squassina, Alessio; Stamm, Thomas J; Stopkova, Pavla; Tighe, Sarah K; Tortorella, Alfonso; Turecki, Gustavo; Volkert, Julia; Witt, Stephanie H; Wright, Adam J; Young, L Trevor; Zandi, Peter P; Potash, James B; DePaulo, J Raymond; Bauer, Michael; Reininghaus, Eva; Novák, Tomáš; Aubry, Jean-Michel; Maj, Mario; Baune, Bernhard T; Mitchell, Philip B; Vieta, Eduard; Frye, Mark A; Rybakowski, Janusz K; Kuo, Po-Hsiu; Kato, Tadafumi; Grigoroiu-Serbanescu, Maria; Reif, Andreas; Del Zompo, Maria; Bellivier, Frank; Schalling, Martin; Wray, Naomi R; Kelsoe, John R; Alda, Martin; McMahon, Francis J; Schulze, Thomas G; Rietschel, Marcella; Nöthen, Markus M; Cichon, Sven

2018-01-01

Bipolar disorder (BD) is a common, highly heritable neuropsychiatric disease characterized by recurrent episodes of mania and depression. Lithium is the best-established long-term treatment for BD, even though individual response is highly variable. Evidence suggests that some of this variability has a genetic basis. This is supported by the largest genome-wide association study (GWAS) of lithium response to date conducted by the International Consortium on Lithium Genetics (ConLiGen). Recently, we performed the first genome-wide analysis of the involvement of miRNAs in BD and identified nine BD-associated miRNAs. However, it is unknown whether these miRNAs are also associated with lithium response in BD. In the present study, we therefore tested whether common variants at these nine candidate miRNAs contribute to the variance in lithium response in BD. Furthermore, we systematically analyzed whether any other miRNA in the genome is implicated in the response to lithium. For this purpose, we performed gene-based tests for all known miRNA coding genes in the ConLiGen GWAS dataset ( n = 2,563 patients) using a set-based testing approach adapted from the versatile gene-based test for GWAS (VEGAS2). In the candidate approach, miR-499a showed a nominally significant association with lithium response, providing some evidence for involvement in both development and treatment of BD. In the genome-wide miRNA analysis, 71 miRNAs showed nominally significant associations with the dichotomous phenotype and 106 with the continuous trait for treatment response. A total of 15 miRNAs revealed nominal significance in both phenotypes with miR-633 showing the strongest association with the continuous trait ( p = 9.80E-04) and miR-607 with the dichotomous phenotype ( p = 5.79E-04). No association between miRNAs and treatment response to lithium in BD in either of the tested conditions withstood multiple testing correction. Given the limited power of our study, the investigation of miRNAs in larger GWAS samples of BD and lithium response is warranted.

Improved dichotomous search frequency offset estimator for burst-mode continuous phase modulation

NASA Astrophysics Data System (ADS)

Zhai, Wen-Chao; Li, Zan; Si, Jiang-Bo; Bai, Jun

2015-11-01

A data-aided technique for carrier frequency offset estimation with continuous phase modulation (CPM) in burst-mode transmission is presented. The proposed technique first exploits a special pilot sequence, or training sequence, to form a sinusoidal waveform. Then, an improved dichotomous search frequency offset estimator is introduced to determine the frequency offset using the sinusoid. Theoretical analysis and simulation results indicate that our estimator is noteworthy in the following aspects. First, the estimator can operate independently of timing recovery. Second, it has relatively low outlier, i.e., the minimum signal-to-noise ratio (SNR) required to guarantee estimation accuracy. Finally, the most important property is that our estimator is complexity-reduced compared to the existing dichotomous search methods: it eliminates the need for fast Fourier transform (FFT) and modulation removal, and exhibits faster convergence rate without accuracy degradation. Project supported by the National Natural Science Foundation of China (Grant No. 61301179), the Doctorial Programs Foundation of the Ministry of Education, China (Grant No. 20110203110011), and the Programme of Introducing Talents of Discipline to Universities, China (Grant No. B08038).

An ROC-type measure of diagnostic accuracy when the gold standard is continuous-scale.

PubMed

Obuchowski, Nancy A

2006-02-15

ROC curves and summary measures of accuracy derived from them, such as the area under the ROC curve, have become the standard for describing and comparing the accuracy of diagnostic tests. Methods for estimating ROC curves rely on the existence of a gold standard which dichotomizes patients into disease present or absent. There are, however, many examples of diagnostic tests whose gold standards are not binary-scale, but rather continuous-scale. Unnatural dichotomization of these gold standards leads to bias and inconsistency in estimates of diagnostic accuracy. In this paper, we propose a non-parametric estimator of diagnostic test accuracy which does not require dichotomization of the gold standard. This estimator has an interpretation analogous to the area under the ROC curve. We propose a confidence interval for test accuracy and a statistical test for comparing accuracies of tests from paired designs. We compare the performance (i.e. CI coverage, type I error rate, power) of the proposed methods with several alternatives. An example is presented where the accuracies of two quick blood tests for measuring serum iron concentrations are estimated and compared.

Chaos and Chaos Control of the Frenkel-Kontorova Model with Dichotomous Noise

NASA Astrophysics Data System (ADS)

Lei, Youming; Zheng, Fan; Shao, Xizhen

Chaos and chaos control of the Frenkel-Kontorova (FK) model with dichotomous noise are studied theoretically and numerically. The threshold conditions for the onset of chaos in the FK model are firstly derived by applying the random Melnikov method with a mean-square criterion to the soliton equation, which is a fundamental topological mode of the FK model and accounts for its nonlinear phenomena. We found that dichotomous noise can induce stochastic chaos in the FK model, and the threshold of noise amplitude for the onset of chaos increases with the increase of its transition rate. Then the analytical criterion of chaos control is obtained by means of the time-delay feedback method. Since the time-delay feedback control raises the threshold of noise amplitude for the onset of chaos, chaos in the FK model is effectively suppressed. Through numerical simulations including the mean top Lyapunov exponent and the safe basin, we demonstrate the validity of the analytical predictions of chaos. Furthermore, time histories and phase portraits are utilized to verify the effectiveness of the proposed control.

Statistics of a neuron model driven by asymmetric colored noise.

PubMed

Müller-Hansen, Finn; Droste, Felix; Lindner, Benjamin

2015-02-01

Irregular firing of neurons can be modeled as a stochastic process. Here we study the perfect integrate-and-fire neuron driven by dichotomous noise, a Markovian process that jumps between two states (i.e., possesses a non-Gaussian statistics) and exhibits nonvanishing temporal correlations (i.e., represents a colored noise). Specifically, we consider asymmetric dichotomous noise with two different transition rates. Using a first-passage-time formulation, we derive exact expressions for the probability density and the serial correlation coefficient of the interspike interval (time interval between two subsequent neural action potentials) and the power spectrum of the spike train. Furthermore, we extend the model by including additional Gaussian white noise, and we give approximations for the interspike interval (ISI) statistics in this case. Numerical simulations are used to validate the exact analytical results for pure dichotomous noise, and to test the approximations of the ISI statistics when Gaussian white noise is included. The results may help to understand how correlations and asymmetry of noise and signals in nerve cells shape neuronal firing statistics.

Resonant activation in piecewise linear asymmetric potentials.

PubMed

Fiasconaro, Alessandro; Spagnolo, Bernardo

2011-04-01

This work analyzes numerically the role played by the asymmetry of a piecewise linear potential, in the presence of both a Gaussian white noise and a dichotomous noise, on the resonant activation phenomenon. The features of the asymmetry of the potential barrier arise by investigating the stochastic transitions far behind the potential maximum, from the initial well to the bottom of the adjacent potential well. Because of the asymmetry of the potential profile together with the random external force uniform in space, we find, for the different asymmetries: (1) an inversion of the curves of the mean first passage time in the resonant region of the correlation time τ of the dichotomous noise, for low thermal noise intensities; (2) a maximum of the mean velocity of the Brownian particle as a function of τ; and (3) an inversion of the curves of the mean velocity and a very weak current reversal in the miniratchet system obtained with the asymmetrical potential profiles investigated. An inversion of the mean first passage time curves is also observed by varying the amplitude of the dichotomous noise, behavior confirmed by recent experiments. ©2011 American Physical Society

Correlates of preferences for home or hospital confinement in Pakistan: evidence from a national survey.

PubMed

Javed, Sajid Amin; Anjum, Muhammad Danish; Imran, Waqas; Haider, Azad; Shiraz, Ayesha; Shaheen, Farzana; Iftikhar ul Husnain, Muhammad

2013-06-24

Despite the pregnancy complications related to home births, homes remain yet major place of delivery in Pakistan and 65 percent of totals births take place at home. This work analyses the determinants of place of delivery in Pakistan. Multivariate Logistic regression is used for analysis. Data are extracted from Pakistan Demographic and Health Survey (2006-07). Based on information on last birth preceding 5 years of survey, we construct dichotomous dependent variable i.e. whether women deliver at home (Coded=1) or at health facility (coded=2). Bivariate analysis shows that 72% (p≤0.000) women from rural area and 81% women residing in Baluchistan delivered babies at home. Furthermore 75% women with no formal education, 81% (p≤0.000) women working in agricultural sector, 75% (p≤0.000) of Women who have 5 and more children and almost 77% (p≤0.000) who do not discussed pregnancy related issues with their husbands are found delivering babies at home. Multivariate analysis documents that mothers having lower levels of education, economic status and empowerment, belonging to rural area, residing in provinces other than Punjab, working in agriculture sector and mothers who are young are more likely to give births at home. A trend for home births, among Pakistani women, can be traced in lower levels of education, lower autonomy, poverty driven working in agriculture sector, higher costs of using health facilities and regional backwardness.

Challenges in the Detection of Working Memory and Attention Decrements among Overweight Adolescent Girls.

PubMed

Bauer, Lance O; Manning, Kevin J

2016-01-01

The present study is unique in employing unusually difficult attention and working memory tasks to reveal subtle cognitive decrements among overweight/obese adolescents. It evaluated novel measures of background electroencephalographic (EEG) activity during one of the tasks and tested correlations of these and other measures with psychological and psychiatric predictors of obesity maintenance or progression. Working memory and sustained attention tasks were presented to 158 female adolescents who were rated on dichotomous (body mass index percentile <85 vs. ≥85) and continuous (triceps skinfold thickness) measures of adiposity. The results revealed a significant association between excess adiposity and performance errors during the working memory task. During the sustained attention task, overweight/obese adolescents exhibited more EEG frontal beta power as well as greater intraindividual variability in reaction time and beta power across task periods than their normal-weight peers. Secondary analyses showed that frontal beta power during the sustained attention task was positively correlated with anxiety, panic, borderline personality features, drug abuse, and loss of control over food intake. The findings suggest that working memory and sustained attention decrements do exist among overweight/obese adolescent girls. The reliable detection of the decrements may depend on the difficulty of the tasks as well as the manner in which performance and brain activity are measured. Future studies should examine the relevance of these decrements to dietary education efforts and treatment response. © 2016 S. Karger AG, Basel.

Theory of Mind Development is Impaired in 4-year-old Children with Prenatal Exposure to Maternal Tobacco Smoking

PubMed Central

Reidy, Rosemary E; Ross, Randal G; Hunter, Sharon K

2014-01-01

Aims Theory of Mind (ToM) is an important component of social cognition. Deficits in ToM are found in various neurodevelopmental disorders and social and environmental factors have been found to influence ToM development. Little previous research has focused on effects of exposure to toxins; this report examines the impact of tobacco. Place of Study Department of Psychiatry, University of Colorado School of Medicine, between April 2006 – August 2012. Methodology 101 children, 18 with prenatal exposure to tobacco, underwent ToM testing at 40 (n=89) and 48 (n=77) months of age. Test questions received dichotomous pass/fail scores and percentage of correct responses was utilized as the primary dependent variable. Results At 40 months of age children were rarely able to correctly answer false belief questions and there were no significant differences according to prenatal tobacco exposure. At 48 months of age, there was a significant effect of prenatal tobacco exposure with non-exposed 48-month-olds correctly answering 45±40.6% of content false belief questions correctly, compared to 13.9±25.3% for 48-month-olds with prenatal tobacco exposure (F=4.79, df= 1,73, p=.032) Conclusion ToM abilities are rapidly developing between 40 and 48 months of age. Prenatal exposure to tobacco is associated with impairment at 48 but not 40 months of age. This finding supports consideration of nicotinic mechanisms as contributors to early development of social cognition. PMID:25558458

The relationship between aircraft noise exposure and day-use visitor survey responses in backcountry areas of national parks.

PubMed

Rapoza, Amanda; Sudderth, Erika; Lewis, Kristin

2015-10-01

To evaluate the relationship between aircraft noise exposure and the quality of national park visitor experience, more than 4600 visitor surveys were collected at seven backcountry sites in four U.S. national parks simultaneously with calibrated sound level measurements. Multilevel logistic regression was used to estimate parameters describing the relationship among visitor responses, aircraft noise dose metrics, and mediator variables. For the regression models, survey responses were converted to three dichotomous variables, representing visitors who did or did not experience slightly or more, moderately or more, or very or more annoyance or interference with natural quiet from aircraft noise. Models with the most predictive power included noise dose metrics of sound exposure level, percent time aircraft were audible, and percentage energy due to helicopters and fixed-wing propeller aircraft. These models also included mediator variables: visitor ratings of the "importance of calmness, peace and tranquility," visitor group composition (adults or both adults and children), first visit to the site, previously taken an air tour, and participation in bird-watching or interpretive talks. The results complement and extend previous research conducted in frontcountry areas and will inform evaluations of air tour noise effects on visitors to national parks and remote wilderness sites.

A Simulation Study of Categorizing Continuous Exposure Variables Measured with Error in Autism Research: Small Changes with Large Effects.

PubMed

Heavner, Karyn; Burstyn, Igor

2015-08-24

Variation in the odds ratio (OR) resulting from selection of cutoffs for categorizing continuous variables is rarely discussed. We present results for the effect of varying cutoffs used to categorize a mismeasured exposure in a simulated population in the context of autism spectrum disorders research. Simulated cohorts were created with three distinct exposure-outcome curves and three measurement error variances for the exposure. ORs were calculated using logistic regression for 61 cutoffs (mean ± 3 standard deviations) used to dichotomize the observed exposure. ORs were calculated for five categories with a wide range for the cutoffs. For each scenario and cutoff, the OR, sensitivity, and specificity were calculated. The three exposure-outcome relationships had distinctly shaped OR (versus cutoff) curves, but increasing measurement error obscured the shape. At extreme cutoffs, there was non-monotonic oscillation in the ORs that cannot be attributed to "small numbers." Exposure misclassification following categorization of the mismeasured exposure was differential, as predicted by theory. Sensitivity was higher among cases and specificity among controls. Cutoffs chosen for categorizing continuous variables can have profound effects on study results. When measurement error is not too great, the shape of the OR curve may provide insight into the true shape of the exposure-disease relationship.

Phase Synchronization in Electroencephalographic Recordings Prognosticates Outcome in Paediatric Coma

PubMed Central

Nenadovic, Vera; Perez Velazquez, Jose Luis; Hutchison, James Saunders

2014-01-01

Brain injury from trauma, cardiac arrest or stroke is the most important cause of death and acquired disability in the paediatric population. Due to the lifetime impact of brain injury, there is a need for methods to stratify patient risk and ultimately predict outcome. Early prognosis is fundamental to the implementation of interventions to improve recovery, but no clinical model as yet exists. Healthy physiology is associated with a relative high variability of physiologic signals in organ systems. This was first evaluated in heart rate variability research. Brain variability can be quantified through electroencephalographic (EEG) phase synchrony. We hypothesised that variability in brain signals from EEG recordings would correlate with patient outcome after brain injury. Lower variability in EEG phase synchronization, would be associated with poor patient prognosis. A retrospective study, spanning 10 years (2000–2010) analysed the scalp EEGs of children aged 1 month to 17 years in coma (Glasgow Coma Scale, GCS, <8) admitted to the paediatric critical care unit (PCCU) following brain injury from TBI, cardiac arrest or stroke. Phase synchrony of the EEGs was evaluated using the Hilbert transform and the variability of the phase synchrony calculated. Outcome was evaluated using the 6 point Paediatric Performance Category Score (PCPC) based on chart review at the time of hospital discharge. Outcome was dichotomized to good outcome (PCPC score 1 to 3) and poor outcome (PCPC score 4 to 6). Children who had a poor outcome following brain injury secondary to cardiac arrest, TBI or stroke, had a higher magnitude of synchrony (R index), a lower spatial complexity of the synchrony patterns and a lower temporal variability of the synchrony index values at 15 Hz when compared to those patients with a good outcome. PMID:24752289

An examination of predictive variables toward graduation of minority students in science at a selected urban university

NASA Astrophysics Data System (ADS)

Hunter, Evelyn M. Irving

1998-12-01

The purpose of this study was to examine the relationship and predictive power of the variables gender, high school GPA, class rank, SAT scores, ACT scores, and socioeconomic status on the graduation rates of minority college students majoring in the sciences at a selected urban university. Data was examined on these variables as they related to minority students majoring in science. The population consisted of 101 minority college students who had majored in the sciences from 1986 to 1996 at an urban university in the southwestern region of Texas. A non-probability sampling procedure was used in this study. The non-probability sampling procedure in this investigation was incidental sampling technique. A profile sheet was developed to record the information regarding the variables. The composite scores from SAT and ACT testing were used in the study. The dichotomous variables gender and socioeconomic status were dummy coded for analysis. For the gender variable, zero (0) indicated male, and one (1) indicated female. Additionally, zero (0) indicated high SES, and one (1) indicated low SES. Two parametric procedures were used to analyze the data in this investigation. They were the multiple correlation and multiple regression procedures. Multiple correlation is a statistical technique that indicates the relationship between one variable and a combination of two other variables. The variables socioeconomic status and GPA were found to contribute significantly to the graduation rates of minority students majoring in all sciences when combined with chemistry (Hypotheses Two and Four). These variables accounted for 7% and 15% of the respective variance in the graduation rates of minority students in the sciences and in chemistry. Hypotheses One and Three, the predictor variables gender, high school GPA, SAT Total Scores, class rank, and socioeconomic status did not contribute significantly to the graduation rates of minority students in biology and pharmacy.

Dichotomal effect of space flight-associated microgravity on stress-activated protein kinases in innate immunity

PubMed Central

Verhaar, Auke P.; Hoekstra, Elmer; Tjon, Angela S. W.; Utomo, Wesley K.; Deuring, J. Jasper; Bakker, Elvira R. M.; Muncan, Vanesa; Peppelenbosch, Maikel P.

2014-01-01

Space flight strongly moderates human immunity but is in general well tolerated. Elucidation of the mechanisms by which zero gravity interacts with human immunity may provide clues for developing rational avenues to deal with exaggerated immune responses, e.g. as in autoimmune disease. Using two sounding rockets and one manned Soyuz launch, the influence of space flight on immunological signal transduction provoked by lipopolysaccharide (LPS) stimulation was investigated in freshly isolated peripheral blood monocytes and was compared to samples obtained from on-board centrifuge-loaded 1 g controls. The effect of microgravity on immunological signal transduction is highly specific, since LPS dependent Jun-N-terminal kinase activation is impaired in the 0 g condition, while the corresponding LPS dependent activation of p38 MAP kinase remains unaffected. Thus our results identify Jun-N-terminal kinase as a relevant target in immunity for microgravity and support using Jun-N-terminal kinase specific inhibitors for combating autoimmune disease. PMID:24968806

Polymer translocation under time-dependent driving forces: resonant activation induced by attractive polymer-pore interactions.

PubMed

Ikonen, Timo; Shin, Jaeoh; Sung, Wokyung; Ala-Nissila, Tapio

2012-05-28

We study the driven translocation of polymers under time-dependent driving forces using N-particle Langevin dynamics simulations. We consider the force to be either sinusoidally oscillating in time or dichotomic noise with exponential correlation time, to mimic both plausible experimental setups and naturally occurring biological conditions. In addition, we consider both the case of purely repulsive polymer-pore interactions and the case with additional attractive polymer-pore interactions, typically occurring inside biological pores. We find that the nature of the interaction fundamentally affects the translocation dynamics. For the non-attractive pore, the translocation time crosses over to a fast translocation regime as the frequency of the driving force decreases. In the attractive pore case, because of a free energy well induced inside the pore, the translocation time can be a minimum at the optimal frequency of the force, the so-called resonant activation. In the latter case, we examine the effect of various physical parameters on the resonant activation, and explain our observations using simple theoretical arguments.

Dichotomal effect of space flight-associated microgravity on stress-activated protein kinases in innate immunity.

PubMed

Verhaar, Auke P; Hoekstra, Elmer; Tjon, Angela S W; Utomo, Wesley K; Deuring, J Jasper; Bakker, Elvira R M; Muncan, Vanesa; Peppelenbosch, Maikel P

2014-06-27

Space flight strongly moderates human immunity but is in general well tolerated. Elucidation of the mechanisms by which zero gravity interacts with human immunity may provide clues for developing rational avenues to deal with exaggerated immune responses, e.g. as in autoimmune disease. Using two sounding rockets and one manned Soyuz launch, the influence of space flight on immunological signal transduction provoked by lipopolysaccharide (LPS) stimulation was investigated in freshly isolated peripheral blood monocytes and was compared to samples obtained from on-board centrifuge-loaded 1 g controls. The effect of microgravity on immunological signal transduction is highly specific, since LPS dependent Jun-N-terminal kinase activation is impaired in the 0 g condition, while the corresponding LPS dependent activation of p38 MAP kinase remains unaffected. Thus our results identify Jun-N-terminal kinase as a relevant target in immunity for microgravity and support using Jun-N-terminal kinase specific inhibitors for combating autoimmune disease.

Markers of atherosclerosis in patients with Cushing's syndrome: a meta-analysis of literature studies.

PubMed

Lupoli, Roberta; Ambrosino, Pasquale; Tortora, Anna; Barba, Livia; Lupoli, Gelsy Arianna; Di Minno, Matteo Nicola Dario

2017-05-01

Several studies reported an increased cardiovascular (CV) risk in Cushing's syndrome (CS). We performed a meta-analysis on the impact of CS on major markers of atherosclerosis. Studies on intima-media thickness (IMT), carotid plaques prevalence, and flow-mediated dilation (FMD) in CS patients and controls were searched in the PubMed, Web of Science, Scopus, and EMBASE. Differences between cases and controls were expressed as mean difference (MD) with 95% confidence intervals (95%CI) for continuous variables, and as Odds Ratio (OR) with 95%CI for dichotomous variables. Fourteen studies (332 CS, 462 controls) were included. Compared with controls, CS patients showed higher IMT (MD: 0.20 mm; 95% CI: 0.12, 0.28; p < .001), increased prevalence of carotid plaques (OR: 8.85, 95%CI: 4.09, 19.14; p < .001), and lower FMD (MD: -2.65%; 95% CI: -3.65, -1.65; p < .001). Difference in IMT and in the prevalence of carotid plaques was confirmed also in patients with CS remission (MD: 0.24 mm; 95% CI: 0.07, 0.40; p = .005 and OR: 9.88, 95%CI: 2.69, 36.3; p < 0.001, respectively). Regression models showed that age, diabetes, obesity, ACTH-dependent CS, serum and urinary cortisol levels impacted on the observed difference in IMT. CS is significantly associated with markers of subclinical atherosclerosis and CV risk. These findings could help establish more specific CV prevention strategies in this clinical setting. Key messages A series of studies reported an increased cardiovascular risk in patients with Cushing's syndrome (CS). In the present meta-analysis we demonstrated that CS is associated with an increased intima-media thickness, higher prevalence of carotid plaques, and lower flow-mediated dilation as compared with controls. These data consistently suggest the need for a strict monitoring of early signs of subclinical atherosclerosis in CS patients.

Sensitivity, specificity and predictive probability values of serum agglutination test titres for the diagnosis of Salmonella Dublin culture-positive bovine abortion and stillbirth.

PubMed

Sánchez-Miguel, C; Crilly, J; Grant, J; Mee, J F

2018-06-01

The objective of this study was to determine the diagnostic value of maternal serology for the diagnosis of Salmonella Dublin bovine abortion and stillbirth. A retrospective, unmatched, case-control study was carried out using twenty year's data (1989-2009) from bovine foetal submissions to an Irish government veterinary laboratory. Cases (n = 214) were defined as submissions with a S. Dublin culture-positive foetus from a S. Dublin unvaccinated dam where results of maternal S. Dublin serology were available. Controls (n = 415) were defined as submissions where an alternative diagnosis other than S. Dublin was made in a foetus from an S. Dublin unvaccinated dam where the results of maternal S. Dublin serology were available. A logistic regression model was fitted to the data: the dichotomous dependent variable was the S. Dublin foetal culture result, and the independent variables were the maternal serum agglutination test (SAT) titre results. Salmonella serology correctly classified 87% of S. Dublin culture-positive foetuses at a predicted probability threshold of 0.44 (cut-off at which sensitivity and specificity are at a maximum, J = 0.67). The sensitivity of the SAT at the same threshold was 73.8% (95% CI: 67.4%-79.5%), and the specificity was 93.2% (95% CI: 90.3%-95.4%). The positive and negative predictive values were 84.9% (95% CI: 79.3%-88.6%) and 87.3% (95% CI: 83.5%-91.3%), respectively. This study illustrates that the use of predicted probability values, rather than the traditional arbitrary breakpoints of negative, inconclusive and positive, increases the diagnostic value of the maternal SAT. Veterinary laboratory diagnosticians and veterinary practitioners can recover from the test results, information previously categorized, particularly from those results declared to be inconclusive. © 2017 Blackwell Verlag GmbH.

Prenatal exposure to lead in Spain: cord blood levels and associated factors.

PubMed

Llop, Sabrina; Aguinagalde, Xabier; Vioque, Jesus; Ibarluzea, Jesús; Guxens, Mònica; Casas, Maribel; Murcia, Mario; Ruiz, María; Amurrio, Ascensión; Rebagliato, Marisa; Marina, Loreto Santa; Fernandez-Somoano, Ana; Tardon, Adonina; Ballester, Ferran

2011-05-01

Lead is a known neurotoxic. Fetuses and infants are very vulnerable to lead exposure, since their blood-brain barrier is not completely formed. Hence, there is an importance for monitoring of blood lead levels prenatally and during early infancy. The aim of this study is to evaluate the prenatal exposure to lead and its association with maternal factors in four population based mother-child cohorts in Spain. The present research was carried out within the framework of the INMA project INfancia y Medio Ambiente (Environment and Childhood). A total of 1462 pregnant women were recruited between 2004 and 2008. Lead was analyzed in a sample of cord blood by thermal decomposition, amalgation, and Atomic Absorption Spectrometry. Maternal sociodemographic, lifestyle and dietary factors were obtained by questionnaires during pregnancy. A multivariate logistic regression model was constructed. The dependent variable was a dichotomous lead level variable (detected vs no detected, i.e. ≥ vs < 2μg/dL). A low percentage of cord blood samples with lead levels ≥ 2μg/dL were found (5.9%). Geometric mean and maximum were 1.06μg/dL and 19μg/dL, respectively. Smoking at the beginning of pregnancy, age, social class, weight gain during pregnancy, gravidity, and place of residence were the maternal factors associated with detectable cord blood lead levels. Mother's diet does not appear to be a determining factor of lead exposure. Nevertheless, daily intake of iron and zinc may act as a protective factor against having cord blood lead levels ≥ 2μg/dL. In the different regions of Spain taking part in this study, lead levels to which newborns are exposed are low. Mobilization of lead from bones may be the main contributor to the cord blood levels. Copyright © 2011 Elsevier B.V. All rights reserved.

Predictors of milk consumption in a population of 17- to 35-year-old military personnel.

PubMed

Klesges, R C; Harmon-Clayton, K; Ward, K D; Kaufman, E M; Haddock, C K; Talcott, G W; Lando, H A

1999-07-01

The purpose of this investigation was to survey an entire population of Air Force recruits (N = 32,144) regarding milk consumption and demographic and health-related factors that may predict milk consumption. All subjects were required to fill out a 53-item health survey at the start of basic military training. All recruits who entered the US Air Force from August 1995 to August 1996 participated in this study (N = 32,144). Potential correlates of milk intake were analyzed using Spearman rank order correlations and multiple linear regression. Variables were removed if they did not make a meaningful contribution to variance in milk intake. Because of skewed distributions, several variables were dichotomized (e.g., age: 17 to 24 vs 25 to 35 years). In terms of milk consumption, 51.7% of the respondents reported intake of fewer than 1 serving per day; only 17.9% reported intake of 3 servings or more per day. Milk intake was positively associated with body weight and fruit/vegetable intake and negatively associated with age, education level, reported milk-related gastric distress, physical activity level, dieting frequency, and concern about weight. Gender (women reported lower intake) and ethnicity (minorities reported lower intake) were independently related to milk consumption. Of all respondents, 16.1% reported themselves to have milk-related gastric distress, but rates varied depending on age, gender, and ethnicity (ranging from 10.2% for younger non-Hispanic white men to 60.4% for older Asian men). Despite the efforts of large, costly campaigns designed to increase milk consumption, self-reported milk consumption in young adults is extremely low. Given the importance of dairy products as a major source of calcium in the American diet, dietetics practitioners should assess milk consumption among young adults to ensure sufficient calcium intake to maximize peak bone mass in this group.

The Role of GABRA2 in Alcohol Dependence, Smoking and Illicit Drug Use in an Australian Population Sample

PubMed Central

Lind, Penelope A; Macgregor, Stuart; Agrawal, Arpana; Montgomery, Grant W; Heath, Andrew C; Martin, Nicholas G; Whitfield, John B

2008-01-01

Background Multiple studies have shown that genetic variation in the α-2 subunit of the GABA-A receptor (GABRA2) is associated with risk for alcohol dependence. Recent reports have suggested that GABRA2 may exert its influence on dependence through factors such as sensitivity to alcohol's intoxicating effects and that GABRA2 may also contribute to a common underlying genetic vulnerability to both alcohol and drug dependence. The present study tested for association between GABRA2 and alcohol dependence, smoking and illicit drug use within the Australian population. Methods We genotyped 11 single nucleotide polymorphisms within or flanking GABRA2 in 4597 subjects (34.6% males) from 2618 families comprising 814 monozygotic pairs, 1177 dizygotic pairs and 627 twins whose co-twin did not participate. Family-based association tests were conducted for binary and quantitative measures of alcohol dependence, smoking, cannabis and other illicit drug use. Results We observed evidence of association (p < 0.05) between multiple GABRA2 SNPs and quantitative measures of alcohol dependence, including symptom scores and principal component factor scores from the 9 criteria for DSM-IV alcohol dependence, in the opposite direction to that previously reported. In contrast, GABRA2 was not associated overall with dichotomous measure of alcohol dependence, nor with smoking, cannabis or illicit drug use. Conclusions The GABRA2 allelic associations found in clinical case-control studies have detectable but minor effects on DSM-defined alcohol dependence in the general community. Systematic comparisons of allelic effects on alcohol dependence in clinical cases and in the general community are required. PMID:18727688

Inter- and Intrarater Agreement on the Outcome of Endovascular Treatment of Aneurysms Using MRA.

PubMed

Jamali, S; Fahed, R; Gentric, J-C; Letourneau-Guillon, L; Raoult, H; Bing, F; Estrade, L; Nguyen, T N; Tollard, É; Ferre, J-C; Iancu, D; Naggara, O; Chagnon, M; Weill, A; Roy, D; Fox, A J; Kallmes, D F; Raymond, J

2016-05-01

Patients treated with coiling are often followed by MR angiography. Our objective was to assess the inter- and intraobserver agreement in diagnosing aneurysm remnants and recurrences by using multimodality imaging, including TOF MRA. A portfolio composed of 120 selected images from 56 patients was sent to 15 neuroradiologists from 10 institutions. For each case, raters were asked to classify angiographic results (3 classes) of 2 studies (32 MRA-MRA and 24 DSA-MRA pairs) and to provide a final judgment regarding the presence of a recurrence (no, minor, major). Six raters were asked to independently review the portfolio twice. A second study, restricted to 4 raters having full access to all images, was designed to validate the results of the electronic survey. The proportion of cases judged to have a major recurrence varied between 16.1% and 71.4% (mean, 35.0% ± 12.7%). There was moderate agreement overall (κ = 0.474 ± 0.009), increasing to nearly substantial (κ = 0.581 ± 0.014) when the judgment was dichotomized (presence or absence of a major recurrence). Agreement on cases followed-up by MRA-MRA was similarly substantial (κ = 0.601 ± 0.018). The intrarater agreement varied between fair (κ = 0.257 ± 0.093) and substantial (κ= 0.699 ± 0.084), improving with a dichotomized judgment concerning MRA-MRA comparisons. Agreement was no better when raters had access to all images. There is an important variability in the assessment of angiographic outcomes of endovascular treatments. Agreement on the presence of a major recurrence when comparing 2 MRA studies or the MRA with the last catheter angiographic study can be substantial. © 2016 by American Journal of Neuroradiology.

Association of Self-Reported Discrimination and Suicide Ideation in Older Chinese Americans.

PubMed

Li, Lydia W; Gee, Gilbert C; Dong, XinQi

2018-01-01

This study examines racial discrimination as a potential novel risk factor for suicide ideation among older Chinese Americans. In a cross-sectional analysis, this study drew on data collected in the Population-based Study of Chinese Elderly in Chicago on Chinese older adults age 60 + in the Greater Chicago area (N = 3,157). Thirty-day suicide ideation was a dichotomous variable, derived from items of the Physical Health Questionnaire and the Geriatric Mental State Examination-Version A. Self-reported discrimination was dichotomously coded, based on the Experiences of Discrimination instrument, which asks respondents whether they have ever experienced discrimination in nine situations because of their race/ethnicity/color. About 4.1% of the sample reported 30-day suicide ideation and 21.5% reported discrimination. Self-reported discrimination was significantly associated with suicide ideation before and after adjusting for covariates including sociodemographic characteristics; neuroticism; social relationships; and physical, cognitive and mental health. In the fully adjusted model, those who reported discrimination had 1.9 times higher odds (OR: 1.9; 95% CI: 1.18-3.08; Wald χ 2  = 6.9, df = 1, p = 0.01) of suicide ideation than those who did not. Chinese American seniors who reported discrimination had an almost twofold greater odds of 30-day suicide ideation compared with those who did not. Clinicians need to recognize the impact of discrimination on ethnic minority elders. For those who report experiencing discrimination, assessment of suicide risk may be necessary. Efforts to promote civil rights and reduce discrimination may also be a form of primary prevention of suicide. Copyright © 2017 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

The Treatment of Brain Arteriovenous Malformation Study (TOBAS): A preliminary inter- and intra-rater agreement study on patient management.

PubMed

Fahed, Robert; Batista, André L; Darsaut, Tim E; Gentric, Jean-Christophe; Ducroux, Célina; Chaalala, Chiraz; Roberge, David; Bojanowski, Michel W; Weill, Alain; Roy, Daniel; Magro, Elsa; Raymond, Jean

2017-07-01

The best management of brain arteriovenous malformation (bAVM) patients remains unknown. Randomized allocation may be more readily accepted when there is uncertainty and disagreement regarding the management of potential participants. In planning for a trial, we aimed to assess variability and agreement among physicians managing bAVM patients. A portfolio composed of 35 patients was sent to 47 clinicians of various specialties managing bAVM patients. For each patient, physicians were asked their best management decision (surgery/embolization/radiosurgery/conservative), their confidence level, and whether they would include the patient in a randomized trial comparing conservative and curative management. Seven physicians, who had access to all images of each patient, independently responded twice, to assess inter and intra-rater agreement using kappa statistics. The inter-rater agreement (30 raters, including 16 neuroradiologists) for best management decision was only "fair" (κ [95%CI]=0.210[0.157; 0.295]). Agreement remained below 'substantial' (κ<.6) between physicians of the same specialty, and when no distinctions were made between various treatments (when responses were dichotomized as conservative versus curative). With access to all images the inter-rater agreement remained fair. The intra-rater agreement reached "substantial" only for the dichotomized decisions. Responding clinicians were willing to include 54.4% of patients (mainly unruptured bAVMs) in a randomized trial. There is a lack of agreement among clinicians involved in the management of bAVM patients. In this study a substantial proportion of clinicians were willing to offer randomized allocation of management options to a substantial number of patients. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

"But He's a Star Football Player!": How Social Status Influences Mock Jurors' Perceptions in a Sexual Assault Case.

PubMed

Pica, Emily; Sheahan, Chelsea; Pozzulo, Joanna

2017-06-01

There have been several recent, high-profile cases in the media that have shed light on the perceived leniency in sentencing defendants in sexual assault cases. In a number of these cases, the defendant was well known within their community (e.g., Brock Turner; People v. Turner) or nationally (e.g., Ghomeshi; R v. Ghomeshi). The purpose of this study was to examine how the social status of the defendant (low vs. high), victim social status (low vs. high), victim gender (male vs. female), and the reason the victim was unconscious during the assault (consuming alcohol vs. consuming cold medicine) influenced mock jurors' decisions in a sexual assault case. Mock jurors ( N = 489) read a mock trial transcript depicting an alleged sexual assault. Mock jurors were asked to render a dichotomous verdict, continuous guilt rating, and rate their perceptions of the victim and defendant. There was no influence of the variables on mock jurors' dichotomous verdicts; however, social status influenced guilt ratings. There also was a combined influence of the defendant's social status and the reason the victim was unconscious such that when the defendant was described as low status, and the victim was unconscious due to alcohol consumption, the defendant received higher guilt ratings compared with when the victim was unconscious due to cold medicine. Moreover, the victim was perceived as having more control over the situation when the defendant was the star quarterback (i.e., high status), the victim was female, and she was unconscious due to alcohol consumption compared with cold medicine. These results suggest that victims may be blamed based on their perceived social status and other factors that may have influenced their control over the sexual assault, such as alcohol consumption.

Serum uric acid levels contribute to new renal damage in systemic lupus erythematosus patients.

PubMed

Reátegui-Sokolova, C; Ugarte-Gil, Manuel F; Gamboa-Cárdenas, Rocío V; Zevallos, Francisco; Cucho-Venegas, Jorge M; Alfaro-Lozano, José L; Medina, Mariela; Rodriguez-Bellido, Zoila; Pastor-Asurza, Cesar A; Alarcón, Graciela S; Perich-Campos, Risto A

2017-04-01

This study aims to determine whether uric acid levels contribute to new renal damage in systemic lupus erythematosus (SLE) patients. This prospective study was conducted in consecutive patients seen since 2012. Patients had a baseline visit and follow-up visits every 6 months. Patients with ≥2 visits were included; those with end-stage renal disease (regardless of dialysis or transplantation) were excluded. Renal damage was ascertained using the SLICC/ACR damage index (SDI). Univariable and multivariable Cox-regression models were performed to determine the risk of new renal damage. Uric acid was included as a continuous and dichotomous (per receiving operating characteristic curve) variable. Multivariable models were adjusted for age at diagnosis, disease duration, socioeconomic status, SLEDAI, SDI, serum creatinine, baseline use of prednisone, antimalarials, and immunosuppressive drugs. One hundred and eighty-six patients were evaluated; their mean (SD) age at diagnosis was 36.8 (13.7) years; nearly all patients were mestizo. Disease duration was 7.7 (6.8) years. Follow-up time was 2.3 (1.1) years. The SLEDAI was 5.2 (4.3) and the SDI 0.8 (1.1). Uric acid levels were 4.5 (1.3) mg/dl. During follow-up, 16 (8.6%) patients developed at least one new point in the renal domain of the SDI. In multivariable analyses, uric acid levels (continuous and dichotomous) at baseline predicted the development of new renal damage (HR 3.21 (1.39-7.42), p 0.006; HR 18.28 (2.80-119.48), p 0.002; respectively). Higher uric acid levels contribute to the development of new renal damage in SLE patients independent of other well-known risk factors for such occurrence.

A Bayesian goodness of fit test and semiparametric generalization of logistic regression with measurement data.

PubMed

Schörgendorfer, Angela; Branscum, Adam J; Hanson, Timothy E

2013-06-01

Logistic regression is a popular tool for risk analysis in medical and population health science. With continuous response data, it is common to create a dichotomous outcome for logistic regression analysis by specifying a threshold for positivity. Fitting a linear regression to the nondichotomized response variable assuming a logistic sampling model for the data has been empirically shown to yield more efficient estimates of odds ratios than ordinary logistic regression of the dichotomized endpoint. We illustrate that risk inference is not robust to departures from the parametric logistic distribution. Moreover, the model assumption of proportional odds is generally not satisfied when the condition of a logistic distribution for the data is violated, leading to biased inference from a parametric logistic analysis. We develop novel Bayesian semiparametric methodology for testing goodness of fit of parametric logistic regression with continuous measurement data. The testing procedures hold for any cutoff threshold and our approach simultaneously provides the ability to perform semiparametric risk estimation. Bayes factors are calculated using the Savage-Dickey ratio for testing the null hypothesis of logistic regression versus a semiparametric generalization. We propose a fully Bayesian and a computationally efficient empirical Bayesian approach to testing, and we present methods for semiparametric estimation of risks, relative risks, and odds ratios when parametric logistic regression fails. Theoretical results establish the consistency of the empirical Bayes test. Results from simulated data show that the proposed approach provides accurate inference irrespective of whether parametric assumptions hold or not. Evaluation of risk factors for obesity shows that different inferences are derived from an analysis of a real data set when deviations from a logistic distribution are permissible in a flexible semiparametric framework. © 2013, The International Biometric Society.

Consistency of maternal telephone administration of the asthma control test using postpartum recall compared to repeated measures during pregnancy.

