Grading the quality of evidence and the strength of recommendations in clinical dentistry: a critical review of 2 prominent approaches.

PubMed

Faggion, Clovis Mariano

2010-06-01

The objective of this article was to critically review 2 prominent approaches used to grade the quality of evidence and the strength of recommendations. Every year much information becomes available as a result of publication of scientific papers, and clinicians should be able to assess current evidence so they, along with their patients, can make the most appropriate clinical decisions. This is particularly important when there is little or no high-quality evidence available about the subject of interest. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) and the Strength of Recommendation Taxonomy (SORT) were evaluated. Strengths and weaknesses of these 2 systems are discussed, mainly on the basis of their relevance to clinical dentistry. The conclusion was that use of a system for grading the quality of evidence and the strength of recommendations is urgently required because of the great heterogeneity of the quality and type of evidence relating to many dental procedures. Use of such a system will enable clinicians and their patients to make more informed decisions.

Systems for grading the quality of evidence and the strength of recommendations I: Critical appraisal of existing approaches The GRADE Working Group

PubMed Central

Atkins, David; Eccles, Martin; Flottorp, Signe; Guyatt, Gordon H; Henry, David; Hill, Suzanne; Liberati, Alessandro; O'Connell, Dianne; Oxman, Andrew D; Phillips, Bob; Schünemann, Holger; Edejer, Tessa Tan-Torres; Vist, Gunn E; Williams, John W

2004-01-01

Background A number of approaches have been used to grade levels of evidence and the strength of recommendations. The use of many different approaches detracts from one of the main reasons for having explicit approaches: to concisely characterise and communicate this information so that it can easily be understood and thereby help people make well-informed decisions. Our objective was to critically appraise six prominent systems for grading levels of evidence and the strength of recommendations as a basis for agreeing on characteristics of a common, sensible approach to grading levels of evidence and the strength of recommendations. Methods Six prominent systems for grading levels of evidence and strength of recommendations were selected and someone familiar with each system prepared a description of each of these. Twelve assessors independently evaluated each system based on twelve criteria to assess the sensibility of the different approaches. Systems used by 51 organisations were compared with these six approaches. Results There was poor agreement about the sensibility of the six systems. Only one of the systems was suitable for all four types of questions we considered (effectiveness, harm, diagnosis and prognosis). None of the systems was considered usable for all of the target groups we considered (professionals, patients and policy makers). The raters found low reproducibility of judgements made using all six systems. Systems used by 51 organisations that sponsor clinical practice guidelines included a number of minor variations of the six systems that we critically appraised. Conclusions All of the currently used approaches to grading levels of evidence and the strength of recommendations have important shortcomings. PMID:15615589

An Approach to Revision and Evaluation of Student Writing.

ERIC Educational Resources Information Center

Duke, Charles R.

An approach to evaluating student writing that emphasizes reformulation and deemphasizes grades teaches students that reworking their writing is a necessary and acceptable part of the writing process. Reformulation is divided into rewriting, revising, and editing. The instructor diagnoses student papers to determine significant problems on a…

Students' Evaluation of Teaching, Approaches to Learning, and Academic Achievement

ERIC Educational Resources Information Center

Diseth, Age

2007-01-01

Students' evaluation and perception of the learning environment are considered to be important predictors of students' approaches to learning. These variables may also account for variance in academic outcome, such as in examination grades, but previous research has rarely included a comparison between all of these variables. This article…

Clinical Course Score (CCS): a new clinical score to evaluate efficacy of neurotrauma treatment in traumatic brain injury and subarachnoid hemorrhage.

PubMed

Brandner, Sebastian; Kellermann, Isabel; Hore, Nirjhar; Bozhkov, Yavor; Buchfelder, Michael

2015-01-01

Neurotrauma continues to represent a challenging public health issue requiring continual improvement in therapeutic approaches. As no such current system exists, we present in this study the Clinical Course Score (CCS) as a new clinical score to evaluate the efficacy of neurotrauma treatment. The CCS was calculated in neurotrauma patients to be the difference between the grade of the Glasgow Outcome Scale 6 months after discharge from our department and the grade of a 1 to 5 point reduced Glasgow Coma Scale on admission. We assessed the CCS in a total of 248 patients (196 traumatic brain injury [TBI] patients and 52 subarachnoid hemorrhage [SAH] patients) who were treated in our Department of Neurosurgery between January 2011 and December 2012. We found negative CCS grades both in mild TBI and in mild SAH patients. In patients with severe TBI or SAH, we found positive CCS grades. In SAH patients, we found higher CCS scores in younger patients compared with elderly subjects in both mild and severe cases. The CCS can be useful in evaluating different therapeutic approaches during neurotrauma therapy. This new score might improve assessment of beneficial effects of therapeutic procedures.

Innovative Concepts and Technology for Railroad-Highway Grade Crossing Motorist Warning Systems : Volume 2. The Generation and Analysis of Alternative Concepts

DOT National Transportation Integrated Search

1977-09-01

The report describes the results of a study directed toward the generation, analysis and evaluation of innovative conceptual and technical approaches to train-activated motorist warning systems for use at railroad-highway grade crossings. Particular ...

Pediatric cranio-vertebral junction tuberculosis: management and outcome.

PubMed

Mehrotra, Anant; Das, Kuntal Kanti; Nair, Anup P; Kumar, Rajan; Srivastava, A K; Sahu, Rabi Narayan; Kumar, Raj

2013-05-01

Tuberculosis (TB) of the cranio-vertebral junction (CVJ) is a rare condition, accounting for 0.3 % to 1 % of all cases of spinal TB. Early diagnosis and treatment are important in preventing long-term neurological sequelae. Management protocol of this rare site of TB is yet to be conclusively established. This holds particularly true for pediatric age group in which this condition is infrequently encountered. A total of 29 consecutive pediatric patients presented to the Department of Neurosurgery at Sanjay Gandhi Post-Graduate Institute of Medical Sciences, Lucknow, from January 1997 to October2011 with clinical and/or radiological features suggestive of CVJ TB. A clinical grading system to evaluate the neurological status was developed, and all patients were evaluated using this scoring system. Patients were radiologically evaluated with computed tomography (CT) of CVJ and magnetic resonance imaging (MRI) with gadolinium enhancement. These cases were managed according to their grade and followed up. Out of a total of 29 cases, 18 were females and 11 males. Age range was 4 to 18 years with mean age 9 ± 3.8 years. The follow-up period ranged from 2 months to 7.5 years with mean follow-up of 2.7 years. Eleven cases were of grades 1 and 2, and 18 cases were of higher grade (grades 3 and 4). Predominantly conservative approach was utilized in cases with better clinical status, and grade (grades 1 and 2) and surgical intervention was needed in the more severe grades. All cases had significant improvement at the last follow-up. One needs to have a high index of suspicion of CVJ TB if one encounters a case with neck pain, neck restriction, and raised erythrocyte sedimentation rate. CT CVJ and MRI with gadolinium contrast enhancement are the investigations of choice for both establishing a diagnosis and planning the management. For cases with mild neurological deficit, conservative approach would work for majority of cases, and for severe cases, initial conservative approach may be tried, failing which surgical intervention would be needed.

Kangfuxinye Enema Combined with Mesalamine for Ulcerative Colitis: A Systematic Review and GRADE Approach

PubMed Central

Ren, Peng-wei; Yang, Wen-jie; Shan, Jing-yan; Hong, Qi; Wen, Shu

2017-01-01

Objectives To critically appraise the efficacy and safety of Kangfuxinye enema combined with mesalamine for the ulcerative colitis (UC) patients and in addition to grade the quality of evidence by using the GRADE (grading of recommendations, assessment, development, and evaluation) approach. Methods A literature search was performed in the Cochrane Library, MEDLINE, EMBASE, CBM, CNKI, VIP, and WanFang Databases. The search restrictions were patients with UC and RCTs. Studies including other treatments except Kangfuxinye with mesalamine were excluded. Results Nineteen studies met the inclusion criteria. We found significant benefits of Kangfuxinye combined with mesalamine against mesalamine alone in improving response rate as well as reducing the recurrence rate and inflammation rate; meanwhile, the increase of the adverse events rate was not observed. Furthermore, the symptoms remission rate and the cure time were insignificant statistically. Additionally, GRADE results indicated that the quality of evidence regarding the above 6 outcomes was rated from very low to moderate quality. Conclusions Although Kangfuxinye enema seems effective and safe for treating UC patients in this systematic review, Kangfuxinye enema combined with mesalamine was weakly recommended due to very low to moderate quality of available evidence by the GRADE approach. PMID:28848616

Multidisciplinary approach for the management of complex hepatic injuries AAST-OIS grades IV-V: a prospective study.

PubMed

Asensio, J A; Petrone, P; García-Núñez, L; Kimbrell, B; Kuncir, E

2007-01-01

Complex hepatic injuries grades IV-V are highly lethal. The objective of this study is to assess the multidisciplinary approach for their management and to evaluate if survival could be improved with this approach. Prospective 54-month study of all patients sustaining hepatic injuries grades IV-V managed operatively at a Level I Trauma Center. survival. univariate and stepwise logistic regression. Seventy-five patients sustained penetrating (47/63%) and blunt (28/37%) injuries. Seven (9%) patients underwent emergency department thoracotomy with a mortality of 100%. Out of the 75 patients, 52 (69%) sustained grade IV, and 23 (31%) grade V. The estimated blood loss was 3,539+/-3,040 ml. The overall survival was 69%, adjusted survival excluding patients requiring emergency department thoracotomy was 76%. Survival stratified to injury grade: grade IV 42/52-81%, grade V 10/23-43%. Mortality grade IV versus V injuries (p < 0.002; RR 2.94; 95% CI 1.52-5.70). Risk factors for mortality: packed red blood cells transfused in operating room (p=0.024), estimated blood loss (p < 0.001), dysryhthmia (p < 0.0001), acidosis (p = 0.051), hypothermia (p = 0.04). The benefit of angiography and angioembolization indicated: 12% mortality (2/17) among those that received it versus a 36% mortality (21/58) among those that did not (p = 0.074; RR 0.32; 95% CI 0.08-1.25). Stepwise logistic regression identified as significant independent predictors of outcome: estimated blood loss (p= 0.0017; RR 1.24; 95% CI 1.08-1.41) and number of packed red blood cells transfused in the operating room (p = 0.0358; RR 1.16; 95% CI 1.01-1.34). The multidisciplinary approach to the management of these severe grades of injuries appears to improve survival in these highly lethal injuries. A prospective multi-institutional study is needed to validate this approach.

Grade Inflation and Law School Admissions

ERIC Educational Resources Information Center

Wongsurawat, Winai

2008-01-01

Purpose: The purpose of this paper is to evaluate the evidence on whether grade inflation has led to an increasing emphasis on standardized test scores as a criterion for law school admissions. Design/methodology/approach: Fit probabilistic models to admissions data for American law schools during the mid to late 1990s, a period during which…

Evaluation of GALAXY Classroom Science for Grades 3-5. Final Report. Executive Summary.

ERIC Educational Resources Information Center

Guth, Gloria J. A.; Austin, Susan; DeLong, Bo; Pasta, David J.; Block, Clifford

The GALAXY Classroom is a package of integrated curricular and instructional approaches, supported by the first U.S. interactive satellite communications network designed to facilitate the introduction of innovative curricula to improve student learning in elementary schools. GALAXY Classroom Science for grades 3-5 features the organization of…

Synthesis, grading, and presentation of evidence in guidelines: article 7 in Integrating and coordinating efforts in COPD guideline development. An official ATS/ERS workshop report.

PubMed

Guyatt, Gordon; Akl, Elie A; Oxman, Andy; Wilson, Kevin; Puhan, Milo A; Wilt, Timothy; Gutterman, David; Woodhead, Mark; Antman, Elliott M; Schünemann, Holger J

2012-12-01

Professional societies, like many other organizations around the world, have recognized the need to use more rigorous processes to ensure that health care recommendations are informed by the best available research evidence. This is the seventh of a series of 14 articles that were prepared to advise guideline developers in respiratory and other diseases on approaches for guideline development. This article focuses on synthesizing, rating, and presenting evidence in guidelines. In this review we addressed the following questions. (1) What evidence should guideline panels use to inform their recommendations? (2) How should they rate the quality of the evidence they use? (3) How should they grade evidence regarding diagnostic tests? (4) What should they do when quality of evidence differs across outcomes? (5) How should they present the evidence in a guideline? We did not conduct systematic reviews ourselves. We relied on prior evaluations of electronic databases and systematic reviews suggesting that the Grades of Recommendation, Assessment, Development and Evaluation Working Group (GRADE) approach includes the desired features of a system for grading quality of evidence, including provision of models for presenting evidence for guideline panels, and for the consumers of practice guidelines. This article describes the GRADE approach to grading the quality of evidence and presenting evidence. Available evidence, the practice of leading guideline developers, and workshop discussions provide the basis for our conclusions. GRADE rates the quality of evidence for each outcome across studies rather than for each study. In the GRADE approach randomized trials start as high-quality evidence and observational studies as low-quality evidence, but both can be rated down or up. Five factors may lead to rating down the quality of evidence: study limitations or risk of bias, inconsistency of results, indirectness of evidence, imprecision, and publication bias. Three factors may lead to rating up the quality of evidence from observational studies: large magnitude of effect, dose-response gradient, and situations in which all plausible confounders would decrease an apparent treatment effect, or would create a spurious effect when results suggest no effect. GRADE suggests use of evidence profiles that provide a comprehensive way to display the key evidence relevant to a clinical question. Guideline developers who follow this structure will find the transparency of their recommendations markedly enhanced.

Convolutional neural networks for an automatic classification of prostate tissue slides with high-grade Gleason score

NASA Astrophysics Data System (ADS)

Jiménez del Toro, Oscar; Atzori, Manfredo; Otálora, Sebastian; Andersson, Mats; Eurén, Kristian; Hedlund, Martin; Rönnquist, Peter; Müller, Henning

2017-03-01

The Gleason grading system was developed for assessing prostate histopathology slides. It is correlated to the outcome and incidence of relapse in prostate cancer. Although this grading is part of a standard protocol performed by pathologists, visual inspection of whole slide images (WSIs) has an inherent subjectivity when evaluated by different pathologists. Computer aided pathology has been proposed to generate an objective and reproducible assessment that can help pathologists in their evaluation of new tissue samples. Deep convolutional neural networks are a promising approach for the automatic classification of histopathology images and can hierarchically learn subtle visual features from the data. However, a large number of manual annotations from pathologists are commonly required to obtain sufficient statistical generalization when training new models that can evaluate the daily generated large amounts of pathology data. A fully automatic approach that detects prostatectomy WSIs with high-grade Gleason score is proposed. We evaluate the performance of various deep learning architectures training them with patches extracted from automatically generated regions-of-interest rather than from manually segmented ones. Relevant parameters for training the deep learning model such as size and number of patches as well as the inclusion or not of data augmentation are compared between the tested deep learning architectures. 235 prostate tissue WSIs with their pathology report from the publicly available TCGA data set were used. An accuracy of 78% was obtained in a balanced set of 46 unseen test images with different Gleason grades in a 2-class decision: high vs. low Gleason grade. Grades 7-8, which represent the boundary decision of the proposed task, were particularly well classified. The method is scalable to larger data sets with straightforward re-training of the model to include data from multiple sources, scanners and acquisition techniques. Automatically generated heatmaps for theWSIs could be useful for improving the selection of patches when training networks for big data sets and to guide the visual inspection of these images.

Quantitative T2 Magnetic Resonance Imaging Compared to Morphological Grading of the Early Cervical Intervertebral Disc Degeneration: An Evaluation Approach in Asymptomatic Young Adults

PubMed Central

Han, Zhihua; Shao, Lixin; Xie, Yan; Wu, Jianhong; Zhang, Yan; Xin, Hongkui; Ren, Aijun; Guo, Yong; Wang, Deli; He, Qing; Ruan, Dike

2014-01-01

Objective The objective of this study was to evaluate the efficacy of quantitative T2 magnetic resonance imaging (MRI) for quantifying early cervical intervertebral disc (IVD) degeneration in asymptomatic young adults by correlating the T2 value with Pfirrmann grade, sex, and anatomic level. Methods Seventy asymptomatic young subjects (34 men and 36 women; mean age, 22.80±2.11 yr; range, 18–25 years) underwent 3.0-T MRI to obtain morphological data (one T1-fast spin echo (FSE) and three-plane T2-FSE, used to assign a Pfirrmann grade (I–V)) and for T2 mapping (multi-echo spin echo). T2 values in the nucleus pulposus (NP, n = 350) and anulus fibrosus (AF, n = 700) were obtained. Differences in T2 values between sexes and anatomic level were evaluated, and linear correlation analysis of T2 values versus degenerative grade was conducted. Findings Cervical IVDs of healthy young adults were commonly determined to be at Pfirrmann grades I and II. T2 values of NPs were significantly higher than those of AF at all anatomic levels (P<0.000). The NP, anterior AF and posterior AF values did not differ significantly between genders at the same anatomic level (P>0.05). T2 values decreased linearly with degenerative grade. Linear correlation analysis revealed a strong negative association between the Pfirrmann grade and the T2 values of the NP (P = 0.000) but not the T2 values of the AF (P = 0.854). However, non-degenerated discs (Pfirrmann grades I and II) showed a wide range of T2 relaxation time. T2 values according to disc degeneration level classification were as follows: grade I (>62.03 ms), grade II (54.60–62.03 ms), grade III (<54.60 ms). Conclusions T2 quantitation provides a more sensitive and robust approach for detecting and characterizing the early stage of cervical IVD degeneration and to create a reliable quantitative in healthy young adults. PMID:24498384

Quantitative T2 magnetic resonance imaging compared to morphological grading of the early cervical intervertebral disc degeneration: an evaluation approach in asymptomatic young adults.

PubMed

Chen, Chun; Huang, Minghua; Han, Zhihua; Shao, Lixin; Xie, Yan; Wu, Jianhong; Zhang, Yan; Xin, Hongkui; Ren, Aijun; Guo, Yong; Wang, Deli; He, Qing; Ruan, Dike

2014-01-01

The objective of this study was to evaluate the efficacy of quantitative T2 magnetic resonance imaging (MRI) for quantifying early cervical intervertebral disc (IVD) degeneration in asymptomatic young adults by correlating the T2 value with Pfirrmann grade, sex, and anatomic level. Seventy asymptomatic young subjects (34 men and 36 women; mean age, 22.80±2.11 yr; range, 18-25 years) underwent 3.0-T MRI to obtain morphological data (one T1-fast spin echo (FSE) and three-plane T2-FSE, used to assign a Pfirrmann grade (I-V)) and for T2 mapping (multi-echo spin echo). T2 values in the nucleus pulposus (NP, n = 350) and anulus fibrosus (AF, n = 700) were obtained. Differences in T2 values between sexes and anatomic level were evaluated, and linear correlation analysis of T2 values versus degenerative grade was conducted. Cervical IVDs of healthy young adults were commonly determined to be at Pfirrmann grades I and II. T2 values of NPs were significantly higher than those of AF at all anatomic levels (P<0.000). The NP, anterior AF and posterior AF values did not differ significantly between genders at the same anatomic level (P>0.05). T2 values decreased linearly with degenerative grade. Linear correlation analysis revealed a strong negative association between the Pfirrmann grade and the T2 values of the NP (P = 0.000) but not the T2 values of the AF (P = 0.854). However, non-degenerated discs (Pfirrmann grades I and II) showed a wide range of T2 relaxation time. T2 values according to disc degeneration level classification were as follows: grade I (>62.03 ms), grade II (54.60-62.03 ms), grade III (<54.60 ms). T2 quantitation provides a more sensitive and robust approach for detecting and characterizing the early stage of cervical IVD degeneration and to create a reliable quantitative in healthy young adults.

Quantitative T2 evaluation at 3.0T compared to morphological grading of the lumbar intervertebral disc: a standardized evaluation approach in patients with low back pain.

PubMed

Stelzeneder, David; Welsch, Goetz Hannes; Kovács, Balázs Krisztián; Goed, Sabine; Paternostro-Sluga, Tatjana; Vlychou, Marianna; Friedrich, Klaus; Mamisch, Tallal Charles; Trattnig, Siegfried

2012-02-01

The purpose of our investigation was to compare quantitative T2 relaxation time measurement evaluation of lumbar intervertebral discs with morphological grading in young to middle-aged patients with low back pain, using a standardized region-of-interest evaluation approach. Three hundred thirty lumbar discs from 66 patients (mean age, 39 years) with low back pain were examined on a 3.0T MR unit. Sagittal T1-FSE, sagittal, coronal, and axial T2-weighted FSE for morphological MRI, as well as a multi-echo spin-echo sequence for T2 mapping, were performed. Morphologically, all discs were classified according to Pfirrmann et al. Equally sized rectangular regions of interest (ROIs) for the annulus fibrosus were selected anteriorly and posteriorly in the outermost 20% of the disc. The space between was defined as the nucleus pulposus. To assess the reproducibility of this evaluation, inter- and intraobserver statistics were performed. The Pfirrmann scoring of 330 discs showed the following results: grade I: six discs (1.8%); grade II: 189 (57.3%); grade III: 96 (29.1%); grade IV: 38 (11.5%); and grade V: one (0.3%). The mean T2 values (in milliseconds) for the anterior and the posterior annulus, and the nucleus pulposus for the respective Pfirrmann groups were: I: 57/30/239; II: 44/67/129; III: 42/51/82; and IV: 42/44/56. The nucleus pulposus T2 values showed a stepwise decrease from Pfirrmann grade I to IV. The posterior annulus showed the highest T2 values in Pfirrmann group II, while the anterior annulus showed relatively constant T2 values in all Pfirrmann groups. The inter- and intraobserver analysis yielded intraclass correlation coefficients (ICC) for average measures in a range from 0.82 (anterior annulus) to 0.99 (nucleus). Our standardized method of region-specific quantitative T2 relaxation time evaluation seems to be able to characterize different degrees of disc degeneration quantitatively. The reproducibility of our ROI measurements is sufficient to encourage the use of this method in future investigations, particularly for longitudinal studies. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Outcome evaluation of a high school smoking reduction intervention based on extracurricular activities.

PubMed

Brown, K Stephen; Cameron, Roy; Madill, Cheryl; Payne, M Elizabeth; Filsinger, Stephanie; Manske, Stephen R; Best, J Allan

2002-11-01

An outcome evaluation of a high school tobacco control intervention using extracurricular activities developed by teachers and students is reported. Eligible subjects (n = 3,028) had participated in a randomized trial of an elementary school smoking prevention curriculum. Their high schools were matched in pairs; one school in each pair was randomly assigned to the intervention condition, the second to a "usual-care" control condition. Data were collected at the end of Grades 9 and 10. For Grade 8 never smokers, regular smoking rates were significantly lower for males from intervention schools (9.8 vs 16.2%, P = 0.02) at the end of Grade 10. There were no significant differences among Grade 10 smoking rates for females, or for students of either gender with previous smoking experience in Grade 8. The extracurricular activities approach to tobacco control is practical to implement and has promise.

Resource utilization and costs associated with the diagnostic evaluation of nonrefluxing primary hydronephrosis in infants.

PubMed

Akhavan, Ardavan; Shnorhavorian, Margarett; Garrison, Louis P; Merguerian, Paul A

2014-09-01

Long-term evaluation of postnatal nonrefluxing primary hydronephrosis presents a dilemma for urologists since most cases resolve without surgery. We report longitudinal resource utilization and costs associated with diagnostic evaluation of infants with isolated primary nonrefluxing hydronephrosis to determine the costs associated with diagnosing a surgical case, and we assess the implications using a cost-consequences analysis. A retrospective chart review was used to capture resource utilization for all patients younger than 6 months with hydronephrosis evaluated at our institution during a 5-year period. Infants with confounding urological diagnoses were excluded. Payer and societal perspectives were used. Costs were estimated from resource utilization, including radiographic imaging and clinical encounter types. Data were collected from first clinic visit until surgery or resolution or 3 years, whichever was shortest. Of 165 included patients surgical rates for hydronephrosis were 0% for grade I, 5% for grade II, 21% for grade III and 74% for grade IV. Median respective costs of identifying a single surgical case per increasing hydronephrosis grade 0 to IV were infinite, $37,600, $11,741 and $2,124 (p <0.001), respectively. Diagnostic evaluation of higher grades of hydronephrosis is significantly more productive in terms of identifying patients requiring surgery vs evaluation of patients with lower grade disease. In patients with grades I and II hydronephrosis a more abbreviated diagnostic strategy than the current standard of care may be warranted. For the population in this analysis we project that a less intensive approach could save about 24% of costs. Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

The process of collecting and evaluating evidences for the development of Guidelines for the management of rheumatoid arthritis, Japan College of Rheumatology 2014: Utilization of GRADE approach.

PubMed

Kojima, Masayo; Nakayama, Takeo; Kawahito, Yutaka; Kaneko, Yuko; Kishimoto, Mitsumasa; Hirata, Shintaro; Seto, Yohei; Endo, Hirahito; Ito, Hiromu; Kojima, Toshihisa; Nishida, Keiichiro; Matsushita, Isao; Tsutani, Kiichiro; Igarashi, Ataru; Kamatani, Naoyuki; Hasegawa, Mieko; Miyasaka, Nobuyuki; Yamanaka, Hisashi

2016-01-01

To describe the process of collecting and evaluating evidence for treating rheumatoid arthritis (RA) for developing clinical practice guidelines (CPGs) for rheumatologists in Japan. The task force comprised rheumatologists, epidemiologists, health economists, and patients. First, the critical outcomes were determined according to a three-round Delphi method, and eight topics with 88 clinical questions (CQs) were formulated. A systematic review of CQs was conducted using the Cochran Database of Systematic Reviews, MEDLINE, and Japana Centra Revvo Medicina (2003-2012). A questionnaire survey and focus group interview were performed to capture the patients' values and preferences. Data from the National Health Insurance drug price list and product information provided by pharmaceutical companies were collected to evaluate drug cost and safety. The GRADE approach was used to describe the evidence quality and determine the strength of recommendations. Recommendations were developed using a modified Delphi method by a multidisciplinary panel including patients. Eight meetings and frequent e-mail communications were conducted to draft a quality assessment of evidence and recommendations. For 88 CQs, recommendation statements were determined. Using the GRADE approach, new CPGs successfully addressed important clinical issues for treating RA patients. Timely updating of recommendations should be routinely considered.

An Evaluation of a Self-Paced Approach to Elementary Chemistry Instruction.

ERIC Educational Resources Information Center

Schaumburg, Gary F.

The objectives of this study were: (1) to compare retention rates between self-paced (SP) and classical lecture (CL) chemistry students as measured by the proportion of students who received a withdrawal or unofficial withdrawal grade; (2) as indicated by the distribution of final grades, to compare student achievement between SP and CL students;…

Representational Practices by the Numbers: How Kindergarten and First-Grade Students Create, Evaluate, and Modify Their Science Representations

ERIC Educational Resources Information Center

Danish, Joshua Adam; Phelps, David

2011-01-01

A productive approach to studying the role of representations in supporting students' learning of science content is to examine their actions from a practice perspective. The current study examines kindergarten and first-grade students' representational practices across a consistent context--the creation of storyboards--both before and after a…

Evaluating the Effectiveness of First Grade Literacy Interventions: Reading Recovery and Leveled Literacy Intervention

ERIC Educational Resources Information Center

Miller, Heidi Thomson

2014-01-01

This is a quantitative research project utilizing secondary data. Reading Recovery and Leveled Literacy Intervention are two early literacy interventions based on a whole language and phonetic approach to reading instruction. For the purposes of this study, the end-of-first-grade benchmark is a Developmental Reading Assessment (DRA) 18 and the…

An Evaluation of Two Approaches for Teaching Reading Comprehension Strategies in the Primary Years Using Science Information Texts

ERIC Educational Resources Information Center

Reutzel, D. Ray; Smith, John A.; Fawson, Parker C.

2005-01-01

There are few research studies on the effects of teaching comprehension strategies to young children in the primary grades. Using a Dominant-Less Dominant Mixed Model design employing both qualitative and quantitative data collection, we evaluated two approaches for teaching comprehension strategies to 7- and 8-year-old children in four…

Diffusion Profiling via a Histogram Approach Distinguishes Low-grade from High-grade Meningiomas, Can Reflect the Respective Proliferative Potential and Progesterone Receptor Status.

PubMed

Gihr, Georg Alexander; Horvath-Rizea, Diana; Garnov, Nikita; Kohlhof-Meinecke, Patricia; Ganslandt, Oliver; Henkes, Hans; Meyer, Hans Jonas; Hoffmann, Karl-Titus; Surov, Alexey; Schob, Stefan

2018-02-01

Presurgical grading, estimation of growth kinetics, and other prognostic factors are becoming increasingly important for selecting the best therapeutic approach for meningioma patients. Diffusion-weighted imaging (DWI) provides microstructural information and reflects tumor biology. A novel DWI approach, histogram profiling of apparent diffusion coefficient (ADC) volumes, provides more distinct information than conventional DWI. Therefore, our study investigated whether ADC histogram profiling distinguishes low-grade from high-grade lesions and reflects Ki-67 expression and progesterone receptor status. Pretreatment ADC volumes of 37 meningioma patients (28 low-grade, 9 high-grade) were used for histogram profiling. WHO grade, Ki-67 expression, and progesterone receptor status were evaluated. Comparative and correlative statistics investigating the association between histogram profiling and neuropathology were performed. The entire ADC profile (p10, p25, p75, p90, mean, median) was significantly lower in high-grade versus low-grade meningiomas. The lower percentiles, mean, and modus showed significant correlations with Ki-67 expression. Skewness and entropy of the ADC volumes were significantly associated with progesterone receptor status and Ki-67 expression. ROC analysis revealed entropy to be the most accurate parameter distinguishing low-grade from high-grade meningiomas. ADC histogram profiling provides a distinct set of parameters, which help differentiate low-grade versus high-grade meningiomas. Also, histogram metrics correlate significantly with histological surrogates of the respective proliferative potential. More specifically, entropy revealed to be the most promising imaging biomarker for presurgical grading. Both, entropy and skewness were significantly associated with progesterone receptor status and Ki-67 expression and therefore should be investigated further as predictors for prognostically relevant tumor biological features. Since absolute ADC values vary between MRI scanners of different vendors and field strengths, their use is more limited in the presurgical setting.

Field evaluation of a wayside horn at a highway-railroad grade crossing

DOT National Transportation Integrated Search

1998-06-01

The current study represents one of several efforts by the Federal Railroad Administration to evaluate the effectiveness of auditory warnings designed to promote awareness of approaching trains. A stationary horn (or wayside horn) located at the grad...

GRADE Evidence to Decision (EtD) frameworks for adoption, adaptation, and de novo development of trustworthy recommendations: GRADE-ADOLOPMENT.

PubMed

Schünemann, Holger J; Wiercioch, Wojtek; Brozek, Jan; Etxeandia-Ikobaltzeta, Itziar; Mustafa, Reem A; Manja, Veena; Brignardello-Petersen, Romina; Neumann, Ignacio; Falavigna, Maicon; Alhazzani, Waleed; Santesso, Nancy; Zhang, Yuan; Meerpohl, Jörg J; Morgan, Rebecca L; Rochwerg, Bram; Darzi, Andrea; Rojas, Maria Ximenas; Carrasco-Labra, Alonso; Adi, Yaser; AlRayees, Zulfa; Riva, John; Bollig, Claudia; Moore, Ainsley; Yepes-Nuñez, Juan José; Cuello, Carlos; Waziry, Reem; Akl, Elie A

2017-01-01

Guideline developers can: (1) adopt existing recommendations from others; (2) adapt existing recommendations to their own context; or (3) create recommendations de novo. Monetary and nonmonetary resources, credibility, maximization of uptake, as well as logical arguments should guide the choice of the approach and processes. To describe a potentially efficient model for guideline production based on adoption, adaptation, and/or de novo development of recommendations utilizing the Grading of Recommendations Assessment, Development and Evaluation (GRADE) Evidence to Decision (EtD) frameworks. We applied the model in a new national guideline program producing 22 practice guidelines. We searched for relevant evidence that informs the direction and strength of a recommendation. We then produced GRADE EtDs for guideline panels to develop recommendations. We produced a total of 80 EtD frameworks in approximately 4 months and 146 EtDs in approximately 6 months in two waves. Use of the EtD frameworks allowed panel members understand judgments of others about the criteria that bear on guideline recommendations and then make their own judgments about those criteria in a systematic approach. The "GRADE-ADOLOPMENT" approach to guideline production combines adoption, adaptation, and, as needed, de novo development of recommendations. If developers of guidelines follow EtD criteria more widely and make their work publically available, this approach should prove even more useful. Copyright © 2016 The Author(s). Published by Elsevier Inc. All rights reserved.

A Gold Standards Approach to Training Instructors to Evaluate Crew Performance

NASA Technical Reports Server (NTRS)

Baker, David P.; Dismukes, R. Key

2003-01-01

The Advanced Qualification Program requires that airlines evaluate crew performance in Line Oriented Simulation. For this evaluation to be meaningful, instructors must observe relevant crew behaviors and evaluate those behaviors consistently and accurately against standards established by the airline. The airline industry has largely settled on an approach in which instructors evaluate crew performance on a series of event sets, using standardized grade sheets on which behaviors specific to event set are listed. Typically, new instructors are given a class in which they learn to use the grade sheets and practice evaluating crew performance observed on videotapes. These classes emphasize reliability, providing detailed instruction and practice in scoring so that all instructors within a given class will give similar scores to similar performance. This approach has value but also has important limitations; (1) ratings within one class of new instructors may differ from those of other classes; (2) ratings may not be driven primarily by the specific behaviors on which the company wanted the crews to be scored; and (3) ratings may not be calibrated to company standards for level of performance skill required. In this paper we provide a method to extend the existing method of training instructors to address these three limitations. We call this method the "gold standards" approach because it uses ratings from the company's most experienced instructors as the basis for training rater accuracy. This approach ties the training to the specific behaviors on which the experienced instructors based their ratings.

Nonoperative management for major blunt hepatic trauma. A case report.

PubMed

Mingoli, Andrea; Saracino, Andrea; Brachini, Gioia; Mariotta, Giovanni; Migliori, Emanuele; Silvestri, Vania

2015-03-16

Over the past 20 years the management of blunt liver trauma has evolved from a primary operative approach to a nonoperative one, for both low and high grade injuries, only on the basis of hemodynamic stability. However, in spite of a high success rate of non operative management, it is frequently observed, also in our country, an old fashioned way to approach these patients, based on habit more than observation and evidence based medicine. We present a case of successful nonoperative treatment of a grade IV blunt liver trauma (lacero-contusive injury of V, VI and VII segments) in a 34-year-old woman. Nowadays more than 85% of liver injuries are managed without operative intervention, irrespective of the injury grade. Success rate of the conservative approach ranges from 82% to 100% and almost all complications (14% in high grade injuries) can be managed with interventional radiology procedures, still avoiding major surgery. Today, in the absence of other abdominal injuries requiring surgical exploration, hemodynamic instability from ongoing hemorrhage after primary evaluation and resuscitative treatment, is the only indication to an operative management of traumatic liver injuries.

Validation of a paper-disk approach to facilitate the sensory evaluation of bitterness in dairy protein hydrolysates from a newly developed food-grade fractionation system.

PubMed

Murray, Niamh M; O'Riordan, Dolores; Jacquier, Jean-Christophe; O'Sullivan, Michael; Cohen, Joshua L; Heymann, Hildegarde; Barile, Daniela; Dallas, David C

2017-06-01

Casein-hydrolysates (NaCaH) are desirable functional ingredients, but their bitterness impedes usage in foods. This study sought to validate a paper-disk approach to help evaluate bitterness in NaCaHs and to develop a food-grade approach to separate a NaCaH into distinct fractions, which could be evaluated by a sensory panel. Membrane filtration generated <0.2-μm and <3-kDa permeates. Further fractionation of the <3-kDa permeate by flash-chromatography generated four fractions using ethanol (EtOH) concentrations of 5, 10, 30 and 50%. As some fractions were poorly soluble in water, the fractions were resolubilzed in EtOH and impregnated into paper-disks for sensory evaluation. Bitterness differences observed in the membrane fractions using this sensory evaluation approach reflected those observed for the same fractions presented as a liquid. The flash-chromatography fractions increased in bitterness with an increase in hydrophobicity, except for the 50% EtOH fraction which had little bitterness. Amino acid analysis of the fractions showed enrichment of different essential amino acids in both the bitter and less bitter fractions. The developed food-grade fractionation system, allowed for a simple and reasonably scaled approach to separating a NaCaH, into physicochemically different fractions that could be evaluated by a sensory panel. The method of sensory evaluation used in this study, in which NaCaH samples are impregnated into paper-disks, provided potential solutions for issues such as sample insolubility and limited quantities of sample. As the impregnated paper-disk samples were dehydrated, their long storage life could also be suitable for sensory evaluations distributed by mail for large consumer studies. The research, in this study, allowed for a greater understanding of the physicochemical basis for bitterness in this NaCaH. As some essential amino acids were enriched in the less bitter fractions, selective removal of bitter fractions could allow for the incorporation of the less bitter NaCaH fractions into food products for added nutritional value, without negatively impacting sensory properties. There is potential for this approach to be applied to other food ingredients with undesirable tastes, such as polyphenols.

Validation of a paper-disk approach to facilitate the sensory evaluation of bitterness in dairy protein hydrolysates from a newly developed food-grade fractionation system

PubMed Central

Murray, Niamh M.; O'Riordan, Dolores; Jacquier, Jean-Christophe; O'Sullivan, Michael; Cohen, Joshua L.; Heymann, Hildegarde; Barile, Daniela; Dallas, David C.

2017-01-01

Casein-hydrolysates (NaCaH) are desirable functional ingredients, but their bitterness impedes usage in foods. This study sought to validate a paper-disk approach to help evaluate bitterness in NaCaHs and to develop a food-grade approach to separate a NaCaH into distinct fractions, which could be evaluated by a sensory panel. Membrane filtration generated <0.2-μm and <3-kDa permeates. Further fractionation of the <3-kDa permeate by flash-chromatography generated four fractions using ethanol (EtOH) concentrations of 5, 10, 30 and 50%. As some fractions were poorly soluble in water, the fractions were resolubilzed in EtOH and impregnated into paper-disks for sensory evaluation. Bitterness differences observed in the membrane fractions using this sensory evaluation approach reflected those observed for the same fractions presented as a liquid. The flash-chromatography fractions increased in bitterness with an increase in hydrophobicity, except for the 50% EtOH fraction which had little bitterness. Amino acid analysis of the fractions showed enrichment of different essential amino acids in both the bitter and less bitter fractions. Practical Applications The developed food-grade fractionation system, allowed for a simple and reasonably scaled approach to separating a NaCaH, into physicochemically different fractions that could be evaluated by a sensory panel. The method of sensory evaluation used in this study, in which NaCaH samples are impregnated into paper-disks, provided potential solutions for issues such as sample insolubility and limited quantities of sample. As the impregnated paper-disk samples were dehydrated, their long storage life could also be suitable for sensory evaluations distributed by mail for large consumer studies. The research, in this study, allowed for a greater understanding of the physicochemical basis for bitterness in this NaCaH. As some essential amino acids were enriched in the less bitter fractions, selective removal of bitter fractions could allow for the incorporation of the less bitter NaCaH fractions into food products for added nutritional value, without negatively impacting sensory properties. There is potential for this approach to be applied to other food ingredients with undesirable tastes, such as polyphenols. PMID:29104365

10 CFR 830.7 - Graded approach.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 4 2013-01-01 2013-01-01 false Graded approach. 830.7 Section 830.7 Energy DEPARTMENT OF ENERGY NUCLEAR SAFETY MANAGEMENT § 830.7 Graded approach. Where appropriate, a contractor must use a graded approach to implement the requirements of this part, document the basis of the graded approach...

10 CFR 830.7 - Graded approach.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 4 2012-01-01 2012-01-01 false Graded approach. 830.7 Section 830.7 Energy DEPARTMENT OF ENERGY NUCLEAR SAFETY MANAGEMENT § 830.7 Graded approach. Where appropriate, a contractor must use a graded approach to implement the requirements of this part, document the basis of the graded approach...

10 CFR 830.7 - Graded approach.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Graded approach. 830.7 Section 830.7 Energy DEPARTMENT OF ENERGY NUCLEAR SAFETY MANAGEMENT § 830.7 Graded approach. Where appropriate, a contractor must use a graded approach to implement the requirements of this part, document the basis of the graded approach...

10 CFR 830.7 - Graded approach.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 4 2011-01-01 2011-01-01 false Graded approach. 830.7 Section 830.7 Energy DEPARTMENT OF ENERGY NUCLEAR SAFETY MANAGEMENT § 830.7 Graded approach. Where appropriate, a contractor must use a graded approach to implement the requirements of this part, document the basis of the graded approach...

Letters, numbers, symbols and words: how to communicate grades of evidence and recommendations

PubMed Central

Schünemann, Holger J.; Best, Dana; Vist, Gunn; Oxman, Andrew D.

2003-01-01

THE GRADE WORKING GROUP IS DEVELOPING and evaluating a common, sensible approach to grading quality of evidence and strength of recommendations in health care. In this article, we discuss the advantages and disadvantages of using letters, numbers, symbols or words to represent grades of evidence and recommendations. Using multiple strategies, we searched for comparative studies of alternative ways of representing ordered categories in any context. In addition, we contacted experts and reviewed theoretical work and qualitative research on how best to communicate grades of any kind quickly and clearly. We were unable to identify health care research that addressed, either directly or indirectly, the best way to present grades of evidence and recommendations. We found examples of symbols used by government, commercial and consumer organizations to communicate quality of evidence or strength of recommendations, but no comparative studies. Although a number of grading systems are used in health care and other fields, there is little or no evidence of how well various presentations are understood. Before promoting the use of specific symbols, numbers, letters or words, the extent to which the intended message is comprehended should be evaluated. PMID:14517128

Developing Seventh Grade Students' Understanding of Complex Environmental Problems with Systems Tools and Representations: A Quasi-Experimental Study

ERIC Educational Resources Information Center

Doganca Kucuk, Zerrin; Saysel, Ali Kerem

2018-01-01

A systems-based classroom intervention on environmental education was designed for seventh grade students; the results were evaluated to see its impact on the development of systems thinking skills and standard science achievement and whether the systems approach is a more effective way to teach environmental issues that are dynamic and complex. A…

Legends for Sale, Poems for Free: Whole Language Activities Can Be Inspired by Risk-Taking and Scene Changes.

ERIC Educational Resources Information Center

Kaminski, Robert

1991-01-01

Describes two classroom activities that were developed to promote a whole language approach to listening, speaking, reading, and writing. One involved fifth grade students who wrote legends that other students paid to read and evaluate, and the other involved an eighth grade English class who gave free poetry readings in a coffee house setting.…

Evaluating the dimensionality of first grade written composition

PubMed Central

Kim, Young-Suk; Al Otaiba, Stephanie; Folsom, Jessica S.; Greulich, Luana; Puranik, Cynthia

2013-01-01

Purpose We examined dimensions of written composition using multiple evaluative approaches such as an adapted 6+1 trait scoring, syntactic complexity measures, and productivity measures. We further examined unique relations of oral language and literacy skills to the identified dimensions of written composition. Method A large sample of first grade students (N = 527) was assessed on their language, reading, spelling, letter writing automaticity, and writing in the spring. Data were analyzed using a latent variable approach including confirmatory factor analysis and structural equation modeling. Results The seven traits in the 6+1 trait system were best described as two constructs: substantive quality, and spelling and writing conventions. When the other evaluation procedures such as productivity and syntactic complexity indicators were included, four dimensions emerged: substantive quality, productivity, syntactic complexity, and spelling and writing conventions. Language and literacy predictors were differentially related to each dimension in written composition. Conclusions These four dimensions may be a useful guideline for evaluating developing beginning writer’s compositions. PMID:24687472

PRECEPT: an evidence assessment framework for infectious disease epidemiology, prevention and control.

PubMed

Harder, Thomas; Takla, Anja; Eckmanns, Tim; Ellis, Simon; Forland, Frode; James, Roberta; Meerpohl, Joerg J; Morgan, Antony; Rehfuess, Eva; Schünemann, Holger; Zuiderent-Jerak, Teun; de Carvalho Gomes, Helena; Wichmann, Ole

2017-10-01

Decisions in public health should be based on the best available evidence, reviewed and appraised using a rigorous and transparent methodology. The Project on a Framework for Rating Evidence in Public Health (PRECEPT) defined a methodology for evaluating and grading evidence in infectious disease epidemiology, prevention and control that takes different domains and question types into consideration. The methodology rates evidence in four domains: disease burden, risk factors, diagnostics and intervention. The framework guiding it has four steps going from overarching questions to an evidence statement. In step 1, approaches for identifying relevant key areas and developing specific questions to guide systematic evidence searches are described. In step 2, methodological guidance for conducting systematic reviews is provided; 15 study quality appraisal tools are proposed and an algorithm is given for matching a given study design with a tool. In step 3, a standardised evidence-grading scheme using the Grading of Recommendations Assessment, Development and Evaluation Working Group (GRADE) methodology is provided, whereby findings are documented in evidence profiles. Step 4 consists of preparing a narrative evidence summary. Users of this framework should be able to evaluate and grade scientific evidence from the four domains in a transparent and reproducible way.

PRECEPT: an evidence assessment framework for infectious disease epidemiology, prevention and control

PubMed Central

Harder, Thomas; Takla, Anja; Eckmanns, Tim; Ellis, Simon; Forland, Frode; James, Roberta; Meerpohl, Joerg J; Morgan, Antony; Rehfuess, Eva; Schünemann, Holger; Zuiderent-Jerak, Teun; de Carvalho Gomes, Helena; Wichmann, Ole

2017-01-01

Decisions in public health should be based on the best available evidence, reviewed and appraised using a rigorous and transparent methodology. The Project on a Framework for Rating Evidence in Public Health (PRECEPT) defined a methodology for evaluating and grading evidence in infectious disease epidemiology, prevention and control that takes different domains and question types into consideration. The methodology rates evidence in four domains: disease burden, risk factors, diagnostics and intervention. The framework guiding it has four steps going from overarching questions to an evidence statement. In step 1, approaches for identifying relevant key areas and developing specific questions to guide systematic evidence searches are described. In step 2, methodological guidance for conducting systematic reviews is provided; 15 study quality appraisal tools are proposed and an algorithm is given for matching a given study design with a tool. In step 3, a standardised evidence-grading scheme using the Grading of Recommendations Assessment, Development and Evaluation Working Group (GRADE) methodology is provided, whereby findings are documented in evidence profiles. Step 4 consists of preparing a narrative evidence summary. Users of this framework should be able to evaluate and grade scientific evidence from the four domains in a transparent and reproducible way. PMID:29019317

[GRADE Evidence to Decision (EtD) frameworks: a systematic and transparent approach to making well informed healthcare choices. 2: Clinical practice guidelines.

PubMed

Morgano, Gian Paolo; Parmelli, Elena; Amato, Laura; Iannone, Primiano; Marchetti, Marco; Moja, Lorenzo; Davoli, Marina; Schünemann, Holger

2018-05-01

In the first article in this series we described the GRADE (Grading of Recommendations Assessment, Development and Evaluation) Evidence to Decision (EtD) frameworks and their rationale for different types of decisions. In this second article, we describe the use of EtD frameworks for clinical recommendations and how it can help clinicians and patients who use those recommendations. EtD frameworks for clinical practice recommendations provide a structured and transparent approach for guideline panels. The framework helps ensure consideration of key criteria that determine whether an intervention should be recommended and that judgments are informed by the best available evidence. Frameworks are also a way for panels to make guideline users aware of the rationale (justification) for their recommendations.

Evaluation and Management of Traumatic Diaphragmatic Injuries: A Practice Management Guideline from the Eastern Association for the Surgery of Trauma.

PubMed

McDonald, Amy A; Robinson, Bryce R H; Alarcon, Louis; Bosarge, Patrick L; Dorion, Heath; Haut, Elliott R; Juern, Jeremy; Madbak, Firas; Reddy, Srinivas; Weiss, Patricia; Como, John J

2018-04-02

Traumatic diaphragm injuries (TDI) pose both diagnostic and therapeutic challenges in both the acute and chronic phases. There are no published practice management guidelines to date for TDI. We aim to formulate a practice management guideline for TDI using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. The working group formulated five Patient, Intervention, Comparator, Outcome (PICO) questions regarding the following topics: 1) diagnostic approach (laparoscopy vs. computed tomography); 2) non-operative management of penetrating right-sided injuries; 3) surgical approach (abdominal or thoracic) for acute TDI, including 4) the use of laparoscopy; and 5) surgical approach (abdominal or thoracic) for delayed TDI. A systematic review was undertaken and last updated December 2016. RevMan 5 (Cochran Collaboration) and GRADEpro (Grade Working Group) software were utilized. Recommendations were voted on by working group members. Consensus was obtained for each recommendation. A total of 56 articles were utilized to formulate the recommendations. Most studies were retrospective case series with variable reporting of outcomes measures and outcomes frequently not stratified to intervention or comparator. The overall quality of the evidence was very low for all PICOs. Therefore, only conditional recommendations could be made. Recommendations were made in favor of laparoscopy over CT for diagnosis, non-operative vs. operative approach for right-sided penetrating injuries, abdominal vs. thoracic approach for acute TDI, and laparoscopy (with the appropriate skill set and resources) vs. open approach for isolated TDI. No recommendation could be made for the preferred operative approach for delayed TDI. Very low-quality evidence precluded any strong recommendations. Further study of the diagnostic and therapeutic approaches to TDI is warranted. Guideline LEVEL OF EVIDENCE: 4.

[The clinical effect and disquisition of anterior cervical approach surgery with posterior longitudinal ligament hook pliers and posterior longitudinal ligament nip pliers].

PubMed

Kuang, Ling-hao; Xu, Dong; Sun, Ya-wei; Cong, Jie; Tian, Ji-wei; Wang, Lei

2010-09-21

To study the clinical effect of anterior cervical approach surgery to removal posterior longitudinal ligament (PLL) with posterior longitudinal ligament hook pliers and posterior longitudinal ligament nip pliers. To retrospectively analyzed anterior cervical approach surgery treatment 73 patients who were cervical spondylosis myelopathy. All patients removal PLL with self-make instrument, According to JOA grade to evaluate effect of operations. Full patients removal PLL were in succeed, in shape of extradural has renew, the JOA grade were increase, (12.8 ± 3.2) vs (8.3 ± 1.9). Removal PLL were increase effect of downright decompress in anterior cervical approach surgery, Operations become safety agile and reduce the complications with self-make instrument.

Mechanical and biological properties of the micro-/nano-grain functionally graded hydroxyapatite bioceramics for bone tissue engineering.

PubMed

Zhou, Changchun; Deng, Congying; Chen, Xuening; Zhao, Xiufen; Chen, Ying; Fan, Yujiang; Zhang, Xingdong

2015-08-01

Functionally graded materials (FGM) open the promising approach for bone tissue repair. In this study, a novel functionally graded hydroxyapatite (HA) bioceramic with micrograin and nanograin structure was fabricated. Its mechanical properties were tailored by composition of micrograin and nanograin. The dynamic mechanical analysis (DMA) indicated that the graded HA ceramics had similar mechanical property compared to natural bones. Their cytocompatibility was evaluated via fluorescent microscopy and MTT colorimetric assay. The viability and proliferation of rabbit bone marrow mesenchymal stem cells (BMSCs) on ceramics indicated that this functionally graded HA ceramic had better cytocompatibility than conventional HA ceramic. This study demonstrated that functionally graded HA ceramics create suitable structures to satisfy both the mechanical and biological requirements of bone tissues. Copyright © 2015 Elsevier Ltd. All rights reserved.

GRADE equity guidelines 1: considering health equity in GRADE guideline development: introduction and rationale.

PubMed

Welch, Vivian A; Akl, Elie A; Guyatt, Gordon; Pottie, Kevin; Eslava-Schmalbach, Javier; Ansari, Mohammed T; de Beer, Hans; Briel, Matthias; Dans, Tony; Dans, Inday; Hultcrantz, Monica; Jull, Janet; Katikireddi, Srinivasa Vittal; Meerpohl, Joerg; Morton, Rachael; Mosdol, Annhild; Petkovic, Jennifer; Schünemann, Holger J; Sharaf, Ravi N; Singh, Jasvinder A; Stanev, Roger; Tonia, Thomy; Tristan, Mario; Vitols, Sigurd; Watine, Joseph; Tugwell, Peter

2017-10-01

This article introduces the rationale and methods for explicitly considering health equity in the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology for development of clinical, public health, and health system guidelines. We searched for guideline methodology articles, conceptual articles about health equity, and examples of guidelines that considered health equity explicitly. We held three meetings with GRADE Working Group members and invited comments from the GRADE Working Group listserve. We developed three articles on incorporating equity considerations into the overall approach to guideline development, rating certainty, and assembling the evidence base and evidence to decision and/or recommendation. Clinical and public health guidelines have a role to play in promoting health equity by explicitly considering equity in the process of guideline development. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

41 CFR 102-80.120 - What analytical and empirical tools should be used to support the life safety equivalency...

Code of Federal Regulations, 2010 CFR

2010-07-01

... used to support the life safety equivalency evaluation? Analytical and empirical tools, including fire models and grading schedules such as the Fire Safety Evaluation System (Alternative Approaches to Life... empirical tools should be used to support the life safety equivalency evaluation? 102-80.120 Section 102-80...

41 CFR 102-80.120 - What analytical and empirical tools should be used to support the life safety equivalency...

Code of Federal Regulations, 2011 CFR

2011-01-01

... used to support the life safety equivalency evaluation? Analytical and empirical tools, including fire models and grading schedules such as the Fire Safety Evaluation System (Alternative Approaches to Life... empirical tools should be used to support the life safety equivalency evaluation? 102-80.120 Section 102-80...

Graphical displays for effective reporting of evidence quality tables in research syntheses.

PubMed

Mignini, Luciano; Champaneria, Rita; Mishanina, Ekaterina; Khan, Khalid S

2016-03-09

When generating guidelines, quality of the evidence is tabulated to capture its several domains, often using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. We developed a graphic display to capture deficiencies, outliers and similarities across comparisons contained in GRADE tables. Based on a systematic literature review capturing the effects of 32 different therapeutic comparisons on dysmenorrhoea, we synthesised evidence quality in tables and graphs. We evaluated time taken to accurately assess evident quality and preference for tables vs. graphs. The plots provided visually striking displays of strengths and weaknesses of the evidence across the spectrum of comparisons on a single page. Equivalent tabulated information spread over 4 pages. Participants preferred and interpreted graphs quicker and more accurately than tables. The graphic approach we developed makes interpreting evidence easier. Large tables are dry and cumbersome to read and assimilate. When guideline statements are accompanied by these plots, they have the scope for improving the credibility of the recommendations made, as the strength of the evidence used can be clearly seen. Further empirical research will establish the place for graphic displays.

An IMU Evaluation Method Using a Signal Grafting Scheme

PubMed Central

Niu, Xiaoji; Wang, Qiang; Li, You; Zhang, Quan; Jiang, Peng

2016-01-01

As various inertial measurement units (IMUs) from different manufacturers appear every year, it is not affordable to evaluate every IMU through tests. Therefore, this paper presents an IMU evaluation method by grafting data from the tested IMU to the reference data from a higher-grade IMU. The signal grafting (SG) method has several benefits: (a) only one set of field tests with a higher-grade IMU is needed, and can be used to evaluate numerous IMUs. Thus, SG is effective and economic because all data from the tested IMU is collected in the lab; (b) it is a general approach to compare navigation performances of various IMUs by using the same reference data; and, finally, (c) through SG, one can first evaluate an IMU in the lab, and then decide whether to further test it. Moreover, this paper verified the validity of SG to both medium- and low-grade IMUs, and presents and compared two SG strategies, i.e., the basic-error strategy and the full-error strategy. SG provided results similar to field tests, with a difference of under 5% and 19.4%–26.7% for tested tactical-grade and MEMS IMUs. Meanwhile, it was found that dynamic IMU errors were essential to guarantee the effect of the SG method. PMID:27294932

Mobility, strength, and fitness after a graded activity program for patients with subacute low back pain. A randomized prospective clinical study with a behavioral therapy approach.

PubMed

Lindström, I; Ohlund, C; Eek, C; Wallin, L; Peterson, L E; Nachemson, A

1992-06-01

Patients with nonspecific mechanical low back pain (n = 103), examined by an orthopaedic surgeon and a social worker, were randomized to an activity group (n = 51) and a control group (n = 52). Patients with defined orthopaedic, medical, or psychiatric diagnoses were excluded before randomization. No patients were excluded due to place of birth or difficulties in speaking or understanding the Swedish language. The purpose of the study was to compare mobility, strength and fitness after traditional care and after traditional care plus a graded activity program with a behavioral therapy approach. A graded activity program, with a behavioral therapy approach was given under the guidance of a physical therapist. The endpoint of the graded activity program was return to work. This program significantly increased mobility, strength, and fitness more than could be explained by only a time recovery effect, especially in males. The patients in the activity group returned to work earlier than did the patients in the control group. Spinal rotation, abdominal muscle endurance time and lifting capacity were significantly correlated to rate of return to work. Traditional care plus a graded activity program were superior to only traditional care, evaluated in terms of mobility, strength and fitness. The graded activity program proved to be a successful method of restoring occupational function and facilitating return to work in subacute low back pain patients. The patients in the graded activity program learned that it is safe to move, while regaining function.

On the analysis of local and global features for hyperemia grading

NASA Astrophysics Data System (ADS)

Sánchez, L.; Barreira, N.; Sánchez, N.; Mosquera, A.; Pena-Verdeal, H.; Yebra-Pimentel, E.

2017-03-01

In optometry, hyperemia is the accumulation of blood flow in the conjunctival tissue. Dry eye syndrome or allergic conjunctivitis are two of its main causes. Its main symptom is the presence of a red hue in the eye that optometrists evaluate according to a scale in a subjective manner. In this paper, we propose an automatic approach to the problem of hyperemia grading in the bulbar conjunctiva. We compute several image features on images of the patients' eyes, analyse the relations among them by using feature selection techniques and transform the feature vector of each image to the value in the adequate range by means of machine learning techniques. We analyse different areas of the conjunctiva to evaluate their importance for the diagnosis. Our results show that it is possible to mimic the experts' behaviour through the proposed approach.

Developing Higher Order Reading Comprehension Skills in the Learning Disabled Student: A Non-Basal Approach.

ERIC Educational Resources Information Center

Solomon, Sheila

This practicum study evaluated a non-basal, multidisciplinary, multisensory approach to teaching higher order reading comprehension skills to eight fifth-grade learning-disabled students from low socioeconomic minority group backgrounds. The four comprehension skills were: (1) identifying the main idea; (2) determining cause and effect; (3) making…

Development of Rationale and Measures of Noncognitive College Student Potential

ERIC Educational Resources Information Center

Schmitt, Neal

2012-01-01

In considering and evaluating approaches to the admission of college students, the usual approach is to try to measure past academic achievement and primarily verbal and math ability on the assumption that these abilities will predict subsequent college academic grades and achievement. These measures do predict classroom achievement, though far…

Creating Rich Portraits: A Mixed-Methods Approach to Understanding Profiles of Intrinsic and Extrinsic Motivations

ERIC Educational Resources Information Center

Corpus, Jennifer Henderlong; Wormington, Stephanie V.; Haimovitz, Kyla

2016-01-01

A person-centered, mixed-methods approach (self-report surveys, semistructured interviews, school records) was used to characterize and evaluate profiles of intrinsic and extrinsic motivations among 243 third- through eighth-grade students. Cluster analysis suggested four distinct profiles: high quantity (high intrinsic, high extrinsic), primarily…

The Satisfaction Rate among Patients and Surgeons after Periareolar Surgical Approach to Gynecomastia along with Liposuction.

PubMed

Taheri, Ahmad Reza; Farahvash, Mohamad Reza; Fathi, Hamid Reza; Ghanbarzadeh, Koorosh; Faridniya, Bijan

2016-09-01

Surgery, as the main approach in higher stages of gynecomastia, has different techniques regarding the staging of the disease. The more the grade of gynecomastia, the more complicated the used surgical techniques, conventionally. This study assessed the success rate of the simplest surgical technique in higher grades of gynecology as well as the satisfaction rate in patients and surgeon to offer using the technique for higher grades of the disease. To evaluate the success and the satisfaction rates of periareolar incision and liposuction among patients with grade II and III gynecomastia, this cross-sectional study was conducted. The satisfaction rate was the main concern of the present study. The patients had a mean satisfaction score of 8.1±1.396 with the range of 5-10 from total 10 score. The majority of the patients expressed their satisfaction by 9 score. The total mean of physician satisfaction score was 8.36 at all levels. Like aesthetic reasons which lead individuals to seek solutions for their annoying gynecomastia, aesthetic satisfaction is a prominent concern for people who undergo surgical approach. So, the least surgical scar and complications are absolutely the most area of focus in this regard.

Surgical management of gynecomastia: an outcome analysis.

PubMed

Kasielska, Anna; Antoszewski, Bogusław

2013-11-01

The aim of the study was to evaluate the surgical management of gynecomastia focusing on techniques, complications, and aesthetic results. The authors also proposed an evaluation scale of the cosmetic results after the treatment. We conducted a retrospective analysis of 113 patients undergoing the surgery for gynecomastia in our department. Preoperative clinical evaluation included the grade of gynecomastia, its etiology, and side, whereas postoperative analysis concerned histologic findings, complications, and cosmetic results. Operative techniques included subcutaneous mastectomy through circumareolar approach in 94 patients, subcutaneous mastectomy with skin excision in 9 patients, inverted-T reduction mastopexy with nipple-areola complex (NAC) transposition in 6 subjects, and breast amputation through inframammary fold approach with free transplantation of NAC in 4 cases. Complications occurred in a total of 25 patients and did not differ statistically within Simon stages. The operative technique appeared to be the crucial determinant of good aesthetic outcome. The postoperative result of shape and symmetry of the NAC was not as satisfactory as postoperative breast size and symmetry. We showed that subcutaneous mastectomy using a circumareolar incision without additional liposuction provides a good or very good aesthetic outcome in patients with Simon grades I to IIa gynecomastia and that it is challenging to achieve a very good or even a good aesthetic outcome in patients with Simon grades IIb to III gynecomastia.

Automatic evidence quality prediction to support evidence-based decision making.

PubMed

Sarker, Abeed; Mollá, Diego; Paris, Cécile

2015-06-01

Evidence-based medicine practice requires practitioners to obtain the best available medical evidence, and appraise the quality of the evidence when making clinical decisions. Primarily due to the plethora of electronically available data from the medical literature, the manual appraisal of the quality of evidence is a time-consuming process. We present a fully automatic approach for predicting the quality of medical evidence in order to aid practitioners at point-of-care. Our approach extracts relevant information from medical article abstracts and utilises data from a specialised corpus to apply supervised machine learning for the prediction of the quality grades. Following an in-depth analysis of the usefulness of features (e.g., publication types of articles), they are extracted from the text via rule-based approaches and from the meta-data associated with the articles, and then applied in the supervised classification model. We propose the use of a highly scalable and portable approach using a sequence of high precision classifiers, and introduce a simple evaluation metric called average error distance (AED) that simplifies the comparison of systems. We also perform elaborate human evaluations to compare the performance of our system against human judgments. We test and evaluate our approaches on a publicly available, specialised, annotated corpus containing 1132 evidence-based recommendations. Our rule-based approach performs exceptionally well at the automatic extraction of publication types of articles, with F-scores of up to 0.99 for high-quality publication types. For evidence quality classification, our approach obtains an accuracy of 63.84% and an AED of 0.271. The human evaluations show that the performance of our system, in terms of AED and accuracy, is comparable to the performance of humans on the same data. The experiments suggest that our structured text classification framework achieves evaluation results comparable to those of human performance. Our overall classification approach and evaluation technique are also highly portable and can be used for various evidence grading scales. Copyright © 2015 Elsevier B.V. All rights reserved.

An Ex-Post Facto Examination of Relationships among the Developmental Designs Professional Development Model/Classroom Management Approach, School Leadership, Climate, Student Achievement, Attendance, and Behavior in High Poverty, Middle Grades Schools

ERIC Educational Resources Information Center

Hough, David L.; Schmitt, Vicki L.

2011-01-01

This study reports finding from an ex post facto causal-comparison study utilizing data from a multifaceted program evaluation of a professional development approach to classroom management known as Development Designs 1 and Developmental Designs 2 (DD1 & D2). Data from this program evaluation indicate that teachers implement a number of classroom…

Evaluation of the Guided Occupational Orientation-Training and Job Placement Project Syracuse City School District.

ERIC Educational Resources Information Center

Holder, Harold D.; And Others

The report provides a summary of the independent, third party evaluation of the 1972-73 funding year of the Guided Occupational Orientation Project of the Syracuse City School District. A systems approach to evaluation was utilized in this effort. The funded project involved all three grade populations--elementary, junior high school, and senior…

Post-traumatic subtalar osteoarthritis: which grading system should we use?

PubMed

de Muinck Keizer, Robert-Jan O; Backes, Manouk; Dingemans, Siem A; Goslings, J Carel; Schepers, Tim

2016-09-01

To assess and compare post-traumatic osteoarthritis following intra-articular calcaneal fractures, one must have a reliable grading system that consistently grades the post-traumatic changes of the joint. A reliable grading system aids in the communication between treating physicians and improves the interpretation of research. To date, there is no consensus on what grading system to use in the evaluation of post-traumatic subtalar osteoarthritis. The objective of this study was to determine and compare the inter- and intra-rater reliability of two grading systems for post-traumatic subtalar osteoarthritis. Four observers evaluated 50 calcaneal fractures at least one year after trauma on conventional oblique lateral, internally and externally rotated views, and graded post-traumatic subtalar osteoarthritis using the Kellgren and Lawrence Grading Scale (KLGS) and the Paley Grading System (PGS). Inter- and intra-rater reliability were calculated and compared. The inter-rater reliability showed an intra-class correlation (ICC) of 0.54 (95 % CI 0.40-0.67) for the KLGS and an ICC of 0.41 (95 % CI 0.26 - 0.57) for the PGS. This difference was not statistically significant. The intra-rater reliability showed a mean weighted kappa of 0.62 for both the KLGS and the PGS. There is no statistically significant difference in reliability between the Kellgren and Lawrence Grading System (KLGS) and the Paley Grading System (PGS). The PGS allows for an easy two-step approach making it easy for everyday clinical purposes. For research purposes however, the more detailed and widely used KLGS seems preferable.

41 CFR 102-80.120 - What analytical and empirical tools should be used to support the life safety equivalency...

Code of Federal Regulations, 2014 CFR

2014-01-01

...) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 80-SAFETY AND ENVIRONMENTAL MANAGEMENT Accident and Fire... used to support the life safety equivalency evaluation? Analytical and empirical tools, including fire models and grading schedules such as the Fire Safety Evaluation System (Alternative Approaches to Life...

41 CFR 102-80.120 - What analytical and empirical tools should be used to support the life safety equivalency...

Code of Federal Regulations, 2013 CFR

2013-07-01

...) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 80-SAFETY AND ENVIRONMENTAL MANAGEMENT Accident and Fire... used to support the life safety equivalency evaluation? Analytical and empirical tools, including fire models and grading schedules such as the Fire Safety Evaluation System (Alternative Approaches to Life...

41 CFR 102-80.120 - What analytical and empirical tools should be used to support the life safety equivalency...

Code of Federal Regulations, 2012 CFR

2012-01-01

...) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 80-SAFETY AND ENVIRONMENTAL MANAGEMENT Accident and Fire... used to support the life safety equivalency evaluation? Analytical and empirical tools, including fire models and grading schedules such as the Fire Safety Evaluation System (Alternative Approaches to Life...

Increasing the Career Choice Readiness of Young Adolescents: An Evaluation Study

ERIC Educational Resources Information Center

Hirschi, Andreas; Lage, Damian

2008-01-01

A career workshop that applies models of the Cognitive Information Processing Approach (Sampson, Reardon, Peterson, & Lenz, 2004) and incorporates critical ingredients (Brown and Ryan Krane, 2000) to promote the career choice readiness of young adolescents was developed and evaluated with 334 Swiss students in seventh grade applying a Solomon…

A Review of Elementary School-Based Substance Use Prevention Programs: Identifying Program Attributes

ERIC Educational Resources Information Center

Hopfer, S.; Davis, D.; Kam, J. A.; Shin, Y.; Elek, E.; Hecht, M. L.

2010-01-01

This article takes a systematic approach to reviewing substance use prevention programs introduced in elementary school (K-6th grade). Previous studies evaluating such programs among elementary school students showed mixed effects on subsequent substance use and related psychosocial factors. Thirty published evaluation studies of 24 elementary…

Web-Assisted Education: From Evaluation to Learning

ERIC Educational Resources Information Center

Stefansson, Gunnar; Sigurdardottir, Asta Jenny

2011-01-01

Exams have traditionally been given to evaluate students but in recent years, with the appearance of freely accessible on-line tutoring, quizzes can also be used as a learning tool. In systems where students can request quiz items until a satisfactory grade is obtained, new probabilistic approaches are required for dealing items to students and…

CT fluoroscopy-guided preoperative short hook wire placement for small pulmonary lesions: evaluation of safety and identification of risk factors for pneumothorax.

PubMed

Iguchi, Toshihiro; Hiraki, Takao; Gobara, Hideo; Fujiwara, Hiroyasu; Matsui, Yusuke; Miyoshi, Shinichiro; Kanazawa, Susumu

2016-01-01

To retrospectively evaluate the safety of computed tomography (CT) fluoroscopy-guided short hook wire placement for video-assisted thoracoscopic surgery and the risk factors for pneumothorax associated with this procedure. We analyzed 267 short hook wire placements for 267 pulmonary lesions (mean diameter, 9.9 mm). Multiple variables related to the patients, lesions, and procedures were assessed to determine the risk factors for pneumothorax. Complications (219 grade 1 and 4 grade 2 adverse events) occurred in 196 procedures. No grade 3 or above adverse events were observed. Univariate analysis revealed increased vital capacity (odds ratio [OR], 1.518; P = 0.021), lower lobe lesion (OR, 2.343; P =0.001), solid lesion (OR, 1.845; P = 0.014), prone positioning (OR, 1.793; P = 0.021), transfissural approach (OR, 11.941; P = 0.017), and longer procedure time (OR, 1.036; P = 0.038) were significant predictors of pneumothorax. Multivariate analysis revealed only the transfissural approach (OR, 12.171; P = 0.018) and a longer procedure time (OR, 1.048; P = 0.012) as significant independent predictors. Complications related to CT fluoroscopy-guided preoperative short hook wire placement often occurred, but all complications were minor. A transfissural approach and longer procedure time were significant independent predictors of pneumothorax. Complications related to CT fluoroscopy-guided preoperative short hook wire placement often occur. Complications are usually minor and asymptomatic. A transfissural approach and longer procedure time are significant independent predictors of pneumothorax.

Operative management and outcomes in 103 AAST-OIS grades IV and V complex hepatic injuries: trauma surgeons still need to operate, but angioembolization helps.

PubMed

Asensio, Juan A; Roldán, Gustavo; Petrone, Patrizio; Rojo, Esther; Tillou, Areti; Kuncir, Eric; Demetriades, Demetrios; Velmahos, George; Murray, James; Shoemaker, William C; Berne, Thomas V; Chan, Linda

2003-04-01

American Association for the Surgery of Trauma (AAST) Organ Injury Scale (OIS) grades IV and V complex hepatic injuries are highly lethal. Our objectives were to review experience and identify predictors of outcome and to evaluate the role of angioembolization in decreasing mortality. This was a retrospective 8-year study of all patients sustaining AAST-OIS grades IV and V hepatic injuries managed operatively. Statistical analysis was performed using univariate and multivariate logistic regression. The main outcome measure was survival. The study included 103 patients, with a mean Revised Trauma Score of 5.61 +/- 2.55 and a mean Injury Severity Score of 33 +/- 9.5. Mechanism of injury was penetrating in 80 (79%) and blunt in 23 (21%). Emergency department thoracotomy was performed in 21 (25%). AAST grade IV injuries occurred in 51 (47%) and grade V injuries occurred in 52 (53%). Mean estimated blood loss was 9,414 mL. Overall survival was 43%. Adjusted overall survival rate after emergency department thoracotomy patients were excluded was 58%. Results stratified to AAST-OIS injury grade were as follows: grade IV, 32 of 51 (63%); grade V, 12 of 52 (23%); grade IV versus grade V (p < 0.001) odds ratio, 2.06; 95% confidence interval, 2.72 (1.40-3.04). Logistic regression analysis identified as independent predictors of outcome Revised Trauma Score (adjusted p < 0.0002), angioembolization (adjusted p < 0.0177), direct approach to hepatic veins (adjusted p < 0.0096), and packing (adjusted p < 0.0013). Improvements in mortality can be achieved with an appropriate operative approach. Angioembolization as an adjunct procedure decreases mortality in AAST-OIS grades IV and V hepatic injuries.

An Evaluation of Two Methods for Teaching United States History to Students with Learning Disabilities

ERIC Educational Resources Information Center

Winchester, Katherine; Darch, Craig; Eaves, Ronald C.; Shippen, Margaret E.; Ern, Greg; Bell, Bedarius

2009-01-01

We compared two approaches to teaching United States history to students with learning disabilities (LD). We randomly assigned students in seventh through ninth grades (n = 44) to separate treatment groups (strategy-based instruction or traditional instruction). In both approaches, students were taught identical content on two units of the Civil…

A collaborative approach to adopting/adapting guidelines - The Australian 24-Hour Movement Guidelines for the early years (Birth to 5 years): an integration of physical activity, sedentary behavior, and sleep.

PubMed

Okely, Anthony D; Ghersi, Davina; Hesketh, Kylie D; Santos, Rute; Loughran, Sarah P; Cliff, Dylan P; Shilton, Trevor; Grant, David; Jones, Rachel A; Stanley, Rebecca M; Sherring, Julie; Hinkley, Trina; Trost, Stewart G; McHugh, Clare; Eckermann, Simon; Thorpe, Karen; Waters, Karen; Olds, Timothy S; Mackey, Tracy; Livingstone, Rhonda; Christian, Hayley; Carr, Harriette; Verrender, Adam; Pereira, João R; Zhang, Zhiguang; Downing, Katherine L; Tremblay, Mark S

2017-11-20

In 2017, the Australian Government funded the update of the National Physical Activity Recommendations for Children 0-5 years, with the intention that they be an integration of movement behaviours across the 24-h period. The benefit for Australia was that it could leverage research in Canada in the development of their 24-h guidelines for the early years. Concurrently, the Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group published a model to produce guidelines based on adoption, adaption and/or de novo development using the GRADE evidence-to-decision framework. Referred to as the GRADE-ADOLOPMENT approach, it allows guideline developers to follow a structured and transparent process in a more efficient manner, potentially avoiding the need to unnecessarily repeat costly tasks such as conducting systematic reviews. The purpose of this paper is to outline the process and outcomes for adapting the Canadian 24-Hour Movement Guidelines for the Early Years to develop the Australian 24-Hour Movement Guidelines for the Early Years guided by the GRADE-ADOLOPMENT framework. The development process was guided by the GRADE-ADOLOPMENT approach. A Leadership Group and Consensus Panel were formed and existing credible guidelines identified. The draft Canadian 24-h integrated movement guidelines for the early years best met the criteria established by the Panel. These were evaluated based on the evidence in the GRADE tables, summaries of findings tables and draft recommendations from the Canadian Draft Guidelines. Updates to each of the Canadian systematic reviews were conducted and the Consensus Panel reviewed the evidence for each behaviour separately and made a decision to adopt or adapt the Canadian recommendations for each behaviour or create de novo recommendations. An online survey was then conducted (n = 302) along with five focus groups (n = 30) and five key informant interviews (n = 5) to obtain feedback from stakeholders on the draft guidelines. Based on the evidence from the Canadian systematic reviews and the updated systematic reviews in Australia, the Consensus Panel agreed to adopt the Canadian recommendations and, apart from some minor changes to the wording of good practice statements, keep the wording of the guidelines, preamble and title of the Canadian Guidelines. The Australian Guidelines provide evidence-informed recommendations for a healthy day (24-h), integrating physical activity, sedentary behaviour (including limits to screen time), and sleep for infants (<1 year), toddlers (1-2 years) and preschoolers (3-5 years). To our knowledge, this is only the second time the GRADE-ADOLOPMENT approach has been used. Following this approach, the judgments of the Australian Consensus Panel did not differ sufficiently to change the directions and strength of the recommendations and as such, the Canadian recommendations were adopted with very minor alterations. This allowed the Guidelines to be developed much faster and at lower cost. As such, we would recommend the GRADE-ADOLOPMENT approach, especially if a credible set of guidelines, with all supporting materials and developed using a transparent process, is available. Other countries may consider using this approach when developing and/or revising national movement guidelines.

[One-stage total en bloc spondylectomy and reconstruction via a single posterior approach for thoracic vertebral symptomatic hemangioma associated with spinal cord dysfunction].

PubMed

Song, Ruo-xian; Zhang, Yong-gang; Zhang, Xue-song; Zheng, Guo-quan; Wang, Yan

2012-04-01

To investigate the surgical results of one-stage total en bloc spondylectomy (TES) and reconstruction via a single posterior approach for thoracic symptomatic vertebral hemangioma associated with spinal cord dysfunction and evaluate its curative effect. A total of 9 patients treated with one-stage TES (7 cases) and total vertebrectomy (2 cases) by posterior approach from March 2006 to January 2010 were retrospectively reviewed. The cases included 2 males and 7 females with a median age of 33.6 years (range 14 to 77 years), and with 1 case of Grade A, 3 cases of Grade B, 3 cases of Grade C, 2 cases of Grade D according to Frankel grade system. All patients suffered from moderate to severe pain and neurological deficit with an average symptom duration of 14.4 months (range 3 - 24 months) MRI revealed severe spinal cord compression. The spinal reconstruction was obtained by titanium mesh filled with autograft and posterior internal fixation with rod-screw system. The operation time was 210 minutes on average (180 - 270 minutes) and the average blood loss was 1800 ml (1000 - 5000 ml). The follow-up period lasted from 18 months to 5 years. All cases with preoperative pain relieved after operation. The visual analogue scale pain scores decreased to 1.1 from 8.3 at 3 months after surgery. No disruption of dural mater, cerebrospinal fluid leakage, iatrogenic spinal cord injury and major vessel damage occurred. Up to now, there was no local recurrence in all cases. Significant neurological function improvement was achieved in all patients with one to three grades in Frankel grade system. Fusion of the autograft was well achieved and no internal fixation failure in all patients. One-stage TES and spine reconstruction by a single posterior approach is feasible, safe and effective to this disease. It is favourable in decreasing the hemangioma recurrence and improvement of the neurological function.

Field Evaluation of Locomotive Conspicuity Lights

DOT National Transportation Integrated Search

1975-05-01

Flashing xenon strobe lamps were installed on locomotives in revenue service as a means of alerting motorists to the hazards they are approaching at a rail-highway grade crossing. Effectiveness of these lights in attracting motorists' attention was e...

POSTEROSUPERIOR SURGICAL ACCESS ROUTE FOR TREATMENT OF ACROMIOCLAVICULAR DISLOCATIONS: RESULTS FROM 84 SURGICAL CASES.

PubMed

Dal Molin, Danilo Canesin; Ribeiro, Fabiano Rebouças; Filho, Rômulo Brasil; Filardi, Cantídio Salvador; Tenor, Antonio Carlos; Stipp, Willian Nandi; Petros, Rodrigo Souto Borges

2012-01-01

To evaluate the results from surgical treatment of 84 cases of acute acromioclavicular dislocation, using a posterosuperior access route. Eighty-four cases of acute acromioclavicular dislocation (grade III in the Allman-Tossy classification) operated between November 2002 and May 2010 were evaluated. The patients' mean age was 34 years. The diagnoses were made using clinical and radiographic evaluations. The patients were operated by the same surgical team, within three weeks of the date of the trauma, using a posterosuperior approach to the shoulder to access the top of the base of the coracoid process for placement of two anchors, which were used in reducing the dislocation. The minimum follow-up was 12 months. The postoperative clinical-radiographic evaluation was done using the modified Karlsson criteria and the University of California at Los Angeles (UCLA) score. 92.8% of the 84 patients treated presented good or excellent results, and 7.2% presented fair or poor results, using the UCLA assessment score. According to the modified Karlsson criteria, 76.2% were assessed as grade A, 17.9% as grade B and 5.9% as grade C. The posterosuperior access route to the shoulder is a new option for accessing the coracoid process and treating acromioclavicular dislocation, with clinical and radiographic results equivalent to those in the literature.

[Anaphylactic shock due to patent blue: four case report and review of literature].

PubMed

Lucas, N; Interne, S Benay; Laine, P; Nicolie, B; Fondrinier, E

2010-04-01

Description of four cases of anaphylactic shock with blue dye injection (bleu patenté V Guerbet 2.5%) during sentinel node biopsy for breast cancer. Women with breast carcinoma and combined approach with radioactive tracer and blue patent injection. Four cases were observed, which means an incidence of 0.57%. We report one case of grade II anaphylactic reaction and three cases of grade III requiring active reanimation and adrenaline perfusion. One patient developed a pulmonary embolism during the postoperative period, but no death was observed. We find an incidence of 1.06% of allergy but only 0.25% of anaphylactic shock (grade III). These rare but serious cases must weigh up the benefits and risks of using blue dye. We suggest using blue dye injection only in case of radioisotope detection failure. Of course, this approach must be evaluated. (c) 2009 Elsevier Masson SAS. All rights reserved.

Giocampus school: a "learning through playing" approach to deliver nutritional education to children.

PubMed

Rosi, Alice; Brighenti, Furio; Finistrella, Viviana; Ingrosso, Lisa; Monti, Giorgia; Vanelli, Maurizio; Vitale, Marco; Volta, Elio; Scazzina, Francesca

2016-01-01

To improve nutritional knowledge of children, single-group educational interventions with pre/post knowledge assessment were performed in primary schools in Parma, Italy, participating to the Giocampus Program. A total of 8165 children (8-11 years old) of 3rd, 4th and 5th grades of primary school were involved in 3 hours per class nutritional lessons, with specifically designed games and activities for each school grade. To evaluate children learning, a questionnaire was administered before and after three months of educational intervention. A total of 16330 questionnaires were analysed. Children nutritional knowledge significantly increased (p< 0.001) in all school grades. The integrated "learning through playing" approach, including the educational figures, tools and games, was successful in improving children's nutritional knowledge. A stable integration of this method in primary school settings could prepare a new generation of citizens, better educated on health-promotion lifestyles.

Comparative evaluation of the powder and compression properties of various grades and brands of microcrystalline cellulose by multivariate methods.

PubMed

Haware, Rahul V; Bauer-Brandl, Annette; Tho, Ingunn

2010-01-01

The present work challenges a newly developed approach to tablet formulation development by using chemically identical materials (grades and brands of microcrystalline cellulose). Tablet properties with respect to process and formulation parameters (e.g. compression speed, added lubricant and Emcompress fractions) were evaluated by 2(3)-factorial designs. Tablets of constant true volume were prepared on a compaction simulator at constant pressure (approx. 100 MPa). The highly repeatable and accurate force-displacement data obtained was evaluated by simple 'in-die' Heckel method and work descriptors. Relationships and interactions between formulation, process and tablet parameters were identified and quantified by multivariate analysis techniques; principal component analysis (PCA) and partial least square regressions (PLS). The method proved to be able to distinguish between different grades of MCC and even between two different brands of the same grade (Avicel PH 101 and Vivapur 101). One example of interaction was studied in more detail by mixed level design: The interaction effect of lubricant and Emcompress on elastic recovery of Avicel PH 102 was demonstrated to be complex and non-linear using the development tool under investigation.

Evaluation of health care system reform in Hubei Province, China.

PubMed

Sang, Shuping; Wang, Zhenkun; Yu, Chuanhua

2014-02-21

This study established a set of indicators for and evaluated the effects of health care system reform in Hubei Province (China) from 2009 to 2011 with the purpose of providing guidance to policy-makers regarding health care system reform. The resulting indicators are based on the "Result Chain" logic model and include the following four domains: Inputs and Processes, Outputs, Outcomes and Impact. Health care system reform was evaluated using the weighted TOPSIS and weighted Rank Sum Ratio methods. Ultimately, the study established a set of indicators including four grade-1 indicators, 16 grade-2 indicators and 76 grade-3 indicators. The effects of the reforms increased year by year from 2009 to 2011 in Hubei Province. The health status of urban and rural populations and the accessibility, equity and quality of health services in Hubei Province were improved after the reforms. This sub-national case can be considered an example of a useful approach to the evaluation of the effects of health care system reform, one that could potentially be applied in other provinces or nationally.

Lack of grading agreement among international hemostasis external quality assessment programs

PubMed Central

Olson, John D.; Jennings, Ian; Meijer, Piet; Bon, Chantal; Bonar, Roslyn; Favaloro, Emmanuel J.; Higgins, Russell A.; Keeney, Michael; Mammen, Joy; Marlar, Richard A.; Meley, Roland; Nair, Sukesh C.; Nichols, William L.; Raby, Anne; Reverter, Joan C.; Srivastava, Alok; Walker, Isobel

2018-01-01

Laboratory quality programs rely on internal quality control and external quality assessment (EQA). EQA programs provide unknown specimens for the laboratory to test. The laboratory's result is compared with other (peer) laboratories performing the same test. EQA programs assign target values using a variety of methods statistical tools and performance assessment of ‘pass’ or ‘fail’ is made. EQA provider members of the international organization, external quality assurance in thrombosis and hemostasis, took part in a study to compare outcome of performance analysis using the same data set of laboratory results. Eleven EQA organizations using eight different analytical approaches participated. Data for a normal and prolonged activated partial thromboplastin time (aPTT) and a normal and reduced factor VIII (FVIII) from 218 laboratories were sent to the EQA providers who analyzed the data set using their method of evaluation for aPTT and FVIII, determining the performance for each laboratory record in the data set. Providers also summarized their statistical approach to assignment of target values and laboratory performance. Each laboratory record in the data set was graded pass/fail by all EQA providers for each of the four analytes. There was a lack of agreement of pass/fail grading among EQA programs. Discordance in the grading was 17.9 and 11% of normal and prolonged aPTT results, respectively, and 20.2 and 17.4% of normal and reduced FVIII results, respectively. All EQA programs in this study employed statistical methods compliant with the International Standardization Organization (ISO), ISO 13528, yet the evaluation of laboratory results for all four analytes showed remarkable grading discordance. PMID:29232255

Surgical treatment of gynecomastia: complications and outcomes.

PubMed

Li, Chun-Chang; Fu, Ju-Peng; Chang, Shun-Cheng; Chen, Tim-Mo; Chen, Shyi-Gen

2012-11-01

Gynecomastia is defined as the benign enlargement of the male breast. Multiple surgical options have been used to improve outcomes. The aim of this study was to analyze the surgical approaches to the treatment of gynecomastia and their outcomes over a 10-year period. All patients undergoing surgical correction of gynecomastia in our department between 2000 and 2010 were included for retrospective evaluation. The data were analyzed for etiology, stage of gynecomastia, surgical technique, complications, risk factors, and revision rate. The surgical result was evaluated with self-assessment questionnaires. A total of 41 patients with 75 operations were included. Techniques included subcutaneous mastectomy alone or with additional ultrasound-assisted liposuction (UAL) and isolated UAL. The surgical revision rate for all patients was 4.8%. The skin-sparing procedure gave good surgical results in grade IIb and grade III gynecomastia with low revision and complication rates. The self-assessment report revealed a good level of overall satisfaction and improvement in self-confidence (average scores 9.4 and 9.2, respectively, on a 10-point scale). The treatment of gynecomastia requires an individualized approach. Subcutaneous mastectomy combined with UAL could be used as the first choice for surgical treatment of grade II and III gynecomastia.

Answering medical questions at the point of care: a cross-sectional study comparing rapid decisions based on PubMed and Epistemonikos searches with evidence-based recommendations developed with the GRADE approach.

PubMed

Izcovich, Ariel; Criniti, Juan Martín; Popoff, Federico; Ragusa, Martín Alberto; Gigler, Cristel; Gonzalez Malla, Carlos; Clavijo, Manuela; Manzotti, Matias; Diaz, Martín; Catalano, Hugo Norberto; Neumann, Ignacio; Guyatt, Gordon

2017-08-07

Using the best current evidence to inform clinical decisions remains a challenge for clinicians. Given the scarcity of trustworthy clinical practice guidelines providing recommendations to answer clinicians' daily questions, clinical decision support systems (ie, assistance in question identification and answering) emerge as an attractive alternative. The trustworthiness of the recommendations achieved by such systems is unknown. To evaluate the trustworthiness of a question identification and answering system that delivers timely recommendations. Cross-sectional study. We compared the responses to 100 clinical questions related to inpatient management provided by two rapid response methods with 'Gold Standard' recommendations. One of the rapid methods was based on PubMed and the other on Epistemonikos database. We defined our 'Gold Standard' as trustworthy published evidence-based recommendations or, when unavailable, recommendations developed locally by a panel of six clinicians following the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Recommendations provided by the rapid strategies were classified as potentially misleading or reasonable. We also determined if the potentially misleading recommendations could have been avoided with the appropriate implementation of searching and evidence summary tools. We were able to answer all of the 100 questions with both rapid methods. Of the 200 recommendations obtained, 6.5% (95% CI 3% to 9.9%) were classified as potentially misleading and 93.5% (95% CI 90% to 96.9%) as reasonable. 6 of the 13 potentially misleading recommendations could have been avoided by the appropriate usage of the Epistemonikos matrix tool or by constructing summary of findings tables. No significant differences were observed between the evaluated rapid response methods. A question answering service based on the GRADE approach proved feasible to implement and provided appropriate guidance for most identified questions. Our approach could help stakeholders in charge of managing resources and defining policies for patient care to improve evidence-based decision-making in an efficient and feasible manner. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Multi-class SVM model for fMRI-based classification and grading of liver fibrosis

NASA Astrophysics Data System (ADS)

Freiman, M.; Sela, Y.; Edrei, Y.; Pappo, O.; Joskowicz, L.; Abramovitch, R.

2010-03-01

We present a novel non-invasive automatic method for the classification and grading of liver fibrosis from fMRI maps based on hepatic hemodynamic changes. This method automatically creates a model for liver fibrosis grading based on training datasets. Our supervised learning method evaluates hepatic hemodynamics from an anatomical MRI image and three T2*-W fMRI signal intensity time-course scans acquired during the breathing of air, air-carbon dioxide, and carbogen. It constructs a statistical model of liver fibrosis from these fMRI scans using a binary-based one-against-all multi class Support Vector Machine (SVM) classifier. We evaluated the resulting classification model with the leave-one out technique and compared it to both full multi-class SVM and K-Nearest Neighbor (KNN) classifications. Our experimental study analyzed 57 slice sets from 13 mice, and yielded a 98.2% separation accuracy between healthy and low grade fibrotic subjects, and an overall accuracy of 84.2% for fibrosis grading. These results are better than the existing image-based methods which can only discriminate between healthy and high grade fibrosis subjects. With appropriate extensions, our method may be used for non-invasive classification and progression monitoring of liver fibrosis in human patients instead of more invasive approaches, such as biopsy or contrast-enhanced imaging.

Scaffolding Middle School Students' Construction of Scientific Explanations: Comparing a Cognitive versus a Metacognitive Evaluation Approach

ERIC Educational Resources Information Center

Wang, Chia-Yu

2015-01-01

This study investigated the effects of scaffolds as cognitive prompts and as metacognitive evaluation on seventh-grade students' growth of content knowledge and construction of scientific explanations in five inquiry-based biology activities. Students' scores on multiple-choice pretest and posttest and worksheets for five inquiry-based activities…

Making Room for Foster Children: A Criterion-Referenced Approach to ESEA Title I Migrant Program Evaluation.

ERIC Educational Resources Information Center

Oxford, Rebecca L.; And Others

The Washington state Title I Migrant Program Evaluation project is a feasibility study designed to assess the suitability of existing normed criterion referenced tests to measuring mathematics achievement at grades four, five, and six. Objectives include judging the technical qualities and content of several normed criterion referenced tests;…

Combined approach for gynecomastia

PubMed Central

El-Sabbagh, Ahmed Hassan

2016-01-01

Background: Gynecomastia is a deformity of male chest. Treatment of gynecomastia varied from direct surgical excision to other techniques (mainly liposuction) to a combination of both. Skin excision is done according to the grade. In this study, experience of using liposuction adjuvant to surgical excision was described. Patients and methods: Between September 2012 and April 2015, a total of 14 patients were treated with liposuction and surgical excision through a periareolar incision. Preoperative evaluation was done in all cases to exclude any underlying cause of gynecomastia. Results: All fourteen patients were treated bilaterally (28 breast tissues). Their ages ranged between 13 and 33 years. Two patients were classified as grade I, and four as grade IIa, IIb or III, respectively. The first 3 patients showed seroma. Partial superficial epidermolysis of areola occurred in 2 cases. Superficial infection of incision occurred in one case and was treated conservatively. Conclusion: All grades of gynecomastia were managed by the same approach. Skin excision was added to a patient that had severe skin excess with limited activity and bad skin complexion. No cases required another setting or asked for 2nd opinion. PMID:26955509

Combined approach for gynecomastia.

PubMed

El-Sabbagh, Ahmed Hassan

2016-01-01

Gynecomastia is a deformity of male chest. Treatment of gynecomastia varied from direct surgical excision to other techniques (mainly liposuction) to a combination of both. Skin excision is done according to the grade. In this study, experience of using liposuction adjuvant to surgical excision was described. Between September 2012 and April 2015, a total of 14 patients were treated with liposuction and surgical excision through a periareolar incision. Preoperative evaluation was done in all cases to exclude any underlying cause of gynecomastia. All fourteen patients were treated bilaterally (28 breast tissues). Their ages ranged between 13 and 33 years. Two patients were classified as grade I, and four as grade IIa, IIb or III, respectively. The first 3 patients showed seroma. Partial superficial epidermolysis of areola occurred in 2 cases. Superficial infection of incision occurred in one case and was treated conservatively. All grades of gynecomastia were managed by the same approach. Skin excision was added to a patient that had severe skin excess with limited activity and bad skin complexion. No cases required another setting or asked for 2(nd) opinion.

The Satisfaction Rate among Patients and Surgeons after Periareolar Surgical Approach to Gynecomastia along with Liposuction

PubMed Central

Taheri, Ahmad Reza; Farahvash, Mohamad Reza; Fathi, Hamid Reza; Ghanbarzadeh, Koorosh; Faridniya, Bijan

2016-01-01

BACKGROUND Surgery, as the main approach in higher stages of gynecomastia, has different techniques regarding the staging of the disease. The more the grade of gynecomastia, the more complicated the used surgical techniques, conventionally. This study assessed the success rate of the simplest surgical technique in higher grades of gynecology as well as the satisfaction rate in patients and surgeon to offer using the technique for higher grades of the disease. METHODS To evaluate the success and the satisfaction rates of periareolar incision and liposuction among patients with grade II and III gynecomastia, this cross-sectional study was conducted. RESULTS The satisfaction rate was the main concern of the present study. The patients had a mean satisfaction score of 8.1±1.396 with the range of 5-10 from total 10 score. The majority of the patients expressed their satisfaction by 9 score. The total mean of physician satisfaction score was 8.36 at all levels. CONCLUSION Like aesthetic reasons which lead individuals to seek solutions for their annoying gynecomastia, aesthetic satisfaction is a prominent concern for people who undergo surgical approach. So, the least surgical scar and complications are absolutely the most area of focus in this regard. PMID:27853693

Grading evidence from test accuracy studies: what makes it challenging compared with the grading of effectiveness studies?

PubMed

Rogozińska, Ewelina; Khan, Khalid

2017-06-01

Guideline panels need to process a sizeable amount of information to issue a decision on whether to recommend a health technology or not. Grading of Recommendations Assessment, Development, and Evaluation (GRADE) is being frequently applied in guideline development to facilitate this task, typically for the synthesis of effectiveness research. Questions regarding the accuracy of medical tests are ubiquitous, and they temporally precede questions about therapy. However, literature summarising the experience of applying GRADE approach to accuracy evaluations is not as rich as one for effectiveness evidence. Type of study design (cross-sectional), two-dimensional nature of the performance measures (sensitivity and specificity), propensity towards a higher level of between-study heterogeneity, poor reporting of quality features and uncertainty about how best to assess for publication bias among other features make this task challenging. This article presents solutions adopted to addresses above challenges for judicious estimation of the strength of test accuracy evidence used to inform evidence syntheses for guideline development. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Including Students with Learning Disabilities in Mainstream Classes: A 2-Year Spanish Study Using a Collaborative Approach to Intervention.

ERIC Educational Resources Information Center

Cardona, Cristina

This study evaluated the effectiveness of an inclusive program for students (grades 2 through 4) with mild learning disabilities (LD) in four elementary schools in Spain. It compared two support strategies, a within-class integrated program versus resource room approach with students having either high or low learning potential. The study also…

Impact of Recycled Asphalt Shingles (RAS) on Asphalt Binder Performance

DOT National Transportation Integrated Search

2018-01-01

This study evaluated the effect of reclaimed asphalt pavement (RAP) and recycled asphalt shingles (RAS) on virgin binder true grade and fracture energy density (FED). A mortar approach, which avoids the need for binder extraction, was adopted to quan...

An investigation of Taiwanese early adolescents' self-evaluations concerning the Big 6 information problem-solving approach.

PubMed

Chang, Chiung-Sui

2007-01-01

The study developed a Big 6 Information Problem-Solving Scale (B61PS), including the subscales of task definition and information-seeking strategies, information access and synthesis, and evaluation. More than 1,500 fifth and sixth graders in Taiwan responded. The study revealed that the scale showed adequate reliability in assessing the adolescents' perceptions about the Big 6 information problem-solving approach. In addition, the adolescents had quite different responses toward different subscales of the approach. Moreover, females tended to have higher quality information-searching skills than their male counterparts. The adolescents of different grades also displayed varying views toward the approach. Other results are also provided.

[Clinical application of atlantoaxial pedicle screw internal fixation for treatment of atlantoaxial dislocation].

PubMed

Yang, Yong-Jun; Zhang, En-Zhong; Tan, Yuan-Chao; Zhou, Ji-Ping; Yao, Shu-Qiang; Jiang, Chuan-Jie; Cong, Pei-Yan

2009-11-01

To investigate the clinical effect of atlantoaxial pedicle screw internal fixation for treatment of atlantoaxial dislocation. Sixteen patients with atlantoaxial dislocation were treated from Dec. 2005 to June 2007, included 10 males and 6 females, aged from 38 to 45 years old (means 40.5 years). Among them 12 patients combined with nerve injury, according to ASIA grade: there were 3 cases in grade B, 5 cases in grade C, 4 cases in grade D. All patients received preoperative CT, radiograph and skull traction. Intraoperative posterior approach general spine pedicle screw-rod orthopaedics fixation system used and iliac bone block were implanted in space of posterior atlantal arch and axial vertebral plate. The outcome and complications were observed in the near future. There was no vascular or neural injury found. The patients were followed up for 12 to 24 months (means 18 months). All head pain, acid storm symptoms were improved after operation. According to the Odom's clinical efficacy evaluation standard, 12 cases were excellent, 4 were good. Eleven cases of 12 with nerve injury recovered significantly. By ASIA classification: 1 cases was in grade B, 2 cases were in grade C, 5 cases were in grade D, 4 cases were in grade E. No looseness or breakage of screw occurred. Bony fusion was achieved in all cases. Posterior approach atlantoaxial pedicle screw internal fixation have the advantages of direct screw placement, short-segment fusion, intraoperative reduction, fixation reliable, high fusion rate, and it can restablish the upper cervical vertebrae stability and help to recover the spinal cord and nerve function.

Variation of student numerical and figural reasoning approaches by pattern generalization type, strategy use and grade level

NASA Astrophysics Data System (ADS)

El Mouhayar, Rabih; Jurdak, Murad

2016-02-01

This paper explored variation of student numerical and figural reasoning approaches across different pattern generalization types and across grade level. An instrument was designed for this purpose. The instrument was given to a sample of 1232 students from grades 4 to 11 from five schools in Lebanon. Analysis of data showed that the numerical reasoning approach seems to be more dominant than the figural reasoning approach for the near and far pattern generalization types but not for the immediate generalization type. The findings showed that for the recursive strategy, the numerical reasoning approach seems to be more dominant than the figural reasoning approach for each of the three pattern generalization types. However, the figural reasoning approach seems to be more dominant than the numerical reasoning approach for the functional strategy, for each generalization type. The findings also showed that the numerical reasoning was more dominant than the figural reasoning in lower grade levels (grades 4 and 5) for each generalization type. In contrast, the figural reasoning became more dominant than the numerical reasoning in the upper grade levels (grades 10 and 11).

The Value of Intraoperative Magnetic Resonance Imaging in Endoscopic and Microsurgical Transsphenoidal Pituitary Adenoma Resection.

PubMed

Pal'a, Andrej; Knoll, Andreas; Brand, Christine; Etzrodt-Walter, Gwendolin; Coburger, Jan; Wirtz, Christian Rainer; Hlaváč, Michal

2017-06-01

The routine use of intraoperative magnetic resonance imaging (iMRI) helps to achieve gross total resection in transsphenoidal pituitary surgery. We compared the added value of iMRI for extent of resection in endoscopic versus microsurgical transsphenoidal adenomectomy. A total of 96 patients with pituitary adenoma were included. Twenty-eight consecutive patients underwent endoscopic transsphenoidal tumor resection. For comparison, we used a historic cohort of 68 consecutive patients treated microsurgically. We evaluated the additional resection after conducting iMRI using intraoperative and late postoperative volumetric tumor analysis 3 months after surgery. Demographic data, clinical symptoms, and complications as well as pituitary function were evaluated. We found significantly fewer additional resections after conducting iMRI in the endoscopic group (P = 0.042). The difference was even more profound in Knosp grade 0-2 adenomas (P = 0.029). There was no significant difference in Knosp grade 3-4 adenomas (P = 0.520). The endoscopic approach was associated with smaller intraoperative tumor volume (P = 0.023). No significant difference was found between both techniques in postoperative tumor volume (P = 0.228). Satisfactory results of pituitary function were significantly more often associated with an endoscopic approach in the multiple regression analysis (P = 0.007; odds ratio, 17.614; confidence interval 95%, 2.164-143.396). With the endoscopic approach, significantly more tumor volume reduction was achieved before conducting iMRI, decreasing the need for further resection. This finding was even more pronounced in adenomas graded Knosp 0-2. In the case of extensive and invasive adenomas with infiltration of cavernous sinus and suprasellar or parasellar extension, additional tumor resection and increase in the extent of resection was achieved with iMRI in both groups. The endoscopic approach seems to result in better endocrine outcomes, especially in Knosp grade 0-2 pituitary adenomas. Copyright © 2017 Elsevier Inc. All rights reserved.

Supporting First-Grade Writers Who Fail to Learn: Multiple Single-Case Evaluation of a Response to Intervention Approach

ERIC Educational Resources Information Center

Arrimada, María; Torrance, Mark; Fidalgo, Raquel

2018-01-01

We report a multiple-baseline single-case study, based in the response to intervention framework, evaluating transcription-only and transcription-and-planning interventions for young, struggling writers. In a baseline phase, 8 classes of Spanish children at the start of their first year of primary (elementary) education completed short, probe…

AHA Scientific Statement Population Approaches to Improve Diet, Physical Activity, and Smoking Habits A Scientific Statement From the American Heart Association

PubMed Central

Mozaffarian, Dariush; Afshin, Ashkan; Benowitz, Neal L.; Bittner, Vera; Daniels, Stephen R.; Franch, Harold A.; Jacobs, David R.; Kraus, William E.; Kris-Etherton, Penny M.; Krummel, Debra A.; Popkin, Barry M.; Whitsel, Laurie P.; Zakai, Neil A.

2013-01-01

Background Poor lifestyle, including suboptimal diet, physical inactivity, and tobacco use are leading causes of preventable diseases globally. Although even modest population shifts in risk substantially alter health outcomes, the optimal population-level approaches to improve lifestyle are not well established. Methods and Results For this American Heart Association Scientific Statement, the writing group systematically reviewed and graded the current scientific evidence for effective population approaches to improve dietary habits, increase physical activity, and reduce tobacco use. Strategies were considered in 6 broad domains: (1) media and education campaigns; (2) labeling and consumer information; (3) taxation, subsidies, and other economic incentives; (4) school and workplace approaches; (5) local environmental changes; and (6) direct restrictions and mandates. The writing group also reviewed the potential contributions of healthcare systems and surveillance systems to behavior change efforts. Several specific population interventions that achieved a Class I or IIa recommendation with grade A or B evidence were identified, providing a set of specific evidence-based strategies that deserve close attention and prioritization for wider implementation. Effective interventions included specific approaches in all 6 domains evaluated for improving diet, increasing activity, and reducing tobacco use. The writing group also identified several specific interventions in each of these domains for which current evidence was less robust, as well as other inconsistencies and evidence gaps, informing the need for further rigorous and interdisciplinary approaches to evaluate population programs and policies. Conclusions This systematic review identified and graded the evidence for a range of population-based strategies to promote lifestyle change. The findings provide a framework for policy makers, advocacy groups, researchers, clinicians, communities, and other stakeholders to understand and implement the most effective approaches. New strategic initiatives and partnerships are needed to translate this evidence into action. PMID:22907934

Validity of peer grading using Calibrated Peer Review in a guided-inquiry, conceptual physics course

NASA Astrophysics Data System (ADS)

Price, Edward; Goldberg, Fred; Robinson, Steve; McKean, Michael

2016-12-01

Constructing and evaluating explanations are important science practices, but in large classes it can be difficult to effectively engage students in these practices and provide feedback. Peer review and grading are scalable instructional approaches that address these concerns, but which raise questions about the validity of the peer grading process. Calibrated Peer Review (CPR) is a web-based system that scaffolds peer evaluation through a "calibration" process where students evaluate sample responses and receive feedback on their evaluations before evaluating their peers. Guided by an activity theory framework, we developed, implemented, and evaluated CPR-based tasks in guided-inquiry, conceptual physics courses for future teachers and general education students. The tasks were developed through iterative testing and revision. Effective tasks had specific and directed prompts and evaluation instructions. Using these tasks, over 350 students at three universities constructed explanations or analyzed physical phenomena, and evaluated their peers' work. By independently assessing students' responses, we evaluated the CPR calibration process and compared students' peer reviews with expert evaluations. On the tasks analyzed, peer scores were equivalent to our independent evaluations. On a written explanation item included on the final exam, students in the courses using CPR outperformed students in similar courses using traditional writing assignments without a peer evaluation element. Our research demonstrates that CPR can be an effective way to explicitly include the science practices of constructing and evaluating explanations into large classes without placing a significant burden on the instructor.

Incidence of Heterotopic Ossification after Surface and Conventional Total Hip Arthroplasty: A Comparative Study Using Anterolateral Approach and Indomethacin Prophylaxis

PubMed Central

Sandri, Andrea; Sambugaro, Elena

2013-01-01

The incidence and severity of heterotopic ossification (HO) in two homogeneous groups of patients that received surface replacement arthroplasty (SRA) and conventional total hip arthroplasty (THA) were evaluated retrospectively. Thirty-nine patients undergoing 42 hip resurfacing procedures and 41 primary cementless THAs through an anterolateral approach received a 10-day course of 150 mg/die of indomethacin postoperatively. The median surgical time was 190 minutes and 156 minutes, respectively (P < 0.003). At a minimum 1-year followup, the development of HO was assessed on standard X-ray using Brooker grading. Ectopic bone formation was detected in five cases (11.9%, two Brooker grade I and three grade II) in the SRA group and in 14 hips (34.1%, 12 grade I and two grade II) treated with conventional THA, but the difference was not significant (P < 0.11). No clinically relevant periprosthetic ossification (Brooker III or IV) occurred in both groups. Although the difference was not statistically significant, the incidence of HO after SRA was lower than conventional THA. More extensive soft tissue trauma, bone debris, and longer operative time in hip resurfacing are not likely to be absolute risk factors for HO. Further investigations including larger patient populations are needed to confirm these findings. PMID:23865045

POSTEROSUPERIOR SURGICAL ACCESS ROUTE FOR TREATMENT OF ACROMIOCLAVICULAR DISLOCATIONS: RESULTS FROM 84 SURGICAL CASES

PubMed Central

Dal Molin, Danilo Canesin; Ribeiro, Fabiano Rebouças; Filho, Rômulo Brasil; Filardi, Cantídio Salvador; Tenor, Antonio Carlos; Stipp, Willian Nandi; Petros, Rodrigo Souto Borges

2015-01-01

Objective: To evaluate the results from surgical treatment of 84 cases of acute acromioclavicular dislocation, using a posterosuperior access route. Methods: Eighty-four cases of acute acromioclavicular dislocation (grade III in the Allman-Tossy classification) operated between November 2002 and May 2010 were evaluated. The patients’ mean age was 34 years. The diagnoses were made using clinical and radiographic evaluations. The patients were operated by the same surgical team, within three weeks of the date of the trauma, using a posterosuperior approach to the shoulder to access the top of the base of the coracoid process for placement of two anchors, which were used in reducing the dislocation. The minimum follow-up was 12 months. The postoperative clinical-radiographic evaluation was done using the modified Karlsson criteria and the University of California at Los Angeles (UCLA) score. Results: 92.8% of the 84 patients treated presented good or excellent results, and 7.2% presented fair or poor results, using the UCLA assessment score. According to the modified Karlsson criteria, 76.2% were assessed as grade A, 17.9% as grade B and 5.9% as grade C. Conclusion: The posterosuperior access route to the shoulder is a new option for accessing the coracoid process and treating acromioclavicular dislocation, with clinical and radiographic results equivalent to those in the literature. PMID:27047866

Developing and Evaluating Communication Strategies to Support Informed Decisions and Practice Based on Evidence (DECIDE): protocol and preliminary results.

PubMed

Treweek, Shaun; Oxman, Andrew D; Alderson, Philip; Bossuyt, Patrick M; Brandt, Linn; Brożek, Jan; Davoli, Marina; Flottorp, Signe; Harbour, Robin; Hill, Suzanne; Liberati, Alessandro; Liira, Helena; Schünemann, Holger J; Rosenbaum, Sarah; Thornton, Judith; Vandvik, Per Olav; Alonso-Coello, Pablo

2013-01-09

Healthcare decision makers face challenges when using guidelines, including understanding the quality of the evidence or the values and preferences upon which recommendations are made, which are often not clear. GRADE is a systematic approach towards assessing the quality of evidence and the strength of recommendations in healthcare. GRADE also gives advice on how to go from evidence to decisions. It has been developed to address the weaknesses of other grading systems and is now widely used internationally. The Developing and Evaluating Communication Strategies to Support Informed Decisions and Practice Based on Evidence (DECIDE) consortium (http://www.decide-collaboration.eu/), which includes members of the GRADE Working Group and other partners, will explore methods to ensure effective communication of evidence-based recommendations targeted at key stakeholders: healthcare professionals, policymakers, and managers, as well as patients and the general public. Surveys and interviews with guideline producers and other stakeholders will explore how presentation of the evidence could be improved to better meet their information needs. We will collect further stakeholder input from advisory groups, via consultations and user testing; this will be done across a wide range of healthcare systems in Europe, North America, and other countries. Targeted communication strategies will be developed, evaluated in randomized trials, refined, and assessed during the development of real guidelines. Results of the DECIDE project will improve the communication of evidence-based healthcare recommendations. Building on the work of the GRADE Working Group, DECIDE will develop and evaluate methods that address communication needs of guideline users. The project will produce strategies for communicating recommendations that have been rigorously evaluated in diverse settings, and it will support the transfer of research into practice in healthcare systems globally.

Classification and grading of muscle injuries: a narrative review

PubMed Central

Hamilton, Bruce; Valle, Xavier; Rodas, Gil; Til, Luis; Grive, Ricard Pruna; Rincon, Josep Antoni Gutierrez; Tol, Johannes L

2015-01-01

A limitation to the accurate study of muscle injuries and their management has been the lack of a uniform approach to the categorisation and grading of muscle injuries. The goal of this narrative review was to provide a framework from which to understand the historical progression of the classification and grading of muscle injuries. We reviewed the classification and grading of muscle injuries in the literature to critically illustrate the strengths, weaknesses, contradictions or controversies. A retrospective, citation-based methodology was applied to search for English language literature which evaluated or utilised a novel muscle classification or grading system. While there is an abundance of literature classifying and grading muscle injuries, it is predominantly expert opinion, and there remains little evidence relating any of the clinical or radiological features to an established pathology or clinical outcome. While the categorical grading of injury severity may have been a reasonable solution to a clinical challenge identified in the middle of the 20th century, it is time to recognise the complexity of the injury, cease trying to oversimplify it and to develop appropriately powered research projects to answer important questions. PMID:25394420

An evaluation of the systems approach to bridge design.

DOT National Transportation Integrated Search

1974-01-01

This study contains the findings from a survey of available integrated computer systems for bridge analysis and design, along with a sample design of a grade separation structure using the two leading design systems, BEST and STRC. It appears that in...

Biomarkers Prognostic for Elevated Intracranial Pressure

DTIC Science & Technology

2016-03-01

hematoma and active extravasation , for which she was taken emergently to interventional radiology for embolization of the bilateral internal iliac...approach to injuries was carried out. She was sent to IR for evaluation of her grade 3 liver laceration with active punctate extravasation and later

A Social Marketing Approach to Promoting Healthful Eating and Physical Activity in Low-Income and Ethnically Diverse Schools

ERIC Educational Resources Information Center

Paek, Hye-Jin; Jung, Yumi; Oh, Hyun Jung; Alaimo, Katherine; Pfeiffer, Karin; Carlson, Joseph J.; Wen, Yalu; Betz, Heather Hayes; Orth, Julie

2015-01-01

Objective: To evaluate the short-term outcome of the social marketing approach used in Project FIT, we developed a school- and community-based programme for promoting healthful eating and physical activity in kindergarten to 5th-grade children and their parents. Design: A 2-year quasi-experiment for children and two cross-sectional surveys for…

Incorporating a Drug Information Consult into a Pharmacy Practice Course to Build Literature Search and Evaluation Skills Through a 3-Stage Model.

PubMed

Wittman, Deborah; Kovera, Craig; Sullivan, Maureen; Rumore, Martha M

2017-06-01

Pharmacy students need to be equipped with skills to research and evaluate literature to effectively apply evidence-based medicine (EBM) in practice. To prepare them, a 3-stage approach to writing a drug information consult (3sDIC) was incorporated into a pharmacy course. The primary objective was to assess students' abilities to retrieve and analyze literature pursuant to a drug information consult. Secondary objectives were to examine feasibility of faculty participation and continuation of the assignment. Ninety students were given a clinical scenario about a patient. The assignment consisted of 3 stages incorporating use of the Population, Intervention, Comparison intervention, Outcome (PICO) method and modified systematic approach (MSA) for stage 1, evaluation of primary literature to write a draft for stage 2, and stage 3, the final consult. All 3 stages were reviewed and graded by faculty. All students completed the 3sDIC, with no grade failures. The rubric employed by faculty was effective, providing students the opportunity to improve the consult. The 3sDIC was found to be feasible with adequate faculty support. The 3sDIC, although not a substitute for a complete drug information course, demonstrated a streamlined approach for Pharmacy year 2 (P2) students to acquire and develop drug information skills.

Validated System for Centralized Grading of Retinopathy of Prematurity: Telemedicine Approaches to Evaluating Acute-Phase Retinopathy of Prematurity (e-ROP) Study.

PubMed

Daniel, Ebenezer; Quinn, Graham E; Hildebrand, P Lloyd; Ells, Anna; Hubbard, G Baker; Capone, Antonio; Martin, E Revell; Ostroff, Candace P; Smith, Eli; Pistilli, Maxwell; Ying, Gui-Shuang

2015-06-01

Measurable competence derived from comprehensive and advanced training in grading digital images is critical in studies using a reading center to evaluate retinal fundus images from infants at risk for retinopathy of prematurity (ROP). Details of certification for nonphysician trained readers (TRs) have not yet been described. To describe a centralized system for grading ROP digital images by TRs in the Telemedicine Approaches to Evaluating Acute-Phase Retinopathy of Prematurity (e-ROP) Study. Multicenter observational cohort study conducted from July 1, 2010, to June 30, 2014. The TRs were trained by experienced ROP specialists and certified to detect ROP morphology in digital retinal images under supervision of an ophthalmologist reading center director. An ROP reading center was developed with standard hardware, secure Internet access, and customized image viewing software with an electronic grading form. A detailed protocol for grading was developed. Based on results of TR gradings, a computerized algorithm determined whether referral-warranted ROP (RW-ROP; defined as presence of plus disease, zone I ROP, and stage 3 or worse ROP) was present in digital images from infants with birth weight less than 1251 g enrolled from May 25, 2011, through October 31, 2013. Independent double grading was done by the TRs with adjudication of discrepant fields performed by the reading center director. Digital retinal images. Intragrader and intergrader variability and monitoring for temporal drift. Four TRs underwent rigorous training and certification. A total of 5520 image sets were double graded, with 24.5% requiring adjudication for at least 1 component of RW-ROP. For individual RW-ROP components, the adjudication rate was 3.9% for plus disease, 12.4% for zone I ROP, and 16.9% for stage 3 or worse ROP. The weighted κ for intergrader agreement (n = 80 image sets) was 0.72 (95% CI, 0.52-0.93) for RW-ROP, 0.57 (95% CI, 0.37-0.77) for plus disease, 0.43 (95% CI, 0.24-0.63) for zone I ROP, and 0.67 (95% CI, 0.47-0.88) for stage 3 or worse ROP. The weighted κ for grade-regrade agreement was 0.77 (95% CI, 0.57-0.97) for RW-ROP, 0.87 (95% CI, 0.67-1.00) for plus disease, 0.70 (95% CI, 0.51-0.90) for zone I ROP, and 0.77 (95% CI, 0.57-0.97) for stage 3 or worse ROP. These data suggest that the e-ROP system for training and certifying nonphysicians to grade ROP images under the supervision of a reading center director reliably detects potentially serious ROP with good intragrader and intergrader consistency and minimal temporal drift.

The use of GRADE approach in systematic reviews of animal studies.

PubMed

Wei, Dang; Tang, Kun; Wang, Qi; Estill, Janne; Yao, Liang; Wang, Xiaoqin; Chen, Yaolong; Yang, Kehu

2016-03-15

The application of GRADE (Grading of Recommendations Assessment, Development and Evaluation) in SR of animal studies can promote the translation from bench to bedside. We aim to explore the use of GRADE in systematic reviews of animal studies. We used a theoretical analysis method to explore the use of GRADE in SR of animal studies and applied in a SR of animal studies. Meanwhile, we presented and discussed our results in two international conferences. Five downgrade factors were considered as follows in systematic reviews of animal studies: 1) Risk of bias: the SYRCLE tool can be used for assessing the risk of bias of animal studies. 2) Indirectness: we can assess indirectness in systematic reviews of animal studies from the PICO. 3) Inconsistency: similarity of point estimates, extent of overlap of confidence intervals and statistical heterogeneity are also suitable to evaluate inconsistency of evidence from animal studies. 4) Imprecision: optimal information size (OIS) and 95% confidence intervals (CIs) are also suitable for systematic reviews of animal studies, like those of clinical trials. 5) Publication bias: we need to consider publication bias comprehensively through the qualitative and quantitative methods. The methods about the use of GRADE in systematic review of animal studies are explicit. However, the principle about GRADE in developing the policy based on the evidence from animal studies when there is an emergency of public health. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Transcriptional Analysis of Aggressiveness and Heterogeneity across Grades of Astrocytomas

PubMed Central

Wang, Chunjing; Funk, Cory C.; Eddy, James A.; Price, Nathan D.

2013-01-01

Astrocytoma is the most common glioma, accounting for half of all primary brain and spinal cord tumors. Late detection and the aggressive nature of high-grade astrocytomas contribute to high mortality rates. Though many studies identify candidate biomarkers using high-throughput transcriptomic profiling to stratify grades and subtypes, few have resulted in clinically actionable results. This shortcoming can be attributed, in part, to pronounced lab effects that reduce signature robustness and varied individual gene expression among patients with the same tumor. We addressed these issues by uniformly preprocessing publicly available transcriptomic data, comprising 306 tumor samples from three astrocytoma grades (Grade 2, 3, and 4) and 30 non-tumor samples (normal brain as control tissues). Utilizing Differential Rank Conservation (DIRAC), a network-based classification approach, we examined the global and individual patterns of network regulation across tumor grades. Additionally, we applied gene-based approaches to identify genes whose expression changed consistently with increasing tumor grade and evaluated their robustness across multiple studies using statistical sampling. Applying DIRAC, we observed a global trend of greater network dysregulation with increasing tumor aggressiveness. Individual networks displaying greater differences in regulation between adjacent grades play well-known roles in calcium/PKC, EGF, and transcription signaling. Interestingly, many of the 90 individual genes found to monotonically increase or decrease with astrocytoma grade are implicated in cancer-affected processes such as calcium signaling, mitochondrial metabolism, and apoptosis. The fact that specific genes monotonically increase or decrease with increasing astrocytoma grade may reflect shared oncogenic mechanisms among phenotypically similar tumors. This work presents statistically significant results that enable better characterization of different human astrocytoma grades and hopefully can contribute towards improvements in diagnosis and therapy choices. Our results also identify a number of testable hypotheses relating to astrocytoma etiology that may prove helpful in developing much-needed biomarkers for earlier disease detection. PMID:24146911

Transcriptional analysis of aggressiveness and heterogeneity across grades of astrocytomas.

PubMed

Wang, Chunjing; Funk, Cory C; Eddy, James A; Price, Nathan D

2013-01-01

Astrocytoma is the most common glioma, accounting for half of all primary brain and spinal cord tumors. Late detection and the aggressive nature of high-grade astrocytomas contribute to high mortality rates. Though many studies identify candidate biomarkers using high-throughput transcriptomic profiling to stratify grades and subtypes, few have resulted in clinically actionable results. This shortcoming can be attributed, in part, to pronounced lab effects that reduce signature robustness and varied individual gene expression among patients with the same tumor. We addressed these issues by uniformly preprocessing publicly available transcriptomic data, comprising 306 tumor samples from three astrocytoma grades (Grade 2, 3, and 4) and 30 non-tumor samples (normal brain as control tissues). Utilizing Differential Rank Conservation (DIRAC), a network-based classification approach, we examined the global and individual patterns of network regulation across tumor grades. Additionally, we applied gene-based approaches to identify genes whose expression changed consistently with increasing tumor grade and evaluated their robustness across multiple studies using statistical sampling. Applying DIRAC, we observed a global trend of greater network dysregulation with increasing tumor aggressiveness. Individual networks displaying greater differences in regulation between adjacent grades play well-known roles in calcium/PKC, EGF, and transcription signaling. Interestingly, many of the 90 individual genes found to monotonically increase or decrease with astrocytoma grade are implicated in cancer-affected processes such as calcium signaling, mitochondrial metabolism, and apoptosis. The fact that specific genes monotonically increase or decrease with increasing astrocytoma grade may reflect shared oncogenic mechanisms among phenotypically similar tumors. This work presents statistically significant results that enable better characterization of different human astrocytoma grades and hopefully can contribute towards improvements in diagnosis and therapy choices. Our results also identify a number of testable hypotheses relating to astrocytoma etiology that may prove helpful in developing much-needed biomarkers for earlier disease detection.

Screen-and-treat approaches for cervical cancer prevention in low-resource settings: a randomized controlled trial.

PubMed

Denny, Lynette; Kuhn, Louise; De Souza, Michelle; Pollack, Amy E; Dupree, William; Wright, Thomas C

2005-11-02

Non-cytology-based screen-and-treat approaches for cervical cancer prevention have been developed for low-resource settings, but few have directly addressed efficacy. To determine the safety and efficacy of 2 screen-and-treat approaches for cervical cancer prevention that were designed to be more resource-appropriate than conventional cytology-based screening programs. Randomized clinical trial of 6555 nonpregnant women, aged 35 to 65 years, recruited through community outreach and conducted between June 2000 and December 2002 at ambulatory women's health clinics in Khayelitsha, South Africa. All patients were screened using human papillomavirus (HPV) DNA testing and visual inspection with acetic acid (VIA). Women were subsequently randomized to 1 of 3 groups: cryotherapy if she had a positive HPV DNA test result; cryotherapy if she had a positive VIA test result; or to delayed evaluation. Biopsy-confirmed high-grade cervical cancer precursor lesions and cancer at 6 and 12 months in the HPV DNA and VIA groups compared with the delayed evaluation (control) group; complications after cryotherapy. The prevalence of high-grade cervical intraepithelial neoplasia and cancer (CIN 2+) was significantly lower in the 2 screen-and-treat groups at 6 months after randomization than in the delayed evaluation group. At 6 months, CIN 2+ was diagnosed in 0.80% (95% confidence interval [CI], 0.40%-1.20%) of the women in the HPV DNA group and 2.23% (95% CI, 1.57%-2.89%) in the VIA group compared with 3.55% (95% CI, 2.71%-4.39%) in the delayed evaluation group (P<.001 and P = .02 for the HPV DNA and VIA groups, respectively). A subset of women underwent a second colposcopy 12 months after enrollment. At 12 months the cumulative detection of CIN 2+ among women in the HPV DNA group was 1.42% (95% CI, 0.88%-1.97%), 2.91% (95% CI, 2.12%-3.69%) in the VIA group, and 5.41% (95% CI, 4.32%-6.50%) in the delayed evaluation group. Although minor complaints, such as discharge and bleeding, were common after cryotherapy, major complications were rare. Both screen-and-treat approaches are safe and result in a lower prevalence of high-grade cervical cancer precursor lesions compared with delayed evaluation at both 6 and 12 months. Trial Registration http://clinicaltrials.gov Identifier: NCT00233727.

Quantitative in vivo MRI evaluation of lumbar facet joints and intervertebral discs using axial T2 mapping.

PubMed

Stelzeneder, David; Messner, Alina; Vlychou, Marianna; Welsch, Goetz H; Scheurecker, Georg; Goed, Sabine; Pieber, Karin; Pflueger, Verena; Friedrich, Klaus M; Trattnig, Siegfried

2011-11-01

To assess the feasibility of T2 mapping of lumbar facet joints and intervertebral discs in a single imaging slab and to compare the findings with morphological grading. Sixty lumbar spine segments from 10 low back pain patients and 5 healthy volunteers were examined by axial T2 mapping and morphological MRI at 3.0 Tesla. Regions of interest were drawn on a single slice for the facet joints and the intervertebral discs (nucleus pulposus, anterior and posterior annulus fibrosus). The Weishaupt grading was used for facet joints and the Pfirrmann score was used for morphological disc grading ("normal" vs. "abnormal" discs). The inter-rater agreement was excellent for the facet joint T2 evaluation (r = 0.85), but poor for the morphological Weishaupt grading (kappa = 0.15). The preliminary results show similar facet joint T2 values in segments with normal and abnormal Pfirrmann scores. There was no difference in mean T2 values between facet joints in different Weishaupt grading groups. Facet joint T2 values showed a weak correlation with T2 values of the posterior annulus (r = 0.32) This study demonstrates the feasibility of a combined T2 mapping approach for the facet joints and intervertebral discs using a single axial slab.

Spatio-Temporal Dynamic Analysis of Sustainable Development in China Based on the Footprint Family.

PubMed

Zhao, Jing; Ma, Caihong; Zhao, Xiangui; Wang, Xiaoyu

2018-02-01

The existing index systems on sustainable evaluation are mostly based on a multi index comprehensive evaluation method. The main disadvantage of this approach is that the selection and assignment of evaluation indexes are greatly influenced by subjective factors, which can result in poor comparability of results. By contrast, the Footprint Family (including ecological footprint, carbon footprint, and water footprint) is not affected by subjective factors. The Footprint Family also covers the basic tenets of sustainable development. This paper proposes use of a sustainable development evaluation index system based on the principle of the Footprint Family, and including the ecological pressure index ( EPI ), the ecological occupancy index ( EOI ), the ecological economic coordination index ( EECI ), the GHG (Greenhouse Gas) emission index ( CEI ), the water resources stress index ( WSI ), and the sustainable development index ( SDI ). Furthermore, a standard for grading the evaluated results based on global benchmarks is formulated. The results of an empirical study in China were the following. The development situation deteriorated from 1990 to 2015. The results showed that the SDI decreased from a medium level (grade 5) to a lower-medium level (grade 4). The results of this empirical study also showed that the method of evaluation can avoid the influence of subjective factors and can be used in the evaluation of sustainable development for various temporal and spatial conditions.

Spatio-Temporal Dynamic Analysis of Sustainable Development in China Based on the Footprint Family

PubMed Central

Ma, Caihong; Zhao, Xiangui; Wang, Xiaoyu

2018-01-01

The existing index systems on sustainable evaluation are mostly based on a multi index comprehensive evaluation method. The main disadvantage of this approach is that the selection and assignment of evaluation indexes are greatly influenced by subjective factors, which can result in poor comparability of results. By contrast, the Footprint Family (including ecological footprint, carbon footprint, and water footprint) is not affected by subjective factors. The Footprint Family also covers the basic tenets of sustainable development. This paper proposes use of a sustainable development evaluation index system based on the principle of the Footprint Family, and including the ecological pressure index (EPI), the ecological occupancy index (EOI), the ecological economic coordination index (EECI), the GHG (Greenhouse Gas) emission index (CEI), the water resources stress index (WSI), and the sustainable development index (SDI). Furthermore, a standard for grading the evaluated results based on global benchmarks is formulated. The results of an empirical study in China were the following. The development situation deteriorated from 1990 to 2015. The results showed that the SDI decreased from a medium level (grade 5) to a lower-medium level (grade 4). The results of this empirical study also showed that the method of evaluation can avoid the influence of subjective factors and can be used in the evaluation of sustainable development for various temporal and spatial conditions. PMID:29389886

The Science behind Curriculum Development and Evaluation: Taking a Design Science Approach in the Production of a Tier 2 Mathematics Curriculum

ERIC Educational Resources Information Center

Doabler, Christian T.; Clarke, Ben; Fien, Hank; Baker, Scott K.; Kosty, Derek B.; Cary, Mari Strand

2015-01-01

The production of an effective mathematics curriculum begins with a scientific development, evaluation, and revision framework. The purpose of this study was to conduct an initial investigation of a recently developed Tier 2 mathematics curriculum designed to improve the outcomes of first grade students at risk for mathematics difficulties (MD).…

Estimating Effectiveness of the Control of Violence and Socioeconomic Development in Colombia: An Application of Dynamic Data Envelopment Analysis and Data Panel Approach

ERIC Educational Resources Information Center

Poveda, Alexander Cotte

2012-01-01

This paper develops an index to evaluate the level of effectiveness of the control of violence based on the data envelopment analysis approach. The index is used to examine the grade of effectiveness of the control of violence at the level of Colombian departments between 1993 and 2007. Comparing the results across Colombian departments, we find…

Effects of Making Sense of SCIENCE[TM] Professional Development on the Achievement of Middle School Students, Including English Language Learners. Final Report. NCEE 2012-4002

ERIC Educational Resources Information Center

Heller, Joan I.

2012-01-01

This study evaluated an approach to professional development for middle school science teachers by closely examining one grade 8 course that embodies that approach. Using a cluster-randomized experimental design, the study tested the effectiveness of the Making Sense of SCIENCE[TM] professional development course on force and motion (Daehler,…

Readability Level of Spanish-Language Patient-Reported Outcome Measures in Audiology and Otolaryngology

PubMed Central

Coco, Laura; Colina, Sonia; Atcherson, Samuel R.

2017-01-01

Purpose The purpose of this study was to examine the readability level of the Spanish versions of several audiology- and otolaryngology-related patient-reported outcome measures (PROMs) and include a readability analysis of 2 translation approaches when available—the published version and a “functionalist” version—using a team-based collaborative approach including community members. Method Readability levels were calculated using the Fry Graph adapted for Spanish, as well as the Fernandez-Huerta and the Spaulding formulae for several commonly used audiology- and otolaryngology-related PROMs. Results Readability calculations agreed with previous studies analyzing audiology-related PROMs in English and demonstrated many Spanish-language PROMs were beyond the 5th grade reading level suggested for health-related materials written for the average population. In addition, the functionalist versions of the PROMs yielded lower grade-level (improved) readability levels than the published versions. Conclusion Our results suggest many of the Spanish-language PROMs evaluated here are beyond the recommended readability levels and may be influenced by the approach to translation. Moreover, improved readability may be possible using a functionalist approach to translation. Future analysis of the suitability of outcome measures and the quality of their translations should move beyond readability and include an evaluation of the individual's comprehension of the written text. PMID:28892821

Learning Physical Science through Astronomy Activities: A Comparison between Constructivist and Traditional Approaches in Grades 3-6

NASA Astrophysics Data System (ADS)

Ward, R. Bruce; Sadler, Philip M.; Shapiro, Irwin I.