PubMed

Xu, Ronghui; Li, Mofei; Johnson, Diana L; Luo, Yunjun; Chambers, Christina D

2017-05-01

Suboptimal asthma control during pregnancy may impact perinatal outcomes. U.S. guidelines recommend questionnaires to assess asthma control including the Asthma Control Test (ACT). It is unknown in a research setting to what extent recall differs by the time between symptom occurrence and the administration of the questionnaire. Between 2009-2014, 196 pregnant asthmatic women were recruited by the Organization of Teratology Information Specialists (OTIS) MotherToBaby Pregnancy Studies. Participants were administered the ACT at enrollment, gestational weeks 20 and 32, and shortly after delivery. The same women were also administered the ACT retrospectively at approximately 6 months postpartum. The Pearson correlation coefficients between the in-pregnancy and retrospective continuous ACT scores for the 1st, 2nd and 3rd trimesters were: 0.67 (95% CI: 0.58, 0.74), 0.61 (0.52, 0.70) and 0.65 (0.56, 0.72), respectively. When dichotomized into well-controlled asthma (ACT score ≥ 20) versus otherwise, the chi-square test for all three trimesters resulted in p values <0.0001. Cohen's Kappa statistics for the same dichotomized scores were 0.51, 0.45 and 0.40 for each trimester respectively. There was no evidence that adverse outcome of pregnancy (recall bias) influenced postpartum responses. The retrospectively recalled ACT score obtained postpartum was substantially different compared to in-pregnancy administration of the same questionnaire which could reflect test-retest variability as well as attenuation of recall. Documentation of the magnitude and direction of these differences could be useful in interpretation of the impact of asthma control when the ACT is used in retrospective case-control studies for pregnancy outcomes.

Clinical performance validation of PITX2 DNA methylation as prognostic biomarker in patients with head and neck squamous cell carcinoma.

PubMed

Sailer, Verena; Gevensleben, Heidrun; Dietrich, Joern; Goltz, Diane; Kristiansen, Glen; Bootz, Friedrich; Dietrich, Dimo

2017-01-01

Despite advances in combined modality therapy, outcomes in head and neck squamous cell cancer (HNSCC) remain dismal with five-year overall survival rates of less than 50%. Prognostic biomarkers are urgently needed to identify patients with a high risk of death after initial curative treatment. Methylation status of the paired-like homeodomain transcription factor 2 (PITX2) has recently emerged as a powerful prognostic biomarker in various cancers. In the present study, the clinical performance of PITX2 methylation was validated in a HNSCC cohort by means of an independent analytical platform (Infinium HumanMethylation450 BeadChip, Illumina, Inc.). A total of 528 HNSCC patients from The Cancer Genome Atlas (TCGA) were included in the study. Death was defined as primary endpoint. PITX2 methylation was correlated with overall survival and clinicopathological parameters. PITX2 methylation was significantly associated with sex, tumor site, p16 status, and grade. In univariate Cox proportional hazards analysis, PITX2 hypermethylation analyzed as continuous and dichotomized variable was significantly associated with prolonged overall survival of HNSCC patients (continuous: hazard ratio (HR) = 0.19 [95%CI: 0.04-0.88], p = 0.034; dichotomized: HR = 0.52 [95%CI: 0.33-0.84], p = 0.007). In multivariate Cox analysis including established clinicopathological parameters, PITX2 promoter methylation was confirmed as prognostic factor (HR = 0.28 [95%CI: 0.09-0.84], p = 0.023). Using an independent analytical platform, PITX2 methylation was validated as a prognostic biomarker in HNSCC patients, identifying patients that potentially benefit from intensified surveillance and/or administration of adjuvant/neodjuvant treatment, i.e. immunotherapy.

Cultural factors affecting urban Mexican male homosexual behavior.

PubMed

Carrier, J M

1976-03-01

Some aspects of the mestizoized urban culture in Mexico are linked to male homosexuality in support of the theory that cultural factors play an important role in the kind of life styles and sex practices of males involved in homosexual behavior. The following factors are considered relevant: the sharp dichotomization of gender roles, dual categorization of females as good or bad, separate social networks maintained by males before and after marriage, proportion of unmarried males, and distribution of income. One result of the sharp dichotomization of male and female gender roles is the widely held belief that effeminate males generally prefer to play the female role rather than the male. Effeminacy and homosexuality are also linked by the belief that as a result of this role preference effeminate males are sexually interested only in masculine males with whom they play the passive sex role. The participation of masculine males in homosexual encounters is related in part to a relatively high level of sexual awareness in combination with the lack of stigmatization of the insertor sex role and in part to the restraints placed on alternative sexual outlets by available income and/or marital status. Males involved in homosexual behavior in Mexico operate in a sociocultural environment which gives rise to expectations that they should play either the insertee or insertor sex role but not both and that they should obtain ultimate sexual satisfaction with anal intercourse rather than fellatio. In spite of cultural imperatives, however, individual preferences stemming from other variables such as personality needs, sexual gratification, desires of wanted partners, and amount of involvement may override the imperatives with resulting variations in sexual behavior patterns.

Fear of childbirth in primiparous Italian pregnant women: The role of anxiety, depression, and couple adjustment.

PubMed

Molgora, Sara; Fenaroli, Valentina; Prino, Laura Elvira; Rollè, Luca; Sechi, Cristina; Trovato, Annamaria; Vismara, Laura; Volpi, Barbara; Brustia, Piera; Lucarelli, Loredana; Tambelli, Renata; Saita, Emanuela

2018-04-01

The prevalence of fear of childbirth in pregnant women is described to be about 20-25%, while 6-10% of expectant mothers report a severe fear that impairs their daily activities as well as their ability to cope with labour and childbirth. Research on fear of childbirth risk factors has produced heterogeneous results while being mostly done with expectant mothers from northern Europe, northern America, and Australia. The present research investigates whether fear of childbirth can be predicted by socio-demographic variables, distressing experiences before pregnancy, medical-obstetric factors and psychological variables with a sample of 426 Italian primiparous pregnant women. Subjects, recruited between the 34th and 36th week of pregnancy, completed a questionnaire packet that included the Wijma Delivery Expectancy Questionnaire, the Edinburgh Postnatal Depression Scale, the State-Trait Anxiety Inventory, the Dyadic Adjustment Scale, the Multidimensional Scale of Perceived Social Support, as well as demographic and anamnestic information. Fear of childbirth was treated as both a continuous and a dichotomous variable, in order to differentiate expectant mothers as with a severe fear of childbirth. Results demonstrate that anxiety as well as couple adjustment predicted fear of childbirth when treated as a continuous variable, while clinical depression predicted severe fear of childbirth. Findings support the key role of psychological variables in predicting fear of childbirth. Results suggest the importance of differentiating low levels of fear from intense levels of fear in order to promote adequate support interventions. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Predictors of the number of under-five malnourished children in Bangladesh: application of the generalized poisson regression model

PubMed Central

2013-01-01

Background Malnutrition is one of the principal causes of child mortality in developing countries including Bangladesh. According to our knowledge, most of the available studies, that addressed the issue of malnutrition among under-five children, considered the categorical (dichotomous/polychotomous) outcome variables and applied logistic regression (binary/multinomial) to find their predictors. In this study malnutrition variable (i.e. outcome) is defined as the number of under-five malnourished children in a family, which is a non-negative count variable. The purposes of the study are (i) to demonstrate the applicability of the generalized Poisson regression (GPR) model as an alternative of other statistical methods and (ii) to find some predictors of this outcome variable. Methods The data is extracted from the Bangladesh Demographic and Health Survey (BDHS) 2007. Briefly, this survey employs a nationally representative sample which is based on a two-stage stratified sample of households. A total of 4,460 under-five children is analysed using various statistical techniques namely Chi-square test and GPR model. Results The GPR model (as compared to the standard Poisson regression and negative Binomial regression) is found to be justified to study the above-mentioned outcome variable because of its under-dispersion (variance < mean) property. Our study also identify several significant predictors of the outcome variable namely mother’s education, father’s education, wealth index, sanitation status, source of drinking water, and total number of children ever born to a woman. Conclusions Consistencies of our findings in light of many other studies suggest that the GPR model is an ideal alternative of other statistical models to analyse the number of under-five malnourished children in a family. Strategies based on significant predictors may improve the nutritional status of children in Bangladesh. PMID:23297699

Elucidating Article 45.6 of the International Code of Zoological Nomenclature: a dichotomous key for the determination of subspecific or infrasubspecific rank.

PubMed

Lingafelter, Steven W; Nearns, Eugenio H

2013-01-01

We present an overview of the difficulties sometimes encountered when determining whether a published name following a binomen is available or infrasubspecific and unavailable, following Article 45.6 of the International Code of Zoological Nomenclature (ICZN, 1999). We propose a dichotomous key that facilitates this determination and as a preferable method, given the convoluted and subordinate discussion, exceptions, and qualifications laid out in ICZN (1999: 49-50). Examples and citations are provided for each case one can encounter while making this assessment of availability status of names following the binomen.

Friend or foe: the dichotomous impact of T cells on neuro-de/re-generation during aging.

PubMed

Coder, Brandon; Wang, Weikan; Wang, Liefeng; Wu, Zhongdao; Zhuge, Qichuan; Su, Dong-Ming

2017-01-24

The interaction between T cells and the central nervous system (CNS) in homeostasis and injury has been recognized being both pathogenic (CD4+ T-helper 1 - Th1, Th17 and γδT) and ameliorative (Th2 and regulatory T cells - Tregs). However, in-depth studies aimed to elucidate the precise in the aged microenvironment and the dichotomous role of Tregs have just begun and many aspects remain unclear. This is due, not only to a mutual dependency and reciprocal causation of alterations and diseases between the nervous and T cell immune systems, but also to an inconsistent aging of the two systems, which dynamically changes with CNS injury/recovery and/or aging process. Cellular immune system aging, particularly immunosenescence and T cell aging initiated by thymic involution - sources of chronic inflammation in the elderly (termed inflammaging), potentially induces an acceleration of brain aging and memory loss. In turn, aging of the brain via neuro-endocrine-immune network drives total body systemic aging, including that of the immune system. Therefore, immunotherapeutics including vaccination and "protective autoimmunity" provide promising means to rejuvenate neuro-inflammatory disorders and repair CNS acute injury and chronic neuro-degeneration. We review the current understanding and recent discoveries linking the aging immune system with CNS injury and neuro-degeneration. Additionally, we discuss potential recovery and rejuvenation strategies, focusing on targeting the aging T cell immune system in an effort to alleviate acute brain injury and chronic neuro-degeneration during aging, via the "thymus-inflammaging-neurodegeneration axis".

Friend or foe: the dichotomous impact of T cells on neuro-de/re-generation during aging

PubMed Central

Wang, Liefeng; Wu, Zhongdao; Zhuge, Qichuan; Su, Dong-Ming

2017-01-01

The interaction between T cells and the central nervous system (CNS) in homeostasis and injury has been recognized being both pathogenic (CD4+ T-helper 1 - Th1, Th17 and γδT) and ameliorative (Th2 and regulatory T cells - Tregs). However, in-depth studies aimed to elucidate the precise in the aged microenvironment and the dichotomous role of Tregs have just begun and many aspects remain unclear. This is due, not only to a mutual dependency and reciprocal causation of alterations and diseases between the nervous and T cell immune systems, but also to an inconsistent aging of the two systems, which dynamically changes with CNS injury/recovery and/or aging process. Cellular immune system aging, particularly immunosenescence and T cell aging initiated by thymic involution - sources of chronic inflammation in the elderly (termed inflammaging), potentially induces an acceleration of brain aging and memory loss. In turn, aging of the brain via neuro-endocrine-immune network drives total body systemic aging, including that of the immune system. Therefore, immunotherapeutics including vaccination and “protective autoimmunity” provide promising means to rejuvenate neuro-inflammatory disorders and repair CNS acute injury and chronic neuro-degeneration. We review the current understanding and recent discoveries linking the aging immune system with CNS injury and neuro-degeneration. Additionally, we discuss potential recovery and rejuvenation strategies, focusing on targeting the aging T cell immune system in an effort to alleviate acute brain injury and chronic neuro-degeneration during aging, via the “thymus-inflammaging-neurodegeneration axis”. PMID:27738345

Combined effects of physiological condition and environmental attributes in determining call plasticity.

PubMed

Ziegler, Lucia; Arim, Matias; Bozinovic, Francisco

2018-05-07

Evidence is growing on the ability of anurans to make immediate call adjustments in response to the propagation properties of the environment. However, our understanding of such flexibility is typically based on dichotomous stimuli (i.e. presence/absence), while its condition-dependence has been little explored. We experimentally studied the ability of adjustment and its condition dependence of advertisement calls of Hypsiboas pulchellus in response to different levels of attenuation. Individuals modified most call parameters analyzed, although the direction of adjustments was contingent on individual identity, level of attenuation and trait category (i.e. spectral or temporal). Under low attenuation conditions males lengthened some call elements, partially supporting the hypothesis of plasticity oriented towards maintaining signal transmission, but this trend was not present in the high attenuation treatment. Also, under both attenuation treatments males gave higher frequency notes, as expected from an energy-saving response to changes in social environment or reducing attractiveness due to risk perception. Across treatments individuals in better condition tended to exhibit higher plasticity. These results indicate that call structure could depend on the integration of different cues such as habitat propagation characteristics, acoustic competition for females, and predation risk, while the ability to behave flexibly depends on current body reserves. Copyright © 2018 Elsevier B.V. All rights reserved.

Testing manifest monotonicity using order-constrained statistical inference.

PubMed

Tijmstra, Jesper; Hessen, David J; van der Heijden, Peter G M; Sijtsma, Klaas

2013-01-01

Most dichotomous item response models share the assumption of latent monotonicity, which states that the probability of a positive response to an item is a nondecreasing function of a latent variable intended to be measured. Latent monotonicity cannot be evaluated directly, but it implies manifest monotonicity across a variety of observed scores, such as the restscore, a single item score, and in some cases the total score. In this study, we show that manifest monotonicity can be tested by means of the order-constrained statistical inference framework. We propose a procedure that uses this framework to determine whether manifest monotonicity should be rejected for specific items. This approach provides a likelihood ratio test for which the p-value can be approximated through simulation. A simulation study is presented that evaluates the Type I error rate and power of the test, and the procedure is applied to empirical data.

Back pain in adults living in quilombola territories of Bahia, Northeastern Brazil

PubMed Central

Santos, Luis Rogério Cosme Silva; Assunção, Ada Ávila; Lima, Eduardo de Paula

2014-01-01

OBJECTIVE To analyze the factors associated with back pain in adults who live in quilombola territories. METHODS A population-based survey was performed on quilombola communities of Vitória da Conquista, state of Bahia, Northeastern Brazil. The sample (n = 750) was established via a raffle of residences. Semi-structured interviews were conducted to investigate sociodemographics and employment characteristics, lifestyle, and health conditions. The outcome was analyzed as a dichotomous variable (Poisson regression). RESULTS The prevalence of back pain was of 39.3%. Age ≥ 30 years and being a smoker were associated with the outcome. The employment status was not related to back pain. CONCLUSIONS The survey identified a high prevalence of back pain in adults. It is suggested to support the restructuring of the local public service in order to outline programs and access to healthy practices, assistance, diagnosis, and treatment of spine problems. PMID:25372165

[Workplace Violence in the health sector: validation of the Italian version of the WHO questionnaire].

PubMed

La Torre, G; Sestili, C; Iavazzo, E; Mannocci, A

2017-01-01

The phenomenon of violence and aggression in the workplace is frequent and constantly increasing. Healthcare professionals are most exposed to this phenomenon, especially those who work in urgent and psychiatric emergency departments. To validate the Italian version of the questionnaire "Workplace Violence in the Health Sector Case Study Research Instruments Survey Questionnaire", conducted by WHO. 55 randomly selected workers took part in the validation of the questionnaire among physicians, nurses and nursing trainees. The internal consistency analysis of the demand of 5 dichotomous variables on binary values ​​for violence levels suggests that Cronbach's alpha is 0.61, and Cronbach's alpha calculated on standardized elements is 0.69, which means that Reliability shows sufficient levels. The Italian translation carried out in this WHO questionnaire study shows good internal reliability and consistency and could be considered a useful tool in assessing and preventing aggression and violence against health professionals.

Sensitive response of a model of symbiotic ecosystem to seasonal periodic drive

NASA Astrophysics Data System (ADS)

Rekker, A.; Lumi, N.; Mankin, R.

2014-11-01

A symbiotic ecosysytem (metapopulation) is studied by means of the stochastic Lotka-Volterra model with generalized Verhulst self-regulation. The effect of variable environment on the carrying capacities of populations is taken into account as an asymmetric dichotomous noise and as a deterministic periodic stimulus. In the framework of the mean-field theory an explicit self-consistency equation for the system in the long-time limit is presented. Also, expressions for the probability distribution and for the moments of the population size are found. In certain cases the mean population size exhibits large oscillations in time, even if the amplitude of the seasonal environmental drive is small. Particularly, it is shown that the occurrence of large oscillations of the mean population size can be controlled by noise parameters (such as amplitude and correlation time) and by the coupling strength of the symbiotic interaction between species.

Boolean approach to dichotomic quantum measurement theories

NASA Astrophysics Data System (ADS)

Nagata, K.; Nakamura, T.; Batle, J.; Abdalla, S.; Farouk, A.

2017-02-01

Recently, a new measurement theory based on truth values was proposed by Nagata and Nakamura [Int. J. Theor. Phys. 55, 3616 (2016)], that is, a theory where the results of measurements are either 0 or 1. The standard measurement theory accepts a hidden variable model for a single Pauli observable. Hence, we can introduce a classical probability space for the measurement theory in this particular case. Additionally, we discuss in the present contribution the fact that projective measurement theories (the results of which are either +1 or -1) imply the Bell, Kochen, and Specker (BKS) paradox for a single Pauli observable. To justify our assertion, we present the BKS theorem in almost all the two-dimensional states by using a projective measurement theory. As an example, we present the BKS theorem in two-dimensions with white noise. Our discussion provides new insight into the quantum measurement problem by using this measurement theory based on the truth values.

Awareness and attitude of the public toward personalized medicine in Korea

PubMed Central

Lee, Iyn-Hyang; Kang, Hye-Young; Suh, Hae Sun; Lee, Sukhyang; Oh, Eun Sil

2018-01-01

Objectives As personalized medicine (PM) is expected to greatly improve health outcomes, efforts have recently been made for its clinical implementation in Korea. We aimed to evaluate public awareness and attitude regarding PM. Methods We performed a self-administered questionnaire survey to 703 adults, who participated in the survey on a voluntary basis. The primary outcome measures included public knowledge, attitude, and acceptance of PM. We conducted multinomial multivariate logistic analysis for outcome variables with three response categories and performed multivariate logistic regression analyses for dichotomous outcome variables. Results Only 28% of participants had knowledge that genetic factors can contribute to inter-individual variations in drug response and the definition of PM (199 out of 702). Higher family income was correlated with greater knowledge concerning PM (OR = 3.76, p = 0.034). A majority of respondents preferred integrated pharmacogenomic testing over drug-specific testing and agreed to inclusion of pharmacogenomic testing in the national health examination (64% and 77%, respectively), but only 51% were willing to pay for it. Discussion Our results identify the urgent need for public education as well as the potential health disparities in access to PM. This study helps to frame policies for implementing PM in clinical practice. PMID:29451916

Major histocompatibility complex harbors widespread genotypic variability of non-additive risk of rheumatoid arthritis including epistasis.

PubMed

Wei, Wen-Hua; Bowes, John; Plant, Darren; Viatte, Sebastien; Yarwood, Annie; Massey, Jonathan; Worthington, Jane; Eyre, Stephen

2016-04-25

Genotypic variability based genome-wide association studies (vGWASs) can identify potentially interacting loci without prior knowledge of the interacting factors. We report a two-stage approach to make vGWAS applicable to diseases: firstly using a mixed model approach to partition dichotomous phenotypes into additive risk and non-additive environmental residuals on the liability scale and secondly using the Levene's (Brown-Forsythe) test to assess equality of the residual variances across genotype groups per marker. We found widespread significant (P < 2.5e-05) vGWAS signals within the major histocompatibility complex (MHC) across all three study cohorts of rheumatoid arthritis. We further identified 10 epistatic interactions between the vGWAS signals independent of the MHC additive effects, each with a weak effect but jointly explained 1.9% of phenotypic variance. PTPN22 was also identified in the discovery cohort but replicated in only one independent cohort. Combining the three cohorts boosted power of vGWAS and additionally identified TYK2 and ANKRD55. Both PTPN22 and TYK2 had evidence of interactions reported elsewhere. We conclude that vGWAS can help discover interacting loci for complex diseases but require large samples to find additional signals.

Risky business for a juvenile marine predator? Testing the influence of foraging strategies on size and growth rate under natural conditions

PubMed Central

DiBattista, Joseph D.; Moore, Jonathan W.; Ward, Eric J.; Fisk, Aaron T.; Kessel, Steven; Guttridge, Tristan L.; Feldheim, Kevin A.; Franks, Bryan R.; Gruber, Samuel H.; Weideli, Ornella C.; Chapman, Demian D.

2017-01-01

Mechanisms driving selection of body size and growth rate in wild marine vertebrates are poorly understood, thus limiting knowledge of their fitness costs at ecological, physiological and genetic scales. Here, we indirectly tested whether selection for size-related traits of juvenile sharks that inhabit a nursery hosting two dichotomous habitats, protected mangroves (low predation risk) and exposed seagrass beds (high predation risk), is influenced by their foraging behaviour. Juvenile sharks displayed a continuum of foraging strategies between mangrove and seagrass areas, with some individuals preferentially feeding in one habitat over another. Foraging habitat was correlated with growth rate, whereby slower growing, smaller individuals fed predominantly in sheltered mangroves, whereas larger, faster growing animals fed over exposed seagrass. Concomitantly, tracked juveniles undertook variable movement behaviours across both the low and high predation risk habitat. These data provide supporting evidence for the hypothesis that directional selection favouring smaller size and slower growth rate, both heritable traits in this shark population, may be driven by variability in foraging behaviour and predation risk. Such evolutionary pathways may be critical to adaptation within predator-driven marine ecosystems. PMID:28381626

Risky business for a juvenile marine predator? Testing the influence of foraging strategies on size and growth rate under natural conditions.

PubMed

Hussey, Nigel E; DiBattista, Joseph D; Moore, Jonathan W; Ward, Eric J; Fisk, Aaron T; Kessel, Steven; Guttridge, Tristan L; Feldheim, Kevin A; Franks, Bryan R; Gruber, Samuel H; Weideli, Ornella C; Chapman, Demian D

2017-04-12

Mechanisms driving selection of body size and growth rate in wild marine vertebrates are poorly understood, thus limiting knowledge of their fitness costs at ecological, physiological and genetic scales. Here, we indirectly tested whether selection for size-related traits of juvenile sharks that inhabit a nursery hosting two dichotomous habitats, protected mangroves (low predation risk) and exposed seagrass beds (high predation risk), is influenced by their foraging behaviour. Juvenile sharks displayed a continuum of foraging strategies between mangrove and seagrass areas, with some individuals preferentially feeding in one habitat over another. Foraging habitat was correlated with growth rate, whereby slower growing, smaller individuals fed predominantly in sheltered mangroves, whereas larger, faster growing animals fed over exposed seagrass. Concomitantly, tracked juveniles undertook variable movement behaviours across both the low and high predation risk habitat. These data provide supporting evidence for the hypothesis that directional selection favouring smaller size and slower growth rate, both heritable traits in this shark population, may be driven by variability in foraging behaviour and predation risk. Such evolutionary pathways may be critical to adaptation within predator-driven marine ecosystems. © 2017 The Author(s).

Correlates of children and parents being physically active together.

PubMed

Lee, Sarah M; Nihiser, Allison; Strouse, Darcy; Das, Barnali; Michael, Shannon; Huhman, Marian

2010-11-01

Co-physical activity (between parents and children), as an outcome variable, and its correlates have not been examined previously. The purpose of this study was to investigate correlates of co-physical activity among a nationally representative sample of 9- to 13-year-old children and their parents. Data were from the 2004 Youth Media Campaign Longitudinal Survey, a national survey of 5177 child-parent dyads. Parents of 9- to 13-year-old children were asked to report co-physical activity. Parents and children responded to a series of sociodemographic, behavioral, and psychosocial measures. Co-physical activity was treated as a dichotomous variable (ie, some or none). Logistic regression was used to assess associations of correlates directly and possible interactions between correlates. More than three-quarters of parents reported co-physical activity at least 1 day in the prior week. Age, race/ethnicity, sports team participation, eating meals together, parental confidence to influence the child's organized activity, and the child's perception of parental support were significantly associated with co-physical activity. The majority of respondents reported participating in co-physical activity, and multiple sociodemographic, behavioral, and psychosocial correlates were significantly associated with co-physical activity. This study provides insight for physical activity interventions that might involve parents.

Testing the direct, indirect, and moderated effects of childhood animal cruelty on future aggressive and non-aggressive offending.

PubMed

Walters, Glenn D

2014-01-01

The relationship between childhood cruelty toward animals and subsequent aggressive offending was explored in 1,336 (1,154 male, 182 female) participants from the 11-wave Pathways to Desistance study (Mulvey, 2013). Aggressive and income offending at Waves 1 through 10 were regressed onto a dichotomous measure of prior involvement in animal cruelty and four control variables (age, race, sex, early onset behavior problems) assessed at Wave 0 (baseline). Results indicated that childhood animal cruelty was equally predictive of aggressive and non-aggressive (income) offending, a finding inconsistent with the hypothesis that cruelty toward animals desensitizes a person to future interpersonal aggression or in some way prepares the individual for interpersonal violence toward humans. Whereas a significant sex by animal cruelty interaction was predicted, there was no evidence that sex or any of the other demographic variables included in this study (age, race) consistently moderated the animal cruelty-subsequent offending relationship. On the other hand, two cognitive-personality measures (interpersonal hostility, callousness/unemotionality) were found to successfully mediate the animal cruelty-subsequent offending relationship. Outcomes from this study imply that a causal nexus-partially or fully mediated by hostility, callousness/unemotionality, and other cognitive-personality variables-may exist between childhood animal cruelty and subsequent offending, although the effect is not specific to violence. © 2013 Wiley Periodicals, Inc.

A new approach for modeling patient overall radiosensitivity and predicting multiple toxicity endpoints for breast cancer patients.

PubMed

Mbah, Chamberlain; De Ruyck, Kim; De Schrijver, Silke; De Sutter, Charlotte; Schiettecatte, Kimberly; Monten, Chris; Paelinck, Leen; De Neve, Wilfried; Thierens, Hubert; West, Catharine; Amorim, Gustavo; Thas, Olivier; Veldeman, Liv

2018-05-01

Evaluation of patient characteristics inducing toxicity in breast radiotherapy, using simultaneous modeling of multiple endpoints. In 269 early-stage breast cancer patients treated with whole-breast irradiation (WBI) after breast-conserving surgery, toxicity was scored, based on five dichotomized endpoints. Five logistic regression models were fitted, one for each endpoint and the effect sizes of all variables were estimated using maximum likelihood (MLE). The MLEs are improved with James-Stein estimates (JSEs). The method combines all the MLEs, obtained for the same variable but from different endpoints. Misclassification errors were computed using MLE- and JSE-based prediction models. For associations, p-values from the sum of squares of MLEs were compared with p-values from the Standardized Total Average Toxicity (STAT) Score. With JSEs, 19 highest ranked variables were predictive of the five different endpoints. Important variables increasing radiation-induced toxicity were chemotherapy, age, SATB2 rs2881208 SNP and nodal irradiation. Treatment position (prone position) was most protective and ranked eighth. Overall, the misclassification errors were 45% and 34% for the MLE- and JSE-based models, respectively. p-Values from the sum of squares of MLEs and p-values from STAT score led to very similar conclusions, except for the variables nodal irradiation and treatment position, for which STAT p-values suggested an association with radiosensitivity, whereas p-values from the sum of squares indicated no association. Breast volume was ranked as the most significant variable in both strategies. The James-Stein estimator was used for selecting variables that are predictive for multiple toxicity endpoints. With this estimator, 19 variables were predictive for all toxicities of which four were significantly associated with overall radiosensitivity. JSEs led to almost 25% reduction in the misclassification error rate compared to conventional MLEs. Finally, patient characteristics that are associated with radiosensitivity were identified without explicitly quantifying radiosensitivity.

Identification of Patients with Sleep Disordered Breathing: Comparing the Four-Variable Screening Tool, STOP, STOP-Bang, and Epworth Sleepiness Scales

PubMed Central

Silva, Graciela E.; Vana, Kimberly D.; Goodwin, James L.; Sherrill, Duane L.; Quan, Stuart F.

2011-01-01

Study Objective: The Epworth Sleepiness Scale (ESS) has been used to detect patients with potential sleep disordered breathing (SDB). Recently, a 4-Variable screening tool was proposed to identify patients with SDB, in addition to the STOP and STOP-Bang questionnaires. This study evaluated the abilities of the 4-Variable screening tool, STOP, STOP-Bang, and ESS questionnaires in identifying subjects at risk for SDB. Methods: A total of 4,770 participants who completed polysomnograms in the baseline evaluation of the Sleep Heart Health Study (SHHS) were included. Subjects with RDIs ≥ 15 and ≥ 30 were considered to have moderate-to-severe or severe SDB, respectively. Variables were constructed to approximate those in the questionnaires. The risk of SDB was calculated by the 4-Variable screening tool according to Takegami et al. The STOP and STOP-Bang questionnaires were evaluated including variables for snoring, tiredness/sleepiness, observed apnea, blood pressure, body mass index, age, neck circumference, and gender. Sleepiness was evaluated using the ESS questionnaire and scores were dichotomized into < 11 and ≥ 11. Results: The STOP-Bang questionnaire had higher sensitivity to predict moderate-to-severe (87.0%) and severe (70.4%) SDB, while the 4-Variable screening tool had higher specificity to predict moderate-to-severe and severe SDB (93.2% for both). Conclusions: In community populations such as the SHHS, high specificities may be more useful in excluding low-risk patients, while avoiding false positives. However, sleep clinicians may prefer to use screening tools with high sensitivities, like the STOP-Bang, in order to avoid missing cases that may lead to adverse health consequences and increased healthcare costs. Citation: Silva GE; Vana KD; Goodwin JL; Sherrill DL; Quan SF. Identification of patients with sleep disordered breathing: comparing the Four-Variable screening tool, STOP, STOP-Bang, and Epworth Sleepiness Scales. J Clin Sleep Med 2011;7(5):467-472. PMID:22003341

The Neighborhood Food Resource Environment and the Health of Residents with Chronic Conditions

PubMed Central

Vargas, Roberto B.; Ang, Alfonso; Pebley, Anne R.

2008-01-01

Background Residence in disadvantaged neighborhoods is associated with poorer access to healthy foods. Objective To understand associations between the neighborhood food resource environment and residents’ health status and body mass index (BMI) for adults with and without chronic conditions. Design Cross-sectional multilevel analysis. Participants 2,536 adults from the 2000–2001 Los Angeles Family and Neighborhood Survey. Measurements The food resource environment was defined as the number of chain supermarkets, independent supermarkets, small markets, or convenience stores per roadway miles in the census tract. The main dependent variables were self-rated health, dichotomized as excellent or fair/poor, and body mass index (BMI). Multilevel regression models examined the association between the food resource environment and both BMI and the odds of reporting excellent health after adjustment for neighborhood SES and individual characteristics. Results More chain supermarkets per roadway mile in a census tract was associated with higher adjusted rates of reporting excellent health (33%, 38%, and 43% for those in the lowest, middle, and highest tertiles of chain supermarkets) and lower adjusted mean BMI (27, 26, and 25 kg/m2) for residents without a chronic condition, but not those with a chronic condition. In contrast, having more convenience stores per roadway mile was associated with lower health ratings only among adults with a chronic condition (39%, 32%, and 27% for the lowest to highest tertile of convenience stores). Conclusion Health status and BMI are associated with the local food environment, but the associations differ by type of market and presence of a chronic condition. PMID:18483833

Maternal pre-pregnancy obesity and risk for inattention and negative emotionality in children.

PubMed

Rodriguez, Alina

2010-02-01

This study aimed to replicate and extend previous work showing an association between maternal pre-pregnancy adiposity and risk for attention deficit hyperactivity disorder (ADHD) symptoms in children. A Swedish population-based prospective pregnancy-offspring cohort was followed up when children were 5 years old (N = 1,714). Mothers and kindergarten teachers rated children's ADHD symptoms, presence and duration of problems, and emotionality. Dichotomized outcomes examined difficulties of clinical relevance (top 15% of the distribution). Analyses adjusted for pregnancy (maternal smoking, depressive symptoms, life events, education, age, family structure), birth outcomes (birth weight, gestational age, infant sex) and concurrent variables (family structure, maternal depressive symptoms, parental ADHD symptoms, and child overweight) in an attempt to rule out confounding. Maternal pre-pregnancy overweight and obesity predicted high inattention symptom scores and obesity was associated with a two-fold increase in risk of difficulties with emotion intensity and emotion regulation according to teacher reports. Means of maternal ratings were unrelated to pre-pregnancy body mass index (BMI). Presence and duration of problems were associated with both maternal over and underweight according to teachers. Despite discrepancies between maternal and teacher reports, these results provide further evidence that maternal pre-pregnancy overweight and obesity are associated with child inattention symptoms and extend previous work by establishing a link between obesity and emotional difficulties. Maternal adiposity at the time of conception may be instrumental in programming child mental health, as prenatal brain development depends on maternal energy supply. Possible mechanisms include disturbed maternal metabolic function. If maternal pre-pregnancy obesity is a causal risk factor, the potential for prevention is great.

[Developing a predictive model for the caregiver strain index].

PubMed

Álvarez-Tello, Margarita; Casado-Mejía, Rosa; Praena-Fernández, Juan Manuel; Ortega-Calvo, Manuel

Patient homecare with multiple morbidities is an increasingly common occurrence. The caregiver strain index is tool in the form of questionnaire that is designed to measure the perceived burden of those who care for their families. The aim of this study is to construct a diagnostic nomogram of informal caregiver burden using data from a predictive model. The model was drawn up using binary logistic regression and the questionnaire items as dichotomous factors. The dependent variable was the final score obtained with the questionnaire but categorised in accordance with that in the literature. Scores between 0 and 6 were labelled as "no" (no caregiver stress) and at or greater than 7 as "yes". The version 3.1.1R statistical software was used. To construct confidence intervals for the ROC curve 2000 boot strap replicates were used. A sample of 67 caregivers was obtained. A diagnosing nomogram was made up with its calibration graph (Brier scaled = 0.686, Nagelkerke R 2 =0.791), and the corresponding ROC curve (area under the curve=0.962). The predictive model generated using binary logistic regression and the nomogram contain four items (1, 4, 5 and 9) of the questionnaire. R plotting functions allow a very good solution for validating a model like this. The area under the ROC curve (0.96; 95% CI: 0.994-0.941) achieves a high discriminative value. Calibration also shows high goodness of fit values, suggesting that it may be clinically useful in community nursing and geriatric establishments. Copyright © 2015 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.

Physical activity and cardiac function in the oldest old.

PubMed

Stessman-Lande, Irit; Jacobs, Jeremy M; Gilon, Dan; Leibowitz, David

2012-02-01

The relationship of physical activity (PA) and cardiac function in the oldest old remains unclear. The objective of this study was to evaluate the relationship between PA and cardiac structure and function, in the oldest old. Subjects were recruited from the Jerusalem Longitudinal Cohort Study that was initiated in 1990 and has followed an age homogeneous cohort of Jerusalem residents born in 1920-1921. A total of 496 of the subjects from the most recent set of data collection in 2005-2006 underwent echocardiography at their place of residence in addition to structured interviews and physical examination. Standard echocardiographic assessment of cardiac structure and function including ejection fraction (EF) and diastolic function as assessed by E:E' measurements was performed. PA was defined as a dichotomous (≥4 hr of light exercise weekly) and as a categorical variable (<4 hr weekly/4 hours weekly/at least 1 hr daily/sport at least twice weekly). On bivariate analysis, mean EF was lower among sedentary versus active women (55.5%±8.5% vs. 58.4%±8.3, p=0.021). No other significant differences were observed between sedentary and active subjects, for either systolic or diastolic function. After adjusting for sex, education, diabetes, ischemic heart disease, hypertension, dependence in activities of daily living, and body mass index (BMI), no significant associations were found between systolic or diastolic function, or left ventricular structure and PA. Gender-specific analyses yielded similar findings. Our study of the oldest old did not demonstrate an association between PA and cardiac structure or function.

Multiple performance measures are needed to evaluate triage systems in the emergency department.

PubMed

Zachariasse, Joany M; Nieboer, Daan; Oostenbrink, Rianne; Moll, Henriëtte A; Steyerberg, Ewout W

2018-02-01

Emergency department triage systems can be considered prediction rules with an ordinal outcome, where different directions of misclassification have different clinical consequences. We evaluated strategies to compare the performance of triage systems and aimed to propose a set of performance measures that should be used in future studies. We identified performance measures based on literature review and expert knowledge. Their properties are illustrated in a case study evaluating two triage modifications in a cohort of 14,485 pediatric emergency department visits. Strengths and weaknesses of the performance measures were systematically appraised. Commonly reported performance measures are measures of statistical association (34/60 studies) and diagnostic accuracy (17/60 studies). The case study illustrates that none of the performance measures fulfills all criteria for triage evaluation. Decision curves are the performance measures with the most attractive features but require dichotomization. In addition, paired diagnostic accuracy measures can be recommended for dichotomized analysis, and the triage-weighted kappa and Nagelkerke's R 2 for ordinal analyses. Other performance measures provide limited additional information. When comparing modifications of triage systems, decision curves and diagnostic accuracy measures should be used in a dichotomized analysis, and the triage-weighted kappa and Nagelkerke's R 2 in an ordinal approach. Copyright © 2017 Elsevier Inc. All rights reserved.

Effects of interdisciplinary teamwork on patient-reported experience of cancer care.

PubMed

Tremblay, Dominique; Roberge, Danièle; Touati, Nassera; Maunsell, Elizabeth; Berbiche, Djamal

2017-03-20

Interdisciplinary teamwork (ITW) is deemed necessary for quality cancer care practices. Nevertheless, variation in ITW intensity among cancer teams is understudied, and quantitative evidence of the effect of different ITW intensities among cancer teams on patients' perceived experience of care is limited. This study aims to compare patient-reported experience measures (PREMs) of cancer outpatients followed by teams characterized by high vs. low ITW intensity. The study is designed as an ex post facto quasi-experimental study. Participants (n = 1379) were recruited in nine outpatient oncology clinics characterized by different ITW intensities. ITW intensities were evaluated using the characteristics of structure (team composition and size) and process (interactions among team members), as per West's seminal work on team effectiveness. ITW intensity was dichotomized (high vs. low ITW intensity). PREMs were classified and measured using validated scales corresponding to six dimensions: Prompt access to care, Person-centred response, Quality of patient-professional communication, Quality of the care environment, Continuity of care, and Results of care. Dichotomous variables were created for each dimension (positive vs. less positive experience). Multiple logistic regression analyses were performed to assess the association between ITW intensities and the six PREMs dimensions, while controlling for patient and organizational characteristics. PROC GENMOD was used to fit logistic models for categorical variables. Outpatients treated by teams characterized by high ITW intensity reported almost four times more positive perceptions of Prompt access to care compared to patients treated by low ITW intensity teams (OR = 3.99; CI = 1.89-8.41). High ITW intensity also positively affected patients' perceptions of Quality of patient-professional communication (OR = 2.37; CI = 1.25-4.51), Person-centred response (OR = 2.11; CI = 1.05-4.24], and Continuity of care (OR = 2.18; CI = 1.07-4.45). No significant association was found between ITW intensity and perceived Results of care (OR = 1.31; CI = 0.68-2.52) or Quality of the care environment (OR = 0.66; CI = 0.31-1.39). This study provides empirical evidence, from the patient's perspective, that ITW intensity affects some critical aspects of patient-reported quality of care. Future research will allow explaining how and why ITW structure and processes may contribute to positive cancer care experiences.

Assessing Hospital Disaster Readiness Over Time at the US Department of Veterans Affairs.

PubMed

Der-Martirosian, Claudia; Radcliff, Tiffany A; Gable, Alicia R; Riopelle, Deborah; Hagigi, Farhad A; Brewster, Pete; Dobalian, Aram

2017-02-01

Introduction There have been numerous initiatives by government and private organizations to help hospitals become better prepared for major disasters and public health emergencies. This study reports on efforts by the US Department of Veterans Affairs (VA), Veterans Health Administration, Office of Emergency Management's (OEM) Comprehensive Emergency Management Program (CEMP) to assess the readiness of VA Medical Centers (VAMCs) across the nation. Hypothesis/Problem This study conducts descriptive analyses of preparedness assessments of VAMCs and examines change in hospital readiness over time. To assess change, quantitative analyses of data from two phases of preparedness assessments (Phase I: 2008-2010; Phase II: 2011-2013) at 137 VAMCs were conducted using 61 unique capabilities assessed during the two phases. The initial five-point Likert-like scale used to rate each capability was collapsed into a dichotomous variable: "not-developed=0" versus "developed=1." To describe changes in preparedness over time, four new categories were created from the Phase I and Phase II dichotomous variables: (1) rated developed in both phases; (2) rated not-developed in Phase I but rated developed in Phase II; (3) rated not-developed in both phases; and (4) rated developed in Phase I but rated not- developed in Phase II. From a total of 61 unique emergency preparedness capabilities, 33 items achieved the desired outcome - they were rated either "developed in both phases" or "became developed" in Phase II for at least 80% of VAMCs. For 14 items, 70%-80% of VAMCs achieved the desired outcome. The remaining 14 items were identified as "low-performing" capabilities, defined as less than 70% of VAMCs achieved the desired outcome. Measuring emergency management capabilities is a necessary first step to improving those capabilities. Furthermore, assessing hospital readiness over time and creating robust hospital readiness assessment tools can help hospitals make informed decisions regarding allocation of resources to ensure patient safety, provide timely access to high-quality patient care, and identify best practices in emergency management during and after disasters. Moreover, with some minor modifications, this comprehensive, all-hazards-based, hospital preparedness assessment tool could be adapted for use beyond the VA. Der-Martirosian C , Radcliff TA , Gable AR , Riopelle D , Hagigi FA , Brewster P , Dobalian A . Assessing hospital disaster readiness over time at the US Department of Veterans Affairs. Prehsop Disaster Med. 2017;32(1):46-57.

Agreement Analysis: What He Said, She Said Versus You Said.

PubMed

Vetter, Thomas R; Schober, Patrick

2018-06-01

Correlation and agreement are 2 concepts that are widely applied in the medical literature and clinical practice to assess for the presence and strength of an association. However, because correlation and agreement are conceptually distinct, they require the use of different statistics. Agreement is a concept that is closely related to but fundamentally different from and often confused with correlation. The idea of agreement refers to the notion of reproducibility of clinical evaluations or biomedical measurements. The intraclass correlation coefficient is a commonly applied measure of agreement for continuous data. The intraclass correlation coefficient can be validly applied specifically to assess intrarater reliability and interrater reliability. As its name implies, the Lin concordance correlation coefficient is another measure of agreement or concordance. In undertaking a comparison of a new measurement technique with an established one, it is necessary to determine whether they agree sufficiently for the new to replace the old. Bland and Altman demonstrated that using a correlation coefficient is not appropriate for assessing the interchangeability of 2 such measurement methods. They in turn described an alternative approach, the since widely applied graphical Bland-Altman Plot, which is based on a simple estimation of the mean and standard deviation of differences between measurements by the 2 methods. In reading a medical journal article that includes the interpretation of diagnostic tests and application of diagnostic criteria, attention is conventionally focused on aspects like sensitivity, specificity, predictive values, and likelihood ratios. However, if the clinicians who interpret the test cannot agree on its interpretation and resulting typically dichotomous or binary diagnosis, the test results will be of little practical use. Such agreement between observers (interobserver agreement) about a dichotomous or binary variable is often reported as the kappa statistic. Assessing the interrater agreement between observers, in the case of ordinal variables and data, also has important biomedical applicability. Typically, this situation calls for use of the Cohen weighted kappa. Questionnaires, psychometric scales, and diagnostic tests are widespread and increasingly used by not only researchers but also clinicians in their daily practice. It is essential that these questionnaires, scales, and diagnostic tests have a high degree of agreement between observers. It is therefore vital that biomedical researchers and clinicians apply the appropriate statistical measures of agreement to assess the reproducibility and quality of these measurement instruments and decision-making processes.

Development of a Gestational Age-Specific Case Definition for Neonatal Necrotizing Enterocolitis.

PubMed

Battersby, Cheryl; Longford, Nick; Costeloe, Kate; Modi, Neena

2017-03-01

Necrotizing enterocolitis (NEC) is a major cause of neonatal morbidity and mortality. Preventive and therapeutic research, surveillance, and quality improvement initiatives are hindered by variations in case definitions. To develop a gestational age (GA)-specific case definition for NEC. We conducted a prospective 34-month population study using clinician-recorded findings from the UK National Neonatal Research Database between December 2011 and September 2014 across all 163 neonatal units in England. We split study data into model development and validation data sets and categorized GA into groups (group 1, less than 26 weeks' GA; group 2, 26 to less than 30 weeks' GA; group 3, 30 to less than 37 weeks' GA; group 4, 37 or more weeks' GA). We entered GA, birth weight z score, and clinical and abdominal radiography findings as candidate variables in a logistic regression model, performed model fitting 1000 times, averaged the predictions, and used estimates from the fitted model to develop an ordinal NEC score and cut points to develop a dichotomous case definition based on the highest area under the receiver operating characteristic curves [AUCs] and positive predictive values [PPVs]. Abdominal radiography performed to investigate clinical concerns. Ordinal NEC likelihood score, dichotomous case definition, and GA-specific probability plots. Of the 3866 infants, the mean (SD) birth weight was 2049.1 (1941.7) g and mean (SD) GA was 32 (5) weeks; 2032 of 3663 (55.5%) were male. The total included 2978 infants (77.0%) without NEC and 888 (23.0%) with NEC. Infants with NEC in group 1 were less likely to present with pneumatosis (31.1% vs 47.2%; P = .01), blood in stool (11.8% vs 29.6%; P < .001), or mucus in stool (2.1% vs 5.6%; P = .048) but more likely to present with gasless abdominal radiography findings (6.3% vs 0.9%; P = .009) compared with infants with NEC in group 3. In the ordinal NEC score analysis, we allocated 3 points to pneumatosis, 2 points to blood in stool, and 1 point each to abdominal tenderness and abdominal discoloration; 1 point was assigned if 1 or more of pneumoperitoneum, fixed loop, and portal venous gas were present, and 1 point was assigned if both increased and/or bilious aspirates and abdominal distension were present. The cutoff scores for the dichotomous GA-specific case definition were 2 or greater for infants in groups 1 and 2, 3 or greater for infants in group 3, and 4 or greater for infants in group 4. The ordinal NEC score and dichotomous case definition discriminated well between infants with (AUC, 87%) and without (AUC, 80%) NEC. The case definition has a sensitivity of 66.2% (95% CI, 63.0-69.4), a specificity of 94.4% (95% CI, 93.2-95.4), an AUC of 80.0% (95% CI, 79-82), and a PPV of 85.5% (95% CI, 82.6-88.1). Applying the cut points to the 431 infants who underwent a laparotomy yielded a sensitivity of 76.5% (95% CI, 70.0-82.1), a specificity of 74.4% (95% CI, 68.3-80.0), an AUC of 75.0% (95% CI, 71.0- 80.0), and a PPV of 72.9% (95% CI, 66.4-78.7). The risk of NEC and clinical presentation are associated with GA. Adoption of a consistent GA-specific case definition would strengthen global efforts to reduce the population burden of this devastating neonatal disease.

[Short stature in children of Karapotó ethnic background, São Sebastião, Alagoas, Brazil].

PubMed

Campos, Samara Bonfim Gomes; de Menezes, Risia Cristina Egito; Oliveira, Maria Alice Araújo; Silva, Danielle Alice Vieira da; Longo-Silva, Giovana; Oliveira, Juliana Souza; Asakura, Leiko; Costa, Emília Chagas; Leal, Vanessa Sá

2016-06-01

To describe the prevalence of short stature among children of Karapotó ethnic background. Cross-sectional, population-based study that included children between 6 and 59 months of age from the Plak-Ô native village and the Terra Nova settlement, São Sebastião, Alagoas, carried out between 2008 and 2009. Short stature was evaluated by the Height/Age index, using as cutoff z score ≤-2. The prevalence of short stature was determined by comparing simple and relative frequencies. The population growth curves were compared to the WHO reference curves. Data analysis included the outcome variable: Height/Age and the predictor variables: place of residence, gender, age, anemia, birth weight, family income, maternal literacy. The chi-square test was used to compare the categorical variables, whereas the chi-square test with Yates correction was used for dichotomous variables, considering as statistically significant p-values≤0.05. The prevalence of short stature was 15.6% for children from the Terra Nova settlement and 9.1% for those from Plak-Ô native village. The prevalence of short stature among the Karapotó ethnicity was 13.4%. The variables: maternal literacy, family income and low birth weight were statistically associated with short stature. The observed short stature prevalence rates are significant, being characterized as a public health problem. Among the associated factors, the following are noteworthy: unfavorable conditions of maternal literacy, family income and low birth weight. The planning of strategies to reverse the situation must take such factors into consideration. Copyright © 2015 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

In vivo confocal microscopy appearance of Fusarium and Aspergillus species in fungal keratitis.

PubMed

Chidambaram, Jaya Devi; Prajna, Namperumalsamy Venkatesh; Larke, Natasha; Macleod, David; Srikanthi, Palepu; Lanjewar, Shruti; Shah, Manisha; Lalitha, Prajna; Elakkiya, Shanmugam; Burton, Matthew J

2017-08-01

Clinical outcomes in fungal keratitis vary between Fusarium and Aspergillus spp, therefore distinguishing between species using morphological features such as filament branching angles, sporulation along filaments (adventitious sporulation) or dichotomous branching may be useful. In this study, we assessed these three features within Heidelberg Retina Tomograph 3 in vivo confocal microscopy (IVCM) images from culture-positive Fusarium and Aspergillus spp keratitis participants. Prospective observational cohort study in Aravind Eye Hospital (February 2011-February 2012). Eligibility criteria: age ≥18 years, stromal infiltrate ≥3 mm diameter, Fusarium or Aspergillus spp culture-positive. previous/current herpetic keratitis, visual acuity <6/60 in fellow eye, >80% corneal thinning. IVCM was performed and images analysed for branch angle, presence/absence of adventitious sporulation or dichotomous branching by a grader masked to the microbiological diagnosis. 98 participants were included (106 eligible, 8 excluded as no measurable branch angles); 68 were positive for Fusarium spp, 30 for Aspergillus spp. Mean branch angle for Fusarium spp was 59.7° (95% CI 57.7° to 61.8°), and for Aspergillus spp was 63.3° (95% CI 60.8° to 65.8°), p=0.07. No adventitious sporulation was detected in Fusarium spp ulcers. Dichotomous branching was detected in 11 ulcers (7 Aspergillus spp, 4 Fusarium spp). There was very little difference in the branching angle of Fusarium and Aspergillus spp. Adventitious sporulation was not detected and dichotomous branching was infrequently seen. Although IVCM remains a valuable tool to detect fungal filaments in fungal keratitis, it cannot be used to distinguish Fusarium from Aspergillus spp and culture remains essential to determine fungal species. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Quantum dynamics in strong fluctuating fields

NASA Astrophysics Data System (ADS)

Goychuk, Igor; Hänggi, Peter

A large number of multifaceted quantum transport processes in molecular systems and physical nanosystems, such as e.g. nonadiabatic electron transfer in proteins, can be treated in terms of quantum relaxation processes which couple to one or several fluctuating environments. A thermal equilibrium environment can conveniently be modelled by a thermal bath of harmonic oscillators. An archetype situation provides a two-state dissipative quantum dynamics, commonly known under the label of a spin-boson dynamics. An interesting and nontrivial physical situation emerges, however, when the quantum dynamics evolves far away from thermal equilibrium. This occurs, for example, when a charge transferring medium possesses nonequilibrium degrees of freedom, or when a strong time-dependent control field is applied externally. Accordingly, certain parameters of underlying quantum subsystem acquire stochastic character. This may occur, for example, for the tunnelling coupling between the donor and acceptor states of the transferring electron, or for the corresponding energy difference between electronic states which assume via the coupling to the fluctuating environment an explicit stochastic or deterministic time-dependence. Here, we review the general theoretical framework which is based on the method of projector operators, yielding the quantum master equations for systems that are exposed to strong external fields. This allows one to investigate on a common basis, the influence of nonequilibrium fluctuations and periodic electrical fields on those already mentioned dynamics and related quantum transport processes. Most importantly, such strong fluctuating fields induce a whole variety of nonlinear and nonequilibrium phenomena. A characteristic feature of such dynamics is the absence of thermal (quantum) detailed balance.ContentsPAGE1. Introduction5262. Quantum dynamics in stochastic fields531 2.1. Stochastic Liouville equation531 2.2. Non-Markovian vs. Markovian discrete state fluctuations531 2.3. Averaging the quantum propagator533  2.3.1. Kubo oscillator535  2.3.2. Averaged dynamics of two-level quantum systems exposed to two-state stochastic fields537 2.4. Projection operator method: a primer5403. Two-state quantum dynamics in periodic fields542 3.1. Coherent destruction of tunnelling542 3.2. Driving-induced tunnelling oscillations (DITO)5434. Dissipative quantum dynamics in strong time-dependent fields544 4.1. General formalism544  4.1.1. Weak-coupling approximation545  4.1.2. Markovian approximation: Generalised Redfield Equations5475. Application I: Quantum relaxation in driven, dissipative two-level systems548 5.1. Decoupling approximation for fast fluctuating energy levels550  5.1.1. Control of quantum rates551  5.1.2. Stochastic cooling and inversion of level populations552  5.1.3. Emergence of an effective energy bias553 5.2. Quantum relaxation in strong periodic fields554 5.3. Approximation of time-dependent rates554 5.4. Exact averaging for dichotomous Markovian fluctuations5556. Application II: Driven electron transfer within a spin-boson description557 6.1. Curve-crossing problems with dissipation558 6.2. Weak system-bath coupling559 6.3. Beyond weak-coupling theory: Strong system-bath coupling563  6.3.1. Fast fluctuating energy levels565  6.3.2. Exact averaging over dichotomous fluctuations of the energy levels566  6.3.3. Electron transfer in fast oscillating periodic fields567  6.3.4. Dichotomously fluctuating tunnelling barrier5687. Quantum transport in dissipative tight-binding models subjected tostrong external fields569 7.1. Noise-induced absolute negative mobility571 7.2. Dissipative quantum rectifiers573 7.3. Limit of vanishing dissipation575 7.4. Case of harmonic mixing drive5758. Summary576Acknowledgements578References579

Energy balance related behaviour: personal, home- and friend-related factors among schoolchildren in Europe studied in the ENERGY-project.

PubMed

te Velde, Saskia J; Singh, Amika; Chinapaw, Mai; De Bourdeaudhuij, Ilse; Jan, Natasa; Kovacs, Eva; Bere, Elling; Vik, Froydis N; Bringolf-Isler, Bettina; Manios, Yannis; Moreno, Luis; Brug, Johannes

2014-01-01

To design interventions that target energy balance-related behaviours, knowledge of primary schoolchildren's perceptions regarding soft drink intake, fruit juice intake, breakfast consumption, TV viewing and physical activity (PA) is essential. The current study describes personal beliefs and attitudes, home- and friend-related variables regarding these behaviours across Europe. Cross-sectional study in which personal, family and friend -related variables were assessed by validated questionnaires, and dichotomized as favourable versus unfavourable answers. Logistic regression analyses were conducted to estimate proportions of children giving unfavourable answers and test between-country differences. A survey in eight European countries. A total of 7903 10-12 year old primary schoolchildren. A majority of the children reported unfavourable attitudes, preferences and subjective norms regarding soft drink, fruit juice intake and TV viewing accompanied with high availability and accessibility at home. Few children reported unfavourable attitudes and preferences regarding breakfast consumption and PA. Many children reported unfavourable health beliefs regarding breakfast consumption and TV viewing. Substantial differences between countries were observed, especially for variables regarding soft drink intake, breakfast consumption and TV viewing. The surveyed children demonstrated favourable attitudes to some healthy behaviours (PA, breakfast intake) as well as to some unhealthy behaviours (soft drink consumption, TV viewing). Additionally, many children across Europe have personal beliefs and are exposed to social environments that are not supportive to engagement in healthy behaviours. Moreover, the large differences in personal, family and friend-related variables across Europe argue for implementing different strategies in the different European countries.

Inter-reader reproducibility of dynamic contrast-enhanced magnetic resonance imaging in patients with non-small cell lung cancer treated with bevacizumab and erlotinib.

PubMed

van den Boogaart, Vivian E M; de Lussanet, Quido G; Houben, Ruud M A; de Ruysscher, Dirk; Groen, Harry J M; Marcus, J Tim; Smit, Egbert F; Dingemans, Anne-Marie C; Backes, Walter H

2016-03-01

Objectives When evaluating anti-tumor treatment response by dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) it is necessary to assure its validity and reproducibility. This has not been well addressed in lung tumors. Therefore we have evaluated the inter-reader reproducibility of response classification by DCE-MRI in patients with non-small cell lung cancer (NSCLC) treated with bevacizumab and erlotinib enrolled in a multicenter trial. Twenty-one patients were scanned before and 3 weeks after start of treatment with DCE-MRI in a multicenter trial. The scans were evaluated by two independent readers. The primary lung tumor was used for response assessment. Responses were assessed in terms of relative changes in tumor mean trans endothelial transfer rate (K(trans)) and its heterogeneity in terms of the spatial standard deviation. Reproducibility was expressed by the inter-reader variability, intra-class correlation coefficient (ICC) and dichotomous response classification. The inter-reader variability and ICC for the relative K(trans) were 5.8% and 0.930, respectively. For tumor heterogeneity the inter-reader variability and ICC were 0.017 and 0.656, respectively. For the two readers the response classification for relative K(trans) was concordant in 20 of 21 patients (k=0.90, p<0.0001) and for tumor heterogeneity in 19 of 21 patients (k=0.80, p<0.0001). Strong agreement was seen with regard to the inter-reader variability and reproducibility of response classification by the two readers of lung cancer DCE-MRI scans. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Individual sequences in large sets of gene sequences may be distinguished efficiently by combinations of shared sub-sequences

PubMed Central

Gibbs, Mark J; Armstrong, John S; Gibbs, Adrian J

2005-01-01

Background Most current DNA diagnostic tests for identifying organisms use specific oligonucleotide probes that are complementary in sequence to, and hence only hybridise with the DNA of one target species. By contrast, in traditional taxonomy, specimens are usually identified by 'dichotomous keys' that use combinations of characters shared by different members of the target set. Using one specific character for each target is the least efficient strategy for identification. Using combinations of shared bisectionally-distributed characters is much more efficient, and this strategy is most efficient when they separate the targets in a progressively binary way. Results We have developed a practical method for finding minimal sets of sub-sequences that identify individual sequences, and could be targeted by combinations of probes, so that the efficient strategy of traditional taxonomic identification could be used in DNA diagnosis. The sizes of minimal sub-sequence sets depended mostly on sequence diversity and sub-sequence length and interactions between these parameters. We found that 201 distinct cytochrome oxidase subunit-1 (CO1) genes from moths (Lepidoptera) were distinguished using only 15 sub-sequences 20 nucleotides long, whereas only 8–10 sub-sequences 6–10 nucleotides long were required to distinguish the CO1 genes of 92 species from the 9 largest orders of insects. Conclusion The presence/absence of sub-sequences in a set of gene sequences can be used like the questions in a traditional dichotomous taxonomic key; hybridisation probes complementary to such sub-sequences should provide a very efficient means for identifying individual species, subtypes or genotypes. Sequence diversity and sub-sequence length are the major factors that determine the numbers of distinguishing sub-sequences in any set of sequences. PMID:15817134

COMT Genetic Reduction Produces Sexually Divergent Effects on Cortical Anatomy and Working Memory in Mice and Humans.

PubMed

Sannino, Sara; Gozzi, Alessandro; Cerasa, Antonio; Piras, Fabrizio; Scheggia, Diego; Managò, Francesca; Damiano, Mario; Galbusera, Alberto; Erickson, Lucy C; De Pietri Tonelli, Davide; Bifone, Angelo; Tsaftaris, Sotirios A; Caltagirone, Carlo; Weinberger, Daniel R; Spalletta, Gianfranco; Papaleo, Francesco

2015-09-01

Genetic variations in catechol-O-methyltransferase (COMT) that modulate cortical dopamine have been associated with pleiotropic behavioral effects in humans and mice. Recent data suggest that some of these effects may vary among sexes. However, the specific brain substrates underlying COMT sexual dimorphisms remain unknown. Here, we report that genetically driven reduction in COMT enzyme activity increased cortical thickness in the prefrontal cortex (PFC) and postero-parieto-temporal cortex of male, but not female adult mice and humans. Dichotomous changes in PFC cytoarchitecture were also observed: reduced COMT increased a measure of neuronal density in males, while reducing it in female mice. Consistent with the neuroanatomical findings, COMT-dependent sex-specific morphological brain changes were paralleled by divergent effects on PFC-dependent working memory in both mice and humans. These findings emphasize a specific sex-gene interaction that can modulate brain morphological substrates with influence on behavioral outcomes in healthy subjects and, potentially, in neuropsychiatric populations. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

A Quasi-Linear Behavioral Model and an Application to Self-Directed Learning

NASA Technical Reports Server (NTRS)

Ponton, Michael K.; Carr, Paul B.

1999-01-01

A model is presented that describes the relationship between one's knowledge of the world and the concomitant personal behaviors that serve as a mechanism to obtain desired outcomes. Integrated within this model are the differing roles that outcomes serve as motivators and as modifiers to one's worldview. The model is dichotomized between general and contextual applications. Because learner self-directedness (a personal characteristic) involves cognition and affection while self-directed learning (a pedagogic process) encompasses conation, behavior and introspection, the model can be dichotomized again in another direction. Presented also are the roles that cognitive motivation theories play in moving an individual through this behavioral model and the roles of wishes, self-efficacy, opportunity and self-influence.

A method of bias correction for maximal reliability with dichotomous measures.

PubMed

Penev, Spiridon; Raykov, Tenko

2010-02-01

This paper is concerned with the reliability of weighted combinations of a given set of dichotomous measures. Maximal reliability for such measures has been discussed in the past, but the pertinent estimator exhibits a considerable bias and mean squared error for moderate sample sizes. We examine this bias, propose a procedure for bias correction, and develop a more accurate asymptotic confidence interval for the resulting estimator. In most empirically relevant cases, the bias correction and mean squared error correction can be performed simultaneously. We propose an approximate (asymptotic) confidence interval for the maximal reliability coefficient, discuss the implementation of this estimator, and investigate the mean squared error of the associated asymptotic approximation. We illustrate the proposed methods using a numerical example.

Quantile Regression in the Study of Developmental Sciences

PubMed Central

Petscher, Yaacov; Logan, Jessica A. R.

2014-01-01

Linear regression analysis is one of the most common techniques applied in developmental research, but only allows for an estimate of the average relations between the predictor(s) and the outcome. This study describes quantile regression, which provides estimates of the relations between the predictor(s) and outcome, but across multiple points of the outcome’s distribution. Using data from the High School and Beyond and U.S. Sustained Effects Study databases, quantile regression is demonstrated and contrasted with linear regression when considering models with: (a) one continuous predictor, (b) one dichotomous predictor, (c) a continuous and a dichotomous predictor, and (d) a longitudinal application. Results from each example exhibited the differential inferences which may be drawn using linear or quantile regression. PMID:24329596

Use of generalised additive models to categorise continuous variables in clinical prediction

PubMed Central

2013-01-01

Background In medical practice many, essentially continuous, clinical parameters tend to be categorised by physicians for ease of decision-making. Indeed, categorisation is a common practice both in medical research and in the development of clinical prediction rules, particularly where the ensuing models are to be applied in daily clinical practice to support clinicians in the decision-making process. Since the number of categories into which a continuous predictor must be categorised depends partly on the relationship between the predictor and the outcome, the need for more than two categories must be borne in mind. Methods We propose a categorisation methodology for clinical-prediction models, using Generalised Additive Models (GAMs) with P-spline smoothers to determine the relationship between the continuous predictor and the outcome. The proposed method consists of creating at least one average-risk category along with high- and low-risk categories based on the GAM smooth function. We applied this methodology to a prospective cohort of patients with exacerbated chronic obstructive pulmonary disease. The predictors selected were respiratory rate and partial pressure of carbon dioxide in the blood (PCO2), and the response variable was poor evolution. An additive logistic regression model was used to show the relationship between the covariates and the dichotomous response variable. The proposed categorisation was compared to the continuous predictor as the best option, using the AIC and AUC evaluation parameters. The sample was divided into a derivation (60%) and validation (40%) samples. The first was used to obtain the cut points while the second was used to validate the proposed methodology. Results The three-category proposal for the respiratory rate was ≤ 20;(20,24];> 24, for which the following values were obtained: AIC=314.5 and AUC=0.638. The respective values for the continuous predictor were AIC=317.1 and AUC=0.634, with no statistically significant differences being found between the two AUCs (p =0.079). The four-category proposal for PCO2 was ≤ 43;(43,52];(52,65];> 65, for which the following values were obtained: AIC=258.1 and AUC=0.81. No statistically significant differences were found between the AUC of the four-category option and that of the continuous predictor, which yielded an AIC of 250.3 and an AUC of 0.825 (p =0.115). Conclusions Our proposed method provides clinicians with the number and location of cut points for categorising variables, and performs as successfully as the original continuous predictor when it comes to developing clinical prediction rules. PMID:23802742

Addendum to "Colored-noise-induced discontinuous transitions in symbiotic ecosystems".

PubMed

Sauga, Ako; Mankin, Romi

2005-06-01

A symbiotic ecosystem with Gompertz self-regulation and with adaptive competition between populations is studied by means of a N-species Lotka-Volterra stochastic model. The influence of fluctuating environment on the carrying capacity of a population is modeled as a dichotomous noise. The study is a follow up of previous investigations of symbiotic ecosystems subjected to the generalized Verhulst self-regulation [Phys. Rev. E 69, 061106 (2004); 65, 051108 (2002)]. In the framework of mean-field approximation the behavior of the solutions of the self-consistency equation for a stationary system is examined analytically in the full phase space of system parameters. Depending on the mutual interplay of symbiosis and competition of species, variation of noise parameters (amplitude, correlation time) can induce doubly unidirectional discontinuous transitions as well as single unidirectional discontinuous transitions of the mean population size.

Addendum to ``Colored-noise-induced discontinuous transitions in symbiotic ecosystems''

NASA Astrophysics Data System (ADS)

Sauga, Ako; Mankin, Romi

2005-06-01

A symbiotic ecosystem with Gompertz self-regulation and with adaptive competition between populations is studied by means of a N -species Lotka-Volterra stochastic model. The influence of fluctuating environment on the carrying capacity of a population is modeled as a dichotomous noise. The study is a follow up of previous investigations of symbiotic ecosystems subjected to the generalized Verhulst self-regulation [Phys. Rev. E 69, 061106 (2004); 65, 051108 (2002)]. In the framework of mean-field approximation the behavior of the solutions of the self-consistency equation for a stationary system is examined analytically in the full phase space of system parameters. Depending on the mutual interplay of symbiosis and competition of species, variation of noise parameters (amplitude, correlation time) can induce doubly unidirectional discontinuous transitions as well as single unidirectional discontinuous transitions of the mean population size.

Influence of advections of particulate matter from biomass combustion on specific-cause mortality in Madrid in the period 2004-2009.

PubMed

Linares, C; Carmona, R; Tobías, A; Mirón, I J; Díaz, J

2015-05-01

Approximately, 20 % of particulate and aerosol emissions into the urban atmosphere are of natural origin (including wildfires and Saharan dust). During these natural episodes, PM10 and PM2.5 levels usually exceed World Health Organisation (WHO) health protection thresholds. This study sought to evaluate the possible effect of advections of particulate matter from biomass fuel combustion on daily specific-cause mortality among the general population and the segment aged ≥ 75 years in Madrid. Ecological time-series study in the city of Madrid from January 01, 2004 to December 31, 2009. The dependent variable analysed was daily mortality due to natural (ICD-10:A00-R99), circulatory (ICD-10:I00-I99), and respiratory (ICD-10:J00-J99) causes in the population, both general and aged ≥ 75 years. The following independent and control variables were considered: a) daily mean PM2.5 and PM10 concentrations; b) maximum daily temperature; c) daily mean O3 and NO2 concentrations; d) advection of particulate matter from biomass combustion ( http://www.calima.ws/ ), using a dichotomous variable and e) linear trend and seasonalities. We conducted a descriptive analysis, performed a test of means and, to ascertain relative risk, fitted a model using autoregressive Poisson regression and stratifying by days with and without biomass advection, in both populations. Of the 2192 days analysed, biomass advection occurred on 56, with mean PM2.5 and PM10 values registering a significant increase during these days. PM10 had a greater impact on organic mortality with advection (RRall ages = 1.035 [1.011-1.060]; RR  ≥  75 years = 1.066 [1.031-1.103]) than did PM2.5 without advection (RRall ages = 1.017 [1.009-1.025]; RR  ≥  75 years = 1.012 [1.003-1.022]). Among specific causes, respiratory-though not circulatory-causes were associated with PM10 on days with advection in ≥ 75 year age group. PM10, rather than PM2.5, were associated with an increase in natural cause mortality on days with advection of particulate matter from biomass combustion, particularly in the ≥ 75 year age group.

THE ASSOCIATION BETWEEN MENSTRUAL CYCLE CHARACTERISTICS AND PERCEIVED BODY IMAGE: A CROSS-SECTIONAL SURVEY OF POLISH FEMALE ADOLESCENTS.

PubMed

Kaczmarek, Maria; Trambacz-Oleszak, Sylwia

2016-05-01

The increasing prevalence of negative body perceptions among adolescent girls and the tendency towards wishing to be thinner have become a cultural norm in Western culture. Adolescent girls are particularly vulnerable to developing a negative body image due to physical and sexual changes occurring during puberty. This study aimed to evaluate the association between different measures of body image perceptions and different phases of the menstrual cycle after controlling for weight status and other potential confounders in Polish adolescent girls aged 12-18 years. Three-hundred and thirty participants of a cross-sectional survey conducted in 2009, normally cycling and with no eating disorders, completed a background questionnaire and the Stunkard Figure Rating Scale, and their anthropometric measurements were collected. The dependent outcome variables were measures of body image (actual body image, ideal body image and ideal-self discrepancy) and dichotomous body image perception (satisfied versus dissatisfied) adjusted for other predictor factors: socio-demographic variables, menstrual history and cycle phases, and weight status. One-way ANOVA indicated that weight status, age at menarche and menstrual cycle phase were associated with actual body image and rate of ideal-self discrepancy. Ideal body image was associated with weight status and menstrual cycle phase. General logistic regression models were constructed to evaluate associations of body dissatisfaction and all potential predictor variables. The final selected model of the multiple logistic regression analysis using the backward elimination procedure revealed that adjusted for other factors, negative body image was significantly associated with different phases of the menstrual cycle (p trend=0.033) and increasing body weight status (p trend=0.0007). The likelihood of body dissatisfaction was greatest during the premenstrual phase of the menstrual cycle (OR=2.38; 95% CI 1.06, 5.32) and among girls in obesity class I (OR=8.04; 95% CI 2.37, 27.26). The study confirmed the association between body image dissatisfaction in adolescent girls and different phases of the menstrual cycle after controlling for weight status. The issue of negative body self-image is not only of cognitive, but also of practical value as understanding better the factors contributing to the formation of a negative body image may be instrumental in developing preventive health programmes targeted at young people.

Quality of life and attitudes towards psychotropics and dependency: consumers vs. non-consumers aged 50 and over.

PubMed

Baumann, M; Bonnetain, F; Briançon, S; Alla, F

2004-10-01

To assess the relationships between socio-demographic factors, quality of life and attitudes towards psychotropic drugs and dependency and to compare those relationships in continuous consumers (CC), occasional consumers (OC) and non-consumers (NC) of those drugs. Quality of life (SF36) and attitudes (14 statements) were measured in 601 subjects (45-60 years old) from the SUVIMAX cohort (SUpplementation en VItamines et en sels Mineraux AntioXydants). Data were obtained on 334 NC, 142 CC, 125 OC from the inclusion questionnaire and the monthly consumption report notebooks kept by subjects between 1994 and 1998. Dichotomous and polychotomous logistic regressions were used for the analysis. The lower the quality of life score the more frequent was consumption. NC tended to be men, with high quality of life scores. They entertained negative attitudes towards psychotropics and dependency. OC tended to be women reporting a chronic pathology, with fairly high social status. They had intermediate quality of life and denied dependency. CC tended to be men with no professional activity and low quality of life scores in particular for mental health and perceived health. They had positive attitudes towards psychotropics and accept dependency. Assessment of patients' quality of life and understanding of their attitudes towards psychotropics can provide essential information for those in charge of health promotion programmes and may help in identifying new intervention strategies. Preventive education and follow-up of therapy may be better suited to the needs of patients.

Surfacers change their dive tactics depending on the aim of the dive: evidence from simultaneous measurements of breaths and energy expenditure.

PubMed

Okuyama, Junichi; Tabata, Runa; Nakajima, Kana; Arai, Nobuaki; Kobayashi, Masato; Kagawa, Shiro

2014-11-22

Air-breathing divers are assumed to have evolved to apportion their time between surface and underwater periods to maximize the benefit gained from diving activities. However, whether they change their time allocation depending on the aim of the dive is still unknown. This may be particularly crucial for 'surfacers' because they dive for various purposes in addition to foraging. In this study, we counted breath events at the surface and estimated oxygen consumption during resting, foraging and other dives in 11 green turtles (Chelonia mydas) in the wild. Breath events were counted by a head-mounted acceleration logger or direct observation based on an animal-borne video logger, and oxygen consumption was estimated by measuring overall dynamic body acceleration. Our results indicate that green turtles maximized their submerged time, following this with five to seven breaths to replenish oxygen for resting dives. However, they changed their dive tactic during foraging and other dives; they surfaced without depleting their estimated stores of oxygen, followed by only a few breaths for effective foraging and locomotion. These dichotomous surfacing tactics would be the result of behavioural modifications by turtles depending on the aim of each dive. © 2014 The Author(s) Published by the Royal Society. All rights reserved.

Surfacers change their dive tactics depending on the aim of the dive: evidence from simultaneous measurements of breaths and energy expenditure

PubMed Central

Okuyama, Junichi; Tabata, Runa; Nakajima, Kana; Arai, Nobuaki; Kobayashi, Masato; Kagawa, Shiro

2014-01-01

Air-breathing divers are assumed to have evolved to apportion their time between surface and underwater periods to maximize the benefit gained from diving activities. However, whether they change their time allocation depending on the aim of the dive is still unknown. This may be particularly crucial for ‘surfacers’ because they dive for various purposes in addition to foraging. In this study, we counted breath events at the surface and estimated oxygen consumption during resting, foraging and other dives in 11 green turtles (Chelonia mydas) in the wild. Breath events were counted by a head-mounted acceleration logger or direct observation based on an animal-borne video logger, and oxygen consumption was estimated by measuring overall dynamic body acceleration. Our results indicate that green turtles maximized their submerged time, following this with five to seven breaths to replenish oxygen for resting dives. However, they changed their dive tactic during foraging and other dives; they surfaced without depleting their estimated stores of oxygen, followed by only a few breaths for effective foraging and locomotion. These dichotomous surfacing tactics would be the result of behavioural modifications by turtles depending on the aim of each dive. PMID:25297856

The Transcriptomic Signature of RacA Activation and Inactivation Provides New Insights into the Morphogenetic Network of Aspergillus niger

PubMed Central

Kwon, Min Jin; Nitsche, Benjamin M.; Arentshorst, Mark; Jørgensen, Thomas R.; Ram, Arthur F. J.; Meyer, Vera

2013-01-01

RacA is the main Rho GTPase in Aspergillus niger regulating polarity maintenance via controlling actin dynamics. Both deletion and dominant activation of RacA (RacG18V) provoke an actin localization defect and thereby loss of polarized tip extension, resulting in frequent dichotomous branching in the ΔracA strain and an apolar growing phenotype for RacG18V. In the current study the transcriptomics and physiological consequences of these morphological changes were investigated and compared with the data of the morphogenetic network model for the dichotomous branching mutant ramosa-1. This integrated approach revealed that polar tip growth is most likely orchestrated by the concerted activities of phospholipid signaling, sphingolipid signaling, TORC2 signaling, calcium signaling and CWI signaling pathways. The transcriptomic signatures and the reconstructed network model for all three morphology mutants (ΔracA, RacG18V, ramosa-1) imply that these pathways become integrated to bring about different physiological adaptations including changes in sterol, zinc and amino acid metabolism and changes in ion transport and protein trafficking. Finally, the fate of exocytotic (SncA) and endocytotic (AbpA, SlaB) markers in the dichotomous branching mutant ΔracA was followed, demonstrating that hyperbranching does not per se result in increased protein secretion. PMID:23894378

Morphological Examination and Phylogenetic Analyses of Phycopeltis spp. (Trentepohliales, Ulvophyceae) from Tropical China

PubMed Central

Zhu, Huan; Zhao, Zhijuan; Xia, Shuang; Hu, Zhengyu; Liu, Guoxiang

2015-01-01

During an investigation of Trentepohliales (Ulvophyceae) from tropical areas in China, four species of the genus Phycopeltis were identified: Phycopeltis aurea, P. epiphyton, P. flabellata and P. prostrata. The morphological characteristics of both young and adult thalli were observed and compared. Three species (P. flabellata, P. aurea and P. epiphyton) shared a symmetrical development with dichotomously branching vegetative cells during early stages; conversely, P. prostrata had dishevelled filaments with no dichotomously branching filaments and no symmetrical development. The adult thalli of the former three species shared common morphological characteristics, such as equally dichotomous filaments, absence of erect hair and gametangia formed in prostate vegetative filaments. Phylogenetic analyses based on SSU and ITS rDNA sequences showed that the three morphologically similar species were in a clade that was sister to a clade containing T. umbrina and T. abietina, thus confirming morphological monophyly. Conversely, Phycopeltis prostrata, a species with erect filaments, sessile gametangia on the basal erect hair, larger length/width ratio of vegetative cells and very loosely coalescent prostrate filaments, branched separately from the core Phycopeltis group and the T. umbrina and T. abietina clade. Based on morphological and molecular evidence, the genus Phycopeltis was paraphyletic. Furthermore, the traditional taxonomic criteria for Phycopeltis must be reassessed based on phylogeny using more species. A new circumscription of the Phycopeltis and the erection of new genera are recommended. PMID:25643363

A phylogenetic approach to total evaporative water loss in mammals.

PubMed

Van Sant, Matthew J; Oufiero, Christopher E; Muñoz-Garcia, Agustí; Hammond, Kimberly A; Williams, Joseph B

2012-01-01

Maintaining appropriate water balance is a constant challenge for terrestrial mammals, and this problem can be exacerbated in desiccating environments. It has been proposed that natural selection has provided desert-dwelling mammals physiological mechanisms to reduce rates of total evaporative water loss. In this study, we evaluated the relationship between total evaporative water loss and body mass in mammals by using a recent phylogenetic hypothesis. We compared total evaporative water loss in 80 species of arid-zone mammals to that in 56 species that inhabit mesic regions, ranging in size from 4 g to 3,500 kg, to test the hypothesis that mammals from arid environments have lower rates of total evaporative water loss than mammals from mesic environments once phylogeny is taken into account. We found that arid species had lower rates of total evaporative water loss than mesic species when using a dichotomous variable to describe habitat (arid or mesic). We also found that total evaporative water loss was negatively correlated with the average maximum and minimum environmental temperature as well as the maximum vapor pressure deficit of the environment. Annual precipitation and the variable Q (a measure of habitat aridity) were positively correlated with total evaporative water loss. These results support the hypothesis that desert-dwelling mammals have lower rates of total evaporative water loss than mesic species after controlling for body mass and evolutionary relatedness regardless of whether categorical or continuous variables are used to describe habitat.

Risk score for identifying adults with CSF pleocytosis and negative CSF Gram stain at low risk for an urgent treatable cause.

PubMed

Hasbun, Rodrigo; Bijlsma, Merijn; Brouwer, Matthijs C; Khoury, Nabil; Hadi, Christiane M; van der Ende, Arie; Wootton, Susan H; Salazar, Lucrecia; Hossain, Md Monir; Beilke, Mark; van de Beek, Diederik

2013-08-01

We aimed to derive and validate a risk score that identifies adults with cerebrospinal fluid (CSF) pleocytosis and a negative CSF Gram stain at low risk for an urgent treatable cause. Patients with CSF pleocytosis and a negative CSF Gram stain were stratified into a prospective derivation (n = 193) and a retrospective validation (n = 567) cohort. Clinically related baseline characteristics were grouped into three composite variables, each independently associated with a set of predefined urgent treatable causes. We subsequently derived a risk score classifying patients into low (0 composite variables present) or high (≥ 1 composite variables present) risk for an urgent treatable cause. The sensitivity of the risk score was determined in the validation cohort and in a prospective case series of 214 adults with CSF-culture proven bacterial meningitis, CSF pleocytosis and a negative Gram stain. A total of 41 of 193 patients (21%) in the derivation cohort and 71 of 567 (13%) in the validation cohort had an urgent treatable cause. Sensitivity of the dichotomized risk score to detect an urgent treatable cause was 100.0% (95% CI 93.9-100.0%) in the validation cohort and 100.0% (95% CI 97.8-100.0%) in bacterial meningitis patients. The risk score can be used to identify adults with CSF pleocytosis and a negative CSF Gram stain at low risk for an urgent treatable cause. Copyright © 2013 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

Willingness to volunteer during an influenza pandemic: perspectives from students and staff at a large Canadian university.

PubMed

Rosychuk, Rhonda J; Bailey, Tracey; Haines, Christina; Lake, Robert; Herman, Benjamin; Yonge, Olive; Marrie, Thomas J

2008-03-01

A future influenza pandemic will require greater demand on numerous essential services and a reduced capacity to meet that demand. Recruitment of volunteers is an important issue for pre-pandemic planning. To identify factors and attitudes towards volunteerism in the event of a pandemic of influenza. A 42-item web-questionnaire was administered to all faculty, staff and students at the University of Alberta. Respondents indicated their willingness to volunteer. Responses were dichotomized and logistic regression models were developed to capture the association between willingness to volunteer and (i) demographic and information source variables, (ii) risk perception and general knowledge, and (iii) volunteering attitudes and priority access variables. Many factors predicted willingness to volunteer and several involved interactions with other variables. Individuals who were older, relied on University Health Centre information and who had past volunteerism experience were generally more likely to be willing to volunteer. Those willing to volunteer were more likely to think spread could be prevented by covering mouth when coughing/sneezing, and treatment would include drinking fluids. Those who thought influenza would be treated by antibiotics were less willing to volunteer. Likely volunteers thought that healthcare students should be encouraged to volunteer if there was a healthcare worker shortage. This study provides guidance for those who are preparing universities to deal with pandemic influenza. The results suggest factors that might be important in the recruitment of volunteers during an influenza pandemic and these factors might be relevant for other sectors as well.