We report on an evaluation of the effectiveness of Project ARIES, an astronomy- based physical science curriculum for upper elementary and middle school children. ARIES students use innovative, simple, and affordable apparatus to carry out a wide range of indoor and outdoor hands-on, discovery- based activities. Student journals and comprehensive teacher materials aid in making the science content accessible to students based on their shared experiences and observations. Approximately 750 Grades 3 6 students in ARIES (or treatment) classrooms are compared with approximately 650 Grades 4 6 students in control classrooms through a series of open-ended assessment measures, using a pretest and posttest format. A detailed analysis by item measures the gain in treatment and control groups. We identify concepts where the ARIES approach is more effective, where both are equally effective, and where neither results in much learning. (The ARIES approach was never less effective.) Although learning is in evidence for both control and treatment groups, overall, the ARIES students achieve roughly four times the gain of their control counterparts. In particular, ARIES students had much greater gains for the concepts that the control students found most difficult.

McGraw-Hill Programmed Reading Evaluation.

ERIC Educational Resources Information Center

Norfolk Public Schools, VA.

One of the programs included in "Effective Reading Programs...," this program, begun in 1972, serves about 3,600 disadvantaged first through fourth grade students. The independent learning approach is featured in this program. Placement tests help teachers determine each child's needs, and diagnostic tests monitor student progress.…

Galaxy Classroom Project Evaluation, Language Arts, Grades 3-5. Final Report.

ERIC Educational Resources Information Center

Guth, Gloria J. A.; Block, Clifford

The GALAXY Language Arts Demonstration Program is a package of integrated curricular and instructional approaches that features the organization of instruction around themes presented through television broadcasts, children's literature, classroom activities, and the use of interactive technology. During the GALAXY Project demonstration phase for…

KDIGO Clinical Practice Guideline on the Evaluation and Care of Living Kidney Donors.

PubMed

Lentine, Krista L; Kasiske, Bertram L; Levey, Andrew S; Adams, Patricia L; Alberú, Josefina; Bakr, Mohamed A; Gallon, Lorenzo; Garvey, Catherine A; Guleria, Sandeep; Li, Philip Kam-Tao; Segev, Dorry L; Taler, Sandra J; Tanabe, Kazunari; Wright, Linda; Zeier, Martin G; Cheung, Michael; Garg, Amit X

2017-08-01

The 2017 Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guideline on the Evaluation and Care of Living Kidney Donors is intended to assist medical professionals who evaluate living kidney donor candidates and provide care before, during and after donation. The guideline development process followed the Grades of Recommendation Assessment, Development, and Evaluation (GRADE) approach and guideline recommendations are based on systematic reviews of relevant studies that included critical appraisal of the quality of the evidence and the strength of recommendations. However, many recommendations, for which there was no evidence or no systematic search for evidence was undertaken by the Evidence Review Team, were issued as ungraded expert opinion recommendations. The guideline work group concluded that a comprehensive approach to risk assessment should replace decisions based on assessments of single risk factors in isolation. Original data analyses were undertaken to produce a "proof-in-concept" risk-prediction model for kidney failure to support a framework for quantitative risk assessment in the donor candidate evaluation and defensible shared decision making. This framework is grounded in the simultaneous consideration of each candidate's profile of demographic and health characteristics. The processes and framework for the donor candidate evaluation are presented, along with recommendations for optimal care before, during, and after donation. Limitations of the evidence are discussed, especially regarding the lack of definitive prospective studies and clinical outcome trials. Suggestions for future research, including the need for continued refinement of long-term risk prediction and novel approaches to estimating donation-attributable risks, are also provided.In citing this document, the following format should be used: Kidney Disease: Improving Global Outcomes (KDIGO) Living Kidney Donor Work Group. KDIGO Clinical Practice Guideline on the Evaluation and Care of Living Kidney Donors. Transplantation. 2017;101(Suppl 8S):S1-S109.

Immunotherapy for high-grade glioma: how to go beyond Phase I/II clinical trials.

PubMed

van Gool, Stefaan

2013-10-01

Evaluation of: Lasky JL 3rd, Panosyan EH, Plant A et al. Autologous tumor lysate-pulsed dendritic cell immunotherapy for pediatric patients with newly diagnosed or recurrent high-grade gliomas. Anticancer Res. 33, 2047-2056 (2013). Immunotherapy for children and adults with high-grade glioma (HGG) is an emerging innovative treatment approach, which aims at stimulating the body's own immune system against HGG by using autologous dendritic cells pulsed with autologous tumor lysate as a therapeutic vaccine. This is the third report on immunotherapy for HGG in children, bringing additional knowledge and experience to the scientific community. However, at the same time, this and other manuscripts urge for the next step in treatment development.

Differentiation of aroma characteristics of pine-mushrooms (Tricholoma matsutake Sing.) of different grades using gas chromatography-olfactometry and sensory analysis.

PubMed

Cho, In Hee; Lee, Soh Min; Kim, Se Young; Choi, Hyung-Kyoon; Kim, Kwang-Ok; Kim, Young-Suk

2007-03-21

Two independent approaches, gas chromatography-olfactometry and sensory analysis, were used to evaluate and compare the aroma characteristics of pine-mushrooms (Tricholoma matsutake Sing.) of four different grades. The aroma-active compounds responsible for the sensory attributes of pine- mushrooms were investigated based on the correlation between instrumental and sensory analyses through partial least-square regression. Piny, meaty, and floral attributes were strongly correlated with each other and were the most important descriptors for defining the pine-mushrooms of the highest grade, and they decreased as the grade decreased. Among 23 aroma-active compounds, (E)-2-decenal, alpha-terpineol, phenylethyl alcohol, and 2-methylbutanoic acid ethyl ester contributed most to these attributes. On the other hand, the major aroma characteristics of the pine-mushrooms of the lowest grade were wet soil-like, alcohol, metallic, moldy, and fermented, and they decreased as the grade increased. These aroma characteristics were strongly associated with 1-octen-3-one, 1-octen-3-ol, 3-octanol, 3-octanone, (E)-2-octen-1-ol, and methional.

Thermomechanical response of metal-ceramic graded composites for high-temperature aerospace applications

NASA Astrophysics Data System (ADS)

Deierling, Phillip Eugene

Airframes operating in the hypersonic regime are subjected to complex structural and thermal loads. Structural loads are a result of aggressive high G maneuvers, rapid vehicle acceleration and deceleration, and dynamic pressure, while thermal loads are a result of aerodynamic heating. For such airframes, structural members are typically constructed from steel, titanium and nickel alloys. However, with most materials, rapid elevations in temperature lead to undesirable changes in material properties. In particular, reductions in strength and stiffness are observed, along with an increase in thermal conductivity, specific heat and thermal expansion. Thus, hypersonic airframes are typically designed with external insulation, active cooling or a thermal protection system (TPS) added to the structure to protect the underling material from the effects of temperature. Such thermal protection may consist of adhesively bonded, pinned, and bolted thermal protection layers over exterior panels. These types of attachments create abrupt changes in thermal expansion and stiffness that make the structure susceptible to cracking and debonding as well as adding mass to the airframe. One of the promising materials concepts for extreme environments that was introduced in the past is the so-called Spatially Tailored Advanced Thermal Structures (STATS). The concept of STATS is rooted in functionally graded materials (FGMs), in which a directional variation of material properties exists. These materials are essentially composites and consist of two or more phases of distinct materials in which the volume fractions of each phase continuously change in space. Here, the graded material will serve a dual-purpose role as both the structural/skin member and thermal management with the goal of reducing the weight of the structure while maintaining structural soundness. This is achieved through the ability to tailor material properties to create a desired or enhanced thermomechanical response through spatial variation (e.g. grading). The objective of this study is to present a computational framework for modeling and evaluating the thermomechanical response of STATS and FGMs for highly maneuverable hypersonic (Mach > 5) airframes. To meet the objective of this study, four key steps have been defined to study the thermomechanical response of such materials in extreme environments. They involve: (1) modeling of graded microstructures; (2) validation of analytical and numerical modeling techniques for graded microstructures; (3) determination of effective properties of variable composition composites; (4) parametric studies to evaluate the performance of FGMs for use in the hypersonic operating environment; (5) optimization of the material spatial grading in hypersonic panels aiming to improve the thermomechanical performance. Modeling of graded microstructures, representing particulate reinforced FGMs, has been accomplished using power law distribution functions to specify the spatial variation of the constituents. Artificial microstructures consisting of disks and spheres have been generated using developed algorithms. These algorithms allow for the creation of dense packing fractions up to 0.61 and 0.91 for 2D and 3D geometry, respectively. Effective properties of FGMs are obtained using micromechanics models and finite element analysis of representative volume elements (RVEs). Two approaches have been adopted and compared to determine the proper RVE for materials with graded microstructures. In the first approach, RVEs are generated by considering regions that have a uniform to slow variation in material composition (i.e., constant volume fraction), resulting in statistically homogenous piecewise RVEs of the graded microstructure neglecting interactions from neighboring cells. In the second approach, continuous RVEs are generated by considering the entire FGM. Here it is presumed that modeling of the complete variation in a microstructure may influence the surrounding layers due to the interactions of varying material composition, particularly when there is a steep variation in material composition along the grading direction. To determine these effects of interlayer interactions, FGM microstructures were generated using three different types of material grading functions, linear, quadratic and square root, providing uniform, gradual and steep variations, respectively. Two- and three-dimensional finite element analysis was performed to determine the effective temperature-dependent material properties of the composite over a wide temperature range. The outcome of the computational analysis show that the similar effective properties are obtained by each of the modeling approaches. Furthermore, the obtained computational results for effective elastic, thermal, and thermal expansion properties are consistent with the known analytical bounds. Resulting effective temperature-dependent material properties were used to evaluate the time-dependent thermostructural response and effectiveness of FGM structural panels. Structural panels are subjected to time- and spatial-dependent thermal and mechanical loads resulting from hypersonic flight over a representative trajectory. Mechanical loads are the by-product of aggressive maneuvering at high air speeds and angles of attack. Thermal loads as a result of aerodynamic heating are applied to the material systems as laminar, turbulent and transitional heat flux on the outer surface. Laminar and turbulent uniform heat fluxes are used to evaluate the effectiveness of FGM panels graded in the through-thickness direction only. Transitional heat fluxes are used to evaluate the effectiveness of FGMs graded in two principal directions, e.g., through-thickness and the surface parallel to flow. The computational results indicate that when subjected to uniform surface heat flux, the graded material system can eliminate through-thickness temperature gradients that are otherwise present in traditional thermal protection systems. Furthermore, two-dimensional graded material systems can also eliminate through-thickness temperature gradients and significantly reduce in-plane surface temperature gradients when subjected to non-uniform surface aerodynamic heating.

Aggregate assesment and durability evaluation of optimized graded concrete in the state of Oklahoma

NASA Astrophysics Data System (ADS)

Ghaeezadeh, Ashkan

This research is a part of a larger project that emphasizes on creating a more scientific approach to designing concrete mixtures for concrete pavements that use less cement and more aggregate which is called optimized graded concrete. The most challenging obstacle in optimized mixtures is reaching enough workability so that one doesn't have to add more cement or super-plasticizer to reach the desired level of flowability. Aggregate gradation and characteristics have found to be very important when it comes to the workabaility of optimized graded concrete. In this research a new automated method of aggregate assessment was used to compare the shape and the surface of different aggregates as well as their influence on the concrete flowability. At the end, the performance of optimized graded concrete against drying shrinkage and freezing and thawing condition were investigated.

Rheology of multiphase polymer systems using novel "melt rigidity" evaluation approach

NASA Astrophysics Data System (ADS)

Kracalik, Milan

2015-04-01

Multiphase polymer systems like blends, composites and nanocomposites exhibit complex rheological behaviour due to physical and also possibly chemical interactions between individual phases. Up to now, rheology of heterogeneous polymer systems has been usually described by evaluation of viscosity curve (shear thinning phenomenon), storage modulus curve (formation of secondary plateau) or plotting information about damping behaviour (e.g. Van Gurp-Palmen-plot). On the contrary to evaluation of damping behaviour, "melt rigidity" approach has been introduced for description of physical network of rigid particles in polymer matrix as relation of ∫G'/∫G" over specific frequency range. This approach has been experimentally proved for polymer nanocomposites in order to compare shear flow characteristics with elongational flow field. In this contribution, LDPE-clay nanocomposites with different dispersion grades (physical networks) have been prepared and characterized by both conventional as well as novel "melt rigidity" approach.

Linguistic pattern analysis of misspellings of typically developing writers in grades 1-9.

PubMed

Bahr, Ruth Huntley; Sillian, Elaine R; Berninger, Virginia W; Dow, Michael

2012-12-01

A mixed-methods approach, evaluating triple word-form theory, was used to describe linguistic patterns of misspellings. Spelling errors were taken from narrative and expository writing samples provided by 888 typically developing students in Grades 1-9. Errors were coded by category (phonological, orthographic, and morphological) and specific linguistic feature affected. Grade-level effects were analyzed with trend analysis. Qualitative analyses determined frequent error types and how use of specific linguistic features varied across grades. Phonological, orthographic, and morphological errors were noted across all grades, but orthographic errors predominated. Linear trends revealed developmental shifts in error proportions for the orthographic and morphological categories between Grades 4 and 5. Similar error types were noted across age groups, but the nature of linguistic feature error changed with age. Triple word-form theory was supported. By Grade 1, orthographic errors predominated, and phonological and morphological error patterns were evident. Morphological errors increased in relative frequency in older students, probably due to a combination of word-formation issues and vocabulary growth. These patterns suggest that normal spelling development reflects nonlinear growth and that it takes a long time to develop a robust orthographic lexicon that coordinates phonology, orthography, and morphology and supports word-specific, conventional spelling.

Evaluation of a Social Contextual Model of Delinquency: A Cross-Study Replication.

ERIC Educational Resources Information Center

Scaramella, Laura V.; Conger, Rand D.; Spoth, Richard; Simons, Ronald L.

2002-01-01

Examined three theories for predicting risk for delinquency during adolescence with sixth- and seventh-grade students: an individual difference perspective, social interactional model, and social contextual approach. Found that lack of nurturant and involved parenting indirectly predicted delinquency by increasing antisocial behavior and deviant…

Human Relations Education; A Guidebook to Learning Activities.

ERIC Educational Resources Information Center

Buffalo Public Schools, NY. Human Relations Project of Western New York.

This guidebook is designed to acquaint teachers with human relations classroom materials, extracurricular activities, and an inservice approach to self-evaluation. A product of an ESEA Title III program, it contains human relations-oriented lessons--divided by grade level and subject matter--intended to supplement or enrich existing curricula and…

Evaluating an In-School Drug Prevention Program for At-Risk Youth.

ERIC Educational Resources Information Center

DeWit, David J.; Steep, Barbara; Silverman, Gloria; Stevens-Lavigne, Andrea; Ellis, Kathy; Smythe, Cindy; Rye, Barbara J.; Braun, Kathy; Wood, Eileen

2000-01-01

A drug prevention program involving 167 at-risk students in grades 8-10 at 9 Ontario schools resulted in reduced use of and less supportive attitudes toward alcohol, cannabis, tobacco, and tranquilizers. Program success is attributed to high attendance and retention, community health professionals' participation, comprehensive approach, strong…

Profiles of Intrinsic and Extrinsic Motivations in Elementary School: A Longitudinal Analysis

ERIC Educational Resources Information Center

Corpus, Jennifer Henderlong; Wormington, Stephanie V.

2014-01-01

The authors used a person-centered, longitudinal approach to identify and evaluate naturally occurring combinations of intrinsic and extrinsic motivations among 490 third- through fifth-grade students. Cluster analysis revealed 3 groups, characterized by high levels of both motivations ("high quantity"): high intrinsic motivation but low…

Kinder Lernen Deutsch. Materials Project Part I. Revised.

ERIC Educational Resources Information Center

American Association of Teachers of German.

The Kinder Lernen Deutsch (LKD) materials evaluation project identifies materials appropriate for the elementary school German classrooms in grades K-8. This guide consists of an annotated bibliography, with ratings, of these materials. The guiding principles by which the materials were assessed were: use of the communicative approach; integration…

Program for Autistic Children's Education: A Curriculum Guide for Autistic Students.

ERIC Educational Resources Information Center

Lister, Bob; And Others

The curriculum guide presents activity suggestions for teachers to use with autistic students in grades K-12. Brief remarks are offered on placement criteria, student characteristics, and parent participation. Goals, objectives, procedures, materials, domain areas, and evaluation approaches are listed for eight skill areas: (1) pre-vocational…

Lessons Learned With Laparoscopic Management of Complicated Grades of Acute Appendicitis

PubMed Central

Gomes, Carlos Augusto; Junior, Cleber Soares; Costa, Evandro de Freitas Campos; Alves, Paula de Assis Pereira; de Faria, Carolina Vieira; Cangussu, Igor Vitoi; Costa, Luisa Pires; Gomes, Camila Couto; Gomes, Felipe Couto

2014-01-01

Background Laparoscopy has not been consolidated as the approach of first choice in the management of complicated appendicitis. Methodological flaws and absence of disease stratification criteria have been implicated in that less evidence. The objective is to study the safe and effectiveness of laparoscopy in the management of complicated appendicitis according to laparoscopic grading system. Method From January 2008 to January 2011, 154 consecutive patients who underwent a laparoscopic appendectomy for complicated appendicitis were evaluated in the prospective way. The patient’s age ranged from 12 to 75 years old (31.7 ± 13.3) and 58.3% were male. Complicated appendicitis refers to gangrenous and/or perforated appendix and were graded as 3A (segmental necrosis), 3B (base necrosis), 4A (abscess), 4B (regional peritonitis) and 5 (diffuse peritonitis). The outcomes including operative time, infection complication, operative complications and conversion rate were chosen to evaluate the procedure. Results The grade 3A was the most frequent with 50 (32.4%) patients. The mean operative time was 69.4 ± 26.3 minutes. The grade 4A showed the highest mean operative time (80.1 ± 26.7 minutes). The wound and intra-abdominal infection rates were 2.6 and 4.6%, respectively. The base necrosis was the most important factor associated with the conversion (5.2%). The grades 4A and 5 were associated with greater possibility of intra-abdominal collection. There were no operative complications. Conclusion The laparoscopic management of all complicated grades of acute appendicitis is safe and effective and should be the procedure of first choice. The laparoscopic grading system allows us to assess patients in the same disease stage. PMID:24883151

A counterfactual impact evaluation of a bilingual program on students' grade point average at a spanish university.

PubMed

Arco-Tirado, J L; Fernández-Martín, F; Ramos-García, A M; Littvay, L; Villoria, J; Naranjo, J A

2018-06-01

This observational study intends to estimate the causal effects of an English as a Medium of Instruction (EMI) program (as predictor) on students Grade Point Average (GPA) (as outcome) at a particular University in Spain by using a Counterfactual Impact Evaluation (CIE). The need to address the crucial question of causal inferences in EMI programs to produce credible evidences of successful interventions contrasts, however, with the absence of experimental or quasi-experimental research and evaluation designs in the field. CIE approach is emerging as a methodologically viable solution to bridge that gap. The program evaluated here consisted in delivering an EMI program in a Primary Education Teacher Training Degree group. After achieving balance on the observed covariates and recreating a situation that would have been expected in a randomized experiment, three matching approaches such as genetic matching, nearest neighbor matching and Coarsened Exact Matching were used to analyze observational data from a total of 1288 undergraduate students, including both treatment and control group. Results show unfavorable effects of the bilingual group treatment condition. Potential interpretations and recommendations are provided in order to strengthen future causal evidences of bilingual education programs' effectiveness in Higher Education. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Non operative management of blunt splenic trauma: a prospective evaluation of a standardized treatment protocol.

PubMed

Brillantino, A; Iacobellis, F; Robustelli, U; Villamaina, E; Maglione, F; Colletti, O; De Palma, M; Paladino, F; Noschese, G

2016-10-01

The advantages of the conservative approach for major spleen injuries are still debated. This study was designed to evaluate the safety and effectiveness of NOM in the treatment of minor (grade I-II according with the American Association for the Surgery of Trauma; AAST) and severe (AAST grade III-V) blunt splenic trauma, following a standardized treatment protocol. All the hemodynamically stable patients with computer tomography (CT) diagnosis of blunt splenic trauma underwent NOM, which included strict clinical and laboratory observation, 48-72 h contrast-enhanced ultrasonography (CEUS) follow-up and splenic angioembolization, performed both in patients with admission CT evidence of vascular injuries and in patients with falling hematocrit during observation. 87 patients [32 (36.7 %) women and 55 (63.2 %) men, median age 34 (range 14-68)] were included. Of these, 28 patients (32.1 %) had grade I, 22 patients (25.2 %) grade II, 20 patients (22.9 %) grade III, 11 patients (12.6 %) grade IV and 6 patients (6.8 %) grade V injuries. The overall success rate of NOM was 95.4 % (82/87). There was no significant difference in the success rate between the patients with different splenic injuries grade. Of 24 patients that had undergone angioembolization, 22 (91.6 %) showed high splenic injury grade. The success rate of embolization was 91.6 % (22/24). No major complications were observed. The minor complications (2 pleural effusions, 1 pancreatic fistula and 2 splenic abscesses) were successfully treated by EAUS or CT guided drainage. The non operative management of blunt splenic trauma, according to our protocol, represents a safe and effective treatment for both minor and severe injuries, achieving an overall success rate of 95 %. The angiographic study could be indicated both in patients with CT evidence of vascular injuries and in patients with high-grade splenic injuries, regardless of CT findings.

Histogram Profiling of Postcontrast T1-Weighted MRI Gives Valuable Insights into Tumor Biology and Enables Prediction of Growth Kinetics and Prognosis in Meningiomas.

PubMed

Gihr, Georg Alexander; Horvath-Rizea, Diana; Kohlhof-Meinecke, Patricia; Ganslandt, Oliver; Henkes, Hans; Richter, Cindy; Hoffmann, Karl-Titus; Surov, Alexey; Schob, Stefan

2018-06-14

Meningiomas are the most frequently diagnosed intracranial masses, oftentimes requiring surgery. Especially procedure-related morbidity can be substantial, particularly in elderly patients. Hence, reliable imaging modalities enabling pretherapeutic prediction of tumor grade, growth kinetic, realistic prognosis, and-as a consequence-necessity of surgery are of great value. In this context, a promising diagnostic approach is advanced analysis of magnetic resonance imaging data. Therefore, our study investigated whether histogram profiling of routinely acquired postcontrast T1-weighted images is capable of separating low-grade from high-grade lesions and whether histogram parameters reflect Ki-67 expression in meningiomas. Pretreatment T1-weighted postcontrast volumes of 44 meningioma patients were used for signal intensity histogram profiling. WHO grade, tumor volume, and Ki-67 expression were evaluated. Comparative and correlative statistics investigating the association between histogram profile parameters and neuropathology were performed. None of the investigated histogram parameters revealed significant differences between low-grade and high-grade meningiomas. However, significant correlations were identified between Ki-67 and the histogram parameters skewness and entropy as well as between entropy and tumor volume. Contrary to previously reported findings, pretherapeutic postcontrast T1-weighted images can be used to predict growth kinetics in meningiomas if whole tumor histogram analysis is employed. However, no differences between distinct WHO grades were identifiable in out cohort. As a consequence, histogram analysis of postcontrast T1-weighted images is a promising approach to obtain quantitative in vivo biomarkers reflecting the proliferative potential in meningiomas. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

Applying GRADE-CERQual to qualitative evidence synthesis findings-paper 4: how to assess coherence.

PubMed

Colvin, Christopher J; Garside, Ruth; Wainwright, Megan; Munthe-Kaas, Heather; Glenton, Claire; Bohren, Meghan A; Carlsen, Benedicte; Tunçalp, Özge; Noyes, Jane; Booth, Andrew; Rashidian, Arash; Flottorp, Signe; Lewin, Simon

2018-01-25

The GRADE-CERQual (Grading of Recommendations Assessment, Development and Evaluation-Confidence in Evidence from Reviews of Qualitative research) approach has been developed by the GRADE working group. The approach has been developed to support the use of findings from qualitative evidence syntheses in decision-making, including guideline development and policy formulation. CERQual includes four components for assessing how much confidence to place in findings from reviews of qualitative research (also referred to as qualitative evidence syntheses): (1) methodological limitations, (2) relevance, (3) coherence and (4) adequacy of data. This paper is part of a series providing guidance on how to apply CERQual and focuses on CERQual's coherence component. We developed the coherence component by searching the literature for definitions, gathering feedback from relevant research communities and developing consensus through project group meetings. We tested the CERQual coherence component within several qualitative evidence syntheses before agreeing on the current definition and principles for application. When applying CERQual, we define coherence as how clear and cogent the fit is between the data from the primary studies and a review finding that synthesises that data. In this paper, we describe the coherence component and its rationale and offer guidance on how to assess coherence in the context of a review finding as part of the CERQual approach. This guidance outlines the information required to assess coherence, the steps that need to be taken to assess coherence and examples of coherence assessments. This paper provides guidance for review authors and others on undertaking an assessment of coherence in the context of the CERQual approach. We suggest that threats to coherence may arise when the data supporting a review finding are contradictory, ambiguous or incomplete or where competing theories exist that could be used to synthesise the data. We expect the CERQual approach, and its individual components, to develop further as our experiences with the practical implementation of the approach increase.

Performance analysis of clustering techniques over microarray data: A case study

NASA Astrophysics Data System (ADS)

Dash, Rasmita; Misra, Bijan Bihari

2018-03-01

Handling big data is one of the major issues in the field of statistical data analysis. In such investigation cluster analysis plays a vital role to deal with the large scale data. There are many clustering techniques with different cluster analysis approach. But which approach suits a particular dataset is difficult to predict. To deal with this problem a grading approach is introduced over many clustering techniques to identify a stable technique. But the grading approach depends on the characteristic of dataset as well as on the validity indices. So a two stage grading approach is implemented. In this study the grading approach is implemented over five clustering techniques like hybrid swarm based clustering (HSC), k-means, partitioning around medoids (PAM), vector quantization (VQ) and agglomerative nesting (AGNES). The experimentation is conducted over five microarray datasets with seven validity indices. The finding of grading approach that a cluster technique is significant is also established by Nemenyi post-hoc hypothetical test.

Contrasting grading approaches in introductory physics and quantum mechanics: The case of graduate teaching assistants

NASA Astrophysics Data System (ADS)

Marshman, Emily; Sayer, Ryan; Henderson, Charles; Singh, Chandralekha

2017-06-01

At large research universities, physics graduate teaching assistants (TAs) are often responsible for grading in courses at all levels. However, few studies have focused on TAs' grading practices in introductory and advanced physics courses. This study was designed to investigate whether physics graduate TAs grade students in introductory physics and quantum mechanics using different criteria and if so, why they may be inclined to do so. To investigate possible discrepancies in TAs' grading approaches in courses at different levels, we implemented a sequence of instructional activities in a TA professional development course that asked TAs to grade student solutions of introductory physics and upper-level quantum mechanics problems and explain why, if at all, their grading approaches were different or similar in the two contexts. We analyzed the differences in TAs' grading approaches in the two contexts and discuss the reasons they provided for the differences in their grading approaches in introductory physics and quantum mechanics in individual interviews, class discussions, and written responses. We find that a majority of the TAs graded solutions to quantum mechanics problems differently than solutions to introductory physics problems. In quantum mechanics, the TAs focused more on physics concepts and reasoning and penalized students for not showing evidence of understanding. The findings of the study have implications for TA professional development programs, e.g., the importance of helping TAs think about the difficulty of a problem from an introductory students' perspective and reflecting on the benefits of formative assessment.

Place of Arterial Embolization in Severe Blunt Hepatic Trauma: A Multidisciplinary Approach

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

Monnin, Valerie, E-mail: val_monnin@yahoo.fr; Sengel, Christian; Thony, Frederic

2008-09-15

This study evaluates the efficacy of arterial embolization (AE) for blunt hepatic traumas (BHT) as part of a combined management strategy based on the hemodynamic status of patients and CT findings. From 2000 to 2005, 84 patients were admitted to our hospital for BHT. Of these, 14 patients who had high-grade injuries (grade III [n = 2], grade IV [n = 9], grade V [n = 3]) underwent AE because of arterial bleeding and were included in the study. They were classified into three groups according to their hemodynamic status: (1) unresponsive shock, (2) shock improved with resuscitation, and (3)more » hemodynamic stability. Four patients (group 1) underwent, first, laparotomy with packing and, then, AE for persistent bleeding. Ten patients who were hemodynamically stable (group 1) or even unstable (group 2) underwent AE first, based on CT findings. AE was successful in all cases. The mortality rate was 7% (1/14). Only two angiography-related complications (gallbladder infarction) were reported. Liver-related complications (abdominal compartment syndrome and biliary complications) were frequent and often required secondary interventions. Our multidisciplinary approach for the management of BHT gives a main role to embolization, even for hemodynamically unstable patients. In this strategy AE is very efficient and has a low complication rate.« less

Grading Rigor in Counselor Education: A Specifications Grading Framework

ERIC Educational Resources Information Center

Bonner, Matthew W.

2016-01-01

According to accreditation and professional bodies, evaluation and grading are a high priority in counselor education. Specifications grading, an evaluative tool, can be used to increase grading rigor. This article describes the components of specifications grading and applies the framework of specifications grading to a counseling theories course.

Using Elite Athletes to Promote Drug Abstinence: Evaluation of a Single-Session School-Based Drug Use Prevention Program Delivered by Junior Hockey Players

ERIC Educational Resources Information Center

Wong, Jennifer

2016-01-01

School-based substance use prevention programs are a common method to approaching drug use in youths. Project SOS is a single-session drug prevention program developed by police officers and delivered by elite junior hockey players to students in grades 6 and 7. The current study evaluates the effects of Project SOS at achieving its objectives of…

Percutaneous Transcatheter Interventions for Aortic Insufficiency in Continuous-Flow Left Ventricular Assist Device Patients: A Systematic Review and Meta-Analysis.

PubMed

Phan, Kevin; Haswell, Joshua M; Xu, Joshua; Assem, Yusuf; Mick, Stephanie L; Kapadia, Samir R; Cheung, Anson; Ling, Frederick S; Yan, Tristan D; Tchantchaleishvili, Vakhtang

De novo progressive aortic insufficiency (AI) is a side effect frequently related to prolonged support with continuous-flow left ventricular assist devices (CF-LVAD). Its progression can result in recurrent clinical heart failure symptoms and significantly increased mortality. Recently, percutaneous intervention methods, such as transcatheter aortic valve replacement (TAVR) and percutaneous occluder devices, have emerged. However, given the very scarce global experience with these approaches, evidence in the literature is lacking. We sought to assess the outcomes of CF-LVAD patients who had undergone percutaneous intervention for AI. A systematic search of six databases from inception to April 2016 was performed by two independent reviewers. Eligible studies were those that included series or cases where patients had percutaneous transcatheter interventions for AI in CF-LVAD patients. Data were extracted and meta-analyzed from the identified studies. A total of 29 patients from 15 published studies and 3 unpublished records were included in the analysis. Mean patient age was 56.6 ± 13.7 years, and 72.4% were male. The etiology of heart failure resulting in LVAD placement was ischemic cardiomyopathy in 17.2%. The two intervention groups were TAVR (27.6%) and occluder devices (72.4%). A transfemoral approach (69%), apical approach (10%), brachial approach (7%), subclavian approach (3%), and mini-sternotomy (3%) were used. The preintervention AI grade was severe with a median grade of 4 (interquartile range, 4-4). Postoperatively, the AI grade improved significantly to a median grade of 0 (0-2). At long-term follow-up AI grade was still trivial with a median AI grade of 1 (0-1). Subgrouping the treatments into the occluder device and TAVR, it was found that both interventional techniques were similarly effective in reducing the AI grade from severe to trivial. In terms of complications, from the occluder group, two patients were complicated with device migration and another two with transient hemolysis. In the TAVR cohort, two patients experienced device migration and another had significant postimplant perivalvular leakage. Our results indicate that percutaneous interventions for AI in CF-LVAD patients with TAVR, and closure devices demonstrate similar efficacy in significantly reducing severe AI. Current results are encouraging, potentiating viability as a treatment option, particularly in nonsurgical candidates. Future research with larger patient cohorts and comparative controls is required to sufficiently evaluate the efficacy of this technique and promote its widespread acceptance as a mainstay treatment.

Observed Gossip Moderates the Link between Anxious Withdrawal and Friendship Quality in Early Adolescence

ERIC Educational Resources Information Center

Menzer, Melissa M.; McDonald, Kristina L.; Rubin, Kenneth H.; Rose-Krasnor, Linda; Booth-LaForce, Cathryn; Schulz, Annie

2012-01-01

We evaluated whether gossip between best friends moderated the relation between anxious withdrawal and friendship quality in early adolescence, using an Actor-Partner Interdependence Model ("APIM," Kenny, Kashy, & Cook, 2006) approach. Participants (n = 256) were 5th and 6th grade young adolescents (actors) and their best friends…

Cost-Effectiveness of Comprehensive School Reform in Low Achieving Schools

ERIC Educational Resources Information Center

Ross, John A.; Scott, Garth; Sibbald, Tim M.

2012-01-01

We evaluated the cost-effectiveness of Struggling Schools, a user-generated approach to Comprehensive School Reform implemented in 100 low achieving schools serving disadvantaged students in a Canadian province. The results show that while Struggling Schools had a statistically significant positive effect on Grade 3 Reading achievement, d = 0.48…

Entomology: Promoting Creativity in the Science Lab

ERIC Educational Resources Information Center

Akcay, Behiye B.

2013-01-01

A class activity has been designed to help fourth grade students to identify basic insect features as a means of promoting student creativity while making an imaginary insect model. The 5Es (Engage, Explore, Explain, Extend [or Elaborate], and Evaluate) learning cycle teaching model is used. The 5Es approach allows students to work in small…

Bibliographic Instruction in a Step-by-Step Approach.

ERIC Educational Resources Information Center

Soash, Richard L.

1992-01-01

Describes an information search process based on Kuhlthau's model that was used to teach bibliographic research to ninth grade students. A research test to ensure that students are familiar with basic library skills is presented, forms for helping students narrow the topic and evaluate materials are provided, and a research process checklist is…

Evaluating High School Students' Anxiety and Self-Efficacy towards Biology

ERIC Educational Resources Information Center

Çimen, Osman; Yilmaz, Mehmet

2015-01-01

Anxiety and self-efficacy are among the factors that impact students' performance in biology. The current study aims to investigate high school students' perception of biology anxiety and self-efficacy, in relation to gender, grade level, interest in biology, negative experience associated with biology classes, and teachers' approaches in the…

Integrating Wikis as Educational Tools for the Development of a Community of Inquiry

ERIC Educational Resources Information Center

Eteokleous, Nikleia; Ktoridou, Despo; Orphanou, Maria

2014-01-01

This article describes a study that attempted to evaluate the integration of wikis as an educational tool in successfully achieving the learning objectives of a fifth-grade linguistics and literature course. A mixed-method approach was employed--data were collected via questionnaires, reflective journals, observations, and interviews. The results…

A Hands-On Approach to Maglev for Gifted Students.

ERIC Educational Resources Information Center

Budd, Raymond T.

2003-01-01

This article discusses how Magnetic Levitation (Maglev) can be taught to gifted students in grades 4-9 using hands-on activities that align to the National Science Standards. Principles of magnetic levitation, advantages of magnetic levitation, construction of a Maglev project, testing and evaluation of vehicles, and presentation of the unit are…

Individualized Language Arts--Diagnosis, Prescription, Evaluation. A Teacher's Resource Manual...ESEA Title III Project: 70-014.

ERIC Educational Resources Information Center

Weehawken Board of Education, NJ.

This document is a teachers' resource manual, grades Kindergarten through Twelve, for the promotion of students' facility in written composition in the context of a language-experience approach and through the use of diagnostic-prescriptive techniques derived from modern linguistic theory. The "Individualized Language Arts: Diagnosis,…

Stress-Prevention in Secondary Schools: Online- versus Face-to-Face-Training

ERIC Educational Resources Information Center

Fridrici, Mirko; Lohaus, Arnold

2009-01-01

Purpose: The purpose of this paper is to focus on the evaluation of an internet-delivered stress-prevention program for adolescents as a possible alternative for school-based implementation of mental health promotion. Design/methodology/approach: A total of 904 adolescents in grades eight and nine were assigned to four treatment conditions…

Accelerating the Learning of At-Risk Students: An Evaluation of Project ACCEL.

ERIC Educational Resources Information Center

Ramaswami, Soundaram

Project Accelerated Curriculum Classes Emphasizing Learning (ACCEL) was implemented by the Newark School District (New Jersey) in the 1989-90 school year in response to the ineffective practice of retaining underachieving students. The innovative approach of accelerated learning was made available to retained sixth and seventh grade students.…

Measuring the Impact of Varied Instructional Approaches in an Introductory Animal Science Course

ERIC Educational Resources Information Center

Bolt, Brian Grady

2009-01-01

The objectives of this project were to: evaluate the impact of demographic descriptors (gender, class rank and final grade) on student's self perceived level of engagement in classroom activities; measure the impact of varying teaching styles on a student's likelihood of correctly answering a knowledge based question and: assessing the…

Diagnostic accuracy of Onen's Alternative Grading System combined with Doppler evaluation of ureteral jets as an alternative in the diagnosis of obstructive hydronephrosis in children.

PubMed

de Bessa, Jose; Rodrigues, Cicilia M; Chammas, Maria Cristina; Miranda, Eduardo P; Gomes, Cristiano M; Moscardi, Paulo R; Bessa, Marcia C; Molina, Carlos A; Tiraboschi, Ricardo B; Netto, Jose M; Denes, Francisco T

2018-01-01

Ureteropelvic junction obstruction (UPJO) is a common congenital anomaly leading to varying degrees of hydronephrosis (HN), ranging from no apparent effect on the renal function to atrophy. Evaluation of these children is based on Diuretic Renal Scintigraphy (DRS) and Ultrasonography (US). Recent studies have suggested that new parameters of conventional and color Doppler ultrasonography (CDUS) may be useful in discriminating which kidneys are obstructed. The present study aims to assess the diagnostic accuracy of such parameters in the diagnosis of obstruction in children with UPJO. We evaluated 44 patients (33 boys) with a mean age of 6.53 ± 4.39 years diagnosed with unilateral high-grade hydronephrosis (SFU grades 3 and 4). All underwent DRS and index tests (conventional US and CDUS to evaluate ureteral jets frequency) within a maximum interval of two weeks. Hydronephrotic units were reclassified according to the alternative grading system (AGS) proposed by Onen et al. Obstruction in the DRS was defined as a differential renal function <40% on the affected side and/or features indicating poor drainage function like T1/2 >20 minutes after the administration of furosemide, and a plateau or ascending pattern of the excretion curve. Nineteen hydronephrotic units (43.1%) were obstructed. Some degree of cortical atrophy-grades 3 (segmental) or 4 (diffuse)-was present in those obstructed units. AGS grades had 100% sensitivity, 76% of specificity and 86.4% of accuracy. The absence of ureteral jets had a sensitivity of 73.68%, a specificity of 100% with an accuracy of 88.6%. When we analyzed the two aspects together and considered obstructed the renal units classified as AGS grade 3 or 4 with no jets, sensitivity increased to 78.9%, accuracy to 92%, remaining with a maximum specificity of 100%. These features combined would allow us to avoid performing DRS in 61% of our patients, leaving more invasive tests to inconclusive cases. Although DRS remains the mainstay to distinguishing obstructive from non-obstructive kidneys, grade of hydronephrosis and frequency of ureteral jets, independently or in combination may be a reliable alternative in the mostly cases.This alternative approach has high accuracy, it is less invasive, easily reproducible and may play a role in the diagnosis of obstruction in pediatric population.

Evaluation of myeloid cells (tumor-associated tissue eosinophils and mast cells) infiltration in different grades of oral squamous cell carcinoma.

PubMed

Debta, Priyanka; Debta, Fakir Mohan; Chaudhary, Minal; Bussari, Smita

2016-01-01

The multifunctional involvement and infiltration of myeloid cells (tumor-associated tissue eosinophils [TATE] and mast cells) can provide a unique opportunity to define relevant effectors functions that may represent novel, therapeutic options for modulation of tumor onset/growth. Our study aimed to evaluate infiltration of myeloid cells (TATE and Mast cells) infiltration in different grades (WHO grading) of oral squamous cell carcinoma (OSCC). Total 30 cases of OSCC were selected for this study. Hematoxylin and eosin stain and toluidine blue special stain, to evaluate TATE and the mast cells infiltration, were used. Three-year follow-up of OSCC cases was done. Among 30 cases, 63.33% cases of OSCC showed TATE-positive and 36.66% cases showed TATE-negative. Regarding mast cells infiltration, 66.66% OSCC cases showed mast cells positive and 33.33% cases did not show significant mast cells infiltration. We found significant association of TATE and mast cells infiltration in OSCC cases. These myeloid cells infiltration significantly associated with age of patients but did not show any significant association with gender, site, and habit of cases. When we compared these cells infiltration with clinical stages and different histological grades of tumor, we found their infiltration is decreasing, from Stages 1 to Stage 3 of tumor and from well to poorly differentiated carcinoma. We have also found the less infiltration of these myeloid in recurrence cases of OSCC. As the infiltration of TATE and mast cells are correlated, along with evaluation of TATE, we should also evaluate the presence of mast cells infiltration in OSCC. The assessment of myeloid cells could become, in the future, useful for therapeutic approaches in this subset of the patient.

Early incontinence after radical prostatectomy: a community based retrospective analysis in 911 men and implications for preoperative counseling.

PubMed

Khoder, Wael Y; Trottmann, Matthias; Stuber, Andrea; Stief, Christian G; Becker, Armin J

2013-10-01

Radical prostatectomy (RP) is curative for localized prostatic cancer. Incontinence after RP (P-RP-I) varies widely (2% to <60%) according to the definition and quantification of incontinence, timing of evaluation, and who evaluates (physician or patient). Conservative treatments, including pelvic floor muscle training (PFMT), anal electrical stimulation (AES), lifestyle adjustment, or combination are usually recommended at first for P-RP-I. Between January 2002 and December 2004, a total of 911 patients, median age 63 years (46-78), with different grades of P-RP-I have been retrospectively examined for perioperative risk factors and effect of rehabilitation procedures. These consecutive patients were from 67 clinics with median postoperative interval of 26 days. Incontinence was graded by Stamey classification, number of used pads and pads' consistency (dry, lightly wet, and wet). Therapeutic measures were done by team of specialists in rehabilitation, psycho-oncology, physiotherapy, internal medicine, and urology. Ninety-six percent of patients suffered different grades of incontinence at beginning of hospitalization. This was reported as Stamey first grade (49.4%), second grade (36.4%), and third grade (10.3%). Analysis included patients' age, body mass index (BMI), prostate volume, surgical approach, nerve sparing, pelvic lymphadenectomy, previous therapy, and catheterization time. Analysis showed age, nerve sparing, and BMI as significant risk factors for P-RP-I. Conservative therapy, including PFMT, AES, or combinations has been performed on all patients. Grade of P-RP-I showed significant improvement after 3 weeks rehabilitation period. Preoperative counseling of patients should provide them with realistic expectations for P-RP-I and motivate them to conservative therapy, as it reduces the duration and degree of urinary incontinence. Copyright © 2013 Elsevier Inc. All rights reserved.

Gaining insight into the Clinical Practice Guideline development processes: qualitative study in a workshop to implement the GRADE proposal in Spain

PubMed Central

Calderón, Carlos; Rotaeche, Rafael; Etxebarria, Arritxu; Marzo, Mercé; Rico, Rosa; Barandiaran, Marta

2006-01-01

Background The GRADE method represents a new approach to grading the quality of evidence and strength of recommendations in the preparation of Clinical Practice Guidelines (CPG). In the context of a pilot study to assess the implementability of the system in Spain, we considered it relevant to gain an insight into the significance of the perceptions and attitudes expressed by the actual experts participating in the system try-out. Methods Qualitative research with an ethnographic approach, through non-participant observation and focus groups within the context of a consensus workshop in which 19 CPG experts participated to evaluate the GRADE proposal using 12 evidence tables taken from hypertension, asthma and arthritis CPGs. The interventions were recorded, under a guarantee of confidentiality. The transcriptions and field notes were analyzed, based on a sociological discourse analysis model, and the provisional findings were re-sent to participants in order to improve their validity. Results 1) Certain problems over procedure and terminology hindered the acceptance of this new method as a common reference system for the preparation of CPGs. 2). A greater closeness to clinical practice was accompanied by concerns over value judgments and subjectivity, with a demand for greater explicitness in the consensus process. 3). The type of "evidence" on which the guidelines are based, how and by whom the evidence is prepared, and what the role of the different actors should be, all constitute unresolved concerns in the CPG preparation and implementation processes. 4). The grading process is not neutral: professional background, prior experience and the degree of leadership all condition the participants' input and interactions. Conclusion The findings obtained allow the quantitative evaluation to be better interpreted and, in turn, go beyond the particularities of the GRADE method. Adaptation to the complexities of clinical practice, the need for carefully designed multi-disciplinary work and the reflexivity present in the CPG preparation process, all represent lines of debate that are necessary to improve the CPG quality in the Spanish health care sector. PMID:17059600

Is Needle Biopsy Clinically Useful in Preoperative Grading of Central Chondrosarcoma of the Pelvis and Long Bones?

PubMed

Roitman, Pablo D; Farfalli, Germán L; Ayerza, Miguel A; Múscolo, D Luis; Milano, Federico E; Aponte-Tinao, Luis A

2017-03-01

Central chondrosarcoma of bone is graded on a scale of 1 to 3 according to histological criteria. Clinically, these tumors can be divided into low-grade (Grade 1) and high-grade (Grade 2, Grade 3, and dedifferentiated) chondrosarcomas. Although en bloc resection has been the most widely used treatment, it has become generally accepted that in selected patients with low-grade chondrosarcomas of long bones, curettage is safe and effective. This approach requires an accurate preoperative estimation of grade to avoid under- or overtreatment, but prior reports have indicated that both imaging and biopsy do not always give an accurate prediction of grade. (1) What is the concordance of image-guided needle preoperative biopsy and postoperative grading in central (intramedullary) chondrosarcomas of long bones, and how does this compare with the concordance of image-guided needle preoperative biopsy and postoperative grading in central pelvic chondrosarcomas? (2) What is the concordance of preoperative image-guided needle biopsy and postoperative findings in differentiating low-grade from high-grade central chondrosarcomas of long bones, and how does this compare with the concordance in central pelvic chondrosarcomas? Between 1997 and 2014, in our institution, we treated 126 patients for central chondrosarcomas located in long bones and the pelvis. Of these 126 cases, 41 were located in the pelvis and the remaining 85 cases were located in long bones. This study considers 39 (95%) and 40 (47%) of them, respectively. We included all cases in which histological information was complete regarding preoperative and postoperative tumor grading. We excluded all cases with incomplete data sets or nondiagnostic preoperative biopsies. To evaluate the needle biopsy accuracy, we compared the histological tumor grade, obtained from the preoperative biopsy, with the final histological grade obtained from the postoperative surgical specimen. The weighted and nonweighted kappa statistics were used to evaluate the agreement. Concordance between the preoperative biopsy and the final pathological analysis in terms of histological grade was much higher in long-bone chondrosarcoma than in pelvic chondrosarcoma (83% [33 of 40] versus 36% [14 of 39]; odds ratio, 8, 48). Likewise, the weighted kappa coefficients were higher in long-bone chondrosarcoma than in pelvic chondrosarcoma for the determination of histological grade (0.63; 95% confidence interval [CI], 0.34-0.91 versus 0.12; -0.32 to 0.57; p < 0.001). When categorizing the lesions as low grade or high grade, concordance between the preoperative biopsy and the final pathological analysis was much higher in long-bone chondrosarcoma than in pelvic chondrosarcoma (90% [36 of 40] versus 67% [26 of 39]; odds ratio, 4, 5). Likewise, the weighted kappa coefficients were higher in long-bone chondrosarcoma than in pelvic chondrosarcoma (0.73; 95% CI, 0.51-0.94 versus 0.26; 0.04-0.48; p < 0.001). Image-guided needle biopsy, when performed by a specialist radiologist and evaluated by an experienced bone pathologist, is a useful tool in determining the histological grade of long-bone chondrosarcomas allowing identification of true low-grade tumors. The histological grade should be correlated with imaging and the clinical presentation, but under these circumstances, experienced tumor surgeons may use this information in planning surgical treatment. The same appears not to be true for pelvic lesions, in which histological grade established by needle biopsy should be interpreted with caution. Level III, diagnostic study.

Linguistic Pattern Analysis of Misspellings of Typically Developing Writers in Grades 1 to 9

PubMed Central

Bahr, Ruth Huntley; Silliman, Elaine R.; Berninger, Virginia W.; Dow, Michael

2012-01-01

Purpose A mixed methods approach, evaluating triple word form theory, was used to describe linguistic patterns of misspellings. Method Spelling errors were taken from narrative and expository writing samples provided by 888 typically developing students in grades 1–9. Errors were coded by category (phonological, orthographic, and morphological) and specific linguistic feature affected. Grade level effects were analyzed with trend analysis. Qualitative analyses determined frequent error types and how use of specific linguistic features varied across grades. Results Phonological, orthographic, and morphological errors were noted across all grades, but orthographic errors predominated. Linear trends revealed developmental shifts in error proportions for the orthographic and morphological categories between grades 4–5. Similar error types were noted across age groups but the nature of linguistic feature error changed with age. Conclusions Triple word-form theory was supported. By grade 1, orthographic errors predominated and phonological and morphological error patterns were evident. Morphological errors increased in relative frequency in older students, probably due to a combination of word-formation issues and vocabulary growth. These patterns suggest that normal spelling development reflects non-linear growth and that it takes a long time to develop a robust orthographic lexicon that coordinates phonology, orthography, and morphology and supports word-specific, conventional spelling. PMID:22473834

Mathematical tasks, study approaches, and course grades in undergraduate mathematics: a year-by-year analysis

NASA Astrophysics Data System (ADS)

Maciejewski, Wes; Merchant, Sandra

2016-04-01

Students approach learning in different ways, depending on the experienced learning situation. A deep approach is geared toward long-term retention and conceptual change while a surface approach focuses on quickly acquiring knowledge for immediate use. These approaches ultimately affect the students' academic outcomes. This study takes a cross-sectional look at the approaches to learning used by students from courses across all four years of undergraduate mathematics and analyses how these relate to the students' grades. We find that deep learning correlates with grade in the first year and not in the upper years. Surficial learning has no correlation with grades in the first year and a strong negative correlation with grades in the upper years. Using Bloom's taxonomy, we argue that the nature of the tasks given to students is fundamentally different in lower and upper year courses. We find that first-year courses emphasize tasks that require only low-level cognitive processes. Upper year courses require higher level processes but, surprisingly, have a simultaneous greater emphasis on recall and understanding. These observations explain the differences in correlations between approaches to learning and course grades. We conclude with some concerns about the disconnect between first year and upper year mathematics courses and the effect this may have on students.

Automatic grading of appearance retention of carpets using intensity and range images

NASA Astrophysics Data System (ADS)

Orjuela Vargas, Sergio Alejandro; Ortiz-Jaramillo, Benhur; Vansteenkiste, Ewout; Rooms, Filip; De Meulemeester, Simon; de Keyser, Robain; Van Langenhove, Lieva; Philips, Wilfried

2012-04-01

Textiles are mainly used for decoration and protection. In both cases, their original appearance and its retention are important factors for customers. Therefore, evaluation of appearance parameters are critical for quality assurance purposes, during and after manufacturing, to determine the lifetime and/or beauty of textile products. In particular, appearance retention of textile products is commonly certified with grades, which are currently assigned by human experts. However, manufacturers would prefer a more objective system. We present an objective system for grading appearance retention, particularly, for textile floor coverings. Changes in appearance are quantified by using linear regression models on texture features extracted from intensity and range images. Range images are obtained by our own laser scanner, reconstructing the carpet surface using two methods that have been previously presented. We extract texture features using a variant of the local binary pattern technique based on detecting those patterns whose frequencies are related to the appearance retention grades. We test models for eight types of carpets. Results show that the proposed approach describes the degree of wear with a precision within the range allowed to human inspectors by international standards. The methodology followed in this experiment has been designed to be general for evaluating global deviation of texture in other types of textiles, as well as other surface materials.

Ultrasound and Functional Assessment of Transtendinous Repairs of Partial-Thickness Articular-Sided Rotator Cuff Tears.

PubMed

Ostrander, Roger V; Klauser, Jeffrey M; Menon, Sanjay; Hackel, Joshua G

2017-03-01

Partial-thickness articular-sided rotator cuff tears are a frequent source of shoulder pain. Despite conservative measures, some patients continue to be symptomatic and require surgical management. However, there is some controversy as to which surgical approach results in the best outcomes for grade 3 tears. The purpose of this study was to evaluate repair integrity and the clinical results of patients treated with transtendinous repair of high-grade partial-thickness articular-sided rotator cuff tears. Our hypothesis was that transtendinous repairs would result in reliable healing and acceptable functional outcomes. Case series; Level of evidence, 4. Twenty patients with a minimum follow-up of 2 years were included in the study. All patients underwent arthroscopic repair of high-grade partial-thickness rotator cuff tears utilizing a transtendinous technique by a single surgeon. At latest follow-up, the repair integrity was evaluated using ultrasound imaging, and functional scores were calculated. Ultrasound evaluation demonstrated that 18 of 20 patients had complete healing with a normal-appearing rotator cuff. Two patients had a minor residual partial tear. Sixteen of 20 patients had no pain on visual analog scale. Four patients complained of mild intermittent residual pain. All patients were rated as "excellent" by both the University of California at Los Angeles Shoulder Score and the Simple Shoulder Test. The transtendon technique for the repair of articular-sided high-grade partial rotator cuff tears results in reliable tendon healing and excellent functional outcomes.

Why Good Teaching Evaluations May Reward Bad Teaching: On Grade Inflation and Other Unintended Consequences of Student Evaluations.

PubMed

Stroebe, Wolfgang

2016-11-01

In this article, I address the paradox that university grade point averages have increased for decades, whereas the time students invest in their studies has decreased. I argue that one major contributor to this paradox is grading leniency, encouraged by the practice of university administrators to base important personnel decisions on student evaluations of teaching. Grading leniency creates strong incentives for instructors to teach in ways that would result in good student evaluations. Because many instructors believe that the average student prefers courses that are entertaining, require little work, and result in high grades, they feel under pressure to conform to those expectations. Evidence is presented that the positive association between student grades and their evaluation of teaching reflects a bias rather than teaching effectiveness. If good teaching evaluations reflected improved student learning due to effective teaching, they should be positively related to the grades received in subsequent courses that build on knowledge gained in the previous course. Findings that teaching evaluations of concurrent courses, though positively correlated with concurrent grades, are negatively related to student performance in subsequent courses are more consistent with the assumption that concurrent evaluations are the result of lenient grading rather than effective teaching. Policy implications are discussed. © The Author(s) 2016.

Temporary ovarian suppression during chemotherapy to preserve ovarian function and fertility in breast cancer patients: A GRADE approach for evidence evaluation and recommendations by the Italian Association of Medical Oncology.

PubMed

Lambertini, Matteo; Cinquini, Michela; Moschetti, Ivan; Peccatori, Fedro A; Anserini, Paola; Valenzano Menada, Mario; Tomirotti, Maurizio; Del Mastro, Lucia

2017-01-01

The development of premature ovarian failure and subsequent infertility are possible consequences of chemotherapy use in pre-menopausal women with early-stage breast cancer. Among the available strategies for fertility preservation, pharmacological protection of the ovaries using luteinising hormone-releasing hormone analogues (LHRHa) during chemotherapy has the potential to restore ovarian function and fertility after anticancer treatments; however, the possible efficacy and clinical application of this strategy has been highly debated in the last years. Following the availability of new data on this controversial topic, the Panel of the Italian Association of Medical Oncology (AIOM) Clinical Practice Guideline on fertility preservation in cancer patients decided to apply the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) methodology around the relevant and current question on the clinical utility of temporary ovarian suppression with LHRHa during chemotherapy as a strategy to preserve ovarian function and fertility in breast cancer patients. To answer this question, preservation of ovarian function and fertility were judged as critical outcomes for the decision-making. Three possible outcomes of harm were identified: LHRHa-associated toxicities, potential antagonism between concurrent LHRHa and chemotherapy, and lack of the prognostic impact of chemotherapy-induced premature ovarian failure. According to the GRADE evaluation conducted, the result was a strong positive recommendation in favour of using this option to preserve ovarian function and fertility in breast cancer patients. The present manuscript aims to update and summarise the evidence for the use of this strategy in light of the new data published up to January 2016, according to the GRADE process. Copyright © 2016 Elsevier Ltd. All rights reserved.

Applying GRADE-CERQual to qualitative evidence synthesis findings-paper 6: how to assess relevance of the data.

PubMed

Noyes, Jane; Booth, Andrew; Lewin, Simon; Carlsen, Benedicte; Glenton, Claire; Colvin, Christopher J; Garside, Ruth; Bohren, Meghan A; Rashidian, Arash; Wainwright, Megan; Tunςalp, Özge; Chandler, Jacqueline; Flottorp, Signe; Pantoja, Tomas; Tucker, Joseph D; Munthe-Kaas, Heather

2018-01-25

The GRADE-CERQual (Confidence in Evidence from Reviews of Qualitative research) approach has been developed by the GRADE (Grading of Recommendations Assessment, Development and Evaluation) Working Group. The approach has been developed to support the use of findings from qualitative evidence syntheses in decision-making, including guideline development and policy formulation. CERQual includes four components for assessing how much confidence to place in findings from reviews of qualitative research (also referred to as qualitative evidence syntheses): (1) methodological limitations, (2) coherence, (3) adequacy of data and (4) relevance. This paper is part of a series providing guidance on how to apply CERQual and focuses on CERQual's relevance component. We developed the relevance component by searching the literature for definitions, gathering feedback from relevant research communities and developing consensus through project group meetings. We tested the CERQual relevance component within several qualitative evidence syntheses before agreeing on the current definition and principles for application. When applying CERQual, we define relevance as the extent to which the body of data from the primary studies supporting a review finding is applicable to the context (perspective or population, phenomenon of interest, setting) specified in the review question. In this paper, we describe the relevance component and its rationale and offer guidance on how to assess relevance in the context of a review finding. This guidance outlines the information required to assess relevance, the steps that need to be taken to assess relevance and examples of relevance assessments. This paper provides guidance for review authors and others on undertaking an assessment of relevance in the context of the CERQual approach. Assessing the relevance component requires consideration of potentially important contextual factors at an early stage in the review process. We expect the CERQual approach, and its individual components, to develop further as our experiences with the practical implementation of the approach increase.

Applying GRADE-CERQual to qualitative evidence synthesis findings-paper 5: how to assess adequacy of data.

PubMed

Glenton, Claire; Carlsen, Benedicte; Lewin, Simon; Munthe-Kaas, Heather; Colvin, Christopher J; Tunçalp, Özge; Bohren, Meghan A; Noyes, Jane; Booth, Andrew; Garside, Ruth; Rashidian, Arash; Flottorp, Signe; Wainwright, Megan

2018-01-25

The GRADE-CERQual (Confidence in Evidence from Reviews of Qualitative research) approach has been developed by the GRADE (Grading of Recommendations Assessment, Development and Evaluation) working group. The approach has been developed to support the use of findings from qualitative evidence syntheses in decision-making, including guideline development and policy formulation. CERQual includes four components for assessing how much confidence to place in findings from reviews of qualitative research (also referred to as qualitative evidence syntheses): (1) methodological limitations; (2) coherence; (3) adequacy of data; and (4) relevance. This paper is part of a series providing guidance on how to apply CERQual and focuses on CERQual's adequacy of data component. We developed the adequacy of data component by searching the literature for definitions, gathering feedback from relevant research communities and developing consensus through project group meetings. We tested the CERQual adequacy of data component within several qualitative evidence syntheses before agreeing on the current definition and principles for application. When applying CERQual, we define adequacy of data as an overall determination of the degree of richness and the quantity of data supporting a review finding. In this paper, we describe the adequacy component and its rationale and offer guidance on how to assess data adequacy in the context of a review finding as part of the CERQual approach. This guidance outlines the information required to assess data adequacy, the steps that need to be taken to assess data adequacy, and examples of adequacy assessments. This paper provides guidance for review authors and others on undertaking an assessment of adequacy in the context of the CERQual approach. We approach assessments of data adequacy in terms of the richness and quantity of the data supporting each review finding, but do not offer fixed rules regarding what constitutes sufficiently rich data or an adequate quantity of data. Instead, we recommend that this assessment is made in relation to the nature of the finding. We expect the CERQual approach, and its individual components, to develop further as our experiences with the practical implementation of the approach increase.

Applying GRADE-CERQual to qualitative evidence synthesis findings: introduction to the series.

PubMed

Lewin, Simon; Booth, Andrew; Glenton, Claire; Munthe-Kaas, Heather; Rashidian, Arash; Wainwright, Megan; Bohren, Meghan A; Tunçalp, Özge; Colvin, Christopher J; Garside, Ruth; Carlsen, Benedicte; Langlois, Etienne V; Noyes, Jane

2018-01-25

The GRADE-CERQual ('Confidence in the Evidence from Reviews of Qualitative research') approach provides guidance for assessing how much confidence to place in findings from systematic reviews of qualitative research (or qualitative evidence syntheses). The approach has been developed to support the use of findings from qualitative evidence syntheses in decision-making, including guideline development and policy formulation. Confidence in the evidence from qualitative evidence syntheses is an assessment of the extent to which a review finding is a reasonable representation of the phenomenon of interest. CERQual provides a systematic and transparent framework for assessing confidence in individual review findings, based on consideration of four components: (1) methodological limitations, (2) coherence, (3) adequacy of data, and (4) relevance. A fifth component, dissemination (or publication) bias, may also be important and is being explored. As with the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach for effectiveness evidence, CERQual suggests summarising evidence in succinct, transparent, and informative Summary of Qualitative Findings tables. These tables are designed to communicate the review findings and the CERQual assessment of confidence in each finding. This article is the first of a seven-part series providing guidance on how to apply the CERQual approach. In this paper, we describe the rationale and conceptual basis for CERQual, the aims of the approach, how the approach was developed, and its main components. We also outline the purpose and structure of this series and discuss the growing role for qualitative evidence in decision-making. Papers 3, 4, 5, 6, and 7 in this series discuss each CERQual component, including the rationale for including the component in the approach, how the component is conceptualised, and how it should be assessed. Paper 2 discusses how to make an overall assessment of confidence in a review finding and how to create a Summary of Qualitative Findings table. The series is intended primarily for those undertaking qualitative evidence syntheses or using their findings in decision-making processes but is also relevant to guideline development agencies, primary qualitative researchers, and implementation scientists and practitioners.

Making GRADE accessible: a proposal for graphic display of evidence quality assessments.

PubMed

Khan, Khalid S; Borowiack, Ewa; Roos, Carolien; Kowalska, Monika; Zapalska, Anna; Mol, Ben W; Mignini, Luciano; Meads, Catherine; Walczak, Jacek

2011-06-01

When generating guidelines, quality of evidence is frequently reported in tabulated form capturing several domains, for example, study design, risk of bias and heterogeneity. Increasingly, this is done using the Grading of Recommendations Assessment, Development and Evaluation approach. As assimilating large amount of tabulated data across several comparisons and outcomes spread over many pages (sometimes hundreds) is not easy, there is a need to present evidence summaries in a more effective way. A graphic display plotting the several domains used in evidence grading on equiangular spokes starting from the same point, the data length of each spoke proportional to the magnitude of the quality, succinctly captures tabulated information. These plots allow easy identification of deficiencies, outliers and similarities in evidence quality for individual and multiple comparisons and outcomes, paving the way for their routine use alongside tabulated information.

Learning Through Survival: An Approach to Foreign Language Teaching. A Program Description and Evaluation.

ERIC Educational Resources Information Center

Travers, Claudia S.; Reilly, Joseph T. M.

A foreign travel program for eighth grade French language students from Shoreham, New York was developed to provide language speaking practice in Quebec, Canada. The program was designed to allow students to spend as much time as possible speaking the language and interacting with the people. The following "survival through speaking"…

Evaluation of the Computer Assisted Instruction Title I Project, 1980-81.

ERIC Educational Resources Information Center

Metrics Associates, Inc., Chelmsford, MA.

For the third year, six Massachusetts communities incorporated computer assisted instruction (CAI) into their regular Title I programs, for students in grades 1 through 9. It was hoped that CAI would produce reading and mathematics gains over and above those which are characteristic of more conventional Title I instructional approaches. A pretest,…

The Effects of an Integrated Reading Comprehension Strategy: A Culturally Responsive Teaching Approach for Fifth-Grade Students' Reading Comprehension

ERIC Educational Resources Information Center

Bui, Yvonne N.; Fagan, Yvette M.

2013-01-01

The study evaluated the effects of the Integrated Reading Comprehension Strategy on two levels. The Integrated Reading Comprehension Strategy integrated story grammar instruction and story maps, prior knowledge and prediction method, and word webs through a culturally responsive teaching framework; the Integrated Reading Comprehension Strategy…

Basic Skill Centers Evaluation, September, 1969 - June, 1971.

ERIC Educational Resources Information Center

Clark, Sara Page

The Basic Skill Centers (BSC) program was developed to help students, primarily from the inner-city Target Area schools of Minneapolis, learn to read. The BSC approach was remedial, and each year more than 700 students, the majority in grades four through six, participated in the program. In 1969-70 the Talking Typewriter was one major aspect of…

ASSESSMENT OF RURAL MEXICAN-AMERICAN PUPILS IN PRESCHOOL AND GRADES ONE THROUGH SIX. PRELIMINARY REPORT.

ERIC Educational Resources Information Center

CUMMINS, EMERY J.; PALOMARES, UVALDO H.

AN ASSESSMENT PROJECT TO EVALUATE THE EDUCATIONAL STRENGTHS AND WEAKNESSES OF MEXICAN-AMERICAN STUDENTS IN RELATION TO THEMSELVES AND THE CULTURE-AT-LARGE WAS INITIATED SO THAT CURRICULUM APPROACHES AND EDUCATIONAL TECHNIQUES APPROPRIATE TO THEIR NEEDS COULD BE DEVELOPED. THE SAMPLE CHOSEN FOR THE STUDY WERE ELEMENTARY SCHOOL STUDENTS WITH SPANISH…

Evaluation of Visual Arts Lesson Gains According to the Learning Steps of Cognitive, Affective Psychomotor Areas

ERIC Educational Resources Information Center

Tataroglu, Eylem

2012-01-01

Primary education (1-8 Grades) Visual Arts Instruction Schedule is a program built up and constituted by a commission composed of academicians and specialist teachers in their fields within the body of Ministry of National Education in year 2006 on the basis of "constructivist approach" philosophy of education. Instruction Schedule…

7th Class Students' Opinions on Sun, Earth and Moon System

ERIC Educational Resources Information Center

Aydin, Suleyman

2017-01-01

This study is conducted to detect the students' perceptions on Sun, Moon and Earth (SME) system and define the 7th grade students' attitudes on the subject. In the study, since it was aimed to detect and evaluate the students' perceptions on some basic astronomical concepts without changing the natural conditions, a descriptive approach was…

Middle School Mathematics: 2006-07 to 2008-09. Impact Evaluation. E&R Report No. 10.11

ERIC Educational Resources Information Center

Paeplow, Colleen

2010-01-01

In 2006-07, seven Wake County Public School System (WCPSS) middle schools piloted Algebraic Thinking as an alternate approach to teaching middle school mathematics. Algebraic Thinking was developed to help students in grade 6 reach higher mathematics courses by combining the regular and advanced middle school mathematics courses into one…

The Effectiveness of Teaching Mnemonics in the Study of the Solar System.

ERIC Educational Resources Information Center

Pickens, Teresa Lynn

This study evaluates the effectiveness of a mnemonic approach to teaching about the solar system to non-leveled Grade 9 students versus a traditional outline format. A mixture of 54 regular and special education students participated in the control group receiving facts about the solar system through lecture and transparencies and recorded the…

Helping Low-Achieving First-Grade Readers: A Program Combining Reading Recovery Tutoring and Small-Group Instruction.

ERIC Educational Resources Information Center

Dorn, Linda; Allen, Anne

1995-01-01

Evaluates an approach that supplemented existing Reading Recovery programs with small-group, early literacy instruction in 28 Arkansas public schools. The program enabled many children to receive timely support. When space became available in Reading Recovery, these children made accelerated progress and were discontinued earlier than children who…

Management of complicated gallstones: results of an alternative approach to difficult cholecystectomies.

PubMed

Lirici, Marco Maria; Califano, Andrea

2010-10-01

Laparoscopic cholecystectomy (LC) is the gold standard treatment of gallstones. Nevertheless, the incidence of conversion and injuries to the biliary tract is still high in difficult cholecystectomies. In this study we sought to determine how using operative risk predictive scores (PSs) and the Nassar scale to grade the difficulty of LC would optimize the perioperative management of complicated gallstone patients. We also evaluated whether the "fundus-first" approach to LC combined with ultrasonic dissection minimizes the risk of conversion and biliary injury in difficult cholecystectomies, and avoids routine intraoperative cholangiography. A prospective non-randomized study was carried out from 2005 to 2007 including 237 patients referred for gallbladder diseases. All patients were evaluated using an operative risk PS. The LC grade of difficulty was assessed according to Nassar. Diagnostic accuracy, sensitivity, and specificity of PS were calculated. LC in difficult cases was accomplished with a fundus-first approach. Outcome measures included: Conversion rate, bile duct (BD) injury rate, and postoperative complications according to Clavien. In 178 out of 237 patients, a higher risk of conversion and complication was predicted. In 146 out of these 178 cases, intra-operative grading confirmed the difficulty of the procedure. The PS diagnostic accuracy was 0.865, sensitivity was 100%, and specificity 65%. Positive predictive value and negative predictive value were 0.82 and 1, respectively. Conversion rate was 2.7%. Mean operating time and postoperative length of hospital stay were 75 minutes and 3.5 days. Intra-operative cholangiography was necessary in five cases, and one intraoperative biliary complication occurred with an uneventful postoperative course. Overall, postoperative complications were 2.7% with a mortality rate of 0.68% (1 myocardial infarction). Fundus-first LC by ultrasonic dissection is safe and minimizes the risk of conversion and biliary injuries in difficult cases. Difficult cholecystectomies may be predicted preoperatively; in these cases the fundus-first approach and ultrasound dissection may be advised.

Diagnosis and kidney-sparing treatments for upper tract urothelial carcinoma: state of the art.

PubMed

Territo, Angelo; Foerster, Bear; Shariat, Shahrokh F; Rouprêt, Morgan; Gaya, Jose M; Palou, Joan; Breda, Alberto

2018-02-01

Conservative management of upper tract urothelial cancer (UTUC) is becoming increasingly popular: the key to success is correct selection of patients with low-risk UTUC based on size (≤ 2 cm), focality (single lesion), stage (< T2), and grade (low grade). Despite the recent growing interest in the conservative approach to UTUC, the diagnostic process is still a challenge, and kidney-sparing surgery (KSS) is traditionally reserved for patients with contraindications to radical nephroureterectomy. In order to explore the "state of the art" in the diagnosis and conservative treatment of UTUC, a systematic review of the literature was performed. A PubMed, Scopus, and Cochrane search for peer-reviewed studies was performed using the keywords "upper tract urothelial carcinoma" OR "UTUC" OR "upper urinary tract" AND "biopsy" OR "diagnosis" OR "endomicroscopy" OR "imaging" AND "URS" OR "ureteroscopy" OR "kidney-sparing surgery" OR "laser ablation" OR "ureterectomy". We considered as relevant comparative prospective studies (randomized, quasi-randomized, no randomized), retrospective studies, meta-analyses, systematic reviews, and case report series written in the English language. Letters to the editor and contributions written in languages other than English were not considered of value for this review. Eligible articles were reviewed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) criteria. Two hundred and sixty-three (263) records were identified using the above-mentioned keywords. Overall, 30 studies were considered relevant for the purpose of this systematic review and for the evidence evaluation process during qualitative synthesis. The outcomes evaluated in this review were the current diagnostic methods and the KSS approaches in UTUC. Furthermore, we included in the review the emerging technology for distinguishing between normal tissue, low-grade UTUC, and high-grade UTUC. Conclusive diagnosis is fundamental to the decision-making process in patients who could benefit from conservative treatment of UTUC. The most relevant diagnostic modalities are computed tomography urography, local urine cytology, and ureteroscopy with acquisition of an adequate biopsy sample for histology. KSS includes the endourological approach and segmental ureterectomy. Promising technology in the endourological management of UTUC helps in providing intraoperative information on UTUC grading and staging, with a high accuracy. Patients treated conservatively have to undergo stringent postoperative follow-up in order to detect and, if necessary, treat any recurrence promptly. Further larger and multicenter studies are needed to confirm these findings.

Normative Functional Performance Values in High School Athletes: The Functional Pre-Participation Evaluation Project.

PubMed

Onate, James A; Starkel, Cambrie; Clifton, Daniel R; Best, Thomas M; Borchers, James; Chaudhari, Ajit; Comstock, R Dawn; Cortes, Nelson; Grooms, Dustin R; Hertel, Jay; Hewett, Timothy E; Miller, Meghan Maume; Pan, Xueliang; Schussler, Eric; Van Lunen, Bonnie L

2018-01-01

  The fourth edition of the Preparticipation Physical Evaluation recommends functional testing for the musculoskeletal portion of the examination; however, normative data across sex and grade level are limited. Establishing normative data can provide clinicians reference points with which to compare their patients, potentially aiding in the development of future injury-risk assessments and injury-mitigation programs.   To establish normative functional performance and limb-symmetry data for high school-aged male and female athletes in the United States.   Cross-sectional study.   Athletic training facilities and gymnasiums across the United States.   A total of 3951 male and female athletes who participated on high school-sponsored basketball, football, lacrosse, or soccer teams enrolled in this nationwide study.   Functional performance testing consisted of 3 evaluations. Ankle-joint range of motion, balance, and lower extremity muscular power and landing control were assessed via the weight-bearing ankle-dorsiflexion-lunge, single-legged anterior-reach, and anterior single-legged hop-for-distance (SLHOP) tests, respectively. We used 2-way analyses of variance and χ 2 analyses to examine the effects of sex and grade level on ankle-dorsiflexion-lunge, single-legged anterior-reach, and SLHOP test performance and symmetry.   The SLHOP performance differed between sexes (males = 187.8% ± 33.1% of limb length, females = 157.5% ± 27.8% of limb length; t = 30.3, P < .001). A Cohen d value of 0.97 indicated a large effect of sex on SLHOP performance. We observed differences for SLHOP and ankle-dorsiflexion-lunge performance among grade levels, but these differences were not clinically meaningful.   We demonstrated differences in normative data for lower extremity functional performance during preparticipation physical evaluations across sex and grade levels. The results of this study will allow clinicians to compare sex- and grade-specific functional performances and implement approaches for preventing musculoskeletal injuries in high school-aged athletes.

KDIGO Clinical Practice Guideline on the Evaluation and Care of Living Kidney Donors

PubMed Central

Lentine, Krista L.; Kasiske, Bertram L.; Levey, Andrew S.; Adams, Patricia L.; Alberú, Josefina; Bakr, Mohamed A.; Gallon, Lorenzo; Garvey, Catherine A.; Guleria, Sandeep; Li, Philip Kam-Tao; Segev, Dorry L.; Taler, Sandra J.; Tanabe, Kazunari; Wright, Linda; Zeier, Martin G.; Cheung, Michael; Garg, Amit X.

2017-01-01

Abstract The 2017 Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guideline on the Evaluation and Care of Living Kidney Donors is intended to assist medical professionals who evaluate living kidney donor candidates and provide care before, during and after donation. The guideline development process followed the Grades of Recommendation Assessment, Development, and Evaluation (GRADE) approach and guideline recommendations are based on systematic reviews of relevant studies that included critical appraisal of the quality of the evidence and the strength of recommendations. However, many recommendations, for which there was no evidence or no systematic search for evidence was undertaken by the Evidence Review Team, were issued as ungraded expert opinion recommendations. The guideline work group concluded that a comprehensive approach to risk assessment should replace decisions based on assessments of single risk factors in isolation. Original data analyses were undertaken to produce a “proof-in-concept” risk-prediction model for kidney failure to support a framework for quantitative risk assessment in the donor candidate evaluation and defensible shared decision making. This framework is grounded in the simultaneous consideration of each candidate's profile of demographic and health characteristics. The processes and framework for the donor candidate evaluation are presented, along with recommendations for optimal care before, during, and after donation. Limitations of the evidence are discussed, especially regarding the lack of definitive prospective studies and clinical outcome trials. Suggestions for future research, including the need for continued refinement of long-term risk prediction and novel approaches to estimating donation-attributable risks, are also provided. In citing this document, the following format should be used: Kidney Disease: Improving Global Outcomes (KDIGO) Living Kidney Donor Work Group. KDIGO Clinical Practice Guideline on the Evaluation and Care of Living Kidney Donors. Transplantation. 2017;101(Suppl 8S):S1–S109. PMID:28742762

An evaluation of automated chest radiography reading software for tuberculosis screening among public- and private-sector patients.

PubMed

Rahman, Md Toufiq; Codlin, Andrew J; Rahman, Md Mahfuzur; Nahar, Ayenun; Reja, Mehdi; Islam, Tariqul; Qin, Zhi Zhen; Khan, Md Abdus Shakur; Banu, Sayera; Creswell, Jacob

2017-05-01

Computer-aided reading (CAR) of medical images is becoming increasingly common, but few studies exist for CAR in tuberculosis (TB). We designed a prospective study evaluating CAR for chest radiography (CXR) as a triage tool before Xpert MTB/RIF (Xpert).Consecutively enrolled adults in Dhaka, Bangladesh, with TB symptoms received CXR and Xpert. Each image was scored by CAR and graded by a radiologist. We compared CAR with the radiologist for sensitivity and specificity, area under the receiver operating characteristic curve (AUC), and calculated the potential Xpert tests saved.A total of 18 036 individuals were enrolled. TB prevalence by Xpert was 15%. The radiologist graded 49% of CXRs as abnormal, resulting in 91% sensitivity and 58% specificity. At a similar sensitivity, CAR had a lower specificity (41%), saving fewer (36%) Xpert tests. The AUC for CAR was 0.74 (95% CI 0.73-0.75). CAR performance declined with increasing age. The radiologist grading was superior across all sub-analyses.Using CAR can save Xpert tests, but the radiologist's specificity was superior. Differentiated CAR thresholds may be required for different populations. Access to, and costs of, human readers must be considered when deciding to use CAR software. More studies are needed to evaluate CAR using different screening approaches. Copyright ©ERS 2017.

An evaluation of automated chest radiography reading software for tuberculosis screening among public- and private-sector patients

PubMed Central

Rahman, Md Toufiq; Codlin, Andrew J.; Rahman, Md Mahfuzur; Nahar, Ayenun; Reja, Mehdi; Islam, Tariqul; Qin, Zhi Zhen; Khan, Md Abdus Shakur; Banu, Sayera

2017-01-01

Computer-aided reading (CAR) of medical images is becoming increasingly common, but few studies exist for CAR in tuberculosis (TB). We designed a prospective study evaluating CAR for chest radiography (CXR) as a triage tool before Xpert MTB/RIF (Xpert). Consecutively enrolled adults in Dhaka, Bangladesh, with TB symptoms received CXR and Xpert. Each image was scored by CAR and graded by a radiologist. We compared CAR with the radiologist for sensitivity and specificity, area under the receiver operating characteristic curve (AUC), and calculated the potential Xpert tests saved. A total of 18 036 individuals were enrolled. TB prevalence by Xpert was 15%. The radiologist graded 49% of CXRs as abnormal, resulting in 91% sensitivity and 58% specificity. At a similar sensitivity, CAR had a lower specificity (41%), saving fewer (36%) Xpert tests. The AUC for CAR was 0.74 (95% CI 0.73–0.75). CAR performance declined with increasing age. The radiologist grading was superior across all sub-analyses. Using CAR can save Xpert tests, but the radiologist's specificity was superior. Differentiated CAR thresholds may be required for different populations. Access to, and costs of, human readers must be considered when deciding to use CAR software. More studies are needed to evaluate CAR using different screening approaches. PMID:28529202

Ultrasound-guided shoulder MR arthrography: comparison of rotator interval and posterior approach.

PubMed

Ogul, Hayri; Bayraktutan, Ummugulsum; Ozgokce, Mesut; Tuncer, Kutsi; Yuce, Ihsan; Yalcin, Ahmet; Pirimoglu, Berhan; Sagsoz, Erdem; Kantarci, Mecit

2014-01-01

The purpose of this study was to prospectively evaluate the two different ultrasound-guided injection techniques for magnetic resonance (MR) arthrography of the shoulder. This study included 100 patients [50 rotator interval group (n=50) vs. 50 posterior approach group (n=50)]. All procedures were performed by the same radiologist. The two injection techniques were compared. The discomfort during and after arthrography was evaluated. Extraarticular contrast media extravasation was graded according to the MRI findings. The number of injection attempts, effect of contrast media extravasation rate on diagnostic quality and procedure times were recorded. There were no significant difference between the posterior and rotator interval puncture groups with regard to pain (P=.915), procedure times (P=.401) or attempt scores (P=.182). There were significantly more contrast media extravasations with rotator interval approach than posterior approach (P<.05). Both techniques were successful and well tolerated by patients. Posterior injection technique provided a more effective route with decreased extravasation rate and easier approach compared to the rotator interval approach. © 2014.

Redesign and Evaluation of a Patient Assessment Course

PubMed Central

Sobieraj, Diana M.; McCaffrey, Desmond; Lee, Jennifer J.

2009-01-01

Objectives To redesign a patient assessment course using a structured instructional design process and evaluate student learning. Design Course coordinators collaborated with an instructional design and development expert to incorporate new pedagogical approaches (eg, Web-based self-tests), create new learning activities (eg, peer collaboration on worksheets, SOAP note writing), and develop grading rubrics. Assessment Formative and summative surveys were administered for student self-assessment and course evaluation. Seventy-six students (78%) completed the summative survey. The mean course grade was 91.8% ± 3.6%, with more than 75% of students reporting achievement of primary course learning objectives. All of the additional learning activities helped students meet the learning objectives with the exception of the written drug information response. Conclusion The use of a structured instructional design process to redesign a patient assessment course was successful in creating a curriculum that succeeded in teaching students the specified learning objectives. Other colleges and schools are encouraged to collaborate with an instructional design and development expert to improve the pharmacy curriculum. PMID:19960090

GLISTRboost: Combining Multimodal MRI Segmentation, Registration, and Biophysical Tumor Growth Modeling with Gradient Boosting Machines for Glioma Segmentation.

PubMed

Bakas, Spyridon; Zeng, Ke; Sotiras, Aristeidis; Rathore, Saima; Akbari, Hamed; Gaonkar, Bilwaj; Rozycki, Martin; Pati, Sarthak; Davatzikos, Christos

2016-01-01

We present an approach for segmenting low- and high-grade gliomas in multimodal magnetic resonance imaging volumes. The proposed approach is based on a hybrid generative-discriminative model. Firstly, a generative approach based on an Expectation-Maximization framework that incorporates a glioma growth model is used to segment the brain scans into tumor, as well as healthy tissue labels. Secondly, a gradient boosting multi-class classification scheme is used to refine tumor labels based on information from multiple patients. Lastly, a probabilistic Bayesian strategy is employed to further refine and finalize the tumor segmentation based on patient-specific intensity statistics from the multiple modalities. We evaluated our approach in 186 cases during the training phase of the BRAin Tumor Segmentation (BRATS) 2015 challenge and report promising results. During the testing phase, the algorithm was additionally evaluated in 53 unseen cases, achieving the best performance among the competing methods.

Metacognition in Upper-Division Biology Students: Awareness Does Not Always Lead to Control

PubMed Central

Dye, Kathryn Morris; Stanton, Julie Dangremond

2017-01-01

Students with awareness and control of their own thinking can learn more and perform better than students who are not metacognitive. Metacognitive regulation is how you control your thinking in order to learn. It includes the skill of evaluation, which is the ability to appraise your approaches to learning and then modify future plans based on those appraisals. We asked when, why, and how upper-division biology students evaluated their approaches to learning. We used self-evaluation assignments to identify students with potentially high metacognition and conducted semistructured interviews to collect rich qualitative data from them. Through content analysis, we found that students evaluated their approaches to learning when their courses presented novel challenges. Most students evaluated in response to an unsatisfactory grade. While evaluating study strategies, many students considered performance and learning simultaneously. We gained insights on the barriers students face when they try to change their approaches to learning based on their evaluations. A few students continued to use ineffective study strategies even though they were aware of the ineffectiveness of those strategies. A desire to avoid feeling uncomfortable was the primary reason they avoided strategies that they knew were more effective. We examined the behavioral change literature to help interpret these findings. PMID:28495935

Effects of multisensory resources on the achievement and science attitudes of seventh-grade suburban students taught science concepts on and above grade level

NASA Astrophysics Data System (ADS)

Roberts, Patrice Helen

This research was designed to determine the relationships among students' achievement scores on grade-level science content, on science content that was three years above-grade level, on attitudes toward instructional approaches, and learning-styles perceptual preferences when instructional approaches were multisensory versus traditional. The dependent variables for this investigation were scores on achievement posttests and scores on the attitude survey. The independent variables were the instructional strategy and students' perceptual preferences. The sample consisted of 74 educationally oriented seventh-grade students. The Learning Styles Inventory (LSI) (Dunn, Dunn, & Price, 1990) was administered to determine perceptual preferences. The control group was taught seventh-grade and tenth-grade science units using a traditional approach and the experimental group was instructed on the same units using multisensory instructional resources. The Semantic Differential Scale (SDS) (Pizzo, 1981) was administered to reveal attitudinal differences. The traditional unit included oral reading from the textbook, completing outlines, labeling diagrams, and correcting the outlines and diagrams as a class. The multisensory unit included five instructional stations established in different sections of the classroom to allow students to learn by: (a) manipulating Flip Chutes, (b) using Electroboards, (c) assembling Task Cards, (d) playing a kinesthetic Floor Game, and (e) reading an individual Programmed Learning Sequence. Audio tapes and scripts were provided at each location. Students circulated in groups of four from station to station. The data subjected to statistical analyses supported the use of a multisensory, rather than a traditional approach, for teaching science content that is above-grade level. T-tests revealed a positive and significant impact on achievement scores (p < 0.0007). No significance was detected on grade-level achievement nor on the perceptual-preference effect. Furthermore, the students indicated significantly more positive attitudes when instructed with a multisensory approach on either grade-level or above-grade level science content (p < 0.0001). The findings supported using a multisensory approach when teaching science concepts that are new to and difficult for students (Martini, 1986).

Approaches to Learning and Kolb's Learning Styles of Undergraduates with Better Grades

NASA Astrophysics Data System (ADS)

Almeida, Patrícia; Teixeira-Dias, José Joaquim; Martinho, Mariana; Balasooriya, Chinthaka

The purpose of this study is to investigate if the teaching, learning and assessment strategies conceived and implemented in a higher education chemistry course promote the development of conceptual understanding, as intended. Thus, our aim is to analyse the learning styles and the approaches to learning of chemistry undergraduates with better grades. The overall results show that the students with better grades possess the assimilator learning style, that is usually associated to the archetypal chemist. Moreover, the students with the highest grades revealed a conception of learning emphasising understanding. However, these students diverged both in their learning approaches and in their preferences for teaching strategies. The majority of students adopted a deep approach or a combination of a deep and a strategic approach, but half of them revealed their preference for teaching-centred strategies.

Limited knowledge of fraction representations differentiates middle school students with mathematics learning disability (dyscalculia) versus low mathematics achievement.

PubMed

Mazzocco, Michèle M M; Myers, Gwen F; Lewis, Katherine E; Hanich, Laurie B; Murphy, Melissa M

2013-06-01

Fractions pose significant challenges for many children, but for some children those challenges persist into high school. Here we administered a fractions magnitude comparison test to 122 children, from Grades 4 to 8, to test whether their knowledge of fractions typically learned early in the sequence of formal math instruction (e.g., fractions equivalent to one-half, fraction pairs with common denominators) differentiates those with mathematics learning disability (MLD) versus low achievement (LA) or typical achievement (TA) in mathematics and whether long-term learning trajectories of this knowledge also differentiate these groups. We confirmed that although fourth graders with TA (n=93) were more accurate in evaluating "one-half" fractions than in evaluating "non-half" fractions (until they reached ceiling performance levels on both types of fractions), children with MLD (n=11) did not show a one-half advantage until Grade 7 and did not reach ceiling performance even by Grade 8. Both the MLD and LA groups had early difficulties with fractions, but by Grade 5 the LA group approached performance levels of the TA group and deviated from the MLD group. All groups showed a visual model advantage over Arabic number representation of fractions, but this advantage was short-lived for the TA group (because ceiling level was achieved across formats), whereas it was slightly more persistent for the LA group and persisted through Grade 8 for children with MLD. Thus, difficulties with fractions persist through Grade 8 for many students, but the nature and trajectories of those difficulties vary across children with math difficulties (MLD or LA). Copyright © 2013 Elsevier Inc. All rights reserved.

Applying GRADE-CERQual to qualitative evidence synthesis findings-paper 3: how to assess methodological limitations.

PubMed

Munthe-Kaas, Heather; Bohren, Meghan A; Glenton, Claire; Lewin, Simon; Noyes, Jane; Tunçalp, Özge; Booth, Andrew; Garside, Ruth; Colvin, Christopher J; Wainwright, Megan; Rashidian, Arash; Flottorp, Signe; Carlsen, Benedicte

2018-01-25

The GRADE-CERQual (Confidence in Evidence from Reviews of Qualitative research) approach has been developed by the GRADE (Grading of Recommendations Assessment, Development and Evaluation) Working Group. The approach has been developed to support the use of findings from qualitative evidence syntheses in decision-making, including guideline development and policy formulation. CERQual includes four components for assessing how much confidence to place in findings from reviews of qualitative research (also referred to as qualitative evidence syntheses): (1) methodological limitations, (2) coherence, (3) adequacy of data and (4) relevance. This paper is part of a series providing guidance on how to apply CERQual and focuses on CERQual's methodological limitations component. We developed the methodological limitations component by searching the literature for definitions, gathering feedback from relevant research communities and developing consensus through project group meetings. We tested the CERQual methodological limitations component within several qualitative evidence syntheses before agreeing on the current definition and principles for application. When applying CERQual, we define methodological limitations as the extent to which there are concerns about the design or conduct of the primary studies that contributed evidence to an individual review finding. In this paper, we describe the methodological limitations component and its rationale and offer guidance on how to assess methodological limitations of a review finding as part of the CERQual approach. This guidance outlines the information required to assess methodological limitations component, the steps that need to be taken to assess methodological limitations of data contributing to a review finding and examples of methodological limitation assessments. This paper provides guidance for review authors and others on undertaking an assessment of methodological limitations in the context of the CERQual approach. More work is needed to determine which criteria critical appraisal tools should include when assessing methodological limitations. We currently recommend that whichever tool is used, review authors provide a transparent description of their assessments of methodological limitations in a review finding. We expect the CERQual approach and its individual components to develop further as our experiences with the practical implementation of the approach increase.

[Grades evaluation of Scutellariae Radix slices based on quality constant].

PubMed

Deng, Zhe; Zhang, Jun; Jiao, Meng-Jiao; Zhong, Wen; Cui, Wen-Jin; Cheng, Jin-Tang; Chen, Sha; Wang, Yue-Sheng; Liu, An

2017-05-01

By measuring the morphological indexes and the marker components content of 22 batches of Scutellariae Radix slices as well as calculating the quality constant, this research was aimed to establish a new method of evaluating the specifications and grades of Scutellariae Radix slices. The quality constants of these samples were in the range of 0.04-0.49, which can be divided into several grades based on the real requirement. If they were divided into three grades, the quality constant was ≥0.39 for the first grade, <0.39 but ≥0.24 for the second grade, and <0.24 for the third grade. This work indicated that the quality constants characterizing both apparent parameters and intrinsic quality can be used as a comprehensive evaluation index to classify the grades of traditional Chinese medicine quantitatively, clearly and objectively. The research results in this paper would provide new ideas and references for evaluating the specifications and grades of traditional Chinese medicines. Copyright© by the Chinese Pharmaceutical Association.

World Health Organization recommendations are often strong based on low confidence in effect estimates.

PubMed

Alexander, Paul E; Bero, Lisa; Montori, Victor M; Brito, Juan Pablo; Stoltzfus, Rebecca; Djulbegovic, Benjamin; Neumann, Ignacio; Rave, Supriya; Guyatt, Gordon

2014-06-01

Expert guideline panelists are sometimes reluctant to offer weak/conditional/contingent recommendations. Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidance warns against strong recommendations when confidence in effect estimates is low or very low, suggesting that such recommendations may seldom be justified. We aim to characterize the classification of strength of recommendations and confidence in estimates in World Health Organization (WHO) guidelines that used the GRADE approach and graded both strength and confidence (GRADEd). We reviewed all WHO guidelines (January 2007 to December 2012), identified those that were GRADEd, and, in these, examined the classifications of strong and weak and associated confidence in estimates (high, moderate, low, and very low). We identified 116 WHO guidelines in which 43 (37%) were GRADEd and had 456 recommendations, of which 289 (63.4%) were strong and 167 (36.6%) were conditional/weak. Of the 289 strong recommendations, 95 (33.0%) were based on evidence warranting low confidence in estimates and 65 (22.5%) on evidence warranting very low confidence in estimates (55.5% strong recommendations overall based on low or very low confidence in estimates). Strong recommendations based on low or very low confidence estimates are very frequently made in WHO guidelines. Further study to determine the reasons for such high uncertainty recommendations is warranted. Copyright © 2014 Elsevier Inc. All rights reserved.

Applying GRADE-CERQual to qualitative evidence synthesis findings-paper 2: how to make an overall CERQual assessment of confidence and create a Summary of Qualitative Findings table.

PubMed

Lewin, Simon; Bohren, Meghan; Rashidian, Arash; Munthe-Kaas, Heather; Glenton, Claire; Colvin, Christopher J; Garside, Ruth; Noyes, Jane; Booth, Andrew; Tunçalp, Özge; Wainwright, Megan; Flottorp, Signe; Tucker, Joseph D; Carlsen, Benedicte

2018-01-25

The GRADE-CERQual (Confidence in Evidence from Reviews of Qualitative research) approach has been developed by the GRADE (Grading of Recommendations Assessment, Development and Evaluation) Working Group. The approach has been developed to support the use of findings from qualitative evidence syntheses in decision making, including guideline development and policy formulation. CERQual includes four components for assessing how much confidence to place in findings from reviews of qualitative research (also referred to as qualitative evidence syntheses): (1) methodological limitations, (2) coherence, (3) adequacy of data and (4) relevance. This paper is part of a series providing guidance on how to apply CERQual and focuses on making an overall assessment of confidence in a review finding and creating a CERQual Evidence Profile and a CERQual Summary of Qualitative Findings table. We developed this guidance by examining the methods used by other GRADE approaches, gathering feedback from relevant research communities and developing consensus through project group meetings. We then piloted the guidance on several qualitative evidence syntheses before agreeing on the approach. Confidence in the evidence is an assessment of the extent to which a review finding is a reasonable representation of the phenomenon of interest. Creating a summary of each review finding and deciding whether or not CERQual should be used are important steps prior to assessing confidence. Confidence should be assessed for each review finding individually, based on the judgements made for each of the four CERQual components. Four levels are used to describe the overall assessment of confidence: high, moderate, low or very low. The overall CERQual assessment for each review finding should be explained in a CERQual Evidence Profile and Summary of Qualitative Findings table. Structuring and summarising review findings, assessing confidence in those findings using CERQual and creating a CERQual Evidence Profile and Summary of Qualitative Findings table should be essential components of undertaking qualitative evidence syntheses. This paper describes the end point of a CERQual assessment and should be read in conjunction with the other papers in the series that provide information on assessing individual CERQual components.

Stratification of HPV-Induced Cervical Pathology using the Virally-Encoded Molecular Marker E4 in Combination with p16 or MCM

PubMed Central

Griffin, Heather; Soneji, Yasmina; Van Baars, Romy; Arora, Rupali; Jenkins, David; van de Sandt, Miekel; Wu, Zhonglin; Quint, Wim; Jach, Robert; Okon, Krzysztof; Huras, Hubert; Singer, Albert; Doorbar, John

2015-01-01

High-risk HPV types cause cervical lesions of varying severity, ranging from transient productive infections to high-grade neoplasia. Disease stratification requires the examination of lesional pathology, and possibly also the detection of biomarkers. P16INK4a and MCM are established surrogates of high-risk HPV E6/E7 activity, and can be extensively expressed in high-grade lesions. Here we have combined these two cellular biomarkers with detection of the abundant HPV-encoded E4 protein in order to identify both productive and transforming lesions. This approach has allowed us to distinguish true papillomavirus infections from similar pathologies, and has allowed us to divide the heterogeneous CIN2 category into those that are CIN1-like and express E4, and those that more closely resemble non-productive CIN3. To achieve this, 530 lesional areas were evaluated according to standard pathology criteria and by using a multiple staining approach that allows us to superimpose biomarker patterns either singly or in combination onto an annotated haematoxylin & eosin image. Conventional grading of neoplasia was established by review panel, and compared directly to the composite molecular pathology visualised on the same tissue section. The detection of E4 coincided with the onset of vacuolation, becoming abundant in koilocytes as the MCM marker declined and cells lost their defined nuclear margins as visualised by standard H&E staining. Of the dual marker approaches, p16INK4a and E4 appeared most promising, with E4 generally identifying areas of low-grade disease even when p16INK4a was present. Extensive p16INK4a expression usually coincided with an absence of E4 expression or its focal retention in sporadic cells within the lesion. Our results suggest that a straightforward molecular evaluation of HPV life-cycle deregulation in cervical neoplasia may help improve disease stratification, and that this can be achieved using complementary molecular biomarker pairs such as MCM/E4 or more promisingly, p16INK4a/E4 as an adjunct to conventional pathology. PMID:25953390

Evaluating Middle School Students' Spatial-Scientific Performance within Earth/Space Astronomy in Terms of Gender and Race/Ethnicity

ERIC Educational Resources Information Center

Wilhelm, Jennifer; Toland, Michael D.; Cole, Merryn

2017-01-01

Differences were examined between groups of sixth grade students? spatial-scientific development pre/post implementation of an Earth/Space unit. Treatment teachers employed a spatially-integrated Earth/Space curriculum, while control teachers implemented their Business as Usual (BAU) Earth/Space units. A multi-level modeling approach was used in a…

One Approach to Formulating and Evaluating Student Work Groups in Legal Environment of Business Courses

ERIC Educational Resources Information Center

Camara, Joan E.; Carr, B. Nathaniel; Grota, Barbara L.

2007-01-01

The principal focus of this study is an investigation of whether students' grade point average (GPA) is a viable criterion for forming student work groups in the undergraduate Legal Environment of Business course. More specifically, the research focuses on the impact of: (1) GPA-homogeneous (HO) and GPA-heterogeneous (HE) groups upon student…

Cases and Controversy: Guide to Teaching the Public Issues Series/Harvard Social Studies Project, and Supplement.

ERIC Educational Resources Information Center

Oliver, Donald W.; Newmann, Fred M.

This general guide presents an overview and explains the rationale of the teaching approach of the "Public Issues Series," units produced by the Harvard Social Studies Project to help students in grades 9-19 analyze and discuss human dilemmas related to public issues. (A detailed report on the nature, development, and evaluation of the Harvard…

Learning Physical Science through Astronomy Activities: A Comparison between Constructivist and Traditional Approaches in Grades 3-6

ERIC Educational Resources Information Center

Ward, R. Bruce; Sadler, Philip M.; Shapiro, Irwin I.

2008-01-01

We report on an evaluation of the effectiveness of Project ARIES, an astronomy-based physical science curriculum for upper elementary and middle school children. ARIES students use innovative, simple, and affordable apparatus to carry out a wide range of indoor and outdoor hands-on, discovery-based activities. Student journals and comprehensive…

An evaluation of the grades and value of red alder lumber in southeast Alaska

Treesearch

Allen M. Brackley; David Nicholls; Michael Hannan

2009-01-01

Many stands in southeast Alaska harvested since 1950, especially where there has been a high degree of disturbance of mineral soil, have regenerated to red alder (Alnus rubra Bong.) and are now approaching maturity. The availability of red alder raises questions addressed in this study about the recovery of lumber from this resource. Information in...

Mentoring Approaches to Create a College-Going Culture for At-Risk Secondary Level Students

ERIC Educational Resources Information Center

Radcliffe, Richard; Bos, Beth

2011-01-01

Based on NAEP data, many adolescents may not be adequately prepared for postsecondary education. This is a Year Five report from a seven-year longitudinal study of a student cohort starting in sixth grade year (n = 50). It uses a quasi-experimental design, and collects data from surveys, interviews, and reflective statements to evaluate mentoring…

The Power of a Woman's Story: A Three-Step Approach to Historical Significance in High School World History

ERIC Educational Resources Information Center

Kohlmeier, Jada

2005-01-01

The author's ninth grade world history students communicated the connection they felt to three women whose stories they evaluated in class. The women represented ordinary people living during time periods being studied, and their personal stories demonstrated how the political, economic and cultural events had an impact on people in unique and…

Evaluating the Effectiveness of Montessori Reading and Math Instruction for Third Grade African American Students in Urban Elementary Schools

ERIC Educational Resources Information Center

Brown, Katherine Elizabeth

2016-01-01

Improving academic achievement for students of color has long been the subject of debate among advocates of education reform (Anyon, 2013; Breitborde & Swiniarski, 2006; Payne, 2008). Some scholars have advocated for the Montessori method as an alternative educational approach to address some chronic problems in public education (Lillard,…

Evaluation of Fourth-Grade Primary School Students' Attitudes and Self-Efficacy towards Physical Education Course Using Socio-Cultural Approach

ERIC Educational Resources Information Center

Aydogan, Hayri

2016-01-01

Changes in the national education system in Turkey have negative effects on the development of sports. Because, as classroom teachers teach Physical Education courses themselves, instead Physical Education teachers teach the course. This was because of a recent legislation released by the Ministry of National Education related to 4+4+4 compulsory…

GRADE guidelines: 10. Considering resource use and rating the quality of economic evidence.

PubMed

Brunetti, Massimo; Shemilt, Ian; Pregno, Silvia; Vale, Luke; Oxman, Andrew D; Lord, Joanne; Sisk, Jane; Ruiz, Francis; Hill, Suzanne; Guyatt, Gordon H; Jaeschke, Roman; Helfand, Mark; Harbour, Robin; Davoli, Marina; Amato, Laura; Liberati, Alessandro; Schünemann, Holger J

2013-02-01

In this article, we describe how to include considerations about resource utilization when making recommendations according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. We focus on challenges with rating the confidence in effect estimates (quality of evidence) and incorporating resource use into evidence profiles and Summary of Findings (SoF) tables. GRADE recommends that important differences in resource use between alternative management strategies should be included along with other important outcomes in the evidence profile and SoF table. Key steps in considering resources in making recommendations with GRADE are the identification of items of resource use that may differ between alternative management strategies and that are potentially important to decision makers, finding evidence for the differences in resource use, making judgments regarding confidence in effect estimates using the same criteria used for health outcomes, and valuing the resource use in terms of costs for the specific setting for which recommendations are being made. With our framework, decision makers will have access to concise summaries of recommendations, including ratings of the quality of economic evidence, and better understand the implications for clinical decision making. Copyright © 2013 Elsevier Inc. All rights reserved.

Factors Influencing Students' Peer Evaluation in Cooperative Learning.

ERIC Educational Resources Information Center

Persons, Obeua S.

1998-01-01

In an accounting class in which 25% of grades were derived from group work, students completed peer evaluations. Regression analyses revealed that accounting majors and students with higher grade point averages received higher peer evaluations. Higher group homework and class participation grades were associated with higher peer evaluations. (SK)

The Evaluation of Pre­-Service Preschool Teachers' Knowledge about the Concept of Environment

ERIC Educational Resources Information Center

Ahi, Berat; Alisinanoglu, Fatma

2015-01-01

The purpose of the research is to evaluate pre-­service preschool teachers' knowledge about environment by analyzing their drawings about it. 70 first grade, 99 second grade, 56 third grade and 44 fourth grade, with a total of 269 students have been evaluated in this research. This qualitative research was made with social structuralism vision.…

[Application of relative quality constant in grades evaluation of Glycyrrizae Radix et Rhizome pieces].

PubMed

Deng, Zhe; Jiao, Meng-Jiao; Zhang, Jun; Xian, Jing; Zhang, Qing; Chen, Chang; Wang, Yue-Sheng; Liu, An

2017-07-01

Quality constant evaluation is a comprehensive method for grades evaluation of traditional Chinese medicine pieces, but when it comes to Glycyrrizae Radix et Rhizome pieces, grades evaluation is diverged due to significant difference in contents of liquiritin and glycyrrhizic acid and unreasonable weight of index. To solve this problem, we have established a relative quality constant method in this paper to evaluate grades of Glycyrrizae Radix et Rhizome pieces. Twenty-nine batches of different quality samples were collected and tested, and finally, 17 batches of them were chosen as researcher objects. The results revealed that the range of the relative quality constant of these samples was from 1.78 to 11.49. When Glycyrrizae Radix et Rhizome pieces are divided into three grades: the relative quality constant of first grade is greater than or equal to 9.19; the second grade is greater than or equal to 5.75 but less than 9.19; while the third grade is less than 5.75. This research indicates that relative quality constant can divide the grades of herbal pieces in a scientific, reasonable, objective and specific way and remedy the shortage of quality constant perfectly. It provides a novel mode for grading pieces of Chinese medicine that contains multi-target ingredients. Copyright© by the Chinese Pharmaceutical Association.

Physical evaluation of color and monochrome medical displays using an imaging colorimeter

NASA Astrophysics Data System (ADS)

Roehrig, Hans; Gu, Xiliang; Fan, Jiahua

2013-03-01

This paper presents an approach to physical evaluation of color and monochrome medical grade displays using an imaging colorimeter. The purpose of this study was to examine the influence of medical display types, monochrome or color at the same maximum luminance settings, on diagnostic performance. The focus was on the measurements of physical characteristics including spatial resolution and noise performance, which we believed could affect the clinical performance. Specifically, Modulation Transfer Function (MTF) and Noise Power Spectrum (NPS) were evaluated and compared at different digital driving levels (DDL) between two EIZO displays.

Clinical Performance Evaluations of Third-Year Medical Students and Association With Student and Evaluator Gender.

PubMed

Riese, Alison; Rappaport, Leah; Alverson, Brian; Park, Sangshin; Rockney, Randal M

2017-06-01

Clinical performance evaluations are major components of medical school clerkship grades. But are they sufficiently objective? This study aimed to determine whether student and evaluator gender is associated with assessment of overall clinical performance. This was a retrospective analysis of 4,272 core clerkship clinical performance evaluations by 829 evaluators of 155 third-year students, within the Alpert Medical School grading database for the 2013-2014 academic year. Overall clinical performance, assessed on a three-point scale (meets expectations, above expectations, exceptional), was extracted from each evaluation, as well as evaluator gender, age, training level, department, student gender and age, and length of observation time. Hierarchical ordinal regression modeling was conducted to account for clustering of evaluations. Female students were more likely to receive a better grade than males (adjusted odds ratio [AOR] 1.30, 95% confidence interval [CI] 1.13-1.50), and female evaluators awarded lower grades than males (AOR 0.72, 95% CI 0.55-0.93), adjusting for department, observation time, and student and evaluator age. The interaction between student and evaluator gender was significant (P = .03), with female evaluators assigning higher grades to female students, while male evaluators' grading did not differ by student gender. Students who spent a short time with evaluators were also more likely to get a lower grade. A one-year examination of all third-year clerkship clinical performance evaluations at a single institution revealed that male and female evaluators rated male and female students differently, even when accounting for other measured variables.

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.

Phase II Study of HER-2/neu Intracellular Domain Peptide-Based Vaccine Administered to Stage IV HER2 Positive Breast Cancer Patients Receiving Trastuzumab

DTIC Science & Technology

2007-05-01

the combined approach as well as the immunogenicity of HER2 ICD peptide vaccination. If there is evidence to suggest that the true rate of Grade IV... approach will be evaluated as the ability of the vaccine to elicit HER2 ICD specific T cell immunity, to elicit epitope spreading, and to stimulate...July 2006. Unfortunately, by the time all needed source documents (i.e., imaging, clinical labs, cardiac function tests) were collected, this

Increasing Word Recognition with Racially Diverse Second-Grade Students Using Fluency-Oriented Reading Approaches

ERIC Educational Resources Information Center

Turner, Franklin Dickerson

2012-01-01

The author examined the effectiveness of 2 fluency-oriented reading programs on improving reading fluency for an ethnically diverse sample of second-grade students. The first approach is Fluency-Oriented Reading Instruction (S. A. Stahl & K. Heubach, 2005), which incorporates the repeated reading of a grade-level text over the course of an…

A Guide to Concept Teaching, United States History, Grade 9. (From Reconstruction to the Present).

ERIC Educational Resources Information Center

Madison Public Schools, WI.

GRADES OR AGES: Grade 9. SUBJECT MATTER: United States history. ORGANIZATION AND PHYSICAL APPEARANCE: The conceptual approach forms the basis for each of four sections: Defining and Implementing a Conceptual Approach to Teaching Social Studies; Social Studies Skills To Be Developed and Reinforced by the Learner; Classroom Curriculum Planning; and…

Suggestions for Teaching Mathematics Using Laboratory Approaches Grades 1-6. 4. Measurement. Experimental Edition.

ERIC Educational Resources Information Center

New York State Education Dept., Albany. Bureau of Elementary Curriculum Development.

This guide describes activities and materials which can be used in a mathematics laboratory approach to a basic mathematics program for grades 1-6. One-hundred thirteen activities pertaining to measurement concepts are described in terms of purpose, suggested grade levels, materials needed, and procedures. Some specific concepts include: linear…

Middle school science curriculum design and 8th grade student achievement in Massachusetts public schools

NASA Astrophysics Data System (ADS)

Clifford, Betsey A.

The Massachusetts Department of Elementary and Secondary Education (DESE) released proposed Science and Technology/Engineering standards in 2013 outlining the concepts that should be taught at each grade level. Previously, standards were in grade spans and each district determined the method of implementation. There are two different methods used teaching middle school science: integrated and discipline-based. In the proposed standards, the Massachusetts DESE uses grade-by-grade standards using an integrated approach. It was not known if there is a statistically significant difference in student achievement on the 8th grade science MCAS assessment for students taught with an integrated or discipline-based approach. The results on the 8th grade science MCAS test from six public school districts from 2010 -- 2013 were collected and analyzed. The methodology used was quantitative. Results of an ANOVA showed that there was no statistically significant difference in overall student achievement between the two curriculum models. Furthermore, there was no statistically significant difference for the various domains: Earth and Space Science, Life Science, Physical Science, and Technology/Engineering. This information is useful for districts hesitant to make the change from a discipline-based approach to an integrated approach. More research should be conducted on this topic with a larger sample size to better support the results.

Appearance and characterization of fruit image textures for quality sorting using wavelet transform and genetic algorithms.

PubMed

Khoje, Suchitra

2018-02-01

Images of four qualities of mangoes and guavas are evaluated for color and textural features to characterize and classify them, and to model the fruit appearance grading. The paper discusses three approaches to identify most discriminating texture features of both the fruits. In the first approach, fruit's color and texture features are selected using Mahalanobis distance. A total of 20 color features and 40 textural features are extracted for analysis. Using Mahalanobis distance and feature intercorrelation analyses, one best color feature (mean of a* [L*a*b* color space]) and two textural features (energy a*, contrast of H*) are selected as features for Guava while two best color features (R std, H std) and one textural features (energy b*) are selected as features for mangoes with the highest discriminate power. The second approach studies some common wavelet families for searching the best classification model for fruit quality grading. The wavelet features extracted from five basic mother wavelets (db, bior, rbior, Coif, Sym) are explored to characterize fruits texture appearance. In third approach, genetic algorithm is used to select only those color and wavelet texture features that are relevant to the separation of the class, from a large universe of features. The study shows that image color and texture features which were identified using a genetic algorithm can distinguish between various qualities classes of fruits. The experimental results showed that support vector machine classifier is elected for Guava grading with an accuracy of 97.61% and artificial neural network is elected from Mango grading with an accuracy of 95.65%. The proposed method is nondestructive fruit quality assessment method. The experimental results has proven that Genetic algorithm along with wavelet textures feature has potential to discriminate fruit quality. Finally, it can be concluded that discussed method is an accurate, reliable, and objective tool to determine fruit quality namely Mango and Guava, and might be applicable to in-line sorting systems. © 2017 Wiley Periodicals, Inc.

Assessment Strategies for Laboratory Reports

NASA Astrophysics Data System (ADS)

Nadji, Taoufik; Lach, Michael; Blanton, Patricia

2003-01-01

National and state science standards tell us that we should use inquiry approaches to help students develop understanding of key concepts. Physics education research groups have validated the effectiveness of this approach. It is then left to the teacher to provide the scaffolding on which to construct these concepts, the guidance necessary to complete the task, and the assessment strategies to evaluate the effectiveness of the approach. Most teachers will require students to write a report to communicate their efforts and understanding, and then are faced with the enormous task of grading the volumes generated in an efficient, consistent, and fair manner. Two teachers share with us some of the strategies they use.

Comparative analysis of the vapor headspace of military-grade TNT versus NESTT TNT under dynamic and static conditions

NASA Astrophysics Data System (ADS)

Edge, Cindy C.; Gibb, Julie; Wasserzug, Louis S.

1998-09-01

The Institute for Biological Detection Systems (IBDS) has developed a quantitative vapor delivery system that can aid in characterizing dog's sensitivity and ability to recognize odor signatures for explosives and contraband substances. Determining of the dog's odor signature for detection of explosives is important because it may aid in eliminating the risk of handling explosives and reducing cross-contamination. Progress is being made in the development of training aids that represent the headspace of the explosives. NESTTTM TNT materials have been proposed as an approach to developing training aid simulates. In order for such aids to be effective they must mimic the headspace of the target material. This study evaluates the NESTTTM TNT product with regard to this criterion. NESTTTM TNT vapor was generated by the IBDS vapor delivery system, which incorporates a vapor generation cell that enables the user to control the conditions under which a substance is tested. The NESTTTM TNT vapor was compared to the headspace of military-grade TNT. The findings identify and quantify major vapor constituents of military-grade TNT and NESTTTM TNT. A comparative analysis evaluated the degree to which the NESTTTM TNT mimics the headspace of an actual TNT sample.

Distributing free fresh fruit and vegetables at school: results of a pilot outcome evaluation.

PubMed

Coyle, Karin K; Potter, Susan; Schneider, Doris; May, Gary; Robin, Leah E; Seymour, Jennifer; Debrot, Karen

2009-01-01

Consumption of fruit and vegetables among children is generally below recommended levels. This evaluation addressed two questions: (1) To what extent did children's attitudes toward, familiarity with, and preferences for fruit and vegetables change during the school year? and (2) To what extent did children's consumption of fruit and vegetables change during the school year? During the 2004-2005 school year, the Mississippi Department of Education, Child Nutrition Programs initiated a pilot program to distribute free fruit and vegetables to students (kindergarten through 12th grade) during the school day. Data were collected in 2004-2005 within a one-group pretest/posttest design using a self-report questionnaire (n=725) and 24-hour dietary recalls (n=207) with a sample of students from five schools in Mississippi. Data were analyzed in 2006-2007. Results showed greater familiarity with fruit and vegetables at all grade levels (p<0.05) and increased preferences for fruit among eighth- and 10th-grade students (p<0.01). Eighth-grade students also reported more positive attitudes toward eating fruit and vegetables (p<0.01), increased perceived self-efficacy to eat more fruit (p<0.01), and increased willingness to try new fruit. Finally, results showed increased consumption of fruit, but not vegetables, among eighth- and 10th-grade students (p<0.001). Distributing free fruit and vegetables at school may be a viable component of a more comprehensive approach for improving students' nutrition attitudes and behaviors. More program emphasis is needed on ways to promote vegetable consumption.

Teaching Children to Become Fluent and Automatic Readers

PubMed Central

Kuhn, Melanie R.; Schwanenflugel, Paula J.; Morris, Robin D.; Morrow, Lesley Mandel; Woo, Deborah Gee; Meisinger, Elizabeth B.; Sevcik, Rose A.; Bradley, Barbara A.; Stahl, Steven A.

2009-01-01

The purpose of the study was to examine the effects of two instructional approaches designed to improve the reading fluency of 2nd-grade children. The first approach was based on Stahl and Heubach’s (2005) fluency-oriented reading instruction (FORI) and involved the scaffolded, repeated reading of grade-level texts over the course of each week. The second was a wide-reading approach that also involved scaffolded instruction. hut that incorporated the reading of 3 different grade-level texts each week and provicled significantly less opportunity for repetition. By the end of the school year. FORI and wide-reading approaches showed similar benefits for standardized measures of word reading efficiency and reading comprehension skills compared to control approachcs. although the benefits of the wide-reading approach emerged earlier and included oral text reading fluency skill. Thus, we conclude that fluency instruction that emphasizes extensive oral reading of grade-level text using scaffolded approaches is effective for promoting reading development in young learners. PMID:19946472

Procurement engineering - the productivity factor

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

Bargerstock, S.B.

1993-01-01

The industry is several years on the road to implementation of the Nuclear Management and Resources Council (NUMARC) initiatives on commercial-grade item dedication and procurement. Utilities have taken several approaches to involve engineering in the procurement process. A common result for the approaches is the additional operations and maintenance (O M) cost imposed by the added resource requirements. Procurement engineering productivity is a key element in controlling this business area. Experience shows that 400 to 500% improvements in productivity are possible with a 2-yr period. Improving the productivity of the procurement engineering function is important in today's competitive utility environment.more » Procurement engineering typically involves four distinct technical evaluation responsibilities along with several administrative areas. Technical evaluations include the functionally based safety classification of replacement components and parts (lacking a master parts list), the determination of dedication requirements for safety-related commercial-grade items, the preparation of a procurement specification to maintain the licensed design bases, and the equivalency evaluation of alternate items not requiring the design-change process. Administrative duties include obtaining technical review of vendor-supplied documentation, identifying obsolete parts and components, resolving material nonconformances, initiating the design-change process for replacement items (as needed), and providing technical support to O M. Although most utilities may not perform or require all the noted activities, a large percentage will apply to each utility station.« less

Evaluating the Quality of Evidence from a Network Meta-Analysis

PubMed Central

Salanti, Georgia; Del Giovane, Cinzia; Chaimani, Anna; Caldwell, Deborah M.; Higgins, Julian P. T.

2014-01-01

Systematic reviews that collate data about the relative effects of multiple interventions via network meta-analysis are highly informative for decision-making purposes. A network meta-analysis provides two types of findings for a specific outcome: the relative treatment effect for all pairwise comparisons, and a ranking of the treatments. It is important to consider the confidence with which these two types of results can enable clinicians, policy makers and patients to make informed decisions. We propose an approach to determining confidence in the output of a network meta-analysis. Our proposed approach is based on methodology developed by the Grading of Recommendations Assessment, Development and Evaluation (GRADE) Working Group for pairwise meta-analyses. The suggested framework for evaluating a network meta-analysis acknowledges (i) the key role of indirect comparisons (ii) the contributions of each piece of direct evidence to the network meta-analysis estimates of effect size; (iii) the importance of the transitivity assumption to the validity of network meta-analysis; and (iv) the possibility of disagreement between direct evidence and indirect evidence. We apply our proposed strategy to a systematic review comparing topical antibiotics without steroids for chronically discharging ears with underlying eardrum perforations. The proposed framework can be used to determine confidence in the results from a network meta-analysis. Judgements about evidence from a network meta-analysis can be different from those made about evidence from pairwise meta-analyses. PMID:24992266

Redesign of a pediatric pharmacotherapy elective course to accommodate budget reductions.

PubMed

Williams, Jennifer; Motycka, Carol; St Onge, Erin

2011-12-15

To redesign a pediatric elective pharmacotherapy course and determine whether the redesign resulted in changes in outcome measures. Active learning activities were moved to an online format. Prerecorded lectures continued to be used. Peer evaluation was incorporated to give the students more feedback on their performance. ASSESSMENT; Presentation grades, average examination grades, course grades, and evaluation scores from each student who completed University course evaluations were documented for students during the 2 semesters before and the 2 semesters after the course redesign. Although for undetermined reasons a drop in examination grades occurred after the course redesign, no significant differences in presentation grades, final grades, or course evaluation grades occurred. A strategic course redesign successfully reduced the costs and faculty time required to offer an elective course viewed as essential to the curriculum, allowing the course to be continued in the face of state budget cuts.

Quantification of confocal fluorescence microscopy for the detection of cervical intraepithelial neoplasia.

PubMed

Sheikhzadeh, Fahime; Ward, Rabab K; Carraro, Anita; Chen, Zhao Yang; van Niekerk, Dirk; Miller, Dianne; Ehlen, Tom; MacAulay, Calum E; Follen, Michele; Lane, Pierre M; Guillaud, Martial

2015-10-24

Cervical cancer remains a major health problem, especially in developing countries. Colposcopic examination is used to detect high-grade lesions in patients with a history of abnormal pap smears. New technologies are needed to improve the sensitivity and specificity of this technique. We propose to test the potential of fluorescence confocal microscopy to identify high-grade lesions. We examined the quantification of ex vivo confocal fluorescence microscopy to differentiate among normal cervical tissue, low-grade Cervical Intraepithelial Neoplasia (CIN), and high-grade CIN. We sought to (1) quantify nuclear morphology and tissue architecture features by analyzing images of cervical biopsies; and (2) determine the accuracy of high-grade CIN detection via confocal microscopy relative to the accuracy of detection by colposcopic impression. Forty-six biopsies obtained from colposcopically normal and abnormal cervical sites were evaluated. Confocal images were acquired at different depths from the epithelial surface and histological images were analyzed using in-house software. The features calculated from the confocal images compared well with those features obtained from the histological images and histopathological reviews of the specimens (obtained by a gynecologic pathologist). The correlations between two of these features (the nuclear-cytoplasmic ratio and the average of three nearest Delaunay-neighbors distance) and the grade of dysplasia were higher than that of colposcopic impression. The sensitivity of detecting high-grade dysplasia by analysing images collected at the surface of the epithelium, and at 15 and 30 μm below the epithelial surface were respectively 100, 100, and 92 %. Quantitative analysis of confocal fluorescence images showed its capacity for discriminating high-grade CIN lesions vs. low-grade CIN lesions and normal tissues, at different depth of imaging. This approach could be used to help clinicians identify high-grade CIN in clinical settings.

The efficacy and safety of combined microneedle fractional radiofrequency and sublative fractional radiofrequency for acne scars in Asian skin.

PubMed

Park, Jae Yang; Lee, Eo Gin; Yoon, Moon Soo; Lee, Hee Jung

2016-06-01

Microneedle fractional radiofrequency has been reported to be effective for improving wrinkles, enlarged pores and various scars. Sublative fractional radiofrequency has been shown to induce both fractional ablation of epidermis and upper dermal remodelling, which had rejuvenation effects in photoaged skin. Both modalities may have the potential synergy to improve acne scars. To evaluate the efficacy and safety of combined microneedle and sublative fractional radiofrequency for acne scars in Asian skin. Twenty subjects comprised 11 males and 9 females (mean age 23.65 ± 2.94, skin phototype III-IV) with moderate to severe acne scars. The subjects received three consecutive combined microneedle and sublative fractional radiofrequency at 4-week intervals over 12 weeks. Both blinded dermatologists and subjects assessed the clinical improvement based on the standardized photography and questionnaires, respectively. The quartile grading scale was utilized and defined as follows: grade 1, 0-25% improvement; grade 2, 26-50% improvement; grade 3, 51-75% improvement and grade 4, 76-100% improvement. All 20 subjects were assessed to have grade 2 or more clinical improvement by physicians; four (20%) had grade 4, 10 (50%) had grade 3, and six (30%) had grade 2 improvement. The subjects' grading also showed a good concordance as indicated by Kappa index of 0.695. The mean duration of post-therapy crusting was 5.2 days and post-therapy erythema lasted 2.5 days. Combined microneedle and sublative fractional radiofrequency can have a positive therapeutic effect with no serious complications and may provide a new therapeutic approach on acne scars in Asians. © 2015 Wiley Periodicals, Inc.

[Grades evaluation of Phellodendri chinensis cortex pieces based on quality constant].

PubMed

Deng, Zhe; Jiao, Meng-Jiao; Zhang, Jun; Zhang, Qing; Cui, Wen-Jin; Shen, Li; Cheng, Jin-Tang; Liu, An

2017-09-01

Quality constant is a comprehensive grades evaluation method for traditional Chinese medicine decoction pieces, which is better but based on traditional way. In this paper, a new grading mode for Phellodendri chinensis pieces was established based on quality constant evaluation method. The results showed that the range of relative quality constant for 15 batches of different samples was from 0.41 to 0.96. As customary, if these samples were divided into three grades: the relative quality constant shall be ≥0.77 for first grade; <0.77 but ≥0.48 for the second grade; and ＜0.48 for the third grade. This research indicated that the quality constant mode can be used to effectively grade the P. chinensis pieces in a scientific, reasonable, objective and specific way. Simultaneously, it provided a beneficial reference for grading cortex herbal pieces or medicines. Copyright© by the Chinese Pharmaceutical Association.

Building a knowledge base of severe adverse drug events based on AERS reporting data using semantic web technologies.

PubMed

Jiang, Guoqian; Wang, Liwei; Liu, Hongfang; Solbrig, Harold R; Chute, Christopher G

2013-01-01

A semantically coded knowledge base of adverse drug events (ADEs) with severity information is critical for clinical decision support systems and translational research applications. However it remains challenging to measure and identify the severity information of ADEs. The objective of the study is to develop and evaluate a semantic web based approach for building a knowledge base of severe ADEs based on the FDA Adverse Event Reporting System (AERS) reporting data. We utilized a normalized AERS reporting dataset and extracted putative drug-ADE pairs and their associated outcome codes in the domain of cardiac disorders. We validated the drug-ADE associations using ADE datasets from SIDe Effect Resource (SIDER) and the UMLS. We leveraged the Common Terminology Criteria for Adverse Event (CTCAE) grading system and classified the ADEs into the CTCAE in the Web Ontology Language (OWL). We identified and validated 2,444 unique Drug-ADE pairs in the domain of cardiac disorders, of which 760 pairs are in Grade 5, 775 pairs in Grade 4 and 2,196 pairs in Grade 3.

Development of self-handicapping tendencies.

PubMed

Kimble, C E; Kimble, E A; Croy, N A

1998-08-01

This study was undertaken to determine when U.S. children begin to self-handicap, that is, to reduce preparation effort before evaluations rather than applying themselves to do their best. The personal variables examined for their impact on practice behavior were gender, grade level, and self-esteem. The situational variables were time of the self-esteem test (before or after the evaluation task) and importance of the evaluation task. The results showed that (a) the 6th-grade boys were more likely than the 6th-grade girls to self-handicap, (b) the 3rd-grade children were not as affected as the 6th-grade children by the self-evaluation implications of performance evaluations, (c) self-handicapping by low-self-esteem and high-self-esteem 6th graders depended on recent experiences, and (d) the self-affirming experience of a self-esteem test reduced the motivation to self-handicap among high-self-esteem 6th-grade boys.

Olfactory groove meningioma: report of 99 cases surgically treated at the Catholic University School of Medicine, Rome.

PubMed

Pallini, Roberto; Fernandez, Eduardo; Lauretti, Liverana; Doglietto, Francesco; D'Alessandris, Quintino Giorgio; Montano, Nicola; Capo, Gabriele; Meglio, Mario; Maira, Giulio

2015-02-01

We reviewed our series of olfactory groove meningiomas (OGMs) with the aim to relate the surgical approach with outcome and to define clinical and pathologic predictors of prognosis. Ninety-nine patients who underwent 113 craniotomies at our Institution between 1984 and 2010 were entered this study. The relationship between surgical approach (bifrontal, fronto-orbito-basal, and pterional) and either tumor diameter, extent of tumor resection, complication rate, need of reoperation, and Karnofsky Performance Status (KPS) was analyzed. The impact of age (≤ 70 vs. > 70 years), sex, tumor diameter (< 6 vs. ≥ 6 cm), pre- and postoperative KPS (< 80 vs. ≥ 80), Simpson grade (I-II vs. III-IV), and World Health Organization (WHO) histologic grade (I vs. II-III) on survival was assessed. Kaplan-Meier survival curves were plotted and differences in survival between groups of patients were compared. A multivariate analysis adjusted for age, pre- and postoperative KPS, Simpson grade, tumor diameter, and WHO histologic grade also was performed. The fronto-orbito-basal approach (n = 22) allowed a significantly greater percentage of Simpson I-II removals than the bifrontal (n = 70) and pterional approach (n = 21) (P = 0.0354 and P = 0.0485, respectively). The risk of life-threatening complications trended to be lower in patients operated upon either via the fronto-orbito-basal and via the pterional approach than in those treated via the bifrontal approach. Retraction-related brain swelling did not occur in any case after the fronto-orbito-basal approach (P = 0.0384); however, this approach was associated with a greater rate of cerebrospinal fluid leak (P = 0.0011). Among prognostic factors, age ≤ 70 years (P = 0.0044), tumor diameter <6 cm (P = 0.0455), pre- and postoperative KPS ≥ 80 (both P < 0.0001), Simpson grade I-II (P = 0.0096), and WHO histologic grade I (P = 0.0112) were significantly associated with longer overall survival. Age (P = 0.0393) and WHO histologic grade (P = 0.0418) emerged as independent prognostic factors for overall survival on multivariate analysis. In the largest series of OGMs published to date, the bifrontal approach was associated with a greater risk of life-threatening complications compared with the lateral pterional and fronto-orbito-basal approaches. The fronto-orbito-basal approach provided greater chances of total tumor removal than the bifrontal and pterional approaches. Two independent factors for overall survival of patients with OGM were identified, namely age and WHO grade. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

[Neurosurgical treatment of complications of intra-disk injections of triamcinolone hexacetonide. Value of a radio-clinical classification].

PubMed

Privat, J M; Finiels, P J

1997-01-01

Epidural granulomas following intra-discal injection of triamcinolone hexacetonide are a well-known complication of this procedure, which is still encountered, even if its utilization was discontinued several years ago. According to the results of their experience, the authors propose a new radio-clinical grading system: grade I: disc calcification with aspect of "sub-ligamentar hernia" on CT scan; grade II: ascendant or descendant retrosomatic migration of distal content; grade III: pseudotumoral epidural infiltrate producing progressive narrowing of the spinal canal with neurological disturbance. Surgical indications in these cases can be drawn from their evolution: posterior approach can be used, with or without laminectomy, for excision as complete as possible of the involved disc (grades I and II); anterior approach should be preferred in cases of multiples recurrences after medical treatment and failure of classical posterior approach, or in case of necrotico-inflammatory proliferation with narrowing of the spinal canal (grade III).

Affecting Student Perception and Performance by Grading with 10,000 Points

ERIC Educational Resources Information Center

Peterson, Claudette M.; Peterson, Tim O.

2016-01-01

As professors, we each have our own approach to grading which allows us to assess learning and provide useful feedback to our students, yet is not too onerous. This article explains one approach we have used that differs from standard grading scales we often hear about from our colleagues. Rather than being based on 100 points or 100% over the…

Variation of Student Numerical and Figural Reasoning Approaches by Pattern Generalization Type, Strategy Use and Grade Level

ERIC Educational Resources Information Center

El Mouhayar, Rabih; Jurdak, Murad

2016-01-01

This paper explored variation of student numerical and figural reasoning approaches across different pattern generalization types and across grade level. An instrument was designed for this purpose. The instrument was given to a sample of 1232 students from grades 4 to 11 from five schools in Lebanon. Analysis of data showed that the numerical…

Integrating the 6+1 Writing Traits Model with Cross-Age Tutoring: An Investigation of Elementary Students' Writing Development

ERIC Educational Resources Information Center

Paquette, Kelli R.