Occupation-related psychological distress among police constables of Udupi taluk, Karnataka: A cross-sectional study.

PubMed

Parsekar, Shradha Sadanand; Singh, Mannat Mohanjeet; Bhumika, T V

2015-01-01

Police occupational stress is an extensive issue due to number of negative consequences on an individual as well as the police department which is often neglected. This study is the first of its kind in Udupi district. The present study intended to find out the prevalence of psychological distress among police constable, assess stressors, and the factors influencing it. A cross-sectional study was conducted among police constables in police stations of Udupi taluk. A total of 76 constables participated in the study, who were taken up from seven randomly selected police stations. General health questionnaire and organizational and operational police stress questionnaire were used to assess psychological distress and stressors, respectively. Data were analyzed using SPSS version 15. Results were tabulated using frequency distribution and proportions for dichotomous variables and mean with a standard deviation for continuous variables. Chi-square test was performed to find the association between psychological distress and other variables. One-fourth (95% confidence interval: 0.153, 0.347) of the participants reported as having high levels of psychological distress. Years of service and 28 stressful activities were significantly associated with psychological distress. Psychological distress among the police constables is of concern; hence some modifications such as sharing work, fixed duty hours, etc., should be done in the police department in order to avoid stress and its adverse effects. Stress management training can be given at regular intervals to improve competitiveness and enhance coping skills.

["Who profits?" - patient characteristics as outcome predictors in psychosomatic rehabilitation].

PubMed

Oster, J; Müller, G; Wietersheim, J von

2009-04-01

The study was to examine how far treatment success in psychosomatic rehabilitation can be predicted from patients' characteristics. The aim of this study included the development of outcome criteria, the analysis of bivariate correlations, as well as development and examination of multivariate models. The motivation for dealing with job-related problems was evaluated separately. Data were available from admission, discharge and three-months follow-up. The data of 463 patients were included. Generated were success criteria concerning sociomedical development, health as well as the ability to work. All success criteria were dichotomized. In the criteria defined, successful outcomes were found in 40 to 60% of the patients. In the bivariate analyses, it was shown that many sick days before rehabilitation, applications for pension, severe disability, high impairment, and suggestion for rehabilitation by the insurance agency, have basically negative effects on success. Correlations with the variables concerning motivation for dealing with job-related problems were rather weak. In multivariate model development, models of different quality were found. For prediction of working ability at discharge, there was an explained variance of nearly 60%. In the other success criteria as well, explained variance amounted to over 20%. The models consist of different constellations of variables, the number of sick days before rehabilitation, variables of application for pension and severity of the impairment frequently included. In case of a current sick leave, rehabilitation should be started early, sociomedical problems have to be dealt with explicitly, and rehabilitation should be accompanied by preparatory and aftercare measures.

Tooth loss in middle-aged adults with diabetes and hypertension: Social determinants, health perceptions, oral impact on daily performance (OIDP) and treatment need

PubMed Central

Maia, Fabiana-Barros-Marinho; Sampaio, Fábio-Correia; Freitas, Cláudia-Helena-Soares-de Morais; Forte, Franklin-Delano-Soares

2018-01-01

Background This study aimed to explore the association between tooth loss and social determinants, health self-perceptions, OIDP and self-concept of dental treatment need in middle-aged adults with diabetes and hypertension. Material and Methods A cross-sectional study was developed with 212 hypertensive and diabetic middle-aged adults (50-65 years). Data were collected from clinical examinations (DMFT) and a questionnaire regarding socioeconomic status, dental health assistance, self-perceptions of oral and general health, OIDP, and the self-concept of dental treatment need. Tooth loss was dichotomized considering the cutoff point of 12 (Model I) or 24 missing teeth (Model II). Data were analyzed using Chi-square, Fisher’s exact test and logistic regression (p≤0.05). Results Tooth loss was significantly associated with variables such as last dental visit, reason for dental visit, OIDP, perception of dental treatment need, and general self-perception (Model I). Schooling, last dental visit, oral health self-perception and perception of dental treatment need were significantly associated with tooth loss in the Model II. When Model 1 and 2 were adjusted, they demonstrated that last dental visit and perception of dental treatment need were predictor variables. Conclusions The annual dental visit and the self-concept of dental treatment need were associated with tooth loss, demonstrating that these variables reduce the tooth loss prevalence. Key words:Access /barriers to care, Dental treatment, Geriatric dentistry. PMID:29476679

Variables involved in the perception of psychological harassment in the nursing work environment.

PubMed

Fontes, Kátia Biagio; Carvalho, Maria Dalva de Barros

2012-01-01

This is a descriptive-exploratory study with a quantitative approach, with the objective of identifying how nurses perceive psychological harassment at work, the behaviors experienced and the variables involved. In collecting data, two questionnaires were used: one socio-professional and another for identifying the behaviors involving psychological harassment experienced by the subjects in the previous twelve months, along with the duration and frequency of the behaviors. At the end of the questionnaire, a dichotomous question was added, which addressed nurses' perceptions in relation to feeling victimized by psychological harassment at work. Both the questionnaires were applied in electronic and print format between May and September 2010. The data was analyzed through descriptive statistics. The results showed that some of the subjects felt that they were victims of psychological harassment. Only the variables related to characterization of the psychological harassment presented significant association. The following were highlighted among the most-referred-to behaviors: "They question your decisions" and "You receive verbal attacks criticizing work you have done". It's important to open spaces for discussing violence at work, so that managers may establish strategic measures for preventing and containing this type of violence, so as to ensure health, dignity and well-being at work. It is also important to discuss this issue in the academic space, so as to give the theme greater visibility, such that future nurses will be able to identify and appropriately confront this type of violence.

RISK SCORE FOR IDENTIFYING ADULTS WITH CSF PLEOCYTOSIS AND NEGATIVE CSF GRAM STAIN AT LOW RISK FOR AN URGENT TREATABLE CAUSE

PubMed Central

Hasbun, Rodrigo; Bijlsma, Merijn; Brouwer, Matthijs C; Khoury, Nabil; Hadi, Christiane M; van der Ende, Arie; Wootton, Susan H.; Salazar, Lucrecia; Hossain, Md Monir; Beilke, Mark; van de Beek, Diederik

2013-01-01

Background We aimed to derive and validate a risk score that identifies adults with cerebrospinal fluid (CSF) pleocytosis and a negative CSF Gram stain at low risk for an urgent treatable cause. Methods Patients with CSF pleocytosis and a negative CSF Gram stain were stratified into a prospective derivation (n=193) and a retrospective validation (n=567) cohort. Clinically related baseline characteristics were grouped into three composite variables, each independently associated with a set of predefined urgent treatable causes. We subsequently derived a risk score classifying patients into low (0 composite variables present) or high ( ≥ 1 composite variables present) risk for an urgent treatable cause. The sensitivity of the risk score was determined in the validation cohort and in a prospective case series of 214 adults with CSF-culture proven bacterial meningitis, CSF pleocytosis and a negative Gram stain. Findings A total of 41 of 193 patients (21%) in the derivation cohort and 71 of 567 (13%) in the validation cohort had an urgent treatable cause. Sensitivity of the dichotomized risk score to detect an urgent treatable cause was 100.0% (95%CI 93.9-100.0%) in the validation cohort and 100.0% (95%CI 97.8-100.0%) in bacterial meningitis patients. Interpretation The risk score can be used to identify adults with CSF pleocytosis and a negative CSF Gram stain at low risk for an urgent treatable cause. PMID:23619080

Vertically transmitted fecal IgA levels distinguish extra-chromosomal phenotypic variation

PubMed Central

Wallace, Meghan A.; D, Carey-Ann; Burnham; Virgin, Herbert W.; Stappenbeck, Thaddeus S.

2014-01-01

Summary The proliferation of genetically modified mouse models has exposed phenotypic variation between investigators and institutions that has been challenging to control1-5. In many cases, the microbiota is the presumed culprit of the variation. Current solutions to account for phenotypic variability include littermate and maternal controls or defined microbial consortia in gnotobiotic mice6,7. In conventionally raised mice, the microbiome is transmitted from the dam2,8,9. Here we show that microbially–driven dichotomous fecal IgA levels in WT mice within the same facility mimic the effects of chromosomal mutations. We observed in multiple facilities that vertically-transmissible bacteria in IgA-Low mice dominantly lowered fecal IgA levels in IgA-High mice after cohousing or fecal transplantation. In response to injury, IgA-Low mice showed increased damage that was transferable by fecal transplantation and driven by fecal IgA differences. We found that bacteria from IgA-Low mice degraded the secretory component (SC) of SIgA as well as IgA itself. These data indicate that phenotypic comparisons between mice must take into account the non-chromosomal hereditary variation between different breeders. We propose fecal IgA as one marker of microbial variability and conclude that cohousing and/or fecal transplantation enables analysis of progeny from different dams. PMID:25686606

Dental postoperative bleeding complications in patients with suspected and documented liver disease.

PubMed

Hong, C H; Scobey, M W; Napenas, J J; Brennan, M T; Lockhart, P B

2012-10-01

The aims of this study were to determine the frequency of bleeding complications following dental procedures in patients with known or suspected chronic liver disease and whether international normalized ratio (INR) determination could aid in predicting bleeding complications in these patients. We identified 90 patients (mean age: 51 ± 9 years) in this retrospective chart review. Sixty-nine patients had a known history of chronic liver disease and 21 had suspected chronic liver disease. Descriptive statistics were determined. Independent sample t-test and one-way variance test were utilized for continuous variables and chi-square test for dichotomous variables. The mean INR value for all patients was 1.2 ± 0.3. The INR value was significantly associated with the diagnosis of liver cirrhosis, the diagnoses of Hepatitis B and C together, the presence of ascites alone, and the number of clinical signs and symptoms (i.e. ascites, jaundice and encephalopathy) present. Nine patients with INR values between 1.5 and 2 underwent invasive dental procedures without postoperative bleeding complications. There were no episodes of postoperative bleeding in patients. The findings suggest that clinicians should not rely solely on an INR value to predict post-procedure bleeding in patients with liver disease. © 2012 John Wiley & Sons A/S.

Patellar denervation with electrocautery in total knee arthroplasty without patellar resurfacing: a meta-analysis.

PubMed

Cheng, Tao; Zhu, Chen; Guo, Yongyuan; Shi, Sifeng; Chen, Desheng; Zhang, Xianlong

2014-11-01

The impact of patellar denervation with electrocautery in total knee arthroplasty (TKA) on post-operative outcomes has been under debate. This study aims to conduct a meta-analysis and systematic review to compare the benefits and risks of circumpatellar electrocautery with those of non-electrocautery in primary TKAs. Comparative and randomized clinical studies were identified by conducting an electronic search of articles dated up to September 2012 in PubMed, EMBASE, Scopus, and the Cochrane databases. Six studies that focus on a total of 849 knees were analysed. A random-effects model was conducted using the inverse-variance method for continuous variables and the Mantel-Haenszel method for dichotomous variables. There was no significant difference in the incidence of anterior knee pain between the electrocautery and non-electrocautery groups. In term of patellar score and Knee Society Score, circumpatellar electrocautery improved clinical outcomes compared with non-electrocautery in TKAs. The statistical differences were in favour of the electrocautery group but have minimal clinical significance. In addition, the overall complications indicate no statistical significance between the two groups. This study shows no strong evidence either for or against electrocautery compared with non-electrocautery in TKAs. Therapeutic study (systematic review and meta-analysis), Level III.

Development and reliability testing of a food store observation form.

PubMed

Rimkus, Leah; Powell, Lisa M; Zenk, Shannon N; Han, Euna; Ohri-Vachaspati, Punam; Pugach, Oksana; Barker, Dianne C; Resnick, Elissa A; Quinn, Christopher M; Myllyluoma, Jaana; Chaloupka, Frank J

2013-01-01

To develop a reliable food store observational data collection instrument to be used for measuring product availability, pricing, and promotion. Observational data collection. A total of 120 food stores (26 supermarkets, 34 grocery stores, 54 gas/convenience stores, and 6 mass merchandise stores) in the Chicago metropolitan statistical area. Inter-rater reliability for product availability, pricing, and promotion measures on a food store observational data collection instrument. Cohen's kappa coefficient and proportion of overall agreement for dichotomous variables and intra-class correlation coefficient for continuous variables. Inter-rater reliability, as measured by average kappa coefficient, was 0.84 for food and beverage product availability measures, 0.80 for interior store characteristics, and 0.70 for exterior store characteristics. For continuous measures, average intra-class correlation coefficient was 0.82 for product pricing measures; 0.90 for counts of fresh, frozen, and canned fruit and vegetable options; and 0.85 for counts of advertisements on the store exterior and property. The vast majority of measures demonstrated substantial or almost perfect agreement. Although some items may require revision, results suggest that the instrument may be used to reliably measure the food store environment. Copyright © 2013 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Longitudinal assessment of clinical risk factors for depression in schizophrenia spectrum disorders.

PubMed

Onwuameze, Obiora E; Uga, Aghaegbulam; Paradiso, Sergio

2016-08-01

During initial assessment of individuals with schizophrenia and related disorders (schizophrenia spectrum disorders [SSDs]), clinicians tend to pay greater attention to psychotic symptoms than mood symptoms, including depression. Depression is reported to influence the course of SSDs, but not much is known about the risk factors for depression in SSDs. In the present study, we examined clinical predictors of depression in SSDs. The sample included 71 patients with SSDs followed in a modified Assertive Community Treatment program, the Community Support Network of Springfield, Illinois. The study design was naturalistic, prospective, and longitudinal (mean follow-up = 8.3 years; SD = 7.3). The GENMOD procedure appropriate for repeated measures analysis with dichotomous outcome variables followed longitudinally was computed. Rates of depression ranged from 18% to 41% over the differing assessment periods. Schizophrenia and schizoaffective disorder did not vary by depression rate. Depression independent of SSD diagnosis was associated with greater hospitalization rates. Clinical variables predict- ing depression were auditory hallucinations, delusions, poor insight, and poor judgment. Psychotic symptoms in the course of SSDs are risk factors for depression. As a consequence, the mental status examination of patients with SSDs with active psychosis should include assessment of mood changes. Further research is warranted to determine if treatment of depression among patients with SSDs may reduce their rates of hospitalization.

Are Study and Journal Characteristics Reliable Indicators of "Truth" in Imaging Research?

PubMed

Frank, Robert A; McInnes, Matthew D F; Levine, Deborah; Kressel, Herbert Y; Jesurum, Julia S; Petrcich, William; McGrath, Trevor A; Bossuyt, Patrick M

2018-04-01

Purpose To evaluate whether journal-level variables (impact factor, cited half-life, and Standards for Reporting of Diagnostic Accuracy Studies [STARD] endorsement) and study-level variables (citation rate, timing of publication, and order of publication) are associated with the distance between primary study results and summary estimates from meta-analyses. Materials and Methods MEDLINE was searched for meta-analyses of imaging diagnostic accuracy studies, published from January 2005 to April 2016. Data on journal-level and primary-study variables were extracted for each meta-analysis. Primary studies were dichotomized by variable as first versus subsequent publication, publication before versus after STARD introduction, STARD endorsement, or by median split. The mean absolute deviation of primary study estimates from the corresponding summary estimates for sensitivity and specificity was compared between groups. Means and confidence intervals were obtained by using bootstrap resampling; P values were calculated by using a t test. Results Ninety-eight meta-analyses summarizing 1458 primary studies met the inclusion criteria. There was substantial variability, but no significant differences, in deviations from the summary estimate between paired groups (P > .0041 in all comparisons). The largest difference found was in mean deviation for sensitivity, which was observed for publication timing, where studies published first on a topic demonstrated a mean deviation that was 2.5 percentage points smaller than subsequently published studies (P = .005). For journal-level factors, the greatest difference found (1.8 percentage points; P = .088) was in mean deviation for sensitivity in journals with impact factors above the median compared with those below the median. Conclusion Journal- and study-level variables considered important when evaluating diagnostic accuracy information to guide clinical decisions are not systematically associated with distance from the truth; critical appraisal of individual articles is recommended. © RSNA, 2017 Online supplemental material is available for this article.

The Dichotomous Effect of Chronic Stress on Obesity.

PubMed

Razzoli, Maria; Bartolomucci, Alessandro

2016-07-01

Obesity and metabolic diseases are linked to chronic stress and low socioeconomic status. The mechanistic link between stress and obesity has not been clarified, partly due to the inherent complexity exemplified by the bidirectional effect of stress on eating and body weight. Recent studies focusing on adaptive thermogenesis and brown adipose tissue (BAT) function support a dichotomous relation to explain the impact of stress on obesity: stress promotes obesity in the presence of hyperphagia and unchanged BAT function; stress results in weight loss and/or obesity resistance in the presence of hypophagia, or when hyperphagia is associated with BAT recruitment and enhanced thermogenesis. Mechanistically dissecting the bidirectional effects of stress on metabolic outcomes might open new avenues for innovative pharmacotherapies for the treatment of obesity-associated diseases. Copyright © 2016 Elsevier Ltd. All rights reserved.

The dichotomous effect of chronic stress on obesity

PubMed Central

Razzoli, Maria; Bartolomucci, Alessandro

2016-01-01

Obesity and metabolic diseases are linked to chronic stress and low socio-economic status. The mechanistic link between stress and obesity has not been clarified, partly due to the inherent complexity exemplified by the bidirectional effect of stress on eating and body weight. Recent studies focusing on adaptive-thermogenesis and brown adipose tissue (BAT) function support a dichotomous relationship to explain the impact of stress on obesity: stress promotes obesity in the presence of hyperphagia and unchanged BAT function; stress results in weight-loss/obesity-resistance in the presence of hypophagia, or when hyperphagia is associated with BAT recruitment and enhanced thermogenesis. Mechanistically dissecting the bidirectional effects of stress on metabolic outcomes might open new avenues for innovative pharmacotherapies for the treatment of obesity-associated diseases. PMID:27162125

Problematic Dichotomization of Risk for Intensive Care Unit (ICU)-Acquired Invasive Candidiasis: Results Using a Risk-Predictive Model to Categorize 3 Levels of Risk From a Multicenter Prospective Cohort of Australian ICU Patients.

PubMed

Playford, E Geoffrey; Lipman, Jeffrey; Jones, Michael; Lau, Anna F; Kabir, Masrura; Chen, Sharon C-A; Marriott, Deborah J; Seppelt, Ian; Gottlieb, Thomas; Cheung, Winston; Iredell, Jonathan R; McBryde, Emma S; Sorrell, Tania C

2016-12-01

 Delayed antifungal therapy for invasive candidiasis (IC) contributes to poor outcomes. Predictive risk models may allow targeted antifungal prophylaxis to those at greatest risk.  A prospective cohort study of 6685 consecutive nonneutropenic patients admitted to 7 Australian intensive care units (ICUs) for ≥72 hours was performed. Clinical risk factors for IC occurring prior to and following ICU admission, colonization with Candida species on surveillance cultures from 3 sites assessed twice weekly, and the occurrence of IC ≥72 hours following ICU admission or ≤72 hours following ICU discharge were measured. From these parameters, a risk-predictive model for the development of ICU-acquired IC was then derived.  Ninety-six patients (1.43%) developed ICU-acquired IC. A simple summation risk-predictive model using the 10 independently significant variables associated with IC demonstrated overall moderate accuracy (area under the receiver operating characteristic curve = 0.82). No single threshold score could categorize patients into clinically useful high- and low-risk groups. However, using 2 threshold scores, 3 patient cohorts could be identified: those at high risk (score ≥6, 4.8% of total cohort, positive predictive value [PPV] 11.7%), those at low risk (score ≤2, 43.1% of total cohort, PPV 0.24%), and those at intermediate risk (score 3-5, 52.1% of total cohort, PPV 1.46%).  Dichotomization of ICU patients into high- and low-risk groups for IC risk is problematic. Categorizing patients into high-, intermediate-, and low-risk groups may more efficiently target early antifungal strategies and utilization of newer diagnostic tests. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

SubID, a non-median dichotomization tool for heterogeneous populations, reveals the pan-cancer significance of INPP4B and its regulation by EVI1 in AML.

PubMed

Dzneladze, Irakli; Woolley, John F; Rossell, Carla; Han, Youqi; Rashid, Ayesha; Jain, Michael; Reimand, Jüri; Minden, Mark D; Salmena, Leonardo

2018-01-01

Our previous studies demonstrated that INPP4B, a member of the PI3K/Akt signaling pathway, is overexpressed in a subset of AML patients and is associated with lower response to chemotherapy and shorter survival. INPP4B expression analysis in AML revealed a right skewed frequency distribution with 25% of patients expressing significantly higher levels than the majority. The 75% low/25% high cut-off revealed the prognostic power of INPP4B expression status in AML, which would not have been apparent with a standard median cut-off approach. Our identification of a clinically relevant non-median cut-off for INPP4B indicated a need for a generalizable non-median dichotomization approach to optimally study clinically relevant genes. To address this need, we developed Subgroup Identifier (SubID), a tool which examines the relationship between a continuous variable (e.g. gene expression), and a test parameter (e.g. CoxPH or Fisher's exact P values). In our study, Fisher's exact SubID was used to reveal EVI1 as a transcriptional regulator of INPP4B in AML; a finding which was validated in vitro. Next, we used CoxPH SubID to conduct a pan-cancer analysis of INPP4B's prognostic significance. Our analysis revealed that INPP4Blow is associated with shorter survival in kidney clear cell, liver hepatocellular, and bladder urothelial carcinomas. Conversely, INPP4Blow was shown to be associated with increased survival in pancreatic adenocarcinoma in three independent datasets. Overall, our study describes the development and application of a novel subgroup identification tool used to identify prognostically significant rare subgroups based upon gene expression, and for investigating the association between a gene with skewed frequency distribution and potentially important upstream and downstream genes that relate to the index gene.

SubID, a non-median dichotomization tool for heterogeneous populations, reveals the pan-cancer significance of INPP4B and its regulation by EVI1 in AML

PubMed Central

Han, Youqi; Rashid, Ayesha; Jain, Michael; Reimand, Jüri; Minden, Mark D.; Salmena, Leonardo

2018-01-01

Our previous studies demonstrated that INPP4B, a member of the PI3K/Akt signaling pathway, is overexpressed in a subset of AML patients and is associated with lower response to chemotherapy and shorter survival. INPP4B expression analysis in AML revealed a right skewed frequency distribution with 25% of patients expressing significantly higher levels than the majority. The 75% low/25% high cut-off revealed the prognostic power of INPP4B expression status in AML, which would not have been apparent with a standard median cut-off approach. Our identification of a clinically relevant non-median cut-off for INPP4B indicated a need for a generalizable non-median dichotomization approach to optimally study clinically relevant genes. To address this need, we developed Subgroup Identifier (SubID), a tool which examines the relationship between a continuous variable (e.g. gene expression), and a test parameter (e.g. CoxPH or Fisher’s exact P values). In our study, Fisher’s exact SubID was used to reveal EVI1 as a transcriptional regulator of INPP4B in AML; a finding which was validated in vitro. Next, we used CoxPH SubID to conduct a pan-cancer analysis of INPP4B’s prognostic significance. Our analysis revealed that INPP4Blow is associated with shorter survival in kidney clear cell, liver hepatocellular, and bladder urothelial carcinomas. Conversely, INPP4Blow was shown to be associated with increased survival in pancreatic adenocarcinoma in three independent datasets. Overall, our study describes the development and application of a novel subgroup identification tool used to identify prognostically significant rare subgroups based upon gene expression, and for investigating the association between a gene with skewed frequency distribution and potentially important upstream and downstream genes that relate to the index gene. PMID:29415082

Clinical endpoints in the controlled human challenge model for Shigella: A call for standardization and the development of a disease severity score

PubMed Central

Lynen, Amanda; Riddle, Mark S.; Talaat, Kawsar; Sack, David; Gutiérrez, Ramiro L.; McKenzie, Robin; DeNearing, Barbara; Feijoo, Brittany; Kaminski, Robert W.; Taylor, David N.; Kirkpatrick, Beth D.; Bourgeois, A. Louis

2018-01-01

Background Since 1946 the controlled human infection model (CHIM) for Shigella has been used to improve understanding of disease pathogenesis, describe clinical and immunologic responses to infection and as a tool for vaccine development. As the frequency and intent for use in vaccine comparisons increases, standardization of the primary endpoint definition is necessary. Methods Subject-level data were obtained from previously conducted experimental Shigella CHIM studies. Signs and symptoms severity were categorized consistently across all studies. Sign and symptom correlations were estimated and univariate models were utilized to describe the association between stool output and other Shigella-attributable signs and symptoms. Multiple correspondence and hierarchical clustering analyses were performed to describe the co-occurrence of signs and symptoms. A disease score is proposed based on the co-occurrence of these events. Results Data were obtained on 54 subjects receiving 800 to 2000 colony forming units (cfu) of S. flexneri. The median maximum 24 hour stool output was 514 ml (IQR: 300, 998 ml) with a median frequency of 6 (IQR: 4, 9). Subjects reported abdominal pain or cramps (81.5%), headache (66.7%) and anorexia (64.8%), 50.0% had a fever and 27.8% had gross blood in multiple loose stools. Multiple correspondence analyses highlighted co-occurrence of symptoms based on severity. A 3-parameter disease severity score predicted shigellosis endpoints and better differentiated disease spectrum. Conclusion Dichotomous endpoints for Shigella CHIM fail to fully account for disease variability. An ordinal disease score characterizing the breadth of disease severity may enable a better characterization of shigellosis and can decrease sample size requirements. Furthermore, the disease severity score may be a useful tool for portfolio management by enabling prioritization across vaccine candidates with comparable efficacy estimates using dichotomous endpoints. PMID:29590182

Cannabis Liberalization and Adolescent Cannabis Use: A Cross-National Study in 38 Countries

PubMed Central

Shi, Yuyan; Lenzi, Michela; An, Ruopeng

2015-01-01

Aims To assess the associations between types of cannabis control policies at country level and prevalence of adolescent cannabis use. Setting, Participants and Design Multilevel logistic regressions were performed on 172,894 adolescents 15 year of age who participated in the 2001/2002, 2005/2006, or 2009/2010 cross-sectional Health Behaviour in School-Aged Children (HBSC) survey in 38 European and North American countries. Measures Self-reported cannabis use status was classified into ever use in life time, use in past year, and regular use. Country-level cannabis control policies were categorized into a dichotomous measure (whether or not liberalized) as well as 4 detailed types (full prohibition, depenalization, decriminalization, and partial prohibition). Control variables included individual-level sociodemographic characteristics and country-level economic characteristics. Findings Considerable intra-class correlations (.15-.19) were found at country level. With respect to the dichotomized cannabis control policy, adolescents were more likely to ever use cannabis (odds ratio (OR) = 1.10, p = .001), use in past year (OR = 1.09, p = .007), and use regularly (OR = 1.26, p = .004). Although boys were substantially more likely to use cannabis, the correlation between cannabis liberalization and cannabis use was smaller in boys than in girls. With respect to detailed types of policies, depenalization was associated with higher odds of past-year use (OR = 1.14, p = .013) and regular use (OR = 1.23, p = .038), and partial prohibition was associated with higher odds of regular use (OR = 2.39, p = .016). The correlation between cannabis liberalization and regular use was only significant after the policy had been introduced for more than 5 years. Conclusions Cannabis liberalization with depenalization and partial prohibition policies was associated with higher levels of regular cannabis use among adolescents. The correlations were heterogeneous between genders and between short- and long-terms. PMID:26605550

Can palpation-induced muscle pain pattern contribute to the differential diagnosis among temporomandibular disorders, primary headaches phenotypes and possible bruxism?

PubMed Central

Porporatti, André-Luís; Calderon, Patrícia-dos-Santos; Conti, Paulo-César-Rodrigues; Bonjardim, Leonardo-Rigoldi

2016-01-01

Background The evaluation of possible differences in the distribution or characteristics of palpation-induced pain in the masticatory muscles could be valuable in terms of diagnostic assessment. The aim of this study was to evaluate the impact of different combinations of anterior temporalis (AT) and masseter palpation-induced pain in the diagnostic of temporomandibular disorder (TMD), primary headaches and bruxism. Material and Methods A total of 1200 dental records of orofacial pain adult patients were analyzed. The outcomes were dichotomously classified (presence/absence) as following: a) AT and/or masseter palpation-induced pain; b) myogenous TMD; c) temporomandibular joint (TMJ) arthralgia (arthrogenous TMD); d) migraine; e) tension-type headache (TTH); f) self-reported bruxism. Binomial logistic regression model (α = 5%) was applied to the data considering the palpation-induced muscle pain as the dependent variable. Results Mean age (SD) were 35.7 years (13.4) for 635 included dental records (83% females). Myogenous and arthrogenous TMD, migraine, TTH and bruxism were mainly associated with, respectively, masseter palpation-induced pain (p<0.001 - OR=5.77, 95%CI 3.86-8.62), AT or masseter palpation-induced pain (p<0.001 - OR=2.39, 95%CI 1.57-3.63), bilateral AT palpation-induced pain (p<0.001 - OR=2.67, 95%CI 1.64-4.32), masseter and AT palpation-induced pain (p=0.009 - OR=1.62, 95%CI 1.12-2.33) and bilateral masseter palpation-induced pain (p=0.01 - OR=1.74, 95%CI 1.13-2.69). Conclusions Palpation-induced pain in the masticatory muscles may play a role in the differential diagnosis among painful TMD, primary headaches and bruxism. Key words:Diagnosis, temporomandibular joint disorders, migraine, tension-type headache, bruxism. PMID:26615507

Rab25 acts as an oncogene in luminal B breast cancer and is causally associated with Snail driven EMT

PubMed Central

Mitra, Shreya; Federico, Lorenzo; Zhao, Wei; Dennison, Jennifer; Sarkar, Tapasree Roy; Zhang, Fan; Takiar, Vinita; Cheng, Kwai W.; Mani, Sendurai; Lee, Ju Seog; Mills, Gordon B.

2016-01-01

The Rab GTPases regulate vesicular trafficking machinery that transports and delivers a diverse pool of cargo, including growth factor receptors, integrins, nutrient receptors and junction proteins to specific intracellular sites. The trafficking machinery is indeed a major posttranslational modifier and is critical for cellular homeostasis. Deregulation of this stringently controlled system leads to a wide spectrum of disorders including cancer. Herein we demonstrate that Rab25, a key GTPase, mostly decorating the apical recycling endosome, is a dichotomous variable in breast cancer cell lines with higher mRNA and protein expression in Estrogen Receptor positive (ER+ve) lines. Rab25 and its effector, Rab Coupling Protein (RCP) are frequently coamplified and coordinately elevated in ER+ve breast cancers. In contrast, Rab25 levels are decreased in basal-like and almost completely lost in claudin-low tumors. This dichotomy exists despite the presence of the 1q amplicon that hosts Rab25 across breast cancer subtypes and is likely due to differential methylation of the Rab25 promoter. Functionally, elevated levels of Rab25 drive major hallmarks of cancer including indefinite growth and metastasis but in case of luminal B breast cancer only. Importantly, in such ER+ve tumors, coexpression of Rab25 and its effector, RCP is significantly associated with a markedly worsened clinical outcome. Importantly, in claudin-low cell lines, exogenous Rab25 markedly inhibits cell migration. Similarly, during Snail-induced epithelial to mesenchymal transition (EMT) exogenous Rab25 potently reverses Snail-driven invasion. Overall, this study substantiates a striking context dependent role of Rab25 in breast cancer where Rab25 is amplified and enhances aggressiveness in luminal B cancers while in claudin-low tumors, Rab25 is lost indicating possible anti-tumor functions. PMID:27259233

Can palpation-induced muscle pain pattern contribute to the differential diagnosis among temporomandibular disorders, primary headaches phenotypes and possible bruxism?

PubMed

Costa, Yuri-Martins; Porporatti, André-Luís; Calderon, Patrícia-dos-Santos; Conti, Paulo-César-Rodrigues; Bonjardim, Leonardo-Rigoldi

2016-01-01

The evaluation of possible differences in the distribution or characteristics of palpation-induced pain in the masticatory muscles could be valuable in terms of diagnostic assessment. The aim of this study was to evaluate the impact of different combinations of anterior temporalis (AT) and masseter palpation-induced pain in the diagnostic of temporomandibular disorder (TMD), primary headaches and bruxism. A total of 1200 dental records of orofacial pain adult patients were analyzed. The outcomes were dichotomously classified (presence/absence) as following: a) AT and/or masseter palpation-induced pain; b) myogenous TMD; c) temporomandibular joint (TMJ) arthralgia (arthrogenous TMD); d) migraine; e) tension-type headache (TTH); f) self-reported bruxism. Binomial logistic regression model (α = 5%) was applied to the data considering the palpation-induced muscle pain as the dependent variable. Mean age (SD) were 35.7 years (13.4) for 635 included dental records (83% females). Myogenous and arthrogenous TMD, migraine, TTH and bruxism were mainly associated with, respectively, masseter palpation-induced pain (p<0.001 - OR=5.77, 95%CI 3.86-8.62), AT or masseter palpation-induced pain (p<0.001 - OR=2.39, 95%CI 1.57-3.63), bilateral AT palpation-induced pain (p<0.001 - OR=2.67, 95%CI 1.64-4.32), masseter and AT palpation-induced pain (p=0.009 - OR=1.62, 95%CI 1.12-2.33) and bilateral masseter palpation-induced pain (p=0.01 - OR=1.74, 95%CI 1.13-2.69). Palpation-induced pain in the masticatory muscles may play a role in the differential diagnosis among painful TMD, primary headaches and bruxism.

Imaging Amyloidopathy in Parkinson Disease and Parkinsonian Dementia Syndromes.

PubMed

Frey, Kirk A; Petrou, Myria

2015-02-01

Dementia arising in patients with Parkinson disease or parkinsonian neurodegeneration comprises a heterogeneous neuropathology. Clinical labeling of patients with both dementia and Parkinson disease is dichotomous, depending on the temporal development of cognitive impairment and motor parkinsonism. Patients with dementia arising first (or within the first year of PD) are classified as dementia with Lewy bodies; patients with PD for more than one year before cognitive decline are classified as Parkinson disease with dementia. Despite this differential clinical classification, autopsy studies demonstrate variable admixtures of cortical synuicleinopathy, Aβ-amyloidopathy and tau neurofibrillary tangle deposition. There are no routine clinical diagnostic measures that accurately distinguish the underlying neuropathologies in individual patients. In the present paper, we review the published literature describing characteristics of fibrillary Aβ-amyloid deposition on the basis of PET radiotracer imaging in patients with Parkinson disease and in parkinsonian dementia syndromes. Although individual reports often include only small-to-modest subject numbers, there is overall suggestion that PD patients have a lower incidence of Aβ-amyloid deposition than seen amongst elderly normal subjects, and that Parkinson disease with dementia patients have a lower incidence of Aβ-amyloid deposition than do patients with dementia with Lewy bodies. These apparent features contrast the findings of Aβ-amyloid-PET imaging in normal aging and the development of Alzheimer disease, where Aβ-amyloid deposition arises asymptomatically and apparently many years before development of signs or symptoms of dementia. It is proposed that focused, prospective studies are needed to further address and understand the complex role(s) of Aβ-amyloid pathology in Parkinson disease, and that this understanding will be critical to the development of targeted disease-modifying therapy for dementia in PD.

Physical Examination-Indicated Cerclage: A Systematic Review and Meta-analysis.

PubMed

Ehsanipoor, Robert M; Seligman, Neil S; Saccone, Gabriele; Szymanski, Linda M; Wissinger, Christina; Werner, Erika F; Berghella, Vincenzo

2015-07-01

To estimate the effectiveness of physical examination-indicated cerclage in the setting of second-trimester cervical dilatation by systematic review and meta-analysis of published studies. We searched MEDLINE, EMBASE, Scopus, ClinicalTrials.gov, Web of Science, and the Cochrane Library for studies published between 1966 and 2014 that evaluated cervical cerclage for the treatment of cervical insufficiency. The search yielded 6,314 citations. We included cohort studies and randomized controlled trials comparing cerclage placement with expectant management of women with cervical dilatation between 14 and 27 weeks of gestation. Two investigators independently reviewed each citation for inclusion or exclusion and discordant decisions were arbitrated by a third reviewer. Summary estimates were reported as the mean difference and 95% confidence interval (CI) for continuous variables or relative risk and with 95% CI for dichotomous outcomes. Fixed- and random-effects meta-analysis was used, depending on heterogeneity. Ten studies met inclusion criteria and were included in the final analysis. One was a randomized controlled trial, two were prospective cohort studies, and the remaining seven were retrospective cohort studies. Of the 757 women, 485 (64%) underwent physical examination-indicated cerclage placement and 272 (36%) were expectantly managed. Cerclage was associated with increased neonatal survival (71% compared with 43%; relative risk 1.65, 95% CI 1.19-2.28) and prolongation of pregnancy (mean difference 33.98 days, 95% CI 17.88-50.08). Physical examination-indicated cerclage is associated with a significant increase in neonatal survival and prolongation of pregnancy of approximately 1 month when compared with no such cerclage. The strength of this conclusion is limited by the potential for bias in the included studies.

Comparing 2 methods of assessing 30-day readmissions: what is the impact on hospital profiling in the veterans health administration?

PubMed

Mull, Hillary J; Chen, Qi; O'Brien, William J; Shwartz, Michael; Borzecki, Ann M; Hanchate, Amresh; Rosen, Amy K

2013-07-01

The Centers for Medicare and Medicaid Services' (CMS) all-cause readmission measure and the 3M Health Information System Division Potentially Preventable Readmissions (PPR) measure are both used for public reporting. These 2 methods have not been directly compared in terms of how they identify high-performing and low-performing hospitals. To examine how consistently the CMS and PPR methods identify performance outliers, and explore how the PPR preventability component impacts hospital readmission rates, public reporting on CMS' Hospital Compare website, and pay-for-performance under CMS' Hospital Readmission Reduction Program for 3 conditions (acute myocardial infarction, heart failure, and pneumonia). We applied the CMS all-cause model and the PPR software to VA administrative data to calculate 30-day observed FY08-10 VA hospital readmission rates and hospital profiles. We then tested the effect of preventability on hospital readmission rates and outlier identification for reporting and pay-for-performance by replacing the dependent variable in the CMS all-cause model (Yes/No readmission) with the dichotomous PPR outcome (Yes/No preventable readmission). The CMS and PPR methods had moderate correlations in readmission rates for each condition. After controlling for all methodological differences but preventability, correlations increased to >90%. The assessment of preventability yielded different outlier results for public reporting in 7% of hospitals; for 30% of hospitals there would be an impact on Hospital Readmission Reduction Program reimbursement rates. Despite uncertainty over which readmission measure is superior in evaluating hospital performance, we confirmed that there are differences in CMS-generated and PPR-generated hospital profiles for reporting and pay-for-performance, because of methodological differences and the PPR's preventability component.

Physical activity in Black breast cancer survivors: implications for quality of life and mood at baseline and 6-month follow-up.

PubMed

Diggins, Allyson D; Hearn, Lauren E; Lechner, Suzanne C; Annane, Debra; Antoni, Michael H; Whitehead, Nicole Ennis

2017-06-01

The present study sought to examine the influence of physical activity on quality of life and negative mood in a sample of Black breast cancer survivors to determine if physical activity (dichotomized) predicted mean differences in negative mood and quality of life in this population. Study participants include 114 women diagnosed with breast cancer (any stage of disease, any type of breast cancer) recruited to participate in an adaptive cognitive-behavioral stress management intervention. The mean body mass index of the sample at baseline was 31.39 (standard deviation = 7.17). A multivariate analysis of covariance (MANCOVA) was conducted to determine if baseline physical activity predicted mean differences in negative mood and quality of life at baseline and at follow ups while controlling for relevant covariates. A one-way MANCOVA revealed a significant multivariate effect by physical activity group for the combined dependent variables at Time 2 (post 10-week intervention), p = .039. The second one-way MANCOVA revealed a significant multivariate effect at Time 3 (6 months after Time 2), p = .034. Specifically, Black breast cancer survivors who engaged in physical activity experienced significantly lower negative mood and higher social/family well-being at Time 2 and higher spiritual and functional well-being at Times 2 and 3. Results show that baseline physical activity served protective functions for breast cancer survivors over time. Developing culturally relevant physical activity interventions specifically for Black breast cancer survivors may prove vital to improving quality of life and mood in this population. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Rab25 acts as an oncogene in luminal B breast cancer and is causally associated with Snail driven EMT.

PubMed

Mitra, Shreya; Federico, Lorenzo; Zhao, Wei; Dennison, Jennifer; Sarkar, Tapasree Roy; Zhang, Fan; Takiar, Vinita; Cheng, Kwai W; Mani, Sendurai; Lee, Ju Seog; Mills, Gordon B

2016-06-28

The Rab GTPases regulate vesicular trafficking machinery that transports and delivers a diverse pool of cargo, including growth factor receptors, integrins, nutrient receptors and junction proteins to specific intracellular sites. The trafficking machinery is indeed a major posttranslational modifier and is critical for cellular homeostasis. Deregulation of this stringently controlled system leads to a wide spectrum of disorders including cancer. Herein we demonstrate that Rab25, a key GTPase, mostly decorating the apical recycling endosome, is a dichotomous variable in breast cancer cell lines with higher mRNA and protein expression in Estrogen Receptor positive (ER+ve) lines. Rab25 and its effector, Rab Coupling Protein (RCP) are frequently coamplified and coordinately elevated in ER+ve breast cancers. In contrast, Rab25 levels are decreased in basal-like and almost completely lost in claudin-low tumors. This dichotomy exists despite the presence of the 1q amplicon that hosts Rab25 across breast cancer subtypes and is likely due to differential methylation of the Rab25 promoter. Functionally, elevated levels of Rab25 drive major hallmarks of cancer including indefinite growth and metastasis but in case of luminal B breast cancer only. Importantly, in such ER+ve tumors, coexpression of Rab25 and its effector, RCP is significantly associated with a markedly worsened clinical outcome. Importantly, in claudin-low cell lines, exogenous Rab25 markedly inhibits cell migration. Similarly, during Snail-induced epithelial to mesenchymal transition (EMT) exogenous Rab25 potently reverses Snail-driven invasion. Overall, this study substantiates a striking context dependent role of Rab25 in breast cancer where Rab25 is amplified and enhances aggressiveness in luminal B cancers while in claudin-low tumors, Rab25 is lost indicating possible anti-tumor functions.

Nuance and behavioral cogency: How the Visible Burrow System inspired the Stress-Alternatives Model and conceptualization of the continuum of anxiety.

PubMed

Robertson, James M; Prince, Melissa A; Achua, Justin K; Carpenter, Russ E; Arendt, David H; Smith, Justin P; Summers, Torrie L; Summers, Tangi R; Summers, Cliff H

2015-07-01

By creating the Visible Burrow System (VBS) Bob Blanchard found a way to study the interaction of genetics, physiology, environment, and adaptive significance in a model with broad validity. The VBS changed the way we think about anxiety and affective disorders by allowing the mechanisms which control them to be observed in a dynamic setting. Critically, Blanchard used the VBS and other models to show how behavioral systems like defense are dependent upon context and behavioral elements unique to the individual. Inspired by the VBS, we developed a Stress Alternatives Model (SAM) to further explore the multifaceted dynamics of the stress response with a dichotomous choice condition. Like the VBS, the SAM is a naturalistic model built upon risk assessment and defensive behavior, but with a choice of response: escape or submission to a large conspecific aggressor. The anxiety of novelty during the first escape must be weighed against fear of the aggressor, and a decision must be made. Both outcomes are adaptively significant, evidenced by a 50/50 split in outcome across several study systems. By manipulating the variables of the SAM, we show that a gradient of anxiety exists that spans the contextual settings of escaping an open field, escaping from aggression, and submitting to aggression. These findings correspond with increasing levels of corticosterone and increasing levels of NPS and BDNF in the central amygdala as the context changes.Whereas some anxiolytics were able to reduce the latency to escape for some animals, only with the potent anxiolytic drug antalarmin (CRF1R-blocker) and the anxiogenic drug yohimbine (α2 antagonist) were we able to reverse the outcome for a substantial proportion of individuals. Our findings promote a novel method for modeling anxiety, offering a distinction between low-and-high levels, and accounting for individual variability. The translational value of the VBS is immeasurable, and it guided us and many other researchers to seek potential clinical solutions through a deeper understanding of regional neurochemistry and gene expression in concert with an ecological behavioral model.

A Critical Meta-Analysis of Lens Model Studies in Human Judgment and Decision-Making

PubMed Central

Kaufmann, Esther; Reips, Ulf-Dietrich; Wittmann, Werner W.

2013-01-01

Achieving accurate judgment (‘judgmental achievement’) is of utmost importance in daily life across multiple domains. The lens model and the lens model equation provide useful frameworks for modeling components of judgmental achievement and for creating tools to help decision makers (e.g., physicians, teachers) reach better judgments (e.g., a correct diagnosis, an accurate estimation of intelligence). Previous meta-analyses of judgment and decision-making studies have attempted to evaluate overall judgmental achievement and have provided the basis for evaluating the success of bootstrapping (i.e., replacing judges by linear models that guide decision making). However, previous meta-analyses have failed to appropriately correct for a number of study design artifacts (e.g., measurement error, dichotomization), which may have potentially biased estimations (e.g., of the variability between studies) and led to erroneous interpretations (e.g., with regards to moderator variables). In the current study we therefore conduct the first psychometric meta-analysis of judgmental achievement studies that corrects for a number of study design artifacts. We identified 31 lens model studies (N = 1,151, k = 49) that met our inclusion criteria. We evaluated overall judgmental achievement as well as whether judgmental achievement depended on decision domain (e.g., medicine, education) and/or the level of expertise (expert vs. novice). We also evaluated whether using corrected estimates affected conclusions with regards to the success of bootstrapping with psychometrically-corrected models. Further, we introduce a new psychometric trim-and-fill method to estimate the effect sizes of potentially missing studies correct psychometric meta-analyses for effects of publication bias. Comparison of the results of the psychometric meta-analysis with the results of a traditional meta-analysis (which only corrected for sampling error) indicated that artifact correction leads to a) an increase in values of the lens model components, b) reduced heterogeneity between studies, and c) increases the success of bootstrapping. We argue that psychometric meta-analysis is useful for accurately evaluating human judgment and show the success of bootstrapping. PMID:24391781

Better functional mobility in community-dwelling elderly is related to D-hormone serum levels and to daily calcium intake.

PubMed

Dukas, L; Staehelin, H B; Schacht, E; Bischoff, H A

2005-01-01

The influence of calcitropic hormones on functional mobility has been studied in vitamin D (calcidiol) deficient elderly or elderly with a history of falls, however, data in community-dwelling independent vitamin D replete elderly are missing. We therefore assessed in an observational survey the association of calcidiol (25(OH)D3) and calcitriol (D-hormone / 1,25(OH)2D3) status as well as of daily calcium intake on functional mobility in older subjects We evaluated 192 women and 188 men, aged superior 70 years and living independently. Average Timed-up and go test (TUG-test) in seconds was taken as measure of functional mobility. Calcidiol and D-hormone serum concentrations and daily calcium intake were studied in multivariate controlled linear regression models with TUG-test performance as the dependent variable and/or as dichotomous variables (deficient vs. non-deficient, above vs. below the median, respectively). Subjects with low D-hormone serum concentrations took significantly more time to perform the TUG-test (low = 7.70s +/- 2.52 SD ; high = 6.70s +/- 1.29 SD; p = 0.004). In the linear multivariate controlled regression model increased D-hormone serum concentrations predicted better TUG-test performance (estimate -0.0007, p = 0.044). Participants with a calcium intake of > or =512 mg/day were significantly faster to perform the TUG-test than participants with a daily calcium intake of <512 mg/day (estimate:-0.43, p = 0.007). Other significant predictors of better TUG-test performance in both models were: male gender, less comorbid conditions, younger age, lower BMI, iPTH serum levels and creatinine clearance. Calcidiol serum levels were not associated with TUG-test performance. Higher D-hormone status and a calcium intake of > or =512 mg/day in community-dwelling independent older persons are significant determinants of better functional mobility. Therefore, to ensure optimal functional mobility, the care of older persons should address correction of D-hormone deficiency and increasing daily calcium intake.

Nuance and behavioral cogency: How the Visible Burrow System inspired the Stress-Alternatives Model and conceptualization of the continuum of anxiety

PubMed Central

Robertson, James M.; Prince, Melissa A.; Achua, Justin K.; Carpenter, Russ E.; Arendt, David H.; Smith, Justin P.; Summers, Torrie L.; Summers, Tangi R.; Summers, Cliff H.

2015-01-01

By creating the Visible Burrow System (VBS) Bob Blanchard found a way to study the interaction of genetics, physiology, environment, and adaptive significance in a model with broad validity. The VBS changed the way we think about anxiety and affective disorders by allowing the mechanisms which control them to be observed in a dynamic setting. Critically, Blanchard used the VBS and other models to show how behavioral systems like defense are dependent upon context and behavioral elements unique to the individual. Inspired by the VBS, we developed a Stress Alternatives Model (SAM) to further explore the multifaceted dynamics of the stress response with a dichotomous choice condition. Like the VBS, the SAM is a naturalistic model built upon risk-assessment and defensive behavior, but with a choice of response: escape or submission to a large conspecific aggressor. The anxiety of novelty during the first escape must be weighed against fear of the aggressor, and a decision must be made. Both outcomes are adaptively significant, evidenced by a 50/50 split in outcome across several study systems. By manipulating the variables of the SAM, we show that a gradient of anxiety exists that spans the contextual settings of escaping an open field, escaping from aggression, and submitting to aggression. These findings correspond with increasing levels of corticosterone and increasing levels of NPS and BDNF in the central amygdala as the context changes. Whereas some anxiolytics were able to reduce the latency to escape for some animals, only with the potent anxiolytic drug antalarmin (CRF1R-blocker) and the anxiogenic drug yohimbine (α2 antagonist) were we able to reverse the outcome for a substantial proportion of individuals. Our findings promote a novel method for modeling anxiety, offering a distinction between low-and-high levels, and accounting for individual variability. The translational value of the VBS is immeasurable, and it guided us and many other researchers to seek potential clinical solutions through a deeper understanding of regional neurochemistry and gene expression in concert with an ecological behavioral model. PMID:26066728

A critical meta-analysis of lens model studies in human judgment and decision-making.

PubMed

Kaufmann, Esther; Reips, Ulf-Dietrich; Wittmann, Werner W

2013-01-01

Achieving accurate judgment ('judgmental achievement') is of utmost importance in daily life across multiple domains. The lens model and the lens model equation provide useful frameworks for modeling components of judgmental achievement and for creating tools to help decision makers (e.g., physicians, teachers) reach better judgments (e.g., a correct diagnosis, an accurate estimation of intelligence). Previous meta-analyses of judgment and decision-making studies have attempted to evaluate overall judgmental achievement and have provided the basis for evaluating the success of bootstrapping (i.e., replacing judges by linear models that guide decision making). However, previous meta-analyses have failed to appropriately correct for a number of study design artifacts (e.g., measurement error, dichotomization), which may have potentially biased estimations (e.g., of the variability between studies) and led to erroneous interpretations (e.g., with regards to moderator variables). In the current study we therefore conduct the first psychometric meta-analysis of judgmental achievement studies that corrects for a number of study design artifacts. We identified 31 lens model studies (N = 1,151, k = 49) that met our inclusion criteria. We evaluated overall judgmental achievement as well as whether judgmental achievement depended on decision domain (e.g., medicine, education) and/or the level of expertise (expert vs. novice). We also evaluated whether using corrected estimates affected conclusions with regards to the success of bootstrapping with psychometrically-corrected models. Further, we introduce a new psychometric trim-and-fill method to estimate the effect sizes of potentially missing studies correct psychometric meta-analyses for effects of publication bias. Comparison of the results of the psychometric meta-analysis with the results of a traditional meta-analysis (which only corrected for sampling error) indicated that artifact correction leads to a) an increase in values of the lens model components, b) reduced heterogeneity between studies, and c) increases the success of bootstrapping. We argue that psychometric meta-analysis is useful for accurately evaluating human judgment and show the success of bootstrapping.

A meta-analysis of predictors of seizure freedom in the surgical management of focal cortical dysplasia.

PubMed

Rowland, Nathan C; Englot, Dario J; Cage, Tene A; Sughrue, Michael E; Barbaro, Nicholas M; Chang, Edward F

2012-05-01

Focal cortical dysplasia (FCD) is one of the most common causes of medically refractory epilepsy leading to surgery. However, seizure control outcomes reported in isolated surgical series are highly variable. As a result, it is not clear which variables are most crucial in predicting seizure freedom following surgery for FCD. The authors' aim was to determine the prognostic factors for seizure control in FCD by performing a meta-analysis of the published literature. A MEDLINE search of the published literature yielded 37 studies that met inclusion and exclusion criteria. Seven potential prognostic variables were determined from these studies and were dichotomized for analysis. For each variable, individual studies were weighted by inverse variance and combined to generate an odds ratio favoring seizure freedom. The methods complied with a standardized meta-analysis reporting protocol. Two thousand fourteen patients were included in the analysis. The overall rate of seizure freedom (Engel Class I) among patients undergoing surgery for FCD in the cohort of studies was 55.8% ± 16.2%. Partial seizures, a temporal location, detection with MRI, and a Type II Palmini histological classification were associated with higher rates of postoperative seizure control. As a treatment-related factor, complete resection of the anatomical or electrographic abnormality was the most important predictor overall of seizure freedom. Neither age nor electroencephalographic localization of the ictal onset significantly affected seizure freedom after surgery. Using a large population cohort pooled from the published literature, an analysis identified important factors that are prognostic in patients with epilepsy due to FCD. The most important of these factors-diagnostic imaging and resection-provide modalities through which improvements in the impact of FCD can be effected.

T-Wave Morphology Restitution Predicts Sudden Cardiac Death in Patients With Chronic Heart Failure.

PubMed

Ramírez, Julia; Orini, Michele; Mincholé, Ana; Monasterio, Violeta; Cygankiewicz, Iwona; Bayés de Luna, Antonio; Martínez, Juan Pablo; Pueyo, Esther; Laguna, Pablo

2017-05-19

Patients with chronic heart failure are at high risk of sudden cardiac death (SCD). Increased dispersion of repolarization restitution has been associated with SCD, and we hypothesize that this should be reflected in the morphology of the T-wave and its variations with heart rate. The aim of this study is to propose an electrocardiogram (ECG)-based index characterizing T-wave morphology restitution (TMR), and to assess its association with SCD risk in a population of chronic heart failure patients. Holter ECGs from 651 ambulatory patients with chronic heart failure from the MUSIC (MUerte Súbita en Insuficiencia Cardiaca) study were available for the analysis. TMR was quantified by measuring the morphological variation of the T-wave per RR increment using time-warping metrics, and its predictive power was compared to that of clinical variables such as the left ventricular ejection fraction and other ECG-derived indices, such as T-wave alternans and heart rate variability. TMR was significantly higher in SCD victims than in the rest of patients (median 0.046 versus 0.039, P <0.001). When TMR was dichotomized at TMR=0.040, the SCD rate was significantly higher in the TMR≥0.040 group ( P <0.001). Cox analysis revealed that TMR≥0.040 was strongly associated with SCD, with a hazard ratio of 3.27 ( P <0.001), independently of clinical and ECG-derived variables. No association was found between TMR and pump failure death. This study shows that TMR is specifically associated with SCD in a population of chronic heart failure patients, and it is a better predictor than clinical and ECG-derived variables. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

Bisphenol-A and Sleep Adequacy among Adults in the National Health and Nutrition Examination Surveys.

PubMed

Beydoun, Hind A; Beydoun, May A; Jeng, Hueiwang Anna; Zonderman, Alan B; Eid, Shaker M

2016-02-01

To evaluate bisphenol-A (BPA) level and its relationship to sleep adequacy in a nationally representative sample of U.S. adults. A population-based cross-sectional study was conducted using 2005-2010 National Health and Nutrition Examination Survey whereby data were collected using in-person interviews, physical examination and laboratory testing. BPA level was measured in urine samples and analyzed as loge-transformed variable and in quartiles (< 0.9 ng/mL; 0.9 to < 1.9 ng/mL; 1.9 to < 3.7 ng/mL; 3.7+ ng/mL). Sleep adequacy was operationalized with three questions: "How much sleep do you usually get at night on weekdays or workdays?", "Have you ever told a doctor or other health professionals that you have trouble sleeping?" and "Have you ever been told by a doctor or other health professional that you have a sleep disorder?" Sleep duration was further categorized as (< 6 h, ≥ 6 h); (< 7 h, 7-8 h, > 8 h); (< 5 h, 5-6 h, 7-8 h, ≥ 9 h). Linear, binary, and ordinal logistic regression models were constructed. Loge-transformed BPA level was inversely related to sleep duration defined, in hours, as a continuous variable, a dichotomous variable (≥ 6, < 6), or an ordinal variable (≥ 9, 7-8, 5-6, < 5), after adjustment for confounders. Help-seeking behavior for sleep problems and diagnosis with sleep disorders were not significantly associated with loge-transformed BPA level in fully adjusted models. Loge-transformed BPA level may be associated with fewer hours of sleep among U.S. adults, with implications for prevention. Further research involving diverse populations are needed to confirm these study findings. © 2016 Associated Professional Sleep Societies, LLC.

Determining Directional Dependency in Causal Associations

PubMed Central

Pornprasertmanit, Sunthud; Little, Todd D.

2014-01-01

Directional dependency is a method to determine the likely causal direction of effect between two variables. This article aims to critique and improve upon the use of directional dependency as a technique to infer causal associations. We comment on several issues raised by von Eye and DeShon (2012), including: encouraging the use of the signs of skewness and excessive kurtosis of both variables, discouraging the use of D’Agostino’s K2, and encouraging the use of directional dependency to compare variables only within time points. We offer improved steps for determining directional dependency that fix the problems we note. Next, we discuss how to integrate directional dependency into longitudinal data analysis with two variables. We also examine the accuracy of directional dependency evaluations when several regression assumptions are violated. Directional dependency can suggest the direction of a relation if (a) the regression error in population is normal, (b) an unobserved explanatory variable correlates with any variables equal to or less than .2, (c) a curvilinear relation between both variables is not strong (standardized regression coefficient ≤ .2), (d) there are no bivariate outliers, and (e) both variables are continuous. PMID:24683282

A Mixed-Method Analysis of Reports on 100 Cases of Improper Prescribing of Controlled Substances

PubMed Central

DuBois, James M.; Chibnall, John T.; Anderson, Emily E.; Eggers, Michelle; Baldwin, Kari; Vasher, Meghan

2017-01-01

Improper prescribing of controlled substances contributes to opioid addictions and deaths by overdose. Studies conducted to-date have largely lacked a theoretical framework and ignored the interaction of individual with environmental factors. We conducted a mixed-method analysis of published reports on 100 cases that occurred in the United States. An average of 17 reports (e.g., from medical boards) per case were coded for 38 dichotomous variables describing the physician, setting, patients, and investigation. A theory on how the case occurred was developed for each case. Explanatory typologies were developed and then validated through hierarchical cluster analysis. Most cases involved physicians who were male (88%), >40 years old (90%), non-board certified (63%), and in small private practices (97%); 54% of cases reported facts about the physician indicative of self-centered personality traits. Three explanatory typologies were validated. Increasing oversight provided by peers and trainees may help prevent improper prescribing of controlled substances. PMID:28663601

Athletic amenorrhea: energy deficit or psychogenic challenge?

PubMed Central

Pauli, Samuel A.; Berga, Sarah L.

2010-01-01

Athletic women are at risk for developing ovulatory dysfunction, which presents variably as menstrual irregularity or absence. Initially characterized as an isolated disruption of hypothalamic gonadotropin releasing hormone (GnRH) release, athletic amenorrhea, a form of hypogonadotropic hypogonadism, is invariably accompanied by additional neuroendocrine aberrations, including activation of adrenal and suppression of thyroidal axes. Exercise may elicit intermittent or chronic metabolic stress due to increased energy expenditure and/or insufficient or imbalanced nutrient intake. In addition, athletic activities are motivated by or serve as psychogenic stressors. Prior studies dichotomized stressors as metabolic or psychogenic. Not only is this a false dichotomy because all stressors have both a metabolic and a psychogenic component, but also stressors act synergistically rather than in isolation to compromise GnRH drive and endocrine homeostasis. To ameliorate reproductive and endocrine consequences of stress, then, requires identification and amelioration of all relevant stressors. Formal psychosocial support helps individuals to develop better coping strategies and make appropriate lifestyle changes. Our research has shown that cognitive behavior therapy restores reproductive and endocrine balance. PMID:20840250

AnthropMMD: An R package with a graphical user interface for the mean measure of divergence.

PubMed

Santos, Frédéric

2018-01-01

The mean measure of divergence is a dissimilarity measure between groups of individuals described by dichotomous variables. It is well suited to datasets with many missing values, and it is generally used to compute distance matrices and represent phenograms. Although often used in biological anthropology and archaeozoology, this method suffers from a lack of implementation in common statistical software. A package for the R statistical software, AnthropMMD, is presented here. Offering a dynamic graphical user interface, it is the first one dedicated to Smith's mean measure of divergence. The package also provides facilities for graphical representations and the crucial step of trait selection, so that the entire analysis can be performed through the graphical user interface. Its use is demonstrated using an artificial dataset, and the impact of trait selection is discussed. Finally, AnthropMMD is compared to three other free tools available for calculating the mean measure of divergence, and is proven to be consistent with them. © 2017 Wiley Periodicals, Inc.

Genome-wide physical activity interactions in adiposity - A meta-analysis of 200,452 adults.

PubMed

Graff, Mariaelisa; Scott, Robert A; Justice, Anne E; Young, Kristin L; Feitosa, Mary F; Barata, Llilda; Winkler, Thomas W; Chu, Audrey Y; Mahajan, Anubha; Hadley, David; Xue, Luting; Workalemahu, Tsegaselassie; Heard-Costa, Nancy L; den Hoed, Marcel; Ahluwalia, Tarunveer S; Qi, Qibin; Ngwa, Julius S; Renström, Frida; Quaye, Lydia; Eicher, John D; Hayes, James E; Cornelis, Marilyn; Kutalik, Zoltan; Lim, Elise; Luan, Jian'an; Huffman, Jennifer E; Zhang, Weihua; Zhao, Wei; Griffin, Paula J; Haller, Toomas; Ahmad, Shafqat; Marques-Vidal, Pedro M; Bien, Stephanie; Yengo, Loic; Teumer, Alexander; Smith, Albert Vernon; Kumari, Meena; Harder, Marie Neergaard; Justesen, Johanne Marie; Kleber, Marcus E; Hollensted, Mette; Lohman, Kurt; Rivera, Natalia V; Whitfield, John B; Zhao, Jing Hua; Stringham, Heather M; Lyytikäinen, Leo-Pekka; Huppertz, Charlotte; Willemsen, Gonneke; Peyrot, Wouter J; Wu, Ying; Kristiansson, Kati; Demirkan, Ayse; Fornage, Myriam; Hassinen, Maija; Bielak, Lawrence F; Cadby, Gemma; Tanaka, Toshiko; Mägi, Reedik; van der Most, Peter J; Jackson, Anne U; Bragg-Gresham, Jennifer L; Vitart, Veronique; Marten, Jonathan; Navarro, Pau; Bellis, Claire; Pasko, Dorota; Johansson, Åsa; Snitker, Søren; Cheng, Yu-Ching; Eriksson, Joel; Lim, Unhee; Aadahl, Mette; Adair, Linda S; Amin, Najaf; Balkau, Beverley; Auvinen, Juha; Beilby, John; Bergman, Richard N; Bergmann, Sven; Bertoni, Alain G; Blangero, John; Bonnefond, Amélie; Bonnycastle, Lori L; Borja, Judith B; Brage, Søren; Busonero, Fabio; Buyske, Steve; Campbell, Harry; Chines, Peter S; Collins, Francis S; Corre, Tanguy; Smith, George Davey; Delgado, Graciela E; Dueker, Nicole; Dörr, Marcus; Ebeling, Tapani; Eiriksdottir, Gudny; Esko, Tõnu; Faul, Jessica D; Fu, Mao; Færch, Kristine; Gieger, Christian; Gläser, Sven; Gong, Jian; Gordon-Larsen, Penny; Grallert, Harald; Grammer, Tanja B; Grarup, Niels; van Grootheest, Gerard; Harald, Kennet; Hastie, Nicholas D; Havulinna, Aki S; Hernandez, Dena; Hindorff, Lucia; Hocking, Lynne J; Holmens, Oddgeir L; Holzapfel, Christina; Hottenga, Jouke Jan; Huang, Jie; Huang, Tao; Hui, Jennie; Huth, Cornelia; Hutri-Kähönen, Nina; James, Alan L; Jansson, John-Olov; Jhun, Min A; Juonala, Markus; Kinnunen, Leena; Koistinen, Heikki A; Kolcic, Ivana; Komulainen, Pirjo; Kuusisto, Johanna; Kvaløy, Kirsti; Kähönen, Mika; Lakka, Timo A; Launer, Lenore J; Lehne, Benjamin; Lindgren, Cecilia M; Lorentzon, Mattias; Luben, Robert; Marre, Michel; Milaneschi, Yuri; Monda, Keri L; Montgomery, Grant W; De Moor, Marleen H M; Mulas, Antonella; Müller-Nurasyid, Martina; Musk, A W; Männikkö, Reija; Männistö, Satu; Narisu, Narisu; Nauck, Matthias; Nettleton, Jennifer A; Nolte, Ilja M; Oldehinkel, Albertine J; Olden, Matthias; Ong, Ken K; Padmanabhan, Sandosh; Paternoster, Lavinia; Perez, Jeremiah; Perola, Markus; Peters, Annette; Peters, Ulrike; Peyser, Patricia A; Prokopenko, Inga; Puolijoki, Hannu; Raitakari, Olli T; Rankinen, Tuomo; Rasmussen-Torvik, Laura J; Rawal, Rajesh; Ridker, Paul M; Rose, Lynda M; Rudan, Igor; Sarti, Cinzia; Sarzynski, Mark A; Savonen, Kai; Scott, William R; Sanna, Serena; Shuldiner, Alan R; Sidney, Steve; Silbernagel, Günther; Smith, Blair H; Smith, Jennifer A; Snieder, Harold; Stančáková, Alena; Sternfeld, Barbara; Swift, Amy J; Tammelin, Tuija; Tan, Sian-Tsung; Thorand, Barbara; Thuillier, Dorothée; Vandenput, Liesbeth; Vestergaard, Henrik; van Vliet-Ostaptchouk, Jana V; Vohl, Marie-Claude; Völker, Uwe; Waeber, Gérard; Walker, Mark; Wild, Sarah; Wong, Andrew; Wright, Alan F; Zillikens, M Carola; Zubair, Niha; Haiman, Christopher A; Lemarchand, Loic; Gyllensten, Ulf; Ohlsson, Claes; Hofman, Albert; Rivadeneira, Fernando; Uitterlinden, André G; Pérusse, Louis; Wilson, James F; Hayward, Caroline; Polasek, Ozren; Cucca, Francesco; Hveem, Kristian; Hartman, Catharina A; Tönjes, Anke; Bandinelli, Stefania; Palmer, Lyle J; Kardia, Sharon L R; Rauramaa, Rainer; Sørensen, Thorkild I A; Tuomilehto, Jaakko; Salomaa, Veikko; Penninx, Brenda W J H; de Geus, Eco J C; Boomsma, Dorret I; Lehtimäki, Terho; Mangino, Massimo; Laakso, Markku; Bouchard, Claude; Martin, Nicholas G; Kuh, Diana; Liu, Yongmei; Linneberg, Allan; März, Winfried; Strauch, Konstantin; Kivimäki, Mika; Harris, Tamara B; Gudnason, Vilmundur; Völzke, Henry; Qi, Lu; Järvelin, Marjo-Riitta; Chambers, John C; Kooner, Jaspal S; Froguel, Philippe; Kooperberg, Charles; Vollenweider, Peter; Hallmans, Göran; Hansen, Torben; Pedersen, Oluf; Metspalu, Andres; Wareham, Nicholas J; Langenberg, Claudia; Weir, David R; Porteous, David J; Boerwinkle, Eric; Chasman, Daniel I; Abecasis, Gonçalo R; Barroso, Inês; McCarthy, Mark I; Frayling, Timothy M; O'Connell, Jeffrey R; van Duijn, Cornelia M; Boehnke, Michael; Heid, Iris M; Mohlke, Karen L; Strachan, David P; Fox, Caroline S; Liu, Ching-Ti; Hirschhorn, Joel N; Klein, Robert J; Johnson, Andrew D; Borecki, Ingrid B; Franks, Paul W; North, Kari E; Cupples, L Adrienne; Loos, Ruth J F; Kilpeläinen, Tuomas O

2017-04-01

Physical activity (PA) may modify the genetic effects that give rise to increased risk of obesity. To identify adiposity loci whose effects are modified by PA, we performed genome-wide interaction meta-analyses of BMI and BMI-adjusted waist circumference and waist-hip ratio from up to 200,452 adults of European (n = 180,423) or other ancestry (n = 20,029). We standardized PA by categorizing it into a dichotomous variable where, on average, 23% of participants were categorized as inactive and 77% as physically active. While we replicate the interaction with PA for the strongest known obesity-risk locus in the FTO gene, of which the effect is attenuated by ~30% in physically active individuals compared to inactive individuals, we do not identify additional loci that are sensitive to PA. In additional genome-wide meta-analyses adjusting for PA and interaction with PA, we identify 11 novel adiposity loci, suggesting that accounting for PA or other environmental factors that contribute to variation in adiposity may facilitate gene discovery.

Assessing the clinical utility of agoraphobia in the context of panic disorder.

PubMed

Schmidt, Norman B; Cromer, Kiara R

2008-01-01

In the DSM-IV, a panic disorder (PD) diagnosis includes specification of agoraphobia, which is primarily an index of situational avoidance due to fear of panic. No other anxiety diagnosis requires specification of level of avoidance. This raises the question as to whether agoraphobia provides unique information beyond the core features of PD (i.e., panic attacks and panic-related worry). The incremental validity of agoraphobia, defined using DSM-IV specifiers versus level of situational avoidance, was examined in relation to the expression and treatment of PD (N=146). Analyses indicate that agoraphobia status adds uniquely to the prediction of PD symptoms, impairment, and response to treatment. However, level of situational avoidance, defined either as a continuous or dichotomous variable, appears to have greater utility compared to the DSM-IV method of classifying agoraphobia. In summary, the agoraphobia specifier seems to have clinical utility but this could be improved by focusing on a dimensional assessment of situational avoidance.

The effects of a social media policy on pharmacy students' facebook security settings.

PubMed

Williams, Jennifer; Feild, Carinda; James, Kristina

2011-11-10

To examine how students entering a doctor of pharmacy (PharmD) program used Facebook privacy settings before and after the college's social media policy was presented to them. The Facebook profiles of all entering first-year pharmacy students across 4 campuses of a college of pharmacy were evaluated. Ten dichotomous variables of interest were viewed and recorded for each student's Facebook account at 3 time points: before the start of the semester, after presentation of the college's social media policy, and at the end of the semester. Data on whether a profile could be found and what portions of the profile were viewable also were collected. After introduction of the policy, a significant number of students increased their security settings (made information not visible to the public) related to Facebook walls, information pages, and links. Making pharmacy students aware of a college's social media policy had a positive impact on their behaviors regarding online security and privacy.

The Effects of a Social Media Policy on Pharmacy Students’ Facebook Security Settings

PubMed Central

Feild, Carinda; James, Kristina

2011-01-01

Objective. To examine how students entering a doctor of pharmacy (PharmD) program used Facebook privacy settings before and after the college's social media policy was presented to them. Methods. The Facebook profiles of all entering first-year pharmacy students across 4 campuses of a college of pharmacy were evaluated. Ten dichotomous variables of interest were viewed and recorded for each student's Facebook account at 3 time points: before the start of the semester, after presentation of the college's social media policy, and at the end of the semester. Data on whether a profile could be found and what portions of the profile were viewable also were collected. Results. After introduction of the policy, a significant number of students increased their security settings (made information not visible to the public) related to Facebook walls, information pages, and links. Conclusions. Making pharmacy students aware of a college's social media policy had a positive impact on their behaviors regarding online security and privacy. PMID:22171105

Mothers' self-reports of parenthood across the first 6 months postpartum.

PubMed

Grace, J T

1993-12-01

A postpartum measure, What Being the Parent of a New Baby is Like, was administered to explore the development of maternal role for mothers (N = 76) at 1, 3, 4 1/2, and 6 months postpartum. Individual differences were relatively stable across time and accounted for much more variance than time effects. Mean scores on the Centrality (of baby) and Help (with parenting tasks) subscales decreased over time, and Evaluation (satisfaction with role performance) and Lifechange subscale scores increased. Primiparas demonstrated the steepest mean increase in Evaluation scores over time. Mean Evaluation scores for first- (n = 29) and second-time mothers (n = 33) were similar, but mothers of three or more children (n = 14) had significantly higher scores. Parity was also related inversely to amount of life change, and maternal education was related inversely to Evaluation and Centrality scores. Demographic, subscale, and contextual variable interrelationships were generally consistent with maternal role adaptation theory. Findings also suggest that parity effects are more complex than a dichotomous primipara/multipara representation.

Cerebrovascular disease, beta-amyloid and cognition in aging

PubMed Central

Marchant, Natalie L.; Reed, Bruce R.; DeCarli, Charles S.; Madison, Cindee M.; Weiner, Michael W.; Chui, Helena C.; Jagust, William J.

2011-01-01

The present study evaluated cerebrovascular disease (CVD), β-amyloid (Aβ), and cognition in clinically normal elderly adults. Fifty-four participants underwent MRI, PIB-PET imaging, and neuropsychological evaluation. High white matter hyperintensity burden and/or presence of infarct defined CVD status (CVD−: N = 27; CVD+: N = 27). PIB-PET ratios of Aβ deposition were extracted using Logan plotting (cerebellar reference). Presence of high levels of Aβ in prespecified regions determined PIB status (PIB−: N = 33; PIB+: N = 21). Executive functioning and episodic memory were measured using composite scales. CVD and Aβ, defined as dichotomous or continuous variables, were unrelated to one another. CVD+ participants showed lower executive functioning (P = 0.001) when compared to CVD− individuals. Neither PIB status nor amount of Aβ affected cognition (Ps ≥ .45), and there was no statistical interaction between CVD and PIB on either cognitive measure. Within this spectrum of normal aging CVD and Aβ aggregation appear to be independent processes with CVD primarily affecting cognition. PMID:22048124

How do we assign punishment? The impact of minimal and maximal standards on the evaluation of deviants.

PubMed

Kessler, Thomas; Neumann, Jörg; Mummendey, Amélie; Berthold, Anne; Schubert, Thomas; Waldzus, Sven

2010-09-01

To explain the determinants of negative behavior toward deviants (e.g., punishment), this article examines how people evaluate others on the basis of two types of standards: minimal and maximal. Minimal standards focus on an absolute cutoff point for appropriate behavior; accordingly, the evaluation of others varies dichotomously between acceptable or unacceptable. Maximal standards focus on the degree of deviation from that standard; accordingly, the evaluation of others varies gradually from positive to less positive. This framework leads to the prediction that violation of minimal standards should elicit punishment regardless of the degree of deviation, whereas punishment in response to violations of maximal standards should depend on the degree of deviation. Four studies assessed or manipulated the type of standard and degree of deviation displayed by a target. Results consistently showed the expected interaction between type of standard (minimal and maximal) and degree of deviation on punishment behavior.

Shared and Distinct Rupture Discriminants of Small and Large Intracranial Aneurysms.

PubMed

Varble, Nicole; Tutino, Vincent M; Yu, Jihnhee; Sonig, Ashish; Siddiqui, Adnan H; Davies, Jason M; Meng, Hui

2018-04-01

Many ruptured intracranial aneurysms (IAs) are small. Clinical presentations suggest that small and large IAs could have different phenotypes. It is unknown if small and large IAs have different characteristics that discriminate rupture. We analyzed morphological, hemodynamic, and clinical parameters of 413 retrospectively collected IAs (training cohort; 102 ruptured IAs). Hierarchal cluster analysis was performed to determine a size cutoff to dichotomize the IA population into small and large IAs. We applied multivariate logistic regression to build rupture discrimination models for small IAs, large IAs, and an aggregation of all IAs. We validated the ability of these 3 models to predict rupture status in a second, independently collected cohort of 129 IAs (testing cohort; 14 ruptured IAs). Hierarchal cluster analysis in the training cohort confirmed that small and large IAs are best separated at 5 mm based on morphological and hemodynamic features (area under the curve=0.81). For small IAs (<5 mm), the resulting rupture discrimination model included undulation index, oscillatory shear index, previous subarachnoid hemorrhage, and absence of multiple IAs (area under the curve=0.84; 95% confidence interval, 0.78-0.88), whereas for large IAs (≥5 mm), the model included undulation index, low wall shear stress, previous subarachnoid hemorrhage, and IA location (area under the curve=0.87; 95% confidence interval, 0.82-0.93). The model for the aggregated training cohort retained all the parameters in the size-dichotomized models. Results in the testing cohort showed that the size-dichotomized rupture discrimination model had higher sensitivity (64% versus 29%) and accuracy (77% versus 74%), marginally higher area under the curve (0.75; 95% confidence interval, 0.61-0.88 versus 0.67; 95% confidence interval, 0.52-0.82), and similar specificity (78% versus 80%) compared with the aggregate-based model. Small (<5 mm) and large (≥5 mm) IAs have different hemodynamic and clinical, but not morphological, rupture discriminants. Size-dichotomized rupture discrimination models performed better than the aggregate model. © 2018 American Heart Association, Inc.

Asymptotic violation of Bell inequalities and distillability.

PubMed

Masanes, Lluís

2006-08-04

A multipartite quantum state violates a Bell inequality asymptotically if, after jointly processing by general local operations an arbitrarily large number of copies of it, the result violates the inequality. In the bipartite case we show that asymptotic violation of the Clauser-Horne-Shimony-Holt inequality is equivalent to distillability. Hence, bound entangled states do not violate it. In the multipartite case we consider the complete set of full-correlation Bell inequalities with two dichotomic observables per site. We show that asymptotic violation of any of these inequalities by a multipartite state implies that pure-state entanglement can be distilled from it, although the corresponding distillation protocol may require that some of the parties join into several groups. We also obtain the extreme points of the set of distributions generated by measuring N quantum systems with two dichotomic observables per site.

Typical Werner states satisfying all linear Bell inequalities with dichotomic measurements

NASA Astrophysics Data System (ADS)

Luo, Ming-Xing

2018-04-01

Quantum entanglement as a special resource inspires various distinct applications in quantum information processing. Unfortunately, it is NP-hard to detect general quantum entanglement using Bell testing. Our goal is to investigate quantum entanglement with white noises that appear frequently in experiment and quantum simulations. Surprisingly, for almost all multipartite generalized Greenberger-Horne-Zeilinger states there are entangled noisy states that satisfy all linear Bell inequalities consisting of full correlations with dichotomic inputs and outputs of each local observer. This result shows generic undetectability of mixed entangled states in contrast to Gisin's theorem of pure bipartite entangled states in terms of Bell nonlocality. We further provide an accessible method to show a nontrivial set of noisy entanglement with small number of parties satisfying all general linear Bell inequalities. These results imply typical incompleteness of special Bell theory in explaining entanglement.

The niche party concept and its measurement.

PubMed

Meyer, Thomas M; Miller, Bernhard

2015-03-01

The concept of the niche party has become increasingly popular in analyses of party competition. Yet, existing approaches vary in their definitions and their measurement approaches. We propose using a minimal definition that allows us to compare political parties in terms of their 'nicheness'. We argue that the conceptual core of the niche party concept is based on issue emphasis and that a niche party emphasizes policy areas neglected by its rivals. Based on this definition, we propose a continuous measure that allows for more fine-grained measurement of a party's 'nicheness' than the dominant, dichotomous approaches and thereby limits the risk of measurement error. Drawing on data collected by the Comparative Manifesto Project, we show that (1) our measure has high face validity and (2) exposes differences among parties that are not captured by alternative, static or dichotomous measures.

Rigid dietary control, flexible dietary control, and intuitive eating: Evidence for their differential relationship to disordered eating and body image concerns.

PubMed

Linardon, Jake; Mitchell, Sarah

2017-08-01

This study aimed to replicate and extend from Tylka, Calogero, and Daníelsdóttir (2015) findings by examining the relationship between rigid control, flexible control, and intuitive eating on various indices of disordered eating (i.e., binge eating, disinhibition) and body image concerns (i.e., shape and weight over-evaluation, body checking, and weight-related exercise motivations). This study also examined whether the relationship between intuitive eating and outcomes was mediated by dichotomous thinking and body appreciation. Analysing data from a sample of 372 men and women recruited through the community, this study found that, in contrast to rigid dietary control, intuitive eating uniquely and consistently predicted lower levels of disordered eating and body image concerns. This intuitive eating-disordered eating relationship was mediated by low levels of dichotomous thinking and the intuitive eating-body image relationship was mediated by high levels of body appreciation. Flexible control predicted higher levels of body image concerns and lower levels of disordered eating only when rigid control was accounted for. Findings suggest that until the adaptive properties of flexible control are further elucidated, it may be beneficial to promote intuitive eating within public health approaches to eating disorder prevention. In addition to this, particular emphasis should also be made toward promoting body acceptance and eradicating a dichotomous thinking style around food and eating. Copyright © 2017 Elsevier Ltd. All rights reserved.

Coping and help in birth: An investigation into 'normal' childbirth as described by new mothers and their attending midwives.

PubMed

Darra, Susanne; Murphy, Fiona

2016-09-01

to investigate how 'normal' childbirth is described by new mothers and their attending midwives. a qualitative, reflexive, narrative study was used to explore birth stories using in-depth, un-structured interviews. 21 new mothers and their 16 attending midwives were recruited from the locality surrounding a district general hospital in South Wales, United Kingdom (UK). the findings identified that the mothers wanted to cope with labour and birth, by breathing through it and using some birth interventions with the help of knowledgeable midwives. Midwives aimed to achieve 'normality' in birth but also commonly utilised birth interventions. Consequently the notion of 'normal' birth as not involving interventions in birth was not found to be a useful defining concept in this study. Furthermore, current dichotomous models and theories of birth and midwifery in particular those relating to pain management did not fully explain the perspectives of these women and their midwives. dichotomous models and theories for birth and midwifery practice and those which incorporate the term 'normal' birth are shown to be not entirely useful to fully explain the contemporary complexity of childbirth in the UK. Therefore it is now necessary to consider avoiding using dichotomous models of birth and midwifery in the UK and to instead concentrate on developing integrated models that reflect the real life current experiences of women and their midwives. Copyright © 2016 Elsevier Ltd. All rights reserved.