2009-01-01

A mixed methodological approach was used to examine the effect of a cross-age tutoring writing program among second- and fourth-grade students in a rural elementary school in Delaware. Pre-test and post-test writing prompts were administered and evaluated using the 6+1 traits writing assessment rubric. Students were assessed qualitatively through…

Tools for Teaching Problem Solving: An Evaluation of a Modeling and Systems Thinking Approach.

ERIC Educational Resources Information Center

Zuman, John P.; Weaver, Suzie L.

During the summer of 1986 a group of 15 racially diverse students entering 10th and 11th grades participated in an intensive 4-week course taught by members of an NSF-funded project. The project's goals were to develop science and mathematics curricula based on the principles of systems dynamics. The course was a test of materials intended to…

Blending Problem Based Learning and History of Science Approaches to Enhance Views about Scientific Inquiry: New Wine in an Old Bottle

ERIC Educational Resources Information Center

Dogan, Nihal

2017-01-01

In 2016, the Program for International Student Assessment (PISA) showed that approximately 44.4% of students in Turkey obtained very low grades when their scientific knowledge was evaluated. In addition, the vast majority of students were shown to have no knowledge of basic scientific terms or concepts. Science teachers play a significant role in…

Inkjet Assisted Creation of Self-Healing Layers Between Composite Plies

DTIC Science & Technology

2013-07-29

technology into a prepreg manufacturing process. The approach consisted of depositing novel thermoplastic low-viscosity microdroplets with chemically and...mechanically comparable properties to epoxy matrix in aerospace grade composites onto fiber-reinforced epoxy prepregs before curing using an ink-jet... prepreg Cycom977-2. Double cantilever beam (DCB) and short beam shear (SBS) tests were used to evaluate the self-healing efficiency. It was shown

Assessing the Accuracy of Generalized Inferences From Comparison Group Studies Using a Within-Study Comparison Approach: The Methodology.

PubMed

Jaciw, Andrew P

2016-06-01

Various studies have examined bias in impact estimates from comparison group studies (CGSs) of job training programs, and in education, where results are benchmarked against experimental results. Such within-study comparison (WSC) approaches investigate levels of bias in CGS-based impact estimates, as well as the success of various design and analytic strategies for reducing bias. This article reviews past literature and summarizes conditions under which CGSs replicate experimental benchmark results. It extends the framework to, and develops the methodology for, situations where results from CGSs are generalized to untreated inference populations. Past research is summarized; methods are developed to examine bias in program impact estimates based on cross-site comparisons in a multisite trial that are evaluated against site-specific experimental benchmarks. Students in Grades K-3 in 79 schools in Tennessee; students in Grades 4-8 in 82 schools in Alabama. Grades K-3 Stanford Achievement Test (SAT) in reading and math scores; Grades 4-8 SAT10 reading scores. Past studies show that bias in CGS-based estimates can be limited through strong design, with local matching, and appropriate analysis involving pretest covariates and variables that represent selection processes. Extension of the methodology to investigate accuracy of generalized estimates from CGSs shows bias from confounders and effect moderators. CGS results, when extrapolated to untreated inference populations, may be biased due to variation in outcomes and impact. Accounting for effects of confounders or moderators may reduce bias. © The Author(s) 2016.

[Surgical treatment of thoracic disc herniation].

PubMed

Hrabálek, L; Kalita, O; Langová, K

2010-08-01

The aim of this study was to compare the efficiency of different surgical approaches to thoracic disc herniation, and to show the role of segmental fusion and selection of an appropriate microsurgical decompression technique for the successful outcome of surgery. A group of 27 patients, 10 men and 17 women, between 31 and 70 years (average age, 49.33 years) were included in this prospective study. They underwent surgery for thoracic degeneration disc disease in the period from June 1994 to August 2008. In all patients, the severity of myelopathy was assessed using the grading Frankel system and JOA score, axial and radicular pain intensity was evaluated with VAS and ODI rating systems. The diagnosis was established on the basis of thoracic spine radiography, thoracic spine MRI and a CT scan of the segment. A total of 30 thoracic segments, in the range of Th4/Th5 to Th12/L1, were indicated for surgery. Localisation of the hernia was medial at 19 segments, mediolateral at three and lateral at eight segments. Soft disc herniation was found in 17 cases and hard disc protrusion at the remaining 13 segments. Surgery for significant myelopathy was carried out in 23 patients and for pain in four patients. According to the surgical procedure used, the patients were allocated to two groups: group A comprised 10 patients treated without disc replacement through a laminectomy or a costotransversectomy exposure, and group B consisted of 17 patients undergo- ing intersomatic fusion via a thoracotomy. Clinical and radiographic examinations were made at regular intervals for at least 1 year of follow-up. The results of clinical assessment, including JOA scores, JOA Recovery Rate, VAS scores at rest and after exercise and ODI, were statistically analysed for each group and compared. There was a statistically significant difference in JOA evaluation of myelopathy between the groups in group A, the mean JOA score declined from 7.9 to 7.0, i.e., -0.9 point, while in group B it increased from 6.71 to 9.12, i.e., +2.41 points. The mean JOA Recovery Rate did not reach a plus value in group A, while in group B it improved by 55 %. JOA Recovery Rate: Of the seven patients in group A evaluated for myelopathy, a fair result was in one, unchanged in two and worse in four patients. Of the 16 patients evaluated for myelopathy in group B, the results were excellent in four, good in six, fair in four and unchanged in two patients. Frankel grade function: In group A, one patient improved by one grade, two remained unchanged, two deteriorated by one grade and two by two grades. In group B, five patients improved by one grade, two patients by two grades and two patients by three grades. Eight patients remained unchanged and no patient deteriorated. The post-operative pain intensity, as assessed by the mean VAS score, was lower at rest and after exercise in both groups; the score was better in group B, but the difference was not statistically significant. The ODI was evaluated only in group B its mean value improved from 41.4% to 26.1%, i.e., by 15.3%. Between 7 to 15 % of the patients have asymptomatic thoracic disc herniation, while symptomatic herniation is very rare and accounts for only 0.25 % to 0.57 % of herniated discs in the whole spine. Severe or progressive myelopathy is a clear indication for surgical intervention in thoracic disc herniation, but the role of surgery in pain control is controversial. There are five approaches for thoracic disc herniation. Transpleural anterolateral thoracotomy has an advantage over the other methods because it permits the treatment of all types of herniation, whether localised centrally, laterally or contralaterally, i.e., soft, calcified or sequestered intradural disc herniation. The results of treatment will depend on the outcome of surgical spinal cord decompression and the degree of spinal stabilisation achieved. The surgical procedure via thoracotomy with intersomatic fusion resulted in a statistically more significant improvement of myelopathy than the posterior approach without disc replacement, and it provided greater pain relief. The authors recommend to treat thoracic disc herniation by discectomy via a thoracotomy and by intersomatic fusion.

Liberal Grading Improves Evaluations but Not Performance.

ERIC Educational Resources Information Center

Vasta, Ross; Sarmiento, Robert F.

1979-01-01

The effects of examination grades on undergraduates' study behaviors, attendance, and evaluations of instruction were examined. Liberal grading was found to result in higher evaluations of course and instructor but had no demonstrable effect on studying or attendance. The implications of these findings and alternative interpretations are…

Evaluation of Life Sciences and Social Sciences Course Books in Term of Societal Sexuality

ERIC Educational Resources Information Center

Aykac, Necdet

2012-01-01

This study aims to evaluate primary school Life Sciences (1st, 2nd, and 3rd grades) and Social Sciences (4th, 5th, and 6th grades) course books in terms of gender discrimination. This study is a descriptive study aiming to evaluate the primary school Life Sciences (1st, 2nd, 3rd grades) and Social Sciences (4th, 5th, and 6th grades) course books…

Impact of the Leading an Empowered Organisation programme.

PubMed

Hancock, Helen; Campbell, Steve

To evaluate the impact of the Leading an Empowered Organisation (LEO) programme on the role of grade G nurses and their multidisciplinary colleagues in one NHS trust. The LEO programme encourages and promotes leadership skills among NHS staff. A purposive sample of four grade G nurses, one from each of the hospital's four clinical divisions, was included. Each grade G nurse, and his or her matron, nominated eight colleagues for interview. The final sample comprised four grade G nurses and 32 of their colleagues. Data were analysed using the principles of thematic analysis described by Attride-Stirling (2001). The LEO programme improved the grade G nurses' approach to their work in relation to competence, communication strategies, problem solving, risk taking, leadership and management style. Factors that affected the grade G nurses' implementation of the LEO principles included: relationships, personality, experience, work context, staffing levels, autonomy and authority. This study provided insight into how the grade G nurses applied the principles of the LEO programme in their daily work. Their ability to apply the LEO principles was both restricted and assisted by the culture in which they worked. A partnership between theory and practice is needed. This finding has implications for the LEO programme and the need for it to be implicit in the local working philosophy, that is, the context in which its principles are to be used. This is so that the working context and people within it are intimately engaged with the individual undertaking the course.

Validity and reliability of three definitions of hip osteoarthritis: cross sectional and longitudinal approach.

PubMed

Reijman, M; Hazes, J M W; Pols, H A P; Bernsen, R M D; Koes, B W; Bierma-Zeinstra, S M A

2004-11-01

To compare the reliability and validity in a large open population of three frequently used radiological definitions of hip osteoarthritis (OA): Kellgren and Lawrence grade, minimal joint space (MJS), and Croft grade; and to investigate whether the validity of the three definitions of hip OA is sex dependent. from the Rotterdam study (aged > or= 55 years, n = 3585) were evaluated. The inter-rater reliability was tested in a random set of 148 x rays. The validity was expressed as the ability to identify patients who show clinical symptoms of hip OA (construct validity) and as the ability to predict total hip replacement (THR) at follow up (predictive validity). Inter-rater reliability was similar for the Kellgren and Lawrence grade and MJS (kappa statistics 0.68 and 0.62, respectively) but lower for Croft's grade (kappa statistic, 0.51). The Kellgren and Lawrence grade and MJS showed the strongest associations with clinical symptoms of hip OA. Sex appeared to be an effect modifier for Kellgren and Lawrence and MJS definitions, women showing a stronger association between grading and symptoms than men. However, the sex dependency was attributed to differences in height between women and men. The Kellgren and Lawrence grade showed the highest predictive value for THR at follow up. Based on these findings, Kellgren and Lawrence still appears to be a useful OA definition for epidemiological studies focusing on the presence of hip OA.

The Correlation Between Aqueous Humor Flow and IOP Before and After Trabectome: Developing a Grading System to Quantify Flow.

PubMed

Ueda, Toshihiko; Suzumura, Hirotaka; Johnstone, Murray; Uda, Shigekazu; Yoshida, Kazuhide

2018-06-01

To develop a grading system that provides objective quantification of flow through the conventional aqueous humor outflow (AHO) system. The technique gives clinicians an additional assessment option in the evaluation of glaucoma treatment approaches. This was a retrospective observational study. This study evaluated the eyes of all primary open-angle glaucoma patients who underwent a Trabectome (NeoMedix Corp., Tustin, CA, USA) procedure with or without cataract surgery in the interval between April and September 2016 (n = 73). The nasal hemisphere was divided into three regions. Utilizing a four-level grading system designed for this study, an aqueous humor outflow grade (G0-G3) was assigned to each region using a video taken during examinations. The individual grade levels of the three regions were combined to get a composite AHO score. The correlation between the composite AHO score and intraocular pressure (IOP) was then analyzed. Additionally, the speed of red blood cell (RBC) clusters in the episcleral veins (ESV) was calculated when made possible by the existence of pulsatile flow. At 3 months following the Trabectome procedure, average IOP decreased from 26 to 15 mmHg. Assessment of the relationship between AHO grade and IOP demonstrated that a high composite AHO score was correlated with lowered IOP (Tukey-Kramer method p < 0.05). Additionally, it was found that if one of the three regions had an AHO grade of ≥ G2, an IOP of < 20 mmHg could be predicted. (Fischer's exact test p < 0.0001). Calculated speed was as follows: at G1, the speed was 0.68 ± 0.26 mm/s (n = 7), at G2, the speed was 1.8 ± 0.84 mm/s (n = 5), and at G3, the speed was 6.8 ± 3.3 mm/s (n = 6). There was a significant correlation between an increase in the composite AHO score and a decrease in IOP. Additionally, the speed of RBC clusters as they traveled through the ESVs remained consistent for each of the grades, and the span of the speeds from lower to higher grades represented a significant range. These findings suggest that the grading system is a reliable measure of AHO. UMIN 000031745.

Promoting Fitness and Safety in Elementary Students: A Randomized Control Study of the Michigan Model for Health.

PubMed

O'Neill, James M; Clark, Jeffrey K; Jones, James A

2016-07-01

In elementary grades, comprehensive health education curricula have demonstrated effectiveness in addressing singular health issues. The Michigan Model for Health (MMH) was implemented and evaluated to determine its impact on nutrition, physical fitness, and safety knowledge and skills. Schools (N = 52) were randomly assigned to intervention and control conditions. Participants received MMH with 24 lessons in grade 4 and 28 more lessons in grade 5 including material focusing on nutrition, physical fitness, and safety attitudes and skills. The 40-minute lessons were taught by the classroom teacher who received curriculum training and provided feedback on implementation fidelity. Self-report survey data were collected from the fourth-grade students (N = 1983) prior to the intervention, immediately after the intervention, and 6 weeks after the intervention, with the same data collection schedule repeated in fifth grade. Analysis of the scales was conducted using a mixed-model approach. Students who received the curriculum had better nutrition, physical activity, and safety skills than the control-group students. Intervention students also reported higher consumption of fruits; however, no difference was reported for other types of food consumption. The effectiveness of the MMH in promoting fitness and safety supports the call for integrated strategies that begin in elementary grades, target multiple risk behaviors, and result in practical and financial benefits to schools. © 2016, American School Health Association.

Flow and compaction properties of hypromellose: new directly compressible versus the established grades.

PubMed

Grdešič, Peter; Vrečer, Franc; Ilić, Ilija

2016-11-01

Information about flow and compaction properties of hypromellose (HPMC) polymers is essential for the technologists who are facing challenges regarding poor flow and compaction while developing new controlled release matrix tablets. There is a profound lack of studies in this field and none of the published ones deal with the compaction of the newly introduced HPMC grades specifically designed for direct compression (DC). The objective behind this study was the evaluation of flow and compaction properties of six different grades of HPMC substitution type 2208 polymers, including two second generation directly compressible grades from Dow Chemical Company (K100LV, K15M, K4M CR, K4M DC, K100M CR and K100M DC). Flow properties were determined using flow time and Carr index. Compaction properties were quantified using "out-of-die" Heckel and modified Walker models as well as tensile strength profile and elastic recovery. We used statistical approach to analyze the results. Due to larger, rounder and smoother particles both DC grades showed distinctly better flow properties compared to their non-DC counterparts. Overall, K15M showed the best compaction properties, closely followed by K100LV. K100M grades showed superior compaction properties over K4M grades. The new, second generation DC grades had poorer compaction properties, however, they exhibited better flow properties on the other hand. Considering all compaction results, the Heckel model gave better description of compressibility compared to the Walker model, so it may be preferred in case of studying HPMC polymers and other similar materials.

Conducting Molecular Epidemiological Research in the Age of HIPAA: A Multi-Institutional Case-Control Study of Breast Cancer in African-American and European-American Women

PubMed Central

Ambrosone, Christine B.; Ciupak, Gregory L.; Bandera, Elisa V.; Jandorf, Lina; Bovbjerg, Dana H.; Zirpoli, Gary; Pawlish, Karen; Godbold, James; Furberg, Helena; Fatone, Anne; Valdimarsdottir, Heiddis; Yao, Song; Li, Yulin; Hwang, Helena; Davis, Warren; Roberts, Michelle; Sucheston, Lara; Demissie, Kitaw; Amend, Kandace L.; Tartter, Paul; Reilly, James; Pace, Benjamin W.; Rohan, Thomas; Sparano, Joseph; Raptis, George; Castaldi, Maria; Estabrook, Alison; Feldman, Sheldon; Weltz, Christina; Kemeny, Margaret

2009-01-01

Breast cancer in African-American (AA) women occurs at an earlier age than in European-American (EA) women and is more likely to have aggressive features associated with poorer prognosis, such as high-grade and negative estrogen receptor (ER) status. The mechanisms underlying these differences are unknown. To address this, we conducted a case-control study to evaluate risk factors for high-grade ER- disease in both AA and EA women. With the onset of the Health Insurance Portability and Accountability Act of 1996, creative measures were needed to adapt case ascertainment and contact procedures to this new environment of patient privacy. In this paper, we report on our approach to establishing a multicenter study of breast cancer in New York and New Jersey, provide preliminary distributions of demographic and pathologic characteristics among case and control participants by race, and contrast participation rates by approaches to case ascertainment, with discussion of strengths and weaknesses. PMID:19865486

IMPACT: Imaging and Molecular Markers for Patients with Lung Cancer: Approaches with Molecular Targets, Complementary/Innovative Treatments, and Therapeutic Modalities

DTIC Science & Technology

2016-04-01

Hypomagnesemia, Grade 3 in 1 patient • Hypokalemia, Grade 3 in 2 patient • Pneumonia , Grade 3 in 7 patients • Dehydration, Grade 3 in 3 patients. Once...improvements on lab- scale radiosynthesis (Fig. 9) so that it is readily scaled up and adopted by the cGMP manufacturing. We are working on an automated...reproducibly building at the nanometer scale , including the need for streamlined and “bottom-up” approaches for assembling nanoparticle architectures, the

Treatment of Grade II and III Actinic Keratosis Lesions with a Film-Forming Medical Device Containing Sunscreen/Piroxicam 0.8% and a Retinoic Acid/Glycolic Gel: A Pilot Trial.

PubMed

Puviani, Mario; Milani, Massimo

2018-05-31

Lesion and field-targeted treatments of actinic keratosis (AK) are commonly indicated for grade I and II type lesions. Grade III lesions are in general more difficult to treat. A film-forming medical device containing piroxicam 0.8% and sunscreen (SPF 50+) (PS) has been shown to be effective in the treatment of grade I and II AK lesions. Topical and oral retinoids have been utilized in AK and non-melanoma skin cancers. Topical glycolic acid promotes keratolysis and stimulates collagen synthesis for repair and skin rejuvenation and could be useful in AK treatment strategies. A gel containing retinoid acid (0.02%) and glycolic acid (4%) (RC) is commercially available. The objective of the study was to evaluate the efficacy and local tolerability of a combined treatment approach with PS and RC in subjects with multiple grade II and III AK lesions. Twenty-two subjects (16 males and 6 females; mean age 68 years) with more than five AK lesions were enrolled after obtaining their informed consent in a 3-month trial. PS cream was applied twice daily every day and RC gel was applied twice daily for 2 consecutive days every week. The primary endpoint was the evolution of the AK mean number from baseline to the end of the trial. Secondary endpoints were the thickness of the target lesion (expressed in mm 3 ) and the erythema score (hemoglobin content), evaluated using a standardized computer-based image acquisition analysis system (Anthera 3D). At baseline, the mean (SD) lesion number was 7.7 (3) for grade II and 1.4 (1) for grade III AK. At the end of the study, a significant (P = 0.001) reduction was observed for both grade II (- 81%; from 7.7 to 1.5) and grade III (- 22%) lesions. Six grade III lesions out of 31 (20%), presented at baseline, completely disappeared at month 3. For grade III lesions, a significant mean thickness reduction of 51% was observed at month 3. The erythema score (all lesions) was reduced by 70%. Four patients out of 22 (18%) were completely free of AK lesions at month 3. No severe side effects were reported. In this exploratory trial, a combined treatment with a cream containing piroxicam and sunscreen and a retinoic/glycolic gel was associated with a substantial reduction of both grade II and III AK lesions with good local tolerability. Cantabria Labs Difa Cooper.

When performance-approach goals predict academic achievement and when they do not: a social value approach.

PubMed

Dompnier, Benoît; Darnon, Céline; Butera, Fabrizio

2013-09-01

Research on achievement goal promotion at University has shown that performance-approach goals are perceived as a means to succeed at University (high social utility) but are not appreciated (low social desirability). We argue that such a paradox could explain why research has detected that performance-approach goals consistently predict academic grades. First-year psychology students answered a performance-approach goal scale with standard, social desirability and social utility instructions. Participants' grades were recorded at the end of the semester. Results showed that the relationship between performance-approach goals and grades was inhibited by the increase of these goals' social desirability and facilitated by the increase of their social utility, revealing that the predictive validity of performance-approach goals depends on social value. © 2013 The British Psychological Society.

Peer tutoring pilot program for the improvement of oral health behavior in underprivileged and immigrant children.

PubMed

Reinhardt, Claus H; Löpker, Nadine; Noack, Michael J; Klein, Klaus; Rosen, Evelyne

2009-01-01

Caries prevalence in underprivileged children is particularly high and, even though many efforts have been made, adherence to dental preventive programs is low. The purpose of this study was to evaluate whether a tutoring program can improve oral health behavior in underprivileged and/or immigrant children. Thirty fourth-grade children (mean age = 9.6), over 50 percent of immigrant background, participated in this longitudinal pilot study. The fourth graders were invited to develop on oral health program for their first-grade peers. For this purpose, the fourth graders learned oral health practices and developed the peer tutoring program. Prior to the intervention and after having instructed their first-grade peers, all fourth graders were interviewed about their oral health habits and their tooth-brushing was recorded on video. Toothbrushing time, performance of circular tooth-brushing movements, and systematic cleaning of all dental surfaces were analyzed before and after the intervention. After peer teaching, there was a significant increase concerning tooth-brushing time (P = .004), performance of circular tooth-brushing movements (P < .001), and systematic cleaning of all dental surfaces (P < .001). The tutoring program yielded a significant improvement in relevant oral care behavior. This approach provided an environment which, in contrast to traditional approaches, facilitates empowerment.

Machine learning: a useful radiological adjunct in determination of a newly diagnosed glioma's grade and IDH status.

PubMed

De Looze, Céline; Beausang, Alan; Cryan, Jane; Loftus, Teresa; Buckley, Patrick G; Farrell, Michael; Looby, Seamus; Reilly, Richard; Brett, Francesca; Kearney, Hugh

2018-05-16

Machine learning methods have been introduced as a computer aided diagnostic tool, with applications to glioma characterisation on MRI. Such an algorithmic approach may provide a useful adjunct for a rapid and accurate diagnosis of a glioma. The aim of this study is to devise a machine learning algorithm that may be used by radiologists in routine practice to aid diagnosis of both: WHO grade and IDH mutation status in de novo gliomas. To evaluate the status quo, we interrogated the accuracy of neuroradiology reports in relation to WHO grade: grade II 96.49% (95% confidence intervals [CI] 0.88, 0.99); III 36.51% (95% CI 0.24, 0.50); IV 72.9% (95% CI 0.67, 0.78). We derived five MRI parameters from the same diagnostic brain scans, in under two minutes per case, and then supplied these data to a random forest algorithm. Machine learning resulted in a high level of accuracy in prediction of tumour grade: grade II/III; area under the receiver operating characteristic curve (AUC) = 98%, sensitivity = 0.82, specificity = 0.94; grade II/IV; AUC = 100%, sensitivity = 1.0, specificity = 1.0; grade III/IV; AUC = 97%, sensitivity = 0.83, specificity = 0.97. Furthermore, machine learning also facilitated the discrimination of IDH status: AUC of 88%, sensitivity = 0.81, specificity = 0.77. These data demonstrate the ability of machine learning to accurately classify diffuse gliomas by both WHO grade and IDH status from routine MRI alone-without significant image processing, which may facilitate usage as a diagnostic adjunct in clinical practice.

Morbidity Assessment in Surgery: Refinement Proposal Based on a Concept of Perioperative Adverse Events

PubMed Central

Kazaryan, Airazat M.; Røsok, Bård I.; Edwin, Bjørn

2013-01-01

Background. Morbidity is a cornerstone assessing surgical treatment; nevertheless surgeons have not reached extensive consensus on this problem. Methods and Findings. Clavien, Dindo, and Strasberg with coauthors (1992, 2004, 2009, and 2010) made significant efforts to the standardization of surgical morbidity (Clavien-Dindo-Strasberg classification, last revision, the Accordion classification). However, this classification includes only postoperative complications and has two principal shortcomings: disregard of intraoperative events and confusing terminology. Postoperative events have a major impact on patient well-being. However, intraoperative events should also be recorded and reported even if they do not evidently affect the patient's postoperative well-being. The term surgical complication applied in the Clavien-Dindo-Strasberg classification may be regarded as an incident resulting in a complication caused by technical failure of surgery, in contrast to the so-called medical complications. Therefore, the term surgical complication contributes to misinterpretation of perioperative morbidity. The term perioperative adverse events comprising both intraoperative unfavourable incidents and postoperative complications could be regarded as better alternative. In 2005, Satava suggested a simple grading to evaluate intraoperative surgical errors. Based on that approach, we have elaborated a 3-grade classification of intraoperative incidents so that it can be used to grade intraoperative events of any type of surgery. Refinements have been made to the Accordion classification of postoperative complications. Interpretation. The proposed systematization of perioperative adverse events utilizing the combined application of two appraisal tools, that is, the elaborated classification of intraoperative incidents on the basis of the Satava approach to surgical error evaluation together with the modified Accordion classification of postoperative complication, appears to be an effective tool for comprehensive assessment of surgical outcomes. This concept was validated in regard to various surgical procedures. Broad implementation of this approach will promote the development of surgical science and practice. PMID:23762627

Evaluation of different grades of ginseng using Fourier-transform infrared and two-dimensional infrared correlation spectroscopy

NASA Astrophysics Data System (ADS)

Zhang, Yan-ling; Chen, Jian-bo; Lei, Yu; Zhou, Qun; Sun, Su-qin; Noda, Isao

2010-06-01

Ginseng is one of the most widely used herbal medicines which have many kinds of pharmaceutical values. The discrimination of grades of ginseng includes the cultivation types and the growth years herein. To evaluate the different grades of ginseng, the fibrous roots and rhizome roots of ginseng were analyzed by Fourier-transform infrared and two-dimensional infrared correlation spectroscopy in this paper. The fibrous root and rhizome root of ginseng have different content of starch, calcium oxalate and other components. For the fibrous roots of ginseng, mountain cultivation ginseng (MCG), garden cultivation ginseng (GCG) and transplanted cultivation ginseng (TCG) have clear difference in the infrared spectra and second derivative spectra in the range of 1800-400 cm -1, and clearer difference was observed in the range of 1045-1160 and 1410-1730 cm -1 in 2D synchronous correlation spectra. Three kinds of ginseng can be clustered very well by using SIMCA analysis on the basis of PCA as well. For the rhizome roots, the content of calcium oxalate and starch change with growth years in the IR spectra, and some useful procedure can be obtained by the analysis of 2D IR synchronous spectra in the range of 1050-1415 cm -1. Also, ginsengs cultivated in different growth years were clustered perfectly by using SIMCA analysis. The results suggested that different grades of ginseng can be well recognized using the mid-infrared spectroscopy assisted by 2D IR correlation spectroscopy, which provide the macro-fingerprint characteristics of ginseng in different parts and supplied a rapid, effective approach for the evaluation of the quality of ginseng.

Ventilation rate in adults with a tracheal tube during cardiopulmonary resuscitation: A systematic review.

PubMed

Vissers, Gino; Soar, Jasmeet; Monsieurs, Koenraad G

2017-10-01

The optimal ventilation rate during cardiopulmonary resuscitation (CPR) with a tracheal tube is unknown. We evaluated whether in adults with cardiac arrest and a secure airway (tracheal tube), a ventilation rate of 10min -1 , compared to any other rate during CPR, improves outcomes. A systematic review up to 14 July 2016. We included both adult human and animal studies. A GRADE (Grades of Recommendation, Assessment, Development and Evaluation) approach was used to evaluate the quality of evidence for each outcome. We identified one human observational study with 67 patients and ten animal studies (234 pigs and 30 dogs). All studies carried a high risk of bias. All studies evaluated for return of spontaneous circulation (ROSC). Studies showed no improvement in ROSC with a ventilation rate of 10 min-1 compared to any other rate. The evidence for longer-term outcomes such as survival to discharge and survival with favourable neurological outcome was very limited. A ventilation rate recommendation of 10 min-1 during adult CPR with a tracheal tube and no pauses for chest compression is a very weak recommendation based on very low quality evidence. Copyright © 2017 Elsevier B.V. All rights reserved.

Sprint mechanics return to competition follow-up after hamstring injury on a professional soccer player: A case study with an inertial sensor unit based methodological approach.

PubMed

Setuain, Igor; Lecumberri, Pablo; Izquierdo, Mikel

2017-10-03

The present research aimed to describe an inertial unit (IU)-based sprint mechanics evaluation model for assessing players' readiness to return to competition after suffering a grade I hamstring injury. A professional male football player (age 19years; height 177cm; weight 70kg, midfielder, Spanish, 3° Division) with a grade 1 biceps femoris injury was evaluated at pre-season, at return to play after injury and at the end of the competitive season. Sprint mechanics were analyzed via the use of an inertial orientation tracker (Xsens Technologies B.V. Enschede, Netherlands) attached over the L3-L4 region of the subject's lumbar spine. Sprint mechanics such as horizontal components of ground reaction force were assessed in both legs during sprinting actions. Findings and interpretation: Both the coefficient of the horizontal force application (SFV) and the ratio of forces (DRF) applied at increasing velocity were decreased in the injured limb compared with the contralateral healthy limb at the return to play evaluation (73% and 76% reductions, respectively) and returned to symmetrical levels at the end-season evaluation. Copyright © 2017 Elsevier Ltd. All rights reserved.

Applying GRADE-CERQual to qualitative evidence synthesis findings-paper 7: understanding the potential impacts of dissemination bias.

PubMed

Booth, Andrew; Lewin, Simon; Glenton, Claire; Munthe-Kaas, Heather; Toews, Ingrid; Noyes, Jane; Rashidian, Arash; Berg, Rigmor C; Nyakang'o, Brenda; Meerpohl, Joerg J

2018-01-25

The GRADE-CERQual (Confidence in Evidence from Reviews of Qualitative research) approach has been developed by the GRADE (Grading of Recommendations Assessment, Development and Evaluation) Working Group. The approach has been developed to support the use of findings from qualitative evidence syntheses in decision-making, including guideline development and policy formulation. CERQual includes four components for assessing how much confidence to place in findings from reviews of qualitative research (also referred to as qualitative evidence syntheses): (1) methodological limitations, (2) coherence, (3) adequacy of data and (4) relevance. This paper is part of a series providing guidance on how to apply CERQual and focuses on a probable fifth component, dissemination bias. Given its exploratory nature, we are not yet able to provide guidance on applying this potential component of the CERQual approach. Instead, we focus on how dissemination bias might be conceptualised in the context of qualitative research and the potential impact dissemination bias might have on an overall assessment of confidence in a review finding. We also set out a proposed research agenda in this area. We developed this paper by gathering feedback from relevant research communities, searching MEDLINE and Web of Science to identify and characterise the existing literature discussing or assessing dissemination bias in qualitative research and its wider implications, developing consensus through project group meetings, and conducting an online survey of the extent, awareness and perceptions of dissemination bias in qualitative research. We have defined dissemination bias in qualitative research as a systematic distortion of the phenomenon of interest due to selective dissemination of studies or individual study findings. Dissemination bias is important for qualitative evidence syntheses as the selective dissemination of qualitative studies and/or study findings may distort our understanding of the phenomena that these syntheses aim to explore and thereby undermine our confidence in these findings. Dissemination bias has been extensively examined in the context of randomised controlled trials and systematic reviews of such studies. The effects of potential dissemination bias are formally considered, as publication bias, within the GRADE approach. However, the issue has received almost no attention in the context of qualitative research. Because of very limited understanding of dissemination bias and its potential impact on review findings in the context of qualitative evidence syntheses, this component is currently not included in the GRADE-CERQual approach. Further research is needed to establish the extent and impacts of dissemination bias in qualitative research and the extent to which dissemination bias needs to be taken into account when we assess how much confidence we have in findings from qualitative evidence syntheses.

Nondestructive evaluation of nuclear-grade graphite

NASA Astrophysics Data System (ADS)

Kunerth, D. C.; McJunkin, T. R.

2012-05-01

The material of choice for the core of the high-temperature gas-cooled reactors being developed by the U.S. Department of Energy's Next Generation Nuclear Plant Program is graphite. Graphite is a composite material whose properties are highly dependent on the base material and manufacturing methods. In addition to the material variations intrinsic to the manufacturing process, graphite will also undergo changes in material properties resulting from radiation damage and possible oxidation within the reactor. Idaho National Laboratory is presently evaluating the viability of conventional nondestructive evaluation techniques to characterize the material variations inherent to manufacturing and in-service degradation. Approaches of interest include x-ray radiography, eddy currents, and ultrasonics.

A Study of the Correlation of the Improvement of Teaching Evaluation Scores Based on Student Performance Grades

ERIC Educational Resources Information Center

Chen, Chi Yuan; Wang, Shu-Yin; Yang, Yi-Fang

2017-01-01

The purpose of the study is to explore the influence of teaching evaluations on teachers in that they might try to please their students by giving higher grades in order to get higher teaching evaluation scores. To achieve this purpose, the study analyzed the correlations between teaching evaluation scores, student's final grades and course fail…

[Early recurrent miscarriage: Evaluation and management].

PubMed

Gallot, V; Nedellec, S; Capmas, P; Legendre, G; Lejeune-Saada, V; Subtil, D; Nizard, J; Levêque, J; Deffieux, X; Hervé, B; Vialard, F

2014-12-01

To establish recommendations for early recurrent miscarriages (≥3 miscarriages before 14weeks of amenorrhea). Literature review, establishing levels of evidence and recommendations for grades of clinical practice. Women evaluation includes the search for a diabetes (grade A), an antiphospholipid syndrome (APS) (grade A), a thyroid dysfunction (grade A), a hyperprolactinemia (grade B), a vitamin deficiency and a hyperhomocysteinemia (grade C), a uterine abnormality (grade C), an altered ovarian reserve (grade C), and a couple chromosome analysis (grade A). For unexplained early recurrent miscarriages, treatment includes folic acid and progesterone supplementation, and a reinsurance policy in the first quarter (grade C). It is recommended to prescribe the combination of aspirin and low-molecular-weight heparin when APS (grade A), glycemic control in diabetes (grade A), L-Thyroxine in case of hypothyroidism (grade A) or the presence of thyroid antibodies (grade B), bromocriptine if hyperprolactinemia (grade B), a substitution for vitamin deficiency or hyperhomocysteinemia (grade C), sectionning a uterine septum (grade C) and treating an uterine acquired abnormality (grade C). These recommendations should improve the management of couples faced with early recurrent miscarriages. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Contemporary evaluation and management of renal trauma.

PubMed

Chouhan, Jyoti D; Winer, Andrew G; Johnson, Christina; Weiss, Jeffrey P; Hyacinthe, Llewellyn M

2016-04-01

Renal trauma occurs in approximately 1%-5% of all trauma cases. Improvements in imaging and management over the last two decades have caused a shift in the treatment of this clinical condition. A systematic search of PubMed was performed to identify relevant and contemporary articles that referred to the management and evaluation of renal trauma. Computed tomography remains a mainstay of radiological evaluation in hemodynamically stable patients. There is a growing body of literature showing that conservative, non-operative management of renal trauma is safe, even for Grade IV-V renal injuries. If surgical exploration is planned due to other injuries, a conservative approach to the kidney can often be utilized. Follow up imaging may be warranted in certain circumstances. Urinoma, delayed bleeding, and hypertension are complications that require follow up. Appropriate imaging and conservative approaches are a mainstay of current renal trauma management.

Tissue Oxygenation Monitoring using Resonance Raman Spectroscopy during Hemorrhage

DTIC Science & Technology

2013-12-27

saturation measurements using resonance Raman intravital micros- copy. Am J Physiol Heart Circ Physiol. 2005;289:H488 H495. 14. Ward KR, Ivatury RR, Barbee...Nighswander-Rempel SP, Kupriyanov VV, Shaw RA. Relative contribu- tions of hemoglobin and myoglobin to near-infrared spectroscopic images of cardiac tissue...DC, Shapiro NI. The microcirculation image quality score: development and preliminary evaluation of a proposed approach to grading quality of image

Does an Evidence-Based Healthy Relationships Program for 9th Graders Show Similar Effects for 7th and 8th Graders? Results from 57 Schools Randomized to Intervention

ERIC Educational Resources Information Center

Crooks, C. V.; Scott, K. L.; Broll, R.; Zwarych, S.; Hughes, R.; Wolfe, D. A.

2015-01-01

Integrating social and emotional learning (SEL) programming throughout curricula to support the development of healthy behaviors and prevent violence is critical for a comprehensive approach to school health. This study used a post-test comparison design to evaluate a healthy relationships program for eighth grade students that applies a SEL…

An Evaluation of Grades 9 and 10 Mathematics Textbooks vis-a-vis Fostering Problem Solving Skills

ERIC Educational Resources Information Center

Buishaw, Alemayehu; Ayalew, Assaye

2013-01-01

This study sought to evaluate the adequacy of integration of problematic situations and general problem-solving strategies (heuristics) in grades 9 and 10 mathematics textbooks. Grade 9 and grade 10 mathematics textbooks were used for analysis. Document analysis and interview were used as data gathering instruments. Document analysis was carried…

Transection of Nasolacrimal Duct in Endoscopic Medial Maxillectomy: Implication on Epiphora.

PubMed

Imre, Abdulkadir; Imre, Seher Saritepe; Pinar, Ercan; Ozkul, Yilmaz; Songu, Murat; Ece, Ahmet Ata; Aladag, Ibrahim

2015-10-01

Management of the nasolacrimal system is usually recommended during medial maxillectomy via external approach because of reported higher rates of postoperative epiphora. Association of the endoscopic medial maxillectomy (EMM) with epiphora, however, is not clearly stated. In this study, we attempted to evaluate whether patients develop epiphora after simple transection of the nasolacrimal duct during EMM. Medical records of 26 patients who underwent endoscopic tumor resection for inverted papilloma (IP) were retrospectively reviewed. Patients who underwent EMM with nasolacrimal canal transection were included and recalled for lacrimal system evaluation. Twelve patients were eligible for inclusion and fluorescein dye disappearance test (FDDT) was performed for each patient. Patient demographics, tumor data, surgical procedures, and follow-up time were recorded. Of the 12 patients included in the study, 6 underwent canine fossa transantral approach concurrently with EMM. The mean duration of follow-up was 21.1 months (range, 6-84 months). Eight patients were graded as 0, whereas 4 patients were graded as 1 according to FDDT. All test results were interpreted as negative for epiphora. All patients were completely symptom free of epiphora. Epiphora after EMM with nasolacrimal canal transection among patients with sinonasal tumors appears to be uncommon. Therefore, prophylactic concurrent management of nasolacrimal system including stenting, dacryocystorhinostomy (DCR), or postoperative lacrimal lavage are not mandatory for all patients.

A multicenter, phase II study of bortezomib (PS-341) in patients with unresectable or metastatic gastric and gastroesophageal junction adenocarcinoma.

PubMed

Shah, Manish A; Power, Derek G; Kindler, Hedy L; Holen, Kyle D; Kemeny, Margaret M; Ilson, David H; Tang, Laura; Capanu, Marinela; Wright, John J; Kelsen, David P

2011-12-01

The transcription factor nuclear factor-kB (NFkB) is implicated in gastric cancer carcinogenesis and survival, and its inhibition by proteosome inhibition is associated with preclinical gastric cancer anti-tumor activity. We examined the single agent efficacy of bortezomib, a selective proteasome inhibitor, in gastric adenocarcinoma. We performed a phase II trial of bortezomib in patients with advanced gastric adenocarcinoma. Bortezomib 1.3 mg/m(2) was administered on days 1, 4, 8, and 11 every 21 days. The primary endpoint was objective response rate(RR); the null hypothesis was RR <1% versus the alternative ≥15%. One response in the first stage(15 patients) was required before proceeding with an additional 18 patients. If at least 2 or more responses out of 33 were observed, further study with bortezomib was warranted. Correlative studies evaluated pre-treatment tumor expression of NFkB, IkB, p53, p21, and cyclin D1. We enrolled 16 patients (15 evaluable for response) from four institutions. No patients demonstrated an objective response(95% CI, 0-22%); one patient achieved stable disease. Fourteen out of 16 patients experienced ≥ grade 2 toxicity. The most common toxicity was fatigue in six patients (n = 4 grade 2, n = 2 grade 3). Seven patients experienced neuropathy (n = 5 grade 1, and 1 each grade 2 and 3). Seven (60%) had high cytoplasmic staining for NFkB. Single agent bortezomib is inactive in metastatic gastric adenocarcinoma and should not be pursued. Future study of proteasome inhibition in gastric adenocarcinoma should be considered in combination with targeted inhibition of other non-overlapping oncogenic pathways as a potential rational approach.

Promoting energy-balance behaviors among ethnically diverse adolescents: overview and baseline findings of The Central Texas CATCH Middle School Project.

PubMed

Springer, Andrew E; Kelder, Steven H; Byrd-Williams, Courtney E; Pasch, Keryn E; Ranjit, Nalini; Delk, Joanne E; Hoelscher, Deanna M

2013-10-01

The Central Texas Coordinated Approach To Child Health (CATCH) Middle School Project is a 3.5-year school-based project aimed at promoting physical activity (PA), healthy eating, and obesity prevention among public middle school students in Texas. This article describes the CATCH intervention model and presents baseline findings from spring 2009. CATCH comprises six core components: CATCH Team, CATCH PE, CATCH Classroom, CATCH Eat Smart Cafeteria, CATCH Family, and CATCH Social Marketing. A group randomized serial cross-sectional design is being employed to test the effect of three program support conditions (n = 10 schools each) on energy-balance behaviors: Basic (training and curriculum only), Basic Plus (training and curriculum plus CATCH facilitator support), and Basic Plus Social Marketing (all inputs plus social marketing component). The study sample is composed of a cross-sectional sample of eighth-grade students (primary outcome evaluation sample) and sixth- and seventh-grade students (PE process evaluation sample) who are selected and measured each year. At baseline, 37.9% of eight-grade students (n = 2,841; 13.9 years) were overweight/obese and 19.2% were obese. Eighth-grade students reported, on average, consuming sugar-sweetened beverages more than two times on the previous day and fruits and vegetables roughly three times on the previous day; only two of five school districts surpassed the recommended 50% cut-point for class time spent in moderate-and-vigorous PA as measured in classes of sixth- and seventh-grade students. Additional behavioral findings are reported. Body mass index and behaviors were comparable across conditions. Baseline findings underscore the need to promote student energy-balance behaviors.

Evaluating and Reporting Dysphagia in Trials of Chemoirradiation for Head-and-Neck Cancer

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

Gluck, Iris; Feng, Felix Y.; Lyden, Teresa

2010-07-01

Purpose: Reporting long-term toxicities in trials of chemoirradiation (CRT) of head-and-neck cancer (HNC) has mostly been limited to observer-rated maximal Grades {>=}3. We evaluated this reporting approach for dysphagia by assessing patient-reported dysphagia (PRD) and objective swallowing dysfunction through videofluoroscopy (VF) in patients with various grades of maximal observer-reported dysphagia (ORD). Methods and Materials: A total of 62 HNC patients completed quality-of-life questionnaires periodically through 12 months post-CRT. Five PRD items were selected: three dysphagia-specific questions, an Eating-Domain, and 'Overall Bother.' They underwent VF at 3 and 12 months, and ORD (Common Terminology Criteria for Adverse Events) scoring every 2more » months. We classified patients into four groups (0-3) according to maximal ORD scores documented 3-12 months post-CRT, and assessed PRD and VF summary scores in each group. Results: Differences in ORD scores among the groups were considerable throughout the observation period. In contrast, PRD scores were similar between Groups 2 and 3, and variable in Group 1. VF scores were worse in Group 3 compared with 2 at 3 months but similar at 12 months. In Group 1, PRD and VF scores from 3 through 12 months were close to Groups 2 and 3 if ORD score 1 persisted, but were similar to Group 0 in patients whose ORD scores improved by 12 months. Conclusions: Patients with lower maximal ORD grades, especially if persistent, had similar rates of PRD and objective dysphagia as patients with highest grades. Lower ORD grades should therefore be reported. These findings may have implications for reporting additional toxicities besides dysphagia.« less

A Holistic Approach to Grading.

ERIC Educational Resources Information Center

Schullery, Nancy M.

2003-01-01

Adopts a holistic approach to grading, using seven foundation concepts that are essential to every business communication, regardless of genre. Argues that such assignments more clearly simulate the response of supervisors, clients, customers, and other readers in the business world. (SG)

Using Qualitative Research to Inform Development of Professional Guidelines: A Case Study of the Society of Critical Care Medicine Family-Centered Care Guidelines.

PubMed

Coombs, Maureen A; Davidson, Judy E; Nunnally, Mark E; Wickline, Mary A; Curtis, J Randall

2017-08-01

To explore the importance, challenges, and opportunities using qualitative research to enhance development of clinical practice guidelines, using recent guidelines for family-centered care in the ICU as an example. In developing the Society of Critical Care Medicine guidelines for family-centered care in the neonatal ICU, PICU, and adult ICU, we developed an innovative adaptation of the Grading of Recommendations, Assessments, Development and Evaluations approach to explicitly incorporate qualitative research. Using Grading of Recommendations, Assessments, Development and Evaluations and the Council of Medical Specialty Societies principles, we conducted a systematic review of qualitative research to establish family-centered domains and outcomes. Thematic analyses were undertaken on study findings and used to support Population, Intervention, Comparison, Outcome question development. We identified and employed three approaches using qualitative research in these guidelines. First, previously published qualitative research was used to identify important domains for the Population, Intervention, Comparison, Outcome questions. Second, this qualitative research was used to identify and prioritize key outcomes to be evaluated. Finally, we used qualitative methods, member checking with patients and families, to validate the process and outcome of the guideline development. In this, a novel report, we provide direction for standardizing the use of qualitative evidence in future guidelines. Recommendations are made to incorporate qualitative literature review and appraisal, include qualitative methodologists in guideline taskforce teams, and develop training for evaluation of qualitative research into guideline development procedures. Effective methods of involving patients and families as members of guideline development represent opportunities for future work.

[Clinical studies of pedicle screw-rod fixation of thoracolumbar burst fractures through posterior unilateral approach after vertebrae corpectomy fusion].

PubMed

Hua, Yong-jun; Wang, Ren-yan; Guo, Zhi-hui; Shu, Cun-hong; Li, Chao-hua

2016-01-01

To compare the clinical curative effect of thoracolumbar burst fracture treated by the posterior unilateral approach corpectomy fusion screw-rod fixation and anterior corpectomy bone fusion screw plate fixation. From January 2008 to May 2014,36 cases of thoracolumbar burst fracture underwent operation of decompression, fusion, and internal fixation was retrospective analyzed. Among them, 16 patients were treated through posterior approach as posterior group, including 13 males and 3 females aged from 37 to 62 years old; 9 cases caused by falling injury, 3 cases by traffic accident injury,4 cases by heavy aboved;the injury segment was on T₁₂ in 2 cases, L₁ in 5 cases, L₂ in 7 cases, L₃ in 2 cases; according ASIA grade, 3 cases were grade A, 2 cases were grade B, 2 cases were grade C, 5 cases were grade D, 4 cases were grade E; the time between injury and operation ranged from 5 to 15 days. Other 20 patients were treated through anterior-lateral approach as anterior-lateral group, including 15 males and 5 females with age from 27 to 62 years old; 12 cases caused by falling injury, 4 cases by traffic accident injury, 4 cases by heavy aboved; the injury segment was on T₁₂ in 2 cases, L₁, in 7 cases, L₂ in 9 cases, L₃ in 2 cases; for ASIA grade: 4 cases were grade A, 2 cases were grade B, 4 cases were grade C, 6 cases were grade D, 4 cases were grade E; the time between injury and operation ranged from 4 to 12 days. The operation time, bleeding during operation and postoperative drainage volume were observed in two groups,and the changes of nerve function of ASIA grade, clinical efficacy,improved degree of thoracic and lumbar lordosis,and bony fusion were compared between two groups. All patients were followed up from 12 to 24 months with an average of (15.8 ± 3.3) months. The operation time, bleeding during operation, and postoperative drainage volume had no significant different between two groups (P > 0.05). As compared with preoperative, ASIA grade of two groups at last follow-up had statistically significantly different (P < 0.01), the neural function of two groups after operation was recovered for different extent. The JOA score of two groups was compared between last follow-up and preoperative, the difference had statistically significant (P < 0.01), the two groups showed good clinical effect. The clinical results of ASIA grade, JOA score and RIS had no significant differences between two groups. All patients of two groups were obtained fusion. Thoracic and lumbar lordosis angle improvement degree had no significant difference between two groups ,it bad significant difference had statistical significance compared with preoperative, the two approaches could effectively restore the spinal sequence. For patients with thoracolumbar burst fracture just treated by anterior decompression and reconstruction of anterior column, according to the degree of operation performer' skill proficiency and the patient' condition to choose, but for patients must performed the spinal canal decompression anterior and posterior, the three column-reconstruction to required anterior-posterior approach, the posterior unilateral approach corpectomy fusion screw-rod fixation obviously shorten operation time, reduce the operation wound, it is worth the clinical promotion.

Grading Practices and Distributions Across Internal Medicine Clerkships.

PubMed

Fazio, Sara B; Torre, Dario M; DeFer, Thomas M

2016-01-01

Clerkship evaluation and grading practices vary widely between U.S. medical schools. Grade inflation continues to exist, and grade distribution is likely to be different among U.S. medical schools. Increasing the number of available grades curtails "grade inflation." A national survey of all Clerkship Directors in Internal Medicine members was administered in 2011. The authors assessed key aspects of grading. Response rate was 76%. Among clerkship directors (CDs), 61% of respondents agreed that grade inflation existed in the internal medicine clerkship at their school, and 43% believed that it helped students obtain better residency positions. With respect to grading practices, 79% of CDs define specific behaviors needed to achieve each grade, and 36% specify an ideal grade distribution. In addition, 44% have a trained core faculty responsible for evaluating students, 35% describe formal grading meetings, and 39% use the Reporter-Interpreter-Manager-Educator (RIME) scheme. Grading scales were described as follows: 4% utilize a pass/fail system, 13% a 3-tier (e.g., Honors/Pass/Fail), 45% 4-tier, 35% 5-tier, and 4% 6+-tier system. There was a trend to higher grades with more tiers available. Grade inflation continues in the internal medicine clerkship. Almost half of CDs feel that this practice assists students to obtain better residency positions. A minority of programs have a trained core faculty who are responsible for evaluation. About one third have formal grading meetings and use the RIME system; both have been associated with more robust and balanced grading practices. In particular, there is a wide variation between schools in the percentage of students who are awarded the highest grade, which has implications for residency applications. Downstream users of clinical clerkship grades must be fully aware of these variations in grading in order to appropriately judge medical student performance.

An official American thoracic society workshop report: developing performance measures from clinical practice guidelines.

PubMed

Kahn, Jeremy M; Gould, Michael K; Krishnan, Jerry A; Wilson, Kevin C; Au, David H; Cooke, Colin R; Douglas, Ivor S; Feemster, Laura C; Mularski, Richard A; Slatore, Christopher G; Wiener, Renda Soylemez

2014-05-01

Many health care performance measures are either not based on high-quality clinical evidence or not tightly linked to patient-centered outcomes, limiting their usefulness in quality improvement. In this report we summarize the proceedings of an American Thoracic Society workshop convened to address this problem by reviewing current approaches to performance measure development and creating a framework for developing high-quality performance measures by basing them directly on recommendations from well-constructed clinical practice guidelines. Workshop participants concluded that ideally performance measures addressing care processes should be linked to clinical practice guidelines that explicitly rate the quality of evidence and the strength of recommendations, such as the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) process. Under this framework, process-based performance measures would only be developed from strong recommendations based on high- or moderate-quality evidence. This approach would help ensure that clinical processes specified in performance measures are both of clear benefit to patients and supported by strong evidence. Although this approach may result in fewer performance measures, it would substantially increase the likelihood that quality-improvement programs based on these measures actually improve patient care.

NASA Kennedy Space Center Educator Workshops: Exploring Their Impact on Teacher Attitudes and Concerns

NASA Technical Reports Server (NTRS)

Dreschel, Thomas W.

1996-01-01

The National Aeronautics and Space Administration holds summer teacher workshops to motivate teachers to use space science in their lessons. In evaluating these workshops, the areas of interest were participant beliefs about science and science teaching and concerns about educational change and innovation. The teachers attending workshops in 1995, past participants, teachers that received materials but had not attended a workshop, and science researchers were surveyed using the Beliefs about Science and Science Education Survey and/or the Stages of Concern Questionnaire. Comparisons were made by workshop length, time since workshop, and highest grade taught. Reductions in concerns were most evident in the four week workshop. Changes in beliefs were also observed relative to teaching approach and ability. Differences in beliefs were observed between teachers and science researchers. Differences were also observed relative to time since attendance and by grade level taught. It is recommended that the workshops be at least four weeks in length and in length and target specific grade levels, that refresher workshops be offered.

Chinese approaches to understanding and building resilience in at-risk children and adolescents.

PubMed

Lee, Tak-Yan; Shek, Daniel T L; Kwong, Wai-Man

2007-04-01

This article discusses the prevailing Chinese belief systems that have bearings on the perception and practices of promoting resilience among children and youth in a major city in China. It briefly describes a huge social intervention program entitled "Understanding the Adolescent Project" to combat the problems among grade 7 students identified as adolescents at risk from 2001 to 2004 in Hong Kong Special Administrative Region. A critical review of the problems encountered by social workers in the delivery of the program is presented to support the move to provide the preventive program for grade 4 students with clinical symptoms on a screening tool for identification of at-risk status. Starting in 2005, a large-scale positive youth development program was being developed for all secondary one to three (grades 7 to 9) students. Encouraging results of the evaluation studies demonstrated the effectiveness of this new preventive program, entitled Positive Adolescent Training through Holistic Social Programs.

Students' Opinions about Their Ninth Grade Biology Textbook: From the Perspective of Constructivist Learning Approach

ERIC Educational Resources Information Center

Çimer, Atilla; Coskun, Sibel

2018-01-01

The study aimed to determine students' opinions about their ninth grade biology textbook that had been created in accordance with the constructivist learning approach. On the basis of a detailed literature review of studies on textbooks; questionnaires used for assessment of textbooks; and constructivist learning approach, a questionnaire was…

The Relationship between Mathematics Teachers' Teaching Approaches and 9th Grade Students' Mathematics Self

ERIC Educational Resources Information Center

Briede, Liene

2016-01-01

The aim of the study is to investigate the relationship between the teaching approach adopted by mathematics teachers and their 9th grade students' mathematical self. The study searched for the answers on three research questions, namely, about 1) the approaches prevailing in mathematics teachers' beliefs about effective teaching and self-reports…

Ligamentum teres tenodesis in medial approach open reduction for developmental dislocation of the hip.

PubMed

Bache, Christopher Edward; Graham, H Kerr; Dickens, D Robert V; Donnan, Leo; Johnson, Michael B; Nattrass, Gary; O'Sullivan, Mark; Torode, Ian P

2008-09-01

When closed reduction of a developmental dislocation of the hip fails, some form of open reduction is required. In recent years, the many advantages of the medial approach open reduction have been emphasized. However, there have been suggestions that the rate of growth disturbance in the proximal femur and the requirement for secondary surgical procedures may be higher with this route than with others. The purpose of this study was to investigate the efficacy and safety of a modified medial approach open reduction, in which the stability of the reduction is enhanced by resection of the redundant ligamentum teres and suturing of the stump of the tendon to the anteromedial capsule. The hospital records and radiographs of 92 infants and children with 109 dislocated hips were reviewed retrospectively. Key demographic and pretreatment data were collected by the first author and compared with the outcome at the most recent follow-up. In addition, 69 children returned for a clinical evaluation by the first author. The outcome at the most recent follow-up was graded according to Severin, and associations were sought between pretreatment grade of dislocation according to Tonnis, the presence of ossific nucleus, changes in the acetabular index, the requirements for secondary surgery, associations with previous treatment, and the position of abduction in the postoperative cast. At a mean follow-up of 9 years, 89% of hips were classified as Severin grade 1 or 2. Avascular necrosis (AVN) was classified according to the system of Kalamchi and MacEwen. The incidence of AVN was 41%, but two thirds of these were grade 1 (temporary irregular ossification), and the Severin grading in these hips was not compromised. The presence of ossification in the capital epiphysis and a range of abduction of less than 60 degrees in the hip spica were noted to be protective against the development of AVN. Three hips redislocated and required additional treatment. Thirty-eight hips required a total of 44 additional surgical procedures. We have demonstrated that it is possible to use a medial approach for open reduction of the congenitally dislocated hip in combination with tenodesis of the ligamentum teres to the anteromedial joint capsule. The incidence of growth disturbance in the proximal femur is high and cumulative with long-term follow-up. However, in this large series, the rate of hip stability, growth disturbance, and need for secondary surgery are comparable to other series. We conclude that the many advantages of open reduction by the medial approach outweigh the disadvantages.

Acromegaly: an endocrine society clinical practice guideline.

PubMed

Katznelson, Laurence; Laws, Edward R; Melmed, Shlomo; Molitch, Mark E; Murad, Mohammad Hassan; Utz, Andrea; Wass, John A H

2014-11-01

The aim was to formulate clinical practice guidelines for acromegaly. The Task Force included a chair selected by the Endocrine Society Clinical Guidelines Subcommittee (CGS), five experts in the field, and a methodologist. The authors received no corporate funding or remuneration. This guideline is cosponsored by the European Society of Endocrinology. This evidence-based guideline was developed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system to describe both the strength of recommendations and the quality of evidence. The Task Force reviewed primary evidence and commissioned two additional systematic reviews. One group meeting, several conference calls, and e-mail communications enabled consensus. Committees and members of the Endocrine Society and the European Society of Endocrinology reviewed drafts of the guidelines. Using an evidence-based approach, this acromegaly guideline addresses important clinical issues regarding the evaluation and management of acromegaly, including the appropriate biochemical assessment, a therapeutic algorithm, including use of medical monotherapy or combination therapy, and management during pregnancy.

Clinical Practice Guidelines for Gastric Cancer in Korea: An Evidence-Based Approach

PubMed Central

Lee, Jun Haeng; Jung, Hye-Kyung; Kim, Jung Hoon; Jeong, Woo Kyoung; Jeon, Tae Joo; Kim, Joon Mee; Kim, Young Il; Ryu, Keun Won; Kong, Seong-Ho; Kim, Hyoung-Il; Jung, Hwoon-Yong; Kim, Yong Sik; Zang, Dae Young; Cho, Jae Yong; Park, Joon Oh; Lim, Do Hoon; Jung, Eun Sun; Ahn, Hyeong Sik; Kim, Hyun Jung

2014-01-01

Although gastric cancer is quite common in Korea, the treatment outcome is relatively favorable compared to those in western countries. However, there are currently no Korean multidisciplinary guidelines for gastric cancer. Experts from related societies developed guidelines de novo to meet Korean circumstances and requirements, including 23 recommendation statements for diagnosis (n=9) and treatment (n=14) based on relevant key questions. The quality of the evidence was rated according to the GRADE evidence evaluation framework: the evidence levels were based on a systematic review of the literature, and the recommendation grades were classified as either strong or weak. The applicability of the guidelines was considered to meet patients' view and preferences in the context of Korea. The topics of the guidelines cover diagnostic modalities (endoscopy, endoscopic ultrasound, and radiologic diagnosis), treatment modalities (surgery, therapeutic endoscopy, chemotherapy, and radiotherapy), and pathologic evaluation. An external review of the guidelines was conducted during the finalization phase. PMID:25061536

MR-defecography in obstructed defecation syndrome (ODS): technique, diagnostic criteria and grading.

PubMed

Piloni, V; Tosi, P; Vernelli, M

2013-10-01

The aim of this study was to evaluate the use of a magnetic resonance (MR)-based classification system of obstructive defecation syndrome (ODS) to guide physicians in patient management. The medical records and imaging series of 105 consecutive patients (90 female, 15 male, aged 21-78 years, mean age 46.1 ± 5.1 years) referred to our center between April 2011 and January 2012 for symptoms of ODS were retrospectively examined. After history taking and a complete clinical examination, patients underwent MR imaging according to a standard protocol using a 0.35 T permanent field, horizontally oriented open-configuration magnet. Static and dynamic MR-defecography was performed using recognized parameters and well-established diagnostic criteria. Sixty-seven out of 105 (64 %) patients found the prone position more comfortable for the evacuation of rectal contrast while 10/105 (9.5 %) were unable to empty their rectum despite repeated attempts. Increased hiatus size, anterior rectocele and focal or extensive defects of the levator ani muscle were the most frequent abnormalities (67.6, 60.0 and 51.4 %, respectively). An MR-based classification was developed based on the combinations of abnormalities found: Grade 1 = functional abnormality, including paradoxical contraction of the puborectalis muscle, without anatomical defect affecting the musculo-fascial structures; Grade 2 = functional defect associated with a minor anatomical defect such as rectocele ≤ 2 cm in size and/or first-degree intussusception; Grade 3 = severe defects confined to the posterior anatomical compartment, including >2 cm rectocele, second- or higher-degree intussusception, full-thickness external rectal prolapse, poor mesorectal posterior fixation, rectal descent >5 cm, levator ani muscle rupture, ballooning of the levator hiatus and focal detachment of the endopelvic fascia; Grade 4 = combined defects of two or three pelvic floor compartments, including cystocele, hysterocele, enlarged urogenital hiatus, fascial tears enterocele or peritoneocele; Grade 5 = changes after failed surgical repair abscess/sinus tracts, rectal pockets, anastomotic strictures, small uncompliant rectum, kinking and/or lateral shift of supra-anastomotic portion and pudendal nerve entrapment. According to our classification, Grades 1 and 2 may be amenable to conservative therapy; Grade 3 may require surgical intervention by a coloproctologist; Grade 4 would need a combined urogynecological and coloproctological approach; and Grade 5 may require an even more complex multidisciplinary approach. Validation studies are needed to assess whether this MR-based classification system leads to a better management of patients with ODS.

Determination of acid ionization constants for weak acids by osmometry and the instrumental analysis self-evaluation feedback approach to student preparation of solutions

NASA Astrophysics Data System (ADS)

Kakolesha, Nyanguila

One focus of this work was to develop of an alternative method to conductivity for determining the acid ionization constants. Computer-controlled osmometry is one of the emerging analytical tools in industrial research and clinical laboratories. It is slowly finding its way into chemistry laboratories. The instrument's microprocessor control ensures shortened data collection time, repeatability, accuracy, and automatic calibration. The equilibrium constants of acetic acid, chloroacetic acid, bromoacetic acid, cyanoacetic acid, and iodoacetic acid have been measured using osmometry and their values compared with the existing literature values obtained, usually, from conductometric measurements. Ionization constant determined by osmometry for the moderately strong weak acids were in reasonably good agreement with literature values. The results showed that two factors, the ionic strength and the osmotic coefficient, exert opposite effects in solutions of such weak acids. Another focus of the work was analytical chemistry students solution preparation skills. The prevailing teacher-structured experiments leave little room for students' ingenuity in quantitative volumetric analysis. The purpose of this part of the study was to improve students' skills in making solutions using instrument feedback in a constructivist-learning model. After making some solutions by weighing and dissolving solutes or by serial dilution, students used the spectrophotometer and the osmometer to compare their solutions with standard solutions. Students perceived the instrument feedback as a nonthreatening approach to monitoring the development of their skill levels and liked to clarify their understanding through interacting with an instructor-observer. An assessment of the instrument feedback and the constructivist model indicated that students would assume responsibility for their own learning if given the opportunity. This study involved 167 students enrolled in Quantitative Chemical Analysis from fall 1998 through spring 2001. Surveys eliciting students' reactions to the instrument feedback approach showed an overwhelmingly positive response. The results of this research demonstrated that self-evaluation with instrumental feedback was a useful tool in helping students apply the knowledge they have acquired in lectures to the practice of chemistry. A demographic survey to determine whether part-time or full-time jobs had a negative impact on their experiment grades showed a small but significant correlation between hours worked and grade earned. However, the study showed that grades students earned on this experiment were predictive of overall semester lab grades.

Proposal for a Novel Severity Grading System for Pterygia Based on Corneal Topographic Data.

PubMed

Miyata, Kazunori; Minami, Keiichiro; Otani, Atsushi; Tokunaga, Tadatoshi; Tokuda, Shouta; Amano, Shiro

2017-07-01

To propose a grading system of pterygium severity based on corneal higher-order irregularity (HOI) and to evaluate postoperative changes in corneal irregularity of the graded pterygia. In 268 eyes of 226 patients undergoing excision surgery of primary nasal pterygium, Placido corneal topography images were taken before and until 6 months after surgery. The best-corrected visual acuity (BCVA) and pterygium size with respect to the corneal diameter were also measured. HOI components within 1.0-, 3.0-, and 5.0-mm diameters were obtained using Fourier harmonic analysis of corneal topography data. With threshold levels when the HOIs for 3 diameters steeply increased, 4 levels of grading from 0 (mild) to 3 (severe) were determined. Associations of the grades with the preoperative surface regularity index (SRI), irregular components (IRRs) obtained from the 3.0-mm diameter Fourier analysis, and BCVA were examined. Time-course changes in the indexes after surgery were evaluated for each grade. There were 62, 65, 41, and 100 eyes in grades 0 to 3, respectively. Preoperatively, the SRI in grade 3 was significantly higher than in the other grades (P < 0.001), and the IRR and BCVA varied with the grade (P < 0.001). Between 1 and 6 months postoperatively, grade 3 pterygia showed significant changes in the SRI and IRR (P = 0.013 and 0.017, respectively), whereas there was no change after 3 months postoperatively in the SRI, IRR, and BCVA for all other grades. The proposed grading effectively classified the severity of pterygia and evaluated postoperative restoration of corneal irregularity. Using corneal topographic data allowed for objective evaluation of pterygium severity.

MFDFA and Lacunarity Analysis of Synthetic Multifractals and Pre-Cancerous Tissues

NASA Astrophysics Data System (ADS)

Roy, A.; Das, N.; Ghosh, N.