An Entropy-Based Measure of Dependence between Two Groups of Random Variables. Research Report. ETS RR-07-20

ERIC Educational Resources Information Center

Kong, Nan

2007-01-01

In multivariate statistics, the linear relationship among random variables has been fully explored in the past. This paper looks into the dependence of one group of random variables on another group of random variables using (conditional) entropy. A new measure, called the K-dependence coefficient or dependence coefficient, is defined using…

A genome wide association study of alcohol dependence symptom counts in extended pedigrees identifies C15orf53

PubMed Central

Wang, Jen-Chyong; Foroud, Tatiana; Hinrichs, Anthony L; Le, Nhung XH; Bertelsen, Sarah; Budde, John P; Harari, Oscar; Koller, Daniel L; Wetherill, Leah; Agrawal, Arpana; Almasy, Laura; Brooks, Andrew I; Bucholz, Kathleen; Dick, Danielle; Hesselbrock, Victor; Johnson, Eric O; Kang, Sun; Kapoor, Manav; Kramer, John; Kuperman, Samuel; Madden, Pamela AF; Manz, Niklas; Martin, Nicholas G; McClintick, Jeanette N; Montgomery, Grant W; Nurnberger, John I; Rangaswamy, Madhavi; Rice, John; Schuckit, Marc; Tischfield, Jay A; Whitfield, John B; Xuei, Xiaoling; Porjesz, Bernice; Heath, Andrew C; Edenberg, Howard J; Bierut, Laura J; Goate, Alison M

2013-01-01

Several studies have identified genes associated with alcohol use disorders, but the variation in each of these genes explains only a small portion of the genetic vulnerability. The goal of the present study was to perform a genome-wide association study (GWAS) in extended families from the Collaborative Study on the Genetics of Alcoholism (COGA) to identify novel genes affecting risk for alcohol dependence. To maximize the power of the extended family design we used a quantitative endophenotype, measured in all individuals: number of alcohol dependence symptoms endorsed (symptom count). Secondary analyses were performed to determine if the single nucleotide polymorphisms (SNPs) associated with symptom count were also associated with the dichotomous phenotype, DSM-IV alcohol dependence. This family-based GWAS identified SNPs in C15orf53 that are strongly associated with DSM-IV alcohol (p=4.5×10−8, inflation corrected p=9.4×10−7). Results with DSM-IV alcohol dependence in the regions of interest support our findings with symptom count, though the associations were less significant. Attempted replications of the most promising association results were conducted in two independent samples: non-overlapping subjects from the Study of Addiction: Genes and Environment (SAGE) and the Australian twin-family study of alcohol use disorders (OZALC). Nominal association of C15orf53 with symptom count was observed in SAGE. The variant that showed strongest association with symptom count, rs12912251 and its highly correlated variants (D′=1, r2≥ 0.95), has previously been associated with risk for bipolar disorder. PMID:23089632

A Non-linear Predictive Model of Borderline Personality Disorder Based on Multilayer Perceptron.

PubMed

Maldonato, Nelson M; Sperandeo, Raffaele; Moretto, Enrico; Dell'Orco, Silvia

2018-01-01

Borderline Personality Disorder is a serious mental disease, classified in Cluster B of DSM IV-TR personality disorders. People with this syndrome presents an anamnesis of traumatic experiences and shows dissociative symptoms. Since not all subjects who have been victims of trauma develop a Borderline Personality Disorder, the emergence of this serious disease seems to have the fragility of character as a predisposing condition. Infect, numerous studies show that subjects positive for diagnosis of Borderline Personality Disorder had scores extremely high or extremely low to some temperamental dimensions (harm Avoidance and reward dependence) and character dimensions (cooperativeness and self directedness). In a sample of 602 subjects, who have had consecutive access to an Outpatient Mental Health Service, it was evaluated the presence of Borderline Personality Disorder using the semi-structured interview for the DSM IV-TR personality disorders. In this population we assessed the presence of dissociative symptoms with the Dissociative Experiences Scale and the personality traits with the Temperament and Character Inventory developed by Cloninger. To assess the weight and the predictive value of these psychopathological dimensions in relation to the Borderline Personality Disorder diagnosis, a neural network statistical model called "multilayer perceptron," was implemented. This model was developed with a dichotomous dependent variable, consisting in the presence or absence of the diagnosis of borderline personality disorder and with five covariates. The first one is the taxonomic subscale of dissociative experience scale, the others are temperamental and characterial traits: Novelty-Seeking, Harm-Avoidance, Self-Directedness and Cooperativeness. The statistical model, that results satisfactory, showed a significance capacity (89%) to predict the presence of borderline personality disorder. Furthermore, the dissociative symptoms seem to have a greater influence than the character traits in the borderline personality disorder e disease. In conclusion, the results seem to indicate that to borderline personality disorder development, contribute both psychic factors, such as temperament and character traits, and environmental factors, such as traumatic events capable of producing dissociative symptoms. These factors interact in a nonlinear way in producing maladaptive behaviors typical of this disorder.

Ecocultural range-expansion scenarios for the replacement or assimilation of Neanderthals by modern humans.

PubMed

Wakano, Joe Yuichiro; Gilpin, William; Kadowaki, Seiji; Feldman, Marcus W; Aoki, Kenichi

2018-02-01

Recent archaeological records no longer support a simple dichotomous characterization of the cultures/behaviors of Neanderthals and modern humans, but indicate much cultural/behavioral variability over time and space. Thus, in modeling the replacement or assimilation of Neanderthals by modern humans, it is of interest to consider cultural dynamics and their relation to demographic change. The ecocultural framework for the competition between hominid species allows their carrying capacities to depend on some measure of the levels of culture they possess. In the present study both population densities and the densities of skilled individuals in Neanderthals and modern humans are spatially distributed and subject to change by spatial diffusion, ecological competition, and cultural transmission within each species. We analyze the resulting range expansions in terms of the demographic, ecological and cultural parameters that determine how the carrying capacities relate to the local densities of skilled individuals in each species. Of special interest is the case of cognitive and intrinsic-demographic equivalence of the two species. The range expansion dynamics may consist of multiple wave fronts of different speeds, each of which originates from a traveling wave solution. Properties of these traveling wave solutions are mathematically derived. Depending on the parameters, these traveling waves can result in replacement of Neanderthals by modern humans, or assimilation of the former by the latter. In both the replacement and assimilation scenarios, the first wave of intrusive modern humans is characterized by a low population density and a low density of skilled individuals, with implications for archaeological visibility. The first invasion is due to weak interspecific competition. A second wave of invasion may be induced by cultural differences between moderns and Neanderthals. Spatially and temporally extended coexistence of the two species, which would have facilitated the transfer of genes from Neanderthal into modern humans and vice versa, is observed in the traveling waves, except when niche overlap between the two species is extremely high. Archaeological findings on the spatial and temporal distributions of the Initial Upper Palaeolithic and the Early Upper Palaeolithic and of the coexistence of Neanderthals and modern humans are discussed. Copyright © 2017 Elsevier Inc. All rights reserved.

Validity of a Residualized Dependent Variable after Pretest Covariance Adjustments: Still the Same Variable?

ERIC Educational Resources Information Center

Nimon, Kim; Henson, Robin K.

2015-01-01

The authors empirically examined whether the validity of a residualized dependent variable after covariance adjustment is comparable to that of the original variable of interest. When variance of a dependent variable is removed as a result of one or more covariates, the residual variance may not reflect the same meaning. Using the pretest-posttest…

Lameness detection based on multivariate continuous sensing of milk yield, rumination, and neck activity.

PubMed

Van Hertem, T; Maltz, E; Antler, A; Romanini, C E B; Viazzi, S; Bahr, C; Schlageter-Tello, A; Lokhorst, C; Berckmans, D; Halachmi, I

2013-07-01

The objective of this study was to develop and validate a mathematical model to detect clinical lameness based on existing sensor data that relate to the behavior and performance of cows in a commercial dairy farm. Identification of lame (44) and not lame (74) cows in the database was done based on the farm's daily herd health reports. All cows were equipped with a behavior sensor that measured neck activity and ruminating time. The cow's performance was measured with a milk yield meter in the milking parlor. In total, 38 model input variables were constructed from the sensor data comprising absolute values, relative values, daily standard deviations, slope coefficients, daytime and nighttime periods, variables related to individual temperament, and milk session-related variables. A lame group, cows recognized and treated for lameness, to not lame group comparison of daily data was done. Correlations between the dichotomous output variable (lame or not lame) and the model input variables were made. The highest correlation coefficient was obtained for the milk yield variable (rMY=0.45). In addition, a logistic regression model was developed based on the 7 highest correlated model input variables (the daily milk yield 4d before diagnosis; the slope coefficient of the daily milk yield 4d before diagnosis; the nighttime to daytime neck activity ratio 6d before diagnosis; the milk yield week difference ratio 4d before diagnosis; the milk yield week difference 4d before diagnosis; the neck activity level during the daytime 7d before diagnosis; the ruminating time during nighttime 6d before diagnosis). After a 10-fold cross-validation, the model obtained a sensitivity of 0.89 and a specificity of 0.85, with a correct classification rate of 0.86 when based on the averaged 10-fold model coefficients. This study demonstrates that existing farm data initially used for other purposes, such as heat detection, can be exploited for the automated detection of clinically lame animals on a daily basis as well. Copyright © 2013 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Integrating models that depend on variable data

NASA Astrophysics Data System (ADS)

Banks, A. T.; Hill, M. C.

2016-12-01

Models of human-Earth systems are often developed with the goal of predicting the behavior of one or more dependent variables from multiple independent variables, processes, and parameters. Often dependent variable values range over many orders of magnitude, which complicates evaluation of the fit of the dependent variable values to observations. Many metrics and optimization methods have been proposed to address dependent variable variability, with little consensus being achieved. In this work, we evaluate two such methods: log transformation (based on the dependent variable being log-normally distributed with a constant variance) and error-based weighting (based on a multi-normal distribution with variances that tend to increase as the dependent variable value increases). Error-based weighting has the advantage of encouraging model users to carefully consider data errors, such as measurement and epistemic errors, while log-transformations can be a black box for typical users. Placing the log-transformation into the statistical perspective of error-based weighting has not formerly been considered, to the best of our knowledge. To make the evaluation as clear and reproducible as possible, we use multiple linear regression (MLR). Simulations are conducted with MatLab. The example represents stream transport of nitrogen with up to eight independent variables. The single dependent variable in our example has values that range over 4 orders of magnitude. Results are applicable to any problem for which individual or multiple data types produce a large range of dependent variable values. For this problem, the log transformation produced good model fit, while some formulations of error-based weighting worked poorly. Results support previous suggestions fthat error-based weighting derived from a constant coefficient of variation overemphasizes low values and degrades model fit to high values. Applying larger weights to the high values is inconsistent with the log-transformation. Greater consistency is obtained by imposing smaller (by up to a factor of 1/35) weights on the smaller dependent-variable values. From an error-based perspective, the small weights are consistent with large standard deviations. This work considers the consequences of these two common ways of addressing variable data.

Willingness to volunteer during an influenza pandemic: perspectives from students and staff at a large Canadian university

PubMed Central

Rosychuk, Rhonda J.; Bailey, Tracey; Haines, Christina; Lake, Robert; Herman, Benjamin; Yonge, Olive; Marrie, Thomas J.

2008-01-01

Background  A future influenza pandemic will require greater demand on numerous essential services and a reduced capacity to meet that demand. Recruitment of volunteers is an important issue for pre‐pandemic planning. Objectives  To identify factors and attitudes towards volunteerism in the event of a pandemic of influenza. Participants/methods  A 42‐item web‐questionnaire was administered to all faculty, staff and students at the University of Alberta. Respondents indicated their willingness to volunteer. Responses were dichotomized and logistic regression models were developed to capture the association between willingness to volunteer and (i) demographic and information source variables, (ii) risk perception and general knowledge, and (iii) volunteering attitudes and priority access variables. Results  Many factors predicted willingness to volunteer and several involved interactions with other variables. Individuals who were older, relied on University Health Centre information and who had past volunteerism experience were generally more likely to be willing to volunteer. Those willing to volunteer were more likely to think spread could be prevented by covering mouth when coughing/sneezing, and treatment would include drinking fluids. Those who thought influenza would be treated by antibiotics were less willing to volunteer. Likely volunteers thought that healthcare students should be encouraged to volunteer if there was a healthcare worker shortage. Conclusion  This study provides guidance for those who are preparing universities to deal with pandemic influenza. The results suggest factors that might be important in the recruitment of volunteers during an influenza pandemic and these factors might be relevant for other sectors as well. PMID:19453473

The association between social network relationships and depressive symptoms among older Americans: what matters most?

PubMed

Litwin, Howard

2011-08-01

Although social network relationships are linked to mental health in late life, it is still unclear whether it is the structure of social networks or their perceived quality that matters. The current study regressed a dichotomous 8-item version of the Center for Epidemiological Studies Depression Scale (CESD-8) score on measures of social network relationships among Americans, aged 65-85 years, from the first wave of the National Social Life, Health and Aging Project. The network indicators included a structural variable - social network type - and a series of relationship quality indicators: perceived positive and negative ties with family, friends and spouse/ partner. Multivariate logistic regression analyses controlled for age, gender, education, income, race/ethnicity, religious affiliation, functional health and physical health. The perceived social network quality variables were unrelated to the presence of a high level of depressive symptoms, but social network type maintained an association with this mental health outcome even after controlling for confounders. Respondents embedded in resourceful social network types in terms of social capital--"diverse," "friend" and "congregant" networks--reported less presence of depressive symptoms, to varying degrees. The results show that the structure of the network seems to matter more than the perceived quality of the ties as an indicator of depressive symptoms. Moreover, the composite network type variable stands out in capturing the differences in mental state. The construct of network type should be incorporated in mental health screening among older people who reside in the community. One's social network type can be an important initial indicator that one is at risk.

[Bone mineral density in overweight and obese adolescents].

PubMed

Cobayashi, Fernanda; Lopes, Luiz A; Taddei, José Augusto de A C

2005-01-01

To study bone density as a concomitant factor for obesity in post-pubertal adolescents, controlling for other variables that may interfere in such a relation. Study comprising 83 overweight and obese adolescents (BMI > or = P85) and 89 non obese ones (P5 < or = BMI < or = P85). Cases and controls were selected out of 1,420 students (aged 14-19) from a public school in the city of São Paulo. The bone mineral density of the lumbar spine (L2-L4 in g/cm2) was assessed by dual-energy x-ray absorptiometry (LUNARtrade mark DPX-L). The variable bone density was dichotomized using 1.194 g/cm2 as cutoff point. Bivariate analyses were conducted considering the prevalence of overweight and obesity followed by multivariate analysis (logistic regression) according to a hierarchical conceptual model. The prevalence of bone density above the median was twice more frequent among cases (69.3%) than among controls (32.1%). In the bivariate analysis such prevalence resulted in an odds ratio (OR) of 4.78. The logistic regression model showed that the association between obesity and mineral density is yet more intense with an OR of 6.65 after the control of variables related to sedentary lifestyle and intake of milk and dairy products. Obese and overweight adolescents in the final stages of sexual maturity presented higher bone mineral density in relation to their normal-weight counterparts; however, cohort studies will be necessary to evaluate the influence of such characteristic on bone resistance in adulthood and, consequently, on the incidence of osteopenia and osteoporosis at older ages.

Ruling out Legionella in community-acquired pneumonia.

PubMed

Haubitz, Sebastian; Hitz, Fabienne; Graedel, Lena; Batschwaroff, Marcus; Wiemken, Timothy Lee; Peyrani, Paula; Ramirez, Julio A; Fux, Christoph Andreas; Mueller, Beat; Schuetz, Philipp

2014-10-01

Assessing the likelihood for Legionella sp. in community-acquired pneumonia is important because of differences in treatment regimens. Currently used antigen tests and culture have limited sensitivity with important time delays, making empirical broad-spectrum coverage necessary. Therefore, a score with 6 variables recently has been proposed. We sought to validate these parameters in an independent cohort. We analyzed adult patients with community-acquired pneumonia from a large multinational database (Community Acquired Pneumonia Organization) who were treated between 2001 and 2012 with more than 4 of the 6 prespecified clinical variables available. Association and discrimination were assessed using logistic regression analysis and area under the curve (AUC). Of 1939 included patients, the infectious cause was known in 594 (28.9%), including Streptococcus pneumoniae in 264 (13.6%) and Legionella sp. in 37 (1.9%). The proposed clinical predictors fever, cough, hyponatremia, lactate dehydrogenase, C-reactive protein, and platelet count were all associated or tended to be associated with Legionella cause. A logistic regression analysis including all these predictors showed excellent discrimination with an AUC of 0.91 (95% confidence interval, 0.87-0.94). The original dichotomized score showed good discrimination (AUC, 0.73; 95% confidence interval, 0.65-0.81) and a high negative predictive value of 99% for patients with less than 2 parameters present. With the use of a large independent patient sample from an international database, this analysis validates previously proposed clinical variables to accurately rule out Legionella sp., which may help to optimize initial empiric therapy. Copyright © 2014 Elsevier Inc. All rights reserved.

Estimation of Causal Mediation Effects for a Dichotomous Outcome in Multiple-Mediator Models using the Mediation Formula

PubMed Central

Nelson, Suchitra; Albert, Jeffrey M.

2013-01-01

Mediators are intermediate variables in the causal pathway between an exposure and an outcome. Mediation analysis investigates the extent to which exposure effects occur through these variables, thus revealing causal mechanisms. In this paper, we consider the estimation of the mediation effect when the outcome is binary and multiple mediators of different types exist. We give a precise definition of the total mediation effect as well as decomposed mediation effects through individual or sets of mediators using the potential outcomes framework. We formulate a model of joint distribution (probit-normal) using continuous latent variables for any binary mediators to account for correlations among multiple mediators. A mediation formula approach is proposed to estimate the total mediation effect and decomposed mediation effects based on this parametric model. Estimation of mediation effects through individual or subsets of mediators requires an assumption involving the joint distribution of multiple counterfactuals. We conduct a simulation study that demonstrates low bias of mediation effect estimators for two-mediator models with various combinations of mediator types. The results also show that the power to detect a non-zero total mediation effect increases as the correlation coefficient between two mediators increases, while power for individual mediation effects reaches a maximum when the mediators are uncorrelated. We illustrate our approach by applying it to a retrospective cohort study of dental caries in adolescents with low and high socioeconomic status. Sensitivity analysis is performed to assess the robustness of conclusions regarding mediation effects when the assumption of no unmeasured mediator-outcome confounders is violated. PMID:23650048

Factors affecting variability in the urinary biomarker 1,6-hexamethylene diamine in workers exposed to 1,6-hexamethylene diisocyanate.

PubMed

Gaines, Linda G T; Fent, Kenneth W; Flack, Sheila L; Thomasen, Jennifer M; Whittaker, Stephen G; Nylander-French, Leena A

2011-01-01

Although urinary 1,6-hexamethylene diamine (HDA) is a useful biomarker of exposure to 1,6-hexamethylene diisocyanate (HDI), a large degree of unexplained intra- and inter-individual variability exists between estimated HDI exposure and urine HDA levels. We investigated the effect of individual and workplace factors on urine HDA levels using quantitative dermal and inhalation exposure data derived from a survey of automotive spray painters exposed to HDI. Painters' dermal and breathing-zone HDI-exposures were monitored over an entire workday for up to three separate workdays, spaced approximately one month apart. One urine sample was collected before the start of work with HDI-containing paints, and multiple samples were collected throughout the workday. Using mixed effects multiple linear regression modeling, coverall use resulted in significantly lower HDA levels (p = 0.12), and weekday contributed to significant variability in HDA levels (p = 0.056). We also investigated differences in urine HDA levels stratified by dichotomous and classification covariates using analysis of variance. Use of coveralls (p = 0.05), respirator type worn (p = 0.06), smoker status (p = 0.12), paint-booth type (p = 0.02), and more than one painter at the shop (p = 0.10) were all found to significantly affect urine HDA levels adjusted for creatinine concentration. Coverall use remained significant (p = 0.10), even after adjusting for respirator type. These results indicate that the variation in urine HDA level is mainly due to workplace factors and that appropriate dermal and inhalation protection is required to prevent HDI exposure.

Food insecurity, a determinant of obesity? - an analysis from a population-based survey in the Paris metropolitan area, 2010.

PubMed

Martin-Fernandez, Judith; Caillavet, France; Lhuissier, Anne; Chauvin, Pierre

2014-01-01

The relationship between food insecurity and obesity is discussed in the literature. The objective of this study was to determine whether food insecurity and obesity were associated in the Paris metropolitan area. We used data from third wave of the Health, Inequalities and Social Ruptures (SIRS) cohort study, a longitudinal population-based, representative health and socioepidemiological survey of the general population in the Paris metropolitan area. The participants' BMI (calculated using self-reported height and weight) was analyzed as a continuous variable, and a dichotomous variable (BMI < 30 kg/m(2)/BMI ≥ 30 kg/m(2)) was constructed. Food insecurity was estimated using the Household Food Security Scale Module (HFSSM) and was treated as a trichotomous variable (food security / low food security / very low food security). Multilevel models were estimated for men and women separately. Obesity (BMI ≥ 30 kg/m(2)) prevalence was 10.2%. The determinant of obesity differs according to gender. After adjustment for age, income and the sociooccupational group, very low food security was associated with obesity in women (OR = 2.01, 95%CI 1.05-3.82), and women with very low food security had a higher BMI (Coef. = 1.78, 95% CI 0.24-3.31). This association, however, was not significant for men (OR = 1.84, 95%CI 0.64-5.30). In times of economic crisis, it is increasingly essential to explore and understand the pathway through which very low food security is linked to obesity.

Estimation of causal mediation effects for a dichotomous outcome in multiple-mediator models using the mediation formula.

PubMed

Wang, Wei; Nelson, Suchitra; Albert, Jeffrey M

2013-10-30

Mediators are intermediate variables in the causal pathway between an exposure and an outcome. Mediation analysis investigates the extent to which exposure effects occur through these variables, thus revealing causal mechanisms. In this paper, we consider the estimation of the mediation effect when the outcome is binary and multiple mediators of different types exist. We give a precise definition of the total mediation effect as well as decomposed mediation effects through individual or sets of mediators using the potential outcomes framework. We formulate a model of joint distribution (probit-normal) using continuous latent variables for any binary mediators to account for correlations among multiple mediators. A mediation formula approach is proposed to estimate the total mediation effect and decomposed mediation effects based on this parametric model. Estimation of mediation effects through individual or subsets of mediators requires an assumption involving the joint distribution of multiple counterfactuals. We conduct a simulation study that demonstrates low bias of mediation effect estimators for two-mediator models with various combinations of mediator types. The results also show that the power to detect a nonzero total mediation effect increases as the correlation coefficient between two mediators increases, whereas power for individual mediation effects reaches a maximum when the mediators are uncorrelated. We illustrate our approach by applying it to a retrospective cohort study of dental caries in adolescents with low and high socioeconomic status. Sensitivity analysis is performed to assess the robustness of conclusions regarding mediation effects when the assumption of no unmeasured mediator-outcome confounders is violated. Copyright © 2013 John Wiley & Sons, Ltd.

Quantifying Individual Brain Connectivity with Functional Principal Component Analysis for Networks.

PubMed

Petersen, Alexander; Zhao, Jianyang; Carmichael, Owen; Müller, Hans-Georg

2016-09-01

In typical functional connectivity studies, connections between voxels or regions in the brain are represented as edges in a network. Networks for different subjects are constructed at a given graph density and are summarized by some network measure such as path length. Examining these summary measures for many density values yields samples of connectivity curves, one for each individual. This has led to the adoption of basic tools of functional data analysis, most commonly to compare control and disease groups through the average curves in each group. Such group differences, however, neglect the variability in the sample of connectivity curves. In this article, the use of functional principal component analysis (FPCA) is demonstrated to enrich functional connectivity studies by providing increased power and flexibility for statistical inference. Specifically, individual connectivity curves are related to individual characteristics such as age and measures of cognitive function, thus providing a tool to relate brain connectivity with these variables at the individual level. This individual level analysis opens a new perspective that goes beyond previous group level comparisons. Using a large data set of resting-state functional magnetic resonance imaging scans, relationships between connectivity and two measures of cognitive function-episodic memory and executive function-were investigated. The group-based approach was implemented by dichotomizing the continuous cognitive variable and testing for group differences, resulting in no statistically significant findings. To demonstrate the new approach, FPCA was implemented, followed by linear regression models with cognitive scores as responses, identifying significant associations of connectivity in the right middle temporal region with both cognitive scores.

Myosurus

USDA-ARS?s Scientific Manuscript database

The genus Myosurus is treated for The Jepson Manual of the higher plants of California, a detailed floristic manual for the state published by the University of California. Four species are recognized; full morphological descriptions, dichotomous keys, and brief summaries of geographical and ecolog...

Ranunculus

USDA-ARS?s Scientific Manuscript database

The genus Ranunculus is treated for The Jepson Manual of the higher plants of California, a detailed floristic manual for the state published by the University of California. Thirty-one species are recognized; full morphological descriptions, dichotomous keys, and brief summaries of geographical an...

Ranunculaceae

USDA-ARS?s Scientific Manuscript database

The family Ranunculaceae is treated for The Flora of New Mexico, a floristic manual covering the state of New Mexico. Sixty species in fifteen genera are known from the state; full morphological descriptions, dichotomous keys, and brief summaries of geographical and ecological distribution, economic...

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.

An introduction to analyzing dichotomous outcomes in a longitudinal setting: a NIDRR traumatic brain injury model systems communication.

PubMed

Pretz, Christopher R; Ketchum, Jessica M; Cuthbert, Jeffery P

2014-01-01

An untapped wealth of temporal information is captured within the Traumatic Brain Injury Model Systems National Database. Utilization of appropriate longitudinal analyses can provide an avenue toward unlocking the value of this information. This article highlights 2 statistical methods used for assessing change over time when examination of noncontinuous outcomes is of interest where this article focuses on investigation of dichotomous responses. Specifically, the intent of this article is to familiarize the rehabilitation community with the application of generalized estimating equations and generalized linear mixed models as used in longitudinal studies. An introduction to each method is provided where similarities and differences between the 2 are discussed. In addition, to reinforce the ideas and concepts embodied in each approach, we highlight each method, using examples based on data from the Rocky Mountain Regional Brain Injury System.

No-signaling, perfect bipartite dichotomic correlations and local randomness

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

Seevinck, M. P.

2011-03-28

The no-signaling constraint on bi-partite correlations is reviewed. It is shown that in order to obtain non-trivial Bell-type inequalities that discern no-signaling correlations from more general ones, one must go beyond considering expectation values of products of observables only. A new set of nontrivial no-signaling inequalities is derived which have a remarkably close resemblance to the CHSH inequality, yet are fundamentally different. A set of inequalities by Roy and Singh and Avis et al., which is claimed to be useful for discerning no-signaling correlations, is shown to be trivially satisfied by any correlation whatsoever. Finally, using the set of newlymore » derived no-signaling inequalities a result with potential cryptographic consequences is proven: if different parties use identical devices, then, once they have perfect correlations at spacelike separation between dichotomic observables, they know that because of no-signaling the local marginals cannot but be completely random.« less

The niche party concept and its measurement

PubMed Central

Miller, Bernhard

2015-01-01

The concept of the niche party has become increasingly popular in analyses of party competition. Yet, existing approaches vary in their definitions and their measurement approaches. We propose using a minimal definition that allows us to compare political parties in terms of their ‘nicheness’. We argue that the conceptual core of the niche party concept is based on issue emphasis and that a niche party emphasizes policy areas neglected by its rivals. Based on this definition, we propose a continuous measure that allows for more fine-grained measurement of a party’s ‘nicheness’ than the dominant, dichotomous approaches and thereby limits the risk of measurement error. Drawing on data collected by the Comparative Manifesto Project, we show that (1) our measure has high face validity and (2) exposes differences among parties that are not captured by alternative, static or dichotomous measures. PMID:28066152

Variation in Treatment Recommendations for Dupuytren Disease.

PubMed

McMillan, Catherine; Yeung, Celine; Binhammer, Paul

2017-12-01

To examine agreement on Dupuytren disease (DD) treatment recommendations in an international sample of hand surgeons. A survey was developed to determine expertise in needle aponeurotomy, surgery, and collagenase injection to treat DD and to examine treatment recommendations for 16 case scenarios. Case scenarios were predeveloped using expert input. Each case represented a unique combination of 4 dichotomous variables including cord thickness, contracture severity, patient age, and joint involvement. Interrater reliability statistics were calculated and multinomial logistic regression modeling and analysis of variance were used to examine the impact of surgeon- and case-related variables on treatment recommendations. A total of 36 hand surgeons from 9 countries (mean experience, 17 years) participated. Average pairwise percent agreement and Krippendorff's alpha were 26% and .012, respectively. Predictors of a recommendation for surgery over multiple options were a total contracture of greater than 70°, a thick precentral cord, involvement of the metacarpophalangeal and proximal interphalangeal joints, and greater years in practice. A greater number of years in practice predicted recommendation for collagenase injection and the presence of a thick precentral cord predicted a recommendation for needle aponeurotomy. Little agreement exists on treatment recommendations for common presentations of DD in this sample. Further investigation into the sources of potential widespread discrepancies in the management of DD may improve the capacity to make evidence-based recommendations. Copyright © 2017 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

A meta-analysis of robotic-assisted pancreatectomy versus laparoscopic and open pancreatectomy.

PubMed

Chen, Yigang; Yan, Jun; Yuan, Ziming; Yu, Song; Wang, Zhigang; Zheng, Qi

2013-12-01

To perform a meta-analysis of eligible studies from multiple medical centers to assess the safety, feasibility, and efficacy of robotic-assisted pancreatectomy (RP). We searched the electronic databases PubMed and EMBASE for studies comparing RP with laparoscopic pancreatectomy (LP) and open pancreatectomy (OP) for patients with pancreatic disease from June 2009 to June 2012. Continuous variables were pooled using the standardized mean difference (SMD) and odds ratio (OR), and dichotomous variables were pooled using the risk difference (RD) method. For all analyses, the 95% confidence interval (CI) was calculated. Three studies comparing RP and LP, and 4 studies comparing RP and OP were suitable for meta-analysis. Six published studies met the inclusion criteria. Our results showed that RP can reduce estimated blood loss and duration of hospitalization more than OP. For pancreatic fistula, there were no statistical differences between RP, OP, and LP, and no significant differences in intraoperative conversion rates between RP and LP. Robotic-assisted pancreatectomy may be able to increase microscopic negative margins of resection (R0) and spleen preserving rates. Robotic-assisted pancreatectomy was associated with increased R0 resection rates and spleen preserving rates than LP and OP. Moreover, RP can reduce estimated blood loss and duration of hospitalization more than OP. A robotic approach to pancreatectomy may be suited to patients with pancreatic disease.

Factors Associated with Blunt Cerebrovascular Injury in Patients with Cervical Spine Injury

PubMed Central

NAKAJIMA, Hiroyuki; NEMOTO, Manabu; TORIO, Tetsuya; TAKEDA, Ririko; OOIGAWA, Hidetoshi; ARAKI, Ryuichiro; KURITA, Hiroki

2014-01-01

Blunt cerebrovascular injury (BCVI) is known to be a potentially fatal complication of cervical spine injury (CSI). Methods for screening the appropriate population remain to be elucidated, especially in Japan. This retrospective study was conducted to predict the risk factors relevant to BCVIs. Among 92 patients with CSI transferred to our institution from April 2007 to March 2012, 40 patients (35 men, 5 women) with neurological deficits and/or significant cervical spine fracture including fracture of transversarium, facet, body, lamina, and spinous process, underwent multi-detector computed tomography angiography (MDCTA) and magnetic resonance angiography (MRA), which identified 10 patients with BCVI [2 carotid artery injuries (BCAIs) and 9 vertebral artery injuries (BVAIs); 1 patient suffered both]. Univariate analyses exploring associations between individual risk factors and BCVI and BVAI were performed using Fisher's exact test and Chi-square test for dichotomous variables and the unpaired t-test for continuous variables. Multiple logistic regression analyses for BCVI and BVAI were carried out using stepwise methods. On univariate and multivariate analysis, hyperextension injury was significantly associated with BVAI (p = 0.01 and p = 0.02), and subluxation (dislocation of vertebral body > 5 mm) was a significant predictor of BCVI (p = 0.04 and p = 0.03) and BVAI (p = 0.01 and p = 0.01). Prompt evaluation for BCVIs is recommended in CSI patients with hyperextension injury and dislocation of the vertebral body. PMID:24390186

Measuring and communicating meaningful outcomes in neonatology: A family perspective.

PubMed

Janvier, Annie; Farlow, Barbara; Baardsnes, Jason; Pearce, Rebecca; Barrington, Keith J

2016-12-01

Medium- and long-term outcomes have been collected and described among survivors of neonatal intensive care units for decades, for a number of purposes: (1) quality control within units, (2) comparisons of outcomes between NICUs, (3) clinical trials (whether an intervention improves outcomes), (4) end-of-life decision-making, (5) to better understand the effects of neonatal conditions and/or interventions on organs and/or long-term health, and finally (6) to better prepare parents for the future. However, the outcomes evaluated have been selected by investigators, based on feasibility, availability, cost, stability, and on what investigators consider to be important. Many of the routinely measured outcomes have major limitations: they may not correlate well with long-term difficulties, they may artificially divide continuous outcomes into dichotomous ones, and may have no clear relationship with quality of life and functioning of children and their families. Several investigations, such as routine term cerebral resonance imaging for preterm infants, have also not yet been shown to improve the outcome of children nor their families. In this article, the most common variables used in neonatology as well as some variables which are rarely measured but may be of equal importance for families are presented. The manner in which these outcomes are communicated to families will be examined, as well as recommendations to optimize communication with parents. Copyright © 2016 Elsevier Inc. All rights reserved.

Genotypic variability-based genome-wide association study identifies non-additive loci HLA-C and IL12B for psoriasis.

PubMed

Wei, Wen-Hua; Massey, Jonathan; Worthington, Jane; Barton, Anne; Warren, Richard B

2018-03-01

Genome-wide association studies (GWASs) have identified a number of loci for psoriasis but largely ignored non-additive effects. We report a genotypic variability-based GWAS (vGWAS) that can prioritize non-additive loci without requiring prior knowledge of interaction types or interacting factors in two steps, using a mixed model to partition dichotomous phenotypes into an additive component and non-additive environmental residuals on the liability scale and then the Levene's (Brown-Forsythe) test to assess equality of the residual variances across genotype groups genome widely. The vGWAS identified two genome-wide significant (P < 5.0e-08) non-additive loci HLA-C and IL12B that were also genome-wide significant in an accompanying GWAS in the discovery cohort. Both loci were statistically replicated in vGWAS of an independent cohort with a small sample size. HLA-C and IL12B were reported in moderate gene-gene and/or gene-environment interactions in several occasions. We found a moderate interaction with age-of-onset of psoriasis, which was replicated indirectly. The vGWAS also revealed five suggestive loci (P < 6.76e-05) including FUT2 that was associated with psoriasis with environmental aspects triggered by virus infection and/or metabolic factors. Replication and functional investigation are needed to validate the suggestive vGWAS loci.

Risk factors for indications of intraoperative blood transfusion among patients undergoing surgical treatment for colorectal adenocarcinoma.

PubMed

Gonçalves, Iara; Linhares, Marcelo; Bordin, Jose; Matos, Delcio

2009-01-01

Identification of risk factors for requiring transfusions during surgery for colorectal cancer may lead to preventive actions or alternative measures, towards decreasing the use of blood components in these procedures, and also rationalization of resources use in hemotherapy services. This was a retrospective case-control study using data from 383 patients who were treated surgically for colorectal adenocarcinoma at 'Fundação Pio XII', in Barretos-SP, Brazil, between 1999 and 2003. To recognize significant risk factors for requiring intraoperative blood transfusion in colorectal cancer surgical procedures. Univariate analyses were performed using Fisher's exact test or the chi-squared test for dichotomous variables and Student's t test for continuous variables, followed by multivariate analysis using multiple logistic regression. In the univariate analyses, height (P = 0.06), glycemia (P = 0.05), previous abdominal or pelvic surgery (P = 0.031), abdominoperineal surgery (P<0.001), extended surgery (P<0.001) and intervention with radical intent (P<0.001) were considered significant. In the multivariate analysis using logistic regression, intervention with radical intent (OR = 10.249, P<0.001, 95% CI = 3.071-34.212) and abdominoperineal amputation (OR = 3.096, P = 0.04, 95% CI = 1.445-6.623) were considered to be independently significant. This investigation allows the conclusion that radical intervention and the abdominoperineal procedure in the surgical treatment of colorectal adenocarcinoma are risk factors for requiring intraoperative blood transfusion.

Risk is not our business: safety of thoracic surgery in patients using antiplatelet therapy.

PubMed

Bertolaccini, Luca; Terzi, Alberto; Rizzardi, Giovanna; Gorla, Alberto; Viti, Andrea; Palmisano, Sarah; Coletta, Giuseppe

2012-02-01

American Heart Association recommendations have changed preoperative management of patients with antiplatelet therapy (APT). We assessed safety and outcomes of surgery in patients who were receiving APT. A prospective study of patients operated on while receiving APT was matched with those with no APT (ratio 1:4), using the propensity score method. Logistic regression analysis was used to identify covariates among imbalanced baseline patient variables. Both χ(2) test and Fisher's test were used to calculate the probability value for the comparison of dichotomous variables. Between January 2008 and December 2010, 38 patients who received APT at the time of surgery were matched with 141 patients who had not received APT. APT indications were a history of myocardial infarction, coronary artery by-pass graft and/or valve replacement (19), coronary artery stent (11) and severe peripheral vascular disease (8). None of the patients required re-operation for bleeding. Two patients received blood transfusions. The amount of chest tube drainage was not statistically significantly different. There were no statistically significant differences between the outcomes for the operative time, length of hospital stay, estimated blood loss or morbidity. The results show that thoracic surgical procedures can safely be performed in patients receiving APT at the time of surgery, with no increased risk of bleeding or morbidity and no differences in the operative time and the length of hospital stay.

Damage control of civilian penetrating brain injuries in environments of low neuro-monitoring resources.

PubMed

Charry, José D; Rubiano, Andrés M; Puyana, Juan C; Carney, Nancy; David Adelson, P

2016-01-01

Gunshot wounds to the head are more common in military settings. Recently, a damage control (DC) approach for the management of these lesions has been used in combat areas. The aim of this study was to evaluate the results of civilian patients with penetrating gunshot wounds to the head, managed with a strategy of early cranial decompression (ECD) as a DC procedure in a university hospital with few resources for intensive care unit (ICU) neuro-monitoring in Colombia. Fifty-four patients were operated according to the DC strategy (<12 h after injury), over a 4-year period. Variables were analysed and results were evaluated according to the Glasgow Outcome Scale (GOS) at 12 months post injury; a dichotomous variable was established as 'favourable' (GOS 4-5) or 'unfavourable' (GOS 1-3). A univariate analysis was performed using a χ(2) test. Forty (74.1%) of the patients survived and 36 (90%) of them had favourable GOS. Factors associated with adverse outcomes were: Injury Severity Score (ISS) greater than 25, bi-hemispheric involvement, intra-cerebral haematoma on the first CT, closed basal cisterns and non-reactive pupils in the emergency room. DC for neurotrauma with ECD is an option to improve survival and favourable neurological outcomes 12 months after injury in patients with penetrating traumatic brain injury treated in a university hospital with few resources for ICU neuro-monitoring.

PILATES (Physical Activity and Diet Survey): An Italian Self-Administered Questionnaire Evaluating Diet Habits of Gym-Goers. Validation Process.

PubMed

Gianfredi, Vincenza; Nucci, Daniele; Ceccarelli, Francesco; Villarini, Milena; Moretti, Massimo

2018-04-19

PILATES study aims are to assess the main characteristics related to food habits, diet behaviors, and nutrition knowledge and how and where gym-goers get information on dietary supplementation. We present evidence for the reliability, feasibility, and construct validity of the PILATES questionnaire. Cohen's kappa statistic (k) for dichotomous variables was used to assess the agreement between the two administrations (interrater agreement). The nutrient composition and energy of food were derived from the Food Composition Database for Epidemiological Studies in Italy (Banca Dati di Composizione degli Alimenti per Studi Epidemiologici in Italia - BDA). Because of energy intake, waist circumference and weight are continuous variables; we calculate the agreement between the two interviews using Spearman's rho coefficient (nonparametric measure of rank correlation). An Italian 21-item self-administered questionnaire was designed and pretested on 28 students in food science and human nutrition at the University of Perugia who were enrolled on a voluntary basis. After verifying the feasibility of the questionnaire, pretest evaluation showed a generally high concordance with an 87.32% of agreement and k value = 0.71 ± 0.23. In addition, weight, daily energy intake, and waist circumference confirmed a statistically significant agreement (p <.001, Spearman rho coefficient). PILATES questionnaire is a valid tool to estimate dietary intakes in a fairly simple, cost-effective, and timesaving manner.

A proposal of the diagnosis-dynamic characteristic (DDC) model describing the relation between search time and confidence levels for a dichotomous judgment, and its application to ROC curve generation

NASA Astrophysics Data System (ADS)

Matsumoto, Toru; Fukuda, Nobuo; Furukawa, Akira; Suwa, Koji; Wada, Shinichi; Matsumoto, Mitsuomi; Sone, Shusuke

2006-03-01

When physicians inspect an image, they make up a certain degree of confidence that the image are abnormal; p(t), or normal; n(t)[n(t)=1-p(t)]. After infinite time of the inspection, they reach the equilibrium levels of the confidence of p*=p(∞) and n*=n(∞). There are psychological conflicts between the decisions of normal and abnormal. We assume that the decision of "normal" is distracted by the decision of "abnormal" by a factor of k(1 + ap), and in an inverse direction by a factor of k(1 + bn), where k ( > 0) is a parameter that relates with image quality and skill of the physicians, and a and b are unknown constants. After the infinite time of inspection, the conflict reaches the equilibrium, which satisfies the equation, k(1 + ap*)n* = k(1 + bn*)p*. Here we define a parameter C, which is 2p*/[p*(1 - p*)]. After the infinite time of inspection, the conflict reaches the equilibrium, which satisfies t that changes in the confidence level with the time (dp/dt) is proportional to [k(1+ap)n - k(1+bn)p], i.e. k[-cp2 + (c - 2)p + 1]. Solving the differential equation, we derived the equation; t(p) and p(t) depending with the parameters; k, c, S. S (0-1) is the value arbitrary selected and related with probability of "abnormal" before the image inspection (S = p(0)). Image reading studies were executed for CT images. ROC curves were generated both by the traditional 4-step score-based method and by the confidence level; p estimated from the equation t(p) of the DDC model using observed judgment time. It was concluded that ROC curves could be generated by measuring time for dichotomous judgment without the subjective scores of diagnostic confidence and applying the DDC model.