2017-12-01

Multifractal Detrended Fluctuation Analysis (MFDFA) has been employed for evaluating complex variations in the refractive index (RI) of human pre-cancerous tissues. While this was primarily aimed towards the early diagnosis of cancer in the human cervix, question remains whether multifractal analysis alone can be conclusively used for distinguishing between various grades of pre-cancerous tissues. Lacunarity is a parameter that was developed for multiscale analysis of data and has been shown to be theoretically related to the correlation dimension, D2, by dlog(L)/dlog(x) = D2 - 2. Further, research has proven that not only can Lacunarity be used as a preliminary indicator of multifractal behavior but it also distinguishes between images with similar correlation dimension values. In order to compare the efficacy of the two approaches namely, MFDFA and Lacunarity, in distinguishing between pre-cancerous tissues of various grades, we test these techniques on a set of 2-dimensional theoretical random multifractal fields. MFDFA is employed for computing the width of the singularity spectrum f(α), which is a measure of multifractal behavior. A weighted mean of the log-transformed lacunarity values at different scales is employed for differentiating between patterns with the same correlation dimension but differences in texture. The two different techniques are then applied to images containing RI values of biopsy samples from human cervical tissues that were histo-pathologically characterized as grade-I and grade-II pre-cancerous cells. The results show that the two approaches are complementary to one another when it comes to multi-scale analysis of complex natural patterns manifested in the images of such pre-cancerous cells.

Four Steps in Grading Reform

ERIC Educational Resources Information Center

Guskey, Thomas R.; Jung, Lee Ann

2012-01-01

The field of education is moving rapidly toward a standards-based approach to grading. School leaders have become increasingly aware of the tremendous variation that exists in grading practices, even among teachers of the same courses in the same department in the same school. Consequently, students' grades often have little relation to their…

Grading Written Projects: What Approaches Do Students Find Most Helpful?

ERIC Educational Resources Information Center

Smith, Lois J.

2008-01-01

Conscientious marketing faculty spend extensive hours grading student essays and projects. As instructors work on grading papers, they may wonder how effective their comments are. The author explored how students in a marketing principles class reported their use of various grading methods. Students generally preferred rubrics with ratings and…

Long-term Outcomes With Planned Multistage Reduced Dose Repeat Stereotactic Radiosurgery for Treatment of Inoperable High-Grade Arteriovenous Malformations: An Observational Retrospective Cohort Study.

PubMed

Marciscano, Ariel E; Huang, Judy; Tamargo, Rafael J; Hu, Chen; Khattab, Mohamed H; Aggarwal, Sameer; Lim, Michael; Redmond, Kristin J; Rigamonti, Daniele; Kleinberg, Lawrence R

2017-07-01

There is no consensus regarding the optimal management of inoperable high-grade arteriovenous malformations (AVMs). This long-term study of 42 patients with high-grade AVMs reports obliteration and adverse event (AE) rates using planned multistage repeat stereotactic radiosurgery (SRS). To evaluate the efficacy and safety of multistage SRS with treatment of the entire AVM nidus at each treatment session to achieve complete obliteration of high-grade AVMs. Patients with high-grade Spetzler-Martin (S-M) III-V AVMs treated with at least 2 multistage SRS treatments from 1989 to 2013. Clinical outcomes of obliteration rate, minor/major AEs, and treatment characteristics were collected. Forty-two patients met inclusion criteria (n = 26, S-M III; n = 13, S-M IV; n = 3, S-M V) with a median follow-up was 9.5 yr after first SRS. Median number of SRS treatment stages was 2, and median interval between stages was 3.5 yr. Twenty-two patients underwent pre-SRS embolization. Complete AVM obliteration rate was 38%, and the median time to obliteration was 9.7 yr. On multivariate analysis, higher S-M grade was significantly associated ( P = .04) failure to achieve obliteration. Twenty-seven post-SRS AEs were observed, and the post-SRS intracranial hemorrhage rate was 0.027 events per patient year. Treatment of high-grade AVMs with multistage SRS achieves AVM obliteration in a meaningful proportion of patients with acceptable AE rates. Lower obliteration rates were associated with higher S-M grade and pre-SRS embolization. This approach should be considered with caution, as partial obliteration does not protect from hemorrhage. Copyright © 2017 by the Congress of Neurological Surgeons

Evaluation of ground granulated iron blast-furnace slag : grade-100.

DOT National Transportation Integrated Search

2002-09-01

Currently, the use of grade-120 Granulated Ground Blast Furnace Slag (GGBFS) is incorporated into the specifications of LA DOTD concrete mixes. This study evaluates grade-100 GGBFS and its effect on the properties of hydraulic cement concretes used i...

Advancing Resident Assessment in Graduate Medical Education

PubMed Central

Swing, Susan R.; Clyman, Stephen G.; Holmboe, Eric S.; Williams, Reed G.

2009-01-01

Background The Outcome Project requires high-quality assessment approaches to provide reliable and valid judgments of the attainment of competencies deemed important for physician practice. Intervention The Accreditation Council for Graduate Medical Education (ACGME) convened the Advisory Committee on Educational Outcome Assessment in 2007–2008 to identify high-quality assessment methods. The assessments selected by this body would form a core set that could be used by all programs in a specialty to assess resident performance and enable initial steps toward establishing national specialty databases of program performance. The committee identified a small set of methods for provisional use and further evaluation. It also developed frameworks and processes to support the ongoing evaluation of methods and the longer-term enhancement of assessment in graduate medical education. Outcome The committee constructed a set of standards, a methodology for applying the standards, and grading rules for their review of assessment method quality. It developed a simple report card for displaying grades on each standard and an overall grade for each method reviewed. It also described an assessment system of factors that influence assessment quality. The committee proposed a coordinated, national-level infrastructure to support enhancements to assessment, including method development and assessor training. It recommended the establishment of a new assessment review group to continue its work of evaluating assessment methods. The committee delivered a report summarizing its activities and 5 related recommendations for implementation to the ACGME Board in September 2008. PMID:21975993

Approaches to Studying and Academic Performance in Short Essay Exams

ERIC Educational Resources Information Center

Minbashian, Amirali; Huon, Gail F.; Bird, Kevin D.

2004-01-01

Previous research has generally failed to find a relation between the way students approach the task of studying and their exam grades. The present study investigated why it is that a deep approach to studying, which has been shown to result in a higher quality of learning, does not consistently result in higher exam grades. The participants in…

Micturating cystourethrogram as a tool for investigating UTI in children - An institutional audit.

PubMed

Hua, L; Linke, R J; Boucaut, H A P; Khurana, S

2016-10-01

Micturating cystourethrograms (MCUG) are the gold standard for evaluating vesicoureteric reflux (VUR). There is a growing consensus for increasing the threshold for performing MCUGs following urinary tract infections (UTI) in children. There are several varying guidelines. It is important to detect high-grade reflux in the setting of an UTI because of potential long-term complications. This audit aimed to retrospectively: (1) identify the conformance rate of local guidelines at the Women's and Children's Hospital (WCH); (2) assess predictors for an abnormal MCUG; and (3) compare local guidelines against the Royal Children's Hospital, Melbourne (RCH), National Institute for Healthcare and Excellence (NICE), and American Academy of Pediatrics (AAP) guidelines for selectively detecting high-grade reflux. The number of MCUGs performed from 2008 to 2012 at the WCH radiology department was collected. Patients undergoing MCUG during the 2012 calendar year were identified. Only children having an initial MCUG as part of an UTI investigation with prerequisite imaging as per guidelines were included. Each child's age, sex, referral source, reason, renal ultrasound (RUS) prior to the MCUG, MCUG result and VUR grade were recorded. The WCH guidelines were applied to determine conformance, to evaluate predictors for an abnormal MCUG, and compared against other retrospectively applied guidelines (RCH, NICE, AAP). There was complete data for 168 children who underwent MCUG as part of an UTI investigation (median age 0.79 years, range 0.12-8.74, male:female 67:101). There were 67/168 abnormal MCUGs (62 children with VUR, five bladder diverticulum), and 97 refluxing renal units (43 high-grade VUR units). No posterior urethral valves (PUV) were identified as part of the UTI investigation. A total of 143/168 patients had prior RUS (normal:abnormal 67:76). The WCH guidelines had 82% conformance. There was no statistically significant association between an abnormal MCUG and age, sex, referral source, reason, or prior RUS result. The WCH guidelines may have missed five children with high-grade VUR (four children had surgery), compared with RCH, APP and NICE, with 8, 15, and 17 children, respectively, having high-grade VUR (two, five, and five children had surgery, respectively) show in the Summary Table. The retrospective study had limitations and possible selection bias (children with UTI without a MCUG). There were no standard treatment approaches for VUR; hence establishing a MCUG guideline is difficult. An alternative is the top-down approach. Current institutional guidelines for considering MCUG following UTI in children vary considerably. The MCUG guidelines at any institution must take into account the local management guidelines for high-grade VUR. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

Definition and classification of chyle leak after pancreatic operation: A consensus statement by the International Study Group on Pancreatic Surgery.

PubMed

Besselink, Marc G; van Rijssen, L Bengt; Bassi, Claudio; Dervenis, Christos; Montorsi, Marco; Adham, Mustapha; Asbun, Horacio J; Bockhorn, Maximillian; Strobel, Oliver; Büchler, Markus W; Busch, Olivier R; Charnley, Richard M; Conlon, Kevin C; Fernández-Cruz, Laureano; Fingerhut, Abe; Friess, Helmut; Izbicki, Jakob R; Lillemoe, Keith D; Neoptolemos, John P; Sarr, Michael G; Shrikhande, Shailesh V; Sitarz, Robert; Vollmer, Charles M; Yeo, Charles J; Hartwig, Werner; Wolfgang, Christopher L; Gouma, Dirk J

2017-02-01

Recent literature suggests that chyle leak may complicate up to 10% of pancreatic resections. Treatment depends on its severity, which may include chylous ascites. No international consensus definition or grading system of chyle leak currently is available. The International Study Group on Pancreatic Surgery, an international panel of pancreatic surgeons working in well-known, high-volume centers, reviewed the literature and worked together to establish a consensus on the definition and classification of chyle leak after pancreatic operation. Chyle leak was defined as output of milky-colored fluid from a drain, drain site, or wound on or after postoperative day 3, with a triglyceride content ≥110 mg/dL (≥1.2 mmol/L). Three different grades of severity were defined according to the management needed: grade A, no specific intervention other than oral dietary restrictions; grade B, prolongation of hospital stay, nasoenteral nutrition with dietary restriction, total parenteral nutrition, octreotide, maintenance of surgical drains, or placement of new percutaneous drains; and grade C, need for other more invasive in-hospital treatment, intensive care unit admission, or mortality. This classification and grading system for chyle leak after pancreatic resection allows for comparison of outcomes between series. As with the other the International Study Group on Pancreatic Surgery consensus statements, this classification should facilitate communication and evaluation of different approaches to the prevention and treatment of this complication. Copyright © 2016 Elsevier Inc. All rights reserved.

Integration of Place-Based Education Into Science Classes From Prekindergarten Through Grade 5

NASA Astrophysics Data System (ADS)

Wade-Lyles, Terri A.

In a large urban district in Ohio, 29.2% of Grade 5, 28.7% of Grade 8, and 45.7% of Grade 10 students passed the state test in science. School district administrators formed a community partnership with local science institutions in order to provide students with hands-on place-based learning experiences intended to improve science academic achievement in PK-Grade 5. The purpose of this qualitative program evaluation was to determine the level of implementation of that place-based program by examining the efficacy of the teachers' embedded professional development and their experiences with the training components. Bruner's theory of cognitive development was used to examine teachers' needs in facilitating the program. A stratified random sample of 659 PK-Grade 5 teachers from 73 district elementary schools was selected, and 57 teachers responded to an anonymous online survey of 5 open-ended questions. Data were analyzed using thematic analysis to identity factors that enhanced or impeded the implementation of place-based education programming based on their professional development. The key findings indicated that over half of the participants viewed resources as lacking, training as limited, and planning that is too time consuming, and complicated. Participants expressed the need for clarity regarding resources and more training on how to plan for and integrate the placed-based approach. The resulting project was an executive summary and interactive workshop for program stakeholders, such as administrators, teachers, and ultimately students, who would benefit from this project by improving the place-based program.

Empowering Teaching for Participatory Citizenship: Evaluating the Impact of Alternative Civic Education Pedagogies on Civic Attitudes, Knowledge and Skills of Eight-Grade Students in Mexico

ERIC Educational Resources Information Center

Reimers, Fernando M.; Ortega, Maria Elena; Cardenas, Mariali; Estrada, Armando; Garza, Emanuel

2014-01-01

In spite of the fact that public schools were established to prepare students for citizenship, the alignment of teaching practice with this goal is poor. In part, this is because the knowledge base about the efficacy of curricular and pedagogical approaches in supporting specific civic outcomes is limited, as is our knowledge about the extent to…

Detection of Potentially Severe Retinopathy of Prematurity by Remote Image Grading.

PubMed

Quinn, Graham E; Ying, Gui-Shuang; Pan, Wei; Baumritter, Agnieshka; Daniel, Ebenezer

2017-09-01

Telemedicine in retinopathy of prematurity (ROP) has the potential for delivering timely care to premature infants at risk for serious ROP. To describe the characteristics of eyes at risk for ROP to provide insights into what types of ROP are most easily detected early by image grading. Secondary analysis of eyes with referral-warranted (RW) ROP (stage 3 ROP, zone I ROP, plus disease) on diagnostic examination from the Telemedicine Approaches to Evaluating Acute-Phase Retinopathy of Prematurity (e-ROP) study was conducted from May 1, 2011, to October 31, 2013, in 1257 premature infants with birth weights less than 1251 g in 13 neonatal units in North America. Data analysis was performed between February 1, 2016, and June 5, 2017. Serial imaging sessions with concurrent diagnostic examinations for ROP. Time of detecting RW-ROP on image evaluation compared with clinical examination. In the e-ROP study, 246 infants (492 eyes) were included in the analysis; 138 (56.1%) were male. A total of 447 eyes had RW-ROP on diagnostic examination. Image grading in 123 infants (mean [SD] gestational age, 24.8 [1.4] weeks) detected RW-ROP earlier than diagnostic examination (early) in 191 (42.7%) eyes by about 15 days and detected RW-ROP in 123 infants (mean [SD] gestational age, 24.6 [1.5] weeks) at the same time (same) in 200 (44.7%) eyes. Most of the early eyes (153 [80.1%]) interpreted as being RW-ROP positive on imaging evaluation agreed with examination findings when the examination subsequently documented RW-ROP. At the sessions in which RW-ROP was first found by examination, stage 3 or more in 123 infants (mean [SD] gestational age, 24.8 [1.4] weeks) ROP was noted earlier on image evaluation in 151 of 191 early eyes (79.1%) and in 172 of 200 of same eyes (86.0%) (P = .08); the presence of zone I ROP was detected in 57 of 191 (29.8%) early eyes vs 64 of 200 (32.0%) same eyes (P = .90); and plus disease was noted in 30 of 191 (15.7%) early eyes and 45 of 200 (22.5%) same eyes (P = .08). In both early and same eyes, zone I and/or stage 3 ROP determined a significant proportion of RW-ROP; plus disease played a relatively minor role. In most early RW-ROP eyes, the findings were consistent with clinical examination and/or image grading at the next session. Because ROP telemedicine is used more widely, development of standard approaches and protocols is essential.

Paraffin immunoreactivity of CD10, CDw75, and Bcl-6 in follicle center cell lymphoma.

PubMed

Dunphy, C H; Polski, J M; Lance Evans, H; Gardner, L J

2001-05-01

Follicle center cell lymphoma(FCCL) has the following immunophenotype(IP): sIg+, Pan B+, CD10+/-, CD5-, CD23-/+, CD43-, CD11c-, CD25-. In addition, reactivities of a malignant lymphoma with CDw75(LN-1) and bcl-6 are considered indicators of FCCL. Bcl-6 expression is common in Grade 1 FCCL (100%) and rare in other indolent B-cell lymphomas(BCL). In contrast, bcl-2 expression is common in FCCL (80%) and in other BCL subtypes. Since no previous study has correlated paraffin immunoreactivity(PIR) of CD10, CDw75, and bcl-6 in FCCL (Grades 1-3), this is this study's purpose. Twenty-nine FCCL's were identified and reviewed (6, Grade 1; 10, Grade 2; 13, Grade 3) from the Division of Hematopathology, St. Louis University. The diagnoses were based on morphology and immunohistochemistry(IH)(21 cases) +/- the flow cytometric IP(14 cases). The paraffin blocks were stained for CD10 (Novacastra, Vector Laboratories, Burlingame, CA), CDw75 and bcl-6 (DAKO Corporation, Carpinteria, CA). Results showed that, CD10 by paraffin IH(PIH) was positive in 23 [18(strong); 3(moderate); 2(weak)] and negative in 6(3, Grade 2; 3, Grade 3). All CD10-cases were CDw75+; 4, bcl-6+. The two CD10-, bcl-6-cases were Grade 2. CDw75 was positive in 28 cases [16(strong); 11(moderate); 1(weak)] and negative in 1 (Grade 3; CD10+, bcl-2+, bcl-6+). Bcl-6 was positive in 26 [16(strong); 6(moderate); 4(weak)] and negative in 3(Grade 2's). Thus, the sensitivity of CD10, CDw75, and bcl-6 by PIH for FCCL was 79%, 97%, and 90%, respectively. Of the three stains evaluated by PIH in FCCL, CDw75 was the most sensitive, closely followed by bcl-6. CD10 was least sensitive-79%. By combining these 3 stains, the sensitivity was 100%; thus, a combined approach is recommended.

Enhancing course grades and evaluations using distance education technologies.

PubMed

Carpenter, Roger; Theeke, Laurie; Smothers, Angel

2013-01-01

Delivering appropriate amounts of course content using appropriate methods is a concern for nursing faculty. To address this problem, webcasting, Camtasia, and Wimba Live Classroom were evaluated for impact on course grades and student evaluations in a medical-surgical nursing course. The addition of Camtasia resulted in improved final grades and Student Evaluations of Instruction scores that reflected enhanced critical thinking, teacher effectiveness, and overall learning. Students preferred recorded content that could be viewed on mobile devices.

An Analysis of Grades, Class Level and Faculty Evaluation Scores in the United Arab Emirates

ERIC Educational Resources Information Center

Waller, Lee

2016-01-01

This study examined the results of a student evaluation of faculty against the grades awarded and the level of the course for a higher education institution in the United Arab Emirates. The purpose of the study was to determine if the grades awarded in the course and/or level of the course impacted the evaluation scores awarded to the faculty…

Grading Homework to Emphasize Problem-Solving Process Skills

ERIC Educational Resources Information Center

Harper, Kathleen A.

2012-01-01

This article describes a grading approach that encourages students to employ particular problem-solving skills. Some strengths of this method, called "process-based grading," are that it is easy to implement, requires minimal time to grade, and can be used in conjunction with either an online homework delivery system or paper-based homework.

Automatic brain tumor segmentation with a fast Mumford-Shah algorithm

NASA Astrophysics Data System (ADS)

Müller, Sabine; Weickert, Joachim; Graf, Norbert

2016-03-01

We propose a fully-automatic method for brain tumor segmentation that does not require any training phase. Our approach is based on a sequence of segmentations using the Mumford-Shah cartoon model with varying parameters. In order to come up with a very fast implementation, we extend the recent primal-dual algorithm of Strekalovskiy et al. (2014) from the 2D to the medically relevant 3D setting. Moreover, we suggest a new confidence refinement and show that it can increase the precision of our segmentations substantially. Our method is evaluated on 188 data sets with high-grade gliomas and 25 with low-grade gliomas from the BraTS14 database. Within a computation time of only three minutes, we achieve Dice scores that are comparable to state-of-the-art methods.

Standards-Based Grading and Reporting Will Improve Education

ERIC Educational Resources Information Center

Muñoz, Marco A.; Guskey, Thomas R.

2015-01-01

Grading and reporting are foundational elements in nearly every educational system. Grading represents teachers' evaluations, formative or summative, of students' performance. Reporting is how the results of those evaluations are communicated to students, parents, or others. Because of their fundamental nature, educators must ensure that grading…

How Is a Matisse Like a Mondrian?

ERIC Educational Resources Information Center

Brock, Barbara

1991-01-01

Reviews St. Philip Neri Elementary School's (Omaha, Nebraska) use of an art education approach incorporating aesthetics and art history, criticism, and production. Describes lessons on Matisse and Mondrian (kindergarten), Rouault's "Portrait of a Clown" (fifth grade) and da Vinci's "Last Supper" (second grade). Recommends the approach for…

Grading of Student's Attainment: Purposes and Functions.

ERIC Educational Resources Information Center

Lysne, Anders

1984-01-01

Traces the history of grading and discusses the complex problem of evaluation and grading of student achievement. Reviews the various reference measures and notes the type of functions grades are supposed to serve. Cites seven alternatives to traditional grading. Concludes that "grades are the tail that wags the dog." (BRR)

Comparing Multiple Intelligences Approach with Traditional Teaching on Eight Grade Students' Achievement in and Attitudes toward Science

ERIC Educational Resources Information Center

Kaya, Osman Nafiz; Dogan, Alev; Gokcek, Nur; Kilic, Ziya; Kilic, Esma

2007-01-01

The purpose of this study was to investigate the effects of multiple intelligences (MI) teaching approach on 8th Grade students' achievement in and attitudes toward science. This study used a pretest-posttest control group experimental design. While the experimental group (n=30) was taught a unit on acids and bases using MI teaching approach, the…

Impact of the Systemic Approach on Literacy Achievement of Jordanian 1st Graders at Mu'tah University Model School

ERIC Educational Resources Information Center

Al-Hajaya, Nail

2012-01-01

This study investigates the effect of the systemic approach in literacy achievement of the first grade students at Mu'tah University's Model School. The sample (N = 45) consisted of all first grade students, who were assigned into two groups; a control group taught traditionally while the other group was exposed to the system approach during the…

Automated high-grade prostate cancer detection and ranking on whole slide images

NASA Astrophysics Data System (ADS)

Huang, Chao-Hui; Racoceanu, Daniel

2017-03-01

Recently, digital pathology (DP) has been largely improved due to the development of computer vision and machine learning. Automated detection of high-grade prostate carcinoma (HG-PCa) is an impactful medical use-case showing the paradigm of collaboration between DP and computer science: given a field of view (FOV) from a whole slide image (WSI), the computer-aided system is able to determine the grade by classifying the FOV. Various approaches have been reported based on this approach. However, there are two reasons supporting us to conduct this work: first, there is still room for improvement in terms of detection accuracy of HG-PCa; second, a clinical practice is more complex than the operation of simple image classification. FOV ranking is also an essential step. E.g., in clinical practice, a pathologist usually evaluates a case based on a few FOVs from the given WSI. Then, makes decision based on the most severe FOV. This important ranking scenario is not yet being well discussed. In this work, we introduce an automated detection and ranking system for PCa based on Gleason pattern discrimination. Our experiments suggested that the proposed system is able to perform high-accuracy detection ( 95:57% +/- 2:1%) and excellent performance of ranking. Hence, the proposed system has a great potential to support the daily tasks in the medical routine of clinical pathology.

Eighth Grade Social Studies. An Experimental Program in Geography and Anthropology.

ERIC Educational Resources Information Center

Hanson, James; And Others

GRADES OR AGES: Grade 8. SUBJECT MATTER: Geography and Anthropology. ORGANIZATION AND PHYSICAL APPEARANCE: The introductory material includes descriptions of geography and anthropology as disciplines, the basic course objectives, techniques for evaluating objectives and a student self-evaluation form. The guide covers six units: 1) "What Kind of…

Intraocular Hemorrhages and Retinopathy of Prematurity in the Telemedicine Approaches to Evaluating Acute-Phase Retinopathy of Prematurity (e-ROP) Study.

PubMed

Daniel, Ebenezer; Ying, Gui-Shuang; Siatkowski, R Michael; Pan, Wei; Smith, Eli; Quinn, Graham E

2017-03-01

To describe the clinical characteristics of intraocular hemorrhages (IOHs) in infants in the Telemedicine Approaches to Evaluating Acute-Phase Retinopathy of Prematurity (e-ROP) Study and to evaluate their potential use for prediction of disease severity. Secondary data analysis from a prospective study. Preterm infants with birth weight (BW) ≤1250 g. Infants underwent serial digital retinal imaging in both eyes starting at 32 weeks' postmenstrual age. Nonphysician trained readers (TRs) evaluated all image sets from eyes that ever had IOHs documented on image evaluation or eye examination for the presence, location, type, area, and relation of the IOH to the junction between vascularized and avascular retina. Associations of IOH with demographic and neonatal factors, and with the presence and severity of retinopathy of prematurity (ROP) were investigated by univariate and multivariate analyses. Sensitivity and specificity of the telemedicine system for detecting referral-warranted ROP (RW-ROP) were calculated with and without incorporating hemorrhage into the standardized grading protocol. Retinal and vitreous hemorrhage. Among 1239 infants (mean [standard deviation] BW = 864 [212] g; gestational age [GA] = 27 [2.2] weeks) who underwent an average of 3.2 imaging sessions, 22% had an IOH in an eye on at least 1 of the e-ROP visits. Classification of IOH was preretinal (57%), blot (57%), dot (38%), flame-shaped (16%), and vitreous (8%); most IOHs were unilateral (70%). The IOH resolved in 35% of eyes by the next imaging session and in the majority (76%) of cases by 8 weeks after initial detection. Presence of IOH was inversely associated with BW and GA and significantly associated (P < 0.0001) with the presence and severity of ROP (BW and GA adjusted odds ratios [ORs] of 2.46 for any ROP, 2.88 for stage 3, and 3.19 for RW-ROP). Incorporating IOH into the grading protocol minimally altered the sensitivity of the system (94% vs. 95%). Approximately 1 in 5 preterm infants examined had IOHs, generally unilateral. The presence of hemorrhage was directly correlated with both presence and severity of ROP and inversely correlated with BW and GA, although including hemorrhage in the grading algorithm only minimally improved the sensitivity of the telemedicine system to detect RW-ROP. Copyright © 2016 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

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

Valous, Nektarios A.; Lahrmann, Bernd; Halama, Niels

Purpose: The interactions of neoplastic cells with each other and the microenvironment are complex. To understand intratumoral heterogeneity, subtle differences should be quantified. Main factors contributing to heterogeneity include the gradient ischemic level within neoplasms, action of microenvironment, mechanisms of intercellular transfer of genetic information, and differential mechanisms of modifications of genetic material/proteins. This may reflect on the expression of biomarkers in the context of prognosis/stratification. Hence, a rigorous approach for assessing the spatial intratumoral heterogeneity of histological biomarker expression with accuracy and reproducibility is required, since patterns in immunohistochemical images can be challenging to identify and describe. Methods: Amore » quantitative method that is useful for characterizing complex irregular structures is lacunarity; it is a multiscale technique that exhaustively samples the image, while the decay of its index as a function of window size follows characteristic patterns for different spatial arrangements. In histological images, lacunarity provides a useful measure for the spatial organization of a biomarker when a sampling scheme is employed and relevant features are computed. The proposed approach quantifies the segmented proliferative cells and not the textural content of the histological slide, thus providing a more realistic measure of heterogeneity within the sample space of the tumor region. The aim is to investigate in whole sections of primary pancreatic neuroendocrine neoplasms (pNENs), using whole-slide imaging and image analysis, the spatial intratumoral heterogeneity of Ki-67 immunostains. Unsupervised learning is employed to verify that the approach can partition the tissue sections according to distributional heterogeneity. Results: The architectural complexity of histological images has shown that single measurements are often insufficient. Inhomogeneity of distribution depends not only on percentage content of proliferation phase but also on how the phase fills the space. Lacunarity curves demonstrate variations in the sampled image sections. Since the spatial distribution of proliferation in each case is different, the width of the curves changes too. Image sections that have smaller numerical variations in the computed features correspond to neoplasms with spatially homogeneous proliferation, while larger variations correspond to cases where proliferation shows various degrees of clumping. Grade 1 (uniform/nonuniform: 74%/26%) and grade 3 (uniform: 100%) pNENs demonstrate a more homogeneous proliferation with grade 1 neoplasms being more variant, while grade 2 tumor regions render a more diverse landscape (50%/50%). Hence, some cases show an increased degree of spatial heterogeneity comparing to others with similar grade. Whether this is a sign of different tumor biology and an association with a more benign/malignant clinical course needs to be investigated further. The extent and range of spatial heterogeneity has the potential to be evaluated as a prognostic marker. Conclusions: The association with tumor grade as well as the rationale that the methodology reflects true tumor architecture supports the technical soundness of the method. This reflects a general approach which is relevant to other solid tumors and biomarkers. Drawing upon the merits of computational biomedicine, the approach uncovers salient features for use in future studies of clinical relevance.« less

Empowerment in Science Curriculum Development: A Microdevelopmental Approach

ERIC Educational Resources Information Center

Schwartz, Marc S.; Sadler, Philip M.

2007-01-01

This study characterizes how learning and teaching differs as the responsibility for choosing curriculum goals and the strategies to reach those goals shifts between teacher and the students. Three different pedagogical approaches were used with 125 seventh-grade and eighth-grade students. All three curricula focus on electromagnetism, and were…

[Success quotas in exercise questions in the discipline of rheumatology in preparation for the written state examination in German universities from 2012 to 2016 : Evaluation of the AMBOSS databank according to professorships in rheumatology with and without freedom of instruction in German universities].

PubMed

Sengewein, R; Brinks, R; Pongratz, G

2018-04-30

The discipline rheumatology is underrepresented in German universities with only seven professorial chairs with freedom of instruction. The teaching positions with and without freedom of instruction are associated with a different quantity of teaching. The effect of the teaching position on the quality of teaching and on the training of medical students is unclear. In order to approach the answer to this question we have evaluated 2,610,217 examination questions from 32,166 students over a time period of 4 years according to location and freedom of instruction, which are documented on the teaching platform AMBOSS. In total, in the evaluated examination performance in the discipline of rheumatology, the majority of students just about achieved the grade of "sufficient". Locations with freedom of instruction had significantly better grades; however, these differences had no relevance with respect to the complete state examination. The examination pressure on German medical students to learn for the examination discipline of rheumatology can be estimated as rather low.

Computerized summary scoring: crowdsourcing-based latent semantic analysis.

PubMed

Li, Haiying; Cai, Zhiqiang; Graesser, Arthur C

2017-11-03

In this study we developed and evaluated a crowdsourcing-based latent semantic analysis (LSA) approach to computerized summary scoring (CSS). LSA is a frequently used mathematical component in CSS, where LSA similarity represents the extent to which the to-be-graded target summary is similar to a model summary or a set of exemplar summaries. Researchers have proposed different formulations of the model summary in previous studies, such as pregraded summaries, expert-generated summaries, or source texts. The former two methods, however, require substantial human time, effort, and costs in order to either grade or generate summaries. Using source texts does not require human effort, but it also does not predict human summary scores well. With human summary scores as the gold standard, in this study we evaluated the crowdsourcing LSA method by comparing it with seven other LSA methods that used sets of summaries from different sources (either experts or crowdsourced) of differing quality, along with source texts. Results showed that crowdsourcing LSA predicted human summary scores as well as expert-good and crowdsourcing-good summaries, and better than the other methods. A series of analyses with different numbers of crowdsourcing summaries demonstrated that the number (from 10 to 100) did not significantly affect performance. These findings imply that crowdsourcing LSA is a promising approach to CSS, because it saves human effort in generating the model summary while still yielding comparable performance. This approach to small-scale CSS provides a practical solution for instructors in courses, and also advances research on automated assessments in which student responses are expected to semantically converge on subject matter content.

Evaluating the Predictive Validity of Academic and Social-Emotional Screening Assessments for Measuring Academic and Social-Emotional Success at the End of First Grade

ERIC Educational Resources Information Center

Erhart, Amber C.

2013-01-01

By the end of the kindergarten, students are expected to possess early academic skills as well as the social maturity to be successful in first grade. Students leaving kindergarten without these readiness skills are sometimes held back in first grade or referred for a special education evaluation in later grades if they fail to make adequate…

Using the Title I Control Group Model for Evaluation Research and Development of a Supplemental Mathematics Project for Third and Fifth Grade Students.

ERIC Educational Resources Information Center

Slaughter, Helen B.

Mathematics achievement of Elementary Secondary Education Act Title I students was evaluated, using RMC Model B, the control group model. The third-grade students in 8 of 17 Title I elementary schools and the fifth-grade students in the remaining 9 schools were chosen for the pilot project. The remaining third-and fifth-grade students served as…

Contrasting Grading Approaches in Introductory Physics and Quantum Mechanics: The Case of Graduate Teaching Assistants

ERIC Educational Resources Information Center

Marshman, Emily; Sayer, Ryan; Henderson, Charles; Singh, Chandralekha

2017-01-01

At large research universities, physics graduate teaching assistants (TAs) are often responsible for grading in courses at all levels. However, few studies have focused on TAs' grading practices in introductory and advanced physics courses. This study was designed to investigate whether physics graduate TAs grade students in introductory physics…

Cetuximab plus gemcitabine/oxaliplatin (GEMOXCET) in first-line metastatic pancreatic cancer: a multicentre phase II study

PubMed Central

Kullmann, F; Hollerbach, S; Dollinger, M M; Harder, J; Fuchs, M; Messmann, H; Trojan, J; Gäbele, E; Hinke, A; Hollerbach, C; Endlicher, E

2009-01-01

Targeting the epidermal growth factor receptor pathway in pancreatic cancer seems to be an attractive therapeutic approach. This study assessed the efficacy of cetuximab plus the combination of gemcitabine/oxaliplatin in metastatic pancreatic cancer. Eligible subjects had histological or cytological diagnosis of metastatic pancreatic adenocarcinoma. The primary end point was response according to RECIST. Patients received cetuximab 400 mg m−2 at first infusion followed by weekly 250 mg m−2 combined with gemcitabine 1000 mg m−2 as a 100 min infusion on day 1 and oxaliplatin 100 mg m−2 as a 2-h infusion on day 2 every 2 weeks. Between January 2005 and August 2006, a total of 64 patients (22 women (34%), 42 men (66%); median age 64 years (range 31–78)) were enrolled at seven study centres. On October 2007, a total of 17 patients were alive. Sixty-two patients were evaluable for baseline and 61 for assessment of response to treatment in an intention-to-treat analysis. Six patients had an incomplete drug combination within the first cycle of the treatment plan (n=4 hypersensitivity reactions to the first cetuximab infusion, n=2 refused to continue therapy). Reported grade 3/4 toxicities (% of patients) were leukopaenia 15%, anaemia 8%, thrombocytopaenia 10%, diarrhoea 7%, nausea 18%, infection 18% and allergy 7%. Cetuximab-attributable skin reactions occurred as follows: grade 0: 20%, grade 1: 41%, grade 2: 30% and grade 3: 10%. The intention-to-treat analysis of 61 evaluable patients showed an overall response rate of 33%, including 1 (2%) complete and 19 (31%) partial remissions. There were 31% patients with stable and 36% with progressive disease or discontinuation of the therapy before re-staging. The presence of a grade 2 or higher skin rash was associated with a higher likelihood of achieving objective response. Median time to progression was 118 days, with a median overall survival of 213 days. A clinical benefit response was noted in 24 of the evaluable 61 patients (39%). The addition of cetuximab to the combination of gemcitabine and oxaliplatin is well tolerated but does not increase response or survival in patients with metastatic pancreatic cancer. PMID:19293797

Development of Individuality in Children's Handwriting.

PubMed

Srihari, Sargur N; Meng, Lu; Hanson, Lisa

2016-09-01

Handwriting of children in early grades is studied from the viewpoint of quantitatively measuring the development of handwriting individuality. Handwriting samples of children, in grades 2-4, writing a paragraph of text in both handprinted and cursive, collected over a period of 3 years, were analyzed using two different approaches: (i) characteristics of the word "and" and (ii) entire paragraphs using an automated system. In the first approach, word characteristics were analyzed using statistical measures. In the second approach, pairs of paragraphs were compared. Both types of analysis, single word and complete writing, led to the same conclusions: (i) handwriting of each child remains relatively similar when handwriting has been just learnt and becomes markedly different from grades 3 to 4 and (ii) handwriting of different children becomes progressively more different from grades 2 to 4. The results provide strong support that handwriting becomes more individualistic with child development. © 2016 American Academy of Forensic Sciences.

Selective Laser Melting: a regular unit cell approach for the manufacture of porous, titanium, bone in-growth constructs, suitable for orthopedic applications.

PubMed

Mullen, Lewis; Stamp, Robin C; Brooks, Wesley K; Jones, Eric; Sutcliffe, Christopher J

2009-05-01

In this study, a novel porous titanium structure for the purpose of bone in-growth has been designed, manufactured and evaluated. The structure was produced by Selective Laser Melting (SLM); a rapid manufacturing process capable of producing highly intricate, functionally graded parts. The technique described utilizes an approach based on a defined regular unit cell to design and produce structures with a large range of both physical and mechanical properties. These properties can be tailored to suit specific requirements; in particular, functionally graded structures with bone in-growth surfaces exhibiting properties comparable to those of human bone have been manufactured. The structures were manufactured and characterized by unit cell size, strand diameter, porosity, and compression strength. They exhibited a porosity (10-95%) dependant compression strength (0.5-350 Mpa) comparable to the typical naturally occurring range. It is also demonstrated that optimized structures have been produced that possesses ideal qualities for bone in-growth applications and that these structures can be applied in the production of orthopedic devices. (c) 2008 Wiley Periodicals, Inc.

Closing the Achievement Gap through Modification of Neurocognitive and Neuroendocrine Function: Results from a Cluster Randomized Controlled Trial of an Innovative Approach to the Education of Children in Kindergarten

PubMed Central

Blair, Clancy; Raver, C. Cybele

2014-01-01

Effective early education is essential for academic achievement and positive life outcomes, particularly for children in poverty. Advances in neuroscience suggest that a focus on self-regulation in education can enhance children’s engagement in learning and establish beneficial academic trajectories in the early elementary grades. Here, we experimentally evaluate an innovative approach to the education of children in kindergarten that embeds support for self-regulation, particularly executive functions, into literacy, mathematics, and science learning activities. Results from a cluster randomized controlled trial involving 29 schools, 79 classrooms, and 759 children indicated positive effects on executive functions, reasoning ability, the control of attention, and levels of salivary cortisol and alpha amylase. Results also demonstrated improvements in reading, vocabulary, and mathematics at the end of kindergarten that increased into the first grade. A number of effects were specific to high-poverty schools, suggesting that a focus on executive functions and associated aspects of self-regulation in early elementary education holds promise for closing the achievement gap. PMID:25389751

Closing the achievement gap through modification of neurocognitive and neuroendocrine function: results from a cluster randomized controlled trial of an innovative approach to the education of children in kindergarten.

PubMed

Blair, Clancy; Raver, C Cybele

2014-01-01

Effective early education is essential for academic achievement and positive life outcomes, particularly for children in poverty. Advances in neuroscience suggest that a focus on self-regulation in education can enhance children's engagement in learning and establish beneficial academic trajectories in the early elementary grades. Here, we experimentally evaluate an innovative approach to the education of children in kindergarten that embeds support for self-regulation, particularly executive functions, into literacy, mathematics, and science learning activities. Results from a cluster randomized controlled trial involving 29 schools, 79 classrooms, and 759 children indicated positive effects on executive functions, reasoning ability, the control of attention, and levels of salivary cortisol and alpha amylase. Results also demonstrated improvements in reading, vocabulary, and mathematics at the end of kindergarten that increased into the first grade. A number of effects were specific to high-poverty schools, suggesting that a focus on executive functions and associated aspects of self-regulation in early elementary education holds promise for closing the achievement gap.

Decision Analysis Using Value-Focused Thinking for Retention of Long-Term Officers in the Korean Army

DTIC Science & Technology

2012-03-01

Figure 2 Advantage of Value Focused Thinking Figure 3 shows the ten-step approach for executing VFT. This helps people learn techniques to...country is economically. So, it is natural proxy scale. Among winter Olympic Games, the players in figure skating are evaluated by examiners using...dollars Gross national product Constructed Points in Figure skating Letter Grade in School 17 2.4.4 Step-4 Create Value Function It is

The Development of Thematic Mathematics Book Based on Environment with a Realistic Approach to Implant the Attitude of Caring about Environment at Students of Elementary School Grade One in Kupang

ERIC Educational Resources Information Center

Ekowati, Ch. Krisnandari; Nenohai, Juliana M. H.

2017-01-01

The backdrop of this research is among others (1) the content of article 8 legislation national education system 20/2003 that the society takes the participation in planning and evaluating education, (2) the criterion of curriculum 2013 that is integrated and has a theme of natural environment, (3) the reality in the field showing that mathematics…

Xenotransplantation of uterine leiomyoma in Wistar rats: a pilot study.

PubMed

Sousa, Willane Bandeira de; Garcia, João Batista Santos; Nogueira Neto, João; Furtado, Pablo Gustavo Ribeiro; Anjos, Jonhnathan Adriano Araújo dos

2015-07-01

To evaluate whether xenografts derived from hysterectomized patients would implant successfully and lead to uterine leiomyoma in Wistar rats. This experimental study examined six female Wistar rats implanted with uterine leiomyoma obtained from patients who underwent hysterectomies at the gynecological surgery service of the HUUFMA. The rats were divided into two groups. Group I consisted of three rats in which the uterine leiomyoma had been implanted in the parietal peritoneum, and group II consisted of three rats in which the uterine leiomyoma was implanted in the subcutaneous tissue. The immunosuppressant mycophenolate mofetil (MMF) was administered orally by gavage (at a dose of 40 mg/kg of body weight) to prevent transplant rejection starting 15 days before the transplant and continuing throughout the entire experiment. After four weeks, necrosis and neovascularization were evaluated histologically in both groups and were classified as either absent or present. Lymphocytic inflammatory infiltration was also examined and classified as mild, moderate or intense (by hematoxylin and eosin staining), and fibrosis was classified as grade I-III (by Masson's trichrome staining). Necrosis was absent from all three rats in group I and was observed in only one rat from group II. Neovascularization was present in two rats from group I and in only one rat from group II. The lymphocytic inflammatory infiltrate was mild in two rats and moderate in one rat from group I, and it was moderate in two rats and intense in one rat from group II. Two rats from group 1 exhibited grade III fibrosis, and one rat presented grade I fibrosis. In group II, two rats presented grade I fibrosis and one rat had grade II fibrosis. When necrosis and neovascularization were evaluated as variables, group I demonstrated greater evidence of successful implantation when compared to group II, indicating that the peritoneal implantation technique produces better results than the subcutaneous approach (p=0.039). This study demonstrates that the xenotransplantation of uterine leiomyoma into the parietal peritoneum is more effective than the xenotransplantation of uterine leiomyoma into the subcutaneous tissue, and it describes a promising new model for the study of leiomyoma in vivo. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Evaluation of Eleventh Grade Turkish Pupils' Comprehension of General Chemistry Concepts

ERIC Educational Resources Information Center

Belge Can, Hatice; Boz, Yezdan

2011-01-01

The main purpose of this study is to evaluate eleventh grade Turkish pupils' comprehension of various general chemistry concepts which in turn enables to investigate chemistry concepts which are easier and harder for students to comprehend. Examining the effect of gender and last semester chemistry course grades on pupils' comprehension of general…

NEW EDUCATIONAL MATERIALS, PRE-KINDERGARTEN THROUGH GRADE TWELVE.

ERIC Educational Resources Information Center

ALLISON, MARY L., COMP.

THIS IS A COMPILATION OF EVALUATIONS AND REVIEWS WRITTEN BY TEACHERS, LIBRARIANS, AND CURRICULUM SPECIALISTS WHO HAVE TESTED THE MATERIALS. FROM PRE-KINDERGARTEN TO GRADE 12, BOOKS AND INSTRUCTIONAL MATERIALS FOR LANGUAGE ARTS, SOCIAL STUDIES, AND SCIENCE ARE REVIEWED. FOR GRADES 7 TO 12, MATERIALS ARE EVALUATED FOR ART AND MUSIC, HEALTH AND…

A Computer Vision System for Automated Grading of Rough Hardwood Lumber Using a Knowledge-Based Approach

Treesearch

Tai-Hoon Cho; Richard W. Conners; Philip A. Araman

1990-01-01

A sawmill cuts logs into lumber and sells this lumber to secondary remanufacturers. The price a sawmiller can charge for a volume of lumber depends on its grade. For a number of species the price of a given volume of material can double in going from one grade to the next higher grade. Thus, accurately establishing the grade of a volume of hardwood lumber is very...

Toxicity Assessment of Pelvic Intensity-Modulated Radiotherapy With Hypofractionated Simultaneous Integrated Boost to Prostate for Intermediate- and High-Risk Prostate Cancer

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

McCammon, Robert; Rusthoven, Kyle E.; Kavanagh, Brian

Purpose: To evaluate the toxicity of pelvic intensity-modulated radiotherapy (IMRT) with hypofractionated simultaneous integrated boost (SIB) to the prostate for patients with intermediate- to high-risk prostate cancer. Methods and Materials: A retrospective toxicity analysis was performed in 30 consecutive patients treated definitively with pelvic SIB-IMRT, all of whom also received androgen suppression. The IMRT plans were designed to deliver 70 Gy in 28 fractions (2.5 Gy/fraction) to the prostate while simultaneously delivering 50.4 Gy in 28 fractions (1.8 Gy/fraction) to the pelvic lymph nodes. The National Cancer Institute Common Terminology Criteria for Adverse Events, version 3.0, was used to scoremore » toxicity. Results: The most common acute Grade 2 events were cystitis (36.7%) and urinary frequency/urgency (26.7%). At a median follow-up of 24 months, late toxicity exceeding Grade 2 in severity was uncommon, with two Grade 3 events and one Grade 4 event. Grade 2 or greater acute bowel toxicity was associated with signficantly greater bowel volume receiving {>=}25 Gy (p = .04); Grade 2 or greater late bowel toxicity was associated with a higher bowel maximal dose (p = .04) and volume receiving {>=}50 Gy (p = .02). Acute or late bladder and rectal toxicity did not correlate with any of the dosimetric parameters examined. Conclusion: Pelvic IMRT with SIB to the prostate was well tolerated in this series, with low rates of Grade 3 or greater acute and late toxicity. SIB-IMRT combines pelvic radiotherapy and hypofractionation to the primary site and offers an accelerated approach to treating intermediate- to high-risk disease. Additional follow-up is necessary to fully define the long-term toxicity after hypofractionated, whole pelvic treatment combined with androgen suppression.« less

Facilitating healthcare decisions by assessing the certainty in the evidence from preclinical animal studies.

PubMed

Hooijmans, Carlijn R; de Vries, Rob B M; Ritskes-Hoitinga, Merel; Rovers, Maroeska M; Leeflang, Mariska M; IntHout, Joanna; Wever, Kimberley E; Hooft, Lotty; de Beer, Hans; Kuijpers, Ton; Macleod, Malcolm R; Sena, Emily S; Ter Riet, Gerben; Morgan, Rebecca L; Thayer, Kristina A; Rooney, Andrew A; Guyatt, Gordon H; Schünemann, Holger J; Langendam, Miranda W

2018-01-01

Laboratory animal studies are used in a wide range of human health related research areas, such as basic biomedical research, drug research, experimental surgery and environmental health. The results of these studies can be used to inform decisions regarding clinical research in humans, for example the decision to proceed to clinical trials. If the research question relates to potential harms with no expectation of benefit (e.g., toxicology), studies in experimental animals may provide the only relevant or controlled data and directly inform clinical management decisions. Systematic reviews and meta-analyses are important tools to provide robust and informative evidence summaries of these animal studies. Rating how certain we are about the evidence could provide important information about the translational probability of findings in experimental animal studies to clinical practice and probably improve it. Evidence summaries and certainty in the evidence ratings could also be used (1) to support selection of interventions with best therapeutic potential to be tested in clinical trials, (2) to justify a regulatory decision limiting human exposure (to drug or toxin), or to (3) support decisions on the utility of further animal experiments. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach is the most widely used framework to rate the certainty in the evidence and strength of health care recommendations. Here we present how the GRADE approach could be used to rate the certainty in the evidence of preclinical animal studies in the context of therapeutic interventions. We also discuss the methodological challenges that we identified, and for which further work is needed. Examples are defining the importance of consistency within and across animal species and using GRADE's indirectness domain as a tool to predict translation from animal models to humans.

Using patient values and preferences to inform the importance of health outcomes in practice guideline development following the GRADE approach.

PubMed

Zhang, Yuan; Coello, Pablo Alonso; Brożek, Jan; Wiercioch, Wojtek; Etxeandia-Ikobaltzeta, Itziar; Akl, Elie A; Meerpohl, Joerg J; Alhazzani, Waleed; Carrasco-Labra, Alonso; Morgan, Rebecca L; Mustafa, Reem A; Riva, John J; Moore, Ainsley; Yepes-Nuñez, Juan José; Cuello-Garcia, Carlos; AlRayees, Zulfa; Manja, Veena; Falavigna, Maicon; Neumann, Ignacio; Brignardello-Petersen, Romina; Santesso, Nancy; Rochwerg, Bram; Darzi, Andrea; Rojas, Maria Ximena; Adi, Yaser; Bollig, Claudia; Waziry, Reem; Schünemann, Holger J

2017-05-02

There are diverse opinions and confusion about defining and including patient values and preferences (i.e. the importance people place on the health outcomes) in the guideline development processes. This article aims to provide an overview of a process for systematically incorporating values and preferences in guideline development. In 2013 and 2014, we followed the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to adopt, adapt and develop 226 recommendations in 22 guidelines for the Ministry of Health of the Kingdom of Saudi Arabia. To collect context-specific values and preferences for each recommendation, we performed systematic reviews, asked clinical experts to provide feedback according to their clinical experience, and consulted patient representatives. We found several types of studies addressing the importance of outcomes, including those reporting utilities, non-utility measures of health states based on structured questionnaires or scales, and qualitative studies. Guideline panels used the relative importance of outcomes based on values and preferences to weigh the balance of desirable and undesirable consequences of alternative intervention options. However, we found few studies addressing local values and preferences. Currently there are different but no firmly established processes for integrating patient values and preferences in healthcare decision-making of practice guideline development. With GRADE Evidence-to-Decision (EtD) frameworks, we provide an empirical strategy to find and incorporate values and preferences in guidelines by performing systematic reviews and eliciting information from guideline panel members and patient representatives. However, more research and practical guidance are needed on how to search for relevant studies and grey literature, assess the certainty of this evidence, and best summarize and present the findings.

Marketing low-grade hardwoods for furniture stock - a new approach

Treesearch

Hugh W. Reynolds; Charles J. Gatchell

1979-01-01

A hardwood shortage of high-grade lumber exists while there is a surplus of low-grade hardwood timber. Two things are needed for the surplus to correct the shortage: a new manufacturing system and a new marketing technique. Utilization research at the Princeton Forestry Sciences Laboratory has developed the new system for converting low-grade hardwood for furniture use...

Mapping Educational Equity and Reform Policy in the Borderlands: LatCrit Spatial Analysis of Grade Retention

ERIC Educational Resources Information Center

Rodríguez, Cristóbal; Amador, Adam; Tarango, B. Abigail

2016-01-01

The purpose of our study is to investigate reform policy, specifically a proposed third grade reading retention policy within the Borderlands. Under this policy, students not performing proficiently on the third grade reading standardized exam will be automatically retained in the third grade. The research methods and approach used in this study…

Nutrition and Dentistry: A Joint Educational Approach to Snacks and Lunch Time Treats

ERIC Educational Resources Information Center

Chute, Debbie

1976-01-01

The approach described teaches food/snack choices as recommended by a Dental and Nutrition Education Position Paper developed by Public Health Dentists and Community Nutritionists in Ontario. A teaching technique (adaptable to other grades) for helping third grade students select and record balanced lunch menus is included. (MS)

Effects of a Paired Literacy Program on Emerging Bilingual Children's Biliteracy Outcomes in Third Grade

ERIC Educational Resources Information Center

Soltero-González, Lucinda; Sparrow, Wendy; Butvilofsky, Sandra; Escamilla, Kathy; Hopewell, Susan

2016-01-01

This longitudinal study examined whether the implementation of a Spanish-English paired literacy approach provides an academic advantage to emerging bilingual students over a sequential literacy approach. The study employed a quasi-experimental design. It compared the biliteracy outcomes of third-grade emerging bilingual learners participating in…

Walking and Talking Geography: A Small-World Approach

ERIC Educational Resources Information Center

Fertig, Gary; Silverman, Rick

2007-01-01

When teaching geography to students in the primary grades, teachers should provide firsthand experiences that young children need to make meaningful sense of their world. David Sobel, author of "Mapmaking with Children: Sense of Place Education for the Elementary Years," suggests that teachers in the early grades adopt a small-world approach to…

Creative Endeavors: Inspiring Creativity in a First Grade Classroom

ERIC Educational Resources Information Center

Cress, Susan W.; Holm, Daniel T.

2016-01-01

With an emphasis on high-stakes testing and a focused curriculum, it would seem at times, the joy of creativity is missing from the classroom. This article describes a curricular approach the children named "Creative Endeavors", as implemented by a first grade teacher. The approach is described in three phases. In the exploratory stage…

Active Learning in the Middle Grades Classroom: Overcoming the Barriers to Implementation

ERIC Educational Resources Information Center

Edwards, Susan

2015-01-01

The Association for Middle Level Education advocates for instruction that incorporates active learning and multiple learning approaches in middle grades classrooms. The aim of this qualitative study was to examine middle level teachers who are able to implement active learning and multiple learning approaches within the standardized testing and…

A new surgical technique for concealed penis using an advanced musculocutaneous scrotal flap.

PubMed

Han, Dong-Seok; Jang, Hoon; Youn, Chang-Shik; Yuk, Seung-Mo

2015-06-19

Until recently, no single, universally accepted surgical method has existed for all types of concealed penis repairs. We describe a new surgical technique for repairing concealed penis by using an advanced musculocutaneous scrotal flap. From January 2010 to June 2014, we evaluated 12 patients (12-40 years old) with concealed penises who were surgically treated with an advanced musculocutaneous scrotal flap technique after degloving through a ventral approach. All the patients were scheduled for regular follow-up at 6, 12, and 24 weeks postoperatively. The satisfaction grade for penile size, morphology, and voiding status were evaluated using a questionnaire preoperatively and at all of the follow-ups. Information regarding complications was obtained during the postoperative hospital stay and at all follow-ups. The patients' satisfaction grades, which included the penile size, morphology, and voiding status, improved postoperatively compared to those preoperatively. All patients had penile lymphedema postoperatively; however, this disappeared within 6 weeks. There were no complications such as skin necrosis and contracture, voiding difficulty, or erectile dysfunction. Our advanced musculocutaneous scrotal flap technique for concealed penis repair is technically easy and safe. In addition, it provides a good cosmetic appearance, functional outcomes and excellent postoperative satisfaction grades. Lastly, it seems applicable in any type of concealed penis, including cases in which the ventral skin defect is difficult to cover.

How to identify students for school-based depression intervention: can school record review be substituted for universal depression screening?

PubMed

Kuo, Elena S; Vander Stoep, Ann; Herting, Jerald R; Grupp, Katherine; McCauley, Elizabeth

2013-02-01

Early identification and intervention are critical for reducing the adverse effects of depression on academic and occupational performance. Cost-effective approaches are needed for identifying adolescents at high depression risk. This study evaluated the utility of school record review versus universal school-based depression screening for determining eligibility for an indicated depression intervention program implemented in the middle school setting. Algorithms derived from grades, attendance, suspensions, and basic demographic information were evaluated with regard to their ability to predict students' depression screening scores. The school information-based algorithms proved poor proxies for individual students' depression screening results. However, school records showed promise for identifying low, medium, and high-yield subgroups on the basis of which efficient screening targeting decisions could be made. Study results will help to guide school nurses who coordinate indicated depression intervention programs in school settings as they evaluate options of approaches for determining which students are eligible for participation. © 2012 Wiley Periodicals, Inc.

Genome-Wide Association Studies for Taxane-Induced Peripheral Neuropathy in ECOG-5103 and ECOG-1199.

PubMed

Schneider, Bryan P; Li, Lang; Radovich, Milan; Shen, Fei; Miller, Kathy D; Flockhart, David A; Jiang, Guanglong; Vance, Gail; Gardner, Laura; Vatta, Matteo; Bai, Shaochun; Lai, Dongbing; Koller, Daniel; Zhao, Fengmin; O'Neill, Anne; Smith, Mary Lou; Railey, Elda; White, Carol; Partridge, Ann; Sparano, Joseph; Davidson, Nancy E; Foroud, Tatiana; Sledge, George W

2015-11-15

Taxane-induced peripheral neuropathy (TIPN) is an important survivorship issue for many cancer patients. Currently, there are no clinically implemented biomarkers to predict which patients might be at increased risk for TIPN. We present a comprehensive approach to identification of genetic variants to predict TIPN. We performed a genome-wide association study (GWAS) in 3,431 patients from the phase III adjuvant breast cancer trial, ECOG-5103 to compare genotypes with TIPN. We performed candidate validation of top SNPs for TIPN in another phase III adjuvant breast cancer trial, ECOG-1199. When evaluating for grade 3-4 TIPN, 120 SNPs had a P value of <10(-4) from patients of European descent (EA) in ECOG-5103. Thirty candidate SNPs were subsequently tested in ECOG-1199 and SNP rs3125923 was found to be significantly associated with grade 3-4 TIPN (P = 1.7 × 10(-3); OR, 1.8). Race was also a major predictor of TIPN, with patients of African descent (AA) experiencing increased risk of grade 2-4 TIPN (HR, 2.1; P = 5.6 × 10(-16)) and grade 3-4 TIPN (HR, 2.6; P = 1.1 × 10(-11)) compared with others. An SNP in FCAMR, rs1856746, had a trend toward an association with grade 2-4 TIPN in AA patients from the GWAS in ECOG-5103 (OR, 5.5; P = 1.6 × 10(-7)). rs3125923 represents a validated SNP to predict grade 3-4 TIPN. Genetically determined AA race represents the most significant predictor of TIPN. ©2015 American Association for Cancer Research.

Awarding global grades in OSCEs: evaluation of a novel eLearning resource for OSCE examiners.

PubMed

Gormley, Gerard J; Johnston, Jenny; Thomson, Clare; McGlade, Kieran

2012-01-01

A novel online resource has been developed to aid OSCE examiner training comprising a series of videos of OSCE performances that allow inter-examiner comparison of global grade decisions. To evaluate this training resource in terms of usefulness and ability to improve examiner confidence in awarding global grades in OSCEs. Data collected from the first 200 users included global grades awarded, willingness to change grades following peer comparison and confidence in awarding grades before and after training. Most (86.5%) agreed that the resource was useful in developing global grade scoring ability in OSCEs, with a significant improvement in confidence in awarding grades after using the training package (p<0.001). This is a useful and effective online training package. As an adjunct to traditional training it offers a practical solution to the problem of availability of examiners.

Students' Perceptions of Peer Evaluation: An Expectancy Perspective

ERIC Educational Resources Information Center

Chen, Yining; Lou, Hao

2004-01-01

Because of the difficulty of evaluating uneven performance among group members, many researchers suggest incorporating peer evaluations in a grading system that permits an instructor to evaluate and grade individual performance more equitably within a group. In this study, the authors employ expectancy theory to assess key factors that may…

Effects of Repeated Intraperitoneal Injection of Pharmaceutical-grade and Nonpharmaceutical-grade Corn Oil in Female C57BL/6J Mice.

PubMed

Hubbard, Jennifer S; Chen, Patty H; Boyd, Kelli L

2017-11-01

Due to potential adverse effects on animal wellbeing, the use of nonpharmaceutical-grade substances in animal research must be scientifically justified in cases where a pharmaceutical-grade version of the substance exists. This requirement applies to all substances, including vehicles used to solubilize experimental drugs. To date, no studies have evaluated the direct effect of the pharmaceutical classification of a compound on animal wellbeing. In this study, we evaluated intraperitoneal administration of pharmaceutical-grade corn oil, nonpharmaceutical-grade corn oil, and saline in female C57BL/6J mice. Compounds were administered every 48 h for a total of 4 injections. Mice were evaluated clinically by using body weight, body condition score, visual assessment score, CBC, and serum chemistries. Animals were euthanized at 24 h and 14 d after the final injection. Inflammation of the peritoneal wall and mesenteric fat was assessed microscopically by using a semiquantitative scoring system. Saline-dosed groups had lower pathology scores at both time points. At day 21, pharmaceutical-grade corn oil had a significantly higher pathology score compared with nonpharmaceutical-grade corn oil. No other significant differences between the corn oil groups were observed. The use of nonpharmaceutical grade corn oil did not result in adverse clinical consequences and is presumed safe to use for intraperitoneal injection in mice. Differences in inflammation between the 2 groups suggest that the use of either pharmaceutical-grade or nonpharmaceutical-grade corn oil should be consistent within a study.

Grade inflation at a north american college of veterinary medicine: 1985-2006.

PubMed

Rush, Bonnie R; Elmore, Ronnie G; Sanderson, Michael W

2009-01-01

Grade inflation, an upward shift in student grade-point averages without a similar rise in achievement, is considered pervasive by most experts in post-secondary education in the United States. Grade-point averages (GPAs) at US universities have increased by roughly 0.15 points per decade since the 1960s, with a 0.6-point increase since 1967. In medical education, grade inflation has been documented and is particularly evident in the clinical setting. The purpose of this study was to evaluate grade inflation over a 22-year period in a college of veterinary medicine. Academic records from 2,060 students who graduated from the College of Veterinary Medicine at Kansas State University between 1985 and 2006 were evaluated, including cumulative GPAs earned during pre-clinical professional coursework, during clinical rotations, and at graduation. Grade inflation was documented at a rate of approximately 0.2 points per decade at this college of veterinary medicine. The difference in mean final GPA between the minimum (1986) and maximum (2003) years of graduation was 0.47 points. Grade inflation was similar for didactic coursework (years 1-3) and clinical rotations (final year). Demographic shifts, student qualifications, and tuition do not appear to have contributed to grade inflation over time. A change in academic standards and student evaluation of teaching may have contributed to relaxed grading standards, and technology in the classroom may have led to higher (earned) grades as a result of improved student learning.

Sports concussion: management and predictors of outcome.

PubMed

Reddy, Cara Camiolo; Collins, Michael W

2009-01-01

Interest in sports concussion has grown widely in the last two decades among laypersons and medical professionals. Significant contributions of evidence-based research have led to a better understanding of this multifaceted, but still often elusive, injury. This information has transformed all aspects of concussion management, from on-field evaluation through return-to-play guidelines. The aim of this article is to highlight important research regarding predictors of outcome and treatment protocols. This research has been the basis of the paradigm shift from traditional concussion grading scales to individualized care. Today, concussion management requires a patient-centered approach with individualized assessment, including risk factor analysis, neurocognitive testing, and a thorough symptom evaluation.

The South Carolina Amazing Coast Program: Using Ocean Sciences to Address Next Generation Science Standards in Grades 3-5

NASA Astrophysics Data System (ADS)

Bell, E. V.; Thomas, C.; Weiss, B.; Bliss, A.; Spence, L.

2013-12-01

The Next Generation Science Standards (NGSS) are more inclusive of ocean sciences than the National Science Standards and respective state science standards. In response, the Center for Ocean Sciences Education Excellence-SouthEast (COSEE SE) is piloting the South Carolina's Amazing Coast (SCAC) program: a three-year initiative that incorporates ocean science concepts in grades 3-5 with the goals of addressing NGSS, STEM (science-technology-engineering-math) disciplines, and inquiry skills. The SCAC program targeted two Charleston County, South Carolina elementary schools that were demographically similar: Title 1 status (75% free or reduced lunch), > 90% African American student population, grade level size <55, and proximity to tidal salt marsh or barrier islands (< 2 miles). Fourteen teachers and approximately 240 students participated in the SCAC program between 2010 and 2013. The SCAC framework uses a scaffolding and multi-pronged approach for teacher professional development and student engagement. The scaffolding approach to curriculum implementation focuses on one grade level per year (Year 1 = 3rd; Year 2 = 4th, and Year 3 = 5th), thus building student and teacher literacy in ocean sciences. The coach-mentor model of teacher professional development was also used for the implementation of the program which differs from the traditional 'train the trainer' method in allowing for more frequent and consistent interaction by COSEE SE staff with the students and teachers during the school year. The coach mentor model enabled the creation of a community of practice where teachers served as both learners and practitioners of student learning. Methods for student engagement aligned with the NGSS and included hands-on classroom activities, use of 'hook' species such as loggerhead sea turtles (Caretta caretta), diamondback terrapins (Malaclemys terrapin) and smooth cord grass (Spartina alterniflora), field experiences to explore local ecosystems, interactions with marine scientists, and a capstone project incorporating STEM and inquiry skills. Specifically, third grade students learn about coastal habitats, animal and plant adaptations, and human impacts to the environment, and engage in a salt marsh restoration capstone project. This part of the curriculum aligns with the NGSS Core Ideas 3-LS1, 3-LS3, 3-LS4, 3-ESS3. The fourth grade students learn about weather, organism responses to the environment, and engage in a weather buoy construction capstone project. This part of the curriculum aligns with the NGSSS Core Ideas 4-LS1, 4-ESS2, 4-ESS3, 3-5-ETS1. In 5th grade, students focus specifically on the ocean ecosystem, human impacts on the environment and engage in a capstone project of designing and constructing remotely operated vehicles. This part of the curriculum aligns with NGSS Core Ideas 5-PS2, 5-LS1, 5-LS2, 5-ESS2, 3-5-ETS1. Initial evaluation results indicate that the SCAC teachers value the coach mentor approach for teacher professional development as well as the impact of field based experiences, place-based learning, and a culminating capstone project on student learning. Teacher feedback also indicates elements of sustainability that extend beyond the scope of the pilot project.These initial evaluation results poise the SCAC curriculum to be replicated in other southeastern states.

[Depression in children at the beginning of school education. Prevalence of the phenomenon and its relation to the child's adaptive capacity].

PubMed

Bomba, J; Jaklewicz, H

1990-01-01

Depression in children has an unfavourable influence on the psychosocial development of the individual, therefore it requires suitable therapeutic and prophylactic approach. The dependencies between school-age immaturity and the prevalence of depression in children were evaluated in the prospective study. The school maturity, and one year later the prevalence of depression were studied in a representative sample of 502 "0"-grade children from the large urban population. The school immaturity was found in 10.56% of probands. More common symptoms were: withdrawal and antisocial behaviour. Depression was found in 32.79% of first-grade students, more frequent children with adaptation difficulties, especially among school-immature boys. The premature biological development, the symptoms of organic brain damage, and low I.Q. do not explain sufficiently neither the school-immaturity nor the prevalence of depression in children. It was found that emotional and social immaturity to the school duties facilitates the onset of depression among I grade students, while the role of the family and school in the genesis of both phenomena studied requires further investigations.

Multifunctional graded dielectrics fabricated using dry powder printing

NASA Astrophysics Data System (ADS)

Good, Austin J.; Roper, David; Good, Brandon; Yarlagadda, Shridhar; Mirotznik, Mark S.

2017-09-01

The ability to fabricate multifunctional devices that combine good structural properties with embedded electromagnetic functionality has many practical applications, including antireflective surfaces for structural radomes, load bearing conformal antennas, integrated RF transmission lines and passive beam forming networks. We describe here a custom made 3D printer that can print high dielectric constant ceramic powders within a low-loss structural composite substrate to produce mechanically robust parts with integrated graded dielectric properties. We fabricated a number of these parts and evaluated their anisotropic dielectric properties by determining the complete permittivity tensor of the printed samples as a function of local powder weight. This data was then experimentally validated using two practical examples: a Chebyshev antireflective stack and a 2D passive beamsteering network. The results of both electromagnetic systems displayed acceptable agreement between the simulated and measured results. This agreement shows that powder printing is a potential approach for fabricating spatially graded dielectric electromagnetic systems. This paper was submitted for review on 15 February 2017. The project is funded by the Office of Naval Research, Code 331.

Defining quality for distal pancreatectomy: does the laparoscopic approach protect patients from poor quality outcomes?

PubMed

Baker, Marshall S; Sherman, Karen L; Stocker, Susan; Hayman, Amanda V; Bentrem, David J; Prinz, Richard A; Talamonti, Mark S

2013-02-01

Established systems for grading postoperative complications do not change the assigned grade when multiple interventions or readmissions are required to manage a complication. Studies using these systems may misrepresent outcomes for the surgical procedures being evaluated. We define a quality outcome for distal pancreatectomy (DP) and use this metric to compare laparoscopic distal pancreatectomy (LDP) to open distal pancreatectomy (ODP). Records for patients undergoing DP between January 2006 and December 2009 were reviewed. Clavien-Dindo grade IIIb, IV, and V complications were classified as severe adverse--poor quality--postoperative outcomes (SAPOs). II and IIIa complications requiring either significantly prolonged overall lengths of stay including readmissions within 90 days or more than one invasive intervention were also classified as SAPOs. By Clavien-Dindo system alone, 91 % of DP patients had either no complication or a low/moderate grade (I, II, IIIa) complication. Using our reclassification, however, 25 % had a SAPO. Patients undergoing LDP demonstrated a Clavien-Dindo complication profile identical to that for SDP but demonstrated significantly shorter overall lengths of stay, were less likely to require perioperative transfusion, and less likely to have a SAPO. Established systems undergrade the severity of some complications following DP. Using a procedure-specific metric for quality, we demonstrate that LDP affords a higher quality postoperative outcome than ODP.

Metacognitive Prediction and Evaluation Skills and Mathematical Learning in Third-Grade Students

ERIC Educational Resources Information Center

Desoete, Annemie

2009-01-01

In a 2-year longitudinal study, 66 children were assessed in Grades 3 and 4 with a within-method-and-time design on metacognition (including the computerized Evaluation and Prediction Assessment [EPA2000]) and mathematics. Moreover, half of the children were trained in Grade 3 in the metacognitive skill of predicting their abilities in solving…

An Evaluation of Teachers' Perceptions of a State Developed Educational Portal

ERIC Educational Resources Information Center

Caraccio, Beth Katz

2009-01-01

The purpose of this study was to investigate teachers' perceptions use of a state developed educational portal. The research evaluated the differences in the quality, usefulness, and relevance of learning objects found on the website based on teachers' gender and grade level they taught. Grade level taught referred to those grades that are the…

The Long and Winding Road: Grades, Psychological Disengagement and Motivation among Female Students in (Non-)Traditional Career Paths

ERIC Educational Resources Information Center

Rinfret, Natalie; Tougas, Francine; Beaton, Ann M.; Laplante, Joelle; Ngo Manguelle, Christiane; Lagacé, Marie Claude

2014-01-01

The purpose of this study was to evaluate the links between grades, psychological disengagement mechanisms (discounting evaluative feedback and devaluing school), and motivation among female students in traditional and non-traditional career paths. We predicted that the association between grades and discounting is affected by the importance of…

English-French Bilingual Education in the Early Grades: The Elgin Study through Grade Four

ERIC Educational Resources Information Center

Barik, Henri C.; Swain, Merrill

1976-01-01

This paper presents the results of an evaluation of a bilingual education program for English-speaking pupils, grades 1-4, in Ontario. It is a partial French immersion program, with instruction in French or English half of each day. Evaluative tests are described, and English and French language skills examined. (CHK)

Evaluating the Impact and Determinants of Student Team Performance: Using LMS and CATME Data

ERIC Educational Resources Information Center

Braender, Lynn M.; Naples, Michele I.

2013-01-01

Practitioners find it difficult to allocate grades to individual students based on their contributions to the team project. They often use classroom observation of teamwork and student peer evaluations to differentiate an individual's grade from the group's grade, which can be subjective and imprecise. We used objective data from student activity…

Do Student Evaluations of Teaching Depend on the Distribution of Expected Grade?

ERIC Educational Resources Information Center

Matos-Diaz, Horacio; Ragan, James F., Jr.

2010-01-01

Prior research suggests that student evaluations of teaching may depend on the average grade expected in a class. We hypothesize that, because of risk aversion, student ratings also depend on the distribution of expected grades. As predicted, student ratings at the University of Puerto Rico at Bayamon are significantly and negatively related to…

An Evaluation of a Comprehensive Mentoring Program on Selected At-Risk Students with Specific School Problems

ERIC Educational Resources Information Center

Washington, Taren L.

2015-01-01

This study evaluated a comprehensive mentoring program on selected at-risk students with specific school problems (attendance, discipline referrals, and core area grades). The sample included youths in Grades 4-8 who differed on some characteristics including grade-level, ethnicity, and gender. For the purpose of this mixed methods study, the…

Grade Inflation and Student Individual Differences as Systematic Bias in Faculty Evaluations

ERIC Educational Resources Information Center

Germain, Marie-Line; Scandura, Terri A.

2005-01-01

The media has recently exposed that grade inflation is a concern for higher education in North America. Grade inflation may be due to consumerism by universities that now compete for students. Keeping students happy (and paying) may have been emphasized more than learning. We review the literature on faculty evaluation and present a model that…

Plus and Minus Grading Options: Toward Accurate Student Performance Evaluations.

ERIC Educational Resources Information Center

California Community Colleges, Sacramento. Academic Senate.

Although both the University of California and the California State University systems have the option to use plus or minus grades in student evaluations, the Board of Governors of the California Community Colleges (CCC) does not allow the use of such a grading system. Since 1985, the CCC's Academic Senate has lobbied the Board to allow local…

The Effect of Blended Learning Approach on Fifth Grade Students' Academic Achievement in My Beautiful Language Textbook and the Development of Their Verbal Creative Thinking in Saudi Arabia

ERIC Educational Resources Information Center

Al-Madani, Feras Mohammed

2015-01-01

This study aims at investigating the effect of Blended Learning approach compared to the traditional learning approach on fifth grade students' achievement in My Beautiful Language Textbook and the development of their verbal creative thinking. The study consisted of 49 students among which 25 are males in the Experimental Group and 24 females in…

Anatomical grades of nerve sparing: a risk-stratified approach to neural-hammock sparing during robot-assisted radical prostatectomy (RARP).

PubMed

Tewari, Ashutosh K; Srivastava, Abhishek; Huang, Michael W; Robinson, Brian D; Shevchuk, Maria M; Durand, Matthieu; Sooriakumaran, Prasanna; Grover, Sonal; Yadav, Rajiv; Mishra, Nishant; Mohan, Sanjay; Brooks, Danielle C; Shaikh, Nusrat; Khanna, Abhinav; Leung, Robert

2011-09-01

• To report the potency and oncological outcomes of patients undergoing robot-assisted radical prostatectomy (RARP) using a risk-stratified approach based on layers of periprostatic fascial dissection. • We also describe the surgical technique of complete hammock preservation or nerve sparing grade 1. • This is a retrospective study of 2317 patients who had robotic prostatectomy by a single surgeon at a single institution between January 2005 and June 2010. • Included patients were those with ≥ 1 year of follow-up and who were potent preoperatively, defined as having a sexual health inventory for men (SHIM) questionnaire score of >21; thus, the final number of patients in the study cohort was 1263. • Patients were categorized pre-operatively by a risk-stratified approach into risk grades 1-4, where risk grade 1 patients received nerve-sparing grade 1 or complete hammock preservation and so on for risk grades 2-4, as long as intraoperative findings permitted the planned nerve sparing. • We considered return to sexual function post-operatively by two criteria: i) ability to have successful intercourse (score of ≥ 4 on question 2 of the SHIM) and ii) SHIM >21 or return to baseline sexual function. • There was a significant difference across different NS grades in terms of the percentages of patients who had intercourse and returned to baseline sexual function (P < 0.001), with those that underwent NS grade 1 having the highest rates (90.9% and 81.7%) as compared to NS grades 2 (81.4% and 74.3%), 3 (73.5% and 66.1%), and 4 (62% and 54.5%). • The overall positive surgical margin (PSM) rates for patients with NS grades 1, 2, 3, and 4 were 9.9%, 8.1%, 7.2%, and 8.7%, respectively (P = 0.636). • The extraprostatic extension rates were 11.6%, 14.3%, 29.3%, and 36.2%, respectively (P < 0.001). • Similarly, in patients younger than 60, intercourse and return to baseline sexual function rates were 94.9% and 84.3% for NS grade 1 as compared to 85.5% and 77.2% for NS grades 2, 76.9% and 69% for NS grades 3, and 64.8% and 57.7% for NS Grade 4 (P < 0.001). • The risk-stratified approach and anatomical technique of neural-hammock sparing described in the present manuscript was effective in improving potency outcomes of patients without compromising cancer control. • Patients with greater degrees of NS had higher rates of intercourse and return to baseline sexual function without an increase in PSM rates. © 2011 THE AUTHORS. BJU INTERNATIONAL © 2011 BJU INTERNATIONAL.

Evaluation of grades 3 and 4 chondromalacia of the knee using T2*-weighted 3D gradient-echo articular cartilage imaging.

PubMed

Murphy, B J

2001-06-01

To determine the accuracy of T2*-weighted three-dimensional (3D) gradient-echo articular cartilage imaging in the identification of grades 3 and 4 chondromalacia of the knee. A retrospective evaluation of 80 patients who underwent both arthroscopic and MRI evaluation was performed. The 3D images were interpreted by one observer without knowledge of the surgical results. The medial and lateral femoral condyles, the medial and lateral tibial plateau, the patellar cartilage and trochlear groove were evaluated. MR cartilage images were considered positive if focal reduction of cartilage thickness was present (grade 3 chondromalacia) or if complete loss of cartilage was present (grade 4 chondromalacia). Comparison of the 3D MR results with the arthroscopic findings was performed. Eighty patients were included in the study group. A total of 480 articular cartilage sites were evaluated with MRI and arthroscopy. Results of MR identification of grades 3 and 4 chondromalacia, all sites combined, were: sensitivity 83%, specificity 97%, false negative rate 17%, false positive rate 3%, positive predictive value 87%, negative predictive value 95%, overall accuracy 93%. The results demonstrate that T2*-weighted 3D gradient-echo articular cartilage imaging can identify grades 3 and 4 chondromalacia of the knee.

Selection and evaluation of performance-graded asphalt binders for Virginia.

DOT National Transportation Integrated Search

1999-06-01

This study recommended performance-graded (PG) binders to be used in hot-mix asphalt in Virginia. Ten conventional viscosity-graded asphalt cements, representing the asphalt typically available in Virginia, were graded under the PG system to develop ...

Cleanrooms and tissue banking how happy I could be with either GMP or GTP?

PubMed

Klykens, J; Pirnay, J-P; Verbeken, G; Giet, O; Baudoux, E; Jashari, R; Vanderkelen, A; Ectors, N

2013-12-01

The regulatory framework of tissue banking introduces a number of requirements for monitoring cleanrooms for processing tissue or cell grafts. Although a number of requirements were clearly defined, some requirements are open for interpretation. This study aims to contribute to the interpretation of GMP or GTP guidelines for tissue banking. Based on the experience of the participating centers, the results of the monitoring program were evaluated to determine the feasibility of a cleanroom in tissue banking and the monitoring program. Also the microbial efficacy of a laminar airflow cabinet and an incubator in a cleanroom environment was evaluated. This study indicated that a monitoring program of a cleanroom at rest in combination with (final) product testing is a feasible approach. Although no statistical significance (0.90 < p < 0.95) was found there is a strong indication that a Grade D environment is not the ideal background environment for a Grade A obtained through a laminar airflow cabinet. The microbial contamination of an incubator in a cleanroom is limited but requires closed containers for tissue and cell products.

Evidence-based interventions in pediatric psychology: progress over the decades.

PubMed

Palermo, Tonya M

2014-09-01

This introduction to the special issue on Evidence-Based Interventions in Pediatric Psychology provides background on the process used to develop the special issue, a summary of the key findings from the series of reviews, and discussion of the implications for evidence-based practice. Authors followed a three-phase approach to develop their systematic reviews using rigorous systematic review methodology drawn heavily from the Cochrane Collaboration. The strength of the evidence for each pediatric psychology intervention was evaluated using Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. The introduction discusses the progress that has been made in the evidence base for pediatric psychology interventions since the first special series published in 1999. Recommendations to stimulate further research and expand and strengthen the quality of the evidence base are described. The introduction concludes with implications from the special issue for pediatric psychology training in evidence-based practice. © The Author 2014. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Wilderness Medical Society practice guidelines for the out-of-hospital evaluation and treatment of accidental hypothermia.

PubMed

Zafren, Ken; Giesbrecht, Gordon G; Danzl, Daniel F; Brugger, Hermann; Sagalyn, Emily B; Walpoth, Beat; Weiss, Eric A; Auerbach, Paul S; McIntosh, Scott E; Némethy, Mária; McDevitt, Marion; Dow, Jennifer; Schoene, Robert B; Rodway, George W; Hackett, Peter H; Bennett, Brad L; Grissom, Colin K

2014-12-01

To provide guidance to clinicians, the Wilderness Medical Society (WMS) convened an expert panel to develop evidence-based guidelines for the out-of-hospital evaluation and treatment of victims of accidental hypothermia. The guidelines present the main diagnostic and therapeutic modalities and provide recommendations for the management of hypothermic patients. The panel graded the recommendations based on the quality of supporting evidence and the balance between benefits and risks/burdens according the criteria published by the American College of Chest Physicians. The guidelines also provide suggested general approaches to the evaluation and treatment of accidental hypothermia that incorporate specific recommendations. Copyright © 2014 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

Laparoscopic approach to colorectal procedures in the obese patient: risk factor or benefit?

PubMed

Scheidbach, Hubert; Benedix, Frank; Hügel, Omar; Kose, Daniela; Köckerling, Ferdinand; Lippert, Hans

2008-01-01

Obesity is a modern-day phenomenon that is increasing throughout the world. The aim of the present study was to provide data to establish whether the laparoscopic approach to colorectal surgery in the obese patient represents a risk or, rather, a benefit for the patient. The data presented in this paper were obtained within the framework of a prospective multicenter study initiated by the "Laparoscopic Colorectal Surgery Study Group (LCSSG)" and performed on 5,853 recruited patients. The perioperative course was compared between the three groups: nonobese, obesity grade I, and obesity grade II/III. Increasing body mass index correlated with a highly significant increase in the duration of the operation (nonobese 167 min, grade I 182 min, grade II/III 191 min; p < 0.001) and in the conversion rate (nonobese 5.5%, obesity grade I 7.9%, obesity grade II/III 13.1%; p < 0.001). The intraoperative complication rate also showed a tendency to increase (nonobese 5.0%, grade I 6.2%, grade II/III 7.1%; p = 0.219). In contrast, no significant differences were found between the groups with regard to the postoperative complication rate (nonobese 20.7%, grade I 21.0%, grade II/III 20.2%), the reoperation rate (nonobese 4.1%, grade I 3.9%, grade II/III 3.6%), and the postoperative mortality rate (nonobese 1.1%, grade I 1.9%, grade II/III 1.8%). Laparoscopic colorectal surgery is clearly more technically demanding in the obese patient. Apart from this, however, it is not associated with any increased risk of postoperative complications, and thus demonstrates that the pathologically overweight patient can benefit to a particular degree from the laparoscopic modality.

49 CFR 392.11 - Railroad grade crossings; slowing down required.

Code of Federal Regulations, 2010 CFR

2010-10-01

... MOTOR CARRIER SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION FEDERAL MOTOR CARRIER SAFETY REGULATIONS DRIVING OF COMMERCIAL MOTOR VEHICLES Driving of Commercial Motor Vehicles § 392.11 Railroad grade..., upon approaching a railroad grade crossing, be driven at a rate of speed which will permit said...

Low cost automated whole smear microscopy screening system for detection of acid fast bacilli.

PubMed

Law, Yan Nei; Jian, Hanbin; Lo, Norman W S; Ip, Margaret; Chan, Mia Mei Yuk; Kam, Kai Man; Wu, Xiaohua

2018-01-01

In countries with high tuberculosis (TB) burden, there is urgent need for rapid, large-scale screening to detect smear-positive patients. We developed a computer-aided whole smear screening system that focuses in real-time, captures images and provides diagnostic grading, for both bright-field and fluorescence microscopy for detection of acid-fast-bacilli (AFB) from respiratory specimens. To evaluate the performance of dual-mode screening system in AFB diagnostic algorithms on concentrated smears with auramine O (AO) staining, as well as direct smears with AO and Ziehl-Neelsen (ZN) staining, using mycobacterial culture results as gold standard. Adult patient sputum samples requesting for M. tuberculosis cultures were divided into three batches for staining: direct AO-stained, direct ZN-stained and concentrated smears AO-stained. All slides were graded by an experienced microscopist, in parallel with the automated whole smear screening system. Sensitivity and specificity of a TB diagnostic algorithm in using the screening system alone, and in combination with a microscopist, were evaluated. Of 488 direct AO-stained smears, 228 were culture positive. These yielded a sensitivity of 81.6% and specificity of 74.2%. Of 334 direct smears with ZN staining, 142 were culture positive, which gave a sensitivity of 70.4% and specificity of 76.6%. Of 505 concentrated smears with AO staining, 250 were culture positive, giving a sensitivity of 86.4% and specificity of 71.0%. To further improve performance, machine grading was confirmed by manual smear grading when the number of AFBs detected fell within an uncertainty range. These combined results gave significant improvement in specificity (AO-direct:85.4%; ZN-direct:85.4%; AO-concentrated:92.5%) and slight improvement in sensitivity while requiring only limited manual workload. Our system achieved high sensitivity without substantially compromising specificity when compared to culture results. Significant improvement in specificity was obtained when uncertain results were confirmed by manual smear grading. This approach had potential to substantially reduce workload of microscopists in high burden countries.

Teaching Grade 5 Life Science with a Case Study Approach

ERIC Educational Resources Information Center

Olgun, Ozlem Sila; Adali, Belgin

2008-01-01

The main purpose of this study was to investigate the effects of a case study approach on students' achievement and attitudes towards viruses, bacteria, fungi, and protista. Fifth-grade students (N = 88) from two different classes were involved in the study. One intact class was assigned as the experimental group, whereas the other intact class…

Methodology in Reading Instruction as a Controlling Variable in the Constructive or Destructive Channeling of Aggression.

ERIC Educational Resources Information Center

Grobler, C. van Eyk

Fourth grade students (half of whom received reading instruction through the Language Experience Approach and the other half through the Basal Reader Approach since the first grade) were observed to determine the behavioral channeling of aggression when influenced by method of instruction. The methods were: (1) a Directed Reading-Thinking Activity…

Teaching and Learning about Matter in Grade 6 Classrooms: A Conceptual Change Approach

ERIC Educational Resources Information Center

Pimthong, Pattamaporn; Yutakom, Naruemon; Roadrangka, Vantipa; Sanguanruang, Sudjid; Cowie, Bronwen; Cooper, Beverley

2012-01-01

The purpose of this study was to enhance the teaching and learning of matter and its properties for grade 6 students. The development of a conceptual change approach instructional unit was undertaken for this purpose. Pre- and post-concept surveys, classroom observations, and student and teacher interviews were used to collect data. The teaching…

An Analysis of Approaches to Goal Setting in Middle Grades Personalized Learning Environments

ERIC Educational Resources Information Center

DeMink-Carthew, Jessica; Olofson, Mark W.; LeGeros, Life; Netcoh, Steven; Hennessey, Susan

2017-01-01

This study investigated the goal-setting approaches of 11 middle grades teachers during the first year of their implementation of a statewide, personalized learning initiative. As an increasing number of middle level schools explore personalized learning, there is an urgent need for empirical research in this area. Goal setting is a critical…

Identifying Meaningful Behaviors for Social Competence: A Contextual Approach.

ERIC Educational Resources Information Center

Warnes, Emily D.; Sheridan, Susan M.; Geske, Jenenne; Warnes, William A.

An exploratory study was conducted which assessed behaviors that characterize social competence in the 2nd and 5th grades. A contextual approach was used to gather information from 2nd and 5th grade children and their parents and teachers regarding the behaviors they perceived to be important for getting along well with peers. Data were gathered…

The Effect of a Conceptual Change Approach on Understanding of Students' Chemical Equilibrium Concepts

ERIC Educational Resources Information Center

Atasoy, Basri; Akkus, Huseyin; Kadayifci, Hakki

2009-01-01

The purpose of this study was to compare the effects of a conceptual change approach over traditional instruction on tenth-grade students' conceptual achievement in understanding chemical equilibrium. The study was conducted in two classes of the same teacher with participation of a total of 44 tenth-grade students. In this study, a…

National Beef Quality Audit-2011: Survey of instrument grading assessments of beef carcass characteristics

USDA-ARS?s Scientific Manuscript database

The instrument grading assessments for the 2011 National Beef Quality Audit evaluated seasonal trends of beef carcass quality and yield attributes over the course of the year. One week of instrument grading data, HCW, gender, USDA quality grade (QG), and yield grade (YG) factors, were collected ever...

First Grade Baseline Evaluation

ERIC Educational Resources Information Center

Center for Innovation in Assessment (NJ1), 2013

2013-01-01

The First Grade Baseline Evaluation is an optional tool that can be used at the beginning of the school year to help teachers get to know the reading and language skills of each student. The evaluation is composed of seven screenings. Teachers may use the entire evaluation or choose to use those individual screenings that they find most beneficial…

Vaginal prolapse repair using the Prolift kit: a registry of 100 successive cases.

PubMed

Simon, Marie; Debodinance, Philippe

2011-09-01

To evaluate anatomical, functional outcomes and complications inherent to the treatment of pelvic organ prolapse by implantation of polypropylene mesh, using the Prolift kit. Single-center observational study of 100 successive patients enrolled in a registry, who underwent Prolift prolapse repair. Data on prior treatments, associated procedures and per- and post-operative complications were collected and the patients were seen after 2, 6 and 12 months. Anatomical outcomes were assessed using the International Continence Society Pelvic Organ Prolapse Quantification (ICS POP-Q) system. Function was assessed in terms of urinary and digestive problems, and impact on sex life. Failure was defined as relapse of POP-Q Grade 2 or more. Of the 100 patients, 32 had an anterior, 14 a posterior, 54 a total Prolift; 53 had concomitant urinary incontinence surgery. At 6 and 12 months respectively, 8% and 12% of the patients were lost to follow-up. Mean operating time was 39.8 min. With respect to peri-operative complications, there was no bladder or rectal damage but three patients experienced bleeding (≥ 300 ml) without needing transfusion. POP-Q Grades before surgery were: Grades III-IV cystocele in 65.7% of the anterior Prolift patients; Grades II-III rectocele in the posterior; and 77.8% of total were Grade III and 11.1% Grade IV. The incidence of recurrence was 3.6% at Month 6 and 10.2% at Month 12. Significant (p<0.05) improvements were seen in median scores for the various POP-Q items. With respect to functional problems, stress urinary incontinence was cured in 92% of the patients but 7.7% reported new-onset urinary incontinence after one year. One case of vaginal exposure after one year was observed and major or symptomatic mesh retraction was observed in 8%. New-onset dyspareunia was reported by 11.1% of the patients. These results confirm the feasibility of using the Prolift kit in the repair of prolapse via a vaginal approach and the low per- and post-operative morbidity associated with that technique. Nevertheless, longer-term evaluation is required to confirm the results. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Accurate visible speech synthesis based on concatenating variable length motion capture data.

PubMed

Ma, Jiyong; Cole, Ron; Pellom, Bryan; Ward, Wayne; Wise, Barbara

2006-01-01

We present a novel approach to synthesizing accurate visible speech based on searching and concatenating optimal variable-length units in a large corpus of motion capture data. Based on a set of visual prototypes selected on a source face and a corresponding set designated for a target face, we propose a machine learning technique to automatically map the facial motions observed on the source face to the target face. In order to model the long distance coarticulation effects in visible speech, a large-scale corpus that covers the most common syllables in English was collected, annotated and analyzed. For any input text, a search algorithm to locate the optimal sequences of concatenated units for synthesis is desrcribed. A new algorithm to adapt lip motions from a generic 3D face model to a specific 3D face model is also proposed. A complete, end-to-end visible speech animation system is implemented based on the approach. This system is currently used in more than 60 kindergarten through third grade classrooms to teach students to read using a lifelike conversational animated agent. To evaluate the quality of the visible speech produced by the animation system, both subjective evaluation and objective evaluation are conducted. The evaluation results show that the proposed approach is accurate and powerful for visible speech synthesis.

Evaluation of a Randomized Intervention to Delay Sexual Initiation among Fifth-Graders Followed through the Sixth Grade

ERIC Educational Resources Information Center

Koo, Helen P.; Rose, Allison; El-Khorazaty, M. Nabil; Yao, Qing; Jenkins, Renee R.; Anderson, Karen M.; Davis, Maurice; Walker, Leslie R.

2011-01-01

US adolescents initiate sex at increasingly younger ages, yet few pregnancy prevention interventions for children as young as 10-12 years old have been evaluated. Sixteen Washington, DC schools were randomly assigned to intervention versus control conditions. Beginning in 2001/02 with fifth-grade students and continuing during the sixth grade,…

Evaluation of Project RACE. Weatherford Independent School District, Weatherford, Texas. Final Report.

ERIC Educational Resources Information Center

Belcher, Mary H.; And Others

The third party evaluation of the K-12 career education project RACE (Researched Activities for Career Education) focused on test results of students in four selected grades. A career education questionnaire was administered as a pre-test and again as a post-test to students in the third and sixth grades. Ninth and twelfth grade students were…

Effects of Grading Leniency and Low Workload on Students' Evaluations of Teaching: Popular Myth, Bias, Validity, or Innocent Bystanders?

ERIC Educational Resources Information Center

Marsh, Herbert W.; Roche, Lawrence A.

2000-01-01

Discusses two studies that debunk the popular myths that student evaluations of teaching (SETs) are substantially biased by low workload and grading leniency. Results imply teaching effects were related to SETs. Contrary to predictions workload, expected grades, and their relations to SETs were stable over 12 years. (Author/MKA)

A SCIENCE PROGRAM FOR THE ELEMENTARY SCHOOLS OF LOWER MERION SCHOOL DISTRICT.

ERIC Educational Resources Information Center

Lower Merion Township School District, Ardmore, PA.

AFTER AN EVALUATION MADE BY THE TEACHERS OF KINDERGARTEN THROUGH GRADE 6, THE FOLLOWING AREAS OF CLARIFICATION, REWRITING, OR ADDITIONS WERE INDICATED--THE PURPOSE AND USE OF THE SCIENCE GUIDE, EVALUATION OF THE UNITS BY GRADES, ADDITIONAL MATERIALS FOR THE UNITS, A REWRITING OF PARTICULAR UNITS, HEALTH UNITS FOR GRADES 1 THROUGH 5, THE USE OF…

A New Strategy for Dealing with Social Loafers on the Group Project: The Segment Manager Method

ERIC Educational Resources Information Center

Dommeyer, Curt J.

2012-01-01

Professors often give members of a group project the same grade or they use peer evaluations to provide individualized grades. Unfortunately, both these methods have shortcomings. This article describes the segment manager method (SMM), a method for assigning individualized grades on the group project that does not rely on peer evaluations. A…

Family Life and Human Development: Sample Units, K-6. Revised.

ERIC Educational Resources Information Center

Prince George's County Public Schools, Upper Marlboro, MD.

Sample unit outlines, designed for kindergarten through grade six, define the content, activities, and assessment tasks appropriate to specific grade levels. The units have been extracted from the Board-approved curriculum, Health Education: The Curricular Approach to Optimal Health. The instructional guidelines for grade one are: describing a…

Environmental Education Manual for Grades I to XII.

ERIC Educational Resources Information Center

Houghton, J. R.

This manual focuses on the interdisciplinary approach to environmental education for grades 1 to 12 by providing curriculum models for each grade level. Models, presented in a three-column format, display relationships between concepts and ideas with an environmental focus and various subjects/disciplines. The central column (headed Environmental…

Are Immigrants and Girls Graded Worse? Results of a Matching Approach

ERIC Educational Resources Information Center

Kiss, David

2013-01-01

Using Progress in International Reading Literacy Study 2001 and Programme for International Student Assessment 2003 data for Germany, this paper examines whether second-generation immigrants and girls are graded worse in math than comparable natives and boys, respectively. Once all grading-relevant characteristics, namely math skills and oral…

PAX1 methylation analysis by MS-HRM is useful in triage of high-grade squamous intraepithelial lesions.

PubMed

Wang, Zhen-Ming

2014-01-01

This study is aimed to investigate the role of paired boxed gene 1 (PAX1) methylation analysis by methylation- sensitive high-resolution melting (MS-HRM) in the detection of high grade lesions in atypical squamous cells cannot exclude high-grade squamous intraepithelial lesion (ASC-H) and compared its performance with the Hybrid Capture 2 (HC2) human papillomavirus (HPV) test. In our study, 130 cases with a diagnosis of ASC-H from the cervical cytological screening by Thinprep cytologic test (TCT) technique were selected for triage. Their cervical scrapings were collected and evaluated by using PAX1 methylation analysis (MS-HRM) and high-risk HPV DNA test (HC2), followed by colposcopy and cervical biopsy. Chi-square test were used to test the differences of PAX1 methylation or HPV infection between groups. In the detection of CIN2+, the sensitivity, specificity, the PPV, NPV and the accuracy of PAX1 MS-HRM assay and high-risk HPV (HR-HPV) tests were respectively 80.6% vs 67.7%, 94.9% vs 54.5%, 83.3%, vs 31.8%, 94.0% vs 84.4%, and 91.5% vs 57.7%. The PAX1 MS-HRM assay proved superior to HR-HPV testing in the detection of high grade lesions (CIN2+) in ASC-H. This approach could screen out the majority of high grade lesion cases of ASC-H, and thus could reduce the referral rate to colposcopy.

Development of a framework for resilience measurement: Suggestion of fuzzy Resilience Grade (RG) and fuzzy Resilience Early Warning Grade (REWG).

PubMed

Omidvar, Mohsen; Mazloumi, Adel; Mohammad Fam, Iraj; Nirumand, Fereshteh

2017-01-01

Resilience engineering (RE) can be an alternative technique to the traditional risk assessment and management techniques, to predict and manage safety conditions of modern socio-technical organizations. While traditional risk management approaches are retrospective and highlight error calculation and computation of malfunction possibilities, resilience engineering seeks ways to improve capacity at all levels of organizations in order to build strong yet flexible processes. Considering the resilience potential measurement as a concern in complex working systems, the aim of this study was to quantify the resilience by the help of fuzzy sets and Multi-Criteria Decision-Making (MCDM) techniques. In this paper, we adopted the fuzzy analytic hierarchy process (FAHP) method to measure resilience in a gas refinery plant. A resilience assessment framework containing six indicators, each with its own sub-indicators, was constructed. Then, the fuzzy weights of the indicators and the sub-indicators were derived from pair-wise comparisons conducted by experts. The fuzzy evaluating vectors of the indicators and the sub-indicators computed according to the initial assessment data. Finally, the Comprehensive Resilience Index (CoRI), Resilience Grade (RG), and Resilience Early Warning Grade (REWG) were established. To demonstrate the applicability of the proposed method, an illustrative example in a gas refinery complex (an instance of socio-technical systems) was provided. CoRI of the refinery ranked as "III". In addition, for the six main indicators, RG and REWG ranked as "III" and "NEWZ", respectively, except for C3, in which RG ranked as "II", and REWG ranked as "OEWZ". The results revealed the engineering practicability and usefulness of the proposed method in resilience evaluation of socio-technical systems.

SU-D-207B-04: Morphological Features of MRI as a Correlate of Capsular Contracture in Breast Cancer Patients with Implant-Based Reconstructions

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

Tyagi, N; Sutton, E; Hunt, M

Purpose: Capsular contracture (CC) is a serious complication in patients receiving implant-based reconstruction for breast cancer. The goal of this study was to identify image-based correlates of CC using MRI imaging in breast cancer patients who received both MRI and clinical evaluation following reconstructive surgery. Methods: We analyzed a retrospective dataset of 50 patients who had both a diagnostic MR and a plastic surgeon’s evaluations of CC score (Baker’s score) within a six month period following mastectomy and reconstructive surgery. T2w sagittal MRIs (TR/TE = 3500/102 ms, slice thickness = 4 mm) were used for morphological shape features (roundness, eccentricity,more » solidity, extent and ratio-length) and histogram features (median, skewness and kurtosis) of the implant and the pectoralis muscle overlying the implant. Implant and pectoralis muscles were segmented in 3D using Computation Environment for Radiological Research (CERR) and shape and histogram features were calculated as a function of Baker’s score. Results: Shape features such as roundness and eccentricity were statistically significant in differentiating grade 1 and grade 2 (p = 0.009; p = 0.06) as well as grade 1 and grade 3 CC (p = 0.001; p = 0.006). Solidity and extent were statistically significant in differentiating grade 1 and grade 3 CC (p = 0.04; p = 0.04). Ratio-length was statistically significant in differentiating all grades of CC except grade 2 and grade 3 that showed borderline significance (p = 0.06). The muscle thickness, median intensity and kurtosis were significant in differentiating between grade 1 and grade 3 (p = 0.02), grade 1 and grade 2 (p = 0.03) and grade 1 and grade 3 (p = 0.01) respectively. Conclusion: Morphological shape features described on MR images were associated with the severity of CC. MRI may be important in objectively evaluating outcomes in breast cancer patients who undergo implant reconstruction.« less

SOAP Methodology in General Practice/Family Medicine Teaching in Practical Context.

PubMed

Santiago, Luiz Miguel; Neto, Isabel

2016-12-30

Medical records in General Practice/Family Medicine are an essential information support on the health status of the patient and a communication document between health professionals. The development of competencies in General Practice/Family Medicine during pre-graduation must include the ability to make adequate medical records in practical context. As of 2012, medicine students at the University of Beira Interior have been performing visits using the Subjective, Objective, Assessment and Plan - SOAP methodology, with a performance evaluation of the visit, with the aim to check on which Subjective, Objective, Assessment and Plan - SOAP aspects students reveal the most difficulties in order to define improvement techniques and to correlate patient grade with tutor evaluation. Analysing the evaluation data for the 2015 - 2016 school year at the General Practice/Family Medicine visit carried out by fourth year students in medicine, comparing the averages of each item in the Subjective, Objective, Assessment and Plan - SOAP checklist and the patient evaluation. In the Subjective, Objective, Assessment and Plan - SOAP, 29.7% of students are on the best grade quartile, 37.1% are on the best competencies quartile and 27.2% on the best patient grade quartile. 'Evolution was verified/noted' received the worst grades in Subjective, 'Record of physical examination focused on the problem of the visit' received the worst grades in Objective, 'Notes of Diagnostic reasoning / differential diagnostic' received de worst grades in Assessment and 'Negotiation of aims to achieve' received the worst grades in Plan. The best tutor evaluation is found in 'communication'. Only one single study evaluated student´s performance under examination during a visit, with similar results to the present one and none addressed the patient's evaluation. Students revealed a good performance in using the Subjective, Objective, Assessment and Plan - SOAP. The findings represent the beginning of the introduction of the Subjective, Objective, Assessment and Plan - SOAP to the students. This evaluation breaks ground towards better ways to teach the most difficult aspects.

ICD-9-CM and ICD-10-CM mapping of the AAST Emergency General Surgery disease severity grading systems: Conceptual approach, limitations, and recommendations for the future.

PubMed

Utter, Garth H; Miller, Preston R; Mowery, Nathan T; Tominaga, Gail T; Gunter, Oliver; Osler, Turner M; Ciesla, David J; Agarwal, Suresh K; Inaba, Kenji; Aboutanos, Michel B; Brown, Carlos V R; Ross, Steven E; Crandall, Marie L; Shafi, Shahid

2015-05-01

The American Association for the Surgery of Trauma (AAST) recently established a grading system for uniform reporting of anatomic severity of several emergency general surgery (EGS) diseases. There are five grades of severity for each disease, ranging from I (lowest severity) to V (highest severity). However, the grading process requires manual chart review. We sought to evaluate whether International Classification of Diseases, 9th and 10th Revisions, Clinical Modification (ICD-9-CM, ICD-10-CM) codes might allow estimation of AAST grades for EGS diseases. The Patient Assessment and Outcomes Committee of the AAST reviewed all available ICD-9-CM and ICD-10-CM diagnosis codes relevant to 16 EGS diseases with available AAST grades. We then matched grades for each EGS disease with one or more ICD codes. We used the Official Coding Guidelines for ICD-9-CM and ICD-10-CM and the American Hospital Association's "Coding Clinic for ICD-9-CM" for coding guidance. The ICD codes did not allow for matching all five AAST grades of severity for each of the 16 diseases. With ICD-9-CM, six diseases mapped into four categories of severity (instead of five), another six diseases into three categories of severity, and four diseases into only two categories of severity. With ICD-10-CM, five diseases mapped into four categories of severity, seven diseases into three categories, and four diseases into two categories. Two diseases mapped into discontinuous categories of grades (two in ICD-9-CM and one in ICD-10-CM). Although resolution is limited, ICD-9-CM and ICD-10-CM diagnosis codes might have some utility in roughly approximating the severity of the AAST grades in the absence of more precise information. These ICD mappings should be validated and refined before widespread use to characterize EGS disease severity. In the long-term, it may be desirable to develop alternatives to ICD-9-CM and ICD-10-CM codes for routine collection of disease severity characteristics.

A new approach for Roux-en-Y reconstruction after pancreaticoduodenectomy.

PubMed

Xu, Meng; Wang, Min; Zhu, Feng; Tian, Rui; Shi, Cheng-Jian; Wang, Xin; Shen, Ming; Qin, Ren-Yi

2014-12-01

Postoperative pancreatic fistula remains the most common complication of pancreaticoduodenectomy (PD) and is potentially lethal. It contributes significantly to prolonged hospitalization and mortality. In this study, we introduced a new technical approach, a modified Roux-en-Y reconstruction and evaluated its safety and feasibility. We retrospectively reviewed the patients who had undergone PD with the modified Roux-en-Y reconstructive technique for periampullary malignancies from January 2011 to June 2012. The data on complications, hospital stay and outcomes after the modified Roux-en-Y reconstruction were analyzed. The reconstruction was performed in 171 patients, of whom 92 received pancreaticogastrostomy and 79 received pancreaticojejunostomy. The median duration of surgery was 4.0 hours (range 3.1-6.9) in all patients, and the median blood loss was 530 mL (range 200-2000). Sixty-nine patients were subjected to transfusions, with a median transfusion volume of 430 mL (range 200-1400). The median hospital stay of the patients was 14 days (range 11-38). Their operative mortality was zero and overall morbidity was 18.1% (31 patients). Only four patients (2.3%) developed pancreatic fistulas (grade A fistulas in two patients and grade B in two patients); no patients developed grade C fistula. None of the patients developed bile reflux gastritis. The modified Roux-en-Y reconstruction, which isolates biliary anastomosis from pancreatic, gastric or jejunal anastomosis, is a safe, reliable, and favorable technique. But it needs further investigation in randomized controlled trials.

Effects of Repeated Intraperitoneal Injection of Pharmaceutical-grade and Nonpharmaceutical-grade Corn Oil in Female C57BL/6J Mice

PubMed Central

Hubbard, Jennifer S; Chen, Patty H; Boyd, Kelli L

2017-01-01

Due to potential adverse effects on animal wellbeing, the use of nonpharmaceutical-grade substances in animal research must be scientifically justified in cases where a pharmaceutical-grade version of the substance exists. This requirement applies to all substances, including vehicles used to solubilize experimental drugs. To date, no studies have evaluated the direct effect of the pharmaceutical classification of a compound on animal wellbeing. In this study, we evaluated intraperitoneal administration of pharmaceutical-grade corn oil, nonpharmaceutical-grade corn oil, and saline in female C57BL/6J mice. Compounds were administered every 48 h for a total of 4 injections. Mice were evaluated clinically by using body weight, body condition score, visual assessment score, CBC, and serum chemistries. Animals were euthanized at 24 h and 14 d after the final injection. Inflammation of the peritoneal wall and mesenteric fat was assessed microscopically by using a semiquantitative scoring system. Saline-dosed groups had lower pathology scores at both time points. At day 21, pharmaceutical-grade corn oil had a significantly higher pathology score compared with nonpharmaceutical-grade corn oil. No other significant differences between the corn oil groups were observed. The use of nonpharmaceutical grade corn oil did not result in adverse clinical consequences and is presumed safe to use for intraperitoneal injection in mice. Differences in inflammation between the 2 groups suggest that the use of either pharmaceutical-grade or nonpharmaceutical-grade corn oil should be consistent within a study. PMID:29256373

Radiolucent cage for cervical vertebral reconstruction: a prospective study of 17 cases with 2-year minimum follow-up.

PubMed

Söderlund, C H; Pointillart, V; Pedram, M; Andrault, G; Vital, J M

2004-12-01

In cervical spondylotic myelopathy, extended anterior spinal cord decompression necessitates subsequent stable vertebral reconstruction. Reconstruction with an iliac crest graft and screw-plate fixation gives satisfactory clinical and radiological results, but they are often compromised by morbidity involving the bone harvest. The purpose of this study was to evaluate the contribution to cervical reconstruction of a biocompatible, radiolucent cage combined with screw-plate fixation, making use of bone harvested in situ. This prospective study was performed between July 2000 and March 2001 in eight women and nine men (mean age, 55 years) operated for cervical spondylotic myelopathy. Situated between levels C3 and C6, the cage was inserted after one corporectomy in ten patients, two corporectomies in five patients, and three corporectomies in two patients. The cage consisted of a polyester mesh impregnated with poly-L-lactic acid (PLLA) conferring temporary rigidity to the cage during bony fusion. Clinical and radiological follow-up (plain films, computed tomographic reconstruction in three cases) was performed at 2 months, 6 months, 12 months, 24 months and 36 months, postoperatively, with a mean follow-up of 30 months. Functional results were evaluated according to the Japanese Orthopaedic Association's scoring system. An independent surgeon assessed the radiological evidence of anterior cervical fusion using the grades proposed by Bridwell [6]. Every patient experienced neurological recovery. At last follow-up, radiological findings were consistent with grade I (complete fusion) in five cases, grade II (probable fusion) in ten cases, grade III (radiolucent halo in favor of non fusion) in one case, and grade IV (graft lysis) in one case with persistent neck pain. In three cases there was screw breakage (two grade II, one grade IV). None of these cases required surgical revision at latest follow-up. In extensive spinal cord decompression through an anterior approach, cervical reconstruction using the present type of cage can achieve clinical results comparable to conventional techniques. The rigidity of the cage meets biomechanical imperatives. Its radiolucency permits one to monitor the course of consolidation, contrary to metal cages. The cases of probable non-fusion and screw breakage were not accompanied by signs of instability on the flexion extension films. This cage meets the biologic and biomechanical imperatives of cervical reconstruction. It obviates complications involving bone harvest.

Murray secretion scale and fiberoptic endoscopic evaluation of swallowing in predicting aspiration in dysphagic patients.

PubMed

Kuo, Chia-Wei; Allen, Clint Tanner; Huang, Chu-Chun; Lee, Chia-Jung

2017-06-01

The objective of this retrospective review is to evaluate the ability of the Murray secretion scale to predict aspiration as determined by fiberoptic endoscopic evaluation of swallowing. Patients with dysphagia undergoing a fiberoptic endoscopic evaluation of swallowing study between January 2013 and November 2015 from a single, tertiary care institution were retrospectively reviewed. The Murray secretion scale and penetration aspiration scale on fiberoptic endoscopic evaluation of swallowing examination were determined. Spearman's correlation analysis, sensitivity, specificity, predictive values, and relative risk evaluating the relationship between the Murray secretion scale and aspiration on fiberoptic endoscopic evaluation of swallowing were calculated. Subgroups of head and neck cancer patients, penetration group, and aspiration group were also analyzed. The mean age of the cases (N = 212) was 62.4 years. Eighty percent were male. There was a strong correlation between Murray secretion scale grade and penetration aspiration scale score (r = 0.785, p < 0.001). The sensitivity and specificity of a Murray secretion scale grade 2 or higher in predicting aspiration were 74 and 90%, respectively. Individuals with a Murray secretion scale grade of 2 or higher were 13.6 times more likely to aspirate than patients with a lower Murray secretion scale grade. All subgroups showed similar trend. Determination of a Murray secretion scale grade, determined by flexible nasopharyngoscopy, may predict patients at high risk for aspiration. In clinical scenarios where more complete assessments of aspiration risk are immediately impossible or impractical, the Murray secretion scale grade may add valuable information to assist in clinical decision-making in patients with dysphagia.

Buried penis: classification surgical approach.

PubMed

Hadidi, Ahmed T

2014-02-01

The purpose of this study was to describe morphological classification of congenital buried penis (BP) and present a versatile surgical approach for correction. Sixty-one patients referred with BP were classified into 3 grades according to morphological findings: Grade 1-29 patients with Longer Inner Prepuce (LIP) only, Grade II-20 patients who presented with LIP associated with indrawn penis that required division of the fundiform and suspensory ligaments, and Grade III-12 patients who had in addition to the above, excess supra-pubic fat. A ventral midline penile incision extending from the tip of prepuce down to the penoscrotal junction was used in all patients. The operation was tailored according to the BP Grade. All patients underwent circumcision. Mean follow up was 3 years (range 1 to 10). All 61 patients had an abnormally long inner prepuce (LIP). Forty-seven patients had a short penile shaft. Early improvement was noted in all cases. Satisfactory results were achieved in all 29 patients in grade I and in 27 patients in grades II and III. Five children (Grades II and III) required further surgery (9%). Congenital buried penis is a spectrum characterized by LIP and may include in addition; short penile shaft, abnormal attachment of fundiform, and suspensory ligaments and excess supra-pubic fat. Congenital Mega Prepuce (CMP) is a variant of Grade I BP, with LIP characterized by intermittent ballooning of the genital area. Copyright © 2014 Elsevier Inc. All rights reserved.

Evaluation of the Buckeye Crossbuck at public, passive railroad/highway grade crossings in Ohio.

DOT National Transportation Integrated Search

2000-12-01

Two new crossbuck designs for use at passive Railroad/Highway Grade Crossings (RRX) were evaluated. The Standard Improved and the Buckeye crossbuck were evaluated on a state-wide basis in Ohio with respect to their potential to alter driver risk taki...

Team-based learning for midwifery education.

PubMed

Moore-Davis, Tonia L; Schorn, Mavis N; Collins, Michelle R; Phillippi, Julia; Holley, Sharon

2015-01-01

Many US health care and education stakeholder groups, recognizing the need to prepare learners for collaborative practice in complex care environments, have called for innovative approaches in health care education. Team-based learning is an educational method that relies on in-depth student preparation prior to class, individual and team knowledge assessment, and use of small-group learning to apply knowledge to complex scenarios. Although team-based learning has been studied as an approach to health care education, its application to midwifery education is not well described. A master's-level, nurse-midwifery, didactic antepartum course was revised to a team-based learning format. Student grades, course evaluations, and aggregate American Midwifery Certification Board examination pass rates for 3 student cohorts participating in the team-based course were compared with 3 student cohorts receiving traditional, lecture-based instruction. Students had mixed responses to the team-based learning format. Student evaluations improved when faculty added recorded lectures as part of student preclass preparation. Statistical comparisons were limited by variations across cohorts; however, student grades and certification examination pass rates did not change substantially after the course revision. Although initial course revision was time-consuming for faculty, subsequent iterations of the course required less effort. Team-based learning provides students with more opportunity to interact during on-site classes and may spur application of knowledge into practice. However, it is difficult to assess the effect of the team-based learning approach with current measures. Further research is needed to determine the effects of team-based learning on communication and collaboration skills, as well as long-term performance in clinical practice. This article is part of a special series of articles that address midwifery innovations in clinical practice, education, interprofessional collaboration, health policy, and global health. © 2015 by the American College of Nurse-Midwives.

Comparison of Different Methods of Grading a Level Turn Task on a Flight Simulator

NASA Technical Reports Server (NTRS)

Heath, Bruce E.; Crier, tomyka

2003-01-01

With the advancements in the computing power of personal computers, pc-based flight simulators and trainers have opened new avenues in the training of airplane pilots. It may be desirable to have the flight simulator make a quantitative evaluation of the progress of a pilot's training thereby reducing the physical requirement of the flight instructor who must, in turn, watch every flight. In an experiment, University students conducted six different flights, each consisting of two level turns. The flights were three minutes in duration. By evaluating videotapes, two certified flight instructors provided separate letter grades for each turn. These level turns were also evaluated using two other computer based grading methods. One method determined automated grades based on prescribed tolerances in bank angle, airspeed and altitude. The other method used was deviations in altitude and bank angle for performance index and performance grades.

Oncologic results of nephron sparing endoscopic approach for upper tract low grade transitional cell carcinoma in comparison to nephroureterectomy - a case control study.

PubMed

Hoffman, Azik; Yossepowitch, Ofer; Erlich, Yaron; Holland, Ronen; Lifshitz, David

2014-12-02

There is paucity of data as to the results of the endoscopic approach in comparison to the golden standard of nephro-ureterectomy in elective, low grade TCC, patients. Our purpose is to report our results of a nephron sparing approach compared to nephro-ureterectomy in those patients. From a retrospective data base we identified 25 patients and 23 patients who underwent a nephron sparing ureterosocpic resection and nephro-reterectomy for low grade UT-TCC, respectively. The endoscopic technique included endoscopic tumor biopsy followed by primary resection and/or fulguration. The nephron sparing group was followed by bi-annual ureteroscopy and upper tract imaging, timely cystoscopy and urine cytology collection. Data for overall and disease related mortality, bladder and ureteral TCC recurrence and renal function are reported in both groups. Median follow - up time was 26 months. 11 (44%) patients developed bladder recurrence at a median period of 9 months after initial ureteroscopy, compared to 9 (39%) in the NUx group (P < 0.05). Recurrent ureteral low grade TCC was observed in 9 patients (median: 9 months). All were treated endoscopicaly successfully. Renal function remained stable in the nephron sparing group. No disease related mortality was recorded in the nephron-sparing group while one patient died of his disease following NUx. Disease related mortality following a nephron sparing endoscopic approach or nephroureterectomy for low grade upper tract TCC is excellent. However, the nephron sparing approach is associated with a relatively high rate of ureteral and bladder recurrence. Therefore, a stringent follow-up protocol is required.

Evaluating Sermons: The Function of Grades in Teaching Preaching

ERIC Educational Resources Information Center

Helsel, Carolyn Browning

2017-01-01

What are grades doing in a homiletics classroom? This article traces the function of grades through the broader history of the educational system in the United States and then makes suggestions for how grades can be used more effectively in teaching preaching. Beginning in the nineteenth century, teachers used grades to rank and motivate students,…

Spatial intratumoral heterogeneity of proliferation in immunohistochemical images of solid tumors.

PubMed

Valous, Nektarios A; Lahrmann, Bernd; Halama, Niels; Bergmann, Frank; Jäger, Dirk; Grabe, Niels

2016-06-01

The interactions of neoplastic cells with each other and the microenvironment are complex. To understand intratumoral heterogeneity, subtle differences should be quantified. Main factors contributing to heterogeneity include the gradient ischemic level within neoplasms, action of microenvironment, mechanisms of intercellular transfer of genetic information, and differential mechanisms of modifications of genetic material/proteins. This may reflect on the expression of biomarkers in the context of prognosis/stratification. Hence, a rigorous approach for assessing the spatial intratumoral heterogeneity of histological biomarker expression with accuracy and reproducibility is required, since patterns in immunohistochemical images can be challenging to identify and describe. A quantitative method that is useful for characterizing complex irregular structures is lacunarity; it is a multiscale technique that exhaustively samples the image, while the decay of its index as a function of window size follows characteristic patterns for different spatial arrangements. In histological images, lacunarity provides a useful measure for the spatial organization of a biomarker when a sampling scheme is employed and relevant features are computed. The proposed approach quantifies the segmented proliferative cells and not the textural content of the histological slide, thus providing a more realistic measure of heterogeneity within the sample space of the tumor region. The aim is to investigate in whole sections of primary pancreatic neuroendocrine neoplasms (pNENs), using whole-slide imaging and image analysis, the spatial intratumoral heterogeneity of Ki-67 immunostains. Unsupervised learning is employed to verify that the approach can partition the tissue sections according to distributional heterogeneity. The architectural complexity of histological images has shown that single measurements are often insufficient. Inhomogeneity of distribution depends not only on percentage content of proliferation phase but also on how the phase fills the space. Lacunarity curves demonstrate variations in the sampled image sections. Since the spatial distribution of proliferation in each case is different, the width of the curves changes too. Image sections that have smaller numerical variations in the computed features correspond to neoplasms with spatially homogeneous proliferation, while larger variations correspond to cases where proliferation shows various degrees of clumping. Grade 1 (uniform/nonuniform: 74%/26%) and grade 3 (uniform: 100%) pNENs demonstrate a more homogeneous proliferation with grade 1 neoplasms being more variant, while grade 2 tumor regions render a more diverse landscape (50%/50%). Hence, some cases show an increased degree of spatial heterogeneity comparing to others with similar grade. Whether this is a sign of different tumor biology and an association with a more benign/malignant clinical course needs to be investigated further. The extent and range of spatial heterogeneity has the potential to be evaluated as a prognostic marker. The association with tumor grade as well as the rationale that the methodology reflects true tumor architecture supports the technical soundness of the method. This reflects a general approach which is relevant to other solid tumors and biomarkers. Drawing upon the merits of computational biomedicine, the approach uncovers salient features for use in future studies of clinical relevance.

RMP Evaluations, Course Easiness, and Grades: Are They Related?

ERIC Educational Resources Information Center

Rizvi, Syed A.

2015-01-01

This paper investigates the relationship between the student evaluations of the instructors at the RateMyProfessors.com (RMP) website and the average grades awarded by those instructors. As of Spring 2012, the RMP site included evaluations of 538 full-and part-time instructors at the College of Staten Island (CSI). We selected the evaluations of…

Re-evaluation of Second Grade, Revised MANS Tests. Evaluation Report 7-B-4. Extended Pilot Trial of the Comprehensive School Mathematics Program.

ERIC Educational Resources Information Center

Herbert, Martin

The Comprehensive School Mathematics Program (CSMP) is a program of CEMREL, Inc., one of the national educational laboratories, and was funded by the National Institute of Education (NIE). Its primary purpose is the development of curriculum materials for kindergarten through grade 6. This study compared CSMP and non-CSMP second-grade students'…

Cytological grading of canine cutaneous mast cell tumours.

PubMed

Scarpa, Filippo; Sabattini, Silvia; Bettini, Giuliano

2016-09-01

A cytological grading for mast cell tumours (MCTs) would be highly desirable, allowing to select the most appropriate therapeutic intervention prior to surgery. This study evaluates the applicability on fine-needle aspirations (FNAs) of the novel Kiupel grading system, based on number of mitoses, multinucleated cells, bizarre nuclei and presence of karyomegaly. Fifty consecutive cases with pre-operative cytological diagnosis were included. In cytological specimens, approximately 1000 cells were evaluated, and the histological grade was assessed on the corresponding resected specimens. On cytology, the above parameters were significantly different between histologically low-grade and high-grade tumours (P < 0.001). The cytograding correctly predicted the histological grade in 47 cases (accuracy, 94%; sensitivity, 84.6%; specificity, 97.3%). Two high-grade MCTs (4%) were not detected on cytology. The cytograding can provide helpful insights to assist clinical decisions in most cases. However, the risk of underestimation in a minority of patients represents a limit to the overall utility of the technique. © 2014 John Wiley & Sons Ltd.

C2 nerve root on magnetic resonance imaging of occipital neuralgia.

PubMed

Yi, Minkyung; Lee, Joon Woo; Yeom, Jin S; Joe, Eugene; Hong, Sung Hwan; Lee, Guen Young; Kang, Heung Sik

2014-06-01

Review and grade the morphology of the C1-C2 neural foramina, from the MR images of patients who underwent C1-C2 spinal surgery, and determine the relationship with ON. To evaluate the feasibility of MRI for C1-C2 neural foramen evaluation with a new grading system and to correlate the C1-C2 neural foramen grade with ON. There have been no MRI studies of patients with and without ON in relation to C2 nerve root ganglion findings. Among the registry of 124 patients who underwent C1-C2 spinal surgery between July 2004 and May 2012 in Seoul National University Bundang Hospital, we enrolled 101 patients who had information about ON and a relevant preoperative cervical spine MR image. A total of 202 neural foramina were evaluated with our new C1-C2 neural foramen grading system (grade, 0-3) using consensus reading by 2 experienced radiologists who were blinded to the clinical information. The relationship between the C1-C2 grading system and ON was assessed using a χ test and Fisher exact test. Inter- and intraobserver reliability agreement was assessed using the κ statistic. All C1-C2 neural foramina were delineated on T2 parasagittal images. Among 202 C1-C2 neural foramina, grade zero was found in 49 foramina (24.3%), grade 1 in 95 (47.0%), grade 2 in 30 (14.9%), and grade 3 in 28 (13.9%). Grade 1 stenosis was most frequently noted. The grade 2 group had the most frequent prevalence of ON (43.3%), followed by grade 3 (35.7%), grade zero (30.6%), and grade 1 (29.5%). However, the relationship between the grade and ON was not statistically significant. Inter- and intraobserver agreements were substantially high. C1-C2 neural foramina can be depicted on MR image. However, the relationship between the new grading system for C1-C2 neural foramina and ON was not statistically significant. 4.

Teaching Mathematical Functions Using Geometric Functions Approach and Its Effect on Ninth Grade Students' Motivation

ERIC Educational Resources Information Center

Akçakin, Veysel

2018-01-01

The purpose of this study is to investigate the effects of using geometric functions approach on 9th grade students' motivation levels toward mathematics in functions unit. Participants of this study were 87 students who were ongoing in the first year of high school in Turkey. In this research, pretest and posttest control group quasiexperimental…

Exploration of a Blended Learning Approach to Reading Instruction for Low SES Students in Early Elementary Grades

ERIC Educational Resources Information Center

Schechter, Rachel; Macaruso, Paul; Kazakoff, Elizabeth R.; Brooke, Elizabeth

2015-01-01

This study investigated the potential benefits of a blended learning approach on the reading skills of low socioeconomic status students in Grades 1 and 2. Treatment students received English language arts instruction that was both teacher-led and technology-based. Comparisons were made with control students who received the same English language…

Effectiveness of the REACT Strategy on 12th Grade Students' Understanding of the Alkenes Concept

ERIC Educational Resources Information Center

Karsli, Fethiye; Yigit, Mahmut

2017-01-01

Background: The context-based approach (CBA) is one of the approaches that allow learning to take place with real and related context, and this has increasingly become more popular. Purpose: The purpose of this study is to investigate the effect of the REACT strategy of the CBA on remedying 12th grade students' alternative conceptions of…

An Approach to Environmental Education: A Three-Stage Program for Intermediate Grades.

ERIC Educational Resources Information Center

Taylor, Ken

This resource booklet explains a multidisciplinary approach to environmental education for the intermediate grades. Its major aim is to make the student aware of what is happening around him as well as being aware of what he is doing to his own surroundings. A three-stage program was utilized consisting of a cooperative learning project aided by…

Improving the Grade Point Average of Our At-Risk Students: A Collaborative Group Action Research Approach.

ERIC Educational Resources Information Center

Saurino, Dan R.; Hinson, Kenneth; Bouma, Amy

This paper focuses on the use of a group action research approach to help student teachers develop strategies to improve the grade point average of at-risk students. Teaching interventions such as group work and group and individual tutoring were compared to teaching strategies already used in the field. Results indicated an improvement in the…

Programmed Approach vs. Conventional Approach Using highly Consistent Sound-Symbol System of Reading in Three Primary Grades.

ERIC Educational Resources Information Center

Shore, Robert Eugene

The effects of two primary reading programs using a programed format (with and without audio-supplement) and a conventional format (the program format deprogramed) in a highly consistent sound-symbol system of reading at three primary grade levels were compared, using a pretest, post-test control group design. The degree of suitability of…

A Contextual Approach to the Assessment of Social Skills: Identifying Meaningful Behaviors for Social Competence

ERIC Educational Resources Information Center

Warnes, Emily D.; Sheridan, Susan M.; Geske, Jenenne; Warnes, William A.

2005-01-01

An exploratory study was conducted which assessed behaviors that characterize social competence in the second and fifth grades. A contextual approach was used to gather information from second- and fifth-grade children and their parents and teachers regarding the behaviors they perceived to be important for getting along well with peers. Data were…

Suggestions for Curriculum Development [And] Handbook High School Grades, Part D, 10-12. Environmental Education Interdependence: A Concept Approach. Revised.

ERIC Educational Resources Information Center

King, David C.; Wood, Jayne Millar

Two booklets comprise the grades 10-12 component of a series of guides for incorporating environmental education into the existing curriculum. The guide and handbook emphasize a multidisciplinary approach, use the concept of interdependence as an organizing theme, and offer suggestions for using the local community as a resource. The guide…

The Effects of Argumentation Based Science Learning Approach on Creative Thinking Skills of Students

ERIC Educational Resources Information Center

Küçük Demir, Betül; Isleyen, Tevfik

2015-01-01

The aim of this study is to explore the effects of argumentation-based science learning (ABSL) approach on 9th Grade of Secondary Education students' creative thinking skills. The sample of the study included 22 9th grade of Secondary Education students in Bayburt in 2012-2013 academic year. In this study quantitative research method and…

Reification in the Learning of Square Roots in a Ninth Grade Classroom: Combining Semiotic and Discursive Approaches

ERIC Educational Resources Information Center

Shinno, Yusuke

2018-01-01

This paper reports on combining semiotic and discursive approaches to reification in classroom interactions. It focuses on the discursive characteristics and semiotic processes involved in the teaching and learning of square roots in a ninth grade classroom in Japan. The purpose of this study is to characterize the development of mathematical…

Shared-Book Experience Using Science-Themed Books to Develop Scientific Literacy: An Interactive Approach with Struggling Readers

ERIC Educational Resources Information Center

Chung, Mi-Hyun; Keckler, Barbara

2016-01-01

This paper will explain what a reading teacher learned from working with a group of first-grade struggling readers in a series of shared-book experience classes. The shared-book experience approach used a variety of science-themed books that were aligned with the first-grade curriculum and appropriate for beginning readers. Considering the…

Insights into Fluency Instruction: Short- and Long-Term Effects of Two Reading Programs

ERIC Educational Resources Information Center

Schwanenflugel, Paula J.; Kuhn, Melanie R.; Morris, Robin D.; Morrow, Lesley Mandel; Meisinger, Elizabeth B.; Woo, Deborah Gee; Quirk, Matthew; Sevcik, Rose

2009-01-01

The purpose of the study was to examine short- and long-term effects of two instructional approaches designed to improve the reading fluency of second-grade children: Fluency-Oriented Reading Instruction (or FORI; Stahl & Heubach, 2005) and a wide reading approach (Kuhn et al., 2006). By the end of second grade, children in the wide reading…

Long-Term Performance of Readers Trained in Grading Crohn Disease Activity Using MRI.

PubMed

Puylaert, Carl A J; Tielbeek, Jeroen A W; Bipat, Shandra; Boellaard, Thierry N; Nio, C Yung; Stoker, Jaap

2016-12-01

We aim to evaluate the long-term performance of readers who had participated in previous magnetic resonance imaging (MRI) reader training in grading Crohn disease activity. Fourteen readers (8 women; 12 radiologists, 2 residents; mean age 40; range 31-59), who had participated in a previous MRI reader training, participated in a follow-up evaluation after a mean interval of 29 months (range 25-34 months). Follow-up evaluation comprised 25 MRI cases of suspected or known Crohn disease patients with direct feedback; cases were identical to the evaluation set used in the initial reader training (of which readers were unaware). Grading accuracy, overstaging, and understaging were compared between training and follow-up using a consensus score by two experienced abdominal radiologists as the reference standard. In the follow-up evaluation, overall grading accuracy was 73% (95% confidence interval [CI]: 62%-81%), which was comparable to reader training grading accuracy (72%, 95% CI: 61%-80%) (P = .66). Overstaging decreased significantly from 19% (95% CI: 12%-27%) to 13% (95% CI: 8%-21%) between training and follow-up (P = .03), whereas understaging increased significantly from 9% (95% CI: 4%-21%) to 14% (95% CI: 7%-26%) (P < .01). Readers have consistent long-term accuracy for grading Crohn disease activity after case-based reader training with direct feedback. Copyright © 2016 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Technology selection for ballast water treatment by multi-stakeholders: A multi-attribute decision analysis approach based on the combined weights and extension theory.