Migration plans of the rural populations of the Third World countries: a probit analysis of micro-level data from Asia, Africa, and Latin America.

PubMed

Mcdevitt, T M; Hawley, A H; Udry, J R; Gadalla, S; Leoprapai, B; Cardona, R

1986-07-01

This study 1) examines the extent to which a given set of microlevel factors has predictive value in different socioeconomic settings and 2) demonstrates the utility of a probit estimation technique in examining plans of rural populations to migrate. Data were collected in 1977-1979 in Thailand, Egypt, and Colombia, 3 countries which differ in culture, extent of urbanization, and proportion of labor force engaged in nonextractive industries. The researchers used identical questionnaires and obtained interviews in 4 rural villages with the "migration shed" of each country's capital city. There were 1088 rural-resident men and women interviewed in Thailand, 1088 in Colombia, and 1376 in Egypt. The researchers gathered information about year-to-year changes in residence, marital status, fertility, housing, employment status, occupation, and industry. While in all 3 countries return moves are relatively frequent, especially among males, the proportions of migrants who have moved 3 or more times do not rise above 10%. The model used portrays the formation of migration intentions of the individual as the outcome of a decision process involving the subjective weighing of perceived differentials in well-being associated with current residence and 1 or more potential destinations, taking into account the direct relocation costs and ability to finance a move. The researchers used dichotomous probit and ordinal probit techniques and 4 variations on the dependant variable to generate some of the results. The only expectancy variable significant in all countries is age. Education is also positively and significantly associated with intentions to move for both sexes in Colombia and Egypt. Marital status is a deterrent to migration plans for males in Colombia and both sexes in Egypt. Previous migration experience fails to show any significant relationship to propensity to move. Conclusions drawn from the data include: 1) the effects of age and economic status appear to increase, both in strength and significance, for males in countries as the likelihood of a move increases; and 2) the effect of the kin and friend contract variable in Colombia appears to be related to its usefulness in explaining th initial consideration of a move rather than the plans that carry a probability or certainty of implementation. The careful measurement of strength of migration intentions and the application of ordinal probit estimation methods to the analysis of prospective migration may contribute to the refinement of our understanding of the process of migration decision making across a range of geographical, cultural, and developmental contexts.

Agreement between core laboratory and study investigators for imaging scores in a thrombectomy trial.

PubMed

Fahed, Robert; Ben Maacha, Malek; Ducroux, Célina; Khoury, Naim; Blanc, Raphaël; Piotin, Michel; Lapergue, Bertrand

2018-05-14

We aimed to assess the agreement between study investigators and the core laboratory (core lab) of a thrombectomy trial for imaging scores. The Alberta Stroke Program Early CT Score (ASPECTS), the European Collaborative Acute Stroke Study (ECASS) hemorrhagic transformation (HT) classification, and the Thrombolysis In Cerebral Infarction (TICI) scores as recorded by study investigators were compared with the core lab scores in order to assess interrater agreement, using Cohen's unweighted and weighted kappa statistics. There were frequent discrepancies between study sites and core lab for all the scores. Agreement for ASPECTS and ECASS HT classification was less than substantial, with disagreement occurring in more than one-third of cases. Agreement was higher on MRI-based scores than on CT, and was improved after dichotomization on both CT and MRI. Agreement for TICI scores was moderate (with disagreement occurring in more than 25% of patients), and went above the substantial level (less than 10% disagreement) after dichotomization (TICI 0/1/2a vs 2b/3). Discrepancies between scores assessed by the imaging core lab and those reported by study sites occurred in a significant proportion of patients. Disagreement in the assessment of ASPECTS and day 1 HT scores was more frequent on CT than on MRI. The agreement for the dichotomized TICI score (the trial's primary outcome) was substantial, with less than 10% of disagreement between study sites and core lab. NCT02523261, Post-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Is there a relationship between periodontal disease and causes of death? A cross sectional study.

PubMed

Natto, Zuhair S; Aladmawy, Majdi; Alasqah, Mohammed; Papas, Athena

2015-01-01

The aim of this study was to evaluate whether there is any correlation between periodontal disease and mortality contributing factors, such as cardiovascular disease and diabetes mellitus in the elderly population. A dental evaluation was performed by a single examiner at Tufts University dental clinics for 284 patients. Periodontal assessments were performed by probing with a manual UNC-15 periodontal probe to measure pocket depth and clinical attachment level (CAL) at 6 sites. Causes of death abstracted from death certificate. Statistical analysis involved ANOVA, chi-square and multivariate logistic regression analysis. The demographics of the population sample indicated that, most were females (except for diabetes mellitus), white, married, completed 13 years of education and were 83 years old on average. CAL (continuous or dichotomous) and marital status attained statistical significance (p<0.05) in contingency table analysis (Chi-square for independence). Individuals with increased CAL were 2.16 times more likely (OR=2.16, 95% CI=1.47-3.17) to die due to CVD and this effect persisted even after control for age, marital status, gender, race, years of education (OR=2.03, 95% CI=1.35-3.03). CAL (continuous or dichotomous) was much higher among those who died due to diabetes mellitus or out of state of Massachusetts. However, these results were not statistically significant. The same pattern was observed with pocket depth (continuous or dichotomous), but these results were not statistically significant either. CAL seems to be more sensitive to chronic diseases than pocket depth. Among those conditions, cardiovascular disease has the strongest effect.

Anatomical study of the articular branches innervated the hip and knee joint with reference to mechanism of referral pain in hip joint disease patients.

PubMed

Sakamoto, Junya; Manabe, Yoshitaka; Oyamada, Joichi; Kataoka, Hideki; Nakano, Jiro; Saiki, Kazunobu; Okamoto, Keishi; Tsurumoto, Toshiyuki; Okita, Minoru

2018-07-01

Referred pain in the anterior knee joint is the most common symptom in hip disease patients. The development of referred pain is considered to be related to dichotomizing peripheral sensory fibers. However, no gross anatomical findings identify any dichotomizing fibers innervating both the hip and knee joints. We dissected the femoral and obturator nerves in human cadavers to investigate the distribution of the articular branches in the hip and knee joints. Fourteen embalmed left lower limbs from 14 Japanese adult cadavers (five from females, nine from males, average age 73.8 ± 14.1 years) were observed macroscopically. The articular branches of the femoral and obturator nerves were dissected at the anterior margin of the groin toward the thigh region. After dissections of the articular nerves of the hip joints, the femoral and obturator nerves were exposed from proximally to distally to identify the articular nerves of the knee joints. The branching pattern of the articular branches in the hip and knee joints was recorded. In six of 14 limbs (42.9%), the femoral nerve supplied articular branches to the anteromedial aspect of both the hip and knee joints. These articular branches were derived from the same bundle of femoral nerve. These gross anatomical findings suggested that dichotomizing peripheral sensory fibers innervate the hip and knee joints and these could relate to the referred pain confirmed in the anterior knee joints of patients with hip disease. Clin. Anat. 31:705-709, 2018. © 2018 Wiley Periodicals, Inc. © 2018 Wiley Periodicals, Inc.

Key to the recognition of normapolles and some morphologically similar pollen genera

USGS Publications Warehouse

Batten, D.J.; Christopher, R.A.

1981-01-01

A dichotomous key to the recognition of 86 Normapolles and morphologically similar pollen genera is presented. The key is accompanied by line drawings of each genus and an illustrated glossary of descriptive terms. ?? 1981.

Ulmaceae

USDA-ARS?s Scientific Manuscript database

The family Ulmaceae is treated for The Jepson Manual of the higher plants of California, a detailed floristic manual for the state published by the University of California. One genus and four species are recognized; full morphological descriptions, dichotomous keys, and brief summaries of geograph...

The Model Averaging for Dichotomous Response Benchmark Dose (MADr-BMD) Tool

EPA Pesticide Factsheets

Providing quantal response models, which are also used in the U.S. EPA benchmark dose software suite, and generates a model-averaged dose response model to generate benchmark dose and benchmark dose lower bound estimates.

A comparison of three models for determining test fairness.

DOT National Transportation Integrated Search

1979-01-01

There are three prominent models of test fairness in the dichotomous situation: : (a) Thorndike's Constant Ratio model (the ratio of the proportion successful to the proportion selected should be equal for the majority and the minority group); : (b) ...

Methods for Evaluating Mammography Imaging Techniques

DTIC Science & Technology

2000-06-01

independent of disease prevalence . When test outcomes are dichotomous, sensitivity and specificity measure test accuracy. Sensitivity is the...phers were not provided with the disease prevalence in the The model we use accounts for within mammographer test set. Mammographers provided one

Use of the oral sugar test in ponies when performed with or without prior fasting.

PubMed

Knowles, E J; Harris, P A; Elliott, J; Menzies-Gow, N J

2017-07-01

It is recommended that the oral sugar test (OST) for insulin dysregulation (ID) be performed after an overnight fast, but fasting is impractical in ponies kept solely at pasture. There are few data on OST repeatability and reliability in ponies. To report 1) whether OST results obtained in the morning after an overnight fast or without fasting in the afternoon (FASTING/FED) can be used interchangeably, 2) time of highest insulin concentration T max [insulin], repeatability and reliability of insulin response to the OST when FASTING or FED and 3) dichotomous agreement (ID/normal) within a small sample when FASTING or FED. Method comparison study. Oral sugar tests were performed on four occasions in 10 adult native British ponies, twice FASTING and twice FED. Insulin concentrations were measured by radioimmunoassay at 0-120 min (T 0,30,60,75,90,120 ). Differences between FASTING and FED results were assessed using mixed effects models. Indices of repeatability and reliability were calculated; dichotomous agreement was reported using kappa statistics. Serum [insulin] was significantly (P≤0.05) higher at T 60 -T 90 with prior fasting (estimated differences [95% confidence intervals]): T 60 : 23.5 μiu/ml (8.7-38.4 μiu/ml), T 75 : 27.1 μiu/ml (12.3-41.8 μiu/ml), T 90 : 15.1 (0.36-29.9 μiu/ml). Most frequently, T max [ins] occurred at T 30 . At any single time point, within-subject coefficients of variation were: FASTING: 40% and FED: 31%. The 95% limits for repeatability were FASTING: 29-340%, FED: 41-240%. Test reliabilities were FASTING: 0.70 and FED: 0.67. For dichotomous interpretation similar results (kappa = 0.7) were obtained using cut-offs of [Insulin] >60 μiu/ml at T 60 or T 90 for FASTING and [Insulin] >51 μiu/ml at T 30 or T 60 for FED samples. Oral sugar tests were performed on a small number of animals on one pasture during one season (spring). Clinicians should beware of interpreting changes in absolute OST results owing to poor repeatability. When stabling is unavailable, OSTs of ponies at pasture may yield similar dichotomous results without prior fasting. © 2016 EVJ Ltd.

[Correlation coefficient-based classification method of hydrological dependence variability: With auto-regression model as example].

PubMed

Zhao, Yu Xi; Xie, Ping; Sang, Yan Fang; Wu, Zi Yi

2018-04-01

Hydrological process evaluation is temporal dependent. Hydrological time series including dependence components do not meet the data consistency assumption for hydrological computation. Both of those factors cause great difficulty for water researches. Given the existence of hydrological dependence variability, we proposed a correlationcoefficient-based method for significance evaluation of hydrological dependence based on auto-regression model. By calculating the correlation coefficient between the original series and its dependence component and selecting reasonable thresholds of correlation coefficient, this method divided significance degree of dependence into no variability, weak variability, mid variability, strong variability, and drastic variability. By deducing the relationship between correlation coefficient and auto-correlation coefficient in each order of series, we found that the correlation coefficient was mainly determined by the magnitude of auto-correlation coefficient from the 1 order to p order, which clarified the theoretical basis of this method. With the first-order and second-order auto-regression models as examples, the reasonability of the deduced formula was verified through Monte-Carlo experiments to classify the relationship between correlation coefficient and auto-correlation coefficient. This method was used to analyze three observed hydrological time series. The results indicated the coexistence of stochastic and dependence characteristics in hydrological process.

Are your covariates under control? How normalization can re-introduce covariate effects.

PubMed

Pain, Oliver; Dudbridge, Frank; Ronald, Angelica

2018-04-30

Many statistical tests rely on the assumption that the residuals of a model are normally distributed. Rank-based inverse normal transformation (INT) of the dependent variable is one of the most popular approaches to satisfy the normality assumption. When covariates are included in the analysis, a common approach is to first adjust for the covariates and then normalize the residuals. This study investigated the effect of regressing covariates against the dependent variable and then applying rank-based INT to the residuals. The correlation between the dependent variable and covariates at each stage of processing was assessed. An alternative approach was tested in which rank-based INT was applied to the dependent variable before regressing covariates. Analyses based on both simulated and real data examples demonstrated that applying rank-based INT to the dependent variable residuals after regressing out covariates re-introduces a linear correlation between the dependent variable and covariates, increasing type-I errors and reducing power. On the other hand, when rank-based INT was applied prior to controlling for covariate effects, residuals were normally distributed and linearly uncorrelated with covariates. This latter approach is therefore recommended in situations were normality of the dependent variable is required.

Ulmaceae for Flora of Missouri

USDA-ARS?s Scientific Manuscript database

The family Ulmaceae is treated for the Flora of Missouri, a detailed floristic manual for the state published by the Missouri (State) Department of Conservation. Three genera and 11 species are recognized; full morphological descriptions, dichotomous keys, and brief summaries of geographical and ec...

Sapindaceae and Acer

USDA-ARS?s Scientific Manuscript database

The genus Acer (maples) is treated for The Jepson Manual of the higher plants of California, a detailed floristic manual for the state published by the University of California. Six species are recognized; full morphological descriptions, dichotomous keys, and brief summaries of geographical and ec...

Revision of the Oberthuerellinae (Cynipoidea: Liopteridae)

USDA-ARS?s Scientific Manuscript database

The Afrotropical endemic Oberthuerellinae is revised, and new dichotomous and multi-entry keys to the species of Oberthuerella, Tessmannella, and Xenocynips are provided. All previously described species in these genera are redescribed; descriptions are augmented by color images of each species' ho...

Science Notes.

ERIC Educational Resources Information Center

School Science Review, 1986

1986-01-01

Describes activities, games, experiments, demonstrations, and computer-oriented exercises in all science areas. Topics include energy flow through a marine ecosystem, using 2,4-dichlorophenoxyethanoic acid to demonstrate translocation in plants, use of the dichotomous key, use of leaf yeasts to monitor atmospheric pollution, and others. (JN)

Maintaining Cultural Coherence in the Midst of Cultural Diversity.

ERIC Educational Resources Information Center

Raeff, Catherine

1997-01-01

Clarifies a reconceptualization of constructs of individualism, collectivism, independence, and interdependence which represents a departure from traditional conceptualization and a move away from understanding these constructs in dichotomous, stereotypical, and unidimensional terms. Discusses implications of this perspective for stereotyping…

Optimization of a GO2/GH2 Swirl Coaxial Injector Element

NASA Technical Reports Server (NTRS)

Tucker, P. Kevin; Shyy, Wei; Vaidyanathan, Rajkumar

1999-01-01

An injector optimization methodology, method i, is used to investigate optimal design points for a gaseous oxygen/gaseous hydrogen (GO2/GH2) swirl coaxial injector element. The element is optimized in terms of design variables such as fuel pressure drop, DELTA P(sub f), oxidizer pressure drop, DELTA P(sub 0) combustor length, L(sub comb), and full cone swirl angle, theta, for a given mixture ratio and chamber pressure. Dependent variables such as energy release efficiency, ERE, wall heat flux, Q(sub w) injector heat flux, Q(sub inj), relative combustor weight, W(sub rel), and relative injector cost, C(sub rel), are calculated and then correlated with the design variables. An empirical design methodology is used to generate these responses for 180 combinations of input variables. Method i is then used to generate response surfaces for each dependent variable. Desirability functions based on dependent variable constraints are created and used to facilitate development of composite response surfaces representing some, or all, of the five dependent variables in terms of the input variables. Two examples illustrating the utility and flexibility of method i are discussed in detail. First, joint response surfaces are constructed by sequentially adding dependent variables. Optimum designs are identified after addition of each variable and the effect each variable has on the design is shown. This stepwise demonstration also highlights the importance of including variables such as weight and cost early in the design process. Secondly, using the composite response surface that includes all five dependent variables, unequal weights are assigned to emphasize certain variables relative to others. Here, method i is used to enable objective trade studies on design issues such as component life and thrust to weight ratio.

Mothers' maximum drinks ever consumed in 24 hours predicts mental health problems in adolescent offspring

PubMed Central

Malone, Stephen M.; McGue, Matt; Iacono, William G.

2009-01-01

Background The maximum number of alcoholic drinks consumed in a single 24-hr period is an alcoholism-related phenotype with both face and empirical validity. It has been associated with severity of withdrawal symptoms and sensitivity to alcoholism, genes implicated in alcohol metabolism, and amplitude of a measure of brain activity associated with externalizing disorders in general. In a previous study we found that the maximum number of drinks fathers had ever consumed in 24 hrs was associated with externalizing behaviors and disorders in preadolescent and adolescent children. The purpose of the present study was to determine whether maternal maximum consumption has similar correlates. Method We examined associations between maternal maximum consumption and alcohol dependence, respectively, and disruptive disorders and substance-related problems in two large independent population-based cohorts of 17-year-old adolescents. Results Maximum consumption was associated with conduct disorder, disruptive disorders in general, early substance use and misuse, and substance disorders in adolescent children regardless of sex. Associations were consistent across cohorts, providing internal replication. They also paralleled our previous findings regarding paternal status. They could not be explained by maternal alcohol dependence, effects of drinking during pregnancy, or paternal maximum consumption. They were not simple artifacts of the fact that maximum consumption is a continuous measure while alcohol dependence is dichotomous. Conclusions Despite deriving from a single question about lifetime behavior, parental maximum consumption appears to reflect vulnerability for mental health problems, especially substance-related ones, more directly than a diagnosis of alcohol dependence. PMID:20085606

Comparison of genetic and visual identification of cisco and lake whitefish larvae from Chaumont Bay, Lake Ontario

USGS Publications Warehouse

George, Ellen M.; Hare, Matthew P.; Crabtree, Darran L.; Lantry, Brian F.; Rudstam, Lars G.

2017-01-01

Cisco Coregonus artedi are an important component of native food webs in the Great Lakes, and their restoration is instrumental to the recovery of lake trout Salvelinus namaycush and Atlantic salmon Salmo salar. Difficulties with visual identification of larvae can confound early life history surveys, as cisco are often difficult to distinguish from lake whitefish C. clupeaformis. We compared traditional visual species identification methods to genetic identifications based on barcoding of the mitochondrial cytochrome C oxidase I gene for 726 coregonine larvae caught in Chaumont Bay, Lake Ontario. We found little agreement between the visual characteristics of cisco identified by genetic barcoding and the most widely used dichotomous key, and the considerable overlap in ranges of traditionally utilized metrics suggest that visual identification of coregonine larvae from Chaumont Bay is impractical. Coregonines are highly variable and plastic species, and often display wide variations in morphometric characteristics across their broad range. This study highlights the importance of developing accurate, geographically appropriate larval identification methods in order to best inform cisco restoration and management efforts.

Leisure-time physical inactivity among healthcare workers.

PubMed

Rocha, Saulo Vasconcelos; Barbosa, Aline Rodrigues; Araújo, Tania Maria

2018-01-15

To estimate the prevalence of leisure-time physical inactivity (LTPI) and associated factors among healthcare workers. The cross-sectional study carried out with 2684 healthcare workers from 4 municipalities from the northeast region, Brazil. The LTPI was assessed by dichotomous question. The association between LTPI and the various independent variables was examined through the multinomial logistic regression analysis (crude and adjusted). The prevalence of LTPI was 47.9% (95% confidence interval (CI): 46.01-48.80). The adjusted analysis (sociodemographic and occupational characteristics) showed that women and individuals with higher levels of education were more LTPI (p = 0.05). The prevalence of LTPI was high among the population investigated, especially among women and individuals with higher education. These results show the importance of developing actions to encourage adherence to physical activity during leisure time among workers, especially among the most vulnerable groups (people with higher education and women), given the benefits of this behavior to health. Int J Occup Med Environ Health 2018;31(3):251-260. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Socioemotional selectivity in older adults: Evidence from the subjective experience of angry memories.

PubMed

Uzer, Tugba; Gulgoz, Sami

2015-01-01

Few studies have compared the phenomenological properties of younger and older adults' memories for emotional events. Some studies suggest that younger adults remember negative information more vividly than positive information whereas other studies suggest that positive emotion yields phenomenologically richer memories than negative emotion for both younger and older adults. One problem with previous studies is a tendency to treat emotion as a dichotomous variable. In contrast, emotional richness demands inclusion of assessments beyond just a positive and negative dimension (e.g., assessing specific emotions like anger, fear and happiness). The present study investigated different properties of autobiographical remembering as a function of discrete emotions and age. Thirty-two younger and thirty-one older adults participated by recalling recent and remote memories associated with six emotional categories and completed the Memory Characteristics Questionnaire for each. Results demonstrated that older adults' angry memories received lower ratings on some phenomenological properties than other emotional memories whereas younger adults' angry memories did not show this same pattern. These results are discussed within the context of socioemotional selectivity theory.

Acro-osteolysis as an indicator of severity in systemic sclerosis.

PubMed

Arana-Ruiz, Juan Carlos; Amezcua-Guerra, Luis Manuel

2016-01-01

Systemic sclerosis is a rare disease that predominantly affects women. The Medsger severity scale has been used to assess the severity, but it requires expensive and poorly accessible studies and it does not include complications such acrosteolysis, calcinosis, pericardial disease or hypothyroidism that occur on a relatively frequent basis in this disease. There is no study that considers if comorbidities, such as primary biliary cirrhosis, are related to gravity. To determine the correlation between severity and the presence of such complications. 40 patients with systemic sclerosis, dividing them into tertiles according to severity were studied. Dichotomous variables were described using percentages, while dimensional by averages+SD. Statistical inference was performed using chi square test or Kruskal-Wallis test with Dunn post-test, as appropriate. A significance at P<.05 was set. Of all the complications studied there were only differences in severity with acrosteolysis. Within comorbidities, primary biliary cirrhosis is not associated with gravity. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

A fit-for-purpose approach to analytical sensitivity applied to a cardiac troponin assay: time to escape the 'highly-sensitive' trap.

PubMed

Ungerer, Jacobus P J; Pretorius, Carel J

2014-04-01

Highly-sensitive cardiac troponin (cTn) assays are being introduced into the market. In this study we argue that the classification of cTn assays into sensitive and highly-sensitive is flawed and recommend a more appropriate way to characterize analytical sensitivity of cTn assays. The raw data of 2252 cardiac troponin I (cTnI) tests done in duplicate with a 'sensitive' assay was extracted and used to calculate the cTnI levels in all, including those below the 'limit of detection' (LoD) that were censored. Duplicate results were used to determine analytical imprecision. We show that cTnI can be quantified in all samples including those with levels below the LoD and that the actual margins of error decrease as concentrations approach zero. The dichotomous classification of cTn assays into sensitive and highly-sensitive is theoretically flawed and characterizing analytical sensitivity as a continuous variable based on imprecision at 0 and the 99th percentile cut-off would be more appropriate.

Elemental composition of PM 10 and PM 2.5 in urban environment in South Brazil

NASA Astrophysics Data System (ADS)

Braga, C. F.; Teixeira, E. C.; Meira, L.; Wiegand, F.; Yoneama, M. L.; Dias, J. F.

The purpose of the present study is to analyze the elemental composition and the concentrations of PM 10 and PM 2.5 in the Guaíba Hydrographic Basin with HV PM 10 and dichotomous samplers. Three sampling sites were selected: 8° Distrito, CEASA and Charqueadas. The sampling was conducted from October 2001 to December 2002. The mass concentrations of the samplers were evaluated, while the elemental concentrations of Si, S, Cl, K, Ca, Ti, V, Cr, Mn, Fe, Ni, Cu and Zn were determined using the Particle-Induced X-ray Emission (PIXE) technique. Factor Analysis and Canonical Correlation Analysis were applied to the chemical and meteorological variables in order to identify the sources of particulate matter. Industrial activities such as steel plants, coal-fired power plants, hospital waste burning, vehicular emissions and soil were identified as the sources of the particulate matter. Concentration levels higher than the daily and the annual average air quality standards (150 and 50 μg m -3, respectively) set by the Brazilian legislation were not observed.

Sexual Risk-Taking in HIV-Negative Gay and Bisexual Men Increases with Depression: Results from a U.S. National Study

PubMed Central

Millar, Brett M.; Starks, Tyrel J.; Grov, Christian; Parsons, Jeffrey T.

2017-01-01

The link between depression and sexual risk-taking has received mixed findings in the literature. The current study analyzed the links between depression and recent condomless anal sex (CAS) with casual partners among 1033 HIV-negative, non-PrEP-using, gay and bisexual men. When CAS was dichotomized as either none or some, depression was not associated with the odds of CAS (with receptive and insertive combined) or insertive CAS only, but was positively associated with the odds of receptive CAS. When CAS was tallied as a count variable of events, depression was positively associated with total CAS, receptive CAS, and insertive CAS. With the addition of a quadratic term for depression, a positive quadratic effect was only found for total CAS and receptive CAS, but not for insertive CAS. These findings highlight the utility of using count data for CAS events and treating CAS separately with regard to receptive and insertive positioning when considering the role of depression among gay and bisexual men. PMID:27475943

The PEDA Model. An advocacy tool modeling the interrelationships between population, development, the environment and agriculture in Africa.

PubMed

1999-01-01

This article reports on the PEDA (population changes, environment, socioeconomic development and agriculture) model and its implication for policy-making in Africa. PEDA is an interactive computer simulation model (developed for a Windows environment) demonstrating the long-term impacts of alternative national policies on food security status of the population. The model is based on multistate demographic techniques, projecting at the same time 8 different subgroups (by age and sex) in the population, and based on 3 dichotomous individual characteristics: urban/rural place of residence; literacy status; and food security status. Through the manipulation of scenario variables, the model enables the user to project the proportion of the population that will be food secure and food insecure for a chosen point in time. This model developed by Dr. W. Lutz, Director of the International Institute for Applied Systems Analysis, will serve as an advocacy tool to help convince policy-makers and country experts in Africa of the negative synergy arising from the interconnections of population growth, environmental deterioration, and declining agricultural production.

Genome-wide physical activity interactions in adiposity ― A meta-analysis of 200,452 adults

PubMed Central

Feitosa, Mary F.; Barata, Llilda; Chu, Audrey Y.; Mahajan, Anubha; Hadley, David; Xue, Luting; Workalemahu, Tsegaselassie; den Hoed, Marcel; Ahluwalia, Tarunveer S.; Qi, Qibin; Ngwa, Julius S.; Quaye, Lydia; Eicher, John D.; Hayes, James E.; Cornelis, Marilyn; Kutalik, Zoltan; Lim, Elise; Luan, Jian’an; Huffman, Jennifer E.; Zhang, Weihua; Zhao, Wei; Griffin, Paula J.; Haller, Toomas; Ahmad, Shafqat; Marques-Vidal, Pedro M.; Bien, Stephanie; Yengo, Loic; Teumer, Alexander; Smith, Albert Vernon; Kumari, Meena; Harder, Marie Neergaard; Justesen, Johanne Marie; Kleber, Marcus E.; Hollensted, Mette; Lohman, Kurt; Rivera, Natalia V.; Whitfield, John B.; Zhao, Jing Hua; Stringham, Heather M.; Lyytikäinen, Leo-Pekka; Huppertz, Charlotte; Willemsen, Gonneke; Peyrot, Wouter J.; Wu, Ying; Kristiansson, Kati; Demirkan, Ayse; Fornage, Myriam; Hassinen, Maija; Bielak, Lawrence F.; Cadby, Gemma; Tanaka, Toshiko; Mägi, Reedik; van der Most, Peter J.; Jackson, Anne U.; Bragg-Gresham, Jennifer L.; Vitart, Veronique; Marten, Jonathan; Navarro, Pau; Bellis, Claire; Pasko, Dorota; Johansson, Åsa; Snitker, Søren; Cheng, Yu-Ching; Eriksson, Joel; Lim, Unhee; Aadahl, Mette; Adair, Linda S.; Amin, Najaf; Balkau, Beverley; Auvinen, Juha; Beilby, John; Bergman, Richard N.; Bergmann, Sven; Bertoni, Alain G.; Blangero, John; Bonnefond, Amélie; Bonnycastle, Lori L.; Borja, Judith B.; Brage, Søren; Busonero, Fabio; Buyske, Steve; Campbell, Harry; Chines, Peter S.; Collins, Francis S.; Corre, Tanguy; Smith, George Davey; Delgado, Graciela E.; Dueker, Nicole; Dörr, Marcus; Ebeling, Tapani; Eiriksdottir, Gudny; Esko, Tõnu; Faul, Jessica D.; Fu, Mao; Færch, Kristine; Gieger, Christian; Gläser, Sven; Gong, Jian; Gordon-Larsen, Penny; Grallert, Harald; Grammer, Tanja B.; Grarup, Niels; van Grootheest, Gerard; Harald, Kennet; Hastie, Nicholas D.; Havulinna, Aki S.; Hernandez, Dena; Hindorff, Lucia; Hocking, Lynne J.; Holmens, Oddgeir L.; Holzapfel, Christina; Hottenga, Jouke Jan; Huang, Jie; Huang, Tao; Hui, Jennie; Huth, Cornelia; Hutri-Kähönen, Nina; James, Alan L.; Jansson, John-Olov; Jhun, Min A.; Juonala, Markus; Kinnunen, Leena; Koistinen, Heikki A.; Kolcic, Ivana; Komulainen, Pirjo; Kuusisto, Johanna; Kvaløy, Kirsti; Kähönen, Mika; Lakka, Timo A.; Launer, Lenore J.; Lehne, Benjamin; Lindgren, Cecilia M.; Lorentzon, Mattias; Luben, Robert; Marre, Michel; Milaneschi, Yuri; Monda, Keri L.; Montgomery, Grant W.; De Moor, Marleen H. M.; Mulas, Antonella; Müller-Nurasyid, Martina; Musk, A. W.; Männikkö, Reija; Männistö, Satu; Narisu, Narisu; Nauck, Matthias; Nettleton, Jennifer A.; Nolte, Ilja M.; Oldehinkel, Albertine J.; Olden, Matthias; Ong, Ken K.; Padmanabhan, Sandosh; Paternoster, Lavinia; Perez, Jeremiah; Perola, Markus; Peters, Annette; Peters, Ulrike; Peyser, Patricia A.; Prokopenko, Inga; Puolijoki, Hannu; Raitakari, Olli T.; Rankinen, Tuomo; Rasmussen-Torvik, Laura J.; Rawal, Rajesh; Ridker, Paul M.; Rose, Lynda M.; Rudan, Igor; Sarti, Cinzia; Sarzynski, Mark A.; Savonen, Kai; Scott, William R.; Sanna, Serena; Shuldiner, Alan R.; Sidney, Steve; Silbernagel, Günther; Smith, Blair H.; Smith, Jennifer A.; Snieder, Harold; Stančáková, Alena; Sternfeld, Barbara; Swift, Amy J.; Tammelin, Tuija; Tan, Sian-Tsung; Thorand, Barbara; Thuillier, Dorothée; Vandenput, Liesbeth; Vestergaard, Henrik; van Vliet-Ostaptchouk, Jana V.; Vohl, Marie-Claude; Völker, Uwe; Waeber, Gérard; Walker, Mark; Wild, Sarah; Wong, Andrew; Wright, Alan F.; Zillikens, M. Carola; Zubair, Niha; Haiman, Christopher A.; Lemarchand, Loic; Gyllensten, Ulf; Ohlsson, Claes; Hofman, Albert; Rivadeneira, Fernando; Uitterlinden, André G.; Pérusse, Louis; Wilson, James F.; Hayward, Caroline; Polasek, Ozren; Cucca, Francesco; Hveem, Kristian; Hartman, Catharina A.; Tönjes, Anke; Bandinelli, Stefania; Palmer, Lyle J.; Kardia, Sharon L. R.; Rauramaa, Rainer; Sørensen, Thorkild I. A.; Tuomilehto, Jaakko; Salomaa, Veikko; Penninx, Brenda W. J. H.; de Geus, Eco J. C.; Boomsma, Dorret I.; Lehtimäki, Terho; Mangino, Massimo; Laakso, Markku; Bouchard, Claude; Martin, Nicholas G.; Kuh, Diana; Liu, Yongmei; Linneberg, Allan; März, Winfried; Strauch, Konstantin; Kivimäki, Mika; Harris, Tamara B.; Gudnason, Vilmundur; Völzke, Henry; Qi, Lu; Järvelin, Marjo-Riitta; Chambers, John C.; Kooner, Jaspal S.; Froguel, Philippe; Kooperberg, Charles; Vollenweider, Peter; Hallmans, Göran; Hansen, Torben; Pedersen, Oluf; Metspalu, Andres; Wareham, Nicholas J.; Langenberg, Claudia; Weir, David R.; Porteous, David J.; Boerwinkle, Eric; Chasman, Daniel I.; Abecasis, Gonçalo R.; McCarthy, Mark I.; Frayling, Timothy M.; O’Connell, Jeffrey R.; van Duijn, Cornelia M.; Boehnke, Michael; Heid, Iris M.; Mohlke, Karen L.; Fox, Caroline S.; Hirschhorn, Joel N.; Johnson, Andrew D.; Borecki, Ingrid B.; Franks, Paul W.; North, Kari E.; Cupples, L. Adrienne; Loos, Ruth J. F.; Kilpeläinen, Tuomas O.

2017-01-01

Physical activity (PA) may modify the genetic effects that give rise to increased risk of obesity. To identify adiposity loci whose effects are modified by PA, we performed genome-wide interaction meta-analyses of BMI and BMI-adjusted waist circumference and waist-hip ratio from up to 200,452 adults of European (n = 180,423) or other ancestry (n = 20,029). We standardized PA by categorizing it into a dichotomous variable where, on average, 23% of participants were categorized as inactive and 77% as physically active. While we replicate the interaction with PA for the strongest known obesity-risk locus in the FTO gene, of which the effect is attenuated by ~30% in physically active individuals compared to inactive individuals, we do not identify additional loci that are sensitive to PA. In additional genome-wide meta-analyses adjusting for PA and interaction with PA, we identify 11 novel adiposity loci, suggesting that accounting for PA or other environmental factors that contribute to variation in adiposity may facilitate gene discovery. PMID:28448500

Low Interrater Reliability in Grading of Rectal Bleeding Using National Cancer Institute Common Toxicity Criteria and Radiation Therapy Oncology Group Toxicity Scales: A Survey of Radiation Oncologists

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

Huynh-Le, Minh-Phuong; Zhang, Zhe; Tran, Phuoc T.

2014-12-01

Purpose: To measure concordance among genitourinary radiation oncologists in using the National Cancer Institute Common Toxicity Criteria (NCI CTC) and Radiation Therapy Oncology Group (RTOG) grading scales to grade rectal bleeding. Methods and Materials: From June 2013 to January 2014, a Web-based survey was sent to 250 American and Canadian academic radiation oncologists who treat prostate cancer. Participants were provided 4 case vignettes in which patients received radiation therapy and developed rectal bleeding and were asked for management plans and to rate the bleeding according to NCI CTC v.4 and RTOG late toxicity grading (scales provided). In 2 cases, participantsmore » were also asked whether they would send the patient for colonoscopy. A multilevel, random intercept modeling approach was used to assess sources of variation (case, respondent) in toxicity grading to calculate the intraclass correlation coefficient (ICC). Agreement on a dichotomous grading scale (low grades 1-2 vs high grades 3-4) was also assessed, using the κ statistic for multiple respondents. Results: Seventy-two radiation oncologists (28%) completed the survey. Forty-seven (65%) reported having either written or been principal investigator on a study using these scales. Agreement between respondents was moderate (ICC 0.52, 95% confidence interval [CI] 0.47-0.58) when using NCI CTC and fair using the RTOG scale (ICC 0.28, 95% CI 0.20-0.40). Respondents who chose an invasive management were more likely to select a higher toxicity grade (P<.0001). Using the dichotomous scale, we observed moderate agreement (κ = 0.42, 95% CI 0.40-0.44) with the NCI CTC scale, but only slight agreement with the RTOG scale (κ = 0.19, 95% CI 0.17-0.21). Conclusion: Low interrater reliability was observed among radiation oncologists grading rectal bleeding using 2 common scales. Clearer definitions of late rectal bleeding toxicity should be constructed to reduce this variability and avoid ambiguity in both reporting and interpretation.« less

Association Between Treatment at a High-Volume Facility and Improved Survival for Radiation-Treated Men With High-Risk Prostate Cancer

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

Chen, Yu-Wei; Mahal, Brandon A.; Harvard Medical School, Boston, Massachusetts

Purpose: Although the association between higher hospital volume and improved outcomes has been well-documented in surgery, there is little data about whether this effect exists for radiation-treated patients. We investigated whether treatment at a radiation facility that treats a high volume of prostate cancer patients is associated with improved survival for men with high-risk prostate cancer. Methods and Materials: We used the National Cancer Database (NCDB) to identity patients diagnosed with prostate cancer from 2004 to 2006. The radiation case volume (RCV) of each hospital was based on its number of radiation-treated prostate cancer patients. We used propensity-score based analysismore » to compare the overall survival (OS) of high-risk prostate cancer patients in high versus low RCV hospitals. Primary endpoint is overall survival. Covariates adjusted for were tumor characteristics, sociodemographic factors, radiation type, and use of androgen deprivation therapy (ADT). Results: A total of 19,565 radiation-treated high-risk patients were identified. Median follow-up was 81.0 months (range: 1-108 months). When RCV was coded as a continuous variable, each increment of 100 radiation-managed patients was associated with improved OS (adjusted hazard ratio [AHR]: 0.97; 95% confidence interval [CI]: 0.95-0.98; P<.0001) after adjusting for known confounders. For illustrative purposes, when RCV was dichotomized at the 80th percentile (43 patients/year), high RCV was associated with improved OS (7-year overall survival 76% vs 74%, log-rank test P=.0005; AHR: 0.91, 95% CI: 0.86-0.96, P=.0005). This association remained significant when RCV was dichotomized at 75th (37 patients/year), 90th (60 patients/year), and 95th (84 patients/year) percentiles but not the 50th (19 patients/year). Conclusions: Our results suggest that treatment at centers with higher prostate cancer radiation case volume is associated with improved OS for radiation-treated men with high-risk prostate cancer.« less

The levels of perceptual processing and the neural correlates of increasing subjective visibility.

PubMed

Binder, Marek; Gociewicz, Krzysztof; Windey, Bert; Koculak, Marcin; Finc, Karolina; Nikadon, Jan; Derda, Monika; Cleeremans, Axel

2017-10-01

According to the levels-of-processing hypothesis, transitions from unconscious to conscious perception may depend on stimulus processing level, with more gradual changes for low-level stimuli and more dichotomous changes for high-level stimuli. In an event-related fMRI study we explored this hypothesis using a visual backward masking procedure. Task requirements manipulated level of processing. Participants reported the magnitude of the target digit in the high-level task, its color in the low-level task, and rated subjective visibility of stimuli using the Perceptual Awareness Scale. Intermediate stimulus visibility was reported more frequently in the low-level task, confirming prior behavioral results. Visible targets recruited insulo-fronto-parietal regions in both tasks. Task effects were observed in visual areas, with higher activity in the low-level task across all visibility levels. Thus, the influence of level of processing on conscious perception may be mediated by attentional modulation of activity in regions representing features of consciously experienced stimuli. Copyright © 2017 Elsevier Inc. All rights reserved.

Regional myocardial flow heterogeneity explained with fractal networks

PubMed Central

VAN BEEK, JOHANNES H. G. M.; ROGER, STEPHEN A.; BASSINGTHWAIGHTE, JAMES B.

2010-01-01

There is explain how the distribution of flow broadens with an increase in the spatial resolution of the measurement, we developed fractal models for vascular networks. A dichotomous branching network of vessels represents the arterial tree and connects to a similar venous network. A small difference in vessel lengths and radii between the two daughter vessels, with the same degree of asymmetry at each branch generation, predicts the dependence of the relative dispersion (mean ± SD) on spatial resolution of the perfusion measurement reasonably well. When the degree of asymmetry increases with successive branching, a better fit to data on sheep and baboons results. When the asymmetry is random, a satisfactory fit is found. These models show that a difference in flow of 20% between the daughter vessels at a branch point gives a relative dispersion of flow of ~30% when the heart is divided into 100–200 pieces. Although these simple models do not represent anatomic features accurately, they provide valuable insight on the heterogeneity of flow within the heart. PMID:2589520

FAST TRACK COMMUNICATION Local randomness in Hardy's correlations: implications from the information causality principle

NASA Astrophysics Data System (ADS)

Rajjak Gazi, MD.; Rai, Ashutosh; Kunkri, Samir; Rahaman, Ramij

2010-11-01

Study of non-local correlations in terms of Hardy's argument has been quite popular in quantum mechanics. Hardy's non-locality argument depends on some kind of asymmetry, but a two-qubit maximally entangled state, being symmetric, does not exhibit this kind of non-locality. Here we ask the following question: can this feature be explained by some principle outside quantum mechanics? The no-signaling condition does not provide a solution. But, interestingly, the information causality principle (Pawlowski et al 2009 Nature 461 1101) offers an explanation. It shows that any generalized probability theory which gives completely random results for local dichotomic observable, cannot provide Hardy's non-local correlation if it is restricted by a necessary condition for respecting the information causality principle. In fact, the applied necessary condition imposes even more restrictions on the local randomness of measured observable. Still, there are some restrictions imposed by quantum mechanics that are not reproduced from the considered information causality condition.

Differential coding of reward and movement information in the dorsomedial striatal direct and indirect pathways.

PubMed

Shin, Jung Hwan; Kim, Dohoung; Jung, Min Whan

2018-01-26

The direct and indirect pathways of the basal ganglia have long been thought to mediate behavioral promotion and inhibition, respectively. However, this classic dichotomous model has been recently challenged. To better understand neural processes underlying reward-based learning and movement control, we recorded from direct (dSPNs) and indirect (iSPNs) pathway spiny projection neurons in the dorsomedial striatum of D1-Cre and D2-Cre mice performing a probabilistic Pavlovian conditioning task. dSPNs tend to increase activity while iSPNs decrease activity as a function of reward value, suggesting the striatum represents value in the relative activity levels of dSPNs versus iSPNs. Lick offset-related activity increase is largely dSPN selective, suggesting dSPN involvement in suppressing ongoing licking behavior. Rapid responses to negative outcome and previous reward-related responses are more frequent among iSPNs than dSPNs, suggesting stronger contributions of iSPNs to outcome-dependent behavioral adjustment. These findings provide new insights into striatal neural circuit operations.

Colored-noise-induced discontinuous transitions in symbiotic ecosystems

NASA Astrophysics Data System (ADS)

Mankin, Romi; Sauga, Ako; Ainsaar, Ain; Haljas, Astrid; Paunel, Kristiina

2004-06-01

A symbiotic ecosystem is studied by means of the Lotka-Volterra stochastic model, using the generalized Verhulst self-regulation. The effect of fluctuating environment on the carrying capacity of a population is taken into account as dichotomous noise. The study is a follow-up of our investigation of symbiotic ecosystems subjected to three-level (trichotomous) noise [

Water Recreation and Illness Severity

EPA Science Inventory

Abstract Background: The health endpoint of prior studies of water recreation has been the occurrence gastrointestinal (GI) of illness. The use of this dichotomous health outcome fails to take into account the range of symptom severity among those with GI illness, as well as thos...

Guide to Regeneration of Bottomland Hardwoods

Treesearch

Martha R. McKevlin

1992-01-01

This guide will help landowners, consulting foresters, and public service foresters regenerate bottomland hardwoods. It discusses (1) interpretation of site characteristics, (2) selection of species, and (3) selection of regeneration methods. A dichotomous key for selection of appropriate regeneration methods under various conditions is presented.

A Framework for Dimensionality Assessment for Multidimensional Item Response Models

ERIC Educational Resources Information Center

Svetina, Dubravka; Levy, Roy

2014-01-01

A framework is introduced for considering dimensionality assessment procedures for multidimensional item response models. The framework characterizes procedures in terms of their confirmatory or exploratory approach, parametric or nonparametric assumptions, and applicability to dichotomous, polytomous, and missing data. Popular and emerging…

Infant Visual Expectations: Advances and Issues.

ERIC Educational Resources Information Center

Haith, Marshall M.; Wass, Tara S.; Adler, Scott A.

1997-01-01

Speculates on underlying processes for the reaction time variance and age differences in anticipation latency using the Visual Expectation Paradigm. Discusses the dichotomization of reactive and anticipatory behavior, limitations of longitudinal designs, drawbacks in using standard procedures and materials, and inferences that can be made…

Reactive and proactive aggression as meaningful distinctions at the variable and person level in primary school-aged children.

PubMed

Carroll, Annemaree; McCarthy, Molly; Houghton, Stephen; Sanders O'Connor, Emma; Zadow, Corinne

2018-04-24

Reactive and proactive aggression is a dichotomous classification of aggression in adults and children. This distinction has been supported by a number of variable-based and factor analytic studies. Due to high inter-correlations, however, the reactive-proactive aggression distinction may not be entirely useful for understanding how group or individual aggressive behavior varies in children and adolescents. Drawing on a sample of primary school-aged children (N = 242) aged 7-12 years, this study sought to determine whether reactive and proactive aggression could be distinguished at the variable-level and the person-level in children. Exploratory Factor Analysis of data from an aggression instrument measuring both functions and forms of aggression, found a two-factor construct of aggression constituted by a reactive and proactive aggression factor. A person-based analysis was then conducted after classifying children according to the presence of reactive and/or proactive aggression. Discriminant function analysis was used to discern whether classifications on the basis of aggression function produced meaningful distinctions in terms of antisocial traits and emotional valence and intensity measures. Two functions were identified which distinguished children with different combinations of reactive and proactive aggression. Reactive-only aggressive children were defined primarily by high levels of impulsivity, while proactive-only children were defined primarily by higher levels of antisocial traits. Children high in both types of aggression exhibited both the presence of antisocial traits and impulsivity. Contrary to recent findings, this suggests that differences in aggression functions remain meaningful at the person level in children. Implications for interventions are discussed. © 2018 Wiley Periodicals, Inc.

Impact of asylum interviews on the mental health of traumatized asylum seekers

PubMed Central

Schock, Katrin; Rosner, Rita; Knaevelsrud, Christine

2015-01-01

Background Asylum interviews within the asylum procedure are associated with psychological stress for traumatized asylum seekers. This study investigates the impact of asylum interviews on the mental health in a sample of 40 traumatized asylum seekers. The comparison group consisted of refugees (N=10) that had not been invited to an asylum interview. Additionally, the moderating effects of trial-related variables such as perceived justice of the trial, stress of giving testimony, and stress of waiting for the asylum interview were examined. Method Participants were assessed on average 10 days before (t1) and 16 days after (t2) the asylum interview. Chi-square tests for dichotomous and categorical variables were used to compare the descriptive statistics of the two groups. To investigate symptom changes from t1 to t2, paired t-tests were calculated. The magnitude of effects was measured by Cohen's effect size d within groups. Hierarchical regression analyses were conducted for demographic and trial variables predicting posttraumatic intrusions, avoidance, and hyperarousal. Results Data showed a significant increase in posttraumatic intrusions and a significant decrease in posttraumatic avoidance and hyperarousal symptoms from t1 to t2. No significant symptom changes in the posttraumatic stress disorder subscales were found in the comparison group. The results of hierarchical regression analyses revealed perceived justice of the interview to predict the increase of intrusions and the number of experienced traumata and testimony stress to predict posttraumatic avoidance. Conclusions The present findings underline the stressful impact of asylum interviews on traumatized refugees. They indicate that the asylum interview might decrease posttraumatic avoidance and trigger posttraumatic intrusions, thus highlight the importance of ensuring that the already vulnerable group of traumatized refugees needs to be treated with empathy during their asylum interview. PMID:26333540

Correlates of Irritability in College Students With Depressive Symptoms

PubMed Central

Pedrelli, Paola; Nyer, Maren; Holt, Daphne; Bakow, Brianna R.; Fava, Maurizio; Baer, Lee; Cassiello, Clair; Mulligan, Maura; Cusin, Cristina; Farabaugh, Amy

2015-01-01

Depression is a prevalent psychiatric disorder associated with significant personal and societal burden. There is accumulating evidence for the presence of a subtype of depression characterized by the presence of irritability that is associated with increased morbidity, risk for suicidal ideation, and functional impairments in adults. Little is known about the features of depressive symptoms with and without irritability among young adults in college. The primary aim of this study was to characterize the presentation of college students with depressive symptoms and irritability. Two-hundred eighty-seven undergraduate college students with depressive symptoms with and without irritability were compared across several psychiatric and functional outcome variables. Independent samples t-tests or logistic regressions were conducted for each outcome variable using the irritability item of the Beck Depression Inventory as a dichotomous grouping variable. Analyses were conducted separately for the men and the women. Both male and female students with depressive symptoms and severe irritability reported a greater severity of depressive symptoms compared with their peers with no or mild irritability. In the women, the presence of irritability was associated with greater symptoms of anxiety, whereas in the men, it was associated with increased likelihood of engaging in risky behaviors, including compulsive use of alcohol, illicit drugs, and prescription drugs. The male and female college students with depressive symptoms with and without irritability did not differ on severity of suicidal ideation, hopelessness, or cognitive functioning. The findings from this study suggest that depressive symptoms and irritability may characterize a subtype of college students who have a greater symptom burden and with the potential need for more aggressive and prompt treatment. PMID:24177482

The influence of lifestyle on cardiovascular risk factors. Analysis using a neural network.

PubMed

Gueli, Nicoló; Piccirillo, Gianfanco; Troisi, Giovanni; Cicconetti, Paolo; Meloni, Fortunato; Ettorre, Evaristo; Verico, Paola; D'Arcangelo, Enzo; Cacciafesta, Mauro

2005-01-01

The cardiovascular pathologies are the most common causes of death in the elderly patient. To single out the main risk factors in order to effectively prevent the onset of the disease, the authors experimented a special computerized tool, the neural network, that works out a mathematical relation that can obtain certain data (defined as output) as a function of other data (defined as input). Data were processed from a sample of 276 subjects of both sexes aged 26-69 years old. The output data were: high/low cholesterolemia, HDL cholesterol, triglyceridemia with respect to an established cut-off; the input data were: sex, age, build, weight, married/single, number of children, number of cigarettes smoked/day, amount of wine and number of cups of coffee. We conclude that: (i) a relationship exists, deduced from a neural network, between a set of input variables and a dichotomous output variable; (ii) this relationship can be expressed as a mathematical function; (iii) a neural network, having learned the data on a sufficiently large population, can provide valid predictive data for a single individual with a high probability (up to 93.33%) that the response it gives is correct. In this study, such a result is found for two of the three cardiovascular risk indicators considered (cholesterol and triglycerides); (iv) the repetition of the neural network analysis of the cases in question after a "pruning" operation provided a somewhat less good performance; (v) a statistical analysis conducted on those same cases has confirmed the existence of a strong relationship between the input and the output variables. Therefore the neural network is a valid instrument for providing predictive in a single subject on cardiovascular pathology risks.

Child marriage and women's attitude towards wife beating in a nationally representative sample of currently married adolescent and young women in Pakistan.

PubMed

Nasrullah, Muazzam; Muazzam, Sana; Khosa, Faisal; Khan, Muhammad Mobarak Hussain

2017-01-01

Child marriage (before 18 years) is widely prevalent in Pakistan, and disproportionately affects young girls in rural, low income and poorly-educated households. Our study aims to determine the association of child marriage and attitude towards wife beating among currently married Pakistani women aged 15-24 after controlling for social equity indicators (education, wealth index, rural residence). We limited the data from Pakistan Demographic and Health Survey, 2012-2013 to currently married women aged 15-24 years (n=2648). Five specified dichotomous variables indicating women's attitude towards wife beating (goes out without telling husband, neglects the children, argues with husband, refuses to have sex with husband, burns the food) were considered as outcome variables. The likelihood (OR and 95% CI) of each outcome variable for the child marriage group was estimated using logistic regression models. The prevalence of child marriage was significantly higher among women having no education and Balochi ethnicity, living in Khyber Pakhtunkhwa region and rural area, and belonging to the poorest quintile of wealth index. Women married as children compared with women married as adults were more likely to justify wife beating for all five specified reasons. However, these associations were lost when social equity indicators and national region of residence were adjusted in the regression models. Highly prevalent child marriage practice among women can be minimized by promoting education and providing economic opportunities in Pakistan. © The Author 2016. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Postoperative pain after manual and mechanical glide path: a randomized clinical trial.

PubMed

Pasqualini, Damiano; Mollo, Livio; Scotti, Nicola; Cantatore, Giuseppe; Castellucci, Arnaldo; Migliaretti, Giuseppe; Berutti, Elio

2012-01-01

This prospective randomized clinical trial evaluated the incidence of postoperative pain after glide path performed with PathFile (PF) (Dentsply Maillefer, Ballaigues, Switzerland) versus stainless-steel K-file (KF). In 149 subjects, the mechanical glide path was performed with nickel-titanium (NiTi) rotary PF; in 146 subjects, the manual glide path was performed with stainless-steel KFs. Postoperative pain, analgesics consumption, and the number of days to complete pain resolution were evaluated in the following 7 days. An analysis of variance model for repeated measures was used to compare the variation of pain-scale values (P < .05). The Student's t test for continuous variables normally distributed, the nonparametric Mann-Whitney U test for the nonnormally distributed variables, and the chi-square test for dichotomous variables were used (P < .05). Despite homogeneous baseline conditions at diagnosis, tooth type, pain prevalence, and scores, the postoperative pain prevalence curves in PF group evidenced a more favorable trend in terms of time to pain resolution compared with the KF group (P = .004). The difference was also evident in the model adjusted for analgesics consumption in both groups (P = .012). The mean analgesics intake per subject was significantly higher in the KF group (3.7 ± 2.2) compared with the PF group (2 ± 1.7) (P < .001). Mean pain stop values were also significantly higher in the KF group (2.7) compared with the PF group (1.7) (P = .001). The glide path with NiTi Rotary PF leads to less postoperative pain and faster symptom resolution. Copyright © 2012 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Simplex-based optimization of numerical and categorical inputs in early bioprocess development: Case studies in HT chromatography.

PubMed

Konstantinidis, Spyridon; Titchener-Hooker, Nigel; Velayudhan, Ajoy

2017-08-01

Bioprocess development studies often involve the investigation of numerical and categorical inputs via the adoption of Design of Experiments (DoE) techniques. An attractive alternative is the deployment of a grid compatible Simplex variant which has been shown to yield optima rapidly and consistently. In this work, the method is combined with dummy variables and it is deployed in three case studies wherein spaces are comprised of both categorical and numerical inputs, a situation intractable by traditional Simplex methods. The first study employs in silico data and lays out the dummy variable methodology. The latter two employ experimental data from chromatography based studies performed with the filter-plate and miniature column High Throughput (HT) techniques. The solute of interest in the former case study was a monoclonal antibody whereas the latter dealt with the separation of a binary system of model proteins. The implemented approach prevented the stranding of the Simplex method at local optima, due to the arbitrary handling of the categorical inputs, and allowed for the concurrent optimization of numerical and categorical, multilevel and/or dichotomous, inputs. The deployment of the Simplex method, combined with dummy variables, was therefore entirely successful in identifying and characterizing global optima in all three case studies. The Simplex-based method was further shown to be of equivalent efficiency to a DoE-based approach, represented here by D-Optimal designs. Such an approach failed, however, to both capture trends and identify optima, and led to poor operating conditions. It is suggested that the Simplex-variant is suited to development activities involving numerical and categorical inputs in early bioprocess development. © 2017 The Authors. Biotechnology Journal published by WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Preconceptional factors associated with very low birthweight delivery in East and West Berlin: a case control study

PubMed Central

Grimmer, Ingrid; Bührer, Christoph; Dudenhausen, Joachim W; Stroux, Andrea; Reiher, Horst; Halle, Horst; Obladen, Michael

2002-01-01

Background Very low birthweight, i.e. a birthweight < 1500 g, is among the strongest determinants of infant mortality and childhood morbidity. To develop primary prevention approaches to VLBW birth and its sequelae, information is needed on the causes of preterm birth, their personal and social antecedents, and on conditions associated with very low birthweight. Despite the growing body of evidence linking sociodemographic variables with preterm delivery, little is known as to how this may be extrapolated to the risk of very low birthweight. Methods In 1992, two years after the German unification, we started to recruit two cohorts of very low birthweight infants and controls in East and West Berlin for a long-term neurodevelopmental study. The present analysis was undertaken to compare potential preconceptional risk factors for very low birthweight delivery in a case-control design including 166 mothers (82 East vs. 84 West Berlin) with very low birthweight delivery and 341 control mothers (166 East vs. 175 West). Results Multivariate logistic regression analysis was used to assess the effects of various dichotomous parental covariates and their interaction with living in East or West Berlin. After backward variable selection, short maternal school education, maternal unemployment, single-room apartment, smoking, previous preterm delivery, and fetal loss emerged as significant main effect variables, together with living in West Berlin as positive effect modificator for single-mother status. Conclusion Very low birthweight has been differentially associated with obstetrical history and indicators of maternal socioeconomic status in East and West Berlin. The ranking of these risk factors is under the influence of the political framework. PMID:12095425

Dolichoectatic aneurysms of the vertebrobasilar system: clinical and radiographic factors that predict poor outcomes.

PubMed

Xu, David S; Levitt, Michael R; Kalani, M Yashar S; Rangel-Castilla, Leonardo; Mulholland, Celene B; Abecassis, Isaac J; Morton, Ryan P; Nerva, John D; Siddiqui, Adnan H; Levy, Elad I; Spetzler, Robert F; Albuquerque, Felipe C; McDougall, Cameron G

2018-02-01

OBJECTIVE Fusiform dolichoectatic vertebrobasilar aneurysms are rare, challenging lesions. The natural history of these lesions and medium- and long-term patient outcomes are poorly understood. The authors sought to evaluate patient prognosis after diagnosis of fusiform dolichoectatic vertebrobasilar aneurysms and to identify clinical and radiographic predictors of neurological deterioration. METHODS The authors reviewed multiple, prospectively maintained, single-provider databases at 3 large-volume cerebrovascular centers to obtain data on patients with unruptured, fusiform, basilar artery dolichoectatic aneurysms diagnosed between January 1, 2000, and January 1, 2015. RESULTS A total of 50 patients (33 men, 17 women) were identified; mean clinical follow-up was 50.1 months and mean radiographic follow-up was 32.4 months. At last follow-up, 42% (n = 21) of aneurysms had progressed and 44% (n = 22) of patients had deterioration of their modified Rankin Scale scores. When patients were dichotomized into 2 groups- those who worsened and those who did not-univariate analysis showed 5 variables to be statistically significantly different: sex (p = 0.007), radiographic brainstem compression (p = 0.03), clinical posterior fossa compression (p < 0.001), aneurysmal growth on subsequent imaging (p = 0.001), and surgical therapy (p = 0.006). A binary logistic regression was then created to evaluate these variables. The only variable found to be a statistically significant predictor of clinical worsening was clinical symptoms of posterior fossa compression at presentation (p = 0.01). CONCLUSIONS Fusiform dolichoectatic vertebrobasilar aneurysms carry a poor prognosis, with approximately one-half of the patients deteriorating or experiencing progression of their aneurysm within 5 years. Despite being high risk, intervention-when carefully timed (before neurological decline)-may be beneficial in select patients.

Genetic and environmental influences on sleep quality in middle-aged men: a twin study.

PubMed

Genderson, Margo R; Rana, Brinda K; Panizzon, Matthew S; Grant, Michael D; Toomey, Rosemary; Jacobson, Kristen C; Xian, Hong; Cronin-Golomb, Alice; Franz, Carol E; Kremen, William S; Lyons, Michael J

2013-10-01

Poor sleep quality is a risk factor for a number of cognitive and physiological age-related disorders. Identifying factors underlying sleep quality are important in understanding the etiology of these age-related health disorders. We investigated the extent to which genes and the environment contribute to subjective sleep quality in middle-aged male twins using the classical twin design. We used the Pittsburgh Sleep Quality Index to measure sleep quality in 1218 middle-aged twin men from the Vietnam Era Twin Study of Aging (mean age = 55.4 years; range 51-60; 339 monozygotic twin pairs, 257 dizygotic twin pairs, 26 unpaired twins). The mean PSQI global score was 5.6 [SD = 3.6; range 0-20]. Based on univariate twin models, 34% of variability in the global PSQI score was due to additive genetic effects (heritability) and 66% was attributed to individual-specific environmental factors. Common environment did not contribute to the variability. Similarly, the heritability of poor sleep-a dichotomous measure based on the cut-off of global PSQI>5-was 31%, with no contribution of the common environment. Heritability of six of the seven PSQI component scores (subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, and daytime dysfunction) ranged from 0.15 to 0.31, whereas no genetic influences contributed to the use of sleeping medication. Additive genetic influences contribute to approximately one-third of the variability of global subjective sleep quality. Our results in middle-aged men constitute a first step towards examination of the genetic relationship between sleep and other facets of aging. © 2013 European Sleep Research Society.

Genetic and Environmental Influences on Sleep Quality in Middle-Aged Men: A Twin Study

PubMed Central

Genderson, Margo R.; Rana, Brinda K.; Panizzon, Matthew S.; Grant, Michael D.; Toomey, Rosemary; Jacobson, Kristen C.; Xian, Hong; Cronin-Golomb, Alice; Franz, Carol E.; Kremen, William S.; Lyons, Michael J.

2013-01-01

SUMMARY Poor sleep quality is a risk factor for a number of cognitive and physiological age-related disorders. Identifying factors underlying sleep quality are important in understanding the etiology of these age-related health disorders. We investigated the extent to which genes and the environment contribute to subjective sleep quality in middle-aged male twins using the classical twin design. We used the Pittsburgh Sleep Quality Index (PSQI) to measure sleep quality in 1218 middle-aged twin men from the Vietnam Era Twin Study of Aging (VETSA)(mean age=55.4 years; range 51–60; 339 monozygotic twin pairs, 257 dizygotic twin pairs, 26 unpaired twins). The mean PSQI global score was 5.6 (SD=3.6; range 0–20). Based on univariate twin models, 34% of variability in the global PSQI score was due to additive genetic effects (heritability) and 66% was attributed to individual-specific environmental factors. Common environment did not contribute to the variability. Similarly, the heritability of poor sleep—a dichotomous measure based on the cut-off of global PSQI>5--was 31% with no contribution of the common environment. Heritability of six of the seven PSQI component scores (Subjective Sleep Quality, Sleep Latency, Sleep Duration, Habitual Sleep Efficiency, Sleep Disturbances, and Daytime Dysfunction) ranged from .15 to .31, where as no genetic influences contributed to Use of Sleeping Medication. Additive genetic influences contribute to approximately one-third of the variability of global subjective sleep quality. Our results in middle-aged men constitute a first step toward examination of the genetic relationship between sleep and other facets of aging. PMID:23509903

A retrospective study on the outcomes of cataract surgery in an Eastern Regional Health Authority hospital of Trinidad and Tobago

PubMed Central

Sonron, Ebiakpo-aboere; Bridgemohan, Petra; Sharma, Subash

2015-01-01

Background. Worldwide, cataract is a major cause of blindness. The paper aims to evaluate factors associated with borderline and poor outcomes of cataract surgery at an Eastern Regional Health Authority (ERHA) hospital in Trinidad and Tobago. Materials and Methods. A hospital-based, retrospective study was done on 401 patients who had undergone cataract surgery (unilateral and bilateral) at an ERHA Hospital between March 2009 and September 2014. Data was collected on variables concerning demographic, medical history, surgical history, ocular findings and visual acuity (VA). The outcome variable of interest was Snellen’s post-operative (presenting) VA which was transformed into a dichotomous variable with borderline and poor outcomes as one and good outcomes as the other. Data were analysed using univariate and multivariate logistic regression analyses. Results. Good outcome (presenting VA 6/18 or better) was seen in 350 (67%) eyes. The fitted model consisted of ocular co-morbidity (OR =2.133; 95% CI [1.346–3.380]), hypertension (OR = 0.520; 95% CI [0.381–0.928]), surgical procedure (OR = 1.56; 95% CI [1.004–2.425]), good preoperative VA (OR = 0.388, 95% CI [0.211–0.714]), borderline preoperative VA (OR = 0.485; 95% CI = [0.278–0.843]) and year of first visit to clinic (OR = 2.243; 95% CI [1.215–4.141]). Conclusion. There is a need for community-based outreach to increase awareness of eye health and diseases. It is recommended that the general population is encouraged to take responsibility for personal management. The facilities at the Hospital should also be enhanced. PMID:26357596

The use of antidepressants in patients with advanced cancer--results from an international multicentre study.

PubMed

Janberidze, Elene; Hjermstad, Marianne Jensen; Brunelli, Cinzia; Loge, Jon Håvard; Lie, Hanne Cathrine; Kaasa, Stein; Knudsen, Anne Kari

2014-10-01

Depression is common in patients with advanced cancer; however, it is not often recognized and therefore not treated. The aims of this study were to examine the prevalence of the use of antidepressants (ADs) in an international cross-sectional study sample and to identify sociodemographic and medical variables associated with their use. The study was conducted in patients with advanced cancer from 17 centres across eight countries. Healthcare professionals registered patient and disease-related characteristics. A dichotomous score (no/yes) was used to assess the use of ADs other than as adjuvant for pain. Self-report questionnaires from patients were used for the assessment of functioning and symptom intensity. Of 1051 patient records with complete data on ADs, 1048 were included (M:540/F:508, mean age 62 years, standard deviation [SD] 12). The majority were inpatients, and 85% had metastatic disease. The prevalence of AD use was 14%. Multivariate logistic regression analyses showed that younger age (odds ratio [OR] 2.46; confidence interval [CI] 1.32-4.55), female gender (OR 1.59; CI 1.09-2.33), current medication for pain (OR 2.68; CI 1.65-4.33) and presence of three or more co-morbidities (OR 4.74; CI 2.27-9.91) were associated with AD use for reasons other than pain. Disease-related variables (diagnoses, stage, Karnofsky Performance Status and survival) were not associated with the use of ADs. Female gender, younger age, analgesic use and multiple co-morbidities were associated with the use of ADs. However, information is still limited on which variables guide physicians in prescribing AD medication. Further longitudinal studies including details on psychiatric and medication history are needed to improve the identification of patients in need of ADs. Copyright © 2014 John Wiley & Sons, Ltd.

Independent and incremental prognostic value of Doppler-derived left ventricular total isovolumic time in patients with systolic heart failure.

PubMed

Bajraktari, Gani; Dini, Frank Lloyd; Fontanive, Paolo; Elezi, Shpend; Berisha, Venera; Napoli, Anna Maria; Ciuti, Manrico; Henein, Michael

2011-05-05

A prolonged total isovolumic time (T-IVT) has been shown to be associated with worsening survival in patients submitted to coronary artery surgery. However, it is not known whether it has prognostic significance in patients with chronic systolic heart failure (HF). To determine the prognostic value of T-IVT in comparison with other clinical, biochemical and echocardiographic variables in patients with chronic systolic HF. Patients (n=107; age 68±12 years, 25% women) with chronic systolic HF, left ventricular ejection fraction (EF)<45%, and sinus rhythm, underwent a complete Doppler echocardiographic study, that included tissue Doppler long axis velocities and total isovolumic time (T-IVT), determined as [60-(total ejection time+total filling time)]. Plasma N-terminal pro-B natriuretic peptide (NT-pro-BNP) was also measured. The associations of dichotomous variables selected according to the Receiver Operator Characteristic analysis were assessed using the Cox proportional hazard model. Follow-up period was 37±18 months. Multivariate predictors of events were T-IVT≥12.3% s/min, mean E/Em ratio≥10, log NT-pro-BNP levels≥2.47 pg/ml and LV EF≤32.5%. On Kaplan-Meier analysis, patients with prolonged T-IVT, high mean E/Em ratio, increased NT-pro-BNP levels and decreased LV EF had a worse outcome compared with those without. The addition of T-IVT and NT-pro-BNP to conventional clinical and echocardiographic variables significantly improved the chi-square for the prediction of the outcome from 33.1 to 38.0, (P<0.001). Prolonged T-IVT added to the prognostic stratification of patients with systolic HF. Copyright © 2009 Elsevier Ireland Ltd. All rights reserved.

How the Timing of a Patient's Self-ratings of Suicidality and the Relationship to the Recipient Affect Patient Responses: A Case Study.

PubMed

Giddens, Jennifer M; Sheehan, David V

2014-09-01

This case study explores to what extent, if any, a subject's reporting varies depending upon whom the subject believes will view the data and the relationship the subject has with the reviewer. It also explores the variance in reporting if several days pass between the timeframe in question and the time of data collection. The subject answered three suicidality-related scales (the Sheehan-Suicidality Tracking Scale, the Suicidality Modifiers, and the Alphs Dichotomous Impulsivity and Hopelessness Two Questions) for 24 distinct timeframes. The scales were rated three different ways for each timeframe. The first was for only the patient. Immediately afterward, the scales were answered for the subject's therapist. A few days later, the scales were again answered by the patient, but only for the patient. The three different interviews for the same timeframe were compared to investigate any deviations. This case study found clinically relevant deviations between the three ratings completed for the same timeframe. This case study illustrates that a patient's reporting of his or her symptoms of suicidality using a patient-rated scale can vary depending upon the context, distance from timeframe in question, and the patient's relationship with the reviewer of the data.

Progressive Elaboration and Cross-Validation of a Latent Class Typology of Adolescent Alcohol Involvement in a National Sample

PubMed Central

Donovan, John E.; Chung, Tammy

2015-01-01

Objective: Most studies of adolescent drinking focus on single alcohol use behaviors (e.g., high-volume drinking, drunkenness) and ignore the patterning of adolescents’ involvement across multiple alcohol behaviors. The present latent class analyses (LCAs) examined a procedure for empirically determining multiple cut points on the alcohol use behaviors in order to establish a typology of adolescent alcohol involvement. Method: LCA was carried out on six alcohol use behavior indicators collected from 6,504 7th through 12th graders who participated in Wave I of the National Longitudinal Study of Adolescent Health (AddHealth). To move beyond dichotomous indicators, a “progressive elaboration” strategy was used, starting with six dichotomous indicators and then evaluating a series of models testing additional cut points on the ordinal indicators at progressively higher points for one indicator at a time. Analyses were performed on one random half-sample, and confirmatory LCAs were performed on the second random half-sample and in the Wave II data. Results: The final model consisted of four latent classes (never or non–current drinkers, low-intake drinkers, non–problem drinkers, and problem drinkers). Confirmatory LCAs in the second random half-sample from Wave I and in Wave II support this four-class solution. The means on the four latent classes were also generally ordered on an array of measures reflecting psychosocial risk for problem behavior. Conclusions: These analyses suggest that there may be four different classes or types of alcohol involvement among adolescents, and, more importantly, they illustrate the utility of the progressive elaboration strategy for moving beyond dichotomous indicators in latent class models. PMID:25978828

Can we rely on simulated patients' satisfaction with their consultation for assessing medical students' communication skills? A cross-sectional study.

PubMed

Gude, T; Grimstad, H; Holen, A; Anvik, T; Baerheim, A; Fasmer, O B; Hjortdahl, P; Vaglum, P

2015-12-18

In medical education, teaching methods offering intensive practice without high utilization of faculty resources are needed. We investigated whether simulated patients' (SPs') satisfaction with a consultation could predict professional observers' assessment of young doctors' communication skills. This was a comparative cross-sectional study of 62 videotaped consultations in a general practice setting with young doctors who were finishing their internship. The SPs played a female patient who had observed blood when using the toilet, which had prompted a fear of cancer. Immediately afterwards, the SP rated her level of satisfaction with the consultation, and the scores were dichotomized into satisfaction or dissatisfaction. Professional observers viewed the videotapes and assessed the doctors' communication skills using the Arizona Communication Interview Rating Scale (ACIR). Their ratings of communication skills were dichotomized into acceptable versus unacceptable levels of competence. The SPs' satisfaction showed a predictive power of 0.74 for the observers' assessment of the young doctors and whether they reached an acceptable level of communication skills. The SPs' dissatisfaction had a predictive power of 0.71 for the observers' assessment of an unacceptable communication level. The two assessment methods differed in 26% of the consultations. When SPs felt relief about their cancer concern after the consultation, they assessed the doctors' skills as satisfactory independent of the observers' assessment. Accordance between the dichotomized SPs' satisfaction score and communication skills assessed by observers (using the ACIR) was in the acceptable range. These findings suggest that SPs' satisfaction scores may provide a reliable source for assessing communication skills in educational programs for medical trainees (students and young doctors). Awareness of the patient's concerns seems to be of vital importance to patient satisfaction.

Optimization of a GO2/GH2 Impinging Injector Element

NASA Technical Reports Server (NTRS)

Tucker, P. Kevin; Shyy, Wei; Vaidyanathan, Rajkumar

2001-01-01

An injector optimization methodology, method i, is used to investigate optimal design points for a gaseous oxygen/gaseous hydrogen (GO2/GH2) impinging injector element. The unlike impinging element, a fuel-oxidizer- fuel (F-O-F) triplet, is optimized in terms of design variables such as fuel pressure drop, (Delta)P(sub f), oxidizer pressure drop, (Delta)P(sub o), combustor length, L(sub comb), and impingement half-angle, alpha, for a given mixture ratio and chamber pressure. Dependent variables such as energy release efficiency, ERE, wall heat flux, Q(sub w), injector heat flux, Q(sub inj), relative combustor weight, W(sub rel), and relative injector cost, C(sub rel), are calculated and then correlated with the design variables. An empirical design methodology is used to generate these responses for 163 combinations of input variables. Method i is then used to generate response surfaces for each dependent variable. Desirability functions based on dependent variable constraints are created and used to facilitate development of composite response surfaces representing some, or all, of the five dependent variables in terms of the input variables. Three examples illustrating the utility and flexibility of method i are discussed in detail. First, joint response surfaces are constructed by sequentially adding dependent variables. Optimum designs are identified after addition of each variable and the effect each variable has on the design is shown. This stepwise demonstration also highlights the importance of including variables such as weight and cost early in the design process. Secondly, using the composite response surface which includes all five dependent variables, unequal weights are assigned to emphasize certain variables relative to others. Here, method i is used to enable objective trade studies on design issues such as component life and thrust to weight ratio. Finally, specific variable weights are further increased to illustrate the high marginal cost of realizing the last increment of injector performance and thruster weight.

Regression Methods for Categorical Dependent Variables: Effects on a Model of Student College Choice

ERIC Educational Resources Information Center

Rapp, Kelly E.

2012-01-01

The use of categorical dependent variables with the classical linear regression model (CLRM) violates many of the model's assumptions and may result in biased estimates (Long, 1997; O'Connell, Goldstein, Rogers, & Peng, 2008). Many dependent variables of interest to educational researchers (e.g., professorial rank, educational attainment) are…

Socio-economic factors explain differences in public health-related variables among women in Bangladesh: a cross-sectional study.

PubMed

Khan, Md Mobarak H; Kraemer, Alexander

2008-07-23

Worldwide one billion people are living in slum communities and experts projected that this number would double by 2030. Slum populations, which are increasing at an alarming rate in Bangladesh mainly due to rural-urban migration, are often neglected and characterized by poverty, poor housing, overcrowding, poor environment, and high prevalence of communicable diseases. Unfortunately, comparisons between women living in slums and those not living in slums are very limited in Bangladesh. The objectives of the study were to examine the association of living in slums (dichotomized as slum versus non-slum) with selected public health-related variables among women, first without adjusting for the influence of other factors and then in the presence of socio-economic variables. Secondary data was used in this study. 120 women living in slums (as cases) and 480 age-matched women living in other areas (as controls) were extracted from the Bangladesh Demographic and Health Survey 2004. Many socio-economic and demographic variables were analysed. SPSS was used to perform simple as well as multiple analyses. P-values based on t-test and Wald test were also reported to show the significance level. Unadjusted results indicated that a significantly higher percent of women living in slums came from country side, had a poorer status by household characteristics, had less access to mass media, and had less education than women not living in slums. Mean BMI, knowledge of AIDS indicated by ever heard about AIDS, knowledge of avoiding AIDS by condom use, receiving adequate antenatal visits (4 or more) during the last pregnancy, and safe delivery practices assisted by skilled sources were significantly lower among women living in slums than those women living in other areas. However, all the unadjusted significant associations with the variable slum were greatly attenuated and became insignificant (expect safe delivery practices) when some socio-economic variables namely childhood place of residence, a composite variable of household characteristics, a composite variable of mass media access, and education were inserted into the multiple regression models. Taken together, childhood place of residence, the composite variable of mass media access, and education were the strongest predictors for the health related outcomes. Reporting unadjusted findings of public health variables in women from slums versus non-slums can be misleading due to confounding factors. Our findings suggest that an association of childhood place of residence, mass media access and public health education should be considered before making any inference based on slum versus non-slum comparisons.

Silent strain of caregiving: exploring the best predictors of distress in family carers of geriatric patients.

PubMed

Bień-Barkowska, Katarzyna; Doroszkiewicz, Halina; Bień, Barbara

2017-01-01

The aim of this article was to identify the best predictors of distress suffered by family carers (FCs) of geriatric patients. A cross-sectional study of 100 FC-geriatric patient dyads was conducted. The negative impact of care (NIoC) subscale of the COPE index was dichotomized to identify lower stress (score of ≤15 on the scale) and higher stress (score of ≥16 on the scale) exerted on FCs by the process of providing care. The set of explanatory variables comprised a wide range of sociodemographic and care-related attributes, including patient-related results from comprehensive geriatric assessments and disease profiles. The best combination of explanatory variables that provided the highest predictive power for distress among FCs in the multiple logistic regression (LR) model was determined according to statistical information criteria. The statistical robustness of the observed relationships and the discriminative power of the model were verified with the cross-validation method. The mean age of FCs was 57.2 (±10.6) years, whereas that of geriatric patients was 81.7 (±6.4) years. Despite the broad initial set of potential explanatory variables, only five predictors were jointly selected for the best statistical model. A higher level of distress was independently predicted by lower self-evaluation of health; worse self-appraisal of coping well as a caregiver; lower sense of general support; more hours of care per week; and the motor retardation of the cared-for person measured with the speed of the Timed Up and Go (TUG) test. Worse performance on the TUG test was only the patient-related predictor of distress among the variables examined as contributors to the higher NIoC. Enhancing the mobility of geriatric patients through suitably tailored kinesitherapeutic methods during their hospital stay may mitigate the burden endured by FCs.

GNPAT p.D519G is independently associated with markedly increased iron stores in HFE p.C282Y homozygotes.

PubMed

Barton, James C; Chen, Wen-Pin; Emond, Mary J; Phatak, Pradyumna D; Subramaniam, V Nathan; Adams, Paul C; Gurrin, Lyle C; Anderson, Gregory J; Ramm, Grant A; Powell, Lawrie W; Allen, Katrina J; Phillips, John D; Parker, Charles J; McLaren, Gordon D; McLaren, Christine E

2017-03-01

GNPAT p.D519G positivity is significantly increased in HFE p.C282Y homozygotes with markedly increased iron stores. We sought to determine associations of p.D519G and iron-related variables with iron stores in p.C282Y homozygotes. We defined markedly increased iron stores as serum ferritin >2247pmol/L (>1000μg/L) and either hepatic iron >236μmol/g dry weight or iron >10g by induction phlebotomy (men and women). We defined normal or mildly elevated iron stores as serum ferritin <674.1pmol/L (<300μg/L) or either age≥40y with iron ≤2.5g iron by induction phlebotomy or age≥50y with ≤3.0g iron by induction phlebotomy (men only). We compared participant subgroups using univariate methods. Using multivariable logistic regression, we evaluated associations of markedly increased iron stores with these variables: age; iron supplement use (dichotomous); whole blood units donated; erythrocyte units received as transfusion; daily alcohol consumption, g; and p.D519G positivity (heterozygosity or homozygosity). The mean age of 56 participants (94.6% men) was 55±10 (SD) y; 41 had markedly increased iron stores. Prevalences of swollen/tender 2nd/3rd metacarpophalangeal joints and elevated aspartate or alanine aminotransferase were significantly greater in participants with markedly increased iron stores. Only participants with markedly increased iron stores had cirrhosis. In multivariable analyses, p.D519G positivity was the only exposure variable significantly associated with markedly increased iron stores (odds ratio 9.9, 95% CI [1.6, 60.3], p=0.0126). GNPAT p.D519G is strongly associated with markedly increased iron stores in p.C282Y homozygotes after correction for age, iron-related variables, and alcohol consumption. Copyright © 2016 Elsevier Inc. All rights reserved.

Quantitative EEG Metrics Differ Between Outcome Groups and Change Over the First 72 h in Comatose Cardiac Arrest Patients.

PubMed

Wiley, Sara Leingang; Razavi, Babak; Krishnamohan, Prashanth; Mlynash, Michael; Eyngorn, Irina; Meador, Kimford J; Hirsch, Karen G

2018-02-01

Forty to sixty-six percent of patients resuscitated from cardiac arrest remain comatose, and historic outcome predictors are unreliable. Quantitative spectral analysis of continuous electroencephalography (cEEG) may differ between patients with good and poor outcomes. Consecutive patients with post-cardiac arrest hypoxic-ischemic coma undergoing cEEG were enrolled. Spectral analysis was conducted on artifact-free contiguous 5-min cEEG epochs from each hour. Whole band (1-30 Hz), delta (δ, 1-4 Hz), theta (θ, 4-8 Hz), alpha (α, 8-13 Hz), beta (β, 13-30 Hz), α/δ power ratio, percent suppression, and variability were calculated and correlated with outcome. Graphical patterns of quantitative EEG (qEEG) were described and categorized as correlating with outcome. Clinical outcome was dichotomized, with good neurologic outcome being consciousness recovery. Ten subjects with a mean age = 50 yrs (range = 18-65) were analyzed. There were significant differences in total power (3.50 [3.30-4.06] vs. 0.68 [0.52-1.02], p = 0.01), alpha power (1.39 [0.66-1.79] vs 0.27 [0.17-0.48], p < 0.05), delta power (2.78 [2.21-3.01] vs 0.55 [0.38-0.83], p = 0.01), percent suppression (0.66 [0.02-2.42] vs 73.4 [48.0-97.5], p = 0.01), and multiple measures of variability between good and poor outcome patients (all values median [IQR], good vs. poor). qEEG patterns with high or increasing power or large power variability were associated with good outcome (n = 6). Patterns with consistently low or decreasing power or minimal power variability were associated with poor outcome (n = 4). These preliminary results suggest qEEG metrics correlate with outcome. In some patients, qEEG patterns change over the first three days post-arrest.