PubMed

Ren, Jingzheng

2018-01-01

This objective of this study is to develop a generic multi-attribute decision analysis framework for ranking the technologies for ballast water treatment and determine their grades. An evaluation criteria system consisting of eight criteria in four categories was used to evaluate the technologies for ballast water treatment. The Best-Worst method, which is a subjective weighting method and Criteria importance through inter-criteria correlation method, which is an objective weighting method, were combined to determine the weights of the evaluation criteria. The extension theory was employed to prioritize the technologies for ballast water treatment and determine their grades. An illustrative case including four technologies for ballast water treatment, i.e. Alfa Laval (T 1 ), Hyde (T 2 ), Unitor (T 3 ), and NaOH (T 4 ), were studied by the proposed method, and the Hyde (T 2 ) was recognized as the best technology. Sensitivity analysis was also carried to investigate the effects of the combined coefficients and the weights of the evaluation criteria on the final priority order of the four technologies for ballast water treatment. The sum weighted method and the TOPSIS was also employed to rank the four technologies, and the results determined by these two methods are consistent to that determined by the proposed method in this study. Copyright © 2017 Elsevier Ltd. All rights reserved.

Development of Genetic Occurrence Models for Geothermal Prospecting

NASA Astrophysics Data System (ADS)

Walker, J. D.; Sabin, A.; Unruh, J.; Monastero, F. C.; Combs, J.

2007-12-01

Exploration for utility-grade geothermal resources has mostly relied on identifying obvious surface manifestations of possible geothermal activity, e.g., locating and working near steaming ground or hot springs. This approach has lead to the development of over 130 resources worldwide, but geothermal exploration done in this manner is akin to locating hydrocarbon plays by searching for oil seeps. Confining exploration to areas with such features will clearly not discover a blind resource, that is, one that does not have surface expression. Blind resources, however, constitute the vast majority of hydrocarbon plays; this may be the case for geothermal resources as well. We propose a geothermal exploration strategy for finding blind systems that is based on an understanding of the geologic processes that transfer heat from the mantle to the upper crust and foster the conditions for hydrothermal circulation or enhanced geothermal exploration. The strategy employs a genetically based screening protocol to assess potential geothermal sites. The approach starts at the plate boundary scale and progressively focuses in on the scale of a producing electrical-grade field. Any active margin or hot spot is a potential location for geothermal resources. Although Quaternary igneous activity provides a clear indication of active advection of hot material into the upper crust, it is not sufficient to guarantee a potential utility-grade resource. Active faulting and/or evidence of high strain rates appear to be the critical features associated with areas of utility-grade geothermal potential. This is because deformation on its own can advect sufficient heat into the upper crust to create conditions favorable for geothermal exploitation. In addition, active deformation is required to demonstrate that open pathways for circulation of geothermal fluids are present and/or can be maintained. The last step in the screening protocol is to identify any evidence of geothermal activity, including high heat flow, anomalous temperature water wells, high-temperature indications from aqueous geothermometry and geochemistry, Pliocene or younger ages from low-temperature thermochronometers, as well as more obvious factors such as geysers and fumaroles (which by definition will be missing for blind resources). Our occurrence-model strategy inverts the current approach that relies first on obvious evidence of geothermal activity. We evaluated our approach by retrospectively applying the protocol to the characteristics of producing geothermal fields, and in all cases, known resource areas fit the parameters identified from a genetic perspective.

A new approach to delineating lymph node target volumes for post-operative radiotherapy in gastric cancer: A phase II trial.

PubMed

Haijun, Yu; Qiuji, Wu; Zhenming, Fu; Yong, Huang; Zhengkai, Liao; Conghua, Xie; Yunfeng, Zhou; Yahua, Zhong

2015-08-01

In the context of gastric cancer, lymph node target volume delineation for post-operative radiotherapy is currently built on the traditional system of dividing the stomach and 2-D treatment methods. Here, we have proposed a new delineation approach with irradiation indications for lymph node stations. Its safety and efficacy were evaluated in a phase II clinical trial. Fifty-four gastric cancer patients with D2 lymph node dissection received 2 cycles of FOLFOX4. They subsequently received concurrent chemoradiotherapy (45 Gy at 1.8 Gy per fraction, 5 fractions per week for 5 weeks) with a 5-fluorouracil/leucovorin regimen, followed by 4 additional FOLFOX4 cycles. The target volume included the remnant stomach, anastomosis site, tumor bed, and regional lymph nodes selected through our new approach by taking gastric arteries as references. The most common grade 3-4 adverse event was neutropenia (14.8%). Neutropenia, anemia, and nausea were common grade 1-2 toxicities. No treatment-related deaths occurred during treatment. The 3-year overall, disease-free, and locoregional recurrence-free survival rates were 81.6%, 70.2%, and 91.1%, respectively. Eight patients developed peritoneal or distant metastases. Using our new approach and irradiation indications, delineation of the target volume of post-operative lymph node stations was feasible and well tolerated after D2 resection in patients with gastric cancer. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Detailed statistical assessment of the characteristics of the ESMO Magnitude of Clinical Benefit Scale (ESMO-MCBS) threshold rules.

PubMed

Dafni, Urania; Karlis, Dimitris; Pedeli, Xanthi; Bogaerts, Jan; Pentheroudakis, George; Tabernero, Josep; Zielinski, Christoph C; Piccart, Martine J; de Vries, Elisabeth G E; Latino, Nicola Jane; Douillard, Jean-Yves; Cherny, Nathan I

2017-01-01

The European Society for Medical Oncology (ESMO) has developed the ESMO Magnitude of Clinical Benefit Scale (ESMO-MCBS), a tool to assess the magnitude of clinical benefit from new cancer therapies. Grading is guided by a dual rule comparing the relative benefit (RB) and the absolute benefit (AB) achieved by the therapy to prespecified threshold values. The ESMO-MCBS v1.0 dual rule evaluates the RB of an experimental treatment based on the lower limit of the 95%CI (LL95%CI) for the hazard ratio (HR) along with an AB threshold. This dual rule addresses two goals: inclusiveness: not unfairly penalising experimental treatments from trials designed with adequate power targeting clinically meaningful relative benefit; and discernment: penalising trials designed to detect a small inconsequential benefit. Based on 50 000 simulations of plausible trial scenarios, the sensitivity and specificity of the LL95%CI rule and the ESMO-MCBS dual rule, the robustness of their characteristics for reasonable power and range of targeted and true HRs, are examined. The per cent acceptance of maximal preliminary grade is compared with other dual rules based on point estimate (PE) thresholds for RB. For particularly small or particularly large studies, the observed benefit needs to be relatively big for the ESMO-MCBS dual rule to be satisfied and the maximal grade awarded. Compared with approaches that evaluate RB using the PE thresholds, simulations demonstrate that the MCBS approach better exhibits the desired behaviour achieving the goals of both inclusiveness and discernment. RB assessment using the LL95%CI for HR rather than a PE threshold has two advantages: it diminishes the probability of excluding big benefit positive studies from achieving due credit and, when combined with the AB assessment, it increases the probability of downgrading a trial with a statistically significant but clinically insignificant observed benefit.

Detailed statistical assessment of the characteristics of the ESMO Magnitude of Clinical Benefit Scale (ESMO-MCBS) threshold rules

PubMed Central

Dafni, Urania; Karlis, Dimitris; Pedeli, Xanthi; Bogaerts, Jan; Pentheroudakis, George; Tabernero, Josep; Zielinski, Christoph C; Piccart, Martine J; de Vries, Elisabeth G E; Latino, Nicola Jane; Douillard, Jean-Yves; Cherny, Nathan I

2017-01-01

Background The European Society for Medical Oncology (ESMO) has developed the ESMO Magnitude of Clinical Benefit Scale (ESMO-MCBS), a tool to assess the magnitude of clinical benefit from new cancer therapies. Grading is guided by a dual rule comparing the relative benefit (RB) and the absolute benefit (AB) achieved by the therapy to prespecified threshold values. The ESMO-MCBS v1.0 dual rule evaluates the RB of an experimental treatment based on the lower limit of the 95%CI (LL95%CI) for the hazard ratio (HR) along with an AB threshold. This dual rule addresses two goals: inclusiveness: not unfairly penalising experimental treatments from trials designed with adequate power targeting clinically meaningful relative benefit; and discernment: penalising trials designed to detect a small inconsequential benefit. Methods Based on 50 000 simulations of plausible trial scenarios, the sensitivity and specificity of the LL95%CI rule and the ESMO-MCBS dual rule, the robustness of their characteristics for reasonable power and range of targeted and true HRs, are examined. The per cent acceptance of maximal preliminary grade is compared with other dual rules based on point estimate (PE) thresholds for RB. Results For particularly small or particularly large studies, the observed benefit needs to be relatively big for the ESMO-MCBS dual rule to be satisfied and the maximal grade awarded. Compared with approaches that evaluate RB using the PE thresholds, simulations demonstrate that the MCBS approach better exhibits the desired behaviour achieving the goals of both inclusiveness and discernment. Conclusions RB assessment using the LL95%CI for HR rather than a PE threshold has two advantages: it diminishes the probability of excluding big benefit positive studies from achieving due credit and, when combined with the AB assessment, it increases the probability of downgrading a trial with a statistically significant but clinically insignificant observed benefit. PMID:29067214

Ipsilateral irradiation for well lateralized carcinomas of the oral cavity and oropharynx: results on tumor control and xerostomia

PubMed Central

Cerezo, Laura; Martín, Margarita; López, Mario; Marín, Alicia; Gómez, Alberto

2009-01-01

Background In head and neck cancer, bilateral neck irradiation is the standard approach for many tumor locations and stages. Increasing knowledge on the pattern of nodal invasion leads to more precise targeting and normal tissue sparing. The aim of the present study was to evaluate the morbidity and tumor control for patients with well lateralized squamous cell carcinomas of the oral cavity and oropharynx treated with ipsilateral radiotherapy. Methods Twenty consecutive patients with lateralized carcinomas of the oral cavity and oropharynx were treated with a prospective management approach using ipsilateral irradiation between 2000 and 2007. This included 8 radical oropharyngeal and 12 postoperative oral cavity carcinomas, with Stage T1-T2, N0-N2b disease. The actuarial freedom from contralateral nodal recurrence was determined. Late xerostomia was evaluated using the European Organization for Research and Treatment of Cancer QLQ-H&N35 questionnaire and the National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE), version 3. Results At a median follow-up of 58 months, five-year overall survival and loco-regional control rates were 82.5% and 100%, respectively. No local or contralateral nodal recurrences were observed. Mean dose to the contralateral parotid gland was 4.72 Gy and to the contralateral submandibular gland was 15.30 Gy. Mean score for dry mouth was 28.1 on the 0-100 QLQ-H&N35 scale. According to CTCAE v3 scale, 87.5% of patients had grade 0-1 and 12.5% grade 2 subjective xerostomia. The unstimulated salivary flow was > 0.2 ml/min in 81.2% of patients and 0.1-0.2 ml/min in 19%. None of the patients showed grade 3 xerostomia. Conclusion In selected patients with early and moderate stages, well lateralized oral and oropharyngeal carcinomas, ipsilateral irradiation treatment of the primary site and ipsilateral neck spares salivary gland function without compromising loco-regional control. PMID:19723329

Evaluation of the Buckeye Crossbuck at public, passive railroad/highway grade crossings in Ohio : executive summary.

DOT National Transportation Integrated Search

2000-12-01

Two new crossbuck designs for use at passive Railroad/Highway Grade Crossings (RRX) were evaluated. : The Standard Improved and the Buckeye crossbuck were evaluated on a state-wide basis in Ohio with : respect to their potential to alter driver risk ...

Management of high-grade dysplasia in Barrett's esophagus.

PubMed

Palley, S L; Sampliner, R E; Garewal, H S

1989-08-01

When Barrett's esophagus is complicated by adenocarcinoma, surgery is indicated in appropriate patients. Until now, high-grade dysplasia in Barrett's esophagus has been managed in a similar fashion. We explore this approach and review reported cases of high-grade dysplasia to suggest guidelines for collection of data to make future clinical decisions more rational.

Structured Dialogues among Communities of First Grade Learners.

ERIC Educational Resources Information Center

Palincsar, Annemarie Sullivan; And Others

In an effort to implement a program of reciprocal teaching dialogues, 6 first-grade teachers orally presented third-grade biology lessons to a group of 6 students, most of whom were identified as at risk for academic difficulty. Teachers aimed to teach students ways to approach learning from text and increase students' understanding of biological…

Grade Retention and Its Association with School Misconduct in Adolescence: A Multilevel Approach

ERIC Educational Resources Information Center

Demanet, Jannick; Van Houtte, Mieke

2013-01-01

Few studies with respect to grade retention and school-disruptive behavior have focused on adolescence. Moreover, previous retention research has ignored multilevel issues. This study aims to fill these research lacunae by addressing the role of grade retention in adolescent students' school misconduct. Furthermore, we explore the role of the…

Factors Influencing Mathematic Problem-Solving Ability of Sixth Grade Students

ERIC Educational Resources Information Center

Pimta, Sakorn; Tayraukham, Sombat; Nuangchalerm, Prasart

2009-01-01

Problem statement: This study aims to investigate factors influencing mathematic problem-solving ability of sixth grade students. One thousand and twenty eight of sixth grade students, studying in the second semester of academic year 2007 were sampled by stratified random sampling technique. Approach: The research instruments used in the study…

Pedagogy for Change: A Critical Multicultural Approach to First Grade Education

ERIC Educational Resources Information Center

Silva, Janelle M.

2010-01-01

Using data from a nine month ethnographic study of a first grade public charter school classroom in central California, this paper examines how one teacher is using an alternative, artist-focused curriculum, to teach her first grade students about significant social identities (race, ethnicity, gender, sexuality, class and physical ableness) and…

Inclusive Education in the United States: Middle School General Education Teachers' Approaches to Inclusion

ERIC Educational Resources Information Center

Mackey, Megan

2014-01-01

Research examined how three middle school teachers included students with disabilities in their general education classrooms. Purposive sampling was used to select a sixth grade science teacher, seventh grade social studies teacher, and eighth grade math teacher whose classrooms were identified as exemplifying the characteristics of inclusive…

Grading Innovation in an International Marketing Course: Promoting Student Collaboration and Individual Accountability

ERIC Educational Resources Information Center

Chelminski, Piotr

2017-01-01

In this article, the author proposes an innovative, exam-based homework grading method to facilitate both collaboration among students and individual accountability while learning a complex theory and applying it to solve a problem. Results from this novel approach to grading a "comparative advantage theory" homework assignment, using an…

Rectal intussusception and unexplained faecal incontinence: findings of a proctographic study.

PubMed

Collinson, R; Cunningham, C; D'Costa, H; Lindsey, I

2009-01-01

The aetiology of faecal incontinence is multifactorial, yet there remains an approach to assessment and treatment that focusses on the sphincter. Rectal intussusception (RI) is underdiagnosed and manifests primarily as obstructed defecation. Yet greater than 50% of these patients admit to faecal incontinence on closer questioning. We aimed to evaluate the incidence of RI at evacuation proctography selectively undertaken in the evaluation of patients with faecal incontinence. Patients with faecal incontinence seen in a pelvic floor clinic were evaluated with anorectal physiology and ultrasound. Where the faecal incontinence was not fully explained by physiology and ultrasound, evacuation proctography was undertaken. Studies were classified as 'normal', 'low-grade RI' (recto-rectal), 'high-grade RI' (recto-anal) or 'anismus'. Forty patients underwent evacuation proctography (33 women, 83%). Median age was 63 years (range 34-77 years). Seven patients (17%) had a normal proctogram. Three (8%) had recto-rectal RI. Twenty-five (63%) demonstrated recto-anal RI. Five patients (12%) had anismus. Recto-anal intussusception is common in patients undergoing selective evacuation proctography for investigation of faecal incontinence. The role of recto-anal intussusception in the multifactorial aetiology of faecal incontinence has been largely overlooked. Evacuation proctography should be considered as part of routine work-up of patients with faecal incontinence.

A review of elementary school-based substance use prevention programs: identifying program attributes.

PubMed

Hopfer, S; Davis, D; Kam, J A; Shin, Y; Elek, E; Hecht, M L

2010-01-01

This article takes a systematic approach to reviewing substance use prevention programs introduced in elementary school (K-6th grade). Previous studies evaluating such programs among elementary school students showed mixed effects on subsequent substance use and related psychosocial factors. Thirty published evaluation studies of 24 elementary school-based substance use prevention programs were reviewed. The study selection criteria included searching for program evaluations from 1980 to 2008. Among 27 evaluation studies that examined program effects on substance use, 56% (n = 15) found significant decreases. In addition, programs most often demonstrated effects on increasing negative substance use attitudes, increasing knowledge, decreasing perceptions of prevalence rates (i.e., descriptive norms), and improving resistance skills. These results have implications for the appropriateness and value of introducing substance use prevention programs to youth in elementary school.

Midterm results of surgical treatment of displaced proximal humeral fractures in children.

PubMed

Pavone, Vito; de Cristo, Claudia; Cannavò, Luca; Testa, Gianluca; Buscema, Antonio; Condorelli, Giuseppe; Sessa, Giuseppe

2016-07-01

To analyse the clinical outcomes of 26 children treated surgically for displaced proximal humerus fracture. From January 2008 to December 2012, 26 children/adolescents (14 boys, 12 girls) were treated surgically for displaced fractures at the proximal extremity of the humerus. Ten were grade III and 16 were grade IV according to the Neer-Horowitz classification with a mean age of 12.8 ± 4.2 years. Twenty young patients were surgically treated with a closed reduction and direct percutaneous pinning; six required an open approach. To obtain a proper analysis, we compared the Costant scores with the contralateral shoulder (Δ Costant). The mean follow-up period was 34 months (range 10-55). Two grade IV patients showed a loss in the reduction after percutaneous treatment. This required open surgery with a plate and screws. On average, the treated fractures healed at 40 days. The mean Δ Costant score was 8.43 (range 2-22). There was a statistically significant improvement in the mean Δ Costant score in grade III patients. In grade IV patients, there was a significant improvement in the mean Δ Costant score in those treated with open surgery versus mini-invasive surgery. Our study shows excellent results with percutaneous k-wires. This closed surgery had success in these patients, and the excellent outcomes noted here lead us to prefer the mini-invasive surgical approach in NH grade III fractures. In grade IV, the best results were noted in patients treated with open surgery. We suggest an open approach for these patients. III.

A Learner-Centered Spiral Knowledge Approach to Teaching Isotope Geology

NASA Astrophysics Data System (ADS)

Reid, M. R.

2006-12-01

Aided by the insights I gained by participation in the Arizona Board of Regents Tri-University Collaboration on Learner-Centered Practice, I made major changes to a graduate course in isotope geology (GLG617), including: 1) implementation of a spiral knowledge approach (e.g., Bruner, 1990; Dyar et al., 2004); 2) incorporation of more learner-centered in-class activities; and 3) more explicit emphasis on skills that I regarded as important for success in geochemistry. In the geosciences, the field of isotope geology is now an essential area of inquiry with implications for geologic timescales, climate information, tracing geochemical processes, and biological evolution, to name a few. The traditional approach to teaching isotope geology suffers from the fact that learning tends to be compartmentalized by technique/approach and one subfield (e.g., stable or radiogenic isotopes) is usually favored by appearing earlier in semester. To make learning more integrated, I employed a simplified spiral learning approach so that common principles could be revisited several times over the course of the semester and, in so doing, students' grasp of the fundamental principles could be scaffolded into greater understanding. Other learner-centered changes to the course included more explicit emphasis on helping students become comfortable with interpreting data displayed graphically and explicit emphasis on helping students give and evaluate oral presentations that rely on isotope data. I also developed a detailed grading rubric for the final paper and allowed students to have a draft of their final papers evaluated and graded (guided by Huba and Freed, 2000) A number of cooperative learning activities developed specifically for this course (19 in all) enabled me to gain a better appreciation for students' learning. Activities included pair share, round-robin, small group explorations of techniques and case studies (sometimes as introduction to, sometimes as review of material), and Jeopardy-style review sessions. Student learning was also encouraged by brief take-home assignments (graded for "participation") and announced and unannounced quizzes on reading and lecture material. On assessment questionnaires completed after three major milestones in the course (the mid-term exam, the first oral presentation, and the final paper), students ranked the in-class cooperative learning activities as on par with lectures and homework exercises in facilitating their learning. Students recorded improvements in perceived comfort levels with the three major goals identified for the course as the semester progressed even though they were not explicitly reminded of these goals at the time of assessment. Exam performance was better than average and student evaluations indicated greater instructor satisfaction. I enjoyed teaching the class as much as any I have ever taught. References cited: Bruner, J., 1990. Acts of Meaning. Harvard University Press.; Dyar, M.D., Gunter, M.E., Davis, J.C., and Odell, M.R., 2004. Integration of new methods into teaching mineralogy; Huba, M.E. and Freed, J.E., 2000. Learner-centered Assessment on College Campus: Shifting the Focus from Teaching to Learning. Allyn and Bacon.

Influence of "Halo" and "Demon" Effects in Subjective Grading.

ERIC Educational Resources Information Center

Gibb, Gerald D.

1983-01-01

The phenomenon of "halo" effects in subjective grading was investigated. Two groups of three raters evaluated 20 term papers in introductory psychology. Term paper grades correlated significantly with course grades when information about previous academic performance was made available. When this information was not available, the…

Student Perspectives of Grading in Physical Education

ERIC Educational Resources Information Center

Zhu, Xihe

2015-01-01

Recent state and federal legislations on educational accountability push evaluation and grading to the frontline. This study examined students' perspectives of grading in physical education. The participants included students (N = 39) from two middle schools. Data were collected through observation, student profile grading sheets and interviews.…

Evaluation du programme d'etudes de francais langue seconde en immersion a la 6e annee. La comprehension orale et la production orale, 1990. Rapport Final. (Evaluation of French as a Second Language Study Program for Grade Six Immersion. Oral Comprehension and Speaking Skills, 1990. Final Report).

ERIC Educational Resources Information Center

Theberge, Raymond

An evaluation of Manitoba's French immersion programs at the levels of grades 3, 6, and 9 focused on program effectiveness in teaching listening comprehension and speech skills. The results for grade 6 are presented here. The first section describes the framework of the immersion curriculum and the listening and oral skills targeted in it. The…

Limited knowledge of fraction representations differentiates middle school students with mathematics learning disability (dyscalculia) vs. low mathematics achievement

PubMed Central

Mazzocco, Michèle M. M.; Myers, Gwen F.; Lewis, Katherine E.; Hanich, Laurie B.; Murphy, Melissa M.

2014-01-01

Fractions pose significant challenges for many children, but for some children those challenges persist into high school. Here we administered a fractions magnitude comparison test to 122 children, from Grades 4 to 8, to test whether their knowledge of fractions typically learned early in the sequence of formal math instruction (e.g., fractions equivalent to “one-half,” and fraction pairs with common denominators) differentiates those with mathematical learning disability (MLD) versus low achievement (LA) or typical achievement (TA) in mathematics, and whether long term learning trajectories of this knowledge also differentiate these groups. We confirmed that although 4th graders with LA (n = 18) or TA (n = 93) are more accurate evaluating one-half vs. non-half fractions (until they reach ceiling performance levels on both types of fractions), children with MLD (n=11) do not show a one-half advantage until Grade 7 and do not reach ceiling performance even by Grade 8. Both the MLD and LA groups have early difficulties with fractions, but by Grade 5 the LA group approaches performance levels of the TA group and deviates from the MLD group. All groups showed a visual model advantage over Arabic number representation of fractions, but this advantage was short lived for the TA group (because ceiling level was achieved across formats), slightly more persistent for the LA group, and persisted through Grade 8 for children with MLD. Thus, difficulties with fractions persist through Grade 8 for many students, but the nature and trajectories of those difficulties varies across children with math difficulties (MLD or LA). PMID:23587941

Phase II trial of yttrium-90-DOTA-biotin pretargeted by NR-LU-10 antibody/streptavidin in patients with metastatic colon cancer

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

Knox, S J.; Goris, M L.; Tempero, M

A Phase II study of yttrium-90-tetra-azacyclododecanetetra-acetic acid-biotin (Y-90-DOTA-biotin) pretargeted by NR-LU-10 antibody/streptavidin (SA) was performed. The primary objectives of the study were to evaluate the efficacy and safety of this therapy in patients with metastatic colon cancer. Twenty-five patients were treated with a single dose of 110 mCi/m{sup 2} (mean administered dose, 106.5-10.3 mCi/m{sup 2}) of Y-90-DOTA-biotin. There were three components of the therapy. Patients first received NR-LU-10/SA on day 1. A clearing agent (biotin-galactose-human serum albumin) was administered 48 h after the NR-LU-10/SA to remove residual circulating unbound NR-LU-10/SA. Lastly, 24 h after administration of clearing agent, patients receivedmore » biotin-DOTA-labeled with 110 mCi/m{sup 2} Y-90. All three components of the therapy were administered i.v. Both hematological and nonhematological toxicities were observed. Diarrhea was the most frequent grade 4 nonhematological toxicity (16%; with 16% grade 3 diarrhea). Hematological toxicity was less severe with 8% grade 3 and 8% grade 4 neutropenia and 8% grade 3 and 16% grade 4 thrombocytopenia. The overall response rate was 8%. Two partial responders had freedom from progression of 16 weeks. Four patients (16%) had stable disease with freedom from progression of 10-20 weeks. Despite the relatively disappointing results of this study in terms of therapeutic efficacy and toxicity, proof of principle was obtained for the pretargeting approach. In addition, valuable new information was obtained about normal tissue tolerance to low-dose-rate irradiation that will help to provide useful guidelines for future study designs.« less

Adding Liver Stiffness Measurement to the Routine Evaluation of Hepatocellular Carcinoma Resectability Can Optimize Clinical Outcome.

PubMed

Cucchetti, Alessandro; Cescon, Matteo; Colecchia, Antonio; Neri, Flavia; Cappelli, Alberta; Ravaioli, Matteo; Mazzotti, Federico; Ercolani, Giorgio; Festi, Davide; Pinna, Antonio Daniele

2017-10-01

Purpose  Liver stiffness (LS) has been shown to be of use in chronic liver disease patients but its utility in surgical judgment still needs to be proven. A decision-making approach was applied to evaluate whether LS measurement before surgery of hepatocellular carcinoma (HCC) can be useful in avoiding post-hepatectomy liver failure (PHLF). Materials and Methods  Decision curve analysis (DCA) was applied to 202 HCC patients (2008 - 14) with LS measurement prior to hepatectomy to verify whether the occurrence of PHLF grades B/C should be reduced through a decision-making approach with LS.  Results  Within 90 days of surgery, 4 patients died (2 %) and grades B/C PHLF occurred in 29.7 % of cases. Ascites and/or pleural effusion, treatable with medical therapy, were the most frequent complications. DCA showed that using the "expected utility theory" LS measurement can reduce up to 39 % of cases of PHLF without the exclusion of any patient from surgery that duly undergoes an uncomplicated postoperative course. LS measurement does not add any information to normal clinical judgment for patients with a low (< 10 %) risk of PHLF. Conclusion  LS measurement can determine a reduction of PHLF under "expected utility theory" fulfilment. However, the degree of PHLF can be minor and "risk seeking" individuals can accept such a risk on the basis of surgical benefits. © Georg Thieme Verlag KG Stuttgart · New York.

Formulation and evaluation of Bacillus coagulans-loaded hypromellose mucoadhesive microspheres.

PubMed

Alli, Sk Md Athar

2011-01-01

Development of a novel delivery system has been attempted to deliver viable probiotic cells into the gut for a prolonged period of time while maintaining high numbers of viable cells within the formulation throughout the shelf-life of the product and during the gastrointestinal transit. Core mucoadhesive microspheres of Bacillus coagulans were developed employing several grades of hypromellose, a mucoadhesive polymer, following coacervation and phase separation technique and were subsequently enteric-coated with hypromellose phthalate. Microspheres were evaluated for percent yield; entrapment efficiency; in vitro swelling; surface morphology; particle size, size distribution, and zeta potential; flow property, mucoadhesion property by the ex vivo mucoadhesive strength test and the in vitro wash off test; in vitro release profile and release kinetic; in vivo probiotic activity; and stability. The values for the kinetic constant and regression coefficient of model-dependent approaches and the difference factor (f(1)), the similarity factor (f(2)), and the Rescigno index (ξ(1) and ξ(2)) of model independent approaches were determined for comparing in vitro dissolution profiles. Freeze dried B. coagulans cells were successfully formulated as enteric-coated mucoadhesive microspheres with satisfactory physical structure and yield. The viability of B. coagulans was maintained in the simulated gastric conditions and during processing; in simulated intestinal conditions exhibiting mucoadhesion, and controlling and extending the viable cell release following zero-order; and was satisfactorily stable at room temperature. Test results depict statistically significant effects of the hypromellose grade and their concentration on the performance and release profile of formulations.

Formulation and evaluation of Bacillus coagulans-loaded hypromellose mucoadhesive microspheres

PubMed Central

Alli, Sk Md Athar

2011-01-01

Development of a novel delivery system has been attempted to deliver viable probiotic cells into the gut for a prolonged period of time while maintaining high numbers of viable cells within the formulation throughout the shelf-life of the product and during the gastrointestinal transit. Core mucoadhesive microspheres of Bacillus coagulans were developed employing several grades of hypromellose, a mucoadhesive polymer, following coacervation and phase separation technique and were subsequently enteric-coated with hypromellose phthalate. Microspheres were evaluated for percent yield; entrapment efficiency; in vitro swelling; surface morphology; particle size, size distribution, and zeta potential; flow property, mucoadhesion property by the ex vivo mucoadhesive strength test and the in vitro wash off test; in vitro release profile and release kinetic; in vivo probiotic activity; and stability. The values for the kinetic constant and regression coefficient of model-dependent approaches and the difference factor (f1), the similarity factor (f2), and the Rescigno index (ξ1 and ξ2) of model independent approaches were determined for comparing in vitro dissolution profiles. Freeze dried B. coagulans cells were successfully formulated as enteric-coated mucoadhesive microspheres with satisfactory physical structure and yield. The viability of B. coagulans was maintained in the simulated gastric conditions and during processing; in simulated intestinal conditions exhibiting mucoadhesion, and controlling and extending the viable cell release following zero-order; and was satisfactorily stable at room temperature. Test results depict statistically significant effects of the hypromellose grade and their concentration on the performance and release profile of formulations. PMID:21674019

Antero-medial approach to the wrist: anatomic basis and new application in cases of fracture of the lunate facet.

PubMed

Uzel, A-P; Bulla, A; Laurent-Joye, M; Caix, P

2011-08-01

The Henry approach is the classical anterolateral surgical exposure of the volar aspect of the distal radius. This approach does not allow good access to the medial side of the volar distal radius (lunate facet) and the distal radio-ulnar joint, unless it is extended proximally, retracting the tendons and the median nerve medially, which can cause some trauma. The purpose of our study was to investigate the anatomic basis and to outline the advantages of the unusual anteromedial approach, reporting our experience in the treatment of 4 distal radius fractures, with a 90° or 180° twist of the lunate facet, and 10 wrist dissections on cadavers. The average follow-up was 68.8 months (range 18 to 115 months). In our series, this approach did not cause any nerve injuries or any sensory loss of the distal forearm and the palm. All the fractures of the lunate facet and of the radial styloid process healed. One patient with an ulnar styloid process fracture associated showed pseudarthrosis, but with no instability of the distal radio-ulnar joint or pain on the ulnar side. Using the criteria of Green and O'Brien, modified by Cooney, the results were: excellent in two cases, good in one case, and average in another. The evaluation of arthritis according to Knirk and Jupiter's classification showed grade 0 in three cases and grade 3 in one case with osteochondral sclerosis. We showed that the anteromedial approach is reliable and convenient in the case of fractures situated in the antero-medial portion of the radius, for the double objective of reducing the fracture under direct control and checking the congruence of the distal radio-ulnar joint.

Satisfactory arterial repair 1 year after ultrathin strut biodegradable polymer sirolimus-eluting stent implantation: an angioscopic observation.

PubMed

Ishihara, Takayuki; Awata, Masaki; Iida, Osamu; Fujita, Masashi; Masuda, Masaharu; Okamoto, Shin; Nanto, Kiyonori; Kanda, Takashi; Tsujimura, Takuya; Uematsu, Masaaki; Mano, Toshiaki

2018-01-15

The ultrathin strut biodegradable polymer sirolimus-eluting stent (Orsiro, O-SES) exhibits satisfactory clinical outcomes. However, no report to date has documented the intravascular status of artery repair after O-SES implantation. We examined 5 O-SES placed in 4 patients (age 65 ± 12 years, male 75%) presenting with stable angina pectoris due to de novo lesions in native coronary arteries. Coronary angioscopy was performed immediately after percutaneous coronary intervention and 1 year later. Angioscopic images were analyzed to determine the following: (1) dominant grade of neointimal coverage (NIC) over the stent; (2) maximum yellow plaque grade; and (3) existence of thrombus. Yellow plaque grade was evaluated both immediately after stent implantation and at the time of follow-up observation. The other parameters were evaluated at the time of follow-up examination. NIC was graded as: grade 0, stent struts exposed; grade 1, struts bulging into the lumen, although covered; grade 2, struts embedded in the neointima, but translucent; grade 3, struts fully embedded and invisible. Yellow plaque severity was graded as: grade 0, white; grade 1, light yellow; grade 2, yellow; and grade 3, intensive yellow. Angioscopic findings at 1 year demonstrated the following: dominant NIC grade 1, grade 2, and grade 3 in 1, 2, and 2 stents, respectively; all stents were covered to some extent; focal thrombus adhesion was observed in only 1 stent. Yellow plaque grade did not change from immediately after stent implantation to follow-up. O-SES demonstrated satisfactory arterial repair 1 year after implantation.

Effectiveness of Child Advocacy Centers and the multidisciplinary team approach on prosecution rates of alleged sex offenders and satisfaction of non-offending caregivers with allegations of child sexual abuse: a systematic review.

PubMed

Nwogu, Ngozi N; Agrawal, Lynet; Chambers, Stephanie; Buagas, Archiel B; Daniele, Rose Mary; Singleton, Joanne K

2016-01-15

Child sexual abuse is a multifaceted issue that negatively affects the lives of millions of children worldwide. These children suffer numerous medical and psychological long-term adverse effects both in childhood and adulthood. It is imperative to implement evidence- based interventions for the investigation of this crime. The use of Child Advocacy Centers and the multidisciplinary team approach may improve the investigation of child sexual abuse. To evaluate the effectiveness of Child Advocacy Centers and the multidisciplinary team approach on prosecution rates of alleged sex offenders and satisfaction of non-offending caregivers of children less than 18 years of age, with allegations of child sexual abuse. Children under 18 years, of any race, ethnicity or gender with allegations of child sexual abuse. Other participants included in this review are non-offending caregivers of children with allegations of child sexual abuse, and alleged sex offenders. Type of intervention : The use of Child Advocacy Centers and the multidisciplinary team approach on child sexual abuse investigations. Types of outcomes : Prosecution rates of alleged sex offenders and the satisfaction of non-offending caregivers of children with allegations of child sexual abuse. Types of studies: This review includes quasi-experimental and descriptive studies. The search strategy aimed to find published and unpublished articles in the English language published from 1985 through April 2015 for inclusion. The databases searched include: PubMed, CINAHL, EMBASE, PsycINFO, Cochrane Central Register of Controlled Trials (CENTRAL), Health Source: Nursing/Academic Edition, Criminal Justice Periodicals, ProQuest Dissertations & Theses and Criminal Justice Collections. An additional grey literature search was conducted. Two reviewers evaluated the included studies for methodological quality using standardized critical appraisal instruments from the Joanna Briggs Institute. Data were extracted using standardized data extraction instruments from the Joanna Briggs Institute. Due to heterogeneity between the included studies, statistical meta-analysis was not possible. Results are presented in a narrative form. The use of Child Advocacy Centers and the multidisciplinary team approach in child sexual abuse investigation may have positive benefits in increasing non-offending caregivers' satisfaction and prosecution rates of alleged sex offenders. Utilization of Child Advocacy Centers and the multidisciplinary team approach for child sexual abuse investigations may be beneficial in improving prosecution rates and the experiences of families involved. The use of satisfaction surveys for non-offending caregivers may be an effective tool to evaluate the satisfaction with services rendered by Child Advocacy Centers. Findings from this review may help to guide reforms. It is hoped that client satisfaction may lead to or improve utilization of services important for the healing process of victims of abuse. Child Advocacy Center multidisciplinary team interventions may improve prosecution rates and satisfaction of non-offending caregiver’ in children less than 18 years of age with allegations of child sexual abuse (Grade B). When available, children with allegations of child sexual abuse should be referred to Child Advocacy Centers for evaluation (Grade B). The use of non-offending caregiver satisfaction survey is recommended to evaluate the ongoing effectiveness of the Child Advocacy Centers multidisciplinary team approach. The quality improvement process will help measure the quality of care rendered by a Child Advocacy Centers and identify areas in need of improvement so a Child Advocacy Centers can continue to provide optimal care in the investigation of child sexual abuse while improving the utilization of services important for the healing process for victims of abuse (Grade B). Future studies may consider interventions that include greater sample size and more diverse ethnic groups to promote generalizability of findings. The Joanna Briggs Institute.

A Phenomenology Study of First-Year Teachers Looking at the Shared Lived Experience of Learning to Grade

ERIC Educational Resources Information Center

Yost, Brandon Lee

2015-01-01

This study describes the phenomenon of how first-year teachers learn to evaluate students learning by (letter) grades. Grades seem simple enough; but in reality, each grade carries serious consequences with it--for either good or bad. For example, grades affect benefits/consequences at home; they affect placement in remedial or advanced courses;…

Characterizing the adoption of low-grade hardwood lumber by the secondary wood processing industry

Treesearch

Robert L. Smith; Wibke Pohle; Philip Araman; Dan Cumbo

2004-01-01

This study investigated the adoption of low-grade lumber in the secondary hardwood industry. Factors influencing decisions regarding the utilization of low-grade lumber were identified and value-added opportunities to increase the use of low-grade lumber among manufacturers currently using higher grades were evaluated. Data were collected via a nationwide mail survey...

Report on METHODS OF Evaluating Students at the University of California, Berkeley.

ERIC Educational Resources Information Center

Miller, Stuart

Several arguments are made for changing the present system of grading in college. The arguments deal with: (1) the negative effect of grading on the teaching situation--the system is capricious and variable and encourages "grade grubbing"; (2) the lack of accuracy and uniformity of grades; (3) the effect of grading, as an enforcer of the…

Outcomes of a novel minimalist approach for the treatment of cubital tunnel syndrome.

PubMed

Lan, Zheng D; Tatsui, Claudio E; Jalali, Ali; Humphries, William E; Rilea, Katheryn; Patel, Akash; Ehni, Bruce L

2015-06-01

We describe a minimalist approach to perform in situ decompression of the ulnar nerve. Our technique employs a unique small skin incision strategically placed to minimize postoperative scarring over the ulnar nerve and potentially decrease the risk of iatrogenic injury to the medial antebrachial cutaneous nerve. We retrospectively report the outcome of patients who have undergone this procedure at our institution, the Michael E. DeBakey Veterans Affairs Medical Center, from January 1 2007 through November 29 2010. All individuals underwent in situ decompression via the previously described minimalist approach. Outcome variables were Louisiana State University Medical Center (LSU) ulnar neuropathy grade, patient satisfaction, subjective improvement, complications and re-operation rate. A total of 44 procedures were performed in this cohort of 41 patients. Overall, patients' postoperative LSU grades showed a statistically significant improvement (p=0.0019) compared to preoperative grades. Improvement of at least one grade in the LSU scale was observed in 50% of the procedures with a preoperative grade of four or less. Overall procedure satisfaction rate was 88% (39 of 44) with 70% (31 of 44) of the procedures resulting in improvement of symptoms. There were no intraoperative or postoperative complications. One patient required re-operation due to failure of neurological improvement. Our minimalistic approach to perform in situ decompression of the ulnar nerve at the cubital tunnel is both safe and effective. We observed a statistically significant improvement in LSU ulnar neuropathy grades and a success rate comparable to those reported for other more extensive surgical techniques while providing the benefit of a smaller incision, less scarring, decreased risk of iatrogenic nerve injury and minimal complications. Copyright © 2015 Elsevier Ltd. All rights reserved.

Methodologies for semiquantitative evaluation of hip osteoarthritis by magnetic resonance imaging: approaches based on the whole organ and focused on active lesions.

PubMed

Jaremko, Jacob L; Lambert, Robert G W; Zubler, Veronika; Weber, Ulrich; Loeuille, Damien; Roemer, Frank W; Cibere, Jolanda; Pianta, Marcus; Gracey, David; Conaghan, Philip; Ostergaard, Mikkel; Maksymowych, Walter P

2014-02-01

As a wider variety of therapeutic options for osteoarthritis (OA) becomes available, there is an increasing need to objectively evaluate disease severity on magnetic resonance imaging (MRI). This is more technically challenging at the hip than at the knee, and as a result, few systematic scoring systems exist. The OMERACT (Outcome Measures in Rheumatology) filter of truth, discrimination, and feasibility can be used to validate image-based scoring systems. Our objective was (1) to review the imaging features relevant to the assessment of severity and progression of hip OA; and (2) to review currently used methods to grade these features in existing hip OA scoring systems. A systematic literature review was conducted. MEDLINE keyword search was performed for features of arthropathy (such as hip + bone marrow edema or lesion, synovitis, cyst, effusion, cartilage, etc.) and scoring system (hip + OA + MRI + score or grade), with a secondary manual search for additional references in the retrieved publications. Findings relevant to the severity of hip OA include imaging markers associated with inflammation (bone marrow lesion, synovitis, effusion), structural damage (cartilage loss, osteophytes, subchondral cysts, labral tears), and predisposing geometric factors (hip dysplasia, femoral-acetabular impingement). Two approaches to the semiquantitative assessment of hip OA are represented by Hip OA MRI Scoring System (HOAMS), a comprehensive whole organ assessment of nearly all findings, and the Hip Inflammation MRI Scoring System (HIMRISS), which selectively scores only active lesions (bone marrow lesion, synovitis/effusion). Validation is presently confined to limited assessment of reliability. Two methods for semiquantitative assessment of hip OA on MRI have been described and validation according to the OMERACT Filter is limited to evaluation of reliability.

Two-Year Operational Evaluation Of A Consumer Electronics-Based Data Acquisition System For Equipment Monitoring

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

Van Hoy, Blake W.; Phillips, Larry D.; Wetherington Jr, G Randall

Oak Ridge National Laboratory (ORNL) has performed a two-year evaluation of the performance of an in-house developed consumer electronics-based data acquisition system (DAS). The main advantage of this approach compared to conventional instrumentation grade systems is cost; instrument grade data acquisition systems average costs range from $800 to $2,000 per channel compared to a range of $200 - $400 per channel for a consumer electronics-based system. The DAS is operated as a full-time in-situ vibration monitor. The resulting data stream is streamed over the ORNL network, at an aggregate rate of approximately 2 megabytes/s, to a Linux server. The servermore » includes the capability to implement event-triggered data stores, as well as real-time files for the implementation of continuous display monitoring of the spectra. Detailed spectral analysis is performed post event. The DAS is installed on a large industrial chiller and cooling water pump associated with ORNL’s Titan supercomputer. These mechanical systems include rotating components that operate at fundamental frequencies within the range of 30 Hz to over 3 KHz. Evaluation of the DAS data over a two-year operating period leads to the conclusion that for many industrial processes this system could form the basis for a cost effective means of obtaining operating health data in real time from rotating machinery. The deployment has also shown that the DAS technology is reliable. Furthermore, because the cost of the DAS is low, the other significant advantage of this approach is that the DAS can be deployed in a dedicated manner and operated on a full-time basis.« less

Locating, characterizing and minimizing sources of error for a paper case-based structured oral examination in a multi-campus clerkship.

PubMed

Kumar, A; Bridgham, R; Potts, M; Gushurst, C; Hamp, M; Passal, D

2001-01-01

To determine consistency of assessment in a new paper case-based structured oral examination in a multi-community pediatrics clerkship, and to identify correctable problems in the administration of examination and assessment process. Nine paper case-based oral examinations were audio-taped. From audio-tapes five community coordinators scored examiner behaviors and graded student performance. Correlations among examiner behaviors scores were examined. Graphs identified grading patterns of evaluators. The effect of exam-giving on evaluators was assessed by t-test. Reliability of grades was calculated and the effect of reducing assessment problems was modeled. Exam-givers differed most in their "teaching-guiding" behavior, and this negatively correlated with student grades. Exam reliability was lowered mainly by evaluator differences in leniency and grading pattern; less important was absence of standardization in cases. While grade reliability was low in early use of the paper case-based oral examination, modeling of plausible effects of training and monitoring for greater uniformity in administration of the examination and assigning scores suggests that more adequate reliabilities can be attained.

Physical Properties of Normal Grade Biodiesel and Winter Grade Biodiesel

PubMed Central

Sadrolhosseini, Amir Reza; Moksin, Mohd Maarof; Nang, Harrison Lau Lik; Norozi, Monir; Yunus, W. Mahmood Mat; Zakaria, Azmi

2011-01-01

In this study, optical and thermal properties of normal grade and winter grade palm oil biodiesel were investigated. Surface Plasmon Resonance and Photopyroelectric technique were used to evaluate the samples. The dispersion curve and thermal diffusivity were obtained. Consequently, the variation of refractive index, as a function of wavelength in normal grade biodiesel is faster than winter grade palm oil biodiesel, and the thermal diffusivity of winter grade biodiesel is higher than the thermal diffusivity of normal grade biodiesel. This is attributed to the higher palmitic acid C16:0 content in normal grade than in winter grade palm oil biodiesel. PMID:21731429

The Effect of the DISTAR Instructional System on First and Second Grade Achievement: An Evaluation of the 1971-1972 Title I Program of Winthrop, Massachusetts.

ERIC Educational Resources Information Center

Kaufman, Maurice

The Distar I Reading, Language and Arithmetic programs were used with two first grade classes. The Distar II programs were used with two second grade classes. One first grade Distar class appeared to make some progress in oral language. Comparison of the first grade Distar classes with a first grade control class that used a Scott-Foresman basal…

Evaluation of the Cobas TaqMan MTB Test for the Detection of Mycobacterium tuberculosis Complex According to Acid-Fast-Bacillus Smear Grades in Respiratory Specimens

PubMed Central

Huh, Hee Jae; Koh, Won-Jung; Song, Dong Joon

2014-01-01

We evaluated the performance of the Cobas TaqMan MTB test (Roche Diagnostics, Basel, Switzerland), stratified by acid-fast bacilli (AFB) smear grades. The sensitivity of this test in smear-positive specimens was >95% in all grades, while that in trace and negative specimens was 85.3% and 34.4%, respectively. PMID:25428157

Sample of Second Grade Classroom Protocols from Special Study A of the Beginning Teacher Evaluation Study for the California Commission for Teacher Preparation and Licensing.

ERIC Educational Resources Information Center

Tikunoff, William J.; And Others

Second grade classroom protocols collected within this volume are examples of the protocols developed by the ethnographers associated with Special Study A: "An Ethnographic Study of the Forty Classrooms of the Beginning Teacher Evaluation Study." Twenty teachers at both the second and fifth grades were observed for one week by an…

Sample of Fifth Grade Classroom Protocols from Special Study A of the Beginning Teacher Evaluation Study for the California Commission for Teacher Preparation and Licensing.

ERIC Educational Resources Information Center

Tikunoff, William J.; And Others

Classroom protocols collected within this volume are examples of the protocols from grade 5 developed by the ethnographers associated with Special Study A: "An Ethnographic Study of the Forty Classrooms of the Beginning Teacher Evaluation Study." Twenty teachers at both the second and fifth grades were observed for one week by an…

Operability score: an innovative tool for quantitative assessment of operability in comparative studies on surgical anatomy.

PubMed

Gagliardi, Filippo; Boari, Nicola; Roberti, Fabio; Caputy, Anthony J; Mortini, Pietro

2014-09-01

Comparative anatomical studies have proved to be invaluable in the evaluation of advantages and drawbacks of single approaches to access established target areas. Approach-related exposed areas do not necessarily represent useful areas when performing surgical manoeuvres. Accordingly the concept of "operability" has recently been introduced as a qualitative assessment of the ability to execute surgical manoeuvres. The authors propose an innovative model for the quantitative assessment of the operability, defined as "operability score" (OS), which can be effectively and easily applied to comparative studies on surgical anatomy. A microanatomical study was conducted on six cadaveric heads. Morphometric measurements were collected and operability scores in selected target points of the surgical field were calculated. As illustrative example, the operability score was applied to the extradural subtemporal transzygomatic approach (ESTZ). The operability score is effective in grading system of surgical operability, and instruments manipulation capability. It is a useful tool to evaluate, in a single approach, areas that can be exposed, and to quantify how those areas are suitable for surgical manoeuvres. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Achievement Test Provincial Report, June 1987 Administration.

ERIC Educational Resources Information Center

Alberta Dept. of Education, Edmonton. Student Evaluation and Records Branch.

This document summarizes results of province-wide achievement tests given in Alberta, Canada in June 1987. These tests evaluated student achievement in third grade science, sixth grade mathematics, and ninth grade social studies. The test questions for each subject area reflected Alberta's curriculum specifications for that subject. The grade 3…

Grade Inflation: An Issue for Higher Education?

ERIC Educational Resources Information Center

Caruth, Donald L.; Caruth, Gail D.

2013-01-01

Grade inflation impacts university credibility, student courses of study, choices of institution, and other areas. There has been an upward shift in grades without a corresponding upward shift in knowledge gained. Some of the most frequently mentioned causes of grade inflation are: (1) student evaluations of professors; (2) student teacher…

25 CFR 36.30 - Standard X-Grading requirements.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 25 Indians 1 2012-04-01 2011-04-01 true Standard X-Grading requirements. 36.30 Section 36.30 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR EDUCATION MINIMUM ACADEMIC STANDARDS FOR THE... Evaluation § 36.30 Standard X—Grading requirements. (a) Each school shall implement a uniform grading system...

25 CFR 36.30 - Standard X-Grading requirements.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 25 Indians 1 2013-04-01 2013-04-01 false Standard X-Grading requirements. 36.30 Section 36.30 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR EDUCATION MINIMUM ACADEMIC STANDARDS FOR THE... Evaluation § 36.30 Standard X—Grading requirements. (a) Each school shall implement a uniform grading system...

25 CFR 36.30 - Standard X-Grading requirements.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 25 Indians 1 2011-04-01 2011-04-01 false Standard X-Grading requirements. 36.30 Section 36.30 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR EDUCATION MINIMUM ACADEMIC STANDARDS FOR THE... Evaluation § 36.30 Standard X—Grading requirements. (a) Each school shall implement a uniform grading system...

25 CFR 36.30 - Standard X-Grading requirements.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 25 Indians 1 2014-04-01 2014-04-01 false Standard X-Grading requirements. 36.30 Section 36.30 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR EDUCATION MINIMUM ACADEMIC STANDARDS FOR THE... Evaluation § 36.30 Standard X—Grading requirements. (a) Each school shall implement a uniform grading system...

25 CFR 36.30 - Standard X-Grading requirements.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Standard X-Grading requirements. 36.30 Section 36.30 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR EDUCATION MINIMUM ACADEMIC STANDARDS FOR THE... Evaluation § 36.30 Standard X—Grading requirements. (a) Each school shall implement a uniform grading system...

DPP-4 inhibitors for the treatment of type 2 diabetes: a methodology overview of systematic reviews.

PubMed

Ling, Juan; Ge, Long; Zhang, Ding-Hua; Wang, Yong-Feng; Xie, Zhuo-Lin; Tian, Jin-Hui; Xiao, Xiao-Hui; Yang, Ke-Hu

2018-06-01

To evaluate the methodological quality of systematic reviews (SRs), and summarize evidence of important outcomes from dipeptidyl peptidase-4 inhibitors (DPP4-I) in treating type 2 diabetes mellitus (T2DM). We included SRs of DPP4-I for the treatment of T2DM until January, 2018 by searching the Cochrane Library, PubMed, EMBASE and three Chinese databases. We evaluated the methodological qualities with the AMSTAR (Assessing the Methodological Quality of Systematic Reviews) tool and the GRADE (The Grading of Recommendations Assessment, Development and Evaluation) approach. Sixty-three SRs (a total of 2,603,140 participants) receiving DPP4-I for the treatment of T2DM were included. The results of AMSTAR showed that the lowest quality was "a list of studies (included and excluded) item" with only one (1.6%) study provided, followed by the "providing a priori design" item with only four (6.3%) studies conforming to this item, the next were "the status of publication (gray literature) used as an inclusion criterion item", with only 18 (28.9%) studies conforming to these items. Only seven (11.1%) studies scored more than nine points in AMSTAR, indicating high methodological quality. For GRADE, of the 128 outcomes, high quality evidence was provided in only 28 (21.9%), moderate in 70 (54.7%), low in 27 (21.1%), and very low in three (2.3%). The methodological quality of SRs of DPP4-I for type 2 diabetes mellitus is not high and there are common areas for improvement. Furthermore, the quality of evidence level is moderate and more high quality evidence is needed.

Sifting through course evaluations: medical student comments driving surgery curriculum changes.

PubMed

French, Judith C; Bickett, Melissa M; Iocono, Joseph A

2013-01-01

Student empowerment of curriculum changes is a double-edged sword. When examining our third-year surgery course every year, we debate where the line is between improving education through student input against allowing the students to design "an easy course." Written student comments on end-of-course evaluations (from the academic years 2006-2007 to 2010-2011) were analyzed using the qualitative approach described by Miles and Huberman. We compared the grouped comments to the course changes that were made over these years to determine what extent were we listening to students. Finally, we took the course changes made and juxtaposed them with student grades and with student course perceptions provided by the end-of-course evaluation analysis. We identified 17 alterations to our curriculum since the year 2007-2008 and of those, 12 are directly related to student comments. Some examples of our changes were a grading-scale alteration, grouping of workshops, and adding a shelf examination review session. The overall course ratings by the students steadily rose over the 5-year period (2.57 to 3.39), while the percentages of A's earned by students decreased over that same time until the year 2010-2011 when the percent of A's earned increased by over 30%. Because of the fact that 12 of 17 course changes can be directly related back to the student comments, we feel confident that we are listening to students. The increase in perception of the course through the first 4 years did not coincide with higher grades. The changes made have been instrumental in the course winning the best clerkship award for the last 4 years. Copyright © 2013 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Are we a gift shop? A perspective on grade inflation.

PubMed

Shoemaker, J K; DeVos, M

1999-12-01

Grade inflation is a phenomenon that has been written about extensively since the mid 1970s. It is theorized that it made its initial appearance as an adjustment to the rigorous educational standards that were imposed in the post-Sputnik era. Some authors speculate that grade inflation as we know it is an outcome of student demands for high grades combined with faculty willingness to capitulate to them. Others believe the problem is related to lack of faculty knowledge about evaluation methods, or the quest for positive student evaluations in support of promotion, tenure, and merit decisions. Of particular concern is the lack of published studies of grade inflation in nursing education. The purpose of this article is to describe what we know about grade inflation-its history, causative factors, and implications for nursing.

A partial economic evaluation of blended learning in teaching health research methods: a three-university collaboration in South Africa, Sweden, and Uganda

PubMed Central

Kumpu, Minna; Atkins, Salla; Zwarenstein, Merrick; Nkonki, Lungiswa

2016-01-01

Background Novel research training approaches are needed in global health, particularly in sub-Saharan African universities, to support strengthening of health systems and services. Blended learning (BL), combining face-to-face teaching with computer-based technologies, is also an accessible and flexible education method for teaching global health and related topics. When organised as inter-institutional collaboration, BL also has potential for sharing teaching resources. However, there is insufficient data on the costs of BL in higher education. Objective Our goal was to evaluate the total provider costs of BL in teaching health research methods in a three-university collaboration. Design A retrospective evaluation was performed on a BL course on randomised controlled trials, which was led by Stellenbosch University (SU) in South Africa and joined by Swedish and Ugandan universities. For all three universities, the costs of the BL course were evaluated using activity-based costing with an ingredients approach. For SU, the costs of the same course delivered with a classroom learning (CL) approach were also estimated. The learning outcomes of both approaches were explored using course grades as an intermediate outcome measure. Results In this contextually bound pilot evaluation, BL had substantially higher costs than the traditional CL approach in South Africa, even when average per-site or per-student costs were considered. Staff costs were the major cost driver in both approaches, but total staff costs were three times higher for the BL course at SU. This implies that inter-institutional BL can be more time consuming, for example, due to use of new technologies. Explorative findings indicated that there was little difference in students’ learning outcomes. Conclusions The total provider costs of the inter-institutional BL course were higher than the CL course at SU. Long-term economic evaluations of BL with societal perspective are warranted before conclusions on full costs and consequences of BL in teaching global health topics can be made. PMID:27725076

A partial economic evaluation of blended learning in teaching health research methods: a three-university collaboration in South Africa, Sweden, and Uganda.

PubMed

Kumpu, Minna; Atkins, Salla; Zwarenstein, Merrick; Nkonki, Lungiswa

2016-01-01

Novel research training approaches are needed in global health, particularly in sub-Saharan African universities, to support strengthening of health systems and services. Blended learning (BL), combining face-to-face teaching with computer-based technologies, is also an accessible and flexible education method for teaching global health and related topics. When organised as inter-institutional collaboration, BL also has potential for sharing teaching resources. However, there is insufficient data on the costs of BL in higher education. Our goal was to evaluate the total provider costs of BL in teaching health research methods in a three-university collaboration. A retrospective evaluation was performed on a BL course on randomised controlled trials, which was led by Stellenbosch University (SU) in South Africa and joined by Swedish and Ugandan universities. For all three universities, the costs of the BL course were evaluated using activity-based costing with an ingredients approach. For SU, the costs of the same course delivered with a classroom learning (CL) approach were also estimated. The learning outcomes of both approaches were explored using course grades as an intermediate outcome measure. In this contextually bound pilot evaluation, BL had substantially higher costs than the traditional CL approach in South Africa, even when average per-site or per-student costs were considered. Staff costs were the major cost driver in both approaches, but total staff costs were three times higher for the BL course at SU. This implies that inter-institutional BL can be more time consuming, for example, due to use of new technologies. Explorative findings indicated that there was little difference in students' learning outcomes. The total provider costs of the inter-institutional BL course were higher than the CL course at SU. Long-term economic evaluations of BL with societal perspective are warranted before conclusions on full costs and consequences of BL in teaching global health topics can be made.

Comparing Science Learning among 4th-, 5th-, and 6th-Grade Students: STS versus Textbook-Based Instruction

ERIC Educational Resources Information Center

Yager, Robert E.; Choi, AeRan; Yager, Stuart O.; Akcay, Hakan

2009-01-01

Fifteen 4th-, 5th-, and 6th-grade teachers from five school districts each taught two sections of science--one with a Science-Technology-Society (STS) approach and the other with a more traditional textbook approach in which basic science concepts were the major organizers. Local, current, and personally relevant issues provided the context and…

Variable- and Person-Centered Approaches to the Analysis of Early Adolescent Substance Use: Linking Peer, Family, and Intervention Effects with Developmental Trajectories

ERIC Educational Resources Information Center

Connell, Arin M.; Dishion, Thomas J.; Deater-Deckard, Kirby

2006-01-01

This 4-year study of 698 young adolescents examined the covariates of early onset substance use from Grade 6 through Grade 9. The youth were randomly assigned to a family-centered Adolescent Transitions Program (ATP) condition. Variable-centered (zero-inflated Poisson growth model) and person-centered (latent growth mixture model) approaches were…

Suggestions for Curriculum Development [And] Handbook Upper Elementary Grades, Part B, 4-6. Environmental Education Interdependence: A Concept Approach. Revised.

ERIC Educational Resources Information Center

King, David C.; Long, Cathryn J.

Two booklets comprise the grades 4-6 component of a series of guides for incorporating environmental education into the existing curriculum. Both the guide and handbook emphasize a multidisciplinary approach, use the concept of interdependence as an organizing theme, and offer suggestions for using the local community as a resource to study the…

"I Just Want The Credit!"--Perceived Instrumentality as the Main Characteristic of Boys' Motivation in a Grade 11 Science Course

ERIC Educational Resources Information Center

Nieswandt, Martina; Shanahan, Marie-Claire

2008-01-01

This case study examines the motivational structure of a group of male students (n = 10) in a grade 11 General Science class at an independent single-sex school. We approach the concept of motivation through the integration of three different theoretical approaches: sociocultural theory, future time perspective and achievement goal theory. This…

Salvage prostate re-irradiation using high-dose-rate brachytherapy or focal stereotactic body radiotherapy for local recurrence after definitive radiation therapy.

PubMed

Mbeutcha, Aurélie; Chauveinc, Laurent; Bondiau, Pierre-Yves; Chand, Marie-Eve; Durand, Matthieu; Chevallier, Daniel; Amiel, Jean; Kee, Daniel Lam Cham; Hannoun-Lévi, Jean-Michel

2017-03-09

Optimal management of locally recurrent prostate cancer after definitive radiation therapy is still challenging. With the development of highly accurate radiotherapy devices, prostate salvage re-irradiation might generate lower toxicity rates than classical salvage therapies. We retrospectively evaluated the toxicity and the feasibility of a prostate re-irradiation after definitive radiation therapy failure. Two modalities were investigated: high-dose-rate brachytherapy (HDRB) on whole prostate gland and focal stereotactic radiotherapy (SBRT) using CyberKnife® linac. Between 2011 and 2015, 28 patients with imaged and/or biopsy-proven intra-prostatic recurrence of cancer after definitive radiation therapy underwent a salvage re-irradiation using HDRB (n = 10) or focal SBRT (n = 18). The schedule of re-irradiation was 35 Gy in 5 fractions. Biological response (defined as post-salvage radiation PSA variation) and biochemical no-evidence of disease (bNED) were evaluated in the whole cohort. For patients who had a positive biological response after salvage radiation, biochemical recurrence (BCR) and survival after salvage radiotherapy were evaluated. Post-salvage toxicities were assessed according to the Common Terminology Criteria for Adverse Events (CTCAE) v4.03 and were compared to baseline status. Within a median follow-up of 22.5 months (IQR = 8-42), 9 (90%) patients experienced a positive biological response after salvage HDRB and 5 (50%) remained bNED at the end of the follow-up. Among patients who initially responded to salvage HDRB, the BCR rate was 44.4% after a median interval of 19.5 months (IQR = 11.5-26). Only one patient experienced a transient grade 3 urinary complication. In the SBRT group, the median follow-up was 14.5 months (IQR = 7-23) and 10 (55.6%) out of the 18 patients remained bNED. Among the 15 patients who initially responded to salvage SBRT, 5 (33.3%) experienced a BCR. One patient experienced a transient grade 4 urinary complication. At the end of the follow-up, all evaluated patients had a urinary status grade variation ≤ +1 grade. No grade 3-4 digestive toxicity was observed. Salvage prostate re-irradiation for locally recurrent cancer is feasible and generate low toxicities rates when using with HDRB or focal SBRT. However, further investigations are necessary to confirm these findings and to determine predictive features for patients who might benefit from such an approach.

Novel, improved grading system(s) for IDH-mutant astrocytic gliomas.

PubMed

Shirahata, Mitsuaki; Ono, Takahiro; Stichel, Damian; Schrimpf, Daniel; Reuss, David E; Sahm, Felix; Koelsche, Christian; Wefers, Annika; Reinhardt, Annekathrin; Huang, Kristin; Sievers, Philipp; Shimizu, Hiroaki; Nanjo, Hiroshi; Kobayashi, Yusuke; Miyake, Yohei; Suzuki, Tomonari; Adachi, Jun-Ichi; Mishima, Kazuhiko; Sasaki, Atsushi; Nishikawa, Ryo; Bewerunge-Hudler, Melanie; Ryzhova, Marina; Absalyamova, Oksana; Golanov, Andrey; Sinn, Peter; Platten, Michael; Jungk, Christine; Winkler, Frank; Wick, Antje; Hänggi, Daniel; Unterberg, Andreas; Pfister, Stefan M; Jones, David T W; van den Bent, Martin; Hegi, Monika; French, Pim; Baumert, Brigitta G; Stupp, Roger; Gorlia, Thierry; Weller, Michael; Capper, David; Korshunov, Andrey; Herold-Mende, Christel; Wick, Wolfgang; Louis, David N; von Deimling, Andreas

2018-04-23

According to the 2016 World Health Organization Classification of Tumors of the Central Nervous System (2016 CNS WHO), IDH-mutant astrocytic gliomas comprised WHO grade II diffuse astrocytoma, IDH-mutant (AII IDHmut ), WHO grade III anaplastic astrocytoma, IDH-mutant (AAIII IDHmut ), and WHO grade IV glioblastoma, IDH-mutant (GBM IDHmut ). Notably, IDH gene status has been made the major criterion for classification while the manner of grading has remained unchanged: it is based on histological criteria that arose from studies which antedated knowledge of the importance of IDH status in diffuse astrocytic tumor prognostic assessment. Several studies have now demonstrated that the anticipated differences in survival between the newly defined AII IDHmut and AAIII IDHmut have lost their significance. In contrast, GBM IDHmut still exhibits a significantly worse outcome than its lower grade IDH-mutant counterparts. To address the problem of establishing prognostically significant grading for IDH-mutant astrocytic gliomas in the IDH era, we undertook a comprehensive study that included assessment of histological and genetic approaches to prognosis in these tumors. A discovery cohort of 211 IDH-mutant astrocytic gliomas with an extended observation was subjected to histological review, image analysis, and DNA methylation studies. Tumor group-specific methylation profiles and copy number variation (CNV) profiles were established for all gliomas. Algorithms for automated CNV analysis were developed. All tumors exhibiting 1p/19q codeletion were excluded from the series. We developed algorithms for grading, based on molecular, morphological and clinical data. Performance of these algorithms was compared with that of WHO grading. Three independent cohorts of 108, 154 and 224 IDH-mutant astrocytic gliomas were used to validate this approach. In the discovery cohort several molecular and clinical parameters were of prognostic relevance. Most relevant for overall survival (OS) was CDKN2A/B homozygous deletion. Other parameters with major influence were necrosis and the total number of CNV. Proliferation as assessed by mitotic count, which is a key parameter in 2016 CNS WHO grading, was of only minor influence. Employing the parameters most relevant for OS in our discovery set, we developed two models for grading these tumors. These models performed significantly better than WHO grading in both the discovery and the validation sets. Our novel algorithms for grading IDH-mutant astrocytic gliomas overcome the challenges caused by introduction of IDH status into the WHO classification of diffuse astrocytic tumors. We propose that these revised approaches be used for grading of these tumors and incorporated into future WHO criteria.